于栀子豉汤方内。加入甘草二两。余根据前法。得吐。止后服。
栀豉汤证具。若少气者。本方加甘草。按少气乃津液被夺。加甘草者。取其能益中而存
液。并取其能载药而速吐也。
于栀子豉汤方内。加入生姜五两。余根据前法得吐。止后服。
栀豉汤证具。若呕者。本方加生姜。盖呕则膈上之热。已犯及胃。生姜升散。领引胃中
之热。一概涌之上出。此导引之药也。
栀子(十四枚擘) 干姜(二两)
上二味。以水三升半。煮取一升半。去滓。分三服。温进一服。得吐者。止后服。
伤寒。医以丸药大下之。身热不去。微烦者。栀子干姜汤主之。喻嘉言谓此乃温中散邪
之法
。余谓不然。温中不宜用栀子。且中已宜温。何堪再吐。按误下多阳邪内陷。此则虽经误下
。而身热不去。微烦。则阳邪犹未入里。故可引之上越。必以干姜断阳邪入里之路。而栀子
乃得载邪上出。一寒一温。相反而实以相成。此之谓圣。
栀子(十四枚擘) 浓朴(四两姜炙) 枳实(四两水浸去穣炒)
以上三味。以水三升半。煮取一升半。去滓。分三服。温进一服。得吐止后服。
此虽取吐而不专恃乎吐法也。伤寒下后。心烦腹满。卧起不安者。栀子浓朴汤主之。盖
表邪虽
经误下。心烦则邪半踞于上。腹满则邪半陷于下。故以栀子涌上邪。而以枳朴通下气。亦两
解之法也。
在栀子豉汤的方剂组成中,加入甘草二两。其余按照前面的煎服方法操作,服药后出现呕吐反应,则停止服用剩余的药液。
栀子豉汤证候具备,如果患者伴有少气(气息微弱、气短)的症状,在本方中加入甘草。按:少气是由于津液被耗夺所致,加入甘草,是取其能够补益中焦并保存津液的作用,同时也取其能够载药上行以迅速引发呕吐的效果。
在栀子豉汤的方剂组成中,加入生姜五两。其余按照前面的煎服方法操作,服药后出现呕吐反应,则停止服用剩余的药液。
栀子豉汤证候具备,如果患者伴有呕吐的症状,在本方中加入生姜。盖因呕吐表明膈上的热邪已经侵犯到胃腑,生姜具有升散之性,能引领胃中的热邪,一并涌吐而出,这是作为导引药物使用。
栀子(十四枚,掰开) 干姜(二两)
以上两味药,用水三升半,煮取一升半药液,滤去药渣,分三次服用。温服一次,若服药后出现呕吐,则停止服用剩下的药液。
伤寒病,医生用丸药猛烈攻下,导致身热不退,心中微烦,应当用栀子干姜汤主治。喻嘉言认为这是温中散邪的方法。我认为并非如此。温中不宜使用栀子,且中焦已宜温,怎能再使用催吐之法?按:误用下法多导致阳邪内陷,此症虽然经过误下,但身热不退、心中微烦,说明阳邪尚未完全入里,因此可以引导其向上发散。必须用干姜阻断阳邪入里的路径,而栀子才能承载邪气从上排出。一寒一温,看似相反实则相辅相成,这就叫做圣妙。
栀子(十四枚,掰开) 厚朴(四两,姜汁炙) 枳实(四两,水浸去瓤炒)
以上三味药,用水三升半,煮取一升半药液,滤去药渣,分三次服用。温服一次,若服药后出现呕吐,则停止服用剩下的药液。
此方虽然旨在取吐,但并不专门依赖吐法。伤寒经误下后,出现心烦、腹部胀满、坐卧不安的症状,应当用栀子厚朴汤主治。盖因表邪虽然经过误下,但心烦说明邪气一半踞守于上焦,腹满说明邪气一半陷入下焦,因此用栀子涌吐上焦之邪,用枳实、厚朴疏通下焦之气,这也是上下两解的方法。
In the formula of Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), add Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*) two liang. Follow the previous method for preparation and administration. If vomiting occurs, discontinue the remaining dose.
