甘草汤
甘草（二两）
水三升，煮取一升半，去滓，温服七合，日二服。
王晋三曰∶一药治病，是曰奇方。
徐洄溪曰∶大甘为土之正味，能制肾水越上之火。王朴庄曰∶自《灵》《素》至汉、晋、宋、齐诸古方，凡云一两者，
以今之七分六厘准之。凡云一升者，以今之六勺七抄准之。汪按∶唐人之方则一两，当古之三两。
雄按∶鞠通，凡引古
方，辄改定其分两，而轻重甚未当也。学人审之。
雄按∶《伤寒类要》治伤寒心悸，脉结代。《圣济总录》治舌肿塞口。《外科精要》治一切痈疽诸发及丹石烟火药发。
《兵部手集》治悬痈。《直指方》治痘疮烦渴及虫毒药毒。《金匮玉函》治小儿撮口及小儿羸瘦。《得效方》治小儿遗溺。
皆以一味甘草为方，妙用良多，总不外乎养阴缓急，清热化毒也。汪按∶亦兼取和中利水。
桔梗汤
桔梗（一两） 甘草（二两）
水三升，煮取一升，去滓，分温再服。
邹润安曰∶肾家邪热，循经而上，肺不任受，遂相争竞，二三日邪热未盛，故可以甘草泻火而愈。若不愈，是肺窍
不利，气不宣泄也。以桔梗开之，肺窍既通，气遂宣泄，热自透达矣。
雄按∶虽以桔梗名汤，而倍用甘草以为驾驭，后人改称甘桔汤是矣。但须审证而投，不可泥为通治咽痛之方也。黄
锦芳《医案求真》尝论及之，医者不可不知。
猪肤汤
猪肤（一斤）
雄按∶以猪皮去其肉肥，刮如纸薄，杭人能造，名曰肉 。可以充馔。
水一斗，煮取五升，去滓，加白蜜一升，白粉五合。即是米粉，熬香，和令相得，温分六服。
王晋三曰∶肾应彘而肺主肤。肾液下泄，不能上蒸于肺，致络燥而为咽痛者，又非甘草所能治矣。当以猪肤润肺肾
之燥，解虚烦之热，白粉、白蜜缓中，俾猪肤比类而致津液从肾上入肺中，循喉咙，复从肺出络心，注胸中，而上中下
燥邪解矣。
黄连阿胶汤
黄连（四两） 黄芩（一两） 芍药（二两） 阿胶（三两） 鸡子黄（二枚）水五升，先煮三物，取二升，去滓；
内胶烊尽小冷；内鸡子黄搅令相得。温服七合，日三服。
邹润安曰∶尤氏云∶阳经之寒，变为热则归于气；阴经之寒，变为热则归于血。阳经或有归于血者，惟阴经之热，
则必不归于气，故三阴有热结证，不用调胃承气、小承气，而独用大承气。诸下利证不已，必便脓血，是其验也。心中
烦，不得卧，热证也。至二三日以上，乃心中烦，不得卧，则非始即属热矣。始即属热，心中烦，不得卧者，为阴虚。
阴虚则不得泻火。今至二三日以上始见，则为阳盛，阳盛则宜泻火。然致此阳盛，亦必其阴本虚。故阿胶、芍药、鸡子
黄、无非救阴之品。泻火则惟恃芩、连。而芩止一两，连乃四两，此黄连之任，独冠一方，而为补剂中泻药矣。
猪苓汤
猪苓（去皮） 茯苓 泽泻 滑石 阿胶（各一两）水四升，先煮四味，取二升，去滓；内阿胶烊消，温服七合，
日二。
周禹载曰∶热盛膀胱，非水能解，何者？水，有止渴之功，而无祛热之力也。故用猪苓之淡渗，与泽泻之咸寒，与
五苓不异。而此易术以胶者，彼属气，此属血也；易桂以滑石者，彼有表，而此为消热也。然则所蓄之水去，则热消矣。
润液之味投，则渴除矣。
邹润安曰∶松之概挺拔劲正，枫之概柔弱易摇。松之理粗疏，枫之理坚细。松之叶至冬益苍翠而不凋，枫之叶至冬
遂鲜赤而即落。是其一柔一刚，显然殊致。茯苓属阳，治停蓄之水不从阳化者。猪苓属阴，治鼓荡之水不从阴化者。是
故仲景以猪苓名方者，其所治之证，曰少阴病，下利，咳而呕渴，心烦不得眠者，猪苓汤主之。若五苓散则其治有渴者、
有不渴者。至茯苓入他方，所治之病，则不渴者居多。盖渴者水气被阳逼迫，欲得阴和而不能也，与之猪苓，使起阴气
以和阳化水，譬之枫叶已丹，遂能即落也。
大承气汤
浓朴（去皮，炙，八两） 枳实（炙，五枚） 大黄（四两，酒洗） 芒硝（三合）水一斗，先煎二物，取五升，
去滓；内大黄，煮取二升，去滓；内硝，更上微火一二沸，温再服。得下，余勿服。
邹润安曰∶柯氏云∶浓朴倍大黄为大承气，大黄倍浓朴为小承气。是承气者在枳、朴。应不在大黄矣。但调胃承气
汤不用枳、朴，亦名承气何也？且三承气汤中，有用枳、朴者，有不用枳朴者；有用芒硝者，有不用芒硝者；有用甘草
者，有不用甘草者。惟大黄则无不用，是承气之名，固当属之大黄。况浓朴三物汤即小承气汤，浓朴分数且倍于大黄，
而命名反不加承气字。犹不可见承气不在枳、朴乎？自金元人以“顺”释“承”。而大黄之功不显。考《本经》首推大黄
通血，再以《六微旨大论》亢则害，承乃制之义参之，则承气者，非血而何？夫气者，血之帅。故血随气行，亦随气滞，
气滞血不随之滞者，是气之不足，非气之有余。惟气滞并波及于血，于是气以血为窟宅，血以气为御侮。遂连衡宿食，
蒸逼津液，悉化为火。此时惟大黄能直捣其巢，倾其窟穴，气之结于血者散，则枳朴遂能效其通气之职，此大黄所以为
承气也。
雄按∶此余夙论如此，邹氏先得我心。汪按∶大黄本血分之药，故知此说确不可易。
白虎汤
石膏（一斤） 知母（六两） 甘草（炙，二两） 粳米（六合）水一斗，煮米熟汤成，去滓，温服一升，日三服。
方中行曰∶白虎者，西方之金神，司秋之阴兽。虎啸谷风冷，凉风酷暑消神于解热，莫如白虎。石膏、知母辛甘而
寒，辛者，金之味。寒者，金之性。辛甘体寒，得白虎之体焉。甘草、粳米，甘平而温，甘取其缓，温取其和，缓而且
和，得伏虎之用焉。饮四物之成汤，来白虎之嗥啸。阳气者，以天地之疾风名也。风行而虎啸者，同气相求也；虎啸而
风生者，同声相应也；风生而热解者，物理必至也。抑尝以此合大小青龙、真武而论之，四物者四方之通神也。而以命
名，盖谓化裁四时，神妙万世，名义两符，实自然而然者也。方而若此，可谓至矣。然不明言其神，而神卒莫之掩者，
君子慎德，此其道之所以大也。汪按∶饮四物之成汤以下数行语。多支离牵强必宜削去。夫白虎汤清热乃甘雨非凉风也。
既备四方之神。朱鸟一方何以独缺。且热剂而名真武。名与实爽矣。医者不能研究医理。乃附会经义以自文其浅陋甚且
衍。先天论太极以欺人。实则无关于辨证处方也。自明以来。庸医陋习。大率如此。学人戒之。
白虎加人参汤
原方加人参（三两）煮服同前法。
邹润安曰∶伤寒脉浮，发热无汗，其表不解者，不可与白虎汤；汪按∶洄溪云，“无汗”二字最为白虎所忌。渴欲饮
水，无表证者，白虎加人参汤主之。可见白虎加人参汤之治，重在渴。其时时恶风，则非常常恶风矣。背微恶寒，则非
遍身恶寒矣。常常恶风，遍身恶寒者，谓之表证也。时时恶风，背微恶寒者，表邪已经化热，特尚未尽耳，谓之无表证
可也。然热邪充斥，津液消亡。用栝蒌根，生津止渴可也，何以必用人参？《灵枢·决气篇》∶腠理发泄，汗出溱溱，是
谓津。津为水，阴属也。能外达上通则阳矣。夫是之谓阴中之阳。人参亦阴中之阳。惟其入阴，故能补阴；惟其为阴中
之阳，故能入阴，使人阴中之气化为津，不化为火，是非栝蒌根可为力矣。
雄按∶朱奉议云∶再三汗下热不退者，以此汤加苍术一钱如神。
黄芩汤
黄芩（三两） 甘草（炙） 芍药（各二两） 大枣（十二枚）水一斗，煮取三升，去滓，温服一升，日再，夜一
