素盛人丰有湿痰，九蒸苍术向君谈，防风通圣（散）疗诸病，更奉二陈（汤）作指南。
素禀之衰，亦由于先天。其脉多短，其人贪逸而恶劳，喜暖而恶凉。伤寒及一切杂病，
汗、吐、下酌量用之，即解肌、消导、寒润等剂，亦须照顾元气，病势一退，即宜温补。
然素衰之人，外邪易入而亦易出，得轻宣则解，或啜热粥亦解。若常服补养之品，以人参养荣
汤、归脾汤、还少丹为良法，若小便微短者，可审其寒温，而用六、八味丸。又富贵之家，
无病时亦喜服丸药，其实非法也，然亦不可无以应之。兹得张心在十味补心汤、散、丸、饮
、膏，随人所欲，亦为切用之剂。
素禀衰兮补养先，归脾（汤）还少（丸）养荣（汤）煎，补心汤散丸膏妙，肾气（六味丸）地黄（丸）效补
天（寻常服食，余极夸其效，若大病用之则误矣。）
桂枝汤 治伤风自汗，头痛项强，发热恶寒等症（凡《伤寒论》、《金匮》、《千金》、
《外台》、《圣济方》俱改为小剂，以便时用，下仿此。）
桂枝 白芍 生姜（各三钱） 炙甘草（二钱） 大枣（四枚）
水煎服，啜热粥，覆取微汗，未汗再服，一日夜可三服。此方姜、桂、甘草、大枣之辛
甘以补阳，芍药、大枣、甘草之苦甘以补阴，是补剂非汗剂也。妙在服后，温啜粥，取谷
气胜邪以为汗，则汗不受伤，则绝无变症之患。无论四时、南北、老幼、强弱，皆可服之。
麻黄汤 治伤寒中风发热、恶寒、头痛、身疼痛、项强、无汗而喘等证。
麻黄（去根节三钱） 桂枝（二钱） 炙草（一钱） 杏仁（二十四粒
水三杯，先煮麻黄至二杯，去沫，入诸药同煮至八分，温服，覆取微汗，不啜粥，未汗
再服，一日夜可三服。此方麻杏从表以发表；桂甘从肌以达表；不啜粥者，恐其逗留麻黄之
性，发汗太过也。
升麻葛根汤（钱仲阳） 治阳明伤寒中风，头疼，身痛，发热恶寒，无汗，口渴，目痛鼻干
，不得卧，及阳明发斑，欲出不出，寒暄不时，人多疫疾。
升麻（三钱） 葛根 白芍（各二钱） 炙草（一钱）加姜煎。
愚以此方葛根可用三、四钱，升麻只用一钱许，加川芎、白芷、紫苏、黄芩、石膏之类
俱可加入。
此方非《伤寒论》阳明证之正方也。但就表证而论，阳明以肌肉为表，与太阳不同，故
取葛根以清肌肉之热为君，亦不啜粥者，恐胃得补而增热也。
按∶阳明证，《内经》以身热，目痛鼻干，不得卧为提纲，仲景以胃家实为提纲。前圣
后圣，立说不同，或从宋人用升麻葛根汤，是宗《内经》经气之传以为治也。但葛根非阳明
正药，以其宣肌络，除大热，取阳明主肌肉而蒸蒸发热之义也。《伤寒论》入手，有用桂枝
汤，麻黄汤法，却无用葛根法，而传为白虎证，以及承气证，古今之治法一辙也。
小柴胡汤（方见下） 治少阳病，胁痛，目眩，耳聋，口苦，寒热往来，呕吐等症。此方《
伤寒论》以太阳病邪气欲从少阳而出，取之以助枢转也。然正少阳症，亦不外此方，盖以少
阳主枢，柴胡为转枢之神品，切勿以发汗诬之。
按∶头为诸阳之会，伤寒中风阳证，必有头痛。《经》云∶太阳之脉，其直者从巅入络
脑，还出列下项，循肩膊由夹脊，抵腰中，故太阳头痛，脑痛而连项脊也。阳明之脉，起
于
鼻，络于目，交额中，故阳明头痛，额痛而连面目也。少阳之脉，起于目锐 ，上抵头角，
下耳后，其支者，从耳后，入耳中，出走耳前，故少阳头痛，耳前后痛，上连头角也。
身体壮实且体型丰满的人，体内多有湿痰。治疗时以经过九次蒸制的苍术为君药进行探讨，防风通圣散可治疗多种疾病，同时应遵循二陈汤的原则作为指导。
体质素来虚弱的人，其衰弱也源于先天不足。这类人的脉象多短促，性格贪图安逸而厌恶劳动，喜欢温暖而厌恶寒冷。对于伤寒及一切杂病，发汗、催吐、攻下等法需酌情使用；即使是解肌、消导、寒凉滋润等方剂，也必须顾护元气。一旦病势减退，就应当采用温补之法。然而，体质虚弱之人，外邪容易侵入也容易排出，使用轻清宣散的方剂即可解除病邪，或者喝热粥也能帮助出汗解表。如果经常服用补养药物，以人参养荣汤、归脾汤、还少丹为良方；若小便轻微短少，可审察其属寒属热，从而选用六味地黄丸或八味肾气丸。另外，富贵人家，即使没有生病也喜欢服用丸药，这其实是不符合医理的，但也无法完全不予回应。这里收录了张心在的十味补心汤、散、丸、饮、膏，根据病人的喜好选择，也是切实有用的方剂。
