治妇人血气不调,脏腑怯弱,风冷邪气,乘虚客搏,脐腹冷疼,胁肋时胀,面
黄,肌体羸瘦,怠情嗜卧,不思饮食。常服补虚损,暖下脏,逐痼冷,进饮食。
沉香 莪术 诃子(煨,去核) 椒红(微炒,出汗) 当归(微炒) 附子(炮,去
尖、脐
、皮) 白术(各一两) 麝香(一分,别研) 丁香 肉豆蔻(炮) 良姜(切,麻油炒,
各半两
上细末,入麝香匀,酒煮面糊丸如梧桐子大,每服十丸,温酒吞下,空心食前。
莪术 三棱 陈皮(去白) 青皮(去白) 缩砂(炒) 香附子(忌铁) 干姜(炮)
丁皮(
去粗皮) 浓朴(姜制,炒,各等分)
上细末。煮麸糊为丸如梧桐子大,每服五十丸,生姜紫苏汤送下,不拘时候。
治太阳中风,阳脉浮,阴脉弱,发热汗出恶寒,鼻鸣干呕。桂枝汤。(今伤风古方谓之
中风)
桂枝(去皮,不见火) 芍药(各一两半) 甘草(一两,炙)
上粗末,抄五钱,水一盏半,生姜三片,枣一个,同煎至八分,去滓温服。若二三月病
温,宜阳旦汤。
治太阳病头痛发热,身疼恶风,无汗而喘。
麻黄(去节,百沸汤泡,去黄汁,焙干,一两半) 杏仁(三十五枚,去皮尖) 桂枝
(去
皮,不见火,一两) 甘草(半两,炙)
上粗末,每服五钱。水一盏半,煎至八分,去滓温服,覆取微汗,不须KT 粥。
加减法。伤寒热病,药性须凉,不可大温。夏至后麻黄汤须加知母半两、石膏一两、黄
芩一分。
方,不有
仲景论治伤寒一则桂枝,二则麻黄,三则大青龙。桂枝治中风;麻黄治伤寒;大青龙治
中风
不用
对之
黄对
若证
荣行脉中,卫行
仲景用桂枝以发
肌之药耳,故仲景于桂枝证云∶令遍
知中风不可大发汗,汗过则反动荣血
而荣行脉中者也。寒邪居脉中,非
是以汗不出而热,齿干以烦冤。仲
之邪。荣卫之病尔,大抵二药皆发
也。何以验之?仲景《桂枝第十九
以卫气不共荣气和谐故尔。以荣行脉
《第四十七证》云∶发热汗出者,此
中风汗出者,荣和而卫不和。又《第一卷
则伤卫,寒则伤荣,荣卫俱病,骨节烦疼,当发其汗。是知伤寒脉浮紧者,荣卫俱病也,麻
黄汤中并用桂枝。此仲景之意也。至于大青龙虽治伤风见寒脉,伤寒见风脉之病。然仲景云
∶汗出恶风者,不可服之,服之厥逆,便有筋惕肉 之证,故大青龙一证尤难用,须是形证
谛当,然后可行。故王实大夫证治,只用桂枝麻黄各半汤,盖审之也。
【椒红丸】治疗妇女气血不调,脏腑功能虚弱,风冷邪气乘虚侵入体内搏结,导致脐腹部冷痛,胁肋部时常胀满,面色萎黄,身体消瘦,精神倦怠嗜睡,不想进食。经常服用可以补益虚损,温暖下焦脏腑,驱除陈寒痼冷,增进食欲。
药材:沉香、莪术、诃子(煨制,去核)、椒红(微炒至出油)、当归(微炒)、附子(炮制,去尖端、脐部及皮)、白术(以上各一两)、麝香(一分,单独研磨)、丁香、肉豆蔻(炮制)、良姜(切片,用麻油炒,以上各半两)。
制作与用法:将上述药物研成细末,加入麝香混合均匀,用酒煮面糊制成梧桐子大小的药丸。每次服用十丸,空腹或饭前用温酒送服。
【另一理气方】
药材:莪术、三棱、陈皮(去白)、青皮(去白)、缩砂(炒制)、香附子(忌接触铁器)、干姜(炮制)、丁皮(去粗皮)、浓朴(姜汁制后炒制,以上各等分)。
制作与用法:将上述药物研成细末,用煮麸皮糊制成梧桐子大小的药丸。每次服用五十丸,不拘时间,用生姜紫苏汤送服。
【桂枝汤】治疗太阳中风证,阳脉浮,阴脉弱,发热,出汗,恶寒,鼻鸣,干呕。(现在的伤风,古方称为中风)。
药材:桂枝(去皮,不可用火烤)、芍药(以上各一两半)、甘草(一两,炙制)。
制作与用法:将药物捣成粗末,取五钱,加水一盏半,生姜三片,大枣一个,共同煎煮至八分,去渣温服。如果是二三个月后的温热病,适宜使用阳旦汤。
药材:麻黄(去节,用百沸水泡,去黄汁,焙干,一两半)、杏仁(三十五枚,去皮尖)、桂枝(去皮,不可用火烤,一两)、甘草(半两,炙制)。
制作与用法:将药物捣成粗末,每次服用五钱。加水一盏半,煎煮至八分,去渣温服,服药后覆盖衣被以取得微微汗出,不需要喝热粥来助药力。
加减法:伤寒热病,药性应当偏凉,不可过于温燥。夏至之后,使用麻黄汤必须加知母半两、石膏一两、黄芩一分。
方论:没有比张仲景论述治疗伤寒更明确的了,第一是桂枝汤,第二是麻黄汤,第三是大青龙汤。桂枝汤治疗中风;麻黄汤治疗伤寒;大青龙汤治疗……(原文此处有残缺/错乱,推测意为治疗风寒束表之重证)。若证候表现为荣行脉中,卫行脉外……张仲景使用桂枝作为发散肌表的药物,所以张仲景在桂枝汤证中说:“令遍身漐漐微似有汗者益佳,不可令如水流漓”。知道中风出汗者,不可大发汗,发汗过度则会扰动营血,因为营气是在脉中运行的。寒邪居于脉中,不是……所以不出汗而发热,牙齿干燥,心中烦闷冤屈。这是……的邪气。营卫的病罢了,大致这两种药都是发汗的药啊。何以验证呢?张仲景《桂枝第十九》……以卫气不与营气和谐的缘故。因为营行脉中,《第四十七证》说:“发热汗出者,此名中风。”中风汗出者,是营气和而卫气不和。又《第一卷》……则伤卫,寒则伤荣,荣卫都生病,骨节烦疼,应当发汗。由此可知伤寒脉浮紧者,是荣卫都生病,所以麻黄汤中同时使用桂枝。这是张仲景的本意。至于大青龙汤虽然治疗伤风见寒脉,伤寒见风脉的病。然而张仲景说:“汗出恶风者,不可服用它,服用了会出现四肢厥逆,甚至有筋惕肉瞤的症状”,所以大青龙汤这一证尤其难以使用,必须是形证确切无误,然后才可以施行。所以王实大夫的治疗案例,只使用桂枝麻黄各半汤,这是经过审慎考量的结果。
