上三味。以水一斗。先煮茵陈减六升。内二味。煮取三升。去滓。分。温三服。小盒饭利。
尿如皂角汁状。色正赤。一宿腹减。黄从小便去也。
越。散也。头汗。瘀热。发黄。皆见太阳篇。茵陈逐湿郁之黄。栀子除胃家之热。大黄推壅
塞之瘀。三物者苦以泄热。热泄则黄散也。
（六十三）阳明病。面合赤色。不可攻之。必发热色黄。小便不利也。
合。应也。赤。热色也。阳明之脉起于鼻。胃热上行。面应赤色。攻则亡津液。故发热色黄。
小便不利。
（六十四）阳明病。无汗。小便不利。心中懊 者。身必发黄。
无汗。小便不利。则湿停。懊 。湿停热郁也。所以知黄必发也。
（六十五）阳明病。被火。额上微汗出。小便不利者。必发黄。
阳明之脉。循发际。至额颅。故被火热甚。汗出额上也。黄。火迫土也。
（六十六）阳明病。下血谵语者。此为热入血室。但头汗出者。刺期门。随其实而泻之。
然汗出。则愈。
血室。头汗。期门。皆见太阳篇。阳明之脉。其直者从缺盆下乳内廉。下挟脐。入气街中。
血室之脉。起于气街。上行至胃中而散。所以妇人热入血室。则似结胸而谵语。阳明热入血室。
则亦谵语下血。男顺女逆。道则同也。故亦刺期门。
（六十七）阳明病证。其人喜忘者。必有蓄血。所以然者。本有久瘀血。故令喜忘。屎虽硬。
大便反易。其色必黑。宜抵当汤下之。
喜忘。好忘前言往事也。志伤则好忘。然心之所之谓志。志伤则心昏。心昏则血滞。所以知
必有蓄血也。大便反易。血主滑利也。黑血色也。方见太阳上编。
（六十八）病患无表里证。发热七八日。虽脉浮数者。可下之。假令已下。脉数不解。合热。
则消谷善饥。至六七日不大便者。有瘀血。宜抵当汤。
表谓无太阳。里谓胃不实。虽脉浮数。可下者久也。合热。谓数阳不退。热亦应未除也。
善饥。犹言快饥也。不大便有瘀血。大意与血证反复略同。此疑太阳篇错简。
若脉数不解而下不止。必协热而便脓血也。
抵当下之。数仍不退。热未除也。利不止。所以知协热必便脓血也。
（六十九）阳明病。发潮热。大便溏。小便自可。胸胁满不去者。小柴胡汤主之。
潮热。少阳阳明之涉疑也。大便溏。小便自可。胃不实也。胸胁满不去。则潮热仍属少阳。
明矣。故须仍从小柴胡。方见太阳上。
（七十）阳明病。胁下硬满。不大便而呕。舌上白苔者。可与小柴胡汤。上焦得通。津液得
下。胃气因和。身 然而汗出解也。
此承上条而言。即使不大便。而胁下硬满在。若有呕与舌苔。则少阳为多。亦当从小柴胡。上
焦通。硬满开也。津液下。大便行也。百体皆受气于胃。故胃和则身和。汗出而病解。方见太阳上。
（七十一）二阳并病。太阳证罢。但发潮热。手足 汗出。大便难而谵语者。下之则愈。宜大
承气汤。
此以太阳阳明言。谓须太阳罢。方可治阳明之意。
（七十二）阳明少阳合病。必下利。其脉不负者。顺也。负者。失也。互相克贼。名为负也。
脉滑而数者。有宿食也。当下之。宜大承气汤。
阳明属土。其主水谷。少阳属木。其主风。风主飧泄。故知下利可必也。阳明脉大。少阳脉
弦。不负。谓大而不弦。无相胜负而相得也。失。得之反也。谓弦则木克土。不大则土受木贼。少
阳胜而阳明负。为不相得。犹言不宜也。滑主食。数主热。宿食可知也。大承气汤者。陈宜推。
所以通因通用也。
（七十三）三阳合病。腹满身重。难以转侧。口不仁而面垢。谵语。遗尿。发汗则谵语甚。
下之则额上生汗。手足逆冷。若自汗出者。白虎汤主之。
阳明主胃。胃主肌肉而通窍于口。不仁。胃不正而饮食不利便。无口之知觉也。然则腹满身重。
不仁谵语。阳明也。灵枢曰。足少阳之正。上肝贯心以上。挟咽出颐颔中。散于面。故又曰。是
动则病口苦。善太息。心胁痛。不能转侧。甚则面微有
尘。垢亦尘也。遗尿。太阳膀胱不约也。故曰三阳合病。五合之表里俱伤也。发汗则偏攻太阳。
邪并于阳明。而谵语益甚。下则偏攻阳明。不惟阴虚。而阳亦损。故手足逆冷。而额上生汗。生。
不流也。是则汗下皆不可也。自汗者邪遍三阳。热搏五合。卫疏而表不固。荣弱而里不守也。夫
汗下既皆不可。和之于少阳。则亦偏于一而非所宜。是故白虎者。能解秋而彻表里之热。所以又
得为三阳通该之一解也。然病属三阳。治又不从阳明。而类阳明篇者。一则阳明居多。二则阳明
