答曰。伤寒瘥后发热者何。此名劳食复也。内经云。多食则复,食肉则复。缘病瘥后。气尚
虚。津液未复。因劳动生热。气既还复入经络。名曰劳复。仲景云。伤寒。瘥后更发热者。
小柴胡汤主之。脉浮者。以汗解。脉沉者。以下解。又伤寒瘥后劳复者。枳实栀子汤主之。
千金方劳复起死。人参麦门冬汤。又有食复者。大病新瘥。脾胃尚弱。谷气未复。(谷王宇
泰本作谷)强食过多。停积不化。因尔发热。名曰食复。仲景于枳实栀子汤证云。若有宿食
。内加大黄如博棋子大五六枚。服之愈。
枳实栀子汤
枳实(一枚去穣麸炒) 栀子(三枚半肥者) 豉(一两半)
上以清浆水二盏半。煎九分。下豉再煎五六沸。去滓温服。覆令汗出。
若有宿食。加内大黄如博棋子大五六枚服之。日煎服之。
答曰。阴阳大论云。春气温和。夏气暑热。秋气清凉。冬气凛冽。此则四时正气之序也。冬
时严寒。万类深藏。君子固密。则不伤于寒。若伤于寒者。凡名伤寒耳。其一岁之中。长幼
之病多相似者。故名时行之气也。其伤于四时之气。皆能为病。以伤寒为毒者。以其最盛杀
厉之气。中而即病者。名曰伤寒不即病。寒毒藏于肌肤。至春变而为温病。至夏变而为暑病
。暑病者。热极重于温也。详此三证。皆因寒气而受邪。寒极生热。热气熏煮其胎。故损也
。
罩胎散(见六十问中)
人参羌活汤。治妊娠感冒。发热头疼。身体痛。
白茯苓 羌活 独活 前胡 芎 枳壳(炒) 桔梗 人参(各一两) 甘草(炙半两) 干葛
陈皮(各一两)
上为细末。每服三钱。水一盏。姜五片。枣一枚。煎七分。去滓温服。
黄龙汤。治妊娠瘟疾。寒热头痛。嘿嘿不欲饮食。胁下痛。呕逆痰气。及产后伤风。热入胞
宫。寒热如疟。
柴胡 黄芩 甘草 人参(各一两)
上锉如麻豆大。每服五钱。水盏半。煎八分。去滓温服。不拘时。
治妊娠患时疾。
黄芩尖者。出锥郁金。
上为细末。每服一钱。板蓝根地黄水调下。汗出效。未愈。再服即愈。
治妊娠患时疾。
鸡子(坠井底泥上隔宿取出吞之必无虞矣)
答:伤寒病愈后再次出现发热,这是什么原因?这被称为“劳复”和“食复”。《内经》说:“饮食过多会导致复发,吃肉会导致复发。”因为病刚痊愈时,正气尚且虚弱,津液尚未恢复。如果因劳动而生热,气机重新运行并进入经络,这就叫做“劳复”。张仲景说:“伤寒病愈后再次发热,用小柴胡汤主治。脉象浮的,用发汗法解表;脉象沉的,用泻下法通里。”另外,伤寒病愈后因劳累而复发者,用枳实栀子汤主治。《千金方》中记载治疗劳复起死回生的方子是“人参麦门冬汤”。还有因饮食不当导致的“食复”,大病刚刚痊愈,脾胃功能依然虚弱,谷气(消化能力)尚未恢复。如果勉强进食过多,导致食物停滞积聚无法消化,因此引起发热,这就叫做“食复”。张仲景在枳实栀子汤的证治中提到:“如果有宿食积滞,加大黄如博棋子大小五六枚,服用后痊愈。”
枳实栀子汤
枳实(一枚,去掉瓤,麸皮炒) 栀子(三枚半,选肥大的) 豆豉(一两半)
以上药材用清浆水二盏半,煎煮至九分满,放入豆豉再煎煮五六沸,去渣温服。服药后覆盖衣被令其出汗。
如果有宿食积滞,加入大黄如博棋子大小五六枚,每日煎服。
答:《阴阳大论》说:春季气候温和,夏季气候暑热,秋季气候清凉,冬季气候凛冽。这是四季正气的正常顺序。冬季严寒,万物深藏,君子(指养生有道的人)固密腠理,就不会受寒邪伤害。如果受到寒邪伤害,都称为伤寒。如果在一年之中,无论老少患病大多相似,这就叫做“时行之气”。凡是感受四时不正之气,都能致病。其中伤寒最为毒烈,是因为它含有最盛杀厉之气。感受后立即发病的,叫做伤寒;如果不立即发病,寒毒潜伏在肌肤之间,到春天就转变为温病,到夏天就转变为暑病。暑病的热度比温病更重。详细考察这三种病症,都是因为寒气而受邪,寒极生热,热气熏蒸煎熬胎儿,所以造成损伤。
罩胎散(见第六十问中)
人参羌活汤,治疗妊娠期间感冒,发热头痛,身体疼痛。
白茯苓、羌活、独活、前胡、川芎、枳壳(炒)、桔梗、人参(各一两),甘草(炙半两),干葛、陈皮(各一两)。
以上药材研为细末。每次服用三钱,用水一盏,生姜五片,大枣一枚,煎煮至七分,去渣温服。
黄龙汤,治疗妊娠期间瘟疫疾病,寒热往来,头痛,沉默不欲饮食,胁下疼痛,呕吐逆气痰多,以及产后伤风,热入胞宫,寒热如疟疾状。
