《病源》夫天行病,阴气少,阳气多,故身热而烦,其毒瓦斯在于心腑而烦者,则令人闷
而欲呕,若其人胃内有燥粪而烦者,则谬语,时绕脐痛,腹满,皆当察其证候也。(出第九
卷中)
文仲疗天行表里虚烦不可攻者。但当与竹叶汤方。
竹叶(二把) 石膏(碎,绵裹一升) 麦门冬(去心一升) 半夏(半升洗) 人参 甘
草
(各二两)
上六味,切,以水一斗,煮取六升,去滓,纳粳米一升,煮米熟去之,分五服。呕者与
橘皮汤。汤方在上呕 篇中。不愈者重作此,宫泰数用甚效。若伤寒后虚烦,亦宜服此方,
是仲景方。忌羊肉、海藻、菘菜、饧。
又疗虚烦不可攻方。
青竹茹(二升)
上一味,以水四升,煎至三升,去滓,分温五服,徐徐服之。
《病源》夫病热盛则弃衣而走,登高而歌,或至不食数日,逾垣上屋,所上非其素时所
能也。病反能者,皆阴阳气争而外并于阳,四肢者,诸阳之本也。阳盛则四肢实,实则能登
高而歌,热盛于身,故弃衣而走,阳盛故妄言骂詈,不避亲疏,大热遍身,狂言而妄见妄闻
也。(出第九卷中)
《千金》水道散 疗天行病烦热如火,狂言妄语欲走方。
白芷(一两) 甘遂(二两熬)
上二味,捣筛,以水服方寸匕。须臾令病患饮冷水,腹满则吐之,小盒饭赤也。一名濯
腹汤,此方疗大急者。(出第十卷中,文仲、《范汪》同)
又五苓散 主天行热病,但狂言烦躁不安,精采言语与人不相主当方。
猪苓(二分) 白术(三分) 泽泻(五分) 茯苓(三分) 桂心(二分)
上五味,捣筛为散,水服方寸匕,日三服。多饮暖水,汗出愈。忌大醋、生葱、桃、李
、雀肉等。(张仲景论、《深师》同,出第九卷中)
《古今录验》疗天行壮热,狂言谬语五六日者方。
鸡子(三枚) 芒硝(方寸匕) 井花水(一杯)
上三味,合搅,尽服之。心烦,下则愈。(出第三卷中)
《诸病源候论》说:凡是天行病(具有传染性的外感热病),阴气少而阳气多,所以身体发热且心中烦闷。如果邪毒之气蕴结在心腑导致心烦的,就会使人感到胸闷并想呕吐;如果患者胃中有燥屎积滞而导致心烦的,就会出现胡言乱语、时常围绕肚脐疼痛、腹部胀满等症状,这些都应当仔细辨别其证候。(出自第九卷中)
文仲治疗天行病表里俱虚、心中烦闷不可使用攻下法的方剂。只应当给予竹叶汤方。
竹叶(两把) 石膏(捣碎,用绵布包裹,一升) 麦门冬(去心,一升) 半夏(半升,洗净) 人参 甘草(各二两)
以上六味药,切碎,用水一斗,煎煮取汁六升,去掉药渣,加入粳米一升,煮至米熟后去掉米粒,分五次服用。若伴有呕吐症状的,给予橘皮汤。该汤方见上文“呕”篇中。若服药后未愈,可重新制作此方,宫泰多次使用非常有效。如果是伤寒病后出现的虚烦,也适宜服用此方,这是张仲景的方子。忌食羊肉、海藻、菘菜(白菜)、饴糖。
青竹茹(二升)
以上一味药,用水四升,煎煮至三升,去掉药渣,分五次温服,慢慢服用。
《诸病源候论》说:患热盛病的患者会脱掉衣服奔跑,登上高处唱歌,或者几天不吃饭,翻越墙垣、爬上屋顶,这些行为都是他平时所不能做的。病人反而能做出这些举动,都是因为阴阳之气相争,阳气向外偏并于阳经所致。四肢是诸阳之本。阳气旺盛则四肢充实有力,所以能够登高唱歌;体内热盛,所以脱衣奔跑;阳气过盛所以胡言乱语、骂人,不分亲疏;全身大热,出现狂言妄语、幻觉和幻听。(出自第九卷中)
《千金方》中的水道散,治疗天行病烦热如火,胡言乱语、想要奔跑的方剂。
以上两味药,捣碎筛成细粉,用水送服一方寸匕。片刻后让患者喝冷水,如果腹部胀满就催吐,直到吐出赤色液体为止。又名濯腹汤,此方用于治疗病情急重的患者。(出自第十卷中,文仲、《范汪方》相同)
又有五苓散,主治天行热病,仅表现为胡言乱语、烦躁不安,精神恍惚,言语与常人不对应。
猪苓(二分) 白术(三分) 泽泻(五分) 茯苓(三分) 桂心(二分)
以上五味药,捣碎筛成粉末,用水送服一方寸匕,每日三次。服药后多喝暖水,出汗即愈。忌食大醋、生葱、桃、李、雀肉等。(张仲景论述、《深师方》相同,出自第九卷中)
《古今录验》治疗天行壮热,胡言乱语持续五六日的方剂。
鸡蛋(三个) 芒硝(一方寸匕) 井花水(一杯,清晨第一次汲取的井水)
以上三味药,混合搅匀,全部服下。若心烦,大便通畅后即可痊愈。(出自第三卷中)
According to the *Zhubing Yuanhou Lun* (Treatise on the Pathogenesis and Manifestations of All Diseases): In cases of Tianxing disease (epidemic febrile diseases with contagious nature), Yin Qi is deficient while Yang Qi is excessive, resulting in fever and vexation. If the toxic pathogenic factors reside in the Heart and Fu organs causing vexation, it leads to chest oppression and a desire to vomit. If the patient has dry feces retained in the Stomach causing vexation, it manifests as delirious speech, periumbilical pain occurring intermittently, and abdominal fullness. All these conditions require careful differentiation of syndromes. (From Volume IX)
Wen Zhong treats Tianxing disease characterized by deficiency and vexation in both the exterior and interior, where purgative methods are contraindicated. One should administer the Zhuye Tang (Bamboo Leaf Decoction).
