六经各有提纲，则应用各有方法。如太阳之提纲主表，法当汗解，而表有虚实之不同，故立桂枝、麻黄二
法。阳明提纲主胃实，法当下解，而实亦有微甚，故分大、小承气。少阳提纲有口苦、咽干、目眩之症，法当清
火，而火有虚实∶若邪在半表，则制小柴胡以解虚火之游行，大柴胡以解相火之热结，此治少阳寒热往来之二
法；若邪入心腹之半里，则有半夏、泻心、黄连、黄芩等剂。叔和搜采仲景旧论，录其对症真方，提防世急，
于少阳太阴二经，不录一方，因不知少阳证，故不知少阳方耳。
小柴胡汤∶
柴胡 人参 黄芩 甘草 半夏 姜 枣
此为少阳枢机之剂，和解表里之总方也。少阳之气游行三焦，而司一身腠理之开 。血弱气虚，腠理开发，
邪气因入与正气相搏，邪正分争，故往来寒热。与伤寒头疼发热而脉弦细、中风两无关者，皆是虚火游行于半
表。故取柴胡之轻清微苦微寒者，以解表邪，即以人参之微甘微温者，预补其正气，使里气和而外邪勿得入也。
其口苦、咽干、目眩、目赤、头汗、心烦、舌苔等症，皆虚火游行于半里。故用黄芩之苦寒以清之，即用甘、
枣之甘以缓之，亦以提防三阴之受邪也。太阳伤寒则呕逆，中风则干呕。此欲呕者，邪正相搏于半里，故欲
呕而不逆。胁居一身之半，为少阳之枢，邪结于胁，则枢机不利，所以胸胁苦满默默不欲食也。引用姜、半之
辛散，一以佐柴、芩而逐邪，一以行
甘、枣之泥滞，可以止呕者，即可以泄满矣。夫邪在半表，势已向里，未有定居，故有或为之证，所以方有
加减，药无定品之可拘也。若胸中烦而不呕者，去半夏、人参，恐其助烦也。若烦而呕者，则人参可去，而半
夏不得不用矣。加栝蒌实者，取其苦寒降火而除烦也。若渴者，是元气不足而津液不生，去半夏之辛温，再加
人参以益气而生津液，更加栝蒌根之苦寒者，以升阴液而上滋也。若腹中痛者，虽相火为患，恐黄芩之苦，转
属于太阴，故易芍药之酸以泻木。若邪结于胁下而痞硬者，去大枣之甘能助满，加牡蛎之咸以软坚也。若心下
悸、小便不利者，是为小逆，恐黄芩之寒转属于少阴，故易茯苓之淡渗而利水。若内不渴而外微热者，是里气
未伤，而表邪未解，不可补中，故去人参，加桂枝之辛散，温覆而取其微汗。若咳者，是相火迫肺，不可益气，
故去人参，所谓肺热还伤肺者此也。凡发热而咳者重在表，故小青龙于麻、桂、细辛中加干姜、五味。此往来
寒热而咳者，重在里，故并去姜、枣之和营卫者，而加干姜之苦辛，以从治相火上逆之邪，五味之酸，以收肺
金之气也。合而观之，但顾邪气之散，而正气无伤，此制小柴胡之意欤！是方也，与桂枝汤相仿。而柴胡之解
表，逊于桂枝；黄芩之清里，重于芍药；姜、枣、甘草，微行辛甘发散之常；而人参甘温，已示虚火可补之义。
且去滓再煎之法，又与他剂不同。粗工恐其闭住邪气，妄用柴、芩而屏绝人参，所以夹虚之症，不能奏功，反
以速毙也。按，本方七味，柴胡主表邪不解，甘草主里气不调，五物皆在进退之列。本方若去甘草，便名大柴
胡；若去柴胡，便名泻心、黄芩、黄连等汤矣。前辈皆推柴胡为主治，卢氏又以柴胡三生半冬配半夏为主治，
皆未审本方加减之义耳。本方为脾家虚热、四时疟疾之圣药，余义详少阳病解制方大法。
大柴胡汤∶
柴胡 黄芩 半夏 芍药 枳实 姜枣
伤寒发热，汗出不解，十余日结热在里，心下痞硬，呕吐下利，复往来寒热；或妄下后，柴胡证仍在，
与小柴胡汤，呕不止，心下急，郁郁微烦者。此皆少阳半表里气分之症。此方是治三焦无形之热邪，非治胃腑
有形之实邪也。其心下急烦痞硬，是病在胃口，而不在胃中，结热在里，不是结实在胃。因不属有形，故十余
日复能往来寒热，若结实在胃，则蒸蒸而发热，不复知有寒矣。因往来寒热，故倍生姜，佐
柴胡以解表∶结热在里，故去参、甘，加枳、芍以破结。条中并不言及大便硬，而且有下利症，仲景不用大黄
之意晓然。后人因有下之二字，妄加大黄以伤胃气。非大谬乎？妄作伤寒书者，总不知凭脉辨症以用药，专以并
合仲景方为得意。如加甘草于大承气中，而名三一承气，加柴、芩、芍药于承气中，而名六一顺气，以为可以
代三承气、大柴胡、大陷胸等汤。竟不审仲景方分大小，药分表里，设方命剂，当因病患病机变迁轻重耳。岂圣
贤之立方不精也，须尔辈更改乎？大小柴胡，俱是两解表里之剂。大柴胡主降气，小柴胡主调气。调气无定法，
故小柴胡除柴胡、甘草外，皆可进退；降气有定局，故大柴胡无加减法。后人每方俱有加减，岂知方者哉！
柴胡桂枝干姜汤∶
柴胡 桂枝 干姜 黄芩 甘草 牡蛎 栝蒌根
伤寒五六日，发汗不解，尚在太阳界，反下之，胸胁满微结，是系在少阳矣。此微结与阳微结不同∶阳微
结对纯阴结言，是指结实在胃；此微结对大结胸言，是指胸胁痞硬。小便不利者，因下后下焦津液不足也。头
为三阳之会，阳气不得降，故但头汗出；半表半里之寒邪未解，上下二焦之邪热已甚，故往来寒热心烦耳。此
方全从柴胡加减。心烦不呕不渴，故去半夏之辛温，加栝蒌根以生津。胸胁满而微结，故减大枣之甘满，加牡蛎
之咸以软之。小便不利而心下不悸，是无水可利，故不去黄芩，不加茯苓。虽渴而太阳之余邪不解，故不用参而
加桂。生姜之辛，易干姜之温苦，所以散胸胁之满结也。初服烦即微者，黄芩、栝蒌之效；继服汗出周身，内
外全愈者，姜桂之功。小柴胡加减之妙，若无定法，而实有定局矣。更其名曰柴胡桂枝干姜，以柴胡证具，而太
阳之表犹未解，里已微结，须此桂枝解表，干姜解结，以佐柴胡之不及耳。
柴胡桂枝汤∶
柴胡 桂枝 人参 甘草 半夏 黄芩 芍药 大枣 生姜
柴胡二汤，皆调和表里之剂。桂枝汤重解表，而微兼清里；柴胡汤重和里，而微兼散表。此伤寒六七日，正
寒热当退之时，尚见发热恶寒诸表症，更兼心下支结诸里症，表里不解，法当双解之。然恶寒微，则发热亦微可
知；支节烦疼，则一身骨节不痛可知。微呕心下亦微结，故谓之支结。表症虽不去而已轻，里症虽已见而未甚，
此太阳少阳并病之轻者。故取桂枝之半，以解太阳未尽之邪；取柴胡之半，以解少阳之微结。凡口不渴，身有微热者，
当去人参。此以六七日来邪虽不解，而正气已虚，故用人参以和之也。外症虽在，而病机已见于里，故方以柴
胡冠桂枝之前，为双解两阳之轻剂。
柴胡加龙骨牡蛎汤∶
柴胡 人参 黄芩 半夏 生姜 龙骨 牡蛎 桂枝 铅丹 茯苓 大黄 大枣
伤寒八九日不解，阳盛阴虚，下之应不为过，而变症蜂起者，是未讲于调胃承气之法，而下之不得其术也。
胸满而烦，小便不利，三阳皆有是症。而惊是木邪犯心，谵语是热邪入胃。一身尽重，是病在阳明而无气以动
也；不可转侧，是关少阳而枢机不利也。此为少阳阳明并病。故取小柴胡之半，以转少阳之枢；辅大黄之勇，
以开阳明之 。满者忌甘，故去甘草∶小便不利，故加茯苓。惊者须重以镇怯，铅禀于金之体，受癸水之气，
能清上焦无形之烦满，中焦有形之热结，炼而成丹，不特入心而安神，且以入肝而滋血矣。龙骨重能镇惊而平
木，蛎体坚不可破，其性守而不移，不特静可以镇惊，而寒可以除烦热。且咸能润下，佐茯苓以利水，又能软
坚，佐大黄以清胃也。半夏引阳入阴，能治目不瞑，亦安神之品，故少用为佐。人参能通血脉，桂枝能行营气，
一身尽重不可转侧者，在所必须，故虽胸满谵语而不去也。此于柴胡方加味而取龙蛎名之者，亦以血气之属，
同类相求耳。
黄连汤∶
黄连 人参 甘草 桂枝 干姜 半夏 大枣
伤寒表不发热，而胸中有热，是其人未伤寒时素有蓄热也。热在胸中，必上形头面，故寒邪不得上干∶上焦
