治太阳, 少阳合病, 自下利者.
若呕者, 加半夏, 生姜. 黄芩 甘草 芍药各三两 大枣 ( 擘 ) 十
二枚,, 右四味, 以水一斗, 煮取三升; 去滓, 温服一升, 日再服,
夜一服. 呕者, 加半夏半升, 生姜三两.
【集注】程应旄曰: 此之合病者, 头痛, 胸满口苦, 咽干, 目眩, 或
往来寒热, 或脉大而弦, 半表之邪, 不待太阳传递而即合. 少阳里气
失守, 所以下痢, 阳热渐盛, 所以上呕. 故用黄芩汤清热益阴, 半里
清而半表自解矣. 柯琴曰: 太阳, 少阳合病, 是热邪已入少阳之里.
胆火下攻于脾, 故自下痢, 上逆于胃, 故兼呕也. 与黄芩汤, 酸苦相
济,调中以存阴也. 热不在半表, 故不用柴胡, 今热已入半里, 故黄
芩主之. 虽非胃实, 亦非胃虚, 故不须人参以补中. 兼呕者, 故仍加
半夏, 生姜, 以降逆也.
治伤寒胸中有热, 胃中有邪气, 腹中痛欲呕吐者.
黄连三两 干姜三两 甘草三两 人参二两 桂枝三两 半夏半升
大枣十二枚,, 右七味, 以水一斗, 煮取六升; 去滓, 温服一升, 日
三服, 夜二服.
【集注】程应旄曰: 热在胸中, 有烦躁郁闷之证可知. 胃中反有邪气
,以寒邪被格在下故也. 此证寒热俱有, 较之大青龙之寒热, 已向近
里一层, 故其证不见之表里际, 而只见之上下际. 腹中痛者, 阴邪在
胃而寒乃独治于下也. 欲呕吐者, 阳邪在胸, 而热乃独治于上也. 此
为上下相格治法, 亦寒热并施, 而辛寒易以苦寒, 辛热加以苦热, 更
以人参, 半夏以补宣中气, 升降阴阳. 自此条而互及泻心诸汤, 皆其
法也. 成无己曰: 湿家下后, 舌上如胎者, 以丹田有热, 胸中有寒 ,
是邪气入里而为下热上寒也. 此伤寒传里而为下寒上热也. 喻昌曰 :
阴阳悖逆, 皆当和解法.
治疗太阳经与少阳经合病，出现自发性腹泻的症状。
如果伴有呕吐症状的，加入半夏、生姜。黄芩、甘草、芍药各三两，大枣（掰开）十二枚。以上四味药，用水一斗，煎煮至三升；滤去药渣，温服一升，白天服用两次，晚上服用一次。若有呕吐症状的，加入半夏半升，生姜三两。
【集注】程应旄说：这种合病的情况，表现为头痛、胸中胀满、口苦、咽干、目眩，或者寒热往来，或者脉象大而弦。这是半表之邪，不待太阳经传变而直接与少阳经相合。少阳里气失守，所以导致下痢；阳热逐渐盛行，所以上逆为呕。因此使用黄芩汤清热益阴，半里清利则半表之邪自然解除。柯琴说：太阳、少阳合病，说明热邪已经深入少阳之里。胆火向下攻伐脾土，所以自发下痢；向上逆犯胃腑，所以兼有呕吐。给予黄芩汤，酸味与苦味相互济助，调和脾胃以保存阴液。热邪不在半表，所以不用柴胡；如今热邪已入半里，所以由黄芩为主药。虽然并非胃实热证，也非胃虚寒证，所以不需要人参来补中益气。兼有呕吐的，所以仍加半夏、生姜，以降逆止呕。
治疗伤寒病，胸中有热邪，胃中有邪气，腹部疼痛且想要呕吐的症状。
黄连三两，干姜三两，甘草三两，人参二两，桂枝三两，半夏半升，大枣十二枚。以上七味药，用水一斗，煎煮至六升；滤去药渣，温服一升，白天服用三次，晚上服用两次。
【集注】程应旄说：热邪在胸中，可以推知有烦躁郁闷的症状。胃中反而有邪气，是因为寒邪被格拒在下部所致。此证寒热俱存，比之大青龙汤证的寒热，已向里深入一层，所以症状不见于表里之间，而只见于上下之间。腹部疼痛，是因为阴邪在胃，寒气独盛于下。想要呕吐，是因为阳邪在胸，热气独盛于上。这是针对上下格拒的治疗方法，也是寒热并用，将辛寒改为苦寒，辛热加上苦热，再用人参、半夏来补益和宣通中气，升降阴阳。从此条可以互参泻心汤诸方，都是此类治法。成无己说：湿病患者误用下法后，舌苔如胎状，是因为丹田有热，胸中有寒，是邪气入里导致下热上寒。此条是伤寒传里导致的下寒上热。喻昌说：阴阳悖逆，都应当采用和解的方法。
Treats the combined disease of Taiyang (Greater Yang) and Shaoyang (Lesser Yang), presenting with spontaneous diarrhea.
