（附论）
夫时气五日少阴受病。少阴脉。贯肾络肺。系于舌本。故得病五日。口热舌干渴而欲饮。
其病在肠。故可下而愈也。
方
大黄饮子（出圣惠方）治时气五日。大热。三部脉悉洪数者。可下之。
川大黄（锉碎微炒一两五钱） 川朴硝（一两五钱） 黄芩（一两） 栀子（三分） 枳
壳（麸
炒微黄去瓤） 甘草（炙微赤锉各半两） 上细锉。和匀。每服半两。以水一大盏。煎至五
分。
去滓。不计时候。温服。
柴胡散（出圣惠方）治时气五日。热毒不除。心神烦闷。大小肠秘涩。或时
头痛。
柴胡（一两去苗） 枳壳（麸炒微黄去瓤一两） 栀子仁（一两） 黄芩（一两） 石
膏（一两）
大青（一两） 川芒硝（一两） 川大黄（一两锉碎炒微黄一两） 麦门冬（一两五钱去心
炒） 甘
草（半两炙微赤锉） 上为散。每服五钱。以水一中盏。煎至五分。去滓。不计时候。温服。
黄芩散（出圣惠方）治时气五日。心腹壅闷。骨节疼痛。背膊烦热。不下饮
食。
黄芩（一两） 栀子仁（一两） 犀角屑（一两） 赤芍药（一两） 柴胡（一两去苗）
枳壳
（一两麸炒微黄） 槟榔（一两） 上为散。每服五钱。以水一中盏。煎至五分。去滓。不
计时
候。温服。
竹茹饮子（出圣惠方）治时气五日。头痛壮热。食则呕逆。
竹茹（五钱） 人参（五钱去芦头） 芦根（五钱） 黄芩（五钱） 栀子仁（五钱） 上
为细
锉。和匀。每服半两。以水一大盏。入生姜半分。煎至五分。去滓。不计时候。温服。
承气汤 治时气五日。胸中壅闷。或时谵语。为肠中有结燥。宜服。
川大黄（一两碎锉微炒） 川朴硝（一两） 枳实（麸炒微黄五钱） 浓朴（去粗皮涂
生姜汁
炙令香熟半两） 上为散。每服四钱。用水一中盏。煎至六分。去滓。不计时候。温服。以
利为度。
消毒散 治时气五日未解。壮热。心神烦躁。
大青（一两） 栀子仁（一两） 葛根（一两锉） 川朴硝（一两） 上为散。每服五
钱。用水
一大盏。入豉五十粒。煎至五分。去滓。下地黄汁半合。更煎三两沸。不计时候。温服。
理中丸 治时行四五日。大下后。或不下。皆患心中结满。两胁痞塞。胸中气急
。厥逆欲绝。心起高胸。手不得近。不过二三日辄便死殁。诸医用泻心汤。余用大小陷
胸汤。病不得疗。重思此或者下后虚逆。而气已不理。而毒复上攻。毒瓦斯相搏。结于
胸中。纵不下者。毒已入胃。胃中不通。毒还冲上。复搏于气。气毒相激故致此病。
疗之先当理其气。次下诸疾。思与增损。
人参（二两） 白术（二两） 甘草（二两） 茯苓（二两） 牡蛎（二两熬） 加栝
蒌根（二两）
干姜（六分炮） 枳实（四枚） 上为末。以蜜和为丸。服如弹子一丸。熟水下。不歇复服。
余
时用此。效的神速。下喉即折。续复与之。不过服五六丸。胸中豁然矣。用药之效未尝见此。
然渴者当加栝蒌。不渴除之。下者当加牡蛎。不下勿用。余因以告领军韩康伯。右卫毛仲祖
。光禄王道预。灵台郎顾君苗。著作商仲堪诸人。并悉用之。叹其应速。于时枳实乃为之贵
。难者曰。伤寒热病。理中温药。今不解之以冷。而救之以温。其可论乎。余应之曰。夫今
诊时行。始于项强赤色。次于失眠发热。中于烦燥见水。终于生疮下利。大率如此耳。忌海
藻、菘菜、酢物、桃、李、雀肉等。
牵马丸 治天行病。四五日。下部生疮。医所不能疗者。
附子（一枚炮） 藜芦（一两炙） 桂心（一两） 巴豆（去皮心熬一两） 上捣筛。
研巴豆如
膏。和散。蜜丸如梧桐子。空腹服二丸。热在膈上下。饮半升。热饮投。吐之。后下。下部
疮自瘥。神良。病家尝牵马买药。因名牵马丸。老小半之。以意消息之。忌野猪肉、生葱、
狸肉、芦笋等物。
知母汤 治欲似天行。四五日。热歇后。时来时往。恶寒微热。不能食者。
知母（二两） 枳实（三两炙） 栀子仁（三两） 豉（一升熬别裹） 上切。以水六
升。煮取
二升半。去滓。分温三服。如人行七八里一服。忌蒜、面。
竹茹饮 热天行五日。头痛壮热食则呕者。
竹茹（二两） 黄芩（二两） 栀子仁（二两） 生姜（三两） 上切。以水五升。煮
取一升六
合。去滓。分温三服。忌蒜、热面等五日。
瓜蒂散 治天行病不即疗。经四五日。渴引饮。心上急强。手不得近。又不得眠
。荒乱。此则是黄。不必待发出黄始服药。凡是心强气急。不眠卧。服此汤吐即瘥。
瓜蒂（按量一合熬令似黄勿令焦） 小豆（一合小弱量用） 上为散。凡有病如前候。
及天
行病。得四五日不歇。皆宜服此方。以浆水饮五合。和散一钱匕服之。二食久必吐。更与半
钱服。吐毕即瘥。中男以上量。以意斟酌服之。
