《伤寒论》原文∶少阴病,下利,白通汤主之。
【白通汤方】葱白四茎,干姜一两,附子一枚生用去皮破八片。
上三味,以水三升煮取一升,去滓,分温再服。
下利固系少阴有寒,然实与脾胃及心脏有关,故方中用附子
以暖肾,用干姜以暖脾胃,用葱白以通心肾之气,即引心君之火下济(天道下济而光明),以消肾中之寒也。
《伤寒论》原文∶少阴病,下利脉微者,与白通汤。利不
止,厥逆无脉,干呕烦者,白通加猪胆汁汤主之。服汤脉暴出者
死,微续者生。
【白通加猪胆汁汤方】葱白四茎,干姜一两,附子一枚生用去皮破八片,人尿五合,猪胆汁一合。
以上三味,以水三升,煮取一升,去滓,纳胆汁、人尿,和令相得,分温再服。若无胆,亦可用。
此节较前节所言之病为又重矣。而于白通汤中加人尿、猪胆汁,即可挽回者,此中原有精微之理在也。
人尿原含有脏腑自然之生气,愚友毛××之侄病霍乱,六脉皆闭,两目已瞑,气息已无,舁诸床上,毛××以
手掩其口鼻觉仿佛仍有呼吸,灌水少许,似犹知下咽。乃急用现接之童便,和朱砂细末数分灌之,须臾顿醒,
则人尿之功效可知矣。至于猪胆汁,以人之生理推之,原少阳相火之所寄生,故其味甚苦,此与命门相火原
有先后天之分,当此元阳衰微、命门相火将绝之时,而以后天助其先天,西人所谓脏器疗法也。且人尿与猪
胆汁之性皆凉,加于热药之中以为引导,则寒凉凝聚之处自无格拒,此又从治之法也。
其脉暴出者,提纲中以为不治,以其将脱之脉象已现也。而愚临证数十年,于屡次实验中,得一救脱
之圣药,其功效远过于参 ,而自古至今未有发明,其善治脱者其药非他,即山萸肉一味大剂煎服也。盖无
论上脱、下脱、阴脱、阳脱、奄奄一息,危在目前者,急用生净萸肉(药局中恒有将酒浸萸肉蒸熟者,用之无效)
三两,急火煎浓汁一大碗,连连温饮之,其脱即止,脱回之后,再用萸肉二两,生怀山药一两,真野台参五
钱煎汤一大碗,复徐徐温饮之,暴脱之证约皆可救愈。想此节所谓脉暴出者用之亦可愈也。
《伤寒论》原文:少阴病(少阴经受邪所致的病证),出现下利(腹泻),以白通汤为主治方剂。
【白通汤方】葱白四茎,干姜一两,附子一枚(生用,去皮,破成八片)。
以上三味药,用水三升,煎煮至取药液一升,滤去药渣,分两次温服。
下利固然属于少阴寒证,但实际上与脾胃及心脏有关,因此方中使用附子来温暖肾脏,使用干姜来温暖脾胃,使用葱白来通达心肾之气,即引导心君之火下行以济助肾水(天道下济而光明),从而消除肾中的寒邪。
《伤寒论》原文:少阴病,下利且脉象微细的,给予白通汤。如果下利不止,出现四肢厥冷(手足逆冷)、无脉、干呕、心烦的症状,以白通加猪胆汁汤为主治方剂。服药后若脉搏突然暴出者死,脉搏微微续接者生。
【白通加猪胆汁汤方】葱白四茎,干姜一两,附子一枚(生用,去皮,破成八片),人尿五合,猪胆汁一合。
以上药物,用水三升,煎煮至取药液一升,滤去药渣,纳入胆汁和人尿,调和均匀,分两次温服。如果没有胆汁,也可以不用。
这一节所述病情比前一节更为严重。而在白通汤中加入人尿、猪胆汁,即可挽回生机,这其中有精妙的道理存在。
人尿原本含有脏腑自然的生气,我的朋友毛××的侄子患霍乱,六脉皆闭,双眼已闭,气息已无,抬到床上时,毛××用手掩住其口鼻,感觉仿佛仍有呼吸,灌入少许水,似乎还知道吞咽。于是急忙使用刚采集的童便,混合朱砂细末数分灌服,片刻之后顿时苏醒,由此可知人尿的功效。至于猪胆汁,从人的生理推导,原为少阳相火所寄生,所以味道极苦,这与命门相火原本就有先天和后天的区别,当此时元阳衰微、命门相火即将断绝之时,以后天之气资助先天之气,即西方人所说的脏器疗法。而且人尿与猪胆汁的性质都偏凉,加入热药之中作为引导,则寒凉凝聚之处自然不会产生格拒(排斥反应),这是从治(顺从病性)的方法。
所谓脉搏突然暴出的,在提纲中认为是不治之症,因为其将脱失的脉象已经显现。而我临证数十年,在屡次实验中,得到一种救治脱证的圣药,其功效远过于人参,但自古至今未有发明,善于治疗脱证的药不是别的,就是山萸肉一味,大剂量煎服即可。无论上脱、下脱、阴脱、阳脱,气息奄奄,危险就在眼前的情况,急用生净萸肉三两(药局中常有将酒浸萸肉蒸熟的情况,使用无效),急火煎浓汁一大碗,连续温饮,其脱证即可停止,脱回之后,再用萸肉二两,生怀山药一两,真野台参五钱煎汤一大碗,再徐徐温饮,暴脱之证大约都可以救愈。想这一节所说的脉暴出者,用此法也可治愈。
Original text from *Shanghan Lun*: Shaoyin disease (disease syndrome caused by pathogenic invasion of the Shaoyin meridian), presenting with diarrhea, is primarily treated with Baotong Decoction.
