成五两云耳。加减诸方。经止言加减。原无载方。旧本后人增补成方。类附卷末。而多谬误。今
根据增补校勘。移就各该法下。以便用者。不费寻讨云。
（十三）太阳病。头痛。发热。汗出。恶风者。桂枝汤主之。
此与前第二条。文虽差互详略。而证治则一。前条有脉无头痛以揭病名。此有头痛无脉以言治。
互相详略耳。无异殊也。盖前条以为揭病名也。故必言脉。而后可以为得尽其详。以头痛已见于
首条之太阳病也。故可得而略焉。此以从泛言而论治也。故虽不言脉不足以为略。详及头痛者。
以前条既遗。此申之。所以为互相发明之意也。桂枝汤。（方见前。下同。）
（十四）太阳病。发热汗出者。此为荣弱卫强。故使汗出。欲救邪风者。宜桂枝汤主之。
此亦申上条而释之。与前第三条申释第二条之意同。第三条言阳浮而阴弱。此言荣弱卫强。卫
强即阳浮。荣弱即阴弱。彼此互言而互相发明者也。救者。解救救护之谓。不曰风邪而曰邪风者。
以本体言也。
（十五）太阳病。初服桂枝汤反烦不解者。先刺风池风府。却与桂枝汤。则愈。
此乃默喻人以救服汤不如法。发汗不如经。因而生变者之微旨。读者当以意逆。斯则得之。
毋徒影射可也。盖桂枝全在服法。发汗切要如经。若服不如法。汗不如经。经曰。病必不除。岂
惟病不除。风愈得入而变愈剧。所以反烦。反。转也。言转加热闷也。先刺风池风府者。
预为杜塞风之门路也。风池二穴。在耳后陷者中。按之引于耳中。手足少阳脉之会。刺
可入同身寸之四分。风府。在项上入发际。同身寸之一寸。大筋内宛宛中。督脉阳维二经之会。刺
可入同身寸之四分。
（十六）太阳病。外证未解。脉浮弱者。当以汗解。宜桂枝汤。
外证未解。谓头痛项强恶寒等犹在也。浮弱。即阳浮而阴弱。此言太阳中风凡在未传变者。仍
当从于解肌。盖严不得下早之意。故下条云。
（十七）太阳病。外证未解者。不可下也。下之为逆。欲解外者。宜桂枝汤主之。
下。去声。后皆仿此。此承上条当汗解之旨。更并下早之禁而申言之。重致叮咛之意也。下。
通大便也。亦谓攻里是也。夫所谓治病之道者。即其病之所在从而疗理之。求所以去之之谓也。
病在东而疗西。欲其去也。其可得乎。盖风寒者。外邪也。皮肤肌肉者。人之外体也。外邪外入。
犹在外体。汗之。所以逐其还复外散。则于理为顺而于道为合也。下而通
大便。通腑也。腑。内也。病在外而求之内。欲何求哉。于理则不顺。故于道则颠倒悖戾而谓为
逆也。经曰。从外而之内者。治其外。正谓此也。故上下条反复深致戒谨如此。
（十八）太阳病。先发汗不解而复下之。脉浮者不愈。浮为在外而反下之。故令不愈。今
脉浮。故知在外。当须解外则愈。宜桂枝汤主之。
反。音板。下仿此。复。亦反也。此总上二条而申释之。重致反复叮咛戒谨之意。
（十九）风家。表解而不了了者。十二日愈。
风家。谓中风之病也。表。外证也。解。罢也。了了。犹惺惺也。言中风之病。外证俱罢。大势
已除。余邪未尽。犹未复初也。十二日。经尽之时也。言至此时。则余邪当悉去而初当复也。盖
晓人当静养以待。勿多事反扰之意。素问曰。食养尽之。毋使过之。伤其正也。此之谓也。
（二十）中风发热。六七日不解而烦。有表里证。渴欲饮水。水入则吐者。名曰水逆。五苓
散主之。
五苓散方
猪苓（十八铢去皮） 茯苓（十八铢） 泽泻（一两六铢） 白术（十八铢） 桂（半两）
上五味为散。以白饮和服方寸匕。日三。多服暖水。汗出愈。
散。上声。和。去声。此太阳中风失于未治。久而入里之证。盖中风发热。必自汗出。六七日
不解。出为过多可言也。烦者。汗出过多。亡津液而内燥也。表以外证未罢言。里以烦渴属腑言。
欲饮水者。燥甚而渴。希救故也。吐。伏饮内作。故外者不得入也。盖饮亦水也。以水得水。涌溢
而为格拒。所以谓之曰水逆也。泽泻长于行水。由其咸寒能走肾也。术性最善胜湿。以其苦甘而
益脾也。二苓淡渗。利水以滋干。桂擅辛甘。祛风而和表。然术与泽泻。有苓事也。桂与苓者。岂
非以其走阴而致师邪。谓五苓散两解表里而得汗者。里属腑。腑者。阳也。表本阳。所以一举而两
得。故曰汗出愈也。术上不当有白字。说在本草钞术条下。是书编始于叔和。叔和有脉经。脉经
术上皆无白字。足可征也。然则白为后人所加明甚。呜呼。一字之加虽微。自夫执方者视之。为
祸后世甚大。所谓杀人以政无异于刃者。此不殆有甚邪。
（二十一）太阳病不解。热结膀胱。其人如狂。血自下。下者愈。其外不解者。尚未可攻。
当先解外。外解已。但少腹急结者。乃可攻之。宜桃核承气汤。
桃核承气汤方
