（附论）
夫伤寒为病。六经受邪。始传于三阳。病在表者可汗。其病三日。传于三阴。病入里者
可下
身
止
愈
或
他病
方
犀角汤（出圣济总录）治伤寒过经不解。热结在里。往来寒热。烦渴躁闷。
犀角屑（一两） 柴胡（去苗） 吴蓝（各三分） 大青 升麻（各一两） 乌梅（去
核） 黄芩
（去
取七
分
鳖甲汤 治伤寒过经。半月不解。
鳖甲（去裙 醋炙） 柴胡（去苗） 升麻（各一两） 乌梅（去核半两） 枳实（去
瓤麸炒）
犀角
七分。
去
木通汤 治伤寒十三日。过经不解。脐腹胀满。小便淋涩。烦闷躁渴。
木通（锉） 葛根（锉） 槟榔（锉） 滑石 瞿麦穗 青橘皮（汤洗去白盐炒各一两）
上捣
筛。
万应散 治伤寒过经。心胸痞满。烦躁狂言。积热毒瓦斯。及妇人血风血气。经候
不调。寒热
甘遂（连珠者） 威灵仙（去土） 五灵脂（各一两） 上为散。每服一钱。如伤寒日
数多。
有积
冷即
柴胡汤 治伤寒发汗下之后。过经不解。胸膈满结而不呕。但头汗。往来寒热。
小便不通。
柴胡（去苗二两） 桂（去粗皮） 黄芩（去黑心各一两） 牡蛎（生用） 甘草（炙
各半两）
栝蒌
葱
白五
保安散 治伤寒过经不解。三焦滞闷。身重疼痛。
黄 （锉） 木通（锉） 青橘皮（汤浸去白焙） 桑根白皮（锉） 白术 陈橘皮（汤
浸去白
焙各
汤调
下。
麦奴丸 治伤寒五六日以上不解。热在胸中。口噤不能言。惟欲饮水。为坏伤寒
所不能解。为成死人。精魂已竭。心下才温。以杖发其口开。灌药咽中。药得下则愈
。麦奴。一曰黑
釜底墨 灶底墨 梁上尘 麦奴 黄芩（一方无） 大黄 芒硝（各一两） 麻黄（二
两）
上为
饮水
竟汗
小麦
乃可
柴胡饮子 治解一切肌骨蒸积热作发。寒热往来。表热里和。则发寒。里热表和
。则发热。邪热半在表。半在里。出入进退无和。积寒热往来。阴阳相盛也。蓄热寒战
。表之阳和。正气与邪热并蓄。脉道不行。故身冷脉绝寒战。而反烦渴也。及伤寒发汗
不解。或中外诸邪热。口干烦渴。或下后未愈。汗后营伤。或骨蒸痿。喘嗽。妇人积疾
。产后经病。及小儿伤寒
柴胡 人参 黄芩 甘草 大黄 当归 芍药（各半两） 上为末。每服炒三钱。水一
盏。
生
各
两。上如大劳热病。五七钱。以利为度。未利。更加。使病不再发也。
和解汤 治气血虚。若外感寒邪。身体疼倦。壮热恶寒。腹中疼痛。鼻塞头昏。
痰多咳嗽。
白芍药 桂（各三分） 浓朴 甘草 干姜 白术（各一两） 人参 茯苓（各一两半）
上
为粗
顺气人参散 温和表里。祛逐风寒。治壮热头痛。项强腰痛。心胸气痞。咳嗽痰多
。发热恶
人参 桔梗 干姜 白芷 白术（各一两） 甘草（半两） 上为粗末。每服二钱。水
一盏。
姜
大神术汤（出济生拔粹方）通解四时伤寒。
苍术（四两制） 羌活 防风 芎 黄芩 枳壳（一作枳实） 甘草（各半两） 白
芷（一
两
服四钱
匕
以意消息。随证增损。非发热而渴。非里实心下满。不可用枳实也。
麻黄升麻汤（出直指方）治伤寒发汗。解利不止。血气壅泄。谓红汗者是也
。
麻黄（去节汤泡二两半） 升麻（一两） 黄芩 芍药 石膏（ ） 甘草（生） 茯
苓（各一
两）
败毒散（出直指方）伤寒热证。通用。
