成湿温疫疠之病。而为发热倦怠，胸闷腹胀，肢酸咽肿，斑疹身黄，颐肿口渴，溺赤便闭，吐泻疟痢，淋浊疮疡等证。
但看病患舌苔淡白，或浓腻，或干黄者，是暑湿热疫之邪尚在气分。悉以此丹治之立效。并主水土不服诸病。汪按∶普
济消毒饮用芩、连、陈皮、元参、连翘、甘桔、升柴、马勃、鼠粘、薄荷、板蓝根、僵蚕。或加人参大黄。今附载。
神犀丹
乌犀角尖（磨汁） 石菖蒲 黄芩（各六两） 真怀生地（冷水洗净浸透，捣绞汁） 银花（各一斤，如有鲜者捣
汁用尤良） 粪清 连翘（各十两） 板蓝根（九两，无则以飞净青黛代之） 香豉（八两） 元参（七两） 花粉 紫
草（各四两）各生晒研细（忌用火炒），以犀角，地黄汁、粪清和捣为丸（切勿加蜜，如难丸可将香豉煮烂），每重三钱，
凉开水化服，日二次，小儿减半。如无粪清，可加人中黄四两，研入。
雄按∶温热暑疫诸病，邪不即解，耗液伤营，逆传内陷，痉厥昏狂，谵语发斑等证。但看病患舌色干光，或紫绛，
或圆硬，或黑苔，皆以此丹救之。若初病即觉神情昏躁而舌赤口干者，是温暑直入营分。酷暑之时，阴虚之体，及新产
妇人，患此最多。急须用此，多可挽回。切勿拘泥日数，误投别剂，以偾事也。兼治痘 毒重，夹带紫斑危证。暨痘疹
后，余毒内炽，口糜咽腐，目赤神烦诸证。方中犀角为君，镑而煎之。味极难出，磨则需时，缓不及待。抑且价昂，非
贫人所能猝办。有力者，预为合就施送，则患者易得，救活必多；贫者重生，阴功亦大。或存心之药铺照本制售。亦方
便之一端也。
温胆汤
竹茹 枳实 半夏（各一两） 橘红（一两五钱） 茯苓（七钱） 甘草（炙，四钱）每服四五钱，生姜一片，红
枣一枚，水一钟五分，煎七分服。
罗东逸曰∶胆为中正之官，清静之府。喜宁谧，恶烦扰。喜柔和，不喜壅郁。盖东方木德，少阳温和之气也。是以
虚烦惊悸者，中正之官，以 热而不宁也。热呕、吐苦者，清静之府，以郁久而不谧也。痰气上逆者，土家湿热反乘，
而木不得遂其条达也。如是者，首当清热，及解利三焦。方中以竹茹清胃脘之阳。而臣以甘草、橘、半，通胃以调其气。
佐以枳实，除三焦之痰壅。使以茯苓平渗，致中焦之清气。且以驱邪，且以养正，三焦平而少阳平，三焦正而少阳正，
胆家有不清宁而和者乎！和，即温也。温之者，实凉之也。晋三亦云∶胆气退热为温，非谓胆寒而温之也。
雄按∶此方去姜、枣，加黄连，治湿热痰而化疟者，甚妙。古人所未知也。
麻黄杏仁甘草石膏汤
药即汤见。
张石顽曰∶此大青龙汤去桂枝、越脾汤加杏仁也。
雄按∶彼二方有姜、枣。专祛上焦湿热痰气，与苓桂术甘汤互发。
彼借苓术，专祛心下之支饮。此借石膏，专祛膈上之湿热也。汪按∶此语可商石膏除热非祛湿之品也。
尤在泾曰∶汗出而喘，无大热者，其邪不在经腠而在肺中。故非桂枝所能发。麻、杏辛甘入肺，散邪气。肺被邪郁
而生热，石膏辛寒入肺，除热气。甘草甘温，安中气。且以助其散邪清热之用，乃肺脏邪气发喘之的剂也。又曰∶大青
龙主散表寒而兼清里热，故麻黄多于石膏。此清肺热而兼散肺邪，故石膏多于麻黄。
白头翁汤
白头翁（二两） 秦皮 黄连 黄柏（各三两）
水七升煮取二升，去滓，温服一升。
柯韵伯曰∶三阴俱有下利证。自利不渴者，属太阴，是脏有寒也；自利渴者，属少阴，以下焦虚寒，津液不升，故
引水自救也。惟厥阴下利属于热，以厥阴主肝而司相火。肝旺则气上撞心，火郁则热利下重。温热秽气，奔迫广肠，魄
门重滞而难出，《内经》云“暴注下迫”者是矣。脉沉为在里，弦为肝脉，是本郁之征也。渴欲饮水，厥阴病则消渴也。
白头翁，临风偏静，长于驱风。用为君者，以厥阴风木，风动则木摇而火旺，欲平走窍之火，必宁摇动之风。秦皮，木
小而高，得清阳上升之象为臣。是木郁达之，所以遂其发陈之性也。黄连，泻君火，可除上焦之渴，是苦以发之。黄柏
泻相火，可止下焦之利，是苦以坚之也。治厥阴热利有二∶初利，用此方以升阳散火，是谓下者举之，寒因热用法；久
利，则用乌梅丸之酸以收火。佐以苦寒，杂以温补，是谓逆之从之，随所利而行之，调其气使之平也。
雄按∶徐氏亦云，乌梅丸治久痢之圣方也。
缩脾饮
缩砂仁 乌梅肉 草果仁（煨） 甘草（炙，各四两） 干葛 白扁豆（各二两）
每服四钱，水一碗，煎八分，水澄冷服以解烦，或欲温、欲热，任意服。
雄按∶脾为阴土，喜燥而恶湿，贪凉饮冷，则脾阳为湿所滞，而缓纵解佚，不能宣运如常矣。故以砂仁、草果快脾
而去其所恶之湿。臣以甘草、扁豆，甘淡以培其正气。即佐葛根、乌梅，一以振其敷布之权，一以缩其缓纵之势。况梅
能生液，湿去津生，最为可法。
三甲散
鳖甲 龟甲（并用酥炙黄为末，各一钱，如无酥，各以醋炙代之） 穿山甲（土炒黄，为末） 蝉蜕（洗净，炙干）
白僵蚕（切，生用） 牡蛎（ 为末） 当归（各五分） 白芍（酒炒，七分） 甘草（三分） 虫（三个，干者擘
碎，鲜者杵烂，和酒少许，取汁入汤药同服，其滓入诸药同煎）
水二钟，煎八分，滤去滓，温服。
雄按∶此方从《金匮》鳖甲煎丸脱胎。
白虎加苍术汤
即白虎汤加苍术一味。
叶香岩曰∶知母，气味苦寒，入足阳明。甘草，气味甘平，入足太阴。石膏，气味辛寒，入手太阴，足阳明。苍术，
气味苦辛温，入足太阴。粳米，气味甘平，入手足太阴。此治暑湿相搏而为湿温病者，以苦寒辛寒之药清其暑，以辛温
雄烈之药燥其湿，而以甘平之药缓其中，则贼邪正邪皆却，正自安矣。
清暑益气汤
人参 黄 白术 广皮 神曲 泽泻（各五分） 苍术 升麻（各一钱） 麦冬 炙草 葛根 当归 黄柏（各
二分） 青皮（二分半） 五味子（九粒）
水二盏，煎一盏，去滓，温服。
雄按∶《治法汇》止用参、 、术、草、归身、橘皮、五味、麦冬、黄柏九味，加姜、枣。汪按∶东垣此方洄溪已讥
其用药杂乱。此去苍术升麻葛根是矣。然犹不免近杂。用此方者。加减尚宜斟酌。
王晋三曰∶此治膏粱之体，因避暑而袭凉饮冷，内伤脾胃，抑遏真阳之剂，故方中以清解与补益兼施。
尤拙吾曰∶元气本虚，而又伤于暑湿，以致四肢倦怠，精神短少，懒于动作，胸气短促，不思饮食，脉浮缓而迟者。
雄按∶其脉如是，乃气虚湿盛，兼吸微暑也。可用此方。若体实脉盛，或虽虚而不甚，及津涸烦渴多火者，则不可
混投也。
雄按∶《湿热病篇》第三十八条后，余有清暑益气法，可用也。汪按∶梦隐所定清暑益气方。用西洋参石斛麦冬黄连
竹叶荷秆知母甘草梗米西瓜翠衣十味。较东垣之方为妥。然临证尚宜加减斟酌。又按。伤暑倦怠投参麦五味立效。然必
