伤寒解后。虚羸少气。气逆欲吐者。竹叶石膏汤主之。
伤寒邪气已解。自当热退身凉。得谷而愈矣。但邪之所凑。其气必虚。此其常也。乃虚弱羸瘦。气少力绵。
呼吸短浅。更气上逆而欲吐者。此胃气虚而未和也。仲景虽未言脉。若察其脉虚数而渴者。当以竹叶石膏汤主之。
虚寒者别当消息也。
竹叶石膏汤方
竹叶（一把） 石膏（三两） 半夏（五钱） 人参（五钱） 甘草（五钱） 粳米（半合） 麦冬（一两）
上七味。以水一斗。煮取六升。去滓。内粳米。煮米熟汤成。去米。温服一升。日三服。
竹叶性寒而止烦热。石膏入阳明而清胃热。半夏蠲饮而止呕吐。人参补病后之虚。同麦冬而大添胃中之津液。又
恐寒凉损胃。故用甘草和之。而又以粳米助其胃气也。
（附评陶氏谬说）
按长沙自序中。但云伤寒卒病论合十六卷。自成无己注后。王叔和本已不可复见。未知其篇卷何似。
及严器之为成氏作序文云。聊摄成公。注成伤寒论十卷。有三百九十七法。一百一十三方。至宋林亿等奉
诏校理伤寒。亦云百病之急。莫急于伤寒。今校定伤寒论十卷。总二十二篇。证外合三百九十七法。除
重复。定有一百一十二方。以此推之。方法之数。虽出自后人。然亦必有所因。但惜其原本已失。远不可
考耳。观前人指某条为一法。某条二法。又此篇共几法。彼篇又几法。皆属勉强。及至紧要之法。反遗失
而不录。所以王安道溯洄集中。三百九十七法辨云。以有论有方诸条数之。则不及其数。以有论有方有
论无方诸条通数之。则过其数。遂至寝食与俱。细绎其说。始悟其所计之数。于理未通。若以法言。则仲
景一书。无非法也。岂独有方者然后为法哉。且如论证论法。与夫谆谆教戒。按之以为准则者。其谓之
法乎。非法乎。阅王氏此论。前疑已如冰释。然三百九十七法之说。原非出之仲景氏。未可强求印合。大
约六经证治中。无非是法。无一句一字非法也。其有方者未尝无法。而法中亦未尝无方。故以方推之。则方
中自有法。以法论之。则法内自有方。不必拘拘于三百九十七也。若必支离牵合。以实其数。则凿矣。
故未敢以臆见揣度。胶泥古人之活法也。至于一百一十二方。现下论中者。固可征信。即后人加减失宜者。
亦可详辨。其有讹伪失真者。亦不得不辨论也。今人有一百一十三方之说。盖因朱奉议活人书误以桂枝
附子汤改为桂附汤。重出于第十二卷之第十七方耳。若去其重出
者。仍是一百一十二方。后人又因一百一十三方之说。而欲强合其数。遂以蜜导胆导两法。分而为二。以符其说。而盛
行于世。活人书又于一百一十三方之外。另增杂方一百二十六首。如升麻汤。阴旦阳旦汤。黑奴丸。霹雳散。
葳蕤汤。五积散。阳毒升麻汤。葶苈苦酒汤之类。其适于用者固有。而不近于理者亦颇多。至陶节庵伤寒六书之
杀车槌三十七法。既以仲景方改名增减。又以各家之方改头换面。殊属可笑。如麻黄汤改为升麻发表汤。增入升麻
羌活川芎白芷。不知升麻白芷已入阳明。非太阳经药矣。又加江西豆豉一撮为槌法。不知何意。岂知仲景以
麻黄杏仁俱为肺经专药。因肺主皮毛。为内经开鬼门之要药。借之以开发腠理。故能治头痛发热。体痛呕逆。
恶风无汗之伤寒。陶氏不知经旨。岂能窥仲景立方之义乎。以桂枝汤改而为疏邪实表汤。增入防风川芎羌活犹可。
而白术之加。殊属不解。又加胶饴二匙为槌法。既非桂枝原汤。又非小建中汤。叛经乱法。莫此为甚。小柴胡汤
改为柴胡双解饮。既云和解表里。又妄加芍药之酸收。而以生艾叶汁三匙为槌法。令人难解。葛根汤改为柴葛解肌
汤。不知仲景之葛根汤。其有麻黄者。为太阳无汗之伤寒。初传阳明而设。其桂枝葛根汤。为太阳有汗之中风。
初入阳明而设。舍麻黄桂枝。则风寒不辨。入柴胡芍药。则经络无分。又加石膏末一钱为槌法。邪尚在表。岂可即用
石膏。况又止一钱。真如儿戏矣。白虎汤改为如神白虎汤。如神二字。已属陋语。况不分虚实。概加人参五味麦
冬等收补之品。殊失仲景白虎汤及白虎加人参汤之义。又加淡竹叶为槌法。气味轻薄。其可谓之杀车槌耶。桃仁承
气汤改为桃仁承气对子。增入柴胡白芍枳实。且白芍为敛阴止血之药。则蓄血之治安在。更以苏木汁三匙为槌法。
岂以三匙之苏木汁。偏能破血而专力于此耶。四逆汤改为回阳救急汤。既云回阳救急。又增入补滞收敛之人参白术
