麻黄汤 治冬月正伤寒，太阳经营分受邪〔寒则伤营。〕头痛发热恶寒，〔膀胱经脉，上额入络
脑，还出别下项，故太阳头痛自额至巅顶脑后。痛连风府，寒邪外束，则玄府闭，阳气不得散越，乃
郁而为热，寒邪在表，不得复任寒，故恶寒，〕身疼腰痛脊强，〔膀胱经脉循肩 内挟脊抵腰中，贯
臀入 。寒伤营血不利，故经脉所过皆痛。〕无汗，〔寒主闭藏，故令无汗。〕脉浮而紧，〔寒气刚劲，
故令脉紧。〕体重，呕逆喘满，皆伤寒之的症。〔阴凝血滞故体重，寒气客胃故呕逆，肺气壅逆故喘满。〕
麻黄〔辛热，开腠发汗。〕 桂枝〔入营驱寒，各五分至一钱。〕 杏仁〔泄肺利气。〕 甘草
〔扶中散邪。〕羌活香苏散，可代此方。〔热服用浓被复首取汗，待汗干，轻轻揭去，中病即止，不得
多服，多则反致别病。服之汗差者，需再煎服，服至三剂，汗不出者己成坏病，宜随症治之。〕
按此汤虽太阳经发汗重剂，实兼发散肺经之邪。夫邪必从皮毛而入，皮毛为肺之合，肺主卫气，
包罗一身，是症虽属太阳，而肺实受邪气，故轻则时兼面赤拂郁，咳嗽有痰胸满。重则为喘，皆肺气愤郁也。
凡用发汗药，宜审病患有无宿疾，不可轻汗。如咽喉干燥者，〔津液素亏也。〕不可发汗，淋家
不可发汗，〔膀胱
为热所闭，气化不行也。〕发汗则便血。〔膀胱愈扰，而血从小便出矣，〕疮家〔肌表素虚，营血暗亏。〕
虽伤寒头痛身痛，不可发汗，汗出则痉。〔外风袭虚，内血不盈也。〕亡血家不可发汗，发汗则寒栗而
振。〔以阴亡则阳孤无偶，汗则阳从外越，阴阳两竭也。〕素多汗家重发汗，必恍惚心乱，〔再汗则
血少。〕小便已阴疼，〔小肠之血亦伤。〕尺中脉微者，〔里阴素虚也。〕不可发汗。尺中脉迟者，〔元
阳素薄，营血衰少。〕不可发汗。脉沉者〔即邪在里者。〕不可发汗。诸虚者，〔如劳倦阴虚，经行经
断，胎漏新产等症。〕不可发汗。总是相人津液之奥旨。然表有邪，不汗何从而出？但不可用麻桂重剂大
发其汗，只宜轻剂则微汗，如羌防香苏散，九味羌活汤之属，或加建中气之药，或加生津液之品，活法对
症，加减治之。其用下之法，亦然。发动气汗者死。〔动气者，藏气不调，不拘脐之或上或下，或左或
右，按之不移，或痛，筑筑跳动者是也。〕或发少阴汗，则动血死，〔或从口鼻出，或从目出，谓之下厥
上竭。〕误用麻黄，令人汗多亡阳，将发披入水盆中，足露出外，用炒糯米半升，龙骨、牡蛎、麻黄根
各一两，研末，周身扑之，温经益元汤加减救之。亦有不可用桂、附者，须活泼泼地运用。
桂枝汤 治冬月正伤风，太阳经卫分受邪，〔风则伤卫。〕
头痛发热恶风，〔风在表，表实，故发热恶风未有不兼恶寒者。〕脊强自汗，〔卫伤则无以周卫津液，
故令自汗。〕脉浮而缓，〔卫气不能鼓也。〕鼻鸣干呕，亦伤风之的症。〔鼻鸣者，阳邪上壅也，干
呕者，阳邪上逆也。〕
桂枝〔辛甘发散为阳，故用以治风。〕 芍药〔营未受邪，恐桂走泄阴气，故用白芍酸以收
之。〕 炙甘草〔扶中气以散邪。〕 生姜〔辛热发散。〕 大枣〔同姜行脾中之津液而和其
营卫。〕羌防香苏散，去苏叶加白芍可代。〔温服，须臾吸稀粥，以助药力，复被令遍身微似有汗，不
可令如水流，病必不除，若不汗，仍根据前法服。〕
按，桂枝汤一方，专和营卫。但桂枝气味俱薄，其力易尽，助以热粥，补胃气而益气血之源，使胃
气旺而营卫充，则药力行而风邪散，不传于内。盖三时感冒，皆是风邪为病，皆可效用此法。要知药入
于胃，全赖胃气转运，所以邪在太阳及虚人感冒，皆不当禁其饮食，若传胃府，则粒米不可妄投，恐助胃
中实邪，经所谓勿盛盛也。及传少阳，须少食以助胃气，以御少阳之邪。至传三阴，亦以胃气为主。今
人一遇感冒，辄禁其饮食，病者亦甘忍饥饿，更且发表剂中，杂投消导，致胃虚邪陷，病剧至死，是惧食
复之故也。帝问∶病热当何禁之，岐伯曰∶病热少愈，食肉则复，多食则遗。因胃中余热未除，食气与
病气相并，则两热相合，致流连不解，故名曰遗，原为食肉多食所致，未尝禁其不食也。故凡病患能食者，
即可少少与之，不能食者，莫之强与，此要法也。
此汤本为解肌，但取微汗，不使太过，太过则邪未入而先扰其营，甚则汗不止而亡阳，不及则邪
欲出而尚闭其门，必至病不除而生变。若其人脉浮紧，发热汗不出者，不可与也。伤寒误用白芍，则
寒邪无出路，当须识此，勿令误也。凡服桂枝汤吐者，以湿热素盛，其后必吐脓血也。吐逆则热愈淫
溢于上焦，蒸为败浊。又酒客病，不可与桂枝汤，因平索湿热搏结胸中，得汤则呕，以酒客不喜甘故也
。宜用辛凉，以彻其热，辛苦以消其湿。
大青龙汤〔即麻黄桂枝二汤合用，去芍药加石膏。〕治冬月风寒两伤营卫，头疼发热恶寒，身
疼腰痛脊强，无汗烦躁，〔皆伤寒之症，而兼烦躁则风之征矣，风因寒纠缠，不能自汗外泄，气郁热蒸，
故发烦躁。〕脉浮而紧。
麻黄〔去节〕 桂枝〔去皮〕 杏仁〔去皮尖研。〕 甘草〔炙〕 石膏〔生研〕
生姜 大枣〔切碎〕 羌防香苏散加石膏可代。〔温服取微汗。〕
此汤主发汗以解烦躁，麻桂二汤合用而去芍者，恐助寒邪沉滞之性也。凡病之因寒者，热易郁，加
石膏祛其郁热，气虽寒而味则辛，辛则散也。经曰∶阳之汗似天地之雨，名曰大青龙者，言其声势之张，
而兴云致雨之骤也。若脉微弱，汗出恶风而烦躁，则是少阴亡阳之症，脉浮弱，汗出恶风而不烦躁，即
风伤卫症，皆不可服，服之则汗多亡阳而厥逆，津液枯少，筋血失养而跳动，以真武汤救之。
温经益元汤〔即十全大补汤，去川芎∶加附子、陈皮。仲景只用姜、附、术、苓、芍，名真
武汤，方中已备。〕治发汗太过，卫虚亡阳，汗出不止，或汗后大虚，心下悸。〔心亡津液，肾气凌
心。〕头眩，〔阴气上逆，阳虚无主也。〕身 动振振欲 地。〔汗多气血皆虚，不能荣养筋骨，其身
不能主持，故为脉振摇也。 者辟也避也，心神恍惚，似乎全无外廓，欲擗地而避也，处其内即避虚就
实之意也。〕
人参 黄 白术 甘草 附子 肉桂 熟地 生地 当归 白芍 陈皮 加姜枣糯米如内热
去附、桂。
此方总以大补气血为主，果系汗多亡阳，见上诸症，方服之。以上四方，皆治冬月正伤寒，当师
其法，不必泥用其药。
羌活冲和汤〔即九味羌活汤。〕治春夏秋三时感冒，暴寒头痛，发热恶寒，身疼痛腰脊强，无汗，
脉浮而紧。此足太阳经受邪，宜此发散，不与冬时正伤寒同治法。
羌活〔太阳解表之主药，二、三钱。〕 防风〔卑贱之卒，随所引而至，一、二钱。〕 川芎
