〔钱〕身热不饮水者,热在外。身热饮水者,热在内。〔海〕四顺饮子,治热在
内而不厥。连翘饮,治热在外而不厥。〔薛〕壮热,恶风寒,为元气不充,表之虚
热也。壮热,不恶风寒,为外邪所客,表之实热也。壮热饮汤,为津液短少,里之
虚热也。壮热饮水,为内火销烁,里之实热也。
按∶伤风恶风,伤寒恶寒,岂可以恶风寒为元气不充,而不恶风寒为外邪所
客乎。薛氏之意本圆而语则滞,痴人前岂可说梦,须以东垣外感内伤辨细别之,则
无失矣。
薛云∶热而二便调和,风邪蕴结于里而发者,用惺惺散加麻黄汗之。
败毒散 治伤风、瘟疫、风湿、头目昏眩,四肢作痛,憎寒壮热,项强睛疼,或恶
寒咳嗽,鼻塞声重。
柴胡 前胡 川芎 枳壳(炒) 羌活 独活 茯苓 桔梗 人参(各一两) 甘草(半两)
上,每服二钱,生姜薄荷水煎。
消风散 治小儿解脱,致令风邪客于皮毛,入于脏腑,则令恶风发热,胸膈痰涎,
目涩多睡。(即消风丸见风痫。)
清解散 治感风发热头疼,鼻塞涕流,及温壮,悉主之。
北参 防风 天麻 北前胡 茯苓 北梗 枳壳(锉) 甘草(各二钱) 细辛 柴胡(各一
钱半) 川芎(三钱)
上末。每一钱,水小盏,薄荷干三叶略煎,温和服。
《集验》荆术散 治小儿伤风伤寒,或疮或疹,此药,无寒无热,疏风顺气。一切诸
热证。
荆芥穗 赤芍药(各一两) 苍术(二两,制) 甘草(半两,炒)
细末。随大小一二钱。又名冲和散。伤风伤寒,壮热咳嗽,鼻塞声重,生姜葱
白汤下。伤风潮热,或变蒸发热,薄荷汤下。风热伤肺,鼻涕气粗,紫苏汤
下。暴卒急惊风热,宜急惊门疏风散。久病后急慢惊热,《保婴》全蝎散。发
汗,去节麻黄汤调。盗汗自汗,牡蛎浮麦汤调。丹毒风热,煎四顺饮汤调。眼暴
赤热肿,煎羌活黄芩生地黄汤调。口舌腮项热肿生疮,煎防风牛蒡子汤调。
咽喉重舌,煎升麻枳壳大黄防风薄荷汤调。
人参羌活散 治伤寒发热,头痛身疼,或潮热烦渴,痰实咳嗽。
羌活 白独活 柴胡 川芎 人参 甘草(炙) 白茯苓 枳壳(各一两) 前胡 桔梗
地骨皮 天麻(酒浸,焙。各半两)
咀。每一钱,水半盏,姜一片,枣半个,薄荷一叶煎,温服,无时。疮疹未
发,亦可服。
羌活散 治伤风时气,头痛发热,身体烦疼,痰壅咳嗽失音,鼻塞声重,及解时行下痢赤白。
人参(去芦) 羌活 赤茯苓(去皮) 柴胡(去芦) 前胡(去芦) 川芎 独活 桔梗
(锉,炒) 枳壳 苍术(各如前制) 甘草(各一两)
上锉。每服二钱,水一盏,姜二片,薄荷三叶,煎七分,无时温服。发散风邪,入葱白同煎。痢证,姜仓米煎。
人参辛梗汤 治小儿伤风发热,鼻塞咳嗽,时行疮疹。
人参(七分) 细辛(五分) 桔梗 干葛 升麻 白术 茯苓 柴胡(各七分) 薄荷 甘草(各五分)
每服,水一钟,姜三片,煎五分,不拘时服。
红绵散 治小儿四时感冒寒风,遍身发热,变蒸诸惊,胎惊丹毒等热,并皆治之,及急慢惊风,亦宜服之。
人参(二钱半) 天麻(洗) 僵蚕(炒) 麻黄(去节) 全蝎(去毒。各二钱) 甘草(炙)
辰砂(一钱半,细研)
上件为末,然后入朱砂和匀,再乳极细。每服半钱,用水半盏,煎数沸,入干
胭脂少许,再煎一沸,温温服,不拘时。
惺惺散(见痘)
【钱乙】身体发热但不想喝水的,是热邪在体表。身体发热且想喝水的,是热邪在体内。
【海藏】四顺饮子,治疗热邪在体内但未出现四肢厥冷的情况。连翘饮,治疗热邪在体表但未出现四肢厥冷的情况。
【薛己】高热,怕风怕冷,这是元气不足导致的表虚热。高热,不怕风不怕冷,这是外邪侵袭导致的表实热。高热且想喝热水,这是津液短少导致的里虚热。高热且想喝水,这是内火消耗津液导致的里实热。
