辛散太阳法∶(见前)
挽正回阳法∶(见前)
甘热祛寒法∶治寒邪直中三阴之证。
甘草(二钱,炙) 淡干姜(一钱) 淡附片(一钱) 淡吴萸(一钱)
用开水略煎,冷服。
此即仲景四逆汤也。拟加吴萸之大热,祛厥阴之寒邪,以之治寒中三阴,最为中的。 庵原解曰∶寒淫
于内,治以甘热,故以姜、附大热之剂,伸发阳气,表散寒邪;甘草亦散寒补中之品,又以缓姜、附之上僭
也。必冷服者,寒盛于中,热饮则格拒不纳,经所谓“热因寒用”,又曰“治寒以热,凉而行之”是也。
辛凉解表法∶(见前)
清凉透邪法∶(见前)
祛热宣窍法∶(见前)
辛温解表法∶(见前)
凉解里热法∶(见前)
麻黄汤∶治伤寒太阳病,恶寒发热,头痛项强,无汗而喘,脉浮而紧者。
麻黄 桂枝 杏仁 甘草
水煎,温服,覆取微汗。
葛根汤∶治伤寒太阳未罢,又传阳明,脉浮长,缘缘面赤,
头痛连额,发热恶寒而无汗,目痛鼻干不得眠等证。
葛根 麻黄 桂枝 白芍 甘草 生姜 大枣
水煎,温服,取微似汗。
小柴胡汤∶治伤寒少阳病,往来寒热,口苦耳聋,胁满脉弦,目眩,不欲食,心烦喜呕,及妇
人伤寒,热入血室等证。
柴胡 人参 制夏 黄芩 甘草 生姜 大枣
水煎,温服。
理中汤∶治伤寒太阴病,自利不渴,寒多而呕,腹痛便溏,
脉沉无力,或厥冷拘急,或结胸吐蛔,及感寒霍乱。
人参 白术 炮姜 炙草
本方加附子名附子理中汤。
真武汤∶治少阴伤寒腹痛,小便不利,四肢沉重疼痛,自下利者,此为有水气,或咳或呕,或小
便利,及太阳病发汗,汗出不解,仍发热,心悸头眩,筋惕肉 ,振振欲擗地,气虚恶寒。
附子 白芍 白术 茯苓
加生姜,煎服。
四逆汤∶治三阴伤寒,身痛腹痛,下痢清谷,恶寒不渴,四肢厥冷,或反不恶寒,面赤烦躁,
里寒外热,或干呕,或咽痛,脉沉微细欲绝。
附子 干姜 炙甘草
水煎,冷服。
丰按∶伤寒之方,计有一百一十三道,长沙书中,已全备矣。凡学医者,必须熟玩。今录此六方,
不过明六经伤寒之用,其寒邪化热,及传变诸方,不能尽录,当阅伤寒之书,自明着矣。
千金阳旦汤∶治冬温脉浮发热,项强头痛。
桂枝 白芍 黄芩 甘草
加姜、枣,煎服。
千金阴旦汤∶治冬温内寒外热,肢节疼痛,中挟寒食。
即阳旦汤加干姜。
丰按∶阳旦汤,主治先感冬温,又被风寒所遏之病。阴旦汤主治体质本寒,忽受冬温之病。如咳嗽口
渴甚者,姜、桂究难浪用。凡一切温热之病,最忌辛温之药,偶或用之,非本质
属寒,即外加寒气,倘拘于阳旦阴旦,为冬温一定之方,不亦惑乎!
