北方肾脉，其形何似？师曰∶肾者，水也，名曰少阴。其脉沉滑，是肾脉也。肾病自得沉滑而濡者，愈也。
按∶东、南、西方，皆有其文，惟缺北方，仿经文补之。（《医宗金鉴》）
太阳病，当恶寒发热。今自汗出，不恶寒发热，关上脉细数者，以医吐之过也。一二日吐之者，腹中饥，口
不能食；三四日吐之者，不喜糜粥，欲食冷食，朝食暮吐，以医吐之所致，此为小逆。
按∶欲食冷食之下，当有五、六日吐之者六字。若无此一句，则不喜糜粥、欲食冷食，与朝食暮吐之文
不相联属。且以上文一
二日、三四日之文细玩之，则可知必有五、六日吐之一句。由浅及深之义也，当补之。（《医宗金鉴》）
太阳病，下之后，脉促、胸满者，桂枝去芍药汤主之。若微恶寒者，去芍药方中加附子汤主之。
按∶微恶寒之上，当有汗出二字。若无此二字，乃表未解也，无加附子之理，当补之。（《医宗金鉴》）
太阳病不解，热结膀胱，其人如狂，血自下者，愈。其外不解者，尚未可攻，当先解外（宜桂枝汤）；
外解已，但少腹急结者，乃可攻之，宜桃仁承气汤。
宜桂枝汤四字，从《金匮》增入。（《伤寒类方》）
太阳病，六七日，表证仍在，脉微而沉，反不结胸，其人如狂者，以热在下焦，少腹当硬满，小便自利者，
下血乃愈。所以然者，以太阳随经，瘀热在里故也，抵当汤主之。
此亦病发于阳，误下热入之证也。表证仍在下，当有而反下之句。（柯韵伯）
发汗已，脉浮数，烦渴者，五苓散主之。
按∶脉浮数之下，当有小便不利四字。若无此四字，则为阳明内热口燥之烦渴，是白虎汤证也。惟其小便
不利而烦渴，斯为太阳水热瘀结之烦渴。始属五苓散证。若非小便不利而用五苓散，则犯重竭津液之禁矣。况
太阳上编类此证者数条，惟水入即吐一条，乃水不下行，故无小便不利之文。余皆有小便不利四字。今此四字
必是传写之遗，当补之。（《医宗金鉴》）
伤寒，汗出而渴者，五苓散主之；不渴者，茯苓甘草汤主之。
汗出下，当有心下悸三字。不然，汗出而渴，是白虎汤证。汗后不渴而无他证，是病已瘥，可勿药矣。（柯韵伯）
心下痞，按之濡，其脉关上浮者，大黄黄连泻心汤主之。濡当作硬。按之濡下，当有大便，不恶寒，反恶热句，故立此
汤。观泻心汤治痞，是攻补兼施，寒热并驰之剂，此则尽去温补，独任苦寒下泄之品，且用麻沸汤渍绞浓汁，
而生用之，利于急下。如此而不言及热结当攻诸证，谬矣！夫按之濡为气痞，是无形也，则不当下。且结胸证，
其脉浮大者，不可下，则心下痞而关上浮者，反可下乎？小结胸按之痛者，尚不用大黄，何此比陷胸汤更峻？
是必有当急下之证比结胸更甚者，故制此峻攻之剂也。学人用古方治今病，如据此条脉证而用此方，下咽即死
耳。勿以断简残文，尊为圣经，而曲护其说，以遗祸后人也。（柯韵伯）
心下痞，按之濡，其脉关上浮者，大黄黄连泻心汤主之。
按∶按之濡，当是按之不濡。若按之濡，乃虚痞也，补之不暇，岂有用大黄泻之之理乎？当补之。（《医宗金鉴》）
病发热头痛，脉反沉，若不瘥，身体疼痛，当温其里，宜四逆汤。
按∶身体疼痛之下，当有下利清谷四字。若无此四字，则当温其里之文竟无着落矣，未有表病而温里
之理也。阅后《太阴篇》中云∶伤寒医下之，续得下利清谷不止，身疼痛者，急当救里，宜四逆汤，其义益明。
遵《经》补之。（《医宗金鉴》）
伤寒，脉浮缓，身不痛，但重，乍有轻时，无少阴证者，大青龙汤发之。
脉浮缓下，当有发热、恶寒、无汗、烦躁等证。盖脉浮缓，身不痛，见表证同轻。但身重，乍有轻时，见
表证将罢。以无汗烦躁，故合用大青龙。无少阴证，仲景正为不汗出而烦躁之证，因少阴亦有发热恶寒无汗
烦躁之证，与大青龙同，法当温补；若反与麻黄之散，石膏之寒，真阳立亡矣。必细审其所不用，然后不失
其所当用也。（柯韵伯）
伤寒，不大便六七日，头痛有热者，（未可）与承气汤。其小便清者，知不在里，仍在表也，当须发汗，若头
痛者必衄。宜桂枝汤。
