调胃承气汤 缓下胃腑结热法 俞氏经验方
生锦纹（一钱酒浸） 清炙草（五分） 鲜生姜（一片） 元明粉（五分） 大红枣（两枚）
【秀按】调胃者。调和胃气也。大黄虽为荡涤胃肠之君药。而用酒浸。佐甘草者。一藉酒性上升。一藉炙草
甘缓。皆以缓大黄之下性。然犹恐其随元明粉咸润直下。故又使以姜枣之辛甘。助胃中升发之气。元明粉之分
量。减半于大黄。合而为节节弥留之法。否则大黄随急性之元明粉。一直攻下。而无恋膈生津之用。何谓调胃
耶。此为阳明燥热。初结胃腑之良方。
小承气汤 直下小肠结热法 俞氏经验方
生川军（三钱酒洗） 小枳实（二钱） 薄川朴（一钱）
【秀按】小肠火腑。非苦不通。故君以生军之苦寒。以涤小肠。臣以枳实之苦降。直达幽门。但苦非辛不
通。故佐以浓朴之苦辛。助将军一战成功也。此为阳明实热。蕴结小肠之良方。若热结旁流。加川连一钱尤妙。
大承气汤 峻下大肠结热法 俞氏经验方
元明粉（三钱） 生锦纹（四钱） 小枳实（二钱） 薄川朴（一钱）
【秀按】大肠与胃同为燥金之腑。《易》曰、燥万物者莫 乎火。燥非润不降。火非苦不泻。故君以元明粉润燥
软坚。生川军荡实泻火。臣以枳实去痞。原朴泄满。合而为痞满燥实坚。大肠实火之良方。加甘草名三一承气汤。
【廉勘】唐容川曰。三承气汤。不但药力有轻重之分。而其主治。亦各有部位之别。故调胃承气汤。仲景提
出心烦二字。以见胃络通于心。而调胃承气。是注意在治胃燥也。故以大黄芒硝泻热润燥。合之甘草。使药力
缓缓留中。以去胃热。故名调胃也。大承气汤。仲景提出大便已硬四字。是专指大肠而言。大肠居下。药力欲
其直达。不欲其留于中宫。故不用甘草。大肠与胃。同禀燥气。故同用硝黄以润降其燥。用枳朴者。取木气疏
泄。助其速降也。若小承气汤。则重在小肠。故仲景提出腹大满三字为眼目。盖小肠正当大腹之内。小肠通
身接连油网。油是脾所司。膜网上连肝系。肝气下行。则疏泄脾土。而膏油滑利。肝属木。故枳朴秉木气者。
能疏利脾土。使油膜之气。下达小肠而出也。又用大黄归于脾土者。泻膏油与肠中之实热。此小承气所以重在
小肠也。其不用芒硝。以小肠不秉燥气。故不取硝之咸润。至大承气亦用枳朴者。以肝木之气。从油膜下接
大肠。《内经》所谓肝与大肠通也。三承气汤。药力皆当从胃中过。从大肠而去。但其命意。则各有区别。用者当
审处焉。观此。则吴鞠通调胃承气、导赤承气二方。似觉多事。
三仁承气汤 缓下脾脏结热法 俞氏经验方
大麻仁（三钱炒香） 松子仁（三钱研透） 小枳实（钱半炒香） 大腹皮（二钱） 光杏仁（三钱勿研）
生川军（一钱蜜炙） 油木香（五分） 猪胰略炒（一钱）
【秀按】脾与胃以膜相连。膜者脂膜也。上济胃阴。下滋肠液。皆脾所司。若发汗利小便太过。则胆火炽
盛。烁胃熏脾。胃中燥而烦实。实则大便难。其脾为约。约则脾之脂膜枯缩矣。故君以麻、杏、松仁等多脂而
香之物。濡油脾约。以滋胃燥。然胃热不去。则胆火仍炽。又必臣以生军、枳实。去胃热以清胆火。所谓釜底
抽薪是也。佐以油木香、大腹皮者。以脾气喜焦香。而油木香则滑利脂膜。脾络喜疏通。而大腹皮又能直达脾
膜也。妙在使以猪胰。善去油腻而助消化。以洗涤肠中垢浊。此为胃燥脾约。液枯便闭之良方。
陷胸承气汤 肺与大肠并治法 俞氏经验方
栝蒌仁（六钱杵） 小枳实（钱半） 生川军（二钱） 仙半夏（三钱） 小川连（八分） 风化硝（钱半）
【秀按】肺伏痰火。则胸膈痞满而痛。甚则神昏谵语。肺气失降。则大肠之气亦痹。肠痹则腹满便闭。故君
以蒌仁、半夏。辛滑开降。善能宽胸启膈。臣以枳实、川连。苦辛通降。善能消痞泄满。然下既不通。必壅乎
上。又必佐以硝、黄。咸苦达下。使痰火一齐通解。此为开肺通肠。痰火结闭之良方。
犀连承气汤 心与小肠并治法 俞氏经验方
犀角汁（两瓢冲） 小川连（八分） 小枳实（钱半） 鲜地汁（六瓢冲） 生锦纹（三钱） 真金汁（一两冲）
【秀按】心与小肠相表里。热结在腑。上蒸心包。症必神昏谵语。甚则不语如尸。世俗所谓蒙闭证也。便通
者宜芳香开窍。以通神明。若便秘而妄开之。势必将小肠结热。一齐而送入心窍。是开门揖盗也。此方君以大
黄、黄连。极苦泄热。凉泻心小肠之火。臣以犀、地二汁。通心神而救心阴。佐以枳实。直达小肠幽门。俾心
与小肠之火。作速通降也。然火盛者必有毒。又必使以金汁。润肠解毒。此为泻心通肠。清火逐毒之良方。
白虎承气汤 清下胃腑结热法 俞氏经验方
生石膏（八钱细研） 生锦纹（三钱） 生甘草（八分） 白知母（四钱） 元明粉（二钱） 陈仓米（三
钱，荷叶包）
【秀按】胃之支脉。上络心脑。一有邪火壅闭。即堵其神明出入之窍。故昏不识人。谵语发狂。大热大烦。
大渴大汗。大便燥结。小便赤涩等症俱见。是方白虎合调胃承气。一清胃经之燥热。一泻胃腑之实火。此为胃
火炽盛。液燥便闭之良方。
桃仁承气汤 急下肠中瘀热法 俞氏经验方
光桃仁（三钱勿研） 五灵脂（二钱包） 生蒲黄（钱半） 鲜生地（八钱） 生川军（二钱酒洗） 元明粉（
一钱） 生甘草（六分） 犀角汁（四匙，冲）
【秀按】下焦瘀热。热结血室。非速通其瘀。而热不得去。瘀热不去。势必上蒸心脑。蓄血如狂。谵语。下
烁肝肾。亦多小腹串疼。带下如注。腰痛如折。病最危急。此方以仲景原方去桂枝。合犀角地黄及失笑散。三