桃仁（五十个去皮尖） 桂枝（三两去皮） 大黄（四两） 芒硝（二两） 甘草（二两炙）
上五味。以水七升。煮取二升半。去滓。内芒硝。更上火。微沸。下火。先食温服五合。
日三服。当微利。
去。上。皆上声。内。音纳。更。下。先。皆去声。合。音鸽。后皆仿此。热结膀胱。即下
条太阳随经瘀热在里之互词。狂。心病也。心主血而属火。膀胱。居下焦而属水。膀胱热结。水
不胜火。心火无制。则热与血搏。不自归经。反侮所不胜而走下焦。下焦蓄血。心虽未病。以火
无制而反侮所不胜。故悖乱颠倒语言妄谬。与病心而狂者无异。故曰如狂也。血自下则邪热不
复停。故曰愈也。少腹。指膀胱也。急结者。有形之血蓄积也。桃仁。逐血也。桂枝。解外也。硝黄。
软坚而荡热也。甘草。甘平而缓急也。然则五物者。太阳随经入腑之轻剂也。先食。谓先服汤。而
饮食则续后进也。
（二十二）太阳病。六七日。表证仍在。脉微而沉。反不结胸。其人发狂者。以热在下焦。少
腹当硬满。小便自利者。下血乃愈。所以然者。以太阳随经瘀热在里故也。抵当汤主之。
抵当汤方
水蛭（三十个熬） 虻虫（三十个熬去翅足） 大黄（三两） 桃仁（二十个去皮尖）
上四味为散。以水五升。煮取三升。去滓。温服一升。不下。再服。
少。下血。不下之下。抵当之当。皆去声。瘀。影据切。去。上声。此承上条而复以其较重者言。
详其义。变制以出其治。上言不解。此言表证仍在。上言当先解外。此言脉与反不结胸。发狂。则
主血之心亦病。而重于如狂。硬满即急结。皆上条变文之互词。小便自利见下。下血。言不自下
者当须下之。皆互相发明者也。所以然者至末。结上起下以发出治之词。里。膀胱也。腑也。故曰随
经。瘀。血气壅秘也。抵。至也。水蛭虻虫。攻坚而破瘀。桃仁大黄。润滞而推热。四物者。虽曰
比上则为较剧之重剂。然亦至当不易之症治也。
（二十三）太阳病。身黄脉沉结。少腹硬。小便不利者。为无血也。小便自利其人如狂者。血
证谛也。抵当汤主之。
此总上二条而分晓之。以决言抵当为的于用之意。黄。瘀热外薄也。小便不利以下。承上文
以辨白上二条而分别之也。谛。审也。言如此则为血证审实。无复可疑。必须抵当者乃其的对。勉
人勿贰之意也。
（二十四）太阳病。发汗后。大汗出。胃中干。烦燥不得眠。欲得饮水者。少少与饮之。令胃
气和则愈。若脉浮。小便不利。微热消渴者。与五苓散主之。
燥。音埽。干。音干。令字。读平声。伤寒宜发汗。发汗则病解。中风宜解肌。发汗则变生。
然则太阳病发汗后。大汗出者。中风误于发汗。变也。胃中干者。汗出过多亡津液也。烦燥者。干则燥。
燥则热。热则烦也。不得眠者。胃为阴。干则不足。不足则不和。不和。所以不得眠也。素问曰。
胃不和。则卧不安。此之谓也。欲得饮水者。热思凉而燥作渴。引水以自救也。少少
与者。胃属土。土干固燥。得水则润。润则和。和则万物生。所以愈也。不然多则涝。涝则反为
土所恶矣。若脉浮。言或不即
愈。而脉又转单浮之谓。浮则邪见还表可知矣。小便不利。土干则水竭也。微热。邪还表则病已
减。故热亦轻也。消。言饮水而小便又不利。则其水有似乎内自消也。渴。言能饮且能多也。五苓
散者。导湿滋干。功兼其全也。干得滋而湿得导。则热不期退而自退。病不言愈而愈可知。此又
用五苓之一义也。（方见前）
（二十五）太阳病。发汗。汗出不解。其人仍发热。心下悸。头眩身 动。振振欲擗地者。真
武汤主之。
悸。群季切。眩。匣绢切。 。日伦切。振。平声。擗。滂吉切。此举下编首条末后为逆之
一节。更互其词以详其义。出其治以救其逆。盖太阳中风。误服大青龙而致逆之救法也。发汗而
病不解者。其为误汗可知也。仍发热。言汗虽出。病依旧在也。悸。怔忡也。眩。昏晕也。 。
HT动也。振振。振作也。擗。拊心也。言心怔而忡。头昏而晕。肉HT 而动。手拊心而无何可奈。
厥逆筋惕肉 变文之互词也。夫太阳。中风。阳浮阴弱。汗出恶风。例虽名曰发汗。义则实在解肌。
解肌者。桂枝汤也。法曰。遍身 。微似汗者益佳。不可令如水流漓。病必不除。苟至流漓。岂
惟病不除。多见亡阳而虚甚也。微弱与浮弱大略相仿佛。亦互文也。汗出恶风。桂枝证也。服大
青龙。势必流漓可知。仍发热。翕翕不除而变甚也。厥逆而至于振振欲擗地。
啬啬淅淅变剧也。病变剧矣。亡阳虚甚矣。大敌在前。良将重选。是故茯苓行水。术性导湿。湿导水
行。祖龙归海也。芍药收阴。附子回阳。阳回阴收。铁甲当关也。生姜以醒其昏。为救厥逆之剧。
盖龙之为龙。方其旱也。固奋然升天行雨以显诸仁。及其涝也。则又幡然蹈海潜渊以藏诸用。行雨
