三建汤所用附子天雄川乌而莫晓其命名之义比见一老医云川乌建上头目虚风者主之附子
建中脾胃虚寒者主之天雄建下腰肾虚惫者主之故名之曰三建汤是也(癸心杂志)
凡人胃气为湿热所伤必泻其土实而元气乃得上下同流此承气之所由名也
或曰吐血衄血之症乃心气不足所致仲景治法不用补心汤而反用泻心汤何也余曰若心气独
不
足则不止吐衄也此乃邪热因不足而客之则虚火妄动故有吐衄之症得大黄之寒以苦泄其热以苦
补其心则火亦有制而无妄动之害一举而两得之矣岂莫学所能知哉
古人汤散命名必有取义如催生方名为达(音脱)生散何也羊初生曰达羊子易生无留难也故
取其易生而无产难之义诗经生民篇云诞弥厥月先生如达是也
戴原礼辩伤寒论中所谓传经一日太阳二日阳明三日少阳岂有第二日病在里而第三日又在
半表
半里者何也以五行生克论之阳主生则水生木太阳膀胱阳水合传之少阳胆木兼太阳在表少阳表
里之间阳明在里自外渐入于内次第正当阳明居少阳之次此说实前人之所未发陶节庵伤寒琐
言未之及何耶
近世患阴症伤寒往往疑似参瘥初便不敢用附子直待阴极阳竭而用之则为迟矣大抵治法有
是病
而投是药岂可狐疑而误治也哉且夹阴伤寒先因欲事伏阴于内却又着寒内外皆阴阴气独盛则阳
气以衰故脉沉而足冷也必须急用人参健脉以益元气为主佐以附子温肾经散寒邪以退阴而回阳
也若舍此二味不用将何以救之哉近见一人病阴症伤寒先因感寒湿既而发热不食数日后不省人
事语多错乱神思昏迷面青齿露人谓其必死张致和诊之两手脉沉细先以小柴胡汤与之急以四君
子汤加炮附子数片煎成药置盆中以水制其热性少时令温与服其脉渐回神思亦爽更用他药调理
而愈
The Fuzi (Aconiti Lateralis Radix Praeparata), Tianxiong (Aconiti Kusnezoffii Radix), and Chuanwu (Aconiti Karakolicis Radix) used in Sanjian Tang (Three Establishments Decoction) are not understood by people regarding the meaning of their naming. Later, an old physician was seen saying: Chuanwu treats deficiency-wind of the head and eyes, establishing the "Upper"; Fuzi treats deficiency-cold of the spleen and stomach, establishing the "Middle"; Tianxiong treats deficiency-exhaustion of the waist and kidneys, establishing the "Lower." Hence it is named Sanjian Tang (Three Establishments Decoction). (From *Guixin Zazhi*)
Generally, when a person's Stomach Qi (Stomach Vital Energy) is injured by damp-heat, one must purge the excess of the Spleen Earth so that Yuan Qi (Original Vital Energy) can flow up and down smoothly. This is the reason for the name Chengqi Tang (Inheriting Qi Decoction).
Someone asked: Are symptoms such as hematemesis (vomiting blood) and epistaxis (nosebleed) caused by insufficiency of Heart Qi? Why does Zhang Zhongjing's treatment method not use Xinbu Tang (Heart-Nourishing Decoction) but instead uses Xiexin Tang (Draining Heart Decoction)? I replied: If only Heart Qi were insufficient, the symptoms would not be limited to hematemesis and epistaxis. This occurs because pathogenic heat invades due to insufficiency, causing deficient fire to move recklessly, thus resulting in hematemesis and epistaxis. Obtaining the cold nature of Dahuang (Rhei Radix et Rhizoma), one uses bitterness to drain the heat; using bitterness to tonify the Heart, the fire will then be controlled without the harm of reckless movement. This achieves two benefits with one action. How could this be known by those lacking learning?
The naming of ancient decoctions and powders always had specific meanings. For example, the formula for inducing labor is named Dasheng San (Reaching Life Powder). Why? Because a newborn lamb is called "Da" (reaching). Lambs are born easily without obstruction. Thus, it takes the meaning of easy birth without difficulty. The *Shijing* (Classic of Poetry), chapter "Shengmin," states: "When the month was full, the firstborn came forth like a lamb."
Dai Yuanli analyzed the so-called transmission of meridians in *Shanghan Lun* (Treatise on Cold Damage): Day 1 Taiyang (Greater Yang), Day 2 Yangming (Bright Yang), Day 3 Shaoyang (Lesser Yang). Could it be that on the second day the disease is in the interior, and on the third day it returns to half-exterior and half-interior? Discussing from the perspective of Five Elements generation and restriction: Yang governs growth; Water generates Wood. Taiyang Bladder belongs to Yang Water, transmitting to Shaoyang Gallbladder which belongs to Wood. Shaoyang combines with Taiyang at the exterior and lies between the exterior and interior; Yangming is in the interior. Pathogens enter gradually from the outside to the inside, in proper sequence, with Yangming following Shaoyang. This theory was indeed unpublished by predecessors. Why did Tao Jian'an's *Shanghan Suoyan* (Trivial Words on Cold Damage) not mention it?
In recent times, patients suffering from Yin-pattern cold damage often present with ambiguous symptoms. At the initial stage, practitioners dare not use Fuzi (Aconiti Lateralis Radix Praeparata). They wait until Yin is extreme and Yang is exhausted before using it, which is too late. Generally, the treatment principle is to administer the appropriate medicine for the disease. How can one hesitate and cause mis-treatment? Furthermore, Jia Yin Shanghan (Cold Damage with Concomitant Yin Deficiency) initially arises from sexual activity causing Yin to hide within, followed by exposure to cold. Both interior and exterior are Yin; Yin Qi alone becomes excessive while Yang Qi declines. Therefore, the pulse is deep and the feet are cold. One must urgently use Renshen (Ginseng Radix) to strengthen the vessels and tonify Yuan Qi as the main approach, assisted by Fuzi to warm the Kidney Meridian and disperse cold pathogens, thereby retreating Yin and restoring Yang. If these two herbs are discarded, what else can be used to save the patient? Recently, I saw a person suffering from Yin-pattern cold damage. Initially, he contracted cold-dampness, then developed fever and loss of appetite. After several days, he became unconscious, spoke confusedly, suffered mental coma, had a cyan face, and exposed teeth. Others said he would surely die. Zhang Zhihe examined his bilateral pulses, finding them deep and fine. He first administered Xiaochaihu Tang (Minor Bupleurum Decoction). Then, he prepared Sijunzi Tang (Four Gentlemen Decoction) with several slices of Pao Fuzi (Prepared Aconite), boiled the medicine, placed it in a basin, and cooled it with water to mitigate its hot nature. He instructed the patient to take it warm. The patient's pulse gradually returned, and his mental state cleared. He was cured after further regulation with other medicines.