《活人书》论伤寒小儿、大人治法∶一般但小分剂，药性差凉耳。问∶头汗出者，何也？病患表实里虚，元腑不开
则阳气上，出汗者见于头。凡头汗出者，五内干枯，胞中空虚，津液少也。慎不可下，下之者谓之重虚。然头汗出者有
数证∶伤寒五、六日，头汗出，微恶寒，手足冷，心下满，口不欲食，大便硬，脉细者，此为阳微结。必有表，复有里
也，脉沉亦有里也。汗出为阳微，假令纯阴结，不得复有外证，悉入在里，此为半在里半在外也。脉虽沉紧，不得为少
阴病。所以然者，阴不得有汗，今头汗出，故知非少阴也。（小柴胡汤主之。）伤寒五、六日，已汗下，胸胁满，微结，
小便不利，渴而不呕，但头汗出，往来寒热，心烦者，此表未解。（柴胡桂枝干姜汤主之。）病患但头汗出，身无汗，剂
颈而还，小便不利，渴引水浆者，此为瘀热在里，身必发黄，（五苓散、茵陈汤。）阳明病下之，其外有热，手足温，
不结
胸，心中懊 ，饥不能食，但头汗出者，（栀子豉汤主之。）心下紧满，无大热，头汗出者，（茯苓汤主之。仲景云∶伤
寒心下紧满，无大热，但头汗出者，此名为水结在胸胁，以汗头出别水结证，用小半夏加茯苓汤。）
《活人书》仲景小柴胡汤
柴胡（四两） 黄芩（一两半。若腹中痛者，去黄芩加芍药一两半。若心下悸，小便不利者，去黄芩加茯苓二两）
人参（一两半。若不渴，外有微热者，去人参，加桂枝一两半，温覆微汗愈。若咳嗽者，去人参并枣子，加五味子一两
一分、干姜一两） 甘草（一两半） 半夏（一两一分，汤洗。若胸中烦不呕者，去半夏、人参，加栝蒌实半枚，用四
分之一。若渴者去半夏，更加人参三分，苦栝蒌根二两） 枣子（六枚。若胁下痞硬，去枣子加牡蛎二两，熬）
上锉如麻豆大。每服抄五钱匕，生姜四片，枣子一个，水一盏半，煮至八分，去滓温服。日三服。
《活人书》仲景柴胡桂枝干姜汤
柴胡（二两） 桂枝（去皮） 黄芩（各一两半） 栝蒌根（二两） 干姜 甘草（炙） 牡蛎（熬。各一两）
上锉如麻豆大。每服抄五钱匕，水一盏半，煮至八分，去滓温服，食顷再服。
《活人书》仲景五苓散，方见伤寒自汗门中。
《活人书》仲景茵陈蒿汤
茵陈蒿（嫩者，一两半） 大黄（半两，去皮） 栀子（大者，三枚半）
上锉如麻豆大，以水二大白盏，先煮茵陈，减半盏，次内二味，煮八分，去滓温服。日三服。小盒饭利，
尿如皂荚汁状，色正赤。一宿腹减，黄从小便中去也。
《活人书》仲景栀子豉汤
肥栀子（十四枚，掰） 香豉（四合）
上锉如麻豆大。每服五钱，水一盏，煎至八分，去滓温服。得快吐止后服。
《活人书》赤茯苓汤
赤茯苓 陈橘皮（汤浸去白瓤，焙） 人参（去芦头。各一两） 半夏（汤洗七遍，去滑） 芎 白术（炮。各
半两）
上件药捣为粗末。每服四钱，以水一钟半，生姜五片，煎至七分，去滓。不计时候温服。
《活人书》小半夏加茯苓汤
半夏（五两，汤浸洗七遍） 白茯苓（三两，去黑软皮）
上锉如麻豆大。每服半两，水三盏，煎至一盏；秤生姜四钱，取自然汁，投药中更煎一、两沸。热吃，不
拘时候。
《活人书》论述伤寒在小儿和成人中的治法：大体相同，只是剂量较小，药性偏凉罢了。问：为什么会出现头汗出？答：患者表实里虚，元腑（元气之腑，指下焦肾与膀胱等脏腑功能）不开，则阳气上逆，出汗仅见于头部。凡是头汗出的，都是五脏内部干枯，胞宫（此处泛指下焦空窍或膀胱等津液排泄通道）空虚，津液匮乏所致。切不可使用攻下法，若用攻下法，称为“重虚”（使虚者更虚）。然而头汗出有多种证候：伤寒五六日，头汗出，轻微恶寒，手足冷，心下胀满，口不想吃东西，大便硬，脉细的，这是“阳微结”。既有表证，又有里证，脉沉说明有里证。汗出是因为阳气微结，假如是纯阴结，就不会再有外证，症状全部入里，这属于半在里半在表。脉虽然沉紧，但不能诊断为少阴病。之所以这样，是因为阴证通常不会有汗，现在头汗出，所以知道这不是少阴病。（用小柴胡汤主治。）伤寒五六日，已经发汗或攻下后，胸胁胀满，轻微痞结，小便不利，口渴但不呕吐，只有头汗出，怕冷发热交替出现，心烦的，这是表证未解。（用柴胡桂枝干姜汤主治。）患者只有头汗出，身上无汗，汗止于颈部而还，小便不利，口渴想喝水浆的，这是瘀热在里，身体一定会发黄，（用五苓散、茵陈汤治疗。）阳明病经过攻下后，体表仍有热，手足温暖，没有形成结胸，心中烦闷懊恼，饥饿却不能吃食物，只有头汗出的，（用栀子豉汤主治。）心下拘急胀满，没有大热，头汗出的，（用茯苓汤主治。张仲景说：伤寒心下拘急胀满，没有大热，只有头汗出的，这叫水饮结聚在胸胁，通过头汗出来辨别是水结证，用小半夏加茯苓汤。）
《活人书》记载张仲景的小柴胡汤方：
柴胡（四两） 黄芩（一两半。如果腹中痛的，去掉黄芩，加入芍药一两半。如果心下悸动，小便不利的，去掉黄芩，加入茯苓二两）
人参（一两半。如果不渴，体表有微热的，去掉人参，加入桂枝一两半，覆盖衣被微微出汗即愈。如果咳嗽的，去掉人参和枣子，加入五味子一两一分、干姜一两）
甘草（一两半） 半夏（一两一分，开水烫洗。如果胸中烦闷但不呕吐的，去掉半夏、人参，加入栝蒌实半枚，用量取四分之一。如果口渴的，去掉半夏，增加人参三分，苦栝蒌根二两）
枣子（六枚。如果胁下痞硬，去掉枣子，加入牡蛎二两，炒制）
以上药物切碎如麻豆大小。每次服用五钱匕，生姜四片，枣子一个，水一盏半，煮至八分，去渣温服。每日三次。
《活人书》记载张仲景的柴胡桂枝干姜汤方：
柴胡（二两） 桂枝（去皮） 黄芩（各一两半） 栝蒌根（二两） 干姜 甘草（炙） 牡蛎（炒制。各一两）
以上药物切碎如麻豆大小。每次服用五钱匕，水一盏半，煮至八分，去渣温服，饭后不久再服。
《活人书》记载张仲景的茵陈蒿汤方：
茵陈蒿（嫩的，一两半） 大黄（半两，去皮） 栀子（大的，三枚半）
以上药物切碎如麻豆大小，用水二大白盏，先煮茵陈，减半盏，然后放入另外两味药，煮至八分，去渣温服。每日三次。小便利通后，尿色像皂荚汁一样，颜色正红。过一夜腹部减轻，黄色从小便中排出。
《活人书》记载张仲景的栀子豉汤方：
肥栀子（十四枚，掰开） 香豉（四合）
以上药物切碎如麻豆大小。每次服用五钱，水一盏，煎至八分，去渣温服。得到快速吐泻后停止服药。
《活人书》赤茯苓汤方：
