此篇集丹溪、海藏诸贤治伤寒，皆以补养兼发散之法，实本经成败倚伏生于动，动而不已则变作，及风雨
寒热，不得虚邪不能独伤人之旨也。盖凡外伤风寒者，皆先因动作烦劳不已，而内伤体虚，然后外邪得入，故
一家之中，有病者，有不病者，由体虚则邪入而病，体不虚则邪无隙入而不病也。是故伤寒为病，属内伤者十
居八九。后学无知，举世皆谓伤寒无补法，但见发热，不分虚实，一利下汗而致夭横者，滔滔皆是，此实医门
之罪人也。今集此法于仲景之后，其应如响，使人遵之，不犯虚虚实实之戒也。
〔丹〕伤寒主乎温散 有卒中天地之寒气者，有口食生冷之物者，故伤寒为病，必须身犯寒气，口食寒物
者，是以从补中益气汤加发散药。属内伤者十居八九，其法邪之所凑，其气必虚，只用补中益气汤中从所见之
症出入加减。气虚甚者，少用附子，以行参术之气。（补中益气汤方见治发热。）内伤之病，专主东垣，
《内外伤辨》甚详。世之病此者为多，但有挟痰挟外邪者，郁热于内而发者，皆以补元气为主，宜看其所
挟而兼用药。
一男子素嗜酒，因暴风寒衣薄，遂觉倦怠，不思饮食半日，至睡后，大发遍身疼痛如被杖，微恶寒。天明
诊之，六脉浮大，按之豁然，左为甚。予作极虚受风寒治之，人参为君，黄 、白术、归身为臣，苍术、甘草、
木通、干葛为佐，使大剂与之，至五帖后，通身汗如雨，凡三易被得睡，觉来诸症悉除。
白术 陈皮 干葛 苍术（各三钱） 人参 川芎（各钱半） 黄 归身 木通（各一钱） 甘草（五分）
上分三帖，水煎服。
卢兄年四十九岁，自来大便下血，脉来沉迟涩，面黄神倦者二年矣。九月间，因劳倦发热，自服参苏饮二
帖，热退，早起小劳，遇寒，两手背与面紫黑，昏仆，少时却醒，身大热，妄语，口干，身痛，至不可眠，脉
之三部不调，微带数，重取虚豁，左手大于右手。以人参二钱半，带节麻黄、黄 各一钱，白术二钱，当归五
分，与三五帖得睡，醒来大汗如雨即安。两日后再发，胁痛咳嗽，若睡时嗽不作而妄语，且微恶寒，诊其脉似
前而左略带紧。予曰∶此体虚再感寒也。再以前药加半夏、茯苓，至十余帖，再得大汗而安。后身倦不可久坐，
不思饮食，用补中益气去凉药，加神曲、半夏、砂仁，五七十帖而安。
一丈夫因劳倦发热甚倦，不可以伤寒治之。用
人参（四钱） 白芍药 陈皮 当归（各三钱） 黄 （三钱半） 苍术（二钱） 木通（一钱） 甘草（少）
上分三帖，水煎温服。
一丈夫发热五日，倦甚，略渴，得洪脉，不甚数，略重则散大，此内伤症也。用
白术（二钱） 人参 陈皮 柴胡（各钱半） 黄 苍术（各一钱） 木通（六分） 甘草（少）
上分二帖，水煎服。
一大夫倦甚，口干发热，汗不出。用
陈皮（三钱） 人参 白术 苍术（各二钱） 干葛（钱半） 黄 木通（各一钱）
上分二帖，水煎服。
一丈夫发热振 ，倦怠口渴。
人参 白术 白芍 柴胡（各二钱） 陈皮（三钱） 黄 （一钱） 木通（钱半） 甘草（少）
上分四帖，水煎热饮。
王孺人因辛苦发热。
芍药（五钱） 白术（三钱半） 人参 当归（各二钱） 陈皮（一钱） 川芎 甘草 木通（各钱半）
上分四帖，水煎温服。
第四女发热，冒风冷。
麻黄 人参（各五分） 苍术（一钱） 甘草（少）
上水煎，温服。
上十方，皆补养中气兼发散之剂。
杭州叶君章，腊月因斋素中饥而冒寒作劳，遂患发热头痛。医与小柴胡汤，遂自汗，神昏，耳聋，目不见
物。予诊其脉大如指，似有力，热不退。与人参、黄 、白术、熟附、炙甘草作大剂之，一日而汗少，二日而
热减半，耳微有闻，目能视物。初用药至四帖，前药中加苍术与两服，再得汗而热除。本日遂去苍术、附子，
又与前药作小剂服，三日而安。
吕仲修年六十六岁，正月间因忍饥冒寒作劳，头疼恶寒发热，骨节皆疼，无汗，至次日妄语，热愈甚，而
妄语时止时作，热亦不为十分。自服参苏饮两帖，汗不出，又再进一服，以衣覆取汗大出，而热不退。至第四
日，予诊其脉，两手皆洪数，而上为甚。此因饥而冒寒，加之作劳，阳明经虽受寒气，不可攻击，当急以大
剂补之，以回其虚，俟胃气充实，自能出汗而解。遂以参、 、白术、归身、陈皮、炙甘草，每帖加熟附子一
片，一昼夜服五帖。至第三日，口稍干，言语有次，诸症虽解而热未退，遂去附子，加白芍。又两日思食，却
作肉羹间与之。又三日，精神全。二日许，自汗出而热退，诊其脉不数，洪脉却尚有些，洪脉作大脉论，年高
而误汗，此后必有虚症见，又与前药。至次日言，我大便自病来不曾更衣，今谷道逼痛，坐努责状如不堪，医
者必欲投大黄、巴豆等剂。予谓大便非实秘，为是气因误汗而虚，不得充腹，无力可努，仍与前补药以肉粥及
苁蓉与之一日半，煎浓葱椒汤浸下体，方下大便软块者五六枚。诊其脉仍旧大未敛，此因气血未得回复，又与
前药两帖，经两日，小便不通，少腹下妨闷，颇为所苦，但仰卧则点滴而出。予曰∶补药服之未尽，于前药内
倍加参、 大剂服两日，小便方利而安。
陶明节年十九岁，不惮劳 ，不息农作，忽一日因劳倦大发热而渴，恣饮冷泉水数碗，次日热退，目不识
人，言语谬误，自言肚痛不能转侧，饮食不进，身战掉不自持。又二日，求予诊之。两手涩而大，而上为甚。
遂于气海灸三十壮，用白术二钱，黄 二钱，熟附一片，陈皮五分，与十帖不效，又增发热微渴，余症仍在，
却可进二匙稀粥。予曰∶此气欲利而血未应也，于前药内去附子加当归以和血，因有热，加人参一钱半，服三
十帖而安。
