（一曰中风）
夫伤风之候，头痛项强，股节烦疼，或目疼、肌热、干呕、鼻鸣、手足温、自汗出、恶风寒，
脉阳浮而缓，阴浮而弱也（关前曰阳，关后曰阴）。此为邪热在表，皆桂枝汤解肌之证也。或汗出憎
风而加项背强痛者，宜桂枝汤加葛根汤也；反无汗者宜葛根汤也。虽已服桂枝，反烦不解而无里证者，
先刺风池、风府，却与服之。或服桂枝大汗出，脉浮而洪大，再宜服之。发汗后半日许，复热烦，脉
浮数者，再宜桂枝汤也。当汗而反下之，不成结胸而但下利，清谷不化，表证尚在者，表热里寒也，
此言承气寒药下之者也，或误用巴豆热药下之，而协热利不止者，或表里皆热，自利或呕者，皆宜五苓散止利兼解表也。
急以四逆汤温里；利止里和，急以桂枝汤解表。
或表热里和，下利同法。
或阳明病，脉浮迟、汗出、微恶寒。或太阴病，腹满而脉浮者，并宜桂枝汤也。
脉反沉实者，大承气汤下之。
或下之早，而心下痞，汗出、恶寒、脉浮者，表未解也。先桂枝汤以解表，已而以下血也。
宜桃仁承气汤，或抵当丸攻之。
头项痛、肢疼、手足温，中风也。反无汗、恶寒、脉浮紧者，伤寒也。或头项痛、腰脊强、身拘急、
指末微厥、不自汗，为伤寒也。反烦躁而脉缓者，为伤风也。风则伤卫，而寒则伤荣。
万物必以阴求阳、阳求阴，阴阳相应，则为和平。故荣者阴气也，寒加
之则伤耳。故又曰寒伤血，血亦阴也。卫阳气也，风亦阳也，故风加之则伤
耳。故曰热伤气，气为阳也。经言阴寒主于闭藏，而阳热主于开泄。故寒伤荣，则腠理闭密，拂热
内作，燥热而无汗，故脉数浮而紧也；风伤卫，则腠理开泄而自汗也，故脉浮而缓；以邪热泄越，
故脉不能实；阳明主于肌肉，故自汗多而脉反迟也。热乃阳中之至阳，故伤热气则大汗自出，病虽为热，
脉不能实而虚弱也。然拂热痞闭无汗者故当病也，其汗泄通泰而亦病者，盖泰极则否也。夫人气和而为
汗，如天地气和而为雨，过多则涝，久不雨则旱，有无多少贵乎应时，兴衰失常则灾害至矣。万事皆然。
荣卫俱伤，则表里热甚也，宜大青龙汤。
小青龙汤 治伤寒表未罢，心下有水气。
表虽未罢，而已有热入于里，怫郁于胃，则饮食水液不能传化宣行，蓄
积不散而为此，非里热大实，烦渴引饮过多，停积而为病者。
干呕发热而咳，或渴、或利、或噎、或小便不利，少腹满，或喘者。
水不能浸润宣散，滋润肠胃脏腑，故热而渴，或噎、或喘、或小便不利、
少腹满而喘也；水液不能宣行，则湿热盛于肠胃，故或利也。
小柴胡汤 治伤寒中风，其病半在表、半在里（脉在肌肉不沉不浮），筋脉拘急。
身体疼痛，寒热往来（恶寒为表热，发热为里热）。寒热往来者，邪热半在表、
半在里也，进退不已，而言无常也。
或呕、或咳，胸胁痞满硬痛，下之前后，无问日数及汗后余热不解，或无问
伤寒、杂病、蒸热作发并两感，可和解者，并宜服之。
凉膈散（一名连翘饮子）治伤寒表不解，半入于里，下证未全，或复未愈者；或燥热怫结于
内，而烦心懊 不得眠者；及无问伤寒、杂病、大人、小儿、脏腑积热、烦躁多渴、面热、头昏、唇
焦、咽躁、舌肿、喉痹、目赤、鼻衄，颔颊结硬、口舌生疮、痰实不利、咳唾稠粘、睡卧不安、谵语狂
妄、肠胃湿燥、便尿闷结、一切风热壅滞、风眩、疮癣及伤寒阳明胃热发斑、下证未全者；或误服暖药
过多，为诸热证，并酒甚热毒，兼小儿 疹、痘疮未出及惊风积热、伤寒不能辨
别者；或热甚痘疮已出未快者，或热极黑陷将死者。
小儿疹痘未出，误以热药发汗，致使阳热转甚，则重密出不快，多致黑陷而死。因以世俗多
疹不敢服药，以误小儿诸病多矣。亦不知古人所留凉泻之药，通治风、惊、积热、伤寒热病，纵误是
疮，亦使热势稍退，而稀少出快，早得痊安也。若用此最为妙也。
阎孝忠集《小儿方论》未达钱氏本意，不明造化之理，反妄言疹病黑陷
为寒，及曰凡 疹始终不可服凉泻之药。后人因之反致热甚黑陷而死者不可
胜计也。阎公岂不详自所编钱氏方治 疹黑陷用牛李膏及百祥丸，凡寒药下之而多得痊愈者，而不
救则必死。然则痘疹为热病岂不明哉。况经曰∶诸痛痒疮疡皆属于心。及夫 疮黑陷，无不腹满喘喝（
嘶声）而小便赤涩不通，岂不是热极乎。况 疹本因热而生，病势转甚也，岂能反为寒者也。
并两感诸证（三阴三阳双传诸证），并宜服之。或伤寒热极将死，阴气衰残则不宜下，下之则阴
气暴绝，阳气后竭而死矣。惟宜养阴退阳，以至脉复而有力，而后以三一承气汤微下之。下后未愈者，
更以凉膈散调之，虽愈后犹宜少少服之，庶邪热不致再作也。
白虎汤治伤风自汗，桂枝证表未解，半入里，可以和解者。
脉在肌肉而不可下者也。
或中暑自汗脉虚弱者。
热伤气而反自汗大出，故脉不能自实而反虚弱。
或伤寒自汗，脉滑数而实，表里俱热。
