石膏(一斤,捶,不见铁) 知母(去浮皮,六两) 甘草(二两) 粳米(六合)
伤寒,传入于胃,不恶寒,反恶热,有汗作渴,脉大而长者,此方主之。
传入于胃,邪入里矣。表无其邪,故不恶寒;里有实热,故反恶热;热越故有汗;里燥
故作渴;邪盛故脉大;邪在阳明故脉长。白虎,西方金神也。五行之理,将来者进,功成者
退,如秋金之令行,则夏火之炎息。此方名曰白虎,所以行清肃之令而除热也。石膏大寒,
用之以清胃;知母味浓,用之以生津;大寒之性行,恐伤胃气,故用甘草、粳米以养胃。是
方也,惟伤寒内有实热者可用之。若血虚身热,证象白虎,误服白虎者死无救,又东垣之所
以垂戒矣。
柴胡(半斤,去芦) 黄芩(三两) 人参(三两,去芦) 甘草(三两) 半夏(半
斤,制)
伤寒,寒热往来,胁痛,口苦,脉弦者,此邪在少阳经,半表半里之证也,本方主之。
邪在表则恶寒,邪在里则发热,邪在半表半里则恶寒且热,故令寒热往来。少阳之脉行
于两胁,故令胁痛;其经属于胆,胆汁上溢故口苦。胆者,肝之腑,在五行为木,有垂枝之
象,故脉弦。柴胡性辛温,辛者金之味,故用之以平木,温者春之气,故就之以入少阳;黄
芩质枯而味苦,枯则能浮,苦则能降,君以柴胡,则入少阳矣。然邪之伤人,常乘其虚,用
人参、甘草者,欲中气不虚,邪不得复传入里耳。是以中气不虚之人,虽有柴胡证俱,而人
参在可去也。邪初入里,里气逆而烦呕,故用半夏之辛以除呕逆,邪半在表,则荣卫争,故
用姜、枣之辛甘以和荣卫。
仲景云∶胸中烦而不呕,去半夏、人参,加栝蒌实一枚;若渴者,去半夏,更加人参一
两五钱、栝蒌根四两;若腹中痛者,去黄芩,加芍药三两;若胁下痞硬,去大枣,加牡蛎四
两;若心下悸,小便不利者,去黄芩,加茯苓四两;若不渴,外有微热者,去人参,加桂枝
三两,温覆取微汗;若咳者,去人参、大枣、生姜,加五味子半斤、干姜二两。以上加减法,
皆
石膏(一斤,捣碎,避免接触铁器) 知母(去除表面浮皮,六两) 甘草(二两) 粳米(六合)
伤寒病邪传入胃腑,患者不恶寒,反而怕热,伴有出汗且口渴,脉象大而长,此证适用本方治疗。
病邪传入胃腑,说明邪气已入里。体表无邪气,所以不恶寒;体内有实热,所以反而怕热;热气外越所以出汗;体内津液干燥所以口渴;邪气盛实所以脉象大;邪气位于阳明经所以脉象长。白虎是西方金神。五行的道理是:后来者前进,功成者退去,就像秋季金气当令时,夏季火气的炎势就会熄灭。本方命名为“白虎”,是为了施行清肃的政令以清除热邪。石膏性大寒,用它来清泻胃热;知母味道浓厚,用它来生津液;因大寒之性运行,恐怕会损伤胃气,所以用甘草、粳米来养护胃气。这个方子,只有伤寒病内里有实热的才可以使用。如果是血虚导致的身体发热,症状表现像白虎汤证,误服白虎汤的人将会死亡且无法救治,这是李东垣所特意告诫的。
柴胡(半斤,去除芦头) 黄芩(三两) 人参(三两,去除芦头) 甘草(三两) 半夏(半斤,炮制)
伤寒病出现忽冷忽热的症状,胁肋疼痛,口苦,脉象弦,这是邪气在少阳经,属于半表半里的证候,本方主治。
邪气在体表则恶寒,邪气在体内则发热,邪气在半表半里则既恶寒又发热,所以导致寒热往来。少阳经脉行经两侧胁肋,所以导致胁痛;该经归属于胆,胆汁上溢所以口苦。胆是肝的腑,在五行中属木,有下垂枝条的形象,所以脉象呈弦状。柴胡性味辛温,辛是金的味,所以用它来平抑木气;温是春季的气候,所以顺势使其进入少阳经;黄芩质地枯槁且味苦,枯则能上浮,苦则能下降,以柴胡为君药,则药力可入少阳经。然而邪气伤人,常趁人体虚弱之时侵袭,使用人参、甘草,是为了使中焦之气不虚,防止邪气再次传入体内。因此,对于中气不虚的人,即使具备柴胡汤证的所有症状,人参也可以去掉。邪气初入体内,里气上逆导致心烦呕吐,所以用半夏的辛味来消除呕逆;邪气一半在体表,导致营卫之气相争,所以用生姜、大枣的辛甘味道来调和营卫。
张仲景说:如果胸中烦闷但不呕吐,去掉半夏、人参,加栝楼实一枚;如果口渴,去掉半夏,再加人参一两五钱、栝楼根四两;如果腹中疼痛,去掉黄芩,加芍药三两;如果胁下痞塞硬满,去掉大枣,加牡蛎四两;如果心下悸动,小便不利,去掉黄芩,加茯苓四两;如果不渴,体表有轻微发热,去掉人参,加桂枝三两,覆盖衣被取微汗;如果咳嗽,去掉人参、大枣、生姜,加五味子半斤、干姜二两。以上加减法,都是……
Shigao (Gypsum Fibrosum, one jin, crushed, avoid contact with iron) Zhimu (Anemarrhenae Rhizoma, remove floating skin, six liang) Gancao (Glycyrrhizae Radix et Rhizoma, two liang) Jingmi (Oryzae Fructus Germinatus, six he)
When the pathogen of Shanghan (Cold Damage) transmits to the Stomach, and the patient presents with aversion to cold absent but aversion to heat present, accompanied by sweating and thirst, with a pulse that is large and long, this formula is indicated.
