小青龙汤方第二十九
[方义]
此辛温解表兼祛水饮之方。
[主治]
太阳病，无汗，咳嗽，吐痰，气喘，不得卧，身肿等。但必须没有口渴、喜冷饮的内热现象。
[药品]
麻黄一至二钱 生杭芍一至二钱 细辛五分至一钱 桂枝一至二钱 干姜五分至一一钱 炙草一钱至钱半 五味子五分至一钱 半夏一至二钱
[加减法]
(1)渴者，去半夏加瓜蒌根一至二钱，因半夏性燥，故以清热生津之蒌根代之，或仿《金匮要略》加生石膏一至二钱。
(2)利者，去麻黄，加茯苓一钱半至二钱。原系加荛花，太原本地无此药。因利为里证，不宜发表，宜利水，故加茯苓。
(3)噎者，去麻黄，加附子一钱至钱半。噎是痰涎水气阻碍食道或胃脘之间，饮食不得下行之证，不宜麻黄解表，而宜附子温里，因痰涎水气得温方可散也。
(4)小便不利，小腹胀满者，去麻黄，加茯苓钱半至二钱。
(5)喘者，加杏仁(原方去麻黄，根据实践经验，麻黄治喘有效，不必去掉)。
[煎服法]
水二茶杯半，煎至多半茶杯，去滓温服。
[用药大意]
麻桂二方以散表寒．细辛、五味以止咳嗽，干姜、半夏以除痰饮水气。(根据实践，生姜、杏仁不可去掉。)
[禁忌证]
无表证者忌之，有口渴喜冷饮者也忌之。
[类似方剂参考]
(1)香苏散：此治外感风寒咳嗽之通用方。
(2)银翘散、桑菊饮：此二方是治外感风热咳嗽之方．
(3)小青龙加石膏汤：此治本证兼有热证之方。
(4)从龙汤：此治服本汤后其病未愈或愈而复发之方。
小建中汤方第三十
[方义]
此温中补虚、缓急止痛之方。
[主治]
腹痛喜按，或心悸心烦。但必须是不喜冷性饮食，脉虚弱者。
按：此方补而不滞，治虚而兼寒之胃下垂、大便不利、腹胀，不适用参、芪补剂者用之最效。
[药品]
桂枝一钱半至三钱 炙草一至二钱 生姜钱半至二钱生杭芍三至六钱 大枣二至四枚 饴糖二至四钱
[煎服法]
水三茶杯，煎至一茶杯，去滓，人饴糖再煎至半茶杯，温服。
[用药大意]
桂枝、芍药温通血脉，饴糖、大枣、生姜、炙草补中散寒，故治虚而兼寒之种种疾病。
[禁忌证]
呕家不可服，甘能动呕也。喜冷者不可服，热证不宜用温性方药也。腹痛拒按者不可服，实证不宜用补性方药也。
[类似方剂参考]
(1)桂枝加芍药汤：此是治寒性腹痛之方。
(2)桂枝甘草汤：此是治心阳虚心悸之方。
(3)内补当归建中汤：此是治产后虚羸不足，腹中绞痛不止之方。
小柴胡汤方第三十一
[方义]
此和解少阳半表半里，散风清火，降逆止呕，补正祛邪，治少阳虚证之方，也系少阳病之主方。
[主治]
少阳病，寒热往来，胸胁苦满，心烦喜呕，头晕目眩，或头角痛，口苦，咽干，苔白，耳聋，溺赤，脉浮弦而细。
[药品]
柴胡二钱半至四钱 黄芩钱半至二钱半 人参一钱至一钱半 炙草五分至一钱 生姜二至三片 半夏二至三钱 大枣二至四枚
[加减法]
(1)胸中烦而不呕者，去人参、半夏，加瓜蒌实。烦是热证，不宜人参大补，恐助热也；半夏止呕，今不呕，故去之；瓜蒌实能通胸中之热，故加之。
(2)渴者，去半夏，加人参、瓜蒌根．渴者，津液不足也，半夏性燥伤津，故去之；人参、蒌根生津，清热止渴，故加之。
(3)腹中痛者，去黄芩，加芍药。腹痛是寒邪郁滞不通的证候，故去黄芩之寒，加芍药以通血痹，通则不痛也。
(4)胁下痞坚者，去大枣，加牡蛎。去大枣者，恶其甘以助满也；加牡蛎者，取其咸以软坚也。
(5)心下悸，小便不利者，去黄芩，加茯苓。心悸、小便不利者，是阳气虚，水气停宿也。黄芩性寒，恐伤阳气，故去之；茯苓利水，故加之。
(6)不渴，外有微热者，去人参，加桂枝。不渴是津液尚足，故不须人参之生津；外有微热是兼太阳之表邪，故须加桂枝之解肌。
(7)咳者，去人参、大枣、生姜，加干姜、五味子。咳是寒邪与水饮伤肺，肺气上逆之证，故去参枣之补，生姜之散；加干姜温肺寒，以化水饮，加五味敛肺气，以止咳逆。
[煎服法]
水二茶杯半，煎至半茶杯，去渣温服。
[用药大意]
柴胡是和解少阳半表半里之主药，对于寒热往来、胸胁满、头眩痛等症最为相宜；黄芩泻火以治口苦；半夏、生姜降逆止呕；参、草、枣补胃气之虚，并调和诸药。
[禁忌证]
少阳实证，胸下及腹拒按，大便燥者，忌之；伏暑、湿温所见之胸痛寒热如疟，及太阳病寒热如疟等证，均忌之。