五味半夏茯苓。临服又加麝香三厘。不知无阳之证。最不
宜于发泄。用此香窜走窍之物。殊非正道。全不虞其耗散真气耶。又治汗后大虚头眩。振振欲擗地。肉 筋
惕之卫虚亡阳证。不用仲景论中之真武汤。而以生熟地人参白术黄 芍药当归茯苓甘草陈皮肉桂等甘缓腻膈之
品以治之。又加糯米一撮为槌法。浊乱粘滞。不几气血兼补之十全大补汤矣。直是不知医者之妄作耳。其可
为天下法乎。又以大小承气调胃承气及大柴胡汤改为六一顺气汤。即以大柴胡汤去半夏加芒硝为之。是无表
里轻重之分。大失仲景立法之制矣。入铁锈水三匙为槌法。而云千金不传之秘。非吾子孙。焉肯泄露。如此家
秘。而又刊行于世。其设辞也。不亦陋乎。其于阴阳易之烧 散。仲景原只取妇人男子中 近隐处剪
下烧灰。以水和服方寸匕。并无他药。王海藏云。脉在厥阴。当以当归四逆汤下烧 散。在少阴当以通脉四
逆汤下之。在太阴当以理中汤同下。所用之药。各随其经。而效自速也。不然。则阴肿或缩。少腹绞痛。手足
蜷。脉绝而死矣。其后人之青竹茹汤及 鼠粪汤。恐未必能合仲景原文中之诸阴证也。而节庵之治阴阳易。则
以人参知母竹青。如卵缩腹痛。倍加黄连甘草滑石生地韭根柴胡犀角。然后反加烧 裆末为己之槌法。
一派寒凉。岂能治体重少气。少腹里急。阴中拘挛。热上冲胸。头重眼花。膝胫拘急之诸阴寒见证哉。又以
东垣补中益气汤改为调荣养卫汤。增入川芎生地细辛羌活防风。全不知东垣引清阳上升之义。而混入血药及
发散风寒之物。又以葱白一茎为槌法。不知仿仲景白通汤之义乎。抑欲使其辛散发汗乎。即黄龙汤一方。又
非活人书之黄龙汤矣。活人则用柴胡黄芩人参甘草。此以承气而加人参。虽为虚人胃实之所宜用。然其中
当归一味。不知何意。承气汤为攻下胃实之气药。而忽加一血药。或者以为油当归能滑利肠胃而取之。然其识
趣亦卑且陋矣。其后悔悟而改作全生集。阅其条例。似有可观。究竟但以仲景之言发其端。仍以背谬不经之臆见终
其说。抹杀仲景而奄为己有。犹之可也。其叛经乱法。遗误后人。则如之何。若举其书而悉辨之。则有不
胜其辨者。姑节取其大谬者。略论其一二。如一卷第三条。以头疼发热恶寒脉浮缓自汗。即仲景之所谓
中风者。改称鼻塞声重之伤风。盖仲景之所谓中风。非半身不遂。口眼歪斜。语言蹇涩。痰涎壅盛之中风也。
乃六气中之风邪伤卫。与寒伤营证并峙齐驱者。非鼻塞声重。伤风咳嗽之小疾也。伤风仅伤肺气。故鼻塞
声重而咳嗽。无入里传经之变。故为病之轻。所谓中风者。风为阳邪。性缓而入浅。故必中而后伤卫气。
若云乎伤。则又浅矣。非若寒邪锋锐。伤之即入营而为伤寒矣。若寒邪称中。则必深入而犯三阴矣。即阳
明为两阳合明之盛阳。寒邪中之。即不能食矣。故中伤二字之浅深。不可不辨。庸可乱乎。其一卷第五条中。
有脉沉足冷。面赤微热。谓之夹阴伤寒。不知此即仲景少阴篇中之手足厥逆。脉微欲绝。身反不恶寒。其
人面赤。或腹痛。或干呕之通脉四逆汤症。及厥阴篇中之脉沉迟。其人面少赤。身有微热之戴阳下虚证也。
又以脉沉足冷。面青小腹绞痛而无热者。谓之夹阴中寒。不知此即仲景厥阴篇之手足厥冷。小腹满痛。
冷结在膀胱关元症也。陶氏不言少阴厥阴而名之曰夹阴。则经络无分矣。不思所谓夹者。夹杂之意。若于
三阳证中。偶然见一阴症。方可谓之夹阴。若手足厥冷而至戴阳。脉沉足冷而至面青小腹绞痛。则纯是阴
寒极盛之证。其可谓之夹乎。前第四条即有无热恶寒。面青少腹痛。足冷脉沉。蜷卧不渴。吐利。舌卷囊
缩。昏沉。手足指甲皆青。冷过肘膝。心下胀满。汤药不受。陶氏但谓之肾经挟阴中寒。以理论之。其见
证若此。恐不止于少阴肾脏一经矣。仲景论中。虽少囊缩一证。而素问热病论中。即有六日厥阴受之。
厥阴之脉循阴器而络于肝。故烦满而囊缩。则知其病已入厥阴矣。陶氏全然不晓。何也。更有以头痛身
热。恶寒拘急。恶心。中脘痞满。或吐或呕。或痛或泻。谓之夹食伤寒。不知头疼身热。恶寒拘急。
恶心。即仲景论中所谓头痛发热。身疼腰痛。恶风无汗。麻黄汤主之之太阳伤寒也。中脘痞满。或吐或呕。
或痛或泻者。乃寒邪犯胃之太阴病也。陶氏岂犹未辨。混为一串。不分经络。而改名为夹食伤寒耶。又以
