《伤寒》《金匮》方 后汉张仲景着《伤寒》《金匮》两书，为后世医方之祖。其方治病，
虽千头万绪，而条理不紊。方中之药，少者仅一二味，而又无所不包括；多者至二三十味，
而又无一味不紧切，所以谓之“方祖”。此卷所辑，皆其方也。间附后世数方，使人从流溯
源，知夫熔古化新之妙。学人能于此卷诸方，精思而熟读之，应变无穷矣。
治太阳病风寒在表，头项强痛，身疼腰痛，骨节疼痛，发热恶寒，恶风无汗，胸满而喘，
其脉浮紧或浮数者，宜此发汗。若脉浮弱，汗自出，或尺脉微迟者，俱不可服。若风、寒、
湿三气成痹，及冷风哮嗽，最效也。
麻黄（三两去节） 桂枝（二两去皮） 杏仁（七十个去皮尖） 甘草（一两炙） 以
水九升，先煮麻黄减二升，去上沫，纳诸药，煮取二升半，去滓，温服八合。复取微似汗，
不须啜粥。
治湿家身烦疼。
麻黄汤原方加白术四两。
麻黄发汗之峻剂，监以桂草斯无弊。（麻黄开窍发汗，性最猛烈，故以桂枝监之，不使
其大汗亡阳，甘草和之，不使其劫阴脱营，如驭马防其放逸耳。）麻黄入肺杏入心，发汗必
通营与卫。（麻黄轻清入肺，杏仁重浊入心。仲景治太阳初病，必从心营肺卫立方也。）先煮
麻黄取力专，（麻黄先煮，取其力专，不仅为去上沫已也。）不须啜粥恐留滞。（不须啜粥，
恐留恋麻黄之性也。）减去大枣与生姜，恐碍杏麻升降制。（仲景发汗方中，每加姜、枣，此
不用者，以生姜横散解肌，碍麻黄之上升，大枣缓中腻膈，碍杏仁之下降故耳。其精切又如
此。）要知麻桂性辛温，仲景原为风寒制。无论伤寒与中风，卫实麻黄表虚桂。（麻黄汤治卫
实，桂枝汤治表虚，在有汗无汗上分，不在风寒上分也。）后人妄用治温暑，无怪下咽人即
毙。（麻黄、桂枝二方，原为冬月即病之正伤寒而设，后人误以之治温暑，无怪乎下咽即毙
也。）伤寒初病在太阳，头项强痛此经系。（头项强痛，为太阳经的证。）发热恶寒无汗喘，
脉浮而紧麻黄谛。（以上为麻黄汤的证要诀。麻黄治无汗，杏仁治喘，桂枝治恶寒，甘草和
诸药，无一味不紧切，故谓“经方”。）寸关浮弱（表虚）尺迟微（里虚），误汗亡阳祸不细。
（若浮弱微
，非麻、桂温通关节，宣发寒邪不效。虚者，同补气血药服。）冷风哮嗽还堪济。（冷风哮证
，由风寒客于背俞，屡止屡作，用此散寒利肺最效。病哮喘，虽服麻黄而不作汗也。）《金
匮》麻黄加术汤，湿家身体烦疼诣。（湿外盛者，阳必内郁，故烦疼也。）寒湿在表汗之宜，
麻术相须功益济。（麻黄得术，自不至于过汗；术得麻黄，并可以行表里之湿。此治寒湿在
表之正法也。）发散方中白术加，海藏神术（汤）从此例。（发散方中加白术，洁古谓之“开
鬼门”。王海藏仿此意而制神术散，以代麻、桂，自云神妙。）安道辨论颇精明，（王安道着
《医经溯洄集》，辨伤寒温热甚悉。）《活人》加减休拘泥。（朱肱《类证活人书》载夏至后用
麻黄汤，须加知母、石膏、黄芩，后学多宗其说，亦见之不明，可见暑湿何可更用麻黄。）
此乃伤寒第一方，读书勿被书瞒蔽。（旭高按∶麻黄汤或谓专治伤寒，或谓通治杂病，只缘
未识正旨也。若知明为寒伤营之主剂，非惟温暑不取用，即邪浅在卫，亦何至于误用。而凡
寒邪在营者，何不以通用也。）
《伤寒论》与《金匮要略》方剂：后汉时期张仲景撰写了《伤寒论》和《金匮要略》这两部著作，它们成为后世医方之祖。其方剂治疗疾病，虽然头绪繁多，但条理清晰不乱。方中的药物，少的仅有一两味，却无所不包；多的达到二三十味，却没有一味不是紧扣病情的，因此被称为“方祖”。本卷所收录的，都是他的方剂。偶尔附上后世的一些方剂，使人能够由流溯源，了解融汇古人智慧并化创新意的奥妙。学医者若能对本卷诸方深思熟读，应对变化就能无穷无尽了。
治疗太阳病（太阳经受邪所致的病证），风寒邪气在体表，出现头项强痛、身体疼痛、腰痛、骨节疼痛、发热恶寒、怕风且无汗、胸闷而气喘，脉象浮紧或浮数的，适宜使用此方发汗。如果脉象浮弱，汗自出，或者尺脉微迟的，都不可服用。如果是风、寒、湿三气结合导致痹证，以及冷风引起的哮喘咳嗽，此方最为有效。
麻黄（三两，去节） 桂枝（二两，去皮） 杏仁（七十个，去皮尖） 甘草（一两，炙） 用水九升，先煮麻黄，减少二升水，去掉上面的泡沫，加入其他药物，煮取二升半药液，去掉药渣，温服八合。服药后需覆盖衣被使身体微微似有汗出，不需要喝热粥助汗。
