当归（一两） 黄连（一两） 黄芩（一两） 龙胆草（一两） 栀子仁（一两） 大
黄（五钱） 芦荟（五钱） 青黛（五钱） 木香（二钱五分） 黄柏（一两） 麝香（另研，五钱）
上为末，炒神曲，糊丸。每服二十丸，姜汤下。
【集注】汪昂曰∶肝木为生火之本，肝火盛则诸经之火相因而起，为病不止一端矣。故
以当归、芦荟、龙胆草、青黛直入本经气血
两途，先平其甚者，而诸经之火，无不渐平矣，佐以黄芩泻肺火，黄连泻心火，黄柏泻
肾火，大黄泻肠胃火，栀子泻三焦火，备举大苦大寒而直折之，使上、中、下三焦之火，
悉从大、小二便利出。少加木香、麝香者，取其调气开窍灵通周至也。然非实火不可轻投。
越婢加半夏汤 治咳而上气；此为肺胀，其人喘，目如脱状，脉浮大者。
麻黄（六两） 石膏（半斤） 生姜（三两） 甘草（二两） 半夏（半升） 大枣（十五枚）
上六味，以水六升，先煮麻黄，去沫，内药，取三升，分温三服。
小青龙加石青汤 治肺胀，咳而上气，烦躁而喘，脉浮者，心下有水气。
麻黄（三两） 桂枝（三两） 细辛（三两） 芍药（三
两） 半夏（半升） 石膏（三两） 干姜（三两） 五味子（半升） 甘草（三两）
上九味，以水一斗，煮麻黄，去沫，内诸药，取三升。强人服一升，羸者减之，日三服。小儿服四合。
【集注】喻昌曰∶前一方，麻黄汤中以桂、杏易石膏，以脉大有热而加姜、枣，则发散
之力微而且缓也。后一方，小青龙汤中加入石膏，以证兼烦躁，虽宜汗散寒饮，犹防助
热伤津也。越婢方中有石膏、半夏二物，协力建功。石膏清热，藉辛热亦能豁痰，半夏
豁痰，借辛凉亦能清热。前麦冬汤方中下气止逆，全藉半夏入生津药中。此二方又藉半
夏入清温剂中，仲景加减成方，无非化裁后学矣。
清燥救肺汤 治诸气 郁，诸痿喘呕。
桑叶（经霜者，三钱） 石膏（炒，二钱五分） 甘草（一钱） 胡麻仁（炒、研，一钱）
真阿胶（八分） 人参（七分） 麦冬（一钱二分） 杏仁（去皮尖、炒黄，七分） 枇杷
叶（去毛，蜜炙，一片）
上九味，以水一碗，煎六分，频频二三次，滚热服。
痰多加贝母、栝蒌。血枯加生地。热甚加犀角、羚羊角，或加牛黄。
【集注】喻昌曰∶按诸气 郁之属于肺者，属于肺之燥也，而古今治气郁之方，用辛香
行气，绝无一方治肺之燥者。诸痿喘呕之属于上者，亦属于肺之燥也。而古今治法，以
痿、呕属阳明，以喘属肺，是则呕与痿属之中、下，而惟喘属上矣，所以亦无一方及于
肺之燥也。即喘之属于肺者，非表即下，非行气即泄气，间有一二用润剂者，又不得其
肯綮。今拟此方名清燥救肺，大约以胃为主，胃土为肺金之母也。其天冬。知母能清金滋
水，以苦寒而不用，至如苦寒降火之药，尤在所忌。盖肺金自至于燥，所存阴气不过一
线耳。倘更以苦寒下其气，伤其胃，其人尚有生理乎？诚仿此增减以救肺燥变生诸证，庶克有济。
柯琴曰∶古方用香燥之品以治气郁，不获奏效者，以火就燥也。惟缪仲醇知之，故
用甘凉滋润之品，以清金保肺立法。喻昌宗其旨，集诸润剂，而制清燥救肺汤，用意深，
取药当，无遗蕴矣。
【按】经云∶损其肺者益其气。肺主诸气故也。然火与元气不两立，故用人参、甘草
甘温而补气，气壮火自消，是用少火生气之法也。若夫火燥 郁于肺，非佐甘寒多液之
品，不足以滋肺燥，而肺气反为壮火所食，益助其燥矣。故佐以石膏、麦冬、桑叶、阿胶、
胡麻仁辈，使清肃令行，而壮火亦从气化也。经曰∶肺苦气上逆，急食苦以降之。故又佐
以杏仁、枇杷叶之苦以降气。气降火亦降，而制节有权；气行则不郁，诸痿喘呕自除矣。要
知诸 郁，则肺气必大虚，若泥于肺热伤肺之说而不用人参，郁必不开而火愈炽，皮聚
毛落，喘咳不休而死矣。此名之救肺，凉而能补之谓也。若谓实火可泻，而久服芩、连，
苦从火化，亡可立待耳。
麦门冬汤 火逆上气，咽喉不利，止逆下气者主之。
麦门冬（七升） 半夏（一升） 人参（三两） 甘草（二两） 粳米（三合） 大枣（十二枚）
上六味，以水一斗二升，煮取六升，温服一升；日三服，夜一服。
【集注】喻昌曰∶此方治胃中津液干枯，虚火上炎，治本之良法也。夫用降火之药而
火反升，用寒凉之药而热转炽者，徒知与火热相争，弗知补正气以生津液，不惟无益而
反害之矣。凡肺病有胃气则生，无胃气则死。胃气者，肺之母气也。《本草》有知母之名，
谓肺藉其清凉，知清凉为肺之母也。又有贝母之名，谓肺藉其豁痰，豁痰为肺之母也。然
屡施于火逆上气，咽喉不利之证，而屡不应者，名不称矣。孰知仲景妙法，于麦冬、人
参、甘草、大枣、粳米大补中气以生津液队中，又增入半夏辛温之味，以开胃行津而润
肺，岂特用其利咽下气哉！顾其利咽下气，非半夏之功，实善用半夏之功也。
人参清肺汤 治肺胃虚寒，咳嗽喘急，坐卧不安。并治久年劳嗽，吐血腥臭。
人参 阿胶 骨皮 知 母 乌梅 粟壳 炙草 杏 仁 桑皮（各等分）
加枣子，煎服。
人参定喘汤
人参 麻黄 阿胶 五味 粟壳 甘草 半夏曲（各一钱） 桑皮（二钱）
生姜三片，水煎服。
人参泻肺汤 治肺经积热上喘，胸隔胀满痰多，大便涩。
人参 黄芩 栀子 枳壳 薄荷 甘草 连翘 杏仁 桑皮 大 黄 桔梗
水煎服。
【集注】王又原曰∶经云∶邪之所凑，其气必虚。又肺为娇脏，其不堪破耗也明矣。自
肺热伤肺之说行，曰保肺补肺，众共哗之。曰清肺泻肺，药与和之。岂知古人清肺、泻肺
等汤，而必皆以人参立名，夫亦可晓然于肺气之不可耗，而人参之在所必用也。肺体清
而法天，下济而司降令，一切混浊不得上干者，皆胸中之气健营运而不息也。若肺气少
弛，则降下失令，混浊之气遂逆上行，此为咳嗽为喘急，肺叶胀举，胸膈紧痛，移热大