头痛身热。恶寒微汗。微渴蜷卧。懒言胁痛。骨腿酸疼。为劳力伤寒。尤为错杂紊乱。夫头疼身热。恶寒微汗。
乃仲景论中之中 也。蜷卧。乃仲景论中少阴厥阴证也。胁痛。少阳证也。骨腿酸疼。太阳经风寒表证也。
经络混淆。见症杂合。而强名之曰劳力伤寒。仲景论中六经证治。并无此名。岂非杜撰。下文夹痰夹气二段。
伤寒论中。俱未有此脉证名目。至于心胸胁痛。小腹有痛处不移。一般头疼身热。恶寒烦热。而谓之血郁
内伤外感。夫外感乃风寒外感。即仲景所谓中风伤寒也。内伤是饮食内伤。即东垣脾胃论之一则也。若夫血
郁二字。恐亦从无此说。既非伤寒蓄血。又非妇人经闭。又不言阴分血分如何受病。殊属不解。想今街坊里巷。
俗称跌打损伤为内伤之意。故谓之血郁内伤。又因一般头疼身热。故又曰外感耳。苟非庸俗者流。而能立名
若是耶。下文既曰名正则言顺。而谓有伤寒伤风伤暑伤湿。温病热病时气寒疫。冬温温毒风湿湿温中 等证。
皆以伤寒称之。而曰以伤寒为病之总名。岂知仲景论中有中风而无伤风。有中 而无伤暑。有伤寒而无寒疫。
热病即是伤寒。并未分论。盖言寒邪中人。郁而为热耳。故黄帝未明其故。于热病论中问曰。今夫热病者。
皆伤寒之类也。岐伯对曰。人之伤于寒也。则为病热。因寒郁为热。故伤寒即称热病。自王叔和伤寒例中。有
春夏多温热病句。后人宗之。而朱奉议成无己王海藏辈皆惑之。遂以温热暑并论。而有夏月暑热病之谬说矣。
而不知内经以先夏至日者为病温。后夏至日者为病暑。并无夏月称热病之例。后人以暑作热。岂非谬甚。又如
伤寒中风有柴胡证。但见一证便是。不必悉具。此仲景但论少阳一经之证。未可六经通用。而陶氏乃云。上
工问证以知外。察脉以知内。全在活
法。但见一二证便作主张。不必悉具。岂非以此为六经通用乎。又云此理不明。攻之为逆。一逆尚引日。再逆促
命期。此二句。乃仲景论风温证之不可误治。岂可移论他证。又云如少阴证。用白虎汤四逆散。寒药也。
且勿论四逆散本非寒药。但不热耳。而仲景少阴篇中。从无用白虎汤者。乱经坏法。贻误后人。若此之类。
正所谓不待教而诛者也。其可家 户诵。为天下法乎。致今之医者。舍天人之理而不究。弃阴阳变化而不察。
内经畏其难解。经穴厌其纠缠。惟读陶氏之书。不须辨察阴阳。何必六经分讲。凡有表证者。大约以冲和
汤芎苏散神术汤及柴葛解肌汤正气散等为便用。渴则加天花粉知母。胸满加枳桔。恶心干呕加姜汁半夏。泄泻加
苍白术。热甚加黄连黄芩。夹暑加香薷。腹痛加木香。天寒无汗加麻黄苏叶。头痛加川芎。眩晕加天麻。
咳嗽加金沸草五味子。脚痛加牛膝木瓜之类。令人一见了然。并无难处。人皆易而习之。以为医之为道。尽于
此矣。遂恃此以为根蒂。便觉胸次满足。高谈阔论。旁若无人。侮慢矜夸。靡所不至。自以为虽岐伯复生。仲景再世。
亦不我若矣。以此自欺。以此自误。又其谁惜之。而不知自欺者必至欺人。自误者必至误人。揆厥所由。非立说者
之咎欤。
伤寒病邪解除之后，患者身体虚弱消瘦，气息短少，气机上逆想要呕吐的，应当用竹叶石膏汤主治。
伤寒邪气已经解除，自然应该热退身凉，通过进食谷物而痊愈。但是邪气聚集的地方，正气必然虚弱，这是常理。然而患者出现虚弱羸瘦、气少力弱、呼吸短浅，更兼气上逆而欲吐的症状，这是胃气虚弱且不和顺的表现。张仲景虽然没有提及脉象，但如果诊察到脉象虚数且伴有口渴，就应当以竹叶石膏汤主治。如果是虚寒证，则应另行斟酌处理。
竹叶石膏汤方剂组成：
竹叶（一把） 石膏（三两） 半夏（五钱） 人参（五钱） 甘草（五钱） 粳米（半合） 麦冬（一两）
以上七味药，用水一斗，煮取六升药液，滤去药渣，加入粳米，继续煮至米熟汤成，再滤去米粒，每次温服一升，每日服用三次。
竹叶性寒，能止烦热；石膏入阳明经，能清胃热；半夏能祛除痰饮并停止呕吐；人参补益病后的虚弱，配合麦冬能大量补充胃中的津液。又担心寒凉药物损伤胃气，所以用甘草来调和，并用粳米来辅助胃气。
（附评陶氏谬说）
