更加斑烂也。其或大便自利，怫郁短气，燥粪不通，黑斑主不治。汗下不解，足冷耳聋、烦闷咳逆，便是斑疹
之候也。
柴胡 玄参 黄连 知母 石膏 青黛 生地黄 山栀 犀角 人参 甘草
上锉剂，生姜一片，枣一枚，水煎。临服入醋一匙同服。
伤寒汗吐下后，烦躁口渴，阳厥极深者，表里大热也。
黄连解毒汤 治伤寒大热不止、烦躁干呕、口渴喘满、阳厥极深、蓄热内甚及汗吐下后，寒凉不能退
其热者。
黄芩 黄连 黄柏 栀子（各二钱） 柴胡 连翘（各二钱）
上锉一剂，水煎温服。
凉膈散 治伤寒三四日以里，用发表之药，无汗者或已汗而不解者，根据本方加石膏、知母，以解表里
之药最为稳当。（方见火门。）
伤寒小便利，大便黑，漱水不咽，口燥者，下焦瘀血也。
桃仁承气汤 治热邪传里，热蓄膀胱，其人如狂，小便自利、大便黑、小腹满痛、身面目黄、谵语燥
渴，为蓄血症。脉沉有力，宜此下尽黑物则愈。未服前血自下者，不必服，为欲愈。
桃仁（十个，去皮尖，研） 桂枝（一钱） 大黄（三钱） 芒硝（一钱） 甘草（一钱）
上锉一剂，生姜三片，水煎去滓，入芒硝再煎一沸温服。血尽为度，如血未尽再服。
伤寒结胸者，热痰结也。
清火化痰汤 治热痰在胸膈间不化，咯吐不出、寒热气急、满闷作痛者，名结痰。
黄连 黄芩 栀子 栝萎仁 贝母 桔梗 桑白皮 甘草 木香（另研） 杏仁
上锉生姜三片，水煎，入竹沥、姜汁少许，磨木香同服。
解热化痰汤 治伤寒结胸，有痰、有热、有气滞，并咳嗽失声。
苏子 白芥子 枳实 黄连 桔梗 黄芩 栝萎仁 石膏 杏仁 乌梅 黄柏
上锉剂，生姜一片，水煎温服。
姜熨法 治伤寒胸膈不宽，一切寒结、热结、水结、食结、痞结、痰结、大小便结、胸痞气结者俱治。
生姜捣烂如泥，去汁取渣，炒热绢包，渐渐揉熨心胸胁下，其满痛豁然自愈。若姜渣冷，再入姜再炒再熨。
结热不用炒。
伤寒发黄者，湿热盛也。
退黄散 治伤寒发黄，身目俱黄如金色，小便如浓黄柏汁，诸药不效。
柴胡 升麻 茵陈 龙胆草 黄连 黄芩 桅子 黄柏 木通 滑石 甘草
上锉剂，灯草一团，水煎服。大便实加大黄；目睛黄倍龙胆草，虚弱加人参。外用生姜捣烂，时时于黄处
擦之，其黄自退。
伤寒汗下烦热者，表里俱虚也。
竹叶石膏汤 治伤寒已经汗下，表里俱虚，津液枯竭，心烦发热，气逆欲吐，及诸烦热并宜服之。
石膏（二钱） 半夏（二钱） 麦门冬（去心） 人参 甘草（各一钱）
上锉剂，用青竹叶、生姜各五片、粳米百余粒，水煎温服。极热发狂倍知母、石膏；热呕加姜汁。
伤寒病后不眠者，心胆虚怯也。
湿胆汤 治病后虚烦不得卧及心胆虚怯，触事易惊，短气悸乏，或复自汗并治。
陈皮（去白） 半夏（姜汁炒） 茯苓（去皮） 枳实（麸炒，各二钱半） 竹茹（一钱） 酸枣仁（炒一
钱） 甘草（五分）
上锉剂，生姜三片，水煎温服。心胆虚怯，触事易惊加麦门冬、人参、柴胡、桔梗。
竹茹温胆汤 治伤寒日数过多，其热不退、梦寐不宁、心悸恍惚、烦躁多痰不眠者。
柴胡（二钱） 竹茹 桔梗 枳实（麸炒。各二钱） 黄连（五分） 人参（五钱） 陈皮 半夏 茯苓
香附（八分） 甘草（三分）
上锉一剂，生姜三片、枣一枚，水煎服。
伤寒懊 者，闷郁不舒也。其症因表症误下，正气内虚，阳邪内陷，结于其间，重则结胸也。邪在胸中宜
吐，热结在胃腑宜下。凡伤寒汗吐下后，虚烦不眠，若剧者，必反复颠倒，心中懊 宜此。
栀豉汤 治汗吐下后，心胸满闷或痛，或头微汗，虚烦不得眠，反复颠倒，心中懊 ，乃燥热怫郁于
内而气不宣通也。
红栀子 淡豆豉
上水煎温服。烦躁者，懊 不得眠也；懊 者，郁闷不舒之貌。烦者，气也，火入于肺也；躁者，血也，
火入于肾也。故用桅子以治肺烦，豆豉以治肾躁。少气虚满加甘草；呕哕加生姜、橘红；有宿食而烦躁者加大黄
；下后胀满而烦加枳实、浓朴，下后身热而烦加甘草、干姜；瘥后劳复加枳实。
伤寒百合者，百没是处也。其病又非寒又非热，欲食不食，欲行不行，欲坐不坐，服药即吐，小便赤。如见
此，谓之百合病。
加味柴胡汤 治百合病。
人参 半夏 柴胡 黄芩 百合 知母 甘草
上锉剂，青竹茹一团、粳米炒食盐一撮，入姜汁少许，水煎服。
伤寒痰气紧满者，宜上吐也。
瓜蒂散 治伤寒四五日，病在胸膈，痰气紧满于上不得息者，以此吐之。
甜瓜蒂（炒） 赤小豆（各等分）
上为末，每服一钱，豆豉煎汤调服，以吐为度。
伤寒神昏不语者，越经症也。
泻心导赤饮 治伤寒心下不痛、腹中不满、大便如常、身无寒热、渐变神昏不语，或睡中独语三旬，
目赤神焦，将水与之则咽，不与则不思，形如醉人，医者不识，便呼为死症。若以针火灸误人者多矣，殊不知