服。
邹润安曰∶或问黄芩汤，治何等证？其证腹痛与否？若腹痛何以用黄芩？若腹不痛何以用芍药？汪按∶腹痛因乎热
者甚多，谓腹痛必因寒者，前人拘滞之见也。曰∶其证身热不恶风，亦不恶热，或下利，或呕，腹则不痛。盖芍药、甘
草、大枣、桂枝汤里药也，以不恶风，故不用姜、桂；黄芩、甘草、大枣、小柴胡里药也，以不往来寒热，故不用柴胡。
以其常热，故不用人参。若不呕则并不用半夏、生姜，至芍药则并不因腹痛而用，以桂枝汤证原无腹痛也。亦不心下痞
硬，故不去大枣也。又《厥阴篇》云∶伤寒脉迟，与黄芩汤除其热，腹中则冷不能食，可知黄芩汤证之脉必数。黄芩所
治之热，必自里达外，不治但在表分之热矣。然仲景用黄芩有三耦焉。气分热结者，与柴胡为耦。血分热结者，与芍药
为耦。湿热阻中者，与黄连为耦。以柴胡能开气分之结，不能泄气分之热；芍药能开血分之结，不能清迫血之热；黄连
能治湿生之热，不能治热生之湿。譬之解斗，但去其斗者，未平其致斗之怒，斗终未已也。故黄芩协柴胡能清气分之热。
协芍药，能泄迫血之热。协黄连，能解热生之湿也。
汪按∶前人方解，不过望文生义，必如邹氏诸条，始觉有味可咀矣。
黄芩加半夏生姜汤
原方加半夏（半升） 生姜（三两）煮服法同前。
邹润安曰∶呕而脉数、口渴者，为火气犯胃，不宜加此。
雄按∶章虚谷云∶生姜性热，仅能治寒，不可泛施于诸感也。汪按∶伤寒一百十三方。用姜者五十七。则此味原非
禁剂。然温暑证最宜慎用。用之不当。或致杀人。洄溪谓虽与芩连同用。亦尚有害是也。又古时未有炮制之法。凡方用
半夏无不兼用姜者。义取制半夏之毒。其所以治病者。功在半夏。不在姜也。今所用半夏。必先已姜制。可不必兼用姜
矣。后人不察。但见古方用姜者不少。遂不论何证随手妄施。其中必有误人而不自觉者戒之。
栀子豉汤
栀子（十四枚） 香豉（四合，绵裹）水四升，先煮栀子得二升半；内豉，煮取升半，去滓，分为二服。温进一服，
得吐，止后服。
徐洄溪曰∶此剂分两最小，凡治上焦之药皆然。按此汤加减七方，既不注定何经，亦不专治何误。总由汗、吐、下
之后，正气已虚，尚有痰涎滞气，凝结上焦，非汗下之所能除。
雄按∶温暑湿热之证，每有痰涎滞气，凝结上焦，不必
在汗吐下后也。既非汗下可除，尤忌妄投补剂。经所云∶“在上者，因而越之”，则不动经气，而正不重伤，此为最便，
乃不易之法也。古方栀子皆生用，故入口即吐，后人作汤，以栀子炒黑，不复作吐，全失用栀子之意，然服之于虚烦证
亦有验，想其清肺除烦之性故在也。汪按∶欲取吐者，必宜生用。
一物瓜蒂汤
瓜蒂（二个，锉）水一升，煮取五合，去滓，顿服。
尤在泾曰∶暑之中人也，阴虚而多火者，暑即寓于火之中，为汗出而烦渴。宜白虎加人参以清热生阴。阳虚而多湿
者，暑即伏于湿之内，为身热而疼重。故暑病恒以湿为病，而治湿即所以治暑。瓜蒂苦寒，能吐能下，去身面四肢水气，
水去而暑无所根据，将不治而自解矣。此治中暑兼湿者之法也。
炙甘草汤（一名复脉汤）
甘草（四两，炙） 生地黄（一斤） 麦冬 麻仁（各半斤） 桂枝 生姜（各三两） 人参 阿胶（各二两） 大
枣（三十枚）方中行曰∶地黄上不当有“生”字。
清酒七升，水八升，先煮八味，取三升，去滓；内胶烊消尽，温服一升，日三。
沈亮宸曰∶此汤为千古养阴之祖方也。
邹润安曰∶地黄分数，独甲于炙甘草汤者。盖地黄之用，在其脂液，能荣养筋骸、经脉干者，枯者，皆能使之润泽
也。功能复脉，故又名复脉汤。脉者原于肾而主于心，心血枯槁，则脉道泣涩。此《伤寒论》所以脉结代与心动悸并称，
《金匮要略》又以脉结悸与汗出而闷并述。至肺痿之心中温温液液，涎唾多，则阴皆将尽之孤注，阳仅膏覆之残焰，惟
此汤可增其壳内络外之脂液也。
瓜蒂散
瓜蒂（熬黄） 赤小豆（各一分）汪按∶赤小豆乃小粒赤豆，俗名米赤者是也。勿误用相思子。各别筛为散已，合
治之，取一钱匕，以香豉一合，用热汤七合，煮作稀糜，去滓；取汁，和散，温顿服之。不吐者，少少加，得快吐为止。
诸亡血虚家，不可与之。
卢子繇曰∶瓜象实在须蔓间也。蒂、瓜之缀蔓处也。性遍蔓延，末繁于本，故少延辄腐。《尔雅》云∶其绍瓞；《疏》
云∶继本曰绍，形小曰瓞。故近本之瓜常小，近末之瓜转大也。凡实之吮抽津液，惟瓜称最。而吮抽津液之枢惟蒂，是
以瓜蒂具彻下炎上之用，乃蒂味苦而瓜本甘，以见中枢之所以别于上下内外，诚涌泄之宣剂通剂也。
麻黄连轺赤小豆汤
麻黄 连轺 甘草（炙） 生姜（各二两） 赤小豆 生梓白皮（各一升） 杏仁（四十个） 大枣（十二枚）潦
水一斗，先煮麻黄再沸，去上沫；内诸药，煮取三升，分温三服。半日服尽。
邹润安曰∶《本经》胪列连翘之功。以寒热起，以热结终。此条瘀热在里句，适与连翘功用不异。郭景纯《尔雅》注∶
一名连苕，苕，轺声同字异耳！而今本《伤寒论》注曰∶连轺即连翘根，遂以《本经》有名未用翘根当之。陶隐居云∶
甘草汤
甘草（二两）
用水三升，煮取药液一升半，滤去药渣，每次温服七合，每日服用两次。
王晋三说：只用一味药治病，这叫做奇方。
徐洄溪说：大甘之味是土的正味，能够制约肾水上越的虚火。王朴庄说：从《灵枢》《素问》到汉、晋、宋、齐各代的古方，凡是说一两的，用现在的七分六厘来折算。凡是说一升的，用现在的六勺七抄来折算。汪氏按语：唐代人的方子中，一两相当于古代的三两。
我（王士雄）按语：鞠通（吴鞠通），凡是引用古方，总是擅自更改其分量，而且轻重非常不恰当。学习中医的人要仔细审察。
我（王士雄）按语：《伤寒类要》治疗伤寒引起的心悸、脉象结代。《圣济总录》治疗舌肿塞口。《外科精要》治疗一切痈疽疮疡及丹石烟火药毒发作。《兵部手集》治疗悬痈。《直指方》治疗痘疮烦渴及虫毒药毒。《金匮玉函》治疗小儿撮口风及小儿羸瘦。《得效方》治疗小儿遗尿。都是用一味甘草作为方剂，妙用很多，总不外乎养阴缓急，清热化毒。汪氏按语：也兼有和中利水的作用。
桔梗汤
桔梗（一两） 甘草（二两）
用水三升，煮取药液一升，滤去药渣，分两次温服。
邹润安说：肾家的邪热，沿着经脉上行，肺不能承受，于是相互争竞，发病二三天时邪热尚未炽盛，所以可以用甘草泻火而痊愈。如果病不好，是因为肺窍不利，气机不能宣泄。用桔梗来开宣肺气，肺窍既通，气机得以宣泄，热邪自然透达。
我（王士雄）按语：虽然以桔梗命名汤剂，但倍用甘草来驾驭药性，后人改称为甘桔汤是正确的。但是必须审察证候而投药，不可拘泥于它是治疗咽痛的通用方。黄锦芳在《医案求真》中曾论述过这一点，医生不可不知道。
猪肤汤
猪肤（一斤）
我（王士雄）按语：将猪皮去掉上面的肉和肥油，刮得像纸一样薄，杭州人能制作，名叫“肉”，可以用来食用。
用水一斗，煮取药液五升，滤去药渣，加入白蜜一升，白粉五合。（白粉就是米粉，炒香后）调和均匀，分六次温服。
