治厥阴病干呕吐涎沫。头痛者主之。又少阴病吐利。手足厥冷。烦躁欲死者主之
谷欲呕者。属阳明也。吴茱萸汤主之。得汤反剧者。属上焦也。
吴茱萸(一升 洗。) 人参(三两) 生姜(六两) 大枣(十二枚)
上四味。以水七升。煮取二升。去滓。温服七合。日三服。
歌曰 升许吴萸三两参。生姜六两救寒侵。枣投十二中宫主。吐利头疼烦躁寻。
蔚按。少阴之脏。皆本阳明之水谷以资生。而复交会于中土。若上吐下利则中土大虚。
中土
少阴之气而上交。则为躁。甚则烦躁欲死。方用吴茱萸之大辛大温以救欲绝之阳。佐人参之
冲和以安中气。姜、枣和胃以行四末。师于不治之证。不忍坐视。专求阳明。是得绝处逢生
之妙。所以与通脉四逆汤、白通加猪胆汁汤三方鼎时也。论云。食谷欲呕者属阳明也。吴茱
萸汤主
之气。为厥阴专药。然温中散寒。又为三阴并用之药。而佐以人参、姜、枣。又为胃阳衰败
之神方。昔贤所以有论方不论药之训也。
治少阴病下利咽痛。胸满心烦者主之。
猪肤(一斤)
上一味。以水一斗。煮取五升。去滓。加白蜜一升。白粉五合。熬香和令相得。温分六
服。
歌曰 斤许猪肤斗水煎。水煎减半滓须捐。再投粉(白粉。五合。)蜜(白蜜。一升。)
熬香服
张令韶曰。此方合下四方。皆以少阴主枢。旋转内外。无有止息。逆则病也。夫少阴上
火下
水火不交则神机枢转不出。故胸满。神机内郁。故心烦。猪为水畜。肤取其遍达周身。从内
而外。亦从外而内之义也。蜜乃稼穑之味。粉为五谷之精。熬香者。取香气助中土以交合水
火。转运枢机者也。
治疗厥阴病,出现干呕、吐涎沫以及头痛症状的,用本方主治。又治少阴病,出现呕吐、下利,手足冰冷,烦躁得快要死去的,也用本方主治。
想要呕吐而进食谷物时加重的,属于阳明病,用吴茱萸汤主治。如果服用汤药后病情反而加剧的,说明病位在上焦。
吴茱萸(一升,洗净) 人参(三两) 生姜(六两) 大枣(十二枚)
以上四味药,用水七升,煮取二升药液,去掉药渣,每次温服七合,每天服用三次。
歌诀说:一升许的吴茱萸配三两人参,六两生姜用来救治寒邪侵袭。加入十二枚大枣以主宰中宫脾胃,针对呕吐、下利、头痛和烦躁的症状来寻找疗效。
蔚按(陈念祖自注):少阴脏器的功能,都依赖阳明胃腑的水谷精微来滋养生成,并且与中土脾胃相互交会。如果上吐下利,就会导致中土脾胃极度虚弱。少阴之气不能正常上交,就会表现为躁动,严重时甚至烦躁欲死。方中使用吴茱萸的大辛大温之性来挽救即将断绝的阳气,佐助人参的平和之性来安定中气。生姜和大枣调和胃气以运行气血至四肢末端。医生对于看似无法治疗的证候,不忍心坐视不管,专门从阳明胃腑入手求治,这是得到在绝境中逢生奥妙的关键。因此,该方与通脉四逆汤、白通加猪胆汁汤三方并列鼎立。《伤寒论》中说:“进食谷物就想呕吐的,属于阳明病”,吴茱萸汤主治。吴茱萸是厥阴肝经的专用药物,然而它温中散寒的功效,又是三阴经(太阴、少阴、厥阴)通用的药物,再佐以人参、生姜、大枣,就成为挽救胃阳衰败的神效方剂。以前的贤者所以有“论方不论药”的教诲啊。
治疗少阴病,出现下利、咽喉疼痛、胸部胀满、心烦症状的,用本方主治。
猪肤(一斤)
以上一味药,用水一斗,煮取五升药液,去掉药渣,加入白蜜一升、白粉五合,熬制出香味并混合均匀。分六次温服。
歌诀说:一斤许的猪肤用一斗水煎煮,水煎减半后必须去掉药渣。再加入白粉(白粉,五合)和白蜜(白蜜,一升),熬出香味后服用。
张令韶(张隐庵)说:这个方子结合下面的四个方子,都是以少阴为主枢,旋转内外,没有停止休息的时候。如果逆乱就会生病。少阴上面是火下面是水,水火不交则神机枢转不出,所以胸部胀满;神机内郁,所以心烦。猪是水畜,猪肤取其能遍达周身,既有从内而外的意思,也有从外而内的意思。蜂蜜是稼穑(土)的味道,白粉是五谷的精微,熬出香味,是为了取香气帮助中土脾胃来交合水火,转运枢机的作用。
Indicated for Jueyin disease (Disease of the Jueyin channel) presenting with dry retching, vomiting of saliva and froth, and headache. It is also indicated for Shaoyin disease (Disease of the Shaoyin channel) presenting with vomiting and diarrhea, coldness of the hands and feet, and severe restlessness bordering on death.
