故稍从其轻者，此羌活汤、败毒散所由立也。九味汤主寒邪伤营，故于发表中加芎、地，引
而入血，即借以调荣。用葱姜为引，使通体汗出，庶三阳血分之邪，直达而无所滞矣。败
毒散主风邪伤卫，故于发表中加参、苓、枳、桔，引而达卫，固托以宣通。用生姜为使，使
留连肺部，则上焦气分之邪不能干矣。是方亦可用黄芩者，以诸药气味辛温，恐其僭亢，
一以润之，一以清之也。
柴葛解肌汤 治三阳合病，头痛发热，心烦不眠，嗑干耳聋，恶寒无汗，三阳证同见者。
石膏 柴胡 羌活 白芷 黄芩 芍药 桔梗 甘草 葛根
加姜枣，水煎服。
【注】陶华制此以代葛根汤。不知葛根汤，只是太阳、阳明药，而此方君柴胡，则是又
治少阳也；用之于太阳、阳明合病，不合也。若用之以治三阳合病，表里邪轻者，无不效
也。仲景于三阳合病，用白虎汤主之者，因热甚也，曰汗之则谵语遗尿，下之则额汗厥
逆，正示人惟宜以和解立法，不可轻于汗下
也。此方得之葛根、白芷，解阳明正病之邪，羌活解太阳不尽之邪，柴胡解少阳初入之邪。
佐膏、芩治诸经热，而专意在清阳明，佐芍药敛诸散药而不令过汗，桔梗载诸药上行三
阳，甘草和诸药通调表里。施于病在三阳，以意增减，未有不愈者也。若渴引饮者，倍石
膏加栝蒌根，以清热而生津也。若恶寒甚无汗，减石膏、黄芩加麻黄，春夏重加之，以
发太阳之寒。若有汗者，加桂枝以解太阳之风，无不可也。
升麻葛根汤 治阳明表热下利，兼治痘疹初发。
升麻 葛根 芍药 甘草（炙）
上四味，水煎服。
【集注】柯琴曰∶此为阳明初病，解表和里之剂，可用以散表热，亦可用以治里虚，一
方而两擅其长也。夫身热汗自出，不恶寒反恶热。是阳明之本证。仲景未尝立治表之方，
见阳明初起，汗出多而恶寒者，便用桂枝汤；及无汗而恶寒者，则用葛根汤。证同太阳而
称阳明者，是阳明之表病自太阳传来，故治仍同太阳也。此方治阳明自病，不用麻桂者，
恐汗太过而亡津液，反致胃燥也。用升麻、葛根发胃脘之阳，以散肌肉之表热；芍药、甘
草泻脾经之火，以解胃府之里热。有汗则发，无汗则止，功同桂枝，而已远干姜、桂，且
不须啜稀粥以助阳也。胃实为阳明之里证，仲景用承气三方。然阳明初病，往往有移热于
脾而下利者，《内经》所谓暴注下迫，皆属于热也。下利，正是胃热之兆，故太阳阳明合
病，必自下利，仲景用葛根汤以发两阳之表热，即所以治里热也。此方即仿其义，去姜、
桂之辛热，以升麻代麻黄，便是阳明表剂，而非太阳表剂矣。葛根禀性甘凉，可以散表实，
协升麻以上升，则使清阳达上而浊阴下降。可知芍药收敛脾阴，甘草缓急和里，则下利自
止。可知治里仍用表药者，以表实下利、而非里实故也。痘疹自里达表，出于少阴而发
于太阳，初起则内外皆热，故亦宜于凉散耳。若无汗加麻黄，有汗加桂枝，渴热加石膏，咽
痛加桔梗，头痛合芎芷散，头面肿合消毒饮，有少阳证加柴，芩，火盛加芩、连，凡邪在
三阳，以此出入，无不利也。
参苏饮 治感冒风寒，头痛发热，憎寒咳嗽，涕唾稠粘，胸膈满闷，脉弱无汗。
人参（八分） 苏叶（八分） 干葛（八分） 前胡（八分） 陈皮（八分） 枳壳（八分）
茯苓（八分） 半夏（八分） 桔梗（五分） 木香（五分） 甘草（五分） 生姜（五片） 大枣（一枚）
上水煎，热服取汗。
【注】风寒感冒太阳则传经，以太阳主表，故用麻、桂二方，发营卫之汗也。若感太阴
则不传经，以太阴主肺，故用此汤外散皮毛，内宣肺气也。盖邪之所凑，其气必虚，故君
人参以补之。皮毛者，肺之合也，肺受风寒，皮毛先病，故有头痛无汗，发热憎寒之表，以
苏叶、葛根、前胡为臣以散之。肺一受邪，胸中化浊，故用枳、桔、二陈以清之，则咳嗽、
涕唾稠粘、胸膈满闷之证除矣。加木香以宣诸里气，加姜、枣以调诸表气，斯则表里之
气和，和则解也。以本方去人参加川芎，以前胡易柴胡，名芎苏饮。治气实有火者，头
痛甚亦加之。喘嗽者，加杏仁以降气，桑皮以泻肺。合四物名茯苓补心汤，治气血两虚，
及新产之后虚损吐血，感冒伤风咳嗽，最相宜也。
藿香正气散 治外受四时不正之气，内停饮食，头痛寒热，或霍乱吐泄，或作疟疾。
藿香 桔梗 紫苏 白芷 浓朴 大腹皮 半夏 茯苓 陈皮 甘草
上十味，加姜枣，水煎，热服。
【集注】吴琨曰∶四时不正之气，由鼻而入，不在表而在里，故不用大汗以解表，但
用芬香利气之品以正里。苏、芷、陈、腹、朴、梗，皆气胜者也，故能正不正之气；茯、半、
甘草则甘平之品，所以培养中气者也。若病在太阳，与此汤全无干涉，伤寒脉沉发热，与
元气本虚之人，并夹阴发热者宜戒。又金不换正气散，即平胃散加半夏、藿香，凡受山
岚瘴气及出远方不服水土、吐泻下利者主之。盖平胃散，可以平湿土而消瘴，半夏之燥以
醒脾，藿香之芬以开胃，名曰正气，谓能正不正之气也。
神术汤 主治三时外感寒邪、内伤生冷而发热及脾泻肠风。
白术（三钱） 防风（二钱） 甘草（一钱）
上三味，无汗用苍术加葱白、生姜，有汗用白术、生姜。
【集注】柯琴曰∶此王好古得意之方，仿仲景麻、桂二方之义，而制为轻剂也。然此
是太阴之剂，可以理脾胃之风湿，而不可治太阳之风寒，亦不可以治阳明之表证与少阳
之半表里也。《内经》所谓春伤于风，邪气留连而洞泄，至夏而飧泄、肠 者宜之。若冬
伤于寒，至春而温病者，又非所宜也。今人不知仲景立方之旨，只恐麻黄、桂枝之伤人
也，得此平和之剂恃为稳当。不知营卫不和，非调和脾胃者所可代。胃家之实者，非补虚
之品所能投。肝胆之相火往来，少阴之水火相射者，不得以燥剂该摄也。失明药之理，始
得方之用，能知方，始可用方而不执方。若病在太阳，先发阳明之汗，是引贼破家，张
洁古岂独为葛根道哉！
麻黄加术汤 治湿家身烦疼。
麻黄（三两） 桂枝（二两） 甘草（炙，二两） 杏仁（七十个） 白术（炒，四两）
上五味，以水九升，煮麻黄，减二升，去沫，内诸药，煮取二升半，去滓，温服八合，
覆取微似汗。
【集注】程知曰∶此汤为湿家表散法也。身疼为湿，身烦为热。加白术于麻黄汤中，一
以助其去湿，一以恐其过散，此治湿之正法也。发散方中加白术，又为张洁古、王好古二人开法门。
桂枝附子汤 主冶伤寒八九日，风湿相搏，身体烦疼，不能转侧，不呕不渴，脉浮虚而涩者。
桂枝（四两） 附子（炮，三枚） 甘（一两） 生姜（三两） 大枣（十二枚）
上五味，以水六升，煮取二升，去滓，分温三服。
【集注】程知曰∶湿与风相搏，流入关节，身疼极重，而无头痛、呕、渴等证，脉浮虚
者风也，涩者寒湿也。风在表者，散以桂、甘之辛甘。湿在经者，逐以附子之辛热。姜、枣
