枳实(二枚) 栀子(十四枚) 豉(一升)
上三味。以清浆水七升。空煮取四升。内枳实栀子。煮取二升。下豉。更煮五六沸。去
滓。温分再服。覆令微似汗。
栀豉汤散上焦之结热。为取吐之轻剂。此则先用清浆水空煮减三升。则水性熟而沉。使
栀豉从
枳实下行之力。清上泄下。以此通利三焦。营卫得和而病自愈。若有宿食者。加大黄如博棋
子大五六枚。则食复之治法。亦不外是矣。因食而复。去其食。而邪自化。从此可悟治病总
当责邪也。
栀子(十五枚) 甘草(一两炙) 黄柏(一两)
上三味。以水四升。煮取一升半。去滓。分温再服。
伤寒身黄发热者。栀子柏皮汤主之。按身黄发热。热已有外泄之机。从内之外者治其内
。故
用栀子柏皮。直清其热。则热清而黄自除。用甘草者。正引药逗遛中焦。以清热而导湿也。
按栀豉汤乃取吐之轻剂。此方之用栀子。得炙草之甘缓。黄柏之苦降。而栀子又能从中
焦分解湿热。洵乎处方之妙。乃用药而不为药用者也。
瓜蒂(熬黄) 赤小豆(各一分)
上二味。各别捣筛为散已。合治之取一钱匕。以香豉一合。用热汤七合。煮作稀糜。去
滓。和散。顿服之。不吐者少少加,得快吐乃止。诸亡血虚家。不可与之。
凡邪在胸中者宜吐。所谓在上者因而越之是也。三味皆探吐之品。必煮作稀糜。留恋中
焦。方得引邪上涌而出。栀豉汤吐虚邪。此方以吐实邪。同一吐法。而所主不同。
以上三味药。用清浆水七升,先空煮至剩余四升。加入枳实和栀子,煮取二升药液。再加入豆豉,继续煮沸五六次。滤去药渣。温服,分两次服用。服药后覆盖衣被,使身体微微似有汗出。
栀豉汤散上焦之结热,是作为催吐的轻剂。此处先用清浆水空煮减少三升,则水性变得熟而沉,借助枳实下行的力量,引导栀豉下行,从而清泄上部、通利下部,以此疏通三焦。营卫调和则病自愈。如果有宿食停滞者,加大黄如棋子大小五六枚,这是治疗因饮食复发的方法,也不外乎此理。因为饮食不当而复发,去除积食,邪气自然化解。从此可以领悟治病总应当责求于邪气。
以上三味药。用水四升,煮取一升半药液。滤去药渣。分两次温服。
伤寒导致身体发黄且发热的,主治方为栀子柏皮汤。按:身体发黄发热,说明热邪已有向外透泄的趋势。病由内达外,应治其内部。因此使用栀子、黄柏,直接清泄热邪,热清则黄疸自除。使用甘草的目的,正是引导药物停留于中焦,以清热并导湿。
按:栀豉汤是作为催吐的轻剂。此方中使用栀子,配合炙甘草的甘缓之性,以及黄柏的苦降之性,而栀子又能从中焦分解湿热,确实是处方精妙之处,达到了用药而不拘泥于药物常规功效的境界。
以上两味药,分别捣碎筛成粉末后,混合均匀。取一钱匕量的药粉。用香豉一合,热汤七合,煮成稀粥状。滤去药渣,将药粉与药汁混合,一次性顿服。如果不呕吐,少量增加剂量,直到引起剧烈呕吐为止。凡是失血或体质虚弱的人,不可给予此方。
凡邪气在胸中的,适宜采用催吐法。这就是所谓“在上者,因而越之”的道理。这三味药都是探吐的药物。必须煮成稀粥状,使其留恋于中焦,才能引导邪气向上涌出而排出。栀豉汤吐出的是虚邪,此方吐出的是实邪。虽然同属催吐法,但所主治的情况不同。
Zhi Shi (Immature Bitter Orange, Fructus Aurantii Immaturus) [2 pieces] Zhi Zi (Gardenia Fruit, Fructus Gardeniae) [14 pieces] Chi Xiao Dou (Fermented Soybean, Semen Sojae Preparatum) [1 sheng]
The above three ingredients. Boil in seven sheng of Qing Jiang Shui (clear sour rice water) alone until reduced to four sheng. Add Zhi Shi and Zhi Zi, boil until two sheng remains. Then add Chi Xiao Dou, boil for five or six more boils. Strain the dregs. Take warm, divided into two doses. Cover with blankets to induce a slight sweat.
