芍药（三两味酸微寒） 甘草（三两炙味甘平） 附子（一枚炮去皮破八片味辛热）
（芍药之酸。收敛津液而益营。附子之辛热。固阳气而补胃。甘草之甘。调和辛酸而安
正气
发汗。若下之。病仍不解。烦躁者。茯苓四逆汤主之。
（发汗若下。病宜解也。若病仍不解。则发汗。外虚阳气。下之。内虚阴气。阴阳俱虚。
邪
茯苓四逆汤方
茯苓（六两味甘平） 人参（一两味甘温） 附子（一枚生用去皮破八片味辛热） 甘
草（二
两炙
（四逆汤以补阳。加茯苓、人参以益阴。） 上五味。以水五升。煮取三升。去滓。温
服
七
发汗后。恶寒者。虚故也。不恶寒。但热者。实也。当和胃气。与调胃承气汤。
（汗出而恶寒者。表虚也。汗出而不恶寒。但热者。里实也。经曰。汗出不恶寒者。此
表解
太阳病。发汗后。大汗出。胃中干。烦躁不得眠。欲得饮水者。少少与饮之。令胃气和
则愈
（发汗已解。胃中干。烦躁不得眠。欲饮水者。少少与之。胃气得润则愈。若脉浮者。
表未
也。
五苓散方
猪苓（十八铢味甘平去皮） 泽泻（一两六铢半味酸咸） 茯苓（十八铢味甘平） 桂
（半两
去皮
（淡者。一也。口入一而为甘。甘甚而反淡者。甘缓而淡渗。猪苓、白术、茯苓三味之
甘
以
发汗已。脉浮数。烦渴者。五苓散主之。
（发汗已。脉浮数者。表邪未尽也。烦渴。亡津液。胃燥也。与五苓散。和表润燥。）
伤寒汗出而渴者。五苓散主之。不渴者。茯苓甘草汤主之。
（伤寒汗出而渴者。亡津液。胃燥。邪气渐传里也。五苓散以和表里。若汗出不渴者。
邪气
茯苓甘草汤方
茯苓（二两味甘平） 桂枝（二两去皮味辛热） 生姜（三两切味辛温） 甘草（一两
炙味甘
平）
（茯苓、甘草之甘。益津而和卫。桂枝、生姜之辛。助阳气而解表。） 上四味。以水
四
升。
中风发热。六七日不解而烦。有表里证。渴欲饮水。水入则吐者。名曰水逆。五苓散主
之。
（中风发热。至六七日则当解。若不解。烦者。邪在表也。渴欲饮水。邪传里也。里热
甚则
故名
未持脉时。病患手叉自冒沁。师因教试令咳而不咳者。此必两耳聋无闻也。所以然者。
以重
（发汗多亡阳。胸中阳气不足者。病患手叉自冒沁。师见外证。知阳气不足也。又试令
咳而
发汗后。饮水多。必喘。以水灌之。亦喘。
（喘肺疾。饮水多喘者。饮冷伤肺也。以冷水灌洗而喘者。形寒伤肺也。）
发汗后。水药不得入口。为逆。若更发汗。必吐下不止。
（发汗后。水药不得入口。为之吐逆。发汗亡阳。胃中虚冷也。若更发汗。则愈损阳气。
胃
发汗吐下后。虚烦不得眠。若剧者。必反复颠倒。心中懊 。栀子豉汤主之。
（发汗吐下后。邪热乘虚客于胸中。谓之虚烦者。热也。胸中烦热。郁闷而不得发散者
是也
昏。
者因
栀子豉汤方
栀子（十四枚擘味苦寒） 香豉（四合绵裹味苦寒）
（酸苦涌泄为阴。苦以涌吐。寒以胜热。栀子豉汤相合。吐剂宜矣。） 上二味。以水
四
升。
若少气者。栀子甘草豉汤主之。若呕者。栀子生姜豉汤主之。
（少气者。热伤气也。加甘草以益气。呕者。热烦而气逆也。加生姜以散气。少气则气
为热
发汗。若下之而烦热。胸中窒者。栀子豉汤主之。
（阳受气于胸中。发汗若下。使阳气不足。邪热客于胸中。结而不散。故烦热而胸中窒
塞。
伤寒五六日。大下之后。身热不去。心中结痛者。未欲解也。栀子豉汤主之。
（伤寒五六日。邪气在里之时。若大下后。身热去。心中空者为欲解。若大下后。身热
去。而心结痛者。结胸也。身热不去。心中结痛者。虚烦也。结胸。为热结胸中。为实。是
热气
六七日为欲解之时。以热为虚烦。故云未欲解也。与栀子豉汤以吐除之。）
伤寒下后。心烦腹满。起卧不安者。栀子浓朴汤主之。
（下后但腹满。而不心烦。即邪气入里。为里实。但心烦而不腹满。即邪气在胸中。为
虚烦
朴汤
栀子浓朴汤方
栀子（十四枚擘味苦寒） 浓朴（四两姜炙味苦温） 枳实（四枚水浸去瓤炒味苦寒）
（酸苦涌泄。栀子之苦。以涌虚烦。浓朴、枳实之苦。以泄腹满。） 以上三味。以水
三
升半
伤寒。医以丸药大下之。身热不去。微烦者。栀子干姜汤主之。
（凡药不能除热。但损正气。邪气乘虚留于胸中。而未入深者。则身热不去而微烦。与
栀子
栀子干姜汤方
栀子（十四枚擘味苦寒） 干姜（二两味辛热）
（苦以涌之。栀子之苦以吐烦。辛以润之。干姜之辛以益气。） 上二味。以水三升半。
煮取
凡用栀子汤。病患旧微溏者。不可与服之。
（病患旧微溏者。里虚而寒在下也。虽烦。则非蕴热。故不可与栀子汤。内经曰。先泄
而后
太阳病。发汗。汗出不解。其人仍发热。心下悸。头眩。身 动振振欲擗地者。真武汤
主
里虚
咽喉干燥者。不可发汗。
（津液不足也。）
淋家。不可发汗。发汗必便血。
（膀胱里热则淋。反以汤药发汗。亡耗津液。增益客热。膀胱虚燥。必小便血。）
疮家。虽身疼痛。不可发汗。发汗则 。
（表虚聚热。则生疮。疮家身疼。如伤寒。不可发汗。发汗。则表气愈虚。热势愈甚生
风。
衄家。不可发汗。汗出必额上陷。脉急紧。直视不能 。不得眠。
（衄者。上焦亡血也。若发汗。则上焦津液枯竭。经络干涩。故额上陷。脉急紧。诸脉
者。
则目
亡血家。不可发汗。发汗则寒栗而振。
（针经曰。夺血者无汗。夺汗者无血。亡血发汗。则阴阳俱虚。故寒栗而振摇。）
汗家。重发汗。必恍惚心乱。小便已阴疼。与禹余粮。丸阙。
（汗者。心之液。汗家重发汗。则心虚。恍惚心乱。夺汗则无水。故小便已阴中疼。）
病患有寒。复发汗。胃中冷。必吐蛔。
（病患有寒。则当温散。反发汗损阳气。胃中冷。必吐蛔也。）
本发汗。而复下之。此为逆也。若先发汗。治不为逆。本先下之。而反汗之。为逆。若
先下
（病在表者。汗之为宜。下之为逆。病在里者。下之为宜。汗之为逆。经曰。阳盛阴虚。
汗
伤寒医下之。续得下利清谷不止。身疼痛者。急当救里。后身疼痛。清便自调者。急当
救表。救里。宜四逆汤。救表。宜桂枝汤。
（伤寒下之。续得下利清谷不止。身疼痛者。急当救里者。以里气不足。必先救之。急
与四
病
病发热。头痛。脉反沉。若不瘥。身体疼痛。当救其里。宜四逆汤。
（发热头痛。表病也。脉反沉者。里脉也。经曰。表有病者。脉当浮大。今脉反沉迟。
故知
太阳病。先下之而不愈。因复发汗。以此表里俱虚。其人因致冒。冒家汗出自愈。所以
然者
（冒者郁也。下之则里虚而亡血。汗之则表虚而亡阳。表里俱虚。寒气怫郁。其人因致
冒。
冒家欲
太阳病。未解。脉阴阳俱停。必先振栗。汗出而解。但阳脉微者。先汗出而解。但阴脉
微者
（脉阴阳俱停。无偏胜者。阴阳气和也。经曰。寸口。关上。尺中。三处大小浮沉迟数
同等
足
虚
太阳病。发热。汗出者。此为营弱卫强。故使汗出。欲救邪风者。宜桂枝汤。
（太阳中风。风并于卫。则卫实而营虚。营者。阴也。卫者。阳也。发热汗出。阴弱阳
强也
伤寒五六日。中风。往来寒热。胸胁苦满。默默不欲饮食。心烦。喜呕。或胸中烦而不
呕。
小柴
（病有在表者。有在里者。有在表里之间者。此邪气在表里之间。谓之半表半里证。五
六日
来寒热
证
邪
今只言胸胁
静也。邪在
