治阴毒寒伤,唇青面黑,身背强,四肢冷。
附子(三分,炮裂,去皮脐) 桂心(半两) 当归(半两,锉,炒) 半夏(一分,姜制)
干姜(一分,炮) 白术(半两)
上件为细末,每服二三钱,水一中盏,生姜半钱,煎至六分,去滓。不计时候热服,衣
覆取汗,如人行地十里。未汗,再服。
治阴毒伤寒,面青,张口气出,心下硬,身不热,只额上有汗,烦渴不止,舌黑多睡,
四肢俱冷。
附子(一枚炮裂,去皮脐) 皂荚(一挺,醋炙,去皮弦子) 干姜(一分) 甘草(一分,
炙) 麝香(一钱,另研)
上细末,每服一钱,水一中盏,煎至五分,不计时候,和滓热服。
治阴盛隔阳,烦躁不饮水。
附子一枚半两者,炮热取出,用冷灰焙之,细研,入真腊茶一大钱,和匀分作二服,水一盏,煎至六分,临熟入蜜半匙,放温或冷服之。须臾,躁止得睡,汗出
即瘥。
治伤寒恶候。
舶上硫黄 附子(去皮,生用) 新腊茶(各一两)
上为细末,先将好酒一升,调药分大新碗口中,于火上摊荡令干,合于瓦上,每一碗下
烧艾
熟一拳大,以瓦起,无令火着,直至烟尽,冷即刮取,却细研入瓷合盛。每服二钱,酒一
盏,共煎七分,有火焰起,勿讶。伤寒阴毒者,四肢冷,脉沉细,或吐或泻,五心躁烦,胸
中结硬,或转作伏阳在内,汤水不下,或无脉,先吃一服,如吐,却更进一服。服后心中热
,其病已瘥,下至脏腑中。表未解者,浑身壮热,脉气洪大,宜用发表药。或表解者,更不
发热,便得眠睡,浑身有汗,方可用下胸膈行脏腑药,渐用调和脾胃,补治元气汤散。如服
此药,三二服不应者,不可治也。
海藏云∶表后既解,不发热,得睡,身有汗,方可用下脏腑药,此一句利害非轻。若稍少
有痞
应,犹不可治,可以妄下行脏腑乎?用者宜详。
仲景伤寒脉浮,自汗出,小便数,心烦微寒,脚挛急。与桂枝汤,欲攻表,误也。得之
便厥,咽中干,燥烦吐逆,作甘草干姜汤与之,以复其阳。若厥愈足温者,更作芍药甘草汤与之
,其脚即伸。若胃气不和谵语者,少与调胃承气汤。
上此一条,先温后下,不可轻用,内别有消息。
治疗阴毒寒邪损伤,症见嘴唇发青、面色发黑、身体背部僵硬、四肢冰冷。
附子(三分,炮制裂开,去掉皮和脐) 桂心(半两) 当归(半两,切碎,炒制) 半夏(一分,生姜炮制)
干姜(一分,炮制) 白术(半两)
以上药物研成细末,每次服用二三钱,用水一中盏,生姜半钱,煎煮至六分,滤去药渣。不分时候,趁热服用,覆盖衣被取汗,如同人行走十里路的时间。若未出汗,再服用一次。
治疗阴毒伤寒,症见面色青紫、张口喘气、心下部位坚硬、身体不发热、仅额头有汗、烦躁口渴不止、舌苔黑、嗜睡、四肢全部冰冷。
附子(一枚,炮制裂开,去掉皮和脐) 皂荚(一挺,醋炙,去掉皮和籽) 干姜(一分) 甘草(一分,炙制) 麝香(一钱,单独研磨)
以上研成细末,每次服用一钱,用水一中盏,煎煮至五分,不分时候,连同药渣一起趁热服用。
治疗阴盛格阳,症见烦躁但不想喝水。
附子一枚半两重,炮热后取出,用冷灰焙干,细细研磨,加入真腊茶一大钱,混合均匀分为两次服用,用水一盏,煎煮至六分,临熟时加入蜂蜜半匙,放温或冷服。片刻之后,烦躁停止并能入睡,出汗即痊愈。
治疗伤寒的危重证候。
舶上硫黄 附子(去皮,生用) 新腊茶(各一两)
以上研成细末,先将好酒一升,将药物调匀倒入大新碗中,在火上摊荡使酒干,盖在瓦片上,每碗下面烧艾绒一拳大,用瓦片盖住,不要让火直接烧着药,直到烟尽,冷却后刮取药物,再次细细研磨放入瓷盒中保存。每次服用二钱,酒一盏,共同煎煮七分,若有火焰升起,不要惊讶。伤寒阴毒者,四肢冰冷,脉象沉细,或呕吐或腹泻,五心烦热,胸中结块坚硬,或者转变为伏阳在内,汤水无法下咽,或者无脉,先服用一剂,如果呕吐,再进服一剂。服药后心中发热,病情已愈,药力下行至脏腑。表证未解者,浑身壮热,脉象洪大,宜用解表药。若表证已解,不再发热,便能安睡,浑身有汗,才可用通下胸膈、行脏腑的药,逐渐使用调和脾胃、补治元气的汤散。如服用此药,两三剂无效者,不可治愈。
海藏说:表证既已解除,不发热,能入睡,身上有汗,才可用通下脏腑的药,这一句利害非轻。如果稍有一点痞证应验,尚且不可治愈,岂可妄用通下脏腑之法?使用者应当详察。
仲景伤寒脉浮,自汗出,小便频数,心烦微恶寒,脚挛急。给予桂枝汤,想要攻表,是错误的。得之便出现四肢厥逆,咽喉干燥,燥烦吐逆,制作甘草干姜汤给予患者,以恢复其阳气。若四肢厥逆痊愈、足部温暖者,再制作芍药甘草汤给予患者,其脚即可伸展。若胃气不和出现谵语者,少量给予调胃承气汤。
以上这一条,先温后下,不可轻用,内别有深意。
Treating Yin-toxin cold injury, presenting with cyanotic lips, dark complexion, stiffness of the back and body, and cold limbs.
