主伤寒腹中急痛。
胶饴(一升) 甘草(一两,炙) 桂枝(三两,去皮) 芍药(六两) 大枣(十二枚,去核)
生姜(三两,切) 水七升,煮三升,去滓,纳胶饴,微火消解,温服一升,日三服。呕家不用建中,
恐甘缓在上也。
阳气传太阴而痛,其症有二,腹满便闭按之痛者,实也,宜下之。肠鸣泄利而痛者,虚也,
宜与建中汤。成氏曰∶脾应中央,一有不调,则荣卫失所育,津液失所行,必以此汤温建中脏,
故建中名焉。胶饴甘温,甘草甘平,脾欲缓急食甘以缓之,故
以饴为君,甘草为臣,桂枝辛热辛散也,润也。荣卫不足润而散之,芍药酸寒,酸收
也,泄也。津液不逮,收而行之,是以桂枝、芍药为佐,生姜辛温,大枣甘温,胃
者,卫之源,脾者,荣之本,卫为阳,益之必以辛,荣为阴,补之必以甘辛,甘相合,
脾胃健而荣卫通,是以姜枣为使。
普济消毒饮
见头痛门。
主两感伤寒,及四时不正之气,憎寒壮热,头疼身痛,口渴,人人相似者。
羌活 防风 苍术(一钱五分) 细辛(五分) 川芎 白芷 生地黄 黄芩 甘草(一钱)
生姜、葱白水煎服。
吴昆曰∶非其时而有其气,长幼之病多相似。药之辛者,得天地之金气,于人则为
义,故能匡正而黜邪,羌活苍细芎芷皆辛物也,邪在太阳治以羌活,邪在阳明治以白
芷,邪在少阳治以黄芩,邪在太阴治以苍术,邪在少阴治以细辛,邪在厥阴治以川
芎,防风为诸药之卒,徒生地去血热,甘草和诸药,而除气中之热,易老自序云∶冬可
治寒,夏可治热,春可治温,秋可治燥,是诸路之应兵也。但阴虚气弱之人,非所宜
主治伤寒病中出现的腹部拘急疼痛。
胶饴(一升) 甘草(一两,炙烤) 桂枝(三两,去皮) 芍药(六两) 大枣(十二枚,去核)
生姜(三两,切片) 用水七升,煎煮至三升,滤去药渣,加入胶饴,用小火加热使其溶解,每次温服一升,每日服用三次。呕吐患者不宜使用建中汤,
因为担心甘味药物会缓和上焦的气机。
阳气传入太阴经导致的腹痛,其症状有两种:腹部胀满、大便不通、按压时疼痛的,属于实证,适宜采用泻下法。肠鸣腹泻且伴有疼痛的,属于虚证,
适宜给予建中汤治疗。成无己说∶脾脏对应中央方位,一旦功能不调,则营气(营养气血)和卫气(防御外邪之气)失去滋养来源,津液(体内正常液体)运行受阻,必须用此汤剂温补并建立中焦脾胃的功能,
所以命名为“建中”。胶饴味甘性温,甘草味甘性平,脾脏喜欢舒缓急迫的状态,食用甘味食物可以缓解这种急迫,因此
以饴糖为君药(主药),甘草为臣药(辅药)。桂枝味辛性热,具有发散作用,同时也有润养之效。营卫之气不足时,通过润养和发散来调理;芍药味酸性寒,具有收敛作用,
以及泄降之功。当津液不能到达所需部位时,通过收敛和推动来运行,因此桂枝和芍药作为佐药(辅助主药或制约副作用的药)。生姜味辛性温,大枣味甘性温,
胃是卫气的源头,脾是营气的根本,卫气属阳,补益它必须用辛味药,营气属阴,补益它必须用甘味和辛味药相结合,甘味与辛味相合,
能使脾胃功能强健而营卫之气通畅,因此生姜和大枣为使药(引导药力直达病所或调和诸药)。
普济消毒饮
参见头痛章节。
主治两感伤寒(表里两经同时受邪),以及四季不正之气(非时之气)引起的憎恶寒冷、高热、头痛、身体疼痛、口渴,且症状在人群中表现相似的情况。
羌活 防风 苍术(一钱五分) 细辛(五分) 川芎 白芷 生地黄 黄芩 甘草(一钱)
用水煎服,服药时配合生姜和大葱白。
吴昆说∶在非其应有的季节出现相应的气候异常,老少患病多表现相似。药物的辛味,得自天地间的金气,在人身上体现为“义”(决断、刚正),
因此能够扶正祛邪。羌活、苍术、细辛、川芎、白芷都是辛味药物,邪气在太阳经用羌活治疗,邪气在阳明经用白芷治疗,邪气在少阳经用黄芩治疗,邪气在太阴经用苍术治疗,邪气在少阴经用细辛治疗,邪气在厥阴经用川芎治疗,防风作为诸药的先锋士卒,生地黄去除血分的热邪,甘草调和诸药,并清除气分中的热邪。易老(李东垣)在自序中说∶冬季可治寒邪,夏季可治热邪,春季可治温邪,秋季可治燥邪,这是应对各种情况的军队。但对于阴虚气弱的人,并不适宜使用。
Indicated for abdominal urgency and pain caused by Shanghan (Cold Damage).
