大青龙汤 麻杏甘石汤 白虎汤 承气汤(俱见伤寒
九味羌活汤 治四时感冒,头痛、发热、项强、恶寒、恶风、身痛。代麻黄桂枝青龙
各半等汤。
羌活(入太阳) 苍术(入太阴) 防风(各一钱半,周行通身) 白芷(入阳明) 川芎(入桂阴) 黄芩
(入少阳) 生地黄(养汁以作汗) 细辛(入少阴) 甘草(各一钱,和诸药
加生姜五片,葱头二根。如伤风自汗,去葱头加白术,倍防风;胸满,去地黄,加枳壳
、桔梗;喘加杏仁;夏加石膏、知母;汗下兼行加大黄。
按∶生地黄、黄芩虽能退热,然初起不可遽用苦寒,不如用葳蕤柔润,以养汗源,且能
助正气而驱风邪。
三黄解毒汤 治大热、谵语、发斑、发黄、吐衄、下血等症。
黄连 黄柏 黄芩 栀子(各二钱) 甘草(一钱
水煎服。
犀角地黄汤 治火邪吐血、衄血、尿血、谵语、斑黄、赤淋,妇人血崩等症。
生地(三钱) 犀角尖 丹皮 芍药(各二钱
水煎服。
柯韵伯曰∶“气为阳,血为阴,阳密乃固,阳盛则伤阴矣。阴平阳秘,阴虚者阳必凑之
矣。故气有余即是火,火入血室,血不荣经,即随逆气而妄行,上升者出于口鼻,下陷者出于
二便,虽有在经在腑之分,要皆心肝受热所致也。心为荣血之主,心火旺则血不安,故用生
犀、生地酸咸甘寒之味,以清君火。肝为藏血之室,肝火旺则血不守,故用丹皮、芍药辛苦
微寒之品,以平相火。此方虽曰清火而实滋阴之剂。盖失血则阴虚,阴虚则无气,故阴不足
者,当补之以味,勿得反伤其气也。若用芩、连、胆草、栀、柏以泻其气,则阳之剧者,苦
从火化,已衰者,气从苦发,燎原而飞越矣。”
防风通圣散(见中风
口糜 鼻衄 齿衄
甘露饮(方见食) 治胃火炽盛等症。
喉痹 双蛾 单蛾
导赤散 治火盛口疮,喉痹、双单蛾及赤淋,茎中痛如刀割等症。
生地(三钱) 木通 甘草(各二钱
加竹叶二十四片,水煎服。
季楚重曰∶泻心汤用黄连,所以治实邪,实邪责木之有余,泻子以清母也。导赤散用地
黄,所以治虚邪,虚邪责水之不足,壮水以制火也。
大青龙汤、麻杏甘石汤、白虎汤、承气汤(均见于《伤寒论》相关章节)。
九味羌活汤:治疗四时感冒,症状包括头痛、发热、项背强直、恶寒、恶风、全身疼痛。此方可替代麻黄汤、桂枝汤、大青龙汤、小青龙汤、各半汤等方剂。
药材组成:羌活(入太阳经)、苍术(入太阴经)、防风(各一钱半,通行周身)、白芷(入阳明经)、川芎(入厥阴经)、黄芩(入少阳经)、生地黄(滋养津液以助发汗)、细辛(入少阴经)、甘草(各一钱,调和诸药)。
煎服法:加生姜五片,葱头二根同煎。若为伤风自汗者,去掉葱头,加入白术,加倍使用防风;若胸中胀满,去掉生地黄,加入枳壳、桔梗;若气喘,加入杏仁;夏季服用,加入石膏、知母;若需汗下兼施,加入大黄。
按语:生地黄、黄芩虽然能退热,但在疾病初起时不可急于使用苦寒药物,不如使用葳蕤(玉竹)柔润之品,以滋养汗源,且能扶助正气而驱除风邪。
三黄解毒汤:治疗大热、胡言乱语(谵语)、皮肤发斑、发黄、吐血、鼻衄、便血等症状。
药材组成:黄连、黄柏、黄芩、栀子(各二钱),甘草(一钱)。
煎服法:水煎服。
犀角地黄汤:治疗火邪导致的吐血、鼻衄、尿血、胡言乱语、斑黄、赤淋,以及妇女血崩等症状。
药材组成:生地黄(三钱),犀角尖、牡丹皮、芍药(各二钱)。
煎服法:水煎服。
柯韵伯说:“气属阳,血属阴,阳气致密则阴固,阳气过盛则会损伤阴液。阴平阳秘,若阴虚则阳气必凑集于内。因此,气有余即是火,火进入血室,血液不能荣养经脉,就会随着逆乱之气妄行,向上冲的从口鼻而出,向下陷的从大小便而出。虽然有在经在腑的区别,但总之都是心肝受热所致。心是营血的主宰,心火旺盛则血液不安宁,所以用生犀角、生地黄酸咸甘寒的味道,来清泻君火。肝是藏血的脏器,肝火旺盛则血液不守舍,所以用牡丹皮、芍药辛苦微寒的性质,来平抑相火。这个方子虽然说是清火,实际上是滋阴的药剂。因为失血会导致阴虚,阴虚则无气,所以对于阴不足的人,应当用味道厚实的药物来补益,不要反而损伤其气。如果使用黄芩、黄连、龙胆草、栀子、黄柏来泻气,那么阳气极盛的,苦味会从火化,阳气已衰的,气会从苦味发散,如火燎原般飞越失控。”
导赤散:治疗火盛引起的口疮、喉痹、双单乳蛾及赤淋,尿道刺痛如刀割等症状。
药材组成:生地黄(三钱),木通、甘草(各二钱)。
煎服法:加竹叶二十四片,水煎服。
季楚重说:“泻心汤使用黄连,是用来治疗实邪的,实邪责求于木气的有余,通过泻子脏(心/小肠)来清母脏(肝/胆)。导赤散使用生地黄,是用来治疗虚邪的,虚邪责求于水气的不足,通过壮水(滋补肾阴)来制约火气。”
