阴毒之为病，面青身痛如被杖，咽喉痛，五日可治，七日不可治，升麻鳖甲汤去雄黄蜀椒主之。（升麻
鳖甲汤方见阳毒。）
〔《活》〕阴毒甘草汤 治伤寒时气，初得病一二日，便结成阴毒，或服药后六七日以上至十日，变成阴毒，身重
背强，腹中绞痛，咽喉不利，毒瓦斯攻心，心下坚强，短气不得息，呕逆，唇青面黑，四肢厥冷，其脉沉细而
疾，身如被杖，咽喉痛，五六日可治，七日不可治。
甘草（炙） 升麻 当归（各五钱） 雄黄（二钱半） 桂枝（去皮，五钱） 蜀椒（炒，去汗并闭口者及子二分）
鳖甲（酥炙，一两半）
上 咀，水煎服，如人行五里许，更进一服，覆取汗，毒从汗出，汗出即愈。若未汗，再服。
〔《本》〕阴毒本因肾气虚冷，因欲事或食冷物后伤风，内既伏阴，外又感寒，或先感外寒而后伏阴，内
外皆阴，则阳气不守，遂发头痛，腰重，腹痛，眼睛疼，身体倦怠而不甚热，四肢逆冷，额上及手背冷汗不止，
或多烦渴，精神恍惚，如有所失，或可起行，不甚觉重，诊之则六脉俱沉细而疾，尺部短小，寸口或无，六脉
俱浮大，或沉取之，大而不甚疾者，非阴症也。若服凉药过多，则渴转甚，躁转急，有此症者，急服还阳退阴
之药即安，惟补虚和气而已，宜服正元散、退阴散、五胜散。阴症不宜发汗，如气正脉大，身热未瘥，用药发
汗无妨。
正元散 治伤寒如觉风寒吹着，四肢头目骨节疼痛，急服此药。如人行五里许再服，连进三服，出汗
立瘥。若患阴毒伤寒，入退阴散五分同煎。或伤冷伤食，头昏气满，及心腹诸疾服之，无有不效。
麻黄（去节） 陈皮 大黄（生） 甘草 干姜 肉桂 芍药 附子 吴茱萸 半夏（制。各等分）
上 咀，麻黄加一半，茱萸减一半，同为末，每服一钱，水一盏，姜三片，枣一枚，煎七分，热服，以衣
被盖覆取汗，切须候汗干去之。如是阴毒，不可用麻黄，免更出汗。
退阴散 治阴毒伤寒，手足逆冷，脉沉细，头痛腰重，连服三次，小小伤冷，每服一字，入正元散同煎，入盐
一捻。阴毒伤寒咳逆，煎一服，细细热呷，病止。
川乌 干姜（等分）
上为粗末，炒令转色，放冷再捣为细末。每服一钱，水一盏，盐一捻，煎至半盏，去渣温服。
五胜散 治伤寒头痛，壮热，骨节疼痛，昏沉困倦，咳嗽鼻塞，不思饮食。兼治伤寒夹冷气，并慢阴毒，神效。
白术（一两半） 甘草 五味子 石膏（各一两） 干姜（三两半）
上 咀，每服五钱，水一盏，入盐少许，同煎服。如冷气相夹，入姜、枣煎，或治阴毒病，入艾叶少许，
煎服。
〔海〕白术散 治阴毒伤寒，心闷烦躁，四肢厥冷。
川乌（炮，去皮脐） 桔梗 附子（炮） 白术 细辛（各一两） 干姜（炮，半两）
上 咀，或末之，白汤调下一钱匕。
〔罗〕正阳丹 治阴毒伤寒，手足厥冷，指甲青色，体冷，脉沉细而微，神效。
用憨葱四五枝，陈蜂房四五个，烧存性，为细末，用憨葱捣和丸，如弹子大，手心内握定，用手帕紧系定，
须臾汗出，以绵被覆盖。如手心热甚，休教解开。如服药，先服升麻汤五钱，连须葱三茎，生姜五片，水二
大盏，煎至一盏，去渣温服，被覆取汗则愈。
〔《本》〕阴毒渐深候 积阴感于下，则微阳消于上，故其候四肢沉重，逆冷，腹痛转甚，或咽喉不利，
或心下胀满结硬，燥渴，虚汗不止，或时狂言，爪甲面色青黑，六脉沉细而一息七至以来。有此症者，速宜于
气海、关元二穴灸二三百壮，以手足温暖为效。仍服金液丹、来苏丹、玉女散、还阳散、退阴散。
玉女散
川乌（去皮脐，冷水浸七日，薄切晒干，纸袋盛之。有患者，取研末一大钱，入盐一小钱，水一盏，
煎至七分服。压下阴毒，所注如猪血相似。未已，再进一服，效。）
还阳散 治阴毒面青，四肢逆冷，心躁腹痛。
用硫黄末，新汲水调下二钱，良久，或寒一起，或热一起，更看紧慢再服，汗出瘥。
〔《活》〕返阴丹 治阴毒伤寒，心神烦躁，头疼，四肢逆冷。
硫黄（五两） 附子（炮，去皮脐） 干姜（炮） 桂心（各半两） 硝石（另研） 太阴玄精石（另研。各二两）
上用生铁铫，先铺玄精末一半，次铺硝石末一半，中间下硫黄末，又着硝石一半，盖硫黄，却以玄精石末
盖上，用小盏合著，用三斤炭火烧令得所，勿令烟出，细研似面，后三味捣罗为末，与前药同研令匀，软饭
和丸，如桐子大，每服十五丸至二十丸，煎艾汤下，频服，汗出为度，病重则三十丸。此方甚验，喘促与吐
逆者，入口便住，又服此药三五服不退者，更于脐下一寸灸之，须是昼夜大段不住手灸，不限多少壮数灸之，
