十四首、附方八
(仲景)中用桂枝,杏仁甘草四般施。发热恶寒头项痛,伤寒服此汗淋漓。〔麻黄(去
节)三两,桂枝二两,杏仁七十枚(去皮尖),甘草(炙)一两。伤寒太阳表证无汗,用此
发之。麻黄善发汗,恐其力猛,故以桂枝监之,甘草和之,不令大发也。按∶桂、麻二汤虽
治太阳证,而先正每云皆肺药,以伤寒必自皮毛入,而桂、麻又入肺经也。〕
(仲景)治太阳(中)风,芍药甘草姜枣同。(桂枝、芍药、生姜各三钱,炙草三两,
大枣干二枚。治太阳中风有汗,用此解肌,以和营卫,中犹伤也。仲景《伤寒论》通用。)
桂麻相合名各半汤,太阳如疟此为功。(热多寒少,如疟状者,宜之。)
(仲景)桂麻黄,杏草石膏姜枣藏。(麻黄六两,桂枝、炙草各三两,杏仁四十枚,石
膏鸡子大,生姜三两,大枣十二枚。)太阳无汗兼烦躁,(烦为阳、为风,躁为阴、为寒。必
太阳证兼烦躁者,方可用之。以杏、草佐麻黄发表,以姜、枣佐桂枝解肌,石膏质重泻火,
气轻亦达肌表。义取青龙者,龙兴而云升雨降,郁热赖除,烦躁乃解也。若少阴烦躁,而误
服此则逆。)风寒两解此为良。(麻黄汤治寒,桂枝汤治风,大青龙小风寒而两解之。陶节庵
曰∶此汤险峻,今人罕用。)
第十四首,附方八首
(张仲景)在方剂中使用桂枝汤,只需杏仁、甘草两味药配合。出现发热、恶寒、头项疼痛的症状时,伤寒患者服用此方即可大汗淋漓。〔麻黄(去节)三两,桂枝二两,杏仁七十枚(去皮尖),甘草(炙)一两。用于治疗伤寒太阳表证且无汗的情况,以此发汗。麻黄善于发汗,但担心其药力猛烈,所以用桂枝来制约它,用甘草来调和它,不让其过度发汗。按语:桂枝汤和麻黄汤虽然都治疗太阳病,但前代医家常说它们都是入肺经的药,因为伤寒邪气必定从皮毛侵入,而桂枝、麻黄又都入肺经。〕
(张仲景)治疗太阳中风证,使用芍药、甘草、生姜、大枣同煮。(桂枝、芍药、生姜各三钱,炙甘草三两,干大枣二枚。用于治疗太阳中风且有汗出的情况,以此解肌,调和营卫,“中”即“伤”的意思。这是张仲景《伤寒论》中的通用方。)将桂枝汤与麻黄汤各取半量合并,名为桂枝麻黄各半汤,适用于太阳病症状如疟疾般发作的情况。(表现为热多寒少,像疟疾一样的症状,适宜使用此方。)
(张仲景)大青龙汤由桂枝、麻黄、杏仁、甘草、石膏、生姜、大枣组成。(麻黄六两,桂枝、炙甘草各三两,杏仁四十枚,石膏如鸡蛋大小,生姜三两,大枣十二枚。)用于太阳病无汗且兼有烦躁症状的情况。(烦属于阳、属于风,躁属于阴、属于寒。必须是太阳病兼见烦躁者,才可以服用此方。用杏仁、甘草辅助麻黄发表,用生姜、大枣辅助桂枝解肌,石膏质地沉重能泻火,气味轻清也能达于肌表。取名“青龙”,是因为龙兴则云升雨降,郁积的热邪得以清除,烦躁也就解除了。如果是少阴病的烦躁,误服此方则会导致逆证。)风寒两解,此方疗效良好。(麻黄汤治疗寒邪,桂枝汤治疗风邪,大青龙汤针对风寒之邪而同时解除。陶节庵说:此汤药性险峻,现在人很少使用。)
Chapter 14, with Eight Supplementary Formulas
(From Zhang Zhongjing) In the application of Guizhi Tang (Cinnamon Twig Decoction), only three additional ingredients are used: Xingren (Apricot Seed), Gancao (Licorice Root). When symptoms such as fever (Fa Re), aversion to cold (E Han), and pain in the head and nape occur, patients with Shanghan (Cold Damage) can achieve profuse sweating by taking this formula. [Mahuang (Ephedrae Herba, removed nodes) 3 liang, Guizhi (Cinnamomi Ramulus) 2 liang, Xingren (Armeniacae Semen Amarum, peeled and crushed) 70 pieces, Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) 1 liang. This is used to induce sweating for Taiyang (Taiyang Syndrome) exterior syndrome caused by Cold Damage where there is no sweat. Mahuang is good at inducing sweating, but its power is feared to be too fierce; therefore, Guizhi is used to restrain it, and Gancao to harmonize it, preventing excessive sweating. Note: Although both Guizhi Tang and Mahuang Tang treat Taiyang syndrome, ancient physicians often stated that they are medicines entering the Lung Meridian, because Cold Damage pathogens must enter from the skin and hair, and both Cinnamon Twig and Ephedra enter the Lung Meridian.]
(From Zhang Zhongjing) To treat Taiyang Fengzhong (Wind Strike on Taiyang), Shaoyao (Paeoniae Radix Alba), Gancao, Shengjiang (Zingiberis Rhizoma Recens), and Dazao (Jujubae Fructus) are combined together. [Guizhi, Shaoyao, and Shengjiang each 3 qian, Zhi Cao (Honey-fried Licorice) 3 liang, dried Dazao 2 pieces. This treats Taiyang Fengzhong with sweating, using it to release the muscle layer and harmonize Ying (Nutritive Qi) and Wei (Defensive Qi); "Zhong" here means "injured". This is a general formula in Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage).] Combining half doses of Guizhi Tang and Mahuang Tang creates Ge Ban Tang (Guizhi Mahuang Ge Ban Decoction), which is effective for Taiyang conditions resembling malaria. [When heat is predominant over cold, presenting like malaria, this is appropriate.]
(From Zhang Zhongjing) Da Qing Long Tang contains Guizhi, Mahuang, Xingren, Gancao, Shigao (Gypsum Fibrosum), Shengjiang, and Dazao. [Mahuang 6 liang, Guizhi and Zhi Gancao each 3 liang, Xingren 40 pieces, Shigao the size of an egg, Shengjiang 3 liang, Dazao 12 pieces.] It treats Taiyang syndrome without sweat accompanied by restlessness (Fan Zao). [Restlessness (Fan) belongs to Yang and Wind; agitation (Zao) belongs to Yin and Cold. Only when Taiyang syndrome is accompanied by Fan Zao should this formula be used. Xingren and Gancao assist Mahuang in releasing the exterior; Shengjiang and Dazao assist Guizhi in releasing the muscle layer; Shigao, being heavy in texture, clears fire, and light in aroma, also reaches the muscle surface. The name "Qing Long" (Azure Dragon) implies that when the dragon rises, clouds ascend and rain falls, clearing stagnant heat and resolving restlessness. If Fan Zao arises from Shaoyin syndrome, mistaken use of this formula will lead to adverse reactions.] This formula excellently resolves both Wind and Cold simultaneously. [Mahuang Tang treats Cold pathogen, Guizhi Tang treats Wind pathogen; Da Qing Long Tang resolves both Wind and Cold pathogens. Tao Jie'an stated: This decoction is perilous and峻烈 (fierce/strong), rarely used by people today.]