【纲】仲景曰。伤寒脉迟。六七日。而反与黄芩汤彻其热。脉迟为寒。今与黄芩汤复除其热。
腹中应冷。当不能食。今反能食。此名除中。必死。
【目】刘完素曰。除者。除去也。与除夕之除同义。夫脉迟为寒。胃中真阳已薄。不可更与凉
药。盖胃暖乃能纳食。今胃冷而反能食。则是胃之真气发露无余。而胃阳亦必渐去而不能久存。故
必死。腹中。即胃中也。
魏荔彤曰。此为阳虚阴寒家立法。见厥阴一症。原寒热杂合。其盈虚消息之机。全在临时斟酌。
为阳气盛。热有余。则越之散之。甚且凉之下之。为阴气盛。热不足。则升之举之。甚且温之补之。
俱难一以为治也。此固为厥阴传经之邪言之。而不止此也。伤寒中何经不然。杂病中何症不然。故
此条俱未尝专指厥阴也。学人可不察乎。
【纲】仲景曰。眼睛不慧。语言不出。而设食反多者。此为除中。口虽欲言。舌不能言。
伤寒始发热六日。厥反九日而利。凡厥利者。当不能食。今反能食者。恐为除中。食以索饼。
不发热者。知胃气尚在。必愈。恐暴热来出而复去也。后三日脉之。其热续在者。期之旦日夜半愈。
【目】杨士瀛曰。除中者。脏寒应不能食。今反能食是也。有三症。悉属厥阴。其一由误服黄
芩汤而致。期以必死。其一则热少厥多。胃气在者愈。暴来出而复者死。其热续在者生。此不因药
故也。其一至眼不慧。舌不能言。则为坏症。必死
【纲】张仲景说：患伤寒病，脉象迟缓。经过六七天，反而给予黄芩汤来清除其热。脉迟代表寒证，现在用黄芩汤再次去除其热，腹中应当变冷，按理应该不能进食，现在反而能进食，这叫做“除中”，必定死亡。
【目】刘完素说：“除”的意思是除去，与除夕的“除”意思相同。脉迟为寒证，胃中的真阳已经薄弱，不可再给予凉药。因为胃暖才能接纳食物，现在胃冷却反而能进食，这是胃的真气完全暴露无余，而胃阳也必将逐渐离去而不能长久存在，所以必定死亡。“腹中”指的就是胃。
魏荔彤说：这是为阳虚阴寒体质的人确立的治疗法则。见到厥阴病这一症状，原本就是寒热错杂，其虚实消长的关键，全在于临时的斟酌权衡。如果是阳气盛、热有余，就用发散的方法；甚至用清凉或攻下的方法。如果是阴气盛、热不足，就用升提或举托的方法；甚至用温补的方法。这些都难以用单一的方法治疗。这固然是在谈论厥阴经传变的邪气，但不仅仅局限于此。伤寒病中哪一经不是这样？杂病中哪个症状不是这样？所以这条条文并没有专门指代厥阴经。学习的人怎能不仔细考察呢？
【纲】张仲景说：眼睛昏花不明，语言不能发出，如果给予食物反而吃得很多，这叫做“除中”。口虽然想说话，但舌头不能言语。
伤寒开始发热六天，四肢厥冷反而持续九天并且伴有下利。凡是出现厥冷和下利的，应当不能进食，现在反而能进食，恐怕是“除中”。给患者吃索饼（面条），如果不发热，说明胃气还在，必定痊愈。担心的是突然发热随后又消失。三天后诊察脉象，如果热度持续存在，预期在第二天半夜痊愈。
【目】杨士瀛说：“除中”是指脏腑寒冷本应不能进食，现在反而能进食的情况。有三种症状表现，都属于厥阴病。第一种是由误服黄芩汤导致的，预期必定死亡。第二种是热少厥多，如果胃气尚存则痊愈，如果突然发热随后又消失则死亡，如果热度持续存在则生存。这种情况不是因为用药错误引起的。第三种是眼睛昏花不明，舌头不能言语，这就属于坏病，必定死亡。
[Outline] Zhang Zhongjing stated: In Taiyang disease (Sun Yang Disease), if the pulse is slow, and after six or seven days, one mistakenly administers Huangqin Tang (Scutellaria Decoction) to clear heat. A slow pulse indicates cold. By administering Huangqin Tang to further remove heat, the abdomen should become cold, and logically, the patient should be unable to eat. However, if the patient can eat contrary to expectation, this is termed "Chu Zhong" (Elimination of the Middle). This condition is fatal.
[Commentary] Liu Wansu explained: "Chu" means to remove, identical in meaning to "Chu Xi" (New Year's Eve). A slow pulse indicates cold; the true Yang energy in the stomach is already thin. One must not administer cooling medicines. Since a warm stomach is required to accept food, if the stomach is cold yet the patient can eat, it signifies that the true Qi of the stomach is exposed without reserve, and Stomach Yang will inevitably gradually depart and cannot persist long. Therefore, it is fatal. "Abdomen" here refers to the stomach.
Wei Litong stated: This establishes a principle for patients with Yang deficiency and Yin-cold constitution. Observing the symptom of Jueyin disease (Jueyin Disorder), which is originally a mixture of cold and heat, the mechanism of waxing and waning depends entirely on temporary deliberation. If Yang Qi is excessive and heat is surplus, disperse and scatter it; even use cooling or purging methods. If Yin Qi is excessive and heat is insufficient, lift and raise it; even use warming and tonifying methods. It is difficult to treat these with a single method. This certainly discusses pathogens transmitted through the Jueyin channel, but not limited to this. Which meridian in Shanghan (Cold Damage) is not like this? Which symptom in miscellaneous diseases is not like this? Thus, this clause does not specifically refer only to Jueyin. Students must examine this carefully.
[Outline] Zhang Zhongjing stated: When the eyes are dim and vision unclear, and speech cannot be produced, yet the patient eats more when offered food, this is called "Chu Zhong". Although the mouth desires to speak, the tongue cannot articulate.
In Shanghan disease, fever began for six days, but cold extremities (Jue) lasted for nine days accompanied by diarrhea. Generally, those with cold extremities and diarrhea should be unable to eat. If they can eat now, one should fear "Chu Zhong". Feed the patient Suobing (noodle cakes). If there is no fever, it indicates that Stomach Qi remains, and recovery is certain. The concern is whether sudden heat will appear and then disappear. Three days later, upon palpating the pulse, if the heat continues, recovery is expected at midnight of the next day.
[Commentary] Yang Shiying stated: "Chu Zhong" refers to the condition where internal cold should prevent eating, yet the patient can eat. There are three presentations, all belonging to Jueyin. The first results from the mistaken administration of Huangqin Tang (Scutellaria Decoction), leading to certain death. The second involves less heat and more cold extremities; if Stomach Qi remains, the patient recovers; if sudden heat appears and then disappears, the patient dies; if heat continues, the patient lives. This case is not due to medication error. The third presentation involves dim eyes and an inability of the tongue to speak, constituting a "Huai Bing" (ruined disease/complication), which is fatal.