者。致水也。潜渊者。伏水也。然则水也者。龙之所以神其变化者也。而真武者。则又专位乎北。
而为司水之神也。龙既不能外水以自神。水又必由真武以神其主。大哉青龙。吾知其不能
不降于真武矣。道之所符而自然之验固如是夫。是故误服神汤而变剧者。必有神汤而后救也。神
乎神乎。圣而不可知之之谓。此非细义。读者最宜致思。（方见少阴篇）
（二十六）太阳病。发汗。遂漏不止。其人恶风。小便难。四肢微急。难以屈伸者。桂枝加附子汤主之。
桂枝加附子汤方
于桂枝汤方内加附子三枚。余根据桂枝汤法。
此亦太阳中风误汗之变证。发汗。遂漏不止者。由反治。所以汗反出而势不容已也。恶风者。
太阳中风本自汗出腠理疏而恶风。既漏不止。则腠理愈疏而恶愈甚也。小便难者。汗漏不止。则亡
阳亡津液。亡阳则气不足。亡津液则水道枯竭。且小便者。膀胱所司也。膀胱本太阳经而为诸阳
主气。气不足则化不行也。四肢微急难以屈伸者。脾统血而主四肢。胃司津液而为之合。津液亡
而胃不足。则脾亦伤而血亦亏。血气亏涩。筋骨所以不利也。夫固表敛液。无出桂枝之
右矣。而欲复阳益气。所以有附子之加焉。然三枚盖出于增补。非经之本文。用者宜 酌。
（二十七）风湿相抟。骨节烦疼掣痛。不得屈伸。近之则痛剧。汗出短气。小便不利。恶风不
欲去衣。或身微肿者。甘草附子汤主之。
甘草附子汤方
甘草（二两炙） 附子（二枚炮去皮脐破） 白术（二两） 桂枝（四两去皮）
上四味。以水六升。煮取三升。去滓。温服一升。日三服。初服得微汗则解。能食汗出复烦者。
服五合。恐一升多者。宜服六七合为妙。
抟。定文切。剧。群吉切。去。溪矩切。抟。 聚也。言风与湿 合团聚。共为一家之病也。有本
来感受天地之风湿。而为风湿相抟者。有中风汗出过多。湿沾衣被。致成风湿相抟者。有伤寒发汗
过多。衣被不更。变而为风湿相抟者。三者所受之因虽殊。而其为病则一。故其为治亦皆大略相同。
此盖以中风之风湿相搏而言。烦。风也。痛。湿也。风淫则掣。湿淫则痛。风湿之邪。注经络。
流关节。渗骨髓。四体所以烦疼掣痛而不利也。近之则痛剧者。外邪客于内。迕之则逆也。短气者。
汗多亡阳而气伤也。恶风不欲去衣者。以重伤故恶甚也。或。未定之词。身微肿。湿外薄也。不外薄
则不肿。故曰或也。甘草益气和中。附子温经散湿。术能胜水燥脾。桂枝祛风固卫。此四物者。所
以为风湿相搏之的药也。
（二十八）太阳病。中风。以火劫发汗。邪风被火热。血气流溢。失其常度。两阳相熏灼。其
身发黄。阳盛则欲衄。阴虚则小便难。阴阳俱虚竭。身体则枯燥。但头汗出。剂颈而还。腹满而喘。
口干咽烂。或不大便。久则 语。甚者至哕。手足躁扰。捻衣摸床。小便利者。其人可治。
衄。疑木切。 。素问作谵。与詹同。下仿此。强夺而取之之谓劫。邪风被火热。承上起下之词。
It is merely five liang. Regarding the various formulas with modifications, the Classic only mentions "modifications" without recording the original formulas. The old editions contain formulas added by later generations, mostly appended to the end of the volume, but they are often erroneous. Now, based on these additions, I have collated and corrected them, moving them under their respective treatment methods for the convenience of users, so they do not need to waste time searching.
(13) In Taiyang disease (disease of the Taiyang channel), characterized by headache (headache), fever (fever), sweating (sweating), and aversion to wind (aversion to wind), Guizhi Tang (Cinnamon Twig Decoction) is the primary treatment.