赤茯苓 陈橘皮（开水浸泡去掉白色瓤，焙干） 人参（去掉芦头。各一两） 半夏（开水烫洗七遍，去掉滑腻物） 川芎 白术（炮制。各半两）
以上药物捣成粗末。每次服用四钱，用水一钟半，生姜五片，煎至七分，去渣。不限时候温服。
《活人书》小半夏加茯苓汤方：
半夏（五两，开水浸泡洗七遍） 白茯苓（三两，去掉黑色软皮）
以上药物切碎如麻豆大小。每次服用半两，水三盏，煎至一盏；称取生姜四钱，取自然汁，投入药液中再煎一两个沸腾。热服，不限时候。
The *Huoren Shu* (Book of Vitality) discusses the treatment methods for Shanghan (Cold Damage) in both children and adults: generally, they are the same, but with smaller dosages and slightly cooler medicinal properties. Question: Why does sweating occur only on the head? Answer: When the exterior is excess and the interior is deficient, and the Yuan Fu (the lower jiao organs governing primal qi, such as the kidneys and bladder) fails to open, Yang Qi ascends, causing sweat to appear only on the head. In cases of head sweating alone, the five zang organs are dry and depleted internally, the Bao Zhong (lower jiao cavities or fluid-excreting pathways like the bladder) is empty, and body fluids are scarce. One must absolutely avoid purgative methods; using them constitutes "double deficiency" (making the deficient even more deficient). However, head sweating presents several syndromes: If, after five or six days of Shanghan, there is head sweating, slight aversion to cold, cold hands and feet, fullness in the epigastrium, lack of desire to eat, hard stools, and a fine pulse, this is termed "Yang Wei Jie" (slight Yang binding). There is both an exterior syndrome and an interior syndrome; a deep pulse indicates an interior condition. Sweating occurs due to slight Yang binding. If it were pure Yin binding, there would be no exterior symptoms remaining, as all would have entered the interior; this is considered half-exterior and half-interior. Although the pulse may be deep and tight, it cannot be diagnosed as Shaoyin disease. The reason is that Yin syndromes typically do not present with sweating; since there is head sweating here, we know it is not Shaoyin. (Treat with Xiao Chai Hu Tang / Minor Bupleurum Decoction.) If, after five or six days of Shanghan, following sweating or purging therapies, there is fullness in the chest and hypochondrium, slight binding, difficulty in urination, thirst without vomiting, head sweating only, alternating chills and fever, and irritability, this indicates the exterior syndrome has not yet resolved. (Treat with Chai Hu Gui Zhi Gan Jiang Tang / Bupleurum, Cinnamon Twig, and Dried Ginger Decoction.) If a patient has head sweating only, no sweating on the body, sweat stopping at the neck, difficulty in urination, and thirst prompting intake of water or liquids, this is Stagnant Heat in the