（此系仲景原文）
太阴之为病。腹满而吐。食不下。自利益甚。时腹自痛若下之。必胸下结硬。（此条言太阴病。乃阳邪传里之证也。
太阴之脉。入腹属脾络胃。邪热壅甚。则为腹满。邪迫于上。则吐而食不下。邪迫于下。则利甚而腹时痛。成注云。阴
寒在内。则腹中常痛。此阳邪干里。故虽痛而不常。但时时腹自痛。言有时而痛。有时则又止也。邪虽干里。既痛且利。
则此腹痛之候。宜和而不宜下矣。若误下之。必胸下结硬。此即前第五卷太阳下编云。病发于阴而反下之。因作痞者。
此之谓也。或问此条病。在未下之先。仲景法。当用何药。余答云太阴受病。当四五日发。以其脉布胃中。络于嗌。故
腹满嗌干。庞安时以大承气汤下之。今者。腹虽满而嗌不干。是病热不甚。既吐且利。其邪未实。故不可下。愚以仲景
法。还宜以桂枝加芍药汤主之。要之此汤。本太阳病误下。腹满时痛。转属太阴之药。若未经误下。而病已属太阴者。
则此汤中桂枝。另宜以升麻或葛根代之。）
太阴中风四肢烦疼。阳微阴涩而长者。为欲愈（此条系太阴中风证。一言太阴。当见腹满等候矣。兼之四肢烦疼者。
太阴之经属脾。脾主四肢成注云。风淫末疾是也。夫烦疼一候。似兼表邪。今者阳脉既微。表邪少也。阴脉则涩。里未
和也。条辩云。血凝气滞则脉涩。此非向愈之征。其欲愈者。乃脉长故也。尚论篇云。微涩之中。更察其脉之长。此为
邪气已退。正气欲复。故其病为欲自愈也。）
太阴病欲解时从亥至丑上。（注已见前第三卷太阳上编）
太阴病脉浮者。可发汗宜桂枝汤。（此条太阴病。当是太阳经传来者。夫曰太阴病。当见腹满等候。诊其脉不沉细而
浮。则知太阳经风邪犹未解也。故宜桂枝汤以汗解之。汤见前第三卷太阳篇中。）
自利不渴者属太阴。以其藏有寒故也。当温之宜四逆辈。（此条系真寒病。正文与注并汤见中寒论中）
伤寒脉浮而缓。手足自温者。系在太阴。太阴当发身黄。若小便自利者。不能发黄。至七八日。虽暴烦下利日十余
行。必自止。以脾家实。腐秽当去故也。（此条系太阴伤寒。自利欲解之证。前阳明篇中。伤寒脉浮而缓云云。至八九日。
大便硬者。此为转属阳明。今者以脾家实。故虽暴烦要之腐秽。当自利而去何也。盖太阴病。必腹满。腹满者。胃中有
物也。胃中水谷之积。既变而为腐秽。则邪应从大小便出。其暴烦者。邪欲泄而正气与之争也。成注云下利烦躁者死。
此为先利而后烦。是正气脱而邪气扰也。兹则先烦后利。是脾家之正气实。故不受邪而与之争。因暴发烦热也。下利日
十余行者。邪气随腐秽而得下泄也。以故腐秽去尽。利必自止。而病亦愈。）
本太阳病。医反下之。因尔腹满时痛者。属太阴也。桂枝加芍药汤主之。（此条系太阳病。传入太阴之证。太阳病。
何以骤传入太阴。成注云。表邪未罢。医下之。邪因乘虚。传于太阴。里气不和。故腹满时痛。此阳邪陷入于阴分也。
故仍用桂枝汤。以解太阳未尽之表邪。加芍药。以和太阴里虚之腹痛。）
（这是张仲景的原文）
太阴病的症状表现为：腹部胀满，呕吐，饮食难以下咽，腹泻逐渐加重，时常出现腹部自发性疼痛。如果误用攻下法治疗，必然导致心窝部痞结硬满。（这一条论述的是太阴病，属于阳邪传入体内的证候。