方复而为剂。可谓峻猛矣。然急证非急攻不可。重证非重方不效。古圣心传。大抵如斯。但必辨证精切。明告
病家。此为背城一战之策。效否亦难预必。信则服之。否则另请高明可也。
解毒承气汤 峻下三焦毒火法 俞氏经验方
银花（三钱） 生山栀（三钱） 小川连（一钱） 生川柏（一钱） 青连翘（三钱） 青子芩（二钱） 小枳
实（二钱） 生锦纹（三钱） 西瓜硝（五分） 金汁（一两，冲） 白头蚯蚓（两支）
先用雪水六碗。煮生绿豆二两。滚取清汁。代水煎药。
【秀按】疫必有毒。毒必传染。症无六经可辨。故喻嘉言从三焦立法。殊有卓识。此方用银翘栀芩。轻清宣
上。以解疫毒。喻氏所谓升而逐之也。黄连合枳实。善疏中焦。苦泄解毒。喻氏所谓疏而逐之也。黄柏、大
黄、瓜硝、金汁。咸苦达下。速攻其毒。喻氏所谓决而逐之也。即雪水、绿豆清。亦解火毒之良品。合而为泻
火逐毒。三焦通治之良方。如神昏不语。人如尸厥。加《局方》紫雪。消解毒火。以清神识。尤良。
养荣承气汤 润燥兼下结热法 俞氏经验方载吴又可《温疫论》
鲜生地（一两） 生白芍（二钱） 小枳实（钱半） 真川朴（五分） 油当归（三钱） 白知母
（三钱） 生锦纹（一钱）
【秀按】火郁便闭。不下则无以去其结热。液枯肠燥。不润则适以速其亡阴。方以四物汤去川芎。重加知
母。清养血液以滋燥。所谓增水行舟也。然徒增其液。而不解其结。则扬汤止沸。转身即干。故又以小承气去
其结热。此为火盛烁血。液枯便闭之良方。
【廉勘】吴鞠通重用细生地、元参、麦冬、合调胃承气。名曰增液承气汤。从此方套出。皆为热结液枯。肠
燥便闭而设。
【荣斋按】本方何秀山按语中有“重加知母”句，我认为“知母”是“生地”二字之误。
浓朴七物汤 攻里兼解表法 俞氏经验方 载《金匮要略》
薄川朴（二钱） 生锦纹（酒浸一钱） 鲜生姜（一钱） 大红枣（四枚） 小枳实（钱半） 川桂枝（八
分） 清炙草（六分）
【秀按】腹满而痛。大便不通。为内实气滞之的证。故君以小承气法。疏气机以泄里实。但肢冷身热。表邪
未净。佐桂枝汤去白芍之酸收。解表邪而和营卫。此为太阳阳明。攻里解表之良方。
柴芩清膈煎 攻里兼和解法 俞氏经验方
川柴胡（八分） 生锦纹（酒浸，钱半） 生枳壳（钱半） 焦山栀（三钱） 青子芩（钱半） 苏薄荷（钱半）
苦桔梗（一钱） 青连翘（二钱） 生甘草（六分） 鲜淡竹叶（三十六片）
【秀按】少阳表邪。内结膈中。膈上如焚。寒热如疟。心烦懊 。大便不通。故君以凉膈散法。生军领栀芩
之苦降。荡胃实以泄里热。佐以枳桔。引荷、翘、甘、竹之辛凉。宣膈热以解表邪。妙在柴胡合黄芩。分解寒
热。此为少阳阳明。攻里清膈之良方。
六磨饮子 下气通便法 俞氏经验方
上沉香（一钱） 尖槟榔（一钱） 小枳实（一钱） 广木香（一钱） 台乌药（一钱） 生锦纹（一钱，各
用原支）
用开水各磨汁两匙。仍和开水一汤碗服。
【秀按】胃为阳府。宜通宜降。五磨饮子。本为气郁上逆而设。得锦纹汁。则疏气滞。降实火。尤为得力。
此为郁火伤中。痞满便秘之良方。功用甚多。学人宜注意之。
枳实导滞汤 下滞通便法 俞氏经验方
小枳实（二钱） 生锦纹（钱半酒洗） 净楂肉（三钱） 尖槟榔（钱半） 薄川朴（钱半） 小川连（六
分） 六和曲（三钱） 青连翘（钱半） 老紫草（三钱） 细木通（八分） 生甘草（五分）
【秀按】凡治温病热症。往往急于清火。而忽于里滞。不知胃主肌肉。胃不宣化。肌肉无自而松。即极力凉
解。反成冰伏。此方用小承气合连槟为君。苦降辛通。善导里滞。臣以楂、曲疏中。翘、紫宣上。木通导下。
佐以甘草和药。开者开。降者降。不透发而自透发。每见大便下后。而疹 齐发者以此。此为消积下滞。三焦
并治之良方。
加味凉膈煎 下痰通便法 俞氏经验方
风化硝（一钱） 煨甘遂（八分） 葶苈子（钱半） 苏薄荷（钱半） 生锦纹（一钱酒洗） 白芥子（八分）
片黄芩（钱半） 焦山栀（三钱） 青连翘（钱半） 小枳实（钱半） 鲜竹沥（两瓢） 生姜汁（两滴，同冲）
【秀按】凡温热者。多挟痰火壅肺。其证痰多咳嗽。喉有水鸡声。鼻孔煽张。气出入多热。胸膈痞胀。腹满
便秘。甚则喘胀闷乱。胸腹坚如铁石。胀闷而死。急救之法。惟速用此方。凉膈散为君。以去其火。臣以枳、
葶、芥、遂。逐其痰而降其气。佐以竹沥、姜汁。辛润通络。庶可转危为安。若畏其峻险而不用。仍以疲药塞
责。则百不救一矣。
陶氏黄龙汤 攻补兼施法 俞氏经验方载陶氏《六书》
生锦纹（钱半酒浸） 真川朴（六分） 吉林参（钱半另煎） 清炙草（八分） 元明粉（一钱） 小枳实
（八分蜜炙） 白归身（二钱） 大红枣（二枚）
【秀按】此方为失下证。循衣撮空。神昏肢厥。虚极热盛。不下必死者立法。故用大承气汤急下以存阴。又
用参归草枣。气血双补以扶正。此为气血两亏。邪正合治之良方。
【廉勘】以上十六方。名承气者十方。暗用承气而另易方名者六方。温清消补。气血痰食。无法不备。可谓
法良意美矣。然用承气者有八禁焉。一者表不解。如恶寒未除。小便清长。知病仍在表也。法当汗解。二者
心下硬满。心下为膈中上脘之间。硬满则邪气尚浅。若误攻之。恐利遂不止。三者合面赤色。面赤为邪在表。
