(景岳) 治伤寒瘟疫,阴暑 疟。凡阴寒气胜,而邪有不能散者,非此不可。无论诸
经四季,凡有是证,即宜是药,勿谓夏月不可用也。不必浓盖,但取津津微汗,透出为度。
此实麻黄桂枝之变方,而其神效,则大有同于二方者,不可不为细察。
官桂(一二钱) 当归(三四钱) 炙甘草(一钱) 麻黄(二三钱) 陈皮(随宜用
或不用) 水一
加熟地三五钱。
(景岳) 凡患阳虚伤寒,及一切四时劳倦,寒疫阴暑之气。身虽炽热,时犹畏寒,
即在夏月,亦欲衣被盖,或喜热汤,或兼呕恶泄泻。但六脉无力,肩背怯寒,邪气不能外达
等证,此元阳大虚,正不胜邪之候。若非峻补托散,则寒邪日深,必至不救。温中自可散寒
,即此方也。服后畏寒悉除,觉有躁热,乃阳回作汗佳兆,不可疑之畏之。此外凡以素禀薄
弱之辈,或感阴邪寒疫,发热困倦,虽未见如前阴证,而热邪未甚者,但于初感时,即速用
此饮,连进二三服。无不随药随愈,真神剂也。此方宜与理阴煎麻桂饮相参用。
熟地(三五七钱) 于白术(三五钱) 当归(三五钱。如泄泻者不宜用,或山药代。)
人参(
干姜(炒热
汗。如气虚
防风细辛亦
(洁古) 治两感伤寒。(内经曰∶伤寒一日,巨阳受之,太阳经脉,循腰脊,经头
项,故头项痛,腰脊强。二日阳明受之,阳明主肉,其脉侠鼻,络于目,故身热目疼,而鼻
干,不得卧。三日少阴受之,少阳主胆,其脉循胁,络于耳,故胸胁痛,而耳聋。四日太阴
受之,太阴脉布胃中,络于嗌,故腹满而嗌干。五日少阴受之。少阴脉贯肾,络于肺,系舌
本,故口燥舌干而渴。六日厥阴受之,厥阴脉循阴器,络于肝,故烦满而囊缩。两感者,谓
一日则太阳与少阴俱病,有头痛项强,而又口干烦渴也。二日则阳明与太阴俱病,有身热胆
语,而又腹满不欲食也。三日则少阳与厥阴俱病,有胁痛耳聋,而又囊缩厥逆也,此阴阳表
里俱病。欲汗之则有里证,欲下之则有表证,故仲景不立治法。吴鹤皋曰∶易老制此方,意
谓传经者,皆为阳邪,一于升阳散热,滋养阴脏,则感之浅者,尚或可平也。)
羌活 独活 防风 细辛 防己 黄芩 黄连 苍术 甘草(炙) 白术(三钱) 知
母川芎
此阴阳两解之药也。气薄则发泄,故用羌独苍防芎细,祛风发表,升散传经之邪。寒能
胜热
表里
俱作
汤。
利不
日太
三日
虚之
(张景岳)治疗伤寒瘟疫、阴暑和疟疾。凡是阴寒之气偏盛,导致邪气无法消散的情况,非用此方不可。无论涉及哪一经络或哪个季节,只要有这些证候,就应当使用此药,不要说夏季就不能使用。服药后不必厚盖衣被,只要取得微微出汗的效果即可作为标准。这实际上是麻黄汤和桂枝汤的变方,但其神效,与这两大方剂大有相似之处,不可不仔细考察。
官桂(一两至二钱) 当归(三至四钱) 炙甘草(一钱) 麻黄(二至三钱) 陈皮(酌情使用或不用) 水一碗,加入熟地黄三至五钱。
(张景岳)凡是患有阳虚伤寒,以及四季因劳倦受寒疫、阴暑之气侵袭的人。身体虽然发热炽盛,但时常仍怕冷,即使在夏天,也想要穿衣盖被,或者喜欢喝热汤,或者兼有呕吐恶心、腹泻等症状。只要六脉无力,肩背感觉寒冷,邪气不能向外透达等证候,这是元阳大虚,正气不能战胜邪气的表现。如果不是用峻补的方法托举并发散邪气,那么寒邪会日益深入,必定导致无法挽救。温中散寒自然可以驱散寒邪,就是这个方子。服用后如果畏寒症状完全消除,感觉到有些躁热,那是阳气回复准备出汗的好兆头,不要怀疑或畏惧它。此外,对于素体薄弱的人,或者感受了阴邪寒疫,出现发热困倦,虽然没有见到前面提到的阴证,但热邪也不严重的情况,只要在初感时,立即迅速使用此饮,连续服用二三服。没有不随药而愈的,真是神效之剂。此方适宜与理阴煎、麻桂饮配合参酌使用。
熟地黄(三至七钱) 炒白术(三至五钱) 当归(三至五钱。如果有腹泻则不宜使用,可用山药代替。) 人参(适量) 干姜(炒热)……(原文此处有缺漏,如“汗”、“如气虚”、“防风细辛亦”等字样散落,意指根据气虚出汗等情况加减防风、细辛等)。
(李东垣/洁古)治疗两感伤寒。(《内经》说:伤寒第一天,太阳经受邪,太阳经脉,沿着腰脊,经过头项,所以头痛项强。第二天阳明经受邪,阳明主管肌肉,其脉夹鼻,联络于目,所以身热目疼,鼻干,不能安卧。第三天少阳经受邪,少阳主胆,其脉循胁肋,联络于耳,所以胸胁痛,耳聋。第四天太阴经受邪,太阴脉布散在胃中,联络于咽喉,所以腹满咽干。第五天少阴经受邪。少阴脉贯穿肾,联络于肺,系舌本,所以口燥舌干而渴。第六天厥阴经受邪,厥阴脉循行于阴器,联络于肝,所以烦闷胀满且睾丸收缩。“两感”,是指第一天太阳与少阴同时发病,有头痛项强,而又口干烦渴;第二天阳明与太阴同时发病,有身热谵语,而又腹满不想吃东西;第三天少阳与厥阴同时发病,有胁痛耳聋,而又睾丸收缩、四肢厥逆。这是阴阳表里同时发病。想发汗则有里证,想攻下则有表证,所以张仲景没有设立治法。吴鹤皋说:易老(李东垣)制定这个方子,意思是传经的病,都是阳邪,一味地升阳散热,滋养阴脏,那么感邪浅的,或许还可以平复。)
羌活 独活 防风 细辛 防己 黄芩 黄连 苍术 甘草(炙) 白术(三钱) 知母 川芎
这是阴阳两解的药物。药气轻薄则能发泄,所以用羌活、独活、苍术、防风、川芎、细辛,祛风发表,升散传经的邪气。寒性药物能胜热……(原文后半部分残缺,涉及表里俱作、汤剂、利不、日太、三日、虚之等零碎字词,意指表里双解之意)。
