治脏腑中寒,四肢强直。
人参 干姜(炮) 甘草(炙) 白术(各等分) 水煎服。
一方
干姜 橘红 半夏 白术(麸炒) 浓朴(姜汁炒) 茯苓 桂心 甘草 水煎服。
一方
用食盐,同吴茱萸炒,绢包,熨儿脐腹。
夫天气下降则清明,地气上升则晦塞,故阴邪为害,不发则已,其发必暴,是以中
寒一症,乃仓卒感受天地大寒肃杀之气,其病即发,非若阳寒之邪,由表循经,以渐而
深也。有卒中天地之寒者,有口得寒物者,然邪之所凑,其气必虚,治法主乎温散,多
从补中益气汤,用参 以托住正气,加入温散药以治之。气虚甚者少加附子,以行参
之势,是症多因中气大虚,肤腠疏豁,故外寒内冷,得以感中,不分经络,惟当温补,
其脉沉细,手足厥冷,息微身倦而懒言动,虽身热而不渴者是也,宜急温之,迟则不
救,必藉姜桂附子之猛,方能胜病,即四君元老之剂,不可以理繁治剧也。与热症相
似,而大不同,盖逼阳在外,易相类耳。凡阴邪上冲,孤阳扰乱,急进纯阳之剂,以驱
阴气,辟乾坤而揭日月,光明之用,岂不彰哉!若脉数有力者,或壮热饮水者,烦燥动
摇者,方为热病。寒热如水火,误治则杀人。可不细辨欤!
夫寒症或外受或内伤,皆当时受病之
名。若稍久则郁而成热,故伤寒经名病热也。然有终不能成热者,由其人阳气素虚,
向已阴盛阳微,今一感外寒,微阳益损,焉能有力变热也?然阴症俗论必归房劳,又必
归伤寒,而不及杂病,且专责男子,而不及妇人小儿,殊为可怪。夫阴症即虚寒症,亦
即亡阳症也。男女老幼杂病伤寒皆有之。如产妇亡血及崩漏过多;又如卒然大吐血不
止,与霍乱吐泻无度,或因汗吐下太过,及为寒凉药所伤,或暑月咨意追凉,冬月忍饥
劳倦,为寒所中,凡此之类,皆能令人元气暴脱,忽变为手足厥冷,体疲无气,脉微欲
绝,与房欲脱阳之症,无丝毫异,而治法总不外人参、附子、肉桂、干姜救之。急则
生,缓则死,同归一辙,胡可歧为二也?能明乎此,则阴症未尝必犯于有欲之人,及伤
寒一症也。总之,阴阳调和,则百病不生,及其既病,则阴阳不调可知矣。偏之轻者,
其病亦轻,用平和之药以调之,偏之甚者,其病必笃,苟非峻用偏寒偏热之药,以救其
偏,何能有济?今人见病危笃,药益轻平,勿任怨尤,重惜名节,真心救世者,万勿如
此,当寒即寒,当热即热,当攻即攻,当补即补,倘逡巡退缩,不寒不热,不补不攻,
谚所谓∶不治病,不损命。嗟嗟!既不治病,复不损命,有是理乎?
夫病有虚而热,虚而寒,从未有寒而不虚者,盖虚而热,则非真热矣,虚而寒,则
为真虚矣。况至纯以沉寒病见,则为亡阳气脱之势,岂特虚而已也?故凡一切寒症,皆
为虚论,纵有外寒直中,亦由元阳内虚,试思古人中寒,必用参术姜附,而曰“宜急温
之,迟则不救”之语可知矣。且书曰∶阳气一分不尽,则不死,中寒者,阳气根据希之
也,故治宜温补,不待言矣。然更须审明脏腑,盖脏为阴,必用纯阳之药方效;腑为
阳,必加阴药一二味,制其僭热始安,然寒者阴也。夫脏亦阴也,物聚以类,故寒多中
脏,寒必伤荣也。
Treats cold in the Zang-Fu organs, with stiffness and rigidity of the four limbs.
Ren Shen (Ginseng Radix), Gan Jiang (Zingiberis Rhizoma, processed), Gan Cao (Licorice Root, honey-fried), Bai Zhu (Atractylodis Macrocephalae Rhizoma) in equal parts. Decoct in water and take orally.
Another prescription:
Gan Jiang (Zingiberis Rhizoma), Ju Hong (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Tuber), Bai Zhu (Atractylodis Macrocephalae Rhizoma, bran-fried), Hou Po (Magnoliae Officinalis Cortex, ginger-juice fried), Fu Ling (Poria), Gui Xin (Cinnamomi Ramulus), Gan Cao (Licorice Root). Decoct in water and take orally.
Another method:
Use salt, stir-fry together with Wu Zhu Yu (Evodiae Fructus), wrap in silk, and apply hot compress to the infant's umbilicus and abdomen.