浮火聚于上。而未结于下。故未可攻。又面赤而娇艳。为戴阳症。尤宜细辨。四者平素食少。或病中反能食。
盖平素食少。则胃气虚。故不可攻。然病中有燥粪。即不能食。若反能食。则无燥粪。不过便硬耳。但须润
之。亦未可攻也。五者呕多。呕属少阳。邪在上焦。故未可攻也。六者脉迟。迟为寒。攻之则呃。七者津液内
竭。病患自汗出。小便自利。此为津液内竭。不可攻之。宜蜜煎导而通之。八者小便少。病患平日小便日三四
行。今日再行。知其不久即入大肠。宜姑待之。不可妄攻也。知此八禁。庶免误投。
五仁橘皮汤 滑肠通便法 俞氏经验方
甜杏仁（三钱研细） 松子仁（三钱） 郁李净仁（四钱，杵） 原桃仁（二钱杵） 柏子仁（二钱
杵） 广橘皮（钱半，蜜炙）
【秀按】杏仁配橘皮。以通大肠气闭。桃仁合橘皮。以通小肠血秘。气血通润。肠自滑流矣。故以为君。郁
李仁得橘皮。善解气与水互结。洗涤肠中之垢腻。以滑大便。故以为臣。佐以松、柏、通幽。幽通则大便自
通。此为润燥滑肠。体虚便闭之良方。若欲急下。加元明粉二钱。提净白蜜一两。煎汤代水可也。挟滞。加枳
实导滞丸三钱。挟痰。加礞石滚痰丸三钱。挟饮。加控涎丹一钱。挟瘀。加代抵当丸三钱。挟火。加当归龙荟
丸三钱。挟虫。加椒梅丸钱半。或吞服。或包煎。均可随证酌加。此最为世俗通行之方。时医多喜用之。取其
润不滞气。下不伤饮耳。
增附丸方
Tiaowei Chengqi Tang (Regulate the Stomach Decoction): A method for gentle purgation of heat accumulation in the stomach, Yu's empirical formula.
Sheng Jinwen (Raw Rhubarb) (1 qian, soaked in wine) Qing Zhi Cao (Honey-fried Licorice Root) (5 fen) Xian Sheng Jiang (Fresh Ginger Slice) (1 piece) Yuan Ming Fen (Mirabilite/Niter) (5 fen) Da Hong Zao (Large Red Date) (2 pieces)
[Commentary by Xiu] "Regulating the stomach" means harmonizing stomach qi. Although Rhubarb is the sovereign herb for cleansing the intestines and stomach, soaking it in wine and assisting it with Licorice Root serves two purposes: one utilizes the ascending nature of wine, and the other utilizes the sweet and緩 (gentle/slowing) nature of honey-fried Licorice. Both are used to moderate the purgative nature of Rhubarb. However, there is still concern that it will descend directly with the salty and moistening Mirabilite. Therefore, the pungent and sweet properties of Ginger and Dates are used to assist the ascending qi of the stomach. The dosage of Mirabilite is halved compared to Rhubarb, combining to form a method of gradual retention. Otherwise, Rhubarb would follow the acute Mirabilite in a direct attack downwards, lacking the function of lingering in the diaphragm area to generate body fluids. How can this be called "regulating the stomach"? This is an excellent formula for initial accumulation of dry-heat in the stomach due to Yangming syndrome.
Xiao Chengqi Tang (Minor Order the Qi Decoction): A method for direct purgation of heat accumulation in the small intestine, Yu's empirical formula.