辛散太阳法:(见前文)
挽正回阳法:(见前文)
甘热祛寒法:治疗寒邪直接侵入三阴经的证候。
甘草(二钱,蜜炙) 淡干姜(一钱) 淡附片(一钱) 淡吴茱萸(一钱)
用开水略加煎煮,放冷后服用。
这就是张仲景的四逆汤(Sini Decoction)。拟加入大热的吴茱萸,以祛除厥阴经的寒邪,用来治疗寒邪直中三阴,最为对症。庵原注解道:寒邪淫溢于体内,应用甘热之品治疗,所以用干姜、附子等大热药物,来振奋阳气,表散寒邪;甘草也是散寒补中的药物,同时又能缓和干姜、附子上冲僭越的副作用。必须冷服的原因在于,体内寒盛,若热饮则会格拒不受,这正是《内经》所说的“热因寒用”,又说“治疗寒证用热药,但要凉着服用”。
辛凉解表法:(见前文)
清凉透邪法:(见前文)
祛热宣窍法:(见前文)
辛温解表法:(见前文)
凉解里热法:(见前文)
麻黄汤(Ephedra Decoction):治疗伤寒太阳病(Taiyang Disease),症见恶寒发热、头痛项强、无汗而喘、脉浮紧。
麻黄 桂枝 杏仁 甘草
水煎,温服,服药后覆盖衣被以取得微汗。
葛根汤(Pueraria Decoction):治疗伤寒太阳病未愈,又传入阳明经,脉象浮长,面色缘缘发赤,头痛连及额部,发热恶寒且无汗,目痛鼻干不得眠等证候。
葛根 麻黄 桂枝 白芍 甘草 生姜 大枣
水煎,温服,取微似汗出。
小柴胡汤(Minor Bupleurum Decoction):治疗伤寒少阳病(Shaoyang Disease),症见往来寒热、口苦耳聋、胁肋胀满脉弦、目眩、不欲饮食、心烦喜呕,以及妇女伤寒,热入血室等证候。
柴胡 人参 制半夏 黄芩 甘草 生姜 大枣
水煎,温服。
理中汤(Regulate the Middle Decoction):治疗伤寒太阴病(Taiyin Disease),症见自利不渴、寒多而呕、腹痛便溏、脉沉无力,或四肢厥冷拘急,或结胸吐蛔,以及感受寒邪导致的霍乱。
人参 白术 炮姜 炙甘草
本方加入附子名为附子理中汤(Aconite Regulate the Middle Decoction)。
真武汤(True Warrior Decoction):治疗少阴伤寒(Shao Yin Cold Damage)腹痛,小便不利,四肢沉重疼痛,自下利者,此为有水气,或咳嗽或呕吐,或小便利,以及太阳病发汗后,汗出不解,仍发热,心悸头眩,筋肉跳动,身体震颤欲倒在地上,气虚恶寒。
附子 白芍 白术 茯苓
加入生姜,煎服。
四逆汤(Sini Decoction):治疗三阴伤寒,身痛腹痛,下痢清谷(大便中有未消化的食物),恶寒不渴,四肢厥冷,或反而不恶寒,面赤烦躁,里寒外热,或干呕,或咽痛,脉沉微细欲绝。
附子 干姜 炙甘草
水煎,冷服。
雷丰按语:伤寒的方剂,共计有一百一十三首,在长沙(指张仲景)的书中已经完备了。凡是学医的人,必须熟读玩味。现在只收录这六首方剂,不过是为了阐明六经伤寒的用法,那些寒邪化热,以及传变的其他方剂,不能全部收录,应当阅读《伤寒论》一书,自然明了。
千金阳旦汤(Qianjin Yangdan Decoction):治疗冬温病,脉浮发热,项强头痛。
桂枝 白芍 黄芩 甘草
加入姜、枣,煎服。
千金阴旦汤(Qianjin Yindan Decoction):治疗冬温病内寒外热,肢节疼痛,中挟寒食积滞。
即阳旦汤加入干姜。
雷丰按语:阳旦汤,主治先感受冬温,又被风寒所遏制的病证。阴旦汤主治体质本寒,忽然感受冬温的病证。如咳嗽口渴严重的,姜、桂终究难以随意使用。凡是一切温热性质的疾病,最忌辛温的药物,偶尔使用,如果不是本质属寒,就是外加寒气,倘若拘泥于阳旦汤和阴旦汤是治疗冬温的固定方剂,不是糊涂吗!
Xin San Taiyang Method: (See previous text)
Wan Zheng Hui Yang Method: (See previous text)
Gan Re Qu Han Method: Treats syndromes where cold pathogen directly invades the Three Yin meridians.
Gancao (2 qian, honey-fried), Dan Ganjiang (1 qian), Dan Fupian (1 qian), Dan Wuzhu Yu (1 qian).
Briefly decoct in boiling water and take when cool.
This is Zhang Zhongjing's Sini Decoction (Sini Tang). It is proposed to add Wu Zhu Yu, which is extremely hot, to dispel cold pathogen from the Jueyin meridian; using it to treat cold invading the Three Yin meridians is most accurate. An Yuan’s commentary states: When cold overflows internally, treat with sweet and hot substances; therefore, use Gan Jiang and Fu Zi, agents of great heat, to stimulate yang qi and disperse cold pathogen externally; Gan Cao is also an agent that disperses cold and tonifies the middle, while simultaneously moderating the upward rebellion of Gan Jiang and Fu Zi. The reason for taking it cool is that cold is abundant in the interior; if taken hot, it will be rejected and not accepted. This corresponds to the Classic saying "use heat due to cold" (Re Yin Han Yong), and also "treat cold with heat, but administer it cool" (Zhi Han Yi Re, Liang Er Xing Zhi).
