太阳与阳明合病不下利但呕者葛根加半夏汤主之
二阳合病经迫腑郁不能容纳水谷未化之食必当涌吐而上半夏降胃逆而止呕吐也
葛根(四两) 麻黄(三两炮去黄汗焙) 桂枝(二两) 芍药(二两) 甘草(二两) 生姜(三两) 大枣(十
二枚) 半夏(半升洗)
上八味以水一斗先煮葛根麻黄减二升去上沫内诸药煮取二升去滓温服一升覆取微似汗
阳明病自经传腑腑病宜下其经证未罢犹见恶寒则宜先汗而后下经证已解恶寒不作而潮热汗出全是腑证当相其缓急而
用下法也
太阳病三日发汗不解蒸蒸发热者属胃也调胃承气汤主之
太阳病二日阳明三日少阳此但传经络而不入脏腑发汗则解矣乃当三日少阳之期发汗不解而反蒸蒸发热者此不在经而
在胃也宜早以调胃承气调之免后此之用大承气此大承气之初证也
大黄(三两清酒浸去皮) 甘草(二两炙) 芒硝(半斤)
上三味 咀以水三升煮取一升去滓内芒硝更上火微煮令沸少少温服
二阳并病太阳证罢但发潮热手足 汗出大便难而谵语者下之则愈宜大承气汤
二阳并病太阳经证既罢但有阳明腑证潮热汗出大便难而谵语全是胃腑燥热闭塞不通下之泄其胃热则愈宜大承气汤也
潮热即日晡发热按时发作期如潮信也
大黄(四两) 芒硝(三两) 枳实(五枚炙) 浓朴(半斤炙去皮)
上四味以水一斗先煮枳朴取五升去滓内大黄煮取二升去滓内芒硝更上火微一两沸分温再服得下余勿服
太阳病与阳明病同时发病,没有腹泻但出现呕吐症状的,用葛根加半夏汤主治。
两阳经合病,邪气逼迫腑气郁结,导致无法容纳未消化的水谷食物,必然引起涌吐反应;此时应当使用半夏来降逆胃气以停止呕吐。
葛根(四两) 麻黄(三两,炮制去除黄汗后焙干) 桂枝(二两) 芍药(二两) 甘草(二两) 生姜(三两) 大枣(十二枚) 半夏(半升,洗净)
以上八味药,用水一斗,先煮葛根和麻黄,水量减少二升时,撇去上浮的泡沫,再加入其他药物,煎煮至取药液二升,滤去药渣,温服一升,服药后覆盖衣被使身体微微出汗。
阳明病由经络传入腑部,腑病适宜用下法治疗。如果其经络证候尚未解除,仍然见到恶寒症状,则应当先用发汗法,然后再用下法;如果经络证候已经解除,不再恶寒,而是出现潮热、汗出,完全是腑证的表现,应当根据病情的缓急而采用下法。
太阳病经过三天,发汗后病邪未解,出现蒸蒸发热的症状,这是病邪属于胃腑,用调胃承气汤主治。
太阳病第二天传阳明,第三天传少阳,这通常只是传变到经络而没有进入脏腑,发汗即可痊愈。然而到了第三天的少阳阶段,发汗后病邪未解反而出现蒸蒸发热,这说明病邪不在经络而在胃腑,应当尽早用调胃承气汤调理,以免日后需要使用大承气汤,这是大承气汤证的初期表现。
大黄(三两,用清酒浸泡并去皮) 甘草(二两,炙烤) 芒硝(半斤)
以上三味药,切碎,用水三升,煎煮至取药液一升,滤去药渣,加入芒硝,再放在火上微煮至沸腾,少量多次温服。
两阳经并病,太阳经证候已罢,只出现潮热、手足濈然汗出、大便困难且伴有谵语的症状,用下法治疗即可痊愈,适宜用大承气汤。
两阳经并病,太阳经证候既然已经解除,只剩下阳明腑证,表现为潮热、汗出、大便困难且谵语,这完全是胃腑燥热闭塞不通所致,用下法泄除胃热即可痊愈,适宜用大承气汤。
潮热是指日晡时分(下午3-5点)发热,按时发作,像潮水一样有定时。
大黄(四两) 芒硝(三两) 枳实(五枚,炙烤) 厚朴(半斤,炙烤去皮)
以上四味药,用水一斗,先煮枳实和厚朴,取药液五升,滤去药渣,加入大黄,煎煮至取药液二升,滤去药渣,加入芒硝,再放在火上微煮一两沸,分两次温服,如果已经通便,剩下的药液不要服用。
Taiyang and Yangming diseases occur simultaneously. In cases without diarrhea but with vomiting, Gegen Jia Banxia Tang (Kudzu and Pinellia Decoction) is the primary treatment.