属土。土者万物之所归。而病之吉凶生死机焉。所以归重于阳明而入其类例。此又叔和之深意也。
方见太阳下。
（七十四）伤寒发汗已。身目为黄。所以然者。以寒湿在里不解故也。以为不可下也。于寒
湿中求之。
上为。去声。此揭下文三条之总。湿以汗发不对言。详见痉湿 篇中。里以黄言。不可下者。
里非表里之里也。寒湿中求之。以下文三条言也。
（七十五）伤寒瘀热在里。身必发黄。麻黄连轺赤小豆汤方
麻黄（二两） 赤小豆（一升） 杏仁（四十枚去皮尖） 连轺（二两连翘根也） 大枣
（十二枚劈） 生姜（一两切） 甘草（一两炙） 生梓白皮（一升切）
以上八味。以潦水一斗。先煮麻黄再沸。去上沫。内诸药。煮取三升。分。温三服。半日服尽。
此条互上条之文以出治。并下二条乃三目也。麻黄甘草杏仁。利气以散寒。麻黄汤中之选要
也。连轺小豆梓皮。行湿以退热。去瘀散黄之领袖也。姜枣益土为克制。潦水无力不助湿 轺。
本草作翘。翘本鸟尾。以草子析开。其间片片相
比如翘得名。轺本使者小车乘马者。无义。疑误。
（七十六）伤寒七八日。身黄如橘子色。小便不利。腹微满者。茵陈蒿汤主之。
此与上略同而较重。橘子色。言黄之鲜明也。腹微满。湿不行也。方见前。
（七十七）伤寒身黄发热者。栀子柏皮汤主之。
栀子柏皮汤方
栀子（十五枚擘） 甘草（一两炙） 黄柏（一两）
上三味。以水四升。煮取一升半。去滓。分。温再服。
此承上三条而以发热出治。然热既发于外。则里证较轻可知。故解之以栀子柏皮。而和之以
甘草。以为退之之轻剂。所谓于寒湿中求之者。盖亦参酌乎上三条而近取云也。以上四条疑太阳
中篇错简。当移。
The above three herbs are decocted with one *dou* (approx. 10 liters) of water. First, boil Yinchen (Artemisiae Scopariae Herba) until the volume reduces by six *sheng* (approx. 6 liters). Then add the remaining two herbs and boil to obtain three *sheng* (approx. 3 liters) of liquid. Strain out the dregs. Divide into three doses and take warm. Urination should become smooth, and the urine will resemble the dark red juice of a gourd (*Gleditsia sinensis*), appearing bright red. After one night, abdominal distension will decrease, and the jaundice will be expelled through urination.
"Yue" means dispersion. Head sweating, stasis-heat, and jaundice have been discussed in the Taiyang chapter. Yinchen (Artemisiae Scopariae Herba) expels dampness-induced jaundice; Zhizi (Gardeniae Fructus) clears heat from the Stomach; Dahuang (Rhei Radix et Rhizoma) pushes out obstructive blood stasis. These three herbs are bitter in flavor and drain heat. Once heat is drained, the jaundice dissipates.
