经曰；冬三月，此谓闭藏，水冰地坼，无扰乎阳，早卧晚起，必待日光。夫中寒者，卒中天地
之寒气也。或冬月严凝之气，或三时暴客之寒。手足厥冷，脐腹绞痛，战悚昏迷，唇青口噤，面如
刀刮，引衣蜷卧，不渴。当分三阴治之。中脘痛属太阴，理中汤；脐腹痛属少阴，五积散；小腹痛
属厥阴，四逆
汤（倍附子，加吴萸）治之。先用灸熨之法，稍缓不救。如腹不痛，惟脉沉肢冷者，俗谓阴证伤寒
是也。医以房室受寒为论，若患人因平素斫丧肾虚而成，病时不犯，必坚执不伏，不肯服药；或以
他证外治，反乐从之，药亦怠缓，不满六日而死。呜呼！遇此之候，但根据方调理，勿以犯淫为论，
致病者疑惑。有初感乍寒乍热，脉弦似疟，犹能行动，失用附子温散，三、四日手指渐冷而毙。脉
迟紧或沉细涩，皆寒；坚弦或沉细为中寒。寒脉散者，死。有汗，尺脉迟滞，寒在下焦者，死。
主方 （回阳救急汤） 人参 白术 茯苓 半夏（姜制） 干姜（炮） 肉桂 附子（煨，去皮脐）
甘草（炙。各一钱） 陈皮（五分） 五味子（九粒） 加姜煎服。
上方通治中寒证，甚者倍附子。干呕吐痰涎白沫，加吴茱萸；无脉加猪胆汁一匙；泻甚加黄
、升麻；吐甚多加姜汁，次兼官桂、当归温血分，盖寒伤荣也。仓卒无药，用布条缠作圈放脐上，
中安炒盐，上以大艾炷三个，灸多壮，腹痛止为度。更灸气海（一穴，脐下一寸五分，二十壮）、丹田
（一穴，脐下二寸）、关元（一穴，脐下三寸。治脏结不可攻者及阴汗不止、腹胀肠鸣、面黑指甲
青，百余壮。量法。病患屈中指，中节两折纹尖为一寸。）
熨法 用食盐（一斤，炒热，）布二层包，熨腹脐痛处，冷即换（无盐，麦麸、灰、砂皆可。）
一法用吴茱萸二升，酒拌炒，煮热，以绢袋盛，或二、三合煮滚。入麸一升，盐一合炒，包熨
心腹及手足心，气通则止。姜葱熨（方见伤寒）。
一法用葱一握，束缚如饼，切去根叶，存白二寸许，先以火烙一遍，令通热，着病患脐上下，
以熨斗火熨之。先以麝香、硫黄安脐中尤妙，更作三、四饼，坏则换。手足温，微汗乃止。内服主方。
蒸脐法 麝香 半夏末 皂角末（各三分，）安脐中，上铺盐，灸二、七壮。
理中汤 治太阴中脘痛，自利不渴，寒多，腹痛泻，霍乱厥冷。
人参 白术 干姜 甘草（各二钱，病轻减）上加生姜煎服。
肾气动者，去术加桂二钱；吐多，去术加生姜三钱、丁香五分；利多，加木香一钱；小便涩，
加茯苓；渴加术；寒加姜；腹痛下利，加附子炮、二钱；霍乱转筋，加 石膏五钱。枳实理中丸
治寒实结胸，加茯苓、枳实，为末，蜜丸弹大，白汤下。
五积散 治少阴脐腹痛及感冒寒邪，头疼，身痛拘急，呕吐。不问外感风寒，内伤生冷，寒湿
客于经络，腰背酸疼，妇人经闭。
白芷 当归 川芎 陈皮 浓朴 苍术 白芍 枳壳 桔梗 半夏（制。各一钱）干姜 茯苓 官桂（各五分）
甘草（三分） 麻黄（冬八分，夏二分） 加生姜三片，葱头三个，煎服。
四逆汤 治厥阴小腹痛，太阴自利不渴，阴证脉沉，身痛（先服轻剂）。
附子（一枚，生，去皮脐，切作八片。）甘草（炙，六钱） 干姜（五钱） 分二剂，水煎温服，取汗。
茱萸四逆汤 治厥阴中寒，小腹痛甚。通脉四逆汤（前方倍加甘草）。
吴萸（泡） 附子（炮） 干姜（各二钱） 炙草（钱半）上加姜，水煎服。
附子散 中寒阴证，唇青面黑，身背强直，四肢厥冷，诸沉寒痼冷。
附子（制熟，二钱） 官桂 当归 白术 干姜 半夏（各七分） 姜（五片） 枣（二枚）煎服。
苏合香丸 治中风、中气、中寒，卒倒，口噤不省，暴感寒毒，脐腹绞痛，肢冷吐泻，心痛
痹疼，鬼祟邪恶，痨瘵传尸，疫疠秽气，岚瘴蛊疰，小儿急、慢惊风。每服男、妇一丸，小儿半丸
，生姜汁化开，姜汤调下。牙紧半丸擦，牙开灌之。如感冒风寒，咳嗽痰喘，姜、葱汤下。产后泄
泻、腹痛，一切风寒、怒气胸满等证，防雾露，酒服。火病戒服。
香附 白术 安息香（如无，以白豆蔻代） 檀香 木香 荜茇 犀角（另锉末） 沉香 诃子（肉。
各二两） 麝香 乳香 朱砂（水飞，重研） 苏合油（各一两） 冰片（五钱）
上各取真者，另研细末，次入麝、冰、油、砂，研匀加炼熟白蜜和。每丸重二钱，黄蜡浓封或
入小瓶，蜡封口，勿令泄气，勿湿润。