审其无外感者。若有暑邪投之其危立至。不可不慎也。
雄按∶东垣专事升阳，徐洄溪、章杏云皆深非之，此方亦从补中益气加味。魏柳洲云∶补中益气汤，为东垣治内伤
外感第一方。后人读其书者，鲜不奉为金科玉律。然不知近代，病患类多真阴不足，上盛下虚者，十居八九。即遇内伤
外感之证，投之辄增剧，非此方谬，要知时代禀赋各殊耳。陆丽京尝言，阴虚人，误服补中益气，往往暴脱，司命者审
诸。今人吸烟者多，阴液既已耗伤，痰气极易升逆。按∶丹溪云∶素无痰者，服升柴不致满闷。孙文垣云∶经谓升降浮
沉必顺之。又曰∶天时不可伐，虽宜升提之病，而冬之闭藏，实为春令发生之本，天人一理。若罔顾天时，而强用升提
之法，是伐天和而泄元气，根本既亏，来春何以发生？此等至理，皆不可不知也。余谓东垣立方，命名本错。设当时立
此培中举陷之法，名曰补中升气汤，则后人顾名思义，咸知其为升剂矣。原以升药举陷，乃既曰补中，复云益气。后人
遂以为参术得升柴，如黄 得防风，而功愈大。既能补脾胃之不足，又可益元气之健行。凡属虚人，皆堪服饵，而忘其
为治中虚兼外感之方，再经立斋之表章，每与肾气丸相辅而行。幸张会卿一灵未泯，虽好温补，独谓此方未可浪用，奈
何以卢不远之贤，亦袒新甫，甚矣！积重之难返也。惟叶天士谓立斋用药，每执死法，未免有不中肯綮者。汪按∶洄溪
亦以立斋为庸医之首。
生脉散
方见《湿热病篇》第三十九条。
香薷饮
四味香薷饮、黄连香薷饮、五物香薷饮、十味香薷饮，并见《湿热病篇》第四十条。
真人养脏汤
人参 白术（炒焦，各钱半） 肉桂 诃子肉 木香 肉豆蔻 罂粟壳（各五分）
水煎，温服。一方有白芍、甘草。甚者，加附子五分。
雄按∶此治久泻而脾肾虚寒，脏气不撮之方也。汪按∶此方诃子肉 粟壳并用。较益黄散更涩。亦宜未服。不宜煎
服。又按。此方必纯属虚寒者方可用。若用以治暑热之痢。则必噤口告危。杀人如草矣。
冷香饮子
附子（炮） 陈皮 草果（各一钱，炙） 甘草（一钱五分） 生姜（五片）
水一钟，煎滚即滤，井水顿冷服。
雄按∶此方与大顺散，皆治阴寒冷湿之气，客于太少二阴而为霍乱吐下之方也。多由畏热而浴冷卧风，过啖冰瓜所
致。乃暑月之中寒证，非病暑也。若痢疾门中，可用此方之证，甚属罕见。苟谛审未确，切须慎之。万一误投，噬脐奚
及。洄溪云∶如有暑邪者，姜断不可用。虽佐芩、连，不可救也。况姜、附同用，而无监制之品可乎？俞东扶云∶昔罗
谦甫治商参政与完颜小将军二案，俱用热药，俱不名曰暑病。又吴球治远行人一案，虽在暑月，直曰中寒。盖恐后世误
以热药治暑，特举病因以称之，可谓名正言顺矣。盖寒暑者，天地一定之阴阳，不容混淆。隆冬，既有热病，盛夏，岂
无寒病？故辨证为医家第一要务。辨证既明，自然不惑于悠悠之谬论，而无倒行逆施，遗人夭殃之虑矣。
败毒散
羌活 独活 柴胡 前胡 川芎 枳壳 桔梗 茯苓 甘草 薄荷为细末。每服二钱。水一盏，煎七分，温服，或
沸汤点服，亦得。
雄按∶此即《活人》本方去人参、姜，加薄荷。
余师愚曰∶此足三阳药也。羌活入太阳而理游风。独活，入太阴而理伏邪，兼能除痛。柴胡，散热升清，协川芎和
血平肝，以治头痛目昏。前胡、枳壳，降气行痰，协桔梗、茯苓以泄肺热，而除湿消肿。甘草，和里。更以薄荷为君，
取其清凉气味皆薄，疏导经络，表散能除高巅邪热。方名败毒，良有以也。疫证初起，服此先去其爪牙。
雄按∶爪牙者，
表邪之谓也。无表邪者，不可用也。使邪不盘踞经络，有斑即透，较升葛荆防，发表多多矣。如口干舌燥加黄芩。喉痛
加山豆根、倍甘、桔。
雄按∶虽加苦寒之品，终嫌升散，必恶寒无汗者，始可用也。古方引用生姜，生姜性太热，与疫
证不宜，以葱白易之可也。
雄按∶喻氏论疫，推服此方为第一，极言其功效之神，后人从而和之。然羌、独、柴、芎，类属温升。考《活人书》
治伤寒瘟疫，风湿风眩，拘蜷风痰，头痛目眩，四肢痛，憎寒壮热，项强睛疼。则所治者，原是风寒湿障杂感之伤寒瘟
疫，并非兼治暑燥之病者。余氏因熊氏先剪爪牙之说，遂谓温热之疫，初起亦当先服此方，虽每服二钱，尚是小剂，但
必外挟风寒湿之表邪者，始为合拍。否则热得风而愈炽，能无亢逆之忧乎？惟桔梗汤最为中 ，用者审之。
清瘟败毒饮
生石膏（大剂六两至八两，中剂二两至四两，小剂八钱至一两二钱）
小生地（大剂六钱至一两，中剂三钱至五钱，小剂二钱至四钱）
乌犀角（大剂六钱至八钱，中剂三钱至五钱，小剂二钱至四钱）
真川连（大剂四钱至六钱，中剂二钱至四钱，小剂一钱至一钱半）
栀子 桔梗 黄芩 知母 赤芍 元参 连翘 甘草 丹皮 鲜竹叶
先煮石膏数十沸，后下诸药，犀角磨汁和服。
此十二经泄火之药也。凡一切火热，表里俱盛，狂躁、烦心、口干、咽痛，大热干呕，错语不眠，吐血衄血，热甚
发斑，不论始终，以此为主方。盖斑疹虽出于胃，亦诸经之火有以助之。重用石膏，直入胃经，使其敷布于十二经，退
其淫热。佐以黄连、犀角、黄芩，泄心肺火于上焦。丹皮栀子、赤芍，泄肝经之火。连翘、元参，解散浮游之火。生地、
知母，抑阳扶阴，泄其亢甚之火，而救欲绝之水。桔梗、竹叶，载药上行，使以甘草和胃。此大寒解毒之剂，重用石膏，
则甚者先平，而诸经之火，自无不安矣。若疫证初起，恶寒发热，头痛如劈，烦躁谵妄，身热肢冷，舌刺唇焦，上呕下
泄。六脉沉细而数，即用大剂；沉而数者，即用中剂；浮大而数者，用小剂。如斑一出，即加大青叶，并少佐升麻四五
导致湿温、疫疠等疾病。出现发热倦怠，胸闷腹胀，肢体酸痛咽喉肿痛，斑疹身黄，腮部肿胀口渴，小便赤涩大便闭结，呕吐腹泻疟疾痢疾，淋证浊症疮疡等证候。
只要看病患舌苔淡白，或厚腻，或干黄的，这是暑湿热疫之邪尚在气分。全部用这个丹剂治疗立即见效。并且主治水土不服等各种疾病。汪按：普济消毒饮使用黄芩、黄连、陈皮、玄参、连翘、甘草桔梗、升麻柴胡、马勃、牛蒡子、薄荷、板蓝根、僵蚕。或者加入人参大黄。现在附载于此。
神犀丹
乌犀角尖（磨汁） 石菖蒲 黄芩（各六两） 真怀生地（冷水洗净浸透，捣碎绞汁） 银花（各一斤，如果有新鲜的捣汁使用更好） 粪清 连翘（各十两） 板蓝根（九两，没有则用飞净青黛代替） 香豉（八两） 玄参（七两） 花粉 紫草（各四两）各生晒研细（忌用火炒），用犀角、地黄汁、粪清调和捣制成丸（千万不要加蜜，如果难以制丸可以将香豉煮烂），每丸重三钱，凉开水化服，每日二次，小儿减半。如果没有粪清，可以加入人中黄四两，研入药中。
