论云,治伤寒有法,医杂病有方。方即义方,法即法令。外病用法令,犹奸邪外扰,非
刑不除;内病用义方,犹父子兄弟不足,以礼格之而已。故内外之治,由是而分。外邪难辨
,当以例明;内证易知,只叙方证,学人不可不审。
治肝实热,阳气伏邪,胁痛,忿忿悲怒,发热喘逆满闷,目痛视物不明,狂悸
非意而言,乍宽乍急,所作反常。
前胡(去苗) 柴胡 秦皮(去粗皮) 细辛(去苗) 栀子仁 黄芩 升麻 蕤仁 决明子(各等分)
上锉散。每服四钱,水两盏,苦竹叶、车前叶各五片,煎至盏半,纳药再煎至八分,去
滓,入芒硝一钱匕,煎熔,不以时服。
治胆实热,反洒洒恶寒,腹中气满,胁下硬,口苦咽干,头痛,不欲食。
半夏(三两,汤洗去滑) 生地黄(五两) 酸枣仁(二两半) 黄芩(一两) 远志(去心,姜汁合炒)
茯苓(各二两) 甘草(炙,一两)
上锉散。长流水一斗,糯米一升,煮蟹眼沸,扬二三千遍,澄清,每用二盏,抄药四钱
匕,姜七片,煎七分,去滓,不以时服。
治肝虚寒,两胁满,筋急,不得太息,寒热腹满,不欲饮食,悒悒不乐,四肢
冷,发抢,心腹痛,目视KT KT ;或左胁偏痛,筋痿脚弱。及治妇人心痛乳痈,膝热
消渴,爪甲枯,口面青。
山茱萸 甘草(炙) 桂心(各一两) 细辛(去苗) 茯苓 桃仁(麸炒,去皮尖) 柏子仁
防风(各二两) 川乌头(炮去皮脐,半两)
上锉散。每服四大钱,水盏半,姜五片,枣三枚,煎至七分,去滓,空心服。
古人论述说,治疗伤寒有固定的法则,医治杂病有具体的方剂。所谓“方”,是指合乎道义的规范;所谓“法”,是指如同法令般的准则。对于外感疾病使用“法”,就像对待奸邪外扰一样,必须依靠刑罚才能清除;对于内伤疾病使用“方”,就像父子兄弟之间情感不足时,用礼仪来调和约束罢了。因此,内治与外治的方法由此区分开来。外感邪气难以辨别,应当通过条例加以明确;内伤病证容易知晓,只需叙述方剂与证候的对应关系,学习的人不可不仔细审察。
治疗肝脏实热证,阳气伏留之邪气,表现为胁肋疼痛,情绪愤懑易怒,发热气喘、胸满闷塞,眼睛疼痛、视物模糊,狂乱惊悸,非正常地言语妄动,情绪时而宽松时而急躁,行为举止反常。
处方:前胡(去苗)、柴胡、秦皮(去粗皮)、细辛(去苗)、栀子仁、黄芩、升麻、蕤仁、决明子(各等分)。
以上药物捣碎成散剂。每次服用四钱,加水两盏,苦竹叶、车前叶各五片,煎煮至一盏半,加入药散再煎至八分,滤去药渣,加入芒硝一钱匕,煎至熔化,不拘时候服用。
治疗胆腑实热证,表现为阵阵恶寒,腹部气机胀满,胁下坚硬,口苦咽干,头痛,不想进食。
处方:半夏(三两,汤洗去滑腻)、生地黄(五两)、酸枣仁(二两半)、黄芩(一两)、远志(去心,姜汁合炒)、茯苓(各二两)、甘草(炙,一两)。
以上药物捣碎成散剂。取长流水一斗,糯米一升,煮至蟹眼状沸腾,反复扬搅二三千遍,澄清后,每次取两盏,放入药散四钱匕,生姜七片,煎至七分,滤去药渣,不拘时候服用。
治疗肝脏虚寒证,表现为两胁胀满,筋脉拘急,不能深长呼吸,寒热交替伴腹部胀满,不想饮食,心情抑郁不乐,四肢冰冷,突发刺痛,心腹疼痛,视力模糊不清;或者左胁偏侧疼痛,筋脉痿软,脚部无力。以及治疗妇女心痛、乳痈,膝部发热,消渴症,指甲枯槁,口唇面部发青。
处方:山茱萸、甘草(炙)、桂心(各一两)、细辛(去苗)、茯苓、桃仁(麸炒,去皮尖)、柏子仁、防风(各二两)、川乌头(炮制去皮脐,半两)。
以上药物捣碎成散剂。每次服用四大钱,加水一盏半,生姜五片,大枣三枚,煎至七分,滤去药渣,空腹服用。
The ancients stated that there are specific principles for treating Shanghan (Cold Damage diseases) and specific formulas for treating miscellaneous diseases. "Formula" refers to righteous norms, while "principle" refers to laws and decrees. For external diseases, principles are applied, akin to using punishment to eliminate internal corruption or external disturbances; for internal diseases, formulas are used, similar to using propriety to regulate relationships when familial affection is insufficient. Thus, the treatments for internal and external conditions are distinguished accordingly. External pathogens are difficult to differentiate and should be clarified through established categories; internal syndromes are easier to understand, so only the correspondence between formulas and syndromes needs to be narrated. Students must examine this carefully.
