[用药大意]
赭石镇降逆气；旋覆花、半夏、生姜消除痰饮，兼祛寒邪；参、草、大枣调补中气，以善其后。
[禁忌证]
有喜冷恶热的热证者忌之。大便硬、腹拒按的实证也忌之。
[类似方剂参考]
(1)生姜泻心汤：此治寒热虚夹杂，心下痞硬，噫气之方。
(2)干姜黄连黄芩人参汤：此乃治寒热虚夹杂之呕吐方。
(3)橘皮竹茹汤：此治虚热呃逆之方。
瓜蒂散方第六十四
[方义]
此涌吐痰涎宿食之方。
[主治]
胸膈痰涎或上脘宿食。其症胸中痞满，气上冲咽喉，不得息，或身热有汗如桂枝证，或心下满而烦，饥不能食，或上脘部拒按。但必须具有痰和热相兼的症状，或有吐出为快的感觉，或有停食的事实，脉必须浮而有力。
[药品]
瓜蒂(炒黄) 赤小豆各等份
[制服法]
共为细末，每次服一至二钱，服时先用香豆豉二钱，热汤煮作稀糜，去滓和药散服之。不吐者，稍加之，以得快吐为度。如再不吐，可口噙砂糖一块，或兼饮热汤即吐。若一次吐量过少，病不除者，次日或隔日可再服之，但不可令人体虚。若吐过甚者，可饮葱白煎汤，或冷开水，或加减六君子汤即解。
[用药大意]
瓜蒂吐风热痰涎，赤小豆利水除湿，豆豉解热除烦。赤小豆、香豆豉二药合用，助瓜蒂苦毒之品以涌吐，并借谷物以保护胃气，使不致影响饮食也。
[禁忌证]
诸亡血家、虚家，脉虚无力者，均忌之。
[类似方剂参考]
(1)大陷胸丸：此治胸部水饮燥热互结宜于攻下之方。
(2)小陷胸汤：此治心下痰热互结，清热降痰开胸膈之方。
白虎汤方第六十五
[方义]
此清阳明燥热之方。
[主治]
阳明经病，大热、大渴、大汗、大烦，喜冷饮，恶热，脉洪大有力，舌苔黄或黑而燥，甚则谵语，神昏。
[药品]
生石膏三钱至一两 知母二至五钱 炙草一至二钱 粳米二至五钱
[加减法]
脉较虚者加人参；发斑者加犀角。
[煎服法]
水三茶杯，煎至多半茶杯，去滓温服。石膏多者，最好用频服的方法。
[用药大意]
石膏甘寒清热，知母苦寒滋水，粳米、甘草补中。
[禁忌证]
(1)伤寒无汗，表证不解者，不可与(此证当先解表，或加解表药品)。
(2)脉细或沉者，不可与(因系虚寒现象)。
(3)不渴者，不可与(因没有内热)。
(4)喜热不喜冷者，不可与(因是寒证的表现)。
(5)腹拒按者，不可与(此属承气实热证)。
(6)大便溏者，不可与(因是虚寒现象)。
(7)舌苔白润者，不可与(因不是燥热证，或兼有表证)。
(8)舌赤者，不可与(因热邪已入营血)。
[类似方剂参考]
(1)大承气汤：此治阳明腑病里实证之方。
(2)六味地黄汤加肉桂五味子：此治三消证口渴害饮之方。
白虎加人参汤方第六十六
[方义]
此清阳明经热兼补虚之方。
[主治]
阳明经病，大热，大汗，大渴，喜冷，恶热，口舌干燥，一般同白虎证，但脉洪大而力不足，或兼芤，或洪大无伦者。
[药品]
人参一至二钱 生石膏三钱至一两 知母二至五钱 炙草一至二钱 粳米二至五钱
[煎服法]
水二至三茶杯，煎至半茶杯，去滓温服。
按：人参也可另煎兑服。石膏用量多者，煎成后，分若干次频频服之为宜。
[用药大意]
白虎汤清热生津，人参强心补虚。
[禁忌证]
(1)表不解，恶风寒无汗者，忌之。
按：恶风寒本是表不解的主要症状。但在有汗和口舌干燥、喜饮冷的情况下，或“背微恶寒”，或“时时恶风”，都不得谓之表不解。因为此为内热太盛，自觉室温较低而有背微恶寒或时时恶风之感觉。
(2)脉洪大有力者忌之。因内热太盛，心气不虚，不需人参之补。
(3)舌红者忌之。因热已入营血，需配合清营凉血之品。
[类似方剂参考]
(1)白虎汤：此治阳明经热而心气不虚之方。
(2)玉女煎：此清热兼凉血之方。
桂枝附子汤方第六十七
[方义]
此散风寒、补阳胜湿之方。
[主治]
风寒湿痹，风寒较盛，湿邪较轻，兼有阳虚现象者。其症身体疼烦，不能转侧。但必须具有恶风寒、不喜冷性饮食、口不渴、不呕、脉浮虚而涩或脉较微等风寒和阳虚现象。
[药品]
桂枝三至四钱 附子二至三钱 炙草一至二钱 大枣二至四枚 生姜一至三钱
[加减法]
桂枝附子汤，减轻分量名桂枝去芍药加附子汤。治太阳病误下后，胸满、脉微、恶寒之证。
按：此二方从药的品种上看是相同的，从药的剂量上看是不相同的，因此名称既异，作用当然不同，这是容易理解的。但在临床实际上互用起来是否会有害处，这是一个重要的问题。我认为，彼方用于此证绝不会有显著效果，因为桂、附用量减少，甘、枣补缓之性相对增强，而此证宜于温散，不宜于补缓也。此方如用于彼证反会发生害处，因桂枝散性过甚，不利于阳虚之体。
