治烧针令其汗。针处被寒。核起而赤者。必发奔豚。气从小腹上冲心。灸其核
与此方主之。
桂枝（五两） 芍药（三两） 生姜（三两） 甘草（二两） 大枣（十二枚）
上五味。以水七升。煮取三升。去滓。温服一升。按本论云。与桂枝加桂汤。更加桂二
两。
歌曰 气从脐逆号奔豚。汗为烧针启病源。只取桂枝汤本味。再加二两桂枝论。
蔚按。少阴上火而下水。太阳病以烧针令其汗。汗多伤心。火衰而水乘之。故发奔豚。
用桂
核
治火逆下之。因烧针烦躁者。此汤主之。
桂枝（一两） 甘草（二两） 龙骨（二两） 牡蛎（二两）
上四味。以水五升。煮取二升半。去滓。温服八合。日三服。
歌曰 二甘一桂不雷同。龙牡均行二两通。火逆下之烦躁起。交通上下取诸中。
蔚按。太阳病因烧针而为火逆者多。今人不用烧针而每有火逆之证者。炮姜、桂、附、
荆、
遇阴而烦。阴陷于下。不得遇阳而躁。故取龙、牡水族之物。抑亢阳以下交于阴。取桂枝辛
温之品。启阴气以上交于阳。最妙在甘草之多。资助中焦。使上下阴阳之气交通于中土。而
烦躁自平也。
治太阳病热在下焦。小腹硬满。下血乃愈。所以然者。以太阳随经瘀热在里故也。
主之。
虻虫（三十个 去足翅。熬。） 水蛭（三十个 熬。） 大黄（三两 酒洗。） 桃仁
（三十个
上四味。锉如麻豆。以水五升。煮取三升。去滓。温服一升。不下。再服。
歌曰 大黄三两抵当汤。里指任冲不指胱。虻蛭桃仁各三十。攻其血下定其狂。
张令韶曰。太阳有经与气之分。亦有外与表之别。桃仁承气证热结膀胱。乃太阳肌腠之
邪从
阳肤表之邪从胸中而下结于小腹。表气通于胸。故曰。表证仍在。反不结胸。皮毛为表也。
盖太阳之气。从胸而出入太阳之经。循背膂而下络膀胱。经病外邪从背而入结于膀胱者。详
于桃仁承气汤方注。而气病表邪从胸而入。不涉于膀胱。故不曰热结膀胱。而曰反不结胸。
热在下
亦居小腹。故前章曰小腹急结。此章曰小腹硬满。急结者急欲下通之象。不必攻之。故曰下
者愈。只用桃仁承气足矣。此曰硬满。全无下通之势。故不曰血自下。而曰下血乃愈。言必
攻而始下也。非抵当不可。二证之分别如此。又曰。太阳病六七日。正当太阳主气之期。表
证仍在。脉当浮。今微而沉者。气随经络沉而内薄也。内薄于胸当结胸。今反不结胸者。知
表邪从胸而下入于阴分。阴不胜阳故发狂。热在下焦故小腹硬满。硬满而小便自利。便知其
不在无形之气分而在有形之血分也。方用虻虫、水蛭。一飞一潜。吮血之物也。在上之热随
经而入。
拒大敌。四
治疗因烧针强迫发汗，导致针孔处受寒，出现红肿硬结的患者。此类患者必定会发作奔豚病，表现为气从小腹向上冲击心脏。应对红肿硬结处施灸，并服用此方主治。
桂枝（五两） 芍药（三两） 生姜（三两） 甘草（二两） 大枣（十二枚）
以上五味药，用水七升，煎煮至三升，去渣滓。温服一升。按《伤寒论》原文记载，此处使用的是桂枝加桂汤，即在原方基础上再加桂枝二两。
歌诀曰：气从脐部上逆称为奔豚，发汗是由烧针开启了病源。只取桂枝汤的本味组成，再增加二两桂枝进行论述。
陈蔚按语：少阴经上部有火、下部有水。太阳病若用烧针强迫发汗，汗出过多会损伤心阳，导致心火衰微而肾水乘虚上犯，因此引发奔豚。
治疗因误用火法治疗后又误用攻下法，随后因烧针导致烦躁不安的患者。此方主治。
以上四味药，用水五升，煎煮至二升半，去渣滓。温服八合，每日三次。
歌诀曰：两份甘草一份桂枝不雷同，龙骨和牡蛎各用二两通治。火逆与误下导致烦躁兴起，通过交通上下之气来取效于中焦。
陈蔚按语：太阳病因烧针而导致火逆证的很多。现在的人虽然不用烧针，但常有火逆证的表现。这是因为炮姜、桂枝、附子等辛热药物，遇到阴邪则烦；阴气陷于下部，不能遇阳气则躁。因此选用龙、牡这类水族之物，以抑制亢盛的阳气使其下行交于阴；选用桂枝这种辛温的药物，以激发阴气上行交于阳。最妙之处在于多用甘草，资助中焦脾胃之气，使上下阴阳之气在中土得以交通，从而烦躁自平。
治疗太阳病，热邪位于下焦，小腹坚硬胀满，排出瘀血后痊愈。之所以这样，是因为太阳表邪随经络内入，瘀热结于体内所致。此方主治。
虻虫（三十个，去掉足翅，炒制。） 水蛭（三十个，炒制。） 大黄（三两，酒洗。） 桃仁（三十个，去皮尖，双仁者去除）
以上四味药，锉碎如麻豆大小，用水五升，煎煮至三升，去渣滓。温服一升。若未见效，再服一次。
歌诀曰：抵当汤中大黄用三两，这里的“里”指的是任脉和冲脉而非膀胱。虻虫、水蛭、桃仁各用三十个，攻逐瘀血而定其狂乱。
