[类似方剂参考]
(1)大黄黄连泻心汤：此是治心下痞满不痛而无痰饮之方。
(2)半夏泻心汤：此是治心下痞满不痛，寒热夹杂，虚而有痰之方。
大陷胸汤方第五十三
[方义]
此系治痰饮与邪热互结于胸膈部及腹部，攻下之峻剂。
[主治]
大结胸病，胸膈部及胸膈下部硬满而痛，拒按，甚者从心下至少腹手不可近。但必须具有痰饮邪热互结的实证现象，如脉沉滑有力，咳吐痰涎，大便秘结等。
按：此证没有痰饮和胸膈满痛便是承气证，没有邪热便是寒实结胸证。
[药品]
大黄一至三钱 芒硝一至二钱 甘遂(研细末)五分至一钱
[煎服法]
水二茶杯，先煎大黄至一茶杯，去滓，入芒硝溶化后，煮至半茶杯，再人甘遂末，温服。得快利止后服。
[用药大意]
大黄、芒硝泻其燥热，甘遂逐其痰饮。
[禁忌证]
脉浮大者忌之；舌上白苔滑者也忌之；不兼痰饮证，或不兼热证，都不可用。
[类似方剂参考]
(1)大陷胸丸：此治结胸证兼胸部症状之方。
(2)大承气汤：此治心腹部胀满硬痛拒按，无痰饮现象之方。
(3)白散：此治寒实结胸之方。
(4)瓜蒂散：此治痰热结于胸中宜涌吐之方。
大陷胸丸方第五十四
[方义]
此系治痰饮与邪热互结于胸膈上下，或连及胃肠，攻下之缓剂。
[主治]
大结胸病，胸膈上下胀痛拒按，或兼喘急。但必须具有痰热互结的现象，如喘不得卧，或喜冷便燥等。
[药品]
大黄一至二钱 葶苈子(炒)一至二钱 芒硝一至二钱杏仁(去皮尖炒黑)一至二钱 甘遂五分至一钱
[制服法]
共研细末，炼蜜为丸，二钱半至三钱重。每服一丸，开水送下。
[用药大意]
葶苈、杏仁、甘遂逐胸膈上下之痰饮，并治喘急；大黄、芒硝荡涤肠胃之燥热。兼消胸膈下部的胀痛。
[禁忌证]
舌1：白苔，或有表邪者，不可服；无痰饮、燥热者也不可服。
[类似方剂参考]
(1)大陷胸汤：此是治大结胸病偏于下部之方。
(2)瓜蒂散：此是治痰热在胸部宜涌吐之方。
(3)小青龙加石膏汤：此是治表寒之痰喘证，痰热在胸部宜于表散之方。
(4)麻杏石甘汤：此治表热之痰喘证之方。
文蛤散方第五十五
[方义]
此清热利湿之轻剂，治热被寒郁之证。
[主治]
应该发汗的热性病，误被水噀、冰覆或冷水浴后体温增高，心烦不安，肉上粟起，意欲饮水反不渴(此证内热不甚，故不渴)之证。
按：水噀之法，今天在此地(太原)概不使用，但冰袋冷覆之法也有同样的流弊，仍应注意防治。
[药品]
文蛤一两(不煅)
[制服法]
研细末，每服一至二钱，开水送下。
[用药大意]
文蛤清热利湿但作用不大，对于热被寒郁轻证或者有效，重者需遵柯氏之说用《金匮要略》文蛤汤治之为宜。
[禁忌证]
除寒湿证不宜用外，一切湿而兼热的证候均不忌之。因药性和平不会有其他副作用。
[类似方剂参考]
(1)文蛤汤：即大青龙汤去桂加文蛤，为治湿热内郁，解表清里之重剂。但须症见身热口渴喜冷等现象方宜使用。
(2)五苓散：为温性利水解表之方。治本证之偏于湿者。
白散方第五十六
[方义]
此开肺祛痰，排脓破结，温下之方。
[主治]
寒实结胸，或急性喉炎，或肺痈等病，胸部或喉间或心下闭塞不舒，痰涎壅积，呼吸困难。但必须没有热证现象，而脉有力或大便秘者，方可试用。
[药品]
桔梗 川贝母 巴豆各等份
[制服法]
先将巴豆去皮，炒黑去油，合二药研为细末。体壮者每次服一至五分，弱者酌减，米汤送下。不吐不泄者，可饮热汤；吐或泄甚者，可饮冷开水即止。
[用药大意]
桔梗排脓祛痰，贝母除痰解结，是治胸腔疾患之要药；巴豆辛热，破胸腹中之坚结。合之为治寒实结胸之良方。
[禁忌证]
脉虚者，喜冷者，不可服；大便利者，不可用。
[类似方剂参考]
瓜蒂散：此是治胸部或心下部痞满有痰，应用吐法治疗之方。
大黄黄连泻心汤方第五十七
[方义]
此苦寒泻火清热，治热痞之方。
[主治]
心下痞满证，按之硬，或按之软而大便不利。但必须具有口苦，或喜冷性饮食，或自觉内部有发热现象。
[药品]
大黄一至二钱 黄连一钱
按：有人根据附子泻心汤认为本方中应该有黄芩，此说似颇有理。但我认为应该根据证候需要来决定。
[煎服法]
用开水一茶杯浸一刻钟或半小时，去滓温服。
按：浸的时间长短，决定于病位的上下，或病势的轻重。病的部位在上，其势较轻者，浸的时间少些；反之，则浸的时间多些。这是因为清轻上浮，重浊下沉之故。
[用药大意]
二药都是取其苦寒泻火、消痞之作用。
[禁忌证]
兼有恶寒者不可服，因恶寒有兼有表证者，有兼阳虚者．而不可使用此苦寒之剂；喜热饮食者不可服，因此系寒证，更没有以寒治寒的道理。
[类似方剂参考]
小承气汤：此治实证腹胀满之方，与心下痞满有高下之殊。
附子泻心汤方第五十八
[方义]
此泻胃热，补肾阳，治痞证兼阳虚之方。乃寒热并用的又一种方法。
[主治]
心下痞硬兼恶寒汗出之证。但必须具有口苦。或心烦，或大便不利，或胃部觉热，或喜冷性饮食而不能食，更必须具有平素阳虚的病史，且没有头痛、发热、脉浮的表证。
[药品]
大黄一至二钱(酒浸) 炒黄连一钱 黄芩一至二：钱附子二钱(另煎)
[煎眼法]
三黄用开水半茶杯，浸一刻钟，去滓取液。同时用水二茶杯煎附子至半茶杯，去滓取液。将二液和匀，分二次温眼。
[用药大意]
三黄泻胃热，以治热痞；附子温肾阳，以治恶寒汗出。
[禁忌证]
有恶寒无汗之表寒证者，不可服；有恶寒有汗脉浮之桂枝证者，也不可服：没有恶寒、汗小之阳虚旺，或口苦、喜冷的内热证，更不可服。
[类似方剂参考]
大黄黄连泻心汤：此治热痞之方。
半夏泻心汤方第五十九
[方义]
此调理肠胃寒热，兼补虚之方。
[主治]