柴胡、黄芩、甘草、人参(各一两)。
以上药材锉成麻豆大小的碎片。每次服用五钱,用水一盏半,煎煮至八分,去渣温服,不拘时间。
治疗妊娠期间患时行疾病:
选用黄芩尖部,取出锥郁金。
以上研为细末。每次服用一钱,用板蓝根地黄水调服,出汗即见效。未痊愈者,再服用即可痊愈。
治疗妊娠期间患时行疾病:
鸡蛋(坠入井底泥上,隔宿取出吞服,必定没有危险了)
Answer: What is the cause of fever recurring after the recovery from Shanghan (Cold Damage)? This is termed "Laofu" (Relapse due to overexertion) and "Shifu" (Relapse due to improper diet). The *Neijing* states: "Excessive eating leads to relapse, eating meat leads to relapse." This is because after the illness has subsided, the Qi (Vital Energy) is still deficient, and body fluids have not yet recovered. If heat is generated by physical labor, and the Qi returns and enters the meridians, it is called "Laofu". Zhang Zhongjing stated: "For fever recurring after Shanghan recovery, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is the primary treatment. If the pulse is floating, resolve via sweating; if the pulse is sunken, resolve via purgation." Furthermore, for Laofu following Shanghan recovery, Zhi Shi Zhi Zi Tang (Immature Bitter Orange and Gardenia Decoction) is used. The *Qianjin Fang* records Ren Shen Mai Men Dong Tang (Ginseng and Ophiopogon Decoction) for treating fatal cases of Laofu. There is also "Shifu" caused by dietary indiscretion. After a major illness has just healed, the Spleen and Stomach remain weak, and Gu Qi (digestive capacity) has not recovered. Forcing excessive food intake causes stagnation and accumulation that cannot be digested, leading to fever; this is called "Shifu". In the syndrome description for Zhi Shi Zhi Zi Tang, Zhang Zhongjing noted: "If there is retained food (Su Shi), add Da Huang (Rhubarb Root) in pieces the size of dice, five or six pieces; take until cured."