《黄帝内经》说：冬季的三个月，叫做闭藏，此时水结冰、地开裂，不要扰动阳气，应当早睡晚起，一定要等到太阳出来再起床。所谓中寒，就是突然遭受天地间的寒气侵袭。或者是冬季严寒凝滞之气，或者是春、夏、秋三时突然袭来的寒气。（症状表现为）手足厥冷，肚脐和腹部绞痛，颤抖战栗甚至昏迷，嘴唇发青、牙关紧闭，面色像被刀刮过一样苍白，拉着衣服蜷缩而卧，口不渴。应当根据三阴经进行辨证治疗。中脘部疼痛属于太阴病，用理中汤；肚脐周围疼痛属于少阴病，用五积散；小腹部疼痛属于厥阴病，用四逆汤（加倍附子用量，加入吴茱萸）来治疗。首先应当使用艾灸和热敷的方法，如果病情稍缓而不救治，就会危及生命。如果腹部不痛，只有脉象沉、四肢冰冷的，这是俗称的阴证伤寒。医生如果将其归咎于房事受寒，若患者是因为平素纵欲导致肾虚而发病，但在患病期间并没有犯淫，医者必定固执己见，不肯服药；或者采用其他外治法，患者反而乐于接受，但用药迟缓，不到六天就会死亡。唉！遇到这种情况，只要按照方剂调理，不要以犯淫为由论断，致使患者产生疑惑。有的初感时忽冷忽热，脉象弦细类似疟疾，还能行动，但如果失于使用附子温散，三、四天后手指逐渐变冷而死。脉象迟紧或沉细涩，都是寒象；脉象坚弦或沉细是中寒。脉象散乱的，主死。有汗出，尺脉迟滞，寒邪在下焦的，主死。
主方（回阳救急汤）：人参、白术、茯苓、半夏（姜制）、干姜（炮制）、肉桂、附子（煨，去皮脐）、甘草（炙，以上各一钱）、陈皮（五分）、五味子（九粒）。加生姜煎服。
上方通治中寒证，重症加倍附子用量。干呕并吐出白色痰涎泡沫的，加吴茱萸；无脉象的，加猪胆汁一匙；腹泻严重的，加黄连、升麻；呕吐严重的，多加姜汁，随后兼用官桂、当归温补血分，因为寒邪损伤了营血。仓促间没有药物，用布条缠成圈放在肚脐上，中间安放炒热的盐，上面放三个大艾炷，灸至多壮数，以腹痛停止为度。另外灸气海穴（一穴，位于脐下一寸五分，灸二十壮）、丹田穴（一穴，位于脐下二寸）、关元穴（一穴，位于脐下三寸。治疗脏结不可攻下的病症以及阴汗不止、腹胀肠鸣、面色黑、指甲青紫等症，需灸百余壮。取穴度量方法：让患者弯曲中指，其中节两折纹尖端为一寸。）
熨法：用食盐一斤，炒热，用两层布包裹，熨烫腹部和脐部疼痛处，冷了即更换（如果没有盐，麦麸、灶灰、砂子都可以）。另一种方法是用吴茱萸二升，用酒拌炒，煮热，用绢袋盛装，或者将二、三合吴茱萸煮滚，加入一升麦麸、一合盐一起炒，包好熨烫心腹及手足心，气机通畅即止。姜葱熨法（方剂见伤寒篇）。另一种方法是用葱一把，捆扎如饼状，切去根叶，保留白色部分约二寸长，先用火烙一遍，使其通热，贴在患者脐上下，用熨斗加热熨烫。先在脐中放入麝香、硫黄尤妙，再做三、四个葱饼，坏了就换。待手足温暖，微微出汗即可停止。内服主方。
蒸脐法：麝香、半夏末、皂角末（各三分），放在脐中，上面铺盐，灸十四壮。
理中汤：治疗太阴中寒引起的中脘痛，自利不渴，寒气重，腹痛腹泻，霍乱厥冷。
人参、白术、干姜、甘草（各二钱，病情轻则减量）。上加生姜煎服。
肾气动者，去掉白术，加桂枝二钱；呕吐多者，去掉白术，加生姜三钱、丁香五分；腹泻多者，加木香一钱；小便涩滞，加茯苓；口渴加白术；寒重加干姜；腹痛下利，加炮附子二钱；霍乱转筋，加石膏五钱。枳实理中丸：治疗寒实结胸，加茯苓、枳实，研为细末，蜂蜜为丸如弹子大，白开水送服。
五积散：治疗少阴脐腹痛及感冒寒邪，头痛，身体疼痛拘急，呕吐。不问是外感风寒还是内伤生冷，寒湿客于经络，腰背酸痛，妇人经闭。
白芷、当归、川芎、陈皮、厚朴、苍术、白芍、枳壳、桔梗、半夏（制，以上各一钱）、干姜、茯苓、官桂（以上各五分）、甘草（三分）、麻黄（冬季八分，夏季二分）。加生姜三片，葱头三个，煎服。
四逆汤：治疗厥阴小腹痛，太阴自利不渴，阴证脉沉，身痛（先服用轻剂）。
附子（一枚，生，去皮脐，切成八片）、甘草（炙，六钱）、干姜（五钱）。分为两剂，水煎温服，取汗。
茱萸四逆汤：治疗厥阴中寒，小腹痛甚。通脉四逆汤（前方加倍甘草用量）。
吴茱萸（泡）、附子（炮）、干姜（各二钱）、炙甘草（钱半）。上加生姜，水煎服。
附子散：治疗中寒阴证，唇青面黑，身背强直，四肢厥冷，各种沉寒痼冷之症。