[类似方剂参考]
大柴胡汤：此治少阳兼阳明实证之方。
柴胡桂枝干姜汤方第三十二
[方义]
此是小柴胡汤加减之方，也是和解方中寒热并用之剂。
[主治]
太阳病误用汗下后，形成小柴胡证的兼证，其症寒热往来，胸胁满结，口渴，心烦，但头汗出，小便不利。必须具有大便溏，或口苦，太阳证未尽，或脉浮有力等。
[药品]
柴胡一至三钱 桂枝一至二钱 干姜一至二钱 炙草一钱 牡蛎一至三钱 瓜蒌根钱半至三钱 黄芩钱半至二钱
[煎服法]
水三茶杯，煎至多半茶杯，去滓温服。
按：此方初服微烦，因药力未及，且用桂、姜散阳郁之寒，散寒必先助火，虽有黄芩以减其热，但仍难免出现心阳火郁之心微烦之症。再服桂、姜，辛温之性已升达，而火郁外发，故汗出便愈。
[用药大意]
往来寒热、胸胁满是小柴胡汤的主症，故用小柴胡汤加减治之。渴而不呕，故去半夏加瓜蒌根；胁下满结，故去火枣，加牡蛎；心烦是内热的表现，故用黄芩以清之；下后大便不正常，故加干姜以温之；因太阳证未尽，或但头汗出，或外有微热，或身有痛处，或脉浮有力，故去人参，加桂枝以调和营卫。
[禁忌证]
没有大便溏，不得用干姜；没有寒多热少或但寒不热，不得用桂枝；没有脉浮无力，不得用人参。
[类似方剂参考]
(1)小柴胡汤的加减法：此是本方用药的依据。
(2)栀子干姜汤：此是本方使用干姜的标准。
(3)金匮柴胡桂姜汤：即本方之异名，治疟寒多微有热，或但寒不热．此是本方使用桂枝的标准．
柴胡桂枝汤方第三十三
[方义]
此和解少阳、调和营卫之方。
[主治]
发热恶寒，骨节疼痛(桂枝证)，呕吐，胸胁满闷，口苦(柴胡证)，脉较弱。
[药品]
柴胡钱半至三钱 黄芩钱半至二钱 人参一钱至钱半半夏钱半至二钱 炙草一钱至钱半 桂枝一至二钱 芍药钱半至二钱 生姜一至二钱 大枣二至四枚
[煎服法]
水二茶杯半，煎至半茶杯，去滓温服。
[用药大意]
此合桂枝、柴胡二方，而各取其半，用以和解太阳少阳各半之邪。
整理者按：《千金翼方)卷九本方的方论“本云人参汤，作如桂枝法，加柴胡、黄芩，复如柴胡法，今用人参作半剂”亦足资参考。
[禁忌证]
脉有力者不可使用，因方内有人参之补，恐犯实实之戒。
[类似方剂参考]
(1)人参败毒散：此补正祛邪之方，但散邪药较多。
(2)桂枝人参汤：此祛邪补正之方，但温补之药较多。
(3)柴葛解肌汤：此治三阳合病之方。
柴胡加龙骨牡蛎汤方第三十四
[方义]
此散邪安神，泻火祛痰，兼扶正之剂，乃救误中较为复杂之方。
[主治]
伤寒误下后神识失常，烦惊，谵语，胸满身重，小便不利等。但必须兼有寒热往来或发热恶寒等太少两阳的表证现象。及大便不利、口苦、吐痰、脉虚等虚实错杂现象。
[药品]
柴胡一至三钱 黄芩一至二钱 生姜一钱至二钱半 龙骨一至三钱 人参五分至一钱 桂枝一至二钱 牡蛎一至三钱 铅丹五分至一钱 茯苓二至三钱 半夏一至二钱 大枣二至四枚 大黄一至二钱
[煎服法]
水三茶杯，煎至半茶杯，去滓温服。煎时大黄可在煎至水去一半时加入。
[用药大意]
柴胡、桂枝、生姜以散邪；人参、大枣以扶正；龙骨、牡蛎、铅丹、半夏以安神祛痰；黄芩、大黄以泻火通便；茯苓利水以祛湿。
[禁忌证]
单纯精神失常，或脉不虚，或大小便通利者，均忌之。
[类似方剂参考]
(1)小柴胡汤：此柴、芩、半夏和人参同用治少阳虚证之方。
(2)大柴胡汤：此柴、芩、半夏和大黄同用治少阳兼阳明实证之方。
(3)桂枝甘草龙骨牡蛎汤：此桂枝和龙、牡同用，治心阳虚，镇心安神之方。
大柴胡汤方第三十五
[方义]
此和解少阳，兼泻阳明实热，表里两解之方。
[主治]
少阳病，寒热往来，胸胁苦满，呕吐，口苦(少阳表证)，心下或腹部拒按，及大便不利(阳明里证)等。但舌苔必黄白相兼，脉象必浮沉有力。
[药品]
柴胡二至四钱 黄芩钱半至二钱半 生杭芍钱半至二钱半 半夏钱半至三钱 生姜二至三钱 枳实钱半至二钱半大枣二至四枚 大黄一至二钱
[加减法]
(1)大便利者去大黄，恐攻下太过也。
(2)舌苔黄燥或舌质红赤，内热太甚者，宜去半夏，酌加石膏、生地、芍药。
[煎服法]
水三杯，煎至半茶杯，去滓温服。
[用药大意]
