治栀子豉汤证中若加呕者。此方主之。
栀子（十四枚） 生姜（五两 内台。止用一两）香豉（四合）
上三味。以水四升。先煮栀子、生姜。取二升半。内豉。煮取升半。去滓。分温二服。
歌曰 栀豉原方效可夸。气羸二两炙甘加。若加五两生姜入。专取生姜治呕家。
蔚按。栀豉解见上。汗吐下后。中气虚不能交通上下。故加甘草以补中。呕者汗吐下后
胃阳
治伤寒下后。心烦腹满。卧起不安者。此方主之。
栀子（十四枚） 浓朴（四两） 枳实（四枚 水浸去穣。炒。）
上三味。以水三升。煮取一升半。去滓。分温二服。（本张氏重订。）
歌曰 朴须四两枳四枚。十四山栀亦妙哉。下后心烦还腹满。止烦泄满效兼该。
柯韵伯曰。心烦则难卧。腹满则难起。起卧不安是心移热于胃。与反复颠倒之虚烦不同。
栀
治伤寒医以丸药大下之。身热不去。微烦者主之。
栀子（十四枚） 干姜（二两）
上二味。以水三升半。煮取一升半。去滓。分二服。温进一服。（从张氏。删去二句。）
歌曰 十四山栀二两姜。以丸误下救偏方。微烦身热君须记。辛苦相需尽所长。
张令韶曰。栀子导阳热以下行。干姜温中土以上达。上下交而烦热止矣。
嘉庆戊辰。吏部谢芝田先生令亲。患头项强痛。身疼。心下满。小便不利。服表药。无
汗。
形之太阳也。但使有形之太阳小便一利。则所有病气俱随无形之经气而汗解矣。用桂枝去桂
加茯苓白术汤。一服遂瘥。惟夜间不寐。特告曰。此名虚烦。因辛热遗害。若用枣仁、远志、
茯神等药。反招集其所遗而为孽。病必复作矣。用栀子豉汤。即愈。
嘉庆己巳季春。曹扶谷明府。患头痛项强恶寒等证。自差次回垣后。更增出寒热往来。
欲呕胸满等证。家严诊其脉数中见小。按之虚不应指。骇谓之曰。阳证见阴脉。法在不治。
所幸者大小便如常。神识颇清。正虽虚而尚未溃。察其胸满欲呕寒热往来之证。俱是病气欲
从枢转之象。当乘机而利导之。遂令一日服小柴胡两剂。柴胡每剂八钱。次日再诊。以上诸
证虽退。而心胸懊 不安。语言错乱无次。实觉可忧。又诊其脉略缓。遂为之喜曰。邪从枢
转而出。故寒热等证俱平。正为邪热所伤。故烦昏等证并见。此时须当救正。但救正二字。
不读伤寒、金匮。便以人参误事。立主用栀子豉汤从离坎交媾处拨动神机。服后停药。静候
三日。值阳明主气之期。申酉为阳明正旺之时。戊癸相合自愈。果如言应期而效。
To treat cases of Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) syndrome where vomiting is added, this formula is the primary treatment.
Zhizi (Gardeniae Fructus, 14 pieces), Shengjiang (Zingiberis Rhizoma Recens, 5 liang; note: actually use only 1 liang), Xiangchi (Sojae Semen Praeparatum, 4 he).
Take the above three herbs. Add four sheng of water. First decoct Zhizi and Shengjiang to obtain two and a half sheng of liquid. Add Xiangchi, and decoct further to obtain one and a half sheng. Strain the dregs, divide into two doses, and take warm.
The song says: The efficacy of the original Zhichi formula is praiseworthy. For those with Qi deficiency, add two liang of Zhi Gancao (Honey-fried Licorice Root). If five liang of Shengjiang are added, it specifically targets treating patients with vomiting.
Wei's commentary: The explanation for Zhichi can be found above. After sweating, emesis, or purging, the Middle Qi is deficient and unable to communicate between upper and lower, hence Gancao (Licorice Root) is added to tonify the Middle. Vomiting occurs due to damage to Stomach Yang after sweating, emesis, or purging...
To treat Taiyang disease (Cold Damage) after purgation, presenting with vexillation in the chest, abdominal fullness, and restlessness in lying down or sitting up, this formula is the primary treatment.
Zhizi (Gardeniae Fructus, 14 pieces), Houpo (Magnoliae Officinalis Cortex, 4 liang), Zhishi (Aurantii Fructus Immaturus, 4 pieces, soaked in water, removed of pith, stir-fried).
Take the above three herbs. Add three sheng of water, decoct to obtain one and a half sheng. Strain the dregs, divide into two doses, and take warm. (Revised according to Zhang's edition.)