[煎服法]
水三茶杯，煎至半茶杯，去滓温服。
[用药大意]
桂枝、生姜辛温以散风寒，附子补阳以胜寒湿，甘草、大枣和诸药以保护中气。
[禁忌证]
有内热现象者忌之，例如口苦、喜冷、脉象实大洪数等都是。
[类似方剂参考]
(1)桂枝附子去桂加白术汤(即白术附子汤方)：此治阳虚寒湿较胜风邪较轻之痹证的方剂。
(2)甘草附子汤：此治脾虚阳虚、寒湿较甚之痹证的方剂。
白术附子汤方第六十八
(即桂枝附子去桂加白术汤)
[方义]
此补阳胜湿兼散风寒之方。陈修园谓之湿胜风之主方，是也。
[主治]
风寒湿痹，身体疼痛较甚，不能转侧，大便溏，小便利，脉浮虚而涩等。但必须具有不喜冷性饮食或不渴的寒证或阳虚现象。
按：此证脉较小者用之都有效，不一定只限于浮虚而涩，因为小脉属于阳虚范围之脉。又：桂枝不去亦无弊害，因此证还有外因的一面。
[药品]
生白术三至四钱 附子二至三钱 炙草一至二钱 生姜二至三钱 大枣二至四枚
[煎服法]
水二茶杯，煎至半茶杯，去滓温服。服药后如身有麻痹，或神识昏冒现象者勿惧，此附子毒性副作用的表现，当减其量用之。
[用药大意]
附子、白术温经通阳，以治寒湿，余药调和营卫以散风邪。
[禁忌证]
口渴，喜冷，脉洪大有内热证者，忌之。
[类似方剂参考]
桂枝附子汤：此治风寒湿痹，身体疼痛，湿邪较轻之方。
甘草附子汤方第六十九
[方义]
此健脾补阳，祛寒湿，兼散风邪，治痹证之方。
[主治]
风寒湿痹，关节肿痛，不得屈伸，手不可近。但必须具有大便溏、小便不利、不喜冷性饮食，兼恶风寒、汗出等症。
[药品]
炙草一至三钱 炮附子二至四钱 白术二至三钱 桂枝二至三钱
[煎服法]
水二茶杯，煎至半茶杯，去滓温服。
[用药大意]
炙草、白术、附子健脾补阳，以治寒湿；桂枝辛温以散风寒。
[禁忌证]
痹证有喜冷性饮食之热证者忌之；有大便不溏或小便利等脾阳不虚证者也忌之。
[类似方剂参考]
(1)桂枝加附子汤：此解肌和营卫兼温经回阳之方。
(2)桂枝附子去桂加白术汤(即白术附子汤)：此补阳胜湿兼散风寒之方。
芍药甘草附子汤方第七十
[方义]
此敛阴回阳之方。
[主治]
发汗后，表证已解，汗尚未止反恶寒者，阴阳两虚也。但脉必微而数方能确定。表证已解，故不用桂枝：，汗未止，兼见数脉方为阴虚；反恶寒，兼见微脉方为阳虚。
按：仲景原文曰：发汗不解，反恶寒，虚故也，本汤主之。“不解”二字不是指表邪不解，而是指没有恢复正常，是指反恶寒之症而言。果系表邪不解，应有头痛、发热、脉浮，宜用桂枝加附子汤，绝没有使用本方之必要。“虚”是阴阳俱虚或营卫俱虚。以营为阴血，卫为阳气也，但绝不是单纯卫阳虚之证，因卫阳虚宜芪附，不宜芍附。
[药品]
生杭芍三至五钱 炙草一至二钱 炮附子三至五钱
[煎服法]
水二茶杯半，煎至半茶杯，去滓温服。
[用药大意]
附子补阳以治恶寒，芍药滋阴以敛汗液，甘草补中兼和，既可固后天之本，又可和二药之偏。
[禁忌证]
有发热、头痛、脉浮之表证者忌之；有喜冷性饮食之热证者也忌之。
[类似方剂参考]
(1)桂枝加附子汤：此治表证不解兼阳虚之方。
(2)芪附汤：此治卫阳虚自汗之方。
干姜附子汤方第七十一
[方义]
此温中回阳，去里寒之方。
[主治]
阳虚烦躁，昼日发作，不得卧，夜间安静。但必须经过汗下，具有手足厥逆、脉沉而微、不喜冷性饮食、身无大热等症，且不兼有口苦、喜冷之热证，小便不利、苔白而滑之水证，恶风寒之表证，及年老体衰之虚证。
[药品]
干姜一至二钱 附子一至三钱
[煎服法]
水二茶杯，煎至半茶杯。去滓温服。
[用药大意]
干姜温脾胃之阳，附子补肾命之阳。
按：此方去四逆之甘草，其力甚猛，比四逆汤为峻，回阳力强，如增加药味，反牵制其力，减低功效。
[禁忌证]
一切热证均忌之。
[类似方剂参考]
(1)茯苓四逆汤：此治阳虚气虚兼水证烦躁之方。
(2)大青龙汤：此治表寒里热烦躁之方。
十枣汤方第七十二
[方义]
此寒性逐水饮之峻剂。
[主治]
胸胁腹部积水停饮，其症心下痞硬满，呼吸咳唾引胁下痛，干呕短气。但必须体壮，脉实，没有寒证、表证现象者方可使用。
[药品]
芫花 甘遂 大戟各等份
[煎服法]
共研细末，每服三分至五分，用大枣十枚，煎水送下，得快下利后，糜粥自养。下少病不除者，隔日再服之。
