用栀子鼓汤去谷加茵陈蒿(六两)大黄(二两)治谷疸之为病寒热不食食即头眩心胸
安久
久发黄为谷疸又治阳明病但头汗出身无汗剂颈而还身必发黄伤寒七八日身黄如橘子色小便不
利腹微满者成无己云小热之气凉以和之大热之气寒以取之茵陈栀子之苦寒以逐胃燥大
寒以下疹热
治病如桂枝证头不痛项不强寸脉微浮胸中痞硬气上冲咽喉不得息者此为胸有寒也当
瓜蒂(一分熬黄苦寒) 赤小豆(一分酸温)
上二味各别捣筛为散已合治之取一钱匕以香豉一合用热汤七合煮作稀糜去滓取汁和散温
顿服
按成无己云华佗曰四日在胸则可吐之此迎而夺之之法也千金方曰气浮上部填塞心胸胸中
满者
喉不
上者
即前方止用瓜蒂(二七个)以水一升煎取五合去滓顿服治太阳中 身热疼重而
以
夏月伤冷水水行皮中所致也又治伤寒三四日者或觉心满坚硬脚手心但热变黄不治
瓜蒂为细末每用一字吹鼻令黄水出余残末水调服之得呕黄水一二升乃愈
用瓜蒂(十四个)丁香(一个)黍米(四十九粒)为细末噙水取一字 鼻下黄涎
按衍义云瓜蒂即甜瓜蒂也瓜蒂成熟自落其蒂在蔓茎上采得曝干不拘多少为细末量病轻重
每服
又治偏正头痛久不愈服诸药及针刺不效者以其湿在头也瓜蒂一味为细末以少许 之鼻中
清水
头目
在胸
之皆
涎潮热发则
切胸上
块下咽
用栀子豉汤去掉谷芽,加入茵陈蒿(六两)、大黄(二两),治疗谷疸这种病证:患者出现寒热往来、不能进食,一吃东西就感到头晕目眩,心胸部位感觉不适。久而久之身体发黄,这就是谷疸。又用于治疗阳明病,仅头部出汗,身上无汗,汗出仅限于颈部而止,身体必然发黄;以及伤寒病程七八天,身体黄色如橘子色,小便不通利,腹部轻微胀满的情况。成无己说:“小热之气,用凉性药调和它;大热之气,用寒性药攻取它。”茵陈蒿和栀子的苦寒之性,用来驱除胃中的燥热;大黄的大寒之性,用来泻下实热。
如果病症表现为类似桂枝汤证(太阳中风表虚证),但头痛、项强等症状不存在,且寸脉微浮,胸中痞塞坚硬,气向上冲至咽喉导致呼吸不畅的,这是胸中有痰饮(寒邪)所致。应当使用瓜蒂散(一分,炒至微黄,味苦寒)和赤小豆(一分,味酸温)。以上两味药,分别捣碎并过筛成散剂,混合均匀。取一方寸匕的药散,用香豉一合,加热水七合,煮成稀粥状,去渣取汁,将药散调入药汁中,温热时一次性服下。
按语:成无己引用华佗的话说:“病邪在胸膈四日之内,可以用吐法治疗。”这是迎头痛击、夺其邪气的治法。《千金方》说:“气机浮越于上部,填塞心胸,胸中胀满,气上冲咽喉不得息的,”
即前方仅用瓜蒂(十四个),加水一升,煎取五合,去渣后一次性服下。用于治疗夏季中暑,身体发热、疼痛沉重,这是因为夏天贪凉饮冷,水湿停留在皮肤腠理之间所致。又用于治疗伤寒三四天后,或者自觉心下痞满坚硬,手脚心发热,病情转化为黄疸且难以治愈的情况。将瓜蒂研为细末,每次取一字量的药粉吹入鼻中,使黄水流出;剩余的粉末用水调服。若吐出或流出黄水一二升,病即可痊愈。
用瓜蒂(十四个)、丁香(一个)、黍米(四十九粒)研为细末,含水含在口中,取一字量的药粉吹入鼻中,引出黄涎。
按语:《衍义》说:“瓜蒂就是甜瓜蒂。瓜蒂成熟后会自然脱落,采摘其连接藤蔓茎部的蒂,晒干,数量不限,研为细末。根据病情的轻重,每次服用少许吹入鼻中。”
又用于治疗偏头痛或正头痛,久治不愈,服用各种药物及针刺均无效者,这是因为湿气在头部。单用瓜蒂一味研为细末,取少许吹入鼻中,引出清水和黄涎。
Use Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), remove the rice sprouts, add Yinchen Hao (Artemisiae Scopariae Herba, 6 liang) and Dahuang (Rhei Radix et Rhizoma, 2 liang) to treat Gu Dan (Grain Jaundice). The disease presents with alternating chills and fever, anorexia, dizziness immediately after eating, and discomfort in the chest and epigastrium. Over time, jaundice develops, which is termed Gu Dan. It is also used for Yangming disease where there is sweating only on the head, no sweating on the body, sweat stopping at the neck, and inevitable jaundice; as well as for Cold Damage (Shanghan) lasting seven or eight days, presenting with jaundice like the color of an orange, difficulty in urination, and slight abdominal fullness. Cheng Wuji stated: "For mild heat, use cool herbs to harmonize it; for severe heat, use cold herbs to purge it." The bitter-cold nature of Yinchen Hao and Zhizi is used to drive out gastric dryness-heat, while the great-cold nature of Dahuang is used to purge excess heat downward.
