治伤寒八九日下之。胸胁满。烦惊。小便不利。谵言。一身尽重不可转
柴胡(一两半) 龙骨(一两半) 黄芩(一两半) 生姜(一两半) 人参(一两半)
茯苓(一两半) 铅丹(一两半) 牡蛎(一两半) 桂枝(一两半) 半夏(一两半) 大
枣(六枚)
上十二味。以水八升。煮取四升。内大黄。更煮一二沸。去滓。温服一升。(此分两照
宋本
歌曰 参芩龙牡桂丹铅。苓夏柴黄姜枣全。枣六余皆一两半。大黄二两后同煎。
内台方议云。伤寒八九日。邪气错杂。表里未分。而误下之。则虚其里而伤其表。胸满
而烦
胃
而除胸胁满。
以人参、半夏为臣。辅之。加生姜、大枣而通其津液。加龙骨、牡蛎、铅丹收敛神气而
镇惊
错杂之邪。共为使。以此十一味之剂。共救伤寒坏逆之法也。伤寒论共十二味。一本无黄芩。
止十一味也。
治伤寒脉浮。医以火迫劫之。亡阳必惊狂。起卧不安
桂枝(三两) 甘草(二两) 大枣(十二枚) 生姜(三两) 牡蛎(熬。五两) 龙
骨
上为末。以水一斗二升。先煮蜀漆。减二升。内诸药。煮取三升。去滓。温服一升。(一
本
歌曰 桂枝去芍已名汤。蜀漆还加龙牡藏。五牡四龙三两漆。能疗火劫病惊狂。
张令韶曰。伤寒脉浮。病在阳也。太阳与君火相合而主神。心为阳中之太阳。医以火迫
劫亡
枝色赤入心。取之以保心气。佐以龙、牡者。取水族之物以制火邪。取重镇之品以治浮越也。
芍
用甘草、大枣、生姜。以资助中焦之气也。病在阳复以火劫。此为逆也。故曰救逆。
治疗伤寒病程已达八九日,经过误用泻下法治疗后,出现胸胁部胀满、烦躁惊恐、小便不通利、胡言乱语、全身沉重难以翻身转侧的症状。
柴胡(一两半) 龙骨(一两半) 黄芩(一两半) 生姜(一两半) 人参(一两半)
茯苓(一两半) 铅丹(一两半) 牡蛎(一两半) 桂枝(一两半) 半夏(一两半) 大
枣(六枚)
以上十二味药,用水八升,煎煮至四升,加入大黄,再煮沸一两次,滤去药渣,温服一升。(此处的分量参照宋本《伤寒论》)
歌诀曰:参芩龙牡桂丹铅,苓夏柴黄姜枣全。枣六余皆一两半,大黄二两后同煎。
《内台方议》评论说:伤寒病程达八九日,邪气错杂,表里界限不清,此时若误用泻下法,就会使里气虚弱而损伤表气,导致胸部胀满和心烦。
以人参、半夏作为臣药,辅助主药;加入生姜、大枣来通调津液;加入龙骨、牡蛎、铅丹来收敛神气以镇惊安神,共同消除错杂之邪,共为使药。以此十一味药的方剂,作为救治伤寒误治后变逆证的方法。《伤寒论》原方共十二味,另一版本无黄芩,止有十一味。
治疗伤寒脉象浮,医生用火疗强迫发汗,导致亡阳,必然出现惊恐狂乱、坐卧不安的症状。
桂枝(三两) 甘草(二两) 大枣(十二枚) 生姜(三两) 牡蛎(熬制,五两) 龙
骨 蜀漆
以上药物研为粗末,用水一斗二升,先煮蜀漆,减少二升水量,再加入其他药物,煎煮至三升,滤去药渣,温服一升。(另一版本……)
歌诀曰:桂枝去芍已名汤,蜀漆还加龙牡藏。五牡四龙三两漆,能疗火劫病惊狂。
张令韶说:伤寒脉浮,说明病在阳分。太阳经与君火相合而主宰神志,心是阳中之太阳。医生用火疗强迫发汗导致亡阳。桂枝色赤入心,取用它来保护心气;佐以龙骨、牡蛎,是取水族之物以制约火邪,取重镇之品以治疗阳气浮越。
Treats Taiyang disease (disease of the Bladder and Small Intestine channels) persisting for eight or nine days, following a mistaken purgative treatment. Symptoms include fullness in the chest and hypochondrium, irritability and fright, difficulty in urination, delirious speech, and heaviness of the entire body making turning difficult.