辛甘，行营卫通津液以和表。盖阳虚则湿不行，温经助阳散湿，多藉附子之大力也。
栝蒌桂枝汤 治太阳证备，身体强KT KT 然，脉反沉迟，此为痉，此汤主之。
栝蒌根（二两） 桂枝（三两） 芍药（三两） 甘草（二两） 生姜（三两） 大枣（十二枚）
上六味，以水九升，煮取三升，分温三服，取微汁，汗不出，食顷须啜热粥发之。
【集注】喻昌曰∶伤寒方中，治项背KT KT ，用桂枝加葛根汤矣。彼之汗出恶风，其邪在
表，而此之太阳证，罔不具备，其邪之亦在于表可知也。但以脉之沉迟，知其在表之邪
为津液内竭所召，不当从风寒之表法起见，故不用葛根之发表解肌，改用栝蒌根之味苦入
阴，擅生津液之长者为君，加之桂枝和营卫、养筋脉而治其痉，乃变表法为和法也。然既
君以栝蒌根当增之，桂枝为臣当减之。
水解散 治天行时气初起，头痛，壮热等疫。
大黄（四两） 白芍（二两） 黄芩 甘草（炙） 桂心 麻黄（各三两）
上为粗末，每撮一两，水煎服。汗下不再服。
二圣救苦丹
川大黄（生，一斤） 皂角（猪牙者，去皮弦，微炒，四两）
上为末，和匀，水泛为丸，每服三钱，无根水下。弱者减服。
【注】天行时气，即四时不正之气，感而为病者，初不名疫也。因病气互相传染，老
幼相似，沿门阖境而共病之，故曰∶天行时气也。然此疫气从鼻而入，一受其邪，脏腑
皆病，若不急逐病出，则多速死。急逐之法，非汗即下，故古人治疫之方，以下为主，以
汗次之，是为病寻出路也。此二方，一以治冬疫，一以治春疫。冬疫多寒，春疫多热。多
寒者宜水解散，方中用麻、桂、芍，草发营卫之汗，大黄，黄芩泻疫毒之邪。多热者宜
救苦丹，方中用皂角开窍而发表，大黄泻火而攻里，使毒亦从汗下而出也，二方审而用
之，治疫之大法可类推矣。
天水散（一名益无散一名六一散） 治夏时中暑，热伤元气，内外俱热，无气以动，烦渴
欲饮，肠胃枯涸者。又能催生下乳，积聚水蓄，里急后重，暴注下迫者宜之。
桂府滑石（水飞，六两） 甘草（一两） 辰砂（三钱）
上为细末，新汲水一碗，调服三钱。
【集注】柯琴曰∶元气虚而不支者死，邪气盛而无制者亦死。今热伤元气，无气以动，
斯时用参、 以补气，则邪愈甚；用芩、连以清热，则气更伤。惟善攻热者，不使败人
元气；善补虚者，不使助人邪气，必得气味纯粹之品以主之。滑石禀土中冲和之气，行
西方清肃之令，秉秋金坚重之形，寒能胜热，甘不伤脾，含天乙之精而具流走之性，异于
石膏之凝滞，能上清水原，下通水道，荡涤六腑之邪热从小便而泄。炙甘草禀草中冲和
之性，调和内外，止渴生津；用以为佐，保元气而泻虚火，则五脏自和矣。然心为五赃
主，暑热扰中，神明不安，必得朱砂以镇之，则神气可以虚遽复；凉水以滋之，则邪热可以
急除，此清心之阳热可通行也。至于热利初起，里急后重者宜之，以滑可去着也。催生
下乳，积聚蓄水等证，同乎此义，故兼治之。是方也，益气而不助邪，逐邪而不伤气，不
负益元之名，宜与白虎、生脉三方鼎足也。
香蒂饮 治暑热乘凉饮冷、阳气为阴邪所遏、头痛发热、恶寒烦躁、口渴腹满、吐泻者。
香薷 浓朴（姜汁炒） 白扁豆（炒）
水煎浸，冷服。
【集注】叶仲坚曰∶饮与汤稍有别，服有定数者名汤，时时不拘者名饮。饮因渴而设，
用之于温暑则最宜者也。然胃恶燥，脾恶湿，多饮伤脾，反致下利。治之之法，心下有水
气者发汗，腹中有水气者利小便。然与其有水患而治之，曷若先选其能汗、能利者用之。
香薷芳香辛温，能发越阳气，有彻上彻下之功，故治暑者君之，以解表利小便。佐浓朴
以除湿，扁豆以和中，合而用之为饮。饮入于胃，热去而湿不留，内外之暑悉除矣，若
心烦口渴者，去扁豆加黄连，名黄连香薷饮。加茯苓、甘草，名五物。加木瓜、参、 、橘、
术，名十味。随证加减，尽香薷之用也。然劳倦内伤，必用清暑益气，内热大渴，必用
人参白虎，若用香薷，是重虚其表而反济其内热矣。香薷乃夏月解表之药，如冬月之麻
黄，气虚者尤不可服。今人不知暑伤元气，概用以代茶，是开门揖盗也。
因此，稍微顺应病情较轻的情况，这就是羌活汤、败毒散创立的原因。九味羌活汤主治寒邪损伤营分，所以在发表药中加入川芎、地黄，引导药力进入血分，借此来调和营气。用葱、姜作为引经药，使全身出汗，这样三阳经血分中的邪气就能直达病所而无所滞留。败毒散主治风邪损伤卫分，所以在发表药中加入人参、茯苓、枳壳、桔梗，引导药力到达卫分，固护正气以宣通经络。用生姜作为使药，使药力留连于肺部，那么上焦气分中的邪气就不能干扰了。这个方剂中也可以使用黄芩，是因为其他药物气味辛温，担心它们过于亢烈，用黄芩一来滋润，二来清热。
柴葛解肌汤：治疗三阳合病，症状包括头痛发热、心烦失眠、咽喉干燥耳聋、恶寒无汗，三阳经证候同时出现者。
石膏、柴胡、羌活、白芷、黄芩、芍药、桔梗、甘草。
加生姜、大枣，水煎服。
【注】陶华制作此方是为了替代葛根汤。但他不知道葛根汤只是治疗太阳、阳明经病的药物，而这个方剂以柴胡为君药，则是又治疗少阳经病了；用它来治疗太阳、阳明合病，是不合适的。如果用它来治疗三阳合病且表里邪气较轻的情况，没有不有效的。张仲景对于三阳合病，使用白虎汤为主治，是因为热势很盛，他说发汗会导致谵语和遗尿，攻下会导致额头出汗和四肢厥逆，这正是提示人们只适宜采用和解的立法，不可轻易使用发汗或攻下的方法。此方得到葛根、白芷，可以解除阳明经正病的邪气，羌活解除太阳经未尽的邪气，柴胡解除少阳经初入的邪气。佐以石膏、黄芩治疗各经的热邪，而专门意在清泄阳明经热，佐以芍药收敛各种发散药而不令发汗过度，桔梗载诸药上行至三阳经，甘草调和诸药通调表里。施用于病在三阳经的情况，根据病情意旨增减药味，没有不痊愈的。如果口渴想喝水，加倍石膏并加入栝蒌根，以清热生津。如果恶寒严重且无汗，减少石膏、黄芩并加入麻黄，春夏季节加重用量，以发散太阳经的寒邪。如果有汗，加入桂枝以解除太阳经的风邪，没有不可以的。
升麻葛根汤：治疗阳明经表热引起的腹泻，兼治痘疹初发。
升麻、葛根、芍药、甘草（炙）。
以上四味药，水煎服。
