赵运使夫人。年五十八岁。于至元甲戌三月中。病脐腹冷疼。相引胁下痛不可忍。反复闷乱。
不得安卧。予以当归四逆汤主之。先灸中庭穴。
【当归四逆汤】治脐腹冷痛。相引腰胯而痛。
当归尾(七分) 附子(炮) 官桂 茴香(炒)
柴胡(各五分) 芍药(四分) 茯苓 玄胡索
川楝子(各三分。酒煮) 泽泻(二分)
上十味 咀。作一服。水二盏半。煎至一盏。去渣。温服。空心食前。数服而愈。
论曰。难经云。任之为病。内结七疝。此寒积所致也。内经云。寒淫于内。治以辛热、佐以苦
温。以附子、官桂
甘辛大热。助阳退阴、用以为君。玄胡、茴香辛温。除下焦虚寒当归辛温。和血止痛。故以为臣。
芍药之酸寒。补中焦之气。又防热药损其肝温。泽泻咸平。茯苓甘平。去膀胱中留垢。川楝子苦寒
。酒煮之止痛。又为引用。乃在下者引而竭之之意也。柴胡苦平。行其本经。故以为使也。中庭
一穴。在膻中下一寸六分陷者中。任脉气所发。可灸五壮。针入三分。或灸二七壮、三七壮效。
【升麻葛根汤】治大人小儿时气温疫。头痛发热。肢体烦疼。
升麻 甘草 白芍药(各十两) 葛根(十五两)
上四味锉碎。每服三钱。水一盏半。煎八分。稍热服。不以时。日二三服。
【惺惺散】治小儿风热疮疹。伤寒时气。头痛壮热。目涩多睡。咳嗽喘粗。鼻塞清涕。
人参 细辛 栝蒌根 茯苓
白术 甘草 桔梗(各一两半)
上七味为末。每服一钱。水一小盏。入薄荷三叶。同煎。至四分。温服。如要和气。入生姜煎
服。不以时。○一法加防风、川芎各一分。同煎。
【人参生犀散】解小儿时气。寒壅咳嗽。痰逆喘满。心忪惊悸。脏腑或秘或泻。调胃进食
。又主一切风热。服寻常凉药即泻而减食者。(钱氏方)
前胡(七钱) 杏仁(去皮尖。麸炒) 桔梗(各五钱) 人参(三钱)
甘草(炙。二钱)
上为粗末。每服二钱。水一盏。煎至六分。去渣。温服。食后。
【大青膏】治伤风吐泻。身温凉热。(匕谓匙也。应服药多少。逐方说不尽。并临时以意
加减之。钱氏方)
天麻(一分末) 白附(生末。一钱半) 青黛(一钱。研) 蝎尾(去毒。半钱)
天竺黄(一字) 乌梢蛇肉(酒浸焙末。半钱) 麝香(一字匕)
朱砂(一字)
上再研细和匀。生蜜和成膏。每服半皂角子大至一皂角子大。月中儿粳米大。同牛黄膏、温薄
荷水化一处服之。五岁以上。同甘露散服之。
【天麻防风丸】治一切惊风。身体壮热。多睡惊悸。手足抽掣。痰涎不利。及风温邪热。
干蝎(炒) 白僵蚕(炒。各半两) 天麻 防风
人参(各一两) 朱砂 雄黄(各二钱半) 麝香(一钱)
甘草(二钱半) 牛黄(一钱)
上十味为末。蜜丸桐子大。每服一丸至二丸。薄荷汤化下。不以时。
【涂囟法】治伤寒。(钱氏方)
麝香(研。一字) 牛黄(末一字) 青黛(末。一字匕) 蜈蚣(末。半字)
蝎尾(去毒炒末。半字) 薄荷(半字匕)
上同研匀。熟枣肉剂成膏。新绵上涂匀。贴囟上四方。可出一指许。火上炙手热。频熨。百日
里内外儿。可用此涂。
【浴体法】(钱氏方)
青黛(三钱) 天麻(末。二钱) 乌梢肉(酒浸焙末。三钱) 蝎尾(去毒炒)
朱砂(研。各半钱) 白矾(三钱) 麝香(一字)
上七味。同研匀。入白矾末三钱和匀。每用三钱。水三碗。桃枝一握。并叶五七枚同煎十沸。
温热得所。浴之。勿浴背上。
【紫霜丸】治乳哺失节。宿滞不化。胸膈痞满。呕吐恶心。或大便酸臭。乳食不消。
代赭石(醋淬。细研) 赤石脂(各一两) 杏仁(去皮尖炒别研。五十枚)
巴豆(去皮心。出油炒研。三十粒)
上为末和匀。汤浸蒸饼。丸如黄米大。儿生三十日外。可服一丸。一岁至三岁可服二丸至三丸
。皂角子煎汤送下。米饮亦得。微利为度。未利再服。更量虚实加减。
【消积丸】(钱氏方)
砂仁(十二个) 丁香(九个) 乌梅(三个) 巴豆(二个去心膜。出油)
上为末。糊丸如黍米大。三岁以上三五丸。以下二三丸。温水送下。无时。
【浓肠丸】治小儿失乳。以食饲之。未有食肠。不能克化。而生腹胀。四肢瘦弱。或病色
无常。
苍术(三钱。炒) 神曲(五分。炒) 大麦 (五分。炒) 橘皮(去白)
半夏(汤洗) 枳实(炒。各三分) 人参 浓朴(姜制)
青皮(各二分)
