治中风僵仆风痫发作并皆服之此下剂也
大黄 芒硝 浓朴 枳实（各一两） 甘草（五钱宣明论方甘草倍于四味）上 咀分作三服每服水二盏生姜三片同
煎七分去滓温服不拘时候以利为度
双解散 治伤寒伤风或有汗或无汗表证悉具内热口干
通圣 天水（各一半）上为 咀每服二两水二大钟生姜三片葱白三根同煎七分去滓微热服以取其汗
清解散 治一切感冒
苍术（炒） 荆芥（各二两） 甘草（一两） 麻黄（一两半）上四味 咀每服一两水二钟生姜三片葱白一茎同煎
七分去滓微热服以被盖覆以汗出为度
半夏橘皮汤 治一切呕吐不止
人参 白术 白茯苓 甘草 黄芩 半夏 浓朴 藿香叶 葛根 橘皮（各等分）上为 咀每服一两水一碗煎七分
去滓入生姜自然汁少许温服不拘时
补养兼发散例
丹溪云有卒中天地之寒气者有口食生冷之物者故伤寒为病必身犯寒气口食寒物者是以从补中益气汤加发散药属内
伤者十居八九其法邪之所凑其气必虚只用补中益气汤中从所见之证出入加减气虚甚者少用附子以行参术之气（补中益气
汤方见杂病劳倦门）内伤之病专主东垣内外伤辨甚详世之病此者为多但有挟痰挟外邪者郁热于内而发者皆以补元气为主
宜看其所挟而兼用药 一男子素嗜酒因暴风寒衣薄遂觉倦怠不思饮食半日至睡后大发热遍身疼痛如被杖微恶寒天明诊
之六脉浮大按之豁然左为甚予作极虚受风寒治之人参为君黄 白术归身为臣苍术甘草木通干葛为佐使大剂与之至五帖
后通身汗如雨凡三易被得睡醒后诸证悉除 卢兄年四十九岁自来大便下血脉来沉迟涩面黄神倦者二年矣九月间因劳倦
发热自服参苏饮二帖热退早起小劳遇寒两手背与面紫黑昏仆少时却醒身大热妄语口干身痛至不可眠脉之三部不调微带
数重取虚豁左手大于右手以人参二钱半带节麻黄黄 各一钱白术二钱当归五分与三五帖得睡醒来大汗如雨即安两日后
再发胁痛咳嗽若睡时嗽不作而妄语且微恶寒诊其脉似前而左略带紧予曰此体虚再感寒也再以前药加半夏茯苓至十余帖
再得大汗而安后身倦不可久坐不思饮食用补中益气去凉药加神曲半夏砂仁五七十帖而安 杭州叶君章腊月因斋素中饥
而冒寒作劳遂患发热头痛医与小柴胡汤遂自汗神昏耳聋目不见物予诊其脉大如指似有力热不退与人参黄 白术熟附子
炙甘草作大剂服之一日而汗少二日而热减半耳微有闻目能视物初用药至四帖前药中加苍术与两服再得汗而热除本日遂
去苍术附子又与前药作小剂服三日而安 吕仲修年六十六岁正月间因忍饥冒寒作劳头痛恶寒发热骨节皆疼无汗至次日
妄语热愈甚而妄语时止时作热亦不为十分自服参苏饮两帖汗不出又再进一服以衣覆取汗大出而热不退至第四日予诊其
脉两手皆洪数而右为甚此因饥而冒寒加之作劳阳明经虽受寒气不可攻击宜急以大剂补之以回其虚俟胃气充实自能出汗
而解遂以参 白术归身陈皮炙甘草每帖加熟附子一片一昼夜服五帖至第三日口稍干言语有次诸证虽解而热未退遂去附
子加白芍又两日思食却作肉羹间与之又三日精神全二日许自汗出而热退诊其脉不数洪脉却尚有些洪脉作大脉论年高而
误汗此后必有虚证见又与前药至次日言我大便自病来不曾更衣今谷道逼痛虚坐努责状如不堪医者必欲投大黄巴豆等剂
予谓大便非实秘为是气因误汗而虚不得充腹无力可努仍与前补药以肉粥及苁蓉与之一日半煎浓葱椒汤浸下体下大便软
块者五六枚诊其脉仍旧大未敛此因气血未得回复又与前药两帖经两日小便不通少腹下妨闷颇为所苦但仰卧则点滴而出
予曰补药服之未尽于前药内倍加参 大剂服两日小便方利而安
汪机治一人年三十余因冒寒发热医用发表不愈继用小柴胡热炽汗多遂昏昏愦愦不知身之所在卧则如云之停空行则
如风之飘毛兼有消谷善饥多遗诸证观其形类肥者曰此内火燔灼而然虚极矣诊其脉皆浮洪如指曰脉经云脉不为汗衰者死
在法不治所幸者脉虽大按之不鼓形虽长而色尚苍可救也医以外感治之所谓虚其虚误矣经云邪之所凑其气必虚宜以内伤
为重遂用参 归术大剂少加桂附服十余帖病减十之二三再减桂附加芍药黄芩服十余贴病者始知身卧于床足履于地喜曰
可不死矣服久果起
薛院使已治一人年七十九仲冬将出少外家入房致头痛发热眩晕喘急痰涎壅盛小便频数口干引饮偏舌生刺缩敛如荔枝
然下唇黑裂面目俱赤烦躁不寐或时喉间如烟火上冲急饮凉茶少解已濒于死脉洪大而无伦且有力扪其身烙手此肾经虚火
游行于外投以十全大补加山茱萸泽泻丹皮山药麦门五味附子一钟熟寐良久脉证各减三四再与八味丸服之诸证悉退后畏
冷物而痊
本事方黄 建中加当归汤 治发热头疼脉浮数而尺中迟弱者宜先服此药补血却与麻黄桂枝辈
黄 当归（各一两半） 白芍药 桂枝 甘草（各一两）上为 咀每服五钱姜三片枣一枚水煎日三夜二服如脉尚
沉少迟再进一服
海 黄 汤治伤寒两感拘急三焦气虚自汗及手足汗出或手背偏多或肢体振摇腰腿沉重面赤目红但欲睡眠头
面壮热两胁热甚手足自温两手心热自利不渴大便或难或如常度或口干咽燥或渴欲饮汤不欲饮水或少欲饮水呕哕将作心
下满闷腹中疼痛或时喜笑或时悲哭或时太息或时语言错乱疑作谵语狂言者非也神不守舍耳始得病于寤寐之间或恐悸头
项不甚痛行步只如旧此阴盛阳虚之故也两手脉浮沉不一或左或右往来不定有沉涩弱微弦五种阴脉形状按之全无力浮之
损小沉之亦损小皆阴脉也宜先缓而后急缓宜用黄 汤
黄 汤方
人参 生姜 黄 白茯苓 白术 白芍药（各一两） 甘草（七钱）呕者加藿香陈皮各五钱甚者加干姜炮一钱 上
咀水煎量证加减多少用之 如大便秘结者调中丸主之
调中丸方
人参 白术 白茯苓 干姜 甘草（各等分）上为末炼蜜丸每两作十丸或五丸每服一二丸水少许煎服若病急者黄
汤每服加干姜一钱大便结者理中丸主之
理中丸方
人参 白术 干姜（炮恐热以生姜代之） 甘草（炙）上等分为末炼蜜丸每两作五丸白汤化下先缓后急也若尤急者
无汗宜附子干姜甘草汤若自汗者宜白术附子甘草汤量脉证可于四逆汤或真武汤或通脉四逆汤选用之
丹 矩新书谓有杂合邪者当以杂合法治之譬如恶寒发热得之感冒明是外合之邪已得浮数之脉而气口又紧盛明为
食所伤病者又倦怠脉重按俱有豁意而胸膈痞满间引两胁其脉轻取又似乎弦此又平昔多怒肝邪之所为也细取左尺大细沉
弱此又平时房劳之过也治法宜以感冒一节且放后先视其形色强弱浓薄且以补中化食行滞清凉胃火而以姜辣行之则中气
稍回伤滞稍行津液得和通体得汗外感之邪自解医者不肯详审求之只顾表散外邪又不推究兼见之邪脉亦不穷问所得之病
因与性情之执着巧施杂合治法将见正气自虚邪气愈固皆拙工之过也
娄 此篇集丹溪海藏诸贤治伤寒皆以补养兼发散之法实本经成败倚伏生于动动而不已则变作及风雨寒热不得虚邪
不能独伤人之旨也盖凡外伤风寒者皆先因动作烦劳不已而内伤体虚然后外邪得入故一家之中有病者有不病者由体虚则
