治阴寒脉沉。四肢厥冷。呕吐泄泻。
附子（生用。一枚） 干姜（五钱） 甘草（六钱）
上三味。水煎。分温再服。强人可服大附子一枚。干姜一两。
四逆加人参汤（玉函） 治恶寒脉微而利。
四逆汤加人参三钱至一两。
茯苓四逆汤（玉函） 治发汗。若下之。病仍不解烦躁。
四逆汤加人参三钱至一两。茯苓六钱。
通脉四逆汤（玉函） 治少阴病下利清谷。里寒外热。
四逆汤倍用干姜。
通脉四逆加猪胆汁汤（玉函） 治吐以下断。四肢拘急不解。脉微欲绝者。
四逆汤倍干姜加猪胆汁。
白通汤（玉函） 治少阴病下利脉微。
四逆汤去甘草。木方姜、附各三钱。加葱白四茎。
白通加猪胆汁汤（玉函） 治少阴病下利。厥逆无脉。干呕而烦。
四逆汤去甘草。木方姜、附各用三钱。加葱白四茎。人尿五合。猪胆汁一合。
干姜附子汤（玉函。一名姜附汤） 治少阴病昼日烦躁。
四逆汤去甘草。 四逆汤用姜、附之辛热恢复其阳。即用甘草以缓其性。使之徐行以达四末
。专为始病便见厥逆。脉沉不发热者而设。即太阴自利腹痛。厥阴下利拘急。总不出此。以厥阴
之邪。无不由少阴而入也。非但三阴俱可取用。并太阳之头痛。发热脉沉。亦须用此。先救其里
。然后解表。方为合辙。而少阴病昼日烦躁。用干姜附子汤。即四逆汤中除去甘草。专用二味以
迅扫阴霾。与白通立法无异。以意逆之。四逆一方。太阳尚所攸赖。白通二例。与厥阴独无干预
耶。虽厥阴经中。但有通脉。而无白通。详二方止互更一味。通脉有甘草而无葱白。白通有葱白
而无甘草。一取甘缓以徐复欲绝之脉。一去甘草以急追将脱之阳。皆用猪胆以除假热。白通专用
葱白以通真阳。又恐葱白性升引领姜、附上僭。故以人尿折而下之。其通脉本方。虽无葱白。方
后便有面赤加葱之例。葱白既可加用。人尿独不可加用乎。况厥阴五内风木。得无面赤戴阳。可
用葱白之治乎。上法皆末流之挽。无问直中
沉寒。传经坏病。病气至此转逆。元气至此殆尽。非始病便见脉沉发热之比。纵两感势剧。尚有
麻黄附子细辛汤。尽力可救。与前太阳例中先后救里解表之法。互相挥发。辨治之微。惟在头之
痛与不痛为确据也。精义至此。尽情剖露。后世略不加察。妄立两感之方。总未达长沙万一耳。
回阳返木汤 治阳虚躁渴。面赤戴阳。欲坐卧泥水中。脉来无力欲绝者。
四逆汤加人参、麦门冬、五味子、腊茶、陈皮。面赤者。下虚也。加葱七茎。黄连少许。用
泥浆水澄清煎服。入白蜜五匙。冷服取汗。 此以白通合生脉。治阴极似阳。最为神妙。加用腊
茶、浆水等味当矣。但陈皮一味。似属不必。当知人参既合姜、附。其势 张。奚藉陈皮发扬之
力哉。
羌活附子散 治胃冷呃逆。
四逆汤去甘草。本方用附子半两。干姜二钱。加羌活、茴香各半两。木香一钱。为散。每服
二钱。入盐一字。水煎微温服。
木香散 治虚寒滑泄不止。
四逆汤本方用甘草、干姜各二两。附子一两。加丁香、木香、肉豆蔻、广藿香、诃子肉、赤
石脂各一两。为散。每服三钱。
陈米汤上。（世本。无炮姜。多当归。）
冷香饮子 治中暑内挟生冷冻饮料食。腹痛泻利。
四逆汤去干姜。本方甘草、附子各一钱。加草果仁、橘红各一钱。生姜五片。浸冷服之。
浆水散 治中暑泄泻。多汗脉弱。
四逆汤本方三味各用五钱。加肉桂五钱。良姜、半夏各二钱五分。（二味俱醋炒） 浆水煎。去
滓冷服。 按浆水乃秫米和曲酿成。如醋而淡。今人点牛乳作饼用之。或用真粉作。纳绿豆者尤
佳。
茵陈四逆汤 治阴黄脉沉细。肢体逆冷。腰以上自汗。
四逆汤本方用炮姜一钱五分。附子、甘草各一钱。加茵陈蒿一钱五分。
茵陈附子干姜汤 治阴黄脉沉细。
四逆汤去甘草。用熟附三钱。炮姜二钱。加白术二钱。豆蔻、枳实、半夏、茯苓、泽泻、橘
红各八分。茵陈蒿一钱。生姜五片。
治疗阴寒证，脉象沉细，四肢厥冷，呕吐，腹泻。
附子（生用，一枚） 干姜（五钱） 甘草（六钱）
以上三味药，加水煎煮，分两次温服。身体强壮者可服用大附子一枚，干姜一两。
四逆加人参汤（出自《伤寒论·玉函》篇）：治疗恶寒，脉微细而伴有下利。
在四逆汤基础上加入人参三钱至一两。
