治伤寒表不解,心下有水气,咳而微喘,干呕,发热不渴,或渴或利,或小便不利,少
腹满者;并治溢饮,身体重痛,肌肤悉肿。
麻黄(去节) 芍药 细辛 干姜 甘草 桂枝(各三两) 半夏 五味子(各半升) 水
一斗,先煮麻黄减二升,去沫,纳诸药,煮取三升,去滓,温服一升。(此方有加减法,
另详余所着《古方余论》中。
治肺胀咳而上气,烦躁而喘,脉浮者,心下有水气也。
小青龙汤原方加石膏二两。煮法同。强人服一升,虚人减之。
小青龙汤治水气,喘咳不渴呕利慰。(凡水停心下之证,多喘咳而不渴,此要诀也。其
余下利与小便不利,或然或不然也。)姜桂麻黄芍药甘,细辛半夏兼五味,备举辛温散水寒,
兼
病属有形,非一味发散所能除,故备举辛温以散水,兼用酸苦以安肺,于麻、桂二汤内,
不但留白芍之酸收,拘其发散之猛,再复五味、干姜摄太阳之气,监制其逆,细辛、半夏温
散水寒,从阴出阳,庶几水从汗解而不伤阴,此发汗散水之圣方也。)溢饮水肿服之奇,发
汗散水此所谓。(溢饮者,水肿也。水饮外溢于肌肤,旁流于四肢,故一身悉肿。然亦必有
喘咳见证,用此发汗散水,其效乃奇。)肺胀烦躁加石膏,寒温并进斯为贵。(肺胀咳喘,多
因水饮,而烦躁则挟热邪,故于小青龙汤加石膏,寒温并进,水热俱蠲,于法尤为密矣。)
治疗伤寒表证未解,心下有停饮,咳嗽且轻微气喘,干呕,发热但不口渴,或者出现口渴、腹泻,或者小便不利、小腹胀满的症状;同时也治疗溢饮,表现为身体沉重疼痛,全身肌肤浮肿。
麻黄(去节) 芍药 细辛 干姜 甘草 桂枝(各三两) 半夏 五味子(各半升) 用水一斗,先煮麻黄减少二升,撇去浮沫,加入其余药物,煎取三升,滤去药渣,温服一升。(此方有加减法,另详余所著《古方余论》中。)
治疗肺胀,咳嗽且气逆,烦躁而喘,脉象浮的,这是心下有停饮所致。
在小青龙汤原方基础上加石膏二两。煎煮方法相同。体质强者服一升,体质虚弱者减量服用。
小青龙汤主治水气引起的喘咳,不渴、呕吐或腹泻是常见症状。(凡是水饮停聚在心下的病证,多伴有喘咳且不口渴,这是关键要点。其余的下利与小便不利,或有或无。)方中包含姜、桂、麻黄、芍药、甘草,以及细辛、半夏和五味子,全面列举了辛温药物以散除水寒之邪,兼用酸苦药物以安定肺气。在麻黄汤和桂枝汤的基础上,不仅保留白芍的酸收之性,以制约发汗的猛烈之势,再用五味子和干姜摄纳太阳经之气,监制其逆乱;细辛和半夏温散水寒之邪,使病邪从阴出阳,这样水湿才能随汗而解而不伤阴液,这是发汗散水的圣方。(溢饮和水肿服用此方效果奇特,这就是所谓的发汗散水之法。)溢饮即是水肿。水饮外溢于肌肤,旁流于四肢,所以全身都浮肿。但也必然伴有喘咳的症状,使用此方发汗散水,疗效神奇。(肺胀伴烦躁加用石膏,寒温并用最为可贵。)肺胀咳嗽气喘,多因水饮引起,而烦躁则夹杂热邪,所以在小青龙汤中加入石膏,寒温并进,水热俱除,在治法上尤为严密。
Treats cases where the exterior syndrome of Shanghan (Cold Damage) is not resolved, with fluid retention in the epigastrium, coughing with slight wheezing, dry retching, fever without thirst, or alternatively thirst, diarrhea, or inadequate urination with fullness in the lower abdomen; also treats Yi Yin (Overflowing Drink), characterized by heaviness and pain in the body, and swelling of the skin and muscles throughout.
Ephedrae Herba (Mahuang, 麻黄) [devoid of joints], Paeoniae Radix Alba (Baishao, 白芍), Asari Radix et Rhizoma (Xixin, 细辛), Zingiberis Rhizoma Recens (Ganjiang, 干姜), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), Cinnamomi Ramulus (Guizhi, 桂枝) [each 3 liang], Pinelliae Rhizoma Preparatum (Banxia, 半夏), Schisandrae Fructus (Wuweizi, 五味子) [each 0.5 sheng]. Use one dou of water. First decoct Ephedrae Herba until reduced by two sheng, skim off the foam, then add the remaining herbs. Decoct to obtain three sheng, strain, and take one sheng warm. (This formula has modification methods, detailed elsewhere in my work *Gu Fang Yu Lun*.)
Treats Fei Zhang (Lung Distension) with coughing and qi rebellion, irritability, wheezing, and a floating pulse, which indicates fluid retention in the epigastrium.
Add Shi Gao (Gypsum Fibrosum, 石膏) 2 liang to the original Xiao Qing Long Tang (Minor Blue Dragon Decoction). The decoction method is the same. Strong individuals take one sheng; weak individuals reduce the dose.
Xiao Qing Long Tang (Minor Blue Dragon Decoction) treats wheezing and coughing caused by fluid qi; lack of thirst, vomiting, or diarrhea are common symptoms. (In all cases where fluid stagnates in the epigastrium, wheezing and coughing without thirst are prevalent; this is a key diagnostic point. Diarrhea and inadequate urination may or may not occur.) The formula includes Ginger, Cinnamon Twig, Ephedra, White Peony Root, Licorice, along with Asarum, Pinellia, and Schisandra. It comprehensively employs acrid-warm herbs to disperse cold-fluid, and simultaneously uses sour-bitter herbs to calm the Lung. Within the frameworks of Ma Huang Tang (Ephedra Decoction) and Gui Zhi Tang (Cinnamon Twig Decoction), it retains the astringent nature of Bai Shao (White Peony Root) to restrain the vigorous dispersing action. Furthermore, Wu Wei Zi (Schisandra) and Gan Jiang (Dried Ginger) gather the Qi of the Taiyang (Greater Yang) channel to control rebellious flow. Xi Xin (Asarum) and Ban Xia (Pinellia) warm and disperse cold-fluid, allowing the pathogen to emerge from Yin to Yang. Thus, the fluid resolves through sweating without injuring Yin. This is a supreme formula for inducing sweating to dissipate fluid. (It yields miraculous results for Yi Yin (Overflowing Drink) and edema; this is referred to as inducing sweating to dissipate fluid.) Yi Yin (Overflowing Drink) refers to edema. When fluid overflows into the skin and muscles and flows laterally into the limbs, the entire body swells. However, wheezing and coughing must necessarily be present. Using this formula to induce sweating and dissipate fluid yields miraculous efficacy. (For Fei Zhang (Lung Distension) accompanied by irritability, adding Shi Gao (Gypsum Fibrosum) is best. Combining cold and warm properties is precious.) Fei Zhang (Lung Distension) with coughing and wheezing is often due to fluid retention, while irritability indicates the presence of heat pathogens. Therefore, adding Shi Gao (Gypsum Fibrosum) to Xiao Qing Long Tang (Minor Blue Dragon Decoction) combines cold and warm actions, dispelling both fluid and heat, making the therapeutic method particularly rigorous.