【集注】柯琴说：这是治疗阳明经初起疾病，解表和里的方剂，可以用来疏散表热，也可以用来治疗里虚，一方而兼有两方面的长处。身体发热、自然出汗，不怕冷反而怕热，这是阳明经的本证。张仲景未曾设立治疗表证的方剂，见到阳明经初起，出汗多且恶寒的，就用桂枝汤；以及无汗且恶寒的，就用葛根汤。证候同于太阳经而称为阳明经的，是阳明经的病自太阳经传来，所以治疗仍同于太阳经。此方治疗阳明经自发的疾病，不用麻黄、桂枝，是担心发汗太过而亡失津液，反而导致胃燥。用升麻、葛根发散胃脘的阳气，以疏散肌肉表面的热邪；芍药、甘草泻脾经的火邪，以解除胃府的里热。有汗则发汗，无汗则止汗，功效同于桂枝汤，但已经远离干姜、桂枝，而且不需要喝稀粥来助阳。胃实是阳明经的里证，张仲景使用承气汤三方。然而阳明经初起，往往有热邪移于脾脏而导致腹泻，《内经》所说的急骤腹泻、肛门重坠感，都属于热证。腹泻，正是胃热的征兆，所以太阳阳明合病，必然自发腹泻，张仲景用葛根汤来发散两阳经的表热，这也就是治疗里热的方法。此方即模仿其义理，去掉姜、桂的辛热之性，用升麻代替麻黄，就是阳明经的表剂，而不是太阳经的表剂了。葛根禀受甘凉的性质，可以疏散表实，协助升麻以上升，则使清阳达于上部而浊阴下降。可知芍药收敛脾阴，甘草缓急和里，则腹泻自然停止。可知治疗里证仍用表药的原因，是因为表实导致的腹泻，而非里实所致。痘疹从里达表，出于少阴经而发于太阳经，初起时内外皆热，所以也适宜用凉散的方法。如果无汗加麻黄，有汗加桂枝，口渴热盛加石膏，咽痛加桔梗，头痛合用川芎、白芷散，头面肿胀合用消毒饮，有少阳经证候加柴胡、黄芩，火盛加黄芩、黄连，凡是邪气在三阳经，以此方加减出入，没有不利的。
参苏饮：治疗感冒风寒，头痛发热，憎寒咳嗽，鼻涕唾液稠粘，胸膈满闷，脉弱无汗。
人参（八分）、苏叶（八分）、干葛（八分）、前胡（八分）、陈皮（八分）、枳壳（八分）、茯苓（八分）、半夏（八分）、桔梗（五分）、木香（五分）、甘草（五分）、生姜（五片）、大枣（一枚）。
以上用水煎，热服取汗。
【注】风寒感冒，若传入太阳经则传经，因为太阳经主表，所以用麻黄汤、桂枝汤二方，发散营卫之汗。如果感受太阴经邪气则不传经，因为太阴经主肺，所以用此汤外散皮毛之邪，内宣肺气。大概邪气聚集的地方，正气必定虚弱，所以用人参为君药以补益正气。皮毛是肺的外合，肺受风寒侵袭，皮毛先发病，所以有头痛无汗、发热憎寒的表证，以苏叶、葛根、前胡为臣药以疏散邪气。肺一旦受邪，胸中化为浊气，所以用枳壳、桔梗及二陈汤以清化浊气，则咳嗽、鼻涕唾液稠粘、胸膈满闷的症状就消除了。加木香以宣通各种里气，加姜、枣以调和各种表气，这样表里之气和谐，和谐则病解。以此方去掉人参加入川芎，以前胡替换柴胡，名为芎苏饮。治疗气实有火的人，头痛严重的也适用。喘咳的人，加杏仁以降气，桑白皮以泻肺。合用四物汤名为茯苓补心汤，治疗气血两虚，以及新产之后虚损吐血，感冒伤风咳嗽，最为适宜。
藿香正气散：治疗外受四时不正之气，内停饮食，头痛寒热，或霍乱吐泄，或发作疟疾。
藿香、桔梗、紫苏、白芷、浓朴、大腹皮、半夏、茯苓、陈皮、甘草。
以上十味药，加生姜、大枣，水煎，热服。
【集注】吴琨说：四时不正之气，从鼻而入，不在表而在里，所以不用大汗法来解表，只用芬香利气的药物来调理里气。苏叶、白芷、陈皮、大腹皮、厚朴、桔梗，都是气胜的药物，所以能纠正不正之气；茯苓、半夏、甘草则是甘平的药物，所以能培养中气。如果病在太阳经，与此汤完全无关，伤寒脉沉发热，与元气本虚之人，以及夹阴发热者，应当戒忌。另外金不换正气散，即平胃散加半夏、藿香，凡是受山岚瘴气及出远方不服水土、吐泻下利者主治。大概平胃散，可以平湿土而消瘴气，半夏的燥性以醒脾，藿香的芬香以开胃，名叫正气，谓能纠正不正之气。
神术汤：主治三个季节外感寒邪、内伤生冷而发热及脾泻肠风。
白术（三钱）、防风（二钱）、甘草（一钱）。
以上三味药，无汗用苍术加葱白、生姜，有汗用白术、生姜。
【集注】柯琴说：这是王好古得意的方子，模仿张仲景麻黄汤、桂枝汤二方的义理，而制成轻剂。然而这是太阴经的方剂，可以调理脾胃的风湿，而不能治疗太阳经的风寒，也不可以治疗阳明经的表证与少阳经的半表里证。《内经》所说的春天伤于风，邪气留连而洞泄，到了夏天而飧泄、肠澼者适宜用此方。如果冬天伤于寒，到了春天而得温病者，又不适宜了。现在的人不知道张仲景立方的宗旨，只是害怕麻黄、桂枝伤害人体，得到此平和的方剂倚仗以为稳当。不知道营卫不和，不是调和脾胃者所能替代的。胃家实证者，不是补虚的药物所能投用的。肝胆相火往来，少阴水火相射者，不能用燥剂概括摄纳。不明药物的道理，才懂得方剂的作用，能懂方剂，才开始可以用方而不拘泥于方。如果病在太阳经，先发阳明经的汗，是引贼破家，张洁古难道只是为葛根汤说道吗！
麻黄加术汤：治疗湿家身体烦疼。
麻黄（三两）、桂枝（二两）、甘草（炙，二两）、杏仁（七十个）、白术（炒，四两）。
以上五味药，用水九升，煮麻黄，减去二升，去沫，加入诸药，煮取二升半，去滓，温服八合，覆盖取微似汗。
【集注】程知说：此汤为湿家表散法。身疼为湿，身烦为热。在麻黄汤中加入白术，一来帮助去湿，二来恐怕发汗太过，这是治疗湿病的正法。在发散方中加入白术，又是为张洁古、王好古二人开创法门。
桂枝附子汤：主治伤寒八九日，风湿相搏，身体烦疼，不能转侧，不呕不渴，脉浮虚而涩者。
桂枝（四两）、附子（炮，三枚）、甘草（一两）、生姜（三两）、大枣（十二枚）。
以上五味药，用水六升，煮取二升，去滓，分三次温服。
【集注】程知说：湿与风相搏，流入关节，身疼极重，而无头痛、呕、渴等证，脉浮虚的是风邪，涩的是寒湿。风在表者，用桂枝、甘草的辛甘之性发散。湿在经者，用附子的辛热之性驱逐。姜、枣辛甘，行营卫通津液以和表。大概阳虚则湿不行，温经助阳散湿，多借助附子的强大力量。
栝蒌桂枝汤：治疗太阳证具备，身体强直僵硬然，脉反沉迟，此为痉病，此汤主治。
栝蒌根（二两）、桂枝（三两）、芍药（三两）、甘草（二两）、生姜（三两）、大枣（十二枚）。
以上六味药，用水九升，煮取三升，分三次温服，取微汁，汗不出，吃顿饭的功夫须喝热粥以发汗。
【集注】喻昌说：伤寒方中，治疗项背强直，用桂枝加葛根汤了。那个方子是汗出恶风，邪在表，而这个方子的太阳证，无不具备，邪也在表可知。但以脉象沉迟，知道在表的邪气是由于津液内竭所召致，不应当从风寒表法来看待，所以不用葛根的发表解肌，改用栝蒌根味苦入阴，擅长生津液的长处为君药，加之桂枝调和营卫、养筋脉而治其痉，乃是变表法为和法。既然以栝蒌根为君药应当增加，桂枝为臣药应当减少。
水解散：治疗天行时气初起，头痛，壮热等疫病。
大黄（四两）、白芍（二两）、黄芩、甘草（炙）、桂心、麻黄（各三两）。
以上为粗末，每撮一两，水煎服。汗下不再服。
二圣救苦丹
川大黄（生，一斤）、皂角（猪牙者，去皮弦，微炒，四两）。
以上为末，和匀，水泛为丸，每服三钱，无根水下。弱者减服。