柴胡、半夏、黄芩、生姜以解少阳之表；芍药、大黄、枳实以泻阳明之里；大枣之甘以保护胃气。
[禁忌证]
单纯少阳半表半里证，不兼阳明实证者，不可用；单纯阳明实证，不兼少阳半表半里证者，也不可用。因奉方兼有两方面之作用故也。
[类似方剂参考]
(1)小柴胡汤：此治少阳虚证，和解之方。
(2)柴胡加芒硝汤：此治少阳虚证兼阳明燥热之方。
柴胡加芒硝汤方第三十六
[方义]
此治少阳虚证兼阳明实证，救误之方。
[主治]
少阳病，寒热往来，口苦，胸胁满，呕吐，日晡潮热，因误下后大便微利，但必须腹有拒按。
按：此证腹部不拒按者，也可先用小柴胡汤，因小柴胡汤也有治疗潮热的作用。若小柴胡力有未胜，则适用本方为是。
[药品]
柴胡二至三钱 黄芩一至二钱 人参五分至一钱 炙草一钱 生姜一至二钱 半夏二至三钱 大枣二至四枚 芒硝钱半至三钱
[煎服法]
水三茶杯，煎减半，去滓，人芒硝，再煎至半茶杯，温服。
[用药大意]
小柴胡汤和解少阳，芒硝治阳明之潮热。
[禁忌证]
(1)少阳病兼潮热下利，如腹不拒按者，不可用。
(2)腹拒按，潮热下利，如没有少阳虚证也不可用。
[类似方剂参考]
(1)大柴胡汤：此治少阳兼阳明实证之方。
(2)小柴胡汤：此治少阳虚证之方。
茯苓桂枝甘草大枣汤方第三十七
[方义]
此利水补阳，散寒健中，预防奔豚证之方。
[主治]
发汗后，阳气被伤，寒水初动，脐下悸欲作奔豚。但必须兼有小便不利、不喜冷性饮食、脉沉而迟等寒证和水证现象。
[药品]
茯苓三至五钱 桂枝二二至二钱 甘草一钱至钱半 大枣二至四枚
[煎服法]
水二茶杯半，煎至半茶杯，去滓温服。
[用药大意]
茯苓淡渗利水，桂枝补阳散寒，甘草、大枣补中以防寒水上泛。
[禁忌证]
兼口苦喜冷者忌之，恐兼有热证也。
[类似方剂参考]
桂枝加桂汤：此为治寒证奔豚但不兼水气之方。
茯苓桂枝白术甘草汤方第三十八
[方义]
此补心阳、散寒邪、降逆气、补脾利水之方。
[主治]
(1)伤寒误用吐下药，心阳被伤，水气凌心，心下逆满，气上冲胸，起则头眩，脉沉紧。
(2)水饮短气。
(3)心下支饮，胸胁满，目眩。
以上三证都必须具有小便不利或小便不多、不喜冷性饮食、脉沉紧或沉迟等现象。因为这都是心阳虚而有寒，水邪停蓄不化之故。
[药品]
茯苓三至四钱 桂枝二至三钱 生白术二至三钱 炙甘草一至二钱
[煎服法]
水三茶杯，煎至多半茶杯，去滓温服。
[用药大意]
茯苓利水；白术、甘草补脾，并助水邪之吸收；桂枝温散寒邪，兼降水邪之上逆。
[禁忌证]
凡有口苦、喜冷性饮食等热证者忌之。
[类似方剂参考]
(1)真武汤：此回阳镇水之方。
(2)茯苓四逆汤：此回阳治水兼补气之方。
(3)肾气丸：此系治气短但偏于补肾阳之方。
茯苓甘草汤方第三十九
[方义]
散寒利水。此方治证较五苓散证寒证较重而水证较轻。
[主治]
外感寒邪，心阳被伤，水邪不化，留于心下致心悸，小便不利，或汗出口不渴。但必须具有不喜冷性饮食，或兼发热恶风寒的表寒现象。
[药品]
茯苓二至五钱 炙甘草一至二钱 桂枝二至三钱 生姜一至三钱
[煎服法]
水二茶杯，煎至半茶杯，去滓温服。
[用药大意]
茯苓制水，桂、甘、生姜解表散寒。
[禁忌证]
小便利者，喜冷性饮食者，无表寒证现象者，均不可用。
[类似方剂参考]
(1)五苓散：此散寒利水，治水证较重之方。
(2)茯苓四逆汤：此回阳利水兼补气之方。
(3)真武汤：此回阳利水兼理脾和肝之方。
五苓散方第四十
[方义]
此化气利水、温经散寒、表里双解之方。
按：此证较茯苓甘草汤证水证较重寒证较轻。
[主治]
(I)蓄水证：小便不利，烦渴，汗出，微热，脉浮数。
(2)水逆证：渴欲饮水，水入则吐者。
但都必须具有不喜冷性饮食、舌不黄燥及表寒现象。
Xiao Qing Long Tang (Minor Blue Dragon Decoction), Formula No. 29
[Formula Rationale]
This is a formula that releases the exterior with acrid-warm herbs and expels fluid retention simultaneously.
