治伤寒头痛壮热。骨节疼痛。昏沉困倦。咳嗽鼻息不思饮食。兼治伤寒夹冷。气慢阴毒。
甘草 五味子 石膏（各一两） 干姜（三两半） 白术（一两半）
上五味为细末。每服二钱。入盐少许。煎至七分。通口服。如冷气相夹。入姜枣煎。若治阴毒。入艾叶同煎。脉浮
而紧者。阳证也。沉而紧者。阴证也。
琥按上论。头痛壮热。骨节疼痛。全是阳证。又且不思饮食。缘何用干姜白术。又如五味子。亦收敛不可用也。若
伤寒夹冷。气慢阴毒。则石膏又大相背谬。此等方皆宜删之。恐误后之学人。
此药配类二气。均调阴阳。夺天地中和之气乃水火既济之方。可冷可热。可缓可急。善治营卫不交。养心肾不升降。
上实下虚。气闭痰厥。心腹冷痛。脏腑虚滑。不问男女老幼危急之证。但有胃气。无不获安。助真补虚。救阴助阳。为
效殊胜。
舶上硫黄（透明不夹石者。一两） 太阴玄精石（一两研水飞） 硝石（半两同硫黄并为细末。入定瓷罐内。以慢
火炒。篦子不住手搅。令阴阳相入。不可火太过。伤药力。再研极细。名曰二气末。） 五灵脂（二两酒浸。用五台山
者。水澄去砂石。晒干拣净。称。） 陈皮（去白） 青皮（去穣各三两）
上用五灵脂。二皮为细末。次下玄精石末。及前二药末。拌匀。以酒醋打糊为丸。如豌豆大。每服三十丸。空心粥
饮吞下。甚者。五十粒。
琥按上方。用硫黄酸温大热为君。疗心腹积聚。邪气冷痛。又主腰肾久冷。补命门不足。阳气暴绝。硝石辛温为臣。
治伏暑伤冷。霍乱吐利。升散三焦火郁。调和脏腑虚寒。乃火硝而非朴硝。此与硫黄皆大热药也。玄精石咸寒。能制硝
黄而调和阴阳。除风冷邪气。心腹积聚。四肢逆冷。五灵脂又治心腹冷气冷积。兼入厥阴血分。皆以为佐。四者相合。
而又使以陈皮青皮。通利三焦之气则阴寒解而阳气自回。有灵验也。此丹损益兼行。中病便已。不可过剂。以其效虽紧。
而其患亦速。可不慎之。
【背景信息】
书名：中寒论辩证广注 作者：丹波元胤 章节：五胜散方 / （局方）来复丹方 类别：医论
【待处理原文】
治疗伤寒（外感热病初期阶段）引起的头痛、高热。骨节疼痛。神志昏沉、困倦乏力。咳嗽、鼻塞、呼吸不畅、不想吃东西。兼治伤寒夹冷邪、气机缓慢、阴毒证。
甘草（各一两）、五味子、石膏（各一两）、干姜（三两半）、白术（一两半）。
以上五味药研成细末。每次服用二钱。加入少许盐。煎煮至七分满。一次性口服。如果伴有冷气夹杂，加入生姜和大枣一起煎煮。如果是治疗阴毒证，加入艾叶同煎。脉象浮而紧的，是阳证；脉象沉而紧的，是阴证。
琥按：上述论述中，头痛、高热、骨节疼痛，完全是阳证的表现。而且患者不思饮食，为何使用干姜、白术？又如五味子，具有收敛作用，也不宜使用。如果是治疗伤寒夹冷邪、气机缓慢、阴毒证，那么石膏则完全背道而驰。这些方剂都应该删除，恐怕会误导后世的学医者。
此药的配伍调和阴阳二气，均匀调节阴阳。夺取天地中和之气，是水火既济的方剂。可冷可热，可缓可急。善于治疗营卫不交（营气与卫气运行失调），滋养心肾不升降（心火不能下降，肾水不能上升）。上实下虚，气闭痰厥，心腹冷痛，脏腑虚滑。不问男女老幼危急之证，只要有胃气，无不获得安宁。辅助真气，补益虚弱，救阴助阳，疗效特别显著。
舶上硫黄（透明不夹杂石头的，一两）、太阴玄精石（一两，研碎后用水飞法处理）、硝石（半两，与硫黄一起研为细末，放入定瓷罐内，用慢火炒，用篦子不停地搅拌，使阴阳相互融合，不可火太大，以免损伤药力，再研极细，名叫二气末）、五灵脂（二两，酒浸，用五台山的，用水澄洗去砂石，晒干拣净，称量）、陈皮（去掉白色部分）、青皮（去掉瓤，各三两）。
以上用五灵脂、二皮（陈皮、青皮）研为细末，其次加入玄精石末，以及前面两种药末，拌匀。用酒醋打糊做成丸药，如豌豆大小。每次服用三十丸，空腹时用米汤送服。病情严重的，服用五十粒。
琥按：上方，用硫黄酸温大热作为君药，治疗心腹积聚、邪气冷痛。又主治腰肾久冷，补命门不足，阳气暴绝。硝石辛温作为臣药，治疗伏暑伤冷、霍乱吐利，升散三焦火郁，调和脏腑虚寒。这是火硝而非朴硝。这与硫黄都是大热药。玄精石咸寒，能制约硝石和硫黄的燥热而调和阴阳，祛除风冷邪气，治疗心腹积聚、四肢逆冷。五灵脂又治疗心腹冷气冷积，兼入厥阴血分，都作为佐药。这四者相合，而又以陈皮、青皮为使药，通利三焦之气，则阴寒解除而阳气自然回归，有灵验。此丹药损益兼行，中病即止，不可过量。因为其疗效虽然迅速，但其危害也很快出现，能不谨慎吗？
[Background Information]
Book: Zhong Han Lun Bian Zheng Guang Zhu (Annotated and Expanded Commentary on the Differentiation of Cold Damage)
Author: Danbo Yuanyin (Tambayama Gen'in)
Chapter: Wusheng San Formula / (Ju Fang) Laifu Dan Formula
Category: Medical Discussion
[Original Text]
To treat headache and high fever caused by Shanghan (an early stage of exogenous febrile disease). Pain in bone joints. Mental confusion, drowsiness, and fatigue. Cough, nasal congestion, difficult breathing, and loss of appetite. Also treats Shanghan complicated with cold pathogen, slow Qi movement, and Yin Du syndrome.
