长夏湿热蒸炎。四肢困倦。精神减少。身热气高烦心。便黄口渴。而自汗脉虚者。此方
主之。清暑益气草参 。麦味青陈曲柏奇。二木葛根升泽泻。暑伤元气此为宜。(人参黄
甘草炙当归麦冬五味青皮陈皮神曲黄柏葛根苍术白术升麻泽泻。姜枣煎。)
KT 吴鹤皋方考。暑令行于夏。至长夏则兼湿令矣。此方兼而治之。炎暑则表气易泄。
兼湿则中气不固。黄 轻清散表气。又能领人参五味之苦酸。同达于表以实表。神曲消磨伤
中气。又能佐白术甘草之甘温。消补互用以调中。酷暑横流。肺金受病。人参五味麦冬。所
以补肺敛肺清肺。经所谓扶其所不胜也。火盛则水衰。故以黄柏泽泻滋其化源。津液亡则口
渴。故以当归干葛生其胃液。清气不升。升麻可升。浊气不降。二皮可降。苍术之用。为兼
长夏湿也。
治胁痛口苦。耳聋耳肿。筋痿阴湿热痒阴肿。血浊溲血。
龙胆泻肝通泽柴。车前生地草归偕。栀芩一派清凉品。湿热肝邪力可排。(胆草三分。
栀子黄芩泽泻柴胡各一钱。车前子木通各五分。当归三分。甘草生地各三分。)
龙胆柴胡。泻肝胆之火。佐以黄芩栀子木通车前泽泻。俾湿火从小便而出也。然泻之过
甚。恐伤肝血。故又以生地当归补之。肝苦急。急食甘以缓之。故以甘草缓其急。且欲以大
甘之味。济其大苦。不令过于泄下也。
长夏季节湿热蒸腾炽盛。四肢困倦乏力。精神萎靡减少。身体发热、气高(呼吸急促)、心烦、小便黄赤、口渴,并且自汗、脉象虚弱的患者,此方主治。清暑益气汤由甘草、人参、黄芪、麦冬、五味子、青皮、陈皮、神曲、黄柏、葛根、苍术、白术、升麻、泽泻组成。(用人参、黄芪、炙甘草、当归、麦冬、五味子、青皮、陈皮、神曲、黄柏、葛根、苍术、白术、升麻、泽泻,加生姜、大枣煎服。)
吴鹤皋在《方考》中论述:暑气盛行于夏季,到了长夏则兼夹湿气。此方兼顾治疗这两种邪气。炎热酷暑导致体表之气容易外泄,兼夹湿气则中焦之气不固。黄芪性轻清,能疏散表气,又能引领人参、五味子的苦酸之味,共同达于体表以充实卫表。神曲能消磨食积以保护中气,又能佐助白术、甘草的甘温之性,通过消补互用的方法来调理中焦。酷暑横行,肺金受病,人参、五味子、麦冬的作用在于补肺、敛肺、清肺。正如经典所说,扶助被克制的一方(土生金,此处指补脾益肺或针对火克金时的救逆,原文意指扶其不胜)。火气过盛会耗伤肾水,因此用黄柏、泽泻来滋生化之源。津液亡失则导致口渴,因此用当归、干葛来生成胃中津液。清气不升,可用升麻提升;浊气不降,青皮、陈皮可以降气。使用苍术的原因,是为了兼治长夏的湿邪。
治疗胁痛、口苦、耳聋、耳部肿胀、筋脉痿软、阴部湿热瘙痒、阴囊肿大、尿血浑浊或便血的症状。龙胆泻肝汤由龙胆草、柴胡、车前子、生地、甘草、当归、栀子、黄芩、木通、泽泻组成。(龙胆草三分,栀子、黄芩、泽泻、柴胡各一钱,车前子、木通各五分,当归三分,甘草、生地各三分。)
龙胆草和柴胡的作用是泻肝胆之火,佐以黄芩、栀子、木通、车前子、泽泻,使湿火从小便排出。然而,如果泻下太过,恐怕会损伤肝血,所以又用生地、当归来补养。肝体阴而用阳,肝气急迫时,食用甘味食物可以缓和它,所以用甘草来缓解肝之急迫。并且想用大甘之味,济助大苦之药,不让药物过于攻伐泄下。
During the late summer season, damp-heat steams and blazes. The limbs feel heavy and fatigued; mental spirit is diminished. There is body heat, rapid breathing (Qi Gao), vexation in the heart, yellow urine, thirst, spontaneous sweating, and a deficient pulse. This formula is indicated for such cases. Qing Shu Yi Qi Tang consists of Gancao (Licorice Root), Renshen (Ginseng Root), Huangqi (Astragalus Root), Maidong (Ophiopogon Tuber), Wuweizi (Schisandra Fruit), Qingpi (Green Tangerina Peel), Chenpi (Tangerina Peel), Shenqu (Medicated Leaven), Huangbai (Phellodendron Bark), Gegen (Puerariae Radix), Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Shengma (Cimicifugae Rhizoma), and Zexie (Alisma Rhizome). (Decoct Renshen, Huangqi, roasted Gancao, Danggui (Angelica Sinensis Root), Maidong, Wuweizi, Qingpi, Chenpi, Shenqu, Huangbai, Gegen, Cangzhu, Baizhu, Shengma, and Zexie, with fresh ginger and dates.)
