治伤寒温疫, 风湿风眩, 拘蜷风痰, 头痛目眩, 四
肢痛, 憎寒壮热, 项强睛疼. 老人小儿皆可服.
羌活 独活 前胡 柴胡 川芎 枳壳 白茯苓 桔梗 人参各一两
甘草五钱., 右为细末, 每服二钱, 水一盏, 入生姜三片, 煎七分,
温服, 或沸汤点服. 烦热口干, 加黄芩.
【集注】赵羽皇曰: 东南地土卑湿, 凡患感冒, 辄以伤寒二字混称.
不知伤者, 正气伤于中; 寒者, 寒气客于外, 未有外感而内不伤者也
.仲景医门之圣, 立法高出千古, 其言冬时严寒, 万类深藏, 君子固
密,不伤于寒. 触冒之者, 乃名伤寒, 以失于固密而然. 可见人之伤
寒,悉由元气不固, 肤腠之不密也. 昔人常言伤寒为汗病, 则汗法其
首重矣. 然汗之发也, 其出自阳, 其源自阴, 故阳气虚, 则营卫不和
而汗不能作; 阴气弱, 则津液枯涸而汗不能滋. 但攻其外之, 不顾其
内可乎 ? 表汗无如败毒散, 羌活汤, 其药如二活, 二胡, 芎, 苍,
辛,芷群队辛温, 非不发散, 若无人参, 生地之大力者居乎其中, 则
形气素虚者, 必至亡阳; 血虚挟热者, 必至亡阴, 而成痼疾矣. 是败
毒散之人参, 与冲和汤之生地, 人谓其补益之法, 我知其托里之法.
盖补中兼发, 邪气不致于流连; 发中带补, 真元不致于耗散, 施之于
东南地卑气暖之乡, 最为相宜, 此古人制方之义. 然形气俱实, 或内
热炽盛, 则更当以河间法为是也. 胡天锡曰: 非其时而有其气, 惟气
血两虚之人受之. 寒客营而风客卫, 不可用峻剂, 故稍从其轻者, 此
羌活汤, 败毒散所由立也. 九味汤主寒邪伤营, 故于发表中加芎, 地
,引而入血, 即借以调荣. 用葱姜为引, 使通体汗出, 庶三阳血分之
邪, 直达而无所滞矣. 败毒散主风邪伤卫, 故于发表中加参, 苓,
枳,桔, 引而达卫, 固托以宣通. 用生姜为使, 使留连肺部, 则上焦
气分之邪不能干矣. 是方亦可用黄芩者, 以诸药气味辛温, 恐其僭亢
,一以润之, 一以清之也.
[Indications] Treats Shanghan (Cold Damage), Wenyi (Warm Epidemic), wind vertigo caused by Wind-Dampness, spasmodic curling and Wind-Phlegm, headache and dizziness, pain in the four limbs, aversion to cold with high fever, stiffness of the neck and eye pain. It can be taken by both the elderly and children.
Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Qianhu (Peucedani Radix), Chaihu (Bupleuri Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhike (Aurantii Fructus), Baifuling (Poria Cocos cum Ligno), Jiegeng (Platycodonis Radix), Renshen (Ginseng Radix et Rhizoma) each 1 liang; Gancao (Glycyrrhizae Radix et Rhizoma) 5 qian. The above herbs are ground into a fine powder. Each dose is 2 qian, boiled with one cup of water, adding three slices of Shengjiang (Zingiberis Rhizoma Recens), decocted until reduced to seven-tenths volume, taken warm; or taken by infusing with boiling water. If symptoms of vexatious heat and dry mouth occur, add Huangqin (Scutellariae Radix).