上为末。糊丸如麻子大。每服二十丸。温水送下。食前。忌饱食。
赵运使的夫人,五十八岁。在至元甲戌年三月期间,出现脐腹部冷痛,疼痛牵连胁下,痛感剧烈难以忍受,反复感到烦闷扰乱,无法安稳躺卧。我使用当归四逆汤(Danggui Sini Decoction)作为主治方剂。先对中庭穴(Zhongting, CV10)进行艾灸治疗。
【当归四逆汤】用于治疗脐腹部冷痛,疼痛牵连腰胯部而痛。
配方:当归尾(七分)、附子(炮制)、官桂、茴香(炒制)、柴胡、芍药(各五分)、茯苓、玄胡索、川楝子(各三分,酒煮)、泽泻(二分)。
以上十味药材,切碎,为一服量。加水二盏半,煎煮至一盏,去渣,温服。空腹或进食前服用,数服后即可痊愈。
论述说:《难经》记载:“任脉为病,内结七疝”,这是由寒邪积聚所致。《内经》记载:“寒邪淫溢于体内,用辛热药物治疗,辅以苦温药物。”因此,使用附子、官桂,性味甘辛大热,能助阳退阴,作为君药。玄胡索、茴香性味辛温,能祛除下焦虚寒;当归性味辛温,能和血止痛,故作为臣药。芍药性味酸寒,能补益中焦之气,又能防止热药损伤肝气;泽泻性味咸平,茯苓性味甘平,能去除膀胱中的积滞污垢;川楝子性味苦寒,经酒煮后能止痛,又作为引经药,体现了“在下者引而竭之”的意思。柴胡性味苦平,能行其本经之气,故作为使药。中庭穴位于膻中穴下一寸六分的凹陷处,是任脉之气所发之处,可灸五壮,针刺入三分,或者灸十四壮、二十一壮有效。
【升麻葛根汤】用于治疗成人和儿童的时气温疫,症状包括头痛发热、肢体烦疼。
配方:升麻、甘草、白芍药(各十两)、葛根(十五两)。
以上四味药材锉碎。每次服用三钱,加水一盏半,煎煮至八分,稍热时服用。不限时间,每日二三次服用。
【惺惺散】用于治疗小儿风热疮疹、伤寒时气,症状包括头痛壮热、眼睛干涩多睡、咳嗽喘粗、鼻塞流清涕。
配方:人参、细辛、栝蒌根、茯苓、白术、甘草、桔梗(各一两半)。
以上七味药材研为末。每次服用一钱,加水一小盏,加入三片薄荷,共同煎煮至四分,温服。如果要调和胃气,加入生姜煎服。不限时间。另一方法:加防风、川芎各一分,共同煎煮。
【人参生犀散】用于解除小儿时气,治疗寒壅咳嗽、痰逆喘满、心慌惊悸、脏腑或便秘或腹泻,调理胃气促进进食。也主治一切风热,对于服用普通凉药即导致腹泻且食欲减退者适用。(出自钱乙方)
配方:前胡(七钱)、杏仁(去皮尖,麸炒)、桔梗(各五钱)、人参(三钱)、甘草(炙,二钱)。
以上药材研为粗末。每次服用二钱,加水一盏,煎煮至六分,去渣,温服,饭后服用。
【大青膏】用于治疗伤风引起的吐泻,身体温度忽冷忽热。(“匕”指勺子。服药剂量多少,在各方的说明中未尽述,应临时根据情况加减。)(出自钱乙方)
配方:天麻(一分末)、白附子(生末,一钱半)、青黛(一钱,研细)、蝎尾(去毒,半钱)、天竺黄(一字)、乌梢蛇肉(酒浸焙干研末,半钱)、麝香(一字匕)、朱砂(一字)。
以上药材再次研细混合均匀,用生蜜调和成膏状。每次服用半个皂角子大到一个大皂角子大小,一个月大的婴儿如粳米大小。与牛黄膏、温薄荷水一起化开服用。五岁以上儿童,与甘露散一起服用。
【天麻防风丸】用于治疗一切惊风,症状包括身体壮热、多睡惊悸、手足抽搐、痰涎不利,以及风温邪热。
配方:干蝎(炒制)、白僵蚕(炒制,各半两)、天麻、防风、人参(各一两)、朱砂、雄黄(各二钱半)、麝香(一钱)、甘草(二钱半)、牛黄(一钱)。
以上十味药材研为末,蜂蜜炼制成梧桐子大小的丸剂。每次服用一至二丸,用薄荷汤化开送服。不限时间。
【涂囟法】用于治疗伤寒。(出自钱乙方)
配方:麝香(研细,一字)、牛黄(末,一字)、青黛(末,一字匕)、蜈蚣(末,半字)、蝎尾(去毒炒末,半字)、薄荷(半字匕)。
以上药材共同研匀,用熟枣肉制成膏状。涂在新棉布上,贴在囟门上四方,范围可出一指许。用手在火上烤热,频繁熨烫。适用于百日内的婴儿内外使用。
【浴体法】(出自钱乙方)
配方:青黛(三钱)、天麻(末,二钱)、乌梢肉(酒浸焙干末,三钱)、蝎尾(去毒炒制)、朱砂(研细,各半钱)、白矾(三钱)、麝香(一字)。