肠，大便艰涩，种种显有余之象，实种种为不足之征。故不问内伤外感，为热为寒，要
以人参保定肺气为主。或佐骨皮、知母、阿胶滋之，乌梅、五味、罂粟壳敛之，半夏曲、
生姜降之，杏仁，桑皮、枳壳、桔梗利之，栀子、黄芩、连翘凉之，麻黄、薄荷发之，大
黄下之，总恃人参之大力，握枢而运，已入之邪易出，而将来之邪无从入也。肺邪得诸
药以俱出，而肺气不随诸药以俱出也。然则人参亦何尝伤肺，乃畏而不敢用耶？又谓风
寒咳嗽，忌用五味子；嗽用粟壳，止嗽如神，切肺如刀。然此无本之言，不知始自何出，皆
因不读《本草》，不知药之性味功能，以讹传讹也。近世之医，亦不能辨，惟识者察之。
泻白散 治肺气郁热，咳嗽而喘，面肿身热。
桑白皮 地骨皮 甘草
水煎服。
【集注】季楚重曰∶经云∶肺苦气上逆。上逆则上焦郁热，气郁生涎，火郁生热，因
而制节不行，壅甚为喘满肿嗽。白者肺之色，泻白泻肺气之有余也。君以桑白皮，质液而
味辛，液以润燥，辛以泻肺。臣以地骨皮，质轻而性寒，轻以去实，寒以胜热。甘草生用
泻火，佐桑皮、地骨皮泻诸肺实，使金清气肃而喘嗽可平，较之黄芩、知母苦寒伤胃者
远矣。夫火热伤气，救肺之治有三∶实热伤肺，用白虎汤以治其标；虚火刑金，用生脉
散以治其本；若夫正气不伤，郁火又甚，则泻白散之清肺调中，标本兼治，又补二方之
不及也。
阿胶散 治肺虚有火，嗽无津液，咳而硬气者。
真阿胶（一两） 牛蒡子（炒，二钱半） 马兜铃（炒，五钱） 杏仁（七钱） 炙甘草（五
钱） 糯米）一合）
每服两许，水煎服。
【集注】程应旄曰∶痰带红线，嗽有血点，日渐成痿，缘肺处脏之最高，叶间布有细窍，
气从此出入，呼吸成液，灌溉周身，所谓水出高源也，一受火炎，吸时徒引火升，呼时
并无液出，久则肺窍俱闭，喉间或痒或疮，六叶遂日焦枯矣。今用阿胶为君者，消窍瘀也。
用杏仁，大力子，宣窍道也。马兜铃者，清窍热也。糯米以补脾，母气到则肺自轻清无碍矣。
二陈汤 治肥盛之人，湿痰为患，喘嗽胀满。
半夏（制，三钱） 茯苓（三钱） 陈皮（去白，二钱） 甘草（一钱）
上四味，加姜三片，水煎服。
【集注】李中梓曰∶肥人多湿，湿挟热而生痰，火载气而逆上，半夏之辛，利二便而
去湿。陈皮之辛，通三焦而理气。茯苓佐半夏，共成燥湿之功。甘草佐陈皮，同致调和
之力。成无己曰∶半夏行水气而润肾燥。经曰∶辛以润之是也。行水则土自燥，非半夏
之性燥也。或曰∶有痰而渴，宜去半夏代以贝母。吴琨曰∶渴而喜饮，小便利者易之。不
能饮水，小便不利，虽渴宜半夏也，此湿为本，热为标，所谓湿极而兼胜已之化，非真
象也。又东南之人，湿热生痰，故朱震亨主之加枳实、砂仁，名枳实二陈汤，其性较急
也，先哲云∶二陈为治痰之妙剂，其于上下、左右无所不宜，然只能治实痰之标，不能治
虚痰之本。虚痰之本在脾胃，治者详之。
温胆汤 治热呕吐苦，虚烦，惊悸不眠，痰气上逆。
竹茹 枳实 半夏 甘草 陈皮 茯苓 生姜
上七味，水煎服。
【集注】罗谦甫曰∶胆为中正之官，清静之府，喜宁谧，恶烦扰，喜柔和，恶壅郁。盖
东方木德，少阳温和之气也。若病后，或久病而宿有痰饮未消，胸膈之余热未尽，必致
伤少阳之和气，以故虚烦惊悸者，中正之官，以 蒸而不宁也。热呕吐苦者，清静之府，以
郁炙而不谧也。痰气上逆者，木家挟热而上升也。方以二陈治一切痰饮，加竹茹以清热，
加生姜以止呕，加枳实以破逆，相济相须，虽不治胆而胆自和，盖所谓胆之痰热去故也。命
名温者，乃谓温和之温，非谓温凉之温也。若谓胆家真畏寒而怯而温之，不但方中无温胆
之品，且更有凉胃之药也。
小半夏汤 呕家本渴，渴为欲解，今反不渴，心下有支饮故也。
半夏（一升） 生姜（半斤）
以水七升，煮取一升半，分温再服。
小半夏加茯苓汤 治卒呕吐，心下痞，膈间有水，眩悸者。
半夏（一升） 生姜（半斤） 茯苓（三两）
煎服如前。
《外台》茯苓饮 治心胸中有痰饮宿水，自吐出水，复心胸间虚气满不能食，消痰气令能食。
茯苓（三两） 人参（三两） 白术（三两） 枳实（二两） 橘皮（二两半） 生姜（四两）
上六味，水六升，煮取一升八合，分三服。如人行八九里，再进之。
【集注】赵良曰∶呕为痰饮动中，涌而出之。呕尽本当渴，渴则可征支饮之全去。今
反不渴，是其饮尚留，去之未尽也。用半夏之辛温，生姜之辛散，散其欲出之饮，则所
留之邪自尽矣。半夏、生姜皆味辛，可治膈上痰，心下坚，呕逆目眩。然悸必心受水凌，
故加茯苓以去水，伐肾邪安心神也。后方加人参、枳实、橘皮，此由上、中二焦气弱，水
饮入胃，脾不能输归于肺，肺不能通调水道，以致停积为痰、为宿水。吐之则下气因而上
逆，虚与气结，满不能食，当补益中气。以人参、白术为君，茯苓逐宿水，枳实破诸气
为臣。开脾胃，宣扬上焦，发散凝滞，则陈皮、生姜为使也。其积饮既去，而虚气塞满
其中，不能进食，此证最多。
当归（一两） 黄连（一两） 黄芩（一两） 龙胆草（一两） 栀子仁（一两） 大黄（五钱） 芦荟（五钱） 青黛（五钱） 木香（二钱五分） 黄柏（一两） 麝香（另研，五钱）
将上述药物研磨成粉末，用炒过的神曲糊作为粘合剂制成丸药。每次服用二十丸，用姜汤送服。
【集注】汪昂说：肝木是产生内火的根本，肝火旺盛则各条经络的火随之而起，导致的疾病不止一端。因此用当归、芦荟、龙胆草、青黛直接入肝经的气血两途，先平息最严重的火势，那么各条经络的火，没有不逐渐平息的。辅以黄芩泻肺火，黄连泻心火，黄柏泻肾火，大黄泻肠胃火，栀子泻三焦火，列举所有大苦大寒的药物来直接折损火势，使上、中、下三焦的火，都从大便和小便排出。少量加入木香、麝香，是取它们调理气机、开窍灵通、周全细致的功效。然而如果不是实火，不可轻易投用此方。
