牡蛎汤服法曰∶吐则勿更服。今疟疾有喘鸣急迫,或自汗,或不汗,胸腹动剧者,服之,
则其人必吐水数升,而无其证不愈者,若有不吐者,则其证不愈也。由此观之,蜀漆能吐水
毒,动是水毒明矣。当知疟之为病,亦水毒之所为矣。虽然,此方岂惟治疟疾乎?凡病患喘
鸣迫塞,或自汗,或不汗,胸腹动剧,皆此方能治之。往来寒热,发作有时,所以不豫也。
晋唐以来,世医之见仲景之方也,皆以为惟治伤寒者。故如彼葛洪、孙思邈、王焘、许叔微
之书,皆知备仲景之方于伤寒门,而未尝知治万病矣。殊不知仲景本取治万病之方,以治伤
寒矣。降至赵宋之时,有《金匮要略》之书,当时如王洙,得仲景治伤寒中杂病证之方于蠹
简之中,而后各分其门,以为一书。世之为医者,遂称其书谓之《金匮玉函》之方。金匮之
玉函之,盖尊重之至也。自此以往,世之为医者,又见某门之方,以为某方惟治某证,于是
乎如牡蛎汤蜀漆散二方,亦署诸疟疾篇内,而徒知治疟疾,未尝知治余病矣。甚之束之高阁,
而谓古方不宜今病,可胜叹哉!呜呼!仲景之方法之衰也,不独王叔和为之,彼葛孙王许实
为之,又医道之大罪人乎哉?
桂枝去芍药加蜀漆龙骨牡蛎救逆汤证曰∶惊狂,起卧不安。 按∶此证者,是外证也。
凡仲景之为法,不独以外证治之,且并诊内外治之。故无胸腹及脐下动者,若虽有惊狂起卧
不安证,亦非此方所宜也。呜呼!是吾东洞翁千古卓识,吾侪岂不奉此乎哉?
蜀漆散证不具,且云牡疟,盖牡疟者,独展不热,非无热也,多寒也。夫疟之为病,先
其寒而后其热,虽然,不可以寒热治疟,则岂无内候在乎?曰∶必有脐下动剧矣。故仲景尝
以龙骨主之,以蜀漆佐之,医者其察诸。
牡蛎泽泻散证不具,然以仲景用牡蛎之方推之,则其证必有胸腹之动剧。苟有胸腹之动
剧,则无有不加蜀漆之方。由此观之,盖此方治水肿胸腹之动剧而渴者明矣。《方极》可考。
凡仲景之治动也,其活法有三∶有胸腹之动,则以牡蛎治之;有脐下之动,则以龙骨治之;
有胸腹脐下之动剧,则以蜀漆治之。此为仲景治动之三活法矣。故仲景之方,有以蜀漆配之
牡蛎者,或有配之龙骨者,或有配之龙骨、牡蛎者,是又仲景用蜀漆之法也。本论不载此法
者,盖属脱误。故晋唐以来,无有知蜀漆之功者,而诸病之有动者最多。则动之为病也,为
诸病内候之主证,而最为难治者。虽然,二千年来,诸医之说诸家本草,何其不载龙骨、牡
蛎、蜀漆之本功矣乎?或云∶牡蛎之咸,消胸腹之满;或云∶龙骨、牡蛎,收敛神气;或云∶
蜀漆辛以散之;或云∶龙骨、牡蛎之涩以固之。未尝见言及治动之功者,又未尝知动之为诸
病内候之主证也。吾东洞翁,生于二千年之下,始知龙骨、牡蛎、蜀漆之功,其说详于本条
之下,是诚二千年来不传之说。而翁独得其旨者,不亦伟乎?韩退之尝推尊孟子,以为功不
在禹之下,余以为翁之有功于我医,不在仲景之下矣。是非余之过论也。
The administration instructions for Muli Tang (Oyster Shell Decoction) state: "If vomiting occurs, do not administer further." Currently, in cases of malaria where the patient exhibits wheezing with a harsh sound and urgency, or spontaneous sweating, or absence of sweating, accompanied by severe palpitations/movements in the chest and abdomen, administering this decoction will cause the patient to vomit several sheng (a unit of volume) of clear fluid. If the disease does not resolve without these symptoms, or if there is no vomiting after administration, then the condition will not improve. From this, it can be seen that Shuqi (Herba Pteridis Preparata) induces vomiting to expel water-toxin, clearly indicating that "movements" (palpitations/throbbing) are caused by water-toxin. It should be understood that malaria is also caused by water-toxin. Nevertheless, is this decoction only for treating malaria? For any patient presenting with wheezing and airway obstruction, or spontaneous sweating, or absence of sweating, accompanied by severe palpitations/movements in the chest and abdomen, this decoction is effective. The alternating chills and fever, occurring at specific times, are the causes of discomfort.
