治太阳病反下之。因而腹满时痛者。
桂枝(三两) 芍药(六两) 甘草(二两) 生姜(三两) 大枣(十二枚)
上五味。以水七升。煮取三升。去滓。分温三服。
治太阳病反下之。因而大实痛者。
即前方加大黄。(二两。)
歌曰 桂枝倍芍转输脾。泄满升邪止痛宜。大实痛因反下误。黄加二两下无疑。
述 桂枝加芍药汤。倍用芍药之苦降。能令桂枝深入于至阴之分。举误陷之邪。而腹痛
自止
道。去实满。枣、草助转输。使其邪悉从外解下行。各不相背。
论云。少阴之为病。脉微细。但欲寐也。此以少阴标本水火阴阳之气。见于脉证者为提
纲也
神
或在于表。或在于里。或在于经。或归于中土。俱明神机枢转上下出入之至理。故其方亦寒
热攻补表里之不同。
治少阴病始得之。反发热。脉沉者。此方主之。
麻黄(二两) 细辛(二两) 附子(一枚 炮。)
上三味。以水一斗。先煮麻黄。减二升。去上沫。内诸药。煮取三升。去滓。温服一升。
日
歌曰 麻黄二两细辛同。附子一枚力最雄。始得少阴反发热。脉沉的证奏奇功。
蔚按。少阴病始得之。是当无热。而反发热。为太阳标阳外呈。脉沉为少阴之生气不升。
恐阴阳内外不相接。故以熟附子助太阳之表阳而内合于少阴。麻黄、细辛启少阴之水阴而外
合于太阳。须知此汤非发汗法。乃交阴阳法。
治疗太阳病,误用攻下法。导致腹部胀满、间歇性疼痛的证候。
桂枝(三两) 芍药(六两) 甘草(二两) 生姜(三两) 大枣(十二枚)
以上五味药。用水七升。煮取三升药液。滤去药渣。分三次温服。
治疗太阳病,误用攻下法。导致腹部剧烈胀痛(大实痛)的证候。
即前方基础上加大黄(二两)。
歌诀曰:桂枝汤中芍药加倍以转输脾气。泄除胀满、升散邪气、止痛适宜。大实痛是因误用攻下所致。加入大黄二两,通下无疑。
阐述:桂枝加芍药汤。倍用芍药的苦降之性。能使桂枝深入至阴之分。举起因误治而陷入的邪气。腹痛自然停止。
道:去除实邪胀满。大枣、甘草帮助转输脾气。使邪气完全从外部解表或向下排出。各药作用不相违背。
《伤寒论》论述:少阴病的提纲是:脉象微细。只想睡觉(但欲寐)。这是以少阴经标本水火阴阳之气。在脉象和症状上的表现为提纲。
神:病邪或在体表。或在体内。或在经络。或归于中土(脾胃)。都阐明了神机枢转、上下出入的根本道理。所以其方剂也有寒热、攻补、表里等不同。
治疗少阴病,初起时。反而出现发热。脉象沉的证候。此方主治。
麻黄(二两) 细辛(二两) 附子(一枚,炮制。)
以上三味药。用水一斗。先煮麻黄。减少二升水量。去掉水面上的浮沫。加入其他药物。煮取三升药液。滤去药渣。温服一升。
歌诀曰:麻黄二两配细辛。附子一枚药力最雄强。初得少阴病反而发热。脉沉为确证,奏效神奇。
蔚按(徐蔚按语):少阴病初起时。应当没有发热。却反而发热。这是太阳标阳外现的表现。脉沉是因为少阴的生气不能上升。
担心阴阳内外不能相接。所以用熟附子辅助太阳的表阳而内合于少阴。麻黄、细辛激发少阴的水阴而外合于太阳。须知此汤不是发汗法。而是交济阴阳的方法。
Treats Taiyang disease (Taiyang syndrome) where purgation was incorrectly applied. Consequently, abdominal fullness and intermittent pain occur.
Guizhi Tang (Cinnamon Twig Decoction) with added Shaoyao: Guizhi (Cinnamomi Ramulus, 3 liang), Shaoyao (Paeoniae Radix, 6 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang), Shengjiang (Zingiberis Rhizoma Recens, 3 liang), Dazao (Jujubae Fructus, 12 pieces).
Take the above five herbs. Boil in 7 sheng of water. Reduce to 3 sheng. Remove dregs. Divide into three warm doses.
Treats Taiyang disease where purgation was incorrectly applied. Consequently, severe abdominal fullness and pain (da shi tong) occur.
Add Dahuang (Rhei Radix et Rhizoma, 2 liang) to the previous formula.
Song says: Doubling Shaoyao in Guizhi Tang aids spleen transport. It is suitable for draining fullness, raising pathogenic factors, and relieving pain. Severe pain results from erroneous purgation. Adding two liang of Dahuang for downward purging is unquestionable.
Explanation: In Guizhi Jia Shaoyao Tang (Guizhi Decoction plus Paeonia), the bitter descending nature of doubled Shaoyao allows Guizhi to penetrate deeply into the extreme yin levels. It lifts the pathogenic factor trapped by error, and abdominal pain naturally ceases.
Dao: Removing excess fullness. Dazao and Gancao assist transport, ensuring the pathogenic factor resolves completely from the exterior or descends. The actions of each herb do not contradict one another.
The Treatise states: The hallmark of Shaoyin disease (Shaoyin syndrome) is a faint and fine pulse, and only desiring sleep (dan yu mei). This serves as the outline based on the Shaoyin jing-biao fire-water yin-yang qi manifesting in pulse and symptoms.
Shen: The pathogen may be in the exterior, interior, meridians, or return to the central earth (spleen/stomach). All clarify the profound principle of Shen-jing pivot transformation and upward-downward entry-exit. Thus, its formulas vary in cold-heat, attack-tonify, and exterior-interior approaches.
Treats Shaoyin disease at its onset, where fever appears contrary to expectation, and the pulse is deep. This formula governs this condition.
Mahuang (Ephedrae Herba, 2 liang), Xixin (Asari Radix et Rhizoma, 2 liang), Fuzi (Aconiti Lateralis Radix Praeparata, 1 piece, processed).
Take the above three herbs. Boil in 1 dou of water. First boil Mahuang, reducing by 2 sheng. Remove the foam on the surface. Add other herbs. Boil to obtain 3 sheng. Remove dregs. Take 1 sheng warm.
Song says: Two liang of Mahuang with Xixin. One piece of Fuzi has the most potent force. Onset of Shaoyin disease with contrary fever. Deep pulse confirms the indication, achieving miraculous efficacy.
Wei's Commentary: At the onset of Shaoyin disease, there should be no fever. Contrary fever indicates the outward manifestation of Taiyang biao-yang. A deep pulse indicates that the vital qi of Shaoyin fails to ascend.
One must fear that yin and yang, interior and exterior, fail to connect. Therefore, prepared Fuzi assists Taiyang biao-yang to internally merge with Shaoyin. Mahuang and Xixin awaken Shaoyin shui-yin to externally merge with Taiyang. Note that this decoction is not a sweating method, but a method of harmonizing yin and yang.