Sheng Chuan Jun (Raw Rhubarb from Sichuan) (3 qian, washed in wine) Xiao Zhi Shi (Immature Bitter Orange) (2 qian) Bo Chuan Po (Thin Magnolia Bark from Sichuan) (1 qian)
[Commentary by Xiu] The small intestine is a fire organ; bitterness is required for unblocking. Thus, Raw Rhubarb's bitter-cold nature is used as the sovereign herb to cleanse the small intestine. Immature Bitter Orange's bitter-descending nature is used as the minister herb to reach directly to the pylorus. However, bitterness alone cannot unblock without pungency. Therefore, Magnolia Bark's bitter-pungent nature is used as the assistant to help the General (Rhubarb) achieve victory in one battle. This is an excellent formula for excess heat accumulating in the small intestine due to Yangming syndrome. If there is heat binding with diarrhea (heat binding leading to watery discharge), adding Coptis Chinensis (Huanglian) 1 qian is particularly effective.
Da Chengqi Tang (Major Order the Qi Decoction): A method for severe purgation of heat accumulation in the large intestine, Yu's empirical formula.
Yuan Ming Fen (Mirabilite/Niter) (3 qian) Sheng Jinwen (Raw Rhubarb) (4 qian) Xiao Zhi Shi (Immature Bitter Orange) (2 qian) Bo Chuan Po (Thin Magnolia Bark from Sichuan) (1 qian)
[Commentary by Xiu] The large intestine and the stomach both belong to the Dry Metal element. The I Ching states: "Nothing dries things more than fire." Dryness cannot descend without moisture; fire cannot be drained without bitterness. Thus, Mirabilite is used as the sovereign herb to moisten dryness and soften hardness. Raw Rhubarb is used to purge solidity and drain fire. Immature Bitter Orange removes stagnation (pi), and Magnolia Bark drains fullness (man). Together, they form an excellent formula for pi (stagnation), man (fullness), zao (dryness), shi (solidity), and jian (hardness), representing excess fire in the large intestine. Adding Licorice Root creates San Yi Chengqi Tang (Three-One Order the Qi Decoction).
[Commentary by Lian] Tang Rongchuan said: The three Chengqi Decoctions differ not only in the strength of their medicinal power but also in their specific therapeutic sites. Tiaowei Chengqi Tang, Zhang Zhongjing highlighted the term "heart vexation" to show that the stomach collaterals connect to the heart. Tiaowei Chengqi Tang focuses on treating stomach dryness. Thus, Rhubarb and Niter are used to drain heat and moisten dryness, combined with Licorice Root to make the medicinal power linger slowly in the middle jiao to remove stomach heat, hence the name "Regulate the Stomach." Da Chengqi Tang, Zhang Zhongjing highlighted "stool has become hard," referring specifically to the large intestine. The large intestine is located inferiorly; the medicinal power should reach directly without lingering in the middle jiao, so Licorice Root is omitted. The large intestine and stomach share the dry nature, so both use Niter and Rhubarb to moisten and descend dryness. Immature Bitter Orange and Magnolia Bark are used to take advantage of Wood qi's dispersing and draining action to assist rapid descent. As for Xiao Chengqi Tang, the focus is on the small intestine. Zhang Zhongjing highlighted "abdominal distension and fullness" as the key point. The small intestine lies within the great abdomen. The small intestine connects throughout to the omental network (mesentery). Oil is governed by the Spleen. The membranes connect superiorly to the Liver system. When Liver qi descends, it disperses Spleen earth, making the fat/oil slippery and smooth. The Liver belongs to Wood; thus, Immature Bitter Orange and Magnolia Bark, possessing Wood qi, can disperse and benefit Spleen earth, allowing the qi of the oil membranes to descend to the small intestine and exit. Rhubarb is also used to return to Spleen earth to drain the solid heat in the fat/oil and intestines. This is why Xiao Chengqi Tang focuses on the small intestine. Niter is not used because the small intestine does not possess the dry nature, so the salty-moistening property of Niter is not taken. As for Da Chengqi Tang using Immature Bitter Orange and Magnolia Bark, it is because Liver Wood qi connects inferiorly to the large intestine through the oil membranes, as stated in the Nei Jing: "The Liver communicates with the Large Intestine." The medicinal power of all three Chengqi Decoctions passes through the stomach and exits via the large intestine, but their intentions differ. Users must examine carefully. From this, Wu Jutong's Tiaowei Chengqi and Daochi Chengqi formulas seem superfluous.
San Ren Chengqi Tang (Three Seeds Order the Qi Decoction): A method for gentle purgation of heat accumulation in the spleen, Yu's empirical formula.
Da Ma Ren (Hemp Seed) (3 qian, fried until fragrant) Song Zi Ren (Pine Nut Kernel) (3 qian, ground thoroughly) Xiao Zhi Shi (Immature Bitter Orange) (1.5 qian, fried until fragrant) Da Fu Pi (Areca Peel) (2 qian) Guang Xing Ren (Apricot Seed) (3 qian, do not grind)
Sheng Chuan Jun (Raw Rhubarb from Sichuan) (1 qian, honey-fried) You Mu Xiang (Vetiver Root) (5 fen) Zhu Yi (Pig Pancreas, slightly fried) (1 qian)
[Commentary by Xiu] The spleen and stomach are connected by membranes, specifically fatty membranes. These nourish stomach yin superiorly and intestinal fluids inferiorly, all governed by the spleen. If sweating or promoting urination is excessive, Gallbladder fire becomes blazing, scorching the stomach and steaming the spleen. The stomach becomes dry with vexation and solidity, resulting in difficult defecation. This is called "Spleen Contraction" (Pi Yue). Contraction means the spleen's fatty membranes have shriveled and dried. Thus, Hemp Seed, Apricot Seed, and Pine Nut Kernel, which are oily and fragrant, are used as sovereign herbs to moisten Spleen Contraction and nourish stomach dryness. However, if stomach heat remains, Gallbladder fire stays blazing. Therefore, Raw Rhubarb and Immature Bitter Orange are used as minister herbs to remove stomach heat and clear Gallbladder fire, known as "removing firewood from under the cauldron." Vetiver Root and Areca Peel are used as assistants because the spleen qi likes scorched fragrance, and Vetiver Root lubricates the fatty membranes; the spleen collaterals like unblocking, and Areca Peel reaches the spleen membranes directly. It is ingenious to use Pig Pancreas as the envoy, which is good at removing grease and aiding digestion to wash away intestinal filth. This is an excellent formula for stomach dryness, spleen contraction, fluid depletion, and constipation.
