【方解及其應用範圍】本方乃溫中之劑。白朮甘溫，燥濕而健脾，主治風寒濕痹。乾薑辛溫，主胸滿咳逆上氣，又能暖中宮之氣。徐靈胎曰：“凡味厚之藥主守，氣厚之藥主散，薑氣味俱厚，故散而能守，夫散不全散，守不全守，則旋轉於經絡臟腑之間，驅寒除濕，和血通氣，所必然矣。”甘草與辛藥同用，便可化周身之陽氣，陽氣化行，陰邪即滅。但恐辛熱太盛，故用人參之微寒繼之，有剛柔相繼之意，陰陽庶幾不偏。仲景在前太陽中篇33條曾雲：“理中者，理中焦”，中焦是脾胃所司，乃《傷寒論》太陰病溫中散寒之主方，原文已有幾種加減法，參看前面所述，此處不再贅敘。鄭氏在《醫法圓通》中說：“理中湯所治的主症是腹滿而吐，食不下，時腹自痛，不利，口不渴。”是太陰病的典型證候。其基本病理是脾胃虛寒，氣機阻滯，故以溫中散寒補脾之理中湯為首選方，其圓通應用法，鄭氏舉出：（l）治吐血，（2）治四肢浮腫，（3）治心下嘈雜吐水，（4）治咳嗽吐清水，（5）治唾水不休，（6）治呃逆不休，（7）治手足微冷少神。以上七症，皆由脾胃虛寒，轉輸失職所引，故能治之而愈。筆者經驗用此方加味治療脾臟咳嗽。其因脾臟陽虛而咳嗽者，乃脾臟之陽不足，不能轉輸津液水穀而作，理中湯能溫陽利濕，益氣化痰，故可治之而愈。如由於胃寒發吐而咳嗽者，則加砂、蔻、半夏，其效始著。
今人用本方加減化裁以治虛寒性的消化道疾病，如慢性胃炎、腸炎及胃痛、胃潰瘍、多見良效。
五、傷寒解後，虛羸少氣①，氣逆欲吐，竹葉石膏湯主之。原文397
①虛羸：虛弱消瘦之意。
鄭論：按寒邪既稱解後，人既虛羸少氣，本屬不足，氣逆欲吐，大半陰邪上逆，正氣不支，法宜溫中、扶陽、降逆為是。原文以竹葉石膏湯，是為胃熱上攻者說法，若施之於虛羸少氣之人，斷乎不可。學者務宜於病情或寒或熱上體會，庶不致誤。
【闡釋】傷寒解後，無論汗解、下解，其為傷胃陰則一。胃虛津傷，餘熱未除，方可用竹葉石膏湯。若病後虛羸少氣者，元氣衰乏，腎氣不足也，病屬少陰；氣逆欲吐者，脾虛不能攝飲，飲邪上逆，病屬太陰，法當扶陽補氣，理脾固腎，竹葉石膏萬不可用，可選用附子理中湯加砂仁、故紙等藥。故鄭氏曰：“學者務宜於病情或寒或熱上體會，庶不致誤。”
竹葉石膏湯方（校補）
竹葉二把石膏一斤半夏半升（洗）人參二兩麥門冬一升（去心）甘草二兩（炙）粳米半升上七味，以水一鬥，煮取六升，去渣，內粳米，煮米熟，湯成去米，溫服一升，日三服。
【方解及其應用範圍】本方為白虎人參湯加減而成。竹葉、石膏除煩清熱，人參、甘草益氣生津，麥冬，粳米滋養胃液，半夏降逆。合之能生津益氣，清熱養陰。本方推廣應用於急性熱病，肺熱、胃熱之咳喘或呃逆，受暑之吐瀉，以及熱病後期津氣兩傷，餘熱未盡各症。筆者用治小兒麻疹已出透，仍繼續高熱，咳嗽劇烈者，則熱去而津生，咳嗽自愈。
差後食複
計一法（據舒本校補）
病人脈已解①，而日暮微煩，以病新差，人強與穀，脾胃氣尚弱，不能消穀，故令微煩，損穀則愈②。原文398
①脈已解：病脈已除，即脈搏平和的意思。
②損穀：即節制食物的意思。
鄭論：按胃氣旺，則食谷易消，胃氣弱，則食難化，此亦理之常也。今日暮而微煩，正陰長陽消之時也。損穀則愈，使其食不驟，而胃氣寬舒，自可無虞矣。
【闡釋】病人已愈，尚見日暮微煩，因病當新愈，正氣未複，勉強進食，脾胃虛弱，只要減食則愈。此即揭示病癒後，應注意飲食調護，不可過食也。
計一法
傷寒陰陽易之為病，其人身體重，少氣，少腹裏急，或引陰中拘攣①，熱（氣）〔上〕沖胸，頭重不欲舉，眼中生花，膝脛拘急者，燒褌散主之。原文392
①引陰中拘攣：牽引陰部拘急痙攣。
鄭論：按陰陽易病，皆由新病初愈，餘邪尚未大盡，男與女交則女病，女與男交則男病，以致一線之餘毒，勢必隨氣鼓蕩，從精竅而發洩也。治之不外扶正為主。至於燒褌散一方，男用女褌，女用男褌，近陰處布方寸，燒灰兌藥服之，亦是取陰陽至近之氣機，必引藥深入，亦是近理之論。余於此等證，在大劑扶陽，取童便為引，服之屢屢獲效。
【闡釋】陰陽易病者，是男子或婦人傷寒病新差未平復，而與之交接得病者。其證狀是身體重，少氣、少腹裏急等，這是下寒證；熱上沖胸，頭痛不欲舉等，這是上熱證。下寒是真寒，上熱是假熱。鄭氏認為治之不外扶正為主，用大劑回陽扶陽，取童便為引，服之屢屢獲效，誠不易之治法矣。筆者從之，並認為燒褌散決不可用。
燒褌散方（校補）
婦人中褌近隱處，取燒作灰。
上一味，水服方寸匕，日三服。小便即利，陰頭微腫，此為愈矣。婦人病，取男子褌燒灰服。
【闡釋】筆者對此證此方，體會很少，不作強解。
外附
太陽少陰總論
夫陽者，即坎中真陽也；少陰者，即坎水也。陽居二陰之中，陰含一陽之內。人身中一水一火，即在此處攸分。故太陽為人身綱領，主皮膚，統營衛者是也。太陽之氣上升，則水精之陰，即從太陽而上行，從皮膚而出水氣。太陽為外邪干犯，必由毛竅而入，仲景所以著《傷寒》，皆是從根底上來也。故太陽之底〔面〕是少陰，少陰之底面即是太陽，所以太陽發汗有亡陽之虞，即此是也。後學不知根底，著春溫，著利證，種種不一，自以為補仲景之不逮，而不知仲景列六經，早已發明其要，惜後人之學識未到，功力未深，自詡以為獨得之秘，而其中亦有好處，不得即為之無用也。總之根底未澈，源頭未清，不得不直言之也。
