179．问曰∶病有太阳阳明，有正阳阳明，有少阳阳明，何谓也？答曰∶太阳阳明者，脾约（一云络）是也；
正阳阳明者，胃家实是也；少阳阳明者，发汗、利小便已，胃中燥、烦、实、大便难是也。
180．阳明之为病，胃家实（一作寒）是也。
181．问曰∶何缘得阳明病，答曰∶太阳病，若发汗、若下、若利小便，此亡津液，胃中干燥，因转属阳明。
不更衣，内实大便难者，此名阳明也。
182．问曰∶阳明病外证云何？答曰∶身热、汗自出、不恶寒反恶热也。
183．问曰∶病有得之一日，不发热而恶寒者，何也？答曰∶虽得之一日，恶寒将自罢，即汗出而恶热也。
184．问曰∶恶寒何故自罢？答曰∶阳明居中，主土也。万物所归，无所复传。始虽恶寒，二日自止，此
为阳明病也。
185．本太阳，初得病时，发其汗，汗先出不彻，因转属阳明也。伤寒发热、无汗、呕不能食、而反汗出
然者，是转属阳明也。
186．伤寒三日，阳明脉大。
187．伤寒脉浮而缓，手足自温者，是为系在太阴。
太阴者，身当发黄；若小便自利者，不能发黄；至七八日，大便硬者，为阳明病也。
188．伤寒转系阳明者，其人 然微汗出也。
189．阳明中风，口苦、咽干、腹满、微喘、发热、恶寒、脉浮而紧。若下之，则腹满小便难也。
190．阳明病，若能食，名中风；不能食，名中寒。
191．阳明病，若中寒者，不能食，小便不利，手足 然汗出，此欲作固瘕，必大便初硬后溏。所以然
者，以胃中冷，水谷不别故也。
192．阳明病，初欲食，小便反不利，大便自调，其人骨节疼，翕翕如有热状，奄然发狂， 然汗出而解
者，此水不胜谷气，与汗共并，脉紧则愈。
193．阳明病，欲解时，从申至戌上。
194．阳明病，不能食，攻其热必哕。所以然者，胃中虚冷故也。以其人本虚，攻其热必哕。
195．阳明病，脉迟，食难用饱。饱则微烦头眩，必小便难，此欲作谷瘅，虽下之，腹满如故。所以然者，
脉迟故也。
196．阳明病，法多汗，反无汗，其身如虫行皮中状
者，此以久虚故也。
197．阳明病，反无汗而小便利，二三日呕而咳，手足厥者，必苦头痛；若不咳、不呕、手足不厥者，头不痛。
（一云冬阳明。）
198．阳明病，但头眩，不恶寒。故能食而咳，其人咽必痛；若不咳者，咽不痛。（一云冬阳明）
199．阳明病，无汗、小便不利、心中懊 者，身必发黄。
200．阳明病，被火，额上微汗出，而小便不利者，必发黄。
201．阳明病，脉浮而紧者，必潮热发作有时；但浮者，必盗汗出。
202．阳明病，口燥但欲漱水，不欲咽者，此必衄。
203．阳明病，本自汗出。医更重发汗，病已瘥，尚微烦不了了者，此必大便硬故也。以亡津液，胃中干
燥，故令大便硬。当问其小便日几行，若本小便日三四行，今日再行，故知大便不久出。今为小便数少，以津
液当还入胃中，故知不久必大便也。
204．伤寒呕多，虽有阳明证，不可攻之。
205．阳明病，心下硬满者，不可攻之。攻之，利遂不止者死；利止者愈。
206．阳明病，面合色赤，不可攻之。必发热，色黄者，小便不利也。
207．阳明病，不吐、不下、心烦者，可与调胃承气汤。方一。
甘草（炙，二两） 芒硝（半斤） 大黄（清酒洗，四两）
上三味，切，以水三升，煮二物至一升，去滓；内芒硝，更上微火一二沸，温顿服之，以调胃气。
208．阳明病，脉迟，虽汗出不恶寒者，其身必重，短气，腹满而喘，有潮热者，此外欲解，可攻里也。手
足然汗出者，此大便已硬也，大承气汤主之；若汗多，微发热恶寒者，外未解也；（一法与桂枝汤）其热不
潮，未可与承气汤；若腹大满不通者，可与小承气汤，微和胃气，勿令至大泄下。大承气汤。方二。
大黄（酒洗，四两） 浓朴（炙，去皮，半斤） 枳实（炙，五枚） 芒硝（三合）
上四味，以水一斗，先煮二物，取五升，去滓；内大黄，更煮取二升，去滓；内芒硝，更上微火一两
沸，分温再服。得下，余勿服。
小承气汤方∶
大黄（酒洗，四两） 浓朴（去皮，炙，二两） 枳实（大者，炙，
三枚）
上三味，以水四升，煮取一升二合，去滓，分温二服。初服汤当更衣，不尔者尽饮之；若更衣者，
勿服之。
209．阳明病，潮热、大便微硬者，可与大承气汤；不硬者，不可与之。若不大便六七日，恐有燥屎，欲知
之法，少与小承气汤，汤入腹中，转失气者，此有燥屎也，乃可攻之；若不转失气者，此但初头硬，后必溏，
不可攻之，攻之必胀满不能食也。欲饮水者，与水则哕，其后发热者，必大便复硬而少也，以小承气汤和之；不
转失气者，慎不可攻也。小承气汤。方三。（用前第二方。）
210．夫实则谵语，虚则郑声。郑声者，重语也；直视、谵语、喘满者死，下利者亦死。
211．发汗多，若重发汗者，亡其阳，谵语，脉短者死；脉自和者不死。
212．伤寒若吐、若下后不解，不大便五六日，上至十余日，日晡所发潮热，不恶寒，独语如见鬼状；若剧
者，发则不识人，循衣摸床，惕而不安，（一云顺衣妄撮怵惕不安）微喘直视，脉弦者生，涩者死。微者，但
发热谵语
者，大承气汤主之。若一服利，则止后服。方四。（用前第二方。）
213．阳明病，其人多汗，以津液外出，胃中燥，大便必硬，硬则谵语，小承气汤主之。若一服谵语止者，
更莫复服。方五。（用前第二方。）
214．阳明病，谵语、发潮热、脉滑而疾者，小承气汤主之。因与承气汤一升，腹中转气者，更服一升；
若不转气者，勿更与之。明日又不大便，脉反微涩者，里虚也，为难治，不可更与承气汤也。方六。（用前第二
方。）
215．阳明病，谵语、有潮热、反不能食者，胃中必有燥屎五六枚也；若能食者，但硬耳。宜大承气汤下
之。方七。（用前第二方。）
216．阳明病、下血、谵语者，此为热入血室。但头汗出者，刺期门，随其实而泻之， 然汗出则愈。
217．汗（汗一作卧）出谵语者，以有燥屎在胃中，此为风也。须下者，过经乃可下之；下之若早，语言必
乱，以表虚里实故也。下之愈，宜大承气汤。方八。（用前第二方，一云大柴胡汤。）
218．伤寒四五日，脉沉而喘满。沉为在里，而反发其汗，津液越出，大便为难；表虚里实，久则谵语。
219．三阳合病，腹满、身重，难以转侧，口不仁、面垢、（又作枯，一云向经）谵语、遗尿。发汗，则谵
语；下之，则额上生汗、手足逆冷；若自汗出者，白虎汤主之。方九。
知母（六两） 石膏（碎，一斤） 甘草（炙，二两） 粳米（六合）
上四味，以水一斗，煮米熟，汤成去滓。温服一升，日三服。
220．二阳并病，太阳证罢，但发潮热，手足 汗出、大便难而谵语者，下之则愈，宜大承气汤。方十。
（用前第二方。）
221．阳明病，脉浮而紧、咽燥、口苦、腹满而喘、发热汗出、不恶寒反恶热、身重，若发汗则躁，心愦愦
（公对切）反谵语；若加温针，必怵惕烦躁不得眠；若下之，则胃中空虚，客气动膈，心中懊 。舌上苔者，
栀子豉汤主之。方十一。
肥栀子（擘，十四枚） 香豉（绵裹，四合）
上二味，以水四升，煮栀子取二升半，去滓；内豉，更煮取一升半，去滓，分二服。温进一服，得快
吐者，止后服。
222．若渴欲饮水，口干舌燥者，白虎加人参汤主之。方十二。
知母（六两） 石膏（碎，一斤） 甘草（炙，二两） 粳米（六合） 人参（三两）
