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，身体则枯燥。但头汗出，剂颈
而还，其身发黄。阳盛则欲衄，阴虚则小便难。阴阳俱虚竭，腹满而喘，口渴咽烂，或不大便。久则谵语，甚者
至哕，手足躁扰，捻衣摸床。小便利者，其人可治。
太阳中风，不以麻黄、青龙发汗，而以火攻其汗，则不须言风邪之患，当知火邪之利害矣。血得热则流，气
得热则溢。血气不由常度，而变由生也。风为阳邪，火为阳毒，所谓两阳也。两阳相灼，故即见两阳合明之病，
身体枯燥。身无汗也，故身发黄。头汗至颈，故但身黄，而头至颈不黄也。首为元阳之会，不枯燥，是阳未虚竭；
有汗出，是阴未虚竭。此两阳尚熏于形身，而未内灼于脏腑也。此血气流溢之轻者。若其人阳素盛者，因熏灼而
伤血，其鼻必衄。其人阴素虚者，因熏灼而伤津，小便必难。若其人阴阳之气俱虚竭者，胸满而喘，口干咽烂
而死者有矣。或胃实而谵语，或手足躁扰，而至于捻衣摸床者有矣。皆气血流溢，失其常度故也。小便利，是反
应小便难句。凡伤寒之病，以阳为主，故最畏亡阳。而火逆之病，则以阴为主，故最怕阴竭。小便利者为可治，
是阴不虚，津液未亡，太阳膀胱之气化犹在也。阳盛阴虚，是火逆一症之纲领。阳盛则伤血，阴虚则亡津，又是
伤寒一书之大纲领。
太阳病二日，烦躁，反熨其背而大汗出。大热入胃，胃中水竭，躁烦，必发谵语。十余日振栗自下利者，此为
欲解也。故其汗从腰以下不得汗，欲小便不得，反呕，欲失溲。足下恶风。大便硬，小盒饭数，而反不数及多。
大便已，头卓然而痛。其人足心必热，谷气下流故也。
此指火逆之轻者言之。太阳病经二日，不汗出而烦躁，此大青龙
症也。不知发汗而兼以清火，而反以火熨其背。背者，太阳之部也。太阳被火迫，因转属阳明。胃者，阳明之府，
水谷之海也。火邪入胃，胃中水竭，屎必燥硬。烦躁不止，谵语所由发也。非调胃承气下之，胃气绝矣。十余
日句，接大汗出来。盖其人虽大汗出，而火热未入胃中。胃家无恙，谵语不发，烦躁已除。至二候之后，火气已
衰。阳气微，故振栗而解；阴气复，故自利而解。此阴阳自和而自愈者也。“故其汗”至末，是倒叙法。释未利
未解前症，溯其因而究其由也。言所以能自下利者，何以故？因其自汗出时，从腰以下不得汗。夫腰以下为地，
地为阴，是火邪未陷入于阴位也，二肠膀胱之液俱未伤也。欲小便不得，而反呕欲失溲，此非无小便也，其津液
在上焦，欲还入胃中故也。凡大便硬者，小盒饭数而不多。今小便反不数而反多，此应前欲小便不得句，正以明
津液自还入胃中而下利之意也。利是通利，非泻利之谓，观大便已可知矣。头为诸阳之会，卓然而痛者，阴气复则
阳气虚也。足心必热，响应足下恶风句。前大汗出则风已去，故身不恶风。汗出不至足，故足下恶风也。今火气下
流，故足心热。火气下流，则谷气因之下流，故大便自利也。大便已头疼，可与小便已阴疼者参之。欲小便不得，
反失溲，小盒饭数，反不数、反多，与上条小便难、小便利，俱是审其阴气之虚不虚、津液之竭不竭耳。
太阳病，以火熏之，不得汗，其人必躁，过经不解，必圊血。名为火邪。
首条以火劫发汗而衄血，是阳邪盛于阳位，故在未过经时。此条以火熏不得汗而圊血，是阳邪下陷入阴分，
故在过经不解时。次条大汗出后十余日，振栗下利而解。此条不得汗，过经圊血而犹不解。可知劫汗而得汗者，
其患速；不得汗者，其患迟。名为火邪，则但治其火，而不虑其前此之风寒矣。
伤寒脉浮，医以火迫劫之，亡阳，必惊狂起卧不安者，桂枝去芍药加蜀漆龙骨牡蛎救逆汤主之。
上文皆阳盛之症，以中风为阳邪也。此后是阳虚之症，以伤寒为阴邪也。阳盛者，轻则发狂谵语，重则衄
血圊血，此不戢自焚者也。阳虚者，神不守舍，起居如惊，其人如狂，是弃国而逃者也。
方注详桂枝篇。
上论火逆症。
太阳伤寒者，加温针必惊也。
温针者，即烧针也，烧之令其温耳。寒在形躯而用温针刺之，寒气内迫于心，故振惊也。
若重发汗，复加烧针者，四逆汤主之。
重发汗而病不解，则不当汗矣。复加烧针，以迫其汗，寒气内侵，当救其里。烧针后宜有脱文。
火逆下之，因烧针烦躁者，桂枝甘草龙骨牡蛎汤主之。
方注详桂枝篇。
其脉沉者，营气微也。营气微者加烧针，则血流不行，更发热而烦躁也。
按∶流、行二字，必有一误。此阴阳俱虚竭之候也。
烧针令其汗，针处被寒，核起而赤者，必发奔豚。气从少腹上冲者，灸其核上各一壮，与桂枝加桂汤。
方注详桂枝篇。
上论火针症。
脉浮宜以汗解。用火灸之，邪无从出，因火而盛，病从腰以下必重而痹，名火逆也。脉浮热甚，反灸之，
此为实，实以虚治，因火而动，必咽燥吐血。
微数之脉，慎不可灸。因火为邪，则为烦逆，追虚逐实，血散脉中。火气虽微，内攻有力，焦骨伤筋，血
难复也。
此皆论灸之而生变也。腰以下重而痹者，因腰以下不得汗也。咽燥吐血者，亦阳盛而然也，比衄加甚矣。
当知灸法为虚症设，不为风寒设，故叮咛如此。
上论火灸症。
Taiyang disease with wind-stroke, treated by fire to forcibly induce sweating, causes the pathogenic wind and heat to combine. This leads to blood and qi overflowing beyond their normal limits. The two yangs (wind and fire) mutually scorch and smolder, causing the body to become dry and withered. Sweat appears only on the head, stopping at the neck, while the body turns yellow. Excess yang may lead to epistaxis; yin deficiency results in difficult urination. When both yin and yang are depleted, symptoms include abdominal fullness and wheezing, thirst with throat ulceration, or constipation. Prolonged cases may develop delirium; severe cases may present with hiccups, restlessness of the hands and feet, and unconscious picking at clothes and bedrails. If urination is free, the condition is treatable.
