按太阴腹痛吐利。一属寒湿。六脉沉细。舌润不渴。是也。宜理中、二陈、藿、朴之类。温
中散寒。一属湿热。舌燥口渴。小便短赤。是也。宜二陈、二苓、枳实、浓朴、川连之类。清热利湿。
邵评∶太阴腹痛吐利二症。有寒湿湿热二因。宜温宜清。治法不同。必须详辨。
东南之地。水潦归焉。居其处者。多蒙湿邪之害。然闽广湿胜。江浙则湿热相兼。感
之为病。内应太阴。以太阴湿土所主也。今将太阴本病传经。并列于下。病无遁形矣。
凡见腹痛。吐利交作。脘闷不食。六脉沉细。或伏。舌苔黑滑。或白滑。口不渴饮。此太阴感寒本病
也。当以理中汤为主治。兼外感加苏叶。胀满加浓朴。有食加青、陈、楂、曲之类。吐多加丁香、藿梗。
泻多加木香、木瓜。（太阴感寒）
邵评∶此太阴感寒之正法。
有腹痛痞满。呕吐不纳。舌燥渴饮。或大便泄泻。小水不利。或二便俱秘。此湿热内结于太阴。急宜开
之。须半夏、赤苓、浓朴、草蔻、川连、通草、广皮、滑石之类。如便秘不泻。加枳实、大黄行之。此即
转属阳明也。（湿热内结）
邵评∶此湿热内结之正法。
如发热不已。头重身痛。大便顺。小便涩。脘满不饥。舌苔白腻。脉象沉细而缓者。此湿邪内着。太阴受
病也。宜二陈、茅术、浓朴、猪苓、泽泻、茵陈、米仁、姜皮之类。湿邪去。热自退矣。汗多加桂枝、
秦艽。汗少加紫苏。（湿邪内着）
若发热一身尽痛。而兼四肢微肿者。此风湿流注手足也。宜二陈。加米仁、桂枝、秦
艽、防己、羌活、木瓜、片姜黄之类。足胫红肿。合二妙。（风湿流注）
凡伤寒热甚不解。但头汗出。腹满溺涩。目黄口渴。舌苔黄腻。此湿热郁于太阴。欲发黄也。急用茵陈二苓、
枳实、浓朴、黄柏、栀子、茅术、秦艽、车前、泽泻等。利之清之。二便俱秘。小腹胀满者。此转属阳
明也。宜茵陈蒿汤。（湿热发黄）
凡遇伤寒发热之症。已经解表清里。俱不应。但看舌苔白滑粘腻。脘闷恶心。口不渴饮。虽热不欲去
衣被者。此外感风湿之邪。着于太阴肌躯之表。其病尚在气分。宜解肌法。用桂枝。秦艽、紫苏、半夏、
苓皮、姜皮、浓朴、广皮之类、微微汗之。则风湿俱去矣。（肌表风湿）
邵评∶此肌表风湿之正法。若一身尽痛。可再加羌、防、白芷。
若外感湿邪。又兼内伤生冷。以致寒热泄泻者。太无神术散加减妙。（内外寒湿）
以上诸条。皆太阴本经自病。
若邪从阳经传入太阴。则热愈深。毒愈甚。舌见纯黄纯黑。唇齿焦燥。目黄面赤。腹大热。或晡热。
手足不欲暖盖。小便赤涩。舌无芒刺者。热毒暴下也。舌起芒刺者。大
便不通也。三阴无窍。俱借阳明为出路。故兼见阳明证者为轻。大便通者。只宜清
里解毒。大便不通者。兼导之清之。清里解毒。如犀角、芩连、栀翘、银花、人中黄之类。
导下。如枳实、浓朴、槟榔、大黄之类。（阳邪传入太阴热症）
若由失表失清。以致毒邪凝结于里。陷于太阴。每有发为五 者。其症反脉静身
凉。有似邪退正复之象。但看舌苔纯黄中见黑点。纯黑中见红点。或黑苔聚于中心。此皆生 之验也。
火重者 必红。毒深者 反白。若蓝 。则食毒俱足。胃将烂矣。紫 发于少腹章门之间。毒传于肾也。
黄发于手足唇口之上。毒归于脾也。均属危恶之症。治法亦只清解毒火。宣通气血。用犀角、连翘、赤
芍、银花、川连、人中黄、栝蒌皮、牛蒡子、槟榔、楂肉、天虫、角刺之属。内外两解。若见面白目青。
则阳气下陷。已属不治。此药又不可投。若见身上汗出津津。则元气已泄。其死尤速。盖病邪传里。虽病
太阴。而三阴与之同病者也。所藉者独一肺经而已。肺气开则面红。肺气闭则面白。若面黄则胆气绝矣。
身黄则脾气绝矣。病在三阴。临症者。尤宜深察焉。（阳邪内陷太阴 症）
按语：太阴病的腹痛、呕吐与下利，一种属于寒湿证。表现为六脉沉细，舌面湿润且不口渴，即是此证。适宜使用理中汤、二陈汤、藿香、厚朴之类的药物，以温中散寒。另一种属于湿热证。表现为舌面干燥且口渴，小便短少色赤，即是此证。适宜使用二陈汤、茯苓、猪苓、枳实、厚朴、黄连之类的药物，以清热利湿。
邵评：太阴病的腹痛和呕吐下利两个症状，有寒湿和湿热两种病因。治疗宜用温法或清法，治法不同，必须详细辨别。
东南地区，雨水汇聚。居住在那里的人，多遭受湿邪的危害。然而福建、广东湿气胜，江浙地区则是湿热相兼。感受这种邪气致病，内应太阴经，因为太阴主司湿土。现在将太阴的本病及传经病变，并列在下面，病症便无处隐藏了。
凡是见到腹痛，呕吐与下利同时发作，胃脘部闷胀不想进食，六脉沉细，或者伏匿，舌苔黑而滑润，或者白而滑润，口不渴饮，这是太阴感受寒邪的本病。应当以理中汤为主治方。兼有外感加紫苏叶，胀满加厚朴，有食积加青皮、陈皮、山楂、神曲之类的药物。呕吐多加丁香、藿香梗。腹泻多加木香、木瓜。（太阴感寒）
