中寒伤寒殊非一，伤则渐深中直入，或因外受肃杀气，或因内伤生冷物，猝然口噤并失
音，四肢强直不知人，脉来沉软而无力，加味理中汤可寻，参术干姜并肉桂，茯陈甘草半细
辛。
加煨生姜五大片，服入姜汁一盏半，仍用姜渣炒极热，绢包腹上熨有验。恶寒甚者麻黄
加，
加泡附子去皮脐，依旧加姜并姜汁。但见目红知附毒，解之汁取生萝卜，犀角甘草及黄
连，
急救中寒 仓猝无药，急用葱白一大束如茶盏口大，用纸卷紧，快刀切一指浓片置脐上，
以
理中汤、治中汤、补中汤、姜附汤、四顺汤、四逆汤，治五脏中寒，口噤失音，四肢强
直；
皆效
附子理
吐透方
泻泄；补中汤加附一钱，治溏泄，加砂仁一钱，治米谷不化；去白术，加附子，名四顺汤，
治霍乱、心腹痛、手足厥冷；去参术，加附子，名四逆汤，治即病太阴及三阴诸证，自病不
渴，脉微欲绝，四肢厥冷；去参、术
回阳救苦丹 治伤寒初起，不头痛，不身热，就怕寒，四肢逆冷，或过肘膝，或腹痛，
或口
为
加
五积散（生料） 治感冒寒邪，头痛身疼，强硬拘急，恶寒吐呕，或腹痛。又治伤寒发
热，头
快。
陈皮一钱 浓朴 桔梗 枳壳 白芍 白茯苓 当归 干姜 麻黄各八分 白芷 川芎
半
艾醋，足肿加五加皮、大腹皮，风痹加羌活、独活、防风，腰痛加牛膝、杜仲、小茴香，手
足拘挛加槟榔、木瓜、牛膝，咳嗽加杏仁、桑白皮、马兜苓，遍身疼痛加乳香、没药、细辛，
难产加麝香、交桂，此药气味辛温，开
防风通圣散（见中风）为治热燥之圣药。
生料五积散 为治寒湿之圣药。
顺气散（方见中风） 平气散（方见） 槟榔散（方见） 通圣散（方见）
余论
丹溪云∶中寒由内伤者，十居八九，必先用参、 ，托住正气。戴氏云∶身受肃杀，口
伤生
急温
中气 星香散（见猝中） 四七汤（见气）
八味顺气散 凡中风中食俱宜先服此药，顺其气而后治风消食。
青皮 陈皮（俱去白） 香白芷 天台乌药各五分合四君子煎服。
中寒与伤寒并非同一种病，伤寒是邪气由表入里、逐渐深入；而中寒则是邪气直中脏腑。其成因或是外受肃杀寒气侵袭，或是内伤生冷食物。发病时突然口噤（牙关紧闭）且失音，四肢强直、神志昏迷，脉象沉软无力，此时可用加味理中汤治疗。方药组成包括人参、白术、干姜、肉桂、茯苓、陈皮、甘草、细辛各半两，另加煨生姜五大片，服用时兑入姜汁一盏半。此外，还可将姜渣炒至极热，用绢布包裹敷熨腹部，亦有疗效。若恶寒症状严重者，可加入麻黄；若需加用附子，须去皮脐，并配合生姜及姜汁使用。但若见目红，则知为附子中毒，需用生萝卜汁解毒，或配伍犀角、甘草及黄连进行急救。
对于仓促无药的中寒急症，可用葱白一大束（粗细如茶盏口），用纸卷紧，用快刀切成一指厚的片状置于脐上，再施以理中汤、治中汤、补中汤、姜附汤、四顺汤、四逆汤等方剂，可治愈五脏中寒引起的口噤失音、四肢强直等症状，皆有效验。
另有吐透方，用于泻泄；补中汤加一钱附子，治疗溏泄；加一钱砂仁，治疗米谷不化；若去白术加附子，名为四顺汤，治疗霍乱、心腹痛、手足厥冷；若去人参、白术加附子，名为四逆汤，治疗即病太阴及三阴诸证，表现为自病不渴、脉微欲绝、四肢厥冷。
回阳救苦丹，治疗伤寒初起，症见不头痛、不身热，但极度怕寒，四肢逆冷过肘膝，或腹痛，或口噤。
五积散（生料）：治疗感冒寒邪，症见头痛身疼、僵硬拘急、恶寒吐呕，或腹痛。又治伤寒发热，头项强痛等症，见效快。方药组成：陈皮一钱，浓朴、桔梗、枳壳、白芍、白茯苓、当归、干姜、麻黄各八分，白芷、川芎半两。若足肿加五加皮、大腹皮；风痹加羌活、独活、防风；腰痛加牛膝、杜仲、小茴香；手足拘挛加槟榔、木瓜、牛膝；咳嗽加杏仁、桑白皮、马兜铃；遍身疼痛加乳香、没药、细辛；难产加麝香、交桂。此药气味辛温，能开郁散结。
防风通圣散（见中风篇）：为治疗热燥之圣药。
生料五积散：为治疗寒湿之圣药。
顺气散（方见中风篇）、平气散（方见前文）、槟榔散（方见前文）、通圣散（方见前文）。
余论：
丹溪云：中寒由内伤者，十居八九，必先用参、芪，托住正气。戴氏云：身受肃杀寒气，口伤生冷之物，急当温中气。
星香散（见猝中篇）、四七汤（见气滞篇）。
八味顺气散：凡中风、中食俱宜先服此药，顺其气而后治风消食。方药组成：青皮、陈皮（俱去白）、香白芷、天台乌药各五分，合四君子汤煎服。
