治风湿相搏。客在皮肤。关节疼痛。腰以下疼重。脉浮自汗恶风。
防己(酒洗) 黄 (各钱半) 白术(一钱) 甘草(炙。八分) 生姜(四片) 大枣(二枚。擘)
上六味。水煎热服。后当如虫行皮中。腰以下如冰。后坐被上。又以一被绕腰下。温令微汗瘥。
喘加麻黄。胃气不和。加芍药。气上冲。加桂枝。下有陈气。加细辛。(陈气。久积之寒气也。)
防己茯苓汤(金匮) 治皮水四肢肿。皮肤聂聂动。
防己黄 汤去白术、姜、枣。本方中防己、黄 各三钱。甘草一钱。加肉桂三钱。茯苓六钱。
水煎。温分三服。
千金防己汤 治历节四肢。痛如锥刺。
防己黄 汤去黄 、大枣。本方中防己、白术、生姜各四钱。甘草三钱。加桂心、茯苓各四钱。
乌头一枚。(去皮。熬。)人参二钱。以苦酒和水煮。日三夜一服。当觉焦热。痹忽忽然。慎勿
怪也。若不觉。复服。以觉乃止。
治汗下不解。虚邪留于膈上。心下结痛。虚烦懊 不得眠。反复颠倒。卧起不安者。
栀子(十四枚。擘) 香豉(四合)
上二味。水煎。分二服。温进一服。得快吐。止后服。按仲景太阳例中。用栀子豉汤有三。
皆主汗下后虚邪不解之证。其栀子必取肥者生用。一吐而膈上之邪与火俱散也。若其时行疫疠。
头痛发热。此汤加葱白最捷。多有服之不吐者。胃气强也。加齑汁服之。或以鹅翎采之。或借用以
清解膈上郁结之火。不欲其吐。又须山栀炒黑用之。便屈曲下行小便矣。如卫气素虚人感冒客邪。
自汗多者。此方中香豉须炒熟用之。至于少气。为胃气之虚。则加甘草以缓调之。呕为痰饮之逆。
则加生姜以开豁之。下后心烦腹满。明是浊气内陷。乃于本方除去香豉表药。加枳、朴以涌泄之。
丸药大下后。身热不去微烦。明是虚火外扰。本方亦不用香豉。而加干姜以温顺之。其有身黄发热。
明是湿邪郁发。亦于本方去香豉。而加柏皮以苦燥之。下后劳复食复。明是正不胜邪。本方加
枳实以清理其内。用清浆水煮。取味微酸。使之下行而不上越也。若有宿食。则加大黄如博棋子大
五六枚。同一栀子豉法。功用之妙。神化莫测。非庸俗所能拟议也。
栀子甘草豉汤(玉函) 治下后少气。
栀子豉汤加甘草
栀子生姜豉汤(玉函) 治下后呕吐。
栀子豉汤加生姜。
栀子浓朴汤(玉函) 治下后心烦腹满。
栀子豉汤去豉加枳实、浓朴。
栀子干姜汤(玉函) 治丸药大下后。身热不去。微烦。
栀子豉汤去豉加干姜。上四方服法。如栀子豉汤。
栀子柏皮汤(玉函) 治太阳证身黄发热。
栀子豉汤去豉加柏皮、甘草。水煎。分温再服。
枳实栀子豉汤(玉函) 治劳复食复。
栀子豉汤倍香豉。加枳实三枚。用清浆水七升。空煮取四升。纳枳实、栀子煮取三升。
下豉更煮五六沸。去滓。分温再服。覆令微似汗。有食。加大黄如博棋子大五六枚。
栀子大黄汤 治酒瘅心中懊 。或热痛。
栀子豉汤加枳实、大黄。
黄芩清肺饮 治渴而小便不利。
栀子豉汤去豉。用炒黑山栀。加黄芩等分。热服探吐之。不应。加香豉一撮。此方妙用。
全在探吐以提其上。则肺气立清。若服而不吐。不特绵延不能克应。纵或小瘥。其苦寒之性。
留薄于内。大伤氤氲之气。得不为之预虑乎。
栀子仁汤 治小便不通。烦闷腹胀。
栀子豉汤去豉。加甘草、茅根、葵子。
治疗风湿相互搏结,邪气客居在皮肤之间,导致关节疼痛,腰部以下疼痛且沉重,脉象浮而自汗出、怕风。
防己(用酒洗) 黄芪(各一两半) 白术(一两) 甘草(炙过的,八分) 生姜(四片) 大枣(两枚,掰开)
以上六味药,用水煎煮后热服。服药后应当感觉像有虫子在皮肤中爬行,腰部以下感觉像冰一样冷。随后坐在被子上,再用一条被子环绕腰部以下,使其微微出汗即可痊愈。
