苍术（四两制） 羌活 防风 川芎（各一两） 黄芩 枳壳（一作枳实） 甘草（各半两） 白芷（一两半） 石
膏（二两） 细辛（三钱） 知母（七钱）
上 咀。石膏为细末。入药。水煎。欲汗之。热服汤投。（言于汤中投石膏。末而热服之也。）春。倍防风羌活。夏。
倍黄芩知母。季夏淫雨。倍术白芷。秋加桂五钱。冬加至一两。亦可以意消息。随证增损。非发热而渴。不可用石膏知
母。非里实。心下痞。不可用枳实也。
琥按上主疗云。通解四时伤寒。则凡四时之中。皆有寒气伤人。皆得谓之伤寒矣。上方乃太阳阳明。太阴少阴兼
入厥阴之剂。止无关于少阳。所以方后云。宜以意消息随证增损也。
琥又按上方后云。秋加桂五钱。此系秋深时。故与冬令同治。若秋初湿热。或行燥令。医者亦当以意消息随证增损。
易老解利法。经云。有汗不得服麻黄。无汗不得服桂枝。若差服。则其变不可胜言。故立此法。
使不犯三阳禁忌。解表神方。（此亦洁古方也。张洁古讳元素。易水人。故又称易老。）
羌活（一两半治太阳肢节痛。君主之药也。然非无为主也。乃拨乱反正之主。故大无不通。小无不入。关节痛。非
此不除。） 防风（一两半治一身尽痛。乃卒伍卑下之职。一听君命将令而行。随所使所引而至。） 苍术（一两半。别
有雄壮上行之气。能除湿。下安太阴。使邪气不内传于足太阴脾） 细辛（半两治足少阴肾苦头痛。） 川芎（一两。治
厥阴头痛在脑。） 白芷（一两治阳明头痛在额。） 生地黄（一两。治少阴心热在内。） 黄芩（一两治太阴肺热在胸。）
甘草（一两。能缓里急调和诸药。故有国老之称。）
以上九味。虽为一方。然亦不可执。当视其经络前后左右之不同。从其多少大小轻重之不一。增损用之。其效如神。
咀。水煎服。若急汗（准绳作急欲汗）热服以羹粥投之。（准绳作以热汤助之。）若缓汗。温服。而不用汤投之也。
脉浮而不解者。先急后缓脉沉而不解者。先缓后急。此汤。不独解利伤寒。治杂病亦神。
琥按上汤。即前大神术汤。去枳壳知母石膏。而加生地黄也。陶氏杀车槌改名羌活冲和汤。用之以代桂枝麻黄青
龙各半等汤。云春可治温。夏可治热。秋可治湿。此太阳经之神药。要之此汤用药。气味不齐。阴阳诸经皆走。只无碍
于少阳。所以方后云。当视其经络。增损用之。其效始如神也。陶氏不明斯义。竟以此汤治太阳伤寒。又即以此汤减苍
术细辛。加白术黄 。治太阳中风。更不帮助洁古当日所以制方之义。使后学宗之。以至六经不明。乱投药剂。其为害
可胜道邪。吾恐医工用此汤。以治病增减若差。其变亦犹麻桂之不可胜言。若云。不犯三阳禁忌。竟为解表乱服之方。
误之甚矣。
李东垣云。夫伤寒者。始自风寒得之。故风则伤卫。寒则伤营。风寒并入。营卫俱伤。仲景所以处桂枝麻黄大青龙
汤。此三者。皆发表之要药也。然用之当则随手而愈。用之不当则非徒无益。而又害之也。故仲景有此三者之戒。使后
人不敢轻用也。今采择诸方之中发表之药。可以代此者。如升麻汤败毒散。羌活解肌汤。柴胡散。葛根汤。五积散之类
是也。可选而用之。
琥按上论云。发表之药。如升麻汤。败毒散。柴胡散。葛根汤。是兼主阳明少阳之剂。又五积散。乃发表散寒积
之杂方。治法举要中皆不载。惟载冲和汤一方。今录于后。
苍术（四两，经炮制） 羌活 防风 川芎（各一两） 黄芩 枳壳（一种版本作枳实） 甘草（各半两） 白芷（一两半） 石膏（二两） 细辛（三钱） 知母（七钱）
以上药材切碎。将石膏研成细粉，加入药中。加水煎煮。若要发汗，需热服汤剂。（意思是把石膏末投入汤中，趁热服用。）春季，加倍使用防风、羌活；夏季，加倍使用黄芩、知母；长夏多雨时节，加倍使用苍术、白芷；秋季加桂枝五钱；冬季加至一两。也可以根据具体情况灵活斟酌，随证增减。如果没有发热且口渴的症状，不可使用石膏、知母；如果不是里实证，没有心下痞满的症状，不可使用枳实。
王琥按：上述主治功效说“通解四时伤寒”，那么凡是在四季之中，都有寒气伤人，都可以称为伤寒。上方是治疗太阳病、阳明病，兼治太阴病、少阴病并涉及厥阴病的方剂，唯独不涉及少阳病。所以方后注说：“应当凭医者心意斟酌，随证增减。”