[Peohong Pill] Treats women with irregular Qi and Blood, weak Zang-Fu organs, where Wind-Cold pathogenic factors invade due to deficiency and lodge in the body, causing cold pain in the umbilical and abdominal regions, occasional distension in the hypochondrium, sallow complexion, emaciation, lethargy with a desire to lie down, and loss of appetite. Regular use can tonify deficiencies, warm the lower Jiao (Lower Burner) organs, dispel entrenched Cold, and promote appetite.
Herbs: Chenxiang (Aquilaria Lignum), Ezhu (Curcumae Rhizoma), Hezi (Terminaliae Chebulae Fructus, roasted, pitted), Jiaohong (Zanthoxyli Pericarpium, lightly stir-fried until oil exudes), Danggui (Angelicae Sinensis Radix, lightly stir-fried), Fuzi (Aconiti Lateralis Radix Praeparata, processed, tip, navel, and skin removed), Baizhu (Atractylodis Macrocephalae Rhizoma; each 1 liang), Shexiang (Moscus, 1 fen, separately ground), Dingxiang (Caryophylli Flos), Roudoukou (Myristicae Semen, processed), Liangjiang (Alpiniae Officinarum Rhizoma, sliced, stir-fried with sesame oil; each half liang).
Preparation and Administration: Grind the above herbs into a fine powder, mix uniformly with Moscus, and make pills using wine-boiled wheat paste, sized like Sophora japonica seeds. Take 10 pills per dose, swallowed with warm wine on an empty stomach or before meals.
[Another Qi-Regulating Formula]
Herbs: Ezhu (Curcumae Rhizoma), Sanleng (Sparganii Rhizoma), Chenpi (Citri Reticulatae Pericarpium, white pith removed), Qingpi (Citri Reticulatae Pericarpium Viride, white pith removed), Suosha (Amomi Fructus Rotundus, stir-fried), Xiangfuzi (Cyperi Rhizoma, avoid iron), Ganjiang (Zingiberis Rhizoma, processed), Dingpi (Caryophylli Cortex, rough bark removed), Nongpo (Magnoliae Officinalis Cortex, ginger juice processed and stir-fried; all in equal proportions).
