治阳明病脉浮,发热,渴欲饮水;少阴病下利六七日,咳而呕渴,心烦不得眠者。
猪苓 茯苓 泽泻 滑石 阿胶(各一两)
上五味,以水四升,先煮四味,取二升,去滓,纳阿胶溶,温服七合,日三服。
赵羽皇曰∶仲景制猪苓汤,以行阳明、少阴二经水热,然其旨全以益阴,不专利水。(二
语
津
竭
亦于胃家养阴;佐以二苓之淡渗者行之,既疏浊热,而不留其瘀壅,亦润真阴,而不苦其枯
燥,源清而流有不清者乎?顾太阳利水用五苓者,以太阳职司寒水,故急加桂以温之,是暖
肾以行水之也;阳明、少阴之用猪苓,以二经两关津液,特用阿胶、滑石以润之,是滋养无
形,以行有形也。(妙义环生。)利水虽同,寒温迥别,惟明者知之。
治阳明症,汗出,渴欲饮水,脉洪大浮滑,不恶寒,反恶热。
石膏(一斤碎绵裹) 知母(六两) 甘草(二两炙) 粳米(六合)
上五味,以水一斗,煮米熟汤成,去滓,服一升,日三服。
柯韵伯曰∶邪入阳明,故反恶热,热越故汗出,因邪热烁其精液,故渴欲饮水,邪盛而
实,
又
脾
知母气寒主
之缓其寒,
佐,阴寒之
白虎为西方
甘草、粳米
治太阳中热,汗出,恶寒,身热而渴者, 是也。
知母(六两) 石膏(一斤) 甘草(二两) 粳米(六合) 人参(三两)
上五味,以水如前煮服法。
赵以德曰∶汗出、恶寒、身热而不渴者,中风也;汗出,恶寒,而渴者,中 也。其症
相似
人参汤
恶寒
也。
之源
治疗阳明病,脉象浮,发热,口渴想喝水;以及少阴病,腹泻持续六七天,伴有咳嗽、呕吐、口渴、心烦、无法入睡的症状。
以上五味药,用水四升,先煮前四味药,取汁二升,滤去药渣,加入阿胶使其溶化,每次温服七合,每日服用三次。
赵羽皇说:张仲景制定猪苓汤,是为了疏通阳明经和少阴经的水热之邪,然而其主旨完全在于滋养阴液,并非专门为了利水。(此方在津液枯竭时也能滋养胃家之阴;佐以茯苓、猪苓淡渗利湿之品以引导邪气,既能疏泄浊热,又不遗留瘀滞壅塞,同时滋润真阴,而不致因苦寒导致枯燥,源头清澈了,水流怎么会不清澈呢?反观太阳病利水用五苓散,是因为太阳经主管寒水,所以急加桂枝以温通,这是通过温暖肾脏来行水;而阳明、少阴病用猪苓汤,是因为这两条经络都关乎津液,特意使用阿胶、滑石来滋润,这是通过滋养无形的阴液,来推动有形的邪水排出。(其中妙义层出不穷。)虽然都是利水,但一寒一温截然不同,只有明理的人才能知晓。
治疗阳明证,汗出,口渴想喝水,脉象洪大浮滑,不恶寒,反而怕热。
石膏(一斤,打碎,用棉布包裹)、知母(六两)、甘草(二两,炙烤)、粳米(六合)
以上五味药,用水一斗,煮至米熟汤成,滤去药渣,每次服用一升,每日服用三次。
柯韵伯说:邪气进入阳明经,所以反而怕热,热气外越所以汗出,因为邪热煎熬人体的精液,所以口渴想喝水,邪气盛实,……(原文此处有缺漏或排版错误,仅翻译可见部分逻辑)……知母性寒,主……缓和其寒性,……佐使,阴寒之……白虎为西方……甘草、粳米……
治疗太阳中热(暑病),汗出,恶寒,身体发热且口渴的病症,就是白虎加人参汤。
知母(六两)、石膏(一斤)、甘草(二两)、粳米(六合)、人参(三两)
以上五味药,用水按照前面的方法煎煮并服用。
赵以德说:汗出、恶寒、身体发热但不口渴的,是中风;汗出,恶寒,并且口渴的,是中暍(中暑)。其症状相似,……恶寒……之源。
Treats Yangming disease presenting with a floating pulse, fever, and thirst with desire to drink water; as well as Shaoyin disease presenting with diarrhea for six or seven days, accompanied by cough, vomiting, thirst, irritability, and inability to sleep.
