（此方自原论中第四卷太阳下编移附于此）
知母（六两） 石膏（一斤碎） 甘草（二两） 粳米（六合）
上四味。以水一斗。煮米熟。汤成。去滓。温服一升。日三服。
成氏明理论云。白虎西方金神也。应秋而归肺热甚于内者。以寒下之热甚于外者。以凉解之。其有中外俱热。内
不得泄。外不得发者。非此汤则不能解也。夏热秋凉。暑 之气。得秋而止。秋之令曰处暑。是汤以白虎名之。谓能止
热也。知母味苦寒。内经曰。热淫所胜。佐以苦甘。又曰。热淫于内以苦发之。欲彻表热。必以苦为主。故以知母为君。
石膏味甘微寒。热则伤气。寒以胜之。甘以缓之。热胜其气。必以甘寒为助。是以石膏为臣。甘草粳米味甘平。脾欲缓。
急食甘以缓之。热气内余。消烁津液。则脾气燥。必以甘平之物缓其中。故以甘草粳米为使。是太阳中 。得此汤则顿
除。即热见白虎而尽矣。立秋后不可服白虎。为大寒剂。秋王之时。若不能食。服之而为哕逆。成虚羸者多矣。徐春沂
云。立秋后云云。疑是后人所加。
李东垣云。身以前胃之经也。胸胃肺之室也。邪在阳明。肺受火制。故用辛寒以清肺。所以号为白虎汤也。
琥按白虎汤。大都是甘寒。清肺胃之剂。成注云。缓脾燥者。以胃热得清。而脾自不燥也。成注又云。太阳中 。
得此汤则顿除。此不过暂假以为用耳。至仲景云。三阳合病。用白虎汤。能兼主少阳经热。殊为不解。况上文云。面垢。
愚以面垢者。亦阳明经病。盖阳明经之脉。实循面而行故也。细审上条。全是阳明经中 证。曰腹满者。阳明之脉。循
腹里也。曰身重者。阳明脉行身之前。身以前热甚。故困极而重也。曰口不仁而面垢。及额上生汗者。阳明之脉挟口。
循两颊。上行于面而至额颅也。经云。因于暑。汗烦则喘渴。静则多言。上证虽未至喘渴。然既谵语自汗出矣。则胃中
燥热。已具喘渴之势。复何疑而不用白虎汤也。尚论篇云。此证。夏月最多。斯言甚是有理。张兼善云。活人书谓白虎
汤治中 。并汗后一解表药耳。非正伤寒药也。夫白虎汤。具载仲景之书。证治昭然明白。何为而言非正伤寒之药也。
况伤寒论言无表证者。可与白虎汤。今云汗后一解表药耳。于法既无表证。何解之有。
琥按白虎汤。活人书谓汗后一解表之药。不为误也。阳明病汗多表热不解。用之。与太阳病用桂枝汤解表之义相同。
张氏不明此义。引伤寒论言无表证者。可与白虎汤主之。殊不知仲景云无表证者。乃表无恶寒无汗等证也。今既有汗而
大热不解。其邪仍在肌肉之间斯时而用白虎。谓非仍是解表药邪。即如仲景大青龙汤中用石膏。且能治汗不出而烦躁。
则是石膏之解肌表。愈可信矣。
张兼善又云。活人书谓夏月阴气在内。白虎尤宜戒之。而明理论又云。立秋后不可服白虎。夫伤寒之法。有是证则
投是药。安可拘于时而为治哉。假如秋冬之间。患伤寒。身无表证而大烦渴。于法合用白虎汤。苟拘其时。何以措手。
若以白虎为大寒。其承气又何行于冬令乎。夏既宜戒。秋后又不可行。然则宜于何时也。
琥又按白虎汤。张氏云。于法合用。不可拘于时令。实为有理。故内台方议亦云。古人一方对一证。若严冬之时。
果有白虎汤证。安得不用石膏斯言实与张氏之论相合。但张氏云。伤寒身无表证。后用白虎汤。竟认白虎汤非解表热之
药此与仲景之论又相反矣。内台方议又云。发汗后。大热不解。多汗出。不恶寒。大渴能饮水者。用白虎汤。乃知无表
证者。但谓无恶寒汗不出证也。若阳明汗出。肌表间大热不解。仍为必用之药。
琥又按白虎汤。病患于夏秋热燥时。大宜用热邪伤气。此汤乃解阳明经与府气分燥热之药也。冬寒时所当慎用。此
为不易之论。
琥又按白虎汤。古无下走大肠之说。余曾治一人伤寒。六七日不大便。热渴。多汗谵语。饮水不解。医曾以小承气
试之。虽大便。亦不多。而病依然。医复欲以大承气下之。余往诊其脉。得洪大而长。此热伤阳明气分也。因以白虎汤
去粳米加陈皮芦根。一服后。得大便而病悉愈乃悟石膏一味。不但外解肌表之热。其性沉寒。兼能内入大肠而下气分热
秘。此诚千古未发之义。
（附例）伤寒脉浮滑。此表有热。里有寒。白虎汤主之。（此条自太阳下编移附于此。伤寒脉浮滑者。滑为里热。浮
滑为表兼风。而亦主热。此太阳风寒之邪。已传入阳明。而经与府齐病热也。今则云。表有热。里有寒。补亡论校正云。
伤寒脉浮滑。此表里有热。斯言乃为定论。条辩云。里有寒者。以伤寒之热。本寒因也。实则表里俱热。故用白虎汤以
内外两解之也。）
伤寒脉滑而厥者。里有热也。白虎汤主之。（此条病自厥阴篇移附于此。伤寒本热病。热伤阳明。则脉滑。脉滑者。
脉经云。往来流利。乃热盛气壅之诊也。脉虽滑而外证见厥。厥者。手足逆冷也。叔和因其手足逆冷。遂撰入厥阴篇。
以厥阴者。阴之尽。邪伤其经。不分冷热。而外证见厥者多。殊不知足阳明胃府属土。土主四末。府热亢极。则气壅而
