太阳症反下之，太阳表症已解，心下满，按之大痛者，为大结胸，用大陷胸汤丸下之。若不
大痛，为小结胸症，用小陷胸汤以和解，不用下法。若但心下痞满，而不痛者，为痞气，用
泻心汤和解心下。要知下后若下症仍急者，不得已而用大陷胸汤以再下。若下后不见下症，
岂有再行之理？今因误下再下之说，不论有下症无下症，悉用再下，甚至误下太早，表邪内
陷，内乱神明，亦执误下再下之法。不知恶寒拘紧，身痛发热，皆是皮毛经络之病，未入肠
胃脏腑者也，切不可下。故外感之邪，从毛窍而入，必使之仍从毛窍而出。若不从表散，反
用下行，不死不休。夫下之一法，原为内有燥屎，腹满胀实，不得出而用者。苟外邪得解，
大便自顺，何苦推肠刮腹，伤津竭液乎！不知身发寒热，其病在外，见症治症，发散为捷。
故《内经》云∶因于暑，体若燔炭，汗出则散。此言因于暑热，若外冒表邪者，尚要汗出，况
因于风寒者乎！世之治外感发热，不用升发胃气，敷布胃汁作汗外解，良由不识外感发热
症，必要从毛窍而出耳。
秦子曰∶恶寒恶风，以一症而分轻重。恶风者，见风则恶，无风即止；恶寒者，即无风亦恶
寒。恶寒、恶风、发热皆是表邪，虽里症悉具，若有一些恶寒、头疼、身痛、手足冷，即是
表邪，宜先解表，不宜清里攻下。然恶寒有阴症阳症分别，不发热，脉沉迟，口不干，神清
便清，阴症恶寒，治宜温经。发热脉数，头痛心烦，阳症恶寒，治宜散表。然温经散表各有
分别，太阳症，无汗恶寒，发热脉浮紧，为表邪伤营，宜发汗，西北冬月，用麻黄汤，南方
三时，用加减羌活汤、十味芎苏散。有汗恶风发热，脉浮缓，为表邪伤卫，宜解肌，西北冬
月，桂枝汤，南方三时，加减防风汤。阳明症，目痛，脉浮大，无汗恶寒发热，宜发汗，葛
根汤。有汗恶寒发热，宜解肌，防风干葛汤、升麻葛根汤。若口渴消水，加知母、石膏。少
阳寒热，无汗恶寒，脉浮弦紧，宜发汗，柴胡防风汤。有汗恶寒，脉浮弦数，宜小柴胡汤。
以上三阳表症恶寒也。又有太阳病，重发其汗，不发热而恶寒；又有脉微人，不应发汗，误
汗之，亦恶寒；更有卫气不足，表气虚，误汗之，亦恶寒。以上乃过汗亡阳而恶寒也，治宜
黄建中汤、玉屏散。例如热病胃寒人，多服寒凉，反变里寒而用温里者也。另有阴症恶
寒，治宜温经，又各不同，此直中三阴中寒恶寒也。
仲景云∶太阳病，脉浮头项强痛而恶寒。
此分别太阳病，必脉浮，头项强痛而恶寒者。
太阳病，有发热恶寒者，发于阳也。无热恶寒者，发于阴也。
此分别太阳病，若初起恶寒时即发热者，为风伤卫气，发于阳也。若起初恶寒，未即发热，
停一二日发热者，为伤营血，发于阴也。旧注发热恶寒为阳症，无热恶寒为阴症，误也。
太阳病，头痛发热，汗出恶风者，桂枝汤主之。
此分别头痛恶风，发热汗出，乃是风伤卫之中风症，宜用解肌者。
太阳病，医发汗，遂发热恶寒。因复下之，心下痞，表里俱虚，阴阳并竭，无阳则阴独。复
加烧针，因胸烦，面青黄，肤 者，难治。色微黄，手足温者，可治。
此重言太阳中风症，不应用麻黄汤。若误汗之，则发热恶寒，又复误下，心下痞满，阴阳
两伤而恶寒。妄加烧针，因胸满烦，面青黄，肌肉 而难治。惟面色微黄，手足尚温，或
可治之。
太阳病或已发热，或未发热，必恶寒体重呕逆，脉阴阳俱紧者，名曰伤寒。
此申明发热恶寒、无热恶寒之症，一起病，或即发热未发热，若恶寒体重呕逆，六脉皆浮
而紧急，此名伤寒而非中风。
太阳病，头痛发热，身疼腰痛，骨节疼痛，恶风无汗而喘者，麻黄汤主之。
此申上章寒伤营之伤寒，必头痛发热，身疼腰痛，骨节疼，恶风无汗而喘，当用发汗者。
发汗病不解，反恶寒者，虚也，芍药甘草附子汤主之。
未发汗而恶寒，表邪也；既发汗后反恶寒，此误汗亡血中之阳，用芍药甘草附子汤，不比
亡气中之阳，用四逆汤者。
伤寒六七日，发热微恶寒，肢节烦疼，微呕，心下支结，外症未去者，柴胡桂枝汤主之。
此申明伤寒不拘日数，但以微恶寒骨节烦疼，心下支结，外症未去。当以桂枝柴胡等，散
太阳少阳表邪，不用桂枝柴胡汤，用柴胡桂枝汤，以少阳症多于太阳耳。
伤寒大下后，复发汗，心下痞，恶寒者，表未解也，不当攻痞，当先解表，乃可攻里。解表
桂枝汤，攻痞宜大黄黄连泻心汤。
此申明汗下后，痞满若恶寒，为表邪未解，故先用桂枝汤解表，后用大黄黄连泻心汤攻
痞。不比恶热之痞气，即用泻心汤攻里者。
阳明病，脉迟，汗出多，微恶寒者，表未解也，可发汗，宜桂枝汤。
阳明病，汗出多，本不恶寒；阳明脉，汗出多，本不迟。今本阳明病，尚见浮迟浮缓之脉，
汗虽多，仍微恶寒，尚是太阳风伤卫表症，故重申解肌散表之治也。
阳明病，脉浮无汗而喘者，发汗则愈，宜麻黄汤。
阳明病，脉本不浮，阳明病，本有汗。今阳明病，见浮紧太阳脉，又见无汗而喘，太阳寒
伤营之症，故重申发汗散表之治也。
本太阳病，初得时，发其汗，汗先出不彻，因转属阳明也。若汗多微发热恶寒者，外未解
也，其热不潮，未可与承气汤。若腹大满不通者可以小承气汤，微和胃气，勿令大泄。
此太阳病，因发汗出不彻，以致转入阳明。若汗虽多，尚微发热恶寒，外邪未解，且未见
潮热，未可用承气汤。若腹大满，又见大便不通，亦止可以小承气汤，略微和胃气，勿令
其大泄，以起初汗不透彻故耳。
阳明中风，口苦咽干，腹满微喘，发热恶寒，脉浮而紧，若下之，则腹满小便难也。
口苦咽干，腹满阳明症也。但微喘发热恶寒，又见浮紧太阳脉，则不可下，若误下，则表
邪内陷，腹满而小便不利。
伤寒五六日，头汗出，微恶寒，手足冷，心下满，口不欲食，大便硬，脉细者，此为阳微
结，必有表复有里也，可与小柴胡汤。
伤寒五六日，少阳时也。头汗出，微恶寒，手足冷，心下满，口不欲食，少阳症也。大便
硬，阳明结也。但脉细，此少阳微结，非阳明实结，故用小柴胡汤。
少阴病，下利。若利自止，恶寒蜷卧。手足温者，可治。
此条以下，皆中寒阴症也。
少阴病，恶寒而蜷，时时自烦，欲去衣被者，可治。
少阴病，恶寒身蜷而利，手足逆冷者，不治。
少阴病，四逆，恶寒而身蜷，脉不至，不烦而躁者，死。
少阴病，得之一二日，口中和，其背恶寒者，当灸之，附子汤。
同一背恶寒，若口干而渴，以别阳明，口中和而不渴，以别少阴。
麻黄汤
麻黄 桂枝 杏仁 甘草
仲景治北方冬令，太阳经恶寒发热，头痛，脉浮，无汗之症，以麻黄、桂枝发营卫之邪，