未可二字从《金匮》增入，《伤寒论》失此二字。（《伤寒类方》）
伤寒，若吐、若下后，七八日不解，热结在里，表里俱热，时时恶风，大渴，舌上干燥而烦，欲饮水数升者，
白虎加人参汤主之。
按∶伤寒之下，当有若汗二字。盖汗较吐下伤津液为多也。时时恶风，当是时汗恶风，若非汗字，则时时
恶风是表不解，白虎汤在所禁也。《论》中谓发热无汗，表不解者，不可与白虎汤；渴欲饮水，无表证者，
白虎加人参汤主之。细玩经文，自知当补之、改之。（《医宗金鉴》）
阳明病，脉迟，汗出多，微恶寒者，表未解也，可发汗，宜桂枝汤。
按∶汗出多之下，当有发热二字。若无此二字，则脉迟、汗出多、微恶寒，乃表阳虚，属桂枝附子汤证也。
岂有用桂枝汤发汗之理乎？当补之。（《医宗金鉴》）
阳明病，若脉浮发热、渴欲饮水、小便不利者，猪苓汤主之。
按∶此浮字误也。《活人》云∶脉浮者，五苓散，脉沉者，猪苓汤。则知此证脉字下脱一不字也。据
《太阳篇》内五苓散，乃猪苓、泽泻、茯苓三味中加桂、白术也。《阳明篇》内猪苓汤，乃猪苓、泽泻、茯苓
三味中加阿胶、滑石也。桂与白术味甘辛为阳，主外，阿胶、滑石味甘寒为阴，主内。奉议之言，亦可谓不失
仲景之旨矣。第奉议欲区别二药分晓，不觉笔下以沉对浮，遂使后人致疑三阳证中不当言脉沉，更不复致疑经文
之有阙也。（《证治准绳》）
少阴病，始得之，反发热，脉沉者，麻黄附子细辛汤主之。
本条当有无汗、恶寒证。（柯韵伯）
伤寒，厥而心下悸者，（以饮水多），宜先治水，当服茯苓甘
草汤，却治其厥。不尔，水渍入胃，必作利也。
按∶厥而心下悸者之下，当有以饮水多四字。若无此四字，乃阴盛之厥悸，非停水之厥悸矣。何以即知是
水，而曰宜先治水耶？当补之。（《医宗金鉴》）
伤寒，脉迟，六七日，而反与黄芩汤彻其热，脉迟为寒，今与黄芩汤复除其热，腹中应冷，当不能食，今反
能食，此名除中，必死。
按∶伤寒脉迟六七日之下，当有厥而下利四字。若无此四字，则非除中证也。况有此四字，始与下文反
与黄芩汤之义相属，当补之。（《医宗金鉴》）
伤寒，发热，口中勃勃气出，头痛，目黄，衄不可制。贪水者，必呕；恶水者，厥。若下之，咽中生疮。假
令手足温者，必下重，便脓血；头痛目黄者，若下之，则两目闭。贪水者，（下之其）脉必厥，其声嘤，咽喉
塞；若发汗则战栗，阴阳俱虚。恶水者，若下之则里冷不嗜食，大便完谷出；若发汗则口中伤，舌上白苔，烦
躁，脉数实，不大便六七日，后必便血。若发汗则小便自利也。
下之其三字，从《玉函经》增入。（《伤寒缵论》）
北方肾脉，其形态如何？老师回答说：肾属水，名为少阴。其脉象沉而滑，这就是肾脉。肾病若出现沉、滑且濡的脉象，是痊愈的征兆。
按语：东、南、西方（的经文）都有记载，唯独缺少北方的内容，仿照经文补充。（《医宗金鉴》）
太阳病，应当有怕冷发热的症状。现在病人自汗出，不怕冷也不发热，关部脉象细数，这是医生误用吐法造成的过失。发病一二天就误用吐法的，病人感到腹中饥饿，但嘴里不想吃东西；发病三四天就误用吐法的，不喜欢喝稀粥，想吃冷食，早上吃晚上吐，这是医生误用吐法导致的，这属于轻微的逆证。
按语：在“想吃冷食”之下，应当有“五六天误用吐法者”六个字。如果没有这一句，那么“不喜欢喝稀粥、想吃冷食”与“早上吃晚上吐”的文意就不连贯。而且结合上文关于一二天、三四天的论述仔细推敲，就可以知道必定有“五六天误用吐法者”这一句。这是由浅入深的道理，应当补上。（《医宗金鉴》）
太阳病，经过泻下治疗后，脉象急促、胸部胀满的，用桂枝去芍药汤主治。如果伴有轻微怕冷的，在去掉芍药的方子中加入附子汤主治。
按语：在“轻微怕冷”之上，应当有“出汗”二字。如果没有这两个字，说明表证未解，就没有加入附子的道理，应当补上。（《医宗金鉴》）
太阳病未愈，热邪结聚在膀胱，病人神志狂乱如癫狂状，如果瘀血自行排出，病就会好。如果表证仍未解除，还不可以攻下，应当先解表（适宜用桂枝汤）；表证解除后，只有小腹部拘急硬结的，才可以攻下，适宜用桃仁承气汤。