附子（制熟，二钱）、官桂、当归、白术、干姜、半夏（以上各七分）、生姜（五片）、大枣（二枚）。煎服。
苏合香丸：治疗中风、中气、中寒，突然昏倒，牙关紧闭不省人事，暴感寒毒，脐腹绞痛，肢冷吐泻，心痛痹疼，鬼祟邪恶，劳瘵传尸，疫疠秽气，岚瘴蛊疰，小儿急惊风、慢惊风。每次服用，男女一丸，小儿半丸，用生姜汁化开，姜汤调下。牙关紧闭者，用半丸擦牙，牙开后灌服。如果是感冒风寒，咳嗽痰喘，用姜葱汤送服。产后泄泻、腹痛，一切风寒、怒气导致的胸满等证，防雾露，用酒送服。火病患者忌服。
香附、白术、安息香（如无，以白豆蔻代替）、檀香、木香、荜茇、犀角（另锉成末）、沉香、诃子（肉，以上各二两）、麝香、乳香、朱砂（水飞，重研）、苏合油（以上各一两）、冰片（五钱）。
以上各药取真品，分别研成细末，其次加入麝香、冰片、苏合油、朱砂，研磨均匀，加入炼熟的白蜜调和。每丸重二钱，用厚黄蜡密封或装入小瓶，蜡封口，不要让气体泄漏，也不要受潮。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The three months of winter are called "closing and storing." At this time, water freezes and the earth cracks; one should not disturb the Yang Qi. One should go to bed early and rise late, waiting until sunlight appears. What is referred to as "Zhong Han" (Cold Strike) is the sudden invasion by the cold qi of heaven and earth. This may be due to the severe condensing cold of winter or the violent guest-cold of the spring, summer, and autumn seasons. Symptoms include coldness of the hands and feet, colicky pain in the umbilical and abdominal regions, trembling and coma, cyanosis of the lips, locked jaw, a face pale as if scraped by a knife, curling up while holding clothes, and absence of thirst. Treatment should be differentiated according to the Three Yin channels. Pain in the Zhongwan region belongs to Taiyin disease and is treated with Lizhong Tang (Regulate the Middle Decoction); pain around the navel belongs to Shaoyin disease and is treated with Wuji San (Five Accumulations Powder); pain in the lower abdomen belongs to Jueyin disease and is treated with Sini Tang (Frigid Extremities Decoction) (with doubled dose of Fuzi and added Wuzhuyu). Initially, moxibustion and hot compress methods should be used; if the condition is slightly alleviated but not