胃气虚寒 素有内寒之人。复感寒邪。当温中散寒。若大发其汗。胃中谷气化汗
外达。则胃气转馁。蛔失谷气以养。则不安而上逆。仲景云。病患有寒。复发汗。胃中
冷。必吐蛔。是也。故凡伤寒吐蛔。虽有大热。忌用寒凉。乃大凶之兆。急用理中汤去甘草。加椒梅主之。
盖蛔闻甘而起。遇酸而伏。见苦则安也。蛔吐不止者死。吐蛔不能食者亦死。（以上述古）
邵评∶中阳虚而受寒。宜温中散寒为治。反大汗之。则胃阳益伤。不能化谷气以养蛔。则蛔
上逆。而从口出也。盖阳虚而有寒邪。复发汗以伤其阳。则胃阳虚而胃中冷。故用椒梅理中汤法温之。
肝邪犯胃 按吐蛔。仲景列于厥阴篇内。则为肝邪犯胃可知。凡伤寒如见寒热。
干呕。心胸格拒。或吐痰涎浊沫。或吐酸苦黄绿之水。或吐蛔下蛔。皆属厥阴乘犯
阳明。治宜泄肝和胃。如川连、桂枝、乌梅、川椒、（炒黑）生白芍、淡吴萸、（盐水炒）黄芩、茯苓
之类。如泄肝和胃不效。乃胃中虚空若谷。客气逆犯上冲。须镇逆安胃。宜人参、
茯苓、半夏、代赭石、炒川椒、乌梅肉、川楝子之类。
邵评∶厥阴属肝木。为至阴之经。阴极则阳生。木中有相火。凡病邪传入厥阴。深沉之至邪。每
挟木火内燔。势必顺阳明而犯胃。伤耗阴津胃液。而见症如此。治宜泄厥阴以安阳明为法。
邪陷厥阴 伤寒暑湿温热之邪。上阻气分。则身热耳聋。入于营分。则舌绛神昏。
治法当清解心营肺卫。如连翘、淡竹叶、滑石粉、川贝母、天竺黄、鲜菖蒲、炒竹茹、绿
豆皮之类。以清上焦。若身热不解。口渴胸痞。耳聋干呕。吐蛔拒纳。此暑湿内蒸。其
邪渐结厥阴之界。乃险症也。宜川连、半夏、枳实、菖蒲、茯苓、黄芩、干姜。苦辛以开内结。
邵评∶温热暑湿之邪。从口鼻吸受。始在上焦气分。或渐入营。与伤寒见症不同。
治法亦异。当宗河间三焦立法。分心营肺卫论治。上焦之邪不解。蔓延中下而
入里。可以治同伤寒。故治温暑与伤寒。始异而终同也。惟药味宜轻清。宣泄上焦。涤痰化热。
邪结气分 如吐蛔与饮。脘闷口渴。舌苔白中带黄。此湿热结于气分。胃中不和而蛔
逆也。宜二陈加干姜、川连。（以上参叶案）
邵评∶此痰饮挟湿热。结于阳明气分。胃热气逆。而蛔上出。胃有痰热。则舌苔白
中带黄。邪内结。则脘闷。用二陈以化痰。姜连以开痞达邪。
Stomach Qi Deficiency and Cold: Individuals who have chronic internal cold, upon contracting exogenous cold pathogens, should be treated with methods to warm the middle and dissipate cold. If heavy sweating is induced, the grain qi within the stomach transforms into sweat and escapes outward, causing the Stomach Qi to become further depleted. Ascaris lumbricoides (roundworms), deprived of nourishment from grain qi, become restless and rebel upward. Zhang Zhongjing stated, "If a patient has cold syndrome and sweating is erroneously induced, causing cold in the Stomach, vomiting of ascarids will inevitably occur." This is precisely such a case. Therefore, in any case of Taiyang disease presenting with vomiting of ascarids, even if there is significant heat, cold-natured herbs must be contraindicated; this is an ominous sign indicating severe danger. One should immediately administer Lizhong Tang (Cinnamon Twig and Atractylodes Decoction) by removing Gancao (Licorice Root) and adding Chuanjiao (Sichuan Pepper) and Wumei (Mume Fruit). This is because ascarids are aroused by sweetness, subdue themselves with sourness, and remain calm with bitterness. Death ensues if vomiting of ascarids persists without cessation, or if vomiting occurs alongside the inability to ingest food. (The above cites ancient texts.)
Shao's Commentary: When Middle Jiao Yang is deficient and cold pathogens invade, the treatment should be warming the middle and dissipating cold. Instead, inducing heavy sweating injures Stomach Yang further, preventing the transformation of grain qi to nourish ascarids, leading them to rebel upward and exit through the mouth. Generally, when Yang deficiency coexists with cold pathogens, erroneous sweating damages Yang, resulting in Stomach Yang deficiency and cold in the Stomach. Thus, one uses the method of Sichuan Pepper and Mume Fruit combined with Lizhong Tang to warm the interior.
