消斑青黛饮 治邪热传里,里实表虚,血热不散,热气乘于皮肤而为斑也。
黄连(去毛,一钱) 甘草(五分) 石膏( ,一钱五分) 知母(五分) 柴胡(去芦,五分) 人参
(去芦,五分) 犀角(镑,一钱) 青黛(一钱) 山栀(一钱) 生地(一钱)
大便实者,去人参,加大黄,多寡酌之。
上 咀,水二盅,姜一片,枣二枚,煎之捶法,临服入苦酒一匙调服。
寒温暑三病,有发斑证,而暑斑人多忽之,不知其形与寒温同,或大如豆,或细如线痕,或如蚤点,甚亦有羊
毛疔者,皆宜前药清之。
伤寒伤暑,温凉诸证,皆邪气欺正气也。用药如对敌,药入则邪渐退,药力尽而邪复炽,必一服周时,即详势
诊脉,药对则连进,日夜三五服,以邪退病安为止。此法惟汉张仲景伤寒。隋孙思邈《千金方》中载此。孙云夏月
昼五夜三,冬月昼三夜五,必期病退而后止,如御敌者,愈驱逐愈加精锐,期于荡平而后班师,此万全之胜算也。
自宋以后不传,故取效寡而活人之功疏,愚以此法屡治人,极有神效。
张凤逵之着《伤暑全书》也,翻古人之成案,妙生心之化裁,可谓善于立言者矣。第疫证引说
不明,关系医学非小,虽以东垣之渊通,丹溪之博洽,亦随俗相沿,未有确解,近喻嘉言先生,以
通今博古之才,着开天辟地之论,扫叔和之秽,阐仲景之奥,不剿陈言,独标新义,从来迷谬,涣
然冰释,至于治法,高出千古,直发前人所未发,谁谓今人不及古人之精乎?故附刊之,而以治案
名方,缀于其后,用告业医之士焉。盖天地以生为心,寒热温凉,四气递运,万古不易,人生其间,
感触寒暑而病者,皆其起居无时,饮食不节,气虚体弱,自行犯之,非寒暑之过也。然亦不过千百
之一二耳!若以寒暑为杀厉之气,触之即病,则人无 类久矣,岂天地生人自然之道哉!至非其
时而有其气,谓之不正之气则可,谓之疫气则非也。何也?不正之气,人感之者,有病有不病,未
可一概论也。若夫疫气,则不论富贵贫贱,老幼男女,强弱虚实,沿门合境,传染相同,人无得免
者,此唯大兵大荒之后则有之,而饥馑之年尤甚,流离满野,道 相望,或趋乡镇,或集郡邑,或
聚都城,安置失所,赈济乏术,九重万里,呼吁无门,三五为群,死无虚日,千百一冢,埋藏不深,
掩盖不浓,时至春和,地气转动,浮土塌陷,白骨暴露,血水汪洋,死气尸气,浊气秽气,随地气上
升,混入苍天清净之气,而天地生物之气,变为杀物之气,无形无影,无声无臭,从口从鼻而入,
直犯脏腑,正气闭塞,邪气充斥,顷刻云亡,莫可救药。《说文》云∶疫者民皆病也,厉鬼为灾,斯为
疫耳!《礼记·月令》云∶孟春之月,先王掩骼埋 ,正以是月天气下降,地气上升,诚恐 骼污秽
之气,随天地之气升降,溷合为一,有害人物,故掩埋之。此预补造化,天无功也。盖以人在气交
之中,如鱼在水,一毫渣滓,混杂不得。设川泽泼灰,池溏入油,鱼鲜有得生者。人受疫气,何以
异此!是以自古圣君贤相,参赞化育,燮理阴阳,消弭疫端于平日,捍患御灾,煮粥施药,救济疫
害于临时,人无横夭,世跻雍熙,文人解为泽及枯骨,失其旨矣。讵春月当泽及枯骨,而夏秋冬
之枯骨,遂不当泽及哉!近有好事之辈,设立坛厂,每于小儿出痘之年,购求夭亡尸骸,虽经埋
瘗,亦必刨集如山,架火焚烧,烈焰张炽,腥闻于天,神人掩鼻,毒瓦斯熏蒸,恶味氤氤,流行传染,
以致婴孩生出一等怪症,似痘非痘,似疹非疹,似 非 ,一二日间,即涉危笃。虽有良医,莫能
措手,共相诧愕,咸谓天生灾异,不知致此之由,频年以来,冤枉赤子,何啻数万?离城二三十里,
即无此症,岂非明验与!嗟嗟,异端妖术,惑世诬民,昧者反以为善,聚众哗之,敛财助之,此倡彼
和,奔走若狂,揆之先王掩骼埋 之义,不大相乖舛耶?因序疫症而并及之,以望世之学医者,加
之意焉。
时康熙十四年七月朔渔阳林起龙北海识于补拙斋
消斑青黛饮:治疗邪热传入体内,导致里实表虚、血热郁滞不散,热气侵袭皮肤而形成的斑疹。
黄连(去毛,一钱) 甘草(五分) 石膏(打碎,一钱五分) 知母(五分) 柴胡(去芦头,五分) 人参(去芦头,五分) 犀角(镑成薄片,一钱) 青黛(一钱) 山栀(一钱) 生地(一钱)
以上药材切碎,加水两盅,生姜一片,大枣二枚,煎煮至药汁浓缩如捶打后的状态,临服用醋一匙调匀后服用。
伤寒、温病、暑病这三种疾病,都有出现发斑的症状,但暑病引起的斑疹人们往往忽视,不知道它的形态与伤寒、温病相同,有的大如豆粒,有的细如线痕,有的像跳蚤咬的斑点,严重的也有像羊毛疔那样的,都适宜用前面的药物来清解。
伤寒、伤暑以及温凉等各种证候,都是邪气欺侮正气的表现。用药如同对敌作战,药力进入体内则邪气逐渐消退,药力耗尽时邪气又会复炽,必须在一服药一个时辰内,详细观察病情并诊察脉象,如果药证相符就连续进服,日夜三五次,以邪气退去、病情安定为停止标准。这种方法只有汉代张仲景在《伤寒论》中记载。隋代孙思邈《千金方》中也载有此法。孙思邈说夏季白天服五次夜间服三次,冬季白天服三次夜间服五次,一定要等到病退才停止,就像抵御敌人一样,越驱逐敌人越发精锐,期望彻底平定后才撤军,这是万全的胜利策略。自宋代以后此法失传,所以取效少而救人的功效稀疏,我以此法多次治疗病人,极有神效。