越婢加半夏汤 治疗咳嗽且气逆；这是肺胀病，患者气喘，眼睛像要脱出一样，脉象浮大的。
麻黄（六两） 石膏（半斤） 生姜（三两） 甘草（二两） 半夏（半升） 大枣（十五枚）
以上六味药，用水六升，先煮麻黄，去掉浮沫，再加入其他药物，煮取三升，分三次温服。
小青龙加石膏汤 治疗肺胀，咳嗽且气逆，烦躁而喘，脉浮的，这是心下有饮邪水气。
麻黄（三两） 桂枝（三两） 细辛（三两） 芍药（三两） 半夏（半升） 石膏（三两） 干姜（三两） 五味子（半升） 甘草（三两）
以上九味药，用水一斗，煮麻黄，去掉浮沫，加入其余药物，煮取三升。身体强壮的人服一升，瘦弱的人减量，每天服三次。小儿服四合。
【集注】喻昌说：前一方（越婢加半夏汤），是在麻黄汤中以桂枝、杏仁换成石膏，因为脉大有热而加入姜、枣，那么发散的力量就微弱而且缓和了。后一方（小青龙加石膏汤），在小青龙汤中加入石膏，因为证候兼有烦躁，虽然适宜发汗散除寒饮，但仍需防止助热伤津。越婢方中有石膏、半夏两味药，协力建功。石膏清热，借助辛热之性也能豁痰；半夏豁痰，借助辛凉之性也能清热。前麦冬汤方中下气止逆，全靠半夏进入生津药中发挥作用。这两个方子又借助半夏进入清温剂中，张仲景加减成方，无非是化裁以教导后学罢了。
清燥救肺汤 治疗各种气郁，各种痿证、喘证、呕吐。
桑叶（经霜的，三钱） 石膏（炒，二钱五分） 甘草（一钱） 胡麻仁（炒、研，一钱） 真阿胶（八分） 人参（七分） 麦冬（一钱二分） 杏仁（去皮尖、炒黄，七分） 枇杷叶（去毛，蜜炙，一片）
以上九味药，用水一碗，煎至六分，频频分两三次，滚热服用。
痰多加贝母、栝蒌。血枯加生地。热甚加犀角、羚羊角，或加牛黄。
【集注】喻昌说：按诸气郁属于肺的，是属于肺的燥邪，而古今治疗气郁的方子，多用辛香行气药，绝无一方治疗肺燥的。诸痿、喘、呕属于上部的，也是属于肺的燥邪。而古今治法，认为痿、呕属于阳明胃，认为喘属于肺，这样呕与痿属于中、下部，而只有喘属于上部了，所以也没有一方涉及肺燥。即使喘属于肺的，不是解表就是攻下，不是行气就是泄气，偶尔有一两个用润剂的，又没有抓住关键。现在拟定这个方子名为清燥救肺，大约以胃为主，因为胃土是肺金之母。其中天冬、知母能清金滋水，但因为苦寒而不采用，至于如苦寒降火之药，更是所忌讳的。因为肺金至于干燥，所存的阴气不过一线罢了。倘若再用苦寒药下其气，损伤其胃，那人还有生机吗？诚然仿照此方增减以救治肺燥变生的各种证候，才可能有济于事。
柯琴说：古方用香燥之品治疗气郁，不能奏效的，是因为火就燥（火上浇油）。只有缪仲醇知道这一点，所以用甘凉滋润之品，以清金保肺为立法原则。喻昌遵循他的宗旨，集合各种润剂，而制成清燥救肺汤，用意深远，取药恰当，没有遗漏蕴意了。
【按语】经文说：损伤肺脏的要益其气。因为肺主诸气。然而火与元气不两立，所以用人参、甘草甘温而补气，气壮火自消，这是用少火生气的法则。如果火燥郁结于肺，不佐以甘寒多液的药品，不足以滋润肺燥，而肺气反被壮火所食，更加助长其燥了。所以佐以石膏、麦冬、桑叶、阿胶、胡麻仁等，使清肃令行，而壮火也从气化而消散。经文说：肺苦气上逆，急食苦味以降之。所以又佐以杏仁、枇杷叶之苦以降气。气降火亦降，而制节有权；气行则不郁，各种痿、喘、呕自然消除了。要知道各种气郁，肺气必大虚，如果拘泥于肺热伤肺之说而不用人参，郁结必然不开而火更炽盛，皮毛枯落，喘咳不休而死。这名叫救肺，是指凉而能补。如果说实火可泻，而久服黄芩、黄连，苦从火化，死亡立刻等待。
麦门冬汤 治疗火逆上气，咽喉不利，以止逆下气为主。
麦冬（七升） 半夏（一升） 人参（三两） 甘草（二两） 粳米（三合） 大枣（十二枚）
以上六味药，用水一斗二升，煮取六升，温服一升；每天三次，夜间一次。
【集注】喻昌说：此方治疗胃中津液干枯，虚火上炎，是治本的好方法。如果用降火药而火反而上升，用寒凉药而热转炽盛的，只知道与火热相争，不知道补正气以生津液，不仅无益反而有害。凡是肺病有胃气则生，无胃气则死。胃气，是肺之母气。《本草》有知母之名，说是肺借其清凉，知清凉为肺之母也。又有贝母之名，说是肺借其豁痰，豁痰为肺之母也。然而屡施用于火逆上气，咽喉不利的证候，却屡不应验，名不副实。谁知道张仲景的妙法，在麦冬、人参、甘草、大枣、粳米大补中气以生津液的队伍中，又增入半夏辛温之味，以开胃行津而润肺，岂只是用它利咽下气呢！看它利咽下气，不是半夏的功效，实在是善用半夏的功效。
人参清肺汤 治疗肺胃虚寒，咳嗽喘急，坐卧不安。并治疗多年劳嗽，吐血腥臭。
人参 阿胶 地骨皮 知母 乌梅 粟壳 炙甘草 杏仁 桑白皮（各等分）
加枣子，煎服。
人参定喘汤
人参 麻黄 阿胶 五味子 粟壳 甘草 半夏曲（各一钱） 桑白皮（二钱）
生姜三片，水煎服。
人参泻肺汤 治疗肺经积热上喘，胸膈胀满痰多，大便涩滞。
人参 黄芩 栀子 枳壳 薄荷 甘草 连翘 杏仁 桑白皮 大黄 桔梗
水煎服。