Zhu Ling (Polypori), Fuling (Poria), Zexie (Alismatis Rhizoma), Huashi (Talcum), Ejiao (Colla Corii Asini) (each 1 liang).
Take the above five herbs, add four sheng of water, first decoct the first four herbs, reduce to two sheng, strain off the dregs, add Ejiao until dissolved, take warm, seven ge per dose, three times daily.
Zhao Yuhuang stated: Zhang Zhongjing formulated Zhu Ling Tang to circulate water-heat in the Yangming and Shaoyin meridians; however, its main purport lies entirely in nourishing Yin, not merely in promoting diuresis. (In cases where body fluids are exhausted, it also nourishes the Yin of the Stomach system; assisted by the bland-draining properties of Fuling and Zhu Ling to guide the pathogen, it both disperses turbid heat without leaving stasis and obstruction, and moistens True Yin without causing dryness through bitter-cold damage. If the source is clear, how can the flow be turbid? Conversely, when treating water retention in Taiyang disease with Wu Ling San, it is because Taiyang governs cold-water metabolism, thus Gui Zhi is urgently added to warm it, which is warming the Kidney to move water; whereas using Zhu Ling Tang for Yangming and Shaoyin diseases is because these two meridians concern body fluids, specifically employing Ejiao and Huashi to moisten them. This is nourishing the formless [Yin] to move the formed [pathogenic water]. (Profound meanings arise continuously.) Although both promote diuresis, one is cold and the other warm, differing significantly; only those with clarity of understanding know this.
Treats Yangming syndrome presenting with sweating, thirst with desire to drink water, a surging-large-floating-slippery pulse, aversion to cold absent but aversion to heat present.
Shi Gao (Gypsum Fibrosum) (one jin, crushed, wrapped in cotton), Zhimu (Anemarrhenae Rhizoma) (six liang), Gancao (Glycyrrhizae Radix et Rhizoma Preparatum) (two liang, honey-fried), Jingmi (Oryza Sativa) (six he).
Take the above five herbs, add ten dou of water, decoct until the rice is cooked and the soup is ready, strain off the dregs, take one sheng per dose, three times daily.
Ke Yunbo stated: When pathogens enter the Yangming meridian, there is aversion to heat; because heat escapes outward, there is sweating; because pathogenic heat scorches essence and fluids, there is thirst with desire to drink water; the pathogen is abundant and excess... [Text fragment]: Zhimu is cold in nature and governs... to moderate its coldness... assisting... yin-cold... Baihu represents the West... Gancao, Jingmi...
Treats Taiyang Zhongre (Heatstroke/Sunstroke) presenting with sweating, aversion to cold, body heat, and thirst; this refers to [Baihu Jia Renshen Tang].
Zhimu (Anemarrhenae Rhizoma) (six liang), Shi Gao (Gypsum Fibrosum) (one jin), Gancao (Glycyrrhizae Radix et Rhizoma) (two liang), Jingmi (Oryza Sativa) (six he), Renshen (Ginseng Radix) (three liang).
Take the above five herbs, decoct and administer according to the previous method.
Zhao Yi de stated: Sweating, aversion to cold, body heat but no thirst indicates Wind-stroke (Zhong Feng); sweating, aversion to cold, and thirst indicate Heatstroke (Zhong Shu). Their symptoms are similar... aversion to cold... origin.