仲景以小柴胡治少阳证口苦舌干、往来寒热而呕。盖柴胡味苦平。行少阳经。黄芩味苦寒为佐
。治发热口苦。生姜辛温。半夏辛热。治发寒而呕。人参甘温。安胃和中。大枣甘平温。和阴阳。
调荣卫。生律液。使半表半里之邪而自解矣。大承气汤治阳明本实痞满燥实。枳实苦微寒、泄痞。
浓朴苦温、除满。芒硝辛寒、润燥。邪入于腑而作热实。以大黄苦寒下之。酒制者为因用。热散气
升而作汗解矣。因以承气名之。钱仲阳以升麻汤治小儿寒暄不时。阳明经受邪。身热目疼。鼻干不
得卧。及疮疹未发。发而不匀。升麻苦平、葛根甘
平、解散外邪。甘草甘温。芍药酸微寒。调和中气。拒邪不能伤其里。白术散治小儿阳明本
虚。阴阳不和。吐利后而亡津液。虚热口干。人参、甘草、白术、甘温。和中补胃。藿香、木香辛
温芳馨。可以助脾。茯苓甘平。分阴阳而导其湿。葛根甘平。倍于众药。其气轻浮。鼓舞胃气上行
。生津液而解肌热。局方中四物汤。调荣养卫。益气滋血。当归辛温。熟地黄甘温能滋血。川芎辛
温。白芍药味酸微寒。能养气。盖血为荣。气为卫。四物相合。故有调益滋养之实。黄 建中汤治
面色痿黄。脐腹急痛。脾胃不足者。肝木乘之也。木胜其中。土走于外。故痿黄见于面。难经曰。
其平和不可得见。衰乃见耳。黄 、甘草。甘温能补脾土。芍药之酸。能泻肝木。水挟木势。亦来
侮土。故作脐腹急痛。官桂辛热。散其寒水。生姜、大枣、饴糖。辛甘大温。益气缓中。又与脾胃
行其津液。以养四脏。建脾制水。补子泻鬼。使四脏各安其气。必清必净。则病气衰去。建中之
名。亦不诬矣。上数方。药证相对。名实相辅。可垂法于世。近世用双解散。治风寒暑湿。饥饱劳
逸。殆无此理。且如风邪伤卫。必自汗而恶风。寒邪伤荣。必无汗而恶寒。又云。伤寒伤风。其证
不同。中暑自汗。必身热而气虚。中湿自汗。必体疼而沉重。且四时之气。更伤五脏。一往一来。
未有齐至者也。饥则损气。饱则伤胃。劳则气耗。逸则气滞。其证不同。治法亦异。盖劳者温之。
损者补之。逸者行之。内伤者消导之。今内外八邪。一方治之。有此理乎。内经云调气之方。必别
阴阳。内者内治。外者外治。故仲景云。且除其表。又攻其里。言仍似是。其理实违。其是之谓欤
。如搜风丸、祛风丸。有搜风祛风之名。无搜风祛风之实。百解散亦此类也。谚云看方三年。无病可
医。疗病三年。无药可用。此亦名实不相辅故也。噫。去圣逾远。其术 昧。人自为法。无可考证
。昔在圣
人。垂好生之德着本草。作内经。仲景遵而行之以立方。号群方之祖。后之学人。以仲景之心为心
。庶得制方之旨。
张仲景用小柴胡汤治疗少阳证，表现为口苦、舌干、寒热往来且伴有呕吐。这是因为柴胡味苦平，能行于少阳经；黄芩味苦寒作为佐药，治疗发热和口苦；生姜辛温，半夏辛热，治疗发冷和呕吐；人参甘温，能安胃和中；大枣甘平温，能调和阴阳，调理营卫，生成津液，从而使半表半里的邪气自然解除。大承气汤治疗阳明腑实证中的痞、满、燥、实。枳实苦微寒，泄除痞塞；浓朴苦温，消除胀满；芒硝辛寒，润燥通便。邪气入腑化为热实，用大黄苦寒攻下。酒制的大黄是为了顺应病势利用其药性，使热散气升而通过出汗解表。因此以“承气”命名。钱乙（钱仲阳）用升麻葛根汤治疗小儿因气候寒暖不时导致的疾病，这是阳明经受邪，表现为身体发热、眼睛疼痛、鼻子干燥、无法安卧，以及疮疹尚未发出或发出但不均匀。升麻苦平、葛根甘平，能解散外邪；甘草甘温；芍药酸微寒，能调和中气，抵御邪气不使其伤害体内脏腑。白术散治疗小儿阳明本虚，阴阳不和，在吐泻后导致津液亏损，出现虚热、口干。人参、甘草、白术，味甘性温，能调和中气，补益脾胃；藿香、木香味辛性温且芳香，可以助益脾脏；茯苓味甘性平，能分利阴阳并引导湿气排出；葛根味甘性平，用量倍于其他药物，其气轻浮，能鼓舞胃气上行，生成津液并解除肌表之热。局方中的四物汤，能调理荣血，养护卫气，益气滋血。当归辛温，熟地黄甘温能滋养血液，川芎辛温，白芍药味酸微寒能养护气机。因为血为荣，气为卫，四物药相合，所以具有调理补益滋养的实效。黄芪建中汤治疗面色萎黄，脐腹拘急疼痛，这是由于脾胃不足，肝木乘虚克制所致。木气过盛于中焦，土气外越，所以面色呈现萎黄。《难经》说：“平和之气不可见，只有衰败时才显现。”黄芪、甘草，味甘性温能补益脾土；芍药的酸味，能泻肝木。水气挟带木势，也来反侮脾土，所以导致脐腹拘急疼痛。官桂辛热，能散寒水之气；生姜、大枣、饴糖，味辛甘性大温，能益气缓急止痛，又与脾胃共同运行津液，以滋养四脏，建立脾土制约水气，补子脏泻鬼贼之脏，使四脏各安其位，气息清静纯净，则病气衰退去除，“建中”的名称，也确实没有虚妄。以上几个方剂，药物与证候相对，名称与实际相符，可以流传法则于世。近代使用双解散，治疗风寒暑湿、饥饱劳逸等病，这大概没有这样的道理。况且风邪伤及卫气，必然自汗且恶风；寒邪伤及营气，必然无汗且恶寒。又说伤寒与伤风，证候不同；中暑自汗，必然身体发热且气虚；中湿自汗，必然身体疼痛且沉重。而且四季之气，轮流伤害五脏，一往一来，没有同时到达的情况。饥饿则损伤气，饱食则伤害胃，劳累则耗气，安逸则气滞，这些证候都不同，治疗方法也各异。大概劳损者用温法，虚损者用补法，安逸致滞者用行气法，内伤者用消导法。如今用一方治疗内外八种邪气，有这样的道理吗？《内经》说：调理气机的方剂，必须辨别阴阳，内伤病从内治，外感病从外治。所以张仲景说：先解其表，再攻其里。这话听起来似乎有理，其实违背了医理，这所谓的“是”对吗？如搜风丸、祛风丸，有搜风祛风的名声，却没有搜风祛风的实效，百解散也是这一类。谚语说：看方三年，无病可医；疗病三年，无药可用。这也是名实不相符的缘故啊。唉，距离圣人时代越远，医术就越昏暗不明，人们各自创立法则，无可考证。昔日圣人，垂示好生之德，著《本草》，作《内经》，张仲景遵循并以此创立方剂，号称群方之祖。后世的学医者，若能以张仲景的心意为自己的心意，或许就能得到制方的宗旨。
Zhang Zhongjing used Xiao Chai Hu Tang (Minor Bupleurum Decoction) to treat Shaoyang syndrome (disease of the Shaoyang channel), characterized by bitter taste in the mouth, dry tongue, alternating chills and fever, and vomiting. This is because Chai Hu (Bupleuri Radix) has a bitter and neutral flavor and acts on the Shaoyang channel; Huang Qin (Scutellariae Radix), with a bitter and cold flavor, serves as an assistant herb to treat fever and bitter taste; Sheng Jiang (Zingiberis Rhizoma Recens), acrid and warm, and Ban Xia (Pinelliae Rhizoma), acrid and hot, treat chills and vomiting; Ren Shen (Ginseng Radix et Rhizoma), sweet and warm, stabilizes the stomach and harmonizes the middle jiao; Da Zao (Jujubae Fructus), sweet, neutral, and warm, harmonizes yin and yang, regulates Ying (nutritive qi) and Wei (defensive qi), generates