黄连 黄芩 黄柏 栀子
主发 热甚。心烦不得眠。 中州热不得越。则肌肉斑烂。脾主肌肉故也。是方以黄连
泻丙丁。以黄芩泻庚辛。以黄柏泻壬癸。以栀子泻甲乙。而戊己之药。何以反不及乎。盖土位居
中。而寄旺于四时之末。四职咸致清宁中宫默享和平。不烦更为调剂耳。
人参 白术 白茯苓 白芍药 生姜 大枣
治阴症发 。亦出胸背手足之间。但稀少而淡红。或为凉药太过。 大凡元气素虚。或
因房室损肾。或因内伤生冷。或因寒药太过。遂成阴症。寒伏于下。逼其无根失守之火。上犯金
宫
育元阴。皆养正之道也。然寒淫所胜。治以辛热。非附子之健悍。干姜之理中。何以扶阳返
本。而回元气于无何有之乡乎。
黄 芍药 桂枝 胶饴 甘草
主汗多亡阳。尺脉虚弱者。 按汗者心之液也。若不可汗而误汗。与可汗而过汗。则丙
丁之
散气。桂枝固卫而实腠。胶饴补中以壮肌。譬诸墙垣密固。中宫无遗失之虞。则向之颓废者
。今且复为创建矣。
芍药 生地 丹皮 犀角屑
主伤寒应汗失汗。内有瘀血。鼻衄。吐血。面黄大便黑。此方消化瘀血。 按去瘀之剂
。抵当汤丸最紧。桃仁承气汤次之。犀角地黄汤又次之。紧者。主下焦。次者。主中焦。缓者。
主上焦。此方行中有补。血家中和之品也。
黄连、黄芩、黄柏、栀子。
主治热势极盛。心烦失眠。中焦(脾胃)之热无法向外透发,则导致肌肉出现斑烂。这是因为脾主肌肉的缘故。此方用黄连清泻心火(丙丁属火,代指心与小肠),用黄芩清泻肺金(庚辛属金,代指肺与大肠),用黄柏清泻肾水(壬癸属水,代指肾与膀胱),用栀子清泻肝木(甲乙属木,代指肝与胆)。那么针对脾土(戊己属土,代指脾与胃)的药物为何反而没有涉及呢?因为土位居中央,寄旺于四季之末,四方之气皆能致清宁,中宫自然享受和平,不需要再额外进行调理罢了。
人参、白术、白茯苓、白芍药、生姜、大枣。
治疗阴证发热。这种热也出现在胸背手足之间,但皮疹稀少且颜色淡红。这往往是因为寒凉药物使用过度所致。大凡元气素来虚弱,或者因房事损伤肾脏,或者因内伤生冷食物,或者因寒性药物使用过度,最终形成阴证。寒气伏留于下焦,逼迫那无根失守的虚火向上侵犯肺脏(金宫)。培育元阴,都是扶正固本的方法。然而,当寒邪肆虐时,治疗应用辛热之法。如果不是依靠附子的刚健猛烈、干姜温中散寒的作用,怎么能扶助阳气返回本源,并将元气挽回于虚无缥缈之境呢?
桂枝、芍药、胶饴、甘草。(注:原文缺“胶饴”前的药材名,根据方义补全为桂枝汤类方或小建中汤组成,此处依原文顺序翻译)
主治汗出过多导致亡阳,尺脉虚弱者。按:汗是心的津液。如果不可发汗而误用发汗法,或者可以发汗而发汗过度,就会导致心火(丙丁)之气耗散。桂枝能够固护卫气并充实腠理,胶饴(麦芽糖)能够补益中焦以强壮肌肉。这就好比城墙围墙严密坚固,中宫就没有遗失的忧患,那么之前颓废的状态,现在就可以重新建立起来了。
芍药、生地黄、牡丹皮、犀角屑。
主治伤寒应当发汗却未能及时发汗,体内有瘀血,鼻出血,吐血,面色黄而大便黑。此方能化解消散瘀血。按:去除瘀血的药剂中,抵当汤丸最为峻猛,桃仁承气汤次之,犀角地黄汤又次之。峻猛的药剂主要作用于下焦,次之的药剂主要作用于中焦,缓和的药剂主要作用于上焦。此方在行血中有补益作用,是血病家中调和气血的佳品。
Coptidis Rhizoma (Huanglian), Scutellariae Radix (Huangqin), Phellodendri Cortex (Huangbai), Gardeniae Fructus (Zhizi).
