(表退而热结血分) 伤寒身热未能安,少腹满应小便难,今反利时因有血,须将汤药
合成丸。
抵当汤丸
虻蛭桃仁合大黄,汤丸随证用偏良,破开瘀血沉 起,从此其人不发狂。
【入阳明去路】
(表寒未解而内有火郁) 表热不用桂枝汤,外散内清另有方。汗出喘生无大热,麻甘杏石治偏良。
麻黄杏仁甘草石膏汤
麻黄发表泄皮毛,里热宜清用石膏,甘草杏仁还并入,和中降逆法弥高。
(表解而里有热方见太阳正病) 伤寒已服桂枝汤,汗出烦生渴饮浆,脉象更兼洪且大,
人参白虎是良方。
(表解而里有热) 此证已经汗出初,恶寒乃是属阳虚,若还恶热原为实,胃气调和病自
除。
调胃承气汤
汗后须将胃气调,大黄甘草合芒硝,津伤阳实全能治,热满胸中一概消。
【入太阴去路】
(表未解而里有水 方见太阳本病) 燥生汗后不眠时,和胃除烦少饮宜,小便维艰浮脉见
,热微消渴五苓施。
(误汗而里阳虚) 心烦便数汗弥漫,两脚拘
挛更恶寒,汤用桂枝温反误,亡阳厥逆觉咽干。
甘草干姜汤
桂枝误服竟亡阳,厥逆心烦病象彰,同气相招真善法,补宜甘草热宜姜。
芍药甘草汤
(证附 误汗而里阴虚) 误汗伤阴厥逆生,拘挛两脚步难行,只须芍药兼甘草,补血舒筋治效呈。
(表证已解,热邪结于血分)伤寒病后身体发热不得安宁,小腹胀满且应当小便困难,现在反而小便通利,这是因为体内有瘀血,需要将汤剂药物制成丸药服用。
抵当汤与抵当丸
虻虫、水蛭、桃仁与大黄相合,根据病情选择使用汤剂或丸剂效果更佳,能破除深层积聚的瘀血,从此患者不再出现发狂的症状。
【转入阳明病的转归】
(表寒未解而内有火郁)表热证不使用桂枝汤,外散表邪内清里热另有方剂。汗出伴有气喘且没有大热,用麻黄杏仁甘草石膏汤治疗较为适宜。
麻黄杏仁甘草石膏汤
麻黄发散表邪透达皮毛,里热适宜用石膏清泄,甘草和杏仁一并加入,调和中气、降逆平喘的法度非常高明。
(表证已解而里有热,此方见太阳病正治法)伤寒已经服用过桂枝汤,汗出后产生烦躁,口渴想喝浆水,脉象更加洪大有力,人参白虎汤是良方。
(表证已解而里有热)这种证候已经是发汗之后初期,恶寒属于阳气虚弱,如果还怕热则原本为实证,胃气调和疾病自然消除。
调胃承气汤
发汗后需要调理胃气,大黄、甘草配合芒硝,津液损伤兼阳气实热都能治疗,胸中的热胀满一概消除。
【转入太阴病的转归】
(表证未解而里有水饮,此方见太阳本病)燥热在发汗后导致失眠时,调和胃气、除烦并少量饮水为宜,小便艰涩不利且见到浮脉,热微消渴可用五苓散施治。
(误用发汗法导致里阳虚)心烦、大便频数、汗出淋漓,两脚拘挛抽搐且更觉恶寒,此时若用桂枝汤温散则是误治,会导致亡阳、四肢厥冷逆乱,感觉咽喉干燥。
(Exterior syndrome has resolved, heat is bound in the blood level) After a cold damage disease, the body remains feverish and restless. The lower abdomen is full and distended, and urination should be difficult; however, urination is now free. This indicates the presence of blood stasis. Therefore, the decoction ingredients should be processed into pills.
Didang Tang (Maggot and Leech Decoction) and Didang Wan (Maggot and Leech Pill)
The combination of *Tabanus* (Mengchong), *Hirudo* (Shizhi), *Prunus persica* seed (Taoren), and *Rheum palmatum* root (Dahuang) offers excellent efficacy whether used as a decoction or a pill, depending on the specific condition. It breaks up deep-seated blood stasis, thereby preventing the patient from going mad.
[Transition to Yangming Disease Pathways]
(Exterior cold has not resolved, while internal fire is constrained) For exterior heat syndromes, Guizhi Tang (Cinnamon Twig Decoction) is not used. There are other formulas for dispersing the exterior and clearing the interior simultaneously. If there is sweating, wheezing, but no high fever, Mahuang Xingren Gaozhi Shigao Tang (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction) is particularly suitable.
Mahuang Xingren Gaozhi Shigao Tang (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction)
Mahuang (Ephedrae Herba) releases the exterior and vents through the skin and hair; Gaoshui (Gypsum Fibrosum) is appropriate for clearing internal heat. Combined with Gancao (Licorice Root) and Xingren (Apricot Seed), this formula harmonizes the middle and descends rebellious qi, demonstrating a superior therapeutic method.
(Exterior syndrome has resolved, while heat exists in the interior; see Taiyang Zhengbing for this formula) After a cold damage disease, if Guizhi Tang (Cinnamon Twig Decoction) has already been taken, resulting in sweating, subsequent irritability, thirst for drinking fluids, and a surging and large pulse, Renshen Baihu Tang (Ginseng White Tiger Decoction) is an excellent prescription.
(Exterior syndrome has resolved, while heat exists in the interior) In this syndrome, which occurs shortly after sweating, chills indicate yang deficiency. If the patient fears heat, it is originally an excess syndrome. Once the stomach qi is harmonized, the disease will resolve spontaneously.
Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction)
After sweating, the stomach qi must be regulated using Dahuang (Rhubarb Root), Gancao (Licorice Root), together with Mangxiao (Mirabilite). It treats both fluid injury and yang excess, eliminating all heat and fullness in the chest.
[Transition to Taiyin Disease Pathways]
(Exterior syndrome has not resolved, while water retention exists in the interior; see Taiyang Benbing for this formula) When dryness generates after sweating, leading to insomnia, one should harmonize the stomach, relieve irritability, and drink small amounts of water. If urination is difficult and a floating pulse is observed, with mild heat and thirst, Wuling San (Five-Ingredient Powder with Poria) should be administered.
(Misuse of sweating methods leads to interior yang deficiency) Irritability, frequent bowel movements, profuse sweating, spasms and cramping in both legs, along with increased aversion to cold, may occur. Using Guizhi Tang (Cinnamon Twig Decoction) to warm at this stage is a misdiagnosis, leading to loss of yang, cold extremities, and a sensation of dryness in the throat.
Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction)
The mistaken use of Guizhi Tang (Cinnamon Twig Decoction) causes loss of yang, manifesting as cold extremities and irritability. Utilizing the principle of similar energies attracting each other is a truly good method: Gancao (Licorice Root) is used for tonification, and Ganjiang (Dried Ginger Rhizome) for warming.
Shaoyao Gancao Tang (Peony and Licorice Decoction)
(Attached Syndrome: Misuse of sweating methods leads to interior yin deficiency) Mistaken sweating injures yin, generating cold extremities and leg spasms that make walking difficult. Simply using Shaoyao (White Peony Root) combined with Gancao (Licorice Root) provides effective treatment by nourishing blood and relaxing sinews.