王晋三说：肾对应豕（猪），肺主皮毛。肾液下泄，不能上蒸于肺，导致络脉干燥而发生咽痛，这就不是甘草所能治疗的了。应当用猪肤来润肺肾之燥，解除虚烦之热，白粉和白蜜缓和其中焦，使得猪肤通过类比作用引导津液从肾上入肺中，沿着喉咙，再从肺出来联络心，注入胸中，这样上、中、下三焦的燥邪就解除了。
黄连阿胶汤
黄连（四两） 黄芩（一两） 芍药（二两） 阿胶（三两） 鸡子黄（二枚）
用水五升，先煮前三味药，取药液二升，滤去药渣；放入阿胶使其完全溶化，稍凉后；放入鸡子黄搅匀。每次温服七合，每日服用三次。
邹润安说：尤在泾先生说：阳经的寒邪，变为热则归于气分；阴经的寒邪，变为热则归于血分。阳经有的会归于血分，只有阴经的热邪，必定不归于气分，所以三阴病有热结证时，不用调胃承气汤、小承气汤，而独用大承气汤。各种下利证不止，必然出现便脓血，这就是验证。心中烦躁，不能入睡，这是热证。到了二三天以上，才出现心中烦躁、不能入睡，那就不是开始就属于热证了。如果一开始就属于热证，出现心中烦躁、不能入睡，那是阴虚。阴虚就不能单纯泻火。现在到了二三天以上才见到，则是阳盛，阳盛则适宜泻火。然而导致这种阳盛，也必然是因为阴本虚。所以阿胶、芍药、鸡子黄，无非都是救阴的药物。泻火则只依靠黄芩、黄连。而黄芩只有一两，黄连却有四两，这里黄连的任务，独冠一方，成为补剂中的泻药。
猪苓汤
猪苓（去皮） 茯苓 泽泻 滑石 阿胶（各一两）
用水四升，先煮前四味药，取药液二升，滤去药渣；放入阿胶使其完全溶化，每次温服七合，每日两次。
周禹载说：热盛于膀胱，非水能解，为什么呢？水，有止渴的功效，但没有祛热的力量。所以用猪苓的淡渗利湿，配合泽泻的咸寒，这与五苓散不同。而这里用阿胶代替白术，是因为彼属气分，此属血分；用滑石代替桂枝，是因为彼有表证，而此是为了消除内热。既然这样，蓄积的水气去除，热邪就消除了。投入润液的药物，口渴就消除了。
邹润安说：松树的气概挺拔劲正，枫树的气概柔弱易摇。松树的纹理粗疏，枫树的纹理坚细。松树的叶子到冬天更加苍翠而不凋落，枫树的叶子到冬天变红随即脱落。这是一柔一刚，显然有不同的情致。茯苓属阳，治疗停蓄之水不从阳气转化的情况。猪苓属阴，治疗鼓荡之水不从阴气转化的情况。所以张仲景以猪苓命名方剂的，其所治疗的证候，说是少阴病，下利，咳而呕渴，心烦不得眠的，用猪苓汤主治。如果是五苓散，则其治疗有口渴的，有不口渴的。至于茯苓进入其他方剂，所治疗的疾病，则大多是不口渴的。大概口渴是因为水气被阳气逼迫，想要得到阴气的调和而不能，给它猪苓，使起阴气以调和阳气化水，就像枫叶已红，就能随即脱落一样。
大承气汤
浓朴（去皮，炙，八两） 枳实（炙，五枚） 大黄（四两，酒洗） 芒硝（三合）
用水一斗，先煎浓朴、枳实二味，取药液五升，滤去药渣；放入大黄，煮取药液二升，滤去药渣；放入芒硝，再上火微沸一二滚，温服两次。如果大便通了，剩下的不要喝。
邹润安说：柯韵伯先生说：浓朴倍加大黄是大承气汤，大黄倍加浓朴是小承气汤。这说明承气的作用在于枳实、浓朴，应该不在大黄了。但是调胃承气汤不用枳实、浓朴，也叫承气汤，为什么呢？况且在三承气汤中，有用枳实、浓朴的，有不用枳实、浓朴的；有用芒硝的，有不用芒硝的；有用甘草的，有不用甘草的。只有大黄是无不用到的，那么承气的名字，当然应该归属于大黄。何况浓朴三物汤就是小承气汤，浓朴的分量甚至倍于大黄，而命名反而不加“承气”二字。这不就可以看出承气不在枳实、浓朴吗？自从金元人以“顺”解释“承”。大黄的功效就不显著了。考证《神农本草经》首先推崇大黄通血，再以《素问·六微旨大论》“亢则害，承乃制”的意思参悟，那么承气者，不是血还能是什么？气，是血的统帅。所以血随气行，也随气滞，气滞而血不随之滞的，是气不足，不是气有余。只有气滞并波及于血，于是气以血为窟宅，血以气为抵御外侮的力量。于是连衡宿食，蒸逼津液，全部化为火。此时只有大黄能直捣其巢穴，倾覆其窟宅，气结于血的状况消散，那么枳实、浓朴就能发挥其通气的作用，这就是大黄所以被称为承气的原因。
我（王士雄）按语：这是我平素的论点，邹氏先得我心。汪氏按语：大黄本是血分的药物，所以知道这个说法确实不可改变。
白虎汤
石膏（一斤） 知母（六两） 甘草（炙，二两） 粳米（六合）
用水一斗，煮米熟汤成，滤去药渣，每次温服一升，每日服用三次。
方中行说：白虎，是西方的金神，司掌秋季的阴兽。虎啸则谷风冷，凉风则酷暑消。在解热方面，没有比得上白虎的。石膏、知母辛甘而寒，辛，是金的味道。寒，是金的性质。辛甘体寒，具备了白虎的形体。甘草、粳米，甘平而温，甘取其缓，温取其和，缓而且和，具备了伏虎的作用。饮用这四味药组成的成汤，引来白虎的嗥啸。阳气，是以天地疾风命名的。风行而虎啸，是同气相求；虎啸而风生，是同声相应；风生而热解，是物理必然的结果。我曾经将此方与大小青龙汤、真武汤合而论之，这四味药是四方之通神。以此命名，大概是说化裁四时，神妙万世，名义相符，实在是自然而然。方剂如此，可以说是到了极致。然而不明言其神妙，而神妙终究无法掩盖，君子慎德，这就是其道之所以伟大的原因。汪氏按语：从“饮四物之成汤”以下数行话，多支离牵强，必须删去。白虎汤清热乃是甘雨而非凉风。既然备有四方的神灵，朱鸟一方为何独缺？而且热剂却命名为真武，名与实不符了。医生如果不能研究医理，就附会经义来掩饰自己的浅陋，甚至衍生出先天论太极来欺骗人。实际上这与辨证处方无关。自明代以来，庸医陋习，大体如此。学习中医的人要警惕。
白虎加人参汤
原方加人参（三两），煮服方法同前。
邹润安说：伤寒脉浮，发热无汗，表证未解的，不可给予白虎汤；汪氏按语：徐洄溪说，“无汗”二字是白虎汤最忌讳的。口渴想喝水，没有表证的，用白虎加人参汤主治。可见白虎加人参汤的治疗，重在口渴。其时时恶风，则不是常常恶风。背微恶寒，则不是遍身恶寒。常常恶风，遍身恶寒的，叫做表证。时时恶风，背微恶寒的，表邪已经化热，只是尚未完全罢了，可以说没有表证。然而热邪充斥，津液消亡。用栝蒌根，生津止渴是可以的，为什么一定要用人参？《灵枢·决气篇》说：腠理发泄，汗出溱溱，这叫津。津为水，属阴。能外达上通则阳。这就叫阴中之阳。人参也是阴中之阳。正因为入阴，所以能补阴；正因为是阴中之阳，所以能入阴，使人阴中之气化为津，不化为火，这不是栝蒌根所能做到的。
我（王士雄）按语：朱奉议说：反复发汗、攻下后热不退的，用此汤加苍术一钱，如神效。
黄芩汤
黄芩（三两） 甘草（炙） 芍药（各二两） 大枣（十二枚）
用水一斗，煮取药液三升，滤去药渣，每次温服一升，每日两次，夜间一次。
