白头翁（二两） 黄连 黄柏 秦皮（各三两）
上四味，以水七升，煮取二升，去滓温服一升，不愈更服一升。
霖按∶此治厥阴热利方也，何以移治暑厥？夫白头翁临风偏静，长于驱风，用为君者，以风动则火生，风平则
火熄，欲平走窍之火，必宁摇动之风也。秦皮、黄柏，泻少阳相火，而手少阳与手厥阴表里，故佐以黄连以泻心包
络火热，风平火熄，则痉止厥回矣，此釜下抽薪法也。
升麻 当归 甘草（各二两） 雄黄（半两，研） 蜀椒（炒去汗，一两） 鳖甲（手掌大一片，炙）
上六味，以水四升，煮取一升，顿服之，老小再服取汗。《肘后千金方》，阳毒用升麻汤无鳖甲，有桂；阴毒用
甘草汤，无雄黄。
赵以德曰∶按古方书，谓阳毒者，阳气独盛，阴气暴衰，内外皆阳，故成阳毒。谓阴毒者，阴气独盛，阳气暴
衰，内外皆阴，故成阴毒。二者或伤寒初得，便为是证，或服药后变而成之。阳毒尽治以寒凉，阴毒尽治以温热，
药剂如冰炭之异，何乃仲景用一方治之乎？虽曰阴毒去雄黄、蜀椒，则是反去其温热者矣。且注曰∶《肘后千金方》
阳毒用升麻汤无鳖甲有桂，阴毒用甘草汤无雄黄，岂非皆是热毒之伤于阴阳二经络耶？在阳经络则面赤斑斑如
锦文，吐脓血，在阴经络则面青身如被杖，此皆阴阳水火动静之本象如此，岂是寒热之邪乎？尝以升麻鳖甲之药考之
本草，谓升麻能解时气毒厉诸毒，攻咽喉痛，与热毒成脓，开壅闭，疗发斑。当归能破恶血，养新血，补五脏肌
肤。甘草和中，利血脉，缓急止痛，调药奏功。鳖甲去恶血。雄黄破骨节积聚，辟鬼邪恶气，骨蒸热极。蜀椒通血脉，
调关节逐肌骨皮肤死肌，去留结破血，治天行时气。诸药所能者如此，即此观之，仲景于阴阳二毒之证，总用一
方，盖可见矣。病形虽由阴阳发证，论邪则一属热毒与血病也。所以不分表里，俱以升麻解热毒为君，当归和血为臣，
余者佐之而已。但雄黄蜀椒，理阳气药也，故病在阴者去之，如《肘后千金》阳毒去鳖甲有桂枝者。鳖，水族，
乃阴中之阳，不如桂枝能调阳络之血，阴毒不去蜀椒者，蜀椒亦阴中之阳，非若雄黄阳中之阳，故留之以治阴也。
方旨如此而已。
白头翁（二两） 黄连 黄柏 秦皮（各三两）
以上四味药，用水七升，煎煮至剩余二升，滤去药渣，温服一升，若未痊愈，再服用一升。
霖按：这是治疗厥阴热利（厥阴经受邪导致的以发热、下痢脓血为主要表现的病证）的方剂，为什么移用来治疗暑厥（因暑热之邪导致的神志昏迷、四肢逆冷）呢？因为白头翁在风中偏于静止，擅长驱散风邪，将其作为君药（主药），是因为风动则火生，风平则火熄，想要平息走窜窍道之火，必须使摇动之风安宁。秦皮、黄柏，能泻少阳相火（少阳经中的寄居之火），而手少阳三焦经与手厥阴心包经互为表里，所以佐以黄连来泻心包络火热，风平火熄，那么抽搐停止、四肢回暖了，这就是釜底抽薪（从根本上解决问题）的方法。
升麻 当归 甘草（各二两） 雄黄（半两，研碎） 蜀椒（炒制去油汗，一两） 鳖甲（手掌大一片，炙烤）
以上六味药，用水四升，煎煮至剩余一升，一次性服下，老人小孩可再服一次以取汗。《肘后备急方》和《千金方》中，阳毒使用升麻汤没有鳖甲，有桂枝；阴毒使用甘草汤，没有雄黄。
赵以德说：查阅古方书，称阳毒是阳气独盛，阴气突然衰败，内外都是阳，所以形成阳毒。称阴毒是阴气独盛，阳气突然衰败，内外都是阴，所以形成阴毒。这两种病或者在伤寒初起时就出现这种证候，或者服药后变化而成。阳毒完全用寒凉药物治疗，阴毒完全用温热药物治疗，药剂性质如同冰炭般不同，为什么张仲景用一个方子来治疗它们呢？如果说阴毒去掉雄黄、蜀椒，那就是反而去掉了温热药了。而且注释说：《肘后备急方》和《千金方》中阳毒用升麻汤没有鳖甲有桂枝，阴毒用甘草汤没有雄黄，这难道不是热毒伤害了阴阳两条经络吗？在阳经络则面色红赤斑纹如锦缎花纹，吐脓血，在阴经络则面色青紫身体像被棍棒打过一样，这都是阴阳水火动静的基本象如此，难道是寒热之邪吗？我曾经考察升麻鳖甲汤的药物在本草中的记载，说升麻能解时气毒厉各种毒，攻治咽喉痛，与热毒成脓，开通壅闭，治疗发斑。