(治感受风寒暑湿饮食失余霍乱吐泻贴心脐照金仙膏加药)
苍术(
活防风 荆芥 川芎 白芷 杏仁 香附 乌药 青皮 大腹皮 槟榔 草果 木瓜 郁
金细辛 香薷 白术 车前子 黄连(姜汁炒透) 大黄 猪苓 木通 泽泻 莱菔子(各
一两) 紫苏(子同) 柴胡(炒) 干葛 薄荷(各七钱) 吴萸 川乌 甘草(各五钱) 滑石(
四两)○生姜 薤白 葱白 大蒜头 菖蒲(各二两) 凤仙(一株) 白芥子 川椒 陈佛手
干(各一两) 油丹熬 入雄黄朱砂砂仁明矾绛香木香丁香官桂(各五钱)
(治麻脚痧冷汗厥逆者加附桂丁麝末贴胸脐须参金仙膏注)
生附子
萸苍术 草乌 独活 故纸 良姜 延胡 灵脂 草蔻仁(各一两) 川芎 防风 桂枝
细辛 酒芍 当归(各七钱) 陈皮 浓朴 荜澄茄 乌梅 炙甘草 巴戟 益智仁 大茴
姜黄连 乌药 麦冬 五味子 肉蔻仁(各五钱)○或加党参黄 各一两○生姜(二十片)薤白(
七个)韭白 艾(各二两) 菖蒲(三钱) 凤仙 白芥子(五钱) 白胡椒(一两) 油丹熬 入
雄黄朱砂矾檀香木香丁香砂仁乳香没药(各五钱)
(附子二两炮姜党参吴萸麦冬一两黄连五味知母五钱熬贴并用回
本汤人参麦冬钱半附子炮姜肉桂五味陈皮腊茶一钱炙草五分如姜枣煎浓汁调蜜擦心口)
按黄
按徐子默论治麻脚痧云阴寒直中三阴于素体虚寒饱
。劳顿肥胖之人为多。其症舌苔色白。渴而不燥。(白为寒宜温药若转黄苔方可清凉有舌现
镜面红色而仍杂白苔者乃阳药太过胃中寒邪未尽肾中阴精已涸难治)胸中气闷。(未吐泻者用
藿香神曲杏仁陈皮半夏干姜佛手干白蔻仁等)呕吐(寒邪上冲于胃胃窍闭则吐下冲于脾脾窍闭
则泻吐用吴萸炒黄连广皮半夏桂枝干姜生姜乌梅等可止)下利(用参术姜草吴萸桂枝白芍附子
小茴五味陈皮肉蔻仁半夏等有食加山楂麦芽)厥逆。(中土衰而气不布于四肢也先冷手者责在
脾肺先冷足者责在脾肾用参麦味附桂半陈萸椒生姜等如抽掣者加木瓜)烦躁(阳上格则心烦阴
先竭则肾躁此真寒假热也用川连附子麦冬白芍桂枝五味归身干姜甘草焦术 牡蛎等)口渴。(
此津液下拔所致用参连麦术姜桂芍归石斛乌梅甘桔等或但用姜梅)冷汗(真阳外越也若周身汗
气喘则脱矣用参附 术姜桂归芍麦味茯甘 牡蛎等)转筋。(寒主收故筋脉抽掣也热症抽掣不
甚痛而手足温和寒症必大痛而手足大冷间有不抽者或寒轻或气败也气败者外象必重虽不抽必
伤命)治法不外温经通阳。以祛寒邪以归阴火。遵仲景治三阴之旨而已。(诸药均可用以煎抹
炒熨)○热膏心口皆忌(只可三分)如误贴(鼻干喉痛)清阳膏解之。
(治疗因感受风寒暑湿或饮食不当导致的霍乱、呕吐、腹泻,贴敷于脐部。此方在金仙膏基础上加药。)
苍术、活防风、荆芥、川芎、白芷、杏仁、香附、乌药、青皮、大腹皮、槟榔、草果、木瓜、郁金、细辛、香薷、白术、车前子、黄连(用姜汁炒透)、大黄、猪苓、木通、泽泻、莱菔子(以上各一两);紫苏(连同紫苏子一起使用)、柴胡(炒制)、干葛、薄荷(以上各七钱);吴茱萸、川乌、甘草(以上各五钱);滑石(四两)。○生姜、薤白、葱白、大蒜头、石菖蒲(以上各二两);凤仙花(一株);白芥子、川椒、陈佛手干(以上各一两)。用油丹熬制成膏,加入雄黄、朱砂、砂仁、明矾、降香、木香、丁香、官桂(以上各五钱)。
(治疗麻脚痧出现冷汗、四肢厥逆者,需加入附子、肉桂、丁香、麝香的粉末,贴敷于胸腹部。必须参考金仙膏的注释。)
