（张介宾《新方八阵》） 治水亏火盛，六脉浮洪滑大，少阴不足，阳明有余，烦热干
渴，头痛牙疼，失血等证。若大便溏者非宜。
生石膏（三五钱） 熟地（三五钱或一两） 麦冬（二钱） 知母 牛膝（各一钱半） 水
一钟半，煎七分，温服或冷服。
玉女煎方熟地膝，麦冬知母石膏集。（此寓补阴于清火之中。泻黄散用防风，欲其火从
上散；此用牛膝，欲其火从下达。）水亏火盛脉浮洪，（《脉诀》∶“浮洪为虚火，浮滑为痰热。
”）烦热渴干征效必。头痛牙疼失血余，少阴不足阳明实。（失血之余，虽有烦热渴干等证，
总由阴虚火亢，治之必须滋其阴气；若虚甚者，加人参尤妙。此方治少阴阴虚、阳明火盛之
法；若少阴阳虚、阳明胃实，当用附子泻心汤。）若然大便泄而溏，此剂非宜临证悉。
治伤寒阳明腑证，热邪入里，胃实不大便，潮热谵语，自汗出，不恶寒，反恶热，痞满
燥实坚全具；杂病三焦大热，脉沉实滑数者；及少阴病，自利清水，色纯青，心下结痛，口
干舌燥者；亦治阳明刚痉，胸满口噤，卧不着席，脚挛急，必 齿。
大黄（四两酒洗） 浓朴（半斤炙） 枳实（五枚炙） 芒硝（三合） 以水一斗，先
煮朴、实取五升，去滓，纳大黄，煮取二升，去滓，纳芒硝，更上微火一两沸，分温再服。
得下，止后服。大承气汤用芒硝，枳实大黄浓朴饶。（大黄治大实，芒硝治大燥大坚，二味
治有形血药；浓朴治大满，枳实治痞，二味治无形气药。盖肠胃燥实，气必不通。故攻积之
剂，必用气分之药。其煎法先煮枳、朴，次纳大黄，再入芒硝，取生则气锐而先行，熟则气
纯而和缓。仲景欲使芒硝先化燥屎，大黄继通地道，而后枳、朴除其痞满，俾燥屎去，地道
通，则阴气上承，故方名曰“承气”。）救阴泻热功偏擅，急下阳明有七条。（《伤寒论·阳明
篇》中云急下之者，共有七条，当知夺阴者芒硝，而通阴者亦芒硝，故仲景既有下多亡阴之
大戒，而复着急下存阴之活法。盖阳明燥结日久，肾中真水为热邪吸引，告竭甚急，急泻其
热，正以急救其阴也。）痞满燥实坚潮热，（此用承气之要诀。胸闷不食为痞，胸腹膨胀为满，
大便干结为燥，腹满痛不大便为实，按之石硬为坚，日晡发热为潮热。）杂病伤寒通治疗。（有
是证则用是方，为千古心法。）热利清水口干燥，（凡口干舌燥，皆当作热治。下利而用硝、
黄，是通因通用法。）刚痉脚挛 齿要。（阳明之脉，下行至足，上入齿中。脚挛 齿，是阳
明邪火极盛，加以胸满口噤，热邪充斥三焦矣。《灵枢》谓“热而痉者死”，而仲景云“可与
此汤”，乃死里求生之法。阴气不尽为阳热所劫，因而得生者多矣。）病须过经乃可下，（病
至七八日为过经）下之若早语昏嚣。（下早则引邪入里，语言昏乱。）承气原为燥屎设，燥屎
之证当详标，汗出谵语（阳明本自汗出，加以谵语，胃中燥结矣。）不能食，（肠胃实极，故
谷食全不能入。）喘冒不卧舌干焦，（下既不通，必反上逆而为喘冒不得卧，舌干焦黑，土燥
水竭也。）脉滑数（为有宿食）而转矢气，（“矢气”，屁气也，燥粪下攻之征。）此皆承气汤
宜调。（以上为用承气之法）恶寒（病在表）呕哕（病在上焦）俱禁用，直视喘高命不牢。（直
视喘高，阳气欲脱，虽不大便，下之必死。戒之！）
（出自张介宾《新方八阵》）治疗肾阴亏损而火气亢盛，六脉呈现浮、洪、滑、大之象，少阴肾水不足，阳明胃火有余，表现为烦热、口干渴、头痛、牙痛、出血等症状。如果大便稀溏者，不宜使用此方。
生石膏（三至五钱），熟地黄（三至五钱或一两），麦冬（二钱），知母，牛膝（各一钱半）。加水一钟半，煎煮至七分量，温服或冷服。
玉女煎歌诀：熟地、牛膝、麦冬、知母、石膏齐聚一堂。（此处寓补阴于清火之中。泻黄散中使用防风，意在使火热从上焦发散；此处使用牛膝，意在使火热从下焦引泄。）肾阴亏虚火气盛则脉象浮洪，（《脉诀》说：“浮洪为虚火，浮滑为痰热。”）烦热与口渴征象明显。头痛、牙痛及出血等其余症状，源于少阴不足而阳明实证。（在出血之后，虽有烦热口渴等症状，总归是由于阴虚火旺所致，治疗必须滋养阴气；若虚损严重，加入人参尤为巧妙。此方是治疗少阴阴虚、阳明火盛的方法；若是少阴阳虚、阳明胃实，应当使用附子泻心汤。）如果大便泄泻且稀溏，此剂就不适宜，临证时需详尽辨别。
治疗伤寒阳明腑证，热邪入里，胃中实热导致不大便，潮热谵语，自汗出，不恶寒反而恶热，痞、满、燥、实、坚五种症状全部具备；杂病中三焦大热，脉象沉实滑数的；以及少阴病，自利清水，颜色纯青，心下结痛，口干舌燥的；也治疗阳明刚痉，胸满口噤，卧时背部不着席，脚部拘挛急迫，必定咬牙。
大黄（四两，酒洗），厚朴（半斤，炙），枳实（五枚，炙），芒硝（三合）。用水一斗，先煮厚朴和枳实，取五升药液，去渣，加入大黄，再煮取二升药液，去渣，加入芒硝，再上火微沸一两分钟，分两次温服。服药后若已通便，停服后面的药。