〔头痛，用钱许。〕 白芷〔阳明引经之药，钱许。〕 细辛〔手足少阴引经之药，三、四分。不可
多用，二味随症去留。〕 苍术〔用五分，伤风自汗去之〕 炙甘草〔调和诸药，五、七分。〕
生地〔甘寒养阴，二、三、四钱。〕 黄芩〔苦寒清热，钱许。二味里有热者用之〕。加姜枣。
〔调和荣卫。〕
按此解表而兼清里之剂，节庵治三时感冒风寒，每用此方，代麻黄、桂枝、青龙等汤。气薄则发泄，
故以羌、防、芎、芷、辛、苍之气薄者，散其寒邪∶胜热，故用地之甘寒养阴，芩之苦寒清热，以升散
诸药，而臣以寒凉，则升者不
峻；以寒凉之药，而君以升散，则寒者不滞，甘、枣益其脾胃，而建中营之帜。陶氏极称其神，
然未可全用，活法对症加减。自神效也。愚按∶此方加减，外以辛凉透表，内以清热养阴，用治冬伤
于寒之春温症，极为合法，陶氏之治两感伤寒，头痛发热恶寒，〔少阳症也，〕口燥舌干者，〔少
阴症也。〕本方去苍术、白芷，加麦冬、知母、石羔，大剂救之。表症多者，表药为君，里症急者，
里药为主，有下症者，可微下之。〔经言∶两感必不免于死，此方亦万死一生之兵也。〕
香苏散 治感冒风寒，头痛身热恶寒。
生香附〔疏表利气，二、三钱〕 紫苏〔辛温散寒，三钱，有汗去之。〕 橘红〔
下气消痰，钱许。〕 甘草〔和中辅正，五、七分。〕
愚加羌、防、芎、豉，名羌防香苏散，每代前方，引用姜、枣。痰嗽加前胡、杏仁，伤风自汗
不止，加白芍，甚者再加生黄 。〔邪在表，须从表解，故以本方散邪， 、芍实表，并而行之。凡治
感冒大法，有汗要使无汗，无汗要使有汗，病即易解。〕虚弱者加人参，〔三、五分，即参苏饮法。〕
胸胁满闷，加枳壳、桔梗，〔枳壳汤治痞症。〕呕恶加姜汁、半夏，〔血家渴家汗家勿用。〕渴加麦冬、
花粉、知母等，甚者再加石膏，腹痛加木香、砂仁，泻者无汗加苍术，有汗加白术。若先伤饮食，内有
嗳腐吞酸，痞胀腹满，复感风寒，必左右手俱有力，此为夹食感冒，方可加神
曲，麦芽，肉食加山楂。〔解表而消滞食，否则惟宜解表。盖风寒伤表，表里营卫，气郁不行，以致
未病所食之物，停滞而不传化，但行解表散邪，使大气一转，食自消化。况方中香、苏、豉、橘，皆
利气之品，原有裨于传化之助也。〕
此辛温发表之剂，感冒轻浅，而无六经之症可求者，总以疏表利气之药为主，随兼症而加减之，
四时通用。
小柴胡汤 治足少阳胆经受邪，〔或感春令温风之邪，或受伤寒温邪病传经之邪皆是。〕往来
寒热，〔少阳之半表半里之间，邪入而并于阴则寒，出而并于阳则热。〕头角微痛，〔脾土上抵头角故
也。〕口苦咽干，〔胆者，咽为之使，邪偏于里，热聚于胆，故口苦咽干。〕目眩耳聋，〔木盛生风
故眩晕，胆脉入于耳中，风热上壅，故耳聋，甚者目赤，或耳中上下两边肿痛。〕胸胁苦满，默默不欲
饮食，〔抑郁胃气不伸，则水谷亦不消，故默默不欲食。〕心烦喜呕，〔邪乘心则烦，邪乘胃则呕。〕
但见一症便是，往来寒热是也。〕不必悉具，此汤主之。
柴胡〔味苦微寒，为少阳之表药，二、三钱。〕 黄芩〔邪入内则热，故用之。〕 半夏〔
有饮而呕，故同姜用之，各一、二钱。〕 人参〔三、五、七分，中气不虚者去之。〕 甘草〔五、
七分。〕 大枣〔二枚。〕 生姜〔二片。〕
胸中满，加枳壳，未效再加黄连、栝蒌实。〔合半夏即小陷胸汤。〕胸中烦而不呕，去人参、半
夏加栝篓实。〔消胸膈之痰，以除其烦。〕渴者〔邪吸胃津故也。〕去半夏，〔以其滑润利窍，恐重竭其津
液也。〕加麦冬、花粉、知母，〔生津止渴。〕甚者则加石膏。〔清热止渴。〕腹中痛，〔邪乘脾也。〕
加炒芍药。〔以泻土中之木也，〕胁下
痞硬，〔外邪挟痰，搏结少阳之本位。〕去大枣，〔恐其甘能滞气。〕加牡蛎。〔咸寒以软坚痰。〕
胁痛，〔少阳本症也。〕加青皮。〔疏通滞气。〕心下悸小便不利者，〔邪郁于中，水饮不输，反挟肾
水凌心。〕加茯苓。〔导水以泻肾邪。〕咳嗽〔邪反侮金。〕去人参、大枣，〔恐壅肺气。〕
加前胡、杏仁。〔散肺经之邪气。〕大便不实，〔邪乘脾也，〕加白芍、茯苓。如协热下利，口渴甚者，
再加黄连、〔清脾中之郁热。〕黄柏。〔坚北方之元阴。〕如兼见目痛鼻干不得卧，〔即少阳阳明症。〕
不呕无汗，去半夏加葛根。〔即柴葛解肌之法。〕喜凉恶热，自汗烦躁，口渴饮冷者，合白虎汤加麦冬、
竹叶。妇人经水适来适断，热邪乘虚陷入血室，其血必结，寒热如疟，发作有时，〔邪血搏击，
正邪纷争，阴阳之胜，势如疟状，故为有时。〕昼日明了，暮则如见鬼，〔肝开窍于目，热血链接，魂
不归舍，而反影于目。〕胸胁下满，如结胸状，〔邪聚血结故也。〕谵语者，〔血室之邪冲也。〕加
生地、丹参、〔凉血去瘀。〕羚羊角。〔清肝热，祛恶血，胸满胁满，并疗肌热，伏热并除。〕
按此治少阳经半表半里之症，乃和解药也。然柴胡欲出表，黄芩欲入里，半夏欲驱痰，动而不和，
故仲景去渣复煎，使药性合一，又非和于表，亦非和于里，乃和于中。盖欲解表里之邪，全借胃气敷布，
所以方中用人参、甘草、大枣，助胃气以为干旋，使药表里分消，所谓大力者负之
而去耳。大抵太阳禁下，阳明禁发汗，利小便，少阳有三禁，不可汗吐下，只此一方和解，随症
加减，并无别方。
柴胡丹皮汤 治清明以后，少阴君火司令，感冒温风，厥阴心包代心君为病，头痛或不痛，
〔脉不循头，故不痛者多。〕但身热，〔风热之邪在表也。〕始起微恶寒无汗，〔少阴所至，为恶寒
战栗，邪感心包，热收于内，邪正相搏，郁遏经气，不达于外，所以恶寒，甚者战栗，少顷气达于
表，身即发汗。〕心中澹澹大动，〔包络邪盛，故跳动不安。〕或烦躁发疹，〔扰乱为烦，愤怒为躁，
麻黄汤：治疗冬季感受正伤寒，太阳经营分受邪（寒邪伤及营分）。症状包括头痛、发热、恶寒（足太阳膀胱经脉，上行至额部并入络于脑，复出别行下行至项部，因此太阳病头痛从额头到头顶再到脑后。疼痛牵连风府穴，寒邪束缚体表，导致玄府闭塞，阳气无法发散，郁结而化热；寒邪在表，身体无法承受寒气，所以恶寒），身体疼痛、腰痛、脊背僵硬（足太阳膀胱经脉沿肩胛内侧挟脊柱抵腰部，贯穿臀部进入腘窝。寒邪伤害营血导致运行不利，所以经脉经过的地方都疼痛），无汗（寒性主闭藏，所以导致无汗），脉象浮而紧（寒气刚劲有力，所以导致脉紧），身体沉重，呕吐逆气，气喘胸闷，这些都是伤寒的确切症状（阴血凝滞所以身体沉重，寒气客居胃部所以呕吐逆气，肺气壅塞上逆所以气喘胸闷）。