麻黄是发汗的峻猛药剂，用桂枝和甘草监制就没有弊端。（麻黄开通腠理发汗，药性最猛烈，所以用桂枝来监制它，防止其大汗导致亡阳，甘草调和药性，防止其劫夺阴液脱失营血，就像驾驭马匹防止其放纵逃逸一样。）麻黄入肺经，杏仁入心经，发汗必须通达营气和卫气。（麻黄轻清入肺，杏仁重浊入心。张仲景治疗太阳病初起，必定从心营肺卫的角度立方的。）先煮麻黄以取其力专一，（麻黄先煮，是为了使其药力专一，不仅仅是为了去掉上面的泡沫罢了。）不需要喝热粥，恐怕会导致药性留滞。（不需要喝热粥，是担心留恋麻黄的药性。）减去大枣和生姜，恐怕妨碍杏仁和麻黄的升降作用。（张仲景的发汗方中，通常加入姜、枣，这里不用，是因为生姜横散解肌，妨碍麻黄的上升；大枣缓中腻膈，妨碍杏仁的下降。由此可见其用药的精切之处。）要知道麻黄、桂枝的药性是辛温的，张仲景原本是为风寒之邪制定的。无论是伤寒还是中风，卫气实者用麻黄汤，表虚者用桂枝汤。（麻黄汤治疗卫气实证，桂枝汤治疗表虚证，区别在于有汗无汗，不在于区分风寒。）后人妄用此方治疗温病暑病，难怪病人服药即死。（麻黄、桂枝两个方子，原本是为冬季即时发病的正伤寒而设，后人误用来治疗温病暑病，难怪服药即毙命。）伤寒初起在太阳经，头项强痛是该经所属的症状。（头项强痛，是太阳经的典型证候。）发热恶寒无汗气喘，脉浮而紧是麻黄汤的确切指征。（以上为麻黄汤的证候要点诀要。麻黄治无汗，杏仁治喘，桂枝治恶寒，甘草调和诸药，没有一味不是紧扣病情的，所以称为“经方”。）寸关脉浮弱（表虚），尺脉迟微（里虚），误用发汗导致亡阳，祸患不小。（如果脉象浮弱微细，非要用麻黄、桂枝温通关节、宣发寒邪才有效。对于虚证患者，应配合补气血的药物服用。）冷风哮喘咳嗽还可以救治。（冷风哮证，是由于风寒客居于背部俞穴，屡次停止又发作，用此方散寒利肺最为有效。患有哮喘病，虽然服用麻黄但不一定出汗。）《金匮要略》中的麻黄加术汤，治疗湿气重之人身体烦疼非常恰当。（湿气外盛，阳气必然内郁，所以出现烦疼。）寒湿在体表应当发汗，麻黄与白术相须为用，功效更加协同。（麻黄得到白术，就不会导致过汗；白术得到麻黄，可以并行表里之湿。这是治疗寒湿在体表的正确方法。）发散方中加入白术，王海藏的神术汤从此有了先例。（发散方中加入白术，洁古老人称之为“开鬼门”。王海藏模仿这个意思制成神术散，用来代替麻黄、桂枝，自称神妙。）王安道的辨论颇为精明，（王安道撰写《医经溯洄集》，对伤寒和温热的辨析非常详尽。）《活人书》的加减不要拘泥。（朱肱《类证活人书》记载夏至后使用麻黄汤，必须加知母、石膏、黄芩，后学者多遵循此说，这也可见见识不明，可见暑湿之证怎么还能再用麻黄。）这乃是伤寒第一方，读书不要被书本蒙蔽。（高旭按：麻黄汤有人说专门治疗伤寒，有人说通治杂病，只因为未识得正旨。如果知道它是寒伤营血的主方，不仅温病暑病不取用，即使邪气浅在卫分，又何至于误用。而凡是寒邪在营分的，为什么不能通用呢？）
Formulas from the *Shanghan Lun* and *Jingui Yaolue*: Zhang Zhongjing of the Later Han Dynasty authored these two works, *Shanghan Lun* (Treatise on Cold Pathogenic Diseases) and *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), which became the ancestors of medical formulas for later generations. Although the conditions treated by his formulas are numerous and complex, their principles are clear and orderly. The herbs in a formula may be few, only one or two, yet they cover all aspects; or they may be many, up to twenty or thirty, yet not a single herb is irrelevant to the condition. Hence, they are called the "Ancestors of Formulas." This