杵为散。浆水服方寸匕，日三。汪按∶赤小豆乃赤豆之小种。今药肆以半红半黑之相思子为赤小豆。医者亦多误用。
然相思子不能出芽。即此方可证其讹。
二妙散
茅山苍术（生用） 川黄柏（炒黑）
为末。捣生姜，煎沸汤调服。
王晋三曰∶此偶方之小制也。苍术，生用，入阳明经，能发二阳之汗；黄柏，炒黑，入太阴经，能除至阴之湿。一
生一熟，相为表里，治阴分之湿热，有如鼓应桴之妙。
生姜泻心汤
生姜（四两） 甘草（炙） 人参 黄芩（各三两） 半夏（半升） 黄连 干姜（各一两） 大枣（十二枚）
水一斗，煮取六升，去渣；煎取三升，温服一升，日三。
徐洄溪曰∶汗后而邪未尽，必有留饮在心下，其证甚杂。而方中诸药，一一对证。内中又有一药治两证者。亦有两
药合治一证者，错综变化，攻补兼施，寒热互用，皆本《内经》立方诸法，其药性又皆与《神农本草》所载，无处不合，
学人能于此等方，讲求其理而推展之，则操纵在我矣。
半夏泻心汤
半夏（半升） 黄芩 干姜 甘草（炙） 人参（各二两） 黄连（一两） 大枣（十二枚）
水一斗，煮取六升，去渣；再煎取三升，温服一升，日三。
方中行曰∶半夏、干姜，辛以散虚满之痞。黄芩、黄连，苦以泄心膈之热。人参、甘草甘以益下后之虚。大枣，甘
温润以滋脾胃之液。曰泻心者，言满在心膈而不在胃也。
大黄黄连泻心汤
大黄（二两） 黄连（一两）
麻沸汤二升渍之，须臾，绞去滓，分温再服。
尤在泾曰∶成氏云∶此导虚热之方也。按所谓虚热者，对燥矢而言也。盖邪热入里与糟粕相结，则为实热；不与糟
粕相结，则为虚热。非阴虚阳虚之谓。本方以大黄、黄连为剂，而不用枳、朴等药者，盖以泄虚热，非以荡实热也。
雄按∶不但不用枳、朴等药也。二味仅以麻沸汤渍，须臾即绞，其味甚薄，乃可泄虚热。若久渍味浓，虽无枳朴，
亦能下走肠胃也。汪按∶尤氏解释极精妙。梦隐更以煎法释之，亦妙！
附子泻心汤
大黄（二两，酒浸） 黄连（炒） 黄芩（炒，各一两） 附子（一枚，去皮，别煮取汁）
以麻沸汤二升，渍三味，须臾绞去渣；内附子汁，分温再服。
徐洄溪曰∶前方乃法之最奇者，不取煎而取泡，欲其轻扬清淡，以涤上焦之邪。此法更精。附子用煎，三味用泡，
扶阳，欲其热而性重，开痞，欲其生而性轻也。
雄按∶观此可知用药之道。
邹润安曰∶心之为体，于卦象离，今被邪逼，则外阳内伐，内阴沸腾。故半夏、甘草、生姜三泻心汤，治阴邪之未
化者也。大黄黄连、附子二泻心汤，治阴邪之已化者也。阴邪已化，不逼心阳，则在内之沸乱略定。惟在外之邪气尚阻，
则取二黄之泄热，荡去其邪，邪去正自安矣。恶寒汗出者，在上之阴邪才化，在下之阴气复逆，故轻取二黄之气以荡热
除秽。重任附子之威，以追逐逆阴，使之异趋同归，相成而不相背也。其未化者，阳馁 于阳位，而恣肆于阴分，邪盘
踞于清道，而溃泄于下焦，非干姜、半夏、生姜之振散阴霾，不足以廓清心之外郭。非人参、黄连之养阴泄热，不足以
安扰心之内讧也。又曰，余治疟发时先呕者，用半夏泻心。吐泻交作者，用生姜泻心。胸痞下利者，用甘草泻心，皆应
如桴鼓。
小承气汤
大黄（四两） 浓朴（二两） 枳实（三枚）
水四升，煮取一升二合，去滓，分温二服。初服汤，当更衣；不尔者，尽饮之。若更衣勿服。
雄按∶于大承气汤既去芒硝而减枳、朴，复以大黄同煎，而缓其荡涤之性，古人谓之和胃之剂，故曰小承气汤。
牛黄清心丸
陕西牛黄（二分五厘） 镜面朱砂（一钱五分） 生黄连（五钱） 黄芩 山栀（各三钱） 郁金（二钱）
为末，蒸饼为糊，丸如黍米大。每服七八丸。
王晋三曰∶此丸古有数方，其义各别。若治温邪内陷，包络神昏者，惟万氏此方为妙。盖温热入于心包络，邪在里
矣。草木之香，仅能达表，不能透里，必借牛黄幽香物性，乃能内透包络，与神明相合，然尤在佐使之品，配合咸宜。
万氏用芩、连、山栀以泻心火。郁金以通心气。辰砂以镇心神，合之牛黄相使之妙。是丸调入犀角、羚羊角、金汁、甘
草、人中黄、连翘、薄荷等汤剂中，颇建奇功。
雄按∶周公谨云∶《局方》牛黄清心丸，止是前八味至蒲黄而止。自山药以后，凡二十一味，乃补虚中山芋丸。当时
不知何以误并为一，因循不曾改正，贻误后人匪细。凡此之类，读书者不可不知也。一方用牛黄、雄黄、黄连、黄芩、
栀子、犀角、郁金、朱砂各一两、真珠五钱、冰片、麝香各二钱五分，研炼蜜丸，每重一钱，金箔为衣，蜡匮，功效较
万方为胜。汪按∶万方太轻，此方较有力。
至宝丹
生乌犀角 生玳瑁 琥珀 镜面 朱砂（研飞） 雄黄（研飞，各一两） 西牛黄（五钱） 龙脑（研） 麝香（研，
各一钱） 安息香（一两五钱，为末，酒研飞净一两，熬膏，用水安息尤妙） 金箔银箔（各五十片，研细为衣）
先将犀、玳为细末，入余药研匀，将安息香膏，重汤煮，凝成后，入诸药中，和搜成剂，丸如梧子大，蜡护，临服
剖，用人参汤化下三丸至五丸。《本事方》有人参、南星、天竺黄。
王晋三曰∶此治心脏神昏，从表透里之方也。黄，犀、玳、珀，以有灵之物，内通心窍。朱、雄、二箔，以重坠之
品，安镇心神。佐以脑、麝、安息，搜剔幽隐诸窍。东垣云∶冰、雄、牛、麝，入骨髓，透肌肤。抱朴子言∶金箔、雄
黄，合饵为地仙，若与丹砂同用为圣金。饵之可以飞升。故热入心包络，舌绛神昏者，以此丹入寒凉汤药中用之。能祛
阴起阳，立展神明，有非他药所可及。徐氏云∶安神定魄，必备之方，真神丹也。若病因头痛而即神昏不语者，此肝虚
魂升于顶，当用牡蛎救逆以降之，又非至宝丹所宜轻试。
凉膈散（一名连翘饮子）
连翘（四两） 大黄（酒浸） 芒硝 甘草（各二两） 黄芩（酒炒） 薄荷 栀子（各一两）
为粗末。每服三五钱，加竹叶七片，水一碗半，煎一碗，去滓；入生白蜜一匙，微煎温服。
与四物各半服，能和营泄热，名双和散。《本事方》加赤芍、干葛，治诸热累效。《玉机》云∶轻者，宜桔梗汤。汪
按∶此方与第二方桔梗汤名同实异。即本方去硝、黄，加桔梗舟楫之品。浮而上之，去膈中无形之热，且不犯中下二焦
也。
雄按∶此方加减法，详《宣明论》。
徐洄溪曰∶此泻中上二焦之火，即调胃承气加疏风清火之品也。
余师愚曰∶热淫于内，治以咸寒，佐以苦甘，故以连翘、黄芩、竹叶、薄荷升散于上。大黄、芒硝推荡其中。使上
升下行，而膈自清矣。余谓疫疹乃无形之热，投以硝黄之猛烈，必致内溃，因去硝、黄，加生石膏、桔梗，使热降清升，
而疹自透，亦上升下行之义也。
雄按∶法本宣明，剪裁甚善。
犀角地黄汤
暹罗犀角（磨汁） 连翘（各三钱） 生地（五钱） 生甘草（五分）
水二钟，武火煎三物至八分，去滓；入犀汁和服。
王晋三曰∶温热入络，舌绛烦热，八九日不解，医反治经，寒之，散之，攻之，热势益炽，得此汤立效者。非解阳
明热邪，解心经之络热也。按《本草》犀角、地黄能走心经，专解营热。连翘入心，散客热。甘草入心，和络血。以治
温热证，热邪入络，功胜《局方》。
导赤散
生地 木通 甘草梢（各等分，雄按∶生地、木通不应等分。）
水煎服，或加淡竹叶。汪按∶古方淡竹叶即竹叶也，淡竹乃竹名耳。今药肆所售淡竹叶草，是小青之别种，性能凉
胃，不能清心，医人每多误用。
雄按∶本方去甘草，加黄芩蜜丸，名火府丹，亦治心热溺涩淋渴等证；本方加升麻、黄连、丹皮，名升麻清胃汤。
