(张元素方) 治伤寒伤风,憎寒壮热,无汗,头项腰脊强痛,呕吐口渴,及感冒四时
不正之气,温病热病。此解表之通剂。
羌活 防风 苍术(各钱半) 细辛(五分) 川芎 白芷 生地 黄芩 甘草(各一
钱) 加生姜、葱白煎。(自汗,去苍术,加白术。胸满,去生地,加枳壳、桔梗。喘,加
杏仁。夏月,加石膏、知母。汗下兼行,加大黄。药备六经,治通四时,用者当随证加减,
不可执一。)
九味羌活(汤)张元素,辛防苍芷葱姜互。(羌活入足太阳理游风,细辛入足少阴散伏
寒,苍术入足太阴去湿,白芷入足阳明散风,防风、葱、姜通发周身之汗)。益以芩草监辛
温,(诸药气味辛温,恐其僭亢,故用黄芩苦寒以监制之,甘草以调和之。)地芎入血调营故。
(生地、川芎引诸药入血祛邪,即借以调营。徐灵胎嫌生地寒滞,易以当归。甚是,宜遵之。)
三阳解表通用灵,四时感冒兼能顾。此方原以代麻黄,气弱阴虚人禁哺。(汪 庵《医方集
解》引张元素曰∶“有汗不得用麻黄,无汗不得用桂枝,若差服,则其变不可言,故立此方,
使不犯三阳禁忌,为解表效方。冬可治寒,夏可治热,春可治温,秋可治湿,是诸路之应兵
,代麻黄等汤,诚为稳当,但阴虚气弱之人在所禁耳。”)
(此方出自张元素)治疗伤寒或伤风,症见恶寒发热、无汗、头项腰脊僵硬疼痛、呕吐口渴,以及因感受四时不正之气引起的感冒,还有温病和热病。这是解表剂的通用方。
羌活、防风、苍术(各一钱半)、细辛(五分)、川芎、白芷、生地、黄芩、甘草(各一钱)。煎服时加入生姜、葱白。(若患者自汗,去掉苍术,加白术。若胸中胀满,去掉生地,加枳壳、桔梗。若气喘,加杏仁。夏季使用时,加石膏、知母。若需兼用发汗与泻下法,加大黄。本药涵盖六经病变,治疗遍及四季,使用者应当根据具体证候进行加减,不可拘泥固定。)
九味羌活汤 作者:张元素
歌诀:辛防苍芷葱姜互。(羌活入足太阳膀胱经以理游风,细辛入足少阴肾经以散伏寒,苍术入足太阴脾经以祛湿,白芷入足阳明胃经以散风,防风、葱、姜共同发散周身之汗)。益以芩草监辛温,(诸药气味多属辛温,恐其过于升散亢奋,故用黄芩之苦寒以监制,用甘草以调和诸药)。地芎入血调营故。(生地、川芎引导诸药进入血分以祛除邪气,即借此以调理营血。徐灵胎嫌弃生地性寒而滞腻,建议改用当归。非常正确,应当遵循此法)。三阳解表通用灵,四时感冒兼能顾。此方原以代麻黄,气弱阴虚人禁哺。(汪昂《医方集解》引用张元素的话说:“有汗者不可用麻黄,无汗者不可用桂枝,如果误服,则变证不可胜言,因此创立此方,使其不触犯三阳经的禁忌,成为解表的效方。冬季可治寒邪,夏季可治热邪,春季可治温邪,秋季可治湿邪,是应对各种情况的应兵,替代麻黄汤等方剂,确实稳妥,但气虚阴虚之人禁用。”)
(Zhang Yuansu's Formula) Treats Shanghan (Cold Damage) or Shangfeng (Wind Strike), presenting with aversion to cold and high fever, absence of sweating, stiffness and pain in the head, neck, waist, and spine, vomiting, and thirst. It is also indicated for common cold caused by pathogenic factors of the four seasons, as well as Wenbing (Warm Diseases) and Rebing (Heat Diseases). This is a general formula for releasing the exterior.
Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Cangzhu (Atractylodis Rhizoma) (each 1.5 qian), Xixin (Asari Radix et Rhizoma) (0.5 fen), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Shengdi (Rehmanniae Radix), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 qian). Decoct with Shengjiang (Zingiberis Rhizoma Recens) and Congbai (Allii Fistulosi Bulbus). (If spontaneous sweating occurs, remove Cangzhu and add Baizhu. If chest fullness is present, remove Shengdi and add Zhike (Aurantii Fructus) and Jiegeng (Platycodonis Radix). If wheezing occurs, add Xingren (Armeniacae Semen Amarum). In summer months, add Shigao (Gypsum Fibrosum) and Zhimu (Anemarrhenae Rhizoma). If both sweating and purging methods are required, add Dahuang (Rhei Radix et Rhizoma). This medicine covers the Six Meridians and treats conditions throughout the four seasons; users should modify it according to the specific syndrome and not adhere rigidly to one fixed prescription.)
Jiuwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction) - Zhang Yuansu
Mnemonic: Xin, Fang, Cang, Zhi, Cong, Jiang interact. (Qianghuo enters the Foot-Taiyang Bladder Meridian to manage wandering wind; Xixin enters the Foot-Shaoyin Kidney Meridian to disperse latent cold; Cangzhu enters the Foot-Taiyin Spleen Meridian to eliminate dampness; Baizhi enters the Foot-Yangming Stomach Meridian to disperse wind; Fangfeng, Congbai, and Shengjiang collectively induce sweating throughout the body). Supplement with Qin and Cao to monitor the acrid-warm nature. (Since the flavors of the various herbs are predominantly acrid and warm, fearing they may become overly ascending and hyperactive, bitter-cold Huangqin is used to restrain them, and Gancao is used to harmonize them). Di and Xiong enter the blood to regulate Ying. (Shengdi and Chuanxiong guide the other herbs into the blood level to expel pathogens, thereby regulating Ying [Nutritive Qi]. Xu Lingtai disliked the cold and cloying nature of Shengdi and suggested replacing it with Danggui (Angelicae Sinensis Radix). This is very correct and should be followed). It is effective for releasing the exterior in the Three Yang meridians and can also address common colds across the four seasons. This formula was originally intended to replace Mahuang Tang (Ephedra Decoction); it is contraindicated for those with weak Qi and Yin deficiency. (Wang Ang's *Yifang Jijie* quotes Zhang Yuansu saying: "Those with sweating must not use Mahuang; those without sweating must not use Guizhi (Cinnamon Twig). If taken incorrectly, the resulting complications are indescribable. Therefore, this formula was established to avoid violating the taboos of the Three Yang meridians, serving as an effective formula for releasing the exterior. It can treat Cold in winter, Heat in summer, Warmth in spring, and Dampness in autumn. It is a versatile force, replacing formulas like Mahuang Tang, which is indeed safe, but strictly contraindicated for individuals with Qi deficiency and Yin deficiency.")