When the syndrome of Zhizi Chi Tang is present, if there is a sensation of shortness of breath (Shaoqi, Qi deficiency manifesting as weak respiration), add Gancao (Licorice Root) to this base formula. Note: Shortness of breath results from the depletion of body fluids (Jinye). Adding Gancao utilizes its ability to tonify the Middle Jiao and preserve fluids, as well as its capacity to carry the medicinal action upward to induce rapid emesis.
In the formula of Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), add Shengjiang (Fresh Ginger, *Zingiberis Rhizoma Recens*) five liang. Follow the previous method for preparation and administration. If vomiting occurs, discontinue the remaining dose.
When the syndrome of Zhizi Chi Tang is present, if vomiting is present, add Shengjiang (Fresh Ginger) to this base formula. Vomiting indicates that the heat in the upper diaphragm has invaded the Stomach. Shengjiang possesses ascending and dispersing properties; it guides the heat in the Stomach to be vomited out entirely. Thus, it serves as an emetic guide.
Zhizi (Gardeniae Fructus, *Gardeniae Fructus*) fourteen seeds, broken apart; Ganjiang (Dried Ginger, *Zingiberis Rhizoma*) two liang.
These two ingredients are boiled in three and a half sheng of water to obtain one and a half sheng of decoction. Strain the dregs. Divide into three doses. Take one dose warm. If vomiting occurs after taking a dose, discontinue the remaining doses.
In Cold Damage (Shanghan), if a physician used pill-based purgatives to cause severe downward purging, resulting in persistent body heat and slight restlessness (Wei Fan), Zhizi Ganjiang Tang (Gardenia and Dried Ginger Decoction) should be administered. Yu Jiayan argued that this is a method of warming the middle and dissipating pathogens. I disagree. Warming the middle is not suitable with Zhizi, and since the middle jiao requires warming, how can one tolerate further emesis? Generally, erroneous purgation leads to the internal entrapment of Yang pathogens. In this case, although erroneous purgation occurred, the persistence of body heat and slight restlessness indicate that the Yang pathogen has not yet fully entered the interior. Therefore, it can be guided upward to exit. Ganjiang must be used to block the path of the Yang pathogen entering the interior, allowing Zhizi to carry the pathogen upward. One cold and one warm, seemingly opposite but actually complementary, constitutes the sagely method.
Zhizi (Gardeniae Fructus) fourteen seeds, broken apart; Houpo (Magnolia Bark, *Magnoliae Officinalis Cortex*) four liang, processed with ginger juice; Zhishi (Immature Bitter Orange, *Aurantii Fructus Immaturus*) four liang, soaked in water, pith removed, stir-fried.
These three ingredients are boiled in three and a half sheng of water to obtain one and a half sheng of decoction. Strain the dregs. Divide into three doses. Take one dose warm. If vomiting occurs after taking a dose, discontinue the remaining doses.
Although this formula aims at inducing emesis, it does not rely exclusively on the emetic method. After erroneous purgation in Cold Damage, if there is mental irritability (Xin Fan), abdominal fullness, and restlessness in lying down or sitting up, Zhizi Houpo Tang (Gardenia and Magnolia Bark Decoction) should be administered. Although the exterior pathogen was subjected to erroneous purgation, mental irritability indicates the pathogen partially occupies the Upper Jiao, while abdominal fullness indicates the pathogen partially sinks into the Lower Jiao. Therefore, Zhizi is used to涌 (surge/induce expulsion of) the pathogen in the Upper Jiao, while Zhishi and Houpo are used to unblock the Qi in the Lower Jiao. This is also a method of resolving both upper and lower aspects simultaneously.