太阳病二三日不得卧但欲起心下必结脉微弱者此本有寒分也反下之若利止必作结胸未止者四日复下之此作协热利也
太阳病二三日正传阳明少阳之时但欲起不能卧外烦如是知其心下必结盖病入阳明少阳胃逆胆壅经气郁迫故心下结硬
相火上炎是以烦生若脉见微弱此必有寒气在内格其阳火乃反下之寒盛脾亏必当下利若下利已止脾气不陷而寒邪在中不得
下泄必当上逆胆胃壅塞则病结胸若下利未止脾气方陷四日见其外热愈甚而复下之则里寒益增外热更剧寒益增而利益甚此
作协热利也结胸与协热利皆有寒分之邪在内寒邪上冲则胃逆而为结胸寒邪下泄则脾陷而为协热利其病标异而本同协热利
者内寒协合外热而下利也
痞者异日之太阴今日误下而成者也阳性虚而阴性实人之心下虚空者清阳升而浊阴降也升降清浊之权在乎中气下伤中
气升降失职浊气上逆则生 胀清气下降则生飧泄故痞证与下利兼见悉因中气之败也太阴之证腹满自利腹满者痞之根本而
未至成痞下之而胸下结硬乃成痞焉痞乃太阴之坏病也太阴脏寒温宜四逆阳旺寒消自无余事及其成痞则下寒而兼上热四逆
不受故变为泻心清上温下寒热并用灵思妙解神化无穷矣
太阳病外证未解而数下之遂协热而利利下不止心下痞硬表里不解者桂枝人参汤主之
太阳病外证不解而数下之外热不退而内寒亦增遂协合外热而为下利利而不止清阳既陷则浊阴上逆填于胃口而心下痞
硬缘中气虚败不能分理阴阳升降倒行清浊易位是里证不解而外热不退是表证亦不解表里不解当内外兼医桂枝人参汤桂枝
通经而解表热参术姜甘温补中气以转升降之机也太阴之胸下结硬即痞证也自利益盛即下利不止也中气伤败痞与下利兼见
人参汤（即理中汤）助中气之推迁降阳中之浊阴则痞消升阴中之清阳则利止是痞证之正法诸泻心则因其下寒上热从此而
变通者也
太阳病经过两三天，患者无法安卧，只想坐起，此时心下部位必然有结滞感。如果脉象微弱，说明患者原本体内就有寒邪分争。此时若误用攻下法，如果腹泻停止，必然会形成结胸证；如果腹泻未止，到了第四天再次误用攻下法，就会形成协热利。
太阳病发病两三天，正值病邪传入阳明、少阳的时期，患者只想坐起而不能平卧，伴有烦躁不安。据此可以推断其心下必然有结滞。这是因为病邪进入阳明、少阳，导致胃气上逆、胆气壅滞，经气郁结逼迫，所以心下出现结硬。
相火上炎，因此产生烦躁。如果脉象微弱，这说明体内必有寒气，格拒了阳火。此时若反而使用攻下法，会导致寒气更盛、脾脏虚弱，必然引起腹泻。如果腹泻已经停止，脾气没有下陷，而寒邪停留在中焦无法向下排泄，必然会上逆，导致胆胃壅塞，从而形成结胸证。如果腹泻未止，说明脾气正在下陷，到了第四天看到外热更加严重，却再次使用攻下法，那么里寒会更加增加，外热更加剧烈，寒邪越重则腹泻越严重，这就是协热利。结胸和协热利都有寒邪在内。寒邪上冲，导致胃气上逆而形成结胸；寒邪下泄，导致脾气下陷而形成协热利。它们的病状表现不同，但根本原因相同。所谓协热利，是指内寒与外热相合而导致的腹泻。
痞证是太阴病的变证，是由于今日误用攻下法而形成的。阳气性质虚浮，阴气性质实盛。人心下虚空，是因为清阳上升、浊阴下降。升降清浊的关键在于中气。如果中气受损，升降功能失职，浊气上逆就会产生胀满，清气下降失常则会产生完谷不化的泄泻。因此，痞证与下利同时出现，都是由于中气衰败造成的。太阴病的症状包括腹部胀满和自发性腹泻。腹满是痞证的根源，但在尚未形成痞证时误用攻下法，导致胸下结硬，这才形成了痞证。所以痞证是太阴病的坏病（误治后的病变）。太阴脏寒，适宜用四逆汤温补，阳气旺盛则寒气消散，自然就没有其他问题了。等到形成痞证时，则是下寒兼有上热，四逆汤不再适用，因此变为使用泻心汤类方剂，清上温下，寒热并用，构思巧妙，变化无穷。
太阳病表证未解，却多次使用攻下法，于是导致协热利，腹泻不止，心下痞硬，表里同病，应当用桂枝人参汤主治。
太阳病表证未解，却多次攻下，导致外热不退且内寒增加，于是内外之热相合而导致腹泻，腹泻不止。清阳既已下陷，浊阴便上逆，填塞于胃口，导致心下痞硬。这是因为中气虚败，不能调理阴阳，导致升降倒行，清浊位置互换。这是里证未解而外热不退，也就是表证也未解。表里同病，应当表里双解。桂枝人参汤中，桂枝通经以解除表热，人参、白术、干姜、甘草温补中气，以恢复升降之机。太阴病胸下的结硬就是痞证，腹泻日益加重就是下利不止。中气受伤衰败，痞证与下利同时出现。人参汤（即理中汤）帮助中气的运转，降下阳中的浊阴则痞消，升举阴中的清阳则利止，这是治疗痞证的正法。其他的泻心汤则是针对下寒上热的情况，由此变通而来的。
Taiyang disease persisting for two to three days, with the patient unable to lie down and desiring only to sit up, indicates that there must be a knotting in the epigastrium. If the pulse is faint, this originally stems from an internal cold pathogen. If purgation is erroneously applied, and if diarrhea ceases, Jie Xiong (Chest Binding) will inevitably develop; if diarrhea does not cease, and purgation is again applied on the fourth day, Xie Re Li (Heat-Colluding Diarrhea) will result.
