温中，去人参、胶饴者，畏其满而守也，加浓朴以泻湿中浊气，槟榔以散结气，直达下焦，广皮通行十
二经之气，改名救中汤，急驱浊阴，所以救中焦之真阳也。九痛丸一面扶正，一面驱邪，其驱邪之功
最迅，故亦可服。再按前吐泻之霍乱，有阴阳二证，干霍乱则纯有阴而无阳，所谓天地不通，闭塞
而成冬，有若否卦之义。若语言乱者，邪干心包，故先以至宝丹，驱包络之邪也。
救中汤方（苦辛通法）
蜀椒（炒出汗，三钱） 淡干姜（四钱） 浓朴（三钱） 槟榔（二钱） 广皮（二钱）
水五杯，煮取二杯，分二次服。兼转筋者，加桂枝（三钱） 防己（五钱） 薏仁（三钱）。厥者加附子二钱。
九痛丸方（治九种心痛，苦辛甘热法）
附子（三两） 生野狼牙（一两） 人参（一两） 干姜（一两） 吴茱萸（一两） 巴豆（去皮心熬碾如膏，一两）
蜜丸梧子大，酒下，强人初服三丸，日三服，弱者二丸。
兼治卒中恶，腹胀痛，口不能言；又治连年积冷，流注心胸痛，并冷、冲上气，落马、坠车、血病等
证皆主之。忌口如常法。
〔方论〕《内经》有五脏胃腑心痛，并痰虫食积，即为九痛也。心痛之因，非风即寒，故以干姜、附
子驱寒壮阳，吴茱萸能降肝脏浊阴下行，生野狼牙善驱浮风，以巴豆驱逐痰虫陈滞之积，人参养正驱
邪，因其药品气血皆入，补泻攻伐皆备，故治中恶腹胀痛等证。
附录《外台》走马汤，治中恶、心痛、腹胀、大便不通，苦辛热法。沈目南注云∶中恶之证，俗谓绞
肠乌痧，即秽臭恶毒之气，直从口鼻，入于心胸肠胃脏腑，壅塞正气不行，故心痛腹胀，大便不通，是
为实证。非似六淫侵入而有表里清浊之分。故用巴豆极热大毒峻猛之剂，急攻其邪，佐杏仁以利肺
与大肠之气，使邪从后阴，一扫尽除，则病得愈。若缓须臾，正气不通，营卫阴阳机息则死，是取
通则不痛之义也。
巴豆（去心皮熬，二枚） 杏仁（二枚）
上二味，以绵缠槌令碎，热汤二合，捻取白汁饮之，当下。老小强弱量之。通治飞尸鬼击病。
按《医方集解》中，治霍乱用阴阳水一法，有协
和阴阳，使不相争之义。又治干霍乱用盐汤探吐一法，盖闭塞至极之证，除针灸之外，莫如吐法通
阳最速。夫呕，厥阴气也，寒痛，太阳寒水气也，否，冬象也，冬令太阳寒水，得厥阴气至，风能上升，则
一阳开泄，万象皆有生机矣。至针法，治病最速，取祸亦不缓，当于《甲乙经》中求之，非善针者，不
可令针也。
立生丹（治伤暑、霍乱、痧证、疟、痢、泄泻、心痛、胃痛、腹痛、吞吐酸水，及一切阴寒之证、结胸、
小儿寒痉）
母丁香（一两二钱） 沉香（四钱） 茅苍术（一两二钱） 明雄黄（一两二钱）
上为细末，用蟾酥八钱，铜锅内加火酒一小杯，化开，入前药末，丸绿豆大。每服二丸，小儿一
丸，温水送下。又下死胎如神。凡被蝎蜂螫者，调涂立效，惟孕妇忌之。
此方妙在刚燥药中加芳香透络。蟾乃土之精，上应月魄，物之浊而灵者，其酥入络，以毒攻毒，而
方又有所监制，故应手取效耳。
独胜散（治绞肠痧痛急，指甲唇俱青，危在顷刻）
马粪（年久弥佳）
不拘分两，瓦上焙干为末。老酒冲服二、三
钱，不知，再作服。
此方妙在以浊攻浊。马性刚善走，在卦为干，粪乃浊阴所结，其象圆，其性通，故能摩荡浊阴之
邪，仍出下窍。忆昔年济南方 庵 任九江，临行，一女子忽患痧证，就地滚嚎，声嘶欲绝。 庵云∶偶
因择日不谨，误犯红痧，或应此乎？余急授此方，求马粪不得；即用骡粪，并非陈者，亦随手奏功。
在救中汤中，去掉人参和胶饴（麦芽糖），是因为担心它们会导致气机壅滞且性质守而不走；加入浓朴以泻除湿浊之气，槟榔以消散结聚之气，使药力直达下焦，广皮（陈皮）通行十二经的气机，因此改名为救中汤，旨在迅速驱逐浊阴之邪，从而挽救中焦的真阳。九痛丸一方面扶助正气，一方面驱除邪气，其驱邪的功效最为迅捷，所以也可以服用。再按前文所述吐泻型的霍乱，分为阴证和阳证两种，干霍乱则纯粹只有阴证而没有阳证，这就像天地之气不通，闭塞而成冬季的景象，具有《易经》否卦的含义。如果出现言语错乱的症状，是邪气干扰了心包络，所以先用至宝丹来驱除心包络的邪气。
救中汤方（属于苦辛通法）
蜀椒（炒至出汗，三钱） 淡干姜（四钱） 浓朴（三钱） 槟榔（二钱） 广皮（二钱）
用水五杯，煮取两杯药液，分两次服用。如果兼有转筋症状，加桂枝（三钱）、防己（五钱）、薏仁（三钱）。如果出现四肢厥冷，加附子二钱。
九痛丸方（治疗九种心痛，属于苦辛甘热法）
附子（三两） 生野狼牙（一两） 人参（一两） 干姜（一两） 吴茱萸（一两） 巴豆（去皮心，熬制碾成膏状，一两）
用蜂蜜制成梧桐子大小的丸剂，酒送服。体质强壮的人初次服用三丸，每天三次；体质虚弱的人服用两丸。
此外还治疗突然中受恶毒之气，腹部胀满疼痛，口不能言；又治疗连年积冷，流注导致心胸疼痛，以及冷气冲上气息、落马、坠车等引起的血瘀病症，都主治这些情况。忌口方法如常规一样。
〔方论〕《内经》中提到五脏及胃腑的心痛，加上痰、虫、食积，合起来就是九种痛。心痛的成因，不是风邪就是寒邪，所以用干姜、附子来驱散寒邪、壮盛阳气，吴茱萸能降肝脏的浊阴下行，生野狼牙善于驱散浮游之风，用巴豆驱逐痰虫和陈旧的积滞，人参养护正气并辅助驱邪，因为这些药物的气血特性都能入药，补益与攻伐兼备，所以能治疗中恶腹胀痛等病症。