“适宜桂枝汤”这四个字，是从《金匮要略》中增补进去的。（《伤寒类方》）
太阳病，过了六七天，表证仍然存在，脉象微而沉，反而没有形成结胸证，病人神志狂乱如癫狂状，这是因为热邪在下焦，小腹部应当硬满，小便通畅自利的，通过下血才能痊愈。之所以这样，是因为太阳经邪随经入里，瘀热在里的缘故，用抵当汤主治。
这也是病发于阳，误用下法导致热邪内陷的证候。在“表证仍然存在”之下，应当有“反而误用下法”这几个字。（柯韵伯）
按语：在“脉浮数”之下，应当有“小便不利”四个字。如果没有这四个字，那就是阳明经内热引起的口燥烦渴，那是白虎汤的适应证。正因为有小便不利而烦渴，这才是太阳经水热互结引起的烦渴，才属于五苓散的适应证。如果不是因为小便不利而使用五苓散，就犯了再次耗竭津液的禁忌了。况且太阳篇中类似的证候有好几条，只有“水入即吐”那条，是因为水不下行，所以没有“小便不利”的文字。其余都有“小便不利”这四个字。现在这四个字必定是传抄遗漏的，应当补上。（《医宗金鉴》）
伤寒，出汗并且口渴的，用五苓散主治；不口渴的，用茯苓甘草汤主治。
在“出汗”之下，应当有“心下悸动”三个字。不然的话，出汗且口渴，是白虎汤的适应证。出汗后不口渴且没有其他症状，是病已经痊愈，可以不用药了。（柯韵伯）
心下部痞塞胀满，按压时柔软，脉象关部浮的，用大黄黄连泻心汤主治。“柔软”应当作“坚硬”。在“按压时柔软”之下，应当有“大便不通，不怕冷，反而怕热”的句子，所以才设立这个汤剂。看泻心汤治疗痞证，是攻补兼施、寒热并用的药剂，而这个方子却完全去掉温补药，独任苦寒泄下的药物，并且用麻沸汤浸泡绞取浓汁，生用，利于急下。像这样却不提及热结应当攻下的各种证候，是错误的！夫按压柔软为气痞，是无形的，就不应当攻下。而且结胸证，脉象浮大的，不可攻下，那么心下部痞塞而关脉浮的，反而可以攻下吗？小结胸证按压疼痛的，尚且不用大黄，为什么这个方子比陷胸汤更峻猛？必定是有应当急下的证候比结胸更严重，所以制定这种峻猛的攻下剂。学习的人用古方治今病，如果根据这条脉证而使用此方，药咽下去就会致死。不要以残缺不全的简文，尊奉为圣经，从而曲意维护其说法，遗祸后人。（柯韵伯）
心下部痞塞胀满，按压时柔软，脉象关部浮的，用大黄黄连泻心汤主治。
按语：“按压时柔软”，应当是“按压时不柔软”。如果按压柔软，那是虚痞，补益都来不及，哪里有用大黄泻下的道理呢？应当补上。（《医宗金鉴》）
病人发热头痛，脉象反而沉，如果病不好转，身体疼痛，应当温补里虚，适宜用四逆汤。
按语：在“身体疼痛”之下，应当有“下利清谷”四个字。如果没有这四个字，那么“应当温补里虚”的说法就没有着落了，没有表证却温补里虚的道理。阅读后面的《太阴篇》中说：伤寒医生误用下法，接着出现下利清谷不止，身体疼痛的，急需救里，适宜用四逆汤，其中的意义更加明确。遵循经文补上。（《医宗金鉴》）
伤寒，脉象浮缓，身体不痛，只是沉重，偶尔有减轻的时候，没有少阴证的，用大青龙汤发汗。
在“脉浮缓”之下，应当有发热、恶寒、无汗、烦躁等证候。因为脉浮缓、身体不痛，表明表证较轻。但身体沉重，偶尔有减轻，表明表证将要罢除。因为无汗且烦躁，所以合用大青龙汤。没有少阴证，张仲景正是针对不出汗而烦躁的证候，因为少阴也有发热恶寒无汗烦躁的证候，与大青龙汤证相同，治法应当温补；如果反而给予麻黄的发散、石膏的寒凉，真阳立刻就会亡失。必须仔细审察那些不适用的情况，然后才不会失去适用的情况。（柯韵伯）
伤寒，不大便六七天，头痛且有发热的，（不可以）给承气汤。如果小便清亮的，知道病不在里，仍在表，应当需要发汗，如果头痛的必定会流鼻血。适宜用桂枝汤。
“不可以”这两个字是从《金匮要略》增补进去的，《伤寒论》丢失了这两个字。（《伤寒类方》）
