赤石脂（二两） 干姜（一两） 或加乌附（炮半个）
上为细末。稀糊为丸。桐子大。每服三五十丸。米饮下。久痢便紫血者。当归汤下。治丙。赤石脂。干姜附子。治
庚。白石脂。附子干姜。
琥按仲景桃花汤。虽出少阴病例。实则手阳明大肠寒极冷滑之证。故上方中加附子。其意同也。又云治丙者。丙为
火府。乃小肠寒极而不通也。云治庚者。庚为金府。乃大肠寒极而下泄也。
夫病发热而恶寒者。发于阳也。不发热而恶寒者。发于阴也。发于阳者。可攻其外。发于阴者。可温其内。发表以
桂枝汤。温里以四逆汤。凡阴病宜与四逆理中辈。皆自愈。若夏月得阴证。亦虑四逆太热。宜与理中最佳也。又云。大
抵发热恶寒者。是表证。属太阳也。只恶寒。是阴证也。然阴证即有发热者。盖是表热里寒。其脉必沉迟。或手足微厥。
或下利清谷。更以别证验之可知也。又云。本是阴病。医与热药过多。却见热证者。亦斟酌以凉药解之。又云。阴证形
静。无发狂者。惟饵温药过多。胸中热实。或大便硬。有发狂者。亦宜用承气辈下之。但不可轻用。本是阳病热证。医
误吐下过多。遂成阴证者。却与理中四逆辈温之。
琥按上论。实发仲景未发之义。仲景云发热恶寒云云。原论中无治法。王氏以桂枝四逆二汤主之。又云夏月得阴证。
亦虑四逆太热。宜与理中最佳。此即仲景辩霍乱病。寒多不用水者。同一治法。又云。阴证服温热药过多。亦斟酌以凉
药解之。或用承气下之。此即仲景太阳病例中云。伤寒脉浮。自汗出。小便数。心烦。微恶寒。脚挛急云云。服甘草干
姜汤。若胃气不和。谵语者。少与调胃承气汤。及证象阳旦云云。以承气汤微溏。则止其谵语。二条论。即阴病过服温
热药之意。其用承气本相仿也。至若阳病热证。误吐下过多。遂成阴证者。此即仲景云。太阳病下之后。脉促胸满云云。
若微恶寒者。桂枝去芍药。加附子汤主之。又下之后。复发汗云云。不呕不渴。无表证。脉沉微。身无大热者。干姜附
子汤主之之类是也。后之学人。能于此等证。一一细辩。则知阴证不专用热药。亦有时用凉泻之剂。阳证不专用寒药。
亦有时用热补之方。大率不可执也。
Red Halloysite (Er Liang), Dried Ginger (Yi Liang), or add Prepared Aconitum Lateralis Radix Preparata and Prepared Aconitum Carmichaelii Radix Preparata (Ban Ge).
Grind the above into fine powder. Form pills with thin rice paste, size of *Cerasi Fructus* (Wutongzi). Take 30-50 pills per dose, washed down with rice water. For chronic dysentery with purple blood in stool, take with *Danggui Tang* (Angelica Sinensis Decoction). Treats Bing (Fire Fu/Small Intestine cold syndrome). Red Halloysite, Dried Ginger, Aconite treat Geng (Metal Fu/Large Intestine cold syndrome). White Halloysite, Aconite, Dried Ginger.
Hu notes: Zhang Zhongjing's *Taohua Tang* (Peach Blossom Decoction), although appearing in the Shaoyin disease chapter, actually treats a condition of extreme cold in the Hand-Yangming Large Intestine leading to slippery incontinence. Therefore, adding Aconite to the above formula shares the same intent. It is also said to treat "Bing" (丙); Bing belongs to the Fire Fu, which refers to the Small Intestine suffering from extreme cold and obstruction. It is said to treat "Geng" (庚); Geng belongs to the Metal Fu, which refers to the Large Intestine suffering from extreme cold and diarrhea.