上五味，以水一斗，煮米熟，汤成去滓，温服一升，日三服。
223．若脉浮、发热、渴欲饮水、小便不利者，猪苓汤主之。方十三。
猪苓（去皮） 茯苓 泽泻 阿胶 滑石（碎，各一两）
上五味，以水四升，先煮四味，取二升，去滓；内阿胶烊消。温服七合，日三服。
224．阳明病，汗出多而渴者，不可与猪苓汤。以汗多胃中燥，猪苓汤复利其小便故也。
225．脉浮而迟，表热里寒，下利清谷者，四逆汤主之。方十四。
甘草（炙，二两） 干姜（一两半） 附子（生用，去皮，破八片，一枚）
上三味，以水三升，煮取一升二合，去滓，分温二服。强人可大附子一枚，干姜三两。
226．若胃中虚冷，不能食者，饮水则哕。
227．脉浮、发热，口干、鼻燥、能食者则衄。
228．阳明病，下之，其外有热，手足温，不结胸，心中懊 ，饥不能食，但头汗出者，栀子豉汤主之。
方十五。（用前第十一方。）
229．阳明病，发潮热、大便溏、小便自可、胸胁满不去者，与小柴胡汤。方十六。
柴胡（半斤） 黄芩（三两） 人参（三两） 半夏（洗，半升） 甘草（炙，三两） 生姜（切，三两）
大枣（擘，十二枚）
上七味，以水一斗二升，煮取六升，去滓，再煎取三升。温服一升，日三服。
230．阳明病，胁下硬满，不大便而呕，舌上白苔者，可与小柴胡汤。上焦得通，津液得下，胃气因和，身
然汗出而解。方十七。（用上方。）
231．阳明中风，脉弦浮大，而短气，腹都满，胁下及心痛，久按之气不通，鼻干，不得汗，嗜卧，一身及
目悉黄，小便难，有潮热，时时哕，耳前后肿，刺之小瘥，外不解。病过十日，脉续浮者，与小柴胡汤。方十八。
（用上方。）
232．脉但浮，无余证者，与麻黄汤。若不尿，腹满加哕者，不治。麻黄汤。方十九。
麻黄（去节，三两） 桂枝（去皮，二两） 甘草（炙，一两） 杏仁（去皮尖，七十个）
上四味，以水九升，煮麻黄减二升，去白沫；
内诸药，煮取二升半，去滓。温服八合，覆取微似汗。
233．阳明病，自汗出。若发汗，小便自利者，此为津液内竭，虽硬不可攻之；当须自欲大便，宜蜜煎导而
通之。若土瓜根及大猪胆汁，皆可为导。方二十。蜜煎导方。
食蜜（七合）
上一味，于铜器内微火煎，当须凝如饴状，搅之勿令焦着，欲可丸，并手捻作挺，令头锐，大如
指，长二寸许。当热时急作，冷则硬。以内谷道中，以手急抱，欲大便时乃去之。疑非仲景意，已试甚良。
又大猪胆一枚，泻汁，和少许法醋，以灌谷道内，如一食顷，当大便出宿食恶物，甚效。
234．阳明病，脉迟、汗出多、微恶寒者，表未解也，可发汗，宜桂枝汤。方二十一。
桂枝（去皮，三两） 芍药（三两） 生姜（三两） 甘草（炙，二两） 大枣（擘，十二枚）
上五味，以水七升，煮取三升，去滓，温服一升。须臾，啜热稀粥一升，以助药力取汗。
235．阳明病，脉浮、无汗而喘者，发汗则愈，宜麻黄汤。方二十二。（用前第十九方）
236．阳明病，发热、汗出者，此为热越，不能发黄也。但头汗出，身无汗，剂颈而还，小便不利，渴引水
浆者，此为瘀热在里，身必发黄，茵陈蒿汤主之。方二十三。
茵陈蒿（六两） 栀子（擘，十四枚） 大黄（去皮，二两）
上三味，以水一斗二升，先煮茵陈，减六升；内二味，煮取三升，去滓，分三服。小盒饭利，尿如皂
荚汁状，色正赤，一宿腹减，黄从小便去也。
237．阳明证，其人喜忘者，必有蓄血。所以然者，本有久瘀血，故令喜忘；屎虽硬，大便反易，其色
必黑者，宜抵当汤下之。方二十四。
水蛭（熬） 虻虫（去翅足，熬，各三十个） 大黄（酒洗，三两） 桃仁（去皮尖及两仁者，二十个）
上四味，以水五升，煮取三升，去滓，温服一升；不下更服。
238．阳明病，下之，心中懊 而烦，胃中有燥屎者，可攻。腹微满，初头硬，后必溏，不可攻之。若有燥
屎者，宜大承气汤。方二十五。（用前第二方。）
239．病患不大便五六日，绕脐痛、烦躁、发作有时者，此有燥屎，故使不大便也。
240．病患烦热，汗出则解；又如疟状，日晡所发热者，属阳明也。脉实者，宜下之；脉浮虚者，宜发汗。下
之与大承气汤，发汗宜桂枝汤。方二十六。（大承气汤用前第二方，桂枝汤用前第二十一方。）
241．大下后，六七日不大便，烦不解，腹满痛者，此有燥屎也。所以然者，本有宿食故也，宜大承气汤。
方二十七。（用前第二方。）
242．病患小便不利，大便乍难乍易，时有微热，喘冒（一作息）不能卧者，有燥屎也，宜大承气汤。方二
十八。（用前第二方。）
243．食谷欲呕，属阳明也，吴茱萸汤主之。得汤反剧者，属上焦也。吴茱萸汤。方二十九。
吴茱萸（洗，一升） 人参（三两） 生姜（切，六两） 大枣（擘，十二枚）
179．问：病证有太阳阳明，有正阳阳明，有少阳阳明，这是什么意思？答：所谓太阳阳明，就是脾约（脾的功能受约束，导致津液不能输布，大便干结）；所谓正阳阳明，就是胃家实（胃肠燥热结实）；所谓少阳阳明，是指经过发汗、利小便治疗后，导致胃中干燥、心烦、邪气结实、大便困难的情况。
180．阳明病的特征，就是胃家实（一作“寒”，指胃肠邪气盛实）。
181．问：是什么原因导致阳明病？答：太阳病，如果使用了发汗、泻下或利小便的方法，导致津液耗伤，胃中干燥，因而转属为阳明病。如果不排便，体内邪气结实、大便困难，这就叫做阳明病。
182．问：阳明病的外部证候是怎样的？答：身体发热、自然出汗、不恶寒反而恶热。
183．问：有的病刚得了一天，不发热却恶寒，这是为什么？答：虽然得病才一天，但恶寒将会自行停止，随即出现出汗且恶热的症状。
184．问：恶寒为什么会自行停止？答：阳明位居中焦，五行属土。土是万物归宿之处，邪气传入阳明后不再传变到其他经。开始时虽然恶寒，第二天就会自然停止，这就是阳明病。
185．原本是太阳病，刚开始患病时，使用了发汗法，但汗出得不透彻，因而转属为阳明病。伤寒发热、无汗、呕吐不能进食，反而持续不断出汗的，这是转属阳明病。
187．伤寒脉象浮而缓，手足自然温暖的，这是病系在太阴。太阴病，身体应当发黄；如果小便通畅，就不会发黄；到了第七八天，大便变硬的，就转为阳明病了。
189．阳明中风，出现口苦、咽干、腹部胀满、轻微气喘、发热、恶寒、脉象浮而紧。如果误用泻下法，就会导致腹部胀满、小便困难。
190．阳明病，如果能进食，名叫中风；如果不能进食，名叫中寒。
191．阳明病，如果是中寒，就不能进食，小便不利，手足持续出汗，这将形成固瘕（一种因寒积导致的腹中硬块或腹泻病症），大便必定先硬后稀。之所以这样，是因为胃中寒冷，水谷不能分别清浊的缘故。
192．阳明病，起初想进食，小便反而不利，大便自然调和，病人骨节疼痛，发热像羽毛覆盖一样，突然发狂，持续出汗后病解的，这是因为水湿之气不胜谷气，随汗一起排出，脉象紧则病愈。
193．阳明病，想要解除的时间，是从申时到戌时（下午3点到晚上9点）。
194．阳明病，不能进食，如果攻伐其热，必然导致呃逆。之所以这样，是因为胃中虚冷的缘故。因为病人本来体质虚弱，攻伐其热必然导致呃逆。
195．阳明病，脉象迟，吃饭难以吃饱。吃饱了就轻微心烦、头晕，必然小便困难，这将形成谷瘅（因饮食停滞导致的黄疸类病症），即使使用泻下法，腹部胀满依旧。之所以这样，是因为脉迟（主寒/虚）的缘故。
