（仲景）
治伤寒阳脉涩，阴脉弦，腹中急痛（邪气入里，与正相搏，则腹痛；涩者，血不足也；
弦者，木克土也；太阳在表，无腹痛；少阳在半表半里，有胸胁痛而无腹痛；阳明腹满急痛
者，里实也，宜下之，大柴胡汤、小承气汤；三阴下利而腹痛者，里寒也，宜温之，四逆汤、
附子理中汤；肠鸣泄泻而痛者，里虚有寒也，宜小建中汤温中散寒）；伤寒二三日，心悸而
烦（悸者，阳气虚也，烦者，阴血虚也，气血内虚，与此汤先建其里。倍芍药者，酸以敛阴，
阴收则阳归附也；加饴糖者，甘以润土，土润则万物生也；仍不去姜桂，以散邪也）；通治
虚劳悸衄，里急腹痛，梦遗失精，四肢酸痛，手足烦热，咽燥口干，虚劳黄胆（黄胆，小便
利而色白者，是无热也，不可除热，当作虚寒治之。喻嘉言曰∶虚劳病至于亡血失精，精血
枯槁，难为力矣，急宜建其中脏，使饮食增而阴血旺，故但用稼穑作甘之味，生其精血；而
酸辛酸苦
桂枝 生姜（三两） 芍药（六两） 甘草（一两。炙） 大枣（十二枚。）入饴糖一
升，微火溶服（呕家不可用建中，以甜故也。此即桂枝加芍药汤，但桂有浓薄耳。昂按∶此
汤以饴糖为君，故不名桂枝芍药而名建中，今人用建中者，绝不用饴糖，失仲景遗意矣。吴
鹤皋曰∶桂枝当是桂，桂枝
此足太阴、阳明药也。《准绳》曰∶脾居四脏之中，生育荣卫，通行津液，一有不调，
则失
甘草
液不
经》
脾胃健而荣卫通，故以姜、枣为使（李东垣曰∶《伤寒论》云，阳脉涩，阴脉弦，法当腹中
急痛
肉
解
服，
芍药
治腹痛自
上焦下焦
本方加黄 两半，名黄 建中汤（《金匮》）∶治虚劳诸不足（《准绳》曰∶血不足而用黄
。黄 味甘，加以甘草，大能生血，此仲景之妙法。盖稼穑作甘，甘能补胃，胃为气血之
海，气血所从生也。经曰∶无阳则阴无以生，以甘益胃而生血，旨哉！今人但知参 为气药，
故特表而出之。昂按∶补血汤黄 五倍于当归，而云补血，即此义）；亦治伤寒汗后身痛，
表虚恶寒，脉迟弱者（身痛乃六经俱有之证，有表、有里、有寒、有热、有风、有湿。阳证
身痛，但拘急、身不能转侧；阴寒身痛，体势沉重，宛如被杖，以此别之。此证因过汗耗损
阴气，血少不能营养筋骨，故痛；阳虚故脉迟；汗后故脉弱；用黄 、甘草之甘以补中气，
芍药之酸以收阴气，桂枝辛热，外以益卫而实表，内以和荣而补虚，使中气创建，则能生育
荣卫，通
（张仲景）
治疗伤寒病中，阳脉涩滞、阴脉弦紧，且腹中拘急疼痛的情况。（注：邪气侵入体内，与正气相搏结，则导致腹痛；脉涩，说明血不足；脉弦，说明木气克制土气；太阳病在表，不会出现腹痛；少阳病在半表半里，出现胸胁痛而没有腹痛；阳明病出现腹部胀满急痛，属于里实证，应当用下法，选用大柴胡汤、小承气汤；三阴病出现下利且腹痛，属于里寒证，应当用温法，选用四逆汤、附子理中汤；肠鸣泄泻且疼痛，属于里虚有寒，应当用小建中汤温中散寒）；治疗伤寒发病二三天后，出现心悸且烦躁的症状。（注：悸，是因为阳气虚；烦，是因为阴血虚；气血内部虚弱，因此用此汤先建立中焦脾胃。加倍使用芍药，是因为酸味可以收敛阴气，阴气收敛则阳气得以依附；加入饴糖，是因为甘味可以滋润脾土，脾土滋润则万物生长；仍然保留生姜和桂枝，是为了疏散邪气）；通用治疗虚劳引起的心悸、鼻出血，腹中拘急疼痛，梦中遗精滑泄，四肢酸痛，手足心烦热，咽喉干燥口干，以及虚劳黄疸。（注：黄疸，如果小便通利且颜色发白，说明没有热象，不可清热，应当作为虚寒证治疗。喻嘉言说：虚劳病发展到亡血失精，精血枯竭，很难救治了，急需建立中脏功能，使饮食增加而阴血旺盛，所以只用稼穑作甘之味的药物，来滋生精血；而酸、辛、苦、甘等味配合使用）。
桂枝、生姜（各三两）、芍药（六两）、甘草（一两，炙烤）、大枣（十二枚），加入饴糖一升，用小火融化后服用。（注：呕吐患者不可使用建中汤，因为甜味会助呕。此方即桂枝加芍药汤，只是桂枝的用量有浓淡之别。汪昂按语：此汤以饴糖为君药，所以不叫桂枝芍药汤而叫建中汤，现在人使用建中汤时，完全不用饴糖，失去了张仲景的原意。吴鹤皋说：桂枝应当是肉桂，桂枝……）
这是足太阴脾经、足阳明胃经的药物。《准绳》说：脾位于四脏之中，化生荣卫之气，通行津液，一旦不调，就会失去……
甘草、……液不……《经》……脾胃健运则荣卫通畅，所以用姜、枣为使药（李东垣说：《伤寒论》云，阳脉涩，阴脉弦，法当腹中急痛……肉……解……服，芍药治腹痛自……上焦下焦……）。
本方加入黄芪二两半，名为黄芪建中汤（出自《金匮要略》）：治疗虚劳诸不足（《准绳》说：血不足而用黄芪。黄芪味甘，加上甘草，大能生血，这是张仲景的妙法。盖稼穑作甘，甘能补胃，胃为气血之海，气血由此而生。经文说：无阳则阴无以生，用甘味益胃而生血，旨意深远啊！现在的人只知道人参、黄芪是气药，所以特意指出这一点。汪昂按语：补血汤中黄芪用量五倍于当归，却称为补血，就是这个道理）；也治疗伤寒发汗后身体疼痛，表虚恶寒，脉迟弱的情况。（注：身痛是六经都有的症状，有表证、里证、寒证、热证、风证、湿证。阳证身痛，只是拘急、身体不能转侧；阴寒身痛，身体沉重，宛如被杖打一样，以此区别。此证因过汗耗损阴气，血少不能营养筋骨，故疼痛；阳虚故脉迟；汗后故脉弱；用黄芪、甘草的甘味以补中气，芍药的酸味以收阴气，桂枝辛热，外以益卫气而固表，内以和营气而补虚，使中气建立，则能化生荣卫，通……）
(Zhang Zhongjing)
