主治项背强也。旁治喘而汗出。
考 证
葛根黄连黄芩汤证曰∶喘而汗出。(说在互考中)
以上一方,葛根半斤。
葛根汤证曰∶项背强。
葛根加半夏汤,证不具也。(说在互考中)
桂枝加葛根汤证曰∶项背强。
以上三方,葛根皆四两。
为则曰∶葛根主治项背强急也。葛根汤及桂枝加葛根汤,皆足以征焉。
互 考
葛根黄连黄芩汤,其用葛根最多,而无项背强急之证,盖阙文也。施诸下利喘而汗出者,
终
葛根加半夏汤条曰∶太阳与阳明合病,此须疾医之言也,不取焉。葛根汤证而呕者,此
方即主之也。
品 考
葛根 和、汉无异种。药铺所谓生干者,是为良也。锉用。
主治水也。
考 证
木防己汤证曰∶支饮。
防己茯苓汤证曰∶四肢肿。
防己黄 汤证曰∶身重。又曰∶肿及阴。
以上三方,防己皆四两。
己椒苈黄丸证曰∶肠间有水气。
以上一方,防己一两。
上历观此诸方,其治水也明矣,未见施诸他证者也。
互 考
木防己汤,人参为君,故治心下痞坚而有水者。防己茯苓汤,茯苓为君,故治四肢聂聂
动而水肿者。防己黄 汤,黄 为君,故治身重汗出而水肿者。仲景氏用防己,未见以为君
药者也,而其治水也的然明矣。
品 考
防己 有汉木二种。余家用所谓汉防己者也。为则按∶木防己,出汉中者,谓之汉防己,
譬如汉术辽五味子也。后世岐而二之,其茎谓之木防己,可谓误矣。余试用所谓木防己者,
终无寸效。而所谓汉防己者,能治水也,于是断乎用之。陶弘景曰∶大而青白色虚软者好,
墨点木强者不佳。李当之曰∶其茎如葛蔓延,其根外白内黄,如桔梗,内有黑纹,如车辐解
者良。颂曰∶汉中出者,破之文作车辐解,黄实而香,茎梗甚嫩、苗叶小类牵牛。折其茎,
一头吹之,气从中贯,如木通然。它处者青白虚软,又有腥气,皮皱,上有丁足子,名木防
己。苏恭曰∶木防己,不任用也。
考证
葛根黄连黄芩汤证表现为:气喘且伴有汗出。(详见互考部分)
以上一方,葛根用量为半斤。
葛根汤证表现为:项背强急。
葛根加半夏汤,其证候不全备。(详见互考部分)
桂枝加葛根汤证表现为:项背强急。
以上三方,葛根用量均为四两。
吉益东洞(为则)说:葛根主治项背强急。葛根汤及桂枝加葛根汤,都足以作为证据。
互考
葛根黄连黄芩汤中,葛根的用量最多,但并没有项背强急的症状,这大概是原文有缺漏。应用于下利、气喘且汗出的患者,
终归有效。
葛根加半夏汤条文中说:“太阳与阳明合病”,这是需要医生判断的言辞,不予采纳。如果是葛根汤证兼见呕吐者,此方即主治之。
品考
葛根:中国和日本没有不同的品种。药铺所说的“生干”葛根,是品质优良的。需切碎后使用。
主治水饮病。
考证
木防己汤证表现为:支饮(水饮停聚胸膈)。
防己茯苓汤证表现为:四肢浮肿。
防己黄芪汤证表现为:身体沉重。又说:水肿波及阴部。
以上三方,防己用量均为四两。
己椒苈黄丸证表现为:肠间有水气。
以上一方,防己用量为一两。
纵观上述各方,其治疗水饮的作用是很明确的,未见用于其他证候的情况。
互考
木防己汤以人参为君药,所以治疗心下痞硬且有水饮者。防己茯苓汤以茯苓为君药,所以治疗四肢微微跳动且水肿者。防己黄芪汤以黄芪为君药,所以治疗身体沉重、出汗且水肿者。张仲景使用防己,未见将其作为君药的情况,但其治疗水饮的作用是确凿无疑的。
品考
防己有汉防己和木防己两种。我家使用的是所谓的汉防己。吉益东洞按语说:出自汉中的木防己,称为汉防己,就像苍术被称为汉术、五味子被称为辽五味子一样。后世将其分为两类,称其茎为木防己,这是错误的。我试用所谓的木防己,最终毫无效果。而所谓的汉防己,能治疗水饮病,于是我坚决使用它。陶弘景说:大而呈青白色、质地虚软的为好,有墨点且木质坚硬的不好。李当之说:其茎像葛藤一样蔓延,其根外部白色内部黄色,像桔梗,内部有黑色纹理,像车轮辐条散开形状的是良材。苏颂说:汉中出产的,剖开后纹理呈车轮辐条状,黄色且香,茎梗很嫩,苗叶小得像牵牛花。折断其茎,从一头吹气,气流贯通其中,像木通一样。其他地方出产的呈青白色、质地虚软,又有腥味,皮皱,上面有丁足子,称为木防己。苏恭说:木防己,不可任用。
Translation of the main indications: It governs stiffness and tension in the neck and back. As a secondary indication, it treats wheezing accompanied by sweating.
Textual Verification (Kao Zheng)
The syndrome of Gegen Lianlian Huangqin Tang (Coptis and Scutellaria Decoction with Kudzu Root) is characterized by: wheezing accompanied by sweating. (See Mutual Examination below).
In the above-mentioned one formula, the dosage of Ge Gen (Puerariae Lobatae Radix) is half a jin (approx. 250g or 500g depending on historical standard, kept as 'half a jin').