脉沉浮皆得有力而数，身热、头痛、烦渴、腹满、小便赤黄也。或三阳
合病（言太阳、少阳、阳明合受其为病之热气），腹满、身重，难以转侧，口燥、面垢、谵语、遗尿。
如误发汗则谵语益甚，下之则便额上出汗，后必发黄。
或厥逆自汗者，是谓热越（言自汗散越也）。如或里热而脉厥者；或下证未全者；兼和解两
感伤寒。此方最解头痛，并止自汗，无问中暑、伤寒、风热杂病，及传染时疫，本非外伤风寒，脉便不
浮，而自汗、头痛，欲作汗病者，并宜服之。
无问四时，但随证而用之。他药仿此。
五苓散 治中暑，并伤寒大发汗后，胃中干，烦躁不得眠，脉浮，小便不
利，后热烦渴及表里俱热，饮水反吐（名曰水逆），或攻痞不解，或口干烦渴，小便不利，或痞尚在
而利不止者，或当汗而反下之，利遂不止，脉浮表不解，自利或小便不利者。
凡用五苓散，证无问脉之沉浮。
或一切留饮不散，以此散水止渴，并解两感，太阳、少阴俱病。
经言六经病证者是也。
或一切吐泻霍乱（无问寒热），及小儿泻惊风（无问急慢），皆宜服之。
桂苓甘露散（一名桂苓白术散）治伤寒中风，冒暑饮食，内外一切所伤，传受湿
热内甚，或头痛、口干，或吐泻、烦渴，或小便赤涩、大便急痛，或泻利间作，
并一切湿热，霍乱吐泻，转筋急痛，腹满痛闷，或中外诸邪所伤而并吐泻者，湿
热之时尤宜服之。
并治小儿惊风。
白术散 治伤寒杂病，一切吐泻、烦渴、霍乱、虚损及气弱久虚，保养衰老兼治酒膈呕哕。
四逆汤 治伤寒，表热未入于误以寒药下之太早，其表热本未入，因而里
寒，下利不止，或表热里寒，自利不止者，急以四逆温里。
脉浮不渴，小便清白不温，完谷不化者是也。或辨便、溺之色者，须更审其饮食万物之色也。
或下后协热利不止者，咽干烦渴也，谨不宜温也，宜五苓之类散其湿热也。惟里寒者可以温之，止其寒泻。
利止里和，表证尚在者，急以桂枝汤解表也。或杂病寒饮呕吐者，或寒湿泄泻者。
然虽杂病，若湿热吐泻者，不宜此方。虽亦有湿热痞闭之微者，误中辛
热开发而效，甚者强劫不开，则怫热病转加也。惟里寒可通用四逆汤也。
茯苓半夏汤 治伤寒杂病，一切呕吐或喘咳、头痛者。
半夏橘皮汤 治伤寒杂病，呕哕风眩，痰逆咳喘，头痛并风热反胃吐食诸证。
黄连解毒汤 治伤寒杂病，并酒燥热毒，烦闷干呕，口燥呻吟，错语，不得
眠，凡一切大热狂躁喘满及阴厥极甚，蓄热内深，俗妄传为阴毒者（见前辨）；表热
太甚，头项、肢体痛不可忍，脉洪躁，里有微热不可汗者；或湿热内甚，或欲作痢者。
大便溏数而少腹急痛，小便赤或涩者，必欲作痢也。
或已利，热势甚者（并服本方）；及下之前后，寒凉诸药不能退其热势之甚者。两感诸证同法。
两感者∶一日，太阳与少阴俱病，则头痛、口干而烦满；二日阳明与太阴俱病，则耳
聋、囊缩而厥，通宜此方以退表里诸热。朱氏不明此皆热证，妄言前三日真为病寒，以四逆汤急温里，
而后以桂枝汤急解表，大误人也。
此二方皆不可用，但随表与里，热势微，甚以退其热，使无致热极而死者是也。若势甚宜下者，加
大承气汤下之。及夫经言，此三日传受，亦大略之法也。大抵宜随证以施治，亦不必拘也。
或势甚欲下，虑不能退其热者，加大承气汤下之。或热结极深，而诸药数
下，毕竟不能利，不救必死者，此法更下甘逐末一钱以下之（吐利同效）。或但自热
结胸中，心胸高起，腹虽不满，而但喘急、闷结、谵妄、昏冒，关脉沉数而紧
者，尤宜此法急以下之。
（一曰中风）
所谓伤风的证候，表现为头痛、项部僵硬、大腿关节烦痛，或者眼痛、肌肉发热、干呕、鼻鸣、手足温暖、自汗出、怕风怕冷，脉象在关前（阳位）浮而缓，关后（阴位）浮而弱。（关前称为阳，关后称为阴）。这是邪热在体表，都属于桂枝汤（Cinnamon Twig Decoction）解肌发表的证候。如果出汗且憎恶风邪并伴有项背部强直疼痛的，适宜用桂枝加葛根汤（Guizhi Tang plus Puerariae Radix Decoction）；相反如果没有汗出的，适宜用葛根汤（Puerariae Decoction）。虽然已经服用了桂枝汤，反而感到烦闷不解且没有里证的，先针刺风池穴（Fengchi, GB20）、风府穴（Fengfu, GV16），然后再给予服用桂枝汤。或者服用桂枝汤后大汗出，脉象浮而洪大，再次适宜服用桂枝汤。发汗后约半天时间，又出现发热烦扰，脉象浮数的，再次适宜服用桂枝汤。应当发汗却反而使用泻下法，没有形成结胸证而只是出现下利，大便中有未消化的食物，表证仍在的，这是表热里寒，这里说的是误用承气汤类寒凉药泻下的情况；或者误用巴豆（Crotonis Fructus）这类热性药泻下，导致协热利不止的；或者表里皆热，自利或呕吐的，都适宜用五苓散（Triauretum）止利兼以解表。紧急时用四逆汤（Sini Decoction）温补里阳；利止里气调和后，紧急时用桂枝汤解除表邪。
