甘草(三两炙) 人参(三两) 干姜(一两) 半夏(半升洗) 黄芩(三两) 黄连(一两) 生姜(四两切)
大枣(十二枚擘)
上八味以水一斗,煮取六升去滓。再煎取三升。温服一升日三服。
甘草(四两) 干姜(三两) 半夏(半升洗) 黄芩(三两) 黄连(一两) 大枣(十二枚擘)
上六味。以水一斗。煮取六升。去滓。再煎取三升温服一升。日三服。
半夏(半升洗) 干姜 甘草(炙) 人参 黄芩(各三两) 黄连(一两) 大枣(十二枚擘)
上七味以水一斗。煮取六升。去滓再煮取三升。温服一升。日三服。
按泻心汤诸方。皆治中风汗下后。表解里未和之证其生姜甘草半夏三泻心是治痰湿结聚之痞方中用半夏生姜以涤痰
饮黄芩黄连以除湿热。人参甘草以助胃气干姜炮黑以渗水湿若但用苦寒治热。则拒格不入。必得辛热为之向导。是以干
姜半夏在所必需。若痞极硬满暂去人参。气壅上升。生姜勿用痞而不硬仍用人参。此一方出入而有三治也。其大黄附子
二泻心。乃治阴阳偏胜之痞。一以大黄黄连涤胸中素有之湿热。一加附子兼温经中骤脱之虚寒也。用沸汤渍绞者。取寒
药之性。不经火而力峻也。其附又必煎汁。取寒热各行其性耳。仲景立法之妙。无出乎此。以大黄芩连涤除胃中之邪热。
即以附子温散凝结之阴寒一举而寒热交结之邪尽解。讵知后人曰睹其方而心眩也。
甘草(炙,三两) 人参(三两) 干姜(一两) 半夏(洗净,半升) 黄芩(三两) 黄连(一两) 生姜(切,四两)
大枣(掰开,十二枚)
以上八味药,用水一斗,煎煮至六升,滤去药渣。再次煎煮取三升药液。每次温服一升,每日服用三次。
甘草(四两) 干姜(三两) 半夏(洗净,半升) 黄芩(三两) 黄连(一两) 大枣(掰开,十二枚)
以上六味药,用水一斗,煎煮至六升,滤去药渣。再次煎煮取三升药液。温服一升,每日服用三次。
半夏(洗净,半升) 干姜 甘草(炙) 人参 黄芩(各三两) 黄连(一两) 大枣(掰开,十二枚)
以上七味药,用水一斗,煎煮至六升,滤去药渣,再次煎煮取三升药液。温服一升,每日服用三次。
按:泻心汤系列方剂,均用于治疗中风后经过发汗或攻下治疗,表证已解但里气未和的病证。其中生姜泻心汤、甘草泻心汤、半夏泻心汤这三首泻心汤,是治疗痰湿结聚所致的心下痞满的方剂。方中用半夏、生姜来涤除痰饮,黄芩、黄连来清除湿热,人参、甘草来扶助胃气,干姜炮黑以渗利水湿。如果只用苦寒药清热,则会导致格拒而不受纳,必须得到辛热药作为向导引导药力,因此干姜、半夏在所必需。如果痞满极重且坚硬胀满,暂时去掉人参;如果气机壅滞向上冲逆,不用生姜;如果痞满但不坚硬,仍用人参。这是同一方剂的加减变化而具有三种不同的治法。至于大黄附子泻心汤等另外两首泻心汤,则是治疗阴阳偏胜所致的心下痞满。一首用大黄、黄连涤除胸中素有的湿热,另一首加附子兼温经中突然脱失的虚寒。使用沸水浸泡绞汁的方法,是取寒性药物的药性,不经过火煮而药力峻猛。其中的附子又必须煎煮成汁,是为了让寒性和热性药物各自发挥其特性。张仲景立法的精妙之处,没有超出这个范围。用大黄、黄芩、黄连涤除胃中的邪热,同时用附子温散凝结的阴寒,一举使寒热交结的邪气全部解除。岂料后人看到这些方剂却感到头晕目眩。
Gancao (Licorice Root, prepared with honey, 3 liang) Renshen (Codonopsis Root or Ginseng Radix, 3 liang) Ganjiang (Dried Ginger Rhizome, 1 liang) Banxia (Pinellia Tuber, washed, half sheng) Huangqin (Scutellaria Root, 3 liang) Huanglian (Coptis Rhizome, 1 liang) Shengjiang (Fresh Ginger Rhizome, sliced, 4 liang)
Dazao (Jujube Fruit, broken open, 12 pieces)
Take the above eight herbs, add one dou of water, boil to obtain six sheng, remove the dregs. Decoct again to obtain three sheng. Take one sheng warm, three times a day.
