〔海〕辨表里中三说 假令少阳症,头痛,往来寒热,脉浮,此三症但有其一,即为表也。口失滋味,腹
中不和,大小便或闭而不通,或泄而不调,但有其一,即为里也。如无上下表里症,余皆虚热也,是
病在其中矣。
阳毒之为病,面赤斑斑如锦纹,咽喉痛,唾脓血,五日可治,七日不可治。宜升麻鳖甲汤。
升麻(二两) 当归 蜀椒(炒,去汗) 甘草(各一两) 鳖甲(手指大一片) 雄黄(研,半两)
上六味,以水四升,煮取一升,顿服之,取汗愈。《肘后》、《千金方》阳毒升麻汤有桂,无鳖甲,
阴毒用甘草汤,无雄黄。
〔《活》〕阳毒升麻汤 治伤寒一二日,便成阳毒,或服药吐下之后,变成阳毒。腰背痛,烦闷不安,面
赤,狂言奔走,或见鬼,或下利,脉浮大数,面赤斑斑如锦纹,咽喉痛,下脓血,五日可治,七日不可治。
升麻 犀角(镑) 射干 黄芩 人参 甘草(各等分)
上 咀,水煎服,食顷再服。温覆手足,出汗则解,不解重作。
阳毒栀子汤 治阳毒伤寒发热,百节疼痛。
升麻 黄芩 杏仁(各二钱) 栀子 赤芍(各一钱) 石膏(二钱) 知母 大青(各一钱) 甘草(五分)
柴胡(一钱半)
上 咀,每服半两,姜五片,豉百粒,同煎。
大黄散 治阳毒伤寒未解,热在内,恍惚如狂。
大黄(一两半) 桂心(三分) 甘草(炙) 芒硝 木通 大腹皮(各一两) 桃仁(二十一枚)
上 咀,水煎服,以利为度。
〔海〕葛根散 治阳毒身热如火,头痛躁渴,咽喉干痛。
葛根(七钱半) 黄芩 大黄(醋炒) 甘草 山栀 朴硝(各半两)
上 咀,水煎服。
〔《活》〕黑奴丸 治时行病六七日,未得汗,脉洪大或数,面赤目痛,身体大热,烦躁,狂言欲走,
大渴甚。又五六日以上不解,热在胸中,口噤不能言,为坏伤寒,医所不治。或人精魄已竭,心下尚暖,
拨开其口灌药,下咽即活。兼治阳毒及发斑。
麻黄(去节,泡,三两) 大黄(二两) 釜底煤(研) 黄芩 芒硝 灶突墨(研) 梁上尘 小
麦奴(各一两)
上为末,炼蜜丸,如弹子大,新汲水研下一丸。渴者,与冷水尽饮之。须臾当寒,寒竟汗出,便瘥。
若无汗,再服一丸,须微利,效。小麦奴,即小麦未熟时,丛中不成麦捻之成黑勃是也。此药须是病患大
渴,倍常躁盛者,乃可与之。若不渴者,服之反为祸耳。
脉洪大,内外结热,舌卷焦黑,鼻中如烟煤,宜以水渍布薄之。叠布数重,新水渍之,稍 去水,搭
于胸上,须臾蒸热,又渍冷如前薄之,仍换新水数十易。热甚者,置病患于水中,势才退则已,亦一良法也。
丹砂丸 治伤寒阴阳二毒相伏,危恶形症。
舶上硫黄 水银 太阴石 玄精石(各一两) 硝石(半两) 太阳石(一两)
上为末,用无油铫子,以文武火炒上项药,令匀,如灰色,研极细,生姜自然汁浸,炊饼丸如绿
豆大。每服五丸,龙脑、生姜、蜜水下,压其躁也。若阳毒,枣汤下。阴毒,白汤下。不许于屋底炒。
假如出现少阳病的症状,如头痛、寒热往来、脉象浮,这三种症状只要具备其中一种,就属于表证。口中失去滋味,腹部不适,大小便或者闭塞不通,或者泄泻而不调畅,只要具备其中一种,就属于里证。如果没有上述上下表里的症状,其余的都属于虚热,这是病邪位于半表半里(中)的表现。
阳毒这种病,面部红赤,斑纹像锦缎一样,咽喉疼痛,吐出脓血,发病五天内可以治疗,七天后则难以治愈。适宜使用升麻鳖甲汤。
升麻(二两) 当归 蜀椒(炒制,去汗) 甘草(各一两) 鳖甲(手指大小的一片) 雄黄(研细,半两)
以上六味药,用水四升,煎煮取一升药液,一次性服用,出汗后即可痊愈。《肘后备急方》和《千金方》中的阳毒升麻汤含有桂枝,没有鳖甲;阴毒使用甘草汤,不含雄黄。
【《活人书》】阳毒升麻汤 治疗伤寒一二日,便形成阳毒,或者在服药催吐、攻下之后,变成阳毒。症见腰背疼痛,烦闷不安,面红,胡言乱语,奔跑躁动,或者看见鬼怪,或者腹泻,脉象浮大数,面部红赤斑纹如锦缎,咽喉疼痛,排出脓血,五天内可治,七天后难治。
升麻 犀角(镑片) 射干 黄芩 人参 甘草(各等分)