(63) In Yangming disease, if the face appears entirely red, purgation must not be used. Doing so will inevitably cause fever, yellowing of the skin, and difficulty in urination.
"He" means corresponding or manifesting. "Chi" refers to the color of heat. The Yangming meridian originates at the side of the nose; when Stomach heat ascends, the face should appear red. Purgation consumes body fluids, leading to fever, yellowing, and urinary difficulty.
(64) In Yangming disease, if there is no sweating, difficulty in urination, and mental restlessness with inner vexation (*Ao Nao*), the body will inevitably develop jaundice.
No sweating and difficulty in urination indicate stagnation of dampness. *Ao Nao* indicates dampness stagnation with heat constraint. Therefore, it is known that jaundice will occur.
(65) In Yangming disease, if subjected to fire therapy, with only slight sweating on the forehead and difficulty in urination, jaundice will inevitably develop.
The Yangming meridian follows the hairline to the forehead. Thus, when severely affected by fire-heat, sweating occurs only on the forehead. Jaundice results from fire forcing the Earth element (Spleen/Stomach).
(66) In Yangming disease, if there is bleeding from the lower orifice accompanied by delirium, this is heat entering the Blood Chamber. If there is only head sweating, puncture Qimen (LR14). Drain the excess according to the pattern. Subsequent generalized sweating will lead to recovery.
Blood Chamber, head sweating, and Qimen (Liver 14) are discussed in the Taiyang chapter. The straight branch of the Yangming meridian descends from the Clavicle region to the medial aspect of the breast, passes down flanking the navel, and enters the Qi Street. The vessels of the Blood Chamber originate at the Qi Street and ascend to the Stomach where they disperse. Therefore, in women, heat entering the Blood Chamber presents similarly to Chest Bind with delirium; in Yangming disease, heat entering the Blood Chamber also causes delirium and bleeding. Men follow the smooth flow, women follow the reverse, but the pathological mechanism is the same. Hence, Qimen is also punctured.
(67) In Yangming disease patterns, if the patient suffers from forgetfulness, there must be accumulated blood. This is because pre-existing long-standing blood stasis causes forgetfulness. Although the stool is hard, defecation is surprisingly easy, and the stool color must be black. Digang Tang (Digang Decoction) should be used for purgation.
Forgetfulness refers to forgetting past words and events. Injury to Zhi (Will/Memory) leads to forgetfulness. What the heart directs is called Zhi; injury to Zhi causes heart confusion, which leads to blood stasis. Thus, accumulated blood is inferred. Defecation is easier because blood has a slippery nature. Black is the color of blood. The formula is found in the Upper Bian of the Taiyang chapter.
(68) A patient presents with neither exterior nor interior typical signs, with fever for seven to eight days. Even if the pulse is floating and rapid, purgation may be indicated. If purgation has already been performed and the rapid pulse persists, heat combines internally, leading to excessive hunger and rapid digestion. By the sixth or seventh day, if there is no bowel movement, blood stasis is present, and Digang Tang (Digang Decoction) is appropriate.
"Exterior" refers to the absence of Taiyang syndrome; "Interior" refers to the lack of fullness/hardness in the Stomach/intestines. Purgation is indicated here due to the prolonged duration. "Combined heat" means the Yang pulse remains rapid, indicating heat has not cleared. "Excessive hunger" implies rapid onset of hunger. No bowel movement with blood stasis shares similarities with previous discussions on blood syndromes. This section is suspected to be a misplaced text from the Taiyang chapter.
If the rapid pulse persists and diarrhea continues, heat combined with pathology will cause pus and blood in the stool.
After Digang Tang (Digang Decoction) purges, if the rapid pulse remains, heat is unremoved. Continuous diarrhea indicates combined heat causing pus and blood in the stool.
(69) In Yangming disease, if tidal fever occurs, the stool is loose, urination is normal, and chest/flank fullness persists, Xiaochaihu Tang (Minor Bupleurum Decoction) is the primary treatment.
Tidal fever involves differential diagnosis between Shaoyang and Yangming. Loose stool and normal urination indicate the Stomach is not full/hard. Persistent chest/flank fullness confirms the tidal fever belongs to Shaoyang. Thus, Xiaochaihu Tang (Minor Bupleurum Decoction) is still required. The formula is in the Upper Bian of the Taiyang chapter.
