治伤寒阳脉涩。阴脉弦。法当腹中急痛者。以此方主之。又伤寒二三日。心中悸
此方主之。
芍药（六两） 桂枝（三两） 甘草（二两） 生姜（三两） 胶饴（一升） 大枣（十
二
上六味。以水七升。煮取三升。去滓。内胶饴。更上微火消解。温服一升。日三服。呕
家不
歌曰 建中即是桂枝汤。倍芍加饴绝妙方。饴取一升六两芍。悸烦腹痛有奇长。
程扶生曰。伤寒二三日。邪尚在表。未及传里之时。悸则阳虚。烦则阴虚。故以芍药之
苦以
而姜、桂等又能托邪外出。此为阴阳两虚之人而立一养正驱邪法也。
张令韶曰。经隧之血脉。流行不息。今寒气入而稽迟之。入阳络则阳脉涩。入阴络则阴
脉弦
枢机利则经隧之血脉通矣。通则不痛也。
蔚考。金匮黄 建中汤有加减法。小建中汤无加减法。今查内台方议亦有加减。未知为
年久
者。
胡、地骨皮。
治太阳病未解便传入阳明。大便不通。热实心烦。或寒热往来。其脉沉实者。以
之。
柴胡（半斤） 半夏（半升） 芍药（三两） 黄芩（三两） 生姜（五两） 枳实（四
枚
上七味。以水一斗二升。煮取六升。去滓。再煎。温服一升。日三服。一方。用大黄二
两。
歌曰 八柴四枳五生姜。芩芍三分二大黄。半夏半升十二枣。少阳实证下之良。
蔚按。凡太阳之气逆而内干。必藉少阳之枢转而外出者。仲景名为柴胡证。但小柴胡证
心烦
郁微烦。曰心下痞硬。以此为别。小柴胡证曰喜呕。曰或胸中烦而不呕。而大柴胡证不独不
呕。而且呕吐。不独喜呕。而且呕不止。又以此为别。所以然者。太阳之气不从枢外出。反
从枢内入于君主之分。视小柴胡证颇深也。方用芍药、黄芩、枳实、大黄者。以病势内入。
必取苦泄之品以解在内之烦急也。又用柴胡、半夏以启一阴一阳之气。生姜、大枣以宣发中
焦之气。盖病势虽已内入。而病情仍欲外达。故制此汤。还藉少阳之枢而外出。非若承气之
上承热气也。汪 庵谓加减小柴胡、小承气而为一方。未免以庸俗见测之也。
Treats Taiyang disease (Taiyang syndrome) that has not resolved and has transmitted to Yangming disease (Yangming syndrome), resulting in constipation, heat excess causing mental restlessness, or alternating chills and fever, with a deep and solid pulse. This formula is used to treat it.
Chaihu (Bupleuri Radix, half jin) Banxia (Pinelliae Rhizoma, half sheng) Shaoyao (Paeoniae Radix Alba, three liang) Huangqin (Scutellariae Radix, three liang) Shengjiang (Zingiberis Rhizoma Recens, five liang) Zhishi (Aurantii Fructus Immaturus, four pieces)
The above seven ingredients are boiled in one dou two sheng of water until six sheng remain. The dregs are removed, and the decoction is boiled again. One sheng is taken warm each time, three times a day. Another version uses Dahuang (Rhei Radix et Rhizoma, two liang).
Song says: Eight parts Chaihu, four Zhishi, five Shengjiang. Three parts Huangqin and Shaoyang, two parts Dahuang. Half sheng Banxia, twelve Zao. It is an excellent prescription for purging Shaoyang excess syndromes.
Wei notes: Whenever Qi of Taiyang rebels and invades inward, it must rely on the pivot function of Shaoyang to exit outward. Zhang Zhongjing calls this Chaihu syndrome. However, there is a distinction between Xiao Chaihu Tang (Minor Bupleurum Decoction) syndrome and Da Chaihu Tang syndrome. Xiao Chaihu Tang syndrome presents as slight mental depression and vexation, described as epigastric fullness and hardness, which serves as the differentiation point. Xiao Chaihu Tang syndrome is characterized by a preference for vomiting, or chest vexation without vomiting. In contrast, Da Chaihu Tang syndrome is not only free from vomiting but involves actual vomiting; it is not merely a preference for vomiting but incessant vomiting, which serves as another differentiation point. The reason for this is that Taiyang Qi does not exit via the pivot but instead enters inward through the pivot into the realm of the Sovereign (Heart/Zang-fu), indicating a deeper condition than Xiao Chaihu Tang syndrome. The formula uses Shaoyao, Huangqin, Zhishi, and Dahuang because the pathological trend has moved inward, requiring bitter-draining herbs to resolve internal vexation and urgency. Furthermore, Chaihu and Banxia are used to initiate the Qi of Yin and Yang, while Shengjiang and Zao are used to disseminate the Qi of the Middle Jiao. Although the pathological trend has entered inward, the condition still tends toward outward expression. Therefore, this decoction is formulated to rely on the Shaoyang pivot to expel pathogens outward, unlike Chengqi Tang formulas which simply descend heat. Wang Ang considered this to be a combination derived from modifications of Xiao Chaihu Tang and Xiao Chengqi Tang, which is a vulgar interpretation.