论阳明口渴用石膏汤 论四逆汤 论附子理中汤 论大承气汤
天师曰∶短治者,乃病不必长治,而可以短兵取胜,则用短治之法。譬如阳明之症初起,乘其口渴
引水自救之时,急用石膏、知母煎服。一剂而渴减,再剂而渴止,三剂而病如失,即不可再与四剂矣。
盖石膏初用有荡邪之功,久用有损正之失,故可暂用而不可长用。倘不信吾言,以石膏为夺命之药,日日
与之,必致变为痿症,而不能速起也。故我频频戒用石膏者为此。
仲景创立此方,所以救人伤寒传入阳明之症,不得已而用之,截住其邪,不使再传也。原非教人日
日用之也。奈何世医不知此故,妄自多加,任情纵意,忍于轻用,以致杀人而不悟也,悲夫。此短治之
法,又不可不知之。
张公曰∶吾方得岐天师发明,真大幸也。我立此方,原所以救一时之急,非教人经年累月而亦用
之也。世医不悟,亦可闻岐天师之语而悟矣。短治法不止石膏汤,如四逆汤,不可久服也,久则有火盛自
焚之虑。附子理中汤,亦不可久用,有太刚则折之虞。大承气汤止可一剂,而不可至再,重
则有大下亡阴之祸。诸如此,俱可类推。
华君曰∶同。
(白虎汤,张路玉谓为治 热病主方,极有理,故在伤寒门,亦不可轻用。
李子永识。)
论阳明病口渴使用石膏汤(此处指白虎汤类方,以石膏为主药)
论四逆汤
论附子理中汤
论大承气汤
天师说:短治法,是指疾病不需要长期治疗,而可以用短期、迅猛的手段取胜,这就是短治法。比如阳明病刚开始发作时,趁着患者口渴、饮水自救的时候,紧急使用石膏、知母煎煮服用。服一剂后口渴减轻,服两剂后口渴停止,服三剂后病邪消失,此时就不能再服用第四剂了。因为石膏初次使用时有清除邪气的功效,但长期使用会有损伤正气的弊端,所以可以暂时使用而不能长期服用。如果不相信我的话,把石膏当作夺命的毒药,每天都给患者服用,必然会导致转变为痿证(肢体萎软无力),而不能迅速康复。所以我频繁告诫不要滥用石膏,原因就在这里。
张仲景创立这个方子,是为了救治伤寒传入阳明经的病证,是不得已而使用的,目的是截断病邪,不让它继续传变。原本并不是教人天天、日用来服用的。无奈世间的医生不明白这个道理,胡乱多加剂量,随心所欲,忍心轻易使用,以至于导致病人死亡却不自知,真是可悲啊。这种短治法,又是不可不知道的。
张公说:我刚刚得到岐天师(陈士铎自称或尊称)的阐发,真是大幸。我设立这个方子,原本是为了挽救一时的急症,并不是教人长年累月地服用它。世间的医生如果不醒悟,听了岐天师的话也应该能醒悟了。短治法不仅仅适用于石膏汤,比如四逆汤,也不可以久服,久服则有火气过盛、自取焚毁的忧虑。附子理中汤,也不可以长期使用,有过于刚猛而导致折损的担忧。大承气汤只可服用一剂,不可以用到第二剂,病情重的话会有因过度泻下而导致亡阴的祸患。诸如此类的情况,都可以类推。
华君说:同意。
On the Use of Shigao Tang (Gypsum Decoction) for Thirst in Yangming Disease
On Sini Tang (Frigid Extremities Decoction)
On Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction)
On Dachengqi Tang (Major Order the Qi Decoction)
The Heavenly Master said: "Short treatment" refers to a condition that does not require long-term therapy but can be overcome with short, rapid measures; this is the method of short treatment. For instance, when Yangming disease first begins, while the patient is thirsty and drinking water to save themselves, urgently administer a decoction of Gypsum (Shigao) and Anemarrhenae Rhizoma (Zhimu). After one dose, thirst decreases; after two doses, thirst stops; after three doses, the illness vanishes. At this point, do not administer a fourth dose. This is because Gypsum has the merit of sweeping away pathogenic factors when used initially, but causes damage to healthy qi if used for a long time. Therefore, it can be used temporarily but not continuously. If you do not believe my words and treat Gypsum as a life-taking poison, administering it daily, it will inevitably lead to Wei syndrome (flaccidity syndrome), preventing rapid recovery. This is why I frequently warn against the abuse of Gypsum.
Zhang Zhongjing established this formula to rescue patients suffering from Cold Damage transmitted to the Yangming channel. It was used out of necessity to intercept the pathogen and prevent further transmission. It was never intended to teach people to use it day after day. Alas, how unfortunate that physicians of the world fail to understand this principle, recklessly increasing dosages and acting arbitrarily, using it lightly and causing death without realizing their error. This method of short treatment must not be unknown.
Lord Zhang said: "I have just received enlightenment from Heavenly Master Qi, which is truly fortunate. I formulated this prescription originally to save emergencies, not to teach people to use it year after year. Physicians of the world who do not comprehend this should awaken upon hearing Heavenly Master Qi's words. The method of short treatment applies not only to Shigao Tang. For example, Sini Tang should not be taken for a long time; prolonged use carries the risk of excessive fire leading to self-destruction. Fuzi Lizhong Tang should also not be used long-term, as there is a danger of being broken by excessive rigidity. Dachengqi Tang is suitable for only one dose and should not be repeated; in severe cases, excessive purgation may cause the loss of Yin. Such cases can all be inferred by analogy."
Lord Hua said: "Agreed."
(White Tiger Decoction [Baihu Tang], according to Zhang Luyu, is the principal formula for treating febrile diseases, which is very reasonable. Therefore, even in the category of Cold Damage, it should not be used lightly.
Recorded by Li Ziyong.)