人参(一两) 干姜(炮) 甘草(炙) 白术(各二两)
腹痛者,加人参一两。寒者,加干姜一两半。渴欲得水者,加白
术一
两半。脐上筑者肾气动也,去术,加桂四两。吐多者,去术,加生姜三两。下多者,还用术
。悸者,加茯苓二两。或四肢拘急腹痛者,或腹满下利转筋者,去术,加附子一枚,生用。
上锉如麻豆大,每秤三钱,水一盏半,煮至七分,去滓,温服,日三。
海藏云∶理中汤加减八法,并无寒药。吐利后有表者表之汗出厥者温之;既吐且利,
小便
复利,大汗出,内寒外热者亦温之;至于吐下后,汗出不解,厥逆脉欲绝者,四逆主之。以
是知此候无阳证,皆阴证也。仲景人参桂枝汤,理中汤加桂枝,太阳未除,下之成协热利,心
下痞,表里不解者;《活人》此理中汤内加青陈皮,名治中汤,治胸膈病;许学士改《活人
》方,作补脾丸,治劳则补子,如子富而父不贫,不特虚则补其母也。
以上三证,若有外感与内证饮冷极者,宜五积散。
海藏曰∶皇甫先生云仲景广《汤液》为十卷。文潞公云仲景为群方之祖。朱奉议云仲景泻心
古汤液则少黄芩,后人脱落之。许学士亦云伊芳尹《汤液论》大柴胡汤八味,今监本无大黄,只是
七味,亦为脱落之也。以是知仲景方皆《汤液》也。
四顺散,理中汤、四逆汤、通脉四逆汤、术附汤、姜附汤、真武汤、白通汤,俱见仲景
条下。
其余杂见诸方,凡称仲景者皆是。
人参(一两) 干姜(炮制) 甘草(炙烤) 白术(各二两)
如果腹痛,加人参一两。如果有寒象,加干姜一两半。如果口渴想喝水,加白术一两半。如果脐上跳动不安,这是肾气发动的表现,去掉白术,加桂枝四两。如果呕吐多,去掉白术,加生姜三两。如果腹泻多,仍然使用白术。如果心悸,加茯苓二两。如果出现四肢拘挛急迫且腹痛,或者腹部胀满、腹泻并伴有转筋(肌肉痉挛),去掉白术,加附子一枚,生用。
以上药物锉碎如麻豆大小,每服三钱,加水一盏半,煮至七分,去渣,温服,每日三次。
海藏说:理中汤的加减八法,都没有寒凉药。吐利之后有表证的,用发汗法解表;既吐又泻,小便通利,大汗出,内寒外热的,也用温法;至于吐下之后,汗出而病不解,四肢厥冷、脉搏微弱欲绝的,用四逆汤为主治。由此可知这种证候没有阳证,都是阴证。仲景的人参桂枝汤,是理中汤加桂枝,用于太阳病未除,误下后形成协热利,心下痞塞,表里同病不解的情况;《活人书》在此理中汤内加青皮、陈皮,名为治中汤,治疗胸膈疾病;许学士修改《活人书》的方子,制成补脾丸,治疗劳倦伤脾,遵循“虚则补其母”的原则,就像儿子富裕了父亲就不会贫穷,不仅限于虚证时补母脏。
以上三种证候,如果有外感与内伤饮冷极重的,适宜用五积散。
海藏说:皇甫先生说仲景扩展《汤液经法》为十卷。文潞公说仲景是群方之祖。朱奉议说仲景的泻心古汤在《汤液》中原本少黄芩,是后人脱漏掉的。许学士也说伊尹的《汤液论》中大柴胡汤应有八味,现在官刻本没有大黄,只有七味,也是后人脱漏的。由此可知仲景的方剂都源自《汤液》。
四顺散,理中汤、四逆汤、通脉四逆汤、术附汤、姜附汤、真武汤、白通汤,都见于仲景的相关条目下。
其余杂见于各方书中,凡是称为仲景方的,都是如此。
Ren Shen (Ginseng Radix et Rhizoma, 1 liang) Gan Jiang (Dried Zingiberis Rhizoma, processed by frying) Gan Cao (Licorice Root and Rhizome, honey-fried) Bai Zhu (Atractylodis Macrocephalae Rhizoma, each 2 liang).
