治汗, 吐, 下解之后, 心下痞硬, 噫气不除.
旋覆花三两 人参二两 代赭石一两 半夏 ( 洗 ) 半升 生姜 (
切) 五两 甘草 ( 炙 ) 三两 大枣 ( 擘 ) 十二枚, 右七味, 以
水一斗, 煮取六升, 去滓再煎, 取三升, 温服一升, 日三服.
【集注】罗谦甫曰: 汗, 吐, 下解后, 邪虽去而胃气已亏矣. 胃气既
亏,三焦因之失职, 清无所归而不升, 浊无所纳而不降, 是以邪气留
滞,伏饮为逆, 故心下痞硬, 噫气不除. 方中以人参, 甘草养正补虚
,姜, 枣和脾养胃, 所以安定中州者至矣. 更以代赭石之重, 使之敛
浮镇逆, 旋覆花之辛, 用以宣气涤饮, 佐人参以归气于下, 佐半夏以
蠲饮于上. 浊降痞硬可消, 清升噫气自除. 观仲景治少阴水气上凌,
用真武汤镇之; 治下焦滑脱不守, 用赤石脂禹余粮固之. 此胃虚气失
升降, 复用此法理之. 则胸中转否为泰, 其为归元固下之法, 各极其
妙如此.
治伤寒表不解, 瘀热在里发黄者.
麻黄二两 赤小豆一升 杏仁 ( 去皮, 尖 ) 四十枚 生姜 ( 切 )
一两 大枣 ( 擘 ) 十二枚 甘草 ( 炙 ) 一两 生梓白皮一升 连
轺二两 , 右上八味, 以潦水一斗, 先煮麻黄, 再沸, 去上沫, 纳诸
药,煮取三升, 分温三服, 半日则尽.
【注】湿热发黄无表里证, 热盛者清之, 小便不利者利之, 里实者下
之,表实者汗之, 皆无非为病求去路也. 用麻黄汤以开其表, 使黄从
外而散. 去桂枝者避其湿热也. 佐姜枣者和其营卫也. 加连轺, 梓皮
以泻其热. 赤小豆以利其湿. 同成表实发黄之效也. 连轺即连翘根,
无梓皮以茵陈代之. 成无己曰: 煎以潦水者, 取其味薄不助湿热也.
Treats the condition where, after resolution via sweating (diaphoresis), vomiting (emesis), or purging (catharsis), there is epigastric fullness and hardness, with persistent belching.
Xuanfuhua (Inulae Flos) 3 liang, Renshen (Ginseng Radix et Rhizoma) 2 liang, Daizheshi (Haematitum) 1 liang, Banxia (Pinelliae Rhizoma Preparatum) half sheng (washed), Shengjiang (Zingiberis Rhizoma Recens) 5 liang (sliced), Gancao (Glycyrrhizae Radix et Rhizoma Preparata) 3 liang (roasted), Dazao (Jujubae Fructus) 12 pieces (torn). The above seven herbs, decocted in one dou of water, reduce to six sheng. Strain the dregs and decoct again to obtain three sheng. Take one sheng warm, three times daily.
[Collected Annotations] Luo Qianfu stated: After sweating, vomiting, or purging, although the pathogenic factors have been expelled, the Stomach Qi has already become deficient. Since Stomach Qi is deficient, the Sanjiao (Triple Burner) fails in its duties; Clear Qi has no destination and cannot ascend, while Turbid Qi has no receptacle and cannot descend. Thus, pathogenic factors remain stagnant, and retained fluid reverses upward, causing epigastric fullness and hardness, and persistent belching. In this formula, Renshen and Gancao nourish the righteous Qi and tonify deficiency; Jiang (Shengjiang) and Zao (Dazao harmonize the Spleen and nourish the Stomach, thereby stabilizing the Middle Jiao to an excellent degree. Furthermore, the heaviness of Daizheshi is used to gather floating Yang and suppress rebellion, while the acridity of Xuanfuhua is used to diffuse Lung Qi and wash away retained fluid, assisting Renshen to guide Qi downward, and assisting Banxia to eliminate fluid in the Upper Jiao. As Turbid Qi descends, fullness and hardness dissipate; as Clear Qi ascends, belching naturally ceases. Observe how Zhang Zhongjing treated Shaoyin disease with Water Qi flooding upward by using Zhenwu Tang to anchor it; and treated Lower Jiao sliding and loss of control by using Chishizhi Yuyuliang Wan to consolidate it. Here, due to Stomach deficiency causing dysfunction of Qi ascending and descending, this method of regulating Qi and descending rebellion is applied again. Thus, the obstruction in the chest transforms into smooth flow. These methods of returning to the origin and consolidating the lower are each exquisitely effective.
Treats Taiyang disease where the exterior syndrome is not resolved, and stagnant heat trapped inside causes jaundice.
Mahuang (Ephedrae Herba) 2 liang, Chixiaodou (Phaseoli Semen Rubrum) 1 sheng, Xingren (Armeniacae Semen Amarum) 40 pieces (skin and tip removed), Shengjiang (Zingiberis Rhizoma Recens) 1 liang (sliced), Dazao (Jujubae Fructus) 12 pieces (torn), Gancao (Glycyrrhizae Radix et Rhizoma Preparata) 1 liang (roasted), Shengzibaiqi (Catalpae Cortex) 1 sheng, Lianyao (Forsythiae Radix) 2 liang. The above eight herbs, decocted in one dou of Liaoshui (rainwater/stagnant water). First boil Mahuang, let it boil twice, remove the foam on the surface, then add the remaining herbs. Decoct until three sheng remain. Divide into three warm doses, consumed within half a day.
[Annotation] For jaundice caused by damp-heat without obvious exterior or interior syndromes: if heat is excessive, clear it; if urination is difficult, promote diuresis; if there is interior excess, purge it; if there is exterior excess, induce sweating. All these methods aim to provide an exit for the pathogenic factors. Using Mahuang Tang to open the exterior allows the jaundice to disperse from the outside. Guizhi (Cinnamon Twig) is omitted to avoid aggravating damp-heat. Jiang (Shengjiang) and Zao (Dazao) are added to harmonize Ying (Nutritive) and Wei (Defensive) Qi. Lianyao and Zibaiqi are added to drain heat. Chixiaodou is added to promote diuresis. Together, they achieve the effect of treating exterior-excess jaundice. Lianyao is the root of Forsythia suspensa; if Zibaiqi is unavailable, Yinchen Hao (Artemisiae Scopariae Herba) can be substituted. Cheng Wuji stated: Decocting with Liaoshui is chosen because its flavor is light and thin, preventing the assistance of damp-heat.