赤石脂（一斤） 干姜（一两） 粳米（一升）
少阴病下利便脓血者，此方主之。
此证自三阳传来者，纯是热证。成无己因其下利而曰协热，因其用干姜而曰里寒。昆谓
不然。盖少阴肾水也，主禁固二便，肾水为火所灼，不能济火，火热克伐大肠金，故下利且
便脓血；此方用赤石脂，以其性寒而涩，寒可以济热，涩可以固脱；用干姜者，假其热以从
治，犹之白通汤加人尿、猪胆，干姜黄连黄芩人参汤用芩、连，彼假其寒，此假其热，均之
假以从治尔。《内经》曰∶寒者热之，热者寒之，微者逆之，甚者从之；逆者正治，从者反
治，从少从多，观其事也。正此之谓。用粳米者，恐石脂性寒损胃，故用粳米以和之。向使
少阴有寒，则干姜一两之寡，岂足以温？而石脂一斤之多，适足以济寒而杀人矣！岂仲景之
方乎？噫！以聊摄之明，犹且昧此，则下聊摄者可知矣。
白头翁 黄柏 黄连 秦皮
伤寒热利下重者，此方主之。
热利者，协热而利；下重者，下利频数而重也。药之为性，寒者能除热，苦者能浓肠。
四件皆苦寒，故治热利而疗下重也。
甘草（炙） 枳实（麸炒） 柴胡（去芦） 芍药（炒）
少阴病，四逆者，此方主之。
此阳邪传至少阴，里有结热，则阳气不能交接于四末，故四逆而不温。用枳实，所以破
结气而除里热；用柴胡，所以升发真阳而回四逆；甘草和其不调之气；芍药收其失位之阴。
是证也，虽曰阳邪在里，甚不可下。盖伤寒以阳为主，四逆有阴进之象，若复用苦寒之药下
之，则阳益亏矣，是在所忌。论曰∶诸四逆者，不可下之。盖谓此也！
少阴病（少阴经受邪所致的病证）出现下利（腹泻）、大便带脓血的症状，此方主治。
这种病症如果是从三阳经（太阳、阳明、少阳）传变而来的，完全是热证。成无己因为患者下利，就说这是“协热利”（伴随发热的腹泻）；因为他用了干姜，就说这是里寒证。我认为不是这样。少阴属肾水，主管固摄二便。肾水被火热灼伤，不能制约火势，火热克制大肠（金），所以导致下利且大便带脓血；此方使用赤石脂，是因为它性寒而涩，寒性能清热，涩性能固脱止泻；使用干姜，是借用它的热性来顺从病势（反治法），就像白通汤加入人尿、猪胆汁，以及干姜黄连黄芩人参汤中使用黄芩、黄连一样，那些是借用寒性，这个是借用热性，都是利用“假借”之法来顺应病势。《内经》说：寒证用热药治疗，热证用寒药治疗，病情轻的采用逆其病性的正治法，病情重的采用顺其病性的反治法；采取逆治还是从治，要观察具体情况。说的正是这种情况。使用粳米，是担心石脂性寒损伤胃气，所以用粳米来调和胃气。假如少阴真有寒证，那么一两重的干姜，哪里足以温阳？反而一斤重的石脂，恰好会加重寒邪从而致人死亡！这难道是张仲景的方子吗？唉！像王叔和（字叔和，号聊摄）那样高明的人，尚且对此迷惑不清，那么不如王叔和的人就可想而知了。
伤寒病出现热性痢疾、里急后重（排便时肛门坠胀感强烈）的症状，此方主治。
热利，是指伴随发热而下利；下重，是指下利频繁且伴有沉重坠胀感。药物的性质，寒性的能清除热邪，苦味的能厚肠止泻。这四味药都是苦寒之品，所以能治疗热利并缓解里急后重。
这是阳邪传变至少阴，体内有郁结的热邪，导致阳气不能通达四肢末端，所以出现四肢厥逆而不温暖。使用枳实，是为了破除结聚之气并清除里热；使用柴胡，是为了升发真阳并逆转四肢厥冷；甘草用来调和不调和的气机；芍药用来收敛失位的阴液。这个病症，虽然说是阳邪在里，但极不可用攻下法。因为伤寒以护阳为主，四肢厥逆有阴寒内盛的趋势，如果再用苦寒的药去攻下，阳气就会更加亏损，这是禁忌。医论说：凡是四肢厥逆的，不可用攻下法。说的就是这种情况！
Red Stone Lip (Chi Shi Zhi, 1 jin) Dried Ginger (Gan Jiang, 1 liang) Rice (Jing Mi, 1 sheng)
For Shaoyin disease (disease of the Shaoyin channel) presenting with diarrhea and pus-blood in the stool, this formula is indicated.
