下后有热，血气虚也，太阳阳明之故也。仲景云∶大发其汗，使阳气微，又下之，使
阴气弱，其人亡血，病当寒后乃发热无休止，阴阳既虚，气血俱弱，故其热不可止息。所
用葶苈、栀子，亦酸苦涌泄之义也。
【吐】阳明下之，仍发热，心下懊 ，饥不能食，头汗出，栀子豉汤。
【利】服桂枝汤，或下之，仍头项强，无汗，翕翕发热，心下满，微痛，小便不
利，桂枝汤去桂加茯苓白术汤。
【壮阴】大下后则伤血，故脉涩，葶苈苦酒汤。
汗后恶寒，但表解未尽，则为轻证，法当再汗之。若阳微于外，寒积于内，厥逆自
利，则用四逆汤。若阳微于外，热伏于内，大便实者，下之。若汗后脉不为汗衰，比前躁
疾者，此名阴阳交，交者死。（此篇可与不得汗及前恶寒兼看。）
【发表】汗后恶寒，表未解者，汗之，麻黄汤。
【两解】汗后热不退，大便宜，微恶寒者，先解表，表解后用大柴胡汤、小承气汤。
【温】汗后阳微恶寒，大便不实者，芍药附子甘草汤。汗后恶寒自利厥逆者，四逆汤。
三法俱用之后而病不愈者，其有虚实之故也。若非余邪未尽，必是阴阳两虚。于斯时
也，当斟酌审之，或可泻则泻，可补则补，庶不杀人也。
【和】五六日已发汗复下之，胸胁满，微结，小便不利，渴而不呕，但头汗出，往来
寒热，心烦，为未解，柴胡桂姜汤。太阳汗吐下解后心下痞硬，噫气不除，旋复代赭石汤。
【解】太阳先发汗不解，而复下之，脉浮者，则知病在外，当须解外，桂枝汤。
【清】吐下后七八日不解、热结在里，表里俱热，时时恶风，大渴，舌上干烦饮水者，
白虎加人参汤。
【温】汗下之后病仍不解，躁烦不得眠，茯苓四逆汤。大汗若大利而厥者，四逆汤。
下后复发汗，昼日烦躁不得眠，夜而安静，不呕不渴，无表证，脉沉微，身无大热，干姜附
子汤。下后复发汗，脉微细而振寒者，此内外俱虚也。吐下之后，食入口即吐，干姜黄连
黄芩人参汤。
【吐】发汗吐下后，虚烦不眠，剧者反复颠倒，心中懊 ，栀子豉汤。发汗若下之，烦
热胸中窒，栀子豉汤。
【下】吐下后不大便，五六日至十余日，日晡发潮热，不恶寒，独误如见鬼，循衣
摸床，脉弦者生，涩者死；但发热谵语，大承气汤。吐下后腹胀者，邪热入胃也，调胃承
气汤。太阳吐下后微烦，小便数，大便硬，小承气汤。
【和经益阳】吐下后心下逆满，气上冲胸，头眩，脉沉紧，发汗则动经，身为振摇，茯
苓桂枝白术甘草汤。
【下法后出现发热】
下法之后出现发热，是因为血气虚弱，涉及太阳经和阳明经的病变。张仲景说：大发其汗，导致阳气微弱；又用下法，导致阴气虚弱。此人亡失血液，病情应当表现为先恶寒后发热，且发热没有休止之时。既然阴阳都已虚弱，气血俱弱，所以这种热势无法停止。所用葶苈子和栀子，也符合酸苦涌泄（通过酸味和苦味药物促使呕吐或泻下以排除病邪）的意义。
【吐法相关】
阳明病经过下法治疗后，仍然发热，心中烦闷懊恼，饥饿却不想吃东西，只有头部出汗，适用栀子豉汤。
【利法（通利/攻下）相关】
服用桂枝汤，或者经过下法治疗后，仍然头项强痛，无汗，像羽毛覆盖般轻微发热，心下胀满，轻微疼痛，小便不利，适用桂枝汤去掉桂枝，加入茯苓和白术的方剂。
【壮阴（滋养阴血）相关】
大剂量使用下法后会损伤血液，所以脉象涩滞，适用葶苈苦酒汤。
汗后恶寒
发汗后出现恶寒，如果只是表证未完全解除，属于轻证，治法应当再次发汗。如果阳气在外微弱，寒气积聚在体内，出现四肢厥冷和自发性腹泻，则使用四逆汤。如果阳气在外微弱，热气潜伏在体内，大便干结的，采用下法治疗。如果发汗后脉象不因发汗而减缓，反而比之前更加躁动疾速，这名叫“阴阳交”，阴阳交者预后不良（主死）。（这一篇可以与前面关于无汗及前文恶寒的内容结合来看。）
【两解（表里双解）】
发汗后热势不退，大便通畅，仅有轻微恶寒的，先解表，表解后再用大柴胡汤或小承气汤。
【温法】
发汗后阳气微弱而恶寒，大便不成形的，适用芍药附子甘草汤。发汗后恶寒、自发性腹泻、四肢厥冷的，适用四逆汤。
三法俱用之后而病不愈者
汗、吐、下三种治疗方法都使用后，病仍未痊愈，这是有虚实不同的原因。如果不是余邪未尽，必定是阴阳两虚。在这个时候，应当仔细斟酌审察，如果可以泻下就泻下，可以补益就补益，这样才不会误死人。
【和法】
发病五六天，已经发过汗又用过下法，胸胁胀满，轻微结聚，小便不利，口渴但不呕吐，只有头部出汗，寒热往来，心烦，说明病邪未解，适用柴胡桂姜汤。太阳病经过汗、吐、下法治疗后，心下痞硬，嗳气不止，适用旋复代赭石汤。
【解表】
太阳病先发汗未解，又用下法，脉象浮的，就知道病邪仍在体表，应当需要解表，适用桂枝汤。
【清法】
吐法和下法后七八天病仍未解，热邪结聚在体内，表里都发热，时常怕风，极度口渴，舌上干燥烦躁想喝水的，适用白虎加人参汤。
【温法】
汗法和下法之后病仍不解，躁动烦乱不能睡觉，适用茯苓四逆汤。大汗出或者严重腹泻导致四肢厥冷的，适用四逆汤。
下法后又复发汗，白天烦躁不能睡觉，夜间安静，不呕吐不口渴，没有表证，脉象沉微，身体没有大热，适用干姜附子汤。下法后又复发汗，脉象微细且畏寒颤抖的，这是内外俱虚的表现。吐法和下法之后，食物入口即吐，适用干姜黄连黄芩人参汤。
【吐法】
发汗、吐、下之后，虚烦不能睡觉，严重的反复颠倒，心中烦闷懊恼，适用栀子豉汤。发汗或者下法后，烦热胸中窒塞，适用栀子豉汤。
【下法】
吐法和下法之后不大便，从五六天到十余天，傍晚时分发作潮热，不怕冷，神志不清如见鬼怪，抓摸衣被床沿，脉象弦的预后良好（生），脉象涩的预后不良（死）；只是发热说胡话的，适用大承气汤。吐法和下法之后腹胀的，是邪热进入胃腑，适用调胃承气汤。太阳病经过吐、下法后轻微心烦，小便频数，大便干硬，适用小承气汤。
【和经益阳】
