治阳明表热下利。兼治痘疹初发。
钱氏升麻葛根汤。芍药甘草合成方。(升麻三钱。葛根芍药各二钱。炙草一钱。)阳明发
热兼头痛。(及目痛鼻干不得卧等症。)下利生斑疹痘良。
新订症同太阳。而目痛鼻干不眠称阳明者。是阳明自病。而非太阳转属也。此方仿仲景
葛根汤。恶姜桂之辛热。大枣之甘壅而去之。以升麻代麻黄。便是阳明表剂。与太阳表剂迥
别。葛根甘凉。生津去实。挟升麻。可以托散本经自病之肌热。并可以升提与太阳合病之自
利也。然阳明下利。即是胃实谵语之兆。故以芍药之苦甘。合用以养津液。津液不干。则胃
不实矣。至于疹痘。自里达表内外皆热之症。初起亦须凉解。
六经中风之通剂。
小续命汤(子金)桂附芎。麻黄参芍杏防风。黄芩防己兼甘草。风中诸经以此通。(通
治
六经中风。 邪不遂。语言謇滞。及刚柔二痉。亦治厥阴风泻。防风一钱一分。桂枝麻黄人
参酒芍杏仁川芎黄芩防己甘草各八分。附子四分。姜枣煎服。)
陈修园曰。天地之噫气为风。和风则生长万物。疾风则摧折万物。风之伤人者。皆带严
寒肃杀之气。故此方桂芍姜草。即伤寒论之桂枝汤。麻杏甘草。即伤寒论之麻黄汤。二方合
用。立法周到。然风动则火升。故用黄芩以降火。风胜则液伤。故用人参以生液。血行风自
灭。故用芎芍以行血。防风驱周身之风。为拨乱返正之要药。附子补肾命之根。为胜邪固本
之灵丹。防己纹如车辐。有升转循环之用。以通大经小络。药品虽多。而丝丝入扣。孙真人
询仲景下之一人也。
钱乙的升麻葛根汤,由芍药和甘草合成方剂。(升麻三钱,葛根、芍药各二钱,炙甘草一钱。)阳明经发热兼有头痛。(以及目痛、鼻干、不能安卧等症状。)对于下利并出现斑疹痘疮的情况疗效良好。
新订病症与太阳病相同,但出现目痛、鼻干、不眠而被称为阳明病的,是阳明经自感外邪所致,而非由太阳病传变而来。此方仿照张仲景的葛根汤,因厌恶生姜、桂枝的辛热之性,以及大枣的甘腻壅滞之弊,故去除了这两味药。用升麻代替麻黄,便成为治疗阳明经表证的方剂,这与治疗太阳经表证的方剂截然不同。葛根味甘性凉,能生津液、祛除实热,配合升麻,可以透散本经(阳明经)自感外邪所致的肌表发热,并且可以提升清气,治疗与太阳经合病导致的自发性下利。然而,阳明经下利,往往是胃中燥实、谵语的先兆,所以用芍药的苦甘之性,配合使用以滋养津液。津液不枯竭,则胃中就不会燥实。至于疹痘,属于从体内达于体表、内外皆热的病症,初起时也需要用清凉解表的方法治疗。
六经中风的通用方剂。
小续命汤(出自《子金》/或指孙思邈相关记载):桂枝、附子、川芎;麻黄、人参、芍药、杏仁、防风;黄芩、防己、甘草。风中诸经以此方通治。(通治六经中风,导致肢体不遂、语言謇涩,以及刚痉、柔痉两种痉挛病症,也治疗厥阴经风邪导致的泄泻。处方:防风一钱一分,桂枝、麻黄、人参、酒白芍、杏仁、川芎、黄芩、防己、甘草各八分,附子四分,加生姜、大枣煎服。)
陈修园说:天地之气郁结发出的声音称为“噫”,这种气化为风。和风则使万物生长,疾风则摧折万物。风邪伤害人体,都带有严寒肃杀之气。因此,此方中的桂枝、芍药、生姜、甘草,就是《伤寒论》中的桂枝汤;麻黄、杏仁、甘草,就是《伤寒论》中的麻黄汤。两方合并使用,立法周全严密。然而,风动则火升,所以用黄芩来降火;风胜则津液损伤,所以用人参来滋生津液;血行通畅则风邪自灭,所以用川芎、芍药来活血行血;防风驱散周身之风,是拨乱反正的关键药物;附子补肾命之门,是战胜邪气、巩固根本的灵丹妙药;防己纹理如车轮辐条,具有升转循环的作用,用以疏通大经和小络。药品虽然众多,但丝丝入扣,配合严谨。孙真人曾向张仲景请教,张仲景只教了他一个方子。
Treats diarrhea caused by exterior heat of the Yangming channel. Also treats the initial eruption of smallpox and chickenpox.
