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《卷四十七》
37  | 齊氏曰時毒者為四時邪毒之氣而感之於人也其候發于鼻面耳項咽喉赤腫無頭或結核有根令人憎寒發熱頭疼肢體甚痛恍惚不寧咽喉閉塞人不識者將謂傷寒原夫此疾古無方論世俗通謂丹瘤病家惡言時毒切恐傳染經曰人身忽經變赤狀如塗丹謂之丹毒此風熱惡毒所為自與時毒不同蓋時毒者感四時不正之氣初發狀如傷寒五七日之間乃能殺人若至十日之外則不治自愈也治宜辨之先診其脈凢滑數浮洪沉𦂳弦濇皆其候也但浮數者邪在表也沉濇者邪氣深也察其毒之甚者急服化毒丹以攻之實熱便秘者大黃湯下之其有表證者犀角升麻湯以發之或年高氣鬱者五香連翹湯主之○又於鼻內㗜通氣㪚取十餘嚏作效若㗜藥不嚏者不可治之如嚏出膿血者治之必愈凡左右看病之人日日用㗜藥嚏之必不傳染切須記之其病人每日用嚏藥三五次以泄熱毒此治時證之良法也○凡經三四日不解者不可太下猶宜和解之以犀角㪚芩連消毒飲甚者連翹湯之類至七八日大小便通利而頭面腫起髙赤者可服托裏㪚托裏黃茋湯如腫甚者宜砭患處出惡血以泄其毒氣○此病若五日已前精神昏亂咽喉閉塞語言不出頭面赤腫食不知者必死之候治之無功矣然而此疾有陰有陽有可汗者有可下者嘗見粗工但云熱毒只用寒藥殊不知病有微甚治有逆從不可不審矣羅謙甫云泰和二年先師監濟源稅時四月民多疫癘初覺憎寒體重次傳頭面腫盛目不能開上喘咽喉不利舌乾口燥俗云大頭天行親戚不相訪問染之多不救張縣令姪亦得此病至五六日醫以承氣加板藍根下之稍緩翌日其病如故下之又緩終莫能愈漸至危篤或曰李明之存心於醫可請治之遂請診視具說其由先師曰夫身半已上天之氣也身半已下地之氣也此邪熱客於心肺之間上攻頭目而為腫盛用承氣下之以瀉胃中之實熱是誅伐無過也殊不知適其所至為故遂處一方用黃芩黃連味苦寒瀉心肺間熱以為君橘紅苦平𤣥參苦寒生甘草甘寒人參甘平瀉火補氣以為臣連翹鼠粘子薄荷葉苦辛平板藍根味苦寒馬渤白殭蠶味苦平行少陽陽明二經氣不得伸桔梗味辛温為舟楫不令下行升麻柴胡苦辛以㪚表邪共為細末半用湯調時時服之半蜜為丸噙化之服盡良愈因嘆曰徃者不可追來者猶可及凡他所有病者皆書方以貽之全活甚衆時人皆曰此方天人所制遂刋於石以傳永乆命曰普濟消毒飲 |
| 39 | 又治法曰若脈浮者邪在表也用葛根牛旁湯犀角升麻湯人參敗毒散之類以發之○脈沉濇者邪在裏也用梔子仁湯五利大黃湯之類以下之○表裏俱病而腫不退者用犀角升麻湯甚者砭出惡血并用通關㪚㗜鼻內取嚏以泄其毒○表裏俱不解而內外俱實者防風通聖散○欲其作膿者用托裏消毒散欲其收斂者用托裏散此法最為穩當○常見饑饉之際芻蕘之人多患之乃是胃氣有損邪氣從之為患也故凡以㐫荒勞役而患此者多宜安裏為主或用普濟消毒飲最善 |
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