附子(一枚炮去皮破别煮取汁) 大黄(二两) 黄连(一两) 黄芩(一两)
上四味下三味以麻沸汤二升渍之须臾绞去滓内附子汁分温再服
太阳中风下利呕逆表解者乃可攻之其人 汗出发作有时头痛心下痞硬满引胁下痛干呕短气汗出不恶寒者此表解里
未和也十枣汤主之
太阳中风下利呕逆是有水湿在内于法可攻然必表邪外解乃可攻之其人内有水气格阳于外气蒸窍泄 汗出者而阴阳
胜复发作有时水饮阻格浊气不降头为之痛阴邪上填心下痞结硬满而引胁下疼痛胃气上逆而生干呕肺气上逆而苦短气使非
水饮郁格何以至此若其 汗出而不复恶寒者是表邪已解而里气未和也宜十枣汤大枣保其脾精芫遂大戟泄其水饮也
大枣(十枚) 芫花 甘遂 大戟
上三味等分各捣筛为散以水一升半先煮大枣肥者十枚取八合去滓内诸药末强人服一钱匕羸人服半钱平旦温服若下少
病不除者明日更服加半钱得快下利后糜粥自养
伤寒汗出解之后胃中不和心下痞硬干噫食臭胁下有水气腹中雷鸣下利者生姜泻心汤主之
伤寒汗出解后胃中不和心下痞硬水谷不消陈宿停留浊气冲胸而干呕食臭胆邪克土土虚不能制水水郁胆部而积于胁下
土败木贼阴气激宕腹中雷鸣而病下利者生姜泻心汤生姜半夏降其浊阴黄芩黄连清其心胆姜甘参枣温补中气以转枢轴也
附子(一枚,炮制后去皮、破开,单独煎煮取汁) 大黄(二两) 黄连(一两) 黄芩(一两)
以上四味药,其中三味(大黄、黄连、黄芩)用沸水二升浸泡片刻,绞去药渣,加入附子汁,分两次温服。
太阳中风证出现下利、呕吐逆气,待表证解除后,才可以攻逐里实。其人汗出,发作有定时,头痛,心下部痞塞硬满,牵引胁下疼痛,干呕,短气,汗出而不恶寒,这是表邪已解而里气未和,用十枣汤主治。
太阳中风证出现下利、呕吐逆气,是因为体内有水湿停滞。按照治法可以攻逐,但必须等表邪完全解除后才能攻逐。如果其人内有水气,格拒阳气于外,导致气蒸毛孔泄汗,且阴阳胜负交替,发作有定时;水饮阻滞,浊气不降,头部为之疼痛;阴邪上填,心下部痞结硬满并牵引胁下疼痛;胃气上逆则产生干呕;肺气上逆则苦于短气。如果不是水饮郁结阻滞,怎么会到了这种地步?如果其人汗出而不再恶寒,说明表邪已经解除,但里气尚未调和,适宜用十枣汤。大枣保护脾精,芫花、甘遂、大戟泄除水饮。
以上三味药,各等分,分别捣碎过筛成散剂。用水一升半,先煮肥大红枣十枚,取八合药液,去渣,加入上述药末。体质强壮的人服用一方寸匕,体弱的人服用半方寸匕,清晨温服。如果服药后泻下不多,病未去除,第二天再服,增加半方寸匕。若得快利(剧烈腹泻),之后喝米粥自行调养。
伤寒经发汗治疗后表证已解,但胃中不和,心下部痞塞硬满,频繁嗳气伴有食物腐臭味,胁下有水气停留,肠中雷鸣并伴下利者,用生姜泻心汤主治。
伤寒发汗解表后,胃中不和,心下部痞塞硬满,水谷不能消化,陈宿停滞,浊气冲胸导致干呕和食臭;胆邪克制脾土,脾土虚弱不能制约水湿,水湿郁积在胆部并聚于胁下;脾土败坏,肝木乘虚侵袭,阴气激荡,腹中雷鸣而病发下利。生姜泻心汤中,生姜、半夏降泄浊阴,黄芩、黄连清泄心胆之热,干姜、甘草、人参、大枣温补中气以运转枢机。
Fuzi (one piece, processed, skin removed, broken, decocted separately to obtain juice) Dahuang (two liang) Huanglian (one liang) Huangqin (one liang)
Take the above four herbs. Soak the latter three (Dahuang, Huanglian, Huangqin) in two sheng of boiling water for a moment, strain to remove the dregs, add the Fuzi juice, and take half warm each time, twice a day.