实，必中气虚，故寒邪得从胁而入胃。《内经》云∶“中于胁则入少阳”，此类是已。凡邪在少阳，法当柴胡
主治。此不往来寒热，病不在半表，则柴胡不中与之。胸中为君主之宫城，故用半夏泻心加减。胸中之热不得降，
故炎上而欲呕；胃因邪气之不散，故腹中痛也。用黄连泻心胸之热，姜、桂祛胃中之寒，甘、枣缓腹中之痛，半
夏除呕，人参补虚。虽无寒热往来于外，而有寒热相搏于中，所以寒热并用，攻补兼施，仍不离少阳和解之治法
耳。此症在太阴、少阳之间，此方兼泻心、理中之剂。
黄芩汤∶
黄芩 芍药 甘草 大枣
太阳阳明合病，是寒邪初入阳明之经，胃家未实，移寒于脾，故自下利，此阴盛阳虚，与葛根汤辛甘发散
以维阳也。太阳少阳合病，是热邪陷入少阳之里，胆火肆逆，移热于脾，故自下利，此阳盛阴虚，与黄芩汤苦甘
相淆以存阴也。凡太、少合病，邪在半表者，法当从柴胡桂枝加减。此则热淫于内，不须更顾表邪，故用黄芩
以泄大肠之热，配芍药以补太阴之虚，用甘、枣以调中州之气。虽非胃实，亦非胃虚，故不必人参以补中也。若
呕是上焦之邪未散，故仍加姜、夏。此柴胡桂枝汤去柴桂人参方也。凡两阳之表病，用两阳之表药；两阳之半
表病，用两阳之半表药。此两阳之里病，用两阳之里药。逐条细审，若合符节。然凡正气稍虚，表虽在而预固
其里，邪气正盛，虽下利而不须补中，此又当着眼处。《内经·热病论》云∶“太阳主气，阳明主肉，少阳主
胆。伤寒一日太阳，二日阳明，三日少阳。”冬不藏精，则精不化气，故先气病，次及肉之病而及胆，仍自外
之内。此病本虽因于内，而病因为伤于寒，故一病两名耳。胆汁最苦最寒，乃相火中之真味。火旺之水亏，胆
汁上溢而口苦，故用芩、连之品以滋胆汁而清相火也。
六经各有提纲，则应用各有方法。如太阳之提纲主表，法当汗解，而表有虚实之不同，故立桂枝、麻黄二法。阳明提纲主胃实，法当下解，而实亦有微甚，故分大、小承气。少阳提纲有口苦、咽干、目眩之症，法当清火，而火有虚实∶若邪在半表，则制小柴胡以解虚火之游行，大柴胡以解相火之热结，此治少阳寒热往来之二法；若邪入心腹之半里，则有半夏、泻心、黄连、黄芩等剂。叔和搜采仲景旧论，录其对症真方，提防世急，于少阳太阴二经，不录一方，因不知少阳证，故不知少阳方耳。
小柴胡汤：
柴胡 人参 黄芩 甘草 半夏 姜 枣
此为少阳枢机之剂，和解表里之总方也。少阳之气游行三焦，而司一身腠理之开 。血弱气虚，腠理开发，邪气因入与正气相搏，邪正分争，故往来寒热。与伤寒头疼发热而脉弦细、中风两无关者，皆是虚火游行于半表。故取柴胡之轻清微苦微寒者，以解表邪，即以人参之微甘微温者，预补其正气，使里气和而外邪勿得入也。其口苦、咽干、目眩、目赤、头汗、心烦、舌苔等症，皆虚火游行于半里。故用黄芩之苦寒以清之，即用甘、枣之甘以缓之，亦以提防三阴之受邪也。太阳伤寒则呕逆，中风则干呕。此欲呕者，邪正相搏于半里，故欲呕而不逆。胁居一身之半，为少阳之枢，邪结于胁，则枢机不利，所以胸胁苦满默默不欲食也。引用姜、半之辛散，一以佐柴、芩而逐邪，一以行甘、枣之泥滞，可以止呕者，即可以泄满矣。夫邪在半表，势已向里，未有定居，故有或为之证，所以方有加减，药无定品之可拘也。若胸中烦而不呕者，去半夏、人参，恐其助烦也。若烦而呕者，则人参可去，而半夏不得不用矣。加栝蒌实者，取其苦寒降火而除烦也。若渴者，是元气不足而津液不生，去半夏之辛温，再加人参以益气而生津液，更加栝蒌根之苦寒者，以升阴液而上滋也。若腹中痛者，虽相火为患，恐黄芩之苦，转属于太阴，故易芍药之酸以泻木。若邪结于胁下而痞硬者，去大枣之甘能助满，加牡蛎之咸以软坚也。若心下悸、小便不利者，是为小逆，恐黄芩之寒转属于少阴，故易茯苓之淡渗而利水。若内不渴而外微热者，是里气未伤，而表邪未解，不可补中，故去人参，加桂枝之辛散，温覆而取其微汗。若咳者，是相火迫肺，不可益气，故去人参，所谓肺热还伤肺者此也。凡发热而咳者重在表，故小青龙于麻、桂、细辛中加干姜、五味。此往来寒热而咳者，重在里，故并去姜、枣之和营卫者，而加干姜之苦辛，以从治相火上逆之邪，五味之酸，以收肺金之气也。合而观之，但顾邪气之散，而正气无伤，此制小柴胡之意欤！是方也，与桂枝汤相仿。而柴胡之解表，逊于桂枝；黄芩之清里，重于芍药；姜、枣、甘草，微行辛甘发散之常；而人参甘温，已示虚火可补之义。且去滓再煎之法，又与他剂不同。粗工恐其闭住邪气，妄用柴、芩而屏绝人参，所以夹虚之症，不能奏功，反以速毙也。按，本方七味，柴胡主表邪不解，甘草主里气不调，五物皆在进退之列。本方若去甘草，便名大柴胡；若去柴胡，便名泻心、黄芩、黄连等汤矣。前辈皆推柴胡为主治，卢氏又以柴胡三生半冬配半夏为主治，皆未审本方加减之义耳。本方为脾家虚热、四时疟疾之圣药，余义详少阳病解制方大法。
大柴胡汤：
柴胡 黄芩 半夏 芍药 枳实 姜枣
伤寒发热，汗出不解，十余日结热在里，心下痞硬，呕吐下利，复往来寒热；或妄下后，柴胡证仍在，与小柴胡汤，呕不止，心下急，郁郁微烦者。此皆少阳半表里气分之症。此方是治三焦无形之热邪，非治胃腑有形之实邪也。其心下急烦痞硬，是病在胃口，而不在胃中，结热在里，不是结实在胃。因不属有形，故十余日复能往来寒热，若结实在胃，则蒸蒸而发热，不复知有寒矣。因往来寒热，故倍生姜，佐柴胡以解表∶结热在里，故去参、甘，加枳、芍以破结。条中并不言及大便硬，而且有下利症，仲景不用大黄之意晓然。后人因有下之二字，妄加大黄以伤胃气。非大谬乎？妄作伤寒书者，总不知凭脉辨症以用药，专以并合仲景方为得意。如加甘草于大承气中，而名三一承气，加柴、芩、芍药于承气中，而名六一顺气，以为可以代三承气、大柴胡、大陷胸等汤。竟不审仲景方分大小，药分表里，设方命剂，当因病患病机变迁轻重耳。岂圣贤之立方不精也，须尔辈更改乎？大小柴胡，俱是两解表里之剂。大柴胡主降气，小柴胡主调气。调气无定法，故小柴胡除柴胡、甘草外，皆可进退；降气有定局，故大柴胡无加减法。后人每方俱有加减，岂知方者哉！
柴胡桂枝干姜汤：
柴胡 桂枝 干姜 黄芩 甘草 牡蛎 栝蒌根
伤寒五六日，发汗不解，尚在太阳界，反下之，胸胁满微结，是系在少阳矣。此微结与阳微结不同∶阳微结对纯阴结言，是指结实在胃；此微结对大结胸言，是指胸胁痞硬。小便不利者，因下后下焦津液不足也。头为三阳之会，阳气不得降，故但头汗出；半表半里之寒邪未解，上下二焦之邪热已甚，故往来寒热心烦耳。此方全从柴胡加减。心烦不呕不渴，故去半夏之辛温，加栝蒌根以生津。胸胁满而微结，故减大枣之甘满，加牡蛎之咸以软之。小便不利而心下不悸，是无水可利，故不去黄芩，不加茯苓。虽渴而太阳之余邪不解，故不用参而加桂。生姜之辛，易干姜之温苦，所以散胸胁之满结也。初服烦即微者，黄芩、栝蒌之效；继服汗出周身，内外全愈者，姜桂之功。小柴胡加减之妙，若无定法，而实有定局矣。更其名曰柴胡桂枝干姜，以柴胡证具，而太阳之表犹未解，里已微结，须此桂枝解表，干姜解结，以佐柴胡之不及耳。
柴胡桂枝汤：
柴胡 桂枝 人参 甘草 半夏 黄芩 芍药 大枣 生姜
柴胡二汤，皆调和表里之剂。桂枝汤重解表，而微兼清里；柴胡汤重和里，而微兼散表。此伤寒六七日，正寒热当退之时，尚见发热恶寒诸表症，更兼心下支结诸里症，表里不解，法当双解之。然恶寒微，则发热亦微可知；支节烦疼，则一身骨节不痛可知。微呕心下亦微结，故谓之支结。表症虽不去而已轻，里症虽已见而未甚，此太阳少阳并病之轻者。故取桂枝之半，以解太阳未尽之邪；取柴胡之半，以解少阳之微结。凡口不渴，身有微热者，当去人参。此以六七日来邪虽不解，而正气已虚，故用人参以和之也。外症虽在，而病机已见于里，故方以柴胡冠桂枝之前，为双解两阳之轻剂。