If vomiting occurs, add Banxia (Pinelliae Rhizoma) and Shengjiang (Zingiberis Rhizoma Recens). Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), and Shaoyao (Paeoniae Radix Alba) are each used in amounts of three liang; Dazao (Jujubae Fructus), twelve pieces (torn open). The above four herbs are decocted in ten dou of water until three sheng remain; the dregs are removed, and one sheng is taken warm, twice during the day and once at night. If vomiting occurs, add Banxia (Pinelliae Rhizoma) half a sheng and Shengjiang (Zingiberis Rhizoma Recens) three liang.
[Collected Annotations] Cheng Yingmao states: In this type of combined disease, symptoms include headache, chest fullness, bitter taste in the mouth, dry throat, and vertigo, or alternating chills and fever, or a pulse that is large and wiry. This represents pathogenic factors at the half-exterior level, which combine with Shaoyang without waiting for transmission from Taiyang. When the interior qi of Shaoyang loses its stability, dysentery results; as yang-heat gradually increases, vomiting ensues. Therefore, Huangqin Tang (Scutellaria Decoction) is used to clear heat and nourish yin; once the half-interior is cleared, the half-exterior resolves spontaneously. Ke Qin states: Combined disease of Taiyang and Shaoyang indicates that heat pathogens have entered the interior of Shaoyang. Gallbladder fire attacks downward on the spleen, causing spontaneous dysentery; it rebels upward against the stomach, causing concomitant vomiting. Huangqin Tang is administered, where sour and bitter flavors complement each other to harmonize the middle jiao and preserve yin. Since the heat is not at the half-exterior, Chaihu (Bupleuri Radix) is not used; since the heat has entered the half-interior, Huangqin (Scutellariae Radix) serves as the principal herb. Although there is no excess heat in the stomach, nor is there deficiency cold, Renshen (Ginseng Radix) is not required to tonify the middle. For concomitant vomiting, Banxia (Pinelliae Rhizoma) and Shengjiang (Zingiberis Rhizoma Recens) are added to direct rebellious qi downward.
Treats Shanghan (Cold Damage) where there is heat in the chest, pathogenic factors in the stomach, abdominal pain, and a desire to vomit.
Huanglian (Coptidis Rhizoma) three liang, Ganjiang (Zingiberis Rhizoma) three liang, Gancao (Glycyrrhizae Radix et Rhizoma) three liang, Renshen (Ginseng Radix) two liang, Guizhi (Cinnamomi Ramulus) three liang, Banxia (Pinelliae Rhizoma) half a sheng, Dazao (Jujubae Fructus) twelve pieces. The above seven herbs are decocted in ten dou of water until six sheng remain; the dregs are removed, and one sheng is taken warm, three times during the day and twice at night.
[Collected Annotations] Cheng Yingmao states: Heat in the chest implies symptoms of restlessness and depression. The presence of pathogenic factors in the stomach is due to cold pathogens being repelled to the lower part. This condition presents both cold and heat, representing a deeper penetration into the interior compared to the cold-heat pattern of Da Qinglong Tang (Major Green Dragon Decoction); thus, symptoms manifest between the upper and lower parts rather than between exterior and interior. Abdominal pain occurs because yin-cold pathogens reside in the stomach, with cold dominating the lower aspect. The desire to vomit arises because yang-heat pathogens reside in the chest, with heat dominating the upper aspect. This treatment addresses the mutual obstruction between upper and lower, employing simultaneous regulation of cold and heat: replacing acrid-cold with bitter-cold, and adding bitter-warm to acrid-warm. Furthermore, Renshen (Ginseng Radix) and Banxia (Pinelliae Rhizoma) are used to tonify and unblock middle qi, regulating the ascending and descending of yin and yang. From this clause, one can infer the methods of various Xiexin Tang (Drain the Epigastrium Decoctions); all share this principle. Cheng Wuji states: After inappropriate purgation in a patient with dampness, if the tongue coating resembles a membrane, it indicates heat in the dantian (lower abdomen) and cold in the chest, representing pathogenic factors entering the interior resulting in lower heat and upper cold. This clause describes cold damage transmitting to the interior, resulting in lower cold and upper heat. Yu Chang states: Reversal of yin and yang should be treated with harmonizing methods.