热邪传入少阴心经也。
因火上而逼肺，所以神昏，故名越经症。
栀子 黄芩 麦门冬 滑石 人参 犀角 知母 茯苓 黄连（姜汁炒） 甘草
上锉一剂，生姜一片、枣二枚、灯芯二十根，水煎。临服入新生地黄汁二匙同服。
伤寒阳症似阴者，是火极似水也。自热以至温，由温乃至厥，是传经之邪。轻则宜四逆散合小柴胡汤，
如渴，用白虎汤合解毒汤；重则宜六一顺气汤。
四逆散 柴胡 芍药 枳实 甘草
上锉剂，生姜一片，水煎服。
伤寒阴症似阳者，水极似火也。自得病手足便逆冷而不温者。
四逆汤（方见中寒。）根据本方加参、附。
伤寒狐惑者，唇口生疮声哑也。其症四肢沉重，恶闻食气，默默欲卧，目闭舌白，面目间黑色变异无常。
蚀下部为狐，而唇下有疮，其咽干；虫蚀其脏为惑，上唇有疮声哑。治慝二者并用。
黄连犀角汤∶
黄连 犀角 乌梅 木香 桃仁
上锉，水煎服。
伤寒吐蛔者，手足冷，胃空虚也。宜安蛔汤。
安蛔汤
人参（七分） 白术 茯苓（各一钱） 干姜（炒黑，五分） 乌梅（二个） 花椒（去目，三分）
上锉剂，水煎服。治蛔不可用甘草甜物，盖蛔得甘则动于上，得酸则静，见若则安，得辛辣则头伏于下。
如合丸，用乌梅浸烂蒸熟捣如泥，入前药再捣如泥，每服十丸，米汤吞
下。伤寒吐蛔，虽有大热，忌用凉药，犯之必死，先当用温剂以定蛔，后用凉剂以退热，小柴胡汤之类。
伤寒汗下后，昏闷不省人事者，元气大虚也。
夺命独参汤 治伤寒汗后，终日昏闷不省人事、发热发躁似有狂言，一切危急之症宜此。服后，额
上鼻尖有微汗，是其应也。
楝参（去芦，一两）
上锉作一剂，水煎，不拘时服。渣再煎服。
病后劳复者，宜养血气也。
益气养神汤 治伤寒新瘥，方起劳动应事，或多言劳神而微复动热者日劳复，宜服此。
人参 当归 白芍（酒炒） 麦门冬（去心） 知母（去毛） 桅子（炒。各一钱） 白茯神（去皮）
前胡（各七分） 陈皮（五分） 升麻 生甘草（各三分）
上锉剂，枣一枚，水煎，食远温服。
伤寒瘥后，交接复发欲死，眼不开，不能言语及热病新瘥早起及多食复发。
山栀（三十枚） 锉碎，水煎服。
劳力感寒者，内伤外感也。其症头疼身热、恶寒微渴、 然汗出、身痛、腰腿酸痛、沉困无力、脉空浮无
力，名曰劳力感寒，不可误作正伤寒，大发其汗。故经云∶劳者温之，温能除大热，正此之谓也。宜加味益气
汤；若有下症者，大柴胡汤下之。
加味益气汤 治体怯弱兼之劳，而染感冒伤寒，头痛发热者。
黄 人参（各一钱） 白术 陈皮 当归（各七分） 柴胡（一钱） 升麻（三分） 黄柏（酒炒，七分）
羌活（一钱半） 防风 甘草（五分）
上锉一剂，生姜三片，水煎热服。冬月加细辛三分，如热甚，脉滞有力加黄芩酒炒三分。
伤寒产后禁忌歌∶
新瘥须当自保持，勿将酒肉口中肥；
清宵静睡无思想，用意烦劳最忌之；
节食寡言须晏起，寒暄冬暖减添衣；
勿忌房室阴阳易，悔误难追已噬脐。
补遗秘方。
神仙救苦丸 专治四时伤寒，不论日期远近、阴阳表里、内外虚实、半表半里、男女老幼并皆治之。
麻黄（去节，研细，热水浸取汁） 甘草（炙，去皮，温水浸，取汁。以上各四两） 赤芍（洗去土，温
水浸，取汁，四两） 朱砂（一两五钱，红大颗者研细，水飞过） 雄黄（去夹石，红朗大颗者研细，水飞过，
一两五钱） 升麻（微炒，研细，温水浸取汁） 人参（去芦研碎，温水浸取汁） 当归（用身，研细，水浸
取汁） 柴胡（研碎，温水浸取汁。以上各一两。） 春夏用石膏（研细，水淘净） 枳实（研细，温水浸取
汁，此二味另放一处，临合时入众药内。各五钱） 秋冬用桂枝（研细，温水浸取汁） 细辛（研细，温水浸
取汁，此二药另收一处，临合入众药。各五钱）
上为细末，根据前法修制，各阴干择庚申日共成一处，用温水搅匀，以细绢滤过三遍，将汁盛于瓷罐内，上
以绵纸固之，置之不近湿、不通风处，仍阴干取下细末，择甲子停分两处，一半入春夏药，一半入秋冬药，醋
糊为丸如黍米大，每服一丸。好鲜明雄黄五分于碗内研细，入井花凉水研同药送下。水洗雄黄，务要吃尽，焚
香三寸，自然汗出立愈。如伤寒汗后变为杂症者，应服二丸；内外兼表，仍出汗自愈；若干霍乱等疾，即当内
解，有起死回生之功不能尽述。
阴阳散 治伤寒三五日，或近期、或初觉无汗，服此。
麻黄（一两六钱） 绿豆粉（二钱） 川芎 白芷 石膏 甘草 苏叶（各一钱）
上为细末，每服一钱，凉水调服。吃水二三次，待汗出来方止水。盖被出汗足，以身凉为度。二三日勿出
门见风，食淡饭。
伤寒昏迷不省人事，皂角末捻纸烧烟入鼻，有嚏可治，无则不治，肺气上绝也。可治者，随用皂角、半夏、
