治真阴虚弱,胀满呕逆,痰饮恶心,吐泻腹痛,妇人经迟血滞等证。
熟地(三五七钱或一二两) 当归(二三钱或五七钱) 干姜(炒黄色一二三钱) 甘
草(炙一二
发热脉数不
其效如神
其清利也
钱,甚者
宜去姜桂
茯苓一钱
加山药扁
木香砂仁
此理中汤之变方也。凡脾肾中虚等证,宜刚燥者,当用理中六君之类。宜温润者,当用
理阴
身疼
若
汗
治命门火衰,阴中无阳,阴阳将脱等证。
人参(一二两或数钱) 制附子(二三钱) 炮干姜(二三钱) 炙甘草(一钱) 熟
地(五钱或一
加炙黄 四五
虚阳上浮,加
(仲景) 治三阴伤寒。(四逆汤为少阴主药,然三阴通用之。太阳证脉沉,亦有用此
者。)身痛腹痛,下利清谷,(三阴里寒,自利居多。)恶寒不渴,四肢厥冷。(治四肢厥逆,
故名四逆汤。四肢者,诸阳之本。寒则血脉凝涩,阳气不能敷布,故一身尽痛,而手足厥冷
也。)或反不恶寒,面赤烦躁。(阴盛格阳于外。)里寒外热。或干呕,(膈有寒饮,)或咽痛
,(虚火上炎。)脉沉微细欲绝。(少阴脉有沉有紧有数,而仲景统以微细言之。盖沉必重按
始得,紧数亦在沉细中见,不似阳证浮大而紧敷也。薛慎齐曰∶人知数为热,不知沉细中见
数为寒甚,真阴寒证。脉营有七八至者,但按之无力尔,宜深察之。)
附子(一枚生用) 干姜(一两) 甘草(炙二两) 冷服 面赤者,格阳于上也,加
葱九茎以通
至亡阳。不
阴。咽痛,
加生姜二
寒淫于内,治以甘热。故以姜附大热之剂,伸发阳气,表散寒邪。(附子生用,亦能发
表。)
冷服者
(此制
身痛者
急则
者,
承气
厥。
厥,
相顺
加人参一两,名四逆加人参汤。治恶寒,脉微,复利,利止亡血。(利虽止而津液已竭,
故
两
下后发热人必实。)除附子,用甘草四两,干姜二两,名甘草干姜汤。治伤寒脉浮自汗,小
便数,微恶寒,脚挛急。用桂枝汤误攻其表,得之便厥,咽中干,烦躁吐逆,与此汤以复其
阳。(脉浮自汗,便数恶寒,阳不足也。攻表重虚其阳,得之便厥。故与甘草益气,干姜助
阳
复其
阳
寒
仲
治阴盛格阳。加官桂良姜半夏,名浆水散。(洁古)治虚寒水泻,冷汗脉微,甚者呕吐,此
为
[Liyin Decoction] Treats conditions of deficiency and weakness of True Yin, manifesting as abdominal distension and fullness, vomiting and regurgitation, phlegm-fluid retention with nausea, vomiting and diarrhea with abdominal pain, as well as delayed menstruation and blood stasis in women.
Prepared Rehmanniae Radix (Shu Di Huang) (3-7 qian or 1-2 liang)
Angelicae Sinensis Radix (Dang Gui) (2-3 qian or 5-7 qian)
Zingiberis Rhizoma Preparatum (Gan Jiang) (Stir-fried until yellow, 1-3 qian)
Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gan Cao) (1-2 qian; if severe, remove Ginger and Cinnamon Twig)
Poria (Fu Ling) (1 qian)
Add Dioscoreae Rhizoma (Shan Yao), Puerariae Radix (Bian Dou), Aucklandiae Radix (Mu Xiang), Amomi Fructus (Sha Ren).
This is a modified formula of Lizhong Decoction. For conditions of deficiency-cold in the Spleen and Kidney where pungent-drying herbs are indicated, formulas such as Lizhong Decoction or Liujunzi Decoction should be used. Where moist-warm herbs are indicated, Lyin Decoction should be used.
Body pain... If sweating occurs... Its efficacy is like magic. Its clearing and draining action...
[Liuwei Huiyang Yin / Six-Ingredient Decoction to Return Yang] Treats conditions of decline of Mingmen Fire, absence of Yang within Yin, and impending collapse of Yin and Yang.