轻清凉血，乃秦皇士透化斑疹之良剂。
理中丸
人参 甘草（炙） 术 干姜（各三两）
捣筛为末，蜜和为丸，如鸡子黄大。以沸汤数合和一丸，研碎温服之。日三四服，夜二服。腹中未热，益至三四丸。
雄按∶“未热”二字，须着眼，腹中不冷者，其可服乎。
然不及汤。汤法∶以四味根据两数切，用水八升，煮取三升，去渣，温服一升，日三。
徐洄溪曰∶此仲景治寒多霍乱之方也，盖亦伤寒之类。后人以暑月之吐利当之，而亦用此方，更造为大顺散者，皆
无稽之论也。
四君子汤
人参 白术（炒） 茯苓（各二钱） 甘草（炙，一钱） 生姜（三片） 大枣（二枚）
水煎，温服。
徐洄溪曰∶此补脾之主方。
玉女煎
生石膏（三五钱） 熟地（三五钱或一两） 麦冬（二钱） 知母 牛膝（各一钱五分）
水一钟半，煎七分服。
雄按∶陈修园力辟此方之谬。然用治阴虚胃火炽盛之齿痛，颇有捷效。若治温热病，地黄宜生，牛膝宜删。叶氏引
用，决不泥守成方，近读《景岳发挥》，果与陈氏之论印合。
四物汤
生地 当归（各三两） 芎 （一两五钱） 芍药（二两）
咀。每服四钱，水二盏，煎八分，去滓，温服。
张路玉曰∶四物为阴血受病之专药，非调补真阴之药也。
汪按∶调补真阴宜集灵膏。不宜四物，而人多误会。
小柴胡汤
柴胡（半斤） 黄芩 人参 甘草（炙） 生姜（各三两） 半夏（半升） 大枣（十二枚）
水一斗二升，煮取六升，去滓；再煎取三升，温服一升，日三。
尤拙吾曰∶热入血室三条，其旨不同。第一条是血舍空而热乃入者，空则热不得聚而游其部，故胁满痛。第二条是
热邪与血俱结于血室者，血结亦能作寒热，柴胡亦能去血结，不独和解之谓矣；第三条是热邪入而结，经尚行者，经行
则热亦行而不得留，故必自愈。无犯胃气及上二焦，病在血而不在气，在下而不在上也。若诛伐无过，变证随出，乌能
自愈耶？
沈再平曰∶今人治疟，必用此汤。若非此汤，即不足以为治者。故致辗转淹滞，变生不测，竟能殒命，则知疟本非
死证，惟概以柴胡治疟者，杀之也。夫柴胡为少阳表药，若其疟果发于少阳，而以柴胡治之，无不立愈。若系他经用之，
则必使他经之邪辗转而入少阳，迁延以毙，乃既死犹曰∶柴胡为治疟主药，吾开手即用之，不知其何以死？病家亦以柴
胡治疟而竟不效，真其命之当死也。彼此昏迷，不得一悟，良可浩叹！
雄按∶《内经》论疟，既分六经，又分脏腑，并不
泥定少阳一经，医家绎之。
雄按∶本方柴、半各八两，准今得六钱零八厘。参、草、苓、姜各三两，准今得二钱二分八厘。枣十二枚。以水一
斗二升，准今得八合零四抄，煮至减半，去滓，再煎至减半，夫煎而又煎，只取四分之一，其汤之浓郁甘柔可知。喻氏
谓和药取其各药气味之相和。余谓和者，取其气缓味浓，斯为补正托邪之剂。故惟风寒正疟，邪在少阳者，可以按法而
投。则参、甘、姜、枣，补胃充营。半夏利其枢。柴、芩解其热。病无不愈矣。犹之今人于疟发之先，饱啖羊肉酒饭，
亦能取效。汪按∶疟疾寒来之时。强食过饱。往往一寒不能复热而死。吾见甚多。不可不戒。盖风寒自表而受，胃腑空
虚，自能安谷，治必先助中气，托邪外出，即御外邪，杜其内入，诚一举两全之策也。若温热暑湿诸疟，邪从口鼻而受，
肺胃之气，先已窒滞，病发，即不饥恶谷，脘闷苔黄，苟不分别，但执此汤，奉为圣法。则参、甘、姜、枣，温补助邪，
骤则液涸神昏，缓则邪留结痞，且有耗伤阴血而成疟劳者。即不用全方，而专以柴胡为治疟主药，亦惟营阴充裕，或温
热暑湿之邪，本不甚重。及兼感风寒之表邪者，始可见功。汪按∶治正疟必宜此汤。温暑亦有正疟。不独风寒方用。黄
芩是清热非祛寒也。且柴胡主少阳半表半里。黄芩里药。亦非以治表邪。但当辨其是否正疟耳。若似疟非疟。妄用柴胡。
必提成长热不退。或两耳大痛。甚至神昏。更或引动肝风痉厥立至。生平见之屡矣。故倪涵初所定三方，亦愈病者稀而
加病者多也。汪按∶疟疾强止变成臌胀者多不救。而人但知其臌胀而死。未尝归咎于治疟之不善，故医者终身误人而不
自知。虽告之不信也。世人凡患疟，不究病因，辄以姜枣汤灌之，其弊类此，羊肉亦然。凡属时疟，虽愈后亦忌食，食
则必复，此时疟之所以异于正疟也。可不察哉！
桂枝红花汤
《伤寒》桂枝汤加红花。
原方桂枝芍药、生姜（各三两） 甘草（炙，二两） 大枣（十二枚）
葱豉汤
葱白（一握） 香豉（三合）
水煎，入童子小便一合，日三服。
雄按∶芦根、桑叶、滑石、蔗浆之类，皆可随证佐用。
张路玉曰∶本方药味虽轻，功效最着。凡虚人，风热伏气发温，及产后感冒，靡不随手获效。
尤拙吾曰∶温邪之发，阴必先伤，设有当行解散者，必兼滋阴之品于其中。昔人于葱豉汤内加童便。于栀豉汤中加
捣碎制成散剂。用浆水送服一方寸匕，每日三次。汪氏按语：赤小豆是赤豆的一个小品种。现在药店里把半红半黑的相思子当作赤小豆出售。医生们也大多误用。
然而相思子不能发芽。仅凭这一点就可以证明这是错误的用法。
二妙散
茅山苍术（生用） 川黄柏（炒黑）
研成细末。捣碎生姜，用煎沸的水调服。
王晋三说：这是偶方中的小制方。苍术生用，入阳明经，能发两阳之汗；黄柏炒黑，入太阴经，能除至阴之湿。一为生药，一为熟药，互为表里，治疗阴分的湿热，效果有如鼓应桴那样神奇。
生姜泻心汤
生姜（四两） 甘草（炙） 人参 黄芩（各三两） 半夏（半升） 黄连 干姜（各一两） 大枣（十二枚）
用水一斗，煮取六升，去渣；再煎取三升，温服一升，每日三次。
徐洄溪说：发汗后邪气未尽，必然在心下留有饮邪，其症状非常复杂。而方中的各种药物，一一针对症状。其中有一种药治疗两种症状的，也有两种药合治一种症状的，错综变化，攻补兼施，寒热互用，都依据《内经》立方的各种方法，其药性又都与《神农本草经》所载完全吻合，学医的人如果能对这些方剂推究其原理并加以拓展，就能掌握主动权了。
半夏泻心汤
半夏（半升） 黄芩 干姜 甘草（炙） 人参（各二两） 黄连（一两） 大枣（十二枚）
用水一斗，煮取六升，去渣；再煎取三升，温服一升，每日三次。
方中行说：半夏、干姜，辛味以消散虚满之痞塞。黄芩、黄连，苦味以泄除心膈之热。人参、甘草，甘味以补益下利后的虚弱。大枣，甘温润燥以滋养脾胃之津液。称为“泻心”，是说病满在心膈而不在胃。
大黄黄连泻心汤
大黄（二两） 黄连（一两）
用滚开的麻沸汤二升浸泡这些药，片刻后，绞去药渣，分两次温服。
尤在泾说：成无己说：这是引导虚热的方子。所谓虚热，是相对于燥屎而言的。邪热入里与糟粕相结，就是实热；不与糟粕相结，就是虚热。这里说的不是阴虚或阳虚的意思。本方以大黃、黄连为药，而不用枳实、厚朴等药，是因为要泄虚热，而不是要荡涤实热。
王氏按语：不仅是不用枳实、厚朴等药。这两味药只用麻沸汤浸泡，片刻就绞汁，味道很淡，才可以泄虚热。如果浸泡时间长味道浓，即使没有枳实、厚朴，也能下行肠胃。汪氏按语：尤氏的解释极其精妙。梦隐先生更从煎法来解释，也很巧妙！
附子泻心汤
大黄（二两，酒浸） 黄连（炒） 黄芩（炒，各一两） 附子（一枚，去皮，另煮取汁）
用麻沸汤二升，浸泡前三味药，片刻后绞去药渣；加入附子汁，分两次温服。