When Taiyang disease persists for two to three days, it is the time when the pathogen transmits to Yangming and Shaoyang. The patient desires to sit up but cannot lie down, accompanied by external vexation. From this, it can be known that there is knotting in the epigastrium. This is because the pathogen has entered Yangming and Shaoyang, causing Stomach Qi to rebel upward and Gallbladder Qi to become stagnant, leading to depression and pressure of the channel Qi, thus resulting in hardness and knotting in the epigastrium.
Ministerial Fire flares upward, generating vexation. If the pulse appears faint, it indicates the presence of internal Cold, which repels the Yang Fire. If purgation is erroneously applied at this stage, the Cold becomes excessive and the Spleen weakens, inevitably leading to diarrhea. If the diarrhea stops, the Spleen Qi does not sink, but the Cold pathogen remains in the Middle Jiao without being able to drain downward. It must then rebel upward, causing stagnation in the Gallbladder and Stomach, resulting in Jie Xiong (Chest Binding). If the diarrhea has not stopped, it indicates that Spleen Qi is sinking. On the fourth day, if the external heat is seen to be more severe, yet purgation is applied again, the internal Cold increases further, and the external heat becomes more intense. As the Cold increases, the diarrhea worsens; this is termed Xie Re Li (Heat-Colluding Diarrhea). Both Jie Xiong (Chest Binding) and Xie Re Li (Heat-Colluding Diarrhea) involve an internal Cold pathogen. When the Cold pathogen rushes upward, it causes Stomach Qi to rebel, forming Jie Xiong (Chest Binding); when the Cold pathogen drains downward, it causes Spleen Qi to sink, forming Xie Re Li (Heat-Colluding Diarrhea). Their clinical manifestations differ, but their root cause is the same. Xie Re Li (Heat-Colluding Diarrhea) refers to diarrhea caused by the combination of internal Cold and external Heat.
