机要三化汤中风外有六经之形证先以加减续命汤治之内有便溺之阻隔者此方主之
浓朴 大黄 枳实 羌活(各八分)上锉每服一两水煎
此治风邪入里之下药也即伤寒用承气之意非内实者不可
子和搜风丸治风热上攻眼昏耳鸣鼻塞头痛眩运痰逆涎嗽心腹痞痛大小便结滞
人参 茯苓 天南星 薄荷(各半两) 干生姜 寒水石 生白矾(各一两)
蛤粉 黄芩 大黄(各一两) 滑石 牵牛(各四两) 藿香(一分) 半夏(一两)
上为末水丸小豆大生姜汤下日三
按此方名为搜风其实乃下实热痰之药
宣明防风通圣散治一切风热
防风 川芎 当归 芍药 大黄 芒硝 连翘 薄荷
麻黄(各半两) 甘草(二两) 石膏 桔梗
黄芩(各一两) 滑石(三两) 白术 山栀 荆芥穗(各半两) 一方去芒硝加牛膝人参半夏
上咀末生姜煎
按此乃肺脾膀胱胃肝心经之药也又表里血气之药也海藏云防风麻黄汗剂也大黄芒硝下剂
也栀
子滑石利小便也发表攻里合而并进故治杂病则佳治伤寒伤风有失仲景云发表攻里本自不同在
大定间此药盛行于世而多效何哉当时虽市井之徒口腹备衣着全但志药而形不苦然是凉亦多效
而少失变乱之际齑盐糟糠有所不充加以天地肃杀之运敢用凉药如平泰之世耶故多失而少效有
如仲景用桂枝当汉之末也韩祗和戒桂枝当宋之隆时时世之异不可不知
《机要》中的三化汤:中风病在外表现为六经的形证,先用加减续命汤治疗;若内有二便(大小便)阻隔不通者,此方主治。
浓朴、大黄、枳实、羌活(各八分)。以上药材切碎,每次服用一两,用水煎煮。
这是治疗风邪入里的攻下药,其用意即伤寒论中使用承气汤的意思,如果不是体内实热积滞的患者不可使用。
子和搜风丸:治疗风热上攻导致的眼目昏花、耳鸣、鼻塞、头痛、眩晕、痰逆、涎嗽、心腹痞满疼痛、大小便结滞不通。
人参、茯苓、天南星、薄荷(各半两);干生姜、寒水石、生白矾(各一两);蛤粉、黄芩、大黄(各一两);滑石、牵牛子(各四两);藿香(一分);半夏(一两)。
以上药物研为细末,用水泛丸,如小豆大小,用生姜汤送服,每日三次。
防风、川芎、当归、芍药、大黄、芒硝、连翘、薄荷、麻黄(各半两);甘草(二两);石膏、桔梗、黄芩(各一两);滑石(三两);白术、山栀、荆芥穗(各半两)。另一版本去掉芒硝,加入牛膝、人参、半夏。
以上药物切碎成粗末,加生姜煎煮。
按语:此方是作用于肺、脾、膀胱、胃、肝、心经的药物,也是表里同治、气血双调的药物。海藏(张元素)说:防风、麻黄是发汗剂;大黄、芒硝是泻下剂;栀子、滑石是利小便剂。发表与攻里合而并进,所以治疗杂病效果很好。但治疗伤寒、伤风时,有违背仲景所说的“发表”与“攻里”本自不同的原则。在大定年间,此药在世间盛行且多有效,为什么呢?当时虽然市井之徒口腹满足、衣着齐全,但志向在于服药而形体不苦,因此即使是凉性药也多有效且少有失误。但在战乱变乱之际,连咸菜糟糠都吃不饱,加上天地肃杀之气盛行,岂敢像太平盛世那样随意使用凉药呢?所以多失误而少有效。这就像仲景使用桂枝汤是在汉朝末年一样,韩祗和告诫慎用桂枝是在宋朝兴盛时期,时代世道的差异是不可不知晓的。
Sanhua Tang from *Jiyao*: For wind-stroke presenting with exterior manifestations of the Six Channels, first treat with Jiajian Xuming Tang; if there is internal obstruction of bowel and bladder movements (defecation and urination), this formula is indicated.