If this condition originates from transmission via the Three Yang channels (Taiyang, Yangming, Shaoyang), it is purely a heat syndrome. Cheng Wuji described it as "heat-collateral diarrhea" due to the diarrhea, and as interior cold syndrome due to the use of dried ginger. I disagree. Shaoyin corresponds to Kidney Water, which governs the consolidation of urine and feces. When Kidney Water is scorched by fire and cannot control the fire, the pathogenic fire attacks the Large Intestine (Metal element), resulting in diarrhea with pus and blood. This formula uses Chi Shi Zhi because its nature is cold and astringent; the cold nature clears heat, and the astringent nature consolidates and stops leakage. Dried Gan Jiang is used to borrow its heat to follow the treatment principle (reverse treatment), similar to adding human urine and pig bile to Baitong Decoction, or using Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian) in Ganjiang Huanglian Huangqin Renshen Decoction. Those borrow coldness, while this borrows heat; both utilize the method of borrowing to follow the disease's nature. The *Neijing* states: "Treat cold with heat, treat heat with cold. For mild cases, use contrary treatment (orthodox treatment); for severe cases, use following treatment (reverse treatment). Whether to use contrary or following treatment depends on the specific situation." This refers precisely to this case. Jing Mi (Rice) is used because we fear that the cold nature of Chi Shi Zhi might damage the Stomach Qi, so Jing Mi is added to harmonize the Stomach. If there were truly interior cold in Shaoyin, how could just one liang of Gan Jiang be sufficient to warm? Instead, one jin of Chi Shi Zhi would only suffice to exacerbate the cold and cause death! Could this be a formula by Zhang Zhongjing? Alas! Even someone as enlightened as Wang Shuhe (courtesy name Shuhe, pseudonym Liaoshe) was confused by this, so it is understandable how those inferior to him would fare.
Pulsatillae Radix (Baitouweng) Phellodendri Cortex (Huangbai) Coptidis Rhizoma (Huanglian) Fraxini Cortex (Qinpi)
For Taiyang disease presenting with heat-dysentery and tenesmus (feeling of incomplete defecation with heavy sensation), this formula is indicated.
"Heat-dysentery" refers to diarrhea accompanied by fever; "tenesmus" refers to frequent defecation with a heavy, dragging sensation. The nature of herbs is such that cold-natured herbs can eliminate heat, and bitter herbs can thicken the intestines. All four ingredients are bitter and cold, thus treating heat-dysentery and relieving tenesmus.
Prepared Licorice Root (Zhi Gancao) Immature Bitter Orange (Zhishi, bran-fried) Bupleurum Root (Chaihu, de-rhizome) Peony Root (Shaoyao, stir-fried)
For Shaoyin disease presenting with cold extremities (Sini), this formula is indicated.
This occurs when Yang pathogenic factors transmit to Shaoyin, causing stagnant heat in the interior, which prevents Yang Qi from reaching the four extremities, resulting in cold extremities that are not warm. Zhishi is used to break up stagnant Qi and clear interior heat; Chaihu is used to raise true Yang and reverse cold extremities; Gancao harmonizes the disordered Qi; Shaoyao gathers the displaced Yin fluids. Although this syndrome involves Yang pathogens in the interior, purgation is strictly contraindicated. In Taiyang disease, protecting Yang is paramount. Cold extremities indicate an advancing Yin pattern; if bitter-cold purgatives are used again, Yang will be further depleted. Therefore, it is taboo. The medical theory states: "In all cases of Sini, do not use purgation." This refers to this very situation!