治少阴咽痛。
半夏(洗) 桂枝(去皮) 甘草(炙各等分) 各别捣筛已,合治之,(各研另秤,
则分量准。)白饮和服方寸匕,日三服。若不能散服者,(咽痛能咽者用散,不能咽者用汤。)
以水一升
半夏散(及)汤(此一方二法∶咽痛能咽者用散,不能咽者用汤。)桂甘草,少阴咽痛
服之好。(此即桂枝甘草汤加半夏一味,但分两不同,便治证迥别,后人何得以古方轻于加
减也。)身不发热脉细微,恶寒欲吐方堪捣。(按“少阴病”三字,所该者广,必从少阴诸现
证细细详审,然后咽痛知为少阴之咽痛,否则何以知其非君相火炎与风温燥火之咽痛耶?此
方所主咽痛,脉必紧细,身不发热,必恶寒欲吐,咽虽痛而不红肿。盖阴寒之气上逆,浊痰
痹阻咽喉,故用半夏之辛温,豁其痹阻之痰浊,桂枝之辛热,散其上逆之阴寒,缓以甘草之
甘平,和以白饮之谷味,使少阴之邪由经脉而出肌表,悉从太阳开发,则桂枝、半夏治咽痛,
庶无劫液之虞。)
治伤寒脉浮,自汗出,小便数,心烦,微恶寒,脚挛急者;并治腹中不和而痛
芍药(四两) 甘草(四两炙) 水三升,煮一升五合,分温再服。
治伤寒发汗病不解,反恶寒者,虚故也。
芍药 甘草(各三两炙) 附子(一枚炮) 水五升,煮一升五合,分温三服。
芍药甘草汤平剂,(此亦桂枝汤之变,偏于营分,纯一不杂之方也。)和营止(腹)痛功
无比。(气血不和,肝木乘脾则腹痛。白芍酸收苦泄,能行营气而泻肝木,甘草甘缓,能和
逆气而补脾土,甘酸相合,甲己化土,故治腹痛。)芍药功专止汗烦,(芍药和营益阴,功专
止烦,烦止汗亦止,故《伤寒论》反烦、更烦、心悸而烦者,皆用之。)心烦脚挛阴虚致。
脚筋挛急属阳明,(两足脉阳明居其六行,故脚挛急属阳明。)不从标本从中治。(芍药止烦
汗,甘草缓挛急,斯合乎阳明不从表本,从乎中治之法。)又有芍甘附子汤,汗后而反恶寒
使。(脚挛急与芍药甘草汤,是治阴虚;此汗后反恶寒,是阴阳俱虚,故加附子。)
桂枝去芍药加蜀漆龙骨牡蛎救逆汤 治伤寒脉浮,误以火迫劫之,亡阳惊狂者。
桂枝汤原方去芍药,加蜀漆三两(洗去腥),牡蛎五两(熬),龙骨四两,为末,以水一
斗二升
治疗少阴经咽喉疼痛。
半夏(洗净) 桂枝(去皮) 甘草(炙,各等分)
将三味药分别捣碎、过筛后,混合均匀。(如果分别研磨并单独称量,则分量准确。)用米汤调和,每次服用一方寸匕的药粉,每日三次服用。如果不能服用散剂的患者,(咽喉疼痛但能吞咽的用散剂,不能吞咽的用汤剂。)
用水一升煮
半夏散及汤(此方有两种用法:咽喉疼痛且能吞咽的用散剂,不能吞咽的用汤剂。)桂枝、甘草,治疗少阴经咽喉疼痛,服用后痊愈。(这就是桂枝甘草汤加一味半夏,只是剂量不同,治疗的证候就截然不同,后人为什么轻易对古方进行加减呢?)身体不发热,脉象细微,恶寒,想呕吐,才适合捣碎服用。(按:“少阴病”三个字涵盖的范围很广,必须从少阴病的各种现症仔细详审,然后才能知道咽痛是少阴经的咽痛,否则怎么知道它不是君火相火上炎或风温燥火引起的咽痛呢?此方所主治的咽痛,脉象必定紧细,身体不发热,一定伴有恶寒、想呕吐的症状,咽喉虽然疼痛但不红肿。这是因为阴寒之气上逆,浊痰痹阻咽喉,所以用半夏的辛温,豁除痹阻的痰浊;用桂枝的辛热,疏散上逆的阴寒;用甘草的甘平来缓和,配合白饮的谷气,使少阴经的邪气通过经脉透出肌表,完全从太阳经发散出去,那么桂枝、半夏治疗咽痛,就没有劫伤津液的担忧了。)