In Taiyang wind-stroke, if Ma Huang Tang or Da Qing Long Tang are not used to induce sweating, but fire therapy is employed instead, one need not discuss the harm of wind pathogen but should understand the benefits and harms of fire pathogen. Blood flows faster when heated; qi overflows when heated. When blood and qi deviate from their normal course, pathology arises. Wind is a yang pathogen; fire is a yang toxin. These are the "two yangs." Their mutual scorching produces symptoms akin to "Two Yangs Combining Brightness," manifesting as a dry and withered body. Without sweat on the body, jaundice occurs. Head sweat stops at the neck, so the body is yellow but the head and neck remain unyellowed. The head is the meeting point of primal yang; lack of dryness indicates yang is not yet exhausted; presence of sweat indicates yin fluids are not yet exhausted. This represents mild fire pathogen steaming the exterior without burning the zang-fu organs internally. This is a mild case of blood and qi overflow. If the person originally has strong yang, scorching damages blood vessels, leading to epistaxis. If the person originally has weak yin, scorching damages fluids, leading to difficult urination. If both yin and yang qi are depleted, chest fullness and wheezing occur, along with dry mouth and throat ulceration, potentially leading to death. Alternatively, stomach excess may cause delirium, or hand/foot restlessness may progress to picking at clothes and bedrails. All these result from blood and qi overflowing and losing their normal rhythm. Free urination responds to the earlier mention of difficult urination. In all shanghan diseases, yang is primary, hence fear of yang collapse. In fire-ni (reversal) diseases, yin is primary, hence fear of yin exhaustion. Free urination indicates treatability because yin is not deficient, fluids are preserved, and the Qi transformation of the Taiyang Bladder remains intact. Yang excess and yin deficiency constitute the guideline for fire-ni syndrome. Yang excess damages blood; yin deficiency loses fluids. This is the overarching principle of the entire Shanghan Lun.
On the second day of Taiyang disease, irritability occurs. Instead of sweating, the back is moxibusted/warmed, causing profuse sweating. Intense heat enters the Stomach, depleting Stomach fluids. Irritability inevitably leads to delirium. After more than ten days, if chills and spontaneous diarrhea occur, this indicates impending resolution. Thus, sweat does not appear from the waist down. There is an urge to urinate but inability to do so, accompanied by vomiting and urinary incontinence. The soles of the feet feel aversion to cold. Stool is hard. Urination frequency should be high but is actually low or excessive in volume. After defecation, sudden headache occurs. The soles of the feet must feel hot because Gu Qi (Grain Qi) flows downward.
