（仲景）
治伤寒表不解，心下有水气，干呕，发热而咳，或噎、或喘、或渴、或利、或小便不利，
少
则以
喘；
短气
内渍
膈
而
麻黄（去节） 桂枝 芍药（酒炒） 细辛 甘草（炙） 干姜（三两） 半夏 五味
子（半升。）渴，去半夏，加花粉（半夏温燥；花粉苦寒），去热生津；喘，去麻黄，加杏仁
（喘为气逆，麻黄发阳，杏仁降气）；形肿，亦去麻黄（喘呼形肿，水气标本之病，故并去
之），噎，去麻黄，加附子（经曰∶水寒相搏则噎，附子温经散寒）；小便秘，去麻黄，加茯
苓（便秘忌发汗，宜渗利）。
此足太阳药也。表不解，故以麻黄发汗为君，桂枝、甘草佐之解表，为佐；咳喘，肺气
逆也，故用芍药酸寒，五味酸温以收之（经曰∶肺欲收，急食酸以收之。发汗以散邪水，收
敛以固真水）；水停心下则肾燥，细辛、干姜辛温，能润肾而行水（经曰∶肾苦燥，急食辛
以润之。细辛又为少阴肾经表药）；半夏辛温，能收逆气，散水饮，为使也。外发汗，内行
水，则表里之邪散矣（此证为水寒相搏而伤肺，若寒从外出，而水不内消，必贻异日之患。
《金匮》曰∶病溢饮者，当发其汗，大小青龙汤并主之。程郊倩曰∶水气之渴与白虎汤中之
渴，不特寒热有殊，亦且燥湿各异。《金匮》云∶先渴后呕者，水停心下，小青龙汤主之，
不治渴而专治水，水去，而渴自止矣。李时珍曰∶仲景治伤寒太阳证，表未解，心下有水而
咳，干呕发热或喘或利，小青龙汤主之；表已解，有时头痛恶寒，心下有水，干呕痛引两胁，
或喘或咳，十枣汤主之。盖青龙散表邪，使水从汗出，《内经》所谓开鬼门也；十枣逐里邪，
使水从二
本方加石膏，名小青龙加石膏汤（《金匮》）∶治肺胀咳而上气，烦躁而喘，心下有水，
脉
（张仲景）
治疗伤寒表证未解，心下有停饮，出现干呕、发热且咳嗽，或者伴有噎塞感、气喘、口渴、腹泻、小便不利，
如果水气较轻则表现为气喘；
短气。
体内水气浸渍于膈膜。
麻黄（去节） 桂枝 芍药（酒炒） 细辛 甘草（炙） 干姜（三两） 半夏 五味子（半升）。若口渴，去掉半夏，加入天花粉（因为半夏性温燥；天花粉性苦寒），以清热生津；若气喘，去掉麻黄，加入杏仁（因为气喘是气机上逆，麻黄发散阳气，杏仁能降气）；若身体浮肿，也去掉麻黄（因为气喘和浮肿都是水气为患的本标之病，所以一并去除）；若噎塞，去掉麻黄，加入附子（医经说：水寒之气相互搏结会导致噎塞，附子能温通经脉散寒）；若小便不通畅，去掉麻黄，加入茯苓（小便不利忌用发汗法，宜用渗湿利水法）。
此方属于足太阳膀胱经的药物。表证未解，所以用麻黄发汗作为君药，桂枝、甘草辅助它来解表，作为佐药；咳嗽气喘，是因为肺气上逆，所以用芍药的酸寒、五味子的酸温来收敛肺气（医经说：肺喜欢收敛，急需食用酸味药物来收敛它。发汗是为了疏散邪气和水饮，收敛是为了固护真阴之水）；水液停滞在心下会导致肾燥，细辛、干姜性辛温，能够滋润肾脏并推动水液运行（医经说：肾脏厌恶干燥，急需食用辛味药物来滋润它。细辛又是少阴肾经的表药）；半夏性辛温，能够收敛上逆之气，消散水饮，作为使药。向外发汗，向内行水，那么表里两方面的邪气就都消散了（这种病症是由于水寒之气相互搏结而损伤肺脏，如果寒气从体表外出，而水饮不在体内消除，必定会遗留日后的祸患。《金匮要略》说：患有溢饮病的患者，应当发汗，大小青龙汤都主治此类病症。程郊倩说：水气引起的口渴与白虎汤证中的口渴，不仅寒热性质不同，而且燥湿属性也各异。《金匮要略》说：先口渴后呕吐的，是水饮停滞在心下，用小青龙汤主治，不专门治疗口渴而专门治水，水饮去除，口渴自然停止。李时珍说：张仲景治疗伤寒太阳证，表证未解，心下有停饮而咳嗽，干呕发热或气喘或腹泻，用小青龙汤主治；表证已解，有时头痛恶寒，心下有停饮，干呕疼痛牵引两胁，或气喘或咳嗽，用十枣汤主治。大概青龙汤是解散表邪，使水饮从汗液排出，《内经》所说的“开鬼门”（发汗）；十枣汤是驱逐里邪，使水饮从二便排出。
(Zhang Zhongjing)
Treats Taiyang disease (disease of the Bladder channel) where the exterior syndrome is not resolved, with fluid retention in the epigastrium, presenting as dry retching, fever, and cough. Alternatively, there may be choking sensation, wheezing, thirst, diarrhea, or difficulty in urination. If the fluid retention is mild, it manifests as wheezing; shortness of breath. The internal fluids infiltrate the diaphragm.
