许仁则此病之候,乃有数种,亦有宿患 癖,饮食失宜,因节气初交,亦生此病,亦有
痰积聚,久不通散,冷热相攻,亦生此疾,亦有地居卑湿时属暑热,内有宿病,外感恶气,
亦生此疾,亦有盛夏蒸热饮冷,冷热间隔秋夏气交,亦生此疾,以要言之,终由饮食失常,
寒暑乖宜,上热下系将疗之方,吐下为本,人有强羸,病有轻重,自须临时斟酌,不可一概
言之,此病别有祈祷厌禳而瘥者,自是人心妄识,畏爱生病,亦犹弓影成蛊耳,必有不诬此
法,专意信之,亦任其从禳祷之道,虽然,必须资药以救之,比见用药攻疗,无不瘥者,以
法禳之,则有不效者,以此言之,明知病在于内,徒劳无外耳,此病之始,与天行不多别,
亦头痛骨肉酸楚,手足逆冷,口鼻喉舌干,好饮水毛耸,腰脊强欲反拗,小便赤,但先寒后
热,发作有时,可不审察,其发作日有准,凡经七日以后,先服鳖甲等五味散,取快吐方。
鳖甲(三两生用) 常山(二两) 甘草(二两炙) 松萝(二两) 桂心(一两)
右药捣筛为散,煮乌梅汤下,初服一方寸匕,日二服,稍稍加之,以得吐为限。忌人苋
生葱生菜海藻菘菜。
又审其候若体力全强,日再服,每服皆取吐,自觉气力不甚强,则每一服取吐,晚不须
服,如全绵 ,事须取吐,则三两日一服,经五六度吐讫,但适寒温将息,并食饮,使体气
渐强,若知病虽轻吐,根本未似得除,事须利之,以泄病势,宜合当归等六味散服之取利方。
当归(五两) 白术(五两) 细辛(四两) 桂心(三两) 大黄(五两) 朴硝(四
两)
右药捣筛为散,平旦空肚以酒饮下,初服一方寸匕,日再服,稍稍加之,得利为度,候
气力强羸,取利多少,一一如前取吐法。忌桃李雀肉生葱生菜。
又依前鳖甲等五味散取吐,当归等六味散利后,虽经吐下,其源尚在,如更吐利,又虑
羸,宜合鬼箭羽等十味丸服之方。
细辛(四两) 橘皮(四两) 鬼箭羽(折看之如金色者二两) 白术(五两) 桂心
(四两)
地骨皮(四两) 蜀漆(二两) 甘草(三两炙) 当归(五两) 丁香(三两)
右药捣筛,蜜和丸如梧子,煮乌梅饮下之,初服十五丸,日再,稍稍加至三十丸,服经
三五日后,若觉热甚,每服药后良久,任吃三两口粥饮压之。忌海藻菘菜桃李雀肉生葱。
又疗此病,鲁用释深师一方,大有效,其方有巴豆皂荚藜芦,三味作丸服虽经困苦,一
服永断。(吴升同并出第一卷中)
许仁则认为,这种病的症状表现有好几种。有的患者原本就有宿疾积聚(指体内长期存在的病理产物或肿块),加上饮食不当,在节气交替之时,也会引发此病;有的患者体内有痰饮积聚,长久未能消散,冷热邪气相互攻冲,也会产生这种疾病;有的患者居住在地势低洼潮湿之处,又逢暑热时节,体内原有旧疾,外感秽浊恶气,也会生出此疾;还有的患者在盛夏酷暑时贪凉饮冷,导致冷热之气交错,在夏秋季节交替之际,也会引发此病。总而言之,最终都是因为饮食不规律,寒暑失调所致。
治疗此病的方法,以催吐和泻下为根本原则。但人的体质有强弱之分,病情有轻重之别,必须根据当时的具体情况灵活斟酌,不能一概而论。这种病也有通过祈祷驱邪而痊愈的,这完全是人心中的虚妄认知,因恐惧或喜爱而致病,就像弓影投射在水中误以为是蛊毒一样。如果坚信这种方法而不怀疑,也可以任由其遵循驱邪祈祷的途径。尽管如此,必须依靠药物来救治。近来见到使用药物攻治疗养的,没有不痊愈的;若仅用驱邪祈祷之法,则有不生效的情况。由此可知,此病根源在于体内,徒劳于体外是无用的。
此病发作之初,与天行疫病(具有传染性的流行病)没有太大区别,也出现头痛、骨肉酸痛楚痛、手足逆冷、口鼻咽喉舌头干燥、喜欢喝水、毛发竖起、腰脊僵硬想要反折、小便色赤等症状。只是先感到寒冷,随后发热,发作有固定的时间,不可不仔细审察。其发作日期有定准。凡是病程经过七日以后,先服用鳖甲等五味散,以求迅速呕吐。
【方剂】鳖甲等五味散:
鳖甲(三两,生用)、常山(二两)、甘草(二两,炙)、松萝(二两)、桂心(一两)。
以上药材捣碎过筛制成散剂,用乌梅汤煮送服。初次服用一方寸匕的量,每日两次,逐渐增加剂量,以能够引起呕吐为限度。忌食人苋、生葱、生菜、海藻、菘菜(白菜)。
再审视患者的状况,如果体力完全强健,可以每日服用两次,每次服药都要求引起呕吐;如果自觉气力不是很强,则每次服药只要求引起一次呕吐,晚上不需要再服;如果身体极度虚弱如绵絮般无力,事情上必须引起呕吐,则每隔三两天服用一次。经过五到六次呕吐后,只需适当调节寒温进行调养,注意饮食,使体力逐渐增强。如果知道虽然病情较轻且已催吐,但病根仍未彻底清除,事情上需要通利大便以泄除病势,适宜合制当归等六味散服用以取效。
【方剂】当归等六味散:
当归(五两)、白术(五两)、细辛(四两)、桂心(三两)、大黄(五两)、朴硝(四两)。
以上药材捣碎过筛制成散剂,清晨空腹时用酒送服。初次服用一方寸匕的量,每日两次,逐渐增加剂量,以能够引起腹泻为度。候查患者体力强弱,决定通利的程度,一切如同前面催吐的方法。忌食桃李、雀肉、生葱、生菜。
再次依照前面的方法,先用鳖甲等五味散催吐,再用当归等六味散通利。虽然经过了催吐和泻下,但病源仍在,如果再次催吐或泻下,又担心患者体质虚弱,适宜合制鬼箭羽等十味丸服用。
【方剂】鬼箭羽等十味丸:
细辛(四两)、橘皮(四两)、鬼箭羽(折断看里面呈金色的二两)、白术(五两)、桂心(四两)、地骨皮(四两)、蜀漆(二两)、甘草(三两,炙)、当归(五两)、丁香(三两)。
以上药材捣碎过筛,用蜂蜜调和制成梧桐子大小的药丸,用乌梅饮煮送服。初次服用十五丸,每日两次,逐渐增加到三十丸。服药经过三五天后,如果觉得热象严重,每次服药后过很久,可以吃两三口粥饮来压制它。忌食海藻、菘菜、桃李、雀肉、生葱。
另外治疗此病,鲁地有人采用释深师的一个方子,非常有效。该方含有巴豆、皂荚、藜芦,这三味药做成丸剂服用,虽然过程可能比较痛苦,但服用一次即可永远断根。(吴升相同的内容均出自第一卷中)