【集注】王又原说：经文说：邪气聚集的地方，正气必定虚弱。另外肺为娇脏，它不堪受破耗是明显的。自从“肺热伤肺”的说法流行，有人说保肺补肺，众人哗然反对。有人说清肺泻肺，药物与之调和。哪里知道古人清肺、泻肺等汤，都以人参命名，这也可以明白肺气不可耗损，而人参在所必用了。肺体清而法天，下济而司降令，一切混浊不得上干的，都是胸中之气健运营运而不息。如果肺气稍弛缓，则降下失令，混浊之气遂逆上行，此为咳嗽为喘急，肺叶胀举，胸膈紧痛，移热大肠，大便艰涩，种种显有余之象，实则种种为不足之征。所以不问内伤外感，为热为寒，总要以人参保定肺气为主。或佐地骨皮、知母、阿胶滋养它，乌梅、五味子、罂粟壳收敛它，半夏曲、生姜降逆它，杏仁、桑白皮、枳壳、桔梗利它，栀子、黄芩、连翘凉它，麻黄、薄荷发散它，大黄下它，总依靠人参的大力，握枢而运，已入之邪易出，而将来之邪无从入也。肺邪得诸药以俱出，而肺气不随诸药以俱出。既然这样，人参又何尝伤肺，是人们畏惧而不敢用呢？又说风寒咳嗽，忌用五味子；嗽用粟壳，止嗽如神，切肺如刀。然而这是无根据的话，不知道始自何处，都是因为不读《本草》，不知药之性味功能，以讹传讹。近世的医生，也不能辨别，只有识者察之。
泻白散 治疗肺气郁热，咳嗽而喘，面肿身热。
桑白皮 地骨皮 甘草
水煎服。
【集注】季楚重说：经文说：肺苦气上逆。上逆则上焦郁热，气郁生涎，火郁生热，因而制节不行，壅甚为喘满肿嗽。白色是肺之色，泻白是泻肺气之有余。君药以桑白皮，质液而味辛，液以润燥，辛以泻肺。臣药用地骨皮，质轻而性寒，轻以去实，寒以胜热。甘草生用泻火，佐桑皮、地骨皮泻诸肺实，使金清气肃而喘嗽可平，比之黄芩、知母苦寒伤胃者远矣。夫火热伤气，救肺之治有三：实热伤肺，用白虎汤以治其标；虚火刑金，用生脉散以治其本；如果正气不伤，郁火又甚，则泻白散的清肺调中，标本兼治，又补二方之不及。
阿胶散 治疗肺虚有火，嗽无津液，咳而硬气者。
真阿胶（一两） 牛蒡子（炒，二钱半） 马兜铃（炒，五钱） 杏仁（七钱） 炙甘草（五钱） 糯米（一合）
每次服约一两许，水煎服。
【集注】程应旄说：痰带红线，嗽有血点，日渐成痿，缘肺处脏之最高，叶间布有细窍，气从此出入，呼吸成液，灌溉周身，所谓水出高源也，一受火炎，吸时徒引火升，呼时并无液出，久则肺窍俱闭，喉间或痒或疮，六叶遂日焦枯矣。今用阿胶为君者，消窍瘀也。用杏仁，大力子（牛蒡子），宣窍道也。马兜铃者，清窍热也。糯米以补脾，母气到则肺自轻清无碍矣。
二陈汤 治疗肥盛之人，湿痰为患，喘嗽胀满。
半夏（制，三钱） 茯苓（三钱） 陈皮（去白，二钱） 甘草（一钱）
以上四味药，加姜三片，水煎服。
【集注】李中梓说：肥人多湿，湿挟热而生痰，火载气而逆上，半夏之辛，利二便而去湿。陈皮之辛，通三焦而理气。茯苓佐半夏，共成燥湿之功。甘草佐陈皮，同致调和之力。成无己说：半夏行水气而润肾燥。经文说：辛以润之是也。行水则土自燥，非半夏之性燥也。有人说：有痰而渴，宜去半夏代以贝母。吴琨说：渴而喜饮，小便利者换掉它。不能饮水，小便不利，虽渴宜用半夏，这是湿为本，热为标，所谓湿极而兼胜已之化，非真象也。另外东南之人，湿热生痰，所以朱震亨主张加枳实、砂仁，名枳实二陈汤，其性较急也。先哲说：二陈为治痰之妙剂，其于上下、左右无所不宜，然而只能治实痰之标，不能治虚痰之本。虚痰之本在脾胃，治疗者详之。
温胆汤 治疗热呕吐苦，虚烦，惊悸不眠，痰气上逆。
竹茹 枳实 半夏 甘草 陈皮 茯苓 生姜
以上七味药，水煎服。
【集注】罗谦甫说：胆为中正之官，清静之府，喜宁谧，恶烦扰，喜柔和，恶壅郁。盖东方木德，少阳温和之气也。若病后，或久病而宿有痰饮未消，胸膈之余热未尽，必致伤少阳之和气，以故虚烦惊悸者，中正之官，以蒸而不宁也。热呕吐苦者，清静之府，以郁炙而不谧也。痰气上逆者，木家挟热而上升也。方以二陈治一切痰饮，加竹茹以清热，加生姜以止呕，加枳实以破逆，相济相须，虽不治胆而胆自和，盖所谓胆之痰热去故也。命名温者，乃谓温和之温，非谓温凉之温也。如果说胆家真畏寒而怯而温之，不但方中无温胆之品，且更有凉胃之药也。
小半夏汤 呕吐的人本来口渴，口渴为欲解，现在反而不渴，是因为心下有支饮的缘故。
半夏（一升） 生姜（半斤）
用水七升，煮取一升半，分两次温服。
小半夏加茯苓汤 治疗突然呕吐，心下痞，膈间有水，眩晕心悸者。
半夏（一升） 生姜（半斤） 茯苓（三两）
煎服如前法。
《外台》茯苓饮 治疗心胸中有痰饮宿水，自己吐出水，复心胸间虚气满不能食，消痰气令能食。
茯苓（三两） 人参（三两） 白术（三两） 枳实（二两） 橘皮（二两半） 生姜（四两）
以上六味药，水六升，煮取一升八合，分三次服。如人行走八九里路程的时间，再进服。
【集注】赵良说：呕为痰饮动中，涌而出之。呕尽本当渴，渴则可征支饮之全去。现在反而不渴，是其饮尚留，去之未尽也。用半夏之辛温，生姜之辛散，散其欲出之饮，则所留之邪自尽矣。半夏、生姜皆味辛，可治膈上痰，心下坚，呕逆目眩。然而悸必心受水凌，故加茯苓以去水，伐肾邪安心神也。后方加人参、枳实、橘皮，此由上、中二焦气弱，水饮入胃，脾不能输归于肺，肺不能通调水道，以致停积为痰、为宿水。吐之则下气因而上逆，虚与气结，满不能食，当补益中气。以人参、白术为君，茯苓逐宿水，枳实破诸气为臣。开脾胃，宣扬上焦，发散凝滞，则陈皮、生姜为使也。其积饮既去，而虚气塞满其中，不能进食，此证最多。
Dang Gui (1 liang), Huang Lian (1 liang), Huang Qin (1 liang), Long Dan Cao (1 liang), Zhi Zi Ren (1 liang), Da Huang (5 qian), Lu Hui (5 qian), Qing Dai (5 qian), Mu Xiang (2.5 qian), Huang Bo (1 liang), She Xiang (separately ground, 5 qian).
