治胸中先有蕴热,又受外感,胸中烦闷异常,喘息迫促,其脉浮洪有力,按之未实,舌苔白而未黄者。
生石膏(二两,轧细) 甘草(三钱) 麻黄(二钱)
上药三味,用蒸汽水煎两三沸,取清汤一大碗,分六次温服下。前三次,一点钟服一次,后三次,一点半
钟服一次。病愈则停服,不必尽剂。下焦觉凉者,亦宜停服。僻处若无汽水,可用甘澜水代之。
作甘澜水法∶用大盆盛水,以杓扬之,扬久水面起有若干水泡,旁有人执杓逐取之,即甘澜水。
若以治温病中,似此证者,不宜用麻黄。宜用西药阿斯匹林一瓦,融化于汤中以代之。若僻处药局无阿斯
匹林,又可代以薄荷叶二钱。
奉天钱姓妇于仲冬得伤寒证,四五日间,喘不能卧,胸中烦闷异常,频频呼唤,欲自开其胸。诊其脉浮洪
而长,重按未实,舌苔白浓。知其证虽入阳明,而太阳犹未罢也(胸中属太阳)。此时欲以小青龙汤治喘,则
失于热。欲以白虎汤治其烦热,又遗却太阳之病,而喘不能愈。踌躇再三,为拟此方,取汽水轻浮之力,能引
石膏上升,以解胸中之烦热。甘草甘缓之性,能逗留石膏不使下趋,以专其上行之力。又少佐以麻黄解散太阳
之余邪,兼借以
泻肺定喘,而胸中满闷可除也。汤成后,俾徐徐分六次服之。因病在上焦,若顿服,恐药力下趋,则药过病所,
而病转不愈也。服至三次,胸间微汗,病顿见愈,服至尽剂,病愈十之八九。再诊其脉,关前犹似浮洪,喘息
已平,而从前兼有咳嗽未愈,继用玄参一两,杏仁(去皮)二钱,蒌仁、牛蒡子各三钱,两剂全愈。
治疗胸中原本蕴积有热,又感受外邪,导致胸中烦闷异常,呼吸急促迫促,脉象浮洪有力,重按之下尚未感觉坚实,舌苔白色但未变黄的证候。
以上三味药,用蒸馏水煎煮两三沸,取澄清药汤一大碗,分六次温服。前三次,每隔一小时服用一次;后三次,每隔一个半小时服用一次。病愈即停药,不必服完全部药剂。若服药后下腹部感觉发凉,也应停药。在偏僻地区若无蒸馏水,可用甘澜水代替。
制作甘澜水的方法:用大盆盛水,用勺子舀起水反复扬洒,久后水面泛起若干水泡,旁边有人拿着勺子逐一舀取水面的水泡部分,即为甘澜水。
如果是用于治疗温病中出现此类证候的,不宜使用麻黄。宜用西药阿斯匹林一瓦,融化于药汤中以替代。若在偏僻地区药房无阿斯匹林,又可用薄荷叶二钱代替。
奉天(今辽宁)钱姓妇女在仲冬时节患上伤寒证,四五日间,气喘严重无法平卧,胸中烦闷异常,频频呼唤,想要自己打开胸部以缓解憋闷。诊察其脉象浮洪而长,重按未实,舌苔白厚。判断其证候虽已传入阳明经,但太阳经表证仍未解除(胸中部位归属于太阳经)。此时若想用小青龙汤来治疗气喘,则过于温热而不适宜;若想用白虎汤来治疗其烦热,又会遗漏太阳经的病邪,导致气喘无法痊愈。经过再三斟酌,为此拟定此方,利用蒸馏水轻浮的特性,能引导石膏药力上升,以解除胸中的烦热。甘草具有甘缓的性质,能留住石膏药性不使其迅速下行,从而专门发挥其上行清热的力量。又少量加入麻黄以解散太阳经残留的外邪,同时借助麻黄泻肺定喘的功效,从而使胸中满闷得以消除。汤药煎成后,让患者徐徐分六次服用。因为病位在上焦,如果一次性顿服,恐怕药力会向下走,导致药力超过病所,反而使病情不能痊愈。服用至第三次时,胸间微微出汗,病情顿时减轻;服完全部药剂后,病情痊愈十之八九。再次诊察脉象,关前脉仍似浮洪,但喘息已经平息,而之前兼有的咳嗽未愈,随后使用玄参一两,杏仁(去皮)二钱,瓜蒌仁、牛蒡子各三钱,服用两剂后完全痊愈。
To treat a condition where there is pre-existing heat accumulation in the chest, compounded by an external contraction, resulting in extreme restlessness and oppression in the chest, rapid and forced breathing, a pulse that is floating, large, and forceful but not firm upon deep pressure, and a white tongue coating that has not yet turned yellow.
