方药不用，人无识者。故唐本草去之。岂仲景书有此，六朝人皆不及见，至王海藏忽见之耶？噫！亦必无之事矣。
栀子柏皮汤
栀子（十五枚） 黄柏（二两） 甘草（一两）水四升，煮取升半，去滓，分温再服。
邹润安曰∶栀子大黄汤、茵陈蒿汤、大黄硝石汤、栀子柏皮汤证，其标皆见于阳明。阳明者，有在经、在腑之分。
发热、汗出、懊 ，皆经证也；腹满、小便不利，皆腑证也。栀子大黄汤证，经多而腑少；茵陈蒿汤证，有腑而无经；
栀子柏皮汤证，有经而无腑；大黄硝石汤证，经少而腑多。
雄按∶《金鉴》云∶此方之甘草，当是茵陈蒿，必传写之讹也。
茵陈蒿汤
茵陈蒿（六两） 栀子（十四枚） 大黄（二两）水一斗，先煮茵陈减六升，内二味，煮取三升，去滓，分温三服。
小盒饭利，溺如皂角汁状，色正赤，一宿腹减，病从小便去也。徐洄溪曰∶先煮茵陈，则大黄从小便出，此秘法也。
邹润安曰∶新感之邪，为素有之热，结成黄胆，此证已所谓因陈矣。故《伤寒》、《金匮》二书，几若无疸不因陈者。
然栀子柏皮汤证，有外热而无里热。麻黄连翘赤小豆汤证，有里热而无外热。小建中汤证，小便自利。小柴胡汤证，腹
痛而呕。小半夏汤证，小便色不变而哕。桂枝加黄 汤证，脉浮。栀子大黄汤证，心中懊 。硝石矾石散证，额上黑。
日晡发热，则内外有热，但头汗出，齐颈而还，腹满，小便不利，口渴，为茵陈蒿汤证矣。第腹满之治在大黄，内热之
治在栀子。惟外复有热，但头汗出，小便不利，始为茵陈的治。其所以能治此者，以其新叶，因陈干而生，清芬可以解
郁热，苦寒可以泄停湿也。盖陈干本能降热利水，复加以叶之如丝如缕，挺然于暑湿蒸逼之时，先草木而生，后草木而
凋，不必能发散。而清芳扬溢，气畅不敛，则新感者，遂不得不解，自是汗出不止于头矣。故曰发热汗出，此为热越不
能发黄也。
抵当汤
水蛭（熬） 虻虫（去翅足，熬） 桃仁（去皮尖，各三十个） 大黄（三两，酒浸）
上为末，以水五升，煮取三升，去滓，温服一升。不下再服。
徐洄溪曰∶凡人身瘀血方阻，尚有生气者，易治。阻之久，则无生气而难治。盖血既离经，与正气全不相属，投以
轻药，则拒而不纳。药过峻，又能伤未败之血，故治之极难。水蛭，最喜食人之血。而性又迟缓善入。迟则生血不伤，
善入则坚积易破。借其力以攻积久之滞，自有利而无害也。
雄按∶王肯堂云∶人溺、蜂蜜，皆制蛭毒。
章虚谷曰∶经言∶阳络伤则血外溢，阴络伤则血内溢。外溢则吐衄，内溢则便血。盖阴阳手足十二经交接，皆由络
贯通，接连细络，分布周身，而血随气行，必由经络流注，表里循环，是故络伤则血不能循行，随阴阳之部而溢出，其
伤处即瘀阻，阻久而蓄积，无阳气以化之，乃成死血矣。故仲景用飞走虫药，引桃仁专攻络结之血。大黄本入血分，再
用酒浸，使其气浮，随虫药循行表里，以导死血归肠腑而出，岂非为至妙至当之法哉！由是类推，失血诸证，要必以化
瘀调经络为主矣。余每见有初治即用呆补之法，使瘀结络闭，不能开通，终至于死，良可慨也！
雄按∶王清任论虚劳亦主瘀阻。盖本大黄 虫丸之义而言也。
文蛤散
文蛤（五两）
为散。以沸汤和一钱匕服，汤用五合。
文蛤汤
文蛤 石膏（各五两） 麻黄 甘草 生姜（各三两） 杏仁（五十粒） 大枣（十二枚）
水六升，煮取二升，温服一升，汗出即愈。
邹润安曰∶文蛤即海蛤之有纹理者，吴人谓之花蛤。
雄按∶王晋三云∶若黯色无纹者，服之令人狂走赴水。夏小正∶
季秋之月，雀入于海为蛤。安氏云∶雀，羽虫也。羽虫属火，火炎上，故鸟上飞。曷为入海而为蛤？盖九月火伏于戌，
十月纯阴，金水之令，故羽虫感之而化也。蛤属水，水性下，故下潜。秋冬，水胜火。雀为蛤，象火之伏于水也。又离
为火为雉为蚌，雀雉之类，蛤蚌之类，外刚内柔，皆离之变化也。因而思《伤寒论》反以冷水 灌之证，非火厄于水而
何？《金匮要略》吐后渴欲得水之条，非火之溺于水而何？惟其火在水中而病，故以火入水中而生者治之。然厄于水者
恶水，恶水则火与水未相浃也。故直以是使水中之火，仍畅茂得生而可已，溺于水者喜水。喜水则火与水渐相浃矣。故
必合麻杏甘膏加姜枣，以清发之乃能已也。
五苓散
泽泻（一两六铢）猪苓 茯苓 白术（各十八铢），方中行曰∶术上不当有“白”字。
雄按∶二十四铢为一两，每铢重四分二厘弱，六铢为锱，即二钱五分，十八铢即七钱五分也。
桂枝（半两）
为末。以白饮和服方寸匕，日三，多服暖水，汗出愈。
沈果之曰∶中风发热，六七日不解而烦，有表里证，渴欲饮水，水入即吐者，名曰水逆。五苓散主之。盖表证为太
阳不足，故用桂以宣阳气，通津液于周身，即《内经》“水精四布，五经并行”之旨，非用之以通水道下出也。里证为三
焦之气化不宣，故用泻、术、二苓以通三焦之闭塞，非开膀胱之溺窍也。夫下焦之气化不宣，则腹膨而小便不利。水蓄
膀胱，是为胞痹。此乃水蓄于膀胱之外，不能化入膀胱，故用五苓以化之。至小便不利，汗出而渴者，亦主以是方。而
不渴者，茯苓甘草汤主之。盖渴为阳气不足，水不上升也。不升则不降，故用桂以升之，二苓、泽泻以降之，而用术以
为中枢，乃注者，莫不以渴为热入膀胱，津液被劫所致。如果热入而复用桂、术以温液耗津，又加苓、泽以渗之，是热
之又热，耗之又耗，速之毙矣。且不渴者反不用五苓而用茯苓甘草汤，可知不渴则无须桂、术之蒸腾津液，而桂、术之
非治太阳而治三焦，更不待言矣。
小陷胸汤
栝蒌实（大者一枚） 黄连（一两） 半夏（半升）
水六升，先煮栝蒌取三升，去滓；纳诸药，煮取二升，去滓，分温三服。
邹润安曰∶观仲景之用栝蒌实，在此汤曰小结胸，正在心下，按之则痛；在栝蒌薤白白酒汤，曰喘息咳唾，胸背痛，
短气。而其脉，一则曰浮滑，一则曰寸口沉迟，关上小紧数，是皆阴中有阳，且踞于阳位者也。夫胸背痛，较按之方痛
则甚，痹则较结为轻，咳唾喘息，是其势为上冲，而居于心下，按之才痛。似反静而不动，此其机总缘气与饮相阻，寒