Zhi Chi Tang (Gardenia and Fermented Soybean Decoction) disperses constrained heat in the Upper Jiao (Upper Burner). It serves as a mild emetic. Here, Qing Jiang Shui is boiled alone first to reduce by three sheng, making the water property mature and heavy/sinking. This aids the descending force of Zhi Shi, guiding Zhi Chi downwards. It clears the upper and drains the lower, thereby unblocking the San Jiao (Triple Burner). When Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) harmonize, the disease heals spontaneously. If there is retained food (Su Shi), add Da Huang (Rhubarb Root, Radix et Rhizoma Rhei) in pieces the size of chess stones, about five or six pieces. This is the treatment method for recurrence due to diet, which does not go beyond this principle. Because recurrence is caused by food, removing the food causes the pathogen to transform naturally. From this, one can realize that treating diseases should always focus on addressing the pathogen.
Zhi Zi (Gardenia Fruit, Fructus Gardeniae) [15 pieces] Gan Cao (Licorice Root, Radix Glycyrrhizae Preparata) [1 liang, honey-fried] Huang Bo (Phellodendron Bark, Cortex Phellodendri Chinensis) [1 liang]
The above three ingredients. Boil in four sheng of water until one and a half sheng remains. Strain the dregs. Take warm, divided into two doses.
For Tai Yang Disease (Exogenous Cold Damage) presenting with jaundice and fever, Zhi Zi Bai Pi Tang (Gardenia and Phellodendron Decoction) is the primary formula. Note: Jaundice with fever indicates that the heat has a tendency to vent outward. Since the pathology moves from interior to exterior, treat the interior. Therefore, use Zhi Zi and Huang Bo to directly clear the heat; once the heat is cleared, the jaundice will resolve. Gan Cao is used to guide the medicinal properties to linger in the Middle Jiao (Middle Burner), clearing heat and directing dampness.
Note: Zhi Chi Tang is a mild emetic. In this formula, Zhi Zi is used with the sweet and moderating nature of Honey-fried Gan Cao, and the bitter and descending nature of Huang Bo. Zhi Zi also resolves damp-heat from the Middle Jiao. Truly, this demonstrates the subtlety of prescription formulation, achieving the effect of using medicine without being limited by the conventional efficacy of the herbs.
Gua Di (Melon Seed, Semen Cucumis Melonis) [Stir-fried until yellow] Chi Xiao Dou (Red Adzuki Bean, Semen Phaseoli Angularis) [Each 1 fen]
The above two ingredients. Grind and sieve each separately into powder, then mix them together. Take one Qian Bi (a measure equivalent to a coin scoop) of the powder. Use Xiang Chi Dou (Fragrant Fermented Soybean, Semen Sojae Preparatum) one he, and hot water seven he. Boil into a thin porridge. Strain the dregs. Mix with the powder and take in one dose. If vomiting does not occur, gradually increase the dose slightly until vigorous vomiting occurs. Do not administer to patients who have lost blood or are constitutionally deficient.
Whenever pathogens are located in the chest, emesis is appropriate. This is what is meant by "Those in the upper region should be evacuated upwards." All three ingredients are emetic agents. They must be boiled into a thin porridge so that they linger in the Middle Jiao, thereby guiding the pathogen to surge upward and be expelled. Zhi Chi Tang expels empty/deficiency pathogens, while this formula expels solid/excess pathogens. Although both are emetic methods, their indications differ.