仲景瓜蒂散
子和三圣散
元戎胜金丸
方并见痰饮门
按贾元良曰宣剂者涌吐是也以君召臣曰宣言以上召下之义也俚人以泻为宣非也古曰春宣
五脏
之积滞仲景大法春则人病在头故宜吐之南地人服屠苏自下而上是也下攻者非也然一切风热积
热或火炽者其证寸口脉滑而有力胸中实满烦 气上而不化面赤痰盛骂詈惊骇等证并宜吐之但
以上诸方恐非所宜义见痰饮门
东垣泻阴火升阳汤治肌热烦热面赤食少喘咳痰盛脉右关缓弱或弦或浮数
羌活 甘草(炙) 黄 苍术(各一两) 升麻(八钱) 柴胡(一两半) 人参 黄芩(各
七钱) 黄连(半两酒炒) 石膏(半两秋深勿用)
上 咀每服一两或半两水煎
按此发脾胃火邪之剂又心胆肝肺膀胱药也泻阴火升发阳气荣养气血也
升阳散火汤治男子妇人四肢发热肌热筋痹热骨髓中热发困热如燎扪之烙手此病多因血虚
而得之或胃虚过食冷物抑遏阳气于脾土火郁则发之
升麻 葛根 独活 羌活(各半两) 防风(二钱半) 柴胡(八钱) 甘草(炙三钱) 人参
白芍(各半两) 甘草(生二钱)
上 咀每服半两或一两水煎稍热服
按此胃胆脾肺膀胱经药也
千金麦门冬汤治诸病后火热乘肺咳唾有血胸胁胀满上气羸瘦五心烦热渴而烦闷
麦门冬 桑白皮 生地黄(各一两) 半夏 紫菀 桔梗 淡竹茹 麻黄(各七钱半) 五
味子 甘草(各半两)
上 咀每服五钱或一两入姜煎
按此心肺药也然麻黄恐非病后所宜
拔萃方地骨皮散治浑身壮热脉长而滑阳毒火炽发渴
地骨皮 茯苓(各半两) 柴胡 黄芩 生地黄 知母(各一两) 石膏(二两) 羌活 麻
黄(各七钱半有汗并去之)
上 咀每服一两入姜煎
按此肝心脾肺肾药又表里气血之剂也云歧子曰在五脏之标本者皆可用
栀子仁汤治发热潮热发狂烦躁面赤咽痛
栀子仁 赤芍 大青 知母(各一钱) 升麻 黄芩 石膏(各二钱) 杏仁(二钱) 柴胡
(二钱半) 甘草(二钱) 豉(百粒)
上 咀水煎
按此脾肺肝胆胃经药也
阳毒升麻汤治伤寒杂病汗吐下后变成阳毒发狂谵妄喉痛下利
升麻(五钱) 犀角 射干 黄芩 人参 甘草(各二钱半)
上 咀水煎
按此升散肺胃火热药也
葛根橘皮汤治诸热证温毒成 或咳或心闷或呕
葛根(三钱) 橘皮 杏仁 知母 黄芩 麻黄 甘草(各二钱)
上 咀入姜煎
按此肺胃膀胱经药也
谨按古方治火升散之剂其例少得姑采以上诸方以备其旨
张仲景的瓜蒂散
子和(刘完素弟子,金元四大家之一)的三圣散
元戎(寇宗奭)的胜金丸
这些方剂均详见于“痰饮门”章节。
按语:贾元良说:“宣剂”的作用在于涌吐。所谓“君召臣”,是以上位者召唤下位者的含义。民间将“泻下”称为“宣”,这是错误的。古法认为,春季应宣通五脏的积滞。张仲景的大法指出,春季人体病邪多在头部,因此适宜采用吐法。南方人服用屠苏酒时,是从下往上饮用,这就是顺应气机上升的道理;若用攻下法则是错误的。然而,对于一切风热、积热或火势炽盛的情况,其症状表现为寸口脉滑而有力,胸中实满烦闷,气上逆而不化,面红,痰多,骂人叫喊,惊恐骇异等证候,都适宜使用吐法。只是上述几个方剂恐怕并不完全适宜。具体义理参见“痰饮门”。