邪入而病体不虚则邪无隙可入而不病也是故伤寒为病属内伤者十居八九后学无知举世皆谓伤寒无补法但见发热不分虚
实一例汗下而致夭横者滔滔皆是此实医门之罪人也今集此法于仲景之后其应如响使人遵之不犯虚虚实实之戒也
上纲目之文余见世医泥于伤寒无补法多犯虚虚实实之戒故备述之而删其纯内伤者及丹溪医按之庸芜者又增近代二
医按以为虚人感寒之活例云尔神而明之存乎其人不可泥也余尝治一刻字工人新婚冬月冒寒表证悉具令以人参紫苏茎叶
各一两煎汤饮之汗出而愈一孕妇春夏之交患温病头痛发热不恶寒而渴未及疗治胎堕去血无算昏眩欲绝余令以麦门冬斤
许入淡竹叶香豉频频饮之亦汗出而愈盖用劳复法治之得此活法则于是病庶几可十全矣
韩祗和氏和解因时法
伤寒病有可汗者论中但统言其可汗证及可汗脉或云脉浮而数或云脉浮紧或云脉浮无汗而喘或云脉浮为在表今略举
数条后人但凭其脉之大概并不分脉浮有阴阳虚盛之理又不知有可汗不可汗之证误投发表药则多变成阳毒之患矣今举病
人有汗恶风无汗恶寒分二等及据立春以后立秋以前气候轻重各立方治之庶学人易为开悟耳
一病患二三月以前两手脉浮数或缓或紧按之差软寸关尺若力齐等其力不甚大不甚小者亦未可便投解表药此是见里
证未见表脉也宜候寸脉力小如关尺即可投解表药大抵治伤寒病见证不见脉未见投药见脉未见证虽少投药亦无害也凡治
杂病以证为先脉为后治伤寒病以脉为先证为后
一病患两手脉浮数而紧名曰伤寒若关前寸脉力小关后尺脉力大虽不恶风不自汗出此乃阴气已盛先见于脉也若不投
药和之后必恶风及自汗出若立春以后至清明以前宜调脉汤主之清明以后至芒种以前宜葛根柴胡汤主之芒种以后至立秋
以前宜人参桔梗汤主之
调脉汤方
葛根（一两） 前胡（去苗） 防风（各七钱半） 甘草（炙半两）为粗末每服五钱水一盏生姜一块如小指大劈破
煎七分去滓温服如寸脉根据前力小加枣三枚同煎
葛根柴胡汤
葛根（一两半） 柴胡（去芦一两） 芍药 桔梗 甘草（炙各七钱半） 浓朴（半两）上 咀每服五钱水一盏生
姜二片煎至七分去滓热服如寸脉根据前力小加葱白三寸同煎服
人参桔梗汤
人参 桔梗（各七钱半） 麻黄（去节一两） 石膏（三两） 甘草（炙七钱半） 上每服五钱水一盏荆芥五穗同
煎至七分去滓热服如寸脉根据前力小加麻黄二分去节同煎服
一病患两手脉浮数而缓名曰中风若寸脉力小尺脉力大虽不恶风不自汗此乃阴气已盛先见于脉也若不投药和之后必
恶风自汗出若立春以后清明以前宜薄荷汤主之清明以后芒种以前宜防风汤主之芒种以后至立秋以前宜香芎汤主之
薄荷汤
薄荷（一两） 葛根 人参 甘草（炙各半两） 防风（去芦二两）上 咀每服五钱水一盏煎至七分去滓热服如三
五服寸脉力尚小加薄荷二分同煎
防风汤
防风（去芦一两） 桔梗（三钱） 甘草（炙） 旋复花（各半两） 浓朴（三分）上 咀每服五钱水二盏姜二块
同煎热服如三五服寸脉力尚小加荆芥穗五七茎同煎
香芎汤
川芎（二钱半） 石膏（二两） 升麻（三两） 甘草（炙） 浓朴（制各半两）上 咀每服五钱水二盏煎七分温
服如三五服后寸脉力尚小加细辛二分同煎 前二段文将中风伤寒各立法者何盖谓病患始得病三日以前或因中风脉缓或
因伤寒脉紧然脉虽先见而证犹未见尚可以药解之故立方耳
一病患两手脉浮数或缓紧寸脉短反力小于关尺脉者此名阴盛阳虚也若自汗出恶风是邪气在表阴气有余也素问云阴
气有余为多汗身寒即可投消阴助阳表剂以治之若立春以后清明以前宜六物麻黄汤主之清明以后芒种以前宜七物柴胡汤
主之芒种以后立秋以前宜发表汤主之
六物麻黄汤
麻黄（去节一两） 葛根 苍术（各七钱半） 人参 甘草（炙各半两）上 咀每服五钱水一盏枣二枚煎七分热服
如三五服后汗未止恶风者加荆芥七钱三五服后不恶风犹汗者加丁香皮半两
七物柴胡汤
柴胡 苍术（各二两） 荆芥 麻黄（各一两） 甘草（炙七钱）上 咀每服五钱水一盏姜一块枣二枚同煎七分热
服如三五服后汗未止恶风者入葱白三寸如三五服后汗再未止加当归一两同煎
发表汤
麻黄（去节一两） 苍术（二两） 人参 当归（各半两） 炙甘草 丁香皮（各七钱）上 咀每服五钱水一盏入
姜一块枣三枚同煎至七分去滓热服如三五服汗未止犹恶风者加桂枝七钱如汗未止更加细辛半两以汗止为度
一病患脉浮数或紧或缓其脉上出鱼际寸脉大于关尺者此名阳盛阴虚也若发冒闷口燥咽干者乃是邪气在表阳气独有
余也素问曰阳气有余为身热无汗是也可投消阳助阴药以解表若立春以后清明以前宜人参汤主之清明以后至芒种以前宜
前胡汤主之芒种以后至立秋以前宜石膏汤主之
人参汤
人参（半两） 柴胡（一两） 芍药 炙甘草（各七钱半） 石膏（二两）上 咀每服五钱水一盏姜一块煎七分热
服如三五服后热不解者入豉三十粒同煎服
前胡汤
前胡（一两） 石膏（二两） 甘草（炙半两） 桔梗 豉（各七钱半）上每服五钱水一盏姜五片煎七分去滓热服
如三五服热尚未解加豉三十粒煎再服
石膏汤
石膏（三两） 芍药 柴胡（各一两） 升麻 黄芩 炙甘草（各七钱半）上 咀每服五钱水一盏半豉一合煎八分
热服如三五服后热未解者加知母一两又未解加大黄一两
一病患两手脉浮数或紧或缓三部俱有力无汗恶风者此是阴阳气俱有余素问曰阴阳有余则无汗而寒是也可用药平之
若立春以后至清明以前宜解肌汤主之清明以后至芒种以前宜芍药汤主之芒种以后至立秋以前宜知母汤主之
解肌汤
治疗中风导致的突然跌倒、风痫发作，以及所有适用此方的病症。这是泻下剂。
大黄、芒硝、浓朴、枳实（各一两），甘草（五钱，《宣明论方》中甘草用量是其他四味药的两倍）。将药材切碎，分为三服。每服用水两盏，生姜三片，共同煎煮至七分，去渣，温服，不限时间，以大便通畅为度。
双解散：治疗伤寒或伤风，无论有汗无汗，表证俱全，伴有内热口干。
通圣散、天水散（各一半）。将药材切碎，每服用二两，水两大钟，生姜三片，葱白三根，共同煎煮至七分，去渣，微热服用，以取汗为目的。
清解散：治疗一切感冒。
苍术（炒）、荆芥（各二两），甘草（一两），麻黄（一两半）。以上四味药材切碎，每服用一两，水两钟，生姜三片，葱白一茎，共同煎煮至七分，去渣，微热服用，盖被保暖，以出汗为度。
半夏橘皮汤：治疗一切呕吐不止。
人参、白术、白茯苓、甘草、黄芩、半夏、浓朴、藿香叶、葛根、橘皮（各等分）。将药材切碎，每服用一两，水一碗，煎煮至七分，去渣，加入少许生姜自然汁，温服，不限时间。
补养兼发散法例：
朱丹溪说：有人遭受天地寒气的侵袭，有人因食用生冷食物致病，所以伤寒病必定是身体接触寒气、口中摄入寒物所致。因此，属于内伤的占十之八九。其治法是只用补中益气汤，根据所见症状进行加减。气虚严重者，少量使用附子以运行参、术之气（补中益气汤方见杂病劳倦门）。内伤疾病专门依据李东垣的《内外伤辨》，论述非常详细。世上患此病的人很多，但有的夹杂痰湿、外邪，郁热于内而发，都以补元气为主。应当查看其所夹带的病邪而兼用药物。