interior, and jaundice will certainly develop. (Treat with Wu Ling San / Five-Ingredient Powder with Poria and Yin Chen Hao Tang / Artemisiae Scopariae Decoction.) After purgative therapy for Yangming disease, if there is heat on the exterior, warm hands and feet, no formation of Jie Xiong (Chest Binding), mental restlessness and oppression in the heart, hunger but inability to eat, and head sweating only, (Treat with Zhi Zi Chi Tang / Gardenia and Fermented Soybean Decoction.) If there is tight fullness in the epigastrium, no significant heat, and head sweating, (Treat with Fu Ling Tang / Poria Decoction. Zhang Zhongjing stated: In Shanghan, tight fullness in the epigastrium without significant heat and head sweating only is named Water Binding in the Chest and Hypochondrium. Differentiating this from other binding syndromes by the presence of head sweating, treat with Xiao Ban Xia Jia Fu Ling Tang / Minor Pinellia Decoction plus Poria.)
*Huoren Shu* records Zhang Zhongjing's Xiao Chai Hu Tang (Minor Bupleurum Decoction):
Chai Hu (Bupleuri Radix, 4 liang) Huang Qin (Scutellariae Radix, 1.5 liang. If abdominal pain exists, remove Huang Qin and add Shao Yao/Paeoniae Radix Alba, 1.5 liang. If palpitations in the epigastrium and difficulty in urination exist, remove Huang Qin and add Fu Ling/Poria, 2 liang)
Ren Shen (Ginseng Radix et Rhizoma, 1.5 liang. If there is no thirst and slight heat on the exterior, remove Ren Shen and add Gui Zhi/Cinnamomi Ramulus, 1.5 liang, cover with blankets to induce slight sweating for cure. If coughing exists, remove Ren Shen and Zao/Jujubae Fructus, add Wu Wei Zi/Schisandrae Fructus, 1.1 liang, and Gan Jiang/Zingiberis Rhizoma Recens, 1 liang)
Gan Cao (Glycyrrhizae Radix et Rhizoma, 1.5 liang) Ban Xia (Pinelliae Rhizoma, 1.1 liang, washed with boiling water. If vexation in the chest without vomiting exists, remove Ban Xia and Ren Shen, add Gua Lou Shi/Benincasae Fructus, half a fruit, using one-quarter of the amount. If thirst exists, remove Ban Xia, increase Ren Shen by 0.3 liang, and add Gua Lou Gen/Trichosanthis Radix, 2 liang)
Zao (Jujubae Fructus, 6 pieces. If hardness and fullness under the ribs exist, remove Zao and add Mu Li/Ostrea Concha, 2 liang, stir-fried)
Crush the above herbs to the size of hemp seeds. For each dose, scoop 5 qian bi (approx. 15-20g depending on era standard, literally "five money scoops"), add 4 slices of Sheng Jiang/Zingiberis Rhizoma Recens, 1 Zao, and 1.5 sheng of water. Boil until reduced to 0.8 sheng, strain, and take warm. Take three times daily.