Ginseng Radix et Rhizoma (Ren Shen) (1-2 liang or several qian)
Aconiti Lateralis Radix Preparata (Zhi Fu Zi) (2-3 qian)
Zingiberis Rhizoma Preparatum (Pao Gan Jiang) (2-3 qian)
Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gan Cao) (1 qian)
Prepared Rehmanniae Radix (Shu Di Huang) (5 qian or 1 liang).
Add Astragali Radix Praeparata with Honey (Zhi Huang Qi) (4-5 qian).
Floating deficient Yang, add...
[Sini Tang / Four Reversal Decoction] (From Zhang Zhongjing) Treats Taiyin, Shaoyin, and Jueyin cold damage (San Yin Shang Han). (Sini Tang is the principal formula for Shaoyin disease, but it is generally applicable to all three Yin meridians. In Taiyang syndrome, if the pulse is deep, this formula may also be used.)
Symptoms include: body pain, abdominal pain, diarrhea with undigested food (In San Yin interior cold, spontaneous diarrhea is common), aversion to cold without thirst, and cold limbs. (It is named Sini Tang because it treats reversal cold of the limbs. The limbs are the root of all Yang meridians. Cold causes blood vessels to coagulate and stagnate, and Yang Qi cannot distribute, resulting in whole-body pain and cold hands and feet.) Alternatively, there may be no aversion to cold, red face, and restlessness (Yin excess repels Yang to the exterior), presenting as interior cold with exterior heat. There may be dry retching (Cold fluid in the diaphragm), or sore throat (Deficient fire flaming upward), and a pulse that is deep, faint, thin, and nearly imperceptible. (Shaoyin pulses can be deep, tight, or rapid, but Zhang Zhongjing generalizes them as faint and thin. A deep pulse must be pressed heavily to be felt; tightness and rapidity are seen within the deep and thin quality, unlike Yang syndromes which are floating, large, tight, and forceful. Xue Zhenqi said: People know rapidity indicates heat, but do not know that rapidity seen within a deep and thin pulse indicates extreme cold, a true Yin-cold syndrome. If the Ying Qi pulse beats seven or eight times per breath, but feels powerless upon pressure, one must examine this deeply.)
Ingredients: Aconiti Radix (Fu Zi) (One piece, raw use)
Zingiberis Rhizoma (Gan Jiang) (1 liang)
Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gan Cao) (2 liang, honey-fried).
Take cold. For red face, Yang is repelled upward; add nine stalks of Scallion Stem (Cong Bai) to unblock Yang.
(This preparation...)
When Cold pathogen invades the interior, treat with sweet-hot methods. Therefore, use large hot agents like Ginger and Aconite to extend and emit Yang Qi and disperse Cold pathogen from the exterior. (Raw Aconite can also release the exterior.)
Reason for taking cold...
For body pain... In acute cases... Chengqi Decoction... Reversal cold... Reversal and smooth flow correspond...
Add Ginseng Radix et Rhizoma (Ren Shen) 1 liang, named Sini Tang plus Ginseng Decoction. Treats aversion to cold, faint pulse, recurrent diarrhea, and cessation of diarrhea due to exhaustion of fluids/blood. (Although diarrhea has stopped, fluids and essence have been exhausted, therefore...)
Remove Aconite, use Glycyrrhizae Radix et Rhizoma (Gan Cao) 4 liang and Zingiberis Rhizoma (Gan Jiang) 2 liang, named Gancao Ganjiang Tang / Licorice and Ginger Decoction. Treats cold damage with floating pulse, spontaneous sweating, frequent urination, slight aversion to cold, and cramped legs. Due to mistaken attack on the exterior with Guizhi Tang, reversal cold occurred, with dry throat, restlessness, vomiting, and regurgitation; give this decoction to restore Yang. (Floating pulse, spontaneous sweating, frequent urination, and aversion to cold indicate insufficient Yang. Attacking the exterior further depleted Yang, leading to reversal cold. Therefore, use Licorice to benefit Qi and Ginger to assist Yang to restore Yang.)
Cold pathogen...
Zhang Zhongjing treats Yin excess repelling Yang. Add Cassia Twig (Guan Gui), Alpiniae Officinarum Rhizome (Liang Jiang), Pinelliae Tuber (Ban Xia), named Jiangshui San / Fermented Grain Water Powder. (Li Dongyuan/Jiegu) Treats deficiency-cold watery diarrhea, cold sweat, faint pulse, and severe vomiting; this is...