When Heaven's Qi descends, clarity prevails; when Earth's Qi ascends, obscurity ensues. Therefore, when Yin pathogenic factors cause harm, if they do not manifest, so be it; but once they manifest, their onset is necessarily violent. Thus, the syndrome of Middle Cold (Zhong Han) results from a sudden exposure to the severe, chilling, and desolate Qi of Heaven and Earth. The disease manifests immediately, unlike Yang-cold pathogenic factors which enter from the exterior and follow the meridians, deepening gradually. There are cases of sudden attack by Heaven and Earth's cold, and cases caused by ingesting cold substances. However, where pathogenic factors gather, Zheng Qi (Upright Qi) must be deficient. The treatment principle focuses on warming and dispersing. Often, one starts with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), using Ren Shen (Ginseng Radix) to support and anchor the Zheng Qi, adding warming and dispersing herbs to treat the condition. In cases of severe Qi deficiency, add a small amount of Fu Zi (Aconiti Lateralis Radix Praeparata) to facilitate the action of Ren Shen. This syndrome is mostly due to a great deficiency of Middle Qi, with loose skin and pores, allowing external cold and internal cold to invade without distinction among meridians. One should only employ warming and tonification. The pulse is deep and fine, the hands and feet are cold, respiration is faint, the body is fatigued, and there is a reluctance to speak or move. Although the body may feel feverish, there is no thirst; this is the presentation. Urgent warming is required; delay renders it incurable. One must rely on the potent effects of Gan Jiang (Zingiberis Rhizoma), Rou Gui (Cinnamomi Cortex), and Fu Zi (Aconiti Lateralis Radix Praeparata) to overcome the disease. Even Yuan Lao Zhi Ji (veteran formulas like Si Jun Zi Tang) are insufficient for such acute and severe conditions. It resembles heat syndromes but is fundamentally different, likely because Yang Qi is forced outward, leading to confusion. Whenever Yin pathogenic factors rush upward and solitary Yang causes chaos, one must urgently administer pure Yang formulations to drive out Yin Qi, clearing the Qian and Kun like revealing the sun and moon, making the function of light evident! If the pulse is rapid and forceful, or if there is high fever with desire to drink water, restlessness and agitation, these indicate heat diseases. Cold and heat are like water and fire; misdiagnosis leads to death. How can one fail to distinguish them carefully!
Cold syndromes, whether externally contracted or internally injured, should be named according to the pathology at the time of onset. If prolonged, stagnation transforms into heat; thus, diseases in the Shang Han Jing (Treatise on Cold Damage) are ultimately named as heat diseases. However, some never transform into heat because the person's Yang Qi has always been deficient, characterized by Yin excess and Yang decline. Upon contracting external cold, the slight Yang is further damaged, leaving no strength to transform into heat. Yet, popular discussion of Yin syndromes attributes them solely to sexual exhaustion and cold damage, neglecting miscellaneous diseases, and focusing only on men while ignoring women and children, which is truly strange. Yin syndromes are essentially deficiency-cold syndromes, also known as Wang Yang (Loss of Yang) syndromes. They occur in men, women, the elderly, and children, in both miscellaneous diseases and cold damage. For example, postpartum blood loss or excessive metrorrhagia; sudden massive hematemesis uncontrolled; cholera-like vomiting and diarrhea without limit; excessive sweating, emesis, or purgation; injury from cold-cooling medicines; intentional cooling in summer; enduring hunger and fatigue in winter leading to cold invasion. All these can cause sudden collapse of Yuan Qi (Primordial Qi), suddenly presenting with cold hands and feet, physical exhaustion, lack of energy, and a faint pulse nearly imperceptible. This is identical to symptoms of Yang collapse from sexual excess, yet the treatment invariably relies on Ren Shen (Ginseng Radix), Fu Zi (Aconiti Lateralis Radix Praeparata), Rou Gui (Cinnamomi Cortex), and Gan Jiang (Zingiberis Rhizoma) for rescue. Urgency brings life; slowness brings death. They return to the same path; how can they be divided into two categories? Understanding this reveals that Yin syndromes are not exclusively committed to those with desires nor limited to cold damage. In summary, when Yin and Yang are harmonious, hundred diseases do not arise; once diseased, Yin-Yang disharmony is evident. Mild deviation results in mild disease, treated with balanced herbs. Severe deviation results in critical illness; unless峻猛 (potent) cold or heat herbs are used to correct the deviation, how can there be benefit? Today, seeing critical illness, people use lighter, milder medicines, fearing blame and valuing reputation over saving lives. Sincere healers must not act thus. When cold is indicated, use cold; when heat is indicated, use heat; when attack is indicated, attack; when tonification is indicated, tonify. Hesitation, neither cold nor heat, neither attacking nor tonifying, follows the proverb: "Neither cures the disease nor harms the life." Alas! Neither curing nor harming—can such logic exist?
Diseases can be deficiency with heat, or deficiency with cold. There is never cold without deficiency. Deficiency with heat is not true heat; deficiency with cold is true deficiency. Moreover, when pure, profound cold presents, it indicates the trend of Wang Yang (Loss of Yang) and Qi collapse, going beyond mere deficiency. Therefore, all cold syndromes are discussed under deficiency. Even direct invasion by external cold stems from internal deficiency of Yuan Yang (Primordial Yang). Consider that ancients treating Middle Cold always used Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Jiang (Zingiberis Rhizoma), and Fu Zi (Aconiti Lateralis Radix Praeparata), stating "urgent warming is required; delay renders it incurable." Furthermore, medical texts state: "As long as one part of Yang Qi remains, death does not occur." Those with Middle Cold have extremely scarce Yang Qi; thus, treatment must be warming and tonifying, which goes without saying. However, one must further examine the Zang-Fu organs. Zang organs belong to Yin and require pure Yang herbs to be effective. Fu organs belong to Yang and require one or two Yin herbs to restrain their hyperactive heat tendencies for stability. Since cold belongs to Yin, and Zang organs also belong to Yin, things of the same category gather; thus, cold often invades the Zang organs. Cold inevitably injures Ying Qi (Nutritive Qi).