〔海〕黄 汤治伤寒两感，拘急，三焦气虚，自汗，及手足汗出，或手背偏多，或肢体振摇，腰腿沉重，
面赤目红，但欲睡眠，头面壮热，两胁热甚，手足自温，两手心热，自利不渴，大便或难或如常度，或口干咽
燥，或渴欲饮汤不欲饮水，或少欲饮水，呕哕间作，心下满闷，腹中疼痛，或时喜笑，或时悲哭，或时太息，
或时语言错乱，疑作谵言狂语者非也，神不守舍耳。始得病于寤寐之间，或恐悸，头项不甚痛，行步只如旧，
此阴盛阳虚之故也。两手脉浮沉不一，或左或右，往来不定，有沉涩弱微弦五种阴脉形状，按之全无力，浮之
损小，沉之亦损小，皆阴脉也，宜先缓而后急，缓宜用黄 汤。
黄 汤方
人参 生姜 黄芩 白茯苓 白术 白芍药（各一两） 甘草（七钱）
呕者加藿香、陈皮（各五钱，）甚者加干姜（炮一钱。）
上 咀，水煎，量症加减多少用之。如大便秘结者，调中丸主之。
调中丸方
人参 白术 白茯苓 干姜 甘草（各等分）
上为末，炼蜜丸，每两作十丸，或五丸，每服一二丸，水少许煎服。若病急者，黄 汤每服加干姜一钱，
大便结者，理中丸主之。
理中丸方
人参 白术 干姜（炮，恐热，以生姜代之） 甘草（炙）
上等分为末，炼蜜丸，每两作五丸，白汤化下，先缓后急也。若尤急者，无汗宜附子干姜甘草汤。若自汗
者，宜白术附子甘草汤。量脉症可于四逆汤，或真武汤，或通脉四逆汤选用之。
〔垣〕冯内翰侄栎年十六，病伤寒，目赤而烦渴，脉七八至，医欲承气汤下之，已煮熟矣。偶东垣从外来，
冯告之故。东垣切脉大骇曰∶几杀此儿，彼以脉数为热，今脉七至，是极热也，殊不知至真要大论云∶病有脉
从而病反者何？岐伯对曰∶脉至而从，按之不鼓，诸阳脉皆然。此阴盛格阳于外，非热也。取姜附来，吾以热
因寒用之法治之。治药未就，而病者爪甲已青，顿服八两，汗渐出而愈。
上七法，补兼发散，随所见症加姜附，甚者熟附，微者干姜，又甚者姜附兼施，皆反治法也。
〔丹〕盛孺人年四十岁，外冷内热，身疼头痛，倦怠，脉虚微涩。
川芎 柴胡 芍药（各半两） 羌活 黄柏（各二钱，炒） 南星（一钱） 甘草（炙，三分）
上分两帖，生姜三片，水煎热服。
沈材妻年五十余，满身骨节痛，半日以后发热，黄昏至半夜却退。
苍术 陈皮 羌活（各一钱） 白术（钱半） 木通 炒柏 通草（各五分）
上 咀，水煎温服。
丁亲家于久疟后，暑月涉水，又劳苦，腿HT 痛，渐渐浑身痛，胁亦痛，发热，脉却涩，不甚数。
予曰∶此劳倦乏力。治用
白术 黄 苍术 陈皮（各一钱） 人参 黄柏（酒炒。各五分） 木通（三分） 甘草（炙，二分）
上 咀，水煎，下龙荟丸。
小阿婆午后发热，遍身痛，血少，月经黑色，大便闭。用
芍药（五钱） 黄芩 苍术（各三钱） 黄柏（酒炒） 木通（各二钱）
上 咀，水煎服。
上四方兼补发散，随所见脉症，加炒柏、龙荟，皆正治法也。
陈小娘年二十，发热目闭，开口则热甚，渴思水解，脉涩而浊溷，此食痰也。治用
黄芩 甘草 木通（各五分） 陈皮 白术 干葛（各一钱） 黄连 桔梗（各六分）
上 咀，水煎，下保和丸二三十丸。
一丈夫因恐发热，心不安，用南星、白茯苓各五钱，朱砂二钱，以上为六帖。再用
人参 当归 柴胡（各三钱） 黄芩 川芎 木通（各二钱） 甘草 红花（各五分）
上分四帖，水二盏半，入金银器同煎，至一盏，去渣，热调服。
上二方兼补发散，随所见症，加食积痰药。
〔海〕神术汤 治内伤冷冻饮料，外感寒邪无汗者。
苍术（制） 防风（各二两） 甘草（一两，炒）
上 咀，加葱白、生姜同煎服。如太阳症发热恶寒脉浮而紧者，加羌活二钱。如太阳症脉浮紧中带弦数者，
是兼少阳也，加柴胡二钱。如太阳症脉浮紧中带洪者，是兼阳明也，加黄芩二钱。妇人服者加当归，或加木
香汤，或加 本汤各二钱。如治吹奶，煎成调六一散三五钱，神效。
又神术汤六气加减例∶
太阳寒水司天，加羌活、桂枝，余岁非时变寒亦加，冬亦加。
阳明燥金司天，加白芷、升麻，余岁非时变凉湿亦加，秋亦加。
少阳相火司天，加黄芩、地黄，余岁非时变雨湿亦加，夏亦加。
太阴湿土司天，加白术、 本，余岁非时变热湿亦加，夏末秋初亦加。
少阴君火司天，加细辛、独活，余岁非时变热亦加，春末夏初亦加。
厥阴风木司天，加川芎、防风，余岁非时变温和亦加，春亦加。
以上神术汤六气加减法，非止为司天之气设也。至于岁之主气与月建日时同，前应见者皆当随所见根据上
例加减之。按海藏此论，与戴人云病如不是当年气，看与何年运气同，便向此中求妙法，方知皆在至真中
之歌相表里，实发前人之所未发也。盖海藏此论，所谓某气司天加某药者，治常气之法也，所谓随所应见
加减者，治变气之法也。戴人所谓看与何年同气求治法者，亦治变气之法也。能将二公之法扩充行之，则
《内经》运气之本义灿然矣。夫《内经》论运气，有常气，有变气。常气者有定纪，如某年属某气司天当寒，
某年属某气司天当热是也。变气者，无定纪，如某年属某气司天，当寒反变热，当热反寒是也。王氏注文
释以经无定纪之变气，作有定纪之常气，使后学皆以年岁占运气，而其应者十无一二，是以人莫之信，而
其道湮晦久矣。二公生于数千百年之后，复启其端而续之，与程朱续孔孟不传之绪同功也。今仆谨于海藏
逐年司天加药之后，伸余岁变常之义，其意有不尽者，别述《运气类注》定之，同志之士，幸究心焉。
白术汤 治内伤冷物，外感风寒有汗者。
白术（三两） 防风（二两） 甘草（一两，炙）
