喜寒恶热而呕者,宜降火。喜热恶寒而呕者,宜养胃气。沉实便秘而呕者,宜泻火。脉
细肠鸣腹痛,泻而呕者,托里温中。
一男子胸患毒, 肿喜冷,脉洪数,以黄连解毒汤,二剂顿退;更加金银花散,六剂而
消。
一男子因疮痛伤胃气,少食作呕,恶寒,以六君子汤加当归,四剂稍愈;以十宣散加
白术、茯苓、陈皮,数剂而脓成,针之;又以前散去防风、白芷,数剂而痊。
一男子患发背肿硬,烦渴便秘,脉沉实作呕,以内疏黄连汤,二剂愈;以金银花散,四
剂,并隔蒜灸而消。
一男子腋下患毒,咳逆不食,肠鸣切痛,四肢厥冷,脉细,以托里理中汤,二剂顿愈;
更以香砂六君子汤、二神丸,而饮食顿进;以十全大补汤,下十余剂而敛。
一妇人脾气素弱,患毒未作脓,发寒热兼呕,以不换金正气散,二剂而止;以托里散,
六剂而溃;更以健脾药敛。
一 妇恶心少食,服解毒药愈呕,此胃气虚也,以六君子汤加生姜,治之而安。戴氏(
名元
在胃口上,宜用生姜,盖能开胃豁痰也。
附方
黄连解毒汤 治积热疮疡, 肿作痛,烦躁饮冷,脉洪数,或口舌生疮,或疫毒
发狂。
黄芩 黄柏(炒) 黄连(炒) 山栀(各一钱半) 作一剂,水二钟,煎七分,热服。
六君子汤 治一切脾胃不健,或胸膈不利,饮食少思,或作呕,或食不化,或膨
胀,大便不实,面色痿黄,四肢倦怠。
人参 白术(炒) 茯苓 半夏(姜制) 陈皮(各一钱) 甘草(炙,五分) 作一剂,水二
钟,姜三片,枣二枚,煎八分,食远服。
香砂六君子汤 治一切脾胃不健,饮食少思,或作呕,或过服凉药,致伤脾胃,
即六君子汤加藿香、砂仁。
托里温中汤 治疮为寒变而内陷者,脓出清解,皮肤凉,心下痞满,肠鸣切痛,
大便微溏,食则呕,气短吃逆不绝,不得安卧,时发 愦。
丁香 沉香 茴香 益智仁 陈皮 木香 羌活 干姜(炮,各一钱) 甘草(炙) 附子
(炮,去皮脐,各二钱) 作一剂,水二钟,姜三片,煎八分,不拘时服。
按罗谦甫曰∶经云,寒淫于内,治以辛热,佐以苦温。姜附大辛热,温中外,发阳气,
自里
绝,不下食;益智、丁、沉大辛热,以散寒为佐,疮气内攻,气聚而为满;木香、陈皮苦
辛温,治痞散满为使。
十宣散(方见发背门)
金银花散 消毒托里,止痛排脓,不问肿溃,并效。
金银花 黄 (盐水浸炒) 当归(酒拌) 甘草(各等分) 为末,每服一二钱,滚汤调入
,酒少许服。大人每服一两,水煎服,随饮酒二三杯。
隔蒜灸法(方见发背门)
十全大补汤(方见溃疡发热门)
不换金正气散 治疮疡发热之人,脾气虚弱,寒邪相搏,痰停胸膈,以致发寒热
,服此正脾气,则痰气自消,寒热不作。
浓朴(去皮姜制) 藿香 半夏(姜制) 苍术(米泔浸) 陈皮(去白,各三钱) 甘草(炙
,五分) 作一剂,水二钟,姜三片,枣二枚,煎七分,食远服。
二神丸 治一切脾肾俱虚,侵晨作泻,或饮食少思,或食而不化,或作呕,或作
泻,
邦秀童僮年逾四十,遍身发肿,腹胀如鼓,甚危,诸药不应,用此丸数服,饮食渐进,其肿
渐消,兼以除湿健脾之剂,而愈。
破故纸(四两,炒) 肉豆蔻(二两,生用) 上为末,用大红枣四十九枚,生姜四两切
碎,同枣用水煮熟,去姜取枣肉,和药丸,梧子大。每服五十丸,空心盐汤下。
喜寒恶热而呕吐者,适宜降火。喜热恶寒而呕吐者,适宜养胃气。脉象沉实、大便秘结而呕吐者,适宜泻火。脉象细弱、肠鸣腹痛,腹泻且呕吐者,宜用托里温中法。
一男子胸部患毒疮,肿胀喜冷,脉象洪数,服用黄连解毒汤(Huanglian Jiedu Tang, Coptis Decoction for Resolving Toxic Heat),两剂后症状顿退;再加服金银花散(Jinyinhua San, Honeysuckle Powder),六剂后消散。
一男子因疮痛损伤胃气,进食少则作呕,恶寒,服用六君子汤(Liujunzi Tang, Six Gentlemen Decoction)加当归(Angelicae Sinensis Radix),四剂后稍愈;改用十宣散(Shixuan San, Ten-Supplementing Powder)加白术(Atractylodis Macrocephalae Rhizoma)、茯苓(Poria),数剂后脓成,针刺排脓;又以前方去掉防风(Saposhnikoviae Radix)、白芷(Angelicae Dahuricae Radix),数剂后痊愈。