196．阳明病，按理应该多汗，反而无汗，身体感觉像虫子在皮肤中爬行，这是因为长期虚弱的缘故。
197．阳明病，反而无汗但小便通畅，两三天后出现呕吐、咳嗽，手足厥冷的，必然头痛剧烈；如果不咳嗽、不呕吐、手足不厥冷，头就不痛。（一说为冬阳明。）
198．阳明病，只是头晕，不恶寒。所以能进食且咳嗽的，病人咽喉必然疼痛；如果不咳嗽，咽喉就不痛。（一说为冬阳明。）
199．阳明病，无汗、小便不利、心中烦闷懊恼的，身体必然发黄。
200．阳明病，被火法误治，额头上微微出汗，而小便不利的，必然发黄。
201．阳明病，脉象浮而紧的，必然定时发作潮热；脉象只是浮的，必然盗汗。
202．阳明病，口干燥只想漱口，不想咽下水的，这必然会导致鼻衄（流鼻血）。
203．阳明病，原本就有自汗出。医生又重用发汗法，病虽然好了，但仍有些微心烦、身体不适，这必然是大便坚硬的缘故。因为津液耗伤，胃中干燥，所以导致大便坚硬。应当询问病人每天小便几次，如果原本每天小便三四次，今天只有两次，就知道大便不久就会排出。现在小便次数减少，因为津液应当回流到胃中，所以知道不久必然要大便。
205．阳明病，心下部硬满的，不可使用攻下法。如果攻下，导致腹泻不止的会死亡；腹泻停止的会痊愈。
206．阳明病，满面通红的，不可使用攻下法。如果攻下，必然发热，面色发黄的，是小便不利。
207．阳明病，不呕吐、不泻下、心中烦躁的，可以给予调胃承气汤。方一。
甘草（炙，二两） 芒硝（半斤） 大黄（用清酒洗，四两）
以上三味药，切碎，用水三升，煮其中两味药至一升，去掉药渣；放入芒硝，再上小火煮开一两次，温服一次性喝完，以调和胃气。
208．阳明病，脉象迟，虽然出汗但不恶寒的，身体必然沉重，短气，腹部胀满且气喘，有潮热的，这是表证欲解，可以攻里。手足持续出汗的，这是大便已经坚硬，用大承气汤主治；如果汗多，轻微发热恶寒的，是表证未解；（另一法给予桂枝汤）如果热势不是潮热，不可给予承气汤；如果腹部极度胀满不通的，可以给予小承气汤，轻微调和胃气，不要导致严重泻下。大承气汤。方二。
大黄（酒洗，四两） 厚朴（炙，去皮，半斤） 枳实（炙，五枚） 芒硝（三合）
以上四味药，用水一斗，先煮两味药，取五升，去掉药渣；放入大黄，再煮取二升，去掉药渣；放入芒硝，再上小火煮开一两次，分两次温服。得到泻下后，剩余的药不要服用。
小承气汤方：
大黄（酒洗，四两） 厚朴（去皮，炙，二两） 枳实（大的，炙，三枚）
以上三味药，用水四升，煮取一升二合，去掉药渣，分两次温服。初次服药后应当排便，如果不排便就全部喝完；如果排便了，就不要继续服用。
209．阳明病，潮热、大便微硬的，可以给予大承气汤；大便不硬的，不可给予。如果六七天不大便，担心有燥屎，想知道的方法，是少量给予小承气汤，药汤进入腹中，转矢气（放屁）的，说明有燥屎，才可以攻下；如果不转矢气，这只是大便初头硬，后面必然稀溏，不可攻下，攻下必然导致腹胀满、不能进食。想喝水的人，给水喝就会呃逆，之后发热的，必然是大便再次变硬且量少，用小承气汤调和；不转矢气的，千万不可攻下。小承气汤。方三。（使用前第二方。）
210．实证会出现谵语（胡言乱语），虚证会出现郑声（语言重复低微）。郑声，就是说话重复；直视、谵语、气喘胸满的会死亡，下利的也会死亡。
211．发汗过多，如果再次重发汗，会导致亡阳，出现谵语，脉象短的会死亡；脉象自然调和的不死。
212．伤寒如果使用吐法或下法后病不解，五六天不大便，甚至十多天，傍晚时分发作潮热，不恶寒，独自说话像见到鬼一样；如果病情剧烈，发作时不认识人，循衣摸床，惊恐不安，（一说顺衣妄撮怵惕不安）轻微气喘、直视，脉象弦的生，脉象涩的死亡。病情轻微的，只是发热谵语的，用大承气汤主治。如果服用一次后泻下，就停止后续服用。方四。（使用前第二方。）
213．阳明病，病人多汗，因为津液外泄，胃中干燥，大便必然坚硬，坚硬就会导致谵语，用小承气汤主治。如果服用一次后谵语停止，就不要再服用。方五。（使用前第二方。）
214．阳明病，谵语、发作潮热、脉象滑而快的，用小承气汤主治。因此给予承气汤一升，腹中转气的，再服一升；如果不转气，就不要继续给予。第二天又不大便，脉象反而微涩的，是里虚，为难治之证，不可再给予承气汤。方六。（使用前第二方。）
215．阳明病，谵语、有潮热、反而不能进食的，胃中必然有五六枚燥屎；如果能进食的，只是大便硬而已。适宜用大承气汤攻下。方七。（使用前第二方。）
216．阳明病、下血、谵语的，这是热入血室。只有头部出汗的，针刺期门穴，随着其实证而泻之，持续出汗就会痊愈。
217．出汗且谵语的，是因为胃中有燥屎，这是风邪所致。必须攻下的，要等经过经期才可以攻下；如果攻下过早，语言必然混乱，因为表虚里实的缘故。攻下后痊愈，适宜用大承气汤。方八。（使用前第二方，一说为大柴胡汤。）
218．伤寒四五天后，脉象沉且气喘胸满。沉脉表示病在里，反而使用发汗法，津液外越，大便困难；表虚里实，时间久了就会谵语。
219．三阳合病，腹部胀满、身体沉重，难以翻身，口不知味、面部污垢、（又作枯，一说向经）谵语、遗尿。如果发汗，就会谵语加重；如果攻下，就会额头出汗、手足逆冷；如果自然出汗的，用白虎汤主治。方九。
知母（六两） 石膏（碎，一斤） 甘草（炙，二两） 粳米（六合）
以上四味药，用水一斗，煮到米熟，汤成后去掉药渣。温服一升，每天服三次。
220．二阳并病，太阳证消失，只发作潮热，手足持续出汗、大便困难且谵语的，攻下就会痊愈，适宜用大承气汤。方十。（使用前第二方。）
221．阳明病，脉象浮而紧、咽干、口苦、腹部胀满且气喘、发热出汗、不恶寒反而恶热、身体沉重，如果发汗就会烦躁，心中昏乱反而谵语；如果加用温针，必然惊恐烦躁不得睡眠；如果攻下，就会胃中空虚，客气扰动膈膜，心中懊恼。舌上有苔的，用栀子豉汤主治。方十一。
肥栀子（剖开，十四枚） 香豉（用棉布包裹，四合）
以上两味药，用水四升，煮栀子取二升半，去掉药渣；放入豆豉，再煮取一升半，去掉药渣，分两次服用。温服一次，如果快速呕吐，就停止后续服用。
222．如果口渴想喝水，口干舌燥的，用白虎加人参汤主治。方十二。
知母（六两） 石膏（碎，一斤） 甘草（炙，二两） 粳米（六合） 人参（三两）
以上五味药，用水一斗，煮到米熟，汤成后去掉药渣，温服一升，每天服三次。
223．如果脉象浮、发热、口渴想喝水、小便不利的，用猪苓汤主治。方十三。
猪苓（去皮） 茯苓 泽泻 阿胶 滑石（碎，各一两）
以上五味药，用水四升，先煮前四味，取二升，去掉药渣；放入阿胶溶化。温服七合，每天服三次。
224．阳明病，出汗多且口渴的，不可给予猪苓汤。因为汗多胃中干燥，猪苓汤又会利小便（进一步耗伤津液）的缘故。
225．脉象浮而迟，表热里寒，下利清谷（完谷不化）的，用四逆汤主治。方十四。
甘草（炙，二两） 干姜（一两半） 附子（生用，去皮，破成八片，一枚）
