用葱白二把煎汤服取汗
愚按伤寒法仲景此万古不易之论也但其言简奥浅识不能探赜后世洁古乃立九味羌活汤自
谓不
乡僻
治汗吐下后虚烦不得眠心中懊 及发汗若下之而烦热胸中窒者伤寒五六日大下之
不去心中结痛者又治阳明病下之其外有热手足温不结胸心中懊 不能食但头汗出者
栀子(十四枚擘苦寒) 香豉(四合绵裹苦寒)
上二味以水四升先煮栀子得二升半内豉煮取一升半去滓分为二服温进一服得吐则止后服
按成无己云内经曰其高者因而越之其下者引而竭之中满者泻之于内其有邪者渍形以为汗
其在
则可
若发
涌吐
即栀子豉汤加甘草(二两)治症同前而少气者盖少气则气为热搏散而不收者甘
即栀子豉汤加生姜(五两)治证同前而呕者盖呕则气为热搏逆而不散者辛以散
即栀子豉汤去豉加浓朴(四两)姜炙枳实(四枚)去穣炙令黄治伤寒下后心烦腹满
不安
者盖用栀子之苦以涌虚烦枳朴之苦以泄腹满也
即栀子豉汤去豉加干姜(二两)治伤寒医以圆药大下之身热不去微烦者盖用干姜
以
复正气也
用葱白两把煎汤服用,以取汗出。
我按:伤寒治法中,张仲景的论述是万古不变的真理。但其文字简奥,见识浅薄的人不能探究其深意。后世医家王好古(洁古)于是创立了九味羌活汤,自称……(此处原文有缺漏/语意不全,推测为“自谓不……”或类似评价,因原文断裂,仅译可见部分)。
治疗发汗、催吐、泻下之后,出现虚烦、不得安眠、心中懊恼;以及发汗或泻下后,出现烦热、胸中窒塞感的病证。
又治疗阳明病,经过泻下后,体表仍有发热,手足温暖,没有形成结胸,心中懊恼,不能进食,只有头部出汗的症状。
栀子(十四枚,掰开,味苦性寒) 香豉(四合,绵布包裹,味苦性寒)
以上两味药,用水四升,先煮栀子,取二升半药液,加入香豉,再煮取一升半药液,滤去药渣,分两次温服。第一次服用后,如果引起呕吐,则停止后续服用。
按成无己所说,《内经》记载:“病位高的,顺势涌吐;病位低的,引导排泄;中焦胀满的,从内部泻下;有表邪的,浸渍形体以发汗。”……(此处原文有缺漏)……可以……若发……涌吐……(原文片段,无法构成完整句子,略过不可读部分)。
即栀子豉汤加甘草(二两),主治症状同前,但伴有少气(气短乏力)者。盖因气短是因为气被热邪搏击而散逸不收,甘味能……(原文截断,推测为“甘能补/缓”)。
即栀子豉汤加生姜(五两),主治证候同前,但伴有呕吐者。盖因呕吐是因为气被热邪搏击而逆乱不散,辛味能散……(原文截断,推测为“辛以散逆”)。
即栀子豉汤去掉香豉,加厚朴(四两,姜炙)、枳实(四枚,去瓤,炙至黄色),主治伤寒泻下后心烦、腹部胀满不安的症状。这是因为用栀子的苦味来涌吐虚烦,用枳实、厚朴的苦味来泄除腹满。
即栀子豉汤去掉香豉,加干姜(二两),主治伤寒医生用丸药猛烈泻下后,身体发热不退、轻微心烦的症状。这是因为用干姜……(原文截断,推测为“以温中复正气”)。
即栀子豉汤去掉香豉,加炙甘草、黄柏(各一两),主治伤寒身体发黄、发热的症状。
即栀子豉汤增加香豉(六合),加大黄(一两)、枳实(五枚),主治酒疸,心中懊恼或热痛的症状。
即栀子柏皮汤去掉甘草,增加黄柏,加大黄、硝石(各四两),主治黄疸,腹部胀满,小便不利且色赤,自述表证已解、里实当下之证。
Decoct two bunches of Scallion White (Congbai) in water and take orally to induce sweating.