Daqinglong Decoction (Major Blue Green Dragon Decoction), Ma Xing Gan Shi Tang, Baihu Tang (White Tiger Decoction), Chengqi Tang (Inherit Qi Decoction) (all see relevant chapters of Shanghan Lun).
Jiuwei Qianghuo Tang (Nine-Ingredient Notopterygia Decoction): Treats common cold in all four seasons, with symptoms including headache, fever, stiffness and pain of the neck and back, aversion to cold, aversion to wind, and body ache. This formula can replace Mahuang Tang (Ephedra Decoction), Guizhi Tang (Cinnamon Twig Decoction), Daqinglong Tang, Xiao Qinglong Tang (Minor Blue Green Dragon Decoction), and Ge Ban Tang (Half-Half Decoction).
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix) (enters Taiyang channel), Cangzhu (Atractylodis Rhizoma) (enters Taiyin channel), Fangfeng (Saposhnikoviae Radix) (1.5 qian each, circulates through the whole body), Baizhi (Angelicae Dahuricae Radix) (enters Yangming channel), Chuanxiong (Ligustici Chuanxiong Rhizoma) (enters Jueyin channel), Huangqin (Scutellariae Radix) (enters Shaoyang channel), Sheng Dihuang (Rehmanniae Radix) (nourishes fluids to promote sweating), Xixin (Asari Radix et Rhizoma) (enters Shaoyin channel), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian each, harmonizes the various herbs).
Preparation and administration: Add five slices of Shengjiang (Zingiberis Rhizoma Recens) and two scallion heads for decoction. For wind-strike with spontaneous sweating, remove scallion heads, add Baizhu (Atractylodis Macrocephalae Rhizoma), and double the dosage of Fangfeng; for chest fullness, remove Sheng Dihuang, add Zhike (Aurantii Fructus) and Jiegeng (Platycodonis Radix); for wheezing, add Xingren (Armeniacae Semen Amarum); in summer, add Shigao (Gypsum Fibrosum) and Zhimu (Anemarrhenae Rhizoma); if both sweating and purging are required, add Dahuang (Rhei Radix et Rhizoma).
