（太阴为湿土纯阴之脏也。病入太阴。从阴化者多。从阳化者少。）
何谓太阴之邪从阴化。伤寒论云。腹满。吐食。自利。不渴。手足自温。时腹自痛。是也。宜
理中丸汤主之。不愈。宜四逆辈。
何谓太阴之邪从阳化。伤寒论云。发汗后不解。腹痛。急下之。宜大承气汤是也。又曰。腹满时痛。属
太阴也。时痛者。谓腹时痛时止。桂枝加芍药汤主之。大实痛者。大便坚实而痛。桂枝加大黄汤主之。
内经云。太阴之上。湿气治之。所谓本也。本之下。中之见也。见之下。气之标也。又曰。太阴从本。
又曰。太阴为开。又热病论曰。四日太阴受之。太阴脉布胃中。络于嗌。故腹满而嗌干。
伤寒论云。太阴之为病。腹满而吐。食不下。自利益甚。时腹自痛。若下之。必胸下结硬。
按伤寒论太阴病脉证。只有八条。后人谓为散失不全。及王叔和之变乱。而不知八条中有体有用有
法有方。真能读者。则取之无禁。用之不竭矣。所可疑者。自第一节提纲外。其第二节云。太阴中风证。四
肢烦疼等句。言其欲愈之脉。而不言未愈时何如施治。第三节云。太阴病欲解时。从亥至丑上。以太阴
主开。地辟于丑。故愈于其时也。第四节云。太阴病脉浮者。可发汗。宜桂枝汤。而不言脉若不浮。如何施
治。惟于第五节云。自利不渴者属太阴。以其脏有寒故也。当温之。宜服四逆辈。曰辈者。凡理中汤通脉
四逆汤吴茱萸汤之类。皆在其中。第六节云。伤寒脉浮而缓。手足自温者。系在太阴。太阴当发黄。若小
便自利者。不能发黄。至七八日。虽暴烦下利。日十余行。必自止。以脾家实腐秽当去故也。策七节云。太
阳病。医反下之。因而腹满时痛者。桂枝加芍药汤主之。大实痛者。桂枝加大黄汤主之。第八节云。太阴
为病脉弱。其人续自便利。设当行大黄芍药为训者宜减之。以其人胃气弱易动故也。此外并无方治。
以为少则诚少矣。而不知两节两出其方。大具经权之道。宜分两截看。
仲景所谓太阴证。与内经人伤于寒为热病。腹满嗌干证不同。提纲皆言寒湿为病。以四逆汤为治内
正法。桂枝汤为治外正法。自第一节至第五节。一意浅深相承。不离此旨。所谓经也。此为上半截。
第六节言伤寒脉浮而缓手足自温十二句。意者太阴以中见为主。以上五节。言不得中见之寒证。若
中见太过。太阴湿土。不与寒合而与热合。若小便利。则不发黄。若暴烦下利。则腐秽当去。是常证之外。
略有变局。另作一小段。承上即以起下。第七节言太阳病误下。转属太阴。腹满时痛。大实痛者。以桂枝
加芍药加大黄为主治。一以和太阴之经络。变四逆辈之温而为和法。变桂枝汤之解外而为通调内
外法。是于有力处通其权也。一以脾胃相连。不为太阴之开。便为阳明之阖。既阖而为大实痛。不得不
借阳明之快捷方式。以去脾家之腐秽。要知提纲戒下。原因腹时痛而言。此从正面审到对面以立法。又于
暴烦下利十余行自止节。言其愈尚未言方。此从腐秽既下后。而想到不自下时之治法。是于无方处
互明方意以通权。此为下半截。
总而言之。四逆辈桂枝汤。及桂枝加芍药。桂枝加大黄汤。皆太阴病之要剂。若不渴则四逆辈必须。若
脉弱则芍黄等慎用。脉浮有向外之势。桂枝汤之利导最宜。烦疼当未愈之时。桂枝加芍药汤亦可通
用。原文虽止八条。而诸法无有不具。柯韵伯等增入浓朴生姜半夏甘草人参汤白散麻仁丸等方。欲
广其用。反废其活法。大抵未读圣经之前。先闻砭剥叔和之语。谓非经文。无不可以任意增减移易。致
有是举耳。
按沈尧封云。太阴阳明。俱属土。同主中州。病则先形诸腹。阳明为阳土。阳道实。故病则胃家实而非满
也。太阴为阴土。阴道虚。故病则腹满而不能实也。凡风燥热三阳邪犯阳明。寒与温二阴邪犯太阴。阳
邪犯阳则能食而不呕。阴邪犯阴则不能食而吐。阳邪犯阳则不大便。阴邪犯阴则自利。证俱相反可
