涂蔚生曰∶咳嗽一症,患者最多而最易,治之者,每与之反,岂咳嗽果为不易治之症欤?抑咳嗽之方多未善欤?
曰∶由于未将咳嗽之题目认清。果能将其认清,则除虚痨久咳不治外,即无不可治愈之咳嗽矣。经云∶五脏六腑皆
有咳嗽,而无不聚于胃,关于肺。是先圣已将两大咳嗽之法门,明白揭示。然而肺胃之分,亦各有内外之因焉。何
为内外,曰肺主皮毛,又为华盖,外之风寒有伤皮毛,固可使内部化生之气,不得外出,壅聚于肺,发生咳嗽。而
内部之肺阴干涸,津液不能下降,虚火上刑肺金,亦可发生咳嗽。经云∶外感以咳嗽为轻,内伤以咳嗽为重。盖谓
此耳。其外感风寒者,重则宜麻黄汤,轻则宜十味参苏饮,小柴胡汤加防风杏仁贝母亦治之。热甚者,可去半
夏,加知母,花粉;寒甚者,可去黄芩,加白芷荆芥。其内伤肺阴者,宜人参清肺汤,人参固本汤,清燥救肺汤,
人参泻肺汤以治之。热甚者,知柏芩连均可加入。若夫肾阴亏损,虚火烁肺,外症头目眩晕,溺赤腰痛,咳嗽者,
宜知柏地黄汤加杏仁尖贝五味以治之。其虚极而干呛无痰者,则龟阿二胶,尤宜加入。因其有形之质既损,则非草木
无形之质所能填补者也。然人非消瘦残弱之人,素形体壮,而骤得干呛之症者,尤须防系风寒闭塞于肺,而
妄施滋补焉。胃为仓廪之官,水谷之海,虽不外主皮毛,而风寒之袭,因寒动水,亦可发生咳嗽焉。小青龙汤,
与桂苓术甘汤,乃为治是症之要药。至其内因,则不外夫停痰、停食、停饮。何为停痰,痰者乃津液之变体也。水
谷入胃,水之精为津,谷之精为液,上经火化,变为气血,内输脏腑,外输经络,所以荣色泽,而温养其肢体
者也。若津液为寒所凝,或为火烁,则津液失其常度,变为痰滞,上冲肺脏,发生咳嗽。轻者宜六君子汤,审其
挟寒挟热,酌加姜桂芩连等味以治之。重者宜礞石滚痰丸以涤之。停食者食积于胃,不能消化,温热酝酿,将每
日所已消化之津液,亦熏蒸阻滞,变而为痰,发生咳嗽。唐容川曰∶五更时咳嗽,为食积之火,至寅时流入肺
经,宜小柴胡汤加莱菔子以治之。吾谓宜用二陈汤,酌加白芍枳壳麦芽黄芩等味以治之。停饮者,饮入之茶水停聚
也。仲景虽有痰饮悬饮溢饮支饮四者之分,而由多乎脾胃衰败,阳火失职,而水阴肆行无忌也。唐容川曰∶饮者
水也,停茶停酒,漩液唾涕皆是,而分稠者为痰,清者为饮,合津液者为漩唾,走皮肤者为水肿。又曰∶内之油
网,透出肌肉,则为周身之白膜肥网。水随网油,透出肌表,则为肥肿;及走四肢,则为肿疼。痰饮之人素盛者,
水气充于肌腠也。今反瘦者,则以肌腠之水气,反入于内,而走肠间,不走网膜中矣,故肠中沥沥有声。悬饮者,
水在胁下。胁下有油一大片,俗名板油,上连胸膈。水停板油中不得下,咳则引痛,悬庋于此,故名悬饮。溢饮
者,水入膈膜,不下走油网,以达膀胱,而溢出腠理,以走于四肢,故称溢焉。支饮者,水在油膜中,不下走膀胱,
而上犯于肺。如木枝上发之象,故称支饮。然总参仲景之治法,则不外本乎寒热虚实,而施以汗补温下之法也。
其因外寒而动水者,大小青龙汤主之。其因中土虚寒而停饮者,宜桂苓
术甘汤主之。其因中土寒而不虚者,宜小半夏汤治之。其完全由于寒实者,宜十枣汤下之。其因太阳膀胱寒水不
化者,宜五苓散治之。其因太阳寒而阳明兼虚热者,以木防己汤主之。其太阳寒而阳明兼有实热者,以木防己去石膏