一男子患发背(背部痈疽)肿硬,烦渴便秘,脉象沉实并伴有呕吐,以内疏黄连汤(Neishu Huanglian Tang, Internal-Draining Coptis Decoction),两剂后痊愈;再用金银花散,四剂,并配合隔蒜灸(Garlic-Separator Moxibustion)而消散。
一男子腋下患毒疮,咳逆不食,肠鸣切痛,四肢厥冷,脉象细弱,以托里理中汤(Tuoli Lizhong Tang, Interior-Supporting and Middle-Warming Decoction),两剂后顿愈;更以香砂六君子汤(Xiangsha Liujunzi Tang, Agastache and Amomum Six Gentlemen Decoction)、二神丸(Ershen Wan, Two-Essence Pill),饮食顿时增进;以十全大补汤(Shiquan Dabu Tang, Complete Ten Great Tonifying Decoction),连服十余剂后疮口收敛。
一妇人脾气素来虚弱,患毒疮尚未化脓,出现寒热兼呕吐,以不换金正气散(Buhuanjin Zhengqi San, Non-Changing Metal Upright Qi Powder),两剂后呕吐停止;以托里散(Tuoli San, Interior-Supporting Powder),六剂后溃破;更以健脾药收敛伤口。
一妇人心恶心少食,服用解毒药后呕吐加重,这是胃气虚的表现,以六君子汤加生姜(Zingiberis Rhizoma Recens),治疗而安。戴氏(名元在)认为:药力停留在胃口上,宜用生姜,因为生姜能开胃豁痰。
附方
黄连解毒汤 治疗积热引起的疮疡,肿胀疼痛,烦躁想喝冷水,脉象洪数,或口舌生疮,或疫毒导致发狂。
黄芩(Scutellariae Radix) 黄柏(Phellodendri Cortex,炒) 黄连(Coptidis Rhizoma,炒) 山栀(Gardeniae Fructus)(各一钱半) 作为一剂,水两钟,煎至七分,热服。
六君子汤 治疗一切脾胃功能不强,或胸膈不利,饮食减少,或作呕,或食物不消化,或腹胀,大便不成形,面色萎黄,四肢倦怠。
人参(Ginseng Radix et Rhizoma) 白术(Atractylodis Macrocephalae Rhizoma,炒) 茯苓(Poria) 半夏(Pinelliae Rhizoma,姜制) 陈皮(Citri Reticulatae Pericarpium,各一钱) 甘草(Glycyrrhizae Radix et Rhizoma,炙,五分) 作为一剂,水两钟,生姜三片,大枣二枚,煎至八分,饭后服用。
香砂六君子汤 治疗一切脾胃功能不强,饮食减少,或作呕,或过服凉药导致损伤脾胃,即六君子汤加藿香(Agastachis Herba)、砂仁(Amomi Fructus)。
托里温中汤 治疗疮疡因寒邪变化而内陷的病症,脓液清稀,皮肤凉,心下痞满,肠鸣切痛,大便微溏,进食则呕吐,气短呃逆不止,无法安卧,时常感到烦闷。
丁香(Eugeniae Flos) 沉香(Aquilariae Lignum Resinatum) 茴香(Foeniculi Fructus) 益智仁(Alpiniae Oxyphyllae Fructus) 陈皮(Citri Reticulatae Pericarpium) 木香(Aucklandiae Radix) 羌活(Notopterygii Rhizoma et Radix) 干姜(Zingiberis Rhizoma,炮,各一钱) 甘草(Glycyrrhizae Radix et Rhizoma,炙) 附子(Aconiti Lateralis Radix Praeparata,炮,去皮脐,各二钱) 作为一剂,水两钟,生姜三片,煎至八分,不拘时间服用。
