赤石脂（一斤碎） 禹余粮（一斤碎）
以上二味。以水六升。煮取二升。去滓。三服。
成注引本草云。涩可去脱。石脂之涩。以收敛之。重可去怯。余粮之重。以镇固之。
或问重可以去怯之义。余答云。怯为大肠气馁。馁则不固。故利不止。余粮石脂。皆重剂。一则重而兼能收涩。一
则重而专于镇固。收涩镇固。此亦治利之一法也。
伤寒吐下后。发汗虚烦。脉甚微八九日。心下痞硬胁下痛气上冲咽喉。眩冒。经脉动惕者。久而成痿。
成注云。伤寒吐下后。发汗。则表里之气俱虚。以故内生烦热。脉甚微者。正气内虚也。至八九日。正气当复。
邪气当罢。今者。心下痞硬。是太阳之邪。乘虚而入于中焦也。胁下痛者。邪侵少阳之里也。气上冲咽喉。目眩而头冒。
皆正气内虚。邪气上逆所致。经脉动惕者。此因发汗之故。表气虚。不能充养于身故也。若此者。久而成痿。痿者。四
肢缓弱而不举也。愚按此条论。仲景云。痿者。当是肉痿之病。推其病因。由吐下而心下痞硬。既伤其中州之阴。复发
其汗。经脉动惕。更泄其肌表之阳。脾胃者。中州土也。其主为肌肉。其用在四肢。今者。阴阳衰虚。土失其资生之气。
脾胃邪热壅结。其始也。邪热之气。上冲于头。则眩冒。其继也。邪热之气。下还于经。则痿弱也。尚论篇以痿为两足
先废。此即邪热之气下还于足太阳经之义。又按此条论。仲景无治法。补亡论常器之云。可茯苓甘草白术生姜汤。郭白
云云。当作茯苓桂枝白术甘草汤。成痿者。振痿汤。
伤寒发汗若吐。若下。解后。心下痞硬噫气不除者。旋复代赭石汤主之。（伤寒发汗吐下。大邪解后。而心下痞硬。
此与前数条。泻心汤之痞证不同。成注云。胃气弱而未和。虚气上逆。故心下痞硬。噫气不除。然此噫气。比前生姜泻
心汤之干噫不同。是虽噫而不至食臭。故知其为中气虚也。与旋复代赭石汤。以补虚。散痞。下逆气。）
赤石脂（一斤，捣碎） 禹余粮（一斤，捣碎）
以上两味药。用水六升。煮取二升药液。滤去药渣。分三次服用。
成无己注引《本草》说：涩能固脱。石脂的涩性，用来收敛止泻。重能镇怯。余粮的重性，用来镇固正气。
有人问“重可以去怯”的含义。我回答说：怯是大肠之气虚弱。气虚则不固摄。所以导致腹泻不止。禹余粮和赤石脂，都是重剂。一种重而兼有收涩之功。一种重而专于镇固之效。收涩与镇固，这也是治疗泄泻的一种方法。
伤寒经过吐法、下法后，又发汗，导致虚烦。脉象非常微弱。过了八九天，出现心下部痞塞坚硬，胁下疼痛，气上冲至咽喉，头晕目眩，经脉跳动拘急者，时间久了会发展成痿证。
成无己注说：伤寒经过吐法、下法后，再发汗，那么表里之气都虚弱。因此内生烦热。脉象非常微弱，是正气内部虚弱。到了八九天，正气应当恢复。邪气应当罢退。现在心下部痞塞坚硬，是太阳之邪，乘虚侵入中焦。胁下疼痛，是邪气侵犯少阳之里。气上冲咽喉，眼睛昏花头目眩晕，都是正气内部虚弱，邪气上逆所致。经脉跳动拘急，这是因为发汗的缘故，表气虚弱，不能充养身体。像这种情况，时间久了会发展成痿证。痿证，就是四肢缓弱而不能抬举。我认为这一条论述，仲景所说的“痿”，应当是肉痿的病证。推究其病因，由于吐下导致心下部痞塞坚硬，既损伤了中州的阴液，又再次发汗，导致经脉跳动拘急，更泄伤了肌表的阳气。脾胃，属于中州土。它主管肌肉，作用体现在四肢。现在阴阳衰微虚弱，土失去了资生之气。脾胃邪热壅结。起初，邪热之气，上冲于头部，就会头晕目眩。接着，邪热之气，下行还归于经脉，就会导致痿弱。《尚论篇》认为痿是双足先废用，这就是邪热之气下行还归足太阳经的意思。另外按此条论述，仲景没有给出治法。《补亡论》中常器之说：可用茯苓甘草白术生姜汤。郭白云说：应当作茯苓桂枝白术甘草汤。对于已成痿证的，用振痿汤。
伤寒经过发汗，或者吐法，或者下法，病邪解除后，心下部痞塞坚硬，嗳气不除的，用旋复代赭石汤主治。（伤寒经过发汗、吐法、下法，大邪解除后，而心下部痞塞坚硬。这与前几条关于泻心汤治疗的痞证不同。成无己注说：胃气虚弱而未调和，虚气上逆，所以心下部痞塞坚硬，嗳气不除。然而这种嗳气，与前文生姜泻心汤证的干噫不同，这里是虽然嗳气但不至有食物腐臭的气味，所以知道它是中气虚弱。给予旋复代赭石汤，以补虚，散痞，降逆气。）
Shizhishi (Lapis Kaolinitis, one jin, crushed) Yuyuliang (Lapis Haematitatis, one jin, crushed)
The above two herbs. Boil with six sheng of water. Decoct to obtain two sheng of liquid. Remove the dregs. Divide into three doses for administration.