加茯苓芒硝汤主之。其因胸中水饮与火热交结者,以浓朴大黄汤主之。药虽有缓急之分,而病实有深浅之异。咳者
未必尽系水饮,而水饮未有不咳。凭症以用药,固无虑夫缓急,而执药以寻症,总宜计其深浅。
仲景麻黄汤(见前伤寒方内)
十味参苏饮
人参(一钱) 苏叶(一钱) 半夏(一钱) 茯苓(一钱) 陈皮(一钱) 桔梗(一钱) 前胡(一钱)
葛根(一钱) 枳壳(六分) 甘草(一钱) 生姜(一钱)
仲景小柴胡汤
柴胡(一钱) 党参(一钱) 黄芩(一钱) 半夏(七分) 甘草(一钱) 生姜(一钱) 大枣(一枚)
人参清肺汤
人参(一钱) 阿胶(一钱) 地骨皮(一钱) 知母(一钱) 乌梅(一钱) 桑白皮(一钱) 粟壳(六分)
杏仁(一钱) 甘草(一钱) 大枣(一枚)
人参固本汤
人参(一钱) 熟地(一钱) 生地(一钱) 白芍(一钱) 天冬(一钱) 五味(一钱) 知母(一钱)
陈皮(七分) 麦冬(一钱) 炙草(六分)
清燥救肺汤
人参(一钱) 甘草(一钱) 黑芝麻(一钱) 阿胶(一钱) 石膏(一钱, ) 杏仁(一钱) 寸冬(一钱)
枇杷叶(一钱,炙) 冬桑叶(一钱)
人参泻肺汤
人参(一钱) 黄芩(一钱) 栀子(一钱) 枳壳(七分) 甘草(一钱) 连翘(一钱) 杏仁(一钱)
桔梗(一钱) 桑皮(一钱) 大黄(七分,酒炒) 薄荷(七分)
知柏地黄汤
生地(一钱) 萸肉(一钱) 丹皮(一钱) 山药(一钱) 茯苓(一钱) 泽泻(一钱)
知母(一钱) 黄柏(一钱)
仲景小青龙汤
麻黄(一钱) 桂枝(一钱) 半夏(一钱) 细辛(六分) 芍药(一钱) 五味子(一钱) 干姜(七分)
甘草(一钱)
仲景桂苓术甘汤
桂枝(一钱) 茯苓(一钱) 白术(一钱) 甘草(一钱)
六君子汤
白术(一钱) 党参(一钱) 茯苓(一钱) 陈皮(七分) 半夏(六分) 炙甘草(七分)
二阵汤
半夏(一钱) 陈皮(一钱) 茯苓(一钱) 甘草(一钱)
仲景大青龙汤
麻黄(一钱) 桂枝(一钱) 杏仁(一钱) 炙甘草(一钱) 生姜(一钱) 大枣(一枚) 石膏(一钱)
仲景小半夏汤
半夏(一钱) 生姜(一钱)
仲景十枣汤
芫花 甘遂 大戟
上等分,为末,以肥大枣十枚,煎水冲服。但此药味尽系猛剧,初起切勿多用,宜酌量渐次增加,以快利为度。
因儿有大小强弱,不敢定分量也。
仲景五苓散
桂枝(一钱) 白术(一钱) 茯苓(一钱) 猪苓(一钱) 泽泻(一钱)
仲景木防己汤
木防己(一钱) 桂枝(一钱) 人参(一钱) 石膏(一钱)
仲景木防己去石膏加茯苓芒硝汤
木防己(一钱) 桂枝(一钱) 人参(一钱) 茯苓(一钱) 芒硝(一钱)
涂蔚生曰∶查仲景原方内,无茯苓一味。然其汤名为木防己去石膏加茯苓芒硝汤,其方内应有茯苓可知,想
系誊写者之遗
失。余故为之加入。
仲景浓朴大黄汤
浓朴(一钱) 大黄(一钱) 枳实(一钱)
附方∶
外台茯苓饮 治心胸中有停痰宿水。自吐出水后、心胸间虚气满,不能食。消痰饮,令能食。
茯苓(一钱) 人参(一钱) 白术(一钱) 枳实(五分) 陈皮(七分) 生姜(一钱)
陈修园曰∶此痰饮善后最妥当之方也。
涂蔚生说:咳嗽这一病症,患者最多也最容易得,但治疗者往往与其背道而驰,难道咳嗽真的是难以治疗的病症吗?还是说治疗咳嗽的方剂大多不够完善呢?