伤寒误治后或没有误治的“心下痞满，呕吐，下利”。但必须具有口苦、心烦、胃肠部不拒按、脉象无力或服温补药无效等寒热虚夹杂的证候。
[药品]
半夏一至三钱 黄芩一钱至钱半 干姜一钱至钱半 炙草五分至一钱 人参一钱至钱半 黄连五分至一钱 大枣一至二二枚
按：呕多者可多用半夏；泻多者可多用干姜、人参、大枣、炙草；痞甚有热者可多加芩、连。
[煎服法]
水三茶杯，煎至半茶杯，去滓温服。
按：旧日有去滓重煎之说，试之效果没有显著差别，故去之。
[用药大意]
芩、连、干姜调肠胃之寒热，以解寒热互结之痞满，兼半夏并能止呕；人参、大枣、炙草以补肠胃因误下形成之虚，合干姜尤能止利。
[禁忌证]
凡没有寒热夹杂症状的痞满吐利等者，都不可用。
[类似方剂参考]
(1)桂枝人参汤：此治虚寒痞证之方。
(2)生姜泻心汤：此治寒热不调之虚痞证偏于呕吐之方。
(3)甘草泻心汤：此治寒热不调之痞证偏于下利之方。
(4)大黄黄连泻心汤：此治实热痞证之方。
甘草泻心汤方第六十
[方义]
此补虚兼调理肠胃寒热之方。治心下痞证，但重点偏于止泻方面。
[主治]
屡经误下心下痞硬，下利重于呕吐。但必须具有口苦或心烦、胃肠部不拒按、脉弱或单服温补药不效等寒热虚夹杂现象。
[药品]
炙草二至三钱 黄芩一钱至钱半 干姜一至二钱 半夏一钱至钱半 黄连五分 大枣二至四枚。
按：根据各家注释并结合实践，本方应加人参一钱至二钱半。
[煎服法]
用水三茶杯，煎至半茶杯，去滓温服。
[用药大意]
炙草、人参、大枣以补肠胃屡下之虚，合干姜并能止利；芩、连、干姜寒热并用，以解寒热互结之痞，合半夏又能止呕。
[禁忌证]
没有寒热虚三方面夹杂之证者，忌之。
[类似方剂参考]
(1)桂枝人参汤：此治虚寒痞证之方。
(2)人黄黄连泻心汤：此治实热痞证之方．、
(3)半夏泻心汤：此治寒热不调痞证呕吐下利并重之方。
(4)生姜泻心汤：此治寒热不调痞证偏重呕吐之方。
生姜泻心汤方第六十一
[方义]
此调理肠胃寒热兼补虚之方。治心下痞证，但重点偏于止呕方面。
[主治]
误汗后肠胃寒热不调，心下痞满，呕吐重于下利，或千噫食臭，或胁下有水气，或腹中雷鸣。但必须具有口苦心烦、肠胃部不拒按、脉虚或服温补药不效等寒热虚三方面夹杂的证候。
[药品]
生姜二至三钱 人参一钱至钱半 炙草一至二钱 黄芩一钱至钱半 半夏五分至一钱 干姜一钱 黄连五分至一钱大枣一至二枚
[煎服法]
水三茶杯，煎至半茶杯，去滓温服。
[用药大意]
生姜、半夏以止呕吐，并治干噫食臭、胁下有水气证；厂姜之温，芩、连之寒，以解寒热互结之痞满；人参、大枣、炙草以补肠胃之虚，合干姜并能止利。
[禁忌证]
没有寒热夹杂之证者，即不可用。
[类似方剂参考]
(1)桂枝人参汤：治虚寒痞证之方。
(2)大黄黄连泻心汤：治实热痞证之方。
(3)半夏泻心汤：治寒热不调，心下痞满，呕吐下利并重之方。
(4)甘草泻心汤：治寒热不调，心下痞硬，偏重下刊之方。
禹余粮丸方(阙)
赤石脂禹余粮汤方第六十二
[方义]
此是乎性固脱止利之方。
按：此“利”是泄泻，不是痢疾，但痢疾较久，滑脱不禁时，也可借用。
[主治]
下利滑脱。但必须是日久泄泻不愈，气虚脉象无力，真有不能自禁现象方可用之。决不可把大便次数较多，或欲便时不能忍受，或不能迟延的现象误认为滑脱。有的患者，不敢大声说话，一说话就便下来，有的不自觉就便下来，这才是滑脱的具体表现。
[药品]
赤石脂三至五钱(捣碎) 太乙禹余粮三至五钱(捣碎)
[用药大意]
赤石脂、禹余粮都是收敛固涩之品，所以能治下利虚脱之证。但禹余粮较赤石脂性寒些。
[禁忌证]
下利初起吋不可用。因下利初起时绝没有滑脱之证。痢疾初起吋更不可用，因为用之会造成休息痢。
[类似方剂参考]
桃花汤：此是温性固脱治痢之方。
按：此“痢”是痢疾，不是泄泻，但有时可借用治泄泻之滑脱。
旋覆代赭石汤方第六十三
[方义]
此镇逆除痰、补虚祛寒之方。
[主治]
伤寒表证已解，或噫气，或呕吐，或呃逆，或兼心下痞满等证。但必须具有吐痰、不喜冷性饮食、脉虚或兼滑等现象。方能恰当。
[药品]
旋覆花三至五钱 生赭石三钱至一两 人参一至二钱大枣二至四枚 生姜二至三钱 半夏二至三钱 炙草一至二钱
[煎服法]
水三茶杯，煎至半茶杯，去滓温服，日服二至三次。如系呕吐，可以少量频服，以免吐出药液。
[类似方剂参考]
(1)大黄黄连泻心汤：这是治疗心下痞满但不疼痛，且没有痰饮的方剂。
(2)半夏泻心汤：这是治疗心下痞满但不疼痛，寒热错杂，体虚而有痰饮的方剂。
大陷胸汤方第五十三
[方义]
此方是治疗痰饮与邪热互结于胸膈及腹部，属于攻下的峻猛剂型。
[主治]
大结胸病，表现为胸膈部及胸膈下部硬满且疼痛，拒绝按压，严重时从心窝下直至小腹，手不可触碰。但必须具备痰饮与邪热互结的实证表现，如脉象沉滑有力，咳嗽吐痰涎，大便秘结等。
按：如果此证没有痰饮和胸膈满痛，就是承气汤证；如果没有邪热，就是寒实结胸证。
[药品]
大黄一至三钱 芒硝一至二钱 甘遂（研成细末）五分至一钱
[煎服法]
用水两茶杯，先煎煮大黄至剩一茶杯，滤去药渣，加入芒硝使其溶化，再煮至半茶杯，然后加入甘遂末，温服。服药后若得顺畅大便，则停止服用。
[用药大意]
大黄、芒硝泻除燥热，甘遂逐出痰饮。
[禁忌证]
脉象浮大的禁用；舌苔白滑的禁用；不兼有痰饮证，或不兼有热证的，都不可使用。
[类似方剂参考]
(1)大陷胸丸：这是治疗结胸证兼有胸部症状的方剂。
(2)大承气汤：这是治疗心腹部胀满硬痛拒按，但没有痰饮现象的方剂。
