间，此和解于上下际。表里间俱属阳，上下际之下字，内兼有阴也。阴逆则阳郁，故去柴胡，加黄连以解阳邪，
佐辛温以破阴逆也。（《医径句测》）
干姜黄连黄芩人参汤
妄汗后，水药不得入口，是为水逆。妄吐、下后，食入口即吐，是为食格。此肺气、胃气受伤之别也。入
口即吐，不使少留，乃火炎上之象，故干姜黄连黄芩人参汤，苦寒倍于辛热，用泻心之半，而不名泻心者，以
泻心汤专为痞硬之法耳。要知寒热相结于心下，而成痞硬；寒热相阻于心下，而成格逆。源同而流异也。（柯韵伯）
旋复代赭石汤
此方，乃泻心之变剂。以心虚不可复泻，故去芩、连、干姜辈苦寒辛热之品。○旋复、半夏作汤，调代赭末，
治顽痰结于胸膈，或涎沫上涌者最佳。挟虚者加人参尤效。（柯韵伯）
旋复代赭汤，予每借治反胃噎食，气逆不降者，神效。（周扬俊）
昌用此方治反胃多痰，气逆并哕者，愈千人矣。（喻嘉言）
桂枝人参新加汤、葛根黄芩黄连汤
前方理中加桂枝，而冠桂枝于人参之上；后方泻心加葛根，
而冠葛根于芩、连之首。不名理中、泻心者，总为表未解故耳。补中亦能解表，凉中亦能散表；补中亦能散痞，
凉中亦能止利。仲景制两解方，神化如此！（柯韵伯）
大、小陷胸汤丸
大陷胸汤，太阳药也；大陷胸丸，阳明药也；小陷胸汤，少阳药也。（王海藏）
大、小青龙，攻太阳之表，有水火之分；大、小陷胸，攻太阳之里，有痰饮之别。（柯韵伯）
按∶大承气，所下者燥屎；大陷胸，所下者蓄水；小陷胸，所下者黄涎。（《伤寒类方》）
桃仁承气汤、抵当汤
仲景制大青龙、大柴胡、白虎汤，治三阳无形之热结。三承气之热实，是糟粕为患；桃仁、抵当之实结，
是蓄血为眚。在有形中，又有气血之分也。凡仲景用硝、黄，是荡热除秽，不是除血。后人专以气分、血分对
讲，误认糟粕为血，竟推大黄为血分药，不知大黄之芳香，所以开脾气而除腐秽，故方名承气耳。若不加桃仁，岂
能破血？非加蛭虻，何以攻坚？是血剂中又分轻重也。凡 瘕不散，久而成形者，皆蓄血所致。今人不求其属
而治之，反用三棱等气分之药，重伤元气，元气日衰，邪气易结。盖谓槽粕因气行而除，淤血因气伤而反坚也。
明知此理，则用抵当丸，得治 瘕及追虫攻毒之效。（柯韵伯）
桃仁承气，治淤血将结之时；抵当治淤血已结之后。（《伤寒类方》）
瓜蒂散、栀豉汤
邪在营卫之间，惟汗是其出路，故立麻黄、桂枝二方。邪在胸腹之间，惟吐是其出路，故立瓜蒂、栀豉二
方。瓜蒂散主胸中痞硬，治在上焦；栀豉汤主腹满而喘，治兼中焦。犹麻黄之主皮肤，桂枝之主肌肉。瓜蒂散，
峻剂也，犹麻黄之不可轻用；栀豉
汤，轻剂也，犹桂枝汤之可更用。故太阳表剂，多从桂枝加减；阳明表剂，多从栀豉加减。阳明用栀豉，既可
用之以去邪，即可用之以救逆。今人但知汗为解表，不知吐亦为解表。知吐中便有发散之说，不知所以当吐之
义。故于仲景大法，取其汗下，遗其吐法耳。（柯韵伯）
瓜蒂、栀豉，皆吐剂。要知瓜蒂吐痰食宿寒；栀豉吐虚烦客热。如未经汗、下，邪郁胸膈而痞满者，谓
之实，宜瓜蒂散，此重剂也；已经汗、吐、下，邪热乘虚，客于胸中而懊 者，为虚烦，宜栀豉汤，此轻剂也。
（《医方集解》）
白虎汤
白虎汤，是解胃腑内蒸之热，非治外经之热也。昔人以石膏辛凉，能解利阳明风热，若不佐以麻、葛之品，
何以走外？此说似是而实非。盖阳明在经之邪，纵使有大热，而不烦渴，自有葛根汤、桂枝加葛根等治法，并
无藉于石膏也。（张路玉）
夫以石膏一物之微，入甘温队中则为青龙；从清凉同气则为白虎。惟圣神之哲，乃能用之恰当。此龙虎所
为庆风云之会也。设在表之风寒未除，当用青龙而反用白虎；设在里之热渴已逼，当用白虎而反用青龙。倒行
逆施，能不败乎？世传孙思邈有降龙伏虎之能，岂非以仲景之心法为道法耶？（喻嘉言）
白虎加人参，于清火中益气；调胃用甘草，于攻实中虑虚。（柯韵伯）
三承气汤
诸病皆因于气，秽物之不去，由于气之不顺也。故攻积之剂，必用气分之药。因以承气名汤，方分大、
小，有二义焉∶浓朴倍大黄，是气药为君，名大承气；大黄倍浓朴，是气药为臣，名小承气。味多性猛，制大
其服，欲令大泄下也，因名曰大；味寡性缓，制小其服，欲微和胃气也，因名曰小。且煎法更有妙义∶大
承气用水一斗，煮朴、枳，取五升去滓，内大黄再煮，取二升，
纳芒硝。何哉？盖生者气锐而先行，熟者气纯而和缓。仲景欲使芒硝先化燥矢，大黄继通地道，而后朴、枳除
