本是感症。而兼有他病。丹溪先生所谓杂合病也。其治之即当稍变感症成法矣。用载之篇末
。以成一家之言。
如挟饮食。嗳气酸臭饱胀者。初起平胃散二陈汤主之。见风症者。配发散药一二味。如升柴
薄荷叶。太阳症见者。加羌防。恐太燥。去苍术。见热症者。配酒芩连。口干者。合白虎。作呕
者。加浓朴。如经发表多。而壅热通红。气粗。脉牢实。神思昏沉。胸前按之微痛者。视其微甚
。用逍遥散。加熟地四五钱至一二两。或本方合小柴胡。
平胃散
苍术（米泔浸炒） 浓朴（姜汁炒） 陈皮 甘草（各等分）
二陈汤
半夏（制） 茯苓 陈皮 甘草（各等分）
加生姜大枣。
如见鼻塞头痛发热。或中脘痞满。呕逆恶心。或痰饮凝积者。参苏饮主之。
参苏饮
前胡（佐） 葛根（臣） 半夏（制臣） 茯苓（臣） 陈皮（臣） 甘草（佐） 枳壳（
麸皮炒佐）
桔梗（佐） 苏叶（君） 人参（君） 木香（使） 生姜（引） 大枣（引）
人参木香二味。进退用之。见阳明症者。合白虎。
有一种内伤元气不足之病。其人必元气素弱。或作劳辛苦。或因饥馁受亏。或因色欲过度。
外症身热。自汗体倦。手足心热。忽时作寒。口不知味。出言懒怯。脉虚大无力者。补中益气汤
主之。有一种大虚致感。先以归脾饮补之。待虚回后清邪。
补中益气汤
人参 黄 当归 白术 广皮 甘草 升麻
柴胡
加生姜大枣。
此方俱用轻剂。分量极少。总看病之微甚。为药之多寡可也。六要黄 一钱。人参病甚者一
钱。炙草五分或七分。归术各七分。陈皮五分。升柴二味酒炒。各三分。多汗蜜拌炒。
（此方如气血大虚者。参 术归草可加至数钱之多。不可拘泥。）
见头痛项强太阳症者。配羌防。挟饮食者。配朴半。往来寒热者。配黄芩。热甚者。合白虎
。病久虚而邪不
得汗解者。配益母草红花酒芩连。舌胎干燥黄焦。热甚挟虚。而津液不得上行者。本方合白虎。
归脾饮
人参（君） 黄 （臣蜜炙） 茯神（臣） 白术（臣） 甘草（臣） 枣仁（炒研臣） 当归
（君） 远志（佐） 龙眼肉（使） 煨姜（引） 大枣（引）
挟火者。配黑山栀牡丹皮。甚者配酒黄连。名加味归脾饮。
这本来是外感病证，却兼有其他疾病。这就是丹溪先生所说的“杂合病”。治疗时应当稍微变通治疗外感病的常规方法。现将这些内容记载在篇章末尾，以形成一家之言。
如果兼夹饮食停滞，出现嗳气带有酸臭味、胃脘饱胀等症状的，初起时用平胃散合二陈汤为主治方。如果见到风邪袭表的症状，配伍一到两味发散风邪的药物，如升麻、柴胡、薄荷叶等；如果见到太阳经受邪的症状，加羌活、防风。因为担心药性过于燥烈，去掉苍术。如果见到热象症状，配伍酒制的黄芩、黄连。口干者，合用白虎汤。作呕者，加厚朴。如果经过多次发汗解表治疗后，导致壅滞化热，面部通红，呼吸气粗，脉象牢实有力，神志昏沉，胸部按压有轻微疼痛的，根据病情的轻重，使用逍遥散，加入熟地黄四至五钱，甚至一两。或者用本方合用小柴胡汤。
平胃散：苍术（米泔水浸泡后炒制）、厚朴（姜汁炒制）、陈皮、甘草（各等分）。
二陈汤：半夏（制）、茯苓、陈皮、甘草（各等分），加生姜、大枣。
如果见到鼻塞、头痛、发热，或者中脘部痞闷胀满、呕吐逆气、恶心，或者痰饮凝结积聚等症状的，用参苏饮为主治方。
参苏饮：前胡（佐药）、葛根（臣药）、半夏（制，臣药）、茯苓（臣药）、陈皮（臣药）、甘草（佐药）、枳壳（麸皮炒，佐药）、桔梗（佐药）、苏叶（君药）、人参（君药）、木香（使药）、生姜（引经药）、大枣（引经药）。其中人参和木香两味药，根据病情进退灵活使用。如果见到阳明经症状的，合用白虎汤。
有一种因内伤导致元气不足的病证，这类人必定素来元气虚弱，或者是由于劳累辛苦所致，或者是由于饥饿营养不良受损，或者是由于房事过度耗损。外在症状表现为身体发热、自汗、身体疲倦、手足心发热，时而突然感到寒冷，口不知味，说话懒慢怯弱，脉象虚大无力的，用补中益气汤为主治方。还有一种是大虚导致的外感，先以归脾饮进行补益，待虚损恢复后再清除邪气。
补中益气汤：人参、黄芪、当归、白术、广陈皮、甘草、升麻、柴胡，加生姜、大枣。
以上各方均使用轻剂，药量极少，总要根据病情的轻重来决定药物的多少即可。黄芪一钱，人参重症用一钱，炙甘草五分或七分，当归、白术各七分，陈皮五分，升麻、柴胡两味药酒炒，各三分，多汗者蜜拌炒。（此方如果气血大虚者，人参、白术、当归、甘草可以加到数钱之多，不可拘泥固定。）
如果见到头痛项强等太阳经症状的，配伍羌活、防风。兼夹饮食停滞的，配伍厚朴、半夏。寒热往来的，配伍黄芩。热势严重的，合用白虎汤。病程长久体虚而邪气不能通过发汗解除的，配伍益母草、红花、酒芩、黄连。舌苔干燥焦黄的，热势严重兼有虚损，且津液不能上行的，本方合用白虎汤。
