治内伤冷物。外感风邪。有汗者方。
白术(三两) 防风(二两) 甘草(一两炙)
上 咀。每服秤三钱。水一盏。生姜三片。同煎至七分。去滓。温服无时。一日止一二服。待二三日。渐渐汗少为
解。
娄全善云。海藏用神术汤。白术汤。发散外寒。此皆和解之意。不使真气散失。犹之丹溪治伤寒表证。用东垣补中
益气汤。其意实相同也。愚以前洁古所制黄 汤。川芎汤。亦同此意。
琥按此方。海藏用以代桂枝汤。前方即用以代麻黄汤者也。仲景桂枝麻黄汤。惟冬月宜用。是二方者。则四时皆
可用之。何也。夫四时分属五行。寒热温凉。各一其气。惟土气化湿。寄王于四时之季。故凡时气之伤人。必兼湿气而
至。所以春病多温湿。夏病多热湿。秋病多凉湿。冬病多寒湿。观上二汤。皆以术为主。专入阳明太阴二经以治湿。又
海藏复制苍白术汤。以治伤寒。而云。上解三阳。下安太阴。即此义也。夫四时之气。从外而来者。即八方之风也。风
从外来。故二方中皆佐以防风。用甘草生姜者。乃辛甘发散之义。至于邪气入于诸经。各随经络。合以岁时。照上方加
减例而用药。斯其效自如神耳。
丹溪治第四女。冒风冷。发热医案中有麻黄人参汤。
(娄氏纲目亦集此方)
麻黄 人参(各五分) 苍术(一钱) 甘草(少许)
上 咀。水煎热服。
琥按上方。即仲景麻黄汤变其制也。与前韩祗和六物麻黄汤。其意相仿。大抵体虚人。病风寒无汗者宜服之。有汗
者禁服。
戴院使治伤寒。初得病时。头疼体痛属太阳经。证治要诀有和解散。
治疗因内伤生冷食物,外感风邪所致之证。若有汗出者适用此方。
以上药材切碎。每次称取三钱,加水一盏,生姜三片,共同煎煮至剩余七分药液,滤去药渣。不拘时候温服。一日最多服用一两次。等待两三天后,若汗出逐渐减少,即为病愈。
娄全善说:海藏先生使用神术汤、白术汤来发散外寒,这些方剂都体现了和解之意,旨在防止人体真气散失。这正如丹溪先生治疗伤寒表证时,使用东垣先生的补中益气汤,其用意实际上是相同的。我(作者)认为以前洁古先生所制的黄芪汤、川芎汤,也蕴含同样的意思。
王琥按语:此方,海藏先生用来替代桂枝汤;前一方则用来替代麻黄汤。张仲景的桂枝汤和麻黄汤,适宜在冬季使用;而这两个方剂,四季皆可应用。为什么呢?因为四季分别归属于五行,寒、热、温、凉各自具有不同的气性,只有土气化生湿气,寄旺于四季末月(每季最后十八天)。所以凡是时令邪气伤人,必定兼夹湿气而至。因此春季多患温湿病,夏季多患热湿病,秋季多患凉湿病,冬季多患寒湿病。观察上述两个方剂,都以白术为主药,专门进入阳明经和太阴经以治疗湿气。另外,海藏先生又创制了苍白术汤来治疗伤寒,并说:“上能解三阳之邪,下能安太阴之本”,正是这个道理。四时的气候,从外部侵入人体的,就是八方之风。风从外来,所以在两个方剂中都佐以防风。使用甘草和生姜,是遵循“辛甘发散”的道理。至于邪气传入各条经络,则根据经络走向,结合岁时变化,参照上方加减用药的范例来调整药物,这样疗效自然如神一般灵验。
朱丹溪治疗他的第四个女儿,因冒受风寒冷邪,出现发热症状。(医案中记载有麻黄人参汤)
(娄氏纲目也收录了这个方子)
以上药材切碎,加水煎煮,热服。
王琥按语:上述方剂,即张仲景麻黄汤改变其制法而成。与前代韩祗和的六物麻黄汤,用意相似。大体而言,体质虚弱之人,患风寒而无汗者适宜服用。有汗出者禁止服用。
Treats conditions caused by internal injury from cold foods and external contraction of wind pathogens. This formula is indicated for patients who have sweating.
