许叔微云∶有病伤寒，身热头疼。余视之曰∶邪在表，此表实症也，当汗之以麻黄汤。或问曰∶伤寒大
抵因虚，故邪得以入之。邪在表，何以云表实也？予曰∶古人称邪之所凑，其气则虚；留而不去，其病则实。
盖邪之入人也，始因虚入，邪居中反为实矣。大抵调治伤寒，先要明表里虚实，能明此四字，则仲景三百九十
七法，可立而定也。何以言之有表实、有表虚、有里实、有里虚、有表里俱实、有表里俱虚？仲景麻黄汤
之类，为表实而设也。桂枝汤之类，为表虚而设也。里实则承气之类是也，里虚则四逆之类是也。表
里俱实，所谓阳盛阴虚，下之则愈也。表里俱虚，所谓阳虚阴盛，汗之则愈也。常读《华佗传》，有府吏
倪寻、李延，其症俱头痛身热，所苦正同。佗曰∶寻当下之，延当发汗。或难其异，佗曰∶寻外实，延内
实，故治之异耳。（外实、内实，汗卞倒施，疑有误。此可当伤寒总论。）
一人初得病，四肢逆冷，脐下筑痛，身痛如被杖，盖阴症也。急服金液、破阴、来复等丹，其脉遂沉而
滑。沉者，阴也；滑者，阳也。阴病得阳脉者生。仍灸气海、丹田百壮，手足俱温，阳回得微汗而解。或问滑
沉之脉，如何便有生理？曰∶仲景云，翕奄沉名曰滑。何谓也？沉为纯阴，翕为正阳，阴阳和合，故名曰滑。
古人论脉滑，虽曰往来前却，流利旋转，替替然与数相似，仲景三语而足也。此三字极难晓。翕，合也，言张
而复合也，故曰翕为正阳。沉、言忽降而下也，故曰沉为正阴。方翕而合，俄降而沉，奄为忽忽间。仲景论滑脉，
可谓谛当矣。其言皆有法，故读者难晓，宜细思之。（可作伤寒论读，治阴症指南。）
一人病伤寒下利，神昏多困，谵语，不得眠。或者见下利，便以谵语为阴虚症。许曰∶此亦小承气症。众
骇曰∶下利而服小承气，仲景之法乎？许曰∶此仲景之法也。仲景曰，下利而谵语者，有燥粪也，属小承气汤
而得解。予尝读《素问》云∶微者逆之，甚者从之；逆者正治，从者反治。从多从少，视其事也。帝曰，何谓
反治？岐伯曰，塞因塞用，通因通用。王冰注云∶大热内结，注泻不止，热宜寒疗，结热须除以寒，下之结散
利止，则通因通用也。正合于此，又何疑焉？（引经论治，了如指掌。治里症法。）
一人患伤寒五六日，头汗自出，自颈以下无汗，手足冷，心下痞闷，大便秘结。或见四肢冷，又汗出满闷，
以为阴症。诊其脉沉而紧，为少阴症多是自利，未有秘结也。此症半在表半在里，投以小柴汤得愈。仲景谓
四肢冷，脉沉紧，腹满，全似少阴。然大便硬，头汗出，不得为少阴。盖头者三阳同聚，若三阴止胸而还，有
头汗出，自是阳虚，故曰汗出为阳微，是阴不得有汗也。若少阴，头有汗则死矣。故仲景平脉法云∶心者，火
也。明少阴则无头汗者可治，有汗者死。心为手少阴，肾为足少阴，相与为上下，惟以意逆志者斯可得之。（治
半表半里法。）
一人患伤寒，得汗数日，忽身热自汗，脉弦数，心不得宁，真劳复也。诊之曰∶劳心之所致，神之舍未复
其初，而又劳伤其神，营卫所以失度也，当补其子，益其脾，解其劳，庶几得愈。授以补脾汤，佐以小柴胡汤，
解之而愈。补脾汤∶人参、白术、甘草、橘皮、青皮、干姜各等分。（伤寒之后，防有余热，干姜、白术尚宜斟酌。）
侯国华病伤寒四五日，身微斑，渴欲饮。诊之，沉弦欲厥，阴脉也。服温药数日不已，又以姜、附等药，
觉阳微回，脉渐生。因渴，私饮水一杯，脉退。又见头不举，目不开，问之，则犯阴阳易。只与烧 散连进二
服，出大汗，两昼夜而愈。（阳易治法。）
《衍义》治伤寒汗不出搐脚法∶用海蛤粉、乌头各二两，穿山甲三两，为末，酒糊为丸，大一寸许，捏匾，
置患人足心下。擘葱白盖药，以帛缠足，坐于暖室，取热汤浸脚至膝下。久则水温，又添热水，候遍身汗出为
度。凡一二日一次，浸脚以和为度。（外治取汗法。以上俱《医学纲目》。）
张子和曰∶予之常溪，雪中冒寒入浴，重感风寒，遂病不起。但使煎通圣散单服之，一二日不食，惟渴饮
水，亦不多饮。时时使人捶其股，按其腹，凡三四日不食，日饮水一二十度。至六日，有谵语妄见，以调胃承
气汤下之，汗出而愈。常谓人曰∶伤寒勿妄用药，惟饮水最为妙药，但不可使之伤，常令揉散，乃大佳耳。至
六七日，见有下证，方可下之，岂有变异哉。奈何医者禁人饮水，至有渴死者。病患若不渴，强与水饮亦不肯
饮也。予初病时，鼻塞声重，头痛，小便如灰淋汁。及服调胃承气一两半，觉欲呕状，探而出之，汗出 然。
须臾下五六行，大汗，一日乃瘳。当日饮水下，则痰出约一二碗。痰即是病也，痰去则病去矣。予时年六十一
岁。（伤寒初起在表时，速以麻黄汤解之，则不至成下证。否则二三日后便入里，不得不用承气矣。子和此案
俱得法，惟解表略缓，故须继以承气耳。）
焦百善偶感风寒，壮热头痛，其巷人点蜜茶一碗使啜之。焦因热服之讫，偶思张语曰∶凡苦味皆能涌，今
兼头痛，是病在上。试以箸探之，吐毕，其痛立解。
孙兆治俞伯道，忽患微热，心下满，头痛，汗不能解。众医以为温病，用表。有谓食在膈者，治之不愈。
召孙至，用半夏茯苓汤。问其故，曰∶头有汗，心下满，非湿症，乃水结胸也。小便既去，其病乃愈。且如湿
气心下满，自当遍身有汗。有食心下满，岂得有汗？若言是表，身又不恶寒，疼痛，表症何在？故凡水结胸，
头必有汗。（出《伤寒口诀》。）
窦材治一人，患肺伤寒，（别名。）头痛发热，恶寒咳嗽，肢节疼，脉沉紧。服华盖散、黄 建中汤略解。
至五日，昏睡谵语，四肢微厥，乃肾气虚也。灸关元百壮，服姜附汤，始汗出愈。（作虚治。）
一人伤寒，昏睡妄语，六脉弦大。窦曰∶脉大而昏睡，定非实热，乃脉随气奔也。强为之治，用烈火灸关
元穴。初灸，病患觉痛，至七十壮遂昏睡不痛。灸至三鼓，病患开眼思饮食。令服姜附汤，至三日后，方得元
气来复，大汗而解。
一人患伤寒至八日，脉大而紧，发黄，生紫斑，噫气，足趾冷至脚面。此太阴症也，最重难治。为灸命关
五十壮，关元二百壮，服金液丹、钟乳粉，四日汗出而愈。
一人患伤寒至六日，脉弦紧，身发热，自汗，太阴症也。先服金液丹，灸命关穴。病患不肯灸。伤寒惟太
阴少阴二症死人最速，若不早灸，虽服药无功。不信，至九日泻血而死。
一人伤寒至六日，微发黄。一医与茵陈汤，次日更深黄色，遍身如栀子。此太阴症，误服凉药而致肝木侮
脾。为灸命关五十壮，服金液丹而愈。
