仲景伤寒论狐惑之病其气如伤寒,嘿嘿但欲卧目瞑不得眠,起卧不安,蚀于喉咽者为惑
,蚀于阴者为狐,狐惑之病并恶饮食,不欲闻饮食臭,其面乍赤乍黑乍白,蚀于上部其声嗄
,蚀于下部其咽干,蚀于上部,泻心汤主之,蚀于下部,苦参汤淹洗之,蚀于肛外者,雄黄
熏之。
又泻心汤,兼疗下利不止,心中 坚而呕,肠中鸣者方。
半夏(半升洗) 黄芩(三两) 人参(三两) 干姜(三两) 黄连(一两) 甘草
(四两炙) 大枣(十二枚擘)
上七味切,以水一斗,煮取六升,分服一升,日三服。忌猪肉冷水菘菜海藻羊肉饧。(
千金同出第六卷中)
又雄黄熏法,兼主 病。
雄黄一物研末,以两筒瓦合之烧,以熏下部。
千金疗狐惑,薰草黄连汤方。
黄连(四两去皮) 薰草(四两)
上二味切,以白浆一斗渍之一宿,煮取二升,去滓,分为二服。忌猪肉冷水。(短剧同)
又其人脉数无热微烦,嘿嘿但欲卧,汗出,得之三四日,眼赤如鸠眼者,得之七八
日,其四 黄黑,能食者,脓已成也,疗之方。
以赤小豆三升渍之,令生牙足复干之加当归三两为末,浆水服方寸匕,日三。(短剧同
出第十卷中此本仲景方)
凡病形不可炙,因火为邪,散走血脉,伤脉尚可,伤脏则剧,井输穴肿,黄汁自出,经
络外烂,肉腐为痈脓,此为火疽,(七居反)医所伤也,凡微数之脉,慎不可炙,因火为邪,
即致烦逆,追虚逐实,血散脉中,火气虽微,内攻有力,焦骨伤筋,血难复也。
张仲景《伤寒论》中关于狐惑病的论述:这种病的气象表现类似伤寒,患者神情沉默只想睡觉,眼睛闭合却难以入睡,坐卧不宁。腐蚀在咽喉部位的称为“惑”,腐蚀在外阴部位的称为“狐”。狐惑病患者都厌恶饮食,不想闻到食物的气味,面色时而发红、时而发黑、时而发白。腐蚀在上部(咽喉)的,声音嘶哑;腐蚀在下部(外阴/肛门)的,咽喉干燥。腐蚀在上部的,用泻心汤主治;腐蚀在下部的,用苦参汤浸洗;腐蚀在肛门外部的,用雄黄熏治。
另外,泻心汤还可以兼治下利不止、心中痞硬且呕吐、肠鸣的症状。方剂组成:半夏(半升,洗净)、黄芩(三两)、人参(三两)、干姜(三两)、黄连(一两)、甘草(四两,炙烤)、大枣(十二枚,掰开)。以上七味药切碎,用水一斗,煮取六升,分次服用,每次一升,每日三次。忌食猪肉、冷水、白菜、海藻、羊肉和饴糖。(此方出自《千金方》第六卷)
另外是雄黄熏法,兼治狐惑病。将雄黄一味药研成粉末,用两片瓦合拢烧灼,用烟气熏蒸下部患处。
《千金方》治疗狐惑病的薰草黄连汤方:黄连(四两,去皮)、薰草(四两)。以上两味药切碎,用酸浆水一斗浸泡一夜,煮取二升,去渣,分为两次服用。忌食猪肉和冷水。(《短剧方》相同)
另外,如果患者脉象数而身体无发热,仅有轻微烦躁,神情沉默只想睡觉,出汗,得病三四天后,眼睛红得像斑鸠的眼睛一样;得病七八天后,眼周出现黑色或黄色,如果能进食,说明脓已经形成。这是治疗该阶段的方子。
用赤小豆三升浸泡,让它长出芽来,然后晒干,加入当归三两,研成粉末,用浆水送服一方寸匕的药量,每日三次。(《短剧方》相同,出自第十卷,此本为张仲景的方子)
凡是病情形态不适合艾灸的,如果误用火疗作为邪气,火邪会散走于血脉之中。损伤经脉尚且可以忍受,损伤脏腑则病情严重,会导致井穴和输穴肿胀,黄色汁液自行流出,经络外部溃烂,肌肉腐烂化为痈脓,这叫做“火疽”(音同“居”),是医生误治造成的伤害。凡是脉象微数的,千万不可艾灸,因为火邪会导致烦闷逆乱,追补虚损反而驱逐实邪,导致血液散乱于脉中。火气虽然微弱,但内攻的力量很大,会焦骨伤筋,血液难以恢复。
In Zhang Zhongjing's *Treatise on Cold Pathogenic Diseases* (*Shanghan Lun*), the discussion on the Hu-Huo disease states: The manifestation of this disease resembles Taiyang syndrome (a pattern caused by pathogenic factors affecting the Bladder and Heart meridians). The patient is taciturn, desires only to sleep, keeps their eyes closed but cannot rest, and is restless in sitting or lying down. Erosion occurring in the throat and pharynx is called "Huo" (Confusion), while erosion occurring in the yin organs/genitals is called "Hu" (Fox). Patients with Hu-Huo disease generally dislike food and drink, do not wish to smell food odors, and their facial complexion fluctuates between red, black, and white. When erosion occurs in the upper part (throat/pharynx), the voice becomes hoarse; when erosion occurs in the lower part (genitals/anus), the throat feels dry. For erosion in the upper part, Xie Xin Tang (Drain the Epigastrium Decoction) is the primary treatment. For erosion in the lower part, Kushen Tang (Sophora Root Decoction) is used for soaking/washing. For erosion outside the anus, Xionghuang (Realgar) fumigation is applied.
