太阳与阳明合病喘而胸满者不可下麻黄汤主之
太阳与阳明合病经迫腑郁胃逆肺胀故喘而胸满宜麻黄汤麻黄发表而散汗杏仁降逆而止喘不可下也
太阳病项背强KT KT 反汗出恶风者桂枝加葛根汤主之
阳明经行身之前自头下膈而走足太阳经行身之后自头下项循背而走足太阳经病头痛项强而已不至KT KT 缘太阳
表病不解郁遏阳明经腑之气不得顺降逆冲胸膈背者胸之腑也胸膈胀满则项背壅阻愈格太阳下行之路故KT KT 不柔葛
根泄阳明之经气降逆而达郁也
桂枝(三两) 芍药(二两) 甘草(二两炙) 大枣(十二枚) 生姜(三两切) 葛根(四两)
上六味以水一斗先煮葛根减二升去上沫内诸药煮取三升去滓温服一升覆取微似汗不须啜粥
太阳病项背强KT KT 无汗恶风者葛根汤主之
营为寒伤闭束二阳卫气葛根汤葛根泄阳明之卫麻黄泄太阳之卫桂枝芍药通经络而清营血姜甘大枣和中气而补脾精也
葛根(四两) 麻黄(二两) 桂枝(二两) 芍药(二两) 甘草(二两) 生姜(三两) 大枣(十二枚)
上七味 咀以水一斗先煮麻黄葛根减二升去上沫内诸药煮取三升去滓温服一升覆取微似汗不须啜粥余如桂枝法将息
及禁忌
太阳与阳明合病者必自下利葛根汤主之
太阳表寒外束经络壅迫郁遏阳明胃气不能容纳水谷已化之食必当注泄而下葛根麻黄泄二阳之卫郁以松里气也
太阳病与阳明病同时发病,出现气喘且胸部胀满的症状,此时不可使用攻下法,应当用麻黄汤来主治。
这是因为太阳与阳明两经合病时,外邪逼迫体内,导致腑气郁滞、胃气上逆、肺气胀满,从而引发气喘和胸部胀满,适宜使用麻黄汤。其中,麻黄能发散表邪并促使出汗,杏仁能降逆气并停止气喘,因此不可使用攻下法。
太阳病表现为项背部僵硬拘急不适(KT KT 指项背强直不柔和),反而伴有汗出、恶风症状的,应当用桂枝加葛根汤来主治。
阳明经循行于身体前面,从头向下经过膈部走向足部;太阳经循行于身体后面,从头向下经过颈部沿着背部走向足部。太阳经患病通常只表现为头痛和项部僵硬,而不会发展到项背强直不柔和的程度。之所以出现这种情况,是因为太阳表证未解,郁遏了阳明经和腑的气机,使其不能顺降,反而逆冲于胸膈和背部(胸是腑所在之处)。当胸膈胀满时,会导致项背部壅塞阻滞,更加阻碍太阳经气下行,所以项背强直不柔和。葛根能疏泄阳明经的气机,降逆气并通达郁滞之气。
【方剂组成】桂枝(三两)、芍药(二两)、甘草(炙,二两)、大枣(十二枚)、生姜(切,三两)、葛根(四两)。
以上六味药,用水一斗,先煮葛根,水量减少二升后,撇去浮沫,再加入其他药物,煎煮至取药液三升,滤去药渣,温服一升。服药后覆盖衣被使身体微微似有汗出即可,不需要喝热粥助汗。
太阳病表现为项背部僵硬拘急不适(KT KT),无汗、恶风的,应当用葛根汤来主治。
营血被寒邪所伤,闭束了阳明和太阳两经的卫气。葛根汤中,葛根疏泄阳明的卫气,麻黄疏泄太阳的卫气,桂枝和芍药疏通经络并清利营血,生姜、甘草和大枣调和中气并补益脾精。
【方剂组成】葛根(四两)、麻黄(二两)、桂枝(二两)、芍药(二两)、甘草(二两)、生姜(三两)、大枣(十二枚)。
以上七味药,切碎,用水一斗,先煮麻黄和葛根,水量减少二升后,撇去浮沫,再加入其他药物,煎煮至取药液三升,滤去药渣,温服一升。服药后覆盖衣被使身体微微似有汗出即可,不需要喝热粥。其余调养方法及禁忌同桂枝汤法。
太阳病与阳明病同时发病的人,必定会出现自发性腹泻,应当用葛根汤来主治。
太阳表的寒邪在外部束缚经络,内部壅迫郁遏,导致阳明胃气无法容纳已经消化的水谷食物,必然会导致食物向下注泄而出。葛根和麻黄能疏泄太阳和阳明两经的卫气郁滞,从而松弛内部的氣机。
Taiyang and Yangming diseases occurring simultaneously, with wheezing and chest fullness, are not suitable for purgation; Mahuang Tang (Ephedra Decoction) is the primary treatment.
