（俱见后第七卷少阳篇中）
伤寒十三日不解。胸胁满而呕。（云云至）先宜小柴胡汤以解外。后以柴胡加芒硝汤主之。（此条亦系少阳病。正文
与注并汤。俱见后少阳篇中。）
伤寒十三日不解。过经。谵语者。以有热也。当以汤下之。（云云至）此为内实也。调胃承气汤主之。（按此条证。
系阳明府病。正文与注并汤。俱见后第六卷阳明篇中。）
太阳病不解。热结膀胱。其人如狂血自下。下者愈。其外不解者。尚未可攻。当先解外。外解已。但少腹急结者。
乃可攻之。宜桃核承气汤。（太阳病邪热不解。随经入府。结于膀胱。太阳为多血之经。府有结热。则经中之血。与热相
搏。蓄于下焦。其人如狂。如狂者。乃邪热之气。上熏于心。以故妄乱。与狂相似也。血自下者。邪热随血而出。故云。
愈也。若其人外不解。外即表也。表邪不解。里虽蓄血。尚未可攻。谓当先解其外。外得解已。但少腹急结者。此可验
膀胱热结。下焦蓄血也。乃可竟用药以攻之。成注云。与桃核承气汤以下热散血。愚以下热散血。当作下血散热。夫血
乃有形之物。可下而不可散。热乃无形之气。可散而不可下。）
成注字义。亦欠斟酌。又按热结膀胱。膀胱乃小腹中之物。膀胱热结。其气蒸于少腹。则血不流利。故作急结之形。
为下焦蓄血之证谛也。所以桃核承气汤。乃攻下焦蓄血。治少腹急结之药。实非通膀胱热结之药也。条辩注云。少腹指
膀胱，急结者，有形之血蓄积也。尚论篇注云。少腹急结。为膀胱之血。蓄而不行。若似乎血在膀胱以内。则是服桃核
承气汤后。蓄血当从小便中出矣。二家所言殊欠分析。又按此条论云。外不解者。尚未可攻。仲景当日。独缺解外药。
补亡论郭白云。采千金方云。宜桂枝汤。及考内台方议云。若其外证不解。或脉带浮。或恶寒。或身痛等证。尚未可攻。
且与葛根汤。以解其外。上二汤。皆太阳病解外之药。学人宜临证消息用之。
（以上内容均详见后文第七卷少阳篇中）
伤寒病经过十三天仍未痊愈。出现胸胁部胀满且伴有呕吐。（中间省略部分文字）治疗上应先使用小柴胡汤来解除表邪，随后再用柴胡加芒硝汤主治。（此条文同样属于少阳病范畴，正文、注释及方剂均详见后文少阳篇中。）
伤寒病经过十三天仍未痊愈，病情已传变至他经（过经）。出现胡言乱语的症状，这是因为体内有热邪。应当用汤剂进行攻下治疗。（中间省略部分文字）这属于里实热证，应使用调胃承气汤主治。（按：此条证候属于阳明腑病，正文、注释及方剂均详见后文第六卷阳明篇中。）
太阳病未愈，热邪结聚于膀胱部位。患者出现神志失常、似狂非狂的症状，若瘀血自行排出，则病可愈。若表证仍未解除，则尚不可使用攻下法，应当先解除表证。待表证解除后，仅见少腹部拘急硬痛者，才可进行攻下治疗，宜选用桃核承气汤。（太阳病的邪热未解，随经脉传入脏腑，结聚于膀胱。太阳经是多血之经，腑中有结热，则经脉中的血液与热邪相互搏结，蓄积于下焦。患者出现似狂非狂的症状，所谓“如狂”，是因为邪热之气上熏于心，导致心神妄乱，表现为类似发狂的状态。若瘀血能自行排出，说明邪热随血而出，所以说病可愈。如果患者表证未解，即体表邪气未除，虽然里有蓄血，也暂不可攻下，意为应当先解其表。待表证解除后，仅见少腹部拘急硬痛，这是验证膀胱热结、下焦蓄血的指征，此时方可用药攻下。成无己注解说：“给予桃核承气汤以泻热散血。”我认为“泻热散血”应改为“下血散热”。因为血是有形的物质，可以攻下但不能消散；热是无形的邪气，可以清散但不能攻下。）
成无己注解的字义，也欠斟酌。另外按：热结膀胱，膀胱位于小腹之中。膀胱热结，热气蒸腾于少腹，导致血液运行不畅，从而出现拘急硬痛的表现，这正是下焦蓄血证的确切依据。所以桃核承气汤是攻逐下焦蓄血、治疗少腹急结的药物，实在不是通利膀胱热结的药物。条辩注解说：“少腹指膀胱，急结是指有形的血液蓄积。”尚论篇注解说：“少腹急结，是膀胱之血蓄积不行，似乎血在膀胱内部。”如果是这样，那么服用桃核承气汤后，蓄血应当从小便中排出了。这两家的说法都缺乏细致的分析。另外按：此条论述说：“外不解者，尚未可攻。”张仲景当时唯独缺少解除表邪的方药。《补亡论》引用郭白云的说法，采集《千金方》的内容，认为宜用桂枝汤。又考证《内台方议》指出：“若其表证未解，或脉象带浮，或有恶寒、身痛等症状，尚不可攻下，暂且给予葛根汤以解其表。”上述两个方剂，都是治疗太阳病解除表邪的药物，学习中医的人应当在临证时仔细斟酌使用。
(The above content is detailed in the Shaoyang Chapter of Volume 7 later.)
