(仲景)
治阳明病脉浮发热,渴欲饮水,小便不通(成氏曰∶脉浮发热,上焦热也;渴欲饮水,
中焦热也;小便不利,热结下焦,津液不通也。《准绳》曰∶此浮字误也,是脉字下脱一不
字也
泽
寒
不
昂
明篇,亦用治少阴渴利,取其降火行水,则利自止,烦渴自退,乃泻少阴之腑,以安少阴之
经
药乎?且改脉浮为不浮,方书中无此文法)∶少阴病下利六七日,咳而呕渴,心烦不得眠下
利不渴者,里寒也;渴者,阳邪入里;心烦不眠,知挟热也;咳而渴呕,有停饮也;渴而(下
利,知小便必不利,是热邪已入膀胱也,宜利小便,则热降而便实;通治湿热黄胆,口渴溺
赤)。
猪苓 茯苓 泽泻 滑石 阿胶(各一两)
此足太阳、阳明药也。热上壅则下不通,下不通热益上壅;又湿郁则为热,热蒸更为湿
,故
泽
胶
曰∶以诸药过燥,故又加阿胶以存津液(按∶徐之才曰∶燥可去湿,桑白皮、赤小豆之类是
也。王好古曰∶滑石为至燥之剂。盖皆以行水之药为燥,而不以燥热之药为燥也。故陶隐居
欲于十剂之外加寒热二剂,愚所着《本草备要》,则以热药为燥剂,而以行水属通剂矣。五
苓泻湿胜,故用桂术;猪苓泻热胜,故用滑石)。
(张仲景)
治疗阳明病,脉象浮、发热,口渴想喝水,小便不通畅。(成无己说:脉浮发热,是上焦有热;口渴想喝水,是中焦有热;小便不利,是热邪结聚在下焦,津液运行不畅。《准绳》说:这里的“浮”字是错误的,应该是“脉”字下面脱漏了一个“不”字。在《伤寒论·明篇》中,也用于治疗少阴病的口渴下利,取其降火行水的作用,那么下利自然停止,烦渴自然消退,这是通过泻少阴之腑来安定少阴之经的方法吗?况且将脉浮改为不浮,方书里没有这种行文法度。)
少阴病,下利六七天,咳嗽且呕吐、口渴,心烦不得入睡。(如果下利但不口渴,是里寒证;口渴的,是阳邪入里;心烦失眠,知道夹杂热邪;咳嗽、口渴且呕吐,是有停饮;如果口渴而伴有下利,知道小便一定不通畅,这是热邪已经传入膀胱,适宜通利小便,那么热势下降而大便自实;通用治疗湿热黄疸,口渴、尿色红赤。)
这是足太阳、足阳明经的药物。热气向上壅滞则下部不通畅,下部不通畅热气更加向上壅滞;另外湿气郁结就会化热,热气蒸腾又加重湿气。(徐之才说:因为各种药物过于燥烈,所以又加入阿胶以保存津液。按:徐之才说:燥性可以去除湿气,如桑白皮、赤小豆之类。王好古说:滑石是极燥的药物。大概都是把行水利水的药视为燥,而不把燥热的药视为燥。所以陶隐居想要在十剂之外增加寒、热两剂,我编写的《本草备要》中,则将热药归为燥剂,而把行水利水的药归为通剂。五苓散用于湿胜,所以用桂枝、白术;猪苓汤用于热胜,所以用滑石)。
(Zhang Zhongjing)
Treats Yangming disease presenting with a floating pulse, fever, thirst with desire to drink water, and dysuria (Cheng Wuji states: A floating pulse and fever indicate heat in the Upper Jiao; thirst with desire to drink indicates heat in the Middle Jiao; dysuria indicates heat binding in the Lower Jiao with blocked fluid metabolism. *Zhunsheng* states: The character "floating" here is erroneous; it should be that the character "pulse" is missing the character "not" below it. In the *Ming Pian* of the *Shanghan Lun*, it is also used to treat Shaoyin disease with thirst and diarrhea, taking advantage of its ability to descend fire and promote water metabolism, thereby stopping diarrhea and relieving irritability and thirst. Is this a method of draining the Fu organ of Shaoyin to calm the Jing channel of Shaoyin? Moreover, changing "floating pulse" to "non-floating pulse" has no precedent in formula literature.)
Shaoyin disease with diarrhea for six or seven days, accompanied by cough, vomiting, thirst, irritability, and insomnia. (If diarrhea occurs without thirst, it is an interior cold syndrome; if there is thirst, yang pathogenic factors have entered the interior; irritability and insomnia indicate the presence of heat pathogens; cough, thirst, and vomiting indicate retained fluids; if there is thirst accompanied by diarrhea, it can be inferred that urination must be difficult, indicating that heat pathogens have entered the Bladder. It is appropriate to promote diuresis, so that heat descends and stool solidifies. It is also generally used to treat damp-heat jaundice with thirst and dark red urine.)
Zhu Ling (Polyporus), Fu Ling (Poria), Ze Xie (Alisma Rhizome), Hua Shi (Talcum), E Jiao (Donkey-hide Gelatin) (each 1 liang).
This prescription acts on the Foot-Taiyang and Foot-Yangming channels. When heat obstructs upward, flow downward is blocked; when flow downward is blocked, heat further obstructs upward. Furthermore, dampness stagnation generates heat, and steaming heat exacerbates dampness. (Xu Zhicai states: Because various herbs are overly drying, Donkey-hide Gelatin is added to preserve body fluids. Note: Xu Zhicai stated that dryness can remove dampness, such as Sang Bai Pi (Mori Cortex) and Chi Xiao Dou (Vigna angularis). Wang Haogu stated that Talcum is an extremely drying agent. Generally, they regarded diuretic herbs as drying, rather than heat-drying herbs. Therefore, Tao Hongjing wished to add Cold and Heat categories outside the Ten Categories; in my *Bencao Bei Yao*, I classified heat herbs as drying agents and diuretics as unblocking agents. Wu Ling San addresses excessive dampness, thus using Gui Zhi (Cinnamomi Ramulus) and Bai Zhu (Atractylodis Macrocephalae Rhizome); Zhu Ling Tang addresses excessive heat, thus using Hua Shi (Talcum)).