论发狂见鬼 论发狂不见鬼 论中风堕地 论卒倒不知人。
天师曰∶凡人有病发狂如见鬼状,或跌倒不知人,或中风不语,或自卧而跌在床下者,此皆正气虚
而邪气犯之也。似宜正治邪为是,然而邪之所凑,其气必虚,不治其虚,安问其余。此所以急宜固其正
气,而少佐以祛痰、祛邪之药为妙。如发狂见鬼者,乃虚也,方用人参一两,白术一两,半夏三钱,天南星三钱,附
子一钱,大剂灌之,狂自定矣。(〔批〕祛狂至神丹方。妙。)或倒不
知人,乃气虚也,亦用前方主之。或中风不语者,以人参一两,天南星三钱,生半夏三钱,生附
子一个,名为三生饮,急灌之。又自卧跌床下者,即中风类他,又名尸厥,亦以三生饮救之。
发狂不知人而不见鬼者,乃热也,不可与前汤。此见鬼为虚,而非实热。方用人参,同入于祛痰、祛
邪之药内,乃
因其反而反治之也。
跌倒不知人,虽因气虚,然未有无痰而能跌倒者,既跌倒,亦未有不知人者,故必须祛痰,而佐以
助正之药,此前方之所以可兼治之也。
中风与堕地之症。纯是气虚。气虚之人,未有不生痰者。痰重,卒中卒倒,有由来也。然则徒治其
痰,而不补其气,即所以杀之也。三生饮妙在用生人参一两,同生附、半夏、南星祛邪荡涤之药,驾
驭而攻之。譬如大将登坛,用虎贲之士,以扫荡群妖,必能活生人于杀人之中。若徒正治其邪,而不反
治其本,则十人九死,冤鬼夜号,谁之咎欤。(〔批〕纯。)
张公曰∶发狂见鬼,明是虚而痰中之。用半夏、南星附子以祛痰,不用人参、白术之多,何以驱
驾之而成功哉。此方之妙,不特治发狂见鬼如神,而治中风不语。卒倒不知人,亦神妙之极,盖气虚而
后痰中也。岐天师分析甚精,又引三生饮以治中风等症。其实前方除发狂不见鬼,不可用此方,其余无不
可治,正不必又用三生饮也。然三生饮亦是奇方,亦可采用之。总之,斟酌于二方之间,无不可起生人于
死人之中也。
发狂不见鬼。明是内热之症,岐天师不立方者,待余补之也。方用人参三钱。白芍三钱,
白芥子三钱,半夏三钱,天南星二钱,黄连二钱,陈皮一钱,甘草一钱,水
煎服。此方妙在用黄连。盖厥深则热亦深,去其热则厥自定。黄连入心,引诸补心之味,同群相济,或补或
泻。譬如人家相争,嚷于一室,亲朋各为劝解。自然怒气平而悔心发,黄连之用于补剂之中,正此意也。
华君曰∶是传余之文,无有他方。我尚有数语,请载于
后。中风等症,非大加人参,以祛驾其邪,则痰不能开,而邪不能散。方中妙在用人参至一两,始有力
量。否则,少用反为痰邪所使,又安能助制附子,以直荡群妖哉。
雷公曰∶妙极,各阐发无遗,无可再谈。
真圣人之言。(李子永识。)
天师说:大凡人患病出现发狂、好像看见鬼怪的症状,或者跌倒后不省人事,或者中风不能言语,或者自己躺着却跌落在床下的情况,这都是因为正气虚弱而邪气侵犯所致。表面上看似乎应该用常规方法治疗邪气是对的,然而《内经》云“邪之所凑,其气必虚”,如果不治疗其正气之虚,又怎能顾及其他呢?这就是为什么急需固护正气,并少量辅以祛痰、祛邪的药物为妙。例如发狂见鬼的情况,属于虚证,方剂用人参一两,白术一两,半夏三钱,天南星三钱,附子一钱,用大剂量汤药灌服,发狂自然就会停止。(批注:这是祛狂的神效丹药方,精妙。)如果是跌倒不省人事,属于气虚,也使用前方主治。如果是中风不能言语的,用人参一两,天南星三钱,生半夏三钱,生附子一个,名为三生饮(San Sheng Yin, Three Lives Decoction),紧急灌服。又有自己躺着跌落在床下的,即属于中风类病症,又名尸厥(Shi Jue, Corpse Faintness/Coma),也用三生饮来救治。
发狂不省人事但不见鬼怪的,属于热证,不可使用前面的汤剂。这里见鬼的是虚证,而非实热证。方剂用人参,将其加入祛痰、祛邪的药物中,这是采用“反治法”(Fan Zhi Fa, Contrary Treatment)来治疗。
跌倒不省人事,虽然是因为气虚,但没有无痰就能导致跌倒的,既然跌倒了,也没有不失去知觉的,所以必须祛痰,并辅以扶助正气的药物,这就是前方可以兼治这些症状的原因。
中风和跌倒的病症,纯粹是气虚。气虚的人,没有不生痰的。痰浊壅盛,导致卒中突然倒下,是有其原因的。那么如果只治疗痰而不补气,这实际上是在害死病人。三生饮的精妙之处在于使用生人参一两,配合生附子、半夏、天南星等祛邪涤荡的药物,驾驭它们去攻治病邪。这就好比大将登坛点将,率领勇猛的士兵,去扫荡群妖,必定能在杀机之中救活病人。如果仅仅用常规方法治疗邪气,而不从根本上进行反治,那么十个人会有九个死亡,冤魂夜间哀号,这是谁的过错呢?(批注:纯粹。)
张公说:发狂见鬼,明显是虚证夹痰。使用半夏、南星、附子来祛痰,如果不大量使用人参、白术,怎么能驾驭药力而取得成功呢?这个方子的精妙之处,不仅治疗发狂见鬼如神,而且治疗中风不语、突然倒下不省人事,也极其神妙,这是因为气虚之后才产生痰浊。岐天师分析得非常精细,又引用三生饮来治疗中风等症状。其实除了前方提到的发狂不见鬼不可用此方外,其余病症无不适用,确实不必再另用三生饮了。然而三生饮也是奇方,也可以采用。总之,在两个方剂之间斟酌使用,没有不能把死人救活的道理。
