甘草 干姜 附子
发热。头痛。脉反沉。苦不瘥。身体痛。当救其里。下后。下利清谷。身痛。急当救里
。四
为土味。是以甘草为君。寒淫所胜。平以辛热。是以干姜为臣。温经回阳。非纯阳而健悍者
。无此大作用。是以附子为使。太阴与少阴。俱受阳和之煦。而真气充周于肢节矣。若发热
云云。下后云云。皆阴症故并主之。
大黄 甘草 芒硝
太阳病未解。脉阴阳俱停。必先振栗。汗出乃解。但阳脉微者。先汗出而解。但阴脉微
者。下之而解。若欲下之。宜调胃承气汤。阴阳俱停。是阴阳和已。可以弗药而愈。阳脉微者。
阴胜也。有汗则解。设或无汗。大都宜温。阴脉微者。阳胜也。非下之何以解其亢阳乎。经
曰。热淫于内。治以咸寒。佐以苦寒。芒硝咸寒为君。大黄苦寒为臣。正合此法也。加甘
草以缓之和之。监其峻烈。虽则有承顺其气之势。复有调和其胃之功矣。故名调胃承气。本
阳明药。而此主太阳未解也。
桂枝 甘草 大枣 芍药 生姜 胶饴
伤寒二三日。悸而烦。小建中汤。 阳脉涩阴脉弦。腹中急痛。与小建中汤。
二三日邪方盛。又未经汗下。见症不过悸而烦。不审何故。便行建中。疑必有脱文也
。若阳脉涩而痛脉弦。腹中掣急而痛。灼然虚寒。建中温之当矣。脾居四藏之中。生育营卫。通
行津液。一有不调。则营卫失育。津液失行。此汤甘温。善为中州培养。有创建之气。故曰建中
。脾欲缓急食甘以缓之。故以胶饴甘温为君。甘草甘平为臣。脉弦木旺。土之仇也。以桂与
芍药制之为佐。益卫宜辛。补营宜甘。故以姜枣为使。
Gancao (Licorice Root), Ganjiang (Dried Ginger), Fuzi (Prepared Aconite Root)
Presenting with fever, headache, yet the pulse is unexpectedly deep (Chen). If the condition persists without improvement and body pain is present, one should first treat the interior syndrome. After purgation, if there is diarrhea with undigested food and persistent body pain, urgent treatment of the interior is required.
Gancao (Licorice Root) has a flavor associated with Earth, thus serving as the Sovereign herb (Jun). When cold pathogenic factors prevail, they are pacified by acrid-hot substances; therefore, Ganjiang (Dried Ginger) serves as the Minister herb (Chen). To warm the meridians and restore Yang, only pure Yang herbs that are robust and vigorous possess such significant efficacy; thus, Fuzi (Prepared Aconite Root) serves as the Envoy herb (Shi). Both the Taiyin and Shaoyin channels receive the warming influence of Yang Qi, allowing the True Qi to circulate fully through the limbs and joints. The aforementioned symptoms of "fever" and conditions following "purgation" are all governed by this formula because they stem from Yin syndromes.
Dahuang (Rhubarb Root), Gancao (Licorice Root), Mangxiao (Mirabilite)
When the Taiyang disease has not yet resolved, and the pulses at the superficial (Yang) and deep (Yin) positions both appear stagnant or hidden, the patient will typically experience chills followed by sweating before recovery. If only the Yang pulse (superficial) is slightly active, recovery comes through sweating. If only the Yin pulse (deep) is slightly active, recovery comes through purgation. If purgation is desired, Tiaowei Chengqi Tang (Harmonizing the Stomach and Directing Downward Decoction) is appropriate. "Stagnant Yin and Yang pulses" indicates that Yin and Yang Qi have harmonized, suggesting recovery may occur without medication. A slight Yang pulse indicates Yin excess; sweating resolves it, but if no sweat occurs, warming methods are generally suitable. A slight Yin pulse indicates Yang excess; how else can hyperactive Yang be resolved than through purgation? The Classic states: "For heat lurking within, treat with salty-cold substances, assisted by bitter-cold." Mangxiao (Mirabilite) is salty and cold, serving as the Sovereign herb; Dahuang (Rhubarb Root) is bitter and cold, serving as the Minister herb, which aligns perfectly with this principle. Gancao (Licorice Root) is added to moderate and harmonize, restraining its harshness. Although it has the tendency to direct downward and smooth Qi, it also possesses the function of harmonizing the Stomach, hence the name Tiaowei Chengqi Tang. This formula originally treats Yangming diseases, but here it addresses Taiyang disease that has not resolved while involving interior excess.
Guizhi (Cinnamon Twig), Gancao (Licorice Root), Dazao (Jujube Fruit), Shaoyao (Peony Root), Shengjiang (Fresh Ginger), Jiaoyi (Maltose)
In Shanghan (Cold Damage) affecting the second or third day, presenting with palpitations and irritability, Xiaojianzhong Tang (Minor Construct the Middle Decoction) is indicated. If the Yang pulse is choppy and the Yin pulse is wiry, accompanied by acute abdominal pain, Xiaojianzhong Tang (Minor Construct the Middle Decoction) is administered.
On the second or third day, when pathogens are strong and neither sweating nor purgation has been applied, symptoms limited to palpitations and irritability suggest that applying Jianzhong therapy without further diagnosis implies missing text in the source. However, if the Yang pulse is choppy and the Yin pulse is wiry, with pulling and acute abdominal pain, it is clearly a deficiency-cold pattern, making the warming action of Jianzhong Tang appropriate. The Spleen resides among the other four Zang organs, responsible for generating Ying (Nutrient) and Wei (Defensive) Qi, and circulating Body Fluids. Once its function is impaired, Ying and Wei generation fails, and Body Fluid circulation is obstructed. This decoction is sweet and warm, excellently nurturing the Middle Jiao, possessing the energy to establish the Middle, hence named "Jianzhong" (Construct the Middle). Since the Spleen desires relief from tension, sweet flavors are used to soothe it; thus, Jiaoyi (Maltose), being sweet and warm, serves as the Sovereign herb. Gancao (Licorice Root), being sweet and neutral, serves as the Minister herb. A wiry pulse indicates Wood excess, which controls Earth; Guizhi (Cinnamon Twig) and Shaoyao (Peony Root) are used to restrain this, serving as Assistant herbs. Enhancing Wei Qi requires acrid flavors, while nourishing Ying Blood requires sweet flavors; thus, Shengjiang (Fresh Ginger) and Dazao (Jujube Fruit) serve as Envoy herbs.