苏合香丸 疗传尸骨蒸, 肺痿,疰忤鬼气,卒心痛,霍乱吐痢,时气鬼魅瘴疟,赤白暴痢,瘀血月闭,
癖疔肿,惊痫,鬼忤中人,小儿吐乳,大人狐狸等病。
白术 青木香 乌犀角(屑) 香附子(炒,去毛) 朱砂(研,水飞) 诃藜勒(煨,取皮) 白檀香
安息香(另末,无灰酒一升熬膏) 沉香 麝香(研) 丁香 荜茇(各二两) 龙脑(研) 苏合香油
(入安息香膏内,各一两) 熏陆香(别研,一两)
上为细末,入研药匀,用安息香膏并炼白蜜和剂,每服旋丸如梧桐子大。早朝取井华水,温冷任意,化
服四丸,老人小儿化服一丸,温酒化服亦得,并空心服之。用蜡纸裹一丸如弹子大,绯绢袋当心带之,一切邪
神不敢近。
《易简》三生饮 治卒中昏不知人事,口眼 斜,半身不遂,咽喉作声,痰气上壅,无问外感风寒,内伤喜怒,
或六脉沉伏,或指下浮盛,并宜服之。兼治痰厥、饮厥,及气虚眩晕,悉有神效。但口开手散,眼合遗尿,
声如鼾鼻者难治。
南星(一两) 川乌(去皮) 生附子(各半两) 木香(二钱半)
上 咀,每服半两,水二盏,姜十片,煎至六分,去渣温服。或口噤不省人事者,用细辛、皂角各少许,
为细末,以芦管吹入鼻中,候喷嚏,其人少苏,然后进药。痰涎壅盛者,每服加全蝎四枚,仍用养正丹镇
坠之。一方,气盛人止用南星半两,木香一钱,加生姜七片,名星香散。一方,气虚人用生附子并木香如
前敷煎,名附香饮。亦有天雄代附子者,并治卒中始作,无不克效。因气中,以净汤化苏合香丸,乘热灌
服,仍用前药汁浓磨沉香一呷许,再煎一沸服之,候服前药已定,审的是风,方用醒风汤、小续命汤之
类。中寒则用附子理中汤、姜附汤之类。中湿则白术酒、术附汤之类皆可用。中暑不录于此。痰饮厥逆,气
虚眩晕,止守本方。
胜金丸(《本事》) 治中风忽然昏倒若醉,形体昏闷,四肢不收,风涎潮于上膈,气闭不通。
生薄荷(半两) 猪牙皂角(二两,捶碎,水一升,二味一处浸取汁,慢火研成膏) 瓜蒂(末、一两)
藜芦(二两) 朱砂(半两,研)
上将朱砂末二分,与二味末研匀,用膏子搜和,丸如龙眼大,以朱砂为衣。温酒化下一丸,甚者二丸,
以吐为度。得吐即醒,不醒者不可治。《必用方》论中风无吐法,引金虎、碧霞为戒。且如卒暴涎生,声如引
锯,牙关紧急,气闭不行,汤药不能入,命在须臾者,执以无吐法可乎?但不当用银粉药,恐损脾,坏人四
肢尔。(罗谦甫方,有粉霜、铅粉,无藜芦,治法同。)
治急中风,口闭涎上,欲垂死者,一服即瘥。
江子(二粒,去皮膜) 白矾(如拇指大一块,为末)
上将二味在于新瓦上 令江子焦赤为度,炼蜜丸,如芡实大。每服一丸,用绵裹,放患人口中近喉处,
良久吐痰,立愈。(更参中风门口噤条。)
附∶还魂汤(《千金》) 治卒感忤,鬼击飞尸,诸奄忽气绝无复觉,或已死绞口,口噤不开,去齿下汤。汤入
口不下者,分病患发,左右捉踏肩引之,药下复增,取尽一升,须臾立苏。
麻黄(三两) 桂心(二两) 甘草(一两) 杏仁(七
十粒)
上 咀,水八升,煮取三升,分三服。(《肘后方》云∶张仲景方无桂心,只三味。)
苏合香丸:治疗传尸骨蒸(痨病引起的骨蒸发热)、肺痿、疰忤鬼气(指因接触邪祟或传染病导致的突然昏厥或精神异常)、突发心痛、霍乱吐痢、时行疫病及瘴疟、赤白暴痢(急性脓血便)、瘀血导致的月经闭止、癖疔肿(积聚肿块及疔疮肿痛)、惊痫、鬼忤中人(邪气侵袭人体)、小儿吐乳、大人狐狸病(指狐惑病等疑难杂症)等病症。
配方:白术、青木香、乌犀角(锉屑)、香附子(炒制,去毛)、朱砂(研细,水飞法处理)、诃黎勒(煨制,取皮)、白檀香、安息香(另研为末,用无灰酒一升熬成膏状)、沉香、麝香(研细)、丁香、荜茇(以上各二两)、龙脑(研细)、苏合香油(加入安息香膏中,各一两)、熏陆香(别处研细,一两)。
以上药物制成细末,与研好的药物混合均匀,用安息香膏和炼过的白蜜调和成药剂,每次服用时搓丸如梧桐子大小。早晨取井华水(清晨第一次打的井水),温度冷热随意,化开服用四丸;老人和儿童化开服用一丸;用温酒化服也可以,均需空腹服用。用蜡纸包裹一丸如弹子大小,系在绯色绢袋中挂在胸口,一切邪神不敢靠近。
《易简》三生饮:治疗卒中后昏迷不省人事、口眼歪斜、半身不遂、咽喉发出痰鸣声、痰气上壅,无论外感风寒还是内伤喜怒所致,或者六脉沉伏,或者指下浮盛,都适宜服用。兼治痰厥、饮厥,以及气虚眩晕,都有显著疗效。但如果出现口开手散、眼睛闭合遗尿、声音像打鼾鼻息者,则难以治疗。
配方:南星(一两)、川乌(去皮)、生附子(各半两)、木香(二钱半)。
