大;君一、臣二、佐九,制之大也。
其用有二∶一则病有兼证,邪气不专,不可以一二味治之,宜此大方之类是也。二则治肾、
肝在下而远者,宜分两多而顿服之是也。
小∶君一、臣二、佐四,制之小也。
其用有二∶一则病无兼证,邪气专一,不可以多味治之,宜此小方之类是也。二则治心、肺
在上而近者,宜分两少而频服之是也。
缓∶治主当缓,补上治上,制以缓。凡表里汗下,皆有所当缓。缓则气味薄,薄者则频
而
少服也。
其用有五∶有甘以缓之为缓方者,盖糖、蜜、枣、葵、甘草之类,取其恋膈故也。有丸
以缓之为缓方者,盖丸比汤、
散药力行迟故也。有品味群众之缓方者,盖药味众多,各不能骋其性也。有无毒治病之缓方
者,盖药无毒,则攻自缓也。
有气味薄之缓方者,盖气药味薄,则
急∶治客当急,补下治下,制以急。凡表里汗下,皆有所当急,急则气味浓,浓者则顿
而多服也。
其用有四∶有热盛攻下之急方者,谓热燥、前后闭结、谵忘狂越,宜急攻下之类是也。
有风淫疏涤之急方者,谓中
风口噤不省人事,宜急疏涤之类是也。有药毒治病之急方者,盖药有毒,攻击自速,服后上
涌下泻,夺其病之大势者是
也。有气味浓之急方者,盖药气味浓,则
奇∶君一、臣二,奇之制也。近者奇之,下者奇之。凡阳分者,皆为之奇也。
其用有二∶有药味单行之奇方者,谓独参汤之类是也。有病近宜用奇方者,谓君一、臣二,
君二、臣三。数合于阳也,故宜下之,不宜汗也。(王安导曰∶奇方力寡而微,凡下宜奇者,
谓下本易行,故宜之。偶则药毒,内攻太过也。)
偶∶君二、臣四,偶之制也。远者偶之,汗者偶之。凡在阴分者,皆为之偶也。
其用有三∶有两味相配之偶方者,谓沉附汤之类是也。有两方相合之偶方者,谓胃苓汤
之类
是也。有病远而宜用偶方者,谓君二、臣四,君四、臣六。数合于阴也,故宜汗之,不宜下
也。(王安导曰∶偶方力齐而大,凡汗宜偶者,谓汗或难出,故宜之。奇则药气外发,不足
也。)
奇与偶有味之奇偶,有数之奇偶,并当察之,则不失其寒温矣。
天之阳分为奇,假令升麻汤,升而不降也,亦谓之奇,以其在天之分也。
汗从九地之下,假令自地而升天,非苦无以至地,非温无以至天,故用苦温之剂,从九地之
下,发至九天之上,故为之偶。
地之阴分为偶,假令调胃承气汤,降而不升也,亦谓之偶,以其在地之分也。
下从九天之上,假令自天而降地,非辛无以至天,非凉无以至地,故用辛凉之剂,从九
天之
上,引至地之下,故为之奇。
复∶奇之不去,复以偶;偶之不去,复以奇,故曰复。复者,再也,重也。洁
古云∶十补一泻,数泻一补,所以使不失通塞之道也。
其用有二∶有二、三方相合之为复方者,如桂枝二越婢一汤之类是也。有分两匀同之为
复方
者,如胃风汤,各等分之类是也。又曰重复之复,二三方相合而用也。反复之复,谓奇之不
去,则偶之是也。
大方:君药一味,臣药二味,佐药九味,这是大方的制方规格。
它的应用有两种情况:一是疾病伴有兼证,邪气不单一,不能仅用一两味药治疗,适合使用这类大方。二是治疗位于下焦的肾、肝等脏腑,因距离较远,宜采用分量重且一次性服用的方法。
小方:君药一味,臣药二味,佐药四味,这是小方的制方规格。
它的应用有两种情况:一是疾病没有兼证,邪气单一,不能用多味药治疗,适合使用这类小方。二是治疗位于上焦的心、肺等脏腑,因距离较近,宜采用分量轻且频繁服用的方法。
缓方:治疗主病应当缓和,补益上焦或治疗上焦的病,制方宜缓。凡是表里、发汗、攻下等治法,都有应当缓和的情况。药性缓和则气味淡薄,气味淡薄的药物宜少量多次服用。
它的应用有五种情况:一是用甘味药来缓和,如糖、蜜、枣、冬葵子、甘草之类,取它们留恋膈间的作用。二是用丸剂来缓和,因为丸剂比汤剂、散剂的药力运行迟缓。三是药味众多的缓方,因为药味众多,各药的偏性不能充分发挥。四是无毒药物治疗疾病的缓方,因为药物无毒,攻击之力自然缓慢。五是气味淡薄的缓方,因为药气和药味淡薄,所以作用缓和。
急方:治疗客邪应当紧急,补益下焦或治疗下焦的病,制方宜急。凡是表里、发汗、攻下等治法,都有应当紧急的情况。药性急迫则气味浓厚,气味浓厚的药物宜一次性大量服用。
它的应用有四种情况:一是热盛需急攻下的急方,指热燥、前后二便闭结、胡言乱语、神志狂越等症状,宜急攻下。二是风邪淫溢需急疏涤的急方,指中风导致口噤、不省人事,宜急疏涤。三是药毒治病需急救的急方,因为药物有毒,攻击速度自快,服用后引起呕吐或腹泻,以迅速夺取病势。四是气味浓厚的急方,因为药气和药味浓厚,所以作用急迫。
奇方:君药一味,臣药二味,这是奇方的制方规格。病位近的宜用奇方,病位下的宜用奇方。凡属阳分的病,都适用奇方。
它的应用有两种情况:一是药味单行的奇方,如独参汤之类。二是病位适宜用奇方的情况,指君一臣二、君二臣三。数字合于阳数,所以适宜攻下,不适宜发汗。(王安道说:奇方药力单薄而轻微,凡是适宜用奇方攻下的,是因为攻下本来容易施行,所以适宜用之。如果用偶方,则药力过猛,内攻太过。)
偶方:君药二味,臣药四味,这是偶方的制方规格。病位远的宜用偶方,发汗的宜用偶方。凡属阴分的病,都适用偶方。