其痞满。若小承气以三味同煎，不分次第。同一大黄，而煎法不同。此可见仲景微和之意也。（柯韵伯）
伤寒邪热传里，须看浅深用药。三焦俱伤，则痞、满、燥、实、坚全见，宜大承气汤。邪在中焦，则有燥、
实、坚三证，宜调胃承气汤，加甘草和中，去枳、朴者，恐伤上焦氤氲之气也。邪在上焦，则痞而实，宜小承
气汤，去芒硝者，恐伤下焦真阴也。若表证未除，里证又急，不得不下者，则用大柴胡汤，通表里而缓治之。
大承气最紧，小承气次之，调胃又次之，大柴胡又次之。（陶节庵）
大、小、调胃三承气汤，必须表证悉罢，而发热、恶热、谵语、不大便者，方可用之。若脉浮紧，下之必
成结胸；若脉浮缓，下之必成痞气。以上三法，若有所差，则有遗害。假令调胃承气证，用大承气下之，则愈
后元气不复，以其气药犯之也；大承气证，用调胃承气下之，则愈后神呆不清，以其气药无力也；小承气证，
若用芒硝下之，则下利不止，变成虚矣。三承气之用，岂可瘥乎？（《此事难知》）
三承气汤，为寒下之柔剂；白散、备急丸，为热下之刚剂；附子泻心汤、大黄附子汤，为寒热互结，刚柔
并济之和剂。（张路玉）
甘草干姜汤、芍药甘草汤
甘草干姜汤，得理中之半，取其守中，不须其补中；芍药甘草汤，得桂枝之半，用其和里，不许其攻表。（柯韵伯）
小柴胡汤、乌梅丸
小柴胡为少阳主方；乌梅丸为厥阴主方。二方虽不同，而寒温互用、攻补兼施之法相合者，以脏腑相连，
经络相贯，风木合气，同司相火故也。其中皆用人参，补中益气以固本逐邪，而他
味俱不相袭者，因阴阳异位，阳宜升发，故主以柴胡；阴宜收降，故主以乌梅。阳主热，故重用寒凉；阴主寒，
故重用辛热。阳以动为用，故汤以荡之，其证变幻不常，故柴胡有加减法；阴以静为体，故丸以缓之，其证有
定局，故乌梅无加减法也。（柯韵伯）
大、小柴胡汤
大、小柴胡，俱是两解表里之剂。大柴胡主降气，小柴胡主调气。调气无定法，故小柴胡除柴胡、甘草外，
皆可进退；降气有定局，故大柴胡无加减法也。（柯韵伯）
柴胡桂枝汤
柴胡桂枝汤，治太阳、少阳并病，表证虽不去而已轻，里证虽已见而未甚。故取桂枝之半，以解太阳未尽
之邪；取柴胡之半，以解少阳之征结。为双解两阳之轻剂。（柯韵伯）
柴胡加芒硝汤
大柴胡汤，加大黄、枳实，乃合用小承气也；此加芒硝，乃合用调胃承气也。皆少阳、阳明同治之方。（《伤寒类方》）
浓朴生姜半夏甘草人参汤
太阳汗后胀满，是阳实于里，将转属阳明也；太阴汗后腹满，是寒实于里，而阳虚于内也。邪气盛则实，
故用浓、朴、姜、夏散邪而除胀满；正气夺则虚，故用人参、甘草补中而益元气。此亦理中之剂欤？（柯韵伯）
理中汤、四逆汤
按∶理中、四逆二方，在白术、附子之别。白术为中宫培土益气之品，附子为坎宫扶阳生气之剂。故理中
只理中州脾胃之虚寒；四逆能佐理三焦阴阳之厥逆也。后人加附子于理中，名曰附子理中汤，不知理中不须附
子，而附子之功，不专在理中矣。盖脾为后天，肾为先天。少阴之火，所以生太阴之土。脾为五脏之母，少阴
更太阴之母。此四逆重于理中也。（柯韵伯）
四逆、理中，皆温热之剂。而四逆一类，总不离干姜，以通
阳也，治宜下焦；理中一类，总不离白术，以守中也，治宜中焦。余药皆相同，而功用迥别。（徐灵胎）
诸四逆汤
四逆为太阴主方，而诸经可以并用。在太阴，固本以逐邪也；在少阴，温土以制水也；在厥阴，和土以
生木也；在太阳，益火以扶阳也。惟阳明胃实，少阳相火，非所宜耳。○手足厥逆，有寒、热、表、里之各异。
四逆散，解少阴之里热；当归四逆汤，解厥阴之表寒；通脉四逆汤，挽少阴真阳之将亡；茯苓四逆汤，留太阴
真阴之欲脱。四方有各经轻、重、浅、深之别也。（柯韵伯）
四逆汤，全从回阳起见；四逆散，全从和解表里起见；当归四逆，全从养血通脉起见。不欲入辛热之味，
恐劫其阴也。盖少阴脏中，重在真阳，阳不回，则邪不去；厥阴脏中，职司藏血，血不养，则脉不起。即遇久
寒之人，亦不用干姜、附子。止用吴萸之走肝者，自上而下；生姜之辛散者，自内达外足矣。（周禹载）
茯苓四逆汤、干姜附子汤
茯苓四逆、干姜附子二方，皆从四逆加减，而有救阳、救阴之异。茯苓补先天无形之气，安虚阳外脱之
烦，故以为君；人参配茯苓，补下焦之元气；干姜配生附，回下焦之元阳；调以甘草之甘，比四逆为缓，固里
