四逆汤治病发热头痛，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；下利腹胀满，身疼脉浮者。
先用四逆温里，得利止，乃可随证用药攻表也。
甘草（一两） 附子（半个） 干姜（三分）
咀，以水一升半，煮取六合，去滓，温分作二服。
手足厥，脉微欲绝者，当归四逆汤主之。
当归 桂枝 芍药 细辛（各一两半） 枣（三十六个） 甘草 木通（各一两）
咀，以水四升半，煮二升二合，去滓，每温一盏服。
伤寒表不解，心下有水气，干呕，发热而咳，或渴，或利，或噎，或小便难、腹满而喘者，小
青龙汤主之。
麻黄 芍药 细辛 干姜 甘草 桂枝（各一两半） 半夏（三分） 五味子（半两）
咀，以水六升，先煮麻黄数沸，去上沫，内诸药，煮一升，去滓，每温服一盏。若渴者，去
半夏，加栝蒌根一两半；若微利，去麻黄，加荛花一鸡子大，炒赤；若噎者，去麻黄，加附子一枚，
炮；小便不利、小腹满者，去麻黄，加赤茯苓二两；若喘，去麻黄，加杏仁一两一分。无荛花，以
桃花一鸭子大，不炒代之。
太阳病，得之八九日，如疟状，发热恶寒，热多寒少，其人不呕，清便欲自可，一日二三度发。
脉微缓者，为欲愈也；脉微而恶寒，此阴阳俱虚，不可更发汗吐下也；面色反有热色者，未解也，
以其不能得小汗出，其身必痒，宜桂枝麻黄各半汤。
桂枝汤末 麻黄汤末（各三分）
以水一升半，枣三个，生姜三片，煎减半，去滓，温饮一盏。未有小汗，再服之。
服桂枝汤，大汗出，脉洪，证候不改者，服桂枝汤，如前法；若形似疟状，日再发者，宜桂
枝二麻黄一汤。
桂枝汤末（一两） 麻黄汤末（半两）
以水一升半，姜三片，枣三个，煎减半，去滓，温饮一盏。未有小汗，再服之。
服桂枝汤，大汗出后，大烦渴，脉洪大者，白虎汤加人参主之。（方在厥阴证中。）
庞曰∶伤寒，已得汗，身和脉弦细，谵语妄见，此为津液不和，与小柴胡去人参加桂枝汤服之，
津液和自愈；未瘥，与调胃承气汤下之。
伤寒六七日，发热，微恶寒，肢节烦疼，微呕，心下支结，外证未去，柴胡桂枝汤主之，兼
治寒疝腹痛。
柴胡（一两） 桂枝 黄芩 人参（各半两） 半夏（四钱一字） 芍药（半两） 甘草（一钱
一字） 大枣（九枚） 生姜（半两）
咀，以水三升半，煮取一升七合半，去滓，温饮一盏。
小柴胡汤 治伤寒五六日，中风，往来寒热，胸胁满，嘿嘿不欲食，心烦喜呕，或胸中烦
而不呕，或渴，或腹中痛，或胁下痞硬，或心下悸、小便不利，或不渴、身微热，或咳者。
柴胡（二两） 甘草 黄芩 人参（各三分） 半夏（六钱一字） 生姜（三分） 大枣（三枚）
咀，以水六升，煮取三升，去滓，再煎取一升半，温作三服。若胸中烦而不呕者，去半夏、
人参，加栝蒌半个。若渴，去半夏，加人参成二两二钱半、栝蒌
根二两。若腹中痛，去黄芩，加芍药一两半。若胁下痞硬，去大枣，加牡蛎二两。若心下悸、小便
不利，去黄芩，加茯苓二两。若不渴、外有微热，去人参，加桂枝一两半，温覆微汗愈。若咳，去
人参、大枣、生姜，加五味子一两一分，干姜一两。
伤寒中风，有柴胡证，但见一证，不必悉具。凡以柴胡证而下之，与柴胡汤，必蒸蒸而振，却
复发热汗出而解也。
病十日以上，脉浮细嗜卧者，为已安候，小柴胡和之，细而迟者勿与。
妇人中风七八日，续自寒热，发作有时，经水适断者，此为热入血室，其血必结，故使如疟状，
发作有时，小柴胡汤主之。
妇人伤寒发热，经水适来，昼日明了，暮则谵语，如见鬼状，此为热入血室，无犯胃气，必自
愈。（先宜小柴胡汤，不愈，可刺期门。）
妇人中风，发热恶寒，经水适来，得之七八日，热除而脉迟身凉，胸胁下满如结胸状，谵语，
此为热入血室也，当刺期门，随其实取之。
阳明病，潮热，大便溏，小便自如，胸胁满不去者，小柴胡汤主之。又不大便而呕，舌上白苔
者，亦宜服之。上焦得通，津液得下，胃气因和，身 然汗出而解。
阳明中风，脉浮弦大而短气，腹满，胁下及心痛，久按之气不通，鼻干不得汗，嗜卧，一身及目
悉黄，小便难，有潮热，时时哕，耳前后肿。刺之小瘥，外不解。病过十日，脉续浮者，与小柴胡
汤；若不尿，腹满加哕者，不治。
Si Ni Tang (Four Reversal Decoction) is indicated for treating fever and headache with a pulse that is unexpectedly deep; if the condition does not improve and body pain persists; or when the pulse is floating and slow, indicating exterior heat and interior cold, accompanied by diarrhea with undigested food; or when sweating fails to resolve the fever, internal muscle cramping occurs, joint pain is present, and the