If the presentation resembles Guizhi Tang syndrome (Cinnamon Twig Decoction syndrome), but without headache or stiffness of the neck, with a slightly floating pulse at the cun position, oppression and hardness in the chest, and qi rushing up to the throat causing dyspnea, this indicates phlegm-fluid retention (cold pathogen) in the chest. One should use Gouti San (Melon Pedicle Powder): Gouti (Melonis Fructus Semen, 1 fen, stir-fried until yellowish, bitter and cold) and Chixiaodou (Vigna Angularis Seed, 1 fen, sour and warm). These two herbs are separately pounded and sifted into powder, then mixed. Take one fangcun bi (a measure roughly equivalent to a square inch) of the powder, mix with Xiangchi (Perillae Fructus, 1 he) and hot water (7 he), boil into a thin porridge, strain, take the decoction, mix with the powder, and drink warm in one dose.
Note: Cheng Wuji quoted Hua Tuo saying: "If the pathogen has been in the chest for four days, emesis can be induced. This is the method of intercepting and depriving the pathogen." The Qianjin Fang states: "When qi floats upward, filling the chest and epigastrium, causing chest fullness and qi rushing to the throat preventing respiration..."
That is, the previous formula uses only Gouti (14 pieces), boiled in one sheng of water to obtain five he, strained and taken in one dose. It treats Summerheat stroke characterized by fever, pain, and heaviness, caused by consuming cold water in summer, leading to water-dampness remaining in the skin and interstices. It also treats Cold Damage after three or four days, where the patient feels fullness and hardness in the heart/epigastrium, heat in the palms and soles, progressing to refractory jaundice. Grind Gouti into fine powder. Use one zi (a small measure) insufflated into the nose to discharge yellow fluid. The remaining powder is taken orally with water. If one or two sheng of yellow fluid is vomited or discharged, the disease is cured.
Use Gouti (14 pieces), Dingxiang (Caryophylli Flos, 1 piece), and Shumi (Panicum Miliaceum Grain, 49 grains) ground into fine powder. Moisten with water, hold in mouth, and insufflate one zi into the nose to draw out yellow saliva.
Note: Yan Yi states: "Gouti is the pedicle of the sweet melon. When ripe, it falls naturally. Harvest the pedicle attached to the vine stem, dry it in the sun, grind into fine powder regardless of quantity. Based on the severity of the illness, insufflate a small amount into the nose."
It also treats chronic lateral or frontal headache unresponsive to various medicines and acupuncture, due to dampness in the head. Use single herb Gouti ground into fine powder, insufflate a small amount into the nose to draw out clear fluid and yellow saliva.
Phlegm-fluid located above the chest and diaphragm all emerge with the tidal flow of saliva and heat. Palpate the upper chest; masses may be felt moving down the throat.