黄芩(三两味苦寒) 甘草(二两炙味甘平) 芍药(二两味酸平) 大枣(二十
枚擘味甘温)
上四味。以水一斗。煮取三升。去滓、温服一升。日再。夜一服。若呕者。加半夏
半升。生姜三两。
虚而不实者。苦以坚之。酸以收之。黄芩芍药之苦酸。以坚敛肠胃之气。弱而不足
者。甘以补之。甘草大枣之甘。以补固肠胃之弱。
于黄芩汤方内。加半夏半升。生姜一两半。余根据黄芩汤法服。
伤寒胸中有热。胃中有邪气。腹中痛。欲呕吐者。黄连汤主之。
湿家下后。舌上如苔者。以丹田有热。胸中有寒。是邪气入里。而为下热上寒也。
此伤寒邪气传里。而为下寒上热也。胃中有邪气。使阴阳不交。阴不得升。而独治于
下。为下寒。腹中痛。阳不得降。而独治于上。为胸中热。欲呕吐。与黄连汤。升降阴
阳之气。
黄连(味苦寒) 甘草(炙味甘平) 干姜(味辛热) 桂枝(去皮味辛热各三两)
人参(二两味甘温) 半夏(半升洗味辛温) 大枣(十二枚擘味辛温)
上七味。以水一斗。煮取六升。去滓、温服一升。日三服。夜二服。
上热者。泄之以苦。黄连之苦以降阳。下寒者。散之以辛。桂姜半夏之辛以升阴。
脾欲缓。急食甘以缓之。人参甘草大枣之甘以益胃。
伤寒八九日。风湿相搏。身体疼烦。不能自转侧。不呕不渴。脉浮虚而涩者。桂枝
附子汤主之。
伤寒与中风家。至七八日再经之时。则邪气多在里。身必不苦疼痛。今日数多。
复身体疼烦。不能自转侧者。风湿相搏也。烦者风也。身疼不能自转侧者湿也。经曰。
风则浮虚。脉经曰。脉来涩者。为病寒湿也。不呕不渴。里无邪也。脉得浮虚而涩。身
有疼烦。知风湿但在经也。与桂枝附子汤。以散表中风湿。
若其人大便硬。小便自利者。去桂枝加白术汤主之。
桂发汗。走津液。此小便利。大便硬。为津液不足去桂加术。
黄芩(三两,味苦性寒) 甘草(二两,炙用,味甘性平) 芍药(二两,味酸性平) 大枣(二十枚,掰开,味甘性温)
以上四味药。用水一斗。煎煮至剩余三升。滤去药渣。每次温服一升。每日两次。夜间一次服用。如果出现呕吐症状。加入半夏半升。生姜三两。
体质虚弱而肠胃功能不充实者。用苦味药来坚固它。用酸味药来收敛它。黄芩和芍药的苦酸之性。用来坚固和收敛肠胃之气。体质柔弱而正气不足者。用甘味药来补益它。甘草和大枣的甘味。用来补益和巩固肠胃的虚弱。
在黄芩汤方剂内。加入半夏半升。生姜一两半。其余按照黄芩汤的方法服用。
伤寒病邪导致胸中有热。胃中有邪气。腹部疼痛。想要呕吐的。主治用黄连汤。
患有湿病的患者经过泻下治疗后。舌面上像有苔垢一样。这是因为丹田(下焦)有热。胸中(上焦)有寒。这是邪气入里。形成了下热上寒的局面。
这是伤寒邪气传入体内。形成了下寒上热的局面。胃中有邪气。使得阴阳之气不能交通。阴气不能上升。而独自治理于下部。形成下寒。腹部疼痛。阳气不能下降。而独自治理于上部。形成胸中热。想要呕吐。给予黄连汤。以升降阴阳之气。
黄连(味苦性寒) 甘草(炙用,味甘性平) 干姜(味辛性热) 桂枝(去皮,味辛性热,各三两)
人参(二两,味甘性温) 半夏(半升,洗过,味辛性温) 大枣(十二枚,掰开,味辛性温)
以上七味药。用水一斗。煎煮至剩余六升。滤去药渣。每次温服一升。每日三次。夜间两次服用。
上部有热者。用苦味药泄降它。黄连的苦味用来降阳。下部有寒者。用辛味药散除它。桂枝、干姜、半夏的辛味用来升阴。
脾脏喜欢舒缓。急需食用甘味药来缓和它。人参、甘草、大枣的甘味用来补益胃气。
伤寒病程到了第八九日。风邪与湿邪相互搏结。身体疼痛烦躁。不能自行翻身转动。没有呕吐也没有口渴。脉象浮虚而涩的。主治用桂枝附子汤。
患伤寒或中风的病人。到了第七八日再次传经的时候。邪气多在体内。身体一定不再感到剧烈疼痛。如果现在天数多了。又出现身体疼痛烦躁。不能自行翻身转动的。这是风邪与湿邪相互搏结。烦躁是风邪所致。身体疼痛不能自行翻身转动是湿邪所致。经典说。风邪致病脉象浮虚。脉经说。脉象来势涩滞的。是寒湿病。没有呕吐没有口渴。说明体内没有邪气。脉象呈现浮虚而涩。身体有疼痛烦躁。知道风湿邪气只在经络表浅处。给予桂枝附子汤。以发散体表的风湿邪气。
如果这个人大便干硬。小便通畅自利的。去掉桂枝。加入白术的方剂主治。
桂枝发汗。耗散津液。这里小便通利。大便干硬。是因为津液不足。所以去掉桂枝加入白术。
Huangqin (Radix Scutellariae, three liang, bitter and cold) Gancao (Radix Glycyrrhizae Preparata, two liang, roasted, sweet and neutral) Shaoyao (Radix Paeoniae Alba, two liang, sour and neutral) Dazao (Fructus Jujubae, twenty pieces, torn open, sweet and warm)
The above four herbs. Use one dou of water. Boil to obtain three sheng. Remove the dregs. Take one sheng warm. Twice a day. Once at night. If vomiting occurs, add Banxia (Rhizoma Pinelliae) half a sheng and Shengjiang (Rhizoma Zingiberis Recens), three liang.
