黄连(四两) 黄芩(一两) 芍药(二两) 鸡子黄(二枚) 阿胶(三两)
上五味以水五升。先煮三物。取二升。去滓。纳胶烊尽。小冷纳鸡子黄搅令相得。温服七合。日三服。
此汤本治少阴温热之证以其阴邪炎威伤犯真阴。故二三日以上便见心烦不得卧。所以始病之际。即用芩连□□□药
兼芍药阿胶鸡子黄。以滋养阴血也。然□□□七日后。热传少阴。伤其阴血者。亦可取用与□□□实用承气汤法。虽虚
实补泻悬殊。而祛热滋阴之意则一耳。
白头翁□□黄连 黄柏 秦皮(各二两)
上四味。以水□□□取二升。去滓。温服一升。不愈更服。
厥阴热利下□□□欲饮水者。阴虚生热也。故宜苦寒之剂治之□□作阳虚而用温剂也。所以用白头翁以升。水气之
下。陷秦皮以坚肝肾之滑脱。连柏以泄肠胃之湿热较少阴证便脓血桃花煎之用干姜。迥乎角立也。盖少阴之水气下奔。
虽为热邪。故可用从治之法。厥阴之风气。摧拔。木火 。内动是以不可复用辛温。鼓激其势也。
牡蛎(熬) 泽泻 栝蒌根 蜀漆(洗去腥) 葶苈(熬) 海藻(洗去咸) 商陆根(熬各等)
上七味。异捣下筛为散更入臼中治之。白饮和服方寸匕。小便利。止后服日三。
黄连(四两) 黄芩(一两) 芍药(二两) 鸡子黄(二枚) 阿胶(三两)
以上五味药,用水五升。先煎煮前三味药。取汁二升,滤去药渣。加入阿胶烊化至完全溶解。待药液稍凉后,加入鸡子黄,搅拌均匀。每次温服七合,每日服用三次。
此汤原本用于治疗少阴温热病证,因为阴邪炽盛损伤了真阴。所以发病两三天以上就会出现心烦、无法入睡的症状。因此在疾病初始阶段,就使用黄芩、黄连等清热泻火药物,兼用芍药、阿胶、鸡子黄来滋养阴血。然而如果病程超过七日,热邪传入少阴,损伤了阴血的人,也可以采用此方,这与实际应用承气汤的方法类似。虽然虚实补泻的差异很大,但清热滋阴的意图是一致的。
白头翁 黄连 黄柏 秦皮(各二两)
以上四味药,用水适量煎煮,取汁二升,滤去药渣。温服一升。如果未痊愈,继续服用。
厥阴热利下利脓血,想要喝水的,是阴虚生热的表现。所以适宜用苦寒的药物来治疗,不要误认为是阳虚而使用温补药物。因此使用白头翁以升提下陷的水气,秦皮以固涩肝肾的滑脱,黄连、黄柏以清泄肠胃的湿热。这与少阴证便脓血时桃花汤中使用干姜的做法截然不同。大概少阴的水气下奔,虽然是热邪所致,所以可以使用从治(顺其势而治)的方法;厥阴的风气摧拔,木火内动,因此不可再复用辛温药物,以免鼓动激惹病势。
牡蛎(煅) 泽泻 栝蒌根 蜀漆(洗去腥味) 葶苈(煅) 海藻(洗去咸味) 商陆根(煅,各等量)
以上七味药,分别捣碎过筛成散剂,再放入臼中进一步研磨均匀。用米汤调和,每次服用一方寸匕。如果小便通利,则停止后续服药,每日服用三次。
Huanglian (Coptidis Rhizoma, 4 liang), Huangqin (Scutellariae Radix, 1 liang), Shaoyao (Paeoniae Radix, 2 liang), JiZihuang (Ovi Albumen, 2 pieces), Ejiao (Colla Corii Asini, 3 liang).
Take the above five ingredients with five sheng of water. First decoct the first three ingredients to obtain two sheng of liquid. Strain out the dregs. Add Ejiao and melt it completely. When the liquid has cooled slightly, add JiZihuang and stir until well mixed. Take seven he of the warm decoction orally, three times a day.
This decoction is originally used to treat Shaoyin warm-heat syndromes (diseases caused by warm-heat pathogens affecting the Shaoyin channel), because yin pathogens with fierce inflammation damage the true yin. Therefore, after two or three days of onset, symptoms such as mental restlessness (xin fan) and insomnia (bu de wo) appear. Thus, at the initial stage of the disease, Huangqin and Huanglian are used to clear heat and purge fire, combined with Shaoyao, Ejiao, and JiZihuang to nourish yin and blood. However, if the illness persists for more than seven days and the heat transmits to Shaoyin, damaging yin and blood, this formula can also be adopted. This is similar to the practical application of Chengqi Tang (Gastrointestinal Draining Decoction). Although there is a significant difference between deficiency/excess and tonification/draining, the intention of clearing heat and nourishing yin remains the same.
Baitouweng (Pulsatillae Radix), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), Qinpi (Fraxini Cortex, each 2 liang).
Take the above four ingredients with an appropriate amount of water, decoct to obtain two sheng of liquid. Strain out the dregs. Take one sheng of the warm decoction orally. If not cured, take another dose.
Jueyin hot dysentery (re li) with purulent and bloody stool, accompanied by thirst (yu yin shui), indicates heat generated from yin deficiency. Therefore, bitter-cold agents should be used for treatment, rather than mistakenly treating it as yang deficiency and using warming agents. Thus, Baitouweng is used to lift the sinking qi of water, Qinpi is used to astringe the slipping and loss of control in the liver and kidney, while Huanglian and Huangbai are used to drain damp-heat from the intestines and stomach. This stands in stark contrast to the use of Ganjiang (Zingiberis Rhizoma) in Taohua Jian (Peach Blossom Decoction) for Shaoyin syndrome with purulent and bloody stool. Generally, although the downward rush of water qi in Shaoyin is caused by heat pathogens, the method of following the pathogen's trend (cong zhi) can be applied. In Jueyin, wind qi causes destruction and uprooting, with wood-fire moving internally; therefore, acrid-warm agents cannot be reused, as they would agitate and exacerbate the condition.
Muli (Ostreae Concha, calcined), Zexie (Alismatis Rhizoma), Gualougen (Trichosanthis Radix), Shuqi (Perillae Herba, washed to remove fishy odor), Tingli (Semen Lepidii et Descurainiae, calcined), Haizao (Sargassum, washed to remove saltiness), Shanglugen (Phytolaccae Radix, calcined, equal parts).
The above seven ingredients are separately crushed, sifted into powder, and then further ground together in a mortar. Mix with white rice drink (bai yin) and administer one fangcun bi per dose. Stop subsequent doses when urination becomes smooth. Take three times a day.