干姜 黄芩 黄连 人参
伤寒本自寒下。医复吐下之。寒格更逆吐下。若食入口即吐。此汤主之。上焦寒则吐下
焦寒
为向导之兵。此从治也。
白头翁 黄连 黄柏 秦皮
热利。下重者。下利欲饮水者。以有热故也。均以此汤主之。 自利不渴。为藏寒。与
四逆以温中。下利饮水。为有热。与此汤以消里。 按少阴自利而渴。乃下焦虚寒。而用四逆者
。恐不可以渴不渴分寒热也。正当以小便黄白别之耳。 内经曰。肾欲坚急食苦以坚之。利
则下焦虚。是以纯苦之剂坚之。
人参 干姜 甘草 附子
主恶寒。脉微而复利。利止亡血也。此汤主之。 恶寒脉微而利。是阳虚阴胜也。利止
而津
人参 甘草 白术 干姜
主霍乱。寒多。不用水者。 按仲景法。发热。头痛。身疼。恶寒。吐利者。此名霍乱
。热多饮水者。五苓散主之。寒多不饮水者。此方主之。凡吐利。以无寒热。不头痛为阴。以有
寒热头痛为阳。更以饮水不饮水辨之。百不失也。中州陆沉。吐利交作。其象为乱。故名霍
乱。汤名理中。理者治也。治其乱而敉宁之也。白术甘草。自是脾家要剂。干姜祛太阴之寒
。无他药可代者。寒则必本于虚。故以人参益气。寒甚者。加附子。其功更大。若审症明确
而投之。神效捷于桴鼓。
伤寒病本来就有寒性下利。医生又误用吐法和下法治疗，导致寒邪格拒，更加逆乱出现呕吐和下利。如果食物刚入口就立即吐出，此方主治。上焦有寒则呕吐，下焦有寒作为向导之兵（引导药力）。这是从治法（顺从病势而治）。
热性痢疾。伴有里急后重感的。想喝水的。因为体内有热的原因。均以此方主治。自发性下利且不口渴的，属于脏腑虚寒。给予四逆汤以温中。下利且想喝水的，属于有热。给予此方以清除里热。按：少阴病自发性下利且口渴，是下焦虚寒，而使用四逆汤。恐怕不能仅凭是否口渴来区分寒热。正当以小便颜色黄或白来辨别罢了。《内经》说：肾喜坚固，宜食用苦味药以坚固它。下利则下焦虚弱，所以用纯苦味的药剂来坚固它。
主治恶寒。脉象微弱且伴有下利。下利停止是因为亡失血液（津液枯竭）。此方主治。恶寒、脉微且下利，是阳气虚弱阴气盛实。下利停止而津液...
主治霍乱。寒症较多。不想用水的。按张仲景的法则。发热、头痛、身体疼痛、恶寒、呕吐下利的，这名叫霍乱。热症较多且想喝水的，五苓散主治。寒症较多不想喝水的，此方主治。凡是呕吐下利，以没有寒热、不头痛为阴证，以有寒热、头痛为阳证。再结合想喝水与否来辨别，百无一失。中州（脾胃）如陆地沉陷，呕吐下利同时发作，其象状如混乱，所以名叫霍乱。汤剂名叫理中汤。“理”即治理之意。治理其混乱而使其安宁。白术、甘草，自然是脾经的重要药剂。干姜祛除太阴经的寒邪，没有其他药物可以替代。寒邪必然根源于虚损，所以用人参益气。寒邪严重的，加用附子，功效更大。如果审察症状明确而投用此药，神效迅速如同敲鼓应声。
Ganjiang, Huangqin, Huanglian, Renshen
In a Shanghan (Cold Damage) condition that originally presented with cold-type diarrhea, if the physician erroneously employs vomiting and purging therapies, it leads to cold obstruction causing further reversal of vomiting and diarrhea. If food is vomited immediately upon entering the mouth, this decoction is indicated. Cold in the Upper Jiao causes vomiting; cold in the Lower Jiao acts as a guiding agent. This constitutes a "conforming treatment" (treating according to the apparent nature of the disease).
Baitouweng, Huanglian, Huangbai, Qinpi
For heat-type dysentery accompanied by tenesmus (a sensation of incomplete defecation), or for those desiring to drink water due to internal heat, this decoction is indicated. Spontaneous diarrhea without thirst indicates Zang-organ cold; treat with Sini Tang (Four Reversal Decoction) to warm the middle. Diarrhea with desire for water indicates heat; treat with this decoction to clear interior heat. Note: In Shaoyin disease, spontaneous diarrhea with thirst indicates deficiency-cold of the Lower Jiao, treated with Sini Tang. Therefore, one cannot distinguish cold from heat solely based on thirst. It is appropriate to differentiate by the color of urine (yellow or white). The *Neijing* states: "The Kidney desires firmness; eat bitter substances to firm it." Diarrhea implies deficiency of the Lower Jiao; thus, purely bitter agents are used to firm it.
Renshen, Ganjiang, Gancao, Fuzi
Indicated for aversion to cold, faint pulse, and accompanying diarrhea. If the diarrhea stops due to exhaustion of blood/fluids, this decoction is indicated. Aversion to cold, faint pulse, and diarrhea indicate Yang deficiency and Yin excess. When diarrhea stops but fluids are depleted...
Renshen, Gancao, Baizhu, Ganjiang
Indicated for Huoluan (Colic with Vomiting and Diarrhea). Specifically for cases with predominant cold symptoms where the patient does not desire water. According to Zhang Zhongjing's method: Fever, headache, body ache, aversion to cold, vomiting, and diarrhea constitute Huoluan. For cases with predominant heat symptoms and desire for water, Wuling San (Five-Ling Powder) is indicated. For cases with predominant cold symptoms and no desire for water, this formula is indicated. Generally, for vomiting and diarrhea, absence of fever/chills and headache indicates a Yin pattern; presence of fever/chills and headache indicates a Yang pattern. Further differentiation should be made based on desire for water. This approach is highly accurate. When the Middle Jiao (Spleen/Stomach) collapses like sinking land, and vomiting and diarrhea occur simultaneously, the presentation resembles chaos, hence named Huoluan (Chaos). The decoction is named Lizhong Tang (Regulate the Middle Decoction). "Li" means to regulate. It regulates the chaos to bring peace. Baizhu and Gancao are essential herbs for the Spleen system. Ganjiang dispels cold from the Taiyin channel; no other herb can replace it. Since cold originates from deficiency, Renshen is used to tonify Qi. For severe cold, Fuzi is added, enhancing efficacy. If the syndrome is accurately diagnosed and this formula administered, its miraculous effect is swift as an echo.