治伤寒、温病邪传胃腑，燥渴身热，白虎证俱。其人胃气上逆，心下满闷者。
生石膏（三两，捣细） 知母（两半） 清半夏（八钱） 竹茹粉（六钱）
用水五盅，煎汁三盅，先温服一盅。病已愈者，停后服。若未全愈者，过两点钟，再温服一盅。《伤寒
论》白虎汤，治阳明腑热之圣药也。盖外邪炽盛，势若燎原，胃中津液，立就枯涸，故用石膏之辛寒以祛外感
之邪，知母之凉润以滋内耗之阴。特是石膏质重（虽煎作汤性亦下坠），知母味苦，苦降与重坠相并，下行之
力速，胃腑之热或难尽消。且恐其直趋下焦而为泄泻也，故又借粳米之浓汁、甘草之甘味，缓其下趋之势。以
待胃中微丝血管徐徐吸去，由肺升出为气，由皮肤渗出为汗，余入膀胱为溺，而内蕴之热邪随之俱清，此仲景
制方之妙也。然病有兼证，即用药难拘成方。犹是白虎汤证也，因其人胃气上逆，心下胀满，粳米、甘草不可
复用，而以半夏、竹茹代之，取二药之降逆，以参赞石膏、知母成功也。
一妇人，年三十余，得温证。始则呕吐，五六日间，心下满闷，热而且渴。脉洪滑有力，舌苔黄浓。闻
其未病之先，曾有郁怒未伸，因得斯证，俗名夹恼伤寒。然时当春杪，一得即不恶寒，乃温病，非伤寒也。为
疏此方，有一医者在座，疑而问曰∶此证因胃气上逆作胀满，始将白虎汤方，另为更定。何以方中不用开通气
分之药，若承气汤之用浓朴、枳实，而惟用半夏、竹茹
乎？答曰∶白虎汤用意，与承气迥异。盖承气汤，乃导邪下行之药，白虎汤乃托邪外出之药。故服白虎汤后，
多有得汗而解者。间有服后未即得汗，而大热既消，其饮食之时，恒得微汗，余热亦由此尽解。若因气逆胀满，
恣用破气之药，伤其气分，不能托邪外出，将邪陷愈深，胀满转不能消，或更增剧。试观《伤寒论》多有因误
下伤其气分，成结胸，成心下痞硬证，不可不知也。再试观诸泻心，不轻用破气之品，却有半夏泻心汤。又仲
景治“伤寒解后，气逆欲呕”有竹叶石膏汤，半夏与石膏并用；治“妇人乳、中虚、烦乱、呕逆”有竹皮大丸，
竹茹与石膏并用，是半夏、竹茹善降逆气可知也。今师二方之意，用之以易白虎汤中之甘草、粳米，降逆气而
不伤正气，服后仍可托邪外出，由汗而解，而胀满之证，亦即消解无余。此方愚用之屡矣，未有不随手奏效者。
医者闻言省悟，听愚用药，服后，病患自觉胀满之处，如以手推排下行，病亦遂愈。
治疗伤寒或温病，邪气传入胃腑，出现口干极度渴望饮水、身体发热，具备白虎汤证的所有特征。如果患者同时伴有胃气上逆、心窝部（胃脘）胀满憋闷的症状。
处方：生石膏（三两，捣碎成细粉）、知母（一两半）、清半夏（八钱）、竹茹粉（六钱）。
用水五盅，煎煮取汁三盅。先温热服用一盅。如果病已痊愈，则停止后续服药。如果尚未完全痊愈，间隔两小时后，再温热服用一盅。《伤寒论》中的白虎汤，是治疗阳明腑热的圣药。大概是因为外感邪气炽盛，势头如同燎原大火，胃中的津液立刻就会枯竭干涸，所以使用石膏的辛寒之性来祛除外感的邪气，使用知母的凉润之性来滋养内部耗损的阴液。只是石膏质地沉重（即使煎成汤剂，其药性依然具有下坠之势），知母味道苦，苦味能降泄与重坠之性相结合，向下运行的力量迅速，胃腑的热邪或许难以完全消除。并且担心药力直接趋向于下焦而导致腹泻，所以又借助粳米浓稠的汁液和甘草甘缓的味道，来减缓其向下趋行的势头。等待胃中微丝血管慢慢吸收药力，由肺升发化为气，由皮肤渗出化为汗，其余部分进入膀胱化为尿液，而体内蕴结的热邪随之全部清除，这就是张仲景制定方剂的精妙之处。然而疾病常有兼夹证候，因此用药不能拘泥于成方。同样是白虎汤证，因为患者胃气上逆、心下胀满，就不能再次使用粳米和甘草，而是用半夏和竹茹来代替，取这两味药降逆气的功效，以辅助石膏和知母取得疗效。
