伤寒传里。发热口干。胸满。烦躁。甚则谵语揭衣。皆里实也。攻之无疑。又何
慎焉。不知攻里之法。宜缓不宜速。宜平不宜峻。宜专不宜杂。宜升不宜降。
宜润不宜燥。何以言之。饮食入胃。消之者脾。腐之者中焦易易者。唯一为
所阻。而藉药以化之。则不能朝饮夕效。部分有上中下。用药有深浅次第。
如邪在上中二焦而遽下之。成结胸痞气是也。所谓宜缓不宜速也。人之
所籍以生者胃气耳。既为风寒饮食所伤。而复药以克之。是重伤也。惟用
辛温苦平之剂。令其克化足矣。非比大积大聚。必得蓬术大黄等峻厉以
荡之。庶胃气不大坏。而完复可俟也。所谓宜平不宜峻也。既伤于食。必审
何物受伤。何药能制。如山楂制肉。莱菔制面与豆。陈皮制蛋。杏仁制粉。葛
根制酒。茗制谷气之类。一物一治。用的为君。以他药佐之。庶易见功。不然
泛投取应。岂可得乎。所谓宜专不宜杂也。凡物之理。有升必有降。若降令
太过。则壅塞而不行。胃气喜升。葛根能鼓舞之。胆气欲升。柴胡能条达之。
而后加以内消之药。则升降之道得。而物易以化矣。所谓宜升不宜降也。
大肠主津。小肠主液。肾为胃关。又主五液。其所以能变化传导者赖此耳。
若辛热躁烈之药。有以竭之。则烦躁斑黄谵妄之所由作也。如平胃散中。
浓朴。苦温者也。同以葛根则润。青皮枳实。苦而下降也。缓以甘桔则不峻。
楂肉味酸。能调五味而化油腻。广皮枳壳。能理气而快膈。若妇人多怒。加
香附以调之。故伤寒里药。发表在前。汗液外泄。不可又用苍术木香草果
豆蔻之属。复竭其液也。观其燥结。独用胆汁蜜导。又可知矣。所谓宜润不宜燥也。
枳朴汤
枳壳（麸炒） 浓朴（姜汁炒） 桔梗 柴胡 广皮（各一钱）
山楂 葛根（各一钱五分） 甘草（二分炙）
加砂仁生姜。水煎。如寒未除。加紫苏一钱。伤面。加卜子一钱。邪在下。加
青皮枳实各一钱。去枳壳服四五剂。邪已变化。如未大便。用猪胆或蜜煎导之。
按上表里二法。最为稳当。惟不竭其津液也。岂待清火而后愈乎。盖寒
凉一早。食便不消。其热愈炽。所谓点沸不如抽薪也。
伤寒病邪传入里证。出现发热、口干、胸中胀满、烦躁不安，甚至胡言乱语、掀开衣服等症状，都属于里实证。应当使用攻下法治疗，这没有疑问，又有什么可谨慎犹豫的呢？（然而）不知道攻里的方法，应该缓和而不宜急速，应该平和而不宜峻猛，应该专一而不宜杂乱，应该升提而不宜降泄，应该滋润而不宜燥烈。为什么这样说呢？饮食进入胃中，消化它的是脾，腐熟它的是中焦，这本来是很容易的事。一旦有所阻滞，借助药物来化解，就不能指望早上喝药晚上见效。人体分部有上、中、下三焦之分，用药也有深浅和次第的区别。如果病邪在上焦和中焦就急于使用泻下法，就会形成结胸或痞气等病症。这就是所说的“宜缓不宜速”。人赖以生存的是胃气。既然已经受到风寒和饮食的伤害，再用药物去克伐它，这是双重伤害。只有使用辛温、苦平的药剂，使其能够充分运化即可。不像那些巨大的积聚，必须用蓬术、大黄等峻烈药物来荡涤。这样胃气才不会严重受损，而恢复健康是可以期待的。这就是所说的“宜平不宜峻”。既然伤于饮食，必须审视是什么食物受伤，什么药物能制约它。例如山楂能化解肉食，莱菔子能化解面食和豆类，陈皮能化解蛋类，杏仁能化解粉类，葛根能化解酒毒，茶叶能化解谷气之类。一种食物对应一种治法，确定主药为君药，以其他药物作为佐使，这样才容易见到功效。否则泛泛投药以求应验，怎么可能做到呢？这就是所说的“宜专不宜杂”。大凡事物的道理，有升就有降。如果降泄太过，就会导致壅塞而不运行。胃气喜欢上升，葛根能鼓舞胃气；胆气欲升，柴胡能疏达胆气。然后再加上内消的药物，那么升降的道路就通畅了，食物就容易消化了。这就是所说的“宜升不宜降”。大肠主管津液，小肠主管液，肾是胃的关口，又主管五液。它们之所以能够变化和传导，就是依靠这些。如果使用辛热燥烈的药物，会耗竭津液，从而导致烦躁、发斑、发黄、谵妄等症状的产生。比如平胃散中的厚朴，本是苦温之品，同葛根配合就变得滋润；青皮、枳实，本是苦味且趋向下降的，用甘草、桔梗缓和后就不那么峻猛；山楂肉味酸，能调和五味并化解油腻；广皮、枳壳，能理气并使膈部舒畅。如果妇女多怒，加入香附来调理。所以治疗伤寒里证的药物，发表解表在前，汗液外泄，不可再用苍术、木香、草果、豆蔻这类药物，再次耗竭其津液。观察其燥结的情况，单独使用猪胆汁或蜜煎导法，也就知道了。这就是所说的“宜润不宜燥”。
枳朴汤
枳壳（麸炒） 厚朴（姜汁炒） 桔梗 柴胡 广皮（各一钱）
山楂 葛根（各一钱五分） 甘草（二分炙）
加入砂仁、生姜，水煎服。如果寒邪未除，加紫苏一钱。如果是面食所伤，加莱菔子一钱。邪气在下焦，加青皮、枳实各一钱，去掉枳壳服用四五剂。邪气已经变化，如果还没有大便，用猪胆或蜜煎导法。
按照上述表和里的两种方法，最为稳妥得当，只是不耗竭其津液罢了。哪里需要等到清火之后才能痊愈呢？大概因为过早使用寒凉药，食物和大便就不能消化，体内的热势会更加炽盛。这就是所说的“点沸不如抽薪”（比喻从根本上解决问题）。
When pathogenic cold transmits to the interior (Li), symptoms such as fever, dry mouth, chest fullness, irritability, and even delirium with uncovering of clothes appear; these all indicate Interior Excess (Li Shi). Attack is undoubtedly indicated, so why hesitate? However, one must not be unaware that the method of attacking the interior should be slow rather than rapid, mild rather than severe, focused rather