药物组成：麻黄（辛热，开泄腠理发汗）、桂枝（入营分驱除寒邪，各用五分至一钱）、杏仁（宣泄肺气利气）、甘草（扶助中气散除邪气）。羌活香苏散可以代替此方。（服药后用厚被子覆盖头部取汗，待汗干后轻轻揭开，中病即止，不可多服，多服反而导致其他疾病。服用后汗出病愈的，需要再煎服，服至三剂，如果仍不出汗的，已成坏病，应当随症治疗。）
按语：此汤虽然是太阳经发汗的重剂，实际上兼有发散肺经邪气的作用。邪气必然从皮毛而入，皮毛是肺的合应部位，肺主卫气，包罗一身，此症虽然属于太阳经，但肺实际上受到了邪气，所以轻则时常兼见面赤拂郁、咳嗽有痰、胸满；重则出现气喘，这都是肺气愤郁所致。凡是使用发汗药，应当审查患者有无宿疾，不可轻易发汗。如咽喉干燥者（津液素来亏虚），不可发汗；淋家（患淋证之人，膀胱为热所闭，气化不行）不可发汗，发汗则会导致便血（膀胱更受扰动，血液从小便排出）；疮家（患有疮疡之人，肌表素虚，营血暗亏）即使有伤寒头痛身痛，也不可行发汗，汗出则会导致痉病（外风侵袭虚处，内里血液不充盈）；亡血家（失血之人）不可发汗，发汗则会导致寒战颤抖（因为阴血亡失则阳气孤立无偶，汗出则阳气从外越，导致阴阳两竭）；素来多汗的人再次发汗，必定导致恍惚心乱（再次发汗则血少）；小便结束后阴部疼痛（小肠之血也受伤了）；尺中脉微者（里阴素来虚弱），不可发汗；尺中脉迟者（元阳素来薄弱，营血衰少），不可发汗；脉沉者（即邪气在里），不可发汗；各种虚证（如劳倦阴虚、经期经断、胎漏新产等症），不可发汗。这总是关于顾护人体津液的深奥旨意。然而表有邪气，不发汗怎么能排出？只是不可用麻黄、桂枝这类重剂大发其汗，只宜用轻剂微汗，如羌防香苏散、九味羌活汤之类，或者加入建中气的药，或者加入生津液的品，灵活对症，加减治疗。其使用下法，也是如此。触动动气（动气者，脏气不调，不拘脐之或上或下，或左或右，按之不移，或痛，筑筑跳动者是也）的发汗会致死。或者发少阴汗，则动血致死（或从口鼻出，或从目出，称为下厥上竭）。误用麻黄，令人汗多亡阳，可将病人头发浸入水盆中，脚露在外面，用炒糯米半升，龙骨、牡蛎、麻黄根各一两，研成末，扑遍全身，用温经益元汤加减救治。也有不可用桂枝、附子的情况，必须灵活运用。
桂枝汤：治疗冬季正伤风，太阳经卫分受邪（风邪伤及卫分）。症状包括头痛、发热、恶风（风在表，表实，所以发热恶风没有不兼有恶寒的），脊背僵硬、自汗（卫气受伤则无法周流护卫津液，所以导致自汗），脉象浮而缓（卫气不能鼓动），鼻鸣、干呕，也是伤风的确实症状（鼻鸣是阳邪上壅，干呕是阳邪上逆）。
药物组成：桂枝（辛甘发散为阳，所以用来治风）、芍药（营分未受邪，恐怕桂枝走泄阴气，所以用白芍酸收之）、炙甘草（扶助中气以散邪）、生姜（辛热发散）、大枣（同姜一起运行脾中之津液而调和营卫）。羌防香苏散，去掉苏叶加白芍可以代替。（温服，片刻后喝稀粥，以助药力，盖被令遍身微微似有汗，不可令如水流，否则病必不除，如果不汗，仍按照前法服用。）
按语：桂枝汤这一方，专门调和营卫。但桂枝气味俱薄，其力易尽，借助热粥，补胃气而益气血之源，使胃气旺盛而营卫充实，则药力推行而风邪消散，不传入内部。大概春夏秋三季感冒，都是风邪致病，都可以效用此法。要知道药入于胃，全赖胃气转运，所以邪在太阳及虚人感冒，都不应当禁止饮食，若传入胃腑，则粒米不可妄投，恐怕助长胃中实邪，经书所说不要盛盛（即实证勿用补法，此处指胃中有实邪时不可进食助邪）。及传入少阳，须少食以助胃气，以抵御少阳之邪。至于传入三阴，也以胃气为主。现在的人一遇感冒，就禁止饮食，病人也甘愿忍受饥饿，更且在发表剂中，杂投消导药，导致胃虚邪陷，病重至死，这是害怕食复的缘故。黄帝问：病热应当禁什么？岐伯说：病热稍愈，吃肉则复发，多吃则遗留。因为胃中余热未除，食气与病气相并，则两热相合，导致流连不解，名叫遗，原本是因为吃肉多吃所致，并非禁止不食。所以凡病患能食的，就可以少量给予，不能食的，不要强行给予，这是重要法则。
此汤本为解肌，只取微汗，不使太过，太过则邪未入而先扰其营，甚则汗不止而亡阳，不及则邪欲出而尚闭其门，必至病不除而生变。如果其人脉浮紧，发热汗不出者，不可给予。伤寒误用白芍，则寒邪无出路，应当知晓这一点，勿令误用。凡是服用桂枝汤吐者，是因为湿热素盛，其后必吐脓血也。吐逆则热愈淫溢于上焦，蒸为败浊。又有酒客病，不可与桂枝汤，因为平素湿热搏结胸中，得汤则呕，因为酒客不喜欢甘甜的原因。宜用辛凉，以彻其热，辛苦以消其湿。
大青龙汤（即麻黄汤、桂枝汤二方合用，去芍药加石膏）：治疗冬季风寒两伤营卫，头疼、发热、恶寒，身疼、腰痛、脊强，无汗、烦躁（都是伤寒的症状，而兼有烦躁则是风的征象，风因寒纠缠，不能自汗外泄，气郁热蒸，所以发烦躁），脉浮而紧。
药物组成：麻黄（去节）、桂枝（去皮）、杏仁（去皮尖研）、甘草（炙）、石膏（生研）、生姜、大枣（切碎）。羌防香苏散加石膏可以代替。（温服取微汗。）
此汤主要发汗以解烦躁，麻黄、桂枝二汤合用而去掉芍药，是恐怕助长寒邪沉滞之性。凡是病因为寒的，热容易郁结，加石膏祛其郁热，气虽寒而味则辛，辛则散也。经书说：阳之汗似天地之雨，名叫大青龙，是说其声势之张，而兴云致雨之骤也。如果脉微弱，汗出恶风而烦躁，则是少阴亡阳的症状，脉浮弱，汗出恶风而不烦躁，即是风伤卫症，都不可服用，服用则汗多亡阳而厥逆，津液枯少，筋血失养而跳动，用真武汤救治。
温经益元汤（即十全大补汤，去川芎：加附子、陈皮。仲景只用姜、附、术、苓、芍，名叫真武汤，方中已具备）：治疗发汗太过，卫虚亡阳，汗出不止，或汗后大虚，心下悸（心亡津液，肾气凌心）。头眩（阴气上逆，阳虚无主也），身体动摇振振欲倒地（汗多气血皆虚，不能荣养筋骨，其身不能主持，所以为脉振摇也。辟者避也，心神恍惚，似乎全无外廓，欲擗地而避也，处其内即避虚就实之意也）。
药物组成：人参、黄芪、白术、甘草、附子、肉桂、熟地、生地、当归、白芍、陈皮。加姜枣糯米，如内热去附、桂。
此方总以大补气血为主，果系汗多亡阳，见上述诸症，才服用它。以上四方，都是治疗冬季正伤寒，应当效法其法，不必拘泥使用其药。
羌活冲和汤（即九味羌活汤）：治疗春夏秋三时感冒，暴寒头痛，发热恶寒，身疼痛腰脊强，无汗，脉浮而紧。这是足太阳经受邪，宜用此方发散，不与冬时正伤寒同治法。