The syndrome of Gegen Tang (Kudzu Root Decoction) is characterized by: stiffness and tension in the neck and back.
The syndrome of Gegen Jia Banxia Tang (Kudzu Root Decoction with Pinellia) is not fully specified. (See Mutual Examination below).
The syndrome of Guizhi Jia Gegen Tang (Cinnamon Twig Decoction with Kudzu Root) is characterized by: stiffness and tension in the neck and back.
In the above three formulas, the dosage of Ge Gen (Puerariae Lobatae Radix) is four liang (approx. 60g or 120g depending on historical standard, kept as 'four liang') in each.
Yoshimasu Todo stated: Ge Gen (Puerariae Lobatae Radix) primarily governs stiffness and tension in the neck and back. Both Gegen Tang (Kudzu Root Decoction) and Guizhi Jia Gegen Tang (Cinnamon Twig Decoction with Kudzu Root) serve as sufficient evidence for this.
Mutual Examination (Hu Kao)
In Gegen Lianlian Huangqin Tang (Coptis and Scutellaria Decoction with Kudzu Root), the dosage of Ge Gen (Puerariae Lobatae Radix) is the highest, yet there is no symptom of stiffness and tension in the neck and back; this is likely due to missing text in the original source. When applied to patients with diarrhea, wheezing, and sweating, [it is effective].
Regarding the clause for Gegen Jia Banxia Tang (Kudzu Root Decoction with Pinellia): "Taiyang and Yangming combined disease" is a phrase requiring medical judgment, so it is not adopted here. If the Gegen Tang (Kudzu Root Decoction) syndrome presents with vomiting, this formula is indicated.
Product Examination (Pin Kao)
Ge Gen (Puerariae Lobatae Radix): There are no different species between China and Japan. The "raw dried" Ge Gen (Puerariae Lobatae Radix) sold in herbal shops is of good quality. It should be sliced before use.
It governs water retention (Shui Yin).
Textual Verification (Kao Zheng)
The syndrome of Mufangji Tang (Stephania Tetrandra Decoction) is characterized by: Zhi Yin (fluid retention in the chest and diaphragm).
The syndrome of Fangji Fuling Tang (Stephania Tetrandra and Poria Decoction) is characterized by: edema of the four limbs.
The syndrome of Fangji Huangqi Tang (Stephania Tetrandra and Astragalus Decoction) is characterized by: heaviness of the body. It also states: edema extending to the genital area.
In the above three formulas, the dosage of Fang Ji (Stephaniae Tetrandrae Radix) is four liang (approx. 60g or 120g depending on historical standard, kept as 'four liang') in each.
The syndrome of Jingjiao Li Huang Wan (Alisma, Cistanche, and Catharanthus Pill) is characterized by: water qi in the intestines.
In the above-mentioned one formula, the dosage of Fang Ji (Stephaniae Tetrandrae Radix) is one liang (approx. 15g or 30g depending on historical standard, kept as 'one liang').
Having observed these various formulas, their function in treating water retention is clear; they have not been seen used for other syndromes.
Mutual Examination (Hu Kao)
In Mufangji Tang (Stephania Tetrandra Decoction), Ren Shen (Ginseng Radix et Rhizoma) is the sovereign herb, thus it treats epigastric fullness and hardness with fluid retention. In Fangji Fuling Tang (Stephania Tetrandra and Poria Decoction), Fu Ling (Poria) is the sovereign herb, thus it treats slight tremors in the four limbs with edema. In Fangji Huangqi Tang (Stephania Tetrandra and Astragalus Decoction), Huang Qi (Astragali Radix) is the sovereign herb, thus it treats heaviness of the body, sweating, and edema. Zhang Zhongjing used Fang Ji (Stephaniae Tetrandrae Radix), but it was never used as the sovereign herb; however, its efficacy in treating water retention is unequivocally clear.
Product Examination (Pin Kao)
Fang Ji (Stephaniae Tetrandrae Radix) has two types: Han Fang Ji (Chinese Stephania) and Mu Fang Ji (Woody Stephania). My family uses what is called Han Fang Ji (Chinese Stephania). Yoshimasu Todo commented: Woody Stephania originating from Hanzhong is called Han Fang Ji (Chinese Stephania), just as Atractylodes Macrocephala is called Han Zhu (Chinese Atractylodes) and Schisandra Chinensis is called Liao Wuweizi (Liaoning Schisandra). Later generations erroneously divided them into two, calling the stem "Mu Fang Ji" (Woody Stephania). I tested the so-called Mu Fang Ji (Woody Stephania) and found it completely ineffective. However, the so-called Han Fang Ji (Chinese Stephania) can treat water retention, so I firmly decided to use it. Tao Hongjing said: Those that are large, bluish-white, and spongy/soft are good; those with black spots and woody/hard texture are poor. Li Dangzhi said: Its stems creep like Kudzu; its root is white outside and yellow inside, resembling Platycodon Grandiflorus, with black veins inside resembling the spokes of a wheel; such roots are of good quality. Su Song said: Those from Hanzhong, when broken, show patterns resembling wheel spokes, are yellow and fragrant, have tender stems, and small leaves resembling Ipomoea Batatas. If you break the stem and blow into one end, air passes through as if it were Thunbergia Laurifolia. Those from other places are bluish-white, spongy/soft, have a fishy odor, wrinkled skin, and bumps named "Ding Zu Zi," called Mu Fang Ji (Woody Stephania). Su Gong said: Mu Fang Ji (Woody Stephania) should not be used.