This refers to mild fire-ni cases. On the second day of Taiyang disease, absence of sweat with irritability indicates Da Qing Long Tang syndrome. Failure to use sweating methods combined with clearing heat, and instead warming the back with fire, affects the Back, which is the domain of the Taiyang channel. Taiyang forced by fire transforms into Yangming. The Stomach is the Fu organ of Yangming, the sea of water and grain. Fire pathogen entering the Stomach depletes fluids, making stool dry and hard. Persistent irritability leads to delirium. Without Tiao Wei Cheng Qi Tang to purge, Stomach Qi would perish. The "ten-plus days" clause follows the profuse sweating. Although sweat was profuse, heat did not enter the Stomach. Stomach Qi remained safe, no delirium occurred, and irritability resolved. After two weeks, fire qi declined. Weak yang resolves via chills; restored yin resolves via spontaneous diarrhea. This is self-healing through yin-yang harmony. The section from "thus his sweat" to the end uses flashback narration to explain pre-diarrhea symptoms and trace causes. Why spontaneous diarrhea? Because during sweating, no sweat appeared below the waist. Below the waist is Earth/Yin, indicating fire pathogen did not sink to Yin positions, sparing fluids of the Large Intestine, Small Intestine, and Bladder. Urinary retention with vomiting/incontinence is not true anuria but fluid retention in the Upper Jiao seeking return to the Stomach. Usually, hard stool implies frequent but small-volume urination. Here, infrequent but large-volume urination confirms fluid returning to the Stomach and causing diarrhea. "Li" here means smooth passage, not purgative diarrhea. Sudden headache after defecation relates to pain after urination. The head is the meeting of all yangs; pain indicates yin restoration and relative yang deficiency. Hot soles respond to cold soles. Earlier profuse sweat expelled wind, so no aversion to cold. Lack of sweat to feet caused cold soles. Now fire qi sinks, heating soles. Sinking fire qi allows Gu Qi to flow down, causing spontaneous diarrhea.
Taiyang disease treated with fire fumigation fails to induce sweat. The patient becomes irritable. If the disease persists past the transmission period, rectal bleeding (qing xue) will occur. This is named Huo Xie (Fire Pathogen).
The first case involved epistaxis due to forced sweating, where yang pathogen was abundant in yang positions before transmission. This case involves rectal bleeding due to failed fumigation, where yang pathogen sank into yin positions after transmission. The previous case resolved via chills/diarrhea after ten days. This case persists with rectal bleeding. Forced sweating leading to sweat brings rapid complications; failure to sweat brings delayed complications. Named "Fire Pathogen," treatment focuses solely on fire, ignoring prior wind-cold.
Shanghan with floating pulse, treated by doctor using fire to force sweating, results in Yang Collapse. Symptoms include fright, mania, restlessness, and inability to lie still. Gui Zhi Qu Shao Yao Jia Shu Xi Long Gu Mu Li Jiu Ni Tang is indicated.
The above discussed yang-excess syndromes (wind-stroke is yang pathogen). This discusses yang-deficiency syndromes (shanghan is yin pathogen). Yang excess: mild cases involve mania/delirium; severe cases involve epistaxis/rectal bleeding (self-burning). Yang deficiency: spirit does not reside, causing fright-like behavior and mania (fleeing the country).
Formula notes refer to Gui Zhi Chapter.
Above discusses fire-ni syndromes.
Taiyang shanghan treated with warm needle invariably causes fright.
Warm needle refers to burning needles until warm. Cold in the exterior treated with warm needles forces cold inward to the Heart, causing tremors and fright.
If excessive sweating is followed by burning needles, Si Ni Tang is indicated.
Excessive sweating failing to resolve the disease contraindicates further sweating. Adding burning needles to force sweat invites internal cold; interior rescue is needed. Text likely missing content post-needle burning.
Fire-ni treated with purgatives, followed by burning needles causing irritability, is treated with Gui Zhi Gan Cao Long Gu Mu Li Tang.
Formula notes refer to Gui Zhi Chapter.
Pulse sinking indicates weak Ying Qi. Adding burning needles to weak Ying Qi blocks blood flow, causing fever and irritability.
Note: Either "liu" (flow) or "xing" (move) is erroneous. This signifies dual depletion of yin and yang.
Burning needles to induce sweat, with the puncture site exposed to cold, forming red nodules, inevitably triggers Ben Tun (Running Piglet). Qi rushing from the lower abdomen upward requires moxibustion on each nodule (one cone) and Gui Zhi Jia Gui Tang.
Formula notes refer to Gui Zhi Chapter.
Above discusses fire-needle syndromes.
Floating pulse indicates sweating is appropriate. Using moxa prevents pathogen exit, causing pathogen to flourish due to fire. Symptoms include heaviness and numbness below the waist, named Fire-Ni. Floating pulse with intense heat treated with moxa constitutes treating excess as deficiency. Fire agitates blood, causing dry throat and hemoptysis.
Micro-rapid pulse strictly contraindicates moxa. Fire becomes pathogen, causing烦逆 (irritation/rebellion), chasing deficiency and pursuing excess, scattering blood in vessels. Though fire's power is slight, its internal attack is potent, scorching bones and injuring sinews, making blood recovery difficult.
These discuss complications from moxibustion. Heaviness/numbness below waist stems from lack of sweat there. Dry throat/hemoptysis stems from yang excess, worse than epistaxis. Moxa is for deficiency, not wind-cold; thus the warning.
Above discusses fire-moxa syndromes.