治疗伤寒脉浮,自汗出,小便频数,心烦,微恶寒,脚部拘挛急迫者;同时也治疗腹中不和而疼痛的情况。
芍药(四两) 甘草(四两,炙)
用水三升,煮取一升五合,分两次温服。
治疗伤寒发汗后病未解除,反而出现恶寒症状的,这是虚证的表现。
芍药 甘草(各三两,炙) 附子(一枚,炮制)
用水五升,煮取一升五合,分三次温服。
芍药甘草汤是平和的方剂,(这也是桂枝汤的变方,偏重于营分,纯粹不杂的方子。)调和营卫、止痛的功效无与伦比。(气血不和,肝木乘脾则导致腹痛。白芍酸收苦泄,能运行营气而泻肝木;甘草甘缓,能调和逆气而补脾土,甘酸相合,甲己化土,所以治疗腹痛。)芍药的功效专门在于止汗除烦,(芍药调和营卫、益养阴液,功效专门在于止烦,烦止则汗也止,所以《伤寒论》中提到反烦、更烦、心悸而烦的情况,都使用它。)心烦和脚部拘挛是由阴虚导致的。
脚筋拘挛急迫属于阳明经,(双足的脉象中阳明经占据六行,所以脚部拘挛急迫归属于阳明经。)不从标本而从中间治法。(芍药止汗除烦,甘草缓解拘挛急迫,这符合阳明经不从表本、而从中焦治法的原则。)又有芍药甘草附子汤,发汗后反而恶寒使得病情复杂。(脚部拘挛急迫与芍药甘草汤,是治疗阴虚;此方发汗后反而恶寒,是阴阳俱虚,所以加入附子。)
桂枝去芍药加蜀漆龙骨牡蛎救逆汤 治疗伤寒脉浮,误用火法逼迫劫夺,导致亡阳、惊狂的患者。
桂枝汤原方去掉芍药,加入蜀漆三两(洗净去腥味),牡蛎五两(熬制),龙骨四两,研为末,用水一斗二升
Treats Shaoyin throat pain.
Banxia (Pinelliae Rhizoma, washed) Guizhi (Cinnamomi Ramulus, bark removed) Gancao (Glycyrrhizae Radix et Rhizoma, roasted, equal parts)
Crush and sieve each ingredient separately, then mix them together. (Grinding and weighing each separately ensures accurate dosage.) Mix with white rice decoction (Baiyin) and take one Fangcunbi (a square-inch measure) of the powder per dose, three times a day. For those who cannot take the powder form: (If swallowing is possible despite throat pain, use the powder; if not, use the decoction.)
