少阴病,下利脉微,与白通汤。利不止,厥逆无脉,干呕烦者,白通加猪胆汁汤主之。服
汤,脉暴出者死,微续者生。
太阳病发汗,出不解,其人仍发热,心下悸眩,身 动,振振欲擗地者,真武汤
主之。少阴病,二三日不已,至四五日,腹痛,小便不利,四肢沉重疼痛,自下利者,为有水气
,其人,或小便利,或下利,或呕者,真武汤主之。
伤寒,阳脉涩,阴脉弦,法当腹中急痛,先与小建中汤服之。伤寒二三日,心中悸而烦
者,小建中汤主之。
胸脾心下痞留,气结胸满,胁下逆气抢心,理中汤主之。治脾胃不和,中寒上冲,胸胁
逆满,心腹 痛,痰逆恶心,或时呕吐,心下虚痞,隔塞不通,饮食减少,短气羸瘦,温中逐水
,止汗去湿。又治肠胃冷湿,泄泻注下,水谷不分,腹中雷鸣,及伤寒时气,及里寒外热,
霍乱吐利,手足厥冷,胸脾心痛逆气,并皆治之。有寒者,加附子。胸痹胁下妨闷者,加枳
实半两,茯苓半两。此方自晋宋以后至唐,名医治心腹病者,无有不用此汤,或作丸
随证加减,各有其法。
霍乱,头痛发热,热多欲饮水,五苓散主之;寒多不用水者,理中丸主之。大病瘥后,
喜睡,久不了了,胸中有寒,当以丸药温之,宜理中丸。
少阴病,出现腹泻、脉象微弱,给予白通汤治疗。如果服药后腹泻仍不止,出现四肢厥冷、脉搏摸不到、干呕且心烦的症状,用白通加猪胆汁汤主治。服用该汤药后,如果脉搏突然浮大躁动而出的,预后不良(主死);如果脉搏逐渐微弱恢复的,则预后良好(主生)。
太阳病经过发汗治疗后,病情仍未解除,患者仍然发热,伴有心下悸动、头晕目眩,身体动摇不稳,震颤欲倒地的症状,用真武汤主治。少阴病,病程两三天未愈,发展到四五天,出现腹痛、小便不利、四肢沉重疼痛、自然腹泻的症状,这是体内有水气停留的表现。此类患者,有的小便通畅,有的腹泻,有的呕吐,均用真武汤主治。
伤寒病,阳脉涩滞,阴脉弦紧,按照医理应当出现腹部拘急疼痛的症状,先给予小建中汤服用。伤寒病两三天,心中悸动且烦闷的,用小建中汤主治。
胸膈心下部痞塞留滞,气机结聚导致胸胁胀满,胁下有逆气上冲心胸,用理中汤主治。治疗脾胃不和,中焦虚寒之气上冲,胸胁逆气胀满,心腹疼痛,痰饮上逆恶心,有时呕吐,心下部虚痞,膈间堵塞不通,饮食减少,气息短促、身体消瘦,具有温中散寒、逐水除湿的功效。又治疗肠胃冷湿,泄泻如水注下,水谷不分,肠中雷鸣,以及伤寒时行疫病,还有内寒外热的证候,霍乱引起的吐泻,手足厥冷,胸膈心痛及逆气上冲等症,皆在主治范围内。若有寒邪者,加入附子。若患胸痹、胁下憋闷者,加入半两枳实和半两茯苓。此方自晋宋以后至唐代,名医治疗心腹疾病的,没有不使用该汤剂的,或制成丸剂随证加减,各有其法度。
霍乱病,出现头痛、发热,热象较多且想饮水的,用五苓散主治;寒象较多且不欲饮水的,用理中丸主治。大病初愈后,喜欢嗜睡,久久不能痊愈,原因是胸中有寒邪,应当用丸药温补治疗,适宜使用理中丸。
Shaoyin disease, characterized by diarrhea and a faint pulse, is primarily treated with Baitong Decoction (White Pass Decoction).
In Shaoyin disease, presenting with diarrhea and a faint pulse, Baitong Decoction is administered. If the diarrhea persists despite treatment, accompanied by cold extremities, absence of pulse, dry heaving, and irritability, Baitong Jia Zhudanji Dan Decoction (White Pass Plus Pig Gallbladder Bile Decoction) is indicated. After taking the decoction, if the pulse suddenly emerges violently, death ensues; if the pulse gradually and weakly returns, life is preserved.
After sweating therapy for Taiyang disease fails to resolve the condition, and the patient still exhibits fever, palpitations in the epigastrium, dizziness, body tremors, and a sensation of trembling as if about to fall to the ground, Zhenwu Decoction (True Warrior Decoction) is primarily used. In Shaoyin disease, if the condition persists from two to three days into four or five days, presenting with abdominal pain, dysuria, heaviness and pain in the four limbs, and spontaneous diarrhea, this indicates the presence of retained water qi. Such patients may present with either free urination, diarrhea, or vomiting; in all these cases, Zhenwu Decoction is primarily indicated.
In Shanghan (Cold Damage), if the Yang pulse is choppy and the Yin pulse is string-taut, acute pain in the abdomen is expected according to medical principles. Xiao Jianzhong Decoction (Minor Construct the Middle Decoction) should be administered first. In Shanghan, if after two or three days the patient experiences palpitations and irritability in the heart, Xiao Jianzhong Decoction is primarily indicated.
For stagnation and fullness in the chest, diaphragm, and epigastrium, with Qi knotting causing chest and hypochondriac fullness, and rebellious Qi from the hypochondrium rushing up to the heart, Lizhong Decoction (Regulate the Middle Decoction) is indicated. It treats disharmony of the Spleen and Stomach, upward rushing of Cold from the Middle Jiao, rebellious fullness in the chest and hypochondrium, pain in the heart and abdomen, nausea due to Phlegm rebellion, occasional vomiting, empty fullness in the epigastrium, blockage preventing passage, reduced appetite, shortness of breath, emaciation, and functions to warm the Middle, expel water, stop sweating, and remove dampness. It also treats cold-dampness in the intestines and stomach, watery diarrhea where food and water are not separated, borborygmus in the abdomen, as well as Shanghan seasonal epidemics, interior Cold with exterior Heat, Huoluan (Cholera-like disorder) with vomiting and diarrhea, cold extremities, chest/diaphragm pain, and rebellious Qi. All these are within its scope of treatment. For those with Cold, add Fuzi (Prepared Aconite Root). For chest Bi obstruction and hypochondriac oppression, add half liang of Zhishi (Immature Bitter Orange) and half liang of Fuling (Poria). Since the Jin and Song dynasties through the Tang dynasty, renowned physicians treating heart and abdominal diseases invariably utilized this decoction, sometimes preparing it as pills with modifications according to the syndrome, each having its specific methods.
For Huoluan (Cholera-like disorder) presenting with headache, fever, where heat signs predominate and there is a desire to drink water, Wuling San (Five-Ingredient Powder with Poria) is primarily indicated. Where cold signs predominate and there is no desire to drink water, Lizhong Wan (Regulate the Middle Pill) is primarily indicated. After recovery from a major illness, if the patient prefers sleep and remains lethargic for a long time due to Cold in the chest, it should be treated with warming pills, specifically Lizhong Wan.