Generally, when a disease presents with fever and aversion to cold, it originates from Yang. When there is no fever but only aversion to cold, it originates from Yin. For those originating from Yang, one may attack the exterior; for those originating from Yin, one may warm the interior. To release the exterior, use *Guizhi Tang* (Cinnamon Twig Decoction); to warm the interior, use *Sini Tang* (Frigid Extremities Decoction). Generally, Yin diseases are suitable for treatment with *Sini Tang*, *Lizhong Tang* (Regulate the Middle Decoction) and similar formulas, and they will heal themselves. If a Yin syndrome is contracted in summer, one should fear that *Sini Tang* is too hot; using *Lizhong Tang* is best. It is also said that generally, fever with aversion to cold indicates an exterior syndrome belonging to Taiyang. Only aversion to cold indicates a Yin syndrome. However, Yin syndromes can also present with fever, which is likely due to exterior heat and interior cold; the pulse must be deep and slow, or the hands and feet may be slightly cold, or there may be diarrhea with undigested food. Further verification with other symptoms will clarify this. It is also said that if it was originally a Yin disease, but the physician administered too many hot medicines, resulting in heat signs, one should carefully consider using cool medicines to resolve it. It is also said that Yin syndrome patients are physically quiet and do not experience mania. Only when excessive intake of warm medicines causes heat accumulation in the chest or hard stools, leading to mania, should one use *Chengqi Tang* (Descending the Qi Decoction) category formulas to purge. However, this should not be used lightly. If it was originally a Yang disease with heat signs, but the physician mistakenly used purgative and emetic methods excessively, turning it into a Yin syndrome, one should instead use *Lizhong Tang* or *Sini Tang* to warm it.
Hu notes: The above discussion actually expounds upon meanings not explicitly stated by Zhang Zhongjing. Zhang Zhongjing mentioned "fever and aversion to cold...", but the original text lacked treatment methods. Wang Physician proposed *Guizhi Tang* and *Sini Tang*. He also stated that for Yin syndromes in summer, fearing *Sini Tang* is too hot, *Lizhong Tang* is best. This aligns with Zhang Zhongjing's differentiation of Huoluan disease, where "cold predominance without desire for water" uses the same treatment method. He also stated that if Yin syndromes receive too much warm medicine, one should carefully use cool medicines to resolve it, or use *Chengqi Tang* to purge. This parallels Zhang Zhongjing's Taiyang disease chapter: "Shanghan with floating pulse, spontaneous sweating, frequent urination, vexation, slight aversion to cold, and cramped legs..." After taking *Gancao Ganjiang Tang* (Licorice and Dried Ginger Decoction), if stomach qi becomes disordered and delirium occurs, administer a small amount of *Tiaowei Chengqi Tang* (Regulate the Stomach and Descend the Qi Decoction). Also, regarding the pattern resembling Yangdan... using *Chengqi Tang* to cause slight loose stools stops the delirium. These two discussions reflect the meaning of overusing warm/hot medicines in Yin diseases. The principle of using *Chengqi Tang* is similar. As for Yang disease heat patterns becoming Yin syndromes due to excessive mistaken vomiting and purging, this corresponds to Zhang Zhongjing saying: "After purging a Taiyang disease, if the pulse is rapid and there is chest fullness..." if there is slight aversion to cold, use *Guizhi Qu Shaoyao Jia Fuzi Tang* (Cinnamon Twig Decoction minus Peony plus Aconite). Or after purging and then inducing sweating... if there is no vomiting or thirst, no exterior syndrome, pulse is deep and faint, and body has no significant heat, use *Ganjiang Fuzi Tang* (Dried Ginger and Aconite Decoction). Scholars of later generations, if they carefully differentiate these conditions, will understand that Yin syndromes do not exclusively use hot medicines, but sometimes use cool/purging agents; Yang syndromes do not exclusively use cold medicines, but sometimes use hot/nourishing formulas. Generally, one must not be rigid or dogmatic.