认。若误下则胃中空虚。客气动膈。在阳邪则懊 而烦。在阴邪则胸下结硬。倘再误攻。必致利不止而
死。此太阴病之提纲。凡称太阴。俱指腹满言。
按柯韵伯云。内经云。太阴脉布胃中。络于嗌。故腹满嗌干。此热伤太阴。自阳部注经之证。非论中所云
太阴自病也。仲景以太阴自病为提纲。因太阴主内。故提纲中不及中风四肢烦疼之表。又为阴中之
至阴。故提纲中不及热病嗌干之证。太阴为开。又阴道虚。太阴主脾所生病。脾主湿。又主输。故提纲中
主腹满时痛而吐利。皆是里虚不固。湿胜外溢之证也。脾虚则胃亦虚。食不下者。胃不主纳也。要知胃
家不实。便是太阴病。
（太阴脾脏是湿土性质的纯阴之脏。病邪传入太阴后，多从阴寒化，从阳热化的较少。）
什么是太阴病邪从阴化？《伤寒论》说：腹部胀满，呕吐饮食，自发性腹泻，口不渴，手足自然温暖，时常腹部疼痛，这就是从阴化。适宜用理中丸或理中汤主治。如果无效，适宜使用四逆汤类方剂。
什么是太阴病邪从阳化？《伤寒论》说：发汗后病不解，出现腹痛，应当急下，适宜用大承气汤，这就是从阳化。又说：腹部胀满且时时疼痛，属于太阴病。所谓“时痛”，是指腹部有时痛有时止。适宜用桂枝加芍药汤主治。如果是大实痛，指大便坚硬且疼痛，适宜用桂枝加大黄汤主治。
《内经》说：太阴之上，由湿气主令，这是本。本之下，是中见少阳之火；见之下，是气之标。又说：太阴从本化。又说：太阴为开。又《热病论》说：第四日太阴受邪。太阴经脉散布于胃中，联络于咽喉，所以会出现腹部胀满和咽喉干燥。
《伤寒论》说：太阴病的症状是腹部胀满且呕吐，饮食不下，自发性腹泻日益严重，时常腹部疼痛。如果误用攻下法，必然导致胸下痞结硬满。
考察《伤寒论》中太阴病的脉证，只有八条。后人认为是散失不全，或是王叔和整理时的变乱，却不知道这八条中包含体、用、法、方。真正能读懂的人，取用它们没有禁忌，使用它们不会枯竭。所可疑的是，除了第一节提纲之外，第二节说太阴中风证有四肢烦疼等句，说的是将要痊愈的脉象，而没有说未愈时如何施治。第三节说太阴病欲解的时间，是从亥时到丑时，因为太阴主开，地气在丑时开辟，所以在该时辰痊愈。第四节说太阴病脉浮者，可以发汗，适宜用桂枝汤，但没有说脉如果不浮，如何施治。只有在第五节说：自发性腹泻且口不渴的属于太阴，因为内脏有寒的缘故，应当温补，适宜服用四逆汤类。所谓“辈”，凡是理中汤、通脉四逆汤、吴茱萸汤之类，都包含在内。第六节说：伤寒脉浮而缓，手足自然温暖的，系属太阴。太阴病应当发黄，如果小便自利，则不能发黄。到了七八天，虽然突然烦躁并腹泻，一天十多次，必定会自行停止，因为脾家实，腐秽之物应当排出的缘故。第七节说：太阳病，医生反而误用攻下法，因而导致腹部胀满且时时疼痛的，适宜用桂枝加芍药汤主治；大实痛的，适宜用桂枝加大黄汤主治。第八节说：太阴病脉弱，其人持续自发性便利，假设应当使用大黄、芍药的，应当减量，因为此人胃气虚弱，容易动泄的缘故。除此之外并没有其他方治。
认为条文少确实少了，却不知道这两节两次给出方剂，极具经权之道，应当分两截来看。
仲景所说的太阴证，与《内经》中“人伤于寒为热病，腹满嗌干”的证候不同。提纲都说是寒湿为病，以四逆汤为治内的正法，桂枝汤为治外的正法。从第一节到第五节，意旨深浅相承，不离此宗旨，这叫作“经”。这是上半截。
