治暑热乘凉饮冷, 阳气为阴邪所遏, 头痛发热, 恶寒烦
躁,口渴腹满, 吐泻者.
香薷 厚朴 ( 姜汁炒 ) 白扁豆 ( 炒 ) 水煎浸, 冷服.
【集注】叶仲坚曰: 饮与汤稍有别, 服有定数者名汤, 时时不拘者名
饮.饮因渴而设, 用之于温暑则最宜者也. 然胃恶燥, 脾恶湿, 多饮
伤脾, 反致下痢. 治之之法, 心下有水气者发汗, 腹中有水气者利小
便.然与其有水患而治之, 曷若先选其能汗, 能利者用之. 香薷芳香
辛温, 能发越阳气, 有彻上彻下之功, 故治暑者君之, 以解表利小便
.佐厚朴以除湿, 扁豆以和中, 合而用之为饮, 饮入于胃, 热去而湿
不留, 内外之暑悉除矣. 若心烦口渴者, 去扁豆加黄连, 名黄连香薷
饮;加茯苓, 甘草, 名五物; 加木瓜, 参, 耆, 橘, 术, 名十味. 随
证加减, 尽香薷之用也. 然劳倦内伤, 必用清暑益气, 内热大渴, 必
用人参白虎, 若用香薷, 是重虚其表, 而反济其内热矣. 香薷乃夏月
解表之药, 如冬月之麻黄, 气虚者尤不可服, 今人不知暑伤元气, 概
用以代茶, 是开门揖盗也.
治一切阳热火盛, 面赤口干, 狂燥心烦, 错语不眠,
大热干呕, 吐血衄血, 及下后而便不实, 热仍不已者.
黄连 栀子各等分 黄柏 黄芩水煎服.
【集注】汪昂曰: 寒极曰阴毒, 热极曰阳毒. 是方名曰黄连解毒, 是
君以黄连直解心经火毒也. 黄芩泻肺经火毒, 黄柏泻肾经火毒, 栀子
通泻三焦火毒, 使诸火毒从膀胱出. 若大便实者加大黄, 名栀子金花
汤,利大便, 是使火毒从大, 小二便而出也. 盖阳盛则阴衰, 火盛则
水衰, 故用大苦大寒之药, 抑阳而扶阴, 泻其亢甚之火, 而救其欲绝
之水也. 然非实热不可轻投.
【按】黄连解毒汤, 白虎汤, 三黄石膏汤, 大青龙汤, 皆治表里俱热
证.然大青龙汤治表实壮热, 里热之浅在肌; 三黄石膏汤治表实壮热
,里热之深在胃. 故一以石膏佐麻, 桂 , 一以石膏佐麻, 豉, 均发
太阳之表, 解阳明之里也. 大青龙汤, 则更以杏, 草, 姜, 枣佐麻黄
,其意专发热郁之在肌也. 三黄石膏汤, 则更以芩, 连, 栀, 柏佐石
膏,其意专泻热深之在胃也. 白虎汤治表热在肌, 里热在胃, 所以不
用麻, 桂, 以发太阳, 专主石膏而清阳明也. 解毒汤治表热在三阳,
里热在三焦, 所以亦不以麻, 桂发太阳表, 亦不以石膏清阳明里, 而
专以三黄泻上下内外之实火也. 此皆太阳之邪, 侵及阳明, 而未入腑
成实者也. 若已入腑成实, 则又当从事乎三承气汤, 以下其热也.
Treats conditions where summer-heat is combined with exposure to coolness and consumption of cold drinks, causing yang qi to be constrained by yin pathogens. Symptoms include headache, fever, aversion to cold, irritability, thirst, abdominal fullness, vomiting, and diarrhea.
Xiangru (Moslae Herba), Houpo (Magnoliae Officinalis Cortex) (stir-fried with ginger juice), Baibian Dou (Lablab Album Seed) (stir-fried). Decoct in water, soak, and take cold.