（附论）
当时行疫病经过五天，病邪传入少阴经。少阴经脉贯穿肾脏并联络肺脏，系连于舌根底部。因此患病五天后，会出现口热、舌干、口渴且想喝水的症状。
病邪位于肠道，所以可以通过泻下法使疾病痊愈。
方剂
大黄饮子（出自《圣惠方》），治疗时行疫病第五天，出现大热症状，寸关尺三部脉象全部呈现洪大而数的特征，可以使用泻下法治疗。
川大黄（切碎，微炒一两五钱）、川朴硝（一两五钱）、黄芩（一两）、栀子（三分）、枳壳（麸炒至微黄，去瓤）、甘草（炙至微红，切碎，各半两）。以上药材细切，混合均匀。每次服用半两，用水一大盏，煎煮至剩余五分水量。滤去药渣，不限时间，温服。
柴胡散（出自《圣惠方》），治疗时行疫病第五天，热毒未除，心神烦闷，大小肠便秘涩滞，或偶尔头痛。
柴胡（一两，去苗）、枳壳（麸炒至微黄，去瓤，一两）、栀子仁（一两）、黄芩（一两）、石膏（一两）、大青（一两）、川芒硝（一两）、川大黄（一两，切碎，微炒至微黄）、麦门冬（一两五钱，去心，炒）、甘草（半两，炙至微红，切碎）。以上药材研为散剂。每次服用五钱，用水一中盏，煎煮至剩余五分水量。滤去药渣，不限时间，温服。
黄芩散（出自《圣惠方》），治疗时行疫病第五天，心腹部壅塞闷痛，骨节疼痛，背部和肩膊烦热，无法进食饮水。
黄芩（一两）、栀子仁（一两）、犀角屑（一两）、赤芍药（一两）、柴胡（一两，去苗）、枳壳（一两，麸炒至微黄）、槟榔（一两）。以上药材研为散剂。每次服用五钱，用水一中盏，煎煮至剩余五分水量。滤去药渣，不限时间，温服。
竹茹饮子（出自《圣惠方》），治疗时行疫病第五天，头痛高热，进食后呕吐逆气。
竹茹（五钱）、人参（五钱，去芦头）、芦根（五钱）、黄芩（五钱）、栀子仁（五钱）。以上药材细切，混合均匀。每次服用半两，用水一大盏，加入生姜半分，煎煮至剩余五分水量。滤去药渣，不限时间，温服。
承气汤，治疗时行疫病第五天，胸中壅塞闷痛，或偶尔说胡话，这是因为肠道中有燥屎结聚，适宜服用。
川大黄（一两，碎切，微炒）、川朴硝（一两）、枳实（麸炒至微黄，五钱）、浓朴（去粗皮，涂生姜汁，炙至香熟，半两）。以上药材研为散剂。每次服用四钱，用水一中盏，煎煮至剩余六分水量。滤去药渣，不限时间，温服。以大便通畅为度。
消毒散，治疗时行疫病第五天仍未解除，高热，心神烦躁不安。
大青（一两）、栀子仁（一两）、葛根（一两，切碎）、川朴硝（一两）。以上药材研为散剂。每次服用五钱，用水一大盏，加入豆豉五十粒，煎煮至剩余五分水量。滤去药渣，加入地黄汁半合，再煎煮两三沸。不限时间，温服。
理中丸，治疗时行疫病四五日，经过剧烈泻下后，或者没有泻下，都出现心中结满感，两胁痞塞不通，胸中气急，四肢厥冷欲绝，心窝部高起硬满，手不能触碰。不超过两三天就会死亡。许多医生使用泻心汤，我使用大陷胸汤和小陷胸汤，但病未能治愈。深思此症，或许是泻下后导致正气虚弱逆乱，而气机已经紊乱，同时毒邪再次向上攻冲。毒气相互搏结，凝聚在胸中。即使没有泻下，毒邪也已进入胃中，胃气不通，毒邪反而上冲，再次与气相搏，气毒相互激荡导致此病。治疗时应当先调理气机，其次再攻下其他病症。对此方进行增损思考。
人参（二两）、白术（二两）、甘草（二两）、茯苓（二两）、牡蛎（二两，熬制）、加栝蒌根（二两）、干姜（六分，炮制）、枳实（四枚）。以上药材研为末，用蜂蜜调和制成丸药，如弹子大小的一丸，用温水送服。不停歇地继续服用。平时也使用此方，效果神速迅速。药入喉即见效，继续给予服用。不过服用五六丸，胸中豁然开朗。用药的效果从未见过如此显著。然而口渴者应当加栝蒌，不渴则去除。有腹泻者应当加牡蛎，无腹泻则不用。我曾将此法告知领军韩康伯、右卫毛仲祖、光禄王道预、灵台郎顾君苗、著作商仲堪等人，他们都使用了此方，感叹其反应迅速。当时枳实因此变得珍贵。质疑的人说：伤寒热病，理中丸属于温性药物，现在不解之以寒凉，而救之以温热，这可以吗讨论呢？我回答说：如今诊断时行疫病，开始于项背强直、面色发红，接着是失眠发热，中间表现为烦躁见水，最终出现生疮和下利。大体情况如此。禁忌食用海藻、菘菜、醋物、桃、李、雀肉等。
牵马丸，治疗天行疫病，四五日后，下部生疮，医生无法治愈的情况。
附子（一枚，炮制）、藜芦（一两，炙制）、桂心（一两）、巴豆（去皮心，熬制，一两）。以上药材捣碎筛粉。将巴豆研磨如膏状，与散剂混合，用蜂蜜制成梧桐子大小的丸药。空腹服用二丸。如果热邪在膈肌上下，饮用半升热饮促使呕吐。之后若需泻下，下部疮疡自然痊愈。疗效神奇。病人曾牵着马去买药，因此命名为牵马丸。老人小孩减半剂量，根据病情斟酌调整。禁忌食用野猪肉、生葱、狸肉、芦笋等食物。