[用药大意]
芫花、大戟、甘遂辛苦寒毒，功能逐水；大枣甘平补中，以防剧药有伤脾胃也。
[禁忌证]
有恶寒无汗之表证者忌之；身体衰弱者忌之；对于饮食有喜温恶冷之现象者也忌之。
[类似方剂参考]
(1)小青龙汤：此治水饮兼表证之方。
(2)真武汤：此治阳虚水不化之方。
(3)五苓散：此温性利水散寒之方。
(4)猪苓汤：此育阴利水清热之方。
附子汤方第七十三
[方义]
此补阳益气、健脾利湿、养阴之方。
[主治]
少阴病，身体骨节疼痛，手足厥冷，背恶寒，脉沉而微细。但必须兼有口不干、不苦、不渴及小便不利等症，方为确当。因为口中发干、发苦、发渴乃系内热之证，不可使用附子；小便若利，便无湿邪，不可使用茯苓、白术。
[药品]
附子二至三钱 茯苓一至二钱 人参一至二钱 生白术一至三钱 生白芍一至二钱
[煎服法]
水三茶杯，煎至半茶杯，去滓温服。
[用药大意]
附子补阳，人参补气，苓、术利水。芍药养阴、和肝、补血。
[禁忌证]
口苦，口渴，口干，喜冷，脉浮者，均忌之。恐兼表证和热证。
[类似方剂参考]
真武汤：此回阳利水不兼补气之方。（不字疑误）
大承气汤方第七十四
[方义]
此排除肠胃中燥热、燥屎、宿食之重下剂，也系治里实里热主方之一。
[主治]
(1)阳明腑证，发热不恶寒或反恶热，谵语，日哺潮热，舌苔干燥，或黄，或黑，或有芒刺，大便燥结。
(2)热结旁流证，系阳明腑证，大便自利清水之证；或少阴病，自利清水，色纯青之证．
(3)阳极似阴之证，即少阴三急下证，如神昏不知人，身不热，脉沉傚有力，但舌苔干燥有芒刺。或自利清水，色青。
(4)宿食证，腹胀满疼痛，恶食，大便不利。
(5)奇恒痢疾，即痢疾在上午四时至六时前后偶有神昏谵语、喉塞咽干等现象之证。
按：此证如不急治，下午三时后即会死亡。详陈修园《医学实在易》。
(6)额部汗出如蒸笼．此系曾颖甫验案，详《经方实验录》。
以上六种疾病使用本方的主要关键，一般说来都必须具有腹部胀痛拒按的症状，脉必沉而有力，体必较健，且兼有热证表现。但在前三证中，舌苔或黄或黑干燥而有芒刺是比较肯定的；第四证，腹中胀痛拒按、大便不利最突出，但舌苔不一定会有芒刺，因为此证热势不太重；最后二证，腹部不一定完全胀满拒按，但脉象必沉而有力；第五证，只以大便不利或有其他里热证为重；第六证，只考虑它作用的效果如何，不必有其他顾虑。
[药品]
大黄二至五钱 厚朴二至三钱 枳实二至三钱 芒硝一钱半至三钱
[煎服法]
水三茶杯，先煎枳、朴，继入大黄，煎至多半茶杯时，去滓，再入芒硝，溶化后，温服。一服下利，停止后服。病证较轻者，共同煎之也可。
[用药大意]
枳实、厚朴导滞消胀；大黄、芒硝通便软坚。
[禁忌证]
(1)大便秘结兼有恶寒无汗之表证者忌之，恐外邪内陷也．
(2)大便秘结，不敢服食冷性饮食者忌之。这是寒实证，宜温下法。
(3)大便燥结，因于年老、久病、产后血液不足，或脉弱者，忌之。这是虚中夹实之证，宜补泻兼用。
(4)大便硬、小便少者忌之。因阳明尚未全实，服之恐大便溏泻也。
[类似方剂参考]
(1)小承气汤：此治腹胀满大便不太燥结的方剂。
(2)调胃承气汤：此治大便燥结而腹不胀满的方剂。
(3)黄龙汤：此治里实证兼里虚证的方剂。
(4)温脾汤：此治里实证兼里寒证的方剂。
[General Principles of Medication Use]
Hematitum (Ochre) has the effect of subduing rebellious Qi; Inulae Flos (Inula Flower), Pinelliae Rhizoma Preparatum (Prepared Pinellia Tuber), and Zingiberis Rhizoma Recens (Fresh Ginger Rhizome) eliminate phlegm-fluids and dispel cold pathogens; Ginseng Radix (Ginseng Root), Glycyrrhizae Radix (Licorice Root), and Jujubae Fructus (Jujube Fruit) tonify Middle Qi to conclude the treatment.