Xin Liang Jie Biao Method: (See previous text)
Qing Liang Tou Xie Method: (See previous text)
Qu Re Xuan Qiao Method: (See previous text)
Xin Wen Jie Biao Method: (See previous text)
Liang Jie Li Re Method: (See previous text)
Mahuang Tang (Ephedra Decoction): Treats Taiyang Disease caused by Cold Damage, characterized by aversion to cold and fever, headache and stiffness of the neck, absence of sweating and wheezing, and a floating and tight pulse.
Mahuang, Guizhi, Xingren, Gancao.
Decoct in water, take warm, cover with blankets to induce slight sweating.
Gegen Tang (Pueraria Decoction): Treats Cold Damage where the Taiyang stage has not resolved and has transmitted to the Yangming stage, with a floating and long pulse, continuous redness of the face, headache extending to the forehead, fever and aversion to cold without sweating, eye pain, dry nose, and inability to sleep.
Gegen, Mahuang, Guizhi, Baishao, Gancao, Shengjiang, Dazao.
Decoct in water, take warm, aim for slight sweating.
Xiaochaihu Tang (Minor Bupleurum Decoction): Treats Shaoyang Disease caused by Cold Damage, characterized by alternating chills and fever, bitter taste in the mouth and deafness, fullness and distension in the hypochondrium with a wiry pulse, dizziness, lack of appetite, irritability and frequent vomiting, as well as in women with Cold Damage where heat enters the Blood Chamber.
Chaihu, Renshen, Zhi Banxia, Huangqin, Gancao, Shengjiang, Dazao.
Decoct in water, take warm.
Lizhong Tang (Regulate the Middle Decoction): Treats Taiyin Disease caused by Cold Damage, characterized by spontaneous diarrhea without thirst, excessive cold and vomiting, abdominal pain and loose stools, sinking and powerless pulse, or cold limbs with cramping, chest knotting with expulsion of roundworms, and Cold-induced Huoluan (cholera-like disease).
Renshen, Baizhu, Pao Jiang, Zhigancao.
Adding Fuzi to this formula creates Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction).
Zhenwu Tang (True Warrior Decoction): Treats Shao Yin Cold Damage with abdominal pain, difficulty in urination, heaviness and pain in the four limbs, and spontaneous diarrhea, indicating the presence of fluid retention. It may also present with cough or vomiting, or clear urination. Additionally, it treats cases where after inducing sweating for Taiyang Disease, the condition does not resolve, fever persists, palpitations and dizziness occur, muscle twitching happens, the body trembles as if wanting to fall to the ground, and there is Qi deficiency with aversion to cold.
Fuzi, Baishao, Baizhu, Fuling.
Add Shengjiang and decoct.
Sini Tang (Sini Decoction): Treats Three Yin Cold Damage, characterized by body and abdominal pain, diarrhea with undigested food, aversion to cold without thirst, cold limbs, or conversely no aversion to cold with red face and irritability, internal cold with external heat, dry heaving, sore throat, and a sinking, minute, thin pulse nearly imperceptible.
Fuzi, Ganjiang, Zhigancao.
Decoct in water and take cool.
Lei Feng’s Note: There are one hundred and thirteen formulas for Cold Damage in total, all fully prepared in Changsha’s [Zhang Zhongjing’s] book. Any medical student must study them thoroughly. I record only these six formulas here merely to clarify their application in the Six Meridians Cold Damage. Formulas for when cold pathogen transforms into heat and various transmission patterns cannot be fully recorded; one should consult the Shanghan Lun (Treatise on Cold Damage) to understand them clearly.
Qianjin Yangdan Tang (Qianjin Yangdan Decoction): Treats Winter Warmth disease with floating pulse, fever, stiffness of the neck, and headache.
Guizhi, Baishao, Huangqin, Gancao.
Add Jiang and Zao, decoct and take.
Qianjin Yindan Tang (Qianjin Yindan Decoction): Treats Winter Warmth disease with internal cold and external heat, pain in joints and extremities, complicated by cold-food stagnation.
It is Yangdan Tang plus Ganjiang.
Lei Feng’s Note: Yangdan Tang primarily treats diseases where Winter Warmth was initially contracted and then suppressed by Wind-Cold. Yindan Tang primarily treats diseases where the constitution is inherently cold but suddenly contracts Winter Warmth. In cases of severe cough and thirst, Jiang and Gui are ultimately difficult to use indiscriminately. All warm-heat diseases strictly forbid acrid-warm herbs; occasional use is only justified if the underlying nature is cold or external cold is added. If one rigidly adheres to Yangdan Tang and Yindan Tang as fixed formulas for Winter Warmth, would this not be confused?