Grind the above herbs into powder, use fried Shen Qu paste as a binder to make pills. Take 20 pills each time, with Ginger Decoction for delivery.
[Annotations] Wang Ang said: Gan Mu (Liver Wood) is the root of generating internal fire. When Liver Fire is excessive, fire from all meridians arises sequentially, causing diseases that are not limited to one aspect. Therefore, Dang Gui, Lu Hui, Long Dan Cao, and Qing Dai are used to directly enter the Qi and Blood pathways of the Liver Meridian to first pacify the most severe fire, after which the fire in all meridians will gradually subside. Huang Qin is added to clear Lung Fire, Huang Lian to clear Heart Fire, Huang Bo to clear Kidney Fire, Da Huang to clear Intestine and Stomach Fire, and Zhi Zi to clear San Jiao Fire. All great bitter and cold herbs are listed to directly suppress the fire, allowing the fire of the Upper, Middle, and Lower San Jiao to exit through urination and defecation. A small amount of Mu Xiang and She Xiang is added to regulate Qi, open orifices, and ensure thorough spiritual circulation. However, this formula should not be lightly administered unless it is Excess Fire.
Yue Bi Jia Ban Xia Tang (Ephedra Decoction with Added Pinellia) treats cough with rebellious Qi; this is Fei Zhang (Lung Distension), where the patient wheezes, eyes appear as if protruding, and the pulse is floating and large.
Ma Huang (6 liang), Shi Gao (0.5 jin), Sheng Jiang (3 liang), Gan Cao (2 liang), Ban Xia (0.5 sheng), Da Zao (15 pieces).
Take the above six herbs, add 6 sheng of water, first boil Ma Huang, remove the foam, then add other herbs, decoct to obtain 3 sheng, divide into three warm doses.
Xiao Qing Long Jia Shi Gao Tang (Minor Green Dragon Decoction with Added Gypsum) treats Fei Zhang (Lung Distension), cough with rebellious Qi, irritability and wheezing, floating pulse, indicating Water-Fluid retention under the heart.
Ma Huang (3 liang), Gui Zhi (3 liang), Xi Xin (3 liang), Shao Yao (3 liang), Ban Xia (0.5 sheng), Shi Gao (3 liang), Gan Jiang (3 liang), Wu Wei Zi (0.5 sheng), Gan Cao (3 liang).
Take the above nine herbs, add 1 dou of water, boil Ma Huang, remove the foam, add remaining herbs, decoct to obtain 3 sheng. Strong individuals take 1 sheng per dose, weak individuals reduce the dose, taken three times daily. Children take 4 he.