一个男子平时嗜酒，因暴风寒冷、衣着单薄，于是感到倦怠、不思饮食。半天后，睡醒后大发热，遍身疼痛如被打过，轻微恶寒。天明诊脉，六脉浮大，按之豁然空虚，左侧尤为明显。我将其视为极虚受风寒治疗。以人参为君药，黄芪、白术、当归身为臣药，苍术、甘草、木通、干葛为佐使药，大剂量给予。服至五帖后，全身汗如雨下，换了三次被子才睡着。醒来后，各种症状全部消除。
卢兄，四十九岁，两年来一直大便带血，脉来沉迟涩，面色黄，精神疲倦。九月间因劳累发热，自服参苏饮两帖，热退。早起稍作劳动，遇冷后两手背与面部紫黑，昏倒片刻后苏醒，身体大热，胡言乱语，口干，身体疼痛到无法入睡。诊脉，三部不调，微带数象，重取虚豁，左手大于右手。用人参二钱半，带节麻黄、黄芪各一钱，白术二钱，当归五分，给服三五帖。得睡醒来，大汗如雨，随即安定。两天后再次发作，胁痛咳嗽，若睡觉时咳嗽不作而胡言乱语，且轻微恶寒。诊脉似前，但左脉略带紧象。我说：这是体质虚弱再次感受寒邪。再用以前药方加半夏、茯苓，服至十余帖，再次得大汗而安。后来身体疲倦，不可久坐，不思饮食，用补中益气汤去掉凉药，加神曲、半夏、砂仁，服五七十帖而安。
杭州叶君章，腊月因吃素斋饥饿又冒寒劳作，于是患发热头痛。医生用小柴胡汤，于是自汗、神昏、耳聋、目不见物。我诊其脉大如手指，似乎有力，热不退。给人参、黄芪、白术、熟附子、炙甘草，做大剂服用。一日后汗少，二日后热减半，耳微能闻，眼能视物。初用药至第四帖，在前药中加入苍术，再服两帖，再次得汗而热除。当天便去掉苍术、附子，又与前药做小剂服用，三日而安。
吕仲修，六十六岁，正月间因忍饥冒寒劳作，头痛恶寒发热，骨节皆疼，无汗。至次日胡言乱语，热更甚，胡言乱语时止时作，热也不十分严重。自服参苏饮两帖，汗不出。又再进一服，盖衣取汗，大汗出而热不退。至第四日我诊其脉，两手皆洪数而右侧更甚。这是因为饥饿冒寒加之劳作，阳明经虽受寒气，不可攻伐，宜急以大剂补益以回复其虚气，待胃气充实，自能出汗而解。遂以人参、黄芪、白术、当归身、陈皮、炙甘草，每帖加熟附子一片，一昼夜服五帖。至第三日口稍干，言语有条理，诸证虽解而热未退，遂去掉附子加白芍。又两日思食，却做肉羹偶尔给他吃。又三日精神全复。约两日后自汗出而热退。诊其脉不数，洪脉却尚有些许，洪脉作大脉论。年高而误汗，此后必有虚证出现。又与前药。至次日他说：“我大便自己病了，生病以来不曾排便，现在肛门逼迫疼痛，有虚坐努责状，好像不堪忍受。”医生必欲投大黄、巴豆等剂。我说：大便并非实秘，是因为气因误汗而虚，不得充腹，无力可努。仍与前补药，以肉粥及肉苁蓉与之。一日半，煎浓葱椒汤浸下身，下大便软块者五六枚。诊其脉仍旧大未收敛，这是因为气血未得回复。又与前药两帖。经两日小便不通，少腹下妨闷，颇为所苦，但仰卧则点滴而出。我说：补药服之未尽，于前药内倍加人参，做大剂服用。两日小便方利而安。
汪机治疗一人，三十多岁，因冒寒发热，医生用发表药不愈，继用小柴胡汤，热炽汗多，于是昏昏愦愦不知身在何处，卧则如云之停空，行则如风之飘毛。兼有消谷善饥、多遗精等证。观其形体类肥者，我说：这是内火燔灼而然，虚极了。诊其脉皆浮洪如指，说：《脉经》云“脉不为汗衰者死”，在法上是不治之症。所幸的是脉虽大，按之不鼓，形虽长而色尚苍，可救也。医生以外感治之，所谓虚其虚，误矣。《经》云“邪之所凑，其气必虚”，宜以内伤为重。遂用人参、黄芪、当归、白术，大剂少加桂附，服十余帖，病减十之二三。再减桂附加芍药、黄芩，服十余贴，病者始知身卧于床，足履于地，喜曰：“可不死矣。”服久果起。
薛院使已治疗一人，七十九岁，仲冬将要出门，去岳父家入房，导致头痛发热、眩晕、喘急、痰涎壅盛、小便频数、口干引饮、偏舌生刺缩敛如荔枝然、下唇黑裂、面目俱赤、烦躁不寐。有时喉间如烟火上冲，急饮凉茶稍解，已濒于死。脉洪大而无伦且有力，扪其身烙手。这是肾经虚火游行于外。投以十全大补汤加山茱萸、泽泻、丹皮、山药、麦门冬、五味子、附子一钟，熟睡良久，脉证各减三四。再与八味丸服之，诸证悉退。后畏冷物而痊。
本事方黄芪建中加当归汤：治疗发热头疼，脉浮数而尺中迟弱者，宜先服此药补血，却与麻黄、桂枝辈。
黄芪、当归（各一两半），白芍药、桂枝、甘草（各一两）。将药材切碎，每服五钱，姜三片，枣一枚，水煎，日三夜二服。如脉尚沉，少迟再进一服。
海藏黄芪汤：治疗伤寒两感，拘急，三焦气虚自汗及手足汗出，或手背偏多，或肢体振摇，腰腿沉重，面赤目红，但欲睡眠，头面壮热，两胁热甚，手足自温，两手心热，自利不渴，大便或难或如常度，或口干咽燥，或渴欲饮汤不欲饮水，或少欲饮水，呕哕将作，心下满闷，腹中疼痛，或时喜笑，或时悲哭，或时太息，或时语言错乱，疑作谵语狂言者非也，神不守舍耳。始得病于寤寐之间，或恐悸，头项不甚痛，行步只如旧。此阴盛阳虚之故也。两手脉浮沉不一，或左或右往来不定，有沉涩弱微弦五种阴脉形状，按之全无力，浮之损小，沉之亦损小，皆阴脉也。宜先缓而后急，缓宜用黄芪汤。
黄芪汤方：
人参、生姜、黄芪、白茯苓、白术、白芍药（各一两），甘草（七钱）。呕者加藿香、陈皮各五钱，甚者加干姜炮一钱。将药材切碎，水煎，量证加减多少用之。如大便秘结者，调中丸主之。
调中丸方：
人参、白术、白茯苓、干姜、甘草（各等分）。将药材研为末，炼蜜丸，每两作十丸或五丸，每服一二丸，水少许煎服。若病急者，黄芪汤每服加干姜一钱。大便结者，理中丸主之。
理中丸方：
人参、白术、干姜（炮，恐热以生姜代之）、甘草（炙）。上等分为末，炼蜜丸，每两作五丸，白汤化下。先缓后急也。若尤急者，无汗宜附子干姜甘草汤，若自汗者宜白术附子甘草汤，量脉证可于四逆汤或真武汤或通脉四逆汤选用之。
丹溪《矩新书》谓有杂合邪者，当以杂合法治之。譬如恶寒发热，得之感冒，明是外合之邪；已得浮数之脉，而气口又紧盛，明为食所伤；病者又倦怠，脉重按俱有豁意，而胸膈痞满，间引两胁，其脉轻取又似乎弦，此又平昔多怒肝邪之所为也；细取左尺大细沉弱，此又平时房劳之过也。治法宜以感冒一节且放后，先视其形色强弱浓薄，且以补中化食行滞清凉胃火，而以姜辣行之，则中气稍回，伤滞稍行，津液得和，通体得汗，外感之邪自解。医者不肯详审求之，只顾表散外邪，又不推究兼见之邪，脉亦不穷问所得之病因与性情之执着，巧施杂合治法。将见正气自虚，邪气愈固，皆拙工之过也。
