治伤寒若吐若下后。心下逆满。气上冲胸。起则头眩。脉沉紧。发汗
者。此方主之。
茯苓（四两） 桂枝（三两） 白术（二两） 甘草（二两 炙。）
上四味。以水六升。煮取三升。去滓。分温三服。
歌曰 病因吐下气冲胸。起则头眩身振从。茯四桂三术草二。温中降逆效从容。
张令韶曰。此治吐下后而伤肝气也。心下逆满者。心下为脾之部位。脾主中焦水谷之津。
吐
本脉本证。方
金匮所谓知肝之病当先实脾是也。
治发汗病不解。反恶寒者。虚故也。此汤主之。
芍药（三两） 甘草（三两 炙。） 附子（一枚 炮去皮。破八片）
以上三味。以水五升。煮取一升五合。去滓。温服。
歌曰 一枚附子胜灵丹。甘芍平行三两看。汗后恶寒虚故也。经方秘旨孰能攒。
男元犀按。各家以此证为发汗虚其表阳之气。似是而非。于病不解三字说不去。且虚故
也三
亦有大汗亡阳明之阳用白虎加人参法。亡少阴之阳用真武四逆法。论有明训也。今但云不解。
可
寒若系阳虚。四逆辈犹恐不及。竟以三两之芍药为主。并无姜、桂以佐之。岂不虑恋阴以扑
灭残阳乎。师恐人因其病不解而再行发汗。又恐因其恶寒而径用姜、附。故特切示曰虚故也。
言其所以不解。所以恶寒。皆阴阳素虚之故。补虚自足以胜邪。不必他顾也。方中芍药、甘
草。苦甘以补阴。附子、甘草。辛甘以补阳。附子性猛。得甘草而缓。芍药性寒。得附子而
和。且芍、草多而附子少。皆调剂之妙。此阴阳双补之良方也。论中言虚者。间于节中偶露
一二语。单言虚而出补虚之方者只一节。学人当从此隅反之。
治疗伤寒，经过催吐或泻下治疗后。出现胃脘部胀满逆气感。气向上冲至胸部。起身时头晕目眩。脉象沉而紧。如果误用发汗法（导致病情加重），应当用本方主治。
茯苓（四两） 桂枝（三两） 白术（二两） 甘草（二两，炙过。）
以上四味药。用水六升。煮取三升药液。去掉药渣。分三次温服。
歌诀说：病因吐下导致气冲胸。起身则头晕身体震颤。茯苓四两、桂枝三两、白术和甘草各二两。温中降逆效果从容有效。
张令韶说。这是治疗吐下后损伤肝气的病证。心下逆满的症状。心下部位属于脾的管辖范围。脾主管中焦水谷的精微津液。
原本脉象原本证候。方剂
正如《金匮要略》所说，知道肝脏有病应当先充实脾胃是这个道理。
治疗发汗后病邪未解。反而出现怕冷的症状。这是因为正气虚弱所致。此汤剂主治。
芍药（三两） 甘草（三两，炙过。） 附子（一枚，炮制去皮。掰成八片）
以上三味药。用水五升。煮取一升五合药液。去掉药渣。温服。
歌诀说：一枚附子的功效胜过灵丹妙药。芍药和甘草各用三两来看待。发汗后恶寒是因为虚损的缘故。经方的秘旨谁能掌握。
陈元犀按语。各家将此证解释为发汗导致表阳之气虚弱。看似有理实则不然。无法解释“病不解”这三个字。况且“虚故也”这句话
也有大汗导致亡失阳明之阳的情况，使用白虎加人参法。亡失少阴之阳的情况，使用真武汤或四逆汤法。医论中有明确训诫。现在只说病不解。
如果寒冷是由于阳虚引起，四逆汤类方剂恐怕还嫌力度不够。竟然以三两的芍药为主药。并没有生姜、桂枝来辅助。难道不担心收敛阴气从而扑灭残存的阳气吗？老师（张仲景）是担心人们因为病邪未解而再次发汗。又担心人们因为恶寒而直接使用姜、附等热药。所以特别明确指出这是虚损的缘故。
说明之所以病邪不解。之所以恶寒。都是因为阴阳素来虚弱的缘故。补益虚损自然足以战胜邪气。不必顾虑其他。方中芍药、甘草。苦甘化合以补阴。附子、甘草。辛甘化合以补阳。附子药性猛烈。得到甘草后变得缓和。芍药药性寒凉。得到附子后变得平和。而且芍药、甘草用量多而附子用量少。都是调剂配伍的妙处。这是一个阴阳双补的良好方剂。医论中提到“虚”字的。夹杂在章节中间偶尔露出的一两句。单独提出“虚”并给出补虚方剂的只有一个章节。学习的人应当从此举一反三。
Treats Taiyang disease (disease of the Taiyang channel) after emesis or purgation. Manifestations include fullness and rebellious qi in the epigastrium, qi rushing upward to the chest, dizziness upon standing, and a deep, tight pulse. If sweating therapy is mistakenly applied, this formula should be used as the primary treatment.