附录《外台秘要》中的走马汤，治疗中恶、心痛、腹胀、大便不通，属于苦辛热法。沈目南注释说：中恶这种病症，俗称绞肠乌痧，即秽臭恶毒之气，直接从口鼻进入心胸肠胃脏腑，壅塞正气使其不能运行，所以出现心痛腹胀、大便不通，这是实证。不像六淫侵入那样有表里清浊的区别。所以使用巴豆这种极热大毒、峻猛的药物，急攻其邪，佐以杏仁来利肺与大肠的气机，使邪气从后阴排出，一扫而尽，病就能痊愈。如果稍微迟缓，正气不通，营卫阴阳机能停止就会死亡，这是取“通则不痛”的道理。
巴豆（去心皮，熬制，两枚） 杏仁（两枚）
以上两味药，用棉布包裹捣碎，用热水两合，揉搓提取白色汁液饮用，应当会腹泻。根据老人、小孩及体质的强弱调整剂量。通用治疗飞尸鬼击病。
按《医方集解》中记载，治疗霍乱有一法是用阴阳水，其中有调和阴阳、使二者不相争斗的含义。另外治疗干霍乱有一法是用盐汤探吐，大概是闭塞至极的病症，除了针灸之外，没有比吐法通阳更迅速的。呕吐，是厥阴经的气机表现；寒痛，是太阳寒水之气；否卦，是冬季的象征。冬季令行时太阳寒水之气当令，得到厥阴风气至，风能上升，那么一阳开泄，万物都有生机了。至于针法，治病最快，招致祸患也不慢，应当在《甲乙经》中寻求，不是擅长针灸的人，不可以让他施针。
立生丹（治疗伤暑、霍乱、痧证、疟疾、痢疾、泄泻、心痛、胃痛、腹痛、吞吐酸水，以及一切阴寒之证、结胸、小儿寒痉）
母丁香（一两二钱） 沉香（四钱） 茅苍术（一两二钱） 明雄黄（一两二钱）
以上研为细末，用蟾酥八钱，在铜锅内加一小杯酒化开，加入前面的药末，制成绿豆大小的丸剂。每次服用两丸，小儿服用一丸，温水送下。又能像神一样地下死胎。凡是被人蝎、蜜蜂蛰伤的，调涂后立即见效，只有孕妇禁用。
此方的妙处在于刚燥药中加入芳香透络的药物。蟾蜍是土的精华，上应月魄，是物中浊而灵的东西，其酥入络，以毒攻毒，而且方中有药物监制，所以能应手取效。
独胜散（治疗绞肠痧痛急，指甲嘴唇都发青，危急在顷刻之间）
马粪（年代越久越好）
不拘分两，在瓦上焙干研为粉末。老酒冲服二、三钱，如果不奏效，再服用。
此方的妙处在于以浊攻浊。马性刚健善跑，在八卦中属乾卦，粪便乃浊阴所结，其形状圆，其性通，所以能磨荡浊阴之邪，仍从下窍排出。回忆昔年在济南，方庵担任九江知府时，临行前，一名女子忽然患上痧证，就地打滚嚎叫，声音嘶哑几乎断绝。方庵说：“偶然因为择日不谨慎，误犯红痧，或许应验于此吧？”我急忙传授此方，求不到马粪；就用骡粪，并不是陈年的，也随手奏效。
In the Jiuzhong Decoction (Rescue the Middle Decoction), Ren Shen (Ginseng Root) and Jiaoyi (Malt Sugar) are removed because it is feared that they will cause Qi stagnation and possess a static nature. Nongpu (Magnolia Bark) is added to drain turbid Qi from dampness, Binglang (Areca Seed) to dissipate stagnant Qi, allowing the medicinal effect to reach directly to the Lower Jiao (Lower Burner). Guangpi (Tangerine Peel) circulates Qi through the Twelve Meridians. Therefore, it is renamed Jiuzhong Decoction, aiming to rapidly expel Turbid Yin pathogens, thereby rescuing the True Yang of the Middle Jiao. The Jiutong Wan (Nine Pain Pill) simultaneously supports healthy Qi and expels pathogenic factors; its efficacy in expelling pathogens is the most rapid, so it can also be taken. Regarding the previous discussion on cholera with vomiting and diarrhea, there are two syndromes: Yin and Yang. Gan Huoluan (Dry Cholera) presents purely with Yin syndrome without Yang, resembling the obstruction of Heaven and Earth's Qi, leading to closure akin to winter, which corresponds to the meaning of the Pi Hexagram (Obstruction) in the I Ching. If speech is disordered, it indicates pathogens interfering with the Pericardium (Heart Protector), so Zhibao Dan (Treasure of Life Pill) is used first to expel pathogens from the Pericardium.