【闡釋】鄭氏於書末附太陽少陰總論者，何故？《醫理真傳》一書，首揭乾坤大旨，而以坎、離為人生立命之根。坎水在人身雖屬陰血，但中有真陽，在人身為腎，一點真陽，含于二陰之中，為人立命的真種子。離為火，屬陽，氣也，在人身為心。而中一爻來自坤元，真陰寄在其中。在人身則腎中真陽升發，能使水上交於心，心中真陰能使火下交於腎。氣血循環，周流不息，水升火降，陰平陽秘，使人身體健康，心智煥發，都是坎離互濟交融，一升一降，往來不窮，性命於是乎立。傷寒六經中之太陽，即坎中真陽也；少陰者，即坎水也。六經以太陽為首，凡病邪初入，必由太陽，以太陽為寒水之區，主皮膚，統營衛，為一身綱領。然太陽底面，即是少陰腎經，相為表裏也。若太陽病過發汗，則傷少陰腎中真陽，而有亡陽之虞。太陽一經為病，有經病，有傷風症，有傷寒症，有兩感症，有腑症。腑症之中，又有蓄尿症，蓄熱症，蓄血症，癃閉症。在六經病證中，最為繁多，變化亦大，其治似簡實難。至少陰一經之病，有由傳經而來，亦有外邪直中少陰經。少陰經兼屬手少陰心及足少陰腎，係上火下水，而下水中複有真陽，故本經之病，除經症外，尚有協火、協水兩症。在六經中，除太陽經外，本經較其他諸經為複雜，因其為水、火交會之地，元氣之根，人身立命之主也。病至此際，是元氣衰極，剝至於根，故少陰病中，重症、死症較多。仲景立四逆，是專為救這一點元氣說法。又雲治三陰厥逆，可知這一點元氣，澈上澈下，包羅天地，此方不獨專為少陰立法，而上中下三部之法俱備，知得此理，便知得薑附之功用也。筆者數十年之經驗，對治陽虛諸種病症，用薑、附少則30克，多達250克，從未發生任何副作用，真是藥到病除。不敢自秘，願與同人共用之，以救世之陽虛患者，功莫大焉。
麻腳瘟說
余自幼小時，即聞老人相傳，有麻腳瘟證，終不知此證是何也？今者曆醫有年，始得其要。夫曰麻腳瘟者，人身衛外之陽不足，卒為陰邪所閉也。然有吐有瀉，皆是陰邪已犯中宮，上下逼迫，而人身元氣係在後天，頃刻將元氣剝盡，能令人死。余曾救多人，一見此症，即用大劑回陽，可以移危為安。如斬關丸、四逆湯，皆神效之品。設窮鄉僻壤，覓藥維艱，一遇此等證候，即速搗生薑汁同紅糖服之，如無紅糖，即薑汁亦可；如薑不便，而胡椒亦可，速速吞之，皆能獲效。昧者不識，胡亂施治，未有不速其死者也，願諸公熟記之，至切至切。
【闡釋】鄭氏釋麻腳瘟病為人身衛外之陽不足，卒為陰邪所閉也，是經驗有得之言。因其病來勢兇猛，頃刻將元氣剝盡，能令人死。即用大劑回陽，如四逆湯、斬關元服之，可以轉危為安。對缺醫少藥之窮鄉僻壤，提出簡便易行之薑汁同紅糖服之，或胡椒速吞之，皆能獲效，足以補醫藥之不逮，彌足珍貴。
斬關丸方
硫磺五兩，研細末，貫入豬大腸，線劄煮去腸滾水淘數次曬乾肉桂一兩白蔻、生附子、花椒、生白朮、吳萸、半夏、雞內金各五錢以上共為末，飯碾成丸。
辨認內外發熱證至要約言
醫家治病，務要識得內外兩法，邪有由外而入者，有由內而出者，大有分別。如發熱一證，無論男婦老幼一見發熱，鮮不以為外感也，不知大有分別。餘閱歷數十年，方始識得，不敢自秘，以公諸世，亦救世之意也。千古以來，名賢迭出，惜此未剴切詳明也。曰內曰外，何以辨之？證之？由外感者，無論男婦老幼，一經外感，邪從毛竅而入，閉其外出之氣機，人即沉迷倒臥不起，所現頭疼、身痛、惡風、畏寒等等情狀。若由內而出者，無論男婦老幼，人不困倦，起居一切如無病者，但發熱而已。其間有手心獨發熱者，有上半日發熱者，有下半日發熱者，有夜間發熱者，種種不一。但其人面白、唇青、口不渴、滿口津液，飲食無味，大小便利，不思水飲為據。即有面赤如硃，口紅唇裂、皆在舌上，津液滿口，小便清長，喜飲熱湯上辨之，萬無一失。
【闡釋】發熱有內、外之分，鄭氏原文剴切詳明，無庸贅述。但筆者認為將《醫理真傳》認病捷要總訣發熱類與之合參，則更為全面，故不憚繁而錄之，以供辨證。發熱而身疼者，外感也（自汗桂枝湯，無汗麻黃湯）。發熱而身不疼，飽悶吞酸者，內傷於食也（平胃散加消食行氣之藥）。發熱身疼，不惡寒，舌黃而飲冷者，熱傷於裏也（白虎湯加桂枝幹葛）。發熱身疼，惡寒，口不渴者，邪入少陰也（麻黃附子細辛湯）。素稟不足，無故身大熱，舌青欲飲極熱者，元陽外越也，亦有口不渴者，皆同（吳萸四逆湯）。小兒發熱，氣粗口熱者，表裏俱病，內有熱也（人參敗毒散加芩、連、梔子）。發熱出氣微溫，而口不熱，小便清長，大便不實，素有疾者，元氣不固也（理中湯、六君子湯之類）。
問答計三條
問曰：俗雲服薑附燒幹腎水，果有是說乎？
