治阳明病潮热，手足 然汗出，谵语，汗出多，胃燥，独语如见鬼状，喘冒不能卧，腹
满痛
心
大黄（四两，酒洗） 浓朴（半斤） 枳实（五枚，炙） 芒硝（三钱）
上四味，以水一斗，先煮二物，取五升，纳大黄，煮取二升，去滓，纳芒硝，再上火微
煮三
大黄（四两） 浓朴（二两，炙去皮） 枳实（三枚）
上三味，以水四升，煮取一升二合，去滓，分温三服。初服汤当大便，不尔再服，以利
为度
柯韵伯曰∶诸病皆因于气，秽物之不去，由于气之不顺也。故攻积之剂，必用气分之药，
因
是
其
滓
芒
大
喻嘉言曰∶《金匮》治痉，为病胸满，口噤，卧不着席，脚挛急，必 齿，可与大承气
汤，乃死里求生之法也。《灵枢》谓热而痉者死，腰折，螈 ，齿 也。兹所云卧不着席，
即腰折之变文；脚挛急，即螈 之变文；且 齿加以胸满、口噤，上中下三焦热邪充斥，死
不旋踵矣。在伤寒症，腹满可下，胸满则不可下。然投是汤者，须知所谓胸满，谓其邪尚在
表，故不可下。（存此条，为下能存阴之一证。）此证入里之热，极深极重，匪可比伦。况阳
热至极，阴血立至消亡。即小小下之，尚不足以胜其阳，救其阴。故取此汤以承领其一线之
阴气，阴气不尽为阳热所劫，因而得生者多矣。可与二字甚活，临症酌而用之，初非定法也。
既有下之重伤其
治疗阳明病出现定时发热（潮热），手足持续出汗，胡言乱语，汗出过多导致胃中干燥，独自说话如同看见鬼怪一样，气喘且头昏目眩无法平卧，腹部胀满疼痛。
大黄（四两，用酒清洗） 厚朴（半斤） 枳实（五枚，炙烤） 芒硝（三钱）
以上四味药，用水一斗，先煮厚朴和枳实两味药，取药液五升，加入大黄，继续煮至取药液二升，滤去药渣，加入芒硝，再次放在火上微煮片刻即成。
大黄（四两） 厚朴（二两，炙烤后去皮） 枳实（三枚）
以上三味药，用水四升，煮至取药液一升二合，滤去药渣，分三次温服。第一次服药后应当大便通畅，如果不通再服用，以大便通畅为度。
柯韵伯说：各种疾病都起因于气机失调，秽浊之物不能排出，是由于气机不顺所致。所以攻逐积滞的方剂，必须使用调理气分的药物，因此……（原文此处有缺漏或排版错误，依文意补全逻辑：因气行则积消）。
喻嘉言说：《金匮要略》治疗痉病，症状表现为胸部胀满，牙关紧闭，仰卧时背部反张不着席面，双脚拘挛急迫，必定伴有咬牙，这种情况下可以使用大承气汤，这是死里求生的方法。《灵枢》说热邪导致的痉病会死亡，表现为腰部反折，肢体抽搐，牙齿咬紧。这里所说的“仰卧时背部反张不着席面”，就是“腰部反折”的另一种表述；“双脚拘挛急迫”，就是“肢体抽搐”的另一种表述；而且加上“咬牙”以及“胸部胀满、牙关紧闭”，说明上、中、下三焦的热邪充斥全身，死亡就在顷刻之间了。在伤寒病症中，腹部胀满可以攻下，但胸部胀满则不可攻下。然而，使用此汤剂的人，需要明白所谓的“胸满”，是指邪气尚在体表，所以不可攻下。（保留这一条，作为证明攻下法能够保存阴液的证据之一。）这个证候是入里的热邪，极深极重，无法与其他情况相比。况且阳热达到极致，阴血立刻就会消亡。即使轻微地攻下，还不足以战胜阳热、挽救阴液。所以选用此汤来承接并保全一线尚存的阴气，如果阴气不被阳热劫夺，因而得以生存的情况就很多了。“可与”二字非常灵活，临症时需斟酌使用，并非固定的法则。既然有攻下之法，就要防止重伤其……（原文此处截断）
Treats Yangming disease presenting with tidal fever (periodic fever), continuous sweating of the hands and feet, delirium, excessive sweating leading to dryness in the stomach, solitary muttering as if seeing ghosts, panting and dizziness preventing lying down, abdominal fullness and pain.
Da Huang (Cassiae Semen, 4 liang, washed with wine) Hou Po (Magnoliae Officinalis Cortex, 8 liang) Zhi Shi (Aurantii Fructus Immaturus, 5 pieces, roasted) Mang Xiao (Natrii Sulfas, 3 qian)
The above four ingredients: use one dou of water, first decoct Hou Po and Zhi Shi, obtain five sheng of liquid, add Da Huang, decoct until two sheng remain, remove the dregs, add Mang Xiao, heat slightly again on fire.
Da Huang (Cassiae Semen, 4 liang) Hou Po (Magnoliae Officinalis Cortex, 2 liang, roasted and peeled) Zhi Shi (Aurantii Fructus Immaturus, 3 pieces)
The above three ingredients: use four sheng of water, decoct until one sheng and two he remain, remove the dregs, divide into three warm doses. After the first dose, bowel movement should occur; if not, administer another dose. The goal is smooth bowel movement.
Ke Yunbo stated: All diseases originate from qi dysfunction; the retention of turbid matter is due to the obstruction of qi flow. Therefore, agents that purge accumulations must utilize herbs that regulate the qi aspect... [text incomplete]
Yu Jiayan stated: In *Jin Gui Yao Lue*, for treating spasm disease characterized by chest fullness, trismus (lockjaw), opisthotonos (back arching so the body does not touch the bed), calf cramps, and teeth grinding, Da Cheng Qi Tang (Major Order the Yellow Decoction) may be used; this is a method of seeking life from death. *Ling Shu* states that spasm caused by heat leads to death, manifesting as opisthotonos, convulsions, and teeth grinding. What is described here as "opisthotonos" is a variation of "waist bending"; "calf cramps" is a variation of "convulsions"; furthermore, combined with teeth grinding, chest fullness, and trismus, it indicates that heat pathogens fill the Upper, Middle, and Lower Jiao (San Jiao), and death will follow immediately. In Shaoyang syndrome, abdominal fullness can be purged, but chest fullness cannot. However, those who administer this decoction must understand that the term "chest fullness" refers to pathogenic factors still remaining in the exterior, thus purging is contraindicated. (This clause is retained as evidence that purging can preserve Yin.) This condition involves interior heat that is extremely deep and severe, incomparable to other cases. Moreover, when Yang heat reaches its extreme, Yin blood faces immediate depletion. Even mild purging may not suffice to overcome Yang heat and rescue Yin. Thus, this decoction is taken to inherit and preserve the last thread of Yin qi. If Yin qi is not robbed by Yang heat, many patients survive. The phrase "may be given" is flexible; clinical judgment is required, and it is not a fixed rule. Since there is a method of purging, care must be taken not to severely injure... [text truncated]