如果有腹痛痞满，呕吐不能纳食，舌燥口渴饮水，或者大便泄泻，小便不利，或者大小便都闭塞不通，这是湿热内结于太阴，急需开通。须用半夏、赤茯苓、厚朴、草豆蔻、黄连、通草、广陈皮、滑石之类的药物。如果便秘不下利，加枳实、大黄来行导。这就是转属阳明病了。（湿热内结）
如果发热不止，头重身痛，大便通畅，小便涩滞，胃脘满闷没有饥饿感，舌苔白腻，脉象沉细而缓的，这是湿邪内着，太阴受病。适宜使用二陈汤、苍术、厚朴、猪苓、泽泻、茵陈、薏苡仁、生姜皮之类的药物。湿邪去除，热自然消退。汗多加桂枝、秦艽。汗少加紫苏。（湿邪内着）
如果发热全身疼痛，并且兼有四肢轻微浮肿的，这是风湿流注于手足。适宜使用二陈汤，加薏苡仁、桂枝、秦艽、防己、羌活、木瓜、片姜黄之类的药物。足胫红肿，合用二妙散。（风湿流注）
凡是伤寒热势严重不解，只有头部出汗，腹部胀满，小便涩滞，眼睛发黄，口渴，舌苔黄腻，这是湿热郁结于太阴，将要发黄疸。急用茵陈、二苓（茯苓、猪苓）、枳实、厚朴、黄柏、栀子、苍术、秦艽、车前子、泽泻等药，利湿清热。如果大小便都闭塞，小腹胀满的，这是转属阳明病。适宜使用茵陈蒿汤。（湿热发黄）
凡是遇到伤寒发热的病症，已经解表清里，都不见效，只看舌苔白滑粘腻，胃脘闷恶心想吐，口不渴饮，虽然发热却不想要脱去衣被的，这是外感风湿之邪，附着于太阴肌表。其病尚在气分，适宜用解肌法。使用桂枝、秦艽、紫苏、半夏、茯苓皮、生姜皮、厚朴、广陈皮之类的药物，微微发汗，则风湿都能去除。（肌表风湿）
邵评：这是肌表风湿的正治法。如果全身疼痛，可再加羌活、防风、白芷。
如果外感湿邪，又兼内伤生冷，导致寒热交替、泄泻的，太无神术散加减效果奇妙。（内外寒湿）
以上各条，都是太阴本经自发的疾病。
如果邪气从阳经传入太阴，则热势更深，毒势更甚。舌见纯黄或纯黑色，嘴唇牙齿焦燥，眼睛发黄面色红赤，腹部大热，或者傍晚发热，手脚不喜欢暖盖，小便赤涩。舌上没有芒刺的，是热毒暴下；舌起芒刺的，是大便不通。三阴经没有出路，都借阳明作为出路。所以兼见阳明证的病情较轻。大便通畅的，只宜清里解毒；大便不通的，兼用导下和清热。清里解毒，如犀角、黄芩、黄连、栀子、连翘、金银花、人中黄之类的药物。导下，如枳实、厚朴、槟榔、大黄之类的药物。（阳邪传入太阴热症）
如果因失于解表或失于清热，导致毒邪凝结于里，陷入太阴，每每有发展为斑疹的。其症状反而脉静身凉，有似邪退正复的现象。但看舌苔纯黄中见黑点，纯黑中见红点，或者黑苔聚于中心，这都是生斑疹的征验。火重的，斑疹必红；毒深的，斑疹反白。如果是蓝斑，则食毒俱足，胃将腐烂。紫色斑疹发于少腹章门之间，是毒传于肾。黄色斑疹发于手足唇口之上，是毒归于脾。都属于危恶的病症。治法也只是清热解毒，宣通气血。使用犀角、连翘、赤芍、金银花、黄连、人中黄、瓜蒌皮、牛蒡子、槟榔、山楂肉、僵蚕、皂角刺之类的药物，内外两解。如果见面色白眼睛青，则是阳气下陷，已属不治。这种药又不可投用。如果见身上汗出津津，则是元气已泄，其死更快。大概病邪传里，虽然病在太阴，而三阴与之同病。所依赖的唯独肺经而已。肺气开则面红，肺气闭则面白。如果面黄则是胆气绝了。身体发黄则是脾气绝了。病在三阴，临症者，尤其应该深入考察。（阳邪内陷太阴斑疹症）
Note: Abdominal pain, vomiting, and diarrhea in Taiyin disease fall into two categories. One belongs to Cold-Dampness syndrome, characterized by six pulses that are deep and fine, a moist tongue without thirst. This is treated with formulas such as Lizhong Tang (Cinnamon Twig Decoction), Erchen Tang (Two-Cured Decoction), Huoxiang (Patchouli Herb), and Houpo (Magnolia Bark) to warm the middle and dispel cold. The other belongs to Damp-Heat syndrome, characterized by a dry tongue with thirst, and short, dark urine. This is treated with formulas such as Erchen Tang (Two-Cured Decoction), Fuling (Poria), Zhuling (Polyporus), Zhishi (Immature Bitter Orange), Houpo (Magnolia Bark), and Huanglian (Coptis Rhizome) to clear heat and promote diuresis to remove dampness.