知母汤，治疗类似时行疫病的症状，四五日后，热势间歇，时来时往，恶寒伴有轻微发热，无法进食者。
知母（二两）、枳实（三两，炙制）、栀子仁（三两）、豆豉（一升，熬制，单独包裹）。以上药材切碎，用水六升，煮取二升半。滤去药渣，分三次温服。如人行走七八里的时间服用一次。禁忌食用蒜、面食。
竹茹饮，治疗时行疫病第五天，头痛高热，进食后呕吐者。
竹茹（二两）、黄芩（二两）、栀子仁（二两）、生姜（三两）。以上药材切碎，用水五升，煮取一升六合。滤去药渣，分三次温服。禁忌食用蒜、热面等五日。
瓜蒂散，治疗天行疫病未及时治疗，经过四五日，口渴引饮，心上部急迫强硬，手不能触碰，又无法入睡，精神荒乱。这就是发黄的前兆，不必等到皮肤发黄才开始服药。凡是心上部强硬气急，不能安卧的，服用此汤催吐即可痊愈。
瓜蒂（按量一合，熬至似黄色，勿令焦黑）、小豆（一合，视病情轻重酌情减量）。以上药材研为散剂。凡是有上述前候症状，以及天行疫病，得病四五日未缓解的，都适宜服用此方。用浆水五合，调和散剂一钱匕服用。大约两次进食的时间后必然呕吐。若未吐尽，再给予半钱匕服用。吐完后疾病即愈。十五岁以上男子酌情斟酌服用。
(Attached Discussion)
When the epidemic qi (epidemic pathogen) has persisted for five days, the Shaoyin meridian (the channel of the Heart and Kidney) is affected. The Shaoyin pulse traverses the Kidneys and connects with the Lungs, and is linked to the root of the tongue. Therefore, after five days of illness, symptoms such as heat in the mouth, dryness of the tongue, thirst, and a desire to drink occur.
The pathology lies in the intestines; thus, it can be cured by purgation (downward-draining method).
Prescriptions
Dahuang Yinzi (Cassia Decoction, from *Shenghui Fang*): Treats epidemic qi on the fifth day, characterized by high fever and surging, rapid pulses in all three positions (cun, guan, chi) of both hands. Purgation is indicated.
Radix et Rhizoma Rhei (Chuan Dahuang, 1 liang 5 qian, crushed and lightly stir-fried), Natrii Sulfas (Chuan Puxiao, 1 liang 5 qian), Radix Scutellariae (Huangqin, 1 liang), Fructus Gardeniae (Zhizi, 3 fen), Pericarpium Aurantii (Zhiqiao, bran-fried until slightly yellow, pith removed), Radix Glycyrrhizae (Gancao, honey-fried until slightly red, crushed, 0.5 liang each). Finely crush and mix evenly. Take 0.5 liang per dose. Add one large cup of water, decoct until five parts remain. Strain and take warm at any time.