treated, it will become untreatable. If there is no abdominal pain, only a deep pulse and cold limbs, this is commonly known as Yin Syndrome Cold Damage. Physicians might attribute it to cold contracted during sexual intercourse; however, if the patient became ill due to chronic depletion of Kidney Jing from past excesses, without violating chastity during the illness, the physician must persistently refuse to prescribe medicine; or if other external treatments are adopted, the patient may willingly comply, but the medication is delayed, leading to death within six days. Alas! When encountering such symptoms, one should simply follow the formula for regulation and not discuss sexual misconduct, causing confusion to the patient. Some cases present with initial alternating chills and fever, a wiry pulse resembling malaria, where the patient can still move; if Fuzi is not used for warming and dispersing, the fingers will gradually turn cold, leading to death in three to four days. A slow, tight, deep, fine, or choppy pulse all indicate Cold; a firm, wiry, or deep-fine pulse indicates Zhong Han. A scattered pulse indicates death. Sweating with a sluggish Chi pulse and Cold in the Lower Jiao indicates death.
Main Formula (Huiyang Jiujitang - Return Yang Rescue Crisis Decoction): Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Banxia (Pinelliae Rhizoma processed with ginger), Ganjiang (Zingiberis Rhizoma dried), Rougui (Cinnamomi Cortex), Fuzi (Aconiti Lateralis Radix praeparata, baked, skin and rootlet removed), Gancao (Licorice Radix et Rhizoma roasted), each 1 qian; Chenpi (Citri Reticulatae Pericarpium) 5 fen; Wuweizi (Schisandrae Fructus) 9 grains. Add fresh ginger and decoct for administration.