艾炷勿令小，小则不得力。若其人手足冷，少腹硬，即于脐下两边各开一寸，各安一道，三处齐下火灸之，
仍与当归四逆汤，并返阴丹，亦须频服。内外通透，方得解。若迟误即死矣。又若阴症，加以少腹不通，及
阴囊缩入，少腹绞痛欲死者，更于脐下二寸石门穴急灸之，仍须与返阴丹、当归四逆汤加吴茱萸、生姜，慎
勿与寻常利小便冷滑药。
火焰散 治伤寒恶候。
舶上硫黄 黑附子（去皮，生用） 新腊茶（为细末，各一两）
上为细末，先用好酒一升，调药摊入新碗中，于火上荡干，合在瓦上，每一碗下烧熟艾一拳大，以瓦 起，
无令着火，直至姻尽候冷，即括取研入瓷盒内盛，每服二钱，酒一盏，共煎七分，有火焰起，勿讶。伤寒阴
毒者，四肢冷，脉沉细，或吐泻，五心烦躁，胸中结硬，或转早，伏阴在内，汤水不得下，或无脉，先吃一
服，如吐，却更进一服。服后心中热，其病已瘥。下至脏腑中，表未解者，浑身壮热，脉气洪大，便宜用发
表药。或表解者，更不发热，便得眠睡，浑身有汗，若少有痞结，脉实，方可用下膈行脏腑药，渐用调和元
气，补治脾胃汤散。服此药三服不应者，不可治也。
〔《本》〕阴毒沉困之候，与前后渐染之候皆同，而更加沉重，六脉附骨，取之方有，按之即无，一息八
至以上，或不可数。至此则药饵难为功矣，但于脐下灼火艾如枣大，三百壮以来，手足不和暖者，不可
治也。倘复和暖，以前硫黄及热药助之。若阴气散，阳气来，则渐减热药而和治之，以取瘥也。
〔《活》〕治阴虚阳脱，体冷无脉，气息欲绝，不省人事，及伤寒阴厥，百方不效者。用葱以索缠如臂大，
切去根及叶，惟存白长二寸许，如大饼样，先以火协一面，令通热，勿令着火，乃以热面熨病患脐上连脐下，
又以熨斗满贮火熨之，令葱饼中热气郁入肌肉中，须更作三四饼，一饼坏不可熨，又易一饼，良久病患当苏，
手足温，有汗即瘥，更服四逆汤以温其内。
〔海〕治阴症诸药不效，并汤水不下，身冷脉绝，气息短，不知人。用葱白熨法，莫若用酽醋拌麸皮炒熟，
注布袋中，蒸熨，比上法尤速。
代灸涂脐膏
附子 马蔺子 蛇床子 吴茱萸 肉桂（各等分）
上为细末，可用白面一匙，药末一匙，生姜自然汁煨成膏，摊纸上，圆三寸许，贴脐下关元、气海，自晚
至晓，其火力可代灸百壮。腰痛亦可贴之。一法，用丁香、荜茇、干姜、牡蛎烧灰，放手心中，以唾津调如
泥，以手掩其阴，至暖汗出为度。
阴毒伤寒，四肢逆冷者，用吴茱萸不拘多少，为细末，温酒和匀，生绢袋盛之，热熨脚心，令通畅愈。若
以汤煎温药渫洗，以接四肢亦可。
《本》治阴中伏阳，破阴丹。
硫黄 水银（各一两） 陈皮 青皮（各半两）
上将硫黄先入铫子内熔开，次下水银，用铁杖子打匀，令无星，倾入黑茶盏内，细研，入二味，用面糊丸，
如桐子大，每服三十丸。如烦躁，冷盐汤下。阴症，艾汤下。良效。
有人初得病，四肢逆冷，脐下筑痛，身疼如被杖，盖阴症也，急服金液、破阴、来复等丹，其脉遂沉而滑。
沉者阴也，滑者阳也，病虽阴症而见阳脉，有可生之理，仲景所谓阴病见阳脉者生。仍灸气海、丹田百壮，手
足温温，阳回得汗而解。或问滑沉之状，如何便有生理？予曰∶仲景云∶翕奄沉，名曰滑，何谓也？沉为纯阴，
翕为正阳，阴阳和合，故名曰滑。古人论脉滑，虽曰往来前却，流利旋转，替替然与数相似，仲景三语而足也。
此三字极难晓。翕，合也，言张而复合也，故曰翕为正阳；沉，言忽降而下也，故曰沉为正阴，方翕而合，俄
降而沉；奄，为忽忽间。仲景论滑脉可谓谛当矣。其言皆有法，故读者难晓，宜细思之。
【背景信息】
书名：医学纲目 作者：楼英 朝代：明 章节：阴气毒盛变阴毒 / 阴毒续法 类别：医论
【待处理原文】
阴毒之为病，面青身痛如被杖，咽喉痛，五日可治，七日不可治，升麻鳖甲汤去雄黄蜀椒主之。（升麻鳖甲汤方见阳毒。）
阴毒这种病证，表现为面色发青，身体疼痛如同遭受棍棒击打，咽喉疼痛。发病五天内可以治疗，七天后则难以治愈。主治方剂为升麻鳖甲汤（去除雄黄和蜀椒）。（升麻鳖甲汤的方剂组成见“阳毒”篇。）
〔《活》〕阴毒甘草汤 治伤寒时气，初得病一二日，便结成阴毒，或服药后六七日以上至十日，变成阴毒，身重背强，腹中绞痛，咽喉不利，毒瓦斯攻心，心下坚强，短气不得息，呕逆，唇青面黑，四肢厥冷，其脉沉细而疾，身如被杖，咽喉痛，五六日可治，七日不可治。