一人患伤寒，初起即厥逆，脉一息八九至。诸医以为必死。窦曰∶乃阴毒也。（厥逆脉敝，断为阴毒，
必有爪青、吐利、蜷卧等症。）与姜附汤一盏，至半夜汗出而愈。若以脉数为热，下凉药必死无疑。
张子和之仆，尝与邻人同病伤寒，俱至六七日，下之不通，邻人已死。仆发热极，投于井中，捞出以汲水
贮之槛，使坐其中。适张游他方，家人偶记张治法曰∶伤寒三下不通，不可再攻，盒饭涌之。试服瓜蒂散，良
久，吐胶痰三碗许，与宿食相杂在地，状如一帚，顿快。乃知世医杀人多矣。又一吏吐讫，使服太白散、甘露
散以调之。（邪结阳明，发为狂热，吐之犹是宿食，非若燥粪便硬可下而愈也。）
万密斋治县尹唐肖峰，二月间患伤寒。医进九味羌活汤，不效。又云内伤挟外感，进补中益气汤，不效。
又进紫苓汤去人参，病略减。四日，复发热，头苦痛，医欲下之，未决。万脉之，阳明少阳洪长而弦，曰∶此
元气素虚，因起早感寒得之，今病在少阳阳明并病。乍热乍凉者，少阳也；头苦痛者，阳明也。宜小柴胡合葛
根葱白汤。唐曰∶吾素多痰火病，勿用人参。万曰∶元气不足，乃虚火也。实火宜泻，虚火宜补。幸勿疑，一
剂而病愈。
胡晏年五十，病伤寒十六日不解。其症乍寒时，即以衣被浓覆，蒙头而卧，不胜其寒；乍热时，即撤去衣
被，暴露其身，更用扇，不胜其热。如此一日夜十余次，医皆不识。万至，告以病状可怪，邀诊其脉。曰∶不
必诊，此易知耳。夫恶寒，病在表也，何以无头痛症？恶热，病在里也，何以无渴及便溺不利症？此病在半表
半里，阴阳混乱也。阴气乘阳则恶寒，阳气乘阴则恶热。宜用小柴胡以治其半表半里之邪，栀子、豆豉以治其
阴阳错杂之邪。服之，寒热不再作而愈。
李养晦患伤寒，苦右胁痛。医用陶节庵法，以小柴胡加枳壳、桔梗，服之无效，已十七日。万脉之，沉弦
且急，曰∶此蓄水症也。经云，沉潜为水，支饮脉弦急，必得之饮水过多。问曾服何方？以前药对。万曰∶只
用此方，再加牡蛎以泄其蓄水可耳。一服而痛止。
一门子病伤寒，医与发汗，七日复不愈，小腹满而痛，欲下之未敢。万脉之，沉弦而急，问曾渴饮水乎？
答曰∶甚渴，虽饮水渴不止。曰∶此蓄水似疝症，不可下也。乃用五苓散以利其水，加川楝子、小茴香以止小
腹之痛。一服，洞泄四五行，皆清水。次日再求诊。曰∶不必再药，水尽泄自止矣。三日后果安。
沈天禄病伤寒，汗下后病不解，身无大热，不惺惺，医者但云谵语。以症论之，乃错语也。（谵语错语，
极宜细辨。）缘汗下之后，元气未复，神识不清耳。与补中益气汤去升、柴，加麦冬、生地、熟附子，一服而愈。
孙文垣治张二官，发热头痛，口渴，大便秘结三日未行，脉洪大，曰∶此阳明少阳二经之症。用大柴胡汤
行三五次，所下皆黑粪，夜出臭汗。次日清爽，惟额上仍热，（阳明部位。）用白虎汤加葛根、天花粉。因食粥太
早，复发热咳嗽，口渴殊甚，且恶心，（食复。）用小柴胡加枳实、山栀、麦芽。次日渴不可当，（半夏、枳实、麦
芽，皆能耗阳明津液。）改以白虎汤加麦冬、花粉，外与辰砂益元散，以井水调服五钱，热始退，渴始定。不虞
夜睡失盖，复受寒邪，天明又大发热，人事不知，（复感。）急用小柴胡汤加升麻、葛根、前胡、薄荷。汗
出热退，神思大瘁，四肢皆冷，语言懒倦且咳嗽，以生脉散加石斛、百合、大枣、白芍。服后咳嗽寻止，精
神日加，饮食进而愈。
缪仲淳治姚平子伤寒，头疼身热，舌上黄胎，胸膈饱闷，三四日热不解，奄奄气似不属者。（邪热甚则正
气馁，不可误认为虚。）一医以其体素弱，病久虚，其意欲投参少许。缪叱曰∶一片入口死矣。亟以大黄一两，
栝蒌二枚连子切片，黄连、枳实下之。（小陷胸加大黄。）主人惊疑，不得已，减大黄之半，二剂便通，热立解，遂愈。
高存之一家人妇，伤寒，来乞方，缪已疏方与之矣。见其人少年，曰∶若曾病此否？曰∶然。曰∶愈几日
而妻病？曰∶八九日。曰∶曾有房欲否？曰∶无之。缪故曰∶若有房欲，此方能杀人也。其人即置方不取。遂
以裆、雄鼠粪、麦冬、韭白、柴胡，二剂势定。更用竹皮汤，二三剂全愈。（观此则伤寒初愈，脏
腑犹多热毒，时师不察，骤投参、 、术、附温补，其遗患可胜言哉。）
一奴伤寒热解后，复下血不止。主人以痢药投之，更甚。缪曰∶此伤寒失汗之余症也。用地榆、麦冬、
知母、竹叶，以代仲景诸血症药，遂愈。
翁具茨感冒壮热，舌生黑苔，烦渴，（阳明症。）势甚剧。诸昆仲环视挥泪，群医束手。缪以大剂白虎汤
加人参三钱，一剂立苏。或问缪，治伤寒有秘方乎？缪曰∶熟读仲景书即秘方也。（藜按∶此系温病，故
以人参白虎汤取效。）
常熟吴见田在京邸时，有小青衣患伤寒，愈而复，复而愈，愈而再复，不知其几。谓缪曰∶非兄不能救。
诊之，病患面色黄白，（有胃色。）六脉微弱，（有胃色。）大便不通，胸中不快，亦不思食，曰∶此为伤寒
百合（无经络，百脉一齐致病，谓之百合病。）坏症（正气已虚，邪气留滞，及过经不解；瘥后，或虚羸少气，
皆谓之坏病。）之余，邪且退矣。（以色脉断。）胸中不快，虚而气壅，非实邪；不大便者，久病津液枯，气
弱不能送也。投以人参五钱，麦冬一两，枳壳炒八钱，尽剂立解而瘥。（文田按∶用百合治者方谓之百合病。
今药无百合，而云百合病，非也。此直是伤寒坏症耳。）
梁溪一男子，素虚。春中感冒，头痛，肌痛，发热。羌活二钱，麦冬三钱，炙甘草一钱，紫苏一钱五分，
北细辛七分，前胡一钱五分。次日头痛止，热未退，口渴，缪用白芍、五味子。人曰∶风未退，遽用酸敛何也？
曰∶因人而施尔。一杯即愈。麦冬三钱，甘草一钱，栝蒌根二钱五分，干姜一钱五分，桑皮三钱，桔梗一钱，
白芍一钱，五味子五分。
四明虞吉卿，因三十外出疹，不忌猪肉，兼之好饮，作泄八载矣。忽患伤寒，头疼如裂，满面发赤，（汗