按罗谦甫说:经云,寒邪侵袭体内,用辛热药物治疗,辅以苦温药物。姜、附大辛大热,温暖内外,发散阳气,使寒气自里绝灭,不下行;益智仁、丁香、沉香大辛大热,以散寒为辅助,防止疮毒之气内攻,气聚而成痞满;木香、陈皮苦辛温,治疗痞满、消散胀满为使药。
金银花散 消毒托里,止痛排脓,无论肿胀未溃或已溃,均有效。
金银花(Lonicerae Japonicae Flos) 黄芪(Astragali Radix,盐水浸炒) 当归(Angelicae Sinensis Radix,酒拌) 甘草(Glycyrrhizae Radix et Rhizoma,各等分) 研为末,每次服用一二钱,滚开水冲调,加少许酒送服。成人每次服用一两,水煎服,随饮酒二三杯。
隔蒜灸法(方见发背门)
不换金正气散 治疗疮疡发热之人,脾气虚弱,寒邪相搏,痰停胸膈,以致发寒热,服用此药正脾气,则痰气自消,寒热不作。
浓朴(Magnoliae Officinalis Cortex,去皮姜制) 藿香(Agastachis Herba) 半夏(Pinelliae Rhizoma,姜制) 苍术(Atractylodis Rhizoma,米泔浸) 陈皮(Citri Reticulatae Pericarpium,去白,各三钱) 甘草(Glycyrrhizae Radix et Rhizoma,炙,五分) 作为一剂,水两钟,生姜三片,大枣二枚,煎至七分,饭后服用。
二神丸 治疗一切脾肾俱虚,清晨作泻,或饮食减少,或食而不化,或作呕,或作泻。
邦秀童僮年逾四十,遍身发肿,腹胀如鼓,非常危险,诸药无效,用此丸数服,饮食渐进,其肿渐消,兼以除湿健脾之剂,而痊愈。
破故纸(Psoraleae Fructus,四两,炒) 肉豆蔻(Myristicae Semen,二两,生用) 以上研为末,用大红枣四十九枚,生姜四两切碎,同枣用水煮熟,去姜取枣肉,和药丸,梧桐子大小。每次服用五十丸,空腹盐汤送下。
For vomiting accompanied by a preference for cold and aversion to heat, fire-clearing (降火) is appropriate. For vomiting accompanied by a preference for heat and aversion to cold, nourishing Stomach Qi (养胃气) is appropriate. For vomiting with a deep and solid pulse and constipation, purging fire (泻火) is appropriate. For vomiting with diarrhea, a fine pulse, borborygmus, and severe abdominal pain, interior-supporting and middle-warming methods (托里温中) should be used.
A male patient had a toxic sore on his chest, swelling that preferred cold, and a surging and rapid pulse. He was administered Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxic Heat), two doses of which caused the symptoms to recede abruptly; Jin Yin Hua San (Honeysuckle Powder) was then added, and after six doses, the swelling dissipated.