答曰：子不觀仲景之用薑附，所以回陽也，陽回則津液自生，何以不燒幹腎水而反生津液，生死人而肉白骨乎？此其中大有關鍵，昧者不明陰陽底蘊，畏薑附視若砒霜，不敢輕用，病家亦不敢輕服，相沿成風，牢不可破。猶其不知薑附乃少陰主藥，仲景用之以扶少火而生氣者也。曰：然則薑附其可恒用歟？曰：可。曰：何以知其可恒用也？曰：凡一切陽虛諸症，如少氣、懶言、身重、惡寒、聲低、息短、舌潤、舌黑、二便清利、不思水飲、心悸、神昏、不語、五心潮熱，喜飲熱湯、便血、吐血、閉目妄語，口臭難禁，二便不禁，遺尿遺屎，手足厥逆，自汗，心慌不寐，危候千般，難以枚舉，非薑附何以能勝其任，而轉危為安也乎？曰：然則世之用大黃芒硝以治病者，其故何也？曰：大哉斯問也？曰：夫大黃芒硝乃治壯火食氣之症也。曰：壯火之為病若何？曰：壯火者，是外來之邪熱，入與陽明之燥熱相合，盤據於中，若不急為撲滅，頃刻將真陰灼盡而性命不保，故曰壯火食氣即此。仲景於此，輕則以人參白虎，重則以大承氣、小承氣湯，與夫六味、麥味、雞子黃連潤燥、養陰、救陰諸法，皆一轍也。至所現病情，如氣粗口熱、大渴飲冷、壯熱、煩躁、汗多、身輕、張目不眠、聲音響亮、口臭、芒刺滿口，譫語神昏，二便不利，胸腹痞滿，狂叫不休，便血，吐血，種種危候，難以枚舉。如此之病，不惟薑附不用，即一切辛燥之品，皆當禁服也。由是觀之，則醫亦可學也，而用藥之宜熱宜涼，有一定之理也。噫！先生此論，其可為醫門之一助也，實快事也。
[Formula Analysis and Scope of Application] This formula is a warming-middle agent. Baizhu (Atractylodis Macrocephalae Rhizoma) is sweet and warm, dries dampness and strengthens the spleen, primarily treating wind-cold-damp bi syndrome. Ganjiang (Zingiberis Rhizoma) is acrid and warm, primarily treating chest fullness, cough, and rebellious Qi ascending, and can also warm the Qi of the middle jiao (spleen and stomach). Xu Lingtai said: "Generally, herbs with heavy flavors are for retention/stasis, while herbs with heavy aromas are for dispersion. Ginger has both heavy flavor and aroma, so it can disperse yet retain. Since its dispersion is not complete and its retention is not absolute, it rotates between the meridians and zang-fu organs, driving out cold, eliminating dampness, harmonizing blood, and unblocking Qi; this is inevitable." When Gancao (Glycyrrhizae Radix et Rhizoma) is used with acrid herbs, it can transform the Yang Qi of the whole body. Once Yang Qi transforms and moves, Yin pathogens are extinguished. However, fearing that the acrid-hot nature might be too intense, Renshen (Ginseng Radix et Rhizoma) with its slight coolness is added to follow, embodying the idea of complementing hardness with softness, so that Yin and Yang are hardly biased. Zhang Zhongjing previously stated in Chapter 33 of the Taiyang section of *Shanghan Lun*: "Lizhong [Regulate the Middle] refers to regulating the middle jiao." The middle jiao