Shao's Commentary: The symptoms of abdominal pain and vomiting/diarrhea in Taiyin disease have two etiologies: Cold-Dampness and Damp-Heat. Treatment requires either warming or clearing methods, which differ; therefore, careful differentiation is essential.
In the southeast regions, rainwater accumulates. Those residing there are often harmed by damp pathogenic factors. However, in Fujian and Guangdong, dampness prevails, whereas in Jiangsu and Zhejiang, dampness and heat combine. Contracting these pathogens affects the interior corresponding to the Taiyin channel, as Taiyin governs damp earth. Below are listed the primary diseases of Taiyin and those transmitted via meridians, so that no pathology remains hidden.
Whenever abdominal pain occurs with simultaneous vomiting and diarrhea, epigastric fullness and stifling sensation with loss of appetite, six pulses that are deep and fine or concealed, and a tongue coating that is black and slippery or white and slippery, without thirst, this is the primary disease of Taiyin contracting cold. The principal treatment should be Lizhong Tang (Cinnamon Twig Decoction). If accompanied by exterior contraction, add Ziye (Perilla Leaf); for distension and fullness, add Houpo (Magnolia Bark); for food stagnation, add Qingpi (Green Tangerina Peel), Chenpi (Aged Tangerina Peel), Shanzha (Hawthorn Fruit), and Shenqu (Medicated Leaven). For excessive vomiting, add Dingxiang (Clove) and Huogeng (Patchouli Stem); for excessive diarrhea, add Muxiang (Aucklandia Root) and Mugua (Chaenomeles Fruit). (Taiyin contracting cold)
Shao's Commentary: This is the standard method for Taiyin contracting cold.
