黄 桂(各一钱半) 白芍药(三钱) 甘草(一钱)
伤寒汗后身痛,脉迟弱者,此方主之。
汗后身痛者,此由汗多耗损阴气,不能荣养筋骨,故令身痛。阳虚,故令脉迟;汗后,
故令脉弱。黄 、甘草之甘,补中气也,然桂中有辛,同用之足以益卫气而实表;芍药之酸,
收阴气也,桂中有热,同用之足以利荣血而补虚,此方以建中名者,创建中气,使其生育荣
卫,通行津液,则表不虚而身痛自愈矣。
黄芩(三两,炒) 甘草(二两) 芍药(二两,炒) 大枣(十二枚)
太阳与少阳合病,必自下利者,此方主之。
太阳与少阳合病者,有太阳证头痛、身热、脊强,而又有少阳证耳聋、胁痛、寒热往来
、呕而口苦也。必自下利者,表实里虚,邪热渐攻于里故也。若太阳与阳明合病自下利,为
在表,当与葛根汤发汗;阳明、少阳合病自下利,为在里,可与承气汤下之;此太阳、少阳
合病自下利,为在半表半里,非汗下所宜,故与黄芩汤。师曰∶虚而不实者,苦以坚之,酸
以收之;故用黄芩、芍药以坚敛肠胃;弱而不实者,甘以补之,故用甘草、大枣以补益肠胃。
其
黄连(去毛,炒) 干姜(炒) 桂枝(炒) 甘草(各三两) 人参(二两) 半夏
(半升) 大
伤寒胸中有热而欲呕,胃中有寒而作痛者,与此汤以升降阴阳。
黄连之苦,以泄上热而降阳;姜、桂、半夏之辛,以散中寒而升阴;人参、甘草、大枣
之甘,可缓中急而益胃。是方也;以黄连之寒,佐以姜、桂之辛,则寒者不滞;以姜、桂之
热,君以黄连之苦,则热者不燥。寒热之相用,犹奇正之相倚耳。况夫人参、甘草之益胃,
又所以宰中而建招摇矣乎!
黄耆(一钱半)、桂枝(一钱半)、白芍药(三钱)、甘草(一钱)。
伤寒经过发汗治疗后出现身体疼痛,脉象迟而弱的,此方主治。
发汗后身体疼痛,这是因为发汗过多耗损了阴气,不能濡养筋骨,所以导致身体疼痛。阳气虚弱,所以导致脉象迟;发汗之后,所以导致脉象弱。黄耆、甘草的甘味,可以补益中气;然而桂枝中含有辛味,两者同用足以增益卫气(运行于体表,具有防御外邪作用的气)并固护肌表;芍药的酸味,可以收敛阴气;桂枝中含有热性,两者同用足以疏通营血(行于脉中,具有营养作用的气血)并补益虚损,此方以“建中”命名的原因,在于创建中气,使其化生荣卫之气,通行津液,那么体表就不会虚弱而身体疼痛自然痊愈。
黄芩(三两,炒制)、甘草(二两)、芍药(二两,炒制)、大枣(十二枚)。
太阳经与少阳经同时受邪的合病,必然出现自发性腹泻的,此方主治。
太阳与少阳合病,既有太阳病的头痛、身热、项背强直等症状,又有少阳病的耳聋、胁痛、寒热往来、呕吐且口苦等症状。必然出现自发性腹泻,是因为表实里虚,邪热逐渐内攻入里的缘故。如果是太阳与阳明合病出现自发性腹泻,病位在表,应当给予葛根汤发汗解表;如果是阳明与少阳合病出现自发性腹泻,病位在里,可以给予承气汤类方剂泻下攻里;这是太阳、少阳合病出现自发性腹泻,病位在半表半里之间,不适合使用发汗或泻下的治法,所以给予黄芩汤。老师说:正气虚弱而不充实的,用苦味药来坚固它,用酸味药来收敛它;所以使用黄芩、芍药来坚固和收敛肠胃;正气虚弱而不充实的,用甘味药来补益它,所以使用甘草、大枣来补益肠胃。
黄连(去毛,炒制)、干姜(炒制)、桂枝(炒制)、甘草(各三两)、人参(二两)、半夏(半升)、大枣。
伤寒患者胸中有热因而想要呕吐,胃中有寒因而产生疼痛的,给予此汤以调节阴阳升降。
黄连的苦味,用来清泄上部的热邪并使阳气下降;干姜、桂枝、半夏的辛味,用来散除中焦的寒邪并使阴气上升;人参、甘草、大枣的甘味,可以缓和中焦之急迫并补益胃气。这个方子,用黄连的寒性,佐以干姜、桂枝的辛温,那么寒性药物就不会凝滞;用干姜、桂枝的热性,君以黄连的苦寒,那么热性药物就不会燥烈。寒性与热性的相互运用,就像奇兵与正兵相互倚靠一样。况且人参、甘草对胃气的补益,又正是为了主宰中气并建立中枢调控啊!