[Contraindications]
It is contraindicated in patients with heat syndromes characterized by a preference for cold and aversion to heat. It is also contraindicated in excess syndromes presenting with hard stools and abdominal tenderness upon pressure.
[Reference for Similar Formulas]
(1) Shengjiang Xiexin Decoction: This formula treats mixed conditions of cold, heat, deficiency, and excess, manifesting as fullness and hardness below the heart, and belching.
(2) Ganjiang Huanglian Huangqi Renshen Decoction: This is a formula for treating vomiting caused by mixed conditions of cold, heat, deficiency, and excess.
(3) Jupi Zhuru Decoction: This formula treats hiccups due to deficiency-heat.
Formula No. 64: Gua Di San (Melon Seed Powder)
[Formula Meaning]
This is a formula for inducing vomiting to expel phlegm-fluids and retained food.
[Indications]
Phlegm-fluids in the chest and diaphragm, or retained food in the upper epigastrium. Symptoms include chest fullness and oppression, sensation of Qi rushing up to the throat causing dyspnea, or fever with sweating resembling Guizhi Syndrome, or fullness and irritability below the heart, hunger but inability to eat, or tenderness upon pressure in the upper epigastrium. However, it must be accompanied by symptoms of combined phlegm and heat, a sensation of relief after vomiting, or factual evidence of food stagnation. The pulse must be floating and forceful.
[Ingredients]
Cucumeris Fructus Seed (Melon Seed, stir-fried until yellow) and Adzuki Bean (Vigna angularis) in equal parts.
[Administration Method]
Grind into fine powder. Take 1 to 2 qian per dose. Before taking the medicine, boil 2 qian of Fermented Soybean (Xiang Douchi) in hot water until it forms a thin porridge. Strain and mix with the powder. If vomiting does not occur, slightly increase the dose until vigorous vomiting is achieved. If still no vomiting, hold a piece of rock sugar in the mouth or drink hot water simultaneously to induce vomiting. If the volume vomited is small and the disease persists, it may be taken again the next day or every other day, but care must be taken not to cause excessive weakness. If vomiting is too severe, drink decoction of Scallion White, cold boiled water, or Jiajian Liujunzi Decoction to resolve the side effects.
[General Principles of Medication Use]
Cucumeris Fructus Seed induces vomiting of wind-heat phlegm-fluids; Adzuki Bean promotes urination and removes dampness; Fermented Soybean clears heat and relieves irritability. The combination of Adzuki Bean and Fermented Soybean assists the bitter and toxic nature of Cucumeris Fructus Seed to induce vomiting, while the grain protects Stomach Qi, preventing adverse effects on digestion.
[Contraindications]
Contraindicated in all patients with blood loss, deficiency syndromes, and those with weak and powerless pulses.
[Reference for Similar Formulas]
(1) Da Xianxiong Pill: This formula treats accumulation of water-fluids, dryness, and heat in the chest, suitable for purgative therapy.
(2) Xiao Xianxiong Decoction: This formula treats intermingling of phlegm and heat below the heart, clearing heat, descending phlegm, and opening the chest and diaphragm.
Formula No. 65: Baihu Tang (White Tiger Decoction)
[Formula Meaning]
This is a formula for clearing dryness-heat of the Yangming channel.
[Indications]
Yangming Channel Disease, characterized by high fever, intense thirst, profuse sweating, severe irritability, preference for cold drinks, aversion to heat, forceful and large pulse, yellow or black dry tongue coating, and in severe cases, delirium and unconsciousness.
[Ingredients]
Gypsum Fibrosum (Raw Gypsum) 3 qian to 1 liang; Anemarrhenae Rhizoma (Zhimu) 2 to 5 qian; Prepared Licorice Root (Zhi Cao) 1 to 2 qian; Oryza Sativa (Japonica Rice) 2 to 5 qian.
[Modifications]
Add Ginseng Radix if the pulse is relatively weak; add Rhinoceros Horn (substituted with Water Buffalo Horn) if macules appear.
[Decoction and Administration]
Boil in three cups of water until slightly more than half a cup remains. Strain and take warm. If using a large amount of Gypsum, frequent dosing is recommended.
