Chapter 4, Nue disease[1], its symptoms, pulse and treatment

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疟病脉证并治第四

Chapter 4, Nue disease[1], its symptoms, pulse and treatment


师曰:疟脉自弦,弦数者多热,弦迟者多寒,弦沉紧者下之差,弦迟者可温之,弦浮紧者可发汗、针灸也,弦滑大者可吐之,弦数者风发也,以饮食消息止之。

Master: Nue disease, the pulse is string. String and frequent pulse suggests Hot/Fire; string and late pulse suggests Cold. For person with the string, deep and tight pulse, use bowel-cleansing therapy; for pulse of string and late, use warm therapy; for string, floating and tight pulse, use sweat therapy and acupuncture. For floating, slippery and big pulse, use vomiting therapy; string and frequent pulse, use diet therapy to stop the Nue disease.

 
病疟,以月一日发,当以十五日愈;设不差,当月尽解。如其不差,当云何?师曰:此结为症瘕,名曰疟母,急治之,宜鳖甲煎丸。

Askede: for the Nue disease, if it happens once every month, it should be improved/cured within 15 days (with above proper treatment). If not, it will be solved within the month. If the disease still remains, what should we do? Master: this condition suggests that the Nue has condensed into a mass/lamp, called Nue mother. Urgent treatment is needed, use Biejia Jian Wan.

鳖甲煎丸方

Biejia Jian Wan

鳖甲(十二分,炙) 乌扇(三分,烧) 黄芩(三分) 柴胡(六分) 鼠妇(三分,熬) 干姜(三分) 大黄(三分) 芍药(五分) 桂枝(三分) 葶苈(一分,熬) 石苇(三分,去毛) 厚朴(三分) 牡丹(五分,去心) 瞿麦(二分) 紫威(三分) 半夏(一分) 人参(一分) A2J5虫(五分,熬) 阿胶(三分,炙) 蜂窠(四分,熬) 赤硝(十二分) 蜣蜋(六分,熬) 桃仁(二分)

Content of the Biejia Jian Wan (omit for this movement).
       

右二十三味为末,取锻灶下灰一斗,清酒一斛五斗,浸灰,候酒尽一半,着鳖甲于中,煮令泛烂如胶漆,绞取汁,内诸药,煎为丸,如梧子大。空心服七丸,日三服。

The ways to prepare this herbal formula (omit for this movement).

师曰:阴气孤绝,阳气独发,则热而少气、烦冤,手足热而欲呕,名曰瘅疟;若但热不寒者,邪气内藏于心,外舍分肉之间,令人消铄肌肉。


Master: if the Yinqi in the body is depleted, the Yangqi will floating and cause hot, short of breath and annoyed/impatience, hot in hands and feet and has willing to nausea. This condition is called Dannue. If the person feels only hot but no cold, the Xieqi hides in the Heart, and between the muscle mass to buring the muscle.
       

温疟者,其脉如平,身无寒,但热,骨节疼烦,时呕,白虎加桂枝汤主之。


If the person feels hot/fever but no cold or chilly, feels pain in the (small) joints and nausea from time to time, and his pulse is normal, this condition is called Wennue[2]. Use Baihu jia Guizhi Tang
       

白虎加桂枝汤方

Baihu jia Guizhi Tang
       

知母(六两), 甘草(二两,炙), 石膏(一斤), 粳米(二合), 桂枝(去皮,三两)

Zhimu 90 graml, Gancao (processed) 30 gram, Shigao 248 gram, Genmi 40 gram, Guizhi 45 gram.

右剉,每五钱,水一盏半,煎至八分,去滓。温服,汗出愈。

Grind the herbs into powder. Add 6.5 gram of the powder and water 200 ml. Bring to boil and keep in mild boiling until there is 150 ml liquid left in the pot. Collect the herbal tea, drink the tea when it is warm to get sweat to solve the problem.