甘草（炙） 升麻 当归（各五钱） 雄黄（二钱半） 桂枝（去皮，五钱） 蜀椒（炒，去汗并闭口者及子二分）鳖甲（酥炙，一两半）
上药切碎，用水煎服。大约行走五里路的时间后，再服用一次。服药后覆盖衣被以取汗，毒邪随汗排出，汗出即愈。若未出汗，再次服用。
〔《本》〕阴毒本因肾气虚冷，因欲事或食冷物后伤风，内既伏阴，外又感寒，或先感外寒而后伏阴，内外皆阴，则阳气不守，遂发头痛，腰重，腹痛，眼睛疼，身体倦怠而不甚热，四肢逆冷，额上及手背冷汗不止，或多烦渴，精神恍惚，如有所失，或可起行，不甚觉重，诊之则六脉俱沉细而疾，尺部短小，寸口或无，六脉俱浮大，或沉取之，大而不甚疾者，非阴症也。若服凉药过多，则渴转甚，躁转急，有此症者，急服还阳退阴之药即安，惟补虚和气而已，宜服正元散、退阴散、五胜散。阴症不宜发汗，如气正脉大，身热未瘥，用药发汗无妨。
阴毒原本是因为肾气虚弱寒冷，因房事或食用生冷食物后感冒风寒，体内既有潜伏的阴寒，体外又感受了寒邪；或者先感受外寒而后体内潜伏阴寒，导致内外皆为阴寒，阳气不能固守，于是出现头痛，腰部沉重，腹痛，眼睛疼痛，身体疲倦但发热不明显，四肢冰冷，额头及手背冷汗不止，或者多烦躁口渴，精神恍惚，如有所失，或者勉强可以起身行走，并不觉得特别沉重。诊察脉搏则六脉都沉细且快速，尺部脉短小，寸口脉可能摸不到。如果六脉都浮大，或者沉取时脉大但不算太快，这就不是阴症。如果服用过多的凉药，则口渴更严重，烦躁更急切。有这些症状的患者，应立即服用回阳退阴的药物即可安定，只需补虚益气调和即可，适宜服用正元散、退阴散、五胜散。阴症不宜发汗，但如果正气尚存脉象有力，身体发热未消退，用药发汗也无妨。
正元散 治伤寒如觉风寒吹着，四肢头目骨节疼痛，急服此药。如人行五里许再服，连进三服，出汗立瘥。若患阴毒伤寒，入退阴散五分同煎。或伤冷伤食，头昏气满，及心腹诸疾服之，无有不效。
正元散 治疗伤寒，如果觉得风寒侵袭，四肢、头部、眼部、骨骼关节疼痛，应立即服用此药。大约行走五里路的时间后再服，连续服用三次，出汗后立即痊愈。如果患有阴毒伤寒，加入五分退阴散一同煎煮。或者是受寒伤食，头晕气胀，以及心腹部各种疾病，服用它，没有不有效的。
麻黄（去节） 陈皮 大黄（生） 甘草 干姜 肉桂 芍药 附子 吴茱萸 半夏（制。各等分）
上药切碎，麻黄加一半量，吴茱萸减一半量，共同研为末。每次服用一钱，水一盏，生姜三片，大枣一枚，煎至七分，热服。服药后用衣被覆盖以取汗，务必等到汗干后再去掉衣被。如果是阴毒，不可用麻黄，以免再次出汗。
退阴散 治阴毒伤寒，手足逆冷，脉沉细，头痛腰重，连服三次，小小伤冷，每服一字，入正元散同煎，入盐一捻。阴毒伤寒咳逆，煎一服，细细热呷，病止。
退阴散 治疗阴毒伤寒，手脚逆冷，脉象沉细，头痛腰部沉重，连续服用三次。轻微受寒，每次服用一字，加入正元散同煎，加入一撮盐。阴毒伤寒引起的咳嗽气逆，煎煮一服，慢慢热饮，病症停止。
川乌 干姜（等分）
上药为粗末，炒至变色，放冷后再捣为细末。每次服用一钱，水一盏，一撮盐，煎至半盏，去渣温服。
五胜散 治伤寒头痛，壮热，骨节疼痛，昏沉困倦，咳嗽鼻塞，不思饮食。兼治伤寒夹冷气，并慢阴毒，神效。
五胜散 治疗伤寒头痛，高热，骨骼关节疼痛，昏沉困倦，咳嗽鼻塞，不想饮食。兼治伤寒夹杂冷气，以及慢性阴毒，效果神奇。
白术（一两半） 甘草 五味子 石膏（各一两） 干姜（三两半）
上药切碎，每次服用五钱，水一盏，加入少许盐，同煎服。如果夹杂冷气，加入姜、枣煎煮；或者治疗阴毒病，加入少许艾叶，煎服。
〔海〕白术散 治阴毒伤寒，心闷烦躁，四肢厥冷。
川乌（炮，去皮脐） 桔梗 附子（炮） 白术 细辛（各一两） 干姜（炮，半两）
上药切碎，或者研为末，用白开水调下一钱匕。
〔罗〕正阳丹 治阴毒伤寒，手足厥冷，指甲青色，体冷，脉沉细而微，神效。
用憨葱四五枝，陈蜂房四五个，烧至存性，研为细末，用憨葱捣和制成丸药，如弹子大小，握在手心中，用手帕紧紧系住，一会儿出汗，用绵被覆盖。如果手心很热，不要解开。如果服药，先服升麻汤五钱，连须葱三茎，生姜五片，水两大盏，煎至一盏，去渣温服，覆盖衣被取汗则愈。
〔《本》〕阴毒渐深候 积阴感于下，则微阳消于上，故其候四肢沉重，逆冷，腹痛转甚，或咽喉不利，或心下胀满结硬，燥渴，虚汗不止，或时狂言，爪甲面色青黑，六脉沉细而一息七至以来。有此症者，速宜于气海、关元二穴灸二三百壮，以手足温暖为效。仍服金液丹、来苏丹、玉女散、还阳散、退阴散。
