治少阴中寒,手足厥冷,下利清谷,脉沉细,但欲寐。
附子(五钱) 干姜(五钱) 甘草(炙,二钱
水煎服。如面赤,加葱白二茎;腹痛,加白芍药二钱(酒炒);呕者,加生姜二钱;咽痛
加桔梗一钱;利止脉不出,加人参二钱;小便不利,身重疼痛,或咳,此为有水气,去干
姜,加白术、茯苓二钱五分,生姜三片。
治少阴中寒,阴盛隔阳,热药相拒不入,故加寒味,以立从治之法。
附子(五钱) 干姜(五钱) 葱白(二茎) 人尿(半杯) 猪胆汁(五茶匙
水煎服。
虚者,加人参三钱。
人参(三钱) 白术 白茯苓 干姜(各一钱五分) 川椒(十粒) 乌梅(二个)
上作一服,水二钟,煎七分服。
凡治蛔,不可用甘草,及甜物。盖蛔得甘则动,得苦则安,得酸则静故也。如未止,加
黄连、黄柏各三分,川椒倍之。若足冷,加附子五、七分,甚者倍之。
问曰∶腹中冷痛,何以属直中寒证?答曰∶寒气内攻,腹中骤然暴痛,手足口鼻俱冷,
或腹中寒冷,欲得热物熨之,不比传经腹痛,由渐而至也。且寒痛绵绵不止,热痛时作时止
也。
问曰∶呕吐清涎沫,何以是直中寒证?答曰∶胃腑寒热之气,必见于涎沫,经曰诸水浑
浊,皆属于热,诸病水液,澄彻清冷,皆属于寒。今见呕吐清涎沫,故知为直中寒证。
治疗少阴经感受寒邪,出现手足冰冷,腹泻且粪便中含有未消化的食物,脉象沉细,精神萎靡只想睡觉。
附子(五钱) 干姜(五钱) 甘草(蜜炙,二钱)
加水煎煮后服用。如果面色发红,加葱白两根;腹痛,加白芍药二钱(用酒炒制);呕吐的,加生姜二钱;咽喉痛,加桔梗一钱;腹泻停止但脉搏摸不到,加人参二钱;小便不通畅,身体沉重疼痛,或者咳嗽,这是因为体内有水气,去掉干姜,加白术、茯苓各二钱五分,生姜三片。
治疗少阴经感受寒邪,阴寒过盛格拒阳气,热性药物被排斥无法进入体内,所以加入寒性药味,以建立“从治”(顺从病势假象而治)的方法。
附子(五钱) 干姜(五钱) 葱白(两根) 人尿(半杯) 猪胆汁(五茶匙)
加水煎煮后服用。
体质虚弱的,加人参三钱。
人参(三钱) 白术 白茯苓 干姜(各一钱五分) 川椒(十粒) 乌梅(两个)
以上药材作为一剂,用水两碗,煎至七分满时服用。
凡是治疗蛔虫病,不可使用甘草以及甜食。因为蛔虫遇到甜味就会躁动,遇到苦味就会安静,遇到酸味就会静止。如果症状没有停止,加黄连、黄柏各三分,川椒加倍用量。如果脚冷,加附子五到七分,严重的加倍用量。
问:腹中冷痛,为什么属于寒邪直中(寒邪直接侵入脏腑,不经过六经传变)的证候?答:寒气向内攻冲,腹中突然剧烈疼痛,手脚、口、鼻都发冷,或者腹中寒冷,想要用热物熨烫腹部,这与经过传变而来的腹痛不同,后者是逐渐发展而成的。而且寒性疼痛是绵绵不断持续存在的,热性疼痛则是时而发作时而停止的。
问:呕吐清稀的涎沫,为什么是寒邪直中的证候?答:胃腑的寒热之气,必然反映在涎沫上,《内经》说:各种浑浊的水液,都属于热证;各种病理性水液,清澈透明且寒冷,都属于寒证。现在看到呕吐清稀的涎沫,所以知道这是寒邪直中的证候。
Treat Shaoyin disease (disease of the Kidney meridian) caused by direct invasion of cold pathogen, characterized by coldness and reversal in the hands and feet, diarrhea with undigested food in the stool, a deep and fine pulse, and a desire to sleep with little energy.
Fuzi (Aconiti Lateralis Radix Praeparata, 5 qian) Ganjiang (Zingiberis Rhizoma, 5 qian) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 2 qian)
Decoct in water and take orally. If there is facial flushing, add Congbai (Allii Fistulosi Bulbus, 2 stems); if there is abdominal pain, add Baishao (Paeoniae Radix Alba, wine-fried, 2 qian); if there is vomiting, add Shengjiang (Zingiberis Rhizoma Recens, 2 qian); if there is sore throat, add Jiegeng (Platycodonis Radix, 1 qian); if diarrhea stops but the pulse does not emerge, add Renshen (Ginseng Radix, 2 qian); if there is difficulty in urination, heaviness of the body, pain, or coughing, this indicates the presence of fluid retention; remove Ganjiang, add Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuling (Poria, 2.5 qian each), and Shengjiang (3 slices).
Treat Shaoyin disease caused by cold pathogen, where excessive Yin cold repels Yang, causing heat-inducing medicines to be rejected and unable to enter the body; therefore, cold-natured ingredients are added to establish the method of "following treatment" (treating according to the apparent false symptoms).
Fuzi (Aconiti Lateralis Radix Praeparata, 5 qian) Ganjiang (Zingiberis Rhizoma, 5 qian) Congbai (Allii Fistulosi Bulbus, 2 stems) Reniao (Urine of Human, half cup) Zhudanhui (Bilis Porci, five tea spoons)
Decoct in water and take orally.
For those with deficiency, add Renshen (Ginseng Radix, 3 qian).
Renshen (Ginseng Radix, 3 qian) Baizhu (Atractylodis Macrocephalae Rhizoma) Fuling (Poria) Ganjiang (Zingiberis Rhizoma) (each 1.5 qian) Chuanjiao (Zanthoxyli Pericarpium, 10 grains) Wumei (Mume Fructus, 2 pieces)
Combine these as one dose, use two bowls of water, decoct until seven-tenths remain, and take.
When treating ascariasis (roundworm infection), avoid using Gancao (Glycyrrhizae Radix et Rhizoma) and sweet substances. This is because roundworms become active when exposed to sweetness, calm down when exposed to bitterness, and become quiet when exposed to acidity. If symptoms do not cease, add Huanglian (Coptidis Rhizoma) and Huangbai (Phellodendri Cortex, each 0.3 qian), and double the amount of Chuanjiao. If the feet are cold, add Fuzi (Aconiti Lateralis Radix Praeparata, 0.5-0.7 qian), doubling the dose for severe cases.
Question: Why is cold pain in the abdomen classified as a syndrome of direct invasion by cold? Answer: When cold pathogen attacks internally, sudden and violent abdominal pain occurs, accompanied by coldness in the hands, feet, mouth, and nose, or a sensation of cold in the abdomen that desires warming with hot objects. This differs from abdominal pain resulting from transmission through meridians, which develops gradually. Furthermore, cold pain is continuous and lingering, whereas heat pain comes and goes intermittently.
Question: Why is vomiting of clear saliva considered a syndrome of direct invasion by cold? Answer: The cold and heat conditions of the Stomach manifest in saliva. As stated in the classics: turbid fluids belong to heat; clear, transparent, and cold fluids belong to cold. Since clear saliva is vomited here, it is known to be a syndrome of direct invasion by cold.