人参 赤茯苓 川芎 北梗 羌活 独活 前胡 柴胡 枳壳（制） 甘草（炒等分） 上
锉散
人参顺气散（出鲍氏方）治伤寒壮热。肢节疼痛。手足冷麻。半身不遂。
麻黄（三两） 干姜（一两） 干葛 白术 白芷 桔梗（各六两） 川芎 茯苓 陈
皮（各
四两）
叶。
煎。不
（附论）
伤寒这种病，是六经受到邪气侵袭。起初传变于三阳经，病位在表层的可以用发汗法治疗。如果病程经过三天，邪气传变于三阴经，病位入里的可以用泻下法治疗。
犀角汤（出自《圣济总录》），治疗伤寒过了经界期限而病情未解。热邪结聚在体内，出现忽冷忽热的症状，心烦口渴，烦躁闷乱。
处方组成：犀角屑（一两）、柴胡（去苗）、吴蓝（各三分）、大青、升麻（各一两）、乌梅（去核）、黄芩（去黑心）。
上药捣碎筛成细粉，用水一盏煎至七分，去渣温服。
鳖甲汤，治疗伤寒过了经界期限，半个月病情未解。
处方组成：鳖甲（去裙边，醋炙）、柴胡（去苗）、升麻（各一两）、乌梅（去核半两）、枳实（去瓤，麸炒）。
上药捣碎筛成细粉，每服二钱，水一盏，煎至七分，去渣温服。
木通汤，治疗伤寒十三天，过了经界期限病情未解。脐部及腹部胀满，小便淋漓涩痛，心烦闷乱，躁动口渴。
处方组成：木通（锉碎）、葛根（锉碎）、槟榔（锉碎）、滑石、瞿麦穗、青橘皮（热水洗去白瓤，盐炒，各一两）。
上药捣碎筛成细粉，每服二钱，水一盏，煎至七分，去渣温服。
万应散，治疗伤寒过了经界期限，心胸痞塞胀满，烦躁谵语，积热毒气，以及妇女血风、血气病，月经不调，寒热往来。
处方组成：甘遂（连珠形者）、威灵仙（去土）、五灵脂（各一两）。
上药研为散剂，每次服用一钱。如果伤寒日数较多，有积冷，则加倍用量。
柴胡汤，治疗伤寒经过发汗或泻下治疗后，过了经界期限病情未解。胸膈满闷结滞但不呕吐，仅头部出汗，忽冷忽热，小便不通。
处方组成：柴胡（去苗二两）、桂枝（去粗皮）、黄芩（去黑心，各一两）、牡蛎（生用）、甘草（炙，各半两）、栝蒌根、葱白（五寸）。
上药切碎，用水三大盏，煎至一盏半，去渣分三次温服。
保安散，治疗伤寒过了经界期限病情未解，三焦气机滞闷，身体沉重疼痛。
处方组成：黄芪（锉碎）、木通（锉碎）、青橘皮（热水浸洗去白瓤焙干）、桑根白皮（锉碎）、白术、陈橘皮（热水浸洗去白瓤焙干，各一两）。
上药切碎，每服三钱，水一盏，煎至七分，去渣温服。
麦奴丸，治疗伤寒五六日以上病情未解，热邪在胸中，牙关紧闭不能言语，只想喝水。这是被误治导致的坏伤寒，无法解除，可能导致死亡。此时精气魂魄已竭，只有心下尚有余温，可用杖击打使其口开，灌药入咽喉。若药能咽下则痊愈。
注：麦奴，又称黑釜底墨、灶底墨、梁上尘。
处方组成：麦奴、黄芩（一方无此味）、大黄、芒硝（各一两）、麻黄（二两）。
上药研为细末，炼蜜为丸，如梧桐子大。每次服用十丸，温水送下。若患者能饮水，可随量给予，待其出汗则愈。
柴胡饮子，治疗解除一切肌骨蒸腾积热发作。表现为寒热往来，体表热而体内和，则发寒；体内热而体表和，则发热。邪热一半在表，一半在里，出入进退不和，导致积寒热往来，阴阳相互偏盛。蓄热导致寒战，体表阳气调和，正气与邪热并蓄，脉道不行，所以身体寒冷脉搏微弱甚至摸不到，伴有寒战，反而出现烦渴。也治疗伤寒发汗后病情未解，或者内外各种邪热，口干烦渴，或者泻下后未愈，发汗后营血受损，或者骨蒸痿证，喘咳，妇女积聚疾病，产后经期病，以及小儿伤寒。