归脾饮：人参（君药）、黄芪（臣药，蜜炙）、茯神（臣药）、白术（臣药）、甘草（臣药）、枣仁（炒研，臣药）、当归（君药）、远志（佐药）、龙眼肉（使药）、煨姜（引经药）、大枣（引经药）。
兼夹火邪的，配伍黑山栀、牡丹皮。严重的配伍酒黄连，名为加味归脾饮。
This is originally an exterior syndrome (Wai Gan Zheng, external pathogenic factor syndrome), yet it is complicated by other diseases. This is what Mr. Danxi referred to as "mixed diseases" (Za He Bing). The treatment should slightly modify the standard methods for treating exterior syndromes. These points are recorded at the end of this chapter to establish a unique perspective.
If there is food stagnation accompanied by belching with a sour and foul odor, and abdominal fullness, the initial treatment should be Pingwei San (Pingwei Powder) combined with Erchen Tang (Two-Aged Decoction). If wind-pathogen symptoms are present, combine with one or two diaphoretic herbs, such as Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), and Boheye (Menthae Haplocalycis Folium). If Taiyang syndrome (Taiyang Jing Syndrome, disease pattern involving the Bladder and Small Intestine meridians) is observed, add Qianghuo (Notopterygii Rhizoma et Radix) and Fangfeng (Saposhnikoviae Radix). To avoid excessive dryness, remove Cangzhu (Atractylodis Rhizoma). If heat symptoms are seen, combine with Jiuhuangqin (Scutellariae Radix processed with wine) and Huanglian (Coptidis Rhizoma). For dry mouth, combine with Baihu Tang (White Tiger Decoction). For vomiting, add Houpo (Magnoliae Officinalis Cortex). If excessive diaphoresis has led to heat accumulation with facial redness, coarse breathing, a firm and excess pulse, mental confusion, and slight tenderness upon pressing the chest, assess the severity and use Xiaoyao San (Xiaoyao Powder), adding Shudi (Rehmanniae Radix Preparata) from 4-5 qian up to 1 liang. Alternatively, combine this formula with Xiao Chaihu Tang (Minor Bupleurum Decoction).