Gancao (Licorice Root, 4 liang) Ganjiang (Dried Ginger Rhizome, 3 liang) Banxia (Pinellia Tuber, washed, half sheng) Huangqin (Scutellaria Root, 3 liang) Huanglian (Coptis Rhizome, 1 liang) Dazao (Jujube Fruit, broken open, 12 pieces)
Take the above six herbs, add one dou of water, boil to obtain six sheng, remove the dregs. Decoct again to obtain three sheng. Take one sheng warm, three times a day.
Banxia (Pinellia Tuber, washed, half sheng) Ganjiang (Dried Ginger Rhizome) Gancao (Licorice Root, prepared) Renshen (Codonopsis Root or Ginseng Radix) Huangqin (Scutellaria Root, each 3 liang) Huanglian (Coptis Rhizome, 1 liang) Dazao (Jujube Fruit, broken open, 12 pieces)
Take the above seven herbs, add one dou of water, boil to obtain six sheng, remove the dregs, decoct again to obtain three sheng. Take one sheng warm, three times a day.
Note: The Xie Xin Tang (Drain the Epigastrium Decoctions) series are all used to treat conditions where the exterior syndrome has resolved but the interior qi is not harmonized after wind-stroke and subsequent sweating or purging therapies. Among them, Shengjiang Xie Xin Tang (Fresh Ginger Drain the Epigastrium Decoction), Gancao Xie Xin Tang (Licorice Drain the Epigastrium Decoction), and Banxia Xie Xin Tang (Pinellia Drain the Epigastrium Decoction) are formulas for treating pi (epigastric fullness/oppression) caused by the accumulation of phlegm-dampness. In these formulas, Banxia (Pinellia Tuber) and Shengjiang (Fresh Ginger Rhizome) are used to clear phlegm-fluids, Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome) to clear damp-heat, Renshen (Codonopsis Root or Ginseng Radix) and Gancao (Licorice Root) to support stomach qi, and Ganjiang (Dried Ginger Rhizome) charred to leach out water-dampness. If only bitter-cold herbs are used to clear heat, it will lead to rejection and non-absorption; thus, acrid-hot herbs are necessary as guides. Therefore, Ganjiang (Dried Ginger Rhizome) and Banxia (Pinellia Tuber) are essential. If the pi is extremely hard and full, temporarily remove Renshen (Codonopsis Root or Ginseng Radix); if qi stagnation rises upward, do not use Shengjiang (Fresh Ginger Rhizome); if the pi is present but not hard, still use Renshen (Codonopsis Root or Ginseng Radix). This represents modifications of one formula yielding three different treatments. As for the other two Xie Xin Tangs involving Dahuang (Rhubarb Root) and Fuzi (Aconite Lateral Root Prepared), they treat pi caused by excess of yin or yang. One uses Dahuang (Rhubarb Root) and Huanglian (Coptis Rhizome) to clear pre-existing damp-heat in the chest; the other adds Fuzi (Aconite Lateral Root Prepared) to simultaneously warm sudden deficiency-cold in the meridians. The method of steeping in boiling water and squeezing juice takes advantage of the nature of cold herbs without fire processing, resulting in potent action. The Fuzi (Aconite Lateral Root Prepared) must be decocted into juice separately, so that cold and hot properties act independently. The subtlety of Zhang Zhongjing's (Zhang Jingyue's predecessor, here referring to Zhang Zhongjing) legislative principles lies herein. Using Dahuang (Rhubarb Root), Huangqin (Scutellaria Root), and Huanglian (Coptis Rhizome) to purge evil heat from the stomach, while using Fuzi (Aconite Lateral Root Prepared) to warm and disperse congealed yin-cold, resolves the pathogenic factors of cold-heat entanglement in one stroke. How could later generations see these formulas and feel bewildered?