body fluids, thereby allowing pathogens located at half-exterior and half-interior to resolve spontaneously. Da Cheng Qi Tang (Major Order the Qi Decoction) treats Yangming fu-organ excess syndromes characterized by fullness, oppression, dryness, and accumulation. Zhi Shi (Aurantii Fructus Immaturus), bitter and slightly cold, drains obstruction; Hou Po (Magnoliae Officinalis Cortex), bitter and warm, eliminates distension; Mang Xiao (Natrii Sulfas), acrid and cold, moistens dryness. When pathogens enter the fu-organs and transform into heat-excess, Da Huang (Rhei Radix et Rhizoma), bitter and cold, is used to purge downwards. Wine-processed Da Huang is used to adapt to the disease process and utilize its properties, allowing heat to dissipate and qi to rise, leading to resolution through sweating. Hence it is named "Cheng Qi" (Ordering the Qi). Qian Yi (Qian Zhongyang) used Sheng Ma Ge Gen Tang (Ephedra and Pueraria Decoction) to treat children's illnesses caused by irregular climate changes, where the Yangming channel is affected, presenting with fever, eye pain, nasal dryness, inability to lie down, and unruptured or unevenly erupting rashes. Sheng Ma (Cimicifugae Rhizoma), bitter and neutral, and Ge Gen (Puerariae Lobatae Radix), sweet and neutral, dispel external pathogens; Gan Cao (Glycyrrhizae Radix et Rhizoma), sweet and warm; Bai Shao Yao (Paeoniae Radix Alba), sour and slightly cold, harmonize the middle qi and resist pathogens from damaging the interior. Bai Zhu San (Atractylodis Macrocephalae Powder) treats children with inherent deficiency of the Yangming channel, disharmony of yin and yang, loss of body fluids after vomiting and diarrhea, resulting in deficient heat and dry mouth. Ren Shen, Gan Cao, and Bai Zhu are sweet and warm, harmonizing the middle qi and tonifying the spleen and stomach; Huo Xiang (Agastaches Herba) and Mu Xiang (Aucklandiae Radix) are acrid, warm, and aromatic, assisting the spleen; Fu Ling (Poria), sweet and neutral, separates yin and yang and guides out dampness; Ge Gen, sweet and neutral, is used in double the dosage of other herbs. Its light and floating nature stimulates the ascent of stomach qi, generates body fluids, and resolves muscle-layer heat. Si Wu Tang (Four Substances Decoction) in the Bureau of Medical Relief formula regulates Ying blood, nourishes Wei qi, benefits qi, and nourishes blood. Dang Gui (Angelicae Sinensis Radix) is acrid and warm; Shu Di Huang (Rehmanniae Radix Praeparata) is sweet and warm, nourishing blood; Chuan Xiong (Ligustici Chuanxiong Rhizoma) is acrid and warm; Bai Shao Yao is sour and slightly cold, nourishing qi. Since blood constitutes Ying and qi constitutes Wei, the combination of these four substances yields the actual effect of regulating, benefiting, and nourishing. Huang Qi Jian Zhong Tang (Astragalus Decoction to Establish the Middle) treats sallow complexion and urgent pain in the umbilical and abdominal regions due to insufficiency of the spleen and stomach, allowing Liver Wood to overact upon them. Excessive Wood energy in the center causes Earth qi to scatter outward, resulting in a sallow face. The Nan Jing states: "Harmonious qi cannot be seen; only decline becomes apparent." Huang Qi (Astragali Radix) and Gan