桂枝麻黄类。用者莫轻易。我有一神方。不犯三阳忌。羌防芍细芷。芩草二术地。粗末。米水煎。风寒俱解利。
羌活 防风 芍药 细辛 白芷 黄芩 苍术 白术 生地黄 甘草
上件一十味。等分 咀。每服米一撮。水一大盏。煎三沸。去滓。温服。滓再煎。汗已出。则止汗不以多少为效。
（上云。汗已出。则止汗乃知是方。实发汗药也。愚以当有汗未出。则发汗二句。或传写时脱简耳。）
琥按此方。即易老九味羌活汤。去川芎。加白术芍药也。所入经络。亦与九味羌活汤同。但苍白二术。宜照有无
汗用。又芍药之用。以调营也。愚以有汗者。宜用芍药。无汗者。不如用川芎为稳。
一内证。或内外通身上下。并关节痛者。宜用芎黄汤。
川芎 甘草 麻黄 南枳壳
上件等分。每服三钱或五钱。生姜三片。煎三沸。热服最妙。其痛立止。
琥按上主疗云。内证内字。当是外字之误。纵兼内证。不过胸中。略觉烦闷耳。所以是方。即仲景麻黄汤之变方。
其治内证。止枳壳一味药耳。
治内伤冷冻饮料。外感寒邪。无汗者方。（方见古本东垣。十书阴证略例中）
苍术（制） 防风（各二两） 甘草（一两炙）
上 咀。加葱白三寸。生姜一块。水煎服。
如太阳证。发热恶寒。脉浮而紧者。加羌活。如太阳证。脉浮紧中带弦数者。是兼少阳也。加柴胡。如太阳证。脉
浮紧中带洪者。是兼阳明也。加黄芩。（愚意云。何不加葛根。）以上三证。约量每服。加二钱匕不论三阳。妇人服者。
加当归。治吹奶。煎成。调六一散三五钱。如神。
琥按上方。即洁古川芎汤变其制也。洁古为东垣师。而海藏复师于东垣。故下文所用白术汤。又即洁古黄 汤。
稍变其制。大抵师弟子之相传。前后同一辙耳。
神术汤六气加减法
太阳寒水司天。加桂枝羌活。（娄全善云。余岁非时变寒。亦加冬亦加。）
阳明燥金司天。加白芷升麻。（娄云。余岁非时变凉湿。亦加。秋亦加。愚意云。凉则燥湿。则或寒或热。大抵秋行
燥令居多。若但燥而不湿。白芷不宜加也。以葛根代之甚稳。）
少阳相火司天。加黄芩地黄。（娄云。余岁非时变雨湿。亦加。夏亦加。愚意云。司天之气。有常有变。变气诚不可
定。但既变雨湿。又用上药。与病不合。）
太阴湿土司天。加白术 本。（娄云。余岁非时变热湿。亦加。夏末秋初。亦加。愚意云。非时变热湿。则上所用
药。但治湿耳。与热无与。当更加黄芩等药。）
少阴君火司天。加细辛独活。（娄云。余岁非时变热。亦加春末夏初亦加愚意云。上药亦不合司天。及时令之气也。）
厥阴风木司天。加川芎防风（娄云。余岁非时变温和。亦加。春亦加。）
以上神术汤六气加减法。非止为司天之气设也。至于岁之主气。与月建日时同前应见者。皆当随所见。根据上例而加
减之。
琥按内经中运气之说。有常有变。常气者。即上海藏云。司天之气是也。变气者。即上娄氏云。非时之气是也。
要之气至无定。故上文又云。用药法。皆当随岁月日时。所见之气而加减之。盖天之气。随时而来。人之病。因气而变。
所以伤寒之病。俗名为时气也。上论实与仲景四时八节二十四气决病法。互相发明。学人能参合观之。则因时制宜。用
药治病之法。庶乎其近之矣。
【举要】冲和汤方
桂枝汤与麻黄汤这类方剂，使用的时候不要轻易尝试。我有一张神妙之方，不触犯三阳经的禁忌。药物包括羌活、防风、芍药、细辛、白芷、黄芩、苍术、白术、生地黄、甘草。将药材捣成粗末，用米和水煎煮，风寒之邪都能得到解除。
羌活、防风、芍药、细辛、白芷、黄芩、苍术、白术、生地黄、甘草。
以上十味药，各取等分，切碎。每次服用一撮米量的一勺（注：此处原文“米一撮”疑为剂量描述有误或特指用法，通常理解为加米同煎或特定计量，依原文直译），水一大盏，煎煮至沸腾三次，滤去药渣，温服。药渣再次煎煮。如果汗已经发出，就停止服药，不以出汗多少作为疗效标准。
（上文说：“汗已出，则止”，由此可知此方实际上是发汗药。（我认为应当有“当有汗未出，则发汗”两句，可能是传抄时脱漏了简牍。））
王琥按语：此方即易老（张元素）的九味羌活汤，去掉川芎，加上白术和芍药。所入的经络，也与九味羌活汤相同。但苍术和白术，应该根据有无汗出的情况来选用。另外，芍药的作用在于调和营气。我认为有汗者，宜用芍药；无汗者，不如用川芎更为稳妥。
如果有内伤证候，或者内外通身上下，以及关节疼痛的，适宜使用芎黄汤。
以上各取等分。每次服用三钱或五钱，生姜三片，煎煮至沸腾三次，热服最好。疼痛立即停止。
王琥按语：上述主治中提到的“内证”，“内”字应该是“外”字的误写。即使兼有内证，也不过是胸中略微觉得烦闷罢了。所以这个方子，就是仲景麻黄汤的变方。其治疗所谓的“内证”，只用了枳壳这一味药而已。
治疗内伤冷冻饮料，外感寒邪，无汗者的方子。（方剂见古本东垣《十书阴证略例》中）
切碎，加葱白三寸，生姜一块，水煎服。
