白芍(三钱) 当归(二钱) 肉桂(一钱) 甘草(一钱)
按∶上方主治肝脏气虚,不能生火,以致火不生土。白芍之酸、甘草之甘、此系甲己化土也。肉桂补肝
之子、益土之母,所以培生化之原也。凡脾味不和,饮食不进,其外见症,两胁寒痛,大便泄利,少腹坠痛,
并宜此方治之。再按,此小建中汤原方主治也。千金方加当归,名当归建中。治妇人产后,虚羸不足,腹中痛
引腰背。小腹拘急,今恐甜多入脾,而去胶饴。则当归建中,尤与肝脏气虚切合矣。
凡舌见青色干燥,而形色反见胖嫩者;肝胆气血两虚也,七味饮倍肉桂主之。
熟地(八钱) 山药(四钱) 净萸肉(四钱) 丹皮(三钱) 茯苓(三钱)
泽泻(二钱) 肉桂(二钱)
按∶上方主治肝胆气虚,筋无所养,变为寒症。以致筋骨疼痛,脚软懒行,及伤寒服凉药过多,木中无火,
手足牵引,肝经血虚,以致火燥筋挛,变为结核瘰 等症。经曰∶
“辛以润之。”此方是也。
凡舌见青色滑润,而形色又兼胖嫩者,肝胆木气虚寒也,养荣汤倍肉桂主之。
白芍(三钱) 当归(二钱) 远志(一钱) 五味(钱半) 肉桂(一钱)
熟地(四钱) 陈皮(一钱半) 白术(三钱米泔水浸蒸) 黄 (三钱蜜炙无参倍用) 人参(多少随
宜) 茯苓(一钱半) 炙草(一钱半) 煨姜(一钱半) 大枣(五枚)
按∶上方主治,凡属大虚症,勿论其脉与症,但服此方,诸症悉退,此十全大补汤对子也。但十全大补
只分气血,此则五脏皆补,无虚不到,虚而寒甚者,当加附子以治之;三阴虚更妙。后凡用本
方加减者,主治并同。
凡舌见黄色而坚敛苍老者,脾胃两经邪气盛也,泻黄散主之。
按语:上述方剂主治肝脏气虚,不能生火,导致火不生土。白芍的酸味与甘草的甘味,属于甲己化土(天干中甲属木、己属土,酸甘化阴以健脾)的配伍原理。肉桂补益肝之子(心)、益土之母(火),从而培补生化之源。凡是脾胃不和,饮食不进,外在表现出的症状如两胁寒痛、大便泄泻、少腹坠痛等,都适宜用此方治疗。再按语,这是小建中汤原方的主治范畴。《千金方》中加入当归,名为当归建中汤。用于治疗妇人产后,身体虚弱羸瘦、气血不足,腹痛牵引腰背,小腹拘急疼痛。如今担心甜味药物过多入脾碍胃,所以去掉胶饴(麦芽糖)。这样当归建中汤就更契合肝脏气虚的病机了。
凡是舌象呈现青色且干燥,但舌体形态反而显得胖嫩者,属于肝胆气血两虚,使用七味饮并加倍肉桂为主治方剂。
熟地黄(八钱) 山药(四钱) 净山茱萸肉(四钱) 牡丹皮(三钱) 茯苓(三钱)
泽泻(二钱) 肉桂(二钱)
按语:上述方剂主治肝胆气虚,筋脉失去濡养,演变为寒证。导致筋骨疼痛、腿脚软弱懒于行走,以及伤寒病服用凉药过多,导致肝木中无火,手足抽搐牵引;或因肝经血虚,导致火燥筋挛,演变为结核、瘰疬等症。《内经》说:“辛以润之。”指的就是此方。
凡是舌象呈现青色且滑润,且舌体形态兼有胖嫩者,属于肝胆木气虚寒,使用养荣汤并加倍肉桂为主治方剂。
白芍(三钱) 当归(二钱) 远志(一钱) 五味子(一钱半) 肉桂(一钱)
熟地黄(四钱) 陈皮(一钱半) 白术(三钱,用米泔水浸泡后蒸制) 黄芪(三钱,蜜炙,若无党参则加倍使用) 人参(用量随病情适宜而定) 茯苓(一钱半) 炙甘草(一钱半) 煨生姜(一钱半) 大枣(五枚)
按语:上述方剂的主治范围是,凡是属于大虚证的病症,不论其脉象与症状如何,只要服用此方,各种症状都会消退,这是十全大补汤的对等方剂。但十全大补汤只区分补气与补血,此方则五脏皆补,无处不补到虚损之处。若虚损而寒邪严重者,应当加入附子来治疗;若是三阴虚寒证,效果更佳。此后凡是用本方进行加减治疗的,主治原则均相同。
Bai Shao (Radix Paeoniae Alba, 3 qian) Dang Gui (Radix Angelicae Sinensis, 2 qian) Rou Gui (Cortex Cinnamomi, 1 qian) Gan Cao (Radix Glycyrrhizae Preparata, 1 qian)
Note: The above formula primarily treats Liver Qi deficiency (Liver Qi Xu), where the inability to generate Fire leads to Fire failing to generate Earth. The sour flavor of Bai Shao and the sweet flavor of Gan Cao constitute the principle of "Jia-Ji transforming into Earth" (referring to the interaction between Wood and Earth elements). Rou Gui tonifies the child of the Liver (Heart) and benefits the mother of Earth (Fire), thereby cultivating the source of transformation and generation. For cases of Spleen-Stomach disharmony with poor appetite, presenting with external symptoms such as cold pain in both hypochondria, diarrhea, and dragging pain in the lower abdomen, this formula is suitable. Additionally, this corresponds to the original indication of Xiao Jian Zhong Tang (Minor Construct the Middle Decoction). In *Qian Jin Fang*, Dang Gui is added to create Dang Gui Jian Zhong Tang. It is used to treat postpartum women suffering from emaciation, insufficiency of deficiency and thinness, abdominal pain radiating to the back, and urgency/constriction in the lower abdomen. Currently, fearing that excessive sweetness may hinder the Spleen, Jiao Yi (Maltose) is removed. Thus, Dang Gui Jian Zhong Tang is even more applicable to Liver Qi deficiency.
