伤寒发汗已，身目为黄。所以然者，以表有寒里有湿未解也。夫表寒里湿，郁而发黄
，自非热湿内瘀，郁而成黄者比，故不可下。惟当于表寒里湿中求其治法，宜发其表
寒，利其里湿可也。
【集注】
喻昌曰：伤寒发汗已，热邪解矣，何由反蒸身目为黄？所以然者，寒湿搏聚，适在躯
壳之里，故尔发黄也。里者，在内之通称，非谓寒湿深入在里，盖身目正属躯壳，与
藏府无关也。于寒湿中求之，求其寒湿中之治法也。
程应旄曰：其人素有湿邪在里，表寒虽经发汗，而其为里湿所持者，终在里而无从解
散也。发汗后之寒，与湿郁蒸为热，非实热也，故不可下。仍当于寒湿中，责其或浅
或深而治之可也。
@@@
伤寒瘀热在里，身必发黄，麻黄连轺赤小豆汤主之。
【注】
伤寒表邪未解，适遇其人阳明素有湿邪，热入里而与湿合，湿热蒸瘀，外薄肌表，身
必发黄也。若其人头有汗，小便不利，大便□，则或清、或下、或利小便，自可愈也
。今乃无汗小便利，是里之瘀热未深，表之郁遏犹甚，故用麻黄连轺赤小豆汤，外发
其表，内逐其湿也。
【集注】
喻昌曰：伤寒之邪，得湿而不行，所以热瘀身中而发黄，设泥「里」字，岂有邪在里
而反治其表之理哉！
程应旄曰：凡伤寒瘀热在里者，由湿蒸而来，故身必发黄。此之瘀热未深，祗从表一
边开其郁滞，而散除湿热，麻黄连轺赤小豆汤是其主也。
林澜曰：麻黄连轺一证，虽曰在里，必因邪气在表之时，有失解散，今虽发黄，犹宜
兼汗解以治之也。
汪琥曰：夫寒邪自外而来，若挟内湿瘀于经络之中，则郁而变热，故令其人身目发黄
也。此条乃是太阳经传来者，太阳伤寒，理宜用麻黄汤，只因邪传阳明，热瘀于里，
里非胃府，以阳明经居太阳之里，即『尚论篇』所云躯壳之里是也。惟其里有热，所
以方中用麻黄汤而去桂枝之辛热，更加赤小豆、姜、枣之甘辛，以祛散在表之寒湿，
复加连轺、生梓白皮之苦寒，以清解肌里之瘀热也。
伤寒病经过发汗治疗后，身体和眼睛出现发黄。之所以这样，是因为体表有寒邪、体内有湿邪尚未解除。既然是表寒里湿，郁结而发黄，这就不同于热湿在体内瘀阻、郁积而成黄的情况，所以不能用攻下法。应当在表寒里湿的病机中寻求治法，适宜发散体表的寒邪，通利体内的湿邪即可。
【集注】
喻昌说：伤寒病发汗后，热邪已经解除，为什么反而导致身体和眼睛发黄？之所以这样，是因为寒湿搏结聚集，恰好位于躯壳之内，所以导致发黄。“里”在这里是内部的统称，并非指寒湿深入脏腑内部，因为身体和眼睛正属于躯壳部分，与脏腑无关。应当在寒湿的病机中寻求治疗，即寻找针对寒湿的治疗方法。
程应旄说：此人素来体内就有湿邪，虽然体表的寒邪经过发汗处理，但因为被体内的湿邪所牵制，终究留在体内而无法解散。发汗后残留的寒邪，与湿邪郁结蒸腾化为热，但这并非实热，所以不能用攻下法。仍然应当在寒湿的病机中，根据病位的或浅或深来进行治疗即可。
@@@
伤寒病的瘀热蕴结在体内，身体一定会发黄，用麻黄连轺赤小豆汤主治。
【注】
伤寒的表邪尚未解除，恰逢患者阳明经素来有湿邪，热邪入里与湿邪相合，湿热蒸腾瘀阻，外迫肌表，身体一定会发黄。如果患者头部出汗，小便不利，大便通畅（原文缺字，据理推测为“自调”或类似含义），那么或用清热法、或用攻下法、或用利小便法，自然可以痊愈。现在是无汗且小便通利，说明体内的瘀热并不深重，但体表的郁遏阻滞依然严重，所以使用麻黄连轺赤小豆汤，向外发散表邪，向内驱逐湿邪。
【集注】
喻昌说：伤寒的邪气，遇到湿邪就不能正常运行，所以热邪瘀滞在身体内部而导致发黄，如果拘泥于“里”这个字，哪里有邪气在里却反而治疗其表的道理呢！
程应旄说：凡是伤寒瘀热在里的情况，都是由湿邪蒸腾引起的，所以身体一定会发黄。这里的瘀热并不深重，只需从表这一方面打开郁滞，从而散除湿热，麻黄连轺赤小豆汤就是主治方剂。
林澜说：麻黄连轺赤小豆汤这一证候，虽然说是“在里”，但必定是因为邪气在表的时候，未能及时解散，现在虽然已经发黄，仍然应当兼用发汗解表的方法来治疗。
汪琥说：寒邪从外部侵入，如果挟带内湿瘀阻在经络之中，就会郁结而变热，从而导致身体和眼睛发黄。这一条经文是从太阳经传变而来的，太阳伤寒，按理应该用麻黄汤，只因为邪气传入阳明，热邪瘀滞在里，这里的“里”不是指胃腑，因为阳明经位于太阳经的里面，也就是《尚论篇》所说的“躯壳之里”。正因为里有热，所以方中使用麻黄汤但去掉桂枝的辛热之性，更加上赤小豆、生姜、大枣的甘辛之味，以祛散在表的寒湿，再加上连轺（连翘根）、生梓白皮的苦寒之性，以清解肌理深处的瘀热。
After treating Taiyang disease (Taiyang disorder) with sweating therapy, the body and eyes turn yellow. The reason for this is that cold pathogen remains at the exterior while dampness lingers within, neither having been resolved. Since it is cold at the exterior and dampness within, leading to yellowing through stagnation and constraint, it differs from cases where heat-dampness stasis internally causes yellowing; therefore, purgative methods are contraindicated. One should seek treatment principles within the pattern of exterior cold and interior dampness: it is appropriate to release the exterior cold and promote diuresis to drain the interior dampness.