以上三味药，用水三升，煮取一升二合，去掉药渣，分两次温服。强壮的人可以用大附子一枚，干姜三两。
226．如果胃中虚冷，不能进食的，喝水就会呃逆。
228．阳明病，攻下后，外部有热，手足温暖，没有结胸，心中懊恼，饥饿但不能进食，只有头部出汗的，用栀子豉汤主治。方十五。（使用前第十一方。）
229．阳明病，发作潮热、大便稀溏、小便自然通畅、胸胁满闷不除的，给予小柴胡汤。方十六。
柴胡（半斤） 黄芩（三两） 人参（三两） 半夏（洗，半升） 甘草（炙，三两） 生姜（切，三两） 大枣（剖开，十二枚）
以上七味药，用水一斗二升，煮取六升，去掉药渣，再煎取三升。温服一升，每天服三次。
230．阳明病，胁下硬满，不大便且呕吐，舌上有白苔的，可以给予小柴胡汤。上焦得以通畅，津液得以下行，胃气因而调和，身体持续出汗而病解。方十七。（使用上方。）
231．阳明中风，脉象弦浮大，且短气，腹部都胀满，胁下及心痛，长时间按压气不通畅，鼻干，不能出汗，嗜睡，全身及眼睛都发黄，小便困难，有潮热，时时呃逆，耳前后肿胀，针刺后稍有好转，但表证未解。病过十天，脉象持续浮的，给予小柴胡汤。方十八。（使用上方。）
232．脉象只是浮，没有其他证候的，给予麻黄汤。如果不排尿，腹部胀满加上呃逆的，是不治之症。麻黄汤。方十九。
麻黄（去节，三两） 桂枝（去皮，二两） 甘草（炙，一两） 杏仁（去皮尖，七十个）
以上四味药，用水九升，先煮麻黄减去二升，去掉白沫；
放入其他药，煮取二升半，去掉药渣。温服八合，覆盖衣物取微似汗。
233．阳明病，自汗出。如果发汗，小便自然通畅的，这是津液内部枯竭，虽然大便硬不可攻下；应当等待病人自己想大便时，适宜用蜜煎导法通便。如果用土瓜根及大猪胆汁，都可以作为导法。方二十。蜜煎导方。
食蜜（七合）
以上一味药，在铜器内用小火煎，应当凝结如饴糖状，搅拌不要让它焦糊粘底，想要做成丸状，用手捻成挺状，令头部尖锐，大小如手指，长约二寸。应当在热的时候急忙制作，冷了就会变硬。将其纳入肛门中，用手急抱臀部，想要大便时才取出。怀疑这不是张仲景的原意，但已经试用过效果很好。
又大猪胆一枚，挤出汁液，混合少许法醋，用来灌入肛门内，约一顿饭的时间，应当排出大便及宿食恶物，非常有效。
234．阳明病，脉象迟、出汗多、轻微恶寒的，是表证未解，可以发汗，适宜用桂枝汤。方二十一。
桂枝（去皮，三两） 芍药（三两） 生姜（三两） 甘草（炙，二两） 大枣（剖开，十二枚）
以上五味药，用水七升，煮取三升，去掉药渣，温服一升。一会儿，喝热稀粥一升，以助药力取汗。
235．阳明病，脉象浮、无汗且气喘的，发汗就会痊愈，适宜用麻黄汤。方二十二。（使用前第十九方）
236．阳明病，发热、出汗的，这是热邪外越，不能发黄。只有头部出汗，身体无汗，到颈部为止，小便不利，口渴引水浆的，这是瘀热在里，身体必然发黄，用茵陈蒿汤主治。方二十三。
茵陈蒿（六两） 栀子（剖开，十四枚） 大黄（去皮，二两）
以上三味药，用水一斗二升，先煮茵陈，减去六升；放入另外两味药，煮取三升，去掉药渣，分三次服用。小便应当通畅，尿液像皂荚汁一样，颜色正红，一夜之间腹部胀满减轻，黄色从小便排出。
237．阳明证，病人健忘的，必然有蓄血。之所以这样，是因为原本有久瘀血，所以导致健忘；大便虽然硬，排便反而容易，其颜色必然黑，适宜用抵当汤攻下。方二十四。
水蛭（熬） 虻虫（去翅足，熬，各三十个） 大黄（酒洗，三两） 桃仁（去皮尖及双仁者，二十个）
以上四味药，用水五升，煮取三升，去掉药渣，温服一升；如果不泻下再服。
238．阳明病，攻下后，心中懊恼且烦躁，胃中有燥屎的，可以攻下。腹部微满，初头硬，后面必然稀溏，不可攻下。如果有燥屎，适宜用大承气汤。方二十五。（使用前第二方。）
239．病人五六天不大便，绕脐疼痛、烦躁、发作有定时的，这是有燥屎，所以导致不大便。
240．病人烦热，出汗就缓解；又像疟疾一样，傍晚时分发热的，属于阳明病。脉象实的，适宜攻下；脉象浮虚的，适宜发汗。攻下用大承气汤，发汗适宜用桂枝汤。方二十六。（大承气汤使用前第二方，桂枝汤使用前第二十一方。）
241．大泻下后，六七天不大便，烦躁不解，腹部胀满疼痛的，这是有燥屎。之所以这样，是因为原本有宿食的缘故，适宜用大承气汤。方二十七。（使用前第二方。）
242．病人小便不利，大便忽难忽易，时有微热，气喘头晕（一作休息）不能躺卧的，是有燥屎，适宜用大承气汤。方二十八。（使用前第二方。）
243．吃东西想呕吐，属于阳明病，用吴茱萸汤主治。喝了汤药反而加剧的，属于上焦病。吴茱萸汤。方二十九。
吴茱萸（洗，一升） 人参（三两） 生姜（切，六两） 大枣（剖开，十二枚）
179. Question: There are Taiyang-Yangming, Zhengyang-Yangming, and Shaoyang-Yangming patterns. What do these terms mean? Answer: Taiyang-Yangming refers to Pi Yue (Spleen Constraint, a condition where spleen function is constrained, failing to distribute fluids, leading to dry stools); Zhengyang-Yangming refers to Wei Jia Shi (Stomach Home Excess, characterized by dryness and excess in the stomach and intestines); Shaoyang-Yangming refers to a condition where, after diaphoresis (inducing sweating) and promoting urination, the stomach becomes dry, causing vexation, excess, and difficult defecation.
180. The characteristic of Yangming disease is Wei Jia Shi (Stomach Home Excess, alternatively interpreted as Cold).
181. Question: What causes Yangming disease? Answer: In Taiyang Disease (Taiyang Pattern), if diaphoresis, purgation, or promotion of urination is used, it leads to the loss of Body Fluids (Jin Ye), causing dryness in the stomach, thereby transforming into Yangming Disease. If there is no bowel movement, with internal excess and difficult defecation, this is called Yangming Disease.