This clause corresponds to the second clause previously; although the text varies in detail and brevity, the syndrome and treatment principles are identical. The previous clause mentioned pulse but omitted headache to highlight the disease name; this clause mentions headache but omits pulse to explain the treatment. This is a mutual elaboration and omission, with no difference in essence. The previous clause needed to mention the pulse to fully elaborate on the disease name, as the headache was already stated in the first clause of Taiyang disease, allowing it to be omitted here. This clause discusses treatment from a general perspective, so omitting the pulse is not considered an omission. The detailed mention of headache serves to supplement what was left out in the previous clause, illustrating the intent of mutual clarification. Guizhi Tang (see formula above, same below).
(14) In Taiyang disease, if there is fever and sweating, it is due to Ying (Nutrient) weakness and Wei (Defensive) strength, which causes sweating. To resolve the pathogenic wind, Guizhi Tang (Cinnamon Twig Decoction) is appropriate.
This also elaborates on the previous clause, similar to how the third clause explains the second. The third clause states "Yang floating and Yin weak," while this one says "Ying weak and Wei strong." Wei strength is Yang floating, and Ying weakness is Yin weak; they speak of each other to mutually clarify. "Rescue" means to relieve or save. Saying "pathogenic wind" instead of "wind pathogen" refers to its ontological nature.
(15) In Taiyang disease, if after taking Guizhi Tang (Cinnamon Twig Decoction) initially, one feels aggravated irritability that does not resolve, first puncture Fengchi (GB20) and Fengfu (GV16) acupoints, then administer Guizhi Tang (Cinnamon Twig Decoction), and the patient will recover.
