治伤寒喘促脉伏而厥。
人参 麦门冬（去心） 杏仁（去皮尖） 橘皮（去白各二钱半） 五味子（半两） 生姜（二钱半） 枣子（三
枚破）
上锉如麻豆大。水二大白盏。煮至一盏。去滓。分作二服。
琥按上主疗云喘促。脉伏而厥。当是手厥阴心包相火。兼挟邪热。怫郁于内而发厥也。故上汤大能清心。其兼润
肺者。以火盛防烁金也。第汤中用姜枣人参。嫌其太补。此当是伤寒后。邪气已微。真阴虚。内热不解。而外发厥者。
方宜用之。
治气上冲正在心端。
半夏（汤洗半两） 当归 芍药 茯苓（各一分） 桂枝（一两） 黄芩 甘草（炙各一分） 甘李根白皮（二合）
上锉如麻豆大。每服钞五钱匕。生姜四片。水一盏半。煎至八分。去滓温服。
琥按上主疗云治气上冲。正在心端。此为厥阴经病。盖冲字即撞字之义也。仲景于厥阴篇。首条言证。皆无方治。
故朱氏采此方。治上证。李根甘寒微酸。得木之正气。大能走厥阴。治消渴。止心烦逆气。故以之为君也。诸药剂皆滋
阴降火。清导逆气。惟半夏桂姜。为辛温之剂。意者气上冲心。与水停心下而悸相仿。或者。消渴所饮之水未行可。用
也。否则宁勿服之。
刘河间云。蓄热内甚。阳厥极深。以阳气怫郁。不能营运于身表四肢。以致通身清冷。痛甚不堪。项背拘急。目青
睛疼。（青睛属肝。肝热甚。则疼。青睛疼者。其人目脉当赤。若以目色青作解误矣。）昏眩恍惚咽干。或痛躁渴。虚汗
呕吐。下利腹满实痛。烦冤闷乱。喘急。郑声。脉虽疾数。以其蓄热极深。而脉道不利。反致沉细而欲绝。或始得之阳
热暴甚。而便有此证候者。或两感热势甚者。通宜解毒汤。加大承气下之。热不退者。宜再下之。古人云三下之而热未
退。即死矣。然亦有按法以下三五次。热方退而得活者。免致不下退其热。而必死也。下后热少退而未愈者。黄连解毒
汤调之。或失下热极。以致身冷。脉微。而昏冒将死者。若急下之。残阴暴绝而死。（阳热亢极。则所余之。阴气无几。
故云残阴）盖阳气后竭而然也。然不下亦死。宜凉膈散。或黄连解毒汤。或二药合服。或白虎合凉膈散。养阴退阳。积
热渐以宣散。则心胸温暖。脉渐以生。至于脉复有力。方可三一承气汤下之。或解毒加六一散调之。愈后尚宜服退热之
药。里热。脉滑而厥者宜白虎汤。热极厥深。诸药下毕。竟不能利者。不救必死。黄连解毒汤。更加甘遂末一钱匕。下
之（诸汤散俱见前第六卷阳明篇中。六一散见前第五卷太阳篇后。惟解毒汤附下）
治疗伤寒引起的喘息急促、脉搏隐伏且四肢厥冷。
人参、麦门冬（去除心）、杏仁（去除皮和尖）、橘皮（去除白色部分，各二钱半）、五味子（半两）、生姜（二钱半）、枣子（三枚，剖开）。
以上药物切碎如麻豆大小。用水两大白盏。煮至一盏量。去掉药渣。分两次服用。
王琥按：上述主治说明中提到“喘息急促，脉搏隐伏且四肢厥冷”，这应当是手厥阴心包经的相火，兼夹邪热，郁结在体内而引发四肢厥冷。所以上述汤剂大能清心。其中兼有润肺的作用，是因为火势旺盛防止灼伤肺金（五行中火克金，此处指火热之邪伤肺）。只是汤剂中使用了姜、枣、人参，担心其过于补益。这应当适用于伤寒之后，邪气已经微弱，真阴虚弱，内热不解，并且向外发为四肢厥冷的情况。此方才适宜使用。
治疗气向上冲逆，直抵心窝部位。
半夏（用热水洗过，半两）、当归、芍药、茯苓（各一分）、桂枝（一两）、黄芩、甘草（炙，各一分）、甘李根白皮（二合）。
以上药物切碎如麻豆大小。每次取五钱匕的药量，加生姜四片，水一盏半，煎至八分满。去掉药渣，温服。
王琥按：上述主治说明中说“治疗气向上冲逆，直抵心窝部位”，这是厥阴经的病证。因为“冲”字即“撞”字的含义。张仲景在《伤寒论》厥阴篇的首条论述证候时，都没有给出方治。所以朱氏（朱肱）采集这个方子，来治疗上述证候。李根白皮味甘性寒微酸，得木之正气，大能入厥阴经，治疗消渴病，止心烦逆气，所以把它作为君药。其他药剂都是滋阴降火、清导逆气的。只有半夏、桂枝、生姜，是辛温的药物。推测气上冲心，与水停心下导致的心悸相似。也许是消渴病患者所饮之水未能正常代谢，可以使用此方。否则，宁可不要服用。
