三阳经,有并有合。如太阳并少阳,少阳并阳明,阳明并太阳。三阳合病,皆于经络中
推考其诊,随证治之。所谓并者,二经相并;合者,三经会合。以此强分,使名义易晓,不
必论其一二也。
病者憎寒壮热,自汗恶风,或无汗恶寒,晕眩重着,关节掣痛,手足拘挛,疼痛冷痹,
缓纵不随,心躁气上,呕吐下利,此皆三阳经中风寒暑湿,其脉必浮弦紧数。
治风寒暑湿流注足三阳经,手足拘挛疼痛,行步艰难,憎寒发热,自
汗恶风,头眩腰重,关节掣痛;或卒中昏塞,大小便秘涩;或腹痛,呕吐下利,恶闻食臭,
髀腿顽痹,缓纵不随,热闷惊悸,心烦气上,脐下冷痹,喘满肩息。
麻黄(去节) 干葛 细辛 浓朴(姜制炒) 茯苓 防己 枳壳(麸炒,去瓤) 桂心 羌
活防风(去叉) 柴胡 黄芩 小草(即远志苗) 白姜(炮) 半夏(汤洗去滑) 甘草 麦门
冬(去心,各等分)
上锉散。每服四大钱,水盏半,姜三片,枣一个,煎七分,去滓,空腹服。自汗,加牡
蛎、白术,去麻黄;肿满,加泽泻、木通;热甚无汗,减桂,加橘皮、前胡、升麻;腹痛吐
利,去黄芩,加芍药、附子炮;大便秘,加大黄、竹沥;喘满,加杏仁、桑白皮、紫苏。所
加并等分。凡有此病,详认证状,逐一加减,无不愈者。常服下气消痰,散风湿,退肿,进
饮食,令人不虚。江南诸师,固秘此方,虽父子兄弟不传,学人当敬用之。
三阳经(太阳、阳明、少阳三条阳经)的病证,有“并”和“合”两种情况。例如太阳经与少阳经相并,少阳经与阳明经相并,阳明经与太阳经相并。三阳经合病,都应当在经络中进行推究考察其脉诊表现,根据具体证候进行治疗。所谓“并”,是指两条经脉的邪气相并;所谓“合”,是指三条经脉的邪气会合。以此勉强区分,是为了使名称和含义容易理解,不必过分争论是一经还是二经的问题。
患者出现怕冷且高热、自汗出且怕风,或者无汗且怕冷、头晕目眩、身体沉重困倦、关节牵拉疼痛、手足拘挛抽搐、肢体疼痛且感觉寒冷麻木、肢体松弛无力不能随意运动、心中烦躁、气逆上冲、呕吐腹泻,这些都是三阳经受风寒暑湿邪气侵袭所致,其脉象必定表现为浮、弦、紧、数。
治疗风寒暑湿流注于足部三条阳经(足太阳膀胱经、足阳明胃经、足少阳胆经)引起的病症,如手足拘挛疼痛、行走困难、怕冷发热、自汗怕风、头晕腰重、关节牵拉疼痛;或者突然中风导致神志昏塞、大小便不通畅涩滞;或者腹痛、呕吐腹泻、厌恶食物气味、大腿和小腿顽固性麻木、肢体松弛无力不能随意运动、闷热惊悸、心烦气逆、脐下寒冷麻木、气喘胸闷需耸肩呼吸。
药物组成:麻黄(去除节段)、干葛(葛根)、细辛、浓朴(姜汁制后炒)、茯苓、防己、枳壳(麸皮炒,去瓤)、桂心、羌活、防风(去除叉枝)、柴胡、黄芩、小草(即远志的幼苗)、白姜(炮制)、半夏(热水洗去滑腻)、甘草、麦门冬(去除心),以上各药分量相等。
将上述药材切碎成散剂。每次服用四大钱,用水一盏半,加入生姜三片、大枣一个,煎煮至剩余七分药液,滤去药渣,空腹服用。若见自汗症状,加牡蛎、白术,去掉麻黄;若见肿胀满闷,加泽泻、木通;若热盛且无汗,减少桂心用量,加橘皮、前胡、升麻;若见腹痛呕吐腹泻,去掉黄芩,加炮制的芍药、附子;若大便秘结,加大黄、竹沥;若气喘胸闷,加杏仁、桑白皮、紫苏。所添加的药物分量均与原方等分。凡是患有此类疾病,详细辨证证状,逐一进行加减,没有不痊愈的。常服此方可降气消痰,疏散风湿,消退肿胀,增进饮食,使人不虚损。江南地区的各位医师,一直将此方视为秘密,即使是父子兄弟也不传授,学习中医的人应当恭敬地使用它。
The meridians of the Three Yang (Taiyang, Yangming, Shaoyang) present with conditions of "Bing" (conjoining) and "He" (combining). For instance, Taiyang conjoins with Shaoyang, Shaoyang conjoins with Yangming, and Yangming conjoins with Taiyang. In combined diseases of the Three Yang meridians, one must investigate their diagnosis within the meridians and treat according to the specific syndrome. "Bing" refers to the conjoining of two meridians; "He" refers to the combining of three meridians. This distinction is made merely to clarify the terminology, without needing to debate whether it involves one or two meridians.