【注】天行时气，即四时不正之气，感而为病者，起初不叫疫。因病气互相传染，老幼相似，沿门阖境而共同患病，所以说：天行时气。然而此疫气从鼻而入，一受其邪，脏腑皆病，若不急速驱逐病邪外出，则多迅速死亡。急速驱逐的方法，不是发汗就是攻下，所以古人治疗疫病的方剂，以下法为主，发汗次之，这是为病邪寻找出路。这两个方子，一个治疗冬疫，一个治疗春疫。冬疫多寒，春疫多热。多寒者适宜用水解散，方中用麻黄、桂枝、芍药、甘草发散营卫之汗，大黄、黄芩泻疫毒之邪。多热者适宜用救苦丹，方中用皂角开窍而发表，大黄泻火而攻里，使毒邪也从汗下而出，两个方子审察后使用，治疗疫病的大法可以类推了。
天水散（一名益无散一名六一散）：治疗夏时中暑，热伤元气，内外俱热，无气以动，烦渴欲饮，肠胃枯涸者。又能催生下乳，积聚水蓄，里急后重，暴注下迫者适宜。
桂府滑石（水飞，六两）、甘草（一两）、辰砂（三钱）。
以上为细末，新汲水一碗，调服三钱。
【集注】柯琴说：元气虚而不支者死，邪气盛而无制者亦死。如今热伤元气，无气以动，此时用参、芪以补气，则邪气更甚；用黄芩、黄连以清热，则气更伤。只有善于攻热者，不使败坏人的元气；善于补虚者，不使助长人的邪气，必须得到气味纯粹的药物来主持。滑石禀受土中冲和之气，行西方清肃之令，秉受秋金坚重之形，寒能胜热，甘不伤脾，含天乙之精而具有流走之性，不同于石膏的凝滞，能上清水原，下通水道，荡涤六腑的邪热从小便而泄。炙甘草禀受草中冲和之性，调和内外，止渴生津；用以为佐，保元气而泻虚火，则五脏自然和谐。然而心为五脏之主，暑热扰中，神明不安，必须得朱砂以镇之，则神气可以虚遽复；凉水以滋之，则邪热可以急除，此清心之阳热可通行也。至于热利初起，里急后重者适宜用此，以滑可去着也。催生下乳，积聚蓄水等证，同乎此义，故兼治之。此方，益气而不助邪，逐邪而不伤气，不负益元之名，宜与白虎汤、生脉散三方鼎足而立。
香蒂饮：治疗暑热乘凉饮冷、阳气为阴邪所遏、头痛发热、恶寒烦躁、口渴腹满、吐泻者。
香薷、浓朴（姜汁炒）、白扁豆（炒）。
水煎浸，冷服。
【集注】叶仲坚说：饮与汤稍有区别，服用有定数的名汤，时时不拘名的饮。饮因渴而设，用在温暑时节则最适宜。然而胃恶燥，脾恶湿，多饮伤脾，反而导致腹泻。治疗的方法，心下有水气者发汗，腹中有水气者利小便。然而与其有水患而治疗它，何不先选择能汗、能利的药物使用。香薷芳香辛温，能发越阳气，有彻上彻下之功，所以治疗暑病以它为君药，以解表利小便。佐以浓朴以除湿，扁豆以和中，合而用之为饮。饮入于胃，热去而湿不留，内外之暑悉除矣，如果心烦口渴者，去扁豆加黄连，名黄连香薷饮。加茯苓、甘草，名五物散。加木瓜、人参、黄芪、橘皮、白术，名十味散。随证加减，尽香薷之用。然而劳倦内伤，必须用清暑益气汤，内热大渴，必须用人参白虎汤，如果用香薷，是重虚其表而反济其内热了。香薷乃夏月解表之药，如冬月之麻黄，气虚者尤其不可服用。现在的人不知道暑伤元气，一概用以代茶，是开门揖盗也。
Therefore, slightly accommodating the milder condition is the reason why Qianghuo Tang (Notopterygium Decoction) and Baidu San (Detoxifying Powder) were established. Jiuwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction) governs cold pathogen injuring the Ying (Nutritive) level; thus, Chuanxiong Rhizome (Chuanxiong Radix) and Rehmanniae Radix (Dihuang) are added to the exterior-releasing herbs to guide the medicinal force into the Blood level, thereby utilizing it to harmonize the Ying Qi. Scallion and ginger are used as guides to induce sweating throughout the body, so that the pathogens in the blood level of the three Yang meridians can reach the disease site directly without stagnation. Baidu San (Detoxifying Powder) governs wind pathogen injuring the Wei (Defensive) level; thus, Ginseng Radix et Rhizoma (Renshen), Poria (Fuling), Aurantium Fructus Immaturus (Zhike), and Platycodonis Radix (Jiegeng) are added to the exterior-releasing herbs to guide the medicinal force to the Wei level, consolidating the righteous Qi to promote circulation. Fresh ginger is used as an envoy to keep the medicinal force lingering in the Lung, so that the pathogens in the Qi level of the Upper Jiao cannot interfere. Huangqin (Scutellariae Radix) can also be used in this formula because the other herbs have acrid-warm flavors, and it is feared they may become excessive; Huangqin serves to moisten and clear heat.
