夫伤寒心狂热者。缘心属火也。心主于血。阳气盛。则血并于阳。热邪攻于心络。则心
神烦乱。或默或歌。或言笑猖狂不已。言语失常。惊悸不安。弃衣而走。此皆热毒之气。壅
滞心胸。致令发狂也。重阳者狂。谓阳气独盛也。伤寒热毒既盛。内外皆热。则阳气愤嗔而
发为狂越。其病使人狂走妄言。或骂詈不避亲疏。或妄见妄闻。甚则至于弃衣而走。登高而
歌。或数日不食。逾垣上屋者。盖四肢诸阳之本也。热盛而四肢实。是为重阳。故所止处。
皆非素所能。而病乃能也。若乃因火为邪。而发为惊狂。及内有瘀血。而外证如狂。其为病
虽不同。然其为阳气有余则一也。伤寒发狂者。狂。猖狂也。谓其不宁也。难经曰。狂之始
发也。少卧不饥。而自高贤也。自辨智也。自贵倨也。妄笑好歌乐也。妄行走不休也。狂家
所起。皆阳盛致然。内经曰。阴不胜阳。脉留薄疾。并乃狂也。又曰。邪入于阳则狂。邪入
于阴。则喑。难经曰。重阳者狂。重阴者癫。脉经曰。阴附阳则狂。阳附阴则癫。病源曰。
阳邪并于阳。则狂。阴邪并于阴。则癫。即诸经之狂。为阳盛也明矣。又阳明之病。恶人与
火。闻木音则惕然而惊。心欲动。独闭户牖而处。甚则欲上高而歌。弃衣而走。逾垣上屋。
其所上之处。皆非素所能者。是谓阳邪并于阳明也。伤寒热毒在胃。并于心脏。使神不宁而
志不定。遂发狂也。伤寒至于发狂。为邪热至极也。非大吐下。则不能已。又有热在下焦。
其人如狂者。经曰。热入膀胱。其人如狂。谓之如狂。则未至于狂。但卧起不安尔。其或狂
言。目反直视。又为肾之绝。汗出辄复发狂也。言不能食。又为失志。死。若此。则殆非药
石之所及。是为甚病焉。
活人歌括云。发狂面赤属重阳。葶苈升麻及大黄。血证身黄仍漱水。尿多承气地黄汤。
阴邪并于阴则癫。阳邪并于阳则狂。伤寒热毒在胃。并入于心。遂使神志昏乱。言动急
速而发狂也。狂之发作。少卧不饥。妄语妄笑。妄倨妄辨。妄起妄行。弃衣而走。登高而歌。
甚则逾垣上屋。皆独阳亢热使之。非吐下不能止。有当汗不汗。瘀热在里。下焦蓄血。面如
狂者。小便必利。特如狂而未至于狂耳。其或熏熨迫汗。灼艾 。烧针。令人烦躁。卧起不
安。则谓之火邪惊狂。凡是数者。各有条例。若夫狂言直视。旋溺自遗。其与汗后热多。脉
躁狂言。不食。智者寒心。重阳即阳毒。脉数实。狂走错语。烦躁干呕。面赤咽痛。潮热发
斑。葶苈苦酒汤。阳毒升麻汤。栀子仁汤。三黄汤。大黄散。升麻葛根汤加大黄。狂走者。
水调瓜蒂末。吐痰。瓜蒂散亦可。吐血证如狂。脉微而沉。身黄唇燥。漱水不欲下咽。无寒
热。小腹硬满。小便利。大便微利而黑。轻者。犀角地黄汤。重者。桃仁承气汤。或抵当丸。
取尽黑物为效。张云。太阳病不解。热结膀胱。其人如狂。而血自下。下者愈。若外不解。
可与桂枝汤。外已解但小腹急结。乃以桃仁承气汤攻之。大抵伤寒当汗不汗。热蓄在里。热
化为血。故喜怒如狂。阳狂。寒水石、黄连末。各一钱。冷水调下。皆效。发斑妄语。未可
下者。龙胆草一物汤。火邪惊狂者。医家以火熏熨迫汗。及烧针灼艾而然也。其人亡阳烦躁
。卧起不安。金匮风引汤。柴胡加龙骨牡蛎汤。桂枝甘草龙骨牡蛎汤。又以火劫。腹满微喘
。口干咽烂。或大便不通。 语。小柴胡汤。黑豆解火邪汤。
方
龙骨救逆汤(出圣惠方)治伤寒脉浮。医以火劫。出汗太过。必亡阳。心生狂
热。起卧不安。
龙骨(一两) 桂心〔二(一)两〕 牡蛎(二两烧为粉) 茯神(一两) 人参(一
两去芦头)
麦门冬(二两去心焙) 甘草(二两炙微赤锉) 蜀漆(一两) 上捣粗罗为末。每服四钱。
水一
犀角散 治伤寒有狂热在心。恍惚。或多惊。不得睡卧。
犀角屑(三分) 茵陈(三分) 茯神(二两) 人参(一两去芦头) 栀子仁(半两)
赤芍药
(半两) 麦门冬(一两去心焙) 龙齿(三分) 川升麻(半两) 子芩(三分) 甘草
(三分炙微
水一中盏。入生姜半分。煎至六分。去滓。不计时候。温
核桃承气汤(出圣惠方)治伤寒病不解。热结在膀胱者。其人如狂。血自下。
愈。外未解。不可下。先解其外。解已。但小腹结者。可下之。宜服。内经曰。甘以缓
之。辛以散之。小腹急结。缓以桃仁之甘。下焦蓄血。散以桂枝之辛。大热之气。寒以
取之。热甚搏血。加二物于调胃承气汤之中也。
羚羊角散(出圣惠方)治伤寒心热发狂。
羚羊角屑(半两) 黄芩(半两) 赤芍药(半两) 茯神(半两) 葛根(半两锉) 鼠
尾草
(半两) 栀子仁(半两) 川大黄(半两锉碎微炒) 麦门冬(一两去心焙) 上捣粗罗
为散。每
服四钱。水一中盏。入豉一百粒。煎至六分。去滓。不计时候。温服。
人参散(出圣惠方)治伤寒邪热伤心。恍惚狂言。时有痰逆。不欲饮食。
人参(三分去芦头) 桔梗(半两去芦头) 龙齿(三分) 茯神(三分) 半夏(半
两汤洗七
遍去滑) 远志(一分去心) 枳实(一分麸炒微黄) 麦门冬(三分去心) 沙参(半两
去芦头)
黄(半两锉) 甘草(一分炙微赤锉) 上捣筛为散。每服五钱。水一大盏。入生姜半分。
枣
三枚。粳米五十粒。煎至五分。去滓。不计时候。温服。
地骨皮散(出圣惠方)治伤寒心神烦热。狂语不定。
地骨皮 葳蕤 人参(去芦头) 黄 (锉) 麦门冬(去心) 子芩(以上各一两) 茯
神
(三分) 甘草(半两炙微赤锉) 上捣筛为散。每服四钱。水一中盏。煎至五分。去滓。
入生
地黄汁一合。生姜汁一茶匙。蜜半合。更煎一两沸。不计时候。温服。
龙齿散(出圣惠方)治伤寒心热狂言。恍惚。卧不安席。
龙齿(二两) 犀角屑(一两) 川升麻(一两) 茯神(一两半) 麦门冬(二两去
心焙) 玄
参(一两) 甜竹根(三分锉) 赤芍药(一两半) 生干地黄(二两) 马牙硝(一两半)
上捣粗
罗
又方(出圣惠方)
马牙硝(一两) 铅霜(一分) 龙脑(一分) 朱砂(半两) 铁粉(一两) 上都
研令细。不
计时候。煎竹叶汤。放温。调下一钱。
又方(出圣惠方)
龙齿(半两) 牛黄〔一两(分)细研〕 马牙硝(一两细研) 朱砂(半两细研) 地
龙(一
