治伤寒表不解, 心下有水气, 干呕发热而咳. 或渴,
或痢, 或噎, 或小便不利, 少腹满, 或喘者. 及杂病肤胀, 水肿证,
用此发汗而利水.
麻黄 ( 去节 ) 三两 芍药三两 五味子半升 甘草 ( 炙 ) 三两
干姜二两 半夏 ( 洗 ) 半升 桂枝三两 细辛三两, 右八味, 以水
一斗, 先煮麻黄, 减二升, 去上沫; 纳诸药, 煮取三升, 去滓, 温服
一升. 若渴者, 去半夏加栝蒌根三两. 若噎者, 去麻黄加附子 ( 炮
)一枚. 若小便不利少腹满者, 去麻黄加茯苓四两. 若喘者, 去麻黄
加杏仁 ( 去皮, 尖 ) 半升. 若微痢者, 去麻黄加荛花如鸡子 ( 熬
令赤色 ).
【按】「加荛花如鸡子, 熬令赤色」, 此必传写之讹. 盖本草荛花即
芫花类也, 用之攻水, 其力甚峻, 五分可令人下行数十次, 岂有治停
饮之微痢, 而用鸡子大之荛花者乎? 当改加茯苓四两.
【注】太阳停饮有二: 一中风, 表虚有汗, 五苓散证也; 一伤寒, 表
实无汗, 小青龙汤证也. 表实无汗, 故合麻桂二方以解外. 去大枣者
,以其性泥也. 去杏仁者, 以其无喘也, 有喘者加之. 去生姜者, 以
有干姜也, 若呕者仍用. 佐干姜, 细辛, 极温极散, 使寒与水俱从汗
而解. 佐半夏逐痰饮, 以清不尽之饮. 佐五味收肺气, 以敛耗伤之气
.若渴者, 去半夏加花粉, 避燥以生津也. 若微痢与噎, 小便不利 ,
少腹满, 俱去麻黄, 远表以就里也. 加附子以去噎散寒, 则噎可止.
加茯苓以利水, 则微痢少腹满可除矣. 此方与越婢汤同治水饮溢于表
,而为肤胀, 水肿, 宜发汗外解者, 无不随手而消. 越婢治有热者,
故方中君以石膏以散阳水也. 小青龙治有寒者, 故方中佐以姜, 桂以
消阴水也.
治疗伤寒表证未解，心下有停饮，出现干呕、发热且咳嗽。或者口渴，或者下痢，或者咽喉噎塞，或者小便不利、小腹胀满，或者气喘的病症。以及杂病中的皮肤肿胀、水肿证候，使用此方发汗并利水。
麻黄（去节）三两 芍药三两 五味子半升 甘草（炙）三两 干姜二两 半夏（洗）半升 桂枝三两 细辛三两，以上八味药，用水一斗，先煮麻黄，减少二升水量，去掉水面上的浮沫；加入其余药物，煎煮取汁三升，滤去药渣，温服一升。如果口渴的，去掉半夏，加入栝蒌根三两。如果咽喉噎塞的，去掉麻黄，加入附子（炮制）一枚。如果小便不利、小腹胀满的，去掉麻黄，加入茯苓四两。如果气喘的，去掉麻黄，加入杏仁（去皮尖）半升。如果轻微下痢的，去掉麻黄，加入荛花如鸡蛋大小（熬至红色）。
【按语】“加入荛花如鸡蛋大小，熬至红色”，这必定是传抄过程中的错误。因为本草中记载的荛花属于芫花一类，用来攻逐水饮，其药力非常猛烈，五分即可使人腹泻数十次，哪有治疗停饮引起的轻微下痢，却使用鸡蛋大小的荛花的道理呢？应当改为加入茯苓四两。
【注解】太阳经停饮有两种情况：一种是中风，表虚有汗，属于五苓散证；一种是伤寒，表实无汗，属于小青龙汤证。因为是表实无汗，所以合并使用麻黄汤和桂枝汤两个方剂来解除表邪。去掉大枣，是因为它的性质黏腻。去掉杏仁，是因为没有气喘症状，如果有气喘则加上。去掉生姜，是因为方中已有干姜，如果出现呕吐仍可使用生姜。佐以干姜、细辛，极温极散，使寒邪与水饮都从汗液而解。佐以半夏驱逐痰饮，以清除未尽的水饮。佐以五味子收敛肺气，以敛摄耗伤之气。如果口渴的，去掉半夏加入天花粉（花粉），是为了避开燥性以生津液。如果轻微下痢、咽喉噎塞、小便不利、小腹胀满，都去掉麻黄，是为了远离表邪而专注于治里。加入附子以祛除噎塞、散除寒邪，则噎塞可止。加入茯苓以利水，则轻微下痢和小腹胀满可消除。此方与越婢汤同样用于治疗水饮溢于体表，导致皮肤肿胀、水肿，适宜通过发汗从外解的病症，没有不随手消除的。越婢汤治疗有热证的，所以方中以石膏为君药以发散阳水。小青龙汤治疗有寒证的，所以方中佐以干姜、桂枝以消阴水。
Treats cases where the exterior syndrome of Shanghan (Cold Damage) is not resolved, with fluid retention in the epigastrium, presenting as dry retching, fever, and cough. Or thirst, or dysentery, or a sensation of obstruction in the throat, or difficulty in urination with fullness in the lower abdomen, or wheezing. It is also used for miscellaneous diseases such as skin edema and general edema, to induce sweating and promote diuresis.