徐洄溪说：前方是方法中最奇特的，不采用煎煮而采用泡渍，想要它轻扬清淡，以清除上焦的邪气。此法更加精妙。附子用煎煮，其他三味用泡渍，扶阳气，想要它热而性重；开痞结，想要它生而性轻。
王氏按语：看这个就知道用药的道理。
邹润安说：心的形体，在卦象中属离，现在被邪气逼迫，则外阳内伐，内阴沸腾。所以半夏、甘草、生姜三个泻心汤，治疗阴邪尚未转化的情况。大黄黄连、附子两个泻心汤，治疗阴邪已经转化的情况。阴邪已转化，不再逼迫心阳，则体内的沸乱略微平定。只有体外的邪气尚且阻滞，才取大黄、黄连的泄热作用，荡涤去除邪气，邪去正气自然安宁。恶寒汗出的，是上部的阴邪刚转化，下部的阴气又逆乱，所以轻取大黄、黄连的气以荡热除秽。重用附子的威势，以追逐逆乱的阴气，使它们异途同归，相辅相成而不相违背。那些未转化的，阳气在阳位虚弱，而在阴分肆意妄为，邪气盘踞在清道，而下焦溃泄，非干姜、半夏、生姜振奋驱散阴霾不足以廓清心的外围。非人参、黄连滋养阴液泄除热邪不足以安抚内心的混乱。又说，我治疗疟疾发作前先呕吐的，用半夏泻心汤。吐泻交替发作的，用生姜泻心汤。胸中痞塞下利的，用甘草泻心汤，都效如桴鼓。
小承气汤
大黄（四两） 浓朴（二两） 枳实（三枚）
用水四升，煮取一升二合，去滓，分两次温服。初次服药后，应当排便；如果不排便，就把药全部喝完。如果排了便就不要服用。
王氏按语：在大承气汤中去掉芒硝并减少枳实、厚朴，又让大黄同煎，从而缓和其荡涤的性质，古人称之为和胃的药剂，所以叫小承气汤。
牛黄清心丸
陕西牛黄（二分五厘） 镜面朱砂（一钱五分） 生黄连（五钱） 黄芩 山栀（各三钱） 郁金（二钱）
研成细末，用蒸饼做成糊状，丸如黍米大。每次服用七八丸。
王晋三说：这个丸药古时有几个方子，含义各不相同。如果是治疗温邪内陷，包络神昏的，只有万全的这个方子最妙。因为温热邪气进入心包络，邪气在里了。草木的香气，只能到达体表，不能透达内部，必须借助牛黄幽香的物性，才能内透包络，与神明相合，然而尤其在于佐使之品的配合都很适宜。万全用黄芩、黄连、山栀来泻心火。郁金来通心气。辰砂来镇心安神，加上牛黄的相使之妙。这个丸药调入犀角、羚羊角、金汁、甘草、人中黄、连翘、薄荷等汤剂中，颇建奇功。
王氏按语：周公谨说：《局方》牛黄清心丸，只是前八味到蒲黄为止。自山药以后，共二十一味，乃是补虚中山芋丸。当时不知道为什么会错误地合并为一个方子，因循守旧不曾改正，贻误后人不少。凡是这类情况，读书人不可不知道。有一个方子用牛黄、雄黄、黄连、黄芩、栀子、犀角、郁金、朱砂各一两、真珠五钱、冰片、麝香各二钱五分，研炼蜜丸，每重一钱，金箔为衣，蜡封，功效比万方更好。汪氏按语：万方太轻，这个方子较有力。
至宝丹
生乌犀角 生玳瑁 琥珀 镜面朱砂（研飞） 雄黄（研飞，各一两） 西牛黄（五钱） 龙脑（研） 麝香（研，各一钱） 安息香（一两五钱，为末，酒研飞净一两，熬膏，用水安息尤妙） 金箔银箔（各五十片，研细为衣）
先将犀角、玳瑁研为细末，加入其余药物研匀，将安息香膏，隔水加热煮，凝固后，加入诸药中，调和搜制成剂，丸如梧桐子大，蜡护，临服时剖开，用人参汤化下三丸至五丸。《本事方》中有加入人参、南星、天竺黄。
王晋三说：这是治疗心脏神昏，从表透里的方子。牛黄、犀角、玳瑁、琥珀，以有灵之物，内通心窍。朱砂、雄黄、金箔银箔，以重坠之品，安镇心神。佐以冰片、麝香、安息香，搜剔幽隐诸窍。东垣说：冰片、雄黄、牛黄、麝香，入骨髓，透肌肤。抱朴子说：金箔、雄黄，合服为地仙，若与丹砂同用为圣金。服用可以飞升。所以热入心包络，舌绛神昏的，以此丹加入寒凉汤药中使用。能祛阴起阳，立即展现神明，有不是其他药物所能比的。徐氏说：安神定魄，必备之方，真是神丹啊。如果病因头痛而导致神昏不语的，这是肝虚魂升于顶，应当用牡蛎救逆汤以降之，这又不是至宝丹所适宜轻易尝试的。
凉膈散（一名连翘饮子）
连翘（四两） 大黄（酒浸） 芒硝 甘草（各二两） 黄芩（酒炒） 薄荷 栀子（各一两）
研为粗末。每次服用三五钱，加竹叶七片，水一碗半，煎至一碗，去滓；加入生白蜜一匙，微煎温服。
与四物汤各半服，能和营泄热，名叫双和散。《本事方》中加入赤芍、干葛，治疗各种热证屡见疗效。《玉机》说：轻症，宜用桔梗汤。汪氏按语：此方与第二方桔梗汤同名实异。即本方去掉硝石、大黄，加入桔梗这种舟楫之品。使其浮而上行，去除膈中无形的热邪，且不侵犯中下二焦。
王氏按语：此方的加减法，详见《宣明论》。
徐洄溪说：这是泻中上二焦的火，也就是调胃承气汤加上疏风清火的药物。
余师愚说：热淫于内，用咸寒治疗，佐以苦甘，所以用连翘、黄芩、竹叶、薄荷升散于上。大黄、芒硝推荡其中。使上升下行，而膈自清了。我认为疫疹乃无形的热邪，投以硝黄的猛烈，必然导致内溃，因此去掉硝黄，加入生石膏、桔梗，使热降清升，而疹自透，也是上升下行的意义。
王氏按语：法度本来宣明，剪裁很好。
犀角地黄汤
暹罗犀角（磨汁） 连翘（各三钱） 生地（五钱） 生甘草（五分）
用水二钟，武火煎煮三味药至八分，去滓；加入犀角汁调和服用。
王晋三说：温热入络，舌绛烦热，八九日不解，医生反而治疗经脉，用寒法、散法、攻法，热势更加炽盛，得到这个汤剂立刻见效的。这不是解除阳明热邪，而是解心经的络热。按《本草》，犀角、地黄能走心经，专解营分热。连翘入心，散客热。甘草入心，和络血。用来治疗温热证，热邪入络，功效胜过《局方》。
导赤散
生地 木通 甘草梢（各等分，王氏按语：生地、木通不应等分。）
水煎服，或加淡竹叶。汪氏按语：古方淡竹叶即竹叶也，淡竹乃竹名耳。今药肆所售淡竹叶草，是小青之别种，性能凉胃，不能清心，医人每多误用。
王氏按语：本方去掉甘草，加入黄芩蜜丸，名叫火府丹，也治疗心热溺涩淋渴等证；本方加入升麻、黄连、丹皮，名叫升麻清胃汤。轻清凉血，是秦皇士透化斑疹的良好药剂。
理中丸
人参 甘草（炙） 术 干姜（各三两）
捣筛为末，蜜和为丸，如鸡子黄大。用沸汤数合和一丸，研碎温服之。日三四服，夜二服。腹中未热，益至三四丸。
王氏按语：“未热”二字，须着眼，腹中不冷者，其可服乎。
然而不及汤。汤法：以四味根据两数切，用水八升，煮取三升，去渣，温服一升，日三。
徐洄溪说：这是张仲景治疗寒多霍乱的方子，大概也是伤寒之类。后人把暑月的吐利当作此证，也用此方，更造出大顺散的，都是无稽之谈。
四君子汤
人参 白术（炒） 茯苓（各二钱） 甘草（炙，一钱） 生姜（三片） 大枣（二枚）
水煎，温服。
徐洄溪说：这是补脾的主方。
玉女煎
生石膏（三五钱） 熟地（三五钱或一两） 麦冬（二钱） 知母 牛膝（各一钱五分）
水一钟半，煎七分服。
王氏按语：陈修园极力批判此方的谬误。然而用它治疗阴虚胃火炽盛的齿痛，颇有捷效。如果治疗温热病，地黄宜用生的，牛膝宜删去。叶天士引用，绝不泥守成方，最近读《景岳发挥》，果然与陈氏的论点印证。
四物汤
生地 当归（各三两） 芎 （一两五钱） 芍药（二两）
切碎。每次服用四钱，水二盏，煎八分，去滓，温服。
张路玉说：四物是阴血受病的专药，不是调补真阴的药。
汪氏按语：调补真阴宜用集灵膏。不宜用四物，而人们多误会。
小柴胡汤
柴胡（半斤） 黄芩 人参 甘草（炙） 生姜（各三两） 半夏（半升） 大枣（十二枚）