柴胡加龙骨牡蛎汤：
柴胡 人参 黄芩 半夏 生姜 龙骨 牡蛎 桂枝 铅丹 茯苓 大黄 大枣
伤寒八九日不解，阳盛阴虚，下之应不为过，而变症蜂起者，是未讲于调胃承气之法，而下之不得其术也。胸满而烦，小便不利，三阳皆有是症。而惊是木邪犯心，谵语是热邪入胃。一身尽重，是病在阳明而无气以动也；不可转侧，是关少阳而枢机不利也。此为少阳阳明并病。故取小柴胡之半，以转少阳之枢；辅大黄之勇，以开阳明之 。满者忌甘，故去甘草∶小便不利，故加茯苓。惊者须重以镇怯，铅禀于金之体，受癸水之气，能清上焦无形之烦满，中焦有形之热结，炼而成丹，不特入心而安神，且以入肝而滋血矣。龙骨重能镇惊而平木，蛎体坚不可破，其性守而不移，不特静可以镇惊，而寒可以除烦热。且咸能润下，佐茯苓以利水，又能软坚，佐大黄以清胃也。半夏引阳入阴，能治目不瞑，亦安神之品，故少用为佐。人参能通血脉，桂枝能行营气，一身尽重不可转侧者，在所必须，故虽胸满谵语而不去也。此于柴胡方加味而取龙蛎名之者，亦以血气之属，同类相求耳。
黄连汤：
黄连 人参 甘草 桂枝 干姜 半夏 大枣
伤寒表不发热，而胸中有热，是其人未伤寒时素有蓄热也。热在胸中，必上形头面，故寒邪不得上干∶上焦实，必中气虚，故寒邪得从胁而入胃。《内经》云∶“中于胁则入少阳”，此类是已。凡邪在少阳，法当柴胡主治。此不往来寒热，病不在半表，则柴胡不中与之。胸中为君主之宫城，故用半夏泻心加减。胸中之热不得降，故炎上而欲呕；胃因邪气之不散，故腹中痛也。用黄连泻心胸之热，姜、桂祛胃中之寒，甘、枣缓腹中之痛，半夏除呕，人参补虚。虽无寒热往来于外，而有寒热相搏于中，所以寒热并用，攻补兼施，仍不离少阳和解之治法耳。此症在太阴、少阳之间，此方兼泻心、理中之剂。
黄芩汤：
黄芩 芍药 甘草 大枣
太阳阳明合病，是寒邪初入阳明之经，胃家未实，移寒于脾，故自下利，此阴盛阳虚，与葛根汤辛甘发散以维阳也。太阳少阳合病，是热邪陷入少阳之里，胆火肆逆，移热于脾，故自下利，此阳盛阴虚，与黄芩汤苦甘相淆以存阴也。凡太、少合病，邪在半表者，法当从柴胡桂枝加减。此则热淫于内，不须更顾表邪，故用黄芩以泄大肠之热，配芍药以补太阴之虚，用甘、枣以调中州之气。虽非胃实，亦非胃虚，故不必人参以补中也。若呕是上焦之邪未散，故仍加姜、夏。此柴胡桂枝汤去柴桂人参方也。凡两阳之表病，用两阳之表药；两阳之半表病，用两阳之半表药。此两阳之里病，用两阳之里药。逐条细审，若合符节。然凡正气稍虚，表虽在而预固其里，邪气正盛，虽下利而不须补中，此又当着眼处。《内经·热病论》云∶“太阳主气，阳明主肉，少阳主胆。伤寒一日太阳，二日阳明，三日少阳。”冬不藏精，则精不化气，故先气病，次及肉之病而及胆，仍自外之内。此病本虽因于内，而病因为伤于寒，故一病两名耳。胆汁最苦最寒，乃相火中之真味。火旺之水亏，胆汁上溢而口苦，故用芩、连之品以滋胆汁而清相火也。
Each of the Six Channels (Liu Jing) has its own guiding principle, and thus each application has its specific method. For instance, the guiding principle of Taiyang (Greater Yang) focuses on the exterior, so the method should be sweating to resolve it; however, the exterior differs in deficiency and excess, hence two methods are established: Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction). The guiding principle of Yangming (Yang Brightness) focuses on stomach excess, so the method should be purging to resolve it; yet excess varies in degree, hence Da Chengqi Tang (Major Order the Qi Decoction) and Xiao Chengqi Tang (Minor Order the Qi Decoction) are distinguished. The guiding principle of Shaoyang (Lesser Yang) presents symptoms of bitter taste in the mouth, dry throat, and dizziness, so the method should be clearing fire; however, fire varies in deficiency and excess: if the pathogen is at the half-exterior, then Xiao Chaihu Tang (Minor Bupleurum Decoction) is formulated to resolve the wandering deficient fire, and Da Chaihu Tang (Major Bupleurum Decoction) to resolve the heat accumulation of ministerial fire; these are the two methods for treating alternating chills and fever in Shaoyang. If the pathogen enters the half-interior of the heart and abdomen, there are formulas such as Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium), Huanglian Tang (Coptis Decoction), and Huangqin Tang (Scutellaria Decoction). Hehu Shuhe collected Zhang Zhongjing's old discussions, recorded their true formulas corresponding to symptoms, to prevent urgency in the world, but did not record a single formula for the Shaoyang and Taiyin channels because he did not understand Shaoyang syndromes, and thus did not understand Shaoyang formulas.