太阴经脉，进入腹部，归属于脾，联络胃。邪热壅盛严重，就会导致腹部胀满；邪气逼迫于上，就会呕吐且无法进食；邪气逼迫于下，就会导致严重的腹泻和腹部阵发性疼痛。成无己注解说：“阴寒在内，则腹中常痛。”这是指阳邪侵犯体内，所以虽然疼痛但并不持续，只是时不时地腹部自发疼痛，意思是有时疼痛，有时又停止。邪气虽然侵犯体内，既然既有疼痛又有腹泻，那么这种腹痛的证候，适宜调和而不适宜攻下。如果误用攻下法，必然导致心窝下部痞结硬满。这就是前第五卷太阳篇下编所说的：“病发于阴而反下之，因作痞者”，说的就是这种情况。有人问这条病证，在未经攻下之前，张仲景的法度，应当使用什么药物？我回答说：太阴经受病，应当在发病后第四五天发作，因为它的经脉布散于胃中，联络于咽喉，所以会出现腹部胀满、咽喉干燥的症状。庞安时主张用大承气汤攻下。现在，腹部虽然胀满但咽喉不干燥，说明热邪不严重。既然既有呕吐又有腹泻，邪气尚未结实，所以不可攻下。我认为按照张仲景的法度，还是适宜用桂枝加芍药汤为主治方剂。总之，这个方剂原本是用于太阳病误用攻下法后，腹部胀满、时时疼痛，转属太阴病的药物。如果未经误下，而病证已经属于太阴者，那么这个方剂中的桂枝，另外适宜用升麻或葛根来代替。）
太阴中风，四肢烦扰疼痛。脉象呈现阳微阴涩而长的，是即将痊愈的迹象。（这一条属于太阴中风证。一说太阴，就应当见到腹部胀满等征候了。兼有四肢烦扰疼痛的，是因为太阴经脉属于脾，脾主四肢。成无己注解说：“风淫末疾”就是这个意思。至于“烦疼”这一征候，似乎兼有表邪。现在阳脉既已微弱，说明表邪轻微。阴脉则涩，说明里气未调和。条辩云：“血凝气滞则脉涩。”这并非向愈的征兆。所谓欲愈，是因为脉长。尚论篇云：“微涩之中，更察其脉之长。”此为邪气已退，正气欲复，所以病将自愈。）
太阴病欲解的时间是从亥时到丑时。（注释已见于前第三卷太阳篇上编）
太阴病脉象浮的，可以发汗，适宜用桂枝汤。（这一条太阴病，应当是太阳经传来的。说是太阴病，应当见到腹部胀满等征候。诊察其脉象不沉细而浮，就知道太阳经的风邪尚未解除。所以适宜用桂枝汤通过发汗来解表。方剂见前第三卷太阳篇中。）
自发性腹泻且不口渴的，属于太阴病，因为脏腑内有寒邪，应当温补，适宜用四逆汤类方剂。（这一条属于真寒病。正文与注释以及方剂见《中寒论》中）
伤寒脉象浮而缓，手足自然温暖的，病系在太阴。太阴病应当出现身体发黄，如果小便自利通畅的，就不会发黄。到了七八天，即使突然烦躁并腹泻一天十几次，必定会自行停止，因为脾家实（正气恢复），腐秽之物应当排出的缘故。（这一条属于太阴伤寒，是自利欲解的证候。前阳明篇中，提到“伤寒脉浮而缓……至八九日，大便硬者，此为转属阳明”。现在因为脾家实，所以虽然暴烦，但要排出腐秽之物，应当通过自利而去除。大概太阴病，必然腹部胀满。腹部胀满，说明胃中有积滞。胃中水谷的积滞，既然变为了腐秽，那么邪气应当从大小便排出。所谓的暴烦，是邪气欲泄而正气与之抗争的表现。成无己注解说：“下利烦躁者死”，这是先腹泻而后烦躁，是正气脱失而邪气扰乱。这里则是先烦躁后腹泻，是脾家的正气充实，所以不受邪气干扰而与之抗争，因而暴发烦热。腹泻一天十几次，是邪气随着腐秽之物而下泄。因此腐秽去尽，腹泻必定自行停止，病也就好了。）
原本患太阳病，医生反而误用攻下法，因此导致腹部胀满、时时疼痛的，属于太阴病，用桂枝加芍药汤主治。（这一条属于太阳病传入太阴的证候。太阳病，为何迅速传入太阴？成无己注解说：“表邪未罢，医下之，邪因乘虚，传于太阴，里气不和，故腹满时痛。”这是阳邪陷入阴分。所以仍用桂枝汤，以解除太阳未尽的表邪；加芍药，以调和太阴里虚的腹痛。）
(This is the original text by Zhang Zhongjing.)
