(刘完素《素问病机气宜保命集》 治下利后,腹中虚痛不可忍者。
越桃(即山栀之大者) 高良姜(各三钱研) 每服三钱,米饮或酒调下,痛立止。
越桃(散)栀子与良姜,等分研和酒服良。痢后腹中虚痛甚,溺红短数始相当。(痢后
腹中虚痛,非有实邪。若小便清利者,此下焦有寒也。若小便短赤者,明是肺气下郁于大肠,
积而成热,寒热混而痛也。)寒热混淆因作痛,通阳泄热痛斯忘。(山栀从肺入肠泄其郁热,
良姜宣发胃阳,辟除冷气,阴阳和,痛立止。)
治阳明病脉洪大而长,不恶寒,反恶热,舌上干燥,而烦躁不得卧,渴欲饮水数升者;
及脉滑而手足逆冷,此热厥也,亦主之。若表未解而无汗者,忌服。
石膏(一斤碎绵裹) 知母(六两) 甘草(二两) 粳米(六合) 以水一斗,煮米
熟汤成,去滓
治伤寒服桂枝汤后,大汗出,大烦渴不解,脉洪大者;并治太阳中 ,汗出恶寒,身热
烦渴,及火热伤肺,传为膈消,最良。
白虎汤原方加人参三两,煮服同前法。
白虎汤清气分火,(白虎汤清阳明气分之热邪,调胃承气汤导阳明血分热邪。)石膏知母
甘草佐,再加粳米煮成汤,(石膏清火,知母滋阴,甘草缓阳明之津气。因石膏性重,知母
性滑,恐其疾趋于下,另设煎法,以米熟汤成,俾辛寒重滑之性,得粳米、甘草,载之于上,
逗留阳明,而成清肃肺胃之功。)止渴除烦功用播。汗多热盛最相宜,(汗多热盛,是白虎之
的证。)无汗恶寒大不妥。(无汗恶寒,是白虎之大禁。)脉滑洪长舌燥干,阳明邪热之为祸。
纵使肢寒亦用清,此名热厥医休左。(脉滑而四肢厥冷,内有烦渴谵语等见证,此谓热厥,
治宜清解,误用热药则死。)病久津枯胃火焚,原方加入人参可,(名白虎加人参汤)补虚清
火以生津,(白虎加参,功用若此。)中暑膈消力能荷。(中暑即中 , 者暑热之气也。膈
(刘完素在《素问病机气宜保命集》中记载:治疗痢疾之后,腹部虚痛剧烈、难以忍受的情况。
越桃(即较大的栀子) 高良姜(各三钱,研成粉末),每次服用三钱,用米汤或酒调服,疼痛立即停止。
越桃散歌诀:栀子和良姜,等量研磨混合,用酒送服效果良。痢疾后腹部虚痛非常严重,小便短赤频数才适合使用。(痢疾后腹部虚痛,并非因为有实邪。如果小便清长通畅,这是下焦有寒证。如果小便短少色红,明显是肺气郁结于大肠,积聚而成热,寒热混杂导致疼痛。)寒热混淆因而产生疼痛,通阳泄热疼痛才能消除。(山栀从肺经进入肠经,宣泄其中的郁热;良姜宣发胃阳,驱除冷气,阴阳调和,疼痛立即停止。)
治疗阳明病脉象洪大且长,不恶寒,反而怕热,舌面干燥,烦躁无法入睡,口渴想要喝几升水的情况;
以及脉象滑利而手足逆冷,这属于热厥证,也适用本方。如果表证未解且无汗的,忌用此方。
石膏(一斤,打碎后用棉布包裹) 知母(六两) 甘草(二两) 粳米(六合),用水一斗,煮至米熟汤成,滤去药渣。
治疗伤寒服用桂枝汤后,大汗出,极度烦渴不解,脉象洪大的情况;同时也治疗太阳中暍(中暑),出现汗出恶寒、身体发热、烦渴的症状,以及火热伤肺,传变为膈消(上消),效果最好。
白虎汤原方加入人参三两,煎煮服用方法同前。
白虎汤清气分火邪,(白虎汤清除阳明气分的邪热,调胃承气汤引导阳明血分的邪热。)石膏知母甘草配合,再加粳米煮成汤剂,(石膏清热泻火,知母滋阴润燥,甘草缓和阳明津气的耗损。因为石膏性质沉重,知母性质滑利,担心药性迅速下行,所以另设煎法,待米熟汤成,使辛寒重滑的药性,借助粳米和甘草的作用,停留于上部,逗留于阳明经,从而发挥清肃肺胃的功效。)止渴除烦功效显著。汗多热盛最适合使用,(汗多热盛,是白虎汤的适应证。)无汗恶寒则非常不妥。(无汗恶寒,是白虎汤的大禁忌。)脉象滑、洪、长,舌面干燥,这是阳明邪热造成的祸害。
即使四肢寒冷也要使用清热法,这叫热厥,医生不要误治。(脉象滑而四肢厥冷,伴有内部烦渴、谵语等症状,这叫热厥,治疗应当清解,误用热药会导致死亡。)病程久导致津液枯竭、胃火焚烧,原方加入人参即可,(名为白虎加人参汤)补虚清火以生津液,(白虎汤加人参,功用如此。)中暑和膈消都能胜任。(中暑即中暍,指暑热之气。膈消……)
(Liu Wansu, in *Suwen Bingji Qi Yi Baoming Ji*, records: Treating post-dysenteric abdominal deficiency pain that is unbearable.
