治汗吐下解表后，心下痞硬，噫气不除。
旋复花（三两） 代赭石（一两） 人参（二两） 甘草（炙，三两） 生姜（五两）
大枣（十二
上七味，以水一斗，煎减半，去滓，再煎，取三升，温服，日三服。
罗东逸曰∶仲景此方，治正虚不归元，而承领上下之圣方也。盖发汗吐下解表后，邪虽
去，
以浊邪
养胃，
于下；
使噫气
利在下
胸中转
主治久痢不止，大肠虚脱，服理中丸而利益甚者。
赤石脂 禹余粮（各一斤，俱捣碎）
上二味，以水六升，煮取二升，去渣，分温三服。
柯韵伯曰∶甘、姜、参、术可以补中宫元气之虚，而不足以固下焦脂膏之脱。此利在下
焦者
责在
者
石脂色赤入丙，助火以生土；余粮色黄入戊，实胃而涩肠。急以治下焦之标者，实以培中宫
之本也。要知此证，土虚而火不虚，故不宜于姜、附。仲景曰∶复利不止者，当利其小便。
可知与桃花汤别成一局矣。
治少阴水气为患，腹痛下利，四肢沉重疼痛，小便不利。其人或咳，或呕，或小便利而
下利
白术（二两） 茯苓 白芍（各三两） 大附子（一枚，炮） 生姜（三两）
上五味，以水八升，煮取三升，去滓。温服七合，日三服。
赵羽皇曰∶人之一身，阴阳是也。上焦属阳而主心肺，下焦属阴而主肝肾。肝藏阴血，
肾兼
酸能
也。
孰为之主？故脾家得附子，则火能生土，而水有所归矣；肾中得附
所摄矣。更得芍药之酸，以收肝而敛阴气，阴平阳秘矣。若生姜者
和胃也。盖五苓散行有余之水，真武行不足之水，两者天渊。总之
泛溢妄行者，非大补坎中之阳，大健中宫之气，即日用车前、木通
柯韵伯曰∶坎宫火用不宣，故肾家水体失职，是下焦虚有寒不能制水故也。法当壮元阳
以消阴翳，逐留垢以清水源，因立此汤。方后立加减法，是真武加减证，不是主症，虽皆水
气为患，而不属少阴。其云若咳者，是水气射肺所致，加五味子之酸温，佐芍药以收肾中水
气；细辛之辛温，佐生姜以散肺中水气。小便自利而下利，是胃中无阳，则腹痛不属相火，
四肢困于脾湿，故去芍药之酸寒，加干姜之辛热，即茯苓之甘平者亦去之，此为温中之剂，
而非利水之剂矣。若呕者，是水气在中，故中焦不治，四肢不利，病不涉少阴，由于太阴湿
化不宣也，不须附子之温肾，倍加生姜以散邪，此为和中之剂，而非下焦之剂矣。附子、芍
药、茯苓、白术四味，皆真武所重，若去一味，便不是真武。仲景论证治，多触类旁通，并
不画地为界。
喻嘉言曰∶亡阳而用真武以救之者，盖真武北方司水之神。方中四味，是行水收阴，崇
土回
越，
治疗经过发汗、催吐或泻下等解表法治疗后，出现胃脘部痞塞胀硬，嗳气持续不愈的症状。
旋复花（三两） 代赭石（一两） 人参（二两） 甘草（炙用，三两） 生姜（五两）
大枣（十二枚）
以上七味药，用水一斗，煎煮至药液减半，滤去药渣，再次煎煮，取药液三升，温服，每日服用三次。
罗东逸说：张仲景的这个方子，是治疗正气虚弱导致元气不能归元，从而承接上下气机的圣方。大概是因为发汗、催吐、泻下等解表法之后，邪气虽然去除，但正气受损，中焦脾胃虚弱，导致浊气上逆，清气在下，使得嗳气不止。此方旨在调理中焦，使胸中的气机得以转输通畅。
主治久痢不愈，大肠虚脱，服用理中丸后腹泻反而加重的情况。
赤石脂 禹余粮（各一斤，都捣碎）
以上两味药，用水六升，煎煮取药液二升，滤去药渣，分三次温服。
柯韵伯说：甘草、干姜、人参、白术可以补益中宫（脾胃）元气的虚弱，但不足以固摄下焦脂膏的滑脱。这种腹泻位于下焦的情况，责任在于下焦失守。赤石脂色赤入心（丙火），助火以生脾土；禹余粮色黄入脾（戊土），充实胃气并涩肠止泻。急切地治疗下焦的标症，实际上是为了培补中宫的根基。要知道这个证候，是土虚而火不虚，所以不适合使用干姜、附子。张仲景说：反复腹泻不止的，应当通利小便。可知此方与桃花汤属于不同的治法体系。
治疗少阴病水气为患，出现腹痛腹泻，四肢沉重疼痛，小便不利。患者或者咳嗽，或者呕吐，或者小便清长而下利不止。
白术（二两） 茯苓 白芍（各三两） 大附子（一枚，炮制过） 生姜（三两）
以上五味药，用水八升，煎煮取药液三升，滤去药渣。温服七合，每日服用三次。
赵羽皇说：人的身体，由阴阳构成。上焦属阳而主宰心肺，下焦属阴而主宰肝肾。肝藏阴血，肾兼有真阴真阳。谁为主宰呢？所以脾家得到附子，则命门之火能生脾土，水有所归；肾中得到附子，则阳气得以固摄。再加上芍药的酸味，来收敛肝气并敛聚阴气，达到阴平阳秘的状态。至于生姜，是用来调和胃气的。大概五苓散是行有余之水，真武汤是行不足之水，两者有天壤之别。总之，对于水气泛溢妄行的情况，如果不大补坎中之阳，大健中宫之气，即使用车前子、木通等药也无济于事。