玉女散
川乌（去皮脐，冷水浸七日，薄切晒干，纸袋盛之。有患者，取研末一大钱，入盐一小钱，水一盏，煎至七分服。压下阴毒，所注如猪血相似。未已，再进一服，效。）
还阳散 治阴毒面青，四肢逆冷，心躁腹痛。
用硫黄末，新汲水调下二钱，良久，或寒一起，或热一起，更看紧慢再服，汗出瘥。
〔《活》〕返阴丹 治阴毒伤寒，心神烦躁，头疼，四肢逆冷。
硫黄（五两） 附子（炮，去皮脐） 干姜（炮） 桂心（各半两） 硝石（另研） 太阴玄精石（另研。各二两）
上用生铁铫，先铺玄精末一半，次铺硝石末一半，中间下硫黄末，又着硝石一半，盖硫黄，却以玄精石末盖上，用小盏合著，用三斤炭火烧令得所，勿令烟出，细研似面，后三味捣罗为末，与前药同研令匀，软饭和丸，如桐子大，每服十五丸至二十丸，煎艾汤下，频服，汗出为度，病重则三十丸。此方甚验，喘促与吐逆者，入口便住，又服此药三五服不退者，更于脐下一寸灸之，须是昼夜大段不住手灸，不限多少壮数灸之，艾炷勿令小，小则不得力。若其人手足冷，少腹硬，即于脐下两边各开一寸，各安一道，三处齐下火灸之，仍与当归四逆汤，并返阴丹，亦须频服。内外通透，方得解。若迟误即死矣。又若阴症，加以少腹不通，及阴囊缩入，少腹绞痛欲死者，更于脐下二寸石门穴急灸之，仍须与返阴丹、当归四逆汤加吴茱萸、生姜，慎勿与寻常利小便冷滑药。
火焰散 治伤寒恶候。
舶上硫黄 黑附子（去皮，生用） 新腊茶（为细末，各一两）
上为细末，先用好酒一升，调药摊入新碗中，于火上荡干，合在瓦上，每一碗下烧熟艾一拳大，以瓦起，无令着火，直至姻尽候冷，即括取研入瓷盒内盛，每服二钱，酒一盏，共煎七分，有火焰起，勿讶。伤寒阴毒者，四肢冷，脉沉细，或吐泻，五心烦躁，胸中结硬，或转早，伏阴在内，汤水不得下，或无脉，先吃一服，如吐，却更进一服。服后心中热，其病已瘥。下至脏腑中，表未解者，浑身壮热，脉气洪大，便宜用发表药。或表解者，更不发热，便得眠睡，浑身有汗，若少有痞结，脉实，方可用下膈行脏腑药，渐用调和元气，补治脾胃汤散。服此药三服不应者，不可治也。
〔《本》〕阴毒沉困之候，与前后渐染之候皆同，而更加沉重，六脉附骨，取之方有，按之即无，一息八至以上，或不可数。至此则药饵难为功矣，但于脐下灼火艾如枣大，三百壮以来，手足不和暖者，不可治也。倘复和暖，以前硫黄及热药助之。若阴气散，阳气来，则渐减热药而和治之，以取瘥也。
〔《活》〕治阴虚阳脱，体冷无脉，气息欲绝，不省人事，及伤寒阴厥，百方不效者。用葱以索缠如臂大，切去根及叶，惟存白长二寸许，如大饼样，先以火协一面，令通热，勿令着火，乃以热面熨病患脐上连脐下，又以熨斗满贮火熨之，令葱饼中热气郁入肌肉中，须更作三四饼，一饼坏不可熨，又易一饼，良久病患当苏，手足温，有汗即瘥，更服四逆汤以温其内。
〔海〕治阴症诸药不效，并汤水不下，身冷脉绝，气息短，不知人。用葱白熨法，莫若用酽醋拌麸皮炒熟，注布袋中，蒸熨，比上法尤速。
代灸涂脐膏
附子 马蔺子 蛇床子 吴茱萸 肉桂（各等分）
上为细末，可用白面一匙，药末一匙，生姜自然汁煨成膏，摊纸上，圆三寸许，贴脐下关元、气海，自晚至晓，其火力可代灸百壮。腰痛亦可贴之。一法，用丁香、荜茇、干姜、牡蛎烧灰，放手心中，以唾津调如泥，以手掩其阴，至暖汗出为度。
阴毒伤寒，四肢逆冷者，用吴茱萸不拘多少，为细末，温酒和匀，生绢袋盛之，热熨脚心，令通畅愈。若以汤煎温药渫洗，以接四肢亦可。
《本》治阴中伏阳，破阴丹。
硫黄 水银（各一两） 陈皮 青皮（各半两）
上将硫黄先入铫子内熔开，次下水银，用铁杖子打匀，令无星，倾入黑茶盏内，细研，入二味，用面糊丸，如桐子大，每服三十丸。如烦躁，冷盐汤下。阴症，艾汤下。良效。
有人初得病，四肢逆冷，脐下筑痛，身疼如被杖，盖阴症也，急服金液、破阴、来复等丹，其脉遂沉而滑。沉者阴也，滑者阳也，病虽阴症而见阳脉，有可生之理，仲景所谓阴病见阳脉者生。仍灸气海、丹田百壮，手足温温，阳回得汗而解。或问滑沉之状，如何便有生理？予曰∶仲景云∶翕奄沉，名曰滑，何谓也？沉为纯阴，翕为正阳，阴阳和合，故名曰滑。古人论脉滑，虽曰往来前却，流利旋转，替替然与数相似，仲景三语而足也。此三字极难晓。翕，合也，言张而复合也，故曰翕为正阳；沉，言忽降而下也，故曰沉为正阴，方翕而合，俄降而沉；奄，为忽忽间。仲景论滑脉可谓谛当矣。其言皆有法，故读者难晓，宜细思之。
