葛根(半斤) 黄连 黄芩(各三两) 甘草(炙,二两)
水八升,先煮葛根,减二升,纳诸药,煮二升,分温再服。
柯韵伯曰∶外热不除是表不解,下利不止是里不解,病因则同。一以微弱之脉,而心痞
硬,
而辨
解表
本缓
注下
除喘
者殊
上条脉证是阳虚,虽协热于外,而里则虚寒;下条脉证是阳盛,虽下利不止,而表里俱
实。
之上
中亦能
治太阳误下,邪热入里,脉促,喘而下利。
葛根(半斤) 甘草 黄芩(各二两) 黄连(三两)
上四味,以水八升,先煮葛根,减二升,纳诸药,煮取二升,去滓,分温再服。
喻嘉言曰∶太阳病原无里症,但当用桂枝解外。若反下之,则邪热之在太阳者,未入阳
明之
用葛
太阳
服桂枝汤,或下之,仍头项强痛,翕翕发热,无汗,心下满微痛,小便不利者,桂枝去
桂加
桂枝汤去桂,加白术、茯苓各三两,减芍药一两。
柯韵伯曰∶汗出不彻,而遽下之,表证仍在,而反无汗,更见心下满痛,此谓有表里证
矣。
若
之
芍
可
本
由
便
治太阳、少阳合病,自下利者。若呕者,加半夏、生姜。
黄芩 甘草 芍药(各三两) 大枣(十二枚)
上四味,以水一斗,煮取三升,去滓,温服一升,日再服,夜一服。呕者加半夏半斤,
生姜
程郊倩曰∶此之合病者,头痛,胸满,口苦,咽干,目眩,或往来寒热,脉或大而弦。
半表
虚,
柯韵伯曰∶太阳、少阳合病,是热邪已入少阳之里,胆火上逆,移热于脾,故自下利。
与黄
非胃
葛根(半斤) 黄连 黄芩(各三两) 甘草(炙,二两)
用水八升,先煮葛根,水量减少二升后,加入其他药物,再煮至二升,分两次温服。
柯韵伯说:体表发热不退是表证未解,腹泻不止是里证未解,病因相同。但脉象微弱、心下痞硬、注下(严重腹泻)、除喘等症状却大不相同。
上一条条文中的脉证属于阳虚,虽然伴有外热,但体内却是虚寒;下一条条文中的脉证属于阳盛,虽然腹泻不止,但表里都是实证。
治疗太阳病误用下法,邪热内传入里,出现脉促、气喘且腹泻的症状。
葛根(半斤) 甘草 黄芩(各二两) 黄连(三两)
以上四味药,用水八升,先煮葛根,水量减少二升后,加入其他药物,煮取二升,滤去药渣,分两次温服。
喻嘉言说:太阳病原本没有里证,只应当用桂枝汤解除表邪。如果反而使用下法,那么停留在太阳经的邪热,尚未进入阳明经……
服用桂枝汤,或者经过下法治疗后,仍然头项强痛,翕翕发热(形容发热像羽毛覆盖般温和而持续),无汗,心下满闷微痛,小便不利者,适用桂枝去桂加茯苓白术汤。
桂枝汤去掉桂枝,加入白术、茯苓各三两,减少芍药一两。
柯韵伯说:发汗不彻底,就急于使用下法,表证仍在,反而无汗,更见心下满痛,这称为有表里同病的情况。
治疗太阳与少阳合病,自发腹泻的情况。如果有呕吐症状,加入半夏、生姜。
黄芩 甘草 芍药(各三两) 大枣(十二枚)
以上四味药,用水一斗,煮取三升,滤去药渣,每次温服一升,白天服两次,晚上服一次。呕吐者加入半夏半斤,生姜……
程郊倩说:这种合病的情况,表现为头痛,胸满,口苦,咽干,目眩,或往来寒热,脉象或大或弦。
半表半里……虚……
柯韵伯说:太阳与少阳合病,是热邪已经深入少阳之里,胆火向上逆乱,热气转移至脾脏,所以导致自发性腹泻。
并非胃……
Ge Gen (Puerariae Lobatae Radix, half jin) Huang Lian (Coptidis Rhizoma, three liang each) Huang Qin (Scutellariae Radix, three liang each) Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, two liang)
Take eight sheng of water, first boil Ge Gen until the volume decreases by two sheng, then add the remaining herbs, boil until two sheng remain, and divide into two doses to be taken warm.
