茵陈蒿(六两) 栀子(十四枚,擘) 大黄(二两,去皮) 上三味,以水一斗,先煮茵陈,减六升、茵陈为主
药。纳二味,煮取三升,去渣,分温三服。小盒饭利,尿如皂角汁状,色正赤,一宿腹减,病从小便去
也。先煮茵陈,则大黄从小便出,此秘法也。
阳明病,发热汗出者,此为热越,不能发黄也。但头汗出者,身无汗,剂颈而还,小便不利,引水
浆饮者,此为瘀热在里,身必发黄,茵陈蒿汤主之。《本草》∶茵陈主热结黄胆。
伤寒七、八日,身黄如橘子色,小便不利,腹微满者,阳明瘀热。茵陈汤主之。
麻黄(二两,去节) 连轺(二两,连翘根是) 赤小豆(一升) 生梓白皮(一升,切) 杏仁(四十枚,去皮
尖) 甘草(二两,炙) 生姜(二两,切) 大枣(十二枚,擘) 上八味,以潦水一斗,无根之水。先煮麻黄,再
沸去上沫,纳诸药,煮取三升,去渣,分温三服,半日服尽。连轺即连翘根,气味相近,今人不采,即以连翘代可也。
伤寒瘀热在里,身必发黄,麻黄连轺赤小豆汤主之,前方欲黄从下解,此方欲黄从汗解,乃有表无
表之分也。
麻黄(二两半,去节) 升麻(一两一分) 当归(一两一分) 知母 黄芩 葳蕤(各十八铢) 白术 石膏(碎、
绵裹) 干姜 芍药 天冬(去心) 桂枝(去皮) 茯苓 甘草(各
六铢,炙) 上十四味,以水一斗,先煮麻黄一两沸,去上沫,纳诸药,煮取三升,去渣,分温三服。相去
如炊三斗米顷,令尽,汗出愈。
伤寒六、七日,大下后,寸脉沉而迟,手足厥逆,下部脉不至,咽喉不利,唾脓血,泄利不止者,皆
上热下寒之症。为难治。麻黄升麻汤主之。此乃伤寒坏症,寒热互见,上下两伤,故药亦照症施治。病症之
杂,药味之多,古方所仅见,观此可悟古人用药之法。
Yinchen (Herba Artemisiae Scopariae, 6 liang) Zhi zi (Fructus Gardeniae, 14 pieces, broken open) Dahuang (Radix et Rhizoma Rhei, 2 liang, peeled). The above three herbs are boiled in one dou of water. First, boil Yinchen until the volume reduces by six sheng; Yinchen is the principal herb. Then add the other two herbs, boil to obtain three sheng of decoction, remove the dregs, and divide into three warm doses. Urination should become free, with urine resembling the juice of soap pods, dark red in color. After one night, abdominal fullness decreases, indicating that the pathogenic factor is expelled via urination. Boiling Yinchen first allows Dahuang to be expelled through urination; this is a secret method.
Yangming disease characterized by fever and sweating indicates that heat is venting outward, so jaundice will not occur. If only the head sweats, while the body has no sweat, and sweating stops at the neck, accompanied by dysuria and a desire to drink fluids, this indicates stagnant heat trapped inside, leading inevitably to jaundice. Yinchen Hao Tang (Artemisia Scoparia, Gardenia, and Rhubarb Decoction) is the primary formula. *Bencao* states: Yinchen treats heat-induced jaundice.
In Shanghan (Cold Damage) after seven or eight days, if the body turns yellow like an orange peel, with dysuria and slight abdominal fullness, it is Yangming stagnant heat. Yinchen Tang (Artemisia Scoparia Decoction) is indicated.
Mahuang (Herba Ephedrae, 2 liang, nodes removed) Lianyao (Radix Scrophulariae, 2 liang, which is the root of Qiaqiao/Shaxinsgen) Chixiaodou (Semen Phaseoli Angularis, 1 sheng) Shengzi Bapi (Cortex Catalpae Viridis, 1 sheng, sliced) Xingren (Semen Armeniacae Amarum, 40 pieces, skin and tips removed) Gancao (Radix Glycyrrhizae, 2 liang, honey-fried) Shengjiang (Rhizoma Zingiberis Recens, 2 liang, sliced) Dazao (Fructus Jujubae, 12 pieces, broken open). The above eight herbs are boiled in one dou of Liaoshui (rainwater or dew, i.e., unrooted water). First, boil Mahuang; when boiling, skim off the foam on the surface. Add the remaining herbs, boil to obtain three sheng of decoction, remove dregs, and divide into three warm doses, to be consumed within half a day. Lianyao is the root of Qiaqiao (Fructus Forsythiae); their properties are similar. Since modern practitioners rarely collect the root, Qiaqiao may be used as a substitute.
In Shanghan, when stagnant heat is trapped inside, jaundice inevitably occurs. Mahuang Lianqiao Chixiaodou Tang (Ephedra, Forsythia, and Adzuki Bean Decoction) is indicated. The previous formula aims to resolve jaundice via downward purgation, whereas this formula aims to resolve it via sweating; the distinction lies in the presence or absence of exterior syndrome.
Mahuang (Herba Ephedrae, 2.5 liang, nodes removed) Shengma (Rhizoma Cimicifugae, 1 liang 1 fen) Danggui (Radix Angelicae Sinensis, 1 liang 1 fen) Zhimu (Rhizoma Anemarrhenae) Huangqin (Radix Scutellariae) Weirui (Rhizoma Polygonati Odorati) Baizhu (Rhizoma Atractylodis Macrocephalae) Shigao (Gypsum Fibrosum, crushed, wrapped in cloth) Ganjiang (Rhizoma Zingiberis Secatum) Shaoyao (Radix Paeoniae Alba) Tiandong (Radix Asparagi) Guizhi (Ramulus Cinnamomi, peeled) Fuling (Sclerotium Poriae) Gancao (Radix Glycyrrhizae, 6 zhu each, honey-fried). The above fourteen herbs are boiled in one dou of water. First, boil Mahuang for one boil, skim off the foam, then add the remaining herbs. Boil to obtain three sheng of decoction, remove dregs, and divide into three warm doses. Take the doses at intervals equivalent to the time required to cook three dou of rice, ensuring complete consumption. Recovery occurs with sweating.
In Shanghan, after severe purgation on the sixth or seventh day, if the cun pulse is deep and slow, hands and feet are cold and inverted, the radial pulse at the lower part is imperceptible, there is throat obstruction, expectoration of pus and blood, and continuous diarrhea, these are symptoms of upper heat and lower cold. This is difficult to treat. Mahuang Shengma Tang (Ephedra and Cimicifuga Decoction) is indicated. This is a complicated condition resulting from mishandled Shanghan, featuring mixed cold and heat, and injury to both upper and lower jiao. Therefore, the prescription addresses the complex symptoms. The complexity of the disease and the number of herbs are unique among ancient formulas; studying this reveals the methods of ancient physicians in prescribing.