four extremities are cold; or when diarrhea is accompanied by cold extremities and aversion to cold; or when diarrhea is accompanied by abdominal fullness, body pain, and a floating pulse. One should first use Si Ni Tang (Four Reversal Decoction) to warm the interior. Once the diarrhea stops, one may then treat the exterior syndrome according to the specific presentation.
Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*) (1 liang), Fuzi (Prepared Aconite Root, *Aconiti Lateralis Radix Praeparata*) (half piece, processed), Ganjiang (Dried Ginger, *Zingiberis Rhizoma*) (3 fen).
Coarsely crush, add 1.5 sheng of water, decoct to obtain 6 ge of liquid, remove dregs, and take half in each dose, warm.
For cold extremities and a faint pulse nearly imperceptible, Dang Gui Si Ni Tang (Angelica Four Reversal Decoction) is the primary treatment.
Danggui (Angelica Sinensis Root, *Angelicae Sinensis Radix*), Guizhi (Cinnamon Twig, *Cinnamomi Ramulus*), Shaoyao (White Peony Root, *Paeoniae Radix Alba*), Xixin (Asarum Root, *Asari Radix et Rhizoma*) (each 1.5 liang), Zao (Jujube Fruit, *Ziziphi Jujubae Fructus*) (36 pieces), Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*), Mutong (Akebia Stem, *Akebiae Caulis*) (each 1 liang).
Coarsely crush, add 4.5 sheng of water, decoct to obtain 2.2 sheng of liquid, remove dregs, and take one zhan per dose, warm.
When Taiyang exterior syndrome remains unresolved, with fluid retention in the epigastrium, presenting as dry retching, fever with cough, or thirst, or diarrhea, or a sensation of choking, or difficult urination with abdominal fullness and wheezing, Xiao Qing Long Tang (Minor Green Dragon Decoction) is indicated.
Mahuang (Ephedra Herb, *Ephedrae Herba*), Shaoyao (White Peony Root, *Paeoniae Radix Alba*), Xixin (Asarum Root, *Asari Radix et Rhizoma*), Ganjiang (Dried Ginger, *Zingiberis Rhizoma*), Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*), Guizhi (Cinnamon Twig, *Cinnamomi Ramulus*) (each 1.5 liang), Banxia (Pinellia Tuber, *Pinelliae Rhizoma*) (3 fen), Wuweizi (Schisandra Fruit, *Schisandrae Chinensis Fructus*) (0.5 liang).