柯韵伯说：坎宫（肾）的火用不能宣通，所以肾家的水体失职，这是下焦虚寒不能制约水气的缘故。治法应当壮元阳以消除阴翳，逐留垢以清水源，因此创立了此汤。方后的加减法，是真武汤的加减证，不是主症，虽然都是水气为患，但不属于少阴病的主证。文中说如果咳嗽，是水气射肺所致，加五味子的酸温，佐助芍药来收敛肾中水气；细辛的辛温，佐助生姜来疏散肺中水气。如果小便自利而下利，是胃中无阳，则腹痛不属于相火，四肢困重由于脾湿，所以去掉芍药的酸寒，加干姜的辛热，连茯苓的甘平也去掉，这成为温中的剂型，而不是利水的剂型了。如果呕吐，是水气在中焦，所以中焦不治，四肢不利，病不涉及少阴，是由于太阴湿化不宣通，不需要附子温肾，加倍生姜以散邪，这成为和中的剂型，而不是下焦的剂型了。附子、芍药、茯苓、白术四味药，都是真武汤所重视的，如果去掉一味，就不是真武汤了。张仲景论证治病，多触类旁通，并不画地为界。
Treats the condition of epigastric fullness and hardness, with persistent belching, occurring after treatment with sweating, vomiting, or purgation to release the exterior.
*Inula Flower* (Xuanfuhua) [3 liang] *Hematitum* (Daizheshi) [1 liang] *Ginseng Radix et Rhizoma* (Renshen) [2 liang] *Licorice Root* (Gancao), roasted [3 liang] *Zingiberis Rhizoma Recens* (Shengjiang) [5 liang]
*Jujube Fruit* (Dazao) [12 pieces]
Take the above seven ingredients, add one dou of water, decoct until reduced by half, remove the dregs, decoct again to obtain three sheng of liquid, take warm, three times a day.
Luo Dongyi said: This prescription by Zhang Zhongjing is a sage formula for treating positive deficiency where Yuan Qi fails to return to its origin, thereby connecting the upper and lower aspects. Generally, after sweating, vomiting, or purgation to release the exterior, although the pathogenic factor has been removed, the healthy qi is damaged. The middle jiao (Spleen and Stomach) becomes weak, causing turbid qi to ascend and clear qi to sink, resulting in persistent belching. This formula aims to regulate the middle jiao, allowing the qi mechanism in the chest to circulate smoothly.
Indicated for chronic dysentery that does not cease, prolapse of the Large Intestine due to deficiency, and worsening diarrhea after taking Lizhong Wan.
*Lapidarum Rubrum* (Chishizhi) *Yuyuliang* (Yuyuliang) [each 1 jin, both crushed]
Take the above two ingredients, add six sheng of water, boil to obtain two sheng, remove the residue, divide into three warm doses.