以上七味药材共同研匀,加入白矾末三钱混合均匀。每次取三钱,加水三碗,桃枝一握及叶子五七枚,共同煎煮十沸。水温适宜温热时,给患儿洗浴。不要洗背部。
【紫霜丸】用于治疗哺乳不规律,宿食停滞不化,胸膈痞满,呕吐恶心,或大便酸臭,乳食不消。
配方:代赭石(醋淬,细研)、赤石脂(各一两)、杏仁(去皮尖炒后别研,五十枚)、巴豆(去皮心,出油炒研,三十粒)。
以上药材研为末混合均匀,用汤浸蒸饼制作,丸剂如黄米大小。婴儿出生三十日后可服用一丸,一岁至三岁可服用二至三丸。用皂角子煎汤送下,米饮也可以。以轻微腹泻为度,未腹泻可再服,更需根据虚实情况加减剂量。
【消积丸】(出自钱乙方)
配方:砂仁(十二个)、丁香(九个)、乌梅(三个)、巴豆(二个去心膜,出油)。
以上药材研为末,糊丸如黍米大小。三岁以上服用三至五丸,以下服用二至三丸。温水送下,不限时间。
【浓肠丸】用于治疗小儿断奶过早,以食物喂养,但肠胃尚未发育完全,不能消化,从而产生腹胀,四肢瘦弱,或面色无常。
配方:苍术(三钱,炒制)、神曲(五分,炒制)、大麦(五分,炒制)、橘皮(去白)、半夏(汤洗)、枳实(炒制,各三分)、人参、浓朴(姜制)、青皮(各二分)。
以上药材研为末,糊丸如麻子大小。每次服用二十丸,温水送下,饭前服用。忌饱食。
Madam Zhao, wife of the Transport Commissioner, was fifty-eight years old. In the third month of the Ji Xu year of Zhiyuan, she suffered from cold pain in the umbilical and abdominal regions, with pain radiating to the hypochondrium, unbearable in intensity. She repeatedly felt restless and disturbed, unable to lie down peacefully. I prescribed Danggui Sini Tang (Danggui Sini Decoction) as the primary treatment. First, moxibustion was applied to the Zhongting (CV10) acupoint.
[Danggui Sini Tang] Treats cold pain in the umbilical and abdominal regions, with pain radiating to the waist and hips.
Ingredients: Radix Angelicae Sinensis Tail (7 fen), Prepared Radix Aconiti (Pao), Cinnamon Twig (Guan Gui), Fennel Fruit (Chao), Bupleuri Radix (Chaihu), White Peony Root (Shaoyao) (each 5 fen), Poria (Fuling), Corydalis Rhizome (Yanhusuo), Toosendan Fruit (Chuanlianzi) (each 3 fen, decocted in wine), Alisma Rhizome (Zexie) (2 fen).
The above ten herbs are coarsely crushed. This constitutes one dose. Add two and a half cups of water, decoct until one cup remains, strain, and take warm. Take on an empty stomach or before meals. Recovery occurs after several doses.