Xu Renze believed that the manifestations of this disease present in several varieties. Some patients have pre-existing accumulations (chronic pathological products or masses within the body) and, due to improper diet during solar term transitions, may develop this illness. Others have phlegm-fluids (Tan Yin) accumulating internally for a long time without dispersing; when cold and heat pathogens attack each other, this disease also arises. Some reside in low-lying, damp areas and, during hot summer seasons, with internal chronic conditions and external exposure to foul miasmas (Hui Qi), also contract this disease. Still others, drinking cold substances during the intense heat of midsummer, cause cold and heat energies to intermingle; during the transition between autumn and summer, this disease may also occur. In summary, it ultimately stems from irregular diet and disharmony with cold and heat.
The treatment principle for this disease is based on emesis (inducing vomiting) and purgation (inducing diarrhea). However, individuals vary in robustness, and diseases differ in severity; one must adjust according to the specific situation at hand and cannot apply a uniform rule. There are cases where this disease heals through prayer and exorcism; this is merely a delusion of the mind, where fear or attachment causes illness, similar to mistaking an archer's bow shadow for a gu poison. If one firmly believes in this method without doubt, they may follow the path of exorcism and prayer. Nevertheless, medication must be utilized to save the patient. Recently, those treated with medicinal attacks have invariably recovered; whereas those treated only with exorcism often fail. This indicates that the disease lies internally, and futile efforts directed externally are useless.
At the onset, this disease resembles epidemic febrile diseases (Tian Xing) and presents with headache, soreness and pain in bones and muscles, cold extremities, dryness of the mouth, nose, throat, and tongue, thirst, piloerection (hair standing up), stiffness of the waist and spine with desire for retroflexion, and dark urine. The distinguishing feature is chills preceding fever, occurring at regular intervals, which must be carefully examined. The timing of attacks is precise. After seven days of illness, first administer the Bie Jia Wu Wei San (Turtle Shell Five-Ingredient Powder) to induce rapid vomiting.