生附子、山茱萸、苍术、草乌、独活、补骨脂、高良姜、延胡索、五灵脂、草豆蔻仁(以上各一两);川芎、防风、桂枝、细辛、酒白芍、当归(以上各七钱);陈皮、厚朴、荜澄茄、乌梅、炙甘草、巴戟天、益智仁、大茴香、干姜、黄连、乌药、麦冬、五味子、肉豆蔻仁(以上各五钱)。○或者加入党参、黄芪,各一两。○生姜(二十片)、薤白(七个)、韭白、艾叶(以上各二两);石菖蒲(三钱);凤仙花、白芥子(五钱);白胡椒(一两)。用油丹熬制成膏,加入雄黄、朱砂、明矾、檀香、木香、丁香、砂仁、乳香、没药(以上各五钱)。
(另一配方:附子二两,炮姜、白术、吴茱萸、官桂各一两,丁香、五味子、艾叶各五钱。熬制后贴敷,并配合发汗法。)
(另一配方:附子二两,炮姜、党参、吴茱萸、麦冬各一两,黄连、五味子、知母各五钱。熬制后贴敷,并配合回本汤使用。回本汤组成:人参、麦冬各一钱半,附子、炮姜、肉桂、五味子、陈皮各一钱,炙甘草五分。如煎煮时加入姜、枣,取浓汁调蜂蜜擦拭心口。)
按语:徐子默论述治疗麻脚痧时说,阴寒之邪直中三阴经,多见于素体虚寒、饱食后劳累、肥胖之人。其症状表现为舌苔色白,口渴但不干燥。(舌苔白为寒象,宜用温药;若转为黄苔方可使用清凉药。若舌面呈现镜面红色而仍夹杂白苔,这是阳热药物太过,导致胃中寒邪未尽,肾中阴精已枯竭,属难治之症。)胸中气闷。(对于尚未呕吐腹泻者,可用藿香、神曲、杏仁、陈皮、半夏、干姜、佛手、干白蔻仁等药。)呕吐。(寒邪上冲于胃,胃窍闭塞则呕吐;寒邪下冲于脾,脾窍闭塞则腹泻。止吐可用吴茱萸、炒黄连、广陈皮、半夏、桂枝、干姜、生姜、乌梅等药。)下利(腹泻)。(可用人参、白术、干姜、甘草、吴茱萸、桂枝、白芍、附子、小茴香、五味子、陈皮、肉豆蔻仁、半夏等药;若有积食,加山楂、麦芽。)四肢厥冷。(中焦脾胃衰败,阳气不能布达四肢。先感到手部寒冷,病责在脾肺;先感到足部寒冷,病责在脾肾。可用人参、麦冬、五味子、附子、肉桂、半夏、陈皮、吴茱萸、花椒、生姜等药;若伴有抽搐,加木瓜。)烦躁。(阳气格拒于上则心烦,阴液先竭于下则肾躁,此为真寒假热证。可用川黄连、附子、麦冬、白芍、桂枝、五味子、当归身、干姜、甘草、焦白术、牡蛎等药。)口渴。(这是由于津液向下流失所致。可用人参、黄连、麦冬、白术、干姜、肉桂、白芍、当归、石斛、乌梅、甘草、桔梗等药;或者仅用生姜、乌梅。)冷汗。(这是真阳外越的表现。若周身出汗且气喘,则是阳气脱失之兆。可用人参、附子、白术、干姜、肉桂、当归、白芍、麦冬、五味子、茯苓、甘草、牡蛎等药。)转筋(肌肉痉挛)。(寒性收引,故导致筋脉抽掣。热证引起的抽掣疼痛不剧烈且手足温和;寒证引起的必然大痛且手足极冷。间或有不抽掣的,或是寒邪较轻,或是气机败坏。气机败坏者,外在征象必然严重,即使不抽掣也必危及生命。)治疗方法不外乎温通经脉,宣通阳气,以祛除寒邪,使浮越之火回归本源。遵循张仲景治疗三阴病的宗旨罢了。(上述诸药均可用于煎水擦拭、炒热熨烫。)○热性膏药在心口部位皆忌用(只能贴三分面积)。如果误贴导致鼻干喉痛,可用清阳膏来解救。
(Treating Huoluan [acute gastrointestinal disorder with vomiting and diarrhea] caused by exposure to wind, cold, summer-heat, dampness, or improper diet. Apply to the umbilicus. This formula adds herbs to Jin Xian Gao [Golden Immortal Plaster].)
