伤寒大白 · 秦之桢 · Chapter 23 of 84

总论 宜攻下论

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总论 宜攻下论

宜攻下者,表汗已出,表邪已解,热结在里,而有诸般下症者。故仲景立诸承气汤以下燥粪,抵当汤、桃仁汤以下瘀血。大小陷胸汤以攻结胸。诸泻汤以攻痞满。然原分急下,可下、宜下、微和胃气,俟之,导法缓急轻重。故曰:身无大热,腹胀满,大便不通者,宜攻下。潮热多汗,大便硬,欲大便不得,大便时下臭气者,宜攻下。口燥咽干而渴,大便不通,手足汗出,舌上微黄者,宜攻下。以上下燥粪者也。小腹硬满,小便自利者,宜攻下。心下胀满,漱水在口,不得下咽者,宜攻下。此下淤血者也。误下后,身无热,脉不浮,心下硬痛,有下症者,宜攻下。此下结胸者也。按仲景攻下之法,不详于大便秘结条中,反详于自汗条内。良以攻下一法,最怕表邪未散,表汗未出,今自汗则表邪散者多矣。

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