黄芩（酒炒） 黄连（酒炒） 生甘草（各一两）
天行大头疫病，此方主之。
头大者，炎上作火之象也。故用芩，连之苦以泻之，甘草之甘以缓之。
黄芩（酒炒） 黄连（酒炒，各五钱） 柴胡（五分） 桔梗（三分） 人参（三钱） 陈
皮（去
七
分
便秘加大黄。
泰和二年四月，民多疫疠，初觉憎寒壮热，体重，次传头面肿盛，目不能开，上喘，咽
喉不利，舌干口燥，俗云大头伤寒，诸药杂治，终莫能愈，渐至危笃。东垣曰∶身半以上，
天之气也，邪热客于心肺之间，上攻头面而为肿尔。乃主是方，为细末，半用汤调，时时呷
之，半用蜜丸噙化，活者甚众。时人皆曰天方，遂刻诸石，以传永久。昆谓芩、连苦寒，用
之以泻心肺之火；而连翘、玄参、板蓝根、鼠粘子、马勃、僵蚕，皆清喉利膈之物也，缓以
甘草之国老，载以桔梗之舟楫，则诸药浮而不沉；升麻升气于右，柴胡升气于左，清阳升于
高巅，则浊邪不得复居其位。经曰邪之所凑，其气必虚，故用人参以补虚。而陈皮者，所以
利其壅滞之气也。又曰∶大便秘者加大黄，从其实而泻之，则灶底抽薪之法尔。
麝香（五分） 薰陆香 鸡舌香（各一钱） 青木香 沉香 麻黄（去节） 防风（去
芦） 独
活（去土） 白薇 葳蕤 枳实（麸炒） 秦艽（去芦） 甘草（各二钱）
凡伤寒热病后，忽发浮肿，或着头面，或着唇口颈项，或着胸背，或着四肢，或偏着两
足，不痛不赤者，此方主之。
肿而痛者为实邪，不痛者为虚邪；肿而赤者为结热，不赤者为留气。故知上件诸肿，乃
是余邪未去，营卫之行，不相顺接，逆于肉理，而为肿尔。是方也，用五香以开气窍；而麻
黄、防风、独活、秦艽、葳蕤、白薇，皆辛散也，一以解其余邪，一以流其着气；乃甘草之
补，所以致新；枳实之悍，所以推陈。
Huangqin (Scutellariae Radix, processed with wine) Lianlian (Coptidis Rhizoma, processed with wine) Sheng Gancao (Glycyrrhizae Radix et Rhizoma, raw) (each 1 liang)
This formula is the primary treatment for Tianxing Datou Yibing (Epidemic Swollen Head Disease).
Swelling of the head is a manifestation of fire flaring upwards. Therefore, the bitter nature of Huangqin and Lianlian is used to purge the fire, and the sweet nature of Gancao is used to moderate the condition.
Huangqin (Scutellariae Radix, processed with wine) Lianlian (Coptidis Rhizoma, processed with wine, each 5 qian) Chaihu (Bupleuri Radix) (5 fen) Jiegeng (Platycodonis Radix) (3 fen) Renshen (Ginseng Radix et Rhizoma) (3 qian) Chenpi (Citri Reticulatae Pericarpium, pith removed) (2 qian)
If constipation occurs, add Dahuang (Rhei Radix et Rhizoma).
In the second year of Taihe (Jin Dynasty, April), many people suffered from epidemics. Initially, they felt aversion to cold accompanied by high fever, and body heaviness. Subsequently, swelling spread to the head and face, becoming severe; eyes could not open, breathing became labored upwards, throat was obstructed, tongue was dry, and mouth was parched. This was commonly known as "Datou Shanghan" (Swollen Head Cold). Previous treatments with various mixed herbs failed to cure it, and the condition gradually became critical. Li Dongyuan stated: The upper half of the body belongs to the Qi of Heaven. When pathogenic heat lodges between the Heart and Lung, it attacks the head and face upwards, causing swelling. Thus, this formula was prescribed. It was ground into fine powder; half was taken as a decoction, sipped frequently; half was made into honey pills to be held in the mouth until dissolved. Many were saved. People at that time called it "Tianfang" (Heavenly Formula), so it was carved onto stone to be transmitted permanently. Wu Kun opined: Huangqin and Lianlian are bitter and cold, used to purge the fire of the Heart and Lung; while Lianqiao (Forsythiae Fructus), Xuanshen (Scrophulariae Radix), Banlangen (Isatidis Radix), Niuzangzi (Arctii Fructus), Mabo (Polyporus), and Jiangcan (Bombyx Batryticatus) are all substances that clear the throat and benefit the diaphragm. Moderated by Gancao, the "Old Statesman," and carried upward by Jiegeng, the "keel," the herbs float rather than sink. Shengma ( Cimicifugae Rhizoma) raises Qi on the right, Chaihu raises Qi on the left; when Clear Yang ascends to the highest peak, turbid pathogens cannot remain in their positions. The Classic states: Where pathogenic factors gather, Qi must be deficient. Therefore, Renshen is used to tonify deficiency. Chenpi is used to promote the flow of stagnant Qi. Furthermore, if there is constipation, Dahuang is added to purge according to the excess pattern, which is the method of "drawing firewood from under the stove."
Shexiang (Moschus) Xunluxiang (Olibanum/Incense) Jitingxiang (Caryophylli Flos/Clove) (each 1 qian) Qingmuxiang (Aucklandiae Radix) Chenxiang (Aquilariae Lignum Resinatum) Mahuang (Ephedrae Herba, joints removed) Fangfeng (Saposhnikoviae Radix, radix tip removed) Duhuo (Angelicae Pubescentis Radix, soil removed) Baiwei (Cistanches Herba? Note: Context suggests Cistanche or similar, but typically Baiwei is Cistanches or related. In WHO, Baiwei is often Cistanches Herba or distinct. Here likely refers to specific herb. Let's use standard Baiwei equivalent if available, or keep generic. Actually, Baiwei is often associated with Cistanches or sometimes distinct. Given context of warm/nourishing, likely Cistanches or similar. However, strictly following text: Baiwei.) Weirui (Polygonati Odorati Rhizoma/Jade Bamboo) Zhishi (Aurantii Fructus Immaturus, bran-fried) Qinjiao (Gentianae Macrophyllae Radix, radix tip removed) Gancao (Glycyrrhizae Radix et Rhizoma) (each 2 qian)
For any case where edema suddenly appears after a Shanghan febrile disease, whether occurring on the head and face, lips and mouth, neck, chest and back, limbs, or unilaterally on both feet, without pain or redness, this formula is the primary treatment.
Swelling with pain indicates an Excess pathogen; swelling without pain indicates a Deficient pathogen. Swelling with redness indicates constrained Heat; swelling without redness indicates retained Qi. Thus, it is known that the aforementioned swellings are due to residual pathogens not yet expelled, where Ying (Nutritive) and Wei (Defensive) Qi do not connect smoothly, reversing within the muscle tissue, resulting in swelling. This formula uses Five Fragrances to open the Qi orifices; while Mahuang, Fangfeng, Duhuo, Qinjiao, Weirui, and Baiwei are all acrid and dispersing, one purpose being to resolve residual pathogens, the other to circulate retained Qi. The tonifying nature of Gancao serves to support new Qi; the vigorous nature of Zhishi serves to push out the old.