[Indications]
Taiyang disease (disease pattern resulting from pathogenic invasion of the Taiyang channel), anhidrosis, cough, expectoration, asthma, inability to lie flat, and bodily edema. However, there must be no internal heat signs such as thirst or preference for cold drinks.
[Ingredients]
Ephedrae Herba (Mahuang, 麻黄) 1-2 qian; Raw Paeoniae Radix Alba (Sheng Hangshao, 生杭芍) 1-2 qian; Asari Radix et Rhizoma (Xixin, 细辛) 0.5-1 qian; Cinnamon Twig (Guizhi, 桂枝) 1-2 qian; Dried Ginger (Ganjiang, 干姜) 0.5-1 qian; Honey-fried Licorice Root (Zhi Cao, 炙草) 1-1.5 qian; Schisandrae Fructus (Wuweizi, 五味子) 0.5-1 qian; Pinelliae Tuber (Banxia, 半夏) 1-2 qian.
[Modifications]
(1) For thirst: Remove Banxia, add Tetrastigomatis Radix (Gualougen, 瓜蒌根) 1-2 qian. Since Banxia is drying in nature, it is replaced by Gualougen which clears heat and generates fluids. Alternatively, follow the method in *Jin Gui Yao Lue* by adding Raw Gypsum (Sheng Shigao, 生石膏) 1-2 qian.
(2) For diarrhea: Remove Mahuang, add Poria (Fuling, 茯苓) 1.5-2 qian. The original formula used Aconitum Caraganifolium (Raohua, 荛花), but this herb is unavailable locally in Taiyuan. Since diarrhea is a interior syndrome, exterior-releasing methods are inappropriate; diuresis is preferred, hence Fuling is added.
(3) For choking sensation: Remove Mahuang, add Aconiti Lateralis Radix Praeparata (Fuzi, 附子) 1-1.5 qian. Choking refers to phlegm-fluid obstructing the esophagus or epigastrium, preventing food and drink from descending. Exterior-releasing with Mahuang is unsuitable; warming the interior with Fuzi is appropriate because phlegm-fluid disperses when warmed.
(4) For difficult urination and lower abdominal fullness: Remove Mahuang, add Fuling 1.5-2 qian.
(5) For wheezing: Add Armeniacae Semen Amarum (Xingren, 杏仁). (The original formula removes Mahuang; based on clinical experience, Mahuang is effective for wheezing and need not be removed.)
[Decoction and Administration]
Add water equivalent to two and a half teacups. Boil until slightly more than one teacup remains. Strain and take warm.
[General Principles of Medication]
Mahuang and Guizhi disperse exterior cold; Xixin and Wuweizi stop cough; Ganjiang and Banxia eliminate phlegm-fluid. (Based on practice, Shengjiang and Xingren should not be omitted.)
[Contraindications]
Contraindicated in cases without exterior syndrome, and in those with thirst and preference for cold drinks.
[Reference for Similar Formulas]
(1) Xiang Su San: A general formula for cough due to external wind-cold.
(2) Yin Qiao San and Sang Ju Yin: These formulas treat cough due to external wind-heat.
(3) Xiao Qing Long Jia Shi Gao Tang: Treats the above condition complicated by heat.
(4) Cong Long Tang: Treats recurrence or persistence of symptoms after taking the main formula.
Xiao Jian Zhong Tang (Minor Construct the Middle Decoction), Formula No. 30
[Formula Rationale]
This is a formula that warms the middle, tonifies deficiency, relieves urgency, and stops pain.
[Indications]
Abdominal pain relieved by pressure, palpitations, and irritability. It must be accompanied by aversion to cold foods and a weak pulse.
Note: This formula tonifies without causing stagnation. It is most effective for gastric ptosis, constipation, and abdominal distension due to deficiency-cold, especially in patients unsuitable for tonics like Ginseng and Astragalus.
[Ingredients]
Cinnamon Twig (Guizhi, 桂枝) 1.5-3 qian; Honey-fried Licorice Root (Zhi Cao, 炙草) 1-2 qian; Fresh Ginger (Shengjiang, 生姜) 1.5-2 qian; Raw Paeoniae Radix Alba (Sheng Hangshao, 生杭芍) 3-6 qian; Jujube (Dazao, 大枣) 2-4 pieces; Malt Sugar (Yitang, 饴糖) 2-4 qian.
[Decoction and Administration]
Add water equivalent to three teacups. Boil until one teacup remains. Strain, add Yitang, boil again until half a teacup remains. Take warm.
[General Principles of Medication]
Guizhi and Shaoyao warm and unblock the vessels; Yitang, Dazao, Shengjiang, and Zhi Cao warm the middle and dispel cold, thus treating various diseases of deficiency combined with cold.
[Contraindications]
Contraindicated in vomiting patients, as sweet substances may induce vomiting. Contraindicated in those preferring cold, as heat syndromes do not suit warm formulas. Contraindicated in abdominal pain with rejection to pressure, as excess syndromes do not suit tonifying formulas.
[Reference for Similar Formulas]
(1) Guizhi Jia Shaoyao Tang: Treats cold-type abdominal pain.
(2) Guizhi Gancao Tang: Treats palpitations due to Heart Yang deficiency.