Cangzhu (Atractylodis Rhizoma), Huo Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Herba), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Xingren (Armeniacae Semen Amarum), Xiangfu (Cyperi Rhizoma), Wuyao (Linderae Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Dafupi (Arecae Pericarpium), Binglang (Arecae Semen), Caoguo (Tsaoko Fructus), Mugua (Chaenomelis Fructus), Yujin (Curcumae Longae Rhizoma), Xixin (Asari Radix et Rhizoma), Xiangru (Elsholtziae Herba), Baizhu (Atractylodis Macrocephalae Rhizoma), Cheqianzi (Plantaginis Semen), Huanglian (Coptidis Rhizoma, stir-fried with ginger juice), Dahuang (Rhei Radix et Rhizoma), Zhuling (Polyporus), Mutong (Akebiae Caulis), Zexie (Alismatis Rhizoma), Laifuzi (Raphani Semen) (each 1 liang); Zisu (Perilla Fructus used together with Perilla Folium), Chaihu (Bupleuri Radix, stir-fried), Gange (Puerariae Radix), Bohe (Menthae Haplocalycis Herba) (each 7 qian); Wuyu (Evodiae Fructus), Chuanwu (Aconiti Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each 5 qian); Huashi (Talcum) (4 liang). ○ Shengjiang (Zingiberis Rhizoma Recens), Xiebai (Allii Macrostemonis Bulbus), Congbai (Allii Fistulosi Bulbus), Dasuantou (Allii Sativi Bulbus), Changpu (Acori Tatarinowii Rhizoma) (each 2 liang); Fengxian (Impatiens Petal) (one plant); Baijiezhi (Sinapis Semen), Chuanjiao (Zanthoxyli Pericarpium), Chen Foshougan (Citri Sarcodactylis Fructus Dry) (each 1 liang). Boil with oil and yellow lead oxide to make a plaster. Add Xionghuang (Realgar), Zhusha (Cinnabaris), Sharen (Amomi Fructus), Mingfan (Alumen), Jiangxiang (Daemonorops Draco), Muxiang (Aucklandiae Radix), Dingxiang (Eugeniae Floreos Bud), Guanzi (Cinnamomi Cortex) (each 5 qian).
(For Majia Sha [malaria-like illness with foot cramps] presenting with cold sweat and limb coldness/convulsions, add powder of Fuzi (Aconiti Lateralis Radix Preparata), Rougui (Cinnamomi Cortex), Dingxiang (Eugeniae Floreos Bud), and Shexiang (Moschus). Apply to the chest and umbilicus. Must refer to notes on Jin Xian Gao.)