生白矾共一钱五分为末，入姜汁调服。探吐，痰去苏醒，效。
一人伤寒头疼，发热憎寒、身痛发渴、谵语、日久不出汗。余以大梨一个、生姜一块，同捣取汁，入童便一
碗，重汤煮热服之，汗出如水即愈。
太守云亭刘公患伤寒，发热面红唇赤、面壁蜷身而卧，诸医以小柴胡汤、解毒汤之类，数剂弗效。余诊六脉
浮大无力，此命门无火也。以人参、附子、沉香，一服立愈，三服全安。
一老妪，年七旬，患伤寒初起头疼身痛，发热憎寒，诸医以药发散，数剂弗效。淹延旬日，惭而饮食不下，
昏沉不省，口不能言，眼不能开，咽喉有微气，似欲绝之意，诸医潜退。一家彷徨，召余察之，元气耗绝，即
以人参五钱煎汤，徐徐灌之。须臾稍省，欲饮水，又煎渣服之，顿愈。又逾十年而卒。夫人参回元气于无何有
之乡，果有起死回生之效，信哉不诬。
It becomes more ulcerated and discolored. If the patient has spontaneous diarrhea, chest oppression with shortness of breath, and dry feces that cannot pass, the appearance of black spots indicates a refractory condition. If the pathogen is not resolved after sweating or purging methods, accompanied by cold feet, deafness, mental restlessness, coughing, and counterflow of qi, these are signs of macules and rashes erupting.
Chai Hu (Bupleuri Radix), Xuan Shen (Scrophulariae Radix), Huang Lian (Coptidis Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), Shi Gao (Gypsum Fibrosum), Qing Dai (Indigo Naturalis), Sheng Di Huang (Rehmanniae Radix), Shan Zhi Zi (Gardeniae Fructus), Xi Jiao (Rhinocerotis Cornu), Ren Shen (Ginseng Radix et Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Crush the above herbs into one dose. Add one slice of fresh ginger and one jujube. Decoct in water. Before administration, mix in one spoonful of vinegar and take together.
After sweating, vomiting, or purging for Shanghan (Cold Damage), if there is irritability, thirst, and severe Yang jue (extremity cold due to yang deficiency or heat blockage), this indicates excessive heat in both the exterior and interior.
Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity): Treats Shanghan with persistent high fever, irritability, dry retching, thirst, wheezing and chest fullness, severe Yang jue, intense internal accumulation of heat, and cases where cooling herbs fail to reduce fever after sweating, vomiting, or purging.
Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Huang Bo (Phellodendri Cortex), Zhi Zi (Gardeniae Fructus) (each 2 qian), Chai Hu (Bupleuri Radix), Lian Qiao (Forsythiae Fructus) (each 2 qian).
Crush into one dose, decoct in water, and take warm.
Liang Ge San (Cooling the Diaphragm Powder): For Shanghan within three to four days, if releasing exterior herbs result in no sweat or failure to resolve after sweating, adding Shi Gao (Gypsum Fibrosum) and Zhi Mu (Anemarrhenae Rhizoma) to this formula is the most prudent approach for resolving both exterior and interior pathogens. (See Formula in Fire Chapter.)
If in Shanghan the urine is clear and frequent, stool is black, the patient rinses water in the mouth but does not swallow, and experiences dry mouth, this indicates blood stasis in the lower jiao.
Tao Ren Cheng Qi Tang (Peach Kernel Decoction for Directing Downward): Treats heat pathogen transmitting inward and accumulating in the bladder, causing the patient to act like a madman, with free urination, black stool, lower abdominal fullness and pain, yellowing of body and eyes, delirium, and extreme thirst. This is a blood accumulation syndrome. If the pulse is deep and forceful, use this to purge until black material is expelled, then recovery occurs. If blood passes spontaneously before taking the medicine, do not administer it, as recovery is imminent.
Tao Ren (Persicae Semen) (10 seeds, remove skin and tips, crush), Gui Zhi (Cinnamomi Ramulus) (1 qian), Da Huang (Rhei Radix et Rhizoma) (3 qian), Mang Xiao (Natrii Sulfas) (1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (1 qian).
Crush into one dose, add three slices of fresh ginger, decoct in water, strain, add Mang Xiao, boil once more, and take warm. Continue until blood stasis is exhausted; if not exhausted, repeat.
Shanghan Jie Xiong (Chest Binding) is caused by the binding of hot phlegm.
Qing Huo Hua Tan Tang (Clearing Fire and Transforming Phlegm Decoction): Treats hot phlegm stuck in the chest and diaphragm that cannot be transformed, coughed up, accompanied by alternating chills and fever, rapid breathing, fullness, distension, and pain. This is named "Jie Tan" (Binding Phlegm).
Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Zhi Zi (Gardeniae Fructus), Gua Lou Ren (Trichosanthis Semen), Bei Mu (Fritillariae Bulbus), Jie Geng (Platycodonis Radix), Sang Bai Pi (Mori Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma), Mu Xiang (Aucklandiae Radix) (separately crushed), Xing Ren (Armeniacae Semen Amarum).
Crush, add three slices of fresh ginger, decoct in water. Add a little Zhu Li (Bambusa Textilis Sap) and Jiang Zhi (Zingiberis Recens Juice), grind Mu Xiang powder into the mixture, and take together.
Jie Re Hua Tan Tang (Resolving Heat and Transforming Phlegm Decoction): Treats Shanghan Jie Xiong with phlegm, heat, and qi stagnation, along with cough and loss of voice.
Su Zi (Perillae Fructus), Bai Jie Zi (Sinapis Semen), Zhi Shi (Aurantii Fructus Immaturus), Huang Lian (Coptidis Rhizoma), Jie Geng (Platycodonis Radix), Huang Qin (Scutellariae Radix), Gua Lou Ren (Trichosanthis Semen), Shi Gao (Gypsum Fibrosum), Xing Ren (Armeniacae Semen Amarum), Wu Mei (Mume Fructus), Huang Bo (Phellodendri Cortex).
Crush into one dose, add one slice of fresh ginger, decoct in water, and take warm.
Jiang Yi Fa (Ginger Ironing Method): Treats Shanghan causing chest and diaphragm discomfort, applicable to all types of binding: cold binding, heat binding, water binding, food binding, pi (glomus) binding, phlegm binding, constipation of large and small intestines, chest stuffiness, and qi binding.
Mash fresh ginger into a paste, extract the juice, keep the residue. Stir-fry the residue until hot, wrap in silk, and gently rub and iron over the chest, heart, and hypochondrium. Fullness and pain will suddenly relieve and heal themselves. If the ginger residue cools, add fresh ginger, stir-fry again, and continue ironing. Do not stir-fry for heat binding.
Jaundice in Shanghan is caused by abundant damp-heat.
Tui Huang San (Yellow-Reducing Powder): Treats Shanghan jaundice where the body and eyes are golden yellow, urine is like concentrated Huang Bo (Phellodendri Cortex) juice, and other medicines are ineffective.