Yue Tao (i.e., larger Gardeniae Fructus / Zhi Zi) and Gao Liang Jiang (Galangal Rhizome / Gaoliangjiang), each three qian, ground into powder. Take three qian per dose, mixed with rice water or wine; the pain stops immediately.
Yue Tao San Verse: Gardenia and Galangal, equal parts ground and mixed, taken with wine for good effect. Severe abdominal deficiency pain after dysentery matches only when urine is scanty, red, and frequent. (Abdominal deficiency pain after dysentery is not due to excess pathogens. If urine is clear and free-flowing, this indicates cold in the Lower Jiao. If urine is scanty and red, it clearly shows Lung Qi depressed in the Large Intestine, accumulating into heat; cold and heat mixed cause pain.) Pain arises from the confusion of cold and heat; unblocking Yang and draining heat makes the pain forgettable. (Zhi Zi enters the intestine from the Lung channel to drain stagnant heat; Gaoliang Jiang promotes Stomach Yang and dispels cold qi. When Yin and Yang harmonize, pain stops immediately.)
Treating Yangming disease with a pulse that is flooding (Hong) and long, without aversion to cold but rather aversion to heat, dryness on the tongue, restlessness preventing sleep, and thirst desiring several sheng of water;
Also treating cases where the pulse is slippery while the hands and feet are cold, known as Heat Jue (Heat Syncope/Extremity Cold), this formula also applies. However, if the exterior syndrome is unresolved and there is no sweating, it is contraindicated.
Shi Gao (Gypsum Fibrosum / Shigao), one jin, crushed and wrapped in cotton; Zhi Mu (Anemarrhenae Rhizoma / Zhimu), six liang; Gan Cao (Glycyrrhizae Radix et Rhizoma / Gancao), two liang; Jing Mi (Oryzae Sativa Granum / Jingmi), six he. Use ten dou of water, boil until the rice is cooked and the decoction is ready, then remove the dregs.
Treating cases after taking Guizhi Tang (Cinnamon Twig Decoction) for Shanghan (Cold Damage), where profuse sweating occurs, followed by extreme restlessness and thirst that does not resolve, and a flooding pulse; it also treats Taiyang Zhongshu (Sunstroke), presenting with sweating, aversion to cold, body heat, restlessness, and thirst, as well as fire-heat injuring the Lung, transmitting into Ge Xiao (Diabetes Mellitus type characterized by excessive thirst), yielding the best results.
Baihu Tang (White Tiger Decoction) original formula plus Renshen (Ginseng Radix et Rhizoma / Renshen) three liang, boiled and taken using the previous method.
Baihu Tang clears Fire from the Qi level. (Baihu Tang clears pathogenic heat from the Yangming Qi level, while Tiaowei Chengqi Tang guides pathogenic heat from the Yangming Blood level.) Shi Gao, Zhi Mu, and Gan Cao assist, adding Jing Mi to form the decoction. (Shi Gao clears fire; Zhi Mu nourishes Yin; Gan Cao moderates the consumption of Qi and fluids in the Yangming. Because Shi Gao is heavy and Zhi Mu is slippery, fearing they might rush downward too quickly, a separate decoction method is set: boiling until the rice is cooked allows the acrid-cold, heavy, and slippery properties to be carried upward by Jing Mi and Gan Cao, lingering in the Yangming meridian, thereby achieving the function of clearing and purifying the Lung and Stomach.) Its functions of quenching thirst and removing restlessness are widely disseminated. Profuse sweating and high heat are most suitable indications. (Profuse sweating and high heat are the specific indications for Baihu Tang.) No sweating and aversion to cold are highly inappropriate. (No sweating and aversion to cold are major contraindications for Baihu Tang.) A slippery, flooding, and long pulse with a dry tongue indicates the disaster caused by Yangming pathogenic heat.
Even if the limbs are cold, cooling methods should still be used; this is called Heat Jue, do not let physicians err. (A slippery pulse with cold extremities, accompanied by internal restlessness, thirst, and delirium, is termed Heat Jue. Treatment should involve clearing and resolving; misusing hot medicines will lead to death.) Long-standing illness leads to dried-up Jin-Ye (Body Fluids) and burning Stomach Fire; adding Renshen to the original formula works. (Named Baihu Jia Renshen Tang / White Tiger Decoction with Ginseng). It tonifies deficiency, clears fire, and generates fluids. (The function of Baihu Tang with Renshen is thus.) It can handle Sunstroke and Ge Xiao. (Sunstroke refers to Zhongshu, meaning invasion by summer-heat Qi. Ge Xiao...)