Xianxiong Chengqi Tang (Trap the Chest Order the Qi Decoction): A method for simultaneous treatment of the lung and large intestine, Yu's empirical formula.
Gua Lou Ren (Trichosanthes Seed) (6 qian, crushed) Xiao Zhi Shi (Immature Bitter Orange) (1.5 qian) Sheng Chuan Jun (Raw Rhubarb from Sichuan) (2 qian) Xian Ban Xia (Pinellia Tuber) (3 qian) Xiao Chuan Lian (Coptis Chinensis) (8 fen) Feng Hua Xiao (Weathered Niter) (1.5 qian)
[Commentary by Xiu] Phlegm-fire lurking in the lung causes chest and diaphragm stagnation, fullness, and pain, and even delirium and unconsciousness. If lung qi fails to descend, large intestine qi also becomes obstructed. Intestinal obstruction leads to abdominal fullness and constipation. Thus, Trichosanthes Seed and Pinellia are used as sovereign herbs, pungent and slippery, opening and descending, effectively widening the chest and opening the diaphragm. Immature Bitter Orange and Coptis Chinensis are used as minister herbs, bitter and pungent, unblocking and descending, effectively dissipating stagnation and draining fullness. However, since the lower part is blocked, qi must accumulate above. Therefore, Niter and Rhubarb are added as assistants, salty and bitter, reaching downward, allowing phlegm and fire to be resolved simultaneously. This is an excellent formula for opening the lung and unblocking the intestine, treating phlegm-fire binding.
Xi Lian Chengqi Tang (Rhino Horn and Coptis Order the Qi Decoction): A method for simultaneous treatment of the heart and small intestine, Yu's empirical formula.
Xi Jiao Zhi (Rhinoceros Horn Juice) (2 ladles, mixed in) Xiao Chuan Lian (Coptis Chinensis) (8 fen) Xiao Zhi Shi (Immature Bitter Orange) (1.5 qian) Xian Di Zhi (Rehmannia Juice) (6 ladles, mixed in) Sheng Jinwen (Raw Rhubarb) (3 qian) Zhen Jin Zhi (Gold Water) (1 liang, mixed in)
[Commentary by Xiu] The heart and small intestine are exterior-interior pairs. Heat binding in the fu organs steams upward to the pericardium. Symptoms must include delirium and unconsciousness, or even mutism resembling a corpse, commonly known as "clouding closure" in secular terms. If stool is unblocked, aromatic orifice-opening agents should be used to clarify the spirit. If constipated and orifice-opening agents are wrongly used, the heat binding in the small intestine will be sent directly into the heart orifices, which is like inviting thieves in through the door. This formula uses Rhubarb and Coptis Chinensis as sovereign herbs, extremely bitter to drain heat, cooling and draining fire in the heart and small intestine. Rhino Horn and Rehmannia juices are used as minister herbs to unblock heart spirit and save heart yin. Immature Bitter Orange is used as an assistant to reach directly to the small intestine pylorus, enabling rapid descent of fire in the heart and small intestine. However, excessive fire must have toxicity. Therefore, Gold Water is used as an envoy to moisten the intestine and detoxify. This is an excellent formula for draining the heart, unblocking the intestine, clearing fire, and expelling toxins.
Baihu Chengqi Tang (White Tiger Order the Qi Decoction): A method for clearing and purging heat accumulation in the stomach, Yu's empirical formula.
Sheng Shi Gao (Raw Gypsum Fibrosum) (8 qian, finely ground) Sheng Jinwen (Raw Rhubarb) (3 qian) Sheng Gan Cao (Raw Licorice Root) (8 fen) Bai Zhi Mu (Anemarrhena Rhizome) (4 qian) Yuan Ming Fen (Mirabilite/Niter) (2 qian) Chen Cang Mi (Aged Rice) (3 qian, wrapped in lotus leaf)
[Commentary by Xiu] Branch vessels of the stomach connect superiorly to the heart and brain. Once evil fire blocks them, it obstructs the orifices for the entrance and exit of the spirit/mind. Thus, symptoms such as unconsciousness, delirium, mania, high fever, extreme vexation, extreme thirst, profuse sweating, dry constipation, and dark scanty urine appear together. This formula combines Baihu Tang (White Tiger Decoction) and Tiaowei Chengqi Tang. One clears dry-heat in the stomach meridian, and the other drains excess fire in the stomach fu organ. This is an excellent formula for blazing stomach fire, fluid dryness, and constipation.
Taoren Chengqi Tang (Peach Kernel Order the Qi Decoction): A method for urgent purgation of blood-heat in the intestines, Yu's empirical formula.
Guang Tao Ren (Peach Kernel) (3 qian, do not grind) Wu Ling Zhi (Trogopterus Dung) (2 qian, wrapped) Sheng Pu Huang (Raw Pollen Typhae) (1.5 qian) Xian Sheng Di (Fresh Rehmannia Root) (8 qian) Sheng Chuan Jun (Raw Rhubarb from Sichuan) (2 qian, washed in wine) Yuan Ming Fen (Mirabilite/Niter) (1 qian) Sheng Gan Cao (Raw Licorice Root) (6 fen) Xi Jiao Zhi (Rhinoceros Horn Juice) (4 spoons, mixed in)
[Commentary by Xiu] Lower jiao blood stasis and heat, heat binding in the blood chamber. Without rapidly unblocking the stasis, heat cannot be removed. If blood-heat remains, it will inevitably steam upward to the heart and brain, causing blood accumulation, mania, and delirium. Downward, it scorches the liver and kidneys, often causing stabbing pain in the lower abdomen, leukorrhea like flowing water, and waist pain like breaking. The condition is most critical. This formula takes Zhang Zhongjing's original formula, removes Cinnamon Twig, and combines it with Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) and Shixiao San (Excellent Experience Powder). Combining these three formulas makes it quite fierce. However, urgent conditions require urgent attack, and severe conditions require heavy prescriptions. The transmission of ancient sages is generally like this. But precise differentiation is essential, and the patient's family must be clearly informed. This is a last-resort strategy ("fighting behind the city walls"). Success is not guaranteed. Believe it and take it; otherwise, seek another expert.