Pi Zheng (Epigastric Fullness Syndrome) is a complication of Taiyin disease, resulting from erroneous purgation today. Yang Qi is characterized by deficiency and emptiness, while Yin Qi is characterized by excess and solidity. The emptiness in the epigastrium exists because Clear Yang ascends and Turbid Yin descends. The authority over the ascending and descending of Clear and Turbid substances lies in the Middle Qi. If the Middle Qi is damaged, its ascending and descending functions fail: Turbid Qi rebelling upward generates distension, while failure of Clear Qi to descend generates Sundun (Undigested Food Diarrhea). Therefore, Pi Zheng (Epigastric Fullness Syndrome) occurring simultaneously with diarrhea is entirely due to the collapse of Middle Qi. Taiyin disease presents with abdominal fullness and spontaneous diarrhea. Abdominal fullness is the root of Pi Zheng (Epigastric Fullness Syndrome); however, if purgation is applied before Pi Zheng (Epigastric Fullness Syndrome) fully forms, causing hardness and knotting below the chest, Pi Zheng (Epigastric Fullness Syndrome) is then established. Thus, Pi Zheng (Epigastric Fullness Syndrome) is a Huai Bing (Complication/Deteriorated Disease) of Taiyin. For Taiyin Organ Cold, Si Ni Tang (Frigid Extremities Decoction) is appropriate for warming; once Yang Qi is vigorous, the Cold dissipates, and no other issues remain. However, once Pi Zheng (Epigastric Fullness Syndrome) forms, there is Lower Cold combined with Upper Heat, making Si Ni Tang (Frigid Extremities Decoction) unsuitable. Therefore, Xi Xin Tang (Heart-Draining Decoctions) are used instead, clearing the Upper and warming the Lower, combining Cold and Heat therapies. This demonstrates ingenious thinking and infinite variations.
In Taiyang disease, if the exterior syndrome is unresolved but purgation is applied multiple times, it leads to Xie Re Li (Heat-Colluding Diarrhea) with unremitting diarrhea, epigastric hardness and fullness, and simultaneous interior and exterior pathology. Gui Zhi Ren Shen Tang (Cinnamon Twig and Ginseng Decoction) should be administered.
In Taiyang disease, if the exterior syndrome is unresolved and purgation is applied multiple times, the external heat does not recede, and the internal cold increases. The internal cold colludes with the external heat to cause diarrhea, which does not stop. Since the Clear Yang has sunk, the Turbid Yin rebels upward, filling the stomach opening and causing epigastric hardness and fullness. This is because the Middle Qi is deficient and collapsed, failing to regulate the Yin and Yang, causing the ascending and descending mechanisms to reverse, and the positions of Clear and Turbid substances to swap. This means the interior syndrome is unresolved, and the external heat persists, meaning the exterior syndrome is also unresolved. When both interior and exterior are involved, both must be treated internally and externally. In Gui Zhi Ren Shen Tang (Cinnamon Twig and Ginseng Decoction), Gui Zhi (Cinnamomi Ramulus) unblocks the channels to resolve the exterior heat, while Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Jiang (Zingiberis Rhizoma), and Gan Cao (Glycyrrhizae Radix et Rhizoma) warm and tonify the Middle Qi to restore the mechanism of ascending and descending. The hardness and knotting below the chest in Taiyin disease is Pi Zheng (Epigastric Fullness Syndrome); increasingly severe spontaneous diarrhea is unremitting diarrhea. When the Middle Qi is injured and collapsed, Pi Zheng (Epigastric Fullness Syndrome) and diarrhea occur together. Ren Shen Tang (Ginseng Decoction), which is Li Zhong Tang (Regulate the Middle Decoction), assists the movement of the Middle Qi: descending the Turbid Yin within Yang resolves the epigastric fullness, and ascending the Clear Yang within Yin stops the diarrhea. This is the standard method for treating Pi Zheng (Epigastric Fullness Syndrome). The various Xi Xin Tang (Heart-Draining Decoctions) are modifications based on the condition of Lower Cold and Upper Heat.