When one desires to vomit upon eating grain, it belongs to Yangming disease (Disease of the Yangming channel), and Wuzhuyu Tang (Evodia Decoction) is indicated. If the condition worsens after taking the decoction, it indicates a location in the Upper Jiao (Upper Burner).
Wuzhuyu (Evodiae Fructus, 1 sheng, washed)
Renshen (Ginseng Radix et Rhizoma, 3 liang)
Shengjiang (Zingiberis Rhizoma Recens, 6 liang)
Dazao (Jujubae Fructus, 12 pieces)
The above four ingredients are boiled in 7 sheng of water until 2 sheng remains. The dregs are removed. Take 7 ge warm, three times a day.
Song says:
One sheng of Wuzhuyu and three liang of Renshen,
Six liang of Shengjiang to rescue from cold invasion.
Twelve Dazao govern the Middle Palace (Spleen/Stomach),
Seek relief for vomiting, diarrhea, headache, and restlessness.
Commentary by Wei (Chen Nianzu): The organs of Shaoyin rely on the water and grain from Yangming for nourishment and generation, and they intersect with the Central Earth (Spleen/Stomach). If there is upper vomiting and lower diarrhea, the Central Earth becomes severely deficient. When the Qi of Shaoyin fails to ascend and connect properly, it manifests as agitation; in severe cases, it leads to extreme restlessness bordering on death. This formula uses the large acrid and large warm nature of Wuzhuyu to rescue the nearly exhausted Yang Qi, assisted by the harmonious nature of Renshen to stabilize the Middle Qi. Shengjiang and Dazao harmonize the Stomach to circulate Qi and Blood to the four extremities. The physician, unwilling to sit idly by when facing seemingly incurable conditions, seeks treatment specifically through the Yangming Stomach. This achieves the miracle of finding life in a desperate situation. Therefore, this formula stands in parallel with Tongmai Sini Tang (Pulse-Returning Decoction) and Baitong Plus Porcine Bile Decoction. The Treatise states: "Those who desire to vomit upon eating grain belong to Yangming," treated with Wuzhuyu Tang. Wuzhuyu is the specialized herb for the Jueyin channel, yet its ability to warm the middle and dispel cold makes it applicable to all three Yin channels (Taiyin, Shaoyin, Jueyin). Assisted by Renshen, Shengjiang, and Dazao, it becomes a divine prescription for rescuing the failure of Stomach Yang. Hence, the ancient sages taught "to discuss the formula rather than individual herbs."
Indicated for Shaoyin disease presenting with diarrhea, sore throat, chest fullness, and irritability.
Zhufu (Porcis Cutis, 1 jin)
The above single ingredient is boiled in 1 dou of water until 5 sheng remains. The dregs are removed. Add 1 sheng of Baimit (White Honey) and 5 he of Baifen (White Powder/Rice Flour), boil until fragrant, mix well, and take warm in six divided doses.
Song says:
Boil one jin of Zhufu in one dou of water,
Reduce by half and discard the dregs.
Then add Baifen (Five he) and Baimit (One sheng),
Boil until fragrant and take.
Zhang Lingshao (Zhang Yinan) said: This formula, combined with the following four formulas, all utilize Shaoyin as the pivot to rotate internal and external aspects without cessation. Reversal leads to disease. Shaoyin has Fire above and Water below. When Water and Fire do not interact, the Spirit Mechanism cannot pivot, resulting in chest fullness. When the Spirit Mechanism is internally constrained, it results in irritability. The pig is an animal of Water; Zhufu (pig skin) is used because it can permeate the entire body, symbolizing both moving from inside out and outside in. Honey represents the flavor of Grain/Earth (Ji Se); Baifen is the essence of the five grains. Boiling until fragrant aims to use the aroma to assist the Central Earth in interacting Water and Fire, thereby rotating the pivot mechanism.