The above formula treats Zhong Han generally; for severe cases, double the dose of Fuzi. For dry retching with white phlegm and saliva, add Wuzhuyu; for absent pulse, add one spoonful of Zhu Danzhi (Porcine Bile); for severe diarrhea, add Huanglian (Coptidis Rhizoma) and Shengma ( Cimicifugae Rhizoma); for severe vomiting, add more Jiangzhi (Fresh Ginger Juice), followed by Guanzi Gui (Cinnamomi Cortex) and Danggui (Angelicae Sinensis Radix) to warm the Blood level, as Cold damages Ying (Nutritive Qi). In emergencies without medicine, wrap a cloth strip into a circle and place it on the navel, put fried salt in the center, and apply three large moxa cones on top. Moxa until the number of cones is sufficient, stopping when abdominal pain ceases. Additionally, moxa Qihai (one point, 1.5 cun below the navel, 20 cones), Dantian (one point, 2 cun below the navel), and Guanyuan (one point, 3 cun below the navel). Treats Zang-Jie (organ knotting) which cannot be purged, continuous sweating of the yin area, abdominal distension with borborygmus, black complexion, and cyanotic fingernails (over 100 cones). Measurement method: Have the patient bend the middle finger; the distance between the two creases of the middle joint equals 1 cun.
Hot Compress Method: Use 1 jin of salt, stir-fry until hot, wrap in two layers of cloth, and press over the painful abdominal and umbilical areas. Replace when cool. (If salt is unavailable, wheat bran, ash, or sand can be used.) Another method: Use 2 sheng of Wuzhuyu, mix with wine and stir-fry, then boil hot. Place in a silk bag, or boil 2-3 he of Wuzhuyu until boiling, add 1 sheng of wheat bran and 1 he of salt, stir-fry, wrap, and press over the heart/abdomen and palms/soles. Stop when Qi circulation resumes. Ginger-Scallion Hot Compress (Formula see Shanghan chapter): Take a handful of scallions, bind into a cake shape, cut off roots and green leaves, keeping about 2 cun of the white part. First, sear with fire until thoroughly hot, place above and below the patient's navel, and iron with a heated iron. It is excellent to first place Shexiang (Musk) and Liuhuang (Sulfur) in the navel. Make 3-4 cakes and replace when damaged. Stop when hands and feet are warm and slight sweating occurs. Administer internal main formula.
Navel Steaming Method: Shexiang (Musk), Banxia powder, Saojiao powder (each 3 fen). Place in the navel, cover with salt, and moxa 14 cones.
Lizhong Tang (Regulate the Middle Decoction): Treats Taiyin Zhong Han causing Zhongwan pain, spontaneous diarrhea without thirst, abundant Cold, abdominal pain with diarrhea, Huoluan (cholera-like syndrome) with cold extremities.
Renshen, Baizhu, Ganjiang, Gancao (each 2 qian, reduce for mild cases). Add fresh ginger and decoct.
For moving Kidney Qi, remove Baizhu and add Guizhi (Cinnamon Twig) 2 qian; for excessive vomiting, remove Baizhu and add Shengjiang (Fresh Ginger) 3 qian, Dingxiang (Caryophylli Flos) 5 fen; for frequent diarrhea, add Muxiang (Aucklandiae Radix) 1 qian; for astringent urination, add Fuling; for thirst, add Baizhu; for Cold, add Ganjiang; for abdominal pain with diarrhea, add Paofuzi (Prepared Aconite) 2 qian; for Huoluan with muscle cramps, add Shigao (Gypsum Fibrosum) 5 qian. Zhishi Lizhong Wan (Immature Bitter Orange Regulate the Middle Pill): Treats Han-Shi Jie-Xiong (Cold-Excess Chest Binding). Add Fuling and Zhishi, grind into powder, form pills with honey the size of beans, swallow with warm water.
Wuji San (Five Accumulations Powder): Treats Shaoyin umbilical/abdominal pain and Cold Damage from exogenous Cold, headache, body pain with stiffness, vomiting. Regardless of exogenous Wind-Cold or endogenous injury from raw/cold food, Cold-Dampness lodging in meridians, soreness/pain of waist/back, amenorrhea in women.