182. Question: What are the external manifestations of Yangming Disease? Answer: Fever, spontaneous sweating, absence of aversion to cold, and aversion to heat.
183. Question: Why does some disease present with aversion to cold but no fever on the first day? Answer: Although it has only been one day, the aversion to cold will cease spontaneously, followed by sweating and aversion to heat.
184. Question: Why does the aversion to cold cease spontaneously? Answer: Yangming resides in the middle burner and corresponds to the Earth element. As earth is the destination for all things, pathogenic factors entering Yangming do not transmit further. Although there is initial aversion to cold, it stops naturally on the second day; this is Yangming Disease.
185. Originally a Taiyang pattern, diaphoresis was administered at the onset, but the sweating was incomplete, leading to transformation into Yangming. In Cold Damage (Shang Han), if there is fever, absence of sweating, vomiting with inability to eat, and instead continuous sweating, this indicates transformation into Yangming.
186. On the third day of Cold Damage, the Yangming pulse becomes large.
187. In Cold Damage, if the pulse is floating and moderate, and the hands and feet are naturally warm, the disease is tied to Taiyin. In Taiyin patterns, the body should develop jaundice; if urination is free, jaundice will not develop. If the stool becomes hard by the seventh or eighth day, it transforms into Yangming Disease.
188. When Cold Damage transforms into Yangming, the patient exhibits continuous slight sweating.
189. In Yangming Wind Strike (Zhong Feng), there is bitter taste in the mouth, dry throat, abdominal fullness, slight panting, fever, aversion to cold, and a pulse that is floating and tight. If purgation is mistakenly used, it will result in abdominal fullness and difficult urination.
190. In Yangming Disease, if the patient can eat, it is named Wind Strike (Zhong Feng); if unable to eat, it is named Cold Strike (Zhong Han).
191. In Yangming Disease, if there is Cold Strike, the patient cannot eat, has difficult urination, and continuous sweating of the hands and feet. This indicates the formation of Gu Jia (Solid Mass, a condition of abdominal hardness or diarrhea due to cold accumulation), and the stool will initially be hard and then loose. This occurs because of cold in the stomach, preventing the separation of water and grain.
192. In Yangming Disease, if there is an initial desire to eat, but urination is difficult, and defecation is normal, accompanied by pain in the bones and joints, fever resembling a covering of feathers, sudden madness, and resolution through continuous sweating, this is because dampness cannot overcome Grain Qi (Gu Qi), and is expelled with sweat. A tight pulse indicates recovery.