This implicitly teaches the subtle principle regarding changes arising from improper medication administration or deviating from canonical sweating methods. Readers should infer this meaning rather than making forced analogies. The key to Guizhi Tang lies in the method of administration; sweating must follow canonical guidelines. If administered improperly or if sweating does not follow the canon, the Classic states: "The disease will certainly not be resolved." Not only will the disease persist, but the wind pathogen will penetrate deeper, causing more severe complications, leading to aggravation. "Fan" (reverse/aggravated) implies a change into intensified heat and stifling sensation. Puncturing Fengchi and Fengfu beforehand aims to block the entry points of wind. Fengchi (GB20) is located in the depression behind the ear, where pressure radiates to the ear; it is the meeting point of the Hand and Foot Shaoyang channels. Needling depth is four fen (cun). Fengfu (GV16) is located one cun above the hairline at the nape, within the depression inside the major tendons; it is the meeting point of the Du Mai (Governing Vessel) and Yangwei Mai (Linking Vessel of the Yang). Needling depth is four fen.
(16) In Taiyang disease, if the exterior syndrome has not resolved and the pulse is floating and weak, it should be resolved through sweating, using Guizhi Tang (Cinnamon Twig Decoction).
"Exterior syndrome not resolved" means symptoms like headache, neck stiffness, and aversion to cold persist. Floating and weak pulse indicates Yang floating and Yin weak. This refers to Taiyang Wind Strike syndromes that have not yet transmitted; they should still be treated by resolving the muscle layer (Jie Ji). This strictly warns against premature purgation, hence the next clause states:
(17) In Taiyang disease, if the exterior syndrome has not resolved, purgation (Xia) must not be used. Using purgation is contrary to the proper approach. To resolve the exterior, Guizhi Tang (Cinnamon Twig Decoction) is appropriate.
"Purgation" (Xia) is pronounced with the departing tone. This follows the principle of the previous clause regarding resolving via sweating and reiterates the prohibition against premature purgation, emphasizing caution. Purgation refers to promoting bowel movements, also known as attacking the interior. The way of treating disease is to address the location of the pathology to eliminate it. Treating the west when the disease is in the east cannot remove the disease. Wind and cold are exterior pathogens; skin and muscles constitute the external body. When exterior pathogens enter from outside, remaining in the external body, sweating expels them back to the surface, which is consistent with reason and the Dao. Purgation promotes bowel movements and unblocks the Fu organs (hollow organs), which are internal. Seeking internal solutions for external diseases is illogical and contrary to the Dao, thus termed "contrary" (Ni). The Classic states: "For diseases entering from the exterior, treat the exterior." This is precisely what is meant. Hence, the preceding and following clauses repeatedly warn with deep caution.
(18) In Taiyang disease, if sweating fails to resolve the condition and purgation is subsequently applied, but the pulse remains floating, the disease persists. A floating pulse indicates the pathogen is still exterior; applying purgation inappropriately prevents recovery. Since the pulse is now floating, we know the pathogen is still exterior. It is necessary to resolve the exterior to achieve recovery; Guizhi Tang (Cinnamon Twig Decoction) is appropriate.
"Fan" (reverse) is pronounced like "ban." "Fu" (again/repeat) also implies reversal. This summarizes and explains the previous two clauses, reiterating the warning.
(19) For those prone to wind diseases, if the exterior syndrome resolves but the patient remains uncomfortable or unclear-headed, recovery occurs after twelve days.
"Feng jia" (Wind family/person) refers to Wind Strike disease. "Biao" (Exterior) refers to exterior symptoms. "Jie" (Resolve) means to cease. "Liao liao" means clear-headed or comfortable. It means that although the major exterior symptoms of Wind Strike have ceased and the main pathogen is gone, residual pathogens remain, and the body has not fully recovered. Twelve days mark the completion of a meridian cycle. By this time, residual pathogens should be eliminated, and normal health restored. This advises patients to rest quietly and avoid excessive activity that might disturb healthy Qi. The *Su Wen* states: "Use dietary therapy to eliminate residual pathogens; do not overdo it, lest you damage healthy Qi." This is what is meant.
(20) In Wind Strike with fever, if after six or seven days the condition has not resolved and irritability arises, presenting both exterior and interior signs, thirst with desire to drink water, but vomiting immediately after drinking, this is named Shui Ni (Water Reversal). Wuling San (Five-Ingredient Powder with Poria) is the primary treatment.
Formula for Wuling San (Five-Ingredient Powder with Poria):
Zhu Ling (Polyporus, peeled, 18 zhu) Fu Ling (Poria, 18 zhu) Ze Xie (Alisma, 1 liang 6 zhu) Bai Zhu (Atractylodes Macrocephala, 18 zhu) Gui Zhi (Cinnamon Twig, half liang)
Grind the above five ingredients into a powder. Mix with rice water and take one fang cun bi (square-inch measure) per dose, three times daily. Drink plenty of warm water afterwards; recovery comes with sweating.