处方组成：柴胡、人参、黄芩、甘草、大黄、当归、芍药（各半两）。
上药研为末，每次服用炒过的三钱，水一盏，煎至七分，去渣温服。如果是大病劳热，服用五到七钱，以大便通畅为度。若未通畅，再加量，使疾病不再复发。
和解汤，治疗气血虚弱，若外感寒邪，身体疼痛疲倦，高热恶寒，腹中疼痛，鼻塞头昏，痰多咳嗽。
处方组成：白芍药、桂枝（各三分）、厚朴、甘草、干姜、白术（各一两）、人参、茯苓（各一两半）。
上药切碎，每服三钱，水一盏，煎至七分，去渣温服。
顺气人参散，温和表里，祛除风寒，治疗高热头痛，项强腰痛，心胸气痞，咳嗽痰多，发热恶寒。
处方组成：人参、桔梗、干姜、白芷、白术（各一两）、甘草（半两）。
上药切碎，每服二钱，水一盏，煎至七分，去渣温服。加生姜、大枣同煎。
大神术汤（出自《济生拔粹方》），通治四时伤寒。
处方组成：苍术（四两，制过）、羌活、防风、川芎、黄芩、枳壳（一作枳实）、甘草（各半两）、白芷（一两）。
上药切碎，每服四钱匕，水一盏，煎至七分，去渣温服。根据病情斟酌增减，若非发热且口渴，非里实且心下满，不可使用枳实。
麻黄升麻汤（出自《直指方》），治疗伤寒发汗后，解利不止，血气壅滞泄出，即所谓“红汗”的情况。
处方组成：麻黄（去节，汤泡，二两半）、升麻（一两）、黄芩、芍药、石膏、甘草（生用）、茯苓（各一两）。
上药切碎，水三大盏，煎至一盏半，去渣分三次温服。
败毒散（出自《直指方》），伤寒热证通用。
处方组成：人参、赤茯苓、川芎、北桔梗、羌活、独活、前胡、柴胡、枳壳（制）、甘草（炒，等分）。
上药切碎成散剂，每服二钱，水一盏，煎至七分，去渣温服。加生姜、薄荷同煎。
人参顺气散（出自《鲍氏方》），治疗伤寒高热，肢节疼痛，手足冰冷麻木，半身不遂。
处方组成：麻黄（三两）、干姜（一两）、干葛、白术、白芷、桔梗（各六两）、川芎、茯苓、陈皮（各四两）。
上药切碎，每服三钱，水一盏，煎至七分，去渣温服。加生姜、大枣同煎。
(Attached Discussion)
Shanghan (Cold Damage Disease) is caused by pathogenic factors invading the Six Meridians. Initially, it transmits to the Three Yang meridians; when the disease is in the exterior, diaphoresis (sweating method) can be used. If the disease persists for three days and transmits to the Three Yin meridians, with the pathogen entering the interior, purgation (draining method) can be used.
