凡是表证法当汗之,根据法汗之,其病又不解。汗后不解,其证前后别无异证者,通宜凉膈散(二十
三)调之,以退其热,无使热甚危极也。除此之外,远胜小柴胡汤。两感至此而已,汗后余热用益元散
(五十二)、或小柴胡汤(九)、崔宣武人参石膏汤(三十六)。伤寒大发汗,汗出不解,反无汗,脉
尚浮者,苍术白虎汤(二十三)解之。伤寒用桂枝汤发汗后半日许,复热烦,脉浮者,再宜桂枝汤(二);
汗后不解,下证未全者,白虎汤(二十三);汗后烦躁不得眠,微热而渴,五苓散
(二十四);汗后不解,里外有热,口干烦渴,柴胡饮子(四十七);解表之后尚未
愈者,解毒(二十一)、凉膈(二十三)、天水散(五十二),能调顺阴阳,洗涤脏腑。
凡是里证法当下之,根据法下之,其病又不解。或大下后,或再三下后,热势尚甚而不退,本气虚
损而不能实,拟更下之,恐下脱而立死,不下之则热极而死,寒凉诸药不能退其热势之甚者;或湿热
内余,下利不止,热不退者;或因大下后,湿热利不止而热不退,脉弱气虚不可更下者;或诸湿热
内余,小便赤涩,大便溏泄,频并少腹而急痛者,必欲作痢也,通宜黄连解毒汤(二十一)以解之。
伤寒下之太过,胃中无热,饮水无力,白术散(四十二)。又有大下之后,其热不退,再三下之热愈甚,
若下之不止,其人脉微气虚,气弱不加,以法无可生之理。至此下之亦死、不下亦死,但用凉膈(二
十一)合解毒汤(二十三)调之,阳热退除,阴脉渐生,为之妙法。下之前后无问日数,余热不解,小
柴胡汤(九)。汗下后胃虚,大橘皮汤(三十九)。汗下后胸膈满闷,赤茯苓汤(四十)。
For all exterior syndromes, the treatment method should be sweating. If, according to the standard sweating method, the disease remains unresolved after sweating, and there are no other significant changes in symptoms before and after, it is generally appropriate to regulate with Liangge San (Cooling the Diaphragm Powder) [Formula 23] to reduce heat, preventing it from becoming critically severe. Apart from this, it is far superior to Xiaochaihu Tang (Minor Bupleurum Decoction). For Lianggan (simultaneous involvement of Taiyang and Shaoyin or Yangming and Taiyin) reaching this stage, for residual heat after sweating, Yiyuan San (Benefit the Origin Powder) [Formula 52], or Xiaochaihu Tang [Formula 9], or Cui Xuanwu's Ginseng and Gypsum Decoction [Formula 36] may be used. After severe sweating in Shanghan (Cold Damage), if sweating occurs but the disease does not resolve, and instead there is no sweating with a still floating pulse, Cangzhu Baizhu Tang (Atractylodes Macrocephala and White Tiger Decoction) [Formula 23] should be used to resolve the pathogen. In Shanghan, half a day after taking Guizhi Tang (Cinnamon Twig Decoction) to induce sweating, if fever and irritability recur with a floating pulse, Guizhi Tang [Formula 2] should be administered again; if the disease remains unresolved after sweating but the interior excess syndrome (Xi Zheng) is not fully formed, Baihu Tang (White Tiger Decoction) [Formula 23] is indicated; if after sweating there is irritability, insomnia, slight fever, and thirst, Wuling San (Five-Ingredient Poria Pill) [Formula 24] is used; if after sweating the disease remains unresolved, with heat in both interior and exterior, dry mouth, irritability, and thirst, Chaihu Yinzi (Bupleurum Infusion) [Formula 47] is used; if after resolving the exterior the illness has not yet healed, Jiedu Tang (Detoxification Decoction) [Formula 21], Liangge San [Formula 23], or Tianshui San (Heavenly Water Powder) [Formula 52] can be used to harmonize Yin and Yang and cleanse the Zang-Fu organs.
For all interior syndromes, the treatment method should be purgation. If, according to the standard purgative method, the disease remains unresolved. Or after massive purgation, or repeated purgations, if the heat intensity remains severe and does not subside, while the root Qi (Zheng Qi) is deficient and unable to solidify, intending to purge again risks immediate death due to collapse from purgation; failing to purge leads to death from extreme heat, and cold-cooling herbs cannot reduce such severe heat; or if damp-heat remains internally causing persistent diarrhea without heat reduction; or if after massive purgation, damp-heat causes persistent diarrhea without heat reduction, and the pulse is weak with Qi deficiency making further purgation inadvisable; or if various damp-heats remain internally causing red and scanty urine, loose stools, frequent urgency, and acute pain in the lower abdomen, indicating impending dysentery (Li Ji), then Huanglian Jiedu Tang (Coptis Detoxification Decoction) [Formula 21] is generally appropriate to resolve the condition. If Shanghan is over-purgated, leaving no heat in the Stomach, resulting in inability to drink water effectively, Baizhu San (Atractylodes Macrocephala Powder) [Formula 42] is used. Furthermore, after massive purgation, if heat does not subside and repeated purgations make the heat worse, if purgation continues indefinitely, the patient presents with a faint pulse and Qi deficiency, where Qi weakness cannot be replenished, leaving no rational basis for survival according to standard methods. At this point, purging leads to death, and not purging also leads to death; only by using Liangge San [Formula 21] combined with Jiedu Tang [Formula 23] for regulation, allowing Yang-heat to retreat and Yin pulses to gradually regenerate, can a miraculous outcome be achieved. Regardless of whether it is before or after purgation, and irrespective of the number of days passed, if residual heat remains unresolved, Xiaochaihu Tang [Formula 9] is used. After sweating and purgation leading to Stomach deficiency, Daju Pi Tang (Large Tangerine Peel Decoction) [Formula 39] is used. After sweating and purgation leading to fullness and oppression in the chest and diaphragm, Chi Fuling Tang (Red Poria Decoction) [Formula 40] is used.