药物组成：羌活（太阳解表之主药，二、三钱）、防风（卑贱之卒，随所引而至，一、二钱）、川芎（头痛，用钱许）、白芷（阳明引经之药，钱许）、细辛（手足少阴引经之药，三、四分。不可多用，二味随症去留）、苍术（用五分，伤风自汗去之）、炙甘草（调和诸药，五、七分）、生地（甘寒养阴，二、三、四钱）、黄芩（苦寒清热，钱许。二味里有热者用之）。加姜枣（调和荣卫）。
按语：此方解表而兼清里，节庵治疗三时感冒风寒，每用此方，代替麻黄、桂枝、青龙等汤。气薄则发泄，所以以羌、防、芎、芷、辛、苍之气薄者，散其寒邪；胜热，所以用地之甘寒养阴，芩之苦寒清热，以升散诸药，而臣以寒凉，则升者不峻；以寒凉之药，而君以升散，则寒者不滞，甘、枣益其脾胃，而建中营之帜。陶氏极称其神效，然不可全用，需活法对症加减。我自认为：此方加减，外以辛凉透表，内以清热养阴，用治冬伤于寒之春温症，极为合法，陶氏治疗两感伤寒，头痛发热恶寒（少阳症也），口燥舌干者（少阴症也），本方去苍术、白芷，加麦冬、知母、石膏，大剂救之。表症多者，表药为君，里症急者，里药为主，有下症者，可微下之（经言：两感必不免于死，此方亦万死一生之兵也）。
药物组成：生香附（疏表利气，二、三钱）、紫苏（辛温散寒，三钱，有汗去之）、橘红（下气消痰，钱许）、甘草（和中辅正，五、七分）。
我加上羌活、防风、川芎、豆豉，名叫羌防香苏散，每每代替前方，引用姜、枣。痰嗽加前胡、杏仁，伤风自汗不止，加白芍，甚者再加生黄芪（邪在表，须从表解，所以以本方散邪，芪、芍实表，并而行之。凡治感冒大法，有汗要使无汗，无汗要使有汗，病即易解）。虚弱者加人参（三、五分，即参苏饮法）。胸胁满闷，加枳壳、桔梗（枳壳汤治痞症）。呕恶加姜汁、半夏（血家渴家汗家勿用）。渴加麦冬、花粉、知母等，甚者再加石膏，腹痛加木香、砂仁，泻者无汗加苍术，有汗加白术。若先伤饮食，内有嗳腐吞酸，痞胀腹满，复感风寒，必左右手俱有力，此为夹食感冒，方可加神曲、麦芽，肉食加山楂（解表而消滞食，否则惟宜解表。盖风寒伤表，表里营卫，气郁不行，以致未病所食之物，停滞而不传化，但行解表散邪，使大气一转，食自消化。况方中香、苏、豉、橘，皆利气之品，原有裨于传化之助也）。
此方是辛温发表之剂，感冒轻浅，而无六经之症可求者，总以疏表利气之药为主，随兼症而加减之，四时通用。
小柴胡汤：治疗足少阳胆经受邪（或感春令温风之邪，或受伤寒温邪病传经之邪皆是）。往来寒热（少阳之半表半里之间，邪入而并于阴则寒，出而并于阳则热），头角微痛（脾土上抵头角故也），口苦咽干（胆者，咽为之使，邪偏于里，热聚于胆，故口苦咽干），目眩耳聋（木盛生风故眩晕，胆脉入于耳中，风热上壅，故耳聋，甚者目赤，或耳中上下两边肿痛），胸胁苦满，默默不欲饮食（抑郁胃气不伸，则水谷亦不消，故默默不欲食），心烦喜呕（邪乘心则烦，邪乘胃则呕），但见一症便是（往来寒热是也），不必悉具，此汤主之。
药物组成：柴胡（味苦微寒，为少阳之表药，二、三钱）、黄芩（邪入内则热，故用之）、半夏（有饮而呕，故同姜用之，各一、二钱）、人参（三、五、七分，中气不虚者去之）、甘草（五、七分）、大枣（二枚）、生姜（二片）。
胸中满，加枳壳，未效再加黄连、栝蒌实（合半夏即小陷胸汤）。胸中烦而不呕，去人参、半夏加栝楼实（消胸膈之痰，以除其烦）。渴者（邪吸胃津故也），去半夏（以其滑润利窍，恐重竭其津液也），加麦冬、花粉、知母（生津止渴），甚者则加石膏（清热止渴）。腹中痛（邪乘脾也），加炒芍药（以泻土中之木也）。胁下痞硬（外邪挟痰，搏结少阳之本位），去大枣（恐其甘能滞气），加牡蛎（咸寒以软坚痰）。胁痛（少阳本症也），加青皮（疏通滞气）。心下悸小便不利者（邪郁于中，水饮不输，反挟肾水凌心），加茯苓（导水以泻肾邪）。咳嗽（邪反侮金），去人参、大枣（恐壅肺气），加前胡、杏仁（散肺经之邪气）。大便不实（邪乘脾也），加白芍、茯苓。如协热下利，口渴甚者，再加黄连（清脾中之郁热）、黄柏（坚北方之元阴）。如兼见目痛鼻干不得卧（即少阳阳明症），不呕无汗，去半夏加葛根（即柴葛解肌之法）。喜凉恶热，自汗烦躁，口渴饮冷者，合白虎汤加麦冬、竹叶。妇人经水适来适断，热邪乘虚陷入血室，其血必结，寒热如疟，发作有时（邪血搏击，正邪纷争，阴阳之胜，势如疟状，故为有时），昼日明了，暮则如见鬼（肝开窍于目，热血链接，魂不归舍，而反影于目），胸胁下满，如结胸状（邪聚血结故也），谵语者（血室之邪冲也），加生地、丹参（凉血去瘀）、羚羊角（清肝热，祛恶血，胸满胁满，并疗肌热，伏热并除）。
按语：此方治疗少阳经半表半里之症，乃和解药也。然柴胡欲出表，黄芩欲入里，半夏欲驱痰，动而不和，所以仲景去渣复煎，使药性合一，又非和于表，亦非和于里，乃和于中。盖欲解表里之邪，全借胃气敷布，所以方中用人参、甘草、大枣，助胃气以为干旋，使药表里分消，所谓大力者负之而去耳。大抵太阳禁下，阳明禁发汗，利小便，少阳有三禁，不可汗吐下，只此一方和解，随症加减，并无别方。
柴胡丹皮汤：治疗清明以后，少阴君火司令，感冒温风，厥阴心包代心君为病，头痛或不痛（脉不循头，故不痛者多），但身热（风热之邪在表也），始起微恶寒无汗（少阴所至，为恶寒战栗，邪感心包，热收于内，邪正相搏，郁遏经气，不达于外，所以恶寒，甚者战栗，少顷气达于表，身即发汗），心中澹澹大动（包络邪盛，故跳动不安），或烦躁发疹（扰乱为烦，愤怒为躁，