按语:伤风证怕风,伤寒证怕冷,怎么能因为怕风怕冷就认为是元气不足,而不怕风不怕冷就是外邪侵袭呢?薛己的本意虽然周全,但表述有些僵化。对不懂的人岂可胡言乱语,必须参照李东垣《内外伤辨惑论》仔细辨别,就不会出错了。
薛己说:发热而大小便正常,因风邪郁结在体内而发热的,用惺惺散加麻黄发汗治疗。
败毒散,治疗伤风、瘟疫、风湿引起的头目昏眩,四肢疼痛,憎寒壮热(极度恶寒伴高热),项背强直,眼睛疼痛,或者怕冷咳嗽,鼻塞声音沉重。
组成:柴胡、前胡、川芎、枳壳(炒)、羌活、独活、茯苓、桔梗、人参(各一两),甘草(半两)。
用法:以上药物,每次服用二钱,用生姜、薄荷水煎服。
消风散,治疗小儿脐带脱落护理不当,导致风邪客于皮毛,侵入脏腑,从而引起怕风发热,胸膈痰涎,眼睛干涩多睡。(即消风丸,见“风痫”章节。)
清解散,治疗感受风邪发热头痛,鼻塞流涕,以及温壮热,全部主治。
组成:北参(党参或人参)、防风、天麻、北前胡、茯苓、北桔梗、枳壳(锉碎)、甘草(各二钱),细辛、柴胡(各一钱半),川芎(三钱)。
用法:以上药物研为末。每次取一钱,用水一小盏,加入三片干薄荷叶略煎,温和服用。
《集验方》荆术散,治疗小儿伤风伤寒,或者疮疡疹痘。此药性质平和,无寒无热,能疏风顺气。主治一切热证。
组成:荆芥穗、赤芍药(各一两),苍术(二两,制过),甘草(半两,炒)。
用法:研为细末。根据年龄大小服用一二钱。又名冲和散。伤风伤寒,壮热咳嗽,鼻塞声重,用生姜葱白汤送下。伤风潮热,或变蒸发热,用薄荷汤送下。风热伤肺,鼻涕多呼吸粗重,用紫苏汤送下。暴卒急惊风热,宜用急惊门疏风散。久病后急慢惊热,《保婴撮要》全蝎散。需要发汗时,用去节麻黄汤调服。盗汗自汗,用牡蛎浮小麦汤调服。丹毒风热,用煎好的四顺饮汤调服。眼睛突发红赤热肿,用煎好的羌活黄芩生地黄汤调服。口舌腮项热肿生疮,用煎好的防风牛蒡子汤调服。咽喉重舌,用煎好的升麻枳壳大黄防风薄荷汤调服。
人参羌活散,治疗伤寒发热,头痛身疼,或者潮热烦渴,痰实咳嗽。
组成:羌活、白独活、柴胡、川芎、人参、甘草(炙)、白茯苓、枳壳(各一两),前胡、桔梗、地骨皮、天麻(酒浸,焙干。各半两)。
用法:切碎。每次取一钱,用水半盏,加一片姜,半个枣,一片薄荷叶煎煮,温服,不拘时候。疮疹未发出时,也可以服用。
羌活散,治疗伤风时气,头痛发热,身体烦疼,痰壅咳嗽失音,鼻塞声重,以及解除时行下痢赤白(流行性痢疾,大便脓血)。
组成:人参(去芦头)、羌活、赤茯苓(去皮)、柴胡(去芦头)、前胡(去芦头)、川芎、独活、桔梗(锉碎,炒)、枳壳、苍术(各按前述方法炮制),甘草(各一两)。
用法:以上药物切碎。每次服用二钱,用水一盏,加两片姜,三片薄荷叶,煎至七分,不拘时候温服。发散风邪时,加入葱白同煎。痢疾病症,用姜仓米煎汤送服。
人参辛梗汤,治疗小儿伤风发热,鼻塞咳嗽,时行疮疹。
组成:人参(七分),细辛(五分),桔梗、干葛、升麻、白术、茯苓、柴胡(各七分),薄荷、甘草(各五分)。
用法:每次服用,用水一钟,加三片姜,煎至五分,不拘时候服用。
红绵散,治疗小儿四季感冒寒风,遍身发热,变蒸诸惊,胎惊丹毒等热证,全部治疗,以及急慢惊风,也适宜服用。
组成:人参(二钱半),天麻(洗),僵蚕(炒),麻黄(去节),全蝎(去毒。各二钱),甘草(炙),辰砂(一钱半,细研)。
用法:以上药物制成粉末,然后加入朱砂混合均匀,再次研磨极细。每次服用半钱,用水半盏,煎煮数沸,加入少许干胭脂,再煎一沸,温热服用,不拘时候。
惺惺散(见“痘”章节)
[Qian Yi] Fever without thirst indicates heat in the exterior. Fever with thirst indicates heat in the interior.
