猪苓 茯苓 泽泻 滑石(各三钱) 阿胶(蚌粉炒,一钱)
伤寒少阴下利而主此方者,分其小便而下利自止也。伤寒渴欲饮水,小便不利,而主此
方者,导其阳邪由溺而泄,则津液运化,而渴自愈也。又曰∶猪苓质枯,轻清之象也,能渗
上焦之湿;茯苓味甘,中宫之性也,能渗中焦之湿,泽泻味咸,润下之性也,能渗下焦之湿;
滑
以存津液于决渎尔。
茵陈蒿(半两) 栀子(四枚,炒) 大黄(三钱,酒浸)
伤寒,头汗出,渴饮水浆,小便不利者,身必发黄,此方主之。
头汗出者,只是头有汗,跻颈而还皆无汗也。内有实热,故渴饮水浆,升降不交,故小
便不利;湿热郁于中而不得越,故必发黄。经曰∶大热之气,寒以取之,故用茵陈;苦入心
而寒胜热,故用栀子;推除邪热,必假将军,故用大黄。又曰∶茵陈、栀子能导湿热由小便
而出,故用之。
桔梗(一两) 甘草(二两)
少阴病,咽痛者,此方主之。
口燥舌干而渴,脉来沉者,少阴病也。少阴之脉,循喉咙,挟舌本,病故咽痛。甘草缓
邪热而兼发散,桔梗下膈热而治咽喉。
桂 甘草 生姜(各三两) 芍药(六两,炒) 胶饴(一升) 大枣(十二枚)
伤寒,腹中急痛者,此方主之。
腹中急痛,则阴阳乖于中,而脾气不建矣,故立建中汤。桂肉与桂枝不同,枝则味薄,
故用之以解肌;肉则味浓,故用之以建里。芍药之酸,收阴气而健脾;生姜之辛,散寒邪而
辅正。经曰∶脾欲缓,急食甘以缓之,故用甘草、大枣、胶饴以缓急痛。又曰∶呕家不可用
建中,为其甘也。则夫腹痛而兼呕者,又非建中所宜矣。
猪苓、茯苓、泽泻、滑石(各三钱),阿胶(用蚌粉炒制,一钱)。
伤寒病发展至少阴阶段出现下利,而使用此方的原因,在于通过分利小便使下利自然停止。伤寒病中出现口渴想喝水且小便不利的症状,而使用此方的原因,在于引导阳热之邪从小便排出,从而使津液运化功能恢复,口渴自愈。又说:猪苓质地枯槁,具有轻清的特性,能渗利上焦的湿邪;茯苓味甘,具有中宫(脾胃)的性质,能渗利中焦的湿邪;泽泻味咸,具有润下的性质,能渗利下焦的湿邪;滑石……以在决渎(水道)之中保存津液。
伤寒病中,出现头部出汗、口渴想喝汤水、小便不利的症状,身体必然发黄,此方主治。
所谓头部出汗,仅仅是头部有汗,至颈部即止,其余部位无汗。体内有实热,所以口渴想喝汤水;气机升降失调,所以小便不利;湿热郁结在中焦而不能发散,所以必然发黄。经书说:对于大热之气,要用寒凉药来治疗,所以使用茵陈;苦味入心且能胜热,所以使用栀子;推除邪热,必须借助“将军”(指大黄),所以使用大黄。又说:茵陈、栀子能引导湿热从小便排出,所以使用它们。
少阴病中,出现咽痛症状的,此方主治。
口燥舌干而渴,脉象沉的,属于少阴病。少阴经脉,循行经过喉咙,夹持舌根,患病故导致咽痛。甘草能缓解邪热并兼有发散作用,桔梗能下行膈间之热并治疗咽喉疾病。
桂枝、甘草、生姜(各三两)、芍药(六两,炒制)、胶饴(一升)、大枣(十二枚)。
伤寒病中,出现腹中拘急疼痛症状的,此方主治。
腹中拘急疼痛,说明阴阳在中焦失调,脾气不能健运,所以建立建中汤。桂肉与桂枝不同,桂枝味道淡薄,所以用它来解肌表之邪;桂肉味道浓厚,所以用它来建立中焦之气。芍药的酸味,能收敛阴气并健脾;生姜的辛味,能散寒邪并辅助正气。经书说:脾脏喜好缓和,急需食用甘味食物来缓和它,所以使用甘草、大枣、胶饴来缓解急痛。又说:呕吐患者不可使用建中汤,因为其味甘腻。那么腹痛兼有呕吐的患者,又不适合使用建中汤了。
Zhu Ling Tang (Polyporus Decoction): Zhu Ling (Polyporus), Fu Ling (Poria), Ze Xie (Alisma Rhizome), Hua Shi (Talcum) (each 3 qian), E Jiao (Donkey-hide Gelatin) (stir-fried with clam powder, 1 qian).
