燕京温官人,年小时气弱,常于气海三里灸之,节次约五七千壮,至年老
虽冬天大寒,犹喜寒风,其头痛则愈。微来暖处,或见烟火,其痛复作,五七
灸之过也。
羌活根(三钱) 知母(酒浸) 黄芩(酒浸,各一钱半) 黄柏(酒浸) 炙甘草 黄
(以
本(以上各五分) 蔓荆子
辛红花(各少许)
上锉如麻豆大,分作二服,每服水二盏,煎至一盏,去滓稍热,食后服。
中书左丞姚公茂,年六十七,宿有时毒,至元戊辰春,因酒再发,头面赤肿而痛,耳前
后尤甚,胸中烦闷,咽嗌不利,身半以下恶寒,足 尤甚,由是以床炕相接,身半以上卧于
床,身半之下卧于炕,饮食减少,精神困弱,脉得浮数,按之弦细,上热下寒明矣。《内经
》云∶热胜则肿。春气者病在头。《难经》云∶热在头身宜砭刺之,取其易散故也。遂于肿
上约五十余刺,其血紫黑,如露珠之状,顷时肿痛消散。又于气海穴中,大艾炷灸百壮,
乃助下焦阳虚,退其阴寒,次于三里二穴中,各灸三七壮,治足 冷,亦引导热气下行故也
。遂处方云∶热者寒之。然病有高下,治有远近,无越度其制度,君以黄芩黄连,苦寒酒炒
,亦为因用以泻其上热,桔梗甘草辛甘温上升,佐诸苦药以治其热,柴胡升麻苦平,味之薄
者,阴中之阳,发散上热以为臣,连翘苦辛平,以散结消肿,当归身辛温和血止痛,大黄苦
寒,酒煨,引苦性上行至巅,驱热而下,以为使也,投剂之后,肿痛全减,大便利,再服减
大黄,慎言语,节饮食,不旬日良愈。
燕京的温官人,年轻时体质虚弱,经常在气海穴和足三里穴施灸,累计大约五到七千壮。到了老年,虽然冬天非常寒冷,但他反而喜欢吹冷风,这样头痛就会痊愈;如果稍微来到温暖的地方,或者见到烟火,头痛就会再次发作,这是之前艾灸过多造成的后果。
处方:羌活根(三钱),知母(用酒浸泡),黄芩(用酒浸泡,各一钱半),黄柏(用酒浸泡),炙甘草,黄芪(原文此处有缺漏,依方义补全为黄芪,五分),本(五分),蔓荆子,辛红花(各少许)。
以上药材切碎如麻豆大小,分为两次服用。每次用水两盏,煎煮至一盏,滤去药渣,稍加热后,在饭后服用。
中书左丞姚公茂,六十七岁,素来患有“时毒”病(一种季节性流行的热毒病症)。至元戊辰年春天,因饮酒导致病情复发,头面部红肿疼痛,耳前耳后尤为严重,胸中烦闷,咽喉不利,身体下半部怕冷,脚部尤其严重。因此他让床和炕连接在一起,上半身睡在床上,下半身睡在炕上。饮食减少,精神困倦虚弱。脉象浮数,重按则弦细,这是明显的上热下寒证。《内经》说:“热邪盛则发生肿胀。”春季的病邪多在头部。《难经》说:“热邪在头身适宜用砭石刺络放血,因为这样容易使邪气消散。”于是他在肿胀处大约刺了五十多针,流出的血液呈紫黑色,像露珠一样,片刻之后肿痛就消散了。又在气海穴用大艾炷灸一百壮,以补助下焦阳虚,驱退阴寒;接着在足三里两个穴位各灸二十一家壮,治疗脚冷,也是为了引导热气下行。于是开具处方说:热者寒之。然而疾病有高下之分,治疗有远近之别,不能超越法度。以黄芩、黄连为君药,苦寒并用酒炒,也是利用其特性来泻上部的热邪;桔梗、甘草辛甘温,性上升,作为佐药辅助诸苦寒药治疗热邪;柴胡、升麻苦平,气味轻薄,属于阴中之阳,发散上部热邪作为臣药;连翘苦辛平,以散结消肿;当归身辛温和血止痛;大黄苦寒,用酒煨制,引苦性上行至头顶,驱热下行,作为使药。服药之后,肿痛完全减轻,大便通畅。第二次服药时减去大黄,注意言语节制,控制饮食,不到十天就痊愈了。
Mr. Wen from Yanjing, in his youth had weak Qi (vital energy). He frequently underwent moxibustion at Qihai (CV6) and Zusanli (ST36), accumulating approximately five to seven thousand moxa cones. In his old age, despite the severe cold of winter, he preferred the cold wind, which relieved his headache; however, if he moved to a warm place or encountered smoke/fire, the pain would recur. This was due to excessive moxibustion in the past.