Xijiao Tang (Rhinoceros Horn Decoction) [from *Shengji Zonglu*]: Treats Shanghan that has passed its meridian cycle without resolution. Heat binds in the interior, presenting with alternating chills and fever, irritability, thirst, restlessness, and oppression.
Ingredients: Xijiao (Rhinoceros Horn) slices (1 liang), Chaihu (Bupleuri Radix, removed sprouts), Wulan (Isatidis Folium or similar, 3 fen each), Daqing (Indigo Naturalis), Shengma (Cimicifugae Rhizoma, 1 liang each), Wu Mei (Mume Fructus, pitted), Huangqin (Scutellariae Radix, removed black heart).
Process: The above herbs are crushed and sifted into fine powder. Add one zhan of water, decoct until 0.7 zhan remains, remove dregs, and take warm.
Biejia Tang (Turtle Shell Decoction): Treats Shanghan that has passed its meridian cycle without resolution for half a month.
Ingredients: Biejia (Testudinis Carapax et Plastrum, removed skirt edge, vinegar-fried), Chaihu (Bupleuri Radix, removed sprouts), Shengma (Cimicifugae Rhizoma, 1 liang each), Wu Mei (Mume Fructus, pitted, 0.5 liang), Zhishi (Aurantii Fructus Immaturus, removed pith, bran-fried).
Process: The above herbs are crushed and sifted into fine powder. Take 2 qian per dose, add one zhan of water, decoct until 0.7 zhan remains, remove dregs, and take warm.
Mutong Tang (Akebia Decoction): Treats Shanghan on the thirteenth day, past its meridian cycle without resolution. Distension and fullness in the umbilical and abdominal regions, dysuria with dribbling and astringency, irritability, restlessness, and thirst.
Ingredients: Mutong (Akebiae Caulis, sliced), Gegen (Puerariae Radix, sliced), Binglang (Arecae Semen, sliced), Huashi (Talcum), Qumai (Dianthi Herba), Qing Ju Pi (Citri Reticulatae Pericarpium Viride, washed in hot water to remove white pith, salt-fried, 1 liang each).
Process: The above herbs are crushed and sifted into fine powder. Take 2 qian per dose, add one zhan of water, decoct until 0.7 zhan remains, remove dregs, and take warm.
Wanying San (Ten-Thousand-Response Powder): Treats Shanghan past its meridian cycle without resolution, presenting with chest and epigastric stuffiness and fullness, irritability, delirious speech, accumulated heat and toxic qi, as well as women's blood wind and blood qi disorders, irregular menstruation, and alternating chills and fever.
Ingredients: Gansui (Kansui Radix, pearl-shaped ones), Weilingxian (Salviae Miltiorrhizae Radix et Rhizoma or Clematidis Radix et Rhizoma, cleaned of soil), Wulingzhi (Trogopteri Dung, 1 liang each).
Process: The above herbs are ground into powder. Take 1 qian per dose. If the number of days of Shanghan is long and there is accumulated cold, double the dosage.
Chaihu Tang (Bupleurum Decoction): Treats Shanghan after sweating or purging, past its meridian cycle without resolution. Fullness and binding in the chest and diaphragm without vomiting, only head sweating, alternating chills and fever, and urinary obstruction.
Ingredients: Chaihu (Bupleuri Radix, removed sprouts, 2 liang), Gui (Cinnamomi Ramulus or Cortex, removed coarse bark), Huangqin (Scutellariae Radix, removed black heart, 1 liang each), Muli (Ostreae Concha, raw use), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 liang each), Gualou Gen (Trichosanthis Radix), Cong Bai (Allii Fistulosi Bulbus, 5 cun).
Process: The above herbs are cut into pieces. Add three large zhan of water, decoct until 1.5 zhan remains, remove dregs, and divide into three doses to take warm.
Bao'an San (Peace-Securing Powder): Treats Shanghan past its meridian cycle without resolution, with stagnation and oppression in the Triple Burner, heavy body, and pain.