When Taiyang and Yangming diseases combine, pathogenic factors press upon the fu organs causing stagnation, preventing the retention of undigested food and fluids. This inevitably leads to projectile vomiting; therefore, Banxia (Pinelliae Rhizoma) should be used to descend rebellious stomach qi and stop vomiting.
Gegen (Puerariae Lobatae Radix, 4 liang) Mahuang (Ephedrae Herba, 3 liang, processed to remove yellow sweat and dried) Guizhi (Cinnamomi Ramulus, 2 liang) Shaoyao (Paeoniae Radix Alba, 2 liang) Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang, roasted) Shengjiang (Zingiberis Rhizoma Recens, 3 liang) Dazao (Jujubae Fructus, 12 pieces) Banxia (Pinelliae Rhizoma, half sheng, washed)
Take the above eight ingredients. Add one dou of water, first decoct Gegen and Mahuang until the volume reduces by two sheng. Remove the scum floating on the surface. Then add the remaining herbs and decoct until two sheng of liquid remain. Strain the dregs. Take one sheng warm. After taking the medicine, cover with blankets to induce a slight sweating.
In Yangming disease, if the pathogen transmits from the meridians to the fu organs, fu organ diseases are suitable for purgation. If the meridian syndrome has not yet resolved and chills are still present, sweating should be induced first, followed by purgation. If the meridian syndrome has resolved, chills cease, and tidal fever and sweating appear, indicating a pure fu organ syndrome, purgation should be applied according to the urgency of the condition.
If after three days of Taiyang disease, sweating fails to resolve the condition and steaming-hot fever occurs, the pathogen belongs to the Stomach. Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction) is indicated.
Taiyang disease transmits to Yangming on the second day and to Shaoyang on the third day. Usually, transmission is limited to the meridians without entering the zang-fu organs, and sweating resolves it. However, if on the third day (Shaoyang period), sweating fails to resolve the condition and steaming-hot fever appears instead, the pathogen is no longer in the meridians but in the Stomach. Early intervention with Tiaowei Chengqi Tang is appropriate to prevent the later need for Dachengqi Tang. This represents the initial stage of Dachengqi Tang syndrome.
Dahuang (Rhei Radix et Rhizoma, 3 liang, soaked in clear wine and peeled) Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang, roasted) Mangxiao (Natrii Sulfas, half jin)
Take the above three ingredients. Cut into small pieces. Add three sheng of water and decoct to obtain one sheng of liquid. Strain the dregs. Add Mangxiao. Heat slightly until boiling. Administer warm in small amounts frequently.
In combined Taiyang and Yangming diseases, if the Taiyang meridian syndrome has ceased, presenting only with tidal fever, continuous sweating of the hands and feet, difficulty in defecation, and delirious speech, purgation will cure it. Dachengqi Tang (Major Order the Qi Decoction) is indicated.
In combined Taiyang and Yangming diseases, once the Taiyang meridian syndrome has resolved, only Yangming fu organ symptoms remain: tidal fever, sweating, difficulty in defecation, and delirious speech. These indicate complete blockage due to dryness-heat in the Stomach fu. Purgation to drain stomach heat will cure it. Dachengqi Tang is indicated.
Tidal fever refers to fever occurring at dusk (Shen hour, 3-5 PM), appearing on schedule like the tide.
Dahuang (Rhei Radix et Rhizoma, 4 liang) Mangxiao (Natrii Sulfas, 3 liang) Zhishi (Aurantii Fructus Immaturus, 5 pieces, roasted) Houpo (Magnoliae Officinalis Cortex, half jin, roasted and peeled)
Take the above four ingredients. Add one dou of water. First decoct Zhishi and Houpo until five sheng of liquid remain. Strain the dregs. Add Dahuang and decoct until two sheng of liquid remain. Strain the dregs. Add Mangxiao. Heat slightly until boiling (one or two boils). Divide into two warm doses. If defecation occurs, do not take the remainder.