王琥又按：上述方后注说：“秋季加桂枝五钱”，这是因为深秋时节，所以与冬季治疗方法相同。如果是初秋湿热，或者行燥令，医生也应当凭心意斟酌，随证增减。
易老（张元素）的解利法说：《内经》云：“有汗不得服麻黄，无汗不得服桂枝。”如果误服，其变证不可胜数。因此确立此法，以避免触犯三阳经的禁忌。这是解表的神方。（这也是洁古的方子。张洁古名元素，易水人，所以又称易老。）
羌活（一两半，治疗太阳经肢节疼痛，是君药。但并非无所作为的主药，而是拨乱反正的主帅，所以大邪无不通达，小邪无不深入。关节疼痛，非此药不能除。） 防风（一两半，治疗全身疼痛，地位如同卒伍卑职，听从君主命令和将领指令行动，随使唤和引导而至。） 苍术（一两半，具有雄壮上行之气，能除湿，安定太阴，使邪气不内传于足太阴脾经。） 细辛（半两，治疗足少阴肾经引起的头痛。） 川芎（一两，治疗厥阴经头痛在脑部。） 白芷（一两，治疗阳明经头痛在前额。） 生地黄（一两，治疗少阴心经热在内。） 黄芩（一两，治疗太阴肺经热在胸部。） 甘草（一两，能缓解里急，调和诸药，所以有国老的称呼。）
以上九味药，虽然组成一方，但也不可拘泥执守。应当观察经络前后左右的不同，根据其多少、大小、轻重的不一，进行增减使用。效果如神。切碎，加水煎服。若要急汗（《医方类聚》作急欲汗），热服并用米粥送服（《医方类聚》作用热汤助之）。若要缓汗，温服，而不用汤水送服。
脉浮而不解者，先急后缓；脉沉而不解者，先缓后急。此汤不仅解利伤寒，治疗杂病也很神奇。
王琥按：上述汤剂，就是前文的大神术汤，去掉枳壳、知母、石膏，而加上生地黄。陶华将其改名为羌活冲和汤，用来代替桂枝汤、麻黄汤、青龙汤等各半汤等，说春季可治温病，夏季可治热病，秋季可治湿病。这是太阳经的神药。总之，此汤用药气味不齐，阴阳各经皆走，只是不妨碍少阳经。所以方后注说：“应当观察经络，增减使用。”这样效果才如神。陶氏不明白这个道理，竟然用此汤治疗太阳伤寒，又以此汤减去苍术、细辛，加上白术、黄柏，治疗太阳中风。更不帮助洁古当日制定方义的本意，使得后学者遵循它，以至于六经理论不明，乱投药剂，其危害怎能说得完呢？我恐怕医生使用此汤，若治病加减有误，其变证也像麻黄、桂枝误用那样不可胜数。如果说是不犯三阳禁忌，竟成为解表乱服的方子，那就错得很厉害了。
李东垣说：所谓伤寒，开始是由于风寒所致。所以风伤卫气，寒伤营血。风寒并入，营卫俱伤。仲景因此设立桂枝汤、麻黄汤、大青龙汤。这三者，都是发表的要药。然而使用得当则随手而愈，使用不当则不仅无益，反而有害。所以仲景有此三者的戒律，使后人不敢轻易使用。现在从众多方剂中选择可以替代这些药的发表药物，如升麻汤、败毒散、羌活解肌汤、柴胡散、葛根汤、五积散之类，可以选择使用。
王琥按：上述论述说，发表的药物，如升麻汤、败毒散、柴胡散、葛根汤，是兼主阳明、少阳的方剂。还有五积散，是发表散寒积的杂方，《治法举要》中都不记载。只记载了冲和汤一方，现在录在后面。
Cangzhu (Atractylodis Rhizoma, four liang, processed) Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each one liang), Huangqin (Scutellariae Radix), Zhike (Aurantii Fructus, one version as Zhishi), Gancao (Glycyrrhizae Radix et Rhizoma) (each half liang), Baizhi (Angelicae Dahuricae Radix) (one and a half liang), Shigao (Gypsum Fibrosum) (two liang), Xixin (Asari Radix et Rhizoma) (three qian), Zhimu (Anemarrhenae Rhizoma) (seven qian).