上 咀，每服三钱，水一盏，姜三片，煎至七分，温服，一日止一二服，待二三日渐渐汗少为解。
又白术汤 治伤寒，上解三阳，下安太阴。
白术（如汗之，改用苍术） 防风（各一两）
上 咀，水煎至七分，温服，用后方加减。若发热引饮者，加黄芩、甘草。头疼恶风者，加羌活散三钱∶
羌活一两半，川芎七钱，细辛二钱半。（去芦。）若身热目痛者，加石膏汤四钱∶石膏二钱，知母半两，白芷七钱。
腹中痛者，加芍药汤三钱∶芍药一两，桂枝半两。往来寒热而呕者，加柴胡散三钱∶柴胡一两，半夏半两。
心下痞者，加枳实一钱。若有里症，加大黄一钱，量虚实加减之，邪去止服。
〔洁〕有汗不得服麻黄，无汗不得服桂枝，然春夏汗孔疏，虽有汗不当服桂枝，宜用黄 汤和解之。秋冬
汗孔闭，虽无汗不当服麻黄，宜用川芎汤和解之。春夏有汗，脉微而弱，恶风恶寒者，乃太阳症，秋冬之脉也，
宜用黄 汤，无汗亦用川芎汤。秋冬有汗，脉盛而浮，发热恶热者，乃阳明症，春夏之脉也，宜用黄 汤，无
汗亦用川芎汤。大抵有汗皆宜黄 汤，无汗皆宜川芎汤主之。
黄 汤 有汗则能止之。
This chapter collects the methods of treating Shanghan (Cold Damage) by Danxi, Haizang, and other sages. All employ a method of tonifying and nourishing combined with dispersing. This is actually based on the principle from the *Neijing* that "success and failure, leaning and hiding, arise from movement; if movement does not cease, changes occur," as well as the tenet that "wind, rain, cold, and heat cannot injure humans alone unless there is deficiency allowing evil to enter." Generally, any external contraction of wind-cold first occurs due to excessive physical activity and fatigue, which internally damages the constitution and causes deficiency, only then can external pathogens invade. Therefore, within one family, some fall ill while others do not; this is because when the constitution is deficient, pathogens enter causing disease, but when the constitution is not deficient, pathogens have no gap to enter and thus no disease occurs. Thus, among diseases classified as Shanghan, those belonging to internal injury account for eight or nine out of ten. Ignorant junior physicians, and the world at large, believe there are no tonifying methods for Shanghan. Whenever fever is seen, regardless of excess or deficiency, they indiscriminately use purgation or sweating, leading to premature death in countless cases. These people are truly criminals in the medical field. Now, collecting these methods after Zhang Zhongjing, their efficacy responds like an echo. By following them, one avoids the taboo of making deficiency more deficient and excess more excess.
