（一名通气防风散。一名通解散。）
通圣散 防风 芍药 川芎 大黄 当归 薄荷叶 麻黄 石膏 连翘 黄芩 芒硝（以上
各半两） 桔梗（各一两） 荆芥 滑石（三两） 白术 甘草（二两） 栀子（各二钱半） 上散（七两） 天
水散（七两）
上二药。合一处。相和。名为双解散。搅匀。每服五六钱。水一大盏半。入葱白五寸。生姜三片。煎一盏。滤汁。
去滓。温服无时。日三四服。以效为度。常服三钱。水一中盏。煎六分。绞汁。温服不拘时。
戴人张子和云。刘河间自制通圣散。加益元散。名双解散。千古之下。得仲景之旨者。一人而已。今之议者。以
为双解不可攻里。起谤纷纭。诚可憾也。岂知双解散。煎以葱须豆豉。涌而汗之。一剂立雪所苦。纵不全瘥。亦可小瘳。
俟六经传毕。微下而已。
琥按上方。气血兼走。汗下齐行。乃太阳阳明。表里合病之药也。若云。治太阳伤风。大误之极。戴人虽称此方。
为刘氏独得仲景之旨。要之用药杂乱。此方实为大变仲景之法。不足取也。都梁镏氏云。通圣散中。大黄芒硝麻黄三味。
须对证旋入。自利。去大黄芒硝。自汗去麻黄。后学能如此加减。则庶乎其与病相合矣。
张洁古云。经言有汗。不得服麻黄。无汗不得服桂枝。然春夏汗孔疏。虽有汗不当用桂枝。宜黄 汤以和（准绳作
和解。）之。秋冬汗孔闭。虽无汗。不当用麻黄宜。川芎汤以和（又作和解）之。春夏有汗。脉微而弱。恶风恶寒者。乃
太阳证秋冬之脉也。亦宜黄 汤。无汗。亦宜川芎汤。秋冬有汗。脉盛而浮。发热恶热者。乃阳明证春夏之脉也。亦宜
黄汤。无汗。亦宜川芎汤。大抵有汗皆可黄 汤。无汗皆可川芎汤。
琥按上论云。春夏汗孔疏。虽有汗不当用桂枝。以时当春夏。人本有汗。故虽遇有汗证。亦病之常。不当轻用桂
枝汤。夫桂枝汤者。本甘温辛热之剂。乃秋冬药也。又云。秋冬汗孔闭。虽无汗不当用麻黄。以时值秋冬。人本无汗。
故虽遇无汗证。亦病之常。不当轻用麻黄汤。夫麻黄汤者。亦甘温辛热之剂。洁古云秋冬不当用。更于何时可用麻黄汤
邪。又春之初时犹冬也。秋之初时犹夏也。此皆上论之不可执看者也。
琥又按上论云。春夏脉微弱。犹秋冬之脉。秋冬脉盛浮。犹春夏之脉。阐发四时脉证。诚为切当。但其云阳明证。
发热恶热。有汗者。亦宜黄 汤。临证不无少误。学人宜活变观之。
通圣散由以下药材组成：防风、芍药、川芎、大黄、当归、薄荷叶、麻黄、石膏、连翘、黄芩、芒硝（以上各半两）；桔梗（各一两）；荆芥、滑石（三两）；白术、甘草（二两）；栀子（各二钱半）。以上共为散剂七两。另取水天散（即益元散，Gypsum Rubrum et Talcum Powder）七两。
将上述两种药物混合在一起，调和均匀，称为“双解散”。服用时，取五六钱药粉，加水一大盏半，加入葱白五寸、生姜三片，煎煮至一盏量，滤去药渣。不拘时候温服，每日服用三四次，以见效为度。若作为日常保健服用，每次三钱，加水一中盏，煎煮至六分，绞取汁液，不拘时候温服。
戴人张子和说：刘河间自制通圣散，加入益元散，命名为双解散。千古之下，能领悟仲景心意的，仅有这一方而已。如今议论的人，认为双解散不可用于攻下里实，由此引发诸多诽谤争议，实在令人遗憾。哪里知道双解散用葱须和豆豉煎煮，具有涌吐和发汗的作用，一剂药下去，立刻解除患者的痛苦，即使不能完全痊愈，也能稍微缓解。等到六经传变完毕，再轻微攻下即可。
王琥按语：上方气血兼治，汗法与下法并行，是治疗太阳病与阳明病表里合病的方剂。如果说它治疗太阳伤风，那是极大的错误。戴人虽然称赞此方是刘氏独得仲景心意的方子，但究其用药杂乱，此方实际上大幅改变了仲景的法度，不值得推崇。都梁镏氏说：通圣散中的大黄、芒硝、麻黄三味药，必须根据证候临时加入。如果患者自利（腹泻），去掉大黄和芒硝；如果患者自汗，去掉麻黄。后学若能如此加减，则差不多能与病情相合了。