刘河间说：蓄积的热邪在内很严重，阳厥极深，由于阳气郁结，不能营运于身体表面和四肢，导致全身清冷，疼痛剧烈难以忍受，项背部拘急，眼睛青色且眼珠疼痛。（青睛属肝，肝热甚则疼，所谓青睛疼，是指人的目脉应当发红，如果把目色青理解为症状就错了。）昏眩恍惚，咽干，或者疼痛烦躁口渴，虚汗呕吐，腹泻腹部胀满实痛，烦闷乱，喘急，语言重复（郑声）。脉搏虽然疾数，但因为蓄热极深，脉道不利，反而导致脉搏沉细几乎摸不到。或者刚开始发病时阳热暴盛，就出现这些证候的。或者是两感病热势严重的，都适宜用解毒汤，加大承气汤攻下。热不退的，适宜再次攻下。古人说三次攻下后热仍未退，就会死亡。然而也有按照方法攻下三五次，热才退而存活的。以免因不攻下退热而必死。攻下后热稍微退但未痊愈的，用黄连解毒汤调理。或者因失于攻下导致热极，以致身冷、脉微、昏迷将死的。如果急下，残存的阴气会突然断绝而死。（阳热亢盛到极点，剩余的阴气就很少了，所以说残阴）这是因为阳气后来竭尽的缘故。然而不攻下也会死。适宜用凉膈散，或黄连解毒汤，或两药合服，或白虎汤合凉膈散，养阴退阳，积热逐渐宣散，心胸就会温暖，脉搏逐渐恢复。至于脉搏恢复有力，才可以三一承气汤攻下。或用解毒汤加六一散调理。痊愈后仍宜服用退热的药物。里热，脉搏滑而四肢厥冷的适宜用白虎汤。热极厥深，诸药攻下完毕，竟然不能通利的，无法救治必死。黄连解毒汤，再加甘遂末一钱匕，攻下它。（各种汤散均见前第六卷阳明篇中，六一散见前第五卷太阳篇后，只有解毒汤附在下面）
[From "Ren's Book"] Wuweizi Decoction Formula / And Ligeng Decoction Formula
Treats asthma and rapid breathing, hidden pulse, and cold extremities caused by Shanghan (Cold Damage).
Renshen (Ginseng Radix et Rhizoma), Maimendong (Ophiopogonis Radix) (remove the heart), Xingren (Prunus Armeniaca Seed) (remove skin and tip), Jupi (Citri Reticulatae Pericarpium) (remove white pith, each 2.5 qian), Wuweizi (Schisandrae Chinensis Fructus) (0.5 liang), Shengjiang (Zingiberis Rhizoma Recens) (2.5 qian), Zaozi (Jujubae Fructus) (3 pieces, broken open).
The above herbs are chopped like hemp or bean seeds. Use two large bai zhen of water. Boil until one bai zhen remains. Remove the dregs. Divide into two doses.
Wang Hu notes: The aforementioned indications mention "asthma and rapid breathing, hidden pulse, and cold extremities." This should be due to the ministerial fire of the Hand-Jueyin Pericardium channel, combined with pathogenic heat, stagnating internally and causing cold extremities. Therefore, the aforementioned decoction greatly clears the Heart. Its concurrent moistening of the Lung is because excessive fire prevents the scorching of Metal (Lung). However, the use of Jiang (Ginger), Zao (Jujube), and Renshen in the decoction is suspected to be too tonifying. This formula should apply to cases after Shanghan where pathogenic qi is already weak, true Yin is deficient, internal heat does not resolve, and cold extremities manifest externally. Only in such cases is this formula appropriate.
Treats Qi rushing upward, directly hitting the epigastrium/heart region.