回答说:这是因为没有认清咳嗽的根本题目。如果能将其认清,那么除了虚劳久咳这种不治之症外,就没有不可治愈的咳嗽了。《内经》说:五脏六腑都有咳嗽,但没有不汇聚于胃、关联于肺的。这是先圣已经明白揭示的两大咳嗽治法门类。然而肺和胃的区别,也各有内因和外因。什么是内外呢?回答说:肺主皮毛,又被称为华盖(覆盖诸脏的最高器官),外界的风寒如果伤害皮毛,确实会使内部化生的气机不能外出,壅聚在肺中,从而发生咳嗽。而内部的肺阴干涸,津液不能下降,虚火上炎灼伤肺金,也可以发生咳嗽。《内经》说:外感引起的咳嗽较轻,内伤引起的咳嗽较重。说的就是这种情况。对于外感风寒者,重的适宜用麻黄汤,轻的适宜用十味参苏饮,小柴胡汤加防风、杏仁、贝母也能治疗它。热势严重的,可以去掉半夏,加入知母、花粉;寒势严重的,可以去掉黄芩,加入白芷、荆芥。对于内伤导致肺阴亏损者,适宜用人参清肺汤、人参固本汤、清燥救肺汤、人参泻肺汤来治疗。热势严重的,知母、黄柏、黄芩、黄连都可以加入。如果是肾阴亏损,虚火灼烧肺部,外在症状表现为头目眩晕、小便赤涩、腰痛、咳嗽的,适宜用知柏地黄汤加杏仁尖、贝母、五味子来治疗。那些极度虚弱而干咳无痰的,则特别适宜加入龟板胶和阿胶。因为有形质的精血既已受损,就不是草木无形质的药力所能填补的了。然而,人如果不是消瘦残弱的病人,平时体质强壮,却突然患上干咳的病症,尤其必须防备是风寒闭塞于肺,而不要妄加滋补。胃是仓廪之官,是水谷之海,虽然不直接主管皮毛,但风寒侵袭时,因寒而动水,也可以发生咳嗽。小青龙汤与桂苓术甘汤,乃是治疗这类病症的要药。至于其内因,不外乎停痰、停食、停饮。什么是停痰?痰是津液的变体。水谷进入胃中,水的精华成为津,谷的精华成为液,向上经过火化,变为气血,向内输送到脏腑,向外输送到经络,所以能荣润色泽,温养肢体。如果津液被寒气凝结,或被火热灼烁,就会失去常态,变成痰滞,上冲肺脏,发生咳嗽。轻的适宜用六君子汤,审察其夹杂寒邪还是热邪,酌情加入姜、桂、芩、连等药味来治疗。重的适宜用礞石滚痰丸来涤荡清除。停食者,食物积滞在胃中,不能消化,温热酝酿,将每天已经消化的津液也熏蒸阻滞,变而为痰,发生咳嗽。唐容川说:五更时分咳嗽,是食积之火,到了寅时流入肺经,适宜用小柴胡汤加莱菔子来治疗。我认为适宜用二陈汤,酌情加入白芍、枳壳、麦芽、黄芩等药味来治疗。停饮者,是指喝进去的茶水停滞积聚。张仲景虽然有痰饮、悬饮、溢饮、支饮四种分类,但多是由于脾胃衰败,阳火失职,而水阴肆意横行无忌造成的。唐容川说:饮就是水,停茶、停酒、漩涡状液体、唾沫鼻涕都是,其中稠浊的为痰,清稀的为饮,结合津液的为漩涡状唾沫,流走皮肤的就成为水肿。又说:体内的油网透出肌肉,就成为周身白色的膜状脂肪网。水随着网油透出肌表,就成为浮肿;等到流走四肢,就成为肿痛。素来肥胖的痰饮病人,是因为水气充塞于肌腠之间。现在反而消瘦的,是因为肌腠间的水气反而进入体内,流走于肠间,而不走在网膜中了,所以肠中有沥沥的声音。悬饮,是水在胁下。胁下有一大片油,俗称板油,上连胸膈。水停在板油中不得下行,咳嗽时牵引疼痛,悬挂在此处,所以叫悬饮。溢饮,是水进入膈膜,不向下流走油网到达膀胱,而是溢出腠理,流走于四肢,所以称为溢。支饮,是水在油膜中,不向下流走膀胱,而是上犯于肺。像树枝向上发散的样子,所以称为支饮。然而总参看张仲景的治疗法则,不外乎基于寒热虚实,而施以汗、补、温、下的方法。那些因外寒而动水气的,以大、小青龙汤为主治。那些因中焦土虚寒而停饮的,适宜用桂苓术甘汤主治。那些因中焦寒但不虚的,适宜用小半夏汤治疗。那些完全由于寒实证的,适宜用十枣汤攻下。那些因太阳膀胱寒水不化的,适宜用五苓散治疗。那些因太阳寒而阳明兼有虚热的,以木防己汤主治。那些太阳寒而阳明兼有实热的,以木防己去石膏加茯苓芒硝汤主治。那些因胸中水饮与火热交结的,以浓朴大黄汤主治。药物虽有缓急之分,但病情实在有深浅的差异。咳嗽未必全都是水饮所致,但水饮未有不引起咳嗽的。凭症状来用药,本来不必担忧缓急,但如果拿着药去找症状,总应该考量病情的深浅。
仲景麻黄汤(见前伤寒方内)
十味参苏饮
人参(一钱) 苏叶(一钱) 半夏(一钱) 茯苓(一钱) 陈皮(一钱) 桔梗(一钱) 前胡(一钱)
葛根(一钱) 枳壳(六分) 甘草(一钱) 生姜(一钱)
仲景小柴胡汤
柴胡(一钱) 党参(一钱) 黄芩(一钱) 半夏(七分) 甘草(一钱) 生姜(一钱) 大枣(一枚)
人参清肺汤
人参(一钱) 阿胶(一钱) 地骨皮(一钱) 知母(一钱) 乌梅(一钱) 桑白皮(一钱) 粟壳(六分)
杏仁(一钱) 甘草(一钱) 大枣(一枚)
人参固本汤
人参(一钱) 熟地(一钱) 生地(一钱) 白芍(一钱) 天冬(一钱) 五味(一钱) 知母(一钱)
陈皮(七分) 麦冬(一钱) 炙草(六分)
清燥救肺汤
人参(一钱) 甘草(一钱) 黑芝麻(一钱) 阿胶(一钱) 石膏(一钱, ) 杏仁(一钱) 寸冬(一钱)
枇杷叶(一钱,炙) 冬桑叶(一钱)
人参泻肺汤
人参(一钱) 黄芩(一钱) 栀子(一钱) 枳壳(七分) 甘草(一钱) 连翘(一钱) 杏仁(一钱)
桔梗(一钱) 桑皮(一钱) 大黄(七分,酒炒) 薄荷(七分)
知柏地黄汤
生地(一钱) 萸肉(一钱) 丹皮(一钱) 山药(一钱) 茯苓(一钱) 泽泻(一钱)
知母(一钱) 黄柏(一钱)
仲景小青龙汤
麻黄(一钱) 桂枝(一钱) 半夏(一钱) 细辛(六分) 芍药(一钱) 五味子(一钱) 干姜(七分)
甘草(一钱)
仲景桂苓术甘汤
桂枝(一钱) 茯苓(一钱) 白术(一钱) 甘草(一钱)
六君子汤
