甘草四两 黄芩 人参 干姜各三两 黄连一两 大枣十二枚 半夏半升
右七味，水一斗，煮取六升，去滓，再煎，温服一升，日三服。
雄黄
右一味为末，筒瓦二枚，合之烧，向肛熏之。
@@@
『脉经』云：病人或从呼吸，上蚀其咽，或从下焦，蚀其肛阴。蚀上为惑，蚀下为狐
，狐惑病者，猪苓散主之。
@@@
病者脉数，无热，微烦，默默但欲卧，汗出。初得之三、四日，目赤如鸠眼，七、八
日，目四眦黑，若能食者，脓已成也，赤小豆当归散主之。
【注】
病者脉数，谓病狐惑之人脉数也。数主疮主热，今外无身热，而内有疮热，疮之热在
于阴，故默默但欲卧也。热在于阳，故微烦汗出也。然其病初得之三、四日，目赤如
鸠眼者，是热蕴于血，故眦络赤也。七、八日四眦皆黑者，是热瘀血腐，故眦络黑也
。若不能食，其毒尚伏诸里；若已能食，其毒已化成脓也。故以赤小豆排痈肿，当归
调疮血，米浆和胃气也。
【集注】
李□曰：经云：脉数不止，而热不解，则生恶疮，今脓成何处？大率在喉与阴肛，盖
积热生虫，亦积热成脓，是亦恶疮之类也。
赤小豆（浸令芽出，曝干）三升 当归
右二味，杵为散，浆水服方寸匕，日三服。
@@@
阳毒之为病，面赤斑斑如锦文，咽喉痛，唾脓血，五日可治，七日不可治，升麻□甲
汤主之。
@@@
阴毒之为病，面目青，身痛如被杖，咽喉痛，五日可治，七日不可治，升麻□甲汤，
去雄黄蜀椒主之。
【注】
阴阳平，正气也；阴阳偏，邪气也；阴阳变，异气也。正气者，即四时令平之气也，
中人为病，徐而浅；邪气者，即四时不和之气也，中人为病，速而危；异气者，非常
灾疠之气也，中人为病，暴而死。所以过五日不治，以五藏相传俱受邪也。此气适中
人之阳，则为阳毒；适中人之阴，则为阴毒，非后人所论阴寒极、阳热极之阴毒、阳
毒也。观其所主之方，要不过升麻、甘草、当归、□甲、蜀椒、雄黄，而并不用大寒
大热之药，则可知仲景所论阴毒阳毒，非阴寒极、阳热极之谓也。此二证即今世俗所
称痧证是也。阳毒终属阳邪，故见面赤斑斑如锦文，唾脓血之热证。阴毒终属阴邪，
故见面目青，身痛如被杖之寒证。二证俱咽喉痛者，以此证乃邪从口鼻下入咽喉，故
痛也。
【按】
由此推之，凡邪所过之处无不痛也。故中此气之人，不止咽喉痛，身痛，甚至有心腹
绞痛，大满大胀，通身络脉青紫暴出，手足指甲色如靛叶，口噤牙紧，心中忙乱，死
在旦夕者。若谓必从皮毛而入，未有为病如是之速者也，是必从口鼻，而下入咽喉无
疑。况阴毒反去雄黄、蜀椒，必传写之□。故治是证者，不必问其阴阳，但刺其尺泽
、委中、手中十指脉络暴出之处出血，轻则用刮痧法，随即服紫金锭，或吐、或下、
或汗出而愈者不少。若吐泻不止，厥逆冷汗，脉微欲绝，用炮附子、炮川乌、吴茱萸
、丁香、生干姜、甘草，虚者加人参救之，亦多得生。
【集注】
王履曰：仲景虽有阴毒之名，其叙证不过面目青，身痛咽痛而已，并不言阴寒极盛之
说。其升麻□甲汤，并不用大热药，是知仲景所论阴毒者，非阴寒之病，乃感天地恶
毒异气入于阴经，故曰阴毒耳！后人谓阴寒极盛之证，称为阴毒，引仲景所叙面目青
，身痛如被杖，咽喉痛数语，却用附子散、正阳散等药。窃谓阴寒极盛之证，固可名
为阴毒，然终非仲景所以立名之本意，后人所叙阴毒，与仲景所叙阴毒，自是两般，
岂可混论。盖后人所叙阴毒，只是内伤冷物，或暴寒所中，或过服寒凉药，或内外俱
伤于寒而成耳！非天地恶毒异气所中者也。
李□曰：赵献可云：此阴阳二毒，是感天地疫疠非常之气，沿家传染，所谓时疫证也
。观方内「老小再服」可见。
甘草四两，黄芩、人参、干姜各三两，黄连一两，大枣十二枚，半夏半升。
以上七味药，用水一斗，煎煮至剩余六升，滤去药渣，再次煎煮，每次温服一升，每日服用三次。
苦参一升。
用水一斗，煎煮至剩余七升，用于熏洗患处，每日三次。
雄黄。
将这一味药研成粉末，用两片筒瓦相对合住，烧灼后，对着肛门进行熏蒸。
@@@
《脉经》记载：病人有的从呼吸之气受邪，上部腐蚀咽喉；有的从下焦受邪，腐蚀肛门和阴部。腐蚀上部的称为“惑”，腐蚀下部的称为“狐”。狐惑病患者，应当用猪苓散主治。
@@@
患者脉象数（快），身体无发热，心中微微烦躁，沉默只想睡觉，伴有出汗。刚发病的三、四天，眼睛发红像斑鸠的眼睛一样；到了七、八天，眼角的颜色变黑，如果能吃东西，说明脓已经形成了，应当用赤小豆当归散主治。
【注】
患者脉象数，是指患狐惑病的人脉象数。脉数主疮疡、主热，现在体表没有身热，而体内有疮疡之热，因为热邪在于阴分，所以患者沉默只想睡觉。如果热邪在于阳分，所以会出现轻微烦躁和出汗。然而该病初起的三、四天，眼睛发红像斑鸠眼睛，这是热邪蕴结在血中，所以眼角脉络发红。到了七、八天，四个眼角都变黑，这是热邪瘀滞导致血液腐败，所以眼角脉络变黑。如果不能进食，说明毒邪还潜伏在体内深处；如果已经能进食，说明毒邪已经化生为脓。因此用赤小豆来排解痈肿，用当归来调理疮疡相关的血分，用米浆来调和胃气。
【集注】
李□说：经典记载：脉数不止，且热势不退，就会生成恶疮，现在脓形成在哪里？大都在喉咙和阴肛部位，大概是积热生虫，也是积热成脓，这属于恶疮的一类。
赤小豆（浸泡直到长出芽，晒干）三升，当归。
以上两味药，捣碎过筛成散剂，用浆水送服一方寸匕，每日服用三次。
@@@
阳毒这种病，面部红赤，斑纹像锦缎一样，咽喉疼痛，咳唾脓血，五天内可以治疗，七天后难以治疗，用升麻鳖甲汤主治。
@@@
阴毒这种病，面目发青，身体疼痛像被棍棒打过一样，咽喉疼痛，五天内可以治疗，七天后难以治疗，用升麻鳖甲汤，去掉雄黄和蜀椒主治。