体质衰弱者，应先进行补养。归脾汤、还少丹、人参养荣汤煎服效果良好，补心汤、散、丸、膏也很精妙，肾气丸（即八味丸）和六味地黄丸能有效填补先天之亏。
桂枝汤：治疗伤风引起的自汗、头痛项强、发热恶寒等症状。（凡是《伤寒论》、《金匮要略》、《千金方》、《外台秘要》、《圣济总录》都将此方改为小剂量，以便当时使用，下文仿照此例。）
组成：桂枝、白芍、生姜（各三钱），炙甘草（二钱），大枣（四枚）。
用法：水煎服，服药后喝热粥，覆盖衣被取微汗。若未出汗再服，一昼夜可服三次。此方中姜、桂、甘草、大枣的辛甘味道用以补阳，芍药、大枣、甘草的苦甘味道用以补阴，这是一个补益剂而非单纯的发汗剂。妙处在于服药后温服热粥，利用谷气战胜邪气而化为汗液，这样出汗而不损伤正气，绝无产生变证的隐患。无论四季、南北地域、老人小孩、体质强弱，都可以服用。
麻黄汤：治疗伤寒中风引起的发热、恶寒、头痛、身体疼痛、项强、无汗且喘息等症状。
组成：麻黄（去根节，三钱），桂枝（二钱），炙甘草（一钱），杏仁（二十四粒）。
用法：用水三杯，先煮麻黄至两杯，去掉浮沫，加入其他药物同煮至八分，温服，覆盖衣被取微汗，不喝热粥。若未出汗再服，一昼夜可服三次。此方中麻黄、杏仁从体表发散以发表邪；桂枝、甘草从肌肉层面通达体表。不喝热粥的原因，是担心热粥停留体内会增强麻黄的药性，导致发汗太过。
升麻葛根汤（出自钱乙《小儿药证直诀》）：治疗阳明经伤寒中风，出现头疼、身痛、发热恶寒、无汗、口渴、眼睛痛、鼻子干、不能安卧，以及阳明经发斑疹，欲出而未出的情况，还有气候寒暖不定、人多患疫病的情况。
组成：升麻（三钱），葛根、白芍（各二钱），炙甘草（一钱），加生姜煎服。
我认为此方中葛根可用三到四钱，升麻只用一钱左右，加入川芎、白芷、紫苏、黄芩、石膏等药物均可。
此方并非《伤寒论》中治疗阳明病的正正方。仅就表证而言，阳明经以肌肉为表，与太阳经不同，所以选取葛根作为君药以清除肌肉之热。也不喝热粥，是担心胃得到补益会增加内热。
按语：关于阳明证，《内经》以身热、目痛鼻干、不得卧为提纲，张仲景则以“胃家实”为提纲。前代圣贤与后代圣贤立说不同。有人沿用宋人使用的升麻葛根汤，这是遵循《内经》中经气传变的理论来治疗。但葛根并非阳明经的正药，它是通过宣通肌络、清除大热，取阳明主司肌肉且呈现蒸蒸发热的含义。《伤寒论》开篇，有用桂枝汤、麻黄汤的方法，却没有用葛根汤的方法，病情往往传变为白虎汤证，以及承气汤证，古今的治疗方法是一致的。
小柴胡汤（方剂见下文）：治疗少阳病，出现胁痛、目眩、耳聋、口苦、寒热往来、呕吐等症状。此方在《伤寒论》中，是因为太阳病邪气欲从少阳外出，取此方以助枢机转动。然而真正的少阳症，也不超出此方范围，因为少阳主司枢机，柴胡是转动枢机的神妙药物，切勿将其误认为是发汗剂。
按语：头部是诸阳经汇聚的地方，伤寒中风阳证，必然会有头痛。《内经》说：太阳经脉，直行者从头顶入络于脑，复出下行至项部，沿肩膊由夹脊穴抵腰部，所以太阳经头痛，表现为头脑痛并牵连项脊。阳明经脉，起于鼻旁，联络于目，交会于额中，所以阳明经头痛，表现为额头痛并牵连面目。少阳经脉，起于眼外角，上抵头角，下行至耳后，其支脉从耳后进入耳中，走出耳前，所以少阳经头痛，表现为耳前后痛，向上连及头角。
Individuals with robust constitutions and plump builds often have damp-phlegm (Damp-Phlegm) in their bodies. Treatment involves discussing the use of Atractylodis Rhizoma (Cangzhu, 苍术), steamed nine times, as the sovereign drug. Fangfeng Tongsheng San (Windproof Unblocking All-Purpose Powder) can treat various diseases, while one should also follow the principles of Erchen Tang (Two-Cured Decoction) as a guide.
