治肥盛之人, 湿痰为患, 喘嗽胀满.
半夏 ( 制 ) 三钱 茯苓三钱 陈皮 ( 去白 ) 二钱 甘草一钱, 右
四味, 加姜三片, 水煎服.
【集注】李中梓曰: 肥人多湿, 湿挟热而生痰, 火载气而逆上. 半夏
之辛, 利二便而去湿. 陈皮之辛, 通三焦而理气. 茯苓佐半夏, 共成
燥湿之功. 甘草佐陈皮, 同致调和之力. 成无己曰: 半夏行水气而润
肾燥. 经曰: 辛以润之是也. 行水则土自燥, 非半夏之性燥也. 或曰
:有痰而渴, 宜去半夏代以贝母. 吴琨曰: 渴而喜饮, 小便利者易之
.不能饮水, 小便不利, 虽渴宜半夏也. 此湿为本, 热为标, 所谓湿
极而兼胜己之化, 非真象也. 又东南之人, 湿热生痰, 故朱震亨主之
加枳实, 砂仁, 名枳实二陈汤, 其性较急也. 先哲云: 二陈为治痰之
妙剂, 其于上, 下, 左, 右无所不宜, 然只能治实痰之标, 不能治虚
痰之本. 虚痰之本在脾胃, 治者详之.
治热呕吐苦, 虚烦, 惊悸不眠, 痰气上逆.
竹茄 枳实 半夏 甘草 陈皮 茯苓 生姜, 右七味, 水煎服.
【集注】罗谦甫曰: 胆为中正之官, 清静之腑, 喜宁谧, 恶烦扰; 喜
柔和, 恶壅郁. 盖东方木德, 少阳温和之气也. 若病后, 或久病而宿
有痰饮未消, 胸膈之余热未尽, 必致伤少阳之和气, 以故虚烦惊悸者
,中正之官, 以熇蒸而不宁也. 热呕吐苦者, 清静之腑, 以郁炙而不
谧也. 痰气上逆者, 木家挟热而上升也. 方以二陈治一切痰饮, 加竹
茹以清热, 加生姜以止呕, 加枳实以破逆, 相济相须, 虽不治胆而胆
自和, 盖所谓胆之痰热去故也. 命名温者, 乃谓温和之温, 非谓温凉
之温也, 若谓胆家真畏寒而怯而温之, 不但方中无温胆之品, 且更有
凉胃之药也.
治疗形体肥胖之人，因湿痰致病，出现气喘咳嗽、胸腹胀满的症状。
制半夏三钱，茯苓三钱，陈皮（去白）二钱，甘草一钱，以上四味药，加生姜三片，用水煎煮后服用。
【集注】李中梓说：肥胖的人多湿气，湿气夹杂热邪而生痰，火气携带气机逆乱向上。半夏的辛味，能通利大小便而去除湿气。陈皮的辛味，能疏通三焦而调理气机。茯苓辅助半夏，共同完成燥湿的功效。甘草辅助陈皮，一同达到调和的作用。成无己说：半夏运行水气而滋润肾燥。《内经》说：辛味可以润燥，正是这个意思。运行水气则脾土自然干燥，并非半夏药性本身燥烈。有人说：有痰且口渴，应当去掉半夏，用贝母代替。吴琨说：口渴且喜欢饮水，小便通畅的，可以用贝母替代。不能饮水，小便不通利的，虽然口渴也应当使用半夏。这是因为湿是根本，热是标象，所谓湿极盛而兼夹克制它的五行之气产生的变化，并非真正的热象。另外东南地区的人，湿热生痰，所以朱震亨主张在方中加入枳实、砂仁，名为枳实二陈汤，其药性较为峻急。先哲说：二陈汤是治疗痰证的妙方，对于上、下、左、右各部位都适宜，然而只能治疗实痰的标象，不能治疗虚痰的根本。虚痰的根本在于脾胃，治疗者需仔细辨别。
治疗热邪引起的呕吐苦水、心中虚烦、惊悸失眠、痰气上逆。
竹茹，枳实，半夏，甘草，陈皮，茯苓，生姜，以上七味药，用水煎煮后服用。
【集注】罗谦甫说：胆是中正之官，清净之腑，喜欢安宁静谧，厌恶烦扰；喜欢柔和，厌恶壅滞郁结。这好比东方木德，具有少阳温和之气。如果病后，或者久病导致体内宿有的痰饮未消，胸膈间的余热未尽，必然损伤少阳的和畅之气，因此出现心中虚烦惊悸，是因为中正之官受到火热熏蒸而不能安宁。热呕吐苦水，是因为清净之腑因郁热熏炙而不能静谧。痰气上逆，是因为肝胆木气挟带热邪而上冲。方中以二陈汤治疗一切痰饮，加入竹茹以清热，加入生姜以止呕，加入枳实以破降逆气，诸药相辅相成，虽然不直接治疗胆，但胆气自然调和，大概是因为胆中的痰热被清除的缘故。命名为“温”，是指温和之意，并非指温凉之温。如果说胆家真正畏寒怯冷而用温法治疗，不仅方中没有温胆的药物，反而还有凉胃的药。
Treats obese individuals suffering from phlegm-dampness, presenting with wheezing and cough, chest and abdominal distension and fullness.
