阳旦汤即桂枝加桂汤再加附子,盖此系他医所治之案,其失处在证原有热,因脚挛误认为寒,竟于
桂枝中增桂加附,以致汗出亡阳,遂至厥逆,仲景因门人之问,重申之而明其所以厥逆之故,实因汗出亡阳。
若欲挽回此证使至夜半可愈,宜先急用甘草干姜汤以回其阳,虽因汗多损液以致咽干,且液伤而大便燥结成阳
明之谵语,亦不暇顾。迨夜半阳回脚伸,惟胫上微拘急,此非阳之未回,实因液伤不能濡筋也。故继服芍
药甘草汤以复其津液,则胫上拘急与咽喉作干皆愈。更用承气汤以通其大便,则谵语亦遂愈也。所用之药息
息与病机相符,故病虽危险可挽回也。
《伤寒论》真武汤乃仲景救误治之方。其人本少阴烦躁,医者误认为太阳烦躁而投以大青龙汤,清之散
之太过,遂至其人真阳欲脱,而急用真武汤以收回其欲脱之元阳,此真武汤之正用
也。观《神州医药学报》所述之案,原系外感在半表半里,中无
大热,故寒热往来,脉象濡缓,而投以湿温之剂,若清之散之太过,证可变为里寒外热(即真寒假热),其
元阳不固较少阴之烦躁益甚,是以其热虽日夜无休止,口唇焦而舌苔黄腻,其脉反细数微浮而濡也。若疑脉
数为有热,而数脉与细浮濡三脉并见实为元阳摇摇欲脱之候,犹火之垂垂欲灭也。急用真武汤以迎回元阳,俾
复本位,则内不凉而外不热矣。是投以真武汤原是正治之法,故能立建奇功,此中原无疑义也。特其语
气激昂,务令笔锋摇曳生姿,于病情之更改,用药之精义皆未发明,是以阅者未能了然也。
Yangdan Decoction is Guizhi Jia Gui Tang (Cinnamon Twig Decoction with Added Cinnamon Twig) plus Fuzi (Aconiti Lateralis Radix Praeparata). This refers to a medical case treated by another physician, where the error lay in the fact that the patient originally had heat syndrome. Because of leg cramps, it was mistakenly diagnosed as cold syndrome. Consequently, Gui Zhi (Cinnamomi Ramulus) was increased within the Guizhi Tang formula and Fuzi was added, leading to excessive sweating and loss of Yang Qi (Vital Energy), which subsequently resulted in Jue Ni (cold extremities). Zhang Zhongjing, prompted by his disciples' questions, reiterated this situation to clarify the cause of the Jue Ni, which was indeed due to sweating causing the loss of Yang Qi. To reverse this condition so that recovery might occur at midnight, one should first urgently use Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) to restore Yang Qi. Although excessive sweating damages body fluids leading to dry throat, and fluid depletion causes dry stool accumulation resulting in Shen Yu (delirious speech) characteristic of Yangming disease, these symptoms need not be attended to at that moment. By midnight, when Yang Qi returns and legs extend, only slight stiffness remains in the calves. This is not because Yang Qi has failed to return, but truly because damaged fluids fail to nourish the sinews. Therefore, continuing to administer Shaoyao Gancao Tang (Peony and Licorice Decoction) to replenish body fluids will cure both the calf stiffness and throat dryness. Subsequently, using Chengqi Tang (Purgative Decoction) to unblock the bowels will resolve the delirium. The herbs used align perfectly with the pathogenesis; thus, although the condition was critical, it could be reversed.
Zhenwu Tang (True Warrior Decoction) in Shanghan Lun (Treatise on Cold Damage Disorders) is a formula formulated by Zhang Zhongjing to rescue errors in treatment. The patient originally suffered from Fan Zao (restlessness and irritability) associated with Shaoyin disease. The physician mistakenly identified it as Fan Zao from Taiyang disease and administered Da Qinglong Tang (Major Green Dragon Decoction). Excessive clearing and dispersing led to the impending collapse of the patient's True Yang Yuan Yang (Primal Yang). Thus, Zhenwu Tang was urgently employed to retrieve the impending collapsing Yuan Yang; this constitutes the correct application of Zhenwu Tang. Observing the case described in *Shenzhou Yiyao Xuebao* (Journal of Chinese Medicine), the original condition involved an external contraction affecting the Half-Exterior Half-Interior region, without significant internal heat, hence presenting with alternating chills and fever and a Ru Huan (soft and slow) pulse. However, formulas for Shi Wen (Damp-Warmth) were administered. If clearing and dispersing were excessive, the syndrome could transform into Li Han Wai Re (Internal Cold with External Heat, i.e., True Cold False Heat). The instability of Yuan Yang would be more severe than the restlessness of Shaoyin disease. Therefore, although the fever persisted day and night, with scorched lips and a yellow greasy tongue coating, the pulse paradoxically appeared Xi Shu Wei Fu Er Ru (fine, rapid, slightly floating, and soft). If one suspects the rapid pulse indicates heat, the simultaneous presence of rapid, fine, floating, and soft pulses actually signifies the precarious state of Yuan Yang about to collapse, akin to a dying fire. Urgently administering Zhenwu Tang to welcome back the Yuan Yang and restore it to its proper position ensures there is no internal cold nor external heat. Hence, the administration of Zhenwu Tang was originally a correct therapeutic method, capable of achieving miraculous results instantly, leaving no room for doubt. The only issue is that the tone is impassioned, striving for literary flair, failing to elucidate the changes in pathology and the profound principles of medication, thereby preventing readers from fully understanding.