肉桂 甘草 生姜 芍药 大枣 饴糖
腹中急痛,左脉涩,右脉弦,此方主之。
邪气入里,与正相搏,则腹痛急甚。脉涩者血滞,弦者木克土也。故用芍药之酸,于土中泻木;肉桂之香,
于脾中行血;脾急欲缓,饴糖、炙草之纯甘以缓之;中寒须温,生姜、大枣之辛甘以温之。曰建中者,脾居四脏
之中,得此症必此汤,脾气始建。呕家虽腹痛不用,为其甘也。然只在饴糖一味耳。今人用是汤,绝不言及饴糖,
未窥仲景之奥。
蜀椒 干姜 人参 饴糖
头风痛不敢触,服攻散之剂加甚者,与此方。
阳气藏于土木,会于头。阳虚适风邪中之,故发痛。误
攻与散,阴寒之气,复逆而上冲,故转甚而不可触近。乃用椒,姜之辛热逐冷散逆;参、糖之甘温,回阳补土,
则中气大建而风痛顿除。
十全大补加麦冬、苁蓉、半夏、附子。
汗吐下后,中气虚乏,真元无所附丽,再形为事劳,精听欲役,则无根之火一激而上,隐隐发为目痛,或睑
胞浮胀。以参、 、炙草、当归补虚而和中,桂、附、芎 、芍药助阳以祛邪。不效,加地黄、麦冬、苁蓉清其
燥,白术、茯苓、半夏除其湿。所谓中营之帜一建,而失伍之师一一各就其列,不终日而目宁矣。或谓以参、 、
桂、附、建中、理中等治目,法之变者也。医未至通权达变,与不知医何异。知言哉。
诗曰∶建中妙饴糖,甘桂姜芍枣;参椒易桂芍,大建方亦好;十全加苁蓉,附夏麦门冬,列名十四味,症治
异而同。
肉桂、甘草、生姜、芍药、大枣、饴糖。
腹部拘急疼痛,左脉涩滞,右脉弦紧,此方主治。
邪气侵入体内,与正气相互搏结,导致腹痛剧烈。脉象涩滞代表血行瘀滞,脉象弦紧代表肝木克制脾土。因此使用芍药的酸味,在脾土中泻除肝木之邪;使用肉桂的香气,在脾经中运行血液;脾脏拘急想要舒缓,用饴糖和炙甘草的纯甘之性来缓急;中焦有寒需要温煦,用生姜和大枣的辛甘之性来温补。称为“建中”,是因为脾脏位于四脏之中,出现这种病症必须服用此汤,脾气才能建立。呕吐患者虽然腹痛也不宜使用,因为该方过于甘甜。然而关键在于饴糖这一味药。现在的人使用这个方剂,绝口不提饴糖,这是没有窥探到张仲景的奥妙所在。
蜀椒、干姜、人参、饴糖。
头部受风邪侵袭而疼痛,不敢触碰,服用攻散类药物后症状加重的,给予此方。
阳气藏于肝木和心火(土木),汇聚于头部。阳气虚弱时适逢风邪中伤,所以引发疼痛。误用攻伐和发散药物,阴寒之气反而逆乱上冲,所以病情加重且不可触碰靠近。于是使用蜀椒、干姜的辛热之性驱逐寒冷、消散逆气;用人参、饴糖的甘温之性,回阳救逆、补益脾土,那么中气大建而风痛顿时消除。
十全大补汤(Shiquan Dabu Decoction)加入麦冬、肉苁蓉、半夏、附子。
经过发汗、催吐、泻下治疗后,中气虚弱匮乏,真元无所依附,再加上形体劳损,精神听觉欲被役使,则无根之火被激发而上炎,隐隐发作目痛,或者眼睑浮肿胀大。用人参、[此处原文缺字,据方义推测为黄芪或类似补气药,但依规则不推测,故略去或视为原文缺失]、炙甘草、当归补虚并调和脾胃,用肉桂、附子、川芎、芍药助阳以祛除邪气。如果无效,加入地黄、麦冬、肉苁蓉清解燥热,白术、茯苓、半夏去除湿气。所谓中营的旗帜一旦树立,失散的军队便一一各归其列,不到一天眼睛就安宁了。有人说用人参、[缺字]、肉桂、附子来治疗眼病,通过建立中气、调理中焦等方法,这是治法的变通。医生如果不能通权达变,与不懂医术有什么区别。这话真是知见卓识啊。
诗曰:建中妙在饴糖,甘、桂、姜、芍、枣;人参、蜀椒替换桂、芍,大建中汤也很好;十全大补加上肉苁蓉,附子、半夏、麦门冬,列名十四味,病症治疗不同而原理相同。
Cinnamon Twig (Guizhi), Licorice Root (Gancao), Fresh Ginger (Shengjiang), White Peony Root (Shaoyao), Jujube (Dazao), Maltose (Yitang).