与热相纠。热甚于寒者，其束缚反急而为结；寒甚于热者，其蔽塞自盛而为痹，是故结胸之病伏，胸痹之病散。伏者，
宜开。散者，宜行。故一则佐以连、夏之逐饮泄热；一则佐以薤、酒之滑利通阳。栝蒌实之裹无形，攒聚有形，使之滑
润而下则同，能使之下，似是治实之方，仅能使之下，不能使其必通，又非纯乎治实之道矣。何以知不能使之必通？盖
有停饮痛甚，至不得卧，即当加半夏。若兼胸满胁下逆抢心，则仍加枳、朴、桂枝，倘竟能通，又何必如是哉？是知栝
蒌实之治，大旨在火与痰结于阳位，不纯乎虚，亦不纯乎实者，皆能裹之而下，此其擅长矣。
百合散
桔梗 贝母（各三分） 巴豆（一分，去皮心膜，熬黑，研如脂）
雄按∶古人以六铢为一分，分字去声即二钱五分也。
为末，内巴豆更于臼中杵之，以白饮和服，强人半钱，羸者减之。病在膈上必吐，在膈下必利。不利进热粥一杯；
利过不止，进冷粥一杯。汪按∶半钱者，以铜钱取药末，仅没钱文之半，即半钱匕，而省“匕”字，非若今人以五分为
半钱也。
邹润安曰∶寒实结胸，无热证者，治以白散。散中用桔梗为疏通气分之主。夫开导胸中之气，仲景于大承气汤、栀
子浓朴等汤，莫不用枳、朴。此偏不用何哉？盖病有上下，治有操纵。结在上者，宿痰停饮也。故凡结胸，无论热实寒
实，宁用甘遂、葶苈、巴豆，不用枳、朴，如大陷胸汤丸、白散是也。结在中下，始热与实浃，气随热化，则于荡涤邪
秽中，疏利其与邪为伍之气，大小承气诸汤是也。况桔梗之用，使气上越，而不使气下泄，今病在至高，固宜操上而纵
下，不使中下无过之地，横被侵陵。故曰，病在膈上必吐，在膈下必利也。热邪与停饮结，治以栝蒌。而佐之者，反用
半夏、黄连；寒邪与停饮结，治以巴豆。而佐之者，反用桔梗、贝母。于寒因热用、热因寒用之中，反佐以取之。可谓
精义入神以致用者矣。
调胃承气汤
大黄（四两，去皮，清酒浸） 甘草（二两，炙） 芒硝（半升）
水三升，先煮大黄、甘草取一升，去滓；内芒硝，更上火微煮，令沸，少少温服之。
徐洄溪曰∶芒硝，善解结热之邪。大承气用之，以解已结之热邪。此方用之，以解将结之热邪。其能调胃，则全赖
甘草也。
升麻鳖甲汤
升麻 当归 甘草（各二两） 蜀椒（炒，去汗，一两） 鳖甲（手指大一片，炙） 雄黄（半两，研）
水四升，煮取一升，顿服之。老小再服，取汗。《金匮要略》阳毒用此方。阴毒去雄黄、蜀椒。《肘后》《千金方》阳
毒用升麻汤，无鳖甲、有桂。阴毒用甘草汤，即本方无雄黄。《活人书》阳毒升麻汤用犀角、射干、黄芩、人参。无当归、
蜀椒、鳖甲、雄黄。
徐洄溪曰∶蜀椒辛热之品，阳毒用而阴毒反去之，疑误。《活人书》加犀角等四味，颇切当。
百合知母汤
百合（七枚） 知母（三两）
先以水洗百合，渍一宿，当白沫出，去其水；别以泉水二升，煎取一升，去滓；别以泉水二升，煎知母取一升；后
合煎取一升五合，分温再服。
王朴庄曰∶百合入药，以野生极小者为胜。
百合鸡子黄汤
百合（七枚） 鸡子黄（一枚）
先煎百合，如前法了；内鸡子黄搅匀，煎五分，温服。
百合滑石代赭汤
百合（七枚，擘） 滑石（三两，碎绵裹） 代赭石（如弹丸大一枚碎绵裹）
先煎百合如前法。别以泉水二升，煎滑石、代赭取一升，去滓；后合和，重煎取一升五合，分温再服。
百合地黄汤
百合（七枚，擘） 生地黄汁（一升）
先煮百合，如前法了；内地黄汁，煎取一升五合，分温再服。中病勿更服，大盒饭如漆。
百合滑石散
百合（一两，灸） 滑石（三两）
为散。饮方寸匕，日三服。当微利者，止服。热则除。
邹润安曰∶玩百合知母汤，可以见汗则伤气，邪搏于气分，为消渴热中也。玩百合鸡子黄汤，可以见吐则伤上，邪
扰于心，为烦懊不寐也。玩百合代赭汤，可以见下则伤血，邪搏于血分，为血脉中热也。玩百合地黄汤，可以见不经吐
下发汗，则系百脉一宗，悉致其病，无气血上下之偏矣。所谓百脉一宗者何？《平人气象论》曰∶胃之大络，名曰虚里，
出于左乳下，其动应衣，为脉宗气，是最近于心，乃着邪焉，是以见证行卧不安，如有神灵，皆心中辗转不适之状，口
苦小便数，身形如和，其脉微数，皆心中热郁气 之征。以此例之，《本经》百合主邪气腹满心痛。盖有若合符节者，而
治法始终不外百合。则以心本不任受邪，心而竟为邪扰，则不责将之谋虑不审，即责相之治节不行。今邪阻于上而不下
行，为肺之不主肃降，无能遁矣。故欲征其愈期，极宜验其小便。凡溺时必肺气下导，小便乃出。今气拄于头，即欲下
行，上先有故，则肺形之轩举不随，气之支结不降，亦又何疑。乃头中之不适，复分三等，其最甚者，至气上拄而为痛，
其次则不痛而为淅淅然，又其次则因小便通而快然，即此验其轩举支结之浅深微甚，既了如指掌矣。况合之以百合地黄
汤下云∶大盒饭如漆。百合滑石散下云∶微利者止服，热则除。则百合之利大小便，又与《本经》吻合矣。
栝蒌牡蛎散
栝蒌根 牡蛎（熬，等分）
为细末。饮服方寸匕，日三服。
邹润安曰∶百合病至一月不解，而变成渴，以百合汤洗之。而仍不瘥，则病为伤中上之阴无疑。虽然，仅曰渴，不
曰欲饮水，且不烦不热，究竟病无驻足之所，仅渴之一端，为得所根据借耳！于此见昔之百脉一宗，悉致其病者，今则上
焦已化，而在下者尚未化也。上焦已化，百脉之病已蠲其半，百合遂无所用之。而下焦之未化者，不得不选用牡蛎，使
之召阳归阴，而其主脑，尤在治上焦之已化者，故方中配以从阳化阴之栝蒌根，两物等分，标名则升栝蒌于牡蛎之上，
为一方之统摄也。
甘草泻心汤
甘草（四两，炙） 黄芩 人参 干姜（各三两） 半夏（半升） 黄连（一两） 大枣（十二枚，《伤寒论》无人
参）
水一斗，煮取六升，去滓；再煎取三升，温服一升，日三。
王晋三曰∶甘草泻心，非泻结热。因胃虚不能调剂上下，水寒上逆，火热不得下降，结为痞，故君以甘草、大枣和
胃之阴。干姜、半夏启胃之阳。坐镇下焦客气，使不上逆，仍用芩、连，将已逆为痞之气，轻轻泻药却，而痞乃成泰矣。
赤豆当归散
赤小豆（三升，浸，令芽出，曝干） 当归（十分）
