〔《山》〕治伤寒坏症，独参汤。
好人参一两，煎服。
〔海〕阳症大汗大下后，亡阳于外，亡血于内，上而津脱，下而液脱，津液两亡，宜以羊肉汤补之。矧阴
症者，岂可不温补哉。此与伤寒太阳症振摇，与真武汤一例。外之阳病至此尚温，况内之阴候岂得不补耶。
〔韩〕产脱血虚者，宜用羊肉汤。伤寒汗下太过，亡阳失血，若只用救逆，效必迟矣，与羊肉汤，为效神速。
病患面色虽见阳，是客热上焦，中下二焦阴气已盛，若调得下焦有阳，则上焦阳气下降丹田，知所归宿矣。
夫气有高下，病有远近，证有中外，治有轻重，各适其至所为。故病八九日汗下太过，二脉沉细无力，多蜷
足卧，恶听人声，皮有粟，时战如疟，宜羊肉汤主之。
当归 白芍药（各一两） 黑附子（炮，去皮脐，四钱） 龙骨（烧通赤，半两） 生姜（二两） 牡蛎（烧赤，
一两） 桂枝（七钱半）
上为粗末，每服一两，羊肉四两，葱白五寸，去黄心，同锉烂，以水五升（一升，今之，一大盏也）
熬至一半以来，滤绞去渣，分三服服之。
〔成〕战者，身为之战摇也。栗者，心战是也。战之与栗，战外而栗内也。又云∶战为正与邪争，则鼓栗
而战；振但虚而不至争，故心耸动而振也。战之与振，振轻而战重也。
伤寒若吐若下后，心下逆满，气上冲胸，起则头眩，脉沉紧，发汗则动经，身为振振摇者，宜茯苓桂枝白术甘草
汤
茯苓（二两） 桂枝（一两半） 白术 甘草（各一两）
上 咀，每服五钱，水一盏半，煎八分，去渣温服。
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。（方见少
阴附下利。）
〔孙〕太乙宫道士周德真患伤寒，发汗出多，惊悸目眩，身战掉欲倒地。众医有欲发汗者，有作风治者，
有用冷药解者，病皆不除。召孙至，曰∶太阳经病得汗早，欲解不解者，因太阳经欲解，复作汗，肾气不足，
汗不来，所以心悸目眩身转。遂作真武汤服之，三服微汗自出，遂解。盖真武汤附子、白术和其肾气，肾气得
行，故汗得来也。若但责太阳者，惟能干涸血液尔。仲景云∶尺脉不足，荣气不足，不可以汗。以此知肾气怯
则难得汗也明矣。许学士云∶乡里有一姓高者子，年三十，初得病，身微汗，脉弱恶风，医以麻黄药与之，汗
遂不止，发热，心多惊悸，夜不得眠，谵语不识人，筋惕肉 ，振振动摇，医又进镇心药。予曰∶强汗之过也。
仲景云∶脉微汗出恶风，不可服青龙汤，服之则筋惕肉 ，此为逆也，惟真武汤可救。进此三服，佐以清心竹
叶汤，数日遂愈。（清心竹叶汤未考。）
下后复发汗，必振寒脉微细，所以然者，以内外俱虚故也。亡血家，不可发汗，发汗则寒栗而振。太阳病，
火熨其背，大汗出，火热入胃，发谵语，十余日振栗，自下利者，此为解也。（论见谵语。）
脉浮紧，按之芤，当战而汗出解。脉芤为虚，是以发战，脉浮为在表，故当汗出解也。（论见大法。）太
阳病，脉阴阳俱停等，必战栗汗出而解。（论见发热。）凡柴胡症下之，若柴胡症不罢者，复与柴胡汤，必蒸蒸
而振，发热汗出而解。（论见往来寒热。）脉浮而迟，面热赤而战惕者，当汗出解也。反发热者，脉迟不能作汗，
其身必痒也。（论见面赤。）
诸乘寒者，则为厥，郁冒不仁，口急不能言，战而栗也。阴中于邪，必内栗也。表气微虚，里气不守，故
邪中于阴也。
[Shan Tian Shi] For treating complicated conditions of Cold Damage (Shanghan), use Single Ginseng Decoction (Dushen Tang).