疟多寒者,名曰牝疟,蜀漆散主之。


If the person with the Nue disease has more cold feeling than hot, the condition is called Munue. Use Shuqi San.

蜀漆散方

Shuqi San

蜀漆(烧去腥), 云母(烧二日夜), 龙骨(等分)

Shuqi (burning to remove the bad odor), Yunmu (burning for two days), Longgu, same about for each herb.
       

右三味,杵为散,未发前,以浆水服半钱。温疟加蜀漆半分,临发时,服一钱匕。

Grind the herbs into powder. Before the onset of the Nue disease, drink 0.6 gram. For the Wennue, add Shuqi 2 gram in the drinking. Before the onset of the Nue disease, drink 1.5 gram.
       

附《外台秘要》方

Herbal formula from << Wai Tai Mi Yao >>:

牡蛎 治牡疟。

Use Muli Tang for the treatment of Munue disease.
      

 牡蛎(四两,熬), 麻黄(四两,去节), 甘草(二两), 蜀漆(三两)

Muli (processed) 60 gram, Mahuang (remove the stem joints) 60 gram, Gancao 30 gram, Shuqi 45 gram.

右四味,以水八升,先煮蜀漆、麻黄,去上沫,得六升,内诸药,煮取二升,温服一升。若吐,则勿更服。

Add the Shuqi and Mahuang, and 2000 ml water into a herbal pot. Bring to boil and keep in mild boiling until the liquid in the pot is about 1500 ml. Remove the upper floating herb residue. Add the Muli and Gancao in. Continue the boiling until there is about 500 ml left. Collect the herbal tea. Drink half of the tea each time. If the person feels vomiting after drinking, stop the drink.

柴胡
半夏加栝蒌汤 治疟病发渴者,亦治劳疟。

Chaihu qui Banxia jia Gualu Tang for Nue disease with thirsty. It is also for the treatment of Laonue. [3]
       

柴胡(八两), 人参 黄芩 甘草(各三两), 栝蒌根(四两), 生姜(二两), 大枣(十二枚)

Chaihu 125 gram, Renshen 45 gram, Huangqin 45 gram, Gancao 45 gram, Gualugen 60 gram, fresh ginger 30 gram, Chinese date 12 badges.

右七味,以水一斗二升,煮取六升,去滓,再煎取三升。温服一升,日二服。

Add the herbs and 3000 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is about 1500 ml water left in the pot. Remove the herbal residues and continue the boiling of the herbal tea until the liquid in the pot is about 750 ml. Drink one third of the tea each time, three times a day.
       

柴胡桂姜汤 治疟寒多,微有热,或但寒不热。

Chaihu Guizhi Ganjiang Tang for the treatment of Nue disease with more cold than hot, or only cold but no hot.

柴胡(半斤), 桂枝(三两,去皮), 干姜(二两), 栝蒌根(四两), 黄芩(三两), 牡蛎(三两,熬), 甘草(二两,炙)

Chaihu 90 gram, Guizhi 45 gram, Ganjiang 30 gram, Gualugen 60 gram, Huangqin 45 gram, Muli (processed) 45 gram, Gancao (processed) 30 gram.
       

右七味,以水一斗二升,煮取六升,去滓,再煎取三升。温服一升,日三服。初服微烦,复服汗出便愈。

Add the herbs and 3000 ml water into a herbal pot. Bring to boil and keep in mild boiling until the liquid in the pot is about 1500 ml. Remove the herbal residue, continue to cook the herbal tea until there is 750 ml left in the pot. Drink one third of the tea. Three times a day. After the first drinking, the person will feel slight annoyed, repeated drink causes sweat to recover.



[1] Nue disease: similar to malaria disease.

[2] Wen here means warm. Nue means malaria like disease. The Nue disease has Wennue (hot Nue disease and Hannue (cold Nue disease).

[3] Laonue: the Nue disease is caused by heavy and exhausting labor work. Lao here means labor work.