方药不被使用，是因为没有人能识别它。所以《唐本草》将其剔除。难道是张仲景的书里有记载，而六朝的人都未能看见，直到王海藏才突然见到吗？唉！这必定是不可能的事情。
栀子柏皮汤
栀子（十五枚） 黄柏（二两） 甘草（一两）用水四升，煮取半升，滤去药渣，分两次温服。
邹润安说：栀子大黄汤、茵陈蒿汤、大黄硝石汤、栀子柏皮汤的证候，其表现都见于阳明病。阳明病，有在经和在腑的区别。
发热、汗出、心中懊恼，都是经证的表現；腹部胀满、小便不利，都是腑证的表现。栀子大黄汤证，经证多而腑证少；茵陈蒿汤证，只有腑证而没有经证；
栀子柏皮汤证，只有经证而没有腑证；大黄硝石汤证，经证少而腑证多。
我按语：《医宗金鉴》说：这个方子里的甘草，应该是茵陈蒿，一定是传抄时的错误。
茵陈蒿汤
茵陈蒿（六两） 栀子（十四枚） 大黄（二两）用水一斗，先煮茵陈蒿减少六升，加入另外两味药，煮取三升，滤去药渣，分三次温服。
小盒饭利（注：此处原文可能有误，通常指小便通利），尿像皂角汁的颜色，色正红，过一夜腹部胀满减轻，病邪从小便排出。徐洄溪说：先煮茵陈蒿，那么大黄就能通过小便排出，这是秘诀。
邹润安说：新感受的病邪，与体内素有的热邪结合，结成黄疸，这个证候已经可以说是“因陈”了。所以《伤寒论》和《金匮要略》两本书中，几乎没有不是因陈致黄的。
然而栀子柏皮汤证，有外热而无里热。麻黄连翘赤小豆汤证，有里热而无外热。小建中汤证，小便自利。小柴胡汤证，腹痛且呕吐。小半夏汤证，小便颜色不变但呃逆。桂枝加黄芪汤证，脉浮。栀子大黄汤证，心中懊恼。硝石矾石散证，额头发黑。
日晡时发热，则内外都有热，仅头部出汗，到颈部为止，腹部胀满，小便不利，口渴，这就是茵陈蒿汤的证候了。只是腹满的治疗在于大黄，内热的治疗在于栀子。唯有外部又有热，仅头部出汗，小便不利，这才是茵陈蒿汤的确切主治。它之所以能治此病，是因为茵陈的新叶生长在陈旧的干茎上，清芬之气可以解郁热，苦寒之性可以泄停积的湿邪。大概陈旧的干茎本身就能降热利水，再加上叶片如丝如缕，挺立在暑湿蒸逼之时，比草木先长，比草木后凋，不必具有发散功能。而清香芳溢，气机通畅不收敛，那么新感的病邪，自然不得不解除，于是汗出就不止于头部了。所以说发热汗出，这是热邪向外发散，不能发黄。
抵当汤
水蛭（熬制） 虻虫（去掉翅膀和脚，熬制） 桃仁（去皮尖，各三十个） 大黄（三两，酒浸）
以上药物研为末，用水五升，煮取三升，滤去药渣，温服一升。若未下再服。
徐洄溪说：凡是人体瘀血刚刚阻滞，还有生气的，容易治疗。阻滞久了，就没有生气而难治。因为血液既已离经，与正气完全不相隶属，投以轻药，则拒绝而不接纳。药力过猛，又会伤害未败坏的血液，所以治疗极难。水蛭，最喜欢吃人的血。而且性质迟缓善于进入。迟缓则不伤新生之血，善于进入则坚硬的积聚容易破除。借助它的力量来攻伐久滞的瘀血，自然有利无害。
我按语：王肯堂说：人溺、蜂蜜，都能制约水蛭的毒性。
章虚谷说：经文说：阳络受伤则血外溢，阴络受伤则血内溢。外溢则吐血衄血，内溢则便血。大概阴阳手足十二经交接，都由络脉贯通，连接细络，分布周身，而血随气行，必须由经络流注，表里循环，所以络脉受伤则血不能循行，随着阴阳的部位而溢出，受伤处就是瘀阻，阻滞久了蓄积，没有阳气来化解，就形成了死血。所以张仲景用飞走的虫类药，引导桃仁专门攻伐络脉结聚的血。大黄本入血分，再用酒浸，使其气上浮，随虫类药循行表里，以引导死血归入肠腑而出，难道不是极其精妙恰当的方法吗！由此类推，失血的各种证候，一定要以化瘀调理经络为主。我常见有人初治就用呆补的方法，使瘀结络闭，不能开通，最终导致死亡，实在令人感慨！
我按语：王清任论述虚劳也主张瘀阻。大概是基于大黄䗪虫丸的意义来说的。
文蛤散
文蛤（五两）
研为散。用沸水调和一方寸匕服用，水用五合。
文蛤汤
文蛤 石膏（各五两） 麻黄 甘草 生姜（各三两） 杏仁（五十粒） 大枣（十二枚）
用水六升，煮取二升，温服一升，汗出即愈。
邹润安说：文蛤就是有纹理的海蛤，吴地人叫它花蛤。
我按语：王晋三说：如果是暗色无纹理的，服用后会让人狂走投水。《夏小正》说：
季秋之月，雀鸟入海化为蛤。安氏说：雀，是羽虫。羽虫属火，火炎上，所以鸟向上飞。为什么入海而化为蛤？大概九月火伏于戌，十月纯阴，是金水当令，所以羽虫感之而化。蛤属水，水性下，所以下潜。秋冬，水胜火。雀化为蛤，象征火伏于水中。又离卦为火为雉为蚌，雀雉之类，蛤蚌之类，外刚内柔，都是离卦的变化。因而想到《伤寒论》中反以冷水浇灌的证候，不是火被水困厄是什么？《金匮要略》吐后渴欲得水的条文，不是火溺于水是什么？正因为火在水中而生病，所以用火入水中而生者来治疗。然而被水困厄的厌恶水，厌恶水则火与水未交融。所以直接用它使水中的火，仍然畅茂得生而病可愈，溺于水的喜欢水。喜欢水则火与水逐渐交融。所以必须配合麻杏甘膏加姜枣，以清发之法才能痊愈。
五苓散
泽泻（一两六铢）猪苓 茯苓 白术（各十八铢），方中行说：术字上面不应有“白”字。
我按语：二十四铢为一两，每铢重四分二厘弱，六铢为锱，即二钱五分，十八铢即七钱五分。
桂枝（半两）
研为末。用米汤调和一方寸匕服用，每日三次，多喝暖水，汗出即愈。
沈果之说：中风发热，六七天不解且烦躁，有表里证，渴欲饮水，水入即吐的，名叫水逆。五苓散主治。大概表证是太阳不足，所以用桂枝宣发阳气，通津液于周身，即《内经》“水精四布，五经并行”的宗旨，不是用来通水道向下排出。里证是三焦的气化不宣，所以用泽泻、白术、猪苓茯苓来通三焦的闭塞，不是开膀胱的溺窍。下焦的气化不宣，则腹部膨隆而小便不利。水蓄积在膀胱，这叫胞痹。这是水蓄积在膀胱之外，不能化入膀胱，所以用五苓散来化它。至于小便不利，汗出而渴的，也用此方主治。而不渴的，用茯苓甘草汤主治。大概渴是阳气不足，水不上升。不升则不降，所以用桂枝升之，二苓、泽泻降之，而用白术作为中枢，然而众人无不认为渴是热入膀胱，津液被劫夺所致。如果热入而又用桂枝、白术来温液耗津，再加茯苓、泽泻来渗利，这是热之又热，耗之又耗，加速死亡罢了。而且不渴的反面不用五苓散而用茯苓甘草汤，可知不渴则无须桂枝、白术蒸腾津液，而桂枝、白术非治太阳而治三焦，更是不言而喻的了。