Zhonghan (Cold Strike) and Shanghan (Cold Damage) are not the same disease. Shanghan involves pathogenic factors entering from the exterior and gradually penetrating deeper, whereas Zhonghan involves pathogenic factors striking directly into the interior organs. The etiology may be external invasion by chilling cold air or internal injury caused by raw and cold food. Onset is sudden with lockjaw (trismus) and aphonia, rigid limbs, and loss of consciousness; the pulse is deep, soft, and powerless. In such cases, Jiawei Lizhong Tang (Modified Cinnamon Twig and Atractylodes Decoction) can be used. The prescription consists of Renshen (Ginseng), Baizhu (Atractylodes Macrocephala Rhizome), Ganjiang (Dried Ginger), Rougui (Cinnamon Bark), Fuling (Poria), Chenpi (Citrus Reticulata Peel), Gancao (Licorice Root), and Xixin (Asarum), each at half liang. Additionally, add five large slices of ginger baked in ash. Take this decoction mixed with one and a half cups of ginger juice. Furthermore, stir-fry the ginger residue until extremely hot, wrap it in silk, and apply it as a hot compress to the abdomen, which has proven effective. If aversion to cold is severe, add Mahuang (Ephedra). If Fuzi (Prepared Aconite Root) is added, remove the skin and navel, and combine with ginger and ginger juice. However, if redness of the eyes appears, it indicates Fuzi toxicity; treat with fresh radish juice, or use Xijiao (Rhinoceros Horn - *Note: Substitute with Water Buffalo Horn in modern practice*), Gancao (Licorice Root), and Huanglian (Coptis Rhizome) for emergency rescue.
For emergencies of Zhonghan where medicine is unavailable, take a bundle of scallion whites (thick as a teacup mouth), roll tightly in paper, slice into pieces one finger-thick using a sharp knife, place on the umbilicus, and administer Lizhong Tang, Zhizhong Tang, Buzhong Tang, Jiangfu Tang, Sishun Tang, or Nixi Tang. These formulas treat Zhonghan of the five zang organs manifesting as lockjaw, aphonia, and limb rigidity, all showing efficacy.
