（陶节庵《伤寒六书》） 治热邪传里，胃有燥屎，心下硬痛，身热、口渴、谵语，下
利稀水，色纯青。
大承气汤方内加人参、当归、甘草、桔梗，姜、枣煎。
黄龙汤即大承气（汤），加人参归甘桔比。煎加姜枣治阳明，证物理虚热结利。（按∶体
质气血虚人，而得阳明胃实之证，或因病误治致虚，而燥屎犹未去者，不下则邪气壅实而死，
下之又恐正气益虚而即脱。此方攻补兼施，庶几不犯虚虚之祸。曰“黄龙”者，大黄得人参
为佐，则能神其功用，如龙得云助，升腾上下，莫能测其变化也。）胃有燥屎心下坚，谵语
下利纯清水。（按∶胃有燥屎，何以又下清水？陶氏《伤寒六书》曰∶“此利非内寒而利，乃
日逐自饮汤药而利也，直急下之，名曰结热利证。”又曰∶“庸医妄谓漏底伤寒，而便用热药
止之，犹如抱薪救火，误人死者多矣。”）攻补兼施此法良，老年除去芒硝饵。（老人气血虚
甚者，去芒硝，恐重劫其阴也。）
（许叔微《普济本事方》） 治痼冷在肠胃间，泄泻腹痛。
浓朴 桂心 附子 干姜 甘草（各半两） 大黄（四钱） 咀，取一两，水二钟，
煎六分，顿服。
（孙思邈《千金要方》） 治久痢赤白，脾胃冷积，脐腹绞结痛甚。
人参 附子 芒硝 甘草（各二两） 大黄（五两） 当归 干姜（各三两） 咀，以
水七升，煮取三升，分服，日三。
温脾汤里大黄少，桂附姜甘浓朴多。（许叔微此方，仿仲景温下之法，以下肠胃之冷积。
夫冷积腹痛泄泻，而仍下之者，以锢冷积滞，久留肠胃而不去，徒用温补无益也。今此方以
干姜、桂、附为君，复入承气汤法，其大黄止用四钱，更为有见。盖不用则温药必不能下，
而久留之积，非攻不去；多用则温药恐不能制，而洞泄之势，或至转增。裁酌用之，真足为
法矣。）痼冷久留肠胃泻，宜先取去勿蹉跎。（许叔微《普济本事方》曰∶“痼冷在肠胃间，
连年泄泻腹痛，休作无时，服诸药不效，宜先取去，然后调治易瘥。不可畏虚以养病也。”
旭高按∶畏虚养病，为千古之通弊。叔微此语，顶门一针，医当猛省。）或益参归除桂朴，
亦
，与《本事方》重用温通，略加大黄，法有殊矣。盖《本事方》治冷积泄泻，故大黄宜少用；
此治滞下赤白，是其始原由于热积，故重用大黄，因痢久脾胃虚寒，而积仍未去，故加参、
甘、姜、附，温补中宫。同一大黄，而佐使君臣不同，则治证亦因之而异，后人乌得以古方
轻于加减也。按∶古方中多硝、黄、芩、连，与姜、茱、桂、附寒热并用者，亦有参、术、
硝、黄补泻兼施者，亦有大黄、麻黄汗下同行者，今人罕识其旨，姑录数方于上，以见治疗
之妙，不一端也。）
（陶节庵《伤寒六书》）治疗热邪传入体内，胃中有干燥的粪便，心窝部位坚硬疼痛，身体发热、口渴、说胡话，腹泻排出稀水，颜色纯青。
在大承气汤方中加入人参、当归、甘草、桔梗，用生姜、大枣煎煮。
黄龙汤即大承气汤，加入人参、当归、甘草、桔梗的比例相当。煎煮时加入生姜、大枣以治疗阳明病，其病机是体质虚弱兼有热结导致的腹泻。（按语：体质气血虚弱的人，却得了阳明胃实证的病，或者因病误治导致正气虚弱，而燥屎仍未去除的情况。如果不攻下，邪气壅盛实证会导致死亡；如果攻下，又恐怕正气更加虚弱而导致虚脱。此方攻邪与补正兼施，差不多可以避免犯“虚虚”之祸（使虚者更虚）。称为“黄龙”，是因为大黄得到人参作为佐助，就能神奇地发挥其功效，如同龙得到云的辅助，升腾上下，无法测度其变化。）胃中有燥屎，心窝坚硬，说胡话，腹泻排出纯清水。（按语：胃中有燥屎，为什么又排清水？陶氏《伤寒六书》说：“这种腹泻不是内寒引起的，而是因为每天自行服用汤药导致的腹泻，应当紧急攻下，名为结热利证。”又说：“庸医胡乱认为是漏底伤寒，便使用热药止泻，这犹如抱薪救火，误死人很多了。”）攻邪与补正兼施这种方法很好，老年人去掉芒硝服用。（气血非常虚弱的老人，去掉芒硝，恐怕会严重劫夺阴液。）
（许叔微《普济本事方》）治疗顽固的冷邪停留在肠胃之间，引起泄泻和腹痛。
浓朴、桂心、附子、干姜、甘草（各半两），大黄（四钱）。切碎，取一两，加水二钟，煎至六分，一次性服用。
（孙思邈《千金要方》）治疗久痢赤白，脾胃冷积，脐腹部绞结疼痛剧烈。
人参、附子、芒硝、甘草（各二两），大黄（五两），当归、干姜（各三两）。切碎，用水七升，煮取三升，分次服用，每日三次。
温脾汤里大黄用量少，桂枝、附子、干姜、甘草、浓朴用量多。（许叔微的这个方子，模仿张仲景温下的方法，用来攻下肠胃中的冷积。对于冷积引起的腹痛泄泻，仍然使用攻下药，是因为顽固的冷积停滞，长久留在肠胃中不除去，单纯使用温补没有益处。现在这个方子以干姜、桂枝、附子为君药，又融入承气汤的方法，其中大黄只用四钱，更有见识。大概是不用的话，温药必然不能下行，而长久停留的积滞，不攻除就不能去掉；用得多了，温药恐怕不能制约，而洞泄的趋势，或许会加重。斟酌使用，真正足以成为典范。）顽固的冷邪长久留在肠胃导致腹泻，应当先攻取去除，不要拖延。（许叔微《普济本事方》说：“顽固的冷邪在肠胃之间，连年泄泻腹痛，发作没有定时，服用各种药物无效，应当先攻取去除，然后调理治疗容易痊愈。不可因为畏惧虚弱而养病。”旭高按语：畏惧虚弱而养病，是千古以来的通病。许叔微这句话，如顶门一针，医生应当猛醒。）或者增加人参、当归，去掉桂枝、浓朴，也与《本事方》重用温通，略微加大黄，方法有所不同了。大概《本事方》治疗冷积泄泻，所以大黄宜少用；这里治疗滞下赤白痢疾，其起因原于热积，所以重用大黄，因为痢疾日久导致脾胃虚寒，而积滞仍未去除，所以加入人参、甘草、干姜、附子，温补中焦脾胃。同样是使用大黄，但佐使君臣不同，则治疗的病症也因此而异，后人怎么能轻易对古方进行加减呢？按语：古方中多用硝石、大黄、黄芩、黄连，与干姜、吴茱萸、桂枝、附子寒热并用的，也有用人参、白术、硝石、大黄补泻兼施的，也有用大黄、麻黄汗下同行的，今人很少理解其中的旨意，姑且记录几个方子在上方，以显示治疗的奥妙，不止一端罢了。）