My commentary: In the treatment of Cold Damage (Shanghan), Zhang Zhongjing's theories are unchanging principles for all ages. However, his writings are concise and profound; those with shallow understanding cannot explore their depths. Later physician Wang Haogu (Jiegu) therefore established the Jiwei Qianghuo Tang (Nine-Ingredient Notopterygia Decoction), claiming... [Text fragment incomplete].
Treating cases of deficiency vexation, insomnia, and inner restlessness (Ao Nan) after sweating, vomiting, or purging; as well as cases where sweating or purging leads to vexation, heat, and a sensation of obstruction in the chest.
Treating cases where, after five to six days of Cold Damage, severe purging was performed but the pathogen remained, resulting in a painful knot in the heart region.
Also treating Yangming disease where, after purging, there is external heat, warm hands and feet, no formation of Chest Binding (Jie Xiong), inner restlessness, inability to eat, and only sweating on the head.
Zhi Zi (Gardeniae Fructus, 14 pods, broken open, bitter, cold) Xiang Chi (Fermented Soybean, 4 he, wrapped in silk cloth, bitter, cold)
Take the above two ingredients, add four sheng of water, first decoct Zhi Zi until half remains (2.5 sheng), then add Xiang Chi and decoct until one and a half sheng remains. Strain the dregs. Divide into two doses. Take warm. If vomiting occurs after the first dose, stop taking the remaining dose.
According to Cheng Wuji, citing the *Neijing*: "For pathogens located high, induce emesis; for those low, guide them out through excretion; for fullness in the middle, purge from within; for exterior pathogens, soak the body to induce sweating." ... [Text fragments omitted due to incompleteness] ... can ... if inducing ... emesis ...
This is Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) plus Gan Cao (Licorice Root, 2 liang). The indications are the same as above, but accompanied by shortness of breath (Shao Qi). This is because shortness of breath results from Qi being scattered and unable to gather due to heat combat; sweet flavor... [Text truncated].
This is Zhi Zi Chi Tang plus Sheng Jiang (Fresh Ginger, 5 liang). The indications are the same as above, but accompanied by vomiting. This is because vomiting results from Qi being rebellious and unable to disperse due to heat combat; pungent flavor can disperse... [Text truncated].
This is Zhi Zi Chi Tang without Xiang Chi, adding Hou Po (Magnolia Bark, 4 liang, ginger-fried) and Zhi Shi (Immature Bitter Orange, 4 pieces, pith removed, fried until yellow). It treats Cold Damage after purging, characterized by vexation, abdominal fullness, and discomfort. This uses the bitterness of Zhi Zi to涌 (urge/vomit) deficiency vexation, and the bitterness of Zhi Shi and Hou Po to drain abdominal fullness.
This is Zhi Zi Chi Tang without Xiang Chi, adding Gan Jiang (Dried Ginger, 2 liang). It treats Cold Damage where a physician used pill medicine for severe purging, resulting in persistent body heat and slight vexation. This uses Gan Jiang... [Text truncated, likely to restore healthy Qi].
This is Zhi Zi Chi Tang without Xiang Chi, adding Zhi Gan Cao (Honey-fried Licorice Root) and Huang Bo (Phellodendron Bark, 1 liang each). It treats Cold Damage presenting with jaundice and fever.
This is Zhi Zi Chi Tang with increased Xiang Chi (6 he), added Da Huang (Rhubarb Root, 1 liang) and Zhi Shi (Immature Bitter Orange, 5 pieces). It treats Wine Jaundice (Jiu Huang Dan) with inner restlessness or hot pain in the heart.
This is Zhi Zi Bai Pi Tang (Gardenia and Phellodendron Bark Decoction) without Gan Cao, increased Huang Bo, added Da Huang (Rhubarb Root) and Xiao Shi (Niter, 4 liang each). It treats Jaundice with abdominal fullness, difficult and dark urination, indicating that the exterior is harmonized and the interior is excess, requiring purgation.