Chaige Jieji Tang (Bupleurum and Pueraria Decoction to Release the Muscle Layer): Treats combined diseases of the three Yang meridians, characterized by headache, fever, irritability, insomnia, dry throat, deafness, aversion to cold, absence of sweat, with symptoms of all three Yang meridians appearing simultaneously.
Shigao (Gypsum Fibrosum), Chaihu (Bupleuri Radix), Qianghuo (Notopterygii Rhizoma et Radix), Baizhi (Angelicae Dahuricae Radix), Huangqin (Scutellariae Radix), Shaoyao (Paeoniae Radix), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma).
Add Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus), decoct in water and take orally.
[Note]: Tao Hua created this formula to replace Gegen Tang (Puerariae Radix Decoction). However, he did not realize that Gegen Tang treats only Taiyang and Yangming meridians, whereas this formula uses Chaihu (Bupleuri Radix) as the sovereign herb, thus also treating Shaoyang meridian disease; using it for combined Taiyang-Yangming disease is inappropriate. If used for combined three-Yang disease where the exterior and interior pathogens are mild, it will invariably be effective. Zhang Zhongjing uses Baihu Tang (White Tiger Decoction) for combined three-Yang disease because the heat is severe; he states that sweating leads to delirium and enuresis, while purging leads to sweating on the forehead and cold limbs. This precisely indicates that one should only adopt a harmonizing method and must not lightly use sweating or purging methods. This formula utilizes Gegen (Puerariae Radix) and Baizhi (Angelicae Dahuricae Radix) to resolve the pathogens of the Yangming meridian's proper disease, Qianghuo (Notopterygii Rhizoma et Radix) to resolve the remaining pathogens of the Taiyang meridian, and Chaihu (Bupleuri Radix) to resolve the newly entering pathogens of the Shaoyang meridian. Shigao (Gypsum Fibrosum) and Huangqin (Scutellariae Radix) assist in treating heat in various meridians, with a specific focus on clearing Yangming heat; Shaoyao (Paeoniae Radix) assists in astringing the dispersing herbs to prevent excessive sweating; Jiegeng (Platycodonis Radix) carries the herbs upward to the three Yang meridians; Gancao (Glycyrrhizae Radix et Rhizoma) harmonizes the herbs and regulates the exterior and interior. Applied to diseases involving the three Yang meridians, with modifications based on clinical judgment, there is no case that does not heal. If there is thirst with desire to drink, double the dose of Shigao (Gypsum Fibrosum) and add Gualougen (Trichosanthis Radix) to clear heat and generate fluids. If there is severe aversion to cold and no sweat, reduce Shigao (Gypsum Fibrosum) and Huangqin (Scutellariae Radix) and add Mahuang (Ephedrae Herba); increase the dose in spring and summer to release Taiyang cold. If there is sweat, add Guizhi (Cinnamomi Ramulus) to release Taiyang wind; there is no situation where this is not applicable.
Shengma Gegen Tang ( Cimicifugae and Puerariae Radix Decoction): Treats diarrhea caused by exterior heat of the Yangming meridian; also treats the initial eruption of smallpox and chickenpox.
Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Radix), Shaoyao (Paeoniae Radix), Gancao (Glycyrrhizae Radix et Rhizoma - honey-fried).
The above four ingredients, decoct in water and take orally.