The song says: Use four liang of Houpo and four pieces of Zhishi; fourteen Gardenia fruits are also wonderful. After purging, if vexillation and abdominal fullness remain, this formula comprehensively stops vexillation and drains fullness.
Ke Yunbo said: Vexillation makes lying down difficult; abdominal fullness makes rising difficult. Restlessness in lying and rising indicates Heart heat transferring to the Stomach, which is different from the empty vexillation characterized by tossing and turning.
To treat Taiyang disease where the physician mistakenly used pill-based strong purgatives, resulting in persistent body heat and slight vexillation, this formula is the primary treatment.
Zhizi (Gardeniae Fructus, 14 pieces), Ganjiang (Zingiberis Rhizoma, 2 liang).
Take the above two herbs. Add three and a half sheng of water, decoct to obtain one and a half sheng. Strain the dregs, divide into two doses, take one dose warm. (Following Zhang's edition, two sentences deleted.)
The song says: Fourteen Gardenia fruits with two liang of Ginger, a remedial prescription for mistaken purging with pills. Remember the slight vexillation and body heat; the combination of pungent and bitter flavors maximizes their efficacy.
Zhanglingshao said: Zhizi guides Yang-heat downward, while Ganjiang warms the Middle Earth upward. When upper and lower communicate, vexillation and heat cease.
In the year Jiachen of Jiaqing, a relative of Mr. Xie Zhitian from the Ministry of Personnel suffered from stiffness and pain in the head and neck, body ache, fullness in the epigastrium, and difficulty urinating. After taking exterior-releasing medicines, there was no sweat.
This is a disorder of the Form-based Taiyang. If the urination of the Form-based Taiyang bladder is facilitated, all pathogenic factors will resolve through sweating along with the movement of the Formless Meridian Qi. Guizhi Qu Gui Jia Fuling Baizhu Tang (Cinnamon Twig Decoction minus Cinnamon Twig plus Poria and Atractylodes Macrocephala Decoction) was used, and the patient recovered after one dose. However, he suffered from insomnia at night. He specifically told me: This is named Empty Vexillation, caused by the lingering harm of pungent-hot drugs. Using herbs such as Suanzaoren (Ziziphi Spinosae Semen), Yuanzhi (Polygalae Radix), and Fushen (Poria with Hostwood) would instead gather the residual pathogens and cause disaster, leading to recurrence. Therefore, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) was used, and he recovered immediately.
In the late spring of the year Yisi of Jiaqing, Magistrate Cao Fugu suffered from headache, neck stiffness, aversion to cold, and other symptoms. After returning home following a period of improvement, he developed alternating chills and fever, desire to vomit, and chest fullness. My father palpated his pulse, finding it rapid but small, and hollow upon pressure, not responding to the finger. Astonished, he said: An Yang syndrome (Heat syndrome) presenting with Yin pulse characteristics is legally considered untreatable. Fortunately, urination and defecation are normal, and consciousness is clear. Although Zheng Qi (Upright Qi) is deficient, it has not yet collapsed. Observing the symptoms of chest fullness, desire to vomit, and alternating chills and fever, these are signs that the pathogenic factor intends to transform via the Shao Yang pivot mechanism. One should seize the opportunity to guide it favorably. Thus, he prescribed two doses of Xiaochaihu Tang (Minor Bupleurum Decoction) per day, with each dose containing eight qian of Chaihu (Bupleuri Radix). On the next day, upon re-examination, although the aforementioned symptoms had subsided, the patient experienced chest and epigastric oppression and discomfort, and disordered speech without sequence, which was truly worrying. Upon re-palpating the pulse, which was slightly slower, he rejoiced and said: The pathogen has exited via the pivot transformation, hence the chills and fever have ceased. Zheng Qi has been injured by pathogenic heat, hence vexillation and confusion appear together. At this time, it is imperative to rescue Zheng Qi. However, the term "rescuing Zheng Qi," if misunderstood by those who have not studied Shanghan Lun (Treatise on Cold Damage) and Jingui Yaolue (Essential Prescriptions from the Golden Cabinet), leads to errors using Renshen (Ginseng Radix). Immediately, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) was advocated to stimulate the Shen mechanism (Spiritual Mechanism) through the interaction of Li (Fire/Heart) and Kan (Water/Kidney). After taking the medicine, it was stopped, and three days were waited quietly. It coincided with the period when Yangming (Stomach/Large Intestine) governs the Qi. Shen and You hours are the peak times of Yangming Qi. Wu and Gui combine naturally, leading to self-healing. Indeed, as predicted, the effect occurred at the expected time.