(3)白散：这是治疗寒实结胸的方剂。
(4)瓜蒂散：这是治疗痰热结于胸中，适宜用涌吐法治疗的方剂。
大陷胸丸方第五十四
[方义]
此方是治疗痰饮与邪热互结于胸膈上下，或连及胃肠，属于攻下的缓剂型。
[主治]
大结胸病，表现为胸膈上下胀痛拒按，或兼有气喘急促。但必须具备痰热互结的现象，如气喘不能平卧，或喜冷、大便干燥等。
[药品]
大黄一至二钱 葶苈子（炒制）一至二钱 芒硝一至二钱 杏仁（去皮尖，炒黑）一至二钱 甘遂五分至一钱
[制服法]
将药物共研为细末，用炼蜜制成丸药，每丸重二钱半至三钱。每次服用一丸，用开水送服。
[用药大意]
葶苈子、杏仁、甘遂逐除胸膈上下的痰饮，并治疗气喘急促；大黄、芒硝荡涤肠胃中的燥热。兼消胸膈下部的胀痛。
[禁忌证]
舌苔白，或有表邪者，不可服用；没有痰饮、燥热者也不可服用。
[类似方剂参考]
(1)大陷胸汤：这是治疗大结胸病偏于下部的方剂。
(2)瓜蒂散：这是治疗痰热在胸部，适宜用涌吐法治疗的方剂。
(3)小青龙加石膏汤：这是治疗表寒引起的痰喘证，痰热在胸部适宜用解表法疏散的方剂。
(4)麻杏石甘汤：这是治疗表热引起的痰喘证的方剂。
文蛤散方第五十五
[方义]
此方是清热利湿的轻剂，治疗因寒邪郁闭导致的热证。
[主治]
本应发汗的热性病，误用水喷、冰敷或冷水浴后，体温升高，心烦不安，皮肤起粟粒状疙瘩，想喝水反而不渴（此证内热不重，所以不渴）。
按：水喷之法，如今在此地（太原）已普遍不再使用，但冰袋冷敷之法也有同样的弊端，仍应注意防治。
[药品]
文蛤一两（不煅烧）
[制服法]
研成细末，每次服用一至二钱，用开水送服。
[用药大意]
文蛤清热利湿，但作用不大，对于热被寒郁的轻证或许有效，重者需遵循柯氏之说，使用《金匮要略》中的文蛤汤治疗为宜。
[禁忌证]
除了寒湿证不宜使用外，一切湿而兼热的证候均不忌用。因为药性平和，不会有其他副作用。
[类似方剂参考]
(1)文蛤汤：即大青龙汤去掉桂枝加上文蛤，是治疗湿热内郁，解表清里的重剂。但必须见到身热、口渴、喜冷等现象才适宜使用。
(2)五苓散：是温性利水兼解表的方剂。治疗本证偏于湿的情况。
白散方第五十六
[方义]
此方是开肺祛痰，排脓破结，温下之方。
[主治]
寒实结胸，或急性喉炎，或肺痈等疾病，表现为胸部或喉间或心下闭塞不适，痰涎壅积，呼吸困难。但必须没有热证表现，且脉象有力或大便秘结者，方可尝试使用。
[药品]
桔梗 川贝母 巴豆各等份
[制服法]
先将巴豆去皮，炒黑去油，与其他两味药研为细末。体质壮实者每次服用一分至五分，体弱者酌情减量，用米汤送服。如果不呕吐也不腹泻，可喝热汤；如果呕吐或腹泻严重，可喝冷开水以止住药效。
[用药大意]
桔梗排脓祛痰，贝母除痰解结，是治疗胸腔疾患的重要药物；巴豆辛热，破除胸腹中的坚结。合用是治疗寒实结胸的良好方剂。
[禁忌证]
脉虚者，喜冷者，不可服用；大便通畅者，不可使用。
[类似方剂参考]
瓜蒂散：这是治疗胸部或心下部痞满有痰，应用吐法治疗的方剂。
大黄黄连泻心汤方第五十七
[方义]
此方是苦寒泻火清热，治疗热痞的方剂。
[主治]
心下痞满证，按之坚硬，或按之柔软但大便不利。但必须具有口苦，或喜冷性饮食，或自觉内部有发热现象。
[药品]
大黄一至二钱 黄连一钱
按：有人根据附子泻心汤认为本方中应该有黄芩，此说似乎颇有道理。但我认为应该根据证候需要来决定。
[煎服法]
用开水一茶杯浸泡一刻钟或半小时，滤去药渣，温服。
按：浸泡时间的长短，取决于病位的上下，或病势的轻重。病的部位在上，病情较轻者，浸泡时间少些；反之，则浸泡时间多些。这是因为清轻之气上浮，重浊之气下沉的缘故。
[用药大意]
这两味药都是取其苦寒泻火、消除痞满的作用。
[禁忌证]
兼有恶寒者不可服用，因为恶寒可能兼有表证，也可能兼有阳虚，都不可使用此苦寒之剂；喜热饮食者不可服用，因为这属于寒证，更没有以寒治寒的道理。
[类似方剂参考]
小承气汤：这是治疗实证腹胀满的方剂，与心下痞满有高下之分。
附子泻心汤方第五十八
[方义]
此方是泻胃热，补肾阳，治疗痞证兼阳虚的方剂。这是寒热并用的又一种方法。
[主治]
心下痞硬兼恶寒汗出的证候。但必须具有口苦，或心烦，或大便不利，或胃部觉热，或喜冷性饮食但不能进食，更必须具有平时阳虚的病史，且没有头痛、发热、脉浮等表证。
[药品]
大黄一至二钱（酒浸） 炒黄连一钱 黄芩一至二钱 附子二钱（另煎）
[煎服法]
三黄（大黄、黄连、黄芩）用开水半茶杯，浸泡一刻钟，滤去药渣取汁。同时用水两茶杯煎煮附子至半茶杯，滤去药渣取汁。将两种药液混合均匀，分两次温服。
[用药大意]
三黄泻胃热，以治疗热痞；附子温肾阳，以治疗恶寒汗出。
[禁忌证]
有恶寒无汗之表寒证者，不可服用；有恶寒有汗、脉浮的桂枝汤证者，也不可服用；没有恶寒、汗出之阳虚证，或口苦、喜冷的内热证，更不可服用。
[类似方剂参考]
大黄黄连泻心汤：这是治疗热痞的方剂。
半夏泻心汤方第五十九
[方义]
此方是调理肠胃寒热，兼补虚的方剂。
[主治]
伤寒误治后或没有误治出现的“心下痞满，呕吐，下利”。但必须具有口苦、心烦、胃肠部不拒按、脉象无力或服用温补药无效等寒热虚夹杂的证候。
[药品]
半夏一至三钱 黄芩一钱至钱半 干姜一钱至钱半 炙甘草五分至一钱 人参一钱至钱半 黄连五分至一钱 大枣一至二枚
按：呕吐多者可多用半夏；腹泻多者可多用干姜、人参、大枣、炙甘草；痞满严重且有热者可多加黄芩、黄连。
[煎服法]
用水三茶杯，煎至半茶杯，滤去药渣，温服。