[Collected Annotations] Zhao Yuhuang stated: In the southeast region, where the terrain is low and damp, people often confuse the term "Shanghan" when referring to common colds. They do not realize that "Shang" refers to injury to the Zhengqi (Upright Qi) within, while "Han" refers to Cold pathogen lodging externally. There is no case of external contraction without internal injury. Zhang Zhongjing was the sage of medicine, whose legislative principles surpassed those of antiquity. He stated that during winter's severe cold, all things hide deeply, and gentlemen should maintain solidity and tightness, thus avoiding injury from Cold. Those who are exposed and offended by it are named as having "Shanghan," due to failure in maintaining solidity and tightness. This shows that human Shanghan is entirely due to unconsolidated Yuanqi (Original Qi) and loose skin and pores. Ancients often said that Shanghan belongs to sweating disorders, so the sweating method is of primary importance. However, the emergence of sweat originates from Yang, but its source lies in Yin. Therefore, if Yang Qi is deficient, Yingwei (Nutritive and Defensive Qi) will be disharmonious, and sweat cannot be produced; if Yin Qi is weak, body fluids will be dried up, and sweat cannot moisten. Can one merely attack the exterior pathogens while neglecting the interior? For releasing the exterior through sweating, there is nothing better than Baidu San (Decoction for Overcoming Toxins) and Qianghuo Tang (Notopterygium Decoction). The herbs in these formulas, such as Er Huo (the two Angelicas), Er Hu (the two Bupleurums), Xiong (Chuanxiong), Cang (Cangzhu/Atractylodis Rhizoma), Xin (Xinyi/Magnolia Flower), Zhi (Baizhi/Peucedani Radix), form a group of acrid-warm substances. They are not incapable of dispersing, but if they lack powerful agents like Renshen (Ginseng) and Shengdi (Rehmanniae Radix) to anchor them within, then those with constitutionally deficient Form and Qi will inevitably suffer from Wangyang (Collapse of Yang); those with Blood deficiency complicated by Heat will inevitably suffer from Wangyin (Collapse of Yin), resulting in stubborn diseases. Thus, the use of Renshen in Baidu San and Shengdi in Chonghe Tang—while others consider this a method of tonification—I know it as a method of Tuoli (Supporting the Interior to Expel Pathogens). Essentially, it combines tonification with dispersion, preventing pathogens from lingering; it combines dispersion with tonification, preventing the loss of True Yuan (Primal Essence). Applied to the low-lying, warm-climate regions of the southeast, this is most appropriate. This is the intent behind the ancients' formulation design. However, if Form and Qi are both solid, or if Internal Heat is blazing, then adopting the methods of Liu Hejian would be more correct.
Hu Tianxi stated: When abnormal qi occurs out of season, only those with dual deficiency of Qi and Blood are susceptible. Cold lodges in the Ying (Nutritive) level, and Wind lodges in the Wei (Defensive) level. Severe medications cannot be used, so the treatment slightly accommodates the milder nature of the pathogen. This is why Qianghuo Tang and Baidu San were established. Jiuwei Tang (Nine-Ingredient Decoction) primarily treats Cold pathogen injuring the Ying level; therefore, it adds Chuanxiong and Dihuang (Rehmanniae Radix Praeparata) among the exterior-releasing herbs to guide the action into the Blood level, thereby regulating Ying. Using Congbai (Allii Fistulosi Bulbus) and Jiang (Zingiberis Rhizoma) as guides induces whole-body sweating, allowing pathogens in the Blood level of the Three Yang channels to reach the surface directly without stagnation. Baidu San primarily treats Wind pathogen injuring the Wei level; therefore, it adds Renshen, Fuling (Poria Cocos), Zhike, and Jiegeng among the exterior-releasing herbs to guide the action to the Wei level, using support and consolidation to promote circulation. Using Shengjiang as an envoy allows it to linger in the Lung organ, preventing pathogens in the Qi level of the Upper Jiao from interfering. This formula can also use Huangqin because the flavors of the other herbs are acrid and warm, fearing their properties might become too hyperactive; Huangqin serves to moisten and clear heat simultaneously.