从皮毛外出。又恐肺得风寒而闭郁，故用杏仁润肺以开泄皮毛。然未可概治江浙温热之
地，三时温热之时，故陶氏有加减法∶里有热，加石膏、黄芩；少阳见症，加柴胡；阳明
见症，加干葛；小便不利，加木通、车前子。夏秋用羌活、独活，易去麻黄、桂枝。
加减羌活汤
羌活 独活 防风 荆芥 柴胡 干葛 广皮 甘草
北方、长沙等地，冬月允宜麻黄汤。若南方温热之时，则麻、桂辛热，故家秘用此方，临
症加减。里有热或火令，加黄芩、石膏、知母；胸前饱闷，加枳壳、浓朴、桔梗；胁肋刺
痛，加青皮、山栀、木通、苏梗；呕吐，加半夏；食滞，加山楂、麦芽、莱菔子；头痛，加川芎。
十味芎苏散
川芎 紫苏 干葛 柴胡 枳壳 桔梗 半夏 茯苓 广皮 甘草
少阳阳明，恶寒发热，兼胸次不宽，用此方散二经表邪，解在里凝滞。恶寒无汗，脉浮，
加羌活、防风；口渴消水，加知母、石膏；里有积热，加栀连；唇焦口燥，去川芎、半夏，
加天花粉、知母。
桂枝汤
桂枝 白芍药 甘草 生姜 大枣
伤寒无汗，发热恶寒，仲景已立麻黄汤。今有汗发热恶风症，立桂枝汤。以症轻于前症，
方亦轻于前，故不用麻黄、杏仁开毛窍，而用白芍药敛津血，姜枣调中气，惟以桂枝一
味，以治汗出邪不解之症。然治南方热令，亦犯辛温，故立加减于后∶春加石膏、黄芩；
热令用防风易桂枝；里有热者，不用此方；恶寒身痛，加羌活；足冷，加独活；时寒时
热，加柴胡；阳明有邪，加干葛。
加减防风汤
防风 荆芥 羌活 独活 白芍药 甘草 生姜 大枣
北方冬令，发热有汗，脉浮缓，用桂枝汤。若南方温热之时，或内有积热之人，家秘化立
此方代之。因陶氏加减冲和汤，未合仲景之旨耳。症兼阳明，加干葛；兼少阳，加柴胡；
口渴消水，加石膏知母；里有积热，加栀连；胸前饱满，加枳壳广皮。
葛根汤
葛根 麻黄 桂枝 白芍药 甘草 生姜 大枣
太阳无汗恶寒，未郁热者，北方冬月用麻黄汤。阳明无汗恶寒，北方用此方。三时南方
人，或里有热者，以羌活、独活易麻、桂；无汗而喘，脉浮而紧，以杏仁易去芍药，口渴
消水，加知母、石膏。
桂枝葛根汤
葛根 白芍药 桂枝 甘草 生姜 大枣
阳明无汗而恶寒，用前方葛根汤；若有汗恶寒，用此方主治。然此亦冬令治法，南方人里
有热，以防风、羌活易去桂枝。口渴消水，加石膏、知母；积热重者，加栀、连。
葛根解肌汤
葛根 白芷 防风 苍术 葱白
前二方，仲景一以治阳明无汗恶风寒，一以治阳明有汗恶风寒。但治冬令则可，南方温
热，家秘用此方。胸前饱闷、加枳朴；呕吐，加半夏；口渴，去苍术，加栝蒌根。
升麻干葛汤
升麻 干葛 白芍药 甘草 生姜 枣肉
前方葛根解肌汤，治阳明发热无汗恶寒者。此方治阳明有汗发热恶寒者，盖汗出而热不
减，不重在发汗。此方妙在但散邪不发汗者。
防葛石膏汤
防风 葛根 石膏 知母 广皮 甘草
葛根解肌汤，治阳明无汗发热恶寒。升麻干葛汤，治阳明有汗发热恶寒。若口渴消水，表
里俱见，立此方和解。
小柴胡汤
柴胡 黄芩 广皮 人参 半夏 甘草
太阳恶寒，阳明恶寒，前已分别各条治法。今少阳寒热，通以小柴胡汤加减，以应变化。
恶寒无汗，加防风；头痛身痛，加川芎、羌活；目痛额痛，加干葛、白芷；恶寒足冷，腰
痛脚痛，加独活；恶寒发热，胁肋痛，加青皮、山栀、枳壳、木通、苏梗；有汗，加白芍
药，助柴胡，同止寒热；血不足而恶寒，倍加当归、白芍药；胸前饱闷，去人参加枳朴；
大便闭结，小腹胀痛，加大黄；小便不利，加木通；喘咳，加枳、桔、杏仁；里有积热，
加栀、连；呕吐，倍半夏，加竹茹、浓朴；口燥痰多，去半夏易栝蒌霜、贝母；口渴唇
焦，加石膏、知母、竹叶。小柴胡汤，有人参，无大黄，治中气虚邪，在半表半里者。大
柴胡汤，有大黄，无人参，治肠胃实热，大便秘结者。柴胡饮子，有人参，有大黄，治中
气虚，大便结热，有潮热者。
柴胡桂枝汤 见发热。
少阳症，又见太阳恶寒，以柴胡汤加羌、独，散太阳表邪。无汗恶寒，加羌活、防风。见
阳明症，加葛根。
黄 建中汤
黄 桂枝 白芍药 甘草 大枣
中气虚寒而恶寒，以建中汤加入黄 ，实营卫；胸前凝滞，加砂仁、广皮；元气虚，加
参、术；血虚，加当归；真阳虚，加桂、附，去桂枝。
玉屏散
黄 防风 甘草
中气虚，则用黄 建中汤；表气虚而恶寒，则用玉屏散。本草云∶黄 得防风，其功愈
大，非言补气之功，言固表之功。元气虚，加参术；阴血虚，加归芍。
吴茱萸汤
吴茱萸 生姜 人参 大枣
以下皆阴症恶寒之方。厥阴干呕，吐涎沫，恶寒，故以此方主治。痰多，加半夏；气逆，
加广皮、藿香、砂仁。
通脉四逆汤
干姜 熟附子 甘草 葱白
不发热而手足厥冷，三阴经阴症寒厥恶寒也，仲景以此方治之。家秘加广皮和中州，助葱
白以行阳气；加黄 协姜、附而达表。方书用黄 同防风，助黄 实腠理。此以用姜、附
加黄 ，助姜、附外固皮毛。
当归四逆汤
当归 白芍药 桂枝 通草 细辛 大枣 甘草
此方治血虚伤寒发表者也。伤寒气血充足，略一恶寒，即发热作汗。若气血虚，不能发热
作汗，故恶寒厥冷，脉细欲绝，宛似阴症。仲景以当归、芍药，与桂枝、细辛同用，全在
养血散表，实非阴症温经治法。家秘加川芎、葱白，助其通阳和阴，作汗外解。
芍药甘草附子汤
白芍药 甘草 附子
未发汗而发热恶寒，宜发汗。既发汗而表症仍在者，尚宜再汗。今因发汗后反恶寒，此因
汗而亡阳恶寒也。然亡气中之阳，用四逆汤；亡血中之阳，用芍药甘草附子汤。
附子汤
附子 白术 白芍药 人参 茯苓
