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 , 右水煎, 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, 加桑皮以泻肺. 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.
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 厚朴 大腹皮 半夏 茯苓 陈皮 甘草
,右十味, 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, 吐泻下痢者主之. 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.
62.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, 右三味, 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, 肠澼者宜之. 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. 先明药之理, 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!
【参苏饮】
治疗感冒风寒,出现头痛、发热、怕冷、咳嗽,鼻涕和痰液稠厚黏腻,胸膈部胀满憋闷,脉象虚弱且无汗的症状。
人参八分 紫苏叶八分 干葛(葛根)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
以上药材,加水煎煮,热服以取汗。
【注释】感受风寒之邪,若传入太阳经,因太阳主一身之表,故使用麻黄汤、桂枝汤两方,以发营卫之汗。若感邪于太阴经,则不传经,因为太阴经主肺,故使用此汤剂,外散皮毛之风寒,内宣肺气之郁滞。大概邪气聚集之处,正气必然虚弱,故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、怕冷的表证,用紫苏叶、葛根、前胡为臣药以发散邪气。肺一旦受邪,胸中化为浊气,故用枳壳、桔梗及二陈汤(陈皮、半夏等)以清化浊气,则咳嗽、涕唾稠粘、胸膈满闷等症状即可消除。加入木香以宣通诸里之气。加入生姜、大枣以调和诸表之气。这样表里之气调和,调和后即可痊愈。将本方去掉人参,加入川芎,以前胡替换柴胡,名为芎苏饮。治疗气实且有火者,头痛剧烈者也可加用。若有气喘咳嗽者,加杏仁以降气,加桑白皮以泻肺。合四物汤(当归、川芎、白芍、熟地黄)名为茯苓补心汤,治疗气血两虚,以及新产后,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,出现头痛、寒热往来,或霍乱吐泻,或发作疟疾。
藿香 桔梗 紫苏 白芷 厚朴 大腹皮 半夏 茯苓 陈皮 甘草
以上十味药,加入生姜、大枣,加水煎煮,热服。
【集注】吴琨说:四时不正之气,从鼻而入,不在表而在里,故不用大汗法来解表,只用芳香利气的药物来纠正里气。苏叶、白芷、陈皮、大腹皮、厚朴、桔梗,都是气味浓厚的药物,故能纠正不正之气;茯苓、半夏、甘草则是甘平的药物,用以培养中气。如果病在太阳经,与此汤剂毫无关系。伤寒脉沉而发热,以及元气本虚之人,并夹阴发热者,应当戒用。另外金不换正气散,即平胃散加入半夏、藿香,凡受山岚瘴气,以及出远方不服水土,出现吐泻下痢者,主治此方。大概平胃散可以平湿土而消瘴气,半夏的燥性可以醒脾,藿香的芬芳可以开胃。命名为正气,谓其能纠正不正之气。
62. 神术汤
主治三季(春、夏、秋)外感寒邪,内伤生冷而发热,以及脾虚泄泻、肠风便血。
白术三钱 防风二钱 甘草一钱
以上三味药,无汗时用苍术,加葱白、生姜;有汗时用白术,加生姜。
【集注】柯琴说:这是王好古得意的方剂,仿效张仲景麻黄汤、桂枝汤的意义,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,也不可治疗阳明经的表证,以及少阳经的半表半里证。《内经》所谓春季伤于风,邪气留连导致洞泄,到夏季发生飧泄、肠澼者适宜使用。如果冬季伤于寒,到春季发生温病者,又不适宜了。现在的人不知道张仲景立方的宗旨,只恐怕麻黄、桂枝伤害人体,得到这个平和的方剂就倚仗它以为稳妥。不知道营卫不和,不是调和脾胃的药物所能替代的;胃家实证,不是补虚的药物所能投用的;肝胆相火往来,少阴水火相射的情况,不能用燥剂概括摄理。先明了药物的道理,才能懂得方剂的用途,能懂方剂,才能使用方剂而不拘泥于方剂。如果病在太阳经,先发阳明经的汗,这是引贼破家,张洁古难道只是为葛根说道吗!
