治伤寒日深，表症仍在，蓄热下焦，脉微沉，不结胸发狂者，小腹胀而硬，小便自
利者，瘀血症也。或阳明蓄热而狂，大便虽硬，而反易，其色黑者，有蓄血也并宜。
桃仁（七个） 大黄（二钱五分） 水蛭（炒） 虻虫（各十个，去翅足，炒） 上分作二
服，水一钟，煎半钟，温服，未下再服。
治阳邪入里，表症未除，里症又急。
柴胡（八两） 黄芩（三两） 枳实（四枚，炙） 芍药（三两） 生姜（五两） 半夏（半斤） 大枣（十
二枚，去核） 大黄（二两，酒洗） 水一斗二升，煮六升，去滓，再煎一升，日三服。
成氏曰∶大满大实则有承气汤。如不大坚满，惟邪热甚而须攻下者，必须轻缓之
剂，乃大柴胡也。伤寒可下则为热，折热必以苦，故以柴胡为君，黄芩为臣。《经》曰∶
酸苦涌泄为阴，泄实折热，必以酸苦，故以芍药、枳实为佐，辛者散也。散逆气者，必
以辛。甘者，缓也。缓正气者，必以甘，故用半夏、姜、枣为使也。加大黄，功专荡
涤，不加恐难攻下，应以为使也。表症未除者，寒热往来，胁痛口苦尚在也。里症又急
者，大便难而燥实也。此为两解之剂。
治伤寒五六日，往来寒热，胸胁苦满，胁痛耳聋，默默不欲食，心烦喜呕，或胸中
烦而不呕，或渴，或腹痛，或胁下痞，或心下悸，小便不利，或不渴，身有微热，或咳
者，此邪在少阳经，半表半里之症也。
柴胡（八两） 黄芩 人参 甘草（炙） 生姜（各三两） 半夏（半升）
大枣（十二枚，去核） 水一斗二升，煮取六升，去滓，再煎，取三升，温服一升，日进三服。
成氏曰∶邪在表则寒，在里则热，半表半里，故寒热往来。在表则不满，在里则胀
满，止言胸胁苦满，知在表里之间，少阳行身之侧，胸胁为少阳之部，其脉循胁络于
耳，故胸胁痛而耳聋。在表则呻吟，在里则烦乱。《经》曰∶阴人之阴则静，默默者在
表里之间也。在表则能食，在里则不能食，不欲饮食者，邪在表里之间，未至于不能食
也。在表则不烦呕，在里则烦呕，心烦喜呕者，邪在表，方传里也。《经》曰∶热淫于
内，以苦发之，柴芩之苦，以发传邪之热，里不足者，以甘缓之，参草之甘，以缓中和
之气，邪半入里，则里气逆，辛以散之，半夏以除烦呕，邪在半表，则荣卫争之，辛甘
解之，姜枣以和荣卫。此为半表半里之剂。太阳经之表热，阳明经之标热，皆不能解
也。若夫阳气虚寒，面赤发热，脉沉足冷者，服之立至危殆，即大便不实，脉息小弱
者，皆在所禁信乎，用方不当，皆可杀人，不独峻剂也。近世医家不分表里寒热虚实，
凡见发热概用此方，去参投之，取其平稳。设遇虚症，岂不误甚！
治疗伤寒病程深入，表证仍在，热邪蓄积于下焦，脉象微沉，未出现结胸和发狂症状，但小腹胀满且坚硬，小便通畅自利的，属于瘀血证。或者是阳明经蓄热导致发狂，大便虽然干硬，反而容易排出，颜色发黑的，也是蓄血证。以上两种情况均适用本方。
桃仁（七个） 大黄（二钱五分） 水蛭（炒制） 虻虫（各十个，去除翅膀和足，炒制） 将上述药物分为两次服用，用水一钟，煎煮至半钟，温服，若未通便则再次服用。
治疗阳邪侵入体内，表证尚未解除，里证又十分急迫的情况。
柴胡（八两） 黄芩（三两） 枳实（四枚，炙烤） 芍药（三两） 生姜（五两） 半夏（半斤） 大枣（十二枚，去核） 大黄（二两，酒洗） 用水一斗二升，煮取六升，滤去药渣，再浓缩煎煮至一升，每日分三次服用。
成无己说：大满大实的病症应当使用承气汤。如果大便并不特别坚硬胀满，只是邪热极盛需要攻下的，必须使用轻缓的药剂，这就是大柴胡汤。伤寒病可以攻下的属于热证，折除热邪必须用苦味药，所以以柴胡为君药，黄芩为臣药。《内经》说：酸味和苦味具有涌吐和泄下的作用，属于阴。泄除实邪、折除热邪，必须用酸苦之品，所以以芍药、枳实为佐药。辛味能发散。发散逆乱之气，必须用辛味药。甘味能缓和。缓和正气，必须用甘味药，所以用半夏、生姜、大枣为使药。加入大黄，功效专门在于荡涤肠胃，如果不加大黄恐怕难以攻下，所以将其作为使药。表证未解除的表现是寒热往来、胁痛口苦依然存在。里证又急迫的表现是大便困难且干燥结实。这是表里双解的方剂。
治疗伤寒五六天，出现寒热往来，胸胁部苦闷胀满，胁痛耳聋，神情沉默不想吃东西，心烦喜欢呕吐，或者心中烦闷但不呕吐，或者口渴，或者腹痛，或者胁下痞塞，或者心下悸动，小便不利，或者不渴，身体有轻微发热，或者咳嗽的，这是邪气在少阳经，属于半表半里的证候。
柴胡（八两） 黄芩 人参 甘草（炙烤） 生姜（各三两） 半夏（半升） 大枣（十二枚，去核） 用水一斗二升，煮取六升，滤去药渣，再浓缩煎煮，取三升，每次温服一升，每天进服三次。