Background Information:
Book Title: Medical Outline (Yixue Gangmu)
Author: Lou Ying
Dynasty: Ming
Chapter: Yin Qi Toxicity Surges and Transforms into Yin Toxicity / Continued Methods for Yin Toxicity
Category: Medical Treatise
Yin toxicity as a disease presents with a cyanotic complexion, body pain resembling being beaten by a stick, and sore throat. It is treatable within five days, but untreatable after seven days. The primary treatment is Shengma Biejia Tang (Cinnamon Twig and Turtle Shell Decoction) without Xionghuang (Realgar) and Shujiao (Sichuan Pepper). (The formula for Shengma Biejia Tang is found in the "Yang Toxicity" section.)
[From *Huoluan Lun*] Yindu Gancao Tang (Yin Toxicity Licorice Decoction) treats Shanghan (Cold Damage) and seasonal epidemics. If yin toxicity forms one or two days after onset of illness, or transforms into yin toxicity six to ten days after taking medication, symptoms include heavy body and stiff back, colicky abdominal pain, difficulty in the throat, toxic vapors attacking the heart, hardness below the heart, shortness of breath, vomiting and reflux, cyanotic lips and black face, cold extremities, pulse deep, fine, and rapid, body pain like being beaten, and sore throat. It is treatable within five to six days, but untreatable after seven days.
Ingredients: Zhi Gancao (Roasted Glycyrrhizae Radix et Rhizoma), Shengma (Cimicifugae Rhizoma), Danggui (Angelicae Sinensis Radix) [each 5 qian]; Xionghuang (Realgar) [2.5 qian]; Guizhi (Cinnamomi Ramulus, peeled) [5 qian]; Shujiao (Zanthoxyli Pericarpium, stir-fried, remove sweat, closed-mouth ones, and seeds, keep 2/10); Biejia (Testudinis Carapax et Plastrum, fried with butter) [1.5 liang].