Prepared Banxia (Pinelliae Rhizoma Praeparatum) 3 qian, Fuling (Poria) 3 qian, Chenpi (Citri Reticulatae Pericarpium, white part removed) 2 qian, Gancao (Glycyrrhizae Radix et Rhizoma) 1 qian. The above four herbs, added with three slices of Shengjiang (Zingiberis Rhizoma Recens), are decocted in water and taken orally.
[Collected Annotations] Li Zhongzi stated: Obese people tend to have dampness; dampness combines with heat to generate phlegm, and fire carries qi rebelliously upward. The pungent nature of Banxia promotes urination and defecation to eliminate dampness. The pungent nature of Chenpi unblocks the Sanjiao (Triple Burner) and regulates qi. Fuling assists Banxia to jointly achieve the effect of drying dampness. Gancao assists Chenpi to harmonize together. Cheng Wuji stated: Banxia moves fluid qi and moistens kidney dryness. As stated in the *Classic of Difficult Issues* (*Nanjing*): "Pungent flavors can moisten," which is exactly this principle. Moving fluids causes the Earth element to naturally dry; it is not that the nature of Banxia itself is drying. Some say: If there is phlegm accompanied by thirst, Banxia should be removed and replaced with Beimu (Fritillariae Bulbus). Wu Kun stated: If one is thirsty and desires to drink, with free urination, substitution is appropriate. If one cannot drink, with obstructed urination, even if thirsty, Banxia should still be used. This is because dampness is the root and heat is the branch; it is referred to as extreme dampness generating a transformation contrary to its controlling element, which is not the true manifestation. Furthermore, people in the Southeast region generate phlegm due to damp-heat; therefore, Zhu Zhenheng advocated adding Zhishi (Aurantii Fructus Immaturus) and Sharen (Amomi Fructus), naming it Zhishi Erchen Tang (Immature Bitter Orange and Two-Cured Decoction), whose nature is more rapid and intense. Ancient sages said: Erchen Tang (Two-Cured Decoction) is an excellent formula for treating phlegm, suitable for the upper, lower, left, and right aspects. However, it can only treat the branch symptoms of excess phlegm, not the root cause of deficiency phlegm. The root of deficiency phlegm lies in the Spleen and Stomach; practitioners must examine this carefully.
Treats vomiting of bitter fluid due to heat, mental restlessness due to deficiency, palpitations with fright, insomnia, and rebellious phlegm-qiang.
Zhuru (Bambusae Caulis in Taenia), Zhishi, Banxia, Gancao, Chenpi, Fuling, Shengjiang. The above seven herbs are decocted in water and taken orally.
[Collected Annotations] Luo Qianfu stated: The Gallbladder is the official of uprightness and purity, a quiet organ; it prefers tranquility and abhors disturbance; it prefers gentleness and abhors stagnation. This corresponds to the virtue of Wood in the East, possessing the mild and warm qi of Shaoyang (Lesser Yang). After illness, or in chronic illness where old phlegm-fluid has not yet dissipated, and residual heat in the chest and diaphragm remains unresolved, the harmonious qi of Shaoyang will inevitably be damaged. Consequently, mental restlessness and palpitations occur because the official of uprightness is unsettled by scorching heat. Vomiting bitter fluid due to heat occurs because the quiet organ is disturbed by stagnant heat. Rebellious phlegm-qiang occurs because the Wood element (Liver/Gallbladder) carries heat upward. This formula uses Erchen Tang to treat all types of phlegm-fluid, adds Zhuru to clear heat, adds Shengjiang to stop vomiting, and adds Zhishi to break rebellious qi. They complement and enhance each other. Although it does not directly treat the Gallbladder, the Gallbladder qi becomes harmonious naturally, precisely because the phlegm-heat in the Gallbladder has been eliminated. It is named "Wen" (Warm) to signify mildness and gentleness, not referring to temperature (warm vs. cool). If it were meant to treat true cold-fear and timidity of the Gallbladder with warming methods, not only would the formula lack Gallbladder-warming herbs, but it would also contain stomach-cooling medicines.