治汗, 吐, 下解之后, 心下痞硬, 噫气不除.
旋覆花三两 人参二两 代赭石一两 半夏 ( 洗 ) 半升 生姜 (
切) 五两 甘草 ( 炙 ) 三两 大枣 ( 擘 ) 十二枚, 右七味, 以
水一斗, 煮取六升, 去滓再煎, 取三升, 温服一升, 日三服.
【集注】罗谦甫曰: 汗, 吐, 下解后, 邪虽去而胃气已亏矣. 胃气既
亏,三焦因之失职, 清无所归而不升, 浊无所纳而不降, 是以邪气留
滞,伏饮为逆, 故心下痞硬, 噫气不除. 方中以人参, 甘草养正补虚
,姜, 枣和脾养胃, 所以安定中州者至矣. 更以代赭石之重, 使之敛
浮镇逆, 旋覆花之辛, 用以宣气涤饮, 佐人参以归气于下, 佐半夏以
蠲饮于上. 浊降痞硬可消, 清升噫气自除. 观仲景治少阴水气上凌,
用真武汤镇之; 治下焦滑脱不守, 用赤石脂禹余粮固之. 此胃虚气失
升降, 复用此法理之. 则胸中转否为泰, 其为归元固下之法, 各极其
妙如此.
治伤寒表不解, 瘀热在里发黄者.
麻黄二两 赤小豆一升 杏仁 ( 去皮, 尖 ) 四十枚 生姜 ( 切 )
一两 大枣 ( 擘 ) 十二枚 甘草 ( 炙 ) 一两 生梓白皮一升 连
轺二两 , 右上八味, 以潦水一斗, 先煮麻黄, 再沸, 去上沫, 纳诸
药,煮取三升, 分温三服, 半日则尽.
【注】湿热发黄无表里证, 热盛者清之, 小便不利者利之, 里实者下
之,表实者汗之, 皆无非为病求去路也. 用麻黄汤以开其表, 使黄从
外而散. 去桂枝者避其湿热也. 佐姜枣者和其营卫也. 加连轺, 梓皮
以泻其热. 赤小豆以利其湿. 同成表实发黄之效也. 连轺即连翘根,
无梓皮以茵陈代之. 成无己曰: 煎以潦水者, 取其味薄不助湿热也.
治疗经过发汗、催吐、泻下等治法解除表邪之后，出现胃脘部痞塞胀硬，嗳气持续不愈的症状。
旋覆花三两，人参二两，代赭石一两，半夏（洗净）半升，生姜（切）五两，甘草（炙）三两，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，取药液三升，每次温服一升，每日服用三次。
【集注】罗谦甫说：经过发汗、催吐、泻下治疗后，虽然邪气已去，但胃气已经亏损。胃气既然亏损，三焦因此失职，清气没有归宿而不能上升，浊气没有容纳之处而不能下降，所以邪气留滞，伏饮上逆，导致心下痞硬，嗳气不止。方中用人参、甘草养护正气、补益虚弱，用姜、枣调和脾胃、滋养胃气，安定中焦的作用达到了极致。再用代赭石的沉重之性，使其收敛浮阳、镇压逆气；用旋覆花的辛散之性，用以宣通肺气、涤除痰饮，辅助人参使气机下行，辅助半夏在上焦消除痰饮。浊气下降，痞硬症状即可消除；清气上升，嗳气自然停止。看张仲景治疗少阴病水气上凌心胸，使用真武汤来镇摄；治疗下焦滑脱不固，使用赤石脂禹余粮丸来固涩。这里是胃虚导致气机升降失常，再次运用这种理气降逆的方法。这样胸中的否塞转为通泰，这归元固下的方法，各自精妙到了极点。
麻黄二两，赤小豆一升，杏仁（去皮尖）四十枚，生姜（切）一两，大枣（掰开）十二枚，甘草（炙）一两，生梓白皮一升，连轺二两。以上八味药，用潦水（雨水或积水）一斗，先煮麻黄，沸腾两次后，撇去上面的浮沫，加入其他药物，煎煮至三升，分三次温服，半天内服完。
【注】湿热发黄如果没有明显的表证或里证，热势盛的用清热法，小便不利的用利湿法，里有实邪的用攻下法，表有实邪的用发汗法，这些都不是为了给病邪寻找出路。使用麻黄汤来开通腠理，使黄色从体表发散出去。去掉桂枝是为了避免助长湿热。佐以姜、枣是为了调和营卫。加入连轺、梓白皮是为了泻热。赤小豆是为了利湿。共同构成治疗表实发黄的功效。连轺就是连翘的根，如果没有梓白皮，可以用茵陈蒿代替。成无己说：用潦水煎煮，是因为它的味道淡薄，不会助长湿热。
Treats the condition where, after resolution via sweating (diaphoresis), vomiting (emesis), or purging (catharsis), there is epigastric fullness and hardness, with persistent belching.
