（张元素方） 治两感伤寒。
羌活 独活 防风 细辛 防己 黄芩 黄连 苍术 白术 甘草（各三钱） 知母 川
芎生地（各一两） 每服五钱，水煎热饮。
大羌活汤即九味，己独知连白术暨。（即九味羌活汤去白芷，加上药。）散热培阴表里和，
（羌、独、苍、防、细辛发表散邪，芩、连、防己、知母、芎、地清里培阴，白术、甘草以
固中州而和表里。）伤寒两感差堪慰。（两感伤寒者，一日太阳与少阴俱病，则头痛口干而烦
满；二日阳明与太阴俱病，则腹满身热，不欲食，谵语；三日少阳与厥阴俱病，则耳聋囊缩
而厥，水浆不入，不知人，六日死，盖以表里阴阳俱病，故必死也。吴鹤皋《医方考》曰∶
“
则感之浅者，尚或可平也。”按钱祯曰∶“两感者，本表里之同病，似若皆以外感为言，而
实有未必尽然者，正以内外俱伤，便是两感。今见有少阴先溃于内，而太阳继之于外者，即
纵情肆欲之两感也；太阴受伤于里，而阳明重感于表者，即劳倦竭力、饮食不调之两感也；
厥阴气逆于脏，而少阳复病于腑者，即七情不慎、疲筋败血之两感也。”此言最切此病，诚
发前人所未发。或谓两感不多见者，盖亦见之不明耳。其治法亦在乎知其由而救其本也。）
（王好古《阴证略例》 治外感寒邪，内伤生冷，发热而无汗者，此代麻黄汤；并治脾
泄肠风。
苍术（二两制） 防风（二两） 甘草（一两炙） 生姜、葱白，水煎服。（如前证有
汗者，去苍术、葱白，加白术二两，名白术汤，代桂枝汤。按∶二术主治略同，特有止汗、
发汗之异耳。）
（这是张元素的方子）治疗两感伤寒。
羌活、独活、防风、细辛、防己、黄芩、黄连、苍术、白术、甘草（各三钱），知母、川芎、生地（各一两）。每次服用五钱，用水煎煮后热服。
大羌活汤的组成歌诀是：“九味羌活去白芷，加上防己、独活、知母、黄连、白术。”（即九味羌活汤去掉白芷，加入这些药物。）此方能散热并滋养阴液，调和表里。（羌活、独活、苍术、防风、细辛发散体表邪气，黄芩、黄连、防己、知母、川芎、生地清泄里热并滋养阴液，白术、甘草稳固中焦脾胃从而调和表里。）对于两感伤寒的治疗让人稍感欣慰。（所谓两感伤寒，是指第一天太阳经与少阴经同时发病，出现头痛、口干、烦闷胀满；第二天阳明经与太阴经同时发病，出现腹部胀满、身体发热、不想吃东西、说胡话；第三天少阳经与厥阴经同时发病，出现耳聋、睾丸收缩、四肢厥冷、无法进水浆、神志不清，到第六天会死亡，这是因为表里阴阳都受病，所以必然致死。吴鹤皋在《医方考》中说：“如果是感受邪气较浅的，或许还可以治愈。”按钱祯的说法：“两感证，本来是表里同病，看似都是外感引起，但实际上未必完全如此，正是因为内外都受伤，才称为两感。现在看到有少阴经先在内部溃败，然后太阳经继而在外部受病的，这就是纵情声色导致的两感证；太阴经在内部受伤，而阳明经再次在外部受邪的，这就是劳累过度、饮食不调导致的两感证；厥阴经气机逆乱于内脏，而少阳经又在腑脏发病的，这就是七情不慎、筋疲力尽、血液败坏导致的两感证。”这些话最切合这种病症，确实阐发了前人未曾发表的观点。有人说两感伤寒不多见，这大概是因为观察得不清楚罢了。治疗这种方法也在于知道病因从而挽救根本。）
（王好古《阴证略例》）治疗外感寒邪，内伤生冷食物，发热且无汗的情况，此方代替麻黄汤；同时也治疗脾虚泄泻和肠风便血。
苍术（二两，炮制）、防风（二两）、甘草（一两，炙过），生姜、葱白，用水煎服。（如果上述症状伴有出汗的，去掉苍术、葱白，加入白术二两，名为白术汤，代替桂枝汤。按：苍术和白术的主治功效大致相同，特别之处在于一个止汗、一个发汗的区别。）
(From Zhang Yuansu's formula) Treats *Lianggan Shanghan* (Two-meridian simultaneous attack by cold damage).
Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix), Xixin (Asari Radix et Rhizoma), Fangji (Stephaniae Tetrandrae Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) (each 3 qian), Zhimu (Anemarrhenae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shengdi (Rehmanniae Radix) (each 1 liang). Take 5 qian per dose, decoct in water and drink hot.
The song for Da Qianghuo Tang is: "Jiuwei Qianghuo removes Bai Zhi, adds Fang Ji, Du Huo, Zhi Mu, Lian Lian, Bai Zhu." (That is, Jiuwei Qianghuo Decoction minus Bai Zhi, plus the aforementioned herbs.) It dissipates heat and nourishes yin, harmonizing the exterior and interior. (Qianghuo, Duhuo, Cangzhu, Fangfeng, and Xixin release the exterior and disperse pathogens; Huangqin, Huanglian, Fangji, Zhimu, Chuanxiong, and Shengdi clear the interior and nourish yin; Baizhu and Gancao stabilize the middle jiao to harmonize the exterior and interior.) The treatment of Lianggan Shanghan brings some comfort. (Regarding Lianggan Shanghan: On the first day, Taiyang and Shaoyin meridians are simultaneously diseased, presenting with headache, dry mouth, irritability, and fullness; on the second day, Yangming and Taiyin meridians are simultaneously diseased, presenting with abdominal fullness, fever, anorexia, and delirium; on the third day, Shaoyang and Jueyin meridians are simultaneously diseased, presenting with deafness, retraction of the testicles, and cold extremities, inability to take fluids, and unconsciousness, leading to death on the sixth day, because both exterior and interior, yin and yang are diseased, hence it is fatal. Wu Hegao in *Yifang Kao* stated: "If the pathogenic invasion is shallow, it may possibly be resolved." According to Qian Zhen: "Lianggan cases are originally simultaneous diseases of the exterior and interior. Although they seem to refer solely to external infections, this is not always the case. It is precisely because both internal and external factors cause injury that it is called Lianggan. Currently, we see cases where Shaoyin fails internally first, followed by Taiyang externally; this is Lianggan caused by indulgence in desires. When Taiyin is injured internally, and Yangming is re-infected externally; this is Lianggan caused by fatigue, overexertion, and irregular diet. When Jueyin qi rebels within the zang organs, and Shaoyang disease occurs again in the fu organs; this is Lianggan caused by imprudent emotions, exhausted sinews, and corrupted blood." These words most accurately describe this disease, truly revealing insights previously unexpressed by predecessors. Some say Lianggan is rare, which is likely due to unclear observation. The treatment method lies in understanding the cause to rescue the root.)
(Wang Haogu's *Yin Zheng Lue Li*) Treats external contraction of cold evil and internal injury from raw/cold food, presenting with fever and absence of sweating; this serves as a substitute for Mahuang Tang. It also treats Pi Xie (Spleen diarrhea) and Chang Feng (intestinal wind/blood in stool).
Cangzhu (2 liang, processed), Fangfeng (2 liang), Gancao (1 liang, honey-fried), Shengjiang (Fresh Ginger), Congbai (Scallion White), decoct in water and take orally. (If the aforementioned symptoms present with sweating, remove Cangzhu and Congbai, add Baizhu 2 liang, named Baizhu Tang, serving as a substitute for Guizhi Tang. Note: Cangzhu and Baizhu have similar therapeutic indications, differing specifically in that one stops sweating while the other induces sweating.)