三一承气汤 治伤寒大承气汤证腹满实痛调胃承气证谵语下利小承气汤证内热不便三乙承气汤合而为一也及
治中风僵仆风痫发作并皆服之此下剂也
大黄 芒硝 浓朴 枳实（各一两） 甘草（五钱宣明论方甘草倍于四味）上 咀分作三服每服水二盏生姜三片同
煎七分去滓温服不拘时候以利为度
双解散 治伤寒伤风或有汗或无汗表证悉具内热口干
通圣 天水（各一半）上为 咀每服二两水二大钟生姜三片葱白三根同煎七分去滓微热服以取其汗
清解散 治一切感冒
苍术（炒） 荆芥（各二两） 甘草（一两） 麻黄（一两半）上四味 咀每服一两水二钟生姜三片葱白一茎同煎
七分去滓微热服以被盖覆以汗出为度
半夏橘皮汤 治一切呕吐不止
人参 白术 白茯苓 甘草 黄芩 半夏 浓朴 藿香叶 葛根 橘皮（各等分）上为 咀每服一两水一碗煎七分
去滓入生姜自然汁少许温服不拘时
补养兼发散例
丹溪云有卒中天地之寒气者有口食生冷之物者故伤寒为病必身犯寒气口食寒物者是以从补中益气汤加发散药属内
伤者十居八九其法邪之所凑其气必虚只用补中益气汤中从所见之证出入加减气虚甚者少用附子以行参术之气（补中益气
汤方见杂病劳倦门）内伤之病专主东垣内外伤辨甚详世之病此者为多但有挟痰挟外邪者郁热于内而发者皆以补元气为主
宜看其所挟而兼用药 一男子素嗜酒因暴风寒衣薄遂觉倦怠不思饮食半日至睡后大发热遍身疼痛如被杖微恶寒天明诊
之六脉浮大按之豁然左为甚予作极虚受风寒治之人参为君黄 白术归身为臣苍术甘草木通干葛为佐使大剂与之至五帖
后通身汗如雨凡三易被得睡醒后诸证悉除 卢兄年四十九岁自来大便下血脉来沉迟涩面黄神倦者二年矣九月间因劳倦
发热自服参苏饮二帖热退早起小劳遇寒两手背与面紫黑昏仆少时却醒身大热妄语口干身痛至不可眠脉之三部不调微带
数重取虚豁左手大于右手以人参二钱半带节麻黄黄 各一钱白术二钱当归五分与三五帖得睡醒来大汗如雨即安两日后
再发胁痛咳嗽若睡时嗽不作而妄语且微恶寒诊其脉似前而左略带紧予曰此体虚再感寒也再以前药加半夏茯苓至十余帖
再得大汗而安后身倦不可久坐不思饮食用补中益气去凉药加神曲半夏砂仁五七十帖而安 杭州叶君章腊月因斋素中饥
而冒寒作劳遂患发热头痛医与小柴胡汤遂自汗神昏耳聋目不见物予诊其脉大如指似有力热不退与人参黄 白术熟附子
炙甘草作大剂服之一日而汗少二日而热减半耳微有闻目能视物初用药至四帖前药中加苍术与两服再得汗而热除本日遂
去苍术附子又与前药作小剂服三日而安 吕仲修年六十六岁正月间因忍饥冒寒作劳头痛恶寒发热骨节皆疼无汗至次日
妄语热愈甚而妄语时止时作热亦不为十分自服参苏饮两帖汗不出又再进一服以衣覆取汗大出而热不退至第四日予诊其
脉两手皆洪数而右为甚此因饥而冒寒加之作劳阳明经虽受寒气不可攻击宜急以大剂补之以回其虚俟胃气充实自能出汗
而解遂以参 白术归身陈皮炙甘草每帖加熟附子一片一昼夜服五帖至第三日口稍干言语有次诸证虽解而热未退遂去附
子加白芍又两日思食却作肉羹间与之又三日精神全二日许自汗出而热退诊其脉不数洪脉却尚有些洪脉作大脉论年高而
误汗此后必有虚证见又与前药至次日言我大便自病来不曾更衣今谷道逼痛虚坐努责状如不堪医者必欲投大黄巴豆等剂
予谓大便非实秘为是气因误汗而虚不得充腹无力可努仍与前补药以肉粥及苁蓉与之一日半煎浓葱椒汤浸下体下大便软
块者五六枚诊其脉仍旧大未敛此因气血未得回复又与前药两帖经两日小便不通少腹下妨闷颇为所苦但仰卧则点滴而出
予曰补药服之未尽于前药内倍加参 大剂服两日小便方利而安
汪机治一人年三十余因冒寒发热医用发表不愈继用小柴胡热炽汗多遂昏昏愦愦不知身之所在卧则如云之停空行则
如风之飘毛兼有消谷善饥多遗诸证观其形类肥者曰此内火燔灼而然虚极矣诊其脉皆浮洪如指曰脉经云脉不为汗衰者死
在法不治所幸者脉虽大按之不鼓形虽长而色尚苍可救也医以外感治之所谓虚其虚误矣经云邪之所凑其气必虚宜以内伤
为重遂用参 归术大剂少加桂附服十余帖病减十之二三再减桂附加芍药黄芩服十余贴病者始知身卧于床足履于地喜曰
可不死矣服久果起
薛院使已治一人年七十九仲冬将出少外家入房致头痛发热眩晕喘急痰涎壅盛小便频数口干引饮偏舌生刺缩敛如荔枝
然下唇黑裂面目俱赤烦躁不寐或时喉间如烟火上冲急饮凉茶少解已濒于死脉洪大而无伦且有力扪其身烙手此肾经虚火
游行于外投以十全大补加山茱萸泽泻丹皮山药麦门五味附子一钟熟寐良久脉证各减三四再与八味丸服之诸证悉退后畏
冷物而痊
本事方黄 建中加当归汤 治发热头疼脉浮数而尺中迟弱者宜先服此药补血却与麻黄桂枝辈
黄 当归（各一两半） 白芍药 桂枝 甘草（各一两）上为 咀每服五钱姜三片枣一枚水煎日三夜二服如脉尚
沉少迟再进一服
海 黄 汤治伤寒两感拘急三焦气虚自汗及手足汗出或手背偏多或肢体振摇腰腿沉重面赤目红但欲睡眠头
面壮热两胁热甚手足自温两手心热自利不渴大便或难或如常度或口干咽燥或渴欲饮汤不欲饮水或少欲饮水呕哕将作心
下满闷腹中疼痛或时喜笑或时悲哭或时太息或时语言错乱疑作谵语狂言者非也神不守舍耳始得病于寤寐之间或恐悸头
项不甚痛行步只如旧此阴盛阳虚之故也两手脉浮沉不一或左或右往来不定有沉涩弱微弦五种阴脉形状按之全无力浮之
损小沉之亦损小皆阴脉也宜先缓而后急缓宜用黄 汤
黄 汤方
人参 生姜 黄 白茯苓 白术 白芍药（各一两） 甘草（七钱）呕者加藿香陈皮各五钱甚者加干姜炮一钱 上
咀水煎量证加减多少用之 如大便秘结者调中丸主之
调中丸方
人参 白术 白茯苓 干姜 甘草（各等分）上为末炼蜜丸每两作十丸或五丸每服一二丸水少许煎服若病急者黄
汤每服加干姜一钱大便结者理中丸主之
理中丸方
人参 白术 干姜（炮恐热以生姜代之） 甘草（炙）上等分为末炼蜜丸每两作五丸白汤化下先缓后急也若尤急者
无汗宜附子干姜甘草汤若自汗者宜白术附子甘草汤量脉证可于四逆汤或真武汤或通脉四逆汤选用之
丹 矩新书谓有杂合邪者当以杂合法治之譬如恶寒发热得之感冒明是外合之邪已得浮数之脉而气口又紧盛明
为
食所伤病者又倦怠脉重按俱有豁意而胸膈痞满间引两胁其脉轻取又似乎弦此又平昔多怒肝邪之所为也细取左尺大细沉
弱此又平时房劳之过也治法宜以感冒一节且放后先视其形色强弱浓薄且以补中化食行滞清凉胃火而以姜辣行之则中气
稍回伤滞稍行津液得和通体得汗外感之邪自解医者不肯详审求之只顾表散外邪又不推究兼见之邪脉亦不穷问所得之病
因与性情之执着巧施杂合治法将见正气自虚邪气愈固皆拙工之过也
娄 此篇集丹溪海藏诸贤治伤寒皆以补养兼发散之法实本经成败倚伏生于动动而不已则变作及风雨寒热不得虚
邪
不能独伤人之旨也盖凡外伤风寒者皆先因动作烦劳不已而内伤体虚然后外邪得入故一家之中有病者有不病者由体虚则
邪入而病体不虚则邪无隙可入而不病也是故伤寒为病属内伤者十居八九后学无知举世皆谓伤寒无补法但见发热不分虚
实一例汗下而致夭横者滔滔皆是此实医门之罪人也今集此法于仲景之后其应如响使人遵之不犯虚虚实实之戒也
上纲目之文余见世医泥于伤寒无补法多犯虚虚实实之戒故备述之而删其纯内伤者及丹溪医按之庸芜者又增近代二