宜缓也。姜、附者，阳中之阳也。用生附而去甘草，则势力更猛，比四逆为峻，回阳当急也。一去甘草，一加
茯苓，而缓急自别。加减之妙，见用方之神乎！（柯韵伯）
麻附细辛汤、麻附甘草汤
少阴制麻附细辛汤，犹太阳之麻黄汤，是急汗之峻剂；制麻附甘草汤，犹太阳之桂枝汤，是缓汗之和剂。
盖太阳为阳中之阳而主表，其汗易发，其邪易散，故初用麻黄、甘草，而助以桂枝；次用桂枝、生姜，而反佐
以芍药。少阴为阴中之阴而主里，其汗最不易发，其邪最不易散，故初用麻黄、附子，而助以细辛；次用麻黄、
附子，而缓以甘草。然必细审其脉沉而无里证者，可发
汗，即知脉沉而证为在里者，不可发汗矣。此等机关，必须看破。（柯韵伯）
附子汤
附子汤与麻黄附子汤，皆治少阴表证，而大不同。彼因病从外来，表有热而里无热，故当温散；此因病
自内出，表里俱寒而大虚，故当温补。然彼发热而用附子，此不热而用芍药，是又阴阳互根之理欤？此与真武
汤似同而实异∶此倍术、附，去姜而用参，全是温补以壮元阳；彼用姜而不用参，尚是温散以逐水气。补散之
分歧，只在一味之旋转欤？○肾主五液，入心为汗。少阴受病，液不上升，所以阴不得有汗。仲景治少阴之表，
于麻黄细辛汤中加附子，是升肾液也。若少阴无主，水火不和，真阴为邪所逼，则水随火越，故反汗出。仲景
治少阴之里，附子汤中任人参，是补肾液也。（柯韵伯）
真武汤
要知真武加减，与小柴胡不同。小柴胡为少阳半表之剂，只不去柴胡一味，便可名柴胡汤；真武以五物
成方，为少阴治本之剂，去一味便不成真武。故去姜加参，即名附子汤。于此见制方有阴阳动静之别也。（柯韵伯）
按∶误服大青龙汤，厥逆、筋惕肉 者，既有亡阳之逆矣。亡阳即当用四逆汤以回阳，乃置而不用，更
推重真武一汤以救之者，其义何居？盖真武乃北方司水之神，龙惟藉水可能变化。而水者，真武之所司也。设
真武不与之以水，青龙之不能奋然升天可知矣。故方中用茯苓、白术、芍药、附子，行水收阴，醒脾崇土之功，
多于回阳。名之曰真武汤，乃收拾分驰离绝之阴阳，互镇于少阴北方之位。其所收拾者，全要收拾其水，使龙
潜而不能见也。设有一毫水气上逆，龙即得遂其升腾变化，纵独用附子、干姜以回阳，其如魄汗不止何哉！厥
后，晋旌阳祖师，以仙术斩蛟，捕至蛟龙遁迹之所，戒其家勿蓄勺水，乃至从砚水中逸去。可见水怪
原有尺水丈波之能。向非真武坐镇北方，天壤间久为龙蛇之窟矣。即此推之，人身阳根于阴，其亡阳之证，乃
少阴肾中之真阳飞越耳。真阳飞越，亟须镇摄归根，阳既归根，阴必翕然从之。阴从则水不逆矣，阴从则阳不
孤矣，岂更能飞越乎？（《尚论篇》）
黄连阿胶汤
此少阴之泻心汤也。凡泻心必藉芩、连，而道引有阴阳之别。病在三阳，胃中不和而心下痞硬者，虚则加
参、甘补之；实则加大黄下之。病在少阴，而心中烦不得卧者，既不得用参、甘以助阳，亦不得用大黄以伤胃
矣。用连、芩以直折心火；佐芍药以收敛神明，所以扶阴而抑阳也。然以但欲寐之病情，而至于不得卧，以微
细之病脉，而反见心烦，非得气血之属，以交合心肾，甘平之味，以滋阴和阳，不能使水升而火降。阴火不归
其部，则少阴之热不除。鸡黄禀离宫之火色，入通于心，可以补心中之血，用生者搅和，取润下之义也；驴皮
(This passage discusses the mechanism of exterior-interior and yin-yang: The exterior and interior both belong to Yang, while the term "upper-lower interface" implies that the "lower" character internally encompasses Yin. If Yin Qi rebels upward, it leads to the stagnation of Yang Qi; therefore, Chai Hu (Bupleuri Radix) is removed, Huang Lian (Coptidis Rhizoma) is added to resolve Yang pathogenic factors, assisted by acrid-warm herbs to break the rebellion of Yin.)