If there is abdominal pain with痞满 (stifling fullness), vomiting and inability to accept food, a dry tongue with thirst, or loose stools with dysuria, or even constipation and urinary retention, this indicates Damp-Heat binding internally within Taiyin. Immediate intervention is required using Banxia (Pinellia Tuber), Chifuling (Red Poria), Houpo (Magnolia Bark), Caodoukou (Black Cardamom Seed), Huanglian (Coptis Rhizome), Tongcao (Tetrapanax Pith), Guangpi (Aged Tangerina Peel), and Huashi (Talcum). If constipation without diarrhea exists, add Zhishi (Immature Bitter Orange) and Dahuang (Rhubarb Root and Rhizome) to promote purgation. This represents a transition to Yangming disease. (Damp-Heat binding internally)
Shao's Commentary: This is the standard method for Damp-Heat binding internally.
If fever persists without abating, accompanied by heavy head and body aches, smooth bowel movements, but scanty or difficult urination, epigastric fullness and lack of hunger, a white greasy tongue coating, and a pulse that is deep, fine, and slow, this indicates Dampness pathogen adhering internally, affecting Taiyin. Treatment should utilize Erchen Tang (Two-Cured Decoction), Baizhu (White Atractylodes Rhizome), Houpo (Magnolia Bark), Zhuling (Polyporus), Zexie (Alisma Rhizome), Yichen (Coix Seed/Artemisia Capillaris - *Note: Text says Yinchen, usually Artemisiae Scopariae Herba*), Yiren (Coix Seed), and Jiangpi (Ginger Peel). Once dampness is eliminated, heat will naturally recede. If sweating is excessive, add Guizhi (Cinnamon Twig) and Qinjiao (Gentiana Macrophylla Root); if sweating is scant, add Zisu (Perilla Leaf). (Dampness adhering internally)
If fever involves whole-body pain accompanied by slight swelling of the four limbs, this indicates Wind-Dampness flowing into the hands and feet. Treatment should use Erchen Tang (Two-Cured Decoction) added with Yiren (Coix Seed), Guizhi (Cinnamon Twig), Qinjiao (Gentiana Macrophylla Root), Fangji (Stephania Tetrandra Root), Qianghuo (Notopterygium Rhizome), Mugua (Chaenomeles Fruit), and Pianjianghuang (Sliced Turmeric Rhizome). If the lower legs and shins are red and swollen, combine with Ermiao San (Two Marvels Powder). (Wind-Dampness flowing)
Whenever Shaoyang-Shanghan presents with severe unresolved heat, only sweating on the head, abdominal fullness, and dysuria, yellow eyes, thirst, and a yellow greasy tongue coating, this indicates Damp-Heat stagnating in Taiyin, predisposing to jaundice. Urgently use Yichen (Artemisiae Scopariae Herba), Erling (Fuling and Zhuling), Zhishi (Immature Bitter Orange), Houpo (Magnolia Bark), Huangbai (Phellodendron Bark), Zhizi (Gardenia Fruit), Baizhu (White Atractylodes Rhizome), Qinjiao (Gentiana Macrophylla Root), Cheqian (Plantago Seed), and Zexie (Alisma Rhizome) to promote diuresis and clear heat. If both stool and urine are retained with lower abdominal fullness, this transitions to Yangming disease. Use Yinchen Hao Tang (Artemisiae Scopariae Decoction). (Damp-Heat causing jaundice)
Whenever encountering Shanghan with fever, if exterior-releasing and interior-clearing treatments have failed, observe the tongue coating: if it is white, slippery, and greasy, with epigastric stifling, nausea, no thirst, and despite fever, the patient does not wish to remove clothing/blankets, this is Exterior Wind-Dampness pathogen adhering to the Taiyin muscle layer. The pathology remains in the Qi level. Employ the Muscle-Releasing method using Guizhi (Cinnamon Twig), Qinjiao (Gentiana Macrophylla Root), Zisu (Perilla Leaf), Banxia (Pinellia Tuber), Lingpi (Poria Peel), Jiangpi (Ginger Peel), Houpo (Magnolia Bark), and Guangpi (Aged Tangerina Peel) to induce slight sweating, thereby eliminating wind-dampness. (Exterior Wind-Dampness)
Shao's Commentary: This is the standard method for Exterior Wind-Dampness. If whole-body pain is present, add Qianghuo (Notopterygium Rhizome), Fangfeng (Saposhnikovia Root), and Baizhi (Angelica Dahurica Root).
