治伤寒始觉吹冻着四肢。头目百节疼痛。急煎此服。如人行五里。再服。或连三服。汗出立瘥。若患阴毒伤寒。入
退阴散半钱同煎或寒冷伤食。头昏气满。及心腹诸疾。服之。无有不效。
麻黄 陈皮 大黄 甘草 干姜 肉桂 白芍药 附子 半夏 吴茱萸（各等分皆用制）
上麻黄加一半。茱萸减一半。同为末。每服一大钱。水一盏。生姜五片。枣一枚。煎至七分。热呷出汗。以被盖覆。
汗出愈阴毒。不可用麻黄出汗。
琥按上论伤寒始觉吹冻。着四肢头目百节疼痛。有似太阳阳明二经。在表之证。又治寒冷伤食。头昏气满。心腹诸
疾。是伤寒挟食矣。及用药又温里发表。二者兼施。服之稍误。岂不杀人。纵使内外皆阴。为寒实之证。何不用浓朴枳
实。而反投大黄。一何悖邪。此等方。不宜采入。今姑存之。以俟识者较正。
治阴毒伤寒。手足逆冷。脉沉细。头痛腰重。小小伤冷。每服一字。入正元散同煎。入盐一捻。阴毒证。咳逆。煎
一服。细细热呷之便止。
川乌头 干姜（各等分）
上为粗末。炒令转色。放冷。捣为细末。每服一钱。水一盏。盐一捻。煎至半盏。去滓温服。
琥按仲景云阴毒。未尝头痛。此独言头痛者。或者内食生冷。外伤风寒。为阳明头痛。宜加白芷倘系厥阴头痛。宜
加吴茱萸。腰重者。风寒伤肾。肾家无火也。宜加肉桂附子。上论云。入正元散同煎。用药错杂。内无专味。殊悖于理。
其入盐一捻者。恐川乌等热药僭上。用之使润下也。
【正元散方】
治疗伤寒初起，感觉受寒邪侵袭四肢。头部、眼部及全身关节疼痛。立即煎煮此药服用。约行走五里的时间后，再次服用。或者连续服用三次，出汗后立即痊愈。如果是患阴毒伤寒，加入退阴散半钱一同煎煮；或者是因寒冷损伤饮食，出现头昏、气胀以及心腹各种疾病，服用此药，没有不有效的。
药材：麻黄、陈皮、大黄、甘草、干姜、肉桂、白芍药、附子、半夏、吴茱萸（各等分，均经过炮制）。
上方中麻黄用量增加一半，吴茸萸用量减少一半，共同研为细末。每次服用一大钱。用水一盏，生姜五片，大枣一枚，煎至七分量，趁热小口饮用以取汗，并用被子覆盖身体。
若汗出则病愈。若是阴毒证，不可使用麻黄发汗。
琥按：上述论述中提到伤寒初起感觉受寒邪侵袭，导致四肢、头部、眼部及全身关节疼痛，症状类似于太阳经和阳明经在表的证候。又提到治疗因寒冷损伤饮食导致的头昏、气胀及心腹各种疾病，这是伤寒挟带食滞。而用药又是温补里气和发散表邪两者兼施。如果服用稍有差错，岂不是会致人于死地？纵使内外皆为阴寒，属于寒实之证，为何不用厚朴、枳实，反而投用大黄？这多么违背常理。这类方剂，不宜收录。现在暂且保留它，以便等待有识之士进行校正。
【退阴散方】
治疗阴毒伤寒，手足逆冷，脉象沉细，头痛，腰部沉重。轻微受寒，每次服用一字，加入正元散一同煎煮，加入一捻盐。对于阴毒证引起的咳嗽气逆，煎煮一服，细细热饮即可停止。
将药材捣成粗末，炒至颜色改变，放凉后，捣为细末。每次服用一钱。用水一盏，一捻盐，煎至半盏量，去渣后温服。
琥按：仲景说阴毒证，不曾出现头痛。这里唯独提到头痛，或许是内有生冷食物，外受风寒，导致阳明头痛，适宜加白芷。倘若属于厥阴头痛，适宜加吴茱萸。腰部沉重，是风寒伤肾，肾阳不足（肾家无火），适宜加肉桂、附子。上述论述中说加入正元散一同煎煮，用药杂乱，内部没有专一的药味，特别违背医理。其中加入一捻盐，恐怕是因为川乌等热性药物容易上僭（药力过猛上行），用盐使其润下（引药下行）。
[Zhengyuan San Formula]
To treat early-stage Shanghan (Cold Damage) where the patient feels cold invading the four limbs. There is pain in the head, eyes, and all joints. Immediately decoct and take this medicine. After walking for the distance of five li, take it again. Or take it three times consecutively; upon sweating, the illness will immediately resolve. If suffering from Yindu Shanghan (Yin Toxin Cold Damage), add Ban Qian (half a qian) of Tuiyin San to decoct together. Or if food injury caused by cold leads to dizziness, abdominal distension, and various heart and abdominal diseases, taking this medicine will be effective without exception.