Gan Jiang Huang Lian Huang Qin Ren Shen Tang (Dried Ginger, Coptis, Scutellaria, and Ginseng Decoction)
After mistaken sweating therapy, water and medicine cannot be taken into the mouth; this is called "Water Rebellion" (Shui Ni). After mistaken vomiting or purging therapies, food is vomited immediately upon entering the mouth; this is called "Food Obstruction" (Shi Ge). This distinguishes the injury to Lung Qi from Stomach Qi. Immediate vomiting without retention indicates the image of Fire flaming upward. Therefore, Gan Jiang Huang Lian Huang Qin Ren Shen Tang is used, where bitter-cold herbs outweigh acrid-warm ones. It utilizes half the efficacy of Xie Xin Tang (Drain the Epigastrium Decoction) but is not named so, because Xie Xin Tang is specifically for treating Pi Ying (fullness and hardness in the epigastrium). One must know that when cold and heat knot together in the epigastrium, Pi Ying forms; when cold and heat obstruct in the epigastrium, Ge Ni (obstruction and rebellion/vomiting) forms. The source is the same, but the manifestation differs. (Ke Yunbo)
Xuan Fu Dai Zhe Shi Tang (Inula and Hematite Decoction)
This formula is a variation of Xie Xin Tang. Because Heart Qi is deficient and cannot withstand further draining, bitter-cold herbs like Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), and acrid-warm herbs like Gan Jiang (Zingiberis Rhizoma) are removed. ○ Xuan Fu Hua (Inulae Flos) and Ban Xia (Pinelliae Rhizoma) are decocted, and Dai Zhe Shi (Hematitum) powder is mixed in. This is best for treating stubborn phlegm knotting in the chest and diaphragm, or surging saliva/phlegm. For cases with deficiency, adding Ren Shen (Ginseng Radix et Rhizoma) is especially effective. (Ke Yunbo)
I often borrow Xuan Fu Dai Zhe Tang to treat Fan Wei (regurgitation) and Ye Shi (dysphagia) with rebellious Qi failing to descend, achieving miraculous effects. (Zhou Yangjun)
Chang used this formula to treat Fan Wei with much phlegm, rebellious Qi, and hiccups, curing thousands of people. (Yu Jiayan)
Gui Zhi Ren Shen Xin Jia Tang (Cinnamon Twig, Ginseng, and New Added Decoction) & Gen Qian Huang Qin Huang Lian Tang (Pueraria, Scutellaria, and Coptis Decoction)
The former adds Gui Zhi (Cinnamomi Ramulus) to Li Zhong Tang (Regulate the Middle Decoction), but places Gui Zhi before Ren Shen; the latter adds Ge Gen (Puerariae Radix) to Xie Xin Tang, but places Ge Gen before Huang Qin and Huang Lian. They are not named Li Zhong Tang or Xie Xin Tang because the exterior syndrome has not yet resolved. Tonifying the middle can also release the exterior; cooling can also scatter the exterior; tonifying the middle can dissipate Pi (fullness); cooling can stop diarrhea. Zhang Zhongjing’s formulation of dual-resolving formulas is so divine and transformative! (Ke Yunbo)
Da Xian Xiong Tang Wan (Major Sinking into the Chest Decoction/Pill) & Xiao Xian Xiong Tang Wan (Minor Sinking into the Chest Decoction/Pill)
Da Xian Xiong Tang is a herb for Tai Yang disease; Da Xian Xiong Wan is a herb for Yang Ming disease; Xiao Xian Xiong Tang is a herb for Shao Yang disease. (Wang Haicang)
Da Qing Long Tang (Major Blue Dragon Decoction) and Xiao Qing Long Tang (Minor Blue Dragon Decoction) attack the Tai Yang exterior, distinguished by water vs. fire pathogens; Da Xian Xiong and Xiao Xian Xiong attack the Tai Yang interior, distinguished by phlegm-fluids vs. knotting. (Ke Yunbo)
Note: Da Cheng Qi Tang (Major Order the Qi Decoction) evacuates dry feces; Da Xian Xiong Tang evacuates accumulated water; Xiao Xian Xiong Tang evacuates yellow sticky phlegm. (Shang Han Lei Fang)
Tao Ren Cheng Qi Tang (Peach Kernel Decoction to Order the Qi) & Di Dang Tang (Worth Attending Decoction)
Zhang Zhongjing formulated Da Qing Long Tang, Da Chai Hu Tang (Major Bupleurum Decoction), and Bai Hu Tang (White Tiger Decoction) to treat formless heat knots in the Three Yang channels. The heat-excess treated by the three Cheng Qi Tangs involves waste products (feces); the excess knots treated by Tao Ren Cheng Qi Tang and Di Dang Tang involve retained blood. Within formless pathogens, there is still a distinction between Qi and Blood levels. Whenever Zhang Zhongjing uses Mang Xiao (Natrii Sulfas) and Da Huang (Rhei Radix et Rhizoma), it is to sweep away heat and remove filth, not to remove blood. Later generations specifically contrasted Qi level and Blood level, mistakenly identifying waste products as blood, and promoting Da Huang as a Blood-level herb. They did not know that Da Huang’s aromatic nature opens Spleen Qi and removes rot and filth, hence the name "Cheng Qi" (Ordering the Qi). Without Tao Ren (Persicae Semen), how could blood be broken? Without Leeches (Shui Zhi) and Horse-leeches (Meng Chong), how could hard knots be attacked? Thus, even among Blood-invigorating agents, there are light and heavy distinctions. Any Zheng Jia (masses) that do not disperse and eventually take form are caused by retained blood. Today’s practitioners, seeking no root cause, use Qi-level herbs like San Leng (Sparganii Rhizoma), severely damaging Yuan Qi (Original Qi). As Yuan Qi declines daily, pathogens easily knot. Generally, waste products are removed as Qi moves, but stasis becomes harder as Qi is damaged. Understanding this principle, using Di Dang Wan allows one to achieve effects in treating Zheng Jia and expelling parasites/toxins. (Ke Yunbo)