邹润安说：有人问黄芩汤，治疗什么证候？其证是否有腹痛？如果有腹痛为什么用黄芩？如果腹不痛为什么用芍药？汪氏按语：腹痛因于热的情况很多，认为腹痛必因于寒，是前人拘泥僵化的见解。回答说：其证身热不恶风，也不恶热，或者下利，或者呕吐，腹部则不痛。大概芍药、甘草、大枣，是桂枝汤里的药物，因为不恶风，所以不用姜、桂；黄芩、甘草、大枣，是小柴胡汤里的药物，因为不往来寒热，所以不用柴胡。因为其常热，所以不用人参。如果不呕吐则并不用半夏、生姜，至于芍药则并不是因为腹痛而用，因为桂枝汤证原本就没有腹痛。也没有心下痞硬，所以不去大枣。又《厥阴篇》说：伤寒脉迟，给予黄芩汤除其热，腹中则冷不能食，可知黄芩汤证的脉必数。黄芩所治的热，必定是自里达外，不治仅在表分的热。然而张仲景用黄芩有三组配伍：气分热结者，与柴胡为耦。血分热结者，与芍药为耦。湿热阻中者，与黄连为耦。因为柴胡能开气分之结，不能泄气分之热；芍药能开血分之结，不能清迫血之热；黄连能治湿生之热，不能治热生之湿。好比解斗，只去掉争斗的人，不平息引发争斗的怒气，争斗最终不会停止。所以黄芩配合柴胡能清气分之热。配合芍药，能泄迫血之热。配合黄连，能解热生之湿。
汪氏按语：前人的方解，不过是望文生义，必须像邹氏的这些条目，才觉得有味可咀嚼。
黄芩加半夏生姜汤
原方加半夏（半升） 生姜（三两），煮服方法同前。
邹润安说：呕吐而脉数、口渴的，是火气犯胃，不宜加此方。
我（王士雄）按语：章虚谷说：生姜性热，只能治寒，不可泛施于各种感邪。汪氏按语：伤寒一百十三方中，用姜的有五十七首，那么这个药味原本不是禁剂。然而温暑证最宜慎用。使用不当，可能导致杀人。徐洄溪说即使与黄芩、黄连同用，也有害处，就是这个意思。另外古时候没有炮制方法，凡是用半夏的方子无不兼用生姜。意义在于制约半夏的毒性。其所以治病，功效在半夏，不在生姜。现在所用的半夏，必须先经过姜制，可以不必兼用生姜了。后人不知考察，只见古方用姜的不少，于是无论什么证候随手妄施。其中一定有误人而不自知的，要警惕。
栀子豉汤
栀子（十四枚） 香豉（四合，绵裹）
用水四升，先煮栀子得药液二升半；放入香豉，煮取药液升半，滤去药渣，分为两次服用。温服一次，如果吐了，停止后服。
徐洄溪说：此药剂量最小，凡是治疗上焦的药物都这样。考据此汤加减七方，既不注定哪一经，也不专治哪种误治。总由发汗、催吐、攻下之后，正气已虚，尚有痰涎滞气，凝结在上焦，不是发汗或攻下所能去除的。
我（王士雄）按语：温暑湿热之证，常有痰涎滞气，凝结在上焦，不一定在汗吐下之后。既然不是汗下所能去除，尤其忌讳妄投补剂。经文所说：“在上者，因而越之”，则不动经气，而正气不重伤，这是最便利的，是不变的法则。古方栀子皆生用，所以入口即吐，后人作汤，将栀子炒黑，不再引起呕吐，完全失去了用栀子的本意，然而服用于虚烦证也有疗效，想是其清肺除烦的性质还在。汪氏按语：想要取吐效果，必须生用。
一物瓜蒂汤
瓜蒂（二个，锉碎）
用水一升，煮取药液五合，滤去药渣，一次性顿服。
尤在泾说：暑邪中人，阴虚而多火的，暑邪就寓居在火之中，表现为汗出而烦渴。宜用白虎加人参汤以清热生阴。阳虚而多湿的，暑邪就潜伏在湿之内，表现为身热而疼重。所以暑病恒常以湿为患，而治湿就是治暑。瓜蒂苦寒，能吐能下，去除身面四肢的水气，水去而暑邪无所凭借，将不治而自解。这是治疗中暑兼湿的方法。
炙甘草汤（一名复脉汤）
甘草（四两，炙） 生地黄（一斤） 麦冬 麻仁（各半斤） 桂枝 生姜（各三两） 人参 阿胶（各二两） 大枣（三十枚）
方中行说：地黄上面不应有“生”字。
清酒七升，水八升，先煮前八味药，取药液三升，滤去药渣；放入阿胶使其完全溶化，每次温服一升，每日三次。
沈亮宸说：此汤是千古养阴的祖方。
邹润安说：地黄的分量，唯独在炙甘草汤中居首位。大概地黄的用处，在于其脂液，能荣养筋骸、经脉，干枯的都能使之润泽。功能恢复脉象，所以又名复脉汤。脉起源于肾而主宰于心，心血枯槁，则脉道涩滞。这就是《伤寒论》所以脉结代与心动悸并称，《金匮要略》又以脉结悸与汗出而闷并述的原因。至于肺痿的心中温温液液，涎唾多，则是阴气即将耗尽的孤注，阳气仅是膏覆般的残焰，只有此汤可以增加其壳内络外的脂液。
瓜蒂散
瓜蒂（熬黄） 赤小豆（各一分）
汪氏按语：赤小豆乃小粒赤豆，俗名米赤的是，勿误用相思子。各自单独筛成散剂后，混合研磨，取一钱匕，用香豉一合，用热汤七合，煮成稀糜，滤去药渣；取汁，和散剂，温顿服之。不吐的，少量增加剂量，以快吐为度。
所有失血虚家，不可给予此方。
卢子繇说：瓜的果实实在须蔓之间。蒂，是瓜连接藤蔓的地方。性遍蔓延，末梢繁茂于根本，所以稍微延长就会腐烂。《尔雅》说：其绍瓞；《疏》说：继本曰绍，形小曰瓞。所以靠近根本的瓜常小，靠近末梢的瓜反而大。凡是果实的吮抽津液，只有瓜称最。而吮抽津液的枢纽唯有蒂，因此瓜蒂具备彻下炎上的作用，蒂味苦而瓜本甘，以此见中枢之所以区别于上下内外，确实是涌泄的宣剂通剂。
麻黄连轺赤小豆汤
麻黄 连轺 甘草（炙） 生姜（各二两） 赤小豆 生梓白皮（各一升） 杏仁（四十个） 大枣（十二枚）
潦水一斗，先煮麻黄再沸，去掉上面的沫；放入诸药，煮取药液三升，分三次温服。半日内服尽。
邹润安说：《神农本草经》罗列连翘的功效，以寒热起，以热结终。此条瘀热在里的句子，恰好与连翘功用无异。郭景纯《尔雅》注：一名连苕，苕，轺声同字异耳！而今本《伤寒论》注曰：连轺即连翘根，遂以《本经》有名未用的翘根当之。陶隐居说：
Gancao Decoction (Licorice Root Decoction)
Licorice Radix et Rhizoma (Radix Glycyrrhizae Preparata, Gancao) (2 liang)
Use three sheng of water, decoct to obtain one and a half sheng of liquid, remove the dregs, take seven ge warm, twice daily.
Wang Jin-san said: Using only one herb to treat disease is called a "Qi Fang" (Wonderful Formula).
Xu Hui-xi said: The great sweet taste is the true flavor of Earth, capable of restraining the fire of Kidney Water that overflows upward. Wang Pu-zhuang said: From the *Ling Shu* and *Su Wen* to the ancient formulas of the Han, Jin, Song, and Qi dynasties, whenever it says "one liang," it corresponds to seven fen six li of modern measurement. Whenever it says "one sheng," it corresponds to six shao seven chao of modern measurement. Wang's annotation: In Tang dynasty formulas, one liang equals three ancient liang.
