桂枝(四两,去皮) 甘草(二两,炙) 上二味,以水三升,煮取一升,去渣,顿服。此以一剂为一服者。
发汗过多,其人叉手自冒心,心下悸,欲得按者,桂枝甘草汤主之。发汗不误,误在过多。汗为心之
液,多则心气虚。二味扶阳补中,此乃阳虚之轻者,甚而振振欲擗地,则用真武汤矣。一症而轻重不同,用
方迥异,其义精矣。
茯苓(半斤) 桂枝(四两,去皮) 甘草(二两,炙) 大枣(十五枚,擘) 上四味,以甘澜水一斗,以水二
斗,扬之万遍取用。按∶甘澜水,大约取其动极思静之意。先煮茯苓 凡方中专重之药,法必先煮。减二升,纳诸
药,煮取三升,去渣,温服一升,日三服。
发汗后,其人脐下悸者,欲作奔豚,茯苓桂枝甘草大枣汤主之。心下悸,是扰胸中之阳,脐下悸,则
因发汗太过,上焦干涸。肾水上救,故重用茯苓以制肾水;桂枝以治奔豚。
桂枝(一两十六铢,去皮) 芍药 生姜(切) 甘草(炙) 麻黄(去节,各一两) 大枣(四枚,擘)
杏仁(二十四枚,去皮及双仁者) 上七味,以水五升,先煮麻黄一、二沸,去上沫。(欲去沫,故先煮。)纳诸药,
煮取一升八合,减去三分之一。去渣,温服六合。一云∶桂枝汤三合,麻黄汤三合,并为六合。顿服将息如上法。
太阳病,得之八九日,过经。如疟状,发热恶寒,热多寒少,邪已渐轻。其人不呕,非少阳。清便欲自
可,无里热。一日二、三度发,非疟象。脉微缓者,不浮不弦不大。为欲愈也。余邪欲退之象。脉微而恶寒
者,此阴阳俱虚,不可更发汗、更下、更吐也。此三句,申明上文欲愈之故。盖由病气虽除,而正气亦衰,
当静以养之,使胃气渐充,则荣卫自和,若更用汗、吐、下之法,益虚其气,则病从药增,医者不审,误
人多矣。
面色反有热色者,未欲解也。面有热色,则余邪尚郁。以其不能得小汗出,身必痒,宜桂枝麻黄各
半汤。微邪已在皮肤中,欲自出不得,故身痒,以此汤取其小汗足矣。阳明篇云∶身痒如虫行皮中状
者,此以久虚故也。
按此方分两甚轻,计共约六两,合今之秤,仅一两三四钱,分三服,只服四钱零,乃治邪退后至轻之
剂,犹勿药也。
桂枝(四两,去皮) 甘草(二两,炙) 以上两味药,用水三升,煎煮至一升,滤去药渣,一次性服下。这是将一剂药作为一次服用的用法。
发汗过多,病人双手交叉按护心前区,心中悸动不安,喜欢按压缓解的,用桂枝甘草汤主治。发汗本身没有错误,错误在于发汗过量。汗是心的体液,出汗过多会导致心气虚弱。这两味药能扶助阳气、补益中焦,这属于阳气虚弱的轻症;如果病情加重,出现身体震颤、想要倒地挣扎的症状,就要使用真武汤了。同一个症状有轻重之分,所用方剂截然不同,其中的医理非常精妙。
茯苓(半斤) 桂枝(四两,去皮) 甘草(二两,炙) 大枣(十五枚,掰开) 以上四味药,用甘澜水一斗(注:原文此处表述略有歧义,通常理解为制备甘澜水或用大量水扬之),具体操作是将水二斗,反复扬起一万遍后取用。按语:甘澜水,大约取其“动极思静”的意思。先煮茯苓。凡是方剂中特别重视的药物,方法上必须先煮。减去二升水量,加入其他药物,煎煮至三升,滤去药渣,温服一升,每日三次服用。
发汗之后,病人感到脐下悸动的,这是即将发生奔豚病的征兆,用茯苓桂枝甘草大枣汤主治。心下悸动,是因为扰动胸中的阳气;脐下悸动,则是由于发汗太过,导致上焦津液干涸。肾水向上救应,所以重用茯苓来制约肾水;用桂枝来治疗奔豚病。
桂枝(一两十六铢,去皮) 芍药 生姜(切) 甘草(炙) 麻黄(去节,各一两) 大枣(四枚,掰开) 杏仁(二十四枚,去皮及双仁者) 以上七味药,用水五升,先煮麻黄一至两沸,去掉水面上的浮沫。(因为要去掉浮沫,所以先煮。)然后加入其他药物,煎煮至一升八合,减去三分之一的水量。滤去药渣,温服六合。另一种说法是:桂枝汤三合,麻黄汤三合,混合为六合,一次性服用,调护方法同上法。
太阳病(太阳经受邪所致的病证),患病八九日,已过经传变。症状像疟疾一样,发热恶寒,热多寒少,说明邪气已经逐渐减轻。病人没有呕吐,说明不是少阳病(少阳经受邪所致的病证)。大小便基本正常,说明没有里热。一天发作两三次,不像典型的疟疾病象。脉象微缓,不浮、不弦、不大,这是将要痊愈的迹象,是余邪欲退的表现。如果脉象微而恶寒,这是阴阳俱虚,不可以再用发汗、攻下、催吐的方法。这三句话,申明了上文说“欲愈”的原因。大概是因为病气虽然去除,但正气也衰败了,应当静养,使胃气逐渐充盈,那么营卫自然调和;如果再用汗、吐、下的方法,会使正气更加虚弱,导致病情因用药而加重,医生如果不仔细审察,误治的人就很多了。
面色反而发红热的,说明病还没有解除。面有热色,说明余邪仍然郁结。因为不能出小汗,身体必定发痒,适宜用桂枝麻黄各半汤。微邪已经在皮肤之中,想要自行排出却排不出来,所以身体发痒,用这个方剂取得小汗即可治愈。《阳明篇》说:“身体发痒,像虫子在皮中游走一样”,这是因为久病体虚的缘故。
按语:这个方的分量很轻,合计大约六两,折合现在的秤,只有一两三四钱,分三次服用,每次只服四钱多一点,这是治疗邪气退去后使用的最轻的方剂,几乎相当于不用药了。
Guizhi (Cinnamon Twig, four liang, peeled) Gancao (Licorice Root, two liang, honey-fried). The above two ingredients are decocted in three sheng of water to obtain one sheng. Remove the dregs and take orally at once. This is a case where one dose constitutes one administration.