李东垣的泻阴火升阳汤,治疗肌表发热、烦热、面红、饮食减少、喘咳、痰多、脉象右关缓弱或弦或浮数。
药材:羌活、甘草(炙)、黄芩、苍术(各一两)、升麻(八钱)、柴胡(一两半)、人参、黄芩(各七钱)、黄连(半两,酒炒)、石膏(半两,深秋时节勿用)。
制法:切碎,每次服用一两或半两,水煎服。
按语:此方是发散脾胃火邪的药剂,同时也涉及心、胆、肝、肺、膀胱经的药物。作用是泻除阴火,升发阳气,以荣养气血。
升阳散火汤,治疗男子妇人四肢发热、肌热、筋痹热、骨髓中热、困倦乏力、热感如火燎原、触摸时烫手。此病多因血虚所致,或因胃虚过食生冷之物,抑制遏阻了阳气在脾土中的运行,导致火郁结而发作。
药材:升麻、葛根、独活、羌活(各半两)、防风(二钱半)、柴胡(八钱)、甘草(炙三钱)、人参、白芍(各半两)、生甘草(二钱)。
制法:切碎,每次服用半两或一两,水煎,稍热时服用。
按语:此方涉及胃、胆、脾、肺、膀胱经的药物。
千金方麦门冬汤,治疗各种疾病之后,火热之邪乘袭肺部,咳嗽唾血,胸胁胀满,气逆上冲,身体消瘦,五心烦热,口渴且烦躁闷乱。
药材:麦门冬、桑白皮、生地黄(各一两)、半夏、紫菀、桔梗、淡竹茹、麻黄(各七钱半)、五味子、甘草(各半两)。
制法:切碎,每次服用五钱或一两,加入生姜同煎。
按语:此方主要作用于心和肺。然而,麻黄恐怕不适用于病后体虚之人。
拔萃方地骨皮散,治疗浑身壮热,脉象长而滑,阳毒火炽,引发口渴。
药材:地骨皮、茯苓(各半两)、柴胡、黄芩、生地黄、知母(各一两)、石膏(二两)、羌活、麻黄(各七钱半,若有汗则去除麻黄)。
制法:切碎,每次服用一两,加入生姜同煎。
按语:此方涉及肝、心、脾、肺、肾经,又是表里双解、气血同调的药剂。云歧子说,凡是在五脏标本层面的病症都可以使用。
栀子仁汤,治疗发热、潮热、发狂、烦躁、面红、咽痛。
药材:栀子仁、赤芍、大青、知母(各一钱)、升麻、黄芩、石膏(各二钱)、杏仁(二钱)、柴胡(二钱半)、甘草(二钱)、豆豉(百粒)。
制法:切碎,水煎服。
按语:此方涉及脾、肺、肝、胆、胃经的药物。
阳毒升麻汤,治疗伤寒杂病,经过汗、吐、下法治疗后,转变为阳毒,出现发狂、谵妄、喉痛、下利等症状。
药材:升麻(五钱)、犀角、射干、黄芩、人参、甘草(各二钱半)。
制法:切碎,水煎服。
按语:此方是升散肺胃火热之邪的药剂。
葛根橘皮汤,治疗各种热证、温毒成疾,或咳嗽,或心胸闷乱,或呕吐。
药材:葛根(三钱)、橘皮、杏仁、知母、黄芩、麻黄、甘草(各二钱)。
制法:切碎,加入生姜同煎。
按语:此方涉及肺、胃、膀胱经的药物。
Zhang Zhongjing's Gengti San (Melon Seed Powder)
Hezi's Sansheng San (Three Holy Powders)
Yuanrong's Shengjin Wan (Winning Gold Pill)
These formulas are detailed in the "Phlegm-Fluids Section".