以上药物切碎,水煎服,过一顿饭的时间后再服一次。覆盖身体温暖手足,出汗则病解,若未解则重新制作服用。
阳毒栀子汤 治疗阳毒伤寒发热,全身关节疼痛。
升麻 黄芩 杏仁(各二钱) 栀子 赤芍(各一钱) 石膏(二钱) 知母 大青(各一钱) 甘草(五分) 柴胡(一钱半)
以上药物切碎,每次服用半两,加生姜五片,豆豉一百粒,共同煎煮。
大黄散 治疗阳毒伤寒未解,热邪在内,神志恍惚如同发狂。
大黄(一两半) 桂心(三分) 甘草(炙) 芒硝 木通 大腹皮(各一两) 桃仁(二十一枚)
以上药物切碎,水煎服,以大便通畅为度。
【海藏】葛根散 治疗阳毒身热如火,头痛烦躁口渴,咽喉干燥疼痛。
葛根(七钱半) 黄芩 大黄(醋炒) 甘草 山栀 朴硝(各半两)
以上药物切碎,水煎服。
【《活人书》】黑奴丸 治疗时行病六七日,未能出汗,脉象洪大或数,面红目痛,身体高热,烦躁,胡言乱语想要跑动,极度口渴。又如果五六日以上病情未解,热邪在胸中,牙关紧闭不能说话,属于坏伤寒,医生无法医治。或者病人精气神已竭,但心口尚暖,撬开其口灌药,咽下即能复活。兼治阳毒及发斑疹。
麻黄(去节,浸泡,三两) 大黄(二两) 釜底煤(研细) 黄芩 芒硝 灶突墨(研细) 梁上尘 小麦奴(各一两)
以上药物研为末,用炼蜜制成丸剂,如弹子大小,用新汲水研磨化开一丸服用。口渴者,给冷水让其饮尽。不久应当感到寒冷,冷过后出汗,病即痊愈。若无汗,再服一丸,应当轻微腹泻,见效。小麦奴,就是小麦未成熟时,丛中不成穗的黑褐色部分。此药必须是病人极度口渴,比平常更加躁盛的情况下,才可以给予。如果不渴,服用反而会造成祸害。
脉象洪大,内外结聚热邪,舌头卷曲焦黑,鼻中如烟煤状,适宜用水浸湿布巾敷贴。叠放数层布,用新水浸湿,稍沥去水分,搭在胸口上,一会儿蒸热后,又浸冷水像前面那样敷贴,仍换新水数十次更换。热势严重的,将病人放入水中,热势刚退即可停止,这也是一种良法。
丹砂丸 治疗伤寒阴阳二毒相互潜伏,呈现危重恶性的症状。
舶上硫黄 水银 太阴石 玄精石(各一两) 硝石(半两) 太阳石(一两)
以上药物研为末,用无油的锅,用文火武火交替炒上述药物,使其均匀,呈灰色,研至极细,用生姜自然汁浸泡,用炊饼粉制成如绿豆大小的丸剂。每次服用五丸,用龙脑、生姜、蜂蜜水送下,以压制躁动。若是阳毒,用枣汤送下。若是阴毒,用白开水送下。不允许在房屋底下炒制。
[Hai Zang] Differentiating between Exterior, Interior, and Middle Concepts
Suppose Shaoyang disease symptoms appear, such as headache, alternating chills and fever, or a floating pulse. If any one of these three symptoms is present, it indicates an Exterior syndrome (Biao Zheng). Loss of taste in the mouth, discomfort in the abdomen, or constipation/diarrhea with irregularity; if any one of these is present, it indicates an Interior syndrome (Li Zheng). In the absence of the aforementioned Exterior/Interior symptoms, the remaining conditions belong to Deficient Heat (Xu Re), indicating that the pathogen is located in the Middle (half-exterior/half-interior).