If the Taiyang syndrome is mistakenly treated with purgation, and the Taiyang exterior syndrome has resolved, but there is fullness in the epigastrium that causes severe pain upon pressure, this is a Major Jie Xiong (Major Chest Binding) syndrome. It should be treated with Da Xian Xiong Tang (Major Downward Draining Chest Decoction) or Da Xian Xiong Wan (Major Downward Draining Chest Pill) to purge. If there is little pain, it is a Minor Jie Xiong (Minor Chest Binding) syndrome, which should be harmonized using Xiao Xian Xiong Tang (Minor Downward Draining Chest Decoction), without employing purgation. If there is only epigastric stuffiness and fullness without pain, it is Pi Qi (Pi Syndrome/Stagnation), which should be harmonized in the epigastrium using Xie Xin Tang (Drain the Epigastrium Decoction). One must understand that after purgation, if symptoms requiring purgation persist urgently, one may reluctantly use Da Xian Xiong Tang again to purge. However, if no purgative indications appear after purgation, how could there be any reason to purge again? Currently, some practitioners, adhering to the notion of "purging again after mistaken purgation," indiscriminately use repeated purgation regardless of whether purgative indications exist. Even when mistaken purgation is too early, causing exterior pathogens to sink inward and disturb the Shen (Spirit), they stubbornly adhere to this method of repeated purgation. They fail to realize that aversion to cold, stiffness, body ache, and fever are diseases of the skin, hair follicles, and meridians; the pathogens have not yet entered the intestines, stomach, or zang-fu organs. Purgation must absolutely not be used. Therefore, external pathogenic factors entering through the pores must be expelled from the pores. If one does not disperse them from the exterior but instead uses downward-purging methods, death is inevitable. The method of purgation was originally intended for cases where dry feces are retained internally, causing abdominal fullness and firmness, making defecation impossible. If the exterior pathogen is resolved and bowel movements become smooth naturally, why forcefully drain the intestines and abdomen, damaging fluids and exhausting essence? One fails to realize that chills and fever indicate the disease is external; treating symptoms as they appear, using dispersing methods is the most expedient approach. Thus, the *Nei Jing* states: "Affected by summerheat, the body feels like burning charcoal; sweating will dissipate it." This refers to summerheat; if one is affected by exterior pathogens, sweating is still required, let alone those affected by wind-cold! In treating external febrile diseases today, physicians do not use methods to raise Stomach Qi and distribute Stomach fluids to transform into sweat for exterior resolution. This is likely because they do not recognize that external febrile diseases must exit through the pores.