A male patient suffered from stomach Qi damage due to pain from a carbuncle, resulting in vomiting after eating little, aversion to cold. He was treated with Liu Jun Zi Tang (Six Gentlemen Decoction) plus Dang Gui (Angelicae Sinensis Radix). After four doses, he improved slightly. Then, Shi Xuan San (Ten-Supplementing Powder) plus Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Fu Ling (Poria) was given for several doses until pus formed, at which point it was punctured. The previous formula was continued without Fang Feng (Saposhnikoviae Radix) and Bai Zhi (Angelicae Dahuricae Radix) for several more doses until recovery.
A male patient suffered from a hard and swollen back carbuncle (Fa Bei), restlessness, thirst, constipation, a deep and solid pulse, and vomiting. Nei Shu Huang Lian Tang (Internal-Draining Coptis Decoction) was administered for two doses, leading to recovery. Jin Yin Hua San (Honeysuckle Powder) was then given for four doses, combined with Garlic-Separator Moxibustion (Ge Suan Jiu), resulting in resolution.
A male patient had a toxic sore in his axilla, characterized by coughing up air, inability to eat, severe borborygmus and pain, cold limbs, and a fine pulse. Tuo Li Li Zhong Tang (Interior-Supporting and Middle-Warming Decoction) was administered for two doses, causing immediate recovery. Xiang Sha Liu Jun Zi Tang (Agastache and Amomum Six Gentlemen Decoction) and Er Shen Wan (Two-Essence Pill) were then used, leading to an immediate improvement in appetite. Finally, Shi Quan Da Bu Tang (Complete Ten Great Tonifying Decoction) was taken for over ten doses, leading to wound contraction.
A female patient with inherently weak Spleen Qi developed a toxic sore that had not yet suppurated, presenting with alternating chills and fever and vomiting. Bu Huan Jin Zheng Qi San (Non-Changing Metal Upright Qi Powder) was administered for two doses, stopping the vomiting. Tuo Li San (Interior-Supporting Powder) was given for six doses, leading to suppuration. Spleen-strengthening herbs were then used to heal the wound.
A female patient experienced nausea and poor appetite. After taking detoxifying herbs, her vomiting worsened, indicating deficiency of Stomach Qi. She was treated with Liu Jun Zi Tang (Six Gentlemen Decoction) plus Sheng Jiang (Zingiberis Rhizoma Recens), resulting in stability. Dai Shi (Dai Yuanzai) stated: If the medicinal effect remains at the stomach opening, Sheng Jiang (Zingiberis Rhizoma Recens) should be used, as it can open the stomach and resolve phlegm.
Attached Formulas
Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxic Heat): Treats carbuncles and sores caused by accumulated heat, presenting with painful swelling, irritability, desire for cold drinks, surging and rapid pulse, mouth and tongue ulcers, or madness due to epidemic toxins.
Huang Qin (Scutellariae Radix), Huang Bo (Phellodendri Cortex, stir-fried), Huang Lian (Coptidis Rhizoma, stir-fried), Shan Zhi (Gardeniae Fructus) (each 1.5 qian). Prepare as one dose, add two zhong of water, decoct to seven-tenths, and take hot.
Liu Jun Zi Tang (Six Gentlemen Decoction): Treats all cases of weak Spleen and Stomach function, chest and diaphragm discomfort, poor appetite, vomiting, indigestion, distension, loose stools, sallow complexion, and limb fatigue.
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried), Fu Ling (Poria), Ban Xia (Pinelliae Rhizoma, processed with ginger), Chen Pi (Citri Reticulatae Pericarpium) (each 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 qian). Prepare as one dose, add two zhong of water, three slices of fresh ginger, and two jujubes. Decoct to eight-tenths and take well after meals.
Xiang Sha Liu Jun Zi Tang (Agastache and Amomum Six Gentlemen Decoction): Treats all cases of weak Spleen and Stomach function, poor appetite, vomiting, or Spleen-Stomach injury caused by excessive intake of cooling herbs. It is Liu Jun Zi Tang (Six Gentlemen Decoction) plus Huo Xiang (Agastachis Herba) and Sha Ren (Amomi Fructus).