Fuzi (Aconiti Lateralis Radix Praeparata), 3 fen, processed until cracked, peel and umbilicus removed; Guixin (Cinnamomi Cortex), 0.5 liang; Danggui (Angelicae Sinensis Radix), 0.5 liang, sliced and stir-fried; Banxia (Pinelliae Rhizoma Praeparatum), 1 fen, prepared with ginger juice; Ganjiang (Zingiberis Rhizoma), 1 fen, processed; Baizhu (Atractylodis Macrocephalae Rhizoma), 0.5 liang.
The above ingredients are ground into a fine powder. Each dose is 2-3 qian, decocted with one zhong zhan of water and half a qian of fresh ginger until reduced to six-tenths. Strain and discard the dregs. Take hot regardless of time, cover with clothing to induce sweating, equivalent to walking ten li. If no sweat occurs, administer another dose.
Treating Yin-toxin shaoyin cold damage, presenting with bluish face, gasping with mouth open, hardness below the heart, absence of fever in the body, only sweat on the forehead, incessant irritability and thirst, black tongue, excessive sleepiness, and coldness of all four limbs.
Fuzi (Aconiti Lateralis Radix Praeparata), one piece, processed until cracked, peel and umbilicus removed; Zaojia (Gleditsiae Fructus), one stick, vinegar-roasted, peel and seeds removed; Ganjiang (Zingiberis Rhizoma), 1 fen; Gancao (Glycyrrhizae Radix et Rhizoma), 1 fen, roasted; Shexiang (Moschus), 1 qian, separately ground.
The above are ground into a fine powder. Each dose is 1 qian, decocted with one zhong zhan of water until reduced to five-tenths. Take hot with the dregs regardless of time.
Treating Yin excess blocking Yang, presenting with irritability but no desire to drink water.
Fuzi (Aconiti Lateralis Radix Praeparata), one and a half liang in weight, processed until hot then taken out, baked in cold ash, finely ground. Add Zhenlacha (Camelliae Sinensis Folium) 1 da qian, mix evenly, divide into two doses. Decoct with one zhan of water until reduced to six-tenths. Just before completion, add half a spoonful of honey. Take warm or cool. Soon after, irritability ceases, sleep is achieved, and sweating leads to recovery.
Treating severe adverse conditions of shaoyin cold damage.
Boshang Liuhuang (Sulfur imported from overseas); Fuzi (Aconiti Lateralis Radix Praeparata), peeled, used raw; Xinlacha (Camelliae Sinensis Folium), each 1 liang.
The above are ground into a fine powder. First, take one sheng of good wine, mix the medicine, pour into a large new bowl, swirl over fire until dry, cover with a tile. Under each bowl, burn mugwort (Ai Ye, Artemisiae Argyi Folium) the size of a fist. Cover with tile, do not let fire touch the medicine directly, until smoke is exhausted. Scrape when cool, grind finely, store in porcelain box. Each dose is 2 qian, decocted with one zhan of wine until seven-tenths remain. Flames may rise, do not be alarmed. For shaoyin cold toxin: cold limbs, deep and thin pulse, vomiting or diarrhea, five-palm heat/irritability, chest knotting/hardness, or transformation to latent Yang inside where fluids cannot pass, or pulselessness. Administer first dose; if vomiting occurs, administer another. After taking, heart feels hot, illness resolves, medicine descends to organs and bowels. If exterior syndrome is unresolved: high fever all over, surging and large pulse, use releasing exterior herbs. If exterior is resolved: no more fever, able to sleep, sweating all over, then use purgative herbs for chest/diaphragm and regulating organs/bowels, gradually using harmonizing spleen/stomach and tonifying original Qi decoctions/powders. If this medicine fails after 2-3 doses, it is incurable.
Haicang said: "After exterior is resolved, no fever, able to sleep, sweating on body, then use purgative herbs for organs/bowels." This statement carries significant gravity. If even slight痞 (pi, glomus/blockage) responds, it is still not curable; how can one rashly use purgatives for organs/bowels? Users should examine carefully.
Zhongjing: Shaoyin cold damage with floating pulse, spontaneous sweating, frequent urination, vexation, slight aversion to cold, and leg cramping. Given Guizhi Tang (Cinnamon Twig Decoction) to attack the exterior, which was an error. Resulted in jue (cold extremities), dry throat, dry vexation, vomiting/reversal. Prepared Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) to restore Yang. If jue resolves and feet become warm, prepare Shaoyao Gancao Tang (Peony and Licorice Decoction); legs will extend. If stomach qi disharmony causes delirious speech, give small amount of Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction).
This passage emphasizes warming first, then purging; do not use lightly, there are subtle nuances within.