My (Wang Shi-xiong) annotation: Ju-tong (Wu Ju-tong) always alters the dosages when citing ancient formulas, and the heaviness or lightness is very inappropriate. Students should examine this carefully.
My (Wang Shi-xiong) annotation: *Shanghan Leiyao* treats palpitations and knotted/intermittent pulse caused by Cold Damage. *Shengji Zonglu* treats tongue swelling obstructing the mouth. *Waike Jingyao* treats all carbuncles, sores, eruptions, and toxicity from Dan-stone and smoke/fire medicines. *Bingbu Shouji* treats xuan-yong (suspense abscess). *Zhizhi Fang* treats irritability and thirst from smallpox, as well as toxicity from insect and medicinal poisons. *Jinkui Yuhan* treats neonatal trismus (jaw locking) and emaciation in children. *Dexiao Fang* treats enuresis in children. All use a single herb, Licorice Radix et Rhizoma, as the formula. Its wonderful applications are numerous, generally not exceeding nourishing Yin, relieving urgency, clearing heat, and resolving toxicity. Wang's annotation: It also harmonizes the Middle and promotes urination.
Jiegeng Decoction (Platycodon Root Decoction)
Platycodon Root (Radix Platycodi, Jiegeng) (1 liang) Licorice Radix et Rhizoma (Radix Glycyrrhizae Preparata, Gancao) (2 liang)
Use three sheng of water, decoct to obtain one sheng of liquid, remove the dregs, divide into two warm doses.
Zou Run-an said: Pathogenic heat from the Kidney travels upward along its meridian. The Lung cannot bear it, leading to conflict. If pathogenic heat is not yet intense after two or three days, Licorice can clear fire and cure the disease. If it does not heal, it is because the Lung orifices are blocked and Qi cannot be vented. Use Platycodon Root to open them. Once the Lung orifices are patent, Qi is vented, and heat naturally dissipates.
My (Wang Shi-xiong) annotation: Although named after Platycodon Root, Licorice is used in double amount to control the formula. Later generations correctly renamed it Gan-Jie Decoction (Licorice and Platycodon Decoction). However, one must assess the syndrome before administering; do not rigidly treat it as a universal formula for sore throat. Huang Jin-fang discussed this in *Yi'an Qiuzhen*. Physicians must know this.
Zhufu Decoction (Pig Skin Decoction)
Pig Skin (Zhufu) (1 jin)
My (Wang Shi-xiong) annotation: Remove the meat and fat from the pig skin, scrape it thin as paper. People in Hangzhou can make it, called "Rou," which can be used for food.
Use ten dou of water, decoct to obtain five sheng of liquid, remove the dregs, add one sheng of White Honey (Baimi) and five ge of White Powder (Baifen, i.e., rice flour, roasted until fragrant), mix well, divide into six warm doses.