张令韶说：太阳病有经脉和气分的区别，也有外感和表证的分别。桃仁承气汤证的热结在膀胱，那是太阳肌腠的邪气从体表进入。而肤表之邪从胸中向下，结于小腹。因为表气通于胸，所以说表证仍在，反而不结胸。皮毛属于表。大概太阳之气，从胸出入太阳之经，沿背部脊柱向下联络膀胱。如果是经病，外邪从背部进入结于膀胱，这在桃仁承气汤方注中有详细说明。而如果是气病，表邪从胸而入，不涉及膀胱，所以不说热结膀胱，而说反不结胸。热在下焦，也位于小腹，所以前章说小腹急结，此章说小腹硬满。“急结”是急于想要下通的征象，不需要攻下，所以说自行下血即可痊愈，只用桃仁承气汤就够了。这里说“硬满”，完全没有下通的趋势，所以不说“血自下”，而说“下血乃愈”，意思是必须经过攻下才能排出瘀血。非抵当汤不可。这两种证候的区别就是这样。又说：太阳病六七天，正当太阳主气的时期，表证仍在，脉应当浮，现在却微而沉，这是气随经络下沉而内迫。如果内迫于胸应当结胸，现在反而不结胸，可知表邪从胸向下进入阴分。阴不胜阳，所以发狂。热在下焦，所以小腹硬满。硬满且小便自利，便知道病不在无形的气分而在有形的血分。方中使用虻虫、水蛭，一飞一潜，都是吮吸血液的生物。在上部的热邪随经传入，（此处原文似有残缺，意指抵挡大敌）。
Treats cases where burning needle therapy was used to induce sweating. Cold has invaded the puncture site, causing nodules to rise and turn red. The patient will inevitably develop *Ben Tun* (Rushing Pig, a condition characterized by gas rushing upward from the lower abdomen). Qi rushes from the lower abdomen up to the heart. Moxibustion should be applied to the nodules, and this formula should be administered as the primary treatment.
Guizhi Tang (Cinnamon Twig Decoction) [Note: Specifically Guizhi Jia Gui Tang] - Cinnamon Twig (Wu Liang / 5 liang), Shaoyao (White Peony Root) (San Liang / 3 liang), Shengjiang (Fresh Ginger) (San Liang / 3 liang), Gancao (Licorice Root) (Liang / 2 liang), Dazao (Jujube) (Shi Er Mei / 12 pieces).
Take the above five ingredients. Add seven sheng of water, boil until three sheng remain, remove the dregs. Take one sheng warm. According to the original text of *Shanghan Lun*, this refers to Guizhi Jia Gui Tang (Cinnamon Twig Plus Cinnamon Twig Decoction), which adds an additional two liang of Guizhi (Cinnamon Twig) to the base formula.
Song says: Qi reversing from the navel is called Ben Tun; sweating induced by burning needles opens the source of disease. Only take the original flavors of Guizhi Tang; add two liang more of Guizhi for discussion.
Chen Wei's commentary: In Shaoyin (Lesser Yin), fire is above and water is below. When Taiyang (Greater Yang) disease is treated with burning needles to induce sweat, excessive sweating damages the Heart. Fire becomes deficient, allowing Water to overpower it, thus triggering Ben Tun.
Treats cases where fire-induced reversal occurred due to inappropriate purging after fire therapy, followed by restlessness caused by burning needles. This decoction is the primary treatment.