[Annotations] Yu Chang said: The former formula (Yue Bi Jia Ban Xia Tang) replaces Gui Zhi and Xing Ren from Ma Huang Tang with Shi Gao; because the pulse is large with heat, adding Jiang and Zao makes the dispersing force mild and slow. The latter formula (Xiao Qing Long Jia Shi Gao Tang) adds Shi Gao to Xiao Qing Long Tang because the syndrome includes irritability; although sweating to disperse cold-fluid is appropriate, one must still prevent assisting heat and damaging fluids. Yue Bi Fang contains Shi Gao and Ban Xia, working together. Shi Gao clears heat, and borrowing the acrid-hot nature can also resolve phlegm; Ban Xia resolves phlegm, and borrowing the acrid-cool nature can also clear heat. In the previous Mai Dong Tang, descending Qi and stopping rebellion relies entirely on Ban Xia entering fluid-generating herbs. These two formulas again utilize Ban Xia entering clearing and warming agents. Zhang Zhongjing’s modifications of established formulas are nothing but adaptations to teach later generations.
Qing Zao Jiu Fei Tang (Clear Dryness Rescue Lung Decoction) treats various Qi stagnations, various Wei syndromes (flaccidity), Chuan syndromes (wheezing), and Ou (vomiting).
Sang Ye (frosted, 3 qian), Shi Gao (stir-fried, 2.5 qian), Gan Cao (1 qian), Hu Ma Ren (stir-fried, ground, 1 qian), Zhen E Jiao (8 fen), Ren Shen (7 fen), Mai Dong (1.2 qian), Xing Ren (skin and tip removed, stir-fried yellow, 7 fen), Pi Pa Ye (hairs removed, honey-fried, 1 piece).
Take the above nine herbs, add 1 bowl of water, decoct to 0.6 portion, take frequently in two or three doses, hot.
If phlegm is abundant, add Bei Mu and Gua Lou. If blood is dry, add Sheng Di. If heat is severe, add Xi Jiao, Ling Yang Jiao, or Niu Huang.
[Annotations] Yu Chang said: Regarding Qi stagnation belonging to the Lung, it belongs to Lung Dryness. Yet ancient and modern formulas for Qi stagnation mostly use acrid-aromatic Qi-moving herbs, with none treating Lung Dryness. Regarding Wei, Chuan, and Ou belonging to the Upper Jiao, they also belong to Lung Dryness. Yet ancient and modern treatments attribute Wei and Ou to Yangming (Stomach/Intestines) and Chuan to Lung, thus placing Wei and Ou in Middle/Lower Jiao and only Chuan in Upper Jiao, so no formula addresses Lung Dryness. Even for Chuan belonging to Lung, treatments are either exterior-releasing or purging, Qi-moving or Qi-draining; occasionally moistening agents are used, but they miss the key point. Now naming this formula Qing Zao Jiu Fei, it roughly focuses on the Stomach, as Stomach Earth is the Mother of Lung Metal. Tian Dong and Zhi Mu can clear Metal and nourish Water, but due to their bitter-cold nature, they are not used; indeed, bitter-cold fire-descending drugs are especially contraindicated. Since Lung Metal has reached dryness, the remaining Yin Qi is but a thread. If bitter-cold drugs are further used to descend Qi and damage the Stomach, will there be any life left? Sincerely following this formula for additions and reductions to rescue Lung Dryness and its varied syndromes may yield results.
Ke Qin said: Ancient formulas using aromatic-dry herbs to treat Qi stagnation fail because "fire follows dryness" (adding fuel to the fire). Only Miao Zhongchun understood this, thus using sweet-cool and moistening herbs to clear Metal and protect Lung as the principle. Yu Chang followed his intent, gathering various moistening agents to create Qing Zao Jiu Fei Tang, with profound intent and appropriate herb selection, leaving no hidden meaning unexplored.
[Note] The Classic says: Damage the Lung, benefit its Qi. Because Lung governs all Qi. However, Fire and Yuan Qi cannot coexist, so Ren Shen and Gan Cao are used for their sweet-warm Qi-tonifying properties; when Qi is strong, Fire naturally subsides, employing the method of "minor fire generates Qi." If Fire-Dryness stagnates in the Lung, without sweet-cold and fluid-rich herbs, Lung Dryness cannot be moistened, and Lung Qi is consumed by vigorous Fire, further aiding Dryness. Thus, Shi Gao, Mai Dong, Sang Ye, E Jiao, and Hu Ma Ren are added to allow Clearing and Descending functions to proceed, so Vigorous Fire dissipates through Qi transformation. The Classic says: Lung dislikes Qi rebelling upward; urgently eat bitter to descend it. Thus, Xing Ren and Pi Pa Ye are added for their bitter property to descend Qi. When Qi descends, Fire descends, and regulation is effective; when Qi moves, stagnation does not occur, and various Wei, Chuan, and Ou syndromes are eliminated. It must be known that in various Qi stagnations, Lung Qi is severely deficient. If one sticks to the theory of "Heat damages Lung" and does not use Ren Shen, stagnation will not open and Fire will blaze, leading to death with withered skin/hair and incessant cough/wheezing. This is named "Rescuing Lung," meaning cooling yet tonifying. If one claims Excess Fire can be purged and takes Huang Qin and Huang Lian for long periods, Bitter transforms into Fire, and death awaits immediately.
Mai Men Dong Tang (Ophiopogon Decoction) treats Fire rebellion with upward Qi, unfavorable throat conditions, primarily for descending rebellious Qi.
Mai Dong (7 sheng), Ban Xia (1 sheng), Ren Shen (3 liang), Gan Cao (2 liang), Jing Mi (3 he), Da Zao (12 pieces).
Take the above six herbs, add 12 sheng of water, decoct to obtain 6 sheng, take 1 sheng warm; three times daily, once at night.
[Annotations] Yu Chang said: This formula treats dried-up fluids in the Stomach and deflected Deficient Fire rising; it is an excellent method for treating the root. Using fire-descending drugs while Fire rises, or using cold-cooling drugs while Heat intensifies, indicates merely knowing to contend with Fire-Heat without knowing to tonify Zheng Qi to generate fluids, which is not only useless but harmful. For Lung diseases, presence of Stomach Qi means life, absence means death. Stomach Qi is the Mother Qi of Lung. Ben Cao mentions Zhi Mu, saying Lung borrows its coolness, implying coolness is the mother of Lung. It mentions Bei Mu, saying Lung borrows its phlegm-resolving action, implying phlegm-resolution is the mother of Lung. However, repeatedly applying these to Fire rebellion with upward Qi and unfavorable throat yields no response, failing to live up to their names. Who knows Zhang Zhongjing’s subtle method: within the team of Mai Dong, Ren Shen, Gan Cao, Da Zao, and Jing Mi which greatly tonify Middle Qi to generate fluids, Ban Xia’s acrid-warm flavor is added to open the Stomach, move fluids, and moisten Lung. Is it merely for benefiting the throat and descending Qi! Its ability to benefit the throat and descend Qi is not Ban Xia’s merit, but the merit of skillfully using Ban Xia.