Wu Hegao discussed this in *Fang Kao*. The pathogenic factor of Summerheat prevails in summer, but by late summer, it combines with Dampness. This formula treats both simultaneously. In intense heat, the defensive Qi on the exterior easily dissipates; combined with Dampness, the Middle Qi becomes insecure. Huangqi is light and clear, dispersing exterior Qi, and can lead the bitter and sour properties of Renshen and Wuweizi to reach the exterior to consolidate the Wei (Defensive) level. Shenqu digests food stagnation to protect Middle Qi, and assists the sweet and warm nature of Baizhu and Gancao. Through the mutual use of reducing and tonifying methods, the Middle Jiao is regulated. When severe summer heat flows rampant, the Lung Metal suffers. Renshen, Wuweizi, and Maidong are used to tonify, astringe, and clear the Lungs. As the classics state, one should support what is unable to overcome [the pathogen]. When Fire is excessive, Water declines; thus, Huangbai and Zexie are used to nourish the source of transformation. When fluids are lost, thirst occurs; therefore, Danggui and Gegen are used to generate Stomach fluids. If Clear Qi does not ascend, Shengma can lift it; if Turbid Qi does not descend, Qingpi and Chenpi can direct it downward. Cangzhu is used to address the Dampness of late summer.
It treats hypochondriac pain, bitter taste in the mouth, deafness, swelling of the ears, flaccidity of tendons, damp-heat itching of the genitals, swelling of the scrotum, turbid urine or hematuria. Long Dan Xie Gan Tang consists of Longdancao (Gentianae Radix), Chaihu (Bupleuri Radix), Cheqianzi (Plantaginis Semen), Shengdi (Rehmanniae Radix), Gancao (Licorice Root), Danggui (Angelica Sinensis Root), Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), Mutong (Akebiae Caulis), and Zexie (Alisma Rhizome). (Longdancao 3 fen, Zhizi, Huangqin, Zexie, Chaihu each 1 qian, Cheqianzi, Mutong each 5 fen, Danggui 3 fen, Gancao, Shengdi each 3 fen.)
Longdancao and Chaihu purge the Fire of the Liver and Gallbladder, assisted by Huangqin, Zhizi, Mutong, Cheqianzi, and Zexie, allowing the Damp-Fire to exit via urination. However, excessive purging may damage Liver Blood; therefore, Shengdi and Danggui are added to nourish it. The Liver dislikes constraint; when there is urgency, sweet flavors soothe it. Thus, Gancao is used to relieve this urgency. Furthermore, the great sweet flavor is intended to moderate the great bitter flavor, preventing the medicine from being overly draining and purgative.