Zhi Shi Zhi Zi Tang (Immature Bitter Orange and Gardenia Decoction)
Zhi Shi (Immature Bitter Orange Fruit, one piece, remove pulp, stir-fried with bran) Zhi Zi (Gardenia Fruit, three and a half large ones) Chi Dou (Prepared Soybean Seed, 1.5 liang)
Take two and a half lamps of Qing Jiang Shui (clear sour soup water), decoct until reduced to nine-tenths. Add Chi Dou and boil for five or six boils. Strain and take warm. Cover with blankets to induce sweating.
If there is retained food, add Da Huang (Rhubarb Root) in pieces the size of dice, five or six pieces. Decoct and take daily.
Answer: The *Yin Yang Da Lun* states: Spring Qi is mild, Summer Qi is hot and humid, Autumn Qi is cool, Winter Qi is biting cold. This is the order of the righteous Qi of the four seasons. In winter, severe cold causes all things to hide deeply. A gentleman who keeps his exterior secure will not be injured by cold. If injured by cold, it is generally named Shanghan. If throughout the year, people of all ages suffer from similar illnesses, it is named "Shi Xing Zhi Qi" (Seasonal Epidemic Qi). Injury by the Qi of the four seasons can all cause disease. Among them, Shanghan is the most toxic because it contains the most vigorous and lethal Qi. Those who fall ill immediately upon exposure are named Shanghan. Those who do not fall ill immediately harbor the cold toxin in the skin and muscles; when spring arrives, it transforms into Wen Bing (Warm Disease); when summer arrives, it transforms into Shu Bing (Summerheat Disease). Shu Bing is more severe in heat than Wen Bing. Examining these three syndromes closely, they all result from pathogenic cold. Extreme cold generates heat; this heat steams and boils the fetus, causing damage.
Zhao Tai San (Fetus-Covering Powder) (See Question 60)
Ren Shen Qiang Huo Tang (Ginseng and Notopterygium Decoction), treats pregnancy complicated by common cold, fever, headache, and body pain.
Bai Fu Ling (Poria), Qiang Huo (Notopterygium Rhizome), Du Huo (Angelica Pubescens Root), Qian Hu (Peucedanum Root), Xiong (Ligusticum Chuanxiong Rhizome), Zhi Ke (Aurantii Fructus, stir-fried), Jie Geng (Platycodon Root), Ren Shen (Ginseng Root) (each 1 liang), Gan Cao (Licorice Root, honey-fried, 0.5 liang), Gan Ge (Pueraria Root), Chen Pi (Citrus Reticulata Peel) (each 1 liang).
Grind into fine powder. Take 3 qian per dose with 1 lamp of water, 5 slices of fresh ginger, and 1 jujube. Decoct to seven-tenths, strain, and take warm.
Huang Long Tang (Yellow Dragon Decoction), treats pregnancy complicated by epidemic diseases, alternating chills and fever, headache, taciturnity with loss of appetite, hypochondriac pain, vomiting with phlegm-qi rebellion, as well as postpartum wind-strike with heat entering the Bao Gong (Uterus), presenting with alternating chills and fever like malaria.
Chai Hu (Bupleurum Root), Huang Qin (Scutellaria Root), Gan Cao (Licorice Root), Ren Shen (Ginseng Root) (each 1 liang).
Cut into pieces the size of hemp seeds. Take 5 qian per dose with 1.5 lamps of water. Decoct to eight-tenths, strain, and take warm at any time.
Treatment for pregnancy complicated by seasonal epidemics:
Use the tips of Huang Qin (Scutellaria Root) containing Zhui Yu Jin (Turmeric Tuber).
Grind into fine powder. Take 1 qian per dose, mixed with Ban Lan Gen (Isatis Root) and Di Huang (Rehmannia Root) water. Sweating indicates efficacy. If not cured, take again to achieve cure.
Treatment for pregnancy complicated by seasonal epidemics:
Ji Zi (Chicken Egg) (Drop into the mud at the bottom of a well, retrieve after one night, and swallow; there will surely be no danger.)