治少阴病, 身痛手足寒, 骨节痛, 口中和, 背恶寒,
脉沉者.
附子 ( 生用, 去皮, 破八片 ) 二枚 茯苓三两 人参二两 白术四
两 芍药三两, , 右五味, 以水八升, 煮取三升, 去滓, 温服一升,
日三服.
【注】少阴为寒水之脏, 故伤寒之重者多入少阴, 所以少阴一经最多
死证. 方中君附子二枚者, 取其力之锐, 且以重其任也. 生用者, 一
以壮少火之阳, 一以散中外之寒, 则恶寒自止, 身痛自除, 手足自温
矣; 所以固生气之原, 令五脏六腑有本, 十二经脉有根, 脉自不沉,
骨节可和矣. 更佐白术以培土, 芍药以平木, 茯苓以伐水. 水伐火自
旺,旺则阴翳消, 木平土益安, 安则水有制, 制则生化. 此万全之术
,其畏而不敢用, 束手待毙者, 曷可胜计耶!
治脉沉厥逆等证.
甘草 ( 炙 ) 二两 干姜一两半 附子 ( 生用, 去皮, 破八片 ) 一
枚,, 右三味, 以水三升, 煮取一升二合, 去滓, 分温再服. 强人可
大附子一枚, 干姜三两.
【注】方名四逆者, 主治少阴中外皆寒, 四肢厥逆也. 君以炙草之甘
温,温养阳气. 臣以姜, 附之辛温, 助阳胜寒. 甘草得姜, 附, 鼓肾
阳温中寒, 有水中暖土之功. 姜附得甘草, 通关节走四肢, 有逐阴回
阳之力. 肾阳鼓寒, 阴消则阳气外达, 而脉升手足温矣.
治疗少阴病,身体疼痛、手足寒冷、骨节疼痛、口中平和(无苦燥感)、背部怕冷、脉象沉细的证候。
附子(生用,去皮,破成八片)二枚 茯苓三两 人参二两 白术四两 芍药三两。以上五味药,用水八升,煮取三升,滤去药渣,每次温服一升,每日服用三次。
【注释】少阴是寒水之脏,所以伤寒重症多传入少阴经,因此少阴一经出现死证的病例最多。方中以附子二枚为君药,取其药力锐利,且承担主要治疗重任。生用的目的,一是为了壮旺少火之阳气,二是为了驱散内外的寒邪,这样怕冷自然停止,身体疼痛自然消除,手足自然温暖;从而巩固生命之气的根本,使五脏六腑有本源,十二经脉有根基,脉象自然不再沉细,骨节得以调和。再佐以白术来培补脾土,芍药来平抑肝木,茯苓来渗利水湿。水湿被渗利则心火自然旺盛,火旺则阴寒消散,肝木平抑则脾土更加安宁,脾土安宁则水湿有所制约,制约得当则生化功能正常。这是万全的治疗策略,那些因为畏惧而不敢使用此方,束手待毙的人,哪里能计算得尽呢!
治疗脉象沉细、四肢厥逆等证候。
甘草(炙)二两 干姜一两半 附子(生用,去皮,破成八片)一枚。以上三味药,用水三升,煮取一升二合,滤去药渣,分两次温服。体质强壮者可加大附子至一枚,干姜至三两。
【注释】方名“四逆”,主治少阴病内外皆寒、四肢厥逆的证候。以炙甘草的甘温之性为君药,温养阳气。以干姜、附子的辛温之性为臣药,助阳胜寒。甘草得到干姜、附子,能鼓动肾阳、温中散寒,具有“水中暖土”的功效。干姜、附子得到甘草,能通达关节、走窜四肢,具有驱逐阴寒、回阳救逆的力量。肾阳鼓动驱散寒邪,阴寒消退则阳气外达,脉象回升,手足温暖。
Treating Shaoyin disease (Shaoyin syndrome), characterized by body pain, coldness of the hands and feet, joint pain, a normal feeling in the mouth (absence of bitterness or dryness), aversion to cold on the back, and a deep pulse.
Fuzi (Aconiti Lateralis Radix Praeparata, raw use, peeled, broken into eight pieces) 2 units; Fuling (Poria) 3 liang; Renshen (Ginseng Radix) 2 liang; Baizhu (Atractylodis Macrocephalae Rhizoma) 4 liang; Shaoyao (Paeoniae Radix Alba) 3 liang. The above five herbs are boiled with 8 sheng of water until 3 sheng remain. Strain the dregs, and take 1 sheng warm each time, three times daily.
[Note] Shaoyin is the zang-organ of cold-water; therefore, severe cases of Cold Damage (Shanghan) often enter the Shaoyin channel. Consequently, the Shaoyin channel has the highest incidence of fatal syndromes. In this formula, two units of Fuzi serve as the sovereign herb, chosen for their sharp potency and primary therapeutic role. Using them raw aims to: first, strengthen the Yang fire of Shaoyin; second, disperse cold from both interior and exterior. Thus, aversion to cold will cease, body pain will be eliminated, and the hands and feet will become warm. This consolidates the root of vital Qi, providing a foundation for the five zang and six fu organs, and roots for the twelve meridians. The pulse will no longer be deep, and the joints will harmonize. Additionally, Baizhu is used to support Earth (Spleen), Shaoyao to pacify Wood (Liver), and Fuling to drain Water (Kidney/Bladder). When Water is drained, Fire naturally prospers; when Fire prospers, Yin pathogens dissipate. When Wood is pacified, Earth becomes stable; when Earth is stable, Water is controlled, allowing for proper transformation and transportation. This is a foolproof method. How many people can be counted who, out of fear, dare not use it and wait helplessly for death?
Treating syndromes such as a deep pulse and reversal cold (Jue-ni) of the limbs.
Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) 2 liang; Ganjiang (Zingiberis Rhizoma) 1.5 liang; Fuzi (Aconiti Lateralis Radix Praeparata, raw use, peeled, broken into eight pieces) 1 unit. The above three herbs are boiled with 3 sheng of water until 1.2 sheng remain. Strain the dregs, and divide into two warm doses. For robust individuals, increase Fuzi to 1 unit and Ganjiang to 3 liang.
[Note] The formula is named "Sini Tang" (Four-Reversal Decoction) because it treats Shaoyin syndrome characterized by cold throughout the interior and exterior, leading to reversal cold of the four limbs. The sovereign herb is honey-fried Gancao, whose sweet-warm nature warms and nourishes Yang Qi. The minister herbs are Ganjiang and Fuzi, whose pungent-warm nature assists Yang to overcome Cold. Gancao, combined with Ganjiang and Fuzi, stirs Kidney Yang and warms Middle Jiao Cold, possessing the function of "warming Earth within Water." Ganjiang and Fuzi, combined with Gancao, penetrate joints and travel to the four limbs, possessing the power to expel Yin and restore Yang. As Kidney Yang stirs and disperses Cold, Yin dissipates, allowing Yang Qi to reach the exterior; consequently, the pulse rises, and the hands and feet become warm.