第六节说“伤寒脉浮而缓手足自温”十二句，大意是太阴以中见为主。以上五节，说的是不得中见的寒证；如果中见太过，太阴湿土不与寒合而与热合，如果小便通利，则不发黄；如果突然烦躁腹泻，则腐秽当去。这是在常证之外，略有变局，另作一小段，承上起下。第七节说太阳病误下，转属太阴，腹满时痛，大实痛的，以桂枝加芍药汤、桂枝加大黄汤为主治。一是调和太阴经络，将四逆汤类的温法变为和法，将桂枝汤的解表法变为通调内外的方法，这是在有力之处通其权变。一是因为脾胃相连，不为太阴之开，便为阳明之阖。既然阖而为大实痛，不得不借用阳明的快捷方式，以去除脾家的腐秽。要知道提纲禁止攻下，原因是针对腹部时时疼痛而言。此处是从正面审察到对面来立法。又在“暴烦下利十余行自止”一节，说其向愈但尚未言方，这是从腐秽既下之后，想到不自下时的治法，是在无方处互明方意以通权变。这是下半截。
总而言之，四逆汤类、桂枝汤，以及桂枝加芍药汤、桂枝加大黄汤，都是太阴病的要剂。如果不口渴，则必须用四逆汤类；如果脉弱，则慎用芍药、大黄等；脉浮有向外之势，桂枝汤的利导最为适宜；烦疼在未愈之时，桂枝加芍药汤也可通用。原文虽然只有八条，但各种治法无不具备。柯韵伯等人增入浓朴生姜半夏甘草人参汤、白散、麻仁丸等方，想要扩大其用途，反而废弃了其活法。大抵是因为未读经典之前，先听到了贬剥王叔和的话，认为不是经文，无不可以任意增减移易，导致了这样的举动。
按沈尧封说：太阴和阳明都属于土，共同主管中州。发病时先表现在腹部。阳明为阳土，阳道实，所以发病时是胃家实而不是单纯的胀满。太阴为阴土，阴道虚，所以发病时是腹部胀满而不能实。凡是风、燥、热三阳邪气侵犯阳明，寒与温二阴邪气侵犯太阴。阳邪犯阳则能食而不呕吐，阴邪犯阴则不能食而呕吐。阳邪犯阳则不大便，阴邪犯阴则自发性腹泻。证候都相反，可以辨认。如果误用攻下，则胃中空虚，客气动膈，在阳邪则懊憹而烦，在阴邪则胸下痞结硬满。倘若再误用攻伐，必然导致腹泻不止而死。这是太阴病的提纲。凡称太阴，都指腹部胀满而言。
按柯韵伯说：《内经》说：太阴经脉散布于胃中，联络于咽喉，所以腹部胀满且咽喉干燥。这是热邪损伤太阴，自阳部注入经脉的证候，不是《伤寒论》中所说的太阴自病。仲景以太阴自病作为提纲，因为太阴主内，所以提纲中不及中风四肢烦疼的表证。又因为太阴是阴中之至阴，所以提纲中不及热病咽喉干燥的证候。太阴为开，又阴道虚，太阴主脾所生病。脾主湿，又主输布，所以提纲中主要讲腹部胀满、时时疼痛、呕吐腹泻，这些都是里虚不固、湿胜外溢的证候。脾虚则胃也虚，饮食不下，是因为胃不主纳。要知道胃家不实，就是太阴病。
(The Taiyin spleen is a pure yin organ of wet earth. When pathogenic factors enter the Taiyin, they mostly transform according to yin (cold), and rarely according to yang (heat).)
What is meant by the transformation of Taiyin pathogens according to yin? The *Shanghan Lun* states: abdominal fullness, vomiting food, spontaneous diarrhea, absence of thirst, natural warmth of the hands and feet, and occasional abdominal pain. This is it. It should be primarily treated with Lizhong Wan or Lizhong Tang. If there is no improvement, Si Ni Tang category formulas should be used.