表之里。在
未至于必不能食
也。邪初入里。
或为之证。）
小柴胡汤方
柴胡（半斤味苦微寒） 黄芩（三两味苦寒） 人参（三两味甘温） 甘草（三两味甘
平） 半夏（
（内经曰。热淫于内。以苦发之。柴胡、黄芩之苦。以发传邪之热。里不足者。以甘缓
之。
在半
去
加减法
若胸中烦而不吐。去半夏、人参。加栝蒌实一枚。
（胸中烦而不呕。热聚而气不逆也。甘者令人中满。方热聚。无用人参之补。辛散逆气。
既
若渴者。去半夏。加人参。合前成四两半。栝蒌根四两。
（半夏燥津液。非渴者所宜。人参甘而润。栝蒌根苦而凉。彻热生津。二物为当。）
若腹中痛者。去黄芩。加芍药三两。
（去黄芩恶寒中。加芍药以通壅。）
若胁下痞硬。去大枣。加牡蛎四两。
（甘令人中满。痞者去大枣之甘。咸以 之。痞硬者加牡蛎之咸。）
若心下悸。小便不利者。去黄芩。加茯苓四两。
（饮而水蓄不行。为悸。小便不利。内经曰。肾欲坚。急食苦以坚之。则水益坚。故去
黄芩
若不渴。外有微热者。去人参。加桂三两。温覆取微汗愈。
（不渴者。里和也。故去人参。外有微热。表未解也。加桂以发汗。）
若咳者。去人参、大枣、生姜。加五味子半升。干姜二两。
（咳者。气逆也。甘则壅气。故去人参、大枣。内经曰。肺欲收。急食酸以收之。五味
子之
血弱气尽。腠理开。邪气因入。与正气相搏。结于胁下。正邪分争。往来寒热。休作有
时。
（人之气血。随时盛衰。当月郭空之时。则为血弱气尽。腠理开疏之时也。邪气乘虚。
伤人
腠理
而结
随经
相搏
服柴胡汤已。渴者。属阳明也。以法治之。
（服小柴胡汤。表邪已而渴。里邪传于阳明也。以阳明治之。）
得病六七日。脉迟浮弱。恶风寒。手足温。医二三下之。不能食而胁下满痛。面目及身
黄。
者哕
（得病六七日。脉迟浮弱。恶风寒。手足温。则邪气在半表半里。未为实。反二三下之。
虚
悉
涩
而
呕
伤寒四五日。身热恶风。颈项强。胁下满。手足温而渴者。小柴胡汤主之。
（身热恶风。颈项强者。表未解也。胁下满而渴者。里不和也。邪在表。则手足通热。
邪在
伤寒阳脉涩。阴脉弦。法当腹中急痛者。先与小建中汤。不瘥者。与小柴胡汤主之。
（脉阳涩。阴弦。而腹中急痛者。当作里有虚寒治之。与小建中汤。温中散寒。若不瘥
者。
里之
小建中汤方
桂枝（三两去皮味辛热） 甘草（三两炙味甘平） 大枣（十二枚擘味甘温） 芍药（六
两味酸微
（建中者。建脾也。内经曰。脾欲缓。急食甘以缓之。胶饴、大枣、甘草之甘。以缓中
也。
气虚
饴。
伤寒中风。有柴胡证。但见一证便是。不必悉具。
（柴胡证。是邪气在表里之间也。或胸中烦而不呕。或渴。或腹中痛。或胁下痞硬。或
心下
候全
凡柴胡汤病证而下之。若柴胡证不罢者。复与柴胡汤。必蒸蒸而振。却发热汗出而解。
（邪在半表半里之间。为柴胡证。即未作里实。医便以药下之。若柴胡证仍在者。虽下
之。
气欲
伤寒二三日。心中悸而烦者。小建中汤主之。
（伤寒二三日。邪气在表。未当传里之时。心中悸而烦。是非邪气搏所致。心悸者。气
虚也
太阳病。过经十余日。反二三下之。后四五日。柴胡证仍在者。先与小柴胡汤。呕不止。
心
（日数过多。累经攻下。而柴胡证不罢者。亦须先与小柴胡汤。以解其表。经曰。凡柴
胡汤
微烦
大柴胡汤方
柴胡（半斤味甘平） 黄芩（三两味苦寒） 芍药（三两味酸微寒） 半夏（半斤洗味
辛温） 生姜
两味苦寒）
（柴胡、黄芩之苦。入心而折热。枳实、芍药之酸苦。涌泄而扶阴。辛者散也。半夏之
辛。
升。
伤寒十三日不解。胸胁满而呕。日晡所发潮热。已而微利。此本柴胡证。下之而不得利。今
反利者。知医以丸药下之。非其治也。潮热者。实也。先宜小柴胡汤。以解外。后以柴胡加
芒硝汤主之。
（伤寒十三日。再传经尽。当解之时也。若不解。胸胁满而呕者。邪气犹在表里之间。
此为
入腑
解
伤寒十三日不解。过经。谵语者。以有热也。当以汤下之。若小便利者。大盒饭硬。而
反下
内实
（伤寒十三日。再传经尽。谓之过经。谵语者。阳明胃热也。当以诸承气汤下之。若小
便利者。津液漏渗。大盒饭硬。反下利者。知医以丸药下之也。下利。脉微而厥者。虚寒也
。今脉调和。则非虚寒。由肠虚胃热。胁热而利也。与调胃承气汤。以下胃热。）
太阳病不解。热结膀胱。其人如狂。血自下。下者愈。其外不解者。尚未可攻。当先解
外。
（太阳。膀胱经也。太阳经邪热不解。随经入腑。为热结膀胱。其人如狂者。为未至于
狂但
为蓄
少腹
外。
桃核承气汤方
芍药（三两，味酸，性微寒） 甘草（三两，炙用，味甘，性平） 附子（一枚，炮制，去皮，破成八片，味辛，性热）
（芍药的酸味，能收敛津液而滋养营气。附子的辛热之性，能固护阳气而温补胃腑。甘草的甘味，能调和辛、酸之性从而安定正气。）
若误用攻下法，病证仍未解除，出现烦躁症状的，用茯苓四逆汤主治。
（发汗或攻下后，病证本应解除。如果病证仍未解除，说明发汗导致体表阳气虚弱，攻下导致体内阴气虚弱，阴阳俱虚。）
茯苓四逆汤方
茯苓（六两，味甘，性平） 人参（一两，味甘，性温） 附子（一枚，生用，去皮，破成八片，味辛，性热） 甘草（二两，炙用）
（四逆汤用于补益阳气，加入茯苓、人参以增益阴气。） 以上五味药，用水五升，煮取三升，去渣，温服七合。
发汗后，出现恶寒症状的，是正气虚弱的缘故；不恶寒，只发热的，是实证。应当调和胃气，给予调胃承气汤。
（汗出而恶寒的，是表虚；汗出而不恶寒，只发热的，是里实。经书说：汗出不恶寒的，这是表证已解。）
太阳病，发汗后，大汗出，导致胃中干燥，烦躁不得安睡，想要喝水的，少量多次地给予饮水，使胃气调和则痊愈。
（发汗后病解，因胃中干燥，烦躁不得安睡，想喝水的，少量给予饮水，胃气得滋润则痊愈。如果脉象浮的，说明表证未解。）
五苓散方
猪苓（十八铢，味甘，性平，去皮） 泽泻（一两六铢半，味酸咸） 茯苓（十八铢，味甘，性平） 桂枝（半两，去皮）
（淡味属一。入口尝为甘，甘甚而反显淡者，是因为甘能缓急而淡能渗湿。猪苓、白术、茯苓三味的甘淡之性……）
发汗后，脉象浮数，心烦口渴的，用五苓散主治。
（发汗后，脉象浮数的，说明表邪未尽。心烦口渴，是津液耗伤，胃燥所致。给予五苓散，以调和表里，润燥生津。）
伤寒汗出而口渴的，用五苓散主治；不口渴的，用茯苓甘草汤主治。
（伤寒汗出而口渴的，是津液耗伤，胃燥，邪气逐渐传入里部。五苓散能调和表里。如果汗出不口渴的，说明邪气……）
茯苓甘草汤方
茯苓（二两，味甘，性平） 桂枝（二两，去皮，味辛，性热） 生姜（三两，切，味辛，性温） 甘草（一两，炙，味甘，性平）
（茯苓、甘草的甘味，能益津液而调和卫气；桂枝、生姜的辛味，能助阳气而解表。） 以上四味药，用水四升，煮取……
中风发热，六七天未解且心烦，伴有表证和里证，想喝水，水入即吐的，名叫水逆证，用五苓散主治。
（中风发热，到六七天本该解除。如果未解除且心烦，说明邪气在表。想喝水，说明邪气传里。里热盛则……故名……）