[Formula for Baotong Decoction] Scallion white (Congbai) four stalks, Dried Ginger (Ganjiang) one tael, Aconite Root (Fuzi) one piece (used raw, skin removed, broken into eight pieces).
The above three ingredients are boiled in three sheng of water until one sheng remains. The dregs are strained out, and the liquid is divided into two doses to be taken warm.
Diarrhea is indeed a cold syndrome of Shaoyin, but it is actually related to the Spleen, Stomach, and Heart. Therefore, Aconite Root is used in the formula to warm the Kidney, Dried Ginger is used to warm the Spleen and Stomach, and Scallion White is used to unblock the Qi between the Heart and Kidney. This guides the Fire of the Heart Monarch downward to assist the Kidney Water (as Heaven's virtue descends to bring light), thereby eliminating the cold in the Kidney.
Original text from *Shanghan Lun*: In Shaoyin disease, if there is diarrhea and the pulse is faint, Baotong Decoction is administered. If the diarrhea does not stop, and symptoms such as cold extremities (cold reversal of the limbs), absence of pulse, dry retching, and irritability occur, Baotong Decoction with Porcine Bile is primarily used. If the pulse suddenly emerges violently after taking the decoction, death ensues; if the pulse slowly resumes continuity, life is preserved.
[Formula for Baotong Decoction with Porcine Bile] Scallion White (Congbai) four stalks, Dried Ginger (Ganjiang) one tael, Aconite Root (Fuzi) one piece (used raw, skin removed, broken into eight pieces), Human Urine (Ren Niao) five he, Porcine Bile (Zhudan Zhi) one he.
The above ingredients are boiled in three sheng of water until one sheng remains. The dregs are strained out, and the bile and human urine are added and mixed well. The mixture is divided into two doses to be taken warm. If bile is unavailable, it may be omitted.
The condition described in this section is more severe than that in the previous section. The addition of human urine and porcine bile to Baotong Decoction can reverse the critical state, which contains profound principles.
Human urine originally contains the natural vital energy of the zang-fu organs. My friend Mao XX’s nephew suffered from cholera, with all six pulses closed, eyes already shut, and breath ceased. When placed on the bed, Mao XX covered his mouth and nose with his hand and felt that there was still faint respiration. After instilling a small amount of water, it seemed the patient could still swallow. Urgently, fresh child’s urine was used, mixed with a few fen of fine Cinnabar powder (Zhusha), and administered. Within a short time, the patient suddenly awakened, demonstrating the efficacy of human urine. As for porcine bile, deducing from human physiology, it is originally parasitic to the Ministerial Fire of Shaoyang, hence its bitter taste. This differs from the Mingmen Ministerial Fire in terms of congenital and acquired origins. At this time, when the primal Yang is weak and the Mingmen Ministerial Fire is about to perish, using the acquired to assist the congenital corresponds to what Westerners call organotherapy. Moreover, both human urine and porcine bile have cool properties. Added to hot medicines as guides, they prevent rejection (refusal of treatment) in areas where cold and coagulation exist. This is a method of treating according to the disease nature (cong zhi).
Regarding the sudden violent emergence of the pulse, the outline considers it untreatable because the pulse image of impending collapse has appeared. However, in my decades of clinical practice, through repeated experiments, I have discovered a holy medicine for rescuing collapse, whose efficacy far exceeds that of Ginseng Radix et Rhizoma (Renshen), yet it has not been elucidated since ancient times. The drug that effectively treats collapse is none other than Cornus Officinalis Fruit (Shanzhuyu) alone, administered in large doses via decoction. Regardless of upper collapse, lower collapse, Yin collapse, or Yang collapse, where breath is faint and danger is imminent, urgently use three liang of pure, raw Cornus Officinalis Fruit (note: pharmacies often sell Cornus Officinalis Fruit steamed after wine soaking, which is ineffective). Boil rapidly to obtain a large bowl of concentrated juice, and drink continuously while warm. The collapse will cease. After recovery from collapse, use two liang of Cornus Officinalis Fruit, one liang of raw Dioscorea Opposita Rhizome (Shanyao), and five qian of wild Codonopsis Pilosula Radix (Taishen) to decoct a large bowl of soup, then drink slowly while warm. Approximately all cases of sudden collapse can be cured. It is thought that the case of sudden violent pulse emergence mentioned in this section can also be cured by this method.