Jiuzhong Decoction Formula (Bitter-Acrid Unblocking Method)
Shujiao (Stir-fried until oil sweats out, 3 qian) Dansheng Jiangyan (Pale Dried Ginger, 4 qian) Nongpu (Magnolia Bark, 3 qian) Binglang (Areca Seed, 2 qian) Guangpi (Tangerine Peel, 2 qian)
Boil five cups of water until reduced to two cups. Divide into two doses for administration. If accompanied by muscle cramps (Zhuanjin), add Guizhi (Cinnamon Twig, 3 qian), Fangji (Stephania Root, 5 qian), and Yiren (Coix Seed, 3 qian). If cold extremities (Jue) occur, add Fuzi (Prepared Aconite Root, 2 qian).
Jiutong Wan Formula (Treating Nine Types of Heartache, Bitter-Acrid-Sweet-Hot Method)
Fuzi (Prepared Aconite Root, 3 liang) Sheng Ye Langya (Raw Wild Wolf's Tooth Herb, 1 liang) Renshen (Ginseng Root, 1 liang) Ganjiang (Dried Ginger, 1 liang) Wuzhuyu (Evodia Fruit, 1 liang) Badou (Croton Seed, peeled and cored, boiled and ground into paste, 1 liang)
Form pills the size of wu zi (Chinese quince seeds) using honey. Administer with wine. For strong individuals, start with three pills, three times daily; for weak individuals, take two pills.
It additionally treats sudden onset of evil qi (Zhong E), abdominal distension and pain, inability to speak; chronic accumulated cold flowing into the heart and chest causing pain; cold qi rushing upward; injuries from falling off horses or carriages resulting in blood stasis syndromes. Dietary restrictions follow standard protocols.
[Formula Commentary] The *Neijing* (Classic of Internal Medicine) mentions heartache arising from the Five Zang organs and the Stomach Fu organ, combined with phlegm, parasites, and food accumulation, constituting the nine pains. The causes of heartache are either Wind or Cold. Thus, Ganjiang and Fuzi are used to dispel cold and strengthen Yang. Wuzhuyu descends turbid Yin from the Liver. Sheng Ye Langya dispels floating Wind. Badou expels phlegm, parasites, and old accumulations. Renshen nourishes healthy Qi while assisting in expelling pathogens. Since these herbs enter both Qi and Blood levels, containing both tonifying and purgative properties, they treat conditions like Zhong E with abdominal distension and pain.