193. The time when Yangming Disease tends to resolve is from Shen to Xu hours (3 PM to 9 PM).
194. In Yangming Disease, if the patient cannot eat, attacking the heat will inevitably cause hiccup (Yue). This is due to deficiency and cold in the stomach. Since the patient is originally deficient, attacking the heat will inevitably cause hiccup.
195. In Yangming Disease, if the pulse is slow (Chi), the patient cannot eat to fullness. Eating to fullness causes slight vexation and dizziness, and inevitably leads to difficult urination. This indicates the formation of Gu Dan (Grain Jaundice, jaundice-like condition due to food stagnation). Even if purgation is used, abdominal fullness remains. This is because the pulse is slow (indicating cold/deficiency).
196. In Yangming Disease, although profuse sweating is expected, if there is no sweating and the body feels as if insects are crawling under the skin, this is due to long-term deficiency.
197. In Yangming Disease, if there is no sweating but urination is free, and after two or three days there is vomiting, coughing, and cold reversal of the hands and feet, severe headache is inevitable. If there is no coughing, no vomiting, and no cold reversal of the hands and feet, there is no headache. (One version says Winter Yangming.)
198. In Yangming Disease, if there is only dizziness and no aversion to cold, the patient can eat. If there is coughing, the throat will definitely be painful; if there is no coughing, the throat will not be painful. (One version says Winter Yangming.)
199. In Yangming Disease, if there is no sweating, difficult urination, and vexation/regret in the heart, the body will inevitably develop jaundice.
200. In Yangming Disease, if treated with fire therapy, resulting in slight sweating on the forehead and difficult urination, jaundice will inevitably develop.
201. In Yangming Disease, if the pulse is floating and tight, tidal fever will occur at regular intervals; if the pulse is only floating, night sweating will occur.
202. In Yangming Disease, if the mouth is dry and the patient only wants to rinse with water without swallowing, epistaxis (nosebleed) is inevitable.
203. In Yangming Disease, if there was originally spontaneous sweating, and the physician heavily induced sweating again, although the disease improved, slight vexation and discomfort remain. This is necessarily due to hard stool. Because body fluids were lost, the stomach became dry, causing hard stool. One should ask about the frequency of urination. If the patient originally urinated three or four times a day, and today only twice, it indicates that stool will soon be passed. The decrease in urination frequency means fluids are returning to the stomach, so defecation is imminent.
204. In Cold Damage, if vomiting is frequent, even if Yangming signs are present, purgation must not be used.
205. In Yangming Disease, if there is hardness and fullness below the heart (epigastrium), purgation must not be used. If purged, incessant diarrhea leads to death; if diarrhea stops, recovery occurs.
206. In Yangming Disease, if the face is uniformly red, purgation must not be used. If purged, fever will occur, and yellow discoloration with difficult urination will follow.
207. In Yangming Disease, if there is no vomiting, no purgation, and vexation in the heart, Tiao Wei Cheng Qi Tang (Stomach-Regulating Order the Qi Decoction) may be given. Formula 1.
Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao, 2 liang), Natrii Sulfas (Mangxiao, 0.5 jin), Rhei Radix et Rhizoma (Dahuang, washed with clear wine, 4 liang).
Cut the above three ingredients. Boil two ingredients in 3 sheng of water until 1 sheng remains. Remove dregs. Add Mangxiao and boil gently for one or two boils. Take the warm decoction in one dose to regulate stomach qi.
208. In Yangming Disease, if the pulse is slow (Chi), and although there is sweating, there is no aversion to cold, the body will feel heavy, with shortness of breath, abdominal fullness, and panting. If there is tidal fever, the exterior pattern is resolving, and interior attack is permissible. If there is continuous sweating of the hands and feet, the stool is already hard; Da Cheng Qi Tang (Major Order the Qi Decoction) governs. If there is profuse sweating, slight fever, and aversion to cold, the exterior is not resolved; (another method suggests Gui Zhi Tang). If the fever is not tidal, Cheng Qi Tang should not be given. If there is severe abdominal fullness and obstruction, Xiao Cheng Qi Tang (Minor Order the Qi Decoction) may be given to mildly harmonize stomach qi, avoiding severe purgation. Da Cheng Qi Tang. Formula 2.
Rhei Radix et Rhizoma (Dahuang, wine-washed, 4 liang), Magnoliae Officinalis Cortex (Houpo, honey-fried, peeled, 0.5 jin), Aurantii Fructus Immaturus (Zhishi, honey-fried, 5 pieces), Natrii Sulfas (Mangxiao, 3 ge).
Boil the above four ingredients in 1 dou of water. First boil two ingredients to obtain 5 sheng, remove dregs. Add Dahuang and boil to 2 sheng, remove dregs. Add Mangxiao and boil gently for one or two boils. Divide into two warm doses. Stop taking the remainder if defecation occurs.
Xiao Cheng Qi Tang Formula:
Rhei Radix et Rhizoma (Dahuang, wine-washed, 4 liang), Magnoliae Officinalis Cortex (Houpo, peeled, honey-fried, 2 liang), Aurantii Fructus Immaturus (Zhishi, large, honey-fried, 3 pieces).
Boil the above three ingredients in 4 sheng of water to obtain 1 sheng and 2 ge. Remove dregs. Divide into two warm doses. Defecation should occur after the first dose; if not, drink the rest. If defecation occurs, do not continue.
209. In Yangming Disease, if there is tidal fever and slightly hard stool, Da Cheng Qi Tang may be given; if not hard, it must not be given. If there is no defecation for six or seven days, fearing dry stool, administer a small amount of Xiao Cheng Qi Tang. If flatus passes after ingestion, dry stool is present, and purgation is permissible. If no flatus passes, only the initial part is hard, and the rest will be loose; purgation is forbidden, as it will cause abdominal distension and inability to eat. If the patient desires water, giving water causes hiccup. Subsequent fever indicates stool becoming hard again but scanty; harmonize with Xiao Cheng Qi Tang. If no flatus passes, purgation is strictly forbidden. Xiao Cheng Qi Tang. Formula 3. (Use previous Formula 2.)
210. Excess patterns manifest as Delirium (Zhan Yu); deficiency patterns manifest as Rhen Sheng (repetitive, low-volume speech). Rhen Sheng is repetitive speech. Staring, delirium, panting, and fullness lead to death; diarrhea also leads to death.
211. If excessive sweating occurs, or if sweating is heavily induced again, Yang collapse occurs, leading to delirium. A short pulse indicates death; a harmonious pulse indicates survival.
212. If Cold Damage is not resolved after emesis or purgation, and there is no defecation for five or six days, up to ten days, with tidal fever in the late afternoon, no aversion to cold, and solitary speech as if seeing ghosts, the condition is severe. If the patient does not recognize people, picks at clothes and bed sheets, is startled and uneasy, (one version says picking clothes wildly, startled and uneasy), has slight panting and staring, a wiry pulse indicates life, while a choppy pulse indicates death. In mild cases, with only fever and delirium, Da Cheng Qi Tang governs. If defecation occurs after one dose, stop subsequent doses. Formula 4. (Use previous Formula 2.)
