治厥阴伤风,恶风而倦,自汗,小腹急痛,寒热如疟,骨节烦疼,其脉尺寸俱微而迟者。
桂心 当归 川芎 前胡 防风(各三分) 芍药(一两半) 甘草(炙) 茯苓(各半两)
上 咀。每服四钱,水一盏半,姜五片,枣三个,煎八分,去滓,食前服。
经云∶冬伤于寒,春为温病。以冬不即病,其寒毒藏于风府之上,至春,温暖之气发而
为病,故曰温病。或愈,或死,死则六七日间,愈则多出旬日之外,世号为大病。要当随此
经络传变,仍以脉证别之,乃可施治。治伤寒法,盖尽于此。至晋集仲景论,于太阳经,出
麻黄桂枝二方治伤寒伤风,并录预备救失加减之法甚详。至阳明少阳与三阴经伤风证治,则
蔑闻矣,故知仲景只就太阳一经格量二病,令勿差互。编集既不诠辨,后学懵无所知,昏翳
典坟,千有余载,略不加省,良可叹息。今辄提其六经伤寒合用对治诸方,以为宗兆,其如
坏证治法,除各见本门外,编集于后,使皂白自分,初不敢取诸胸臆,盖有所本于圣经也。
《内经》论伤寒,惟说足三阴三阳,六经传受,愈否日数,及各随其脏腑经络,流注
去处,而证以行汗下,并两感脉应病形而已。至张长沙以伊芳尹《汤液》作治法,兼述伤风
暑湿等,详略不同,格量互显,使后学举隅而反。至晋不解其义,随行编集,遂行于世,
此后蹈袭者,不可胜计。所谓《百问》、《证治》、《提纲》、《目录》、《撮要》、《备全》、
《活人书》、《伤寒论》、乃至《图形》、《指脉》,皆剥采晋集,初无反隅,虽有意于广传
,皆未明其义类,缘晋集不识偏正,以此类预备之方,杂于正治,而正治之方,多所简脱,
故使典籍愈翳,后学固封,不削繁芜,罔知枢要,因别论于后云。
治疗厥阴经受风邪,出现怕风且疲倦,自汗出,小腹部拘急疼痛,寒热往来像疟疾一样,骨节烦扰疼痛,寸脉和尺脉都微弱而迟缓的症状。
桂心、当归、川芎、前胡、防风(各三分),芍药(一两半),炙甘草、茯苓(各半两)。
将药材切碎。每次服用四钱,加水一盏半,生姜五片,大枣三个,煎煮至剩余八分药液,滤去药渣,在饭前服用。
经书说:冬天感受寒邪,春天会发为温病。因为冬天当时没有立即发病,寒毒潜伏在风府穴上方,到了春天,温暖的气候引发而导致疾病,所以称为温病。有的痊愈,有的死亡,死亡的往往在六七天之间,痊愈的则多在一旬日之外,世人称之为大病。应当根据这些经络的传变规律,仍然通过脉象和证候来辨别,才可以施治。治疗伤寒的方法,大概就在这里了。到了晋代,有人汇编张仲景的论述,在太阳经方面,提出了麻黄汤和桂枝汤两个方子来治疗伤寒和伤风,并详细记录了预备用来补救失误的加减方法。至于阳明经、少阳经以及三阴经的伤风证治,就很少听说了,因此知道张仲景只是针对太阳一经来衡量这两种疾病,令其不混淆。编纂者既然没有进行辨析,后学者懵懂无知,使经典文献变得晦暗不明,一千多年过去了,稍微加以省察的人很少,实在令人叹息。现在我提出六经伤寒合用的对治各方,作为宗旨和先导,至于坏证的治法,除了在各本门中已有记载外,编集在后面,使是非黑白自然分明,我绝不敢凭主观臆断,而是有所依据于经典医书。
《内经》论述伤寒,只讲了足三阴和三阳经,六经的传受过程,痊愈与否的天数,以及各自随其脏腑经络流注的去向,并根据情况施行发汗或攻下法,以及两感病的脉象与病症表现罢了。到了张仲景(长沙太守)以伊尹的《汤液经法》作为治疗方法,兼述伤风、暑湿等病,详略不同,相互印证显现,使后学者能举一反三。到了晋代,人们不理解其中的义理,只是随意跟随编纂,于是流传于世,此后沿袭的人,不可胜数。所谓的《百问》、《证治》、《提纲》、《目录》、《撮要》、《备全》、《活人书》、《伤寒论》,乃至《图形》、《指脉》等书,都是剥取采择晋代汇编的内容,起初并没有做到举一反三,虽然有意于广泛传播,但都没有阐明其义理类别,因为晋代的汇编不认识偏正之分,将这类预备救失的方剂混杂在正治方剂中,而正治方剂又多有所简略脱漏,致使典籍更加晦暗,后学者固守封闭,不删减繁杂芜杂的内容,就无法知晓关键要领,因此在后面另作论述。
Treats Wind-Strike of the Jueyin (Jueyin Wind-Strike, a disease pattern caused by wind pathogen affecting the Jueyin meridian), characterized by aversion to wind and fatigue, spontaneous sweating, acute pain in the lower abdomen, alternating chills and fever resembling malaria, vexing pain in the bone joints, with both the Cun (inch) and Chi (cubit) pulses being faint and slow.