(3) Neibu Danggui Jianzhong Tang: Treats postpartum emaciation and persistent colic.
Xiao Chai Hu Tang (Minor Bupleurum Decoction), Formula No. 31
[Formula Rationale]
This is the principal formula for Shaoyang disease. It harmonizes the Shaoyang half-exterior/half-interior, dissipates wind and clears fire, directs rebellious Qi downward to stop vomiting, tonifies healthy Qi to expel pathogens, and treats Shaoyang deficiency patterns.
[Indications]
Shaoyang disease: alternating chills and fever, chest and hypochondriac fullness and distress, irritability with a tendency to vomit, dizziness and blurred vision, or temporal headache, bitter taste in the mouth, dry throat, white coating, deafness, dark urine, and a floating, wiry, and thin pulse.
[Ingredients]
Bupleuri Radix (Chaihu, 柴胡) 2.5-4 qian; Scutellariae Radix (Huangqin, 黄芩) 1.5-2.5 qian; Ginseng Radix (Renshen, 人参) 1-1.5 qian; Honey-fried Licorice Root (Zhi Cao, 炙草) 0.5-1 qian; Fresh Ginger (Shengjiang, 生姜) 2-3 slices; Pinelliae Tuber (Banxia, 半夏) 2-3 qian; Jujube (Dazao, 大枣) 2-4 pieces.
[Modifications]
(1) For chest irritability without vomiting: Remove Renshen and Banxia, add Trichosanthis Fructus (Gualoushi, 瓜蒌实). Irritability indicates heat; large-tonifying Renshen is contraindicated as it may aggravate heat. Banxia stops vomiting, so remove it if vomiting is absent. Gualoushi clears heat in the chest, so add it.
(2) For thirst: Remove Banxia, add Renshen and Tetrastigomatis Radix (Gualougen, 瓜蒌根). Thirst indicates fluid insufficiency. Banxia is drying and damages fluids, so remove it. Renshen and Gualougen generate fluids, clear heat, and stop thirst, so add them.
(3) For abdominal pain: Remove Huangqin, add Shaoyao. Abdominal pain indicates stagnation of cold pathogen. Remove the cold-natured Huangqin; add Shaoyao to unblock blood stasis. Unblocking leads to cessation of pain.
(4) For hardness/fullness under the ribs: Remove Dazao, add Ostreae Concha (Muli, 牡蛎). Remove Dazao to avoid its sweetness aggravating fullness; add Muli for its salty nature to soften hardness.
(5) For palpitations and difficult urination: Remove Huangqin, add Poria (Fuling, 茯苓). Palpitations and difficult urination indicate Yang deficiency with fluid retention. Huangqin is cold and may damage Yang, so remove it. Fuling promotes urination, so add it.
(6) For no thirst with slight exterior heat: Remove Renshen, add Guizhi. No thirst indicates sufficient fluids, so Renshen for generating fluids is unnecessary. Slight exterior heat indicates concurrent Taiyang exterior pathogen, so add Guizhi to release the muscle layer.
(7) For cough: Remove Renshen, Dazao, and Shengjiang; add Ganjiang and Wuweizi. Cough indicates Lung injury by cold and fluid, with rebellious Lung Qi. Remove the tonifying Renshen/Dazao and dispersing Shengjiang. Add Ganjiang to warm Lung cold and transform fluid; add Wuweizi to astringe Lung Qi and stop cough.
[Decoction and Administration]
Add water equivalent to two and a half teacups. Boil until half a teacup remains. Strain and take warm.
[General Principles of Medication]
Chaihu is the chief herb for harmonizing Shaoyang half-exterior/half-interior, suitable for alternating chills/fever, chest/hypochondriac fullness, and dizziness/headache. Huangqin clears fire to treat bitter taste. Banxia and Shengjiang direct rebellious Qi downward to stop vomiting. Renshen, Caoshu, and Dazao tonify Stomach Qi deficiency and harmonize the herbs.
[Contraindications]
Contraindicated in Shaoyang excess patterns with rejection to pressure below the chest/abdomen and dry stool. Contraindicated in summerheat latent, damp-warmth with chest pain/chills-fever resembling malaria, and Taiyang disease with chills-fever resembling malaria.
[Reference for Similar Formulas]
Da Chai Hu Tang: Treats Shaoyang combined with Yangming excess.
Chaihu Guizhi Ganjiang Tang (Bupleurum, Cinnamon Twig, and Dried Ginger Decoction), Formula No. 32
[Formula Rationale]
This is a modification of Xiao Chai Hu Tang, a harmonizing formula using both cold and warm herbs.
[Indications]
Complications arising from incorrect sweating/purging in Taiyang disease, forming a combination of Xiao Chai Hu patterns: alternating chills and fever, chest/hypochondriac fullness/knotting, thirst, irritability, only sweating on the head, and difficult urination. Must have loose stools, or bitter taste, incomplete resolution of Taiyang signs, or a floating and forceful pulse.
[Ingredients]
Bupleuri Radix (Chaihu, 柴胡) 1-3 qian; Cinnamon Twig (Guizhi, 桂枝) 1-2 qian; Dried Ginger (Ganjiang, 干姜) 1-2 qian; Honey-fried Licorice Root (Zhi Cao, 炙草) 1 qian; Ostreae Concha (Muli, 牡蛎) 1-3 qian; Tetrastigomatis Radix (Gualougen, 瓜蒌根) 1.5-3 qian; Scutellariae Radix (Huangqin, 黄芩) 1.5-2 qian.