is governed by the spleen and stomach; this is the main formula for warming the middle and dispelling cold in Taiyin disease in *Shanghan Lun*. The original text already contains several modification methods; refer to the previous discussion, so no further elaboration is needed here. Zheng Shi said in *Yifa Yuantong*: "The main symptoms treated by Lizhong Tang are abdominal fullness with vomiting, inability to eat, spontaneous abdominal pain at times, diarrhea, and absence of thirst." These are typical syndromes of Taiyin disease. Its basic pathological mechanism is deficiency-cold of the spleen and stomach with stagnation of Qi mechanism; therefore, Lizhong Tang, which warms the middle, dispels cold, and tonifies the spleen, is the first-choice formula. Regarding its flexible application methods, Zheng Shi listed: (1) treating hematemesis, (2) treating edema of the four limbs, (3) treating heartburn and spitting water below the heart, (4) treating cough with clear water expectoration, (5) treating incessant salivation, (6) treating incessant hiccups, (7) treating slightly cold hands and feet with lethargy. All seven symptoms are caused by deficiency-cold of the spleen and stomach and failure of transport and transformation functions, thus they can be cured by this formula. In my experience, using this formula with modifications to treat spleen-related cough: if the cough is due to spleen Yang deficiency, resulting from insufficient spleen Yang failing to transport fluids and food grains, Lizhong Tang can warm Yang, promote diuresis to resolve dampness, benefit Qi, and transform phlegm, thus curing it. If the cough is triggered by vomiting due to stomach cold, adding Sharen (Amomi Fructus), Baixiangdou (Amomi Fructus), and Banxia (Pinelliae Rhizoma) will yield significant effects.
Modern practitioners often use modifications of this formula to treat deficiency-cold digestive tract diseases, such as chronic gastritis, enteritis, stomachache, and gastric ulcers, achieving good results.