王士雄按：温热暑疫各种疾病，邪气不能立即解除，耗伤津液损伤营血，逆传内陷，出现抽搐厥逆昏迷狂乱，说胡话发斑等证候。只要看病患舌色干光，或紫绛，或圆硬，或有黑苔，都用这个丹剂救治。如果初病就感觉神情昏躁且舌赤口干，这是温暑直接入营分。酷暑之时，阴虚体质的人，以及新产后的妇人，患此病最多。急需使用此方，大多可以挽回。千万不要拘泥于发病天数，误投其他药剂，以致坏事。兼治痘毒严重，夹带紫斑的危重证候。以及痘疹之后，余毒内炽，口腔糜烂咽喉腐烂，眼睛红肿精神烦躁等各种证候。方中犀角为君药，镑片煎煮。味道极难煎出，磨粉则需要时间，缓慢来不及等待。况且价格昂贵，不是穷人所能立刻置办的。有钱的人，预先合好赠送施舍，那么患者容易得到，救活的人一定多；穷人得以重生，阴德也很大。或者存心的药店照本制造售卖。也是方便的一个方面。
温胆汤
竹茹 枳实 半夏（各一两） 橘红（一两五钱） 茯苓（七钱） 甘草（炙，四钱）每次服用四五钱，生姜一片，红枣一枚，水一钟五分，煎至七分服用。
罗东逸说：胆是中正之官，清静之府。喜欢安宁静谧，厌恶烦扰。喜欢柔和，不喜欢壅滞郁结。大概是东方木德，少阳温和之气。所以虚烦惊悸的，是中正之官，因为热而不宁静。热呕、吐苦水的，是清静之府，因为郁积久而不宁静。痰气上逆的，是土家湿热反乘，而木不得舒展条达。像这样的情况，首先应当清热，以及疏利三焦。方中以竹茹清胃脘之阳。而以甘草、橘皮、半夏为辅佐，通调胃气以调节其气。以枳实为佐，消除三焦的痰壅。以茯苓为使，平渗，使中焦清气上升。既驱除邪气，又培养正气，三焦平和则少阳平和，三焦正气恢复则少阳正气恢复，胆家有不清宁而和顺的吗！和，就是温。温它，实际上是凉它。晋三也说：胆气退热称为温，不是说胆寒而温补它。
王士雄按：此方去掉姜、枣，加入黄连，治疗湿热痰而化疟的，非常妙。这是古人所不知道的。
麻黄杏仁甘草石膏汤
药物即汤见（指前文已述）。
张石顽说：这是大青龙汤去掉桂枝、越脾汤加入杏仁。
王士雄按：那两个方子有姜、枣。专门祛除上焦湿热痰气，与苓桂术甘汤互相发挥。
那个方子借助苓术，专门祛除心下的支饮。这个方子借助石膏，专门祛除膈上的湿热。汪按：这话值得商榷，石膏除热并非祛湿的药物。
尤在泾说：汗出而喘，没有大热的，邪气不在经络腠理而在肺中。所以不是桂枝所能发散。麻黄、杏仁辛甘入肺，散发邪气。肺被邪气郁结而生热，石膏辛寒入肺，清除热气。甘草甘温，安固中气。并且帮助其散邪清热的作用，乃是肺脏邪气引发气喘的对症良方。又说：大青龙主散表寒而兼清里热，所以麻黄多于石膏。这个方子清肺热而兼散肺邪，所以石膏多于麻黄。
白头翁汤
白头翁（二两） 秦皮 黄连 黄柏（各三两）
水七升煮取二升，去渣，温服一升。
柯韵伯说：三阴都有下利的证候。自利不渴的，属于太阴，是脏有寒；自利口渴的，属于少阴，因为下焦虚寒，津液不升，所以引水自救。只有厥阴下利属于热，因为厥阴主肝而司相火。肝旺则气上撞心，火郁则热利下重。温热秽气，奔迫广肠，魄门重滞而难出，《内经》说“暴注下迫”的就是这种情况。脉沉为在里，弦为肝脉，是本气郁结的征象。渴欲饮水，厥阴病则消渴。白头翁，临风偏静，长于驱风。用作君药，是因为厥阴风木，风动则木摇而火旺，想要平息走窍之火，必须宁静摇动之风。秦皮，树小而高，得清阳上升之象作为臣药。这是木郁达之，所以顺应其发陈的性味。黄连，泻君火，可除上焦之渴，是苦以发之。黄柏泻相火，可止下焦之利，是苦以坚之也。治疗厥阴热利有两种：初利，用此方以升阳散火，这叫下者举之，寒因热用法；久利，则用乌梅丸的酸以收火。佐以苦寒，杂以温补，这叫逆之从之，随所利而行之，调其气使之平和。
王士雄按：徐氏也说，乌梅丸是治疗久痢的圣方。
缩脾饮
缩砂仁 乌梅肉 草果仁（煨） 甘草（炙，各四两） 干葛 白扁豆（各二两）
每次服用四钱，水一碗，煎至八分，水澄清冷服以解烦，或者想温、想热，任意服用。
王士雄按：脾为阴土，喜欢干燥而厌恶湿气，贪凉饮冷，则脾阳被湿气阻滞，而缓纵懈怠，不能宣运如常了。所以用砂仁、草果快脾而去其所厌恶的湿气。以甘草、扁豆为臣，甘淡以培补正气。再加上葛根、乌梅，一个以振奋其敷布的权力，一个以收缩其缓纵的趋势。况且梅能生津，湿去津生，最值得效法。
三甲散
鳖甲 龟甲（并用酥炙黄为末，各一钱，如果没有酥，各以醋炙代替） 穿山甲（土炒黄，为末） 蝉蜕（洗净，炙干）
白僵蚕（切，生用） 牡蛎（为末） 当归（各五分） 白芍（酒炒，七分） 甘草（三分） 虫（三个，干的掰碎，鲜的捣烂，和少许酒，取汁入汤药同服，其渣入诸药同煎）
水二钟，煎至八分，滤去渣，温服。
王士雄按：此方从《金匮》鳖甲煎丸脱胎。
白虎加苍术汤
即白虎汤加苍术一味。
叶香岩说：知母，气味苦寒，入足阳明经。甘草，气味甘平，入足太阴经。石膏，气味辛寒，入手太阴经，足阳明经。苍术，气味苦辛温，入足太阴经。粳米，气味甘平，入手足太阴经。这是治疗暑湿相搏而为湿温病的，用苦寒辛寒的药清其暑，用辛温雄烈的药燥其湿，而以甘平的药缓其中，那么贼邪正邪都退却，正气自然安定了。
清暑益气汤
人参 黄芪 白术 广皮 神曲 泽泻（各五分） 苍术 升麻（各一钱） 麦冬 炙草 葛根 当归 黄柏（各二分） 青皮（二分半） 五味子（九粒）
水二盏，煎至一盏，去渣，温服。
王士雄按：《治法汇》只用参、芪、术、草、归身、橘皮、五味、麦冬、黄柏九味，加姜、枣。汪按：东垣此方洄溪已讥讽其用药杂乱。此方去掉苍术升麻葛根是对的。然而仍然不免接近杂乱。使用此方的人，加减尚宜斟酌。
王晋三说：这是治疗膏粱之体，因避暑而袭凉饮冷，内伤脾胃，抑遏真阳的药剂，所以方中以清解与补益兼施。
尤拙吾说：元气本虚，而又伤于暑湿，以致四肢倦怠，精神短少，懒于动作，胸气短促，不思饮食，脉浮缓而迟的。
王士雄按：其脉象如此，乃气虚湿盛，兼吸微暑。可用此方。如果体质实脉象盛，或者虽虚但不甚，以及津液枯竭烦渴多火的，则不可混投。
王士雄按：《湿热病篇》第三十八条后，我有清暑益气法，可用。汪按：梦隐所定的清暑益气方。用西洋参石斛麦冬黄连竹叶荷秆知母甘草梗米西瓜翠衣十味。较东垣之方更为妥当。然而临证尚宜加减斟酌。又按。伤暑倦怠投参麦五味立效。但必须审察其无外感者。若有暑邪投之其危险立即到来。不可不慎。