伤寒，如果经过吐法或下法后，七八天病未解除，热邪结聚在里，表里都发热，时时怕风，极度口渴，舌上干燥而烦躁，想喝水好几升的，用白虎加人参汤主治。
按语：在“伤寒”之下，应当有“如果出汗”两个字。因为出汗比吐法、下法损伤津液更多。时时怕风，应当是“时时出汗且怕风”，如果不是“出汗”这个字，那么时时怕风就是表证未解，白虎汤就在禁忌之列了。《伤寒论》中说发热无汗、表证未解的，不可给白虎汤；口渴想喝水、没有表证的，用白虎加人参汤主治。仔细玩味经文，自然知道应当补上、改正。（《医宗金鉴》）
阳明病，脉象迟，出汗多，轻微怕冷的，表证未解，可以发汗，适宜用桂枝汤。
按语：在“出汗多”之下，应当有“发热”两个字。如果没有这两个字，那么脉迟、出汗多、轻微怕冷，就是表阳虚，属于桂枝附子汤的适应证。哪里有用桂枝汤发汗的道理呢？应当补上。（《医宗金鉴》）
阳明病，如果脉浮发热、口渴想喝水、小便不利的，用猪苓汤主治。
按语：这个“浮”字是错误的。《活人书》说：脉浮的，用五苓散，脉沉的，用猪苓汤。由此可知这个证候脉字下面脱漏了一个“不”字。据《太阳篇》内的五苓散，是在猪苓、泽泻、茯苓三味药中加入桂枝、白术。《阳明篇》内的猪苓汤，是在猪苓、泽泻、茯苓三味药中加入阿胶、滑石。桂枝和白术味甘辛属阳，主外；阿胶和滑石味甘寒属阴，主内。庞安时的话，也可以说不违背张仲景的宗旨了。只是庞安时想要清楚地区别这两种药，不觉笔下以沉对浮，于是使后人产生怀疑在三阳证中不当说脉沉，更不再怀疑经文是否有缺漏。（《证治准绳》）
少阴病，刚得病时，反而发热，脉象沉的，用麻黄附子细辛汤主治。
伤寒，四肢厥冷且心下悸动的，（因为饮水过多），适宜先治疗水饮，应当服用茯苓甘草汤，然后再治疗四肢厥冷。不这样的话，水气浸渍入胃，必定会导致腹泻。
按语：在“四肢厥冷且心下悸动”之下，应当有“因为饮水过多”这四个字。如果没有这四个字，那就是阴盛导致的厥冷心悸，不是停水导致的厥冷心悸了。怎么就知道是水，而说适宜先治水呢？应当补上。（《医宗金鉴》）
伤寒，脉象迟，六七天，反而给予黄芩汤清除其热，脉迟表示寒，现在给予黄芩汤又清除其热，腹中应当寒冷，应当不能进食，现在反而能进食，这名叫除中，必定死亡。
按语：在“伤寒脉迟六七天”之下，应当有“四肢厥冷而下利”四个字。如果没有这四个字，就不是除中证了。况且有了这四个字，才与下文“反而给予黄芩汤”的意义相联系，应当补上。（《医宗金鉴》）
伤寒，发热，口中热气勃勃冲出，头痛，眼睛发黄，鼻出血无法控制。喜欢水的，必定呕吐；讨厌水的，四肢厥冷。如果误用下法，咽喉会长疮。假如手足温暖的，必定会有肛门重坠感，大便带脓血；头痛眼睛发黄的，如果误用下法，则两眼闭合。喜欢水的，（误用下法后）脉象必定厥冷，声音低微，咽喉堵塞；如果误用发汗法，则战栗，阴阳俱虚。讨厌水的，如果误用下法则里寒不想吃东西，大便完谷不化；如果误用发汗法则口腔受伤，舌上有白苔，烦躁，脉象数实，不大便六七天，后来必定便血。如果误用发汗法则小便自利。
“误用下法后”这三个字，是从《玉函经》中增补进去的。（《伤寒缵论》）
Northern Kidney Pulse, what is its form? The Master said: The Kidney belongs to Water and is named Shaoyin (Lesser Yin). Its pulse is deep and slippery; this is the Kidney pulse. If a Kidney disease presents with a deep, slippery, and soft pulse, it indicates recovery.