Qin Zi said: Aversion to cold and aversion to wind distinguish severity within one symptom. Aversion to wind means fear arises only when exposed to wind and ceases when there is no wind; aversion to cold means feeling cold even without wind. Aversion to cold, aversion to wind, and fever are all exterior pathogens. Even if interior syndromes are fully present, if there is any aversion to cold, headache, body ache, or cold hands and feet, it indicates an exterior pathogen. One should first resolve the exterior and should not clear the interior or purge. However, aversion to cold differs between Yin and Yang syndromes. Without fever, with a deep and slow pulse, dry mouth absent, clear spirit, and normal urination/defecation, it is Yin syndrome aversion to cold, treated by warming the meridians. With fever, rapid pulse, headache, and irritability, it is Yang syndrome aversion to cold, treated by dispersing the exterior. Warming meridians and dispersing the exterior have distinct applications. For Taiyang syndrome, with no sweat, aversion to cold, fever, and floating-tight pulse, indicating exterior pathogen injuring Ying (Nutritive) level, sweating should be induced. In Northwest China during winter, Ma Huang Tang (Ephedra Decoction) is used; in the South during spring, summer, and autumn, Jia Jian Qiang Huo Tang (Modified Notopterygium Decoction) or Shi Wei Xiong Su San (Ten-Ingredient Ligusticum and Perilla Powder) are used. With sweat, aversion to wind, fever, and floating-slow pulse, indicating exterior pathogen injuring Wei (Defensive) level, muscle-releasing should be employed. In Northwest China during winter, Gui Zhi Tang (Cinnamon Twig Decoction) is used; in the South during spring, summer, and autumn, Jia Fang Feng Tang (Modified Saposhnikovia Decoction) is used. For Yangming syndrome, with eye pain, floating-large pulse, no sweat, aversion to cold, and fever, sweating should be induced using Ge Gen Tang (Kudzu Decoction). With sweat, aversion to cold, and fever, muscle-releasing is appropriate, using Fang Feng Gan Ge Tang (Saposhnikovia and Kudzu Decoction) or Sheng Ma Ge Gen Tang (Cimicifuga and Kudzu Decoction). If thirst and excessive water intake occur, add Zhi Mu (Anemarrhena Rhizome) and Shi Gao (Gypsum Fibrosum). For Shaoyang syndrome with alternating chills and fever, no sweat, aversion to cold, and floating-string-tight pulse, sweating should be induced using Chai Hu Fang Feng Tang (Bupleurum and Saposhnikovia Decoction). With sweat, aversion to cold, and floating-string-rapid pulse, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is indicated. These cover aversion to cold in the three Yang exterior syndromes. Additionally, in Taiyang disease, excessive sweating may lead to aversion to cold without fever; individuals with faint pulses who should not be sweated may experience aversion to cold if mistakenly sweated; those with insufficient Wei Qi and deficient Exterior Qi may also experience aversion to cold if mistakenly sweated. These represent aversion to cold due to excessive sweating leading to loss of Yang. Treatment should use Huang Qi Jian Zhong Tang (Astragalus Middle-Nourishing Decoction) or Yu Ping Feng San (Jade Windscreen Powder). For example, patients with heat disease but cold stomach who take too many cold-natured herbs may develop interior cold, requiring interior-warming treatment. There is also Yin syndrome aversion to cold, treated by warming the meridians, which varies differently; this is direct invasion of Cold into the Three Yin channels.
Zhong Jing stated: "Taiyang disease, with floating pulse, stiffness and pain in the head and nape, and aversion to cold."
This distinguishes Taiyang disease, characterized by floating pulse, stiffness/pain in the head/nape, and aversion to cold.
"Taiyang disease with fever and aversion to cold originates in Yang. Without fever but with aversion to cold, it originates in Yin."
This distinguishes Taiyang disease: if fever occurs immediately with initial aversion to cold, it is Wind injuring Wei Qi, originating in Yang. If initial aversion to cold persists without immediate fever, followed by fever after one or two days, it injures Ying Blood, originating in Yin. Old commentaries claiming fever/aversion to cold is Yang syndrome and no-fever/aversion to cold is Yin syndrome are incorrect.
"Taiyang disease with headache, fever, sweating, and aversion to wind is primarily treated with Gui Zhi Tang (Cinnamon Twig Decoction)."
This distinguishes headache, aversion to wind, fever, and sweating as Wind-striking-Wei (Wind Stroke) syndrome, suitable for muscle-releasing methods.