[Hai Zang] Sishun Yin (Four-Compliant Decoction) treats heat in the interior without cold extremities. Liaoqiao Yin (Forsythia Decoction) treats heat in the exterior without cold extremities.
[Xue Ji] High fever with aversion to wind and cold indicates deficiency-heat of the exterior due to insufficient Yuan Qi (Original Qi). High fever without aversion to wind and cold indicates excess-heat of the exterior due to invasion by exogenous pathogens. High fever with desire to drink hot liquids indicates deficiency-heat of the interior due to shortness of body fluids. High fever with desire to drink water indicates excess-heat of the interior due to consumption by internal fire.
Commentary: Wind-strike (Shang Feng) presents with aversion to wind, while Cold damage (Shang Han) presents with aversion to cold. How can one attribute aversion to wind and cold solely to insufficient Yuan Qi, and absence thereof to exogenous pathogen invasion? Although Xue Ji’s intent was comprehensive, his expression was rigid. One must carefully distinguish between external contraction and internal injury according to Li Dongyuan’s *Pi Wei Lun* (Treatise on the Spleen and Stomach) to avoid errors.
Xue Ji stated: For fever with normal urination and defecation, caused by wind pathogen stagnating in the interior, use Xingxing San (Jubilant Powder) plus Mahuang (Ephedrae Herba) to induce sweating.
Baidu San (Decoction for Resisting Toxins) treats wind-strike, plague, wind-dampness, dizziness of head and eyes, pain in limbs, severe chills with high fever, stiffness of the neck and pain in eyes, or aversion to cold with cough, nasal congestion with heavy voice.
Ingredients: Chaihu (Bupleuri Radix), Qianhu (Peucedani Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhike (Aurantii Fructus Immaturus, stir-fried), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Fuling (Poria), Jiegeng (Platycodonis Radix), Renshen (Ginseng Radix et Rhizoma) (each 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (0.5 liang).
Usage: Take 2 qian of the above herbs, decoct with fresh ginger and Bohe (Menthae Haplocalycis Herba) in water.
Xiaofeng San (Wind-Expelling Powder) treats infants whose umbilical cord has fallen off, allowing wind pathogen to lodge in skin and hair, entering viscera and bowels, causing aversion to wind and fever, phlegm-saliva in chest and diaphragm, dry eyes and excessive sleep. (This is Xiaofeng Wan, see "Wind Epilepsy".)
Qingjie San (Clearing and Dispersing Powder) treats fever and headache from wind invasion, nasal congestion with runny nose, and warm-high fever; it treats all such conditions.
Ingredients: Beishen (Codonopsis Radix or Ginseng Radix), Fangfeng (Saposhnikoviae Radix), Tianma (Gastrodiae Rhizoma), Bei Qianhu (Peucedani Radix), Fuling (Poria), Bei Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus Immaturus, sliced), Gancao (Glycyrrhizae Radix et Rhizoma) (each 2 qian), Xixin (Asari Radix et Rhizoma), Chaihu (Bupleuri Radix) (each 1.5 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma) (3 qian).
Usage: Grind into powder. Take 1 qian, add a small cup of water and three dried leaves of Bohe (Menthae Haplocalycis Herba), simmer slightly, and take warm.
Jiyan Fang Jingzhu San (Jingzhu Powder from Collected Proven Prescriptions) treats wind-strike and cold damage in infants, or sores and rashes. This medicine is neither cold nor hot; it disperses wind and regulates qi. It treats all kinds of heat syndromes.
Ingredients: Jingjiesui (Schizonepetae Spica), Chi Shaoyao (Paeoniae Radix Rubra) (each 1 liang), Cangzhu (Atractylodis Rhizoma, 2 liang, processed), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, stir-fried).
