一妇人得伤寒数日。咽干。烦渴。脉弦细。医者汗之。其始衄血。继而脐中出血。医者惊骇
而遁。予曰少阴强汗之所致也。盖少阴不当发汗。仲景云少阴强发汗。必动其血。未知从何道而
出。或从口鼻。或从耳目。是为下厥上竭。此为难治。仲景云无治法。无药方。予投以姜附汤。
数服。血止。后得微汗愈。
论曰。本少阴证。而误汗之。故血妄行。自脐中出。若服以止血药。可见其标。而不见其本。
予以治少阴之本。而用姜附汤。故血止而病除。
乡人李信道。权狱官。得病。六脉俱沉不见。深按至骨。则弦细有力。头疼。身温。烦躁。
手指末皆冷。中满。恶心。更两医矣。而医者不晓。但供调药。予往视之曰。此阴中伏阳也。仲
景方无此证。而世人患者多。若用热药以助之。则阴邪隔绝。不能引导其阳。反生客热。用寒药。
则所伏真火。愈见销铄。须是用破阴丹。行气导水。夺真火之药。使火升水降。然后得汗而解。
予令以冷盐汤。下破阴丹三百丸。作一服。不半时烦躁狂热。手足渐温。谵语躁扰。其家甚惊。
予曰汗证也。须臾稍宁。略睡。 然汗出。自 达旦方止。身凉而病除。（破阴丹方。硫黄水银
各一两。结沙子青皮半两。为末。面糊。和丸桐子大。每服三十丸。冷盐汤送下。出中脏经方脉
举要。）
一位妇人患伤寒几天后，出现咽喉干燥、心烦口渴、脉象弦细的症状。医生采用发汗法治疗，起初患者出现鼻衄（鼻腔出血），随后脐部开始出血。医生惊恐害怕而逃离。我说这是少阴病强行发汗所致。因为少阴病不应当发汗，张仲景说：对少阴病强行发汗，必然会导致动血，不知道血液会从哪个通道流出，或者从口鼻，或者从耳朵眼睛，这被称为“下厥上竭”，属于难治之症。张仲景说对此没有治疗方法，也没有药方。我给予姜附汤服用，服了几剂后，出血停止，后来微微出汗而痊愈。
论述说：本属少阴证，却误用发汗法，导致血液妄行，从脐中流出。如果服用止血药，只能看到表面症状，而不能见到根本原因。我用治疗少阴根本的方法，使用姜附汤，所以血止而病除。
同乡李信道，担任监狱长官，患病。六脉都沉伏不见，深按至骨时，脉象弦细有力。伴有头痛、身体温热、烦躁不安、手指末端皆冷、胸中痞满、恶心呕吐。换了两位医生诊治，但医生不懂病情，只是提供调理药物。我去诊视说：这是阴中伏阳证。张仲景的方书中没有这个证候，但世上的患者很多。如果用热药来助长它，那么阴邪隔绝，不能引导其阳气，反而会产生客热；如果用寒药，那么潜伏的真火，会更加被销蚀消耗。必须使用破阴丹，行气导水，夺取真火的药，使火升水降，然后才能通过出汗而解病。我令他用冷盐汤送服破阴丹三百丸，作为一次服用量。不到半小时，患者出现烦躁狂热、手足逐渐变温、胡言乱语、躁动不安的情况，家属非常惊恐。我说这是汗出的征兆。片刻后稍微安静，略微睡去，随即大汗出，直到天亮才停止，身体变凉而病愈。（破阴丹方：硫黄、水银各一两，结沙子、青皮半两，研为细末，用面糊和药，制成梧桐子大小的丸药。每次服用三十丸，用冷盐汤送下。出自《中脏经》《方脉举要》。）
A woman suffered from Shanghan (Cold Damage) for several days. She presented with dryness of the throat, irritability, and thirst, along with a wiry and fine pulse. The physician treated her with diaphoresis (sweating method). Initially, she experienced epistaxis (nosebleed), which was followed by bleeding from the umbilicus. The physician, terrified, fled. I said, "This is caused by forcing sweating in Shaoyin disease." Indeed, Shaoyin disease should not be treated with sweating. Zhang Zhongjing stated: "If one forces sweating in Shaoyin disease, it will inevitably disturb the blood. It is unknown from which pathway it will emerge; either from the mouth and nose, or from the ears and eyes. This is termed 'Jue at the lower part and Jie at the upper part' [extreme cold at the lower extremities and exhaustion of yin fluids at the upper body], which is difficult to treat." Zhang Zhongjing noted that there is no treatment method or prescription for this. I administered Jiang Fu Tang (Ginger and Aconite Decoction). After several doses, the bleeding stopped. Subsequently, she sweated slightly and recovered.
Commentary states: This was originally a Shaoyin syndrome, but it was mistakenly treated with sweating, causing blood to flow recklessly and exit from the umbilicus. If hemostatic herbs were used, only the branch (symptom) would be addressed, while the root (cause) would remain unseen. By treating the root of Shaoyin using Jiang Fu Tang, the bleeding stopped and the illness was cured.
My fellow townsman Li Xindao, who served as an acting prison official, fell ill. His six pulses were all deep and imperceptible. Upon pressing deeply to the bone, the pulses were wiry, fine, and vigorous. He suffered from headache, warm body, irritability, cold fingertips, abdominal fullness, and nausea. Two other physicians had treated him, but they did not understand the condition and merely provided regulating medicines. I examined him and said, "This is Yang concealed within Yin." There is no such syndrome in Zhang Zhongjing's formulas, yet many patients suffer from it in the world. If hot-natured herbs are used to assist it, the Yin pathogen will become isolated, unable to guide the Yang, and instead generate exogenous heat. If cold-natured herbs are used, the hidden True Fire will be further depleted. One must use Po Yin Dan (Break Yin Pill), which moves Qi, guides water, and extracts the True Fire, causing Fire to ascend and Water to descend, after which recovery can occur through sweating. I instructed him to take three hundred pills of Po Yin Dan with cold salt water as a single dose. Within half an hour, he became irritable, feverish, his hands and feet gradually warmed, and he spoke deliriously and restlessly. His family was greatly alarmed. I said, "This is a sign of impending sweating." Shortly after, he calmed down slightly, slept briefly, and then profuse sweating occurred, lasting until dawn. His body cooled, and the illness was cured. (Formula for Po Yin Dan: Shihuang [Cinnabar? Note: Text says Sulfur/Mercury mix likely implying realgar/cinnabar processing or specific alchemical preparation, strictly translating text: Sulfur and Mercury each 1 liang], Jiesha Zi [Lithospermum Erythrorhizon], Qingpi [Citrus Reticulatae Pericarpium Viride] half 1 liang. Grind into powder, mix with wheat paste, and form pills the size of paulownia seeds. Take thirty pills per dose, delivered with cold salt water. From *Zhong Zang Jing* and *Fang Mai Ju Yao*.)