[Decoction and Administration]
Add water equivalent to three teacups. Boil until slightly more than one teacup remains. Strain and take warm.
Note: Initial intake may cause slight irritability due to insufficient drug potency and the use of Guizhi/Ganjiang to disperse Yang-constrained cold. Dispersing cold requires assisting Fire; although Huangqin reduces heat, slight Heart Yang/Fire constraint irritability may occur. Subsequent doses allow the acrid-warm nature to rise, releasing constrained Fire via sweating, leading to recovery.
[General Principles of Medication]
Alternating chills/fever and chest/hypochondriac fullness are chief symptoms of Xiao Chai Hu Tang, so modifications are used. Thirst without vomiting leads to removing Banxia and adding Gualougen. Hypochondriac fullness/knotting leads to removing Dazao and adding Muli. Irritability indicates internal heat, so Huangqin clears it. Post-purging abnormal bowels lead to adding Ganjiang to warm. Incomplete Taiyang resolution, head-only sweat, slight exterior heat, body pain, or floating forceful pulse lead to removing Renshen and adding Guizhi to harmonize Ying and Wei.
[Contraindications]
Do not use Ganjiang without loose stools. Do not use Guizhi without more chills than fever or only chills without fever. Do not use Renshen without a floating and weak pulse.
[Reference for Similar Formulas]
(1) Modifications of Xiao Chai Hu Tang: Basis for medication in this formula.
(2) Zhizi Ganjiang Tang: Standard for using Ganjiang in this formula.
(3) Jin Gui Chaihu Guijiang Tang: Alternative name for this formula, treating malaria with more chills/slight fever or only chills. Standard for using Guizhi in this formula.
Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction), Formula No. 33
[Formula Rationale]
This formula harmonizes Shaoyang and harmonizes Ying and Wei.
[Indications]
Fever with aversion to cold, bone/joint pain (Guizhi pattern), vomiting, chest/hypochondriac fullness/distress, bitter taste (Chaihu pattern), and relatively weak pulse.
[Ingredients]
Bupleuri Radix (Chaihu, 柴胡) 1.5-3 qian; Scutellariae Radix (Huangqin, 黄芩) 1.5-2 qian; Ginseng Radix (Renshen, 人参) 1-1.5 qian; Pinelliae Tuber (Banxia, 半夏) 1.5-2 qian; Honey-fried Licorice Root (Zhi Cao, 炙草) 1-1.5 qian; Cinnamon Twig (Guizhi, 桂枝) 1-2 qian; Paeoniae Radix (Shaoyao, 芍药) 1.5-2 qian; Fresh Ginger (Shengjiang, 生姜) 1-2 qian; Jujube (Dazao, 大枣) 2-4 pieces.
[Decoction and Administration]
Add water equivalent to two and a half teacups. Boil until half a teacup remains. Strain and take warm.
[General Principles of Medication]
Combines half of Guizhi Tang and half of Chaihu Tang to harmonize pathogens shared by Taiyang and Shaoyang.
Editor's Note: *Qianjin Yifang* Vol. 9 states: "Originally Ren Shen Tang, prepared like Guizhi method, add Chaihu/Huangqin, then prepare like Chaihu method, now use half dose of Renshen." This is also worth referencing.
[Contraindications]
Contraindicated if the pulse is forceful, as the tonifying Renshen may violate the prohibition against tonifying excess.
[Reference for Similar Formulas]
(1) Renshen Baidu San: Tonifies healthy Qi and expels pathogens, but contains more dispersing herbs.
(2) Guizhi Renshen Tang: Expels pathogens and tonifies healthy Qi, but contains more warming/tonifying herbs.
(3) Chaige Jieji Tang: Treats simultaneous involvement of the Three Yang channels.
Chaihu Jia Longgu Muli Tang (Bupleurum plus Dragon Bone and Oyster Shell Decoction), Formula No. 34
[Formula Rationale]
A complex formula for correcting errors, which expels pathogens, calms the Spirit, clears fire, resolves phlegm, and supports healthy Qi.
[Indications]
After incorrect purging in Shanghan: mental confusion, irritability/fright, delirium, chest fullness, heaviness of the body, difficult urination, etc. Must accompany alternating chills/fever or fever/aversion to cold (exterior signs of Taiyang/Shaoyang). Also includes mixed excess/deficiency signs like difficult bowel movements, bitter taste, expectoration, and deficient pulse.
[Ingredients]
Bupleuri Radix (Chaihu, 柴胡) 1-3 qian; Scutellariae Radix (Huangqin, 黄芩) 1-2 qian; Fresh Ginger (Shengjiang, 生姜) 1-2.5 qian; Dragon Bone (Longgu, 龙骨) 1-3 qian; Ginseng Radix (Renshen, 人参) 0.5-1 qian; Cinnamon Twig (Guizhi, 桂枝) 1-2 qian; Ostreae Concha (Muli, 牡蛎) 1-3 qian; Lead Tan (Qiandan, 铅丹) 0.5-1 qian; Poria (Fuling, 茯苓) 2-3 qian; Pinelliae Tuber (Banxia, 半夏) 1-2 qian; Jujube (Dazao, 大枣) 2-4 pieces; Rheum Radix et Rhizoma (Dahuang, 大黄) 1-2 qian.