许叔微说：有人患伤寒，身体发热、头痛。我观察后说：邪气在体表，这是表实证，应当用麻黄汤发汗治疗。有人问：伤寒大多是因为正气虚弱，所以邪气才得以侵入。既然邪气在体表，为什么说它是表实证呢？我说：古人说“邪之所凑，其气必虚”，意思是邪气聚集的地方，正气是虚的；但邪气停留不去，病势就会表现为实。大概邪气进入人体，起初是因为正气虚而入，但邪气居于体内反而导致实证。大致调理治疗伤寒，首先要明白表、里、虚、实这四个概念，能明白这四点，那么张仲景的三百九十七种治法，就可以确立并掌握了。为什么这么说呢？有表实、有表虚、有里有虚、有表里俱实、有表里俱虚？张仲景的麻黄汤之类，是为表实证而设的。桂枝汤之类，是为表虚证而设的。里实证就是承气汤之类的方剂，里虚证就是四逆汤之类的方剂。表里俱实，就是所谓的阳盛阴虚，用泻下法就能痊愈。表里俱虚，就是所谓的阳虚阴盛，用发汗法就能痊愈。常读《华佗传》，里面记载府吏倪寻、李延，他们的症状都是头痛身热，痛苦之处完全相同。华佗说：倪寻应当用泻下法，李延应当用发汗法。有人对这种差异感到疑惑，华佗说：倪寻是外实（指邪气在表），李延是内实（指邪气在里），所以治疗方法不同罢了。（注：原文中“外实、内实”与后文“汗卞倒施”可能存在文字错乱或理解歧义，此处暂按字面意译，此段可作为伤寒总论参考。）
另有一人刚得病时，四肢厥冷，脐下跳痛，全身疼痛像被棍棒打过一样，这是阴证。急忙服用金液丹、破阴丹、来复丹等药物，脉象随即变得沉而滑。沉脉属阴，滑脉属阳。阴证出现阳脉者生。仍然艾灸气海穴、丹田穴各一百壮，手脚都变暖了，阳气回复并微微出汗而痊愈。有人问：滑脉和沉脉同时出现，怎么就有生机了呢？我说：张仲景说，“翕奄沉名曰滑”。这是什么意思呢？沉为纯阴，翕为正阳，阴阳调和，所以叫作滑脉。古人论述滑脉，虽然说是往来流利、旋转替替然与数脉相似，但张仲景三句话就足够了。这三个字极难理解。“翕”，是合的意思，指张开而后闭合，所以说翕为正阳。“沉”，指忽然下降而下潜，所以说沉为正阴。方才翕合，随即降沉，“奄”表示忽忽之间。张仲景论述滑脉，可以说是非常精当的。他的话都有法度，所以读者难以理解，应该仔细思考。（此段可当作《伤寒论》阅读指南，治疗阴证的指导。）
又有一人患伤寒腹泻，神志昏迷、疲倦困顿，胡言乱语，无法入睡。有的人见到腹泻，便认为胡言乱语是阴虚证。许叔微说：这也是小承气汤证。众人惊讶地说：腹泻却服用小承气汤，符合张仲景的法度吗？许叔微说：这正是张仲景的法度。张仲景说，腹泻且胡言乱语的，是有燥屎内结，属于小承气汤证，服药后可解。我曾读《素问》说：“微者逆之，甚者从之；逆者正治，从者反治。”顺从病情的多少，要看具体情况。黄帝问：什么叫反治？岐伯说：塞因塞用，通因通用。王冰注释说：大热内结，导致泄泻不止，热症宜用寒凉药物治疗，内结的热邪须用寒凉药去除，泻下后结散利止，这就是通因通用。这与本例完全吻合，又有什么可怀疑的呢？（引用经典理论指导治疗，了如指掌。治疗里证的方法。）
又有一人患伤寒五六天，只有头部出汗，颈部以下无汗，手脚冰冷，心下痞闷，大便秘结。有人见四肢冷，又有出汗和满闷，以为是阴证。诊察他的脉象沉而紧，少阴证大多伴有自利（腹泻），没有大便秘结的情况。此证半在表半在里，投以小柴胡汤得以痊愈。张仲景说，四肢冷、脉沉紧、腹满，全像少阴证。但是大便硬、头汗出，就不能诊断为少阴证。因为头部是三阳经汇聚之处，若三阴经只到胸部就返回，若有头汗出，自然是阳虚，所以说“汗出为阳微”，阴证不应该有汗。如果是少阴证，头部有汗就会死亡。所以张仲景在《平脉法》中说：心属火。明确少阴证无头汗出的可以治疗，有头汗出的会死亡。心为手少阴，肾为足少阴，上下相应，只有用心意去推求才能得其真谛。（治疗半表半里证的方法。）
又有一人患伤寒，已经发过几天汗，忽然身体发热、自汗，脉弦数，心神不宁，这是真正的劳复（劳累后复发）。诊察后说：这是劳心所致，神的居所未能恢复如初，而又劳伤了神，营卫因此失去节度，应当补益子脏（脾），益脾，解除劳损，或许能痊愈。给予补脾汤，佐以小柴胡汤，解表后痊愈。补脾汤配方：人参、白术、甘草、橘皮、青皮、干姜各等分。（注：伤寒之后，防止有余热，干姜、白术尚需斟酌使用。）
侯国华患伤寒四五日，身上出现轻微斑纹，口渴想喝水。诊察脉象沉弦欲厥，这是阴脉。服用温药几天不见好转，又用姜、附等药，感觉阳气微弱回复，脉象逐渐恢复。因为口渴，私自喝了一杯水，脉象随即退去。又见头抬不起来，眼睛睁不开，询问原因，则是犯了阴阳易（伤寒愈后因房事复发）。只给予烧裈散连续服用两次，出大汗，两昼夜后痊愈。（阴阳易的治疗方法。）
《衍义》记载治疗伤寒不出汗、脚抽筋的方法：用海蛤粉、乌头各二两，穿山甲三两，研为细末，酒糊做成丸药，大小约一寸，捏扁，放在病人足心下。掰开葱白盖在药上，用布缠住脚，坐在暖室里，用热水浸脚至膝盖以下。时间久了水温降低，再添加热水，等到遍身出汗为止。凡是一两天一次，浸脚以舒适为度。（外治取汗法。以上均出自《医学纲目》。）
张子和说：我在常溪时，雪中冒寒洗澡，再次感受风寒，于是病重不起。只是让人煎服防风通圣散单味药，一两天不吃东西，只渴着喝水，但也不多喝。时时让人捶打大腿，按摩腹部。凡是不吃东西三四天，每天喝水一二十次。到了第六天，出现胡言乱语、妄见幻觉，用调胃承气汤泻下，出汗而痊愈。常对人说：伤寒不要胡乱用药，只有喝水是最妙的药，但不要让它造成伤害，经常揉散积滞，才是最好的。到了六七天，看到有可下的证候，才可以泻下，哪里会有什么变异呢？奈何医生禁止病人喝水，以至于有渴死的。如果病人不渴，强行给水喝他们也不会喝。我刚生病时，鼻塞声重，头痛，小便像灰淋汁一样。等到服用一两半调胃承气汤，觉得想呕吐，探吐出来，然后出汗。一会儿排泄五六次，大汗，一天就好了。当天饮水之下，吐出痰约一二碗。痰即是病，痰去则病去。我当时六十一岁。（注：伤寒初起在表时，速以麻黄汤解表，就不会发展成下证。否则两三天后邪气入里，不得不使用承气汤。张子和这个医案都合乎法度，只是解表略缓，所以需要继以承气汤。）
焦百善偶然感受风寒，高热头痛，邻居给他一碗蜜茶让他喝。焦百善趁热喝完，偶然想起张子和的话说：凡是苦味都能涌吐，现在兼有头痛，病位在上。试着用筷子探喉催吐，吐完后，头痛立刻缓解。
孙兆治疗俞伯道，忽然患微热，心下胀满，头痛，出汗不能解表。众医生认为是温病，用解表法。有人说是有食积在膈膜，治疗无效。请孙兆来，用半夏茯苓汤。问他原因，孙兆说：头有汗，心下满，不是湿证，是水结胸证。小便通畅后，病就好了。况且如果是湿气导致的心下满，自然应该遍身有汗。如果有食积导致心下满，怎么会有汗？如果说是在表，身体又不恶寒、疼痛，表证在哪里？所以凡是水结胸，头部一定有汗。（出自《伤寒口诀》。）
