附子(去皮脐,一枚) 大黄(酒浸) 黄连(去毛,炒) 黄芩(炒,各一两)
伤寒心下痞,汗出恶寒者,此方主之。
心下痞,故用三黄以泻痞;恶寒,汗出,故用附子以回阳。无三黄,则不能以去痞热;
无附子,恐三黄益损其阳。热有附子,寒有三黄,寒热并用,斯为有制之兵矣,张机氏谓
医家之善将将者也。俗医用寒则不用热,用热则不用寒,何以异于胶柱而鼓瑟乎?
生姜四两 甘草(炙) 人参(去芦) 黄芩(炒,各三两) 半夏(半升,制) 黄
连(去毛)
伤寒中风,医反下之,其人下利日数十行,谷不化,腹中雷鸣,心下痞硬而满,干呕,
心烦不得安者,此方主之。
病在表而反下之,则逆矣。下面虚其中气,则表邪乘之而入,虚不任邪,故不利日数十
行,今人谓之挟热利也。火性急速,谷虽入而未及化,故谷不化;虚阳奔迫,故令腹中雷鸣;
中
胃虚之圣药也。生姜、半夏、干姜,呕逆之圣药也;黄连、黄芩,痞热之圣药也。
芫花(熬) 甘遂 大戟(各五分) 大枣(十枚)
伤寒表证已去,其人 汗出,心下痞硬,胁痛,干呕,短气者,此邪热内蓄而有伏饮
也,本方主之。
芫花之辛能散饮,戟、遂之苦能泄水。又曰∶甘遂能直达水饮所结之处。三物皆峻利,
故用大枣以益土,此戎衣之后而发巨桥之意也。是方也,惟壮实者能用之,虚羸之人,未可
轻与也。
Fuzi (Aconiti Lateralis Radix Praeparata, peeled and de-navelled, one piece) Dahuang (Rhei Radix et Rhizoma, soaked in wine) Huanglian (Coptidis Rhizoma, de-fuzzed, stir-fried) Huangqin (Scutellariae Radix, stir-fried, each 1 liang)
For Taiyang disease presenting with fullness and oppression in the epigastrium (Xin Xia Pi), sweating, and aversion to cold, this formula is indicated.
Fullness and oppression in the epigastrium is treated by Sanhuang (the "Three Yellows": Coptidis Rhizoma, Scutellariae Radix, and Rhei Radix et Rhizoma) to drain the heat causing the obstruction; aversion to cold and sweating are treated by Fuzi to restore Yang Qi. Without Sanhuang, the heat of the obstruction cannot be removed; without Fuzi, there is a fear that Sanhuang will further damage Yang Qi. With Fuzi addressing the heat aspect and Sanhuang addressing the cold aspect, the simultaneous use of cold and hot herbs constitutes disciplined military strategy. Zhang Ji (Zhang Zhongjing) was known as a physician skilled in commanding generals. Vulgar physicians, when using cold-natured herbs, do not combine them with hot-natured ones, and vice versa. How is this different from gluing the bridges of a zither and attempting to play music?
Shengjiang (Zingiberis Rhizoma Recens, four liang) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) Renshen (Ginseng Radix, de-rhizome) Huangqin (Scutellariae Radix, stir-fried, each 3 liang) Banxia (Pinelliae Tuber, half sheng, processed) Huanglian (Coptidis Rhizoma, de-fuzzed)
For Taiyang disease or Wind-stroke where the physician erroneously applied purgation, resulting in diarrhea occurring dozens of times a day, undigested food in the stool, borborygmus (rumbling in the abdomen), hardness and fullness in the epigastrium, dry heaving, irritability, and inability to find peace, this formula is indicated.
When the pathogen is at the exterior level but the physician erroneously applies purgation, it creates an adverse situation. Purgation empties the Middle Jiao (Zhong Qi), allowing exterior pathogens to penetrate inward. Due to deficiency and inability to resist the pathogen, diarrhea occurs dozens of times daily, a condition now referred to as Diarrhea with Heat (Xie Re Li). Fire nature is rapid and urgent; although grain enters the stomach, it fails to digest in time, hence undigested food in stool. Rushing deficient Yang causes borborygmus. (Note: The original text implies Ren Shen is the holy medicine for Spleen/Stomach deficiency). Shengjiang, Banxia, and Ganjiang (Zingiberis Rhizoma) are the holy medicines for vomiting and rebellious Qi; Huanglian and Huangqin are the holy medicines for Pi-heat (fullness-heat).
Yuanhua (Genkwa Flos, boiled) Gansui (Kansui Radix) Daji (Euphorbiae Pekinensis Radix, each 5 fen) Dazao (Jujubae Fructus, ten pieces)
When the exterior syndrome of Taiyang disease has resolved, yet the patient presents with sweating, hardness and fullness in the epigastrium, hypochondriac pain, dry heaving, and shortness of breath, this indicates internal accumulation of evil heat and latent fluid retention (Fu Yin). This formula is indicated.
The pungency of Yuanhua can dissipate fluid retention; the bitterness of Daji and Gansui can drain water-dampness. It is also said that Gansui can reach directly to the site where water-dampness is knotted. These three substances are all峻利 (pungent and drastic/strongly purgative); therefore, Dazao is used to tonify Earth (Spleen/Stomach). This is analogous to the policy of distributing grain after a war. This formula should only be used in robust and strong individuals; those who are weak and emaciated should not be lightly administered this prescription.