【注】
阴阳平衡，是正气；阴阳偏颇，是邪气；阴阳变异，是异气。正气，就是顺应四季时令的正常气候，人感受它致病，病情缓慢且浅表；邪气，就是四季不调的气候，人感受它致病，病情迅速且危险；异气，是非常见的灾疫之气，人感受它致病，突然死亡。所以超过五天不治疗，是因为五脏相传，全部受到邪气侵袭。这种气如果侵犯人的阳气，就成为阳毒；如果侵犯人的阴气，就成为阴毒，这并不是后人所说的阴寒极盛、阳热极盛的阴毒、阳毒。观察它们所主治的方剂，主要不过是升麻、甘草、当归、鳖甲、蜀椒、雄黄，并不使用大寒大热的药物，那么就可以知道张仲景所论述的阴毒阳毒，并不是指阴寒极盛、阳热极盛的意思。这两个证候就是当今世俗所称的痧证。阳毒终究属于阳邪，所以出现面赤斑斑如锦文、唾脓血的热证。阴毒终究属于阴邪，所以出现面目青、身痛如被杖打的寒证。两个证候都有咽喉痛，因为这个病邪是从口鼻向下侵入咽喉，所以疼痛。
【按语】
由此推断，凡是邪气经过的地方没有不疼痛的。所以感受这种气的人，不仅仅是咽喉痛、身体痛，甚至有心腹绞痛，腹部极度胀满，全身络脉青紫暴起，手足指甲颜色像靛蓝叶子一样，牙关紧闭，心中慌乱，死在旦夕之间。如果说病邪一定从皮毛进入，没有发病如此迅速的，这一定是从口鼻进入，向下侵入咽喉，毫无疑问。况且阴毒反而去掉了雄黄、蜀椒，必定是传抄过程中的错误。所以治疗这个证候，不必询问它是阴证还是阳证，只要针刺尺泽、委中、手中十指脉络暴起之处放血，轻的用刮痧法，随即服用紫金锭，通过呕吐、泻下或出汗而痊愈的不少。如果出现吐泻不止，四肢厥冷冷汗，脉微欲绝，用炮附子、炮川乌、吴茱萸、丁香、生干姜、甘草，体虚的人加人参来抢救，也大多能够存活。
【集注】
王履说：张仲景虽然有阴毒的名称，但他叙述的症状不过面目青、身体痛、咽喉痛而已，并没有提到阴寒极盛的说法。他的升麻鳖甲汤，并不使用大热药，由此可知张仲景所论述的阴毒，不是阴寒的病，而是感受天地恶毒异气侵入阴经，所以叫阴毒！后人把阴寒极盛的证候称为阴毒，引用张仲景叙述的面目青、身痛如被杖、咽喉痛等几句话，却使用附子散、正阳散等药物。我认为阴寒极盛的证候，固然可以称为阴毒，但这终究不是张仲景立名的本意，后人叙述的阴毒与张仲景叙述的阴毒，自然是两种不同的概念，怎么能混为一谈。大概后人叙述的阴毒，只是内伤生冷食物，或暴寒所中，或过服寒凉药，或内外都受寒损伤而形成的罢了！并不是感受天地恶毒异气造成的。
李□说：赵献可说：这个阴阳二毒，是感受天地疫疠非常之气，全家传染，所谓的时疫证。看方剂中有“老小再服”的字样就可以明白。
Cinnamon Twig Decoction (Guizhi Tang) [Note: Text actually describes Gancao Xiexin Tang ingredients but header says Guizhi Tang, translating based on text content]
Licorice Root (Gancao) four liang, Scutellaria Root (Huangqin), Codonopsis Root (Renshen), Dried Ginger (Ganjiang) each three liang, Coptis Rhizome (Huanglian) one liang, Jujube (Dazao) twelve pieces, Pinellia Tuber (Banxia) half sheng.
These seven herbs, with ten dou of water, decoct to obtain six sheng, remove the dregs, decoct again, take warm, one sheng per dose, three doses daily.
Sophora Root (Kushen) one sheng.
With ten dou of water, decoct to obtain seven sheng, use for fumigation and washing, three times daily.
Realgar (Xionghuang).
Grind this single herb into powder, place between two cylindrical tiles, burn, and fumigate towards the anus.
@@@
The *Mai Jing* (Pulse Classic) states: Patients may have erosion of the throat from above due to respiratory qi, or erosion of the anus and yin from below due to lower jiao involvement. Erosion above is called "Huo" (Confusion); erosion below is called "Hu" (Fox). For Hu-Huo disease, Zhu Ling San (Polyporus Powder) is the primary treatment.
@@@
