葱白（四茎） 干姜（一两） 附子（一枚生去皮破八片） 人尿（五合） 猪胆汁（一合）
以上三味。以水三升。煮取一升。去滓。内胆汁人尿。和令相得。分温再服。若无胆。亦可用。
成注引内经曰。若调寒热之逆。令热必行。则热物冷服。下嗌之后。冷体既消。热性便发。由是病气随愈。呕
烦皆除。情且不违。而致大益。此和人尿猪胆汁。咸苦寒物。于白通汤热剂中。要其气相从。则可以去格拒之寒也。
琥按上方后云。若无胆亦可用。则知所重在人尿。方当名白通加人尿汤始妥。人尿咸寒。内汤中。和令相得饮
之。即成注云热物冷服之意。
内台方议云。少阴病下利脉微者。与白通汤服之。利当止。若利不止。厥逆无脉。干呕烦者。乃寒气大甚。内
为格拒。使阳气逆乱也。故加猪胆汁童便二物。以和其阴。内经曰。逆而从之。则格拒因解也。
武陵陈氏云。下利。则寒甚于下。干呕。则寒甚于上。以反见虚烦。乃火无根失守之象。夫姜附之力。不得达
于下焦。而虚阳上浮。其死可立而待非用人尿猪胆汁。以为向导。不可葱白之通阳气。乃正治之法。二物之通阳气。
乃反治之法。人尿咸寒。取其降下。水畜惟胆苦寒。取其同气相求也。
少阴病。二三日不已。至四五日。腹痛。小便不利。四肢沉重。疼痛。自下利者。此为有水气。其人或咳。或
小便利。或下利。或呕者。真武汤主之。（此条系少阴中寒。寒气积结。变为水气之证。少阴二三日。寒邪犹浅。
至四五日。寒邪已深。成注云。肾主水。肾病不能制水。水寒之气内甚。则腹痛。小便不利。及自下利。外甚。则
四肢沉重。疼痛。其人或咳者。水寒气逆也。或小便利者。即下焦虚。有寒。不能制水。小便色白之意。或下利者。
谓前自下利。系二三日之证。此必是前未尝下利。指四五日后。始下利者而言。或呕者。水寒之气上壅也。故与真
武汤。以益阳气。散寒水。）
Scallion White (four stalks) Dried Ginger (one liang) Aconite Root (one piece, raw, peeled, broken into eight slices) Human Urine (five he) Pig Bile (one he)
The above three ingredients. Use three sheng of water. Boil to obtain one sheng. Remove the dregs. Add bile and human urine. Mix well. Divide into two doses and take warm. If bile is unavailable, it may also be used [referring to using human urine alone].
Cheng Wuji's commentary cites the *Neijing* (Classic of Internal Medicine): "If one wishes to regulate the reversal of cold and heat, allowing the heat nature to act, then hot substances should be taken cold. After swallowing, the cold physical state dissipates, and the hot nature emerges. Thus, the pathogenic qi resolves, and vomiting and vexation are eliminated. The patient's disposition remains compliant, resulting in great benefit." This explains the use of human urine and pig bile, which are salty, bitter, and cold substances, within the hot formula of Baitong Tang. By seeking compatibility in their qi, the rejecting cold can be dispelled.
Hu notes: The postscript of the above formula states, "If bile is unavailable, it may also be used," indicating that the emphasis lies on human urine. The formula name should properly be "Baitong Jia Ren Nao Tang" (Baitong Decoction plus Human Urine). Human urine is salty and cold; when added to the decoction and mixed well for consumption, it aligns with Cheng's commentary on "taking hot substances cold."
*Neitai Fangyi* states: In Shaoyin disease presenting with diarrhea and a faint pulse, administer Baitong Tang. The diarrhea should cease. If diarrhea persists, accompanied by cold extremities, absence of pulse, dry retching, and vexation, this indicates extreme cold causing internal rejection, leading to chaotic reversal of yang qi. Therefore, add pig bile and child's urine to harmonize the yin. As the *Neijing* states: "Treating against the trend resolves the rejection."
Chen from Wuling states: Diarrhea indicates extreme cold in the lower part; dry retching indicates extreme cold in the upper part. If false vexation appears instead, this is a sign of rootless fire losing its station. The power of Ginger and Aconite cannot reach the lower jiao, while deficient yang floats upward; death could follow immediately. Without using human urine and pig bile as guides, treatment is ineffective. Scallion White unblocking yang qi is the orthodox method; these two substances [urine and bile] unblocking yang qi is the contrary method. Human urine is salty and cold, utilizing its descending action; Pig Bile is bitter and cold, utilizing the principle of similar qi attracting each other.
Shaoyin disease. If not resolved after two or three days, progressing to four or five days, abdominal pain, difficulty urinating, heaviness and pain in the four limbs, and spontaneous diarrhea indicate the presence of fluid retention. Some patients may cough, have free urination, experience diarrhea, or vomit. Zhenwu Tang is the primary treatment. (This clause pertains to Cold Damage affecting Shaoyin, where accumulated cold qi transforms into fluid retention. At two or three days of Shaoyin disease, the cold pathogen is still shallow. By four or five days, the cold pathogen has deepened. Cheng's commentary states: The Kidney governs water. When Kidney disease fails to control water, excessive cold-water qi internally causes abdominal pain, difficulty urinating, and spontaneous diarrhea; externally it causes heaviness and pain in the four limbs. Coughing indicates reverse flow of cold-water qi. Free urination implies deficiency-cold in the lower jiao failing to control water, resulting in pale urine. Diarrhea here refers to cases where spontaneous diarrhea did not occur in the first two or three days but started after four or five days. Vomiting indicates congestion of cold-water qi upwards. Therefore, Zhenwu Tang is administered to tonify yang qi and disperse cold-water.)