或者是阳明病（Yangming Disease），脉象浮迟、出汗、轻微怕冷。或者是太阴病（Taiyin Disease），腹部胀满而脉象浮的，都适宜用桂枝汤。
脉象反而沉实的，用大承气汤（Major Order the Yellow Decoction）泻下。
或者泻下过早，导致心下痞塞，出汗、怕冷、脉象浮的，说明表证未解。先用桂枝汤解除表邪，随后如果出现便血的，适宜用桃仁承气汤（Tao Ren Chengqi Decoction），或者抵当丸（Didang Pill）攻逐瘀血。
头项痛、肢体疼痛、手足温暖，属于中风。相反没有汗出、怕冷、脉象浮紧的，属于伤寒。或者头项痛、腰脊强直、身体拘急、指尖微冷、不出汗的，属于伤寒。相反烦躁而脉象缓的，属于伤风。风邪伤害卫气，寒邪伤害营血。万物必然以阴求阳、以阳求阴，阴阳相应，才是和平状态。所以营气是阴气，寒邪加之则伤害它。所以说寒伤血，血也是阴。卫气是阳气，风也是阳，所以风邪加之则伤害它。所以说热伤气，气为阳。经文说阴寒主闭藏，阳热主开泄。所以寒伤营，则腠理闭密，郁热内生，燥热而无汗，所以脉象数、浮而紧；风伤卫，则腠理开泄而自汗，所以脉象浮而缓；因为邪热泄越，所以脉象不能充实；阳明主肌肉，所以自汗多而脉象反而迟。热是阳中的至阳，所以伤热气则大汗自出，病虽然是热，但脉象不能充实而虚弱。然而郁热痞闭无汗的固然属于病，其汗泄通畅也属于病的，这是因为泰极则否（物极必反）。人的气和顺则出汗，如同天地气和顺则降雨，过多则涝，久不下雨则旱，有无多少贵在应时，兴衰失常则灾害到来。万事都是如此。
营卫俱伤，则表里热甚，适宜用大青龙汤（Da Qinglong Decoction）。
小青龙汤（Xiao Qinglong Decoction）治疗伤寒表证未罢，心下有停水之气。
表证虽未罢，但已有热入于里，怫郁于胃，则饮食水液不能传化宣行，蓄积不散而产生此病，并非里热大实，烦渴引饮过多，停积而为病的情况。
干呕、发热而咳嗽，或者口渴、或者下利、或者噎膈、或者小便不利、少腹胀满、或者喘息的。
水液不能浸润宣散，滋润肠胃脏腑，所以热而渴，或者噎、或者喘、或者小便不利、少腹胀满而喘；水液不能宣行，则湿热盛于肠胃，所以下利。
小柴胡汤（Xiao Chaihu Decoction）治疗伤寒中风，病势半在表、半在里（脉象在肌肉层，不沉不浮），筋脉拘急。
身体疼痛，寒热往来（怕冷为表热，发热为里热）。寒热往来的，是邪热半在表、半在里，进退不已，变化无常。
或者呕吐、或者咳嗽，胸胁痞满硬痛，无论发病前后，不问日数及发汗后余热不解，或者不问伤寒、杂病、蒸热发作以及两感证，可以和解的，都适宜服用。
凉膈散（Liangge San，又名连翘饮子）治疗伤寒表证不解，半入于里，下证未全，或者复发未愈的；或者燥热怫结于内，而心烦懊恼不得睡眠的；以及不问伤寒、杂病、大人、小儿、脏腑积热、烦躁多渴、面热、头晕、唇焦、咽躁、舌肿、喉痹、目赤、鼻衄、颔颊结硬、口舌生疮、痰实不利、咳唾稠粘、睡卧不安、谵语狂妄、肠胃湿燥、大小便闷结、一切风热壅滞、风眩、疮癣以及伤寒阳明胃热发斑、下证未全的；或者误服暖药过多，导致各种热证，以及酒毒甚热，兼小儿麻疹、痘疮未出及惊风积热、伤寒不能辨别的；或者热甚痘疮已出但未透发的，或者热极黑陷将死的。
小儿麻疹痘疮未出，误用热药发汗，致使阳热更甚，则疹点重密不透发，多导致黑陷而死。因此世俗人多因有疹不敢服药，从而延误了小儿多种疾病的治疗。也不知道古人留下的凉泻之药，通治风、惊、积热、伤寒热病，即使误用于疮疡，也能使热势稍退，而稀少透出快，早日痊愈。如果用此方最为妙。
阎孝忠编纂《小儿方论》未通达钱乙的本意，不明白造化之理，反而妄言疹病黑陷为寒，并且说凡是麻疹始终不可服用凉泻之药。后人因此反而导致热甚黑陷而死者不可胜计。阎公难道不清楚自己编纂的钱乙方治疗疹黑陷用牛李膏及百祥丸，凡是用寒药泻下而多得痊愈的，如果不救则必死吗？既然这样，那么痘疹为热病难道还不明显吗？况且经文说：诸痛痒疮疡皆属于心。至于疮黑陷，无不腹满喘喝（嘶声）而小便赤涩不通，这难道不是热极吗？况且疹本因热而生，病势转甚，岂能反为寒呢？