[Collected Notes] Ye Zhongjian stated: There is a slight difference between Yin (Infusion/Drink) and Tang (Decoction). Those taken in fixed doses are called Tang, while those taken freely at any time are called Yin. Yin is designed for quenching thirst and is most suitable for treating warm diseases and summer-heat. However, the Stomach dislikes dryness, and the Spleen dislikes dampness. Excessive drinking damages the Spleen and may lead to dysentery. The treatment method is: if there is fluid retention in the epigastrium, induce sweating; if there is fluid retention in the abdomen, promote urination. Rather than treating after fluid pathology has occurred, it is better to select herbs that can both induce sweating and promote urination beforehand. Xiangru is aromatic and acrid-warm; it can disperse and raise yang qi, possessing the efficacy of penetrating from top to bottom. Therefore, it is used as the Sovereign herb (Jun Yao) for treating summer-heat, to release the exterior and promote urination. It is assisted by Houpo to dispel dampness, and by Bian Dou to harmonize the middle jiao. Combined into an infusion, once ingested into the Stomach, heat is removed and dampness does not remain, clearing summer-heat from both interior and exterior. If there is mental restlessness and thirst, remove Bian Dou and add Huanglian (Coptidis Rhizoma), named Huanglian Xiangru Yin (Coptis and Mosla Drink); add Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma), named Wuwu Yin (Five-Ingredient Drink); add Mugua (Chaenomelis Fructus), Renshen (Ginseng Radix), Qishi (Astragali Radix), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), named Shiwu Xiangru Yin (Ten-Ingredient Mosla Drink). Adjust according to symptoms to fully utilize the properties of Xiangru. However, for injuries due to fatigue and overwork, Qing Shu Yi Qi Tang (Clear Summer-Heat and Boost Qi Decoction) must be used; for severe internal heat with extreme thirst, Renshen Baihu Tang (Ginseng White Tiger Decoction) must be used. Using Xiangru in these cases would further weaken the exterior and instead aggravate internal heat. Xiangru is an exterior-releasing herb for summer, similar to Mahuang (Ephedrae Herba) in winter. It should especially not be taken by those with qi deficiency. Nowadays, people do not realize that summer-heat damages yuan qi (primordial qi) and generally use it as tea, which is like opening the door to invite thieves in.
Treats all conditions of excessive yang heat and fire prosperity, characterized by red face, dry mouth, manic agitation, mental restlessness, delirious speech, insomnia, high fever with dry retching, hematemesis (vomiting blood), epistaxis (nosebleed), and persistent heat despite purgation resulting in loose stools.
Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus) in equal parts, Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix). Decoct in water and take.
[Collected Notes] Wang Ang stated: Extreme cold is called Yin Du (Yin Toxin), and extreme heat is called Yang Du (Yang Toxin). This formula is named Huanglian Jiedu Tang (Coptis Detoxification Decoction), using Huanglian as the Sovereign herb to directly resolve heart meridian fire toxin. Huangqin drains lung meridian fire toxin, Huangbai drains kidney meridian fire toxin, and Zhizi unblockedly drains triple burner fire toxin, allowing various fire toxins to exit via the Bladder. If stool is hard, add Dahuang (Rhei Radix et Rhizoma), named Zhizi Jinhua Tang (Gardenia Golden Flower Decoction), to promote bowel movement, allowing fire toxins to exit via large and small intestines. Generally, when yang is prosperous, yin declines; when fire is prosperous, water declines. Therefore, bitter-cold herbs are used to suppress yang and support yin, draining excessive fire to save the nearly exhausted water (yin fluids). However, it should not be lightly administered unless it is a excess-heat pattern.
[Commentary] Huanglian Jiedu Tang, Baihu Tang (White Tiger Decoction), Sanhuang Shigao Tang (Three-Yellow Gypsum Decoction), and Daqinglong Tang (Major Blue Dragon Decoction) all treat patterns of heat in both exterior and interior. However, Daqinglong Tang treats exterior excess with high fever, where interior heat is shallow and located in the muscle layer; Sanhuang Shigao Tang treats exterior excess with high fever, where interior heat is deep and located in the Stomach. Thus, Daqinglong Tang uses Shigao (Gypsum Fibrosum) to assist Mahuang and Guizhi (Cinnamomi Ramulus) to release the Taiyang exterior and resolve Yangming interior heat. Daqinglong Tang further uses Xingren (Armeniacae Semen Amarum), Gancao, Jiangsheng (Zingiberis Rhizoma Recens), and Zao (Jujubae Fructus) to assist Mahuang, with the intent specifically to disperse heat stagnation in the muscles. Sanhuang Shigao Tang further uses Huangqin, Huanglian, Zhizi, and Huangbai to assist Shigao, with the intent specifically to drain deep-seated heat in the Stomach. Baihu Tang treats exterior heat in the muscles and interior heat in the Stomach; therefore, it does not use Mahuang or Guizhi to release the Taiyang exterior, but focuses on Shigao to clear Yangming interior heat. Huanglian Jiedu Tang treats exterior heat in the three yang meridians and interior heat in the triple burner; therefore, it neither uses Mahuang or Guizhi to release the Taiyang exterior nor Shigao to clear Yangming interior heat, but exclusively uses the "Three Yellows" (Sanhuang) to drain excess fire from above, below, inside, and outside. These are all cases where Taiyang pathogenic factors have invaded the Yangming but have not yet entered the fu organs to form excess solidifications. If they have entered the fu organs to form excess, then one should resort to the Three Chengqi Decoctions (San Chengqi Tang) to purge the heat.