Chai Hu (Bupleuri Radix), Sheng Ma (Cimicifugae Rhizoma), Yin Chen (Artemisiae Scopariae Herba), Long Dan Cao (Gentianae Radix), Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Zhi Zi (Gardeniae Fructus), Huang Bo (Phellodendri Cortex), Mu Tong (Akebiae Caulis), Hua Shi (Talcum), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Crush into one dose, add a bundle of Deng Xin Cao (Junci Medullia), decoct in water, and take. If stool is solid, add Da Huang (Rhei Radix et Rhizoma); if eyes are particularly yellow, double the Long Dan Cao; if weak, add Ren Shen (Ginseng Radix et Rhizoma). Externally, mash fresh ginger and frequently rub it on the yellow areas; the jaundice will naturally recede.
Irritability and heat after sweating and purging in Shanghan indicate deficiency in both exterior and interior.
Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction): Treats Shanghan after sweating and purging, where exterior and interior are deficient, fluids are depleted, causing mental irritability, fever, rebellious qi with nausea, and various irritabilities and heats. It is suitable for all such conditions.
Shi Gao (Gypsum Fibrosum) (2 qian), Ban Xia (Pinelliae Rhizoma) (2 qian), Mai Men Dong (Ophiopogonis Tuber) (remove heart), Ren Shen (Ginseng Radix et Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 1 qian).
Crush into one dose, use five slices of Qing Zhu Ye (Bamboo Leaf), five slices of fresh ginger, and over a hundred grains of Jing Mi (Oryza Sativa Germen). Decoct in water and take warm. For extreme heat and mania, double Zhi Mu and Shi Gao; for heat with vomiting, add Jiang Zhi (Zingiberis Recens Juice).
Insomnia after Shanghan is due to deficiency and timidity of the Heart and Gallbladder.
Wen Dan Tang (Warm the Gallbladder Decoction): Treats post-illness empty irritability preventing sleep, as well as Heart and Gallbladder deficiency and timidity, easily startled by events, shortness of breath, palpitations, fatigue, or recurrent spontaneous sweating.
Chen Pi (Citri Reticulatae Pericarpium) (remove white pith), Ban Xia (Pinelliae Rhizoma) (stir-fried with ginger juice), Fu Ling (Poria), Zhi Shi (Aurantii Fructus Immaturus) (bran-stir-fried, each 2.5 qian), Zhu Ru (Bambusa Textilis Sap), Suan Zao Ren (Ziziphi Spinosae Semen) (stir-fried, 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (0.5 qian).
Crush into one dose, add three slices of fresh ginger, decoct in water, and take warm. For Heart and Gallbladder deficiency and easy startling, add Mai Men Dong, Ren Shen, Chai Hu, and Jie Geng.
Zhu Ru Wen Dan Tang (Bamboo Leaf Warm the Gallbladder Decoction): Treats prolonged Shanghan with unresolved fever, restless dreams, palpitations, confusion, irritability, excessive phlegm, and insomnia.
Chai Hu (Bupleuri Radix) (2 qian), Zhu Ru (Bambusa Textilis Sap), Jie Geng (Platycodonis Radix), Zhi Shi (Aurantii Fructus Immaturus) (bran-stir-fried, each 2 qian), Huang Lian (Coptidis Rhizoma) (0.5 qian), Ren Shen (Ginseng Radix et Rhizoma) (5 qian), Chen Pi (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), Xiang Fu (Cyperi Rhizoma) (0.8 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (0.3 qian).
Crush into one dose, add three slices of fresh ginger and one jujube, decoct in water, and take.
Shanghan Ao Nao (mental depression and restlessness) refers to a feeling of stifled depression and discomfort. This symptom arises from incorrect purging during exterior syndrome, leading to internal deficiency of healthy qi and inward sinking of yang pathogenic factors, which bind in between. Severe cases lead to Jie Xiong. If pathogen is in the chest, vomiting is appropriate; if heat binds in the stomach fu, purging is appropriate. After sweating, vomiting, or purging in Shanghan, if there is empty irritability and insomnia, and in severe cases, tossing and turning with mental Ao Nao, this formula is suitable.
Zhi Chi Tang (Gardenia and Fermented Soybean Decoction): Treats post-sweating/vomiting/purging chest and heart fullness or pain, slight head sweating, empty irritability preventing sleep, tossing and turning, and mental Ao Nao. This is due to dry heat depressing internally and qi failing to circulate freely.
Hong Zhi Zi (Gardeniae Fructus), Dan Dou Chi (Sojae Semen Praeparatum).
Decoct in water and take warm. Irritability is due to Ao Nao preventing sleep; Ao Nao is the appearance of depression and discomfort. Fan (irritability) relates to qi and fire entering the Lung; Zao (restlessness) relates to blood and fire entering the Kidney. Therefore, Zhi Zi treats Lung qi irritability, and Dou Chi treats Kidney blood restlessness. Add Gan Cao for shortness of breath and empty fullness; add Sheng Jiang (fresh ginger) and Ju Hong (tangerine peel) for vomiting and hiccups; add Da Huang for food retention with irritability; add Zhi Shi and Hou Po (Magnoliae Officinalis Cortex) for fullness and irritability after purging; add Gan Cao and Gan Jiang (dried ginger) for body heat and irritability after purging; add Zhi Shi for recurrence due to overexertion after recovery.
