治大实大满,气上冲,上部有脉,下部无脉,填塞闷乱者,当吐之。
瓜蒂(一分) 赤小豆(一分)
上为极细末,温水少许,调一钱匕,以吐为度。如伤之太重,备急丸下之,此急剂也。
经云∶其下者引而竭之。此之谓也。
干姜(一两,) 生大黄(一两,) 生巴豆(半两,去心膜,研泥,滩新瓦去油,取霜)
上细末,炼蜜丸桐子大。温水下三二丸,无时,以利为度,以意消息渐加。
治时疾内伤,心下痞气不降,米不化。
大黄(一两) 枳实(半两,炒) 桔梗(二两) 牵牛头(末,一分)
上细末,姜糊丸,蒸饼亦得,桐子大。温水下二三十丸,常服减半。内伤戊火已衰,不
能制物,寒药太多,固非所宜,故以温剂主之。
本仲景汤也,易老改丸。治老幼虚弱,食不消,脏腑软。
枳实(三分,麸炒黄色) 白术(一两)
上细末,荷叶裹烧饭为丸,或姜浸蒸饼丸亦得,桐子大。米饮下三二十丸,食后。
小儿丸小。
海藏云∶洁古既有三阴可下之法也,必有三阴可补之法,予欲举此内伤三阴可补之剂。
未见仲
未读,而未之知,而不能言耳!
若饮冷内伤,虽先损胃,未知色脉各在何经。若面青黑,脉浮沉不一,弦而弱者,伤在
厥阴也。若面红赤,脉浮沉不一,细而微者,伤在少阴也;若面黄洁,脉浮沉不一,缓而迟者,
伤在太阴也。
若面青或黑或青黑,俱见脉浮沉不一,弦而弱,伤在厥阴肝之经也。
治疗大实大满,气机上冲,上部有脉象而下部无脉象,胸中填塞、胸闷烦乱的症状,应当采用涌吐法。
瓜蒂(一分) 赤小豆(一分)
将上述药物研成极细的粉末,取少量温水,调和一钱匕的药粉,以患者出现呕吐为度。如果损伤过于严重,备用备急丸来攻下,这是急救的方剂。
《内经》说:“病位在下者,引导并竭除之。”说的就是这个道理。
干姜(一两) 生大黄(一两) 生巴豆(半两,去除心膜,研磨成泥,放在新瓦上除去油分,取得药霜)
将上述药物研成细末,用炼蜜制成如梧桐子大小的丸剂。温水送服二三丸,不拘时间,以大便通畅为度,根据病情逐渐调整剂量。
治疗时行疫病内伤,胃脘部痞塞胀满,气机不降,饮食不能消化。
大黄(一两) 枳实(半两,炒制) 桔梗(二两) 牵牛头(末,一分)
将上述药物研成细末,用姜汁糊制作丸剂,或用蒸饼制作也可以,大小如梧桐子。温水送服二三十丸,日常服用减半。内伤导致戊土(脾胃之火)衰弱,不能制约水谷,若使用过多寒凉药物,本来就不适宜,所以用温性方剂为主治。
这是张仲景的汤剂,易老(张元素之子张璧,号易老)将其改为丸剂。治疗老人和儿童虚弱,食物不消化,脏腑功能软弱。
枳实(三分,麸炒至黄色) 白术(一两)
将上述药物研成细末,用荷叶包裹烧饭制成丸剂,或者用生姜浸泡过的蒸饼制作丸剂也可以,大小如梧桐子。饭后用米饮送服三二十丸。
小儿用药丸要小一些。
海藏老人(王好古自称)说:洁古老人既然提出了三阴经可下的方法,必然也有三阴经可补的方法,我想列举这些内伤三阴经可补的方剂。
没有见到仲景的相关论述,也没有读过相关书籍,因此不知道,无法言说罢了!
如果是因饮用冷饮导致的内伤,虽然先损伤胃,但还不知道色脉分别属于哪一经。如果面色青黑,脉象浮沉不一,弦而弱,是厥阴经受伤。如果面色红赤,脉象浮沉不一,细而微,是少阴经受伤;如果面色黄净,脉象浮沉不一,缓而迟,是太阴经受伤。
如果面色青或黑或青黑,都见到脉象浮沉不一,弦而弱,是厥阴肝经受伤。
For conditions of severe excess and fullness, with Qi rushing upward, pulse present in the upper body but absent in the lower body, and a sensation of blockage, oppression, and confusion, emesis (emetic therapy) should be employed.
*Gua Di* (Cucumeris Fructus, 1 fen) *Chi Xiao Dou* (Adzuki Bean, 1 fen)
Grind the above into an extremely fine powder. Mix with a small amount of warm water to form a dose equivalent to one *qian bi*. Administer until vomiting occurs. If the injury is too severe, use *Beiji Wan* (Emergency Pill) to purge downward; this is an emergency preparation.
The Classics state: "For pathology located below, guide it out and exhaust it." This refers to such cases.
*Gan Jiang* (Dried Ginger, 1 liang) *Sheng Da Huang* (Raw Rhubarb, 1 liang) *Sheng Ba Dou* (Raw Croton Seed, 0.5 liang, remove heart membrane, grind into paste, spread on new tile to remove oil, obtain the frost/residue)
Grind the above into a fine powder. Use refined honey to make pills the size of *Tongzi* (pistacia seeds). Take two or three pills with warm water at any time, stopping when diarrhea occurs. Adjust the dosage gradually according to the condition.
For epidemic diseases causing internal injury, with epigastric痞 (pi syndrome/stagnation), descending Qi failing, and inability to digest rice/food.
*Da Huang* (Rhubarb, 1 liang) *Zhi Shi* (Immature Bitter Orange, 0.5 liang, stir-fried) *Jie Geng* (Platycodon Root, 2 liang) *Qian Niu Tou* (Morning Glory Seed, fine powder, 1 fen)
Grind the above into a fine powder. Make pills using ginger juice paste; steamed bread dough is also acceptable. Size should be like *Tongzi* seeds. Take twenty to thirty pills with warm water; for daily maintenance, reduce the dose by half. Internal injury leads to the decline of Wu Fire (Spleen/Stomach Yang/Fire), which cannot control food processing. Using too many cold-natured herbs is inappropriate; therefore, warm-formulae are used as the primary treatment.
This was originally a decoction from Zhang Zhongjing, modified into pills by Yi Lao (Zhang Bi). It treats weakness in the elderly and children, indigestion, and soft/weak visceral function.
*Zhi Shi* (Immature Bitter Orange, 3 fen, stir-fried with bran to yellow) *Bai Zhu* (Atractylodes Macrocephala, 1 liang)
Grind the above into a fine powder. Wrap in lotus leaves and bake with rice to make pills, or use ginger-infused steamed bread dough. Size like *Tongzi* seeds. Take thirty to twenty pills with rice drink after meals.
Pills for children should be smaller.
Haizang Laoren (Wang Haogu) said: Since Jiegulaoren provided methods for purging the Three Yin channels, there must also be methods for tonifying the Three Yin channels. I wish to list these formulas for tonifying the Three Yin channels in internal injury.
I have not seen Zhongjing's [relevant] text, nor have I read it, and thus do not know it, so I cannot speak of it!
If internal injury is caused by drinking cold liquids, although the Stomach is damaged first, it is unknown which channel the complexion and pulse indicate. If the face is green-black, and the pulse varies in depth (floating/sinking), being wiry and weak, the injury is in the Jueyin channel. If the face is red, and the pulse varies in depth, being thin and faint, the injury is in the Shaoyin channel; if the face is pure yellow, and the pulse varies in depth, being slow and delayed, the injury is in the Taiyin channel.
If the face is green, black, or green-black, and the pulse varies in depth, being wiry and weak, the injury is in the Jueyin Liver channel.