Mahuang Tang (Ephedra Decoction): Treats Zheng Shanghan (True Cold Damage) contracted in winter, where pathogenic factors invade the Ying (Nutritive) level of the Taiyang (Greater Yang) meridian. [Cold damages the Ying.] Symptoms include headache, fever, and aversion to cold. [The Bladder meridian ascends to the forehead, enters the brain, emerges again, descends behind the neck; thus, Taiyang headaches extend from the forehead to the vertex and back of the head. Pain connects to the Fengfu point (DU16). External binding by cold pathogens closes the Xuanku (pores), preventing the dispersion of Yang Qi, which stagnates and transforms into heat. With cold pathogens at the exterior, the body cannot endure the cold, hence aversion to cold.] Body aches, lower back pain, and stiffness of the spine. [The Bladder meridian runs along the medial shoulder, flanks the spine to the waist, penetrates the buttocks, and enters the popliteal fossa. Cold damaging the Ying and Blood causes poor circulation, so all areas traversed by the meridian ache.] Anhidrosis (absence of sweating). [Cold governs closure and storage, thus causing anhidrosis.] Pulse is floating and tight. [Cold Qi is rigid and forceful, thus making the pulse tight.] Heaviness of the body, vomiting, counterflow qi, wheezing, and chest fullness are all definitive symptoms of Shanghan. [Yin blood stagnation causes heaviness; Cold Qi lodging in the Stomach causes vomiting and counterflow; Lung Qi obstruction and counterflow cause wheezing and fullness.]
Ingredients: Mahuang (Ephedrae Herba) [Acrid and hot, opens the Couli (pores) to induce sweating.] Guizhi (Cinnamomi Ramulus) [Enters the Ying level to dispel cold, each used 5 fen to 1 qian.] Xingren (Armeniacae Semen Amarum) [Drains Lung Qi and promotes movement.] Gancao (Glycyrrhizae Radix et Rhizoma) [Supports Middle Jiao Qi and disperses pathogens.] Qianghuo Xiangsu San (Notopterygii and Perillae Powder) can substitute this formula. [Take warm, cover with a thick blanket starting from the head to induce sweat. Once dry, gently remove. Stop when the disease is cured; do not overdose, as excess may cause other illnesses. If sweat resolves the illness, continue decocting and taking it. After three doses, if no sweat occurs, it has become a Huai Bing (ruined disease); treat according to symptoms.]
Commentary: Although this decoction is a heavy sweating agent for the Taiyang meridian, it actually also disperses pathogens in the Lung meridian. Pathogens enter via the skin and hair, which are the external union of the Lung. The Lung governs Wei (Defensive) Qi, enveloping the whole body. Although this syndrome belongs to the Taiyang meridian, the Lung actually receives the pathogenic qi. Mild cases often present with facial redness, depression, cough with phlegm, and chest fullness. Severe cases result in wheezing, all due to stagnation and oppression of Lung Qi.
