栀子 干姜
医以丸药大下之。身热不去。微烦。病在上者。因而越之。其为吐一也。而所以吐则异。
虚烦而兼少气。加甘草以和中。虚烦而兼呕恶。加生姜以散逆。腹满而虚烦。则中州之实也。入
枳朴以宽中。大热而微烦。则中州之虚也。入干姜以理中。内经曰。气有高下。病有远近。
症有中外。治有重轻。适其所以为治。根据而行之。所谓良矣。
茯苓 芍药 生姜 白术 附子
太阳发汗不解。仍发热。心悸。头眩。身 动。振振欲擗地。又少阴病。二三日至四五
日。腹痛。小便不利。四肢沉重。疼痛下利。此为水气。其人或咳。或小便利。或下利。或呕。
真武。北方水神也。水在心下。外带表而属阳。必应辛散。故治以真武汤。真武生少阴之水
。亦治太阳之悸。夫脾恶湿。腹有水气则不治。脾欲缓。甘以缓之。则土调。故以茯苓甘平
为君。白术甘温为臣。经曰。湿淫所胜。佐以酸辛。故以芍药生姜为佐。经曰。寒淫所胜。
平以辛热。故以附子为使。然水气内清。则变动多端。故立加减之法。咳者。水寒射肺也。
肺气逆。则以五味子酸收之。肺恶寒。则以细辛干姜辛润之。小便利。则去茯苓。以其渗泄
也。小便不利。则去芍药。以其酸涩也。加干姜者。散其寒也。呕者。必因于气逆。附子益气
。故去之。生姜散气。故加之。
(Symptoms and treatments are seen in the preceding formula)
Gardenia (Zhizi), Licorice Root (Gancao), Fermented Soybean (Xiangchi)
(Symptoms and treatments are seen in the preceding formula)
Gardenia (Zhizi), Fresh Ginger Shengjiang (Shengjiang), Fermented Soybean (Xiangchi)
Gardenia (Zhizi), Magnolia Bark (Noupu), Immature Bitter Orange (Zhishi)
Mainly treats irritability and abdominal fullness following purgation. Restlessness in lying down and sitting up.
Gardenia (Zhizi), Dried Ginger (Ganjiang)
The physician used pill medicines to purge severely, resulting in persistent fever and slight irritability. For diseases located in the upper jiao, one should employ the method of emesis. This falls under the category of emetic therapy, but the specific mechanism differs.
If there is deficiency-irritability accompanied by shortness of breath, add Licorice Root (Gancao) to harmonize the middle jiao. If there is deficiency-irritability accompanied by nausea and vomiting, add Fresh Ginger (Shengjiang) to disperse rebellious qi. If there is abdominal fullness with deficiency-irritability, it indicates excess in the middle jiao; add Immature Bitter Orange (Zhishi) and Magnolia Bark (Noupu) to broaden the middle and relieve fullness. If there is high fever with slight irritability, it indicates deficiency-cold in the middle jiao; add Dried Ginger (Ganjiang) to regulate the middle. The *Neijing* states: Qi has its high and low positions; diseases have their distant and near origins; symptoms have their internal and external manifestations; treatments have their heavy and light degrees. Adapt to the nature of the disease for treatment, act according to the pathogenesis, and this is called excellent medical practice.
Poria (Fuling), Peony Root (Shaoyao), Fresh Ginger (Shengjiang), Atractylodes Macrocephala Rhizome (Baizhu), Prepared Aconite Root (Fuzi)
After sweating for a Taiyang disease, the condition remains unresolved, with persistent fever, palpitations, dizziness, body tremors, and a sensation of tottering as if about to fall. Alternatively, in Shaoyin disease, after two or three days to four or five days, abdominal pain, dysuria, heaviness and pain in the four limbs, and diarrhea occur. This is due to water qi pathology. The patient may cough, or have clear urine, or suffer from diarrhea, or vomit.
Zhenwu refers to the Water God of the North. When water evil stagnates below the heart, extending outward to the exterior and belonging to Yang, it must be treated with acrid dispersal methods. Therefore, Zhenwu Decoction (Zhenwu Tang) is used. Zhenwu Decoction generates water of the Shaoyin and also treats palpitations caused by Taiyang disease. The Spleen dislikes dampness; when there is water qi in the abdomen, the Spleen fails to govern properly. The Spleen desires relaxation; using sweet herbs to relax it harmonizes the Earth element. Thus, Poria (Fuling), which is sweet and neutral, is used as the Sovereign herb. Atractylodes Macrocephala Rhizome (Baizhu), which is sweet and warm, is used as the Minister herb. The *Classic of Internal Medicine* (*Neijing*) states: "When dampness prevails excessively, assist with sour and acrid herbs." Thus, Peony Root (Shaoyao) and Fresh Ginger (Shengjiang) are used as Assistant herbs. The *Neijing* states: "When cold prevails excessively, pacify with acrid-hot herbs." Thus, Prepared Aconite Root (Fuzi) is used as the Envoy herb. However, internal water qi causes diverse changes, so methods for modifications are established. For coughing, it is water-cold attacking the Lung, causing rebellious Lung qi; use the astringent property of Schisandra Berry (Wuweizi) to collect Lung qi. Since the Lung dislikes cold, use the acrid-moistening properties of Asarum (Xixin) and Dried Ginger (Ganjiang). If urination is free, remove Poria (Fuling) because of its draining and leaching action. If urination is difficult, remove Peony Root (Shaoyao) because of its sour and astringent nature. Adding Dried Ginger (Ganjiang) is to disperse cold. Vomiting is necessarily due to rebellious qi; since Prepared Aconite Root (Fuzi) tonifies qi, it is removed; Fresh Ginger (Shengjiang) disperses qi, so it is added.