还没诊脉时，病人双手交叉护住心胸部。医生于是教他咳嗽，他不咳嗽的，这一定是双耳失聪听不见声音。之所以这样，是因为重发汗……
（发汗过多导致亡阳，胸中阳气不足的病人，双手交叉护住心胸部。医生看到外在证候，知道阳气不足。又试让他咳嗽……）
发汗后，饮水过多，必然气喘；用冷水淋浴，也会气喘。
（气喘是肺部的疾病。饮水多导致气喘的，是饮冷损伤肺气；用冷水淋浴导致气喘的，是形体受寒损伤肺气。）
发汗后，水药无法入口，这是逆证。如果再次发汗，必然呕吐腹泻不止。
（发汗后，水药无法入口，称为吐逆。发汗导致亡阳，胃中虚冷。如果再次发汗，则进一步损伤阳气，胃……）
发汗、催吐、攻下后，出现虚烦不得安睡，如果严重的，必然翻来覆去，心中懊恼，用栀子豉汤主治。
（发汗、催吐、攻下后，邪热乘虚客于胸中，称为虚烦，这是热证。胸中烦热，郁闷而不能发散就是这种情况……昏沉。）
栀子豉汤方
栀子（十四枚，掰开，味苦，性寒） 香豉（四合，绵裹，味苦，性寒）
（酸苦涌泄属于阴。苦能涌吐，寒能胜热。栀子豉汤配合使用，作为吐剂是合适的。） 以上两味药，用水四升，煮……
如果少气的，用栀子甘草豉汤主治；如果呕吐的，用栀子生姜豉汤主治。
（少气的，是热伤元气。加甘草以益气。呕吐的，是热烦导致气逆。加生姜以散气。少气则气被热……）
发汗，或者攻下后，出现烦热，胸中窒塞感的，用栀子豉汤主治。
（阳气受气于胸中。发汗或攻下，使阳气不足，邪热客于胸中，结聚不散，所以烦热而胸中窒塞。）
伤寒五六天，经过大力攻下之后，身体发热不去，心中结痛的，病未欲解。用栀子豉汤主治。
（伤寒五六天，是邪气在里的时期。如果大力攻下后，身热退去，心中空虚的是欲解；如果大力攻下后，身热退去，但心中结痛的是结胸证。身热不去，心中结痛的是虚烦证。结胸证，是热结胸中，属实证。热气……）
（六七天是欲解之时。因为将热视为虚烦，所以说未欲解。给予栀子豉汤以涌吐去除之。）
伤寒攻下后，心烦腹满，坐卧不安的，用栀子厚朴汤主治。
（攻下后只腹满，而不心烦，即邪气入里，为里实证。只心烦而不腹满，即邪气在胸中，为虚烦证……厚朴汤）
栀子厚朴汤方
栀子（十四枚，掰开，味苦，性寒） 厚朴（四两，姜炙，味苦，性温） 枳实（四枚，水浸去瓤炒，味苦，性寒）
（酸苦涌泄。栀子的苦味，用以涌吐虚烦；厚朴、枳实的苦味，用以泄除腹满。） 以上三味药，用水三升半，煮……
伤寒。医生用丸药大力攻下，身体发热不去，轻微心烦的，用栀子干姜汤主治。
（凡药不能除热，反而损伤正气。邪气乘虚留于胸中，而未深入，则身热不去而轻微心烦。给予栀子……）
栀子干姜汤方
栀子（十四枚，掰开，味苦，性寒） 干姜（二两，味辛，性热）
（苦以涌之，栀子的苦味用以吐除烦热；辛以润之，干姜的辛味用以益气。） 以上两味药，用水三升半，煮取……
凡是使用栀子汤，病人平时大便微溏的，不可服用。
（病人平时大便微溏的，是里虚而寒在下。虽然心烦，但不是蕴热，所以不可与栀子汤。内经说：先泄泻而后……）
太阳病，发汗，汗出后病不解，其人仍然发热，心下悸动，头晕，身体震颤动摇，想要趴在地上的，用真武汤主治。
（里虚）
患淋病的人，不可发汗。发汗必然导致尿血。
（膀胱里有热则淋。如果用汤药发汗，耗损津液，增加客热，膀胱虚燥，必然小便出血。）
患疮疡的人，即使身体疼痛，也不可发汗。发汗则……
（表虚聚热，则生疮。疮家身疼，像伤寒一样，不可发汗。发汗，则表气更虚，热势更甚生风……）
患鼻衄的人，不可发汗。汗出必然额上动脉凹陷，脉象急紧，直视不能转动，不得安眠。
（衄血，是上焦亡血。如果发汗，则上焦津液枯竭，经络干涩，所以额上凹陷，脉象急紧。诸脉……则目……）
亡血的人，不可发汗。发汗则寒战颤抖。
（针经说：夺血者无汗，夺汗者无血。亡血而发汗，则阴阳俱虚，所以寒战颤抖。）
多汗的人，再发汗，必然神志恍惚，心中乱，小便后阴部疼痛，给予禹余粮丸（方缺）。
（汗是心的体液。多汗的人再发汗，则心虚，神志恍惚心中乱。夺汗则无水，所以小便后阴中疼痛。）
患有寒证的病人，又发汗，胃中寒冷，必然吐蛔虫。
（患有寒证的病人，应当温散。反而发汗损伤阳气，胃中寒冷，必然吐蛔虫。）
本应先发汗，反而攻下，这是逆治。如果先发汗，治疗不为逆。本应先攻下，反而发汗，这是逆治。如果先攻下……
（病在表的，发汗为宜，攻下为逆。病在里的，攻下为宜，发汗为逆。经书说：阳盛阴虚……）
伤寒医生攻下后，接着出现下利清谷不止，身体疼痛的，紧急当救里。后来身体疼痛，大小便正常的，紧急当救表。救里，宜用四逆汤。救表，宜用桂枝汤。
（伤寒攻下后，接着出现下利清谷不止，身体疼痛的，紧急当救里，是因为里气不足，必须先救它。紧急给予四……病……）
病人发热，头痛，脉象反而沉，如果不愈，身体疼痛的，当救其里，宜用四逆汤。
（发热头痛，是表病。脉象反而沉的，是里脉。经书说：表有病者，脉应当浮大。现在脉象反而沉迟，故知……）
太阳病，先攻下而不愈，因此再次发汗，以此导致表里俱虚。其人因此出现头目昏蒙。昏蒙的病人，汗出自然痊愈。之所以这样……
（冒，是郁结。攻下则里虚而亡血，发汗则表虚而亡阳。表里俱虚，寒气怫郁，其人因此出现昏蒙。……）
（昏蒙的病人想要……）
太阳病，未解，脉象寸关尺三部都潜伏不出，必先出现振栗，汗出而解。如果只有阳脉微的，先汗出而解。如果只有阴脉微的……
（脉象寸关尺三部都潜伏不出，没有偏胜，说明阴阳气和。经书说：寸口、关上、尺中，三处大小浮沉迟数同等……足……虚）
太阳病，发热，汗出的，这是营弱卫强。所以要救治邪风的，宜用桂枝汤。
（太阳中风，风邪并入卫分，则卫实而营虚。营是阴，卫是阳。发热汗出，是阴弱阳强……）
伤寒五六天，中风，往来寒热，胸胁苦满，默默不欲饮食，心烦，喜呕。或者胸中烦而不……小柴胡……
（病有在表的，有在里的，有在表里之间的。这是邪气在表里之间，称为半表半里证。五六日……来寒热……证……邪……）
（现在只说胸胁……静也。邪在……表之里，在……未至于必不能食……也。邪初入里……或为之证。）
小柴胡汤方
柴胡（半斤，味苦，微寒） 黄芩（三两，味苦，性寒） 人参（三两，味甘，性温） 甘草（三两，味甘，性平） 半夏……
（内经说：热淫于内，以苦发之。柴胡、黄芩的苦味，用以发散传变之邪的热。里不足的，以甘缓之……在半……去……）
加减法
如果胸中烦而不呕吐的，去掉半夏、人参，加栝蒌实一枚。
（胸中烦而不呕，是热聚而气不逆。甘味使人中满。方有热聚，无用人参之补。辛散逆气，既然……）
如果口渴的，去掉半夏，加人参，合前共成四两半。加栝蒌根四两。
（半夏燥津液，不适合口渴者。人参甘而润，栝蒌根苦而凉，彻热生津，这两样药合适。）
如果腹中痛的，去掉黄芩，加芍药三两。
（去掉黄芩以免恶寒伤中。加芍药以通壅滞。）
如果胁下痞硬，去掉大枣，加牡蛎四两。
（甘味使人中满。痞证去掉大枣的甘味。咸味软坚。痞硬加牡蛎的咸味。）
如果心下悸动，小便不利的，去掉黄芩，加茯苓四两。