For those who are deficient but not solid, use bitter substances to firm them. Use sour substances to astringe them. The bitter and sour properties of Huangqin and Shaoyao are used to firm and astringe the qi of the intestines and stomach. For those who are weak and insufficient, use sweet substances to tonify them. The sweet properties of Gancao and Dazao are used to tonify and consolidate the weakness of the intestines and stomach.
Add Banxia (Rhizoma Pinelliae) half a sheng and Shengjiang (Rhizoma Zingiberis Recens) one liang and a half to the Huangqin Tang (Scutellaria Decoction). Follow the method of Huangqin Tang for administration otherwise.
In Shanghan (Cold Damage) with heat in the chest and pathogenic qi in the stomach, accompanied by abdominal pain and a desire to vomit, Lindan Tang (Coptis Decoction) is the primary treatment.
After purgation in patients with dampness disorders, if the tongue surface appears coated, it indicates heat in the Dantian (lower jiao) and cold in the chest (upper jiao). This signifies pathogenic qi entering the interior, resulting in lower heat and upper cold.
This refers to Shanghan pathogenic qi transmitting to the interior, resulting in lower cold and upper heat. Pathogenic qi in the stomach prevents the interaction of yin and yang. Yin fails to ascend and governs alone in the lower part, causing lower cold and abdominal pain. Yang fails to descend and governs alone in the upper part, causing heat in the chest and a desire to vomit. Administer Lindan Tang (Coptis Decoction) to regulate the ascending and descending of yin and yang qi.
Huanglian (Rhizoma Coptidis, bitter and cold) Gancao (Radix Glycyrrhizae Preparata, roasted, sweet and neutral) Ganjiang (Rhizoma Zingiberis, pungent and hot) Guizhi (Ramulus Cinnamomi, bark removed, pungent and hot, each three liang)
Renshen (Radix Ginseng, two liang, sweet and warm) Banxia (Rhizoma Pinelliae, half a sheng, washed, pungent and warm) Dazao (Fructus Jujubae, twelve pieces, torn open, pungent and warm)
The above seven herbs. Use one dou of water. Boil to obtain six sheng. Remove the dregs. Take one sheng warm. Three times a day. Twice at night.
For heat in the upper part, drain it with bitterness. The bitterness of Huanglian (Rhizoma Coptidis) descends yang. For cold in the lower part, disperse it with pungency. The pungency of Guizhi (Ramulus Cinnamomi), Ganjiang (Rhizoma Zingiberis), and Banxia (Rhizoma Pinelliae) ascends yin.
The spleen desires relaxation; urgently consume sweet substances to relax it. The sweetness of Renshen (Radix Ginseng), Gancao (Radix Glycyrrhizae Preparata), and Dazao (Fructus Jujubae) benefits the stomach.
In Shanghan (Cold Damage) lasting eight or nine days, where wind and dampness contend, causing body pain and restlessness, inability to turn over independently, no vomiting, no thirst, and a floating, deficient, and choppy pulse, Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) is the primary treatment.
In cases of Shanghan (Cold Damage) or Zhongfeng (Wind Strike), upon reaching the seventh or eighth day during the second cycle of transmission, pathogenic qi is mostly in the interior, and the body typically does not suffer from severe pain. If now, after many days, there is body pain and restlessness with an inability to turn over independently, this is due to wind and dampness contending. Restlessness is caused by wind. Body pain and inability to turn over are caused by dampness. The classics state: "Wind results in a floating and deficient pulse." The Pulse Classic states: "A choppy pulse indicates disease from cold and dampness." No vomiting and no thirst indicate no pathogenic qi in the interior. With a floating, deficient, and choppy pulse and body pain/restlessness, it is known that wind and dampness remain only in the meridians/exterior. Administer Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) to dissipate wind and dampness from the exterior.
If the person has hard stool and spontaneous urination, remove Guizhi (Ramulus Cinnamomi) and add Baizhu (Rhizoma Atractylodis Macrocephalae); the modified formula is the primary treatment.
Guizhi (Ramulus Cinnamomi) induces sweating and depletes body fluids. Here, with frequent urination and hard stool, it indicates insufficiency of body fluids. Therefore, remove Guizhi (Ramulus Cinnamomi) and add Baizhu (Rhizoma Atractylodis Macrocephalae).