以上药物切碎,每次服用半两,加水二盏,生姜十片,煎至六分,去渣温服。如果是牙关紧闭不省人事者,用细辛、皂角各少许,研成细末,用芦管吹入鼻中,等待患者打喷嚏,稍微苏醒后,再进药。如果痰涎壅盛者,每服加全蝎四枚,仍需用养正丹来镇坠痰浊。另一方案,气盛之人只用南星半两、木香一钱,加生姜七片,名为星香散。另一方案,气虚之人用生附子和木香按前述方法煎服,名为附香饮。也有用天雄代替附子的,均治疗卒中初起,无不奏效。如果是因气机逆乱中邪,用净汤化开苏合香丸,趁热灌服,仍用前药汁浓磨沉香约一呷许,再煎一沸后服用。待服用前面的药物稳定后,仔细辨别确是风邪,才使用醒风汤、小续命汤之类的方剂。中寒则用附子理中汤、姜附汤之类的方剂。中湿则白术酒、术附汤之类的方剂皆可用。中暑不收录在此处。痰饮厥逆、气虚眩晕,只守本方。
胜金丸(出自《本事方》):治疗中风忽然昏倒像醉酒一样,身体昏闷,四肢不能收持,风涎潮涌于上膈,气机闭塞不通。
配方:生薄荷(半两)、猪牙皂角(二两,捶碎,用水一升,将两味药一处浸泡取汁,慢火研成膏状)、瓜蒂(末,一两)、藜芦(二两)、朱砂(半两,研细)。
先将朱砂末二分,与另外两味药的粉末研匀,用膏子搜和,丸如龙眼大,以朱砂为衣。温酒化下一丸,重症者两丸,以吐出为度。吐出后即苏醒,不醒的不可治。《必用方》论述中风没有吐法,引用金虎、碧霞作为警戒。况且如突然暴发涎液生成,声音像拉锯,牙关紧急,气闭不行,汤药不能入口,性命在顷刻之间,坚持说没有吐法可以吗?只是不应当使用银粉药,恐怕损伤脾胃,毁坏四肢罢了。(罗谦甫的方子,有粉霜、铅粉,无藜芦,治疗方法相同。)
治疗急中风,口闭涎上,快要死去的,一服药即痊愈。
上将两味药放在新瓦上焙干,令江子焦赤为止,炼蜜丸,如芡实大。每次服用一丸,用绵裹住,放在患者口中靠近喉咙处,良久吐出痰涎,立即痊愈。(更参看中风门口噤条。)
附:还魂汤(出自《千金方》):治疗突然感受忤逆之气、鬼击飞尸、诸种奄忽气绝无知觉,或者已经死亡牙关紧闭,口噤不开,需去掉牙齿下汤。汤入口不下者,分开患者的头发,左右捉踏肩膀牵引,药下后再增加,取尽一升,须臾立刻苏醒。
Suhe Xiang Wan (Styrax Pill): Treats chuan shi gu zheng (consumptive disease with bone-steaming fever), fei wei (lung atrophy), zhu wu gui qi (sudden fainting or mental abnormality caused by evil spirits or infectious diseases), cu xin tong (sudden heart pain), huo luan tu li (cholera-like vomiting and diarrhea), shi qi gui mei zhang nue (epidemic diseases, miasma malaria), chi bai bao li (acute dysentery with blood and pus), yu xue yue bi (amenorrhea due to blood stasis), pi ding zhong (accumulation masses and carbuncle swelling), jing xian (convulsions and epilepsy), gui wu zhong ren (invasion of evil qi into the body), xiao er tu ru (infant regurgitation), da ren hu li deng bing (adult fox disease and other difficult conditions).
Formula: Bai Zhu (Atractylodis Rhizoma), Qing Mu Xiang (Lithospermi Radix et Rhizoma), Wu Xi Jiao (Rhinocerotis Cornu) [crushed], Xiang Fu Zi (Cyperi Rhizoma) [stir-fried, hairs removed], Zhu Sha (Cinnabaris) [ground, processed by water flotation], He Li Le (Terminaliae Fructus) [roasted, peel taken], Bai Tan Xiang (Santalum Album