也。若自下利者。脉当微厥。今反和者。此为内实也。属调胃承气汤。
又曰。伤寒八九日。下之。胸满烦惊。小便不利。谵语。一身尽
重。不得转侧者。属柴胡加龙骨牡蛎汤。
又曰。火逆下之。因烧针。烦躁者。属桂枝甘草龙骨牡蛎汤。
又曰。太阳病。脉浮而动数。浮则为风。数则为热。动则为痛。数
则为虚。头痛发热。微盗汗出。而更恶寒。表未解也。医反下之。动数
变迟。膈内拒痛。（一作头痛即眩）胃中空虚。客气动膈。短气烦躁。
心中懊 。阳气内陷。心下因硬。则为结胸。属大陷胸证。若不结胸。
但头汗出。余处无汗。剂颈而还。小便不利。身必发黄。常氏云。可茵
陈蒿汤、调五苓散。
又曰。伤寒五六日。呕而发热者。柴胡汤证具。而以他药下之。
柴胡证仍在者。复与柴胡汤。此虽已下之。不为逆。必蒸蒸而振。却
发热汗出而解。若心下满而硬痛者。此为结胸也。大陷胸汤主之。若
但满而不痛。此为痞。柴胡不中与之。属半夏泻心汤。
又曰。本以下之。故心下痞。与泻心汤。痞不解。其人渴而口燥
烦。小便不利者。属五苓散。（脉经云。一方言忍之一日乃愈。）
又曰。伤寒中风。医反下之。其人下利日数十行。谷不化。腹中
雷鸣。心下痞硬而满。干呕。心烦不得安。医见心下痞。谓病不尽。复
下之。其痞益甚。此非结热。但以胃中虚。客气上逆。故使硬也。属甘
草泻心汤。
又曰。伤寒。服汤药。下利不止。心下痞硬。服泻心汤已。复以他
药下之。利不止。医以理中与之。利益甚。理中者。理中焦。此利在下
焦。服赤石脂禹余粮汤。复利不止者。当利其小便。庞氏云。可五苓
散。
又曰。太阳病。外证未除而数下之。遂协热而利。利下不止。心
下痞硬。表里不解者。属桂枝人参汤。
又曰。下后。不可更行桂枝汤。汗出而喘。无大热者。属麻黄杏
子甘草石膏汤。
又曰。病患无表里证。发热七八日。脉虽浮数者。可下之。假令
已下。脉数不解。合热则消谷善饥。至六七日不大便者。有瘀血也。
属抵当汤。
又曰。若脉数不解。而下不止。必协热。便脓血。
又曰。本太阳病。医反下之。因而腹满时痛者。属太阴也。桂枝
加芍药汤主之。大实痛者。属桂枝加大黄汤。
又曰。伤寒六七日。大下后。寸脉沉而迟。手足厥冷。下部脉不
至。咽喉不利。吐脓血。泄利不止者。为难治。属麻黄升麻汤。
又曰。伤寒本是自寒下。医复吐下之。寒格。更逆吐下。若食入
口即出。属干姜黄芩黄连人参汤。此证根据脉经定。
千金翼曰。大下后。口燥者。里虚故也。
庞氏曰。因发汗时。汗出如水漏下。还复汗少。喘促不止。脉促
而按之濡者。合当汗而解。脉促而按之实者死。若脉浮。手足微厥。
面垢唇青。昏愦而喘者。阴阳未和。气阻升降。宜服顺阴阳五味子
汤。
又曰。发汗。或下后。痞满。或成结胸。气塞不通。宜槟榔散。
If spontaneous diarrhea occurs, the pulse should be faint or accompanied by cold extremities. Now that the pulse is instead harmonious, this indicates internal excess; it belongs to the category of Tiaowei Chengqi Tang (Regulate the Stomach and Purge Down Decoction).
It is also said: After eight or nine days of Shaoyang disease (Cold Damage), if purgatives are mistakenly administered, resulting in chest fullness, irritability, fright, dysuria, delirium, heaviness of the entire body, and inability to turn over, it belongs to the category of Chaihu Jia Longgu Muli Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction).
It is also said: Due to counterproductive fire therapy followed by purgation, compounded by burning needles, resulting in restlessness and irritability, it belongs to the category of Guizhi Gancao Longgu Muli Tang (Cinnamon Twig and Licorice Plus Dragon Bone and Oyster Shell Decoction).
It is also said: In Taiyang disease (Taiyang Syndrome), the pulse is floating, active, and rapid. Floating indicates wind; rapid indicates heat; active indicates pain; rapid also indicates deficiency. Headache, fever, slight night sweats, yet aversion to cold persists, indicating the exterior syndrome has not resolved. The physician mistakenly applies purgation. The active and rapid pulse changes to a slow one. Pain resists pressure within the diaphragm (alternatively described as headache with dizziness). The stomach becomes empty and deficient; pathogenic qi moves into the diaphragm, causing shortness of breath, irritability, and inner vexation (Ao Nao). Yang qi sinks inward, causing hardness below the heart, forming Jie Xiong (Chest Binding); this belongs to the Da Xianxiong Zheng (Major Chest Binding Syndrome). If Jie Xiong does not form, but there is only sweating on the head with no sweat elsewhere, stopping at the neck, along with dysuria, jaundice will inevitably develop. Chang Shi states that Yinchen Hao Tang (Artemisia Capillaris and Yellow Bean Decoction) and Wu Ling San (Five-Ingredient Powder with Poria) can be used.
