治太阳病。若形如疟。日再发。汗出必解。
桂枝(一两十七铢) 芍药(一两六铢) 麻黄(十六铢) 生姜(一两六铢) 杏仁
(十
上七味。以水五升。先煮麻黄一二沸。去上沫。内诸药。煮取二升。去渣。温服一升。
日再
歌曰 一两六铢芍与姜。麻铢十六杏同行。桂枝一两铢十七。草两二铢五枣匡。
蔚按。服桂枝汤宜令微似汗。若大汗出脉洪大。为汗之太骤。表解而肌未解也。仍宜与
桂枝
以解表邪。
治发汗后热不退。大烦渴饮水者。
知母(六两) 石膏(一斤 碎。绵裹。) 甘草(二两 炙) 粳米(六合) 人参
(三两)
上五味。以水一斗。煮米熟汤成。去滓。温服一升。日三服。
歌曰 服桂渴烦大汗倾。液亡肌腠涸阳明。膏斤知六参三两。二草六粳米熟成。
蔚按。上节言服桂枝大汗出而邪反不能净。宜仍服桂枝以发汗之。或桂枝二麻黄一汤合
肌表
于心。故大烦。阳明为燥土。故大渴。阳气盛。故脉洪大。主以石膏之寒以清肺。知母之苦
以滋水。甘草粳米之甘。人参之补。取气寒补水以制火。味甘补土而生金。金者水之源也。
治太阳病发热恶寒。热多寒少。脉微弱者。此无阳也。不可发汗。此汤主
桂枝(十八铢) 芍药(十八铢) 麻黄(十八铢) 甘草(十八铢) 大枣(四枚) 生
上七味。 咀。以水五升煮麻黄一二沸。去上沫。纳诸药。煎取二升。去滓。温服一升。
本
歌曰 桂芍麻甘十八铢。生姜一两二铢俱。膏铢廿四四枚枣。要识无阳旨各殊。
论中无阳二字。言阳气陷于阴中。既无表阳之证。不可发其表汗。故用越婢汤。方中石
膏质
蔚按。本方分两甚轻。大抵为邪气轻浅者设也。太阳以阳为主。所云热多寒少。是阳气
欲胜
太盛。不可用麻
血而言。有指元阴元阳而言。有指腑脏而言。有指表里而言。有指寒热而言。有指邪正而言。
非细心如发者
难也。
治疗太阳病。如果症状像疟疾一样,一天发作两次,出汗后就会痊愈。
桂枝(一两十七铢) 芍药(一两六铢) 麻黄(十六铢) 生姜(一两六铢) 杏仁
(十枚) 大枣(十二枚 擘) 甘草(二两 炙)
以上七味药,用水五升,先煮麻黄一两次沸腾,去掉上面的浮沫,加入其他药物,煮取二升,去渣,温服一升,一天服用两次。
歌诀说:一两六铢的芍药和生姜,十六铢的麻黄与杏仁同行。桂枝一两十七铢,甘草二两二铢,大枣匡正辅助。
蔚按语:服用桂枝汤应当让身体微微似有汗出。如果大汗出且脉象洪大,是因为发汗过于急促,表邪虽解但肌腠未解。仍然适宜给予
桂枝汤
以解除表邪。
治疗发汗后热势不退,极度烦躁、口渴想喝水的情况。
知母(六两) 石膏(一斤 破碎,用绵布包裹) 甘草(二两 蜜炙) 粳米(六合) 人参
(三两)
以上五味药,用水一斗,煮至米熟汤成,去渣滓,温服一升,一天服用三次。
歌诀说:服用桂枝汤后出现烦渴和大汗淋漓,津液亡失,肌腠干燥,病在阳明经。石膏一斤,知母六两,人参三两,甘草二两,粳米六合,煮至米熟即成。
蔚按语:上一节讲的是服用桂枝汤后大汗出而邪气反而不能净除,适宜仍服用桂枝汤来发汗,或者使用桂枝二麻黄一汤合
并肌表
之邪。因为邪气郁闭于心,所以极度烦躁。阳明属燥土,所以极度口渴。阳气盛,所以脉象洪大。主治用石膏的寒性以清肺热,知母的苦味
以滋养肾水。甘草和粳米的甘味,人参的补益作用,取其气寒补水以制约火邪,味甘补脾土而生肺金。金是水的源头。
治疗太阳病发热恶寒,热多寒少,脉象微弱的人。这是无阳的表现。不可发汗。此汤剂主治。
桂枝(十八铢) 芍药(十八铢) 麻黄(十八铢) 甘草(十八铢) 大枣(四枚) 生
姜(一两二铢) 石膏(二十四铢)
以上七味药,切碎,用水五升煮麻黄一两次沸腾,去掉上面的浮沫,纳入其他药物,煎取二升,去渣滓,温服一升。
本方
歌诀说:桂枝、芍药、麻黄、甘草各十八铢,生姜一两二铢俱备。石膏二十四铢,大枣四枚,要认识“无阳”的宗旨各有不同。
《伤寒论》中的“无阳”二字,指阳气陷于阴中,既然没有表阳证候,不可发其表汗。故使用越婢汤。方中石
膏质地
蔚按语:本方的分量很轻,大抵是为邪气轻浅的患者设立的。太阳经以阳为主,所说的热多寒少,是阳气
欲胜邪但尚未太盛,不可用麻黄
大发其汗。关于“无阳”一词,有的指元气阴阳而言,有的指脏腑而言,有的指表里而言,有的指寒热而言,有的指邪正而言。
若非细心如发者
难以理解。
Treats Taiyang disease (disease of the Taiyang channel). If the symptoms resemble malaria, occurring twice a day, and relief follows sweating.
