治寒疝入腹,上实下虚,小腹 痛,时复泄泻,胸膈痞满,不进饮食。常服温脾补肾。
人参 茯苓 白术 黄 附子(炮去皮脐,各一两) 沉香(四钱) 木瓜一两半 羌活(半两)
甘草(炙) 芎 (各一分) 紫苏(三分)
上为锉散。每服三钱,水一盏,姜三片,枣一枚,煎七分,去滓,食前服。呕,加半夏
半两,添水作盏半,姜七片煎。
经云∶厥者,逆也。有寒厥,有热厥,有六经厥,有尸厥。寒厥者,阴气起于足五指之
里,集于膝下,聚于膝上,故阴气胜,则从五指至膝上寒,阳气衰,不能渗营其经络,阳气
日损,阴气独在,故手足为之寒,名曰寒厥。热厥者,阳气起于足五指之表,集于足下,聚
于足心,故阳气胜,则从五指至足心热,热入于胃,络脉满,经脉虚,阴虚阳入,肾气衰,
阳气独胜,故手足为之热,名曰热厥。六经厥者,头重足弱,发为瞑仆,名太阳厥;妄言走
呼,腹满面赤,名阳明厥;暴聋颊肿,胁 拘痛,名少阳厥;腹胀后闭,食为寒呕,名
太阳厥;口干溺赤,腹满心痛,名少阴厥;泾溲不利, 热阴缩,名厥阴厥。尸厥者,
胀满,暴不知人,或至半日,远至一日。此以阴气盛于上,则下虚,下虚则腹胀,腹胀则下
气重上而邪气逆,逆则阳气乱而不知人矣,名曰尸厥。经论如此,虽粗分六经,殊不出寒热
,二证所因,欲求备治,当历明之。寒厥,则因多欲而夺其精,故致阳衰阴盛。热厥,则因
醉饱入房,精虚则热入,故致阴虚阳盛。考其厥因,多以不胜乘其所胜,气不得行,遂致于
逆。如肾移寒于脾,则水乘于土,水既不行,乃成寒厥;如心移热于肾,则火寒于水,火既
不行,乃成热厥。六经皆然,可次第论也,所谓得其要者,一言而终矣。尸厥亦然,正由脏
气相刑,或与外邪相忤,则气遏不行,闭于经络,诸脉匿伏,昏不知人。唯当随其脏气而通
之,寒则热,热则寒,闭则通,如《经》所谓盛则泻,虚则补,不盛不虚,以经取之,其旨
一也。《经》中以数醉为热厥之因,学人不可拘此。盖伤寒温病,皆有热厥,仲景所谓热深
厥深,圣意以酒能发百脉热,故举此以为例耳,不可不知。
治疗寒疝发作时寒气攻入腹部,表现为上部实而下部虚,小腹部疼痛,时常伴有腹泻,胸膈部位痞塞胀满,食欲不振。长期服用此方可温补脾肾。
配方:人参、茯苓、白术、黄芪、附子(炮制后去皮去脐,各一两)、沉香(四钱)、木瓜(一两半)、羌活(半两)、甘草(炙过)、川芎(各一分)、紫苏(三分)。
将上述药材切碎成散剂。每次服用三钱,加水一盏,生姜三片,大枣一枚,煎煮至剩余七分药液,滤去药渣,在饭前服用。如果出现呕吐症状,加入半夏半两,增加水量至一盏半,加生姜七片煎煮。
经典医籍记载:“厥”的意思是气机逆乱。分为寒厥、热厥、六经厥和尸厥四种。寒厥是由于阴气从足趾内侧产生,汇聚于膝下,聚集于膝上,因此阴气偏盛,导致从足趾到膝盖以上发冷;阳气衰弱,不能渗透滋养经络,阳气日渐损耗,只有阴气存在,所以手足寒冷,称为寒厥。热厥是由于阳气从足趾外侧产生,汇聚于足底,聚集于足心,因此阳气偏盛,导致从足趾到足心发热;热气进入胃中,络脉充盈而经脉空虚,阴虚而阳热内入,肾气衰弱,阳气独盛,所以手足发热,称为热厥。六经厥的表现是:头部沉重脚部软弱,突然昏倒,称为太阳厥;胡言乱语奔跑呼叫,腹部胀满面色发红,称为阳明厥;突然耳聋脸颊肿胀,胁肋拘急疼痛,称为少阳厥;腹部胀满大便闭塞,进食即吐出寒物,称为太阴厥(注:原文此处误作“太阳厥”,据中医理论及上下文应为太阴);口干尿赤,腹部胀满心痛,称为少阴厥;小便不利,阴部收缩发热,称为厥阴厥。尸厥的症状是腹部胀满,突然昏迷不省人事,短则半天,长则一天。这是因为阴气盛于上部,导致下部虚弱,下部虚弱则腹部胀满,腹部胀满则下部的浊气重而上逆,邪气随之逆乱,扰乱阳气而导致昏迷不省人事,称为尸厥。经典论述如此,虽然粗略分为六经,但本质上离不开寒证和热证两种病因,想要全面治疗,应当逐一阐明。寒厥,多因房事过度耗损精气,导致阳气衰弱阴气偏盛。热厥,多因醉酒后行房,精气亏虚导致热邪内入,导致阴虚阳盛。考察厥证的成因,大多是因为某脏之气不胜其所胜之脏,气机运行受阻,从而导致气逆。例如肾的寒邪移传于脾,则是水气乘袭土气,水气不行,便形成寒厥;例如心的热邪移传于肾,则是火气凌驾于水气之上,火气不行,便形成热厥。六经的情况都是这样,可以依次论述,所谓抓住关键,一句话就能概括。尸厥也是如此,正是因为脏腑之气相互克制,或与外邪相冲突,导致气机遏制不能运行,闭阻于经络,所有脉络隐匿伏藏,使人昏迷不省人事。只应当根据脏腑之气进行疏通,寒证用热法,热证用寒法,闭阻则通利,正如《内经》所说“盛则泻之,虚则补之,不盛不虚以经取之”,其宗旨是一致的。《内经》中将多次醉酒作为热厥的成因,学习的人不可拘泥于此。因为伤寒和温病都有热厥,张仲景所说的“热深厥亦深”,圣人是以酒能激发全身血脉发热为例来说明这个道理,这一点不可不知道。
Indicated for cold hernia (Han Shan) where cold qi invades the abdomen, presenting with excess in the upper part and deficiency in the lower part, pain in the lower abdomen, intermittent diarrhea, chest and diaphragm stuffiness and fullness, and loss of appetite. Regular use warms the Spleen and tonifies the Kidney.