The above herbs are cut into small pieces. The Shigao is ground into fine powder and added to the herbs. Decoct with water. If sweating is desired, take the decoction hot. (This means adding the Shigao powder to the decoction and taking it while hot.) In spring, double the dosage of Fangfeng and Qianghuo; in summer, double the dosage of Huangqin and Zhimu; during the late summer rainy season, double the dosage of Cangzhu and Baizhi; add Guizhi (Cinnamomi Ramulus) five qian in autumn; increase to one liang in winter. One may also adjust flexibly according to circumstances, increasing or decreasing based on the syndrome. If there is no fever accompanied by thirst, Shigao and Zhimu should not be used. If there is no excess condition in the interior and no epigastric fullness/stuffiness, Zhishi should not be used.
Wang Hu notes: The aforementioned therapeutic effects state "universally resolves cold damage in all four seasons." Thus, whenever cold pathogenic factors injure the body in any season, it can be called cold damage. The above formula treats Taiyang disease (disease of the Taiyang channel), Yangming disease (disease of the Yangming channel), and simultaneously addresses Taiyin disease (disease of the Taiyin channel), Shaoyin disease (disease of the Shaoyin channel), involving Jueyin disease (disease of the Jueyin channel), but does not involve Shaoyang disease (disease of the Shaoyang channel). Therefore, the post-formula note states: "One should use judgment to adjust and modify based on the syndrome."
Wang Hu further notes: The aforementioned post-formula note says: "Add Guizhi five qian in autumn." This is because deep autumn resembles winter conditions, so the treatment aligns with winter methods. If early autumn involves damp-heat or dry weather patterns, physicians should also use their judgment to adjust and modify based on the syndrome.
Yi Lao (Zhang Yuansu)'s method for resolving and benefiting states: The *Classic of Internal Medicine* says: "Those with sweat should not take Mahuang (Ephedrae Herba); those without sweat should not take Guizhi." If mistakenly administered, the resulting complications are countless. Therefore, this method was established to avoid violating the contraindications of the three Yang channels. This is a divine formula for releasing the exterior. (This is also a formula by Jiegu [Zhang Yuansu]. Zhang Jiegu's given name was Yuansu, from Yishui, hence also known as Yi Lao.)
Qianghuo (one and a half liang): Treats joint and limb pain of the Taiyang channel. It is the Sovereign herb (Jun Yao). However, it is not a sovereign that does nothing; rather, it is the sovereign who restores order. Thus, it penetrates great evils thoroughly and enters small evils deeply. Joint pain cannot be eliminated without this herb. Fangfeng (one and a half liang): Treats whole-body pain. Its role is like that of low-ranking soldiers, obeying the commands of the Sovereign and Generals, arriving wherever directed. Cangzhu (one and a half liang): Possesses a vigorous ascending qi, able to eliminate dampness, stabilize the Taiyin, preventing pathogenic factors from transmitting internally to the Foot-Taiyin Spleen. Xixin (half liang): Treats headache caused by Foot-Shaoyin Kidney issues. Chuanxiong (one liang): Treats headache in the brain due to Jueyin channel involvement. Baizhi (one liang): Treats headache in the forehead due to Yangming channel involvement. Shengdihuang (Rehmanniae Radix) (one liang): Treats internal heat of the Shaoyin Heart. Huangqin (one liang): Treats heat in the chest due to Taiyin Lung involvement. Gancao (one liang): Can relieve internal urgency and harmonize the various herbs, hence the title "State Elder."