用水一斗二升，煮取六升，去滓；再煎取三升，温服一升，每日三次。
尤拙吾说：热入血室三条，其旨意不同。第一条是血舍空而热乃入者，空则热不得聚而游其部，故胁满痛。第二条是热邪与血俱结于血室者，血结亦能作寒热，柴胡亦能去血结，不独和解之谓矣；第三条是热邪入而结，经尚行者，经行则热亦行而不得留，故必自愈。无犯胃气及上二焦，病在血而不在气，在下而不在上也。若诛伐无过，变证随出，乌能自愈耶？
沈再平说：现在人治疗疟疾，必定用此汤。如果不是此汤，就不足以治疗的。所以导致辗转淹滞，变生不测，竟能殒命，就知道疟疾本非死证，只是概以柴胡治疟的，是杀之也。夫柴胡为少阳表药，如果其疟果发于少阳，而以柴胡治之，无不立愈。如果系他经用之，则必使他经之邪辗转而入少阳，迁延以毙，乃既死犹曰：柴胡为治疟主药，吾开手即用之，不知其何以死？病家也以柴胡治疟而竟不效，真其命之当死也。彼此昏迷，不得一悟，良可浩叹！
王氏按语：《内经》论疟，既分六经，又分脏腑，并不泥定少阳一经，医家绎之。
王氏按语：本方柴胡、半夏各八两，准今得六钱零八厘。人参、甘草、茯苓、生姜各三两，准今得二钱二分八厘。枣十二枚。以水一斗二升，准今得八合零四抄，煮至减半，去滓，再煎至减半，夫煎而又煎，只取四分之一，其汤之浓郁甘柔可知。喻氏谓和药取其各药气味之相和。余谓和者，取其气缓味浓，斯为补正托邪之剂。故惟风寒正疟，邪在少阳者，可以按法而投。则人参、甘草、生姜、大枣，补胃充营。半夏利其枢。柴胡、黄芩解其热。病无不愈矣。犹之今人于疟发之先，饱啖羊肉酒饭，亦能取效。汪氏按语：疟疾寒来之时。强食过饱。往往一寒不能复热而死。吾见甚多。不可不戒。盖风寒自表而受，胃腑空虚，自能安谷，治必先助中气，托邪外出，即御外邪，杜其内入，诚一举两全之策也。若温热暑湿诸疟，邪从口鼻而受，肺胃之气，先已窒滞，病发，即不饥恶谷，脘闷苔黄，苟不分别，但执此汤，奉为圣法。则人参、甘草、生姜、大枣，温补助邪，骤则液涸神昏，缓则邪留结痞，且有耗伤阴血而成疟劳者。即不用全方，而专以柴胡为治疟主药，亦惟营阴充裕，或温热暑湿之邪，本不甚重。及兼感风寒之表邪者，始可见功。汪氏按语：治正疟必宜此汤。温暑亦有正疟。不独风寒方用。黄芩是清热非祛寒也。且柴胡主少阳半表半里。黄芩里药。亦非以治表邪。但当辨其是否正疟耳。若似疟非疟。妄用柴胡。必提成长热不退。或两耳大痛。甚至神昏。更或引动肝风痉厥立至。生平见之屡矣。故倪涵初所定三方，亦愈病者稀而加病者多也。汪氏按语：疟疾强止变成臌胀者多不救。而人但知其臌胀而死。未尝归咎于治疟之不善，故医者终身误人而不自知。虽告之不信也。世人凡患疟，不究病因，辄以姜枣汤灌之，其弊类此，羊肉亦然。凡属时疟，虽愈后亦忌食，食则必复，此时疟之所以异于正疟也。可不察哉！
桂枝红花汤
《伤寒论》桂枝汤加红花。
原方桂枝芍药、生姜（各三两） 甘草（炙，二两） 大枣（十二枚）
葱豉汤
葱白（一握） 香豉（三合）
水煎，入童子小便一合，日三服。
王氏按语：芦根、桑叶、滑石、蔗浆之类，皆可随证佐用。
张路玉说：本方药味虽轻，功效最着。凡虚人，风热伏气发温，及产后感冒，靡不随手获效。
尤拙吾说：温邪之发，阴必先伤，设有当行解散者，必兼滋阴之品于其中。昔人于葱豉汤内加童便。于栀豉汤中加
Pounded into a powder. Take one *cun* bi (a measure of volume) with Jiangshui (fermented grain water), three times daily. Wang's note: Chixiaodou (Vigna angularis) is a small variety of ChiDou (Adzuki bean). Currently, pharmacies use Xiangsizi (Abrus precatorius), which is half red and half black, as Chixiaodou. Many physicians also mistakenly use it. However, Xiangsizi cannot sprout. This alone proves the error in this prescription.
**Er Miao San (Two-Awesome Powder)**
Maoshan Cangzhu (Atractylodis Rhizoma, used raw) Chuan Huangbai (Phellodendri Cortex, stir-fried until black)
Grind into fine powder. Crush fresh Shengjiang (Zingiberis Rhizoma Recens), and take mixed with boiling water.
Wang Jinsan said: This is a small formulation within an even-numbered formula. Cangzhu, when used raw, enters the Yangming channel and can induce sweating from the two Yang channels; Huangbai, when stir-fried until black, enters the Taiyin channel and can eliminate dampness from the extreme Yin. One raw, one cooked, they act as exterior and interior to each other. Treating damp-heat in the Yin division is as effective as a drum responding to a drumstick.
**Shengjiang Xiexin Tang (Fresh Ginger Decoction for Draining the Epigastrium)**
Shengjiang (4 liang) Gancao (Licorice Root, honey-fried) Renshen (Ginseng Radix et Rhizoma) Huangqin (Scutellariae Radix) (each 3 liang) Banxia (Pinelliae Rhizoma) (half sheng) Huanglian (Coptidis Rhizoma) Ganjiang (Zingiberis Rhizoma) (each 1 liang) Dazao (Jujubae Fructus) (12 pieces)