考察长沙王自序中，只说《伤寒卒病论》共十六卷。自从成无己作注之后，王叔和整理的版本已不可复见，不知道其篇卷结构是什么样。等到严器之为成无己作序文时说：“聊摄成公，注释《伤寒论》十卷，有三百九十七法，一百一十三方。”到了宋代，林亿等人奉诏校理《伤寒》，也说“百病之急，莫急于伤寒”，如今校定《伤寒论》十卷，总共二十二篇，证候外合计三百九十七法，除去重复，确定有一百一十二方。以此推断，方法的数量虽然出自后人，但也必定有所依据。只是可惜原本已经失传，远不可考证罢了。看前人指出某条为一法，某条二法，又此篇共几法，彼篇又几法，都属于勉强凑数。及至紧要的方法，反而遗失不录。所以王安道在《溯洄集》中《三百九十七法辨》里说：“如果有论有方的条文来计算，则达不到这个数目；如果有论有方、有论无方的条文通算，则超过这个数目。”以至于让他寝食难安，仔细推究他的说法，才明白他所计算的数量，在道理上是不通的。如果从“法”的角度来说，张仲景的书，没有不是法的，难道只有有方的才叫作法吗？况且如论证、论法，以及谆谆教诲、作为准则的内容，称它们为法呢？还是不称它们为法呢？阅读王氏的这篇论述，之前的疑惑已经像冰融化一样消散了。然而“三百九十七法”的说法，原本就不是出自张仲景，不可以强行求合印证。大约六经证治中，无非是法，没有一句一字不是法。那些有方的，未尝无法，而法中亦未尝无方。所以从方来看，方中自有法；从法来看，法内自有方，不必拘泥于三百九十七这个数字。如果一定要支离破碎地牵强附会，以充实那个数字，那就穿凿附会了。所以我不敢凭主观臆测，胶柱鼓瑟地束缚古人的活法。至于那一百一十二方，现在论中存在的，固然可以征信，即使是后人加减不当的，也可以详细辨析。其中有讹误伪失真迹的，也不得不进行辩论。现在人有一百一十三方的说法，大概是因为朱奉议的《活人书》错误地将桂枝附子汤改为桂附汤，重出于第十二卷的第十七方罢了。如果去掉这个重复的，仍然是一百一十二方。后人又因为一百一十三方的说法，想要强行符合这个数字，于是将蜜导法和胆导法分为二种，以符合作者的说法，从而盛行于世。《活人书》又在113方之外，另外增加杂方一百二十六首，如升麻汤、阴旦阳旦汤、黑奴丸、霹雳散、葳蕤汤、五积散、阳毒升麻汤、葶苈苦酒汤之类。其中适于使用的固然有，但不近于理的也有很多。至于陶节庵《伤寒六书》中的杀车槌三十七法，既把张仲景的方剂改名增减，又把各家的方剂改头换面，实在可笑。比如把麻黄汤改为升麻发表汤，加入升麻、羌活、川芎、白芷，不知道升麻、白芷已经入阳明经，不再是太阳经的药了。又加江西豆豉一撮作为槌法，不知道是什么意思。岂不知张仲景认为麻黄、杏仁都是肺经的专药，因为肺主皮毛，是《内经》开鬼门（发汗）的要药，借它们来开发腠理，所以能治疗头痛发热、体痛呕逆、恶风无汗的伤寒。陶氏不懂经典旨意，怎么能窥探张仲景立方的意义呢？把桂枝汤改为疏邪实表汤，加入防风、川芎、羌活还可以，但加入白术，实在让人不解。又加胶饴两匙作为槌法，既不是桂枝原汤，也不是小建中汤，背离经典混乱法度，没有比这更严重的了。小柴胡汤改为柴胡双解饮，既然说是和解表里，又妄加芍药的酸收之性，并以生艾叶汁三匙作为槌法，令人难以理解。葛根汤改为柴葛解肌汤，不知道张仲景的葛根汤，其中有麻黄的，是为太阳无汗的伤寒初传阳明而设的；其桂枝葛根汤，是为太阳有汗的中风初入阳明而设的。舍弃麻黄、桂枝，就无法辨别风寒；加入柴胡、芍药，经络就不分明了。又加石膏末一钱作为槌法，邪气还在体表，怎么可以立即使用石膏？何况只有一钱，真如同儿戏一般。白虎汤改为如神白虎汤，“如神”二字，已经属于粗陋的语言，况且不分虚实，一概加入人参、五味子、麦冬等收敛补益的药物，大大失去了张仲景白虎汤及白虎加人参汤的意义。又加淡竹叶作为槌法，气味轻薄，这能称为杀车槌吗？桃仁承气汤改为桃仁承气对子，加入柴胡、白芍、枳实，而且白芍是敛阴止血的药物，那么蓄血证的治疗在哪里？更以苏木汁三匙作为槌法，难道以为三匙的苏木汁，偏偏能破血而专力于此吗？四逆汤改为回阳救急汤，既然说是回阳救急，又加入补滞收敛的人参、白术、五味子、半夏、茯苓，临服时又加麝香三厘，不知道无阳的证候，最不宜于发泄，使用这种香窜走窍的药物，殊非正道，完全不考虑它耗散真气吗？