Qian Yi's Shengma Gegen Decoction (Cinnamon Twig and Pueraria Root Decoction) is composed of Shaoyao (Paeoniae Radix Alba) and Gancao (Glycyrrhizae Radix et Rhizoma Preparata). [Shengma (Cimicifugae Rhizoma) 3 qian, Gegen (Puerariae Radix) and Shaoyao each 2 qian, Zhi Cao (Prepared Licorice Root) 1 qian.] For Yangming fever accompanied by headache, [as well as symptoms such as eye pain, nasal dryness, and inability to sleep], it is effective for diarrhea with the appearance of macules, papules, or pustules.
The newly defined syndrome presents similarly to Taiyang disease, but is termed Yangming disease due to symptoms like eye pain, nasal dryness, and insomnia. This indicates a primary pathogenic invasion of the Yangming channel itself, rather than transmission from Taiyang. This formula imitates Zhang Zhongjing's Gegen Tang (Pueraria Root Decoction). It omits Shengjiang (Zingiberis Rhizoma Recens), Guizhi (Cinnamomi Ramulus), and Dazao (Jujubae Fructus) because it avoids the acrid-warm nature of ginger and cinnamon twig, and the cloying-sweet stagnation of jujube. By substitions Shengma (Cimicifugae Rhizoma) for Mahuang (Ephedrae Herba), it becomes an exterior-releasing agent for Yangming, distinct from those used for Taiyang. Gegen is sweet and cool; it generates fluids and clears excess heat. Combined with Shengma, it can vent and disperse the exterior heat originating from the Yangming channel itself, and can also lift clear yang to treat spontaneous diarrhea associated with combined Taiyang-Yangming involvement. However, diarrhea in Yangming often signals impending gastric excess and delirious speech. Therefore, Shaoyao’s bitter and sweet properties are used to nourish body fluids. If body fluids are not depleted, the stomach will not become dry and excessive. As for rashes and pox, they are conditions where heat exists both internally and externally, spreading from inside to outside. In the early stage, cooling and resolving methods are required.
A universal formula for wind-stroke affecting the Six Channels.
Xiao Xuming Tang (Minor Continuation Life Decoction): Guizhi (Cinnamomi Ramulus), Fuzi (Aconiti Lateralis Radix Praeparata), Chuanxiong (Chuanxiong Rhizoma); Mahuang (Ephedrae Herba), Renshen (Ginseng Radix et Rhizoma), Baishao (Paeoniae Radix Alba processed with wine), Xingren (Armeniacae Semen Amarum), Fangfeng (Saposhnikoviae Radix); Huangqin (Scutellariae Radix), Fangji (Stephaniae Tetrandrae Radix), Gancao (Glycyrrhizae Radix et Rhizoma). This formula treats wind-stroke affecting all six channels. [It universally treats wind-stroke causing limb paralysis, slurred speech, and both rigid (gang) and flaccid (rou) spasms. It also treats diarrhea caused by wind-pathogen in the Jueyin channel. Prescription: Fangfeng 1.1 qian, Guizhi, Mahuang, Renshen, Jiushaoyao (Wine-processed White Peony Root), Xingren, Chuanxiong, Huangqin, Fangji, Gancao each 0.8 qian, Fuzi 0.4 qian. Decoct with Shengjiang (Fresh Ginger) and Dazao (Jujube).]
Chen Xiuyuan stated: The sound emitted when heaven and earth exhale is called "yi" (groan/exhale), which transforms into wind. Gentle winds allow all things to grow, while violent winds destroy them. When wind pathogens injure humans, they carry the qi of severe cold and austere killing energy. Therefore, the combination of Guizhi, Shaoyao, Shengjiang, and Gancao in this formula constitutes the Guizhi Tang (Cinnamon Twig Decoction) from the *Shanghan Lun* (Treatise on Cold Damage); Mahuang, Xingren, and Gancao constitute the Mahuang Tang (Ephedra Decoction) from the *Shanghan Lun*. Combining these two formulas results in comprehensive therapeutic principles. However, since wind movement causes fire to rise, Huangqin (Scutellaria Root) is used to descend fire. Since wind dominance damages body fluids, Renshen (Ginseng) is used to generate fluids. When blood flows freely, wind extinguishes itself; thus, Chuanxiong and Shaoyao are used to promote blood circulation. Fangfeng (Saposhnikovia Root) drives out wind throughout the body and is a crucial herb for restoring order. Fuzi (Prepared Aconite) tonifies the root of Kidney and Mingmen (Gate of Vitality) and is a miraculous medicine for overcoming pathogens and consolidating the root. Fangji (Stephania Root), with its texture resembling wheel spokes, has the function of ascending and rotating circulation, used to unblock the large and small collaterals. Although there are many herbs, they are intricately coordinated. Sun Simiao once asked Zhang Zhongjing for guidance, and Zhang Zhongjing taught him only one formula.