(吴昆《医方考》) 治一切劳瘵积滞,未经药坏者。
当归 乳香(去油) 没药(去油) 人参(各一钱) 虻虫 水蛭(各十四枚) 大
黄(四钱) 为细末,炼蜜丸桐子大,每服百丸,五更用百劳水(即甘澜水,以杓扬百遍者
也。)下,取下恶物为度。服白粥十日。(一方有桃仁十四枚)百劳丸用大黄归,虻蛭参桃乳
没挥。干血沉 劳瘵服,未经药坏别从违。(百劳丸,许州陈大夫流传出自仲景方,治一切
劳瘵积滞,未经药坏者。细绎是方,无非气血并补,和营逐瘀,其缓中补虚之义,毫不相关,
较之《金匮》 虫丸方,却逊一筹。惟用百劳水不助肾邪,以药留顿中宫,导去脾胃络之瘀
血,使其纳谷流通营卫,亦干血劳之良治。)
治大肠痈,其候少腹肿痞,按之即痛如淋,小便自调,发热恶寒,汗出。其脉迟紧,脓
未成者,可下之,当有血;脉洪数者,脓已成,不可下也。
大黄(四两) 牡丹皮(一两) 桃仁(五十枚) 甜瓜子(半升) 芒硝(三合)水
六升,煮取一升
大黄牡丹汤下剂,桃仁瓜子与芒硝。少腹肿痞按之痛,痛即如淋(大肠之热下注也)小
便调。(病不在小肠水道,故小便自调。)身皮甲错(营血痹聚之故)右足屈,(大肠痈初起,
便右足屈而不伸,小肠痈则左足屈而不伸,以此为区别。)大肠痈肿此能消。脉沉紧者未成
脓,脉洪数者脓已饶。脓未成斯宜下夺,脓成排脓散(排脓散另编《甘桔汤类》)宜邀。(大
肠痈者,其人平素嗜醇酒炙 ,湿热郁蒸,肺气不得宣通,下结于大肠之头,气血壅遏而成
病。在下者因而夺之,故重用大黄、芒硝,开大肠之结,桃仁、丹皮下将败之血,瓜子清肺
润肠,以肺与大肠为表里也。方后云服之“当有血”,下未化脓之血也。若脓已成,形肉已
坏,又当
(吴昆《医方考》)治疗各种虚劳及积滞病症,且尚未因误治而病情复杂化的患者。
当归、乳香(去除油脂)、没药(去除油脂)、人参(各一钱)、虻虫、水蛭(各十四枚)、大黄(四钱)。将上述药材研成细末,用炼蜜制成如梧桐子大小的丸剂。每次服用一百丸,在凌晨五更天时,用百劳水(即甘澜水,用勺子扬动一百遍制成的水)送服,以下除体内恶浊之物为度。服药后连续十天食用白粥。(另一版本方中含有桃仁十四枚。)
百劳丸方歌:大黄归参桃乳没,虻蛭挥散干血沉。劳瘵积滞服此方,未经药坏别从违。
(按语:百劳丸由许州陈大夫流传,源自张仲景的方子,用于治疗各种虚劳积滞且未经误治的患者。仔细推敲此方,无非是气血双补、调和营血、驱逐瘀血,其中“缓中补虚”的含义毫不相关,比起《金匮要略》中的䗪虫丸,却稍逊一筹。只是使用百劳水不助长肾邪,让药物留驻中焦脾胃,引导排出脾胃络脉中的瘀血,使其饮食纳运通畅,营卫运行正常,这也是治疗干血劳的一种良好方法。)
治疗大肠痈(肠道化脓性炎症),其症状表现为少腹部肿胀痞硬,按压时疼痛如同淋病(小便涩痛),但小便自调正常,伴有发热恶寒、出汗。若脉象迟紧,说明脓液尚未形成,可以使用攻下法,大便中可能会有血液排出;若脉象洪数,说明脓液已经形成,则不可使用攻下法。
大黄(四两)、牡丹皮(一两)、桃仁(五十枚)、甜瓜子(半升)、芒硝(三合)。用水六升,煮取一升药液。
大黄牡丹汤方歌:大黄牡丹汤下剂,桃仁瓜子与芒硝。少腹肿痞按之痛,痛即如淋(大肠之热下注也)小便调。(病不在小肠水道,故小便自调。)身皮甲错(营血痹聚之故)右足屈,(大肠痈初起,便右足屈而不伸,小肠痈则左足屈而不伸,以此为区别。)大肠痈肿此能消。脉沉紧者未成脓,脉洪数者脓已饶。脓未成斯宜下夺,脓成排脓散(排脓散另编《甘桔汤类》)宜邀。(大肠痈者,其人平素嗜醇酒炙肉,湿热郁蒸,肺气不得宣通,下结于大肠之头,气血壅遏而成病。在下者因而夺之,故重用大黄、芒硝,开大肠之结,桃仁、丹皮下将败之血,瓜子清肺润肠,以肺与大肠为表里也。方后云服之“当有血”,下未化脓之血也。若脓已成,形肉已坏,又当……)
(Wu Kun's *Yi Fang Kao*) Treats all types of consumptive diseases (Lao Zhai) and stagnation, provided they have not been complicated by improper medication.