[Collected Notes]: Ke Qin says: This is a formula for resolving the exterior and harmonizing the interior at the initial stage of Yangming disease. It can be used to disperse exterior heat and also to treat interior deficiency, excelling in both aspects. Fever with spontaneous sweating, aversion to cold but preference for heat, are the fundamental signs of Yangming. Zhang Zhongjing did not establish a formula specifically for the exterior of Yangming; when seeing Yangming onset with profuse sweating and aversion to cold, he uses Guizhi Tang (Cinnamon Twig Decoction); when there is no sweat and aversion to cold, he uses Gegen Tang (Puerariae Radix Decoction). The syndrome resembles Taiyang but is called Yangming because Yangming disease originates from transmission from Taiyang, so the treatment remains similar to Taiyang. This formula treats spontaneously arising Yangming disease; it does not use Mahuang (Ephedrae Herba) or Guizhi (Cinnamomi Ramulus) to avoid excessive sweating leading to fluid depletion and stomach dryness. Shengma (Cimicifugae Rhizoma) and Gegen (Puerariae Radix) diffuse the Yang qi of the stomach to scatter muscle-layer heat; Shaoyao (Paeoniae Radix) and Gancao (Glycyrrhizae Radix et Rhizoma) drain fire from the Spleen meridian to resolve interior heat of the Stomach organ. It induces sweating if present, stops if absent; its efficacy is similar to Guizhi Tang (Cinnamon Twig Decoction) but avoids the pungent-warm nature of Ganjiang (Zingiberis Rhizoma) and Guizhi (Cinnamomi Ramulus), and does not require drinking warm millet gruel to assist Yang. Excess in the Stomach is an interior sign of Yangming; Zhang Zhongjing uses the three Chengqi formulas. However, in early Yangming disease, heat often shifts to the Spleen causing diarrhea; as stated in the Neijing, sudden diarrhea with tenesmus belongs to heat. Diarrhea is indeed a sign of Stomach heat. Thus, in combined Taiyang-Yangming disease with spontaneous diarrhea, Zhang Zhongjing uses Gegen Tang (Puerariae Radix Decoction) to release the exterior heat of both Yang meridians, which effectively treats the interior heat. This formula imitates this principle, removing the pungent-warm Jiang (Zingiberis Rhizoma) and Gui (Cinnamomi Ramulus), replacing Mahuang (Ephedrae Herba) with Shengma (Cimicifugae Rhizoma), making it a Yangming exterior formula rather than a Taiyang exterior formula. Gegen (Puerariae Radix) has a sweet-cool nature, capable of dispersing exterior excess; assisting Shengma (Cimicifugae Rhizoma) to ascend, it allows clear Yang to reach the upper part and turbid Yin to descend. Shaoyao (Paeoniae Radix) astringes Spleen Yin, Gancao (Glycyrrhizae Radix et Rhizoma) moderates urgency and harmonizes the interior, so diarrhea stops naturally. Treating the interior with exterior herbs works because the diarrhea is due to exterior excess, not interior excess. Rashes emerge from the interior to the exterior, originating from Shaoyin and erupting in Taiyang; initially, both interior and exterior are hot, so cooling dispersion is appropriate. Add Mahuang (Ephedrae Herba) if no sweat, Guizhi (Cinnamomi Ramulus) if sweat, Shigao (Gypsum Fibrosum) if thirst and heat, Jiegeng (Platycodonis Radix) if sore throat, combine with Xiongzhi San (Ligusticum and Angelica Powder) for headache, combine with Xiaodu Yin (Detoxifying Drink) for facial swelling, add Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix) for Shaoyang signs, add Huangqin (Scutellariae Radix) and Lianhua (Scutellariae Radix / Coptidis Rhizoma depending on context, likely Huanglian here) for intense fire. For pathogens in the three Yang meridians, modifying this formula yields favorable results.
Shenru Yin (Ginseng and Perilla Drink): Treats cold-damage wind-cold, headache, fever, aversion to cold, cough, thick sticky nasal discharge and saliva, chest and diaphragm fullness/stuffiness, weak pulse, absence of sweat.
Renshen (Ginseng Radix et Rhizoma - 8 fen), Zhusu Ye (Perillae Folium - 8 fen), Qiange (Puerariae Radix - 8 fen), Qianhu (Peucedani Radix - 8 fen), Chenpi (Citri Reticulatae Pericarpium - 8 fen), Zhike (Aurantii Fructus Immaturus - 8 fen), Fuling (Poria - 8 fen), Banxia (Pinelliae Rhizoma - 8 fen), Jiegeng (Platycodonis Radix - 5 fen), Muxiang (Aucklandiae Radix - 5 fen), Gancao (Glycyrrhizae Radix et Rhizoma - 5 fen), Shengjiang (Zingiberis Rhizoma Recens - 5 slices), Dazao (Jujubae Fructus - 1 piece).
Decoct in water, take hot to induce sweating.
[Note]: Wind-cold damage affecting Taiyang transmits through the meridians because Taiyang governs the exterior; thus, Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) are used to sweat out the Ying and Wei levels. If Taiyin is affected, it does not transmit because Taiyin governs the Lung; thus, this drink is used to disperse pathogens from the skin/hair externally and promote Lung Qi internally. Wherever pathogens gather, Qi must be deficient; therefore, Renshen (Ginseng Radix et Rhizoma) is used as the sovereign herb to tonify. Skin/hair is the exterior correspondence of the Lung; when the Lung is invaded by wind-cold, the skin/hair suffers first, causing exterior symptoms like headache, no sweat, fever, and aversion to cold. Zhusu Ye (Perillae Folium), Gegen (Puerariae Radix), and Qianhu (Peucedani Radix) serve as minister herbs to disperse these pathogens. Once the Lung is invaded, turbidity forms in the chest; Zhike (Aurantii Fructus Immaturus), Jiegeng (Platycodonis Radix), and Erchen Tang (Two-Aged Decoction) are used to clear this turbidity, eliminating cough, thick discharge, and chest stuffiness. Muxiang (Aucklandiae Radix) promotes internal Qi; Jiang (Zingiberis Rhizoma Recens) and Zao (Jujubae Fructus) harmonize external Qi. When interior and exterior Qi are harmonious, resolution occurs. Removing Renshen (Ginseng Radix et Rhizoma) and adding Chuanxiong Rhizome (Chuanxiong Radix), and replacing Chaihu (Bupleuri Radix) with Qianhu (Peucedani Radix) creates Xiongsu Yin (Ligusticum and Perilla Drink), suitable for those with excess Qi and fire, especially with severe headache. For wheezing/cough, add Xingren (Armeniacae Semen Amarum) to direct Qi downward and Sangbaipi (Mori Cortex) to drain Lung heat. Combined with Siwu Tang (Four Substances Decoction), it becomes Fuling Buxin Tang (Poria Heart-Nourishing Decoction), suitable for dual Qi-Blood deficiency, postpartum deficiency with hematemesis, and wind-cold cough.
Huoxiang Zhengqi San (Patchouli Harmonizing Qi Powder): Treats exogenous abnormal Qi of the four seasons, internal food retention, headache with alternating chills and fever, or cholera-like vomiting/diarrhea, or malaria.
Huoxiang (Agastaches Herba), Jiegeng (Platycodonis Radix), Zisu (Perillae Folium), Baizhi (Angelicae Dahuricae Radix), Houpo (Magnoliae Officinalis Cortex), Dafupi (Arecae Pericarpium), Banxia (Pinelliae Rhizoma), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma).
The above ten ingredients, add Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus), decoct in water, take hot.
[Collected Notes]: Wu Kun says: Abnormal Qi of the four seasons enters via the nose, residing in the interior rather than the exterior; thus, heavy sweating to release the exterior is not used. Instead, aromatic Qi-promoting herbs are used to rectify the interior. Zisu (Perillae Folium), Baizhi (Angelicae Dahuricae Radix), Chenpi (Citri Reticulatae Pericarpium), Dafupi (Arecae Pericarpium), Houpo (Magnoliae Officinalis Cortex), and Jiegeng (Platycodonis Radix) are potent in moving Qi, thus correcting abnormal Qi. Fuling (Poria), Banxia (Pinelliae Rhizoma), and Gancao (Glycyrrhizae Radix et Rhizoma) are sweet-neutral, cultivating Middle Qi. If the disease is in Taiyang, this powder is irrelevant. In cold damage with deep pulse and fever, in those with original Qi deficiency, and in cases of "夾阴" (Yin-clasping) fever, caution is advised. Additionally, Jinbuhuan Zhengqi San (Golden Unchanging Righteous Qi Powder) is Pingwei San (Level the Stomach Powder) plus Banxia (Pinelliae Rhizoma) and Huoxiang (Agastaches Herba), indicated for mountain miasma,水土不服 (acclimatization issues), vomiting, diarrhea, and dysentery. Pingwei San (Level the Stomach Powder) levels damp Earth and eliminates miasma; Banxia's (Pinelliae Rhizoma) dryness awakens the Spleen; Huoxiang's (Agastaches Herba) aroma opens the Stomach. Named "Righteous Qi," it rectifies abnormal Qi.