Sheng Shigao (Raw Gypsum Fibrosum, 2 liang, finely crushed) Gancao (Licorice Root, 3 qian) Mahuang (Ephedrae Herba, 2 qian)
The above three herbs are decocted with distilled water for two or three boils. Take one large bowl of the clear decoction and take it warm in six divided doses. For the first three doses, administer once every hour; for the last three doses, administer once every one and a half hours. Discontinue administration when the disease is cured; it is not necessary to finish the entire dose. If coolness is felt in the lower jiao (lower abdomen), administration should also be stopped. In remote areas where distilled water is unavailable, Ganlan Shui (Sweet Ripple Water) may be used as a substitute.
Method for preparing Ganlan Shui: Fill a large basin with water. Use a ladle to scoop and throw the water back into the basin repeatedly. After prolonged tossing, several bubbles will form on the water surface. An assistant nearby uses the ladle to collect these bubbles from the surface; this collected water is called Ganlan Shui.
If treating similar conditions within the context of Warm Diseases (Wen Bing), Mahuang should not be used. Instead, Aspirin (1 grain) dissolved in the decoction may be used as a substitute. If Aspirin is unavailable at pharmacies in remote areas, Bohe Ye (Menthae Haplocalycis Folium, 2 qian) can be used as an alternative.
A woman surnamed Qian from Fengtian suffered from a Cold Damage (Shang Han) syndrome in mid-winter. For four or five days, she experienced severe asthma preventing her from lying down, extreme restlessness and oppression in the chest, frequent calling out, and a desire to open her chest manually. Upon palpation, her pulse was floating, large, long, and not firm upon heavy pressure; her tongue coating was thick and white. It was determined that although the syndrome had entered the Yangming stage, the Taiyang exterior syndrome had not yet resolved (the chest region belongs to Taiyang). At this time, using Xiao Qinglong Tang (Minor Green Dragon Decoction) to treat the asthma would be too heating. Using Baihu Tang (White Tiger Decoction) to treat the irritability and heat would neglect the Taiyang pathology, leaving the asthma unresolved. After much deliberation, this formula was prescribed. The light and ascending nature of the distilled water helps guide Shigao upward to resolve the chest heat. Gancao’s sweet and moderating property retains Shigao, preventing it from descending prematurely, thereby focusing its ascending action. A small amount of Mahuang is added to dissipate residual pathogens of the Taiyang stage and to assist in draining Lung heat and calming asthma, thus removing chest fullness and oppression. After decoction, the patient is instructed to take the medicine slowly in six divided doses. Since the disease is located in the Upper Jiao, administering it all at once might cause the medicinal force to descend, passing beyond the site of the disease, which could prevent recovery. After the third dose, slight sweating occurred in the chest area, and the condition improved significantly. After finishing the entire dose, the condition was cured by 80-90%. Upon re-examination, the pulse at the Guan position still appeared floating and large, but the asthma had ceased. However, the accompanying cough persisted. Subsequently, Xuanshen (Scrophulariae Radix, 1 liang), Xingren (Prunus Armeniaca Seed, peeled, 2 qian), Lou Ren (Trichosanthis Semen, 3 qian), and Niubangzi (Arctii Fructus, 3 qian) were prescribed. Two doses resulted in complete recovery.