Boil Banxia San Ji Tang (Banxia Powder or Decoction) in one sheng (approx. 200ml) of water. (This formula has two methods: use powder if swallowing is possible, use decoction if not.) Guizhi and Gancao treat Shaoyin throat pain; take it to recover. (This is essentially Guizhi Gancao Tang with the addition of Banxia. Although the ingredients are similar, the difference in dosage leads to vastly different therapeutic indications. Why do later practitioners lightly modify ancient formulas?) The body does not feel feverish, the pulse is fine and subtle, there is aversion to cold, and a desire to vomit; only in such cases is it suitable for crushing into powder. (Note: "Shaoyin disease" covers a broad range. One must carefully examine all Shaoyin manifestations to determine if the throat pain belongs to Shaoyin. Otherwise, how can one distinguish it from throat pain caused by ministerial fire flaring up or wind-warmth dryness-fire? The throat pain indicated by this formula presents with a tight, fine pulse, no fever, definite aversion to cold, and desire to vomit. Although the throat hurts, it is not red or swollen. This is due to Yin-cold qi reversing upward and turbid phlegm obstructing the throat. Therefore, Xianban's acrid-warm nature resolves the obstructing turbid phlegm; Guizhi's acrid-hot nature disperses the reversing Yin-cold; Gancao's sweet-neutral nature moderates, combined with the grain flavor of Baiyin, allowing the Shaoyin pathogen to exit via the meridians to the muscle surface, fully venting through the Taiyang opening. Thus, using Guizhi and Banxia for throat pain avoids the risk of damaging fluids.)
Treats Shanghan (Cold Damage) with floating pulse, spontaneous sweating, frequent urination, vexation, slight aversion to cold, and cramping/tethering of the feet; also treats abdominal discomfort and pain.
Shaoyao (Paeoniae Radix Alba, four liang) Gancao (Glycyrrhizae Radix et Rhizoma, roasted, four liang)
Boil in three sheng of water until one sheng five he remains. Divide into two warm doses.
Treats Shanghan where sweating fails to resolve the disease, and aversion to cold appears instead; this indicates deficiency.
Shaoyao Gancao (each three liang, roasted) Fuzi (Aconiti Lateralis Radix Praeparata, one piece, processed)
Boil in five sheng of water until one sheng five he remains. Divide into three warm doses.
Shaoyao Gancao Tang is a balanced formula. (It is also a variation of Guizhi Tang, focusing purely on the Ying level without impurity.) Its ability to harmonize Ying and stop pain is unparalleled. (When Qi and Blood are disharmonious, Liver Wood overacting on Spleen Earth causes abdominal pain. Baishao is sour and astringent, bitter and draining; it moves Ying Qi and drains Liver Wood. Gancao is sweet and relaxing; it harmonizes rebellious Qi and tonifies Spleen Earth. Sweet and Sour combine to transform into Earth (Jia-Ji Hua Tu), thus treating abdominal pain.) Shaoyao specializes in stopping sweating and relieving vexation. (Shaoyao harmonizes Ying and nourishes Yin, specializing in relieving vexation. When vexation ceases, sweating also stops. Hence, in the Shanghan Lun, cases of reverse vexation, worsening vexation, palpitations with vexation, all utilize it.) Vexation and foot cramping are caused by Yin deficiency.
Foot tendon cramping and tethering belong to Yangming. (The Yangming meridian runs through six paths in both legs, so foot cramping belongs to Yangming.) Treatment follows the middle method rather than the root or branch. (Shaoyao stops sweating and relieves vexation; Gancao relaxes cramping. This aligns with the Yangming principle of not treating the exterior/root but addressing the middle.) There is also Shaoyao Gancao Fuzi Tang, which addresses persistent aversion to cold after sweating. (Foot cramping treated by Shaoyao Gancao Tang indicates Yin deficiency; here, persistent aversion to cold after sweating indicates simultaneous deficiency of both Yin and Yang, hence the addition of Fuzi.)
Guizhi Qu Shaoyao Jia Shuqi Longgu Muli Jiuni Tang (Cinnamon Twig Decoction minus Paeonia plus Pinellia, Dragon Bone, and Oyster Shell Rescue Counter-Action Decoction)
Treats Shanghan with floating pulse, mistakenly treated with fire methods forcing sweating, leading to loss of Yang spirit, fright, and mania.
Take the original Guizhi Tang formula, remove Shaoyao, add Shuqi (Perillae Folium or similar, three liang, washed to remove fishy smell), Muli (Ostreae Concha, five liang, calcined), and Longgu (Fossilia Ossis Mamuthi, four liang). Grind into powder. Boil in twelve dou of water.