Banxia (Pinelliae Rhizoma) (washed with hot water, 0.5 liang), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Alba/Fucsinia), Fuling (Poria) (each 1 fen), Guizhi (Cinnamomi Ramulus) (1 liang), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (processed with honey, each 1 fen), Ganli Gen Baipi (Mume Radicis Cortex) (2 he).
The above herbs are chopped like hemp or bean seeds. For each dose, take five qian bi of the herbs, add four slices of Shengjiang (Ginger), and one and a half zhen of water. Decoct until eight parts remain. Remove the dregs and take warm.
Wang Hu notes: The aforementioned indications state "treats Qi rushing upward, directly hitting the heart region." This is a disease of the Jueyin channel. The character "Chong" (rush) implies the meaning of "Zhuang" (collide/bump). Zhang Zhongjing, in the first article of the Jueyin chapter of his treatise, discusses symptoms but provides no formulas. Therefore, Zhu Shi (Zhu Gong) collected this formula to treat the aforementioned syndrome. Ganli Gen Baipi (Ligustrum lucidum root bark) is sweet, cold, and slightly sour, obtaining the upright Qi of Wood. It greatly enters the Jueyin channel, treats Xiao Ke (Wasting-Thirst), and stops mental irritability and rebellious Qi. Thus, it serves as the Sovereign herb. All other herbs nourish Yin, descend Fire, clear, and guide rebellious Qi downward. Only Banxia, Guizhi, and Jiang are acrid-warm agents. It is speculated that Qi rushing upward to the Heart resembles palpitations caused by Water retention below the Heart. Perhaps the water drunk by patients with Xiao Ke has not been metabolized, so this can be used. Otherwise, it is better not to take it.
Liu Hejian said: Accumulated Heat internally is severe, Yang Jue (cold extremities due to heat) is extremely deep. Due to Yang Qi stagnation, it cannot circulate on the body surface and limbs, resulting in whole-body coldness, unbearable severe pain, stiffness and tension of the neck and back, blueish sclera, and eye pain. (The eyes belong to the Liver; when Liver Heat is severe, pain occurs. "Blueish eye pain" means the eye vessels should be red; interpreting it as blue eye color is erroneous.) Dizziness, confusion, dry throat, or painful irritability and thirst, spontaneous sweating, vomiting, diarrhea, abdominal fullness and solid pain, vexation and restlessness, rapid breathing, and repetitive speech (Zhengsheng). Although the pulse is rapid, because the accumulated Heat is extremely deep and the pulse channels are obstructed, the pulse instead becomes deep, thin, and nearly imperceptible. Or, if Yang Heat suddenly becomes severe at the onset, these symptoms appear immediately. Or in cases of Lianggan (simultaneous contraction of two channels) with severe heat, all should generally use Jiedu Tang (Detoxification Decoction) plus Dachengqi Tang (Major Order the Qi Decoction) to purge. If heat does not subside, purging should be repeated. Ancients said that if heat remains after three purgations, death ensues. However, there are cases where following the method and purging three to five times leads to heat subsiding and survival, avoiding inevitable death from failure to purge and reduce heat. After purgation, if heat slightly subsides but recovery is incomplete, adjust with Huanglian Jiedu Tang (Coptis Decoction for Detoxification). Or, if failure to purge earlier led to extreme heat, resulting in cold body, faint pulse, and coma approaching death, urgent purgation would cause the remaining Yin to abruptly cease, leading to death. (When Yang Heat is hyperactive, little Yin remains, hence "remaining Yin".) This is because Yang Qi exhausted later. However, non-purgation also leads to death. One should use Liangge San (Cool the Chest Powder), or Huanglian Jiedu Tang, or both combined, or Baihu Tang (White Tiger Decoction) combined with Liangge San, to nourish Yin and retreat Yang. As accumulated Heat gradually dissipates, the chest and heart will become warm, and the pulse will gradually return. Only when the pulse regains strength can Sanyi Chengqi Tang (Three-One Order the Qi Decoction) be used for purgation. Or adjust with Jiedu Tang plus Liuyi San (Six-to-One Powder). After recovery, it is still advisable to take antipyretic medicines. For interior Heat with a slippery pulse and cold extremities, Baihu Tang is appropriate. In cases of extreme Heat and deep Jue, if after all purgative medications, defecation is impossible, rescue is futile and death is certain. Huanglian Jiedu Tang, plus one qian bi of Gansui powder, can be used for purgation. (All aforementioned decoctions and powders are seen in Volume 6 Yangming Chapter previously; Liuyi San is seen after Volume 5 Taiyang Chapter; only Jiedu Tang is attached here.)