(仲景) 治伤寒太阳证,邪气在表。发热头痛,身痛腰痛骨节痛,项背强,恶寒,恶
风,(但有一毫头痛恶寒。尚为在表。)无汗而喘,脉浮而紧。
亦治太阳阳明合病,喘而胸满。(表邪壅盛,阳气不得宜发,故逆而作喘。若心下满腹
痛为
宜
发
而
且肺内有胶固之痰,复感寒而作。此汤散寒利肺,然唯气实者,可暂用。)
麻黄(去节三两) 桂枝(二两) 杏仁(七十枚去皮尖) 甘草(炙一两)先煮麻黄
数沸,去沫,
去节,醋汤
汗出则愈。
表证当汗
汗当急而
微和,
生,寒
卫和,始
以甘热,
除桂枝,加石膏,名麻黄杏仁甘草石膏汤。(仲景)仲景曰∶发汗后,不可更行桂枝汤,
汗出
用过
以伤
石膏
问发
治
所
治足
先热后
汗为宜,
法。故以
有火攻之
曰∶水之
而加小,
水,发其
里水皆出
兼责阳
附子汤
汤。即
此方耶
加附子
脉浮者
不若以脉
子方尔。
仁。名
曰∶里
即有
水,
水尔
风寒,咳嗽
补中有泻也
忌汗诸证。伤寒伤风辨。阴阳表里辨。
仲景曰∶太阳中风,脉浮紧,发热恶寒,身疼痛,不汗出而烦躁者,大青龙汤主
脉微弱,汗出恶风者,不可服。服之而厥逆,筋惕肉 ,此为逆也,以真武汤救之。
又曰∶伤寒脉浮缓,身不疼,但重,乍有轻时,无少阴证者,大青龙汤发之。(喻嘉言
曰∶
黄二
之欲
在表
麻黄(六两) 甘草(炙) 桂枝(二两) 杏仁(四十枚去皮尖) 石膏(鸡子大块)
生姜(三两)
仲景制方之意,本是桂枝麻黄二汤合用,易芍药以石膏者。所以胜寒郁之内热,且以助
青龙
及
逆
(张仲景)治疗伤寒太阳经证,邪气在体表。出现发热、头痛、全身疼痛、腰痛、骨节疼痛、项背部僵硬、恶寒、恶风的症状。(只要有一点点头痛和恶寒,就说明病邪仍在体表。)无汗且气喘,脉象浮而紧。
也治疗太阳与阳明合病,表现为气喘且胸部胀满。(这是因为表邪壅盛,阳气不能宣发,所以气逆而作喘。如果心下胀满、腹部疼痛,则适宜使用发汗法。而且肺内有胶固的痰饮,又感受寒邪而发作。此汤能散寒利肺,但只有正气充足的人,才可以暂时使用。)
麻黄(去节三两) 桂枝(二两) 杏仁(七十枚,去皮尖) 甘草(炙一两)。先煮麻黄数沸,去掉浮沫,去节,用醋汤煎煮。出汗后病愈。
表证应当发汗。发汗应当急迫且微微持续,以调和营卫为度,始得生发之机,用甘热之药除桂枝,加石膏,名为麻黄杏仁甘草石膏汤。(张仲景)张仲景说:发汗后,不可再用桂枝汤,因为会伤阴助火。问发汗的方法。治所治足先热后汗为宜,法。故以有火攻之曰:水之水,而加小,水,发其里水皆出兼责阳附子汤汤。即此方耶加附子脉浮者不若以脉子方尔。仁。名曰:里即有水,水尔风寒,咳嗽补中有泻也忌汗诸证。伤寒伤风辨。阴阳表里辨。
张仲景说:太阳中风,脉浮紧,发热恶寒,身体疼痛,无汗且烦躁的,用大青龙汤主治。如果脉微弱,汗出恶风的,不可服用。服用了会导致四肢厥冷,筋肉跳动抽搐,这是误治,应用真武汤来救治。
又说:伤寒脉浮缓,身体不疼,只是沉重,偶尔有减轻的时候,没有少阴证的,用大青龙汤发汗。(喻嘉言说:)
(Zhang Zhongjing) Treats Taiyang syndrome (Taiyang disease) of cold damage, where pathogenic factors are in the exterior. Symptoms include fever, headache, body pain, lower back pain, joint pain, stiffness of the neck and back, aversion to cold, and aversion to wind. (As long as there is even a slight headache and aversion to cold, it indicates the pathogen remains in the exterior.) Absence of sweating with wheezing, pulse floating and tight.