Mahuang (Ephedrae Herba, removed nodes) 3 liang, Shaoyao (Paeoniae Radix Alba) 3 liang, Wuweizi (Schisandrae Fructus) half sheng, Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) 3 liang, Ganjiang (Zingiberis Rhizoma) 2 liang, Banxia (Pinelliae Tuber, washed) half sheng, Guizhi (Cinnamomi Ramulus) 3 liang, Xixin (Asari Radix et Rhizoma) 3 liang. The above eight ingredients are decocted with one dou of water. First, boil Mahuang, reduce the volume by two sheng, and remove the foam on the surface. Then add the remaining herbs, boil until three sheng of liquid remains, filter out the dregs, and take one sheng warm. If there is thirst, remove Banxia and add Gualougen (Trichosanthis Radix) 3 liang. If there is a sensation of obstruction in the throat, remove Mahuang and add Fuzi (Aconiti Lateralis Radix Praeparata, processed) one piece. If there is difficulty in urination and fullness in the lower abdomen, remove Mahuang and add Fuling (Poria) 4 liang. If there is wheezing, remove Mahuang and add Xingren (Armeniacae Semen Amarum, peeled and tip removed) half sheng. If there is mild dysentery, remove Mahuang and add Raohua (Stellerae Radix) the size of an egg (stir-fried until red).
[Commentary] "Add Raohua the size of an egg, stir-fried until red" is likely a transcription error. According to Materia Medica, Raohua belongs to the same category as Yuanhua (Daphnes Genkwa Flower). Used to attack water retention, its power is extremely fierce; five fen can cause dozens of bowel movements. How could one use an egg-sized dose of Raohua to treat mild dysentery caused by retained fluids? It should be corrected to adding Fuling (Poria) 4 liang.
[Annotation] There are two types of fluid retention in the Taiyang (Greater Yang) stage: one is Fengzhong (Wind Strike), characterized by exterior deficiency and sweating, which corresponds to the Wuling San (Five-Ingredient Powder with Poria) syndrome; the other is Shanghan (Cold Damage), characterized by exterior excess and absence of sweating, which corresponds to the Xiaoqinglong Tang (Minor Blue Dragon Decoction) syndrome. Since it is exterior excess without sweating, it combines the formulas of Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) to resolve the exterior. Dazao (Jujubae Fructus) is removed because its nature is cloying. Xingren (Armeniacae Semen Amarum) is removed because there is no wheezing; if wheezing occurs, it is added. Shengjiang (Zingiberis Rhizoma Recens) is removed because Ganjiang (Zingiberis Rhizoma) is already present; however, if there is vomiting, Shengjiang may still be used. Ganjiang (Zingiberis Rhizoma) and Xixin (Asari Radix et Rhizoma) act as assistants, being extremely warming and dispersing, causing both cold and water to be resolved through sweat. Banxia (Pinelliae Tuber) assists in driving out phlegm-fluids to clear residual fluids. Wuweizi (Schisandrae Fructus) assists in astringing Lung Qi to gather depleted Qi. If there is thirst, remove Banxia and add Huafen (Trichosanthis Radix) to avoid dryness and generate fluids. For mild dysentery, throat obstruction, difficulty in urination, and lower abdominal fullness, remove Mahuang (Ephedrae Herba) to move away from the exterior and focus on the interior. Add Fuzi (Aconiti Lateralis Radix Praeparata) to remove throat obstruction and disperse cold, thus stopping the obstruction. Add Fuling (Poria) to promote diuresis, thus eliminating mild dysentery and lower abdominal fullness. This formula, along with Yuespi Tang (Yue Bi Decoction), treats water-fluids overflowing into the exterior, resulting in skin edema and general edema suitable for resolution via sweating; they are effective immediately. Yuespi Tang treats conditions with heat, so Shigao (Gypsum Fibrosum) is used as the sovereign herb to dissipate Yang-water. Xiaoqinglong Tang treats conditions with cold, so Ganjiang (Zingiberis Rhizoma) and Guizhi (Cinnamomi Ramulus) are used as assistants to dissipate Yin-water.