窦材治疗一人，患肺伤寒（别名），头痛发热，恶寒咳嗽，肢节疼痛，脉沉紧。服用华盖散、黄芪建中汤后略微缓解。到了第五天，昏睡胡言乱语，四肢微厥，这是肾气虚。灸关元穴一百壮，服用姜附汤，才开始出汗痊愈。（按虚证治疗。）
又有一人伤寒，昏睡胡言乱语，六脉弦大。窦材说：脉大而昏睡，肯定不是实热，而是脉随气奔也。强行治疗，用烈火灸关元穴。刚开始灸，病人觉得痛，灸到七十壮时昏睡不觉痛。灸到三更天，病人睁开眼睛想吃东西。令其服用姜附汤，三天后，元气才恢复，大汗而解。
又有一人患伤寒到第八天，脉大而紧，发黄，生出紫斑，嗳气，脚趾冷至脚面。这是太阴证，最重难治。灸命关穴五十壮，关元穴二百壮，服用金液丹、钟乳粉，四天出汗而愈。
又有一人患伤寒到第六天，脉弦紧，身体发热，自汗，这是太阴证。先服用金液丹，灸命关穴。病人不肯灸。伤寒中只有太阴、少阴两证死人最快，如果不早灸，即使服药也无功。不信，到了第九天泻血而死。
又有一人患伤寒到第六天，微发黄。一位医生给予茵陈汤，第二天黄色更深，遍身如栀子色。这是太阴证，误服凉药导致肝木侮脾。灸命关穴五十壮，服用金液丹而愈。
又有一人患伤寒，初起即四肢厥逆，脉搏一息八九至。众医生认为必死。窦材说：这是阴毒证。（厥逆脉敝，断定为阴毒，必有爪青、吐利、蜷卧等症状。）给予姜附汤一盏，半夜出汗而愈。如果认为脉数是热证，用凉药必死无疑。
张子和的仆人，曾与邻居同患伤寒，都到了六七天，泻下不通，邻居已死。仆人发热极重，被扔进井中，捞出后用汲来的水装满栏杆围成的空间，让仆人坐其中。恰逢张子和游历他方，家人偶然想起张子和的治疗法则说：伤寒三次泻下不通，不可再攻，应当涌吐。试服瓜蒂散，很久以后，吐出胶痰约三碗，与宿食混杂在地上，状如一帚，顿时感觉畅快。才知道世间的医生杀人太多了。又一官吏吐完后，让他服用太白散、甘露散来调理。（邪结阳明，发为狂热，吐之仍是宿食，不像燥屎坚硬可用泻下法痊愈。）
万密斋治疗县尹唐肖峰，二月间患伤寒。医生进九味羌活汤，无效。又说内伤挟外感，进补中益气汤，无效。又进紫苓汤去人参，病情略微减轻。第四天，又发热，头部剧烈疼痛，医生想泻下，未决断。万密斋诊脉，阳明、少阳脉洪长而弦，说：这是元气素虚，因早起感寒所致，现在病在少阳阳明并病。乍热乍凉的是少阳证；头部剧烈疼痛的是阳明证。宜用小柴胡汤合葛根葱白汤。唐肖峰说：我平时多痰火病，不要用参。万密斋说：元气不足，是虚火。实火宜泻，虚火宜补。希望不要怀疑，一剂药而病愈。
胡晏年五十岁，患伤寒十六天不解。症状是：突然怕冷时，就用厚衣被覆盖，蒙头而卧，受不了寒冷；突然发热时，就撤去衣被，暴露身体，甚至用扇子扇，受不了炎热。如此一天一夜十多次，医生都不认识。万密斋到，告知病情奇怪，邀请诊脉。说：不必诊脉，这很容易知道。恶寒，病在表，为什么没有头痛症？恶热，病在里，为什么没有口渴及小便不利症？此病在半表半里，阴阳混乱。阴气乘阳则恶寒，阳气乘阴则恶热。宜用小柴胡汤治疗半表半里之邪，栀子、豆豉治疗阴阳错杂之邪。服用后，寒热不再发作而痊愈。
李养晦患伤寒，苦于右胁痛。医生用陶节庵的方法，用小柴胡汤加枳壳、桔梗，服用无效，已十七天。万密斋诊脉，沉弦且急，说：这是蓄水证。经书说，沉潜为水，支饮脉弦急，必定是由于饮水过多引起。问曾服用什么方？以前药相对。万密斋说：只用此方，再加牡蛎以泄其蓄水即可。一服而痛止。
一门客患伤寒，医生给发汗药，七天仍不愈，小腹满而痛，想泻下不敢。万密斋诊脉，沉弦而急，问曾口渴喝水吗？回答：很渴，虽然喝水渴不止。说：这是蓄水似疝症，不可泻下。乃用五苓散以利其水，加川楝子、小茴香以止小腹之痛。一服，洞泄四五行，全是清水。次日再来求诊。说：不必再药，水尽泄自止矣。三天后果然平安。
沈天禄患伤寒，汗下后病不解，身无大热，神志不清，医生只说是谵语。以症状分析，乃是错语。（谵语错语，极宜细辨。）因为汗下之后，元气未复，神识不清耳。给予补中益气汤去升麻、柴胡，加麦冬、生地、熟附子，一服而愈。
孙文垣治疗张二官，发热头痛，口渴，大便秘结三日未行，脉洪大，说：这是阳明少阳二经之症。用大柴胡汤行三五次，所下皆黑粪，夜出臭汗。次日清爽，惟额上仍热（阳明部位），用白虎汤加葛根、天花粉。因吃粥太早，又发热咳嗽，口渴殊甚，且恶心（食复），用小柴胡汤加枳实、山栀、麦芽。次日渴不可当（半夏、枳实、麦芽，皆能耗阳明津液），改以白虎汤加麦冬、花粉，外与辰砂益元散，以井水调服五钱，热始退，渴始定。不料夜睡失盖，又受寒邪，天明又大发热，人事不知（复感），急用小柴胡汤加升麻、葛根、前胡、薄荷。汗出热退，神思大瘁，四肢皆冷，语言懒倦且咳嗽，以生脉散加石斛、百合、大枣、白芍。服后咳嗽寻止，精神日加，饮食进而愈。
缪仲淳治疗姚平子伤寒，头疼身热，舌上黄胎，胸膈饱闷，三四日热不解，奄奄一息似不属者。（邪热甚则正气馁，不可误认为虚。）一医以其体素弱，病久虚，其意欲投参少许。缪叱曰：一片入口死矣。亟以大黄一两，栝蒌二枚连子切片，黄连、枳实下之。（小陷胸加大黄。）主人惊疑，不得已，减大黄之半，二剂便通，热立解，遂愈。
高存之一家人妇，伤寒，来乞方，缪已疏方与之矣。见其人少年，曰：若曾病此否？曰：然。曰：愈几日而妻病？曰：八九日。曰：曾有房欲否？曰：无之。缪故曰：若有房欲，此方能杀人也。其人即置方不取。遂以裆、雄鼠粪、麦冬、韭白、柴胡，二剂势定。更用竹皮汤，二三剂全愈。（观此则伤寒初愈，脏腑犹多热毒，时师不察，骤投参、术、附温补，其遗患可胜言哉。）
一奴伤寒热解后，复下血不止。主人以痢药投之，更甚。缪曰：此伤寒失汗之余症也。用地榆、麦冬、知母、竹叶，以代仲景诸血症药，遂愈。
翁具茨感冒壮热，舌生黑苔，烦渴（阳明症），势甚剧。诸昆仲环视挥泪，群医束手。缪以大剂白虎汤加人参三钱，一剂立苏。或问缪，治伤寒有秘方乎？缪曰：熟读仲景书即秘方也。（藜按：此系温病，故以人参白虎汤取效。）
常熟吴见田在京邸时，有小青衣患伤寒，愈而复，复而愈，愈而再复，不知其几。谓缪曰：非兄不能救。诊之，病患面色黄白（有胃色），六脉微弱（有胃色），大便不通，胸中不快，亦不思食，曰：此为伤寒百合坏症之余，邪且退矣。（以色脉断。）胸中不快，虚而气壅，非实邪；不大便者，久病津液枯，气弱不能送也。投以人参五钱，麦冬一两，枳壳炒八钱，尽剂立解而瘥。（文田按：用百合治者方谓之百合病。今药无百合，而云百合病，非也。此直是伤寒坏症耳。）