Sheng Fuzi (Aconiti Lateralis Radix), Yuzhu (Corni Fructus), Cangzhu (Atractylodis Rhizoma), Caowu (Aconiti Radix), Duhuo (Angelicae Pubescentis Radix), Guzhi (Psoraleae Fructus), Liangjiang (Alpiniae Officinarum Rhizoma), Yanhu (Corydalis Rhizoma), Lingzhi (Trogopterori Faeces), Cao Kou Ren (Cardamomi Fructus) (each 1 liang); Chuanxiong (Ligustici Chuanxiong Rhizoma), Fangfeng (Saposhnikoviae Radix), Guizhi (Cinnamomi Ramulus), Xixin (Asari Radix et Rhizoma), Jiu Shaoyao (Paeoniae Radix Alba, wine-treated), Danggui (Angelicae Sinensis Radix) (each 7 qian); Chenpi (Citri Reticulatae Pericarpium), Nongpo (Magnoliae Officinalis Cortex), Bidengqie (Piperis Kadsurae Fructus), Wumei (Mume Fructus), Zhi Gancao (Glycyrrhizae Radix et Rhizoma, honey-roasted), Bajiji (Morindae Officinalis Radix), Yizhiren (Alpiniae Oxyphyllae Fructus), Da Hui (Foeniculi Fructus), Jiang (Zingiberis Rhizoma), Huanglian (Coptidis Rhizoma), Wuyao (Linderae Radix), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), Roukou Ren (Myristicae Semen) (each 5 qian). ○ Alternatively, add Dangshen (Codonopsis Radix) and Huangqi (Astragali Radix), each 1 liang. ○ Shengjiang (Zingiberis Rhizoma Recens) (20 slices), Xiebai (Allii Macrostemonis Bulbus) (7 bulbs), Jiubai (Allii Tuberosi Bulbus), Aiye (Artemisiae Argyi Folium) (each 2 liang); Changpu (Acori Tatarinowii Rhizoma) (3 qian); Fengxian (Impatiens Petal), Baijiezhi (Sinapis Semen) (5 qian); Bai Hujiao (Piperis Longi Fructus) (1 liang). Boil with oil and yellow lead oxide to make a plaster. Add Xionghuang (Realgar), Zhusha (Cinnabaris), Fan (Alumen), Tanxiang (Santalum Album Lignum), Muxiang (Aucklandiae Radix), Dingxiang (Eugeniae Floreos Bud), Sharen (Amomi Fructus), Ruxiang (Boswelliae Resina), Moyao (Commiphora Myrrha Resina) (each 5 qian).
(Another formula: Fuzi (Aconiti Lateralis Radix Preparata) 2 liang, Paojiang (Zingiberis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Wuyu (Evodiae Fructus), Guanzi (Cinnamomi Cortex) each 1 liang; Dingxiang (Eugeniae Floreos Bud), Wuweizi (Schisandrae Fructus), Aiye (Artemisiae Argyi Folium) each 5 qian. Boil and apply as a plaster, combined with sweating therapy.)
(Another formula: Fuzi (Aconiti Lateralis Radix Preparata) 2 liang, Paojiang (Zingiberis Rhizoma), Dangshen (Codonopsis Radix), Wuyu (Evodiae Fructus), Maidong (Ophiopogonis Radix) each 1 liang; Huanglian (Coptidis Rhizoma), Wuweizi (Schisandrae Fructus), Zhimu (Anemarrhenae Rhizoma) each 5 qian. Boil and apply as a plaster, combined with Huiben Tang [Return to Root Decoction]. Huiben Tang composition: Renshen (Ginseng Radix), Maidong (Ophiopogonis Radix) each 1.5 qian; Fuzi (Aconiti Lateralis Radix Preparata), Paojiang (Zingiberis Rhizoma), Ronggui (Cinnamomi Cortex), Wuweizi (Schisandrae Fructus), Chenpi (Citri Reticulatae Pericarpium) each 1 qian; Zhi Cao (Glycyrrhizae Radix et Rhizoma) 0.5 fen. If decocted with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus), take the concentrated juice, mix with honey, and wipe the heart region.)
