治阳毒伤寒,壮热,百节疼痛。
栀子仁(炒) 赤芍药 大青 知母(各一两) 升麻 黄芩 石膏 杏仁(去皮尖,各二两)
柴胡(一两半) 甘草(炙,半两)
上锉散。每服四大钱,水一盏,姜三片,豉二十粒,同煎七分,去滓,不以时服。
结胸证者,心下坚满,按之石硬而痛,心膈高起,手不得近,项强如柔 状。
此本伤寒身热,医下之早,热气乘虚而入,痞结不散之所致也。若脉浮大,皆不可下,下之
则死,尚宜发汗。若沉紧者,宜以大小陷胸汤量轻重而下之。又结胸有不按而痛者,有按而
痛者;有水结在胸胁间,但头汗出者;有热实结者,有寒实结者。治之不可不知其轻重也。
各有正方。
治伤寒表未解,而医反下之,鬲内拒痛,手不可近,短气烦躁,心中懊
,心下硬,大便不通,舌燥而渴,热实,脉沉而紧。又治身无大热,有水结在胸胁间者。
大黄(半两) 芒硝(四钱) 甘遂(半钱)
上各为末。水三盏,先煮大黄至一大盏,入硝煮熔,下甘遂末,煮一沸,分二服,得利止。
治结胸病,正在心,按之则痛,脉浮滑者。
黄连(一分) 半夏(汤洗去滑,六钱) 栝蒌实(不用,四分之一)
上为锉散。水二盏,先煎栝蒌,至盏半,入前药,煎至六分,去滓,分二服,利黄涎沫即安。
治疗阳毒伤寒,高热,全身关节疼痛。
栀子仁(炒) 赤芍药 大青 知母(各一两) 升麻 黄芩 石膏 杏仁(去皮尖,各二两)
柴胡(一两半) 甘草(炙,半两)
以上药材切碎成散剂。每次服用四大钱,用水一盏,生姜三片,豆豉二十粒,一同煎煮至七分满,滤去药渣,不拘时间服用。
结胸证(邪热与痰水互结于胸膈),胃脘部坚硬胀满,按压时如石头般坚硬且疼痛,心窝及膈部高起,手不能靠近,颈部僵硬如同柔痉(一种以项背强直、口噤不开为特征的病证)。
这原本是因为伤寒发热,医生过早使用泻下法,导致热气乘虚而入,痞塞郁结不散所致。如果脉象浮大,都不可用泻下法,误用泻下法则会导致死亡,此时仍适宜发汗。如果脉象沉紧,适宜根据病情轻重选用大陷胸汤或小陷胸汤进行泻下治疗。此外,结胸证有不按压也痛的,有按压才痛的;有水饮结聚在胸胁间,仅头部出汗的;有热实结聚的,有寒实结聚的。治疗时必须了解其轻重的区别。
各有对应的正治方剂。
治疗伤寒表证未解,而医生反而使用泻下法,导致胸膈内部拒按疼痛,手不能靠近,呼吸短促烦躁,心中烦闷不安,胃脘部硬满,大便不通,舌面干燥口渴,属于热实证,脉象沉而紧。又用于治疗身体没有大热,但水饮结聚在胸胁间的病症。
大黄(半两) 芒硝(四钱) 甘遂(半钱)
以上药材分别研成粉末。用水三盏,先煎煮大黄至一盏,加入芒硝煮至熔化,再投入甘遂末,煮沸一次,分两次服用,若得腹泻则停止服药。
治疗结胸病,病位正在心窝部,按压则疼痛,脉象浮滑的。
黄连(一分) 半夏(汤洗去滑,六钱) 栝蒌实(不用,四分之一)
以上药材切碎成散剂。用水二盏,先煎煮栝蒌,至一盏半,加入前药,煎煮至六分,滤去药渣,分两次服用,若排出黄色涎沫则病情安定。
Treat Yang-Du Shanghan (Yang-Toxin Cold Damage), characterized by high fever and pain in all joints.