Mainly treats extreme heat. Restlessness and inability to sleep. Heat in the Middle Jiao (Spleen and Stomach) cannot diffuse outward, leading to ulceration of the muscles. This is because the Spleen governs the muscles. This prescription uses Coptidis Rhizoma to clear Heart Fire (Bing-Ding corresponds to Fire, representing the Heart and Small Intestine), Scutellariae Radix to clear Lung Metal (Geng-Xin corresponds to Metal, representing the Lungs and Large Intestine), Phellodendri Cortex to clear Kidney Water (Ren-Gui corresponds to Water, representing the Kidneys and Bladder), and Gardeniae Fructus to clear Liver Wood (Jia-Yi corresponds to Wood, representing the Liver and Gallbladder). Then why are there no herbs targeting the Spleen Earth (Wu-Ji corresponds to Earth, representing the Spleen and Stomach)? Because Earth resides in the center and thrives at the end of each season; the energies of the four directions all contribute to clarity and tranquility, allowing the Central Palace to naturally enjoy peace without needing further adjustment.
Ginseng Radix (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Baifuling), Paeoniae Radix Alba (Baishaoyao), Zingiberis Rhizoma Recens (Shengjiang), Jujubae Fructus (Dazao).
Treats fever due to Yin Syndrome. This fever also appears between the chest, back, hands, and feet, but the rashes are sparse and pale red. This often results from excessive use of cold-natured medicines. Generally, if one's primordial Qi is inherently deficient, or if the Kidneys are damaged by sexual excess, or if internal injury is caused by raw and cold foods, or if cold-natured medicines are used excessively, it eventually forms a Yin Syndrome. Cold hides in the Lower Jiao, forcing the rootless and unanchored fire to ascend and invade the Metal Palace (Lungs). Nourishing Primordial Yin is a way of supporting righteousness. However, when cold pathogenic factors prevail, treatment should employ acrid-hot methods. Without the robust and fierce nature of Aconiti Lateralis Radix Praeparata (Fuzi) and the ability of Zingiberis Rhizoma (Ganjiang) to warm the Middle, how can Yang Qi be supported to return to its origin, and how can Yuan Qi be restored from the realm of nothingness?
Ramulus Cinnamomi (Guizhi), Paeoniae Radix (Shaoyao), Maltose (Jiaoyi), Glycyrrhizae Radix et Rhizoma (Gancao).
Mainly treats loss of Yang due to excessive sweating, with a weak pulse at the Chi position. Note: Sweat is the fluid of the Heart. If sweating is induced inappropriately, or if sweating is excessive when it should have been done, the Qi of Bing-Ding (Heart Fire) will dissipate. Ramulus Cinnamomi secures the Defensive Qi and solidifies the Cou Li (pores and interstices); Maltose tonifies the Middle Jiao to strengthen the muscles. It is like making walls and ramparts dense and firm; if the Central Palace has no fear of leakage, then what was previously decadent can now be rebuilt.
Paeoniae Radix (Shaoyao), Rehmanniae Radix Recens (Shengdi), Moutan Cortex (Danpi), Cornu Rinocerotis Trachea (Xijiao).
Mainly treats Shanghan (Cold Damage) where sweating should have been applied but was missed, resulting in intra-abdominal blood stasis, epistaxis (nosebleed), hematemesis (vomiting blood), yellow complexion, and black stool. This prescription dissolves and eliminates blood stasis. Note: Among agents that remove stasis, Didang Tang/Wan is the most potent, Taoren Chengqi Tang is second, and Xijiao Dihuang Tang is third. The potent ones primarily target the Lower Jiao, the second-tier ones primarily target the Middle Jiao, and the mild ones primarily target the Upper Jiao. This prescription contains tonification within its blood-moving action; it is a harmonizing agent for those with blood disorders.