Chai Hu (Bupleuri Radix), 1 liang 5 qian; Long Gu (Fossil Bone), 1 liang 5 qian; Huang Qin (Scutellariae Radix), 1 liang 5 qian; Sheng Jiang (Zingiberis Rhizoma Recens), 1 liang 5 qian; Ren Shen (Ginseng Radix et Rhizoma), 1 liang 5 qian; Fu Ling (Poria), 1 liang 5 qian; Qian Dan (Lithargyrum), 1 liang 5 qian; Mu Li (Ostreae Concha), 1 liang 5 qian; Gui Zhi (Cinnamomi Ramulus), 1 liang 5 qian; Ban Xia (Pinelliae Tuber); Da Zao (Jujubae Fructus), 6 pieces.
Take the above twelve ingredients, add eight sheng of water, boil to obtain four sheng. Add Da Huang (Rhei Radix et Rhizoma), boil for one or two more boils, strain, and take one sheng warm. (The dosages follow the Song edition).
Song verse:
Ren Shen, Huang Qin, Long Gu, Mu Li, Gui Zhi, Qian Dan, Qian Ye;
Fu Ling, Ban Xia, Chai Hu, Huang Qin, Sheng Jiang, Da Zao complete.
Da Zao is six pieces, others are all one liang five qian;
Da Huang is two liang, added later to decoct together.
*Nei Tai Fang Yi* comments: In Taiyang disease persisting for eight or nine days, pathogenic factors are mixed, and the exterior and interior are indistinct. Mistaken purgation will weaken the interior and damage the exterior, leading to chest fullness and irritability.
Ren Shen and Ban Xia serve as Deputy Ministers (Chen Yao) to assist the Chief Minister (Jun Yao). Sheng Jiang and Da Zao are added to circulate fluids. Long Gu, Mu Li, and Qian Dan are added to consolidate the spirit and calm fright, jointly acting as Envoys (Shi Yao) to dispel the mixed pathogenic factors. This eleven-ingredient formula is used to rescue cases of complicated Taiyang disease due to mistreatment. The original *Shanghan Lun* text lists twelve ingredients; another version lacks Huang Qin, resulting in eleven ingredients.
Treats Taiyang disease with a floating pulse, where the physician mistakenly used fire therapy to force sweating, causing loss of Yang qi, inevitably resulting in fright, mania, restlessness, and inability to lie still.
Gui Zhi (Cinnamomi Ramulus), 3 liang; Gan Cao (Glycyrrhizae Radix et Rhizoma), 2 liang; Da Zao (Jujubae Fructus), 12 pieces; Sheng Jiang (Zingiberis Rhizoma Recens), 3 liang; Mu Li (Ostreae Concha), roasted, 5 liang; Long Gu (Fossil Bone); Shu Qi (Drepanopteris Herba).
Grind the above into coarse powder. Add twelve sheng of water, first boil Shu Qi until reduced by two sheng, then add the other medicines. Boil to obtain three sheng, strain, and take one sheng warm. (Another version...)
Song verse:
Gui Zhi Qu Shao Yao Tang is already named so;
Add Shu Qi along with Long Gu and Mu Li.
Five parts Mu Li, four parts Long Gu, three parts Shu Qi;
Able to treat fright and mania caused by fire coercion.
Zhang Lingshao states: A floating pulse in Taiyang disease indicates the pathology is in the Yang aspect. The Taiyang channel combines with Ministerial Fire to govern the Spirit. The Heart is the Taiyang within the Yang organs. When the physician uses fire therapy to force sweating, it causes loss of Yang qi. Gui Zhi is red and enters the Heart; using it preserves Heart Qi. Long Gu and Mu Li are used as assistants; taking aquatic creatures controls Fire pathogens, and using heavy sedatives treats floating and hyperactive Yang.
Gan Cao, Da Zao, and Sheng Jiang are used to support the Qi of the Middle Jiao. Since the disease is in the Yang aspect and is further coerced by fire, this is a contrary treatment; hence it is called "Rescue from Contrariety" (Jiu Ni).