桂枝 芍药 生姜 甘草 大枣
烧针令汗。针处被寒。核起而赤。必发奔豚气。从少腹上冲心。宜此汤。 奔豚者。如
豕突
药。同桂枝汤用之。则针处被寒之邪。莫不毕散矣。
桂枝 甘草 牡蛎 龙骨
火逆下之。因烧针烦躁。此汤主之。辛甘发散。桂枝甘草之辛甘。以发散经中之火邪。
涩可固脱。龙骨牡蛎之咸涩。以收敛正气之浮越。
水蛭 虻虫 大黄 桃仁
太阳病。身黄。脉沉结。小腹硬。小便不利。为无血。小便自利。其人如狂。血症谛也
。气不行者
去血必以咸。是以水蛭咸寒为君。经曰。苦走血。散血必以苦。是以虻虫苦寒为臣。血结则
干燥。以桃仁之润滑为佐。血结则凝泣。以大黄之荡涤为使。
水蛭 虻虫 大黄 桃仁
伤寒有热。少腹满。应小便不利。今反利。为有血也。当下之。不可余药。宜抵当丸。
少腹满而小便利。为下焦蓄血。若蓄热者。津液不行。则小便不利。今小便利。知为蓄血。蓄血
坚结。非轻缓之剂可疗。必峻猛之剂。方对症耳。以丸较汤。仅得三分之一。为稍缓也。
大黄 葶苈子 芒硝 杏仁 甘遂 白蜜
病发于阳。而反下之。热入。因作结胸。项强如柔痉状。下之则和。宜进此汤。 病发
于阳之表。未传于阴之里。但当汗解。今早下之。热气乘虚。陷入于里。邪热凝聚。结于胸中。
项强如柔痉者。邪气甚也。大黄芒硝之苦咸。善于散结。葶苈杏仁之苦甘。长于泄满。甘遂
取其直达。白蜜取其润利。皆为散结之品。而葶苈尤专主胸中也。
通过烧针法促使发汗。针刺部位受寒邪侵袭,出现红肿硬结(核起而赤)。必然引发奔豚气(一种自觉有气从少腹上冲心胸的病证),感觉气从少腹向上冲击心脏。适宜使用此汤剂。所谓“奔豚”,形容其发作时如猪奔跑般急促猛烈。将这些药材与桂枝汤配合使用,则针刺部位受寒的邪气,没有不完全消散的。
因火疗导致逆证,又误用攻下法,加之再次使用烧针,导致患者烦躁不安。此证主治以本方。辛甘发散:桂枝和甘草的辛甘之性,用以发散经络中的火邪。涩可固脱:龙骨和牡蛎的咸涩之性,用以收敛正气之浮越。
太阳病,身体发黄,脉象沉而结代,小腹坚硬,小便不通利,这是无瘀血的表现;若小便自利,其人神志如狂,则是瘀血的确证。气机不行者,去血必依赖咸味药物。因此,以咸寒的水蛭为君药。经云:“苦走血”,散血必须用苦味药,因此以苦寒的虻虫为臣药。血结则干燥,以桃仁的润滑为佐药。血结则凝滞不畅,以大黄的荡涤作用为使药。
伤寒发热,少腹胀满,应当小便不利,现在反而通利,说明是有瘀血。应当攻下,不可残留药渣,适宜服用抵当丸。少腹胀满而小便通利,是下焦蓄血。若是蓄热,津液运行不畅,则小便不利。现在小便通利,可知是蓄血。蓄血坚结,非轻缓之剂所能治疗,必须用峻猛之剂,才能对症。以丸剂相比汤剂,剂量仅得三分之一,是为了使药力稍缓。
病发于阳证,却反用攻下法,导致热邪内入,因而形成结胸证。颈项强直,类似柔痉的状态。攻下后则和解,适宜进服此方。病发于阳表,未传入阴里,本应发汗解表。现在过早攻下,热气乘虚陷入体内,邪热凝聚,结于胸中。颈项强直类似柔痉,是因为邪气盛重。大黄、芒硝的苦咸之性,善于消散结聚。葶苈子、杏仁的苦甘之性,长于泄除胀满。甘遂取其直达病所,白蜜取其润利。这些均为消散结聚的药物,其中葶苈子尤其专主胸中病症。
Cinnamon Twig, Peony Root, Fresh Ginger, Licorice, Jujube
Sweating was induced by burning needles. The needle site was invaded by cold pathogen, resulting in nodular redness (red, raised knots). Biuntun Qi (a syndrome characterized by the sensation of gas rushing from the lower abdomen to the heart) must occur, with a sensation of qi rushing from the lower abdomen up to strike the heart. This decoction is indicated. "Biuntun" describes the attack as rapid and violent, like a pig charging. When these herbs are used in conjunction with Guizhi Tang (Cinnamon Twig Decoction), the cold pathogen at the needle site will be completely dispersed.