白术(一钱) 党参(一钱) 茯苓(一钱) 陈皮(七分) 半夏(六分) 炙甘草(七分)
二阵汤(注:原文作“二阵汤”,据上下文及常用方名推测应为“二陈汤”)
半夏(一钱) 陈皮(一钱) 茯苓(一钱) 甘草(一钱)
仲景大青龙汤
麻黄(一钱) 桂枝(一钱) 杏仁(一钱) 炙甘草(一钱) 生姜(一钱) 大枣(一枚) 石膏(一钱)
仲景十枣汤
芫花 甘遂 大戟
上等分,研为末,用肥大枣十枚,煎水冲服。但这药味全是猛烈剧烈的,初起切勿多用,应酌量逐渐增加,以通利快畅为度。因为患儿有大小强弱之分,不敢确定固定分量。
仲景五苓散
桂枝(一钱) 白术(一钱) 茯苓(一钱) 猪苓(一钱) 泽泻(一钱)
仲景木防己汤
木防己(一钱) 桂枝(一钱) 人参(一钱) 石膏(一钱)
仲景木防己去石膏加茯苓芒硝汤
木防己(一钱) 桂枝(一钱) 人参(一钱) 茯苓(一钱) 芒硝(一钱)
涂蔚生说:查考张仲景原方内,没有茯苓一味。但其汤名为木防己去石膏加茯苓芒硝汤,可知方内应有茯苓,想是誊写者的遗失。所以我为之加入。
附方:
外台茯苓饮 治疗心胸中有停痰宿水。自吐出水后,心胸间虚气满胀,不能进食。消痰饮,令能进食。
茯苓(一钱) 人参(一钱) 白术(一钱) 枳实(五分) 陈皮(七分) 生姜(一钱)
Tu Weisheng stated: Cough is a symptom with the highest incidence and easiest onset among patients. However, practitioners often treat it contrary to its nature. Is cough truly a difficult-to-treat condition? Or are the formulas for treating cough mostly inadequate?
The answer is: This stems from failing to clearly identify the fundamental nature of cough. If one can clearly identify it, then except for chronic cough due to consumption (Xulao) which is incurable, there is no cough that cannot be cured. The Classics state: "All five zang organs and six fu organs have coughs, but none do not gather in the Stomach and relate to the Lung." This indicates that the ancient sages had already clearly revealed the two major categories of cough treatment methods. However, the distinction between Lung and Stomach also involves both internal and external causes. What are these internal and external causes? It is said: The Lung governs the skin and hair and is known as the "Canopy" (Huagai), covering all other organs. External Wind-Cold damaging the skin and hair can indeed prevent the Qi generated internally from dispersing outward, causing congestion in the Lung and resulting in cough. Conversely, internal dryness of Lung Yin, where body fluids fail to descend, allows Deficient Fire to ascend and scorch Lung Metal, also causing cough. The Classics state: "Cough due to external contraction is mild; cough due to internal injury is severe." This refers to this very point. For cases of external contraction by Wind-Cold, severe cases should use Mahuang Tang (Ephedra Decoction), while mild cases should use Shiwei Renshen Suye Yin (Ten-Ingredient Ginseng and Perilla Leaf Decoction). Xiaochaihu Tang (Minor Bupleurum Decoction) added with Fangfeng, Xingren, and Beimu can also treat it. If