There is also Tutou Fang (Expelling Vomiting and Diarrhea Formula) for diarrhea; Buzhong Tang plus 1 qian of Fuzi treats loose stools; adding 1 qian of Sharen (Amomum Fruit) treats undigested food; removing Baizhu and adding Fuzi creates Sishun Tang, treating cholera-like syndrome, abdominal pain, and cold extremities; removing Renshen and Baizhu and adding Fuzi creates Nixi Tang, treating Taiyin and Shaoyin/Yueyin syndromes presenting with no thirst, faint pulse nearly imperceptible, and cold extremities.
Huiyang Jiuku Dan (Yang-Restoring and Pain-Relieving Pill) treats early-stage Shanghan characterized by absence of headache and fever, but intense aversion to cold, cold extremities extending past elbows and knees, abdominal pain, or lockjaw.
Wuji San (Five Accumulations Powder, Raw Material Version) treats cold pathogen invasion causing headache, body ache, stiffness, spasms, aversion to cold, vomiting, or abdominal pain. It also treats Shanghan fever with stiff neck and head pain, acting quickly. Ingredients: Chenpi 1 qian, Houpo (Magnolia Bark), Jiegeng (Platycodon Root), Zhike (Bitter Orange Fruit), Baishao (White Peony Root), Fuling (Poria), Danggui (Angelica Sinensis), Ganjiang (Dried Ginger), Mahuang (Ephedra) each 8 fen; Baizhi (Angelica Dahurica), Chuanxiong (Ligusticum Rhizome) 0.5 liang. For swollen feet, add Wujia Pi (Acanthopanax Bark) and Dafupi (Areca Peel); for wind-bi (painful obstruction), add Qianghuo (Notopterygium Rhizome), Duhuo (Angelica Pubescens), and Fangfeng (Saposhnikovia Root); for lower back pain, add Niuxi (Achyranthes Root), Duzhong (Eucommia Bark), and Xiaohuixiang (Fennel Fruit); for limb spasms, add Binglang (Betel Nut), Mugua (Chaenomeles Fruit), and Niuxi; for cough, add Xingren (Apricot Seed), Sangbaipi (Mulberry Root Bark), and Madou Ling (Aristolochia Root); for generalized body pain, add Rushen (Frankincense), Moyao (Myrrh), and Xixin; for difficult labor, add Shexiang (Musk) and Jiaogui (Cassia Twig). This medicine is pungent and warm, opening stagnation and dispersing accumulation.
Fangtong Tongsheng San (Wind-Protecting and Unblocking Supreme Harmony Powder, see Stroke chapter) is the supreme remedy for heat-dryness syndromes.
Shengliao Wuji San (Raw Material Five Accumulations Powder) is the supreme remedy for cold-dampness syndromes.
Shunqi San (see Stroke chapter), Pingqi San (see preceding text), Binglang San (see preceding text), Tongsheng San (see preceding text).
Additional Remarks:
Danxi stated: "Most cases of Zhonghan due to internal injury account for eight or nine out of ten; one must first use Renshen (Ginseng) and Huangqi (Astragalus Root) to support and anchor the Zhengqi (Upright Qi)." Dai Shi stated: "When the body suffers chilling cold and the mouth ingests raw/cold items, urgently warm the Zhongqi (Middle Jiao Qi)."
Xingxiang San (see Sudden Stroke chapter), Siqi Tang (see Qi Stagnation chapter).
Bawei Shunqi San (Eight-Ingredient Qi-Smooth Powder): Suitable for both stroke and food stagnation; administer this first to smooth the qi before treating wind or digesting food. Ingredients: Qingpi (Green Tangerine Peel), Chenpi (Tangerine Peel, both white pith removed), Xiangbaizhi (Aromatic Angelica), Tiantai Wuyao (Tiantai Litsea Fruit) each 5 fen, decocted together with Sijunzi Tang (Four Gentlemen Decoction).