又治疗汗后大虚、头眩、振振欲擗地、肉瞤筋惕的卫虚亡阳证，不用张仲景论中的真武汤，而以生地黄、熟地黄、人参、白术、黄芪、芍药、当归、茯苓、甘草、陈皮、肉桂等甘缓腻膈的药物来治疗，又加糯米一撮作为槌法，浊乱粘滞，这不简直就是气血兼补的十全大补汤了吗？简直是不懂医者的妄作罢了。这能成为天下的法则吗？又把大小承气汤、调胃承气汤及大柴胡汤改为六一顺气汤，即以大柴胡汤去掉半夏加入芒硝制成，这就没有表里轻重的区分，大大失去了张仲景立法的原则。加入铁锈水三匙作为槌法，却声称是千金不传的秘方，如果不是我的子孙，怎么会肯泄露。这样的家秘，却又刊行于世，这种设辞，不也很粗陋吗？对于阴阳易病的烧裈散，张仲景原本只取妇人或男子中裈近隐处剪下烧灰，用水和服方寸匕，并没有其他药物。王海藏说：脉在厥阴，当以当归四逆汤送下烧裈散；在少阴，当以通脉四逆汤送下；在太阴，当以理中汤同下。所用的药物，各随其经，疗效自然迅速。不然的话，就会出现阴肿或缩、少腹绞痛、手足蜷曲、脉绝而死的情况。其后人的青竹茹汤及鼠粪汤，恐怕未必能符合张仲景原文中的诸阴证。而节庵治疗阴阳易，则以人参、知母、竹青，如果卵缩腹痛，加倍加入黄连、甘草、滑石、生地、韭根、柴胡、犀角，然后反而加上烧裈裆末作为自己的槌法，一派寒凉，怎么能治疗体重少气、少腹里急、阴中拘挛、热上冲胸、头重眼花、膝胫拘急的诸阴寒见证呢？又把东垣的补中益气汤改为调荣养卫汤，加入川芎、生地、细辛、羌活、防风，完全不知道东垣引清阳上升的意义，而混入血药及发散风寒之物。又以葱白一茎作为槌法，不知道是仿效张仲景白通汤的意义呢，还是想让它辛散发汗呢？就连黄龙汤一方，也不是《活人书》中的黄龙汤了。《活人书》用的是柴胡、黄芩、人参、甘草，这里是用承气汤加入人参，虽然适合虚人胃实的病症，但其中的当归一味，不知道是什么意思。承气汤是攻下胃实的气药，却忽然加入一味血药，或许认为油当归能滑利肠胃而选用它，但这种见识趣味也是卑陋的。他后来后悔而改作《全生集》，阅读其条例，似乎有可取之处，但最终还是以违背经典不经的臆见结束其学说，抹杀张仲景而据为己有，尚且可以说得过去。但他背离经典混乱法度，遗误后人，该怎么办呢？如果列举他的书全部加以辨析，则有辨析不完的时候。姑且选取其中最大的谬误，略论其一二。如第一卷第三条，以头疼、发热、恶寒、脉浮缓、自汗，就是张仲景所说的中风，改称为鼻塞声重的伤风。盖张仲景所说的中风，不是半身不遂、口眼歪斜、语言蹇涩、痰涎壅盛的中风，而是六气中的风邪伤卫，与寒伤营证并峙齐驱者，不是鼻塞声重、伤风咳嗽的小病。伤风仅伤肺气，所以鼻塞声重而咳嗽，没有入里传经的变化，所以病情较轻。所谓中风，风为阳邪，性缓而入浅，所以必中而后伤卫气。如果说伤，那就更浅了，不像寒邪锋锐，伤之即入营而为伤寒。如果寒邪称中，则必深入而犯三阴了。即使阳明为两阳合明的盛阳，寒邪中之，就不能进食了。所以中、伤二字的深浅，不可不辨，岂可乱乎？第一卷第五条中，有脉沉、足冷、面赤微热，称之为夹阴伤寒，不知道这就是张仲景少阴篇中的手足厥逆、脉微欲绝、身反不恶寒、其人面赤，或腹痛、或干呕的通脉四逆汤证，以及厥阴篇中的脉沉迟、其人面少赤、身有微热的戴阳下虚证。又把脉沉足冷、面青小腹绞痛而无热的，称之为夹阴中寒，不知道这就是张仲景厥阴篇的手足厥冷、小腹满痛、冷结在膀胱关元证。陶氏不说少阴厥阴而命名为夹阴，则经络就不分明了。不思所谓夹者，夹杂之意，如果在三阳证中，偶然见到一阴症，才可以称之为夹阴。如果手足厥冷而至戴阳，脉沉足冷而至面青小腹绞痛，则是纯是阴寒极盛的证候，这能称之为夹吗？前第四条即有无热恶寒、面青少腹痛、足冷脉沉、蜷卧不渴、吐利、舌卷囊缩、昏沉、手足指甲皆青、冷过肘膝、心下胀满、汤药不受。陶氏只称之为肾经挟阴中寒，以理论之，其见症若此，恐怕不止于少阴肾脏一经了。张仲景论中，虽少囊缩一证，而《素问·热病论》中，就有六日厥阴受之，厥阴之脉循阴器而络于肝，故烦满而囊缩，则知其病已入厥阴矣。陶氏全然不懂，为什么呢？