医按以为虚人感寒之活例云尔神而明之存乎其人不可泥也余尝治一刻字工人新婚冬月冒寒表证悉具令以人参紫苏茎叶
各一两煎汤饮之汗出而愈一孕妇春夏之交患温病头痛发热不恶寒而渴未及疗治胎堕去血无算昏眩欲绝余令以麦门冬斤
许入淡竹叶香豉频频饮之亦汗出而愈盖用劳复法治之得此活法则于是病庶几可十全矣
韩祗和氏和解因时法
伤寒病有可汗者论中但统言其可汗证及可汗脉或云脉浮而数或云脉浮紧或云脉浮无汗而喘或云脉浮为在表今略举
数条后人但凭其脉之大概并不分脉浮有阴阳虚盛之理又不知有可汗不可汗之证误投发表药则多变成阳毒之患矣今举病
人有汗恶风无汗恶寒分二等及据立春以后立秋以前气候轻重各立方治之庶学人易为开悟耳
一病患二三月以前两手脉浮数或缓或紧按之差软寸关尺若力齐等其力不甚大不甚小者亦未可便投解表药此是见里
证未见表脉也宜候寸脉力小如关尺即可投解表药大抵治伤寒病见证不见脉未见投药见脉未见证虽少投药亦无害也凡治
杂病以证为先脉为后治伤寒病以脉为先证为后
一病患两手脉浮数而紧名曰伤寒若关前寸脉力小关后尺脉力大虽不恶风不自汗出此乃阴气已盛先见于脉也若不投
药和之后必恶风及自汗出若立春以后至清明以前宜调脉汤主之清明以后至芒种以前宜葛根柴胡汤主之芒种以后至立秋
以前宜人参桔梗汤主之
调脉汤方
葛根（一两） 前胡（去苗） 防风（各七钱半） 甘草（炙半两）为粗末每服五钱水一盏生姜一块如小指大劈破
煎七分去滓温服如寸脉根据前力小加枣三枚同煎
葛根柴胡汤
葛根（一两半） 柴胡（去芦一两） 芍药 桔梗 甘草（炙各七钱半） 浓朴（半两）上 咀每服五钱水一盏生
姜二片煎至七分去滓热服如寸脉根据前力小加葱白三寸同煎服
人参桔梗汤
人参 桔梗（各七钱半） 麻黄（去节一两） 石膏（三两） 甘草（炙七钱半） 上每服五钱水一盏荆芥五穗同
煎至七分去滓热服如寸脉根据前力小加麻黄二分去节同煎服
一病患两手脉浮数而缓名曰中风若寸脉力小尺脉力大虽不恶风不自汗此乃阴气已盛先见于脉也若不投药和之后必
恶风自汗出若立春以后清明以前宜薄荷汤主之清明以后芒种以前宜防风汤主之芒种以后至立秋以前宜香芎汤主之
薄荷汤
薄荷（一两） 葛根 人参 甘草（炙各半两） 防风（去芦二两）上 咀每服五钱水一盏煎至七分去滓热服如三
五服寸脉力尚小加薄荷二分同煎
防风汤
防风（去芦一两） 桔梗（三钱） 甘草（炙） 旋复花（各半两） 浓朴（三分）上 咀每服五钱水二盏姜二块
同煎热服如三五服寸脉力尚小加荆芥穗五七茎同煎
香芎汤
川芎（二钱半） 石膏（二两） 升麻（三两） 甘草（炙） 浓朴（制各半两）上 咀每服五钱水二盏煎七分温
服如三五服后寸脉力尚小加细辛二分同煎 前二段文将中风伤寒各立法者何盖谓病患始得病三日以前或因中风脉缓或
因伤寒脉紧然脉虽先见而证犹未见尚可以药解之故立方耳
一病患两手脉浮数或缓紧寸脉短反力小于关尺脉者此名阴盛阳虚也若自汗出恶风是邪气在表阴气有余也素问云阴
气有余为多汗身寒即可投消阴助阳表剂以治之若立春以后清明以前宜六物麻黄汤主之清明以后芒种以前宜七物柴胡汤
主之芒种以后立秋以前宜发表汤主之
六物麻黄汤
麻黄（去节一两） 葛根 苍术（各七钱半） 人参 甘草（炙各半两）上 咀每服五钱水一盏枣二枚煎七分热服
如三五服后汗未止恶风者加荆芥七钱三五服后不恶风犹汗者加丁香皮半两
七物柴胡汤
柴胡 苍术（各二两） 荆芥 麻黄（各一两） 甘草（炙七钱）上 咀每服五钱水一盏姜一块枣二枚同煎七分热
服如三五服后汗未止恶风者入葱白三寸如三五服后汗再未止加当归一两同煎
发表汤
麻黄（去节一两） 苍术（二两） 人参 当归（各半两） 炙甘草 丁香皮（各七钱）上 咀每服五钱水一盏入
姜一块枣三枚同煎至七分去滓热服如三五服汗未止犹恶风者加桂枝七钱如汗未止更加细辛半两以汗止为度
一病患脉浮数或紧或缓其脉上出鱼际寸脉大于关尺者此名阳盛阴虚也若发冒闷口燥咽干者乃是邪气在表阳气独有
余也素问曰阳气有余为身热无汗是也可投消阳助阴药以解表若立春以后清明以前宜人参汤主之清明以后至芒种以前宜
前胡汤主之芒种以后至立秋以前宜石膏汤主之
人参汤
人参（半两） 柴胡（一两） 芍药 炙甘草（各七钱半） 石膏（二两）上 咀每服五钱水一盏姜一块煎七分热
服如三五服后热不解者入豉三十粒同煎服
前胡汤
前胡（一两） 石膏（二两） 甘草（炙半两） 桔梗 豉（各七钱半）上每服五钱水一盏姜五片煎七分去滓热服
如三五服热尚未解加豉三十粒煎再服
石膏汤
石膏（三两） 芍药 柴胡（各一两） 升麻 黄芩 炙甘草（各七钱半）上 咀每服五钱水一盏半豉一合煎八分
热服如三五服后热未解者加知母一两又未解加大黄一两
一病患两手脉浮数或紧或缓三部俱有力无汗恶风者此是阴阳气俱有余素问曰阴阳有余则无汗而寒是也可用药平之
三一承气汤：治疗伤寒大承气汤证（表现为腹部胀满、实证疼痛）、调胃承气汤证（表现为谵语、下利）以及小承气汤证（表现为内热、大便不通），将三者合而为一。也用于治疗中风导致的突然昏倒、风痫发作，均可服用。这是泻下的方剂。
大黄、芒硝、浓朴、枳实（各一两），甘草（五钱，《宣明论》中方中甘草用量是其他四味药的两倍）。以上药材切碎，分为三服。每服用水两盏，加入生姜三片，同煎至七分，去渣，温服，不限时间，以大便通畅为度。
双解散：治疗伤寒或伤风，无论有汗或无汗，表证全部具备，伴有内热、口干。
通圣散、天水散（各取一半）。以上药材切碎，每服用二两，加水两大钟，加入生姜三片、葱白三根，同煎至七分，去渣，微热服用，以发汗为目的。
苍术（炒制）、荆芥（各二两），甘草（一两），麻黄（一两半）。以上四味药材切碎，每服用一两，加水两钟，加入生姜三片、葱白一茎，同煎至七分，去渣，微热服用，盖被保暖，以出汗为度。
人参、白术、白茯苓、甘草、黄芩、半夏、浓朴、藿香叶、葛根、橘皮（各等分）。以上药材切碎，每服用一两，加水一碗，煎至七分，去渣，加入少许生姜自然汁，温服，不限时间。
补养兼发散法举例：
丹溪说：有人遭受天地寒气的侵袭，有人因口食生冷之物致病，所以伤寒病必定是身体接触寒气、口食寒物所致。因此属于内伤的占十之八九。其治法在于“邪之所凑，其气必虚”，只使用补中益气汤，根据所见症状进行加减。气虚严重者，少量使用附子以运行人参、白术之气（补中益气汤方见杂病劳倦门）。内伤疾病专门依据李东垣《内外伤辨》，论述非常详细。世上患此病的人很多，但有的夹杂痰湿、外邪，或因郁热在内而发作，都以补元气为主。应当查看所夹杂的病因而兼用药物。
一个男子平时嗜酒，因暴风寒冷、衣着单薄，随即感到倦怠、不思饮食。半天后，睡后大发热，遍身疼痛如被杖击，轻微恶寒。天明诊察，六脉浮大，按之豁然空虚，左侧更为明显。我将其视为极虚受风寒治疗。以人参为君药，黄芪、白术、当归身为臣药，苍术、甘草、木通、干葛为佐使药，大剂量给予。服至五帖后，全身汗如雨下，共换了三床被子，睡着后醒来，所有症状悉除。