Note: There are texts for the East, South, and West, but only the North is missing. This section has been supplemented imitating the classic text. (Yi Zong Jin Jian)
In Taiyang disease, there should be aversion to cold and fever. Now, if there is spontaneous sweating, no aversion to cold, no fever, and the Guan position pulse is fine and rapid, this is an error caused by the physician's misuse of emesis. If emesis was used on the first or second day, the patient feels hungry in the abdomen but does not wish to eat; if emesis was used on the third or fourth day, the patient dislikes congee, desires cold food, eats in the morning and vomits in the evening. This is caused by the physician's misuse of emesis and is considered a minor adverse reaction.
Note: Below "desires cold food," the six characters "if emesis was used on the fifth or sixth day" should be present. Without this sentence, the text "dislikes congee, desires cold food" does not connect logically with "eats in the morning and vomits in the evening." Furthermore, carefully examining the preceding text regarding the first-second and third-fourth days reveals that the phrase "if emesis was used on the fifth or sixth day" must exist. This reflects the principle of progressing from shallow to deep, and it should be supplemented. (Yi Zong Jin Jian)
In Taiyang disease, after purgation, if the pulse is hurried and the chest is full, Gui Zhi Qu Shao Yao Tang (Cinnamon Twig Decoction without Paeonia) should be administered. If there is slight aversion to cold, Fu Zi Tang (Aconite Decoction) added to the formula without Shao Yao should be administered.