Xiao Chaihu Tang (Minor Bupleurum Decoction):
Chaihu (Bupleuri Radix), Renshen (Ginseng Radix et Rhizoma), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Banxia (Pinelliae Rhizoma), Jiang (Zingiberis Rhizoma Recens), Zao (Jujubae Fructus).
This is a formula for the pivot mechanism of Shaoyang, the general formula for harmonizing the interior and exterior. The Qi of Shaoyang circulates through the Sanjiao (Triple Burner) and controls the opening and closing of the body's couli (pores and interstices). When blood is weak and Qi is deficient, the couli open, allowing pathogens to enter and contend with healthy Qi. The struggle between pathogenic and healthy Qi causes alternating chills and fever. This is unrelated to headache and fever with a wiry and fine pulse in Shanghan (Cold Damage) or wind-stroke. All these are cases of deficient fire wandering at the half-exterior. Therefore, we use Chaihu, which is light, clear, slightly bitter, and slightly cold, to resolve exterior pathogens, and simultaneously use Renshen, which is slightly sweet and slightly warm, to preemptively tonify healthy Qi, ensuring the harmony of interior Qi so that exterior pathogens cannot enter. Symptoms such as bitter taste in the mouth, dry throat, dizziness, red eyes, head sweat, vexation, and tongue coating are all due to deficient fire wandering at the half-interior. Therefore, we use Huangqin, bitter and cold, to clear it, and simultaneously use Gancao and Zao, sweet in nature, to moderate it, also to guard against pathogens invading the Three Yin channels. In Taiyang Cold Damage, there is vomiting and reversal; in wind-stroke, there is dry retching. Here, the desire to vomit occurs because pathogenic and healthy Qi contend at the half-interior, so there is a desire to vomit without reversal. The hypochondrium is located at the halfway point of the body and serves as the pivot of Shaoyang. When pathogens bind in the hypochondrium, the pivot mechanism becomes obstructed, leading to fullness and discomfort in the chest and hypochondrium, silence, and lack of desire to eat. We employ the pungent and dispersing properties of Jiang and Banxia to assist Chaihu and Huangqin in expelling pathogens, and to move the stagnation caused by Gancao and Zao. Stopping vomiting can also relieve fullness. Since pathogens at the half-exterior tend toward the interior without a fixed abode, there are optional symptoms, hence the formula has modifications and no fixed ingredients are strictly adhered to. If there is vexation in the chest without vomiting, remove Banxia and Renshen to avoid aggravating vexation. If there is vexation with vomiting, Renshen can be removed, but Banxia must be used. Adding Gualou Shi (Trichosanthis Fructus) utilizes its bitter and cold nature to descend fire and relieve vexation. If there is thirst, it indicates insufficient primal Qi and failure to generate fluids; remove the pungent and warm Banxia, add more Renshen to boost Qi and generate fluids, and further