heat is severe, Banxia (Pinellia Rhizome) may be removed, and Zhimu (Anemarrhena Rhizome) and Huafen (Trichosanthes Root) added; if cold is severe, Huangqin (Scutellaria Root) may be removed, and Baizhi (Angelica Dahurica Root) and Jingjie (Schizonepeta Spike) added. For internal injuries leading to Lung Yin deficiency, Ren Shen Qingfei Tang (Ginseng Lung-Clearing Decoction), Renshen Guben Tang (Ginseng Root-Firming Decoction), Qingzao Jiufei Tang (Clearing Dryness and Saving the Lung Decoction), and Renshen Xiefei Tang (Ginseng Lung-Draining Decoction) are suitable. If heat is severe, Zhimu, Huangbai (Phellodendron Bark), Huangqin, and Lian (Coptis Rhizome) may all be added. In cases of Kidney Yin deficiency with Deficient Fire scorching the Lung, presenting with external symptoms such as dizziness, red urine, lower back pain, and cough, Zhibai Dihuang Tang (Anemarrhena, Phellodendron, and Rehmannia Pill) added with Xingren jian (Almond tip), Beimu, and Wuweizi is suitable. For those extremely deficient presenting with dry hacking cough without phlegm, Gu Ejiao (Tortoise Shell Glue) and E'jiao (Donkey-Hide Glue) are particularly suitable. Since the substantial essence has been damaged, it cannot be replenished by the formless qualities of herbs. However, individuals who are not emaciated or weak, but whose constitutions are usually robust yet suddenly develop a dry hacking cough, must be wary of Wind-Cold blocking the Lung, and one should not recklessly apply tonification. The Stomach is the official of the granary and the sea of water and grain. Although it does not directly govern the skin and hair, when attacked by Wind-Cold, the cold agitates water, which can also cause cough. Xiao Qinglong Tang (Minor Blue Dragon Decoction) and Guiling Zhugan Tang (Cinnamon Twig, Poria, Atractylodes, and Licorice Decoction) are key formulas for treating such conditions. As for internal causes, they are nothing more than retained phlegm, retained food, and retained fluid. What is retained phlegm? Phlegm is a transformed state of body fluids. When water and grain enter the Stomach, the essence of water becomes Jin (thin fluids), and the essence of grain becomes Ye (thick fluids). These ascend and undergo fire transformation to become Qi and Blood, distributing inward to the Zang-Fu organs and outward