并两感诸证（三阴三阳双传的诸种证候），都适宜服用。或者伤寒热极将死，阴气衰残则不宜泻下，泻下则阴气暴绝，阳气后竭而死。只适宜养阴退阳，直到脉复有力，然后用三一承气汤（Sanyi Chengqi Decoction）微微泻下。泻下后未愈的，再用凉膈散调理，即使痊愈后也宜少量服用，以防邪热不再发作。
白虎汤（Baitu Tang）治疗伤风自汗，桂枝汤证表未解，半入于里，可以和解的。
脉象在肌肉层而不可泻下的。
热伤气而反而自汗大出，所以脉象不能自实而反而虚弱。
脉象沉浮皆得有力而数，身热、头痛、烦渴、腹满、小便赤黄。或者三阳合病（指太阳、少阳、阳明同时受其病热），腹满、身重，难以转侧，口燥、面垢、谵语、遗尿。如果误发汗则谵语更甚，泻下则额头出汗，后来必定发黄。
或者厥逆自汗的，这叫热越（指自汗散越）。如果里热而脉厥的；或者下证未全的；兼和解两感伤寒。此方最解头痛，并止自汗，不问中暑、伤寒、风热杂病，及传染时疫，本非外伤风寒，脉象不浮，而自汗、头痛，欲作汗病的，都适宜服用。
不问四季，只要随证使用即可。其他药物仿照此例。
五苓散（Triauretum）治疗中暑，以及伤寒大发汗后，胃中干燥，烦躁不得眠，脉浮，小便不利，后热烦渴以及表里俱热，饮水反吐（名叫水逆），或者攻痞不解，或者口干烦渴，小便不利，或者痞尚在而利不止的，或者应当发汗却反而泻下，利遂不止，脉浮表不解，自利或小便不利的。
凡是使用五苓散，证候不问脉象的沉浮。
经文所说的六经病证就是这样的。
或者一切吐泻霍乱（不问寒热），以及小儿泻痢惊风（不问急慢），都适宜服用。
桂苓甘露散（Guiling Ganlu San，一名桂苓白术散）治疗伤寒中风，冒暑饮食，内外一切所伤，传受热湿内甚，或者头痛、口干，或者吐泻、烦渴，或者小便赤涩、大便急痛，或者泻利间作，并一切湿热，霍乱吐泻，转筋急痛，腹满痛闷，或者中外诸邪所伤而并吐泻的，湿热之时尤其适宜服用。
并治疗小儿惊风。
白术散（Baizhu San）治疗伤寒杂病，一切吐泻、烦渴、霍乱、虚损及气弱久虚，保养衰老兼治酒膈呕哕。
四逆汤（Sini Decoction）治疗伤寒，表热未入于里，误以寒药泻下太早，其表热本未入，因而里寒，下利不止，或者表热里寒，自利不止的，紧急用四逆汤温里。
脉浮不渴，小便清白不温，完谷不化的就是这种情况。或者辨别大小便颜色的，须更审察其饮食万物的颜色。
或者泻下后协热利不止的，咽干烦渴的，谨慎不宜温补，适宜用五苓散之类疏散湿热。只有里寒的可以温补，止其寒泻。
利止里和，表证尚在的，紧急用桂枝汤解表。或者杂病寒饮呕吐的，或者寒湿泄泻的。
然而虽是杂病，如果是湿热吐泻的，不宜用此方。虽然也有湿热痞闭轻微的，误中辛热开发而有效，严重的强行劫夺不开，则怫热病转加重。只有里寒的可通用四逆汤。
茯苓半夏汤（Fuling Banxia Tang）治疗伤寒杂病，一切呕吐或者喘咳、头痛的。
半夏橘皮汤（Banxia Jupi Tang）治疗伤寒杂病，呕哕风眩，痰逆咳喘，头痛并风热反胃吐食诸证。
黄连解毒汤（Huanglian Jiedu Tang）治疗伤寒杂病，并酒燥热毒，烦闷干呕，口燥呻吟，错语，不得眠，凡一切大热狂躁喘满以及阴厥极甚，蓄热内深，世俗妄传为阴毒的（见前辨析）；表热太甚，头项、肢体痛不可忍，脉洪躁，里有微热不可发汗的；或者湿热内甚，或者欲作痢疾的。
或者已经下利，热势甚重的（并服用本方）；以及泻下之前后，寒凉诸药不能退其热势甚重的。两感诸证同法。
两感证：一日，太阳与少阴俱病，则头痛、口干而烦满；二日阳明与太阴俱病，则耳聋、囊缩而厥，通宜此方以退表里诸热。朱氏不明白这些都是热证，妄言前三日真为病寒，用四逆汤紧急温里，而后用桂枝汤紧急解表，大误人。
这两方都不可用，但只要随表与里，热势微甚以退其热，使不致热极而死即可。如果势甚宜泻下的，加大承气汤泻下。以及经文说的这三日传变，也是大概的方法。大体上适宜随证施治，也不必拘泥。
或者势甚欲泻下，担心不能退其热的，加大承气汤泻下。或者热结极深，而诸药多次泻下，毕竟不能通利，不救必死的，此法再加甘遂末一钱以下之（吐利同效）。或者但自热结胸中，心胸高起，腹部虽不满，但喘急、闷结、谵妄、昏冒，关脉沉数而紧的，尤其适宜此法紧急泻下。
(1. Also known as Wind-Strike)