213. In Yangming Disease, if the patient sweats profusely, fluids escape externally, drying the stomach, leading to hard stool and delirium. Xiao Cheng Qi Tang governs. If delirium stops after one dose, do not repeat. Formula 5. (Use previous Formula 2.)
214. In Yangming Disease, with delirium, tidal fever, and a slippery and rapid pulse, Xiao Cheng Qi Tang governs. Administer 1 sheng of Cheng Qi Tang. If flatus passes, give another 1 sheng. If no flatus passes, do not give more. If there is still no defecation the next day, and the pulse becomes faint and choppy, it indicates interior deficiency, which is difficult to treat; do not give Cheng Qi Tang again. Formula 6. (Use previous Formula 2.)
215. In Yangming Disease, with delirium, tidal fever, and inability to eat, there must be five or six pieces of dry stool in the stomach. If the patient can eat, the stool is merely hard. Da Cheng Qi Tang is appropriate for purgation. Formula 7. (Use previous Formula 2.)
216. In Yangming Disease, with bloody stool and delirium, this is Heat Entering the Blood Chamber (Re Ru Xue Shi). If only the head sweats, needle Qimen (LR14) to drain the excess. Continuous sweating leads to recovery.
217. Sweating and delirium indicate dry stool in the stomach, caused by Wind. Purgation is required, but only after the channel stage has passed. Early purgation causes disordered speech due to exterior deficiency and interior excess. Recovery follows purgation; Da Cheng Qi Tang is appropriate. Formula 8. (Use previous Formula 2; one version says Da Chai Hu Tang.)
218. Four or five days into Cold Damage, the pulse is deep, with panting and fullness. A deep pulse indicates interior location. Mistaken diaphoresis causes fluid loss and difficult defecation. Exterior deficiency and interior excess lead to delirium over time.
219. In Combined Three Yang Patterns, there is abdominal fullness, body heaviness, difficulty turning, loss of taste, facial grime, (also described as withered, one version says towards menstruation), delirium, and enuresis. Diaphoresis worsens delirium; purgation causes forehead sweating and cold reversal of hands and feet. If there is spontaneous sweating, Bai Hu Tang (White Tiger Decoction) governs. Formula 9.
Anemarrhenae Rhizoma (Zhimu, 6 liang), Gypsum Fibrosum (Shigao, crushed, 1 jin), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao, 2 liang), Oryzae Semen (Jingmi, 6 ge).
Boil the above four ingredients in 1 dou of water until the rice is cooked. Remove dregs. Take 1 sheng warm, three times a day.
220. In Combined Two Yang Patterns, when Taiyang signs cease, and only tidal fever, continuous sweating of hands and feet, difficult defecation, and delirium remain, purgation leads to recovery. Da Cheng Qi Tang is appropriate. Formula 10. (Use previous Formula 2.)
221. In Yangming Disease, with a floating and tight pulse, dry throat, bitter taste, abdominal fullness and panting, fever, sweating, no aversion to cold but aversion to heat, and body heaviness, diaphoresis causes agitation, mental confusion, and conversely delirium. Adding warm needling causes fright, vexation, and insomnia. Purgation empties the stomach, allowing guest qi to disturb the diaphragm, causing vexation/regret in the heart. If there is coating on the tongue, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) governs. Formula 11.
Gardeniae Fructus (Zhizi, broken, 14 pieces), Sojae Semen Preparatum (Xiangchi, wrapped in cotton, 4 ge).
Boil the above two ingredients in 4 sheng of water. Boil Zhizi to 2.5 sheng, remove dregs. Add Chi and boil to 1.5 sheng, remove dregs. Divide into two doses. Take one warm dose. If rapid vomiting occurs, stop subsequent doses.
222. If there is thirst with desire to drink, dry mouth, and dry tongue, Bai Hu Jia Ren Shen Tang (White Tiger Plus Ginseng Decoction) governs. Formula 12.
Anemarrhenae Rhizoma (Zhimu, 6 liang), Gypsum Fibrosum (Shigao, crushed, 1 jin), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao, 2 liang), Oryzae Semen (Jingmi, 6 ge), Ginseng Radix et Rhizoma (Renshen, 3 liang).
Boil the above five ingredients in 1 dou of water until the rice is cooked. Remove dregs. Take 1 sheng warm, three times a day.
223. If the pulse is floating, with fever, thirst with desire to drink, and difficult urination, Zhu Ling Tang (Polyporus Decoction) governs. Formula 13.
Polyporus (Zhu Ling, peeled), Poria (Fuling), Alismatis Rhizoma (Zexie), Asini Corii Colla (Ejiao), Talcum (Huashi, crushed, 1 liang each).
Boil the above five ingredients in 4 sheng of water. First boil the first four to obtain 2 sheng, remove dregs. Add Ejiao and dissolve. Take 7 ge warm, three times a day.
224. In Yangming Disease, if there is profuse sweating and thirst, Zhu Ling Tang must not be given. Profuse sweating causes stomach dryness, and Zhu Ling Tang further promotes urination, depleting fluids.
225. If the pulse is floating and slow (Chi), with exterior heat and interior cold, and diarrhea with undigested food, Si Ni Tang (Frigid Extremities Decoction) governs. Formula 14.
Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao, 2 liang), Zingiberis Rhizoma (Ganjiang, 1.5 liang), Aconiti Lateralis Radix Praeparata (Fuzi, raw, peeled, broken into 8 pieces, 1 piece).
Boil the above three ingredients in 3 sheng of water to obtain 1.2 sheng. Remove dregs. Divide into two warm doses. Strong individuals may use 1 large Fuzi and 3 liang Ganjiang.
226. If the stomach is deficient and cold, causing inability to eat, drinking water causes hiccup.
227. If the pulse is floating, with fever, dry mouth, dry nose, and ability to eat, epistaxis will occur.
228. In Yangming Disease, after purgation, if there is exterior heat, warm hands and feet, no Chest Bind, vexation/regret in the heart, hunger but inability to eat, and only head sweating, Zhi Zi Chi Tang governs. Formula 15. (Use previous Formula 11.)
229. In Yangming Disease, with tidal fever, loose stool, free urination, and persistent fullness in the chest and hypochondrium, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is given. Formula 16.
Bupleuri Radix (Chaihu, 0.5 jin), Scutellariae Radix (Huangqin, 3 liang), Ginseng Radix et Rhizoma (Renshen, 3 liang), Pinelliae Rhizoma (Banxia, washed, 0.5 sheng), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao, 3 liang), Zingiberis Rhizoma Recens (Shengjiang, sliced, 3 liang), Jujubae Fructus (Dazao, broken, 12 pieces).
Boil the above seven ingredients in 1.2 dou of water to obtain 6 sheng. Remove dregs. Re-boil to 3 sheng. Take 1 sheng warm, three times a day.