更有以头痛身热、恶寒拘急、恶心、中脘痞满，或吐或呕，或痛或泻，称之为夹食伤寒，不知道头疼身热、恶寒拘急、恶心，就是张仲景论中所谓头痛发热、身疼腰痛、恶风无汗、麻黄汤主之的太阳伤寒也。中脘痞满，或吐或呕，或痛或泻者，乃是寒邪犯胃的太阴病也。陶氏难道还没分辨清楚，混为一串，不分经络，而改名为夹食伤寒吗？又把头痛身热、恶寒微汗、微渴蜷卧、懒言胁痛、骨腿酸疼，称为劳力伤寒，尤为错杂紊乱。夫头疼身热、恶寒微汗，乃张仲景论中的中湿也。蜷卧，乃张仲景论中少阴厥阴证也。胁痛，少阳证也。骨腿酸疼，太阳经风寒表证也。经络混淆，见症杂合，而强名之为劳力伤寒，张仲景论中六经证治，并无此名，岂不是杜撰？下文夹痰夹气二段，《伤寒论》中，俱未有此脉证名目。至于心胸胁痛、小腹有痛处不移，一般头疼身热、恶寒烦热，而称之为血郁内伤外感。夫外感乃风寒外感，即张仲景所谓中风伤寒也。内伤是饮食内伤，即东垣脾胃论中的一则也。若夫血郁二字，恐怕也从未有此说法。既非伤寒蓄血，又非妇人经闭，又不言阴分血分如何受病，实在让人不解。想今街坊里巷，俗称跌打损伤为内伤之意，故谓之血郁内伤，又因一般头疼身热，故又曰外感耳。苟非庸俗者流，而能立名若是耶？下文既曰名正则言顺，而谓有伤寒、伤风、伤暑、伤湿、温病、热病、时气、寒疫、冬温、温毒、风湿、湿温、中湿等证，都以伤寒称之，而曰以伤寒为病之总名，岂知张仲景论中有中风而无伤风，有中湿而无伤暑，有伤寒而无寒疫，热病即是伤寒，并未分论，盖言寒邪中人，郁而为热耳。故黄帝未明其故，于《热病论》中问曰：“今夫热病者，皆伤寒之类也。”岐伯对曰：“人之伤于寒也，则为病热。”因寒郁为热，故伤寒即称热病。自王叔和《伤寒例》中有“春夏多温热病”句，后人宗之，而朱奉议、成无己、王海藏辈皆惑之，遂以温热暑并论，而有夏月暑热病之谬说矣。而不知《内经》以先夏至日者为病温，后夏至日者为病暑，并无夏月称热病之例。后人以暑作热，岂非谬甚？又如“伤寒中风有柴胡证，但见一证便是，不必悉具”，此张仲景但论少阳一经之证，未可六经通用，而陶氏乃云：“上工问证以知外，察脉以知内，全在活法，但见一二证便作主张，不必悉具。”岂非以此为六经通用乎？又云：“此理不明，攻之为逆，一逆尚引日，再逆促命期。”此二句，乃张仲景论风温证之不可误治，岂可移论他证？又云：“如少阴证，用白虎汤四逆散，寒药也。”且勿论四逆散本非寒药，但不热耳，而张仲景少阴篇中，从无用白虎汤者，乱经坏法，贻误后人。若此之类，正所谓不待教而诛者也。其可家喻户晓，为天下法乎？致今之医者，舍天人之理而不究，弃阴阳变化而不察，《内经》畏其难解，经穴厌其纠缠，惟读陶氏之书，不须辨察阴阳，何必六经分讲。凡有表证者，大约以冲和汤、芎苏散、神术汤及柴葛解肌汤、正气散等为便用。渴则加天花粉、知母，胸满加枳桔，恶心干呕加姜汁半夏，泄泻加苍白术，热甚加黄连、黄芩，夹暑加香薷，腹痛加木香，天寒无汗加麻黄苏叶，头痛加川芎，眩晕加天麻，咳嗽加金沸草、五味子，脚痛加牛膝、木瓜之类，令人一见了然，并无难处。人皆易而习之，以为医之为道，尽于此矣。遂恃此以为根蒂，便觉胸次满足，高谈阔论，旁若无人，侮慢矜夸，靡所不至，自以为虽岐伯复生，仲景再世，亦不我若矣。以此自欺，以此自误，又其谁惜之？而不知自欺者必至欺人，自误者必至误人，揆厥所由，非立说者之咎欤？
After the resolution of Shaoyang disease (disease caused by pathogenic factors affecting the Shaoyang channel), if the patient presents with emaciation and weakness, shortness of breath, and rebellious Qi leading to a desire to vomit, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) should be administered.
