草(不拘多少)
此草处处有之,其叶似苍耳,对节而生,用五月五日、七月七日、九月九日,采来晒干
,铺入甑中,用好酒层层匀洒,蒸之复晒,如此九次,为末,炼蜜为丸,如梧桐子大。每服
五十丸,空心无灰酒下。
病患骨节疼痛,缓弱无力,此方主之良。
骨节疼痛,壅疾也,壅者喜通。此物味辛苦而气寒,用九蒸九晒,则苦寒之浊味皆去,
而气轻清矣。《本草》云∶轻可以去实,盖轻清则无窍不入,故能透骨驱风,劲健筋骨。若
未之九蒸九晒,或蒸晒之数不满于九,浊味犹存,阴体尚在,则不能透骨驱风而却病也。此
阴阳清浊之义,惟明者求之。(唐江陵节度使成讷进 丸,知益州张咏进 丸,事考并
见痛风门。)
叙曰∶仲景伤寒方,群方之祖也,自晋唐而降,历朝医哲,罔不宗之,初学之士,能究
其方,识其证,虽施之杂疗,不可胜用,岂徒曰伤寒云尔哉!今取其方七十五首,考之如下,
有
桂枝(三两,洗净) 芍药(三两,炒) 甘草(二两,生) 生姜(三两) 生枣(十
二枚,
头痛发热,汗出恶风,脉缓者,太阳中风也,此汤主之。
风之伤人也,头先受之,故令头痛;风在表则表实,故令发热;风为阳,气亦为阳,同
类相从,则伤卫外之气,卫伤则无以固卫津液,故令汗出;其恶风者,卫气不能卫也;其脉
缓者,卫气不能鼓也。上件皆太阳证,故曰太阳中风。桂枝味辛甘,辛则能解肌,甘则能实
表,经曰∶辛甘发散为阳,故用之以治风;然恐其走泄阴气,故用芍药之酸以收之;佐以甘
草、生姜、大枣,此发表而兼和里之意。是方也,惟表邪可以用之;若阳邪去表入里,里作
燥渴,二便秘结,此宜承气之时也,而误用之则反矣。论曰∶桂枝下咽,阳盛则毙。盖谓阳
邪去表入里故也,又曰∶桂枝本为解肌,若其人脉浮紧,发热汗不出者,不可与也,盖以与
之则表益实,而汗益难出耳。故申之以常须识此,勿令误也。
【背景信息】
书名:医方考 作者:吴昆 朝代:明代 章节:丸 / 伤寒门第二 / 桂枝汤 类别:方剂
【待处理原文翻译】
(此处原文第一段描述的是另一种名为“透骨草”或类似名称的草药制剂,虽标题为桂枝汤,但正文前段描述的是另一首方剂的制作与功效,后段才叙述桂枝汤。根据原文结构,先翻译前段关于该草药丸剂的描述。)
取这种草(数量不限)。这种草到处都有生长,它的叶子像苍耳子,茎节相对而生。要在五月五日、七月七日、九月九日这三天采集,晒干后,铺在蒸笼中,用好酒层层均匀喷洒,进行蒸煮后再晾晒,如此反复九次,然后研成粉末,用炼过的蜂蜜制成丸子,大小如梧桐子。每次服用五十丸,空腹时用无灰酒送服。
如果病患出现骨节疼痛、身体迟缓软弱无力,此方主治效果良好。
骨节疼痛,属于壅滞之疾,壅滞的东西喜欢通畅。这种药味辛苦而性寒,经过九次蒸煮和九次晾晒,其苦寒的浊重气味都去除了,而药气变得轻清了。《本草》说:“轻清的药物可以去掉实邪”,大概是因为轻清则没有孔窍不能进入,所以能穿透骨骼驱除风邪,强健筋骨。如果没有经过九次蒸煮和九次晾晒,或者蒸晒的次数不满九次,浊重的气味仍然存在,阴浊的本质还在,就不能穿透骨骼驱除风邪从而祛除疾病了。这是阴阳清浊的道理,只有明理的人才能探究明白。(唐代江陵节度使成讷进献的[某]丸,知益州张咏进献的[某]丸,事迹考证并见痛风门。)
序言说:张仲景治疗伤寒的方剂,是众方之祖。从晋朝、唐朝以来,历代的医学智者,无不尊崇它。初学的医者,如果能深入研究这些方剂,识别其中的证候,即使将其应用于杂病的治疗,也是用之不竭的,哪里仅仅是用于伤寒呢!现在选取其中的七十五首方剂,考证如下:
有……
桂枝(三两,洗净) 芍药(三两,炒制) 甘草(二两,生用) 生姜(三两) 大枣(十二枚,擘开)
头痛、发热、汗出、怕风,脉象缓弱的,是太阳中风证,此汤剂主治。
风邪伤人,头部首先受邪,所以导致头痛;风邪在体表则导致表实,所以导致发热;风属阳,卫气也属阳,同类相吸,就会损伤护卫体表的卫气,卫气受伤就无法固摄津液,所以导致汗出;之所以怕风,是因为卫气不能正常护卫肌表;之所以脉象缓弱,是因为卫气不能鼓动血脉。以上这些都是太阳经的证候,所以称为太阳中风。桂枝味辛甘,辛味能解肌表之邪,甘味能充实表气,《内经》说:“辛甘发散为阳”,所以用它来治疗风邪;然而担心它耗散阴气,所以用芍药的酸味来收敛它;辅以甘草、生姜、大枣,这是发表的同时兼有调和里气的意思。这个方剂,只有表邪存在时可以使用;如果阳热邪气由表入里,体内出现燥渴,大小便便秘结,这时应该使用承气汤类方剂的时候,如果误用桂枝汤就会适得其反。论中说:“桂枝汤喝下去,如果阳气盛则会致死。”这是指阳热邪气由表入里的情况。又说:“桂枝本是用来解肌的,如果病人脉象浮紧,发热且不出汗,不可给予桂枝汤”,因为如果给予它,会使表气更加闭塞,汗液更加难以排出。所以再次强调要常常记住这一点,不要弄错了。
[Background Information]
Book: Yi Fang Kao (Examination of Medical Formulas)
Author: Wu Kun
Dynasty: Ming Dynasty
Chapter: Pills / Shaoyang Disease Section II / Guizhi Tang (Cinnamon Twig Decoction)
Category: Formula
[Translation of Original Text]
(The first paragraph of the original text describes a different herbal pill preparation, likely involving *Spatholobus* or similar herbs known for penetrating bones, although the section title is Guizhi Tang. The latter part discusses Guizhi Tang. Following the original structure, the translation proceeds accordingly.)