Tao Ren Cheng Qi Tang treats the time when blood stasis is about to knot; Di Dang Tang treats the time after blood stasis has already knotted. (Shang Han Lei Fang)
Gua Di San (Melon Seed Powder) & Zhi Chi Tang (Gardenia and Soybean Fermented Decoction)
When pathogens are between Ying (Nutrient) and Wei (Defensive) levels, only sweating is the exit; thus, Ma Huang Tang (Ephedra Decoction) and Gui Zhi Tang (Cinnamon Twig Decoction) were established. When pathogens are between the chest and abdomen, only vomiting is the exit; thus, Gua Di San and Zhi Chi Tang were established. Gua Di San governs Pi Ying in the chest, treating the Upper Jiao; Zhi Chi Tang governs abdominal fullness with wheezing, treating the Middle Jiao as well. Just as Ma Huang Tang governs the skin, and Gui Zhi Tang governs the muscles. Gua Di San is a harsh agent, just as Ma Huang Tang should not be used lightly; Zhi Chi Tang is a mild agent, just as Gui Zhi Tang can be reused. Therefore, Tai Yang exterior-releasing formulas mostly modify Gui Zhi Tang; Yang Ming exterior-releasing formulas mostly modify Zhi Chi Tang. Using Zhi Chi Tang in Yang Ming can both expel pathogens and correct iatrogenic errors. People today only know sweating releases the exterior, not knowing vomiting also releases the exterior. Knowing vomiting contains dispersing properties, they fail to understand the rationale for vomiting. Thus, regarding Zhang Zhongjing’s great principles, they take sweating and purging but omit vomiting. (Ke Yunbo)
Gua Di San and Zhi Chi Tang are both emetic agents. Know that Gua Di San vomits phlegm, food retention, and old cold; Zhi Chi Tang vomits empty irritability and guest-heat. If no sweating or purging has occurred, and pathogens are depressed in the chest-diaphragm causing fullness, it is called Excess, suitable for Gua Di San (heavy agent); if sweating, vomiting, or purging has already occurred, and pathogenic heat enters the chest due to deficiency causing mental restlessness (Ao Nao), it is called Empty Irritability, suitable for Zhi Chi Tang (light agent). (Yi Fang Ji Jie)
Bai Hu Tang (White Tiger Decoction)
Bai Hu Tang resolves the steaming heat within the Stomach Fu organs, not the heat in the exterior meridians. Previously, some believed Shi Gao (Gypsum Fibrosum) is acrid-cool and can resolve Yang Ming wind-heat; without assisting with Ma Huang or Ge Gen, how would it reach the exterior? This view seems plausible but is actually incorrect. Regarding pathogens in the Yang Ming meridian at the exterior, even if there is high fever, as long as there is no irritability and thirst, there are naturally treatments like Ge Gen Tang (Kudzu Decoction) or Gui Zhi Jia Ge Gen Tang (Cinnamon Twig Decoction plus Kudzu), without needing Shi Gao. (Zhang Luyu)
With the slight power of Shi Gao alone, entering a team of sweet-warm herbs makes it Qing Long Tang; following cool-cold herbs makes it Bai Hu Tang. Only the sagely and wise can use it appropriately. This is the meeting of dragons and tigers celebrating wind and clouds. If exterior wind-cold remains and Qing Long Tang should be used but Bai Hu Tang is instead used; or if interior heat-thirst presses and Bai Hu Tang should be used but Qing Long Tang is instead used—acting against the natural order, how could one not fail? The world传s that Sun Simiao had the ability to subdue dragons and tame tigers; is this not treating Zhang Zhongjing’s heart-method as Daoist method? (Yu Jiayan)
Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng) tonifies Qi amidst clearing fire; Tiao Wei Cheng Qi Tang (Regulate the Stomach Order the Qi Decoction) uses Gan Cao (Licorice Root) to consider deficiency amidst attacking excess. (Ke Yunbo)
Three Cheng Qi Tangs
All diseases arise from Qi; the inability to remove filth is due to unsmooth Qi. Therefore, agents that attack accumulation must use Qi-level herbs. Hence named "Cheng Qi" (Ordering the Qi). The division into Large and Small has two meanings: In Da Cheng Qi Tang, Hou Po (Magnoliae Officinalis Cortex) doubles Da Huang, making the Qi herb the Sovereign, hence "Large"; in Xiao Cheng Qi Tang (Small Cheng Qi Decoction), Da Huang doubles Hou Po, making the Qi herb the Minister, hence "Small". Many flavors, fierce nature, large dosage intended for major purgation, hence "Large"; few flavors, mild nature, small dosage intended for mild harmonization of Stomach Qi, hence "Small". Moreover, the decoction method has subtle meaning: Da Cheng Qi Tang uses one dou of water, boils Hou Po and Zhi Shi (Aurantii Fructus), reduces to five sheng, removes dregs, adds Da Huang, boils again to two sheng, then adds Mang Xiao. Why? Raw herbs have sharp Qi and act first; cooked herbs have pure Qi and act mildly. Zhang Zhongjing wanted Mang Xiao to first dissolve dry stool, Da Huang to subsequently open the intestinal pathway, and then Hou Po and Zhi Shi to remove Pi and fullness. Xiao Cheng Qi Tang decocts all three together without sequence. Same Da Huang, different decoction methods. This shows Zhang Zhongjing’s intent of mild harmonization. (Ke Yunbo)