The decline in innate constitution also stems from congenital deficiency. Their pulse is often short (Short Pulse). These individuals are prone to laziness and dislike labor, preferring warmth and disliking cold. For Taiyang disease (Taiyang Disease) and all miscellaneous diseases, methods such as sweating (Sweating Method), vomiting (Vomiting Method), and purging (Purging Method) must be used judiciously. Even for formulas that release the muscle layer (Release Muscle Layer Method), promote digestion (Promote Digestion Method), or use cold and moistening agents, one must attend to the Yuan Qi (Original Qi). Once the pathogenic trend recedes, warming and tonifying methods should be employed. However, for those with weak constitutions, external pathogens enter easily and exit easily; they can be resolved with light and dispersing agents, or even by drinking hot porridge to induce sweating. If one frequently takes tonic substances, Ren Shen Yang Rong Tang (Ginseng Nourishing Nutritive Decoction), Guipi Tang (Restore the Spleen Decoction), and Huanshao Dan (Return to Youth Pill) are excellent choices. If urine is slightly scanty, one should assess whether it is cold or heat and then use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) or Bawei Shengqi Wan (Eight-Ingredient Kidney Qi Pill). Furthermore, wealthy families often like to take pills even when healthy, which is actually improper practice, yet there is no way to completely ignore this preference. Here, we present Zhang Xinza's Shipei Buxin Tang (Ten-Ingredient Heart-Nourishing Decoction), powder, pill, drink, and paste, chosen according to the patient's desire, which are also practical and useful formulas.
For those with weak innate constitutions, nourishment and tonification should come first. Guipi Tang (Restore the Spleen Decoction), Huanshao Dan (Return to Youth Pill), and Ren Shen Yang Rong Tang (Ginseng Nourishing Nutritive Decoction) are effective when decocted. Shipei Buxin Tang, powder, pill, and paste are exquisite, while Shengqi Wan (Kidney Qi Pill, i.e., Bawei Wan) and Dihuang Wan (Rehmannia Pill, i.e., Liuwei Wan) effectively supplement heaven (congenital essence). (Note: Commonly taken as food/supplement, I highly praise its efficacy, but using it for major illnesses would be a mistake.)
Guizhi Tang (Cinnamon Twig Decoction): Treats symptoms of Shangfeng (Wind Strike) such as spontaneous sweating, headache with neck stiffness, fever, and aversion to cold. (Note: *Shanghan Lun*, *Jinkui Yaolue*, *Qianjin Fang*, *Waitai Miyao*, and *Shengji Zonglu* all modify this formula into smaller doses for contemporary use; subsequent formulas follow this example.)
Ingredients: Guizhi (Cinnamon Twig), Baishao (White Peony Root), Shengjiang (Fresh Ginger) (each 3 qian), Zhigancao (Honey-fried Licorice Root) (2 qian), Dazao (Jujube) (4 pieces).
Usage: Decoct in water, drink hot porridge afterwards, cover with blankets to induce slight sweating. If no sweat occurs, administer again. Can be taken up to three times within a day and night. This formula uses the acrid-sweet nature of ginger, cinnamon, licorice, and jujube to tonify Yang, and the bitter-sweet nature of peony, jujube, and licorice to tonify Yin. It is a tonifying agent, not merely a sweating agent. Its brilliance lies in drinking warm porridge after administration; the grain qi overcomes the pathogen to generate sweat, thus sweating without damaging healthy Qi, eliminating the risk of complications. It can be used regardless of season, geography (north or south), age (old or young), or constitution (strong or weak).
Mahuang Tang (Ephedra Decoction): Treats symptoms of Shanghan (Cold Damage) or Shangfeng (Wind Strike) such as fever, aversion to cold, headache, body pain, neck stiffness, absence of sweat, and wheezing.
