太阳病三日，已发汗，若吐，若下，若温针，仍不解者，此为坏病，桂枝不中与也。观其
脉证，知犯何逆，随证治之。本发汗，而复下之，此为逆也。若先发汗，治不为逆。先本下之，
而复汗之为逆。若先下之，治不为逆。
按太阳病三日经尽，发汗、吐、下、温针诸法仍然不解，此非入阳明之府，即入太阴之脏，是为
太阳坏病。是缘下汗补泄，治法错误而然。盖阳盛而亡其阴，则入于腑；阴盛而亡其阳，则入于脏。虽
太阳表证未解，然不可作太阳病治。相其脉证，知其所犯何逆，随证治之可也。
按太阳坏病，入阳明去路∶表寒未解，而内有火郁，以麻黄杏仁甘草石膏汤主之。表解而内燥，
以人参石膏汤主之。表解而里热，以调胃承气汤主之。入太阴去路∶表未解而里湿，以五苓散主之。表
解而里阳虚，以甘草干姜汤主之。表解而里阴虚，以芍药甘草汤主之。表未解而里寒急，先以四逆汤主
之，后以桂枝汤主之。表未解而里虚，以桂枝加芍药生姜人参新加汤主之。表未解而里热，以葛根黄
芩黄连汤主之。表未解而里寒，以桂枝去芍药汤，桂枝去芍药加附子汤主之。表未解而里实，以桂枝加
浓朴杏仁汤主之。表解而里湿，以桂枝去桂加茯苓白术汤主之。表虚而里实，以浓朴生姜甘草半夏人
参汤主之。里实而宜吐，以栀子浓朴汤栀子干姜汤，栀子香豉汤，栀子甘草汤，栀子生姜汤，随证主
之。入少阴去路∶表虚汗漏，以桂枝加附子汤主之。里虚恶寒，以芍药甘草附子汤主之。里寒有湿，以茯
苓白术桂枝甘草汤主之。里寒有水，以真武汤主之。里虚亡阳，以桂枝甘草汤主之。里寒欲作奔豚，
以桂枝加桂汤，茯苓桂枝甘草大枣汤主之。里虚亡阳惊狂，以桂枝去芍药加蜀漆龙骨牡蛎汤主之。里虚亡阳
烦躁，以桂枝甘草龙骨牡蛎汤主之。表解而里阳虚，以茯苓四逆汤，干姜附子汤主之。
太阳病经过三天，已经使用了发汗法，或者用了催吐法、泻下法、温针法，病情仍然没有解除的，这叫做“坏病”，此时不能再使用桂枝汤治疗。应当观察患者的脉象和证候，了解误治造成了什么逆乱，根据具体的证候进行治疗。
本来应该先发汗解表，却反而用了泻下法，这是错误的治法（逆）。如果先发了汗，治疗就不算错误。原本应该用泻下法，却反而用了发汗法，这也是错误的治法。如果先用了泻下法，治疗就不算错误。
按：太阳病到了第三天，经气已尽，经过发汗、催吐、泻下、温针等各种方法治疗后仍然不解，这说明病邪不是传入阳明腑，就是传入太阴脏，这就是太阳坏病。这是因为汗法和下法补泻不当，治疗方法错误导致的。一般来说，阳气亢盛而耗伤阴液，病邪就会传入腑；阴气亢盛而耗伤阳气，病邪就会传入脏。虽然太阳表的证候尚未解除，但也不能按照普通的太阳病来治疗。应当审视其脉象和证候，判断所犯下的错误是什么，随证进行治疗即可。
按：太阳坏病，传入阳明的路径：表寒未解，而体内有火郁结，用麻黄杏仁甘草石膏汤主治。表证已解而体内干燥，用人参石膏汤主治。表证已解而里有热，用调胃承气汤主治。
传入太阴的路径：表证未解而里有湿，用五苓散主治。表证已解而里阳虚，用甘草干姜汤主治。表证已解而里阴虚，用芍药甘草汤主治。表证未解而里寒急迫，先用四逆汤主治，后用桂枝汤主治。表证未解而里虚，用桂枝加芍药生姜人参新加汤主治。表证未解而里有热，用葛根黄芩黄连汤主治。表证未解而里有寒，用桂枝去芍药汤或桂枝去芍药加附子汤主治。表证未解而里有实邪，用桂枝加厚朴杏子汤主治。表证已解而里有湿，用桂枝去桂加茯苓白术汤主治。表虚而里有实邪，用厚朴生姜半夏甘草人参汤主治。里有实邪且适宜用吐法，用栀子厚朴汤、栀子干姜汤、栀子豉汤、栀子甘草汤、栀子生姜汤，随证选用。
传入少阴的路径：表虚导致汗出不止，用桂枝加附子汤主治。里虚导致恶寒，用芍药甘草附子汤主治。里有寒且有湿，用茯苓白术桂枝甘草汤主治。里有寒且有水饮，用真武汤主治。里虚导致亡阳，用桂枝甘草汤主治。里有寒且欲作奔豚，用桂枝加桂汤或茯苓桂枝甘草大枣汤主治。里虚导致亡阳且惊狂，用桂枝去芍药加蜀漆龙骨牡蛎汤主治。里虚导致亡阳且烦躁，用桂枝甘草龙骨牡蛎汤主治。表证已解而里阳虚，用茯苓四逆汤或干姜附子汤主治。
Taiyang disease (Disease of the Taiyang Channel) for three days, after sweating therapy has been applied, or if emesis, purgation, or warm needle therapy has been used, yet the condition remains unresolved, this is termed "ruined disease" (Huai Bing, a complication arising from misdiagnosis or mistreatment). Guizhi Tang (Cinnamon Twig Decoction) should no longer be administered. One must observe the pulse and manifestations, determine what adverse effects were caused by the error, and treat according to the specific syndrome.