它的应用有三种情况:一是两味药相配的偶方,如沉附汤之类。二是两方相合的偶方,如胃苓汤之类。三是病位遥远适宜用偶方的情况,指君二臣四、君四臣六。数字合于阴数,所以适宜发汗,不适宜攻下。(王安道说:偶方药力均衡且宏大,凡是适宜用偶方发汗的,是因为发汗有时难以排出,所以适宜用之。如果用奇方,则药气向外发散,力量不足。)
奇方和偶方有味道的奇偶,也有数量的奇偶,都应当仔细考察,才不会违背寒温的原则。
天的阳分属于奇,例如升麻汤,只有升发而没有沉降,也称为奇方,因为它作用于天的部位。
汗法从九地之下起效,例如从地上升到天,没有苦味无法到达地下,没有温性无法到达天上,所以使用苦温的药剂,从九地之下,发至九天之上,因此称为偶方。
地的阴分属于偶,例如调胃承气汤,只有沉降而没有升发,也称为偶方,因为它作用于地的部位。
下法从九天之上起效,例如从天下降到地,没有辛味无法到达天上,没有凉性无法到达地下,所以使用辛凉的药剂,从九天之上,引至地之下,因此称为奇方。
复方:奇方无效,再用偶方;偶方无效,再用奇方,所以叫复。复者,再也,重也。洁古说:十次补益配合一次泻下,数次泻下配合一次补益,以此来保持通塞的平衡之道。
它的应用有两种情况:有二方或三方相合而成的复方,如桂枝二越婢一汤之类。有分量均匀的复方,如胃风汤,各药等分之类。又有一种“重复”的复,指二三方相合而用。还有一种“反复”的复,指奇方无效,则改用偶方。
Large Formula (Da Fang): One sovereign herb, two minister herbs, nine assistant herbs; this constitutes the specification of a large formula.
Its applications are twofold: First, when a disease presents with concurrent syndromes and the pathogenic factor is not singular, it cannot be treated with only one or two herbs; such cases are suitable for large formulas. Second, when treating the Kidney and Liver located in the lower jiao (Lower Burner), which are distant from the stomach and intestines, it is appropriate to use larger dosages administered in a single dose.
Small Formula (Xiao Fang): One sovereign herb, two minister herbs, four assistant herbs; this constitutes the specification of a small formula.
Its applications are twofold: First, when a disease lacks concurrent syndromes and the pathogenic factor is singular, it should not be treated with multiple herbs; such cases are suitable for small formulas. Second, when treating the Heart and Lung located in the upper jiao (Upper Burner), which are close to the stomach and intestines, it is appropriate to use smaller dosages administered frequently.
Slow-Acting Formula (Huan Fang): Treatment of the primary condition should be slow; tonification of the upper jiao or treatment of diseases in the upper jiao requires a slow-acting formulation. Whether addressing exterior/interior conditions, inducing sweating, or purging, there are situations requiring slowness. A slow action implies thin qi and flavor; substances with thin qi and flavor should be taken in small amounts but frequently.
