伤寒三日三阳尽，热微烦躁入阴传，其人能食而不呕，脉小尿清为不传。
【注】伤寒三日，三阳受邪为尽，三阴当受邪，其人身热虽微，而烦躁者，谓邪去阳
入阴不解也。若其人反能食而不呕，脉静小，小便清，谓邪未入于阴为不传，欲自愈也。
太阴阴邪沉迟脉，吐食腹满有时疼，手足自温利不渴，理中汤主悸加苓，腹满去术
加附子，吐多去术加姜生，虽吐下多还用术，渴欲得水倍术宁，欲作奔豚术易桂，干姜寒
倍参腹疼。
【注】太阴阴邪，谓邪从阴化之寒证也。脉沉迟，太阴阴邪脉也。吐食、腹满时痛，太
阴里寒证也。手足自温，邪入阴也。自利不渴，脏无热也，宜理中汤主之。若心下悸，加
茯苓。腹满，去术加附子。吐多，去术加生姜。虽吐若下利多，还用白术。若渴欲得饮
水，仍倍加术。若脐下欲作奔豚，去术易桂。中寒倍加干姜，腹痛倍加人参。详太阴篇。
阳邪嗌干腹满痛，误下时痛大实疼，大承桂枝加芍大，脉弱芍大当审行。
【注】阳邪，谓太阴邪从阳化之热证也。嗌干，谓咽干太阴热也。腹满痛，太阴有余
证也。误下，谓误下邪陷太阴当分轻重也。时痛，谓腹有时痛，有时不痛，宜桂枝加芍药
汤和之。大实痛，谓腹大满痛，无时不痛，宜桂枝加大黄汤下之。兼阳明胃实，以大承气
汤下之。若脉弱即当行大黄芍药，宜斟酌减之，以其人胃气弱易动也。详太阴篇。
After three days of cold damage (Shanghan), the pathogenic factors in the three Yang meridians are exhausted. If the heat is slight and irritability occurs, it indicates transmission to the Yin meridians. However, if the patient can eat without vomiting, with a fine pulse and clear urine, it indicates that the pathogen has not transmitted to the Yin meridians.
[Note] After three days of cold damage, the involvement of the three Yang meridians is complete, and the three Yin meridians should next be involved. Although the body heat is slight, the presence of irritability indicates that the pathogen has left the Yang meridians and entered the Yin meridians without being resolved. Conversely, if the patient can eat without vomiting, with a calm and fine pulse and clear urination, it indicates that the pathogen has not entered the Yin meridians; this signifies no transmission, and the disease is likely to heal spontaneously.
The pulse for Taiyin syndrome caused by Yin-cold pathogens is deep and slow, accompanied by vomiting food, abdominal fullness, and occasional pain. The hands and feet remain naturally warm, and there is spontaneous diarrhea without thirst. The primary formula is Lizhong Tang (Replenish the Middle Decoction). If palpitations are present, add Fuling (Poria); if abdominal fullness occurs, remove Baizhu (Atractylodis Macrocephalae Rhizoma) and add Fuzi (Aconiti Lateralis Radix Praeparata); if vomiting is frequent, remove Baizhu and add Shengjiang (Zingiberis Rhizoma Recens); even with frequent vomiting or diarrhea, continue using Baizhu; if thirst with desire for water occurs, double the dosage of Baizhu; if there is a sensation of Qi rushing upward from below the umbilicus (Ben Tun / Running Piglet), replace Baizhu with Guizhi (Cinnamomi Ramulus); if middle-jiao cold is severe, double the dosage of Ganjiang (Zingiberis Rhizoma); for abdominal pain, double the dosage of Renshen (Ginseng Radix et Rhizoma). See the Taiyin chapter for details.
[Note] Taiyin Yin-cold refers to a cold syndrome generated when the pathogen transforms according to Yin characteristics. A deep and slow pulse is the pulse sign of Taiyin Yin-cold. Vomiting food, abdominal fullness, and intermittent pain are signs of interior cold in the Taiyin meridian. Naturally warm hands and feet indicate the pathogen has entered the Yin meridians. Spontaneous diarrhea without thirst indicates the absence of heat in the zang organs, making Lizhong Tang appropriate. For epigastric palpitations, add Fuling. For abdominal fullness, remove Baizhu and add Fuzi. For frequent vomiting, remove Baizhu and add Shengjiang. Even with frequent vomiting or diarrhea, Baizhu should still be used. For thirst and desire to drink, increase the dosage of Baizhu. For impending Ben Tun (Running Piglet) sensation below the umbilicus, remove Baizhu and substitute Guizhi. For severe middle-cold, double Ganjiang; for severe abdominal pain, double Renshen. See the Taiyin chapter for details.
Yang-pathogen (heat syndrome) causes dry throat and abdominal fullness with pain. If mistaken treatment with purgatives leads to complications, one must distinguish between intermittent pain and severe true excess pain. Severe true excess pain may be treated with Guizhi Jiadahuang Tang (Cinnamon Twig and Rhubarb Decoction); however, if the pulse is weak, Da Huang (Rhei Radix et Rhizoma) and Shaoyao (Paeoniae Radix Alba) should be used with caution.
[Note] Yang-pathogen refers to a heat syndrome where the Taiyin pathogen transforms according to Yang characteristics. Dry throat indicates heat in the Taiyin meridian. Abdominal fullness and pain indicate an excess condition in the Taiyin meridian. "Mistaken purgation" refers to the erroneous use of purgative methods causing the pathogen to sink into the Taiyin meridian, requiring assessment of severity. Intermittent pain (pain occurring at times but not others) should be harmonized with Guizhi Jiashao Yao Tang (Cinnamon Twig and Peony Decoction). Severe true excess pain (constant and severe abdominal fullness and pain) should be purged with Guizhi Jiadahuang Tang. If accompanied by Yangming stomach excess, Dachengqi Tang (Major Order the Qi Decoction) should be used for purgation. If the pulse is weak, Da Huang and Shaoyao should be used cautiously and dosages reduced, as such patients have weak Stomach Qi and are prone to disturbance from harsh medications. See the Taiyin chapter for details.