[Decoction and Administration]
Add water equivalent to three teacups. Boil until half a teacup remains. Strain and take warm. Add Dahuang when half the water has evaporated.
[General Principles of Medication]
Chaihu, Guizhi, Shengjiang expel pathogens; Renshen, Dazao support healthy Qi; Longgu, Muli, Qiandan, Banxia calm Spirit and resolve phlegm; Huangqin, Dahuang clear fire and unblock bowels; Fuling promotes urination to drain dampness.
[Contraindications]
Contraindicated in pure mental disorders, non-deficient pulses, or free urination/bowel movements.
[Reference for Similar Formulas]
(1) Xiao Chai Hu Tang: Uses Chaihu, Huangqin, Banxia, Renshen for Shaoyang deficiency.
(2) Da Chai Hu Tang: Uses Chaihu, Huangqin, Banxia, Dahuang for Shaoyang/Yangming excess.
(3) Guizhi Gancao Longgu Muli Tang: Uses Guizhi with Longgu/Muli for Heart Yang deficiency and calming Spirit.
Da Chai Hu Tang (Major Bupleurum Decoction), Formula No. 35
[Formula Rationale]
Harmonizes Shaoyang, clears Yangming excess heat, and resolves both exterior and interior.
[Indications]
Shaoyang disease: alternating chills/fever, chest/hypochondriac fullness/distress, vomiting, bitter taste (Shaoyang exterior); rejection to pressure in epigastrium/abdomen, difficult bowel movements (Yangming interior). Tongue coating must be yellow-white mixed; pulse must be floating/sinking and forceful.
[Ingredients]
Bupleuri Radix (Chaihu, 柴胡) 2-4 qian; Scutellariae Radix (Huangqin, 黄芩) 1.5-2.5 qian; Raw Paeoniae Radix Alba (Sheng Hangshao, 生杭芍) 1.5-2.5 qian; Pinelliae Tuber (Banxia, 半夏) 1.5-3 qian; Fresh Ginger (Shengjiang, 生姜) 2-3 qian; Immature Bitter Orange (Zhishi, 枳实) 1.5-2.5 qian; Jujube (Dazao, 大枣) 2-4 pieces; Rheum Radix et Rhizoma (Dahuang, 大黄) 1-2 qian.
[Modifications]
(1) If bowels are free: Remove Dahuang to avoid excessive purgation.
(2) If tongue coating is yellow/dry or tongue body is red, indicating severe internal heat: Remove Banxia,酌情 add Gypsum, Rehmanniae Radix Recens (Shengdi, 生地), and Shaoyao.
[Decoction and Administration]
Add water equivalent to three cups. Boil until half a teacup remains. Strain and take warm.
[General Principles of Medication]
Chaihu, Banxia, Huangqin, Shengjiang resolve Shaoyang exterior; Shaoyao, Dahuang, Zhishi purge Yangming interior; Dazao protects Stomach Qi with its sweetness.
[Contraindications]
Contraindicated in pure Shaoyang half-exterior/half-interior without Yangming excess. Contraindicated in pure Yangming excess without Shaoyang half-exterior/half-interior, as the formula acts on both aspects.
[Reference for Similar Formulas]
(1) Xiao Chai Hu Tang: Harmonizes Shaoyang deficiency.
(2) Chaihu Jia Mangxiao Tang: Treats Shaoyang deficiency combined with Yangming dry-heat.
Chaihu Jia Mangxiao Tang (Bupleurum plus Mirabilite Decoction), Formula No. 36
[Formula Rationale]
Treats Shaoyang deficiency combined with Yangming excess, correcting errors.
[Indications]
Shaoyang disease: alternating chills/fever, bitter taste, chest/hypochondriac fullness, vomiting, afternoon tidal fever. After incorrect purging, slight diarrhea occurs, but abdomen must show rejection to pressure.
Note: If abdomen does not reject pressure, try Xiao Chai Hu Tang first, as it also treats tidal fever. If Xiao Chai Hu Tang is insufficient, this formula is appropriate.
[Ingredients]
Bupleuri Radix (Chaihu, 柴胡) 2-3 qian; Scutellariae Radix (Huangqin, 黄芩) 1-2 qian; Ginseng Radix (Renshen, 人参) 0.5-1 qian; Honey-fried Licorice Root (Zhi Cao, 炙草) 1 qian; Fresh Ginger (Shengjiang, 生姜) 1-2 qian; Pinelliae Tuber (Banxia, 半夏) 2-3 qian; Jujube (Dazao, 大枣) 2-4 pieces; Mirabilite (Mangxiao, 芒硝) 1.5-3 qian.
[Decoction and Administration]
Add water equivalent to three teacups. Boil until reduced by half. Strain, add Mangxiao, boil again until half a teacup remains. Take warm.
[General Principles of Medication]
Xiao Chai Hu Tang harmonizes Shaoyang; Mangxiao treats Yangming tidal fever.
[Contraindications]
(1) Shaoyang disease with tidal fever and diarrhea, if abdomen does not reject pressure, do not use.
(2) Abdominal rejection with tidal fever/diarrhea, if no Shaoyang deficiency exists, do not use.