王士雄按：东垣专事升阳，徐洄溪、章杏云都深深反对它，此方也从补中益气加味。魏柳洲说：补中益气汤，是东垣治疗内伤外感第一方。后人读他的书，很少不奉为金科玉律。然而不知道近代，病患类多真阴不足，上盛下虚的，十居八九。即使遇到内伤外感的证候，投以此方往往加重，不是此方谬误，要知道时代禀赋各殊罢了。陆丽京曾说，阴虚人，误服补中益气，往往暴脱，司命者审慎。今人吸烟的多，阴液已经耗伤，痰气极易升逆。按：丹溪说：素无痰者，服升柴不致满闷。孙文垣说：经谓升降浮沉必顺之。又说：天时不可伐，虽宜升提的病，而冬之闭藏，实为春令发生之本，天人一理。若不顾天时，而强用升提之法，是伐天和而泄元气，根本既亏，来春何以发生？这些至理，皆不可不知。我认为东垣立方，命名本错。假设当时立此培中举陷之法，名叫补中升气汤，那么后人顾名思义，都知道它是升剂了。原以升药举陷，既然叫补中，又说益气。后人遂以为参术得升柴，如黄芪得防风，而功效更大。既能补脾胃之不足，又可益元气之健行。凡属虚人，皆可服饵，而忘了它是治中虚兼外感的方子，再经立斋之表彰，每与肾气丸相辅而行。幸好张会卿一灵未泯，虽好温补，唯独认为此方不可浪用，奈何卢不远这样的贤人，也袒护新甫，太厉害了！积重之难返也。只有叶天士说立斋用药，每执死法，未免有不中肯綮的。汪按：洄溪也以立斋为庸医之首。
生脉散
方见《湿热病篇》第三十九条。
香薷饮
四味香薷饮、黄连香薷饮、五物香薷饮、十味香薷饮，并见《湿热病篇》第四十条。
真人养脏汤
人参 白术（炒焦，各钱半） 肉桂 诃子肉 木香 肉豆蔻 罂粟壳（各五分）
水煎，温服。一方有白芍、甘草。严重的，加附子五分。
王士雄按：这是治疗久泻而脾肾虚寒，脏气不摄的方子。汪按：此方诃子肉 粟壳并用。较益黄散更涩。也不宜未服。不宜煎服。又按。此方必须纯属虚寒者方可用。如果用来治暑热之痢。则必噤口告危。杀人如草矣。
冷香饮子
附子（炮） 陈皮 草果（各一钱，炙） 甘草（一钱五分） 生姜（五片）
水一钟，煎滚即滤，井水顿冷服。
王士雄按：此方与大顺散，都是治疗阴寒冷湿之气，客于太少二阴而为霍乱吐下的方子。多由畏热而浴冷卧风，过食冰瓜所致。乃暑月之中寒证，非病暑也。如果在痢疾门中，可用此方的证候，甚属罕见。如果诊察未确，切须慎重。万一误投，噬脐莫及。洄溪说：如有暑邪者，姜断不可用。虽然佐以芩、连，不可救也。何况姜、附同用，而没有监制之品可以吗？俞东扶说：昔罗谦甫治商参政与完颜小将军二案，都用热药，都不名为暑病。又吴球治远行人一案，虽然在暑月，直曰中寒。大概是怕后世误以热药治暑，特举病因以称之，可谓名正言顺了。盖寒暑者，天地一定之阴阳，不容混淆。隆冬，既有热病，盛夏，岂无寒病？所以辨证为医家第一要务。辨证既明，自然不惑于悠悠之谬论，而无倒行逆施，遗人夭殃之虑矣。
败毒散
羌活 独活 柴胡 前胡 川芎 枳壳 桔梗 茯苓 甘草 薄荷为细末。每次服用二钱。水一盏，煎七分，温服，或者沸汤点服，也可以。
王士雄按：这就是《活人》本方去人参、姜，加薄荷。
余师愚说：这是足三阳药。羌活入太阳而理游风。独活，入太阴而理伏邪，兼能除痛。柴胡，散热升清，协川芎和血平肝，以治头痛目昏。前胡、枳壳，降气行痰，协桔梗、茯苓以泄肺热，而除湿消肿。甘草，和里。更以薄荷为君，取其清凉气味皆薄，疏导经络，表散能除高巅邪热。方名败毒，良有以也。疫证初起，服此先去其爪牙。
王士雄按：爪牙者，
表邪之谓也。无表邪者，不可用也。使邪不盘踞经络，有斑即透，较升葛荆防，发表多多矣。如口干舌燥加黄芩。喉痛加山豆根、倍甘、桔。
王士雄按：虽然加苦寒之品，终嫌升散，必恶寒无汗者，始可用也。古方引用生姜，生姜性太热，与疫证不宜，以葱白易之可也。
王士雄按：喻氏论疫，推服此方为第一，极言其功效之神，后人从而和之。然羌、独、柴、芎，类属温升。考《活人书》治伤寒瘟疫，风湿风眩，拘蜷风痰，头痛目眩，四肢痛，憎寒壮热，项强睛疼。则所治者，原是风寒湿障杂感之伤寒瘟疫，并非兼治暑燥之病者。余氏因熊氏先剪爪牙之说，遂谓温热之疫，初起亦当先服此方，虽每服二钱，尚是小剂，但必外挟风寒湿之表邪者，始为合拍。否则热得风而愈炽，能无亢逆之忧乎？惟桔梗汤最为中 ，用者审之。
清瘟败毒饮
生石膏（大剂六两至八两，中剂二两至四两，小剂八钱至一两二钱）
小生地（大剂六钱至一两，中剂三钱至五钱，小剂二钱至四钱）
乌犀角（大剂六钱至八钱，中剂三钱至五钱，小剂二钱至四钱）
真川连（大剂四钱至六钱，中剂二钱至四钱，小剂一钱至一钱半）
栀子 桔梗 黄芩 知母 赤芍 元参 连翘 甘草 丹皮 鲜竹叶
先煮石膏数十沸，后下诸药，犀角磨汁和服。
这是十二经泄火的药。凡一切火热，表里俱盛，狂躁、烦心、口干、咽痛，大热干呕，错语不眠，吐血衄血，热甚发斑，不论始终，以此为主方。盖斑疹虽出于胃，亦诸经之火有以助之。重用石膏，直入胃经，使其敷布于十二经，退其淫热。佐以黄连、犀角、黄芩，泄心肺火于上焦。丹皮栀子、赤芍，泄肝经之火。连翘、元参，解散浮游之火。生地、知母，抑阳扶阴，泄其亢甚之火，而救欲绝之水。桔梗、竹叶，载药上行，使以甘草和胃。此大寒解毒之剂，重用石膏，则甚者先平，而诸经之火，自无不安矣。若疫证初起，恶寒发热，头痛如劈，烦躁谵妄，身热肢冷，舌刺唇焦，上呕下泄。六脉沉细而数，即用大剂；沉而数者，即用中剂；浮大而数者，用小剂。如斑一出，即加大青叶，并少佐升麻四五
Causing diseases such as damp-heat warm (Shi Wen) and epidemic pestilence (Yi Li). Manifesting as fever with fatigue, chest tightness and abdominal distension, limb soreness and throat swelling, macules and rashes with jaundice, swollen parotid glands with thirst, dark urine with constipation, vomiting and diarrhea, malaria and dysentery, stranguria and turbidity, sores and ulcers, etc.