张凤逵撰写《伤暑全书》,翻检古人的成案,运用妙手生心进行化裁,可以说是善于立言的人了。只是对于疫证的引说解释不明确,关系医学非小,虽然以东垣的渊博通达、丹溪的博洽,也随俗沿袭,没有确切解释,近代喻嘉言先生,以通今博古之才,著开天辟地之论,扫除王叔和著作中的污秽,阐发张仲景的奥妙,不抄袭陈言,独标新义,从来的迷谬,涣然冰释,至于治法,高出千古,直发前人所未发,谁说今人不及古人之精呢?所以附刊于此,并将治案名方,缀于其后,用以告知业医之士。天地以生养万物为心,寒热温凉四气递运,万古不变,人生于其间,感触寒暑而生病的,都是起居无时,饮食不节,气虚体弱,自行犯之,不是寒暑的过错。然而也不过是千百中的一二罢了!如果把寒暑当作杀厉之气,接触就生病,那么人类早就灭绝了,这难道是天地生人的自然之道吗!至于非其时而有其气,称为不正之气可以,称为疫气就不对了。为什么呢?不正之气,人感之者,有病有不病,不可一概而论。至于疫气,则不论富贵贫贱,老幼男女,强弱虚实,沿门合境,传染相同,人无得免者,这只有在大战大荒之后才有,而饥馑之年尤其严重,流离满野,道路相望,或趋乡镇,或集郡邑,或聚都城,安置失所,赈济乏术,九重万里,呼吁无门,三五成群,死无虚日,千百一冢,埋藏不深,掩盖不浓,时至春和,地气转动,浮土塌陷,白骨暴露,血水汪洋,死气尸气,浊气秽气,随地气上升,混入苍天清净之气,而天地生物之气,变为杀物之气,无形无影,无声无臭,从口从鼻而入,直犯脏腑,正气闭塞,邪气充斥,顷刻云亡,莫可救药。《说文》说:疫者民皆病也,厉鬼为灾,斯为疫耳!《礼记·月令》说:孟春之月,先王掩骼埋胔,正以是月天气下降,地气上升,诚恐骸骨污秽之气,随天地之气升降,溷合为一,有害人物,故掩埋之。这是预补造化,天无功也。盖以人在气交之中,如鱼在水,一毫渣滓,混杂不得。设川泽泼灰,池溏入油,鱼鲜有得生者。人受疫气,何以异此!是以自古圣君贤相,参赞化育,燮理阴阳,消弭疫端于平日,捍患御灾,煮粥施药,救济疫害于临时,人无横夭,世跻雍熙,文人解为泽及枯骨,失其旨矣。讵春月当泽及枯骨,而夏秋冬之枯骨,遂不当泽及哉!近有好事之辈,设立坛厂,每于小儿出痘之年,购求夭亡尸骸,虽经埋瘗,亦必刨集如山,架火焚烧,烈焰张炽,腥闻于天,神人掩鼻,毒瓦斯熏蒸,恶味氤氤,流行传染,以致婴孩生出一等怪症,似痘非痘,似疹非疹,似癍非癍,一二日间,即涉危笃。虽有良医,莫能措手,共相诧愕,咸谓天生灾异,不知致此之由,频年以来,冤枉赤子,何啻数万?离城二三十里,即无此症,岂非明验与!嗟嗟,异端妖术,惑世诬民,昧者反以为善,聚众哗之,敛财助之,此倡彼和,奔走若狂,揆之先王掩骼埋胔之义,不大相乖舛耶?因序疫症而并及之,以望世之学医者,加之意焉。
时康熙十四年七月朔渔阳林起龙北海识于补拙斋
Xiaoban Qingdai Yin (Spotted-Dispersing Indigo Decoction): Treats conditions where pathogenic heat transmits inward, resulting in interior excess and exterior deficiency, with blood heat stagnating and failing to disperse. The heat qi invades the skin, causing macules (skin eruptions).
Coptidis Rhizoma (Huanglian, 黄连) - de-haired, 1 qian; Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) - 5 fen; Gypsum Fibrosum (Shigao, 石膏) - crushed, 1.5 qian; Anemarrhenae Rhizoma (Zhimu, 知母) - 5 fen; Bupleuri Radix (Chaihu, 柴胡) - de-rhizome, 5 fen; Ginseng Radix (Renshen, 人参) - de-rhizome, 5 fen; Rhinocerotis Cornu (Xijiao, 犀角) - sliced, 1 qian; Indigo Naturalis (Qingdai, 青黛) - 1 qian; Gardeniae Fructus (Shanzhi, 山栀) - 1 qian; Rehmanniae Radix (Shengdi, 生地) - 1 qian.
If the stool is dry and solid, remove Ginseng Radix (Renshen, 人参) and add Rheum Palmatum (Dahuang, 大黄), adjusting the dosage as appropriate.