娄全善此篇集丹溪、海藏诸贤治伤寒，皆以补养兼发散之法，实本《经》“成败倚伏生于动，动而不已则变作”及“风雨寒热不得虚邪不能独伤人之旨也”。盖凡外伤风寒者，皆先因动作烦劳不已而内伤体虚，然后外邪得入。故一家之中有病者有不病者，由体虚则邪入而病，体不虚则邪无隙可入而不病也。是故伤寒为病，属内伤者十居八九。后学无知，举世皆谓伤寒无补法，但见发热，不分虚实，一例汗下，而致夭横者，滔滔皆是，此实医门之罪人也。今集此法于仲景之后，其应如响，使人遵之不犯虚虚实实之戒也。
上纲目之文，余见世医泥于“伤寒无补法”，多犯“虚虚实实”之戒，故备述之，而删其纯内伤者及丹溪医按之庸芜者，又增近代二医按以为虚人感寒之活例云尔。神而明之，存乎其人，不可泥也。余尝治一刻字工人，新婚冬月冒寒，表证悉具，令以人参、紫苏茎叶各一两煎汤饮之，汗出而愈。一孕妇春夏之交患温病，头痛发热，不恶寒而渴，未及疗治，胎堕去血无算，昏眩欲绝。余令以麦门冬斤许，入淡竹叶、香豉，频频饮之，亦汗出而愈。盖用劳复法治之，得此活法则于是病庶几可十全矣。
韩祗和氏和解因时法：
伤寒病有可汗者，论中但统言其可汗证及可汗脉，或云脉浮而数，或云脉浮紧，或云脉浮无汗而喘，或云脉浮为在表。今略举数条，后人但凭其脉之大概，并不分脉浮有阴阳虚盛之理，又不知有可汗不可汗之证，误投发表药则多变成阳毒之患矣。今举病人有汗恶风、无汗恶寒分二等，及据立春以后立秋以前气候轻重各立方治之，庶学人易为开悟耳。
一病患二三月以前，两手脉浮数或缓或紧，按之差软，寸关尺若力齐等，其力不甚大不甚小者，亦未可便投解表药。此是见里证未见表脉也。宜候寸脉力小如关尺即可投解表药。大抵治伤寒病，见证不见脉，未见投药；见脉未见证，虽少投药亦无害也。凡治杂病以证为先，脉为后；治伤寒病以脉为先，证为后。
一病患两手脉浮数而紧，名曰伤寒。若关前寸脉力小，关后尺脉力大，虽不恶风不自汗出，此乃阴气已盛先见于脉也。若不投药和之，后必恶风及自汗出。若立春以后至清明以前，宜调脉汤主之；清明以后至芒种以前，宜葛根柴胡汤主之；芒种以后至立秋以前，宜人参桔梗汤主之。
调脉汤方：
葛根（一两），前胡（去苗）、防风（各七钱半），甘草（炙半两）。为粗末，每服五钱，水一盏，生姜一块如小指大劈破，煎七分，去滓温服。如寸脉根据前力小，加枣三枚同煎。
葛根柴胡汤：
葛根（一两半），柴胡（去芦一两），芍药、桔梗、甘草（炙各七钱半），浓朴（半两）。将药材切碎，每服五钱，水一盏，生姜二片，煎至七分，去滓热服。如寸脉根据前力小，加葱白三寸同煎服。
人参桔梗汤：
人参、桔梗（各七钱半），麻黄（去节一两），石膏（三两），甘草（炙七钱半）。上每服五钱，水一盏，荆芥五穗同煎至七分，去滓热服。如寸脉根据前力小，加麻黄二分去节同煎服。
一病患两手脉浮数而缓，名曰中风。若寸脉力小，尺脉力大，虽不恶风不自汗，此乃阴气已盛先见于脉也。若不投药和之，后必恶风自汗出。若立春以后清明以前，宜薄荷汤主之；清明以后芒种以前，宜防风汤主之；芒种以后至立秋以前，宜香芎汤主之。
薄荷汤：
薄荷（一两），葛根、人参、甘草（炙各半两），防风（去芦二两）。将药材切碎，每服五钱，水一盏，煎至七分，去滓热服。如三五服寸脉力尚小，加薄荷二分同煎。
防风汤：
防风（去芦一两），桔梗（三钱），甘草（炙）、旋复花（各半两），浓朴（三分）。将药材切碎，每服五钱，水二盏，姜二块同煎，热服。如三五服寸脉力尚小，加荆芥穗五七茎同煎。
香芎汤：
川芎（二钱半），石膏（二两），升麻（三两），甘草（炙）、浓朴（制各半两）。将药材切碎，每服五钱，水二盏，煎七分温服。如三五服后寸脉力尚小，加细辛二分同煎。前二段文将中风伤寒各立法者何？盖谓病患始得病三日以前，或因中风脉缓，或因伤寒脉紧，然脉虽先见而证犹未见，尚可以药解之，故立方耳。
一病患两手脉浮数或缓紧，寸脉短反力小于关尺脉者，此名阴盛阳虚也。若自汗出恶风，是邪气在表，阴气有余也。《素问》云“阴气有余为多汗身寒”，即可投消阴助阳表剂以治之。若立春以后清明以前，宜六物麻黄汤主之；清明以后芒种以前，宜七物柴胡汤主之；芒种以后立秋以前，宜发表汤主之。
六物麻黄汤：
麻黄（去节一两），葛根、苍术（各七钱半），人参、甘草（炙各半两）。将药材切碎，每服五钱，水一盏，枣二枚，煎七分热服。如三五服后汗未止恶风者，加荆芥七钱；三五服后不恶风犹汗者，加丁香皮半两。
七物柴胡汤：
柴胡、苍术（各二两），荆芥、麻黄（各一两），甘草（炙七钱）。将药材切碎，每服五钱，水一盏，姜一块，枣二枚同煎七分，热服。如三五服后汗未止恶风者，入葱白三寸；如三五服后汗再未止，加当归一两同煎。
发表汤：
麻黄（去节一两），苍术（二两），人参、当归（各半两），炙甘草、丁香皮（各七钱）。将药材切碎，每服五钱，水一盏，入姜一块，枣三枚同煎至七分，去滓热服。如三五服汗未止犹恶风者，加桂枝七钱；如汗未止更加细辛半两，以汗止为度。
一病患脉浮数或紧或缓，其脉上出鱼际，寸脉大于关尺者，此名阳盛阴虚也。若发冒闷，口燥咽干者，乃是邪气在表，阳气独有余也。《素问》曰“阳气有余为身热无汗”，是可投消阳助阴药以解表。若立春以后清明以前，宜人参汤主之；清明以后至芒种以前，宜前胡汤主之；芒种以后至立秋以前，宜石膏汤主之。
人参汤：
人参（半两），柴胡（一两），芍药、炙甘草（各七钱半），石膏（二两）。将药材切碎，每服五钱，水一盏，姜一块，煎七分热服。如三五服后热不解者，入豉三十粒同煎服。
前胡汤：
前胡（一两），石膏（二两），甘草（炙半两），桔梗、豉（各七钱半）。上每服五钱，水一盏，姜五片，煎七分，去滓热服。如三五服热尚未解，加豉三十粒煎再服。
石膏汤：
石膏（三两），芍药、柴胡（各一两），升麻、黄芩、炙甘草（各七钱半）。将药材切碎，每服五钱，水一盏半，豉一合，煎八分，热服。如三五服后热未解者，加知母一两；又未解，加大黄一两。
一病患两手脉浮数或紧或缓，三部俱有力，无汗恶风者，此是阴阳气俱有余。《素问》曰“阴阳有余则无汗而寒”，是也可用药平之。若立春以后至清明以前，宜解肌汤主之；清明以后至芒种以前，宜芍药汤主之；芒种以后至立秋以前，宜知母汤主之。
解肌汤
Treatment for sudden collapse due to wind-stroke, attacks of wind-epilepsy, and all conditions where this formula is applicable. This is a purgative formula.
Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas), Nongpu (Magnoliae Officinalis Cortex), Zhishi (Aurantii Fructus Immaturus) (each 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (5 qian; in *Xuanming Lun Fang*, the dosage of Gancao is double that of the other four herbs). Cut the medicinal materials into pieces, divide into three doses. For each dose, use 2 zhan of water and 3 slices of Shengjiang (Zingiberis Rhizoma Recens), decoct together until reduced to 7/10, remove the dregs, take warm, at any time, with the goal of achieving bowel movement as the limit.
Shuangjie San (Double Resolution Powder): Treats Shanghan (Cold Damage) or Shangfeng (Wind Strike), whether with or without sweating, where exterior symptoms are complete, accompanied by internal heat and dry mouth.
Tongsheng San (Universal Benefit Powder) and Tianshui San (Sky Water Powder) (half of each). Cut the medicinal materials into pieces, use 2 liang per dose, 2 zhong of water, 3 slices of Shengjiang (Zingiberis Rhizoma Recens), and 3 roots of Congbai (Allii Fistulosi Bulbus), decoct together until reduced to 7/10, remove the dregs, take slightly warm to induce sweating.
Qingjie San (Clearing Resolution Powder): Treats all types of colds.
Cangzhu (Atractylodis Rhizoma) (stir-fried), Jingjie (Perillae Folium) (each 2 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (1 liang), Mahuang (Ephedrae Herba) (1.5 liang). The above four herbs are cut into pieces, use 1 liang per dose, 2 zhong of water, 3 slices of Shengjiang (Zingiberis Rhizoma Recens), and 1 stem of Congbai (Allii Fistulosi Bulbus), decoct together until reduced to 7/10, remove the dregs, take slightly warm, cover with blankets to induce sweating as the limit.
Banxia Jupi Tang (Pinellia and Tangerine Peel Decoction): Treats persistent vomiting of all kinds.
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Baifuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqin (Scutellariae Radix), Banxia (Pinelliae Rhizoma), Nongpu (Magnoliae Officinalis Cortex), Huoxiangye (Agastaches Herba), Gegen (Puerariae Lobatae Radix), Jupi (Citri Reticulatae Pericarpium) (equal parts). Cut the medicinal materials into pieces, use 1 liang per dose, 1 bowl of water, decoct until reduced to 7/10, remove the dregs, add a little fresh juice of Shengjiang (Zingiberis Rhizoma Recens), take warm, at any time.
Example of Tonifying and Dispersing Simultaneously:
Zhu Danxi said: Some suffer from the invasion of heaven and earth's cold qi, while others suffer from eating raw and cold foods. Therefore, Shanghan disease must involve physical exposure to cold qi and oral intake of cold substances. Thus, cases belonging to internal injury account for eight or nine out of ten. The method is to use only Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction), modifying it according to the observed symptoms. For severe Qi deficiency, use a small amount of Fuzi (Aconiti Lateralis Radix Praeparata) to facilitate the action of Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) (see Buzhong Yiqi Tang formula in the section on Labor Fatigue in Miscellaneous Diseases). Internal injury diseases specifically follow Li Dongyuan's *Differentiation of External and Internal Injuries*, which is very detailed. Many people in the world suffer from this, but some have phlegm or external pathogens complicated, with stagnant heat inside causing fever; these should primarily tonify Yuan Qi (Original Qi). One should examine what is complicated and use combined medications.
A man who usually loved alcohol, due to a violent cold wind and thin clothing, felt fatigue and loss of appetite. Half a day later, after sleeping, he had high fever, body pain all over as if beaten, and slight aversion to wind. At dawn, his pulse was floating and large in all six positions, empty upon pressure, especially on the left. I treated him as extreme deficiency suffering from wind-cold. Renshen (Ginseng Radix) as Sovereign, Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix) root body as Ministers, Cangzhu (Atractylodis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Mutong (Akebiae Caulis), Gegen (Puerariae Lobatae Radix) as Assistants and Guides. Given in a large dose. After five doses, he sweated profusely like rain, changed blankets three times before sleeping. Upon waking, all symptoms disappeared.
Brother Lu, 49 years old, had blood in stool for two years, with a deep, slow, and choppy pulse, yellow complexion, and mental fatigue. In September, due to labor fatigue and fever, he self-medicated with Shen Su Yin (Ginseng and Perilla Decoction) for two doses, and the fever subsided. Upon rising early and exerting himself slightly, encountering cold caused his hands' backs and face to turn purple-black, fainting briefly then waking up with high fever, delirium, dry mouth, and unbearable body pain preventing sleep. His pulse was irregular in all three positions, slightly rapid, empty upon heavy pressure, with the left hand larger than the right. Prescribed Renshen (Ginseng Radix) 2.5 qian, Mahuang (Ephedrae Herba) with nodes and Huangqi (Astragali Radix) each 1 qian, Baizhu (Atractylodis Macrocephalae Rhizoma) 2 qian, Danggui (Angelicae Sinensis Radix) 0.5 fen, for three to five doses. He slept, woke up sweating profusely like rain, and stabilized. Two days later, relapse occurred with flank pain and coughing; if coughing did not occur during sleep but delirium and slight aversion to wind were present, his pulse was similar to before but slightly tight on the left. I said: This is weakness of constitution re-contracting cold. Use the previous prescription plus Banxia (Pinelliae Rhizoma) and Fuling (Poria) for more than ten doses, achieving stability again through heavy sweating. Later, he felt fatigued, unable to sit long, and lost appetite. Use Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) removing cooling herbs, adding Shenqu (Massa Medicata Fermentata), Banxia (Pinelliae Rhizoma), and Sharen (Amomi Fructus Rotundus), taking fifty to seventy doses to stabilize.
Ye Junzhang of Hangzhou, in the twelfth lunar month, suffered from hunger during vegetarian fasting and worked in the cold, leading to fever and headache. The doctor prescribed Xiao Chaihu Tang (Minor Bupleurum Decoction), resulting in spontaneous sweating, confusion, deafness, and blindness. I diagnosed his pulse as large as a finger, seemingly forceful, with fever persisting. Prescribed Renshen (Ginseng Radix), Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Shu Fuzi (Prepared Aconiti Lateralis Radix), and Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) in a large dose. After one day, sweating decreased; after two days, fever halved, hearing slightly improved, and vision returned. By the fourth dose, Cangzhu (Atractylodis Rhizoma) was added to the previous prescription, taken twice more, inducing sweat and clearing fever. That day, Cangzhu and Fuzi were removed, and a smaller dose of the remaining prescription was taken for three days to stabilize.