卢兄，四十九岁，两年来一直大便下血，脉来沉迟涩，面色黄，精神疲倦。九月间因劳累发热，自服参苏饮两帖，热退。早起稍作劳动，遇冷则两手背与面部紫黑，昏倒片刻后苏醒，身体大热，胡言乱语，口干，身体疼痛至无法入睡。诊脉三部不调，微带数象，重取虚豁，左手大于右手。给予人参二钱半、带节麻黄、黄芪各一钱、白术二钱、当归五分，服三五帖后能睡着，醒来大汗如雨，即安。两日后复发，胁痛咳嗽，若睡觉时咳嗽不作而胡言乱语且微恶寒。诊其脉似前而左略带紧。我说：“这是体虚再次感受寒邪。”再用以前药加半夏、茯苓，服十余帖，再得大汗而安。后来身体疲倦不可久坐，不思饮食，用补中益气汤去掉凉药，加神曲、半夏、砂仁，服五七十帖而安。
杭州叶君章，腊月因吃素斋饥饿中冒寒劳作，遂患发热头痛。医生给小柴胡汤，遂自汗、神昏、耳聋、目不见物。我诊其脉大如指，似有力，热不退。给予人参、黄芪、白术、熟附子、炙甘草做大剂服用。一日后汗少，二日热减半，耳微有闻，目能视物。初用药至四帖，在前药中加入苍术，服两帖，再得汗而热除。本日遂去掉苍术、附子，又与前药做小剂服用，三日而安。
吕仲修，六十六岁，正月间因忍饥冒寒劳作，头痛恶寒发热，骨节皆疼，无汗。至次日胡言乱语，热更甚，胡言乱语时止时作，热也不十分剧烈。自服参苏饮两帖，汗不出。又再进一服，以衣覆盖取汗，大汗出而热不退。至第四日我诊其脉，两手皆洪数而右侧更甚。这是因为饥饿冒寒加之劳作，阳明经虽受寒气，不可攻伐，宜急以大剂补益以回其虚。待胃气充实，自能出汗而解。遂用人参、白术、当归身、陈皮、炙甘草，每帖加熟附子一片，一昼夜服五帖。至第三日口稍干，言语有条理，诸证虽解而热未退，遂去掉附子加白芍。又两日思食，却做肉羹间或给予。又三日精神全复。二日许自汗出而热退。诊其脉不数，洪脉却尚有些许，作大脉论。年高而误汗，此后必有虚证出现。又与前药至次日，他说：“我大便自己病了，生病以来不曾更衣，今肛门逼迫疼痛，有虚坐努责状，好像不堪忍受。”医者必欲投大黄、巴豆等剂。我说：“大便非实秘，是因为气因误汗而虚，不得充腹，无力可努。”仍与前补药，以肉粥及肉苁蓉给予。一日半，煎浓葱椒汤浸下体，下大便软块者五六枚。诊其脉仍旧大未敛，这是气血未得回复。又与前药两帖。经两日小便不通，少腹下妨闷，颇为所苦，但仰卧则点滴而出。我说：“补药服之未尽，于前药内倍加人参，大剂服两日，小便方利而安。”
汪机治疗一人，三十多岁，因冒寒发热，医生用发表药不愈，继用小柴胡汤，热炽汗多，遂昏昏愦愦不知身在何处，卧则如云之停空，行则如风之飘毛。兼有消谷善饥、多遗精等证。观其形类肥者，曰：“此内火燔灼而然，虚极矣。”诊其脉皆浮洪如指，曰：“《脉经》云：脉不为汗衰者死，在法不治。所幸者脉虽大，按之不鼓；形虽长而色尚苍，可救也。”医以外感治之，所谓虚其虚，误矣。《经》云：邪之所凑，其气必虚。宜以内伤为重。遂用人参、当归、白术大剂，少加桂附，服十余帖，病减十之二三。再减桂附加芍药、黄芩，服十余帖，病者始知身卧于床，足履于地，喜曰：“可不死矣。”服久果起。
薛院使已治疗一人，七十九岁，仲冬将出，少外出，入房致头痛发热、眩晕、喘急、痰涎壅盛、小便频数、口干引饮、偏舌生刺缩敛如荔枝然、下唇黑裂、面目俱赤、烦躁不寐。或时喉间如烟火上冲，急饮凉茶少解，已濒于死。脉洪大而无伦且有力，扪其身烙手。此为肾经虚火游行于外。投以十全大补汤加山茱萸、泽泻、丹皮、山药、麦门冬、五味子、附子一钟，熟寐良久，脉证各减三四。再与八味丸服之，诸证悉退。后畏冷物而痊。
本事方黄芪建中加当归汤：治疗发热头疼、脉浮数而尺中迟弱者，宜先服此药补血，却与麻黄、桂枝辈（配合使用）。
黄芪、当归（各一两半），白芍药、桂枝、甘草（各一两）。以上药材切碎，每服五钱，姜三片、枣一枚，水煎，日三夜二服。如脉尚沉少迟，再进一服。
海藏黄芪汤：治疗伤寒两感、拘急、三焦气虚自汗及手足汗出，或手背偏多，或肢体振摇、腰腿沉重、面赤目红、但欲睡眠、头面壮热、两胁热甚、手足自温、两手心热、自利不渴、大便或难或如常度、或口干咽燥、或渴欲饮汤不欲饮水、或少欲饮水、呕哕将作、心下满闷、腹中疼痛、或时喜笑、或时悲哭、或时太息、或时语言错乱、疑作谵语狂言者非也，神不守舍耳。始得病于寤寐之间，或恐悸，头项不甚痛，行步只如旧。此阴盛阳虚之故也。两手脉浮沉不一，或左或右往来不定，有沉、涩、弱、微、弦五种阴脉形状，按之全无力，浮之损小，沉之亦损小，皆阴脉也。宜先缓而后急，缓宜用黄芪汤。
黄芪汤方：
人参、生姜、黄芪、白茯苓、白术、白芍药（各一两），甘草（七钱）。呕者加藿香、陈皮各五钱，甚者加干姜炮一钱。以上药材切碎，水煎，量证加减多少用之。如大便秘结者，调中丸主之。
调中丸方：
人参、白术、白茯苓、干姜、甘草（各等分）。以上为末，炼蜜丸，每两作十丸或五丸，每服一二丸，水少许煎服。若病急者，黄芪汤每服加干姜一钱。大便结者，理中丸主之。
理中丸方：
人参、白术、干姜（炮，恐热以生姜代之）、甘草（炙）。上等分为末，炼蜜丸，每两作五丸，白汤化下。先缓后急也。若尤急者，无汗宜附子干姜甘草汤，若自汗者宜白术附子甘草汤。量脉证可于四逆汤、真武汤或通脉四逆汤选用之。
丹溪《矩新书》谓有杂合邪者，当以杂合法治之。譬如恶寒发热，得之感冒，明是外合之邪，已得浮数之脉，而气口又紧盛，明为食所伤。病者又倦怠，脉重按俱有豁意，而胸膈痞满，间引两胁，其脉轻取又似乎弦，此又平昔多怒，肝邪之所为也。细取左尺大细沉弱，此又平时房劳之过也。治法宜以感冒一节且放后，先视其形色强弱浓薄，且以补中化食、行滞、清凉胃火，而以姜辣行之，则中气稍回，伤滞稍行，津液得和，通体得汗，外感之邪自解。医者不肯详审求之，只顾表散外邪，又不推究兼见之邪，脉亦不穷问所得之病因与性情之执着，巧施杂合治法，将见正气自虚，邪气愈固，皆拙工之过也。
娄氏此篇集丹溪、海藏诸贤治伤寒，皆以补养兼发散之法，实本《经》“成败倚伏生于动，动而不已则变作”及“风雨寒热，不得虚邪不能独伤人之旨也”。盖凡外伤风寒者，皆先因动作烦劳不已而内伤体虚，然后外邪得入。故一家之中有病者有不病者，由体虚则邪入而病，体不虚则邪无隙可入而不病也。是故伤寒为病，属内伤者十居八九。后学无知，举世皆谓伤寒无补法，但见发热，不分虚实，一例汗下，而致夭横者，滔滔皆是，此实医门之罪人也。今集此法于仲景之后，其应如响，使人遵之不犯虚虚实实之戒也。
上纲目之文，余见世医泥于伤寒无补法，多犯虚虚实实之戒，故备述之，而删其纯内伤者及丹溪医按之庸芜者，又增近代二医按以为虚人感寒之活例云尔。神而明之，存乎其人，不可泥也。余尝治一刻字工人，新婚冬月冒寒，表证悉具，令以人参、紫苏茎叶各一两煎汤饮之，汗出而愈。一孕妇春夏之交患温病，头痛发热，不恶寒而渴，未及疗治，胎堕去血无算，昏眩欲绝。余令以麦门冬斤许，入淡竹叶、香豉，频频饮之，亦汗出而愈。盖用劳复法治之，得此活法则于是病庶几可十全矣。