In Taiyang Wind-stroke syndrome with diarrhea and vomiting/retching, once the exterior syndrome is resolved, one may proceed to attack the interior. If the patient sweats, with headaches occurring at specific times, epigastric fullness and hardness radiating to the hypochondrium, dry retching, shortness of breath, sweating without aversion to cold, this indicates that the exterior pathogen has resolved but the interior qi is not harmonized. Shizao Tang (Ten Jujube Decoction) is the primary formula.
Taiyang Wind-stroke with diarrhea and vomiting/retching indicates the presence of internal water-dampness. According to the methods, it can be attacked, but only after the exterior pathogen has completely resolved externally. If there is internal water-qi repelling Yang Qi to the exterior, causing steaming pores and sweating, with alternating dominance of Yin and Yang resulting in periodic episodes; if water-drink obstruction prevents turbid Qi from descending, causing headache; if Yin pathogen fills upward, causing epigastric stuffiness, hardness, and pain radiating to the hypochondrium; if Stomach Qi rebels upward causing dry retching; if Lung Qi rebels upward causing distressing shortness of breath—unless obstructed by water-drink stagnation, how could it reach such a state? If the patient sweats and no longer has aversion to cold, it means the exterior pathogen has resolved, but the interior Qi is unharmonized. Shizao Tang (Ten Jujube Decoction) should be used. Dazao (Jujube) protects Spleen essence, while Yuanhua (Genkwa Flower), Gansui (Kansui Root), and Daji (Euphorbia Lathyris Root) drain the water-drink.
Dazao (ten pieces) Yuanhua Gansui Daji
The above three herbs are mixed in equal parts, each pounded and sifted into powder. Take one and a half sheng of water, first decoct ten large Dazao until reduced to eight ge, remove the dregs, and add the herb powders. Strong individuals take one cun-bi (a measure roughly equivalent to a teaspoonful); frail individuals take half a cun-bi. Take warm on an empty stomach in the morning. If the purgation is slight and the disease persists, administer again the next day, increasing by half a cun-bi. After achieving rapid purgation (profuse watery stool), nourish oneself with millet porridge.
After Taiyang disease is resolved via sweating, if the Stomach is disharmonious, presenting with epigastric stuffiness and hardness, frequent belching with a smell of food rot, water-qi accumulating under the hypochondrium, borborygmus in the abdomen, and diarrhea, Shengjiang Xiexin Tang (Fresh Ginger Decoction for Harmonizing the Heart) is the primary formula.
After Taiyang disease is resolved via sweating, if the Stomach is disharmonious, presenting with epigastric stuffiness and hardness, inability to digest water and grain, retention of old food residues, turbid Qi rushing to the chest causing dry retching and food-rotting belch; if Gallbladder pathogen overacts on Earth (Spleen), causing Spleen deficiency unable to control water, leading to water stagnation in the Gallbladder region and accumulation under the hypochondrium; if Earth fails and Wood (Liver) invades, causing agitation of Yin Qi, borborygmus in the abdomen, and diarrhea: In Shengjiang Xiexin Tang, Shengjiang (Fresh Ginger) and Banxia (Pinellia Tuber) descend turbid Yin; Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome) clear Heat from the Heart and Gallbladder; Ganjiang (Dried Ginger), Gancao (Licorice Root), Renshen (Ginseng Root), and Dazao (Jujube) warm and tonify Middle Qi to rotate the pivot mechanism.