按：旧时有滤去药渣后重新煎煮的说法，试用后发现效果没有显著差别，故去掉此步骤。
[用药大意]
黄芩、黄连、干姜调理肠胃之寒热，以解除寒热互结之痞满，兼半夏并能止呕；人参、大枣、炙甘草以补肠胃因误下形成的虚弱，合干姜尤能止泻。
[禁忌证]
凡没有寒热夹杂症状的痞满吐利等证，都不可用。
[类似方剂参考]
(1)桂枝人参汤：这是治疗虚寒痞证的方剂。
(2)生姜泻心汤：这是治疗寒热不调之虚痞证偏于呕吐的方剂。
(3)甘草泻心汤：这是治疗寒热不调之痞证偏于下利的方剂。
(4)大黄黄连泻心汤：这是治疗实热痞证的方剂。
甘草泻心汤方第六十
[方义]
此方是补虚兼调理肠胃寒热的方剂。治疗心下痞证，但重点偏于止泻方面。
[主治]
屡经误下导致的心下痞硬，下利重于呕吐。但必须具有口苦或心烦、胃肠部不拒按、脉弱或单服温补药不效等寒热虚夹杂现象。
[药品]
炙甘草二至三钱 黄芩一钱至钱半 干姜一至二钱 半夏一钱至钱半 黄连五分 大枣二至四枚。
按：根据各家注释并结合实践，本方应加人参一钱至二钱半。
[煎服法]
用水三茶杯，煎至半茶杯，滤去药渣，温服。
[用药大意]
炙甘草、人参、大枣以补肠胃屡下之虚，合干姜并能止泻；黄芩、黄连、干姜寒热并用，以解寒热互结之痞，合半夏又能止呕。
[禁忌证]
没有寒热虚三方面夹杂之证者，忌用。
[类似方剂参考]
(1)桂枝人参汤：这是治疗虚寒痞证的方剂。
(2)大黄黄连泻心汤：这是治疗实热痞证的方剂。
(3)半夏泻心汤：这是治疗寒热不调痞证呕吐下利并重的方剂。
(4)生姜泻心汤：这是治疗寒热不调痞证偏重呕吐的方剂。
生姜泻心汤方第六十一
[方义]
此方是调理肠胃寒热兼补虚的方剂。治疗心下痞证，但重点偏于止呕方面。
[主治]
误汗后肠胃寒热不调，心下痞满，呕吐重于下利，或干噫食臭，或胁下有停饮，或腹中雷鸣。但必须具有口苦心烦、肠胃部不拒按、脉虚或服用温补药不效等寒热虚三方面夹杂的证候。
[药品]
生姜二至三钱 人参一钱至钱半 炙甘草一至二钱 黄芩一钱至钱半 半夏五分至一钱 干姜一钱 黄连五分至一钱 大枣一至二枚
[煎服法]
用水三茶杯，煎至半茶杯，滤去药渣，温服。
[用药大意]
生姜、半夏以止呕吐，并治疗干噫食臭、胁下有停饮之证；干姜之温，黄芩、黄连之寒，以解寒热互结之痞满；人参、大枣、炙甘草以补肠胃之虚，合干姜并能止泻。
[禁忌证]
没有寒热夹杂之证者，即不可用。
[类似方剂参考]
(1)桂枝人参汤：治疗虚寒痞证的方剂。
(2)大黄黄连泻心汤：治疗实热痞证的方剂。
(3)半夏泻心汤：治疗寒热不调，心下痞满，呕吐下利并重的方剂。
(4)甘草泻心汤：治疗寒热不调，心下痞硬，偏重下利的方剂。
禹余粮丸方（缺）
赤石脂禹余粮汤方第六十二
[方义]
此方是平性固脱止泻的方剂。
按：此“利”是指泄泻，不是痢疾，但痢疾日久，出现滑脱不禁时，也可借用。
[主治]
下利滑脱。但必须是日久泄泻不愈，气虚脉象无力，真正出现不能自禁的现象方可用之。决不可把大便次数较多，或欲便时不能忍受，或不能迟延的现象误认为滑脱。有的患者，不敢大声说话，一说话就排便，有的不自觉就排便，这才是滑脱的具体表现。
[药品]
赤石脂三至五钱（捣碎） 太乙禹余粮三至五钱（捣碎）
[用药大意]
赤石脂、禹余粮都是收敛固涩之品，所以能治疗下利虚脱之证。但禹余粮较赤石脂性寒一些。
[禁忌证]
下利初起时不可用。因为下利初起时绝没有滑脱之证。痢疾初起时更不可用，因为使用会造成休息痢。
[类似方剂参考]
桃花汤：这是温性固脱治痢的方剂。
按：此“痢”是指痢疾，不是泄泻，但有时可借用治疗泄泻之滑脱。
旋覆代赭石汤方第六十三
[方义]
此方是镇逆除痰、补虚祛寒的方剂。
[主治]
伤寒表证已解，或出现噫气，或呕吐，或呃逆，或兼有心下痞满等证。但必须具有吐痰、不喜冷性饮食、脉虚或兼滑等现象，方能恰当。
[药品]
旋覆花三至五钱 生赭石三钱至一两 人参一至二钱 大枣二至四枚 生姜二至三钱 半夏二至三钱 炙甘草一至二钱
[煎服法]
用水三茶杯，煎至半茶杯，滤去药渣，温服，每日服用二至三次。如果是呕吐，可以少量频服，以免吐出药液。
[Reference for Similar Formulas]
(1) Dahuang Huanglian Xiexin Tang (Rhubarb and Coptis Decoction to Drain the Epigastrium): This is a formula used to treat epigastric fullness and stuffiness without pain, where there is no phlegm-fluid retention.
(2) Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium): This is a formula used to treat epigastric fullness and stuffiness without pain, characterized by a mixture of cold and heat deficiency with phlegm-fluid retention.
Da Xianxiong Tang Formula No. 53
[Formula Rationale]