Danggui (Angelica sinensis), Ruxiang (Boswellia carterii, de-oiled), Moyao (Commiphora myrrha, de-oiled), Renshen (Panax ginseng) (each 1 qian), Machong (Blatta orientalis), Shizhi (Hirudo nipponica) (each 14 pieces), Dahuang (Rhei Radix et Rhizoma) (4 qian). Grind into fine powder, mix with refined honey to make pills the size of tung tree seeds. Take 100 pills each time. Administer at the hour of Wugeng (approx. 3-5 AM) using Bailao water (i.e., Ganlan water, prepared by stirring vigorously with a ladle one hundred times). Continue until foul matter is evacuated. Follow with a white rice porridge diet for ten days. (Another version includes Taoren 14 pieces.)
Song of Bailao Wan: Dahuang, Danggui, Renshen, Taoren, Ruxiang, Moyao; Machong and Shizhi disperse dry blood accumulation. For Lao Zhai and stagnation, take this formula; if not yet damaged by prior treatment, follow this path.
(Note: Bailao Wan was transmitted by Dr. Chen from Xuzhou, originating from Zhang Zhongjing's prescriptions, treating various consumptive diseases with stagnation that have not been mishandled. Upon careful examination, this formula merely tonifies both Qi and Blood, harmonizes Ying and Wei, and expels stasis; it bears no relation to the principle of "soothing the middle and tonifying deficiency." It is inferior to the Chongwan formula in *Jin Gui Yao Lue*. However, the use of Bailao water avoids aiding kidney pathogens, allowing the medicine to remain in the Middle Jiao (Spleen and Stomach), guiding out stasis from the collateral vessels of the Spleen and Stomach, thereby facilitating digestion and ensuring smooth circulation of Ying and Wei. This is also an excellent treatment for Dry Blood Lao.)
Treats Da Chang Yong (Intestinal Abscess). The symptoms include swelling and distension in the lower abdomen, pain upon pressure resembling Lin syndrome (dysuria), but urination remains normal, accompanied by fever, aversion to cold, and sweating. If the pulse is slow and tight, pus has not yet formed; purgation may be used, and blood may appear in the stool. If the pulse is surging and rapid, pus has already formed; purgation is contraindicated.
Dahuang (4 liang), Mudanpi (Moutan Cortex) (1 liang), Taoren (Persicae Semen) (50 pieces), Tian Guazi (Benincasa hispida seed) (0.5 sheng), Mangxiao (Natrii Sulfas) (3 he). Boil in 6 sheng of water until reduced to 1 sheng.
Song of Dahuang Mudan Tang: Dahuang Mudan Tang is a purgative formula; combined with Taoren, Guazi, and Mangxiao. Lower abdominal swelling and hardness cause pain on pressure; pain resembles Lin syndrome (due to heat pouring down from the Large Intestine). Urination is normal (the disease is not in the Small Intestine water passages, hence urination is normal). Skin is rough like fish scales (due to obstruction of Ying and Blood); right leg is flexed (at the onset of Large Intestine abscess, the right leg flexes and does not extend, whereas Small Intestine abscess causes left leg flexion; this distinguishes them). This formula can eliminate Large Intestine abscess. A deep and tight pulse indicates unformed pus; a surging and rapid pulse indicates abundant pus. When pus is unformed, purgation should be employed; when pus is formed, Painong San (Paired Orange Decoction class, see separate section) should be invited. (Large Intestine abscess arises in individuals who habitually consume rich wine and roasted meats, leading to damp-heat stagnation. Lung Qi fails to diffuse, descending to the head of the Large Intestine, causing Qi and Blood congestion. Since the pathology is below, it is treated by draining; thus, heavy doses of Dahuang and Mangxiao are used to open the intestinal knot, Taoren and Mudanpi to move failing blood, and Guazi to clear the Lung and moisten the intestines, as the Lung and Large Intestine are exterior-interior pairs. The prescription notes "blood will appear," referring to un-pusified blood being evacuated. If pus has formed and flesh is ruined, then...)