治腹中不和而痛。(此阴阳气血不和,肝木乘脾而然。腹痛,有寒有热,有虚
食积,有湿痰,有死血,有虫。寒痛者,痛无增减,或兼吐利。热痛者,时痛时止
结。实痛者,痛甚胀满,手不可按。虚痛者,按之即止。食痛者,痛甚则利,利后
血痛者,痛有常处。湿痰痛者,脉滑,痰气阻碍,不得升降。虫痛者,时作时止,
大抵胃脘下大腹痛者,多属食积外邪。绕脐痛者,属痰火积热。脐下少腹痛者,
仲景用治误表发厥,脚挛吐逆,与甘草干姜汤,以复其阳。厥愈足温者,更作
阴,其脚即伸。(酸甘相合,用补阴血。)
白芍药 甘草(炙各四两) 脉缓伤水,加桂枝生姜。脉洪伤金,加黄 大枣。脉涩伤
血,加
气血不和,故腹痛。白芍酸收而苦泄,能行营气,炙草温散而甘缓,能和逆气。又痛为
木盛
甘
加白术,名白术芍药汤。(机要)治脾湿水泻,身重困弱。(保命集曰∶泻痢不止,或暴
下者
(仲景)治太阳少阳合病,自下利者。(合病者,谓有太阳证之身热头痛脊强,又有少
阳证之耳聋胁痛,呕而口苦,寒热往来也。自利者,不因攻下而泄泻也。)
黄芩(三两) 芍药 甘草(二两) 大枣(十二枚)
太阳阳明合病下利,为在表,与葛根汤以汗之。少阳阳明合病下利,为阳邪入里,与承
气汤
不苟
之,
加半夏(半升) 生姜(二两) 名黄芩加半夏生姜汤,(仲景)治前证兼呕者。(呕,
胃气逆也
半夏以治
苦,胆液
及火升
外台黄芩汤。黄芩人参干姜(各三两) 桂枝(一两) 大枣(十二枚) 半夏(半斤)
治干呕下
治疗腹中不适而疼痛。(这是阴阳气血不和,肝木乘脾所致。腹痛,有寒痛、热痛、虚痛、食积痛、湿痰痛、死血痛、虫痛之分。寒痛者,疼痛无增减,或兼有呕吐腹泻。热痛者,时痛时止。实痛者,疼痛剧烈且胀满,手不可按压。虚痛者,按压后疼痛缓解。食积痛者,疼痛剧烈则腹泻,泻后痛减。死血痛者,疼痛部位固定。湿痰痛者,脉滑,因痰气阻碍,气机不得升降。虫痛者,时作时止。大抵胃脘下方至大腹部的疼痛,多属于食积或外邪。绕脐疼痛者,属于痰火积热。脐下少腹部的疼痛,……)
张仲景用此方治疗误用发汗法导致四肢厥冷、脚部拘挛、呕吐逆气之证,先与甘草干姜汤以恢复阳气。待四肢厥冷痊愈、足部变温后,再改用芍药甘草汤以滋养阴血,此时脚部即可伸展。(酸味与甘味相合,用以补益阴血。)
白芍药、甘草(炙,各四两)。若脉缓且伤水(津液),加桂枝、生姜;若脉洪大且伤金(肺/气),加大枣;若脉涩且伤血,加……(此处原文残缺,推测为养血之品)。
阴阳气血不和,故导致腹痛。白芍药味酸能收敛,味苦能泄降,能运行营气;炙甘草性温能散,味甘能缓急,能调和逆乱之气。又因疼痛多为肝木过盛克制脾土所致,故……(此处原文逻辑跳跃,接下文方剂组成)。
加入白术,名为白术芍药汤。(出自《医学启源》)治疗脾虚湿盛之水泻,身体沉重困倦。(《保命集》记载:痢疾不止,或突然暴泻者……)
(张仲景)治疗太阳病与少阳病合病,出现自发性下利的情况。(所谓合病,是指既有太阳病的发热、头痛、项背强直症状,又有少阳病的耳聋、胁痛、呕吐、口苦、寒热往来等症状。自利,是指不因攻下法而导致的泄泻。)
太阳病与阳明病合病之下利,病位在表,给予葛根汤以发汗解表。少阳病与阳明病合病之下利,是阳邪入里,给予承气汤……(此处原文残缺,意为攻下)。
加入半夏(半升)、生姜(二两),名为黄芩加半夏生姜汤,(张仲景)治疗上述证候兼有呕吐者。(呕吐,是胃气上逆所致。半夏用于……苦味,胆液……及火气上升……)
Treats discomfort and pain in the abdomen. (This is caused by disharmony of Yin and Yang, Qi and Blood, where Liver Wood overacts on Spleen Earth. Abdominal pain can be due to Cold, Heat, Deficiency, Food Stagnation, Damp-Phlegm, Fixed Blood Stasis, or Parasites. In Cold pain, the pain does not fluctuate in intensity, possibly accompanied by vomiting and diarrhea. In Heat pain, the pain comes and goes intermittently. In Excess pain, the pain is severe with distension, and the abdomen cannot be pressed. In Deficiency pain, pressing relieves the pain. In Food Stagnation pain, severe pain leads to diarrhea, which alleviates the pain afterward. In Fixed Blood Stasis pain, the pain is located in a fixed area. In Damp-Phlegm pain, the pulse is slippery, with obstruction of Qi mechanism by Phlegm preventing ascending and descending. In Parasite pain, the pain occurs and stops intermittently. Generally, pain below the epigastrium extending to the large abdomen belongs to Food Stagnation or External Pathogens. Pain around the umbilicus belongs to Phlegm-Fire and accumulated Heat. Pain in the lower abdomen below the umbilicus...)