Note: Above "slight aversion to cold," the two characters "sweating" should be present. Without these two characters, the exterior syndrome remains unresolved, and there is no rationale for adding Fu Zi. It should be supplemented. (Yi Zong Jin Jian)
If Taiyang disease is unresolved and heat accumulates in the Bladder, the person may appear manic. If blood discharges spontaneously, the disease will heal. If the exterior syndrome is still unresolved, attack cannot yet be employed; one must first resolve the exterior (Gui Zhi Tang is appropriate). Once the exterior is resolved, if there is only urgency and binding in the lower abdomen, then attack can be employed, and Tao Ren Cheng Qi Tang (Peach Kernel Decoction to Order the Qi) is appropriate.
The four characters "Gui Zhi Tang is appropriate" were added from the Jin Gui Yao Lue. (Shang Han Lei Fang)
In Taiyang disease, after six or seven days, if the exterior symptoms remain, the pulse is faint and deep, and contrary to expectation, there is no Jie Xiong (Chest Binding), but the person appears manic, it is because heat is in the Lower Jiao. The lower abdomen should be hard and full, and urination should be normal. Healing occurs through blood discharge. The reason for this is that the Taiyang pathogen follows the meridians into the interior, resulting in stasis-heat in the interior; Di Dang Tang (Siege-Removing Decoction) should be administered.
This is also a syndrome where the disease originated in Yang, and mistaken purgation allowed heat to enter. Below "exterior symptoms remain," the phrase "but mistakenly used purgation" should be present. (Ke Yunbo)
After inducing sweating, if the pulse is floating and rapid, and there is irritability and thirst, Wu Ling San (Five-Ingredient Powder with Poria) should be administered.
Note: Below "pulse floating and rapid," the four characters "difficult urination" should be present. Without these four characters, this would be irritability and thirst due to internal heat in the Yangming channel, which is a Bai Hu Tang (White Tiger Decoction) syndrome. Because there is difficult urination accompanied by irritability and thirst, this is irritability and thirst due to water-heat binding in the Taiyang channel, belonging to the Wu Ling San syndrome. If Wu Ling San were used without difficult urination, it would violate the prohibition against further depleting body fluids. Moreover, in the Taiyang chapter, there are several similar cases; only the case of "water intake immediately followed by vomiting" lacks the text "difficult urination" because the water fails to descend. All others contain the four characters "difficult urination." These four characters here must have been lost during transcription and should be supplemented. (Yi Zong Jin Jian)
In Shanghan (Cold Damage), if there is sweating and thirst, Wu Ling San should be administered; if there is no thirst, Fu Ling Gan Cao Tang (Poria and Licorice Decoction) should be administered.
Below "sweating," the three characters "epigastric palpitations" should be present. Otherwise, sweating with thirst indicates a Bai Hu Tang syndrome. Sweating followed by no thirst and no other symptoms indicates the disease has healed, and medication is unnecessary. (Ke Yunbo)
If there is epigastric stuffiness, which is soft upon pressure, and the Guan position pulse is floating, Da Huang Huang Lian Xie Xin Tang (Rhubarb and Coptis Decoction to Drain the Epigastrium) should be administered. "Soft" should read "hard." Below "soft upon pressure," the sentence "constipation, no aversion to cold, but aversion to heat" should be present, which is why this decoction was established. Observing that Xie Xin Tang treats epigastric stuffiness as a formula combining attack and tonification, and cold and heat, this specific prescription removes all warming and tonifying herbs, relying solely on bitter-cold draining agents, and uses boiling water to soak and squeeze out a concentrated juice, used raw, facilitating urgent draining. To state this without mentioning the syndromes of heat-binding requiring attack is erroneous! Epigastric stuffiness that is soft upon pressure is Qi stuffiness, which is formless, and thus should not be drained. Furthermore, in Jie Xiong syndrome, if the pulse is large and floating, draining is contraindicated; so, how can epigastric stuffiness with a floating Guan pulse be drained? Xiao Jie Xiong (Minor Chest Binding), which is painful upon pressure, does not use Da Huang; why is this formula more severe than Xian Xiong Tang? There must be syndromes requiring urgent draining that are more severe than Jie Xiong, hence this severe draining formula was created. Students using ancient formulas for modern diseases, if they use this formula based on this pulse and symptom presentation, will die upon ingestion. Do not regard fragmented texts as sacred scriptures and distort their meaning to protect them, thereby bringing disaster to future generations. (Ke Yunbo)
If there is epigastric stuffiness, which is soft upon pressure, and the Guan position pulse is floating, Da Huang Huang Lian Xie Xin Tang should be administered.