The above herbs are chopped, decocted with two cups of water, one slice of Zingiberis Rhizoma Recens (Shengjiang, 生姜), and two Jujubae Fructus (Dazao, 大枣), until reduced by boiling. Before administration, mix with one spoonful of vinegar for oral intake.
Shaoyin Cold Damage (Shanghan, 伤寒), Warm diseases (Wenbing, 温病), and Summerheat diseases (Shubing, 暑病) all present with macule eruptions. However, macules caused by summerheat are often overlooked by people. They do not realize that the morphology is similar to that of Shaoyin Cold Damage and Warm diseases: some are as large as beans, some as fine as thread marks, some like flea bites, and severe cases may resemble Yangmao Ding (wool carbuncle). All these should be cleared using the aforementioned prescription.
Shaoyin Cold Damage, Summerheat injury, and various warm/cool syndromes are all manifestations of pathogenic qi bullying healthy qi. Using medicine is like fighting an enemy: when the medicine enters, the pathogen gradually recedes; when the medicinal force exhausts, the pathogen flares up again. Within one shichen (two hours) after a dose, carefully observe the condition and palpate the pulse. If the prescription matches the syndrome, administer consecutively, three to five times day and night, stopping only when the pathogen retreats and the disease stabilizes. This method was recorded by Zhang Zhongjing of the Han Dynasty in his treatise on Shaoyin Cold Damage. Sun Simiao's *Qianjin Fang* from the Sui Dynasty also records this method. Sun stated that in summer, administer five times during the day and three at night; in winter, three times during the day and five at night. One must continue until the disease recedes, just like repelling enemies: the more you drive them back, the fiercer they become, aiming for complete pacification before withdrawing troops. This is the ultimate strategy for victory. After the Song Dynasty, this method was lost, resulting in fewer effective treatments and less merit in saving lives. I have used this method to treat many patients with miraculous effects.