Cheng Wuji’s commentary cites *Bencao* stating: Astringents can treat prolapse/loss of control. The astringent nature of Shizhishi is used to consolidate and stop leakage. Heavy substances can dispel timidity/fear. The heavy nature of Yuyuliang is used to settle and secure the upright qi.
Someone asked about the meaning of "heavy substances can dispel timidity." I replied: Timidity here refers to the deficiency of Large Intestine qi. When deficient, it fails to maintain control. Thus, diarrhea persists. Both Yuyuliang and Shizhishi are heavy agents. One is heavy and possesses astringent properties; the other is heavy and specializes in settling and securing. Astringency and securing are also methods for treating diarrhea.
After purging and catharsis in Cold Damage, followed by sweating, leading to deficiency vexation. The pulse is extremely faint. After eight or nine days, if there is epigastric fullness and hardness, pain in the hypochondrium, qi rushing up to the throat, dizziness and vertigo, and twitching/trembling of the meridians, prolonged duration will result in Wei syndrome (flaccidity syndrome).
Cheng Wuji’s commentary states: After purging and catharsis in Cold Damage, followed by sweating, both exterior and interior qi become deficient. Hence, internal vexation and heat arise internally. An extremely faint pulse indicates internal deficiency of upright qi. By the eighth or ninth day, upright qi should recover, and pathogenic qi should cease. Now, epigastric fullness and hardness indicate that Shaoyang pathogenic qi has entered the Middle Jiao taking advantage of the deficiency. Pain in the hypochondrium indicates pathogenic qi invading the interior of Shaoyang. Qi rushing to the throat, blurred vision, and dizziness are all caused by internal deficiency of upright qi and counterflow of pathogenic qi upward. Twitching of the meridians is due to sweating causing exterior qi deficiency, failing to nourish the body. In such cases, prolonged duration leads to Wei syndrome. Wei syndrome refers to flaccidity and weakness of the four limbs, unable to lift them. I opine that in this discussion, Zhongjing's mention of "Wei" likely refers to Rouwei disease (muscle flaccidity). Tracing the etiology, purging and catharsis cause epigastric fullness and hardness, damaging the yin of the Central State (Middle Jiao). Subsequent sweating causes meridian twitching, further depleting the yang of the muscle surface. Spleen and Stomach belong to the Earth of the Central State. They govern muscles and their function manifests in the four limbs. Now, yin and yang are depleted and deficient; Earth loses its generating qi. Pathogenic heat in Spleen and Stomach becomes congested and knotted. Initially, pathogenic heat rushes upward to the head, causing dizziness and vertigo. Subsequently, pathogenic heat returns downward to the meridians, causing flaccidity and weakness. *Shanglun Pian* considers Wei as the initial failure of both legs, which aligns with the meaning of pathogenic heat returning downward to the Foot-Taiyang Meridian. Furthermore, regarding this discussion, Zhongjing provides no treatment method. *Buwang Lun* by Chang Qizhi states: Fuling Gancao Baizhu Shengjiang Tang (Poria, Licorice, Atractylodes Macrocephala, and Fresh Ginger Decoction) may be used. Guo Baiyun states: It should be Fuling Guizhi Baizhu Gancao Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction). For established Wei syndrome, Zhenwei Tang (Shake-Wei Decoction) is used.
After Cold Damage treated with sweating, or purging, or catharsis, after the resolution of the pathogen, if there is epigastric fullness and hardness with persistent belching, Xuanfu Daizhe Shi Tang (Inula and Hematite Decoction) is the primary formula. (After Cold Damage treated with sweating, purging, and catharsis, after the major pathogen resolves, epigastric fullness and hardness occur. This differs from the Pi-syndrome (fullness syndrome) treated with Xiexin Tang formulas mentioned earlier. Cheng Wuji’s commentary states: Stomach qi is weak and unharmonized, deficient qi counters upward, causing epigastric fullness and hardness and persistent belching. However, this belching differs from the dry belching in the Shengjiang Xiexin Tang pattern mentioned before; here, although there is belching, there is no odor of undigested food, indicating deficiency of Middle Qi. Xuanfu Daizhe Shi Tang is given to tonify deficiency, dissipate fullness, and direct rebellious qi downward.)