The syndrome of wind-strike presents with headache, stiffness of the neck and nape, severe pain in the thighs and joints, or eye pain, muscle heat, dry retching, nasal congestion (rhonchus), warmth of the hands and feet, spontaneous sweating, and aversion to wind and cold. The pulse is floating and slow at the Yang position (anterior to the cun-guan-chi junction) and floating and weak at the Yin position (posterior to the cun-guan-chi junction). This indicates pathogenic heat located on the exterior, representing a syndrome suitable for Guizhi Tang (Cinnamon Twig Decoction) to resolve the muscle layer and release the exterior. If there is sweating, aversion to wind, accompanied by stiffness and pain in the nape and back, Guizhi Tang plus Puerariae Radix Decoction (Guizhi Jia Gegen Tang) is appropriate. Conversely, if there is no sweating, Puerariae Decoction (Gegen Tang) is appropriate. Although Guizhi Tang has been administered, if vexation persists without interior signs, first puncture Fengchi (GB20) and Fengfu (GV16), then administer Guizhi Tang again. Or, after taking Guizhi Tang, if there is profuse sweating and a floating, surging-large pulse, it is appropriate to administer Guizhi Tang again. About half a day after sweating, if fever and vexation recur with a floating and rapid pulse, Guizhi Tang is appropriate again. If purgation is used instead of diaphoresis, resulting in diarrhea with undigested food but without chest binding (Jie Xiong), while exterior signs remain, this is exterior heat and interior cold, caused by the mistaken use of cold purgatives like Chengqi Decoctions. If mistakenly treated with hot purgatives like Crotonis Fructus (Badou), leading to persistent diarrhea with heat, or if both exterior and interior are hot with spontaneous diarrhea or vomiting, Triauretum (Wuling San) is appropriate to stop diarrhea and release the exterior simultaneously. Urgently use Sini Decoction (Sini Tang) to warm the interior; once diarrhea stops and the interior harmonizes, urgently use Guizhi Tang to release the exterior.