Zhang Fengkui, in writing *Shangshu Quanshu*, reviewed ancient medical cases and skillfully adapted them, demonstrating great eloquence in establishing his discourse. However, his explanation of epidemic diseases is unclear, which is significant for medicine. Even with Li Dongyuan's profound knowledge and Zhu Danxi's erudition, they followed common practices without providing definitive explanations. Recently, Mr. Yu Jiayan, with his talent for integrating past and present, wrote groundbreaking theories, clearing away the obscurities of Wang Shuhe, elucidating the profundities of Zhang Zhongjing, rejecting stale doctrines, and proposing new meanings. Previous confusions were dispelled like melting ice. His therapeutic methods surpass those of antiquity, revealing what predecessors had not yet expressed. Who says modern practitioners are inferior to ancients? Therefore, I append this work, along with treatment cases and prescriptions, to inform medical professionals. Heaven and Earth nurture life; the four Qi (Cold, Heat, Warm, Cool) cycle eternally unchanged. Humans living within this environment fall ill due to exposure to cold or summerheat because of irregular lifestyle and diet, weak Qi and body, offending themselves rather than blaming cold or summerheat. Such instances are rare, one or two in a thousand. If cold and summerheat were lethal pathogens causing immediate illness upon contact, humanity would have perished long ago. Is this the natural way of Heaven and Earth giving birth to humans? When abnormal Qi appears out of season, it can be called "abnormal Qi," but not "epidemic Qi." Why? Because exposure to abnormal Qi results in illness in some and health in others; it cannot be generalized. Epidemic Qi, however, affects everyone regardless of wealth, poverty, age, gender, strength, or deficiency, spreading door-to-door and region-wide with identical transmission. No one escapes. This occurs mainly after major wars and famines, especially during years of hunger. People wander everywhere, gathering in towns, counties, or capitals, lacking proper shelter and relief. From the imperial court far away, cries go unheard. Groups of three or five die daily without exception. Graves are shallow and poorly covered. When spring arrives and Earth Qi moves, loose soil collapses, exposing white bones, blood, and water. Death Qi, corpse Qi, turbid Qi, and foul Qi rise with Earth Qi, mixing with the pure Qi of Heaven. The Qi that generates life transforms into the Qi that destroys life. Formless, shadowless, soundless, odorless, it enters through the mouth and nose, directly attacking the Zang-Fu organs. Healthy Qi becomes blocked, pathogenic Qi fills the space, leading to sudden death beyond remedy. *Shuowen Jiezi* states: "Yi means all people are sick; malevolent ghosts bring disaster, this is Yi." *Liji Yue Ling* states: "In the first month of spring, kings bury bones and flesh, precisely because in this month Heaven Qi descends and Earth Qi rises. Fearing that filth from bones and flesh mixes with Heaven and Earth Qi, harming beings, they are buried." This pre-empts creation's flaws, avoiding heavenly blame. Humans exist within the intersection of Qi, like fish in water; even a tiny impurity cannot mix. If ash is thrown into rivers or oil into ponds, few fish survive. How is human infection by epidemic Qi different? Thus, since ancient times, sage rulers and virtuous ministers assisted in nurturing transformation, harmonizing Yin and Yang, preventing epidemics in peacetime, and providing porridge and medicine during disasters to save lives, ensuring no premature deaths and promoting harmony. Literati interpreting this as "nourishing dead bones" miss the point. Should spring nourish dead bones while summer, autumn, and winter do not? Recently, meddlesome individuals set up altars and factories. In years when children contract smallpox, they purchase corpses of deceased infants. Even if buried, they dig them up, piling them like mountains, burning them with fire. Flames rage, stench reaches heaven, gods and men cover their noses. Toxic fumes and foul odors spread, causing strange diseases in infants—resembling smallpox but not quite, resembling rash but not quite. Within one or two days, the condition becomes critical. Even skilled physicians cannot intervene. Everyone is shocked, attributing it to heavenly anomalies, unaware of the cause. For years, countless innocent babies have suffered unjustly. Within twenty to thirty li of the city, this disease does not occur, proving this clearly! Alas, heterodox sorcery confuses the world and deceives the people. Ignorant people think it is good, gathering crowds to shout, collecting money to support it. One advocates, another echoes, running madly. Does this not greatly contradict the meaning of ancient kings burying bones and flesh? I mention this while prefaceing epidemic diseases, hoping future medical students pay attention.
Written by Lin Qilong of Yuyang, Beihai, at Buche Studio, on the first day of the seventh month, 14th year of Kangxi.