Note: Xu Zimo discussed treating Majia Sha, stating that Yin-cold directly invading the Three Yin meridians is common in individuals with constitutive deficiency-cold, those who overeat then exert themselves, or obese persons. Symptoms include white tongue coating, thirst without dryness. (White indicates cold, suitable for warming herbs; if it turns yellow, cooling herbs may be used. If the tongue appears mirror-red but still has mixed white coating, this indicates excessive yang-warming herbs, leaving stomach cold pathogen unresolved while kidney yin essence is exhausted; this is difficult to treat.) Chest oppression/qi stagnation. (For those not yet vomiting or having diarrhea, use Huoxiang (Agastaches Herba), Shenqu (Massa Medicata Fermentata), Xingren (Armeniacae Semen Amarum), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Ganjiang (Zingiberis Rhizoma), Foshou (Citri Sarcodactylis Fructus), Gan Baokouren (Amomi Fructus Rotundus) etc.) Vomiting. (Cold pathogen rushing upward closes the stomach orifice causing vomiting; downward rushing closes the spleen orifice causing diarrhea. To stop vomiting, use Wuyu (Evodiae Fructus), stir-fried Huanglian (Coptidis Rhizoma), Guangchenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Guizhi (Cinnamomi Ramulus), Ganjiang (Zingiberis Rhizoma), Shengjiang (Zingiberis Rhizoma Recens), Wumei (Mume Fructus) etc.) Diarrhea. (Use Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Jiang (Zingiberis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Wuyu (Evodiae Fructus), Guizhi (Cinnamomi Ramulus), Baishao (Paeoniae Radix Alba), Fuzi (Aconiti Lateralis Radix Preparata), Xiaohui (Foeniculi Fructus), Wuweizi (Schisandrae Fructus), Chenpi (Citri Reticulatae Pericarpium), Roukou Ren (Myristicae Semen), Banxia (Pinelliae Rhizoma); if food stagnation exists, add Shanzha (Crataegi Fructus), Maiya (Hordei Fructus Germinatus).) Limb coldness/convulsions. (Middle jiao spleen/stomach decline, qi cannot distribute to four limbs. Cold hands first indicate pathology in Lung/Spleen; cold feet first indicate pathology in Kidney/Spleen. Use Renshen (Ginseng Radix), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), Fuzi (Aconiti Lateralis Radix Preparata), Rougui (Cinnamomi Cortex), Banxia (Pinelliae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Wuyu (Evodiae Fructus), Jiaojiao (Zanthoxyli Pericarpium), Shengjiang (Zingiberis Rhizoma Recens) etc.; if convulsions occur, add Mugua (Chaenomelis Fructus)). Irritability/restlessness. (Yang repelled upward causes heart vexation; Yin exhausted first causes kidney restlessness; this is true cold false heat. Use Chuanlian (Coptidis Rhizoma), Fuzi (Aconiti Lateralis Radix Preparata), Maidong (Ophiopogonis Radix), Baishao (Paeoniae Radix Alba), Guizhi (Cinnamomi Ramulus), Wuweizi (Schisandrae Fructus), Dangguishen (Angelicae Sinensis Radix), Ganjiang (Zingiberis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Jiaozhu (Atractylodis Macrocephalae Rhizoma, charred), Muli (Concha Ostreae) etc.). Thirst. (Caused by fluid draining downward. Use Renshen (Ginseng Radix), Lian (Coptidis Rhizoma), Maidong (Ophiopogonis Radix), Zhu (Atractylodis Macrocephalae Rhizoma), Jiang (Zingiberis Rhizoma), Gui (Cinnamomi Cortex), Shao (Paeoniae Radix Alba), Gui (Angelicae Sinensis Radix), Shihu (Dendrobii Caulis), Wumei (Mume Fructus), Gan (Glycyrrhizae Radix et Rhizoma), Jie (Scrophulariae Radix) etc.; or simply use Jiang (Zingiberis Rhizoma Recens) and Mei (Mume Fructus)). Cold sweat. (True Yang floating outward. If whole body sweats and panting occurs, it is Yang collapse. Use Renshen (Ginseng Radix), Fuzi (Aconiti Lateralis Radix Preparata), Zhu (Atractylodis Macrocephalae Rhizoma), Jiang (Zingiberis Rhizoma), Gui (Cinnamomi Cortex), Gui (Angelicae Sinensis Radix), Shao (Paeoniae Radix Alba), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), Fu (Poria), Gan (Glycyrrhizae Radix et Rhizoma), Muli (Concha Ostreae) etc.). Muscle cramps/twitching. (Cold causes contraction, hence tendon spasms. Heat-induced spasms are less painful with warm extremities; cold-induced spasms are severely painful with very cold extremities. Rare cases without spasms indicate mild cold or qi exhaustion. Qi exhaustion presents with severe external signs; even without spasms, life is endangered.) Treatment methods do not exceed warming meridians and unblocking Yang to dispel cold pathogen and return floating fire to its source. Follow Zhang Zhongjing's principles for treating Three Yin diseases. (All above herbs can be used for decoction wiping, stir-frying, or hot compressing.) ○ Heat-type plasters are contraindicated on the heart region (apply only to one-third area). If mistakenly applied causing dry nose and sore throat, resolve with Qingyang Gao [Clear Yang Plaster].