有一位三十多岁的妇人，得了温病。起初呕吐，在五六天之间，心窝部胀满憋闷，既发热又口渴。脉象洪大滑利且有力，舌苔黄厚浓浊。听说她在生病之前，曾有郁怒未能舒展的情况，因此得了这种病，俗称“夹恼伤寒”。然而当时正值春末，一发病就不怕冷，这是温病，不是伤寒。我给她开了这个方子，当时有一位医生在场，怀疑并问道：“这个病症是因为胃气上逆导致胀满，才开始将白虎汤的方剂另行修改。为什么方中不用开通气分的药物，比如承气汤中使用的厚朴、枳实，而只用半夏和竹茹呢？”我回答说：“白虎汤的用意，与承气汤截然不同。承气汤是引导邪气向下排出的药物，白虎汤是托举邪气向外透发的药物。所以服用白虎汤后，大多通过出汗而解病。间或有服用后没有立即出汗，但大热已经消退，在进食的时候，常常会有微微出汗，余热也由此全部解除。如果因为气逆胀满，肆意使用破气耗散的药物，损伤了正气，就不能托举邪气外出，会导致邪气陷入更深，胀满反而不能消除，或者更加严重。试看《伤寒论》中多有因误用攻下法损伤正气，形成结胸证、心下痞硬证的案例，不可不知道这些道理。再试看诸泻心汤，不轻易使用破气之品，却有半夏泻心汤。另外张仲景治疗‘伤寒解后，气逆想呕吐’有竹叶石膏汤，半夏与石膏并用；治疗‘妇人乳中虚，烦乱，呕逆’有竹皮大丸，竹茹与石膏并用，这说明半夏和竹茹善于降逆气是显而易见的。现在效法这两个方子的意思，用它们来替换白虎汤中的甘草和粳米，降逆气而不伤正气，服用后仍可托举邪气外出，通过汗液排出而解病，而胀满的症状，也就随即消除干净。这个方子我多次使用，没有不随手奏效的。”那位医生听了我的话恍然大悟，听从我的用药建议，病人服药后，自觉胀满的地方，好像用手推排向下运行一样，病也随之痊愈。
Treats conditions where pathogenic factors from Shanghan (Cold Damage) or Wenbing (Warm Diseases) have transmitted to the Stomach Fu organ, presenting with extreme dryness and thirst, body heat, and all symptoms characteristic of Baihu Tang syndrome. Additionally, if the patient experiences rebellious Qi in the Stomach and fullness/stuffiness in the epigastrium (Xin Xia).
Prescription: Sheng Shigao (Calcitum, Raw Gypsum, 3 liang, finely crushed), Zhi Mu (Anemarrhenae Rhizoma, 1.5 liang), Qing Banxia (Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine, 8 qian), Zhuru Fen (Bambusae Caulis in Taenia Pulvis, 6 qian).