血不流通。以故四肢之末见厥。在里则燥热实盛。乃热深者厥亦深也。故宜用白虎汤以解其里热。）
金镜内台方议云。仲景所用白虎汤三证。然有大小不同处。亦皆古人载之经典。复详味之。若果用白虎汤。无差误
矣。必须多汗饮水也。所以白虎汤戒曰。白虎乃大寒之剂。若非大热多汗渴饮水者。不可服也。又古赋曰。无汗喜渴。
而脉单浮者。勿投白虎。学人须明识此。则用汤自无差错矣。
（重出例）二阳并病太阳证罢。但发潮热（云云至）宜大承气汤（注已见前）
阳明病。脉浮而紧。咽燥。口苦腹满而喘。发热汗出不恶寒。反恶热。身重。若发汗则躁。心愦愦。反谵语。若加
烧针。必怵惕烦躁不得眠。若下之。则胃中空虚。客气动膈。心中懊 。舌上苔者。栀子豉汤主之。（此条连下条。乃阳
明病宜吐之证也。阳明病见浮紧之脉。其风寒之邪。当自太阳经传来也。阳明之脉挟口。太阴之脉挟咽。二经表里相合。
阳明病热。故口苦而并咽亦燥也。然胆热则口苦。咽又为胆之使。故口苦也。腹满者。热入阳明之府也。但发热而喘。
此是太阳经风寒未尽。风寒未尽者。当恶寒不恶热。今者。汗出不恶寒。反恶热而身重。身重者阳明主肌肉湿土重着也。
盖此条病。表里之证两未全具。不可误汗误下。若加烧针。则更误矣。医人不识而发其汗。则津液伤而邪愈炽。当见心
躁极而愦乱。及谵语而病剧矣。若加烧针。则火热犯心。当见怵惕烦躁不眠等变证矣。怵惕者。恐惧之貌也。若误下之。
则邪未内实。徒伤胃气。将客邪之气。乘虚而入于膈中。多变动等证矣。心中懊 。注已见前太阳篇中。既懊 而舌上
又生苔者。此为寒邪郁热于胸之验也。成注云。与栀子豉汤以吐胸中之邪。可见阳明病。亦有宜吐之证也。愚按舌上苔。
仲景不言何色。成注云。舌上苔白。知热气客于胸中。胸中者胃口也。若热聚胃中。当见苔黄。热结大肠。当见苔黑矣。
若然。则是仲景云。舌苔。当是白苔无疑。陈亮斯云。按本文汗下烧针。独详言误下治法者。以阳明一篇。所重在下。
故辩之独深悉焉。栀子豉汤方见前第四卷太阳中篇）
（附例）阳明病下之。其外有热。手足温。不结胸。心中懊 。饥不能食。但头汗出者。栀子豉汤主之。（此亦阳明
病误下之变证。阳明误下。邪热虽应内陷。不比太阳病误下之深。故其身外犹有余热。手足温。不结胸。手足温者。征
其表和而无大邪。不结胸者。征其里和而无大邪。表里已无大邪。其邪但在胸膈之间。以故心中懊 。饥不能食者。言
懊之甚。则似饥非饥。嘈杂不能食也。但头汗出者。成注云。热自胸中。熏蒸于上。故但头汗出而身无汗也。与栀子
豉汤。以吐胸中之邪热此条即从后移附于此）
若渴欲饮水。口干舌燥者。白虎加人参汤主之。（此条本在前条栀子豉汤证之下。成注云。此下后之见证。愚意云。
此条不但误下。兼之误汗所致误下。则胃中虚。误汗。则胃中不惟虚。而且燥热极矣。渴欲饮水。口干舌燥者。此热邪
伤气耗液之征也。故用白虎加人参汤。以清热补气。润津液。或问。舌者心之苗。白虎加人参汤。但治胃虚燥热。何为
而兼主心也。余答云胃居中州。胃热则脾困。心肺亦受其熏蒸。以故口干者。口为脾之窍也。汤名白虎。专能清肺。心
肺相连。以故兼治舌燥。一气可相通也。然亦必心肺脾气分燥热者。宜用之。若热在血分。又当改用泻心汤方也。）
(This formula was transferred from the lower section of Volume 4, Taiyang chapter, in the original treatise and attached here.)
Zhimu (Anemarrhenae Rhizoma) six liang. Shigao (Gypsum Fibrosum) one jin, crushed. Gancao (Glycyrrhizae Radix et Rhizoma) two liang. Jingmi (Oryzae Fructus Glutinosa) six he.
The above four ingredients. Use ten dou of water. Boil until the rice is cooked. The decoction is ready. Strain to remove the dregs. Take one sheng warm. Administer three times a day.