Herbs: Ephedrae Herba (Mahuang, 麻黄), Citri Reticulatae Pericarpium (Chenpi, 陈皮), Rhei Radix et Rhizoma (Dahuang, 大黄), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), Zingiberis Rhizoma Recens (Ganjiang, 干姜), Cinnamomi Cortex (Rougui, 肉桂), Paeoniae Radix Alba (Baishao, 白芍药), Aconiti Lateralis Radix Praeparata (Fuzi, 附子), Pinelliae Rhizoma Preparatum (Banxia, 半夏), Evodiae Fructus (Wuzhuyu, 吴茱萸) (all in equal parts, all processed).
For the above formula, increase the dosage of Mahuang by half, and decrease the dosage of Wuzhuyu by half. Grind them together into fine powder. Take one Da Qian per dose. Use one Liang of water, five slices of fresh ginger, and one jujube. Decoct until seven-tenths remain. Drink hot in small sips to induce sweating, and cover with a blanket.
If sweating occurs, the disease resolves. For Yindu syndrome, do not use Mahuang to induce sweating.
Hu notes: The above discussion mentions that early Shanghan feels like cold invasion, causing pain in the four limbs, head, eyes, and all joints. This resembles exterior syndromes of the Taiyang (Taiyang Jing, Taiyang meridian) and Yangming (Yangming Jing, Yangming meridian) channels. It also treats dizziness, qi fullness, and various heart/abdominal ailments caused by cold damaging food, which indicates Shanghan complicated with food stagnation. Yet the medication combines warming the interior and releasing the exterior. If taken even slightly incorrectly, would it not kill the patient? Even if both interior and exterior are Yin-cold, constituting a cold-excess syndrome, why not use Magnoliae Officinalis Cortex (Houpo, 厚朴) and Immature Bitter Orange (Zhishi, 枳实), but instead administer Rheum? How contrary to logic! Such formulas should not be included. For now, they are retained pending correction by knowledgeable practitioners.
[Tuiyin San Formula]
To treat Yindu Shanghan, characterized by cold reversal of the hands and feet, deep and fine pulse, headache, and heavy sensation in the waist. For minor cold injuries, take one Zi per dose, decoct together with Zhengyuan San, adding a pinch of salt. For coughing and counterflow qi due to Yindu syndrome, decoct one dose, drink slowly while hot, and it will stop.
Herbs: Aconiti Kusnezoffii Radix (Chuanwutou, 川乌头), Zingiberis Rhizoma Recens (Ganjiang, 干姜) (equal parts).
Grind the herbs into coarse powder, stir-fry until the color changes, let cool, then grind into fine powder. Take one Qian per dose. Use one Liang of water and a pinch of salt. Decoct until half a Liang remains, strain, and take warm.
Hu notes: Zhang Zhongjing stated that Yindu does not involve headache. Here, headache is specifically mentioned. Perhaps there is internal consumption of cold/raw food combined with external wind-cold invasion, leading to Yangming headache; Bai Zhi (Angelicae Dahuricae Radix, 白芷) should be added. If it is Jueyin headache, Wu Zhu Yu (Evodiae Fructus, 吴茱萸) should be added. Heavy waist indicates wind-cold damaging the Kidney, with lack of fire in the Kidney (Kidney deficiency); Rou Gui (Cinnamon Twig/Cortex, 肉桂) and Fu Zi (Prepared Aconite Root, 附子) should be added. The above discussion states to decoct together with Zhengyuan San; the medication is mixed and lacks specific targeted ingredients, which is highly illogical. Regarding the addition of a pinch of salt, it is likely because Chuan Wu Tou (Kusnezoff Monkshood Root, 川乌头) and other hot medicines may cause excessive upward flaming (Qian Shang); salt is used to guide the action downward (Run Xia).