If the patient's tongue coating is pale white, or thick and greasy, or dry and yellow, this indicates that the pathogenic factors of summerheat-damp-heat epidemic are still in the Qi level. All can be treated effectively with this pill. It also treats various illnesses due to unacclimatization. Wang's note: Pu Ji Xiao Du Yin uses Huang Qin (Scutellariae Radix), Lian Lian (Coptidis Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Yuan Shen (Scrophulariae Radix), Lian Qiao (Forsythiae Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma) combined with Jie Geng (Platycodonis Radix), Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), Ma Bo (Belamcandae Stamen), Niu Bang Zi (Arctii Fructus), Bo He (Menthae Haplocalycis Herba), Ban Lan Gen (Isatidis Radix), Jiang Can (Bombyx Batryticatus). Or add Ren Shen (Ginseng Radix et Rhizoma) and Da Huang (Rhei Radix et Rhizoma). Now attached here.
Shen Xi Dan
Wu Xi Jiao Jian (Horn of Rhinoceros Cornu, ground into juice) Shi Chang Pu (Acori Tatarinowii Rhizoma) Huang Qin (Scutellariae Radix) [each 6 liang] Zhen Huai Sheng Di (Rehmanniae Radix Preparata from Huaiqing, washed clean with cold water, soaked until permeated, crushed and juiced) Yin Hua (Flos Lonicerae Japonicae) [each 1 jin; if fresh ones are available, crushing them for juice is even better] Fen Qing (Urina humana fermentata) Lian Qiao (Forsythiae Fructus) [each 10 liang] Ban Lan Gen (Isatidis Radix) [9 liang; if unavailable, replace with Fei Jing Qing Dai (Indigo Naturalis purified)] Xiang Chi (Fermented Soybean Semen Sojae Preparatum) [8 liang] Yuan Shen (Scrophulariae Radix) [7 liang] Hua Fen (Pollen Typhae) Zi Cao (Arnebiae Radix seu Lithospermi Radix) [each 4 liang]. All are sun-dried and finely ground (avoid fire roasting). Mix with Xi Jiao juice, Di Huang juice, and Fen Qing, knead into pills (do not add honey; if difficult to form pills, boil Xiang Chi until soft). Each pill weighs 3 qian. Dissolve in cool boiled water and take orally, twice a day. Children take half dose. If Fen Qing is unavailable, add Ren Zhong Huang (Humanis Faeces Purificatae) 4 liang, grind and incorporate.
Wang's note: For various warm-heat and summerheat epidemic diseases, if the pathogen does not resolve immediately, consuming body fluids and damaging the Ying level, leading to counterflow transmission and internal entrapment, manifesting as spasms, convulsions, coma, mania, delirium, and macules, etc. If the patient's tongue color is dry and glossy, or purple-crimson, or round and stiff, or has black coating, use this pill to save them. If at the onset of illness one feels mental confusion and restlessness with a red tongue and dry mouth, this is warm-heat directly entering the Ying level. During intense summer heat, individuals with Yin deficiency constitution, and postpartum women, suffer from this most frequently. Urgent use of this formula can often reverse the condition. Do not rigidly adhere to the number of days since onset, nor mistakenly administer other prescriptions, which would ruin the treatment. It also treats severe toxin accumulation from smallpox/variolous eruptions complicated by purple macules indicating critical conditions. And after smallpox/variolous eruptions, residual toxins burning internally causing oral ulceration, pharyngeal decay, red eyes, and mental agitation. In the formula, Xi Jiao (Rhinoceros Cornu) is the Sovereign herb. Sliced and decocted, its flavor is extremely difficult to extract; grinding takes time and is too slow for emergencies. Moreover, it is expensive and not readily affordable for the poor. Those with means should prepare it in advance to distribute, making it accessible to patients and saving many lives; the poor gaining life brings great merit. Alternatively, pharmacies with good intentions can manufacture and sell it according to the prescription. This is also a convenient approach.
Wen Dan Tang
Zhu Ru (Bambusae Caulis in Taeniam) Zhi Shi (Aurantii Fructus Immaturus) Ban Xia (Pinelliae Rhizoma Praeparatum) [each 1 liang] Ju Hong (Citri Reticulatae Pericarpium) [1.5 liang] Fu Ling (Poria) [7 qian] Gan Cao (Glycyrrhizae Radix et Rhizoma, prepared) [4 qian]. Take 4-5 qian per dose, with 1 slice of Sheng Jiang (Zingiberis Rhizoma Recens) and 1 Hong Zao (Jujubae Fructus), in 1.5 zhong of water, decoct to 0.7 zhong and take.
Luo Dongyi said: The Gallbladder is the official of uprightness, the residence of clarity and tranquility. It prefers quietude and abhors disturbance. It prefers gentleness and dislikes stagnation. It corresponds to the Virtue of Wood in the East, the mild and warm Qi of Shaoyang. Therefore, in cases of deficiency-related irritability and palpitations, the official of uprightness is restless due to heat. In cases of hot vomiting and bitter regurgitation, the residence of clarity and tranquility is disturbed due to long-standing stagnation. In cases of Phlegm-Qi rebelling upward, Damp-Heat of the Earth element overacts, preventing Wood from spreading freely. In such cases, one must first clear Heat and benefit the San Jiao. In the formula, Zhu Ru clears Yang in the stomach region. It is assisted by Gan Cao, Ju Hong, and Ban Xia to regulate Stomach Qi. Zhi Shi eliminates Phlegm obstruction in the San Jiao. Fu Ling promotes diuresis and allows Clear Qi to ascend in the Middle Jiao. It both expels pathogens and nourishes righteousness. When San Jiao is peaceful, Shaoyang is peaceful; when San Jiao's Qi is correct, Shaoyang's Qi is correct. How could the Gallbladder fail to be clear and harmonious? "Harmonizing" (He) is equivalent to "warming" (Wen). Warming it actually means cooling it. Jin San also said: Gallbladder Qi retreating heat is called warming, not implying Gallbladder Cold requiring warming.
