（仲景） 治太阳病六七日，表证仍在，（发热恶寒。头痛项强。）脉微而沉，反不结胸
其人发狂者。以热在下焦，少腹当硬满，小便自利者，必有蓄血，令人善忘。所以然者，以
太阳随经于热在里故也。
水蛭（三十个猪脂熬黑） 虻虫（三十个去头足翅） 桃仁（二十枚去皮尖研） 大黄
（四两酒浸）
苦走血，咸渗血，虻虫水蛭之苦咸，以除蓄血。甘缓急，苦泄热，桃仁大黄之甘苦，以
下结热。（程郊倩曰∶表证仍在，脉微而沉，是有表证而无表脉。热在下焦可知，非桂枝所
能散，桃仁所能攻。缘热结膀胱，与瘀热在里，邪有浅深，故桃仁承气与抵当汤，攻有缓急。）
减水蛭十个，虻虫桃仁各减五个，分为四丸，每水煮一丸，名抵当丸，治本病无喜忘如
狂之证者。附代抵当丸，大黄（四两）、生地、归尾、桃仁、穿山甲、元明粉（各一两）、桂
心（三钱）、蜜丸。（桃仁归尾生地，润以通之，桂心热以动之，大黄元明粉，苦寒咸寒以推
荡之，加穿山
（仲景） 治伤寒外证不解，热结膀胱，小腹胀满，大便黑，小便利，燥渴谵语，蓄血，
发热如狂。及血于胃痛腹痛肋痛，疟疾实热夜发，痢疾蓄血急痛。
桃仁（五十枚去皮尖研） 大黄（四两） 芒硝 甘草 桂枝（二两）
大黄芒硝，荡热去实，甘草和胃缓中，此调胃承气汤也。热甚则搏血，血聚则肝燥，故
加桃仁之甘苦，以润燥而缓肝。加桂枝之辛热，直连于所而行之也。〔撄宁生曰∶（滑伯仁。
号撄宁生。）血溢血泄，诸蓄妄者，其始也。率以桃仁、大黄行血破于之剂，折其锐气，然
后区别治之。或问失血复下，虚何以当。伊芳举曰∶血既妄行，迷失故道，不去蓄利瘀，则以
妄为常。何以御之，且去者自去，生者自生，何虚之有。喻嘉言曰∶用桃仁以达血所，加桂
枝以解外邪，亦犹大柴胡汤用柴胡解外相似，益见太阳随经之邪，非桂枝不解尔。程郊倩曰∶
五苓散与桃仁承气，均为太阳犯府之药。一利前而主气分，一利后而主血分，治各不同。〕
节奄加青皮枳实当归芍药酥木汁柴胡，名桃仁承气对子。（加青皮枳实，破血必行气也。
加当归芍药，去瘀而生新也。柴胡平肝，升清而散表热，酥木助桃仁桂心以逐于血。）
（张仲景）治疗太阳病经过六七天，表证依然存在，（表现为发热恶寒、头痛项强。）脉象微而沉，反而没有形成结胸。
如果病人出现发狂的症状，这是因为热邪在下焦，小腹部应当硬满，小便通畅自利，这必定是有蓄血，使人容易健忘。之所以这样，是因为太阳经的邪热随经入里所致。
水蛭（三十个，用猪脂熬至黑色） 虻虫（三十个，去掉头、足、翅） 桃仁（二十枚，去皮尖后研碎） 大黄（四两，用酒浸泡）
苦味药能走血分，咸味药能渗透血分，虻虫和水蛭的苦咸之性，用来消除蓄积的血瘀。甘味药能缓和急迫，苦味药能泄热，桃仁和大黄的甘苦之性，用来攻下凝结的热邪。（程郊倩说：表证仍在，脉象微而沉，这是有表证的表现而没有表证的脉象。可知热邪在下焦，这不是桂枝所能解散的，也不是桃仁所能攻下的。因为热结在膀胱，与瘀热在里的情况不同，邪气有浅深之分，所以桃仁承气汤和抵当汤，攻下的力度有缓急之别。）
减少水蛭十个，虻虫和桃仁各减少五个，分成四丸，每次用水煮一丸服用，名叫抵当丸，用于治疗原本的疾病但没有喜欢遗忘或像发狂那样的症状的情况。附上代用的抵当丸方：大黄（四两）、生地、归尾、桃仁、穿山甲、元明粉（各一两）、桂心（三钱），炼蜜为丸。（桃仁、归尾、生地，用滋润的方法来疏通；桂心，用热性来推动；大黄、元明粉，用苦寒和咸寒的性质来推荡积滞，加上穿山甲……）
（张仲景）治疗伤寒外证未解，热邪结于膀胱，小腹胀满，大便色黑，小便通利，烦躁口渴，胡言乱语，属于蓄血证，发热如狂。以及血瘀引起的胃痛、腹痛、肋痛，疟疾实热夜间发作，痢疾蓄血引起的急痛。
桃仁（五十枚，去皮尖后研碎） 大黄（四两） 芒硝 甘草 桂枝（二两）
大黄和芒硝，荡涤热邪去除实邪，甘草调和胃气缓和中焦，这是调胃承气汤。热势严重则会搏结血液，血液聚积则导致肝燥，所以加入桃仁的甘苦之性，以滋润燥热并缓和肝脏。加入桂枝的辛热之性，直接连接病所并引导药力运行。（撄宁生说：[滑伯仁，号撄宁生] 血溢血泄，各种蓄血妄行的情况，起初都是如此。通常使用桃仁、大黄行血破瘀的药剂，挫败其锐气，然后再区别治疗。有人问失血后又用下法，虚证如何承受？伊芳举回答说：血液既然妄行，迷失了原来的通道，如果不除去蓄积的瘀血，就会把妄行当作常态。用什么来抵御它呢？况且去除了旧的，新的自然会生长，有什么虚损可言呢？喻嘉言说：使用桃仁来通达血分，加入桂枝来解除外邪，也就像大柴胡汤中使用柴胡解除外邪一样，更可见太阳经随经传入的邪气，非桂枝不能解散。程郊倩说：五苓散和桃仁承气汤，都是治疗太阳病侵犯腑脏的药物。一个通利前阴而主司气分，一个通利后阴而主司血分，治疗方法各不相同。）