If the exterior is hot but the interior is harmonized, the treatment for diarrhea is the same.
In Yangming Disease (Yangming Bing), with a floating and slow pulse, sweating, and slight aversion to cold, or in Taiyin Disease (Taiyin Bing), with abdominal fullness and a floating pulse, Guizhi Tang is appropriate.
If the pulse is unexpectedly deep and solid, Major Order the Yellow Decoction (Dachengqi Tang) should be used to purge.
If purgation is performed too early, resulting in epigastric stuffiness, sweating, aversion to cold, and a floating pulse, the exterior has not yet resolved. First, use Guizhi Tang to release the exterior; subsequently, if blood appears in the stool, Tao Ren Chengqi Decoction (Taoren Chengqi Tang) or Didang Pill (Didang Wan) should be used to attack and remove blood stasis.
Head and neck pain, limb pain, and warmth of the hands and feet indicate Wind-Strike. Conversely, no sweating, aversion to cold, and a floating-tight pulse indicate Cold Damage (Shanghan). Head and neck pain, stiffness of the waist and spine, body rigidity, slight coldness of the fingertips, and absence of sweating also indicate Cold Damage. Conversely, irritability with a slow pulse indicates Wind-Strike. Wind injures the Defensive Qi (Wei Qi), while Cold injures the Nutritive Blood (Ying Blood). All things seek Yin for Yang and Yang for Yin; when Yin and Yang correspond, there is peace. Thus, Ying Blood is Yin; when Cold attacks, it injures it. Hence, Cold injures Blood, which is also Yin. Wei Qi is Yang; Wind is also Yang, so when Wind attacks, it injures it. Hence, Heat injures Qi, which is Yang. The classics state that Yin Cold governs closure and storage, while Yang Heat governs opening and dispersal. Therefore, when Cold injures Ying, the interstices become closed and dense,郁热 (stagnant heat) arises internally, causing dryness, heat, and anhidrosis, resulting in a rapid, floating, and tight pulse. When Wind injures Wei, the interstices open and disperse, causing spontaneous sweating, resulting in a floating and slow pulse. Because pathogenic heat dissipates, the pulse cannot be solid. Yangming governs the muscles, so profuse sweating leads to a surprisingly slow pulse. Heat is the utmost Yang within Yang; thus, injury by heat causes profuse spontaneous sweating. Although the disease is heat, the pulse is not solid but weak. However, stagnant heat with obstruction and anhidrosis is indeed a disease; even sweating freely can be pathological, as extreme ease turns to adversity. When human Qi is harmonious, sweat is produced, just as when Heaven and Earth Qi are harmonious, rain falls. Too much causes flooding, lack of rain causes drought; existence and non-existence, abundance and scarcity must be timely. Deviation from normality brings disaster. This applies to all matters.
When both Ying and Wei are injured, exterior and interior heat becomes severe, suitable for Da Qinglong Decoction (Da Qinglong Tang).
Xiao Qinglong Decoction (Xiao Qinglong Tang) treats Cold Damage where the exterior has not resolved, and there is fluid retention in the heart region.
Although the exterior has not resolved, heat has entered the interior, stagnating in the Stomach, preventing the transformation and dissemination of food and fluids, leading to accumulation and this condition. It is not due to excessive interior heat excess, thirst, and drinking, nor fluid retention causing pathology.
Dry retching, fever, and cough, or thirst, or diarrhea, or dysphagia, or difficulty urinating, lower abdominal fullness, or wheezing.
Fluids cannot moisten and disseminate, failing to nourish the intestines and organs, causing heat and thirst, dysphagia, wheezing, difficulty urinating, lower abdominal fullness, and wheezing; fluids cannot circulate, causing damp-heat to flourish in the intestines, leading to diarrhea.
Xiao Chaihu Decoction (Xiao Chaihu Tang) treats Cold Damage or Wind-Strike where the disease is half-exterior and half-interior (pulse located in the muscle layer, neither deep nor floating), with tendon and vessel rigidity.
Body pain, alternating chills and fever (aversion to cold indicates exterior heat, fever indicates interior heat). Alternating chills and fever indicate pathogenic heat half-exterior and half-interior, advancing and retreating incessantly, changing unpredictably.
Vomiting or coughing, epigastric and hypochondriac stuffiness, hardness, and pain, regardless of timing before or after onset, number of days, or residual heat after sweating, whether Cold Damage, miscellaneous diseases, steaming heat eruptions, or simultaneous contraction of two meridians, if reconciliation is possible, Xiao Chaihu Tang is appropriate.