to the meridians, thereby nourishing the complexion and warming the limbs. If body fluids are congealed by Cold or scorched by Fire, they lose their normal state and transform into stagnant phlegm, rushing upward to the Lung and causing cough. Mild cases should use Liujunzi Tang (Six Gentlemen Decoction); depending on whether Cold or Heat is involved, Jiang (Ginger), Rougui (Cinnamon Bark), Huangqin, and Lian may be酌情 added. Severe cases should use Mengshi Gun Tan Wan (Lapis Maris Rubus Rolling Phlegm Pill) to purge them. Retained food refers to food stagnation in the Stomach that cannot be digested. Heat and dampness brew within, steaming and obstructing the body fluids digested daily, transforming them into phlegm and causing cough. Tang Rongchuan stated: "Cough occurring at dawn (Wugeng) is caused by fire from food stagnation flowing into the Lung Meridian during the Yin hour; Xiaochaihu Tang added with Laifuzi (Radish Seed) is suitable." I believe Erchen Tang (Two-Aged Decoction) added with Baishao (White Peony Root), Zhike (Bitter Orange), Maiya (Malt), and Huangqin is suitable. Retained fluid refers to the accumulation of ingested tea and water. Although Zhang Zhongjing classified phlegm-fluid retention into four types—Tan Yin (Phlegm-Fluid), Xuan Yin (Hanging Fluid), Yi Yin (Overflowing Fluid), and Zhi Yin (Branching Fluid)—these mostly arise from the decline of the Spleen and Stomach, failure of Yang Fire to perform its duties, and the unchecked rampant flow of Yin Water. Tang Rongchuan stated: "Yin is water; retained tea, retained wine, vortex-like fluids, saliva, and mucus are all included. Thick ones are called Tan (Phlegm), clear ones are called Yin (Fluid). Combined with body fluids, they form vortex-like saliva; flowing onto the skin, they become edema." He further stated: "The internal oil networks penetrating the muscles become the white membranous fat network throughout the body. Water following the oil networks penetrating the muscle surface becomes generalized edema; flowing to the limbs, it becomes swollen and painful. Patients with phlegm-fluid retention who were formerly obese have water Qi filling the interstices. Those who now appear thin have water Qi from the interstices entering the interior, flowing into the intestines rather than the omental membrane, hence the