如果是太阳病（太阳经受邪所致的病证），出现发热、恶寒（怕冷）、脉象浮而紧的症状，加羌活。如果是太阳病，脉象浮紧中带弦数的，是兼有少阳病（少阳经受邪所致的病证），加柴胡。如果是太阳病，脉象浮紧中带洪大的，是兼有阳明病（阳明经受邪所致的病证），加黄芩。（我的意见是：为什么不加葛根呢？）以上三种证候，大约每服量，每种加二钱匕。不论三阳哪一经，妇人服用者，加当归。治疗吹乳（乳腺炎），煎好后，调服六一散三五钱，效果如神。
王琥按语：上方，即洁古（张元素）川芎汤变化其制法而成。洁古是东垣（李杲）的老师，而海藏（王好古）又师从于东垣，所以下文所用的白术汤，又是洁古的黄汤稍变其制法。大抵师徒之间的传承，前后遵循同一辙迹。
太阳寒水司天（运气学说中，主管上半年气候的六气之一，主寒水之气），加桂枝、羌活。（娄全善说：我遇到岁运非时令变寒的情况，也加冬令的药物，也加。）
阳明燥金司天（主管上半年气候的六气之一，主燥金之气），加白芷、升麻。（娄氏说：我遇到岁运非时令变凉湿的情况，也加。秋季也加。我的意见是：凉则致燥湿，则或寒或热，大抵秋季行燥令居多，如果只是燥而不湿，白芷不宜加，用葛根代替很稳妥。）
少阳相火司天（主管上半年气候的六气之一，主相火之气），加黄芩、生地黄。（娄氏说：我遇到岁运非时令变雨湿的情况，也加。夏季也加。我的意见是：司天之气，有常理也有变化，变气确实不可定，但如果既变雨湿，又用上药，与病情不合。）
太阴湿土司天（主管上半年气候的六气之一，主湿土之气），加白术、藁本。（娄氏说：我遇到岁运非时令变热湿的情况，也加。夏末秋初，也加。我的意见是：非时令变热湿，那么上面所用的药，只能治湿，与热无关，应当再加黄芩等药。）
少阴君火司天（主管上半年气候的六气之一，主君火之气），加细辛、独活。（娄氏说：我遇到岁运非时令变热的情况，也加。春末夏初也加。我的意见是：上面的药也不符合司天及时令之气。）
厥阴风木司天（主管上半年气候的六气之一，主风木之气），加川芎、防风。（娄氏说：我遇到岁运非时令变温和的情况，也加。春季也加。）
以上神术汤六气加减法，不仅仅是为了司天之气设立的。至于岁之主气，以及与月建、日时同时应见的情况，都应当根据所见到的情况，依据上面的例子进行加减。
王琥按语：《内经》中的运气之说，有常理也有变化。常气，就是上海藏所说的司天之气。变气，就是上面娄氏所说的非时之气。要气到来没有定数，所以上文又说：用药法则，都应当随着岁月日时所见到之气而加减。大概天的气，随时而来，人的病，因气而变化。所以伤寒病，俗名叫做时气。上面的论述实际上与仲景的四时八节二十四气决病法，互相发明。学人如果能参合观察，那么因时制宜，用药治病的方法，差不多就接近了。
[Summary] Chonghe Tang Formula
For formulas such as Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction), one should not use them lightly. I have a divine formula that does not violate the contraindications of the Three Yang meridians. It contains Qianghuo, Fangfeng, Shaoyao, Xixin, Baizhi, Huangqin, Cangzhu, Baizhu, Shengdihuang, and Gancao. Grind the herbs into coarse powder, decoct with rice and water, and both wind and cold pathogens will be resolved effectively.
Qianghuo, Fangfeng, Shaoyao, Xixin, Baizhi, Huangqin, Cangzhu, Baizhu, Shengdihuang, Gancao.
Take the above ten ingredients in equal parts, chop them. For each dose, add a pinch of rice (note: text implies adding rice to decoction or specific measure), one large cup of water, boil three times, filter the dregs, and take warm. Re-decoct the dregs. If sweating has already occurred, stop taking the medicine; efficacy is not measured by the amount of sweat produced.