Lu Zhongxiu, 66 years old, in January, endured hunger, cold exposure, and labor, resulting in headache, aversion to wind, fever, joint pain, and no sweat. The next day, delirium occurred, fever intensified but fluctuated, and was not extremely severe. Self-medicating with Shen Su Yin (Ginseng and Perilla Decoction) for two doses yielded no sweat. Taking another dose and covering with clothes induced heavy sweating, but fever persisted. On the fourth day, his pulse was surging and rapid in both hands, worse on the right. This was due to hunger, cold exposure, and labor; although the Yangming Channel received cold qi, attack methods are contraindicated. Urgent large-dose tonification is needed to restore deficiency; once Stomach Qi is sufficient, sweating will naturally resolve the condition. Prescribed Renshen (Ginseng Radix), Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix) root body, Chenpi (Citri Reticulatae Pericarpium), and Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma), adding one slice of Shu Fuzi (Prepared Aconiti Lateralis Radix) per dose, taken five times within a day and night. By the third day, mouth was slightly dry, speech coherent, symptoms resolved but fever remained. Fuzi was removed and Shaoyao (Paeoniae Radix Alba) added. Two days later, desire for food appeared, meat broth was occasionally given. Three days later, spirit fully recovered. About two days later, spontaneous sweating occurred and fever subsided. Pulse was no longer rapid, but the surging pulse remained somewhat full and large. In an elderly person, mistaken sweating leads to subsequent deficiency signs. Continued with the previous prescription. The next day, he said: "My bowels have been ill; since falling sick, I haven't had a bowel movement, and now my anus feels constricted and painful, with a sensation of straining without passage, unbearable." Doctors would likely prescribe Dahuang (Rhei Radix et Rhizoma) or Badou (Crotonis Fructus). I said: The stool is not truly constipated; Qi is deficient due to mistaken sweating, unable to fill the abdomen, lacking strength to strain. Continue with tonifying medicine, meat porridge, and Rongsu (Cynomorii Herba). In one and a half days, soak the lower body in strong scallion and pepper soup, passing five or six soft stool lumps. Pulse remained large and unconsolidated, indicating Qi and Blood had not yet recovered. Two more doses of the previous prescription. Two days later, urinary retention, lower abdominal distension and discomfort, worsening when lying down, only dripping when supine. I said: The tonifying medicine was not fully effective; double the Renshen (Ginseng Radix) in the previous prescription and take in a large dose. After two days, urination became smooth and he stabilized.
Wang Ji treated a man in his thirties who contracted cold and fever. The doctor used dispersing methods without success, then Xiao Chaihu Tang (Minor Bupleurum Decoction), leading to intense heat, excessive sweating, confusion, disorientation, feeling as if floating in clouds when lying or walking. Accompanied by polyphagia, frequent seminal emissions. Observing his fat-like physique, I said: This is internal fire blazing, extreme deficiency. His pulse was floating and surging like a finger. I stated: *Mai Jing* says "If the pulse does not diminish after sweating, death occurs"; legally untreatable. Fortunately, although the pulse was large, it lacked force upon pressure; although the form was elongated, the complexion was still dark-green, so it could be saved. The doctor treated it as an external contraction, thus weakening the deficiency further, which was erroneous. The Classics state: "Where evil gathers, Qi must be deficient." Priority should be given to internal injury. Prescribed Renshen (Ginseng Radix), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma) in a large dose with minor additions of Guizhi (Cinnamomi Ramulus) and Fuzi (Aconiti Lateralis Radix Praeparata). After ten doses, illness reduced by two or three tenths. Then reduced Guizhi (Cinnamomi Ramulus) and Fuzi (Aconiti Lateralis Radix Praeparata), adding Shaoyao (Paeoniae Radix Alba) and Huangqin (Scutellariae Radix), taken for ten more doses. The patient finally realized he was lying on the bed and standing on the ground, rejoicing: "I can avoid death!" Long-term use eventually led to recovery.
Xue Yuanshi treated a 79-year-old man in mid-winter preparing to go out to his wife's family home, engaging in sexual activity, resulting in headache, fever, vertigo, asthma, copious phlegm, frequent urination, dry mouth with thirst, tongue prickles and shrinking like a lychee, black cracked lower lip, red face and eyes, irritability, insomnia, occasional sensation of smoke/fire rising in the throat, temporarily relieved by drinking cold tea, nearing death. Pulse was surging, large, boundless, and forceful; body felt hot to touch. This was Kidney channel deficiency fire roaming externally. Prescribed Shiquan Dabu Tang (Ten Complete Tonifying Decoction) plus Shanzhuyu (Corni Fructus), Zexie (Alismatis Rhizoma), Danpi (Moutan Cortex), Shanyao (Dioscoreae Rhizoma), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), and Fuzi (Aconiti Lateralis Radix Praeparata) in one zhong. He slept soundly for a long time, pulse and symptoms reduced by three or four tenths. Prescribed Bawei Wan (Eight-Ingredient Pill) subsequently, all symptoms receded. Recovered after avoiding cold.
*Benshi Fang* Huangqi Jianzhong Jia Danggui Tang (Astragalus and Middle-Warming Decoction with Added Angelica): Treats fever, headache, floating and rapid pulse with delayed and weak Chi position. It is appropriate to first take this medicine to nourish Blood, rather than using Mahuang (Ephedrae Herba) or Guizhi (Cinnamomi Ramulus) type formulas.
Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix) (each 1.5 liang), Shaoyao (Paeoniae Radix Alba), Guizhi (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 liang). Cut into pieces, take 5 qian per dose with 3 slices of ginger and one jujube, decoct in water, three times daily and two times nightly. If the pulse remains deep and slow, administer another dose.
Haizang Huangqi Tang (Sea Storehouse Astragalus Decoction): Treats Shanghan (Cold Damage) affecting both channels, spasms, deficiency of Sanjiao Qi with spontaneous sweating and sweating of hands and feet (possibly more on the back of hands), limb tremors, heavy waist and legs, red face and eyes, desire to sleep, high fever on head and face, heat in hypochondrium, warm hands and feet, heat in palms, spontaneous diarrhea without thirst, difficult or normal stools, dry mouth/throat, desire to drink hot liquids but not wanting to drink, or slight desire to drink, impending retching, chest fullness, abdominal pain, intermittent laughter, crying, sighing, or confused speech (not delirium/hallucinations, but unsettled Spirit). Illness begins between wakefulness and sleep, possibly with palpitations, minimal head/neck pain, normal gait. This is due to excess Yin and deficiency Yang. Pulses in both hands vary in depth and speed, sometimes left, sometimes right, showing five types of Yin pulses (deep, choppy, weak, minute, string-taut), completely powerless upon pressure, diminished upon superficial and deep palpation. Prioritize gentle treatment first, then urgent. Gentle treatment uses Huangqi Tang (Astragalus Decoction).
Huangqi Tang Formula:
Renshen (Ginseng Radix), Shengjiang (Zingiberis Rhizoma Recens), Huangqi (Astragali Radix), Baifuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Shaoyao (Paeoniae Radix Alba) (each 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (7 qian). For retching, add Huoxiang (Agastaches Herba) and Chenpi (Citri Reticulatae Pericarpium) each 5 qian; for severe cases, add Pao Ganjiang (Prepared Zingiberis Rhizoma) 1 qian. Cut into pieces, decoct in water, adjust dosage based on symptoms. For severe constipation, use Tiaozhong Wan (Regulate Middle Pill).
Tiaozhong Wan Formula:
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Baifuling (Poria), Ganjiang (Zingiberis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) (equal parts). Grind into powder, make honey pills, 10 or 5 pills per liang, take 1-2 pills decocted in a little water. If illness is urgent, add 1 qian of Ganjiang (Zingiberis Rhizoma) to Huangqi Tang (Astragalus Decoction) per dose. For constipation, use Lizhong Wan (Regulate Middle Pill).
