治元气大虚, 昏厥, 脉微欲绝. 及妇人崩产, 脱血, 血晕.
人参 分两随人, 随证
须上拣者, 浓煎顿服, 待元气渐回, 随证加减.
【集注】柯琴曰: 一人而系一世之安危者, 必重其权而专任之; 一物
而系一人之死生者, 当大其服而独用之. 故先启于气几息, 血将脱之
证,独用人参二两, 浓煎顿服, 能挽回性命于瞬息之间, 非他物所可
代也. 世之用者, 恐或补住邪气, 姑稍稍以试之, 或加消耗之味以监
制之, 其权不重, 力不专, 人何赖以得生乎? 如古方霹雳散, 大补丸
,皆用一物之长而取效最捷, 于独参汤何疑耶!
【按】苦病兼别因, 则又当随机应变, 于独参汤中或加热, 附补阳而
回厥逆, 或加生地凉阴而止吐衄, 或加黄耆固表之汗, 或加当归救血
之脱, 或加姜汁以除呕吐, 或加童便以止阴烦, 或加茯苓令水化津生
治消渴泄泻, 或加黄连折火逆冲上治噤口毒痢. 是乃相得相须以有成
,何害其为独哉? 如薛己治中风, 加人参两许于三生饮中, 以驾驭其
邪,此真善用独参者矣.
治阴阳气血暴脱等证.
人参 附子(制)水煎服.
【注】先身而生, 谓之先天; 后身而生, 谓之后天. 先天之气在肾,
是父母之所赋; 后天之气在脾, 是水谷之所化. 先天之气为气之体,
体主动, 故子在胞中, 赖母息以养生气, 则神藏而机静. 后天之气为
气之用, 用主动, 故育形之后, 资水谷以奉生身, 则神发而运动. 天
人合德, 二气互用, 故后天之气得先天之气, 则生生而不息; 先天之
气得后天之气, 始化化而不穷也. 若夫起居不慎则伤肾, 肾伤则先天
气虚矣. 饮食不洁而伤脾, 脾伤则后天气虚矣. 补后天之气无如人参
,补先天之气无如附子, 此参附汤之所由立也. 二脏虚之微甚, 参附
量为君主, 二药相须, 用之得当, 则能瞬息化气于乌有之乡, 顷刻生
阳于命门之内, 方之最神捷者也. 若表虚自汗, 以附子易黄耆, 名人
参黄耆汤, 补气兼止汗. 失血阴亡, 以附子易生地, 名人参生地黄汤
,固气兼救阴. 寒湿厥汗, 以人参易白术, 名术附汤, 除湿兼温里.
易虚厥汗, 以人参易黄耆, 名耆附汤, 补阳兼固表. 此皆参附汤之转
换变化法也, 医者扩而充之, 不能尽述其妙.
Treats conditions of extreme deficiency of Yuan Qi (Original Qi), syncope, and a pulse that is faint and nearly imperceptible. It also treats women suffering from metrorrhagia or postpartum hemorrhage leading to blood-loss syncope.
Use Ren Shen (Ginseng Radix). The dosage should be adjusted according to the patient's constitution and syndrome. One must select high-quality, raw-dried Rhizoma Ginseng, decoct it strongly, and administer it in one dose. Once the Yuan Qi gradually recovers, modify the prescription according to the specific syndrome.
[Collected Annotations] Ke Qin stated: When the safety of a generation rests on one person, one must grant them significant authority and rely on them exclusively; when a single herb determines life and death for an individual, one should increase its dosage and use it alone. Therefore, in critical syndromes where Qi is about to cease and Blood is about to collapse, using two liang of Ren Shen (Ginseng Radix) alone, decocted strongly and administered in one dose, can rescue life within moments. No other herb can replace it. Practitioners today often fear that tonification might trap pathogenic factors, so they test it with small doses or add draining herbs to restrain it. This dilutes its authority and focus; how can patients survive relying on such weak measures? Ancient formulas like Pili San (Thunderbolt Powder) and Dabu Wan (Great Tonifying Pill) both utilize the strength of a single herb to achieve rapid effects. What doubt remains regarding Dushen Tang (Single Ginseng Decoction)?