Discussion: The *Nan Jing* states, "When the Ren Mai is diseased, internal binding of the seven types of hernia occurs." This is caused by the accumulation of Cold. The *Nei Jing* states, "When Cold overflows internally, treat it with Acrid-Hot herbs, assisted by Bitter-Warm herbs." Therefore, Aconite and Cinnamon Twig, being Sweet-Acrid and Greatly Hot, assist Yang and repel Yin, serving as the Sovereign herbs. Corydalis and Fennel, being Acrid-Warm, dispel deficiency-Cold in the Lower Jiao; Angelica, being Acrid-Warm, harmonizes Blood and alleviates pain, serving as the Minister herbs. White Peony, being Sour-Cold, tonifies Qi in the Middle Jiao and prevents the hot herbs from damaging Liver Yin. Alisma, being Salty-Neutral, and Poria, being Sweet-Neutral, remove turbid residues in the Bladder. Toosendan, being Bitter-Cold, when decocted in wine, alleviates pain and serves as a guiding herb, embodying the principle of "drawing out what is below." Bupleuri, being Bitter-Neutral, circulates Qi in its own meridian, serving as the Envoy herb. The Zhongting (CV10) acupoint is located 1.6 cun below Danzhong (CV17) in the depression. It is where the Qi of the Ren Mai emerges. Moxibustion of five cones is applicable, or needle insertion to a depth of 3 cun. Alternatively, moxibustion of fourteen or twenty-one cones is effective.
[Shengma Gegen Tang] Treats seasonal warm epidemics in adults and children, characterized by headache, fever, and painful limbs.
Ingredients: Cimicifugae Rhizoma (Shengma), Licorice Root (Gancao), White Peony Root (Baishaoyao) (each 10 liang), Kudzu Root (Gegen) (15 liang).
The above four herbs are chopped. Each dose is 3 qian. Add one and a half cups of water, decoct until 8 fen remains. Take slightly warm. Take at any time, two to three times daily.
[Xingxing San] Treats wind-heat sores and rashes in children, and cold damage/seasonal qi, characterized by high fever headache, dry eyes, excessive sleepiness, coughing with coarse breathing, nasal congestion with clear discharge.
Ingredients: Ginseng Radix (Renshen), Asarum Root (Xixin), Trichosanthes Root (Gualougen), Poria (Fuling), Atractylodes Macrocephala Rhizome (Baizhu), Licorice Root (Gancao), Platycodon Root (Jiegeng) (each 1.5 liang).
The above seven herbs are powdered. Each dose is 1 qian. Add one small cup of water and three leaves of Mint, decoct together until 4 fen remains. Take warm. To harmonize the Stomach Qi, add Ginger and decoct. Take at any time. Another method: add Saposhnikovia Root (Fangfeng) and Ligusticum Rhizome (Chuanxiong), each 1 fen, and decoct together.
[Renshen Shengxi San] Resolves childhood seasonal qi disorders, treating cold obstruction cough, rebellious phlegm with wheezing and fullness, palpitations and fright, bowel irregularities (constipation or diarrhea), regulates Stomach Qi and promotes appetite. Also treats all wind-heat conditions, specifically for cases where ordinary cooling herbs cause diarrhea and reduced appetite. (Formula from Qian Yi)
Ingredients: Peucedani Radix (Qianhu), Apricot Seed (Xingren) (dehulled, bran-fried), Platycodon Root (Jiegeng) (each 5 qian), Ginseng Radix (Renshen) (3 qian), Licorice Root (Gancao) (roasted, 2 qian).
The above are made into a coarse powder. Each dose is 2 qian. Add one cup of water, decoct until 6 fen remains, strain, and take warm after meals.
[Daqing Gao] Treats vomiting and diarrhea due to Wind-Cold, and alternating body temperatures. ("Bi" refers to a spoon. Dosages vary by formula and should be adjusted according to circumstances.) (Formula from Qian Yi)
Ingredients: Gastrodia Rhizoma (Tianma) (1 fen powder), Typhonii Rhizoma (Baifu) (raw powder, 1.5 qian), Indigo Naturalis (Qingdai) (1 qian, ground), Scorpion (Xiewei) (detoxified, 0.5 qian), Bamboo Calculus (Tianzhu Huang) (one character measure), Zaocys (Wushaoshe) meat (wine-soaked, baked, powdered, 0.5 qian), Moschus (Shexiang) (one character measure), Cinnabar (Zhusha) (one character measure).
Grind these finely and mix uniformly. Form into a paste using raw honey. Each dose ranges from half to one soybean pod size. For infants under one month, use rice-grain size. Dissolve together with Calculus Bovis (Niuhuang) paste and warm Mint water. For children over five years old, take with Ganlu San.