Mudou (Magnoliae Officinalis Cortex), Dahuang (Rhei Radix et Rhizoma), Zhishi (Aurantii Fructus Immaturus), Qianghuo (Notopterygii Rhizoma et Radix) (each 8 fen). The above herbs are cut into pieces; each dose is 1 liang, decocted in water.
This is a purgative formula for treating pathogenic wind entering the interior, embodying the principle of using Chengqi Decoction in Cold Damage disorders. It must not be used unless there is internal excess accumulation.
Sofeng Wan (Search Wind Pill) by He Zizheng: Treats wind-heat attacking upward, causing blurred vision, tinnitus, nasal congestion, headache, vertigo, rebellious phlegm, salivary cough, epigastric and abdominal fullness and pain, and constipation of both bowels and bladder.
Ren Shen (Ginseng Radix), Fuling (Poria), Tiannanxing (Arisaematis Rhizoma), Bohe (Menthae Haplocalycis Herba) (each 0.5 liang); Gan Jiang (Zingiberis Rhizoma), Hanshuishi (Halloysitum Rubrum), Sheng Baifan (Alumen Crude) (each 1 liang); Ha Fen (Concha Meretricis et Cyprinis), Huang Qin (Scutellariae Radix), Dahuang (Rhei Radix et Rhizoma) (each 1 liang); Huashi (Kaolinitum), Qianniu (Pharbitidis Semen) (each 4 liang); Huoxiang (Agastaches Herba) (1 fen); Banxia (Pinelliae Rhizoma) (1 liang).
The above herbs are powdered and formed into pills the size of small beans, taken with Ginger Decoction, three times daily.
Note: Although named "Search Wind," this is actually a formula for purging excess heat and phlegm turbidity.
Fengtong Sheng San (Wind-Blocking Unblocking Powder) from *Xuanming*: Treats all types of wind-heat conditions.
Fangfeng (Saposhnikoviae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Alba), Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas), Lianqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba), Mahuang (Ephedrae Herba) (each 0.5 liang); Gancao (Glycyrrhizae Radix et Rhizoma) (2 liang); Shigao (Gypsum Fibrosum), Jiegeng (Platycodonis Radix), Huang Qin (Scutellariae Radix) (each 1 liang); Huashi (Kaolinitum) (3 liang); Baizhu (Atractylodis Macrocephalae Rhizoma), Shanzhi (Gardeniae Fructus), Jingjie Sui (Schizonepetae Spica) (each 0.5 liang). An alternative version removes Mangxiao and adds Niuxi (Achyranthis Bidentatae Radix), Ren Shen (Ginseng Radix), and Banxia (Pinelliae Rhizoma).
The above herbs are cut into coarse powder and decocted with fresh ginger.
Note: This formula acts on the Lung, Spleen, Bladder, Stomach, Liver, and Heart channels; it is also a formula that treats both exterior and interior, as well as qi and blood. Haizang (Zhang Yuansu) stated: Fangfeng and Mahuang are diaphoretic agents; Dahuang and Mangxiao are purgative agents; Shanzhi and Huashi promote urination. By combining exterior-releasing and interior-purging actions to advance together, it yields good results for miscellaneous diseases. However, when treating Cold Damage or Wind-Cold, it deviates from Zhongjing's principle that releasing the exterior and purging the interior should be distinct. During the Dading era, this medicine was prevalent and often effective. Why? At that time, although commoners had sufficient food and clothing, their minds were focused on taking medicine while their bodies endured no hardship; thus, even cooling medicines were often effective with few adverse changes. But during times of war and chaos, when even pickles and chaff are insufficient, coupled with the austere and killing qi of heaven and earth, how could one dare use cooling medicines as calmly as in peaceful times? Hence, there were many failures and few successes. This is akin to Zhongjing using Guizhi Tang at the end of the Han Dynasty, or Han Zhihe cautioning against Guizhi during the prosperity of the Song Dynasty. The differences in times and circumstances must not be ignored.