治大病之后, 虚劳气乏. 补血益气, 不热不冷, 温而调之.
白芍二钱 黄耆 ( 炙 ) 一钱半 甘草 ( 炙 ) 七分 中桂七分 当
归一钱 熟地黄一钱 川芎七分 生姜三片, 大枣二枚, 水二盏, 煎
一盏, 温服.
【注】此汤乃李杲以黄耆建中汤, 减饴糖合四物之方也. 黄耆建中,
治虚劳不足, 是从脾胃中化生血气. 此则直补阴血, 兼之温养阳气,
所以减饴糖之甘, 加纯阴之品, 名曰双和也. 地骨皮饮, 其意在凉血
热,故左二皮以清之. 圣愈汤, 其意在救血脱, 故佐参, 耆以补之.
双和饮, 其意在温养血气, 故佐耆, 桂, 炙草以温之. 经曰: 形不足
者,温之以气是也.
治脾肺俱虚, 发热恶寒, 肢体瘦倦, 食少作泻等证
.若气血虚而变见诸证, 弗论其病期脉, 但用此汤, 诸证悉退.
人参 白术 茯苓 甘草 黄耆 陈皮 当归 熟地 白芍 桂心
远志 五味子, 右十二味, 加姜三片, 枣二枚, 水煎服.
【集注】柯琴曰: 古人治气虚以四君子, 治血虚以四物, 气血俱虚者
以八珍, 更加黄耆, 肉桂名十全大补, 宜乎万举万当也. 而用之有不
获效者, 盖补气而不用行气之品, 则气虚之甚者, 几无气以运动. 补
血而仍用行血之物, 则血虚之甚者, 更无血以流行. 故加陈皮以行气
,而补气者悉得效其用. 去川芎行血之味, 而补血者因以奏其功. 此
善治者, 只一加一减, 便能转旋造化之机也. 然气可召而至, 血易亏
而难成, 苟不有以求其血脉之主而养之, 则营气终归不足. 故倍人参
为君, 而佐以远志之苦, 先入心以安神定志, 使甘温之品, 始得化而
为血, 以奉生身. 又心苦缓, 必得五味子之酸, 以收敛神明, 使营行
脉中而流于四脏. 名之曰养荣, 不必仍十全之名, 而收效有如此者.
治疗大病之后,因虚劳导致的气血匮乏。此方具有补血益气的作用,药性不寒不热,温和地调理身体。
白芍二钱、炙黄耆一钱半、炙甘草七分、中桂七分、当归一钱、熟地黄一钱、川芎七分、生姜三片、大枣二枚。用水两盏,煎煮至一盏,温服。
【注】这个汤剂是李杲以黄耆建中汤为基础,减去饴糖并合入四物汤而成的方子。黄耆建中汤治疗虚劳不足,是从脾胃中化生血气。而这个方子则直接滋补阴血,同时温养阳气,所以减去饴糖的甘味,加入纯阴的药物,命名为“双和”。地骨皮饮,其意图在于凉血清热,所以用左氏二皮(指地骨皮等)来清解。圣愈汤,其意图在于救治血脱,所以佐用人参、黄耆来补益。双和饮,其意图在于温养血气,所以佐用黄耆、肉桂、炙甘草来温补。《内经》说:“形体虚弱的人,用气来温补”,就是这个道理。
治疗脾肺俱虚,出现发热恶寒、肢体消瘦疲倦、食欲不振、腹泻等症状。如果是气血虚弱而变生各种证候,不论其病程长短和脉象如何,只要使用这个汤剂,各种症状都会消退。
人参、白术、茯苓、甘草、黄耆、陈皮、当归、熟地黄、白芍、桂心、远志、五味子。以上十二味药,加生姜三片、大枣二枚,水煎服。
【集注】柯琴说:古人治疗气虚用四君子汤,治疗血虚用四物汤,气血俱虚用八珍汤,再加黄耆、肉桂称为十全大补汤,理应万无一失。但有时使用却不获效,原因在于补气时不用行气的药物,那么气虚严重的人,几乎没有气来运动;补血时仍用行血的药物,那么血虚严重的人,更没有血来流通。所以加入陈皮来行气,使补气药都能发挥效用;去掉川芎这种行血的药物,使补血药因此能奏效。这是善于治病的人,只通过一加一减,就能扭转造化之机。然而气可以召唤而至,血容易亏损且难以生成,如果不寻求血脉的主宰来滋养它,那么营气终究会不足。所以加倍使用人参作为君药,佐以远志的苦味,先入心经以安神定志,使甘温的药物得以化生为血,以供养身体。另外,心苦于涣散,必须得到五味子的酸味,来收敛神明,使营气运行于脉中并流布于四脏。命名为“养荣”,不必沿用十全大补汤的名字,却能收到如此的效果。
Treatment of Qi and Blood deficiency resulting from consumptive fatigue after severe illness. This formula nourishes blood and tonifies Qi, possessing neither hot nor cold properties, gently regulating the body.