This formula treats the mutual binding of phlegm-fluid retention and pathogenic heat in the chest-diaphragm region and abdomen; it is a harsh purgative.
[Indications]
Major Jie-Xiong Syndrome (Condensed Chest Syndrome), presenting with hardness, fullness, and pain in the chest-diaphragm region and below the diaphragm, with tenderness to palpation. In severe cases, from the epigastrium down to the lower abdomen, the area is so tender that it cannot be touched. However, it must present signs of excess syndrome due to the mutual binding of phlegm-fluid and pathogenic heat, such as a deep, slippery, and forceful pulse, coughing up salivary phlegm, and constipation.
Note: If this syndrome lacks phlegm-fluid and chest-diaphragm fullness/pain, it is Chengqi Syndrome. If it lacks pathogenic heat, it is Cold-Excess Jie-Xiong Syndrome.
[Ingredients]
Dahuang (Rhei Radix et Rhizoma) 1–3 qian
Mangxiao (Natrii Sulfas) 1–2 qian
Gansui (Kansui Radix, ground into fine powder) 0.5–1 qian
[Decoction and Administration Method]
Add two tea cups of water. First decoct Dahuang until one tea cup remains. Strain out the dregs. Add Mangxiao and dissolve it. Continue boiling until half a tea cup remains. Then add Gansui powder. Take warm. Stop taking after achieving smooth bowel movements.
[General Principle of Medication]
Dahuang and Mangxiao purge dryness and heat; Gansui expels phlegm-fluid.
[Contraindications]
Contraindicated if the pulse is floating and large; contraindicated if the tongue coating is white and slippery; not applicable if there is no accompanying phlegm-fluid syndrome or no accompanying heat syndrome.
[Reference for Similar Formulas]
(1) Da Xianxiong Wan (Major Condensed Chest Pill): A formula for Jie-Xiong Syndrome accompanied by chest symptoms.
(2) Dachengqi Tang (Major Order the Qi Decoction): A formula for abdominal distension, fullness, hardness, pain, and tenderness without phlegm-fluid phenomena.
(3) Baisan (White Powder): A formula for Cold-Excess Jie-Xiong Syndrome.
(4) Goudisan (Melon Stem Powder): A formula for phlegm-heat condensed in the chest, suitable for treatment via emesis.
Da Xianxiong Wan Formula No. 54
[Formula Rationale]
This formula treats the mutual binding of phlegm-fluid and pathogenic heat above and below the chest-diaphragm, or extending to the stomach and intestines; it is a mild purgative.
