治少阴病始得之,无汗恶寒,头不痛,但欲寐,反发热脉沉者。
麻黄(去节) 细辛(各二两) 附子(一枚炮) 以水一斗,先煮麻黄减二升,去上
沫,纳诸药,煮取三升,去滓,温服一升,日三服。麻黄附子细辛汤,发表温经两法彰。无
汗恶寒(与太阳同)头不痛,脉沉欲寐(俱少阴证)少阴殃。若无发热当温补,(用附子汤)
反热邪犹连太阳。故用麻辛兼发表,温经熟附恐亡阳。(少阴主里,应无表证,今始受风寒
,即便发热,则邪犹连太阳,未尽入阴,犹可引之外达,故用细辛引麻黄入于少阴,以提始
入之邪,仍从太阳而解。然恐肾中真阳随汗外亡,必用熟附温经固肾,庶无过汗亡阳之虑。
此少阴表病无里证者发汗之法也。)
治伤寒瘀热在里,但头汗出,小便不利,身发黄者。
麻黄(去节) 连翘(各二两) 赤小豆 生梓白皮(各一升) 杏仁(四十枚) 甘
草生姜(各二两) 大枣(十二枚) 以潦水一斗,先煮麻黄再沸,去沫,纳诸药,煮取
三升,去滓,分温三服。(降注雨水,谓之潦水,取其味薄,不助湿热也。)
麻黄连翘赤小豆(汤),杏仁甘草梓皮凑,煮以潦水加姜枣,瘀热身黄功克奏。泄湿从
阴出太阳,(此表里分解法。或太阳之热,或阳明之热,内合太阴之湿,乃成瘀热发黄,病
虽从外之内,而粘着之邪,当从阴以出阳也。杏仁、赤小豆泄肉里湿热,生姜、梓白皮泄肌
表湿热,仍以甘草、大枣奠安太阴之气,麻黄使湿热从汗而出太阳,连翘导湿热从小便而出
太阳,潦水助药力从阴出阳。经云∶“湿上甚为热。”若湿下行则热解,热解则黄退也。)黄
从汗解无留垢。缘其有表此方施,若无表证茵陈究。(本方使黄从汗解,茵陈蒿汤使黄从下
解,乃有表无表之分也。)
治疗少阴病初起,无汗、恶寒,头部不痛,只想睡觉,反而发热且脉象沉的病症。
麻黄(去节) 细辛(各二两) 附子(一枚,炮制) 用水一斗,先煮麻黄减少二升,去掉上面的浮沫,加入其他药物,煮取三升,滤去药渣,温服一升,每日三次服用。麻黄附子细辛汤,发表与温经两种治法显著。无汗恶寒(与太阳病相同),头不痛,脉沉欲寐(都是少阴病的证候),这是少阴病的灾殃。如果没有发热应当用温补法(使用附子汤),反而发热说明邪气仍然牵连太阳经。所以用麻黄、细辛兼以发表,配合熟附子温经防止亡阳。(少阴主里,本应无表证,如今刚受风寒就发热,说明邪气仍连属太阳,未完全进入阴分,还可以引导其向外透达,所以用细辛引导麻黄进入少阴,提起初入之邪,仍从太阳经而解。然而担心肾中真阳随汗液外泄亡失,必须用熟附子温经固护肾脏,才没有过汗导致亡阳的忧虑。这是少阴表病而无里证时的发汗方法。)
治疗伤寒瘀热郁结在体内,仅头部出汗,小便不利,身体发黄的症状。
麻黄(去节) 连翘(各二两) 赤小豆 生梓白皮(各一升) 杏仁(四十枚) 甘草 生姜(各二两) 大枣(十二枚) 用雨水一斗,先煮麻黄至再次沸腾,去掉浮沫,加入其他药物,煮取三升,滤去药渣,分三次温服。(降落的地面雨水称为潦水,取其味道淡薄,不助长湿热。)麻黄连翘赤小豆汤,由杏仁、甘草、梓皮组成,用潦水煎煮并加入姜枣,清除瘀热、消退身黄的疗效显著。湿气通过阴分出至太阳经(这是表里分解的方法。无论是太阳经的热,还是阳明经的热,内合太阴经的湿,便形成瘀热发黄。病势虽由外向内发展,但黏着的邪气,应当从阴分透出阳分。杏仁、赤小豆排泄肌肉里的湿热,生姜、梓白皮排泄肌表的湿热,仍以甘草、大枣稳固太阴之气,麻黄使湿热从汗液排出至太阳经,连翘引导湿热从小便排出至太阳经,潦水帮助药力从阴出阳。经文说:“湿气在上部严重会导致热。”如果湿气向下行则热自解,热解则黄疸退去。)黄色从汗解而不留污垢。因为伴有表证所以施用此方,如果没有表证则应究治茵陈蒿汤。(本方使黄疸从汗解,茵陈蒿汤使黄疸从下焦解,这是有表证和无表证的区别。)
Treats Shaoyin disease at its onset, characterized by anhidrosis (absence of sweating), aversion to cold, absence of headache, desire to sleep, fever, and a deep pulse.