When the pathogenic factors of Shanghan (Cold Damage) have been resolved, naturally the fever should subside and the body should become cool, and recovery should occur with the intake of grain. However, where the pathogen gathers, the healthy Qi must be deficient; this is the normal pattern. Yet, if the patient exhibits weakness and emaciation, scarcity of Qi and lack of strength, shallow respiration, and furthermore rebellious Qi causing a desire to vomit, this indicates that Stomach Qi is deficient and not harmonized. Although Zhang Zhongjing did not mention the pulse, if upon examination the pulse is found to be deficient and rapid accompanied by thirst, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) should be used as the primary treatment. If it is a deficiency-cold pattern, it should be considered separately.
Formula for Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction):
Zhuye (Bamboo Leaves, one handful) Shigao (Gypsum Fibrosum, three taels) Banxia (Pinelliae Rhizoma, five qian) Renshen (Ginseng Radix et Rhizoma, five qian) Gancao (Licorice Root, five qian) Jingsmi (Oryza Sativa, half he) Maidong (Ophiopogonis Radix, one liang)
The above seven ingredients are boiled in ten dou of water until six sheng of liquid remain. The dregs are filtered out, Jingsmi (Rice) is added, and it is boiled until the rice is cooked and the decoction is ready. The rice is then removed. Take one sheng warm, three times a day.
Zhuye (Bamboo Leaves) is cold in nature and stops irritability and heat; Shigao (Gypsum Fibrosum) enters the Yangming channel and clears Stomach heat; Banxia (Pinelliae Rhizoma) eliminates phlegm-fluids and stops vomiting; Renshen (Ginseng Radix et Rhizoma) tonifies post-illness deficiency, and together with Maidong (Ophiopogonis Radix) greatly replenishes fluids in the Stomach. Furthermore, fearing that cold-natured herbs might damage the Stomach, Gancao (Licorice Root) is used to harmonize, and Jingsmi (Rice) is used to assist Stomach Qi.
(Commentary on Tao's Erroneous Views)
Examining the Preface by Wang Chong of Changsha, it only states that *Shanghan Zubi Lun* (Treatise on Cold Damage and Miscellaneous Diseases) consisted of sixteen volumes. Since Cheng Wuji provided commentary, Wang Shuhe's compiled version has become irretrievable, so it is unknown what its chapter and volume structure resembled. When Yan Qiwei wrote the preface for Cheng Wuji's commentary, he said: "Cheng Gong from Liaonie commented on *Shanghan Lun* in ten volumes, containing 397 methods and 113 formulas." In the Song Dynasty, Lin Yi and others were commissioned to collate *Shanghan*, stating that "of all urgent diseases, none is more urgent than Shanghan." They collated *Shanghan Lun* into ten volumes, totaling twenty-two chapters, with 397 methods outside the syndromes. Removing duplicates, they determined there were 112 formulas. From this, we can infer that although the number of methods originated from later generations, it must have had some basis. It is just a pity that the original text has been lost and cannot be verified from afar. Observing how predecessors pointed out that certain lines constitute one method or two methods, and counting how many methods are in this chapter versus that chapter, these are all forced calculations. Crucial methods are often omitted. Therefore, Wang Andao, in his *Suihui Ji* (Collection of Tracing the Source), in "Refutation of 397 Methods," stated: "Counting only lines with both discussion and formula yields fewer than this number; counting lines with discussion, with or without formula, exceeds this number." This kept him awake at night. Upon careful analysis, he realized that the count was logically flawed. If speaking of 'methods', every part of Zhang Zhongjing's book is a method. Is it only those with formulas that are called methods? Moreover, discussions on syndromes, discussions on methods, and earnest teachings serving as standards—are they methods or not? Reading Wang's argument dispelled my previous doubts like melting ice. However, the concept of "397 methods" did not originate from Zhang Zhongjing himself and should not be forced to fit. Essentially, in the treatment of the Six Channels, everything is a method; no sentence or word is not a method. Those with formulas inherently contain methods, and within methods, there are implicitly formulas. Thus, deducing from formulas, there are methods within them; discussing from methods, there are formulas within them. There is no need to rigidly adhere to the number 397. If one insists on disjointed and forced associations to fill that number, it becomes pedantic speculation. Therefore, I dare not use subjective guesses to rigidly constrain the flexible methods of the ancients. As for the 112 formulas currently in the text, they can certainly be trusted. Even those modified improperly by later generations can be analyzed in detail. Those with errors or distortions must also be debated. The current notion of 113 formulas likely arises because Zhu Fengyi's *Huo Ren Shu* (Book Reviving People) erroneously changed Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) to Guifu Tang, duplicating it as the 17th formula in Volume 12. If this duplicate is removed, it remains 112 formulas. Later generations, wanting to force the number to match 113, split the Honey Suppository Method and Gallbladder Suppository Method into two, popularizing this view. *Huo Ren