Guixin (Cinnamon Heartwood), Danggui (Angelica Sinensis Root), Chuanxiong (Ligusticum Chuanxiong Rhizome), Qianhu (Peucedani Radix), Fangfeng (Saposhnikoviae Radix) (each 3 fen), Shaoyao (Paeoniae Radix) (1 liang 5 qian), Zhigancao (Prepared Licorice Root), Fuling (Poria) (each 0.5 liang).
Crush the herbs. For each dose, take 4 qian, add 1.5 zhan of water, 5 slices of fresh ginger, and 3 jujubes. Decoct until 0.8 zhan remains, strain off the dregs, and administer before meals.
The Classics state: "If one is injured by Cold in winter, Warm Disease (Wenbing, febrile diseases occurring in spring due to latent cold) will manifest in spring." This is because if the disease does not occur immediately in winter, the Cold toxin hides above the Fengfu (GV16) acupoint. When the warming Qi arrives in spring, it triggers the disease, hence it is called Warm Disease. Some recover, some die; those who die often do so within six or seven days, while those who recover usually take more than ten days. The world calls this a major disease. One must follow the transmission changes of these meridians and distinguish them by pulse and symptoms to apply treatment. The methods for treating Shanghan (Cold Damage) are essentially contained herein. By the Jin Dynasty, Zhang Zhongjing's discussions were compiled; regarding the Taiyang (Taiyang Meridian, the exterior defensive level) meridian, two formulas—Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction)—were presented to treat Shanghan and Shangfeng (Wind Strike), along with detailed preparatory methods for correcting errors via modifications. However, treatments for Wind Strike involving the Yangming (Yangming Meridian), Shaoyang (Shaoyang Meridian), and the three Yin meridians were scarcely heard of. Thus, it is known that Zhang Zhongjing only measured these two diseases based on the Taiyang meridian to prevent confusion. Since the compilers did not clarify and distinguish these, later learners remained ignorant, obscuring the classics for over a thousand years with little reflection, which is truly lamentable. Now, I extract the various formulas used to counteract Cold Damage across the Six Meridians as the guiding principles. As for the treatment of complicated cases (Huazheng, damaged or complicated disease patterns), except where they appear in their respective sections, they are compiled below to clearly distinguish right from wrong. I dare not rely on personal speculation but have grounds in the sacred scriptures.
The *Neijing* (Inner Canon) discusses Shanghan, mentioning only the foot Three Yin and Three Yang meridians, the transmission of the Six Meridians, the number of days for recovery or non-recovery, and the flow and injection sites according to their respective Zang-Fu organs and meridians, applying sweating or purging methods accordingly, and describing the pulse responses and clinical manifestations of Lianggan (Simultaneous Invasion, a severe form of cold damage affecting both exterior and interior simultaneously). It was Zhang Changsha (Zhang Zhongjing, who served as Prefect of Changsha) who used Yi Yin's *Tangye Jingfa* (Classic of Decoctions) as the basis for treatment methods, additionally discussing Wind Strike, Summerheat, and Dampness, with varying degrees of detail, allowing later learners to infer other cases from one example. In the Jin Dynasty, people failed to understand its meaning, merely compiling and circulating it, leading to countless subsequent imitators. Works such as *Baiwen*, *Zhengzhi*, *Tigang*, *Mulu*, *Cuoyao*, *Beiquan*, *Haren Shu* (Book of Vitality), *Shanghan Lun* (Treatise on Cold Damage), and even *Tuxing* and *Zhimai* all plagiarized the Jin compilations without achieving true understanding (*ju yi fan san*). Although intended for widespread dissemination, they failed to clarify the categories of meaning. Because the Jin compilation failed to distinguish between primary and secondary treatments, mixing preparatory formulas with primary treatment formulas, while omitting much of the primary formulas, further obscured the texts. Later learners became rigidly confined; without removing the superfluous, they could not grasp the essentials. Therefore, I discuss this separately hereafter.