飞滑石十五两 淡 芩十两 茵 陈十一两 藿 香四两 连 翘四两 石菖蒲六两
白 2 四两 薄 荷四两 木 通五两 射 干四两 川贝母五两
神3糊为末。
犀 尖六两 生 地一斤熬膏 香 4 八两熬膏 连 翘十两 黄 芩六两 板蓝根九两
银 花一斤 金 汁十两 元 参七两 花 粉四两 石菖蒲六两 紫 草四两
即用生地香4金汁捣丸,每丸重三钱,开水送下。
痰者,津液所化。盖由风伤肺,肺气不清而生痰,湿伤脾,脾气凝浊而生痰。其人亦憎寒壮热,恶风自
汗。但胸膈病满,气上?咽不得息,皆因肺气不舒。故虽类伤寒,但头不痛,项不强,或寸脉浮滑,或沈
伏为异尔。宜瓜蒂散或稀涎散吐之。
伤食类伤寒者,以其亦有发热恶寒头疼等症,但非若伤寒之甚者也。其症或兼恶食,或噫气作酸。
或饱闷作痛,气口脉紧者是也。当于消食门中求之。
烦者热也,心中郁郁不安,故谓之烦也]盖缘其人素弱有劳损。因而损气,气衰则精虚,精虚则火旺,
即内经所谓阴虚生内热也。以内有热。则应于外。然虽发热而无恶寒头疼身痛等症。治宜补中益
气汤加黄柏。
脚气类伤寒者,以其有发热头疼身痛等症,但起初足胫肿痛,或足膝屈强不能移动为异尔。其病
始于受湿,复感挟风寒暑热而成,故陈无泽曰、脚气不专主一气,亦不专在一经,若自汗走注为风
胜,无汗挛急为寒胜,肿满重者为湿胜,烦渴热蒸为暑胜,若四气兼中,但推其多者为胜。又曰、足胫
焮赤而肿者,湿热也。黄白而肿者,寒湿也。大法用二术以燥湿,苓柏以清热,归芍以调血,木香槟榔
以行气,乌附行经络以除湿散寒,羌独利关节以散风胜湿,防己牛膝,行之下引,以去湿消肿。更看
所梜风寒暑热之有无微甚,及在表在里,总当于脚气门中求之。切不可用补剂,及汤药淋洗,并冷
药摊?,使毒气上入心腹,胸痹气喘,死矣。
飞滑石十五两,淡黄芩十两,茵陈十一两,藿香四两,连翘四两,石菖蒲六两,白蔻仁四两,薄荷四两,木通五两,射干四两,川贝母五两。
将上述药材研为细末,用神曲糊作为粘合剂制成丸药。
犀角尖六两,生地黄一斤熬成膏,麝香八两熬成膏,连翘十两,黄芩六两,板蓝根九两,金银花一斤,金汁十两,玄参七两,天花粉四两,石菖蒲六两,紫草四两。
立即使用生地黄、麝香、金汁捣碎混合制成丸药,每丸重三钱,用开水送服。
痰,是由津液转化而成的。大概是因为风邪伤及肺脏,肺气不清肃而产生痰;湿邪伤及脾脏,脾气凝滞浑浊而产生痰。患者也会出现憎寒壮热(怕冷且高热)、恶风自汗的症状。但是胸膈部位痞满胀闷,气逆上冲咽喉导致呼吸困难,这都是因为肺气不舒展的缘故。所以虽然症状类似伤寒,但头部不痛,项部不强硬,或者寸脉浮滑,或者沉伏,以此作为区别。适宜使用瓜蒂散或稀涎散进行催吐治疗。
伤食证类似伤寒者,是因为它也有发热、恶寒、头痛等症状,但不像伤寒那样严重。其症状有时兼有厌恶食物,有时嗳气泛酸。有时饱胀闷痛,气口脉紧的,就是这种情况。应当在消食导滞的门类中寻求治疗方法。
烦,属于热证,心中郁郁不安,所以称为“烦”。大概是因为患者素体虚弱且有劳损。因而损伤了气,气衰则精虚,精虚则火旺,即《内经》所说的阴虚生内热。因为体内有热,所以反映在体表。然而虽然有发热,却没有恶寒、头痛、身痛等症状。治疗适宜使用补中益气汤加黄柏。
脚气病类似伤寒者,是因为它有发热、头痛、身痛等症状,但起初足胫部肿痛,或者足膝僵硬不能移动,以此作为区别。这种病始于感受湿邪,又夹杂风寒暑热而成,所以陈无泽说:脚气不专门由一种邪气引起,也不专门局限于一条经络,如果自汗且疼痛游走不定是风邪偏胜,无汗且拘挛紧急是寒邪偏胜,肿胀沉重是水湿偏胜,烦躁口渴热气蒸腾是暑邪偏胜,如果四种邪气同时侵犯,只推究其中偏胜的那一种。又说:足胫红肿灼热的是湿热,色黄白而肿的是寒湿。大法则是用苍术、白术来燥湿,茯苓、黄柏来清热,当归、白芍来调血,木香、槟榔来行气,乌头、附子通行经络以除湿散寒,羌活、独活利关节以散风胜湿,防己、牛膝下行引经以祛湿消肿。更要看所夹的风寒暑热有无及轻重程度,以及在表在里,总应当在脚气病的门类中寻求治疗。切不可使用补益剂,以及汤药淋洗,和冷药外敷,以免毒气上入心腹,导致胸痹气喘,甚至死亡。
Fei Huashi (Calcined Gypsum, 15 liang), Dan Huangqin (Scutellaria Root, 10 liang), Yinchen (Artemisiae Scopariae Herba, 11 liang), Huoxiang (Pogostemonis Herba, 4 liang), Lianqiao (Forsythiae Fructus, 4 liang), Shichangpu (Acori Tatarinowii Rhizoma, 6 liang), Baishaoren (Amomi Fructus Rotundus, 4 liang), Bohe (Menthae Haplocalycis Herba, 4 liang), Mutong (Akebiae Caulis, 5 liang), Shegan (Belamcandae Rhizoma, 4 liang), Chuanbeimu (Fritillariae Cirrhosae Bulbus, 5 liang).