"San" (Powder) is pronounced with the rising tone. "He" (Mix) is pronounced with the departing tone. This syndrome results from untreated Wind Strike in Taiyang, where the pathogen enters the interior over time. Wind Strike with fever typically involves spontaneous sweating. If unresolved after six or seven days, excessive sweating has occurred. Irrability arises from fluid loss and internal dryness. "Exterior" refers to unresolved exterior symptoms; "Interior" refers to irritability and thirst associated with Fu organ dysfunction. Thirst indicates severe dryness seeking relief. Vomiting occurs because retained fluids (Yin) obstruct intake. Water meets water, causing overflow and rejection, hence "Water Reversal." Ze Xie promotes water metabolism via its salty-cold nature targeting the Kidney. Bai Zhu overcomes dampness via its bitter-sweet nature benefiting the Spleen. Zhu Ling and Fu Ling are bland and permeable, promoting urination to moisten dryness. Gui Zhi uses pungent-sweet properties to dispel wind and harmonize the exterior. However, Bai Zhu and Ze Xiang require Poria to assist. Gui Zhi and Poria work together to guide energy inward. Wuling San resolves both exterior and interior, inducing sweating. The interior belongs to Fu organs (Yang); the exterior is originally Yang. Thus, one action achieves two goals, hence "recovery with sweating." The character "Bai" (White) before Bai Zhu is incorrect; see *Ben Cao Chao*. Wang Shuhe's *Mai Jing* also lacks this character, confirming it was added later. Though minor, such errors can be harmful to future practitioners.
(21) In Taiyang disease, if unresolved, heat accumulates in the Bladder. The patient exhibits manic-like behavior. If blood passes spontaneously, the patient recovers. If exterior symptoms persist, attack (purgation/blood-draining) is not yet indicated. Resolve the exterior first. Once the exterior is resolved, if only the lower abdomen is tense and knotted, then attack is possible; Taohe Chengqi Tang (Peach Kernel Decocture to Order the Qi) is appropriate.
Formula for Taohe Chengqi Tang (Peach Kernel Decocture to Order the Qi):
Tao Ren (Peach Seed, peeled and tip removed, 50 pieces) Gui Zhi (Cinnamon Twig, peeled, 3 liang) Da Huang (Rhubarb, 4 liang) Mang Xiao (Mirabilite, 2 liang) Gan Cao (Licorice, roasted, 2 liang)
Boil the above five ingredients in seven sheng of water to obtain two and a half sheng. Strain, add Mang Xiao, boil briefly, then remove from heat. Take five ge (approx. 100ml) warm before meals, three times daily. Mild laxation is expected.
"Heat accumulating in the Bladder" is synonymous with "Sunjing stasis-heat in the interior" in the next clause. Mania is related to the Heart. The Heart governs blood and belongs to Fire; the Bladder is in the Lower Jiao and belongs to Water. Bladder heat accumulation leads to Water failing to control Fire. Unchecked Heart Fire causes heat and blood to bind, deviating from their channels and affecting the Lower Jiao. Stasis in the Lower Jiao affects the Heart indirectly due to unchecked Fire, causing confusion and delirium similar to true mania, hence "manic-like." Spontaneous bleeding removes the pathogenic heat, leading to recovery. "Lower abdomen" refers to the Bladder area. "Tense and knotted" indicates有形 (solid) blood accumulation. Tao Ren expels blood stasis; Gui Zhi resolves the exterior; Mang Xiao and Da Huang soften hardness and purge heat; Gan Cao moderates urgency. These five herbs form a mild formula for Taiyang pathogen entering the Fu organ. "Before meals" means taking the decoction prior to food.
(22) In Taiyang disease, after six or seven days, if exterior signs persist, the pulse is faint and deep, and there is no Jie Xiong (Chest Binding), but the patient is manic, it is because heat is in the Lower Jiao. The lower abdomen should be hard and full. If urination is normal, bleeding will lead to recovery. This is because Taiyang pathogen followed the channels, causing stasis-heat in the interior. Shuidang Tang (Dare-to-Go Decoction) is the primary treatment.
