二十、红绵散。一名天麻散。治伤寒及痘疹
天麻 荆芥(各一分) 甘草(炙) 麻黄(去节,各二钱) 全蝎(七个,全者)
上为末令匀,每服一钱,水半盏,薄荷二三叶,酒四五滴,煎二三沸,带热服之。如疹
子未出,再进一服。相次又进一服,若是伤风,服亦不妨。此药大抵为解表之药也。治身有
大热,面赤气粗无汗者,为表未解也,可服之。盖此药以天麻麻黄为主治也,有汗不得服麻
黄者,其腠理已疏开,不宜更发汗也。如有热更有汗者,则惺惺散为和解之药也。故仲景论
表证,有发汗者,有和解者,有调和营卫者,今有汗者不可服麻黄,则和解药为可用,如更
有虚寒证者,勿服,宜调荣卫也,如和中散之类是也。论此药能治疮疹者,荆芥主寒热,鼠
瘰 ,生疮下瘀血,天麻治诸毒恶气,皮肤壅满,热毒痈肿,蝎治诸风瘾疹,筋脉诸风,
小儿惊风,其荆芥天麻蝎三味皆性平治疮理血,故宜疮痘所服也。
二十一、五积散。治伤寒寒痰,内伤生冷者所服也。疮痘本为寒毒,小儿热盛,渴则饮
冷,热则当风,反被风寒所伏,寒热相搏,面青发热,心烦自利者,宜以此药散其内外寒毒
,然后热气上行,或汗,或疮痘,或瘾疹,服之而愈矣。
方见寒门。
二十二、麻黄汤,治疮疹烦喘甚者主之。
麻黄 杏仁(去皮尖) 甘草(炙) 桑白皮(蜜炙)
上锉为散,每药一钱,用水七分盏,同煎至四分盏,去渣温服之。若脉数有热未退者,
入竹沥少许,咽喉痛或嗽者,煎热入麝香少许服之。
二十、红绵散。又名天麻散。治疗伤寒以及痘疹(天花与麻疹等出疹性疾病)。
天麻、荆芥(各一分)、甘草(经蜜炙处理)、麻黄(去除节部,各二钱)、全蝎(七个,需为完整的蝎子)。
将上述药物研磨成细末并混合均匀。每次服用一钱,加入半盏水、两到三片薄荷叶、四到五滴酒,煎煮二三沸后,趁热服用。如果皮疹尚未发出,可再服一次。随后再次服用一次。如果是伤风感冒,服用此药也无妨。此药大体上属于解表(解除肌表邪气)的药物。治疗身体有大热、面色发红、气息粗重且无汗的症状,这是因为表邪未解,可以服用此药。大概是因为此药以天麻和麻黄为主要治疗成分。通常规定有汗者不得服用麻黄,因为此时腠理(皮肤毛孔及纹理)已经疏松开放,不适宜再发汗。如果有热并且已经有汗的情况,那么惺惺散(一种和解表里的方剂)作为和解之药更为合适。所以张仲景在论述表证时,指出有发汗的治法,有和解的治法,有调和营卫(调节体内营养之气与防御之气)的治法。现在对于有汗者不可服用麻黄,则和解类药物可以使用;如果还有虚寒证候,则不要服用,应当调理营卫,如和中散之类的方剂就是如此。论述此药能治疗疮疹的原因在于:荆芥主治寒热往来及鼠瘰(颈部淋巴结结核),能生肌敛疮并下瘀血;天麻主治各种毒气和恶气,以及皮肤壅滞胀满、热毒痈肿;全蝎主治各种风邪引起的瘾疹(荨麻疹)、筋脉诸风以及小儿惊风。这三味药——荆芥、天麻、全蝎,性质都平和,能治疗疮疡并调理血液,因此适合用于疮痘的治疗。
二十一、五积散。治疗伤寒寒痰,以及因内伤生冷食物所致病症的患者服用。疮痘本质上是由寒毒引起,小儿体内热盛,口渴时饮用冷水,发热时吹受风寒,反而被风寒所伏遏,寒热相互搏结,出现面色青紫、发热、心烦、自发性腹泻等症状,适宜用此药来发散内外的寒毒,然后热气上行,通过出汗、发出疮痘或瘾疹等方式排出病邪,服药后即可痊愈。
该方详见“寒门”章节。
麻黄、杏仁(去皮尖)、甘草(经蜜炙处理)、桑白皮(经蜂蜜炙烤)。
将上述药物切碎制成散剂。每取药末一钱,用水七分盏,共同煎煮至剩余四分盏,去渣滓后温服。如果脉搏快且有热象未退,加入少许竹沥(竹子茎秆中的汁液);如果咽喉痛或咳嗽,煎好后趁热加入少许麝香服用。
Twenty, Hongmian San (Red Silk Powder), also known as Tianma San. It treats Taiyang disease (exogenous febrile diseases affecting the exterior) and variola/varioliform eruptions (smallpox and measles-like diseases).