发狂不见鬼,明显是内热证,岐天师没有开方,是等待我来补充。方剂用人参三钱,白芍三钱,白芥子三钱,半夏三钱,天南星二钱,黄连二钱,陈皮一钱,甘草一钱,水煎服。这个方子的精妙之处在于使用黄连。盖因厥逆越深,热邪也越深,去除热邪则厥逆自然平息。黄连入心经,引导各种补心的药物,与诸药相互济助,或补或泻。就像人家发生争执,在一间屋子里吵闹,亲朋好友各自劝解,自然怒气平息悔意产生。黄连用在补益剂中,正是这个意思。
华君说:这是传承给我的文章,没有其他方剂。我还有几句话,请记载在后面。中风等病症,如果不大量加入人参,以驾驭祛除邪气,那么痰就不能开通,邪气就不能消散。方中的精妙在于使用人参至一两重,才开始有力量。否则,用量少反而被痰邪所利用,又怎么能辅助制约附子,去直接扫荡群妖呢?
On Mania with Hallucinations of Ghosts, On Mania without Hallucinations of Ghosts, On Stroke Leading to Falling, On Sudden Collapse and Loss of Consciousness.
The Heavenly Master said: When a person suffers from illness manifesting as mania with hallucinations of ghosts, or falls down and loses consciousness, or suffers from stroke with aphasia, or lies down but falls off the bed, these are all caused by deficiency of Zheng Qi (Upright Qi) allowing Xie Qi (Pathogenic Factors) to invade. Superficially, it seems correct to treat the pathogen directly; however, where the pathogen gathers, there must be deficiency of Qi. If one does not treat the deficiency, how can one attend to other matters? This is why it is urgent to consolidate Zheng Qi (Upright Qi), supplemented by small amounts of herbs that resolve Phlegm and dispel Pathogens, which is the subtle approach. For example, mania with hallucinations of ghosts is due to deficiency. The prescription uses Ren Shen (Ginseng Radix) 1 liang, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 1 liang, Ban Xia (Pinelliae Tuber) 3 qian, Tian Nan Xing (Arisaematis Rhizoma Preparatum) 3 qian, and Fu Zi (Aconiti Lateralis Radix Praeparata) 1 qian. Administered in a large dose as a decoction, the mania will naturally subside. (Comment: This is the divine pill formula for dispelling mania, exquisite.) If the patient falls and loses consciousness, this is due to Qi deficiency, and the same prescription should be used. If the patient has stroke with aphasia, use Ren Shen (Ginseng Radix) 1 liang, Tian Nan Xing (Arisaematis Rhizoma Preparatum) 3 qian, raw Ban Xia (Pinelliae Tuber) 3 qian, and one raw Fu Zi (Aconiti Lateralis Radix), named San Sheng Yin (Three Lives Decoction). Administer urgently. Those who fall off the bed while lying down suffer from a condition similar to stroke, also known as Shi Jue (Corpse Faintness/Coma), and should also be saved with San Sheng Yin (Three Lives Decoction).