When Taiyang and Yangming diseases occur simultaneously, external pathogens force inward, causing stagnation in the fu organs, rebellion of Stomach Qi, and distension of the Lung, resulting in wheezing and chest fullness. Mahuang Tang is appropriate here. Mahuang (Ephedrae Herba) releases the exterior and induces sweating, while Xingren (Armeniacae Semen Amarum) directs rebellious Qi downward and stops wheezing. Therefore, purgation should not be used.
In Taiyang disease, if there is stiffness and tightness in the neck and back (gang jiang bu rou), accompanied by spontaneous sweating and aversion to wind, Guizhi Jia Gegen Tang (Cinnamon Twig Decoction with Pueraria Root) is the primary treatment.
The Yangming meridian runs along the anterior aspect of the body, descending from the head through the diaphragm to the feet. The Taiyang meridian runs along the posterior aspect, descending from the head through the nape and along the back to the feet. Taiyang meridian pathology typically presents with headache and neck stiffness, but does not usually extend to severe stiffness in the neck and back. This occurs because unresolved exterior Taiyang pathogen stagnates the Qi of the Yangming meridian and fu organs, preventing it from descending smoothly and instead causing it to rebel upward into the chest, diaphragm, and back (the chest is the residence of the fu organs). When the chest and diaphragm become full and distended, it causes obstruction in the neck and back, further blocking the downward flow of Taiyang Qi, leading to stiffness and lack of flexibility in the neck and back. Gegen (Puerariae Radix) drains the Qi of the Yangming meridian, directs rebellious Qi downward, and resolves stagnation.
[Formula Composition] Guizhi (Cinnamomi Ramulus, 3 liang), Shaoyao (Paeoniae Radix Alba, 2 liang), Gancao (Glycyrrhizae Radix et Rhizoma, prepared, 2 liang), Dazao (Ziziphi Jujubae Fructus, 12 pieces), Shengjiang (Zingiberis Rhizoma Recens, sliced, 3 liang), Gegen (Puerariae Radix, 4 liang).
Take the above six ingredients, add one dou of water, first decoct Gegen until the volume reduces by two sheng, remove the foam on the surface, then add the remaining herbs. Decoct until three sheng remain, strain, and take one sheng warm. Cover with blankets to induce a slight sweat; do not consume hot porridge to assist sweating.
In Taiyang disease, if there is stiffness and tightness in the neck and back (gang jiang bu rou), without sweating and with aversion to wind, Gegen Tang (Pueraria Decoction) is the primary treatment.
Nutritive Qi (Ying) is injured by cold, binding the Defensive Qi (Wei) of both Yangming and Taiyang. In Gegen Tang, Gegen drains the Defensive Qi of Yangming, Mahuang drains the Defensive Qi of Taiyang, Guizhi and Shaoyao unblock the collaterals and clear the Nutritive Blood, while Shengjiang, Gancao, and Dazao harmonize the Middle Jiao and tonify Spleen essence.
[Formula Composition] Gegen (Puerariae Radix, 4 liang), Mahuang (Ephedrae Herba, 2 liang), Guizhi (Cinnamomi Ramulus, 2 liang), Shaoyao (Paeoniae Radix Alba, 2 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang), Shengjiang (Zingiberis Rhizoma Recens, 3 liang), Dazao (Ziziphi Jujubae Fructus, 12 pieces).
Take the above seven ingredients, crush them, add one dou of water, first decoct Mahuang and Gegen until the volume reduces by two sheng, remove the foam on the surface, then add the remaining herbs. Decoct until three sheng remain, strain, and take one sheng warm. Cover with blankets to induce a slight sweat; do not consume hot porridge to assist sweating. Rest and dietary precautions follow those of Guizhi Tang.
When Taiyang and Yangming diseases occur simultaneously, spontaneous diarrhea will inevitably ensue; Gegen Tang (Pueraria Decoction) is the primary treatment.
Exterior cold from Taiyang binds the collaterals externally, forcing and stagnating internally, preventing the Stomach Qi of Yangming from accommodating digested food and fluids. Consequently, the contents must drain downward as diarrhea. Mahuang and Gegen drain the stagnant Defensive Qi of both Taiyang and Yangming meridians, thereby relaxing the internal Qi dynamics.