It also treats combined diseases of Taiyang and Yangming, presenting with wheezing and chest fullness. (This is because exterior pathogens are congested, preventing the proper dispersion of Yang Qi, leading to rebellious Qi causing wheezing. If there is fullness below the heart and abdominal pain, dispersing methods are appropriate. Furthermore, if there is tenacious phlegm in the lungs compounded by a new cold contraction, this decoction disperses cold and benefits the lungs; however, it should only be used temporarily for those with robust Qi.)
Ephedrae Herba (Mahuang, 麻黄) (3 liang, nodes removed) Cinnamon Twig (Guizhi, 桂枝) (2 liang) Apricot Seed (Xingren, 杏仁) (70 seeds, skin and tips removed) Licorice Root (Gancao, 甘草) (1 liang, honey-fried). Boil Ephedra first for several boils, remove the foam, remove nodes, decoct with vinegar water. Cure is achieved when sweat appears.
Exterior syndromes require diaphoresis. Diaphoresis should be prompt yet mild and sustained, harmonying Ying and Wei (Nutritive and Defensive levels), initiating life-generating mechanisms, using sweet-hot herbs. Remove Cinnamon Twig, add Gypsum, named Mahuang Xinggan Caoshigao Tang (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction). (Zhang Zhongjing) Zhang Zhongjing said: After inducing sweating, Guizhi Tang (Cinnamon Twig Decoction) should not be administered again, as it may injure Yin and aid Fire. Regarding the method of inducing sweating... [Text contains fragmented/corrupted passages regarding fire therapy, water retention, Fu Zi Tang (Aconite Decoction), etc.] ...differentiating between Cold Damage and Wind Strike, and Yin-Yang Exterior-Interior.
Zhang Zhongjing said: For Taiyang Wind Strike, if the pulse is floating and tight, with fever, aversion to cold, body pain, absence of sweating, and irritability, Da Qinglong Tang (Great Azure Dragon Decoction) is the primary treatment. If the pulse is weak and faint, with sweating and aversion to wind, it must not be taken. Taking it will lead to cold limbs (Jue Ni, 厥逆) and twitching muscles/fasciculations (Jin Ti Rou Tiao, 筋惕肉瞤), which constitutes an adverse reaction; Zhen Wu Tang (True Warrior Decoction) should be used to rescue the patient.
He also said: In cold damage, if the pulse is floating and slow, the body does not ache but feels heavy, occasionally becoming lighter, and there are no Shaoyin syndrome signs, Da Qinglong Tang (Great Azure Dragon Decoction) should be used to induce sweating. (Yu Jiayan stated:)
Ephedrae Herba (Mahuang, 麻黄) (6 liang) Licorice Root (Gancao, 甘草) (fried) Cinnamon Twig (Guizhi, 桂枝) (2 liang) Apricot Seed (Xingren, 杏仁) (40 seeds, skin and tips removed) Gypsum (Shigao, 石膏) (size of a chicken egg) Ginger Root (Shengjiang, 生姜) (3 liang).
The intention behind Zhang Zhongjing's formulation was originally to combine Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction), replacing Red Peony Root (Shaoyao, 芍药) with Gypsum. This serves to overcome internal heat constrained by cold pathogens and assists... [Text ends abruptly]