add Gualou Gen (Trichosanthis Radix), bitter and cold, to raise Yin fluids and nourish from above. If there is abdominal pain, although caused by ministerial fire, fearing that the bitterness of Huangqin might transfer to Taiyin, replace it with Shaoyao (Paeoniae Radix Alba), sour in nature, to drain Wood. If pathogens bind under the hypochondrium causing hardness and痞 (plugged sensation), remove the sweetness of Dazao (which aids fullness) and add Muli (Ostreae Concha), salty in nature, to soften hardness. If there is palpitation below the heart and difficult urination, this is a minor deviation; fearing that the coldness of Huangqin might transfer to Shaoyin, replace it with Fuling (Poria), bland and leaching, to promote urination. If there is no internal thirst but slight external heat, interior Qi is unharmed but exterior pathogens remain unresolved; do not tonify the middle, so remove Renshen and add Guizhi (Cinnamomi Ramulus), pungent and dispersing, cover warmly to induce slight sweating. If there is cough, it is due to ministerial fire forcing Lung Qi; do not tonify Qi, so remove Renshen, as stated, "Lung heat again injures the Lung." Generally, when fever accompanies cough, the focus is on the exterior, so in Xiao Qinglong Tang (Minor Blue Dragon Decoction), Ganjiang (Zingiberis Rhizoma) and Wuweizi (Schisandrae Fructus) are added to Mahuang, Guizhi, and Xixin. Here, alternating chills and fever with cough focus on the interior, so both Jiang and Zao, which harmonize Ying and Wei, are removed, and Ganjiang, bitter and pungent, is added to treat the counterflow of ministerial fire, and Wuweizi, sour in nature, to collect Lung Metal Qi. Viewing them together, only the dispersion of pathogens is considered while healthy Qi remains unharmed; this is the intent behind formulating Xiao Chaihu Tang! This formula is similar to Guizhi Tang. However, Chaihu's resolution of the exterior is inferior to Guizhi; Huangqin's clearing of the interior is heavier than Shaoyao; Jiang, Zao, and Gancao slightly perform the usual pungent-sweet dispersing action; and Renshen, sweet and warm, already indicates the principle that deficient fire can be tonified. Moreover, the method of straining and decocting again differs from other formulas. Crude practitioners fear it will trap pathogens, recklessly using Chaihu and Huangqin while excluding Renshen, so conditions with mixed deficiency fail to respond and instead lead to rapid death. According to records, the seven ingredients of this formula: Chaihu governs unresolved exterior pathogens, Gancao governs discordant interior Qi, and the other five items are subject to addition and subtraction. If Gancao is removed from this formula, it becomes named Da Chaihu Tang; if Chaihu is removed, it becomes named Xiexin, Huangqin, Huanglian, etc., Decoctions. Predecessors all promoted Chaihu as the main treatment, and Mr. Lu paired three parts of winter-harvested Chaihu with Banxia as the main treatment; neither examined the meaning of additions and subtractions in this formula. This formula is a sacred medicine for spleen deficiency-heat and four-season malaria; remaining principles are detailed in the explanation of Shaoyang disease and the general method of formulating.