Chaihu San (Bupleurum Powder, from *Shenghui Fang*): Treats epidemic qi on the fifth day where heat toxin remains uneliminated, causing mental restlessness and oppression, constipation of the large and small intestines, or occasional headache.
Radix Bupleuri (Chaihu, 1 liang, remove seedlings), Pericarpium Aurantii (Zhiqiao, bran-fried until slightly yellow, pith removed, 1 liang), Semen Gardeniae (Zhiziren, 1 liang), Radix Scutellariae (Huangqin, 1 liang), Gypsum Fibrosum (Shigao, 1 liang), Cortex Saposhnikoviae? No, Radix Isatidis? Actually Daqing is Folium Isatidis (Daqingye/Indigo Naturalis source, here likely referring to the herb itself, 1 liang), Natrii Sulfas (Chuan Mangxiao, 1 liang), Radix et Rhizoma Rhei (Chuan Dahuang, 1 liang, crushed and lightly stir-fried until slightly yellow), Radix Ophiopogonis (Maimendong, 1 liang 5 qian, remove heart, stir-fried), Radix Glycyrrhizae (Gancao, 0.5 liang, honey-fried until slightly red, crushed). Grind into powder. Take 5 qian per dose. Add one medium cup of water, decoct until five parts remain. Strain and take warm at any time.
Huangqin San (Scutellaria Powder, from *Shenghui Fang*): Treats epidemic qi on the fifth day, characterized by chest and abdominal fullness and oppression, pain in bone joints, heat and irritability in the back and shoulders, and inability to eat or drink.
Radix Scutellariae (Huangqin, 1 liang), Semen Gardeniae (Zhiziren, 1 liang), Cornu Rinocerontis (Xijiao, shredded, 1 liang), Radix Paeoniae Rubra (Chishaoyao, 1 liang), Radix Bupleuri (Chaihu, 1 liang, remove seedlings), Pericarpium Aurantii (Zhiqiao, 1 liang, bran-fried until slightly yellow), Semen Arecae (Binglang, 1 liang). Grind into powder. Take 5 qian per dose. Add one medium cup of water, decoct until five parts remain. Strain and take warm at any time.