Grind the above herbs into fine powder. Use Shenqu paste as a binder to form pills.
Xijian (Rhinocerotis Cornu, 6 liang), Shengdihuang (Rehmanniae Radix Praeparata, 1 jin boiled into paste), Xexiang (Moschus, 8 liang boiled into paste), Lianqiao (Forsythiae Fructus, 10 liang), Huangqin (Scutellariae Radix, 6 liang), Banlangen (Isatidis Radix, 9 liang), Yinhua (Lonicerae Japonicae Flos, 1 jin), Jinzhi (Human Feces Distillate, 10 liang), Yuanshen (Scrophulariae Radix, 7 liang), Huafen (Trichosanthis Radix, 4 liang), Shichangpu (Acori Tatarinowii Rhizoma, 6 liang), Zicao (Arnebiae Radix seu Lithospermi Radix, 4 liang).
Immediately mix Shengdihuang, Xexiang, and Jinzhi by pounding to form pills. Each pill weighs three qian. Take with warm water.
Tan (Phlegm) is transformed from Jinye (Body Fluids). Generally, it arises because Wind pathogen injures the Lung, causing Lung Qi to fail in clearing and descending, thus generating Phlegm; or Dampness pathogen injures the Spleen, causing Spleen Qi to stagnate and become turbid, thus generating Phlegm. The patient may also exhibit Zhenghan Zhuangre (aversion to cold with high fever), Efeng (aversion to wind), and Zi Han (spontaneous sweating). However, there is fullness and distension in the chest and diaphragm, with Qi rebelling upwards to the throat causing difficulty in breathing, all due to the unsmooth flow of Lung Qi. Therefore, although the symptoms resemble Shanghan (Cold Damage), the head does not hurt, the neck is not stiff, and the pulse at the Cun position may be floating and slippery, or deep and hidden, which serves as the distinction. It is appropriate to use Guiti San (Melon Seed Powder) or Xixian San (Thin Saliva Powder) to induce vomiting.
Shangshi Lei Shanghan (Food Injury resembling Cold Damage) occurs because it also presents with symptoms such as fever, aversion to cold, and headache, but not as severely as in typical Shanghan. Symptoms may include aversion to food, belching with acid reflux, or pain and distension after overeating, accompanied by a tight pulse at the Koukou (Radial Artery at the wrist). Treatment should be sought within the category of promoting digestion and removing food stagnation.
Fan (Restlessness/Agitation) belongs to Heat syndrome. The heart feels郁郁 (oppressed and uneasy), hence it is called "Fan". This generally arises because the patient has a constitutionally weak body with prior劳损 (fatigue damage). Consequently, Qi is damaged; when Qi declines, Jing (Essence) becomes deficient; when Jing is deficient, Fire flares up. This corresponds to what the Neijing (Inner Canon) states: "Yin deficiency generates internal heat." Because there is heat internally, it manifests externally. However, although there is fever, there are no symptoms such as aversion to cold, headache, or body pain. Treatment should utilize Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Huangbai (Phellodendri Cortex).
Jiaqi Lei Shanghan (Foot Qi resembling Cold Damage) occurs because it presents with symptoms such as fever, headache, and body pain, but initially features swelling and pain in the lower legs, or stiffness and inability to move the feet and knees, which serves as the distinction. This disease originates from Dampness invasion, compounded by Wind, Cold, Summer-heat, or Heat. Thus, Chen Wuze stated: Foot Qi is not exclusively caused by one pathogen, nor confined to one meridian. If there is spontaneous sweating and wandering pain, it indicates Wind excess; if there is no sweating and spasmodic tightness, it indicates Cold excess; if there is swelling and heaviness, it indicates Dampness excess; if there is restlessness, thirst, and steaming heat, it indicates Summer-heat excess. If all four pathogens combine, identify which one is predominant. He further stated: Red, swollen, and burning lower legs indicate Damp-Heat; yellowish-white swelling indicates Cold-Damp. The general principle is to use Zhushu (Atractylodes Macrocephala and Atractylodes Lancea) to dry Dampness, Lingpai (Poria and Phellodendron) to clear Heat, Guishao (Angelica Sinensis and Paeonia lactiflora) to regulate Blood, Muxiang (Aucklandiae Radix) and Binglang (Arecae Semen) to move Qi, Wufu (Aconitum carmichaelii and Aconitum kusnezoffii) to unblock collaterals, dispel Dampness, and scatter Cold, Qiangdu (Notopterygii Rhizoma et Radix and Saposhnikoviae Radix) to benefit joints, disperse Wind, and overcome Dampness, Fangji (Stephaniae Tetrandrae Radix) and Niuxi (Achyranthis Bidentatae Radix) to guide downwards, expel Dampness, and reduce swelling. One must also consider the presence and severity of combined Wind, Cold, Summer-heat, or Heat, and whether the pathogen is in the exterior or interior. Treatment should always be sought within the category of Foot Qi. One must absolutely avoid using tonifying agents, herbal decoctions for washing, or cold external applications, lest the toxic Qi ascend into the heart and abdomen, causing Xiongbi (Chest Bi syndrome) and asthma, leading to death.