韩祗和氏和解因时法：
伤寒病有可汗者，论中但统言其可汗证及可汗脉，或云脉浮而数，或云脉浮紧，或云脉浮无汗而喘，或云脉浮为在表。今略举数条，后人但凭其脉之大概，并不分脉浮有阴阳虚盛之理，又不知有可汗不可汗之证，误投发表药，则多变成阳毒之患矣。今举病人有汗恶风、无汗恶寒分二等，及据立春以后立秋以前气候轻重各立方治之，庶学人易为开悟耳。
一病患二三月以前，两手脉浮数或缓或紧，按之差软，寸关尺若力齐等，其力不甚大不甚小者，亦未可便投解表药。此是见里证未见表脉也。宜候寸脉力小如关尺即可投解表药。大抵治伤寒病，见证不见脉，未见投药；见脉未见证，虽少投药亦无害也。凡治杂病以证为先，脉为后；治伤寒病以脉为先，证为后。
一病患两手脉浮数而紧，名曰伤寒。若关前寸脉力小，关后尺脉力大，虽不恶风不自汗出，此乃阴气已盛，先见于脉也。若不投药和之，后必恶风及自汗出。若立春以后至清明以前，宜调脉汤主之；清明以后至芒种以前，宜葛根柴胡汤主之；芒种以后至立秋以前，宜人参桔梗汤主之。
调脉汤方：
葛根（一两），前胡（去苗）、防风（各七钱半），甘草（炙半两）。为粗末，每服五钱，水一盏，生姜一块如小指大劈破，煎七分，去滓温服。如寸脉根据前力小，加枣三枚同煎。
葛根柴胡汤：
葛根（一两半），柴胡（去芦一两），芍药、桔梗、甘草（炙各七钱半），浓朴（半两）。以上药材切碎，每服五钱，水一盏，生姜二片，煎至七分，去滓热服。如寸脉根据前力小，加葱白三寸同煎服。
人参桔梗汤：
人参、桔梗（各七钱半），麻黄（去节一两），石膏（三两），甘草（炙七钱半）。以上每服五钱，水一盏，荆芥五穗同煎至七分，去滓热服。如寸脉根据前力小，加麻黄二分去节同煎服。
一病患两手脉浮数而缓，名曰中风。若寸脉力小，尺脉力大，虽不恶风不自汗，此乃阴气已盛，先见于脉也。若不投药和之，后必恶风自汗出。若立春以后清明以前，宜薄荷汤主之；清明以后芒种以前，宜防风汤主之；芒种以后至立秋以前，宜香芎汤主之。
薄荷汤：
薄荷（一两），葛根、人参、甘草（炙各半两），防风（去芦二两）。以上药材切碎，每服五钱，水一盏，煎至七分，去滓热服。如三五服寸脉力尚小，加薄荷二分同煎。
防风汤：
防风（去芦一两），桔梗（三钱），甘草（炙）、旋复花（各半两），浓朴（三分）。以上药材切碎，每服五钱，水二盏，姜二块同煎，热服。如三五服寸脉力尚小，加荆芥穗五七茎同煎。
香芎汤：
川芎（二钱半），石膏（二两），升麻（三两），甘草（炙）、浓朴（制各半两）。以上药材切碎，每服五钱，水二盏，煎七分，温服。如三五服后寸脉力尚小，加细辛二分同煎。前二段文将中风伤寒各立法者何？盖谓病患始得病三日以前，或因中风脉缓，或因伤寒脉紧，然脉虽先见而证犹未见，尚可以药解之，故立方耳。
一病患两手脉浮数或缓紧，寸脉短反力小于关尺脉者，此名阴盛阳虚也。若自汗出恶风，是邪气在表，阴气有余也。《素问》云：阴气有余为多汗身寒。即可投消阴助阳表剂以治之。若立春以后清明以前，宜六物麻黄汤主之；清明以后芒种以前，宜七物柴胡汤主之；芒种以后立秋以前，宜发表汤主之。
六物麻黄汤：
麻黄（去节一两），葛根、苍术（各七钱半），人参、甘草（炙各半两）。以上药材切碎，每服五钱，水一盏，枣二枚，煎七分热服。如三五服后汗未止恶风者，加荆芥七钱；三五服后不恶风犹汗者，加丁香皮半两。
七物柴胡汤：
柴胡、苍术（各二两），荆芥、麻黄（各一两），甘草（炙七钱）。以上药材切碎，每服五钱，水一盏，姜一块，枣二枚同煎七分，热服。如三五服后汗未止恶风者，入葱白三寸；如三五服后汗再未止，加当归一两同煎。
发表汤：
麻黄（去节一两），苍术（二两），人参、当归（各半两），炙甘草、丁香皮（各七钱）。以上药材切碎，每服五钱，水一盏，入姜一块，枣三枚同煎至七分，去滓热服。如三五服汗未止犹恶风者，加桂枝七钱；如汗未止更加细辛半两，以汗止为度。
一病患脉浮数或紧或缓，其脉上出鱼际，寸脉大于关尺者，此名阳盛阴虚也。若发冒闷、口燥咽干者，乃是邪气在表，阳气独有余也。《素问》曰：阳气有余为身热无汗。是可投消阳助阴药以解表。若立春以后清明以前，宜人参汤主之；清明以后至芒种以前，宜前胡汤主之；芒种以后立秋以前，宜石膏汤主之。
人参汤：
人参（半两），柴胡（一两），芍药、炙甘草（各七钱半），石膏（二两）。以上药材切碎，每服五钱，水一盏，姜一块，煎七分热服。如三五服后热不解者，入豉三十粒同煎服。
前胡汤：
前胡（一两），石膏（二两），甘草（炙半两），桔梗、豉（各七钱半）。以上每服五钱，水一盏，姜五片，煎七分，去滓热服。如三五服热尚未解，加豉三十粒煎再服。
石膏汤：
石膏（三两），芍药、柴胡（各一两），升麻、黄芩、炙甘草（各七钱半）。以上药材切碎，每服五钱，水一盏半，豉一合，煎八分，热服。如三五服后热未解者，加知母一两；又未解加大黄一两。
San Yi Cheng Qi Tang: Treats Taiyang disease (disease of the Taiyang channel) presenting with Da Cheng Qi Tang syndrome (abdominal fullness, solid pain), Tiao Wei Cheng Qi Tang syndrome (delirium, diarrhea), and Xiao Cheng Qi Tang syndrome (internal heat, constipation), combining them into one formula. It is also used for sudden collapse due to wind-stroke and onset of wind-phlegm epilepsy; it can be taken in all these cases. This is a purgative formula.
Da Huang (Rhei Radix et Rhizoma), Mang Xiao (Natrii Sulfas), Nong Po (Magnoliae Officinalis Cortex), Zhi Shi (Aurantii Fructus Immaturus) (each 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma) (5 qian). In *Xuan Ming Lun*, the dosage of Gan Cao is double that of the other four herbs. The above herbs are cut into small pieces, divided into three doses. Each dose is decocted with two cups of water and three slices of fresh ginger until reduced to 70%, then filtered. Take warm, at any time, stopping when bowel movement becomes free.
