海蛤 滑石 甘草(各二两) 芒硝(一两)
上为细末,每服二钱,鸡子清调下。小肠通利,则胸膈血散;膻中血聚,则小肠壅;
小肠既壅,则膻中血不流行,宜此方。小便利,血数行,更宜桂枝红花汤,发其汗则愈。
妇人伤风,发热恶寒,经水适来,得之七、八日,热除脉迟,身凉,胸胁下满如结胸状
,谵语者,此为热入血室也。当刺期门穴,随其实而取之。期门穴在乳直下筋骨近腹处是也
。凡妇人病,法当刺期门,不用行子午法,恐缠脏膜引气上,但下针令病患吸五吸,停针良
久,徐徐出针,此是平泻法也。凡针期门,必泻勿补,可肥人二寸,瘦人寸半深也。
夫妇人咳嗽者,由肌体虚,外受于寒、热、风、湿所得也。肺为四脏之华盖,内统诸脏
之气,外合于皮毛。若为寒、热、风、湿所伤,邪气自皮毛而入于肺,中外皆伤,故令咳也
。大抵治咳,不可一概,治当以脉息辨之。其脉浮而弦者,起于风;濡而弱者,起于湿;洪
而数者,起于热;迟而涩者,起于寒。风者散之,湿者燥之,热者凉之,寒者温之,虚者补
之,未有不安者也。
(初虞世)
经曰∶微寒为嗽,寒甚为肠癖。古人立方治嗽,未有不本于温药,如干姜、桂心、细辛
之属。以寒气入里,非辛甘不能发散。以此推之,未有不因寒而嗽也。又曰∶热在上焦,因
咳为肺痿。又实则为肺痈,虚则为肺痿。此人其始或血不足;或酒色滋味太过;或因服利药
重亡津液。燥气内焚,肺金受邪,脉数发热,咳嗽脓血。病至于此,亦已危矣。古人立方,
亦用温药,如建中之属。今人但见发热咳嗽,率用柴胡、鳖甲、门冬、葶苈等药,旋踵受弊
而不知非,可为深戒!就使不可进以温药,亦须妙以汤丸委曲调治,无为卤莽,致伤人命。
治虚中有热,咳嗽脓血,口苦咽干。黄 散。
海蛤、滑石、甘草(各二两),芒硝(一两)。
将上述药材研成细末,每次服用二钱,用鸡蛋清调服。小肠通畅利达,则胸膈部的瘀血得以消散;若膻中部位瘀血积聚,则会导致小肠气机壅滞;小肠一旦壅滞,就会导致膻中部位的血液运行不畅,适宜使用此方。若小便通利,且瘀血多次排出后,更适宜使用桂枝红花汤,通过发汗的方法即可痊愈。
妇女患伤风病,出现发热、恶寒的症状,正值月经来潮,病程经过七八天后,热势退去、脉象迟缓、身体凉爽,但出现胸胁部胀满如同结胸证的样子,并有胡言乱语的表现,这是热邪陷入血室所致。应当针刺期门穴,根据其实证的性质进行泻法治疗。期门穴位于乳头直下,肋骨边缘接近腹部之处。凡是妇女患病,按照医理都应当针刺期门穴,不使用子午流注补泻手法,恐怕会缠绕脏腑膜络导致气机上逆,只需进针时让患者吸气五次,留针较长时间,然后缓慢出针,这就是平泻法。凡是针刺期门穴,必须采用泻法而不可用补法,体型肥胖者可深刺二寸,体型瘦弱者深刺一寸半。
至于妇女咳嗽,是由于机体虚弱,外感寒、热、风、湿邪气所致。肺被称为五脏的华盖,内统摄各脏之气,外合于皮毛。如果受到寒、热、风、湿邪气的伤害,邪气从皮毛侵入肺部,导致内外皆受伤,所以引起咳嗽。大抵治疗咳嗽,不能一概而论,应当通过脉象来辨别。脉象浮而弦的,起因于风邪;脉象濡而弱的,起因于湿邪;脉象洪大而数的,起因于热邪;脉象迟而涩的,起因于寒邪。风邪引起的应当疏散,湿邪引起的应当燥湿,热邪引起的应当清热凉之,寒邪引起的应当温散,虚损引起的应当补益,没有不安愈的。
(初虞世)
经典记载:轻微受寒引发咳嗽,寒邪严重则导致痢疾。古人制定方剂治疗咳嗽,没有不基于温药的,如干姜、桂心、细辛之类的药物。因为寒气入里,非辛甘之味不能发散。由此推断,没有不是因寒而引发的咳嗽。又说:热邪在上焦,因咳嗽导致肺痿。实证则为肺痈,虚证则为肺痿。这些人起初或是血液不足;或是酒色滋味太过;或是因为服用泻利药物严重耗伤津液。燥气在内焚烧,肺金受到邪气侵害,脉数发热,咳嗽脓血。病情发展到这种地步,也已经很危险了。古人制定方剂,也使用温药,如建中汤之类的。现在的人只见到发热咳嗽,就随意使用柴胡、鳖甲、麦冬、葶苈等药物,转眼之间遭受危害却不知其错误,这值得深深警戒!即使不能使用温药,也必须巧妙地用汤剂丸剂委婉调理,不要鲁莽草率,以致伤害人命。治疗虚中有热,咳嗽脓血,口苦咽干,使用黄芩散。
Haige (Clam Shell), Huashi (Talcum), Gancao (Licorice Root) (each 2 liang), Mangxiao (Mirabilite) (1 liang).