Commentary: Jia Yuanliang stated that the function of Xuan agents (Agents for Dissemination/Dispersal) is to induce vomiting. The concept of "the Sovereign summoning the Minister" implies the principle of the superior calling down to the inferior. It is incorrect for laypeople to equate "purging" (Xie) with "disseminating" (Xuan). Ancient methods held that in spring, one should disseminate and clear stagnation in the five Zang organs. Zhang Zhongjing's general principle states that in spring, pathogenic factors tend to affect the head, so vomiting therapy is appropriate. In southern regions, people consume Tusu wine from bottom to top, which aligns with the upward movement of Qi; using purgative methods would be incorrect. However, for all conditions involving wind-heat, accumulated heat, or blazing fire, characterized by a slippery and forceful pulse at the Cun position (distal radial artery), fullness and oppression in the chest, rebellious Qi that fails to transform, red face, profuse phlegm, cursing, shouting, fright, and terror, vomiting therapy is suitable. Nevertheless, the aforementioned formulas may not be entirely appropriate. For further principles, refer to the "Phlegm-Fluids Section".
Li Dongyuan's Xie Yin Huo Sheng Yang Tang (Decoction to Drain Yin-Fire and Raise Yang) treats muscle fever, vexatious heat, red face, poor appetite, wheezing and coughing, profuse phlegm, and a pulse that is slow and weak, wiry, or floating and rapid at the Right Guan position (radial artery over the scaphoid bone).
Herbs: Qianghuo (Notopterygii Rhizoma et Radix), Gancao (Licorice Root, processed with honey), Huangqin (Scutellariae Radix), Cangzhu (Atractylodis Rhizoma) (each 1 liang); Shengma (Cimicifugae Rhizoma) (8 qian); Chaihu (Bupleuri Radix) (1.5 liang); Renshen (Ginseng Radix et Rhizoma), Huangqin (Scutellariae Radix) (each 7 qian); Huanglian (Coptidis Rhizoma) (0.5 liang, stir-fried with wine); Shigao (Gypsum Fibrosum) (0.5 liang, do not use in late autumn).
Preparation: Coarsely crush. Take 1 liang or 0.5 liang per dose, decoct in water.
Commentary: This formula disperses Fire-Evil of the Spleen and Stomach. It also acts on the Heart, Gallbladder, Liver, Lung, and Bladder meridians. Its action is to drain Yin-Fire, raise Yang-Qi, and nourish Blood and Qi.
Sheng Yang San Huo Tang (Decoction to Raise Yang and Disperse Fire) treats men and women suffering from heat in the four limbs, muscle heat, heat in sinews and bi-syndromes, heat in the bone marrow, lethargy, and a sensation of heat like burning embers where the skin feels hot to the touch. This condition often arises from Blood deficiency or from excessive consumption of cold foods due to Stomach deficiency, which suppresses and obstructs Yang-Qi within the Spleen-Earth, causing Fire to stagnate and erupt.
Herbs: Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Radix), Duhuo (Angelicae Pubescentis Radix), Qianghuo (Notopterygii Rhizoma et Radix) (each 0.5 liang); Fangfeng (Saposhnikoviae Radix) (2.5 qian); Chaihu (Bupleuri Radix) (8 qian); Gancao (Licorice Root, processed with honey) (3 qian); Renshen (Ginseng Radix et Rhizoma), Baishao (Paeoniae Radix Alba) (each 0.5 liang); Sheng Gancao (Raw Licorice Root) (2 qian).
Preparation: Coarsely crush. Take 0.5 liang or 1 liang per dose, decoct in water, and take slightly warm.
Commentary: This formula acts on the Stomach, Gallbladder, Spleen, Lung, and Bladder meridians.
Qianjin Fang's Maimendong Tang (Decoction of Ophiopogon) treats various post-illness conditions where Heat-Fire attacks the Lung, causing coughing and spitting blood, distension and fullness in the chest and hypochondrium, rebellious Qi, emaciation, heat sensation in the five centers (palms, soles, and chest), thirst, and vexation with mental restlessness.
