雍曰。仲景本论门自三阴三阳。至发汗吐下以后证而终。自病
可温以下。本论原无门目。其论说皆仲景之言。其见于三阳三阴诸
门者。王叔和重出于脉经以备仓猝寻按。今根据脉经所撰录诸后。
仲景曰。大法。冬宜服热药及灸。
又师曰。病发热头痛。脉反沉。若不瘥。身体疼痛。当救其里。宜
温药。四逆汤。雍曰。凡温药。皆用四逆汤。厥脉细者。宜当归四逆
汤。凡脉微欲绝。及脉不出者。通脉四逆汤。内有久寒者。当归四逆
加吴茱萸生姜汤主之。
又曰。下利腹胀满。身体痛。先温其里。宜四逆汤。
又曰。自利不渴者。属太阴。以其脏有寒故也。当温之。宜四逆
辈。
又曰。少阴病。其人饮食入口则吐。心中温温欲吐。复不能吐。
始得之。手足寒。脉弦迟。若膈上有寒饮。干呕者。不可吐。当温之。
宜四逆汤。
又曰。少阴病。脉沉者。急温之。宜四逆汤。
又曰。下利。欲食者。就当温之。
又曰。下利。脉迟紧。为痛未欲止。当温之。得冷者。满而便肠
垢。
又曰。下利。其脉浮大。此为虚。以强下之故也。设脉浮革。因尔
肠鸣。当温之。宜当归四逆汤。
又曰。少阴病。下利。脉浮涩者。必呕。汗出必数。更衣反少。当
温之。
又曰。伤寒。医下之。续得下利清谷不止。身体疼痛。急当救里。
宜温之以四逆汤。
庞氏以凡病发热头疼。脉反沉。若不瘥。身体疼痛者。脉浮迟。
表热里寒。下利清谷者。汗出热不去。内拘急。支节疼。四逆者。下
利。厥逆恶寒者。下利。腹痛胀满。身疼痛。脉浮者。凡五证。先用四
逆汤温其里。得利止。乃可随证用药攻表也。
Guo Yong stated: Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage) originally begins with the chapters on the Three Yin and Three Yang meridians and concludes with the post-sweating, post-emetic, and post-purgative syndromes. The section starting from "Diseases Suitable for Warming" lacks an original chapter title in the primary text. These discussions are all words of Zhang Zhongjing; those appearing in the various chapters of the Three Yang and Three Yin were recompiled by Wang Shuhe into the *Mai Jing* (Pulse Classic) for emergency reference. I now organize and record these based on what is written in the *Mai Jing*.
Zhang Zhongjing said: The general principle is that in winter, it is appropriate to administer hot-natured medicines and moxibustion.
Furthermore, the Master said: When a patient presents with fever and headache, but the pulse is unexpectedly deep (Chen), if the condition does not improve and body pain persists, one should urgently rescue the interior deficiency-cold. It is suitable to use warming medicines, such as Sini Tang (Four Reversal Decoction).
Guo Yong said: For all cases requiring warming interior medicines, Sini Tang may be used. If there is cold extremities (Jue) with a fine (Xi) pulse, Danggui Sini Tang (Angelica Sinensis Decoction for Reversing Cold Extremities) is indicated. If the pulse is faint (Wei) and nearly imperceptible, or absent, Tongmai Sini Tang (Unblocking Pulse Sini Decoction) is indicated. If there is long-standing cold within, Danggui Sini Tang plus Wu Zhu Yu and Sheng Jiang (Fresh Ginger) should be administered.
He also said: In cases of diarrhea with abdominal fullness and body pain, one should first warm the interior, using Sini Tang.
He also said: Spontaneous diarrhea without thirst belongs to Taiyin disease, due to cold in the zang organs. One should apply warming methods, using formulas similar to Sini Tang.
He also said: In Shaoyin disease, if food enters the mouth and is immediately vomited, and the person feels a sense of warmth and nausea in the heart region but cannot actually vomit; upon initial onset, if the hands and feet are cold and the pulse is wiry (Xuan) and slow (Chi); if there is cold-fluid retention above the diaphragm causing dry heaving, emesis should not be induced. Instead, one should warm the interior, using Sini Tang.
He also said: In Shaoyin disease, if the pulse is deep (Chen), urgent warming is required, using Sini Tang.
He also said: In diarrhea, if the patient desires food, warming should be applied.
He also said: In diarrhea, if the pulse is slow (Chi) and tight (Jin), it indicates that pain has not yet ceased, and warming should be applied. If exposed to cold, abdominal fullness will occur accompanied by the passage of thin, turbid feces.
He also said: In diarrhea, if the pulse is floating (Fu) and large (Da), this indicates deficiency, caused by aggressive purgation. If the pulse is floating and hollow (Ge), resulting in borborygmus (intestinal rumbling), warming should be applied, using Danggui Sini Tang.
He also said: In Shaoyin disease, with diarrhea, a floating (Fu) and choppy (Se) pulse indicates inevitable vomiting. Profuse sweating occurring frequently, yet defecation frequency increases while volume decreases, requires warming.
He also said: In Shanghan (Cold Damage), if a physician incorrectly uses purgation, leading to continuous diarrhea of undigested food (Qing Gu) and body pain, one must urgently rescue the interior by warming it with Sini Tang.
Pang Anshi believed that for any disease presenting with fever and headache but a deep pulse, which does not resolve and involves body pain; or a floating and slow pulse indicating exterior heat and interior cold; or diarrhea of undigested food; or sweating with persistent fever, internal cramping, and joint pain; or cold extremities with diarrhea and aversion to cold; or diarrhea with abdominal pain, fullness, body pain, and a floating pulse—these five syndromes should first be treated with Sini Tang to warm the interior. Only after the diarrhea stops should one proceed to treat the exterior according to the specific symptoms.