知母 石膏 甘草 粳米 人参
主太阳中 。发热恶寒。脉微弱。手足逆冷而渴者。白虎加人参汤。又曰。身无大热。
口渴心烦。背微恶寒者。白虎加人参汤主之。伤寒脉浮。发热无汗。其表不解。不渴者。
宜麻黄汤。渴者宜五苓散。并非白虎所宜也。惟大渴饮水。无表症者。乃可与白虎。加人参
以除里热。
猪苓 泽泻 茯苓 桂 白术
太阳汗后。胃干。烦躁不眠。欲饮水者。少少与之。脉浮。小便不利而渴。宜用此方。
太阳
渴为膀胱经本病。然则治渴者。当泻膀胱之热。泻膀胱之热者。利小便而已矣。淡味渗泄为阳
。内蓄水饮。须渗泄之。故以三苓泽泻为主。脾土强旺。则水饮不敢停留。故以白术为佐
。水蓄则肾燥。经曰。肾苦燥急食辛以润之。故用桂为向导之使。
柴胡 桂枝 黄芩 干姜 牡蛎 甘草 栝蒌根
伤寒五六日。已发汗。复下之。胸胁满。微结。小便不利。渴而不呕。但头汗出。往来
寒热
邪在半表半里也。小便不利而渴者。汗下津亡内燥也。若热消津液。令小便不利而渴者。当
呕。今
桂枝干姜汤。以解表里之邪。复津液以助阳也。
柴胡 半夏 大黄 人参 桂枝 茯苓 龙骨 黄芩 铅丹 牡蛎 生姜 大枣
八九日下之。胸满烦惊。小便不利。谵语。一身尽重。伤寒八九日。邪热已深。下之而
满烦者。热未尽也。惊者。心恶热。而神不守也。小便不利者。津液不行也。谵语者。胃实也。
身重不可转侧者。阳气伏于里。不行于表也。与柴胡汤。以除烦闷。加龙骨牡蛎丹铅。以镇
惊。加茯苓以行津液。利小便。加大黄。以涤胃热。止谵语。加桂枝。以行阳气。解身重。而
错杂之邪。靡不悉愈矣。
知母、石膏、甘草、粳米、人参。
主治太阳中暍(中暑)。症见发热恶寒,脉象微弱,手足逆冷且口渴者,用白虎加人参汤。又说:身体没有大热,但口渴心烦,背部微微怕冷者,由白虎加人参汤主治。伤寒脉浮,发热无汗,表证未解,口不渴者,宜用麻黄汤;若口渴者,宜用五苓散。这些情况都不是白虎汤所适宜的。只有大渴饮水,且无表证者,才可给予白虎汤,加入人参以清除里热。
猪苓、泽泻、茯苓、桂枝、白术。
太阳病发汗后,胃中干燥,烦躁失眠,想喝水的,应少量多次给予饮水。若脉浮,小便不利且口渴,宜用此方(五苓散)。
太阳病中,口渴是膀胱经的本病。然而治疗口渴,应当清泻膀胱之热。清泻膀胱之热的办法,就是通利小便。淡味药物具有渗湿泄浊的作用,属于阳。体内有水饮停蓄,必须通过渗湿泄浊来消除,所以以三苓(茯苓、猪苓、泽泻)和泽泻为主药。脾土强旺,则水饮不敢停留,所以以白术为佐药。水液停蓄会导致肾燥,经书说:“肾苦燥,急食辛以润之。”所以用桂枝作为引导药。
柴胡、桂枝、黄芩、干姜、牡蛎、甘草、栝蒌根(天花粉)。
伤寒五六天,已经发过汗,又用过下法,出现胸胁满闷,轻微结滞,小便不利,口渴但不呕吐,仅头部出汗,往来寒热,这是邪气在半表半里的表现。小便不利而口渴,是因为发汗和下法导致津液亡失,内部干燥。如果是因为热邪消耗津液,导致小便不利而口渴,应当伴有呕吐。这里提到的桂枝干姜汤(此处原文似有误,结合上下文及小柴胡汤加减法,实指小柴胡去半夏加栝蒌根等变化,或指针对此类病机的调理),旨在解除表里之邪,恢复津液以助阳气。
柴胡、半夏、大黄、人参、桂枝、茯苓、龙骨、黄芩、铅丹、牡蛎、生姜、大枣。
伤寒八九天,误用下法,出现胸满、烦乱惊悸,小便不利,说胡话(谵语),全身沉重。伤寒经过八九天,邪热已经深入,误用下法后出现胸满烦乱,说明热邪未尽。惊悸,是因为心厌恶热邪,神志不能守舍。小便不利,是因为津液运行不畅。说胡话,是因为胃中有实热。全身沉重无法转侧,是因为阳气伏郁在里,不能通达于表。给予柴胡汤以清除烦闷,加入龙骨、牡蛎、铅丹以镇惊安神,加入茯苓以通行津液、利小便,加入大黄以涤荡胃热、停止谵语,加入桂枝以通行阳气、解除身重。这样,各种错杂的邪气,没有不完全治愈的。
Rhizoma Anemarrhenae (Zhimu), Gypsum Fibrosum (Shigao), Radix Glycyrrhizae Preparata (Gancao), Oryzae Fructus (Jingmi), Radix Panacis Ginseng (Renshen).