Da Chaihu Tang (Major Bupleurum Decoction):
Chaihu, Huangqin, Banxia, Shaoyao, Zhishi (Aurantii Fructus Immaturus), Jiang, Zao.
In Shanghan, fever persists despite sweating; after more than ten days, heat accumulates in the interior, causing epigastric hardness, vomiting, diarrhea, and recurring alternating chills and fever; or after reckless purging, Chaihu syndrome remains, and when given Xiao Chaihu Tang, vomiting does not cease, there is urgency below the heart, and slight vexation. These are all syndromes of the Qi aspect at the half-exterior and half-interior of Shaoyang. This formula treats formless heat pathogens in the Sanjiao, not tangible excess pathogens in the stomach organ. The urgency, vexation, and hardness below the heart indicate the disease is at the stomach opening, not within the stomach; heat accumulation in the interior is not solidification in the stomach. Because it is not tangible, after ten days, alternating chills and fever can recur. If it were solid in the stomach, there would be steaming fever, and one would no longer know of chills. Due to alternating chills and fever, double the amount of Shengjiang (Fresh Ginger) to assist Chaihu in resolving the exterior; because heat accumulates in the interior, remove Renshen and Gancao, and add Zhishi and Shaoyao to break up accumulation. The text does not mention hard stool, and even includes diarrhea, making Zhang Zhongjing's reason for not using Dahuang (Rhei Radix et Rhizoma) obvious. Later generations, seeing the characters "purge down," recklessly added Dahuang to damage Stomach Qi. Is this not a great error? Those who recklessly write Shanghan books generally do not know how to use medication based on pulse and symptom differentiation, taking pride solely in combining Zhang Zhongjing's formulas. For example, adding Gancao to Da Chengqi Tang creates San Yi Chengqi Tang; adding Chaihu, Huangqin, and Shaoyao to Chengqi Tang creates Liu Yi Shunqi Tang, believing they can replace San Chengqi, Da Chaihu, and Da Xianxiong Decoctions. They completely fail to examine that Zhang Zhongjing's formulas distinguish between large and small, and drugs between exterior and interior; prescribing formulas and naming agents should depend on the changes in severity of the patient's condition and pathology. Are the sages' formulations not precise enough, requiring your generation to change them? Both Da and Xiao Chaihu are formulas that resolve both exterior and interior. Da Chaihu primarily descends Qi, while Xiao Chaihu primarily regulates Qi. Regulating Qi has no fixed method, so except for Chaihu and Gancao, everything in Xiao Chaihu can be adjusted; descending Qi has a fixed pattern, so Da Chaihu has no modification method. Later generations added modifications to every formula; how could they know about formulas!
