易简参苏饮治感冒发热头痛或因痰饮凝积为热状似伤寒者
前胡 人参 紫苏 干葛 半夏 茯苓(各三分) 枳壳 陈皮 甘草 桔梗 木香(各
半钱)
上 咀生姜五片水煎服
人参败毒散(方见咳门)
按此二方足少阳柴胡例药
参苏饮解见痰饮门
局方柴胡升麻汤治发热头痛恶风体疼鼻寒咽干痰盛方见伤风门
按此足少阳阳明手太阴药也
葛根解肌汤治发热恶寒头痛项强伤寒温病
葛根(四钱) 桂(一钱) 黄芩 甘草 白芍(各二钱) 麻黄(三钱)
上 咀入姜枣煎
按此足太阳阳明太阴药也
知母葛根汤治身热头痛风温温毒证
知母(一钱半) 葛根(四钱) 石膏(三钱) 甘草 木香 升麻 黄芩 南星 人参 防
风杏仁 川芎 羌活(各一钱) 葳蕤(二钱半) 麻黄(二钱)
上 咀作二服入姜煎
按此足太阳阳明手太阴药也以上三方并足太阳例
河间六神通解散治发热头痛发渴身疼脉洪无汗
麻黄(二钱) 甘草(三钱) 石膏 滑石 黄芩(各四钱) 苍术(八钱)
上 咀入姜葱煎
按此足三阳手足太阴药也出太阳例
易老九味羌活汤治发热恶寒无汗或自汗头痛项强或伤风见寒脉伤寒见风脉并宜服之
羌活 防风 苍术(各一钱半) 川芎 白芷 生地黄 黄芩 甘草 细辛(一钱)
上 咀水煎
按此足太阳阳明三阴药也
易老云经曰有汗不得服麻黄无汗不得服桂枝若瘥失则其变不可胜言故立此法使不犯三阳
禁忌为解利神方非独活杂病药也
谨按仲景论伤寒发表药分六经及解肌可刺诸法盖恐药致误变逆慎之至也今集以上诸方皆
伤寒
表药之变法宜详审脉证而择用之然易老九味河间通解意虽不同务在药证相对名实相符方可行
之否则犯禁致逆及失其立法之意也是以许文正公曰近世论医有主河间刘氏者有主易老张氏者
张氏用药根据准四时阴阳升降而增损之正内经四气调神之义医而不知此妄行也刘氏用药务在推
陈致新不使少有怫郁正造化新新不停之义医而不知此无术也然而主张氏者或未尽张氏之妙则
瞑眩之剂终莫敢投至失几后时而不救者多矣主刘氏者或未悉刘氏之蕴则劫效目前阴损正气遗
祸于后日者多矣能用二家之长而无二家之弊则治庶几乎于此二方制法可见大抵学人当于经论
中求之知其所主不可偏执于一家而已
易简参苏饮治疗感冒引起的发热、头痛,或因痰饮积聚化热,症状类似伤寒的情况。
前胡、人参、紫苏、干葛(即葛根)、半夏、茯苓(各三分),枳壳、陈皮、甘草、桔梗、木香(各半钱)。
以上药物切碎,加入生姜五片,水煎服。
人参败毒散(方剂见咳嗽门)
按:这两首方剂属于足少阳胆经柴胡类药物的用法。
参苏饮的解释详见痰饮门。
局方柴胡升麻汤治疗发热、头痛、恶风、身体疼痛、鼻中发冷、咽喉干燥、痰多等症状(方剂见伤风门)。
按:此方涉及足少阳胆经、足阳明胃经及手太阴肺经的药物。
葛根解肌汤治疗发热、恶寒、头痛、项背强直,适用于伤寒和温病。
葛根(四钱)、桂枝(一钱)、黄芩、甘草、白芍(各二钱)、麻黄(三钱)。
以上药物切碎,加入生姜和大枣煎煮。
按:此方涉及足太阳膀胱经、足阳明胃经及手太阴肺经的药物。
知母葛根汤治疗身体发热、头痛,适用于风温和温毒证候。
知母(一钱半)、葛根(四钱)、石膏(三钱)、甘草、木香、升麻、黄芩、天南星、人参、防风、杏仁、川芎、羌活(各一钱)、葳蕤(即玉竹,二钱半)、麻黄(二钱)。
以上药物切碎,分两次服用,加入生姜煎煮。
按:此方涉及足太阳膀胱经、足阳明胃经及手太阴肺经的药物。以上三方均遵循足太阳经的用药法则。
河间六神通解散治疗发热、头痛、口渴、身体疼痛、脉象洪大、无汗。
麻黄(二钱)、甘草(三钱)、石膏、滑石、黄芩(各四钱)、苍术(八钱)。
以上药物切碎,加入生姜和葱白煎煮。
按:此方涉及足三阳经及手足太阴经的药物,出自足太阳经的变法。
易老九味羌活汤治疗发热、恶寒、无汗或自汗、头痛、项强,或者因伤风出现寒脉、因伤寒出现风脉者,均适宜服用。
羌活、防风、苍术(各一钱半)、川芎、白芷、生地黄、黄芩、甘草、细辛(一钱)。
以上药物切碎,水煎服。
按:此方涉及足太阳、足阳明及三阴经的药物。
易老(张元素)说:《内经》记载有汗者不可服用麻黄,无汗者不可服用桂枝,如果误用导致病情变化,后果不堪设想。因此创立此法,使其不触犯三阳经的禁忌,成为解表利邪的神方,并非仅仅用于杂病的药物。
谨按:张仲景在论述伤寒发表药物时,分为六经以及解肌、针刺等各种方法,大概是担心药物使用不当导致误治变证,极为谨慎。现在收集以上各方,都是伤寒表证的变法,应当详细审察脉象和证候来选择使用。然而,易老的九味羌活汤与河间的六神通解散,立意虽不同,但务必使药物与证候相对,名实相符方可施行,否则违反禁忌导致逆证,就失去了立法的本意。所以许文正公(许衡)说:近世讨论医学,有主张河间刘氏(刘完素)的,有主张易老张氏(张元素)的。张氏用药根据四季阴阳升降规律进行增减,符合《内经》“四气调神”的意义;医生如果不了解这一点而妄行处方,是没有医术的。刘氏用药致力于推陈出新,不让体内稍有郁滞,符合造化生生不息的意义;医生如果不了解这一点,也是没有医术的。然而,主张张氏的人,或许未能完全掌握张氏的奥妙,对于产生瞑眩反应(服药后病情暂时加重随后好转)的药剂最终不敢投用,以致错失良机、延误时机而无法救治的情况很多。主张刘氏的人,或许未能透彻理解刘氏的深意,虽然能迅速见效,却损伤正气,留下日后祸患的情况也很多。如果能运用两家的长处而避免两家的弊端,那么治疗大概就可以达到理想境界了。从这两方的制法可以看出,大体上学医之人应当在经典理论中探求,知道各自的主旨,不可偏执于一家而已。