It is also said: In Cold Damage lasting five or six days, vomiting and fever indicate that the Chaihu Tang (Bupleurum Decoction) pattern is complete. If other medicines are mistakenly used for purgation, and the Chaihu pattern remains, administering Chaihu Tang again is appropriate. Although purgation has been performed, it is not a counterproductive error. The patient will inevitably experience shivering and trembling, followed by fever and sweating, leading to resolution. If the epigastrium is full, hard, and painful, this is Jie Xiong (Chest Binding), treated primarily with Da Xianxiong Tang (Major Chest Binding Decoction). If it is merely full without pain, this is Pi (Glomus/Blockage); Chaihu Tang is not indicated. It belongs to the category of Banxia Xiexin Tang (Pinellia Drain the Epigastrium Decoction).
It is also said: Originally due to mistaken purgation causing Pi (Glomus) below the heart, Xiexin Tang was given, but the Pi did not resolve. If the person is thirsty, has dry mouth and vexation, and experiences dysuria, it belongs to the category of Wu Ling San (Five-Ingredient Powder with Poria). (The Mai Jing states that one version suggests enduring it for a day leads to recovery.)
It is also said: In Cold Damage with Wind Strike, if the physician mistakenly uses purgation, the person may suffer from diarrhea dozens of times a day, undigested food, borborygmus in the abdomen, hardness and fullness below the heart, dry retching, and mental vexation preventing peace. Seeing the Pi below the heart, the physician assumes the pathogen is not exhausted and purges again, making the Pi worse. This is not heat binding, but rather deficiency in the stomach with rebellious pathogenic qi rising, causing hardness. It belongs to the category of Gancao Xiexin Tang (Licorice Drain the Epigastrium Decoction).
It is also said: In Cold Damage, after taking herbal medicine, diarrhea continues incessantly with hardness below the heart. After taking Xiexin Tang, other purgatives are mistakenly used, and diarrhea persists. The physician administers Lizhong Tang (Regulate the Middle Decoction), but the diarrhea worsens. Lizhong Tang regulates the Middle Jiao; this diarrhea is located in the Lower Jiao. One should take Chishizhi Yuyuliang Tang (Red Stone Lipid and Hematite Decoction). If diarrhea persists despite this, one should promote urination. Pang Shi states that Wu Ling San (Five-Ingredient Powder with Poria) can be used.
It is also said: In Taiyang disease, if the exterior syndrome remains but multiple purgations are applied, it leads to Xiere Li (Collateral Heat Diarrhea), with incessant diarrhea, hardness below the heart, and unresolved interior and exterior conditions. It belongs to the category of Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction).
It is also said: After purgation, Guizhi Tang (Cinnamon Twig Decoction) should not be used again. If there is sweating and wheezing without significant heat, it belongs to the category of Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction).
It is also said: If the patient has neither obvious exterior nor interior symptoms, but has had fever for seven or eight days, and although the pulse is floating and rapid, purgation may be considered. Suppose purgation has already been applied, but the rapid pulse remains unresolved. Combined heat consumes grain, leading to easy hunger. By the sixth or seventh day, if there is no bowel movement, there is blood stasis. It belongs to the category of Dandang Tang (Resist the Bull Decoction).
It is also said: If the rapid pulse remains unresolved and diarrhea continues, it must involve collateral heat, leading to pus and blood in the stool.
It is also said: Originally Taiyang disease, if the physician mistakenly uses purgation, resulting in abdominal fullness and intermittent pain, it belongs to the Taiyin syndrome. It is primarily treated with Guizhi Jia Shaoyao Tang (Cinnamon Twig Plus White Peony Root Decoction). For severe excessive pain, it belongs to Guizhi Jia Dahuang Tang (Cinnamon Twig Plus Rhubarb Decoction).
It is also said: In Cold Damage lasting six or seven days, after severe purgation, the Cun (Inch) pulse is deep and slow, with cold extremities, and the pulses at the lower position are absent. With difficulty opening the throat, expectoration of pus and blood, and incessant diarrhea, it is difficult to treat. It belongs to the category of Mahuang Shengma Tang (Ephedra and Ma-Huang Decoction).
It is also said: Cold Damage originally arose from cold descending internally. If the physician further applies emesis and purgation, it causes Han Ge (Cold Obstruction), exacerbating vomiting and diarrhea. If food is vomited immediately upon ingestion, it belongs to the category of Ganjiang Huangqin Huanglian Renshen Tang (Dried Ginger, Scutellaria, Coptis, and Ginseng Decoction). This pattern is determined based on the Mai Jing.
Qianjin Yi states: After severe purgation, dry mouth occurs due to interior deficiency.
Pang Shi states: During sweating therapy, if sweat pours out like leaking water, then later sweat decreases but wheezing continues incessantly, and the pulse is rapid but soft upon palpation, it should be resolved through sweating. If the pulse is rapid and firm upon palpation, death is likely. If the pulse is floating, with slightly cold extremities, greasy complexion, blue lips, stupor, and wheezing, yin and yang are not harmonized, and qi mechanism obstructs ascending and descending. One should take Shun Yin Yang Wuweizi Tang (Harmonize Yin and Yang with Schisandra Decoction).
It is also said: After sweating or purgation, if Pi Man (Glomus and Fullness) occurs, or Jie Xiong (Chest Binding) forms, with blocked qi flow, Binglang San (Areca Seed Powder) is suitable.