梁溪一男子，素虚。春中感冒，头痛，肌痛，发热。羌活二钱，麦冬三钱，炙甘草一钱，紫苏一钱五分，北细辛七分，前胡一钱五分。次日头痛止，热未退，口渴，缪用白芍、五味子。人曰：风未退，遽用酸敛何也？曰：因人而施尔。一杯即愈。麦冬三钱，甘草一钱，栝蒌根二钱五分，干姜一钱五分，桑皮三钱，桔梗一钱，白芍一钱，五味子五分。
四明虞吉卿，因三十外出疹，不忌猪肉，兼之好饮，作泄八载矣。忽患伤寒，头疼如裂，满面发赤，（汗
Xu Shuwei said: A patient suffered from Shanghan (Cold Damage), with fever and headache. Upon examination, I stated: The pathogenic factor is in the exterior; this is an Exterior Excess syndrome. It should be treated with sweating therapy using Mahuang Tang (Ephedra Decoction). Someone asked: Shanghan generally arises due to deficiency, which allows the pathogen to enter. If the pathogen is in the exterior, why is it called an Exterior Excess syndrome? I replied: The ancients said, "Where the pathogen gathers, the Qi is deficient"; however, if the pathogen lingers and does not depart, the disease manifests as excess. Generally, when a pathogen enters the human body, it initially enters due to deficiency, but once the pathogen resides within, it creates an excess condition. In general, treating Shanghan requires first clarifying the concepts of Exterior, Interior, Deficiency, and Excess. Understanding these four terms allows one to master Zhang Zhongjing's 397 treatment methods. Why is this so? There are Exterior Excess, Exterior Deficiency, Interior Excess, Interior Deficiency, Exterior-Interior both Excess, and Exterior-Interior both Deficiency. Zhang Zhongjing's Mahuang Tang is designed for Exterior Excess. Guizhi Tang (Cinnamon Twig Decoction) is designed for Exterior Deficiency. Interior Excess corresponds to Chengqi Tang (Gut-Clearing Decoction) formulas, while Interior Deficiency corresponds to Sini Tang (Frigid Extremities Decoction) formulas. Exterior-Interior both Excess refers to Yang Excess and Yin Deficiency, cured by purging. Exterior-Interior both Deficiency refers to Yang Deficiency and Yin Excess, cured by sweating. Reading the "Biography of Hua Tuo," we find officials Ni Xun and Li Yan, who both presented with headache and fever, suffering identically. Hua Tuo said: Ni Xun should be treated with purging, Li Yan with sweating. When questioned about the difference, Hua Tuo explained: Ni Xun has Exterior Excess, Li Yan has Interior Excess; hence the different treatments. (Note: The terms "Exterior Excess" and "Interior Excess" here may contain textual errors or require specific contextual interpretation regarding the application of sweating and purging; this passage serves as a general discussion on Shanghan.)