Xuanfuhua (Inulae Flos) 3 liang, Renshen (Ginseng Radix et Rhizoma) 2 liang, Daizheshi (Haematitum) 1 liang, Banxia (Pinelliae Rhizoma Preparatum) half sheng (washed), Shengjiang (Zingiberis Rhizoma Recens) 5 liang (sliced), Gancao (Glycyrrhizae Radix et Rhizoma Preparata) 3 liang (roasted), Dazao (Jujubae Fructus) 12 pieces (torn). The above seven herbs, decocted in one dou of water, reduce to six sheng. Strain the dregs and decoct again to obtain three sheng. Take one sheng warm, three times daily.
[Collected Annotations] Luo Qianfu stated: After sweating, vomiting, or purging, although the pathogenic factors have been expelled, the Stomach Qi has already become deficient. Since Stomach Qi is deficient, the Sanjiao (Triple Burner) fails in its duties; Clear Qi has no destination and cannot ascend, while Turbid Qi has no receptacle and cannot descend. Thus, pathogenic factors remain stagnant, and retained fluid reverses upward, causing epigastric fullness and hardness, and persistent belching. In this formula, Renshen and Gancao nourish the righteous Qi and tonify deficiency; Jiang (Shengjiang) and Zao (Dazao harmonize the Spleen and nourish the Stomach, thereby stabilizing the Middle Jiao to an excellent degree. Furthermore, the heaviness of Daizheshi is used to gather floating Yang and suppress rebellion, while the acridity of Xuanfuhua is used to diffuse Lung Qi and wash away retained fluid, assisting Renshen to guide Qi downward, and assisting Banxia to eliminate fluid in the Upper Jiao. As Turbid Qi descends, fullness and hardness dissipate; as Clear Qi ascends, belching naturally ceases. Observe how Zhang Zhongjing treated Shaoyin disease with Water Qi flooding upward by using Zhenwu Tang to anchor it; and treated Lower Jiao sliding and loss of control by using Chishizhi Yuyuliang Wan to consolidate it. Here, due to Stomach deficiency causing dysfunction of Qi ascending and descending, this method of regulating Qi and descending rebellion is applied again. Thus, the obstruction in the chest transforms into smooth flow. These methods of returning to the origin and consolidating the lower are each exquisitely effective.
Treats Taiyang disease where the exterior syndrome is not resolved, and stagnant heat trapped inside causes jaundice.
Mahuang (Ephedrae Herba) 2 liang, Chixiaodou (Phaseoli Semen Rubrum) 1 sheng, Xingren (Armeniacae Semen Amarum) 40 pieces (skin and tip removed), Shengjiang (Zingiberis Rhizoma Recens) 1 liang (sliced), Dazao (Jujubae Fructus) 12 pieces (torn), Gancao (Glycyrrhizae Radix et Rhizoma Preparata) 1 liang (roasted), Shengzibaiqi (Catalpae Cortex) 1 sheng, Lianyao (Forsythiae Radix) 2 liang. The above eight herbs, decocted in one dou of Liaoshui (rainwater/stagnant water). First boil Mahuang, let it boil twice, remove the foam on the surface, then add the remaining herbs. Decoct until three sheng remain. Divide into three warm doses, consumed within half a day.
[Annotation] For jaundice caused by damp-heat without obvious exterior or interior syndromes: if heat is excessive, clear it; if urination is difficult, promote diuresis; if there is interior excess, purge it; if there is exterior excess, induce sweating. All these methods aim to provide an exit for the pathogenic factors. Using Mahuang Tang to open the exterior allows the jaundice to disperse from the outside. Guizhi (Cinnamon Twig) is omitted to avoid aggravating damp-heat. Jiang (Shengjiang) and Zao (Dazao) are added to harmonize Ying (Nutritive) and Wei (Defensive) Qi. Lianyao and Zibaiqi are added to drain heat. Chixiaodou is added to promote diuresis. Together, they achieve the effect of treating exterior-excess jaundice. Lianyao is the root of Forsythia suspensa; if Zibaiqi is unavailable, Yinchen Hao (Artemisiae Scopariae Herba) can be substituted. Cheng Wuji stated: Decocting with Liaoshui is chosen because its flavor is light and thin, preventing the assistance of damp-heat.