太和散 治疮痘后寒热往来,嗜卧,顿闷躁乱。
生地 当归 地骨皮 人参 甘草(炙) 白芍药(各等分)
上 咀,每服一钱,水半盏,煎至三分,去渣温服。
〔丹〕陈十妹,年二十岁出痘而有孕七个半月,大渴,不甚出透,寒热交作,血虚气虚。
人参 白术 黄 陈皮 甘草(炙) 归身(各一钱) 姜三片,酒水各半盏,煎服。
〔海〕疮疹大肠闭涩,或发渴。四君子加栝蒌根、桔梗主之。若身热小渴者,六味人参麦门冬散治
之。如不愈,或身热大渴者,七味人参白术散治之。又不愈,十一味木香散。
六味人参麦门冬散
麦门冬(去心,一两) 人参(去芦) 甘草(炙) 陈皮 白术 浓朴(姜制。各半两)
上 咀,每服三钱,水一盏,煎至六分,去渣温服,虚人减浓朴。
七味人参白术散(方见消渴门。以上四方,四君子加减法也。)
〔丹〕初起烦躁渴引饮者,急以凉药解其标。
〔钱〕身热烦渴,腹满而喘,大小便涩而赤,闷乱大吐,此当利小便,不瘥者,宣风散下之。
〔陈〕十一味木香散,《集验方》本治疮痘身热作渴。(方见后渴泻条。)
文中云∶腹胀渴者,泻渴者,足指冷渴者,惊悸渴者,身温渴者,身热面 白色渴者,寒战渴不止
者,气急切牙渴者,饮水转水泻不已者,以上九证,即非热也,乃津液少,脾胃肌肉虚故也,宜木香
散治之。如不愈,更加丁香、官桂。(此说必加审用之。胀渴、泻渴、惊悸渴、寒战渴、切牙渴,亦多属
热者,不可不察。)
太和散:治疗痘疮痊愈后出现寒热往来、嗜睡倦怠、头昏闷躁乱的症状。
处方组成:生地黄、当归、地骨皮、人参、炙甘草、白芍药(以上药材各取等量)。
煎服方法:将药材切碎,每次服用一钱,加水半盏,煎煮至剩余三分之一的药液,滤去药渣,温服。
〔朱丹溪医案〕陈十妹,二十岁,出痘时怀孕七个半月,症状为大渴、痘疹未能完全透发、寒热交替发作,辨证为血虚兼气虚。
处方:人参、白术、黄芩、陈皮、炙甘草、当归身(以上各一钱),生姜三片。用酒和水各半盏,煎煮后服用。
〔海藏观点〕痘疹导致大肠闭塞不通,或引发口渴。以四君子汤加瓜蒌根、桔梗为主治方。若身体发热且轻微口渴者,用六味人参麦门冬散治疗。如果无效,或者身体发热且严重口渴者,用七味人参白术散治疗。若仍不愈,使用十一味木香散。
六味人参麦门冬散:
处方组成:麦门冬(去心,一两)、人参(去芦)、炙甘草、陈皮、白术、姜制厚朴(以上各半两)。
煎服方法:将药材切碎,每次服用三钱,加水一盏,煎煮至剩余六分之一的药液,滤去药渣,温服。体质虚弱者减少厚朴用量。
七味人参白术散(方剂见消渴门。以上四方均为四君子汤的加减法。)
〔朱丹溪观点〕痘疹初起时烦躁、口渴欲饮水者,急需使用凉性药物解除标症。
〔钱乙观点〕身体发热、烦躁口渴、腹部胀满且气喘、大小便涩滞且色赤、烦闷混乱伴剧烈呕吐,此证应当通利小便;若无效,则用宣风散攻下。
〔陈文中观点〕十一味木香散,《集验方》原本用于治疗痘疮身热作渴。(方剂见后文“渴泻”条。)
文中记载:腹胀而渴者、腹泻而渴者、足趾发冷而渴者、惊悸而渴者、体温正常而渴者、身体发热面色苍白而渴者、寒战不止而渴者、气息急促咬牙而渴者、饮水后转为水样腹泻不止者,以上九种证候,并非热证,而是津液不足、脾胃肌肉虚弱所致,适宜用木香散治疗。如果无效,再加丁香、官桂。(此说法必须审慎使用。腹胀渴、腹泻渴、惊悸渴、寒战渴、咬牙渴,也多属于热证,不可不仔细辨别。)
Taihe San (Great Harmony Powder): Treats alternating chills and fever, lethargy, dizziness, stifling sensation, and restlessness following the eruption of smallpox/variolous diseases.