Process the herbs into coarse pieces, decoct in water, and take orally. After walking approximately five li (about 2.5 km), administer another dose. Cover with blankets to induce sweating; toxins exit with sweat, and recovery follows upon sweating. If no sweat occurs, administer again.
[From *Bencao*] Yin toxicity originates from deficiency-cold of Kidney Qi. It may result from sexual activity or consuming cold foods followed by wind-cold invasion. Internally latent yin-cold coexists with externally contracted cold, or external cold precedes internal latent yin, resulting in both interior and exterior being yin-cold. Consequently, Yang Qi fails to maintain its position, leading to headache, heavy waist, abdominal pain, eye pain, bodily fatigue without significant fever, cold extremities, continuous cold sweat on the forehead and dorsum of hands, frequent irritability and thirst, mental confusion as if losing something, or ability to walk but not feeling particularly heavy. Pulse diagnosis reveals all six pulses are deep, fine, and rapid; the Chi (cun-chi) pulse is short; the Cun (inch) pulse may be imperceptible. If all six pulses are floating and large, or deep-palpated as large but not rapid, it is not a yin syndrome. If excessive cooling medicines are taken, thirst and irritability worsen. Patients with these symptoms should urgently take Huanyang Tuiyin (Restore Yang and Retreat Yin) medicines to stabilize condition; the principle is merely tonifying deficiency and harmonizing Qi. Suitable formulas include Zhengyuan San, Tuiyin San, and Wusheng San. Yin syndromes are generally unsuitable for diaphoresis (sweating therapy); however, if Qi is robust and pulse is strong, with unresolved fever, using medicine to induce sweating is permissible.
Zhengyuan San treats Shanghan where wind-cold feels like it has blown onto the patient, causing pain in limbs, head, eyes, and joints. Take this medicine urgently. Administer again after walking five li, continuing for three doses; sweating leads to immediate recovery. For yin toxicity Shanghan, add 5 fen of Tuiyin San to decoct together. It is also effective for cold-dietary injury causing dizziness, qi distension, and various heart-abdominal diseases.
Ingredients: Mahuang (Ephedrae Herba, nodes removed), Chenpi (Citri Reticulatae Pericarpium), Dasheng (Rhei Radix et Rhizoma, raw), Gancao (Glycyrrhizae Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma), Rougui (Cinnamomi Cortex), Shaoyao (Paeoniae Radix Alba), Fuzi (Aconiti Lateralis Radix Praeparata), Wuzhuyu (Evodiae Fructus), Banxia (Pinelliae Rhizoma Praeparatum) [equal parts].
Process into coarse pieces. Increase Mahuang by half, decrease Wuzhuyu by half. Grind into powder. Take 1 qian per dose with 1 sheng water, 3 slices of fresh ginger, and 1 jujube. Decoct to 7/10 volume, take warm. Cover with blankets to induce sweating; ensure sweat dries before removing coverings. For yin toxicity, do not use Mahuang to avoid excessive sweating.
Tuiyin San treats yin toxicity Shanghan with cold extremities, deep fine pulse, headache, and heavy waist. Take consecutively three times. For minor cold exposure, take 1 zi per dose, decocted with Zhengyuan San and a pinch of salt. For cough and airway reversal due to yin toxicity Shanghan, decoct one dose, sip slowly while hot, and symptoms cease.
Ingredients: Chuanwu (Aconiti Radix), Ganjiang (Zingiberis Rhizoma) [equal parts].
Grind into coarse powder, stir-fry until color changes, cool, then grind into fine powder. Take 1 qian per dose with 1 sheng water and a pinch of salt. Decoct to half volume, strain, and take warm.
Wusheng San treats Shanghan headache, high fever, joint pain, drowsiness and fatigue, cough, nasal congestion, and loss of appetite. It also treats Shanghan complicated by cold qi and chronic yin toxicity with miraculous efficacy.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma) [1.5 liang], Gancao (Glycyrrhizae Radix et Rhizoma), Wuweizi (Schisandrae Chinensis Fructus), Shigao (Gypsum Fibrosum) [each 1 liang]; Ganjiang (Zingiberis Rhizoma) [3.5 liang].
Process into coarse pieces. Take 5 qian per dose with 1 sheng water and a little salt. Decoct together. If complicated by cold qi, add ginger and jujube. For treating yin toxicity, add a small amount of Aiyi (Artemisiae Argyi Folium) and decoct.
[From *Hai*] Baizhu San treats yin toxicity Shanghan with chest oppression, irritability, and cold extremities.
Ingredients: Chuanwu (Aconiti Radix, processed, peel and navel removed), Jiegeng (Platycodonis Radix), Fuzi (Aconiti Lateralis Radix Praeparata), Baizhu (Atractylodis Macrocephalae Rhizoma), Xixin (Asari Radix et Rhizoma) [each 1 liang]; Ganjiang (Zingiberis Rhizoma, processed) [0.5 liang].
Process into coarse pieces or powder. Mix with warm water and take 1 qian bi (approx. 1-2 grams).
[From *Luo*] Zhengyang Dan treats yin toxicity Shanghan with cold extremities, cyanotic nails, cold body, and deep fine faint pulse, with miraculous efficacy.