小陷胸汤
栝蒌实（大者一枚） 黄连（一两） 半夏（半升）
用水六升，先煮栝蒌取三升，滤去药渣；纳入其他药物，煮取二升，滤去药渣，分三次温服。
邹润安说：看张仲景使用栝蒌实，在这个汤中叫小结胸，正在心下，按压才痛；在栝蒌薤白白酒汤中，叫喘息咳唾，胸背痛，短气。而其脉，一个说浮滑，一个说寸口沉迟，关上小紧数，这都是阴中有阳，且占据阳位的情况。胸背痛，较之按压才痛则严重，痹较之结为轻，咳唾喘息，是其势向上冲，而居于心下，按压才痛。似乎反而静止不动，这个机理总缘于气与饮相阻，寒与热相纠。热甚于寒的，束缚反而急而为结；寒甚于热的，蔽塞自然盛而为痹，所以结胸的病潜伏，胸痹的病散漫。潜伏的，宜开。散漫的，宜行。所以一个佐以连、夏的逐饮泄热；一个佐以薤、酒的滑利通阳。栝蒌实包裹无形，攒聚有形，使之滑润而下是一样的，能使之下，看似是治实的方子，仅能使之下，不能使其必通，又不是纯粹治实的方法了。怎么知道不能使其必通？大概有停饮痛甚，至不能卧，就应当加半夏。若兼胸满胁下逆抢心，则仍加枳实、厚朴、桂枝，倘若竟能通，又何必如此呢？由此可知栝蒌实的治疗，大旨在于火与痰结于阳位，不纯乎虚，也不纯乎实的，都能裹之而下，这是它的擅长之处。
百合散
桔梗 贝母（各三分） 巴豆（一分，去皮心膜，熬黑，研如脂）
我按语：古人以六铢为一分，分字去声即二钱五分。
研为末，加入巴豆继续在臼中杵捣，用米汤调和服用，体壮者半钱，体弱者减量。病在膈上必吐，在膈下必利。若不利用热粥一杯；利过不止，进冷粥一杯。汪按：半钱者，是用铜钱取药末，仅没钱文的一半，即半钱匕，而省略“匕”字，不像现在人以五分为半钱。
邹润安说：寒实结胸，无热证的，用白散治疗。散中用桔梗作为疏通气分的主药。开启胸中之气，张仲景在大承气汤、栀子厚朴汤等方中，无不使用枳实、厚朴。这里偏偏不用为什么呢？大概病有上下，治有操纵。结在上者的，是宿痰停饮。所以凡结胸，无论热实寒实，宁可用甘遂、葶苈、巴豆，不用枳实、厚朴，如大陷胸汤丸、白散就是这样。结在中下的，始热与实交融，气随热化，则在荡涤邪秽中，疏利其与邪为伍之气，大小承气诸汤就是这样。况且桔梗的作用，使气上越，而不使气下泄，今病在至高，固宜操上而纵下，不使中下无辜之地，横受侵凌。所以说，病在膈上必吐，在膈下必利。热邪与停饮结，用栝蒌治疗。而佐助的，反而用半夏、黄连；寒邪与停饮结，用巴豆治疗。而佐助的，反而用桔梗、贝母。在寒因热用、热因寒用之中，反佐以取效。可以说是精义入神以致用的了。
调胃承气汤
大黄（四两，去皮，清酒浸） 甘草（二两，炙） 芒硝（半升）
用水三升，先煮大黄、甘草取一升，滤去药渣；加入芒硝，再上火微煮，令沸，少量温服。
徐洄溪说：芒硝，善于解结热之邪。大承气汤用它，以解已结的热邪。此方用它，以解将结的热邪。其能调胃，则全赖甘草。
升麻鳖甲汤
升麻 当归 甘草（各二两） 蜀椒（炒，去汗，一两） 鳖甲（手指大一片，炙） 雄黄（半两，研）
用水四升，煮取一升，顿服。老小再服，取汗。《金匮要略》阳毒用此方。阴毒去雄黄、蜀椒。《肘后备急方》《千金方》阳毒用升麻汤，无鳖甲、有桂枝。阴毒用甘草汤，即本方无雄黄。《活人书》阳毒升麻汤用犀角、射干、黄芩、人参。无当归、蜀椒、鳖甲、雄黄。
徐洄溪说：蜀椒辛热之品，阳毒用而阴毒反去之，怀疑有误。《活人书》加犀角等四味，颇切当。
百合知母汤
百合（七枚） 知母（三两）
先用水洗百合，浸泡一夜，当白沫出，去其水；另以泉水二升，煎取一升，滤去药渣；另以泉水二升，煎知母取一升；后合煎取一升五合，分两次温服。
王朴庄说：百合入药，以野生极小者为优。
百合鸡子黄汤
百合（七枚） 鸡子黄（一枚）
先煎百合，如前法完成；加入鸡子黄搅匀，煎五分，温服。
百合滑石代赭汤
百合（七枚，掰开） 滑石（三两，碎绵裹） 代赭石（如弹丸大一枚碎绵裹）
先煎百合如前法。另以泉水二升，煎滑石、代赭取一升，滤去药渣；后合和，重煎取一升五合，分两次温服。
百合地黄汤
百合（七枚，掰开） 生地黄汁（一升）
先煮百合，如前法完成；加入地黄汁，煎取一升五合，分两次温服。中病勿更服，大便必如漆。
百合滑石散
百合（一两，灸） 滑石（三两）
研为散。饮送服一方寸匕，每日三次。当微利者，停止服用。热则除。
邹润安说：玩味百合知母汤，可以看出汗则伤气，邪搏于气分，为消渴热中。玩味百合鸡子黄汤，可以看出吐则伤上，邪扰于心，为烦懊不寐。玩味百合代赭汤，可以看出下则伤血，邪搏于血分，为血脉中热。玩味百合地黄汤，可以看出不经吐下发汗，则系百脉一宗，悉致其病，无气血上下之偏了。所谓百脉一宗的是什么？《平人气象论》说：胃之大络，名曰虚里，出于左乳下，其动应衣，为脉宗气，是最近于心，乃着邪焉，是以见证行卧不安，如有神灵，皆心中辗转不适之状，口苦小便数，身形如和，其脉微数，皆心中热郁气滞之征。以此类推，《本经》百合主邪气腹满心痛。大概有若合符节者，而治法始终不外百合。则以心本不任受邪，心而竟为邪扰，则不责将之谋虑不审，即责相之治节不行。今邪阻于上而不下行，为肺之不主肃降，无能遁矣。故欲征其愈期，极宜验其小便。凡溺时必肺气下导，小便乃出。今气拄于头，即欲下行，上先有故，则肺形之轩举不随，气之支结不降，亦又何疑。乃头中之不适，复分三等，其最甚者，至气上拄而为痛，其次则不痛而为淅淅然，又其次则因小便通而快然，即此验其轩举支结之浅深微甚，既了如指掌矣。况合之以百合地黄汤下云：大便必如漆。百合滑石散下云：微利者止服，热则除。则百合之利大小便，又与《本经》吻合矣。