Ingredients: Shengdi Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Digupi (Lycii Cortex), Renshen (Ginseng Radix et Rhizoma), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), Baishao Yao (Paeoniae Radix Alba) (all in equal parts).
Preparation and Administration: Coarsely crush the herbs. For each dose, take one qian, add half zhan of water, decoct until one-third remains, remove the dregs, and administer warm.
[Case by Zhu Danxi] Chen Shi Mei, aged twenty, contracted smallpox while seven and a half months pregnant. Symptoms included extreme thirst, incomplete eruption of the rash, and alternating chills and fever. The pattern was identified as Blood Deficiency combined with Qi Deficiency.
Prescription: Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqin (Scutellariae Radix), Chenpi (Citri Reticulatae Pericarpium), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), Guishen (Radix Angelicae Sinensis - root body) (each 1 qian), Shengjiang (Zingiberis Rhizoma Recens) (3 slices). Decoct with half zhan of wine and half zhan of water, then administer.
[View from Zhang Congzheng/Haizang] When pox/rash causes obstruction and dryness in the Large Intestine, or induces thirst, Si Jun Zi Tang (Four Gentlemen Decoction) added with Gualougen (Trichosanthis Radix) and Jiegeng (Platycodonis Radix) is the primary treatment. If there is fever with slight thirst, Liu Wei Ren Shen Mai Men Dong San (Six-Ingredient Ginseng and Ophiopogon Decoction) treats it. If ineffective, or if there is fever with severe thirst, Qi Wei Ren Shen Bai Zhu San (Seven-Ingredient Ginseng and Atractylodes Decoction) treats it. If still ineffective, use Shi Yi Wei Mu Xiang San (Eleven-Ingredient Aucklandia Decoction).
Liu Wei Ren Shen Mai Men Dong San (Six-Ingredient Ginseng and Ophiopogon Decoction):
Ingredients: Mai Men Dong (Ophiopogonis Tuber, heart removed, 1 liang), Renshen (Ginseng Radix et Rhizoma, rhizome removed), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Houpo (Magnoliae Officinalis Cortex, prepared with ginger) (each 0.5 liang).
Preparation and Administration: Coarsely crush the herbs. For each dose, take three qian, add one zhan of water, decoct until one-sixth remains, remove the dregs, and administer warm. Reduce the amount of Houpo for patients with deficiency.
Qi Wei Ren Shen Bai Zhu San (Seven-Ingredient Ginseng and Atractylodes Decoction) (Formula see section on Xiao Ke/Wasting-Thirst. The above four formulas are modifications of Si Jun Zi Tang).
[View by Zhu Danxi] At the initial stage, if there is irritability and thirst with desire to drink, urgently use cooling medicines to resolve the branch symptoms.
[View by Qian Yi] If there is fever, irritability, and thirst, abdominal fullness with panting, obstructed and reddish urine and stool, mental confusion with severe vomiting, this condition should be treated by promoting urination. If ineffective, use Xuan Feng San (Promoting Wind Powder) to purge.
[View by Chen Wenzhong] Shi Yi Wei Mu Xiang San (Eleven-Ingredient Aucklandia Decoction), originally from Ji Yan Fang, was used to treat fever and thirst caused by pox/rash. (Formula see section on Thirst and Diarrhea below.)
The text states: Abdominal distension with thirst, diarrhea with thirst, cold toes with thirst, palpitations with fright with thirst, normal body temperature with thirst, fever with pale complexion with thirst, unceasing chills with thirst, rapid breathing with teeth grinding with thirst, drinking water leading to incessant watery diarrhea—these nine syndromes are not Heat patterns, but rather due to insufficient Jin Ye (Body Fluids) and deficiency of the Spleen-Stomach and muscles/flesh. Muxiang San (Aucklandia Powder) is suitable for treatment. If ineffective, add Dingxiang (Caryophylli Flos) and Guigui (Cinnamomi Cortex). (This statement must be applied with caution. Abdominal distension thirst, diarrhea thirst, palpitation fright thirst, chills thirst, and teeth-grinding thirst also often belong to Heat patterns; careful differentiation is essential.)