Its applications are fivefold: 1) Using sweet herbs to induce slowness, such as sugar, honey, dates, Malva verticillata seeds, and Glycyrrhizae Radix et Rhizoma (Licorice Root), taking advantage of their ability to linger in the diaphragm. 2) Using pills to induce slowness, as pill formulations act more slowly than decoctions or powders. 3) Formulas with numerous ingredients, where the multitude of herbs prevents any single herb from exerting its full potency rapidly. 4) Formulas using non-toxic herbs to treat disease, where the absence of toxicity naturally results in a slower attack on the pathogen. 5) Formulas with thin qi and flavor, where the subtle nature of the herbs leads to a gentle effect.
Urgent Formula (Ji Fang): Treatment of exogenous pathogens should be urgent; tonification of the lower jiao or treatment of diseases in the lower jiao requires an urgent formulation. Whether addressing exterior/interior conditions, inducing sweating, or purging, there are situations requiring urgency. An urgent action implies strong qi and flavor; substances with strong qi and flavor should be taken in large amounts in a single dose.
Its applications are fourfold: 1) Urgent purgation for excessive heat, indicated by dryness, constipation of both bowels, delirium, and mania, requiring immediate purgation. 2) Urgent cleansing for wind invasion, indicated by stroke with locked jaw and loss of consciousness, requiring immediate cleansing. 3) Emergency treatment for drug toxicity, where toxic herbs act swiftly; administration induces vomiting or diarrhea to rapidly overcome the severe pathological trend. 4) Formulas with strong qi and flavor, where the potent nature of the herbs leads to an urgent effect.
Odd Formula (Qi Fang): One sovereign herb, two minister herbs; this constitutes the specification of an odd formula. Diseases located proximally or inferiorly are treated with odd formulas. All conditions in the Yang aspect are treated with odd formulas.
Its applications are twofold: 1) Odd formulas with single-natured herbs, such as Du Shen Tang (Single Ginseng Decoction). 2) Cases where the pathology suits an odd formula, defined as one sovereign and two ministers, or two sovereigns and three ministers. These numbers align with Yang; thus, they are suitable for purgation rather than inducing sweating. (Wang Andao stated: Odd formulas have weak power. When purgation is indicated, an odd formula is suitable because purgation is inherently easier to execute. Using an even formula would result in excessive internal attack.)
Even Formula (Ou Fang): Two sovereign herbs, four minister herbs; this constitutes the specification of an even formula. Diseases located distally or those requiring induced sweating are treated with even formulas. All conditions in the Yin aspect are treated with even formulas.
Its applications are threefold: 1) Even formulas composed of paired herbs, such as Chen Fu Tang (Cyperus and Aconite Decoction). 2) Even formulas formed by combining two prescriptions, such as Wei Ling Tang (Stomach and Five Herbs Decoction). 3) Cases where distant pathology suits an even formula, defined as two sovereigns and four ministers, or four sovereigns and six ministers. These numbers align with Yin; thus, they are suitable for inducing sweating rather than purgation. (Wang Andao stated: Even formulas have balanced and substantial power. When sweating is indicated, an even formula is suitable because sweating can be difficult to achieve. Using an odd formula would cause the medicinal qi to disperse outwardly, resulting in insufficient power.)
Both Odd and Even formulas involve odd/even characteristics in terms of taste and numerical composition, which must be carefully examined to avoid violating principles of cold and warmth.
The Yang aspect of Heaven corresponds to Odd. For example, Sheng Ma Tang (Cimicifugae Decoction) ascends without descending, hence it is called an Odd formula, as it acts in the realm of Heaven.
Sweating originates from the depths of Earth (Nine Earths). To ascend from Earth to Heaven, bitter flavors are needed to reach the depths, and warm properties are needed to reach the heights. Therefore, bitter-warm agents are used to rise from Nine Earths to Nine Heavens, making it an Even formula.
The Yin aspect of Earth corresponds to Even. For example, Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction) descends without ascending, hence it is called an Even formula, as it acts in the realm of Earth.
Purgation originates from the heights of Heaven (Nine Heavens). To descend from Heaven to Earth, pungent flavors are needed to reach the heights, and cool properties are needed to reach the depths. Therefore, pungent-cool agents are used to guide from Nine Heavens down to the depths of Earth, making it an Odd formula.
Compound Formula (Fu Fang): If an Odd formula fails, apply an Even formula; if an Even formula fails, apply an Odd formula; hence it is called "Fu" (Repeat/Compound). "Fu" means again or repeatedly. Jiegu stated: Ten parts tonification to one part purgation, or several parts purgation to one part tonification, serves to maintain the balance of unblocking and obstructing.
Its applications are twofold: 1) Compounds formed by combining two or three formulas, such as Gui Zhi Er Yue Bi Yi Tang (Two Parts Cinnamon Twig and One Part Ephedra Decoction). 2) Compounds with equal dosages, such as Wei Feng Tang (Wind Protecting Decoction), where all herbs are used in equal proportions. Additionally, "Fu" refers to repetition in combination (combining two or three formulas) and "Fu" refers to alternation (if an Odd formula fails, switch to an Even formula).