Treats Taiyang disease (Disease of the Taiyang channel) where the Yang pulse is choppy and the Yin pulse is string-taut, accompanied by acute pain in the abdomen. (Note: When pathogenic factors enter the interior and contend with healthy Qi, abdominal pain occurs; a choppy pulse indicates blood deficiency; a string-taut pulse indicates Wood overacting on Earth; Taiyang disease is at the exterior and does not present with abdominal pain; Shaoyang disease is at the half-exterior half-interior, presenting with chest and hypochondriac pain but no abdominal pain; Yangming disease presents with abdominal fullness and acute pain due to interior excess, which should be treated with purgation using Da Chaihu Tang or Xiao Chengqi Tang; diseases of the Three Yin channels presenting with diarrhea and abdominal pain are due to interior cold, which should be treated with warming using Sini Tang or Fuzi Lizhong Tang; borborygmus, diarrhea, and pain indicate interior deficiency with cold, which should be treated with Xiaojianzhong Tang to warm the middle and dissipate cold). Treats Taiyang disease occurring two to three days after onset, presenting with palpitations and irritability. (Note: Palpitations are due to Yang Qi deficiency; irritability is due to Yin Blood deficiency; internal deficiency of Qi and Blood necessitates this decoction to first establish the interior. Doubling the dosage of Shaoyao is because its sour flavor astringes Yin; when Yin is gathered, Yang returns and attaches; adding Yitang is because its sweet flavor moistens the Spleen Earth; when Earth is moistened, all things grow; retaining Shengjiang and Guizhi is to disperse pathogenic factors). It is generally used to treat Xu Lao (Deficiency-Consumption) presenting with palpitations, epistaxis, abdominal urgency and pain, nocturnal emission, soreness and pain of the four limbs, heat sensation in the hands and feet, dry throat and mouth, and Xu Lao Huangdan (Deficiency-Consumption Jaundice). (Note: In Huangdan, if urination is free and the urine color is white, it indicates absence of heat; one must not clear heat, but rather treat it as deficiency-cold. Yu Jiayan stated: When Xu Lao progresses to loss of blood and essence, with exhaustion of Jing and Blood, it is difficult to effect a cure; urgently one must build up the Middle Zang organs so that food intake increases and Yin Blood flourishes. Therefore, only flavors associated with "Sowing and Reaping" making Sweetness are used to generate Essence and Blood; combining Sour, Pungent, Bitter, and Sweet flavors).
