浓朴（半斤去皮炙味苦温） 生姜（半斤切味辛温） 半夏（半斤洗味辛平） 人
参（一两味温） 甘草（二两炙味甘平）
上五味。以水一斗。煮取三升。去滓、温服一升。日三服。
内经曰。脾欲缓。急食甘以缓之。用苦泄之。浓朴之苦。以泄腹满。人参甘草之甘。
以益脾胃。半夏生姜之辛。以散滞气。
王三阳云。曰吐曰下后。胀满为实者。表邪未除而误下之故也。此发汗后。邪气已
散矣。故知非里实也。
伤寒若吐若下后。心下逆满。气上冲胸。起则头眩。脉沉紧。发汗则动经。身为振
振
摇者。茯苓桂枝白术甘草汤主之。
吐下之后。阳气虚陷。虽心下逆满。皆阳虚不能主持中气也。故与白术甘草以补中
枝。以益阳。茯苓以泄满。
吐下后。里虚气上逆者。心下逆满。气上冲胸。表虚阳不足。起则头眩。脉浮紧。为
邪在表。当发汗。脉沉紧。为邪在里。则不可发汗。发汗则外动经络。损伤阳气。阳气
外虚。则不能主持诸脉。身为振振摇也。与此汤以和经益阳。
茯苓（四两味甘平） 桂枝（三两去皮味辛热） 白术（二两味苦甘温） 甘草（二
两炙味甘平）
上四味。以水六升。煮取三升。去滓、分温参服。
阳不足者。补之以甘。茯苓白术。生津液而益阳也。里气逆者。散之以辛。桂枝甘
草。行阳散气。
沈亮宸云。满用术甘。非石山立斋。谁与言此。茯苓、松根气所结。故降逆气。虚
者尤宜。
发汗。病不解。反恶寒者。虚故也。芍药甘草附子汤主之。
发汗病解。则不恶寒。发汗病不解。表实者。亦不恶寒。今发汗。病且不解。又反
恶寒者。荣卫俱虚也。汗出则荣虚。恶寒则卫虚。与芍药甘草附子汤以补荣卫。
【浓朴生姜甘草半夏人参汤方第二十七】
浓朴（半斤，去皮，炙，味苦温） 生姜（半斤，切，味辛温） 半夏（半斤，洗，味辛平） 人参（一两，味温） 甘草（二两，炙，味甘平）
以上五味药。用水一斗，煮取三升药液。滤去药渣，每次温服一升，每日服用三次。
《内经》说：脾脏喜好缓和，遇到急迫时，应食用甘味药物来缓和它；若需疏导，则用苦味药物。浓朴的苦味，用来消除腹部胀满；人参、甘草的甘味，用来补益脾胃；半夏、生姜的辛味，用来疏散停滞的气机。
王三阳说：经过催吐或泻下治疗后，出现胀满且属实证的，是因为表邪未除而误用下法所致。此方证是发汗后，邪气已经消散，所以知道不是里实证。
伤寒病经过催吐或泻下治疗后，胃脘部逆觉胀满，气向上冲至胸部，起身时头晕目眩，脉象沉紧。如果此时再发汗，就会扰动经络，导致身体震颤摇晃。应以茯苓桂枝白术甘草汤为主治方剂。
经过吐下治疗后，阳气虚弱下陷，虽然表现为胃脘部逆觉胀满，这都是因为阳气虚弱不能主持中焦之气。所以用白术、甘草来补益中气，用桂枝来增益阳气，用茯苓来渗泄水饮以消除胀满。
经过吐下治疗后，里虚导致气机上逆，出现胃脘部逆觉胀满，气向上冲至胸部。若表虚阳气不足，起身时头晕目眩，脉象浮紧，说明邪气在表，应当发汗；若脉象沉紧，说明邪气在里，则不可发汗。若误用发汗法，就会外动经络，损伤阳气。阳气在外虚弱，就不能主持诸经脉，从而导致身体震颤摇晃。给予此汤剂以调和经络、增益阳气。
【茯苓桂枝白术甘草汤方第二十八】
茯苓（四两，味甘平） 桂枝（三两，去皮，味辛热） 白术（二两，味苦甘温） 甘草（二两，炙，味甘平）
以上四味药。用水六升，煮取三升药液。滤去药渣，分三次温服。
阳气不足的，用甘味药物来补益。茯苓、白术能生津液并增益阳气。里气上逆的，用辛味药物来疏散。桂枝、甘草能通行阳气、疏散气滞。
沈亮宸说：治疗胀满使用白术和甘草，如果不是石山立斋，谁能说出这样的话呢？茯苓是松树根气凝结而成，所以能降逆气，对于虚证尤其适宜。
发汗后，病证未解，反而出现恶寒症状的，属于虚证。应以芍药甘草附子汤为主治方剂。
发汗后病证解除，就不会恶寒；发汗后病证未解，若是表实证，也不会恶寒。现在发汗后，病证不仅未解，反而更加恶寒，这是营卫俱虚的表现。汗出导致营血虚，恶寒导致卫气虚。给予芍药甘草附子汤以补益营卫。
[Formula 27: Pinelliae, Ziziphi Jujubae, Ginseng, Ginger, and Magnolia Bark Decoction]
Magnoliae Officinalis Cortex (Pinelliae, Ziziphi Jujubae, Ginseng, Ginger, and Magnolia Bark Decoction) (8 liang, peeled, processed with heat, bitter and warm flavor) Fresh Ginger (8 liang, sliced, pungent and warm flavor) Pinelliae Rhizoma Preparatum (8 liang, washed, pungent and neutral flavor) Ginseng Radix et Rhizoma (1 liang, warm flavor) Glycyrrhizae Radix et Rhizoma Preparatum (2 liang, processed with heat, sweet and neutral flavor)
Take the above five herbs. Boil in 10 dou of water until reduced to 3 sheng of liquid. Remove the dregs. Take 1 sheng warm, three times a day.
