柴胡汤原方，加芒硝，分两各不同。
柴胡（二两十六铢） 黄芩 甘草（炙） 人参 生姜（切，各一两） 半夏（二十铢） 大枣（四枚，擘） 芒
硝（二两） 上八味，以水四升，煮取二升，去渣，纳芒硝，更煮微沸，分温再服，不解更作。不解，不大便也。
此药剂之最轻者，以今秤计之，约二两，分二服，则一服，止一两耳。
按∶大柴胡汤，加大黄、枳实，乃合用小承气也；此加芒硝，乃合用调胃承气也。皆少阳阳明同治之方。
伤寒十三日不解，胸胁满而呕，日晡所发潮热，已而微利，此本柴胡证，下之而不得利，今反利者，知
医以丸药下之，此非其治也。潮热者实也，先宜服小柴胡汤以解外，后以柴胡加芒硝汤主之。《本草》∶芒
硝治六腑积聚。因其利而复下之，所谓通因通用之法也，潮热而利，则邪不停结，故较之大柴胡症，用药稍轻。
栀子（十四枚，擘） 香豉（四合，绵裹） 上二味，以水四升，先煮栀子，得二升半，纳豉，煮取升半，去
渣，分为二服，温进一服，得吐者，止后服。此剂分两最小，凡治上焦之药皆然。
发汗吐下后，诸法俱用，未必皆误，而正气已伤矣。虚烦不得眠，虚为正气虚，烦为邪气扰。发汗吐
下，实邪虽去，而其余邪，因正气不充，留于上焦，故阳气扰动而不得眠也。若剧者，必反复颠倒，心中懊
，反复颠倒，身不得宁也；心中懊 ，心不得安也。栀子豉汤吐之。此非汗下之所能除者，吐之而痰涎
结气，无不出矣。
按∶汗、吐、下之后，而邪未尽，则不在经而在肺胃之间，为有形之物，故必吐而出之，反复颠倒，心
中懊 。摩写病状，何等详切，凡医者之于病患，必事事体贴，如若身受之，而后用药无误。
发汗若下之，而烦热胸中窒者，烦热且窒，较前虚烦等象为稍实。栀子豉汤主之。
伤寒五、六日，大下之后，误治。身热不去，心中结痛者，未欲解也。外内之邪，俱未解，结痛更甚于
窒矣。栀子豉汤主之。按∶胸中窒，结痛，何以下用小陷胸？盖小陷胸症，乃心下痛，胸中在心之上，故
不得用陷胸。何以不用泻心诸法？盖泻心症乃心下痞，痞为无形，痛为有象，故不得用泻心。古人治病，非
但内外不失厘毫，即上下亦不逾分寸也。
阳明病，脉浮而紧，咽燥口苦，胸满而喘，发热汗出，不恶寒，反恶热身重，以上皆阳明本症，非因
误治而得者。若发汗则躁，心愦愦反谵语，汗多阳虚。若加烧针，必怵惕、烦躁不得眠，即前以火逼汗，亡
阳惊狂之意。若下之，则胃中空虚，客气动膈，心中懊 ，以前因用三法，未必合度，故病不解，各有现
症如此。舌上苔者，此句乃要诀，舌上有白苔，则胸中有物，而可用吐法。否则，邪尚未结，恐无物可
吐也。栀子豉汤主之。
阳明病，下之，其外有热，表邪未尽。手足温，不
结胸，无实邪。心中懊 ，饥不能食，痰涎停结。但头汗出，阳邪在上，欲泄不泄。栀子豉汤主之。
下利后，更烦，按之心上濡者，濡者，湿滞之象，非窒非痛也。为虚烦也，宜栀子豉汤。
柴胡汤的原方，加入芒硝，各药物的分量各不相同。
柴胡（二两十六铢） 黄芩 甘草（炙） 人参 生姜（切，各一两） 半夏（二十铢） 大枣（四枚，擘开） 芒硝（二两） 以上八味药，用水四升，煎煮至剩余二升，滤去药渣，加入芒硝，再稍微煮沸，分两次温服，若病不解，再制作服用。所谓“不解”，是指大便不通。
此药剂是分量最轻的，以现在的秤计算，大约二两，分两次服用，那么一次服用，仅一两而已。
按：大柴胡汤，加入大黄、枳实，乃是合用小承气汤的意思；此处加入芒硝，乃是合用调胃承气汤的意思。都是少阳病与阳明病同治的方剂。
伤寒病十三天仍未解除，胸胁部胀满且呕吐，傍晚时分出现潮热，随后轻微腹泻，这原本属于柴胡汤证，误用下法后并未导致腹泻，现在反而腹泻了，可知医生使用了丸药进行攻下，这不是正确的治疗方法。出现潮热说明体内有实邪，先宜服用小柴胡汤以解除表邪，随后用柴胡加芒硝汤为主进行治疗。《本草》记载：芒硝治疗六腑的积聚。因为已经腹泻而再次使用泻下法，这就是所谓的“通因通用”的治疗方法。出现潮热且腹泻，说明邪气没有停聚结块，所以相较于大柴胡汤证，用药稍轻。
栀子（十四枚，擘开） 香豉（四合，绵纸包裹） 以上两味药，用水四升，先煮栀子，取汁二升半，加入香豉，再煎煮至剩余半升，滤去药渣，分为两次服用，温服一次，如果引起呕吐，则停止后续服用。此药剂的分量最小，凡是治疗上焦的药物大多如此。
经过发汗、催吐、泻下之后，各种方法都使用过，未必都是错误，但正气已经受损。出现虚烦不得睡眠，“虚”指正气虚弱，“烦”指邪气干扰。发汗、催吐、泻下后，实邪虽然去除，但其余留的邪气，因为正气不充足，停留于上焦，所以阳气扰动而导致无法入睡。如果病情严重，必定会出现翻来覆去、心中烦闷懊恼的症状，“反复颠倒”指身体无法安宁；“心中懊恼”指内心无法安定。此时应用栀子豉汤催吐。这不是发汗或泻下所能消除的，通过催吐，痰涎和郁结的气机，没有不能排出的。