茯苓四逆汤（出自《伤寒论·玉函》篇）：治疗经过发汗或攻下治疗后，病邪仍未解除，出现烦躁不安。
在四逆汤基础上加入人参三钱至一两、茯苓六钱。
通脉四逆汤（出自《伤寒论·玉函》篇）：治疗少阴病，下利完谷不化，体内寒冷体外发热（真寒假热）。
在四逆汤基础上加倍使用干姜。
通脉四逆加猪胆汁汤（出自《伤寒论·玉函》篇）：治疗呕吐与下利停止后，四肢拘挛紧急不能缓解，脉象微弱几乎摸不到。
在四逆汤基础上加倍干姜，并加入猪胆汁。
白通汤（出自《伤寒论·玉函》篇）：治疗少阴病，下利，脉象微细。
在四逆汤基础上去掉甘草。原方中干姜、附子各用三钱，加入葱白四根。
白通加猪胆汁汤（出自《伤寒论·玉函》篇）：治疗少阴病，下利，四肢厥冷且无脉，干呕且心烦。
在四逆汤基础上去掉甘草。原方中干姜、附子各用三钱，加入葱白四根、人尿五合、猪胆汁一合。
干姜附子汤（出自《伤寒论·玉函》篇，又名姜附汤）：治疗少阴病，白天烦躁不安。
在四逆汤基础上去掉甘草。四逆汤利用干姜、附子的辛热之性来恢复阳气，同时使用甘草以缓和其药性，使其缓慢发挥作用到达四肢末端。此方专为发病初期即见四肢厥冷、脉沉而不发热的情况而设。即使是太阴病的自发性腹泻腹痛，以及厥阴病的下利伴四肢拘急，总不出这个范围，因为厥阴经的病邪，没有不是从少阴经传入的。不仅三阴经病症都可以取用此法，即使是太阳病的头痛、发热但脉沉，也必须先用此法先救里阳，然后再解表，这才符合治疗法则。对于少阴病白天烦躁的情况，使用干姜附子汤，即在四逆汤中除去甘草，专门使用这两味药来迅速扫除阴寒阴霾，这与白通汤的立法意图无异。推究其意，四逆汤一方，太阳病尚且有所依赖，难道白通汤的两个例子，与厥阴经就毫无干预吗？虽然在厥阴经篇章中，只有通脉四逆汤，而没有白通汤的详细记载，但详细考察这两个方剂，只是互换了一味药：通脉四逆汤有甘草而无葱白，白通汤有葱白而无甘草。前者取甘缓之意以徐徐恢复将绝之脉，后者去掉甘草以急切追回将脱之阳。两者都使用猪胆以清除假热，白通汤专门使用葱白以通达真阳。又担心葱白性升，引领干姜、附子上僭（过于升散），所以用人尿将其折降而下。至于通脉四逆汤原方，虽然没有葱白，但在方后已有面色发红加用葱白的先例。既然葱白可以加用，人尿难道不可加用吗？况且厥阴经内属风木，难道不会出现面色发红、戴阳（虚阳上浮）的情况，可以使用葱白来治疗吗？上述方法都是针对病情末期的挽救措施，无论是直中沉寒，还是传经导致的坏病，病气至此已经转逆，元气至此已经耗尽，这不同于发病初期就见脉沉发热的情况。即使是两感病（太阳与少阴同病）形势剧烈，还有麻黄附子细辛汤，尽力还可以救治。这与前面太阳病篇中“先救里后解表”的方法相互印证，辨治的精微之处，只在于是否有头痛作为确凿依据。精义至此，已尽情剖析显露。后世医家略不加察，妄立两感病的方剂，总未达到张仲景（长沙太守）医术的万分之一啊。
回阳返本汤：治疗阳虚躁渴，面色发红呈戴阳状，想要坐在泥水中，脉象无力几乎摸不到。
在四逆汤基础上加入人参、麦门冬、五味子、腊茶、陈皮。若面色发红，属于下虚，加葱七根、少许黄连。用泥浆水澄清后煎服，加入白蜜五匙，冷服以取汗。这是将白通汤与生脉散结合，治疗阴极似阳的证候，最为神妙。加用腊茶、浆水等味道是恰当的。但陈皮一味，似乎没有必要。应当知道人参既然配合干姜、附子，其气势已经盛大，哪里还需要借助陈皮发扬之力呢？
羌活附子散：治疗胃寒呃逆。
在四逆汤基础上去掉甘草。本方使用附子半两、干姜二钱，加入羌活、茴香各半两、木香一钱，研为散剂。每次服用二钱，加入盐一字，加水煎煮，微温服下。
木香散：治疗虚寒滑泄不止。
四逆汤本方使用甘草、干姜各二两，附子一两，加入丁香、木香、肉豆蔻、广藿香、诃子肉、赤石脂各一两，研为散剂。每次服用三钱。
（世传版本中，没有炮姜，多加入了当归。）
冷香饮子：治疗中暑内部夹杂生冷冷冻饮食，导致腹痛泻利。
在四逆汤基础上去掉干姜。本方使用甘草、附子各一钱，加入草果仁、橘红各一钱、生姜五片，浸泡后冷服。