Grind the above herbs into a fine powder. Take 2 qian per dose, mixed with egg white and taken orally. When the Small Intestine is unobstructed and urination is smooth, the blood stasis in the chest and diaphragm will dissipate; when blood stasis accumulates at the Danzhong (Conception Vessel 17), it causes obstruction in the Small Intestine; once the Small Intestine is obstructed, the blood flow in the Danzhong area becomes stagnant. This formula is suitable for such conditions. If urination is smooth and blood stasis has been discharged multiple times, Guizhi Honghua Tang (Cinnamon Twig and Safflower Decoction) is more appropriate; inducing sweating will lead to recovery.
When a woman suffers from wind-cold invasion, presenting with fever and aversion to cold, during her menstrual period, and after seven or eight days the fever subsides, pulse becomes slow, body temperature returns to normal, yet she experiences fullness and distension in the hypochondrium resembling Jie Xiong syndrome (chest binding syndrome), accompanied by delirium, this is known as Re Ru Xue Shi (Heat Entering the Blood Chamber). The Qimen (Liver 14) acupoint should be punctured, applying reduction method according to the excess pattern. Qimen (Liver 14) is located directly below the nipple, near the ribs close to the abdomen. For all women's diseases, according to medical principles, Qimen (Liver 14) should generally be punctured. The Ziwu Liu Zhu (Midnight-Noon Ebb-Flow) tonification-reduction technique should not be used, lest it entangle the organ membranes and cause Qi to ascend. Simply insert the needle while the patient inhales five times, retain the needle for a considerable duration, and withdraw it slowly; this is the Ping Xie (Neutral Reduction) method. Whenever puncturing Qimen (Liver 14), reduction must be applied without tonification. For obese individuals, insert to a depth of 2 cun; for thin individuals, 1.5 cun.
Regarding cough in women, it arises from bodily deficiency combined with external invasion of Cold, Heat, Wind, and Dampness. The Lung is considered the "Canopy" of the five Zang organs, internally governing the Qi of all organs, and externally connecting with the skin and hair. If injured by Cold, Heat, Wind, or Dampness, pathogenic factors enter the Lung from the skin and hair, injuring both interior and exterior, thus causing cough. Generally, treating cough cannot be uniform; it must be differentiated by pulse diagnosis. A floating and wiry pulse indicates origin from Wind; a soggy and weak pulse indicates origin from Dampness; a surging and rapid pulse indicates origin from Heat; a slow and choppy pulse indicates origin from Cold. For Wind, disperse it; for Dampness, dry it; for Heat, cool it; for Cold, warm it; for Deficiency, tonify it. There will be no case that does not heal.
(Chu Yushi)
The Classics state: Mild cold causes cough; severe cold leads to intestinal dysentery. Ancient physicians formulated remedies for cough based invariably on warm herbs, such as Ganjiang (Dried Ginger), Guixin (Cinnamon Bark), and Xixin (Asarum). Since cold pathogens penetrate inward, only pungent and sweet flavors can disperse them. By this reasoning, coughs are rarely not caused by cold. It is also stated: Heat in the Upper Jiao, due to cough, results in Fei Wei (Lung Asthenia). Excess patterns manifest as Fei Yong (Lung Abscess); deficiency patterns manifest as Fei Wei (Lung Asthenia). These patients initially may have had insufficient Blood; or excessive indulgence in alcohol, sex, and rich flavors; or severe loss of Body Fluids due to purgative medications. Dryness burns internally, damaging Metal (Lung), leading to rapid pulse, fever, coughing of pus and blood. At this stage, the condition is already critical. Ancient formulas also utilized warm herbs, such as Jianzhong Tang (Middle-Warming Decoction). Modern practitioners, seeing only fever and cough, indiscriminately use Chaihu (Bupleurum), Biejia (Turtle Shell), Maidong (Ophiopogon), and Tingli (Descurainia Seed), suffering harm shortly thereafter without realizing their error. This deserves deep caution! Even if warm herbs cannot be administered, one must skillfully use decoctions and pills for gentle regulation, avoiding rash actions that could endanger life. To treat deficiency with internal heat, coughing pus and blood, bitter taste in the mouth, and dry throat, use Huangqin San (Scutellaria Powder).