Bai Shao (Radix Paeoniae Alba) 2 qian, Zhi Huangqi (Prepared Radix Astragali) 1.5 qian, Zhi Gancao (Prepared Radix Glycyrrhizae) 0.7 qian, Zhonggui (Cinnamon Twig) 0.7 qian, Danggui (Radix Angelicae Sinensis) 1 qian, Shudihuang (Prepared Radix Rehmanniae) 1 qian, Chuanxiong (Rhizoma Ligustici Chuanxiong) 0.7 qian, Shengjiang (Fresh Rhizoma Zingiberis) 3 slices, Dazao (Fructus Jujubae) 2 pieces. Decoct with 2 liang of water until 1 liang remains, take warm.
[Note] This decoction is a formula by Li Gao, derived from Huangqi Jianzhong Tang (Astragalus Decoction to Establish the Middle), with Yitang (Maltose) removed and Siwu Tang (Four Substances Decoction) combined. Huangqi Jianzhong treats insufficiency due to consumptive fatigue by generating Qi and Blood from the Spleen and Stomach. This formula directly tonifies Yin Blood while simultaneously warming and nourishing Yang Qi; hence, the sweetness of Yitang is reduced, and purely Yin herbs are added, named "Shuanghe" (Double Harmony). Digupi Yin (Lycium Bark Decoction) aims to cool blood heat, thus using "Zuo Er Pi" (referring to bark herbs like Lycii Cortex) to clear it. Shengyu Tang (Sage Renewal Decoction) aims to rescue from blood collapse, thus assisting with Renshen (Ginseng Root) and Huangqi to tonify. Shuanghe Yin aims to warmly nourish Qi and Blood, thus assisting with Huangqi, Rougui (Cinnamon Bark), and Zhi Gancao to warm. The Classics state: "For those with insufficient form, warm them with Qi," which refers to this principle.
Treatment for simultaneous deficiency of the Spleen and Lung, presenting with fever and aversion to cold, emaciation and fatigue of the limbs, poor appetite, and diarrhea. If various syndromes arise due to Qi and Blood deficiency, regardless of the disease stage or pulse characteristics, simply using this decoction will cause all symptoms to recede.
Renshen (Ginseng Root), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Gancao (Radix Glycyrrhizae), Huangqi (Radix Astragali), Chenpi (Citri Reticulatae Pericarpium), Danggui (Radix Angelicae Sinensis), Shudihuang (Prepared Radix Rehmanniae), Baishao (Radix Paeoniae Alba), Guixin (Cinnamon Bark), Yuanzhi (Radix Polygalae), Wuweizi (Fructus Schisandrae Chinensis). The above twelve ingredients, add Shengjiang (Fresh Rhizoma Zingiberis) 3 slices, Dazao (Fructus Jujubae) 2 pieces, decoct with water and take orally.
[Collected Notes] Ke Qin stated: In ancient times, Si Junzi Tang (Four Gentlemen Decoction) was used for Qi deficiency, Siwu Tang (Four Substances Decoction) for Blood deficiency, and Bazhen Tang (Eight Treasures Decoction) for both Qi and Blood deficiency. Adding Huangqi and Rougui creates Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction), which should theoretically be infallible. However, sometimes it fails to produce results. This is because when tonifying Qi without moving Qi, those with severe Qi deficiency have almost no Qi to move; when tonifying Blood while still using herbs that move Blood, those with severe Blood deficiency have even less Blood to circulate. Therefore, Chenpi is added to move Qi, allowing the Qi-tonifying herbs to exert their effect; Chuanxiong, an herb that moves Blood, is removed, allowing the Blood-nourishing herbs to achieve their function. This is how skilled practitioners can turn the mechanism of creation through just one addition and one subtraction. However, Qi can be summoned, but Blood is easily depleted and hard to regenerate. If one does not seek the master of the blood vessels to nourish them, Ying Qi (Nutritive Qi) will ultimately remain insufficient. Thus, Renshen is doubled as the Sovereign herb, assisted by the bitter taste of Yuanzhi, which first enters the Heart to calm the Spirit and stabilize the Will, enabling the sweet-warm herbs to transform into Blood to nourish the body. Furthermore, since the Heart dislikes laxity, the sour taste of Wuweizi is necessary to astringe the Spirit, causing Ying Qi to flow within the vessels and distribute to the Four Viscera. It is named "Yangrong" (Nourishing Ying), and although it does not retain the name of Shiquan Dabu, it achieves such efficacy.