[Bie Jia Wu Wei San / Turtle Shell Five-Ingredient Powder]
Bie Jia (Shell of Trionyx sinensis, 3 liang, raw); Chang Shan (Radix Dichroae, 2 liang); Gan Cao (Radix Glycyrrhizae, 2 liang, honey-fried); Song Luo (Usnea, 2 liang); Gui Xin (Cortex Cinnamomi, 1 liang).
Pulverize these herbs and sieve them into a powder. Take with decocted Wu Mei Tang (Mume Fruit Decoction). Initial dose: one Fang Cun Bi (a square-inch measure). Administer twice daily, gradually increasing the dose until vomiting occurs. Avoid eating Ren Xian (Amaranthus manihot), raw Cong (Allium fistulosum), raw vegetables, Hai Zao (Sargassum), and Song Cai (Brassica rapa var. pekinensis).
Re-evaluate the patient's condition. If physical strength is fully robust, administer twice daily, ensuring each dose induces vomiting. If self-perceived energy is not strong, ensure only one dose induces vomiting per administration, and do not take the evening dose. If the body is extremely weak like cotton, yet vomiting is necessary, administer once every three to five days. After five or six episodes of vomiting, simply regulate temperature appropriately, rest, and manage diet to gradually strengthen the constitution. If it is known that although the disease is mild and vomiting has occurred, the root cause remains uncleared, and purgation is required to drain the pathological trend, it is appropriate to compound and administer Dang Gui Liu Wei San (Angelica Sinensis Six-Ingredient Powder) to induce purgation.
[Dang Gui Liu Wei San / Angelica Sinensis Six-Ingredient Powder]
Dang Gui (Radix Angelicae Sinensis, 5 liang); Bai Zhu (Rhizoma Atractylodis Macrocephalae, 5 liang); Xi Xin (Herba Asari, 4 liang); Gui Xin (Cortex Cinnamomi, 3 liang); Da Huang (Radix et Rhizoma Rhei, 5 liang); Po Xiao (Natrii Sulfas, 4 liang).
Pulverize and sieve these herbs into a powder. Take in the morning on an empty stomach with wine. Initial dose: one Fang Cun Bi. Administer twice daily, gradually increasing the dose until purgation occurs. Assess the patient's strength to determine the extent of purgation, following the same principles as the emetic method above. Avoid Tao Li (Prunus persica), Que Rou (Pullet meat), raw Cong (Allium fistulosum), and raw vegetables.
Again, following the previous method, first use Bie Jia Wu Wei San to induce vomiting, then Dang Gui Liu Wei San to induce purgation. Although emesis and purgation have been performed, the source of the disease persists. If further emesis or purgation is considered, there is concern about weakening the patient further. Therefore, it is appropriate to compound and administer Gui Jian Yu Shi Wei Wan (Spiny Elm Ten-Ingredient Pill).
[Gui Jian Yu Shi Wei Wan / Spiny Elm Ten-Ingredient Pill]
Xi Xin (Herba Asari, 4 liang); Ju Pi (Pericarpium Citri Reticulatae, 4 liang); Gui Jian Yu (Ramulus Eucommiae Ulmoidis, select golden interior, 2 liang); Bai Zhu (Rhizoma Atractylodis Macrocephalae, 5 liang); Gui Xin (Cortex Cinnamomi, 4 liang); Di Gu Pi (Cortex Lycii, 4 liang); Shu Qi (Radix Dichroae, 2 liang); Gan Cao (Radix Glycyrrhizae, 3 liang, honey-fried); Dang Gui (Radix Angelicae Sinensis, 5 liang); Ding Xiang (Flos Caryophylli, 3 liang).
Pulverize and sieve these herbs, mix with honey, and form pills the size of wu zi (wu berry seeds). Take with decocted Wu Mei Yin (Mume Fruit Drink). Initial dose: 15 pills. Administer twice daily, gradually increasing to 30 pills. After taking the medicine for three to five days, if severe heat is felt, wait a long time after taking the medicine, then consume two or mouthfuls of porridge drink to suppress it. Avoid Hai Zao (Sargassum), Song Cai (Brassica rapa var. pekinensis), Tao Li (Prunus persica), Que Rou (Pullet meat), and raw Cong (Allium fistulosum).
Additionally, to treat this disease, Lu employed a formula from Shi Shen Shi, which is highly effective. This formula contains Ba Dou (Seminar Crotonis Tiglii), Zao Jiao (Fructus Gleditsiae Sinensis), and Li Lu (Radix Veratri NigrI). These three ingredients are formed into pills. Although the process may be arduous, a single dose can permanently eradicate the disease. (Wu Sheng's identical content appears in Volume I.)