Mania with loss of consciousness but without hallucinations of ghosts is due to Heat. One must not use the previous decoction. The presence of hallucinations indicates deficiency, not Excess Heat. The prescription uses Ren Shen (Ginseng Radix) incorporated into herbs that resolve Phlegm and dispel Pathogens. This employs Fan Zhi Fa (Contrary Treatment), treating the disease by using methods contrary to its apparent nature.
Falling and loss of consciousness, although caused by Qi deficiency, never occur without Phlegm. Once fallen, consciousness is invariably lost. Therefore, resolving Phlegm is necessary, assisted by herbs that support Zheng Qi (Upright Qi). This explains why the previous prescription can treat these conditions concurrently.
Stroke and falling are purely due to Qi deficiency. Those with Qi deficiency inevitably generate Phlegm. Heavy accumulation of Phlegm leads to sudden stroke and collapse, which has its origins. Thus, treating only the Phlegm without tonifying Qi is tantamount to killing the patient. The subtlety of San Sheng Yin (Three Lives Decoction) lies in using raw Ren Shen (Ginseng Radix) 1 liang, combined with raw Fu Zi (Aconiti Lateralis Radix), Ban Xia (Pinelliae Tuber), and Tian Nan Xing (Arisaematis Rhizoma Preparatum)—herbs that dispel pathogens and cleanse the body—to drive them against the disease. It is like a general taking command, leading brave soldiers to sweep away demons; surely, life can be saved amidst death. If one merely treats the pathogen directly without addressing the root through contrary treatment, nine out of ten will die, and vengeful spirits will wail at night. Whose fault is this? (Comment: Pure.)
Master Zhang said: Mania with hallucinations of ghosts is clearly deficiency complicated by Phlegm. Using Ban Xia (Pinelliae Tuber), Tian Nan Xing (Arisaematis Rhizoma Preparatum), and Fu Zi (Aconiti Lateralis Radix) to resolve Phlegm requires substantial doses of Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) to guide the medicinal power to success. The subtlety of this prescription is not only in its efficacy for mania with hallucinations but also in its miraculous effect on stroke with aphasia and sudden collapse with loss of consciousness, because Phlegm arises after Qi deficiency. The Heavenly Master Qi analyzed this with great precision and further cited San Sheng Yin (Three Lives Decoction) for stroke. In fact, except for mania without hallucinations where this prescription is contraindicated, it is applicable to all other conditions, so there is no need to use San Sheng Yin (Three Lives Decoction) separately. However, San Sheng Yin (Three Lives Decoction) is also an extraordinary formula and can be adopted. In summary, by weighing between these two prescriptions, one can save the dying.
Mania without hallucinations of ghosts is clearly an internal Heat syndrome. The Heavenly Master Qi did not prescribe a formula, waiting for me to supplement it. The prescription uses Ren Shen (Ginseng Radix) 3 qian, Bai Shao (Paeoniae Radix Alba) 3 qian, Bai Jie Zi (Sinapis Semen) 3 qian, Ban Xia (Pinelliae Tuber) 3 qian, Tian Nan Xing (Arisaematis Rhizoma Preparatum) 2 qian, Huang Lian (Coptidis Rhizoma) 2 qian, Chen Pi (Citri Reticulatae Pericarpium) 1 qian, and Gan Cao (Glycyrrhizae Radix et Rhizoma) 1 qian. Decoct in water and take orally. The subtlety of this prescription lies in the use of Huang Lian (Coptidis Rhizoma). As the depth of Jue Ni (Reversal Cold/Collapse) increases, the heat also deepens; removing the heat causes the Jue Ni (Reversal Cold/Collapse) to settle naturally. Huang Lian (Coptidis Rhizoma) enters the Heart channel, guiding various Heart-tonifying ingredients to assist each other, either tonifying or draining. It is like neighbors arguing in a room, where relatives and friends intervene to mediate; naturally, anger subsides and repentance arises. The use of Huang Lian (Coptidis Rhizoma) within a tonifying formula embodies this principle.
Master Hua said: This text was transmitted to me, containing no other formulas. I have a few words to add. For stroke and similar conditions, if one does not add substantial amounts of Ren Shen (Ginseng Radix) to drive out pathogens, Phlegm cannot be resolved, and pathogens cannot be dispersed. The subtlety of the formula lies in using Ren Shen (Ginseng Radix) up to 1 liang to gain sufficient strength. Otherwise, a small dose would be manipulated by Phlegm and pathogens, and how could it assist in restraining Fu Zi (Aconiti Lateralis Radix Praeparata) to directly sweep away the demonic pathogens?
Lord Lei said: Extremely subtle. Each has expounded upon this without omission, leaving nothing more to discuss.
Truly the words of a Sage. (Recorded by Li Ziyong.)