Zhang Zhongjing uses this formula to treat cases where mistaken sweating therapy led to cold limbs (Jue), leg cramps, and vomiting/reversal of Qi. First, Gancao Ganjiang Tang (Licorice and Ginger Decoction) is given to restore Yang Qi. Once the cold limbs resolve and the feet become warm, Shaoyao Gancao Tang (Peony and Licorice Decoction) is administered to nourish Yin and Blood, at which point the legs extend. (The combination of Sour and Sweet flavors is used to tonify Yin and Blood.)
Baishao Yao (Radix Paeoniae Alba), Gancao Zhi (Prepared Radix Glycyrrhizae), each 4 liang. If the pulse is slow indicating injury to Water (Fluids), add Guizhi (Ramulus Cinnamomi) and Shengjiang (Rhizoma Zingiberis Recens). If the pulse is surging indicating injury to Metal (Lung/Qi), add Dazao (Fructus Jujubae). If the pulse is choppy indicating injury to Blood, add... [Text incomplete].
Disharmony of Yin, Yang, Qi, and Blood causes abdominal pain. Baishao Yao (Radix Paeoniae Alba) is Sour in flavor for astringency and Bitter for draining, capable of moving Ying Qi; Zhi Gancao (Prepared Radix Glycyrrhizae) is Warm for dispersing and Sweet for moderating urgency, capable of harmonizing rebellious Qi. Furthermore, pain is often due to excessive Liver Wood suppressing Spleen Earth... [Text jumps to formula composition].
Adding Baizhu (Rhizoma Atractylodis Macrocephalae) creates Baizhu Shaoyao Tang (Atractylodes and Peony Decoction). (From *Yixue Qiyuan*) It treats watery diarrhea due to Spleen Dampness, accompanied by heaviness and weakness in the body. (*Baoming Ji* states: For dysentery that does not cease, or sudden violent diarrhea...)
(Zhang Zhongjing) treats spontaneous diarrhea resulting from the simultaneous occurrence of Taiyang and Shaoyang diseases. (Simultaneous occurrence means there are Taiyang symptoms such as fever, headache, and stiffness of the neck and back, along with Shaoyang symptoms such as deafness, hypochondriac pain, vomiting, bitter taste in the mouth, and alternating chills and fever. Spontaneous diarrhea refers to diarrhea occurring without prior purgative treatment.)
Huangqin (Radix Scutellariae), Shaoyao (Radix Paeoniae), Gancao (Radix Glycyrrhizae), Dazao (Fructus Jujubae).
Diarrhea from the simultaneous occurrence of Taiyang and Yangming diseases indicates the pathogen is in the Exterior; Gegen Tang (Kudzu Decoction) is given to induce sweating. Diarrhea from the simultaneous occurrence of Shaoyang and Yangming diseases indicates the Yang pathogen has entered the Interior; Chengqi Tang (Gastrointestinal Draining Decoction)... [Text incomplete].
Adding Banxia (Fructus Pinelliae Preparatus) and Shengjiang (Rhizoma Zingiberis Recens) creates Huangqin Jia Banxia Shengjiang Tang (Scutellaria plus Pinellia and Fresh Ginger Decoction). (Zhang Zhongjing) treats the aforementioned conditions complicated by vomiting. (Vomiting is due to Rebellious Stomach Qi. Banxia is used to... Bitter flavor, Gallbladder fluid... and rising Fire...)
*Waitai Miyao*’s Huangqin Tang: Huangqin (Radix Scutellariae), Renshen (Radix Ginseng), Ganjiang (Rhizoma Zingiberis), each 3 liang; Guizhi (Ramulus Cinnamomi) 1 liang; Dazao (Fructus Jujubae) 12 pieces; Banxia (Fructus Pinelliae Preparatus) half jin. Treats dry heaving with diarrhea...