Ke Yunbo said: Licorice, Zingiber, Ginseng, and Atractylodes Macrocephala can tonify the deficiency of primordial qi in the Middle Palace (Spleen/Stomach), but are insufficient to secure the slippage of the essence and fat in the Lower Jiao. For this diarrhea located in the Lower Jiao, the responsibility lies in the failure of the Lower Jiao to hold. Chishizhi (Red Stone Lipite) is red and enters Bing (Heart/Fire), assisting Fire to generate Earth; Yuyuliang (Magnetitum) is yellow and enters Wu (Spleen/Earth), solidifying the Stomach and astringing the intestines. Urgently treating the branch symptom in the Lower Jiao is actually to cultivate the root of the Middle Palace. One must know that in this syndrome, Earth is deficient but Fire is not, so Zingiber and Aconite are not suitable. Zhang Zhongjing said: "If diarrhea persists despite repeated episodes, one should promote urination." Thus, it is known that this formula differs from Taohua Tang (Peach Kernel Decoction).
Treats disorders caused by Water Qi in Shaoyin, presenting with abdominal pain and diarrhea, heaviness and pain in the four limbs, and difficult urination. The patient may also have cough, vomiting, or clear urine with persistent diarrhea.
*Atractydis Macrocephalae Rhizoma* (Baizhu) [2 liang] *Poria* (Fuling) *Paeoniae Radix Alba* (Baishao) [each 3 liang] *Aconiti Lateralis Radix Praeparata* (Da Fuzi), processed [1 piece] *Zingiberis Rhizoma Recens* (Shengjiang) [3 liang]
Take the above five ingredients, add eight sheng of water, boil to obtain three sheng, remove the dregs. Take 7 he of warm liquid, three times a day.
Zhao Yuhuang said: The human body consists of Yin and Yang. The Upper Jiao belongs to Yang and governs the Heart and Lung; the Lower Jiao belongs to Yin and governs the Liver and Kidney. The Liver stores Yin Blood, and the Kidney contains both True Yin and True Yang. Who is the master? Therefore, when the Spleen receives Fuzi (Prepared Aconite Root), the Fire of the Gate of Vitality generates Spleen Earth, and Water finds its source; when the Kidney receives Fuzi, Yang Qi is secured. Furthermore, with the sour nature of Baishao (White Peony Root), it constrains the Liver and gathers Yin Qi, achieving a state of balanced Yin and Yang. As for Shengjiang (Fresh Ginger), it harmonizes the Stomach. Essentially, Wuling San (Five-Ingredient Powder with Poria) moves excess water, while Zhenwu Tang (True Warrior Decoction) moves insufficient water; there is a world of difference between the two. In short, for conditions where Water Qi overflows and acts recklessly, without greatly tonifying the Yang within Kan (Kidney) and greatly strengthening the Qi of the Middle Palace, even using Cheqianzi (Plantago Seed) and Mutong (Akebia Caulis) would be ineffective.
Ke Yunbo said: The functional use of Fire in Kan Gong (Kidney) is not unblocked, so the Water system of the Kidney fails in its duty; this is due to deficiency-cold in the Lower Jiao failing to control Water. The method should be to strengthen Yuan Yang to dispel Yin shadows and eliminate stagnation to clear the water source, thus establishing this decoction. The modification methods listed after the formula are modifications for Zhenwu Tang, not the main symptoms. Although all involve Water Qi disorders, they do not belong to the main Shaoyin syndrome. It states that if there is cough, it is caused by Water Qi attacking the Lung; add Wuweizi (Schisandra Berry) for its sour-warm property to assist Baishao in collecting Kidney Water Qi; add Xixin (Asarum) for its pungent-warm property to assist Shengjiang in dispersing Lung Water Qi. If urination is spontaneous and accompanied by diarrhea, it indicates lack of Yang in the Stomach; thus abdominal pain does not belong to Ministerial Fire, and limb heaviness is due to Spleen dampness. Therefore, remove the sour-cold Baishao, add Ganjiang (Dried Ginger) for its pungent-hot property, and even remove the sweet-neutral Fuling. This becomes a warming-the-middle agent, not a diuretic. If there is vomiting, it is because Water Qi is in the Middle Jiao, so the Middle Jiao is not regulated, leading to limb discomfort. The disease does not involve Shaoyin but stems from the failure of Taiyin Dampness transformation to unblock. It does not require Fuzi to warm the Kidney; instead, double the amount of Shengjiang to disperse pathogens. This becomes a harmonizing-the-middle agent, not a Lower Jiao agent. Fuzi, Baishao, Fuling, and Baizhu are the four key ingredients of Zhenwu Tang; removing any one means it is no longer Zhenwu Tang. Zhang Zhongjing’s discussion of syndromes and treatments often involves analogical reasoning and does not confine itself to rigid boundaries.
Yu Jiayan said: When Yang collapse occurs and Zhenwu Tang is used for rescue, it is because Zhenwu is the deity governing Water in the North. The four ingredients in the formula act to move water, collect Yin, elevate Earth, and restore Yang...