Transmission to the Stomach indicates the pathogen has entered the interior. Since there is no pathogen on the exterior, there is no aversion to cold; since there is excess heat in the interior, there is aversion to heat; because heat escapes outward, there is sweating; due to dryness in the interior, there is thirst; because the pathogen is vigorous, the pulse is large; because the pathogen is in the Yangming channel, the pulse is long. Baihu (White Tiger) is the Golden Spirit of the West. According to the principles of Wuxing (Five Elements), what comes later advances, and what has completed its function retreats. Just as when the command of Autumn Metal prevails, the blazing fire of Summer extinguishes. This formula is named "Baihu" to execute the command of clearing and purifying so as to eliminate heat. Shigao is extremely cold; it is used to clear Stomach heat. Zhimu has a rich flavor; it is used to generate fluids. Because the nature of extreme cold may damage Stomach Qi, Gancao and Jingmi are used to nourish the Stomach. This formula is only applicable for Shanghan cases where there is excess heat within. If body heat is caused by Blood deficiency, and the symptoms resemble those of the Baihu pattern, mistaken administration of Baihu Tang will lead to death without remedy; this is the warning left by Li Dongyuan.
Chaihu (Bupleuri Radix, half a jin, remove the rhizome head) Huangqin (Scutellariae Radix, three liang) Renshen (Ginseng Radix, three liang, remove the rhizome head) Gancao (Glycyrrhizae Radix et Rhizoma, three liang) Banxia (Pinelliae Rhizoma Preparatum, half a jin, processed)
In Shanghan, if there are alternating chills and fever, hypochondriac pain, bitter taste in the mouth, and a wiry pulse, this indicates the pathogen is in the Shaoyang channel, representing a syndrome of half-exterior and half-interior. This formula treats such conditions.
When the pathogen is on the exterior, there is aversion to cold; when in the interior, there is fever; when in half-exterior and half-interior, there are both aversion to cold and fever, thus causing alternating chills and fever. The Shaoyang channel runs along the bilateral hypochondrium, causing hypochondriac pain; this channel belongs to the Gallbladder, and upward overflow of bile causes a bitter taste in the mouth. The Gallbladder is the Fu-organ of the Liver; in Wuxing it belongs to Wood, having the image of hanging branches, hence the pulse is wiry. Chaihu is acrid and warm. Acridity is the flavor of Metal, so it is used to pacify Wood; warmth is the qi of Spring, so it naturally enters the Shaoyang channel. Huangqin is withered in texture and bitter in flavor; withered means it can float, bitter means it can descend. With Chaihu as the Sovereign herb, the action enters the Shaoyang channel. However, pathogens often attack when the body is deficient. Renshen and Gancao are used to ensure the Middle Jiao Qi is not deficient, preventing the pathogen from transmitting further into the interior. Therefore, in individuals whose Middle Jiao Qi is not deficient, even if all Chaihu patterns are present, Renshen may be omitted. When the pathogen first enters the interior, the interior Qi rebels causing irritability and vomiting, so the acridity of Banxia is used to eliminate vomiting and rebellion; when the pathogen is partly on the exterior, Ying and Wei struggle, so the acrid-sweet nature of Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus) is used to harmonize Ying and Wei.
Zhongjing stated: If there is irritability in the chest but no vomiting, remove Banxia and Renshen, add one Gualou Fruit (Trichosanthis Fructus); if there is thirst, remove Banxia, add an additional one liang five qian of Renshen and four liang of Gualou Root (Trichosanthis Radix); if there is abdominal pain, remove Huangqin, add three liang of Shaoyao (Paeoniae Radix Alba); if there is fullness and hardness under the hypochondrium, remove Dazao, add four liang of Muli (Ostreae Concha); if there is palpitation in the heart region and difficulty urinating, remove Huangqin, add four liang of Fuling (Poria); if there is no thirst but slight external heat, remove Renshen, add three liang of Guizhi (Cinnamomi Ramulus), cover with blankets to induce slight sweating; if there is coughing, remove Renshen, Dazao, and Shengjiang, add half a jin of Wuweizi (Schisandrae Fructus) and two liang of Ganjiang (Zingiberis Rhizoma). The above modification methods are...