(The text above states: "If sweating has occurred, then stop," from which it can be known that this formula is actually a diaphoretic. (I believe there should be two sentences missing: "When there is sweat but it has not emerged, induce sweating"; this may be due to lost bamboo slips during transcription.)
Wang Hu notes: This formula is essentially Jiwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction) by Zhang Yishan (Zhang Yuansu), with Chuanxiong removed and Baizhu and Shaoyao added. The meridians entered are the same as those of Jiwei Qianghuo Tang. However, Cangzhu and Baizhu should be selected based on the presence or absence of sweating. Furthermore, the function of Shaoyao is to harmonize Ying (Nutritive Qi). I suggest that for patients with sweating, Shaoyao should be used; for those without sweating, using Chuanxiong is more stable.
If there is an internal injury syndrome, or pain throughout the entire body internally and externally, including joint pain, Xionghuang Tang (Chuanxiong and Licorice Decoction) is appropriate.
Chuanxiong, Gancao, Mahuang, Nan Zhike.
Take the above ingredients in equal parts. Each dose is 3 qian or 5 qian, with 3 slices of Shengjiang (Fresh Ginger), decoct until boiling three times. Take hot for best results. The pain will stop immediately.
Wang Hu notes: In the aforementioned indications, the character "internal" (Nei) in "internal syndrome" is likely a typo for "external" (Wai). Even if accompanied by internal symptoms, it is merely slight stuffiness in the chest. Therefore, this formula is a variation of Zhongjing's Mahuang Tang. Regarding its treatment of so-called "internal syndrome," only Zhike (Aurantii Fructus) is used.
Formula for treating internal injury from frozen beverages combined with external contraction of cold pathogen, presenting with no sweating. (See ancient edition of Dongyuan's *Ten Books: Brief Examples of Yin Syndromes*.)
Cangzhu (processed), Fangfeng (each 2 liang), Gancao (1 liang, honey-fried).
Chop, add 3 cun of Congbai (Scallion White) and a piece of Shengjiang (Fresh Ginger), decoct with water and take.