[Collected Annotations]
Yu Chang stated: After sweating therapy for Taiyang disease, the heat pathogen should be resolved. Why does the body and eyes then turn yellow? This occurs because cold and dampness bind and gather within the "shell" of the body (the superficial layers), causing yellowing. Here, "interior" refers generally to the inside, not implying that cold-dampness has deeply penetrated the Zang-Fu organs. The body and eyes belong to the shell, unrelated to the Zang-Fu. Treatment must be sought within the context of cold-dampness, specifically targeting the therapeutic approach for cold-dampness.
Cheng Yingmao stated: The patient inherently possesses dampness pathogen within. Although the exterior cold was addressed by sweating, it remains constrained by the interior dampness and cannot dissipate. The residual cold after sweating combines with dampness to stagnate and transform into heat, but this is not excess-heat; thus, purgatives are contraindicated. Treatment should still address the cold-dampness, adjusting based on whether the pathology is shallow or deep.
@@@
When stagnant heat in Taiyang disease resides within, the body will inevitably turn yellow; Ma Huang Lian Qiao Chi Xiao Dou Tang (Ephedra, Forsythia Root, and Red Bean Decoction) is the primary formula.
[Annotation]
The exterior pathogen of Taiyang disease has not yet resolved, coinciding with the patient's inherent dampness in the Yangming channel. Heat enters the interior and combines with dampness; the steaming and stagnation of heat-dampness presses outward upon the muscle surface, causing the body to turn yellow. If the patient has sweat on the head, difficulty urinating, and normal bowel movements, one may use clearing heat, purging, or promoting urination methods to achieve recovery. However, in this case, there is no sweat and urination is free, indicating that the interior stagnant heat is not yet deep, but the exterior constraint is severe. Therefore, Ma Huang Lian Qiao Chi Xiao Dou Tang is used to release the exterior and expel dampness from within.
[Collected Annotations]
Yu Chang stated: The Taiyang pathogen, when encountering dampness, cannot circulate freely, causing heat to stagnate in the body and result in yellowing. If one rigidly interprets "interior," how could one treat the exterior when the pathogen is supposedly in the interior?
Cheng Yingmao stated: Cases of stagnant heat in the interior due to Taiyang disease arise from dampness steaming, inevitably causing yellowing. Since this stagnant heat is not deep, one should open the stagnation from the exterior side to disperse the heat-dampness; Ma Huang Lian Qiao Chi Xiao Dou Tang is the principal formula.
Lin Lan stated: Although this syndrome of Ma Huang Lian Qiao is described as "in the interior," it originates from a failure to resolve the pathogen while it was at the exterior. Even though yellowing has occurred, sweating and releasing the exterior should still be combined in treatment.
Wang Hu stated: Cold pathogen enters from outside; if it carries internal dampness to stagnate in the meridians, it transforms into heat through stagnation, causing jaundice of the body and eyes. This clause describes transmission from the Taiyang channel. Taiyang Taiyang disease typically requires Ma Huang Tang (Ephedra Decoction). However, since the pathogen transmitted to Yangming and heat stagnated in the "interior," this "interior" does not refer to the Stomach Fu organ, but rather the interior of the Yangming channel relative to Taiyang, which is what *Shanglun Pian* calls the "interior of the shell." Because there is heat within, the formula uses Ma Huang Tang but removes Gui Zhi (Cinnamon Twig) for its acrid-warm nature, adds Chi Xiao Dou (Adzuki Bean), Sheng Jiang (Fresh Ginger), and Da Zao (Jujube) for their sweet-acrid properties to dispel exterior cold-dampness, and further adds Lian Qiao (Forsythia Fruit/Root) and Sheng Zi Bai Pi (Catalpa Bark) for their bitter-cold properties to clear stagnant heat in the muscle layer.