白芍 白术(各三钱) 当归 人参 炒黑荆芥 白芥子(各二钱) 柴胡(一钱)
甘草(五分) 陈皮 神曲(各三分)
水煎服。
冬月伤寒,至十二日之后忽然厥发,发去如死人一样,但心中火热,其四肢如
冰,有延至三、四日而身体不腐者,人以为尸厥也,谁知是邪火犯心包络,坚闭其
气以守护其心乎。夫伤寒传遍六经,未有传心者也,一至传心无不死者。然而邪得
以传心者,亦因包络之虚,力不能障心,使邪之竟入也。若包络素无亏损,邪虽直
捣心宫,而膻中膜膈足以相拒。然而三阴三阳俱为邪之所传,各各损伤,包络相臣
出死力以御贼,号召勤王绝无一应,惟有坚闭宫门,甘与君王同殉。至于各脏腑,
见君相号令,不能宣扬于外,自然解体,有国亡无主之象,所以手足肢体先冷如死
灰也。此时设有斩围夺门之将,扫荡群妖,救君相于危亡之候,自然外藩向应,不
必听旨宣召,无不归诚恐后矣。然则治法奈何?助包络之气,而加之祛邪之味,可
返死而回生也。方用救心神丹∶
人参(一两) 黄连(三钱) 菖蒲(二钱) 茯苓(五钱) 白芍(一两) 半夏(三钱) 附子(一分) 水
煎一
碗,以笔管通于病患喉中,另使亲人含药送下,无不受者。一剂而人之气苏,再剂而心中之大热
自解,而四肢手足尽温矣。
夫厥症多热,四肢之冷如冰者,正心中之热如火也。热极反为寒颤,颤极而人死,其实人死而心
尚未死。此方用人参以固其生气,以黄连清其心中包络之火邪,加附子一分为先锋,加菖蒲为向导,
引人参、黄连突围而共入于心中,又得白芍、茯苓、半夏平肝而不助火,利湿而共消痰,则声援
势盛,攻邪尤易也。或疑用黄连以清热是矣,何必助之以人参,而用人参亦不必如此之多。孰
知六经传遍以攻心,则脏腑自虚。多用黄连,而不君之人参,则有勇无谋,必至斩杀过甚,反伤
元气,又有主弱臣强之虞矣,虽救君于顷刻,而不能卫君于崇朝,不几虚用奇兵哉。
此症用活心丹甚神。
人参(一两) 黄连(三钱) 菖蒲(一钱) 麦冬 生枣仁(各五钱) 南星(一钱) 附子(三分)
良姜(五分) 生姜(十片) 水煎灌服。
白芍、白术(各三钱)、当归、人参、炒黑荆芥、白芥子(各二钱)、柴胡(一钱)、甘草(五分)、陈皮、神曲(各三分)。
用水煎服。
冬季感受寒邪,到了十二天之后忽然出现四肢厥冷,发作时身体僵硬如同死人一般,但心中感觉火热,四肢冰冷如冰,有的延续到三四天后身体仍未腐烂,人们以为是尸厥证,哪里知道这是邪火侵犯心包络,紧紧闭塞气机以守护心脏的缘故。伤寒病传遍六经,没有传变到心脏的,一旦传变到心脏就没有不死亡的。然而邪气能够传变到心脏,也是因为心包络虚弱,力量不能阻挡心脏,使邪气径直侵入。如果心包络素来没有亏损,邪气虽然直捣心宫,但膻中部位的膜膈足以抗拒。然而三阴三阳经络都被邪气传变,各自受到损伤,心包络作为臣僚拼死抵抗贼寇,号召勤王救援却没有任何回应,只有紧闭宫门,甘愿与君王一同殉难。至于各个脏腑,看到君相(心与心包)的号令无法向外宣扬,自然解体,呈现出国家灭亡没有主君的象,所以手足肢体先变得冰冷如同死灰一样。此时如果有能斩断包围、夺门而出的将领,扫荡群妖,在危亡时刻拯救君相,自然外藩会响应,不必等待旨意宣召,无不归顺诚恐落后。那么治疗方法如何?辅助心包络的气,并加入祛除邪气的药物,可以起死回生。方剂用救心神丹:
人参(一两)、黄连(三钱)、石菖蒲(二钱)、茯苓(五钱)、白芍(一两)、半夏(三钱)、附子(一分)。
水煎一碗,用笔管通入患者喉中,另外让亲人含着药液送下,没有不被接受的。服用一剂人气复苏,再服用一剂心中大热自然解除,四肢手足都温暖了。
厥证多属热证,四肢冰冷如冰,正是心中火热如火的表现。热极反而出现寒颤,寒颤剧烈而人死亡,其实人死了心脏尚未死。此方用人参来固护生气,用黄连清泄心中及心包络的火邪,加附子一分作为先锋,加石菖蒲作为向导,引导人参、黄连突围共同进入心中,又得到白芍、茯苓、半夏平抑肝气而不助长火势,利湿而共同消除痰浊,则声援势力强盛,攻伐邪气尤其容易。有人怀疑使用黄连清热是对的,何必辅助以人参,而且使用人参也不必如此之多。谁知道六经传遍以攻心,则脏腑自然虚弱。多用黄连,如果不以人参为君药,则有勇无谋,必定导致斩杀过甚,反而损伤元气,又有主弱臣强的忧虑,虽然能在顷刻间拯救君主,但不能在短暂时间内保卫君主,这不几乎是虚用奇兵吗。
此症使用活心丹非常神奇。
人参(一两)、黄连(三钱)、石菖蒲(一钱)、麦冬、生枣仁(各五钱)、天南星(一钱)、附子(三分)、高良姜(五分)、生姜(十片)。
水煎灌服。
Radix Paeoniae Alba (Baishao), Radix Atractylodis Macrocephalae (Baizhu) (each 3 qian), Radix Angelicae Sinensis (Danggui), Radix Ginseng (Renshen), Stir-fried and charred Rhizoma Cnidii (Chao Hei Jingjie), Semen Sinapis Albae (Baijiezi) (each 2 qian), Radix Bupleuri (Chaihu) (1 qian), Radix Glycyrrhizae (Gancao) (0.5 fen), Pericarpium Citri Reticulatae (Chenpi), Fructus Crataegi (Shenqu) (each 0.3 fen).