Yijian Rensu Yin (Easy-Standard Ginseng and Perilla Decoction) treats febrile diseases caused by cold invasion with fever and headache, or heat resembling shaoyang syndrome due to phlegm-fluid retention.
Qianhu (Peucedani Radix), Renshen (Ginseng Radix et Rhizoma), Zisu (Perillae Folium), Gange (Puerariae Lobatae Radix), Banxia (Pinelliae Rhizoma), Fuling (Poria), each 3 fen; Zhike (Aurantii Fructus Immaturus), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Muxiang (Aucklandiae Radix), each half qian.
The above herbs are cut into small pieces, five slices of Shengjiang (Zingiberis Rhizoma Recens) are added, and the mixture is decocted in water for oral administration.
Renshen Baidu San (Ginseng Toxin-Resolving Powder) (Formula see Cough Section).
Note: These two formulas follow the example of Chaihu (Bupleuri Radix) from the Shaoyang channel (Lesser Yang).
The explanation of Rensu Yin can be found in the Phlegm-Fluid Section.
Jufang Chaihu Shengma Tang (Official Formulation Bupleurum and Cimicifuge Decoction) treats fever, headache, aversion to wind, body pain, cold sensation in the nose, dry throat, and profuse phlegm (Formula see Wind-Injury Section).
Note: This formula involves herbs belonging to the Shaoyang (Lesser Yang), Yangming (Greater Yang), and Taiyin (Greater Yin) channels.
Gegen Jiexi Tang (Kudzu Root Muscle-Releasing Decoction) treats fever, aversion to cold, headache, and stiffness of the neck and back, applicable to Shanghan (Cold Damage) and Wenbing (Warm Diseases).
Gegen (Puerariae Lobatae Radix, 4 qian), Gui (Cinnamomi Ramulus, 1 qian), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Baishao (Paeoniae Radix Alba), each 2 qian; Mahuang (Ephedrae Herba, 3 qian).
The above herbs are cut into small pieces, Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus) are added, and the mixture is decocted.
Note: This formula involves herbs belonging to the Taiyang (Greater Yang), Yangming (Greater Yang), and Taiyin (Greater Yin) channels.
Zhimu Gegen Tang (Anemarrhenae and Kudzu Root Decoction) treats body heat, headache, applicable to Fengwen (Wind-Warmth) and Wendu (Warm-Toxic) syndromes.