大承气汤歌诀：大承气汤用芒硝，加上枳实、大黄、厚朴。（大黄治疗大实，芒硝治疗大燥大坚，这两味药治理有形的血瘀积滞；厚朴治疗大满，枳实治疗痞块，这两味药治理无形的气滞。因为肠胃燥实，气机必然不通。所以攻积的药剂，必须使用理气分的药物。其煎法是先煮枳实、厚朴，次纳大黄，最后入芒硝，目的是取生大黄之气锐利而先行，熟则气纯正而和缓。张仲景希望芒硝先化解燥屎，大黄接着疏通肠道，然后枳实、厚朴消除痞满，使得燥屎去除，肠道通畅，阴气得以上承，所以方名叫做“承气”。）本方擅长救阴泻热，急下存阴有七种情况。（《伤寒论·阳明篇》中提到需要急下的，共有七条，应当知道夺阴的是芒硝，而通阴的也是芒硝，所以张仲景既有下法过多亡阴的大戒律，又反复强调急下存阴的灵活方法。因为阳明燥结日久，肾中真水被热邪吸引，枯竭得非常紧急，急泻其热，正是为了急救其阴。）痞、满、燥、实、坚、潮热，（这是使用承气汤的要诀。胸闷不食称为痞，胸腹膨胀称为满，大便干结称为燥，腹满痛且不大便称为实，按之像石头一样硬称为坚，下午发热称为潮热。）杂病和伤寒都通用治疗。（有这些证候就用这个方子，这是千古不变的心法。）热性下利清水且口干燥，（凡是口干舌燥，都应当当作热证治疗。下利用芒硝、大黄，是通因通用的治法。）刚痉脚挛急且咬牙是关键。（阳明的经脉，下行至足，上行进入齿中。脚挛急且咬牙，是阳明邪火极盛的表现，再加上胸满口噤，热邪充斥三焦了。《灵枢》说“热而痉者死”，而张仲景说“可与此汤”，这是死里求生的方法。只要阴气没有被阳热完全劫夺，因而得生的情况很多。）病须经过传变阶段才可攻下，（病至七八日为过经）攻下过早会导致神昏谵语。（攻下过早会引邪入里，导致语言昏乱。）承气汤原本是为燥屎设立的，燥屎的证候应当详细辨别，汗出谵语（阳明本来自汗出，加上谵语，说明胃中燥结）、不能进食（肠胃实热至极，所以食物完全无法进入）、喘促头晕不能卧、舌干焦黑（下法不通，必然反向上逆而为喘促头晕不得卧，舌干焦黑，这是土燥水竭的表现）、脉滑数（表示有宿食）且转矢气（“矢气”即放屁，是燥粪向下攻逐的迹象），这些都是适合调服承气汤的指征。（以上是用承气汤的方法）若有恶寒（病在表）或呕哕（病在上焦）均禁用，出现直视、喘促抬肩则生命危殆。（直视喘高，阳气欲脱，即使不大便，攻下必死。切记！）
(From Zhang Jiebin's *Xin Fang Ba Zhen*) Treats conditions of Kidney Yin deficiency with Fire hyperactivity, where the six pulses are floating, surging, slippery, and large. It addresses Shaoyin insufficiency (deficiency of the Shaoyin channel/Kidney) and Yangming excess (excess in the Yangming channel/Stomach), manifesting as vexation and heat, dryness and thirst, headache, toothache, and bleeding. It is not suitable for those with loose stools.
Raw Gypsum (3-5 qian), Prepared Rehmannia Root (3-5 qian or 1 liang), Ophiopogon Tuber (2 qian), Anemarrhena Rhizome, Achyranthes Bidentata Root (each 1.5 qian). Add one and a half zhong of water, decoct to seven-tenths volume, take warm or cold.
**Yunü Jian (Jade Woman Decoction) Formula Verse:**
Shu Di, Niu Xi, Mai Dong, Zhi Mu, Shi Gao gather together. (This implies nourishing Yin within the process of clearing Fire. In Xie Huang San, Fang Feng is used to allow Fire to scatter from above; here, Niu Xi is used to allow Fire to descend from below.) When Water (Yin) is deficient and Fire is excessive, the pulse is floating and surging. (*Mai Jue* states: "Floating