附片、官桂、炮姜各五分、别直参、湖广术、辰茯神各一钱、姜半夏、炒橘白各七分、炙甘草五分、五味子三
分、麝香三厘冲。)最妙。妙在参附桂与麝香同用。世俗皆知麝香为散气通窍之药。而不知其实为壮脑补神
之要药。丁氏《化学实验新本草》。曹氏《麝香辨》皆已发明之。惜吾医界多茫茫耳。次如冯氏全真一气汤(别
直参二钱、提麦冬五钱、北五味子三分、大熟地五钱至一两、江西术二钱、淡附片一钱、酒蒸淮牛膝二钱。)亦
佳。凡治湿热症。劫伤太甚。阴损及阳。而神沉不语者。颇验。此为冯楚瞻《锦囊》中得意之方。功在于一派滋养
阴液之中。得参附气化。俾上能散津于肺。下能输精于肾。且附子得牛膝引火下行。不为食气之壮火。而为生
气之少火。大有云腾致雨之妙。故救阴最速。陶冯二方。虽同为急救阴阳之良剂。而一则注重阳气。一则注重
阴气。临症用方时。务宜注意。而复脉振神如复脉汤。冲入参桂养荣酒一瓢。奏功最速。其次《千金》生脉散煎
汤。冲鹿茸酒一瓢。亦灵。二方之效。效在酒能提神刺激血液之循环。以强壮心机。而复经脉之营运。庶几脉
无歇止。而神亦因之清醒矣。
【荣斋按】冯氏《锦囊》载∶“治赵宦、面赤如妆,不省人事,口多谵语,手足躁动,六脉洪大搏指,
所服乃柴、广、半之类,以其剂小不能为害,不知真阴失守,虚阳上浮,神气欲脱,补救尚虞不及,
敢以清利速其死也。以人参八钱、熟地、麦冬、丹参、白芍、茯神、远志、牛膝、姜炭。每日两剂,不
数日而愈。”此方与全真一气汤稍有出入,我意以为赵证亦可用全真一气汤,较有疗效。《锦囊》
载此类治案甚多,足供本例参证。
附片、官桂、炮姜各五分,别直参、湖广术、辰茯神各一钱,姜半夏、炒橘白各七分,炙甘草五分,五味子三分,麝香三厘(冲服)。这方子最为精妙。其精妙之处在于人参、附子、肉桂与麝香同用。世俗之人只知道麝香是散气通窍的药物,却不知道它其实是壮脑补神的要药。丁氏的《化学实验新本草》和曹氏的《麝香辨》都已经阐明了这一点,可惜我们医学界大多对此茫然无知。其次像冯氏的全真一气汤(别直参二钱,提麦冬五钱,北五味子三分,大熟地五钱至一两,江西术二钱,淡附片一钱,酒蒸淮牛膝二钱),也很好。凡是治疗湿热症,劫伤太过,阴损及阳,导致神志昏沉不语的情况,颇为有效。这是冯楚瞻《锦囊》中的得意之方,功效在于一派滋养阴液之中,得到人参、附子的气化作用,使得上能散津于肺,下能输精于肾。而且附子得牛膝引导火气下行,不成为耗气的壮火,而成为生气的少火,大有云腾致雨的奇妙效果。所以救阴最快。陶氏和冯氏的两个方子,虽然同为急救阴阳的良剂,但一个注重阳气,一个注重阴气,临证选方时,务必注意。还有复脉振神如复脉汤,冲入参桂养荣酒一瓢,奏效最快。其次,《千金》生脉散煎汤,冲鹿茸酒一瓢,也很灵验。这两个方子的疗效,在于酒能提神刺激血液的循环,以强壮心机,恢复经脉的营运,这样脉搏就不会有歇止,神志也会因此清醒。
【荣斋按】冯氏《锦囊》记载:“治疗赵宦,面色红赤如妆,不省人事,口中多谵语,手足躁动,六脉洪大搏指,所服用的乃是柴胡、广皮、半夏之类的药物,因为药量小不能造成危害,不知道这是真阴失守,虚阳上浮,神气欲脱,补救还担心来不及,岂敢用清利之法加速其死亡呢?用人参八钱、熟地、麦冬、丹参、白芍、茯神、远志、牛膝、姜炭。每日两剂,不几天就好了。”这个方子与全真一气汤稍有出入,我认为赵某的病症也可以用全真一气汤,疗效会更好。《锦囊》中记载这类治案很多,足以供本例参考验证。
Prepared Aconite Root (Fupian), Cinnamon Twig (Guizhi), and Prepared Ginger Rhizome (Paojiang) each 1.5g; Ginseng Radix et Rhizoma Rubra (Biezhishen), Atractylodis Rhizoma (Huguangshu), and Poria (Chenfushen) each 3g; Pinellia Tuber (Jiangbanxia) and Tangerine Peel (Chaoju Bai) each 2.1g; Glycyrrhizae Radix et Rhizoma (Zhi Gancao) 1.5g; Schisandrae Fructus (Wuweizi) 0.9g; Moschus (Shexiang) 0.09g, taken with medicine (chongfu). This prescription is most exquisite. Its excellence lies in the combined use of Ginseng, Aconite, Cinnamon, and Moschus. The common people only know Moschus as a drug that disperses Qi and opens orifices, not realizing that it is actually an essential herb for strengthening the brain and nourishing the spirit. Ding's "New Materia Medica of Chemical Experiments" and Cao's "Differentiation of Moschus" have both elucidated this point, yet unfortunately, much of our medical community remains ignorant of this. Secondly, Feng's Quan Zhen Yi Qi Tang (Ginseng Radix et Rhizoma Rubra 6g, Ophiopogonis Tuber 15g, Schisandrae Fructus 0.9g, Rehmanniae Radix Praeparata 15-30g, Atractylodis Rhizoma 6g, Prepared Aconite Lateralis Radix Praeparata 3g, Achyranthis Bidentatae Radix steamed