Ren Shen Qing Fei Tang (Ginseng Clearing Lung Decoction) treats Lung-Stomach Deficient-Cold, cough and acute wheezing, restlessness in sitting or lying. Also treats chronic consumptive cough with bloody sputum having a foul odor.
Ren Shen, E Jiao, Gu Pi (Gu Pi usually refers to Cortex Lycii or Cortex Phellodendri, context suggests Cortex Lycii/Digupi for deficiency heat), Zhi Mu, Wu Mei, Su Ke, Zhi Gan Cao, Xing Ren, Sang Pi (equal parts).
Add dates, decoct and take.
Ren Shen Ding Chuan Tang (Ginseng Calming Wheezing Decoction)
Ren Shen, Ma Huang, E Jiao, Wu Wei, Su Ke, Gan Cao, Ban Xia Qu (each 1 qian), Sang Pi (2 qian).
Three slices of Sheng Jiang, decoct in water and take.
Ren Shen Xie Fei Tang (Ginseng Draining Lung Decoction) treats Lung Meridian accumulated Heat causing upward wheezing, chest and diaphragm fullness with much phlegm, constipation.
Ren Shen, Huang Qin, Zhi Zi, Zhi Qiao, Bo He, Gan Cao, Lian Qiao, Xing Ren, Sang Pi, Da Huang, Jie Geng.
Decoct in water and take.
[Annotations] Wang Youyuan said: The Classic says: Where evil gathers, Qi must be deficient. Furthermore, Lung is a delicate organ, obviously intolerant to depletion. Since the theory of "Lung Heat damages Lung" spread, some advocated protecting and tonifying Lung, causing public outcry. Others advocated clearing and draining Lung, harmonizing with drugs. How could one know that ancient Clearing Lung and Draining Lung formulas were all named after Ren Shen? This reveals clearly that Lung Qi cannot be depleted and Ren Shen is essential. Lung body is pure and models Heaven, descends to assist and governs descending commands. All turbid matters that do not disturb the upper are due to robust circulation of Qi in the Chest. If Lung Qi slackens slightly, descending command is lost, turbid Qi rebels upward, causing cough and acute wheezing, lung lobes distend, chest/diaphragm tight pain, heat transfers to Large Intestine, stool becomes difficult. These seemingly Excess symptoms are actually signs of Deficiency. Therefore, regardless of internal injury or external contraction, heat or cold, the primary goal is to stabilize Lung Qi with Ren Shen. Or assist with Gu Pi, Zhi Mu, E Jiao to nourish; Wu Mei, Wu Wei Zi, Ying Su Ke to astringe; Ban Xia Qu, Sheng Jiang to descend; Xing Ren, Sang Pi, Zhi Qiao, Jie Geng to facilitate; Zhi Zi, Huang Qin, Lian Qiao to cool; Ma Huang, Bo He to disperse; Da Huang to purge. Relying entirely on Ren Shen’s great power to grasp the pivot and circulate, existing evil exits easily, and future evil has no entry. Lung evil exits with the herbs, but Lung Qi does not exit with them. Then how does Ren Shen harm the Lung, yet people fear and dare not use it? Some say Wind-Cold cough contraindicates Wu Zi; using Su Ke for cough stops cough like magic but cuts Lung like a knife. However, this is baseless talk, origin unknown, stemming from not reading Ben Cao, not knowing herb properties/functions, spreading errors. Modern doctors also cannot distinguish; only experts observe.
Xie Bai San (Drain White Powder) treats Lung Qi stagnation-Heat, cough and wheezing, facial swelling and body heat.
Sang Bai Pi, Di Gu Pi, Gan Cao.
Decoct in water and take.
[Annotations] Ji Chuzhong said: The Classic says: Lung dislikes Qi rebelling upward. Rebelling upward causes Upper Jiao stagnation-Heat, Qi stagnation generates saliva, Fire stagnation generates heat, thus regulation fails, congestion leads to wheezing, fullness, swelling, and cough. White is Lung’s color; Xie Bai drains Lung Qi excess. Sovereign herb Sang Bai Pi, liquid quality and acrid taste, liquid moistens dryness, acrid drains Lung. Minister herb Di Gu Pi, light quality and cold nature, light removes excess, cold overcomes heat. Raw Gan Cao drains fire, assisting Sang Pi and Di Gu Pi to drain Lung excess, making Metal clear and Qi肃 (solemn/clear) so wheezing/cough can calm, far superior to Huang Qin and Zhi Mu which damage Stomach with bitter-cold. Fire-Heat damages Qi; treating Lung has three aspects: Excess Heat damaging Lung uses Bai Hu Tang to treat the branch; Deficient Fire punishing Metal uses Sheng Mai San to treat the root; if Zheng Qi is undamaged but Stagnant Fire is severe, Xie Bai San’s clearing Lung and regulating Middle treats both branch and root, supplementing the inadequacy of the other two formulas.
E Jiao San (Donkey-Hide Gelatin Powder) treats Lung Deficiency with Fire, cough without fluids, cough with hard/rebellious Qi.
Zhen E Jiao (1 liang), Niu Bang Zi (stir-fried, 2.5 qian), Ma Dou Ling (stir-fried, 5 qian), Xing Ren (7 qian), Zhi Gan Cao (5 qian), Nuomi (1 he).
Take approx. 1 liang per dose, decoct in water and take.
[Annotations] Cheng Yingmao said: Phlegm with red threads, cough with blood spots, gradually becoming Wei syndrome. Because Lung is highest among organs, leaves have fine pores, Qi enters/exits here, breathing forms fluids irrigating the whole body, called "Water originates from high source." Once subjected to Fire flare-up, inhalation draws Fire up, exhalation produces no fluid. Long-term, Lung pores close, throat itches or ulcerates, six lobes scorch daily. Now using E Jiao as sovereign to dissolve pore stasis. Using Xing Ren and Da Li Zi (Niu Bang Zi) to open pore pathways. Ma Dou Ling clears pore heat. Nuomi tonifies Spleen; when Mother Qi arrives, Lung naturally becomes light/clear without obstruction.
