白芍 白术(各三钱) 当归 人参 炒黑荆芥 白芥子(各二钱) 柴胡(一钱)
甘草(五分) 陈皮 神曲(各三分)
水煎服。
冬月伤寒,至十二日之后忽然厥发,发去如死人一样,但心中火热,其四肢如
冰,有延至三、四日而身体不腐者,人以为尸厥也,谁知是邪火犯心包络,坚闭其
气以守护其心乎。夫伤寒传遍六经,未有传心者也,一至传心无不死者。然而邪得
以传心者,亦因包络之虚,力不能障心,使邪之竟入也。若包络素无亏损,邪虽直
捣心宫,而膻中膜膈足以相拒。然而三阴三阳俱为邪之所传,各各损伤,包络相臣
出死力以御贼,号召勤王绝无一应,惟有坚闭宫门,甘与君王同殉。至于各脏腑,
见君相号令,不能宣扬于外,自然解体,有国亡无主之象,所以手足肢体先冷如死
灰也。此时设有斩围夺门之将,扫荡群妖,救君相于危亡之候,自然外藩向应,不
必听旨宣召,无不归诚恐后矣。然则治法奈何?助包络之气,而加之祛邪之味,可
返死而回生也。方用救心神丹∶
人参(一两) 黄连(三钱) 菖蒲(二钱) 茯苓(五钱) 白芍(一两) 半夏(三钱) 附子(一分) 水
煎一
碗,以笔管通于病患喉中,另使亲人含药送下,无不受者。一剂而人之气苏,再剂而心中之大热
自解,而四肢手足尽温矣。
夫厥症多热,四肢之冷如冰者,正心中之热如火也。热极反为寒颤,颤极而人死,其实人死而心
尚未死。此方用人参以固其生气,以黄连清其心中包络之火邪,加附子一分为先锋,加菖蒲为向导,
引人参、黄连突围而共入于心中,又得白芍、茯苓、半夏平肝而不助火,利湿而共消痰,则声援
势盛,攻邪尤易也。或疑用黄连以清热是矣,何必助之以人参,而用人参亦不必如此之多。孰
知六经传遍以攻心,则脏腑自虚。多用黄连,而不君之人参,则有勇无谋,必至斩杀过甚,反伤
元气,又有主弱臣强之虞矣,虽救君于顷刻,而不能卫君于崇朝,不几虚用奇兵哉。
此症用活心丹甚神。
人参(一两) 黄连(三钱) 菖蒲(一钱) 麦冬 生枣仁(各五钱) 南星(一钱) 附子(三分)
良姜(五分) 生姜(十片) 水煎灌服。
Radix Paeoniae Alba (Baishao), Radix Atractylodis Macrocephalae (Baizhu) (each 3 qian), Radix Angelicae Sinensis (Danggui), Radix Ginseng (Renshen), Stir-fried and charred Rhizoma Cnidii (Chao Hei Jingjie), Semen Sinapis Albae (Baijiezi) (each 2 qian), Radix Bupleuri (Chaihu) (1 qian), Radix Glycyrrhizae (Gancao) (0.5 fen), Pericarpium Citri Reticulatae (Chenpi), Fructus Crataegi (Shenqu) (each 0.3 fen).
Decoct in water and take orally.