V. After the resolution of Shanghan, if the patient presents with emaciation and shortness of breath①, and rebellious Qi causing a desire to vomit, Zhuye Shigao Tang should be used. Original Text 397
① Xu lei: Refers to weakness and emaciation.
Zheng's Commentary: Since the cold pathogen is said to have resolved, and the person is weak, emaciated, and short of breath, the condition inherently belongs to deficiency. Rebellious Qi and desire to vomit largely indicate upward reversal of Yin pathogens, with righteous Qi unable to support itself. The treatment method should prioritize warming the middle, supporting Yang, and descending rebellious Qi. The original text uses Zhuye Shigao Tang, which addresses stomach heat attacking upward. Applying it to someone who is weak, emaciated, and short of breath is absolutely contraindicated. Scholars must carefully comprehend whether the condition is cold or hot to avoid errors.
[Interpretation] After the resolution of Shanghan, whether through sweating or purging, the damage to Stomach Yin remains the same. Only when there is Stomach deficiency, fluid injury, and residual heat remaining can Zhuye Shigao Tang be used. If the post-illness state involves emaciation and shortness of breath, it indicates exhaustion of Yuan Qi and insufficiency of Kidney Qi, belonging to Shaoyin; rebellious Qi and desire to vomit indicate Spleen deficiency failing to control fluids, with fluid pathogens reversing upward, belonging to Taiyin. The treatment method should support Yang, tonify Qi, regulate the Spleen, and secure the Kidneys. Zhuye Shigao Tang must never be used. Instead, Fuzi Lizhong Tang plus Sharen (Amomi Fructus) and Guzhi (Psoraleae Fructus) can be selected. Thus, Zheng Shi said: "Scholars must carefully comprehend whether the condition is cold or hot to avoid errors."
Zhuye Shigao Tang Formula (Collated and Supplemented)
Zhuye (Two handfuls), Shigao (One jin), Banxia (Half sheng, washed), Renshen (Two liang), Maimendong (One sheng, hearts removed), Gancao (Two liang, roasted), Jingmi (Half sheng).
These seven ingredients are boiled in ten dou of water to obtain six sheng. Strain the dregs, add Jingmi, boil until the rice is cooked, remove the rice, and take one sheng warm, three times daily.
[Formula Analysis and Scope of Application] This formula is derived from Baihu Jia Renshen Tang with modifications. Zhuye and Shigao clear irritability and heat; Renshen and Gancao benefit Qi and generate fluids; Maimendong and Jingni nourish Stomach fluids; Banxia descends rebellious Qi. Together, they generate fluids, benefit Qi, clear heat, and nourish Yin. This formula is widely applied to acute febrile diseases, cough and asthma due to Lung Heat or Stomach Heat, hiccups, vomiting and diarrhea due to summerheat, and various conditions in the late stage of febrile diseases involving dual injury of fluids and Qi with residual heat. I have used this formula to treat pediatric measles where the rash has fully erupted but high fever persists with severe coughing; the result was heat clearance, fluid generation, and spontaneous cessation of cough.
Post-Illness Dietary Relapse
Method One (Supplemented according to Shu Ben)
When the patient's pulse has resolved①, but slight irritability occurs at dusk, it is because the illness has just healed, and forcing food intake while the Spleen and Stomach Qi are still weak cannot digest the food, thus causing slight irritability. Reducing food intake leads to recovery②. Original Text 398
① Pulse resolved: The pathological pulse has disappeared, meaning the pulse is peaceful.
② Reduce grain: Means to restrict food intake.
Zheng's Commentary: When Stomach Qi is vigorous, food digests easily; when Stomach Qi is weak, food is hard to transform; this is common sense. Now, slight irritability at dusk coincides with the time when Yin grows and Yang declines. Reducing food intake leads to recovery, preventing sudden increase in food burden, allowing Stomach Qi to relax, thus ensuring safety without worry.
[Interpretation] The patient has recovered but shows slight irritability at dusk. Since the illness has just healed, righteous Qi has not yet restored, and forced eating causes Spleen and Stomach weakness. Simply reducing food intake leads to recovery. This reveals that after recovery, dietary care should be noted, avoiding overeating.
Yin-Yang Exchange Disease
Method One
In exchange disease following Shanghan, the patient experiences heavy body, shortness of breath, urgency and tightness in the lower abdomen, possibly牵引ing cramping in the yin organs①, heat rushing up to the chest, heaviness of head unwilling to lift, flowers before eyes, and stiffness/spasm of knees and calves. Shaofen San should be used. Original Text 392
① Yin zhong ju chuan: Cramping and spasm牵引ed into the yin region.