Although these nine herbs form one prescription, one must not adhere rigidly to it. One should observe the differences in meridians anterior/posterior and left/right, and adjust usage based on variations in quantity, size, lightness, and heaviness. The efficacy will be miraculous. Cut into pieces, decoct with water, and take orally. For urgent sweating (as recorded in *Yifang Leiju*, "urgent desire to sweat"), take hot and assist with rice porridge (or hot soup as per *Yifang Leiju*). For gradual sweating, take warm without assisting with fluids.
If the pulse is floating and unresolved, treat urgently first, then gradually. If the pulse is sunken and unresolved, treat gradually first, then urgently. This decoction not only resolves cold damage miraculously but also treats miscellaneous diseases effectively.
Wang Hu notes: The aforementioned decoction is the previous Dashenshu Tang, with Zhike, Zhimu, and Shigao removed, and Shengdihuang added. Tao Hua renamed it Qianghuo Chonghe Tang and used it to replace formulas such as Guizhi Tang (Cinnamon Twig Decoction), Mahuang Tang (Ephedra Decoction), and Qinglong Tang (Green Dragon Decoction) at half doses. He claimed it could treat Warmth diseases in spring, Heat diseases in summer, and Dampness diseases in autumn. It is considered a divine medicine for the Taiyang channel. In essence, the herbs in this formula have varied flavors and properties, traversing both Yin and Yang channels, except for the Shaoyang channel. Hence, the post-formula note advises observing the meridians and adjusting accordingly for miraculous efficacy. Tao Hua did not understand this principle; he actually used this formula to treat Taiyang Cold Damage, and modified it by reducing Cangzhu and Xixin, adding Baizhu (Atractylodis Macrocephalae Rhizoma) and Huangbo (Phellodendri Cortex), to treat Taiyang Wind Strike. This fails to support the original intent of Jiegu when creating the formula, leading later students to follow it blindly, resulting in unclear Six Channel theory and indiscriminate medication use. The harm caused is incalculable. I fear that if physicians use this formula and make errors in modification, the resulting complications will be as countless as those from mistaken use of Mahuang and Guizhi. To claim it avoids Three Yang contraindications and serves merely as a formula for indiscriminate exterior release is a grave error.
Li Dongyuan stated: Cold damage begins with wind-cold. Wind injures the Wei Qi (Defensive Qi), and cold injures the Ying Blood (Nutritive Blood). When wind and cold combine, both Ying and Wei are injured. Therefore, Zhang Zhongjing established Guizhi Tang, Mahuang Tang, and Daqinglong Tang (Great Green Dragon Decoction). These three are essential formulas for releasing the exterior. However, if used correctly, they cure immediately; if used incorrectly, they are not only ineffective but harmful. Thus, Zhang Zhongjing issued warnings regarding these three, discouraging casual use by later generations. Currently, among various prescriptions, exterior-releasing drugs that can substitute for these include Shengma Tang (Cimicifugae Decoction), Baidu San (Detoxification Powder), Qianghuo Jieji Tang (Qianghuo Muscle-Releasing Decoction), Chaihu San (Bupleurum Powder), Gegen Tang (Pueraria Decoction), Wuji San (Five Accumulations Powder), etc. These can be selected for use.
Wang Hu notes: The aforementioned discussion mentions that exterior-releasing drugs such as Shengma Tang, Baidu San, Chaihu San, and Gegen Tang are formulas that primarily address Yangming and Shaoyang channels. Additionally, Wuji San is a miscellaneous formula for releasing the exterior and dispersing cold accumulation. None of these are recorded in *Zhifa Juyao* (Essentials of Treatment Methods). Only the Chonghe Tang formula is recorded here, which is transcribed below.