In Shaoyin syndrome (disease of the Kidney and Heart channels) complicated with diarrhea, this formula is indicated to stop the diarrhea by promoting diuresis. In Taiyang syndrome (exterior syndrome) presenting with thirst for water and dysuria, this formula is indicated to guide the Yang-pathogenic heat out through urination, thereby restoring fluid metabolism and curing the thirst. It is said: Zhu Ling has a withered texture, reflecting its light and clear nature, capable of draining dampness from the Upper Jiao (Upper Burner); Fu Ling tastes sweet, reflecting the nature of the Central Palace (Spleen/Stomach), capable of draining dampness from the Middle Jiao; Ze Xie tastes salty, reflecting its descending and moistening nature, capable of draining dampness from the Lower Jiao; Hua Shi... preserves body fluids within the Du Shu (water passages).
Yin Chen Hao Tang (Artemisiae Scopariae Decoction): Yin Chen Hao (Artemisiae Scopariae Herba) (0.5 liang), Zhi Zi (Gardeniae Fructus) (4 pieces, stir-fried), Da Huang (Rhei Radix et Rhizoma) (3 qian, soaked in wine).
In Taiyang syndrome, if there is sweating only on the head, thirst for drinking liquids, and dysuria, jaundice will inevitably develop; this formula treats such cases.
"Sweating only on the head" means sweat is present only on the head and stops at the neck, with no sweat elsewhere. Internal excess heat causes thirst for drinking; failure of ascending and descending mechanisms causes dysuria; damp-heat stagnates in the Middle Jiao without being able to vent outward, causing jaundice. The Classics state: "For severe heat, use cold to treat it," hence Yin Chen is used; "Bitter enters the Heart and overcomes heat," hence Zhi Zi is used; "To eliminate pathogenic heat, one must rely on the 'General' (Da Huang)," hence Da Huang is used. It is also said: Yin Chen and Zhi Zi guide damp-heat out through urine, hence they are used.
Jie Geng Tang (Platycodon Decoction): Jie Geng (Platycodonis Radix) (1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma) (2 liang).
In Shaoyin syndrome, if sore throat occurs, this formula is indicated.
Dry mouth and tongue with thirst, and a deep pulse, indicate Shaoyin syndrome. The Shaoyin meridian runs along the throat and surrounds the root of the tongue; thus, disease in this channel causes sore throat. Gan Cao relieves pathogenic heat and has a dispersing effect; Jie Geng descends heat from the diaphragm and treats throat diseases.
Xiao Jian Zhong Tang (Minor Construct the Middle Decoction): Rou Gui (Cinnamomi Cortex) [Note: Text implies Cinnamon Twig/branch contextually but lists 'Gui', later clarifies distinction], Gan Cao (Glycyrrhizae Radix et Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens) (each 3 liang), Bai Shao (Paeoniae Radix Alba) (6 liang, stir-fried), Jiao Yi (Malt Sugar) (1 sheng), Da Zao (Jujubae Fructus) (12 pieces).
In Taiyang syndrome, if acute pain in the abdomen occurs, this formula is indicated.
Acute abdominal pain indicates disharmony of Yin and Yang in the Middle Jiao and failure of the Spleen Qi to establish itself; therefore, the Jian Zhong (Construct the Middle) formula is established. Cinnamon bark (Rou Gui) differs from Cinnamon twig (Gui Zhi); the twig has a thin flavor and is used to release the muscle layer; the bark has a rich flavor and is used to strengthen the interior. The sourness of Bai Shao collects Yin Qi and strengthens the Spleen; the pungency of Sheng Jiang disperses cold pathogens and assists healthy Qi. The Classics state: "The Spleen desires relaxation; urgently eat sweet substances to relax it," hence Gan Cao, Da Zao, and Jiao Yi are used to relieve acute pain. It is also said: Patients who vomit should not use Jian Zhong Tang because of its sweetness. Therefore, patients with abdominal pain accompanied by vomiting are not suitable for Jian Zhong Tang.