Take high-quality Ren Shen (Ginseng Radix) 1 liang, decoct and administer.
[Hai Zang Shi] After excessive sweating or purgation in Yang syndromes, Yang Qi is lost externally, and Blood is depleted internally. Upper depletion of Jin Ye (Body Fluids) and lower depletion of Ye (Essence/Fluids) result in the exhaustion of both fluids; it is appropriate to tonify with Mutton Soup. How much more so for Yin syndrome patients, who certainly require warming and tonification? This is analogous to the tremulousness seen in Taiyang syndrome of Cold Damage, treated with Zhen Wu Tang (True Warrior Decoction). If external Yang pathology reaches this state and still requires warming, how much more necessary is tonification for internal Yin cold patterns?
[Han Zhihe] For postpartum blood loss leading to Blood deficiency, Mutton Soup is appropriate. In Cold Damage, if sweating and purgation are excessive, leading to loss of Yang and Blood, relying solely on methods to rescue deviation will yield slow results; administering Mutton Soup yields miraculous speed.
Although the patient's complexion may appear Yang-warm, this is merely transient heat lingering in the Upper Jiao (Upper Burner), while Yin Qi is already abundant in the Middle and Lower Jiaos. If the Lower Jiao can be regulated to generate Yang Qi, then the Yang Qi of the Upper Jiao will descend into the Dantian, finding its proper residence.
Qi has its levels of ascent and descent; disease has its distances; symptoms have their interior and exterior locations; treatments have their degrees of severity. Each must suit the specific situation. Therefore, after eight or nine days of illness, due to excessive sweating and purgation, resulting in deep, thin, and forceless pulses in both wrists, a tendency to curl the feet while lying down, aversion to hearing human voices, skin with gooseflesh, and frequent chills resembling malaria, Mutton Soup should be the primary treatment.
Dang Gui (Angelicae Sinensis Radix), Bai Shao Yao (Paeoniae Radix Alba) (each 1 liang); Hei Fu Zi (Aconiti Lateralis Radix Praeparata, blackened Aconite Root, prepared, peel and umbilicus removed, 4 qian); Long Gu (Fossilia Ossis Mastodi, fossilized mammal bone, calcined until red hot, 0.5 liang); Sheng Jiang (Zingiberis Rhizoma Recens, fresh Ginger, 2 liang); Mu Li (Concha Ostreae, oyster shell, calcined until red hot, 1 liang); Gui Zhi (Cinnamomi Ramulus, Cinnamon Twig, 7.5 qian).
Grind the above herbs into coarse powder. For each dose, take 1 liang of the powder, combined with 4 liang of mutton meat and 5 cun of Cong Bai (Allii Fistulosi Bulbus, scallion white, remove yellow heart). Chop finely together. Add 5 sheng of water (1 sheng equals one large cup today). Boil until reduced by half. Strain and squeeze out the juice, discarding the dregs. Divide into three doses for administration.
[Cheng Wuji] "Zhan" (shivering/trembling) refers to the shaking of the body. "Li" (trepidation/fear) refers to the trembling of the mind/heart. The difference between Zhan and Li is that Zhan is external, while Li is internal. It is also said: Zhan occurs when righteous Qi contends with pathogenic factors, causing drumming-like trembling; Zhen (vibration/shaking) occurs merely due to deficiency without contention, causing the heart to startle and shake. Compared to Zhan, Zhen is mild, while Zhan is severe.
After vomiting or purgation in Cold Damage, if there is fullness and rebellious Qi rising from the epigastrium, Qi rushing up to the chest, dizziness upon standing, and a deep, tight pulse, further sweating will disturb the collaterals, causing the body to tremble and shake; Ling Fu Gui Zhi Bai Zhu Gan Cao Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction) is indicated.
Fu Ling (Poria, 2 liang); Gui Zhi (Cinnamomi Ramulus, 1.5 liang); Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 liang); Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 liang).
Cut the herbs. For each dose, take 5 qian, add 1.5 cups of water, decoct to 0.8 cups, strain, and take warm.
