(仲景)治水气,喘咳呕哕渴利慰。(太阳表证未解,心下有水气者用之。或喘或咳,
或呕或哕,或渴或利,或短气,或小便秘,皆水气内积所致。)姜桂麻黄芍药甘,细辛半夏
兼五味。〔干姜、麻黄、桂枝、芍药(酒炒)、炙草、细辛各二两,半夏、五味子各半升。桂
枝解表,使水从汗泄;芍药敛肺,以收喘咳;姜、夏、细辛润肾行水,止渴呕,亦表里分消
之意。〕
(仲景)内麻黄襄,二味加入桂枝汤。(桂枝、芍药、炙草各二两,姜三两,枣十二枚,
此桂枝汤也,加葛根四两,麻黄三两。)轻可去实因无汗,(中风表实,故汗不得出。《十剂》
曰∶轻可去实,葛根、麻黄之属是也。)有汗加葛无麻黄。(名桂枝加葛根汤,仲景治太阳有
汗恶风。)
钱氏(钱乙),再加芍药甘草是。(升麻三钱,葛根、芍药各二钱,炙草一钱。轻可去实,
辛能达表,故用升药发散阳明表邪。阳邪盛则阴气虚,故加芍药敛阴和血。升麻、甘草升阳
解毒,故亦治时疫。)阳明发热与头疼,无汗恶寒均堪倚。(及目痛鼻干、不得卧等症。)亦
治时疫与阳斑,痘疹已出慎勿使。(恐升散重虚其表也。)
(汤,张元素)用防风,细辛苍芷与川芎。黄芩生地同甘草,三阳解表益姜葱。
防风、苍术各钱半,白芷、川芎、生地、甘草各一钱,细辛五分,加生姜、葱白煎。)阳虚
气弱人禁用,加减临时在变通。(洁古制此汤,以代麻黄、桂枝、青龙、各半等汤。用羌、
防、苍、细、芎、芷,各走一经,祛风散寒,为诸路之应兵。加黄芩泄气中之热,生地泄血
中之热,甘草以调和诸药。然黄芩、生地,寒滞未可概施,用时宜审。)
(张仲景)治疗水气病,缓解气喘、咳嗽、呕吐、呃逆、口渴及下利。(适用于太阳表证未解,且心下有停饮的情况。患者可能出现气喘或咳嗽,或呕吐或呃逆,或口渴或下利,或呼吸短促,或小便不利,这些都是由于水气内积所致。)方中包含干姜、桂枝、麻黄、芍药、甘草、细辛、半夏和五味子。〔干姜、麻黄、桂枝、芍药(酒炒)、炙甘草、细辛各二两,半夏、五味子各半升。桂枝能解除表邪,使水气随汗液排出;芍药收敛肺气,以平息气喘和咳嗽;干姜、半夏、细辛温肾化饮,止渴止呕,这也体现了表里双解的意图。〕
(张仲景)在麻黄汤的基础上,加入两味药到桂枝汤中。(桂枝、芍药、炙甘草各二两,生姜三两,大枣十二枚,这是桂枝汤的底方,再加入葛根四两、麻黄三两。)因无汗而身体感觉实滞,可用轻扬之药去除实邪(中风表实证,所以汗不得出。《十剂》中说:轻可去实,葛根、麻黄这类药物就是代表)。如果有汗,则加葛根而不加麻黄。(名为桂枝加葛根汤,张仲景用于治疗太阳病有汗且恶风的情况)。
(钱乙)在此基础上,再加芍药和甘草。(升麻三钱,葛根、芍药各二钱,炙甘草一钱。轻扬之药可去实邪,辛味药能通达体表,所以用升麻发散阳明经的表邪。阳热邪气盛则阴气虚弱,所以加入芍药收敛阴气、调和血液。升麻、甘草提升阳气、解毒,因此也能治疗时行疫病。)治疗阳明经发热和头痛,以及无汗恶寒等症状都适宜依靠此方。(还包括目痛鼻干、无法安卧等症状)。也用于治疗时行疫病和阳斑,但如果痘疹已经发出,务必不要使用。(担心升散之药会再次损伤虚弱的体表正气)。
(张元素)使用防风,配合细辛、苍术、白芷和川芎。再加上黄芩、生地和甘草,辅以生姜、葱白煎服,可增强三阳经解表的效果。〔防风、苍术各一钱半,白芷、川芎、生地、甘草各一钱,细辛五分,加入生姜、葱白煎煮。〕阳气虚弱的人禁用,具体加减需根据病情灵活变通。(洁古制作此方,是为了替代麻黄汤、桂枝汤、小青龙汤、大青龙汤、桂枝麻黄各半汤等方剂。使用羌活、防风、苍术、细辛、川芎、白芷,各走一经,祛风散寒,如同各路应援之兵。加入黄芩清泄气分中的热邪,生地清泄血分中的热邪,甘草用来调和诸药。然而黄芩、生地性寒,若寒邪凝滞则不可一概施用,使用时应当审慎辨别。)
(Zhang Zhongjing) treats water qi (accumulation of pathological fluid), relieving wheezing, cough, vomiting, hiccups, thirst, and diarrhea. [Indicated for cases where the Taiyang exterior syndrome is unresolved and there is fluid retention in the epigastrium. Symptoms may include wheezing or coughing, vomiting or hiccups, thirst or diarrhea, shortness of breath, or difficulty urinating, all caused by internal accumulation of water qi.] The formula contains Ganjiang (Dried Ginger), Guizhi (Cinnamon Twig), Mahuang (Ephedra), Shaoyao (Peony Root), Gancao (Licorice Root), Xixin (Asarum), Banxia (Pinellia Tuber), and Wuweizi (Schisandra Berry). [Ganjiang, Mahuang, Guizhi, Shaoyao (wine-fried), Zhi Gancao (Honey-fried Licorice), and Xixin are each used in 2 liang; Banxia and Wuweizi are each used in half a sheng. Guizhi releases the exterior, allowing water to be expelled through sweat; Shaoyao astringes the Lung Qi to calm wheezing and coughing; Ganjiang, Banxia, and Xixin warm the Kidney and promote water metabolism, stopping thirst and vomiting, reflecting the strategy of resolving both interior and exterior.]