Shanghan Bai He (Lily Disease) means the patient feels uncomfortable everywhere. The disease is neither cold nor heat. The patient wants to eat but cannot, wants to walk but cannot, wants to sit but cannot. Taking medicine causes vomiting, and urine is red. These symptoms constitute Bai He Bing (Lily Disease).
Jia Wei Chai Hu Tang (Modified Bupleuri Decoction): Treats Bai He Bing.
Ren Shen (Ginseng Radix et Rhizoma), Ban Xia (Pinelliae Rhizoma), Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Bai He (Lilii Bulbus), Zhi Mu (Anemarrhenae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Crush into one dose, add a ball of Qing Zhu Ru (green bamboo sap), stir-fried rice with a pinch of salt, and a little ginger juice. Decoct in water and take.
For Shanghan with tight phlegm and qi causing fullness, upward vomiting (emesis) is appropriate.
Gua Di San (Melon Tip Powder): Treats Shanghan after four to five days, where the pathogen is in the chest and diaphragm, and tight phlegm and qi obstruct the upper body causing breathing difficulty. Use this to induce vomiting.
Tian Gua Di (Momordicae Fructus Spermatium) (stir-fried), Chi Xiao Dou (Vigna Semen Rubrum) (equal parts).
Grind into fine powder. Take 1 qian per dose, mixed with Dou Chi decoction. Stop when vomiting occurs.
Shanghan with coma and inability to speak is Yue Jing Syndrome (Transgressing Meridian Syndrome).
Xie Xin Dao Chi Yin (Drain Heart and Guide Out Redness Decoction): Treats Shanghan where the epigastrium is not painful, abdomen is not full, stool is normal, body has no chills or fever, but gradually develops coma and inability to speak, or talks alone in sleep for thirty days. Eyes are red, spirit is scorched. The patient swallows water if offered but does not seek it otherwise, resembling a drunkard. Doctors who do not recognize this may call it a death syndrome. Many have been harmed by incorrect acupuncture or moxibustion. Unknowingly, this is heat pathogen transmitting to the Shaoyin Heart meridian. Because heart fire forces the lung, coma results, hence named Yue Jing Syndrome.
Zhi Zi (Gardeniae Fructus), Huang Qin (Scutellariae Radix), Mai Men Dong (Ophiopogonis Tuber), Hua Shi (Talcum), Ren Shen (Ginseng Radix et Rhizoma), Xi Jiao (Rhinocerotis Cornu), Zhi Mu (Anemarrhenae Rhizoma), Fu Ling (Poria), Huang Lian (Coptidis Rhizoma) (stir-fried with ginger juice), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Crush into one dose, add one slice of fresh ginger, two jujubes, and twenty roots of Deng Xin Cao (Junci Medullia). Decoct in water. Before taking, add two spoonfuls of fresh Sheng Di Huang (Rehmanniae Radix) juice.
Yang Zheng Si Yin (Yang Syndrome Resembling Yin) in Shanghan is extreme fire resembling water. From heat to warmth, from warmth to jue (cold extremities), this is transmitted meridian pathogen. Mild cases suit Si Ni San combined with Xiao Chai Hu Tang. If thirsty, use Bai Hu Tang combined with Jie Du Tang. Severe cases suit Liu Yi Shun Qi Tang.
Si Ni San (Reverse the Extremities Powder): Chai Hu (Bupleuri Radix), Shao Yao (Paeoniae Radix Alba), Zhi Shi (Aurantii Fructus Immaturus), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Crush into one dose, add one slice of fresh ginger, decoct in water, and take.
Yin Zheng Si Yang (Yin Syndrome Resembling Yang) in Shanghan is extreme water resembling fire. From onset, hands and feet are cold and do not warm.
Si Ni Tang (Reverse the Extremities Decoction) (See Cold Damage Chapter). Add Ren Shen and Fu Zi based on this formula.
Shanghan Hu Huo (Fox-Huo Disease) involves sores on lips and mouth and hoarseness. Symptoms include heavy limbs, aversion to food smells, silence wanting to lie down, closed eyes, white tongue, and variable dark discoloration on face. Erosion of lower parts is "Hu" (Fox), with sores under lips and dry throat. Worms eroding organs is "Huo", with sores on upper lips and hoarseness. Treat both simultaneously.
Huang Lian Xi Jiao Tang (Coptis and Rhino Horn Decoction):
Huang Lian (Coptidis Rhizoma), Xi Jiao (Rhinocerotis Cornu), Wu Mei (Mume Fructus), Mu Xiang (Aucklandiae Radix), Tao Ren (Persicae Semen).
Crush, decoct in water, and take.
Shanghan with vomiting of roundworms is due to cold hands and feet and empty stomach. An Hui Tang (Calming Roundworms Decoction) is suitable.