Herbs: Maimendong (Ophiopogonis Tuber), Sangbaipi (Mori Cortex), Sheng Dihuang (Rehmanniae Radix Recens) (each 1 liang); Banxia (Pinelliae Rhizoma), Ziwan (Asteri Radix), Jiegeng (Platycodonis Radix), Dan Zhuru (Bambusae Caulis in Taenia), Mahuang (Ephedrae Herba) (each 7.5 qian); Wuweizi (Schisandrae Fructus), Gancao (Licorice Root) (each 0.5 liang).
Preparation: Coarsely crush. Take 5 qian or 1 liang per dose, decoct with fresh ginger.
Commentary: This formula primarily targets the Heart and Lungs. However, Mahuang (Ephedrae Herba) is likely unsuitable for patients recovering from illness.
Bacui Fang's Digupi San (Powder of Lycii Cortex) treats severe whole-body fever, a long and slippery pulse, Yang-Toxin with blazing Fire, and thirst.
Herbs: Digupi (Lycii Cortex), Fuling (Poria) (each 0.5 liang); Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Sheng Dihuang (Rehmanniae Radix Recens), Zhimu (Anemarrhenae Rhizoma) (each 1 liang); Shigao (Gypsum Fibrosum) (2 liang); Qianghuo (Notopterygii Rhizoma et Radix), Mahuang (Ephedrae Herba) (each 7.5 qian; discard Mahuang if sweating is present).
Preparation: Coarsely crush. Take 1 liang per dose, decoct with fresh ginger.
Commentary: This formula acts on the Liver, Heart, Spleen, Lung, and Kidney meridians, and serves as a formula for both exterior and interior, regulating both Blood and Qi. Yunqi Zi stated that it can be used for conditions related to the root and branch of the five Zang organs.
Zhizi Ren Tang (Decoction of Gardenia Seed) treats fever, tidal fever, mania, irritability, red face, and sore throat.
Herbs: Zhizi Ren (Gardeniae Semen), Chishao (Red Peony Root), Daqing (Indigo Naturalis), Zhimu (Anemarrhenae Rhizoma) (each 1 qian); Shengma (Cimicifugae Rhizoma), Huangqin (Scutellariae Radix), Shigao (Gypsum Fibrosum) (each 2 qian); Xingren (Pruni Semen) (2 qian); Chaihu (Bupleuri Radix) (2.5 qian); Gancao (Licorice Root) (2 qian); Chi Xiao Dou (Fermented Soybean) (100 grains).
Preparation: Coarsely crush, decoct in water.
Commentary: This formula acts on the Spleen, Lung, Liver, Gallbladder, and Stomach meridians.
Yangdu Shengma Tang (Decoction of Cimicifuga for Yang-Toxin) treats Shanghan (Cold Damage) and miscellaneous diseases that, after sweating, vomiting, or purging therapies, transform into Yang-Toxin, manifesting as mania, delirium, sore throat, and diarrhea.
Herbs: Shengma (Cimicifugae Rhizoma) (5 qian); Xijiao (Rhinocerotis Cornu), Shegan (Belamcandae Rhizoma), Huangqin (Scutellariae Radix), Renshen (Ginseng Radix et Rhizoma), Gancao (Licorice Root) (each 2.5 qian).
Preparation: Coarsely crush, decoct in water.
Commentary: This formula raises and disperses Fire-Heat of the Lung and Stomach.
Gegen Jupi Tang (Decoction of Kudzu Root and Tangerine Peel) treats various heat syndromes, Warm-Toxin becoming established, cough, chest oppression, or vomiting.
Herbs: Gegen (Puerariae Radix) (3 qian); Jupi (Citri Reticulatae Pericarpium), Xingren (Pruni Semen), Zhimu (Anemarrhenae Rhizoma), Huangqin (Scutellariae Radix), Mahuang (Ephedrae Herba), Gancao (Licorice Root) (each 2 qian).
Preparation: Coarsely crush, decoct with fresh ginger.
Commentary: This formula acts on the Lung, Stomach, and Bladder meridians.
Respectfully noted: Ancient formulas employing ascending and dispersing methods to treat Fire are few in number. I have tentatively collected the above formulas to preserve their intent.