Wang's note: Removing Sheng Jiang and Hong Zao from this formula and adding Huang Lian (Coptidis Rhizoma) to treat Malaria transformed from Damp-Heat and Phlegm is excellent. This was unknown to the ancients.
Ma Huang Xing Ren Gan Cao Shi Gao Tang
The ingredients are as listed in the preceding text.
Zhang Shiweng said: This is Da Qing Long Tang minus Gui Zhi (Cinnamomi Ramulus) plus Xing Ren (Armeniacae Semen Amarum) from Yue Bi Tang.
Wang's note: Those two formulas contain Sheng Jiang and Hong Zao. They specifically dispel Damp-Heat and Phlegm-Qi in the Upper Jiao, working in conjunction with Ling Gui Zhu Gan Tang.
That formula utilizes Fu Ling and Bai Zhu (Atractylodis Macrocephalae Rhizoma) to specifically dispel fluid retention under the heart. This formula utilizes Shi Gao (Gypsum Fibrosum) to specifically dispel Damp-Heat above the diaphragm. Wang's note: This statement is debatable; Shi Gao clears Heat but is not a drug for dispelling Dampness.
You Zaijing said: Sweating with wheezing and no significant high heat indicates the pathogen is not in the meridians and couli but in the Lung. Therefore, Gui Zhi cannot disperse it. Ma Huang and Xing Ren are acrid-sweet and enter the Lung to scatter pathogenic factors. The Lung, constrained by pathogens, generates Heat; Shi Gao is acrid-cold, enters the Lung, and clears Heat. Gan Cao is sweet-warm, stabilizes Middle Qi, and aids in scattering pathogens and clearing Heat. It is the specific remedy for wheezing caused by Lung pathogenic factors. He also said: Da Qing Long primarily disperses Exterior Cold while clearing Interior Heat, hence Ma Huang exceeds Shi Gao. This formula clears Lung Heat while scattering Lung pathogens, hence Shi Gao exceeds Ma Huang.
Bai Tou Weng Tang
Bai Tou Weng (Pulsatillae Radix) [2 liang] Qin Pi (Fraxini Cortex) Huang Lian (Coptidis Rhizoma) Huang Bo (Phellodendri Cortex) [each 3 liang].
Decoct 7 sheng of water to obtain 2 sheng, remove dregs, take 1 sheng warm.
Ke Yunbo said: All three Yin meridians have symptoms of diarrhea. Spontaneous diarrhea without thirst belongs to Taiyin, indicating Cold in the Zang organs. Spontaneous diarrhea with thirst belongs to Shaoyin, because Lower Jiao deficiency-Cold prevents Jin Ye (Body Fluids) from ascending, prompting the desire for water to self-rescue. Only Jueyin diarrhea belongs to Heat, because Jueyin governs the Liver and controls Minister Fire. When Liver Qi is excessive, Qi rushes upward hitting the Heart; when Fire is constrained, Heat-diarrhea with heaviness in the lower rectum occurs. Warm-heat foul qi rushes to the large intestine, causing the anus to feel heavy and difficult to pass, as described in Nei Jing as "sudden violent diarrhea with urgent tenesmus." Pulse deep indicates Interior involvement; pulse wiry indicates Liver pulse, signifying root constraint. Thirst for drinking water indicates Xiao Ke (Consumption-Thirst) in Jueyin disease. Bai Tou Weng remains calm in the wind and excels at dispelling Wind. Used as Sovereign because Jueyin Wind-Wood: when Wind moves, Wood shakes and Fire flares. To quell Fire moving through orifices, one must calm the shaking Wind. Qin Pi grows small but tall, reflecting the image of Clear Yang ascending; used as Minister. This follows the principle of "releasing constrained Wood," thereby facilitating its nature of renewal. Huang Lian drains Minister Fire, relieving Upper Jiao thirst, using Bitter to disperse. Huang Bo drains Minister Fire, stopping Lower Jiao diarrhea, using Bitter to consolidate. There are two approaches to treating Jueyin Heat-diarrhea: Early stage, use this formula to raise Yang and scatter Fire, known as "raising what sinks," applying Cold for Heat method; Late/chronic stage, use Wu Mei Wan (Mume Fructus Pill) with Sour to gather Fire. Assist with Bitter-Cold, mix with Warm-Nourishing, following the principles of opposing and complying, acting according to what benefits, regulating Qi to achieve peace.
Wang's note: Xu also stated that Wu Mei Wan is the sacred formula for chronic dysentery.
Suo Pi Yin
Suo Sha Ren (Amomi Fructus Rotundus) Wu Mei (Mume Fructus) Cao Guo Ren (Tsaoko Fructus, roasted) Gan Cao (Glycyrrhizae Radix et Rhizoma, prepared) [each 4 liang] Gan Ge (Puerariae Lobatae Radix) Bai Bian Dou (Dolichoris Semen) [each 2 liang].
Take 4 qian per dose, with 1 bowl of water, decoct to 0.8 portion. Strain and take cold to relieve irritation, or take warm/hot as desired.
Wang's note: The Spleen is Yin-Earth, preferring dryness and abhorring Dampness. Greed for cold drinks leads to Spleen Yang being stagnant by Dampness, resulting in laxity and inability to transport normally. Thus, Suo Sha Ren and Cao Guo invigorate the Spleen and remove disliked Dampness. Gan Cao and Bai Bian Dou act as Ministers, using Sweet-Bland to cultivate righteous Qi. Ge Gen and Wu Mei act as Assistants: one to revitalize distribution authority, the other to restrain laxity. Moreover, Plum generates fluids; removing Dampness generates Jin Ye, which is highly commendable.
San Jia San
Bie Jia (Testudinis et Carapax et Plastrum) Gui Jia (Chelonis Carapax) [both fried with rendered fat until yellow and powdered, each 1 qian; if no fat, fry with vinegar instead] Chuan Shan Jia (Manis Squama) [soil-fried yellow, powdered] Chan Tui (Cicadae Periostracum) [washed, dried by frying] Bai Jiang Can (Bombyx Batryticatus) [cut, used raw] Mu Li (Ostreae Concha) [powdered] Dang Gui (Angelicae Sinensis Radix) [each 5 fen] Bai Shao (Paeoniae Radix Alba, wine-fried) [7 fen] Gan Cao (Glycyrrhizae Radix et Rhizoma) [3 fen] Tu Chong (Eupolyphaga Seu Steleophaga) [3 specimens, dry ones broken, fresh ones mashed, mixed with a little wine to extract juice for taking with decoction; dregs added to herbs for decoction].
Decoct 2 zhong of water to 0.8 portion, filter dregs, take warm.
Wang's note: This formula is derived from Bie Jia Jian Wan in Jin Gui Yao Lue.
Bai Hu Jia Cang Zhu Tang
This is Bai Hu Tang plus Cang Zhu (Atractylodis Rhizoma).