Shuang Jie San: Treats cold damage or wind-cold, whether with or without sweating, where exterior symptoms are fully present, accompanied by internal heat and dry mouth.
Tong Sheng San and Tian Shui San (half of each). The above herbs are cut into small pieces. Each dose is two liang, decocted with two large cups of water, three slices of fresh ginger, and three roots of scallion white part until reduced to 70%, then filtered. Take slightly warm to induce sweating.
Qing Jie San: Treats all types of common cold.
Cang Zhu (Atractylodis Rhizoma, stir-fried), Jing Jie (Schizonepetae Herba) (each 2 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma) (1 liang), Ma Huang (Ephedrae Herba) (1.5 liang). The above four herbs are cut into small pieces. Each dose is one liang, decocted with two cups of water, three slices of fresh ginger, and one stem of scallion white part until reduced to 70%, then filtered. Take slightly warm, cover with blankets, and stop when sweating occurs.
Ban Xia Ju Pi Tang: Treats persistent vomiting of any kind.
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bai Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma), Huang Qin (Scutellariae Radix), Ban Xia (Pinelliae Rhizoma), Nong Po (Magnoliae Officinalis Cortex), Huo Xiang Ye (Agastaches Herba), Ge Gen (Puerariae Lobatae Radix), Ju Pi (Citri Reticulatae Pericarpium) (equal parts). The above herbs are cut into small pieces. Each dose is one liang, decocted with one bowl of water until reduced to 70%, then filtered. Add a little fresh juice of ginger, take warm, at any time.
Examples of Tonifying and Dispersing Methods:
Danxi stated: Some suffer from heaven-earth cold qi invasion, others from consuming raw and cold food. Thus, cold damage diseases must involve bodily exposure to cold qi and oral consumption of cold substances. Therefore, those belonging to internal injury account for eight or nine out of ten. The method is: "Where evil gathers, qi must be deficient." Use only Bu Zhong Yi Qi Tang (Supplement the Middle and Augment the Qi Decoction), modifying it according to observed symptoms. For severe qi deficiency, add a small amount of Fu Zi (Aconiti Lateralis Radix Praeparata) to promote the qi-moving action of Ren Shen and Bai Zhu (see Miscellaneous Diseases, Fatigue and Overwork section for the formula). Internal injury diseases primarily follow Li Dongyuan's *Differentiation of External and Internal Injury*, which is very detailed. Many people suffer from this, but some have phlegm or external pathogens complicated, or depression-heat arising internally; all should focus on supplementing primordial qi. One should examine the complicating factors and use combined medications.