Coarsely crush, add 6 sheng of water, first boil Mahuang (Ephedra Herb, *Ephedrae Herba*) for several boils, skim off the foam on the surface, add the remaining herbs, decoct to obtain 1 sheng of liquid, remove dregs, and take one zhan per dose, warm. If thirsty, remove Banxia (Pinellia Tuber, *Pinelliae Rhizoma*) and add Gualougen (Trichosanthes Root, *Trichosanthis Radix*) 1.5 liang. If mild diarrhea, remove Mahuang (Ephedra Herb, *Ephedrae Herba*) and add Wanghua (Wikstroemia Flower, *Wikstroemiae Flos*) the size of a chicken egg, stir-fried until red. If choking sensation, remove Mahuang (Ephedra Herb, *Ephedrae Herba*) and add one Paofu Zi (Processed Aconite Root, *Aconiti Lateralis Radix Praeparata*). If difficult urination and lower abdominal fullness, remove Mahuang (Ephedra Herb, *Ephedrae Herba*) and add Chifuling (Red Poria, *Polyporus*) 2 liang. If wheezing, remove Mahuang (Ephedra Herb, *Ephedrae Herba*) and add Xingren (Apricot Seed, *Armeniacae Semen Amarum*) 1.1 liang. In the absence of Wanghua (Wikstroemia Flower, *Wikstroemiae Flos*), substitute with Taohua (Peach Blossom, *Persicae Flos*) the size of a duck egg, unroasted.
In Taiyang disease, after eight or nine days, resembling malaria with alternating fever and chills, where heat predominates over cold, without vomiting, with normal bowel movements, occurring two or three times a day: a slightly缓和 (moderate and slow) pulse indicates impending recovery; a faint pulse with aversion to cold indicates deficiency of both Yin and Yang, precluding further use of diaphoresis, emesis, or purgation; a flushed face indicates the pathogen has not resolved due to inability to produce slight sweating, causing body itching, suitable for Guizhi Mahuang Ge Ban Tang (Guizhi and Mahuang Half-and-Half Decoction).
End of Guizhi Tang (Cinnamon Twig Decoction) powder, End of Mahuang Tang (Ephedra Decoction) powder (each 3 fen).
Add 1.5 sheng of water, three Zao (Jujube Fruit, *Ziziphi Jujubae Fructus*), three slices of Shengjiang (Fresh Ginger, *Zingiberis Rhizoma Recens*), decoct until reduced by half, remove dregs, and drink one zhan, warm. If slight sweating has not occurred, administer again.
After taking Guizhi Tang (Cinnamon Twig Decoction), if profuse sweating occurs with a flooding pulse but the syndrome remains unchanged, continue administering Guizhi Tang (Cinnamon Twig Decoction) as before; if the symptoms resemble malaria and occur twice a day, Guizhi Er Mahuang Yi Tang (Guizhi Two Parts Mahuang One Part Decoction) is indicated.
Guizhi Tang (Cinnamon Twig Decoction) powder (1 liang), Mahuang Tang (Ephedra Decoction) powder (0.5 liang).
Add 1.5 sheng of water, three slices of Jiang (Ginger, *Zingiberis Rhizoma*), three Zao (Jujube Fruit, *Ziziphi Jujubae Fructus*), decoct until reduced by half, remove dregs, and drink one zhan, warm. If slight sweating has not occurred, administer again.
After taking Guizhi Tang (Cinnamon Twig Decoction), if profuse sweating leads to severe irritability and thirst with a flooding pulse, Baihu Tang (White Tiger Decoction) plus Renshen (Ginseng Root, *Panacis Ginseng Radix*) is indicated. (Formula found in Jueyin Syndrome chapter.)