[Danxi] Shanghan primarily requires warm dispersal. Some suffer sudden invasion of heaven-and-earth cold qi, while others consume raw and cold foods. Therefore, Shanghan disease must involve bodily exposure to cold qi and oral consumption of cold substances. Hence, one starts with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) adding dispersing herbs. Cases belonging to internal injury account for eight or nine out of ten. The principle is: "Where pathogenic factors gather, qi must be deficient." One should only add or subtract from Buzhong Yiqi Tang based on observed symptoms. For severe qi deficiency, a small amount of Fuzi (Prepared Aconite Root) is added to facilitate the action of Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala Rhizome). (See Buzhong Yiqi Tang formula in the section on treating fever.) Internal injury diseases specifically follow Dongyuan's teachings, detailed extensively in *Bian Nei Wai Shang* (Differentiation of Internal and External Injury). Many in the world suffer from this, but some have phlegm or external pathogens mixed in, with stagnant heat developing internally. Treatment focuses mainly on tonifying primordial qi, while considering mixed pathogens for adjunctive medication.
A man who habitually drank alcohol felt fatigued and lost his appetite for half a day due to a violent cold wind and thin clothing. After sleeping, he suffered severe whole-body pain as if beaten, with slight aversion to cold. At dawn, his six pulses were floating and large, but hollow upon deep pressure, more pronounced on the left. I treated him as extreme deficiency suffering from wind-cold. Renshen (Ginseng) was used as the sovereign herb, Huangqi (Astragalus Root), Baizhu (Atractylodes Macrocephala Rhizome), and Danggui Shen (Angelica Sinensis Root Heart) as minister herbs, Cangzhu (Atractylodes Lancea Rhizome), Gancao (Licorice Root), Mutong (Akebia Stem), and Genge (Pueraria Root) as assistant herbs. He was given a large dose. After five doses, he sweated profusely like rain, changed bedding three times before sleeping, and upon waking, all symptoms vanished.
Baizhu (3 qian), Chenpi (Tangerine Peel, 3 qian), Genge (3 qian), Cangzhu (3 qian), Renshen (1.5 qian), Chuanxiong (Ligusticum Wallichii Rhizome, 1.5 qian), Huangqi (1 qian), Danggui Shen (1 qian), Mutong (1 qian), Gancao (0.5 qian).
Divide into three doses, decoct in water, and take orally.