When Sha Jing (Cold Damage) pathogenic heat transmits to the interior, medication must depend on depth. If all Three Jiaos are injured, showing Pi, Man (fullness), Zao (dryness), Shi (excess), and Jian (hardness), Da Cheng Qi Tang is suitable. If pathogens are in the Middle Jiao, showing Zao, Shi, and Jian, Tiao Wei Cheng Qi Tang is suitable; Gan Cao is added to harmonize the middle, and Zhi Shi/Hou Po are removed to avoid injuring the misty Qi of the Upper Jiao. If pathogens are in the Upper Jiao, showing Pi and Shi, Xiao Cheng Qi Tang is suitable; Mang Xiao is removed to avoid injuring the True Yin of the Lower Jiao. If exterior syndrome remains and interior syndrome is urgent, requiring purging, Da Chai Hu Tang is used to connect exterior and interior and treat slowly. Da Cheng Qi Tang is most urgent; Xiao Cheng Qi Tang is next; Tiao Wei Cheng Qi Tang is next; Da Chai Hu Tang is last. (Tao Jian’an)
For Da, Xiao, and Tiao Wei Cheng Qi Tangs, exterior symptoms must completely resolve, presenting with fever, aversion to heat, delirium, and constipation, before they can be used. If pulse is floating-tight, purging will definitely cause Jie Xiong (chest knotting); if pulse is floating-slow, purging will definitely cause Pi Qi (Pi syndrome). If these three methods have any error, harm will remain. For example, if Tiao Wei Cheng Qi Tang indication is treated with Da Cheng Qi Tang, post-recovery Yuan Qi will not recover because the Qi herb was too harsh; if Da Cheng Qi Tang indication is treated with Tiao Wei Cheng Qi Tang, post-recovery spirit will be dull and unclear because the Qi herb lacked strength; if Xiao Cheng Qi Tang indication is treated with Mang Xiao, diarrhea will not stop, turning into deficiency. How can the use of the three Cheng Qi Tangs be careless? (Ci Shi Nan Zhi)
The three Cheng Qi Tangs are soft agents of cold purging; Bai San (White Powder) and Bei Ji Wan (Emergency Pill) are hard agents of hot purging; Fu Zi Xie Xin Tang (Aconite Drain the Epigastrium Decoction) and Da Huang Fu Zi Tang (Rhubarb and Aconite Decoction) are harmonizing agents for cold-heat knotting, combining hardness and softness. (Zhang Luyu)
Gan Cao Gan Jiang Tang (Licorice and Dried Ginger Decoction) & Shao Yao Gan Cao Tang (Peony and Licorice Decoction)
Gan Cao Gan Jiang Tang obtains half of Li Zhong Tang, taking its function of guarding the middle, not needing it to tonify the middle; Shao Yao Gan Cao Tang obtains half of Gui Zhi Tang, using its function of harmonizing the interior, forbidding it to attack the exterior. (Ke Yunbo)
Xiao Chai Hu Tang (Minor Bupleurum Decoction) & Wu Mei Wan (Mume Pill)
Xiao Chai Hu Tang is the main formula for Shao Yang disease; Wu Mei Wan is the main formula for Jue Yin disease. Although different, their methods of interusing cold/warm and combining attacking/tonifying align because the zang-fu are connected, meridians intersect, Wind-Wood shares Qi, and they jointly govern Ministerial Fire. Both use Ren Shen to tonify the middle and boost Qi to secure the root and drive out pathogens, while other flavors do not overlap because Yin and Yang occupy different positions. Yang prefers ascending and issuing, so Chai Hu is sovereign; Yin prefers gathering and descending, so Wu Mei (Mume Fructus) is sovereign. Yang governs heat, so cold-cool herbs are heavily used; Yin governs cold, so acrid-warm herbs are heavily used. Yang uses movement, so decoctions are used to sweep; symptoms change unpredictably, so Chai Hu Tang has modification rules. Yin uses stillness as substance, so pills are used to缓 (slow); symptoms have fixed patterns, so Wu Mei Wan has no modification rules. (Ke Yunbo)
Da Chai Hu Tang & Xiao Chai Hu Tang
Both Da and Xiao Chai Hu Tang are agents resolving exterior and interior. Da Chai Hu Tang governs descending Qi; Xiao Chai Hu Tang governs regulating Qi. Regulating Qi has no fixed method, so besides Chai Hu and Gan Cao, other herbs in Xiao Chai Hu Tang can advance or retreat; descending Qi has a fixed pattern, so Da Chai Hu Tang has no modification rules. (Ke Yunbo)
Chai Hu Gui Zhi Tang (Bupleurum and Cinnamon Twig Decoction)
Chai Hu Gui Zhi Tang treats concurrent Tai Yang and Shao Yang disease. Exterior symptoms persist but are mild; interior symptoms appear but are not severe. Thus, half of Gui Zhi Tang is taken to resolve remaining Tai Yang pathogens; half of Chai Hu Tang is taken to resolve Shao Yang knotting. It is a light agent for dual-resolving Two Yangs. (Ke Yunbo)
Chai Hu Jia Mang Xiao Tang (Bupleurum Decoction plus Mang Xiao)