按：在发汗、催吐、泻下之后，如果邪气未完全清除，则病位不在经络而在肺胃之间，形成了有形之物，所以必须通过催吐将其排出。“反复颠倒，心中懊恼”，对病状的描写何等详细确切，凡医者对待病患，必须事事体贴入微，如同自己亲身经历一样，这样用药才无误。
经过发汗或泻下后，出现烦热且胸中窒塞感的，烦热且窒塞，较之前的虚烦等症状稍微属实。应用栀子豉汤为主治疗。
伤寒五六天，经过猛烈攻下之后，属于误治。身体发热不退，心中结痛，说明病未解除。外感和内生的邪气都未解除，结痛比之前的窒塞感更严重。应用栀子豉汤为主治疗。按：胸中窒塞、结痛，为何不用小陷胸汤？因为小陷胸汤证是心下（胃脘部）疼痛，胸中位于心之上，所以不能用陷胸汤。为何不用泻心汤诸法？因为泻心汤证是心下痞满，痞满是无形之气滞，疼痛是有形的征象，所以不能用泻心汤。古人治病，不仅内外不差分毫，上下也不越分寸。
阳明病，脉象浮而紧，咽干口苦，胸满气喘，发热汗出，不恶寒，反恶热身体沉重，以上这些都是阳明病的本证，并非因误治而得的。如果发汗，则会出现烦躁，心中昏乱甚至谵语，这是汗多导致阳虚。如果加用烧针，必定会出现恐惧惊惕、烦躁不得睡眠，即前面所说的用火逼汗导致亡阳惊狂的意思。如果误用下法，则胃中空虚，客气动膈，心中懊恼，这是因为之前使用三种疗法，未必合乎法度，所以病未解除，各自出现上述症状。舌上有苔，这句话是关键要点，舌上有白苔，说明胸中有物，可以使用催吐法。否则，邪气尚未结聚，恐怕无物可吐。应用栀子豉汤为主治疗。
阳明病，经过泻下后，体表仍有热邪，说明表邪未尽。手足温暖，没有形成结胸，说明无实邪。心中懊恼，饥饿但不能进食，这是痰涎停聚结滞的表现。只有头部出汗，是因为阳邪在上，想要宣泄却无法宣泄。应用栀子豉汤为主治疗。
腹泻之后，更加烦躁，按压心窝处感觉柔软濡软的，濡软，是湿滞的现象，不是窒塞也不是疼痛。属于虚烦，适宜用栀子豉汤。
The original formula of Chaihu Tang (Bupleurum Decoction), with the addition of Mangxiao (Mirabilite), has different dosages for each herb.
Chaihu (2 liang 16 zhu) Huangqin (Scutellaria Root) Gancao (Licorice Root, honey-fried) Renshen (Ginseng Root) Shengjiang (Fresh Ginger Slice, cut, each 1 liang) Banxia (Pinellia Tuber, 20 zhu) Dazao (Jujube Fruit, 4 pieces, torn open) Mangxiao (Mirabilite, 2 liang). The above eight herbs are boiled in 4 sheng of water until reduced to 2 sheng. Strain the dregs, add Mangxiao, and boil slightly until bubbling. Divide into two warm doses. If the condition is not resolved, prepare another dose. "Not resolved" refers to constipation.
This prescription is the lightest in dosage. Calculated by modern weights, it is approximately 2 liang. Divided into two doses, one dose amounts to only 1 liang.
Note: Da Chaihu Tang (Major Bupleurum Decoction) adds Dahuang (Rhubarb Root) and Zhishi (Immature Bitter Orange), effectively combining the effects of Xiao Chengqi Tang (Minor Order the Qi Decoction); this formula adds Mangxiao, effectively combining the effects of Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction). Both are formulas treating Shaoyang Yangming combined syndromes.