另外一方在桃仁承气汤基础上加青皮、枳实、当归、芍药、酥木汁、柴胡，名叫桃仁承气对子。（加入青皮、枳实，是为了破血时必须行气。加入当归、芍药，是为了去瘀而生新。柴胡平肝，升清阳而散表热，酥木帮助桃仁、桂心来逐除瘀血。）
(Zhang Zhongjing) Treats Taiyang disease (Taiyang disease, a syndrome caused by pathogenic factors affecting the Taiyang channel) after six or seven days, where exterior symptoms remain (fever and aversion to cold, headache and stiffness of the neck). The pulse is faint and deep, yet there is no formation of Jie Xiong (Chest Binding, a syndrome characterized by chest fullness and pain). If the person becomes manic due to heat in the Lower Jiao (Lower Burner), the lower abdomen should be hard and full. With free urination, there must be Blood Stasis (accumulation of blood), causing forgetfulness. This occurs because the heat from the Taiyang channel follows the meridian into the interior.
Shuizhi (Leech, Hirudo nipponica) [30 pieces, fried with pig fat until black]
Mengchong (Dragonfly larva, Anisoptera) [30 pieces, heads, feet, and wings removed]
Taoren (Peach Kernel, Persicae Semen) [20 seeds, skin and tips removed, ground]
Dahuang (Rhubarb Root, Rheum palmatum) [4 liang, soaked in wine]
Bitter flavors enter the blood level, and salty flavors penetrate the blood. The bitter and salty properties of Mengchong and Shuizhi are used to eliminate Blood Stasis. Sweet flavors relieve urgency, and bitter flavors drain heat. The sweet and bitter properties of Taoren and Dahuang are used to purge consolidated heat. (Cheng Jiaoqian states: Exterior symptoms remain, yet the pulse is faint and deep; this indicates the presence of exterior symptoms without the corresponding exterior pulse. It is evident that heat is in the Lower Jiao. This cannot be dispersed by Guizhi Tang (Cinnamon Twig Decoction) nor attacked by Taoren alone. Because heat is bound in the Bladder, differing from blood-heat in the interior, and pathogens have varying depths, Tao Ren Cheng Qi Tang (Peach Kernel Magnolia Bark and Rhubarb Decoction) and Didang Tang (Definitely Ingest Decoction) differ in the urgency of their purgative action.)