Chaihu Guizhi Ganjiang Tang (Bupleurum, Cinnamon Twig, and Dried Ginger Decoction):
Chaihu, Guizhi, Ganjiang, Huangqin, Gancao, Muli, Gualou Gen.
After five or six days of Shanghan, sweating fails to resolve it, still remaining in the Taiyang realm; contrary purging is applied, causing fullness and slight binding in the chest and hypochondrium, indicating attachment to Shaoyang. This slight binding differs from Yangwei Jie (Yang Minor Binding): Yangwei Jie refers to solidity in the stomach relative to Chun Yin Jie (Pure Yin Binding); this slight binding refers to epigastric and hypochondriac plugged sensation relative to Da Jie Xiong (Major Chest Binding). Difficult urination is due to insufficient fluids in the Lower Jiao after purging. The head is the convergence of the Three Yang channels; when Yang Qi cannot descend, only head sweat occurs. The cold pathogen at the half-exterior and half-interior is unresolved, and pathogenic heat in the Upper and Lower Jiao is severe, hence alternating chills and fever with vexation. This formula is entirely derived from modifications of Chaihu. Vexation without vomiting or thirst leads to removing the pungent-warm Banxia and adding Gualou Gen to generate fluids. Fullness and slight binding in the chest and hypochondrium lead to reducing the sweet-fullness of Dazao and adding salty Muli to soften. Difficult urination without palpitation below the heart means there is no water to promote, so Huangqin is not removed, nor is Fuling added. Although thirsty, residual pathogens of Taiyang remain unresolved, so Renshen is not used, but Guizhi is added. The pungency of Shengjiang is replaced by the warm-bitter nature of Ganjiang to disperse fullness and binding in the chest and hypochondrium. After the first dose, slight reduction in vexation is the effect of Huangqin and Gualou; subsequent doses inducing whole-body sweating and complete recovery internally and externally are the merits of Jiang and Gui. The subtlety of Xiao Chaihu's modifications seems to have no fixed method, but actually has a fixed pattern. Renaming it Chaihu Guizhi Ganjiang Tang is because Chaihu symptoms are present, yet Taiyang exterior is still unresolved, and the interior has slight binding; this requires Guizhi to resolve the exterior and Ganjiang to resolve binding, assisting Chaihu where it falls short.
Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction):
Chaihu, Guizhi, Renshen, Gancao, Banxia, Huangqin, Shaoyao, Dazao, Shengjiang.
The two Chaihu formulas are both agents for harmonizing the interior and exterior. Guizhi Tang focuses on resolving the exterior with slight clearing of the interior; Chaihu Tang focuses on harmonizing the interior with slight dispersing of the exterior. In Shanghan on the sixth or seventh day, when chills and fever should recede, exterior symptoms like fever and aversion to cold persist, accompanied by interior symptoms like epigastric support-binding. With both interior and exterior unresolved, the method should be dual resolution. However, mild aversion to cold implies mild fever; limb soreness implies no pain in the whole body's joints. Mild vomiting and slight epigastric binding are called "support-binding." Exterior symptoms are light though unresolved; interior symptoms are evident but not severe; this is a mild case of concurrent Taiyang and Shaoyang disease. Therefore, half of Guizhi is taken to resolve residual Taiyang pathogens; half of Chaihu is taken to resolve minor Shaoyang binding. Generally, for those with no thirst and slight body heat, Renshen should be removed. Here, after six or seven days, although pathogens remain unresolved, healthy Qi is already deficient, so Renshen is used to harmonize. Although external symptoms persist, the pathology manifests in the interior; thus, the formula places Chaihu before Guizhi, serving as a mild agent for dual resolution of the Two Yangs.
Chaihu Jia Longgu Muli Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction):
Chaihu, Renshen, Huangqin, Banxia, Shengjiang, Longgu (Mammalia Os Fossum), Muli, Guizhi, Qiandan (Plumbi Subcarbonas), Fuling, Dahuang, Dazao.