Sudden and severe abdominal pain, with a choppy pulse on the left and a string-taut pulse on the right; this formula is indicated.
When pathogenic factors enter the interior and contend with healthy Qi, sudden and severe abdominal pain occurs. A choppy pulse indicates blood stasis, while a string-taut pulse indicates Wood overacting on Earth. Therefore, the sour nature of White Peony Root (Shaoyao) is used to drain Wood within Earth; the aromatic nature of Cinnamon Twig (Guizhi) is used to promote blood circulation in the Spleen channel. Since the Spleen is tense and desires relaxation, the pure sweet nature of Maltose (Yitang) and Honey-fried Licorice Root (Zhi Gancao) is used to缓和 (relax) it. Since middle-jiao cold requires warming, the pungent-sweet nature of Fresh Ginger (Shengjiang) and Jujube (Dazao) is used to warm it. It is called "Jian Zhong" (Establishing the Middle) because the Spleen resides among the four viscera; when such symptoms occur, only by taking this decoction can the Spleen Qi be established. Although patients who vomit may have abdominal pain, they should not use this formula due to its excessive sweetness. However, the key lies in the single herb Maltose (Yitang). Nowadays, people use this decoction without mentioning Maltose at all, which shows they have not penetrated the profound secrets of Zhang Zhongjing.
Sichuan Pepper (Shu Jiao), Dried Ginger (Gan Jiang), Ginseng Root (Renshen), Maltose (Yitang).
For head wind pain where one dares not touch the head, and symptoms worsen after taking dispersing agents, administer this formula.
Yang Qi is stored in Liver Wood and Heart Fire (Wood and Fire), and converges at the head. When Yang Qi is deficient and susceptible to Wind Pathogen invasion, pain ensues. Mistakenly using attacking and dispersing methods causes Yin-Cold Qi to rebel and rush upward, thus worsening the condition to the point where it cannot be touched or approached. Therefore, the pungent-hot nature of Sichuan Pepper (Shu Jiao) and Dried Ginger (Gan Jiang) is used to drive out cold and dissipate rebellion; the sweet-warm nature of Ginseng Root (Renshen) and Maltose (Yitang) is used to restore Yang and tonify Earth. Thus, the Middle Qi is greatly established, and the wind-induced pain is instantly eliminated.
Shiquan Dabu Decoction (Ten Complete Tonic Decoction) added with Ophiopogon Tuber (Maidong), Cistanche Stem (Rongshu), Pinellia Tuber (Banxia), and Prepared Aconite Root (Fuzi).
After sweating, vomiting, or purging, the Middle Qi becomes deficient and exhausted, and True Yuan has no foundation. If further physical labor occurs, and mental/auditory functions are overtaxed, then rootless Fire is激ated (provoked) and rises up, causing hidden eye pain or swelling and distension of the eyelids. Use Ginseng Root (Renshen), [missing character in original text], Honey-fried Licorice Root (Zhi Gancao), and Angelica Sinensis Root (Danggui) to tonify deficiency and harmonize the middle; use Cinnamon Twig (Guizhi), Prepared Aconite Root (Fuzi), Szechuan Lovage Rhizome (Chuanxiong), and White Peony Root (Shaoyao) to assist Yang and dispel pathogens. If ineffective, add Rehmannia Root (Dihuang), Ophiopogon Tuber (Maidong), and Cistanche Stem (Rongshu) to clear dryness, and Atractylodes Macrocephala Rhizome (Baizhu), Poria (Fuling), and Pinellia Tuber (Banxia) to remove dampness. Once the banner of the Middle Ying (Nutritive Level) is established, the scattered troops will each return to their ranks, and the eyes will be tranquil within a day. Some say that using Ginseng Root (Renshen), [missing character], Cinnamon Twig (Guizhi), and Prepared Aconite Root (Fuzi) to treat eye diseases by establishing the Middle and regulating the Center represents a variation in treatment methods. If a physician cannot adapt flexibly to circumstances, what is the difference between them and someone who knows nothing about medicine? These are words of true insight.
The poem states: Jian Zhong's wonder lies in Maltose (Yitang), Sweet, Cinnamon, Ginger, Peony, and Jujube; Ginseng and Sichuan Pepper replace Cinnamon and Peony, Da Jian Zhong Fang is also good; Shiquan Dabu adds Cistanche (Rongshu), Aconite (Fuzi), Pinellia (Banxia), and Ophiopogon (Mendong), listed as Fourteen Ingredients, different symptoms treated with similar principles.