Another case: A patient initially presented with cold limbs, throbbing pain below the umbilicus, and body pain as if beaten by a club, indicating a Yin Syndrome. Urgently administered Jinye Dan (Golden Liquid Pill), Poyin Dan (Yin-Breaking Pill), and Laifu Dan (Returning Recovery Pill). The pulse subsequently became Deep and Slippery. Deep indicates Yin; Slippery indicates Yang. A Yin syndrome presenting with a Yang pulse suggests survival. Moxibustion was applied to Qihai (CV6) and Dantian (EX-EN4) points, 100 moxa cones each. The hands and feet warmed, Yang Qi returned, slight sweating occurred, and the patient recovered. Someone asked: How can a combination of Slippery and Deep pulses indicate vitality? I said: Zhang Zhongjing stated, "Xi Yan Chen Ming Yue Hua" (When Xi and Yan combine with Chen, it is called Slippery). What does this mean? Chen is pure Yin, Xi is correct Yang. When Yin and Yang harmonize, it is named Slippery. Ancients described the Slippery pulse as flowing smoothly and rotating, resembling the Rapid pulse, but Zhang Zhongjing's three words suffice. These three characters are difficult to understand. "Xi" means closing; it refers to opening then closing, thus Xi represents correct Yang. "Chen" means suddenly descending, thus Chen represents correct Yin. Just as Xi closes, it suddenly descends into Chen; "Yan" denotes the fleeting moment between. Zhang Zhongjing's discussion on the Slippery pulse is indeed precise. His words have methodological basis, making them hard for readers to grasp; careful reflection is required. (This section can serve as a guide for reading Shanghan Lun and treating Yin syndromes.)
Another case: A patient with Shanghan diarrhea presented with coma, fatigue, delirium, and insomnia. Some physicians, seeing diarrhea, attributed the delirium to Yin Deficiency. Xu Shuwei said: This is also a Xiao Chengqi Tang (Minor Order the Gut Decoction) syndrome. The crowd was shocked, asking: Taking Xiao Chengqi Tang for diarrhea, does this conform to Zhang Zhongjing's method? Xu replied: This is exactly Zhang Zhongjing's method. Zhang Zhongjing said, "In cases of diarrhea with delirium, there is dry fecal impaction; this belongs to Xiao Chengqi Tang." I once read in Suwen: "For mild conditions, treat oppositely; for severe conditions, treat similarly. Opposite treatment is standard regulation; similar treatment is counter-regulation." Huangdi asked: What is counter-regulation? Qibo answered: Use obstruction to treat obstruction, use unblocking to treat unblocking. Wang Bing commented: Severe internal heat binding causes continuous diarrhea. Heat should be treated with cold herbs. The binding heat must be removed with cold; purging disperses the binding, stopping the diarrhea—this is "using unblocking to treat unblocking." This perfectly fits the case. (Citing classics to guide treatment demonstrates mastery. Method for treating Interior syndromes.)
Another case: A patient with Shanghan for five to six days had only head sweating, no sweat below the neck, cold hands and feet, epigastric fullness, and constipation. Seeing cold limbs, sweating, and fullness, some considered it a Yin syndrome. The pulse was Deep and Tight. Shaoyin (Lesser Yin) syndrome usually involves spontaneous diarrhea, rarely constipation. This syndrome is half-exterior, half-interior. Administered Xiaochaihu Tang (Minor Bupleurum Decoction), resulting in recovery. Zhang Zhongjing noted that cold limbs, Deep-Tight pulse, and abdominal fullness resemble Shaoyin syndrome. However, hard stool and head sweating rule out Shaoyin. The head is where the Three Yang meridians converge; if the Three Yin meridians stop at the chest, head sweating indicates Yang deficiency. Thus, "sweating indicates weak Yang"; Yin syndromes should not sweat. If Shaoyin presents with head sweating, death ensues. Therefore, Zhang Zhongjing's Ping Mai Fa states: The Heart is Fire. Clarifying Shaoyin syndrome: no head sweating is treatable; head sweating is fatal. The Heart is Hand-Shaoyin, Kidney is Foot-Shaoyin, interacting above and below; only through intuitive understanding can this be grasped. (Method for treating Half-Exterior Half-Interior syndromes.)
Another case: A patient with Shanghan, after several days of sweating, suddenly developed fever, spontaneous sweating, Wiry-Rapid pulse, and mental unrest. This is true Lao Fu (Relapse due to overexertion). Examination indicated this resulted from mental exertion; the residence of the Spirit had not recovered, and further exertion damaged the Spirit, causing Ying and Wei (Nutritive and Defensive Qi) to lose rhythm. Treatment should tonify the Son organ (Spleen), benefit the Spleen, and resolve the exertion. Prescribed Bupi Tang (Spleen-Tonifying Decoction) assisted by Xiaochaihu Tang. Resolution led to recovery. Bupi Tang formula: Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), Gancao (Licorice Root), Chuanpi (Tangerine Peel), Qingpi (Green Tangerine Peel), Ganjiang (Dried Ginger) in equal parts. (Note: After Shanghan, guard against residual heat; Ganjiang and Baizhu should be used with caution.)
Hou Guohua suffered Shanghan for four to five days, with slight macules on the body and thirst. Pulse was Deep-Wiry, approaching Jue (collapse), a Yin pulse. Warm medicines taken for days were ineffective. Jiang (Fresh Ginger) and Fuzi (Prepared Aconite Root) were added; Yang Qi slightly returned, pulse gradually strengthened. Due to thirst, he privately drank a cup of water, causing the pulse to retreat. He then could not lift his head or open his eyes. Inquiry revealed he committed Yin-Yang Yi (Transmission of disease via sexual intercourse post-recovery). Only Shaokui San (Burnt Underwear Powder) was given continuously for two doses. Profuse sweating occurred, recovering in two days and nights. (Treatment for Yin-Yang Yi.)
Yanyi records a method for Shanghan without sweating and foot cramps: Use Haige Fen (Calcined Concha Meretricis), Wutou (Aconite Root) each 2 liang, Chanshijia (Pangolin Scales) 3 liang. Powder them, bind with wine paste into pills size of 1 cun, flatten, and place under the patient's sole. Cover with scallion white, wrap foot with cloth, sit in a warm room. Soak feet in hot water to below knees. As water cools, add hot water until whole-body sweating occurs. Once every one to two days, soak until comfortable. (External treatment to induce sweating. All above from Yixue Gangmu.)
Zihehe said: While at Changxi, I bathed in snow, catching cold again, leading to severe illness. I simply decocted and took Fangfeng Tongsheng San (Sap-Buffering Universal Release Powder) alone. For one to two days, I ate nothing, only drinking water when thirsty, but not much. People periodically beat my thighs and massaged my abdomen. For three to four days without food, drinking water 10-20 times daily. By the sixth day, delirium and hallucinations appeared. Tiao Wei Chengqi Tang (Regulate the Stomach Gut-Clearing Decoction) was used to purge, sweating ensued, and I recovered. I often tell people: Do not medicate Shanghan recklessly; drinking water is the best medicine, provided it does not cause harm. Regularly massage to disperse stagnation. Only after six to seven days, if purgative signs appear, should one purge. Why do doctors forbid water, leading to deaths from thirst? If not thirsty, forcing water is refused. Initially, I had nasal congestion, heavy voice, headache, urine like ash-dregs. After taking 1.5 liang of Tiao Wei Chengqi Tang, nausea arose; I induced vomiting, then sweated. Soon, five to six bowel movements followed, profuse sweating, recovering in one day. Drinking water caused expulsion of about one to two bowls of phlegm. Phlegm is the disease; removing phlegm removes the disease. I was 61 years old. (Note: Early Shanghan in the exterior should be resolved quickly with Mahuang Tang to prevent progression to interior purgative indications. Otherwise, pathogens enter the interior after 2-3 days, necessitating Chengqi Tang. Zihehe's case is lawful, though exterior resolution was slow, requiring subsequent Chengqi Tang.)