When using sweating agents, one must examine whether the patient has chronic diseases; do not induce sweating lightly. For those with dry throat mucosa, [due to prior deficiency of body fluids,] sweating is contraindicated. Lin jia (patients with strangury) should not be sweated, [as the Bladder is closed by heat, impairing Qi transformation.] Sweating will cause hematuria. [Further disturbance of the Bladder causes blood to exit via urine.] Chuang jia (patients with chronic sores/ulcers) [have inherently weak exterior and hidden deficiency of Ying Blood.] Even with headache and body pain from Shanghan, sweating is contraindicated; inducing sweat will lead to Jing disease (spasm). [External wind attacks deficiency, internal blood is insufficient.] Wangxue jia (patients with massive blood loss) should not be sweated; sweating will cause chills and tremors. [With Yin/Blood loss, Yang is isolated; sweating causes Yang to escape outward, leading to exhaustion of both Yin and Yang.] Patients who naturally sweat excessively should not be re-sweated, or they will suffer from mental confusion and restlessness. [Re-sweating reduces Blood.] Pain in the genitalia after urination indicates injury to Small Intestine blood. A faint pulse at the Chi position [indicates inherent interior Yin deficiency] contraindicates sweating. A slow pulse at the Chi position [indicates inherent thin Yuan Yang and deficient Ying Blood] contraindicates sweating. A deep pulse [indicates pathogens in the interior] contraindicates sweating. All deficiency syndromes [such as fatigue-induced Yin deficiency, menstruation, amenorrhea, threatened miscarriage, or postpartum states] contraindicate sweating. This always concerns the profound principle of preserving body fluids. However, if pathogens are at the exterior, how else can they exit? One simply must not use heavy sweating agents like Mahuang and Guizhi; light agents should be used to induce slight sweating, such as Qianghuo Fangfeng Xiangsu San or Jiawei Qianghuo Tang, or combined with herbs that build Middle Qi or generate fluids. Apply flexible methods based on symptoms. The same applies to purging methods. Moving Qi improperly to induce sweating leads to death. [Dongqi refers to disordered Zang Qi, regardless of location above/below or left/right of the umbilicus, fixed upon pressure, painful, or throbbing.] Inducing sweating in Shaoyin leads to bleeding and death [bleeding from mouth/nose or eyes, termed Xia Jue Shang Jie]. Misuse of Mahuang causes excessive sweating and Yang collapse. Rescue method: Place the patient in a water basin with feet exposed. Use half sheng of fried glutinous rice, Longgu (Fossilia Ossis Mastodi), Muli (Concha Ostreae), and Mahuanggen (Ephedrae Radix) each 1 liang, ground to powder, applied to the whole body. Rescue with Wenjing Yiyuan Tang modified. There are cases where Guizhi and Fuzi are contraindicated; application must be flexible.
Guizhi Tang (Cinnamon Twig Decoction): Treats Zheng Shufeng (True Wind Strike) in winter, where pathogens invade the Wei (Defensive) level of the Taiyang meridian. [Wind damages Wei.]
Symptoms include headache, fever, aversion to wind. [Wind at the exterior creates exterior excess, so fever and aversion to wind invariably accompany aversion to cold.] Stiffness of the spine and spontaneous sweating. [Wei damage impairs the circulation and protection of fluids, causing spontaneous sweating.] Pulse is floating and moderate/slow. [Wei Qi fails to drum.] Nasal congestion/rhonchi and dry retching are also definitive symptoms of Shufeng. [Nasal rhonchi results from Yang pathogens obstructing upward; dry retching results from Yang pathogens counterflowing upward.]
Ingredients: Guizhi (Cinnamomi Ramulus) [Acrid and sweet, dispersing and Yang-natured, thus used for wind.] Shaoyao (Paeoniae Radix Alba) [Ying is not yet damaged; fearing Guizhi might leak Yin Qi, Bai Shao is used for its sour astringency.] Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) [Supports Middle Qi to disperse pathogens.] Shengjiang (Zingiberis Rhizoma Recens) [Acrid and hot, dispersing.] Dazao (Jujubae Fructus) [Together with Ginger, moves Spleen fluids and harmonizes Ying and Wei.] Qianghuo Fangfeng Xiangsu San (Notopterygii, Saposhnikoviae, and Perillae Powder), removing Zisu Ye (Perillae Folium) and adding Baishao can substitute. [Take warm. Shortly after, drink thin congee to assist medicinal power. Cover with blankets to induce slight, uniform sweating. Do not allow profuse sweating like flowing water, or the disease will not be resolved. If no sweat, continue as before.]
Commentary: Guizhi Tang specifically harmonizes Ying and Wei. Guizhi has thin flavor and aroma, and its power dissipates easily. Assisting with hot congee supplements Stomach Qi and benefits the source of Qi and Blood. When Stomach Qi is robust and Ying/Wei are充盈 (full), medicinal power travels, wind pathogens disperse, and transmission inward is prevented. Generally, colds in the three non-winter seasons are caused by wind pathogens, and this method is applicable. Medicine entering the Stomach relies entirely on Stomach Qi for transport. Therefore, for pathogens in Taiyang or colds in deficient persons, diet should not be forbidden. If pathogens transmit to the Yangming Stomach Fu, grains should not be recklessly administered, lest they aid Stomach excess pathogens, as stated in the Classics: "Do not reinforce excess." Upon transmission to Shaoyang, eat sparingly to support Stomach Qi against Shaoyang pathogens. Upon transmission to the Three Yin, Stomach Qi remains paramount. Nowadays, people forbid diet upon any cold, patients endure hunger, and emollient/digestive herbs are mixed into releasing formulas, causing Stomach deficiency and pathogen sinking, leading to severe illness and death, out of fear of food relapse. The Yellow Emperor asked: What should be forbidden in febrile disease? Qibo answered: When febrile disease subsides slightly, eating meat causes relapse; overeating causes lingering pathogens. Because residual heat remains in the Stomach, food Qi combines with pathogen Qi, two heats merge, causing lingering unresolved disease, named "Yi" (lingering), originally caused by eating meat or overeating, not by forbidding food. Thus, if patients can eat, give small amounts; if they cannot, do not force them. This is a key principle.
This decoction aims to resolve the muscle layer, seeking only slight sweating, not excessive. Excessive sweating disturbs Ying before pathogens enter, potentially causing unceasing sweat and Yang collapse. Insufficient sweating keeps the pores closed as pathogens try to exit, ensuring the disease persists and complications arise. If the pulse is floating-tight, with fever but no sweat, do not administer. Misusing Baishao in Shanghan leaves cold pathogens without an exit; remember this. Vomiting after taking Guizhi Tang indicates prior abundant damp-heat; pus and blood will likely follow. Counterflow vomiting allows heat to overflow the Upper Jiao, steaming into turbid败物. Patients habitually drinking alcohol should not take Guizhi Tang because damp-heat is bound in the chest; the soup causes vomiting as they dislike sweet flavors. Use acrid-cool herbs to clear heat and acrid-bitter herbs to eliminate dampness.
Da Qinglong Tang (Major Blue Dragon Decoction): [Combines Mahuang Tang and Guizhi Tang, removes Shaoyao, adds Shigao (Gypsum Fibrosum).] Treats winter Shanghan where Wind and Cold jointly damage Ying and Wei. Symptoms: headache, fever, aversion to cold, body aches, lower back pain, spinal stiffness, anhidrosis, and irritability/restlessness. [These are Shanghan symptoms; irritability indicates Wind. Wind entangled by Cold cannot sweat externally; Qi stagnation and heat steaming cause irritability.] Pulse is floating and tight.
Ingredients: Mahuang (Ephedrae Herba) [Remove joints.] Guizhi (Cinnamomi Ramulus) [Remove bark.] Xingren (Armeniacae Semen Amarum) [Remove skin and tips, grind.] Gancao (Glycyrrhizae Radix et Rhizoma) [Prepared.] Shigao (Gypsum Fibrosum) [Raw, ground.] Shengjiang (Zingiberis Rhizoma Recens) Dazao (Jujubae Fructus) [Chopped.] Qianghuo Fangfeng Xiangsu San plus Shigao can substitute. [Take warm to induce slight sweat.]