Note: Although Sheng Dihuang and Huangqin can reduce fever, bitter-cold medicines should not be used hastily at the onset of the disease. It is better to use Weirui (Polygonati Odorati Rhizoma) for its moistening properties to nourish the source of sweat, and it can assist righteous qi to expel wind pathogenic factors.
Sanhuang Jiedu Tang (Three-Yellow Detoxification Decoction): Treats high fever, delirium (Zhenyu), macules (Faban), jaundice (Fahuang), hematemesis (Tunü), epistaxis (Xuni), and hematochezia/melena (Xiexue).
Ingredients: Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus) (2 qian each), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian).
Preparation and administration: Decoct in water and take orally.
Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction): Treats conditions caused by fire pathogenic factors such as hematemesis, epistaxis, hematuria, delirium, macules/jaundice, red strangury (Chilin), and metrorrhagia in women.
Ingredients: Sheng Dihuang (Rehmanniae Radix) (3 qian), Xijiao Jian (Cornu Bubali), Mudanpi (Moutan Cortex), Shaoyao (Paeoniae Radix Alba) (2 qian each).
Preparation and administration: Decoct in water and take orally.
Ke Yunbo stated: "Qi belongs to Yang, Blood belongs to Yin. When Yang is dense, Yin is secured; when Yang is excessive, it injures Yin. When Yin is peaceful and Yang is secret, if Yin is deficient, Yang will inevitably gather within. Therefore, excess Qi constitutes Fire. When Fire enters the Blood Chamber, Blood fails to nourish the channels and follows rebellious Qi to flow recklessly. What rises exits from the mouth and nose; what sinks exits from the two bowels. Although there are distinctions between being in the channels and the fu organs, they are all caused by heat in the Heart and Liver. The Heart is the master of Ying Blood; when Heart Fire is vigorous, Blood becomes unsettled. Thus, the sour, salty, sweet, and cold flavors of Sheng Xijiao (Rhinoceros Horn) and Sheng Dihuang are used to clear the Ministerial Fire (Junhuo - note: typically Junhuo refers to Heart Fire, text says 'clear Junhuo'). The Liver is the chamber storing Blood; when Liver Fire is vigorous, Blood does not remain contained. Thus, the bitter, pungent, and slightly cold properties of Mudanpi and Shaoyao are used to calm the Assistant Fire (Xianghuo). Although this formula is said to clear Fire, it is actually a Yin-nourishing agent. Because blood loss leads to Yin deficiency, and Yin deficiency leads to Qi deficiency, for those with insufficient Yin, one should tonify with flavor-rich substances and avoid damaging Qi. If Huangqin, Huanglian, Longdancao (Gentianae Radix), Zhizi, and Huangbai are used to drain Qi, then for extreme Yang, the bitter taste transforms into Fire; for declining Yang, Qi disperses due to bitterness, flying away uncontrollably like a prairie fire."
Fangfeng Tongsheng San (Wind-Protecting Universal Salvation Powder) (see Stroke section).
Koumi (Oral thrush), Bini (Epistaxis), Chinü (Gingival bleeding).
Ganlu Yin (Sweet Dew Decoction) (formula see Food Stagnation section): Treats blazing Stomach Fire and other symptoms.
Houbi (Throat obstruction), Shuang'e (Double tonsillar swelling), Dan'e (Single tonsillar swelling).
Daochi San (Direct Red Powder): Treats mouth ulcers caused by excessive Fire, throat obstruction, double/single tonsillar swelling, red strangury, and stabbing pain in the urethra as if cut by a knife.
Ingredients: Sheng Dihuang (Rehmanniae Radix) (3 qian), Mutong (Akebiae Caulis), Gancao (Glycyrrhizae Radix et Rhizoma) (2 qian each).
Preparation and administration: Add twenty-four leaves of Zhuye (Bambusae Folium), decoct in water, and take orally.
Ji Chuchong stated: "Xiexin Tang uses Huanglian to treat Excess pathogens. Excess pathogens are attributed to the surplus of Wood element; draining the Son organ clears the Mother organ. Daochi San uses Sheng Dihuang to treat Deficiency pathogens. Deficiency pathogens are attributed to the insufficiency of Water element; strengthening Water controls Fire."