[Tianma Fangfeng Wan] Treats all types of convulsive disorders, characterized by high fever, excessive sleepiness, palpitations, limb twitching, difficult expectoration of phlegm, and wind-warmth pathogenic heat.
Ingredients: Dry Scorpion (Ganye) (fried), Bombyx Batryticatus (Baijiangcan) (fried, each 0.5 liang), Gastrodia Rhizoma (Tianma), Saposhnikovia Root (Fangfeng), Ginseng Radix (Renshen) (each 1 liang), Cinnabar (Zhusha), Realgar (Xionghuang) (each 2.5 qian), Moschus (Shexiang) (1 qian), Licorice Root (Gancao) (2.5 qian), Calculus Bovis (Niuhuang) (1 qian).
The above ten herbs are powdered and formed into pills the size of paulownia seeds using honey. Each dose is one to two pills, dissolved in Mint decoction and taken. Take at any time.
[Tu Xin Fa] Treats cold damage. (Formula from Qian Yi)
Ingredients: Moschus (Shexiang) (ground, one character measure), Calculus Bovis (Niuhuang) (powder, one character measure), Indigo Naturalis (Qingdai) (powder, one character measure), Centipede (Wugong) (powder, half character measure), Scorpion (Xiewei) (detoxified, fried, powdered, half character measure), Mint (Bohe) (half character measure).
Grind these uniformly. Mix with cooked date flesh to form a paste. Apply evenly onto new cotton cloth and paste onto the anterior fontanelle in four directions, extending about one finger's width. Heat the cloth by warming hands over fire and frequently apply warmth. Suitable for infants within one hundred days.
[Yu Ti Fa] (Formula from Qian Yi)
Ingredients: Indigo Naturalis (Qingdai) (3 qian), Gastrodia Rhizoma (Tianma) (powder, 2 qian), Zaocys (Wushao) meat (wine-soaked, baked, powdered, 3 qian), Scorpion (Xiewei) (detoxified, fried), Cinnabar (Zhusha) (ground, each 0.5 qian), Alum (Baifan) (3 qian), Moschus (Shexiang) (one character measure).
Grind the above seven herbs uniformly. Add 3 qian of Alum powder and mix well. Use 3 qian per bath. Add three bowls of water, a handful of Peach branches with five to seven leaves. Decoct for ten boils. Bathe the child when the temperature is suitably warm. Do not bathe the back.
[Zishuang Wan] Treats irregular feeding, retention of undigested food, chest and diaphragm fullness, vomiting and nausea, sour-smelling stool, and indigestion of milk and food.
Ingredients: Haematitum (Daizheshi) (vinegar-quenched, finely ground), Red Kaolin (Chishizhi) (each 1 liang), Apricot Seed (Xingren) (dehulled, fried, separately ground, 50 seeds), Croton Fructus (Badou) (dehulled, de-oiled, fried, ground, 30 seeds).
Powder these and mix uniformly. Make pills using steamed dough soaked in water, sized like yellow millet grains. Infants over thirty days old may take one pill. Children aged one to three may take two to three pills. Administer with Soja Seed Pod decoction or rice drink. Mild purgation is the goal; if no purgation occurs, administer again. Adjust dosage based on deficiency or excess.
[Xiaoji Wan] (Formula from Qian Yi)
Ingredients: Amomum Fructus (Sharen) (12 pods), Clove Ding (Dingxiang) (9 cloves), Dark Plum (Wumei) (3 fruits), Croton Fructus (Badou) (2 seeds, dehulled, de-oiled).
Powder these and make pills using starch paste, sized like mustard seeds. Children over three years old take three to five pills; younger children take two to three pills. Administer with warm water. Take at any time.
[Nongchang Wan] Treats infants weaned too early and fed solid food prematurely, leading to inability to digest due to immature intestines, resulting in abdominal distension, emaciated limbs, and variable complexion.
Ingredients: Atractylodes Rhizoma (Cangzhu) (3 qian, fried), Medicated Leaven (Shenqu) (5 fen, fried), Hordeum Vulgare (Damai) (5 fen, fried), Tangerine Peel (Chenpi) (peeled), Pinellia Tuber (Banxia) (washed in water), Immature Bitter Orange (Zhishi) (fried, each 3 fen), Ginseng Radix (Renshen), Magnolia Bark (Houpo) (ginger-processed), Green Tangerine Peel (Qingpi) (each 2 fen).
Powder these and make pills the size of sesame seeds. Each dose is twenty pills, administered with warm water before meals. Avoid overeating.