两微炒) 麝香〔一两(钱)细研〕 上捣研令匀。不计时候。以生姜蜜水调下一钱。
黄芩散(出圣惠方)治伤寒热毒在内。心烦发狂。
黄芩(一两) 甘草(半两炙微赤锉) 白薇(一两) 栀子仁(一两) 大青 知母 栝
蒌
川硝石 白藓皮(各一两) 上捣罗为散。每服不计时候。以新汲水调下二钱。
龙齿丸 治伤寒邪热在心。狂言妄语。精神错乱。志意不安。
龙齿(一两) 人参(一两去芦头) 茯神(三分) 远志(半两去心) 黄芩(三分)
麦门冬
(一两去心焙) 黄连(三分去须) 甘草(半两炙微赤锉) 上捣罗为末。炼蜜和捣一二
百杵。
丸
苦参饮(出圣济总录)治伤寒欲发狂。解毒止躁。
苦参(一两) 黄芩(去黑心二两) 甘草(炙半两) 上捣为粗末。每服三钱。水一
盏。煎
至七分。去滓。入生地黄汁约半合。搅匀。温服。不拘时候。
大黄汤(出圣济总录)治伤寒热结在内。心神恍惚。狂妄。
大黄(锉炒) 芒硝(各一两半) 桂(去粗皮三分) 大腹皮(锉) 甘草(炙锉) 木
通(锉
各一两) 桃仁(二十一枚去皮尖双仁麸炒) 上粗捣筛。每服四钱匕。水一盏。煎至六分。
去滓。温服。不计时候。以通利为度。
犀角汤(出圣济总录)治伤寒九日至十日。头战掉。大汗出。恍惚。狂走。眼
见神鬼。
犀角屑(半两) 茵陈蒿(三分) 茯神(去木) 芍药 麦门冬(去心焙) 生干地
黄(焙各
一两半) 栀子仁(半两) 上粗捣筛。每服五钱匕。用水一盏半。入竹叶三七片。同煎至
八
分。去滓。食后温服。
千金丸(出圣济总录)治阳毒发狂。及癫邪狂走。
猪血(一盏生用) 不灰木(为末) 蓝根(连叶为末各一两) 水银(一盏以锡结沙
子) 鸡
子(
令匀。
入瓷罐子内封闭。腊日合之。掘地坑一尺。培。候端午日取出。旋丸如鸡头大。每服一丸。
生姜汁。及新汲水。化破服。
救逆汤(出圣济总录)治伤寒脉浮。医以火劫之。亡阳必惊狂。
桂(去粗皮) 蜀漆(各一两半) 甘草(炙一两) 牡蛎(熬二两半) 龙骨(二两)
上锉如
麻豆大。每服五钱匕。以水一盏半。入生姜半分。切。大枣二枚。擘破。同煎取七分。去滓。
温
人参汤(出圣济总录)治伤寒后。狂言欲走。口干。或时吐逆。
人参 羚羊角屑 葛根(锉) 竹茹 前胡(去芦头) 麦门冬(去心焙各半两) 甘
草(炙
锉一两) 半夏(汤浸去滑炒干半两) 上粗捣筛。每服五钱匕。用水一盏半。入生姜一分。
拍碎。枣三枚。擘破。同煎至八分。去滓。食后温服。
柴胡汤(一名加味小柴胡汤)治伤寒过经不解。热结在里。狂言不定。烦躁欲
走。
柴胡(去苗) 大黄(锉炒) 朴硝 枳壳(去瓤麸炒各一两) 甘草(炙锉半两) 上
粗捣
筛。每服三钱匕。水一盏。煎取六分。去滓。温服。未利再服。一方。加枳实一钱半。
羚羊角散(出圣济总录)治伤寒发汗后。热毒未尽。因有所惊。狂言欲走。
羚羊角屑 犀角屑 防风(去叉) 茯苓(去木) 黄芩(去黑心) 玄参 升麻(各
半两)
龙齿(研一两) 甘草(炙一两) 竹茹 地骨皮(洗焙) 丹参(各三分) 上粗捣筛。
每服五钱
匕。用水一盏半。入葱白五寸。同煎至八分。去滓。温服。
香豉汤(出圣济总录)治伤寒心狂欲走。缘风热毒瓦斯。内乘于心所致。
豉(炒令香熟三两) 芒硝(烧令白于湿地上用纸衬出火毒四两) 上二味。每取豉
半
两。先以水一盏。煎取七分。去滓。下芒硝末三钱匕。再煎三两沸。空腹。分温二服。如人
行三里。更一服。日夜可四服。但初看是风狂者。宜暂缚两手足。三服之后。解之。即无不
愈者。
朴硝汤(出圣济总录)治伤寒发狂欲走。是毒瓦斯壅于上焦。毒热不散。狂盛。
但缚手脚。恐
朴硝(烧令白于湿地纸衬出火毒一分) 豉(炒令香熟一合) 山栀子仁(一分) 上
粗捣
筛。每服三钱匕。以水一盏。煎至半盏。去滓。空腹温服。如人行十里。再一服。如利即止。
大黄汤(出圣济总录)治伤寒狂言欲走。大小便不通。腹痛胀满。
大黄(细锉微炒) 木香(锉各一分) 木通(锉三分) 升麻 羚羊角屑 白茅根(锉)
黄
芩(去黑心各半两) 上粗捣筛。每服五钱匕。用水一盏半。入葱白五寸。同煎至八分。去
滓
温
郁金散(出圣济总录)治伤寒阳盛发狂。大小便不通。腹胀满。
郁金 大黄(细锉微炒) 山栀子仁(各三分) 桂(去粗皮半两) 甘草(炙锉一分)
上捣
罗为细末。每服二钱匕。食后。煎葱豉汤调下。
治伤寒得汗。热毒不解心烦躁闷。言语不定。小便赤涩。大便不通。狂闷欲走方。(出
圣济
大黄(细锉微炒) 朴硝(研各二两) 黄芩(去黑心) 山栀子仁 大青(各一两半)
龙胆
(去土) 苦参(各一两) 上捣罗为细末。炼蜜和成剂。更捣三五百杵。丸如梧桐子大。
每服
二
金箔丸(出圣济总录)治伤寒时行发狂。妄见神鬼。
金箔 银箔(各一十片) 铁落(用水淘出沙泥取铁粉四两) 青黛(半两) 砒霜(半
钱)
麝香(半钱) 上研为细末。入糯米粥为丸。如皂荚子大。新水磨下一丸。如人行五里。吐
出
涎。立效。
不灰木散(出圣济总录)治伤寒热实发狂。烦躁闷乱。
不灰木(二两) 滑石 寒水石 蓝根 甘草(生各一两) 上捣研为散。每服二钱匕。
研
生粟米泔。入乳糖一块如枣大。同化调服。不拘时候。
绛雪丸(出圣济总录)治伤寒发狂。眼通赤。大小便血出。身如金色。兼治六
七日狂躁发热
硝石(一两) 丹砂(一分) 上二味。同研如粉。烧粟米饭和丸。如弹子大。每服一
丸。
沙糖冷水化下。服药后便睡。移时汗出为效。
鹊石散(出医方集成)治伤寒发狂。逾墙上屋。
黄连 寒水石(各等分) 上为末。每服二钱。浓煎甘草汤。候冷调服。
一方(出肘后方)治伤寒发热。阳胜阴。卒发狂。手足温。面红。狂言状如见
鬼。
上用青蒿一把。捣碎为末。入水二盏半。送下。立效。一方。老青松蒿子。童便浸三日。
干为末。每服二钱。乌梅一个。煎服。