Tuo Li Wen Zhong Tang (Interior-Supporting and Middle-Warming Decoction): Treats carbuncles that have collapsed inward due to cold transformation, presenting with clear and thin pus, cool skin, epigastric fullness, severe borborygmus and pain, slight diarrhea, vomiting after eating, shortness of breath, incessant hiccups, inability to lie down comfortably, and occasional mental confusion.
Ding Xiang (Eugeniae Flos), Chen Xiang (Aquilariae Lignum Resinatum), Hui Xiang (Foeniculi Fructus), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), Chen Pi (Citri Reticulatae Pericarpium), Mu Xiang (Aucklandiae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Gan Jiang (Zingiberis Rhizoma, processed, each 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Fu Zi (Aconiti Lateralis Radix Praeparata, processed, peeled and de-navelled, each 2 qian). Prepare as one dose, add two zhong of water and three slices of fresh ginger. Decoct to eight-tenths and take at any time.
Note: Luo Qianfu said: The Classics state, "When cold invades the interior, treat with pungent-hot herbs, assisted by bitter-warm herbs." Ginger and Aconite are greatly pungent and hot, warming the interior and exterior, dispersing Yang Qi, and cutting off cold from within. Yi Zhi Ren, Ding Xiang, and Chen Xiang are greatly pungent and hot, assisting in dispersing cold to prevent toxic Qi from attacking inward and gathering into fullness. Mu Xiang and Chen Pi are bitter, pungent, and warm, treating fullness and dissipating distension, serving as guiding herbs.
Shi Xuan San (Ten-Supplementing Powder) (See Fa Bei section for formula)
Jin Yin Hua San (Honeysuckle Powder): Clears toxicity, supports the interior, relieves pain, and expels pus. Effective regardless of whether the swelling has ulcerated or not.
Jin Yin Hua (Lonicerae Japonicae Flos), Huang Qi (Astragali Radix, stir-fried with salt water), Dang Gui (Angelicae Sinensis Radix, mixed with wine), Gan Cao (Glycyrrhizae Radix et Rhizoma) (equal parts). Grind into powder. Take 1-2 qian per dose, mixed with boiling water, with a little wine. Adults take 1 liang per dose, decocted in water, followed by 2-3 cups of wine.
Ge Suan Jiu (Garlic-Separator Moxibustion) (See Fa Bei section for method)
Shi Quan Da Bu Tang (Complete Ten Great Tonifying Decoction) (See Ulcerative Fever section for formula)
Bu Huan Jin Zheng Qi San (Non-Changing Metal Upright Qi Powder): Treats patients with carbuncles and sores who have fever, weak Spleen Qi, struggling between cold pathogens, and phlegm stagnation in the chest and diaphragm, leading to alternating chills and fever. Taking this herb rectifies Spleen Qi, causing phlegm Qi to dissipate and preventing chills and fever.
Hou Po (Magnoliae Officinalis Cortex, peeled and processed with ginger), Huo Xiang (Agastachis Herba), Ban Xia (Pinelliae Rhizoma, processed with ginger), Cang Zhu (Atractylodis Rhizoma, soaked in rice wash water), Chen Pi (Citri Reticulatae Pericarpium, pith removed, each 3 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 qian). Prepare as one dose, add two zhong of water, three slices of fresh ginger, and two jujubes. Decoct to seven-tenths and take well after meals.
Er Shen Wan (Two-Essence Pill): Treats all cases of combined Spleen and Kidney deficiency, morning diarrhea, poor appetite, indigestion, vomiting, or diarrhea.
Bangxiu Tongtong, aged over forty, had whole-body edema and a drum-like abdominal distension, in critical condition. Various medicines failed. After taking this pill several times, his diet gradually improved, and the swelling subsided. Combined with dampness-dispelling and Spleen-strengthening agents, he recovered.
Po Gu Zhi (Psoraleae Fructus, 4 liang, stir-fried), Rou Dou Kou (Myristicae Semen, 2 liang, raw). Grind into powder. Use 49 large red dates and 4 liang of chopped fresh ginger. Cook together with water until soft. Remove ginger, take the date flesh, and mix with the powder to form pills the size of wutong seeds. Take 50 pills per dose, swallowed with salt water on an empty stomach.