Zhuru Yinzi (Bamboo Shavings Decoction, from *Shenghui Fang*): Treats epidemic qi on the fifth day, characterized by headache, high fever, and vomiting after eating.
Spiralis Bambusae In Taeniam (Zhuru, 5 qian), Radix Ginseng (Renshen, 5 qian, remove rhizome), Rhizoma Phragmitis (Lugen, 5 qian), Radix Scutellariae (Huangqin, 5 qian), Semen Gardeniae (Zhiziren, 5 qian). Finely crush and mix evenly. Take 0.5 liang per dose. Add one large cup of water and half a piece of fresh ginger (Jiangsheng), decoct until five parts remain. Strain and take warm at any time.
Chengqi Tang (Harmonizing the Qi Decoction): Treats epidemic qi on the fifth day, characterized by chest oppression and occasional delirious speech, caused by dry stool accumulation in the intestines. It is suitable for this condition.
Radix et Rhizoma Rhei (Chuan Dahuang, 1 liang, crushed and lightly stir-fried), Natrii Sulfas (Chuan Puxiao, 1 liang), Fructus Aurantii Immaturus (Zhishi, bran-fried until slightly yellow, 5 qian), Cortex Magnoliae Officinalis (Noupo, remove rough bark, coat with fresh ginger juice, fry until fragrant and cooked, 0.5 liang). Grind into powder. Take 4 qian per dose. Add one medium cup of water, decoct until six parts remain. Strain and take warm at any time. Use until bowel movement occurs.
Xiaodu San (Detoxification Powder): Treats epidemic qi that has not resolved after five days, characterized by high fever and mental irritability.
Folium Isatidis (Daqing, 1 liang), Semen Gardeniae (Zhiziren, 1 liang), Radix Puerariae Lobatae (Gegen, 1 liang, crushed), Natrii Sulfas (Chuan Puxiao, 1 liang). Grind into powder. Take 5 qian per dose. Add one large cup of water and 50 grains of prepared soybean (Chidou), decoct until five parts remain. Strain, add half a he of juice from Radix Rehmanniae Preparata (Dihuangzhi), boil for two or three boils. Take warm at any time.
Lizhong Wan (Regulate the Middle Pill): Treats epidemic qi on the fourth or fifth day. After severe purgation, or if purgation did not occur, patients suffer from central chest fullness, flank distension, shortness of breath in the chest, cold extremities approaching collapse, and a hard, elevated mass in the epigastrium that cannot be touched. Death may occur within two to three days. Many physicians use Xiexin Tang (Drain the Heart Decoction); I used Xiaoxie Xiong Tang (Minor Drain the Chest Decoction) and Daxie Xiong Tang (Major Drain the Chest Decoction), but the disease was not cured. Upon deep reflection, this condition arises because purgation has led to deficiency and rebellious qi, while the pathogenic toxin attacks upward again. The toxin and qi struggle and knot in the chest. Even without purgation, the toxin enters the stomach, blocking gastric qi, which then rebels upward, clashing with the qi. To treat this, one must first regulate the qi, then address other pathologies. This formula is modified:
Radix Ginseng (Renshen, 2 liang), Radix Atractylodis Macrocephalae (Baizhu, 2 liang), Radix Glycyrrhizae (Gancao, 2 liang), Poria (Fuling, 2 liang), Concha Ostreae (Muli, calcined, 2 liang), add Radix Trichosanthis (Gualougen, 2 liang), Rhizoma Zingiberis Recens? No, Rhizoma Zingiberis Praeparatum (Ganjiang, processed, 6 fen), Fructus Aurantii Immaturus (Zhishi, 4 pieces). Grind into powder, mix with honey to form pills the size of a bullet. Swallow one pill with cooked water. Continue administering without pause. This formula is also used routinely with rapid and effective results. It works immediately upon ingestion. Administer repeatedly. Within five to six pills, the chest will feel clear. Such efficacy in medication use has rarely been seen. However, if thirsty, add Gualougen; if not thirsty, omit it. If there is diarrhea, add Muli; if no diarrhea, do not use it. I informed Han Kangbo (Commander-in-Chief), Mao Zhongzu (Right Guard), Wang Daoyu (Guanglu), Gu Junmiao (Spirit Platform Attendant), Shang Zhengan (Historiographer), and others. They all used it and marveled at its speed. At that time, Zhishi became highly valued. Critics asked: "In cold damage and febrile diseases, Lizhong Wan consists of warming herbs. Why not use cooling herbs to resolve heat, but instead use warming herbs to save the patient?" I replied: "Currently, diagnosing epidemic qi begins with stiffness of the neck and redness, followed by insomnia and fever, then irritability and aversion to water, and finally sores and diarrhea. This is the general pattern. Avoid seaweed, Chinese cabbage, vinegar foods, peaches, plums, and sparrow meat."