伤寒导致心热发狂的病症,是因为心在五行中属火。心主司血液的运行。当阳气亢盛时,血液就会并聚于阳分。热邪侵袭心之络脉,就会导致心神烦乱躁动。患者可能沉默不语或高声歌唱,或者言语谈笑猖狂不止,说话失去常态,惊恐心悸,坐卧不安,甚至脱掉衣服奔跑。这些都是因为热毒之气壅滞在心胸部位,从而导致发狂。所谓“重阳者狂”,是指阳气单独亢盛。伤寒病中热毒已经炽盛,体内体外都充满热象,于是阳气愤激而发作,表现为狂越失常。这种病使人狂奔乱走、胡言乱语,有时骂人不分亲疏,或者产生幻觉妄见妄闻,严重时甚至脱衣奔跑、登上高处唱歌,或者几天不吃饭,翻墙爬屋。这是因为四肢是诸阳经的根本,热盛则四肢充实有力,这就是所谓的“重阳”。所以病人到达的地方,都是平时所不能做到的,这是疾病的力量所致。如果是因用火疗法治病不当成为邪气,从而引发惊狂;或者体内有瘀血,而外表症状像狂证。虽然这些病因不同,但都是因为阳气有余这一本质是一样的。
伤寒发狂中的“狂”,指猖狂不宁。《难经》说:狂病刚开始发作时,睡眠少且不觉得饥饿,自视甚高自认为贤能,自夸聪明,自视尊贵傲慢,无故大笑喜欢唱歌快乐,胡乱行走不停歇。狂病的起因,都是由于阳气过盛导致的。《内经》说:阴不能制约阳,脉气停留且急迫,阴阳相搏就会发狂。又说:邪气侵入阳分就会发狂,邪气侵入阴分就会失音。《难经》说:阳气重迭亢盛发狂,阴气重迭亢盛发癫。《脉经》说:阴依附于阳则发狂,阳依附于阴则发癫。《诸病源候论》说:阳邪并聚于阳分则发狂,阴邪并聚于阴分则发癫。由此可见,各经的狂证,都是由于阳盛造成的。另外,阳明病的特点是怕见人怕火光,听到木器声音就惊恐心动,心中悸动不安,只想关上门窗独处,严重时想上高处唱歌,脱衣奔跑,翻墙爬屋。他所去的地方,都是平时做不到的,这叫做阳邪并聚于阳明经。伤寒热毒在胃中,并传入心脏,使心神不宁、意志不定,于是发狂。伤寒发展到发狂的程度,是因为邪热已经到了极点,如果不是用大吐法或大下法,就不能治愈。还有热邪在下焦,病人表现像狂证,《内经》说:热邪进入膀胱,病人表现像狂证,这叫“如狂”,即还没有达到真正发狂的程度,只是睡卧起立都不安宁罢了。如果出现胡言乱语、眼睛上翻直视,这是肾气绝的表现;出汗后随即又发狂,不能进食,这是失志,属于死证。像这种情况,大概就不是药物所能救治的了,这是非常严重的疾病。
《活人歌括》说:发狂面红属于重阳证,可用葶苈子、升麻和大黄。如果是血证身黄仍想漱口但不欲咽水,尿多者用承气汤加地黄汤。阴邪并聚于阴分则发癫,阳邪并聚于阳分则发狂。伤寒热毒在胃,并入于心,致使神志昏乱,言行急促而发狂。狂证的发作,表现为睡眠少不饥饿,胡言乱语,无故大笑,傲慢自大,自辩聪明,胡乱起身行走,脱衣奔跑,登高唱歌,严重时翻墙爬屋,这都是独阳亢热所致,非用吐下法不能停止。如果有应当发汗而没有发汗,瘀热在里,下焦蓄血,面部像狂证的样子,小便必然通利,这只是像狂而未至于真狂。如果是用火熏、熨贴强迫发汗,或者艾灸、烧针,令人烦躁,睡卧起立不安,这就叫作“火邪惊狂”。凡是上述几种情况,各有相应的治疗条例。如果是胡言乱语、眼睛直视,小便失禁,以及发汗后热势更重,脉象躁动、胡言乱语、不能进食,这是智者所担忧的危重证候。重阳即为阳毒,脉象数而实,狂奔乱走、错语,烦躁干呕,面红咽痛,潮热发斑,可用葶苈苦酒汤、阳毒升麻汤、栀子仁汤、三黄汤、大黄散、升麻葛根汤加大黄。对于狂奔者,用水调服瓜蒂末以催吐痰涎,瓜蒂散也可以。吐血证出现如狂症状,脉象微而沉,身体发黄,嘴唇干燥,想漱口但不欲咽下,无寒热,小腹硬满,小便通利,大便微利且色黑,轻症用犀角地黄汤,重症用桃仁承气汤,或者抵当丸,直到排出黑色粪便才算有效。张仲景说:太阳病不解,热结在膀胱,病人表现像狂证,如果瘀血自行下行,病就好了。如果表证未解,可与桂枝汤解表;表证已解,仅小腹急结,才用桃仁承气汤攻下。大抵伤寒应当发汗而未发汗,热邪蓄积在里,热化为血,所以喜怒无常像狂证一样。阳狂证,可用寒水石、黄连末,各一钱,冷水调服,都有效。发斑胡言乱语,尚不可用下法的,用龙胆草一味煎汤。火邪惊狂,是医生用火熏熨强迫发汗,以及烧针艾灸所致。病人亡阳烦躁,睡卧起立不安,可用金匮风引汤、柴胡加龙骨牡蛎汤、桂枝甘草龙骨牡蛎汤。又如果用火劫法,导致腹满微喘,口干咽喉溃烂,或者大便不通,谵语,可用小柴胡汤、黑豆解火邪汤。
方剂:
龙骨救逆汤(出自《圣惠方》),治疗伤寒脉浮,医生用火劫法,出汗过多,必然亡阳,心生狂热,起卧不安。
药材:龙骨(一两)、桂心(二两,注:一作一两)、牡蛎(二两,烧成粉)、茯神(一两)、人参(一两,去芦头)、麦门冬(二两,去心焙干)、甘草(二两,炙至微红切碎)、蜀漆(一两)。以上捣碎粗罗为末。每次服用四钱,加水一盏,煎煮……(原文此处似有缺漏,依惯例应为煎至一定量)
犀角散,治疗伤寒有心热发狂,恍惚,或多惊,无法睡卧。
药材:犀角屑(三分)、茵陈(三分)、茯神(二两)、人参(一两,去芦头)、栀子仁(半两)、赤芍药(半两)、麦门冬(一两,去心焙干)、龙齿(三分)、川升麻(半两)、子芩(三分)、甘草(三分,炙微红)。加水一中盏,入生姜半分,煎至六分,去渣滓。不计时候,温服。
核桃承气汤(出自《圣惠方》),治疗伤寒病不解,热结在膀胱,病人像狂证,瘀血自行下行则愈。如果表证未解,不可用下法,先解其表。表解之后,仅小腹结滞者,可下之。宜服用此方。《内经》说:甘味以缓急,辛味以散结。小腹急结,用桃仁之甘来缓解;下焦蓄血,用桂枝之辛来消散。大热之气,用寒凉之法取之。热甚搏血,在调胃承气汤中加入这两味药。
*注:原文标题为“核桃承气汤”,但描述及引用《内经》理论明显对应桃仁承气汤,此处保留原名翻译。*
羚羊角散(出自《圣惠方》),治疗伤寒心热发狂。
药材:羚羊角屑(半两)、黄芩(半两)、赤芍药(半两)、茯神(半两)、葛根(半两,锉碎)、鼠尾草(半两)、栀子仁(半两)、川大黄(半两,锉碎微炒)、麦门冬(一两,去心焙干)。以上捣碎粗罗为散。每次服用四钱,加水一中盏,入豆豉一百粒,煎至六分,去渣滓。不计时候,温服。
人参散(出自《圣惠方》),治疗伤寒邪热伤心,恍惚狂言,时有痰逆,不欲饮食。