Use 4-5 stalks of Hancong (Allium fistulosum var. gigantum), 4-5 old honeycombs. Burn until carbonized (preserve nature), grind into fine powder. Mix with Hancong juice to form pills the size of a bullet. Hold firmly in palm, tie tightly with handkerchief. Sweat will appear shortly; cover with cotton quilt. If palm becomes very hot, do not untie. If taking medicine, first take 5 qian of Shengma Tang, 3 stalks of scallion with roots, 5 slices of ginger, 2 large shengs of water. Decoct to 1 sheng, strain, take warm, cover to induce sweat for cure.
[From *Ben*] Signs of Deepening Yin Toxicity: Accumulated yin at the lower part causes slight yang to dissipate at the upper part. Signs include heavy limbs, cold extremities, worsening abdominal pain, throat obstruction, fullness and hardness below the heart, dry thirst, continuous spontaneous sweat, occasional delirium, cyanotic-black nails and complexion, and six pulses deep and fine with 7+ beats per respiration. For such signs, moxibustion on Qihai (CV6) and Guanyuan (CV4) acupoints should be performed urgently (200-300 moxa cones), with warmth of limbs as the effect indicator. Continue administering Jin Ye Dan, Laishu Dan, Yunü San, Huanyang San, and Tuiyin San.
Yunü San
Chuanwu (Aconiti Radix, peel and navel removed, soak in cold water for 7 days, slice thinly, dry, store in paper bag. For patients, take 1 large qian of powder, add 1 small qian of salt, 1 sheng water. Decoct to 7/10 volume and take. This suppresses yin toxicity; expelled material resembles pig blood. If ineffective, administer another dose.)
Huanyang San treats yin toxicity with cyanotic face, cold extremities, cardiac irritability, and abdominal pain.
Take Sulfur powder, mix with freshly drawn water, take 2 qian. After some time, chills or heat may arise. Observe urgency and administer again. Recovery follows sweating.
[From *Huoluan Lun*] Fanyin Dan treats yin toxicity Shanghan with mental irritability, headache, and cold extremities.
Ingredients: Liuhuang (Sulfur) [5 liang]; Fuzi (Aconiti Lateralis Radix Praeparata, peel and navel removed), Ganjiang (Zingiberis Rhizoma), Guixin (Cinnamomi Ramulus) [each 0.5 liang]; Xiaoshi (Natrii Nitras, separately ground); Taiyin Xuanjingshi (Gypsum Rubrum, separately ground) [each 2 liang].
Use a raw iron pot. Spread half of Xuanjing powder at bottom, then half of Xiaoshi powder. Place Sulfur powder in middle. Add remaining half of Xiaoshi powder to cover sulfur, then cover with remaining Xuanjing powder. Seal with a small cup. Fire with 3 jin of charcoal until properly heated, ensuring no smoke escapes. Grind finely into flour-like consistency. Grind the latter three ingredients into powder, mix uniformly with previous powder. Form pills with soft rice, size of paulownia seeds. Take 15-20 pills per dose, administered with mugwort decoction. Frequent administration until sweating occurs; for severe cases, 30 pills. This formula is highly effective. For panting and vomiting, it stops immediately upon entry. If 3-5 doses fail to resolve symptoms, perform moxibustion 1 cun below the umbilicus. Moxibustion must be continuous day and night, regardless of cone count. Do not use small moxa cones as they lack potency. If extremities are cold and lower abdomen hard, place moxa paths 1 cun left and right of umbilicus, plus one below, firing all three simultaneously. Also administer Danggui Sini Tang (Angelica Sinensis Decoction for Cold Extremities) and Fanyin Dan frequently. Only when interior and exterior are penetrated can resolution occur. Delay leads to death. Furthermore, for yin syndrome with lower abdomen obstruction, retracted testicles, and severe colicky abdominal pain, urgently moxa Shimen (CV5) point 2 cun below umbilicus. Administer Fanyin Dan and Danggui Sini Tang with added Wuzhuyu and ginger. Avoid ordinary diuretic cold-slippery medicines.
Huoyan San treats malignant signs of Shanghan.
Ingredients: Bo Shang Liuhuang (Imported Sulfur), Hei Fuzi (Black Prepared Aconite Root, peel, raw use), Xin La Cha (New Wax Tea) [fine powder, each 1 liang].
Grind into fine powder. Mix with 1 sheng good wine, spread into a new bowl. Dry over fire, place on tile. Burn a fist-sized piece of prepared mugwort under each bowl. Lift tile, prevent ignition. Wait until ash cools, scrape into porcelain box. Take 2 qian per dose with 1 sheng wine. Decoct together to 7/10 volume. Flames may rise; do not be alarmed. For Shanghan yin toxicity with cold limbs, deep fine pulse, vomiting/diarrhea, five-heart irritability, chest hardness, early transformation, latent yin inside preventing intake, or pulselessness, take one dose first. If vomiting occurs, take another. Heat in heart after ingestion indicates recovery. If pathogen descends to zang-fu and exterior remains unresolved, whole-body high fever and surging pulse indicate need for exterior-releasing medicine. If exterior resolved, no fever, sleep ensues, sweating occurs. If slight stagnation and solid pulse remain, use purgative/herb-moving medicines for zang-fu, gradually transitioning to harmonizing Yuan Qi and tonifying spleen-stomach decoctions/powders. If three doses fail, the case is untreatable.