Shanghan unresolved after eight or nine days; Yang is excessive and Yin is deficient. Purging should not be wrong, yet complications arise like bees swarming; this is because the method of Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) was not studied, and purging was performed without proper technique. Fullness in the chest and vexation, difficult urination—these symptoms exist in all Three Yang channels. Palpitations are due to Wood pathogen invading the Heart; delirious speech is due to heat pathogen entering the Stomach. Heaviness throughout the body indicates disease in Yangming with lack of Qi to move; inability to turn over relates to Shaoyang with obstructed pivot mechanism. This is concurrent Shaoyang and Yangming disease. Therefore, half of Xiao Chaihu is taken to turn the Shaoyang pivot; assisted by the courage of Dahuang to open Yangming. Fullness dislikes sweetness, so Gancao is removed; difficult urination leads to adding Fuling. Palpitations require heavy substances to calm fear; Lead Dan (Qiandan), inheriting the nature of Metal and receiving the Qi of Gui Water, can clear formless vexation and fullness in the Upper Jiao, and tangible heat accumulation in the Middle Jiao. Smelted into cinnabar, it not only enters the Heart to calm the Spirit but also enters the Liver to nourish Blood. Longgu is heavy, calming palpitations and pacifying Wood; Muli's body is hard and unbreakable, its nature stable and immovable; not only can stillness calm palpitations, but cold can relieve vexation and heat. Salty nature moistens downward, assisting Fuling to promote urination, and can also soften hardness, assisting Dahuang to clear the Stomach. Banxia guides Yang into Yin, treating insomnia, and is also a Spirit-calming agent, so it is used sparingly as an assistant. Renshen can unblock blood vessels, Guizhi can circulate Ying Qi; for heaviness throughout the body and inability to turn over, these are necessary, so even with chest fullness and delirium, they are not removed. This formula adds flavors to the Chaihu formula and takes the name Dragon Bone and Oyster Shell because blood and Qi belong to similar categories seeking each other.
Huanglian Tang (Coptis Decoction):
Huanglian (Coptidis Rhizoma), Renshen, Gancao, Guizhi, Ganjiang, Banxia, Dazao.
In Shanghan, the exterior does not have fever, but there is heat in the chest; this person had accumulated heat before contracting Shanghan. Heat in the chest must manifest on the head and face, so cold pathogens cannot invade upward; Upper Jiao excess must mean Middle Qi deficiency, so cold pathogens can enter the Stomach from the hypochondrium. The Neijing states: "Attacking the hypochondrium leads to Shaoyang," this type belongs to it. Generally, pathogens in Shaoyang should be treated with Chaihu. Here, there is no alternating chills and fever, the disease is not at the half-exterior, so Chaihu is not appropriate. The chest is the palace city of the Sovereign Mind, so Banxia Xiexin Tang modifications are used. Heat in the chest cannot descend, so it flares upward causing desire to vomit; the Stomach, due to undispersed pathogens, causes abdominal pain. Huanglian is used to drain heat in the Heart and Chest; Jiang and Gui dispel cold in the Stomach; Gan and Zao moderate abdominal pain; Banxia removes vomiting; Renshen tonifies deficiency. Although there is no alternating chills and fever externally, there is contending cold and heat internally, so cold and heat are used together, attack and tonification are combined, still not departing from the Shaoyang harmonizing treatment method. This syndrome lies between Taiyin and Shaoyang; this formula combines Xiexin and Lizhong agents.
Huangqin Tang (Scutellaria Decoction):
Huangqin, Shaoyao, Gancao, Dazao.
Concurrent Taiyang and Yangming disease: cold pathogens initially enter the Yangming channel, the Stomach house is not yet solid, cold transfers to the Spleen, hence spontaneous diarrhea. This is Yin excess and Yang deficiency; Ge Gen Tang (Kudzu Root Decoction) uses pungent-sweet dispersing to maintain Yang. Concurrent Taiyang and Shaoyang disease: heat pathogens sink into the interior of Shaoyang, Gallbladder fire rebels wildly, heat transfers to the Spleen, hence spontaneous diarrhea. This is Yang excess and Yin deficiency; Huangqin Tang uses bitter-sweet mixing to preserve Yin. Generally, for concurrent Tai and Shao diseases with pathogens at the half-exterior, the method should follow Chaihu Guizhi modifications. Here, heat floods internally, no need to further consider exterior pathogens, so Huangqin is used to drain Large Intestine heat, paired with Shaoyao to tonify Taiyin deficiency, and Gan and Zao to regulate Middle State Qi. Although not Stomach excess, nor Stomach deficiency, Renshen is not necessary to tonify the middle. If there is vomiting, it means Upper Jiao pathogens are not dispersed, so Jiang and Xia are still added. This is Chaihu Guizhi Tang minus Chaihu, Guizhi, and Renshen. Generally, for exterior diseases of the Two Yangs, use exterior drugs of the Two Yangs; for half-exterior diseases of the Two Yangs, use half-exterior drugs of the Two Yangs. For interior diseases of the Two Yangs, use interior drugs of the Two Yangs. Examining each clause carefully, they fit perfectly like tally marks. However, whenever healthy Qi is slightly deficient, even if the exterior remains, secure the interior in advance; when pathogenic Qi is vigorous, even with diarrhea, do not tonify the middle; this is another point to focus on. The Neijing · Re Bing Lun states: "Taiyang governs Qi, Yangming governs Flesh, Shaoyang governs Gallbladder. Shanghan on day one is Taiyang, day two is Yangming, day three is Shaoyang." Winter failure to store Essence means Essence does not transform into Qi, so Qi disease comes first, followed by Flesh disease, then Gallbladder, still from outside to inside. Although the disease root is internal, the cause is injury by cold, hence one disease with two names. Gallbladder bile is the most bitter and coldest, being the true flavor of ministerial fire. When Fire is vigorous and Water is deficient, Gallbladder bile overflows upward causing bitter taste in the mouth, so products like Qin and Lian are used to nourish Gallbladder bile and clear ministerial fire.