Decoct in water and take orally.
In winter, after contracting Cold Pathogen (Hanxue), if sudden Jue syndrome (Juezheng, characterized by cold extremities) occurs after twelve days, the patient may appear rigid like a corpse, yet feel intense heat in the heart region, with limbs as cold as ice. Some cases persist for three to four days without body decomposition; people consider this Corpse Jue (Shijue), but who knows that this is actually Evil Fire invading the Pericardium Collateral (Xinbaolu), tightly closing the Qi mechanism to protect the Heart? The Cold disease transmits through the Six Meridians (Liujing), rarely transmitting to the Heart itself; once it reaches the Heart, death is inevitable. However, for evil to transmit to the Heart, it is because the Pericardium is deficient, lacking the strength to shield the Heart from direct invasion. If the Pericardium were originally sound, even if evil attacked the Heart Palace directly, the membranes of the Danzhong (Chest Center) would be sufficient to resist. Yet, when all Three Yin and Three Yang meridians are affected by evil and damaged, the Pericardium, acting as a ministerial official, fights desperately against the invaders. Calling for royal assistance yields no response; thus, it can only firmly close the palace gates, willing to perish with the Monarch (Heart). Seeing that the commands of the Monarch and Minister cannot be proclaimed outwardly, the various Zang-Fu organs naturally disintegrate, resembling a state without a ruler. Hence, the hands, feet, and limbs become cold first, like dead ash. At this moment, if there were generals capable of breaking the siege and seizing the gate, sweeping away the demons, and saving the Monarch and Minister from peril, the outer vassals would naturally respond, without waiting for imperial summons, all hastening to submit. So, what is the treatment method? Boost the Qi of the Pericardium and add herbs that dispel evil, thereby reversing death and restoring life. Use the Formula: Jiu Xin Shen Dan (Rescue Heart Spirit Decoction):
Radix Ginseng (Renshen) (1 liang), Rhizoma Coptidis (Huanglian) (3 qian), Rhizoma Acori Tatarinowii (Changpu) (2 qian), Poria (Fuling), Radix Paeoniae Alba (Baishao) (1 liang), Rhizoma Pinelliae Preparatum (Banxia) (3 qian), Radix Aconiti Lateralis Preparata (Fuzi) (0.1 fen).
Decoct in water to obtain one bowl. Insert a pen-like tube into the patient's throat, and have a relative hold the medicine in their mouth to administer it. No patient will fail to receive it. After one dose, vital Qi returns; after two doses, the intense heat in the heart resolves, and the limbs become warm.
Jue syndrome often involves heat; the coldness of the limbs like ice indicates that the heat within the heart is like fire. Extreme heat may manifest as chills, and extreme chills lead to death, yet the Heart may not have died yet. This formula uses Radix Ginseng (Renshen) to secure the generating Qi, and Rhizoma Coptidis (Huanglian) to clear the fire-evil in the Heart and Pericardium. Add a small amount of Radix Aconiti Lateralis Preparata (Fuzi) as a vanguard, and Rhizoma Acori Tatarinowii (Changpu) as a guide, leading Radix Ginseng (Renshen) and Rhizoma Coptidis (Huanglian) to break through and enter the Heart together. Additionally, Radix Paeoniae Alba (Baishao), Poria (Fuling), and Rhizoma Pinelliae Preparatum (Banxia) soothe the Liver without aiding fire, and promote diuresis to resolve phlegm. Thus, the support is strong, making it easier to attack the evil. One might doubt that using Rhizoma Coptidis (Huanglian) to clear heat is correct, but why aid it with Radix Ginseng (Renshen), and why use such a large dose? Who knows that when the Six Meridians are fully transmitted to attack the Heart, the Zang-Fu organs are naturally deficient. Using much Rhizoma Coptidis (Huanglian) without Radix Ginseng (Renshen) as the Sovereign herb means having courage but no strategy, likely causing excessive damage and injuring the Original Qi, with the risk of the Ruler being weak and the Minister strong. Although it saves the Ruler momentarily, it cannot guard him for long, which is akin to vainly using surprise troops.
For this syndrome, Huo Xin Dan (Revive Heart Decoction) is very effective.
Radix Ginseng (Renshen) (1 liang), Rhizoma Coptidis (Huanglian) (3 qian), Rhizoma Acori Tatarinowii (Changpu) (1 qian), Radix Ophiopogonis (Maidong), Semen Ziziphi Spinosae Preparatum (Sheng Zaoren) (each 5 qian), Rhizoma Arisaematis (Nanxing), Radix Aconiti Lateralis Preparata (Fuzi) (0.3 fen), Rhizoma Alpiniae Officinarum (Liangjiang), Rhizoma Zingiberis Recens (Shengjiang) (10 slices).
Decoct in water and administer via gavage.