治时行头痛壮热一二日方。
桂心 甘草 大黄(各二两) 麻黄(四两)
上四味治下筛,患者以生熟汤浴,讫以暖水服方寸匕,日三,覆取汗,或利便瘥。力强
人服二方寸匕。(《延年秘录》有黄芩、芍药各二两。《古今录验》无甘草,有芍药。治天
行热病生 疮疼痛及解肌出汗)
治时病表里大热欲死方∶
大黄 寒水石 芒硝 石膏 升麻 麻黄 葛根 (各等分)
上八味治下筛,水服方寸匕,日三。
(例一首 方十九首)
例曰∶大法春夏宜发汗。凡发汗欲令手足皆周至 然一时间许益佳,但不可如水流离
耳。若病不解,当更重发汗,汗出多则亡阳,阳虚不可重发汗也。凡服汤药发汗中病便
止,不必尽剂也。凡云可发汗而无汤者,丸散亦可用,要以汗出为解,然不及汤,随证良验。
凡病无故自汗出,复发其汗愈,卫复和故也。
夫脉浮者,病在外,可发汗,宜桂枝汤。
夫脉浮大而数者,亦可发汗,宜桂枝汤。
夫病常自汗出者,此为营气和,营气和而外不解,此为卫气不和也。营行脉中,卫行脉
外,复发其汗,卫和则愈,宜桂枝汤。
夫病患脏无他病,时时发热自汗出而不愈者,此卫气不和故也,先其时发汗则愈,宜桂
枝汤。
太阳病,发热汗出者,此为营弱卫强,故令汗出,欲救邪风,宜桂枝汤。
太阳病,头痛发热汗出恶风寒,宜桂枝汤。
太阳病,下之微喘者,表未解也,宜桂枝加浓朴杏仁汤。
太阳病外证未解者,不可下,宜桂枝汤。
太阳病,先发其汗,不解而复下之,其脉浮者不愈。浮为在外而反下之,故令不愈。今
脉浮,故知在外,当须解表则愈,宜桂枝汤。
太阳病下之,气上冲者,可与桂枝汤,不上冲,不可与。
凡桂枝本为解肌,若脉浮紧,发热无汗者,勿与之,常知此,勿误也。
治疗时行病(流行性外感热病)出现头痛、高热,病程一二天的方剂。
桂心 甘草 大黄(各二两) 麻黄(四两)
以上四味药捣碎过筛,让患者用生水和熟水混合的温水洗浴,洗完后用温开水送服一方寸匕的药粉,每日三次,服药后覆盖衣被以取汗,或者通过腹泻而痊愈。体力强的人服用两方寸匕。(《延年秘录》中有黄芩、芍药各二两。《古今录验》中无甘草,有芍药。用于治疗天行热病引起的皮肤生疮疼痛及解肌出汗)
治疗时行病表里大热、痛苦欲死的方剂:
大黄 寒水石 芒硝 石膏 升麻 麻黄 葛根 (各等分)
以上八味药捣碎过筛,用水送服一方寸匕的药粉,每日三次。
(一例一首,共十九首方剂)
举例说明:大法则是春夏季节适宜发汗。凡是发汗,希望手足都均匀地出汗,持续大约一顿饭的时间更好,但不可像水流一样淋漓不止。如果病邪未解,应当再次发汗,但如果汗出过多则会亡阳,阳气虚损时不可再次发汗。凡是服用汤药发汗,达到治愈效果就停止,不必喝完全部药液。凡是说可以发汗但没有汤药的,丸剂和散剂也可以使用,关键在于以出汗为病解的标志,然而效果不如汤药,需根据证候选择,疗效良好。
凡是疾病无故自汗出的,再次发汗即可痊愈,这是因为卫气恢复调和的缘故。
脉象浮的,病位在体表,可以发汗,适宜用桂枝汤。
脉象浮大而数的,也可以发汗,适宜用桂枝汤。
患病者经常自汗出的,这是营气调和,营气调和而体表之邪未解,这是卫气不和。营气运行在脉管之中,卫气运行在脉管之外,再次发汗,卫气调和则痊愈,适宜用桂枝汤。
患病者脏腑没有其他疾病,时常发热自汗出而不愈的,这是卫气不和的缘故,在发作之前发汗则痊愈,适宜用桂枝汤。
太阳病(太阳经受邪所致的病证),发热汗出的,这是营弱卫强,所以导致汗出,想要解除风邪,适宜用桂枝汤。
太阳病,头痛、发热、汗出、恶风寒的,适宜用桂枝汤。
太阳病,经过误下之后出现轻微喘息的,表证仍未解除,适宜用桂枝加厚朴杏子汤。
太阳病,表证未解除的,不可使用泻下法,适宜用桂枝汤。
太阳病,先发汗治疗,病未解又误用泻下法,脉象仍浮的,病不会好。脉浮表示病邪在表,反而使用泻下法,所以导致病不愈。现在脉象浮,所以知道病邪仍在表,应当解表才能痊愈,适宜用桂枝汤。
太阳病误用泻下法后,气上冲的,可以与桂枝汤;如果不气上冲,则不可给予。
凡是桂枝本是用来解肌的,如果脉象浮紧,发热无汗的,不要给予它,常要知晓这一点,不要误用。
Formula for treating epidemic febrile diseases (epidemic exogenous febrile diseases) presenting with headache and high fever within one or two days.
