温热内发,表里俱热,头痛,身疼,不恶寒反恶热,无汗而喘,大烦,大渴,脉阴阳俱
浮者
麻黄(四两) 杏仁(五十枚) 甘草(炙,二两) 石膏(半斤)
上四味,煎服同麻黄汤法。
柯韵伯曰∶石膏为清火之重剂,青龙、白虎皆赖以建功。然用之不当,适足以招祸,故
青龙
但热
语、
桂枝
出,
程扶生曰∶此治寒深入肺,发为喘热也。汗既出矣,而喘是寒邪未尽。若身无大热,则
是热
散除
治少阴病,身痛,手足寒,骨节痛,口中和,恶寒,脉沉者。
附子(二枚,生) 人参(二两) 白术(四两) 茯苓(三两) 芍药(三两)
上五味,以水八升,煮取三升,去滓,分温服一升,日三服。
柯韵伯曰∶此仲景温补之第一方,乃正治伤寒之法,为少阴固本御邪之剂也。夫伤则宜
补,
中之阴,又为寒水之脏,故伤寒之重者多入少阴,所以少阴一经,最多死证。方中用生附二
枚者,取其力之锐,且以重其任也,益少火之阳,鼓肾间之动气以御外侵之阴翳,则守邪之
神
脏
阳无
水。
以散
子汤
于经
脉
表
与
尚
学人
治汗下后,虚微少气,发热,口燥。去柴胡,名人参三白汤。
人参 柴胡 白术 白芍 白苓 姜 枣
柯韵伯曰∶汗下后里气既虚,当求之于三阴∶而表热复发,又当责之三阳。三阳以少阳
为枢
不得
达少
太阴
为大
冬、
表热
温热之邪从体内发出,表证与里证均呈现热象,出现头痛、身体疼痛,不恶寒反而恶热,无汗且伴有气喘,极度烦躁,极度口渴,寸脉与尺脉均呈现浮象。
麻黄(四两) 杏仁(五十枚) 甘草(炙甘草,二两) 石膏(半斤)
以上四味药,煎煮服用方法同麻黄汤法。
柯韵伯说:石膏是清泻火邪的重剂,大青龙汤、白虎汤都依靠它来建立功效。然而如果运用不当,恰恰足以招致祸患,所以大青龙汤中仅用于热盛语乱、桂枝等症解除后……(注:原文此处有缺漏或断句不清,依文意推测为讨论石膏在青龙汤中的使用限制)。
程扶生说:这是治疗寒邪深入肺部,引发喘促发热的方子。汗液已经排出,但仍有气喘,说明寒邪尚未完全清除。如果身体没有大热,则是热邪已散除。
治疗少阴病,身体疼痛,手脚寒冷,骨节疼痛,口中平和(不苦不燥),恶寒,脉象沉的病症。
附子(两枚,生用) 人参(二两) 白术(四两) 茯苓(三两) 芍药(三两)
以上五味药,用水八升,煮取三升,去滓,分三次温服,每次一升,每日三次。
柯韵伯说:这是张仲景温补的第一方,正是治疗伤寒的正治之法,是固护少阴根本、抵御外邪的方剂。既然受伤就应当补益,少阴属中之阴,又是寒水之脏,所以伤寒重症多传入少阴,因此少阴一经,最多见死证。方中使用生附子两枚,是取其药力锐利,且加重其重任,以增益少火之阳气,鼓动肾间之动气以抵御外侵之阴邪,则守护正气之神……(注:原文此处有缺漏)。
治疗发汗、攻下之后,正气虚弱轻微、气短、发热、口干燥者。去掉柴胡,改名为参胡三白汤。
柯韵伯说:发汗、攻下之后,里气已经虚弱,应当求治于三阴经;而表热复发,又应当责之于三阳经。三阳经中以少阳为枢纽……(注:原文此处有缺漏,涉及太阴、冬、表热等关键词,但语句不完整)。
Warm-heat pathogen originates internally, presenting with heat in both the exterior and interior. Symptoms include headache, body ache, aversion to cold being absent but aversion to heat present, absence of sweating accompanied by wheezing, severe irritability, extreme thirst, and a floating pulse at both the cun (inch) and chi (elbow) positions.
Ephedrae Herba (Mahuang, 麻黄) - four liang
Semen Armeniacae Amarum (Xingren, 杏仁) - fifty seeds
Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhigancao, 炙甘草) - two liang
Gypsum Fibrosum (Shigao, 石膏) - half jin
The above four ingredients are decocted and taken according to the method of Mahuang Tang (Cinnamon Twig Decoction).
Ke Yunbo stated: Gypsum Fibrosum is a heavy agent for clearing fire. Both Da Qinglong Tang (Major Blue Dragon Decoction) and Baihu Tang (White Tiger Decoction) rely on it for their efficacy. However, if used improperly, it may only invite disaster. Therefore, in Da Qinglong Tang, its use is limited... [Text fragmentary] regarding heat-induced delirious speech and after Guizhi Tang symptoms resolve.
Cheng Fusheng stated: This formula treats cold pathogens penetrating deeply into the Lung, causing wheezing and heat. Although sweat has been produced, the persistence of wheezing indicates that the cold pathogen has not yet been fully eliminated. If there is no significant heat in the body, it implies that the heat has dissipated.
Treating Shaoyin disease characterized by body pain, coldness of the hands and feet, bone and joint pain, a normal sensation in the mouth (neither bitter nor dry), aversion to cold, and a deep pulse.
Aconiti Lateralis Radix Praeparata (Fuzi, 附子) - two pieces, raw
Panacis Ginseng Radix (Renshen, 人参) - two liang
Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) - four liang
Poria (Fuling, 茯苓) - three liang
Paeoniae Radix Alba (Baishao, 白芍) - three liang
The above five ingredients are boiled in eight sheng of water until three sheng remain. The dregs are removed, and the liquid is divided into three warm doses, one sheng per dose, taken three times daily.
Ke Yunbo stated: This is Zhang Zhongjing's premier warming and tonifying formula, representing the correct treatment method for Cold Damage (Shanghan). It serves as an agent to consolidate the root of Shaoyin and resist external pathogens. Since injury requires tonification, and Shaoyin belongs to Yin within the interior and is the organ of Cold Water, severe cases of Cold Damage often enter Shaoyin. Consequently, Shaoyin channel diseases have the highest mortality rate. The use of two raw Aconiti Lateralis Radix Praeparata pieces in this formula is to leverage their sharp potency and bear heavy responsibility, thereby augmenting the Yang of the "Lesser Fire" and stirring the vital Qi between the kidneys to resist invading Yin pathogens, thus protecting the spirit of the organs... [Text fragmentary].
Treating conditions following sweating and purging therapies, where there is slight deficiency, shortness of breath, fever, and dry mouth. By removing Chaihu (Bupleuri Radix), it is renamed Renshen Sanbai Tang (Ginseng Three-Whites Decoction).
Panacis Ginseng Radix (Renshen, 人参)
Bupleuri Radix (Chaihu, 柴胡)
Atractylodis Macrocephalae Rhizoma (Baizhu, 白术)
Paeoniae Radix Alba (Baishao, 白芍)
Poria (Baifuling, 白苓)
Zingiberis Rhizoma Recens (Shengjiang, 生姜)
Jujubae Fructus (Dazao, 大枣)
Ke Yunbo stated: After sweating and purging, the interior Qi is deficient, so treatment should seek the Three Yin channels; however, since exterior heat recurs, attention should be directed to the Three Yang channels. Among the Three Yang, Shaoyang acts as the pivot... [Text fragmentary], involving Taiyin, winter, and exterior heat.