浆水散：治疗中暑泄泻，多汗，脉弱。
四逆汤本方三味药各用五钱，加入肉桂五钱、良姜、半夏各二钱五分。（这两味药都用醋炒制）用浆水煎煮，去渣后冷服。按：浆水是用秫米和曲酿造而成，像醋一样但味道淡。现在人们点牛乳做饼时使用它，或者用真粉制作，加入绿豆的尤其好。
茵陈四逆汤：治疗阴黄，脉象沉细，肢体逆冷，腰部以上自汗。
四逆汤本方使用炮姜一钱五分，附子、甘草各一钱，加入茵陈蒿一钱五分。
茵陈附子干姜汤：治疗阴黄，脉象沉细。
在四逆汤基础上去掉甘草。使用熟附子三钱、炮姜二钱，加入白术二钱、豆蔻、枳实、半夏、茯苓、泽泻、橘红各八分、茵陈蒿一钱、生姜五片。
Treat Yin-cold syndrome with deep pulse, cold limbs (Jue-leng), vomiting, and diarrhea.
Fuzi (Raw, one piece) Ganjiang (Dried Ginger, five qian) Gancao (Licorice Root, six qian)
Decoct the above three herbs in water, divide into two doses, and take warm. For robust individuals, a large Fuzi (one piece) and Ganjiang (one liang) may be used.
Si Ni Jia Ren Shen Tang (Four Reversal Decoction plus Ginseng, from *Shanghan Lun - Yu Han*): Treats aversion to cold, faint pulse, and diarrhea.
Add Renshen (Ginseng Root) three qian to one liang to Si Ni Tang.
Fu Ling Si Ni Tang (Poria Four Reversal Decoction, from *Shanghan Lun - Yu Han*): Treats restlessness (Fan-zao) persisting after sweating or purging therapies have failed to resolve the disease.
Add Renshen (Ginseng Root) three qian to one liang, and Fuling (Poria, three qian to one liang) six qian to Si Ni Tang.
Tong Mai Si Ni Tang (Pulse-Rescuing Four Reversal Decoction, from *Shanghan Lun - Yu Han*): Treats Shaoyin disease with diarrhea of undigested food, interior cold with exterior heat (True Cold, False Heat).
Double the dosage of Ganjiang (Dried Ginger) in Si Ni Tang.
Tong Mai Si Ni Jia Zhu Dan Zhi Tang (Pulse-Rescuing Four Reversal Decoction plus Pig Bile, from *Shanghan Lun - Yu Han*): Treats cases where vomiting and diarrhea have ceased but limb spasms persist, and the pulse is faint and nearly imperceptible.