Appendix: Zouma Tang (Running Horse Decoction) from *Waitai Miyao*, treating Zhong E, heartache, abdominal distension, and constipation. This belongs to the Bitter-Acrid-Hot method. Shen Munan commented: Zhong E, commonly known as "Jiaochang Wu Sha" (Intestine-Twisting Black Miasma), refers to foul and toxic qi entering directly through the mouth and nose into the heart, chest, stomach, intestines, and zang-fu organs, obstructing healthy Qi and preventing its circulation, resulting in heartache, abdominal distension, and constipation. This is an Excess syndrome. It differs from invasion by the Six Climatic Factors (Liu Yin), which have distinctions between exterior/interior and clear/turbid. Therefore, Badou, an extremely hot, highly toxic, and potent agent, is used to urgently attack the pathogen. Xingren (Apricot Seed) assists in benefiting Lung and Large Intestine Qi, allowing pathogens to exit via the posterior orifice, clearing everything away so the disease resolves. If delayed even slightly, healthy Qi becomes blocked, Ying-Wei (Nutritive-Defensive) and Yin-Yang mechanisms cease, leading to death. This follows the principle that "unblocked means no pain."
Badou (Remove heart and skin, boil, 2 seeds) Xingren (Apricot Seed, 2 seeds)
Crush the above two ingredients wrapped in cotton. Add two he of hot water, squeeze to extract white juice, and drink. Diarrhea should ensue. Adjust dosage according to age and strength of elderly, children, and robust/frail individuals. Universally treats Feishi Guiji diseases (sudden severe illnesses attributed to evil spirits).
According to *Yifang Jijie* (Collection of Medical Formulas), treating Huoluan with Yin-Yang Water has the meaning of harmonizing Yin and Yang to prevent conflict. Treating Gan Huoluan with Salt Soup inducing vomiting is suitable for extreme obstruction cases; besides acupuncture, no method unblocks Yang more rapidly than emesis. Vomiting relates to Jueyin (Liver/Pericardium) Qi; cold pain relates to Taiyang (Bladder) Cold-Water Qi; the Pi Hexagram represents Winter. In Winter, when Taiyang Cold-Water Qi prevails and Jueyin Wind Qi arrives, wind rises, allowing One Yang to open and release, bringing vitality to all phenomena. Acupuncture treats diseases most rapidly but can also bring disaster quickly; one should seek methods in the *Jia Yi Jing*. Only skilled acupuncturists should perform needling.
Lisheng Dan (Life-Creating Pill) (Treating Heatstroke, Huoluan, Sha Syndrome, Malaria, Dysentery, Diarrhea, Heartache, Stomachache, Abdominal Pain, regurgitation of sour fluid, all Yin-Cold syndromes, Jie Xiong (Chest Binding), and Infantile Cold Spasms)
Mu Dingxiang (Clove, 1 liang 2 qian) Chenxiang (Agarwood, 4 qian) Mao Cangzhu (Atractylodes Rhizome, 1 liang 2 qian) Ming Xionghuang (Realgar, 1 liang 2 qian)
Grind into fine powder. Dissolve Chan Su (Toad Venom, 8 qian) in a copper pot with a small cup of rice wine. Mix with the powder and form pills the size of mung beans. Take two pills per dose, one pill for children, with warm water. Also effectively expels dead fetus. For scorpion or bee stings, apply topically for immediate effect. Contraindicated in pregnancy.
The brilliance of this formula lies in adding aromatic, meridian-penetrating herbs to rigid and drying agents. Toads are the essence of Earth, corresponding to the moon; they are turbid yet spiritual substances. Their venom enters collaterals, attacking toxicity with toxicity, and the formula includes controlling agents, ensuring prompt efficacy.
Dusheng San (Single Victory Powder) (Treating acute Jiaochang Sha pain, cyanosis of nails and lips, critical condition imminent)
Ma Fen (Horse Manure) (Older is better)
No specific dosage. Roast on tiles until dry and grind into powder. Take 2-3 qian mixed with aged wine. If ineffective, administer again.
The merit of this formula lies in using turbidity to attack turbidity. Horses are vigorous and fast-moving, corresponding to the Qian Trigram. Manure is formed of turbid Yin, round in shape and penetrating in nature, thus able to rub away turbid Yin pathogens, expelling them through the lower orifices. Recalling past years in Jinan, when Fang An served as Prefect of Jiujiang, before his departure, a young woman suddenly suffered from Sha syndrome, rolling on the ground screaming hoarsely. Fang An said, "Perhaps due to careless date selection, offending Red Sha?" I urgently prescribed this formula, but could not find horse manure; used mule manure instead, not aged, yet achieved immediate results.