叶石膏汤。王回顾不见。如是者三。遂买见成药两帖。付童使煎。即尽其半。先时头不能举。若戴物千斤。倏
尔轻清。唇亦渐暖。咽膈通畅。
无所碍。悉服之。少顷。汗出如洗。径就睡。及平旦脱然如常时。自正为人谨饬。常茹素。与人斋醮尽诚。故
为神所 如此。
病患脉已解。而日暮微烦。以病新瘥。人强与谷。脾胃气尚弱。不能消谷。故令微烦。损谷则愈。(病患。
玉函。作伤寒。)
〔喻〕脉已解者。阴阳和适。其无表里之邪可知也。日暮微烦者。日中卫气行阳。其不烦可知也。乃因脾
胃气弱。不能消谷所致。损谷则脾胃渐趋于旺。而自愈矣。注家牵扯日暮为阳明之王时。故以损谷为当小下。
(成注)不知此论瘥后之证。非论六经转阳明之证也。(方注)日暮。即内经日西而阳气已衰之意。所以不能
消谷也。损谷。当是减损谷食。以休养脾胃。不可引前条宿食例。轻用大黄。重伤脾胃也。〔魏〕损其谷数。
每食一升者。食七合。食五合者。食三合。俟胃脾渐壮。谷渐增益。亦节饮食防病复之一道也。
玉函经。病后劳复。发热者。麦门冬汤主之。方与金匮要略咳嗽篇所载同。○此条今本遗脱。当是仲景旧文。
服用竹叶石膏汤。王回头张望,却看不见人影。像这样的情况发生了三次。于是购买了现成的成药两帖,交给童仆煎煮。童仆立刻喝掉了其中一半。在此之前,患者头部沉重无法抬起,感觉像是头顶着千斤重物。忽然间感到身体轻清,嘴唇也逐渐回暖,咽喉和胸膈通畅,没有任何阻碍。全部服下后,过了一会儿,汗出如洗,随即入睡。等到天亮时,病体痊愈,恢复如常。此人原本为人谨慎庄重,常年吃素,与人举行斋醮仪式时竭尽诚心,因此被神灵如此护佑。
病患的脉象已经平和,但在傍晚时分出现轻微烦闷。这是因为病刚痊愈,人们强行给病人进食,而脾胃之气尚且虚弱,不能消化食物,所以导致轻微烦闷。减少饮食量就会痊愈。(“病患”二字,《玉函经》作“伤寒”。)
〔喻嘉言〕脉象已经平和,说明阴阳调和,可知没有表里之邪。傍晚时分轻微烦闷,是因为白天卫气行于阳分,此时本不应烦闷。这是由于脾胃气弱,不能消化食物所致。减少饮食,脾胃之气逐渐旺盛,疾病就会自愈。注家们牵强地将日暮解释为阳明经主旺之时,因此认为应当用小承气汤攻下。(成无己注)不知道此条论述的是病愈后的证候,而非六经传变至阳明的证候。(方有执注)日暮,即《内经》所说“太阳西而阳气已衰”的意思,所以不能消化食物。损谷,应当是减少谷物食物的摄入,以休养脾胃,不可引用前一条宿食的例子,轻易使用大黄,从而重伤脾胃。〔魏荔彤〕减少谷物的数量,每餐吃一升的,改为吃七合;吃五合的,改为吃三合。等待胃脾逐渐强壮,再逐渐增加食量,这也是节制饮食以防疾病复发的方法之一。
《玉函经》记载:病后劳复,出现发热的,用麦门冬汤主治。该方与《金匮要略·咳嗽篇》所载相同。○此条在现今版本中遗漏脱失,应当是张仲景的原文。
Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) was administered. Wang looked back but could not see anyone. This occurred three times. Consequently, two doses of ready-made patent medicine were purchased and given to a boy servant for decoction. The servant immediately consumed half of it. Previously, the patient's head was too heavy to lift, feeling as if bearing a thousand jin of weight. Suddenly, the body felt light and clear, the lips gradually warmed, and the throat and diaphragm became unobstructed. After consuming the remainder, shortly thereafter, profuse sweating occurred like a bath, followed by immediate sleep. By dawn, the patient recovered completely, returning to normal. This person was originally cautious and dignified, had been vegetarian for years, and performed zhaijiao (fasting rituals) with utmost sincerity, thus receiving such divine protection.
The patient's pulse had resolved, yet slight restlessness appeared at dusk. This is because the illness had just healed, people forced food upon the patient, and the Qi of the Spleen and Stomach was still weak, unable to digest the food, hence causing slight restlessness. Reducing food intake will lead to recovery. ("Patient" in some texts is written as "Shanghan".)
[Yu Jiayan] The resolution of the pulse indicates that Yin and Yang are harmonious, implying the absence of exterior or interior pathogenic factors. The slight restlessness at dusk occurs because Wei Qi (Defensive Qi) travels through the Yang channels during the day; thus, restlessness should not occur then. It is caused by weak Spleen and Stomach Qi failing to digest food. Reducing food intake allows Spleen and Stomach Qi to gradually strengthen, leading to spontaneous recovery. Commentators erroneously link dusk to the peak time of the Yangming channel, suggesting the use of Xiao Chengqi Tang (Minor Order the Commandant Decoction) for purging. [Cheng Wuji] Fails to realize this discusses post-illness conditions, not the transmission of Six Channels to Yangming. [Fang Youzhi] Dusk refers to the concept in Neijing that "when the sun sets, Yang Qi declines," hence the inability to digest food. "Reducing grain" means decreasing dietary intake to nourish and rest the Spleen and Stomach. One should not cite the previous case of retained food to lightly employ Rhizoma Rhei Preparata (Dahuang), which would severely damage the Spleen and Stomach. [Wei Litong] Reduce the quantity of grain: if one sheng per meal, reduce to seven he; if five he, reduce to three he. Wait for the Stomach and Spleen to gradually strengthen before incrementally increasing food intake. This is also a method of regulating diet to prevent disease recurrence.
Yuhan Jing records: For labor relapse after illness with fever, Mai Men Dong Tang (Ophiopogon Decoction) is the primary treatment. This formula is identical to that recorded in the Cough section of Jin Gui Yao Lue. ○ This paragraph is missing in current editions but is likely original text by Zhang Zhongjing.