当归能破除恶血，滋养新血，补益五脏肌肤。甘草调和脾胃，利血脉，缓解急迫止痛，协调药物奏效。鳖甲去除恶血。雄黄破除骨节积聚，辟除鬼怪邪恶之气，治疗骨蒸潮热至极。蜀椒通血脉，调关节驱逐肌骨皮肤死肌，去除留结破血，治疗天行时气。诸药所能做到的如此，由此看来，张仲景对于阴阳两种毒证，总共使用一个方子，大概可以明白了。病形虽然由阴阳引发证候，论述邪气则都属于热毒与血病。所以不分表里，都用升麻解热毒作为君药，当归和血作为臣药，其余药物作为佐使而已。但是雄黄蜀椒，是调理阳气的药，所以病在阴者去掉它们，如《肘后备急方》和《千金方》中阳毒去掉鳖甲有桂枝的情况。鳖，是水族，属于阴中之阳，不如桂枝能调理阳络之血，阴毒不去掉蜀椒的原因，蜀椒也是阴中之阳，不像雄黄是阳中之阳，所以保留它来治疗阴证。方义主旨就是这样罢了。
Baitouweng (Radix Pulsatillae, 2 liang), Huanglian (Rhizoma Coptidis), Huangbai (Cortex Phellodendri), Qinpi (Cortex Fraxini) (each 3 liang).
The above four herbs are decocted with seven sheng of water until two sheng remain. The dregs are strained off, and the liquid is taken warm, one sheng at a time. If not cured, take another sheng.
Lin's Note: This is a formula for treating Jueyin Re Li (Heat Dysentery of the Jueyin Meridian). Why is it transferred to treat Shu Jue (Summerheat Collapse)? Baitouweng tends to remain still in the wind and is good at dispelling wind. It is used as the Jun herb (Chief Herb) because when wind moves, fire arises; when wind calms, fire extinguishes. To quell the fire that wanders into orifices, one must calm the agitated wind. Qinpi and Huangbai drain Shaoyang Xiang Huo (Ministerial Fire of Shaoyang). Since the Hand-Shaoyang Sanjiao Meridian and the Hand-Jueyin Pericardium Meridian are interior-exteriorly related, Huanglian is added as a Zuo herb (Assistant Herb) to drain the heat-fire of the Xinbao Luo (Pericardium Collateral). When wind calms and fire extinguishes, spasms cease and cold limbs return. This is the method of "removing firewood from under the cauldron" (treating the root cause).