如果气喘,加麻黄;如果胃气不和,加芍药;如果气上冲,加桂枝;如果下部有陈寒之气,加细辛。(陈寒之气,指久积的寒气。)
防己茯苓汤(出自《金匮要略》) 治疗皮水病,四肢浮肿,皮肤微微跳动。
防己茯苓汤即由防己黄芪汤去掉白术、生姜、大枣组成。本方中防己、黄芪各三两,甘草一两,加入肉桂三两,茯苓六两。
用水煎煮,分三次温服。
千金防己汤即由防己黄芪汤去掉黄芪、大枣组成。本方中防己、白术、生姜各四两,甘草三两,加入桂心、茯苓各四两,乌头一枚(去皮,炒熟)。用醋和水一起煎煮,白天服三次,夜间服一次。应当感觉到焦热感,痹痛突然缓解,千万不要奇怪。如果没有感觉,再服用,直到有感觉才停止。
治疗因发汗或攻下后病未解,虚邪留滞于膈上,心下痞结疼痛,心中烦闷懊恼,无法入睡,翻来覆去,坐卧不安的情况。
以上两味药,用水煎煮,分两次服用。温服第一次,如果能引起快速呕吐,就停止服用后面的药。按照张仲景太阳病的例子,使用栀子豉汤有三种情况,都主治发汗或攻下后虚邪未解的证候。其中的栀子必须选用肥大者生用,一吐之后,膈上的邪气和火气一同发散。如果是时行疫病,头痛发热,此汤加入葱白最为快捷。有很多人服用后不呕吐,这是因为胃气强盛。可以加入醋汁服用,或者用鹅毛探喉催吐,或者借用这种方法来清解膈上郁结的火气,并不一定要让它呕吐。又必须将山栀炒黑使用,这样就能屈曲下行进入小便排出。如果是卫气素来虚弱的人感冒外邪,自汗多的,此方中的香豉必须炒熟使用。至于少气,是胃气虚弱,则加甘草来缓和调理。呕吐是痰饮上逆,则加生姜来开豁痰饮。攻下后心烦、腹部胀满,明显是浊气内陷,于是从本方中除去作为表药的香豉,加入枳实、厚朴以涌泄之。服用丸药大泻后,身热不退、轻微烦躁,明显是虚火外扰,本方也不用香豉,而是加入干姜以温顺之。如果有身体发黄、发热,明显是湿邪郁蒸发作,也从本方中除去香豉,加入柏皮以苦燥之。攻下后因劳累或饮食不当复发,明显是正气不胜邪气,本方加入枳实以清理内部,用清浆水煎煮,取其味道微酸,使药力下行而不向上越散。如果有宿食,则加大黄如博戏棋子大小五六枚。这些都是同一类栀子豉汤的方法,其功效之妙,神化莫测,不是平庸世俗之人所能揣测议论的。
栀子干姜汤(出自《玉函经》) 治疗丸药大泻后,身热不去,轻微烦躁。
栀子豉汤去掉豆豉,加入干姜。以上四方剂的服用方法,如同栀子豉汤。
栀子柏皮汤(出自《玉函经》) 治疗太阳病证见身体发黄、发热。
枳实栀子豉汤(出自《玉函经》) 治疗劳复、食复。
栀子豉汤加倍香豉用量,加入枳实三枚,用清浆水七升,先空煮至四升,纳入枳实、栀子煮取三升,再下豆豉煮五六沸,去渣,分两次温服。覆盖衣被令其微微似有汗出。如果有食物积滞,加大黄如博戏棋子大小五六枚。
栀子豉汤去掉豆豉,用炒黑的山栀,加入等分的黄芩。热服以探吐。如果无效,加入一撮香豉。此方的妙用,全在于通过探吐来提升上部气机,则肺气立即清肃。如果服用后不呕吐,不仅病情拖延不能见效,即使稍微好转,其苦寒的性质也会留滞于体内,大伤氤氲生气,能不预先考虑吗?
Treating rheumatism where wind and dampness mutually contend, with pathogenic factors lodging in the skin, causing joint pain, heaviness and pain below the waist, floating pulse, spontaneous sweating, and aversion to wind.