A man who usually indulged in alcohol, due to strong wind and cold and thin clothing, felt fatigue and loss of appetite. Half a day later, after sleeping, he had high fever, body-wide pain as if beaten, slight aversion to cold. At dawn, his six pulses were floating and large, hollow upon pressure, more pronounced on the left. I treated him as extreme deficiency suffering from wind-cold. Ren Shen was the sovereign herb, Huang Qi (Astragali Radix), Bai Zhu, Dang Gui Shen (Angelicae Sinensis Radix root portion) were minister herbs, Cang Zhu, Gan Cao, Mu Tong (Akebiae Caulis), Ge Gen were assistant and guide herbs. A large dose was given. After five doses, he sweated profusely like rain, changed beds three times, slept, and upon waking, all symptoms disappeared.
Brother Lu, aged 49, had been passing blood in stool for two years, with sinking, slow, and choppy pulses, sallow complexion, and mental fatigue. In September, due to labor-induced fever, he self-administered Shen Su Yin (Ginseng and Perilla Infusion) for two doses, and the fever subsided. Upon rising early and exerting himself slightly, encountering cold caused his hands' dorsum and face to turn purple-black, followed by brief unconsciousness, then awakening with high fever, delirium, dry mouth, and unbearable body pain preventing sleep. Pulses in all three positions were irregular, slightly rapid, empty upon heavy pressure, with the left hand larger than the right. Given Ren Shen 2.5 qian, Ma Huang with nodes, Huang Qi each 1 qian, Bai Zhu 2 qian, Dang Gui 0.5 qian. After three to five doses, he could sleep, woke up with profuse sweating, and stabilized. Two days later, relapse occurred with hypochondriac pain and coughing; if sleeping, no cough but delirium and slight aversion to cold. Pulse resembled previous but left side slightly tight. I said: "This is deficiency constitution re-contracted by cold." Used previous formula plus Ban Xia and Fu Ling, taken for over ten doses, achieved profuse sweating and stability. Later, body fatigue prevented long sitting, loss of appetite. Used Bu Zhong Yi Qi Tang removing cooling herbs, adding Shen Qu, Ban Xia, Sha Ren, taken for fifty to seventy doses, and stabilized.
Ye Junzhang of Hangzhou, in the twelfth lunar month, suffered hunger during vegetarian fasting, exposed to cold while working, leading to fever and headache. The doctor prescribed Xiao Chai Hu Tang (Minor Bupleurum Decoction), causing spontaneous sweating, coma, deafness, and blindness. I diagnosed his pulse as large as a finger, seemingly forceful, with fever persisting. Gave a large dose of Ren Shen, Huang Qi, Bai Zhu, Shu Fu Zi (Prepared Aconite Root), Zhi Gan Cao (Honey-fried Licorice). After one day, less sweating; after two days, fever halved, ears slightly responsive, eyes could see. Up to the fourth dose, added Cang Zhu to the previous formula, took two doses, sweated again and fever cleared. That day, removed Cang Zhu and Fu Zi, continued with smaller doses of the previous formula, stabilized after three days.
Lu Zhongxiu, aged 66, in January, endured hunger, cold exposure, and labor, resulting in headache, aversion to cold, fever, joint pain, and anhidrosis. By the next day, delirium, worsening fever (intermittent), slight fever intensity. Self-administered Shen Su Yin for two doses, no sweat. Took another dose, covered with clothes to induce sweating, profuse sweat but fever persisted. On the fourth day, my diagnosis showed both hands' pulses were surging and rapid, more so on the right. This was due to hunger, cold exposure, and labor; although Yangming channel received cold, attack is contraindicated. Urgently tonify with large doses to restore deficiency. Wait for stomach qi to fill, then sweat will resolve naturally. Used Ren Shen, Bai Zhu, Dang Gui Shen, Chen Pi, Zhi Gan Cao, adding one piece of Shu Fu Zi per dose, five doses in one day and night. By the third day, mouth slightly dry, speech coherent, symptoms resolved but fever remained. Removed Fu Zi, added Bai Shao (Paeoniae Radix Alba). Two days later, desired food, gave meat broth occasionally. Three days later, spirit fully recovered. After about two days, spontaneous sweating and fever subsided. Pulse no longer rapid, but lingering surging quality remained. Discussing large pulse in elderly after mistaken sweating, subsequent deficiency signs are expected. Continued previous medicine. Next day, he said: "My bowels have been ill, no bowel movement since illness began, now anal stricture pain, feeling of incomplete defecation (tenesmus-like), unbearable." Doctors wanted to administer Da Huang or Ba Dou. I said: "Not true constipation; qi is deficient due to mistaken sweating, cannot fill abdomen, lacks strength to push." Continued tonifying medicine, gave meat porridge and Cong Rong (Cynomorii Fructus). One and a half days later, soaked lower body in strong green onion and pepper soup, passed five or six soft stool lumps. Pulse still large and unconsolidated, indicating qi and blood not yet restored. Continued previous medicine for two doses. Two days later, urinary retention, lower abdominal distension and discomfort, relieved only when supine. I said: "Tonifying medicine not fully absorbed. Double Ren Shen in previous formula, large dose, two days later urination resumed and stabilized."
Wang Ji treated a man in his thirties who had fever due to cold exposure. The doctor used dispersing medicines without success, then Xiao Chai Hu Tang, leading to intense heat, profuse sweating, confusion, lying down like clouds hovering, walking like wind-blown feathers. Accompanied by polyphagia, frequent seminal emissions. Observing his fat appearance, Wang Ji said: "This is internal fire blazing, extreme deficiency." Pulses were all floating and surging like fingers. He cited *Mai Jing*: "If pulse does not diminish after sweating, death is inevitable, untreatable." Fortunately, although pulse was large, it did not drum under pressure; though body was long/emaciated, complexion was still dark/cyanotic, curable. Treating as external pathogen was wrong, essentially damaging the deficient. *Classic* says: "Where evil gathers, qi must be deficient." Prioritize internal injury. Used large doses of Ren Shen, Dang Gui, Bai Zhu, with small amounts of Gui Zhi (Cinnamomi Ramulus) and Fu Zi. After ten doses, illness reduced by two-tenths to three-tenths. Reduced Gui Zhi, added Bai Shao and Huang Qin, taken for ten doses. Patient realized he was lying on bed, feet on ground, rejoiced: "Can avoid death." Long-term use led to recovery.
Marshal Xue Yi treated a man aged 79. Mid-winter, before going out slightly, engaged in sexual intercourse, resulting in headache, fever, vertigo, asthma, copious phlegm, frequent urination, dry mouth craving drink, tongue tip prickling/shrinking like lychee, black cracked lower lip, red face and eyes, irritability, insomnia. Sometimes throat felt like smoke/fire rising, cooled slightly by drinking cold tea, near death. Pulse was surging, large, boundless, and forceful; body hot to touch. This is kidney channel deficiency fire roaming externally. Prescribed Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction) plus Shan Zhu Yu (Corni Fructus), Ze Xie (Alismatis Rhizoma), Dan Pi (Moutan Cortex), Shan Yao (Dioscoreae Rhizoma), Mai Men Dong (Ophiopogonis Radix), Wu Wei Zi (Schisandrae Fructus), Fu Zi. One cup, deep sleep for a long time, pulse and symptoms reduced by three or four tenths. Then administered Ba Wei Wan (Eight-Ingredient Pill), all symptoms retreated. Recovered after avoiding cold objects.
Ben Shi Fang Huang Qi Jian Zhong Jia Dang Gui Tang (Astragalus Decocting the Center Plus Angelica): Treats fever, headache, floating and rapid pulse, but slow and weak at cunchi position. Should first take this medicine to nourish blood, then combine with Ma Huang, Gui Zhi, etc.
