小柴胡汤

◎方  名：小柴胡汤（和解之剂）

   总  结：半表半里                                                               

   编  号：001                                                                    

   组  成：柴胡、黄芩、半夏、生姜、人参、甘草、大枣                               

   主  治：1.治伤寒中风少阳证，往来寒热，胸胁痞满，默默不欲食，心烦喜呕。

           2.或腹中痛，或下痛，或渴，或欬，或利，或悸，小便不利，或不渴，口苦耳聋，脉弦，或汗后余热不解。

           3.及春月时嗽，疟发寒热。妇人伤寒，热入血室。

           4.亦治伤寒五、六日，头出汗，微恶寒，手足冷，心下满，不欲食，大便，脉细者，为阳微结。

   加  减：(1)呕逆加生姜、陈皮。                                                  

           (2)烦而不呕，去半夏、人参，加栝蒌。                                    

           (3)渴者去半夏，加花粉。                                                

           (4)若不渴，外有微热，去人参，加桂枝，覆取微汗。                        

           (5)嗽去参、枣、生姜，加五味子、干姜。                                

           (6)虚烦加竹叶、粳米。                                                  

           (7)齿燥无津加石膏。                                                    

           (8)痰多加栝蒌、贝母。                                                  

           (9)腹痛去黄芩，加芍药。                                                

           (10)下痞，去大枣、加牡蛎。                                         

           (11)下痛，加青皮、芍药。                                             

           (12)心下悸，小便不利，去黄芩，加茯苓。                                 

           (13)本经头痛加川芎。                                                   

           (14)发黄加茵陈。                                                       

   归  经：足少阳药                                                               

   方  义：(1)胆为清净之府，无出无入，其经在半表半里，不可汗吐下，法宜和解。      

              邪入本经，乃由表而将至里，当彻热发表，迎而夺之，勿令传太阴。        

           (2)柴胡味苦微寒，少阳主药，以升阳达表为君。黄芩苦寒。以养阴退热为臣    

           。                                                                     

              半夏辛温，能健脾和胃，以散逆气而止呕。人参、甘草，以补正气而和中    

           ，                                                                     

              使邪不得复传入里为佐。邪在半里半表，则营卫争。故用姜、枣之辛甘，    

              以和营卫为使也。                                                    

   变化方：(1)本方以前胡代柴胡，名小前胡汤（崔氏），治同。                        

           (2)本方加陈皮、芍药，名柴胡双解散，治同。                              

           (3)本方加芒硝，名柴胡加芒硝汤。                                        

           (4)本方加桂枝，名柴胡加桂枝汤，治伤寒六、七日，发热，微恶寒，支节烦    

           痛，                                                                   

              微呕，心下支结。外证未去者。                                        

           (5)本方除黄芩、甘草，加桂枝、茯苓、龙骨、牡蛎、铅丹、大黄，            

              名柴胡加龙骨牡蛎汤，治伤寒八、九日下之，胸满烦惊，小便不利，谵语    

           ，                                                                     

              身重不可转侧。                                                      

           (6)本方去半夏、人参、姜、枣，加桂枝、干姜，花粉、牡蛎，                

              名柴胡桂枝干姜汤，治伤寒汗下后，胸满，微结，小便不利，渴而不呕    

           ，                                                                     

              但头汗出，往来寒热，心烦者。亦治疟发寒多热少，或但寒不热。          

           (7)本方去半夏，加花粉，名柴胡去半夏加栝蒌根汤，治往来寒热而渴，及劳    

           疟。                                                                   

           (8)本方去柴胡、黄芩，加厚朴，名厚朴生姜半夏甘草人参汤，  治发汗后腹胀满者。              

 (9)本方除半夏，加当归、白芍、大黄，名柴胡饮子，治肌热蒸热积热，  汗后余热，脉洪实弦数。亦治疟疾。                                    

           (10)本方加羌活、防风，名柴胡羌活汤，治瘟疫少阳证。                     

           (11)本方加桔梗，名柴胡桔梗汤，治春嗽。                                 

           (12)本方合平胃散，名柴平汤，治湿疟身痛，身重。                         

           (13)本方加青黛、姜汁糊丸，名清镇丸，治呕吐脉弦头痛及热嗽。             

           (14)本方一分，加四物二分，名柴胡四物汤，治妇人日久虚劳，微有寒热。     

           (15)本方与四物各半，名调经汤。                                         

   来  源：仲景