（此系仲景原文）
太阴之为病。腹满而吐。食不下。自利益甚。时腹自痛若下之。必胸下结硬。（此条言太阴病。乃阳邪传里之证也。
太阴之脉。入腹属脾络胃。邪热壅甚。则为腹满。邪迫于上。则吐而食不下。邪迫于下。则利甚而腹时痛。成注云。阴
寒在内。则腹中常痛。此阳邪干里。故虽痛而不常。但时时腹自痛。言有时而痛。有时则又止也。邪虽干里。既痛且利。
则此腹痛之候。宜和而不宜下矣。若误下之。必胸下结硬。此即前第五卷太阳下编云。病发于阴而反下之。因作痞者。
此之谓也。或问此条病。在未下之先。仲景法。当用何药。余答云太阴受病。当四五日发。以其脉布胃中。络于嗌。故
腹满嗌干。庞安时以大承气汤下之。今者。腹虽满而嗌不干。是病热不甚。既吐且利。其邪未实。故不可下。愚以仲景
法。还宜以桂枝加芍药汤主之。要之此汤。本太阳病误下。腹满时痛。转属太阴之药。若未经误下。而病已属太阴者。
则此汤中桂枝。另宜以升麻或葛根代之。）
太阴中风四肢烦疼。阳微阴涩而长者。为欲愈（此条系太阴中风证。一言太阴。当见腹满等候矣。兼之四肢烦疼者。
太阴之经属脾。脾主四肢成注云。风淫末疾是也。夫烦疼一候。似兼表邪。今者阳脉既微。表邪少也。阴脉则涩。里未
和也。条辩云。血凝气滞则脉涩。此非向愈之征。其欲愈者。乃脉长故也。尚论篇云。微涩之中。更察其脉之长。此为
邪气已退。正气欲复。故其病为欲自愈也。）
太阴病欲解时从亥至丑上。（注已见前第三卷太阳上编）
太阴病脉浮者。可发汗宜桂枝汤。（此条太阴病。当是太阳经传来者。夫曰太阴病。当见腹满等候。诊其脉不沉细而
浮。则知太阳经风邪犹未解也。故宜桂枝汤以汗解之。汤见前第三卷太阳篇中。）
自利不渴者属太阴。以其藏有寒故也。当温之宜四逆辈。（此条系真寒病。正文与注并汤见中寒论中）
伤寒脉浮而缓。手足自温者。系在太阴。太阴当发身黄。若小便自利者。不能发黄。至七八日。虽暴烦下利日十余
行。必自止。以脾家实。腐秽当去故也。（此条系太阴伤寒。自利欲解之证。前阳明篇中。伤寒脉浮而缓云云。至八九日。
大便硬者。此为转属阳明。今者以脾家实。故虽暴烦要之腐秽。当自利而去何也。盖太阴病。必腹满。腹满者。胃中有
物也。胃中水谷之积。既变而为腐秽。则邪应从大小便出。其暴烦者。邪欲泄而正气与之争也。成注云下利烦躁者死。
此为先利而后烦。是正气脱而邪气扰也。兹则先烦后利。是脾家之正气实。故不受邪而与之争。因暴发烦热也。下利日
十余行者。邪气随腐秽而得下泄也。以故腐秽去尽。利必自止。而病亦愈。）
本太阳病。医反下之。因尔腹满时痛者。属太阴也。桂枝加芍药汤主之。（此条系太阳病。传入太阴之证。太阳病。
何以骤传入太阴。成注云。表邪未罢。医下之。邪因乘虚。传于太阴。里气不和。故腹满时痛。此阳邪陷入于阴分也。
故仍用桂枝汤。以解太阳未尽之表邪。加芍药。以和太阴里虚之腹痛。）
(This is the original text by Zhang Zhongjing.)
Taiyin disease manifests as abdominal fullness, vomiting, inability to eat, worsening diarrhea, and spontaneous abdominal pain occurring at times. If purgatives are mistakenly used, it will inevitably lead to hardness and obstruction below the chest. (This clause discusses Taiyin disease, which is a syndrome where Yang pathogenic factors transmit inward.)
The Taiyin meridian enters the abdomen, belongs to the Spleen, and connects with the Stomach. When pathogenic heat is severely congested, abdominal fullness occurs; when pathogens force upward, vomiting and inability to eat occur; when pathogens force downward, severe diarrhea and intermittent abdominal pain occur. Cheng Wuji's commentary states: "When Yin-cold is internal, there is constant abdominal pain." This refers to Yang pathogens invading the interior; thus, although painful, the pain is not continuous but occurs intermittently ("spontaneous pain at times"), meaning it hurts sometimes and stops other times. Although pathogens invade the interior, given both pain and diarrhea, this abdominal pain syndrome should be harmonized rather than purged. If mistakenly purged, hardness and obstruction below the chest will inevitably result. This is what was said in Volume 5, Taiyang Chapter Lower: "Disease originating from Yin, yet treated with purgation, leads to Pi [obstruction] syndrome," referring to this situation. One may ask, before purgation, what medication did Zhang Zhongjing prescribe for this condition? I answer: Taiyin disease typically manifests on the fourth or fifth day of onset because its meridian spreads through the Stomach and connects to the throat, leading to abdominal fullness and dry throat. Pang Anshi advocated using Dachengqi Tang (Major Order the Qi Decoction) for purgation. Now, although the abdomen is full, the throat is not dry, indicating that heat is not severe. Since there is both vomiting and diarrhea, the pathogens are not yet solidified, so purgation is contraindicated. In my opinion, following Zhang Zhongjing's method, Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction Augmented with Peony Root) should still be the primary treatment. Essentially, this decoction was originally intended for Taiyang disease mistakenly purged, resulting in abdominal fullness and intermittent pain, transitioning to Taiyin. If purgation was not performed but the disease has already transitioned to Taiyin, then the Guizhi (Cinnamon Twig) in this decoction should alternatively be replaced with Shengma (Cimicifugae Rhizoma) or Gegen (Puerariae Lobatae Radix).)