[General Principles of Medication Use]
Gypsum Fibrosum is sweet and cold, clearing heat; Anemarrhenae Rhizoma is bitter and cold, nourishing Yin (Water); Oryza Sativa and Glycyrrhizae Radix tonify the Middle.
[Contraindications]
(1) Do not use in Cold Damage with no sweat and unresolved exterior syndrome (treat the exterior first or add exterior-resolving herbs).
(2) Do not use if the pulse is fine or deep (indicating deficiency-cold).
(3) Do not use if there is no thirst (indicating absence of internal heat).
(4) Do not use if preferring heat over cold (indicating cold syndrome).
(5) Do not use if the abdomen is tender upon pressure (indicating excess-heat of the Chengqi pattern).
(6) Do not use if stools are loose (indicating deficiency-cold).
(7) Do not use if the tongue coating is white and moist (not a dry-heat syndrome, or accompanied by exterior syndrome).
(8) Do not use if the tongue is crimson (heat has entered the Ying and Blood levels).
[Reference for Similar Formulas]
(1) Da Chengqi Decoction: This formula treats interior excess syndrome of Yangming Fu-organ disease.
(2) Liuwei Dihuang Decoction plus Cinnamon Twig and Schisandra: This formula treats excessive thirst in the Three Consumptions syndrome.
Formula No. 66: Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng)
[Formula Meaning]
This is a formula for clearing Yangming channel heat and tonifying deficiency.
[Indications]
Yangming Channel Disease, with high fever, profuse sweating, intense thirst, preference for cold, aversion to heat, and dry mouth and tongue. Generally similar to Baihu Tang indications, but the pulse is large and forceless, or knotted, or excessively large without root.
[Ingredients]
Ginseng Radix 1 to 2 qian; Gypsum Fibrosum 3 qian to 1 liang; Anemarrhenae Rhizoma 2 to 5 qian; Prepared Licorice Root 1 to 2 qian; Oryza Sativa 2 to 5 qian.
[Decoction and Administration]
Boil in two to three cups of water until half a cup remains. Strain and take warm.
Note: Ginseng can be decocted separately and mixed in. If using a large amount of Gypsum, divide the decoction into several doses for frequent administration.
[General Principles of Medication Use]
Baihu Tang clears heat and generates fluids; Ginseng Radix strengthens the Heart and tonifies deficiency.
[Contraindications]
(1) Contraindicated if the exterior is unresolved, with aversion to wind-cold and no sweat.
Note: Aversion to wind-cold is a primary symptom of unresolved exterior syndrome. However, in the presence of sweating, dry mouth/tongue, and preference for cold drinks, sensations of "slight aversion to cold on the back" or "intermittent aversion to wind" should not be considered unresolved exterior. This is due to excessive internal heat causing a subjective feeling of low room temperature.
(2) Contraindicated if the pulse is large and forceful. Excessive internal heat means Heart Qi is not deficient, so Ginseng Radix tonification is unnecessary.
(3) Contraindicated if the tongue is red. Heat has entered the Ying and Blood levels, requiring herbs that clear Ying-level heat and cool the Blood.
[Reference for Similar Formulas]
(1) Baihu Tang: This formula treats Yangming channel heat without Heart Qi deficiency.
(2) Yunv Jian: This formula clears heat and cools the Blood.
Formula No. 67: Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction)
[Formula Meaning]
This is a formula for dispersing wind-cold, tonifying Yang, and overcoming dampness.
[Indications]
Wind-Cold-Damp Bi Syndrome, where wind-cold is predominant and dampness is mild, accompanied by Yang deficiency. Symptoms include body pain and restlessness, inability to turn over. Must present with aversion to wind-cold, dislike of cold foods/drinks, no thirst, no vomiting, and a floating, deficient, choppy, or faint pulse, indicating wind-cold and Yang deficiency.
[Ingredients]
Cinnamon Twig 3 to 4 qian; Prepared Aconite Lateral Root 2 to 3 qian; Prepared Licorice Root 1 to 2 qian; Jujubae Fructus 2 to 4 pieces; Fresh Ginger Rhizome 1 to 3 qian.
[Modifications]
Reducing the dosage of Guizhi Fuzi Tang yields Guizhi Qu Shaoyao Jia Fuzi Tang. This treats Taiyang Disease complicated by incorrect purgation, resulting in chest fullness, faint pulse, and aversion to cold.
Note: Although these two formulas contain the same herbs, their dosages differ, leading to different names and effects. Clinically, using the former for this condition would likely be ineffective because reduced Cinnamon Twig and Aconite dosages relative to Licorice and Jujube enhance their harmonizing and tonifying nature, whereas this condition requires warming and dispersing rather than tonifying. Conversely, using this formula for the latter condition could be harmful, as the strong dispersing nature of Cinnamon Twig is unsuitable for Yang deficiency.
[Decoction and Administration]
Boil in three cups of water until half a cup remains. Strain and take warm.