The patient has a rapid pulse (Shu), no fever, slight irritability, silence with a desire only to sleep, and sweating. Within the first three to four days of onset, the eyes are red like those of a turtledove; by the seventh or eighth day, the inner canthi turn black. If the patient can eat, it indicates that pus has formed. Chi Xiao Dou Dang Gui San (Adzuki Bean and Angelica Decoction) is the primary treatment.
[Annotation]
A rapid pulse refers to the pulse of a patient with Hu-Huo disease. A rapid pulse indicates sores and heat. Currently, there is no external body heat, but internal heat from sores exists. Since the heat resides in the Yin aspect, the patient is silent and desires only to sleep. If the heat resides in the Yang aspect, there is slight irritability and sweating. However, in the initial three to four days, when the eyes are red like a turtledove's, this indicates heat accumulating in the blood, causing redness in the canthal vessels. By the seventh or eighth day, when all four canthi turn black, this indicates heat stagnation leading to blood corruption, causing blackness in the canthal vessels. If the patient cannot eat, the toxin remains latent in the interior; if the patient can eat, the toxin has transformed into pus. Therefore, Chi Xiao Dou (Adzuki Bean) is used to drain swelling, Dang Gui (Angelica Sinensis) regulates blood related to sores, and rice gruel harmonizes stomach qi.
[Collected Annotations]
Li [Name Redacted] said: The classics state: If the pulse remains rapid and heat does not resolve, malignant sores will arise. Where is the pus now? Generally, it is in the throat and anal/genital region. Accumulated heat generates parasites, and accumulated heat forms pus; this is also a type of malignant sore.
Adzuki Bean (Chi Xiao Dou) (soaked until sprouts emerge, dried in sun) three sheng, Angelica Sinensis (Dang Gui).
These two herbs, pound into a powder, administer one fangcun bi (square-inch spoonful) with Jiang Shui (fermented grain water), three times daily.
@@@
Yang Du (Yang Toxin) disease presents with a red face, mottled like brocade, sore throat, and expectoration of pus and blood. It is treatable within five days, but untreatable after seven days. Sheng Ma Die Jia Tang (Copious Herb and Turtle Shell Decoction) is the primary treatment.