Ye Tianshi said: Zhi Mu (Anemarrhenae Rhizoma) is Bitter-Cold, entering Foot-Yangming. Gan Cao is Sweet-Ping, entering Foot-Taiyin. Shi Gao is Acrid-Cold, entering Hand-Taiyin and Foot-Yangming. Cang Zhu is Bitter-Acrid-Warm, entering Foot-Taiyin. Jing Mi (Oryza Sativa) is Sweet-Ping, entering Hand and Foot-Taiyin. This treats Wet-Warm disease caused by Summerheat-Dampness interaction. Bitter-Cold and Acrid-Cold drugs clear Summerheat; Acrid-Warm and potent drugs dry Dampness; Sweet-Ping drugs moderate the Middle. Thus, both pathogenic and righteous evils are repelled, and Righteous Qi is secured.
Qing Shu Yi Qi Tang
Ren Shen (Ginseng Radix et Rhizoma) Huang Qi (Astragali Radix) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Guang Pi (Citri Reticulatae Pericarpium) Shen Qu (Massa Medicata Fermentata) Ze Xie (Alismatis Rhizoma) [each 5 fen] Cang Zhu (Atractylodis Rhizoma) Sheng Ma (Cimicifugae Rhizoma) [each 1 qian] Mai Dong (Ophiopogonis Radix) Zhi Cao (Glycyrrhizae Radix et Rhizoma, prepared) Ge Gen (Puerariae Lobatae Radix) Dang Gui (Angelicae Sinensis Radix) Huang Bo (Phellodendri Cortex) [each 2 fen] Qing Pi (Citri Reticulatae Pericarpium Viride) [2.5 fen] Wu Wei Zi (Schisandrae Chinensis Fructus) [9 grains].
Decoct 2 zhan of water to 1 zhan, remove dregs, take warm.
Wang's note: Zhi Fa Hui uses only Ren Shen, Huang Qi, Bai Zhu, Gan Cao, Dang Gui Shen, Ju Pi, Wu Wei Zi, Mai Dong, Huang Bo (nine herbs), plus Sheng Jiang and Hong Zao. Wang's note: Dong Yuan's formula was criticized by Xu Cunchi for messy medication. Removing Cang Zhu, Sheng Ma, and Ge Gen is correct. However, it remains somewhat cluttered. Users should carefully consider modifications.
Wang Jin San said: This treats constitutions accustomed to rich food, who catch cold by avoiding heat and drinking cold beverages, injuring the Spleen and Stomach internally and suppressing True Yang. Hence, the formula combines clearing/resolving with tonifying/nourishing.
You Zhuowu said: Original Qi is inherently deficient, further injured by Summerheat-Dampness, leading to limb fatigue, shortness of spirit, reluctance to move, chest shortness of breath, loss of appetite, and floating-slow-delayed pulse.
Wang's note: Such a pulse indicates Qi deficiency with Dampness excess, combined with slight Summerheat inhalation. This formula can be used. If the constitution is robust with a strong pulse, or deficiency is mild, or there is fluid depletion with irritability/thirst and excessive Fire, do not indiscriminately administer it.
Wang's note: After Article 38 of Re Shi Bing Pian, I have a method for clearing Summerheat and benefiting Qi, which can be used. Wang's note: Meng Yin's Qing Shu Yi Qi Fang uses Xi Yang Shen (Ginseng Radix Rubra), Shi Hu (Dendrobii Caulis), Mai Dong, Huang Lian, Zhu Ye (Bambusae Folium), He Gan (Neoliurisiae Caulis), Zhi Mu, Gan Cao, Geng Mi (Oryzae Semen), Xi Gua Cui Yi (Citrulli Exocarpium) - ten herbs. This is more appropriate than Dong Yuan's formula. However, clinical adjustments are still necessary. Another note: For Summerheat injury causing fatigue, Ren Shen, Mai Dong, and Wu Wei Zi bring immediate effect. But one must verify no Exterior pathogen exists. If Summerheat pathogen is present, administering this is dangerous. Caution is essential.
Wang's note: Dong Yuan focused on raising Yang. Xu Cunchi and Zhang Xingyun strongly opposed this. This formula is also modified from Bu Zhong Yi Qi Tang. Wei Liuzhou said: Bu Zhong Yi Qi Tang is Dong Yuan's primary formula for Internal Injury with External Pathogen. Readers rarely fail to revere it as golden rules. However, they do not know that modern patients mostly have True Yin deficiency and Upper Excess/Lower Deficiency, accounting for 80-90%. Even encountering Internal Injury/External Pathogen, administering it often worsens the condition. Not because the formula is wrong, but because eras and constitutions differ. Lu Lijing once said, Yin-deficient individuals mistakenly taking Bu Zhong Yi Qi Tang often suffer sudden collapse. Physicians must be cautious. Many people smoke today, depleting Yin fluids, making Phlegm-Qi prone to rebelling upward. Note: Danxi said those without Phlegm tolerate Sheng Ma and Chai Hu without fullness. Sun Wenyuan said: Classics state ascension/descension, floating/sinking must follow nature. Also: Heavenly timing cannot be violated. Even for diseases suitable for lifting, Winter storage is the root for Spring generation. Heaven and Man share one principle. Ignoring heavenly timing and forcing lifting methods violates Heavenly Harmony and leaks Original Qi. With roots damaged, how can Spring generation occur? These profound truths must be known. I believe Dong Yuan's naming was incorrect. If he had named this Spleen-nourishing and sinking-lifting method "Bu Zhong Sheng Qi Tang," later generations would know it is a lifting agent from the name. Originally using lifting drugs to raise sinking, yet calling it "Tonify Middle" and "Benefit Qi." Later generations thought Ren Shen and Bai Zhu with Sheng Ma and Chai Hu, like Huang Qi with Fang Feng, increased efficacy. Believing it tonifies Spleen/Stomach insufficiency and boosts Original Qi vigor. Thinking all deficient persons can take it, forgetting it treats Middle Deficiency with External Pathogen. Further exalted by Li Zhongzi, often used with Shen Qi Wan. Fortunately, Zhang Huiqing retained some wisdom; though favoring Warm Tonification, he alone said this formula should not be used recklessly. Yet even virtuous figures like Lu Buyuan supported Xinpu. How difficult it is to reverse entrenched views! Only Ye Tianshi said Li Zhongzi's medication often stuck to rigid methods, missing the mark. Wang's note: Cunchi also considered Li Zhongzi the chief among mediocre physicians.
Sheng Mai San
See Formula in Re Shi Bing Pian Article 39.
Xiang Ru Yin
Si Wei Xiang Ru Yin, Huang Lian Xiang Ru Yin, Wu Wu Xiang Ru Yin, Shi Wei Xiang Ru Yin, all see Re Shi Bing Pian Article 40.
Zhen Ren Yang Zang Tang
Ren Shen Bai Zhu (Stir-fried scorched, each 1.5 qian) Rou Gui (Cinnamomi Cortex) He Zi Rou (Myrobalani Fructus) Mu Xiang (Aucklandiae Radix) Rou Dou Kou (Myristicae Semen) Ying Su Ke (Papaveris Capsicum) [each 5 fen].
Decoct in water, take warm. One version includes Bai Shao and Gan Cao. For severe cases, add Fu Zi (Aconiti Lateralis Radix Praeparata) 5 fen.
Wang's note: This treats chronic diarrhea due to Spleen/Kidney deficiency-Cold and failing organ Qi. Wang's note: This formula uses He Zi Rou and Ying Su Ke together, more astringent than Yi Huang San. It is unsuitable for early stages and not for decoction. Another note: This formula must be used only for pure deficiency-Cold. Using it for Summerheat-Damp Dysentery will cause closed-mouth dysentery and danger, killing like grass.