Brother Lu, aged forty-nine, had been passing blood in his stool for two years, with a deep, slow, and choppy pulse, yellowish complexion, and mental fatigue. In September, due to labor and fatigue, he developed fever. He self-administered Shensu Yin (Ginseng and Perilla Decoction) for two doses; the fever subsided. Upon rising early and exerting himself slightly, he encountered cold wind, causing his hands' dorsum and face to turn purple-black. He fainted but revived shortly after, experiencing high fever, delirium, dry mouth, body pain, and insomnia. His three-position pulses were irregular, slightly rapid, hollow upon deep pressure, with the left hand larger than the right. I prescribed Renshen (2.5 qian), Mahuang (Ephedra Herb) with nodes (1 qian), Huangqi (1 qian), Baizhu (2 qian), and Danggui (0.5 qian). After three to five doses, he slept. Upon waking, he sweated profusely and recovered. Two days later, relapse occurred with hypochondriac pain and cough. During sleep, cough ceased but delirium persisted, with slight aversion to cold. Pulse resembled previous but left side slightly tight. I said: "This is constitutional deficiency re-contracted with cold." I repeated the previous prescription adding Banxia (Pinellia Tuber) and Fuling (Poria), totaling over ten doses, resulting in heavy sweating and recovery. Later, due to fatigue preventing prolonged sitting and loss of appetite, I used Buzhong Yiqi Tang removing cooling herbs, adding Shenqu (Medicated Leaven), Banxia, and Sharen (Amomum Fruit), resolving after fifty to seventy doses.
A husband suffered fever and extreme fatigue due to labor and fatigue; this should not be treated as Shanghan.
Renshen (4 qian), Baishaoyao (White Peony Root, 3 qian), Chenpi (3 qian), Danggui (3 qian), Huangqi (3.5 qian), Cangzhu (2 qian), Mutong (1 qian), Gancao (small amount).
Divide into three doses, decoct in water, and take warm.
A husband had fever for five days, extreme fatigue, slight thirst, and a洪 (Surging) pulse that was not very rapid and dispersed/large upon slight deep pressure. This is an internal injury syndrome.
Baizhu (2 qian), Renshen (1.5 qian), Chenpi (1.5 qian), Chaihu (Bupleurum Root, 1.5 qian), Huangqi (1 qian), Cangzhu (1 qian), Mutong (0.6 qian), Gancao (small amount).
Divide into two doses, decoct in water, and take orally.
A physician suffered extreme fatigue, dry mouth, fever, and absence of sweat.
Chenpi (3 qian), Renshen (2 qian), Baizhu (2 qian), Cangzhu (2 qian), Genge (1.5 qian), Huangqi (1 qian), Mutong (1 qian).
Divide into two doses, decoct in water, and take orally.
A husband suffered fever, trembling, fatigue, and thirst.
Renshen (2 qian), Baizhu (2 qian), Baishaoyao (2 qian), Chaihu (2 qian), Chenpi (3 qian), Huangqi (1 qian), Mutong (1.5 qian), Gancao (small amount).
Divide into four doses, decoct in water, and drink hot.
Lady Wang suffered fever due to hard work.
Shaoyao (Peony Root, 5 qian), Baizhu (3.5 qian), Renshen (2 qian), Danggui (2 qian), Chenpi (1 qian), Chuanxiong (1.5 qian), Gancao (1.5 qian), Mutong (1.5 qian).
Divide into four doses, decoct in water, and take warm.
The fourth daughter suffered fever and exposure to wind-cold.
Mahuang (0.5 qian), Renshen (0.5 qian), Cangzhu (1 qian), Gancao (small amount).
Decoct in water and take warm.
All ten formulas above are agents that tonify middle qi and disperse externally.
Ye Junzhang of Hangzhou, in the twelfth lunar month, became hungry during fasting, exposed to cold, and labored, resulting in fever and headache. A doctor gave Xiao Chaihu Tang (Minor Bupleurum Decoction), causing spontaneous sweating, coma, deafness, and blindness. I diagnosed his pulse as large as a finger, seemingly forceful, with persistent fever. I administered Renshen, Huangqi, Baizhu, Shufu (Prepared Aconite), and Zhi Gancao (Honey-fried Licorice) in a large dose. After one day, sweating decreased; after two days, fever halved, hearing improved slightly, and vision returned. By the fourth dose, Cangzhu was added for two servings, inducing further sweating and clearing fever. That day, Cangzhu and Fuzi were removed, and a smaller dose was given, resolving after three days.