Indicated for Taiyang Zhongshu (Heatstroke affecting the Taiyang channel). Symptoms include fever and aversion to cold, a faint pulse, cold extremities, and thirst. Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) is used. It is also stated that if there is no significant heat in the body, but there is thirst, irritability, and slight aversion to cold on the back, Baihu Jianshen Tang should be administered. In Shaoyang disease with a floating pulse, fever, absence of sweating, and unresolved exterior syndrome, if there is no thirst, Mahuang Tang (Ephedra Decoction) is appropriate; if there is thirst, Wuling San (Five-Ingredient Powder with Poria) is appropriate. These are not suitable for Baihu Tang. Only when there is extreme thirst with desire to drink water, and no exterior syndrome, can Baihu Tang be given, with added Renshen to clear interior heat.
Polyporus (Zuling), Alisma Rhizoma (Zexie), Poria (Fuling), Ramulus Cinnamomi (Guizhi), Atractylodis Macrocephalae Rhizoma (Baizhu).
After sweating therapy in Taiyang disease, if the stomach becomes dry, causing restlessness and insomnia, and the patient desires water, it should be given in small amounts frequently. If there is a floating pulse, difficulty in urination, and thirst, this formula (Wuling San) should be used.
In Taiyang disease, thirst is the primary manifestation of the Bladder channel. However, treating thirst requires clearing heat from the Bladder. Clearing Bladder heat is achieved by promoting diuresis. Bland-tasting herbs have the function of leaching out dampness and belong to Yang. When fluid retention exists internally, it must be resolved through leaching. Therefore, the three Fulings (Poria, Polyporus, Alisma) and Alisma Rhizoma are used as principal herbs. When Spleen Earth is strong, fluid retention cannot remain, so Atractylodis Macrocephalae Rhizoma is used as an assistant herb. Fluid retention leads to Kidney dryness. The Classics state: "The Kidney dislikes dryness; urgently use pungent substances to moisten it." Therefore, Ramulus Cinnamomi is used as a guiding agent.
Bupleuri Radix (Chaihu), Ramulus Cinnamomi (Guizhi), Scutellariae Radix (Huangqin), Zingiberis Rhizoma Recens (Ganjiang), Concha Ostreae (Muli), Radix Glycyrrhizae Preparata (Gancao), Radix Trichosanthis (Gualougen/Tianhuafen).
After five or six days of Shaoyang disease, having undergone sweating therapy followed by purgation, symptoms include fullness in the chest and hypochondrium, slight binding, difficulty in urination, thirst without vomiting, only sweating on the head, and alternating chills and fever. This indicates pathogenic factors located between the exterior and interior. Difficulty in urination with thirst results from the loss of fluids due to sweating and purging, leading to internal dryness. If thirst and difficulty in urination were caused solely by heat consuming fluids, vomiting would likely occur. [Note: The text mentions Guizhi Ganjiang Tang here, which seems contextually inconsistent with the standard Xiaochaihu Tang modifications for these specific symptoms, but translated as per source]. The aim is to resolve exterior and interior pathogens and restore fluids to assist Yang.
Bupleuri Radix (Chaihu), Pinelliae Rhizoma Preparatum (Banxia), Radix Rhei (Dahuang), Radix Panacis Ginseng (Renshen), Ramulus Cinnamomi (Guizhi), Poria (Fuling), Os Draconis (Longgu), Scutellariae Radix (Huangqin), Plumbum Metallicum (Qian Dan), Concha Ostreae (Muli), Zingiberis Rhizoma Recens (Shengjiang), Ziziphi Jujubae Fructus (Dazao).
After eight or nine days of Shaoyang disease, improper use of purgation leads to chest fullness, irritability, and fright, difficulty in urination, delirium, and heaviness of the entire body. After eight or nine days, pathogenic heat has penetrated deeply. Purging when fullness and irritability persist indicates that heat is not yet exhausted. Fright occurs because the Heart dislikes heat, and the Shen (Spirit) fails to reside securely. Difficulty in urination indicates impaired fluid circulation. Delirium indicates excess heat in the Stomach. Heaviness of the body preventing turning over indicates Yang Qi stagnating in the interior and failing to circulate to the exterior. Chaihu Tang is administered to relieve irritability and oppression. Longgu, Muli, and Qian Dan are added to calm fright. Fuling is added to promote fluid circulation and diuresis. Dahuang is added to purge Stomach heat and stop delirium. Guizhi is added to promote Yang Qi circulation and relieve body heaviness. Thus, all complex pathogenic factors will be thoroughly resolved.