Zheng's Commentary: Exchange disease arises when new illness has just healed, residual pathogens are not fully cleared. If man and woman engage in intercourse, the woman becomes ill; if woman and man engage, the man becomes ill. Thus, a trace of residual toxin inevitably surges with Qi and泄s through the essence orifices. Treatment is not outside supporting righteousness as the primary principle. Regarding Shaofen San, using the female's undergarment near the crotch for men, or the male's for women, burning about one square cun of cloth near the yin area to ash and mixing with medicine for oral administration, takes advantage of the closest Yin-Yang Qi mechanism, guiding the medicine deeply; this is a reasonable theory. For such conditions, I mainly use large doses of Yang-supporting herbs, using child urine as a guide, and have frequently achieved efficacy.
[Interpretation] Exchange disease refers to illness contracted through sexual intercourse when a man or woman has just recovered from Shanghan but has not fully stabilized. Symptoms include heavy body, shortness of breath, lower abdominal urgency, etc., which are Lower Cold syndromes; heat rushing to the chest, headache unwilling to lift, etc., are Upper Heat syndromes. Lower cold is true cold; upper heat is false heat. Zheng Shi believes treatment primarily supports righteousness, using large doses of Yang-restoring herbs with child urine as a guide, achieving frequent success, which is indeed an unchangeable treatment method. I follow this view and believe Shaofen San must absolutely not be used.
Shaofen San Formula (Collated and Supplemented)
Take the part of the woman's undergarment near the hidden parts, burn to ash.
One ingredient: Take one fangcun bi (square-inch spoonful) with water, three times daily. Urination becomes smooth, slight swelling of the glans penis/vulva indicates recovery. For women's illness, take the man's undergarment, burn to ash, and administer.
[Interpretation] I have little understanding of this condition and formula, so I do not force an explanation.
Appendix
General Discussion on Taiyang and Shaoyin
Yang refers to the True Yang within Kan; Shaoyin refers to Kan Water. Yang resides within two Yin lines, and Yin contains one Yang line. The Water and Fire in the human body are distinguished here. Therefore, Taiyang is the guideline of the human body, governing the skin and commanding Ying and Wei. When Taiyang Qi ascends, the Yin of water essence ascends with Taiyang and exits the skin as vapor. When Taiyang is invaded by external pathogens, it enters through hair follicles. Zhang Zhongjing's *Shanghan Lun* discusses everything from the root. Thus, the base of Taiyang is Shaoyin, and the base of Shaoyin is Taiyang. Hence, sweating in Taiyang carries the risk of Yang collapse, which is exactly this reason. Later learners who do not know the root write about Spring Warmth and dysentery, among others, claiming to supplement Zhang Zhongjing's deficiencies, unaware that Zhang Zhongjing's Six Meridians had already elucidated the essentials. It is regrettable that later scholars' knowledge and skill were insufficient, boasting exclusive secrets, though some had merits and cannot be deemed useless. In short, since the root was not thoroughly understood and the source not clarified, I must speak plainly.
[Interpretation] Why did Zheng Shi append the General Discussion on Taiyang and Shaoyin at the end of the book? *Yili Zhenchuan* first reveals the principles of Qian and Kun, taking Kan and Li as the root of life. Although Kan Water in the body belongs to Yin Blood, it contains True Yang, corresponding to the Kidney in the body. A point of True Yang is contained within two Yin lines, serving as the true seed of life. Li is Fire, belonging to Yang and Qi, corresponding to the Heart in the body. The middle Yao comes from Kun Yuan, with True Yin residing within. In the body, the rising of True Yang in the Kidney allows Water to ascend and connect with the Heart; the True Yin in the Heart allows Fire to descend and connect with the Kidney. Qi and Blood circulate endlessly, Water rises and Fire descends, Yin is level and Yang is secret, maintaining health and mental clarity. This is all due to the mutual assistance and integration of Kan and Li, rising and falling endlessly, establishing life. Taiyang in the Six Meridians of Shanghan is the True Yang within Kan; Shaoyin is Kan Water. Six Meridians start with Taiyang; whenever pathogens enter initially, they must enter via Taiyang. As the zone of Cold Water, governing skin and commanding Ying and Wei, it is the guideline of the body. However, the base of Taiyang is the Shaoyin Kidney Meridian, exterior-interior related. If Taiyang disease undergoes excessive sweating, it damages the True Yang in the Shaoyin Kidney, risking Yang collapse. Diseases of the Taiyang meridian include meridian diseases, Wind Strike, Cold Damage, Double Invasion, and Fu organ diseases. Among Fu diseases, there are Urine Accumulation, Heat Accumulation, Blood Accumulation, and Lin obstruction. Among Six Meridian diseases, this is the