吐法和下法之后，心下逆满，气向上冲撞胸部，头晕目眩，脉象沉紧，如果此时发汗则会扰动经络，导致身体震颤摇晃，适用茯苓桂枝白术甘草汤。
[After Purging: Heat]
Heat appearing after purgation is due to the deficiency of blood and qi, involving the Taiyang (Greater Yang) and Yangming (Yang Brightness) channels. Zhang Zhongjing stated: Profuse sweating causes yang qi to become weak; subsequent purgation causes yin qi to become weak. The person loses blood, and the condition manifests as alternating chills and fever without cessation. Since both yin and yang are deficient, and blood and qi are both weak, this heat cannot stop. The use of Lepidium seed (Tingli) and Gardenia fruit (Zhizi) also conforms to the principle of sour and bitter inducing emesis or purgation.
[Regarding Emesis]
In Yangming disease, after purgation, if fever persists, accompanied by oppression in the epigastrium with restlessness, hunger but inability to eat, and sweating only on the head, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is indicated.
[Regarding Purgation/Diuresis]
After taking Guizhi Tang (Cinnamon Twig Decoction), or after purgation, if there is still stiffness and pain in the head and nape, absence of sweat, slight fever resembling a feather's touch, fullness in the epigastrium, mild pain, and difficulty in urination, Guizhi Tang (Cinnamon Twig Decoction) with Gui (Cinnamon Twig) removed, plus Fu Ling (Poria) and Bai Zhu (Atractylodes Macrocephala Rhizome) added is indicated.
[Strengthening Yin]
Profuse purgation damages blood, resulting in a choppy pulse. Ting Li Ku Jiu Tang (Lepidium Seed and Vinegar Decoction) is indicated.
[Chills After Sweating]
Chills appearing after sweating indicate that the exterior syndrome has not been completely resolved; this is a mild condition, and the method should be to induce sweating again. If yang qi is weak on the exterior and cold accumulates internally, leading to cold extremities and spontaneous diarrhea, Si Ni Tang (Frigid Extremities Decoction) is used. If yang qi is weak on the exterior and heat is concealed internally, with dry stool, purgation is employed. If the pulse does not slow down after sweating but becomes more rapid and restless than before, this is called "Yin-Yang Intersection" (Yin Yang Jiao), which indicates death. (This section should be read together with sections on failure to sweat and previous chills.)