Liangge San (Liangge San, also known as Lianqiao Yinzi) treats Cold Damage where the exterior has not resolved, half-entering the interior, with incomplete purgative indications, or recurrence without cure; or dry heat stagnating internally causing mental restlessness and insomnia; and regardless of Cold Damage, miscellaneous diseases, adults, children, internal organ heat accumulation, irritability, excessive thirst, facial heat, dizziness, dry lips, throat dryness, swollen tongue, pharyngeal obstruction, red eyes, epistaxis, hard nodules in the jaw and cheeks, mouth and tongue ulcers, phlegm obstruction, thick sticky sputum, restless sleep, delirium, mania, intestinal and stomach damp-dryness, difficult urination and defecation, all wind-heat congestion, wind vertigo, skin sores and tinea, Yangming Stomach heat rash in Cold Damage with incomplete purgative indications; or excessive intake of warming medicines causing various heat syndromes, alcohol toxicity, pediatric measles and smallpox eruption failure, convulsive fever with heat accumulation, indistinguishable Cold Damage; or severe heat with erupted but unsmooth smallpox; or extreme heat with black sinking indicating impending death.
Pediatric measles and smallpox not yet erupted, mistakenly treated with hot diaphoretics, intensifying Yang heat, causing dense, unsmooth eruption, often leading to black sinking and death. Consequently, laypeople often avoid medication for rashes, delaying treatment for many pediatric illnesses. They fail to realize that ancient cooling purgatives treat wind, convulsion, heat accumulation, and febrile diseases generally; even if mistakenly used for sores, they reduce heat slightly, allowing sparse but smooth eruption and early recovery. Using this formula is most excellent.
Yan Xiaozhong’s compilation *Xiao'er Fanglun* fails to understand Qian Yi’s original intent and the principles of creation, wrongly claiming black sinking in rashes is cold, and stating that cooling purgatives should never be used for rashes. Later generations followed this, leading to countless deaths from intensified heat and black sinking. Did Yan not note that Qian Yi’s formulas for black sinking, such as Niuli Gao and Baixiang Wan, involve cold purgatives that often result in recovery, whereas non-treatment leads to certain death? Thus, the heat nature of smallpox/rashes is clear. Moreover, the classics state: "All pain, itching, sores, and ulcers belong to the Heart." Regarding black sores, abdominal fullness, wheezing (hoarse breathing), and dark, scanty, obstructed urination invariably occur, indicating extreme heat. Since rashes originate from heat and worsen, how can they be cold?
For simultaneous contraction of two meridians (simultaneous transmission of three Yin and three Yang meridians), Liangge San is appropriate. In extreme heat Death-like states of Cold Damage, if Yin Qi is depleted, purgation is contraindicated; purging would cause sudden Yin collapse and subsequent Yang exhaustion and death. Instead, nourish Yin and retreat Yang until the pulse returns strong, then mildly purge with Sanyi Chengqi Decoction (Sanyi Chengqi Tang). If unresolved after purging, regulate with Liangge San. Even after recovery, take small amounts to prevent heat recurrence.
Baitu Tang (Baitu Tang) treats Wind-Strike with spontaneous sweating, where Guizhi Tang signs persist, half-entering the interior, suitable for reconciliation.
Pulse located in the muscle layer, unsuitable for purgation.
Or summerheat stroke with spontaneous sweating and a weak pulse.
Heat injuring Qi causes profuse spontaneous sweating, making the pulse weak rather than solid.
Or Cold Damage with spontaneous sweating, slippery-rapid-solid pulse, indicating both exterior and interior heat.
Pulse is forceful and rapid in both deep and floating positions; symptoms include fever, headache, irritability/thirst, abdominal fullness, and dark yellow urine. Or Three-Yang Combined Disease (simultaneous involvement of Taiyang, Shaoyang, and Yangming), abdominal fullness, heaviness, difficulty turning, dry mouth, dirty complexion, delirium, and urinary incontinence. Mistaken diaphoresis worsens delirium; purgation causes sweating on the forehead and later jaundice.
Or cold extremities with spontaneous sweating, termed Heat Dissipation (sweat dispersing heat). If interior heat with cold extremities (pulse reversal); or incomplete purgative indications; or reconciling simultaneous contraction of two meridians in Cold Damage. This formula best relieves headache and stops spontaneous sweating, applicable to summerheat, Cold Damage, wind-heat miscellaneous diseases, infectious epidemics, non-exterior wind-cold cases with non-floating pulses, spontaneous sweating, headache, and impending sweat eruptions.
Use according to syndrome regardless of season. Other formulas follow this principle.
Triauretum (Wuling San) treats summerheat stroke, and post-profuse sweating in Cold Damage causing gastric dryness, irritability, insomnia, floating pulse, difficulty urinating, subsequent heat/vexation/thirst, and both exterior/interior heat with water regurgitation (Shui Ni); or unresolved epigastric stuffiness; or dry mouth/vexation/thirst with difficulty urinating; or persistent stuffiness with diarrhea; or mistaken purgation after needing diaphoresis, causing persistent diarrhea, floating pulse, unresolved exterior, spontaneous diarrhea, or difficulty urinating.