Jiao Baishan accidentally caught wind-cold, with high fever and headache. A neighbor gave him a bowl of honey tea. After drinking it hot, recalling Zihehe's words: "Bitter flavors induce vomiting. Now with headache, the pathogen is upper." He tried inducing vomiting with chopsticks. Vomiting completed, headache instantly resolved.
Sun Zhao treated Yu Bodao, who suddenly had slight fever, epigastric fullness, headache, and sweating that failed to resolve the exterior. Physicians thought it was Warm Disease, using exterior-resolving methods. Others suspected food retention in the diaphragm; treatment failed. Sun Zhao arrived, prescribed Banxia Fuling Tang (Pinellia and Poria Decoction). Asked for reasoning, he said: Head sweating and epigastric fullness indicate not Dampness, but Water Binding in the Chest. Once urination cleared, the disease healed. If it were Dampness causing epigastric fullness, there would be whole-body sweating. If food retention, how could there be sweating? If it were exterior, there would be aversion to cold and pain. Where is the exterior sign? Thus, Water Binding in the Chest always presents with head sweating. (From Shanghan Koujue.)
Dou Cai treated a man with Fei Shanghan (Lung Shanghan, alias), headache, fever, aversion to cold, cough, limb pain, Deep-Tight pulse. Huagai San (Canopy Powder) and Huangqi Jianzhong Tang (Astragalus Middle-Nourishing Decoction) provided slight relief. By the fifth day, coma, delirium, slight cold limbs indicated Kidney Qi Deficiency. Moxibustion on Guanyuan (CV4) 100 cones, plus Jiangfu Tang (Ginger and Aconite Decoction), led to sweating and recovery. (Treated as Deficiency.)
Another case: Shanghan with coma, delirium, Wiry-Large pulse. Dou Cai said: Large pulse with coma is certainly not Excess Heat, but pulse following Qi rushing. Forced treatment involved intense fire moxibustion on Guanyuan. Initially painful, became numb after 70 cones. By third watch, patient opened eyes, desired food. Given Jiangfu Tang. After three days, Yuan Qi (Primal Qi) recovered, profuse sweating ensued, and recovery occurred.
Another case: Shanghan for eight days, Large-Tight pulse, jaundice, purple macules, belching, cold toes extending to feet. This is Taiyin (Greater Yin) syndrome, most severe and difficult. Moxibustion on Mingguan (EX-LE8) 50 cones, Guanyuan 200 cones. Jin Ye Dan and Zhongru Fen (Milky Stone Powder) administered. Sweating after four days led to recovery.
Another case: Shanghan for six days, Wiry-Tight pulse, fever, spontaneous sweating, Taiyin syndrome. First Jin Ye Dan, then moxibustion on Mingguan. Patient refused moxibustion. Only Taiyin and Shaoyin syndromes kill fastest in Shanghan; early moxibustion is crucial, otherwise medicine is useless. Patient did not believe, died from bloody diarrhea on the ninth day.
Another case: Shanghan for six days, slight jaundice. One doctor gave Yinchen Tang (Artemisia Capillaris Decoction); next day yellow deepened, body like Gardenia color. This is Taiyin syndrome, caused by mistaken cooling herbs leading to Liver Wood insulting Spleen Earth. Moxibustion on Mingguan 50 cones, Jin Ye Dan administered, recovery ensued.
Another case: Shanghan starting with cold limbs, pulse 8-9 beats per breath. Physicians deemed fatal. Dou Cai diagnosed Yin Du (Yin Toxin). (Cold limbs, collapsed pulse, diagnosing Yin Toxin requires cyanotic nails, vomiting/diarrhea, curling up.) Given one cup of Jiangfu Tang. Sweating at midnight led to recovery. If pulse speed were mistaken for heat and cooled with cold herbs, death would be certain.
Zihehe's servant fell ill with Shanghan alongside a neighbor. Both reached day six-seven, purgatives failed, neighbor died. Servant had extreme fever, was thrown in a well, retrieved, and placed in a tub filled with well water. Zihehe was away; family remembered his rule: "Three purgatives failing, do not attack again, induce vomiting instead." Tried Gudi San (Melon Spore Powder). After a long time, vomited three bowls of gelatinous phlegm mixed with retained food, resembling a broom. Suddenly felt relieved. Realized many physicians kill. Another official, after vomiting, was given Taibai San and Ganlu San to regulate. (Pathogen binding in Yangming causing manic fever; vomiting expels retained food, unlike hard dry stool which requires purging.)
Wan Mizhai treated County Magistrate Tang Xiaofeng, who contracted Shanghan in February. Jiwei Qianghuo Tang (Six-Ingredient Notopterygium Decoction) failed. Then diagnosed Internal Injury with External Contraction, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) failed. Ziling Tang (Purple Spore Decoction) minus Renshen slightly improved symptoms. On day four, fever returned, severe headache. Physician wanted to purge, hesitated. Wan's pulse: Yangming and Shaoyang Large, Long, Wiry. Said: Constitution originally deficient, caught cold rising early. Now disease is Shaoyang-Yangming concurrent syndrome. Alternating fever/chills is Shaoyang; severe headache is Yangming. Should use Xiaochaihu Tang combined with Gegen Congbai Tang (Kudzu and Scallion Decoction). Tang said: I usually have Phlegm-Fire disease, do not use Ginseng. Wan said: Deficient Yuan Qi constitutes Deficient Fire. Excess Fire needs draining, Deficient Fire needs tonifying. Do not doubt. One dose cured.
Hu Yan, age 50, Shanghan unresolved for 16 days. Symptoms: Paroxysmal chills, covering with thick blankets, head covered, unable to bear cold; paroxysmal heat, stripping clothes, fanning, unable to bear heat. Occurred 10+ times/day/night, physicians baffled. Wan arrived, heard strange symptoms, invited pulse diagnosis. Said: No need to diagnose, easily understood. Aversion to cold implies Exterior, yet no headache? Aversion to heat implies Interior, yet no thirst or urinary difficulty? Disease is Half-Exterior Half-Interior, Yin-Yang chaos. Yin invading Yang causes cold aversion; Yang invading Yin causes heat aversion. Use Xiaochaihu Tang for Half-Exterior Half-Interior pathogen, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) for Yin-Yang mixed pathogen. Taken, cold/heat ceased, recovered.
Li Yanghui suffered Shanghan, bitter right hypochondriac pain. Doctor used Tao Jie'an's method: Xiaochaihu Tang plus Zhike (Aurantii Fructus) and Jiegeng (Platycodon Root). Ineffective for 17 days. Wan's pulse: Deep, Wiry, Urgent. Said: This is Water Retention syndrome. Classics say: Deep sinking indicates water; Branch-Drink pulse is Wiry-Urgent, caused by excessive drinking. Asked previous prescriptions. Wan said: Use same formula, add Muli (Oyster Shell) to drain water retention. One dose stopped pain.