Note: "Soft upon pressure" should read "not soft upon pressure." If it is soft upon pressure, it is deficiency stuffiness, for which tonification is insufficiently applied; how could there be a rationale for using Da Huang to drain? It should be supplemented. (Yi Zong Jin Jian)
If the patient has fever and headache, but the pulse is contrary, sinking, and if the condition does not improve, with body pain, one should warm the interior, and Si Ni Tang (Decoction to Reverse the Collapse) is appropriate.
Note: Below "body pain," the four characters "diarrhea with undigested food" should be present. Without these four characters, the statement "one should warm the interior" has no basis; there is no rationale for warming the interior when there is only an exterior disease. Reading the subsequent Taiyin chapter states: In Shanghan, if the physician mistakenly uses purgation, leading to continuous diarrhea with undigested food, and body pain, one must urgently rescue the interior, and Si Ni Tang is appropriate. This clarifies the meaning. Follow the classic and supplement. (Yi Zong Jin Jian)
In Shanghan, if the pulse is floating and slow, the body is not painful but heavy, occasionally feeling lighter, and there are no Shaoyin signs, Da Qing Long Tang (Major Green Dragon Decoction) should be used to induce sweating.
Below "pulse floating and slow," signs such as fever, aversion to cold, absence of sweating, and irritability should be present. A floating and slow pulse with no body pain indicates a mild exterior syndrome. However, body heaviness with occasional relief indicates the exterior syndrome is about to cease. Due to the absence of sweating and presence of irritability, Da Qing Long Tang is combined. The absence of Shaoyin signs refers specifically to the syndrome of non-sweating with irritability; since Shaoyin also presents with fever, aversion to cold, absence of sweating, and irritability, similar to Da Qing Long Tang, the treatment should be warming and tonifying. If one instead uses the dispersing nature of Ma Huang and the cooling nature of Shi Gao, true Yang will perish instantly. One must carefully examine what is contraindicated to avoid missing what is indicated. (Ke Yunbo)
In Shanghan, if there is constipation for six or seven days, with headache and fever, (do not give) Cheng Qi Tang. If the urine is clear, one knows the disease is not in the interior but remains in the exterior, and sweating should be induced. If there is headache, nasal bleeding will likely occur. Gui Zhi Tang is appropriate.
The two characters "do not" were added from the Jin Gui Yao Lue; they were lost in the Shang Han Lun. (Shang Han Lei Fang)
In Shanghan, if after emesis or purgation, the disease remains unresolved after seven or eight days, with heat binding in the interior, exterior and interior both hot, occasional aversion to wind, extreme thirst, dry tongue with irritability, and desire to drink several liters of water, Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng) should be administered.
Note: Below "Shanghan," the two characters "if sweating" should be present. Sweating damages body fluids more than emesis or purgation. "Occasional aversion to wind" should be "occasional sweating and aversion to wind." Without the character "sweating," occasional aversion to wind would indicate unresolved exterior syndrome, making Bai Hu Tang contraindicated. The Treatise states: For fever with no sweating and unresolved exterior, Bai Hu Tang is forbidden; for thirst desiring water with no exterior syndrome, Bai Hu Jia Ren Shen Tang is administered. Carefully studying the text reveals what needs to be supplemented and corrected. (Yi Zong Jin Jian)
In Yangming disease, if the pulse is slow, sweating is profuse, and there is slight aversion to cold, the exterior is unresolved, and sweating can be induced; Gui Zhi Tang is appropriate.