Lv Zhongxiu, aged sixty-six, endured hunger, cold exposure, and labor in January, suffering headache, aversion to cold, fever, joint pain, and anhidrosis. On the second day, he experienced intermittent delirium and worsening fever. Self-administering Shensu Yin twice failed to induce sweat. A third dose covered with clothes induced heavy sweating without reducing fever. On the fourth day, his pulses were surging and rapid, especially superiorly. Due to hunger, cold, and labor, although the Yangming channel received cold, attack methods were contraindicated. Urgent large-dose tonification was needed to restore deficiency. Once stomach qi was sufficient, sweat would naturally emerge to resolve the condition. I prescribed Renshen, Huangqi, Baizhu, Danggui Shen, Chenpi, and Zhi Gancao, adding one slice of Shufu per dose, taken five times in twenty-four hours. By the third day, mouth was slightly dry, speech coherent, symptoms resolved except fever. Fuzi was removed, Baishaoyao added. Two days later, appetite returned; meat broth was occasionally given. Three days later, spirit fully recovered. Around two days later, spontaneous sweating occurred, fever subsided, pulse slowed, though surging quality remained. Given his age and mistaken sweating, deficiency symptoms were expected. He reported no bowel movement since illness onset, with anal pain and straining sensation. Physicians wanted to administer Dahuang (Rhubarb Root) or Badou (Croton Seed). I stated this was not constipation but qi deficiency from mistaken sweating, lacking strength to push. I continued tonics with meat porridge and Congrong (Cistanche Stem), plus strong scallion-pepper soup for lower body immersion, resulting in passage of five or six soft stools. Pulse remained large and unconsolidated, indicating qi and blood not yet restored. Two more doses were given. Two days later, urinary retention with lower abdominal distension occurred, relieved only by lying supine. I said: "Tonics were not fully consumed." I doubled Renshen and Huangqi in a large dose for two days, resolving urinary issues.
Tao Mingjie, aged nineteen, did not fear labor, continuing farming. Suddenly, due to fatigue, he developed high fever and thirst, drinking several bowls of cold spring water. Fever subsided next day, but he became unable to recognize people, spoke erroneously, complained of abdominal pain preventing turning, refused food, and trembled uncontrollably. Two days later, I examined him. Pulses were choppy and large, superiorly prominent. I moxa Qihai (CV-6) thirty moxibustions. Prescribed Baizhu (2 qian), Huangqi (2 qian), Shufu (one slice), Chenpi (0.5 qian) for ten doses without effect. Fever and slight thirst increased, other symptoms persisted, only able to eat two spoonfuls of thin congee. I said: "Qi desires to flow but blood has not responded." I removed Fuzi, added Danggui to harmonize blood, and Renshen (1.5 qian) due to heat. After thirty doses, he recovered.
[Haizang] Huangqi Tang treats Shanghan Lianggan (simultaneous exterior and interior contraction), spasms, Sanjiao (Triple Burner) qi deficiency, spontaneous sweating, and sweating on hands/feet (often more on hand dorsums), limb tremors, heavy waist/legs, red face/eyes, desire to sleep, intense heat on head/face, heat in hypochondrium, warm hands/feet, hot palms, spontaneous diarrhea without thirst, difficult or normal stools, dry mouth/throat, craving hot drinks but not water, or slight water craving, intermittent vomiting/hiccups, chest fullness, abdominal pain, occasional laughter, crying, sighing, or confused speech (not delirium/manic speech, but spirit not residing in its house). Illness begins between wakefulness and sleep, with fear/palpitations, mild head/neck pain, normal gait. This is due to yin excess and yang deficiency. Pulses vary in floating/sinking, left/right, unstable, showing five yin pulse shapes: deep, choppy, weak, faint, string-taut. Pressing reveals total weakness; floating shows diminished/small; sinking shows diminished/small. All are yin pulses. Treatment should start slow then become urgent. Slow phase uses Huangqi Tang.
Huangqi Tang Formula
Renshen, Shengjiang (Fresh Ginger), Huangqin (Scutellaria Root), Baifuling (Poria), Baizhu, Baishaoyao (each 1 liang), Gancao (7 qian).
For vomiting, add Huoxiang (Patchouli) and Chenpi (each 5 qian); for severe cases, add Ganjiang (Dried Ginger, fried, 1 qian).
Crush, decoct in water, adjust dosage based on symptoms. For severe constipation, use Tiaozhong Wan (Regulate Middle Pill).
Tiaozhong Wan Formula
Renshen, Baizhu, Baifuling, Ganjiang, Gancao (equal parts).
Grind to powder, make honey pills. Each liang makes ten or five pills. Take 1-2 pills, decoct in small amount of water. For urgent cases, add 1 qian Ganjiang to each serving of Huangqi Tang. For constipation, use Lizhong Wan (Regulate Middle Pill).
Lizhong Wan Formula
Renshen, Baizhu, Ganjiang (fried; replace with Shengjiang if fearing heat), Gancao (fried).
Grind to powder, make honey pills. Each liang makes five pills. Dissolve in white water. Start slow, then urgent. If extremely urgent with anhidrosis, use Fuzi Ganjiang Gancao Tang (Aconite, Dried Ginger, Licorice Decoction). If spontaneous sweating, use Baizhu Fuzi Gancao Tang (Atractylodes, Aconite, Licorice Decoction). Select from Sini Tang (Frigid Extremities Decoction), Zhenwu Tang (True Warrior Decoction), or Tongmai Sini Tang (Pulse-Unblocking Frigid Extremities Decoction) based on pulse and symptoms.