栝蒌牡蛎散
栝蒌根 牡蛎（熬，等分）
研为细末。饮送服一方寸匕，每日三次。
邹润安说：百合病至一月不解，而变成渴，用百合汤洗之。而仍不瘥，则病为伤中上之阴无疑。虽然，仅曰渴，不曰欲饮水，且不烦不热，究竟病无驻足之所，仅渴之一端，为得所根据借耳！于此见昔之百脉一宗，悉致其病者，今则上焦已化，而在下者尚未化也。上焦已化，百脉之病已蠲其半，百合遂无所用之。而下焦之未化者，不得不选用牡蛎，使之召阳归阴，而其主脑，尤在治上焦之已化者，故方中配以从阳化阴之栝蒌根，两物等分，标名则升栝蒌于牡蛎之上，为一方之统摄也。
甘草泻心汤
甘草（四两，炙） 黄芩 人参 干姜（各三两） 半夏（半升） 黄连（一两） 大枣（十二枚，《伤寒论》无人参）
用水一斗，煮取六升，滤去药渣；再煎取三升，温服一升，每日三次。
王晋三说：甘草泻心，非泻结热。因胃虚不能调剂上下，水寒上逆，火热不得下降，结为痞，故君以甘草、大枣和胃之阴。干姜、半夏启胃之阳。坐镇下焦客气，使不上逆，仍用芩、连，将已逆为痞之气，轻轻泻却，而痞乃成泰矣。
Medicines are not used because no one recognizes them. Therefore, they were removed in the *Tang Bencao* (Tang Dynasty Materia Medica). Could it be that Zhang Zhongjing's books contained this, yet people of the Six Dynasties failed to see it, until Wang Haizhang suddenly saw it? Alas! This must certainly be impossible.
Zhizi Bopi Tang (Gardenia and Phellodendron Decoction)
Zhizi (Gardeniae Fructus, fifteen fruits), Huangbai (Phellodendri Cortex, two liang), Gancao (Licorice Root, one liang). Use four sheng of water, boil to obtain half a sheng, remove dregs, divide into two warm doses.
Zou Run'an said: The syndromes of Zhizi Dahuang Tang (Gardenia and Rhubarb Decoction), Yinchen Hao Tang (Artemisiae Scopariae Decoction), Dahuang Xiaoshi Tang (Rhubarb and Niter Decoction), and Zhizi Bopi Tang all manifest on the Yangming level. Yangming disease has distinctions between being in the meridians (Jing) and in the fu organs (Fu).
Fever, sweating, and mental restlessness (Ao Nan) are all meridian syndromes; abdominal fullness and difficult urination are all fu organ syndromes. Zhizi Dahuang Tang syndrome has more meridian involvement and less fu involvement; Yinchen Hao Tang syndrome has fu involvement but no meridian involvement;
Zhizi Bopi Tang syndrome has meridian involvement but no fu involvement; Dahuang Xiaoshi Tang syndrome has less meridian involvement and more fu involvement.
My note: *Yizong Jinjian* (Golden Mirror of Medical Tradition) states: The Gancao (Licorice Root) in this formula should be Yinchen Hao (Artemisiae Scopariae Herba); it is likely a transcription error.
Yinchen Hao Tang (Artemisiae Scopariae Decoction)
Yinchen Hao (Artemisiae Scopariae Herba, six liang), Zhizi (Gardeniae Fructus, fourteen fruits), Dahuang (Rhei Radix et Rhizoma, two liang). Use one dou of water, first boil Yinchen Hao until reduced by six sheng, then add the other two herbs, boil to obtain three sheng, remove dregs, divide into three warm doses.