Qianma Wan (Horse-Leading Pill): Treats epidemic disease on the fourth or fifth day, where sores appear in the lower body that doctors cannot cure.
Radix Aconiti Lateralis Preparata (Fuzi, roasted, 1 piece), Rhizoma Veratri (Lilu, 1 liang, fried), Cinnamomi Cortex (Guixin, 1 liang), Semen Crotonis (Badou, peel and remove heart, roast, 1 liang). Pound and sieve. Grind Badou into a paste, mix with the powder, and form pills the size of a sophora seed with honey. Take two pills on an empty stomach. If heat is above or below the diaphragm, drink half a sheng of hot liquid to induce vomiting. If downward purgation is needed later, the lower sores will heal naturally. This is miraculous. Patients once led horses to buy this medicine, hence the name Qianma Wan. Reduce the dose for the elderly and children; adjust according to judgment. Avoid wild boar meat, raw green onions, civet cat meat, and reed shoots.
Zhimu Tang (Anemarrhena Decoction): Treats conditions resembling epidemic qi. On the fourth or fifth day, after fever subsides intermittently, chills alternate with mild fever, and appetite is lost.
Rhizoma Anemarrhenae (Zhimu, 2 liang), Fructus Aurantii Immaturus (Zhishi, 3 liang, fried), Semen Gardeniae (Zhiziren, 3 liang), Fructus Sojae Preparatus (Chi, 1 sheng, roasted separately wrapped). Cut into pieces. Add six sheng of water, decoct to obtain two and a half sheng. Strain. Divide into three warm doses. Take one dose every seven to eight li of walking distance. Avoid garlic and wheat noodles.
Zhuru Yin (Bamboo Shavings Drink): Treats epidemic qi on the fifth day, characterized by headache, high fever, and vomiting after eating.
Spiralis Bambusae In Taeniam (Zhuru, 2 liang), Radix Scutellariae (Huangqin, 2 liang), Semen Gardeniae (Zhiziren, 2 liang), Rhizoma Zingiberis Recens (Jiangsheng, 3 liang). Cut into pieces. Add five sheng of water, decoct to obtain one sheng and six he. Strain. Divide into three warm doses. Avoid garlic and hot noodles for five days.
Gua Di San (Melon Seed Powder): Treats epidemic disease not treated promptly. After four or five days, there is excessive thirst, upper chest tightness and hardness that cannot be touched, insomnia, and mental confusion. This indicates impending jaundice (yellowing); do not wait for visible jaundice before administering medicine. For any case of upper chest tightness, shortness of breath, and inability to lie down, taking this decoction to induce vomiting will result in recovery.
Fructus Momordicae (Gua Di, measure appropriate amount, one he, roast until yellowish but not burnt), Coix Seed (Xiaodou, one he, adjust quantity based on weakness). Grind into powder. For any preceding symptoms or epidemic disease persisting for four or five days without relief, this prescription is suitable. Take with five he of fermented grain water (Jiangshui) mixed with one qian bi of powder. Vomiting will occur after approximately two meal intervals. If necessary, administer another half qian bi. Recovery follows complete vomiting. Adjust dosage for males over ten years old based on judgment.