Zhuye (Bamboo Leaves, 2 handfuls) Shigao (Gypsum Fibrosum, crushed, wrapped in silk, 1 sheng) Maimendong (Ophiopogonis Radix, heart removed, 1 sheng) Banxia (Pinelliae Rhizoma, half sheng, washed) Renshen (Ginseng Radix et Rhizoma) Gancao (Glycyrrhizae Radix et Rhizoma) (each 2 liang)
The above six herbs are sliced, boiled in 1 dou of water until reduced to 6 sheng, filtered to remove dregs, then Jingsmi (Rice) 1 sheng is added. Cook until the rice is ripe, remove the rice grains, and divide into five doses. For those with vomiting, administer Chupi Tang (Tangerine Peel Decoction); see the "Vomiting" section above for the formula. If not cured, repeat this preparation; Gong Tai used it frequently with great efficacy. This formula is also suitable for post-Shanghan (Cold Damage) deficiency vexation; it is a formula from Zhang Zhongjing. Avoid mutton, Zaoxi (Seaweed), Songcai (Chinese Cabbage), and Xing (Maltose).
Another formula for treating deficiency vexation where purgatives are contraindicated:
Qingzhuru (Green Bamboo Shavings, 2 sheng)
The above single herb is boiled in 4 sheng of water until reduced to 3 sheng, filtered, and divided into five warm doses, taken slowly.
According to the *Zhubing Yuanhou Lun*: Patients suffering from intense heat may discard their clothes and run, climb high places and sing, or go without food for several days, climbing over walls and roofs—actions they could not perform normally. The ability to do so arises from the contention of Yin and Yang Qi, with Yang Qi merging outward into the Yang channels. The four limbs are the root of all Yang channels. When Yang is excessive, the limbs become solid and strong, enabling one to climb and sing. Intense heat in the body causes discarding clothes and running; excess Yang leads to reckless speech and cursing regardless of intimacy; widespread severe heat results in manic speech, hallucinations, and auditory delusions. (From Volume IX)
Shuidao San (Water Channel Powder) from the *Qianjin Fang* treats Tianxing disease with burning vexation and heat, delirious speech, and restlessness.
Baizhi (Angelicae Dahuricae Radix, 1 liang) Gansui (Kansui Radix, 2 liang, processed by heating)
The above two herbs are pounded and sifted into powder. Take one fangcun bi (a square-inch measure) with water. Shortly after, have the patient drink cold water. If abdominal fullness occurs, induce vomiting until red fluid is expelled. Also known as Zhuofu Tang (Abdominal Washing Decoction); this formula is for urgent and critical cases. (From Volume X, same as Wen Zhong and Fan Wang's formulas)
Also, Wuling San (Five-Ingredient Powder with Poria) primarily treats Tianxing febrile diseases manifesting only as delirious speech, irritability, and restlessness, with disjointed speech and lack of mental coherence.
Zhu Ling (Polypori Umbellati mycelium, 2 fen) Baizhu (Atractylodis Macrocephalae Rhizoma, 3 fen) Zexie (Alismatis Rhizoma, 5 fen) Fuling (Poria, 3 fen) Guixin (Cinnamomi Cortex, 2 fen)
The above five herbs are pounded and sifted into powder. Take one fangcun bi with water, three times daily. Drink plenty of warm water afterwards; sweating indicates recovery. Avoid strong vinegar, raw green onions, peaches, plums, and sparrow meat. (Same as Zhang Zhongjing's discussion and Shenshi Fang, From Volume IX)
Jingu Luyian treats Tianxing with high fever and delirious speech lasting five to six days.
Jizi (Egg Yolk, 3 pieces) Mangxiao (Natrii Sulfas, one fangcun bi) Jinghua Shui (Well Water drawn at dawn, 1 cup)
Mix the above three ingredients thoroughly and consume entirely. If there is mental vexation, relief comes upon defecation. (From Volume III)