若面黄或洁,或黄洁俱见,脉浮沉不一,缓而迟者,伤在太阴,脾之经也。
人参(一两,腹痛者倍之) 甘草(炙) 白术 干姜(各一两)
上细末,炼蜜和丸鸡子黄大。以汤数合,和丸,研碎,温服之,日三夜二。腹中未热,
益至三四丸,煎热粥饮投之,微温覆,勿揭衣。丸不及汤。
海藏云∶大便结者宜丸,大便软者宜汤。仲景云∶无阳阴强,大便硬者,不可下,下之则
清谷腹满。
以上三经脉皆云浮沉不一者,以其皆似孤亡之体也。
又云∶日三夜二,读之极无味,然仔细思之,利害非轻。恐人不识,故有阴阳寒热各从
类生一条。
假令附子与大黄合而服之,昼服则阳药,成功多于阴药,夜服则阴药成功于阳药,足从
其类
也。况人之疾,独不然乎!若病阳症,昼则增剧,夜则少宁;若病阴症,昼则少宁,夜则增
剧。是人之阴阳寒热,从天地之行阴行阳也,寒热之化,以此随之。故前人治阴证用阳药,
续于夜半之后者,所以却类化之阴,而接身与子所生之阳也。《通玄类证》云∶小建中汤后
亦举日三夜二,及尺脉不至者加黄 。
予尝云∶大便软者宜汤,大便结者宜丸,以丸蜜润也。仲景治霍乱吐下,脾湿大胜,而
用丸何也?
答曰∶以湿言之,岂有润之之理,此正湿已太过,津液极亡,所以转筋也。筋得血而养
,故
能屈伸。利下既多亡阴,失血反成枯燥,燥则所以不能屈伸也。故湿剂以润之,只用丸也,
与妇人血崩过极不止而用四物汤润剂同意。十剂之法,要当谨察。
If the complexion is yellow or clean, or both yellow and clean are present simultaneously, and the pulse is inconsistent in floating and sunken levels, slow and delayed, the injury is in the Taiyin (Greater Yin) channel, which is the Spleen channel.
Renshen (Ginseng Radix et Rhizoma, one tael; double the dose if abdominal pain is present) Gancao (Prepared Licorice Root) Baizhu (Atractylodis Macrocephalae Rhizoma) Ganjiang (Dried Ginger, each one tael).
Grind the above herbs into a fine powder, mix with refined honey to form pills the size of a chicken egg yolk. Dissolve the pill in several he (a traditional unit of liquid measure) of decoction, grind until broken down, and take warm. Administer three times during the day and twice at night. If warmth is not felt in the abdomen, increase to three or four pills. Take with hot congee broth. Cover slightly for warmth, do not remove clothing. Pill preparations act slower than decoctions.
Haicang stated: For constipation, pills are suitable; for loose stools, decoctions are suitable. Zhang Zhongjing stated: In cases of "no Yang and strong Yin" where the stool is hard, purgatives should not be used; using them will result in undigested food in the stool and abdominal fullness.
The pulses mentioned in the above three channels as inconsistent in floating and sunken levels indicate that these conditions resemble a state of solitary Yang depletion.
It is also said: Taking medicine three times by day and twice by night seems extremely tedious when read, but upon careful consideration, the implications are significant. To prevent misunderstanding, there is a section on "Yin and Yang, Cold and Heat generating according to their kind."
Suppose Fuzi (Prepared Aconite Lateralis Radix) and Dahuang (Rhubarb Radix et Rhizoma) are taken together. Taken during the day, they act as Yang medicines, achieving success more through Yang action than Yin; taken at night, they act as Yin medicines, achieving success more through Yin action than Yang, because drugs follow their own kind. How much more so for human diseases! If it is a Yang syndrome, symptoms worsen during the day and ease at night; if it is a Yin syndrome, symptoms ease during the day and worsen at night. This is because human Yin and Yang, cold and heat, follow the movement of Heaven and Earth's Yin and Yang. The transformation of cold and heat follows this pattern. Therefore, ancients treating Yin syndromes with Yang medicines continued administration after midnight to dispel Yin that transforms according to its kind and to reconnect with the Yang generated in the body at Zi hour (11 PM - 1 AM). *Tongxuan Leizheng* states: After Xiaojianzhong Tang (Minor Construct the Middle Decoction), the regimen of three times by day and twice by night is also listed, and Huangqin (Scutellariae Radix) is added if the Chi pulse is absent.
I once stated: Loose stools suit decoctions; constipation suits pills, because pills contain honey which moistens. Why did Zhang Zhongjing use pills for Huoluan (Cholera-like disorder) with vomiting and diarrhea, where Spleen dampness is excessive?
The answer is: Regarding dampness, how could there be a rationale for further moistening? This indicates that dampness has become excessive, and body fluids are extremely depleted, leading to muscle cramps. Tendons require blood nourishment to flex and extend. Excessive purging leads to Yin loss; hemorrhage leads to dryness. Dryness prevents flexion and extension. Thus, using a moistening agent via pills is appropriate, consistent with using Siwu Tang (Four Substances Decoction) as a moistening agent for women with severe uterine bleeding that does not stop. The method of the Ten Categories of Medicines requires careful examination.