Ephedrae Herba (Mahuang, 麻黄) [devoid of nodes], Cinnamon Twig (Guizhi, 桂枝), White Peony Root (Shaoyao, 芍药) [stir-fried with wine], Asarum Root (Xixin, 细辛), Licorice Root (Gancao, 甘草) [roasted], Dried Ginger (Ganjiang, 干姜) [3 liang], Pinellia Tuber (Banxia, 半夏), Schisandra Berry (Wuweizi, 五味子) [0.5 sheng]. If there is thirst, remove Banxia and add Trichosanthes Root (Huafen, 天花粉) because Banxia is warm and drying, whereas Huafen is bitter and cold, thus clearing heat and generating fluids. If there is wheezing, remove Mahuang and add Apricot Seed (Xingren, 杏仁) because wheezing is due to rebellious Qi, Mahuang disperses Yang Qi, while Xingren descends Qi. If there is edema, also remove Mahuang because both wheezing and edema are manifestations of fluid retention affecting the root and branch, so both are removed. If there is a choking sensation, remove Mahuang and add Aconite Lateral Root Preparata (Fuzi, 附子) as stated in the classics: "When water and cold contend, choking occurs"; Fuzi warms the channels and dispels cold. If there is urinary difficulty, remove Mahuang and add Poria (Fuling, 茯苓) because urinary difficulty contraindicates sweating; instead, promote diuresis.
This formula acts on the Foot-Taiyang (Bladder) channel. Since the exterior is not resolved, Mahuang is used as the Sovereign herb to induce sweating. Guizhi and Gancao assist it in resolving the exterior, serving as Assistant herbs. Cough and wheezing result from rebellious Lung Qi; therefore, Shaoyao's sour-cold nature and Wuweizi's sour-warm nature are used to astringe the Lung (as stated in the classics: "The Lung desires astringency; urgently use sour substances to astringe it." Sweating disperses pathogenic factors and fluids, while astringency consolidates true Yin fluids). Fluid stagnation in the epigastrium causes Kidney dryness; Xixin and Ganjiang are acrid and warm, capable of moistening the Kidney and promoting fluid movement (as stated in the classics: "The Kidney dislikes dryness; urgently use acrid substances to moisten it." Xixin is also an exterior herb for the Shaoyin Kidney channel). Banxia is acrid and warm, capable of restraining rebellious Qi and dissipating fluid retention, serving as the Guide herb. Exteriorly inducing sweat and internally moving fluids allows both exterior and interior pathogens to dissipate (This condition arises from water and cold contending and injuring the Lung. If cold exits via the exterior but fluids remain uneliminated internally, it will inevitably cause future complications. *Jin Gui Yao Lue* states: "For patients with Yi Yin (overflowing fluid), sweating should be induced; both Xiao Qing Long Tang and Da Qing Long Tang are indicated." Cheng Jiaoqian stated: "Thirst caused by fluid retention differs from that in Bai Hu Tang syndrome not only in cold-heat nature but also in dryness-dampness attributes." *Jin Gui Yao Lue* says: "If thirst precedes vomiting, it indicates fluid retention in the epigastrium, treated with Xiao Qing Long Tang. It does not specifically treat thirst but treats the water; once the water is gone, thirst ceases." Li Shizhen stated: "Zhang Zhongjing treats Taiyang syndrome of Shanghan where the exterior is unresolved, with fluid retention in the epigastrium causing cough, dry retching, fever, possibly wheezing or diarrhea, using Xiao Qing Long Tang. When the exterior is resolved, if there is headache, aversion to cold, fluid retention in the epigastrium, dry retching, pain radiating to both hypochondria, possibly wheezing or cough, Shi Zao Tang is used. Essentially, Qing Long Tang disperses exterior pathogens, allowing water to exit via sweat, as described in *Nei Jing* as 'opening the ghost gate' (sweating); Shi Zao Tang expels interior pathogens, allowing water to exit via the two bowels.)
Adding Gypsum (Shigao, 石膏) to this formula creates Xiao Qing Long Jia Shi Gao Tang (*Jin Gui Yao Lue*): Treats Lung distension with cough and rebellious Qi, irritability and restlessness with wheezing, fluid retention in the epigastrium, and pulse...