[Can Su Yin (Ginseng and Perilla Decoction)]
Indicated for cold-dampness invasion presenting with headache, fever, aversion to cold, cough, thick and sticky nasal discharge and sputum, chest and diaphragm fullness and oppression, weak pulse, and absence of sweating.
Ren Shen (Ginseng Radix) 8 fen, Zi Su Ye (Perilla Leaf) 8 fen, Gan Ge (Kudzu Root) 8 fen, Qian Hu (Peucedani Radix) 8 fen, Chen Pi (Citrus Reticulatae Pericarpium) 8 fen, Zhi Ke (Aurantii Fructus) 8 fen, Fu Ling (Poria) 8 fen, Ban Xia (Pinelliae Rhizoma) 8 fen, Jie Geng (Platycodonis Radix) 5 fen, Mu Xiang (Aucklandiae Radix) 5 fen, Gan Cao (Licorice Root) 5 fen, Sheng Jiang (Fresh Ginger) 5 slices, Da Zao (Jujube Fruit) 1 piece.
Decoct these ingredients in water, take hot, and induce sweating.
[Annotation] When affected by wind-cold, if the pathogen transmits to the Taiyang channel, since Taiyang governs the exterior, Ma Huang Tang (Ephedra Decoction) and Gui Zhi Tang (Cinnamon Twig Decoction) are used to induce sweating from Ying and Wei. If the pathogen affects the Taiyin channel, it does not transmit, because Taiyin governs the Lung; thus, this decoction is used to disperse wind-cold from the skin and hair externally and to ventilate Lung Qi internally. Generally, where pathogenic factors gather, Zheng Qi (Vital Qi) must be deficient; therefore, Ren Shen (Ginseng) is used as the sovereign herb to tonify deficiency. The skin and hair are the external correspondence of the Lung; when the Lung is invaded by wind-cold, the skin and hair are affected first, resulting in exterior symptoms such as headache, anhidrosis, fever, and aversion to cold. Zi Su Ye (Perilla Leaf), Ge Gen (Kudzu Root), and Qian Hu (Peucedani Radix) are used as minister herbs to disperse the pathogen. Once the Lung is invaded, turbid qi forms in the chest; therefore, Zhi Ke (Aurantii Fructus), Jie Geng (Platycodonis Radix), and Er Chen Tang (Two-Cured Decoction) are used to clear turbidity, thereby eliminating symptoms such as cough, thick sticky discharge, and chest fullness. Mu Xiang (Aucklandiae Radix) is added to circulate Qi in the interior. Sheng Jiang (Fresh Ginger) and Da Zao (Jujube Fruit) are added to harmonize Qi in the exterior. Thus, the Qi of the interior and exterior is harmonized, and harmony leads to resolution. Removing Ren Shen (Ginseng) and adding Chuan Xiong (Ligustici Rhizoma), and replacing Chai Hu (Bupleuri Radix) with Qian Hu (Peucedani Radix) creates Xiong Su Yin (Ligusticum and Perilla Decoction). It treats cases with excess Qi and fire, and can also be added for severe headaches. For wheezing and cough, add Xing Ren (Armeniacae Semen Amarum) to descend Qi, and Sang Bai Pi (Mori Cortex) to drain Lung heat. Combined with Si Wu Tang (Four Substances Decoction), it becomes Fu Ling Bu Xin Tang (Poria Heart-Tonifying Decoction), suitable for treating dual deficiency of Qi and Blood, postpartum deficiency with hematemesis due to exhaustion, and cough from wind-cold invasion.
[Huo Xiang Zheng Qi San (Patchouli Powder to Rectify the Qi)]
Indicated for external invasion of abnormal Qi of the four seasons combined with internal retention of food, presenting with headache, alternating chills and fever, or cholera-like vomiting and diarrhea, or malaria.
Huo Xiang (Agastaches Herba), Jie Geng (Platycodonis Radix), Zi Su (Perilla Herb), Bai Zhi (Angelicae Dahuricae Radix), Hou Po (Magnoliae Officinalis Cortex), Da Fu Pi (Arecae Pericarpium), Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), Chen Pi (Citrus Reticulatae Pericarpium), Gan Cao (Licorice Root).