Take this herb (quantity unrestricted). This herb grows everywhere; its leaves resemble those of *Xanthium sibiricum* (Cang'er), growing in opposite pairs on the stem. It should be harvested on the fifth day of the fifth lunar month, the seventh day of the seventh lunar month, and the ninth day of the ninth lunar month. After sun-drying, spread it into a steamer, sprinkle evenly with good wine layer by layer, steam it, and then dry it again in the sun. Repeat this process nine times. Then, grind it into powder, and make pills using refined honey, sized like *Koelreuteria paniculata* seeds. Take fifty pills per dose, administered orally with non-ash wine on an empty stomach.
For patients suffering from pain in the bone joints, sluggishness, and weakness, this formula is highly effective.
Pain in the bone joints is a condition of obstruction/stagnation (Yong Ji); obstructed substances favor unblocking. This herb has a pungent and bitter taste and a cold nature. Through nine steamings and nine sun-dryings, its heavy, turbid bitter-cold flavors are removed, leaving only its light and clear qi. The *Bencao* (Materia Medica) states: "Light and clear substances can remove excess/real pathogens." Generally, because it is light and clear, it penetrates every orifice, thus enabling it to penetrate the bones, expel wind, and strengthen the sinews and bones. If not subjected to nine steamings and nine sun-dryings, or if the number of steamings/dryings does not reach nine, the turbid flavors remain, and the yin/turbid essence persists. Consequently, it cannot penetrate the bones, expel wind, or cure the disease. This illustrates the principle of yin/yang and clear/turbid qi, which only the enlightened can comprehend. (The [Name] Pill presented by Cheng Ne, Military Commissioner of Jiangling in the Tang Dynasty, and the [Name] Pill presented by Zhang Yong, Prefect of Yizhou, are documented in the Wind-Pain Section.)
Preface says: Zhang Zhongjing's formulas for treating Cold Damage (Shanghan) are the ancestors of all formulas. From the Jin and Tang dynasties onwards, medical scholars of successive dynasties have all revered them. Novice practitioners who can thoroughly investigate these formulas and recognize their syndromes will find them endlessly applicable even in treating miscellaneous diseases, not merely limited to Cold Damage! Here, seventy-five formulas are selected and examined as follows:
There are...
Guizhi Tang (Cinnamon Twig Decoction):
Guizhi (Cinnamomi Ramulus) - 3 liang, washed
Shaoyao (Paeoniae Radix Alba) - 3 liang, stir-fried
Gancao (Glycyrrhizae Radix et Rhizoma) - 2 liang, raw
Shengjiang (Zingiberis Rhizoma Recens) - 3 liang
Dazao (Jujubae Fructus) - 12 pieces, split open
Headache, fever, sweating, aversion to wind, and a moderate pulse indicate Taiyang Wind Strike (Taiyang Zhongfeng). This decoction is indicated.
When wind pathogen attacks the human body, the head is affected first, causing headache; when wind is at the exterior, it causes exterior excess, leading to fever; wind belongs to Yang, and Wei Qi (Defensive Qi) also belongs to Yang. Like attracts like, so it damages the Wei Qi that protects the exterior. When Wei Qi is damaged, it fails to secure and retain body fluids, resulting in sweating; the aversion to wind occurs because Wei Qi cannot properly protect the surface; the moderate pulse results because Wei Qi lacks the strength to propel the blood vessels. All the above are Taiyang syndrome manifestations, hence termed Taiyang Wind Strike. Guizhi has a pungent and sweet flavor. Pungency can resolve the muscle layer, while sweetness can consolidate the exterior. The Classics state: "Pungent and sweet disperse and generate Yang." Therefore, it is used to treat wind. However, fearing it might scatter Yin Qi, Sour Shaoyao is used to astringe it. Assisted by Gancao, Shengjiang, and Dazao, this formula embodies the intent of releasing the exterior while harmonizing the interior. This formula is suitable only when exterior pathogens exist; if Yang heat pathogen moves from the exterior to the interior, causing internal dryness, thirst, and constipation of both bowels, one should use Chengqi Tang (Gut-Harmonizing Decoction) at that time. Misusing Guizhi Tang would be counterproductive. The Treatise states: "If Guizhi Tang is swallowed when Yang is excessive, death may ensue." This refers to the situation where Yang heat pathogen has moved from the exterior to the interior. It also states: "Guizhi is originally for resolving the muscle layer. If the patient's pulse is floating and tight, with fever but no sweating, it must not be given," because administering it would further close the exterior and make sweating even more difficult. Thus, it is reiterated: "You must always remember this, do not err."