Er Chen Tang (Two Aged Herbs Decoction) treats obese individuals suffering from Damp-Phlegm, wheezing/cough/fullness.
Ban Xia (processed, 3 qian), Fu Ling (3 qian), Chen Pi (white removed, 2 qian), Gan Cao (1 qian).
Take the above four herbs, add 3 slices of Jiang, decoct in water and take.
[Annotations] Li Zhongzi said: Obese people have much Dampness; Dampness carries Heat to generate Phlegm, Fire carries Qi to rebel upward. Ban Xia’s acridity benefits urination/defecation and removes Dampness. Chen Pi’s acridity opens San Jiao and regulates Qi. Fu Ling assists Ban Xia to complete drying-Dampness function. Gan Cao assists Chen Pi to achieve harmonizing power. Cheng Wuji said: Ban Xia moves Water-Qi and moistens Kidney Dryness. The Classic says: Acrid moistens. Moving Water makes Earth naturally dry; it is not Ban Xia’s nature that is dry. Some say: With Phlegm and thirst, remove Ban Xia replace with Bei Mu. Wu Kun said: Thirst with desire to drink and frequent urination, substitute it. Cannot drink, infrequent urination, even with thirst, Ban Xia is suitable. This is Dampness as root, Heat as branch, called "Extreme Dampness assumes transformation of its overcoming element," not true appearance. Furthermore, people in Southeast have Damp-Heat generating Phlegm, so Zhu Zhenheng advocated adding Zhi Shi and Sha Ren, naming Zhi Shi Er Chen Tang, its nature is more urgent. Ancients said: Er Chen is a miraculous agent for treating Phlegm, suitable everywhere up/down/left/right, yet it only treats the branch of Excess Phlegm, not the root of Deficient Phlegm. The root of Deficient Phlegm lies in Spleen/Stomach; practitioners should examine carefully.
Wen Dan Tang (Warm Gallbladder Decoction) treats Heat vomiting with bitter taste, empty irritability, palpitations with fright and insomnia, Phlegm-Qi rebelling upward.
Zhu Ru, Zhi Shi, Ban Xia, Gan Cao, Chen Pi, Fu Ling, Sheng Jiang.
Take the above seven herbs, decoct in water and take.
[Annotations] Luo Qianfu said: Dan is the Official of Uprightness, the Mansion of Purity and Tranquility, preferring serenity, hating disturbance, preferring gentleness, hating stagnation. It corresponds to Eastern Wood Virtue, Shaoyang gentle-warm Qi. After illness, or chronic illness with old Phlegm-Fluid unresolved, residual Heat in Chest/Diaphragm not cleared, inevitably damages Shaoyang’s harmonious Qi, thus Empty Irritability and Fright/Palpitations arise, the Official of Uprightness steams without peace. Heat vomiting with bitter taste: the Mansion of Purity is agitated without tranquility due to stagnation-heat. Phlegm-Qi rebelling upward: Wood family carrying Heat rising. The formula uses Er Chen to treat all Phlegm-Fluid, adds Zhu Ru to clear Heat, Sheng Jiang to stop vomiting, Zhi Shi to break rebellion. They complement and require each other; though not directly treating Dan, Dan naturally harmonizes, because Dan’s Phlegm-Heat is removed. Named "Warm" refers to gentle-warm, not warm-cool contrast. If claiming Dan truly fears Cold and needs warming, not only are there no warming Dan herbs in the formula, but there are also Stomach-cooling drugs.
Xiao Ban Xia Tang (Minor Pinellia Decoction) Vomiting patients are normally thirsty; thirst indicates resolution. Now contrary, not thirsty, because there is Zhi Yin (branch fluid) under the heart.
Ban Xia (1 sheng), Sheng Jiang (0.5 jin).
Add 7 sheng of water, decoct to obtain 1.5 sheng, divide into two warm doses.
Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia Decoction with Added Poria) treats sudden vomiting, epigastric stuffiness, water between diaphragm, dizziness and palpitations.
Ban Xia (1 sheng), Sheng Jiang (0.5 jin), Fu Ling (3 liang).
Decoct and take as before.
Wai Tai Fu Ling Yin (External Treasury Poria Drink) treats Phlegm-Fluid and old water in Heart/Chest, self-vomiting water, then emptiness/fullness in Heart/Chest preventing eating, eliminates Phlegm-Qi to enable eating.
Fu Ling (3 liang), Ren Shen (3 liang), Bai Zhu (3 liang), Zhi Shi (2 liang), Ju Pi (2.5 liang), Sheng Jiang (4 liang).
Take the above six herbs, add 6 sheng of water, decoct to obtain 1.8 sheng, divide into three doses. Advance another dose after walking for the distance covered in 8-9 li.
[Annotations] Zhao Liang said: Vomiting is Phlegm-Fluid moving internally, surging out. After vomiting ends, one should be thirsty; thirst confirms complete removal of Zhi Yin. Now contrary, not thirsty, indicating Fluid remains, not fully removed. Use Ban Xia’s acrid-warm and Sheng Jiang’s acrid-dispersing to scatter the impending Fluid, so remaining evil exhausts itself. Ban Xia and Sheng Jiang are both acrid, treating Phlegm above diaphragm, hardness below heart, vomiting/reversal and dizziness. However, palpitations imply Heart submerged by Water, so add Fu Ling to remove Water, attack Kidney Evil to calm Spirit. The latter formula adds Ren Shen, Zhi Shi, Ju Pi, due to weak Qi in Upper/Middle Jiao. Water-Fluid enters Stomach, Spleen cannot transport to Lung, Lung cannot regulate Water passages, leading to accumulation as Phlegm/Old Water. Vomiting causes Lower Qi to rebel upward, emptiness and Qi knot, fullness preventing eating, requiring tonification of Middle Qi. Ren Shen and Bai Zhu as Sovereign, Fu Ling chasing Old Water, Zhi Shi breaking various Qi as Ministers. Opening Spleen/Stomach, promoting Upper Jiao, dispersing stagnation, Ju Pi and Sheng Jiang as Envoys. Once accumulated Fluid is gone, but emptiness/Qi fills inside, preventing eating, this syndrome is common.