(变法者。言其与仲景之法不同。方论中各有权变也。)
葛稚川云。伤寒有数种。庸人不能分别。今取一药兼疗者。若初觉头痛肉热。脉洪起。一二日便作此葱豉汤。
葱白(一虎口) 豉(一升绵裹)
上二味。以水三升。煮取一升。顿服。取汗。若汗不出。更作。加葛根三两一方。更加升麻三两。水五升。煮取二
升。分温再服。徐徐服亦得。必得汗即瘥。若不得汗更作。加麻黄三两。去节煮服。取汗出为效。
琥按上论云。伤寒有数种。则知其病。不但冬时触冒严寒之气。方谓之伤寒。推而广之。凡三时感寒。皆得谓之伤
寒也。又云。初觉头痛肉热。脉洪起。则知其外寒不甚。纯是郁热。可见伤寒皆热病也。上方虽出太阳例。实手足阳明。
又手太阴经药也。加麻黄。始为太阳发汗之的药。学人宜通变用之。若上汤者。可代仲景论。太阳中篇。葛根汤方也。
豉(三升绵裹) 盐(一两)
上二味。以水七升。煮取二升半。去滓。内蜜一升。又煮三沸。顿服一升。安卧。当吐。如不吐。更服一升。取吐
为效。
琥按上论云。汗出不歇。不歇者。邪未解也。言伤寒已三四日。曾发汗。汗出后。邪犹未解。胸中恶者。心胸懊
而烦闷也。上方即仲景栀子豉汤。稍变其制而用之。
苦参(三分) 甘草(炙一分) 瓜蒂 赤小豆(各二七枚)
上四味。以水一升。煮取半升。一服之。当吐。吐不止者。作葱豉粥解之。必息。
琥按上方。即仲景瓜蒂散。用加减法也。
孙真人治伤寒温病。千金方有解肌葛根汤。
(所谓变法,是指与张仲景的方法不同。方论中各有其权宜变通之处。)
葛稚川说:伤寒有几种类型,普通人不能分辨。现在选取一种药物兼治多种情况的方法。如果刚开始觉得头痛、肌肉发热、脉搏洪大且初起,在发病一两天内就制作此葱豉汤。
葱白(一把) 豆豉(一升,用绵布包裹)
以上两味药,用水三升,煮取一升,一次性服下。以出汗为效。如果汗不出,再重新制作。加葛根三两的方子,再加升麻三两,用水五升,煮取二升,分两次温服。慢慢服用也可以。一定要出汗才能痊愈。如果不出汗,再重新制作,加麻黄三两,去节后煮服,以出汗为有效。
琥按:上述论述说,伤寒有几种类型,那么就知道这种病,不仅仅是冬季感受严寒之气才称为伤寒。推而广之,凡是春、夏、秋三季感受寒邪,都可以称为伤寒。又说,刚开始觉得头痛、肌肉发热、脉搏洪大且初起,那么就知道外感寒邪不重,完全是郁热所致。可见伤寒都是热病。上面的方子虽然出自太阳病的范畴,实际上涉及手足阳明经和手太阴经的药物。加入麻黄,才是太阳病发汗的对症良药。学习的人应当灵活变通使用。如果是上面的汤剂,可以代替张仲景《伤寒论》太阳篇中的葛根汤方。
豆豉(三升,用绵布包裹) 盐(一两)
以上两味药,用水七升,煮取二升半,去掉药渣,加入蜂蜜一升,再煮三沸,一次性服下一升。服后安静躺卧,应当呕吐。如果不吐,再服一升,以呕吐为有效。
琥按:上述论述说,汗出而不止,不止的意思,是邪气未解除。说的是伤寒已经三四天,曾经发过汗,汗出之后,邪气仍然没有解除。胸中恶心的,是指心胸烦闷懊恼。上面的方子就是张仲景的栀子豉汤,稍微改变其制法来使用。
苦参(三分) 甘草(炙一分) 瓜蒂 赤小豆(各十四枚)
以上四味药,用水一升,煮取半升,一次服用。应当呕吐。如果吐个不停,用葱豉粥来解它,必定停止。
(What is referred to as "Bian Fa" (Method of Variation) means it differs from the methods of Zhang Zhongjing. Each formula discussion contains its own flexible adaptations.)