Cheng Wuji stated in *Minglun* (Theory of Clarification): Baihu (White Tiger) is the Metal Spirit of the West. It corresponds to Autumn and belongs to the Lung. When heat is severe internally, use cold purgatives to drain it; when heat is severe externally, use cooling methods to resolve it. If there is heat in both the interior and exterior, with internal heat unable to vent and external heat unable to sweat out, this decoction is the only way to resolve it. Summer is hot, Autumn is cool; the Qi of Shu (Summer Heat) stops with the arrival of Autumn. The solar term of Autumn is called "Chu Shu" (End of Heat). This decoction is named Baihu, meaning it can stop heat. Zhimu tastes bitter and is cold. The *Neijing* (Inner Canon) states: "When heat is excessive, assist with bitter and sweet." It also states: "When heat is trapped inside, use bitter to disperse it." To thoroughly clear exterior heat, one must primarily use bitter herbs. Therefore, Zhimu is used as the Sovereign herb. Shigao tastes sweet and is slightly cold. Heat injures Qi; cold overcomes it, and sweet moderates it. When heat exceeds Qi, one must assist with sweet-cold herbs. Thus, Shigao is used as the Minister herb. Gancao and Jingmi taste sweet and are neutral. The Spleen desires moderation; when urgent, eat sweet things to moderate it. Excess heat remaining internally consumes Body Fluids, causing Spleen Qi to become dry. One must use sweet-neutral substances to moderate the interior. Therefore, Gancao and Jingmi are used as the Envoy herbs. This is Taiyang Zhongshu (Heatstroke), and obtaining this decoction will instantly eliminate it, just as seeing the White Tiger causes all heat to vanish. After Liqiu (Start of Autumn), Baihu Tang should not be taken because it is a major cold agent. During the time when Autumn rules, if one cannot eat, taking it will cause hiccups. Many become weak and emaciated. Xu Chunyi said: Regarding the statement about after Liqiu, I suspect it was added by later people.