[Dongyuan] Feng Neihan's nephew, Yue, aged sixteen, had Shanghan with red eyes, irritability, thirst, and pulse of seven to eight beats per breath. A doctor intended to use Chengqi Tang (Chengqi Decoction) for purgation, already cooked. Dongyuan returned, Feng explained. Dongyuan palpated and was shocked: "You almost killed this boy. They took rapid pulse as heat. Now pulse is seven beats, indicating extreme heat. But *Suwen* says: 'When pulse follows disease but condition contradicts?' Qibo answered: 'Pulse follows, but pressing does not drum/beat up. All yang pulses are like this.' This is yin excess repelling yang outward, not heat. Bring ginger and aconite. I will treat with 'treat heat using cold' method." Before medicine was ready, patient's nails turned blue. Instantly administered eight liang, sweat gradually appeared, and he recovered.
The above seven methods combine tonification and dispersal, adding Jiang (Ginger) and Fu (Aconite) based on symptoms. Severe cases use Shufu, mild cases Ganjiang, even more severe use both. All are contrary treatment methods.
[Danxi] Lady Sheng, aged forty, had external cold/internal heat, body/head pain, fatigue, and deficient/faint/choppy pulse.
Chuanxiong, Chaihu, Shaoyao (each ban liang), Qianghuo (Notopterygium Rhizome), Huangbai (Phellodendron Bark, each 2 qian, fried), Nanxing (Arisaema Tuber, 1 qian), Gancao (fried, 3 fen).
Divide into two doses, add three slices of Shengjiang, decoct in water, and drink hot.
Shen Cai's wife, over fifty, had whole-body joint pain, fever starting half a day later, subsiding from dusk to midnight.
Cangzhu, Chenpi, Qianghuo (each 1 qian), Baizhu (1.5 qian), Mutong, Chao Bai (Fried Phellodendron), Tongcao (Akebia Stem, each 0.5 qian).
Crush, decoct in water, and take warm.
Relative Ding, after long-term malaria, waded in water during summer, labored heavily, suffering leg swelling/pain spreading to whole body and hypochondrium, fever, choppy pulse not very rapid.
I said: "This is fatigue-induced weakness." Treatment used:
Baizhu, Huangqi, Cangzhu, Chenpi (each 1 qian), Renshen, Huangbai (wine-fried, each 5 fen), Mutong (3 fen), Gancao (fried, 2 fen).
Crush, decoct in water, take with Longhui Wan (Dragon Gallbladder Pill).
Little Grandma had afternoon fever, whole-body pain, blood deficiency, black menstruation, constipation. Used:
Shaoyao (5 qian), Huangqin (3 qian), Cangzhu (3 qian), Huangbai (wine-fried, 2 qian), Mutong (2 qian).
Crush, decoct in water, and take.
The above four formulas combine tonification and dispersal, adding fried Huangbai and Longhui based on pulse/symptoms. These are direct treatment methods.
Chen Xiaoniang, aged twenty, had fever, closed eyes, worse heat upon opening mouth, thirst for water, choppy/turbid pulse. This is food-phlegm. Treatment used:
Huangqin, Gancao, Mutong (each 5 fen), Chenpi, Baizhu, Genge (each 1 qian), Huanglian (Coptis Rhizome), Jiegeng (Platycodon Root, each 6 fen).
Crush, decoct in water, take with Baohe Wan (Preserve Harmony Pill) 20-30 pills.
A husband had fever due to fear, heart uneasiness. Used Nanxing and Baifuling (each 5 qian), Zhusha (Cinnabar, 2 qian) for six doses. Then used:
Renshen, Danggui, Chaihu (each 3 qian), Huangqin, Chuanxiong, Mutong (each 2 qian), Gancao, Honghua (Safflower, each 5 fen).
Divide into four doses, decoct in 2.5 cups water with gold/silver vessel to 1 cup, strain, take warm.
The above two formulas combine tonification and dispersal, adding food-stagnation/phlegm-resolving herbs based on symptoms.
[Haizang] Shenzhu Tang treats internal injury from frozen/cold drinks and external cold contraction with anhidrosis.
Cangzhu (processed), Fangfeng (Saposhnikovia Root, each 2 liang), Gancao (fried, 1 liang).
Crush, add Congbai (Scallion White) and Shengjiang, decoct and take. If Taiyang syndrome with fever, aversion to cold, floating/tight pulse, add Qianghuo (2 qian). If Taiyang pulse floating/tight with string-rapid quality, indicating Shaoyang involvement, add Chaihu (2 qian). If Taiyang pulse floating/tight with surging quality, indicating Yangming involvement, add Huangqin (2 qian). Women taking it add Danggui, or Muxiang Tang (Costus Root Decoction), or Gaoben Tang (Ligusticum Striatum Decoction) each 2 qian. For mastitis, mix 3-5 qian Liuyi San (Six-to-One Powder) into decoction; miraculous effect.