volume collects these formulas. Occasionally, some formulas from later generations are appended, allowing students to trace the source from the stream, understanding the subtlety of integrating ancient wisdom with innovation. If practitioners can deeply contemplate and memorize the formulas in this volume, they will be able to respond to changes infinitely.
Indicated for Taiyang disease (disease pattern resulting from pathogenic invasion of the Taiyang channel), where wind-cold pathogens are at the exterior, presenting with stiffness and pain in the head and neck, body ache, lower back pain, joint pain, fever with aversion to cold, aversion to wind, absence of sweating, chest fullness with wheezing, and a floating-tight or floating-rapid pulse. This formula is suitable for inducing sweating. If the pulse is floating-weak, spontaneous sweating occurs, or the chi pulse is faint and slow, it must not be taken. It is most effective for bi syndrome (painful obstruction syndrome) caused by the combination of wind, cold, and dampness, as well as for asthma and cough due to cold wind.
Ephedrae Herba (Mahuang, 麻黄) 3 liang, remove joints; Cinnamomi Ramulus (Guizhi, 桂枝) 2 liang, remove bark; Armeniacae Semen Amarum (Xingren, 杏仁) 70 seeds, remove skin and tips; Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) 1 liang, honey-fried. Boil with 9 sheng of water. First, boil Mahuang until the volume reduces by 2 sheng, discard the foam on top. Then add the remaining herbs. Boil until 2.5 sheng remains. Strain. Take 8 he warm. Cover with blankets to induce a slight sweat. There is no need to drink hot porridge.
Indicated for patients with heavy dampness experiencing bodily restlessness and pain.
Add Baizhu (Atractylodis Macrocephalae Rhizoma) 4 liang to the original Mahuang Tang (Cinnamon Twig Decoction).