Yang Poison (Yang Du) manifests as facial erythema with mottled patterns resembling brocade, sore throat, and expectoration of pus and blood. It is treatable within five days but difficult to cure after seven days. Shengma Biejia Tang (Cinnamon Twig and Softshell Turtle Shell Decoction) is indicated.
Shengma (Rhizoma Cimicifugae, 2 liang) Danggui (Radix Angelicae Sinensis) Shujiao (Fructus Zanthoxyli, stir-fried to remove moisture) Gancao (Radix Glycyrrhizae, each 1 liang) Biejia (Carapax et Plastrum Testudinis, one piece the size of a finger) Xionghuang (Realgar, ground, 0.5 liang)
The above six ingredients are decocted in four sheng of water until one sheng remains. Take orally at once. Recovery occurs with sweating. The *Zhouhou Beiji Fang* (Emergency Prescriptions Kept Up the Sleeve) and *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) contain Guizhi (Ramulus Cinnamomi) and lack Biejia for Yang Poison; Yin Poison uses Gancao Tang (Licorice Decoction) without Xionghuang.
[Lu Qiyuan's *Ren Shen Da Quan Shu* / "Huoren Shu"] Yang Poison Shengma Tang treats Shanghan (Cold Damage) progressing to Yang Poison within one or two days, or transforming into Yang Poison after emetic or purgative treatment. Symptoms include back pain, restlessness, facial redness, delirious speech, running about, hallucinations, diarrhea, a floating-large-rapid pulse, facial erythema with brocade-like patterns, sore throat, and passage of pus and blood. Treatable within five days, difficult after seven.
Shengma (Rhizoma Cimicifugae) Xijiao (Cornu Rhinocerotis, sliced) Shegan (Rhizoma Belamcandae) Huangqin (Radix Scutellariae) Renshen (Radix Ginseng) Gancao (Radix Glycyrrhizae, equal parts)
Crush the herbs, decoct in water, and take orally. Repeat after a meal interval. Cover the body to warm the extremities; recovery occurs with sweating. If unresolved, prepare again.
Yang Poison Zhizi Tang treats Yang Poison Shanghan with fever and pain in all joints.
Shengma (Rhizoma Cimicifugae) Huangqin (Radix Scutellariae) Xingren (Semen Pruni Armeniacae, each 2 qian) Zhizi (Fructus Gardeniae) Chishao (Radix Paeoniae Rubra, each 1 qian) Shigao (Gypsum Fibrosum, 2 qian) Zhimu (Rhizoma Anemarrhenae) Daqing (Folium Isatidis, each 1 qian) Gancao (Radix Glycyrrhizae, 0.5 qian) Chaihu (Radix Bupleuri, 1.5 qian)
Crush the herbs. For each dose of half liang, add five slices of Shengjiang (Rhizoma Zingiberis Recens) and one hundred grains of Chi (Semen Sojae Preparatum), and decoct together.