than mixed, ascending rather than descending, and moistening rather than drying. Why is this so? When food enters the stomach, its digestion is managed by the Spleen (Pi), and its decomposition occurs in the Middle Jiao (Zhong Jiao), which is inherently easy. Once obstructed, relying on herbs to resolve it cannot yield results from morning to evening. The body is divided into Upper, Middle, and Lower Jiao, and the use of medicine has degrees of depth and sequence. If pathogens are in the Upper and Middle Jiao but purgatives are used hastily, conditions like Jie Xiong (Chest Binding) or Pi Qi (Stagnant Qi) will form. This illustrates "slow rather than rapid." What sustains human life is Stomach Qi (Wei Qi). Having already been injured by wind-cold and dietary factors, using drugs to attack it further causes double injury. Only by using acrid-warm and bitter-neutral formulas can sufficient transformation be achieved. This differs from large accumulations, which require harsh agents like Euphorbiae Lathyris Radix (Pengzhu) and Rheum Palmatum Radix et Rhizoma (Dahuang) to sweep them away. Thus, Stomach Qi is not severely damaged, and complete recovery can be awaited. This illustrates "mild rather than severe." Since the injury is due to food, one must examine what was ingested and what herb can counteract it. For instance, Crataegi Fructus (Shanzha) resolves meat; Raphani Semen (Laifu) resolves wheat and beans; Citri Reticulatae Pericarpium (Chenpi) resolves eggs; Armeniacae Semen Amarum (Xingren) resolves starches; Puerariae Lobatae Radix (Gegen) resolves alcohol; and Camellia Sinensis Folium (Cha) resolves grain qi. Each substance has a specific treatment; determine the Sovereign (Jun) herb accordingly, assisted by other herbs, to ensure efficacy. Otherwise, indiscriminate prescribing cannot succeed. This illustrates "focused rather than mixed." Generally, for every ascending force, there is a descending one. If descending is excessive, stagnation and obstruction occur. Stomach Qi prefers ascending; Puerariae Lobatae Radix (Gegen) can inspire it. Gallbladder Qi desires ascending; Bupleuri Radix (Chaihu) can smooth it. Then, adding internal resolving herbs allows the pathways of ascending and descending to function, facilitating digestion. This illustrates "ascending rather than descending." The Large Intestine governs Jin Ye (Jin fluids); the Small Intestine governs Ye (Ye fluids); the Kidney (Shen) is the gate of the Stomach