Shenzhu Tang (Divine Skill Decoction): Mainly treats external cold pathogen invasion and internal injury from raw/cold food during three seasons, leading to fever, Spleen diarrhea, and intestinal wind.
Baizhu (Atractylodis Macrocephalae Rhizoma - 3 qian), Fangfeng (Saposhnikoviae Radix - 2 qian), Gancao (Glycyrrhizae Radix et Rhizoma - 1 qian).
The above three ingredients: if no sweat, use Cangzhu (Atractylodis Rhizoma) with Congbai (Allii Fistulosi Bulbus) and Shengjiang (Zingiberis Rhizoma Recens); if sweat, use Baizhu (Atractylodis Macrocephalae Rhizoma) and Shengjiang (Zingiberis Rhizoma Recens).
[Collected Notes]: Ke Qin says: This is Wang Haogu's favored formula, modeled on the principles of Zhang Zhongjing's Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) but made as a mild preparation. However, this is a Taiyin formula; it can regulate Wind-Damp in the Spleen and Stomach but cannot treat Wind-Cold in Taiyang, nor the exterior signs of Yangming or half-exterior/half-interior signs of Shaoyang. As stated in the Neijing, spring wind injury leading to lingering pathogens and chronic diarrhea, manifesting as undigested stool or intestinal pus/blood in summer, is suitable for this. Winter cold injury leading to warm disease in spring is not suitable. Modern people, unaware of Zhang Zhongjing's formulation principles, fear Mahuang (Ephedrae Herba) and Guizhi (Cinnamomi Ramulus) harm the body, relying on this mild formula for safety. They do not realize that Ying-Wei disharmony cannot be replaced by Spleen-Stomach harmonizers. Stomach excess cannot be treated with deficiency-tonics. Liver-Gallbladder ministerial fire fluctuations and Shaoyin water-fire conflict cannot be managed by drying agents. Only by understanding drug properties can one understand formula application; only by understanding formulas can one apply them flexibly. If Taiyang disease is treated by inducing Yangming sweat, it is like inviting thieves to destroy the home; did Zhang Jieguc only speak for Gegen Tang (Puerariae Radix Decoction)!
Mahuang Jia Zhu Tang (Ephedra Plus Atractylodes Decoction): Treats body discomfort and pain in patients with dampness.
Mahuang (Ephedrae Herba - 3 liang), Guizhi (Cinnamomi Ramulus - 2 liang), Gancao (Glycyrrhizae Radix et Rhizoma - honey-fried, 2 liang), Xingren (Armeniacae Semen Amarum - 70 seeds), Baizhu (Atractylodis Macrocephalae Rhizoma - stir-fried, 4 liang).
The above five ingredients, boil in 9 sheng of water, reduce Mahuang (Ephedrae Herba) by 2 sheng, skim foam, add other herbs, boil to 2.5 sheng, strain, take 8 ge warm, cover to induce slight sweating.
[Collected Notes]: Cheng Zhi says: This decoction is the exterior-dispersing method for damp patients. Body ache indicates dampness; restlessness indicates heat. Adding Baizhu (Atractylodis Macrocephalae Rhizoma) to Mahuang Tang (Ephedra Decoction) aids in removing dampness and prevents excessive dispersion; this is the correct method for treating dampness. Adding Baizhu (Atractylodis Macrocephalae Rhizoma) to dispersing formulas opens the door for Zhang Jiegu and Wang Haogu.
Guizhi Fuzi Tang (Cinnamon Twig and Prepared Aconite Decoction): Governs cold damage after eight to nine days, wind-damp binding, severe body pain preventing turning over, no vomiting, no thirst, floating-deficient and choppy pulse.
Guizhi (Cinnamomi Ramulus - 4 liang), Fuzi (Prepared Aconiti Lateralis Radix - 3 pieces), Gancao (Glycyrrhizae Radix et Rhizoma - 1 liang), Shengjiang (Zingiberis Rhizoma Recens - 3 liang), Dazao (Jujubae Fructus - 12 pieces).
The above five ingredients, boil in 6 sheng of water, reduce to 2 sheng, strain, divide into three warm doses.
[Collected Notes]: Cheng Zhi says: Wind and damp bind, flowing into joints, causing severe body pain without headache, vomiting, or thirst. Floating-deficient pulse indicates wind; choppy pulse indicates cold-damp. Wind at the exterior is dispersed by the acrid-sweet of Guizhi (Cinnamomi Ramulus) and Gancao (Glycyrrhizae Radix et Rhizoma). Damp in the channels is driven out by the acrid-hot of Fuzi (Prepared Aconiti Lateralis Radix). Ginger and date are acrid-sweet, promoting Ying-Wei circulation and fluid passage to harmonize the exterior. Yang deficiency causes dampness stagnation; warming channels and assisting Yang to scatter dampness relies heavily on the powerful action of Fuzi (Prepared Aconiti Lateralis Radix).
Gualou Guizhi Tang (Trichosanthes Root and Cinnamon Twig Decoction): Treats complete Taiyang syndrome, stiff and rigid body, reverse deep-slow pulse, indicating Spasm (Jing); this decoction governs.
Gualougen (Trichosanthis Radix - 2 liang), Guizhi (Cinnamomi Ramulus - 3 liang), Shaoyao (Paeoniae Radix - 3 liang), Gancao (Glycyrrhizae Radix et Rhizoma - 2 liang), Shengjiang (Zingiberis Rhizoma Recens - 3 liang), Dazao (Jujubae Fructus - 12 pieces).
The above six ingredients, boil in 9 sheng of water, reduce to 3 sheng, divide into three warm doses. If sweat does not occur after taking, drink hot millet gruel after a meal interval to induce sweating.
[Collected Notes]: Yu Chang says: In cold damage formulas, for neck/back stiffness, Guizhi Jia Gegen Tang (Cinnamon Twig Plus Pueraria Decoction) is used. That formula involves sweating and aversion to wind, with pathogens in the exterior. Here, Taiyang signs are fully present, so pathogens are also in the exterior. However, the deep-slow pulse indicates that exterior pathogens are summoned by internal exhaustion of fluids; thus, one should not view this as a standard Wind-Cold exterior pattern. Therefore, Gegen (Puerariae Radix) for releasing exterior and relaxing muscles is not used. Instead, Gualougen (Trichosanthis Radix), bitter and entering Yin, excels at generating fluids and is used as the sovereign herb. Guizhi (Cinnamomi Ramulus) harmonizes Ying-Wei and nourishes sinews to treat spasm, changing the exterior method to a harmonizing method. Since Gualougen (Trichosanthis Radix) is sovereign, its dose should be increased; since Guizhi (Cinnamomi Ramulus) is minister, its dose should be decreased.
Shuisan Jie (Water-Resolving Dispersion): Treats epidemic Qi at onset, headache, high fever, etc.