Jiedu Chengqi Tang (Detoxification Order the Qi Decoction): A method for severe purgation of poison-fire in the three jiaos, Yu's empirical formula.
Yin Hua (Honeysuckle Flower) (3 qian) Sheng Shan Zhi (Gardenia Fruit) (3 qian) Xiao Chuan Lian (Coptis Chinensis) (1 qian) Sheng Chuan Bo (Phellodendron Bark) (1 qian) Qing Lian Qiao (Forsythia Fruit) (3 qian) Qing Zi Qin (Scutellaria Root) (2 qian) Xiao Zhi Shi (Immature Bitter Orange) (2 qian) Sheng Jinwen (Raw Rhubarb) (3 qian) Xi Gua Xiao (Watermelon Niter) (5 fen) Jin Zhi (Gold Water) (1 liang, mixed in) Bai Tou Qiu Yin (Earthworm) (2 pieces)
First, boil 6 bowls of snow water with 2 liang of raw Mung Beans. After boiling, take the clear juice and use it to decoct the herbs.
[Commentary by Xiu] Epidemics must have poison, and poison is contagious. Symptoms cannot be differentiated by the six meridians. Therefore, Yu Jiayan legislated from the perspective of the three jiaos, showing profound insight. This formula uses Honeysuckle, Forsythia, Gardenia, and Scutellaria, light and clear to ventilate the upper jiao and resolve epidemic poison. This is what Yu Jiayan called "ascending and driving out." Coptis Chinensis combined with Immature Bitter Orange effectively regulates the middle jiao, bitter-draining and detoxifying. This is what Yu Jiayan called "dispersing and driving out." Phellodendron Bark, Rhubarb, Watermelon Niter, and Gold Water are salty and bitter, reaching downward to rapidly attack the poison. This is what Yu Jiayan called "deciding and driving out." Even snow water and Mung Bean clear juice are good materials for resolving fire poison. Combined, they form an excellent formula for draining fire, expelling poison, and treating the three jiaos universally. If there is unconsciousness, mutism, and coma resembling corpse rigidity, add Zi Xue (Purple Snow) from Ju Fang to resolve poison-fire and clarify consciousness, which is especially good.
Yangrong Chengqi Tang (Nourish Glory Order the Qi Decoction): A method for moistening dryness and purging heat accumulation, recorded in Wu Keyang's Treatise on Warm Epidemics.
Xian Sheng Di (Fresh Rehmannia Root) (1 liang) Sheng Bai Shao (White Peony Root) (2 qian) Xiao Zhi Shi (Immature Bitter Orange) (1.5 qian) Zhen Chuan Po (Magnolia Bark from Sichuan) (5 fen) You Dang Gui (Angelica Sinensis) (3 qian) Bai Zhi Mu (Anemarrhena Rhizome) (3 qian) Sheng Jinwen (Raw Rhubarb) (1 qian)
[Commentary by Xiu] Fire depression causes constipation; without purging, accumulated heat cannot be removed. Fluid depletion and intestinal dryness; without moistening, death of yin accelerates. The formula uses Siwu Tang (Four Substances Decoction) minus Chuan Xiong, heavily adding Anemarrhena to clear-nourish blood and moisten dryness, known as "increasing water to move the boat." However, merely increasing fluids without resolving binding is like stirring boiling water to stop it from boiling; it will dry up again immediately. Therefore, Xiao Chengqi Tang is used to remove accumulated heat. This is an excellent formula for fire blazing scorching blood, fluid depletion, and constipation.
[Commentary by Lian] Wu Jutong heavily used Xi Sheng Di (Fine Fresh Rehmannia), Yuan Shen (Scrophularia Root), and Mai Dong (Ophiopogon Tuber), combined with Tiaowei Chengqi Tang, named Zengye Chengqi Tang (Increase Fluids Order the Qi Decoction), derived from this formula. All are designed for heat binding, fluid depletion, intestinal dryness, and constipation.
[Commentary by Rongzhai] In He Xiushan's commentary on this formula, there is a sentence "heavily adding Anemarrhena." I believe "Anemarrhena" is a typo for "Fresh Rehmannia."
Noupo Qiwu Tang (Seven Ingredients of Magnolia Bark Decoction): A method for attacking interior while releasing exterior, Yu's empirical formula, recorded in Jin Gui Yao Lue.
Bo Chuan Po (Thin Magnolia Bark from Sichuan) (2 qian) Sheng Jinwen (Raw Rhubarb, soaked in wine 1 qian) Xian Sheng Jiang (Fresh Ginger) (1 qian) Da Hong Zao (Large Red Date) (4 pieces) Xiao Zhi Shi (Immature Bitter Orange) (1.5 qian) Chuan Gui Zhi (Cinnamon Twig from Sichuan) (8 fen) Qing Zhi Cao (Honey-fried Licorice Root) (6 fen)
[Commentary by Xiu] Abdominal fullness and pain with unpassable stool are definitive signs of interior excess and qi stagnation. Thus, the Xiao Chengqi method is used as the sovereign herb to regulate qi mechanism and drain interior excess. However, cold limbs and body heat indicate residual exterior pathogenic factors. Assisting with Guizhi Tang (Cinnamon Twig Decoction) minus White Peony Root's sour-astringent nature releases exterior pathogens and harmonizes Ying and Wei. This is an excellent formula for Taiyang-Yangming syndrome, attacking interior and releasing exterior.
