(见呕吐。) 治诸黄腹痛而呕者。宜此汤主之。
男元犀按。呕者。胃气不和也。腹痛者。木邪犯胃也。小柴胡汤达木郁。和胃气。使中
枢运
(见血痹虚劳。) 治男子黄。小便自利。当与虚劳小建中汤。
男蔚按。此言土虚而现出黄色也。虚极者。宜补土之母。四逆辈可与间服。然单言男子。
谓妇人血瘀发黄。尚有桃仁承气汤法也。苟属虚黄。亦宜以此汤加当归、益母叶之类也。
(见宿食。校者按。宋本作瓜蒂汤。见 病。) 治诸黄。
男元犀按。瓜蒂散。伤寒论三见。俱主胸中之病。金匮取之附治诸黄。何也。盖黄乃湿
热相
曰治
治黄瘅。
麻黄(三两。)
上一味。以美酒五升。煮取二升半。顿服尽。冬月用酒。春日用水煮之。
歌曰 黄瘅病由郁热成。驱邪解表仗雄兵。五升酒煮麻三两。春换水兮去酒烹。
男元犀按。麻黄轻清走表。乃气分之药。主无汗表实症。黄瘅病不离湿热之邪。用麻黄
醇酒
黄发
(歌见长沙方歌括。) 治火邪者。此汤主之。
桂枝 甘草 生姜 大枣 蜀漆 牡蛎 龙骨
孙男心典禀按。举火邪冠于方首。示人治血先治火也。又恐治火专主寒滞之品。故拈出
此方
治心下悸者。此丸主之。
半夏 麻黄(各等分。)
上二味末之。炼蜜为丸。小豆大。饮服三丸。日三服。
歌曰 心(下)悸都缘饮气维。夏麻等分蜜丸医。一升一降存其意。神化原来不可知。
尤在泾云。半夏蠲饮气。麻黄发阳气。妙在作丸与服。缓以图之。则麻黄之辛甘。不能
发越
善变
(参见呕吐篇。)治疗各种黄疸伴有腹痛且呕吐的患者,适宜用此汤剂主治。
陈元犀按语:呕吐,是胃气不和的表现;腹痛,是肝木之邪侵犯胃腑所致。小柴胡汤能疏达肝木之郁结,调和胃气,使中焦枢机运转正常。
(参见血痹虚劳篇。)治疗男子患黄疸,小便自利的情况,应当给予虚劳病的小建中汤治疗。
陈蔚按语:这是说脾土虚弱而显现出黄色的症状。虚损极重的,应当补益脾土之母(即补肾),四逆汤类方剂可以交替服用。然而文中单提“男子”,是因为妇人若因血瘀发黄,还有桃仁承气汤的治法。如果属于虚黄,也适宜在此汤基础上加入当归、益母草叶之类的药物。
(参见宿食篇。校者按:宋本《金匮要略》作瓜蒂汤,参见痰饮病篇。)治疗各种黄疸。
陈元犀按语:瓜蒂散在《伤寒论》中出现三次,都主治胸中的病证。《金匮要略》引用它来辅助治疗各种黄疸,为什么呢?大概黄色是由于湿热相搏所致……(原文此处有缺漏或断句不清,依文意推测为解释瓜蒂散涌吐湿热之理)。
治疗黄疸病。
麻黄(三两)
以上一味药,用美酒五升,煮取二升半,一次性服完。冬季用酒煮,春季用水煮。
歌诀曰:黄疸病由郁热而成,驱除邪气、解开发表依靠雄兵(指麻黄)。五升酒煮麻黄三两,春季换用水煎而不用酒。
陈元犀按语:麻黄轻清走表,是气分的药物,主治无汗的表实证。黄疸病离不开湿热之邪,使用麻黄醇酒汤……(原文此处有缺漏,意为利用麻黄发汗解表以散湿,酒行药势以清热)。
(歌诀见《长沙方歌括》。)治疗火邪致病的,用此汤剂主治。
桂枝 甘草 生姜 大枣 蜀漆 牡蛎 龙骨
孙心典禀按:将“火邪”列于方名之首,是提示人们治疗血分病要先治火邪。又担心治疗火邪专用寒凉凝滞的药物,所以特意提出此方……(原文此处有缺漏,意为此方兼顾调和营卫与镇惊安神)。
治疗心下悸动的,用此丸剂主治。
半夏 麻黄(各等分)
以上两味药研成末,炼蜜制成丸药,大小如小豆。用温水送服三丸,每日三次。
歌诀曰:心下悸动都源于饮气阻滞,半夏与麻黄等分制成蜜丸医治。一升一降存其意蕴,神妙变化原来不可知。
尤在泾说:半夏能祛除饮气,麻黄能发散阳气。妙在制成丸剂服用,缓缓图之,那么麻黄的辛甘之性,就不能过度发散……(原文此处有缺漏,意为避免伤正,缓消水饮)。善于变通……
(See the section on Vomiting.) Treats various types of jaundice accompanied by abdominal pain and vomiting. This decoction is appropriate for primary treatment.