Li Dongyuan said: The front of the body is the meridian pathway of the Stomach. The chest is the chamber of the Stomach and Lungs. When pathogenic factors are in the Yangming channel, the Lung is constrained by Fire. Therefore, acrid-cold herbs are used to clear the Lung. Hence it is called Baihu Tang.
Hu notes: Baihu Tang is mostly composed of sweet-cold herbs, a formula that clears the Lung and Stomach. Cheng's commentary says: "To moderate Spleen dryness, because once Stomach heat is cleared, the Spleen naturally ceases to be dry." Cheng's commentary also says: "Taiyang Zhongshu is instantly eliminated by this decoction." This is merely borrowing its efficacy temporarily. As for Zhang Zhongjing stating: "In combined disease of the Three Yang, use Baihu Tang," implying it can simultaneously govern Shaoyang channel heat, is truly puzzling. Moreover, the preceding text mentions: "dull complexion." I believe a dull complexion is also a disease of the Yangming channel, because the Yangming channel meridians indeed circulate through the face. Carefully examining the previous clause, it is entirely a Zhongshu syndrome of the Yangming channel. It says "abdominal fullness," because the Yangming channel meridians circulate into the abdomen. It says "heavy body," because the Yangming pulse travels along the anterior aspect of the body; heat is severe on the anterior side, causing extreme fatigue and heaviness. It says "mouth and nose feel unresponsive, dull complexion, and sweating on the forehead," because the Yangming channel meridians flank the mouth, travel along the cheeks, and ascend to the face reaching the forehead. The Classic states: "Due to summer heat, sweating, irritability leads to panting and thirst; quietness leads to excessive talking." Although the aforementioned symptoms have not yet reached the stage of panting and thirst, since there is already delirium and spontaneous sweating, the dry-heat in the Stomach already possesses the momentum for panting and thirst. What doubt remains in not using Baihu Tang? *Shanglun Pian* states: "This syndrome occurs most frequently in summer." This statement is very reasonable. Zhang Jianshan said: *Huo Ren Shu* (Book of Saving Lives) states that Baihu Tang treats Zhongshu and is a formula to release the exterior after sweating, not a orthodox Shanghan (Cold Damage) medicine. Baihu Tang is detailed in Zhang Zhongjing's book, with clear and obvious syndrome differentiation and treatment. Why say it is not an orthodox Shanghan medicine? Moreover, *Shanghan Lun* states: "For those without exterior syndrome, Baihu Tang may be given." Now it is said to be a formula to release the exterior after sweating. Since there is no exterior syndrome according to the method, what is there to release?