Lizhong Wan Formula:
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Ganjiang (Zingiberis Rhizoma) (roasted, or substitute with Shengjiang (Zingiberis Rhizoma Recens) if heat is a concern), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) (equal parts). Grind into powder, make honey pills, 5 pills per liang, dissolve in white water. Prioritize gentle then urgent. If even more urgent, no sweat: use Fuzi Ganjiang Gancao Tang (Aconite, Ginger, and Licorice Decoction); if spontaneous sweat: use Baizhu Fuzi Gancao Tang (Atractylodes, Aconite, and Licorice Decoction). Select from Sini Tang (Frigid Extremities Decoction), Zhenwu Tang (True Warrior Decoction), or Tongmai Sini Tang (Pulse-Unblocking Frigid Extremities Decoction) based on pulse and symptoms.
Danxi's *Juxin Shu* states that mixed pathogens require mixed treatment methods. For example, aversion to wind and fever from a cold indicates external pathogen; floating and rapid pulse with tightness at the Qi Kou indicates food stagnation; fatigue with empty feeling upon deep pressure, chest/diaphragm fullness radiating to hypochondrium, and string-taut pulse upon light pressure indicates Liver pathogen from anger; fine, deep, weak Left Chi pulse indicates past sexual excess. Treatment should prioritize addressing the cold last, first observing complexion and constitution strength, using tonifying middle, resolving food stagnation, moving Qi, clearing stomach heat, and using pungent ginger to guide. Then middle Qi returns, stagnation moves, fluids harmonize, whole-body sweating occurs, and external pathogens resolve. Physicians unwilling to carefully investigate, focusing only on dispersing external pathogens without considering complicated pathogens or questioning pulse origins and emotional attachments, skillfully apply mixed treatments. This results in self-weakening of Righteous Qi and solidification of Evil Qi, all due to incompetent practitioners.
Lou Quanshan collected treatments from Danxi, Haizang, and other sages on Shanghan (Cold Damage), all using tonifying and dispersing simultaneously. This truly follows the Classic principle: "Success and failure lie hidden in movement; continuous movement leads to transformation," and "Wind, rain, cold, and heat cannot injure alone without deficiency." Generally, external wind-cold invasion requires prior internal injury and deficiency from excessive labor/movement before pathogens enter. Thus, within one family, some get sick and others don't; deficiency allows pathogen entry, while robustness prevents it. Therefore, eight or nine out of ten Shanghan cases belong to internal injury. Ignorant students believe there is no tonification method for Shanghan, seeing only fever without distinguishing deficiency/excess, uniformly applying sweating/purging, leading to premature death everywhere. These are criminals of the medical profession. Collecting this method after Zhang Zhongjing, responses are immediate, guiding people to avoid the error of tonifying deficiency and purging excess.
Regarding the outline text above, seeing physicians rigidly adhering to "no tonification for Shanghan" and violating the rule against tonifying deficiency/purging excess, I comprehensively described it, deleting purely internal injury cases and mediocre notes from Danxi's medical records, adding recent physicians' notes as living examples of deficiency contracting cold. Enlightenment depends on the individual; do not be rigid. I once treated a woodblock carver who, after marriage in winter, contracted cold with complete exterior symptoms. I ordered Renshen (Ginseng Radix) and Zisu Jingye (Perillae Caulis et Folium) each 1 liang decocted in water to drink. Sweating occurred and he recovered. A pregnant woman in spring-summer transition suffered warm disease with headache, fever, no aversion to wind, and thirst. Before treatment, she miscarried with massive blood loss, fainting nearly to death. I ordered Maidong (Ophiopogonis Radix) one jin, with Danshuye (Lophatheri Herba) and Xiangchi (Fermented Soybean), frequently administered. Sweating occurred and she recovered. Using labor-relapse treatment method, obtaining such living rules makes near-perfect cure possible for such diseases.
Han Zhihe's Harmonization According to Season Method:
Shanghan (Cold Damage) has cases suitable for sweating. The treatise generally mentions indications and pulses for sweating, such as floating and rapid pulse, floating and tight pulse, floating pulse with no sweat and wheezing, or floating pulse indicating exterior location. Now briefly listing several items, later generations rely only on general pulse characteristics, failing to distinguish Yin/Yang deficiency/excess in floating pulses, and unaware of unsuitable sweating conditions. Mistakenly administering exterior-dispersing medicines often transforms into Yang-toxin complications. Now categorizing patients with sweating/aversion to wind and no-sweat/aversion to cold into two grades, and prescribing formulas based on climate severity from after Start of Spring to before Start of Autumn, hopefully aiding learners' understanding.
For a patient in Feb-March, pulses in both hands are floating, rapid, slow, or tight, slightly soft upon pressure. If Cun, Guan, Chi positions have equal force, neither too large nor too small, do not immediately administer exterior-resolving medicine. This indicates interior symptoms seen but exterior pulse not yet manifest. Wait until Cun pulse force is small like Guan/Chi before administering exterior-resolving medicine. Generally, treating Shanghan (Cold Damage): observe symptoms without pulse, do not prescribe; see pulse without symptoms, prescribing minimally is harmless. For miscellaneous diseases, symptoms precede pulse; for Shanghan (Cold Damage), pulse precedes symptoms.
For a patient with floating, rapid, and tight pulses in both hands, named Shanghan (Cold Damage). If Cun pulse (front) is weak and Chi pulse (back) is strong, even without aversion to wind or spontaneous sweating, this indicates Yin Qi already abundant manifesting in pulse. Without medication to harmonize, aversion to wind and spontaneous sweating will follow. From after Start of Spring to before Clear Brightness, Tiaomai Tang (Regulate Pulse Decoction) is primary. From after Clear Brightness to before Grain in Ear, Gegen Chaihu Tang (Kudzu and Bupleurum Decoction) is primary. From after Grain in Ear to before Start of Autumn, Renshen Jiegeng Tang (Ginseng and Platycodon Decoction) is primary.
Tiaomai Tang Formula:
Gegen (Puerariae Lobatae Radix) (1 liang), Qianhu (Peucedani Radix) (deveined), Fangfeng (Saposhnikoviae Radix) (each 7.5 qian), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) (0.5 liang). Make coarse powder, take 5 qian per dose, 1 zhan of water, 1 piece of Shengjiang (Zingiberis Rhizoma Recens) size of little finger, split, decoct to 7/10, remove dregs, take warm. If Cun pulse is weak as described, add 3 jujubes to decoct.
Gegen Chaihu Tang:
Gegen (Puerariae Lobatae Radix) (1.5 liang), Chaihu (Bupleuri Radix) (de-rooted, 1 liang), Shaoyao (Paeoniae Radix Alba), Jiegeng (Platycodonis Radix), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) (each 7.5 qian), Nongpu (Magnoliae Officinalis Cortex) (0.5 liang). Cut into pieces, take 5 qian per dose, 1 zhan of water, 2 slices of Shengjiang (Zingiberis Rhizoma Recens), decoct to 7/10, remove dregs, take hot. If Cun pulse is weak as described, add 3 cun of Congbai (Allii Fistulosi Bulbus) to decoct.
Renshen Jiegeng Tang:
Renshen (Ginseng Radix), Jiegeng (Platycodonis Radix) (each 7.5 qian), Mahuang (Ephedrae Herba) (de-node, 1 liang), Shigao (Gypsum Fibrosum) (3 liang), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) (7.5 qian). Take 5 qian per dose, 1 zhan of water, 5 spikes of Jingjie (Perillae Folium), decoct to 7/10, remove dregs, take hot. If Cun pulse is weak as described, add 2 fen of Mahuang (Ephedrae Herba) de-node to decoct.
For a patient with floating, rapid, and slow pulses in both hands, named Fengzhong (Wind Strike). If Cun pulse is weak and Chi pulse is strong, even without aversion to wind or spontaneous sweating, this indicates Yin Qi already abundant manifesting in pulse. Without medication to harmonize, aversion to wind and spontaneous sweating will follow. From after Start of Spring to before Clear Brightness, Bohe Tang (Mint Decoction) is primary. From after Clear Brightness to before Grain in Ear, Fangfeng Tang (Saposhnikovia Decoction) is primary. From after Grain in Ear to before Start of Autumn, Xiangxiong Tang (Costus and Ligusticum Decoction) is primary.