These ten ingredients, plus Sheng Jiang (Fresh Ginger) and Da Zao (Jujube Fruit), are decocted in water and taken hot.
[Collected Annotations] Wu Kun stated: Abnormal Qi of the four seasons enters through the nose, residing in the interior rather than the exterior; therefore, heavy sweating to release the exterior is not used. Instead, aromatic herbs that promote Qi circulation are used to rectify the interior. Zi Su (Perilla), Bai Zhi (Angelica Dahurica), Chen Pi (Tangerine Peel), Da Fu Pi (Areca Peel), Hou Po (Magnolia Bark), and Jie Geng (Platycodon) are all potent in aroma and Qi-moving properties, thus capable of rectifying abnormal Qi. Fu Ling (Poria), Ban Xia (Pinellia), and Gan Cao (Licorice) are sweet and neutral herbs used to cultivate Middle Qi. If the disease is in the Taiyang channel, this decoction has no relevance. In cases of Shang Han (Cold Damage) with a deep pulse and fever, or in individuals with original Qi deficiency, or those with heat due to yin collapse, caution is advised. Additionally, Jin Bu Huan Zheng Qi San (Golden Imperishable Qi-Rectifying Powder) consists of Ping Wei San (Peaceful Stomach Powder) plus Ban Xia (Pinellia) and Huo Xiang (Patchouli). It is indicated for mountain miasma, acclimatization issues upon travel, vomiting, diarrhea, and dysentery. Ping Wei San (Peaceful Stomach Powder) can calm damp-earth and eliminate miasma; the drying nature of Ban Xia (Pinellia) awakens the Spleen, and the fragrance of Huo Xiang (Patchouli) opens the stomach. It is named "Zheng Qi" (Rectifying Qi) because it corrects abnormal Qi.
62. Shen Shu Tang (Divine Atractylodes Decoction)
Mainly treats external cold invasion and internal injury from raw/cold food during the three seasons (spring, summer, autumn) leading to fever, as well as Spleen-type diarrhea and intestinal wind bleeding.
Bai Zhu (Atractodis Macrocephalae Rhizoma) 3 qian, Fang Feng (Saposhnikoviae Radix) 2 qian, Gan Cao (Licorice Root) 1 qian.
These three ingredients: for absence of sweating, use Cang Zhu (Atractodis Rhizoma) plus Cong Bai (Scallion White) and Sheng Jiang (Fresh Ginger); for presence of sweating, use Bai Zhu (Atractodis Macrocephalae Rhizoma) and Sheng Jiang (Fresh Ginger).
[Collected Annotations] Ke Qin stated: This is Wang Haogu's favored prescription, modeled after Zhang Zhongjing's Ma Huang Tang (Ephedra Decoction) and Gui Zhi Tang (Cinnamon Twig Decoction), but formulated as a mild agent. However, this is a Taiyin channel formula; it can regulate wind-dampness in the Spleen and Stomach but cannot treat wind-cold in the Taiyang channel, exterior syndromes in the Yangming channel, or half-exterior/half-interior conditions in the Shaoyang channel. As stated in Nei Jing (Inner Canon): Wind injury in spring with lingering pathogen causing profuse diarrhea, which manifests as incomplete digestion diarrhea (Sun Xie) or bloody dysentery (Chang Pi) in summer, is suitable for this. If cold injury occurs in winter and transforms into warm disease in spring, this formula is inappropriate. Modern practitioners, unaware of Zhang Zhongjing's principles, fear that Ma Huang (Ephedra) and Gui Zhi (Cinnamon Twig) harm the body, relying on this mild formula for safety. They do not realize that disharmony of Ying and Wei cannot be substituted by herbs that harmonize the Spleen and Stomach; excess patterns in the Stomach cannot be treated with tonifying herbs; and conditions involving fluctuating Minister Fire of the Liver/Gallbladder or mutual conflict of Water/Fire in the Shaoyin cannot be managed merely by drying agents. One must first understand the principles of herbs to grasp the application of formulas; understanding formulas allows one to use them flexibly without being rigid. If the disease is in the Taiyang channel, inducing sweating via the Yangming channel is like inviting thieves to destroy the house; did Zhang Jieguc only speak for Ge Gen (Kudzu Root)?