Mahuang Tang (Cinnamon Twig Decoction) is a potent agent for inducing sweating; monitored by Guizhi (Cinnamon Twig) and Gancao (Licorice Root), it avoids adverse effects. (Mahuang opens the pores and induces sweating with intense potency; thus, Guizhi monitors it to prevent excessive sweating leading to collapse of Yang, while Gancao harmonizes to prevent depletion of Yin and Ying blood, much like controlling a horse to prevent it from running wild.) Mahuang enters the Lung, Xingren enters the Heart; inducing sweating requires unblocking Ying (Nutritive Qi) and Wei (Defensive Qi). (Mahuang is light and clear, entering the Lung; Xingren is heavy and turbid, entering the Heart. When treating early-stage Taiyang disease, Zhang Zhongjing always establishes prescriptions based on the Heart-Ying and Lung-Wei systems.) Boiling Mahuang first concentrates its power. (Boiling Mahuang first aims to concentrate its efficacy, not merely to remove the foam.) There is no need to drink hot porridge, lest it cause stagnation. (Not drinking hot porridge prevents lingering of Mahuang's properties.) Removing Dazao (Jujube Fruit) and Shengjiang (Fresh Ginger) avoids hindering the ascending-descending actions of Xingren and Mahuang. (In Zhang Zhongjing's diaphoretic formulas, Ginger and Jujube are usually added. Here they are omitted because Shengjiang disperses horizontally to resolve the muscle layer, hindering Mahuang's upward action; Dazao slows the middle and clogs the diaphragm, hindering Xingren's downward action. This demonstrates the precision of the prescription.) One must know that Mahuang and Guizhi are acrid and warm; Zhang Zhongjing originally formulated them for wind-cold. Regardless of whether it is Shanghan (Cold Damage) or Fengzhong (Wind Strike), if the Wei level is excess, use Mahuang Tang; if the exterior is deficient, use Guizhi Tang. (Mahuang Tang treats Wei excess; Guizhi Tang treats exterior deficiency. The distinction lies in the presence or absence of sweating, not in distinguishing between wind and cold.) Later generations wrongly used these for Warm diseases and Summerheat, no wonder patients died immediately after ingestion. (These two formulas were originally designed for true Shanghan occurring in winter. Misusing them for Warm diseases leads to death.) Early Shanghan affects the Taiyang channel, characterized by stiffness and pain in the head and neck. (Stiffness and pain in the head and neck are symptoms of the Taiyang channel.) Fever, aversion to cold, absence of sweating, and wheezing with a floating-tight pulse confirm the indication for Mahuang Tang. (These are the key diagnostic criteria for Mahuang Tang. Mahuang treats absence of sweating, Xingren treats wheezing, Guizhi treats aversion to cold, Gancao harmonizes the herbs; every ingredient is precise, hence called "Classic Formulas".) If the Cun and Guan pulses are floating-weak (Exterior Deficiency) and the Chi pulse is slow-faint (Interior Deficiency), mistaken sweating leads to collapse of Yang, causing severe disaster. (If the pulse is floating-weak-faint, using Mahuang and Guizhi to warm and unblock joints to dispel cold is ineffective. For deficiency patterns, combine with Qi and Blood tonifying herbs.) Cold-wind asthma and cough can still be helped. (Cold-wind asthma results from wind-cold lodging in the Back-Shu points, recurring frequently; this formula effectively disperses cold and benefits the Lung. In asthma cases, taking Mahuang may not induce sweating.) The Mahuang Jia Zhu Tang (Ephedra Decoction plus Atractylodes) in *Jingui Yaolue* is apt for heavy dampness causing bodily restlessness and pain. (When dampness is excessive externally, Yang is internally constrained, causing restlessness and pain.) For cold-damp at the exterior, sweating is appropriate; Mahuang and Baizhu synergistically enhance efficacy. (With Baizhu, Mahuang does not cause excessive sweating; with Mahuang, Baizhu can drain dampness from both exterior and interior. This is the correct method for treating cold-damp at the exterior.) Adding Baizhu to diaphoretic formulas set the precedent for Hai Zang's Shen Zhu San (Divine Atractylodes Powder). (Adding Baizhu to diaphoretic formulas was termed "opening the ghost gate" by Jiegu. Wang Haizang imitated this idea to create Shen Zhu San to replace Mahuang and Guizhi, claiming it was miraculous.) An Dao's discussions were quite insightful. (Wang Andao wrote *Yijing Suhui Ji*, providing detailed distinctions between Shanghan and Warm diseases.) Do not rigidly adhere to modifications in *Huo Ren Shu*. (Zhu Gong's *Leizheng Huoren Shu* records adding Zhimu (Anemarrhenae Rhizoma), Shigao (Gypsum Fibrosum), and Huangqin (Scutellariae Radix) to Mahuang Tang after the Summer Solstice. Many later scholars followed this, showing unclear understanding; how can Ma Huang be used for Summerheat-damp?) This is the primary formula for Shanghan. Do not be misled by books. (Xu Gao notes: Some say Mahuang Tang is specific to Shanghan, others say it treats miscellaneous diseases generally, due to failing to grasp the core principle. If one knows it is the main formula for Cold injuring Ying, it should not be used for Warm diseases or Summerheat, nor even for shallow pathogens in the Wei level. Conversely, why is it not universally applicable for Cold pathogens affecting Ying?)