治伤寒表热未罢,心下有水气,干呕而咳,或渴,或利,或噎,或喘,小腹满,小
便不利,短气不得卧。
麻黄(去节) 桂枝 芍药(酒炒) 细辛 甘草(炙) 干姜(各三两) 半夏 五
味子(半升) 每服五钱,姜水煎服。
主伤寒传入于胃,表里俱热,脉大而长(仲景曰∶浮滑)。
知母(六两) 石膏(一斤,打碎) 甘草(二两,炙) 粳米(六合) 水一斗,煮米熟汤
成,温服一升,日三服。
传胃则邪入里矣。仲景言,浮滑以表邪,亦未解也。成氏曰∶白虎汤解内外之
邪,白虎西方金神,应秋,而归肺。热甚于内者,以寒下之,热甚于外者,以凉解之,
中外俱热,内不得泄,外不得发,非此汤不能解也。夏热秋凉,汤名白虎,言秋气至而
热去也。知母苦寒,《经》曰∶热淫所胜,佐以苦甘;又曰∶热淫于内,以苦发之,故
以知母为君。石膏甘寒,热则伤气寒以胜
之,甘以缓之,故以石膏为臣,甘草、粳米,味皆甘平,脾欲缓,急食甘以缓之,故
以甘草、粳米为使,太阳中 得此顿除,热见白虎而尽矣。立秋后不可服,服则不能
食,多成虚嬴,按∶石膏一物,入甘温队中则为青龙,从清凉同气则为白虎,夫风寒皆
伤,宜从辛甘发散矣,而表里又俱热,则温热不可用,欲并风寒表里之热而俱解之,故
立白虎一法,以辅青龙之不逮也。
治疗伤寒表热尚未解除,心下有停饮,出现干呕且咳嗽,或者口渴,或者腹泻,或者咽喉噎塞感,或者气喘,小腹胀满,小便不利,气短无法平卧。
麻黄(去节) 桂枝 芍药(酒炒) 细辛 甘草(炙) 干姜(各三两) 半夏 五味子(半升) 每次服用五钱,用生姜水煎服。
主治伤寒邪气传入胃腑,表里俱热,脉象大而长(张仲景说:浮滑)。
知母(六两) 石膏(一斤,打碎) 甘草(二两,炙) 粳米(六合) 用水一斗,煮至米熟汤成,温服一升,每日三次。
邪气传入胃腑意味着病邪已入里。张仲景说,脉浮滑表示表邪也未完全解除。成无己说:白虎汤能解除内外的邪气,白虎是西方的金神,对应秋季,归属于肺。体内热势极盛的,用寒凉攻下法;体表热势极盛的,用清凉解表法;内外都热,内部不能宣泄,外部不能发散,不用这个方剂就不能解除。夏季炎热秋季凉爽,汤剂名为白虎,意思是秋气到来而热邪去除。知母味苦寒,《黄帝内经》说:热邪过胜,用苦甘之品佐助;又说:热邪郁结于内,用苦味发散它,所以用知母作为君药。石膏味甘寒,热邪会伤气,寒性可以克制它,甘味可以缓和它,所以用石膏作为臣药。甘草、粳米,味道都是甘平,脾脏喜欢缓急,紧急时用甘味食物来缓和它,所以用甘草、粳米作为使药,太阳经中暑证得到此方立刻消除,热邪见到白虎汤就完全消除了。立秋后不可服用,服用则不能进食,多变成虚弱消瘦。按语:石膏这一味药,加入甘温药队中就成了青龙汤,跟随清凉同类药就成了白虎汤。风寒都会伤人,适宜从辛甘发散的角度治疗,但如果表里又都发热,那么温热药就不可用了,想要一并解散风寒及表里的热邪,所以创立了白虎汤这一方法,以辅助青龙汤的不足。
Treats Shanghan (Cold Damage) where the exterior heat has not yet subsided, with fluid retention in the epigastrium, presenting with dry heaving and coughing, or thirst, or diarrhea, or a sensation of choking in the throat, or wheezing, fullness in the lower abdomen, difficulty in urination, shortness of breath preventing lying flat.
Mahuang (Ephedrae Herba, removed nodes) Guizhi (Cinnamomi Ramulus) Shaoyao (Paeoniae Radix, wine-fried) Xixin (Asari Radix et Rhizoma) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) Ganjiang (Zingiberis Rhizoma, each three liang) Banxia (Pinelliae Tuber) Wuweizi (Schisandrae Fructus, half sheng). Take five qian per dose, decoct with water containing fresh ginger.
Mainly treats Shanghan (Cold Damage) pathogen transmitting to the Stomach, with heat in both interior and exterior, pulse large and long (Zhongjing said: floating and slippery).
Zhimu (Anemarrhenae Rhizoma, six liang) Shigao (Gypsum Fibrosum, one jin, crushed) Gancao (Glycyrrhizae Radix et Rhizoma, two liang, honey-fried) Jingsmi (Oryzae Semen, six ge). Use ten dou of water, boil until the rice is cooked and the decoction is ready, take one sheng warm, three times a day.
Transmission to the Stomach means the pathogen has entered the interior. Zhongjing stated that a floating and slippery pulse indicates the exterior pathogen has also not yet resolved. Cheng Shi said: Baihu Tang (White Tiger Decoction) resolves pathogens in both interior and exterior. Baihu is the Metal Spirit of the West, corresponding to Autumn, and belongs to the Lung. When heat is extreme within, use cold purgation; when heat is extreme on the exterior, use cooling resolution. When heat exists in both middle and exterior, unable to vent internally or diffuse externally, this decoction is required for resolution. Summer is hot, Autumn is cool; the name Baihu (White Tiger) signifies that when Autumn Qi arrives, the heat departs. Zhimu is bitter and cold; the Classics state: "When heat is excessive, assist with bitter and sweet"; and again: "When heat is rampant within, disperse it with bitterness." Therefore, Zhimu is used as the Sovereign herb. Shigao is sweet and cold; heat injures Qi, cold overcomes it, and sweetness moderates it; therefore, Shigao is used as the Minister herb. Gancao and Jingsmi are both sweet and neutral; the Spleen desires moderation, and in urgency, eat sweet substances to moderate it; therefore, Gancao and Jingsmi are used as the Envoy herbs. Taiyang Zhongshu (Summerheat affecting the Taiyang channel) is instantly cured by this, and heat is completely exhausted upon encountering Baihu. It should not be taken after Liqiu (Start of Autumn); if taken, one cannot eat, often resulting in deficiency and emaciation. Note: Gypsum, when added to a group of sweet-warm herbs, becomes Qinglong Tang (Azure Dragon Decoction); when aligned with cooling herbs of similar nature, it becomes Baihu Tang. Wind-cold both injure the body, and treatment should ideally follow pungent-sweet dispersion. However, if both exterior and interior are hot, warm-hot herbs are contraindicated. To simultaneously resolve the heat of wind-cold and the interior-exterior heat, the method of Baihu Tang was established to supplement the inadequacies of Qinglong Tang.