Formula for Shuidang Tang (Dare-to-Go Decoction):
Shui Zhi (Leech, processed, 30) Meng Chong (Dragonfly Larva, wings/legs removed, processed, 30) Da Huang (Rhubarb, 3 liang) Tao Ren (Peach Seed, peeled and tip removed, 20)
Grind the above four ingredients into a powder. Boil in five sheng of water to obtain three sheng. Strain. Take one sheng warm. If no effect, take another dose.
"Shao," "Xia Xue," "Bu Xia," and "Dang" in Shuidang are all pronounced with the departing tone. "Yu" is pronounced "ying ju qie." This continues from the previous clause using a heavier formula. Comparing meanings: "Exterior signs persist" contrasts with "Unresolved"; "Pulse and no Jie Xiong" contrasts with "Resolve exterior first"; "Mania" indicates Heart involvement, heavier than "Manic-like"; "Hard and full" is synonymous with "Tense and knotted"; "Normal urination" and "Bleeding required" are mutually clarifying. From "The reason being..." to the end, summarizes and introduces the treatment. "Interior" refers to the Bladder/Fu organ, hence "following the channels." "Yu" means blood/qi stagnation. "Di" means arrival. Leech and Dragonfly larva break hardness and stasis; Peach Kernel and Rhubarb moisten stagnation and push out heat. Although heavier than the previous formula, it is the correct treatment for this severe condition.
(23) In Taiyang disease, if the body is yellow, pulse is deep and knotted, lower abdomen is hard, and urination is difficult, there is no blood stasis. If urination is normal and the patient is manic-like, blood stasis is confirmed. Shuidang Tang (Dare-to-Go Decoction) is the primary treatment.
This distinguishes the previous two clauses to confirm the use of Shuidang Tang. "Yellow" results from stasis-heat pressing outward. The section on "urination difficulty" differentiates the previous clauses. "Di" means certain/clear. This confirms blood stasis beyond doubt, urging decisive use of Shuidang Tang.
(24) In Taiyang disease, after sweating, if profuse sweating occurs, causing dryness in the Stomach, irritability, insomnia, and desire to drink water, give small amounts of water frequently. When Stomach Qi harmonizes, the patient recovers. If the pulse is floating, urination is difficult, there is slight fever, and polydipsia, Wuling San (Five-Ingredient Powder with Poria) is the primary treatment.
"Sweating" is appropriate for Cold Damage (Taiyin/Shao-Yang/Yangming patterns may differ, but here referring to Taiyang). Sweating resolves the disease; however, for Wind Strike, resolving the muscle layer is correct, while forcing sweat causes complications. Profuse sweating after Taiyang treatment indicates mismanagement of Wind Strike, leading to complication. Stomach dryness results from fluid loss. Irrability stems from dryness turning to heat. Insomnia occurs because the Stomach (Yin) is deficient and disharmonious. The *Su Wen* states: "If the Stomach is disharmonious, sleep is uneasy." Desire to drink water reflects heat seeking coolness and self-rescue. Giving small amounts allows the Earth element (Stomach) to absorb moisture, restoring harmony and health. Excess water causes flooding, which the Earth dislikes. If the pulse becomes floating, it suggests the pathogen returning to the exterior. Difficulty in urination indicates fluid depletion due to dry Earth. Slight fever indicates the pathogen retreating. "Xiao" (consume) refers to drinking water but poor urination, making it seem like water is consumed internally. "Ke" (thirst) implies ability to drink large amounts. Wuling San guides dampness and nourishes dryness. Nourishing dryness and guiding dampness allows heat to subside naturally. This is another application of Wuling San. (See formula above).
(25) In Taiyang disease, after sweating, if the condition does not resolve, the patient still has fever, palpitations, dizziness, tremors, and feels as if falling to the ground, Zhenwu Tang (True Warrior Decoction) is the primary treatment.