An Hui Tang:
Ren Shen (Ginseng Radix et Rhizoma) (0.7 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria) (each 1 qian), Gan Jiang (Zingiberis Rhizoma Recens) (charred, 0.5 qian), Wu Mei (Mume Fructus) (2 pieces), Hua Jiao (Zanthoxyli Pericarpium) (remove seeds, 0.3 qian).
Crush into one dose, decoct in water, and take. Do not use sweet substances like Gan Cao for treating roundworms, as worms move upward with sweetness, calm with sourness, settle with bitterness, and hide downward with pungency/spiciness. For pills, soak Wu Mei until soft, steam, mash into paste, mix with other drugs, mash again. Take ten pills per dose with rice soup. For Shanghan vomiting roundworms, even with great heat, avoid cold medicines, or death ensues. First use warm agents to calm worms, then cool agents to reduce heat, such as Xiao Chai Hu Tang.
After sweating and purging in Shanghan, coma and unconsciousness indicate severe deficiency of Yuan Qi (Original Qi).
Duo Ming Du Shen Tang (Life-Restoring Single Ginseng Decoction): Treats post-sweating Shanghan with all-day coma, unconsciousness, fever, irritability, and delirium. Suitable for all critical conditions. After taking, slight sweat on forehead and nose tip indicates efficacy.
Ren Shen (Ginseng Radix et Rhizoma) (remove rhizome, 1 liang).
Crush into one dose, decoct in water, take at any time. Decoct residue again and take.
Recurrence due to overexertion after illness requires nourishing blood and qi.
Yi Qi Yang Shen Tang (Benefiting Qi and Nourishing Spirit Decoction): Treats recent recovery from Shanghan, rising to labor or affairs, or speaking too much exhausting spirit, causing slight recurrent heat, known as Lao Fu (Labor Recurrence). Suitable for this.
Ren Shen (Ginseng Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba) (wine-fried), Mai Men Dong (Ophiopogonis Tuber) (remove heart), Zhi Mu (Anemarrhenae Rhizoma) (remove hairs), Zhi Zi (Gardeniae Fructus) (stir-fried, each 1 qian), Bai Fu Shen (Poria with Hostwood) (remove skin), Qian Hu (Peucedani Radix) (each 0.7 qian), Chen Pi (Citri Reticulatae Pericarpium) (0.5 qian), Sheng Ma (Cimicifugae Rhizoma), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma) (each 0.3 qian).
Crush into one dose, add one jujube, decoct in water, take warm long after meals.
Post-Shanghan recurrence due to sexual intercourse causing near-death state, eyes unable to open, inability to speak, or early rising/much eating after recent heat illness recovery.
Zhi Zi (Gardeniae Fructus) (30 pods), crush, decoct in water, and take.
Overexertion contracting cold is internal injury plus external contraction. Symptoms: headache, body heat, aversion to cold, slight thirst, continuous sweating, body pain, sore waist and legs, heaviness and weakness, pulse empty and floating without force. Named Lao Li Gan Han (Overexertion Contracting Cold). Do not mistake for regular Shanghan and forcefully sweat. As the classic says: "Tonify the weary with warmth," warmth can remove great heat. This is what is meant. Suit Jia Wei Yi Qi Tang. If excess syndromes exist, use Da Chai Hu Tang to purge.
Jia Wei Yi Qi Tang (Modified Benefiting Qi Decoction): Treats weak constitution plus labor, contracting cold damage with headache and fever.
Huang Qi (Astragali Radix), Ren Shen (Ginseng Radix et Rhizoma) (each 1 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Dang Gui (Angelicae Sinensis Radix) (each 0.7 qian), Chai Hu (Bupleuri Radix) (1 qian), Sheng Ma (Cimicifugae Rhizoma) (0.3 qian), Huang Bo (Phellodendri Cortex) (wine-fried, 0.7 qian), Qiang Huo (Notopterygii Rhizoma et Radix) (1.5 qian), Fang Feng (Saposhnikoviae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma) (0.5 qian).
Crush into one dose, add three slices of fresh ginger, decoct in water, take hot. In winter, add Xi Xin (Asari Radix et Rhizoma) 0.3 qian. If heat is severe and pulse is stagnant and forceful, add wine-fried Huang Qin 0.3 qian.
Song of Contraindications for Postpartum Shanghan:
Newly recovered must maintain oneself,
Do not put wine and meat into your mouth;
Sleep quietly at night without thoughts,
Mental worry and labor are most taboo;
Moderate food, few words, rise late,
Adjust clothes according to cold and warmth;
Do not fear sexual activity causing Yin-Yang transmission,
Regretting mistakes is too late, like biting the navel.
Supplementary Secret Prescriptions.
Shen Xian Jiu Ku Wan (Immortal Saving from Suffering Pill): Specifically treats four-season Shanghan, regardless of time elapsed, yin/yang, exterior/interior, internal/external, deficiency/excess, or half-exterior/half-interior. Treats men, women, old, and young alike.