Paeleiae Radix (Fangji) (washed with wine), Astragali Radix (Huangqi) (each 1.5 qian), Atractylodis Macrocephalae Rhizoma (Baizhu) (1 qian), Glycyrrhizae Radix et Rhizoma (Gancao) (roasted, 8 fen), Zingiberis Rhizoma (Shengjiang) (4 slices), Jujubae Fructus (Dazao) (2 pieces, split).
The above six herbs are decocted in water and taken hot. After taking the medicine, one should feel as if insects are crawling within the skin, and the area below the waist will feel cold like ice. Subsequently, sit on a quilt, wrap another quilt around the lower waist, and induce a slight sweat for recovery.
If there is wheezing, add Ephedrae Herba (Mahuang); if stomach qi is disharmonious, add Paeoniae Radix Alba (Baishao); if qi rushes upward, add Cinnamomi Ramulus (Guizhi); if there is accumulated cold qi below, add Asari Radix (Xixin). (Accumulated cold qi refers to long-standing cold pathogens.)
Fangji Fuling Decoction (from *Jin Gui Yao Lue*) treats edema of the skin type (Pi Shui) with swelling of the four limbs and slight twitching of the skin.
This formula is derived from Fangji Huangqi Tang by removing Atractylodis Macrocephalae Rhizoma (Baizhu), Zingiberis Rhizoma (Shengjiang), and Jujubae Fructus (Dazao). In this formula, Paeleiae Radix (Fangji) and Astragali Radix (Huangqi) are each 3 qian, Glycyrrhizae Radix et Rhizoma (Gancao) is 1 qian, added with Cinnamomi Cortex (Rougui) 3 qian and Poria (Fuling) 6 qian.
Decoct in water and take warm in three divided doses.
Qianjin Fangji Tang treats interarticular rheumatism (Lijie) with pain in the four limbs like needle pricks.
This formula is derived from Fangji Huangqi Tang by removing Astragali Radix (Huangqi) and Jujubae Fructus (Dazao). In this formula, Paeleiae Radix (Fangji), Atractylodis Macrocephalae Rhizoma (Baizhu), and Zingiberis Rhizoma (Shengjiang) are each 4 qian, Glycyrrhizae Radix et Rhizoma (Gancao) is 3 qian, added with Cinnamomi Cortex (Guixin) and Poria (Fuling) each 4 qian, and Aconiti Lateralis Radix Preparata (Wutou) 1 piece (peeled and roasted). Decoct with vinegar and water. Take three times during the day and once at night. One should feel a burning heat, and the bi-syndrome will suddenly alleviate; do not be surprised. If no sensation is felt, take again until sensation occurs, then stop.
Treating cases where disease persists after sweating or purging, with deficient pathogenic factors lingering above the diaphragm, causing epigastric knotting and pain, mental restlessness and vexation (Ao Nu), inability to sleep, tossing and turning, and restlessness in sitting or lying down.
Gardeniae Fructus (Zhizi) (14 pieces, split), Fermented Soybean (Xiangchi) (4 he).
The above two herbs are decocted in water and divided into two doses. Take the first dose warm. If rapid vomiting occurs, discontinue subsequent doses. According to Zhang Zhongjing's examples in the Taiyang chapter, Zhizi Chi Tang is used in three scenarios, all primarily treating conditions where deficient pathogens remain unresolved after sweating or purging. The Gardeniae Fructus (Zhizi) must be plump and raw. Vomiting disperses both the pathogen and fire from above the diaphragm. If it is an epidemic disease with headache and fever, adding Allii Fistulosi Bulbus (Congbai) to this decoction is most effective. Many people do not vomit after taking it because their Stomach Qi is strong. Adding vinegar juice can help, or one may use a goose feather to induce vomiting, or borrow this method to clear stagnant fire above the diaphragm without necessarily inducing vomiting. Alternatively, stir-fried black Gardeniae Fructus (Zhizi) should be used so that the action curves downward to exit via urination. For individuals with inherently weak Wei Qi who catch external pathogens and have excessive spontaneous sweating, the Fermented Soybean (Xiangchi) in this formula must be stir-fried thoroughly. Regarding shortness of breath (Shao Qi), it indicates deficiency of Stomach Qi, so add Glycyrrhizae Radix et Rhizoma (Gancao) to harmonize gently. Vomiting indicates rebellion of phlegm-fluids, so add Zingiberis Rhizoma (Shengjiang) to resolve them. After purging, if there is vexation and abdominal fullness, it clearly indicates turbid qi sinking inward; thus, remove the exterior-releasing Fermented Soybean (Xiangchi) from the base formula and add Aurantii Fructus Immaturus (Zhishi) and Magnoliae Officinalis Cortex (Houpo) to purge downward. After severe purging with pill medicines, if body heat persists and there is slight vexation, it clearly indicates deficient fire disturbing externally; thus, do not use Fermented Soybean (Xiangchi) in the base formula, but add Zingiberis Rhizoma Siccatum (Ganjiang) to warm and harmonize. If there is jaundice with fever, it clearly indicates dampness stagnating and transforming; thus, remove Fermented Soybean (Xiangchi) from the base formula and add Phellodendri Cortex (Bopu) to dry with bitter properties. After purging, if relapse occurs due to labor or diet, it indicates righteous qi failing to overcome pathogens; thus, add Aurantii Fructus Immaturus (Zhishi) to clear the interior, using Qing Jiang Shui (fermented grain water) for decoction to utilize its slight sour taste, guiding the action downward rather than allowing it to rise upward. If there is retained food, add Rheii Radix et Rhizoma (Dahuang) in pieces the size of chess pieces, five or six pieces. These are all variations of the Zhizi Chi Tang method; its efficacy is miraculous and unfathomable, beyond the comprehension of mediocre practitioners.