（饮水而水蓄不行，导致悸动。小便不利。内经说：肾欲坚，急食苦以坚之，则水益坚。所以去掉黄芩……）
如果不渴，外有微热的，去掉人参，加桂枝三两，温覆取微汗则愈。
（不渴，说明里和。所以去掉人参。外有微热，说明表未解。加桂枝以发汗。）
如果咳嗽的，去掉人参、大枣、生姜，加五味子半升，干姜二两。
（咳嗽是气逆。甘味壅气，所以去掉人参、大枣。内经说：肺欲收，急食酸以收之。五味子之……）
血弱气尽，腠理开，邪气因入，与正气相搏，结于胁下。正邪分争，往来寒热，休作有时。
（人的气血，随时间盛衰。当月郭空的时候，就是血弱气尽，腠理开疏的时候。邪气乘虚伤人……腠理……而结……随经……相搏……）
服用柴胡汤后，出现口渴的，属于阳明病，按阳明法治之。
（服用小柴胡汤，表邪已解而口渴，是里邪传于阳明。用阳明法治之。）
得病六七天，脉迟浮弱，恶风寒，手足温，医生反复攻下，不能食而胁下满痛，面目及身黄……哕……
（得病六七天，脉迟浮弱，恶风寒，手足温，则邪气在半表半里，未为实证。反而反复攻下，虚……悉……涩……而……呕……）
伤寒四五天，身热恶风，颈项强，胁下满，手足温而渴的，用小柴胡汤主治。
（身热恶风，颈项强的，是表未解。胁下满而渴的，是里不和。邪在表，则手足通热。邪在……）
伤寒阳脉涩，阴脉弦，法当腹中急痛的，先与小建中汤，不愈的，与小柴胡汤主治。
（脉阳涩，阴弦，而腹中急痛的，当作里有虚寒治之。给予小建中汤，温中散寒。如果不愈者……里之……）
小建中汤方
桂枝（三两，去皮，味辛，性热） 甘草（三两，炙，味甘，性平） 大枣（十二枚，掰开，味甘，性温） 芍药（六两，味酸，微……）
（建中者，建立中气，即健脾。内经说：脾欲缓，急食甘以缓之。胶饴、大枣、甘草的甘味，用以缓中……气虚……饴……）
伤寒中风，有柴胡证，但见一证便是，不必悉具。
（柴胡证，是邪气在表里之间。或胸中烦而不呕，或渴，或腹中痛，或胁下痞硬，或心下……候全……）
凡是柴胡汤病证而被攻下的，如果柴胡证不罢的，再给予柴胡汤，必然蒸蒸而振，随后发热汗出而解。
（邪在半表半里之间，为柴胡证，即未作里实。医生便用药攻下。如果柴胡证仍在，虽下之……气欲……）
伤寒二三天，心中悸而烦的，用小建中汤主治。
（伤寒二三天，邪气在表，未到传里的时期。心中悸而烦，不是邪气搏结所致。心悸是气虚……）
太阳病，过经十余日，反而反复攻下，后四五日，柴胡证仍在的，先给予小柴胡汤。呕吐不止，心……
（日数过多，累经攻下，而柴胡证不罢的，也必须先给予小柴胡汤，以解其表。经书说：凡柴胡汤……微烦……）
大柴胡汤方
柴胡（半斤，味甘，性平） 黄芩（三两，味苦，性寒） 芍药（三两，味酸，微寒） 半夏（半斤，洗，味辛，温） 生姜……两味苦寒）
（柴胡、黄芩的苦味，入心而折热。枳实、芍药的酸苦，涌泄而扶阴。辛者散也。半夏之辛……升……）
伤寒十三天未解，胸胁满而呕，日晡所发潮热，随后轻微腹泻。这本是柴胡证，攻下后不得利，现在反而利，知道医生用丸药攻下，非其治法。潮热是实证。先宜小柴胡汤，以解外。后用柴胡加芒硝汤主治。
（伤寒十三天，再传经尽，是当解之时。如果未解，胸胁满而呕，邪气犹在表里之间。此为……入腑……解……）
伤寒十三天未解，过经，谵语的，因为有热。应当用汤药攻下。如果小便利的，大便应当硬，而反下利……内实……
（伤寒十三天，再传经尽，称为过经。谵语是阳明胃热。应当用诸承气汤攻下。如果小便利，津液漏渗，大便应当硬，反下利的，知道医生用丸药攻下。下利，脉微而厥的，是虚寒。今脉调和，则非虚寒，由肠虚胃热，胁热而利。给予调胃承气汤，以下胃热。）
太阳病不解，热结膀胱，其人如狂。血自下，下者愈。其外不解的，尚未可攻，当先解外。
（太阳，膀胱经也。太阳经邪热不解，随经入腑，为热结膀胱。其人如狂的，是未至于狂但……为蓄……少腹……外……）
Radix Paeoniae Alba (San Liang, sour taste, slightly cold nature) Radix Glycyrrhizae Preparata (San Liang, roasted, sweet taste, neutral nature) Rhizoma Aconiti Lateralis Preparatus (One piece, processed, skin removed, broken into eight pieces, pungent taste, hot nature).
(The sourness of Radix Paeoniae Alba can astringe body fluids and nourish Ying [Nutritive Qi]. The pungent-hot nature of Rhizoma Aconiti Lateralis Preparatus can secure Yang Qi and warm the Stomach. The sweetness of Radix Glycyrrhizae Preparata can harmonize the pungent and sour properties to stabilize healthy Qi.)
If purgation is mistakenly applied and the disease remains unresolved, with symptoms of irritability, Fu Ling Si Ni Tang (Poria Decoction for Four Reversals) is the primary treatment.
(After sweating or purgation, the disease should resolve. If it does not, it indicates that sweating has weakened exterior Yang Qi, and purgation has depleted interior Yin Qi, resulting in deficiency of both Yin and Yang.)
Fu Ling Si Ni Tang Formula
Poria (Liu Liang, sweet taste, neutral nature) Radix Ginseng (Yi Liang, sweet taste, warm nature) Rhizoma Aconiti Lateralis Crude (One piece, used raw, skin removed, broken into eight pieces, pungent taste, hot nature) Radix Glycyrrhizae Preparata (Er Liang, roasted).
