芫花（熬味辛苦） 甘遂（苦寒） 大戟（苦寒） 大枣（十枚擘甘温）
上上三味。等分。各别捣。为散。以水一升半。先煮大枣肥者十枚。取八合。去滓。
内药末。强人服一钱匕。羸人服半钱。温服之。平旦服。若下少。病不除者。明日更服。
加半钱。得快。下利后。糜粥自养。
辛以散之。戟花之辛以散饮。苦以泄之。甘遂大戟之苦以泄水。水者。肾所主也。
甘者。脾之味也。大枣之甘者。益土而胜水。
杜壬云。里未和者。盖痰与燥气壅于中焦。故头疼。干呕。短气。汗出。是痰膈也。非
十枣不治。但此汤不宜轻用。恐损人于倏忽。用药者慎之。
太阳病。医发汗。遂发热恶寒。因复下之。心下痞。表里俱虚。阴阳气并竭。无阳
则阴
独。复加烧针。因胸烦。面色青黄。肤 者难治。今色微黄。手足温者易愈。
太阳病。因发汗。遂发热恶寒者。外虚阳气。邪复不除也。因复下之。又虚其里。表
中虚邪内陷。传于心下为痞。发汗表虚为竭阳。下之里虚为竭阴。表证罢为无阳。
里有痞为阴独。又加烧针。虚不胜火。火气内攻。致胸烦也。伤寒之病。以阳为主。其
人面色青。肤肉 动者。阳气太虚。故云难治。若面色微黄。手足温者。即阳气得复。
故云易愈。
心下痞。按之濡。其脉关上浮者。大黄黄连泻心汤主之。
心下硬按之痛。关脉沉者。实热也。心下痞。按之濡。其脉关上浮者。虚热也。大
黄黄连汤。以导其虚热。
芫花（经炮制，味辛、苦） 甘遂（味苦，性寒） 大戟（味苦，性寒） 大枣（十枚，掰开，味甘，性温）
以上三味药。分量相等。分别捣碎，研成散剂。用水一升半，先煮肥大者十枚大枣。取汁八合，滤去药渣。
加入药末。体质强壮的人服用一钱匕的量。体质虚弱的人服用半钱匕的量。温服。清晨空腹服用。如果腹泻较少，病邪未除的，第二天再服。
增加半钱匕的量。服药后若得畅快泻下，泻下之后，喝稀粥来调养身体。
辛味药物能发散邪气。芫花的辛味能消散水饮。苦味药物能泄降邪气。甘遂、大戟的苦味能泄下水邪。水液，由肾所主管。
甘味，是脾的味道。大枣的甘味，能补益脾气（土）以制约水邪。
杜壬说：里气不和的情况，大概是痰饮与燥气壅滞在中焦，所以出现头痛、干呕、短气、汗出等症状，这是痰膈证。非十枣汤不能治愈。但这种汤剂不宜轻易使用，恐怕在短时间内损伤人体正气。用药者务必谨慎。
太阳病，医生用发汗法治疗，导致发热恶寒，于是又用攻下法治疗，出现心下痞满。表里之气都虚，阴阳之气都衰竭。没有阳气则阴气独存。又加上烧针疗法，导致心中烦闷。面色青黄，肌肉跳动者难治。现在面色微黄，手足温暖者容易痊愈。
太阳病，因为发汗，导致发热恶寒，这是体表阳气虚弱，邪气未能去除。于是又用攻下法，又使里气虚弱。表虚邪气内陷，传入心下形成痞证。发汗导致表虚而竭伤阳气，攻下导致里虚而竭伤阴气。表证解除称为无阳。里有痞塞称为阴独。又加上烧针，正气虚弱不能耐受火邪，火气内攻，导致胸中烦闷。伤寒这类疾病，以阳气为主。病人面色青，肌肉跳动，是阳气太虚，所以说难治。如果面色微黄，手足温暖，就是阳气恢复，所以说容易痊愈。
心下痞满，按之柔软，脉象关部浮的，用大黄黄连泻心汤主治。
心下硬满，按之疼痛，关脉沉的，是实热证。心下痞满，按之柔软，脉象关部浮的，是虚热证。大黄黄连汤，用来导引清除虚热。
Yuanhua (Radix Genkwa, processed, pungent and bitter) Gansui (Radix Kansui, bitter and cold) Daji (Radix Euphorbiae Pekinensis, bitter and cold) Dazao (Fructus Jujubae, ten pieces, split, sweet and warm)
The above three herbs. Equal parts. Each separately pounded into powder. With one sheng and half of water, first decoct ten large Dazao. Obtain eight ge of liquid, remove dregs.
Add the herbal powder. For strong individuals, administer one qianbi dose. For frail individuals, administer half a qianbi dose. Take warm. Administer at dawn on an empty stomach. If the purgation is slight and the disease remains, take again the next day.
Increase by half a qianbi dose. After obtaining free purgation, nourish oneself with millet porridge.
Pungent substances disperse. The pungency of Yuanhua disperses fluid retention. Bitter substances drain. The bitterness of Gansui and Daji drains water. Water is governed by the Kidney.
Sweet is the taste of the Spleen. The sweetness of Dazao benefits Earth (Spleen) to overcome Water.
Du Ren stated: When the interior is not harmonious, it is generally due to phlegm-fluids and dry qi obstructing the Middle Jiao, thus causing headache, dry retching, shortness of breath, and sweating; this is Phlegm-Ge syndrome. It cannot be treated without Shizao Tang. However, this decoction should not be used lightly, as it may damage the person suddenly. Practitioners must exercise caution.
In Taiyang disease, after the physician induced sweating, fever and aversion to cold ensued. Subsequently, purgation was applied, resulting in epigastric fullness (Pi). Both exterior and interior are deficient; both Yin and Yang Qi are exhausted. Without Yang, Yin stands alone. Adding moxibustion (burning needle) caused chest irritability. A bluish-yellow complexion and muscle twitching indicate a difficult-to-treat condition. Currently, a slightly yellow complexion and warm hands and feet indicate easy recovery.
In Taiyang disease, due to sweating, fever and aversion to cold occurred, indicating deficiency of exterior Yang Qi and failure to eliminate pathogenic factors. Subsequent purgation further depleted the interior. Exterior deficiency allowed pathogens to sink inward, transforming into Pi at the epigastrium. Sweating depletes Yang via exterior deficiency; purgation depletes Yin via interior deficiency. Resolution of exterior signs is termed "No Yang." Interior Pi is termed "Yin Alone." Adding burning needle therapy: deficiency cannot withstand fire; fire Qi attacks inward, causing chest irritability. In Shanghan diseases, Yang is primary. A bluish complexion and muscle twitching indicate extreme Yang deficiency, hence "difficult to treat." A slightly yellow complexion and warm extremities indicate Yang recovery, hence "easy to recover."
Epigastric Pi, soft upon palpation, with a floating pulse at the Guan position, is primarily treated with Dahuang Huanglian Xiexin Tang.
Epigastric hardness and pain upon palpation, with a deep Guan pulse, indicates Excess Heat. Epigastric Pi, soft upon palpation, with a floating pulse at the Guan position, indicates Deficiency Heat. Dahuang Huanglian Tang guides out Deficiency Heat.