(Tao Jian'an's *Six Books on Cold Damage*) Treats heat pathogen transmitting inward, with dry feces in the stomach, hardness and pain in the epigastrium, fever, thirst, delirium, diarrhea of watery stool that is purely green.
Add Ginseng Radix et Rhizoma (Renshen), Angelicae Sinensis Radix (Danggui), Glycyrrhizae Radix et Rhizoma (Gancao), Platycodonis Radix (Jiegeng) to the Dachengqi Tang (Major Order the Qi Decoction), decoct with Zingiberis Rhizoma Recens (Shengjiang) and Jujubae Fructus (Dazao).
Huanglong Tang (Yellow Dragon Decoction) is Dachengqi Tang (Major Order the Qi Decoction) added with Renshen, Danggui, Gancao, and Jiegeng in equal proportions. Decoct with Shengjiang and Dazao to treat Yangming disease; the pathology involves deficiency constitution with heat accumulation causing diarrhea. (Note: For individuals with deficient Qi and Blood constitution who contract Yangming Stomach Excess syndrome, or whose deficiency results from mis-treatment while dry feces remain unremoved: if not purged, pathogenic qi stagnation leads to death; if purged, there is fear that righteous qi will further deplete leading to collapse. This formula combines attacking excess and tonifying deficiency, thereby avoiding the error of "making the deficient more deficient." It is called "Huanglong" because Dahuang (Rhei Radix et Rhizoma) assisted by Renshen can miraculously exert its function, like a dragon aided by clouds, ascending and descending, its changes immeasurable.) Dry feces in the stomach, hardness in the epigastrium, delirium, and diarrhea of pure clear water. (Note: If there are dry feces in the stomach, why is there diarrhea of clear water? Tao's *Six Books on Cold Damage* states: "This diarrhea is not due to interior cold, but results from daily self-administration of herbal decoctions; it requires urgent purgation, named 'Heat-Binding Diarrhea.'") Combining attack and tonification is a good method; for the elderly, remove Mangxiao (Natrii Sulfas) before administration. (For the elderly with severe Qi and Blood deficiency, Mangxiao is removed to avoid severely depleting Yin fluids.)