Pang Anshi stated: In Shanghan (Cold Damage), after sweating, if the body is harmonious and the pulse is wiry and fine, yet delirium and visual hallucinations occur, this is due to disharmony of Jin Ye (Body Fluids). Administer Xiaochaihu Tang (Minor Bupleurum Decoction) minus Renshen (Ginseng Root, *Panacis Ginseng Radix*) plus Guizhi Tang (Cinnamon Twig Decoction); once Jin Ye (Body Fluids) are harmonized, self-recovery occurs. If not cured, administer Tiaowei Chengqi Tang (Regulate the Stomach and Descend Rebellion Decoction) to purge.
In Shanghan (Cold Damage) for six or seven days, with fever, slight aversion to cold, vexing pain in limbs and joints, slight vomiting, and support-like fullness in the epigastrium, while exterior signs persist, Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) is indicated, also treating Han Shan Abdominal Pain (Cold Cramp Abdominal Pain).
Chaihu (Bupleurum Root, *Bupleuri Radix*) (1 liang), Guizhi (Cinnamon Twig, *Cinnamomi Ramulus*), Huangqin (Scutellaria Root, *Scutellariae Radix*), Renshen (Ginseng Root, *Panacis Ginseng Radix*) (each 0.5 liang), Banxia (Pinellia Tuber, *Pinelliae Rhizoma*) (4 qian 1 zi), Shaoyao (White Peony Root, *Paeoniae Radix Alba*) (0.5 liang), Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*) (1 qian 1 zi), Dazao (Jujube Fruit, *Ziziphi Jujubae Fructus*) (9 pieces), Shengjiang (Fresh Ginger, *Zingiberis Rhizoma Recens*) (0.5 liang).
Coarsely crush, add 3.5 sheng of water, decoct to obtain 1.75 sheng of liquid, remove dregs, and drink one zhan, warm.
Xiaochaihu Tang (Minor Bupleurum Decoction): Treats Shanghan (Cold Damage) after five or six days, or Wind Strike, presenting with alternating chills and fever, chest and hypochondriac fullness, silent desire not to eat, vexation and frequent vomiting, or chest vexation without vomiting, or thirst, or abdominal pain, or hypochondriac stiffness, or epigastric palpitations with difficult urination, or no thirst with slight exterior heat, or cough.
Chaihu (Bupleurum Root, *Bupleuri Radix*) (2 liang), Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*), Huangqin (Scutellaria Root, *Scutellariae Radix*), Renshen (Ginseng Root, *Panacis Ginseng Radix*) (each 3 fen), Banxia (Pinellia Tuber, *Pinelliae Rhizoma*) (6 qian 1 zi), Shengjiang (Fresh Ginger, *Zingiberis Rhizoma Recens*) (3 fen), Dazao (Jujube Fruit, *Ziziphi Jujubae Fructus*) (3 pieces).