What is meant by the transformation of Taiyin pathogens according to yang? The *Shanghan Lun* states: after sweating, the disease does not resolve, abdominal pain occurs, urgent purgation is required, and Dachengqi Tang is suitable. This is it. It also says: abdominal fullness with occasional pain belongs to Taiyin. "Occasional pain" means the abdomen hurts intermittently. Guizhi Jia Shaoyao Tang should be used. For severe solid pain, characterized by hard stools and pain, Guizhi Jada Huang Tang should be used.
The *Neijing* states: Above Taiyin, dampness governs; this is the root. Below the root is the intermediate manifestation (Shaoyang fire); below the manifestation is the terminal qi. It also states: Taiyin transforms from the root. It also states: Taiyin is the opening. Furthermore, the *Rebing Lun* states: on the fourth day, Taiyin is affected. The Taiyin meridian spreads in the stomach and connects to the throat; therefore, abdominal fullness and dry throat occur.
The *Shanghan Lun* states: The symptoms of Taiyin disease are abdominal fullness and vomiting, inability to eat, worsening spontaneous diarrhea, and occasional abdominal pain. If purgation is applied, chest hypochondriac binding and hardness will certainly result.
Examining the pulse and symptom patterns of Taiyin disease in the *Shanghan Lun*, there are only eight clauses. Later scholars claimed they were incomplete due to loss or Wang Shuhe's alterations, not realizing that these eight clauses contain substance, function, method, and formula. Those who truly understand can utilize them without restriction and without exhaustion. The doubtful point lies in that, apart from the first clause which serves as the outline, the second clause mentions Taiyin wind-stroke syndrome with phrases like "distress and pain in the four limbs," describing the pulse for impending recovery but not how to treat when not yet recovered. The third clause states that Taiyin disease resolves from Hai hour to Chou hour because Taiyin governs opening, and earth opens at Chou, hence recovery occurs at that time. The fourth clause states that if the Taiyin disease pulse is floating, sweating may be induced using Guizhi Tang, but it does not specify treatment if the pulse is not floating. Only in the fifth clause does it say: spontaneous diarrhea with absence of thirst belongs to Taiyin, due to cold in the zang organs; warming is indicated, and Si Ni Tang category formulas are suitable. "Category" includes all such formulas as Lizhong Tang, Tongmai Si Ni Tang, and Wuzhuyu Tang. The sixth clause states: in cold damage, if the pulse is floating and slow, and the hands and feet are naturally warm, it relates to Taiyin. Taiyin should manifest jaundice; if urination is normal, jaundice will not develop. By the seventh or eighth day, even if sudden irritability and diarrhea occur more than ten times a day, it must stop spontaneously, because the Spleen house is real, and putrid filth must be expelled. The seventh clause states: in Taiyang disease, if the physician erroneously applies purgation, leading to abdominal fullness and occasional pain, Guizhi Jia Shaoyao Tang should be used; for severe solid pain, Guizhi Jia Dahuang Tang should be used. The eighth clause states: in Taiyin disease, if the pulse is weak and the person continues to have spontaneous loose stools, if Dahuang or Shaoyao were to be prescribed, their dosage should be reduced because the person's Stomach qi is weak and prone to movement. Aside from this, there are no other prescriptions.
One might think this is indeed few, but failing to realize that two clauses provide formulas twice, possessing great flexibility within principle, one should view them in two halves.
Zhongjing's concept of Taiyin syndrome differs from the *Neijing*'s description of "humans injured by cold becoming heat diseases with abdominal fullness and dry throat." The outlines both describe cold-dampness pathology, treating internally with Si Ni Tang as the orthodox method, and externally with Guizhi Tang as the orthodox method. From the first to the fifth clauses, the intent proceeds in depth, adhering to this principle, which is called the "Classic" (Jing). This constitutes the upper half.