Zhimu (Anemarrhenae Rhizoma, 1.5 qian), Gegen (Puerariae Lobatae Radix, 4 qian), Shigao (Gypsum Fibrosum, 3 qian), Gancao (Glycyrrhizae Radix et Rhizoma), Muxiang (Aucklandiae Radix), Shengma (Cimicifugae Rhizoma), Huangqin (Scutellariae Radix), Nanting (Arisaematis Rhizoma Preparatum), Renshen (Ginseng Radix et Rhizoma), Fangfeng (Saposhnikoviae Radix), Xingren (Armeniacae Semen Amarum), Chuanxiong (Ligustici Chuanxiong Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), each 1 qian; Weirui (Polygonati Odorati Rhizoma, 2.5 qian); Mahuang (Ephedrae Herba, 2 qian).
The above herbs are cut into small pieces, divided into two doses, Shengjiang (Zingiberis Rhizoma Recens) is added, and the mixture is decocted.
Note: This formula involves herbs belonging to the Taiyang (Greater Yang), Yangming (Greater Yang), and Taiyin (Greater Yin) channels. The above three formulas all follow the principles of the Taiyang channel.
Hejian Liushen Tongjie San (Hejian Six-Efficacy Unblocking-Decoction Powder) treats fever, headache, thirst, body pain, surging pulse, and absence of sweating.
Mahuang (Ephedrae Herba, 2 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 3 qian), Shigao (Gypsum Fibrosum), Huashi (Talcum), Huangqin (Scutellariae Radix), each 4 qian; Cangzhu (Atractylodis Rhizoma, 8 qian).
The above herbs are cut into small pieces, Shengjiang (Zingiberis Rhizoma Recens) and Congbai (Allii Fistulosi Bulbus) are added, and the mixture is decocted.
Note: This formula involves herbs belonging to the Three Yang channels and the Hand-Foot Taiyin channels, derived from the Taiyang channel variations.
Yilao Jiuwei Qianghuo Tang (Master Yi's Nine-Ingredient Notopterygium Decoction) treats fever, aversion to cold, absence of sweating or spontaneous sweating, headache, stiffness of the neck, or cases where Shangfeng (Wind-Injury) presents with Hanmai (Cold Pulse) and Shanghan (Cold Damage) presents with Fengmai (Wind Pulse); it is suitable for all such conditions.
Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Cangzhu (Atractylodis Rhizoma), each 1.5 qian; Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Shengdihuang (Rehmanniae Radix Recens), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Xixin (Asari Radix et Rhizoma, 1 qian).
The above herbs are cut into small pieces and decocted in water.
Note: This formula involves herbs belonging to the Taiyang, Yangming, and Three Yin channels.
Master Yi stated: The Classic says that those with sweating should not take Mahuang (Ephedrae Herba), and those without sweating should not take Guizhi (Cinnamomi Ramulus). If mistakes are made, the resulting changes are incalculable. Therefore, this method was established to avoid violating the contraindications of the Three Yang channels, making it a divine formula for resolving exterior pathogens, not merely a medicine for miscellaneous diseases.
Respectfully noted: Zhang Zhongjing, in his discussion on releasing-the-exterior medicines for Shanghan, categorized them into the Six Channels, as well as methods for releasing the muscle layer and acupuncture. This was likely out of caution against misusing medicines leading to erroneous transformations. The above collected formulas are all variations of exterior-releasing treatments for Shanghan. One must carefully examine the pulse and symptoms before choosing to use them. However, although Yilao's Jiuwei Qianghuo Tang and Hejian's Tongjie San have different intentions, one must ensure that the medicine corresponds to the syndrome and that the name matches the reality before applying them. Otherwise, violating contraindications will lead to adverse reactions, losing the original intent of establishing the formula. Thus, Xu Wenzheng Gong (Xu Heng) said: In recent times, medical discussions include proponents of Hejian Liu Shi (Liu Wansu) and proponents of Yilao Zhang Shi (Zhang Yuansu). Zhang Shi's medication is based on the rising and falling of Yin and Yang across the four seasons, aligning with the meaning of "Regulating Spirit according to the Four Qi" in the Neijing. A physician who does not understand this and prescribes recklessly lacks skill. Liu Shi's medication focuses on eliminating the old and generating the new, preventing any stagnation, aligning with the meaning of continuous creation in nature. A physician who does not understand this also lacks skill. However, those advocating Zhang Shi may not fully grasp his subtleties, thus fearing to administer medications causing Mingxuan reactions (initial aggravation followed by improvement), leading to missed opportunities and untreatable delays. Those advocating Liu Shi may not fully comprehend his depth, achieving immediate effects but damaging righteous Qi and leaving future harm. If one can utilize the strengths of both schools while avoiding their drawbacks, treatment will likely succeed. From the formulation methods of these two formulas, it is evident that students of medicine should seek understanding in the classics, knowing their respective emphases, and should not be biased toward a single school.