Mahuang (Ephedrae Herba, removed nodes) 2 liang, Xixin (Asari Radix et Rhizoma) 2 liang, Fuzi (Aconiti Lateralis Radix Praeparata, one piece, processed). Use one dou of water, first boil Mahuang until reduced by two sheng, remove the foam on the surface, add the remaining herbs, boil to obtain three sheng, strain, take one sheng warm, three times daily. Mahuang Fuzi Xixin Tang (Cinnamon Twig, Aconite, and Asari Decoction) manifests both the methods of releasing the exterior and warming the meridians. Anhidrosis and aversion to cold are similar to Taiyang disease; absence of headache, deep pulse, and desire to sleep are all Shaoyin syndrome manifestations, indicating Shaoyin affliction. If there is no fever, warm tonification should be used (using Fuzi Tang); if there is fever, the pathogen still involves the Taiyang meridian. Therefore, Mahuang and Xixin are used to release the exterior, while prepared Fuzi warms the meridians to prevent collapse of Yang. (Shaoyin governs the interior and should not present exterior syndromes. However, fever appearing immediately after wind-cold invasion indicates the pathogen still links with Taiyang and has not fully entered the Yin level, so it can still be guided outward. Thus, Xixin guides Mahuang into Shaoyin to lift the newly entered pathogen, allowing it to resolve via the Taiyang meridian. Yet, fearing that the True Yang in the Kidney may escape with sweat, prepared Fuzi must be used to warm the meridians and secure the Kidney, avoiding the risk of Yang collapse from excessive sweating. This is the method for inducing sweating in Shaoyin exterior diseases without interior syndromes.)
Treats Shanghan (cold damage) where stagnant heat is trapped inside, presenting with sweating only on the head, dysuria (difficulty urinating), and jaundice (yellowing of the body).
Mahuang (Ephedrae Herba, removed nodes) 2 liang, Lianqiao (Forsythiae Fructus) 2 liang, Chixiaodou (Vigna Semen Rubrum) 1 sheng, Sheng Zibai Pi (Phellodendri Cortex or Catalpa Bark, raw) 1 sheng, Xingren (Armeniacae Semen Amarum) 40 pieces, Gancao (Glycyrrhizae Radix et Rhizoma) 2 liang, Shengjiang (Zingiberis Rhizoma Recens) 2 liang, Dazao (Jujubae Fructus) 12 pieces. Use one dou of rainwater (laoshui), first boil Mahuang until it boils again, remove the foam, add the other herbs, boil to obtain three sheng, strain, and divide into three warm doses. (Rainwater collected from the ground is called laoshui; it is chosen for its thin taste, which does not aid damp-heat.) Mahlian Lianqiao Chixiaodou Tang (Mahuang, Forsythia, and Red Adzuki Bean Decoction) combines Xingren, Gancao, and Zibi; boiled with laoshui and added ginger and jujube, it effectively clears stagnant heat and resolves jaundice. Dampness exits from the Yin level to the Taiyang meridian (This is a method of resolving both interior and exterior. Whether the heat originates from Taiyang or Yangming, when combined internally with dampness from Taiyin, it forms stagnant heat leading to jaundice. Although the disease progresses from exterior to interior, the adherent pathogen should exit from Yin to Yang. Xingren and Chixiaodou drain damp-heat from the muscle layer; Shengjiang and Zibai Pi drain damp-heat from the skin and muscles; Gancao and Dazao stabilize Qi in the Taiyin; Mahuang causes damp-heat to exit via sweat to the Taiyang meridian; Lianqiao guides damp-heat out via urine to the Taiyang meridian; laoshui assists the medicinal power to move from Yin to Yang. The classic states: "Severe dampness above leads to heat." If dampness moves downward, heat resolves, and jaundice recedes.) Jaundice resolves through sweating without leaving residual turbidity. This formula is applied because an exterior syndrome exists; if there is no exterior syndrome, Yinchenshao Tang (Artemisiae Scopariae Decoction) should be investigated. (This formula resolves jaundice via sweating, whereas Yinchenshao Tang resolves jaundice via purgation, distinguishing between cases with and without exterior syndromes.)