Huangqi (Astragali Radix, 1.5 qian), Guizhi (Cinnamomi Ramulus, 1.5 qian), Baishao Yao (Paeoniae Radix Alba, 3 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian).
For body pain following sweating in Taiyang disease (disease of the Taiyang channel), with a slow and weak pulse, this formula is indicated.
Body pain after sweating occurs because excessive sweating depletes Yin Qi (the cooling, moistening aspect of vital energy), failing to nourish the sinews and bones, thus causing body pain. Yang Qi deficiency causes a slow pulse; the state after sweating causes a weak pulse. The sweetness of Huangqi and Gancao tonifies Middle Qi (digestive energy); however, Guizhi contains acridity, and their combined use sufficiently benefits Wei Qi (defensive energy circulating on the surface) and consolidates the exterior. The sourness of Shaoyao collects Yin Qi; combined with the heat of Guizhi, it sufficiently promotes Ying Blood (nutritive blood flowing within vessels) and tonifies deficiency. This formula is named "Jianzhong" (Establishing the Middle) because it establishes Middle Qi, enabling the generation of Ying and Wei Qi, and the circulation of Jin-Ye (body fluids), so that the exterior is not deficient and body pain heals spontaneously.
Huangqin (Scutellariae Radix, 3 liang, stir-fried), Gancao (2 liang), Shaoyao (2 liang, stir-fried), Dazao (Ziziphi Jujubae Fructus, 12 pieces).
In He Bing (combined disease) involving both Taiyang and Shaoyang channels, characterized by spontaneous diarrhea, this formula is indicated.
Taiyang-Shaoyang He Bing presents with Taiyang symptoms such as headache, fever, and stiffness of the spine, alongside Shaoyang symptoms such as deafness, hypochondriac pain, alternating chills and fever, vomiting, and bitter taste in the mouth. Spontaneous diarrhea occurs due to excess in the exterior and deficiency in the interior, with pathogenic heat gradually attacking inward. If Taiyang and Yangming He Bing present with spontaneous diarrhea, the pathology is in the exterior, and Gegen Tang (Kudzu Decoction) should be used to induce sweating; if Yangming and Shaoyang He Bing present with spontaneous diarrhea, the pathology is in the interior, and Chengqi Tang formulas can be used for purgation. In this case of Taiyang-Shaoyang He Bing with spontaneous diarrhea, the pathology is at the half-exterior half-interior level, where neither sweating nor purgation is appropriate; therefore, Huangqin Tang is administered. The Master stated: For deficiency without fullness, use bitter flavors to firm and sour flavors to astringe; thus, Huangqin and Shaoyao are used to firm and astringe the intestines and stomach. For weakness without fullness, use sweet flavors to tonify; thus, Gancao and Dazao are used to tonify the intestines and stomach.
Huanglian (Coptidis Rhizoma, de-haired, stir-fried), Ganjiang (Zingiberis Rhizoma, stir-fried), Guizhi (Cinnamomi Ramulus, stir-fried), Gancao (each 3 liang), Renshen (Panacis Ginseng Radix, 2 liang), Banxia (Pinelliae Tuber, half sheng), Dazao.
For Shanghan (cold damage) presenting with heat in the chest causing nausea and cold in the stomach causing pain, this decoction is given to regulate the ascending and descending of Yin and Yang.
The bitterness of Huanglian clears upper heat and descends Yang; the acridity of Ganjiang, Guizhi, and Banxia disperses middle cold and ascends Yin; the sweetness of Renshen, Gancao, and Dazao moderates central urgency and benefits Stomach Qi. In this formula, the cold nature of Huanglian is assisted by the acridity of Ganjiang and Guizhi, preventing stagnation of the cold; the heat of Ganjiang and Guizhi is guided by the bitterness of Huanglian, preventing dryness from heat. The interaction of cold and hot is like the mutual reliance of unorthodox and orthodox strategies. Moreover, the benefit to Stomach Qi by Renshen and Gancao serves to govern the Middle and establish the pivot (Zhong Shu).