gurgling sound in the intestines." Xuan Yin refers to water located under the hypochondrium. There is a large sheet of oil under the hypochondrium, commonly known as plate fat, connecting upwards to the chest and diaphragm. Water trapped in this plate fat cannot descend; coughing draws pain, hanging here, hence named Xuan Yin. Yi Yin refers to water entering the diaphragm, not flowing down through the omental network to reach the Bladder, but overflowing the interstices and flowing to the limbs, hence named Yi. Zhi Yin refers to water in the omental membrane, not flowing down to the Bladder, but attacking the Lung upward. Like branches growing upward from a tree, hence named Zhi Yin. However, generally referring to Zhang Zhongjing's treatment methods, they are nothing more than based on Cold, Heat, Deficiency, and Excess, applying sweating, tonifying, warming, and purging methods. Cases where external Cold moves water should be treated primarily with Da Qinglong Tang (Major Blue Dragon Decoction) and Xiao Qinglong Tang. Cases where middle Jiao Earth deficiency-cold causes fluid retention should be treated primarily with Guiling Zhugan Tang. Cases where middle Jiao is cold but not deficient should be treated with Xiao Banxia Tang (Minor Pinellia Decoction). Cases completely due to Cold-Excess should be purged with Shizao Tang (Ten Jujube Decoction). Cases where Taiyang Bladder cold-water fails to transform should be treated with Wuling San (Five-Ingredient Powder with Poria). Cases where Taiyang Cold combines with Yangming Deficient-Heat should be treated primarily with Mufangji Tang (Stephania Decoction). Cases where Taiyang Cold combines with Yangming Excess-Heat should be treated primarily with Mufangji Qu Shigao Jia Fuling Mangxiao Tang (Stephasia Decoction minus Gypsum plus Poria and Mirabilite). Cases where thoracic fluid-retention knots with fire-heat should be treated with Nongpo Dahuang Tang (Magnolia Bark and Rhubarb Decoction). Although medicines vary in speed and intensity, diseases differ in depth. Cough is not necessarily always due to fluid-retention, but fluid-retention invariably causes cough. Prescribing medicine based on symptoms naturally avoids concerns about speed or slowness, but seeking symptoms based on fixed prescriptions requires assessing the depth of the disease.
