柴胡(半斤,去节) 黄芩(三两,炒) 芍药(三两,炒) 半夏(半升,泡七次) 生
姜(五两) 枳实(四两,面煨) 大黄(二两,酒浸) 大枣(十二枚)
伤寒,阳邪入里,表证未除,里证又急者,此方主之。
表证未除者,寒热往来、胁痛、口苦尚在也;里证又急者,大便难而燥实也。表证未除
,故用柴胡、黄芩以解表;里证燥实,故用大黄、枳实以攻里。芍药能和少阳,半夏能治呕
逆,大枣、生姜,又所以调中而和荣卫也。
大黄(四两,酒浸) 芒硝(半升) 甘草(二两)
伤寒,阳明证俱,大便秘,谵语,脉实者,此方主之。
阳明证俱者,不恶寒,反恶热、作渴是也。传至阳明,则热经数日矣。热久则五液干涸
,故大便秘;液亡则无水以制火,故谵语。谵语者,呢喃而语,妄见妄言也。邪入于里,故
脉实。大黄苦寒,可以荡实,芒硝咸寒,可以润燥;甘草甘平,可以和中。此药行,则胃中
调而里气承顺,故曰调胃承气。然犹有戒焉,表证未去而早下之,则有结胸、痞气之患,此
大、小陷胸汤之所以作
大黄(四两,酒浸) 浓朴(二两,炒) 枳实(三枚,麸炒)
伤寒,腹胀满,潮热,狂言而喘者,此方主之。
邪在上焦则作满,邪在中焦则作胀,胃中实则作潮热。曰潮热者,犹潮水之潮,其来不
失时也!阳乘于心则狂,热干胃口则喘。枳、朴去上焦之痞满,大黄荡胃中之实热。此其里
证虽成,病未危急,痞、满、燥、实、坚犹未全俱,以是方主之,则气亦顺矣;故曰小承气。
柴胡(半斤,去除节段) 黄芩(三两,炒制) 芍药(三两,炒制) 半夏(半升,浸泡七次) 生姜(五两) 枳实(四两,面粉煨制) 大黄(二两,酒浸) 大枣(十二枚)
伤寒病中,阳邪侵入体内,表证尚未解除,而里证又十分急迫的,此方主治。
所谓表证未除,是指寒热往来、胁肋疼痛、口苦等症状依然存在;所谓里证急迫,是指大便困难且干燥结实。因为表证未除,所以使用柴胡、黄芩来解表;因为里证表现为燥实,所以使用大黄、枳实来攻下里实。芍药能够调和少阳经,半夏能够治疗呕吐逆气,大枣和生姜,则是为了调和脾胃并调和营卫之气。
伤寒病中,阳明病证候全部具备,大便秘结,说胡话,脉象有力的,此方主治。
所谓阳明病证候全部具备,是指不恶寒,反而怕热、口渴。病邪传至阳明经,发热已经持续数日了。发热日久则体内的津液干涸,所以大便秘结;津液亡失则没有水来制约火邪,所以出现说胡话的症状。说胡话,是指低声喃喃自语,胡乱看见、胡乱说话。邪气深入体内,所以脉象有力。大黄味苦性寒,可以荡涤积滞;芒硝味咸性寒,可以润燥软坚;甘草味甘性平,可以调和脾胃。这些药物发挥作用后,胃中得到调和,里气得以顺承,所以称为调胃承气汤。然而仍须警惕,如果表证未去而过早使用泻下法,会导致结胸证或痞气的祸患,这也是大陷胸汤和小陷胸汤被创制的缘由。
大黄(四两,酒浸) 厚朴(二两,炒制) 枳实(三枚,麦麸炒制)
伤寒病中,腹部胀满,定时发热,狂乱言语且气喘的,此方主治。
邪气在上焦则产生胀满感,邪气在中焦则产生腹胀感,胃中有实热则产生定时发热。所谓定时发热,就像潮水的涨落一样,按时而来!阳气乘袭于心则发狂,热气干扰胃口则气喘。枳实和厚朴能去除上焦的痞塞胀满,大黄能荡涤胃中的实热。这里的里证虽然已经形成,但病情尚未危急,痞、满、燥、实、坚这五种症状尚未完全具备,用此方主治,气机就能顺畅;所以称为小承气汤。
Chai Hu (Radix Bupleuri, half jin, remove nodes) Huang Qin (Radix Scutellariae, three liang, stir-fried) Shao Yao (Radix Paeoniae Alba, three liang, stir-fried) Ban Xia (Rhizoma Pinelliae, half sheng, soaked seven times) Sheng Jiang (Rhizoma Zingiberis Recens, five liang) Zhi Shi (Fructus Aurantii Immaturus, four liang, baked with flour) Da Huang (Radix et Rhizoma Rhei, two liang, soaked in wine) Da Zao (Fructus Jujubae, twelve pieces)
In Taiyang disease (disease of the Taiyang channel), when yang pathogenic factors have entered the interior, the exterior syndrome has not yet resolved, and the interior syndrome is urgent, this formula is indicated.