Da Chai Hu Tang plus Da Huang and Zhi Shi combines Xiao Cheng Qi Tang; this formula (Chai Hu Jia Mang Xiao Tang) plus Mang Xiao combines Tiao Wei Cheng Qi Tang. Both are formulas treating Shao Yang and Yang Ming simultaneously. (Shang Han Lei Fang)
Hou Po Sheng Jiang Ban Xia Gan Cao Ren Shen Tang (Magnolia Bark, Fresh Ginger, Pinellia, Licorice, and Ginseng Decoction)
After Tai Yang sweating, distension/fullness indicates Yang excess in the interior, transitioning to Yang Ming; after Tai Yin sweating, abdominal fullness indicates Cold-Excess in the interior and Yang deficiency inside. Pathogen excess manifests as Excess, so Hou Po, Hou Po [sic: likely Hou Po, Sheng Jiang, Ban Xia], Gan Jiang, and Ban Xia are used to scatter pathogens and remove distension; Healthy Qi depletion manifests as Deficiency, so Ren Shen and Gan Cao are used to tonify the middle and boost Yuan Qi. Is this also a Li Zhong-type agent? (Ke Yunbo)
Li Zhong Tang & Si Ni Tang (Recover the Extremities Decoction)
Note: The difference between Li Zhong and Si Ni Tangs lies in Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Fu Zi (Aconiti Lateralis Radix Praeparata). Bai Zhu is for cultivating Earth and boosting Qi in the Central Palace; Fu Zi is for supporting Yang and generating Qi in the Kan Palace. Thus, Li Zhong only regulates the deficiency-cold of the Central Zhou (Spleen/Stomach); Si Ni Tang assists in regulating the Jue Ni (extremity reversal) of the Three Jiaos’ Yin and Yang. Later generations added Fu Zi to Li Zhong, naming it Fu Zi Li Zhong Tang, not knowing Li Zhong does not need Fu Zi, and Fu Zi’s merit is not limited to Li Zhong. The Spleen is Post-Heaven; the Kidney is Pre-Heaven. Fire of Shao Yin generates Earth of Tai Yin. Spleen is mother of Five Zang; Shao Yin is mother of Tai Yin. Thus, Si Ni Tang is heavier than Li Zhong. (Ke Yunbo)
Si Ni and Li Zhong are both warm-hot agents. Si Ni category always involves Gan Jiang to unblock Yang, treating the Lower Jiao; Li Zhong category always involves Bai Zhu to guard the middle, treating the Middle Jiao. Other herbs are similar, but functions are vastly different. (Xu Lingtai)
Various Si Ni Tangs
Si Ni Tang is the main formula for Tai Yin, but can be used in all channels. In Tai Yin, it secures the root to drive out pathogens; in Shao Yin, it warms Earth to control Water; in Jue Yin, it harmonizes Earth to generate Wood; in Tai Yang, it benefits Fire to support Yang. Only Yang Ming Stomach Excess and Shao Yang Ministerial Fire are unsuitable. ○ Hand-foot Jue Ni (reversal cold) varies by Cold, Heat, Exterior, Interior. Si Ni San (Dispersal) resolves Shao Yang interior heat; Dang Gui Si Ni Tang (Angelica Decoction to Recover the Extremities) resolves Jue Yin exterior cold; Tong Mai Si Ni Tang (Unblock Vessels Si Ni Decoction) rescues impending loss of Shao Yin True Yang; Fu Ling Si Ni Tang (Poria Si Ni Decoction) retains impending loss of Tai Yin True Yin. The four formulas differ in light/heavy and shallow/deep across channels. (Ke Yunbo)
Si Ni Tang entirely arises from recovering Yang; Si Ni San entirely arises from harmonizing exterior-interior; Dang Gui Si Ni Tang entirely arises from nourishing Blood and unblocking vessels. One avoids acrid-hot flavors to prevent劫 (plundering) Yin. Shao Yin Zang focuses on True Yang; if Yang does not return, pathogens do not leave. Jue Yin Zang governs storing Blood; if Blood is not nourished, vessels do not rise. Even in chronic cold cases, Gan Jiang and Fu Zi are not used. Only using Wu Zhu Yu (Evodiae Fructus) moving to Liver, from top to bottom; and Sheng Jiang (Fresh Ginger) acridly dispersing, from inside to outside, is sufficient. (Zhou Yuzai)
Fu Ling Si Ni Tang & Gan Jiang Fu Zi Tang (Dried Ginger and Aconite Decoction)
Fu Ling Si Ni Tang and Gan Jiang Fu Zi Tang are both modifications of Si Ni Tang, differing in saving Yang vs. saving Yin. Fu Ling tonifies pre-heaven formless Qi and calms irritability from floating Yang, serving as Sovereign; Ren Shen pairs with Fu Ling to tonify Lower Jiao Yuan Qi; Gan Jiang pairs with raw Fu Zi to restore Lower Jiao Yuan Yang; harmonized with sweet Gan Cao, it is milder than Si Ni Tang, as securing the interior requires slowness. Ginger and Aconite are Yang within Yang. Using raw Aconite and removing Gan Cao makes power fiercer and more峻 (harsh) than Si Ni Tang, as recovering Yang requires urgency. Removing Gan Cao and adding Fu Ling creates a distinction between slow and fast. The subtlety of modifications shows the divinity of prescription usage! (Ke Yunbo)
Ma Huang Fu Zi Xi Xin Tang (Ephedra, Aconite, and Asarum Decoction) & Ma Huang Fu Zi Gan Cao Tang (Ephedra, Aconite, and Licorice Decoction)
Shao Yin prescribes Ma Huang Fu Zi Xi Xin Tang, analogous to Tai Yang’s Ma Huang Tang, a harsh agent for urgent sweating; prescribes Ma Huang Fu Zi Gan Cao Tang, analogous to Tai Yang’s Gui Zhi Tang, a mild agent for harmonizing sweating. Tai Yang is Yang within Yang governing exterior; sweat emits easily, pathogens scatter easily, so initially Ma Huang and Gan Cao are used, assisted by Gui Zhi; later Gui Zhi and Sheng Jiang are used, counter-assisted by Shao Yao. Shao Yin is Yin within Yin governing interior; sweat is hardest to emit, pathogens hardest to scatter, so initially Ma Huang and Fu Zi are used, assisted by Xi Xin (Asari Radix et Rhizoma); later Ma Huang and Fu Zi are used, moderated by Gan Cao. However, one must carefully examine if pulse is deep without interior symptoms to allow sweating; knowing pulse deep with interior symptoms prohibits sweating. These mechanisms must be penetrated. (Ke Yunbo)