Guixin (Cinnamon Heart), Gancao (Licorice Root), Dahuang (Rhubarb Rhizome) (each 2 liang), Mahuang (Ephedrae Herba) (4 liang).
Process the above four herbs by crushing and sieving. Let the patient bathe in a mixture of raw and cooked warm water. After bathing, administer one fangcunbi (a square-inch measure) of the powder with warm water, three times daily. Cover the patient to induce sweating, or recovery may occur through diarrhea. Individuals with strong physical constitution may take two fangcunbi. (*Yannian Milu* includes Huangqin (Scutellariae Radix) and Shaoyao (Paeoniae Radix), each 2 liang. *Gujin Luyan* excludes Gancao but includes Shaoyao. Used for treating sores and pain caused by Tianxing febrile diseases and for releasing the muscle layer and inducing sweating.)
Formula for treating epidemic diseases with severe heat in both exterior and interior, causing extreme distress:
Dahuang (Rhubarb Rhizome), Hanshuishi (Calcitum), Mangxiao (Natrii Sulfas), Shigao (Gypsum Fibrosum), Shengma (Cimicifugae Rhizoma), Mahuang (Ephedrae Herba), Gegen (Puerariae Lobatae Radix) (equal parts).
Process the above eight herbs by crushing and sieving. Administer one fangcunbi of the powder with water, three times daily.
(One example, nineteen formulas)
Example: The general principle is that sweating therapy is suitable in spring and summer. When inducing sweating, it is desirable for sweat to be uniform on the hands and feet, lasting approximately the time it takes to eat a meal, which is better, but it should not flow profusely like water. If the pathogen is not resolved, sweating therapy may be repeated; however, excessive sweating leads to Yang collapse, and when Yang is deficient, sweating therapy must not be repeated. Whenever decoctions are taken to induce sweating, stop once the therapeutic effect is achieved; there is no need to finish the entire dose. Whenever sweating therapy is indicated but no decoction is available, pills or powders may also be used, provided that sweating occurs as the sign of resolution, although this is less effective than decoctions. Selection should follow the syndrome for good efficacy.
For spontaneous sweating without an obvious cause, repeating sweating therapy cures the condition because the Wei Qi (Defensive Qi) returns to harmony.
When the pulse is floating, the disease is at the exterior; sweating therapy is applicable, and Guizhi Tang (Cinnamon Twig Decoction) is suitable.
When the pulse is floating, large, and rapid, sweating therapy is also applicable, and Guizhi Tang (Cinnamon Twig Decoction) is suitable.
When a patient frequently sweats spontaneously, this indicates that Ying Qi (Nutritive Qi) is harmonious, but the exterior pathogen remains unresolved due to disharmony of Wei Qi (Defensive Qi). Ying Qi circulates within the vessels, while Wei Qi circulates outside the vessels. Repeating sweating therapy harmonizes Wei Qi, leading to recovery; Guizhi Tang (Cinnamon Twig Decoction) is suitable.
If a patient has no internal organ pathology but experiences recurrent fever and spontaneous sweating without recovery, this is due to disharmony of Wei Qi (Defensive Qi). Inducing sweating before the onset of symptoms leads to recovery; Guizhi Tang (Cinnamon Twig Decoction) is suitable.
In Taiyang disease (disease pattern resulting from pathogenic invasion of the Taiyang channel), fever with sweating indicates weak Ying Qi (Nutritive Qi) and strong Wei Qi (Defensive Qi), causing sweating. To rescue from evil wind, Guizhi Tang (Cinnamon Twig Decoction) is suitable.
In Taiyang disease (disease pattern resulting from pathogenic invasion of the Taiyang channel), presenting with headache, fever, sweating, aversion to wind and cold, Guizhi Tang (Cinnamon Twig Decoction) is suitable.
In Taiyang disease (disease pattern resulting from pathogenic invasion of the Taiyang channel), if purgation was performed first and slight wheezing results, the exterior is still unresolved; Guizhi Jia Houpo Xingren Tang (Cinnamon Twig Decoction with Magnolia Bark and Apricot Seed) is suitable.
In Taiyang disease (disease pattern resulting from pathogenic invasion of the Taiyang channel), if the exterior syndrome is unresolved, purgation is contraindicated; Guizhi Tang (Cinnamon Twig Decoction) is suitable.
In Taiyang disease (disease pattern resulting from pathogenic invasion of the Taiyang channel), if sweating therapy was administered first but failed to resolve the condition, followed by erroneous purgation, and the pulse remains floating, the disease will not heal. A floating pulse indicates the pathogen is at the exterior; applying purgation erroneously prevents healing. Since the pulse is now floating, it is known that the pathogen remains at the exterior; resolving the exterior is necessary for recovery, and Guizhi Tang (Cinnamon Twig Decoction) is suitable.
After erroneous purgation in Taiyang disease, if there is a sensation of Qi rushing upward, Guizhi Tang (Cinnamon Twig Decoction) may be given; if there is no such sensation, it should not be given.
Generally, Guizhi Tang (Cinnamon Twig Decoction) is intended to release the muscle layer. If the pulse is floating and tight, with fever and absence of sweating, do not administer it. Always keep this in mind to avoid errors.