[General Principles of Medication Use]
Cinnamon Twig and Fresh Ginger Rhizome are acrid and warm to disperse wind-cold; Prepared Aconite Lateral Root tonifies Yang to overcome cold-damp; Licorice Root and Jujube Fruit harmonize the herbs and protect Middle Qi.
[Contraindications]
Contraindicated in cases with internal heat signs, such as bitter taste, preference for cold, and solid, large, rapid, or flooding pulses.
[Reference for Similar Formulas]
(1) Guizhi Fuzi Qu Gui Jia Baizhu Tang (i.e., Baizhu Fuzi Tang): This formula treats Bi syndrome with predominant Yang deficiency and cold-damp, and mild wind pathogen.
(2) Gancao Fuzi Tang: This formula treats Bi syndrome with Spleen deficiency, Yang deficiency, and severe cold-damp.
Formula No. 68: Baizhu Fuzi Tang (Atractylodes Macrocephala and Aconite Decoction)
(i.e., Guizhi Fuzi Qu Gui Jia Baizhu Tang)
[Formula Meaning]
This is a formula for tonifying Yang, overcoming dampness, and dispersing wind-cold. Chen Xiuyuan called it the main formula for dampness predominating over wind.
[Indications]
Wind-Cold-Damp Bi Syndrome, with severe body pain, inability to turn over, loose stools, free urination, and floating, deficient, choppy pulse. Must present with dislike of cold foods/drinks or no thirst, indicating cold or Yang deficiency.
Note: This formula is effective even with smaller pulses, not limited to floating-deficient-choppy, as small pulses fall under Yang deficiency. Also, retaining Cinnamon Twig causes no harm since there is an external factor involved.
[Ingredients]
Atractylodis Macrocephalae Rhizoma (Raw) 3 to 4 qian; Prepared Aconite Lateral Root 2 to 3 qian; Prepared Licorice Root 1 to 2 qian; Fresh Ginger Rhizome 2 to 3 qian; Jujubae Fructus 2 to 4 pieces.
[Decoction and Administration]
Boil in two cups of water until half a cup remains. Strain and take warm. If numbness or mental confusion occurs after ingestion, do not fear; this is a toxic side effect of Aconite. Reduce the dose.
[General Principles of Medication Use]
Prepared Aconite Lateral Root and Atractylodis Macrocephalae Rhizoma warm the meridians and unblock Yang to treat cold-damp; other herbs harmonize Ying and Wei to disperse wind pathogens.
[Contraindications]
Contraindicated in cases with thirst, preference for cold, and large, flooding pulse with internal heat.
[Reference for Similar Formulas]
Guizhi Fuzi Tang: This formula treats Wind-Cold-Damp Bi with body pain and mild dampness.
Formula No. 69: Gancao Fuzi Tang (Licorice and Aconite Decoction)
[Formula Meaning]
This is a formula for strengthening the Spleen, tonifying Yang, dispelling cold-damp, and dispersing wind pathogens to treat Bi syndrome.
[Indications]
Wind-Cold-Damp Bi Syndrome, with swollen and painful joints, inability to flex/extend, and extreme sensitivity to touch. Must present with loose stools, difficult urination, dislike of cold foods/drinks, and accompanying aversion to wind-cold and sweating.
[Ingredients]
Prepared Licorice Root 1 to 3 qian; Prepared Aconite Lateral Root 2 to 4 qian; Atractylodis Macrocephalae Rhizoma 2 to 3 qian; Cinnamon Twig 2 to 3 qian.
[Decoction and Administration]
Boil in two cups of water until half a cup remains. Strain and take warm.
[General Principles of Medication Use]
Prepared Licorice Root, Atractylodis Macrocephalae Rhizoma, and Prepared Aconite Lateral Root strengthen the Spleen and tonify Yang to treat cold-damp; Cinnamon Twig is acrid and warm to disperse wind-cold.
[Contraindications]
Contraindicated in Bi syndrome with heat signs like preference for cold foods/drinks; also contraindicated in cases with normal stools or free urination indicating non-deficient Spleen Yang.
[Reference for Similar Formulas]
(1) Guizhi Jia Fuzi Tang: This formula releases the muscle layer, harmonizes Ying and Wei, and warms meridians to restore Yang.
(2) Guizhi Fuzi Qu Gui Jia Baizhu Tang (i.e., Baizhu Fuzi Tang): This formula tonifies Yang, overcomes dampness, and disperses wind-cold.
Formula No. 70: Shaoyao Gancao Fuzi Tang (Peony, Licorice, and Aconite Decoction)
[Formula Meaning]
This is a formula for astringing Yin and restoring Yang.
[Indications]
After sweating, when the exterior syndrome has resolved but sweating continues and aversion to cold appears, indicating dual deficiency of Yin and Yang. The pulse must be faint and rapid to confirm. Since the exterior is resolved, Cinnamon Twig is not used. Continued sweating with a rapid pulse indicates Yin deficiency; aversion to cold with a faint pulse indicates Yang deficiency.