Ingredients: Huangqi (Astragali Radix, sliced), Mutong (Akebiae Caulis, sliced), Qing Ju Pi (Citri Reticulatae Pericarpium Viride, soaked in hot water, white pith removed, dried), Sanggen Baipi (Mori Cortex, sliced), Baizhu (Atractylodis Macrocephalae Rhizoma), Chen Ju Pi (Citri Reticulatae Pericarpium, soaked in hot water, white pith removed, dried, 1 liang each).
Process: The above herbs are cut into pieces. Take 3 qian per dose, add one zhan of water, decoct until 0.7 zhan remains, remove dregs, and take warm.
Mainu Wan (Wheat Mildew Pill): Treats Shanghan persisting for five to six days or more without resolution, with heat in the chest, trismus preventing speech, desire only to drink water. This is a "bad Shanghan" resulting from mismanagement, which cannot be resolved and may lead to death. At this stage, essence and soul are exhausted, but warmth remains only in the epigastrium. One may strike the patient with a stick to open the mouth, pour medicine into the throat. If the medicine is swallowed, recovery occurs.
Note: Mainu (Wheat Mildew) is also known as Hei Fudi Mo (Black Pot Bottom Soot), Zaodi Mo (Stove Bottom Soot), Liangshang Chen (Dust from Beams).
Ingredients: Mainu, Huangqin (Scutellariae Radix, absent in some formulas), Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas, 1 liang each), Mahuang (Ephedrae Herba, 2 liang).
Process: The above herbs are ground into fine powder, mixed with refined honey to form pills the size of tung tree seeds. Take 10 pills per dose with warm water. If the patient can drink, give as desired; sweating indicates recovery.
Chaihu Yinzi (Bupleurum Drink): Treats all cases of bone-steaming accumulated heat erupting. Symptoms include alternating chills and fever. If exterior heat is present and interior is harmonious, chills occur; if interior heat is present and exterior is harmonious, fever occurs. Pathogenic heat is half in the exterior and half in the interior, moving in and out without harmony, leading to accumulated alternating chills and fever, with Yin and Yang competing. Accumulated heat causes rigors; when exterior Yang harmonizes, righteous qi and pathogenic heat accumulate together, blocking the pulse channels, causing cold body, absent pulse, rigors, and paradoxical irritability and thirst. It also treats Shanghan where sweating fails to resolve the condition, or various internal/external heat pathogens causing dry mouth and irritability/thirst, or unresolved conditions after purging, Ying-nutrient damage after sweating, bone-steaming atrophy, wheezing and coughing, women's accumulations, postpartum menstrual disorders, and children's Shanghan.
Ingredients: Chaihu (Bupleuri Radix), Renshen (Ginseng Radix), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Dahuang (Rhei Radix et Rhizoma), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Alba, 0.5 liang each).
Process: The above herbs are ground into powder. Take 3 qian of fried powder per dose, add one zhan of water, decoct until 0.7 zhan remains, remove dregs, and take warm. For severe labor-fever illness, take 5-7 qian, stopping when bowel movement occurs. If not loose, increase dosage to prevent recurrence.
Hejie Tang (Harmonizing Decoction): Treats deficiency of Qi and Blood. If externally affected by cold pathogens, symptoms include body pain and fatigue, high fever with aversion to cold, abdominal pain, nasal congestion, dizziness, excessive phlegm, and coughing.
Ingredients: Baishao Yao (Paeoniae Radix Alba), Gui (Cinnamomi Ramulus, 3 fen each), Houpo (Magnoliae Officinalis Cortex), Gancao (Glycyrrhizae Radix et Rhizoma), Jiangjiang (Zingiberis Rhizoma Recens), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang each), Renshen (Ginseng Radix), Fuling (Poria, 1.5 liang each).