Additionally, Xie Xin Tang can also treat persistent diarrhea, a sensation of hardness/stuffiness in the heart region accompanied by vomiting, and borborygmus (intestinal rumbling). Formula composition: Banxia (Pinelliae Rhizoma, half sheng, washed), Huangqin (Scutellariae Radix, three liang), Renshen (Ginseng Radix, three liang), Ganjiang (Zingiberis Rhizoma, three liang), Huanglian (Coptidis Rhizoma, one liang), Gancao (Glycyrrhizae Radix et Rhizoma, four liang, roasted), Dazao (Jujubae Fructus, twelve pieces, split). The above seven ingredients are cut into small pieces, boiled in ten dou of water until six dou remain. Divide into three doses, taking one dou per dose, three times daily. Avoid pork, cold water, Chinese cabbage (Brassica rapa var. pekinensis), seaweed, mutton, and maltose syrup. (This formula is also found in Volume 6 of *Qianjin Fang*).
The method for Realgar fumigation is also provided, primarily treating Hu-Huo disease. Take one portion of Realgar (Xionghuang), grind it into powder, place it between two tiles joined together, burn it, and use the smoke to fumigate the affected lower area.
*Qianjin Fang* provides the Xuncao Huanglian Tang (Mugwort and Coptis Decoction) for treating Hu-Huo disease. Ingredients: Huanglian (Coptidis Rhizoma, four liang, skin removed), Xuncao (Artemisiae Argyi Folium/Mugwort, four liang). The above two ingredients are cut, soaked in one dou of sour grain water overnight, then boiled until two dou remain. Strain the dregs, divide into two doses. Avoid pork and cold water. (Identical to *Duanju Fang*).
Furthermore, if the patient presents with a rapid pulse without fever, slight irritability, taciturnity, desire to sleep, and sweating; after three or four days of illness, the eyes become red like those of a turtledove; after seven or eight days, the area around the eyes turns yellowish-black; and if the patient is able to eat, it indicates that pus has formed. This is the treatment formula for this stage.
Soak three sheng of Chixiaodou (Adzuki Bean / Vigna angularis) until sufficient sprouts grow, then dry them. Add Danggui (Angelicae Sinensis Radix, three liang), grind into powder, and take one cun-bi (a measure of volume roughly equivalent to a teaspoon) with grain water, three times daily. (Identical to *Duanju Fang*, found in Volume 10; this is originally a formula from Zhang Zhongjing).
For any condition where moxibustion is contraindicated due to the nature of the pathology, applying fire therapy introduces a pathogenic factor. Fire evil scatters through the blood vessels. Injury to the meridians may be tolerable, but injury to the zang-fu organs leads to severe conditions, causing swelling at the Jing-River and Shu points, with yellow fluid oozing out, external rotting of the collaterals, and muscle corruption turning into abscesses/pus. This is called "Fire-Ju" (Fire Carbuncle), an iatrogenic injury caused by the physician. Generally, for patients with a slightly rapid pulse, moxibustion must be strictly avoided. Applying fire creates a pathogenic factor, leading to irritability and counterflow qi. It pursues deficiency and drives out excess, causing blood to scatter within the vessels. Although the fire energy is subtle, its internal attacking power is strong, leading to scorched bones and damaged sinews, making blood recovery difficult.