Fu Zi Tang (Aconite Decoction)
Fu Zi Tang and Ma Huang Fu Zi Tang both treat Shao Yin exterior syndromes but differ greatly. The latter is disease coming from outside, exterior heat without interior heat, so warming-dispersion is needed; the former is disease arising from inside, exterior-interior both cold and greatly deficient, so warming-tonification is needed. Yet the latter uses Fu Zi despite fever, the former uses Shao Yao despite no fever—is this not the principle of Yin-Yang mutual rooting? This resembles Zhen Wu Tang (True Warrior Decoction) but is actually different: This doubles Bai Zhu and Fu Zi, removes Jiang, uses Shen, entirely warming-tonifying to strengthen Yuan Yang; That uses Jiang without Shen, still warming-dispersing to drive out fluid. The divergence of tonifying vs. dispersing lies in the rotation of one herb? ○ Kidney governs five fluids, entering Heart as sweat. Shao Yin disease, fluids do not ascend, so Yin conditions should not have sweat. Zhang Zhongjing treating Shao Yin exterior adds Fu Zi to Ma Huang Xi Xin Tang to ascend Kidney fluids. If Shao Yin lacks mastery, Water-Fire do not harmonize, True Yin forced by pathogens, Water follows Fire upward, so sweat occurs. Zhang Zhongjing treating Shao Yin interior employs Shen in Fu Zi Tang to tonify Kidney fluids. (Ke Yunbo)
Zhen Wu Tang
Know that Zhen Wu Tang modifications differ from Xiao Chai Hu Tang. Xiao Chai Hu Tang is a Shao Yang semi-exterior agent; removing only Chai Hu still names it Chai Hu Tang; Zhen Wu Tang consists of five herbs, a Shao Yin root-treating agent; removing one herb ceases to be Zhen Wu Tang. Thus, removing Jiang and adding Shen names it Fu Zi Tang. Here we see the distinction of Yin-Yang motion-stillness in formula creation. (Ke Yunbo)
Note: Mistakenly服用 (taking) Da Qing Long Tang causes Jue Ni (extremity reversal) and Jin Ti Rou Gu (twitching muscles), indicating Wang Yang (loss of Yang). Wang Yang should use Si Ni Tang to recover Yang, yet it is set aside, and Zhen Wu Tang is heavily promoted for rescue. What is the rationale? Zhen Wu is the God of Water in the North; Dragons rely on Water to transform. Water is governed by Zhen Wu. If Zhen Wu does not provide Water, Dragon cannot ascend. Thus, Fu Ling, Bai Zhu, Shao Yao, and Fu Zi in the formula move water, gather Yin, awaken Spleen, and exalt Earth; their merit in these aspects exceeds recovering Yang. Named Zhen Wu Tang, it gathers scattered/separated Yin-Yang, mutually suppressing them in the Northern position of Shao Yin. What it gathers is entirely Water, making Dragon潜 (submerge) and unseen. If even a trace of Water Qi rebels upward, Dragon ascends. Even using only Fu Zi and Gan Jiang to recover Yang, what of incessant soul-sweat? Later, Patriarch Jingyang of Jin used immortal arts to slay flood-dragons, capturing them where they hid, warning families not to store spoonfuls of water, allowing escape from inkstone water. Visible: Water monsters have power of small water raising big waves.若非 (if not) Zhen Wu sitting in the North, heaven and earth would long be dragon-snake nests. Inferring from this: Human Yang roots in Yin. Wang Yang syndrome is True Yang flying away in Shao Yin Kidney. True Yang flying away urgently needs suppression and returning to root. Once Yang returns to root, Yin follows closely. Yin following means Water does not rebel; Yin following means Yang is not solitary, how can it fly away? (Shang Lun Pian)
Huang Lian E Jiao Tang (Coptis and Donkey-Hide Gelatin Decoction)
This is the Xie Xin Tang of Shao Yin. All Xie Xin treatments require Huang Qin and Huang Lian, but guidance differs by Yin-Yang. Disease in Three Yang, Stomach disharmony with epigastric Pi Ying: Deficiency adds Shen and Gan to tonify; Excess adds Da Huang to purge. Disease in Shao Yin, heart irritability preventing sleep: Cannot use Shen/Gan to assist Yang, nor Da Huang to injure Stomach. Use Lian/Qin to straighten-cut Heart Fire; assist with Shao Yao to gather Spirit, thus supporting Yin and suppressing Yang. However, with condition of Dan Yu Mei (desire to sleep) progressing to Bu De Wo (unable to sleep), with micro-fine pulse showing irritability, unless using Qi-Blood substances to intersect Heart-Kidney, and sweet-flat flavors to nourish Yin and harmonize Yang, Water cannot ascend and Fire cannot descend. If Yin-Fire does not return to its department, Shao Yin heat is not removed. Chicken Egg Yolk inherits Li Palace Fire color, enters/connects to Heart, can tonify Heart Blood; using raw and stirring takes the meaning of moistening downward; Donkey-hide gelatin