治误汗。烦躁吐逆而厥者主之。
甘草(四两) 干姜(二两 炮。)
上 咀。以水三升。煮取一升五合。去渣。分温再服。
歌曰 心烦(火盛。)脚急(热盛灼筋。)理须明。攻表误行厥便成。二两炮姜甘草四。
热因寒
蔚按。误服桂枝汤而厥。其为热厥无疑。何以又用甘草、干姜乎。而不知此方以甘草为
主。
取大甘以化姜、桂之辛热。干姜为佐、妙在炮黑。变辛为苦。合甘草又能守中以复阳也。
论
毕竟热性尚存。其义何居。答曰。此所谓感以同气。则易入也。子能知以大辛回阳主姜、附
而佐以胆尿之妙。便知以大甘复阳主甘草而佐以干姜之神也。推之僵蚕因风而死。取之以治
中风。驴为火畜。大动风火。以伏流之阿水造胶。遂能降火而熄风。皆古圣人探造化之微也
。仲景又以此汤治肺痿。更为神妙。后贤取治吐血。盖学古而大有所得也。
治误汗伤血。厥逆脚挛急主之。
芍药(四两) 甘草(四两 炙。)
上二味。 咀。以水三升。煮取一升半。去滓。分温再服之。
歌曰 芍甘四两各相均。两脚拘挛病在筋。阳旦误投热气烁。苦甘相济实时伸。
蔚按。芍药味苦。甘草味甘。苦甘合用。有人参之气味。所以大补阴血。血得补则筋有
所养
中和之剂。可治百病。凡病患素溏与中虚者。服之无不增剧。诚可痛恨。
治疗因误用发汗法导致的病证。出现烦躁、呕吐逆气且四肢厥冷的,以此方主治。
甘草(四两) 干姜(二两,炮制。)
将药材切碎。用水三升,煮取一升五合药液。去除药渣。分两次温服。
歌诀云:心烦(因火邪亢盛。)脚部拘急(因热盛灼伤筋脉。)道理必须明白。攻表发汗误治导致四肢厥冷。需用二两炮干姜配四两甘草。
以热性药物治热病(此处指热因寒用或反佐之意,结合上下文实为回阳救逆)。
蔚按(陈念祖自注):误服桂枝汤后出现四肢厥冷,这无疑是热厥。为什么又使用甘草和干姜呢?却不知道此方以甘草为主药。
利用甘草的大甘之味来化解干姜、桂枝的辛热之性。干姜作为辅药,妙在炮制成黑色。使其辛味转为苦味。配合甘草又能固守中焦以恢复阳气。
论述
毕竟热邪的性质尚存,其中的义理何在?回答说:这就是所谓的“同气相求”,则容易进入体内。如果你能懂得以大辛大热之药回阳,主药用姜、附子而辅药用猪胆汁的妙处,就能理解以大甘之味复阳,主药用甘草而辅药用干姜的神妙之处。推及僵蚕因风邪而死,取用它来治疗中风。驴是属火的动物,极易引发风火内动,用潜伏流动的阿胶(驴皮胶)来制作,便能降火熄风。这都是古代圣人探究造化细微之处的体现。张仲景又用此汤治疗肺痿,更为神妙。后世贤人取此方治疗吐血,大概是学习古人而大有收获吧。
治疗因误汗损伤阴血导致的病证。出现四肢厥冷、小腿拘挛急迫的,以此方主治。
芍药(四两) 甘草(四两,炙。)
以上两味药。切碎。用水三升,煮取一升半药液。去除药渣。分两次温服。
歌诀云:芍药与甘草各四两比例相当。双脚拘挛病症在于筋脉。误投阳旦汤(桂枝汤类)导致热气灼烁。苦甘相济,症状随即缓解舒展。
蔚按(陈念祖自注):芍药味苦,甘草味甘。苦甘合用,具有人参的气味功效,所以能大补阴血。血液得到补充则筋脉有所滋养。
这是中和的药剂,可以治疗各种疾病。凡是平素大便溏泄和中气虚弱的患者,服用后没有不加重病情的。实在令人痛恨。
Treats conditions caused by erroneous sweating therapy. For patients presenting with irritability, vomiting and regurgitation, and cold extremities (Jue), this formula is indicated.
Gancao (Licoriza Radix et Rhizoma, 4 liang) Ganjiang (Zingiberis Rhizoma Praeparatum, Dried Ginger, 2 liang, processed).
Crush the herbs. Add three sheng of water, decoct to obtain one sheng and five he of liquid. Remove the dregs. Divide into two doses and take warm.
Song says: Mental restlessness (due to excessive Fire) and leg cramping (due to heat scorching the sinews) require clear understanding. Erroneous exterior-attacking sweating leads to Jue. Use two liang of processed ginger and four liang of licorice.
[Note on "Heat due to Cold"]:
Wei An (Chen Nianzu's commentary): If Jue occurs after erroneously taking Guizhi Tang (Cinnamon Twig Decoction), it is undoubtedly a Heat Jue (heat-induced cold extremities). Why use Gancao and Ganjiang? It is unknown that this formula takes Gancao as the principal herb.
It utilizes the great sweetness of Gancao to transform the acrid-hot nature of Ganjiang and Guizhi. Ganjiang serves as an assistant; its brilliance lies in being charred black, transforming its acrid taste into bitter. Combined with Gancao, it can secure the Middle Jiao to restore Yang Qi.
Discussion
After all, the nature of heat still exists; what is the rationale? The answer is: This is referred to as "seeking similar qi," making it easy to enter. If you understand the subtlety of using great acrid-hot herbs to restore Yang, with Jiang (Ginger) and Fu (Aconite) as principals assisted by Gall Bladder Juice, you will know the divinity of using great sweetness to restore Yang, with Gancao as the principal assisted by Ganjiang. Extending this reasoning: Silkworm dies due to wind; taking it treats Wind Stroke. The donkey is a fire animal, prone to stirring up wind and fire; using Ejiao (Donkey-hide Gelatin) made from flowing water can descend fire and extinguish wind. These are all instances where ancient sages explored the subtleties of creation. Zhang Zhongjing also used this decoction to treat Fei Wei (Lung Withered-Leaf Disease), which is even more divine. Later scholars took it to treat hemoptysis, likely gaining much from studying the ancients.
Treats conditions where erroneous sweating damages Yin Blood, leading to cold extremities and calf cramping.
Shaoyao (Paeoniae Radix Alba, White Peony Root, 4 liang) Gancao (Licoriza Radix et Rhizoma Praeparata, Prepared Licorice, 4 liang, honey-fried).
Take the above two ingredients. Crush them. Add three sheng of water, decoct to obtain one sheng and half a sheng of liquid. Remove the dregs. Divide into two doses and take warm.
Song says: Shaoyao and Gancao each at four liang are equal. Cramping of both feet indicates the disease is in the sinews. Erroneous administration of Yangdan Tang (Yang Dawn Decoction, referring to Guizhi Tang type) causes heat to scorch. Bitter and sweet harmonize, providing immediate relief and extension.
Wei An (Chen Nianzu's commentary): Shaoyao tastes bitter, Gancao tastes sweet. When combined, they possess the aroma and effect of Renshen (Ginseng Radix et Rhizoma), thus greatly tonifying Yin Blood. When blood is tonified, the sinews receive nourishment.
This is a neutralizing agent, capable of treating myriad diseases. However, for patients who habitually have loose stools or suffer from Middle Jiao deficiency, taking it will invariably worsen their condition. This is truly lamentable.