Shengma (Rhizoma Cimicifugae), Danggui (Radix Angelicae Sinensis), Gancao (Radix Glycyrrhizae) (each 2 liang), Xionghuang (Realgar, half liang, ground), Shujiao (Fructus Zanthoxyli, stir-fried to remove oil/sweat, 1 liang), Biejia (Carapax et Plastrum Testudinis, one piece the size of a palm, roasted).
The above six herbs are decocted with four sheng of water until one sheng remains. Take it all at once. For the elderly and children, take again to induce sweating. In *Zhouhou Beiji Fang* (Emergency Prescriptions Kept Up My Sleeve) and *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold), Yang Du (Yang Toxicity) uses Shengma Tang without Biejia but with Guizhi (Ramulus Cinnamomi); Yin Du (Yin Toxicity) uses Gancao Tang without Xionghuang.
Zhao Yi-de said: According to ancient medical texts, Yang Du refers to a condition where Yang Qi is exclusively abundant while Yin Qi suddenly declines, resulting in an excess of Yang both internally and externally. Yin Du refers to a condition where Yin Qi is exclusively abundant while Yang Qi suddenly declines, resulting in an excess of Yin both internally and externally. These conditions may appear immediately upon the onset of Shanghan (Cold Damage) or develop after medication. Yang Du is treated entirely with cold-cooling agents, while Yin Du is treated entirely with warm-warming agents. The medicinal properties are as different as ice and charcoal. Why did Zhang Zhongjing use one formula to treat them? Although it is said that for Yin Du, Xionghuang and Shujiao are removed, this would mean removing the warming agents. Furthermore, the annotation states: In *Zhouhou Beiji Fang* and *Qianjin Fang*, Yang Du uses Shengma Tang without Biejia but with Guizhi, and Yin Du uses Gancao Tang without Xionghuang. Does this not indicate that heat-toxin has injured both the Yang and Yin meridians? When affecting the Yang meridian, the face is red with mottled patterns like brocade, and pus and blood are vomited. When affecting the Yin meridian, the face is blue-black, and the body feels as if beaten by a club. These are the fundamental manifestations of Yin-Yang, Water-Fire, Motion-Stillness. Are they not cold and heat pathogens? I have examined the materia medica regarding the herbs in Shengma Biejia Tang. It states that Shengma can resolve epidemic toxins and various poisons, treat sore throat, address abscesses formed by heat-toxin, open obstructions, and treat macules. Danggui can break up evil blood, nourish new blood, and tonify the five Zang organs and skin/flesh. Gancao harmonizes the middle jiao, benefits the vessels, relieves urgency and pain, and coordinates the efficacy of other herbs. Biejia removes evil blood. Xionghuang breaks up accumulations in bones and joints, wards off evil spirits and qi, and treats severe bone-steaming fever. Shujiao unblocks the vessels, regulates joints, expels dead flesh from muscles/bones/skin, removes stagnation and breaks blood, and treats epidemic seasonal diseases. Given these functions, it can be seen that Zhang Zhongjing used a single formula for both Yin and Yang Du syndromes. Although the clinical presentation arises from Yin-Yang imbalances, the pathogenic factor belongs to heat-toxin and blood disorders. Therefore, regardless of exterior-interior differentiation, Shengma is used as the Jun herb (Chief Herb) to resolve heat-toxin, and Danggui is used as the Chen herb (Deputy Herb) to harmonize blood, with the remaining herbs serving as Zuoshi herbs (Adjuvant/Envoy Herbs). However, Xionghuang and Shujiao are herbs that regulate Yang Qi, so they are removed when the disease is in the Yin aspect, similar to how *Zhouhou Beiji Fang* and *Qianjin Fang* remove Biejia and add Guizhi for Yang Du. The turtle is an aquatic creature, representing Yang within Yin. It is inferior to Guizhi in regulating blood in the Yang collaterals. Shujiao is not removed for Yin Du because Shujiao is also Yang within Yin, unlike Xionghuang which is Yang within Yang; thus, it is retained to treat Yin syndromes. Such is the purport of the formula.