Add 1 dou (approx. 10 liters) of water, boil to obtain 6 sheng (approx. 6 liters), remove dregs; decoct again to obtain 3 sheng (approx. 3 liters). Take 1 sheng warm, three times daily.
Xu Huixi said: After sweating, if pathogens are not fully exhausted, there must be retained fluid in the epigastrium, and the symptoms are very complex. The various herbs in the formula correspond precisely to the symptoms. Among them, one herb treats two symptoms, and two herbs combine to treat one symptom. Through intricate changes, attacking and tonifying are applied together, cold and hot properties are used mutually, all based on the methods of prescribing in the *Neijing*. Their medicinal properties also perfectly match those recorded in the *Shennong Bencao Jing*. If students can study the principles behind such formulas and expand upon them, they will have mastery over their application.
**Banxia Xiexin Tang (Pinellia Decoction for Draining the Epigastrium)**
Banxia (half sheng) Huangqin Huanglian Gancao (honey-fried) Renshen (each 2 liang) Huanglian (1 liang) Dazao (12 pieces)
Add 1 dou of water, boil to obtain 6 sheng, remove dregs; decoct again to obtain 3 sheng. Take 1 sheng warm, three times daily.
Fang Zhongxing said: Banxia and Ganjiang, being acrid, dissipate the fullness and palpitations caused by deficiency. Huangqin and Huanglian, being bitter, drain the heat in the heart and diaphragm. Renshen and Gancao, being sweet, benefit the deficiency after purging/diarrhea. Dazao, being sweet, moist, and warm, nourishes the fluids of the spleen and stomach. It is called "Xiexin" (Draining the Heart) because the fullness is in the heart-diaphragm region, not in the stomach.
**Dahuang Huanglian Xiexin Tang (Rhubarb and Coptis Decoction for Draining the Epigastrium)**
Dahuang (2 liang) Huanglian (1 liang)
Soak in 2 sheng of boiling hemp tea (Mafeitang - boiling water) for a moment, then strain off the dregs. Divide into two warm doses.
You Zaijing said: Cheng Shi said: This is a formula to guide away deficient heat. By "deficient heat," he refers to it in contrast to dry feces. When pathogenic heat enters the interior and binds with waste matter, it becomes excess heat; when it does not bind with waste matter, it becomes deficient heat. This does not refer to yin deficiency or yang deficiency. This formula uses Dahuang and Huanglian but does not use Zhishi (Immature Bitter Orange) or Houpo (Magnolia Bark) etc., because it aims to drain deficient heat, not to purge excess heat.
Xiong's note: Not only are Zhishi and Houpo not used. These two herbs are only soaked in boiling water for a moment and then strained; their flavor is very light, which allows them to drain deficient heat. If soaked for a long time, the flavor becomes strong, and even without Zhishi and Houpo, they would descend to the intestines and stomach. Wang's note: You's explanation is extremely exquisite. Mengyin further explains it through the decoction method, which is also brilliant!