After thirteen days of Taiyang cold damage without resolution, there is fullness and distension in the chest and hypochondrium with vomiting, tidal fever occurring in the late afternoon, followed by slight diarrhea. This originally belongs to a Chaihu syndrome. After improper purgation, diarrhea did not occur; now, conversely, diarrhea has occurred. It is known that the physician used pill-based purgatives, which was not the correct treatment. Tidal fever indicates excess pathogenic factors. First, administer Xiao Chaihu Tang (Minor Bupleurum Decoction) to resolve the exterior, then treat primarily with Chaihu Jia Mangxiao Tang (Bupleurum Decoction plus Mirabilite). *Bencao* states: Mangxiao treats accumulations in the six fu organs. Since diarrhea has already occurred, using purgation again exemplifies the method of "treating obstruction with unblocking agents" (Tong Yin Tong Yong). With tidal fever and diarrhea, the pathogen does not stagnate and knot, so the medication is slightly milder compared to Da Chaihu Tang syndrome.
Zhizi (14 Gardenia Fruits, torn open) Xiangchi (4 he Fermented Soybeans, wrapped in silk). The above two herbs are boiled in 4 sheng of water. First boil Zhizi until 2.5 sheng remains, then add Xiangchi, and boil until 0.5 sheng remains. Strain the dregs and divide into two doses. Take one dose warm. If vomiting occurs, stop taking the subsequent dose. This prescription has the smallest dosage; this is typical for all medicines treating the Upper Jiao.
After sweating, vomiting, and purging methods have all been employed, they may not all have been errors, but the Righteous Qi (Zheng Qi) has already been damaged. Deficiency vexation and insomnia occur. "Deficiency" refers to the deficiency of Righteous Qi; "vexation" refers to disturbance by pathogenic factors. Although excess pathogens are removed after sweating, vomiting, and purging, residual pathogens remain in the Upper Jiao due to insufficient Righteous Qi, causing agitation of Yang Qi and resulting in inability to sleep. In severe cases, there must be tossing and turning with inner restlessness ("Ao Nao"). "Tossing and turning" means the body cannot find peace; "inner restlessness" means the heart/mind cannot find tranquility. Apply Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) to induce vomiting. This cannot be eliminated by sweating or purging; inducing vomiting will expel phlegm-fluids and stagnant Qi.
Note: After sweating, vomiting, and purging, if pathogens are not fully cleared, the disease is no longer in the meridians but between the Lung and Stomach, forming tangible pathological products. Therefore, it must be expelled via vomiting. The description of "tossing and turning and inner restlessness" is extremely detailed and precise. Physicians must empathize with patients as if experiencing the symptoms themselves to ensure accurate medication.
After sweating or purging, if vexation-heat and chest oppression occur, the vexation-heat and oppression are slightly more substantial than previous deficiency vexation symptoms. Treat primarily with Zhizi Chi Tang.
During Taiyang cold damage, five or six days later, after violent purging (mis-treatment), body heat persists, and there is knotted pain in the heart/chest area, indicating the disease has not resolved. Both external and internal pathogens remain unresolved; the knotted pain is more severe than simple oppression. Treat primarily with Zhizi Chi Tang. Note: Why not use Xiao Xianxiong Tang (Minor Chest-Harmonizing Decoction) for chest oppression and knotted pain? Because Xiao Xianxiong Tang syndrome involves pain in the Xin Xia (epigastrium/substernal region). The chest is above the heart, so Xianxiong Tang should not be used. Why not use various Xiexin Tang (Drain the Epigastrium Decoctions)? Because Xiexin Tang syndrome involves epigastric fullness-stuffiness (Pi), which is formless Qi stagnation, whereas pain is a tangible sign, so Xiexin Tang should not be used. Ancient physicians treated diseases with precision, ensuring no deviation internally or externally, nor exceeding boundaries vertically.
Yangming disease presents with floating and tight pulse, dry throat and bitter taste, chest fullness and wheezing, fever and sweating, aversion to cold absent but aversion to heat and heavy body present. These are all primary Yangming symptoms, not acquired through mis-treatment. If sweating is induced, irritability, mental confusion, and delirium may occur, indicating Yang deficiency due to excessive sweating. If burning needles are added, fearfulness, palpitations, irritability, and insomnia will definitely occur, reflecting the previous concept of Yang collapse and mania caused by fire-induced sweating. If purging is applied, the Stomach becomes empty, rebellious Qi agitates the Diaphragm, causing inner restlessness. This is because the previous three therapies were likely inappropriate, leading to unresolved disease and these specific manifestations. "Coating on the tongue" is a key diagnostic clue. A white coating on the tongue indicates material accumulation in the chest, allowing for emetic therapy. Otherwise, if pathogens have not yet knotted, there may be nothing to vomit. Treat primarily with Zhizi Chi Tang.
In Yangming disease, after purging, if heat remains on the exterior, it indicates incomplete resolution of exterior pathogens. Hands and feet are warm, ruling out Jie Xiong (Chest Binding). There is no excess pathogen. Inner restlessness, hunger but inability to eat, indicate retention and knotting of phlegm-fluids. Only head sweating occurs because Yang pathogens are above, attempting to vent but failing. Treat primarily with Zhizi Chi Tang.
After diarrhea, if vexation increases, and pressing the epigastrium reveals softness/fluidity (Ru), where "softness" indicates damp stagnation rather than oppression or pain, it constitutes deficiency vexation. Zhizi Chi Tang is appropriate.