Gancao (Licorice Root), Wuweizi (Schisandra Fruit), Shigao (Gypsum Fibrosum) (each 1 liang), Ganjiang (Dried Ginger), Baizhu (Atractylodis Rhizoma) (3.5 liang).
The above five herbs are ground into a fine powder. Take 2 qian per dose. Add a small amount of salt. Decoct until three-tenths remain. Take orally at once. If accompanied by cold Qi, add Shengjiang (Fresh Ginger) and Dazao (Jujube) to decoct. If treating Yin Du syndrome, add Aye (Mugwort Leaf) to decoct together. If the pulse is floating and tight, it is a Yang syndrome; if sinking and tight, it is a Yin syndrome.
Hu notes: In the above discussion, headache, high fever, and joint pain are entirely manifestations of Yang syndrome. Moreover, the patient has no desire to eat, so why use Ganjiang and Baizhu? Furthermore, Wuweizi has astringent properties and should not be used. If treating Shanghan complicated with cold pathogen, slow Qi movement, or Yin Du syndrome, then Shigao is completely contrary. Such formulas should be deleted, lest they mislead future students of medicine.
This formula harmonizes the two Qi (Yin and Yang), evenly regulating Yin and Yang. It captures the neutral Qi of heaven and earth; it is a formula for the mutual interaction of Water and Fire. It can be cooling or warming, relaxing or urgent. It is good at treating Ying-Wei non-interaction (disharmony between Nutritive and Defensive Qi), nourishing the Heart and Kidney when their ascending and descending functions are impaired. Upper excess and lower deficiency, Qi obstruction with Phlegm syncope, cold pain in the heart and abdomen, deficiency and slipping of Zang-Fu organs. Regardless of gender, age, or critical condition, as long as there is Stomach Qi, peace will be restored. It assists True Qi, tonifies deficiency, saves Yin, and assists Yang, with particularly effective results.
Bo Shang Liu Huang (Shipborne Sulfur, transparent without stone impurities, 1 liang), Taiyin Xuanjing Shi (Taiyin Xuanjing Stone, 1 liang, ground and processed by water flotation), Xiaoshi (Natrii Nitras, 0.5 liang, ground finely together with Sulfur, placed in a Ding porcelain jar, stir constantly with a bamboo whisk over low heat until Yin and Yang merge, avoid excessive heat to prevent damaging medicinal potency, then grind extremely fine, named Erqi Mo [Two-Qi Powder]), Wulingzhi (Trogopteri Dung, 2 liang, soaked in wine, using that from Mount Wutai, washed with water to remove sand and stones, dried, sun-dried, picked clean, and weighed), Chenpi (Aged Tangerine Peel, white pith removed), Qingpi (Green Tangerine Peel, albedo removed) (each 3 liang).
Grind Wulingzhi and the two Peels into a fine powder. Then add the Xuanjing Shi powder and the previous two powders, mix well. Use wine and vinegar to make a paste for pills, sized like peas. Take 30 pills per dose, swallowed with congee water on an empty stomach. For severe cases, take 50 pills.
Hu notes: In the above formula, Liu Huang (Sulfur) is sour, warm, and greatly hot, serving as the Sovereign herb. It treats accumulations and masses in the heart and abdomen, cold pain due to evil Qi. It also treats chronic coldness of the waist and kidneys, tonifies Mingmen (Gate of Life) deficiency, and rescues sudden collapse of Yang Qi. Xiaoshi (Natrii Nitras) is acrid, warm, and serves as the Minister herb. It treats latent summerheat injuring cold, cholera with vomiting and diarrhea, disperses Fire stagnation in the Sanjiao, and harmonizes deficiency-cold of the Zang-Fu. This is Fire Nitre, not Puxiao (Saltpeter). Both this and Sulfur are greatly hot herbs. Xuanjing Shi is salty and cold, capable of restraining the dryness and heat of Natrii Nitras and Sulfur to harmonize Yin and Yang, dispel wind-cold evil Qi, treat accumulations and masses in the heart and abdomen, and cold extremities. Wulingzhi (Trogopteri Dung) treats cold Qi and cold accumulations in the heart and abdomen, and enters the Jueyin Blood level. These four serve as Assistant herbs. Combined with Chenpi and Qingpi as Envoy herbs to promote the free flow of Qi in the Sanjiao, the Yin-cold resolves and Yang Qi returns naturally, proving efficacious. This pill balances reduction and tonification. Stop taking it once the disease is cured; do not overdose. Although its effect is rapid, its harm can also appear quickly. How can one not be cautious?