Originally, sweating should have been performed first; applying purgation instead constitutes an adverse treatment (Ni). If sweating was performed first, the treatment is not considered adverse. Originally, purgation should have been performed; applying sweating instead also constitutes an adverse treatment. If purgation was performed first, the treatment is not considered adverse.
Commentary: By the third day of Taiyang disease, the channel qi has exhausted itself. If sweating, emesis, purgation, and warm needle therapies still fail to resolve the condition, it indicates that the pathogen has either entered the Yangming Fu organs or the Taoyin Zang organs, constituting a Taiyang ruined disease. This arises from incorrect application of tonifying and draining methods via sweating and purgation. Generally, when Yang is excessive and Yin is depleted, the disease enters the Fu organs; when Yin is excessive and Yang is depleted, the disease enters the Zang organs. Although the exterior symptoms of Taiyang have not resolved, it cannot be treated as a standard Taiyang disease. One must examine the pulse and manifestations to identify the nature of the error and treat accordingly.
Regarding the progression of Taiyang ruined disease into Yangming: If exterior cold persists while internal fire stagnates, Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction) is indicated. If the exterior is resolved but dryness exists internally, Renshen Shigao Tang (Ginseng and Gypsum Decoction) is indicated. If the exterior is resolved and heat exists in the interior, Tiaowei Chengqi Tang (Regulating the Stomach and Guiding Out Decoction) is indicated.
Regarding the progression into Taoyin: If the exterior is unresolved and dampness exists in the interior, Wuling San (Five-Ingredient Powder with Poria) is indicated. If the exterior is resolved and interior Yang deficiency exists, Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) is indicated. If the exterior is resolved and interior Yin deficiency exists, Shaoyao Gancao Tang (Peony and Licorice Decoction) is indicated. If the exterior is unresolved and interior cold is urgent, Sini Tang (Frigid Extremities Decoction) is administered first, followed by Guizhi Tang (Cinnamon Twig Decoction). If the exterior is unresolved and interior deficiency exists, Guizhi Jia Shaoyao Shengjiang Renshen Xinjia Tang (Modified Cinnamon Twig Decoction with Added Peony, Fresh Ginger, and Ginseng) is indicated. If the exterior is unresolved and interior heat exists, Gegen Huangqin Huanglian Tang (Kudzu, Scutellaria, and Coptis Decoction) is indicated. If the exterior is unresolved and interior cold exists, Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction without Peony) or Guizhi Qu Shaoyao Jia Fuzi Tang (Cinnamon Twig Decoction without Peony plus Aconite) is indicated. If the exterior is unresolved and interior excess exists, Guizhi Jia Houpo Xingren Tang (Cinnamon Twig Decoction with Added Magnolia Bark and Apricot Seed) is indicated. If the exterior is resolved and dampness exists in the interior, Guizhi Qu Gui Jia Fuling Baizhu Tang (Cinnamon Twig Decoction without Cinnamon Twig plus Poria and Atractylodes Macrocephala) is indicated. If the exterior is deficient and interior excess exists, Houpo Shengjiang Banxia Gancao Renshen Tang (Magnolia Bark, Fresh Ginger, Pinellia, Licorice, and Ginseng Decoction) is indicated. If interior excess warrants emesis, Zhizi Houpo Tang (Gardenia and Magnolia Bark Decoction), Zhizi Ganjiang Tang (Gardenia and Dried Ginger Decoction), Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), Zhizi Gancao Tang (Gardenia and Licorice Decoction), or Zhizi Shengjiang Tang (Gardenia and Fresh Ginger Decoction) are selected according to the syndrome.
Regarding the progression into Shaoyin: If exterior deficiency leads to leakage of sweat, Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction plus Aconite) is indicated. If interior deficiency leads to aversion to cold, Shaoyao Gancao Fuzi Tang (Peony, Licorice, and Aconite Decoction) is indicated. If interior cold with dampness exists, Fuling Baizhu Guizhi Gancao Tang (Poria, Atractylodes Macrocephala, Cinnamon Twig, and Licorice Decoction) is indicated. If interior cold with water retention exists, Zhenwu Tang (True Warrior Decoction) is indicated. If interior deficiency leads to collapse of Yang, Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction) is indicated. If interior cold predisposes to Ben Tun (Running Piglet Syndrome), Guizhi Jia Gui Tang (Cinnamon Twig Decoction with Additional Cinnamon Twig) or Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction) is indicated. If interior deficiency leads to collapse of Yang with fright and mania, Guizhi Qu Shaoyao Jia Chujie Longgu Muli Tang (Cinnamon Twig Decoction without Peony plus Cocculus Root, Dragon Bone, and Oyster Shell) is indicated. If interior deficiency leads to collapse of Yang with irritability, Guizhi Gancao Longgu Muli Tang (Cinnamon Twig, Licorice, Dragon Bone, and Oyster Shell Decoction) is indicated. If the exterior is resolved and interior Yang deficiency exists, Fuling Sini Tang (Poria and Frigid Extremities Decoction) or Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction) is indicated.