"Taiyang disease, after physician-induced sweating, presents with fever and aversion to cold. Subsequent purgation leads to epigastric pi (stuffiness). Both exterior and interior are deficient, Yin and Yang are exhausted. Without Yang, Yin stands alone. Adding cauterization causes chest vexation, blue-yellow complexion, and twitching muscles; this is difficult to treat. A slightly yellow complexion and warm hands/feet indicate treatability."
This reiterates that Taiyang Wind Stroke should not use Ma Huang Tang. Mistaken sweating leads to fever/aversion to cold; subsequent mistaken purgation causes epigastric pi, injuring both Yin and Yang, leading to aversion to cold. Reckless cauterization causes chest fullness/vexation, blue-yellow face, and muscle twitching, making it difficult to treat. Only with a slightly yellow face and warm extremities might it be curable.
"Taiyang disease, whether fever has appeared or not, invariably features aversion to cold, heavy body, vomiting/reversal, and tight pulses at cun, guan, and chi; this is named Shang Han (Cold Damage)."
This clarifies fever/aversion to cold and no-fever/aversion to cold: at onset, whether fever appears immediately or not, if accompanied by aversion to cold, heavy body, vomiting, and all six pulses being floating and urgent, this is Shang Han, not Feng Zhong (Wind Strike).
"Taiyang disease with headache, fever, body/lower back pain, joint pain, aversion to wind, no sweat, and wheezing is primarily treated with Ma Huang Tang (Ephedra Decoction)."
This elaborates on Cold injuring Ying (Shang Han): headache, fever, body/back/joint pain, aversion to wind, no sweat, and wheezing require sweating methods.
"If sweating fails to resolve the disease and aversion to cold worsens, it is deficiency, primarily treated with Shao Yao Gan Cao Fu Zi Tang (Peony, Licorice, and Aconite Decoction)."
Aversion to cold before sweating indicates exterior pathogen; worsening aversion to cold after sweating indicates mistaken sweating causing loss of Yang within Blood. Use Shao Yao Gan Cao Fu Zi Tang, distinct from loss of Yang within Qi, which uses Si Ni Tang (Frigid Extremities Decoction).
"Shang Han for six to seven days, with slight fever and aversion to cold, painful limbs/joints, slight vomiting, subcostal binding, and unresolved exterior symptoms is primarily treated with Chai Hu Gui Zhi Tang (Bupleurum and Cinnamon Twig Decoction)."
This clarifies Shang Han is not bound by days; slight aversion to cold, limb/joint pain, subcostal binding, and unresolved exterior indicate dispersing Taiyang and Shaoyang exterior pathogens using Gui Zhi and Chai Hu. Specifically, Chai Hu Gui Zhi Tang is used because Shaoyang symptoms predominate over Taiyang.
"After massive purgation and subsequent sweating in Shang Han, epigastric pi and aversion to cold indicate unresolved exterior. Do not attack the pi; resolve the exterior first, then attack the interior. Resolve exterior with Gui Zhi Tang; attack pi with Da Huang Huang Lian Xie Xin Tang (Rhubarb, Coptis, and Scutellaria Drain Epigastrium Decoction)."
This clarifies that after sweating/purgation, if pi/fullness is accompanied by aversion to cold, the exterior pathogen is unresolved. First resolve exterior with Gui Zhi Tang, then attack pi with Da Huang Huang Lian Xie Xin Tang. This differs from pi associated with aversion to heat, which uses Xie Xin Tang directly for interior attack.
"Yangming disease with slow pulse, profuse sweating, and slight aversion to cold indicates unresolved exterior. Sweating is appropriate; Gui Zhi Tang (Cinnamon Twig Decoction) is suitable."
Yangming disease typically lacks aversion to cold and slow pulse with profuse sweating. Current presentation of floating-slow/slow pulse despite profuse sweating and slight aversion to cold indicates Taiyang Wind-striking-Wei exterior syndrome. Thus, muscle-releasing and exterior-dispersing treatment is reiterated.
"Yangming disease with floating pulse, no sweat, and wheezing resolves with sweating; Ma Huang Tang (Ephedra Decoction) is suitable."
Yangming disease typically lacks floating pulse and has spontaneous sweating. Current floating-tight Taiyang pulse with no sweat and wheezing indicates Taiyang Cold injuring Ying. Thus, sweating and exterior-dispersing treatment is reiterated.
"Original Taiyang disease, upon initial onset, if sweating is induced but sweat is incomplete, it may transfer to Yangming. If profuse sweat occurs with slight fever and aversion to cold, the exterior is unresolved. If fever is not tidal, Cheng Qi Tang (Order the Qi Decoction) should not be given. If abdominal fullness and obstruction exist, Xiao Cheng Qi Tang (Minor Order the Qi Decoction) may be used to mildly harmonize Stomach Qi, avoiding drastic purgation."
This explains Taiyang disease transferring to Yangming due to incomplete sweating. Even with profuse sweat, slight fever/aversion to cold indicates unresolved exterior. Absence of tidal fever contraindicates Cheng Qi Tang. Abdominal fullness and constipation allow only Xiao Cheng Qi Tang to mildly harmonize Stomach Qi, avoiding drastic purgation due to the initial incomplete sweating.
"Yangming Feng Zhong (Wind Strike) with bitter taste, dry throat, abdominal fullness, slight wheezing, fever, aversion to cold, and floating-tight pulse. If purged, abdominal fullness and difficulty urinating result."
Bitter taste, dry throat, and abdominal fullness are Yangming symptoms. Slight wheezing, fever, aversion to cold, and floating-tight Taiyang pulse contraindicate purgation. Mistaken purgation causes exterior pathogens to sink inward, resulting in abdominal fullness and urinary difficulty.