(Si Ni Tang [Four Reversals Decoction] tonifies Yang; adding Poria and Radix Ginseng benefits Yin.) Boil the above five herbs in five Sheng of water, reduce to three Sheng, remove dregs, and take three He of the decoction warm.
After sweating, if chills are present, it is due to deficiency. If there are no chills but only fever, it is an excess syndrome. One should harmonize the Stomach Qi and administer Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction).
(Chills after sweating indicate exterior deficiency. Fever without chills indicates interior excess. The Classics state: Sweating without chills means the exterior syndrome has resolved.)
In Taiyang disease, after sweating, profuse sweating leads to dryness in the Stomach, irritability, inability to sleep, and thirst. Provide small amounts of water frequently until the Stomach Qi harmonizes, and the patient will recover.
(After sweating resolves the disease, dryness in the Stomach causes irritability and insomnia. Providing small amounts of water moistens the Stomach Qi for recovery. If the pulse is floating, the exterior syndrome has not yet resolved.)
Wu Ling San (Five-Ingredient Powder with Poria) Formula
Polyporus (Zhu Sha, sweet taste, neutral nature, skin removed) Alisma Rhizome (Yi Liang Liu Zhu Ban, sour-salty taste) Poria (Zhu Sha, sweet taste, neutral nature) Ramulus Cinnamomi (Ban Liang, skin removed).
(The bland taste corresponds to one. Entering the mouth, it tastes sweet; when sweetness is extreme, it appears bland. Sweetness relaxes, while blandness promotes diuresis. The sweet-bland nature of Polyporus, Atractylodis Macrocephalae Rhizoma, and Poria...)
After sweating, if the pulse is floating and rapid, with irritability and thirst, Wu Ling San (Five-Ingredient Powder with Poria) is the primary treatment.
(After sweating, a floating-rapid pulse indicates residual exterior pathogenic factors. Irritability and thirst result from fluid depletion and Stomach dryness. Wu Ling San harmonizes the exterior and interior and moistens dryness.)
In Shanghan (Cold Damage), if sweating is accompanied by thirst, Wu Ling San (Five-Ingredient Powder with Poria) is the primary treatment. If there is no thirst, Fu Ling Gan Cao Tang (Poria and Licorice Decoction) is the primary treatment.
(Thirst after sweating in Shanghan indicates fluid depletion, Stomach dryness, and the pathogen gradually transmitting inward. Wu Ling San harmonizes the exterior and interior. If sweating occurs without thirst, the pathogen...)
Fu Ling Gan Cao Tang (Poria and Licorice Decoction) Formula
Poria (Er Liang, sweet taste, neutral nature) Ramulus Cinnamomi (Er Liang, skin removed, pungent taste, hot nature) Rhizoma Zingiberis Recens (San Liang, sliced, pungent taste, warm nature) Radix Glycyrrhizae Preparata (Yi Liang, roasted, sweet taste, neutral nature).