and governs the five fluids. Their ability to transform and conduct relies on these. If acrid-hot and drying drugs are used, they deplete fluids, leading to irritability, macules, jaundice, and delirium. For example, in Ping Wei San, Magnoliae Officinalis Cortex (Houpo) is bitter-warm; combined with Gegen, it becomes moistening; Qingpi and Zhi Shi are bitter and descending; when moderated with Glycyrrhizae Radix et Rhizoma (Gancao) and Platycodonis Radix (Jiegeng), they become less harsh; Hawthorn Fruit (Shanzha) is sour, harmonizes the five flavors, and resolves greasiness; Citri Reticulatae Pericarpium (Guangpi) and Aurantii Fructus Immaturus (Zhiqiao) regulate Qi and relieve chest oppression. If women suffer from anger, Cyperi Rhizoma (Xiangfu) is added to regulate. Therefore, in treating Interior Cold Damage, after releasing the exterior and sweating, one must not use Atractylodis Rhizoma (Cangzhu), Costi Radix (Muxiang), Tsaoko Fructus (Caoguo), or Cardamomi Fructus (Doukou) to further deplete fluids. Observing cases of dryness and constipation treated solely with Porcini Bile (Zhichuang) or Honey Suppositories demonstrates this. This illustrates "moistening rather than drying."
Zhi Po Tang (Bitter Orange and Magnolia Decoction)
Aurantii Fructus Immaturus (Zhiqiao, 麸炒 - bran-fried) [1 qian]
Magnoliae Officinalis Cortex (Houpo, 姜汁炒 - ginger-juice fried) [1 qian]
Platycodonis Radix (Jiegeng) [1 qian]
Bupleuri Radix (Chaihu) [1 qian]
Citri Reticulatae Pericarpium (Guangpi, 广皮) [1 qian]
Crataegi Fructus (Shanzha) [1.5 qian]
Puerariae Lobatae Radix (Gegen) [1.5 qian]
Glycyrrhizae Radix et Rhizoma (Gancao, 炙 - honey-fried) [2 fen]
Add Amomi Fructus Rotundus (Sharen) and Zingiberis Rhizoma Recens (Shengjiang). Decoct in water. If cold remains, add Perillae Folium (Zisu) 1 qian. If injured by noodles, add Raphani Semen (Bozi/Laifu) 1 qian. If pathogen is in the lower part, add Qingpi and Zhi Shi 1 qian each; remove Zhiqiao and take for four to five doses. If the pathogen has transformed but constipation persists, use Porcine Bile or Honey Suppository.
According to the above methods for Exterior and Interior, the approach is most stable, provided fluids are not depleted. Why wait for clearing heat to achieve cure? Early use of cold-cooling herbs prevents digestion of food and stool, causing heat to flare up more fiercely. This is akin to "removing the firewood from under the boiling pot" rather than just blowing on the flames.