"Shang Han for five to six days, with head sweating, slight aversion to cold, cold hands/feet, epigastric fullness, lack of desire to eat, hard stool, and fine pulse indicates Yang Wei Jie (Yang Minor Binding), having both exterior and interior. Xiao Chai Hu Tang (Minor Bupleurum Decoction) may be given."
Shang Han for five to six days corresponds to Shaoyang. Head sweating, slight aversion to cold, cold extremities, epigastric fullness, and anorexia are Shaoyang symptoms. Hard stool indicates Yangming binding. Fine pulse indicates Shaoyang minor binding, not Yangming solid binding; thus, Xiao Chai Hu Tang is used.
"Shaoyin disease with diarrhea. If diarrhea stops spontaneously, with aversion to cold and curled posture, but warm hands/feet, it is treatable."
The following clauses all describe Cold invading Yin syndromes.
"Shaoyin disease with aversion to cold, curled posture, occasional inner vexation, and desire to remove clothing/blankets is treatable."
"Shaoyin disease with aversion to cold, curled posture, diarrhea, and cold extremities is untreatable."
"Shaoyin disease with Si Ni (Frigid Extremities), aversion to cold, curled posture, absent pulse, no vexation but restlessness, is fatal."
"Shaoyin disease acquired in one or two days, with neutral mouth sensation and aversion to cold in the back, should be moxa-ed and treated with Fu Zi Tang (Aconite Decoction)."
Back aversion to cold: dry mouth/thirst distinguishes Yangming; neutral mouth/no thirst distinguishes Shaoyin.
Ma Huang Tang (Ephedra Decoction)
Ma Huang (Ephedrae Herba), Gui Zhi (Cinnamomi Ramulus), Xing Ren (Armeniacae Semen Amarum), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Zhong Jing treats Northern Winter Taiyang channel aversion to cold, fever, headache, floating pulse, and no sweat using Ma Huang and Gui Zhi to disperse Ying and Wei pathogens outward from the skin/hair. To prevent Lung closure from Wind-Cold, Xing Ren moistens the Lung to open the skin/hair. However, this cannot be universally applied to Jiangzhe's warm regions or the three warm seasons. Tao's modification adds: internal heat, add Shi Gao (Gypsum Fibrosum) and Huang Qin (Scutellariae Radix); Shaoyang signs, add Chai Hu (Bupleuri Radix); Yangming signs, add Gan Ge (Puerariae Lobatae Radix); difficult urination, add Mu Tong (Akebiae Caulis) and Che Qian Zi (Plantaginis Semen). Summer/Autumn use Qiang Huo (Notopterygii Rhizoma et Radix) and Du Huo (Angelicae Pubescentis Radix), replacing Ma Huang and Gui Zhi.
Jia Jian Qiang Huo Tang (Modified Notopterygium Decoction)
Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Fang Feng (Saposhnikoviae Radix), Jing Jie (Schizonepetae Spica), Chai Hu (Bupleuri Radix), Gan Ge (Puerariae Lobatae Radix), Guang Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma).
In North Changsha etc., winter suits Ma Huang Tang. In Southern warm seasons, Ma Huang and Gui Zhi are acrid-hot; thus, this family secret formula is used with modifications. Internal heat/fire season, add Huang Qin, Shi Gao, Zhi Mu; chest fullness, add Zhi Ke (Aurantii Fructus), Hou Po (Magnoliae Officinalis Cortex), Jie Geng (Platycodonis Radix); hypochondriac stabbing pain, add Qing Pi (Citri Unshiu Pericarpium), Shan Zhi Zi (Gardeniae Fructus), Mu Tong, Su Geng (Perillae Caulis); vomiting, add Ban Xia (Pinelliae Rhizoma); food stagnation, add Shan Zha (Crataegi Fructus), Mai Ya (Hordei Fructus Germinatus), Lai Fu Zi (Radish Seed); headache, add Chuan Xiong (Ligustici Chuanxiong Rhizoma).
Shi Wei Xiong Su San (Ten-Ingredient Ligusticum and Perilla Powder)
Chuan Xiong (Ligustici Chuanxiong Rhizoma), Zi Su (Perillae Folium), Gan Ge (Puerariae Lobatae Radix), Chai Hu (Bupleuri Radix), Zhi Ke (Aurantii Fructus), Jie Geng (Platycodonis Radix), Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), Guang Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma).
For Shaoyang/Yangming aversion to cold/fever with chest tightness, this formula disperses exterior pathogens of both channels and resolves interior stagnation. Aversion to cold/no sweat/floating pulse, add Qiang Huo, Fang Feng; thirst/water drinking, add Zhi Mu, Shi Gao; internal accumulated heat, add Zhi Zi, Huang Lian; dry lips/mouth, remove Chuan Xiong/Ban Xia, add Tian Hua Fen (Trichosanthis Radix), Zhi Mu.
Gui Zhi Tang (Cinnamon Twig Decoction)
Gui Zhi (Cinnamomi Ramulus), Bai Shao Yao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens), Da Zao (Jujubae Fructus).
For Shang Han with no sweat, fever, aversion to cold, Zhong Jing established Ma Huang Tang. For current syndrome with sweat, fever, aversion to wind, Gui Zhi Tang is established. Since symptoms are milder than previous ones, the formula is lighter; Ma Huang/Xing Ren are not used to open pores, but Bai Shao Yao is used to astringe fluids/blood, Ginger/Jujube regulate middle Qi, and Gui Zhi alone treats sweat-with-unresolved-pathogen syndrome. However, treating Southern heat seasons with this risks acrid-warm nature. Modifications: Spring add Shi Gao, Huang Qin; Heat season replace Gui Zhi with Fang Feng; Internal heat, do not use; Aversion to cold/body pain, add Qiang Huo; Cold feet, add Du Huo; Alternating chills/fever, add Chai Hu; Yangming pathogen, add Gan Ge.