Process: The above herbs are cut into coarse pieces. Take 3 qian per dose, add one zhan of water, decoct until 0.7 zhan remains, remove dregs, and take warm.
Shunqi Renshen San (Smooth-Qi Ginseng Powder): Harmonizes exterior and interior, expels wind-cold, treats high fever and headache, stiff neck and lower back pain, chest and epigastric Qi blockage, coughing with excessive phlegm, fever, and aversion to cold.
Ingredients: Renshen (Ginseng Radix), Jiegeng (Platycodonis Radix), Jiangjiang (Zingiberis Rhizoma Recens), Baizhi (Angelicae Dahuricae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang each), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 liang).
Process: The above herbs are cut into coarse pieces. Take 2 qian per dose, add one zhan of water, decoct until 0.7 zhan remains, remove dregs, and take warm. Add fresh ginger and jujube to decoct.
Dashen Zhushu Tang (Great Divine Atractylodes Decoction) [from *Jisheng Bacui Fang*]: Universally treats Shanghan in all four seasons.
Ingredients: Cangzhu (Atractylodis Rhizoma, 4 liang, processed), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Xiong (Ligustici Chuanxiong Rhizoma), Huangqin (Scutellariae Radix), Zhike (Aurantii Fructus, sometimes Zhishi), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 liang each), Baizhi (Angelicae Dahuricae Radix, 1 liang).
Process: The above herbs are cut into pieces. Take 4 qian bi per dose, add one zhan of water, decoct until 0.7 zhan remains, remove dregs, and take warm. Adjust according to symptoms. Do not use Zhishi if there is no fever-thirst or interior excess with epigastric fullness.
Mahuang Shengma Tang (Ephedra and Cimicifuga Decoction) [from *Zhizhi Fang*]: Treats Shanghan after sweating, where relief does not stop, with Qi and Blood stagnation and leakage, known as "red sweat."
Ingredients: Mahuang (Ephedrae Herba, removed nodes, boiled in water, 2.5 liang), Shengma (Cimicifugae Rhizoma, 1 liang), Huangqin (Scutellariae Radix), Shaoyao (Paeoniae Radix), Shigao (Gypsum Fibrosum), Gancao (Glycyrrhizae Radix et Rhizoma, raw), Fuling (Poria, 1 liang each).
Process: The above herbs are cut into pieces. Add three large zhan of water, decoct until 1.5 zhan remains, remove dregs, and divide into three doses to take warm.
Baidu San (Defeat-Toxin Powder) [from *Zhizhi Fang*]: General formula for Shanghan heat syndromes.
Ingredients: Renshen (Ginseng Radix), Chi Fuling (Poria with red mycelium), Chuanxiong (Ligustici Chuanxiong Rhizoma), Bei Jing (Platycodonis Radix), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Qianhu (Peucedani Radix), Chaihu (Bupleuri Radix), Zhike (Aurantii Fructus, processed), Gancao (Glycyrrhizae Radix et Rhizoma, stir-fried, equal parts).
Process: The above herbs are cut into coarse powder. Take 2 qian per dose, add one zhan of water, decoct until 0.7 zhan remains, remove dregs, and take warm. Add fresh ginger and mint to decoct.
Renshen Shunqi San (Ginseng Smooth-Qi Powder) [from *Bao Shi Fang*]: Treats Shanghan with high fever, joint pain, cold and numb hands and feet, and hemiplegia.
Ingredients: Mahuang (Ephedrae Herba, 3 liang), Jiangjiang (Zingiberis Rhizoma Recens, 1 liang), Gange (Puerariae Lobatae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Jiegeng (Platycodonis Radix, 6 liang each), Chuanxiong (Ligustici Chuanxiong Rhizoma), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium, 4 liang each).
Process: The above herbs are cut into pieces. Take 3 qian per dose, add one zhan of water, decoct until 0.7 zhan remains, remove dregs, and take warm. Add fresh ginger and jujube to decoct.