Guizhi Tang (Cinnamon Twig Decoction) [Note: The text lists ingredients for Guizhi Er Mahuang Yi Tang but names Guizhi in context of previous/next, here strictly translating ingredients listed]: Guizhi (Cinnamon Twig, 1 liang 17 zhu), Shaoyao (Peony Root, 1 liang 6 zhu), Mahuang (Ephedra Herb, 16 zhu), Shengjiang (Fresh Ginger, 1 liang 6 zhu), Xingren (Apricot Seed, 10 pieces), Dazao (Jujube, 12 pieces, split), Gancao (Licorice Root, 2 liang, honey-fried).
Take the above seven herbs. Add five sheng of water. First boil Mahuang for one or two boils. Remove the foam on the surface. Add the remaining herbs. Boil to obtain two sheng. Remove the dregs. Take one sheng warm. Twice a day.
The song says: Shaoyao and Shengjiang at 1 liang 6 zhu; Mahuang 16 zhu with Xingren go together. Guizhi is 1 liang 17 zhu; Gancao is 2 liang 2 zhu; Dazao assists.
Wei's commentary: When taking Guizhi Tang, slight perspiration should be desired. If profuse sweating occurs with a surging pulse, it is because sweating was too abrupt; the exterior is resolved but the muscle layer remains unresolved. It is still appropriate to administer
Guizhi Tang
to resolve the exterior pathogen.
Treats cases where heat persists after sweating, accompanied by severe irritability and thirst for drinking water.
Zhimu (Anemarrhena Rhizome, 6 liang), Shigao (Gypsum Fibrosum, 1 jin, crushed, wrapped in cotton), Gancao (Licorice Root, 2 liang, honey-fried), Jingmi (Rice, 6 he), Renshen (Ginseng Root, 3 liang).
Take the above five herbs. Add ten dou of water. Boil until the rice is cooked and the decoction is ready. Remove the dregs. Take one sheng warm. Three times a day.
The song says: After taking Guizhi Tang, irritability, thirst, and profuse sweating occur. Fluids are lost, muscle and pores dry up, involving the Yangming channel. Gypsum 1 jin, Zhimu 6 liang, Renshen 3 liang, Gancao 2 liang, Jingmi 6 he, boiled until rice is cooked.
Wei's commentary: The previous section discussed that after profuse sweating from Guizhi Tang, pathogens were not completely cleared, so it was appropriate to continue taking Guizhi Tang to induce sweating, or combine with Guizhi Er Mahuang Yi Tang to address the
muscle and exterior
pathogens. Because pathogens constrain the heart, there is severe irritability. Yangming belongs to dry earth, hence severe thirst. Yang qi is abundant, hence a surging pulse. The main treatment uses the cold nature of Shigao to clear Lung heat, and the bitter taste of Zhimu
to nourish Kidney water. The sweet taste of Gancao and Jingmi, combined with the tonifying effect of Renshen, utilizes cold qi to supplement water to control fire, and sweet taste to tonify Spleen earth to generate Lung metal. Metal is the source of water.
Treats Taiyang disease with fever and aversion to cold, where heat predominates over cold, and the pulse is faint. This indicates "No Yang." Sweating is contraindicated. This decoction is indicated.
Guizhi (Cinnamon Twig, 18 zhu), Shaoyao (Peony Root, 18 zhu), Mahuang (Ephedra Herb, 18 zhu), Gancao (Licorice Root, 18 zhu), Dazao (Jujube, 4 pieces), Shengjiang (Fresh Ginger, 1 liang 2 zhu), Shigao (Gypsum Fibrosum, 24 zhu).
Take the above seven herbs. Chop them. Add five sheng of water. Boil Mahuang for one or two boils. Remove the foam on the surface. Add the other herbs. Decoct to obtain two sheng. Remove the dregs. Take one sheng warm.
This formula
The song says: Guizhi, Shaoyao, Mahuang, and Gancao are each 18 zhu; Shengjiang is 1 liang 2 zhu. Shigao is 24 zhu, Dazao is four pieces. Understand that the meaning of "No Yang" varies.
In the Treatise on Cold Damage, the term "No Yang" refers to Yang qi sinking into Yin. Since there are no signs of Exterior Yang, exterior-releasing sweating is contraindicated. Therefore, Yebip Tang is used. In this formula, Shigao has a texture
Wei's commentary: The dosages in this formula are very light, generally intended for patients with mild pathogens. The Taiyang channel is governed by Yang. The description "heat predominates over cold" implies Yang qi desires to overcome the pathogen but is not yet excessively strong; thus, Mahuang should not be used to induce
profuse sweating. Regarding the term "No Yang," some refer to Yuan Yin and Yuan Yang (Primordial Yin and Primordial Yang), some to Zang-Fu organs, some to Interior-Exterior, some to Cold-Heat, and some to Pathogenic-Righteous factors.
Only those with meticulous attention to detail
can comprehend it.