桂枝(四两,去皮) 甘草(二两,炙) 上二味,以水三升,煮取一升,去渣,顿服。此以一剂为一服者。
发汗过多,其人叉手自冒心,心下悸,欲得按者,桂枝甘草汤主之。发汗不误,误在过多。汗为心之
液,多则心气虚。二味扶阳补中,此乃阳虚之轻者,甚而振振欲擗地,则用真武汤矣。一症而轻重不同,用
方迥异,其义精矣。
茯苓(半斤) 桂枝(四两,去皮) 甘草(二两,炙) 大枣(十五枚,擘) 上四味,以甘澜水一斗,以水二
斗,扬之万遍取用。按∶甘澜水,大约取其动极思静之意。先煮茯苓 凡方中专重之药,法必先煮。减二升,纳诸
药,煮取三升,去渣,温服一升,日三服。
发汗后,其人脐下悸者,欲作奔豚,茯苓桂枝甘草大枣汤主之。心下悸,是扰胸中之阳,脐下悸,则
因发汗太过,上焦干涸。肾水上救,故重用茯苓以制肾水;桂枝以治奔豚。
桂枝(一两十六铢,去皮) 芍药 生姜(切) 甘草(炙) 麻黄(去节,各一两) 大枣(四枚,擘)
杏仁(二十四枚,去皮及双仁者) 上七味,以水五升,先煮麻黄一、二沸,去上沫。(欲去沫,故先煮。)纳诸药,
煮取一升八合,减去三分之一。去渣,温服六合。一云∶桂枝汤三合,麻黄汤三合,并为六合。顿服将息如上法。
太阳病,得之八九日,过经。如疟状,发热恶寒,热多寒少,邪已渐轻。其人不呕,非少阳。清便欲自
可,无里热。一日二、三度发,非疟象。脉微缓者,不浮不弦不大。为欲愈也。余邪欲退之象。脉微而恶寒
者,此阴阳俱虚,不可更发汗、更下、更吐也。此三句,申明上文欲愈之故。盖由病气虽除,而正气亦衰,
当静以养之,使胃气渐充,则荣卫自和,若更用汗、吐、下之法,益虚其气,则病从药增,医者不审,误
人多矣。
面色反有热色者,未欲解也。面有热色,则余邪尚郁。以其不能得小汗出,身必痒,宜桂枝麻黄各
半汤。微邪已在皮肤中,欲自出不得,故身痒,以此汤取其小汗足矣。阳明篇云∶身痒如虫行皮中状
者,此以久虚故也。
按此方分两甚轻,计共约六两,合今之秤,仅一两三四钱,分三服,只服四钱零,乃治邪退后至轻之
剂,犹勿药也。
Guizhi (Cinnamon Twig, four liang, peeled) Gancao (Licorice Root, two liang, honey-fried). The above two ingredients are decocted in three sheng of water to obtain one sheng. Remove the dregs and take orally at once. This is a case where one dose constitutes one administration.
After excessive sweating, if the patient crosses their hands over the heart region, experiences palpitations in the epigastrium (heart area), and desires pressure for relief, Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction) is indicated. Sweating itself is not erroneous; the error lies in excess. Sweat is the fluid of the Heart; excessive loss leads to deficiency of Heart Qi. These two herbs support Yang and tonify the Middle Jiao. This represents a mild form of Yang deficiency. If the condition worsens to include tremors and a desire to fall to the ground, Zhenwu Tang (True Warrior Decoction) should be used. The same symptom presents with different severities, requiring vastly different formulas, demonstrating profound medical principles.
Fuling (Poria, half jin) Guizhi (Cinnamon Twig, four liang, peeled) Gancao (Licorice Root, two liang, honey-fried) Dazao (Jujube, fifteen pieces, broken open). The above four ingredients are prepared using Ganlan Shui (Ganlan Water). Specifically, take two dou of water, stir it vigorously ten thousand times to prepare the water. Note: Ganlan Water roughly embodies the principle of "seeking stillness after extreme movement." First decoct Fuling. For any herb given primary importance in a formula, the method dictates decocting it first. Reduce the volume by two sheng, add the remaining herbs, and decoct until three sheng remain. Remove the dregs and take one sheng warm, three times daily.
After sweating, if the patient feels palpitations below the umbilicus, indicating an impending Ben Tun (Running Piglet syndrome), Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction) is indicated. Palpitations in the epigastrium result from disturbance of the Yang in the Upper Jiao. Palpitations below the umbilicus occur because excessive sweating has dried up the fluids of the Upper Jiao, causing Kidney Water to rise in rescue. Therefore, a heavy dose of Fuling is used to control Kidney Water, while Guizhi is used to treat Ben Tun.
Guizhi (Cinnamon Twig, one liang sixteen zhu, peeled) Shaoyao (Peony Root) Shengjiang (Fresh Ginger, sliced) Gancao (Licorice Root, honey-fried) Mahuang (Ephedra Stem, nodes removed, each one liang) Dazao (Jujube, four pieces, broken open) Xingren (Apricot Seed, twenty-four pieces, skin and double kernels removed). The above seven ingredients are decocted in five sheng of water. First, boil Mahuang for one or two boils, then remove the foam on the surface. (Foam is removed by boiling first.) Add the other herbs and decoct until one sheng eight he remain, reducing the volume by one-third. Remove the dregs and take six he warm. Another version states: Mix three he of Guizhi Tang with three he of Mahuang Tang to make six he, taken at once, with care instructions as above.
Taiyang Bing (Taiyang Disease), occurring after eight or nine days, has passed its meridian stage. The symptoms resemble malaria: fever and aversion to cold, with more heat than cold, indicating that the pathogenic factor is gradually lightening. The patient does not vomit, ruling out Shaoyang Bing (Shaoyang Disease). Bowel movements and urination are relatively normal, indicating no interior heat. The illness occurs two or three times a day, which is not typical of malaria. A pulse that is slightly slow and relaxed, neither floating, wiry, nor large, indicates recovery. This is a sign of residual pathogen receding. If the pulse is slight and accompanied by aversion to cold, this indicates deficiency of both Yin and Yang. Sweating, purging, or vomiting methods must not be used again. These three sentences clarify the reason for the aforementioned recovery. Generally, although the pathogenic qi has been eliminated, the healthy qi is also depleted. One should rest to nourish the body, allowing Stomach Qi to gradually replenish, so that Ying (Nutritive) and Wei (Defensive) Qi harmonize naturally. If sweating, vomiting, or purging methods are still applied, the Qi will become further deficient, and the disease will worsen due to treatment. If physicians do not examine carefully, many people will be mis-treated.
If the face appears reddish-hot, the disease has not yet resolved. Facial redness indicates that residual pathogens are still stagnant. Because a slight sweat cannot be produced, the body will likely itch. Guizhi Mahuang Ge Ban Tang (Half-Guizhi Half-Mahuang Decoction) is appropriate. The mild pathogen is located in the skin but cannot exit spontaneously, causing itching. This formula induces a slight sweat sufficient to resolve the condition. The Yangming Chapter states: "Itching like insects crawling under the skin" occurs due to chronic deficiency.
Note: The dosages in this formula are very light. The total weight is approximately six liang, which converts to only about one liang and three or four qian in modern weights. Divided into three doses, each dose is only slightly over four qian. It is a very mild formula used after the pathogen has retreated, almost equivalent to no medication.