**Fuzi Xiexin Tang (Aconite Decoction for Draining the Epigastrium)**
Dahuang (2 liang, soaked in wine) Huanglian (stir-fried) Huangqin (stir-fried, each 1 liang) Fuzi (Aconiti Lateralis Radix Praeparata) (one piece, skin removed, boiled separately to extract juice)
Use 2 sheng of boiling water to soak the first three herbs for a moment, then strain off the dregs; add the Fuzi juice. Divide into two warm doses.
Xu Huixi said: The previous formula is the most unique in method, using soaking instead of decoction, desiring its light and clear nature to cleanse the upper jiao pathogens. This method is even more refined. Fuzi is decocted, while the other three are soaked. For supporting yang, we want it hot and heavy in nature; for opening palpitations, we want it raw and light in nature.
Xiong's note: From this, one can understand the way of using medicines.
Zou Run'an said: The heart, in terms of trigram imagery, corresponds to Li (Fire). Now, being forced by pathogens, external yang invades internally, and internal yin boils. Therefore, the Banxia, Gancao, and Shengjiang Xiexin Tangs treat cases where yin pathogens have not yet transformed. The Dahuang Huanglian and Fuzi Xiexin Tangs treat cases where yin pathogens have already transformed. When yin pathogens have transformed, they no longer force heart yang, so the internal turmoil slightly settles. Only when external pathogens remain obstructed do we take the heat-draining power of the two yellows (Dahuang and Huanglian) to sweep away the pathogens; once pathogens are gone, righteousness naturally rests. In cases of aversion to cold and sweating, the yin pathogens in the upper part have just transformed, and the yin qi in the lower part has reversed. Thus, we lightly take the qi of the two yellows to sweep away heat and filth. We heavily rely on the authority of Fuzi to chase away the reversing yin, making them converge towards the same goal, complementing rather than opposing each other. In cases where transformation has not occurred, yang is weak in the yang position and runs rampant in the yin division. Pathogens occupy the clear pathways and leak into the lower jiao. Without Ganjiang, Banxia, and Shengjiang to振奋 (stimulate) and disperse the dark clouds, the outer boundary of the heart cannot be cleared. Without Renshen and Huanglian to nourish yin and drain heat, the internal strife of the heart cannot be pacified. He also said: In my treatment of malaria where vomiting precedes the attack, I use Banxia Xiexin Tang. For alternating vomiting and diarrhea, I use Shengjiang Xiexin Tang. For chest palpitations and diarrhea, I use Gancao Xiexin Tang. All yield results as promptly as a drum responding to a stick.
**Xiao Chengqi Tang (Minor Order the Qi Decoction)**
Dahuang (4 liang) Nongpu (Houpo/Magnolia Bark) (2 liang) Zhishi (Immature Bitter Orange) (3 pieces)
Add 4 sheng of water, boil to obtain 1.2 sheng, remove dregs. Divide into two warm doses. After the first dose, defecation should occur; if not, drink the rest. If defecation occurs, do not take the remaining medicine.
Xiong's note: In Xiao Chengqi Tang, Mangxiao (Mirabilite) is removed from Da Chengqi Tang, and Zhishi and Houpo are reduced. Furthermore, Dahuang is decocted together, slowing its purgative nature. The ancients called this a harmonizing stomach agent, hence the name Xiao Chengqi Tang.
**Niuhuang Qingxin Wan (Calves' Gallbladder Pill for Clearing the Heart)**
Shaanxi Niuhuang (Calculus Bovis) (2.5 fen) Jingmian Zhusha (Cinnabaris) (1.5 qian) Sheng Huanglian (5 qian) Huangqin Zhizi (Gardeniae Fructus) (each 3 qian) Yujin (Curcumae Radix) (2 qian)
Grind into powder, make paste with steamed wheat cake pills, size of millet seeds. Take 7-8 pills per dose.
Wang Jinsan said: There have been several ancient formulas for this pill, each with different meanings. If treating warm pathogens sinking inward causing confusion due to involvement of the Pericardium, only Wan Quan's formula is excellent. Because warm-heat enters the Pericardium, the pathogen is in the interior. The fragrance of herbs can only reach the surface, not penetrate the interior. One must rely on the subtle fragrance of Niuhuang to penetrate the Pericardium internally and merge with the Spirit. However, the efficacy especially lies in the appropriate combination of assistant and courier herbs. Wan Quan uses Huangqin, Huanglian, and Zhizi to drain Heart Fire. Yujin to unblock Heart Qi. Zhusha to calm and anchor the Heart Spirit. Combined with the assisting effect of Niuhuang. This pill, when added to decoctions of Xijiao (Rhinoceros Horn), Lingyangjiao (Antelope Horn), Jinzhi (Gold Juice), Gancao, Renzhonghuang, Lianqiao, Bohe, etc., achieves remarkable results.
Xiong's note: Zhou Gongjin said: The *Ju Fang* Niuhuang Qingxin Wan consists only of the first eight ingredients up to Puhuang. From Shanyao onwards, there are twenty-one ingredients, which belong to the Bushu Zhongshan Wan. At that time, it was unknown why they were erroneously merged into one, and following convention without correction has misled later generations significantly. Readers must be aware of such matters. Another formula uses Niuhuang, Xionghuang, Huanglian, Huangqin, Zhizi, Xijiao, Yujin, Zhusha (each 1 liang), Zhenzhu (Pearl) (5 qian), Bingpian (Borneolum Syntheticum), Shexiang (Moschus) (each 2.5 qian). Grind and mix with refined honey to form pills weighing 1 qian each, coated with Jinbo (Gold Foil), sealed in wax. Its efficacy is superior to Wan Quan's formula. Wang's note: Wan Quan's formula is too light; this one is more potent.
**Zhibao Dan (Precious Treasure Pellet)**
Sheng Wu Xijiao (Black Rhinoceros Horn) Sheng Daimao (Eretmochelys Carapax) Hupo (Succinum) Jingmian Zhusha (ground and floated) Xionghuang (Realgar) (ground and floated, each 1 liang) Xi Niuhuang (5 qian) Longnao (Borneolum) (ground) Shexiang (Moschus) (ground, each 1 qian) Anxi Xiang (Styrax) (1.5 liang, made into powder, washed clean with wine to 1 liang, boiled into paste, using water-styrax is better) Jinbo Yinbo (Gold and Silver Foil) (each 50 pieces, ground fine for coating)
First grind Xijiao and Daimao into fine powder, mix evenly with other herbs. Heat the Anxi Xiang paste in a double boiler. After it solidifies, add to the other herbs, knead into a mass, and form pills the size of wutong seeds. Seal with wax. Before taking, break open and dissolve 3-5 pills in Renshen Tang (Ginseng Decoction). The *Baoshi Fang* adds Renshen, Nanxing (Arisaema Cum Bile), and Tianzhu Huang (Bambusa Textilis Calamus).