张洁古说：经文说，有汗者不得服用麻黄，无汗者不得服用桂枝。然而春夏季节汗孔疏松，即使有汗也不当使用桂枝汤，宜用黄耆建中汤（此处原文似缺字，结合语境推测为黄芪类或调和营卫之剂，暂译作Huangqi Tang以和之）来调和。秋冬季节汗孔闭合，即使无汗，也不当使用麻黄汤，宜用川芎汤来调和。春夏有汗，脉象微而弱，恶风恶寒，这是太阳病在秋冬季节的脉象特征，也宜用黄耆汤。无汗，也宜用川芎汤。秋冬有汗，脉象盛大而浮，发热恶热，这是阳明病在春夏季节的脉象特征，也宜用黄耆汤。无汗，也宜用川芎汤。大抵有汗者皆可适用黄耆汤，无汗者皆可适用川芎汤。
王琥按语：上述论述说，春夏季节汗孔疏松，即使有汗也不当使用桂枝汤，因为时令正值春夏，人体本就容易出汗，所以即使遇到有汗的症状，也是疾病的常态，不应当轻易使用桂枝汤。桂枝汤本是甘温辛热的药剂，属于秋冬季节使用的方剂。又说，秋冬季节汗孔闭合，即使无汗也不当使用麻黄汤，因为时令正值秋冬，人体本就不易出汗，所以即使遇到无汗的症状，也是疾病的常态，不应当轻易使用麻黄汤。麻黄汤也是甘温辛热的药剂，张洁古说秋冬不当使用，那何时才可使用麻黄汤呢？另外，初春之时气候仍像冬天，初秋之时气候仍像夏天，这些都是上述论述中不可拘泥看待的地方。
王琥又按语：上述论述说，春夏季节脉象微弱，如同秋冬季节的脉象；秋冬季节脉象盛浮，如同春夏季节的脉象。这阐发了四时脉证的关系，确实切中要害。但是他说阳明病发热恶热、有汗者，也宜用黄耆汤，临证时难免会有少许偏差。学习者应当灵活变通地看待。
(Also known as Tongqi Fangfeng San, or Tongjie San.)
Tongsheng San consists of the following herbs: Fangfeng (Saposhnikoviae Radix), Shaoyao (Paeoniae Radix), Chuanxiong (Chuanxiong Rhizoma), Dahuang (Rhei Radix et Rhizoma), Danggui (Angelicae Sinensis Radix), Boheye (Menthae Haplocalycis Herba), Mahuang (Ephedrae Herba), Shigao (Gypsum Fibrosum), Lianqiao (Forsythiae Fructus), Huangqin (Scutellariae Radix), Mangxiao (Natrii Sulfas) (each half tael); Jiegeng (Platycodonis Radix) (each one tael); Jingjie (Schizonepetae Spica), Huashi (Talcum) (three taels); Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) (two taels); Zhizi (Gardeniae Fructus) (each two qian and half). The above are processed into a powder totaling seven taels. Additionally, take Tianshui San (Yiyuan San, Gypsum Rubrum et Talcum Powder) seven taels.