[From *Ben*] Signs of Severe Yin Toxicity: Similar to progressive signs but heavier. Six pulses adhere to bone, perceptible only with deep pressure, vanishing upon light touch. 8+ beats per respiration, or uncountable. At this stage, herbal medicine is difficult to effect. Perform moxibustion with date-sized moxa cones below umbilicus (300+ cones). If limbs do not warm, it is untreatable. If warmth returns, assist with sulfur and hot medicines. As yin dissipates and yang returns, gradually reduce hot medicines and harmonize treatment to achieve recovery.
[From *Huoluan Lun*] Treatment for Yin Deficiency and Yang Collapse: Cold body, pulseless, breathing nearly ceased, unconsciousness, and Shanghan yin-jue unresponsive to hundred methods. Use green onion tied like an arm. Cut off roots and leaves, keeping white part ~2 cun long, forming a pancake shape. Heat one side with fire until thoroughly hot (do not ignite). Apply hot side to patient's umbilicus and surrounding area. Use a hot iron to press, forcing heat into muscles. Make 3-4 pancakes; replace when one cools. Patient will revive, limbs warm, sweating indicates recovery. Subsequently administer Sini Tang (Frigid Extremities Decoction) to warm the interior.
[From *Hai*] For yin syndrome unresponsive to all medicines, inability to swallow liquids, cold body, absent pulse, short breath, unconsciousness. For scallion moxibustion method, better to use thick vinegar mixed with bran, stir-fry until cooked, pour into cloth bag, steam and press. This is faster than the above method.
Daijiu Tuqi Gao (Moxibustion-Replacing Navel Paste)
Ingredients: Fuzi (Aconiti Lateralis Radix Praeparata), Malizi (Iris pseudacorus Seed), Shechuangzi (Cnidii Fructus), Wuzhuyu (Evodiae Fructus), Rougui (Cinnamomi Cortex) [equal parts].
Grind into fine powder. Mix 1 spoon white flour, 1 spoon herb powder, and fresh ginger juice to form paste. Spread on paper, circle ~3 cun diameter. Apply to Guanyuan (CV4) and Qihai (CV6) below umbilicus from evening to morning. Its heat power equals 100 moxa cones. Also applicable for lower back pain. Another method: Use Dingxiang (Caryophylli Flos), Bibo (Piperis Kadsurae Fructus), Ganjiang (Zingiberis Rhizoma), Muli (Ostreae Concha) burned to ash. Place in palm, mix with saliva to mud-like consistency. Cover genitalia with hand until warm sweat appears.
For yin toxicity Shanghan with cold extremities, use sufficient Wuzhuyu, grind to powder, mix with warm wine, place in raw silk bag, hot press soles until circulation restores. Alternatively, wash limbs with warm decoction to reconnect limbs.
[Ben] Treating Hidden Yang within Yin: Poyin Dan (Break Yin Pill).
Ingredients: Liuhuang (Sulfur), Shuiyin (Hydrargyrum) [each 1 liang]; Chenpi (Citri Reticulatae Pericarpium), Qingpi (Citri Reticulatae Pericarpium Viride) [each 0.5 liang].
Melt sulfur in pot first, add mercury, beat evenly with iron rod until no stars remain. Pour into black tea cup, grind finely. Add the two citrus peels, form pills with wheat paste, size of paulownia seeds. Take 30 pills per dose. For irritability, take with cold salt water. For yin syndrome, take with mugwort decoction. Excellent efficacy.
A patient initially presented with cold extremities, pounding pain below umbilicus, body pain like being beaten—indicating yin syndrome. Urgently administered Jin Ye Dan, Poyin Dan, Laifu Dan, etc. Pulse became deep and slippery. Deep indicates yin, slippery indicates yang. Although yin syndrome, presence of yang pulse suggests potential for survival, as Zhang Zhongjing stated: "Yin disease presenting with yang pulse indicates life." Moxa Qihai and Dantian 100 cones. When limbs warm and yang returns with sweating, resolution occurs. Question: How does slippery/deep pulse indicate survival? Answer: Zhang Zhongjing said: "Xi yan chen, ming yue hua" (Closing and suddenly sinking is named slippery). What does this mean? Deep is pure yin, Xi (closing/gathering) is correct yang. Yin and yang harmonize, hence named slippery. Ancients described slippery pulse as flowing forward and backward, smooth rotation, similar to rapid pulse. Zhang Zhongjing's three words suffice. These three characters are hard to understand. Xi means closing/gathering, indicating opening then closing, thus Xi is correct yang. Chen means suddenly descending, thus Chen is correct yin. Just as Xi closes, it suddenly sinks. Yan means suddenly/instantly. Zhang Zhongjing's discussion of slippery pulse is precise. His words have method, hence readers find them hard to understand; careful reflection is advised.