Hu notes: *Huo Ren Shu* states that Baihu Tang is a formula to release the exterior after sweating; this is not incorrect. In Yangming disease with profuse sweating and unresolved exterior heat, using it is identical in meaning to using Guizhi Tang (Cinnamon Twig Decoction) to release the exterior in Taiyang disease. Zhang did not understand this principle, citing *Shanghan Lun* saying "those without exterior syndrome may use Baihu Tang." He did not realize that when Zhang Zhongjing said "no exterior syndrome," he meant the absence of exterior signs such as aversion to cold and absence of sweating. Now, since there is sweating but high fever persists, the pathogen remains between the muscles and skin. At this time, using Baihu Tang, can one say it is not still an exterior-releasing medicine? Just as in Zhang Zhongjing's Da Qing Long Tang (Major Green Dragon Decoction), Shigao is used to treat absence of sweating accompanied by irritability. Thus, the ability of Shigao to release muscle-skin heat is even more credible.
Zhang Jianshan further said: *Huo Ren Shu* states that in summer, Yin Qi is within, so Baihu should be especially avoided. And *Minglun* states that Baihu should not be taken after Liqiu. The method of treating Shanghan is: if there is this syndrome, administer this medicine. How can one be bound by the season for treatment? Suppose during autumn or winter, one contracts Shanghan, has no exterior syndrome but experiences great irritability and thirst. According to the method, Baihu Tang should be used. If one is bound by the season, how would one proceed? If Baihu is considered a major cold agent, why is Da Cheng Qi Tang (Major Order the Qi Decoction) also used in winter? If it should be avoided in summer and cannot be used after autumn, then when is it appropriate to use it?
Hu further notes: Regarding Baihu Tang, Zhang said: "According to the method, it should be used; one should not be bound by the seasons." This is truly reasonable. Therefore, *Nei Tai Fang Yi* (Discussion on Formulas of the Inner Palace) also states: "Ancients matched one formula to one syndrome. Even in deep winter, if there is truly a Baihu Tang syndrome, how could one not use Shigao?" This statement aligns with Zhang's argument. However, Zhang said: "In Shanghan, with no exterior syndrome, Baihu Tang is used later." He actually regarded Baihu Tang as not being an exterior-heat releasing medicine. This contradicts Zhang Zhongjing's discussion again. *Nei Tai Fang Yi* further states: "After sweating, if high fever persists, with profuse sweating, no aversion to cold, and great thirst capable of drinking water, use Baihu Tang." From this, we know that "no exterior syndrome" simply means the absence of aversion to cold and absence of sweating. If it is Yangming disease with sweating, and high fever persists between the muscles and skin, it remains a mandatory medicine.
Hu further notes: Regarding Baihu Tang, patients during the hot and dry times of summer and autumn greatly benefit from its use. Heat injury to Qi; this decoction is a medicine to resolve dry-heat in the Qi level of the Yangming channel and fu organs. It should be used with caution during the cold winter. This is an unchangeable truth.
Hu further notes: Ancient texts had no theory of Baihu Tang descending to the Large Intestine. I once treated a person with Shanghan who had not had a bowel movement for six or seven days, with fever, thirst, profuse sweating, and delirium. Drinking water did not relieve it. The physician had tried Xiao Cheng Qi Tang (Minor Order the Qi Decoction); although a bowel movement occurred, it was not much, and the illness remained. The physician wanted to use Da Cheng Qi Tang to purge. I went to diagnose his pulse and found it flooding, large, and long. This indicated heat injuring the Qi level of Yangming. Therefore, I used Baihu Tang, removing Jingmi and adding Chenpi (Citri Reticulatae Pericarpium) and Lugen (Phragmitis Rhizoma). After one dose, a bowel movement occurred, and the illness was completely cured. I realized that Shigao alone not only releases exterior muscle-skin heat externally, but due to its heavy-cold nature, it can also enter internally into the Large Intestine to descend Qi-level dry-heat constipation. This is truly an insight never before expressed in millennia.