Urination becomes smooth, urine resembles the color of soapberry juice, bright red. After one night, abdominal fullness decreases; the pathogen exits via urination. Xu Huixi said: Boiling Yinchen Hao first allows Dahuang to exit via urination; this is a secret method.
Zou Run'an said: New external pathogens, combined with pre-existing internal heat, form jaundice. This syndrome can be described as "due to the old" (Chen). Thus, in both *Shanghan Lun* (Treatise on Cold Damage) and *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet), there are hardly any cases of jaundice not caused by accumulated factors.
However, Zhizi Bopi Tang syndrome has external heat but no internal heat. Mahuang Lianqiao Xiaodou Tang (Ephedra, Forsythia, and Adzuki Bean Decoction) syndrome has internal heat but no external heat. Xiao Jianzhong Tang (Minor Construct the Middle Decoction) syndrome features spontaneous urination. Xiao Chaihu Tang (Minor Bupleurum Decoction) syndrome features abdominal pain and vomiting. Xiao Banxia Tang (Minor Pinellia Decoction) syndrome features unchanged urine color but hiccups. Guizhi Jia Huangqi Tang (Cinnamon Twig Decoction plus Astragalus) syndrome features a floating pulse. Zhizi Dahuang Tang syndrome features mental restlessness (Ao Nan). Shixi Fushi San (Niter and Alum Powder) syndrome features blackening of the forehead.
Fever at dusk indicates heat inside and outside, only head sweating returning at the neck, abdominal fullness, difficult urination, and thirst constitute the Yinchen Hao Tang syndrome. The treatment for abdominal fullness lies in Dahuang; the treatment for internal heat lies in Zhizi. Only when there is external heat, only head sweating, and difficult urination does it become the specific indication for Yinchen Hao Tang. It can treat this because its new leaves grow on old stems; the clear fragrance resolves stagnant heat, and the bitter cold drains retained dampness. Generally, old stems naturally descend heat and promote urination. Added with thread-like leaves emerging during summer damp-heat, growing before other plants and fading after them, without dispersing properties. Yet the clear fragrance spreads, qi flows freely without constriction, so new pathogens are inevitably resolved, and sweating extends beyond just the head. Thus it says: Fever and sweating indicate heat venting outward, preventing jaundice.
Didang Tang (Attacking Blood Stasis Decoction)
Shuizhi (Hirudo, processed), Mengchong (Blatta, wings and feet removed, processed), Taoren (Persicae Semen, skin and tips removed, thirty each), Dahuang (Rhei Radix et Rhizoma, three liang, soaked in wine).
Grind into powder. Use five sheng of water, boil to obtain three sheng, remove dregs, take one sheng warm. If no effect, take again.
Xu Huixi said: When blood stasis is newly obstructed but still has vitality, it is easy to treat. If obstruction persists for a long time, vitality is lost, making it difficult to treat. Once blood leaves the vessels, it is completely disconnected from healthy qi. Mild drugs will be rejected. Overly harsh drugs damage uncorrupted blood, making treatment extremely difficult. Shuizhi (Leech) loves eating human blood. Its nature is slow but good at penetrating. Slowness protects new blood from injury; penetration breaks hard accumulations. Borrowing its strength to attack long-standing stagnation is beneficial and harmless.
My note: Wang Kentang said: Human urine and honey both neutralize leech toxicity.
Zhang Xugu said: The classics state: Injury to yang collaterals causes blood to overflow externally; injury to yin collaterals causes blood to overflow internally. External overflow leads to hematemesis or epistaxis; internal overflow leads to hematochezia. The twelve meridities of yin and yang connect through collaterals, distributing throughout the body. Blood follows qi flow, circulating through meridians, interior and exterior. Thus, collateral injury prevents normal blood flow, causing overflow according to yin/yang regions. The injury site becomes blocked; prolonged stagnation without yang qi transformation forms dead blood. Therefore, Zhang Zhongjing uses flying insects to guide Taoren to specifically attack blood clotted in collaterals. Dahuang enters the blood level; soaking in wine makes its qi float, circulating interior/exterior with insect drugs to guide dead blood out via intestines. Is this not a supreme method? By analogy, various bleeding syndromes must focus on resolving stasis and regulating collaterals. I often see initial treatments using static tonification, causing stasis and collateral closure, leading to death, which is lamentable!
My note: Wang Qingren also advocates blood stasis in consumptive diseases, based on the principle of Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill).
Wenge San (Clam Shell Powder)
Wenge (Tridacnae Concha, five liang).
Grind into powder. Mix one cun-bi with boiling water, use five he for drinking.
Wenge Tang (Clam Shell Decoction)
Wenge (Clam Shell), Shigao (Gypsum Fibrosum, five liang each), Mahuang (Ephedrae Herba), Gancao (Licorice Root), Shengjiang (Zingiberis Rhizoma Recens, three liang each), Xingren (Armeniacae Semen Amarum, fifty grains), Dazao (Jujubae Fructus, twelve fruits).
Use six sheng of water, boil to obtain two sheng, take one sheng warm. Recovery occurs with sweating.
Zou Run'an said: Wenge is sea clam with patterns, called Hua Ge (Flower Clam) in Wu region.
My note: Wang Jinsan said: Dark ones without patterns cause madness and jumping into water if taken. *Xiaozheng* says: In the last month of autumn, sparrows enter the sea and transform into clams. An Shi said: Sparrows are feathered creatures belonging to Fire. Fire flares upward, so birds fly up. Why do they enter the sea and become clams? In September, Fire hides in Xu; in October, Pure Yin prevails, ruling Metal and Water. Feathered creatures sense this and transform. Clams belong to Water; Water sinks, so they dive. In autumn/winter, Water overcomes Fire. Sparrow transforming into clam symbolizes Fire hiding in Water. Li trigram represents Fire, Pheasant, and Mussel. Sparrows/Pheasants and Clams/Mussels are hard outside and soft inside, changes of Li. Thus, considering *Shanghan Lun*'s case of pouring cold water, is it not Fire trapped by Water? *Jingui Yaolue*'s case of thirst after vomiting, is it not Fire drowning in Water? Since illness arises from Fire in Water, treat with things born from Fire entering Water. Those trapped by Water hate Water; hatred means Fire and Water are not mixed. Directly use this to make Fire in Water thrive and recover. Those drowning in Water like Water; liking means gradual mixing. Thus, combine Mahuang, Xixin, Gancao, Shigao plus Ginger/Jujube to clear and vent for recovery.
Wuling San (Five-Ingredient Powder with Poria)
Zexie (Alismatis Rhizoma, one liang six zhu), Zhuling (Polyporus, Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria, eighteen zhu each). Fang Zhongxing said: There should be no "Bai" (White) before Zhu.
My note: Twenty-four zhu equal one liang. Each zhu is slightly less than four fen. Six zhu is a zi, equal to two qian five fen. Eighteen zhu equals seven qian five fen.