Leng Xiang Yin Zi
Fu Zi (Aconiti Lateralis Radix Praeparata, processed) Chen Pi (Citri Reticulatae Pericarpium) Cao Guo (Tsaoko Fructus) [each 1 qian, prepared] Gan Cao (Glycyrrhizae Radix et Rhizoma) [1.5 qian] Sheng Jiang (Zingiberis Rhizoma Recens) [5 slices].
Decoct 1 zhong of water until boiling, strain immediately, and take chilled in well water.
Wang's note: This formula and Da Shun San both treat Cold-Dampness invading Taiyang and Shaoyin causing Huoluan (vomiting and diarrhea). Often caused by fearing heat, bathing in cold, lying in wind, and overeating ice melons. This is Cold injury in Summer months, not Summerheat disease. In the Dysentery chapter, indications for this formula are rare. If diagnosis is uncertain, caution is vital. Mistaken administration leads to regret. Cunchi said: If Summerheat pathogen exists, Ginger must not be used. Even with Huang Qin and Huang Lian, it cannot be saved. Especially combining Ginger and Aconite without restraining agents? Yu Dongfu said: Luo Qianfu treated Shang Zhengcan and Wan Yan Xiao Jiangjun with Hot drugs, neither named Summerheat disease. Wu Qiu treated a traveler case in Summer month, directly called Cold injury. Perhaps to prevent later generations from mistakenly using Hot drugs for Summerheat, citing etiology specifically, which is proper naming. Cold and Summerheat are fixed Yin/Yang of Heaven and Earth,不容混淆. Deep Winter has Heat diseases; Mid-Summer, why no Cold diseases? Thus, differentiation is the physician's primary task. Clear differentiation prevents confusion with erroneous theories and avoids harmful mistakes causing premature death.
Bai Du San
Qiang Huo (Notopterygii Rhizoma et Radix) Du Huo (Angelicae Pubescentis Radix) Chai Hu (Bupleuri Radix) Qian Hu (Peucedani Radix) Chuan Xiong (Ligustici Chuanxiong Rhizoma) Zhi Qiao (Aurantii Fructus) Jie Geng (Platycodonis Radix) Fu Ling (Poria) Gan Cao (Glycyrrhizae Radix et Rhizoma) Bo He (Menthae Haplocalycis Herba) ground to fine powder. Take 2 qian per dose. Decoct 1 zhan of water to 0.7 portion, take warm, or dissolve in boiling water.
Wang's note: This is Huo Ren Ben Fang minus Ren Shen and Sheng Jiang, plus Bo He.
Yu Shiyu said: These are Foot-San Yang drugs. Qiang Huo enters Taiyang and manages wandering Wind. Du Huo enters Taiyin and manages hidden pathogens, also relieving pain. Chai Hu dissipates Heat and raises Clear, assisting Chuan Xiong to harmonize Blood and calm Liver, treating headache and blurred vision. Qian Hu and Zhi Qiao descend Qi and move Phlegm, assisting Jie Geng and Fu Ling to drain Lung Heat, dispel Dampness, and reduce swelling. Gan Cao harmonizes Interior. Bo He acts as Sovereign, utilizing its light cool aroma to dredge meridians and disperse High-Vertex pathogenic Heat. Named Bai Du (Defeat Toxin) for good reason. At initial stage of epidemic, taking this removes its "fangs and teeth" first.
Wang's note: Fangs and teeth refer to
Exterior pathogens. Without Exterior pathogens, it cannot be used. Preventing pathogens from occupying meridians ensures macules erupt quickly, far superior to Sheng Ma, Ge Gen, Jing Jie, and Fang Feng for releasing Exterior. Add Huang Qin for dry mouth/tongue. Add Shan Dou Gen and double Gan Cao/Jie Geng for sore throat.
Wang's note: Although adding Bitter-Cold drugs, the lifting/scattering nature is still concerning. Only usable for aversion-to-cold and anhidrosis. Ancient formulas cite Sheng Jiang, but Ginger is too hot for epidemics; replace with Cong Bai (Allii Fistulosi Bulbus).
Wang's note: Yu Shi ranked this formula first for epidemics, praising its miraculous efficacy, followed by others. However, Qiang Huo, Du Huo, Chai Hu, Chuan Xiong are generally Warm-Lifting. Examining Huo Ren Shu for treating Shang Han Epidemic, Wind-Damp/Dizziness, convulsive Wind-Phlegm, headache/dizziness, limb pain, aversion-to-cold/high fever, neck stiffness/eye pain. The treated conditions were originally Shang Han Epidemic from mixed Wind-Cold-Damp constraints, not Summerheat-Dryness diseases. Yu Shi, following Xiong Shi's "cut fangs and teeth" theory, claimed Warm-Heat epidemics should also start with this formula. Though 2 qian per dose is small, it must be accompanied by Exterior Wind-Cold-Damp pathogens to fit. Otherwise, Heat intensifies with Wind, risking hyperactivity. Only Jie Geng Tang is truly central; users must discern.
Qing Wen Bai Du Yin
Sheng Shi Gao (Gypsum Fibrosum) [Large dose 6-8 liang, Medium 2-4 liang, Small 8 qian-1.2 liang]
Xiao Sheng Di (Rehmanniae Radix Preparata) [Large 6 qian-1 liang, Medium 3-5 qian, Small 2-4 qian]
Wu Xi Jiao (Rhinoceros Cornu) [Large 6-8 qian, Medium 3-5 qian, Small 2-4 qian]
Zhen Chuan Lian (Coptidis Rhizoma) [Large 4-6 qian, Medium 2-4 qian, Small 1-1.5 qian]
Zhi Zi (Gardeniae Fructus) Jie Geng (Platycodonis Radix) Huang Qin (Scutellariae Radix) Zhi Mu (Anemarrhenae Rhizoma) Chi Shao (Paeoniae Radix Rubra) Yuan Shen (Scrophulariae Radix) Lian Qiao (Forsythiae Fructus) Gan Cao (Glycyrrhizae Radix et Rhizoma) Dan Pi (Moutan Cortex) Xian Zhu Ye (Bambusae Folium).
Decoct Shi Gao for dozens of boils first, then add other drugs. Xi Jiao ground into juice and mixed for taking.
This is a drug for draining Fire from Twelve Meridians. For all Fire-Heat, Exterior and Interior both excess, mania, irritability, dry mouth, sore throat, high fever dry vomiting, delirium insomnia, hematemesis/epistaxis, severe Heat causing macules, regardless of stage, use this as main formula. Macules/rashes originate from Stomach but are aided by Fire from various meridians. Heavy use of Shi Gao enters Stomach meridian directly, distributing to Twelve Meridians to retreat excessive Heat. Assisted by Huang Lian, Xi Jiao, Huang Qin to drain Heart/Lung Fire in Upper Jiao. Dan Pi, Zhi Zi, Chi Shao drain Liver Fire. Lian Qiao, Yuan Shen dissipate floating Fire. Sheng Di, Zhi Mu suppress Yang and support Yin, drain excessive Fire and rescue nearly exhausted Water. Jie Geng, Zhu Ye carry drugs upward. Gan Cao harmonizes Stomach as Envoy. This is a major Cold-Toxin-Resolving agent. Heavy Shi Gao calms severe Heat first, allowing Fire in various meridians to settle. If epidemic starts with aversion-to-cold/fever, splitting headache, irritability/delirium, high fever/cold limbs, prickly tongue/scorched lips, upper vomiting/lower diarrhea. Deep-thin-rapid pulse: use Large dose; Deep-rapid: Medium dose; Floating-large-rapid: Small dose. Once macules appear, add Da Qing Ye (Isatidis Folium) and a little Sheng Ma (Cimicifugae Rhizoma) 4-5