治表解有汗, 里热不除, 胃因不和, 而不作解者.
大黄 ( 酒洗 ) 四两 甘草 ( 炙 ) 二两 芒硝半斤, 右三味, 以水
三升, 先煮二味, 取一升, 去滓; 纳芒硝, 微煮令沸, 稍稍温服之.
【注】三承气汤之立名, 而曰大者, 制大其服, 欲急下其邪也; 小者
,制小其服, 欲缓下其邪也. 曰调胃者, 则有调和承顺胃气之义, 非
若大, 小专攻下也. 经曰: 热淫于内, 治以咸寒; 火淫于内, 治以苦
寒. 君大黄之苦寒, 臣芒硝之咸寒, 二味并举, 攻热泻火之力备矣.
更佐甘草之缓, 调停于大黄, 芒硝之间, 又稍稍温服之, 使其力不峻
,则不能速下而和也.
治津液不足, 肠胃干燥, 大便不通.
朱砂 ( 研如飞面 ) 五钱 芦荟 ( 研细, 生用 ) 七钱 滴好酒少许
,和丸. 每服一钱二分, 好酒下.
【集注】柯琴曰: 胃为后天之本, 不及固病, 太过亦病. 然太过复有
阳盛阴虚之别焉. 两阳合明而胃家实, 仲景制三承气汤以下之; 三阳
燥结而津液亡, 前贤又制更衣丸以润之. 古人入厕必更衣, 故以此命
名也. 朱砂以汞为体, 性寒重坠下达, 芦荟以液为质, 味苦膏润下滋
.兼以大寒大苦之性味, 能润燥结, 从上导下而胃关开矣. 合以为丸
,两者相须, 得效最宏, 奏功甚捷, 诚匪夷所思矣.
Treats conditions where the exterior syndrome has resolved with sweating, yet interior heat remains unremoved, stomach qi is disharmonious, and the condition fails to resolve.
Dahuang (Rhei Radix et Rhizoma) four liang, Gancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle) two liang, Mangxiao (Natrii Sulfas) half jin. The above three ingredients: use three sheng of water, first decoct the first two ingredients, obtain one sheng of liquid, remove dregs; add Mangxiao, boil slightly until boiling, take in small doses while warm.
[Note] Regarding the naming of the three Chengqi Decoctions: those named "Da" (Major) have larger dosages, intending to urgently purge pathogens; those named "Xiao" (Minor) have smaller dosages, intending to gently purge pathogens. "Tiaowei" (Regulate Stomach) implies harmonizing and smoothing Stomach qi, unlike Da and Xiao Chengqi Tang which are specifically for purgation. The Classic states: "When heat floods within, treat with salty-cold substances; when fire floods within, treat with bitter-cold substances." Dahuang's bitter-cold nature serves as the Sovereign herb, Mangxiao's salty-cold nature as the Minister herb. Using both together fully provides the power to attack heat and drain fire. Furthermore, Gancao's moderating nature acts as an assistant, mediating between Dahuang and Mangxiao. Taking it in small doses while warm ensures the potency is not too harsh, thereby achieving rapid purgation and harmony.
Treats conditions of insufficient body fluids, dryness of the intestines and stomach, and constipation.
Zhusha (Cinnabar, ground into fine powder) five qian, Lvhui (Aloe Arborescens Folium, ground finely, used raw) seven qian. Add a few drops of good wine, mix to form pills. Take one qian two fen per dose, washed down with good wine.
[Collected Notes] Ke Qin stated: The Stomach is the foundation of the post-heaven existence. Insufficiency causes disease, and excess also causes disease. However, excess differs between Yang excess and Yin deficiency. When two Yangs combine to clarify and lead to Shijia Shi (Excess in the Stomach and Intestines), Zhang Zhongjing formulated the three Chengqi Decoctions to purge it. When the Three Yang channels suffer from dryness and binding with loss of body fluids, ancient experts formulated Gengyi Wan (Changing Clothes Pill) to moisten it. Ancients had to change clothes before entering the toilet, hence the name. Zhusha (Cinnabar), having Mercury as its substance, is cold, heavy, and descending; Lvhui (Aloe), having fluid as its quality, is bitter and moistening, nourishing downwards. Combining their great cold and great bitter properties, they can moisten dryness and bind, guiding from above to below, opening the Stomach gate. Formed into pills together, they assist each other, yielding the greatest efficacy and very rapid results, truly beyond imagination.