(Attached Example) Shanghan with floating and slippery pulse. This indicates heat in the exterior and cold in the interior. Baihu Tang governs it. (This clause was transferred from the lower section of the Taiyang chapter. In Shanghan, a floating and slippery pulse: slippery indicates interior heat; floating and slippery indicates exterior wind combined with heat, thus also governing heat. This is the Wind-Cold pathogen of Taiyang having transmitted to Yangming, where both the channel and the fu organ suffer from heat. Now it says: heat in the exterior, cold in the interior. *Bu Wang Lun* (Supplement to Lost Classics) corrects this: "Shanghan with floating and slippery pulse, this indicates heat in both the interior and exterior." This statement is the definitive conclusion. *Tiao Bian* states: "Cold in the interior" refers to the fact that the heat of Shanghan originates from cold. In reality, both interior and exterior are hot, hence Baihu Tang is used to resolve both interior and exterior.)
Shanghan with a slippery pulse and cold extremities indicates heat in the interior. Baihu Tang governs it. (This case was transferred from the Jueyin chapter. Shanghan is originally a heat disease. Heat injuring Yangming results in a slippery pulse. The *Mai Jing* (Pulse Classic) states: "Coming and going smoothly" is a diagnosis of heat excess and Qi stagnation. Although the pulse is slippery, the external manifestation is Jue (cold extremities). Jue refers to cold hands and feet. She He included this in the Jueyin chapter because Jueyin is the end of Yin; when pathogens injure its channel, regardless of cold or heat, many present with external Jue. Little did he know that the Foot-Yangming Stomach Fu belongs to Earth, and Earth governs the four extremities. When Fu heat is extremely hyperactive, Qi stagnates and blood does not circulate, hence the extremities manifest Jue. Internally, dry-heat and excess are vigorous; the deeper the heat, the deeper the Jue. Therefore, Baihu Tang should be used to resolve the interior heat.)
*Jin Jing Nei Tai Fang Yi* states: There are three syndromes for which Zhang Zhongjing used Baihu Tang, varying in magnitude, all recorded in classics by ancients. Reflecting carefully, if Baihu Tang is indeed used, there will be no errors. It must be accompanied by profuse sweating and desire to drink water. The warning for Baihu Tang states: "Baihu is a major cold agent. If not accompanied by major heat, profuse sweating, and thirst with desire to drink water, do not administer it." Another ancient verse states: "If there is no sweating, yet there is thirst, and the pulse is solely floating, do not administer Baihu." Students must clearly recognize this, and the administration of formulas will naturally be error-free.
(Repeated Example) Er Yang Bing (Combined Disease of Two Yangs), Taiyang syndrome ceases. Only tidal fever occurs... (See previous note for details) Suitable for Da Cheng Qi Tang.
Yangming disease. Pulse is floating and tight, throat dry, bitter taste in mouth, abdominal fullness and panting, fever, sweating, no aversion to cold, but aversion to heat, heavy body. If sweating is induced, then irritability, mental confusion, and delirium occur. If moxibustion with burning needles is added, fright, irritability, and insomnia will definitely result. If purging is performed, the Stomach becomes empty and hollow, guest Qi agitates the Diaphragm, and the heart feels uncomfortable (Ao Nao). With coating on the tongue, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) governs it. (This clause, along with the next, represents a syndrome suitable for vomiting in Yangming disease. Yangming disease presenting with floating-tight pulse suggests the Wind-Cold pathogen likely transmitted from the Taiyang channel. The Yangming channel flanks the mouth; the Taiyin channel flanks the throat. These two channels are exterior-interior partners. Yangming heat causes bitter taste and concurrent throat dryness. Gallbladder heat causes bitter taste; the throat is the envoy of the Gallbladder, hence the bitter taste. Abdominal fullness indicates heat entering the Yangming Fu. Only fever and panting suggest residual Wind-Cold in the Taiyang channel. Residual Wind-Cold should present with aversion to cold, not aversion to heat. Now, sweating with no aversion to cold, but aversion to heat and heavy body. Heavy body is because Yangming governs muscles, and damp-earth is heavy and sticky. Essentially, this case lacks complete exterior and interior syndromes; erroneous sweating or purging must be avoided. Adding burning needles would be an additional error. If the physician fails to recognize this and induces sweating, Body Fluids are injured and pathogens become more vigorous. One should see extreme heart irritability and confusion, plus delirium and worsening illness. Adding burning needles introduces fire-heat invading the Heart, leading to fright, irritability, and insomnia. 