Zhongjing Mahuang Tang (See previous Shanghan formulas)
Shiwei Renshen Suye Yin
Renshen (1 qian) Suye (1 qian) Banxia (1 qian) Fuling (1 qian) Chenpi (1 qian) Jiegeng (1 qian) Qianhu (1 qian)
Gegen (1 qian) Zhike (6 fen) Gancao (1 qian) Shengjiang (1 qian)
Zhongjing Xiaochaihu Tang
Chaihu (1 qian) Dangshen (1 qian) Huangqin (1 qian) Banxia (7 fen) Gancao (1 qian) Shengjiang (1 qian) Dazao (1 piece)
Renshen Qingfei Tang
Renshen (1 qian) Ejiao (1 qian) Digupi (1 qian) Zhimu (1 qian) Wumei (1 qian) Sangbaipi (1 qian) Sukesh (6 fen)
Xingren (1 qian) Gancao (1 qian) Dazao (1 piece)
Renshen Guben Tang
Renshen (1 qian) Shudi (1 qian) Shengdi (1 qian) Baishao (1 qian) Tiandong (1 qian) Wuwei (1 qian) Zhimu (1 qian)
Chenpi (7 fen) Maidong (1 qian) Zhigancao (6 fen)
Qingzao Jiufei Tang
Renshen (1 qian) Gancao (1 qian) Hei Zhima (1 qian) Ejiao (1 qian) Shigao (1 qian, ) Xingren (1 qian) Cundong (1 qian)
Pipaye (1 qian, roasted) Dong Sangye (1 qian)
Renshen Xiefei Tang
Renshen (1 qian) Huangqin (1 qian) Zhizi (1 qian) Zhike (7 fen) Gancao (1 qian) Lianqiao (1 qian) Xingren (1 qian)
Jiegeng (1 qian) Sangpi (1 qian) Dahuang (7 fen, wine-fried) Bohe (7 fen)
Zhibai Dihuang Tang
Shengdi (1 qian) Yurou (1 qian) Danpi (1 qian) Shanyao (1 qian) Fuling (1 qian) Zexie (1 qian)
Zhimu (1 qian) Huangbai (1 qian)
Zhongjing Xiao Qinglong Tang
Mahuang (1 qian) Guizhi (1 qian) Banxia (1 qian) Xixin (6 fen) Shaoyao (1 qian) Wuweizi (1 qian) Ganjiang (7 fen)
Gancao (1 qian)
Zhongjing Guiling Zhugan Tang
Guizhi (1 qian) Fuling (1 qian) Baizhu (1 qian) Gancao (1 qian)
Liujunzi Tang
Baizhu (1 qian) Dangshen (1 qian) Fuling (1 qian) Chenpi (7 fen) Banxia (6 fen) Zhigancao (7 fen)
Erchen Tang (Note: Original text says "Erzhen Tang", likely a typo for Erchen Tang)
Banxia (1 qian) Chenpi (1 qian) Fuling (1 qian) Gancao (1 qian)
Zhongjing Da Qinglong Tang
Mahuang (1 qian) Guizhi (1 qian) Xingren (1 qian) Zhigancao (1 qian) Shengjiang (1 qian) Dazao (1 piece) Shigao (1 qian)
Zhongjing Xiao Banxia Tang
Banxia (1 qian) Shengjiang (1 qian)
Zhongjing Shizao Tang
Yuanhua Gansui Daji
Equal parts, ground into powder, taken with water decocted from ten large jujubes. These medicines are extremely potent and harsh; do not use large amounts initially. Increase gradually according to tolerance, stopping when bowel movement is brisk. Due to variations in children's size and strength, fixed dosages cannot be determined.
Zhongjing Wuling San
Guizhi (1 qian) Baizhu (1 qian) Fuling (1 qian) Zhuling (1 qian) Zexie (1 qian)
Zhongjing Mufangji Tang
Mufangji (1 qian) Guizhi (1 qian) Renshen (1 qian) Shigao (1 qian)
Zhongjing Mufangji Qu Shigao Jia Fuling Mangxiao Tang
Mufangji (1 qian) Guizhi (1 qian) Renshen (1 qian) Fuling (1 qian) Mangxiao (1 qian)
Tu Weisheng stated: Examining Zhang Zhongjing's original formulas, Fuling is absent. However, since the formula is named "Mufangji Decoction minus Gypsum plus Fuling and Mangxiao," it is evident that Fuling should be present. This was likely an omission by the copyist. Therefore, I have added it.
Zhongjing Nongpo Dahuang Tang
Nongpo (1 qian) Dahuang (1 qian) Zhishi (1 qian)
Supplementary Formula:
Waitai Fuling Yin Treats retained phlegm and old fluid in the chest and heart. After vomiting out the fluid, emptiness and fullness remain in the chest and heart, preventing eating. It eliminates phlegm-fluid retention, enabling appetite.
Fuling (1 qian) Renshen (1 qian) Baizhu (1 qian) Zhishi (5 fen) Chenpi (7 fen) Shengjiang (1 qian)
Chen Xiuyuan stated: This is the most appropriate formula for post-recovery care of phlegm-fluid retention.