Huang Qi, Dang Gui (each 1.5 liang), Bai Shao, Gui Zhi, Gan Cao (each 1 liang). Cut into pieces. Each dose 5 qian, three slices of ginger, one jujube, decoct in water. Take three times day, two times night. If pulse remains sinking and slightly slow, take another dose.
Haizang Huang Qi Tang: Treats cold damage affecting two channels, spasms, sanjiao qi deficiency with spontaneous sweating and limb sweating, or excessive hand back sweating, limb tremors, heavy waist/legs, red face/eyes, drowsiness, hot head/face, hot hypochondrium, warm hands/feet, hot palms, spontaneous diarrhea without thirst, difficult or normal stool, dry mouth/throat, craving hot drinks but not wanting to swallow, or slight desire to drink, impending retching, chest fullness, abdominal pain, laughing or crying spontaneously, sighing, disordered speech (not delirium/hallucination, but unsettled spirit). Illness begins between wakefulness and sleep, palpitations, mild head/neck pain, normal gait. This is yin excess and yang deficiency. Pulses float/sink inconsistently, left/right fluctuating, showing five yin pulse shapes: sinking, choppy, weak, minute, wiry. All powerless upon pressure, diminished upon light/heavy pressure. These are all yin pulses. Should treat slowly first, then urgently. Slow treatment uses Huang Qi Tang.
Huang Qi Tang Formula:
Ren Shen, Sheng Jiang (Fresh Ginger), Huang Qi, Bai Fu Ling, Bai Zhu, Bai Shao (each 1 liang), Gan Cao (7 qian). For vomiting, add Huo Xiang and Chen Pi each 5 qian; for severe cases, add Pao Gan Jiang (Fried Dried Ginger) 1 qian. Cut into pieces, decoct in water, adjust dosage based on symptoms. For severe constipation, use Tiao Zhong Wan.
Tiao Zhong Wan Formula:
Ren Shen, Bai Zhu, Bai Fu Ling, Gan Jiang (Dried Ginger), Gan Cao (equal parts). Powder, honey pills. Each liang makes ten or five pills. Take one or two pills, decoct in small amount of water. If urgent, add Gan Jiang 1 qian to Huang Qi Tang per dose. For constipation, use Li Zhong Wan.
Li Zhong Wan Formula:
Ren Shen, Bai Zhu, Gan Jiang (fried, or substitute with Sheng Jiang if fearing heat), Zhi Gan Cao (equal parts). Powder, honey pills. Each liang makes five pills. Dissolve in plain water. Treat slowly first, then urgently. If extremely urgent, anhidrosis: use Fu Zi Gan Jiang Gan Cao Tang. Spontaneous sweating: use Bai Zhu Fu Zi Gan Cao Tang. Select Si Ni Tang, Zhen Wu Tang, or Tong Mai Si Ni Tang based on pulse and symptoms.
Danxi's *Ju Xin Shu* states that mixed pathogens require mixed treatment methods. For example, chills and fever from common cold indicate external pathogen, confirmed by floating-rapid pulse. But if Qi Kou pulse is tight and full, it indicates food stagnation. Patient is fatigued, pulse empty upon heavy pressure, chest/diaphragm fullness radiating to hypochondrium, pulse wiry upon light pressure, indicating liver qi stagnation from anger. Left Chi pulse large/small/sinking/weak indicates past sexual exhaustion. Treatment should prioritize addressing the common cold last. First observe complexion, strength, thickness. Use middle-tonifying, food-digesting, stagnation-resolving, stomach-fire-cooling methods, guided by pungent-warm herbs (ginger/pepper) to restore middle qi, move stagnation, harmonize fluids, induce whole-body sweating, resolving external pathogen. Doctors who do not carefully examine, only focusing on dispersing external pathogen, ignoring complicating pathogens, failing to investigate pulse origins and emotional attachments, skillfully applying mixed treatments, will see righteous qi become deficient and evil qi solidify. This is the fault of incompetent practitioners.
Lou's collection gathers Danxi and Haizang's treatments for cold damage, all using tonifying and dispersing methods, based on the Classic: "Success and failure depend on movement; continuous movement leads to transformation" and "Wind, rain, cold, heat cannot injure alone without deficiency." External wind-cold always enters after internal injury from excessive labor/activity weakening the body. Hence, within one family, some get sick, others don't; deficiency allows evil entry, non-deficiency prevents it. Thus, cold damage is internal injury in eight or nine cases. Ignorant students believe there is no tonification for cold damage, seeing fever regardless of deficiency/excess, uniformly using sweating/purging, leading to premature death. This is a sin of the medical profession. Collecting these methods after Zhang Zhongjing, responses are immediate, guiding adherence to avoid reinforcing deficiency and draining righteousness.
Regarding the outline text, seeing doctors rigidly believing no tonification for cold damage, often violating the principle of avoiding deficiency-excess errors, I detailed this, deleting purely internal injury cases and Danxi's mediocre notes, adding recent doctors' cases as living examples of deficiency-suffering cold. Enlightenment depends on the individual; do not be rigid. I once treated a woodblock carver, newly married, winter cold exposure with full exterior symptoms. Ordered Ren Shen and Zi Su Jing Ye (Perilla Stem and Leaf) each 1 liang decocted and drunk. Sweated and healed. A pregnant woman in spring-summer transition had warm disease, headache, fever, no aversion to cold, thirst. Before treatment, miscarriage with massive bleeding, fainting. Ordered Mai Men Dong 1 jin, Dan Zhu Ye (Lophatheri Herba), Xiang Chi (Fermented Soybean), frequently drunk. Sweated and healed. Using labor-relapse treatment method, obtaining such living rules ensures near-perfect cure for such diseases.
Han Zhihe's Harmonizing According to Season Method:
Cold damage has sweating indications. The discussion generally mentions sweating syndromes and pulses: floating-rapid, floating-tight, floating-no sweat-asthma, or floating indicating exterior. Now briefly listing several, later generations rely only on general pulse characteristics, not distinguishing floating pulse yin/yang deficiency/excess principles, nor knowing unsweatable conditions. Mistakenly administering dispersing medicines often transforms into Yang Du (Yang Toxicity) complications. Now categorizing patients with sweating/aversion to wind and no sweating/aversion to cold into two grades, prescribing formulas based on climate severity from after Start of Spring to before Start of Autumn, to facilitate student understanding.
Patient 1: Before Feb/Mar, both hands floating-rapid or slow/tight, pressing slightly soft. Cun/Guan/Chi equal force, neither too large nor too small. Do not immediately administer exterior-dispersing medicine. This shows interior symptoms without exterior pulse. Wait until Cun pulse force is small like Guan/Chi before administering exterior medicine. Generally, treating cold damage: observe symptoms without pulse, do not prescribe; observe pulse without symptoms, prescribing slightly is harmless. For miscellaneous diseases, symptoms first, pulse second; for cold damage, pulse first, symptoms second.
Patient 2: Both hands floating-rapid and tight, named Cold Damage. If Cun pulse force is small, Chi pulse force is large, even without aversion to wind or spontaneous sweating, this indicates yin qi already abundant, manifesting in pulse first. Without medication to harmonize, later will develop aversion to wind and spontaneous sweating. From Start of Spring to Start of Clear Brightness, use Tiao Mai Tang. From Start of Clear Brightness to Grain in Ear, use Ge Gen Chai Hu Tang. From Grain in Ear to Start of Autumn, use Ren Shen Jie Geng Tang.