The patient experiences aversion to cold with high fever, spontaneous sweating with aversion to wind, or absence of sweating with aversion to cold, dizziness, heaviness, joint pulling pain, spasm and contracture of the hands and feet, painful cold bi-syndrome (painful obstruction), flaccidity and inability to move voluntarily, mental restlessness, rebellious qi, vomiting, and diarrhea. These are all caused by wind, cold, summer-heat, and dampness invading the Three Yang meridians, and the pulse will necessarily be floating, wiry, tight, and rapid.
This treatment addresses wind, cold, summer-heat, and dampness flowing into the Foot Three Yang meridians (Foot-Taiyang Bladder, Foot-Yangming Stomach, Foot-Shaoyang Gallbladder), manifesting as spasm and pain in the hands and feet, difficulty walking, aversion to cold with fever, spontaneous sweating with aversion to wind, dizziness and heavy waist, joint pulling pain; or sudden stroke with stupor and obstruction, constipation and dysuria; or abdominal pain, vomiting and diarrhea, aversion to food odor, stubborn numbness in the thighs and legs, flaccidity and inability to move voluntarily, stifling heat with palpitations, mental irritability with rebellious qi, cold bi-syndrome below the umbilicus, asthma with chest fullness requiring shoulder breathing.
Ingredients: Ephedrae Herba (Mahuang, 麻黄 - removed nodes), Puerariae Radix (Gegen, 干葛), Asari Radix (Xixin, 细辛), Magnoliae Officinalis Cortex (Houpo, 浓朴 - processed with ginger juice and stir-fried), Poria (Fuling, 茯苓), Stephaniae Tetrandrae Radix (Fangji, 防己), Aurantii Fructus (Zhike, 枳壳 - stir-fried with bran, placenta removed), Cinnamomi Cortex (Guixin, 桂心), Notopterygii Rhizoma et Radix (Qianghuo, 羌活), Saposhnikoviae Radix (Fangfeng, 防风 - forked parts removed), Bupleuri Radix (Chaihu, 柴胡), Scutellariae Radix (Huangqin, 黄芩), Polygalae Herba (Xiaocao, 小草 - i.e., seedling of Yuanzhi), Zingiberis Rhizoma Praeparatum (Baijiang, 白姜 - processed), Pinelliae Rhizoma Preparatum (Banxia, 半夏 - washed with hot water to remove slipperiness), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), Ophiopogonis Tuber (Maidong, 麦门冬 - heart removed). All ingredients are in equal proportions.
Crush the above herbs into a powder. Take four qian per dose, decoct with one and a half cups of water, three slices of fresh ginger, and one jujube, until reduced to seven-tenths of the volume. Strain and take on an empty stomach. If spontaneous sweating occurs, add Ostreae Concha (Muli, 牡蛎) and Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), and remove Ephedrae Herba. If swelling and fullness are present, add Alismatis Rhizoma (Zexie, 泽泻) and Akebiae Caulis (Mutong, 木通). If heat is severe with no sweating, reduce the amount of Cinnamomi Cortex and add Citri Reticulatae Pericarpium (Chenpi, 橘皮), Peucedani Radix (Qianhu, 前胡), and Cimicifugae Rhizoma (Shengma, 升麻). If abdominal pain with vomiting and diarrhea occurs, remove Scutellariae Radix and add Paeoniae Radix Alba (Shaoyao, 芍药 - processed) and Aconiti Lateralis Radix Praeparata (Fuzi, 附子 - processed). If feces are dry and difficult to pass, add Rheum Palmatum Radix et Rhizoma (Dahuang, 大黄) and Bambusae Succus (Zhuli, 竹沥). If asthma and chest fullness occur, add Armeniacae Semen Amarum (Xingren, 杏仁), Morus Albae Cortex Radicis (Sangbaipi, 桑白皮), and Perillae Folium (Zisu, 紫苏). The added ingredients should also be in equal proportions. For any such disease, carefully verify the symptoms and adjust the formula accordingly; there will be no case that does not heal. Regular use descends qi and resolves phlegm, disperses wind-dampness, reduces swelling, promotes appetite, and prevents deficiency. Masters in Jiangnan have kept this formula secret, not even passing it down to sons or brothers; students of medicine should respect and use it diligently.