Ma Huang (Ephedrae Herba) (remove joints, grind fine, soak in hot water, extract juice), Gan Cao (Glycyrrhizae Radix et Rhizoma) (roasted, remove skin, soak in warm water, extract juice. Each 4 liang above), Chi Shao (Paeoniae Radix Rubra) (wash dirt, soak in warm water, extract juice, 4 liang), Zhu Sha (Cinnabaris) (1.5 liang, large red grains grind fine, wash with water), Xiong Huang (Realgar), Sheng Ma (Cimicifugae Rhizoma) (lightly roast, grind fine, soak in warm water, extract juice), Ren Shen (Ginseng Radix et Rhizoma) (remove rhizome, grind, soak in warm water, extract juice), Dang Gui (Angelicae Sinensis Radix) (use body, grind fine, soak in water, extract juice), Chai Hu (Bupleuri Radix) (grind, soak in warm water, extract juice. Each 1 liang above). Spring/Summer use Shi Gao (Gypsum Fibrosum) (grind fine, wash clean), Zhi Shi (Aurantii Fructus Immaturus) (grind fine, soak in warm water, extract juice. Place these two aside separately, add to other drugs when mixing. Each 5 qian). Autumn/Winter use Gui Zhi (Cinnamomi Ramulus) (grind fine, soak in warm water, extract juice), Xi Xin (Asari Radix et Rhizoma) (grind fine, soak in warm water, extract juice. Store these two separately, add to other drugs when mixing. Each 5 qian).
Grind into fine powder. Process according to previous methods, dry in shade individually. Choose Geng Shen day, mix together. Stir evenly with warm water, filter through fine silk three times. Store juice in porcelain jar, seal with cotton paper, place in dry, non-ventilated area. Dry in shade again, take fine powder. Choose Jia Zi day, divide into two parts. Half add to spring/summer drugs, half add to autumn/winter drugs. Make pills with vinegar paste, size of millet seeds. Take one pill per dose. Grind 0.5 qian of bright red Xiong Huang in a bowl, add well water, grind together, send down with medicine. Drink all washed Xiong Huang water. Burn three cun of incense, natural sweat will appear, immediate cure. If Shanghan changes to miscellaneous diseases after sweating, take two pills; if exterior and interior both affected, still sweating leads to self-healing; if Gan Huo Luan (dry cholera) etc., resolve internally, having life-restoring power, cannot be fully described.
Yin Yang San (Yin-Yang Powder): Treats Shanghan three to five days, or recently, or initially feeling no sweat. Take this.
Ma Huang (Ephedrae Herba) (1.6 liang), Lu Dou Fen (Vigna Radiata Powder) (2 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Shi Gao (Gypsum Fibrosum), Gan Cao (Glycyrrhizae Radix et Rhizoma), Su Ye (Perillae Folium) (each 1 qian).
Grind into fine powder. Take 1 qian per dose, mix with cool water. Drink water two or three times, stop drinking when sweat appears. Cover with quilt to ensure sufficient sweat, stop when body cools. Do not go out or see wind for two to three days, eat bland food.
For Shanghan coma and unconsciousness, roll Zao Jiao Mo (Gleditsiae Sinensis Fructus Powder) in paper, burn smoke into nose. If sneezing occurs, treatable; if not, untreatable, indicating Lung qi severance. For treatable cases, use Zao Jiao, Ban Xia, and Sheng Bai Fan (Alumen) total 1.5 qian, grind to powder, mix with Jiang Zhi (ginger juice), take. Induce vomiting, remove phlegm, wake up, effective.
One person had Shanghan headache, fever, aversion to cold, body pain, thirst, delirium, long duration without sweat. I used one large pear, one piece of ginger, mashed together to extract juice, added one bowl of Tong Bian (child's urine), heated in double boiler, took warm. Sweat flowed like water, then cured.
Governor Mr. Liu from Yunting suffered Shanghan, fever, red face and lips, lying curled facing wall. Various doctors used Xiao Chai Hu Tang, Jie Du Tang etc., several doses ineffective. I diagnosed six pulses floating, large, and forceless. This is Ming Men (Gate of Life) lacking fire. Used Ren Shen, Fu Zi, Chen Xiang. One dose cured immediately, three doses fully recovered.
An old woman, seventy years old, initial Shanghan headache and body pain, fever, aversion to cold. Doctors used dispersing medicines, several doses ineffective. Delayed ten days, ashamed, could not eat or drink, comatose, unable to speak or open eyes, faint breath in throat, seeming near death. Doctors retreated secretly. Family panicked, summoned me. Diagnosed Yuan Qi exhausted. Immediately decocted 5 qian Ren Shen, slowly灌 (pour/give). Momentarily slightly conscious, wanted water. Decocted residue again and took, instantly cured. Died ten years later. Ren Shen returns Yuan Qi to the realm of nothingness, truly having life-restoring effects, indeed not false.