After excessive sweating, if the patient crosses their hands over the heart region, experiences palpitations in the epigastrium (heart area), and desires pressure for relief, Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction) is indicated. Sweating itself is not erroneous; the error lies in excess. Sweat is the fluid of the Heart; excessive loss leads to deficiency of Heart Qi. These two herbs support Yang and tonify the Middle Jiao. This represents a mild form of Yang deficiency. If the condition worsens to include tremors and a desire to fall to the ground, Zhenwu Tang (True Warrior Decoction) should be used. The same symptom presents with different severities, requiring vastly different formulas, demonstrating profound medical principles.
Fuling (Poria, half jin) Guizhi (Cinnamon Twig, four liang, peeled) Gancao (Licorice Root, two liang, honey-fried) Dazao (Jujube, fifteen pieces, broken open). The above four ingredients are prepared using Ganlan Shui (Ganlan Water). Specifically, take two dou of water, stir it vigorously ten thousand times to prepare the water. Note: Ganlan Water roughly embodies the principle of "seeking stillness after extreme movement." First decoct Fuling. For any herb given primary importance in a formula, the method dictates decocting it first. Reduce the volume by two sheng, add the remaining herbs, and decoct until three sheng remain. Remove the dregs and take one sheng warm, three times daily.
After sweating, if the patient feels palpitations below the umbilicus, indicating an impending Ben Tun (Running Piglet syndrome), Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction) is indicated. Palpitations in the epigastrium result from disturbance of the Yang in the Upper Jiao. Palpitations below the umbilicus occur because excessive sweating has dried up the fluids of the Upper Jiao, causing Kidney Water to rise in rescue. Therefore, a heavy dose of Fuling is used to control Kidney Water, while Guizhi is used to treat Ben Tun.
Guizhi (Cinnamon Twig, one liang sixteen zhu, peeled) Shaoyao (Peony Root) Shengjiang (Fresh Ginger, sliced) Gancao (Licorice Root, honey-fried) Mahuang (Ephedra Stem, nodes removed, each one liang) Dazao (Jujube, four pieces, broken open) Xingren (Apricot Seed, twenty-four pieces, skin and double kernels removed). The above seven ingredients are decocted in five sheng of water. First, boil Mahuang for one or two boils, then remove the foam on the surface. (Foam is removed by boiling first.) Add the other herbs and decoct until one sheng eight he remain, reducing the volume by one-third. Remove the dregs and take six he warm. Another version states: Mix three he of Guizhi Tang with three he of Mahuang Tang to make six he, taken at once, with care instructions as above.
Taiyang Bing (Taiyang Disease), occurring after eight or nine days, has passed its meridian stage. The symptoms resemble malaria: fever and aversion to cold, with more heat than cold, indicating that the pathogenic factor is gradually lightening. The patient does not vomit, ruling out Shaoyang Bing (Shaoyang Disease). Bowel movements and urination are relatively normal, indicating no interior heat. The illness occurs two or three times a day, which is not typical of malaria. A pulse that is slightly slow and relaxed, neither floating, wiry, nor large, indicates recovery. This is a sign of residual pathogen receding. If the pulse is slight and accompanied by aversion to cold, this indicates deficiency of both Yin and Yang. Sweating, purging, or vomiting methods must not be used again. These three sentences clarify the reason for the aforementioned recovery. Generally, although the pathogenic qi has been eliminated, the healthy qi is also depleted. One should rest to nourish the body, allowing Stomach Qi to gradually replenish, so that Ying (Nutritive) and Wei (Defensive) Qi harmonize naturally. If sweating, vomiting, or purging methods are still applied, the Qi will become further deficient, and the disease will worsen due to treatment. If physicians do not examine carefully, many people will be mis-treated.
If the face appears reddish-hot, the disease has not yet resolved. Facial redness indicates that residual pathogens are still stagnant. Because a slight sweat cannot be produced, the body will likely itch. Guizhi Mahuang Ge Ban Tang (Half-Guizhi Half-Mahuang Decoction) is appropriate. The mild pathogen is located in the skin but cannot exit spontaneously, causing itching. This formula induces a slight sweat sufficient to resolve the condition. The Yangming Chapter states: "Itching like insects crawling under the skin" occurs due to chronic deficiency.
Note: The dosages in this formula are very light. The total weight is approximately six liang, which converts to only about one liang and three or four qian in modern weights. Divided into three doses, each dose is only slightly over four qian. It is a very mild formula used after the pathogen has retreated, almost equivalent to no medication.