(70) In Yangming disease, if there is hardness/fullness under the hypochondrium, constipation, vomiting, and a white coating on the tongue, Xiaochaihu Tang (Minor Bupleurum Decoction) may be administered. As the Upper Jiao becomes unobstructed, body fluids descend, Stomach Qi harmonizes, and the patient sweats mildly (*Ji Ran*) for resolution.
This follows the previous clause. Even with constipation, if hypochondriac hardness persists, along with vomiting and a white tongue coating, Shaoyang syndrome predominates, warranting Xiaochaihu Tang (Minor Bupleurum Decoction). Unblocking the Upper Jiao resolves hardness; descending fluids facilitate bowel movement. The whole body receives Qi from the Stomach; thus, Stomach harmony brings bodily harmony, and sweating resolves the disease. The formula is in the Upper Bian of the Taiyang chapter.
(71) In Er Yang Bing (Concurrent Disease of Two Yang channels), once Taiyang symptoms cease, presenting only with tidal fever, continuous sweating on the hands and feet, difficult defecation, and delirium, purgation will cure it. Dachengqi Tang (Major Order the Qi Decoction) is appropriate.
This discusses concurrent Taiyang-Yangming disease, implying that Yangming treatment should only begin after Taiyang symptoms have resolved.
(72) In Yangming-Shaoyang Combined Disease, diarrhea will inevitably occur. If the pulse does not show "Fu" (defeat/loss), it is a favorable condition ("Shun"). "Fu" represents loss. Mutual overacting is called "Fu". A slippery and rapid pulse indicates retained food. Purge it with Dachengqi Tang (Major Order the Qi Decoction).
Yangming belongs to Earth, governing water and grain; Shaoyang belongs to Wood, governing wind. Wind governs incomplete digestion diarrhea, hence diarrhea is expected. Yangming pulse is large; Shaoyang pulse is wiry. "Not Fu" means large but not wiry, indicating harmony without dominance. "Loss" is the opposite of gain. Wiry pulse implies Wood overacting on Earth; if not large, Earth is weakened by Wood. Shaoyang dominance and Yangming defeat indicate disharmony, i.e., unfavorable. Slippery indicates food retention; rapid indicates heat, confirming retained food. Dachengqi Tang (Major Order the Qi Decoction) promotes elimination of the old to generate the new, employing the method of treating obstruction with unblocking agents (Tong Yin Yong Tong).
(73) In San Yang Bing (Combined Disease of Three Yang channels), there is abdominal fullness, heaviness of the body, difficulty turning over, insensitivity in the mouth, greasy facial complexion, delirium, and urinary incontinence. Sweating will worsen delirium; purgation will cause sweating on the forehead and cold extremities. If there is spontaneous sweating, Baihu Tang (White Tiger Decoction) is the primary treatment.
Yangming governs the Stomach, which governs muscles and opens into the mouth. Insensitivity means improper Stomach Qi affecting taste and oral sensation. Abdominal fullness, heaviness, insensitivity, and delirium belong to Yangming. *Ling Shu* states: The regular channel of Foot-Shaoyang ascends through the Liver and Heart, runs alongside the throat, emerges at the jaw, and disperses on the face. Thus, Shaoyang disorders cause bitter taste, sighing, chest/hypochondriac pain, inability to turn, and a dusty facial appearance. "Grease" is dust. Urinary incontinence reflects Taiyang Bladder failure to constrain. Thus, San Yang Bing represents damage to the interior and exterior of the five systems. Sweating attacks Taiyang exclusively, allowing pathogenic factors to merge with Yangming, worsening delirium. Purgation attacks Yangming exclusively, damaging both Yin and Yang, causing cold extremities and forehead sweating. "Sheng" means non-flowing. Thus, both sweating and purgation are contraindicated. Spontaneous sweating indicates pathogens pervading the Three Yang channels and heat binding the Five Systems, with deficient Wei Qi failing to secure the exterior and weak Ying Blood failing to guard the interior. Since sweating and purgation are unsuitable, harmonizing via Shaoyang is also biased. Therefore, Baihu Tang (White Tiger Decoction) clears autumn-like dryness and penetrates interior/exterior heat, serving as a comprehensive solution for the Three Yang channels. However, although the disease involves the Three Yang channels, treatment does not start from Yangming but is classified under the Yangming chapter for two reasons: first, Yangming symptoms predominate; second, Yangming belongs to Earth, the gathering place of all things, where the prognosis of life and death lies. Thus, it is emphasized under Yangming. This is Wang Shuhe's profound intent. The formula is in the Lower Bian of the Taiyang chapter.
