治少阴咽痛者。
甘草(二两 生用。)
上一味。以水一升。煮取升半。去滓。分温再服。
歌曰 甘草名汤咽痛求。方教二两不多收。后人只认中焦药。谁识少阴主治优。(后贤
童便
治少阴咽痛。与甘草不差者。与桔梗汤。
桔梗(一两) 甘草(二两)
上二味。以水三升。煮取一斤。去滓。分温再服。
歌曰 甘草汤投痛未瘥。桔加一两莫轻过。奇而不效须知偶。好把经文仔细哦。
述 少阴之脉。从心系上挟咽。二三日乃三阳主气之期。少阴君火。外合三阳。上循经
脉。
壅遏于会厌狭隘之地也。
治少阴咽中伤。生疮。不能言语。声不出者主之。
半夏(洗破十四枚) 鸡子(一枚 去黄。)
上二味。内半夏着苦酒中。以鸡子壳置刀环中。安火上。令三沸。去滓。少少含咽之。
不瘥。更作三剂。
歌曰 生夏一枚十四开。(洗破十四枚。)鸡清苦酒搅几回。刀环捧壳煎三沸。咽痛频吞
绝妙
蔚按。一鸡子壳之小。安能纳半夏十四枚之多。近刻以讹传讹。即张令韶、张隐庵、柯
韵伯
去其涎。而破为十四枚也。旧本破字模糊。翻刻落此一字。以致贻误至今。特正之。
张令韶曰。此治少阴水阴之气不能上济君火也。君火在上。热伤经络。故咽中伤生疮。
经曰
能环转而上达。故不能语言声不出也。张隐庵有云。人之声音。藉阴中之生气而出。半夏生
当夏半。感一阴之气而生。故能开发声音。破十四枚者。七为奇数。偶七而成十四。是偶中
之奇。取阴中之生阳也。鸡卵属金而白象天。肺主金主天。助肺以滋水之上源也。刀为金器。
环者还也。取金声环转之义也。苦酒醋也。书曰曲直作酸。经曰少阳属肾。一以达少阳初生
之气。一以金遇木击而鸣矣。火上三沸者。金遇火而三伏。三伏已过。金气复矣。枢转利。
水气升。金气清。则咽痛愈而声音出矣。
治疗少阴病咽痛的方剂。
甘草(二两,生用)。
以上一味药,用水一升,煮取半升药液,滤去药渣,分两次温服。
歌诀云:甘草名汤治咽痛求索,方中剂量二两不多收。后人只将其视为调理中焦的药物,谁又能识得它在少阴病主治上的优越性。(后贤补充:童便)
治疗少阴病咽痛,若服用甘草汤后疼痛未缓解的,改用桔梗汤。
桔梗(一两),甘草(二两)。
以上两味药,用水三升,煮取一斤药液,滤去药渣,分两次温服。
歌诀云:服用甘草汤后疼痛未愈,加入桔梗一两莫轻视。奇方不效需知偶方之妙,应仔细研读经文。
论述:少阴经脉,从心脏上行挟持咽喉。发病二三日后,正值三阳主气的时期,少阴君火与外部的三阳相合,沿经脉上行,壅塞在会厌这一狭窄部位。
治疗少阴病咽喉受伤,生疮,不能说话,声音发不出来的病症。
半夏(洗净破开十四枚),鸡蛋(一枚,去掉蛋黄)。
以上两味药,将半夏放入苦酒(醋)中,把鸡蛋壳放在刀环中,置于火上,煮沸三次,滤去药渣,少量含漱并吞咽。若未痊愈,再制作三剂。
歌诀云:生半夏一枚破为十四片。(洗净破开十四枚。)鸡清与苦酒搅拌多次。手持刀环托住蛋壳煎煮三次沸。咽痛时频频吞服,此法绝妙。
蔚按:一个小小的鸡蛋壳,怎么能容纳十四枚半夏之多?近世的刻本以讹传讹,就连张令韶、张隐庵、柯韵伯等人也未能纠正。应当是去除半夏的涎沫,然后破开成十四枚。旧版本中“破”字模糊,翻刻时遗漏了这个字,导致错误流传至今,特此校正。
张令韶说:这是治疗少阴水阴之气不能上济君火的病症。君火在上,热邪损伤经络,所以咽喉受伤生疮。经上说,气能环转而上达,所以不能言语、声音发不出来。张隐庵曾说:人的声音,借助于阴中的生气而发出。半夏生长于夏至前后,感应到一阴之气而生,所以能够开发声音。“破开十四枚”,七是奇数,两个七组成十四,这是偶数中的奇数,取象于阴中之生阳。鸡蛋属金,白色象征天,肺主金、主天,借此帮助肺脏以滋补水之上源。刀是金属器具,“环”意为回转,取金声环转的含义。苦酒即醋,《尚书》说曲直作酸,《内经》说少阳属肾,以此通达少阳初生的气机,以及金遇木击而鸣响的道理。在火上煮沸三次,是因为金遇火则三伏,三伏过后,金气恢复。枢转通畅,水气上升,金气清肃,那么咽痛痊愈,声音就能发出了。
For treating throat pain due to Shaoyin disease.
Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*, 2 liang, used raw).
Take the above single herb, add one sheng of water, boil until half a sheng remains, remove the dregs, and divide into two doses for warm administration.
Song verse:
Seek the Gancao Decoction for throat pain relief,
Two liang is the precise dose, not a bit more or less.
Later scholars only recognize it as a medicine for the Middle Jiao,
Who knows its superior efficacy in treating Shaoyin conditions? (Later sages added: Child's urine)
For treating throat pain due to Shaoyin disease, if the pain does not subside with Gancao Decoction, use Jiegeng Tang (Oroxylum Indicum Decoction).
Jiegeng (Platycodon Root, *Platycodi Radix*, 1 liang); Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*, 2 liang).
Take the above two herbs, add three sheng of water, boil until one jin remains, remove the dregs, and divide into two doses for warm administration.
Song verse:
If pain persists after administering Gancao Decoction,
Do not lightly overlook adding one liang of Jiegeng.
When the odd-numbered formula fails, know the merit of the even-numbered one;
Carefully recite and analyze the classic text.
Discussion:
The Shaoyin meridian ascends from the heart and flanks the throat. After two or three days, it coincides with the period when the Three Yang meridians govern the qi. The Ministerial Fire of Shaoyin combines externally with the Three Yang, ascending along the meridian and obstructing the narrow area of the epiglottis.
This formula is indicated for Shaoyin disease where the throat is injured, sores develop, speech is impaired, and voice cannot be produced.
Banxia (Pinellia Tuber, *Pinelliae Rhizoma*, washed and broken into fourteen pieces); Ji Zi (Chicken Egg, *Galli Felliculus*, one piece, yolk removed).
Place the Banxia into Kujiu (Vinegar, *Acetum*) among the two herbs. Place the eggshell within a knife ring, set over fire, and boil three times. Remove the dregs, and hold a small amount in the mouth to swallow frequently. If not cured, prepare three more doses.
Song verse:
One raw Banxia broken into fourteen pieces. (Washed and broken into fourteen pieces.)
Stir chicken white and vinegar several times.
Hold the shell with the knife ring, boil three times over fire.
Swallow frequently for throat pain; this method is superb.
Commentary by Wei:
How can a small chicken eggshell accommodate fourteen pieces of Banxia? Recent editions have propagated this error. Even Zhanglingshao, Zhang Yinan, and Ke Yunbo failed to correct it. It should be that the phlegm was removed, and then the tuber was broken into fourteen pieces. In old editions, the character "break" (Po) was blurred, and copyists omitted this character, causing errors to persist to this day. This is hereby corrected.
Zhanglingshao stated: This treats the condition where the Yin-water qi of Shaoyin cannot ascend to nourish the Ministerial Fire. The Ministerial Fire is above, and heat injures the collaterals, causing throat injury and sores. The Classics state that qi must circulate and reach upwards; thus, speech and voice are lost.
Zhang Yinan said: Human voice relies on the vital qi within Yin to emerge. Banxia grows at mid-summer, sensing the generation of Yin qi, thus it can open up the voice. Breaking it into fourteen pieces: Seven is an odd number; two sevens make fourteen, which is an odd number within an even number, symbolizing the generating Yang within Yin. The chicken egg belongs to Metal, and its white resembles Heaven. The Lung governs Metal and Heaven; this assists the Lung to nourish the source of Water above. The knife is a metal instrument; "ring" means return/circle, taking the meaning of metal sound circling. Kujiu is vinegar. The Book of Documents states that flexibility and rigidity produce acidity. The Classics state that Shaoyang belongs to the Kidney. This reaches the initial generating qi of Shaoyang and represents metal striking wood to produce sound. Boiling three times over fire signifies that metal meets fire and undergoes three periods of hiding/accumulation. After these three periods, Metal qi is restored. The pivot turns smoothly, Water qi rises, Metal qi clears, then throat pain heals and voice returns.