Another Shenzhu Tang Six Qi Modification Examples:
Taiyang Cold Water ruling heaven: Add Qianghuo, Guizhi (Cinnamon Twig). Added in other years for non-seasonal cold changes, also winter.
Yangming Dry Metal ruling heaven: Add Baizhi (Angelica Dahurica Root), Shengma (Cimicifuga Rhizome). Added in other years for non-seasonal cool/damp changes, also autumn.
Shaoyang Minister Fire ruling heaven: Add Huangqin, Dihuang (Rehmannia Root). Added in other years for non-seasonal rainy/damp changes, also summer.
Taiyin Wet Earth ruling heaven: Add Baizhu, Gaoben. Added in other years for non-seasonal hot/damp changes, also late summer/early autumn.
Shaoyin Sovereign Fire ruling heaven: Add Xixin (Asarum Root), Duhuo (Angelica Pubescens Root). Added in other years for non-seasonal heat changes, also late spring/early summer.
Jueyin Wind Wood ruling heaven: Add Chuanxiong, Fangfeng. Added in other years for non-seasonal mild/warm changes, also spring.
The above Shenzhu Tang Six Qi modifications are not solely for ruling heaven qi. When annual main qi matches month/day/time, prior signs should be modified according to examples. Haizang's theory aligns with Dairen's: "If disease doesn't match current year's qi, see which year's luck matches, seek method here." This reveals interrelations in *Zhi Zhen Yao Da Lun* songs, pioneering new insights. Haizang's "add herb for ruling qi" treats constant qi; "modify based on signs" treats variable qi. Dairen's method also treats variable qi. Expanding these masters' methods clarifies *Neijing* luck theory. *Neijing* discusses constant qi (fixed cycles, e.g., specific year/cold) and variable qi (no fixed cycle, e.g., cold year turns hot). Wang's commentary mistakes variable qi for constant qi, leading to inaccurate predictions and loss of faith in the method. These two masters revived it centuries later, akin to Cheng/Zhu reviving Confucius/Mencius. I谨 (respectfully) extend Haizang's yearly additions to explain variable qi deviations, detailing in *Yunqi Leizhu*. Colleagues, please study earnestly.
Baizhu Tang treats internal injury from cold food and external wind-cold with sweating.
Baizhu (3 liang), Fangfeng (2 liang), Gancao (fried, 1 liang).
Crush, take 3 qian per dose, 1 cup water, 3 slices ginger, decoct to 0.7 cup, take warm. 1-2 doses daily. Wait 2-3 days for gradual sweat reduction to resolve.
Another Baizhu Tang treats Shanghan, resolving Upper Three Yang, calming Inner Taiyin.
Baizhu (use Cangzhu if sweating), Fangfeng (each 1 liang).
Crush, decoct to 0.7 cup, take warm, modify with following formulas. If fever with thirst, add Huangqin, Gancao. If headache/aversion to wind, add Qianghuo San (3 qian): Qianghuo (1.5 liang), Chuanxiong (7 qian), Xixin (2.5 qian, remove rhizome). If body heat/eye pain, add Shigao Tang (4 qian): Shigao (Gypsum, 2 qian), Zhimu (Anemarrhena Rhizome, 0.5 liang), Baizhi (7 qian). If abdominal pain, add Shaoyao Tang (3 qian): Shaoyao (1 liang), Guizhi (0.5 liang). If alternating chills/fever/vomiting, add Chaihu San (3 qian): Chaihu (1 liang), Banxia (0.5 liang). If epigastric fullness, add Zhishi (Immature Bitter Orange, 1 qian). If interior syndrome, add Dahuang (Rhubarb, 1 qian), adjust for deficiency/excess, stop when pathogen leaves.
[Jie] With sweating, do not use Mahuang; without sweating, do not use Guizhi. However, spring/summer pores are open; even with sweating, Guizhi is inappropriate. Use Huangqi Tang to harmonize. Autumn/winter pores are closed; even without sweating, Mahuang is inappropriate. Use Chuanxiong Tang to harmonize. Spring/summer with sweating, weak/faint pulse, aversion to wind/cold: Taiyang syndrome, autumn/winter pulse type. Use Huangqi Tang; if no sweat, use Chuanxiong Tang. Autumn/winter with sweating, strong/surging pulse, fever/aversion to heat: Yangming syndrome, spring/summer pulse type. Use Huangqi Tang; if no sweat, use Chuanxiong Tang. Generally, sweating suits Huangqi Tang; anhidrosis suits Chuanxiong Tang.
Huangqi Tang stops sweating if present.