(The sweetness of Poria and Radix Glycyrrhizae Preparata benefits fluids and harmonizes Wei [Defensive Qi]. The pungency of Ramulus Cinnamomi and Rhizoma Zingiberis Recens assists Yang Qi and releases the exterior.) Boil the above four herbs in four Sheng of water...
In Fengzhong (Wind Strike) with fever, if unresolved after six or seven days with irritability, presenting both exterior and interior signs, with thirst for water but vomiting immediately upon drinking, this is named Shui Ni (Water Revulsion). Wu Ling San (Five-Ingredient Powder with Poria) is the primary treatment.
(Fever from Wind Strike should resolve by day six or seven. If unresolved with irritability, the pathogen is in the exterior. Thirst indicates transmission to the interior. Severe interior heat...) hence the name...
Before taking the pulse, if the patient crosses their hands over the heart region, and the physician instructs them to cough but they do not cough, this indicates bilateral deafness. This is because severe sweating...
(Excessive sweating leads to loss of Yang. In patients with insufficient Yang Qi in the chest, they cross their hands over the heart. Observing these external signs, the physician knows Yang Qi is deficient. Testing for cough...)
After sweating, excessive drinking will必然 cause wheezing; bathing with cold water will also cause wheezing.
(Wheezing is a lung disease. Wheezing from excessive drinking is due to cold injury to the Lung. Wheezing from cold water bathing is due to external cold injuring the Lung.)
After sweating, if food and medicine cannot be kept down, this is a reverse syndrome. If sweating is repeated, vomiting and diarrhea will incessantly continue.
(Inability to keep down food and medicine after sweating is called regurgitation. Sweating causes loss of Yang and cold deficiency in the Stomach. Repeated sweating further damages Yang Qi...)
After sweating, vomiting, or purging, if empty irritability prevents sleep, or if severe, tossing and turning with mental depression (Ao Nu), Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is the primary treatment.
(Empty irritability after sweating, vomiting, or purging is caused by pathogenic heat lodging in the chest due to deficiency. It is a heat syndrome. Heat and irritability in the chest, depressed and unable to dissipate...)
Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) Formula
Fructus Gardeniae (Shi Si Mei, broken, bitter taste, cold nature) Semen Sojae Preparatum (Si He, wrapped in silk, bitter taste, cold nature).
(Sour and bitter induce vomiting and purging, belonging to Yin. Bitter induces vomiting, cold conquers heat. The combination of Gardenia and Fermented Soybean makes it suitable as a vomiting agent.) Boil the above two herbs in four Sheng of water...
If there is shortness of breath, Zhi Zi Gan Cao Chi Tang (Gardenia, Licorice, and Fermented Soybean Decoction) is the primary treatment. If there is vomiting, Zhi Zi Sheng Jiang Chi Tang (Gardenia, Ginger, and Fermented Soybean Decoction) is the primary treatment.
(Shortness of breath indicates heat damaging Qi. Add Radix Glycyrrhizae to benefit Qi. Vomiting indicates heat-induced irritability and rebellious Qi. Add Rhizoma Zingiberis Recens to disperse Qi...)
After sweating or purging, if irritability and heat persist with a sensation of obstruction in the chest, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is the primary treatment.
(Yang Qi receives Qi in the chest. Sweating or purging depletes Yang Qi, allowing pathogenic heat to lodge in the chest, knotting and failing to dissipate, causing irritability and chest obstruction.)
In Shanghan, after five or six days, following severe purging, if body heat persists and there is knotted pain in the heart region, the disease is not resolving. Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is the primary treatment.
(Days five or six in Shanghan is when the pathogen is in the interior. After severe purging, if body heat subsides and the heart region feels empty, resolution is expected. If body heat subsides but knotted pain remains, it is Jie Xiong [Chest Binding]. If body heat persists with knotted pain, it is empty irritability. Jie Xiong is excess heat binding in the chest. Persistent heat with knotted pain is empty irritability...)
(By days six or seven, resolution is expected. Since the heat is treated as empty irritability, it is said not to be resolving. Administer Zhi Zi Chi Tang to vomit it out.)
After purging in Shanghan, if there is irritability, abdominal fullness, and restlessness, Zhi Zi Hou Po Tang (Gardenia and Magnolia Bark Decoction) is the primary treatment.
(Purging leading only to abdominal fullness without irritability indicates the pathogen has entered the interior as an excess syndrome. Irritability without abdominal fullness indicates the pathogen is in the chest as empty irritability... Hou Po Tang)
Zhi Zi Hou Po Tang (Gardenia and Magnolia Bark Decoction) Formula
Fructus Gardeniae (Shi Si Mei, broken, bitter taste, cold nature) Cortex Magnoliae Officinalis (Si Liang, ginger-roasted, bitter taste, warm nature) Fructus Aurantii Immaturus (Si Mei, soaked in water, pulp removed, stir-fried, bitter taste, cold nature).
(Sour and bitter induce vomiting and purging. The bitterness of Gardenia addresses empty irritability; the bitterness of Magnolia Bark and Bitter Orange addresses abdominal fullness.) Boil the above three herbs in three Sheng and half of water...
In Shanghan, if a physician uses pill medicines for severe purging, and body heat persists with slight irritability, Zhi Zi Gan Jiang Tang (Gardenia and Dried Ginger Decoction) is the primary treatment.
(Medicines that fail to clear heat damage healthy Qi. Pathogenic factors lodge in the chest due to deficiency but have not penetrated deeply, causing persistent heat and slight irritability. Administer Zhi Zi...)
Zhi Zi Gan Jiang Tang (Gardenia and Dried Ginger Decoction) Formula
Fructus Gardeniae (Shi Si Mei, broken, bitter taste, cold nature) Rhizoma Zingiberis Preparatum (Er Liang, pungent taste, hot nature).
(Bitter induces vomiting; the bitterness of Gardenia clears irritability. Pungent moistens; the pungency of Dried Ginger benefits Qi.) Boil the above two herbs in three Sheng and half of water...
Generally, for patients using Zhi Zi Tang (Gardenia Decoction) who have a history of loose stools, it should not be administered.
(History of loose stools indicates interior deficiency and cold below. Although irritable, it is not accumulated heat, so Zhi Zi Tang is contraindicated. The Inner Classic states: Diarrhea first followed by...)
In Taiyang disease, after sweating, if the disease does not resolve, and the patient still has fever, palpitations in the heart region, dizziness, and tremors/shaking欲擗地 (wanting to fall to the ground), Zhen Wu Tang (True Warrior Decoction) is the primary treatment.
(Interior deficiency)
If the throat is dry, sweating is contraindicated.
(Insufficiency of body fluids.)
Patients with Lin syndrome (stranguria/dysuria) should not sweat. Sweating will必然 lead to hematuria.
(Heat in the Bladder causes Lin syndrome. Using herbal decoctions to sweat consumes fluids and increases pathogenic heat, leading to Bladder dryness and hematuria.)
Patients with chronic sores/ulcers should not sweat, even if they have body aches. Sweating will...
(Exterior deficiency with accumulated heat generates sores. Body aches in sore patients resemble Shanghan, but sweating is contraindicated. Sweating worsens exterior deficiency and heat, generating wind...)