成无己说：邪气在表则恶寒，在里则发热，在半表半里之间，所以寒热往来。邪气在表则没有胀满感，在里则有胀满感，这里只说胸胁苦满，可知病位在表里之间。少阳经行走在身体侧面，胸胁是少阳经的部位，其经脉循行经过胁肋联络耳朵，所以会出现胸胁痛和耳聋。邪气在表则呻吟，在里则烦躁混乱。《内经》说：阴气进入阴分会使人安静，默默不语是因为邪气在表里之间。邪气在表则能进食，在里则不能进食，不欲饮食是因为邪气在表里之间，还未至于完全不能进食。邪气在表则不烦呕，在里则烦呕，心烦喜欢呕吐是因为邪气在表，正要传入里。《内经》说：热邪淫溢于内，要用苦味药发散它，柴胡和黄芩的苦味，用来发散传入之邪的热；里气不足者，要用甘味药缓和它，人参和甘草的甘味，用来缓和中和之气；邪气一半进入里，则里气上逆，用辛味药散之，半夏用来消除烦呕；邪气在半表，则营卫之气相争，用辛甘之品解之，生姜和大枣用来调和营卫。这是治疗半表半里的方剂。太阳经的表热，阳明经的标热，都不能被解除。如果是阳气虚寒，面赤发热，脉沉脚冷的患者，服用此方会立即导致危殆，即使是大便不成形，脉象细小虚弱的患者，也都属于禁忌。确实如此，用药不当，都会致人死亡，不仅仅是峻猛的药剂。近代医家不分表里、寒热、虚实，凡是见到发热就一概使用此方，去掉人参投给病人，图取平稳。如果遇到虚证，岂不是误事很深！
Treats cases where the pathogen of Cold Damage (Shanghan) has penetrated deeply, yet the exterior syndrome remains. Heat accumulates in the Lower Jiao (Lower Burner), the pulse is slightly deep, there is no chest binding or mania, but the lower abdomen is distended and hard, and urination is normal and spontaneous; this indicates a Blood Stasis syndrome. Alternatively, if Yang organ heat accumulation causes mania, and although the stool is hard, it is surprisingly easy to pass and black in color, this also indicates accumulated blood. Both conditions are suitable for this formula.
Tao Ren (Seven seeds) Dahuang (2.5 qian) Shuizhi (Stir-fried) Mengchong (Each ten, remove wings and feet, stir-fried). Divide into two doses. Use one zhong of water, decoct until half a zhong remains. Take warm. If bowel movement does not occur, take again.
Treats cases where Yang pathogens enter the interior, the exterior syndrome is not yet resolved, and the interior syndrome is urgent.
Chaihu (8 liang) Huangqin (3 liang) Zhishi (Four pieces, roasted) Shaoyao (3 liang) Shengjiang (5 liang) Banxia (0.5 jin) Dazao (Twelve pieces, pitted) Dahuang (2 liang, washed with wine). Use twelve dou of water, boil down to six sheng. Remove dregs, then decoct again to obtain one sheng. Take three times daily.