with wine 6g) is also excellent. It is quite effective in treating damp-heat syndromes where excessive depletion leads to yin damage affecting yang, resulting in lethargy and muteness. This is a favorite prescription from Feng Chuzhan's "Jin Nang". Its efficacy lies in nourishing yin fluids while utilizing the qi-transforming power of Ginseng and Aconite, allowing fluids to scatter to the lungs above and essence to be transported to the kidneys below. Moreover, Aconite, guided by Achyranthes downwards, does not become a consuming "vigorous fire" but becomes a generating "mild fire", producing the wonderful effect of clouds rising to bring rain. Thus, rescuing yin is fastest. Although Tao's and Feng's prescriptions are both good agents for emergency rescue of yin and yang, one emphasizes yang qi and the other emphasizes yin qi; attention must be paid when selecting formulas for clinical practice. Additionally, for restoring pulse and spirit, such as Fu Mai Tang, adding one ladle of Ginseng and Cinnamon Yang Rong Wine yields the fastest results. Secondly, Sheng Mai San from "Qian Jin Fang" decocted and mixed with one ladle of Deer Antler Wine is also effective. The efficacy of these two prescriptions lies in the wine's ability to stimulate blood circulation, strengthen cardiac function, and restore meridian operation, thereby preventing pulse interruptions and clarifying the spirit.
[Rong Zhai's Note] Feng's "Jin Nang" records: "Treating Zhao Huan, whose face was red like makeup, unconscious, speaking deliriously, with restless limbs, and six pulses that were surging and forceful against the finger. He had been administered herbs such as Bupleurum Root (Chaihu), Citrus Reticulata Pericarpium (Guangpi), and Pinellia Tuber (Banxia); because the dosage was small, it did no harm. However, he did not realize that his true yin had lost its hold, deficient yang floated upward, and his spirit qi was about to escape. Remedial measures were barely sufficient, let alone using clearing and draining methods to hasten death. Using Ginseng Radix et Rhizoma Rubra 24g, Rehmanniae Radix Praeparata, Ophiopogonis Tuber, Salvia Miltiorrhiza Radix et Rhizoma (Danshen), Paeoniae Radix Alba (Baishao), Poria, Polygalae Radix (Yuanzhi), Achyranthis Bidentatae Radix, and Prepared Ginger Charcoal (Jiangtan). Two doses daily, cured in a few days." This prescription differs slightly from Quan Zhen Yi Qi Tang. I believe Zhao's condition could also be treated with Quan Zhen Yi Qi Tang, which would likely yield better efficacy. "Jin Nang" contains many such case records, which serve as sufficient reference for this example.