(74) After sweating therapy for Cold Damage, if the body and eyes turn yellow, it is because cold-dampness remains unresolved in the interior. It is considered inadvisable to use purgation; instead, seek treatment within the context of cold-dampness.
"Shang" (Above) refers to the preceding text. This serves as a general heading for the following three clauses. Sweating is incorrect for dampness; see the Jing Shi Wen Chapter. "Interior" refers to jaundice. "Inadvisable to purge" means this "interior" is not the interior relative to the exterior. "Seek in cold-dampness" refers to the subsequent three clauses.
(75) In Cold Damage, if stasis-heat resides in the interior, jaundice will inevitably develop. Mahlian Lianqiao Chixiaodou Tang (Mahuang, Forsythia Root, and Red Bean Decoction) Formula:
Mahuang (Ephedrae Herba, 2 liang), Chixiaodou (Adzuki Bean, 1 sheng), Xingren (Apricot Seed, 40 pieces, peeled and crushed), Lianqiao Gen (Forsythiae Radix, 2 liang), Dazao (Jujube, 12 pieces, split), Shengjiang (Fresh Ginger, 1 liang, sliced), Gancao (Licorice Root, 1 liang, honey-fried), Shengzibapi (Catalpae Cortex, 1 sheng, sliced).
These eight ingredients are decocted with 1 *dou* of rainwater. Boil Mahuang (Ephedrae Herba) first until boiling again, skim off the foam, then add the other herbs. Boil to obtain 3 *sheng*. Divide into three warm doses, consumed within half a day.
This clause cross-references the previous one to outline treatment, forming three items with the next two. Mahuang (Ephedrae Herba), Gancao (Licorice Root), and Xingren (Apricot Seed) promote Qi circulation to dispel cold, key components of Mahuang Tang (Mahuang Decoction). Lianqiao Gen (Forsythiae Radix), Chixiaodou (Adzuki Bean), and Shengzibapi (Catalpae Cortex) move dampness and clear heat, leading agents in resolving stasis and jaundice. Jiang (Ginger) and Zao (Jujube) benefit Earth to control overaction. Rainwater is light and does not aid dampness. "Qiao" in materia medica refers to Forsythia; "Qiao" originally meant bird tail, named for the seed pods resembling tails. "Yao" originally referred to a messenger's carriage, likely an error here.
(76) In Cold Damage lasting seven to eight days, if the body is yellow like an orange peel, urination is difficult, and the abdomen is slightly full, Yinchenshao Tang (Artemisiae Scopariae and Gardenia Decoction) is the primary treatment.
This is similar to the previous clause but more severe. "Orange peel color" describes bright yellow. Slight abdominal fullness indicates stagnant dampness. The formula is cited earlier.
(77) In Cold Damage, if the body is yellow and feverish, Zhizi Bopi Tang (Gardenia and Phellodendron Bark Decoction) is the primary treatment.
Zhizi Bopi Tang (Gardenia and Phellodendron Bark Decoction) Formula:
Zhizi (Gardeniae Fructus, 15 pieces, broken), Gancao (Licorice Root, 1 liang, honey-fried), Huangbai (Phellodendri Cortex, 1 liang).
These three ingredients are decocted with 4 *sheng* of water to obtain 1.5 *sheng*. Strain and divide into two warm doses.
This clause follows the previous three, using fever as the differentiating factor. Since heat manifests externally, internal symptoms are likely milder. Thus, Zhizi Bopi Tang (Gardenia and Phellodendron Bark Decoction) clears heat, harmonized by Gancao (Licorice Root) as a mild agent. This aligns with "seeking treatment in cold-dampness," referencing the previous three clauses. These four clauses are suspected to be misplaced text from the Middle Bian of the Taiyang chapter and should be relocated.