Double Ganjiang (Dried Ginger) in Si Ni Tang and add Zhuyezhi (Pig Bile).
Bai Tong Tang (White Pass Decoction, from *Shanghan Lun - Yu Han*): Treats Shaoyin disease with diarrhea and faint pulse.
Remove Gancao (Licorice Root) from Si Ni Tang. The original formula uses Ganjiang (Dried Ginger) and Fuzi (Aconite Root) three qian each, plus Congbai (Scallion White) four stalks.
Bai Tong Jia Zhu Dan Zhi Tang (White Pass Decoction plus Pig Bile, from *Shanghan Lun - Yu Han*): Treats Shaoyin disease with diarrhea, cold limbs, absence of pulse, dry heaving, and irritability.
Remove Gancao (Licorice Root) from Si Ni Tang. Use Ganjiang (Dried Ginger) and Fuzi (Aconite Root) three qian each, add Congbai (Scallion White) four stalks, Ren Niao (Human Urine) five he, and Zhuyezhi (Pig Bile) one he.
Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction, from *Shanghan Lun*, also known as Jiang Fu Tang): Treats Shaoyin disease with daytime restlessness.
Remove Gancao (Licorice Root) from Si Ni Tang. Si Ni Tang utilizes the acrid-hot nature of Ganjiang (Dried Ginger) and Fuzi (Aconite Root) to restore Yang Qi, while Gancao is used to moderate their intensity, allowing them to act gradually to reach the extremities. This formula is specifically designed for conditions presenting initially with cold limbs, deep pulse, and no fever. Even in Taiyin disease with spontaneous diarrhea and abdominal pain, or Jueyin disease with diarrhea and limb spasms, the principle remains the same, as pathogenic factors in Jueyin invariably enter via Shaoyin. This method applies not only to the Three Yin meridians but also to Taiyang disease presenting with headache, fever, and deep pulse; one must first rescue the interior Yang before releasing the exterior, which aligns with proper treatment principles. For Shaoyin disease with daytime restlessness, Ganjiang Fuzi Tang removes Gancao from Si Ni Tang to use only these two herbs to rapidly dispel Yin-cold turbidity, similar in intent to Bai Tong Tang. Considering this, if Si Ni Tang is applicable to Taiyang, surely Bai Tong Tang has relevance to Jueyin? Although the Jueyin chapter mentions Tong Mai Si Ni Tang but not Bai Tong Tang, a detailed comparison shows they differ by only one herb: Tong Mai Si Ni Tang contains Gancao but lacks Congbai, using the sweet-slowing property to gently restore the near-extinct pulse; Bai Tong Tang lacks Gancao but includes Congbai to urgently pursue escaping Yang. Both use Zhuyezhi (Pig Bile) to clear false heat. Bai Tong Tang specifically uses Congbai to unblock True Yang. However, fearing that the ascending nature of Congbai might lead Ganjiang and Fuzi to become hyperactive, Ren Niao (Human Urine) is added to direct the action downward. Regarding Tong Mai Si Ni Tang, although it lacks Congbai in the base formula, the post-formula notes indicate adding Congbai for facial redness. If Congbai can be added, why not Ren Niao? Moreover, given that Jueyin corresponds to internal Wind-Wood, could it not present with facial redness and Dai Yang (floating Yang)? In such cases, could Congbai not be used? These methods are remedies for late-stage crises, whether from direct invasion of severe cold or complicated diseases from transmission. At this stage, pathogenic qi has turned adverse, and Yuan Qi is nearly exhausted, differing significantly from early-stage presentations of deep pulse and fever. Even in severe Liang Gan (Simultaneous Taiyang-Shaoyin) cases, Ma Huang Fu Zi Xi Xin Tang can still be tried for rescue. This correlates with the "rescue interior then release exterior" method discussed in the Taiyang chapter. The subtlety of differentiation lies precisely in the presence or absence of headache. The essence here is fully exposed. Later generations, failing to examine this carefully, recklessly created formulas for Liang Gan, falling far short of Zhang Zhongjing's (the Prefect of Changsha) wisdom by ten thousandfold.
Hui Yang Fan Ben Tang (Return Yang and Restore Foundation Decoction): Treats Yang deficiency with irritability and thirst, facial redness resembling Dai Yang, desire to sit in mud/water, and weak, nearly imperceptible pulse.