Wang Jin-san said: The Kidney corresponds to the pig, and the Lung governs the skin/fur. When Kidney fluids leak downward and cannot steam upward to the Lung, causing dryness of collaterals and resulting in sore throat, Licorice alone cannot treat it. One should use Pig Skin to moisten the dryness of the Lung and Kidney, resolve deficiency-heat causing vexation. White Powder and White Honey moderate the Middle, allowing Pig Skin to guide fluids from the Kidney up to the Lung, along the throat, out from the Lung to connect with the Heart, and inject into the chest, thereby resolving dryness pathogens in the Upper, Middle, and Lower Jiao.
Huanglian Ejiao Decoction (Coptis and Donkey-hide Gelatin Decoction)
Coptis Rhizome (Rhizoma Coptidis, Huanglian) (4 liang) Scutellaria Root (Radix Scutellariae, Huangqin) (1 liang) Peony Root (Radix Paeoniae Alba, Shaoyao) (2 liang) Donkey-hide Gelatin (Colla Corii Asini, Ejiao) (3 liang) Egg Yolk (Jizihuang) (2 pieces)
Use five sheng of water, first decoct the three herbs, obtain two sheng of liquid, remove dregs; add Gelatin and melt completely, cool slightly; add Egg Yolk and stir until mixed. Take seven ge warm, three times daily.
Zou Run-an said: You Zai-jing stated: Cold in Yang meridians, when transforming into heat, returns to the Qi level; Cold in Yin meridians, when transforming into heat, returns to the Blood level. While some Yang meridians may return to Blood, heat in Yin meridians definitely does not return to Qi. Therefore, for heat-binding syndromes in the Three Yin, Da Chengqi Decoction is used exclusively, not Tiaowei Chengqi or Xiao Chengqi Decoction. If various diarrhea syndromes persist, pus and blood will appear in stools, which is the verification. Vexation in the heart and inability to sleep are heat signs. If these appear only after two or three days, it was not initially a heat syndrome. If present from the start, it indicates Yin deficiency. With Yin deficiency, one cannot simply purge fire. Since it appears now, it indicates Yang excess, requiring fire purging. However, this Yang excess arises from underlying Yin deficiency. Thus, Donkey-hide Gelatin, Peony Root, and Egg Yolk are all Yin-nourishing agents. Fire purging relies solely on Scutellaria and Coptis. Scutellaria is only one liang, while Coptis is four liang. Here, Coptis bears the primary role, acting as a purgative within a tonic formula.
Zhuling Decoction (Polyporus Decoction)
Polyporus (Poria Cum Ligno, Zhuling, peeled) Poria (Fu Ling) Alisma Rhizome (Rhizoma Alismatis, Zexie) Talcum (Hua Shi) Donkey-hide Gelatin (Colla Corii Asini, Ejiao) (each 1 liang)
Use four sheng of water, first decoct the four items, obtain two sheng of liquid, remove dregs; add Gelatin and melt completely. Take seven ge warm, twice daily.
Zhou Yu-zai said: Heat intense in the Bladder cannot be resolved by water alone. Why? Water has the function of quenching thirst but lacks the power to dispel heat. Therefore, Polyporus's bland leaching action is combined with Alisma's salty-cold nature, differing from Wuling San. Here, Atractylodes is replaced by Gelatin because the former relates to Qi and this to Blood; Cassia Twig is replaced by Talcum because the former addresses exterior conditions, while this eliminates internal heat. Thus, when accumulated water is removed, heat dissipates. When fluid-moistening substances are administered, thirst is eliminated.
Zou Run-an said: Pine trees stand tall and straight; maple trees are soft and easily shaken. Pine wood has coarse texture; maple wood is dense and fine. Pine needles remain green in winter without falling; maple leaves turn red and fall in winter. This shows their distinct soft and hard natures. Fu Ling belongs to Yang, treating stagnant water that does not transform via Yang. Zhuling belongs to Yin, treating surging water that does not transform via Yin. Hence, Zhang Zhongjing named the formula Zhuling Decoction for Shaoyin disease presenting with diarrhea, cough, vomiting, thirst, vexation, and insomnia. In contrast, Wuling San treats cases with or without thirst. When Fu Ling enters other formulas, it mostly treats non-thirsty cases. Thirst occurs when water vapor is pressured by Yang, seeking Yin harmony but failing. Giving Zhuling raises Yin Qi to harmonize Yang and transform water, like red maple leaves falling immediately.
Da Chengqi Decoction (Major Order the Qi Decoction)
Magnolia Bark (Cortex Magnoliae Officinalis, Houpo, peeled, processed) Immature Bitter Orange (Fructus Aurantii Immaturus, Zhishi, processed) Rhubarb Radix et Rhizoma (Radix et Rhizoma Rhei, Dahuang, wine-washed) Mirabilite (Natrii Sulfas, Mangxiao) (3 he)
Use one dou of water, first decoct Magnolia Bark and Immature Bitter Orange, obtain five sheng, remove dregs; add Rhubarb, decoct to obtain two sheng, remove dregs; add Mirabilite, boil gently for one or two boils, take warm in two doses. If bowel movement occurs, stop taking the remainder.
Zou Run-an said: Ke Yun-bo stated: Doubling Magnolia Bark over Rhubarb makes Da Chengqi Decoction; doubling Rhubarb over Magnolia Bark makes Xiao Chengqi Decoction. This suggests the "Chengqi" function lies in Immature Bitter Orange and Magnolia Bark, not Rhubarb. But Tiaowei Chengqi Decoction uses neither, yet is named Chengqi. Moreover, among the three Chengqi formulas, some use these barks/orange, some don't; some use Mirabilite, some don't; some use Licorice, some don't. Only Rhubarb is always used. Thus, the name "Chengqi" should belong to Rhubarb. Furthermore, Houpo Sanwu Tang is essentially Xiao Chengqi Decoction, with Magnolia Bark dosage even double that of Rhubarb, yet it lacks "Chengqi" in its name. Does this not show Chengqi is not in the bark/orange? Since the Jin-Yuan scholars interpreted "Cheng" as "following/subduing," Rhubarb's efficacy became obscured. Examining the *Shennong Bencao Jing*, Rhubarb is praised for moving blood. Combining this with the *Suwen* principle "Excess causes harm, subjugation brings regulation," Chengqi refers to Blood. Qi is the commander of Blood. Blood follows Qi in movement and stagnation. If Qi stagnates but Blood does not, it is Qi deficiency, not excess. Only when Qi stagnation affects Blood does Qi take Blood as its dwelling, and Blood defend against Qi. They conspire with retained food, steaming fluids into fire. At this point, only Rhubarb can strike the nest directly, destroying the dwelling. When Qi bound in Blood scatters, Immature Bitter Orange and Magnolia Bark can then perform their Qi-moving functions. This is why Rhubarb is called Chengqi.
My (Wang Shi-xiong) annotation: This aligns with my long-held view; Mr. Zou anticipated my thoughts. Wang's annotation: Rhubarb is inherently a Blood-level herb, confirming this theory is irrefutable.