Chen Yuanxi's commentary: Vomiting indicates disharmony of Stomach Qi (Stomach Energy). Abdominal pain indicates invasion of the Stomach by Wood-pathogen (Liver pathology affecting the Spleen/Stomach). Xiao Chai Hu Tang (Minor Bupleurum Decoction) unblocks Liver Qi stagnation, harmonizes Stomach Qi, and restores the function of the Middle Jiao pivot.
(See the section on Blood Bi and Deficiency Labor.) Treats male patients with jaundice who have free urination. Xu Lao Xiao Jian Zhong Tang (Deficiency Labor Minor Construct the Middle Decoction) should be administered.
Chen Wei's commentary: This describes yellow complexion resulting from deficiency of Earth (Spleen). In cases of extreme deficiency, one should tonify the mother of Earth (Kidney); Si Ni Tang (Four Reversal Decoction) or similar formulas can be taken alternately. However, specifying "male" implies that if a female patient has jaundice due to blood stasis, Tao Ren Cheng Qi Tang (Peach Kernel Downward-Pouring Decoction) is indicated. If it is deficiency-type jaundice, it is also suitable to add Dang Gui (Angelica Sinensis Root) and Yi Mu Cao Ye (Leonurus Leaf) to this formula.
(See the section on Retained Food. Editor's note: Song edition reads Gua Di Tang, see Phlegm-Fluids disease.) Treats various types of jaundice.
Chen Yuanxi's commentary: Gua Di San (Melon Sprout Powder) appears three times in Shang Han Lun (Treatise on Cold Damage), all indicating diseases in the chest. Why does Jin Gui Yao Lue (Essential Prescriptions from the Golden Cabinet) cite it to assist in treating various jaundices? Generally, yellow color arises from the interaction of dampness and heat... [Text fragment] ...treatment of jaundice.
Treats Jaundice Disease (Huang Dan).
Mahuang (Ephedrae Herba, 3 liang).
Take the above single herb, boil in 5 sheng of fine wine until reduced to 2.5 sheng. Take all at once. In winter, use wine; in spring, use water for boiling.
Song verse: Jaundice disease forms from constrained heat; expelling pathogens and releasing the exterior relies on heroic troops. Boil 3 liang of Mahuang in 5 sheng of wine; in spring, switch to water instead of wine.
Chen Yuanxi's commentary: Mahuang is light, clear, and acts on the exterior; it is a Qi-level medicine primarily for exterior excess patterns without sweating. Jaundice disease involves damp-heat pathogens. Using Mahuang Chun Jiu Tang (Mahuang and Mellow Wine Decoction)... [Text fragment] ...yellow hair.
(Song verse seen in Chang Sha Fang Ge Kuo.) Treats Fire Pathogen (Huoxie) conditions. This decoction is the primary treatment.
Guizhi (Cinnamon Twig), Gancao (Licorice Root), Shengjiang (Fresh Ginger), Dazao (Jujube Fruit), Shuqi (Arisaema Cum Bile), Muli (Oyster Shell), Longgu (Fossilized Bone).
Sun Xindian Bing's commentary: Placing "Fire Pathogen" at the head of the formula indicates that treating blood disorders requires first addressing fire. Fearing that treating fire exclusively with cold and stagnant products, this formula is singled out... [Text fragment] ...treats palpitations below the heart. This pill is the primary treatment.
Banxia (Pinelliae Rhizoma), Mahuang (Ephedrae Herba) (equal parts).
Powder the above two herbs. Form pills with refined honey, size of soybeans. Take 3 pills with warm water, three times daily.
Song verse: Palpitations below the heart stem from fluid retention obstructing Qi; Banxia and Mahuang in equal parts treated with honey pills. One ascending and one descending preserves the intent; divine transformation is originally unknowable.
You Zaijing states: Banxia eliminates fluid-Qi obstruction; Mahuang disperses Yang Qi. The subtlety lies in administering them as pills to act gradually. Thus, the acrid and sweet nature of Mahuang cannot excessively disperse... [Text fragment] ...good at adapting.