Note: Zhang Zhongjing's original text states: "After sweating, the condition did not resolve, but aversion to cold appeared, due to deficiency; this decoction governs." "Did not resolve" does not mean the exterior pathogen remains, but that the body has not returned to normal, specifically referring to the aversion to cold. If the exterior pathogen remained, there would be headache, fever, and floating pulse, warranting Guizhi Jia Fuzi Tang, making this formula unnecessary. "Deficiency" refers to dual deficiency of Yin/Yang or Ying/Wei. Ying is Yin-Blood, Wei is Yang-Qi. This is not merely Wei-Yang deficiency, which would require Astragalus and Aconite, not Peony and Aconite.
[Ingredients]
Paeoniae Radix Alba (Hang Shao Yao, Raw) 3 to 5 qian; Prepared Licorice Root 1 to 2 qian; Prepared Aconite Lateral Root 3 to 5 qian.
[Decoction and Administration]
Boil in two and a half cups of water until half a cup remains. Strain and take warm.
[General Principles of Medication Use]
Prepared Aconite Lateral Root tonifies Yang to treat aversion to cold; Paeoniae Radix Alba nourishes Yin to arrest sweating; Licorice Root tonifies the Middle and harmonizes, securing the Post-Heaven foundation and balancing the properties of the other two herbs.
[Contraindications]
Contraindicated in cases with exterior signs like fever, headache, and floating pulse; also contraindicated in heat syndromes with preference for cold foods/drinks.
[Reference for Similar Formulas]
(1) Guizhi Jia Fuzi Tang: This formula treats unresolved exterior syndrome with Yang deficiency.
(2) Qifu Tang: This formula treats spontaneous sweating due to Wei-Yang deficiency.
Formula No. 71: Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction)
[Formula Meaning]
This is a formula for warming the Middle, restoring Yang, and removing interior cold.
[Indications]
Yang deficiency with restlessness, occurring during the day, preventing sleep, but quiet at night. Must follow sweating/purgation, presenting with cold limbs, deep and faint pulse, dislike of cold foods/drinks, and no significant fever. Must not be accompanied by heat signs (bitter taste, preference for cold), water retention signs (difficult urination, white slippery coating), exterior signs (aversion to wind-cold), or deficiency of the elderly/frail.
[Ingredients]
Zingiberis Rhizoma (Dried Ginger) 1 to 2 qian; Prepared Aconite Lateral Root 1 to 3 qian.
[Decoction and Administration]
Boil in two cups of water until half a cup remains. Strain and take warm.
[General Principles of Medication Use]
Zingiberis Rhizoma warms Spleen and Stomach Yang; Prepared Aconite Lateral Root tonifies Kidney and Mingmen Yang.
Note: By removing Licorice Root from Sini Tang, this formula is potent and harsher than Sini Tang, with strong Yang-restoring power. Adding other herbs might constrain its efficacy.
[Contraindications]
Contraindicated in all heat syndromes.
[Reference for Similar Formulas]
(1) Fuling Sini Tang: This formula treats restlessness due to Yang and Qi deficiency with water retention.
(2) Da Qinglong Tang: This formula treats restlessness due to exterior cold and interior heat.
Formula No. 72: Shi Zao Tang (Ten Date Decoction)
[Formula Meaning]
This is a harsh formula for draining water-fluids with cold properties.
[Indications]
Accumulation of fluid in the chest, hypochondrium, and abdomen. Symptoms include fullness and hardness below the heart, pain radiating to the hypochondrium upon breathing/coughing/sputtering, dry retching, and shortness of breath. Must be used only in robust patients with a solid pulse, and without cold or exterior signs.
[Ingredients]
Genkwa Flos (Genkwa Flower), Kansui Radix (Kansui Root), Euphorbiae Pekinensis Radix (Peking Spurge Root) in equal parts.
[Decoction and Administration]
Grind into fine powder. Take 3 to 5 fen per dose, washed down with water decocted from ten Jujubae Fructus (Dates). After achieving vigorous purgation, nourish with millet porridge. If stool output is insufficient and disease persists, repeat every other day.
[General Principles of Medication Use]
Genkwa Flos, Euphorbiae Pekinensis Radix, and Kansui Radix are acrid, bitter, cold, and toxic, functioning to drain water; Jujubae Fructus is sweet and neutral, tonifying the Middle to prevent damage to Spleen and Stomach by the harsh drugs.
[Contraindications]
Contraindicated in cases with exterior signs (aversion to cold, no sweat); in frail patients; and in those who prefer warm foods/drinks over cold.
[Reference for Similar Formulas]
(1) Xiao Qinglong Tang: This formula treats water-fluids with exterior syndrome.
(2) Zhenwu Tang: This formula treats water retention due to Yang deficiency.
(3) Wuling San: This formula promotes urination and dispels cold with warm properties.
(4) Zhuling Tang: This formula nourishes Yin, promotes urination, and clears heat.
Formula No. 73: Fuzi Tang (Aconite Decoction)
[Formula Meaning]
This is a formula for tonifying Yang, benefiting Qi, strengthening the Spleen, draining dampness, and nourishing Yin.