The *Neijing* states: The Spleen desires relaxation; when urgent, use sweet flavors to relax it. To drain, use bitter flavors. The bitterness of Magnoliae Officinalis Cortex drains abdominal fullness. The sweetness of Ginseng Radix et Rhizoma and Glycyrrhizae Radix et Rhizoma tonifies the Spleen and Stomach. The pungency of Pinelliae Rhizoma Preparatum and Fresh Ginger disperses stagnant Qi.
Wang Sanyang stated: After emesis or purgation, if distension is due to excess, it is because exterior pathogenic factors were not resolved and inappropriate purgation was used. In this case, after sweating, the pathogenic factors have already dispersed; thus, it is known not to be an interior excess syndrome.
In Shaoyang disease, after emesis or purgation, if there is rebellious fullness below the heart, Qi rushing upward to the chest, dizziness upon standing, and a deep, tight pulse, further sweating will disturb the meridians, causing the body to tremble and shake. Treat primarily with Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction.
After emesis and purgation, Yang Qi is deficient and sunken. Although there is rebellious fullness below the heart, it is because deficient Yang cannot govern the Middle Qi. Therefore, use Atractylodis Macrocephalae Rhizoma and Glycyrrhizae Radix et Rhizoma to tonify the Middle; use Cinnamomi Ramulus to benefit Yang; use Poria to drain fullness.
After emesis and purgation, interior deficiency leads to rebellious Qi rising, manifesting as rebellious fullness below the heart and Qi rushing upward to the chest. If exterior deficiency and insufficient Yang cause dizziness upon standing and a floating, tight pulse, the pathogen is in the exterior, and sweating should be induced. If the pulse is deep and tight, the pathogen is in the interior, and sweating is contraindicated. Inducing sweating would externally disturb the meridians and damage Yang Qi. With exterior Yang deficiency failing to govern the vessels, the body trembles and shakes. Administer this decoction to harmonize the meridians and benefit Yang.
[Formula 28: Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction]
Poria (4 liang, sweet and neutral flavor) Cinnamomi Ramulus (3 liang, peeled, pungent and hot flavor) Atractylodis Macrocephalae Rhizoma (2 liang, bitter, sweet, and warm flavor) Glycyrrhizae Radix et Rhizoma Preparatum (2 liang, processed with heat, sweet and neutral flavor)
Take the above four herbs. Boil in 6 sheng of water until reduced to 3 sheng of liquid. Remove the dregs. Divide into three doses and take warm.
For insufficient Yang, tonify with sweet flavors. Poria and Atractylodis Macrocephalae Rhizoma generate fluids and benefit Yang. For rebellious interior Qi, disperse with pungent flavors. Cinnamomi Ramulus and Glycyrrhizae Radix et Rhizoma promote Yang circulation and disperse Qi stagnation.
Shen Liangchen said: Using Atractylodis Macrocephalae Rhizoma and Glycyrrhizae Radix et Rhizoma for fullness—if not from Shishan Lizhai, who could speak of this? Poria is formed from the Qi congealing at pine roots; thus, it descends rebellious Qi and is especially suitable for deficiency patterns.
If after sweating the disease does not resolve and chills appear instead, it indicates deficiency. Treat primarily with Peony, Licorice, and Aconite Decoction.
If sweating resolves the disease, chills do not appear. If the disease does not resolve after sweating but is an exterior excess pattern, chills also do not appear. Now, if after sweating the disease does not resolve and chills worsen, it indicates simultaneous deficiency of Ying and Wei. Sweating causes Ying deficiency; chills indicate Wei deficiency. Administer Peony, Licorice, and Aconite Decoction to tonify Ying and Wei.