Jia Fang Feng Tang (Modified Saposhnikovia Decoction)
Fang Feng (Saposhnikoviae Radix), Jing Jie (Schizonepetae Spica), Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Bai Shao Yao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens), Da Zao (Jujubae Fructus).
Northern winter, fever with sweat, floating-slow pulse, use Gui Zhi Tang. Southern warm seasons or internal accumulated heat, this family secret formula replaces it because Tao's Modified Chong He Tang does not align with Zhong Jing's principles. Yangming involvement, add Gan Ge; Shaoyang involvement, add Chai Hu; Thirst/water drinking, add Shi Gao, Zhi Mu; Internal accumulated heat, add Zhi Zi, Huang Lian; Chest fullness, add Zhi Ke, Guang Pi.
Ge Gen Tang (Kudzu Decoction)
Ge Gen (Puerariae Lobatae Radix), Ma Huang (Ephedrae Herba), Gui Zhi (Cinnamomi Ramulus), Bai Shao Yao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens), Da Zao (Jujubae Fructus).
Taiyang no sweat/aversion to cold without constrained heat: Northern winter uses Ma Huang Tang. Yangming no sweat/aversion to cold: Northern use this formula. Southern three seasons or internal heat: replace Ma/Gui with Qiang/Du. No sweat/wheezing/floating-tight pulse: replace Shao Yao with Xing Ren. Thirst/water drinking: add Zhi Mu, Shi Gao.
Gui Zhi Ge Gen Tang (Cinnamon Twig and Kudzu Decoction)
Ge Gen (Puerariae Lobatae Radix), Bai Shao Yao (Paeoniae Radix Alba), Gui Zhi (Cinnamomi Ramulus), Gan Cao (Glycyrrhizae Radix et Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens), Da Zao (Jujubae Fructus).
Yangming no sweat/aversion to cold uses previous Ge Gen Tang; with sweat/aversion to cold, this formula is primary. This is also a winter method; Southerners with internal heat replace Gui Zhi with Fang Feng/Qiang Huo. Thirst/water drinking: add Shi Gao, Zhi Mu; Heavy accumulated heat: add Zhi Zi, Huang Lian.
Ge Gen Jie Ji Tang (Kudzu Muscle-Releasing Decoction)
Ge Gen (Puerariae Lobatae Radix), Bai Zhi (Angelicae Dahuricae Radix), Fang Feng (Saposhnikoviae Radix), Cang Zhu (Atractylodis Rhizoma), Cong Bai (Allii Fistulosi Bulbus).
Previous two formulas: Zhong Jing used one for Yangming no sweat/aversion to cold/wind, another for Yangming sweat/aversion to cold/wind. Suitable for winter; for Southern warmth, this family secret formula is used. Chest fullness, add Zhi/Po; Vomiting, add Ban Xia; Thirst, remove Cang Zhu, add Gua Lou Gen (Trichosanthis Radix).
Sheng Ma Gan Ge Tang (Cimicifuga and Kudzu Decoction)
Sheng Ma (Cimicifugae Rhizoma), Gan Ge (Puerariae Lobatae Radix), Bai Shao Yao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens), Zao Rou (Jujubae Pulpa).
Previous Ge Gen Jie Ji Tang treats Yangming fever/no sweat/aversion to cold. This formula treats Yangming fever/sweat/aversion to cold. Sweat occurs but heat does not subside; emphasis is not on inducing sweat. This formula's brilliance lies in dispersing pathogens without inducing sweat.
Fang Ge Shi Gao Tang (Saposhnikovia, Kudzu, and Gypsum Decoction)
Fang Feng (Saposhnikoviae Radix), Ge Gen (Puerariae Lobatae Radix), Shi Gao (Gypsum Fibrosum), Zhi Mu (Anemarrhenae Rhizoma), Guang Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Ge Gen Jie Ji Tang treats Yangming no sweat/fever/aversion to cold. Sheng Ma Gan Ge Tang treats Yangming sweat/fever/aversion to cold. If thirst/water drinking occurs with simultaneous exterior/interior signs, this formula is established for harmonizing.
Xiao Chai Hu Tang (Minor Bupleurum Decoction)
Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Guang Pi (Citri Reticulatae Pericarpium), Ren Shen (Ginseng Radix), Ban Xia (Pinelliae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Taiyang/Yangming aversion to cold treatments were distinguished previously. Now Shaoyang chills/fever are generally treated with modified Xiao Chai Hu Tang to adapt to changes. Aversion to cold/no sweat, add Fang Feng; Headache/body pain, add Chuan Xiong, Qiang Huo; Eye/forehead pain, add Gan Ge, Bai Zhi; Aversion to cold/cold feet/lower back/leg pain, add Du Huo; Aversion to cold/fever/hypochondriac pain, add Qing Pi, Shan Zhi Zi, Zhi Ke, Mu Tong, Su Geng; With sweat, add Bai Shao Yao to assist Chai Hu in stopping chills/fever; Blood deficiency with aversion to cold, double Dang Gui (Angelicae Sinensis Radix) and Bai Shao Yao; Chest fullness, remove Ren Shen, add Zhi/Po; Constipation/lower abdominal pain, add Da Huang (Rhei Radix et Rhizoma); Difficult urination, add Mu Tong; Wheezing/cough, add Zhi, Jie, Xing Ren; Internal accumulated heat, add Zhi/Lian; Vomiting, double Ban Xia, add Zhu Ru (Bambusae Caulis in Taenia), Hou Po; Dry mouth/phlegm, remove Ban Xia, replace with Gua Lou Shuang (Trichosanthis Fructus Pulvis) and Bei Mu (Fritillariae Bulbus); Thirst/dry lips, add Shi Gao, Zhi Mu, Zhu Ye (Bambusae Folium). Xiao Chai Hu Tang contains Ren Shen, no Da Huang; treats Middle Qi deficiency with pathogen in Half-Exterior/Half-Interior. Da Chai Hu Tang contains Da Huang, no Ren Shen; treats Intestine/Stomach excess heat with constipation. Chai Hu Yin Zi contains Ren Shen and Da Huang; treats Middle Qi deficiency, constipation with heat, and tidal fever.