Taiyin wind-stroke presents with vexing pain in the four limbs. If the pulse is superficially faint and internally choppy yet long, recovery is imminent. (This clause pertains to Taiyin wind-stroke syndrome. Mentioning Taiyin implies symptoms such as abdominal fullness should be present. The addition of vexing pain in the four limbs occurs because the Taiyin meridian belongs to the Spleen, and the Spleen governs the four limbs. Cheng Wuji's commentary states: "Wind excess causes disease in the extremities." The symptom of "vexing pain" seems to involve exterior pathogens. However, since the superficial pulse is faint, exterior pathogens are minimal. The internal pulse is choppy, indicating interior disharmony. Tiaobian states: "Blood stasis and Qi stagnation cause a choppy pulse." This is not a sign of recovery. The sign of impending recovery is the length of the pulse. Shanglun Pian states: "Amidst faint and choppy pulses, observe if the pulse is long." This indicates pathogens have retreated and healthy Qi is recovering, hence the disease will self-heal.)
Taiyin disease resolves between Hai hour (21:00-23:00) and Chou hour (01:00-03:00). (Note previously seen in Volume 3, Taiyang Chapter Upper.)
In Taiyin disease, if the pulse is floating, sweating therapy may be applied, preferably using Guizhi Tang (Cinnamon Twig Decoction). (This Taiyin disease case likely originated from the Taiyang meridian. Being called Taiyin disease implies abdominal fullness should be present. Diagnosing the pulse as floating rather than deep and fine indicates that Wind pathogens of the Taiyang meridian have not yet resolved. Therefore, Guizhi Tang (Cinnamon Twig Decoction) is suitable to resolve the exterior via sweating. See the formula in Volume 3, Taiyang Chapter.)
Spontaneous diarrhea without thirst belongs to Taiyin disease, due to cold in the Zang organs. Warming therapy is indicated, preferably using SiNi Tang (Frigid Extremities Decoction) or similar formulas. (This clause pertains to True Cold disease. The main text, commentary, and formula are found in *Zhong Han Lun*.)
In Shanghan (Cold Damage), if the pulse is floating and slow, and the hands and feet are naturally warm, the disease is located in Taiyin. Taiyin disease typically presents with jaundice; however, if urination is free and easy, jaundice will not develop. By the seventh or eighth day, even if sudden vexation occurs accompanied by diarrhea more than ten times a day, it will necessarily stop spontaneously because the Spleen's healthy Qi is sufficient (Pi Jia Shi), and putrid filth must be expelled. (This clause pertains to Taiyin Shanghan, a syndrome of resolving spontaneous diarrhea. In the previous Yangming chapter, it stated: "Shanghan, pulse floating and slow... by the eighth or ninth day, if stool becomes hard, this transitions to Yangming." Here, because the Spleen's healthy Qi is sufficient, although there is sudden vexation, the putrid filth must be expelled via diarrhea. Generally, Taiyin disease involves abdominal fullness. Abdominal fullness indicates accumulation in the Stomach. Once water and grain accumulations in the Stomach transform into putrid filth, pathogens should exit via urine or feces. The sudden vexation represents the conflict between expelling pathogens and resisting healthy Qi. Cheng Wuji's commentary states: "Diarrhea with vexation indicates death," referring to diarrhea preceding vexation, where healthy Qi collapses and pathogens disturb. Here, vexation precedes diarrhea, indicating the Spleen's healthy Qi is robust, resisting pathogens, causing sudden feverish vexation. Diarrhea occurring more than ten times a day signifies pathogens exiting with the putrid filth. Thus, once the filth is cleared, diarrhea stops, and the disease heals.)
Originally suffering from Taiyang disease, if the physician mistakenly uses purgation, leading to abdominal fullness and intermittent pain, the condition belongs to Taiyin and is treated with Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction Augmented with Peony Root). (This clause pertains to Taiyang disease transmitting to Taiyin. Why does Taiyang disease rapidly transmit to Taiyin? Cheng Wuji's commentary states: "Exterior pathogens remain unresolved; the physician purges, allowing pathogens to exploit deficiency and transmit to Taiyin, causing interior disharmony, hence abdominal fullness and intermittent pain." This is Yang pathogens sinking into the Yin aspect. Therefore, Guizhi Tang (Cinnamon Twig Decoction) is still used to resolve remaining exterior pathogens of Taiyang, while adding Shaoyao (Paeoniae Radix Alba) to harmonize the interior deficiency causing abdominal pain in Taiyin.)