Shu* further added 126 miscellaneous formulas beyond the 113, such as Shengma Tang (Cimicifugae Decoction), Yindan/Yangdan Tang, Heinu Wan (Black Slave Pill), Pili San (Thunderbolt Powder), Weirui Tang, Wujisan (Five Accumulations Powder), Yangdu Shengma Tang, Tingli Kujiu Tang, etc. While some are applicable, many are unreasonable. Regarding Tao Jian'an's *Shanghan Liushu* (Six Books on Cold Damage), his "Killing Cart Hammer 37 Methods" are ridiculous, as he renamed and altered Zhang Zhongjing's formulas and repackaged others. For example, changing Mahuang Tang (Ephedra Decoction) to Shengma Fabiao Tang (Cimicifuga Exterior-Releasing Decoction) by adding Shengma, Qianghuo, Chuanxiong, and Baizhi. One does not know that Shengma and Baizhi enter the Yangming channel and are no longer Sunyang channel herbs. Adding Jiangxi Douchi (Fermented Soybean) as a 'hammer' method makes no sense. Does he not know that Zhang Zhongjing considered Mahuang and Xingren (Apricot Seed) as specific herbs for the Lung channel? Since the Lung governs skin and hair, they are key herbs for opening the pores (Guimen) as per *Neijing*. Borrowing them to open the interstices allows treatment of headache, fever, body pain, vomiting/reversal, aversion to wind, and anhidrosis characteristic of Shanghan. Tao's ignorance of classic principles prevents him from understanding Zhang's formula construction. Changing Guizhi Tang (Cinnamon Twig Decoction) to Shuxie Shibiao Tang (Dispersing Pathogens and Solidifying Exterior Decoction) by adding Fangfeng, Chuanxiong, and Qianghuo is acceptable, but adding Baizhi (Atractylodis Macrocephalae Rhizoma) is inexplicable. Adding Jiaoyi (Maltose) as a hammer method results in a formula that is neither the original Guizhi Tang nor Xiao Jianzhong Tang (Minor Construct the Middle Decoction); this betrayal of classics and confusion of methods is severe. Changing Xiaochaihu Tang (Minor Bupleurum Decoction) to Chaihu Shuangjie Yin (Bupleurum Dual-Solution Drink) claims to harmonize exterior and interior but recklessly adds Sour/Receptive Shaoyao (Peony Root). Adding raw Mugwort juice as a hammer method is baffling. Changing Gegen Tang (Puerariae Decoction) to Chaige Jieji Tang (Bupleurum and Pueraria Relieving Muscle Decoction) ignores that Zhang's Gegen Tang with Mahuang is for Sunyang Shanghan without sweat transmitting to Yangming, while Gegen Tang with Guizhi is for Sunyang Wind Strike with sweat transmitting to Yangming. Discarding Mahuang and Guizhi fails to distinguish Wind-Cold; adding Chaihu and Shaoyao blurs the channels. Adding 1 qian of Shigao (Gypsum Fibrosum) as a hammer method is childish when the pathogen is still in the exterior. Changing Baihu Tang (White Tiger Decoction) to Rushen Baihu Tang adds the vulgar term "Rushen" and indiscriminately adds Renshen, Wuweizi, and Maidong for astringency and tonification, losing the essence of Zhang's Baihu Tang and Baihu Jia Renshen Tang. Adding Dan Zhuye (Light Bamboo Leaf) as a hammer method is too light in flavor to be called a "hammer." Changing Taoren Chengqi Tang (Peach Kernel and Da Huang Decoction) to Taoren Chengqi Duizi adds Chaihu, Shaoyao, and Zhishi. Since Shaoyao is for astringing Yin and stopping bleeding, where is the treatment for Blood Stasis? Adding Sumu juice as a hammer method implies that a small amount can solely break blood stasis. Changing Sini Tang (Frigid Extremities Decoction) to Huiyang Jiuji Tang (Restoring Yang Saving Emergency Decoction) adds tonifying and astringent herbs like Renshen, Baizhu, Wuweizi, Banxia, and Fuling, plus Musk before administration. For patterns lacking Yang, dispersing agents like Musk are contraindicated as they consume true Qi. Treating post-sweat severe deficiency with vertigo, tremors, and muscle twitching (Wei Deficiency and Yang Loss) without using Zhenwu Tang (True Warrior Decoction) from Zhang's text, but instead using heavy, cloying tonics like Sheng/Di Huang, Huangqi, Danggui, Rougui, etc., creates a formula akin to Shiquan Dabu Tang (Ten Complete Tonifying Decoction). This is reckless fabrication by ignorant physicians. Changing Da/Xiao Chengqi Tang and Tiaowei Chengqi Tang along with Daxiahu Tang to Liuyi Shunqi Tang (Six-One Smooth Qi Decoction) by removing Banxia and adding Mangxiao from Daxiahu Tang loses the distinction between exterior/interior and severity, violating Zhang's legislative principles. Adding Iron Rust Water as a secret recipe is absurd. Regarding the Shaobian San (Burned Undergarment Powder) for Yin-Yang Exchange, Zhang only prescribed burning the undergarment near the genitals. Wang Haizang suggested pairing it with Danggui Sini Tang, Tongmai Sini Tang, or Lizhong Tang depending on the channel. Tao's treatment uses cold herbs like Huanglian and Dihuang for symptoms that require warming, completely misunderstanding the pathology. Changing Dongyuan's Buzhong Yiqi Tang to Tiaorong Yangwei Tang mixes blood-invigorating and dispersing herbs, ignoring Dongyuan's principle of raising clear Yang. Changing Huanglong Tang alters its composition significantly. Critiquing these errors reveals widespread confusion among modern practitioners who rely on Tao's simplified, eclectic approaches (like Chonghe Tang, Xongsu San, etc.) rather than studying *Neijing* or Six Channel differentiation. They claim mastery but deceive themselves and others. Ultimately, the fault lies with the originators of these erroneous theories.