The sixth clause, regarding "cold damage, floating and slow pulse, natural warmth of hands and feet" (twelve sentences), implies that Taiyin focuses on the intermediate manifestation. The previous five clauses discuss cold syndromes lacking the intermediate manifestation; if the intermediate manifestation is excessive, Taiyin wet earth combines with heat rather than cold. If urination is free, jaundice does not develop; if sudden irritability and diarrhea occur, putrid filth is expelled. This is a slight variation outside the constant syndrome, forming a small segment connecting above and initiating below. The seventh clause discusses Taiyang disease mismanaged by purgation, transferring to Taiyin, causing abdominal fullness and occasional pain or severe solid pain, treated mainly with Guizhi Jia Shaoyao Tang and Guizhi Jia Dahuang Tang. One aspect harmonizes the Taiyin meridians, changing the warming method of Si Ni Tang categories into a harmonizing method, and changing Guizhi Tang's exterior-releasing method into a method regulating internal and external aspects, exercising flexibility where strength allows. Another aspect acknowledges the connection between Spleen and Stomach; if not opening for Taiyin, it closes for Yangming. Since closing results in severe solid pain, one must borrow Yangming's rapid approach to remove putrid filth from the Spleen house. Note that the outline prohibits purgation because it addresses occasional abdominal pain. Here, legislation is derived by examining from the front to the opposite side. In the section on "sudden irritability, diarrhea over ten times, stopping spontaneously," healing is mentioned without a formula; this reflects considering treatment when filth has not been expelled after it has been expelled, clarifying formula intent in the absence of a formula to exercise flexibility. This constitutes the lower half.
In summary, Si Ni Tang categories, Guizhi Tang, Guizhi Jia Shaoyao Tang, and Guizhi Jia Dahuang Tang are all essential agents for Taiyin disease. If there is no thirst, Si Ni Tang categories are necessary. If the pulse is weak, Shaoyao and Dahuang etc. must be used cautiously. If the pulse is floating, indicating an outward trend, the guiding effect of Guizhi Tang is most appropriate. For distress and pain during the unrecovered stage, Guizhi Jia Shaoyao Tang can also be generally used. Although the original text contains only eight clauses, all methods are present. Ke Yunbo and others added formulas such as N Hou Sheng Jiang Ban Xia Gan Cao Ren Shen Tang, Bai San, and Ma Ren Wan to expand their use, but instead abolished their flexible application. This likely stems from hearing criticisms of Wang Shuhe before reading the Classics, believing that anything not in the text could be arbitrarily added, removed, or moved, leading to such actions.
According to Shen Yaofeng: Taiyin and Yangming both belong to Earth and jointly govern the Central Region. Pathology manifests first in the abdomen. Yangming is Yang Earth, and the Yang pathway is solid; thus, pathology involves Stomach excess rather than just fullness. Taiyin is Yin Earth, and the Yin pathway is deficient; thus, pathology involves abdominal fullness without solidity. Generally, Wind, Dryness, and Heat (Yang pathogens) invade Yangming; Cold and Warmth (Yin pathogens) invade Taiyin. Yang pathogens invading Yang allow eating without vomiting; Yin pathogens invading Yin prevent eating and cause vomiting. Yang pathogens invading Yang cause constipation; Yin pathogens invading Yin cause spontaneous diarrhea. The syndromes are opposite and recognizable. If erroneously purged, the Stomach becomes empty, and hostile qi agitates the diaphragm. With Yang pathogens, there is vexation and regret (*Ao Nu*); with Yin pathogens, there is chest hypochondriac binding and hardness. If further purgation is erroneously applied, unceasing diarrhea and death will result. This is the outline of Taiyin disease. Whenever Taiyin is mentioned, it refers to abdominal fullness.
According to Ke Yunbo: The *Neijing* states: The Taiyin meridian spreads in the stomach and connects to the throat, causing abdominal fullness and dry throat. This is a syndrome where heat damages Taiyin, injecting from the Yang portion into the meridian, not the Taiyin self-disease described in the *Lun*. Zhongjing uses Taiyin self-disease as the outline because Taiyin governs the interior; thus, the outline excludes exterior signs like wind-stroke distress and pain in the four limbs. Also, as the extreme yin among yin, the outline excludes heat disease signs like dry throat. Taiyin is the opening, and the Yin pathway is deficient. Taiyin governs diseases produced by the Spleen. The Spleen governs dampness and transportation; thus, the outline emphasizes abdominal fullness, occasional pain, vomiting, and diarrhea, all being syndromes of interior deficiency and insecurity, with dampness prevailing and overflowing outward. Spleen deficiency leads to Stomach deficiency; inability to eat indicates the Stomach fails to receive. Know that if the Stomach house is not solid, it is a Taiyin disease.