Ke Yunbo stated: The persistence of external heat indicates that the exterior syndrome is unresolved, while continuous diarrhea indicates that the interior syndrome is unresolved; the etiology is the same. However, the manifestations differ significantly in terms of pulse (weak), epigastric fullness and hardness (xin pi ying), severe diarrhea (zhu xia), and wheezing (chuan).
In the previous clause, the pulse and symptoms indicate Yang deficiency; although there is external heat, the interior is deficient and cold. In the latter clause, the pulse and symptoms indicate Yang excess; although there is continuous diarrhea, both the exterior and interior are excess syndromes.
Treats cases where a Taiyang disease was incorrectly treated with purgation, causing pathogenic heat to enter the interior, resulting in a rapid pulse (cu), wheezing, and diarrhea.
Ge Gen (Puerariae Lobatae Radix, half jin) Gan Cao (Glycyrrhizae Radix et Rhizoma) Huang Qin (Scutellariae Radix, two liang each) Huang Lian (Coptidis Rhizoma, three liang)
Take the above four ingredients, use eight sheng of water, first boil Ge Gen until the volume decreases by two sheng, then add the other herbs, boil to obtain two sheng, strain off the dregs, and divide into two doses to be taken warm.
Yu Jiayan stated: Taiyang disease originally has no interior symptoms and should only be treated with Guizhi Tang (Cinnamon Twig Decoction) to resolve the exterior. If purgation is mistakenly used instead, the pathogenic heat remaining in the Taiyang channel has not yet entered the Yangming channel...
After taking Guizhi Tang or undergoing purgation, if there is still stiffness and pain in the head and nape, mild fever (xi xi fa re - feeling of warmth like feathers covering), absence of sweat, fullness and slight pain in the epigastrium, and difficulty in urination, Guizhi Qu Gui Jia Fuling Baizhu Tang (Cinnamon Twig Decoction without Cinnamon Twig plus Poria and Atractylodes Macrocephala Decoction) is indicated.
Guizhi Tang removes Guizhi (Cinnamomi Ramulus), adds Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuling (Poria), each three liang, and reduces Shaoyao (Paeoniae Radix) by one liang.
Ke Yunbo stated: Sweating was incomplete, and purgation was hastily applied. The exterior syndrome remains, yet there is an absence of sweat, accompanied by fullness and pain in the epigastrium. This is referred to as having simultaneous exterior and interior syndromes.
Treats concurrent diseases of Taiyang and Shaoyang characterized by spontaneous diarrhea. If vomiting occurs, add Banxia (Pinelliae Rhizoma) and Shengjiang (Zingiberis Rhizoma Recens).
Huang Qin (Scutellariae Radix) Gan Cao (Glycyrrhizae Radix et Rhizoma) Shaoyao (Paeoniae Radix, three liang each) Dazao (Jujubae Fructus, twelve pieces)
Take the above four ingredients, use one dou of water, boil to obtain three sheng, strain off the dregs, take one sheng warm per dose, twice during the day and once at night. For vomiting, add Banxia (Pinelliae Rhizoma) half jin, Shengjiang (Zingiberis Rhizoma Recens)...
Cheng Jiaoqian stated: This type of concurrent disease presents with headache, chest fullness, bitter taste in the mouth, dry throat, dizziness, or alternating chills and fever, with a pulse that may be large or wiry (xian).
Half-exterior half-interior... deficiency...
Ke Yunbo stated: Concurrent disease of Taiyang and Shaoyang means the pathogenic heat has entered the interior of Shaoyang. Gallbladder fire rebels upward, transferring heat to the Spleen, thus causing spontaneous diarrhea.
It is not the Stomach...