Guizhi (Cinnamomi Ramulus, half liang).
Grind into powder. Mix with rice water, take one cun-bi, three times daily. Drink plenty of warm water; recovery occurs with sweating.
Shen Guozhi said: Wind-stroke fever, unresolved for six-seven days with irritability, presenting exterior/interior signs, thirst for water, vomiting immediately after drinking, named Shui Ni (Water Reversal). Wuling San treats it. Exterior sign indicates Taiyang deficiency; thus Guizhi promotes yang qi and circulates fluids throughout the body, following *Neijing*'s principle "Water essence distributes four ways, five meridians run together," not merely draining water downward. Interior sign indicates Sanjiao qi transformation failure; thus Zexie, Baizhu, Zhuling, Fuling open Sanjiao blockage, not merely opening bladder orifices. Lower jiao qi failure causes abdominal distension and difficult urination. Water accumulation in bladder is Paobi. This is water accumulating outside the bladder, unable to transform into it; hence Wuling San transforms it. For difficult urination, sweating, and thirst, this formula is primary. For non-thirsty cases, Fuling Gancao Tang is used. Thirst indicates yang deficiency, water failing to ascend. Failure to ascend prevents descending; thus Guizhi ascends, Zhuling/Zexie descend, Baizhu acts as pivot. Most attribute thirst to heat entering bladder depleting fluids. If heat enters, using Guizhi/Baizhu to warm consumes fluids, plus Zhuling/Zexiao to drain adds heat to heat, consumption to consumption, hastening death. Non-thirsty cases using Fuling Gancao Tang shows Guizhi/Baizhu are unnecessary for steaming fluids when no thirst exists, proving Guizhi/Baizhu treat Sanjiao, not Taiyang.
Xiao Xianxiong Tang (Minor Trap the Chest Decoction)
Gualou Shi (Trichosanthis Fructus, one large fruit), Huanglian (Coptidis Rhizoma, one liang), Banxia (Pinelliae Rhizoma, half sheng).
Use six sheng of water, first boil Gualou to obtain three sheng, remove dregs; add other herbs, boil to obtain two sheng, remove dregs, divide into three warm doses.
Zou Run'an said: Observing Zhang Zhongjing's use of Gualou Shi: Here it treats Minor Chest Binding, located at the heart center, painful upon pressure; in Gualou Xiebai Baijiu Tang (Trichosanthes, Macrostemon, and White Wine Decoction), it treats wheezing, coughing, chest/back pain, shortness of breath. Pulses are floating-slippery vs. deep-slow at Cun, small-tight-rapid at Guan. Both show yin within yang, occupying yang positions. Chest/back pain is worse than pressure-pain; Bi (obstruction) is lighter than Jie (binding). Coughing/wheezing indicates upward rush, while heart-center pain indicates relative stillness. The mechanism involves qi/damp obstruction and cold/heat conflict. Heat exceeding cold causes tight binding; cold exceeding heat causes heavy obstruction. Thus Chest Binding is latent; Chest Bi is dispersed. Latent requires opening; dispersed requires moving. One assists with Lian/Xia to drain damp/heat; one assists with Xie/Wine to lubricate/unblock yang. Gualou Shi wraps formless, gathers formed, promoting slippery descent. It seems to treat excess but only promotes descent, not guaranteed unblocking, nor pure excess treatment. How do we know it doesn't guarantee unblocking? Severe damp-pain preventing lying down requires adding Banxia. With chest fullness and rib-side qi rushing to heart, add Zhishi, Houpo, Guizhi. If it truly unblocked, why such additions? Thus, Gualou Shi treats fire/phlegm binding at yang positions, neither purely deficient nor purely excess, wrapping and descending them. This is its specialty.
Baihe San (Lily Bulb Powder)
Jiegeng (Platycodonis Radix), Beimu (Fritillariae Cirrhosae Bulbus, three fen each), Badou (Crotonis Fructus, one fen, skin/core/membrane removed, roasted black, ground to paste).
My note: Ancients considered six zhu as one fen. Fen pronounced with departing tone equals two qian five fen.
Grind into powder, mix Badou in mortar, pound well. Mix with rice water, take half qian for strong persons, less for weak. Disease above diaphragm causes vomiting; below diaphragm causes purging. If no purge, drink hot porridge cup; if purge continues, drink cold porridge cup. Wang Note: Half qian refers to medicine amount filling half the coin pattern, i.e., half qian-bi, omitting "bi", not modern half qian (five fen).
Zou Run'an said: Han-Shi Jiexiong (Cold-Excess Chest Binding) without heat signs treated by Baisan (White Powder). Jiegeng is main herb for opening qi. To open chest qi, Zhang Zhongjing uses Zhishi/Houpo in Dachengqi Tang, Zhizi Houpo Tang, etc. Why not here? Disease location dictates manipulation. Bindings above are old phlegm/damp. Thus for all chest bindings, whether heat/excess or cold/excess, prefer Gansui, Tingli, Badou over Zhishi/Houpo, as in Daxiexiong Tang/Wan, Baisan. Bindings below involve heat/excess merging, qi transforming with heat; thus sweeping impurities while regulating qi associated with pathogen, as in Dachengqi/Tang. Moreover, Jiegeng lifts qi up, preventing downward escape. Disease at highest point requires controlling upper/lower, avoiding invasion of innocent middle/lower. Hence: Above diaphragm vomits, below purges. Heat/Damp binding treated by Gualou assisted by Banxia/Huanglian; Cold/Damp binding treated by Badou assisted by Jiegeng/Beimu. Using cold for heat, heat for cold, with counter-assistance to achieve effect. This is profound application.
Tiaowei Chengqi Tang (Regulate the Stomach and Purge the Qi Decoction)
Dahuang (Rhei Radix et Rhizoma, four liang, peeled, soaked in clear wine), Gancao (Licorice Root, two liang, roasted), Mangxiao (Natrii Sulfas, half sheng).
Use three sheng of water, first boil Dahuang/Gancao to obtain one sheng, remove dregs; add Mangxiao, boil lightly until bubbling, take small amounts warm.
Xu Huixi said: Mangxiao resolves clustered heat pathogens. Dachengqi Tang uses it to resolve already clustered heat. This formula uses it to resolve about-to-cluster heat. Its ability to regulate the stomach relies entirely on Gancao.
Shengma Biejia Tang ( Cimicifugae and Turtle Shell Decoction)
Shengma (Cimicifugae Rhizoma), Danggui (Angelicae Sinensis Radix), Gancao (Licorice Root, two liang each), Shujiao (Zanthoxyli Pericarpium, stir-fried, sweat removed, one liang), Biejia (Testudinis Carapax et Plastrum, finger-sized piece, roasted), Xionghuang (Realgar, half liang, ground).