Zhizi Gancao Chi Tang (from *Yu Han Jing*) treats shortness of breath after purging.
Zhizi Chi Tang plus Glycyrrhizae Radix et Rhizoma (Gancao).
Zhizi Shengjiang Chi Tang (from *Yu Han Jing*) treats vomiting after purging.
Zhizi Chi Tang plus Zingiberis Rhizoma (Shengjiang).
Zhizi Houpo Tang (from *Yu Han Jing*) treats vexation and abdominal fullness after purging.
Zhizi Chi Tang minus Fermented Soybean (Chi), plus Aurantii Fructus Immaturus (Zhishi) and Magnoliae Officinalis Cortex (Houpo).
Zhizi Ganjiang Tang (from *Yu Han Jing*) treats persistent body heat and slight vexation after severe purging with pill medicines.
Zhizi Chi Tang minus Fermented Soybean (Chi), plus Zingiberis Rhizoma Siccatum (Ganjiang). The administration methods for the above four formulas are the same as for Zhizi Chi Tang.
Zhizi Bopi Tang (from *Yu Han Jing*) treats Taiyang syndrome presenting with jaundice and fever.
Zhizi Chi Tang minus Fermented Soybean (Chi), plus Phellodendri Cortex (Bopu) and Glycyrrhizae Radix et Rhizoma (Gancao). Decoct in water and take warm in two divided doses.
Zhishi Zhizi Chi Tang (from *Yu Han Jing*) treats relapse due to labor or diet.
Double the amount of Fermented Soybean (Xiangchi) in Zhizi Chi Tang, add three pieces of Aurantii Fructus Immaturus (Zhishi). Use seven sheng of Qing Jiang Shui (fermented grain water), boil empty until four sheng remain, add Aurantii Fructus Immaturus (Zhishi) and Gardeniae Fructus (Zhizi), boil until three sheng remain. Add Fermented Soybean (Chi), boil for five or six boils, strain, and take warm in two divided doses. Cover to induce a slight sweat. If there is food retention, add Rheii Radix et Rhizoma (Dahuang) in pieces the size of chess pieces, five or six pieces.
Zhizi Dahuang Tang treats alcohol jaundice (Jiu Dan) with mental restlessness (Ao Nu) or painful heat in the heart region.
Zhizi Chi Tang plus Aurantii Fructus Immaturus (Zhishi) and Rheii Radix et Rhizoma (Dahuang).
Huangqin Qingfei Yin treats thirst with difficulty in urination.
Zhizi Chi Tang minus Fermented Soybean (Chi), using stir-fried black Gardeniae Fructus (Zhizi) in equal parts with Scutellariae Radix (Huangqin). Take hot to induce vomiting. If ineffective, add a pinch of Fermented Soybean (Xiangchi). The妙用 (profound utility) of this formula lies entirely in inducing vomiting to lift the upper jiao, thereby clearing Lung Qi immediately. If taken without vomiting, not only does the condition prolong and fail to respond, but even if slightly improved, the bitter-cold nature remains trapped inside, severely damaging the vital Qi. Should one not consider this precaution?
Zhizi Ren Tang treats urinary obstruction with vexation, abdominal distension, and fullness.
Zhizi Chi Tang minus Fermented Soybean (Chi), plus Glycyrrhizae Radix et Rhizoma (Gancao), Imperatae Rhizoma (Maogen), and Abelmoschi Semen (Kuizi).