230. In Yangming Disease, with hardness and fullness below the ribs, no defecation, vomiting, and white tongue coating, Xiao Chai Hu Tang may be given. This unblocks the Upper Burner, allows fluids to descend, harmonizes stomach qi, and resolves the disease through continuous sweating. Formula 17. (Use above formula.)
231. In Yangming Wind Strike, the pulse is wiry, floating, and large, with shortness of breath, general abdominal fullness, pain in the hypochondrium and heart, obstruction of qi upon prolonged pressure, dry nose, inability to sweat, lethargy, yellowing of the whole body and eyes, difficult urination, tidal fever, frequent hiccup, and swelling before and behind the ears. Acupuncture provides slight relief, but the exterior is not resolved. If the disease persists for ten days and the pulse remains floating, give Xiao Chai Hu Tang. Formula 18. (Use above formula.)
232. If the pulse is only floating, with no other signs, give Ma Huang Tang (Ephedra Decoction). If there is anuria, abdominal fullness, and added hiccup, it is incurable. Ma Huang Tang. Formula 19.
Ephedrae Herba (Mahuang, nodes removed, 3 liang), Cinnamomi Ramulus (Guizhi, peeled, 2 liang), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao, 1 liang), Armeniacae Semen Amarum (Xingren, peeled and tips removed, 70 pieces).
Boil the above four ingredients in 9 sheng of water. First boil Mahuang, reducing by 2 sheng, and remove white foam.
Add other ingredients and boil to 2.5 sheng. Remove dregs. Take 8 ge warm. Cover to induce slight sweating.
233. In Yangming Disease, with spontaneous sweating, if diaphoresis is used and urination is free, this indicates exhaustion of internal fluids. Although stool is hard, purgation is forbidden. Wait for the urge to defecate, and use Mi Jian Dao (Honey Suppository) to unblock. Tu Gua Gen (Trichosanthes Root) and large pig bile can also be used as guides. Formula 20. Mi Jian Dao Formula.
Edible Honey (7 ge).
Boil this single ingredient in a copper vessel over gentle heat until it congeals like maltose. Stir to prevent burning. Form into a suppository shape by hand, sharp at the tip, finger-sized, about 2 cun long. Make quickly while hot, as it hardens when cold. Insert into the anus, hold buttocks tightly, and remove when the urge to defecate arises. It is suspected this is not Zhongjing's original intent, but it has been tested with good results.
Alternatively, take one large pig gallbladder, extract the juice, mix with a little vinegar, and灌 (guan, irrigate) into the anus. Within the time of a meal, old food and foul matter will be expelled, which is very effective.
234. In Yangming Disease, with a slow pulse, profuse sweating, and slight aversion to cold, the exterior is not resolved. Diaphoresis is permissible; Gui Zhi Tang (Cinnamon Twig Decoction) is appropriate. Formula 21.
Cinnamomi Ramulus (Guizhi, peeled, 3 liang), Paeoniae Radix Alba (Baishao, 3 liang), Zingiberis Rhizoma Recens (Shengjiang, 3 liang), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao, 2 liang), Jujubae Fructus (Dazao, broken, 12 pieces).
Boil the above five ingredients in 7 sheng of water to obtain 3 sheng. Remove dregs. Take 1 sheng warm. Shortly after, drink 1 sheng of hot thin porridge to assist the medicinal power in inducing sweating.
235. In Yangming Disease, with a floating pulse, no sweating, and panting, diaphoresis leads to recovery. Ma Huang Tang is appropriate. Formula 22. (Use previous Formula 19.)
236. In Yangming Disease, fever and sweating indicate heat venting outward, preventing jaundice. If only the head sweats, with no body sweating (stopping at the neck), difficult urination, and thirst with desire for fluids, this is Stasis Heat in the Interior, and jaundice is inevitable. Yin Chen Hao Tang (Capillaris Decoction) governs. Formula 23.
Artemisiae Scopariae Herba (Yinchenhao, 6 liang), Gardeniae Fructus (Zhizi, broken, 14 pieces), Rhei Radix et Rhizoma (Dahuang, peeled, 2 liang).
Boil the above three ingredients in 1.2 dou of water. First boil Yinchen, reducing by 6 sheng. Add the other two ingredients and boil to 3 sheng. Remove dregs. Divide into three doses. Urination should become free, with urine resembling soap pod juice, bright red in color. Abdominal distension reduces overnight, and jaundice is eliminated through urine.
237. In Yangming Pattern, if the patient is forgetful, there must be Accumulated Blood. This is due to pre-existing long-standing blood stasis, causing forgetfulness. Although stool is hard, defecation is easy, and the color is black. Di Dang Tang (Resist Dang Decoction) is appropriate for purgation. Formula 24.
Hirudo (Shuizhi, roasted), Tabanus (Mengchong, wings and legs removed, roasted, 30 each), Rhei Radix et Rhizoma (Dahuang, wine-washed, 3 liang), Persicae Semen (Taoren, peeled, tips and double kernels removed, 20 pieces).
Boil the above four ingredients in 5 sheng of water to obtain 3 sheng. Remove dregs. Take 1 sheng warm. If no purgation occurs, take another dose.
238. In Yangming Disease, after purgation, if there is vexation/regret in the heart and irritability, and dry stool in the stomach, purgation is permissible. If abdominal fullness is slight, with initial hardness and subsequent looseness, purgation is forbidden. If dry stool is present, Da Cheng Qi Tang is appropriate. Formula 25. (Use previous Formula 2.)
239. If a patient has not defecated for five or six days, with periumbilical pain, irritability, and episodic attacks, dry stool is present, causing constipation.
240. If a patient has vexing heat, resolution occurs with sweating. If fever recurs like malaria in the late afternoon, it belongs to Yangming. A solid pulse indicates purgation is appropriate; a floating and deficient pulse indicates diaphoresis is appropriate. Purgation uses Da Cheng Qi Tang; diaphoresis uses Gui Zhi Tang. Formula 26. (Da Cheng Qi Tang uses previous Formula 2; Gui Zhi Tang uses previous Formula 21.)
241. After major purgation, if there is no defecation for six or seven days, unresolved irritability, and abdominal fullness and pain, dry stool is present. This is due to pre-existing retained food. Da Cheng Qi Tang is appropriate. Formula 27. (Use previous Formula 2.)
242. If a patient has difficult urination, alternating difficult and easy defecation, occasional slight fever, panting and dizziness (one version says resting), and inability to lie down, dry stool is present. Da Cheng Qi Tang is appropriate. Formula 28. (Use previous Formula 2.)
243. Vomiting after eating belongs to Yangming. Wu Zhu Yu Tang (Evodia Decoction) governs. If symptoms worsen after taking the decoction, it belongs to the Upper Burner. Wu Zhu Yu Tang. Formula 29.
Evodiae Fructus (Wuzhuyu, washed, 1 sheng), Ginseng Radix et Rhizoma (Renshen, 3 liang), Zingiberis Rhizoma Recens (Shengjiang, sliced, 6 liang), Jujubae Fructus (Dazao, broken, 12 pieces).