Use four sheng of water, boil to obtain one sheng, take in one dose. Elderly/children take again, induce sweating. *Jingui Yaolue* uses this for Yang Du (Yang Toxicity). Yin Du (Yin Toxicity) removes Xionghuang/Shujiao. *Zhouhou Beiji Fang* / *Qianjin Fang* Yang Du uses Shengma Tang, no Biejia, has Guizhi. Yin Du uses Gancao Tang, i.e., this formula without Xionghuang. *Huo Ren Shu* Yang Du Shengma Tang uses Xijiao (Rhinocerotis Cornu), Shegan (Belamcandae Rhizoma), Huangqin (Scutellariae Radix), Renshen (Ginseng Radix). No Danggui, Shujiao, Biejia, Xionghuang.
Xu Huixi said: Shujiao is pungent/hot. Used for Yang Du but removed for Yin Du; suspect error. *Huo Ren Shu* adding Xijiao etc. fits well.
Baihe Zhimu Tang (Lily Bulb and Anemarrhena Decoction)
Baihe (Lilii Bulbus, seven bulbs), Zhimu (Anemarrhenae Rhizoma, three liang).
First wash Baihe, soak overnight until white foam appears, discard water. Separately boil in two sheng spring water to obtain one sheng, remove dregs. Separately boil Zhimu in two sheng spring water to obtain one sheng. Combine and boil to obtain one sheng five he, divide into two warm doses.
Wang Puzhuang said: Baihe for medicine is best when wild and very small.
Baihe Jizihuang Tang (Lily Bulb and Chicken Yolk Decoction)
Baihe (Lilii Bulbus, seven bulbs), Jizihuang (Gallic Ovi Collyrium, one yolk).
First decoct Baihe as before; add Jizihuang, stir evenly, boil for five minutes, take warm.
Baihe Huashi Daizhe Tang (Lily Bulb, Talcum, and Hematite Decoction)
Baihe (Lilii Bulbus, seven bulbs, torn), Huashi (Talcum, three liang, crushed wrapped in silk), Daizheshi (Haematitum, one pill-sized piece, crushed wrapped in silk).
First decoct Baihe as before. Separately boil Huashi/Daizheshi in two sheng spring water to obtain one sheng, remove dregs. Combine and re-boil to obtain one sheng five he, divide into two warm doses.
Baihe Dihuang Tang (Lily Bulb and Rehmannia Decoction)
Baihe (Lilii Bulbus, seven bulbs, torn), Shengdihuang汁 (Rehmanniae Radix Juice, one sheng).
First decoct Baihe as before; add Dihuang juice, boil to obtain one sheng five he, divide into two warm doses. Stop taking when effective. Stool will resemble lacquer.
Baihe Huashi San (Lily Bulb and Talcum Powder)
Baihe (Lilii Bulbus, one liang, roasted), Huashi (Talcum, three liang).
Grind into powder. Take one cun-bi with water, three times daily. Stop if slight diarrhea occurs. Heat is cleared.
Zou Run'an said: Studying Baihe Zhimu Tang reveals sweating damages qi, pathogen combats qi level, causing polydipsia/heat in middle. Studying Baihe Jizihuang Tang reveals vomiting damages upper, pathogen disturbs heart, causing irritability/insomnia. Studying Baihe Daizhe Tang reveals purging damages blood, pathogen combats blood level, causing heat in blood vessels. Studying Baihe Dihuang Tang reveals no vomiting/purging/sweating means all pulses originate from one source, all affected, no bias in qi/blood upper/lower. What is "one source of all pulses"? *Pingren Qixiang Lun* says: Great collateral of stomach named Xuli, emerges left below breast, movement clothes, pulse Zongqi, closest to heart, where pathogen attaches. Signs: restlessness day/night, spirit-like sensation, heart discomfort, bitter taste, frequent urination, body normal, pulse slightly rapid. All signs of heart heat/stagnant qi. By analogy, *Benjing* Baihe treats pathogenic abdominal fullness/heart pain. Matches perfectly. Treatment always centers on Baihe. Heart shouldn't accept pathogen; if disturbed, blame general's strategy or minister's regulation. Now pathogen blocks upper, fails to descend, lung fails to descend, no escape. To predict recovery, check urination. Normally lung qi guides down, urine exits. Now qi stuck at head, wants to descend, but upper has issue, lung shape rises but doesn't follow, qi knot doesn't descend. Doubtless. Head discomfort divides into three: worst is qi stuck causing pain; next is non-painful shivering; least is relief after urination. Verify depth/severity of rising/knotting clearly. Combined with Baihe Dihuang Tang note: Stool like lacquer. Baihe Huashi San note: Stop if slight diarrhea, heat clears. Thus Baihe benefits urination/stool, matching *Benjing*.
Gualou Muli San (Trichosanthes Root and Oyster Shell Powder)
Gualougen (Trichosanthis Radix), Muli (Ostreae Concha, roasted, equal parts).
Grind fine. Take one cun-bi with water, three times daily.
Zou Run'an said: Baihe disease unresolved for one month turns to thirst, washed with Baihe Tang. Still not cured, disease definitely damages upper jiao yin. Although only thirst, not desire to drink, no irritability/heat, disease has no fixed place, only thirst provides basis! Here we see former "all pulses one source" now upper jiao transformed, lower not yet. Upper transformed, half pulse disease cleared, Baihe useless. Lower untransformed requires Muli to call yang back to yin. Main focus remains treating transformed upper jiao, thus pairing Gualougen (yang transforming to yin) with Muli, equal parts, naming Gualou above Muli as formula leader.
Gancao Xiexin Tang (Licorice Decoction to Drain the Epigastrium)
Gancao (Licorice Root, four liang, roasted), Huangqin (Scutellariae Radix), Renshen (Ginseng Radix), Ganjiang (Zingiberis Rhizoma, three liang each), Banxia (Pinelliae Rhizoma, half sheng), Huanglian (Coptidis Rhizoma, one liang), Dazao (Jujubae Fructus, twelve fruits). (*Shanghan Lun* lacks Renshen).
Use one dou water, boil to obtain six sheng, remove dregs; re-boil to obtain three sheng, take one sheng warm, three times daily.
Wang Jinsan said: Gancao Xiexin does not drain clustered heat. Due to stomach deficiency failing to regulate upper/lower, cold water rebels upward, fire heat cannot descend, forming Pi (fullness). Thus Gancao/Dazao harmonize stomach yin. Ganjiang/Banxia stimulate stomach yang. Stabilize lower jiao rebellious qi, prevent upward rebellion. Still use Qin/Lian to gently drain qi already rebelled into Pi, restoring peace.
Chidou Danggui San (Adzuki Bean and Angelica Powder)
Chixiaodou (Vigna angularis, three sheng, soaked until sprouts emerge, dried in sun), Danggui (Angelicae Sinensis Radix, ten parts).