(Zhang Zhongjing) adds two ingredients to the Guizhi Tang (Cinnamon Twig Decoction) along with Mahuang. [Guizhi, Shaoyao, and Zhi Gancao are each 2 liang; Shengjiang (Fresh Ginger) is 3 liang; Dazao (Jujube) is 12 pieces. This constitutes the base of Guizhi Tang, to which Gegen (Kudzu Root) 4 liang and Mahuang 3 liang are added.] Because there is no sweat and the body feels full/restrained, light agents can dispel excess [In Wind-strike exterior excess syndrome, sweat cannot be produced. The "Ten Formulas" states: Light agents can dispel excess; Gegen and Mahuang belong to this category]. If there is sweat, add Gegen but do not use Mahuang. [Named Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Kudzu Root), Zhang Zhongjing used it to treat Taiyang syndrome with sweating and aversion to wind.]
(Qian Yi) Adds Shaoyao and Gancao on top of that. [Shengma (Cimicifugae Rhizoma) 3 qian, Gegen and Shaoyao each 2 qian, Zhi Gancao 1 qian. Light agents dispel excess; acrid substances reach the exterior, so Shengma is used to disperse exterior pathogens of the Yangming channel. When Yang pathogenic factors are excessive, Yin Qi becomes deficient, so Shaoyao is added to astringe Yin and harmonize blood. Shengma and Gancao raise Yang Qi and resolve toxicity, thus also treating epidemic febrile diseases.] It treats Yangming fever and headache, as well as symptoms such as absence of sweat and aversion to cold. [It also covers symptoms like eye pain, nasal dryness, and inability to sleep.] It also treats epidemics and yang macules; however, if the rash has already erupted, it must not be used. [To avoid the risk that ascending and dispersing actions might further deplete the weakened exterior Zheng Qi.]
(Zhang Yuansu) Uses Fangfeng (Saposhnikovia Root), combined with Xixin, Cangzhu (Atractylodis Rhizoma), Baizhi (Angelicae Dahuricae Radix), and Chuanxiong (Ligusticum Chuanxiong Rhizoma). Combined with Huangqin (Scutellaria Root), Shengdi (Rehmannia Root), and Gancao, decocted with Shengjiang and Congbai (Scallion White), it benefits the resolution of exterior syndromes in the three Yang channels. [Fangfeng and Cangzhu each 1.5 qian; Baizhi, Chuanxiong, Shengdi, and Gancao each 1 qian; Xixin 0.5 qian; add Shengjiang and Congbai for decoction.] Contraindicated in persons with Yang deficiency and Qi weakness; modifications should be made flexibly according to the situation. [Jieguo formulated this decoction to replace formulas such as Mahuang Tang, Guizhi Tang, Xiao Qinglong Tang, Da Qinglong Tang, and Guizhi Mahuang Gemi Tang. Using Qianghuo, Fangfeng, Cangzhu, Xixin, Chuanxiong, and Baizhi, each targeting a specific meridian to dispel wind and cold, acting as reinforcements from various routes. Huangqin is added to clear heat in the Qi level, Shengdi to clear heat in the Blood level, and Gancao to harmonize the herbs. However, since Huangqin and Shengdi are cold in nature, they should not be applied indiscriminately when cold stagnation is present; careful judgment is required during use.]