Use five zhong of water, decoct to obtain three zhong of liquid. First, take one zhong warm. If the illness is cured, discontinue subsequent doses. If not fully cured, after two hours, take another zhong warm. Baihu Tang (White Tiger Decoction) from the *Shanghan Lun* is a sacred medicine for treating Yangming Fu heat. Generally, when external pathogens are vigorous, spreading like a prairie fire, the fluids in the Stomach are immediately depleted. Therefore, the acrid-cold nature of Shigao is used to dispel external pathogens, and the cool-moistening nature of Zhimu is used to nourish the internally consumed Yin. However, since Shigao has a heavy substance quality (even when decocted into a soup, its nature remains descending), and Zhi Mu has a bitter taste, the combination of bitter descent and heavy sinking creates a rapid downward force, which may make it difficult to completely eliminate the heat in the Stomach Fu. Furthermore, there is a fear that the medicine will rush directly to the Lower Jiao causing diarrhea. Thus, the thick juice of Jingmi (Oryza Sativa Grain) and the sweet flavor of Gancao (Glycyrrhizae Radix et Rhizoma) are borrowed to slow down this downward momentum. This allows the minute blood vessels in the Stomach to slowly absorb the medicinal power, which then rises via the Lung to become Qi, exudes through the skin as sweat, and the remainder enters the Bladder to become urine. The internally entangled pathogenic heat is thereby cleared along with it. This is the subtlety of Zhang Zhongjing's formula formulation. However, diseases often have concurrent syndromes, so medication cannot be rigidly bound by established formulas. Even if it is a Baihu Tang syndrome, because the patient has rebellious Stomach Qi and epigastric distension, Jingmi and Gancao should not be reused. Instead, Banxia and Zhuru are substituted to utilize their ability to descend rebellious Qi, assisting Shigao and Zhimu in achieving therapeutic success.
A woman, over thirty years old, contracted a Warm Disease. Initially, she vomited. Between the fifth and sixth day, she experienced epigastric fullness and stuffiness, accompanied by fever and thirst. Her pulse was surging, slippery, and forceful; her tongue coating was yellow, thick, and dense. It was reported that before falling ill, she had suffered from unexpressed depression and anger, leading to this condition, commonly known as "Jia Nao Shanghan" (Cold Damage complicated by emotional constraint). However, it was late spring, and upon contracting the disease, she did not feel aversion to cold; thus, it was a Warm Disease, not Cold Damage. I prescribed this formula. A physician present doubted and asked: "This syndrome causes distension and fullness due to rebellious Stomach Qi, so the Baihu Tang formula was modified. Why does the formula not include herbs that open the Qi mechanism, such as Houpo (Magnoliae Officinalis Cortex) and Zhishi (Immaturus Citri Reticulatae Fructus) used in Chengqi Tang, but only uses Banxia and Zhuru?" I replied: "The intent of Baihu Tang is vastly different from Chengqi Tang. Chengqi Tang is a medicine that guides pathogens downward for expulsion, whereas Baihu Tang is a medicine that lifts pathogens outward for release. Therefore, after taking Baihu Tang, most patients resolve through sweating. Occasionally, patients do not sweat immediately after ingestion, but once the high fever subsides, during meals, they often experience slight sweating, and residual heat is thereby completely resolved. If, due to Qi rebellion and distension, one recklessly uses Qi-breaking herbs, damaging the Zheng Qi (Upright Qi), the ability to lift pathogens outward is lost, causing pathogens to sink deeper, making distension impossible to resolve or even worsening it. Observe that in the *Shanghan Lun*, there are many cases where improper purgation damaged the Qi mechanism, resulting in Jie Xiong (Chest Binding) or Xin Xia Pi Ying (Epigastric Fullness and Hardness) syndromes; these must be understood. Furthermore, observe that various Xiexin Tang (Drain the Epigastrium Decoctions) rarely use Qi-breaking substances, yet Banxia Xiexin Tang exists. Additionally, Zhang Zhongjing treated 'after resolution of Cold Damage, rebellious Qi desires vomiting' with Zhuye Shigao Tang, using Banxia together with Shigao; and treated 'women with deficiency in the breast and middle jiao, irritability, restlessness, and vomiting' with Zhupi Da Wan, using Zhuru together with Shigao. This demonstrates that Banxia and Zhuru are effective in descending rebellious Qi. Now, following the intent of these two formulas, I use them to replace Gancao and Jingmi in Baihu Tang. This descends rebellious Qi without damaging righteous Qi. After ingestion, it can still lift pathogens outward for resolution through sweat, and the distension syndrome will also dissipate completely. I have used this formula frequently, never failing to achieve immediate effect." Hearing this, the physician realized his error and accepted my prescription. After the patient took the medicine, she felt as though her distended area was being pushed downward by hand, and the illness was subsequently cured.