After thirteen days, the Shanghan (Cold Damage) disease has not yet resolved. The patient presents with fullness and distension in the chest and hypochondrium accompanied by vomiting. (Omitted text...) Initially, Xiaochaihu Tang (Minor Bupleurum Decoction) should be used to resolve the exterior syndrome. Subsequently, Chaihu Jia Mangxiao Tang (Bupleurum Decoction with Natrii Sulfas) should be administered as the main treatment. (This clause also belongs to the category of Shaoyang disease; the main text, annotations, and formulas are all found in the Shaoyang Chapter later.)
After thirteen days, the Shanghan disease has not yet resolved, and the pathogen has passed through the meridians (Guojing). The patient exhibits delirium due to internal heat. A decoction should be used for purgation. (Omitted text...) This constitutes an interior excess syndrome; Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) should be prescribed. (Note: This syndrome pattern belongs to Yangming Fu-organ disease; the main text, annotations, and formulas are all found in the Yangming Chapter of Volume 6 later.)
When the Taiyang disease does not resolve, heat accumulates in the Bladder region. The patient manifests a manic-like state (Rukuang); if blood discharges spontaneously, the condition will heal. If the exterior syndrome remains unresolved, attack (purgation) is not yet permissible; one must first resolve the exterior. Once the exterior is resolved, if there is only urgency and binding sensation in the lower abdomen, then attack may proceed, using Taohao Chengqi Tang (Peach Pit Direct-Downward Decoction). (The pathogenic heat of Taiyang disease fails to resolve and follows the meridians into the fu-organs, accumulating in the Bladder. The Taiyang meridian is rich in blood. When heat binds in the fu-organ, the blood within the meridians contends with the heat and stagnates in the Lower Jiao. The patient presents with a manic-like state. "Manic-like" refers to the turbid heat qi steaming upward to affect the Heart, causing mental confusion resembling mania. If blood discharges spontaneously, it indicates that the pathogenic heat exits with the blood, hence the statement that the disease heals. If the exterior is unresolved, meaning the exterior pathogen remains, although there is blood stasis internally, attack is not yet permissible, implying that the exterior must be resolved first. After the exterior resolves, the presence of urgency and binding in the lower abdomen serves as evidence of heat binding in the Bladder and blood stasis in the Lower Jiao. Only then can medication be used to attack. Cheng Wuji's annotation states: "Administer Taohao Chengqi Tang to purge heat and dissipate blood." I argue that "purge heat and dissipate blood" should be corrected to "discharge blood and dissipate heat." Blood is a tangible substance; it can be purged but not dissipated. Heat is an intangible qi; it can be dissipated but not purged.)
Cheng Wuji's interpretation of the terminology is also imprecise. Furthermore, regarding "heat binding in the Bladder," the Bladder is located within the lower abdomen. Heat binding in the Bladder causes qi to steam into the lower abdomen, leading to sluggish blood flow and resulting in the manifestation of urgency and binding, which is the definitive sign of Lower Jiao blood stasis. Therefore, Taohao Chengqi Tang is a formula for attacking Lower Jiao blood stasis and treating lower abdominal urgency/binding, rather than a formula for unblocking heat binding in the Bladder. The annotation from *Tiaobian* states: "Lower abdomen refers to the Bladder; urgency and binding refer to the accumulation of tangible blood." The annotation from *Shanglun Pian* states: "Lower abdominal urgency and binding indicate blood in the Bladder stagnating and failing to move, seemingly located inside the Bladder." If this were true, after administering Taohao Chengqi Tang, the stagnant blood should exit via urination. Both interpretations lack analytical rigor. Additionally, this clause states: "If the exterior is unresolved, attack is not yet permissible." Zhang Zhongjing seemingly omitted a formula for resolving the exterior in this specific instance. *Buwang Lun*, citing Guo Baiyun, references *Qianjin Fang* and suggests using Guizhi Tang (Cinnamon Twig Decoction). Furthermore, examination of *Neitai Fangyi* notes: "If exterior symptoms remain unresolved, or if the pulse is floating, or if there are aversion to cold or body pain, attack is not yet permissible; temporarily administer Gegen Tang (Kudzu Decoction) to resolve the exterior." Both aforementioned formulas are treatments for resolving the exterior in Taiyang disease. Practitioners should carefully consider clinical manifestations when applying them.