This decoction induces sweating to resolve irritability. Combining Mahuang and Guizhi Tangs while removing Shaoyao avoids aiding the stagnant nature of cold pathogens. For diseases caused by cold, heat easily stagnates; adding Shigao clears stagnant heat. Although the Qi is cold, the flavor is acrid, and acrid disperses. The Classics state: Yang sweat is like heaven and earth's rain. Named Da Qinglong (Major Blue Dragon) for its majestic momentum and rapid cloud/rain generation. If the pulse is faint, with sweat, aversion to wind, and irritability, it is Shaoyin Yang collapse; do not take. If pulse is floating-weak, with sweat, aversion to wind, but no irritability, it is Wind damaging Wei; do not take. Taking it causes excessive sweat, Yang collapse, cold limbs, dried fluids, malnourished sinews/blood, and twitching; rescue with Zhenwu Tang (True Warrior Decoction).
Wenjing Yiyuan Tang (Warm Meridians and Benefit Origin Decoction): [Based on Shiquan Dabu Tang, removes Chuanxiong, adds Fuzi (Aconiti Lateralis Radix Praeparata) and Chenpi (Citri Reticulatae Pericarpium). Zhang Zhongjing used only Jiang, Fuzi, Zhu, Ling, Shaoyao, named Zhenwu Tang, already prepared in formulas.] Treats excessive sweating causing Wei deficiency and Yang collapse, unceasing sweat, or severe deficiency post-sweating with palpitations under the heart. [Heart loses fluids, Kidney Qi assaults Heart.] Vertigo. [Yin Qi counterflows, Yang lacks mastery.] Trembling and shaking of the body, desire to fall. [Excessive sweat depletes Qi and Blood, failing to nourish sinews and bones; the body cannot support itself, causing trembling. 'Pi' means avoid; mental confusion suggests losing boundaries, wanting to strike the ground to avoid emptiness, staying inside implies avoiding emptiness for solidity.]
Ingredients: Renshen (Ginseng Radix) Huangqi (Astragali Radix) Baizhu (Atractylodis Macrocephalae Rhizoma) Gancao (Glycyrrhizae Radix et Rhizoma) Fuzi (Aconiti Lateralis Radix Praeparata) Rougui (Cinnamomi Cortex) Shudihuang (Rehmanniae Radix Praeparata) Shengdihuang (Rehmanniae Radix) Danggui (Angelicae Sinensis Radix) Baishao (Paeoniae Radix Alba) Chenpi (Citri Reticulatae Pericarpium) Add Jiang, Zao, Nuomici. If internal heat exists, remove Fuzi and Rougui.
This formula primarily tonifies Qi and Blood heavily. Only take if there is excessive sweat, Yang collapse, and the aforementioned symptoms. The above four formulas all treat winter True Shanghan; learn their principles, do not rigidly apply the herbs.
Qianghuo Chonghe Tang (Notopterygium Harmonizing Decoction): [Identical to Jiwei Qianghuo Tang.] Treats colds in spring, summer, and autumn caused by sudden cold. Symptoms: headache, fever, aversion to cold, body pain, stiff waist/spine, anhidrosis, floating-tight pulse. This is pathogen invasion of the Foot Taiyang meridian; use this for dispersal. Treatment differs from winter True Shanghan.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix) [Main herb for Taiyang exterior release, 2-3 qian.] Fangfeng (Saposhnikoviae Radix) [Lowly soldier, follows guiding herbs, 1-2 qian.] Chuanxiong (Ligustici Chuanxiong Rhizoma) [For headache, approx. 1 qian.] Baizhi (Angelicae Dahuricae Radix) [Yangming guiding herb, approx. 1 qian.] Xixin (Asari Radix et Rhizoma) [Hand-Foot Shaoyin guiding herb, 3-4 fen. Do not use excessively; add/remove based on symptoms.] Cangzhu (Atractylodis Rhizoma) [Use 5 fen; remove for wind-cold with spontaneous sweat.] Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) [Harmonizes herbs, 5-7 fen.]
Shengdi (Rehmanniae Radix) [Sweet-cold nourishes Yin, 2-4 qian.] Huangqin (Scutellariae Radix) [Bitter-cold clears heat, approx. 1 qian. Use these two if interior heat exists.] Add Jiang, Zao.
[Harmonizes Ying and Wei.]
Commentary: This is a formula that releases the exterior and clears the interior simultaneously. Jie'an treated colds in the three seasons with this formula, substituting Mahuang, Guizhi, and Qinglong Tangs. Thin Qi exfoliates; thus, using thin-Qi herbs like Qiang, Fang, Xiong, Zhi, Xin, Cang disperses cold. To overcome heat, Di's sweet-cold nourishes Yin, Qin's bitter-cold clears heat. Using ascending drugs assisted by cooling herbs prevents harsh ascent; using cooling drugs guided by ascending herbs prevents stagnation. Gancao and Dazao benefit the Spleen/Stomach, establishing the banner of Ying. Tao praised its efficacy highly, but it should not be used fully without modification. Flexible adjustment yields divine results. My commentary: Modifying this formula, using acrid-cool to vent the exterior and clearing heat/nourishing Yin internally is very appropriate for Spring Warmth caused by Winter Cold. Tao treated Lianggan Shanghan (simultaneous Taiyang and Shaoyang/Yin-Yang involvement) with headache, fever, aversion to cold [Shaoyang symptom], dry mouth/tongue [Shaoyin symptom]. Remove Cangzhu, Baizhi; add Maidong, Zhimu, Shigao in large doses. If exterior symptoms dominate, exterior herbs are chief; if interior symptoms are urgent, interior herbs are chief. If purgative indications exist, mild purgation is allowed. [Classics say: Lianggan inevitably leads to death; this formula is a last resort.]
Xiangsu San (Perilla Powder): Treats colds caused by Wind-Cold. Symptoms: headache, body heat, aversion to cold.
Shengxiangfu (Cyperi Rhizoma) [Releases exterior, promotes Qi, 2-3 qian.] Zisu (Perillae Folium) [Acrid-warm disperses cold, 3 qian; remove if sweating.] Juhong (Citri Reticulatae Pericarpium Rubrum) [Descends Qi, resolves phlegm, approx. 1 qian.] Gancao (Glycyrrhizae Radix et Rhizoma) [Harmonizes Middle, supports righteousness, 5-7 fen.]
I add Qianghuo, Fangfeng, Chuanxiong, Chidou Chi [named Qianghuo Fangfeng Xiangsu San], often substituting previous formulas, using Jiang/Zao as guides. For phlegm-cough, add Qianhu, Xingren. For wind-cold with unceasing spontaneous sweat, add Baishao; severe cases add Sheng Huangqi. [Pathogens at exterior must be resolved from exterior; this formula disperses pathogens, Huangqi/Baishao consolidate exterior, working together. General rule for colds: induce sweat if present, stop sweat if absent; disease resolves easily.] For weakness, add Renshen [3-5 fen, method of Shen Su Yin]. For chest/hypochondriac fullness, add Zhike, Jiegeng [Zhike Tang treats Pi syndrome]. For nausea/vomiting, add Jiangzhi, Banxia [Contraindicated for blood-loss, fluid-deficiency, and sweating patients]. For thirst, add Maidong, Huafen, Zhimu; severe cases add Shigao. For abdominal pain, add Muxiang, Sharen. For diarrhea without sweat, add Cangzhu; with sweat, add Baizhu. If dietary injury preceded, with belching, sour regurgitation, fullness, and subsequent wind-cold, pulses in both hands will be forceful; this is Cold-Damp with Food Retention. Add Shenqu, Maiya; for meat ingestion, add Shanzha. [Release exterior and digest stagnation; otherwise, only release exterior. Wind-Cold damages exterior, stagnating Ying/Wei Qi, causing undigested food to remain. Releasing exterior turns Great Qi, allowing digestion. Moreover, Xiang, Su, Chi, Ju in the formula promote Qi movement, aiding digestion.]