Coarsely crush, add 6 sheng of water, decoct to obtain 3 sheng of liquid, remove dregs, and decoct again to obtain 1.5 sheng of liquid, divide into three warm doses. If chest vexation without vomiting, remove Banxia (Pinellia Tuber, *Pinelliae Rhizoma*) and Renshen (Ginseng Root, *Panacis Ginseng Radix*), add half a Gualou (Trichosanthes Fruit, *Trichosanthis Fructus*). If thirsty, remove Banxia (Pinellia Tuber, *Pinelliae Rhizoma*), increase Renshen (Ginseng Root, *Panacis Ginseng Radix*) to 2.25 liang, and add Gualougen (Trichosanthes Root, *Trichosanthis Radix*) 2 liang. If abdominal pain, remove Huangqin (Scutellaria Root, *Scutellariae Radix*), add Shaoyao (White Peony Root, *Paeoniae Radix Alba*) 1.5 liang. If hypochondriac stiffness, remove Dazao (Jujube Fruit, *Ziziphi Jujubae Fructus*), add Muli (Oyster Shell, *Concha Ostreae*) 2 liang. If epigastric palpitations and difficult urination, remove Huangqin (Scutellaria Root, *Scutellariae Radix*), add Fuling (Poria, *Polyporus*) 2 liang. If no thirst with slight exterior heat, remove Renshen (Ginseng Root, *Panacis Ginseng Radix*), add Guizhi (Cinnamon Twig, *Cinnamomi Ramulus*) 1.5 liang, cover to induce slight sweating for cure. If cough, remove Renshen (Ginseng Root, *Panacis Ginseng Radix*), Dazao (Jujube Fruit, *Ziziphi Jujubae Fructus*), Shengjiang (Fresh Ginger, *Zingiberis Rhizoma Recens*), add Wuweizi (Schisandra Fruit, *Schisandrae Chinensis Fructus*) 1.1 liang, Ganjiang (Dried Ginger, *Zingiberis Rhizoma*) 1 liang.
In Shanghan (Cold Damage) or Zhongfeng (Wind Strike), if there are Chaihu (Bupleurum Root, *Bupleuri Radix*) syndrome signs, it is not necessary for all to be present; seeing just one is sufficient. If Chaihu (Bupleurum Root, *Bupleuri Radix*) syndrome is mistakenly treated with purgation, administering Chaihu Tang (Bupleurum Decoction) will cause shivering followed by fever and sweating, leading to resolution.
If the illness lasts more than ten days, with a floating and fine pulse and a desire to sleep, this is a sign of peace; harmonize with Xiaochaihu Tang (Minor Bupleurum Decoction). Do not administer if the pulse is fine and slow.
In women with Zhongfeng (Wind Strike) for seven or eight days, with continuous alternating chills and fever occurring at regular times, and menstruation having just ceased, this is Re Ru Xue Shi (Heat Entering the Blood Chamber). The blood must be congealed, causing malaria-like symptoms at regular times; Xiaochaihu Tang (Minor Bupleurum Decoction) is indicated.
In women with Shanghan (Cold Damage) fever, with menstruation just beginning, clear consciousness during the day but delirium and hallucinations at night, this is Re Ru Xue Shi (Heat Entering the Blood Chamber). Do not injure Wei Qi (Stomach Qi); the disease will likely resolve spontaneously. (First try Xiaochaihu Tang (Minor Bupleurum Decoction); if ineffective, puncture Qimen (LR14)).
In women with Zhongfeng (Wind Strike), fever and chills, with menstruation just beginning, after seven or eight days, when heat subsides and pulse becomes slow with cool body, but chest and hypochondriac fullness resembles Jie Xiong (Chest Binding), with delirium, this is Re Ru Xue Shi (Heat Entering the Blood Chamber). Puncture Qimen (LR14) to drain excess.
In Yangming disease, with tidal fever, loose stools, normal urination, and persistent chest and hypochondriac fullness, Xiaochaihu Tang (Minor Bupleurum Decoction) is indicated. Also applicable if there is constipation with vomiting and a white coating on the tongue. When the Upper Jiao (Upper Burner) is unblocked, Jin Ye (Body Fluids) descend, Wei Qi (Stomach Qi) harmonizes, and the body sweats naturally, resolving the disease.
In Yangming Zhongfeng (Wind Strike), with a floating, wiry, large pulse and shortness of breath, abdominal fullness, pain in the hypochondrium and heart region, obstruction of Qi upon prolonged pressing, dry nose without sweat, lethargy, jaundice of the whole body and eyes, difficult urination, tidal fever, frequent hiccups, and swelling around the ears: after acupuncture provides slight relief, the exterior remains unresolved. If the illness exceeds ten days and the pulse continues to float, administer Xiaochaihu Tang (Minor Bupleurum Decoction). If there is anuria with increased abdominal fullness and hiccups, it is incurable.