If Taiyang disease (syndrome caused by pathogenic invasion of the Taiyang meridian) presents with fever, aversion to cold, and a floating and tight pulse, add Qianghuo. If Taiyang disease presents with a floating, tight pulse containing wiry and rapid qualities, indicating concurrent Shaoyang disease (syndrome caused by pathogenic invasion of the Shaoyang meridian), add Chaihu. If Taiyang disease presents with a floating, tight pulse containing surging qualities, indicating concurrent Yangming disease (syndrome caused by pathogenic invasion of the Yangming meridian), add Huangqin. (My opinion: Why not add Gegen? Puerariae Radix?) For the above three syndromes, approximately add 2 qianbi (a small spoonful measure) per dose. Regardless of which of the Three Yang meridians is involved, for female patients, add Danggui (Angelicae Sinensis Radix). To treat Chuinai (mastitis), after decoction, mix with Liu Yi San (Six-to-One Powder) 3-5 qian. The effect is miraculous.
Wang Hu notes: The above formula is a variation of Jiegu's Chuanxiong Tang. Jiegu was the teacher of Dongyuan (Li Gao), and Haizang (Wang Haogu) studied under Dongyuan. Thus, the Baizhu Tang mentioned below is a slight variation of Jiegu's Huangtang. Generally, the transmission between master and disciple follows the same pattern.
Shenzhu Tang Modifications according to the Six Qi
Taiyang Cold Water ruling the year (In traditional Chinese medicine cosmology, one of the six qi governing the first half of the year, associated with cold and water), add Guizhi and Qianghuo. (Lou Quanshan said: In years when non-seasonal cold occurs, I also add winter herbs.)
Yangming Dry Metal ruling the year (One of the six qi governing the first half of the year, associated with dryness and metal), add Baizhi and Shengma. (Lou said: In years when non-seasonal cool-dampness occurs, I also add them. Also in autumn. My opinion: Coolness leads to dryness/dampness, which can be either cold or heat. Generally, autumn dominates with dry commands. If it is dry but not damp, Baizhi should not be added; replacing it with Gegen is very stable.)
Shaoyang Ministerial Fire ruling the year (One of the six qi governing the first half of the year, associated with ministerial fire), add Huangqin and Shengdihuang. (Lou said: In years when non-seasonal rainy dampness occurs, I also add them. Also in summer. My opinion: The ruling qi has both constant and variable aspects. Variable qi is indeed unpredictable. But if it changes to rainy dampness, using the above drugs does not match the pathology.)
Taiyin Damp Earth ruling the year (One of the six qi governing the first half of the year, associated with dampness and earth), add Baizhu and Gaoben. (Lou said: In years when non-seasonal hot-dampness occurs, I also add them. Late summer and early autumn, also add. My opinion: Non-seasonal hot-dampness means the above drugs only treat dampness and do not address heat. One should additionally add Huangqin and other herbs.)
Shaoyin Sovereign Fire ruling the year (One of the six qi governing the first half of the year, associated with sovereign fire), add Xixin and Duhuo. (Lou said: In years when non-seasonal heat occurs, I also add them. Late spring and early summer, also add. My opinion: The above drugs do not conform to the ruling qi or seasonal qi.)
Jueyin Wind Wood ruling the year (One of the six qi governing the first half of the year, associated with wind and wood), add Chuanxiong and Fangfeng. (Lou said: In years when non-seasonal mild warmth occurs, I also add them. Also in spring.)
The above modifications of Shenzhu Tang according to the Six Qi are not solely designed for the ruling qi. They also apply to the main qi of the year, as well as conditions corresponding to the month, day, and hour. All should be modified according to the observed patterns based on the examples above.
Wang Hu notes: The theory of Yunqi (Five Movements and Six Qi) in the *Neijing* has both constant and variable aspects. Constant qi refers to what Haizang calls the ruling qi. Variable qi refers to what Lou called non-seasonal qi. Since the arrival of essential qi is不定 (uncertain), the text above further states: The method of medication should always be modified according to the qi observed in the year, month, day, and hour. Heaven's qi arrives with time, and human illness changes due to qi. Therefore, Shanghan (Cold Damage) is commonly known as Shiqi (Seasonal Qi). The above discussion actually elucidates mutually with Zhongjing's method of determining diseases according to the four seasons, eight solar terms, and twenty-four qi. If learners can study these together, their methods of treating diseases with medication according to time will be nearly perfect.