Baitao Decoction (White Tiger Decoction)
Gypsum Fibrosum (Shigao) (1 jin) Anemarrhena Rhizome (Rhizoma Anemarrhenae, Zhimu) (6 liang) Licorice Radix et Rhizoma (Radix Glycyrrhizae Preparata, Gancao, processed) Rice Grains (Jingmi) (6 ge)
Use one dou of water, cook until rice is tender and soup is ready, remove dregs, take one sheng warm, three times daily.
Fang Zhong-xing said: Baihu (White Tiger) is the Metal Spirit of the West, the Yin Beast governing Autumn. The tiger's roar brings cold valley winds; cool winds dissipate summer heat. Nothing clears heat better than the White Tiger. Gypsum and Anemarrhena are acrid, sweet, and cold. Acrid is the flavor of Metal; Cold is the nature of Metal. Acrid-sweet and cold-bodied, they embody the form of the White Tiger. Licorice and Rice are sweet, neutral, and warm. Sweet implies moderation; Warm implies harmony. Moderate and harmonious, they possess the utility of taming the tiger. Drinking this four-herb decoction summons the White Tiger's roar. Yang Qi is named after heaven's swift wind. Wind moves and tiger roars due to similar energies resonating; tiger roars and wind rises due to same sounds responding; wind rises and heat resolves due to natural laws. Comparing this with Qinglong and Zhenwu Decoctions, these four elements represent the divine spirits of the four directions. Naming it thus implies adapting the four seasons, miraculous for eternity, matching name and reality naturally. Such a formula is perfect. Yet it does not explicitly state its divinity, which remains unmasked, showing the gentleman's caution in virtue, hence the greatness of the Dao. Wang's annotation: The passage from "drinking the formed soup..." is disjointed and forced; it should be deleted. Baitao Decoction clears heat like sweet rain, not cool wind. If it prepares the spirits of four directions, why is the Vermilion Bird missing? Also, naming a heat-clearing formula Zhenwu creates a mismatch between name and substance. Physicians who fail to study medical principles resort to forcing interpretations of classics to mask ignorance, even inventing Taiji theories to deceive. This has nothing to do with syndrome differentiation and prescription. Since the Ming Dynasty, quackery has been common. Students beware.
Baitao Jia Renshen Decoction (White Tiger Plus Ginseng Decoction)
Original formula plus American Ginseng / Panax Ginseng (Ren Shen) (3 liang). Decoct and administer as above.
Zou Run-an said: In Cold Damage, if pulse is floating, fever without sweat, and exterior syndrome is unresolved, Baitao Decoction is contraindicated; Wang's annotation: Xu Hui-xi noted that "without sweat" is the greatest taboo for Baitao Decoction. If thirsty for water and no exterior syndrome exists, Baitao Jia Renshen Decoction is indicated. Thus, treatment focuses on thirst. Occasional aversion to wind differs from constant aversion. Slight aversion on the back differs from whole-body aversion. Constant aversion and whole-body chill constitute an exterior syndrome. Occasional aversion and slight back chill indicate exterior pathogen has transformed into heat but not fully cleared; this can be considered "no exterior syndrome." However, with heat rampant and fluids depleted, why use Ren Shen instead of Trichosanthes Root (Gualougen) for generating fluids and stopping thirst? The *Lingshu·Jueqi Chapter* states: "Sweat pouring from pores is called Jin (Fluids)." Jin is water, belonging to Yin. Reaching outward and upward transforms into Yang. This is called "Yang within Yin." Ren Shen is also "Yang within Yin." Because it enters Yin, it tonifies Yin; because it is Yang within Yin, it enters Yin, transforming Yin Qi into Jin rather than Fire, which Trichosanthes Root cannot achieve.
My (Wang Shi-xiong) annotation: Zhu Feng-yi said: For heat remaining after repeated sweating and purging, adding one qian of Atractylodes Lancea (Cangzhu) to this formula works miraculously.
Huangqin Decoction (Scutellaria Decoction)
Scutellaria Root (Radix Scutellariae, Huangqin) (3 liang) Licorice Radix et Rhizoma (Radix Glycyrrhizae Preparata, Gancao, processed) Peony Root (Radix Paeoniae Alba, Shaoyao) (each 2 liang) Jujube (Fructus Jujubae, Dazao) (12 pieces)
Use one dou of water, decoct to obtain three sheng, remove dregs, take one sheng warm, twice daily and once at night.
Zou Run-an said: Someone asked: What syndrome does Huangqin Decoction treat? Is there abdominal pain? If yes, why use Scutellaria? If no, why use Peony? Wang's annotation: Abdominal pain due to heat is common; assuming it must be due to cold is a rigid view of predecessors. Answer: The syndrome presents with body heat, no aversion to wind, no aversion to heat, possibly diarrhea or vomiting, but NO abdominal pain. Shaoyao, Gancao, and Dazao are ingredients of Guizhi Tang; since there is no aversion to wind, Ginger and Cassia Twig are omitted. Huangqin, Gancao, and Dazao are ingredients of Xiaochaihu Tang; since there is no alternating chills and fever, Bupleurum is omitted. Due to constant heat, Ginseng is omitted. If no vomiting, Pinellia and Ginger are omitted. Shaoyao is used not for pain (as Guizhi Tang has no pain) nor for epigastric fullness/hardness (so Dazao is kept). The *Jueyin Chapter* states: "Cold damage with slow pulse, given Huangqin Decoction to clear heat, results in cold abdomen and inability to eat." Thus, Huangqin Decoction pulse must be rapid. The heat treated by Scutellaria spreads from interior to exterior, not just exterior. Zhang Zhongjing pairs Scutellaria in three ways: With Chaihu for Qi-level heat binding; with Shaoyao for Blood-level heat binding; with Huanglian for damp-heat obstructing the Middle. Chaihu opens Qi binding but doesn't clear Qi heat; Shaoyao opens Blood binding but doesn't clear Blood-pushing heat; Huanglian treats damp-generated heat but not heat-generated damp. Like stopping a fight: removing fighters doesn't calm anger. Thus, Scutellaria with Chaihu clears Qi heat; with Shaoyao drains Blood heat; with Huanglian resolves heat-generated damp.
Wang's annotation: Predecessors' formula explanations were often superficial. Only Zou's insights are worth savoring.
Huangqin Jia Banxia Shengjiang Decoction (Scutellaria Plus Pinellia and Fresh Ginger Decoction)
Original formula plus Pinellia Tuber (Rhizoma Pinelliae, Banxia) (0.5 sheng) Fresh Ginger (Rhizoma Zingiberis Recens, Shengjiang) (3 liang). Decoct and administer as above.
Zou Run-an said: Vomiting with rapid pulse and thirst indicates Fire invading the Stomach; this addition is inappropriate.
My (Wang Shi-xiong) annotation: Zhang Xu-gu said: Fresh Ginger is hot and only treats cold; it should not be used indiscriminately for all exogenous pathogens. Wang's annotation: Of 113 Cold Damage formulas, 57 use Ginger, so it is not forbidden. However, in Warm-Temperature syndromes, it must be used cautiously. Improper use can be fatal. Xu Hui-xi warned that even combined with Huangqin and Huanglian, it can be harmful. Anciently, without processing methods, Ginger was always added to Pinellia to detoxify it. The therapeutic effect lies in Pinellia, not Ginger. Modern Pinellia is pre-processed with Ginger, so additional Ginger is unnecessary. Later generations, seeing many ancient formulas use Ginger, apply it blindly regardless of syndrome, harming patients unknowingly. Beware.
