栀子仁 豆豉(倍用) 或加干姜少许。
表证未退,医早下之,阳邪乘虚入里,固结不能散,烦热懊 。更以陷胸汤继投,愈虚其虚,病不起尔。栀、
豉靖虚烦客热,服而探吐。俾误下表邪,一涌而出。去邪存正,此为上策。加姜者,既误必损胃之意。若未经下,
烦闷及多痰头痛,以赤小豆、苦瓜蒂为散主之。盖苦能涌泄,瓜蒂苦物也。燥可去湿,赤小豆燥物也。夫病未经
下,元气虽虚未损,头痛挟痰,又似实症,故用二物在上,吐而夺之,诚为快利。今人唯知汗下,而吐法全不能
讲究,何哉?丹溪曰∶吐中就有发散之义。戴人亦谓吐法兼汗。镜虽不敏,请事斯语矣。
烧盐调热童便,本治霍乱搅肠,愚以治伤食睑肿,痛连
胸膈,三饮而三吐之,亦效。所谓死方活用,全者多矣。
(一方量用蓖麻子、生大黄、生猪膏捣,捏长条,导入肛门内,效尤捷)
蜜二合煎极稠,捏如指,蘸皂角末少许,乘热纳入谷道。病患以手紧抱,勿令出,顷当便;猪胆一枚,入醋
些子,用竹管深深灌入广肠,亦妙。
阳明症自汗,小便利,大便秘者,蜜胆导之。此仲景原文。汪注∶胃实自汗,小便复利,此津液内竭,非热
结也。若与下药,则液愈耗矣。宜用外导之法。按是方只大便不行,别无所苦,及虚羸人燥秘,久病患欲下不敢
下,蜜能润肠,角能通窍,胆寒清热,醋酸致液,迎而夺之,于法允合。若云胃实,应有痞、满、潮、渴等症。
阳明自汗,决为内热逼出,汗亡津液,小便安得反利。立言似此,作述均失之矣,大匠以为如何。
Zhi Zi Ren (Gardenia Seed) and Dou Chi (Fermented Soybean, used in double dose), or add a small amount of Gan Jiang (Dried Ginger).
If the exterior syndrome has not resolved, and the physician prematurely employs purgation, the Yang pathogen enters the interior due to deficiency, becoming fixed and unable to disperse, resulting in vexation-heat and mental restlessness (Ao Nao). If Xian Xiong Tang (Chest-Sinking Decoction) is subsequently administered, it further depletes the already deficient righteous Qi, leading to an incurable condition. Zhi Zi and Dou Chi calm empty vexation and guest heat; after administration, inducing vomiting expels the exterior pathogen that was mistakenly driven inward. This method eliminates the pathogen while preserving the righteous Qi, representing the superior strategy. The addition of Sheng Jiang (Fresh Ginger) is intended to protect the Stomach Qi damaged by the erroneous purgation. If no purgation has been taken, and symptoms include vexation, stuffiness, excessive phlegm, and headache, a powder made of Chi Xiao Dou (Red Bean) and Ku Gua Di (Bitter Melon Pedicel) should be used as the primary treatment. Bitter flavors induce vomiting and drainage; Ku Gua Di is bitter. Dryness can eliminate dampness; Chi Xiao Dou is drying. Since the disease has not undergone purgation, although the Yuan Qi (Primal Qi) is weak, it is not yet damaged. Headache with phlegm resembles an excess syndrome; thus, using these two agents acting on the upper body to purge via vomiting is indeed swift and effective. Today, people only know sweating and purging, but completely neglect the vomiting method. Why? Dan Xi (Zhu Zhenheng) stated: "Vomiting contains the principle of dispersion." Dai Ren (Zhang Congzheng) also said that the vomiting method combines sweating. Although I, Jing (Huang Tingjing), am not intelligent, I propose to practice these words.
Burnt salt mixed with warm Tong Bian (Child's Urine) originally treats Huo Luan (Cholera-like disorder) with intestinal twisting pain. I use it to treat Shang Shi (Food Retention) causing eyelid swelling and pain radiating to the chest and diaphragm. Drinking it three times induces vomiting three times, which is also effective. This is called applying dead formulas flexibly, with many successes.
(Another formula: Use appropriate amounts of Bi Ma Zi (Castor Seed), Sheng Da Huang (Raw Rhubarb), and Sheng Zhu Gao (Raw Pork Fat), pound into a paste, shape into a long strip, and insert into the anus. The effect is even more rapid.)
Mi Feng (Honey), two he, boiled until extremely thick, shaped like a finger, dipped in a small amount of Zao Jiao Mo (Gleditsia Sinensis Powder), and inserted into the anal opening while hot. The patient should hold their buttocks tightly with their hands to prevent expulsion. After a moment, defecation should occur. One pig gallbladder, mixed with a little Cu (Vinegar), deeply infused into the large intestine using a bamboo tube, is also excellent.
Yang Ming syndrome with spontaneous sweating, free urination, and constipation is treated with Mi Dan Dao (Honey-Gallbladder Suppository). This is from Zhang Zhongjing's original text. Wang Ang's annotation states: "Stomach excess with spontaneous sweating and frequent urination indicates internal depletion of fluids, not heat accumulation. Administering purgatives would further consume fluids. External suppository methods are suitable." Analysis: This formula applies only when there is inability to pass stool without other discomforts, or for emaciated individuals with dry constipation, or for chronic patients afraid to take purgatives. Honey moistens the intestines, Zao Jiao opens orifices, Pig Gallbladder clears heat with its cold nature, and Vinegar generates fluids. Attacking the pathogen directly aligns with therapeutic principles. If claiming Stomach Excess, symptoms such as fullness, distension, tidal fever, and thirst should be present. Yang Ming spontaneous sweating is definitely caused by internal heat forcing sweat out, leading to fluid loss; how can urination become frequent? Such statements and compositions contain errors. How does a master judge this?