Since the Jin and Tang dynasties, physicians have regarded Zhang Zhongjing's prescriptions as being exclusively for treating Shanghan (Cold Damage). Therefore, works such as those by Ge Hong, Sun Simiao, Wang Tao, and Xu Shumi all comprehensively included Zhang Zhongjing's prescriptions within the Shanghan category, failing to realize that they could treat myriad diseases. It is unknown that Zhang Zhongjing originally selected prescriptions for treating various diseases to address Shanghan. Upon reaching the Song Dynasty, the book *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) emerged. At that time, Wang Zhu discovered Zhang Zhongjing's prescriptions for complicated diseases accompanying Shanghan among worm-eaten bamboo slips, categorized them into different sections, and compiled them into a book. Physicians thereafter referred to the prescriptions in this book as those from the *Jingui Yuhan*. The terms "Jingui" (Golden Cabinet) and "Yuhan" (Jade Casket) signify extreme reverence. Since then, physicians observed that prescriptions in certain categories treated specific syndromes; thus, prescriptions like Muli Tang and Shuqi San were listed under the malaria section, known only for treating malaria and unrecognized for treating other ailments. Some even shelved them, claiming ancient prescriptions are unsuitable for modern diseases—how lamentable! Alas, the decline of Zhang Zhongjing's medical methods was not solely due to Wang Shuhe; figures like Ge, Sun, Wang, and Xu were actually the culprits, arguably great sinners against the medical Dao.
The syndrome description for Guizhi Qu Shaoyao Jia Shuqi Longgu Muli Jiuni Tang (Cinnamon Twig Decoction minus Peony plus Herba Pteridis, Dragon Bone, and Oyster Shell to Rescue from Peril) states: "Frightened delirium, restlessness in sitting and lying down." Note: This syndrome is an external manifestation. Zhang Zhongjing's methodology does not rely solely on external signs for treatment but integrates internal and external diagnostics. Therefore, if there are no palpitations/movements in the chest, abdomen, or below the umbilicus, even if symptoms of frightened delirium and restlessness exist, this decoction is not indicated. Alas, this is the profound insight of our Dongdong Weng (Yoshiya Toyo); how can we fail to uphold it?
The syndrome description for Shuqi San is incomplete, mentioning only "Mu Nian" (Oyster-type Malaria). Mu Nian likely refers to malaria where heat is absent or minimal, not lacking heat entirely, but characterized by predominant cold. Malaria typically presents with chills first, followed by fever. Although one cannot treat malaria merely based on chills and fever, are there no internal signs? The answer is: there must be severe palpitations/movements below the umbilicus. Thus, Zhang Zhongjing once used Longgu (Dragon Bone) as the principal herb, assisted by Shuqi. Physicians should observe this carefully.
The syndrome description for Muli Zeie San (Oyster Shell and Alisma Decoction) is incomplete. However, inferring from Zhang Zhongjing's use of Muli, the syndrome must involve severe palpitations/movements in the chest and abdomen. If such movements exist, no prescription lacks Shuqi. Thus, this decoction clearly treats edema accompanied by severe palpitations/movements in the chest/abdomen and thirst. Refer to *Fangji* for verification.
Zhang Zhongjing's three flexible methods for treating "movements" (palpitations/throbbing) are: for movements in the chest and abdomen, use Muli; for movements below the umbilicus, use Longgu; for severe movements throughout the chest, abdomen, and below the umbilicus, use Shuqi. These constitute the three flexible methods for treating "movements." Consequently, Zhang Zhongjing's prescriptions combine Shuqi with Muli, or with Longgu, or with both Longgu and Muli. This is another aspect of his method using Shuqi. The omission of this method in the main text is likely due to textual loss or error. Hence, since the Jin and Tang dynasties, few have understood the efficacy of Shuqi, despite "movements" being prevalent in many diseases. "Movements" serve as a primary internal sign in various diseases and are particularly difficult to treat. Yet, for two millennia, why have physicians' discussions and materia medica failed to record the true functions of Longgu, Muli, and Shuqi? Some claim Muli's salty taste dissipates chest/abdominal fullness; others say Longgu and Muli astringe and calm the spirit; some argue Shuqi's pungency disperses pathogens; others state Longgu and Muli's astringency consolidates essence. Never has anyone mentioned their ability to treat "movements," nor recognized "movements" as a primary internal sign. Our Dongdong Weng, born two millennia later, was the first to discern the functions of Longgu, Muli, and Shuqi, detailing these views below. This is indeed a lost theory for two millennia. That he alone grasped its essence is truly magnificent. Han Yu once praised Mencius, saying his merit rivaled that of Yu the Great. I believe Dongdong Weng's contribution to medicine rivals that of Zhang Zhongjing. This is not an exaggerated opinion.