[Releasing the Exterior]
For chills after sweating where the exterior remains unresolved, induce sweating with Ma Huang Tang (Ephedra Decoction).
[Resolving Both Interior and Exterior]
If fever persists after sweating, bowel movements are unobstructed, and there is only slight chills, first resolve the exterior, then use Da Chai Hu Tang (Major Bupleurum Decoction) or Xiao Cheng Qi Tang (Minor Order the Qi Decoction).
[Warming Method]
For weakness of yang and chills after sweating, with loose stools, Shao Yao Fu Zi Gan Cao Tang (Peony, Aconite, and Licorice Decoction) is indicated. For chills, spontaneous diarrhea, and cold extremities after sweating, Si Ni Tang (Frigid Extremities Decoction) is indicated.
[Failure to Cure After All Three Methods]
If the disease persists after using sweating, vomiting, and purging methods, it is due to excess or deficiency. If residual pathogenic factors are not exhausted, it must be a dual deficiency of yin and yang. At this time, careful deliberation is required: purge if appropriate, tonify if appropriate, so as not to cause death.
[Harmonizing Method]
On the fifth or sixth day, after sweating and purging, if there is fullness in the chest and hypochondrium, slight binding, difficulty in urination, thirst without vomiting, sweating only on the head, alternating chills and fever, and irritability, indicating the pathogen is not resolved, Chai Hu Gui Jiang Tang (Bupleurum, Ginger, and Trichosanthes Root Decoction) is indicated. After Taiyang disease is treated with sweating, vomiting, and purging, if there is hardness and oppression in the epigastrium and persistent belching, Xuan Fu Dai Zhe Shi Tang (Inula, Hematite, and Oyster Shell Decoction) is indicated.
[Resolving]
If Taiyang disease was first treated with sweating and failed, then purged, and the pulse is floating, knowing the pathogen is still external, the exterior should be resolved with Guizhi Tang (Cinnamon Twig Decoction).
[Cooling Method]
Seven or eight days after vomiting and purging, if the disease is unresolved, heat is bound internally, causing heat in both interior and exterior, occasional aversion to wind, extreme thirst, dry tongue with irritability and desire to drink water, Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng) is indicated.
[Warming Method]
If the disease remains unresolved after sweating and purging, with restlessness and insomnia, Fu Ling Si Ni Tang (Poria and Frigid Extremities Decoction) is indicated. For profuse sweating or severe diarrhea leading to cold extremities, Si Ni Tang (Frigid Extremities Decoction) is indicated.
After purgation followed by sweating, if there is irritability and insomnia during the day but quietness at night, without vomiting or thirst, no exterior signs, a deep and faint pulse, and no significant body heat, Gan Jiang Fu Zi Tang (Dried Ginger and Aconite Decoction) is indicated. After purgation followed by sweating, if the pulse is faint and fine with trembling from cold, this indicates dual deficiency of interior and exterior. After vomiting and purging, if food is vomited immediately upon entering the mouth, Gan Jiang Huang Lian Huang Qin Ren Shen Tang (Dried Ginger, Coptis, Scutellaria, and Ginseng Decoction) is indicated.
[Emetic Method]
After sweating, vomiting, and purging, if there is empty irritability and insomnia, or severe cases with tossing and turning and inner restlessness, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is indicated. After sweating or purging, if there is irritability, heat, and obstruction in the chest, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is indicated.
[Purgative Method]
After vomiting and purging, if there is constipation for five to six days up to ten-plus days, with tidal fever in the late afternoon, aversion to cold absent, delusions such as seeing ghosts, picking at clothes and bedrails, a wiry pulse indicates survival, while a choppy pulse indicates death. If there is only fever and delirium, Da Cheng Qi Tang (Major Order the Qi Decoction) is indicated. Abdominal distension after vomiting and purging indicates pathogenic heat entering the stomach; Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction) is indicated. After Taiyang disease is treated with vomiting and purging, if there is slight irritability, frequent urination, and hard stool, Xiao Cheng Qi Tang (Minor Order the Qi Decoction) is indicated.
[Harmonizing Channels and Benefiting Yang]
After vomiting and purging, if there is reverse fullness in the epigastrium, qi rushing to the chest, dizziness, and a deep, tight pulse, inducing sweating will disturb the channels, causing body tremors and shaking. Fu Ling Gui Zhu Bai Zhu Gan Cao Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala Rhizome, and Licorice Decoction) is indicated.