[Reference for Similar Formulas]
(1) Da Chai Hu Tang: Treats Shaoyang combined with Yangming excess.
(2) Xiao Chai Hu Tang: Treats Shaoyang deficiency.
Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction), Formula No. 37
[Formula Rationale]
Promotes urination, tonifies Yang, dispels cold, strengthens the middle, and prevents Ben Tun (rushing pig) syndrome.
[Indications]
After sweating, Yang is injured, cold-water begins to move, palpitations below the navel suggesting impending Ben Tun. Must accompany difficult urination, aversion to cold foods, and sinking-slow pulse (cold/fluid signs).
[Ingredients]
Poria (Fuling, 茯苓) 3-5 qian; Cinnamon Twig (Guizhi, 桂枝) 2-2 qian (likely typo in source, usually 2-3 or similar); Licorice Root (Gancao, 甘草) 1-1.5 qian; Jujube (Dazao, 大枣) 2-4 pieces.
[Decoction and Administration]
Add water equivalent to two and a half teacups. Boil until half a teacup remains. Strain and take warm.
[General Principles of Medication]
Fuling leaches out dampness; Guizhi tonifies Yang and dispels cold; Gancao and Dazao strengthen the middle to prevent cold-water flooding upward.
[Contraindications]
Contraindicated with bitter taste and preference for cold, fearing concurrent heat.
[Reference for Similar Formulas]
Guizhi Jia Guizhi Tang: Treats cold-type Ben Tun without fluid retention.
Fuling Guizhi Baizhu Gancao Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction), Formula No. 38
[Formula Rationale]
Tonifies Heart Yang, dispels cold, directs rebellious Qi downward, strengthens Spleen, and promotes urination.
[Indications]
(1) Incorrect emesis/purgation in Shanghan injuring Heart Yang, Water Qi harassing the Heart: subcardial fullness/reversal, Qi rushing to chest, dizziness upon standing, sinking-tight pulse.
(2) Fluid retention causing shortness of breath.
(3) Subcardial fluid retention with chest/hypochondriac fullness and dizziness.
All three must have difficult/scanty urination, aversion to cold foods, and sinking-tight or sinking-slow pulses. These result from Heart Yang deficiency with cold and stagnant fluid.
[Ingredients]
Poria (Fuling, 茯苓) 3-4 qian; Cinnamon Twig (Guizhi, 桂枝) 2-3 qian; Raw Atractylodis Macrocephalae Rhizoma (Sheng Baizhu, 生白术) 2-3 qian; Honey-fried Licorice Root (Zhi Gancao, 炙甘草) 1-2 qian.
[Decoction and Administration]
Add water equivalent to three teacups. Boil until slightly more than one teacup remains. Strain and take warm.
[General Principles of Medication]
Fuling promotes urination; Baizhu and Gancao strengthen Spleen and assist fluid absorption; Guizhi warms/dispels cold and directs fluid downward.
[Contraindications]
Contraindicated in heat signs like bitter taste or preference for cold foods.
[Reference for Similar Formulas]
(1) Zhen Wu Tang: Restores Yang and controls water.
(2) Fuling Sini Tang: Restores Yang, treats water, and tonifies Qi.
(3) Shenqi Wan: Treats shortness of breath, focusing on tonifying Kidney Yang.
Fuling Gancao Tang (Poria and Licorice Decoction), Formula No. 39
[Formula Rationale]
Dispels cold and promotes urination. Treats conditions where cold is heavier and fluid retention is lighter compared to Wuling San.
[Indications]
External cold injuring Heart Yang, failing to transform fluid, retaining in the subcardiac region causing palpitations, difficult urination, or sweating without thirst. Must have aversion to cold foods or concurrent fever/aversion to wind-cold (exterior cold signs).
[Ingredients]
Poria (Fuling, 茯苓) 2-5 qian; Honey-fried Licorice Root (Zhi Gancao, 炙甘草) 1-2 qian; Cinnamon Twig (Guizhi, 桂枝) 2-3 qian; Fresh Ginger (Shengjiang, 生姜) 1-3 qian.
[Decoction and Administration]
Add water equivalent to two teacups. Boil until half a teacup remains. Strain and take warm.
[General Principles of Medication]
Fuling controls water; Guizhi, Gancao, Shengjiang release exterior and dispel cold.
[Contraindications]
Contraindicated in free urination, preference for cold foods, or absence of exterior cold signs.
[Reference for Similar Formulas]
(1) Wuling San: Dispels cold, promotes urination, treats heavier fluid retention.
(2) Fuling Sini Tang: Restores Yang, promotes urination, tonifies Qi.
(3) Zhen Wu Tang: Restores Yang, promotes urination, regulates Spleen/Liver.
Wuling San (Five-Ingredient Powder with Poria), Formula No. 40
[Formula Rationale]
Transforms Qi, promotes urination, warms meridians, dispels cold, and resolves both exterior and interior.
Note: Compared to Fuling Gancao Tang, this pattern has heavier fluid retention and lighter cold.
[Indications]
(1) Water Accumulation Syndrome: Difficult urination, vexatious thirst, sweating, slight fever, floating-rapid pulse.
(2) Water Reversal Syndrome: Thirst for drinking, but vomiting immediately after ingestion.
Must have aversion to cold foods, non-yellow/dry tongue coating, and exterior cold signs.