倪海厦：妙用经方——葛根汤
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">Edit | 覺悟之旅</span></strong></span>： <span style="color: black;">倪師箴言。</span><span style="color: black;">。</span><span style="color: black;">。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">葛根汤：</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">葛根 四两；麻黄 三两；桂枝 二两；</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">芍药 二两；甘草 二两；生姜 三两；</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">大枣 十二枚</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">右七味,以水一斗,先煮麻黄、葛根,减二升,去沫,内诸药,煮取三升,去滓,温服一升,覆取微似汗,不须啜粥。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">馀如桂枝汤法将息及禁忌。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">太阳病，项背强几几，无汗，恶风，葛根汤主之。</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">葛根是桂枝的两倍。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">为何</span>用葛根汤?</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">由于</span>桂枝汤证的时候,本身<span style="color: black;">无</span>失掉<span style="color: black;">非常多</span>津液,体能很好, 葛根汤证的时候,表就很虚了。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q2.itc.cn/q_70/images03/20240903/a2cba307940b4fb0859c721861e20ab3.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">尤其是小<span style="color: black;">孩儿</span>,常常跑来跑去,汗流<span style="color: black;">非常多</span>,风一吹,就得了葛根汤证,<span style="color: black;">由于</span>他在运动的时候,毛孔开着的,汗就流出去了,流汗的<span style="color: black;">同期</span>,滤过性病毒进来,一进来就很深了。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">刚<span style="color: black;">起始</span>从<span style="color: black;">背面</span>进来,<span style="color: black;">导致</span>部份的水已离开汗腺但又不出毛孔,<span style="color: black;">因此</span>项强,水渗在肌肉里面,会很痛,<span style="color: black;">因此</span>背部强硬。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">本来</span>津液就<span style="color: black;">不足</span>了,<span style="color: black;">倘若</span>光靠桂枝汤把肠的津液<span style="color: black;">发布</span>发出来,津液<span style="color: black;">不足</span>,力量会<span style="color: black;">不足</span>,<span style="color: black;">此时</span>候重用葛根,葛根<span style="color: black;">本来</span><span style="color: black;">便是</span><span style="color: black;">提高</span>津液的,把水份发散到皮肤表面上来。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">为何</span>加麻黄?</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">麻黄用的比葛根少,<span style="color: black;">不可</span>太多,皮肤表面<span style="color: black;">无</span>汗,<span style="color: black;">表率</span>有中寒的现象。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">倘若</span>有汗,光是桂枝加葛根汤就<span style="color: black;">能够</span>了,<span style="color: black;">无</span>汗,<span style="color: black;">便是</span>被表寒束到了,要<span style="color: black;">发布</span>发出来,<span style="color: black;">然则</span>光靠桂枝没力量,<span style="color: black;">此时</span>候加麻黄在桂枝上面。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">张仲景在写处方的时候,先写葛根,麻黄,桂枝,麻黄走表,很轻。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q8.itc.cn/q_70/images03/20240903/ae1b6e8ad096420f81945fb64639c1fd.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">光吃麻黄不会<span style="color: black;">步行到</span>皮肤表面,<span style="color: black;">因此</span>单味吃麻黄,不会流汗的,要靠桂枝把它推到肌肉,<span style="color: black;">而后</span>麻黄再到皮肤表面,把病毒排出体外。</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">葛根是升水的,感冒喉咙痛,咽干,<span style="color: black;">便是</span>葛根汤证,葛根是生津止渴的,<span style="color: black;">因此</span>重用葛根,靠葛根的力量就够了。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">肠胃<span style="color: black;">由于</span>有炙甘草、大枣,<span style="color: black;">因此</span>津液很足,</span><span style="color: black;"><strong style="color: blue;">葛根直接把津液从肠胃带到皮肤表面去,到头上、喉咙去了。</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">葛根发散的力量很强,譬如小孩发“水痘”,水痘<span style="color: black;">便是</span>胎毒,小孩在妈妈的肚子里,喝了羊水,到大的时候会发水痘,发起来是一颗小小的一粒,表面上是一粒,结果小孩发高烧,小孩的肠胃的壁表面<span style="color: black;">所有</span>是一片水痘在上面,这<span style="color: black;">便是</span>胎毒。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">服葛根汤,葛根汤能把所有脏的水排到皮肤表面,喝了葛根汤后,小孩早上起来,会发的满脸全身都是水痘,<span style="color: black;">然则</span>小孩<span style="color: black;">特别有</span>精神,不要刺破,让它慢慢消掉就好了,一剂就够了。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">朮附汤,白朮附子等量,能够发痈脓。</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q7.itc.cn/q_70/images03/20240903/85830bf4844244c3a8e35fbf59e7eba3.