Reduce Shuizhi by 10 pieces, and reduce Mengchong and Taoren each by 5 pieces. Divide into four pills. Boil one pill in water per dose. This is named Didang Wan (Definitely Ingest Pill), treating the original disease without symptoms of excessive forgetfulness or mania. Attached is the Dai Didang Wan (Substitute Definite Ingest Pill): Dahuang (4 liang), Shengdi (Rehmannia Root, Rehmanniae Radix), Guiwei (Twig of Angelica Sinensis, Angelicae Sinensis Radix), Taoren (20 seeds, skin and tips removed, ground), Chuanshanjia (Pangolin Scales, Manis Squama), Yuanmingfen (Mirabilite, Natrii Sulfas), Guixin (Cinnamon Bark, Cinnamomi Cortex) [1 liang each for the first six, 3 qian for Guixin], made into pills with honey. (Taoren, Guiwei, and Shengdi use moistening methods to unblock; Guixin uses heat to promote movement; Dahuang and Yuanmingfen use bitter-cold and salty-cold properties to push out stagnation, adding Chuanshanjia...)
(Zhang Zhongjing) Treats Shanghan (Cold Damage) where exterior symptoms are unresolved, heat binds in the Bladder, causing lower abdominal fullness, black stools, free urination, dry thirst, delirium, constituting Blood Stasis, fever resembling mania. Also treats stomach pain, abdominal pain, and hypochondriac pain due to blood stasis; night-onset malaria with excess heat; and acute pain in dysentery due to blood stasis.
Taoren (Peach Kernel, Persicae Semen) [50 seeds, skin and tips removed, ground]
Dahuang (Rhubarb Root, Rheum palmatum) [4 liang]
Mangxiao (Mirabilite, Natrii Sulfas)
Gancao (Licorice Root, Glycyrrhizae Radix)
Guizhi (Cinnamon Twig, Cinnamomi Ramulus) [2 liang]
Dahuang and Mangxiao sweep away heat and remove excess; Gancao harmonizes the Stomach and moderates the Middle Jiao; this constitutes Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct Downward Decoction). When heat is severe, it clashes with blood; when blood gathers, the Liver becomes dry. Therefore, Taoren’s sweet and bitter nature is added to moisten dryness and soothe the Liver. Guizhi’s acrid-hot nature is added to connect directly to the affected area and guide the action. (Yingningsheng [Hua Berning, courtesy name Yingningsheng] states: Hemorrhage and bleeding, various forms of chaotic blood accumulation, initially present thus. Typically, agents like Taoren and Dahuang are used to move blood and break stasis, breaking their momentum, before distinguishing treatments. One asks: if bleeding occurs and purgatives are used again, how can deficiency be tolerated? Yi Fangju replies: Since blood wanders recklessly, losing its proper course, if accumulated stasis is not removed and promoted, reckless flow becomes the norm. How to control it? What leaves departs, what generates regenerates; where is the deficiency? Yu Jiayan states: Using Taoren to reach the blood level, adding Guizhi to resolve exterior pathogens, is similar to using Chaihu (Bupleurum Root, Bupleuri Radix) in Da Chai Hu Tang (Major Bupleurum Decoction) to resolve exterior pathogens. This further shows that pathogens following the Taiyang channel into the interior cannot be resolved without Guizhi. Cheng Jiaoqian states: Wu Ling San (Five-Ingredient Powder with Poria) and Tao Ren Cheng Qi Tang both treat Taiyang invading the Fu organs. One promotes anterior urination focusing on the Qi level; the other promotes posterior evacuation focusing on the Blood level. Their treatments differ.)
Another variation adds Qingpi (Aged Tangerine Peel, Citri Reticulatae Pericarpium), Zhishi (Immature Bitter Orange, Aurantii Fructus), Danggui (Angelica Root, Angelicae Sinensis Radix), Shaoyao (Peony Root, Paeoniae Radix), Sumuzhi (Butter Oil), and Chaihu (Bupleurum Root, Bupleuri Radix) to Tao Ren Cheng Qi Tang, named Tao Ren Cheng Qi Dui Zi. (Adding Qingpi and Zhishi ensures Qi moves when breaking blood. Adding Danggui and Shaoyao removes stasis and generates new blood. Chaihu soothes the Liver, raises clear Yang, and disperses exterior heat; Sumuzhi assists Taoren and Guixin in driving out blood stasis.)