Preparation and Administration: Grind the above herbs into a fine powder. Make pills using boiled bran paste, sized like Sophora japonica seeds. Take 50 pills per dose at any time, administered with Ginger and Perilla Decoction.
[Guizhi Tang (Cinnamon Twig Decoction)] Treats Taiyang Wind Strike (Taiyang Zhongfeng), characterized by floating Yang pulse, weak Yin pulse, fever, sweating, aversion to cold, nasal congestion with roaring sound (Biming), and dry retching. (Modern "common cold" is referred to as "Wind Strike" in ancient texts).
Herbs: Guizhi (Cinnamomi Ramulus, bark removed, do not roast over fire), Shaoyao (Paeoniae Radix Alba, each 1.5 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, honey-fried).
Preparation and Administration: Crush the herbs into coarse pieces. Take 5 qian, add 1.5 sheng of water, 3 slices of Shengjiang (Zingiberis Rhizoma Recens), and 1 Zao (Jujubae Fructus). Simmer together until reduced to 0.8 sheng, strain, and take warm. If the disease occurs in the second or third month and is a Warm Disease (Wenbing), Yangdan Tang is appropriate.
[Mahuang Tang (Ephedra Decoction)] Treats Taiyang Disease presenting with headache, fever, body ache, aversion to wind, absence of sweating, and wheezing.
Herbs: Mahuang (Ephedrae Herba, nodes removed, soaked in boiling water, yellow juice discarded, dried, 1.5 liang), Xingren (Armeniacae Semen Amarum, 35 seeds, skin and tips removed), Guizhi (Cinnamomi Ramulus, bark removed, do not roast over fire, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, half liang, honey-fried).
Preparation and Administration: Crush the herbs into coarse pieces. Take 5 qian per dose. Add 1.5 sheng of water, simmer until reduced to 0.8 sheng, strain, and take warm. Cover with blankets to induce slight sweating. There is no need to drink hot congee to assist the medicinal effect.
Modifications: For Shanghan (Cold Damage) and Heat Diseases, the nature of the medicine should be cool, not overly warming. After the Summer Solstice, when using Mahuang Tang, one must add Zhimu (Anemarrhenae Rhizoma, half liang), Shigao (Gypsum Fibrosum, 1 liang), and Huangqin (Scutellariae Radix, 1 fen).
Formula Theory: There is no treatise more definitive than Zhang Zhongjing’s discussion on treating Shanghan. The first is Guizhi Tang, the second is Mahuang Tang, and the third is Daqinglong Tang. Guizhi Tang treats Wind Strike; Mahuang Tang treats Cold Damage; Daqinglong Tang treats... [Text fragment/corruption here]. If the syndrome involves Ying (Nutritive Qi) circulating within the vessels and Wei (Defensive Qi) circulating outside... Zhang Zhongjing uses Guizhi as a herb to disperse from the muscle layer. Therefore, regarding the Guizhi Tang syndrome, Zhang Zhongjing states: "It is better if there is a slight, continuous sweat covering the whole body; it should not be profuse like flowing water." One knows that for Wind Strike with sweating, one must not induce heavy sweating; excessive sweating will disturb Ying Blood, because Ying Qi circulates within the vessels. Cold pathogens reside within the vessels... thus leading to fever without sweating, dry teeth, and inner vexation. This is a disorder of Ying and Wei. Generally, both these medicines are diaphoretic agents. How to verify this? In Zhang Zhongjing's *Gui Zhi Chapter 19*... it is because Wei Qi does not harmonize with Ying Qi. Since Ying circulates within the vessels, *Chapter 47* states: "Fever and sweating is named Wind Strike." In Wind Strike with sweating, Ying is harmonious but Wei is disharmonious. Also in *Volume 1*... Wind injures Wei, Cold injures Ying. If both Ying and Wei are diseased, causing bone and joint soreness, sweating should be induced. Thus, it is known that in Shanghan with a floating and tight pulse, both Ying and Wei are diseased; therefore, Guizhi is used concurrently in Mahuang Tang. This is Zhang Zhongjing’s intent. As for Daqinglong Tang, although it treats Wind Strike presenting with Cold pulses, or Cold Damage presenting with Wind pulses, Zhang Zhongjing says: "Those with sweating and aversion to wind must not take it; taking it may lead to cold limbs (Jue Ni) and symptoms of muscle twitching (Jin Ti Rou Yun)." Therefore, the indication for Daqinglong Tang is particularly difficult to apply correctly; it can only be used when the form and syndrome match precisely. Hence, in the case treated by Doctor Wang Shi, only Guizhi Mahuang Ge Ban Tang (Half-Guizhi Half-Mahuang Decoction) was used, demonstrating careful deliberation.