Mix the above two medicines together and blend evenly; this is named "Shuangjie San" (Double-Resolving Powder). For administration, take three to five qian of the powder, add one and a half large cups of water, five cun of scallion white (Congbai), and three slices of fresh ginger (Shengjiang). Decoct until one cup remains, strain the liquid, and remove the dregs. Take warm at any time, three to four times a day, until efficacy is achieved. For regular maintenance use, take three qian, add one medium cup of water, decoct until six-tenths remain, squeeze out the juice, and take warm at any time.
Dairen Zhang Zihe stated: Liu Hejian independently formulated Tongsheng San and added Yiyuan San, naming it Shuangjie San. Since ancient times, only this formula has truly grasped the essence of Zhang Zhongjing. Critics today argue that Shuangjie San should not be used for purging interior excess, causing much controversy and slander, which is indeed regrettable. How could they know that when Shuangjie San is decocted with scallion roots and fermented soybeans (Douchi), it induces vomiting and sweating? One dose can immediately relieve the patient's suffering; even if not fully cured, it can provide slight relief. After the transmission through the Six Channels is complete, mild purgation may then be applied.
Wang Hu commented: The above formula treats both Qi and Blood, simultaneously employing sweating and purging methods. It is a prescription for Taiyang-Yangming combined exterior-interior disease. To claim it treats Taiyang wind-strike is extremely erroneous. Although Dairen praised this formula as uniquely capturing Zhang Zhongjing's intent, its herbal composition is chaotic. This formula substantially alters Zhang Zhongjing's principles and is not worthy of adoption. Liu of Duliang stated: In Tongsheng San, the three herbs Dahuang, Mangxiao, and Mahuang must be added according to the specific syndrome. If the patient has spontaneous diarrhea, remove Dahuang and Mangxiao; if the patient has spontaneous sweating, remove Mahuang. If junior practitioners can modify the formula in this manner, it will likely correspond well with the disease.
Zhang Jiegu stated: The classics say, those with sweating should not take Mahuang, and those without sweating should not take Guizhi. However, in spring and summer, when pores are loose, even if there is sweating, Guizhi Tang should not be used; instead, Huangqi Tang should be used to harmonize. In autumn and winter, when pores are closed, even if there is no sweating, Mahuang Tang should not be used; instead, Chuanxiong Tang should be used to harmonize. In spring and summer, if there is sweating, pulse is faint and weak, with aversion to wind and cold, this is the pulse pattern of Taiyang disease in autumn/winter; Huangqi Tang is also suitable. Without sweating, Chuanxiong Tang is also suitable. In autumn and winter, if there is sweating, pulse is vigorous and floating, with fever and aversion to heat, this is the pulse pattern of Yangming disease in spring/summer; Huangqi Tang is also suitable. Without sweating, Chuanxiong Tang is also suitable. Generally, those with sweating can use Huangqi Tang, and those without sweating can use Chuanxiong Tang.
Wang Hu commented: The above discussion states that in spring and summer, when pores are loose, Guizhi Tang should not be used even if sweating occurs, because during these seasons, people naturally sweat; thus, encountering sweating symptoms is often normal and Guizhi Tang should not be lightly employed. Guizhi Tang is inherently a sweet-warm and acrid-hot preparation, intended for autumn and winter. It further states that in autumn and winter, when pores are closed, Mahuang Tang should not be used even if sweating is absent, because during these seasons, people naturally do not sweat; thus, encountering non-sweating symptoms is often normal and Mahuang Tang should not be lightly employed. Mahuang Tang is also a sweet-warm and acrid-hot preparation. If Zhang Jiegu says Mahuang Tang should not be used in autumn and winter, when else can it be used? Moreover, early spring resembles winter, and early autumn resembles summer. These are aspects of the above discussion that should not be viewed rigidly.
Wang Hu further commented: The above discussion states that in spring and summer, a faint and weak pulse resembles the autumn/winter pulse; in autumn and winter, a vigorous and floating pulse resembles the spring/summer pulse. This elucidates the relationship between seasonal pulses and syndromes, which is indeed pertinent. However, his statement that Yangming disease presenting with fever, aversion to heat, and sweating should also use Huangqi Tang may lead to minor errors in clinical practice. Students should view this with flexibility.