[Indications]
Major Jie-Xiong Syndrome, presenting with distending pain and tenderness to palpation above and below the chest-diaphragm, or accompanied by panting and urgency. It must present signs of phlegm-heat mutual binding, such as inability to lie flat due to panting, preference for cold, and dry stool.
[Ingredients]
Dahuang (Rhei Radix et Rhizoma) 1–2 qian
Tinglizi (Lepidii Semen, stir-fried) 1–2 qian
Mangxiao (Natrii Sulfas) 1–2 qian
Xingren (Armeniacae Semen Amarum, peeled, tips removed, stir-fried until black) 1–2 qian
Gansui (Kansui Radix) 0.5–1 qian
[Pill Preparation Method]
Grind all ingredients into fine powder. Mix with refined honey to form pills, each weighing 2.5–3 qian. Take one pill per dose, washed down with boiled water.
[General Principle of Medication]
Tinglizi, Xingren, and Gansui expel phlegm-fluid above and below the chest-diaphragm and treat panting urgency; Dahuang and Mangxiao cleanse dryness-heat in the stomach and intestines. They also alleviate distending pain in the lower chest-diaphragm.
[Contraindications]
Contraindicated if the tongue coating is white or if exterior pathogens are present; contraindicated if there is no phlegm-fluid or dryness-heat.
[Reference for Similar Formulas]
(1) Da Xianxiong Tang: A formula for Major Jie-Xiong Syndrome leaning towards the lower part.
(2) Goudisan: A formula for phlegm-heat in the chest, suitable for emesis.
(3) Xiao Qinglong Jia Shigao Tang (Minor Green Dragon Decoction plus Gypsum): A formula for phlegm-panting caused by exterior cold, where phlegm-heat in the chest is suitable for dispersal via the exterior.
(4) Maxing Shigan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction): A formula for phlegm-panting caused by exterior heat.
Wenge San Formula No. 55
[Formula Rationale]
This is a light formula for clearing heat and promoting urination, treating heat constrained by cold.
[Indications]
Heat diseases that should have been treated with sweating, but were mistakenly sprayed with water, covered with ice, or bathed in cold water, leading to increased body temperature, mental restlessness, pruritic skin (goosebumps), desire to drink but no actual thirst (internal heat is not severe, hence no thirst).
Note: The method of spraying water is no longer commonly used here (Taiyuan), but the method of cold packs has similar drawbacks and requires attention to prevention and treatment.
[Ingredients]
Wenge (Veneris Concha, uncalcined) 1 liang
[Pill Preparation Method]
Grind into fine powder. Take 1–2 qian per dose, washed down with boiled water.
[General Principle of Medication]
Wenge clears heat and promotes urination, though its effect is weak. It may be effective for mild cases of heat constrained by cold. For severe cases, it is advisable to follow Ke’s advice and use Wenge Tang from *Jingui Yaolue*.
[Contraindications]
Except for Cold-Damp syndromes which are unsuitable, all dampness-combined-with-heat syndromes are not contraindicated. Due to its mild nature, it has no other side effects.
[Reference for Similar Formulas]
(1) Wenge Tang: Equivalent to Da Qinglong Tang minus Guizhi plus Wenge. It is a heavy formula for resolving exterior and clearing interior to treat internal constraint of damp-heat. It should only be used when symptoms like fever, thirst, and preference for cold are present.
(2) Wuling San (Five-Ingredient Powder with Poria): A warm formula for promoting urination and resolving the exterior. Used for this syndrome leaning towards dampness.
Baisan Formula No. 56
[Formula Rationale]
This formula opens the lungs, expels phlegm, discharges pus, breaks stagnation, and acts as a warm purgative.
[Indications]
Cold-Excess Jie-Xiong Syndrome, acute laryngitis, lung abscess, etc., presenting with blockage and discomfort in the chest, throat, or epigastrium, accumulation of salivary phlegm, and difficulty breathing. It can be tried only if there are no signs of heat, and the pulse is forceful or there is constipation.
[Ingredients]
Jiegeng (Platycodonis Radix)
Chuanbeimu (Fritillariae Cirrhosae Bulbus)
Badou (Crotonis Fructus)
Each in equal parts.
[Pill Preparation Method]
First, remove the skin of Badou, stir-fry until black, and remove the oil. Grind together with the other two medicines into fine powder. For robust individuals, take 0.1–0.5 fen per dose; reduce dosage for weaker individuals. Wash down with rice soup. If there is no vomiting or diarrhea, drink hot water; if vomiting or diarrhea is severe, drink cold boiled water to stop the effect.
[General Principle of Medication]
Jiegeng discharges pus and expels phlegm; Beimu removes phlegm and resolves nodules; both are key herbs for thoracic diseases. Badou is acrid and hot, breaking hard accumulations in the chest and abdomen. Together, they form an excellent formula for Cold-Excess Jie-Xiong Syndrome.
[Contraindications]
Contraindicated for those with a deficient pulse or preference for cold; contraindicated for those with normal bowel movements.
[Reference for Similar Formulas]
Goudisan: A formula for fullness and phlegm in the chest or epigastrium, treating via emesis.
Dahuang Huanglian Xiexin Tang Formula No. 57
[Formula Rationale]
This bitter-cold formula drains fire and clears heat, treating Heat Pi (Epigastric Stuffiness).
[Indications]
Pi Syndrome presenting with epigastric fullness and stuffiness, hard upon palpation, or soft upon palpation but with difficult defecation. It must present bitter taste in the mouth, preference for cold food/drink, or subjective sensation of internal heat.
[Ingredients]
Dahuang (Rhei Radix et Rhizoma) 1–2 qian
Huanglian (Coptidis Rhizoma) 1 qian
Note: Some believe, based on Fuzi Xiexin Tang, that Huangqin should be included in this formula, which seems reasonable. However, I believe the decision should depend on the specific syndrome.
[Decoction and Administration Method]
Steep one tea cup of boiling water with the herbs for 15 minutes to half an hour. Strain and take warm.
Note: The steeping time depends on the location of the disease (upper/lower) or severity. For upper locations or milder conditions, steep less; otherwise, steep more. This is because clear and light substances rise, while heavy and turbid substances sink.
[General Principle of Medication]
Both herbs utilize their bitter-cold properties to drain fire and resolve stuffiness.
[Contraindications]
Contraindicated if accompanied by aversion to cold, as aversion to cold may indicate an exterior syndrome or Yang deficiency, neither of which suits bitter-cold formulas. Contraindicated for those who prefer hot drinks, as this indicates a cold syndrome, making "treating cold with cold" inappropriate.
[Reference for Similar Formulas]
Xiao Chengqi Tang: A formula for excess-type abdominal distension and fullness, differing from Pi Syndrome in location and nature.
Fuzi Xiexin Tang Formula No. 58
[Formula Rationale]
This formula drains Stomach heat, tonifies Kidney Yang, and treats Pi Syndrome accompanied by Yang deficiency. It represents another method of combining cold and heat treatments.
[Indications]
Pi Syndrome with hardness, accompanied by aversion to cold and sweating. It must present bitter taste, irritability, difficult defecation, sensation of heat in the stomach, or inability to eat despite preference for cold food. Crucially, there must be a history of chronic Yang deficiency, and absence of exterior signs like headache, fever, or floating pulse.
[Ingredients]
Dahuang (Rhei Radix et Rhizoma, wine-steeped) 1–2 qian
Chao Huanglian (Stir-fried Coptidis Rhizoma) 1 qian
Huangqin (Scutellariae Radix) 1–2 qian
Fuzi (Aconiti Lateralis Radix Praeparata) 2 qian (decocted separately)
[Decoction and Administration Method]
Steep the three yellows (Dahuang, Huanglian, Huangqin) in half a tea cup of boiling water for 15 minutes, then strain to obtain the liquid. Simultaneously, decoct Fuzi in two tea cups of water until half a tea cup remains, then strain to obtain the liquid. Mix the two liquids evenly and divide into two doses to take warm.
[General Principle of Medication]
The three yellows drain Stomach heat to treat Heat Pi; Fuzi warms Kidney Yang to treat aversion to cold and sweating.
[Contraindications]
Contraindicated for exterior cold syndrome with aversion to cold and no sweating; contraindicated for Guizhi Syndrome with aversion to cold, sweating, and floating pulse; contraindicated if there is no Yang deficiency with aversion to cold/sweating, or no internal heat with bitter taste/preference for cold.
[Reference for Similar Formulas]
Dahuang Huanglian Xiexin Tang: A formula for Heat Pi.
Banxia Xiexin Tang Formula No. 59
[Formula Rationale]
This formula regulates cold and heat in the stomach and intestines and tonifies deficiency.
[Indications]
"Epigastric fullness, vomiting, and diarrhea" occurring after mistaken treatment of Taiyang syndrome or even without mistaken treatment. It must present bitter taste, irritability, non-tenderness in the gastrointestinal tract, weak pulse, or ineffectiveness of warm-tonifying medicines, indicating a mixed syndrome of cold, heat, and deficiency.
[Ingredients]
Banxia (Pinelliae Rhizoma) 1–3 qian
Huangqin (Scutellariae Radix) 1–1.5 qian
Ganjiang (Zingiberis Rhizoma) 1–1.5 qian
Zhi Cao (Prepared Glycyrrhizae Radix et Rhizoma) 0.5–1 qian
Renshen (Ginseng Radix) 1–1.5 qian
Huanglian (Coptidis Rhizoma) 0.5–1 qian
Dazao (Ziziphi Jujubae Fructus) 1–2 pieces
Note: Increase Banxia if vomiting is prominent; increase Ganjiang, Renshen, Dazao, and Zhi Cao if diarrhea is prominent; increase Huangqin and Huanglian if Pi is severe with heat.
[Decoction and Administration Method]
Add three tea cups of water, decoct until half a tea cup remains, strain, and take warm.
Note: Old texts mention re-decocting after straining, but trials show no significant difference in efficacy, so this step is omitted.
[General Principle of Medication]
Huangqin, Huanglian, and Ganjiang regulate stomach/intestine cold and heat to resolve cold-heat binding Pi; combined with Banxia, it stops vomiting. Renshen, Dazao, and Zhi Cao tonify deficiency caused by mistaken purgation; combined with Ganjiang, they stop diarrhea.
[Contraindications]
Contraindicated for Pi, fullness, vomiting, or diarrhea without mixed cold-heat symptoms.
[Reference for Similar Formulas]
(1) Guizhi Renshen Tang: A formula for Deficient-Cold Pi Syndrome.
(2) Shengjiang Xiexin Tang: A formula for Disharmonious Cold-Heat Deficient Pi Syndrome leaning towards vomiting.
(3) Gancao Xiexin Tang: A formula for Disharmonious Cold-Heat Pi Syndrome leaning towards diarrhea.
(4) Dahuang Huanglian Xiexin Tang: A formula for Excess-Heat Pi Syndrome.
Gancao Xiexin Tang Formula No. 60
[Formula Rationale]
This formula tonifies deficiency and regulates cold/heat in the stomach and intestines. It treats Pi Syndrome, focusing primarily on stopping diarrhea.
[Indications]
Hard epigastric fullness and diarrhea heavier than vomiting following repeated mistaken purgation. It must present bitter taste or irritability, non-tenderness in the GI tract, weak pulse, or ineffectiveness of warm-tonifying medicines alone, indicating mixed cold-heat-deficiency.
[Ingredients]
Zhi Cao (Prepared Glycyrrhizae Radix et Rhizoma) 2–3 qian
Huangqin (Scutellariae Radix) 1–1.5 qian
Ganjiang (Zingiberis Rhizoma) 1–2 qian
Banxia (Pinelliae Rhizoma) 1–1.5 qian
Huanglian (Coptidis Rhizoma) 0.5 qian
Dazao (Ziziphi Jujubae Fructus) 2–4 pieces
Note: Based on various commentaries and practice, Renshen 1–2.5 qian should be added to this formula.
[Decoction and Administration Method]
Add three tea cups of water, decoct until half a tea cup remains, strain, and take warm.