Cao, sweet and warm, tonify Spleen Earth; the sourness of Shao Yao drains Liver Wood. Water, carrying the force of Wood, also insults Earth, causing urgent abdominal pain. Guan Gui (Cinnamomi Cortex), acrid and hot, disperses cold water; Sheng Jiang, Da Zao, and Yi Tang (Maltose), acrid, sweet, and greatly warm, benefit qi and relieve urgency, while jointly promoting the circulation of body fluids in the spleen and stomach to nourish the four zang organs. It establishes Spleen earth to control water, tonifies the son organ, and drains the ghost organ (the organ that insults the spleen), allowing the four zang organs to settle their qi. Once clear and pure, pathogenic qi declines and departs. Thus, the name "Jian Zhong" (Establishing the Middle) is not unfounded. The aforementioned formulas match herbs to syndromes and align names with reality, providing models for posterity. In recent times, Shuang Jie San (Double Resolution Powder) is used to treat wind-cold, summerheat-dampness, hunger/fullness, and labor/rest issues, which is likely incorrect. For instance, Wind pathogen injuring Wei qi必然 causes spontaneous sweating and aversion to wind; Cold pathogen injuring Ying qi必然 causes absence of sweating and aversion to cold. Furthermore, Shang Han (Cold Damage) and Shang Feng (Wind Injury) present different syndromes; Zhong Shu (Summerheat Stroke) with spontaneous sweating必然 presents with fever and qi deficiency; Zhong Shi (Dampness Strike) with spontaneous sweating必然 presents with body pain and heaviness. The qi of the four seasons sequentially injures the five zang organs, coming and going, never arriving simultaneously. Hunger damages qi, fullness injures the stomach, labor exhausts qi, and rest causes qi stagnation. These syndromes differ, and so do their treatments. Generally, labor requires warming, deficiency requires tonification, stagnation from rest requires movement, and internal injury requires digestion and guidance. To use one formula to treat all eight external and internal pathogens—does this make sense? The Nei Jing states: "Formulas for regulating qi must distinguish yin and yang. Internal diseases are treated internally, external diseases externally." Thus, Zhang Zhongjing said: "First release the exterior, then attack the interior." Although this sounds plausible, it actually violates medical principles. Is this truly correct? Formulas like Sou Feng Wan (Wind-Searching Pill) and Qu Feng Wan (Wind-Expelling Pill) have the names of searching and expelling wind but lack the actual efficacy. Bai Bai Jie San (Hundred Resolutions Powder) is of the same category. As the proverb says: "Study formulas for three years, yet no disease can be cured; practice medicine for three years, yet no medicine can be used." This is due to the mismatch between name and reality. Alas, as time moves further from the sages, techniques become obscure. People create their own methods without verification. In ancient times, sages displayed benevolence by authoring Ben Cao (Materia Medica) and Nei Jing (Inner Canon). Zhang Zhongjing followed these to create formulas, earning the title "Ancestor of All Formulas." May later scholars adopt Zhang Zhongjing's mindset as their own, so they may grasp the essence of formula creation.