Chai Hu Gui Zhi Tang (See Fever).
Shaoyang syndrome with Taiyang aversion to cold: use Chai Hu Tang plus Qiang/Du to disperse Taiyang exterior. No sweat/aversion to cold, add Qiang Huo, Fang Feng. Yangming signs, add Ge Gen.
Huang Qi Jian Zhong Tang (Astragalus Middle-Nourishing Decoction)
Huang Qi (Astragali Radix), Gui Zhi (Cinnamomi Ramulus), Bai Shao Yao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Da Zao (Jujubae Fructus).
Middle Qi deficiency/cold with aversion to cold: use Jian Zhong Tang adding Huang Qi to strengthen Ying/Wei. Chest stagnation, add Sha Ren (Amomi Fructus), Guang Pi; Yuan Qi deficiency, add Shen (Ginseng), Zhu (Atractylodis Macrocephalae Rhizoma); Blood deficiency, add Dang Gui; True Yang deficiency, add Gui/Zhi, Fu Zi (Aconiti Lateralis Radix Praeparata), remove Gui Zhi.
Yu Ping Feng San (Jade Windscreen Powder)
Huang Qi (Astragali Radix), Fang Feng (Saposhnikoviae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Middle Qi deficiency uses Huang Qi Jian Zhong Tang; Exterior Qi deficiency with aversion to cold uses Yu Ping Feng San. Materia Medica states: Huang Qi with Fang Feng increases efficacy; this refers not to tonifying Qi but to securing the Exterior. Yuan Qi deficiency, add Shen/Zhu; Yin/Blood deficiency, add Dang Gui/Bai Shao.
Wu Zhu Yu Tang (Evodia Decoction)
Wu Zhu Yu (Evodiae Fructus), Sheng Jiang (Zingiberis Rhizoma Recens), Ren Shen (Ginseng Radix), Da Zao (Jujubae Fructus).
Below are formulas for Yin syndrome aversion to cold. Jueyin dry retching, spitting saliva/froth, aversion to cold: this formula is primary. Phlegm excess, add Ban Xia; Qi rebellion, add Guang Pi, Huo Xiang (Patchouliae Folium), Sha Ren.
Tong Mai Si Ni Tang (Pulse-Unblocking Frigid Extremities Decoction)
Gan Jiang (Zingiberis Rhizoma), Shu Fu Zi (Aconiti Lateralis Radix Praeparata), Gan Cao (Glycyrrhizae Radix et Rhizoma), Cong Bai (Allii Fistulosi Bulbus).
No fever but cold extremities: Three Yin channel Yin syndrome cold jue aversion to cold. Zhong Jing treats this with this formula. Family secret adds Guang Pi to harmonize Middle Jiao, assisting Cong Bai to move Yang Qi; adds Huang Qi to coordinate Jiang/Fu to reach the exterior. Formulary books use Huang Qi with Fang Feng to assist Huang Qi in strengthening Cou Li (pores). Here, Jiang/Fu with Huang Qi assists Jiang/Fu in externally securing skin/hair.
Dang Gui Si Ni Tang (Angelica Frigid Extremities Decoction)
Dang Gui (Angelicae Sinensis Radix), Bai Shao Yao (Paeoniae Radix Alba), Gui Zhi (Cinnamomi Ramulus), Tong Cao (Tetrapanacis Medulla), Xi Xin (Asari Radix et Rhizoma), Da Zao (Jujubae Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma).
This formula treats Blood deficiency Shang Han releasing the exterior. In Shang Han with sufficient Qi/Blood, slight aversion to cold leads to fever and sweat. If Qi/Blood is deficient, unable to generate fever/sweat, aversion to cold, jue cold, fine pulse nearing extinction occurs, resembling Yin syndrome. Zhong Jing uses Dang Gui/Shao Yao with Gui Zhi/Xi Xin to nourish Blood and disperse exterior; truly not a Yin syndrome warming meridian method. Family secret adds Chuan Xiong, Cong Bai to assist unblocking Yang and harmonizing Yin, generating sweat for exterior resolution.
Shao Yao Gan Cao Fu Zi Tang (Peony, Licorice, and Aconite Decoction)
Bai Shao Yao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Fu Zi (Aconiti Lateralis Radix Praeparata).
Before sweating, fever/aversion to cold requires sweating. After sweating, if exterior signs remain, sweating should be repeated. Now, worsening aversion to cold after sweating indicates Yang loss due to sweating. Loss of Yang within Qi uses Si Ni Tang; loss of Yang within Blood uses Shao Yao Gan Cao Fu Zi Tang.
Fu Zi Tang (Aconite Decoction)
Fu Zi (Aconiti Lateralis Radix Praeparata), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bai Shao Yao (Paeoniae Radix Alba), Ren Shen (Ginseng Radix), Fu Ling (Poria).