Prescription: Qianghuo Gen (Radix Notopterygii, 3 qian), Zhimu (Rhizoma Anemarrhenae, soaked in wine), Huangqin (Radix Scutellariae, soaked in wine, each 1.5 qian), Huangbai (Cortex Phellodendri, soaked in wine), Zhi Gancao (Radix Glycyrrhizae Preparata), Huangqi (Radix Astragali, 0.5 fen), Ben Cao (Radix Ligustici Chuanxiong, 0.5 fen), Man Jing Zi (Fructus Viticis, a little), Xing Hong Hua (Flos Carthami Tinctorii, a little).
Crush the herbs into pieces the size of hemp seeds. Divide into two doses. For each dose, add two cups of water, decoct until one cup remains, strain, and take slightly warm after meals.
Yao Gongmao, Left Vice Director of the Secretariat, aged sixty-seven, suffered from "Shidu" (seasonal toxic heat disease). In the spring of the Wuchen year of the Zhiyuan era, the condition recurred due to alcohol consumption. His head and face were red, swollen, and painful, especially around the ears. He experienced chest irritability and difficulty in swallowing. The lower half of his body felt aversion to cold, particularly in the feet. Consequently, he connected a bed and a kang (heated brick bed), sleeping with his upper body on the bed and lower body on the kang. His appetite decreased, and he felt mentally exhausted and physically weak. His pulse was floating and rapid, but deep pressure revealed it to be wiry and thin, indicating clear Upper Heat and Lower Cold. The *Neijing* states: "Excess heat causes swelling." Diseases in spring often affect the head. The *Nanjing* states: "Heat in the head and body is suitable for treatment with bian stones (lancets) because it facilitates dispersion." Therefore, he performed approximately fifty punctures on the swollen area. The blood extracted was purple-black, resembling dewdrops, and the swelling and pain subsided shortly after. He then received one hundred large moxa cones at Qihai (CV6) to assist Yang deficiency in the Lower Jiao and dispel Yin cold. Subsequently, twenty-one moxa cones were applied to each of the Zusanli (ST36) points to treat cold feet and guide the heat downward. The prescription followed the principle: "Treat heat with cold." However, diseases vary in location, and treatments must be appropriate to distance and depth, without exceeding established protocols. Huangqin (Radix Scutellariae) and Huanglian (Rhizoma Coptidis) served as the Sovereign (Jun) herbs, bitter and cold, stir-fried with wine to drain Upper Heat. Jiegeng (Radix Platycodonis) and Gancao (Radix Glycyrrhizae) are acrid, sweet, and warm, ascending in nature, serving as Assistant (Zuo) herbs to aid the bitter drugs in treating heat. Chaihu (Radix Bupleuri) and Shengma (Rhizoma Cimicifugae) are bitter and neutral, with light flavors, representing Yang within Yin, serving as Minister (Chen) herbs to disperse Upper Heat. Lianqiao (Fructus Forsythiae) is acrid, bitter, and neutral, resolving nodules and reducing swelling. Danggui Shen (Radix Angelicae Sinensis Root) is acrid, sweet, and warm, harmonizing blood and relieving pain. Dahuang (Radix et Rhizoma Rhei) is bitter and cold, baked with wine to guide the bitter property upward to the vertex, driving heat downward, serving as Envoy (Shi) herb. After administration, swelling and pain significantly reduced, and bowel movements became unobstructed. In the second dose, Dahuang was removed. With careful speech and dietary regulation, he recovered fully within ten days.