Lignum), An Xi Xiang (Benzoinum) [separately ground into powder, boiled with one sheng of non-ash wine into a paste], Chen Xiang (Aquilariae Lignum Resinatum), She Xiang (Moschus) [ground], Ding Xiang (Caryophylli Flos), Bi Bo (Piperis Longi Fructus) [each two liang], Long Nao (Borneolum Syntheticum) [ground], Su He Xiang You (Styrax Oil) [added to An Xi Xiang paste, each one liang], Xun Lu Xiang (Olibanum) [separately ground, one liang].
The above herbs are made into fine powder, mixed evenly with the ground medicines. Use An Xi Xiang paste and refined white honey to form the pill mass. Each dose is rolled into pills the size of Sophora japonica seeds. In the morning, take Jing Hua Shui (first-drawn well water), temperature as desired, dissolve four pills to take orally. Elderly and children dissolve one pill to take. Taking with warm wine is also acceptable. All should be taken on an empty stomach. Wrap one pill in wax paper the size of a bullet, place it in a crimson silk bag, and wear it over the heart; all evil spirits dare not approach.
Yi Jian San Sheng Yin (Three Lives Decoction from Yi Jian Fang): Treats stroke with unconsciousness, deviation of mouth and eyes, hemiplegia, phlegm-rattle in the throat, obstruction of phlegm-qi. It is suitable regardless of external contraction of wind-cold or internal injury from anger and joy, whether the six pulses are deep and hidden or floating and vigorous. It also treats tan jue (phlegm syncope), yin jue (fluid syncope), and xu xuan yun (vertigo due to qi deficiency), showing miraculous effects. However, cases with open mouth and scattered hands, closed eyes with urinary incontinence, and snoring breath are difficult to treat.
Formula: Nan Xing (Arisaematis Rhizoma Preparatum) [one liang], Chuan Wu (Aconiti Radix) [skin removed], Sheng Fu Zi (Aconiti Lateralis Radix Preparata) [half liang each], Mu Xiang (Aucklandiae Radix) [two qian half].