Note: Below "profuse sweating," the two characters "fever" should be present. Without these two characters, slow pulse, profuse sweating, and slight aversion to cold indicate deficiency of Exterior Yang, belonging to the Gui Zhi Fu Zi Tang syndrome. How could there be a rationale for using Gui Zhi Tang to induce sweating? It should be supplemented. (Yi Zong Jin Jian)
In Yangming disease, if the pulse is floating with fever, thirst desiring water, and difficult urination, Zhu Ling Tang (Polyporus Decoction) should be administered.
Note: The character "floating" here is erroneous. The Huo Ren Shu states: Floating pulse indicates Wu Ling San; sinking pulse indicates Zhu Ling Tang. Thus, we know a "not" character is missing below the word "pulse" in this syndrome. According to the Taiyang chapter, Wu Ling San consists of Zhu Ling, Ze Xie, and Fu Ling plus Gui Zhi and Bai Zhu. In the Yangming chapter, Zhu Ling Tang consists of Zhu Ling, Ze Xie, and Fu Ling plus E Jiao and Hua Shi. Gui Zhi and Bai Zhu are sweet and acrid, belonging to Yang, acting externally; E Jiao and Hua Shi are sweet and cold, belonging to Yin, acting internally. Pang Anshi's words can be said to not deviate from Zhongjing's intent. However, Pang Anshi wished to clearly distinguish these two prescriptions, inadvertently contrasting sinking with floating in his writing, causing later generations to doubt the mention of a sinking pulse in the Three Yang syndromes, rather than doubting the omission in the classic text. (Zheng Zhi Zhun Sheng)
In Shaoyin disease, at the onset, if there is contrary fever and a sinking pulse, Ma Huang Fu Zi Xi Xin Tang (Ephedra, Aconite, and Asarum Decoction) should be administered.
This clause should include signs of absence of sweating and aversion to cold. (Ke Yunbo)
In Shanghan, if there is cold extremities and epigastric palpitations, (due to excessive water intake), one should first treat the water retention, administering Fu Ling Gan Cao Tang, and subsequently treat the cold extremities. Otherwise, water will infiltrate the stomach,必然 causing diarrhea.
Note: Below "cold extremities and epigastric palpitations," the four characters "due to excessive water intake" should be present. Without these four characters, it would be cold extremities and palpitations due to Yin excess, not due to retained water. How would one know it is water and say "first treat water"? It should be supplemented. (Yi Zong Jin Jian)
In Shanghan, with a slow pulse for six or seven days, if one mistakenly administers Huang Qin Tang (Scutellaria Decoction) to clear the heat, noting that a slow pulse indicates cold, and now clearing the heat with Huang Qin Tang, the abdomen should become cold, and the patient should be unable to eat. If the patient can suddenly eat, this is named Chu Zhong (Elimination of the Middle), indicating certain death.
Note: Below "Shanghan, slow pulse for six or seven days," the four characters "cold extremities and diarrhea" should be present. Without these four characters, it is not a Chu Zhong syndrome. Moreover, with these four characters, it connects logically with the following text "mistakenly administer Huang Qin Tang." It should be supplemented. (Yi Zong Jin Jian)
In Shanghan, with fever, breath rushing out vigorously from the mouth, headache, yellow eyes, and uncontrollable nasal bleeding. Those who crave water will surely vomit; those who abhor water will have cold extremities. If purged, ulcers will form in the throat. If the hands and feet are warm, there will be rectal heaviness and pus-blood in the stool. For headache and yellow eyes, if purged, the eyes will close. For those craving water, (after purging) the pulse will surely become choppy/collapsed, the voice will be hoarse, and the throat blocked; if sweated, there will be shivering, and both Yin and Yang will be deficient. For those abhorring water, if purged, there will be interior cold, loss of appetite, and undigested food in the stool; if sweated, there will be oral injury, white coating on the tongue, irritability, a rapid and solid pulse, constipation for six or seven days, and subsequent bloody stool. If sweated, urination will be spontaneous.
The three characters "(after purging)" were added from the Yu Han Jing. (Shang Han Zuan Lun)