Guizhi (Cinnamon Twig) (Yi Liang / 1 liang), Gancao (Licorice Root) (Er Liang / 2 liang), Longgu (Dragon Bone) (Er Liang / 2 liang), Muli (Oyster Shell) (Er Liang / 2 liang).
Take the above four ingredients. Add five sheng of water, boil until two and a half sheng remain, remove the dregs. Take eight ge warm, three times a day.
Song says: Two parts Gancao and one part Guizhi are not identical; Longgu and Muli are equally distributed at two liang each. Fire reversal and purging cause restlessness; communicating the upper and lower through the center resolves it.
Chen Wei's commentary: Many Taiyang diseases result in fire-induced reversal due to burning needles. Nowadays, people do not use burning needles but still present with fire-reversal symptoms. This is because pungent-warm herbs like Pao Jiang (Baked Ginger), Guizhi, and Fuzi interact with Yin pathogenic factors causing vexation; when Yin sinks below and cannot encounter Yang, it causes agitation. Therefore, aquatic substances like Longgu and Muli are used to suppress hyperactive Yang and guide it down to communicate with Yin. Guizhi, being pungent and warm, is used to stimulate Yin Qi to ascend and communicate with Yang. The most ingenious aspect is the generous use of Gancao to support the Middle Jiao (Middle Burner), enabling the communication of Upper and Lower Yin-Yang Qi in the Earth element, thereby calming restlessness naturally.
Treats Taiyang disease where heat resides in the Lower Jiao (Lower Burner), presenting with hardness and fullness in the lower abdomen. Recovery occurs only after bloody stool is passed. This happens because Taiyang exterior pathogens follow the meridians inward, resulting in stasis-heat accumulating internally. This formula is the primary treatment.
Mengchong (Blister Beetle) (Thirty pieces, remove feet and wings, stir-fry), Shuizhi (Leech) (Thirty pieces, stir-fry), Dahuang (Rhubarb Root) (Three liang, washed with wine), Taoren (Peach Kernel) (Thirty pieces, remove skin and tips).
Take the above four ingredients. Crush to the size of hemp seeds. Add five sheng of water, boil until three sheng remain, remove the dregs. Take one sheng warm. If no effect, administer again.
Song says: Dahuang in Didang Tang is three liang; "Li" here refers to the Ren and Chong vessels, not the Bladder. Mengchong, Shuizhi, and Taoren are each thirty pieces; attacking blood stasis calms mania.
Zhanglingshao states: Taiyang disease distinguishes between Meridians and Qi aspects, as well as Exterior and Surface distinctions. In Tao Ren Cheng Qi Tang syndrome, heat binds in the Bladder; this is exterior pathogens from the muscle layer entering from the surface. However, pathogens from the skin surface descend from the chest and bind in the lower abdomen. Since exterior Qi connects to the chest, it is said that while exterior signs remain, there is no Chest Binding. Skin and hair constitute the exterior. Generally, Taiyang Qi enters and exits via the Taiyang Meridian, running along the back spine downward to connect with the Bladder. If it is a Meridian disease, exterior pathogens enter from the back and bind in the Bladder, as detailed in the notes for Tao Ren Cheng Qi Tang. However, if it is a Qi disease, exterior pathogens enter from the chest without involving the Bladder; thus, it is not described as heat binding in the Bladder, but rather as "contrary absence of Chest Binding." Heat in the Lower Jiao also resides in the lower abdomen. Hence, the previous chapter mentions "lower abdominal urgency and knotting," while this chapter mentions "lower abdominal hardness and fullness." "Urgency and knotting" indicates a desire for downward unblocking; attack is unnecessary, so spontaneous passage of blood leads to recovery, requiring only Tao Ren Cheng Qi Tang. Here, "hardness and fullness" shows no tendency for downward unblocking; thus, it is not said that "blood passes spontaneously," but "recovery follows bloody evacuation," implying that attack is required for expulsion. Only Didang Tang suffices. The distinction between these two conditions is thus. Furthermore: In Taiyang disease on the sixth or seventh day, coinciding with the period when Taiyang governs Qi, if exterior signs remain, the pulse should be Floating. Now, if it is Fine and Deep, it indicates Qi sinking along the meridians and pressing inward. If pressing inward at the chest, Chest Binding should occur; since it does not, we know exterior pathogens have descended from the chest into the Yin compartments. Yin failing to overcome Yang causes mania. Heat in the Lower Jiao causes lower abdominal hardness and fullness. Hardness and fullness with normal urination indicate the pathology lies in tangible Blood aspects rather than intangible Qi aspects. The formula uses Mengchong and Shuizhi, one flying and one diving, both creatures that suck blood. Heat from above enters following the meridians... [Text appears truncated].