Dahuang San treats unresolved Yang Poison Shanghan with internal heat causing mental confusion resembling mania.
Dahuang (Radix et Rhizoma Rhei, 1.5 liang) Guixin (Cortex Cinnamomi, 3 fen) Gancao (Radix Glycyrrhizae, honey-fried) Mangxiao (Natrii Sulfas) Mutong (Caulis Akebiae) Dafupi (Pericarpium Arecae) each 1 liang) Taoren (Semen Persicae, 21 pieces)
Crush the herbs, decoct in water, and take orally. Stop when bowel movement is achieved.
[Hai Zang] Gegen San treats Yang Poison with intense body heat like fire, headache, irritability, thirst, dry and painful throat.
Gegen (Radix Puerariae, 7.5 qian) Huangqin (Radix Scutellariae) Dahuang (Radix et Rhizoma Rhei, vinegar-fried) Gancao (Radix Glycyrrhizae) Shanzhi (Fructus Gardeniae) Puxiao (Natrii Sulfas, each 0.5 liang)
Crush the herbs, decoct in water, and take orally.
[Lu Qiyuan's *Ren Shen Da Quan Shu*] Heinu Wan (Black Slave Pill) treats epidemic diseases lasting six or seven days without sweating, presenting with a large or rapid pulse, facial redness, eye pain, high body heat, irritability, delirious speech, desire to run, and extreme thirst. If unresolved after five or six days, with heat in the chest, trismus preventing speech, constituting "Ruined Shanghan" untreatable by physicians, or where vital essence is exhausted but the heart region remains warm: pry open the mouth, administer the medicine, and life returns upon swallowing. It also treats Yang Poison and macular eruptions.
Mahuang (Herba Ephedrae, nodes removed, soaked, 3 liang) Dahuang (Radix et Rhizoma Rhei, 2 liang) Fudi Mei (Coal from the bottom of the cauldron, ground) Huangqin (Radix Scutellariae) Mangxiao (Natrii Sulfas) Zaotu Mo (Ink from the stove flue, ground) Liangshang Chen (Dust from roof beams) Xiaomai Nu (Germs of Triticum aestivum before ripening, each 1 liang)
Grind into powder, bind with refined honey into pills the size of a bullet. Dissolve one pill in fresh well water and ingest. For thirst, allow drinking cold water freely. Soon, chills will occur, followed by sweating and recovery. If no sweat, take another pill; mild diarrhea indicates efficacy. Xiaomai Nu refers to the blackened germ clusters of immature wheat. This medicine is only suitable for patients with extreme thirst and severe agitation. If not thirsty, administration may cause harm.
For a large pulse, internal and external heat accumulation, curled and scorched-black tongue, and nose appearing like soot: apply wet cloth compresses. Stack several layers of cloth, soak in fresh water, wring slightly, and place on the chest. When it warms up, re-soak in cold water and apply again. Change with fresh water dozens of times. For severe heat, immerse the patient in water until heat subsides. This is also a good method.
Dansha Wan treats critical conditions caused by the intermingling of Yin and Yang Poisons in Shanghan.
Bo Shang Huhuang (Sulfur imported from overseas) Shuiyin (Hydrargyrum) Taiyin Shi (Talcum) Xuanjing Shi (Calcitum) each 1 liang) Xiaoshi (Nitrums) 0.5 liang) Taiyang Shi (Sal Ammoniac, 1 liang)
Grind into powder. Stir-fry the above ingredients evenly in a non-oily pot using alternating gentle and strong heat until gray. Grind extremely fine. Soak in fresh ginger juice and bind with steamed bread dough into pills the size of green beans. Take five pills per dose with Longnao (Camphora), ginger juice, and honey water to suppress agitation. For Yang Poison, take with Jujube Decoction. For Yin Poison, take with plain boiled water. Do not stir-fry under a roof.