The term "exterior syndrome has not yet resolved" refers to the persistence of alternating chills and fever, hypochondriac pain, and bitter taste in the mouth; the term "interior syndrome is urgent" refers to difficult defecation accompanied by dryness and accumulation. Since the exterior syndrome persists, Chai Hu and Huang Qin are used to release the exterior; since the interior syndrome presents with dryness and accumulation, Da Huang and Zhi Shi are used to purge the interior. Shao Yao can harmonize the Shaoyang (Lesser Yang) channel, Ban Xia can treat vomiting and rebellious qi, while Da Zao and Sheng Jiang serve to harmonize the middle jiao (middle burner) and harmonize Ying (Nutritive) and Wei (Defensive) qi.
Da Huang (Radix et Rhizoma Rhei, four liang, soaked in wine) Mang Xiao (Natrii Sulfas, half sheng) Gan Cao (Radix Glycyrrhizae Uralensis, two liang)
In Taiyang disease, when all symptoms of Yangming disease (disease of the Yangming channel/stomach-intestine) are present, including constipation, delirium, and a forceful pulse, this formula is indicated.
"All symptoms of Yangming disease are present" means there is no aversion to cold, but rather an aversion to heat and thirst. Once transmitted to the Yangming channel, the heat has persisted for several days. Prolonged heat dries up the body's fluids, leading to constipation; loss of fluids means there is no water to control fire, leading to delirium. Delirium refers to muttering speech, hallucinations, and nonsensical talking. Pathogenic factors entering the interior result in a forceful pulse. Da Huang, being bitter and cold, can purge accumulation; Mang Xiao, being salty and cold, can moisten dryness; Gan Cao, being sweet and neutral, can harmonize the stomach. As these medicines act, the stomach is harmonized and the interior qi becomes compliant, hence it is called Tiao Wei Cheng Qi Tang (Stomach-Regulating Qi-Bearing Decoction). However, caution is still advised: if purgatives are used prematurely while the exterior syndrome remains unresolved, complications such as Jie Xiong (Chest Binding) or Pi Qi (Pi Syndrome) may arise. This is the reason why Da Xian Xiong Tang (Major Chest-Binding Decoction) and Xiao Xian Xiong Tang (Minor Chest-Binding Decoction) were created.
Da Huang (Radix et Rhizoma Rhei, four liang, soaked in wine) Hou Po (Cortex Magnolia Officinalis, two liang, stir-fried) Zhi Shi (Fructus Aurantii Immaturus, three pieces, bran-fried)
In Taiyang disease, presenting with abdominal fullness and distension, tidal fever, manic speech, and wheezing, this formula is indicated.
Pathogenic factors in the Upper Jiao (Upper Burner) cause a sensation of fullness; those in the Middle Jiao cause abdominal distension; excess heat in the stomach causes tidal fever. Tidal fever is likened to the tide of the sea, arriving punctually! When Yang overacts upon the Heart, mania occurs; when heat harasses the Stomach opening, wheezing results. Zhi Shi and Hou Po eliminate pi (stagnation) and man (fullness) in the Upper Jiao, while Da Huang purges excess heat in the stomach. Although the interior syndrome has formed here, the condition is not yet critical, and the five signs of Pi (stagnation), Man (fullness), Zao (dryness), Shi (excess), and Jian (hardness) are not fully present. Using this formula will ensure the smooth flow of qi; hence it is called Xiao Cheng Qi Tang (Minor Qi-Bearing Decoction).