治寒气冷食稽留胃中。心腹满痛。大便不通者。
姜豆大黄备急丸。(干姜大黄各二两。巴豆一两。去皮研如脂。和蜜丸如豆大。密藏勿
泄气候用。每服三四丸。滚水或酒下。)专攻闭痛及停寒。兼疗中恶人昏倒。阴结垂危得此
安。
柯韵伯曰。大便不通。当分阳结阴结。阳结有承气更衣之剂。阴结又制备急。白散之方。
金匮用此治中恶。当知寒邪卒中者宜之。若用于温暑热邪。速其死矣。是方允为阴结者立。
干姜散中焦寒邪。巴豆逐肠胃冷积。大黄通地道。又能解巴豆毒。是有制之师也。然白散治
寒结在胸。故用桔梗佐巴豆。用吐下两解法。此则治寒结肠胃。故用大黄佐干姜巴豆。以直
攻其寒。世徒知有温补之法。而不知有温下之法。所以但讲虚寒。而不议及寒实也。
即大承气汤(方见真方歌括上卷阳明编。)加甘草二钱。
陈修园曰。仲景三承气汤。尽美尽善。无可加减。刘河间于此方加甘草一味。便逾仲景
矩。然意在调胃。于外科杂症等颇亦相宜。视陶节庵六一顺气汤。更高一格。
又按张宪公云。承者。以卑承尊而无专成之义。天尊地卑。一形气也。形统于气。故地
统于天。形以承气。故地以承天。胃。土也。坤之类也。气。阳也。干之属也。胃为十二经
之长。化糟粕。运精微。转味出入。而成传化之府。岂专以块然之形。亦惟承此干行不息之
气耳。汤名承气。确有取义。非取顺气之义也。宪公此解。超出前人。故余既录于真方歌括
后。而又重录之。愈读愈觉其有味也。惜其所着伤寒类疏。未刊行世。宪公讳孝培。古吴人
也。
Treats the retention of cold pathogenic factors and cold food in the stomach. Leading to fullness and pain in the heart and abdomen, and unrelieved bowel movements.
Jiangdou Dahuang Beiji Wan (Prepared Emergency Pill with Ginger, Bean, and Rhubarb). (Composed of Ganjiang [Dried Ginger], Dahuang [Rhubarb] each 2 liang, Badou [Croton Seed] 1 liang. Remove the skin of Badou, grind into a paste-like consistency, mix with honey to form pills the size of beans. Store tightly sealed to prevent moisture leakage. For use: take 3-4 pills per dose, swallow with boiling water or wine.) Specifically attacks obstruction-pain and retained cold. Also treats sudden collapse due to Zhong'e (Sudden attack by foul pathogens causing coma). When Yin Jie (Yin Constipation caused by cold stagnation) is critical, taking this brings peace.
Ke Yunbo said: Unrelieved bowel movements should be differentiated into Yang Jie (Yang Constipation) and Yin Jie (Yin Constipation). Yang Jie has Chengqi Tang (Cinnamon Twig and Rhubarb Decoction) formulas for purging. Yin Jie prepares Beiji Wan and Baisan (White Powder) formulas. The *Jingui Yaolue* uses this formula to treat Zhong'e; one must know it is suitable for cases where cold pathogens strike suddenly. If used for warm diseases or summerheat heat pathogens, it would hasten death. This formula is indeed established for Yin Jie. Ganjiang disperses cold pathogens in the Middle Jiao (Middle Burner); Badou expels cold accumulations in the intestines and stomach; Dahuang unblocks the "Earthly Path" (intestines) and can also detoxify Badou. It is an army with restraint. However, Baisan treats cold accumulation in the chest, so it uses Jiegeng (Platycodon Root) to assist Badou, employing both vomiting and purging methods to resolve the condition. Here, however, it treats cold accumulation in the intestines and stomach, so it uses Dahuang to assist Ganjiang and Badou to directly attack the cold. People only know of warming and tonifying methods, but do not know of warming and purging methods. Therefore, they only discuss deficiency-cold, but do not discuss cold-excess (Cold Excess Syndrome).
It is Dachengqi Tang (Formula seen in *Zhenfang Geku*, Upper Volume, Yangming Section) plus Gancao [Licorice Root] 2 qian.
Chen Xiuyuan said: Zhang Zhongjing's three Chengqi Tangs are perfect and flawless, with nothing to add or subtract. Liu Hejian added one herb, Gancao, to this formula, thereby exceeding Zhang Zhongjing's rules. However, its intent is to harmonize the Stomach, which is quite suitable for surgical miscellaneous diseases etc. It ranks higher than Tao Jian'an's Liuyi Shunqi Tang (Six-One Smooth Qi Decoction).
Furthermore, according to Zhang Xiangong: "Cheng" means receiving from the humble to the noble without independent achievement. Heaven is noble, Earth is humble; they share one shape and Qi. Shape is governed by Qi, thus Earth governs Heaven. Shape receives Qi, thus Earth receives Heaven. The Stomach belongs to Earth, a category of Kun (Earth Trigram). Qi belongs to Yang, a category of Qian (Heaven Trigram). The Stomach is the head of the twelve meridians, transforming waste, transporting essence, circulating flavors in and out, becoming the Fu organs of transmission and transformation. Is it merely relying on its solid form? It also receives this unceasing, vigorous Qi. The decoction is named Chengqi (Receiving Qi), truly having its meaning, not meaning "smooth Qi". Zhang Xiangong's interpretation surpasses predecessors. Therefore, I have recorded it after *Zhenfang Geku*, and re-recorded it here. The more I read, the more flavor I find. Regrettably, his work *Shanghan Leishu* (Classified Commentary on Cold Damage) was not published. Zhang Xiangong, courtesy name Xiaopei, was a person from Guwu.