[Indications]
Shaoyin Disease, with body and joint pain, cold limbs, aversion to cold on the back, and deep, faint, fine pulse. Must be accompanied by no dryness, bitterness, or thirst in the mouth, and difficult urination. Dry/bitter/thirsty mouth indicates internal heat, contraindicating Aconite; free urination indicates no dampness, contraindicating Poria and Atractylodis Macrocephalae Rhizoma.
[Ingredients]
Prepared Aconite Lateral Root 2 to 3 qian; Poria 1 to 2 qian; Ginseng Radix 1 to 2 qian; Atractylodis Macrocephalae Rhizoma (Raw) 1 to 3 qian; Paeoniae Radix Alba (Raw) 1 to 2 qian.
[Decoction and Administration]
Boil in three cups of water until half a cup remains. Strain and take warm.
[General Principles of Medication Use]
Prepared Aconite Lateral Root tonifies Yang; Ginseng Radix benefits Qi; Poria and Atractylodis Macrocephalae Rhizoma promote urination; Paeoniae Radix Alba nourishes Yin, harmonizes the Liver, and tonifies Blood.
[Contraindications]
Contraindicated in cases with bitter taste, thirst, dry mouth, preference for cold, and floating pulse, fearing concurrent exterior or heat syndromes.
[Reference for Similar Formulas]
Zhenwu Tang: This formula restores Yang and promotes urination without tonifying Qi. (The character "not" may be an error.)
Formula No. 74: Da Chengqi Tang (Major Order the Qi Decoction)
[Formula Meaning]
This is a heavy purgative formula for eliminating dryness-heat, dry feces, and retained food in the intestines and stomach, serving as a main formula for interior excess and interior heat.
[Indications]
(1) Yangming Fu Syndrome: Fever without aversion to cold or with aversion to heat, delirium, tidal fever in the afternoon, dry tongue coating (yellow, black, or with prickles), and dry constipation.
(2) Heat Binding with Peripheral Flow: Yangming Fu Syndrome with spontaneous passage of clear watery stool; or Shaoyin Disease with spontaneous passage of pure green watery stool.
(3) Extreme Yang Resembling Yin: One of the three urgent purgation patterns of Shaoyin, such as unconsciousness, no fever, deep and forceful pulse, but dry tongue coating with prickles. Or spontaneous passage of green watery stool.
(4) Retained Food Syndrome: Abdominal distension, pain, aversion to food, and difficulty defecating.
(5) Unusual Dysentery: Dysentery presenting with occasional delirium and throat obstruction/dryness between 4 AM and 6 AM.
Note: If not treated urgently, death will occur after 3 PM. See Chen Xiuyuan's *Yixue Shizai Yi*.
(6) Sweating on the forehead like a steamer. This case record is by Zeng Yingfu, see *Jingfang Shiyan Lu*.
The key to using this formula for the above six diseases generally requires abdominal distension/pain with tenderness upon pressure, deep and forceful pulse, robust constitution, and heat signs. For the first three, dry yellow/black tongue coating with prickles is definitive; for the fourth, abdominal distension/pain and difficulty defecating are prominent, though tongue prickles may be absent due to less severe heat; for the last two, abdominal fullness/tenderness may not be complete, but the pulse must be deep and forceful; for the fifth, difficulty defecating or other interior heat signs are prioritized; for the sixth, only the therapeutic effect matters, without other concerns.
[Ingredients]
Rhei Radix et Rhizoma (Rhubarb) 2 to 5 qian; Magnoliae Officinalis Cortex (Magnolia Bark) 2 to 3 qian; Immature Bitter Orange (Zhi Shi) 2 to 3 qian; Natrii Sulfas (Mirabilite) 1.5 to 3 qian.
[Decoction and Administration]
Boil in three cups of water. First decoct Immature Bitter Orange and Magnolia Bark. Then add Rhubarb. When slightly more than half a cup remains, strain. Add Mirabilite, dissolve, and take warm. If one dose causes purgation, stop subsequent doses. For milder cases, all herbs can be decocted together.
[General Principles of Medication Use]
Immature Bitter Orange and Magnolia Bark guide stagnation and reduce distension; Rhubarb and Mirabilite soften hardness and promote bowel movement.
[Contraindications]
(1) Contraindicated in constipation with exterior signs (aversion to cold, no sweat), fearing inward collapse of exterior pathogens.
(2) Contraindicated in constipation with fear of consuming cold foods/drinks. This is cold-excess syndrome, suitable for warming purgation.
(3) Contraindicated in dry constipation due to old age, chronic illness, postpartum blood deficiency, or weak pulse. This is deficiency with excess, requiring simultaneous tonification and purgation.
(4) Contraindicated in hard stools with scanty urine. Yangming is not fully excess; purgation may cause loose stools.
[Reference for Similar Formulas]
(1) Xiao Chengqi Tang: This formula treats abdominal distension with less dry constipation.
(2) Tiaowei Chengqi Tang: This formula treats dry constipation without abdominal distension.
(3) Huanglong Tang: This formula treats interior excess with interior deficiency.
(4) Wenpi Tang: This formula treats interior excess with interior cold.