Usage: Grind into fine powder. Take 1-2 qian according to age. Also known as Chonghe San (Harmonizing Powder). For wind-strike/cold damage, high fever, cough, nasal congestion with heavy voice, take with Ginger and Congbai (Allii Fistulosi Bulbus) decoction. For wind-strike tidal fever or Bianzheng fever, take with Bohe (Menthae Haplocalycis Herba) decoction. For wind-heat injuring lungs with profuse nasal discharge and coarse breathing, take with Zisu (Perillae Folium) decoction. For sudden acute convulsions due to wind-heat, use Shufeng San (Wind-Expelling Powder) from the Acute Convulsion section. For convulsions after prolonged illness, use Quanxie San (Scorpio Powder) from Baoying. For inducing sweating, take with Mahuang Tang (Ephedra Decoction) minus joints. For night sweats and spontaneous sweating, take with Muli (Ostreae Shell) and Fumai (Triticum Levis Fructus) decoction. For erysipelas and wind-heat, take with Sishun Yin (Four-Compliant Decoction) decoction. For sudden red, hot, swollen eyes, take with Qianghuo (Notopterygii Rhizoma et Radix), Huangqin (Scutellariae Radix), and Shengdihuang (Rehmanniae Radix Recens) decoction. For hot swelling and sores on mouth, tongue, cheeks, and neck, take with Fangfeng (Saposhnikoviae Radix) and Niubangzi (Arctii Fructus) decoction. For double tongue in throat, take with Shengma (Cimicifugae Rhizoma), Zhike (Aurantii Fructus Immaturus), Dahuang (Rhei Radix et Rhizoma), Fangfeng (Saposhnikoviae Radix), and Bohe (Menthae Haplocalycis Herba) decoction.
Renshen Qianghuo San (Ginseng and Notopterygium Powder) treats cold damage with fever, headache and body ache, or tidal fever with irritability and thirst, phlegm-fullness with cough.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix), Bai Duhuo (Angelicae Pubescentis Radix), Chaihu (Bupleuri Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Renshen (Ginseng Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Bai Fuling (Poria), Zhike (Aurantii Fructus Immaturus) (each 1 liang), Qianhu (Peucedani Radix), Jiegeng (Platycodonis Radix), Digupi (Lycii Cortex), Tianma (Gastrodiae Rhizoma, wine-soaked, baked. each 0.5 liang).
Usage: Cut into pieces. Take 1 qian, add half a cup of water, one slice of ginger, half a jujube, and one leaf of Bohe (Menthae Haplocalycis Herba), decoct, and take warm at any time. It can also be taken before the eruption of sores and rashes.
Qianghuo San (Notopterygium Powder) treats wind-strike and seasonal miasma, headache with fever, body aches, phlegm obstruction with cough and loss of voice, nasal congestion with heavy voice, and resolves epidemic dysentery with pus and blood.
Ingredients: Renshen (Ginseng Radix et Rhizoma, remove rhizome), Qianghuo (Notopterygii Rhizoma et Radix), Chi Fuling (Poria, remove bark), Chaihu (Bupleuri Radix, remove rhizome), Qianhu (Peucedani Radix, remove rhizome), Chuanxiong (Ligustici Chuanxiong Rhizoma), Duhuo (Angelicae Pubescentis Radix), Jiegeng (Platycodonis Radix, cut and stir-fried), Zhike (Aurantii Fructus Immaturus), Cangzhu (Atractylodis Rhizoma) (each prepared as above), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 liang).
Usage: Cut into pieces. Take 2 qian, add one cup of water, two slices of ginger, three leaves of Bohe (Menthae Haplocalycis Herba), decoct until reduced to 70%, and take warm at any time. To disperse wind pathogen, decoct together with Congbai (Allii Fistulosi Bulbus). For dysentery, decoct with Jiangcangmi (Ginger-treated Rice).
Renshen Xinggeng Tang (Ginseng, Asarum, and Platycodon Decoction) treats infant wind-strike with fever, nasal congestion and cough, and epidemic sores/rashes.
Ingredients: Renshen (Ginseng Radix et Rhizoma, 0.7 fen), Xixin (Asari Radix et Rhizoma, 0.5 fen), Jiegeng (Platycodonis Radix), Gange (Puerariae Lobatae Radix), Shengma (Cimicifugae Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Chaihu (Bupleuri Radix) (each 0.7 fen), Bohe (Menthae Haplocalycis Herba), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.5 fen).
Usage: Take one zhong of water per dose, add three slices of ginger, decoct until reduced to 0.5 zhong, and take at any time.
Hongmian San (Red Cotton Powder) treats infants suffering from cold wind in all seasons, generalized fever, various convulsions during Bianzheng (physiological fever in infants), fetal convulsions, erysipelas, and other heat syndromes; it also treats acute and chronic convulsions.
Ingredients: Renshen (Ginseng Radix et Rhizoma, 2.5 qian), Tianma (Gastrodiae Rhizoma, washed), Jiangcan (Bombyx Batryticatus, stir-fried), Mahuang (Ephedrae Herba, remove joints), Quanxie (Scorpio, detoxified. each 2 qian), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Chencha (Cinnabaris, 1.5 qian, finely ground).
Usage: Grind the above ingredients into powder, then mix with ZhuSha (Cinnabar), and grind again until extremely fine. Take 0.5 qian, add half a cup of water, boil several times, add a little dried Carthami Flos (Zi Cao), boil once more, and take warm at any time.
Xingxing San (Jubilant Powder) (see "Smallpox" section)