Baizhi (Angelicae Dahuricae Radix), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Chenpi, Houpo (Magnoliae Officinalis Cortex), Cangzhu (Atractylodis Rhizoma), Baishao (Paeoniae Radix Alba), Zhike (Aurantii Fructus Immaturus), Jiegeng (Platycodonis Radix), Banxia (processed, each 1 qian); Ganjiang, Fuling, Guanzi Gui (each 5 fen); Gancao (3 fen); Mahuang (Ephedrae Herba) (8 fen in winter, 2 fen in summer). Add 3 slices of fresh ginger and 3 scallion heads, decoct and administer.
Sini Tang (Frigid Extremities Decoction): Treats Jueyin lower abdominal pain, Taiyin spontaneous diarrhea without thirst, Yin syndrome with deep pulse, body pain (start with a mild dose).
Fuzi (one piece, raw, skin/rootlet removed, cut into 8 slices), Gancao (roasted, 6 qian), Ganjiang (5 qian). Divide into two doses, decoct in water, take warm, induce sweating.
Zhuyu Sini Tang (Evodia Frigidity Extremities Decoction): Treats Jueyin Zhong Han with severe lower abdominal pain. Tongmai Sini Tang (Unblock Pulse Sini Decoction) (Double the Gancao in the previous formula).
Wuzhuyu (soaked), Fuzi (prepared), Ganjiang (each 2 qian), Zhigancao (1.5 qian). Add fresh ginger, decoct in water and administer.
Fuzi San (Aconite Powder): Treats Zhong Han Yin syndrome, cyanotic lips and black face, rigidity of back and body, cold extremities, various entrenched Cold syndromes.
Fuzi (fully prepared/cooked, 2 qian), Guanzi Gui, Danggui, Baizhu, Ganjiang, Banxia (each 7 fen), Shengjiang (5 slices), Dazao (Jujubae Fructus, 2 pieces). Decoct and administer.
Suhe Xiang Wan (Styrax Pill): Treats Zhong Feng (Wind Stroke), Zhong Qi (Qi Strike), Zhong Han (Cold Strike), sudden collapse, locked jaw and unconsciousness, acute Cold-Toxin invasion, colicky abdominal pain, cold extremities with vomiting/diarrhea, Bi-pain of heart, evil spirits, Lao-Zhai (consumptive disease), Yi-Li (epidemic pestilence), foul air, Lan-Zhang (mountain miasma), Gu-Zhu (parasitic disease), pediatric acute/chronic convulsive wind. Dosage: Adults one pill, children half a pill. Dissolve in Fresh Ginger Juice, take with Ginger Water. For locked jaw, rub half a pill on teeth, then administer once open. For Wind-Cold with cough/phlegm/wheezing, take with Ginger-Scallion Water. For postpartum diarrhea/abdominal pain, all Wind-Cold/Anger-induced chest fullness, etc., protect against fog/dew, take with Wine. Contraindicated for Fire syndromes.
Xiangfu (Cyperi Rhizoma), Baizhu, Anshixiang (Styrax), Tanxiang (Sandalwood), Muxiang, Bibo (Piperis Longi Fructus), Xijiao (Rhinocerotis Cornu, separately ground to powder), Chenxiang (Aquilaria Wood), Hezi (Terminalia Chebulae Fructus flesh, each 2 liang); Shexiang, Ruxiang (Boswelliae Resin), Zhusha (Cinnabar, water-ground and re-ground), Suheyou (Styrax Oil, each 1 liang); Bingpian (Borneolum Syntheticum) (5 qian).
Take authentic ingredients, grind separately into fine powders. Then add Musk, Borneol, Styrax Oil, and Cinnabar, grind uniformly. Mix with refined white honey. Each pill weighs 2 qian. Seal thickly with yellow wax or store in small bottles sealed with wax. Prevent gas leakage and moisture.