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">身体里面的瘤,在很深的<span style="color: black;">地区</span>、在子宫或淋巴结里面,<span style="color: black;">始终</span><span style="color: black;">没法</span>发到表面上,<span style="color: black;">倘若</span>能发到皮肤表面,变成大的脓疮,像青春痘、疖子,把脓头去掉就好了,<span style="color: black;">然则</span>在很深的<span style="color: black;">地区</span>或在骨边出不来,</span><span style="color: black;"><strong style="color: blue;">就靠白朮附子</strong></span><span style="color: black;">。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">为何</span>加附子？</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">由于</span>深的<span style="color: black;">地区</span><span style="color: black;">必定</span>接近骨边,<span style="color: black;">因此</span>加附子,</span><span style="color: black;"><strong style="color: blue;">附子壮里阳,把里面的脓疮往外推,白朮有干燥的<span style="color: black;">功效</span></strong></span><span style="color: black;">,<span style="color: black;">因此</span>把葛根汤里面加这两味药下去的时候,<span style="color: black;">能够</span>发全身性的脓疮。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">举例<span style="color: black;">来讲</span>,<span style="color: black;">倘若</span>遇到一个病人,糖尿病足、脚上有伤口化脓,偏偏又得到葛根汤证,<span style="color: black;">咱们</span>就要灵活运用,<span style="color: black;">能够</span>用葛根汤加上白朮附子排脓,<span style="color: black;">由于</span>在脚上,<span style="color: black;">因此</span>加重白芍,把脚的血液循环加速。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">经方是绝对处方,比例是黄金比例,运用之妙存乎一心。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">《方机》曰：鼻渊、脑漏、鼻痈、鼻中息肉等之臭脓滴沥,或浊涕不止,不问香臭等,皆由肺中郁毒之<span style="color: black;">导致</span>,脑漏尤为恶证,若不早治之,则或至不起,俱宜本方加“朮附汤”。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">痈疽初起,壮热憎寒,脉数者,以“葛根汤”发汗后,转以加“朮附汤”而促其酿脓,脓成者,速可刺破。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q0.itc.cn/q_70/images03/20240903/69c5bf9b541643b58123946ba76c6430.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">脑漏,肾主脑,鼻子<span style="color: black;">欠好</span>的头定痛,<span style="color: black;">此时</span>候加强肾,让排脓的力量加强,<span style="color: black;">因此</span>加附子,加白朮。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">这般</span>鼻黏膜就会越来越干。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">鼻涕<span style="color: black;">倘若</span>说是黄、黏稠的,这是湿热,就改成加些黄芩等去热的药在里面。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">无汗、恶风、项背强、喉咙痛、咽干、口渴,<span style="color: black;">便是</span>葛根汤证。太阳与阳明合病, 必自下利,葛根汤<span style="color: black;">亦</span><span style="color: black;">能够</span>治疗下利。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">为何</span>叫太阳与阳明合病者,太阳<span style="color: black;">表率</span>“表”,阳明<span style="color: black;">表率</span>“里”,表被寒束到了,水到表面出不去,就回流,水出去再回来,温度就<span style="color: black;">不足</span>,水就到小肠,小肠是火,小肠本身不是受水的,水一到小肠就听到咕噜咕噜的拉出来了,中医叫作「热利」。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">病人的大便浓稠、散的、很臭,<span style="color: black;">倘若</span>有表证又兼有了利,<span style="color: black;">此时</span>候<span style="color: black;">亦</span>是葛根汤证,<span style="color: black;">便是</span>太阳、阳明并病。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">靠葛根把肠胃中的水拉上来,下利就止掉了,葛根汤为下利初起兼有表证之特效良方。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">这是一种治痢的<span style="color: black;">办法</span>；以后还会教到其它方式,例如和解的方法,还有利尿的<span style="color: black;">办法</span>等等。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">用葛根汤治疗表证兼有下利,有一种<span style="color: black;">状况</span>要<span style="color: black;">重视</span>,遇到中焦很湿热的人,舌苔黄而湿腻,用了葛根汤,结果脸都红起来,湿热都被升提上来了；<span style="color: black;">因此</span>素有中湿之人,<span style="color: black;">爱好</span>吃油腻的东西,比较胖的人,应该加茯苓下去,让湿热从小便排出来。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">治小儿惊风角弓反张,属于刚痉,<span style="color: black;">便是</span>小孩脑膜炎、<span style="color: black;">晕倒</span>、抽筋,<span style="color: black;">此时</span>候葛根汤重用到六七钱的,麻黄用四钱,桂枝用三钱,大剂的下去。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">凡表里两病皆实者,当先解表而后治其里,<span style="color: black;">倘若</span>表实里虚的时候,先解表再治里,临床上,有的时候<span style="color: black;">一块</span>用,有的时候病人<span style="color: black;">已然</span>三四天不大便了,又得到葛根汤证,<span style="color: black;">一块</span>攻出来<span style="color: black;">无</span>关系。</span></p>
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你的见解真是独到，让我受益匪浅。 回顾历史，我们感慨万千；放眼未来，我们信心百倍。 对于这个问题，我有不同的看法...
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