and surging indicates Deficient Fire; floating and slippery indicates Phlegm-Heat.") Vexation, heat, dryness, and thirst are evident signs. Headache, toothache, and bleeding are residual symptoms; Shaoyin is insufficient while Yangming is solid/excess. (After bleeding, although there are signs like vexation, heat, dryness, and thirst, it is fundamentally due to Yin deficiency with Fire hyperactivity; treatment must nourish Yin. If deficiency is severe, adding Ren Shen is excellent. This formula treats Shaoyin Yin deficiency and Yangming Fire excess; if Shaoyin Yang deficiency and Yangming Stomach excess exist, Fuzi Xixin Tang should be used.) If stool is loose and watery, this preparation is unsuitable; clinical judgment must be thorough.
Treats Yangming Fu syndrome of Shanghan (Cold Damage), where Heat pathogen enters the interior, causing Stomach excess with constipation, tidal fever, delirium, spontaneous sweating, aversion to cold absent but aversion to heat present, with all five symptoms of Pi (glomus/fullness), Man (distension), Zao (dryness), Shi (solidity), and Jian (hardness) present; also treats miscellaneous diseases with intense Heat in the Triple Burner and pulses that are deep, solid, slippery, and rapid; and Shaoyin disease presenting with spontaneous purging of clear water, pure green color, epigastric knotting pain, dry mouth, and dry tongue; also treats Yangming Gang Jing (Stiff Spasm), characterized by chest fullness, trismus (lockjaw), inability to lie flat with back touching the bed, leg cramps, and teeth grinding.
Rhubarb Root (4 liang, washed with wine), Magnolia Bark (8 liang, stir-fried), Immature Bitter Orange (5 pieces, stir-fried), Mirabilite (3 he). Use one dou of water. First decoct Magnolia Bark and Immature Bitter Orange to obtain five sheng of liquid, remove dregs, add Rhubarb, decoct to obtain two sheng, remove dregs, add Mirabilite, boil gently for one or two boils, divide into two warm doses. If bowel movement occurs, stop taking the remaining dose.
