赤石脂(一斤碎) 禹余粮(一斤碎)
上二味。以水六升。煮取二升。去滓。分三服。
伤寒服汤药。下利不止。心下痞硬。服泻心汤已。复以他药下之。利不止。医以理中与
之。
利益甚。理中者理中焦。此利在下焦。赤石脂禹粮汤主之。复利不止者。当利其小便。按此
段经文。本已自解明白。利在下焦。关闸尽撤。急当固下焦之脱。石脂余粮固涩之品。性
皆重坠。直走下焦。拦截谷道。修其关闸。此以土胜水之法。若复利不止。则又当通支河
水道。以杀其下奔之势。而关闸始得完固。
甘草(四两炙) 生姜(二两切) 桂枝(三两去皮) 麦冬(半斤去心) 麻子仁(半斤) 人
参(二两) 阿胶(二两) 大枣(十二枚擘) 生地黄(一斤)
上九味。以清酒七升。水八升。先煎八味。取三升。去滓。内胶烊销尽。温服一升。日
三服。一名复脉汤。
伤寒脉结代。心动悸者。炙甘草汤主之。按脉结代而心动悸。则心悸非水饮搏结之心悸
。而
为中气虚馁之心悸矣。经衣冠文物以结阴代阴。昭揭病因。证津液衰竭。阴气不交于阳。已可概
见。君以炙甘草。坐镇中州。而生地麦冬麻仁大枣人参阿胶之属。一派甘寒之药。滋阴复液
。但阴无阳则不能化气。故复以桂枝生姜。宣阳化阴。更以清酒通经隧。则脉复而悸自安矣
。
赤石脂(一斤,捣碎) 禹余粮(一斤,捣碎)
以上两味药。用水六升,煎煮至二升,滤去药渣。分三次服用。
伤寒病患者服用汤药后,腹泻不止,胃脘部痞塞坚硬。服用泻心汤后,医生又用其他药物攻下,导致腹泻仍不止。医生给予理中汤治疗。
腹泻反而加重。理中汤是调理中焦的方剂,此处的腹泻病位在下焦。应当用赤石脂禹余粮汤主治。如果服用后腹泻仍不止,则应当通过利小便的方法来止泻。按这段经文来看,原本已经解释得明白清楚。腹泻病位在下焦,肛门括约功能完全丧失,急需固摄下焦的脱失之证。赤石脂和禹余粮都是具有固涩作用的药物,性质沉重沉降,直达下焦,拦截谷道,修复关闸功能。这是以土克水的治疗方法。如果腹泻仍然不止,则应当疏通旁支水道,以遏制向下奔迫的趋势,这样关闸功能才能得以完固。
甘草(四两,炙烤) 生姜(二两,切片) 桂枝(三两,去皮) 麦冬(半斤,去心) 火麻仁(半斤) 人参(二两) 阿胶(二两) 大枣(十二枚,掰开) 生地黄(一斤)
以上九味药。用清酒七升、水八升,先煎煮前八味药,取汁三升,滤去药渣,加入阿胶烊化直至完全溶解。每次温服一升,每日服用三次。又名复脉汤。
伤寒病患者出现脉搏结代、心跳悸动不安的症状,应当用炙甘草汤主治。按脉搏结代且心跳悸动来看,这种心悸并非由水饮搏结引起的心悸,而是由于中气虚弱不足所致的心悸。经文用“结阴代阴”来揭示病因,表明津液衰竭,阴气不能与阳气相交,情况已可概见。方中以炙甘草为君药,坐镇中州(脾胃),而生地、麦冬、麻仁、大枣、人参、阿胶等药物,均为甘寒性质的药材,旨在滋阴生津。但阴若无阳则无法化生为气,因此辅以桂枝、生姜,宣通阳气以化生阴液,再用清酒通达经络隧道,则脉搏恢复而悸动自然安宁。
Red Stone Lip (Chi Shi Zhi) (one jin, crushed) Yu Yu Liang (one jin, crushed)
These two ingredients. Boil in six sheng of water to obtain two sheng. Remove the dregs. Divide into three doses.
In shaoyang disease, after taking herbal decoctions, diarrhea persists unceasingly, accompanied by a stuffy and hard sensation in the epigastrium. After taking Xiexin Tang (Drain the Epigastm Decoction), the physician again used other purgatives, resulting in persistent diarrhea. The physician administered Lizhong Tang (Regulate the Middle Decoction).
The diarrhea worsened. Lizhong Tang regulates the middle jiao; this diarrhea is located in the lower jiao. It should be treated with Chishizhi Yuyuliang Tang (Red Stone Lip and Hematite Decoction). If the diarrhea still does not stop, one should promote urination to stop the diarrhea. According to this passage from the classic, the explanation is already clear. The diarrhea is in the lower jiao, where the "gate" has completely collapsed, requiring urgent consolidation of the collapse in the lower jiao. Chi Shi Zhi and Yu Yu Liang are astringent substances with heavy and sinking properties, acting directly on the lower jiao to intercept the intestinal tract and repair the "gate." This is a method of using Earth to overcome Water. If the diarrhea still persists, one should then open the collateral channels for water metabolism to curb the downward rushing tendency, so that the "gate" can be fully secured.
Gancao (Licorice Root) (four liang, honey-fried) Shengjiang (Fresh Ginger) (two liang, sliced) Guizhi (Cinnamon Twig) (three liang, bark removed) Maidong (Ophiopogon Tuber) (half jin, heart removed) Huomaren (Hemp Seed) (half jin) Renshen (Ginseng Root) (two liang) Ejiao (Donkey-hide Gelatin) (two liang) Dazao (Jujube Fruit) (twelve pieces, split) Shengdihuang (Rehmannia Root) (one jin)
These nine ingredients. Use seven sheng of clear wine and eight sheng of water. First decoct the first eight ingredients to obtain three sheng. Remove the dregs. Add Ejiao and melt it completely. Take one sheng warm at a time, three times a day. Also known as Fumai Tang (Pulse-Recovering Decoction).
In shaoyang disease, if the pulse is knotted or intermittent (Jie Dai Mai) and there is palpitations (Xin Dong Ji), Zhigancao Tang (Honey-Fried Licorice Decoction) should be used. Considering the knotted/intermittent pulse and palpitations, this palpitations is not caused by the binding of fluid retention (Shui Yin), but rather by deficiency and weakness of the Middle Qi. The classic text uses "binding of Yin and substitution of Yin" to reveal the etiology, indicating exhaustion of body fluids and failure of Yin Qi to interact with Yang, which can be inferred. Gancao serves as the sovereign herb, anchoring the Middle Jiao (Spleen and Stomach). Ingredients such as Shengdi, Maidong, Huomaren, Dazao, Renshen, and Ejiao are all sweet-cold herbs aimed at nourishing Yin and restoring fluids. However, without Yang, Yin cannot transform into Qi. Therefore, Guizhi and Shengjiang are added to disseminate Yang and transform Yin. Furthermore, clear wine is used to unblock the meridians and collaterals, thereby restoring the pulse and calming the palpitations.