Fuling (Poria, 4 liang), Guizhi (Cinnamon Twig, 3 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 2 liang), Gancao (Licorice Root, 2 liang, honey-fried).
Take the above four herbs. Add six sheng of water. Decoct until three sheng remain. Remove the dregs. Divide into three warm doses.
The song states: The cause is qi rushing to the chest due to emesis and purgation; dizziness and body tremors occur upon rising. Use four parts Fuling, three parts Guizhi, two parts each of Baizhu and Gancao. Warming the middle and descending rebellious qi yields effective and从容 results.
Zhanglingshao says. This treats liver qi injury following emesis and purgation. "Fullness and rebellious qi in the epigastrium" refers to the epigastric region, which is the domain of the Spleen. The Spleen governs the fluids and essences of food and drink in the Middle Jiao.
Original pulse and original syndrome. Formula.
As stated in the *Jingui Yaolue*: Knowing that liver disease exists, one must first strengthen the Spleen.
Treats cases where Taiyang disease persists after sweating therapy, accompanied by aversion to cold. This indicates deficiency. This decoction is the primary treatment.
Shaoyao (Peony Root, 3 liang), Gancao (Licorice Root, 3 liang, honey-fried), Fuzi (Prepared Aconite Root, 1 piece, processed, skin removed, broken into eight pieces).
Take the above three herbs. Add five sheng of water. Decoct until one sheng and five he remain. Remove the dregs. Take warm.
The song states: One piece of Fuzi surpasses spiritual elixirs; consider Shaoyao and Gancao equally at three liang each. Aversion to cold after sweating is due to deficiency; who can grasp the secret principles of classic formulas?
Chen Yuanxi notes. Various schools interpret this syndrome as deficiency of exterior Yang qi due to sweating. This seems plausible but is incorrect, as it fails to explain the phrase "disease not resolved." Furthermore, the statement "due to deficiency"
There are also cases of massive sweating leading to loss of Yang Qi of the Yangming channel, treated with Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction). Cases of loss of Yang Qi of the Shaoyin channel are treated with Zhenwu Tang (True Warrior Decoction) or Sini Tang (Frigid Extremities Decoction). These are clearly stated in the treatise. Here, it only says "disease not resolved."
If the cold were due to Yang deficiency, Sini Tang category formulas might still be insufficient. Yet, this formula uses three liang of Shaoyao as the main herb, without Ginger or Cinnamon Twig to assist. Would one not worry about retaining Yin and extinguishing residual Yang? The Master (Zhang Zhongjing) feared people would re-sweat because the disease was not resolved, and feared they would directly use Ginger and Aconite because of aversion to cold. Thus, he specifically pointed out "due to deficiency."
He explains that the reason for the unresolved disease and the aversion to cold is due to inherent deficiency of both Yin and Yang. Tonifying deficiency is sufficient to overcome pathogenic factors; no other considerations are needed. In the formula, Shaoyao and Gancao use bitter and sweet flavors to tonify Yin. Fuzi and Gancao use pungent and sweet flavors to tonify Yang. Fuzi has a fierce nature, which becomes mild when combined with Gancao. Shaoyao has a cold nature, which becomes harmonious when combined with Fuzi. Moreover, the dosage of Shaoyao and Gancao is high while Fuzi is low, demonstrating the subtlety of formulation adjustment. This is an excellent formula for dual tonification of Yin and Yang. Mentions of "deficiency" in the treatise appear occasionally within sections. There is only one section that explicitly mentions "deficiency" and provides a formula for tonifying deficiency. Students should infer from this instance.