Ge Chichuan stated: There are several types of Shanghan (Cold Damage), which laypeople cannot distinguish. Now, a method using one medicine to treat multiple conditions is selected. If at the initial stage one feels headache and muscle heat, with a surging pulse that has just risen, within one or two days, prepare this Cong Chi Tang (Scallion and Fermented Soybean Decoction).
Cong Bai (Scallion White, a handful) Chi (Fermented Soybean, one sheng, wrapped in silk gauze)
Take the above two ingredients, add three sheng of water, boil to obtain one sheng, and take in one dose. The goal is to induce sweating. If sweat does not occur, prepare again. For the variant adding Ge Gen (Puerariae Radix, three liang), additionally add Sheng Ma (Cimicifugae Rhizoma, three liang), use five sheng of water, boil to obtain two sheng, and divide into two warm doses. Slow administration is also acceptable. Recovery occurs only when sweat is induced. If no sweat occurs, prepare again, adding Ma Huang (Ephedrae Herba, three liang), remove joints, boil and administer; inducing sweat is the sign of efficacy.
Hu notes: The above discourse states that there are several types of Shanghan (Cold Damage); thus, it is known that this disease is not merely called Shanghan (Cold Damage) solely due to contracting severe cold qi in winter. Extending this logic, any contraction of cold pathogen during the spring, summer, or autumn seasons can be termed Shanghan (Cold Damage). It further states that feeling headache and muscle heat initially, with a surging pulse just rising, indicates that external cold is slight and the condition is purely internal stagnant heat. Thus, it is evident that Shanghan (Cold Damage) are all heat diseases. Although the above formulas originate from the context of Taiyang (Greater Yang) patterns, they actually involve herbs pertaining to the Hand-Foot Yangming (Hand and Foot Yangming) meridians and the Hand-Taiyin (Hand-Lung) meridian. Only upon adding Ma Huang (Ephedrae Herba) does it become the specific herb for inducing sweating in Taiyang (Greater Yang) disorders. Practitioners should apply these flexibly. If using the aforementioned decoction, it can substitute for the Gegen Tang (Kudzu Decoction) found in the Taiyang chapter of Zhang Zhongjing's Treatise on Cold Damage Disorders.
Chi (Fermented Soybean, three sheng, wrapped in silk gauze) Yan (Salt, one liang)
Take the above two ingredients, add seven sheng of water, boil to obtain two and a half sheng, strain the dregs, add one sheng of honey, and boil for three more boils. Take one sheng in one dose. Lie down quietly afterward; vomiting should occur. If vomiting does not occur, take another sheng; inducing vomiting is the sign of efficacy.
Hu notes: The above discourse mentions "sweating without cessation." "Without cessation" implies that the pathogenic factor has not been resolved. This refers to a case where Shanghan (Cold Damage) has persisted for three or four days, sweating therapy was previously administered, but after sweating, the pathogen remains unresolved. "Discomfort in the chest" refers to mental restlessness and oppression in the heart and chest region. The above formula is essentially Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) by Zhang Zhongjing, used with slight modifications to its preparation.
Ku Shen (Sophorae Flavescentis Radix, three fen) Gan Cao (Licorice Root, roasted, one fen) Gou Di (Melon Twig, unripe fruit) Chi Xiao Dou (Adzuki Bean, each fourteen seeds)
Take the above four ingredients, add one sheng of water, boil to obtain half a sheng, and take in one dose. Vomiting should occur. If vomiting persists indefinitely, resolve it with Cong Chi Zhou (Scallion and Fermented Soybean Porridge), and it will certainly cease.
Hu notes: The above formula is essentially the Goudi San (Melon Seed Powder) by Zhang Zhongjing, employing the method of modification and addition.
Sun Simiao treated Shanghan (Cold Damage) and Wenbing (Warm Diseases); Qianjin Fang (Essential Prescriptions Worth a Thousand Gold) contains Jiemi Gegen Tang (Muscle-Releasing Kudzu Decoction).