(Zhang Jingyue) Treats Shanghan (Cold Damage), plague, Yin-Shu (Yin Summerheat), and malaria. Whenever Yin-Cold pathogenic qi is excessive, causing the pathogen to be unable to dissipate, this formula is indispensable. Regardless of which meridian or season, whenever these syndromes are present, this medicine should be used; do not say it cannot be used in summer. After taking the medicine, there is no need for thick covering; the goal is merely to achieve a slight, even perspiration as the standard. This is actually a modified formula of Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction), but its miraculous efficacy is greatly similar to those two formulas, and thus it must be carefully examined.
Guixin (Cortex Cinnamomi, 1-2 qian) Danggui (Radix Angelicae Sinensis, 3-4 qian) Zhi Gancao (Honey-fried Radix Glycyrrhizae, 1 qian) Mahuang (Herba Ephedrae, 2-3 qian) Chenpi (Pericarpium Citri Reticulatae, use as appropriate or omit) Water one bowl, add Shudi (Prepared Rhizoma Anemarrhenae? Note: Context implies Rehmanniae Radix Praeparata, usually Di Huang/Shu Di Huang, here translated as Prepared Rehmannia Root, 3-5 qian).
(Zhang Jingyue) For those suffering from Yang-deficiency Shanghan, and all cases of seasonal fatigue combined with Cold-Epidemic or Yin-Shu pathogens. Although the body may have high fever, there is still frequent aversion to cold; even in summer, the patient desires clothing and blankets, or prefers hot drinks, or has accompanying vomiting, nausea, and diarrhea. As long as the six pulse positions are weak, the shoulders and back feel cold, and the pathogen cannot reach the exterior, etc., these are signs of severe deficiency of Yuan-Yang (Primal Yang), where the righteous qi cannot overcome the pathogen. If one does not use strong tonification to support and disperse the pathogen, the cold pathogen will deepen daily, leading to an untreatable condition. Warming the middle to dispel cold naturally disperses cold; this is that very formula. After taking it, if aversion to cold is completely removed and a feeling of restlessness or heat arises, this is a good omen of Yang returning and sweating preparing to occur; do not doubt or fear it. Furthermore, for those with constitutionally weak constitutions, or who have contracted Yin-pathogens or Cold-Epidemics, presenting with fever and fatigue, although the previous Yin-syndromes are not seen, and the Heat-pathogen is not severe, if this drink is used rapidly at the initial stage of contraction, taken continuously for two or three doses, recovery follows the medication without fail. It is truly a miraculous agent. This formula is suitable for use in conjunction with Liyin Jian (Replenish Yin Decoction) and Magui Yin (Cinnamon and Ephedra Drink).