Chaiqin Qingge Jian (Bupleurum and Scutellaria Clear Diaphragm Decoction): A method for attacking interior while harmonizing, Yu's empirical formula.
Chuan Chai Hu (Bupleurum Root from Sichuan) (8 fen) Sheng Jinwen (Raw Rhubarb, soaked in wine 1.5 qian) Sheng Zhi Ke (Immature Bitter Orange Peel) (1.5 qian) Jiao Shan Zhi (Charred Gardenia Fruit) (3 qian) Qing Zi Qin (Scutellaria Root) (1.5 qian) Su Bo He (Mint Leaf) (1.5 qian)
Ku Jie Geng (Platycodon Root) (1 qian) Qing Lian Qiao (Forsythia Fruit) (2 qian) Sheng Gan Cao (Raw Licorice Root) (6 fen) Xian Dan Zhu Ye (Lophatherum Leaf) (36 leaves)
[Commentary by Xiu] Shaoyang exterior pathogens bind internally in the diaphragm. The diaphragm feels like burning, chills and fever resemble malaria, heart vexation and restlessness occur, and stool is unpassable. Thus, the Liangge San (Cool Diaphragm Powder) method is used as the sovereign herb. Raw Rhubarb leads the bitter-descending nature of Gardenia and Scutellaria to cleanse stomach excess and drain interior heat. Assisted by Immature Bitter Orange and Platycodon Root to guide the pungent-cool nature of Mint, Forsythia, Licorice, and Lophatherum Leaf to ventilate diaphragm heat and release exterior pathogens. Ingeniously, Bupleurum combined with Scutellaria separates chills and fever. This is an excellent formula for Shaoyang-Yangming syndrome, attacking interior and clearing diaphragm.
Limo Yinzi (Six Grinding Elixir): A method for descending qi and unblocking bowels, Yu's empirical formula.
Shang Chen Xiang (Agarwood) (1 qian) Jian Bing Lang (Betel Nut) (1 qian) Xiao Zhi Shi (Immature Bitter Orange) (1 qian) Guang Mu Xiang (Vetiver Root) (1 qian) Tai Wu Yao (Lindera Root) (1 qian) Sheng Jinwen (Raw Rhubarb) (1 qian, each using whole root)
Grind each in boiling water to obtain 2 spoons of juice. Mix with one bowl of boiling water and take.
[Commentary by Xiu] The stomach is a yang fu organ, suitable for unblocking and descending. Wu Mo Yinzi (Five Grinding Elixir) was originally designed for qi depression with upward reversal. Obtaining Rhubarb juice further benefits it by dispersing qi stagnation and descending excess fire. This is an excellent formula for depression-fire injuring the middle, stagnation-fullness, and constipation. Its functions are numerous; students should pay attention.
Zhishi Daozhi Tang (Immature Bitter Orange Guiding Stasis Decoction): A method for descending stasis and unblocking bowels, Yu's empirical formula.
Xiao Zhi Shi (Immature Bitter Orange) (2 qian) Sheng Jinwen (Raw Rhubarb, 1.5 qian washed in wine) Jing Zha Rou (Hawthorn Flesh) (3 qian) Jian Bing Lang (Betel Nut) (1.5 qian) Bo Chuan Po (Thin Magnolia Bark from Sichuan) (1.5 qian) Xiao Chuan Lian (Coptis Chinensis) (6 fen) Liu He Qu (Medicated Leaven) (3 qian) Qing Lian Qiao (Forsythia Fruit) (1.5 qian) Lao Zi Cao (Arnebia Root/Lithospermum) (3 qian) Xi Mu Tong (Akebia Stem) (8 fen) Sheng Gan Cao (Raw Licorice Root) (5 fen)
[Commentary by Xiu] When treating warm diseases and heat syndromes, one often急于 (hurries to) clear fire while neglecting interior stasis. One must know that the stomach governs muscles. If the stomach does not disseminate and transform, muscles cannot relax naturally. Even with vigorous cooling and resolving, it may result in "ice freezing" (pathogen trapped inside). This formula uses Xiao Chengqi Tang combined with Coptis Chinensis and Betel Nut as sovereign herbs, bitter-descending and pungent-unblocking, effectively guiding interior stasis. Hawthorn and Medicated Leaven are used as minister herbs to regulate the middle. Forsythia and Arnebia are used to vent the upper. Akebia guides downward. Licorice Root harmonizes the drugs. Those that open, open; those that descend, descend. Unblocking occurs spontaneously without forced ventilation. Often, after stool passage, rashes erupt completely, thanks to this formula. This is an excellent formula for eliminating accumulation, descending stasis, and treating the three jiaos simultaneously.
Jiawei Liangge Jian (Modified Cool Diaphragm Decoction): A method for descending phlegm and unblocking bowels, Yu's empirical formula.