In Taiyang syndrome, if sweating fails to resolve the condition, and the patient still has fever, palpitations, dizziness, muscle twitching, and feels as though they want to fall to the ground due to severe trembling, Zhen Wu Tang (True Warrior Decoction) is the primary treatment. (Formula see below under Shaoyin diarrhea.)
[Sun Simiao] Zhou Dezhen, a Daoist priest at Taiyi Palace, suffered from Cold Damage. Excessive sweating led to palpitations, dizziness, and body tremors threatening to make him fall. Various physicians attempted further sweating, wind-dispelling treatments, or cold-clearing drugs, but the illness persisted. Sun Simiao was summoned and stated: This is a Taiyang channel disease where sweating was induced too early. The desire for resolution exists, but because Kidney Qi is insufficient, sweat cannot be generated. Hence, palpitations, dizziness, and body turning occur. He prescribed Zhen Wu Tang. After three doses, slight sweating occurred naturally, and the illness resolved. This is because Zhen Wu Tang’s Fu Zi (Aconiti Lateralis Radix Praeparata) and Bai Zhu harmonize Kidney Qi; once Kidney Qi moves, sweat can be produced. If one only focuses on the Taiyang channel, it will only dry up the blood and fluids. Zhang Zhongjing said: If the Chi (cun-kou) pulse is deficient and Ying Qi (Nutritive Qi) is insufficient, sweating is contraindicated. Thus, it is clear that weak Kidney Qi makes sweating difficult. Xu Xueshi said: There was a thirty-year-old son of a Gao family member in my hometown. Initially ill with slight sweating, weak pulse, and aversion to wind, a physician administered Ma Huang (Ephedrae Herba) drugs. Sweating became uncontrollable, accompanied by fever, frequent palpitations, insomnia, delirium, inability to recognize people, Jin Ti Rou Dun (muscle twitching and fasciculation), and violent trembling. Another physician administered heart-calming drugs. I said: This is an error caused by forced sweating. Zhang Zhongjing said: With a faint pulse, sweating, and aversion to wind, Qing Long Tang (Green Dragon Decoction) is contraindicated; administering it causes Jin Ti Rou Dun, which is adverse. Only Zhen Wu Tang can rescue this. Administering this medicine three times, assisted by Qing Xin Zhu Ye Tang (Clear Heart Bamboo Leaf Decoction), resulted in recovery within several days. (Qing Xin Zhu Ye Tang could not be verified.)
Following purgation and then inducing sweating again inevitably leads to chills and trembling with a faint, thin pulse. This is because both the interior and exterior are deficient. Patients with chronic blood loss should not undergo sweating therapy; doing so causes cold tremors and shaking. In Taiyang syndrome, if the back is scorched with fire, causing excessive sweating, and the fire-heat enters the Stomach leading to delirium, followed by chills and spontaneous diarrhea after ten or twelve days, this indicates the disease is resolving. (Discussion see Delirium chapter.)
If the pulse is floating and tight, but hollow (Kou) upon pressure, the patient should experience trembling followed by sweating and resolution. A Kou pulse indicates deficiency, hence the trembling; a floating pulse indicates the pathogen is in the exterior, hence resolution through sweating. (Discussion see General Principles chapter.) In Taiyang syndrome, when pulses in both positions cease or become equal, the patient will likely experience trembling, sweating, and resolution. (Discussion see Fever chapter.) In all cases of Chai Hu (Bupleurum) syndrome where purgation was mistakenly used, if the Chai Hu syndrome persists, administering Chai Hu Tang again will cause a feeling of warmth rising from within followed by trembling, then fever, sweating, and resolution. (Discussion see Alternating Chills and Fever chapter.) If the pulse is floating and slow, with facial heat/redness and trembling/trepidation, resolution should come through sweating. If there is instead fever, the slow pulse prevents sweating, and the body will likely itch. (Discussion see Red Face chapter.)
For all conditions invaded by Cold pathogens, Jue (Cold Reversal) occurs, along with depression, vertigo, numbness, oral tension, inability to speak, and trembling with cold fear. When Yin aspects are invaded by pathogens, internal trembling necessarily occurs. This is because the exterior Qi is slightly deficient, and the interior Qi fails to hold fast, allowing pathogens to enter the Yin.