Guizhi (Cinnamon Twig), Shengjiang (Fresh Ginger) (each 3 liang), Shaoyao (White Peony Root) (6 liang), Gancao (Licorice Root) (1 liang, honey-fried), Dazao (Jujube) (12 pieces), add Yitang (Maltose) 1 sheng, dissolve over low heat and take. (Note: Patients with vomiting cannot use Jianzhong Tang because sweetness promotes vomiting. This formula is essentially Guizhi Jia Shaoyao Tang, differing only in the thickness/quantity of Cinnamon. Wang Ang's note: This decoction uses Yitang as the Sovereign herb, hence it is named Jianzhong Tang rather than Guizhi Shaoyao Tang. Modern practitioners often omit Yitang entirely, losing Zhang Zhongjing's original intent. Wu Hegao stated: Guizhi should actually be Rougui [Cinnamon Bark], Guizhi...)
This acts on the Foot-Taiyin Spleen and Foot-Yangming Stomach channels. *Zhunsheng* states: The Spleen resides among the Four Zang organs, generating Ying and Wei Qi, and circulating Body Fluids. If it becomes dysfunctional...
Gancao... fluids do not... *Classic*... When the Spleen and Stomach are robust, Ying and Wei Qi flow smoothly; thus, Jiang (Ginger) and Zao (Jujube) are used as Guides (Li Dongyuan stated: *Shanghan Lun* says, Yang pulse choppy, Yin pulse string-taut, legally there should be acute abdominal pain... meat... resolve... take, Shaoyao treats abdominal pain from... Upper Jiao Lower Jiao...).
Adding Huangqi (Astragalus Root) 2.5 liang to this base formula creates Huangqi Jianzhong Tang (*Jingui Yaolue*): Treats various deficiencies in Xu Lao (*Zhunsheng* states: For blood deficiency, use Huangqi. Huangqi is sweet; combined with Gancao, it greatly generates blood, a subtle method of Zhang Zhongjing. Since Sowing and Reaping make Sweetness, and Sweetness tonifies the Stomach, and the Stomach is the Sea of Qi and Blood, from which Qi and Blood arise. The Classic states: Without Yang, Yin cannot be generated; using Sweetness to benefit the Stomach and generate blood is profound! Modern people only know Renshen and Huangqi as Qi-tonifying herbs, so I specifically highlight this. Wang Ang's note: In Buchu Tang, Huangqi is used five times the amount of Danggui, yet it is called for blood supplementation; this illustrates that principle); It also treats body pain after sweating from Taiyang disease, exterior deficiency with aversion to cold, and slow, weak pulses. (Note: Body pain is a symptom common to all Six Channels, involving exterior, interior, cold, heat, wind, and dampness. Yang-pattern body pain involves stiffness and inability to turn the body; Yin-cold pattern body pain involves heaviness, feeling as if beaten with a stick, distinguishing them. This condition arises from excessive sweating damaging Yin Qi; blood deficiency fails to nourish sinews and bones, causing pain; Yang deficiency causes a slow pulse; post-sweating causes a weak pulse; using the sweetness of Huangqi and Gancao tonifies Middle Qi, the sourness of Shaoyao gathers Yin Qi, and the pungent-hot nature of Guizhi benefits Wei Qi externally to secure the exterior, and harmonizes Ying Qi internally to tonify deficiency. Establishing Middle Qi allows it to generate Ying and Wei Qi, unblocking...)