Cinnamon Twig, Licorice, Oyster Shell, Dragon Bone
Due to fire therapy causing adverse reactions, followed by mistaken purgation, and subsequent use of burning needles, the patient experiences irritability and restlessness. This formula is the primary treatment. Pungent and sweet disperse: The pungent and sweet properties of Cinnamon Twig and Licorice are used to disperse fire pathogens within the meridians. Astringent secures leakage: The salty and astringent properties of Dragon Bone and Oyster Shell are used to consolidate and anchor floating Zheng Qi (healthy energy).
Leech, Horsefly, Rhubarb, Peach Kernel
Taiyang disease (disease of the Taiyang/Bladder channel), yellowing of the body, pulse that is deep and knotted, hardness of the lower abdomen, and dysuria indicate absence of blood stasis. If urination is spontaneous and free, and the person exhibits mental agitation resembling mania, this is a definitive sign of blood stasis. When Qi mechanism fails, removing blood requires salty substances. Therefore, Leech (Shuizhi, 水蛭), which is salty and cold, serves as the sovereign drug. The Classics state: "Bitter enters the blood," so dispersing blood requires bitter substances. Thus, Horsefly (Mengchong, 虻虫), which is bitter and cold, serves as the minister drug. Blood stasis leads to dryness; therefore, the lubricating nature of Peach Kernel (Taoren, 桃仁) serves as the assistant. Blood stasis leads to coagulation and stagnation; thus, the scouring action of Rhubarb (Dahuang, 大黄) serves as the envoy.
Leech, Horsefly, Rhubarb, Peach Kernel
In Shanghan (Cold Damage) with fever and fullness of the lower abdomen, one should expect dysuria. However, urination is now free, indicating the presence of blood stasis. It must be purged. One should not leave any residue of the medicine; Diding Wan (Diding Pill) is appropriate. Fullness of the lower abdomen with free urination indicates Xijiao Xuxue (Lower Jiao Blood Accumulation). If it were heat accumulation, Jin Ye (body fluids) would not circulate, leading to dysuria. Since urination is free, we know it is blood accumulation. Blood accumulation is firm and knotted; mild and slow-acting formulas cannot treat it. Only fierce and potent formulas can match the pathology. Compared to a decoction, the pill dosage is only one-third, making the action slightly slower.
Rhubarb, Lepidium Seed, Mirabilite, Apricot Seed, Kansui, White Honey
The disease originated in Yang patterns, but purgation was mistakenly applied, allowing heat to enter internally, thereby forming Jiexiong (Knotting Chest syndrome). The neck and back are stiff, resembling Rouji (Soft Spasm). Purging brings harmony; this formula is appropriate. The disease began on the exterior of Yang patterns and had not yet transmitted to the interior of Yin patterns. Sweating should have been used for resolution. Premature purgation allowed heat qi to sink into the interior due to deficiency. Evil heat condensed and knotted in the chest. Neck stiffness resembling soft spasm indicates severe evil qi. The bitter and salty nature of Rhubarb and Mirabilite excels at dissipating knots. The bitter and sweet nature of Lepidium Seed and Apricot Seed excels at draining fullness. Kansui (Gansui, 甘遂) is chosen for its ability to reach the target directly; White Honey is chosen for its moistening and lubricating properties. All are agents that dissipate knots, among which Lepidium Seed specifically governs chest conditions.