Gastrodia Rhizome (Tianma), Schizonepeta Spike (Jingjie) (each 1 fen); Licorice Root (Gancao), processed with honey; Ephedra Stem (Mahuang), nodes removed (each 2 qian); Whole Scorpion (Quanxie) (seven pieces, whole scorpions).
Grind the above ingredients into a fine powder and mix evenly. Take 1 qian per dose, add half a zhan of water, two or three leaves of Mint Leaf (Bohe), and four or five drops of wine. Boil for two or three boils, and take it while hot. If the rash has not yet erupted, administer another dose. Subsequently, administer one more dose. If it is wind-cold injury, taking this medicine is also acceptable. This medicine is generally an exterior-resolving agent. It treats symptoms such as high fever in the body, flushed face, coarse breathing, and absence of sweating, indicating that the exterior pathogen has not been resolved; it can be taken. Essentially, this medicine relies on Gastrodia Rhizome (Tianma) and Ephedra Stem (Mahuang) as its main therapeutic components. Generally, those with sweating should not take Ephedra Stem (Mahuang), because at that time the Couli (skin pores and interstices) are already loose and open, making further diaphoresis inappropriate. In cases with heat and existing sweating, Xingxing San (a harmonizing formula) is suitable as a harmonizing agent. Therefore, Zhang Zhongjing discussed exterior syndromes, stating there are methods of inducing sweating, harmonizing, and harmonizing Ying and Wei (nutritive and defensive qi). Now, for those with sweating, Ephedra Stem (Mahuang) should not be taken, so harmonizing medicines can be used; if there are also deficiency-cold syndromes, do not take it; instead, regulate Ying and Wei, such as using formulas like Hezhong San. The reason this medicine can treat chuangzhen (sores and rashes) is explained as follows: Schizonepeta Spike (Jingjie) treats alternating chills and fever and scrofula (cervical lymphadenitis), promotes healing of sores and expels blood stasis; Gastrodia Rhizome (Tianma) treats various toxins and malignant qi, skin distension and fullness, and heat-toxin carbuncles and swellings; Scorpion treats various wind-induced urticaria, wind affecting sinews and vessels, and pediatric convulsions. These three herbs—Schizonepeta Spike (Jingjie), Gastrodia Rhizome (Tianma), and Scorpion—all have neutral properties, treat sores, and regulate blood, thus they are suitable for use in treating chuangdou (smallpox/measles).
Twenty-one, Wuji San (Five Accumulations Powder). It is taken by patients suffering from Taiyang disease with cold-phlegm, or due to internal injury from consuming raw and cold foods. Chuangdou (smallpox/measles) originates from cold toxin. Children often have excessive internal heat; when thirsty, they drink cold liquids, and when hot, they expose themselves to wind. Consequently, they are suppressed by wind-cold, leading to a struggle between cold and heat, presenting with bluish complexion, fever, restlessness, and spontaneous diarrhea. It is appropriate to use this medicine to dissipate internal and external cold toxins. Then, the heat qi ascends, and recovery occurs through sweating, eruption of sores/rashes, or urticaria after taking the medicine.
See the "Cold Section" for the formula.
Twenty-two, Mahuang Tang (Ephedra Decoction). It is the primary treatment for severe irritability and panting caused by chuangzhen.
Ephedra Stem (Mahuang), Apricot Seed (Xingren), peeled and crushed; Licorice Root (Gancao), processed with honey; Mulberry Root Bark (Sangbaipi), honey-fried.
Crush the above ingredients into a powder. Take 1 qian of the medicine per dose, add seven-tenths of a zhan of water, and decoct together until four-tenths of a zhan remains. Strain and take warm. If the pulse is rapid and heat has not subsided, add a small amount of Bamboo Sap (Zhuli). If there is sore throat or cough, add a small amount of Moschus (Shexiang) while hot before taking.