This is an acrid-warm exterior-releasing formula. For mild colds without specific Six Meridian symptoms, focus on exterior-releasing and Qi-promoting herbs, modifying for accompanying symptoms. Universal for all seasons.
Xiao Chaihu Tang (Minor Bupleurum Decoction): Treats pathogen invasion of Foot Shaoyang Gallbladder meridian. [Can be spring warm wind pathogens or transmitted cold/warm pathogens.] Alternating chills and fever. [Between exterior and interior of Shaoyang; entering Yin causes chills, exiting Yang causes fever.] Slight pain at temple corners. [Spleen Earth reaches the temples.] Bitter taste in mouth, dry throat. [Gallbladder governs the throat; pathogens偏向 interior, heat gathers in Gallbladder, causing bitter taste and dry throat.] Vertigo, deafness. [Wood excess generates wind causing vertigo; Gallbladder meridian enters ear; wind-heat obstructs upward causing deafness; severe cases have red eyes or swelling/pain in ears.] Chest and hypochondriac distress/fullness, silent desire not to eat. [Depressed Stomach Qi fails to extend, water/grain fail to digest, hence silent anorexia.] Mental vexation, frequent vomiting. [Pathogen assaulting Heart causes vexation; assaulting Stomach causes vomiting.]
Seeing even one symptom [alternating chills and fever] is sufficient; all symptoms need not be present. This formula governs.
Ingredients: Chaihu (Bupleuri Radix) [Bitter, slightly cold, exterior herb for Shaoyang, 2-3 qian.] Huangqin (Scutellariae Radix) [Heat arises when pathogens enter interior, thus used.] Banxia (Pinelliae Rhizoma) [Phlegm-fluid causes vomiting, used with Ginger, 1-2 qian each.] Renshen (Ginseng Radix) [3-7 fen; remove if Middle Qi is not deficient.] Gancao (Glycyrrhizae Radix et Rhizoma) [5-7 fen.] Dazao (Jujubae Fructus) [2 pieces.] Shengjiang (Zingiberis Rhizoma Recens) [2 slices.]
Chest fullness: Add Zhike; if ineffective, add Huanglian, Gualou Shi. [Combined with Banxia forms Xiao Xianxiong Tang.] Vexation in chest without vomiting: Remove Renshen, Banxia; add Gualou Shi. [Resolves phlegm in chest/diaphragm to remove vexation.] Thirst: [Pathogen absorbs Stomach fluids.] Remove Banxia [slippery/moistening, fears further fluid depletion]; add Maidong, Huafen, Zhimu [generates fluids, stops thirst]; severe cases add Shigao [clears heat, stops thirst]. Abdominal pain: [Pathogen assaults Spleen.] Add Fried Shaoyao [drains Wood from Earth]. Hardness/fullness under ribs: [Exterior pathogens bind with phlegm at Shaoyang seat.] Remove Dazao [sweetness may stagnate Qi]; add Muli [salty-cold softens hardness/phlegm]. Hypochondriac pain: [Shaoyang primary symptom.] Add Qingpi [unblocks stagnant Qi]. Palpitations under heart with difficult urination: [Pathogen stagnates middle, fluid retention fails to distribute, Kidney Water assaults Heart.] Add Fuling [guides water, drains Kidney pathogen]. Cough: [Pathogen insults Metal.] Remove Renshen, Dazao [fears clogging Lung Qi]; add Qianhu, Xingren [disperses Lung pathogens]. Loose stools: [Pathogen assaults Spleen.] Add Baishao, Fuling. If accompanied by heat-driven diarrhea with severe thirst, add Huanglian [clears Spleen stagnant heat], Huangbai [secures Yuan Yin of North]. If accompanied by eye pain, nasal dryness, inability to sleep [Shaoyang-Yangming syndrome], no vomiting, no sweat: Remove Banxia, add Gegen [method of Chai Ge Jie Ji]. Preference for cool, aversion to heat, spontaneous sweat, vexation, thirst for cold drinks: Combine with Baihu Tang, add Maidong, Zhuye. In women, during menses onset or cessation, heat pathogens enter Blood Chamber through deficiency, blood coagulates, chills/fever like malaria, periodic episodes. [Pathogen-blood struggle, righteous-pathogen conflict, Yin-Yang fluctuation resembles malaria, hence periodic.] Clear during day, delirious at night seeing ghosts. [Liver opens to eyes; hot blood links, Hun does not return to residence, reflects in eyes.] Fullness under chest/hypochondrium resembling Jie Xiong. [Pathogen gathers, blood coagulates.] Delirium: [Blood Chamber pathogens surge.] Add Shengdi, Danshen [cool blood, remove stasis], Lingyangjiao (Saiga Tataricae Cornu) [clears Liver heat, removes bad blood, treats chest/hypochondriac fullness, muscle heat, latent heat].
Commentary: This treats Shaoyang semi-exterior semi-interior symptoms, a harmonizing formula. Chaihu seeks to exit exterior, Huangqin seeks to enter interior, Banxia seeks to drive phlegm; moving but not harmonizing. Thus, Zhang Zhongjing decants and re-boils to unify medicinal properties. It harmonizes neither exterior nor interior, but the Middle. Resolving exterior-interior pathogens relies entirely on Stomach Qi distribution. Hence, Renshen, Gancao, Dazao support Stomach Qi to rotate, allowing medicines to disperse exterior-interior, like a strong man carrying it away. Generally, Taiyang prohibits purgation, Yangming prohibits sweating/diuresis, Shaoyang has three prohibitions: no sweating, vomiting, or purgation. Only this one harmonizing formula, modified by symptoms, with no other alternatives.
Chaihu Danpi Tang (Bupleurum and Moutan Decoction): Treats post-Clear Brightness period, when Shaoyin Jun Fire commands, catching warm wind. Jueyin Pericardium acts for the Heart Monarch. Headache or no headache. [Meridians do not all go to head, so many have no headache.] Only body heat. [Wind-heat pathogens at exterior.] Initially slight aversion to cold, anhidrosis. [Shaoyin arrival causes chills/tremors; pathogens affect Pericardium, heat retained inside, pathogen-righteous struggle, Qi stagnation fails to reach exterior, hence chills; severe cases tremble. Soon Qi reaches exterior, body sweats.] Palpitations in heart. [Pericardium pathogens excess, hence trembling unrest.] Or vexation, rash eruption. [Disturbance is vexation, anger is agitation,]