Bohe Tang:
Bohe (Menthae Haplocalycis Herba) (1 liang), Gegen (Puerariae Lobatae Radix), Renshen (Ginseng Radix), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) (each 0.5 liang), Fangfeng (Saposhnikoviae Radix) (de-rooted, 2 liang). Cut into pieces, take 5 qian per dose, 1 zhan of water, decoct to 7/10, remove dregs, take hot. If after 3-5 doses Cun pulse is still weak, add 2 fen of Bohe (Menthae Haplocalycis Herba) to decoct.
Fangfeng Tang:
Fangfeng (Saposhnikoviae Radix) (de-rooted, 1 liang), Jiegeng (Platycodonis Radix) (3 qian), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma), Xuanjinhua (Inulae Flos) (each 0.5 liang), Nongpu (Magnoliae Officinalis Cortex) (3 fen). Cut into pieces, take 5 qian per dose, 2 zhan of water, 2 pieces of Shengjiang (Zingiberis Rhizoma Recens), decoct, take hot. If after 3-5 doses Cun pulse is still weak, add 5-7 spikes of Jingjie Sui (Perillae Flos) to decoct.
Xiangxiong Tang:
Chuanxiong (Ligustici Chuanxiong Rhizoma) (2.5 qian), Shigao (Gypsum Fibrosum) (2 liang), Shengma (Cimicifugae Rhizoma) (3 liang), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma), Zhi Nongpu (Processed Magnoliae Officinalis Cortex) (each 0.5 liang). Cut into pieces, take 5 qian per dose, 2 zhan of water, decoct to 7/10, take warm. If after 3-5 doses Cun pulse is still weak, add 2 fen of Xixin (Asari Radix et Rhizoma) to decoct. Why separate formulas for Fengzhong (Wind Strike) and Shanghan (Cold Damage) in the previous two sections? Because within three days of onset, Fengzhong (Wind Strike) may have slow pulse, Shanghan (Cold Damage) may have tight pulse. Although pulse manifests first, symptoms may not yet appear, allowing resolution via medicine, hence the formulas.
For a patient with floating, rapid, slow, or tight pulses in both hands, where Cun pulse is short and weaker than Guan/Chi, this is named Yin Excess and Yang Deficiency. If spontaneous sweating and aversion to wind occur, pathogen is in exterior, Yin Qi is surplus. *Suwen* states: "Yin surplus causes excessive sweating and body cold." Exterior formulas eliminating Yin and assisting Yang can be used. From after Start of Spring to before Clear Brightness, Liuwu Mahuang Tang (Six-Ingredient Ephedra Decoction) is primary. From after Clear Brightness to before Grain in Ear, Qiwi Chaihu Tang (Seven-Ingredient Bupleurum Decoction) is primary. From after Grain in Ear to before Start of Autumn, Fabiao Tang (Disperse Exterior Decoction) is primary.
Liuwu Mahuang Tang:
Mahuang (Ephedrae Herba) (de-node, 1 liang), Gegen (Puerariae Lobatae Radix), Cangzhu (Atractylodis Rhizoma) (each 7.5 qian), Renshen (Ginseng Radix), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) (each 0.5 liang). Cut into pieces, take 5 qian per dose, 1 zhan of water, 2 jujubes, decoct to 7/10, take hot. If after 3-5 doses sweating persists with aversion to wind, add 7 qian of Jingjie (Perillae Folium); if after 3-5 doses no aversion to wind but sweating persists, add 0.5 liang of Dingpicao (Symplocos Racemosae Cortex).
Qiwi Chaihu Tang:
Chaihu (Bupleuri Radix), Cangzhu (Atractylodis Rhizoma) (each 2 liang), Jingjie (Perillae Folium), Mahuang (Ephedrae Herba) (each 1 liang), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) (7 qian). Cut into pieces, take 5 qian per dose, 1 zhan of water, 1 piece of Shengjiang (Zingiberis Rhizoma Recens), 2 jujubes, decoct to 7/10, take hot. If after 3-5 doses sweating persists with aversion to wind, add 3 cun of Congbai (Allii Fistulosi Bulbus); if after 3-5 doses sweating still persists, add 1 liang of Danggui (Angelicae Sinensis Radix) to decoct.
Fabiao Tang:
Mahuang (Ephedrae Herba) (de-node, 1 liang), Cangzhu (Atractylodis Rhizoma) (2 liang), Renshen (Ginseng Radix), Danggui (Angelicae Sinensis Radix) (each 0.5 liang), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma), Dingpicao (Symplocos Racemosae Cortex) (each 7 qian). Cut into pieces, take 5 qian per dose, 1 zhan of water, 1 piece of Shengjiang (Zingiberis Rhizoma Recens), 3 jujubes, decoct to 7/10, remove dregs, take hot. If after 3-5 doses sweating persists with aversion to wind, add 7 qian of Guizhi (Cinnamomi Ramulus); if sweating persists, add 0.5 liang of Xixin (Asari Radix et Rhizoma), stopping when sweating ceases.
For a patient with floating, rapid, tight, or slow pulse, extending to Yuji point, Cun pulse larger than Guan/Chi, this is named Yang Excess and Yin Deficiency. If dizziness, stuffiness, dry mouth, and dry throat occur, pathogen is in exterior, Yang Qi is solely surplus. *Suwen* states: "Yang surplus causes body heat and no sweat." Exterior formulas eliminating Yang and assisting Yin can be used. From after Start of Spring to before Clear Brightness, Renshen Tang (Ginseng Decoction) is primary. From after Clear Brightness to before Grain in Ear, Qianhu Tang (Peucedane Decoction) is primary. From after Grain in Ear to before Start of Autumn, Shigao Tang (Gypsum Decoction) is primary.
Renshen Tang:
Renshen (Ginseng Radix) (0.5 liang), Chaihu (Bupleuri Radix) (1 liang), Shaoyao (Paeoniae Radix Alba), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) (each 7.5 qian), Shigao (Gypsum Fibrosum) (2 liang). Cut into pieces, take 5 qian per dose, 1 zhan of water, 1 piece of Shengjiang (Zingiberis Rhizoma Recens), decoct to 7/10, take hot. If after 3-5 doses fever persists, add 30 grains of Chi (Fermented Soybean) to decoct.
Qianhu Tang:
Qianhu (Peucedani Radix) (1 liang), Shigao (Gypsum Fibrosum) (2 liang), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) (0.5 liang), Jiegeng (Platycodonis Radix), Chi (Fermented Soybean) (each 7.5 qian). Take 5 qian per dose, 1 zhan of water, 5 slices of Shengjiang (Zingiberis Rhizoma Recens), decoct to 7/10, remove dregs, take hot. If after 3-5 doses fever persists, add 30 grains of Chi (Fermented Soybean) to decoct and take again.
Shigao Tang:
Shigao (Gypsum Fibrosum) (3 liang), Shaoyao (Paeoniae Radix Alba), Chaihu (Bupleuri Radix) (each 1 liang), Shengma (Cimicifugae Rhizoma), Huangqin (Scutellariae Radix), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) (each 7.5 qian). Cut into pieces, take 5 qian per dose, 1.5 zhan of water, 1 he of Chi (Fermented Soybean), decoct to 8/10, take hot. If after 3-5 doses fever persists, add 1 liang of Zhimu (Anemarrhenae Rhizoma); if still unresolved, add 1 liang of Dahuang (Rhei Radix et Rhizoma).
For a patient with floating, rapid, tight, or slow pulses in both hands, all three positions forceful, no sweat, aversion to wind, this is excess of both Yin and Yang Qi. *Suwen* states: "Excess of Yin and Yang causes no sweat and cold." Medicines can be used to level it. From after Start of Spring to before Clear Brightness, Jieji Tang (Release Muscle Decoction) is primary. From after Clear Brightness to before Grain in Ear, Shaoyao Tang (Paeonia Decoction) is primary. From after Grain in Ear to before Start of Autumn, Zhimu Tang (Anemarrhena Decoction) is primary.
Jieji Tang