**Da Chengqi Tang (Major Order the Qi Decoction) Formula Verse:**
Da Chengqi Tang uses Mirabilite, along with Rhubarb, Immature Bitter Orange, and Magnolia Bark. (Rhubarb treats major solidity; Mirabilite treats major dryness and hardness; these two treat tangible blood stasis/accumulation. Magnolia Bark treats major fullness; Immature Bitter Orange treats glomus; these two treat intangible Qi stagnation. Since intestinal and stomach dryness-solidity leads to Qi blockage, purgative agents must use Qi-moving herbs. The decoction method first boils Immature Bitter Orange and Magnolia Bark, then adds Rhubarb, and finally Mirabilite. This aims to utilize the sharp Qi of raw Rhubarb to act quickly, while cooked herbs have milder, harmonizing Qi. Zhang Zhongjing intended for Mirabilite to first dissolve dry feces, Rhubarb to subsequently unblock the intestinal pathway, and then Immature Bitter Orange and Magnolia Bark to eliminate glomus and fullness, allowing dry feces to pass and the pathway to open, so that Yin Qi ascends. Hence the name "Chengqi" [Ordering the Qi].) This formula excels at saving Yin and purging Heat; there are seven indications for urgent purgation in Yangming. (In the *Shanghan Lun · Yangming Chapter*, there are seven clauses mentioning urgent purgation. One must know that Mirabilite depletes Yin but also unblocks Yin. Thus, while Zhang Zhongjing issued a strict warning against excessive purgation leading to Yin loss, he also emphasized the flexible method of urgent purgation to preserve Yin. Because Yangming dryness-solidity persists for a long time, the True Water of the Kidney is drawn away by Heat pathogens, facing imminent exhaustion. Urgently purging Heat is precisely to urgently save Yin.) Pi, Man, Zao, Shi, Jian, and tidal fever are key points for using Chengqi formulas. (Glomus without appetite is Pi; chest/abdominal distension is Man; dry hard stool is Zao; abdominal fullness/pain with constipation is Shi; stone-hard upon palpation is Jian; afternoon fever is tidal fever.) These apply to both miscellaneous diseases and Shanghan. (Use this formula when these signs are present; this is an eternal principle.) Hot diarrhea with clear water and dry mouth/thirst: (Any dry mouth and tongue should be treated as Heat. Using Mirabilite and Rhubarb for diarrhea applies the method of "treating obstruction with unblocking".) Stiff spasm, leg cramps, and teeth grinding are critical signs. (The Yangming meridian descends to the foot and enters the teeth. Leg cramps and teeth grinding indicate extreme Yangming Evil Fire, compounded by chest fullness and trismus, with Heat filling the Triple Burner. *Ling Shu* states "Heat with spasm leads to death," yet Zhang Zhongjing says "this decoction may be given," which is a method of seeking life in death. Many survive if Yin Qi is not completely depleted by Yang Heat.) Purgation is only permissible after the disease has passed through its stages (illness lasting 7-8 days is "passing the stage"); purging too early causes delirious speech and confusion. (Early purgation draws the pathogen inward, causing confused speech.) Chengqi Tang was originally designed for dry feces; the signs of dry feces must be carefully distinguished. Signs include sweating and delirium (Yangming naturally sweats; combined with delirium, it indicates Stomach dryness-solidity), inability to eat (extreme intestinal/stomach excess prevents food intake), wheezing, vertigo, insomnia, and dry black tongue coating (failure of downward purgation leads to upward rebellion causing wheezing/vertigo/insomnia; dry black tongue indicates Earth dryness and Water exhaustion); slippery and rapid pulse (indicates retained food) and passing gas ("shi qi" means flatulence, a sign of dry feces attacking downward). All these indicate suitability for adjusting with Chengqi Tang. (These are the methods for using Chengqi.) Aversion to cold (pathogen in the exterior) and belching/hiccups (pathogen in the Upper Burner) are strictly contraindicated. Fixed gaze and labored breathing indicate impending death. (Fixed gaze and labored breathing suggest Yang Qi depletion; even with constipation, purgation will cause death. Beware!)