*Huoren Shu* records Zhang Zhongjing's Chai Hu Gui Zhi Gan Jiang Tang (Bupleurum, Cinnamon Twig, and Dried Ginger Decoction):
Chai Hu (Bupleuri Radix, 2 liang) Gui Zhi (Cinnamomi Ramulus, peeled) Huang Qin (Scutellariae Radix, 1.5 liang each) Gua Lou Gen (Trichosanthis Radix, 2 liang) Gan Jiang/Zingiberis Rhizoma Recens Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) Mu Li (Ostrea Concha, stir-fried, 1 liang each)
Crush the above herbs to the size of hemp seeds. For each dose, scoop 5 qian bi, add 1.5 sheng of water. Boil until reduced to 0.8 sheng, strain, and take warm. Take again shortly after eating.
*Huoren Shu* records Zhang Zhongjing's Wu Ling San (Five-Ingredient Powder with Poria); see the section on Spontaneous Sweating in Shanghan.
*Huoren Shu* records Zhang Zhongjing's Yin Chen Hao Tang (Artemisiae Scopariae Decoction):
Yin Chen Hao (Artemisiae Scopariae Herba, tender parts, 1.5 liang) Da Huang (Rhei Radix et Rhizoma, 0.5 liang, peeled) Zhi Zi (Gardeniae Fructus, large ones, 3.5 pieces)
Crush the above herbs to the size of hemp seeds. Use two large white cups of water. First boil Yin Chen Hao until reduced by half a cup, then add the other two ingredients. Boil until reduced to 0.8 portion, strain, and take warm. Take three times daily. Once urination becomes smooth, the urine will resemble soap pod juice, bright red in color. After one night, abdominal distension decreases, and the yellow pathogen exits via urination.
*Huoren Shu* records Zhang Zhongjing's Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction):
Fei Zhi Zi (Gardeniae Fructus, plump ones, 14 pieces, broken) Xiang Chi (Fermented Soybeans, 4 he)
Crush the above herbs to the size of hemp seeds. For each dose, use 5 qian, add 1 sheng of water. Boil until reduced to 0.8 sheng, strain, and take warm. Stop administration once rapid vomiting/diarrhea occurs.
*Huoren Shu* Chi Fu Ling Tang (Red Poria Decoction):
Chi Fu Ling (Poria cum Radix, red part) Chen Pi (Citri Reticulatae Pericarpium, soaked in boiling water, white pith removed, dried) Ren Shen (Ginseng Radix et Rhizoma, radix tip removed, 1 liang each) Ban Xia (Pinelliae Rhizoma, washed seven times with boiling water, slippery substance removed) Chuan Xiong (Ligustici Chuanxiong Rhizoma) Bai Zhu (Atractylodis Macrocephalae Rhizoma, processed, 0.5 liang each)
Grind the above medicines into coarse powder. For each dose, use 4 qian, add 1.5 zhong of water and 5 slices of Sheng Jiang. Boil until reduced to 0.7 portion, strain. Take warm at any time.
*Huoren Shu* Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia Decoction plus Poria):
Ban Xia (Pinelliae Rhizoma, 5 liang, soaked in boiling water and washed seven times) Bai Fu Ling (Poria, 3 liang, black soft skin removed)
Crush the above herbs to the size of hemp seeds. For each dose, use 0.5 liang, add 3 sheng of water. Boil until reduced to 1 sheng. Weigh 4 qian of Sheng Jiang, extract its natural juice, add to the decoction, and boil for one or two boils. Drink hot, at any time.