Tiao Mai Tang Formula:
Ge Gen (1 liang), Qian Hu (deprived of sprouts), Fang Feng (each 7.5 qian), Zhi Gan Cao (half liang). Coarse powder. Each dose 5 qian, one cup water, ginger piece size of little finger, split, decoct to 70%, filter, take warm. If Cun pulse force is small as described, add three dates, decoct together.
Ge Gen Chai Hu Tang:
Ge Gen (1.5 liang), Chai Hu (deprived of rhizome, 1 liang), Shao Yao, Jie Geng, Zhi Gan Cao (each 7.5 qian), Nong Po (half liang). Cut into pieces. Each dose 5 qian, one cup water, two slices ginger, decoct to 70%, filter, take hot. If Cun pulse force is small as described, add three inches of scallion white, decoct together.
Ren Shen Jie Geng Tang:
Ren Shen, Jie Geng (each 7.5 qian), Ma Huang (deprived of joints, 1 liang), Shi Gao (3 liang), Zhi Gan Cao (7.5 qian). Each dose 5 qian, one cup water, five spikes of Jing Jie, decoct to 70%, filter, take hot. If Cun pulse force is small as described, add 0.2 qian Ma Huang deprived of joints, decoct together.
Patient 3: Both hands floating-rapid and slow, named Wind Strike. If Cun pulse force is small, Chi pulse force is large, even without aversion to wind or spontaneous sweating, this indicates yin qi already abundant, manifesting in pulse first. Without medication to harmonize, later will develop aversion to wind and spontaneous sweating. From Start of Spring to Start of Clear Brightness, use Bo He Tang. From Start of Clear Brightness to Grain in Ear, use Fang Feng Tang. From Grain in Ear to Start of Autumn, use Xiang Xiong Tang.
Bo He Tang:
Bo He (1 liang), Ge Gen, Ren Shen, Zhi Gan Cao (each half liang), Fang Feng (deprived of rhizome, 2 liang). Cut into pieces. Each dose 5 qian, one cup water, decoct to 70%, filter, take hot. If after three to five doses Cun pulse force is still small, add 0.2 qian Bo He, decoct together.
Fang Feng Tang:
Fang Feng (deprived of rhizome, 1 liang), Jie Geng (3 qian), Zhi Gan Cao, Xuan Fu Hua (each half liang), Nong Po (0.3 fen). Cut into pieces. Each dose 5 qian, two cups water, two pieces ginger, decoct, take hot. If after three to five doses Cun pulse force is still small, add five to seven spikes of Jing Jie Sui, decoct together.
Xiang Xiong Tang:
Chuan Xiong (2.5 qian), Shi Gao (2 liang), Sheng Ma (3 liang), Zhi Gan Cao, Zhi Nong Po (each half liang). Cut into pieces. Each dose 5 qian, two cups water, decoct to 70%, take warm. If after three to five doses Cun pulse force is still small, add 0.2 qian Xi Xin, decoct together. Why separate laws for Wind Strike and Cold Damage in previous two paragraphs? Because within three days of onset, Wind Strike may show slow pulse, Cold Damage tight pulse. Although pulse appears first, symptoms may not yet appear, allowing medicinal resolution, hence formulating prescriptions.
Patient 4: Both hands floating-rapid or slow/tight, Cun pulse short and weaker than Guan/Chi, named Yin Excess Yang Deficiency. If spontaneous sweating and aversion to wind, evil is in exterior, yin qi is surplus. *Su Wen* says: Yin surplus causes excessive sweating and body cold. Can administer exterior agents eliminating yin and assisting yang. From Start of Spring to Start of Clear Brightness, use Liu Wu Ma Huang Tang. From Start of Clear Brightness to Grain in Ear, use Qi Wu Chai Hu Tang. From Grain in Ear to Start of Autumn, use Fa Biao Tang.
Liu Wu Ma Huang Tang:
Ma Huang (deprived of joints, 1 liang), Ge Gen, Cang Zhu (each 7.5 qian), Ren Shen, Zhi Gan Cao (each half liang). Cut into pieces. Each dose 5 qian, one cup water, two jujubes, decoct to 70%, take hot. If after three to five doses sweat persists with aversion to wind, add 7 qian Jing Jie. If after three to five doses no longer aversion to wind but still sweating, add 0.5 liang Ding Xiang Pi.
Qi Wu Chai Hu Tang:
Chai Hu, Cang Zhu (each 2 liang), Jing Jie, Ma Huang (each 1 liang), Zhi Gan Cao (7 qian). Cut into pieces. Each dose 5 qian, one cup water, one piece ginger, two jujubes, decoct to 70%, take hot. If after three to five doses sweat persists with aversion to wind, add three inches of scallion white. If after three to five doses sweat still persists, add 1 liang Dang Gui, decoct together.
Fa Biao Tang:
Ma Huang (deprived of joints, 1 liang), Cang Zhu (2 liang), Ren Shen, Dang Gui (each half liang), Zhi Gan Cao, Ding Xiang Pi (each 7 qian). Cut into pieces. Each dose 5 qian, one cup water, one piece ginger, three jujubes, decoct to 70%, filter, take hot. If after three to five doses sweat persists with aversion to wind, add 7 qian Gui Zhi. If sweat persists, add 0.5 liang Xi Xin, stop when sweating ceases.
Patient 5: Pulse floating-rapid or tight or slow, pulse extends to Yu Ji (thenar eminence), Cun pulse larger than Guan/Chi, named Yang Excess Yin Deficiency. If dizziness, chest oppression, dry mouth/throat, evil is in exterior, yang qi is exclusively surplus. *Su Wen* says: Yang surplus causes body heat and anhidrosis. Can administer medicines eliminating yang and assisting yin to resolve exterior. From Start of Spring to Start of Clear Brightness, use Ren Shen Tang. From Start of Clear Brightness to Grain in Ear, use Qian Hu Tang. From Grain in Ear to Start of Autumn, use Shi Gao Tang.
Ren Shen Tang:
Ren Shen (half liang), Chai Hu (1 liang), Shao Yao, Zhi Gan Cao (each 7.5 qian), Shi Gao (2 liang). Cut into pieces. Each dose 5 qian, one cup water, one piece ginger, decoct to 70%, take hot. If after three to five doses fever unresolved, add thirty grains of Chi Dou, decoct together.
Qian Hu Tang:
Qian Hu (1 liang), Shi Gao (2 liang), Zhi Gan Cao (half liang), Jie Geng, Chi Dou (each 7.5 qian). Each dose 5 qian, one cup water, five slices ginger, decoct to 70%, filter, take hot. If after three to five doses fever unresolved, add thirty grains of Chi Dou, decoct, take again.
Shi Gao Tang:
Shi Gao (3 liang), Shao Yao, Chai Hu (each 1 liang), Sheng Ma, Huang Qin, Zhi Gan Cao (each 7.5 qian). Cut into pieces. Each dose 5 qian, one and a half cups water, one heaping measure of Chi Dou, decoct to 80%, take hot. If after three to five doses fever unresolved, add 1 liang Zhi Mu. If still unresolved, add 1 liang Da Huang.
Patient 6: Both hands floating-rapid or tight or slow, all three positions forceful, anhidrosis, aversion to wind. This is yin and yang qi both surplus. *Su Wen* says: Yin and yang surplus cause anhidrosis and cold. Medicines can be used to balance it.