Ingredients: Mahuang (Ephedra Stem, remove root and joints, 3 qian), Guizhi (Cinnamon Twig) (2 qian), Zhigancao (Honey-fried Licorice Root) (1 qian), Xingren (Apricot Seed) (24 grains).
Usage: Use three cups of water. First, boil Mahuang until two cups remain, skim off the foam, then add other herbs and boil until eight-tenths remains. Take warm, cover with blankets to induce slight sweating. Do not drink porridge. If no sweat occurs, administer again. Can be taken up to three times within a day and night. In this formula, Mahuang and Xingren release the exterior from the surface; Guizhi and Gancao reach the exterior from the muscle layer. Porridge is not drunk because it is feared that it might linger in the stomach and enhance the sweating effect of Mahuang excessively.
Shengma Gegen Tang ( Cimicifuga and Pueraria Decoction, attributed to Qian Zhongyang): Treats Yangming Shanghan (Yangming Cold Damage) or Shangfeng (Wind Strike), presenting with headache, body pain, fever, aversion to cold, absence of sweat, thirst, eye pain, nasal dryness, inability to sleep, as well as Yangming macules (skin eruptions) that wish to emerge but do not, irregular weather changes, and epidemic diseases prevalent among people.
Ingredients: Shengma (Cimicifuga Rhizome) (3 qian), Gegen (Pueraria Root), Baishao (White Peony Root) (each 2 qian), Zhigancao (Honey-fried Licorice Root) (1 qian). Add fresh ginger and decoct.
I believe Gegen (Pueraria Root) can be used in doses of 3-4 qian, while Shengma (Cimicifuga Rhizome) should only be used in small amounts around 1 qian. Adding Chuanxiong (Ligusticum Rhizome), Baizhi (Angelica Dahurica Root), Zisu (Perilla Leaf), Huangqin (Scutellaria Root), Shigao (Gypsum Fibrosum), etc., is also acceptable.
This formula is not the primary formula for Yangming syndrome in *Shanghan Lun*. Merely discussing the exterior syndrome, Yangming considers the muscle layer as the exterior, which differs from Taiyang. Therefore, Gegen (Pueraria Root) is taken as the sovereign drug to clear heat from the muscles. Porridge is not drunk because it is feared that tonifying the Stomach will increase heat.
Commentary: Regarding Yangming syndrome, *Neijing* (*Inner Canon*) sets "body heat, eye pain, nasal dryness, and inability to sleep" as the outline, while Zhang Zhongjing sets "Stomach House Excess" (Wei Jia Shi) as the outline. The theories of former and latter sages differ. Some follow Song dynasty physicians using Shengma Gegen Tang, adhering to the transmission of Jing-Qi (Meridian Qi) in *Neijing*. However, Gegen (Pueraria Root) is not the orthodox herb for Yangming; it is used to diffuse muscle collaterals and remove great heat, taking advantage of Yangming's governance over muscles and its tendency to manifest steaming heat. At the beginning of *Shanghan Lun*, there are methods using Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction), but no method using Gegen Tang. The condition often transmits to Baihu Tang (White Tiger Decoction) syndrome or Chengqi Tang (Assist the Qi Decoction) syndrome. The treatment methods of ancient and modern times are consistent.
Xiao Chaihu Tang (Minor Bupleurum Decoction) (Formula seen below): Treats Shaoyang disease, presenting with hypochondriac pain, vertigo, deafness, bitter taste in the mouth, alternating chills and fever, vomiting, etc. In *Shanghan Lun*, this formula is used because the pathogenic factor of Taiyang disease wishes to exit through Shaoyang, and this formula assists the pivot mechanism. However, true Shaoyang syndrome does not exceed this formula, as Shaoyang governs the pivot, and Chaihu (Bupleurum Root) is the divine substance for turning the pivot. Do not mistakenly regard it as a sweating agent.
Commentary: The head is the convergence point of all Yang meridians. Yang syndromes of Shanghan (Cold Damage) and Shangfeng (Wind Strike) must necessarily involve headache. *Jing* (*Neijing*) states: The Taiyang meridian, the straight branch, enters from the vertex to connect with the brain, emerges again at the lower occiput, follows the shoulder blades along the paraspinal region, and reaches the waist. Therefore, Taiyang headache involves brain pain connecting to the neck and spine. The Yangming meridian originates at the nose, connects with the eyes, and intersects at the forehead. Therefore, Yangming headache involves frontal pain connecting to the face and eyes. The Shaoyang meridian originates at the outer canthus of the eye, ascends to the temporal angle, descends behind the ear. Its branch enters the ear from behind the ear, exits anterior to the ear. Therefore, Shaoyang headache involves pain around the ears, connecting upwards to the temporal angle.