甘草(二两炙) 干姜(一两半) 附子(一枚生去皮破八片)
上三味 咀。以水三升煮取一升二合。去滓。分温再服。强人可大附子一枚。干姜三两。
此汤通治三阴脉沉恶寒手足逆冷之证。故取附子之生者。上行头顶。外彻肌表。以温经散寒。干姜亦用生者。以内
温脏腑。甘草独用炙者。以外温营卫。内补中焦也。其云强人可大附子一枚。干姜三两者。则知平常之人。附子不必全
用也。况宋以前人。不善栽培。重半两者即少。大者极是难得。所以仲景有一方中用二三枚者。非若近时西川之多重一
两外也。然川中所产求一两者亦不易得。近世用二三钱一剂。即与仲景时二三枚分三剂。相等耳。○此汤与麻黄附子细
辛汤之用麻黄发散经络之寒邪。熟附温补少阴之真阳。细辛发越肾肝之阳气。似异而意实同。盖彼以麻黄治表邪。附子
温里虚。细辛通其阴经之邪。此以附子治表邪。干姜温里虚。甘草和其胃中之阳。嗣真所谓生附配干姜。补中有发。熟
附配麻黄。发中有补是也。
甘草(二两炙) 干姜(一两半) 附子(一枚生去皮破八片) 人参(一两)
上四味 咀。以水三升。煮取一升二合。去滓。分温再服。
茯苓(六两) 人参(一两) 甘草(二两炙) 干姜(一两半) 附子(一枚生用去皮破八片)
上五味。以水五升煮取三升。去滓。温服七合。日三服。
甘草(二两,经蜜炙处理) 干姜(一两半) 附子(一枚,生用,去皮后破开成八片)
以上三味药,切碎。用水三升,煎煮至取汁一升二合。滤去药渣。分两次温服。体质强壮的人可以使用大附子一枚,干姜三两。
此汤通治三阴经脉象沉细、恶寒、手足逆冷等证候。因此选用生附子,使其上行至头顶,外达肌表,以温通经脉、驱散寒邪。干姜也使用生品,以在内温暖脏腑。唯独甘草使用蜜炙品,以在外温养营卫之气,在内补益中焦脾胃。文中提到“体质强壮的人可使用大附子一枚,干姜三两”,由此可知普通人的用量不必完全按照这个标准。况且宋代以前的人不善于栽培药材,重量超过半两的就已经很少见了,大的更是极难得到。所以张仲景的方剂中有时会用二三枚,并不是像近代四川地区那样,每枚重达一两以上。然而即使在四川产地,想要找到一两重的附子也不容易。近代临床用药,每剂用二三钱,这与张仲景时代将二三枚分为三剂使用的总量是相当的。○此汤与麻黄附子细辛汤在用法上:后者用麻黄发散经络中的寒邪,用熟附子温补少阴经的真阳,用细辛发越肾肝之阳气,看似不同,实则意趣相同。因为前者是用麻黄治疗表邪,附子温补里虚,细辛疏通阴经之邪;而本方是用附子治疗表邪(此处指寒邪深入),干姜温补里虚,甘草调和胃中之阳。正如嗣真所言:“生附子配干姜,补中有发散之意;熟附子配麻黄,发散中有补益之功。”
甘草(二两,经蜜炙处理) 干姜(一两半) 附子(一枚,生用,去皮后破开成八片) 人参(一两)
以上四味药,切碎。用水三升,煎煮至取汁一升二合。滤去药渣。分两次温服。
茯苓(六两) 人参(一两) 甘草(二两,经蜜炙处理) 干姜(一两半) 附子(一枚,生用,去皮后破开成八片)
以上五味药,用水五升,煎煮至取汁三升。滤去药渣。每次温服七合,每日服用三次。
Gancao (Radix Glycyrrhizae Preparata, two liang, honey-fried) Ganjiang (Rhizoma Zingiberis Preparatum, one and a half liang) Fuzi (Radix Aconiti Lateralis Preparata, one raw piece, peeled and broken into eight slices)
The above three ingredients are coarsely crushed. Boil with three sheng of water to obtain one sheng and two he of decoction. Strain the dregs. Divide into two doses and take warm. For robust individuals, a large Fuzi (one piece) and Ganjiang (three liang) may be used.
This decoction treats syndromes involving the Three Yin meridians, characterized by deep pulse, aversion to cold, and cold reversal in the hands and feet. Therefore, raw Fuzi is selected for its ability to ascend to the vertex and penetrate the muscle surface, thereby warming the meridians and dispersing cold. Raw Ganjiang is also used to warm the internal zang-fu organs internally. Only Gancao is used in its honey-fried form to warm the Ying and Wei qi externally and tonify the Middle Jiao internally. The statement that "robust individuals may use a large Fuzi and three liang of Ganjiang" implies that ordinary individuals need not use these full amounts. Moreover, prior to the Song Dynasty, cultivation was poor; pieces weighing more than half a liang were rare, and large ones were extremely difficult to obtain. Thus, Zhang Zhongjing's formulas sometimes used two or three pieces, which was not like modern Sichuan varieties where each piece weighs over one liang. However, even in Sichuan, finding a one-liang piece is difficult. In recent times, using two or three qian per dose is equivalent to dividing two or three pieces into three doses as practiced in Zhang Zhongjing's era. ○ This decoction differs from Mahuang Fuzi Xixin Tang in usage: the latter uses Mahuang to disperse cold pathogens in the meridians, Shu Fuzi (prepared Fuzi) to tonify the True Yang of Shaoyin, and Xixin to stimulate the Yang qi of the Kidney and Liver. Although they appear different, their intent is the same. In the former formula, Mahuang treats exterior pathogens, Fuzi warms interior deficiency, and Xixin unblocks pathogenic factors in the Yin meridians. In this formula, Fuzi treats exterior pathogens (cold invading deeply), Ganjiang warms interior deficiency, and Gancao harmonizes the Yang qi in the Stomach. As Sizhen stated: "Raw Fuzi paired with Ganjiang offers tonification with dispersal; prepared Fuzi paired with Mahuang offers dispersal with tonification."
Gancao (Radix Glycyrrhizae Preparata, two liang, honey-fried) Ganjiang (Rhizoma Zingiberis Preparatum, one and a half liang) Fuzi (Radix Aconiti Lateralis Preparata, one raw piece, peeled and broken into eight slices) Renshen (Radix Ginseng, one liang)
The above four ingredients are coarsely crushed. Boil with three sheng of water to obtain one sheng and two he of decoction. Strain the dregs. Divide into two doses and take warm.
Fuling (Poria, six liang) Renshen (Radix Ginseng, one liang) Gancao (Radix Glycyrrhizae Preparata, two liang, honey-fried) Ganjiang (Rhizoma Zingiberis Preparatum, one and a half liang) Fuzi (Radix Aconiti Lateralis Preparata, one raw piece, peeled and broken into eight slices)
The above five ingredients are boiled with five sheng of water to obtain three sheng of decoction. Strain the dregs. Take seven he warm per dose, three times daily.