Patients with epistaxis (nosebleed) should not sweat. Sweating will必然 cause depression of the temporal arteries, tight pulses, fixed staring gaze, and insomnia.
(Epistaxis indicates blood loss in the Upper Jiao. Sweating depletes Upper Jiao fluids, drying meridians, causing temporal depression, tight pulses, fixed gaze, and insomnia...)
Patients with blood loss should not sweat. Sweating will必然 cause chills and trembling.
(The Needle Classic states: Those who lose blood have no sweat; those who lose sweat have no blood. Sweating in blood-deficient patients causes deficiency of both Yin and Yang, leading to chills and trembling.)
Patients prone to sweating, if sweated again, will必然 experience mental confusion and post-void genital pain. Administer Yu Yi Liang Wan (Hematite Pill) [formula missing].
(Sweat is the fluid of the Heart. Repeated sweating in sweat-prone patients causes Heart deficiency, mental confusion, and lack of fluids, leading to post-void genital pain.)
Patients with cold conditions, if sweated, will develop cold Stomach Qi and必然 vomit roundworms.
(Cold conditions require warming and dispersing. Sweating damages Yang Qi, causing cold Stomach Qi and vomiting roundworms.)
If exterior syndrome requires sweating but purging is performed instead, this is a reverse treatment. If sweating is performed first, it is not reverse. If interior syndrome requires purging but sweating is performed instead, this is reverse. If purging is performed first...
(For exterior syndromes, sweating is appropriate, purging is reverse. For interior syndromes, purging is appropriate, sweating is reverse. The Classics state: Excess Yang and deficiency Yin...)
In Shanghan, if a physician purges and diarrhea with undigested food continues incessantly, with body aches, urgent rescue of the interior is required. Later, if body aches persist but bowel movements normalize, urgent rescue of the exterior is required. To rescue the interior, use Si Ni Tang (Four Reversals Decoction). To rescue the exterior, use Gui Zhi Tang (Cinnamon Twig Decoction).
(Continued diarrhea with undigested food after purging in Shanghan, with body aches, requires urgent interior rescue due to insufficient interior Qi. Urgently administer Si Ni Tang... Disease...)
If a patient has fever, headache, and a sinking pulse, and does not improve, with body aches, rescue the interior is required, preferably with Si Ni Tang (Four Reversals Decoction).
(Fever and headache are exterior syndromes. A sinking pulse indicates an interior pattern. The Classics state: Exterior diseases typically present with floating-large pulses. A sinking-slow pulse indicates...)
In Taiyang disease, if purging is performed first without resolution, followed by sweating, this causes deficiency of both exterior and interior. The patient may experience Mao (vertigo/confusion). Patients with Mao will naturally recover through sweating. This is because...
(Mao refers to stagnation. Purging causes interior deficiency and blood loss; sweating causes exterior deficiency and Yang loss. Deficiency of both exterior and interior with cold qi stagnation causes Mao...)
(Patients with Mao desire...)
In Taiyang disease, if unresolved, and the pulse at Cun, Guan, and Chi positions all stop (are imperceptible), the patient will first experience chills and shaking, then sweating and resolution. If only the Yang pulse (Cun) is faint, sweating will resolve it. If only the Yin pulse (Chi) is faint...
(Imperceptible pulses at all three positions indicate balance of Yin and Yang. The Classics state: Cun, Guan, and Chi positions being equal in size, floating/sinking, slow/rapid...) Foot... Deficiency)
In Taiyang disease, fever and sweating indicate weak Ying (Nutritive) and strong Wei (Defensive) Qi. To treat pathogenic wind, Gui Zhi Tang (Cinnamon Twig Decoction) is indicated.
(Taiyang Fengzhong [Wind Strike]: Wind merges with Wei, making Wei excess and Ying deficiency. Ying is Yin, Wei is Yang. Fever and sweating indicate Yin weakness and Yang strength...)
In Shanghan after five or six days, or Fengzhong, with alternating chills and fever, fullness/hypochondriac distress, silent desire to eat nothing, irritability, and frequent vomiting. Or chest irritability without... Xiao Chai Hu...
(Diseases can be in the exterior, interior, or between exterior and interior. This pathogen is between exterior and interior, termed Half-Exterior Half-Interior syndrome. Five or six days... Alternating chills and fever... Syndrome... Pathogen...)
(Now only mentioning hypochondriac... Stillness. Pathogen in... Interior of exterior, in... Not yet unable to eat... Pathogen initially entering interior... Or causes these signs.)
Xiao Chai Hu Tang (Minor Chest Guardian Decoction) Formula
Radix Bupleuri (Ban Jin, bitter taste, slightly cold) Radix Scutellariae (San Liang, bitter taste, cold nature) Radix Ginseng (San Liang, sweet taste, warm nature) Radix Glycyrrhizae Preparata (San Liang, sweet taste, neutral nature) Rhizoma Pinelliae Preparata...
(The Inner Classic states: For heat rampant within, use bitter to release. The bitterness of Radix Bupleuri and Radix Scutellariae releases transmitted heat. For interior insufficiency, use sweet to relax... In half... Remove...)
Modifications
If chest irritability without vomiting, remove Rhizoma Pinelliae Preparata and Radix Ginseng, add one Fructus Trichosanthis.
(Chest irritability without vomiting indicates heat accumulation without rebellious Qi. Sweetness causes fullness. With heat accumulation, Radix Ginseng's tonification is unnecessary. Pungent disperses rebellious Qi, since...)
If thirsty, remove Rhizoma Pinelliae Preparata, add Radix Ginseng, totaling four Liang and half from previous, plus Radix Trichosanthis (Si Liang).
(Rhizoma Pinelliae Preparata dries fluids, unsuitable for thirst. Radix Ginseng is sweet and moistening; Radix Trichosanthis is bitter and cool, clearing heat and generating fluids. These two are appropriate.)
If abdominal pain, remove Radix Scutellariae, add Radix Paeoniae Alba (San Liang).
(Remove Radix Scutellariae to avoid harming middle Jiao cold. Add Radix Paeoniae Alba to unblock stagnation.)
If hypochondriac stuffiness/hardness, remove Fructus Ziziphi Jujubae, add Concha Ostreae (Si Liang).
(Sweetness causes fullness. For stuffiness, remove the sweetness of Fructus Ziziphi Jujubae. Salty softens hardness. Add Concha Ostreae for its salty nature.)
If palpitations and difficult urination, remove Radix Scutellariae, add Poria (Si Liang).
(Water retention causing palpitations and difficult urination. The Inner Classic states: Kidney desires firmness, urgently feed bitter to firm it, then water becomes firmer. Hence remove Radix Scutellariae...)
If not thirsty with slight exterior fever, remove Radix Ginseng, add Ramulus Cinnamomi (San Liang), cover warmly to induce slight sweating for recovery.
(No thirst indicates interior harmony, hence remove Radix Ginseng. Slight exterior fever indicates unresolved exterior. Add Ramulus Cinnamomi to induce sweating.)
If coughing, remove Radix Ginseng, Fructus Ziziphi Jujubae, and Rhizoma Zingiberis Recens, add Fructus Schisandrae Chinensis (Ban Sheng) and Rhizoma Zingiberis Preparatum (Er Liang).
