即半夏泻心汤去黄芩加桂枝。
黄连 甘草(炙) 干姜 桂枝(去皮,各三两) 人参(二两) 半夏(半升,洗) 大枣(十二枚,擘) 上
七味,以水一斗,煮取六升,去渣,温服一升,日三夜二服。治上焦之病,服药宜少而数。
伤寒胸中有热,胃中有邪气,腹中痛,欲呕吐者,黄连汤主之。诸泻心之法,皆治心胃之间,寒热不调,
全属里症。此方以黄芩易桂枝,去泻心之名,而曰黄连汤,乃表邪尚有一分未尽,胃中邪气,尚当外达,
故加桂枝一味,以和表里,则意无不到矣。
黄芩(三两) 甘草(炙) 芍药(各二两) 大枣(十二枚,擘) 上四味,以水一斗,煮取三升,去渣,温服
一升、日再夜一服。
黄芩(三两) 甘草(炙) 芍药(各二两) 半夏(半升,洗) 生姜(三两,切) 大枣(十二枚,擘) 上
六味,以水一斗,煮取三升,去渣,温服一升,日再夜一服。
太阳与少阳合病、自下利者,与黄芩汤;若呕者,黄芩加半夏生姜汤主之。下利即专于治利,不杂
以风寒表药,此亦急当救里之义,若呕,亦即兼以止呕之药。总之,见症施治,服药后而本症愈,复见他
症,则仍见症施治,可推而知也。
干姜 黄连 黄芩 人参(各三两) 上四味,以水六升,煮取二升,去渣,分温再服。
伤寒本自寒下,本症。医复吐下之,误治。寒格更逆吐下,若食入口即吐,干姜黄连黄芩人参汤主之。
此属厥阴条,寒格自用干姜,吐下自用芩连。因误治而虚其正气,则用人参,分途而治,无所不包,又各
不相碍。古方之所以入化也。
This is Banxia Xiexin Tang (Pinellia Decoction for Draining the Epigastrium) with Huangqin removed and Guizhi added.
Huanglian (Coptidis Rhizoma), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma), Qupi Guizhi (Cinnamomi Ramulus, bark removed; each 3 liang), Renshen (Ginseng Radix et Rhizoma; 2 liang), Xishu Banxia (Pinelliae Tuber, washed; half sheng), Bie Dazao (Jujubae Fructus, broken open; 12 pieces). The above seven ingredients are decocted in one dou of water to obtain six sheng. Strain the dregs, and take one sheng warm. Administer three times during the day and twice at night. This treats diseases of the Upper Jiao (Upper Burner); medication should be taken in small amounts but frequently.
In Shaoyang disease (Shaoyang Syndrome), if there is heat in the chest, pathogenic qi in the stomach, abdominal pain, and a desire to vomit, Huanglian Tang (Coptis Decoction) is the primary treatment. All methods involving Xiexin (Draining the Epigastrium) formulas treat disharmony of cold and heat between the Heart and Stomach, which entirely belongs to interior syndromes. This formula replaces Huangqin with Guizhi, removes the name "Xiexin," and is called Huanglian Tang because there remains a fraction of exterior pathogenic factors unresolved, and the pathogenic qi in the stomach still needs to reach outward. Therefore, adding Guizhi harmonizes the exterior and interior, ensuring comprehensive therapeutic intent.
Huangqin (Scutellariae Radix; 3 liang), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), Shaoyao (Paeoniae Radix; each 2 liang), Bie Dazao (Jujubae Fructus, broken open; 12 pieces). The above four ingredients are decocted in one dou of water to obtain three sheng. Strain the dregs, and take one sheng warm. Administer twice during the day and once at night.
Huangqin (Scutellariae Radix; 3 liang), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), Shaoyao (Paeoniae Radix; each 2 liang), Xishu Banxia (Pinelliae Tuber, washed), Qie Shengjiang (Zingiberis Rhizoma Recens, sliced; 3 liang), Bie Dazao (Jujubae Fructus, broken open; 12 pieces). The above six ingredients are decocted in one dou of water to obtain three sheng. Strain the dregs, and take one sheng warm. Administer twice during the day and once at night. In combined Taiyang and Shaoyang syndromes presenting with spontaneous diarrhea, Huangqin Tang (Scutellaria Decoction) is administered. If vomiting occurs, Huangqin Jia Banxia Shengjiang Tang (Scutellaria Decoction plus Pinellia and Fresh Ginger) is the primary treatment. Diarrhea is treated specifically for the diarrhea without mixing in exterior-releasing herbs for wind-cold; this also reflects the principle of urgently treating the interior when necessary. If vomiting is present, anti-emetic herbs are added accordingly. In summary, treatment is based on symptoms: after the original symptoms resolve upon taking medication, if other symptoms appear, treatment is again based on those new symptoms; this can be inferred by analogy.
Ganjiang (Zingiberis Rhizoma), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Renshen (Ginseng Radix et Rhizoma; each 3 liang). The above four ingredients are decocted in six sheng of water to obtain two sheng. Strain the dregs, and divide into two warm doses.
In Shaoyang disease, if the patient originally had cold-type diarrhea (the root syndrome), and the physician erroneously applied emesis and purgation (mis-treatment), the cold obstruction causes further reversal of vomiting and diarrhea. If food is vomited immediately upon entering the mouth, Ganjiang Huanglian Huangqin Renshen Tang (Dried Ginger, Coptis, Scutellaria, and Ginseng Decoction) is the primary treatment. This belongs to the Jueyin (Jueyin Syndrome) category. For cold obstruction, Ganjiang is used naturally; for vomiting and purgation issues, Huangqin and Huanglian are used. Because mis-treatment has depleted the healthy Qi, Renshen is added. Treating them separately covers all aspects without interfering with each other. This is why ancient formulas achieve such subtlety.