'Chu Ti' describes a state of fear. If erroneously purged, the pathogen is not yet internally solid, vainly injuring Stomach Qi. Guest Qi enters the Diaphragm through the deficiency, causing various changes. 'Heart Ao Nao' (restlessness/discomfort) was noted previously in the Taiyang chapter. Restlessness combined with tongue coating indicates cold-pathogen trapping heat in the Chest. Cheng's commentary states: "Administer Zhi Zi Chi Tang to vomit out the pathogen in the chest." This shows that Yangming disease also has syndromes suitable for vomiting. I note: Zhang Zhongjing did not specify the color of the tongue coating. Cheng's commentary states: "Coating on the tongue is white." Knowing heat Qi resides in the chest. The chest is the stomach opening. If heat gathers in the Stomach, yellow coating should appear. If heat knots in the Large Intestine, black coating should appear. Therefore, Zhang Zhongjing's mention of tongue coating must refer to white coating. Chen Liangsi states: "Regarding the text, sweating, purging, and burning needles are mentioned, but only the treatment for erroneous purging is detailed extensively. This is because in the Yangming chapter, the emphasis is on purging, hence the analysis is particularly thorough." Zhi Zi Chi Tang formula is seen in the previous Volume 4, Taiyang Middle Chapter.)
(Attached Example) Yangming disease after purging, with external heat, warm hands and feet, no Jie Xiong (Chest Binding), heart Ao Nao, hunger but inability to eat, only sweating on the head. Zhi Zi Chi Tang governs it. (This is also a transformation syndrome of erroneous purging in Yangming disease. Erroneous purging in Yangming causes pathogenic heat to sink internally, but not as deeply as in erroneous purging of Taiyang disease. Hence, residual heat remains externally, hands and feet are warm. No Jie Xiong indicates harmony in the exterior without major pathogen. No Jie Xiong indicates harmony in the interior without major pathogen. With no major pathogen in interior/exterior, the pathogen remains only between the Chest and Diaphragm. Hence heart Ao Nao. Hunger but inability to eat means the Ao Nao is severe, feeling like hunger but not quite, with dyspepsia preventing eating. Only sweating on the head: Cheng's commentary states: "Heat steams upward from the chest, hence only head sweats while body does not." Administer Zhi Zi Chi Tang to vomit out pathogenic heat in the chest. This clause was transferred from later sections.)
If thirsty and desiring to drink water, with dry mouth and tongue, Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction) governs it. (This clause originally followed the Zhi Zi Chi Tang syndrome below. Cheng's commentary states: "This is the manifestation after purging." My opinion is: This clause involves not only erroneous purging but also erroneous sweating. Erroneous purging makes the Stomach deficient. Erroneous sweating makes the Stomach not only deficient but also extremely dry-heat. Thirst desiring to drink water, dry mouth and tongue, are signs of heat injury to Qi and consumption of Fluids. Therefore, Baihu Jia Renshen Tang is used to clear heat, tonify Qi, and moisten Fluids. A question arises: The tongue is the sprout of the Heart. Baihu Jia Renshen Tang only treats Stomach deficiency and dry-heat; why does it also govern the Heart? I answer: The Stomach occupies the Central Region. Stomach heat causes Spleen stagnation; the Heart and Lung are also steamed by it. Hence dry mouth, as the mouth is the orifice of the Spleen. The formula is named Baihu, specifically clearing the Lung. Heart and Lung are connected; hence it concurrently treats dry tongue. Qi can communicate through them. However, it must be dry-heat in the Qi level of Heart, Lung, and Spleen to be suitable. If heat is in the Blood level, Xie Xin Tang (Drain the Epigastrium Decoction) should be changed to instead.)