most numerous and variable, seemingly simple but actually difficult to treat. Diseases of the Shaoyin meridian come either from transmission or direct invasion by external pathogens. Shaoyin connects with Hand Shaoyin Heart and Foot Shaoyin Kidney, comprising Upper Fire and Lower Water, with True Yang within the Lower Water. Thus, besides meridian syndromes, there are Fire-Assisting and Water-Assisting syndromes. Among the Six Meridians, excluding Taiyang, this meridian is more complex than others because it is the meeting place of Water and Fire, the root of Yuan Qi, and the master of life. At this stage, Yuan Qi is extremely exhausted, peeling back to the root; thus, Shaoyin disease has many severe and fatal cases. Zhang Zhongjing established Si Ni Tang specifically to save this point of Yuan Qi. He also said it treats Jue Ni of the Three Yin, indicating this point of Yuan Qi penetrates up and down, encompassing Heaven and Earth. This formula is not only for legislating for Shaoyin but covers methods for Upper, Middle, and Lower parts. Understanding this principle reveals the function of Jiang (Ginger) and Fu (Aconite). In my decades of experience treating various Yang deficiency conditions, using Jiang and Fu in doses ranging from 30g to 250g has never caused side effects; truly, the medicine works and the disease is cured. I dare not keep this secret; I wish to share it with colleagues to save patients with Yang deficiency in the world, a great merit.
On Maji Plague
Since childhood, I heard elders talk about Maji Plague, but never knew what it was. Having practiced medicine for years, I finally grasped its essence. Maji Plague refers to insufficient defensive Yang in the body, suddenly closed by Yin pathogens. With vomiting and diarrhea, it means Yin pathogens have invaded the Middle Palace, pressing from above and below. Human Yuan Qi relies on Post-Heaven sources;顷刻间 (in an instant) Yuan Qi is depleted, leading to death. I have saved many people; upon seeing this symptom, I immediately use large doses of Yang-restoring herbs to turn danger into safety. Zhanguan Wan and Si Ni Tang are both miraculous remedies. In remote areas where finding medicine is difficult, upon encountering such symptoms, quickly crush fresh ginger juice mixed with brown sugar. If no brown sugar, ginger juice alone suffices; if ginger is inconvenient, pepper can be used, swallowed quickly, all effective. Ignorant people do not recognize this, treating randomly, inevitably accelerating death. I urge everyone to remember this well.
[Interpretation] Zheng Shi explains Maji Plague as insufficient defensive Yang suddenly closed by Yin pathogens, words gained from experience. Because the disease strikes fiercely, depleting Yuan Qi instantly, leading to death. Using large doses of Yang-restoring herbs like Si Ni Tang or Zhanguan Wan can turn danger into safety. For remote areas lacking medical resources, proposing simple remedies like ginger juice with brown sugar or swallowing pepper is effective, compensating for medical shortages, highly valuable.
Zhanguan Wan Formula
Self-made by Shu Chi Yuan (Added according to Shu Ben, Five Articles before Shaoyin)
Liuhuang (Sulfur) five liang, ground into fine powder, inserted into pig large intestine, tied with thread, boiled, remove intestine, rinse several times with boiling water, dry. Rougui (Cinnamon Bark) one liang, Baixiangdou (Cardamom), Sheng Fuzi (Raw Aconite), Huajiao (Zanthoxylum), Sheng Baizhu (Raw Atractylodes), Wuyu (Evodia), Banxia (Pinellia), Jineijin (Chicken Gizzard Lining) each five qian. Grind all into powder, form pills with rice paste.
Essential Summary on Distinguishing Internal and External Fever
Doctors treating diseases must distinguish internal and external methods. Pathogens enter from outside or emerge from inside; there is a great difference. Regarding fever, regardless of gender or age, seeing fever, few do not consider it external contraction, yet there is a great difference. After decades of experience, I finally recognized it and dare not keep it secret, sharing it with the world, intending to save lives. Since ancient times, sages have emerged, but this has not been clearly explained. How to distinguish internal from external? How to verify? From external contraction, regardless of gender or age, once exposed to external pathogens, pathogens enter through hair follicles, blocking outward Qi mechanism, causing coma and lying down, presenting headache, body pain, aversion to wind, fear of cold, etc. From internal emergence, regardless of gender or age, the person is not fatigued, daily activities remain normal, only experiencing fever. Some have only palms hot, some fever in the first half of the day, some in the second half, some at night, various types. But key indicators are pale face, blue lips, no thirst, abundant saliva, tasteless food, normal urination and defecation, no desire for water/drinks. Even if face is red like cinnabar, red mouth, cracked lips, observe the tongue; if saliva is abundant, urine is clear and long, preferring hot drinks, differentiation is foolproof.