Yi Tang (Maltose) (1 sheng) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 liang, honey-fried) Gui Zhi (Cinnamomi Ramulus, 3 liang, bark removed) Shao Yao (Paeoniae Radix Alba, 6 liang) Da Zao (Ziziphi Jujubae Fructus, 12 pieces, pits removed)
Sheng Jiang (Zingiberis Rhizoma Recens, 3 liang, sliced) Add 7 sheng of water, decoct to obtain 3 sheng, remove the dregs, add Yi Tang, dissolve over low heat, take 1 sheng warm, three times a day. Patients with vomiting should not use Jianzhong Tang (Middle-Jian Decoction),
as it is feared that the sweet and cloying nature may cause Qi to stagnate in the upper jiao.
When Yang Qi transmits to the Taiyin channel causing pain, there are two types of symptoms: abdominal fullness, constipation, and pain upon pressure indicate excess syndrome, which is suitable for purgation. Bowel sounds, diarrhea, and pain indicate deficiency syndrome,
which is suitable for treatment with Jianzhong Tang. Cheng Wuji stated: The Spleen corresponds to the Central Earth element; once its function is disordered, Ying (Nutritive) and Wei (Defensive) Qi lose their source of nourishment, and body fluids lose their proper circulation. It is necessary to use this decoction to warm and establish the Middle Jiao (Central Burner) Zang-Fu organs,
hence the name Jianzhong. Yi Tang is sweet and warm, Gan Cao is sweet and neutral. The Spleen desires relief from tension; eating sweet foods can relieve tension. Therefore,
Yi Tang is used as the Sovereign (Jun) herb, and Gan Cao as the Minister (Chen) herb. Gui Zhi is acrid and hot, possessing dispersing properties, yet also moistening. When Ying and Wei Qi are insufficient, they are regulated through moistening and dispersing. Shao Yao is sour and cold, possessing astringent properties, and also draining effects. When body fluid circulation is inadequate, astringency and guidance promote its movement. Thus, Gui Zhi and Shao Yao serve as Assistant (Zuo) herbs. Sheng Jiang is acrid and warm, Da Zao is sweet and warm. The Stomach is the source of Wei Qi, and the Spleen is the root of Ying Qi. Wei Qi belongs to Yang; tonifying it requires acrid flavors. Ying Qi belongs to Yin; tonifying it requires a combination of sweet and acrid flavors. The combination of sweet and acrid flavors strengthens the Spleen and Stomach, allowing Ying and Wei Qi to flow freely. Therefore, Sheng Jiang and Da Zao act as Envoy (Shi) herbs.
Pu Ji Xiao Du Yin (Universal Benefit Decoction to Eliminate Toxins)
See the section on Headache.
Indicated for Lianggan Shanghan (Simultaneous contraction of exterior and interior channels in Cold Damage), as well as pathogenic factors from abnormal seasonal climates, manifesting as aversion to cold with high fever, headache and body ache, thirst, where symptoms are similar among many people.
Qiang Huo (Notopterygii Rhizoma et Radix) Fang Feng (Saposhnikoviae Radix) Cang Zhu (Atractylodis Rhizoma, 1 qian 5 fen) Xi Xin (Asari Radix et Rhizoma, 5 fen) Chuan Xiong (Ligustici Chuanxiong Rhizoma) Bai Zhi (Angelicae Dahuricae Radix) Sheng Di Huang (Rehmanniae Radix) Huang Qin (Scutellariae Radix) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian)
Decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Cong Bai (Allii Fistulosi Bulbus) in water, and take orally.
Wu Kun stated: When there is climate inappropriate to the season, illness affects both young and old with similar presentations. Acrid herbs derive the Metal Qi of Heaven and Earth, which manifests as "Righteousness" (Yi) in humans,
thus enabling them to support healthy Qi and expel pathogenic factors. Qiang Huo, Cang Zhu, Xi Xin, Chuan Xiong, and Bai Zhi are all acrid substances. For pathogens in the Taiyang channel, treat with Qiang Huo; for pathogens in the Yangming channel, treat with Bai Zhi; for pathogens in the Shaoyang channel, treat with Huang Qin; for pathogens in the Taiyin channel, treat with Cang Zhu; for pathogens in the Shaoyin channel, treat with Xi Xin; for pathogens in the Jueyin channel, treat with Chuan Xiong. Fang Feng acts as the vanguard among these herbs. Sheng Di Huang clears heat from the blood level. Gan Cao harmonizes the various herbs and clears heat from the Qi level. Yi Lao's preface states: In winter, it treats cold; in summer, it treats heat; in spring, it treats warmth; in autumn, it treats dryness. It is an army responding to all fronts. However, it is not suitable for individuals with Yin deficiency and weak Qi.