Baizhu (Atractylodis Macrocephalae Rhizoma) (3 liang) Fangfeng (Saposhnikoviae Radix) (2 liang) Gancao (Glycyrrhizae Radix et Rhizoma, prepared with honey) (1 liang)
Crush the above herbs. For each dose, weigh 3 qian, add 1 zhen of water and 3 slices of fresh ginger. Decoct together until the volume reduces to 7/10. Strain the dregs. Take warm at any time. Administer no more than one or two doses per day. Wait for two or three days; when sweating gradually decreases, the disease is considered resolved.
Lou Quanshan stated: Haicang used Shenzhu Tang (Divine Efficacy Powder) and Baizhu Tang to disperse external cold. All these formulas embody the principle of harmonizing, preventing the dispersion of true qi. This is similar to Danxi's treatment of exterior syndromes in Shanghan (Cold Damage), where he used Dongyuan's Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); their intent is essentially the same. I believe that Huangqi Tang (Astragalus Decoction) and Chuanxiong Tang (Ligustici Chuanxiong Rhizoma Decoction) formulated previously by Jiegou also share this intent.
Wang Hu notes: This formula was used by Haicang as a substitute for Guizhi Tang (Cinnamon Twig Decoction). The previous formula serves as a substitute for Mahuang Tang (Ephedra Decoction). Zhang Zhongjing's Guizhi Tang and Mahuang Tang are suitable for use in winter. These two formulas, however, can be used throughout all four seasons. Why? Because the four seasons correspond to the Five Elements, and cold, heat, warmth, and coolness each possess distinct qi characteristics. Only the earth element generates dampness and its influence prevails during the last eighteen days of each season. Therefore, whenever seasonal pathogens injure the human body, they inevitably carry dampness. Thus, spring diseases often involve warm-dampness, summer diseases hot-dampness, autumn diseases cool-dampness, and winter diseases cold-dampness. Observing the aforementioned two formulas, both rely primarily on Baizhu (Atractylodis Macrocephalae Rhizoma), which specifically enters the Yangming and Taiyin meridians to treat dampness. Furthermore, Haicang created Caibaizhu Tang (White and Black Atractylodes Decoction) to treat Shanghan, stating it "releases the three yang layers externally and stabilizes the taiyin internally," which illustrates this principle. The qi of the four seasons, entering from outside, constitutes the winds from the eight directions. Since wind comes from the exterior, Fangfeng (Saposhnikoviae Radix) is added as an assistant herb in both formulas. The use of Gancao (Glycyrrhizae Radix et Rhizoma) and Shengjiang (Zingiberis Rhizoma Recens) follows the principle of "pungent and sweet induces dispersal." As for pathogens entering various meridians, medication should be adjusted according to the meridian pathways and seasonal changes, following the examples of addition and subtraction in the above formulas. In this way, efficacy will naturally be miraculous.
Danxi treated his fourth daughter, who contracted wind-cold and developed fever. (The medical record mentions Mahuang Renshen Tang).
(Lou's Gangmu also collected this formula.)
Mahuang (Ephedrae Herba) Renshen (Ginseng Radix) (each 5 fen) Cangzhu (Atractylodis Rhizoma) (1 qian) Gancao (Glycyrrhizae Radix et Rhizoma) (a small amount)
Crush the herbs, decoct with water, and take hot.
Wang Hu notes: The above formula is a modification of Zhang Zhongjing's Mahuang Tang (Ephedra Decoction). It shares similar intent with Han Zhihe's Liwu Mahuang Tang (Six-Ingredient Ephedra Decoction) mentioned earlier. Generally, it is suitable for individuals with deficient constitution suffering from wind-cold without sweating. It is contraindicated for those with sweating.
Dai Yuan Shi treated a patient with Shanghan (Cold Damage). At the onset of illness, headache and body pain indicated involvement of the Taiyang meridian. (Hejie San (Harmonizing Powder) is recorded in Zhengzhi Yaojue).