[Interpretation] Fever has internal and external distinctions; Zheng Shi's original text is clear and detailed, requiring no redundancy. However, I believe combining it with the "Quick Diagnosis General Principles" fever category from *Yili Zhenchuan* is more comprehensive, so I record it despite verbosity for differential diagnosis reference. Fever with body pain is external contraction (use Guizhi Tang for spontaneous sweating, Mahuang Tang for no sweating). Fever without body pain, with fullness and acid regurgitation is food injury (use Pingwei San plus food-resolving and Qi-moving herbs). Fever with body pain, no aversion to cold, yellow tongue, craving cold drinks is heat injuring the interior (use Baihu Tang plus Guizhi and Ge Gen). Fever with body pain, aversion to cold, no thirst is pathogen entering Shaoyin (use Mahuang Fuzi Xixin Tang). Constitutionally deficient, sudden high fever without cause, blue tongue, craving extreme heat is Yuan Yang floating outward; some have no thirst, similar (Wuyu Si Ni Tang). Pediatric fever, coarse breathing, hot mouth indicates exterior-interior disease with internal heat (use Renshen Baidu San plus Huangqin, Huanglian, Zhizi). Fever with slightly warm exhaled air, cool mouth, clear long urine, loose stools, chronic illness indicates unstable Yuan Qi (use Lizhong Tang, Liujunzi Tang type formulas).
Q&A Three Items
Question: Common saying says taking Jiang (Ginger) and Fu (Aconite) burns dry Kidney Water, is this true?
Answer: Have you not seen Zhang Zhongjing using Jiang and Fu to restore Yang? When Yang restores, fluids naturally generate. Why would it burn dry Kidney Water instead of generating fluids, reviving the dead, and fleshing bones? There is a key point here. Ignorant people do not understand the essence of Yin and Yang, fearing Jiang and Fu as if they were arsenic, daring not use them lightly. Patients also dare not take them lightly, forming an unbreakable custom. They fail to know that Jiang and Fu are the principal herbs of Shaoyin, used by Zhang Zhongjing to support Lesser Fire to generate Qi. Question: Then can Jiang and Fu be used constantly? Answer: Yes. Question: How do you know they can be used constantly? Answer: For all Yang deficiency syndromes, such as shortness of breath, reluctance to speak, heavy body, aversion to cold, low voice, short breath, moist tongue, black tongue, clear urination and defecation, no desire for water/drinks, palpitations, confusion, muteness, tidal heat in five centers, preference for hot drinks, bloody stool, hematemesis, closing eyes and delirium, unbearable bad breath, incontinence of urine and feces, enuresis and encopresis, cold extremities, spontaneous sweating, panic and insomnia, countless critical signs difficult to enumerate, how else could Jiang and Fu胜任 (be competent) to turn danger into safety? Question: Then why does the world use Dahuang (Rhubarb) and Mangxiao (Mirabilite) to treat diseases? Answer: This question is profound! Dahuang and Mangxiao treat conditions where Vigorous Fire consumes Qi. Question: What are the diseases caused by Vigorous Fire? Answer: Vigorous Fire is external pathogenic heat merging with Yangming dry-heat, entrenched in the middle. If not urgently extinguished, True Yin will be scorched away in an instant, endangering life. Thus, "Vigorous Fire consumes Qi" refers to this. Zhang Zhongjing treats this lightly with Renshen Baihu Tang, heavily with Dachengqi Tang or Xiaochengqi Tang, and also with Liuwei, Maiwei, Ji Zi Huang, Lian strategies for moistening dryness, nourishing Yin, and saving Yin—all follow the same principle. Manifestations include coarse breathing, hot mouth, extreme thirst for cold drinks, high fever, restlessness, profuse sweating, light body, wide-open eyes insomnia, loud voice, bad breath, prickles in mouth, delirium and confusion, difficulty in urination and defecation, chest/abdominal fullness, continuous screaming, bloody stool, hematemesis, countless critical signs difficult to enumerate. For such diseases, not only are Jiang and Fu unused, but all acrid-dry herbs are prohibited. Thus, medicine can be learned, and the choice of hot or cold herbs follows definite principles. Alas! Mr. this discussion can assist the medical field, truly a joyous matter.