Wang Jinsan said: This is a formula for treating cardiac confusion, penetrating from the exterior to the interior. Niuhuang, Xijiao, Daimao, and Hupo, being spiritual substances, internally open the heart orifices. Zhusha, Xionghuang, and the two foils, being heavy and sinking, calm and anchor the heart spirit. Assisted by Longnao, Shexiang, and Anxi Xiang to search out and eliminate hidden pathogens in various orifices. Dongyuan said: Bingpian, Xionghuang, Niuhuang, and Shexiang enter the bone marrow and penetrate the skin. Baopuzi said: Jinbo and Xionghuang, taken together, make one an earthly immortal; combined with Zhusha, they become sacred gold. Taking them allows one to ascend. Therefore, for heat entering the Pericardium with a crimson tongue and confusion, this pellet is added to cold-cooling decoctions. It can dispel yin and raise yang, immediately restoring clarity of mind, surpassing other medicines. Xu's note: A necessary formula for calming the spirit and stabilizing the soul, truly a divine pellet. However, if the cause of confusion and muteness is headache, this indicates Liver deficiency with Hun rising to the vertex. One should use Muli Jiuni Tang (Oyster Shell Rescue Reversal Decoction) to descend it. This is not suitable for the casual use of Zhibao Dan.
**Liangge San (Cool the Diaphragm Powder)**
Lianqiao (4 liang) Dahuang (soaked in wine) Mangxiao (Natrii Sulfas) Gancao (each 2 liang) Huangqin (wine-fried) Bohe (Menthae Haplocalycis Herba) Zhizi (each 1 liang)
Grind into coarse powder. Take 3-5 qian per dose, add 7 leaves of Zhuye (Bamboo Leaf), 1.5 bowls of water, decoct to 1 bowl, remove dregs; add 1 spoonful of raw white honey, simmer slightly, and take warm.
Taking half this formula and half Siwu Tang harmonizes the nutritive level and drains heat, named Shuanghe San. The *Baoshi Fang* adds Chishao (Red Peony Root) and Gange (Puerariae Radix) to treat various heat conditions with repeated efficacy. The *Yuji* says: For mild cases, Jiegeng Tang is appropriate. Wang's note: This formula and the second Jiegeng Tang share the same name but differ in substance. It is this formula minus Mangxiao and Dahuang, plus Jiegeng (Platycodon Root), a boat-like herb that floats upward. It removes无形 (formless) heat from the diaphragm without affecting the middle and lower jiao.
Xiong's note: The modification methods for this formula are detailed in the *Xuanming Lun*.
Xu Huixi said: This drains fire from the middle and upper jiao, essentially Tiaowei Chengqi Tang plus wind-dispersing and fire-clearing herbs.
Yu Shiyu said: When heat floods the interior, treat with salty-cold, assisted by bitter-sweet. Thus, Lianqiao, Huangqin, Zhuye, and Bohe ascend and disperse upwards. Dahuang and Mangxiao push downwards in the middle. Making them rise and fall clears the diaphragm. I believe epidemic rashes are formless heat. Using the fierce Mangxiao and Dahuang would inevitably cause internal collapse. Therefore, I remove Mangxiao and Dahuang, adding Sheng Shigao (Gypsum Fibrosum) and Jiegeng, so that heat descends and clarity rises, allowing the rash to emerge smoothly. This follows the principle of ascending and descending.
Xiong's note: The method is inherently clear, and the modifications are well-executed.
**Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction)**
Xiluo Xijiao (Siamese Rhinoceros Horn, ground into juice) Lianqiao (each 3 qian) Shengdi (Rehmanniae Radix) (5 qian) Sheng Gancao (Licorice Root) (5 fen)
Add 2 zhong of water. Use high heat to decoct the three herbs to 0.8 zhong, remove dregs; mix with Xijiao juice and take.
Wang Jinsan said: When warm-heat enters the collaterals, causing a crimson tongue and vexing fever unresolved for 8-9 days, if doctors mistakenly treat the meridians using cold, dispersing, or purging methods, the heat intensifies. Getting immediate relief from this decoction indicates it is not resolving Yangming heat, but rather collateral heat of the Heart channel. According to the *Bencao*, Xijiao and Dihuang can travel to the Heart channel, specifically resolving Ying-level heat. Lianqiao enters the Heart to scatter guest heat. Gancao enters the Heart to harmonize collateral blood. Used for warm-heat syndromes where heat enters the collaterals, its efficacy surpasses the *Ju Fang*.
**Daochi San (Guide Out Red Powder)**
Shengdi Mutong (Akebiae Caulis) Gancao Shao (Licorice Root Tip) (equal parts. Xiong's note: Shengdi and Mutong should not be equal.)
Decoct in water and take, or add Dan Zhuye (Light Bamboo Leaf). Wang's note: Anciently, Dan Zhuye referred to Zhuye. Dan Zhu is merely a type of bamboo. The current "Dan Zhuye" sold in pharmacies is a different species of Xiaoqing, whose nature cools the Stomach but does not clear the Heart. Physicians often misuse it.
Xiong's note: Removing Gancao from this formula and adding Huangqin to make honey pills creates Huofu Dan, which also treats heart heat, difficult urination, strangury, and thirst. Adding Shengma (Cimicifugae Rhizoma), Huanglian, and Mudanpi (Tree Peony Root Bark) creates Shengma Qingwei Tang. Lightly cooling and clearing blood, it is an excellent agent by Qin Huangshi for transforming rashes.
**Lizhong Wan (Regulate the Middle Pill)**
Renshen Gancao (honey-fried) Zhu (Atractylodis Macrocephalae Rhizoma) Ganjiang (each 3 liang)
Pound and sieve into powder, mix with honey to form pills the size of chicken egg yolks. Dissolve one pill in a few mouthfuls of boiling water, crush, and take warm. Take 3-4 times daily, 2 times at night. If the abdomen does not feel warm, increase to 3-4 pills.
Xiong's note: Pay attention to the words "not warm." If the abdomen is not cold, how can it be taken?
However, it is inferior to the decoction. Decoction method: Cut the four ingredients according to the weight, add 8 sheng of water, decoct to 3 sheng, remove dregs, take 1 sheng warm, three times daily.
Xu Huixi said: This is Zhang Zhongjing's formula for treating cold-dominant Huoluan (cholera-like disorder), which is also a type of Shanghan (Cold Damage). Later generations applied it to summer vomiting and diarrhea, and even created Dasun San, all baseless theories.
**Sijunzi Tang (Four Gentlemen Decoction)**
Renshen Baizhu (Stir-fried) Fuling (Poria) (each 2 qian) Gancao (honey-fried, 1 qian) Shengjiang (3 slices) Dazao (2 pieces)
Decoct in water and take warm.
Xu Huixi said: This is the primary formula for tonifying the Spleen.
**Yunü Jian (Jade Woman Decoction)**
Sheng Shigao (Gypsum Fibrosum) (3-5 qian) Shudi (Prepared Rehmanniae Radix) (3-5 qian or 1 liang) Maidong (Ophiopogonis Radix) (2 qian) Zhimu (Anemarrhenae Rhizoma) Niuxi (Achyranthis Bidentatae Radix) (each 1.5 qian)
Add 1.5 zhong of water, decoct to 0.7 zhong and take.
Xiong's note: Chen Xiuyuan strongly criticized the fallacies of this formula. However, it has rapid effects when used to treat toothache caused by yin deficiency with blazing stomach fire. If treating warm-heat diseases, Shengdi (raw) should be used, and Niuxi should be omitted. Ye Tianshi cited it without rigid adherence to established formulas. Recently reading *Jingyue Faxing*, it indeed corroborates Chen's arguments.