If abdominal pain occurs, add Ren Shen (Ginseng Radix et Rhizoma) 1 liang. If there is cold, add Gan Jiang (Dried Zingiberis Rhizoma) 1.5 liang. If there is thirst and desire for water, add Bai Zhu (Atractylodis Macrocephalae Rhizoma) 1.5 liang. If there is a pulsating sensation above the umbilicus, this indicates movement of Kidney Qi; remove Bai Zhu (Atractylodis Macrocephalae Rhizoma) and add Gui Zhi (Cinnamon Twig) 4 liang. If vomiting is frequent, remove Bai Zhu (Atractylodis Macrocephalae Rhizoma) and add Sheng Jiang (Fresh Zingiberis Rhizoma) 3 liang. If diarrhea is frequent, continue using Bai Zhu (Atractylodis Macrocephalae Rhizoma). If palpitations occur, add Fu Ling (Poria) 2 liang. If there are spasms and stiffness of the four limbs with abdominal pain, or abdominal fullness with diarrhea accompanied by muscle cramps, remove Bai Zhu (Atractylodis Macrocephalae Rhizoma) and add one raw Fu Zi (Aconiti Lateralis Radix Praeparata).
Crush the above herbs to the size of hemp seeds. For each dose of 3 qian, add 1.5 zhan of water, boil until reduced to 0.7 zhan, strain, and take warm. Administer three times daily.
Haicang stated: The eight methods of modification for Lizhong Tang (Spleen-Regulating Decoction) do not include any cold-natured herbs. If after vomiting and diarrhea there is an exterior syndrome, treat it by inducing sweating to release the exterior; if there is both vomiting and diarrhea, with free urination, profuse sweating, and internal cold with external heat, treat it with warming methods; as for after vomiting and purging, if sweating does not resolve the condition, and there is cold extremities with a pulse that is faint and about to disappear, Sini Tang (Frigid Extremities Decoction) is the primary treatment. From this, we know that this condition has no Yang syndromes, but only Yin syndromes. Zhongjing's Renshen Guizhi Tang (Ginseng and Cinnamon Twig Decoction) is Lizhong Tang (Spleen-Regulating Decoction) plus Guizhi (Cinnamon Twig), used when the Taiyang disease (Taiyang Syndrome) has not been resolved, and after mistaken purgation, results in Xiere Li (Heat-Coupling Diarrhea), epigastric stuffiness, and unresolved interior-exterior conditions; Huoren's book adds Qing Pi (Citri Reticulatae Pericarpium Viride) and Chen Pi (Citri Reticulatae Pericarpium) to this Lizhong Tang (Spleen-Regulating Decoction), naming it Zhizhong Tang (Middle-Regulating Decoction), which treats chest and diaphragm diseases; Xu Xueshi modified the formula from Huoren's book to create Bipi Wan (Spleen-Nourishing Pill), treating fatigue-induced spleen deficiency, following the principle of "tonifying the mother when deficient," similar to how a wealthy son ensures his father is not poor, not limited to just tonifying the mother organ in deficiency cases.
For the above three conditions, if there is external contraction combined with severe internal injury from drinking cold substances, Wuji San (Five Accumulations Powder) is appropriate.
Haicang said: Mr. Huangfu stated that Zhongjing expanded the Shanghan Lun's source text, Tangye Jinglun (Treatise on Decoctions), into ten volumes. Wen Lugong stated that Zhongjing is the ancestor of all formulas. Zhu Fengyi stated that Zhongjing's original Xixin Tang (Heart-Unblocking Decoction) lacked Huang Qin (Scutellariae Radix) in the Tangye Jinglun (Treatise on Decoctions), which was lost by later generations. Xu Xueshi also said that in Yi Yin's Tangye Jinglun (Treatise on Decoctions), Daxiehu Tang (Major Draining the Gallbladder Decoction) should have eight ingredients, but the current official edition lacks Da Huang (Rhei Radix et Rhizoma), having only seven, which is also a loss by later generations. From this, we know that Zhongjing's formulas all originate from the Tangye Jinglun (Treatise on Decoctions).
Sishun San (Four-Smooth Powder), Lizhong Tang (Spleen-Regulating Decoction), Sini Tang (Frigid Extremities Decoction), Tongmai Sini Tang (Pulse-Unblocking Frigid Extremities Decoction), Shu Fu Tang (Atractylodes and Aconite Decoction), Jiang Fu Tang (Zingiber and Aconite Decoction), Zhenwu Tang (True Warrior Decoction), and Baitong Tang (White Pass Decoction) are all found under Zhongjing's relevant entries.
The rest scattered in various formularies, all referred to as Zhongjing's formulas, are thus.