Shudi (Prepared Rehmannia Root, 3-7 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried, 3-5 qian) Danggui (Radix Angelicae Sinensis, 3-5 qian. Do not use if diarrhea is present; replace with Shanyao/Dioscoreae Rhizoma.) Ren Shen (Ginseng Radix, amount as needed) Ganjiang (Dried Ginger, stir-fried until hot)... [Text fragmentary: mentions adding Fangfeng/Saposhnikoviae Radix and Xixin/Ligustici Chuanxiong Rhizoma if Qi-deficient or sweating occurs].
(Jiegu / Li Dongyuan) Treats Lianggan Shanghan (Simultaneous Transmission Cold Damage). (The Nei Jing states: On the first day of Shanghan, the Taiyang meridian receives the pathogen. The Taiyang meridian runs along the waist and spine, passing through the head and neck, hence headache, stiff neck, and back rigidity. On the second day, the Yangming meridian receives the pathogen. Yangming governs the flesh, its vessel runs alongside the nose and connects to the eyes, hence fever, eye pain, dry nose, and inability to sleep. On the third day, the Shaoyang meridian receives the pathogen. Shaoyang governs the Gallbladder, its vessel runs along the hypochondrium and connects to the ears, hence hypochondriac pain and deafness. On the fourth day, the Taiyin meridian receives the pathogen. The Taiyin vessel spreads in the stomach and connects to the throat, hence abdominal fullness and dry throat. On the fifth day, the Shaoyin meridian receives the pathogen. The Shaoyin vessel penetrates the Kidney, connects to the Lung, and ties to the root of the tongue, hence dry mouth, dry tongue, and thirst. On the sixth day, the Jueyin meridian receives the pathogen. The Jueyin vessel runs along the genitalia and connects to the Liver, hence irritability, fullness, and retraction of the testicles. "Lianggan" means that on the first day, both Taiyang and Shaoyin are diseased, presenting with headache, stiff neck, yet also dry mouth and irritability/thirst; on the second day, both Yangming and Taiyin are diseased, presenting with fever and delirious speech, yet also abdominal fullness and loss of appetite; on the third day, both Shaoyang and Jueyin are diseased, presenting with hypochondriac pain, deafness, yet also testicular retraction and cold extremities. This is a disease affecting both Yin/Yang and Interior/Exterior simultaneously. To induce sweating confronts the Interior syndrome; to purge confronts the Exterior syndrome. Therefore, Zhang Zhongjing did not establish a treatment method. Wu Hegao said: Yi Lao (Li Dongyuan) formulated this prescription with the intention that transmitted diseases are all Yang pathogens. By solely raising Yang and dissipating heat, while nourishing the Yin organs, those with shallow infection might still be pacified.)
Qianghuo (Notopterygii Rhizoma et Radix) Duhuo (Angelicae Pubescentis Radix) Fangfeng (Saposhnikoviae Radix) Xixin (Ligustici Chuanxiong Rhizoma) Fangji (Stephaniae Tetrandrae Radix) Huangqin (Scutellariae Radix) Huanglian (Coptidis Rhizoma) Cangzhu (Atractylodis Rhizoma) Gancao (Licorice Root, honey-fried) Baizhu (Atractylodis Macrocephalae Rhizoma, 3 qian) Zhimu (Anemarrhenae Rhizoma) Chuanxiong (Ligustici Chuanxiong Rhizoma)
This is a medicine that resolves both Yin and Yang. Because the Qi is thin/light, it causes excretion/dissipation; therefore, Qianghuo, Duhuo, Cangzhu, Fangfeng, Chuanxiong, and Xixin are used to dispel wind and release the exterior, ascending and dispersing the transmitted pathogens. Cold natured herbs can overcome heat... [Text fragmentary: refers to resolving both interior and exterior simultaneously].