This addresses the adverse outcome described at the end of the first clause in the Lower Chapter, rephrasing to clarify the syndrome and treatment to rescue from error. It likely refers to correcting the adverse effects of mistakenly administering Da Qinglong Tang (Major Green Dragon Decoction) for Taiyang Wind Strike. Failure to resolve after sweating indicates erroneous sweating. Persistent fever means the disease remains despite sweating. Palpitations refer to anxiety/fear; dizziness to vertigo; tremors to muscle twitching. "Zhenzhen" means shaking; "Pi" means clutching the heart. This describes severe Yang collapse and fluid loss. The method for Taiyang Wind Strike is resolving the muscle layer with Guizhi Tang, aiming for slight perspiration, not profuse sweating. Profuse sweating leads to Yang collapse. Weak pulse resembles floating-weak pulse. Taking Da Qinglong Tang inevitably causes profuse sweating. The progression to trembling and near-falling indicates severe deterioration and Yang collapse. Therefore, Fu Ling moves water, Bai Zhu guides dampness, Shao Yao collects Yin, and Fu Zi restores Yang. Ginger awakens consciousness. This analogy compares the situation to dragons controlling water; Zhenwu Tang targets the North/Water deity to manage this crisis. Misusing powerful herbs requires specific countermeasures. Readers should ponder this deeply. (See Shaoyin Chapter for formula).
(26) In Taiyang disease, after sweating, if sweating continues uncontrollably, the patient has aversion to wind, difficulty urinating, slight stiffness in the four limbs, and difficulty bending/extending, Guizhi Jia Fuzi Tang (Guizhi Decoction with Added Aconite) is the primary treatment.
Formula for Guizhi Jia Fuzi Tang (Guizhi Decoction with Added Aconite):
Add three pieces of Fu Zi (Aconite) to the Guizhi Tang formula. Follow Guizhi Tang preparation methods otherwise.
This is a complication of erroneous sweating in Taiyang Wind Strike. Uncontrollable sweating results from improper treatment. Aversion to wind worsens because pores remain open. Difficulty urinating results from loss of Yang Qi and fluids, depleting the Bladder's transformative power. Limb stiffness occurs because fluid loss damages the Spleen and Blood, affecting sinews and bones. Guizhi Tang secures the exterior and retains fluids; adding Fu Zi restores Yang and boosts Qi. Note: Three pieces of Fu Zi may be a later addition; users should exercise judgment.
(27) When Wind and Dampness intertwine, causing severe joint pain, pulling pain, inability to bend or extend, exacerbated by touch, sweating, shortness of breath, difficulty urinating, aversion to wind with reluctance to remove clothing, or slight swelling, Gancao Fuzi Tang (Licorice and Aconite Decoction) is the primary treatment.
Formula for Gancao Fuzi Tang (Licorice and Aconite Decoction):
Gan Cao (Licorice, roasted, 2 liang) Fu Zi (Aconite, roasted, peeled, umbilicus removed, broken, 2 pieces) Bai Zhu (Atractylodes Macrocephala, 2 liang) Gui Zhi (Cinnamon Twig, peeled, 4 liang)
Boil the above four ingredients in six sheng of water to obtain three sheng. Strain. Take one sheng warm, three times daily. Initial dose should produce slight sweating for relief. If appetite returns but sweating causes irritability, reduce dose to five he. If one sheng is too much, 6-7 he is optimal.
"Tuan" means gathering. Wind and Dampness combine to cause disease. Causes include original exposure, excessive sweating with wet clothes, or excessive sweating with unchanged bedding. Treatments are generally similar. "Fan" relates to Wind; "Tong" relates to Dampness. Wind causes pulling; Dampness causes pain. Pathogens invade meridians and joints. Touch exacerbates pain due to external pathogens conflicting internally. Shortness of breath results from Qi loss via sweating. Aversion to wind indicates severe injury. Slight swelling indicates external Dampness. Gan Cao tonifies Qi and harmonizes middle; Fu Zi warms meridians and disperses Dampness; Bai Zhu dries Spleen and controls water; Gui Zhi dispels Wind and secures Defense. These four herbs treat Wind-Damp intertwining.
(28) In Taiyang disease with Wind Strike, if fire therapy is forcibly used to induce sweating, the wind pathogen combines with fire heat. Blood and Qi flow excessively, losing their normal rhythm. Two Yangs scorch each other, causing jaundice. Excess Yang leads to epistaxis; Yin deficiency leads to difficult urination. If both Yin and Yang are depleted, the body becomes dry and rough. Only head sweating occurs, stopping at the neck. Abdominal fullness and wheezing, dry mouth, rotten throat, or constipation may occur. Long-term, delirium may arise; severely, hiccups, restlessness, picking at clothes, and bed-touching may occur. If urination is free, the patient is treatable.
"Nu" (epistaxis) is pronounced "yi mu qie." "Chan" (delirium) is written as "Zhan" in Su Wen. "Jie" (force/coerce) means taking by force. "Xie feng bei huo re" connects the preceding and following text.