Zizhiren (Gardeniae Semen, fried) [1 liang], Chishaoyao (Paeoniae Radix Rubra) [1 liang], Daqing (Indigotis Folium) [1 liang], Zhimu (Anemarrhenae Rhizoma) [1 liang]; Shengma (Cimicifugae Rhizoma) [2 liang], Huangqin (Scutellariae Radix) [2 liang], Shigao (Gypsum Fibrosum) [2 liang], Xingren (Armeniacae Semen Amarum, skin and tip removed) [2 liang]; Chaihu (Bupleuri Radix) [1.5 liang], Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) [0.5 liang].
Crush the above into a powder. Take four qian per dose, with one sheng of water, three slices of fresh ginger, and twenty grains of Douchi (Fermented Soybean), decoct together until reduced to seven-tenths, strain, and take at any time.
JieXiong Syndrome (Syndrome of Chest Binding), characterized by hardness and fullness below the heart, stone-hard tenderness upon pressure, bulging of the epigastrium and diaphragm, inability of the hand to approach, and neck stiffness resembling Rou-Jing (Soft Spasm).
This is originally caused by Shanghan (Cold Damage) with body heat, where the physician prematurely used purgatives, allowing heat pathogens to enter due to deficiency and become stuck without dispersing. If the pulse is floating and large, purgation must not be used; using it will lead to death, and sweating should still be preferred. If the pulse is deep and tight, Da-XiaXiong Tang (Major Intra-thoracic Decoction) or Xiao-XiaXiong Tang (Minor Intra-thoracic Decoction) should be used according to the severity to purge. Furthermore, JieXiong includes cases that are painful without pressure, painful only with pressure; cases with water binding between the chest and hypochondrium with sweat only on the head; cases of heat-solid binding, and cases of cold-solid binding. Treatment requires knowing their severity.
Each has its specific correct formula.
Treat Shanghan where the exterior syndrome has not resolved, but the physician erroneously used purgation, resulting in internal rejection and pain in the diaphragm, inability of the hand to approach, shortness of breath with irritability, mental restlessness (Ao-Nao), hardness below the heart, constipation, dry tongue with thirst, representing a heat-solid condition with a deep and tight pulse. Also treats cases where there is no significant body heat but water binding exists between the chest and hypochondrium.
Dahuang (Rhei Radix et Rhizoma) [0.5 liang], Mangxiao (Natrii Sulfas) [4 qian], Gansui (Kansui Radix) [0.5 qian].
Grind each into powder separately. Use three sheng of water, first decoct Dahuang until reduced to one sheng, add Mangxiao and boil until dissolved, then add Gansui powder and boil once. Divide into two doses. Stop taking if diarrhea occurs.
Treat JieXiong disease located exactly at the heart region, painful upon pressure, with a floating and slippery pulse.
Huanglian (Coptidis Rhizoma) [1 fen], Banxia (Pinelliae Rhizoma, washed with hot water to remove slipperiness) [6 qian], Gualou Shi (Trichosanthis Fructus) [use none, quarter part reserved for preparation reference? *Note: Text says "bu yong" (not use) but implies processing or specific part usage contextually often means seed vs fruit, here likely refers to the whole fruit processed differently or a typo in source for 'using the fruit', but strictly translating text*: Gualou Shi (Trichosanthis Fructus, do not use, quarter part)] -> *Correction based on standard TCM practice for this formula*: The text "不用" usually implies a specific processing instruction or exclusion of a part, but in Xiao Xian Xiong Tang, the fruit is used. However, adhering to strict translation of the provided text: Gualou Shi (Trichosanthis Fructus, do not use, quarter part).
*Refined Translation for accuracy to source text*: Gualou Shi (Trichosanthis Fructus, do not use, quarter part).
Crush the above into a powder. Use two sheng of water, first decoct Gualou until reduced to one-and-a-half sheng, add the previous medicines, decoct until reduced to six-tenths, strain, divide into two doses. Relief occurs when yellow phlegm-fluids are discharged.