[General Principle of Medication]
Zhi Cao, Renshen, and Dazao tonify deficiency from repeated purgation; combined with Ganjiang, they stop diarrhea. Huangqin, Huanglian, and Ganjiang combine cold and heat to resolve cold-heat binding Pi; combined with Banxia, they stop vomiting.
[Contraindications]
Contraindicated if there is no mixing of cold, heat, and deficiency.
[Reference for Similar Formulas]
(1) Guizhi Renshen Tang: A formula for Deficient-Cold Pi Syndrome.
(2) Dahuang Huanglian Xiexin Tang: A formula for Excess-Heat Pi Syndrome.
(3) Banxia Xiexin Tang: A formula for Disharmonious Cold-Heat Pi Syndrome with equal emphasis on vomiting and diarrhea.
(4) Shengjiang Xiexin Tang: A formula for Disharmonious Cold-Heat Pi Syndrome leaning towards vomiting.
Shengjiang Xiexin Tang Formula No. 61
[Formula Rationale]
This formula regulates cold/heat in the stomach and intestines and tonifies deficiency. It treats Pi Syndrome, focusing primarily on stopping vomiting.
[Indications]
Disharmony of cold/heat in the stomach and intestines after mistaken sweating, presenting with epigastric fullness, vomiting heavier than diarrhea, dry belching with food odor, fluid retention under the hypochondrium, or borborygmus. It must present bitter taste, irritability, non-tenderness in the GI tract, weak pulse, or ineffectiveness of warm-tonifying medicines, indicating mixed cold-heat-deficiency.
[Ingredients]
Shengjiang (Zingiberis Rhizoma Recens) 2–3 qian
Renshen (Ginseng Radix) 1–1.5 qian
Zhi Cao (Prepared Glycyrrhizae Radix et Rhizoma) 1–2 qian
Huangqin (Scutellariae Radix) 1–1.5 qian
Banxia (Pinelliae Rhizoma) 0.5–1 qian
Ganjiang (Zingiberis Rhizoma) 1 qian
Huanglian (Coptidis Rhizoma) 0.5–1 qian
Dazao (Ziziphi Jujubae Fructus) 1–2 pieces
[Decoction and Administration Method]
Add three tea cups of water, decoct until half a tea cup remains, strain, and take warm.
[General Principle of Medication]
Shengjiang and Banxia stop vomiting and treat dry belching with food odor and fluid retention under the hypochondrium. The warmth of Ganjiang and the cold of Huangqin/Huanglian resolve cold-heat binding Pi. Renshen, Dazao, and Zhi Cao tonify stomach/intestine deficiency; combined with Ganjiang, they stop diarrhea.
[Contraindications]
Contraindicated if there is no mixing of cold and heat.
[Reference for Similar Formulas]
(1) Guizhi Renshen Tang: A formula for Deficient-Cold Pi Syndrome.
(2) Dahuang Huanglian Xiexin Tang: A formula for Excess-Heat Pi Syndrome.
(3) Banxia Xiexin Tang: A formula for Disharmonious Cold-Heat Pi Syndrome with equal emphasis on vomiting and diarrhea.
(4) Gancao Xiexin Tang: A formula for Disharmonious Cold-Heat Pi Syndrome leaning towards diarrhea.
Yuyuliang Wan Formula (Missing)
Chishizhi Yuyuliang Tang Formula No. 62
[Formula Rationale]
This is a neutral formula for consolidating collapse and stopping diarrhea.
Note: This "li" refers to diarrhea (xie xie), not dysentery (li ji). However, it can be borrowed for long-standing dysentery presenting with sliding collapse and incontinence.
[Indications]
Sliding collapse of diarrhea. It must be chronic diarrhea that has not healed, with Qi deficiency and weak pulse, truly presenting with involuntary loss. Do not mistake frequent bowel movements, inability to endure the urge to defecate, or inability to delay defecation as sliding collapse. Specific manifestations include patients who dare not speak loudly because speaking triggers defecation, or unconscious defecation.
[Ingredients]
Chishizhi (Halloysit Rubrum, crushed) 3–5 qian
Taiyi Yuyuliang (Halloysit Alba, crushed) 3–5 qian
[General Principle of Medication]
Chishizhi and Yuyuliang are astringents and consolidants, thus treating deficiency-collapse from diarrhea. Yuyuliang is slightly colder in nature than Chishizhi.
[Contraindications]
Contraindicated at the onset of diarrhea, as sliding collapse does not exist at this stage. More importantly, contraindicated at the onset of dysentery, as its use may lead to chronic/recurrent dysentery (xiu xi li).
[Reference for Similar Formulas]
Taohua Tang: A warm formula for consolidating collapse and treating dysentery.
Note: This "li" refers to dysentery, not diarrhea, but it can sometimes be borrowed to treat sliding collapse in diarrhea.
Xuanshu Daizheshi Tang Formula No. 63
[Formula Rationale]
This formula suppresses rebellion, eliminates phlegm, tonifies deficiency, and dispels cold.
[Indications]
After the exterior syndrome of Taiyang has resolved, presenting with hiccup/belching (ai qi), vomiting, hiccups (e ni), or accompanied by epigastric fullness. It must present expectoration, dislike of cold food/drink, weak or slippery pulse, to be appropriate.
[Ingredients]
Xuanshu Hua (Inulae Flos) 3–5 qian
Sheng Daizheshi (Oolithum, raw) 3 qian–1 liang
Renshen (Ginseng Radix) 1–2 qian
Dazao (Ziziphi Jujubae Fructus) 2–4 pieces
Shengjiang (Zingiberis Rhizoma Recens) 2–3 qian
Banxia (Pinelliae Rhizoma) 2–3 qian
Zhi Cao (Prepared Glycyrrhizae Radix et Rhizoma) 1–2 qian
[Decoction and Administration Method]
Add three tea cups of water, decoct until half a tea cup remains, strain, and take warm. Take twice to three times daily. If vomiting is present, take small amounts frequently to avoid vomiting out the medicine.