Ingredients: Renshen (Ginseng Radix), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqi (Astragali Radix), Fuzi (Aconiti Lateralis Radix Praeparata, processed, skin and umbilicus removed, each 1 liang), Chenxiang (Aquilariae Lignum Resinatum, 4 qian), Mugua (Chaenomelis Fructus, 1.5 liang), Qianghuo (Notopterygii Rhizoma et Radix, 0.5 liang), Gancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle), Xiongqiong (Chuanxiong Rhizoma, each 1 fen), Zisu (Perillae Folium, 3 qian).
Crush the above herbs into a coarse powder. Take 3 qian per dose, add one zhan of water, three slices of fresh ginger, and one jujube. Decoct until only seven-tenths of the liquid remains, strain, and take before meals. If vomiting occurs, add Banxia (Pinelliae Rhizoma) 0.5 liang, increase water to one and a half zhan, add seven slices of ginger, and decoct.
The Classics state: "Jue" refers to counterflow or rebellion of Qi. There are Cold Jue, Hot Jue, Six-Meridian Jue, and Corpse Jue. Cold Jue arises when Yin Qi originates from the interior of the five toes of the foot, gathers below the knee, and accumulates above the knee. Thus, when Yin Qi prevails, coldness extends from the toes to above the knee; Yang Qi declines and cannot permeate and nourish the meridians. As Yang Qi is daily depleted and only Yin Qi remains, the hands and feet become cold, named Cold Jue. Hot Jue arises when Yang Qi originates from the exterior of the five toes, gathers at the sole, and accumulates at the center of the foot. Thus, when Yang Qi prevails, heat extends from the toes to the sole. Heat enters the Stomach, filling the collaterals while emptying the main meridians. Yin deficiency allows Yang heat to enter, Kidney Qi declines, and Yang Qi becomes excessive alone, causing the hands and feet to become hot, named Hot Jue. Six-Meridian Jue manifests as heaviness of the head and weakness of the legs, leading to sudden fainting, named Taiyang Jue; delirious speech, running and shouting, abdominal fullness, and red face, named Yangming Jue; sudden deafness, swollen cheeks, and spasmodic pain in the hypochondrium, named Shaoyang Jue; abdominal distension with constipation, and vomiting of cold substances after eating, named Taiyin Jue (Note: Original text says Taiyang, but context implies Taiyin); dry mouth, red urine, abdominal fullness, and heart pain, named Shaoyin Jue; difficult urination, contraction of the genitals with heat, named Jueyin Jue. Corpse Jue presents with abdominal distension and sudden unconsciousness, lasting from half a day to up to one day. This is because excessive Yin Qi in the upper body causes deficiency in the lower body; lower deficiency leads to abdominal distension; abdominal distension causes heavy lower Qi to rise and pathogenic Qi to rebel; this rebellion disturbs Yang Qi, leading to unconsciousness, named Corpse Jue. The Classics discuss it thus. Although roughly divided into Six Meridians, it essentially does not go beyond the two categories of Cold and Hot patterns. To seek comprehensive treatment, one must clarify them individually. Cold Jue is caused by excessive sexual desire depleting Essence, leading to Yang decline and Yin excess. Hot Jue is caused by intercourse after drunkenness and overeating; Essence deficiency allows Heat to enter, leading to Yin deficiency and Yang excess. Examining the causes of Jue, they mostly arise when one organ's Qi fails to control its controlling organ, causing Qi stagnation and subsequent rebellion. For example, if Kidney Cold transfers to the Spleen, Water attacks Earth; since Water fails to flow, Cold Jue forms; if Heart Heat transfers to the Kidney, Fire overwhelms Water; since Fire fails to flow properly, Hot Jue forms. The same applies to all Six Meridians, which can be discussed sequentially. Grasping the essence, it can be summarized in one word. Corpse Jue is also due to mutual restriction of Zang organ Qi or conflict with external pathogens, causing Qi obstruction and failure to circulate, closing off the meridians, hiding all pulses, and causing unconsciousness. One must follow the Zang organ Qi to unblock it: use Heat for Cold, Cold for Heat, and unblocking for closure. As stated in the Classics, "Excess drain it, deficiency tonify it, neither excess nor deficiency treat via the meridian," the principle is the same. The Classics cite frequent drunkenness as a cause of Hot Jue; students should not rigidly adhere to this. Both Shanghan (Cold Damage) and Wenyi (Warm Diseases) have Hot Jue. Zhang Zhongjing’s statement that "the deeper the heat, the deeper the Jue" uses alcohol’s ability to stimulate heat in all vessels as an example. This must be understood.