药材:人参(三分,去芦头)、桔梗(半两,去芦头)、龙齿(三分)、茯神(三分)、半夏(半两,汤洗七遍去滑)、远志(一分,去心)、枳实(一分,麸炒微黄)、麦门冬(三分,去心)、沙参(半两,去芦头)、黄芪(半两,锉)、甘草(一分,炙微红锉)。以上捣筛为散。每次服用五钱,加水一大盏,入生姜半分,大枣三枚,粳米五十粒,煎至五分,去渣滓。不计时候,温服。
地骨皮散(出自《圣惠方》),治疗伤寒心神烦热,狂语不定。
药材:地骨皮、葳蕤、人参(去芦头)、黄芪(锉)、麦门冬(去心)、子芩(以上各一两)、茯神(三分)、甘草(半两,炙微红锉)。以上捣筛为散。每次服用四钱,加水一中盏,煎至五分,去渣滓,加入生地黄汁一合,生姜汁一茶匙,蜂蜜半合,再煎一两沸。不计时候,温服。
龙齿散(出自《圣惠方》),治疗伤寒心热狂言,恍惚,卧不安席。
药材:龙齿(二两)、犀角屑(一两)、川升麻(一两)、茯神(一两半)、麦门冬(二两,去心焙干)、玄参(一两)、甜竹根(三分,锉)、赤芍药(一两半)、生干地黄(二两)、马牙硝(一两半)。以上捣碎粗罗为散。
又一方(出自《圣惠方》):
马牙硝(一两)、铅霜(一分)、龙脑(一分)、朱砂(半两)、铁粉(一两)。以上研令细。不计时候,煎竹叶汤,放温,调下一钱。
又一方(出自《圣惠方》):
龙齿(半两)、牛黄(一两,细研)、马牙硝(一两,细研)、朱砂(半两,细研)、地龙(一两,微炒)、麝香(一两,细研)。以上捣研令匀。不计时候,以生姜蜜水调下一钱。
黄芩散(出自《圣惠方》),治疗伤寒热毒在内,心烦发狂。
药材:黄芩(一两)、甘草(半两,炙微红锉)、白薇(一两)、栀子仁(一两)、大青、知母、栝楼、川硝石、白鲜皮(各一两)。以上捣罗为散。每次服用不计时候,以新汲水调下二钱。
龙齿丸,治疗伤寒邪热在心,狂言妄语,精神错乱,志意不安。
药材:龙齿(一两)、人参(一两,去芦头)、茯神(三分)、远志(半两,去心)、黄芩(三分)、麦门冬(一两,去心焙干)、黄连(三分,去须)、甘草(半两,炙微红锉)。以上捣罗为末,炼蜜和捣一二百杵,制成丸剂。
苦参饮(出自《圣济总录》),治疗伤寒欲发狂,解毒止躁。
药材:苦参(一两)、黄芩(去黑心二两)、甘草(炙半两)。以上捣为粗末。每次服用三钱,加水一盏,煎至七分,去渣滓,加入生地黄汁约半合,搅匀,温服。不拘时候。
大黄汤(出自《圣济总录》),治疗伤寒热结在内,心神恍惚,狂妄。
药材:大黄(锉炒)、芒硝(各一两半)、桂(去粗皮三分)、大腹皮(锉)、甘草(炙锉)、木通(锉,各一两)、桃仁(二十一枚,去皮尖双仁,麸炒)。以上粗捣筛。每次服用四钱匕,加水一盏,煎至六分,去渣滓,温服。不计时候,以通利为度。
犀角汤(出自《圣济总录》),治疗伤寒九日至十日,头部战栗抖动,大汗出,恍惚,狂走,眼见神鬼。
药材:犀角屑(半两)、茵陈蒿(三分)、茯神(去木)、芍药、麦门冬(去心焙)、生干地黄(焙,各一两半)、栀子仁(半两)。以上粗捣筛。每次服用五钱匕,用水一盏半,入竹叶三七片,同煎至八分,去渣滓,食后温服。
千金丸(出自《圣济总录》),治疗阳毒发狂,及癫邪狂走。
药材:猪血(一盏,生用)、不灰木(为末)、蓝根(连叶为末,各一两)、水银(一盏,以锡结沙子)、鸡子(蛋黄?原文此处可能有缺字,通常为鸡蛋清或全蛋,依上下文推测为调和剂)。以上混合均匀,入瓷罐子内封闭,腊日合之(制作时间),掘地坑一尺,培土掩埋,候端午日取出,旋丸如鸡头大。每次服用一丸,生姜汁及新汲水,化破服。
救逆汤(出自《圣济总录》),治疗伤寒脉浮,医生用火劫法,亡阳必惊狂。
药材:桂(去粗皮)、蜀漆(各一两半)、甘草(炙一两)、牡蛎(熬二两半)、龙骨(二两)。以上锉如麻豆大。每次服用五钱匕,以水一盏半,入生姜半分,切,大枣二枚,擘破,同煎取七分,去渣滓,温服。
人参汤(出自《圣济总录》),治疗伤寒后,狂言欲走,口干,或时吐逆。
药材:人参、羚羊角屑、葛根(锉)、竹茹、前胡(去芦头)、麦门冬(去心焙,各半两)、甘草(炙锉一两)、半夏(汤浸去滑炒干半两)。以上粗捣筛。每次服用五钱匕,用水一盏半,入生姜一分,拍碎,枣三枚,擘破,同煎至八分,去渣滓,食后温服。
柴胡汤(一名加味小柴胡汤),治疗伤寒过经不解,热结在里,狂言不定,烦躁欲走。
药材:柴胡(去苗)、大黄(锉炒)、朴硝、枳壳(去瓤麸炒,各一两)、甘草(炙锉半两)。以上粗捣筛。每次服用三钱匕,水一盏,煎取六分,去渣滓,温服。未利再服。一方,加枳实一钱半。
羚羊角散(出自《圣济总录》),治疗伤寒发汗后,热毒未尽,因有所惊,狂言欲走。
药材:羚羊角屑、犀角屑、防风(去叉)、茯苓(去木)、黄芩(去黑心)、玄参、升麻(各半两)、龙齿(研一两)、甘草(炙一两)、竹茹、地骨皮(洗焙)、丹参(各三分)。以上粗捣筛。每次服用五钱匕,用水一盏半,入葱白五寸,同煎至八分,去渣滓,温服。
香豉汤(出自《圣济总录》),治疗伤寒心狂欲走,缘风热毒瓦斯,内乘于心所致。
药材:豉(炒令香熟三两)、芒硝(烧令白于湿地上用纸衬出火毒四两)。以上二味,每取豉半两,先以水一盏,煎取七分,去渣滓,下芒硝末三钱匕,再煎三两沸。空腹,分温二服。如人行三里,更一服。日夜可四服。但初看是风狂者,宜暂缚两手足,三服之后,解之,即无不愈者。
朴硝汤(出自《圣济总录》),治疗伤寒发狂欲走,是毒瓦斯壅于上焦,毒热不散,狂盛。但缚手脚,恐……(原文此处似有缺漏,意为防止伤人)。
药材:朴硝(烧令白于湿地纸衬出火毒一分)、豉(炒令香熟一合)、山栀子仁(一分)。以上粗捣筛。每次服用三钱匕,以水一盏,煎至半盏,去渣滓,空腹温服。如人行十里,再一服。如利即止。
大黄汤(出自《圣济总录》),治疗伤寒狂言欲走,大小便不通,腹痛胀满。
药材:大黄(细锉微炒)、木香(锉,各一分)、木通(锉三分)、升麻、羚羊角屑、白茅根(锉)、黄芪、黄芩(去黑心,各半两)。以上粗捣筛。每次服用五钱匕,用水一盏半,入葱白五寸,同煎至八分,去渣滓,温服。
郁金散(出自《圣济总录》),治疗伤寒阳盛发狂,大小便不通,腹胀满。
药材:郁金、大黄(细锉微炒)、山栀子仁(各三分)、桂(去粗皮半两)、甘草(炙锉一分)。以上捣罗为细末。每次服用二钱匕,食后,煎葱豉汤调下。
治伤寒得汗,热毒不解心烦躁闷,言语不定,小便赤涩,大便不通,狂闷欲走方。(出自《圣济总录》)
药材:大黄(细锉微炒)、朴硝(研,各二两)、黄芩(去黑心)、山栀子仁、大青(各一两半)、龙胆(去土)、苦参(各一两)。以上捣罗为细末,炼蜜和成剂,更捣三五百杵,丸如梧桐子大。每次服用二……(原文此处似有缺漏,通常为丸数或钱数)。
金箔丸(出自《圣济总录》),治疗伤寒时行发狂,妄见神鬼。
药材:金箔、银箔(各一十片)、铁落(用水淘出沙泥取铁粉四两)、青黛(半两)、砒霜(半钱)、麝香(半钱)。以上研为细末,入糯米粥为丸,如皂荚子大。新水磨下一丸。如人行五里,吐出涎,立效。
不灰木散(出自《圣济总录》),治疗伤寒热实发狂,烦躁闷乱。
药材:不灰木(二两)、滑石、寒水石、蓝根、甘草(生,各一两)。以上捣研为散。每次服用二钱匕,研生粟米泔,入乳糖一块如枣大,同化调服。不拘时候。
绛雪丸(出自《圣济总录》),治疗伤寒发狂,眼通赤,大小便血出,身如金色。兼治六七日狂躁发热。
药材:硝石(一两)、丹砂(一分)。以上二味,同研如粉,烧粟米饭和丸,如弹子大。每次服用一丸,沙糖冷水化下。服药后便睡,移时汗出为效。
鹊石散(出自《医方集成》),治疗伤寒发狂,逾墙上屋。
药材:黄连、寒水石(各等分)。以上为末。每次服用二钱,浓煎甘草汤,候冷调服。
一方(出自《肘后方》),治疗伤寒发热,阳胜阴,卒发狂,手足温,面红,狂言状如见鬼。
上方用青蒿一把,捣碎为末,入水二盏半,送下,立效。一方,老青松蒿子,童便浸三日,干为末。每次服用二钱,乌梅一个,煎服。
The syndrome of heart-heat mania in cold damage arises because the Heart belongs to Fire. The Heart governs Blood. When Yang Qi is excessive, Blood merges into the Yang aspect. Heat pathogens attack the Heart collaterals, causing mental restlessness and confusion. Patients may remain silent or sing aloud, or speak and laugh wildly without cessation, losing normal speech patterns, experiencing fright palpitations, and uneasiness. They may discard their clothes and run about. These are all caused by heat-toxin qi stagnating in the chest and heart, leading to mania. "Chong Yang (Double Yang) results in mania" refers to the solitary excess of Yang Qi. In cold damage, when heat-toxin is abundant, both interior and exterior are hot, causing Yang Qi to become agitated and erupt as manic behavior. This illness causes people to run wildly and speak nonsense, sometimes cursing without distinguishing between relatives and strangers, or having hallucinations and false perceptions. In severe cases, they discard clothes and run, climb high places to sing, or go several days without eating, climbing over walls and roofs. This is because the four limbs are the root of all Yang meridians; heat excess makes the four limbs solid and strong, which is called "Chong Yang." Therefore, places where the patient stops are often things they could never do normally; this power comes from the disease itself. If the condition arises from improper fire therapy becoming a pathogen, leading to fright-manic symptoms, or if there is internal blood stasis with external symptoms resembling mania, although the etiologies differ, the underlying mechanism of Yang excess remains the same.
In cold damage mania, "mania" refers to wild unruliness and lack of peace. The *Nan Jing* states: At the onset of mania, patients sleep little and feel no hunger, regard themselves as superior and virtuous, claim wisdom, act arrogantly, laugh and sing foolishly, and walk around incessantly. The origin of mania is always due to excessive Yang. The *Nei Jing* states: When Yin cannot control Yang, pulse qi stays and becomes rapid, and the conflict leads to mania. It also says: When pathogens enter the Yang aspect, mania occurs; when they enter the Yin aspect, aphonia occurs. The *Nan Jing* states: Chong Yang (excess Yang) leads to mania, while Chong Yin (excess Yin) leads to epilepsy. The *Mai Jing* states: Yin attaching to Yang causes mania, while Yang attaching to Yin causes epilepsy. The *Bing Yuan* states: Yang pathogens merging into Yang cause mania, while Yin pathogens merging into Yin cause epilepsy. Thus, it is clear that mania in various meridians is due to Yang excess. Furthermore, in Yangming disease, patients fear people and fire, startle at the sound of wood, feel heart palpitations, and prefer to stay alone with doors and windows closed. In severe cases, they want to climb high to sing, discard clothes, run, and climb walls and roofs. The places they reach are beyond their normal capabilities; this is called Yang pathogens merging into the Yangming meridian. Cold damage heat-toxin in the Stomach merges into the Heart, disturbing the Spirit and destabilizing the will, resulting in mania. Mania in cold damage indicates extreme evil heat; only drastic purgation or emesis can resolve it. Additionally, heat in the Lower Jiao may cause symptoms resembling mania. The classics state: Heat entering the Bladder causes symptoms resembling mania. "Ru Kuang" (resembling mania) means not yet true mania, but merely restlessness in lying down and rising. If there is delirious speech and eyes rolling upward with fixed gaze, this indicates Kidney exhaustion. Recurrent mania after sweating, inability to eat, and loss of will indicate death. Such conditions are likely beyond the reach of medicine and represent critical illness.
The *Huoren Ge Kuo* states: Mania with red face belongs to Chong Yang; use Lepidium seed, Cimicifuga, and Rhubarb. For blood syndromes with yellow body and thirst for rinsing mouth but not swallowing, with frequent urination, use Chengqi Decoction with Rehmannia. Yin pathogens merging into Yin cause epilepsy; Yang pathogens merging into Yang cause mania. Cold damage heat-toxin in the Stomach merging into the Heart causes mental confusion and rapid speech/movement leading to mania. Mania attacks involve sleeping little, no hunger, delirium, foolish laughter, arrogance, self-righteousness, aimless walking, discarding clothes, climbing high to sing, and climbing walls/roofs, all caused by solitary Yang hyperthermia, resolvable only by emesis or purgation. If sweating should have been induced but wasn't, with stasis-heat in the interior and blood accumulation in the Lower Jiao, the face may look manic, urine will be free, but this is only resembling mania. If forced sweating via moxibustion or burning needles causes irritability and restlessness, it is called "Fire Evil Fright-Mania." Each case has specific protocols. Delirium with fixed gaze, urinary incontinence, post-sweating increased heat, restless pulse, delirium, and anorexia are worrisome signs. Chong Yang is Yang Toxin: rapid and full pulse, running wildly, confused speech, irritability, dry retching, red face, sore throat, tidal fever, and macules. Treatments include Tingli Kujiu Tang, Yangdu Shengma Tang, Zhizi Ren Tang, Sanhuang Tang, Dahuang San, Shengma Gegen Tang plus Dahuang. For running wild, use water-mixed Coptis seed powder to induce vomiting phlegm; Genti San is also effective. For hematemesis with manic symptoms, faint and deep pulse, yellow body, dry lips, desire to rinse mouth but not swallow, no chills/fever, hard/full lower abdomen, free urination, slight black stool: mild cases use Xijiao Dihuang Tang; severe cases use Tao Ren Chengqi Tang or Didang Wan, effective until black stool is passed. Zhang Zhongjing said: If Taiyang disease is unresolved and heat binds in the Bladder, the patient resembles mania; if blood passes spontaneously, it heals. If exterior is unresolved, give Guizhi Tang; if exterior is resolved and only lower abdominal urgency exists, use Tao Ren Chengqi Tang to purge. Generally, if cold damage requires sweating but doesn't get it, heat accumulates internally and transforms into blood, causing erratic mood like mania. For Yang mania, mix Hanshui Shi and Huanglian powder (1 qian each), take with cold water; effective. For macules and delirium where purgation is not yet indicated, use Longdan Cao Yi Wu Tang. For fire evil fright-mania caused by doctor-induced sweating via moxibustion/burning needles: patient suffers Yang depletion, irritability, restlessness; treat with Jin Gui Fengyin Tang, Chaihu Jia Longgu Muli Tang, or Guizhi Gancao Longgu Muli Tang. If fire coercion causes abdominal fullness, slight wheezing, dry mouth, rotten throat, constipation, and delirium, use Xiaochaihu Tang or Heidou Jie Huoxie Tang.
Formulas:
Longgu Jiuniu Tang (from *Shenghui Fang*) treats cold damage with floating pulse, where fire coercion caused excessive sweating, leading to Yang depletion, heart heat-manía, and restlessness.
Ingredients: Longgu (1 liang), Guixin (2 liang, note: 1 liang in some editions), Mumian (2 liang, calcined to powder), Fushen (1 liang), Renshen (1 liang, remove radicle), Maimendong (2 liang, remove heart, roast), Gancao (2 liang, honey-fried to light red, chopped), Shuqi (1 liang). Pound into coarse powder. Take 4 qian per dose, decoct in 1 zhan of water...
Xijiao San treats cold damage with heart heat-manía,恍惚 (trance), frequent fright, and insomnia.
Ingredients: Xijiao xie (3 fen), Yichen (3 fen), Fushen (2 liang), Renshen (1 liang, remove radicle), Zhizi ren (0.5 liang), Chishaoyao (0.5 liang), Maimendong (1 liang, remove heart, roast), Longchi (3 fen), Chuanshengma (0.5 liang), Ziqin (3 fen), Gancao (3 fen, honey-fried). Add 1 zhan of water and 0.5 fen of Shengjiang, decoct to 0.6 zhan, strain. Take warm at any time.
Hetao Chengqi Tang (from *Shenghui Fang*), titled here but describing Tao Ren Chengqi indications: Treats cold damage unresolved, heat binding in Bladder, patient resembling mania, spontaneous blood passage heals. If exterior unresolved, do not purge; resolve exterior first. After exterior resolves, if only lower abdominal knotting remains, purge. *Nei Jing*: Sweet relieves tension, Pungent disperses. Lower abdominal urgency relieved by Tao Ren's sweetness; Lower Jiao blood stasis dispersed by Guizhi's pungency. Great heat taken by cold. Add these two to Tiaowei Chengqi Tang for heat-blood interaction.
*Note: Title retained as original, content matches Tao Ren Chengqi Tang.*
Lingyangjiao San (from *Shenghui Fang*) treats cold damage heart heat-manía.
Ingredients: Lingyangjiao xie (0.5 liang), Huangqin (0.5 liang), Chishaoyao (0.5 liang), Fushen (0.5 liang), Gegen (0.5 liang, chopped), Shuweicao (0.5 liang), Zhizi ren (0.5 liang), Chuan Dahuang (0.5 liang, chopped, lightly fried), Maimendong (1 liang, remove heart, roast). Pound into coarse powder. Take 4 qian, decoct in 1 zhan water with 100 Ci beans, reduce to 0.6 zhan, strain. Take warm anytime.
Renshen San (from *Shenghui Fang*) treats cold damage evil heat injuring Heart, trance, delirium, occasional phlegm reversal, anorexia.
Ingredients: Renshen (3 fen, remove radicle), Jiegeng (0.5 liang, remove radicle), Longchi (3 fen), Fushen (3 fen), Banxia (0.5 liang, wash 7 times in hot water to remove slipperiness), Yuanzhi (1 fen, remove heart), Zhishi (1 fen, bran-fried to light yellow), Maimendong (3 fen, remove heart), Shashen (0.5 liang, remove radicle), Huangqi (0.5 liang, chopped), Gancao (1 fen, honey-fried). Sift into powder. Take 5 qian, decoct in 1 large zhan water with 0.5 fen Shengjiang, 3 dates, 50 grains of Jingmi, reduce to 0.5 zhan, strain. Take warm anytime.
Digupi San (from *Shenghui Fang*) treats cold damage heart spirit烦热 (vexatious heat),不定 (unstable) delirium.
Ingredients: Digupi, Weirui, Renshen (remove radicle), Huangqi (chopped), Maimendong (remove heart), Ziqin (each 1 liang), Fushen (3 fen), Gancao (0.5 liang, honey-fried). Sift into powder. Take 4 qian, decoct in 1 zhan water to 0.5 zhan, strain. Add 1 he of fresh Dihuang juice, 1 tea spoon of Shengjiang juice, 0.5 he of honey, boil briefly. Take warm anytime.
Longchi San (from *Shenghui Fang*) treats cold damage heart heat delirium, trance, restless sleep.
Ingredients: Longchi (2 liang), Xijiao xie (1 liang), Chuanshengma (1 liang), Fushen (1.5 liang), Maimendong (2 liang, remove heart, roast), Xuanshen (1 liang), Tianzhugen (3 fen, chopped), Chishaoyao (1.5 liang), Shenggan Dihuang (2 liang), Mayaxiao (1.5 liang). Pound into coarse powder.
Another prescription (from *Shenghui Fang*):
Mayaxiao (1 liang), Qianshuang (1 fen), Longnao (1 fen), Zhusha (0.5 liang), Tiefen (1 liang). Grind fine. Take 1 qian mixed with warm Zhu Ye decoction anytime.
Another prescription (from *Shenghui Fang*):
Longchi (0.5 liang), Niuhuang (1 liang, finely ground), Mayaxiao (1 liang, finely ground), Zhusha (0.5 liang, finely ground), Dilong (1 liang, lightly fried), Shexiang (1 liang, finely ground). Mix evenly. Take 1 qian mixed with Shengjiang and honey water anytime.
Huangqin San (from *Shenghui Fang*) treats internal cold damage heat-toxin, vexation, mania.
Ingredients: Huangqin (1 liang), Gancao (0.5 liang, honey-fried), Baiwei (1 liang), Zhizi ren (1 liang), Daqing, Zhimu, Gualou, Chuan Xiaoshi, Baixianpi (each 1 liang). Sieve into powder. Take 2 qian mixed with fresh well water anytime.
Longchi Wan treats cold damage evil heat in Heart, delirium, mental confusion, unstable will.
Ingredients: Longchi (1 liang), Renshen (1 liang, remove radicle), Fushen (3 fen), Yuanzhi (0.5 liang, remove heart), Huangqin (3 fen), Maimendong (1 liang, remove heart, roast), Huanglian (3 fen, remove roots), Gancao (0.5 liang, honey-fried). Pound into powder, mix with refined honey, pound 100-200 times, make pills.
Kushen Yin (from *Shengji Zonglu*) treats impending cold damage mania, detoxifies, stops agitation.
Ingredients: Kushen (1 liang), Huangqin (remove black heart 2 liang), Gancao (honey-fried 0.5 liang). Pound into coarse powder. Take 3 qian, decoct in 1 zhan water to 0.7 zhan, strain, add ~0.5 he fresh Dihuang juice, mix well, take warm anytime.
Dahuang Tang (from *Shengji Zonglu*) treats internal cold damage heat-binding, mental trance, madness.
Ingredients: Dahuang (chopped, fried), Mangxiao (each 1.5 liang), Gui (remove bark 3 fen), Dafupi (chopped), Gancao (honey-fried, chopped), Mutong (chopped, each 1 liang), Taoren (21 pieces, peel/remove tips/double kernels, bran-fried). Coarsely sieve. Take 4 qian bi, decoct in 1 zhan water to 0.6 zhan, strain, take warm. Anytime, stop when bowel movement occurs.
Xijiao Tang (from *Shengji Zonglu*) treats cold damage day 9-10, head tremors, profuse sweating, trance, running wildly, seeing spirits.
Ingredients: Xijiao xie (0.5 liang), Yinchenhao (3 fen), Fushen (remove wood), Shaoyao, Maimendong (remove heart, roast), Shenggan Dihuang (roast, each 1.5 liang), Zhizi ren (0.5 liang). Coarsely sieve. Take 5 qian bi, decoct in 1.5 zhan water with 37 Zhu ye leaves to 0.8 zhan, strain, take warm after meals.
Qianjin Wan (from *Shengji Zonglu*) treats Yang toxin mania and epilepsy-running.
Ingredients: Zhuxue (1 zhan, raw), Buhui Mu (powder), Langen (with leaves, powder, each 1 liang), Shuiyin (1 zhan, alloyed with tin), Jizi (egg yolk/white implied). Mix, seal in porcelain jar, bury in 1 chi pit on Laba day, retrieve on Duanwu day. Roll into chicken-head sized pills. Take 1 pill dissolved in Shengjiang juice and fresh water.