Pingwei San: Cangzhu (soaked in rice water and stir-fried), Houpo (stir-fried with ginger juice), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma) (equal parts).
Erchen Tang: Banxia (Prepared Pinelliae Rhizoma), Fuling (Poria), Chenpi, Gancao (equal parts), add Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus).
If nasal congestion, headache, fever, epigastric fullness, retching, nausea, or phlegm-fluid retention are present, Shensu Yin (Ginseng and Perilla Leaf Decoction) is the primary treatment.
Shensu Yin: Qianhu (Peucedani Radix) [Assistant], Gegen (Puerariae Lobatae Radix) [Deputy], Banxia (Prepared) [Deputy], Fuling [Deputy], Chenpi [Deputy], Gancao [Assistant], Zhike (Aurantii Fructus Immaturus stir-fried with bran) [Assistant], Jiegeng (Platycodonis Radix) [Assistant], Suye (Perillae Folium) [Chief], Renshen (Ginseng Radix et Rhizoma) [Chief], Muxiang (Aucklandiae Radix) [Envoy], Shengjiang [Guide], Dazao [Guide]. Renshen and Muxiang should be adjusted according to the progression of the condition. If Yangming syndrome (Yangming Jing Syndrome, disease pattern involving the Stomach and Large Intestine meridians) is observed, combine with Baihu Tang.
There is a type of illness caused by internal injury and insufficient primordial qi. Patients invariably have a constitutionally weak primordial qi, resulting from overexertion, starvation/nutritional deficiency, or excessive sexual activity. External symptoms include body heat, spontaneous sweating, fatigue, heat in the palms and soles, intermittent chills, loss of taste, reluctance to speak, and a deficient, large, and forceless pulse. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is the primary treatment. There is also a case of exterior contraction due to severe deficiency; initially treat with Guipi Yin (Restore the Spleen Decoction) to tonify, and after the deficiency recovers, clear the pathogenic factors.
Bu Zhong Yi Qi Tang: Renshen, Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Guangpi (Citri Reticulatae Pericarpium), Gancao, Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), add Shengjiang and Dazao.
All these formulas use mild agents with very small dosages. Generally, determine the quantity of herbs based on the severity of the illness. Huangqi: 1 qian; Renshen (for severe cases): 1 qian; Zhi Cao (Honey-fried Licorice): 5 or 7 fen; Danggui and Baizhu: each 7 fen; Chenpi: 5 fen; Shengma and Chaihu (wine-fried): each 3 fen; if excessive sweating, honey-fry. (If qi and blood are severely deficient, Renshen, Baizhu, Danggui, and Gancao can be increased to several qian; do not adhere rigidly to fixed dosages.)
For Taiyang syndrome presenting with headache and stiff neck, combine with Qianghuo and Fangfeng. For food stagnation, combine with Houpo and Banxia. For alternating chills and fever, combine with Huangqin (Scutellariae Radix). For severe heat, combine with Baihu Tang. For prolonged illness with deficiency where pathogens cannot be resolved through diaphoresis, combine with Yimucao (Leonuri Herba), Honghua (Carthami Flos), Jiuhuangqin, and Huanglian. For dry, yellow, and scorched tongue coating, indicating severe heat with deficiency and inability of fluids to ascend, combine this formula with Baihu Tang.
Guipi Yin: Renshen [Chief], Huangqi (Honey-fried) [Deputy], Fushen (Poria with Hostwood) [Deputy], Baizhu [Deputy], Gancao [Deputy], Zaoren (Ziziphi Spinosomi Semen stir-fried and ground) [Deputy], Danggui [Chief], Yuanzhi (Polygalae Radix) [Assistant], Longyanrou (Longan Arillus) [Envoy], Weijiang (Ginger roasted until charred) [Guide], Dazao [Guide].
For cases complicated by fire-toxin, combine with Heishanzhi (Gardeniae Fructus carbonized) and Mudanpi (Moutan Cortex). For severe cases, combine with Jiuhuanglian (Coptidis Rhizoma processed with wine), named Jiawei Guipi Yin (Modified Restore the Spleen Decoction).