(Xu Shuwei's *Prescriptions for Saving All Lives*) Treats entrenched cold pathogen lingering between the intestines and stomach, causing diarrhea and abdominal pain.
Mouhou (Magnoliae Officinalis Cortex), Guixin (Cinnamomi Ramulus), Fuzi (Aconiti Lateralis Radix Preparata), Ganjiang (Zingiberis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.5 liang); Dahuang (Rhei Radix et Rhizoma) (4 qian). Coarsely powder, take 1 liang, add 2 zhong of water, decoct to 0.6 zhong, administer in one dose.
(Sun Simiao's *Essential Prescriptions Worth a Thousand Gold*) Treats chronic dysentery with red and white discharge, cold accumulation in the Spleen and Stomach, and severe twisting pain in the umbilical and abdominal regions.
Renshen (Ginseng Radix et Rhizoma), Fuzi (Aconiti Lateralis Radix Preparata), Mangxiao (Natrii Sulfas), Gancao (Glycyrrhizae Radix et Rhizoma) (each 2 liang); Dahuang (Rhei Radix et Rhizoma) (5 liang); Danggui (Angelicae Sinensis Radix), Ganjiang (Zingiberis Rhizoma) (each 3 liang). Coarsely powder, add 7 sheng of water, decoct to obtain 3 sheng, divide into doses, administer three times daily.
In Wenpi Tang (Warm the Spleen Decoction), the amount of Dahuang is small, while Guixin, Fuzi, Ganjiang, Gancao, and Mouhou are large. (Xu Shuwei's formula imitates Zhang Zhongjing's method of warming and purging to eliminate cold accumulation in the intestines and stomach. Regarding abdominal pain and diarrhea caused by cold accumulation, purgatives are still used because entrenched cold stagnation has lingered in the intestines and stomach for a long time without removal; using only warming tonics is of no benefit. In this formula, Ganjiang, Guixin, and Fuzi serve as the sovereign drugs, incorporating the method of Chengqi Tang; Dahuang is used sparingly at 4 qian, showing profound insight. Generally, if not used, the warming herbs cannot descend, and the long-standing accumulation cannot be removed without attack; if used excessively, the warming herbs may fail to control the condition, potentially worsening the profuse diarrhea. Careful dosage makes this truly exemplary.) Entrenched cold lingering in the intestines and stomach causes diarrhea; it is appropriate to first purge and remove it without delay. (Xu Shuwei's *Prescriptions for Saving All Lives* states: "When entrenched cold lies in the intestines and stomach, causing years of diarrhea and abdominal pain with irregular onset and cessation, and various medicines have failed, one should first purge and remove it, after which regulation and treatment will easily lead to recovery. Do not fear deficiency and thereby nurture the disease.") Or, add Renshen and Danggui, remove Guixin and Mouhou; this differs from Xu Shuwei's *Prescriptions for Saving All Lives*, which heavily uses warming and unblocking agents with a slight addition of Dahuang. The reason *Prescriptions for Saving All Lives* treats cold accumulation diarrhea is that Dahuang should be used sparingly; here, treating dysentery with red and white discharge, the origin lies in heat accumulation, so Dahuang is used heavily. Because prolonged dysentery leads to Spleen and Stomach deficiency-cold while accumulation remains, Renshen, Gancao, Ganjiang, and Fuzi are added to warm and tonify the Middle Jiao. Although the same herb, Dahuang, is used, the roles of sovereign, minister, assistant, and courier differ, thus the treated conditions vary accordingly. How can later generations lightly modify ancient formulas? Note: Ancient formulas often combine cooling herbs like Xiaoshi (Natrii Sulfas), Dahuang, Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma) with warming herbs like Ganjiang, Wuzhuyu (Evodiae Fructus), Guizhi (Cinnamomi Ramulus), Fuzi; some combine tonification and purgation using Renshen, Baizhu (Atractylodis Macrocephalae Rhizoma), Xiaoshi, Dahuang; some use Dahuang and Mahuang (Ephedrae Herba) together for sweating and purging. Few today understand their intent. I record a few formulas above to show the subtlety of treatment, which is not limited to one approach.)