If external dampness is compounded by internal injury from raw/cold foods, leading to alternating chills and fever with diarrhea, Taishen Shenzhu San (Great Emperors Divine Operation Powder) modified is effective. (Internal and External Cold-Dampness)
The above items all refer to primary diseases originating within the Taiyin channel itself.
If pathogens transmit from Yang channels into Taiyin, the heat becomes deeper and toxicity more severe. The tongue appears purely yellow or purely black, lips and teeth become dry and scorched, eyes turn yellow, face red, abdomen feels intensely hot, or there is afternoon tidal fever, and the extremities do not desire warmth/covering, with dark, difficult urine. If the tongue lacks prickles, it indicates violent downward expulsion of heat-toxin; if prickles appear, it indicates fecal impaction. The Three Yin channels lack an exit and rely on Yangming as the pathway out. Thus, cases presenting with Yangming symptoms are milder. If stool is unobstructed, only interior-clearing and detoxification are needed; if stool is obstructed, combine purgation with clearing. Interior-clearing and detoxification involve Xijiao (Rhinoceros Horn - *historical term, now substituted*), Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), Zhizi (Gardenia Fruit), Liaoqiao (Forsythia Fruit & Forsythia Stem), Jinyinhua (Lonicera Flower), and Renzhonghuang (Human Waste Charcoal). Purgation involves Zhishi (Immature Bitter Orange), Houpo (Magnolia Bark), Binglang (Areca Seed), and Dahuang (Rhubarb Root and Rhizome). (Yang pathogen transmitting into Taiyin Heat Syndrome)
If due to failure in releasing the exterior or clearing the interior, toxic pathogens condense internally and sink into Taiyin, eruptions (ban zhen) may develop. Symptoms may paradoxically show quiet pulses and cool body, resembling recovery. However, observe the tongue coating: pure yellow with black spots, pure black with red spots, or black coating concentrated in the center indicate signs of eruption formation. If fire is heavy, eruptions will be red; if toxicity is deep, eruptions may be white. Blue eruptions indicate sufficient food and toxin accumulation, suggesting gastric rot. Purple eruptions between Shaoyang area (Zhangmen) indicate transmission of toxicity to Kidney. Yellow eruptions on hands, feet, lips, and mouth indicate toxicity returning to Spleen. All are critical conditions. Treatment focuses on clearing heat, detoxifying, and promoting Qi and Blood circulation using Xijiao (Rhinoceros Horn), Lianqiao (Forsythia Fruit), Chishao (Red Peony Root), Jinyinhua (Lonicera Flower), Chuanlian (Coptis Rhizome), Renzhonghuang (Human Waste Charcoal), Gualoupi (Trichosanthes Peel), Niubangzi (Arctium Fruit), Binglang (Areca Seed), Zharon (Hawthorn Flesh), Tianchong (Bombyx Batryticatus), and Jiaoci (Soap Thorn). This achieves dual interior-exterior resolution. If the face is white and eyes blue, Yang Qi has sunk, indicating incurability; these drugs must not be used. If profuse sweating occurs, Yuan Qi (Original Qi) is leaking, leading to rapid death. Generally, when pathogens transmit inward, although the disease is in Taiyin, the Three Yin channels are affected together. The sole reliance is on the Lung channel. When Lung Qi opens, the face turns red; when Lung Qi closes, the face turns white. Yellow face indicates Gallbladder Qi exhaustion. Yellow body indicates Spleen Qi exhaustion. In diseases of the Three Yin, clinicians must examine deeply. (Yang pathogen sinking into Taiyin Eruption Syndrome)