[Commentary] If the illness involves additional etiologies, one must adapt flexibly. In Dushen Tang (Single Ginseng Decoction), one may add Fuzi (Prepared Aconite Lateral Root) to warm Yang and reverse cold extremities, or add Sheng Di Huang (Rehmannia Root) to cool Yin and stop hematemesis and epistaxis, or add Huang Qi (Astragalus Root) to consolidate the exterior and stop sweating, or add Dang Gui (Angelica Sinensis Root) to rescue from blood collapse, or add Jiang Zhi (Ginger Juice) to eliminate vomiting, or add Tong Bian (Child's Urine) to stop yin-deficiency vexation, or add Fu Ling (Poria) to promote water metabolism and generate fluids to treat polydipsia and diarrhea, or add Huang Lian (Coptis Rhizome) to descend rebellious fire to treat dysentery with inability to swallow. These are complementary and mutually enhancing methods; how does this hinder its designation as "single" (Du)? For instance, Xue Ji treated stroke by adding approximately one liang of Ren Shen (Ginseng Radix) to Sansheng Yin (Three Lives Decoction) to control the pathogen. This is truly a masterful use of Dushen Tang (Single Ginseng Decoction).
Treats syndromes of sudden collapse of Yin, Yang, Qi, and Blood.
Use Ren Shen (Ginseng Radix) and Zhi Fu Zi (Prepared Aconite Lateral Root). Decoct in water and take orally.
[Annotation] That which exists prior to the body is called Xiantian (Pre-heaven/Innate); that which arises after the body is formed is called Houtian (Post-heaven/Acquired). Xiantian Qi resides in the Kidney and is endowed by parents; Houtian Qi resides in the Spleen and is transformed from food and drink. Xiantian Qi is the substance of Qi; substance is characterized by stillness. Thus, while in the womb, the fetus relies on maternal respiration to nourish its vital Qi, resulting in stored spirit and quiet mechanisms. Houtian Qi is the function of Qi; function is characterized by movement. Thus, after form is developed, it relies on food and drink to sustain the body, resulting in active spirit and movement. Heaven and Earth act in harmony, and the two Qi interact. Therefore, when Houtian Qi receives support from Xiantian Qi, life continues unceasingly; when Xiantian Qi receives nourishment from Houtian Qi, transformation becomes infinite. Negligence in daily routine injures the Kidney, causing deficiency of Xiantian Qi. Unclean diet injures the Spleen, causing deficiency of Houtian Qi. To tonify Houtian Qi, nothing surpasses Ren Shen (Ginseng Radix); to tonify Xiantian Qi, nothing surpasses Fu Zi (Prepared Aconite Lateral Root). This is the rationale for establishing Shenfu Tang (Ginseng and Aconite Decoction). Based on the severity of deficiency in these two organs, Ren Shen (Ginseng Radix) and Fu Zi (Prepared Aconite Lateral Root) serve as the sovereign herbs. These two herbs complement each other; when used appropriately, they can instantaneously generate Qi from non-existence and rapidly produce Yang within the Mingmen (Gate of Life). This is the most swift and effective formula. If there is spontaneous sweating due to exterior deficiency, substitute Fu Zi (Prepared Aconite Lateral Root) with Huang Qi (Astragalus Root) to create Renshen Huangqi Tang (Ginseng and Astragalus Decoction), which tonifies Qi and stops sweating. If Yin collapses due to blood loss, substitute Fu Zi (Prepared Aconite Lateral Root) with Sheng Di Huang (Rehmannia Root) to create Renshen Shengdi Huang Tang (Ginseng and Rehmannia Decoction), which consolidates Qi and rescues Yin. If cold-dampness causes cold extremities and sweating, substitute Ren Shen (Ginseng Radix) with Bai Zhu (Atractylodes Macrocephala Rhizome) to create Zhufu Tang (Atractylodes and Aconite Decoction), which drains dampness and warms the interior. If Qi deficiency causes cold extremities and sweating, substitute Ren Shen (Ginseng Radix) with Huang Qi (Astragalus Root) to create Qifu Tang (Astragalus and Aconite Decoction), which tonifies Yang and consolidates the exterior. These are all variations of Shenfu Tang (Ginseng and Aconite Decoction). Physicians who expand upon these principles cannot fully describe their subtleties.