**Siwu Tang (Four Substances Decoction)**
Shengdi Danggui (Angelicae Sinensis Radix) (each 3 liang) Xiongqiong (Chuanxiong Rhizoma) (1.5 liang) Shaoyao (Peoniae Radix) (2 liang)
Chop. Take 4 qian per dose, add 2 lamps of water, decoct to 0.8, remove dregs, take warm.
Zhang Luyu said: Siwu Tang is the specific medicine for diseases of Yin and Blood, not for tonifying True Yin.
Wang's note: To tonify True Yin, Jiling Gao should be used, not Siwu Tang, yet many misunderstand this.
**Xiao Chaihu Tang (Minor Bupleurum Decoction)**
Chaihu (Bupleuri Radix) (half jin) Huangqin Renshen Gancao (honey-fried) Shengjiang (each 3 liang) Banxia (half sheng) Dazao (12 pieces)
Add 1.2 dou of water, boil to obtain 6 sheng, remove dregs; decoct again to obtain 3 sheng. Take 1 sheng warm, three times daily.
You Zhuowu said: The three cases of "Heat Entering the Blood Chamber" have different meanings. The first case is where the Blood Chamber is empty and heat enters; emptiness prevents heat from gathering, so it wanders, causing hypochondriac fullness and pain. The second case is where heat pathogens and blood both bind in the Blood Chamber; blood binding can also cause chills and fever. Chaihu can also resolve blood binding, not just harmonize. The third case is where heat enters and binds, but menstruation is still flowing; since menstruation flows, heat flows with it and cannot stay, so it must heal itself. Do not harm the Stomach Qi and the upper two jiao. The disease is in the Blood, not Qi; in the lower, not upper. If you punish what is innocent, complications will arise, how can it heal itself?
Shen Zaiping said: Modern physicians always use this decoction for malaria. If not this decoction, they think it is insufficient for treatment. This leads to lingering illness, unexpected complications, and even death. Thus, we know malaria is not inherently fatal; it is killed by indiscriminately using Chaihu for malaria. Chaihu is a Shaoyang exterior herb. If malaria truly originates in Shaoyang, treating with Chaihu ensures immediate recovery. If used for other channels, it causes pathogens from other channels to gradually enter Shaoyang, leading to prolonged illness and death. Yet, even after death, they say: "Chaihu is the main drug for malaria, I used it from the start." They do not know why they died. Patients also think: "Chaihu failed to cure my malaria, so I deserved to die." Both sides are confused and unwilling to awaken, which is truly sigh-worthy!
Xiong's note: The *Neijing* discusses malaria, dividing it by Six Channels and Zang-Fu organs, not sticking rigidly to the Shaoyang channel alone. Physicians should interpret this.
Xiong's note: In this formula, Chaihu and Banxia are each 8 liang, equivalent to today's 6 qian 8 li. Renshen, Gancao, Fuling, and Shengjiang are each 3 liang, equivalent to today's 2 qian 2 fen 8 li. 12 Dazao. Water 1.2 dou, equivalent to today's 8 he 4 chao. Boil to half, remove dregs, decoct again to half. Since it is decocted twice, only one-quarter remains. The richness and sweetness of the decoction can be imagined. Yu Shi said harmonizing drugs takes the harmony of flavors. I say "harmonizing" means taking gentle qi and rich flavor, making it a formula that tonifies righteousness and expels pathogens. Therefore, only for Wind-Cold typical malaria with pathogens in Shaoyang can it be administered according to method. Then Renshen, Gancao, Shengjiang, and Dazao tonify the Stomach and fill Ying. Banxia facilitates the pivot. Chaihu and Huangqin resolve heat. Illnesses will surely heal. It is like modern people eating mutton and drinking alcohol before a malaria attack, which can also be effective. Wang's note: During the chills phase of malaria, forcing food until overly full often leads to death because one chill cannot return to heat. I have seen this many times. Must beware. Since Wind-Cold is received from the exterior, and the Stomach is empty, it can naturally digest grain. Treatment must first assist Middle Qi to push pathogens out, defending against external pathogens and preventing internal entry. This is truly a strategy achieving two goals with one move. However, for warm-heat, summer-heat, and dampness malaria, where pathogens enter via mouth and nose, Lung and Stomach Qi are already obstructed. Upon onset, there is lack of appetite, aversion to food, epigastric stuffiness, and yellow coating. If not distinguished, and this decoction is blindly followed as a holy method, then Renshen, Gancao, Shengjiang, and Dazao, being warm and tonifying, will aid the pathogen. Rapidly, fluids dry up and consciousness is lost; slowly, pathogens linger and form palpitations, and Yin-Blood may be consumed leading to malaria consumption. Even without using the full formula, using Chaihu as the main drug for malaria only works if Ying-Yin is abundant, or if warm-heat/summer-heat/dampness pathogens are not severe, or if accompanied by Wind-Cold exterior pathogens. Wang's note: For typical malaria, this decoction is essential. Warm-heat and summer-heat also have typical malaria, not just Wind-Cold. Huangqin clears heat, not cold. Chaihu governs the half-exterior/half-interior of Shaoyang. Huangqin is an interior herb, not for exterior pathogens. One must distinguish whether it is typical malaria. If it resembles malaria but is not, recklessly using Chaihu will likely prolong fever, cause severe ear pain, even confusion, or trigger Liver Wind leading to spasms and convulsions. I have seen this repeatedly. Therefore, the three formulas fixed by Ni Hanchu also cure few and aggravate many. Wang's note: Malaria forcibly stopped often turns into abdominal distension (ascites), which is mostly incurable. People only know they died of ascites and never blame poor malaria treatment. Thus, physicians mislead others lifelong without realizing it. Even if told, they don't believe. Common people suffering from malaria, without investigating the cause, pour Ginger-Jujube Tea on them. The弊端 (drawbacks) are similar. Mutton is the same. For seasonal malaria, even after recovery, eating these is taboo; eating causes relapse. This is why seasonal malaria differs from typical malaria. Must observe carefully!
**Guizhi Honghua Tang (Cinnamon Twig and Safflower Decoction)**
From *Shanghan*: Guizhi Tang plus Honghua (Carthami Flos).
Original Formula: Guizhi, Shaoyao, Shengjiang (each 3 liang) Gancao (honey-fried, 2 liang) Dazao (12 pieces)
**Congchi Tang (Scallion and Fermented Soybean Decoction)**
Congbai (Scallion White) (one handful) Xiangchi (Fermented Soybean) (3 he)
Decoct in water, add 1 he of Tongzi Xiaoye (Boy's Urine), take three times daily.
Xiong's note: Genisteoside (Lugen), Sangye (Mulberry Leaf), Huashi (Talcum), Zhejiang (Sugarcane Juice), etc., can all be used as assistants according to symptoms.
Zhang Luyu said: Although the herbs in this formula are light, the efficacy is prominent. For deficient persons, wind-heat latent qi causing warmth, and postpartum colds, it yields results effortlessly.
You Zhuowu said: When warm pathogens erupt, Yin must be injured first. If dispersion is required, Yin-nourishing herbs must be included. Ancients added Boy's Urine to Congchi Tang and Gardenia to Zhichi Tang...