大黄三两 附子(炮)三枚 细辛二两
右三味,以水五升,煮取二升,分温三服,若强人煮取二升半,分温三服,服后如人
行四、五里,进一服。
@@@
病腹满,发热,十日脉浮而数,饮食如故,厚朴七物汤主之。
【注】
病腹满,里证也。发热,里热也。然十日脉浮而数,表热亦未已也,饮食如故,胃热
能消谷也。因胃热里实,表热发热,故用厚朴七物汤,表里均解,腹满发热两除也。
此桂枝汤、小承气汤之复方也。
【集注】
程林曰:腹满者,内有实热也。十日脉尚浮而数,浮为在表,表热邪未已,故发热,
数为在里,里热能消谷,故饮食如故,与此方荡腹满而除表热。夫表里俱实,当先解
表,乃可攻里,今表邪微而里邪甚,故用承气桂枝二汤,相合以和表里,如伤寒之用
大柴胡,此其义也。
厚朴半筋 甘草三两 大黄二两 大枣十枚 枳实五枚 桂枝二两 生姜五两
右七味,以水一斗,煮取四升,温服八合,日三服。呕者加半夏五合。下利去大黄。
寒多者,加生姜至半筋。
@@@
按之心下满痛者,此为实也,当下之,宜大柴胡汤。
【按】
按之心下满痛之下,当有「有潮热」之三字,若无此三字,则不当与大柴胡汤,是必
传写之遗。
【注】
按之心下满痛,有潮热者,此为表里俱实,当下之,宜大柴胡汤两解之。此二治皆下
实满之法也。
大黄三两 附子(炮制)三枚 细辛二两
以上三味药,用水五升,煎煮至剩余二升,分三次温服。如果是体质强壮的人,煎煮至剩余二升半,分三次温服。服药后如人行走四、五里的时间,再服用一次。
@@@
病症表现为腹部胀满,发热,病程十天,脉象浮而数,饮食正常,用厚朴七物汤主治。
【注】
腹部胀满是里证。发热是里热。然而病程十天脉象仍浮而数,说明表热也未消退。饮食正常,说明胃热能消化食物。因为胃热里实,加上表热发热,所以使用厚朴七物汤,表里双解,腹满和发热同时消除。
这是桂枝汤和小承气汤的复方。
【集注】
程林说:腹部胀满,是因为内有实热。病程十天脉象仍浮而数,浮表示病在表,表热邪气未除,所以发热;数表示病在里,里热能消化食物,所以饮食正常。给予此方以荡涤腹满并清除表热。表里俱实时,应当先解表,然后才可攻里,现在表邪轻微而里邪严重,所以使用承气汤和桂枝汤两方相合以调和表里,如同伤寒病中使用大柴胡汤,其道理是一样的。
厚朴半筋 甘草三两 大黄二两 大枣十枚 枳实五枚 桂枝二两 生姜五两
以上七味药,用水一斗,煎煮至剩余四升,温服八合,每日三次。呕吐者加半夏五合。腹泻者去掉大黄。寒多者,加生姜至半筋。
@@@
按压心下部位感到胀满疼痛的,这是实证,应当攻下,适宜用大柴胡汤。
【按】
“按压心下部位感到胀满疼痛”之下,应当有“有潮热”这三个字,如果没有这三个字,就不应当使用大柴胡汤,这一定是传抄遗漏所致。
【注】
按压心下部位感到胀满疼痛,且有潮热的,这是表里俱实,应当攻下,适宜用大柴胡汤表里双解。这两种治法都是攻下实满的方法。
Da Huang (Rhei Radix et Rhizoma) 3 liang, Fu Zi (Aconiti Lateralis Radix Praeparata, processed) 3 pieces, Xi Xin (Asari Radix et Rhizoma) 2 liang.
The above three herbs are boiled in 5 sheng of water until reduced to 2 sheng. Divide into three warm doses. For robust individuals, boil until reduced to 2.5 sheng and divide into three warm doses. After administration, wait the time it takes for a person to walk four or five li before administering the next dose.
@@@
When the disease presents with abdominal fullness, fever, a duration of ten days, a floating and rapid pulse, and normal appetite, Houpo Qiwu Tang (Magnolia Bark Seven-Ingredient Decoction) is indicated.
[Annotation]
Abdominal fullness indicates a interior syndrome. Fever indicates interior heat. However, since the pulse remains floating and rapid after ten days, exterior heat has not yet resolved. Normal appetite indicates that stomach heat can digest food. Due to stomach heat and interior excess combined with exterior heat and fever, Houpo Qiwu Tang is used to resolve both exterior and interior simultaneously, eliminating both abdominal fullness and fever.
This is a compound formula of Guizhi Tang (Cinnamon Twig Decoction) and Xiao Chengqi Tang (Minor Order the Yang Decoction).
[Collected Annotations]
Cheng Lin stated: Abdominal fullness is due to interior excess heat. The pulse remaining floating and rapid after ten days indicates that floating signifies the exterior, where exterior pathogenic heat persists, causing fever; rapid signifies the interior, where interior heat digests food, hence normal appetite. This formula is given to purge abdominal fullness and clear exterior heat. When both exterior and interior are excess, one should typically resolve the exterior first before attacking the interior. Here, the exterior pathogen is mild while the interior pathogen is severe, so Chengqi Tang and Guizhi Tang are combined to harmonize the exterior and interior, similar to the use of Da Chaihu Tang (Greater Bupleurum Decoction) in Shanghan (Cold Damage), sharing the same principle.
Houpo (Magnoliae Officinalis Cortex) half jin, Gancao (Glycyrrhizae Radix et Rhizoma) 3 liang, Da Huang (Rhei Radix et Rhizoma) 2 liang, Dazao (Ziziphi Jujubae Fructus) 10 pieces, Zhishi (Aurantii Fructus Immaturus) 5 pieces, Guizhi (Cinnamomi Ramulus) 2 liang, Shengjiang (Zingiberis Rhizoma Recens) 5 liang.
The above seven herbs are boiled in 1 dou of water until reduced to 4 sheng. Take 8 he of the decoction warm, three times daily. If vomiting occurs, add Banxia (Pinelliae Rhizoma) 5 he. If diarrhea occurs, remove Da Huang. If there is excessive cold, increase Shengjiang to half jin.
@@@
If pressing the epigastrium reveals fullness and pain, this is an excess syndrome, requiring purgation, and Da Chaihu Tang (Greater Bupleurum Decoction) is appropriate.
[Commentary]
Below "pressing the epigastrium reveals fullness and pain," the phrase "with tidal fever" (you chao re) should be present. Without these three characters, Da Chaihu Tang would not be indicated; this is likely an omission during transcription.
[Annotation]
Pressing the epigastrium revealing fullness and pain, accompanied by tidal fever, indicates both exterior and interior excess. Purgation is required, and Da Chaihu Tang is suitable to resolve both exterior and interior. Both of these treatments are methods for purging interior excess and fullness.