When using Wuling San, apply regardless of pulse depth or superficiality.
For all retained fluid accumulations, use this powder to disperse water, stop thirst, and reconcile simultaneous contraction, involving Taiyang and Shaoyin diseases.
This refers to the six-meridian disease patterns mentioned in the classics.
For all vomiting/diarrhea cholera (regardless of cold/heat), and pediatric diarrhea with convulsions (regardless of acute/chronic), it is appropriate.
Guiling Ganlu San (Guiling Ganlu San, also Guiling Baizhu San) treats Cold Damage/Wind-Strike, summerheat exposure, dietary injury, and all internal/external injuries transmitting severe damp-heat; or headache, dry mouth; or vomiting/diarrhea, irritability/thirst; or dark/scanty urination, urgent bowel pain; or intermittent diarrhea; and all damp-heat, cholera vomiting/diarrhea, tetanic cramps, abdominal fullness/pain/distension, or mixed pathogenic injuries causing vomiting/diarrhea. Especially suitable during damp-heat seasons.
Also treats pediatric convulsions.
Baizhu San (Baizhu San) treats Cold Damage and miscellaneous diseases, all vomiting/diarrhea, irritability/thirst, cholera, deficiency, chronic Qi weakness, preservation of aging, and alcoholic epigastric obstruction with retching.
Sini Decoction (Sini Tang) treats Cold Damage where exterior heat has not entered the interior, but premature cold purgation caused interior cold, persistent diarrhea, or exterior heat/interior cold with persistent diarrhea. Urgently use Sini Tang to warm the interior.
Floating pulse without thirst, clear/cold urine, undigested food in stool. Observe stool/urine color, considering dietary influences.
If post-purgation diarrhea with heat persists, with dry throat and irritability, cautiously avoid warming; use Wuling San to dissipate damp-heat. Only interior cold warrants warming to stop cold diarrhea.
Once diarrhea stops and interior harmonizes, if exterior signs remain, urgently use Guizhi Tang to release the exterior. For miscellaneous disease cold-fluid vomiting or cold-damp diarrhea.
However, for miscellaneous disease damp-heat vomiting/diarrhea, this formula is inappropriate. Mild damp-heat obstruction might respond to acrid-warm dispersal, but severe cases forced open will worsen stagnant heat. Only interior cold universally suits Sini Tang.
Fuling Banxia Tang (Fuling Banxia Tang) treats Cold Damage/miscellaneous diseases, all vomiting, wheezing/cough, headache.
Banxia Jupi Tang (Banxia Jupi Tang) treats Cold Damage/miscellaneous diseases, vomiting/retching, wind vertigo, phlegm-reversal wheezing/cough, headache, wind-heat reverse flow vomiting.
Huanglian Jiedu Tang (Huanglian Jiedu Tang) treats Cold Damage/miscellaneous diseases, alcohol dryness-heat toxicity, irritability, dry retching, dry mouth, groaning, confused speech, insomnia, all severe heat/maniacal restlessness/wheezing/fullness, extreme Yin cold extremities, deep internal heat accumulation (mistakenly called Yin Toxin by laypeople); severe exterior heat with unbearable head/neck/limb pain, surging-restless pulse, slight interior heat unsuitable for diaphoresis; or severe internal damp-heat, or impending dysentery.
Loose frequent stools with lower abdominal urgency/pain, dark or obstructed urination indicate impending dysentery.
If already diarrheic with severe heat (take this formula); or pre/post-purgation where cold medicines fail to reduce severe heat. Simultaneous contraction cases follow this method.
Simultaneous Contraction: Day 1, Taiyang and Shaoyin both diseased, causing headache, dry mouth, irritability/fullness; Day 2, Yangming and Taiyin both diseased, causing deafness, scrotal retraction, cold extremities. Universally use this formula to reduce exterior/interior heat. Zhu Shi misunderstood these as heat syndromes, wrongly claiming the first three days were true cold, urging Sini Tang to warm the interior and Guizhi Tang to release the exterior, a major error.
Neither of these two formulas should be used blindly; rather, adjust based on exterior/interior and heat severity to reduce heat and prevent death from extreme heat. If severe and requiring purgation, add Dachengqi Tang. The classic mention of three-day transmission is a general rule. Treatment should follow the syndrome, not rigid adherence.
If severe and requiring purgation, fearing heat persistence, add Dachengqi Tang. If heat knot is extremely deep, multiple purgations fail, leading to inevitable death, use this method adding one qian of Kansui Root powder (Gansui) to purge (effective for vomiting/diarrhea). If heat knots only in the chest, chest elevation, abdominal fullness absent but with wheezing, oppression, delirium, coma, and deep-rapid-tight Guan pulse, this method urgently purging is especially indicated.