(Coughing indicates rebellious Qi. Sweetness obstructs Qi, hence remove Radix Ginseng and Fructus Ziziphi Jujubae. The Inner Classic states: Lung desires consolidation, urgently feed sour to consolidate. Fructus Schisandrae Chinensis...)
When blood is weak and Qi exhausted, pores open, pathogenic factors enter and contend with healthy Qi, knotting in the hypochondrium. Healthy and pathogenic Qi struggle, causing alternating chills and fever, occurring intermittently.
(Human Qi and Blood fluctuate with time. When the moon is new, blood is weak and Qi exhausted, pores are open. Pathogenic factors exploit deficiency to injure humans... Pores... And knot... Follow meridians... Contend...)
After taking Xiao Chai Hu Tang, if thirst develops, it belongs to Yangming syndrome. Treat according to Yangming methods.
(After Xiao Chai Hu Tang, if exterior pathogen resolves but thirst remains, interior pathogen has transmitted to Yangming. Treat with Yangming methods.)
On the sixth or seventh day of illness, with slow-floating-weak pulse, aversion to wind and cold, warm hands and feet, if physicians purge repeatedly, leading to inability to eat, hypochondriac fullness/pain, yellow face and body... Hiccups...
(Sixth/seventh day, slow-floating-weak pulse, aversion to wind/cold, warm extremities indicate pathogen in half-exterior half-interior, not excess. Repeated purging causes deficiency... All... Choppy... And... Vomiting...)
In Shanghan after four or five days, with body heat, aversion to wind, stiff neck, hypochondriac fullness, warm extremities, and thirst, Xiao Chai Hu Tang (Minor Chest Guardian Decoction) is the primary treatment.
(Body heat, aversion to wind, stiff neck indicate unresolved exterior. Hypochondriac fullness and thirst indicate interior disharmony. Pathogen in exterior causes warm extremities. Pathogen in...)
In Shanghan, if Yang pulse is choppy and Yin pulse is string-like, abdominal cramping pain is expected. First administer Xiao Jian Zhong Tang (Minor Construct the Middle Decoction). If unresolved, administer Xiao Chai Hu Tang (Minor Chest Guardian Decoction).
(Choppy Yang pulse and string-like Yin pulse with abdominal cramping pain should be treated as interior deficiency-cold. Administer Xiao Jian Zhong Tang to warm middle and dispel cold. If unresolved... Interior...)
Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) Formula
Ramulus Cinnamomi (San Liang, skin removed, pungent taste, hot nature) Radix Glycyrrhizae Preparata (San Liang, roasted, sweet taste, neutral nature) Fructus Ziziphi Jujubae (Twelve Mei, broken, sweet taste, warm nature) Radix Paeoniae Alba (Liu Liang, sour taste, slightly... )
(Constructing the Middle means strengthening the Spleen. The Inner Classic states: Spleen desires relaxation, urgently feed sweet to relax. Maltose, Fructus Ziziphi Jujubae, and Radix Glycyrrhizae Preparata's sweetness relaxes the middle... Qi deficiency... Maltose...)
In Shanghan or Fengzhong, if Chai Hu syndrome signs are present, observing one sign is sufficient; complete presentation is not necessary.
(Chai Hu syndrome indicates pathogen between exterior and interior. Or chest irritability without vomiting, or thirst, or abdominal pain, or hypochondriac stuffiness, or heart region... Signs complete...)
If Chai Hu syndrome is treated with purging, and Chai Hu signs persist, administering Xiao Chai Hu Tang (Minor Chest Guardian Decoction) again will必然 cause shivering and shaking, followed by fever, sweating, and resolution.
(Pathogen between half-exterior and half-interior is Chai Hu syndrome, not yet interior excess. Physician purges. If Chai Hu signs persist despite purging... Qi desires...)
In Shanghan on days two or three, if palpitations and irritability occur, Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) is the primary treatment.
(Days two or three in Shanghan, pathogen is in exterior, not yet transmitting to interior. Palpitations and irritability are not caused by pathogen contention. Palpitations indicate Qi deficiency...)
In Taiyang disease, after passing the meridian for ten-plus days, if purged repeatedly, and after four or five days Chai Hu signs persist, first administer Xiao Chai Hu Tang (Minor Chest Guardian Decoction). If vomiting continues, heart...
(Many days passed, repeated purging, yet Chai Hu signs persist. Must first administer Xiao Chai Hu Tang to resolve exterior. Classics state: Generally Chai Hu Tang... Slight irritability...)
Da Chai Hu Tang (Major Chest Guardian Decoction) Formula
Radix Bupleuri (Ban Jin, sweet taste, neutral nature) Radix Scutellariae (San Liang, bitter taste, cold nature) Radix Paeoniae Alba (San Liang, sour taste, slightly cold) Rhizoma Pinelliae Preparata (Ban Jin, washed, pungent taste, warm) Rhizoma Zingiberis Recens... Two bitter-cold herbs)
(The bitterness of Radix Bupleuri and Radix Scutellariae enters Heart to reduce heat. The sour-bitterness of Fructus Aurantii Immaturus and Radix Paeoniae Alba induces vomiting/purging and supports Yin. Pungent disperses. The pungency of Rhizoma Pinelliae Preparata... Ascends...)
In Shanghan unresolved for thirteen days, with chest/hypochondriac fullness and vomiting, tidal fever in the late afternoon, followed by slight diarrhea. This was originally a Chai Hu syndrome. Purging did not stop diarrhea; now diarrhea occurs, indicating the physician used pill medicines for purging, which is incorrect. Tidal fever indicates excess. First use Xiao Chai Hu Tang (Minor Chest Guardian Decoction) to resolve exterior. Then use Chai Hu Jia Mang Xiao Tang (Bupleurum Decoction with Gypsum) as primary treatment.
(Thirteen days in Shanghan, completing transmission cycles, should resolve. If unresolved with chest/hypochondriac fullness and vomiting, pathogen remains between exterior and interior. This is... Entering Fu organs... Resolve...)
In Shanghan unresolved for thirteen days, passing the meridian, with delirium, due to heat. Should be treated with decoctions for purging. If urination is free, stool should be hard, but instead there is diarrhea... Interior excess...
(Thirteen days unresolved, passing the meridian, delirium indicates Yangming Stomach heat. Should use various Cheng Qi Decoctions for purging. Free urination leaks fluids, stool should be hard. Diarrhea indicates physician used pill medicines. Diarrhea with micro-pulse and cold extremities is deficiency-cold. Now pulse is harmonized, not deficiency-cold, but intestinal deficiency/stomach heat,胁 heat causing diarrhea. Administer Tiao Wei Cheng Qi Tang to purge Stomach heat.)
Taiyang disease unresolved, heat knots in Bladder. Patient acts like mad. If blood passes spontaneously, patient recovers. If exterior unresolved, attack is premature; must first resolve exterior.
(Taiyang is Bladder meridian. Unresolved heat in Taiyang meridian transmits to Fu organ, knotting in Bladder. Acting like mad indicates not yet fully manic but... Accumulated Blood... Lower Abdomen... Exterior...)
Tao He Cheng Qi Tang (Peach Kernel Decoction to Order the Qi) Formula