In winter, after contracting Cold Pathogen (Hanxue), if sudden Jue syndrome (Juezheng, characterized by cold extremities) occurs after twelve days, the patient may appear rigid like a corpse, yet feel intense heat in the heart region, with limbs as cold as ice. Some cases persist for three to four days without body decomposition; people consider this Corpse Jue (Shijue), but who knows that this is actually Evil Fire invading the Pericardium Collateral (Xinbaolu), tightly closing the Qi mechanism to protect the Heart? The Cold disease transmits through the Six Meridians (Liujing), rarely transmitting to the Heart itself; once it reaches the Heart, death is inevitable. However, for evil to transmit to the Heart, it is because the Pericardium is deficient, lacking the strength to shield the Heart from direct invasion. If the Pericardium were originally sound, even if evil attacked the Heart Palace directly, the membranes of the Danzhong (Chest Center) would be sufficient to resist. Yet, when all Three Yin and Three Yang meridians are affected by evil and damaged, the Pericardium, acting as a ministerial official, fights desperately against the invaders. Calling for royal assistance yields no response; thus, it can only firmly close the palace gates, willing to perish with the Monarch (Heart). Seeing that the commands of the Monarch and Minister cannot be proclaimed outwardly, the various Zang-Fu organs naturally disintegrate, resembling a state without a ruler. Hence, the hands, feet, and limbs become cold first, like dead ash. At this moment, if there were generals capable of breaking the siege and seizing the gate, sweeping away the demons, and saving the Monarch and Minister from peril, the outer vassals would naturally respond, without waiting for imperial summons, all hastening to submit. So, what is the treatment method? Boost the Qi of the Pericardium and add herbs that dispel evil, thereby reversing death and restoring life. Use the Formula: Jiu Xin Shen Dan (Rescue Heart Spirit Decoction):
Radix Ginseng (Renshen) (1 liang), Rhizoma Coptidis (Huanglian) (3 qian), Rhizoma Acori Tatarinowii (Changpu) (2 qian), Poria (Fuling), Radix Paeoniae Alba (Baishao) (1 liang), Rhizoma Pinelliae Preparatum (Banxia) (3 qian), Radix Aconiti Lateralis Preparata (Fuzi) (0.1 fen).
Decoct in water to obtain one bowl. Insert a pen-like tube into the patient's throat, and have a relative hold the medicine in their mouth to administer it. No patient will fail to receive it. After one dose, vital Qi returns; after two doses, the intense heat in the heart resolves, and the limbs become warm.
Jue syndrome often involves heat; the coldness of the limbs like ice indicates that the heat within the heart is like fire. Extreme heat may manifest as chills, and extreme chills lead to death, yet the Heart may not have died yet. This formula uses Radix Ginseng (Renshen) to secure the generating Qi, and Rhizoma Coptidis (Huanglian) to clear the fire-evil in the Heart and Pericardium. Add a small amount of Radix Aconiti Lateralis Preparata (Fuzi) as a vanguard, and Rhizoma Acori Tatarinowii (Changpu) as a guide, leading Radix Ginseng (Renshen) and Rhizoma Coptidis (Huanglian) to break through and enter the Heart together. Additionally, Radix Paeoniae Alba (Baishao), Poria (Fuling), and Rhizoma Pinelliae Preparatum (Banxia) soothe the Liver without aiding fire, and promote diuresis to resolve phlegm. Thus, the support is strong, making it easier to attack the evil. One might doubt that using Rhizoma Coptidis (Huanglian) to clear heat is correct, but why aid it with Radix Ginseng (Renshen), and why use such a large dose? Who knows that when the Six Meridians are fully transmitted to attack the Heart, the Zang-Fu organs are naturally deficient. Using much Rhizoma Coptidis (Huanglian) without Radix Ginseng (Renshen) as the Sovereign herb means having courage but no strategy, likely causing excessive damage and injuring the Original Qi, with the risk of the Ruler being weak and the Minister strong. Although it saves the Ruler momentarily, it cannot guard him for long, which is akin to vainly using surprise troops.
For this syndrome, Huo Xin Dan (Revive Heart Decoction) is very effective.
Radix Ginseng (Renshen) (1 liang), Rhizoma Coptidis (Huanglian) (3 qian), Rhizoma Acori Tatarinowii (Changpu) (1 qian), Radix Ophiopogonis (Maidong), Semen Ziziphi Spinosae Preparatum (Sheng Zaoren) (each 5 qian), Rhizoma Arisaematis (Nanxing), Radix Aconiti Lateralis Preparata (Fuzi) (0.3 fen), Rhizoma Alpiniae Officinarum (Liangjiang), Rhizoma Zingiberis Recens (Shengjiang) (10 slices).
Decoct in water and administer via gavage.