Zhizi Chi Decoction (Gardenia and Fermented Soybean Decoction)
Gardenia Fruit (Fructus Gardeniae, Zhizi) (14 pieces) Fermented Soybean Bean (Soja Glycines Semen Praeparatum, Xiangchi) (4 he, wrapped in silk)
Use four sheng of water, first decoct Zhizi to obtain 2.5 sheng; add Xiangchi, decoct to obtain 0.5 sheng, remove dregs, divide into two doses. Take one dose warm. If vomiting occurs, stop subsequent doses.
Xu Hui-xi said: This formula has the smallest dosage; all drugs treating the Upper Jiao are like this. Examining its seven modified formulas, they do not specify a meridian or a specific mismanagement error. Generally, after sweating, vomiting, or purging, Righteous Qi is deficient, yet phlegm-fluids and stagnant Qi condense in the Upper Jiao, which sweating or purging cannot remove.
My (Wang Shi-xiong) annotation: In Warm-Temperature and Damp-Heat syndromes, phlegm-fluids and stagnant Qi often condense in the Upper Jiao, not necessarily after sweating/vomiting/purging. Since it cannot be removed by sweating/purging, tonics are strictly contraindicated. The Classic says: "For pathogens above, induce vomiting." This avoids damaging Jing Qi and Righteous Qi, making it the safest method. Anciently, Zhizi was used raw, inducing immediate vomiting. Later, it was charred for decoctions, losing its emetic property, contrary to intent. However, it remains effective for deficiency-vexation due to its lung-clearing and vexation-resolving nature. Wang's annotation: To induce vomiting, it must be used raw.
Yiwu Guiti Decoction (Single Herb Melon Pedicle Decoction)
Melon Pedicle (Cucumeris Fructus Caulis, Guiti) (2 pieces, chopped)
Use one sheng of water, decoct to obtain five ge, remove dregs, take in one dose.
You Zai-jing said: When Summerheat attacks, those with Yin deficiency and excessive Fire harbor Summerheat within Fire, causing sweating, vexation, and thirst. Baitao Jia Renshen Decoction clears heat and generates Yin. Those with Yang deficiency and excessive Dampness harbor Summerheat within Dampness, causing body heat and heavy pain. Summerheat diseases often involve Dampness; treating Dampness treats Summerheat. Guiti is bitter and cold, inducing vomiting and purging, removing water qi from face and limbs. When water is gone, Summerheat loses its basis and resolves spontaneously. This treats Summerheat complicated by Dampness.
Zhigancao Decoction (Processed Licorice Decoction, aka Fumai Decoction)
Licorice Radix et Rhizoma (Radix Glycyrrhizae Preparata, Gancao, processed) (4 liang) Rehmannia Root (Radix Rehmanniae Preparata, Shengdihuang - note: Fang Zhong-xing says "Sheng" should not be here) (1 jin) Ophiopogon Tuber (Tuber Ophiopogonis, Maidong) Sesame Seed (Semen Sesami Nigrum, Mahuang/Renzhong?) [Note: Text says Mah Ren] (each 0.5 jin) Cassia Twig (Ramulus Cinnamomi, Guizhi) Fresh Ginger (Rhizoma Zingiberis Recens, Shengjiang) (each 3 liang) Ginseng Radix et Rhizoma (Radix et Rhizoma Ginseng, Renshen) Donkey-hide Gelatin (Colla Corii Asini, Ejiao) (each 2 liang) Jujube (Fructus Jujubae, Dazao) (30 pieces)
Fang Zhong-xing said: There should be no "Sheng" (Raw) before Dihuang.
Clear Wine (Qingjiu) (7 sheng) Water (8 sheng), first decoct the eight herbs, obtain three sheng, remove dregs; add Gelatin and melt completely. Take one sheng warm, three times daily.
Shen Liang-chen said: This is the ancestral formula for nourishing Yin throughout history.
Zou Run-an said: Dihuang has the highest dosage in Zhigancao Decoction because its efficacy lies in its lipid fluid, nourishing sinews, bones, and meridians, moistening both dry and withered tissues. It restores the pulse, hence the name Fumai Decoction. Pulses originate in the Kidney and are governed by the Heart. When Heart Blood is withered, pulse channels become sluggish. This explains why *Shanghan Lun* links knotted/intermittent pulse with palpitations, and *Jinkui Yaolue* links them with sweating and oppression. In Feiwei (Lung Withering) with inner warmth and excessive saliva, Yin is nearly exhausted, and Yang is a dying ember. Only this formula can replenish the lipid fluids inside and outside the vessels.
Guiti San (Melon Pedicle Powder)
Melon Pedicle (Cucumeris Fructus Caulis, Guiti, roasted yellow) Adzuki Bean (Vigna Angularis, Chixiaodou) (each 1 fen)
Wang's annotation: Chixiaodou refers to small-grit adzuki beans (commonly called Mi Chi); do not mistake them for Abrus precatorius seeds. Sift each separately into powder, mix, take one qian bi. Use one he of Fermented Soybean Bean (Xiangchi), seven he of hot water, cook into a thin porridge, remove dregs; take juice, mix with powder, take warm in one dose. If no vomiting, increase dose slightly until rapid vomiting occurs.
Contraindicated in all blood-loss and deficiency cases.
Lu Zi-yao said: The melon fruit hangs among vines. The pedicle (Di) connects the melon to the vine. It spreads extensively, with tips more abundant than roots, rotting quickly. *Erya* mentions "Shao Die" (successive small melons). Commentary says: Successive to root is Shao, small shape is Die. Thus, melons near the root are small, those near tips are large. Among fruits, melons best suck fluids. The hub of sucking fluids is the pedicle. Thus, Guiti has descending and ascending functions. Pedicle is bitter, melon is sweet, showing the center distinguishes upper/lower and inside/outside. It is indeed a dispersing and draining agent for inducing vomiting.
Mahuang Lianyao Chixiaodou Decoction (Ephedra, Wild Forsythia Root, and Adzuki Bean Decoction)
Ephedra Herb (Herba Ephedrae, Mahuang) Lianyao (Lianqiao Gen? Text implies Forsythia root/stem) Licorice Radix et Rhizoma (Radix Glycyrrhizae Preparata, Gancao, processed) Fresh Ginger (Rhizoma Zingiberis Recens, Shengjiang) (each 2 liang) Adzuki Bean (Vigna Angularis, Chixiaodou) Catalpa Bark (Cortex Catalpae, Shengzi Bapi) (each 1 sheng) Apricot Kernel (Semen Armeniacae Amarum, Xingren) (40 pieces) Jujube (Fructus Jujubae, Dazao) (12 pieces)
Rainwater (Liaoshui) (1 dou), first decoct Mahuang until boiling again, remove foam; add other herbs, decoct to obtain three sheng, divide into three warm doses. Finish within half a day.
Zou Run-an said: The *Bencao Jing* lists Forsythia Flower (Lianqiao) functions: starting with chills/fever, ending with heat binding. This phrase "stagnant heat in the interior" matches Lianqiao's function. Guo Jingchun's *Erya* commentary notes: Also called Liantiao; Tiao and Yao have same sound, different characters. Current *Shanghan Lun* commentary says Lianyao is Forsythia root, equating it with the "named but unused" root in *Bencao Jing*. Tao Hongjing said: