(仲景)中赤小豆,(甜瓜蒂炒黄与赤小豆为末,热水或 水调,量虚实服之。)或入藜
芦郁金凑。(张子和去赤豆加藜芦、防风,一方去赤豆加郁金、韭汁,俱名三圣散。鹅翎探
吐,并治风痰。)此吐实热与风痰,(瓜蒂吐实热,藜芦吐风痰。)虚者参芦(散)一味勾。(虚
人痰壅不得服瓜蒂者,以参芦代之,或加竹沥。)若吐虚烦栀豉汤,(仲景,栀子十四枚,豉
四合,治伤寒后虚烦。)剧痰乌附尖方透。(丹溪治许白云,用瓜蒂、栀子、苦参、藜芦,屡
吐不透,后以浆水和乌附尖服,始得大吐。)古人尚有烧盐方,一切积滞功能奏。(烧盐热汤
调服,以指探吐,治霍乱、宿食、冷痛等症。《千金》曰∶凡病宜吐,大胜用药。)
(散,严用和)皂角白矾斑,〔皂角四挺(去皮弦炙),白矾一两,为末,每服五分。
白矾酸苦涌泄,能软顽痰;皂角辛咸通窍,专制风木。此专门之兵也,国中风时宜用之。〕
或益藜芦微吐间。风中痰升人眩仆,当先服此通其关。(令微吐稀涎,续进他药。)通关散用
细辛皂(角,为末,)吹鼻得嚏保生还。(卒中者用此吹鼻,有嚏者可治,无嚏者为肺气已绝。)
九首、附方五
(仲景)和解供,半夏人参甘草从。更用黄芩加姜枣,少阳百病此为宗。(柴胡八两,
半夏半升,人参、甘草、黄芩、生姜各三两,大枣十二枚。治一切往来寒热,胸满胁痛,心
烦喜呕,口苦耳聋,咳渴悸利,半表半里之证。属少阳经者,但见一症即是,不必悉具。胆
府清净,无出无入,经在半表半里,法宜和解。柴胡升阳达表,黄芩退热和阴,半夏祛痰散
逆,参、草辅正补中,使邪不得复传入里也。)
(张仲景)方中用赤小豆,(将甜瓜蒂炒至发黄,与赤小豆研成细末,用热水或冷水调服,根据患者体质的虚实决定剂量服用。)或者加入藜芦、郁金凑成一方。(张子和去掉赤小豆,加入藜芦和防风;另一方案去掉赤小豆,加入郁金和韭菜汁,都称为三圣散。用鹅毛探喉催吐,共同治疗风痰。)此法用于吐出实热和风痰,(瓜蒂能吐出实热,藜芦能吐出风痰。)体质虚弱者可用参芦(散)一味来替代勾引催吐。(对于痰壅盛但体质虚弱不能服用瓜蒂的人,可以用参芦代替,或者加竹沥。)如果是呕吐虚烦,则用栀子豉汤,(张仲景方:栀子十四枚,香豉四合,治疗伤寒愈后留下的虚烦症状。)若是顽痰剧烈难以吐出,需用乌附尖方能透达。(朱丹溪治疗许白云,先用瓜蒂、栀子、苦参、藜芦,多次催吐未能奏效,后来用浆水和乌头附子尖服用,才终于大吐出来。)古人还有烧盐方,对于各种积滞病症都能发挥作用。(将盐烧红后用热汤调服,用手指探喉催吐,治疗霍乱、宿食、冷痛等症。《千金方》说:凡是疾病适宜用吐法的,效果远胜于用药。)
(严用和的)皂角白矾斑蝥散,〔皂角四挺(去皮弦后炙烤),白矾一两,研成细末,每次服用五分。白矾味酸苦,具有涌泄作用,能软化顽固之痰;皂角味辛咸,能通窍,专门克制风木之气。这是专门的攻邪之兵,在风气流行的季节应当使用。〕或者配合藜芦轻微催吐。中风导致痰升而人突然昏倒,应当先服用此药以开通关窍。(使其微微吐出稀涎,随后再进其他药物。)通关散使用细辛和皂角(研成细末),吹入鼻腔引起喷嚏以保证生命恢复。(卒中患者用此药吹鼻,有喷嚏者可治,无喷嚏者为肺气已绝。)
九首、附方五
(张仲景的)和解剂,半夏、人参、甘草相随。再加黄芩,并加入生姜和大枣,少阳经的各种病症以此为宗。(柴胡八两,半夏半升,人参、甘草、黄芩、生姜各三两,大枣十二枚。治疗一切往来寒热、胸胁胀满疼痛、心烦喜呕、口苦耳聋、咳嗽口渴、心悸下利等半表半里的证候。属于少阳经的,只要见到其中一个症状即可,不必全部具备。胆腑清净,无出无入,经脉位于半表半里之间,治法适宜和解。柴胡升发阳气达于体表,黄芩退热调和阴气,半夏祛除痰饮降逆止呕,人参、甘草扶助正气补益中焦,使邪气不再传入体内。)
(Zhang Zhongjing's) formula contains Xiaohoudou (Vigna angularis, Azuki Bean). [Chantian Gudi (Cucumitis Fructus, Melon Tip) is stir-fried until yellow and powdered together with Xiaohoudou; taken orally mixed with hot or cold water, the dosage is adjusted according to the patient's deficiency or excess.] Alternatively, Lili (Veratrum Nigrum, White Hellebore Rhizome) and Yujin (Curcumae Longae Radix, Turmeric Root) are added. [Zhang Zihe removed Xiaohoudou and added Lili and Fangfeng (Saposhnikoviae Radix, Divaricate Saposhnikovia Root); another prescription removes Xiaohoudou and adds Yujin and Jiu Zhi (Allii Tuberosi Juice), both named Sansheng San (Three Holy Powder). Induced vomiting using a goose feather treats wind-phlegm.] This method induces vomiting of excess-heat and wind-phlegm. [Gudi induces vomiting of excess-heat; Lili induces vomiting of wind-phlegm.] For those with deficiency, Shenlu (Ginseng Stem) alone can be used as an emetic. [For patients with phlegm obstruction who are too weak to take Gudi, Shenlu can replace it, or Zhuli (Bambusa Textilis Var. Multiplex Caulis Juice, Bamboo Sap) can be added.] If the condition involves empty irritability requiring vomiting, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) should be used. [Zhang Zhongjing: 14 Gardeniae Fructus (Gardenia Fruit) and 4 he measures of Douchi (Fermented Soybean), treating residual empty irritability after Shanghan (Cold Damage).] For severe phlegm that is difficult to expel, Wufu Jian (Aconite Lateral Root Process) is required to penetrate. [Zhu Danxi treated Xu Baiyun; initially using Gudi, Zhizi, Kushen (Sophorae Flavescentis Radix, Sophora Root), and Lili failed to induce vomiting repeatedly. Later, administering Jiangshui (Fermented Rice Water) with Wufu Jian resulted in massive vomiting.] The ancients also had Shaoyan Fang (Burned Salt Formula), which is effective for all kinds of stagnation. [Burned salt mixed with hot water, induced vomiting by probing the throat with fingers, treating Huoluan (Cholera-like disorder), Su Shi (Retained Food), Leng Tong (Cold Pain), etc. Qianjin Fang states: For diseases suitable for emesis, this method greatly surpasses medication.]
(Yan Yonghe's) Zaogao Baifan Ban San (Gleditsia Sinensis Fruit, Alum, and Mylabris Powder). [Four stalks of Zaogao (Gleditsia Sinensis Fruit, Chinese Honeylocust Pod - skin and strings removed, roasted), 1 liang of Baifan (Alumen, Alum), powdered. Take 5 fen per dose. Baifan is sour and bitter, inducing vomiting and draining, capable of softening stubborn phlegm; Zaogao is acrid and salty, opening orifices, specifically controlling Wind-Wood pathogenic factors. This is a specialized weapon for attacking pathogens, suitable for use during seasons prone to wind disorders.] Alternatively, combine with Lili for mild vomiting. When wind-stroke causes phlegm to rise leading to sudden fainting, administer this first to open the orifices. [Induce slight vomiting of thin saliva, then proceed with other medications.] Tongguan San (Orifice-Opening Powder) uses Xixin (Asari Radix et Rhizoma, Wild Ginger Root) and Zaogao (powdered), blown into the nose to induce sneezing and ensure survival. [Used for stroke patients; if sneezing occurs, the condition is treatable; if no sneezing occurs, Lung-Qi is exhausted.]
Nine Verses, Five Supplementary Formulas
(Zhang Zhongjing's) Harmonizing formulas rely on Banxia (Pinelliae Rhizoma, Pinellia Tuber), Renshen (Ginseng Radix, Ginseng Root), and Gancao (Glycyrrhizae Radix et Rhizoma, Licorice Root). Add Huangqin (Scutellariae Radix, Skullcap Root), along with Shengjiang (Zingiberis Rhizoma Recens, Fresh Ginger) and Dazao (Jujubae Fructus, Jujube). This is the master formula for all Shaoyang (Lesser Yang) disorders. [Chaihu (Bupleuri Radix, Bupleurum Root) 8 liang, Banxia half sheng, Renshen, Gancao, Huangqin, Shengjiang each 3 liang, Dazao 12 pieces. Treats all alternating chills and fever, chest fullness and hypochondriac pain, irritability with desire to vomit, bitter taste in the mouth, deafness, cough, thirst, palpitations, and diarrhea—symptoms of the half-exterior half-interior syndrome. For conditions belonging to the Shaoyang Meridian, the presence of any single symptom is sufficient; not all need to be present. The Gallbladder Fu organ is pure and quiet, having neither exit nor entry; its meridian lies at the half-exterior half-interior level, so the treatment method should be harmonization. Chaihu raises Yang and reaches the exterior; Huangqin clears heat and harmonizes Yin; Banxia dispels phlegm and directs rebellious Qi downward; Renshen and Gancao support righteous Qi and tonify the Middle Jiao, preventing the pathogen from re-entering the interior.]