A gatekeeper's son had Shanghan. Doctor used sweating method, 7 days unresolved. Lower abdominal fullness/pain, wanted to purge but dared not. Wan's pulse: Deep, Wiry, Urgent. Asked about thirst/water intake. Answer: Very thirsty, drinking doesn't quench thirst. Said: This is Water Retention resembling Hernia, cannot purge. Used Wuling San (Five-Ingredient Poria Powder) to promote urination, plus Chuanlianzi (Toosendan Fruit) and Xiaohuixiang (Fennel Fruit) for lower abdominal pain. One dose, watery diarrhea 4-5 times, all clear water. Next day requested consultation. Said: No more medicine needed, water drained will stop naturally. Three days later, safe.
Shen Tianlu had Shanghan. Post-sweating/purging, disease unresolved. No high fever, not fully conscious, physician only noted delirium. Symptom analysis indicated Cuo Yu (Confused Speech) rather than Zhan Yu (Delirium). (Distinction between Delirium and Confused Speech is critical.) Post-sweating/purging, Yuan Qi not restored, spirit unclear. Prescribed Bu Zhong Yi Qi Tang minus Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix), plus Maidong (Ophiopogonis Radix), Shengdi (Rehmanniae Radix), Shufu (Prepared Aconite Root). One dose cured.
Sun Wenyuan treated Zhang Erguan, fever, headache, thirst, constipation 3 days, Large pulse. Said: Yangming-Shaoyang syndrome. Used Dachaihu Tang (Major Bupleurum Decoction) 3-5 times. Passed black stool, night offensive sweat. Next day refreshed, forehead still hot (Yangming area). Used Baihu Tang (White Tiger Decoction) plus Gegen, Tianguafen (Trichosanthis Radix). Ate porridge too early, relapsed with fever/cough/thirst/nausea (Food Relapse). Used Xiaochaihu Tang plus Zhishi (Aurantii Fructus Immaturus), Zhizi (Gardeniae Fructus), Maiya (Hordei Fructus Germinatus). Next day extreme thirst (Banxia, Zhishi, Maiya consume Yangming fluids). Changed to Baihu Tang plus Maidong, Huafen. Externally used Chensha Yiyuan San (Cinnabar and Honeysuckle Powder), mixed with well water, 5 qian. Fever subsided, thirst settled. Unluckily slept uncovered, re-catched cold. Dawn: high fever, unconscious. Urgently used Xiaochaihu Tang plus Shengma, Gegen, Qianhu (Peucedani Radix), Bohe (Menthae Haplocalycis Herba). Sweating, fever receded, spirit exhausted, cold limbs, lazy speech/cough. Used Shengmai San (Generate the Pulse Powder) plus Shihu (Dendrobii Caulis), Baihe (Lilii Bulbus), Dazao (Jujubae Fructus), Baishao (Paeoniae Radix Alba). Cough stopped soon, spirit improved, diet increased, recovered.
Miu Zhongchun treated Yao Pingzi Shanghan, headache, fever, yellow tongue coating, chest/diaphragm fullness, fever unresolved 3-4 days, gasping as if lifeless. (Severe pathogenic heat depletes righteous Qi, do not mistake for Deficiency.) One physician, noting weak constitution and chronic deficiency, intended to give small amount of Renshen. Miu scolded: One piece would cause death. Urgently used Dahuang (Rhei Radix et Rhizoma) 1 liang, Gualou (Trichosanthis Fructus) 2 fruits sliced with seeds, Huanglian (Coptidis Rhizoma), Zhishi to purge. (Xiao Xianxiong Tang plus Dahuang.) Owner alarmed, reluctantly halved Dahuang. Two doses, bowel movement passed, fever instantly resolved, recovered.
Gao Cunzhi's family wife had Shanghan, sought prescription. Miu had already written one. Saw she was young, asked: Have you had this before? Yes. How many days after recovery did your wife get sick? 8-9 days. Any sexual desire? No. Miu deliberately said: If there was sexual desire, this prescription would kill you. Person put down prescription, did not take it. Instead used Dang (Undergarment), Xiong Shufen (Male Rat Feces), Maidong, Jiu Bai (Scallion White), Chaihu. Two doses stabilized condition. Then Zhupi Tang (Bamboo Peel Decoction), 2-3 doses fully recovered. (Observation: Post-Shanghan recovery, organs still harbor heat-toxin. Contemporary physicians failing to notice, abruptly tonifying with Renshen, Baizhu, Fuzi, their lingering disasters are incalculable.)
A slave, after Shanghan fever resolved, had persistent hematochezia. Master gave dysentery medicine, worsening condition. Miu said: This is residual symptom of missed sweating in Shanghan. Used Diyu (Sanguisorbae Radix), Maidong, Zhimu (Anemarrhenae Rhizoma), Zhuye (Bambusae Folium), replacing Zhang Zhongjing's blood-stopping herbs. Recovered.
Weng Juzi caught cold with high fever, black tongue coating, irritability/thirst (Yangming syndrome), severe condition. Brothers weeping, physicians helpless. Miu used large dose Baihu Tang plus Renshen 3 qian. One dose revived. Asked if Miu had secret recipe for Shanghan? Miu said: Familiarity with Zhang Zhongjing's book is the secret recipe. (Li's note: This is Warm Disease, hence Ren Shen Bai Hu Tang effective.)
Wu Jiantian of Changshu, in Beijing capital, had a maid servant with Shanghan. Recovered, relapsed, recovered, relapsed... countless times. Said to Miu: Only you can save her. Pulse: Yellow-white complexion (Stomach Qi present), Weak pulse in six positions (Stomach Qi present). Constipation, chest discomfort, no appetite. Said: This is residual of Shanghan Baihe Bing (Lily Disease) Huai Bing (Ruined Syndrome). Pathogen retreating. (Diagnosed by color/pulse.) Chest discomfort is Deficiency with Qi stagnation, not Excess pathogen; constipation is due to prolonged illness drying fluids, weak Qi unable to transport. Prescribed Renshen 5 qian, Maidong 1 liang, Chao Zhike 8 qian. Finished dose, instantly resolved and healed. (Wentian's note: Using Baihe [Lily Bulb] defines Baihe Bing. No Baihe in medicine, calling it Baihe Bing is incorrect. This is directly Shanghan Huai Bing.)
Liangxi male, originally deficient. Spring cold, headache, muscle pain, fever. Qianghuo 2 qian, Maidong 3 qian, Zhi Gancao 1 qian, Zisu 1.5 qian, Beixixin 0.7 qian, Qianhu 1.5 qian. Next day headache stopped, fever remained, thirst. Miu used Baishao, Wuweizi (Schisandrae Fructus). People asked: Wind not gone, why use sour/astringent? Said: Tailored to individual. One cup cured. Formula: Maidong 3 qian, Gancao 1 qian, Gualougen 2.5 qian, Ganjiang 1.5 qian, Sangbai Pi 3 qian, Jiegeng 1 qian, Baishao 1 qian, Wuweizi 0.5 qian.
Siming Yu Jiqing, at age 30, had rash, did not avoid pork, liked drinking, diarrhea for 8 years. Suddenly Shanghan, splitting headache, red face. (Sweat...)