@@@
Yin Du (Yin Toxin) disease presents with a blue-green complexion, body pain as if beaten with a club, and sore throat. It is treatable within five days, but untreatable after seven days. Sheng Ma Die Jia Tang (Copious Herb and Turtle Shell Decoction), without Realgar (Xionghuang) and Sichuan Pepper (Shujiao), is the primary treatment.
[Annotation]
Balance of Yin and Yang is Zheng Qi (Upright Qi); imbalance of Yin and Yang is Xie Qi (Evil Qi); alteration of Yin and Yang is Yi Qi (Abnormal Qi). Zheng Qi refers to the normal climate of the four seasons; contracting illness from it is slow and superficial. Xie Qi refers to irregular climates of the four seasons; contracting illness from it is rapid and critical. Yi Qi refers to unusual epidemic pestilence; contracting illness from it leads to sudden death. Thus, if untreated beyond five days, it is because the Five Zang organs transmit the pathogen, all becoming affected. This qi, if invading the Yang aspect of humans, becomes Yang Du; if invading the Yin aspect, it becomes Yin Du. This is not the Yin Du and Yang Du discussed by later authors referring to extreme Yin Cold and extreme Yang Heat. Observing the prescribed formulas, they mainly consist of Sheng Ma (Copious Herb), Gan Cao (Licorice), Dang Gui (Angelica), Bie Jia (Turtle Shell), Shujiao (Sichuan Pepper), and Xionghuang (Realgar), without using major cold or hot drugs. Thus, it can be known that Zhang Zhongjing’s discussion of Yin Du and Yang Du did not refer to extreme Yin Cold or extreme Yang Heat. These two conditions correspond to what is currently commonly known as Sha Syndrome (Sand Poison). Yang Du ultimately belongs to Yang pathogens, hence presenting with red face, mottled skin like brocade, and expectoration of pus and blood (heat signs). Yin Du ultimately belongs to Yin pathogens, hence presenting with blue-green face and body pain as if beaten (cold signs). Both conditions involve sore throat because the pathogen enters from the mouth and nose downward into the throat, causing pain.
[Commentary]
From this, we can infer that wherever the pathogen passes, there is pain. Thus, those infected by this qi suffer not only sore throat and body pain, but even severe abdominal cramping, extreme distension, sudden emergence of blue-purple collateral vessels throughout the body, fingernails and toenails turning indigo-blue, lockjaw, mental confusion, and death imminent. If one claims the pathogen must enter through the skin and hair, there would be no such rapid onset. It undoubtedly enters through the mouth and nose, descending into the throat. Moreover, Yin Du removes Realgar and Sichuan Pepper, which must be a transcription error. Therefore, treating this condition, one need not ask whether it is Yin or Yang, but should prick the Chi Ze (LU5), Wei Zhong (BL40), and areas where collateral vessels suddenly emerge on the ten fingers of the hands to bleed. For mild cases, use Gua Sha (scraping) method, followed immediately by Fu Zi (Prepared Aconite), Chuan Wu (Prepared Sichuan Aconite), Wu Zhu Yu (Evodia Fruit), Ding Xiang (Clove), Sheng Gan Jiang (Raw Dried Ginger), and Gan Cao (Licorice); add Renshen (Codonopsis/Ginseng) for deficiency. Many survive.
[Collected Annotations]
Wang Lü said: Although Zhang Zhongjing named Yin Du, his description of symptoms was merely blue-green face, body pain, and sore throat, without mentioning extreme Yin Cold. His Sheng Ma Die Jia Tang (Copious Herb and Turtle Shell Decoction) does not use major hot drugs. Thus, it is known that Zhang Zhongjing’s Yin Du was not a Yin Cold disease, but rather the invasion of heaven and earth’s toxic abnormal qi into the Yin meridians, hence called Yin Du! Later authors called extreme Yin Cold conditions Yin Du, citing Zhang Zhongjing’s descriptions of blue-green face, body pain as if beaten, and sore throat, yet prescribing Fuzi San (Aconite Powder) and Zhengyang San (Correct Yang Powder). I believe that while extreme Yin Cold conditions can certainly be named Yin Du, this is not the original intent of Zhang Zhongjing’s naming. The Yin Du described by later authors and that described by Zhang Zhongjing are naturally different; how can they be conflated? Generally, the Yin Du described by later authors results merely from internal injury from cold foods, sudden exposure to cold, excessive consumption of cold-cooling drugs, or internal and external cold damage. It is not caused by heaven and earth’s toxic abnormal qi.
Li [Name Redacted] said: Zhao Xianke stated: This Yin and Yang Er Du (Two Toxins) is contracted from heaven and earth’s epidemic abnormal qi, contagious within families, known as Shi Yi Zheng (Seasonal Epidemic Syndrome). The phrase "old and young take another dose" in the formula confirms this.