Add Renshen (Ginseng Root), Maidong (Ophiopogon Tuber), Wuweizi (Schisandra Fruit), La Cha (Preserved Tea), and Chenpi (Tangerine Peel) to Si Ni Tang. For facial redness (indicating lower deficiency), add seven stalks of Congbai (Scallion White) and a small amount of Huanglian (Coptis Rhizome). Decoct in clarified mud-water, add five spoons of Baimi (White Honey), and take cold to induce sweating. This combines Bai Tong Tang with Sheng Mai San to treat extreme Yin mimicking Yang, which is highly effective. Adding La Cha and Jiang Shui (Sour Rice Water) is appropriate. However, Chenpi seems unnecessary. When Renshen is combined with Ganjiang and Fuzi, its momentum is already strong; why rely on Chenpi's dispersing power?
Qiang Huo Fu Zi San (Notopterygium and Aconite Powder): Treats stomach cold with hiccups.
Remove Gancao (Licorice Root) from Si Ni Tang. Use Fuzi (Aconite Root) half liang, Ganjiang (Dried Ginger) two qian, add Qianghuo (Notopterygium Rhizome) and Huixiang (Fennel Fruit) half liang each, and Muxiang (Aucklandia Root) one qian. Grind into powder. Take two qian per dose, add a pinch of Yan (Salt), decoct in water, and take warm.
Muxiang San (Aucklandia Powder): Treats persistent loose stools due to deficiency-cold.
Use Si Ni Tang base: Gancao (Licorice Root) and Ganjiang (Dried Ginger) two liang each, Fuzi (Aconite Root) one liang. Add Dingxiang (Clove), Muxiang (Aucklandia Root), Roudoukou (Nutmeg), Guang Huoxiang (Patchouli), Hezi Rou (Chebulic Myrobalan Flesh), and Chishizhi (Red Halloysite) one liang each. Grind into powder. Take three qian per dose.
(Note: The Shi Ben version lacks Pao Jiang (Roasted Ginger) and adds Danggui (Angelica Sinensis).)
Leng Xiang Yin Zi (Cold Fragrance Drink): Treats summerheat complicated by consumption of raw/cold foods, leading to abdominal pain and diarrhea.
Remove Ganjiang (Dried Ginger) from Si Ni Tang. Use Gancao (Licorice Root) and Fuzi (Aconite Root) one qian each, add Caoguoren (Tsaoko Cardamom Seed), Juhong (Exocarpium Citri Grandis) one qian each, and Shengjiang (Fresh Ginger) five slices. Soak and take cold.
Jiang Shui San (Sour Rice Water Powder): Treats summerheat with diarrhea, profuse sweating, and weak pulse.
Use Si Ni Tang base: each of the three herbs five qian. Add Rougui (Cinnamon Bark) five qian, Liangjiang (Galangal Rhizome), and Banxia (Pinellia Tuber) two qian 5 fen each. (The latter two are stir-fried with vinegar). Decoct in Jiang Shui (Sour Rice Water), strain, and take cold. Note: Jiang Shui is brewed from Shumi (Glutinous Millet) and Qu (Fermentation Starter), resembling vinegar but milder. It is now used in making milk curds or rice flour cakes; adding Moutong Dou (Mung Bean) is especially good.
Yin Chen Si Ni Tang (Artemisia Four Reversal Decoction): Treats Yin Jaundice with deep-thin pulse, cold limbs, and spontaneous sweating above the waist.
Use Pao Jiang (Roasted Ginger) one qian 5 fen, Fuzi (Aconite Root) and Gancao (Licorice Root) one qian each in Si Ni Tang base. Add Yinchenshao (Artemisiae Scopariae Herba) one qian 5 fen.
Yin Chen Fu Zi Gan Jiang Tang (Artemisia, Aconite, and Dried Ginger Decoction): Treats Yin Jaundice with deep-thin pulse.
Remove Gancao (Licorice Root) from Si Ni Tang. Use Shu Fuzi (Prepared Aconite Root) three qian, Pao Jiang (Roasted Ginger) two qian. Add Baizhu (Atractylodes Macrocephala Rhizome) two qian, Doukou (Cardamom Seed), Zhishi (Immature Bitter Orange), Banxia (Pinellia Tuber), Fuling (Poria), Zexie (Alisma Rhizome), Juhong (Exocarpium Citri Grandis) eight fen each, Yinchenshao (Artemisiae Scopariae Herba) one qian, and Shengjiang (Fresh Ginger) five slices.