Taiyin disease manifests as abdominal fullness, vomiting, inability to eat, worsening diarrhea, and spontaneous abdominal pain occurring at times. If purgatives are mistakenly used, it will inevitably lead to hardness and obstruction below the chest. (This clause discusses Taiyin disease, which is a syndrome where Yang pathogenic factors transmit inward.)
The Taiyin meridian enters the abdomen, belongs to the Spleen, and connects with the Stomach. When pathogenic heat is severely congested, abdominal fullness occurs; when pathogens force upward, vomiting and inability to eat occur; when pathogens force downward, severe diarrhea and intermittent abdominal pain occur. Cheng Wuji's commentary states: "When Yin-cold is internal, there is constant abdominal pain." This refers to Yang pathogens invading the interior; thus, although painful, the pain is not continuous but occurs intermittently ("spontaneous pain at times"), meaning it hurts sometimes and stops other times. Although pathogens invade the interior, given both pain and diarrhea, this abdominal pain syndrome should be harmonized rather than purged. If mistakenly purged, hardness and obstruction below the chest will inevitably result. This is what was said in Volume 5, Taiyang Chapter Lower: "Disease originating from Yin, yet treated with purgation, leads to Pi [obstruction] syndrome," referring to this situation. One may ask, before purgation, what medication did Zhang Zhongjing prescribe for this condition? I answer: Taiyin disease typically manifests on the fourth or fifth day of onset because its meridian spreads through the Stomach and connects to the throat, leading to abdominal fullness and dry throat. Pang Anshi advocated using Dachengqi Tang (Major Order the Qi Decoction) for purgation. Now, although the abdomen is full, the throat is not dry, indicating that heat is not severe. Since there is both vomiting and diarrhea, the pathogens are not yet solidified, so purgation is contraindicated. In my opinion, following Zhang Zhongjing's method, Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction Augmented with Peony Root) should still be the primary treatment. Essentially, this decoction was originally intended for Taiyang disease mistakenly purged, resulting in abdominal fullness and intermittent pain, transitioning to Taiyin. If purgation was not performed but the disease has already transitioned to Taiyin, then the Guizhi (Cinnamon Twig) in this decoction should alternatively be replaced with Shengma (Cimicifugae Rhizoma) or Gegen (Puerariae Lobatae Radix).)
Taiyin wind-stroke presents with vexing pain in the four limbs. If the pulse is superficially faint and internally choppy yet long, recovery is imminent. (This clause pertains to Taiyin wind-stroke syndrome. Mentioning Taiyin implies symptoms such as abdominal fullness should be present. The addition of vexing pain in the four limbs occurs because the Taiyin meridian belongs to the Spleen, and the Spleen governs the four limbs. Cheng Wuji's commentary states: "Wind excess causes disease in the extremities." The symptom of "vexing pain" seems to involve exterior pathogens. However, since the superficial pulse is faint, exterior pathogens are minimal. The internal pulse is choppy, indicating interior disharmony. Tiaobian states: "Blood stasis and Qi stagnation cause a choppy pulse." This is not a sign of recovery. The sign of impending recovery is the length of the pulse. Shanglun Pian states: "Amidst faint and choppy pulses, observe if the pulse is long." This indicates pathogens have retreated and healthy Qi is recovering, hence the disease will self-heal.)