Cheng Wuji stated: For severe fullness and excess, Chengqi Tang should be used. If the stool is not particularly hard and full, but only extreme pathogenic heat requires purgation, a mild and slow-acting agent is necessary; this is Dahuang Chaihu Tang. In Cold Damage, if purgation is indicated, it is due to heat. To subdue heat, bitter flavors must be used. Therefore, Chaihu is the Sovereign herb, and Huangqin is the Minister herb. The Classic states: "Sour and bitter induce vomiting and purging, belonging to Yin." To purge excess and subdue heat, sour and bitter agents are essential. Thus, Shaoyao and Zhishi are the Assistant herbs. Pungent flavors disperse. To disperse rebellious Qi, pungent flavors are required. Sweet flavors moderate. To moderate healthy Qi, sweet flavors are needed. Thus, Banxia, Shengjiang, and Dazao are the Envoy herbs. Adding Dahuang specializes in scouring and cleansing; without it, purgation would be difficult, so it serves as an Envoy herb. The unresolved exterior syndrome manifests as alternating chills and fever, along with persistent hypochondriac pain and bitter taste in the mouth. The urgent interior syndrome manifests as difficult and dry, solid stools. This is a formula that resolves both exterior and interior simultaneously.
Treats Cold Damage after five or six days, presenting with alternating chills and fever, oppression and fullness in the chest and hypochondrium, hypochondriac pain, deafness, silence with lack of appetite, irritability and frequent vomiting, or irritability in the chest without vomiting, thirst, abdominal pain, epigastric stuffiness, palpitations under the heart, dysuria, absence of thirst, slight body heat, or cough. These indicate the pathogen is in the Shaoyang channel, representing a Half-Exterior Half-Interior syndrome.
Chaihu (8 liang) Huangqin Renshen Gancao (Roasted) Shengjiang (Each 3 liang) Banxia (0.5 sheng) Dazao (Twelve pieces, pitted). Use twelve dou of water, boil to obtain six sheng. Remove dregs, decoct again to obtain three sheng. Take one sheng warm, three times daily.
Cheng Wuji stated: Pathogen on the exterior causes chills; pathogen on the interior causes heat. Being in the Half-Exterior Half-Interior state results in alternating chills and fever. On the exterior, there is no fullness; on the interior, there is distension. Mentioning only chest and hypochondriac oppression indicates the location is between exterior and interior. The Shaoyang channel runs along the side of the body; the chest and hypochondrium are the regions of Shaoyang. Its pulse circulates through the hypochondrium and connects to the ear, hence chest/hypochondriac pain and deafness. On the exterior, there is groaning; on the interior, there is restlessness. The Classic states: "When Yin enters Yin, there is stillness." Silence indicates the pathogen is between exterior and interior. On the exterior, one can eat; on the interior, one cannot. Lack of desire to eat indicates the pathogen is between exterior and interior, not yet reaching the point of inability to eat. On the exterior, there is no irritability or vomiting; on the interior, there is. Irritability and frequent vomiting indicate the pathogen is on the exterior and transmitting inward. The Classic states: "When heat floods internally, use bitter flavors to vent it." The bitterness of Chaihu and Huangqin vents the heat of the transmitting pathogen. When interior deficiency exists, use sweet flavors to moderate it. The sweetness of Renshen and Gancao moderates the central Qi. When the pathogen is half-inside, interior Qi rebels; pungent flavors disperse it. Banxia eliminates irritability and vomiting. When the pathogen is in the Half-Exterior, Ying and Wei contend; pungent and sweet flavors resolve it. Shengjiang and Dazao harmonize Ying and Wei. This is a formula for the Half-Exterior Half-Interior state. It cannot resolve the exterior heat of the Taiyang channel or the branch heat of the Yangming channel. If there is Yang deficiency and cold, with red face, fever, deep pulse, and cold feet, taking this will lead to immediate danger. Even if the stool is loose and the pulse is small and weak, it is strictly contraindicated. Indeed, improper prescription can kill, not just harsh formulas. Recent physicians do not distinguish between exterior/interior, cold/heat, or deficiency/excess. Upon seeing fever, they generally use this formula, removing Renshen for perceived safety. If applied to deficiency syndromes, the error would be profound!