Jiuniu Tang (from *Shengji Zonglu*) treats cold damage floating pulse, fire coercion causing Yang depletion and fright-manía.
Ingredients: Gui (remove bark), Shuqi (each 1.5 liang), Gancao (honey-fried 1 liang), Muli (calcined 2.5 liang), Longgu (2 liang). Chop like hemp seeds. Take 5 qian bi, decoct in 1.5 zhan water with 0.5 fen chopped Shengjiang and 2 broken dates to 0.7 zhan, strain, take warm.
Renshen Tang (from *Shengji Zonglu*) treats post-cold damage delirium, urge to run, dry mouth, occasional vomiting.
Ingredients: Renshen, Lingyangjiao xie, Gegen (chopped), Zhuru, Qianhu (remove radicle), Maimendong (remove heart, roast, each 0.5 liang), Gancao (honey-fried, chopped 1 liang), Banxia (hot water soak, remove slipperiness, dry fry 0.5 liang). Coarsely sieve. Take 5 qian bi, decoct in 1.5 zhan water with 1 fen crushed Shengjiang and 3 broken dates to 0.8 zhan, strain, take warm after meals.
Chaihu Tang (aka Modified Xiaochaihu Tang) treats cold damage passing stages unresolved, internal heat binding, unstable delirium, irritability, urge to run.
Ingredients: Chaihu (remove sprouts), Dahuang (chopped, fried), Pu Xiao, Zhike (remove pulp, bran-fried, each 1 liang), Gancao (honey-fried, chopped 0.5 liang). Coarsely sieve. Take 3 qian bi, decoct in 1 zhan water to 0.6 zhan, strain, take warm. Repeat if no effect. Another formula adds Zhishi 1.5 qian.
Lingyangjiao San (from *Shengji Zonglu*) treats post-sweating cold damage, residual heat-toxin, fright-induced delirium and urge to run.
Ingredients: Lingyangjiao xie, Xijiao xie, Fangfeng (remove forks), Fuling (remove wood), Huangqin (remove black heart), Xuanshen, Shengma (each 0.5 liang), Longchi (ground 1 liang), Gancao (honey-fried 1 liang), Zhuru, Digupi (wash, roast), Danshen (each 3 fen). Coarsely sieve. Take 5 qian bi, decoct in 1.5 zhan water with 5 cun Congbai to 0.8 zhan, strain, take warm.
Xiangchi Tang (from *Shengji Zonglu*) treats cold damage heart mania urge to run, caused by wind-heat toxins invading Heart.
Ingredients: Chi (fried fragrant 3 liang), Mangxiao (burned white on wet ground with paper liner to remove fire toxicity 4 liang). Take 0.5 liang Chi, decoct in 1 zhan water to 0.7 zhan, strain, add 3 qian bi Mangxiao powder, boil 3 boils. Take on empty stomach, divided into 2 doses. Walk 3 li, take another dose. Up to 4 doses/day. For initial wind-manía, bind hands/feet temporarily, release after 3 doses; all heal.
Pu Xiao Tang (from *Shengji Zonglu*) treats cold damage mania urge to run, toxic vapors congesting Upper Jiao, undispersed heat-toxin, severe manía. Bind limbs to prevent injury.
Ingredients: Pu Xiao (burned white on wet ground with paper liner 1 fen), Chi (fried fragrant 1 he), Shanzhizi ren (1 fen). Coarsely sieve. Take 3 qian bi, decoct in 1 zhan water to 0.5 zhan, strain, take warm on empty stomach. Walk 10 li, take another dose. Stop if diarrhea occurs.
Dahuang Tang (from *Shengji Zonglu*) treats cold damage delirium urge to run, constipation, abdominal pain/fullness.
Ingredients: Dahuang (fine chop, light fry), Muxiang (chop, each 1 fen), Mutong (chop 3 fen), Shengma, Lingyangjiao xie, Baimaogen (chop), Huangqi, Huangqin (remove black heart, each 0.5 liang). Coarsely sieve. Take 5 qian bi, decoct in 1.5 zhan water with 5 cun Congbai to 0.8 zhan, strain, take warm.
Yujin San (from *Shengji Zonglu*) treats cold damage Yang excess mania, constipation, abdominal fullness.
Ingredients: Yujin, Dahuang (fine chop, light fry), Shanzhizi ren (each 3 fen), Gui (remove bark 0.5 liang), Gancao (honey-fried, chopped 1 fen). Sieve into fine powder. Take 2 qian bi after meals, mixed with Congchi Tang.
Formula for cold damage post-sweating, unresolved heat-toxin, heart vexation, unstable speech, dark scanty urine, constipation, manic urge to run (from *Shengji Zonglu*).
Ingredients: Dahuang (fine chop, light fry), Pu Xiao (ground, each 2 liang), Huangqin (remove black heart), Shanzhizi ren, Daqing (each 1.5 liang), Longdan (remove soil), Kushen (each 1 liang). Sieve into fine powder, mix with refined honey, pound 300-500 times, make pills like Wutong seeds. Take 2 ... [text missing].
Jinbo Wan (from *Shengji Zonglu*) treats epidemic cold damage mania, hallucinating spirits.
Ingredients: Jinbo, Yinbo (each 10 pieces), Tielluo (wash sand/mud, take iron powder 4 liang), Qingdai (0.5 liang), Pishuang (0.5 qian), Shexiang (0.5 qian). Grind fine, mix with glutinous rice porridge, make pills like soap pod seeds. Dissolve 1 pill in new water. Walk 5 li, expect salivation; immediate effect.
Buhui Mu San (from *Shengji Zonglu*) treats cold damage heat-excess mania, irritability/confusion.
Ingredients: Buhui Mu (2 liang), Huashi, Hanshui Shi, Langen, Gancao (raw, each 1 liang). Grind into powder. Take 2 qian bi, grind with raw millet water, add date-sized lactose, dissolve and take. Anytime.
Jiangxue Wan (from *Shengji Zonglu*) treats cold damage mania, red eyes, blood in urine/stool, golden skin. Also treats 6-7 day manic fever.
Ingredients: Xiaoshi (1 liang), Dansha (1 fen). Grind together to powder, mix with roasted millet rice, make pills like marbles. Take 1 pill dissolved in brown sugar cold water. Sleep after taking; sweating after a while indicates efficacy.
Que Shi San (from *Yifang Jicheng*) treats cold damage mania, climbing walls/roofs.
Ingredients: Huanglian, Hanshui Shi (equal parts). Make powder. Take 2 qian, mixed with thick decocted Gancao soup cooled down.
One formula (from *Zhouhou Fang*) treats cold damage fever, Yang overcoming Yin, sudden mania, warm extremities, red face, delirium seeing ghosts.
Take 1 bunch Qinghao, crush to powder, mix with 2.5 zhan water, take orally; immediate effect. Another formula: Old pine Songhao seeds, soaked in child's urine for 3 days, dried and powdered. Take 2 qian with 1 Wumei, decocted.