Dahuang (Rhei Radix et Rhizoma - 4 liang), Baishao (Paeoniae Radix Alba - 2 liang), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma - honey-fried), Guixin (Cinnamomi Cortex), Mahuang (Ephedrae Herba) (each 3 liang).
Grind into coarse powder, decoct 1 liang per scoop in water and take. Do not take again after sweating or purging.
Ersheng Jiuku Dan (Two Sages Saving Bitterness Pill)
Dahuang (Rhei Radix et Rhizoma - raw, 1 jin), Zaojiao (Gleditsiae Sinensis Fructus - pig-tooth variety, peel and remove strings, lightly stir-fried, 4 liang).
Grind into powder, mix evenly, form pills with water. Take 3 qian per dose with unrooted water. Reduce dose for weak patients.
[Note]: Tianxing Shiqi (Heavenly Movement Seasonal Qi) refers to abnormal Qi of the four seasons causing disease; initially not called epidemic. Due to contagious disease Qi, affecting old and young similarly, spreading through neighborhoods, it is called Tianxing Shiqi. This epidemic Qi enters via the nose; once infected, all organs are affected. If not urgently expelled, death follows quickly. Urgent expulsion requires either sweating or purging. Thus, ancient epidemic formulas prioritize purging, followed by sweating, providing an exit for pathogens. These two formulas treat winter epidemics and spring epidemics respectively. Winter epidemics are mostly cold; spring epidemics are mostly heat. For cold, Shuisan Jie (Water-Resolving Dispersion) is suitable; Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), Shaoyao (Paeoniae Radix), and Gancao (Glycyrrhizae Radix et Rhizoma) release Ying-Wei sweat; Dahuang (Rhei Radix et Rhizoma) and Huangqin (Scutellariae Radix) purge epidemic toxin. For heat, Jiuku Dan (Saving Bitterness Pill) is suitable; Zaojiao (Gleditsiae Sinensis Fructus) opens orifices and releases exterior; Dahuang (Rhei Radix et Rhizoma) drains fire and attacks interior, allowing toxin to exit via sweat and purge. Use these two formulas judiciously; the major principles of treating epidemics can be inferred.
Tiansan San (Heavenly Water Powder, also known as Yi Wu San or Liu Yi San): Treats summerheat stroke, heat injuring Yuan Qi, internal and external heat, lethargy, irritability/thirst with desire to drink, dry intestines/stomach. Also induces labor/lactation, resolves accumulations/water retention, tenesmus, and sudden diarrhea.
Huashi (Talcum - water-ground, 6 liang), Gancao (Glycyrrhizae Radix et Rhizoma - 1 liang), Chensha (Cinnabaris - 3 qian).
Grind into fine powder, mix with a bowl of fresh well water, take 3 qian.
[Collected Notes]: Ke Qin says: Death comes from Yuan Qi deficiency unable to support, or from pathogenic excess unchecked. Now, heat injures Yuan Qi, causing lethargy. Using Renshen (Ginseng Radix et Rhizoma) and Huangqi (Astragali Radix) to tonify Qi makes pathogens worse; using Huangqin (Scutellariae Radix) and Huanglian (Coptidis Rhizoma) to clear heat further injures Qi. Only those skilled in attacking heat avoid damaging Yuan Qi; those skilled in tonifying deficiency avoid aiding pathogens. Pure-flavored herbs are needed. Huashi (Talcum) embodies the balanced Qi of Earth, executes the clearing/cooling command of West, possesses the firm/heavy form of Autumn Metal, cools heat, is sweet without harming Spleen, contains Tianyi essence with flowing nature, unlike the stagnant Shigao (Gypsum Fibrosum). It clears water sources above and unblocks water pathways below, washing away Six Fu heat via urine. Honey-fried Gancao (Glycyrrhizae Radix et Rhizoma) embodies balanced grass Qi, harmonizes interior/exterior, stops thirst, generates fluids; used as assistant, it protects Yuan Qi and drains deficient fire, harmonizing Five Zang. Heart is master of Five Zang; summerheat disturbs middle, unsettling Shen; Chensha (Cinnabaris) calms it, restoring Shen quickly; cool water nourishes it, rapidly removing heat. This clears Heart Yang-heat. For early heat diarrhea with tenesmus, it is suitable because slippery herbs remove sticking. Inducing labor/lactation and resolving accumulations follow this logic. This formula tonifies Qi without aiding pathogens, expels pathogens without injuring Qi, living up to the name Yiyuan (Benefiting Origin). It stands alongside Baihu Tang (White Tiger Decoction) and Shengmai San (Generate Pulse Powder).
Xiangdi Yin (Costus Drink): Treats summerheat combined with cooling/drinking cold, Yang Qi suppressed by Yin pathogens, headache, fever, aversion to cold, irritability, thirst, abdominal fullness, vomiting/diarrhea.
Xiangru (Moslae Herba), Houpo (Magnoliae Officinalis Cortex - stir-fried with ginger juice), Bian Dou (Phaseoli Semen - stir-fried).
Decoct, soak, take cold.
[Collected Notes]: Ye Zhongjian says: Yin (drink) differs slightly from Tang (decoction); fixed dosage is Tang, unrestricted timing is Yin. Yin is set for thirst, most suitable for warm/summerheat. Stomach dislikes dryness, Spleen dislikes dampness; excessive drinking injures Spleen, causing diarrhea. Treatment: sweating for fluid retention in epigastrium, diuresis for fluid retention in abdomen. Rather than treating existing fluid disorders, better to select herbs that induce sweat or diuresis proactively. Xiangru (Moslae Herba) is aromatic-acrid-warm, diffuses Yang Qi, has comprehensive upper-lower effects, so it is sovereign for summerheat, releasing exterior and promoting diuresis. Houpo (Magnoliae Officinalis Cortex) assists in removing dampness; Bian Dou (Phaseoli Semen) harmonizes middle. Combined as Yin. Entering Stomach, heat goes, dampness stays not, internal/external summerheat removed. For irritability/thirst, remove Bian Dou (Phaseoli Semen), add Huanglian (Coptidis Rhizoma) to make Huanglian Xiangru Yin (Coptis and Costus Drink). Add Fuling (Poria) and Gancao (Glycyrrhizae Radix et Rhizoma) to make Wuwu San (Five-Ingredient Powder). Add Mugua (Chaenomelis Fructus), Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Ju Pi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma) to make Shiwei San (Ten-Ingredient Powder). Modify according to syndrome to maximize Xiangru's utility. However, fatigue/internal injury requires Qing Shu Yi Qi Tang (Clear Summerheat Benefit Qi Decoction); internal heat/severe thirst requires Ren Shen Baihu Tang (Ginseng White Tiger Decoction). Using Xiangru (Moslae Herba) here doubly empties the exterior and aids internal heat. Xiangru (Moslae Herba) is the summer exterior-releasing herb, like Mahuang (Ephedrae Herba) in winter; Qi-deficient patients must not take it. Modern people, unaware summerheat injures Yuan Qi, use it as tea, opening the door to invite thieves.