枳实（三枚炙） 栀子（十四枚擘） 豉（一升绵裹）
上三味。以清浆水七升。空煮取四升。内枳实栀子。煮取二升。下豉。更煮五六沸。去滓。温分再服。覆令微似汗。
成注云。枳实栀子豉汤。则应吐剂。此云覆令。微似汗出者。以其热聚于上。苦则吐之。热散于表者。苦则发之。
内经曰。火淫所胜。以苦发之。此之谓也。
琥按仲景云劳复证。以劳则气上。热气浮越于胸中也。故用枳实为君。以宽中下气。栀子为臣。以除虚烦。香豉为
佐。以解劳热。煮以清浆水者。以瘥后复病。宜助胃气也。胃气升。则劳复之热降矣。覆令微似汗者。胃家之气既升。
则遍身得以和畅。故云微似汗也。成注云。热聚于表。苦则发之误矣。又方氏条辩。注劳复之劳为房劳。尚论篇已斥其
非。
伤寒瘥以后。更发热者。小柴胡汤主之。脉浮者。以汗解之脉沉实者。以下解之。（瘥以后。不因劳食而更发热者。
此半表半里之间有留邪也。故用小柴胡汤。汤中有人参以扶正气。去余邪。乃和解法也。若诊其人而脉浮。是热发在表。
脉沉实。是热发在里。表里有邪。另当斟酌汗下之法。条辩云脉浮是有重感。脉沉实是饮食失节。其说极是。小柴胡汤
方已见前第七卷少阳篇中）
大病瘥后。从腰以下有水气者。牡蛎泽泻散主之。（成注云。大病瘥后。脾胃气虚。不能制约肾水。水溢下焦。腰以
下为肿也。金匮要略云腰以下肿。当利小便。与牡蛎泽泻散。利小便而散水也。）
枳实（三枚，炙） 栀子（十四枚，掰开） 豆豉（一升，用绵布包裹）
以上三味药。用清浆水七升。先空煮至四升。加入枳实和栀子。煮取二升。再加入豆豉。再煮五六沸。去渣。温服，分两次服用。覆盖衣被使身体微微似有汗出。
成无己注解说：枳实栀子豉汤，本应是催吐剂。这里说“覆盖衣被使微似汗出”，是因为热邪聚集在上部，苦味药能使其呕吐；若热邪散于体表，苦味药能使其发散。
《内经》说：火邪过盛，用苦味药发散。说的就是这个道理。
琥按：仲景说劳复证，是因为劳累导致气机上逆，热气浮越于胸中。所以用枳实为君药，以宽中下气；栀子为臣药，以清除虚烦；香豉为佐药，以解除劳热。用清浆水煮，是因为病愈后复发，宜助胃气。胃气上升，则劳复之热自降。覆盖衣被使微似汗出，是因为胃气既升，周身之气得以和畅，所以说微似汗出。成注说“热聚于表，苦则发之”是错误的。另外方氏条辩将劳复的“劳”解释为房劳，《尚论篇》已斥责其非。
伤寒病愈后，再次发热者，用小柴胡汤主治。脉浮者，用发汗法解表；脉沉实者，用泻下法解里。（病愈后，不因劳累或饮食而再次发热者，这是半表半里之间有余邪停留。所以用小柴胡汤。汤中含有人参以扶助正气，祛除余邪，属于和解法。如果诊察其人脉浮，说明热在表；脉沉实，说明热在里。表里有邪，另当斟酌汗下之法。条辩说脉浮是有重感，脉沉实是饮食失节，这种说法非常正确。小柴胡汤方见前第七卷少阳篇中）
大病病愈后，腰部以下有水气者，用牡蛎泽泻散主治。（成注说：大病病愈后，脾胃气虚，不能制约肾水，水溢于下焦，腰部以下浮肿。《金匮要略》说腰以下肿，当利小便。与牡蛎泽泻散，利小便而散水。）
Zhi Shi (Fructus Aurantii Immaturus, three pieces, roasted) Zhi Zi (Fructus Gardeniae, fourteen pieces, broken) Chi Dou (Folium Sojae Praeparatum, one sheng, wrapped in silk gauze)
Take the above three herbs. Boil them in seven sheng of Qing Jiang Shui (clear sour rice water). First, boil alone until reduced to four sheng. Add Zhi Shi and Zhi Zi, and boil until two sheng remain. Then add Chi Dou, and boil for five or six more boils. Strain. Take warm, divided into two doses. Cover with blankets to induce a slight perspiration.
Cheng Wuji commented: Zhi Shi Zhi Zi Chi Tang should be an emetic agent. The text here says "cover with blankets to induce slight perspiration" because the heat is gathered in the upper jiao; bitter substances can induce vomiting. If the heat is scattered on the exterior, bitter substances can disperse it.
The *Nei Jing* states: When fire pathogen prevails, use bitter substances to disperse it. This refers to this principle.
Hu notes: Zhang Zhongjing states that for Laofu syndrome (relapse due to overexertion), exertion causes qi to rise upward, and hot qi floats and rises in the chest. Therefore, Zhi Shi is used as the sovereign herb to broaden the middle and descend qi; Zhi Zi as the minister herb to clear deficiency vexation; and Xiang Chi (aromatic fermented soybean) as the assistant herb to resolve heat from exertion. Boiling with Qing Jiang Shui is because after recovery, when disease recurs, it is appropriate to assist stomach qi. When stomach qi ascends, the heat of Laofu descends. Covering with blankets to induce slight perspiration occurs because once stomach qi ascends, the qi throughout the body becomes harmonious and smooth, hence it is said to be slight perspiration. Cheng's comment that "heat gathers at the exterior, bitter disperses it" is incorrect. Furthermore, Fang Shi's *Tiaobian* interprets the "Laofu" (exertion relapse) as sexual exhaustion, which has been refuted by *Shanglun Pian*.
After Taiyang disease recovers, if fever recurs, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is the primary treatment. If the pulse is floating, treat by inducing sweating; if the pulse is deep and solid, treat by purging. (If fever recurs after recovery without being caused by exertion or diet, this indicates residual pathogen lingering between the interior and exterior. Thus, Xiao Chai Hu Tang is used. The decoction contains Ren Shen (Radix Ginseng) to support healthy qi and eliminate residual pathogen, belonging to the harmonizing method. If upon examination the pulse is floating, the heat is at the exterior; if deep and solid, the heat is at the interior. With pathogen in both interior and exterior, the methods of sweating and purging must be carefully considered. *Tiaobian* states that a floating pulse indicates secondary contraction, and a deep solid pulse indicates irregular diet, which is a very correct explanation. See Xiao Chai Hu Tang formula in Volume 7, Shaoyang chapter.)
After severe disease recovers, if there is fluid accumulation below the waist, Mu Li Ze Xie San (Oyster and Alisma Powder) is the primary treatment. (Cheng commented: After severe disease recovers, Spleen and Stomach qi are deficient and cannot control Kidney water, causing water to overflow into the lower jiao, resulting in edema below the waist. The *Jin Gui Yao Lue* states: For edema below the waist, promote urination. Administer Mu Li Ze Xie San to promote urination and dissipate fluid.)