Taiyin disease resolves between Hai hour (21:00-23:00) and Chou hour (01:00-03:00). (Note previously seen in Volume 3, Taiyang Chapter Upper.)
In Taiyin disease, if the pulse is floating, sweating therapy may be applied, preferably using Guizhi Tang (Cinnamon Twig Decoction). (This Taiyin disease case likely originated from the Taiyang meridian. Being called Taiyin disease implies abdominal fullness should be present. Diagnosing the pulse as floating rather than deep and fine indicates that Wind pathogens of the Taiyang meridian have not yet resolved. Therefore, Guizhi Tang (Cinnamon Twig Decoction) is suitable to resolve the exterior via sweating. See the formula in Volume 3, Taiyang Chapter.)
Spontaneous diarrhea without thirst belongs to Taiyin disease, due to cold in the Zang organs. Warming therapy is indicated, preferably using SiNi Tang (Frigid Extremities Decoction) or similar formulas. (This clause pertains to True Cold disease. The main text, commentary, and formula are found in *Zhong Han Lun*.)
In Shanghan (Cold Damage), if the pulse is floating and slow, and the hands and feet are naturally warm, the disease is located in Taiyin. Taiyin disease typically presents with jaundice; however, if urination is free and easy, jaundice will not develop. By the seventh or eighth day, even if sudden vexation occurs accompanied by diarrhea more than ten times a day, it will necessarily stop spontaneously because the Spleen's healthy Qi is sufficient (Pi Jia Shi), and putrid filth must be expelled. (This clause pertains to Taiyin Shanghan, a syndrome of resolving spontaneous diarrhea. In the previous Yangming chapter, it stated: "Shanghan, pulse floating and slow... by the eighth or ninth day, if stool becomes hard, this transitions to Yangming." Here, because the Spleen's healthy Qi is sufficient, although there is sudden vexation, the putrid filth must be expelled via diarrhea. Generally, Taiyin disease involves abdominal fullness. Abdominal fullness indicates accumulation in the Stomach. Once water and grain accumulations in the Stomach transform into putrid filth, pathogens should exit via urine or feces. The sudden vexation represents the conflict between expelling pathogens and resisting healthy Qi. Cheng Wuji's commentary states: "Diarrhea with vexation indicates death," referring to diarrhea preceding vexation, where healthy Qi collapses and pathogens disturb. Here, vexation precedes diarrhea, indicating the Spleen's healthy Qi is robust, resisting pathogens, causing sudden feverish vexation. Diarrhea occurring more than ten times a day signifies pathogens exiting with the putrid filth. Thus, once the filth is cleared, diarrhea stops, and the disease heals.)
Originally suffering from Taiyang disease, if the physician mistakenly uses purgation, leading to abdominal fullness and intermittent pain, the condition belongs to Taiyin and is treated with Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction Augmented with Peony Root). (This clause pertains to Taiyang disease transmitting to Taiyin. Why does Taiyang disease rapidly transmit to Taiyin? Cheng Wuji's commentary states: "Exterior pathogens remain unresolved; the physician purges, allowing pathogens to exploit deficiency and transmit to Taiyin, causing interior disharmony, hence abdominal fullness and intermittent pain." This is Yang pathogens sinking into the Yin aspect. Therefore, Guizhi Tang (Cinnamon Twig Decoction) is still used to resolve remaining exterior pathogens of Taiyang, while adding Shaoyao (Paeoniae Radix Alba) to harmonize the interior deficiency causing abdominal pain in Taiyin.)