The above herbs are chopped. Take half liang per dose, add two zhan of water and ten slices of fresh ginger, decoct until six fen remains, remove dregs, and take warm. For those with locked jaw and unconsciousness, use a small amount of Xi Xin (Asari Radix et Rhizoma) and Zao Jiao (Gleditsiae Sinensis Spina) separately ground into fine powder, blown into the nose via a reed tube. Wait for sneezing; when the patient slightly revives, then administer the medicine. For excessive phlegm-saliva, add four Quan Xie (Scorpio) per dose, and still use Yang Zheng Dan to suppress the turbidity. Another prescription: for those with abundant qi, use only Nan Xing half liang, Mu Xiang one qian, plus seven slices of fresh ginger, named Xing Xiang San. Another prescription: for those with deficient qi, use Sheng Fu Zi and Mu Xiang as previously decocted, named Fu Xiang Yin. Tian Xiong (Aconiti Radix) can also replace Fu Zi. Both treat early-stage stroke with no failure. If caused by qi stagnation and evil invasion, dissolve Suhe Xiang Wan in clean water and force-feed while hot. Also, grind Chen Xiang thickly in the previous decoction juice (about one ya), boil once more, and take. After the previous medicine stabilizes, carefully determine if it is wind, then use Xing Feng Tang or Xiao Xu Ming Tang. For cold invasion, use Fu Zi Li Zhong Tang or Jiang Fu Tang. For damp invasion, Bai Zhu Jiu or Shu Fu Tang are applicable. Summerheat is not recorded here. For phlegm-fluid syncope and qi-deficiency vertigo, adhere strictly to this formula.
Sheng Jin Wan (Golden Victory Pill, from Ben Shi Fang): Treats sudden stroke coma resembling drunkenness, bodily heaviness and confusion, limbs unable to hold, wind-phlegm surging to the upper diaphragm, and qi closure blocking flow.
Formula: Sheng Bo He (Menthae Haplocalycis Herba) [half liang], Zhu Ya Zao Jiao (Gleditsiae Sinensis Fructus) [two liang, crushed, soaked in one sheng of water to extract juice, slowly boiled into paste], Gua Di (Cucumeritis Fructus) [powder, one liang], Li Lu (Veratri Rhizoma) [two liang], Zhu Sha (Cinnabaris) [half liang, ground].
First, mix two fen of Zhu Sha powder with the powders of the other two ingredients, knead with the paste to form pills the size of longan fruits, coat with Zhu Sha powder. Dissolve one pill in warm wine; severe cases take two pills. The goal is vomiting. Awakening occurs after vomiting; if not awakened, it is incurable. Bi Yong Fang argues against emesis in stroke, citing Jin Hu and Bi Xia as warnings. Yet, in sudden phlegm generation, sawing sound, locked jaw, qi closure preventing oral intake, with life hanging by a thread, is it appropriate to insist on no emesis? Just avoid silver powder medicines to prevent spleen damage and limb destruction. (Luo Qianfu's formula contains Fen Shuang and Qian Fen, but no Li Lu, with similar treatment.)
Treats acute stroke with closed mouth and ascending saliva, near death; one dose cures immediately.
Formula: Jiang Zi (Crotonis Fructus) [two grains, skin and membrane removed], Bai Fan (Alumen) [piece the size of a thumb, ground].
Place both ingredients on a new tile, bake until Jiang Zi turns scorched red. Refine honey to form pills the size of Chinese chestnuts. Take one pill per dose, wrap in cotton, place near the throat in the patient's mouth. After a while, phlegm is vomited, and recovery is immediate. (See also the section on locked jaw in Stroke.)
Appendix: Huan Hun Tang (Soul Returning Decoction, from Qian Jin Fang): Treats sudden contraction of contrary qi, ghost strike or flying corpse, sudden loss of consciousness or apparent death with locked jaw and inability to open the mouth. Remove teeth before administering. If the decoction does not go down, part the patient's hair, grasp and pull the shoulders left and right, add more medicine until one sheng is consumed. The patient will revive instantly.
Formula: Ma Huang (Ephedrae Herba) [three liang], Gui Xin (Cinnamomi Ramulus) [two liang], Gan Cao (Glycyrrhizae Radix et Rhizoma) [one liang], Xing Ren (Armeniacae Semen Amarum) [seventy grains].
Chop the above herbs. Add eight sheng of water, decoct to obtain three sheng. Divide into three doses. (Zhou Hou Fang states: Zhang Zhongjing's formula has no Gui Xin, only three ingredients.)