Feng Hua Xiao (Weathered Niter) (1 qian) Wei Gan Sui (Roasted Kansui Root) (8 fen) Ting Li Zi (Periploca Seed) (1.5 qian) Su Bo He (Mint Leaf) (1.5 qian) Sheng Jinwen (Raw Rhubarb, 1 qian washed in wine) Bai Jie Zi (White Mustard Seed) (8 fen) Pian Huang Qin (Scutellaria Root Slice) (1.5 qian) Jiao Shan Zhi (Charred Gardenia Fruit) (3 qian) Qing Lian Qiao (Forsythia Fruit) (1.5 qian) Xiao Zhi Shi (Immature Bitter Orange) (1.5 qian) Xian Zhu Li (Bamboo Juice) (2 ladles) Sheng Jiang Zhi (Ginger Juice) (2 drops, mixed in)
[Commentary by Xiu] Warm-heat diseases often carry phlegm-fire congesting the lung. Symptoms include abundant phlegm, coughing, a sound in the throat like a water hen, flaring nostrils, hot breath, chest and diaphragm stagnation and fullness, abdominal distension, and constipation. Severe cases lead to wheezing, distension, confusion, and chest/abdomen hard as iron, leading to death from distension. The emergency method is to use this formula quickly. Liangge San (Cool Diaphragm Powder) is used as the sovereign herb to remove fire. Immature Bitter Orange, Periploca Seed, White Mustard Seed, and Kansui Root are used as minister herbs to drive out phlegm and descend qi. Bamboo Juice and Ginger Juice are used as assistants, pungent and moistening to unblock collaterals, turning danger into safety. If one fears its harshness and does not use it, instead using mediocre drugs to shirk responsibility, less than one in a hundred will survive.
Tao Shi Huanglong Tang (Master Tao's Yellow Dragon Decoction): A method for attacking and tonifying simultaneously, Yu's empirical formula, recorded in Tao Shi's Six Books.
Sheng Jinwen (Raw Rhubarb, 1.5 qian soaked in wine) Zhen Chuan Po (Magnolia Bark from Sichuan) (6 fen) Ji Lin Shen (Jilin Ginseng) (1.5 qian, decocted separately) Qing Zhi Cao (Honey-fried Licorice Root) (8 fen) Yuan Ming Fen (Mirabilite/Niter) (1 qian) Xiao Zhi Shi (Immature Bitter Orange, 8 fen honey-fried) Bai Gui Shen (Angelica Sinensis Body) (2 qian) Da Hong Zao (Large Red Date) (2 pieces)
[Commentary by Xiu] This formula is established for "missed purgation" cases (where purgation should have been used but wasn't), presenting with grasping at bedclothes, empty picking movements, unconsciousness, cold limbs, extreme deficiency with blazing heat. Without purgation, death is certain. Thus, Da Chengqi Tang is used for urgent purgation to preserve yin. Meanwhile, Ginseng, Angelica, Licorice, and Dates are used to tonify both qi and blood to support healthy qi. This is an excellent formula for dual deficiency of qi and blood, treating both pathogen and healthy qi.
[Commentary by Lian] Among the above sixteen formulas, ten are named "Chengqi," and six secretly use the Chengqi principle but have different names. Warming, clearing, reducing, and tonifying methods are all present, addressing qi, blood, phlegm, and food. It can be said that the methods are excellent and intentions beautiful. However, there are eight prohibitions for using Chengqi Decoctions: 1. Exterior not resolved, e.g., aversion to cold not removed, clear long urination, indicating disease is still in the exterior. Method should be sweating. 2. Hardness and fullness below the heart. Below the heart refers to the area between the diaphragm and upper epigastrium. Hardness/fullness indicates shallow pathogenic factor. If wrongly attacked, diarrhea may not stop. 3. Full face redness. Redness indicates pathogen in exterior, floating fire gathering above, not binding below. Thus, cannot attack. Also, redness with delicate brightness indicates Dai Yang syndrome (floating yang), requiring careful differentiation. 4. Normally eats little, or during illness eats surprisingly well. Normally eating little implies deficient stomach qi, so cannot attack. However, if dry feces exist, usually unable to eat. If able to eat, no dry feces, just hard stool. Just needs moistening, cannot attack. 5. Frequent vomiting. Vomiting belongs to Shaoyang, pathogen in upper jiao, so cannot attack. 6. Slow pulse. Slow indicates cold. Attacking causes hiccups. 7. Internal exhaustion of body fluids. Patient sweats spontaneously, urinates freely. This is internal fluid exhaustion. Cannot attack. Use Honey Suppository to unblock. 8. Scanty urination. Patient normally urinates 3-4 times daily. Today only twice. Knows it will soon enter the large intestine. Should wait. Do not wrongly attack. Knowing these eight prohibitions prevents misuse.
Wuren Jupi Tang (Five Kernels and Tangerine Peel Decoction): A method for lubricating intestines and unblocking bowels, Yu's empirical formula.
Tian Xing Ren (Sweet Apricot Seed) (3 qian, ground fine) Song Zi Ren (Pine Nut Kernel) (3 qian) Yu Li Jing Ren (Prunus Slender Seed) (4 qian, crushed) Yuan Tao Ren (Peach Kernel) (2 qian, crushed) Bai Zi Ren (Biota Seed) (2 qian, crushed) Guang Ju Pi (Tangerine Peel) (1.5 qian, honey-fried)
[Commentary by Xiu] Apricot Seed combined with Tangerine Peel unblocks large intestine qi closure. Peach Kernel combined with Tangerine Peel unblocks small intestine blood constipation. With qi and blood unblocked and lubricated, the intestine flows smoothly. Thus, used as sovereign herb. Prunus Slender Seed with Tangerine Peel effectively resolves qi-water mutual binding, washing intestinal filth to lubricate stool. Thus, used as minister herb. Biota and Biota Seeds assist in unblocking the obscure (lower orifices). When obscure is unblocked, stool passes naturally. This is an excellent formula for moistening dryness, lubricating intestines, and treating deficiency-type constipation. For urgent purgation, add Mirabilite 2 qian and refined white honey 1 liang, decoct in water substitute. For stasis, add Zhishi Daozhi Wan 3 qian. For phlegm, add Mengshi Tun Tan Wan 3 qian. For fluid retention, add Kong Yan Dan 1 qian. For blood stasis, add Daididang Wan 3 qian. For fire, add Danggui Longhui Wan 3 qian. For parasites, add Jiaomei Wan 1.5 qian. Swallow or wrap-boil, adjust according to syndrome. This is the most common secular formula, favored by contemporary physicians for being moistening without stagnating qi and purging without damaging yin.
Zengfu Wan Formula