Whenever the tongue appears cyanotic and dry, yet its shape appears swollen and tender, it indicates a dual deficiency of Qi and Blood in the Liver and Gallbladder; treat with Qi Wei Yin (Seven-Ingredient Drink) with doubled Rou Gui.
Shu Di Huang (Prepared Radix Rehmanniae, 8 qian) Shan Yao (Rhizoma Dioscoreae, 4 qian) Jing Yu Rou (Pericarpium Corni, 4 qian) Dan Pi (Cortex Moutan, 3 qian) Fu Ling (Poria, 3 qian)
Ze Xie (Rhizoma Alismatis, 2 qian) Rou Gui (Cortex Cinnamomi, 2 qian)
Note: The above formula primarily treats Liver and Gallbladder Qi deficiency, where tendons lack nourishment, transforming into Cold syndromes. This results in pain in bones and tendons, weakness in legs making walking reluctant, and after excessive use of cooling medicines for Shang Han (Cold Damage), leading to a lack of Fire within Wood, causing traction/twitching of hands and feet; or due to Blood deficiency in the Liver meridian, leading to Fire-dryness contracting tendons, transforming into conditions such as tubercles and scrofula (Luo Li). The Classics state: "Pungent flavors moisten." This refers to this formula.
Whenever the tongue appears cyanotic and slippery/moist, and its shape is also swollen and tender, it indicates deficiency-cold of Wood Qi in the Liver and Gallbladder; treat with Yang Rong Tang (Nourish the Vigor Decoction) with doubled Rou Gui.
Bai Shao (Radix Paeoniae Alba, 3 qian) Dang Gui (Radix Angelicae Sinensis, 2 qian) Yuan Zhi (Radix Polygalae, 1 qian) Wu Wei Zi (Fructus Schisandrae, 1.5 qian) Rou Gui (Cortex Cinnamomi, 1 qian)
Shu Di Huang (Prepared Radix Rehmanniae, 4 qian) Chen Pi (Pericium Citri Reticulatae, 1.5 qian) Bai Zhu (Rhizoma Atractylodis Macrocephalae, 3 qian, soaked in rice wash water and steamed) Huang Qi (Radix Astragali, 3 qian, honey-fried; if Dang Shen is unavailable, double the dose) Ren Shen (Radix Ginseng, dosage according to suitability) Fu Ling (Poria, 1.5 qian) Zhi Cao (Radix Glycyrrhizae Preparata, 1.5 qian) Wei Jiang (Zingiberis Rhizoma Praeparatum, 1.5 qian) Da Zao (Fructus Jujubae, 5 pieces)
Note: The primary indication for the above formula is for all major deficiency syndromes; regardless of pulse or symptoms, taking this formula will cause all symptoms to recede. It is the counterpart to Shi Quan Da Bu Tang (Ten Significant Great Tonifying Decoction). However, while Shi Quan Da Bu Tang only distinguishes between Qi and Blood tonification, this formula tonifies all five Zang organs, leaving no deficiency unaddressed. For severe deficiency with cold, Fu Zi (Radix Aconiti Lateralis Preparata) should be added; it is particularly effective for deficiency-cold of the Three Yin meridians. For subsequent modifications of this base formula, the indications remain the same.
Whenever the tongue appears yellow, firm, contracted, and aged/coarse, it indicates excess pathogenic factors in the Stomach and Spleen meridians; treat with Xie Huang San (Drain Yellow Powder).