Liver Pathogen Invading the Stomach: According to Zhang Zhongjing, vomiting of ascarids is listed in the Jueyin Chapter, indicating that this condition arises from Liver pathogenic factors invading the Stomach. In cases of Taiyang disease, if symptoms such as aversion to cold and fever, dry retching, oppression or rejection in the chest and epigastrium, vomiting of phlegm-saliva or turbid froth, vomiting of acidic, bitter, yellow, or green fluids, or vomiting/passing ascarids appear, these all belong to Jueyin Wood overacting on Yangming Earth. The treatment should involve purging the Liver and harmonizing the Stomach, using herbs such as Huanglian (Coptis Rhizome), Guizhi (Cinnamon Twig), Wumei (Mume Fruit), Chuanjiao (Sichuan Pepper, stir-fried until black), Sheng Baishao (Raw White Peony Root), Dan Wuzhuyu (Evodia Fruit, stir-fried with salt water), Huangqin (Scutellaria Root), and Fuling (Poria). If purging the Liver and harmonizing the Stomach proves ineffective, it indicates that the Stomach is empty like a valley, allowing rebellious Qi to rush upward. One must suppress rebellion and stabilize the Stomach, using herbs such as Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Banxia (Pinellia Tuber), Daizheshi (Ochre), Chuanjiao (Sichuan Pepper, stir-fried), Wumei Rou (Mume Fruit Flesh), and Chuanlianzi (Toosendan Fruit).
Shao's Commentary: The Jueyin channel belongs to Liver Wood and is the most Yin channel. When Yin reaches its extreme, Yang is born; within Wood resides Ministerial Fire. When pathogenic factors transmit to Jueyin, they represent deep-seated pathogens often carrying Wood-Fire that burns internally. These inevitably follow the Yangming channel to invade the Stomach, consuming Yin fluids and Stomach essence, resulting in the aforementioned symptoms. The treatment should focus on purging Jueyin to pacify Yangming.
Pathogens Trapped in Jueyin: When Taiyang, Summerheat-Dampness, or Warm-Heat pathogens obstruct the Qi level in the Upper Jiao, symptoms include fever and deafness. If they enter the Ying (Nutritive) level, symptoms include crimson tongue and mental confusion. The treatment method should clear and resolve the Heart Ying and Lung Wei, using herbs such as Lianqiao (Forsythia Fruit), Dan Zhuye (Lophatherum Leaf), Huashi (Talcum), Chuanbeimu (Fritillaria Bulb), Tianzhuhuang (Calamus Tuber), Xian Changpu (Fresh Acorus Rhizome), Chao Zhuru (Bamboo Shavings, stir-fried), and Ludoupi (Mung Bean Skin), to clear the Upper Jiao. If fever persists, accompanied by thirst, chest fullness, deafness, dry retching, vomiting of ascarids, and refusal to eat, this indicates internal steaming of Summerheat-Dampness, with pathogens gradually binding at the boundary of Jueyin. This is a critical condition. One should use Huanglian (Coptis Rhizome), Banxia (Pinellia Tuber), Zhishi (Immature Bitter Orange), Changpu (Acorus Rhizome), Fuling (Poria), Huangqin (Scutellaria Root), and Ganjiang (Dried Ginger), employing bitter and acrid methods to open internal binders.
Shao's Commentary: Warm-heat and Summerheat-Dampness pathogens are inhaled through the nose and mouth, initially affecting the Qi level of the Upper Jiao, or gradually entering the Ying level. This differs from Taiyang disease symptoms and requires different treatments. One should follow Liu Hejian’s San Jiao legislation, treating according to Heart Ying and Lung Wei theories. If Upper Jiao pathogens do not resolve, they spread to the Middle and Lower Jiao and enter the interior, at which point treatment can align with Taiyang disease protocols. Thus, the treatment of Warm diseases and Summerheat differs initially but converges ultimately. However, herbal ingredients should be light and pure to vent the Upper Jiao, eliminate phlegm, and transform heat.
Pathogens Binding in the Qi Level: Symptoms such as vomiting of ascarids while drinking, epigastric stuffiness, thirst, and a white tongue coating with yellow tinges indicate Damp-Heat binding in the Qi level, with disharmony in the Stomach causing ascarid rebellion. One should administer Erchen Tang (Two-Aged Phlegm Resolving Decoction) added with Ganjiang (Dried Ginger) and Huanglian (Coptis Rhizome). (Referencing Ye Tianshi’s medical cases.)
Shao's Commentary: This involves Phlegm-Fluids complicated by Damp-Heat binding in the Yangming Qi level. Stomach Heat causes Qi rebellion, leading to the expulsion of ascarids. Phlegm-Heat in the Stomach manifests as a white tongue coating with yellow tinges; internal pathogen binding causes epigastric stuffiness. Erchen Tang is used to resolve phlegm, while Ganjiang and Huanglian are used to open palpitations and expel pathogens.