To treat Liver Excess-Heat syndrome, where Yang Qi is trapped by latent pathogenic factors, presenting with hypochondriac pain, irritability and anger, fever, wheezing, chest fullness and oppression, eye pain, blurred vision, mania and palpitations, inappropriate speech, fluctuating tension and relaxation, and abnormal behavior:
Qian Hu (Peucedani Radix), Chai Hu (Bupleuri Radix), Qin Pi (Fraxini Cortex), Xi Xin (Asari Radix et Rhizoma), Zhi Zi Ren (Gardeniae Semen), Huang Qin (Scutellariae Radix), Sheng Ma (Cimicifugae Rhizoma), Rui Ren (Pruni Semen Persicae), Jue Ming Zi (Cassiae Semen) (equal parts).
Crush these into a powder. Take 4 qian per dose, add 2 zhan of water, 5 leaves of Ku Zhu Ye (Bitter Bamboo Leaf) and 5 leaves of Che Qian Ye (Plantaginis Leaf), decoct until 1.5 zhan remains. Add the powder and decoct again until 0.8 zhan remains. Strain the dregs, add 1 qian bi of Mang Xiao (Natrii Sulfas), melt it, and take at any time.
To treat Gallbladder Excess-Heat syndrome, presenting with chills, abdominal distension and Qi stagnation, hardness under the hypochondrium, bitter taste in the mouth, dry throat, headache, and anorexia:
Ban Xia (Pinelliae Rhizoma) (3 liang, washed with hot water to remove slipperiness), Sheng Di Huang (Rehmanniae Radix) (5 liang), Suan Zao Ren (Ziziphi Spinosae Semen) (2.5 liang), Huang Qin (Scutellariae Radix) (1 liang), Yuan Zhi (Polygalae Radix) (decocted with Ginger Juice after removing the heart), Fu Ling (Poria) (2 liang each), Gan Cao (Glycyrrhizae Radix et Rhizoma) (roasted, 1 liang).
Crush these into a powder. Take 1 dou of running water and 1 sheng of glutinous rice, boil until bubbling like crab eyes, stir vigorously two or three thousand times, let settle and clarify. Use 2 zhan of the clear liquid per dose, add 4 qian bi of the powder and 7 slices of fresh ginger, decoct until 0.7 portion remains. Strain and take at any time.
To treat Liver Deficiency-Cold syndrome, presenting with fullness in both hypochondria, tendon tightness, inability to take deep breaths, alternating chills and fever with abdominal distension, anorexia, depression, cold limbs, sudden stabbing pain, heart and abdominal pain, blurred vision; or unilateral left hypochondriac pain, tendon flaccidity, and weak legs. Also treats women's heart pain, mammary abscess, knee heat, Xiao Ke (Wasting-Thirst syndrome), withered nails, and cyanosis of the mouth and face.
Shan Zhu Yu (Corni Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma) (roasted), Gui Xin (Cinnamomi Ramulus) (1 liang each), Xi Xin (Asari Radix et Rhizoma) (remove seedlings), Fu Ling (Poria), Tao Ren (Persicae Semen) (bran-fried, skin and tips removed), Bai Zi Ren (Platycladi Semen), Fang Feng (Saposhnikoviae Radix) (2 liang each), Chuan Wu Tou (Aconiti Radix Preparata) (processed, skin and navel removed, 0.5 liang).
Crush these into a powder. Take 4 da qian per dose, add 1.5 zhan of water, 5 slices of fresh ginger, and 3 dates, decoct until 0.7 portion remains. Strain and take on an empty stomach.