小青龙汤方加减法内
若微利者，去麻黄加「茯苓四两」〔荛花如鸡子大，熬令赤色〕。
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「加荛花如鸡子大」，此必传写之误。考本草荛花是芫花类也，每用之攻水其力甚峻
，五分可令人下行数十次，岂有治停饮之微利，用鸡子大之荛花者乎？当改加茯苓四
两。
伤寒心下有水气，欬而微喘，发热不渴，「小青龙汤主之」。服汤已，渴者，此寒去
欲解也。〔小青龙汤主之〕
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「小青龙汤主之」六字，当在发热不渴之下，始与服汤已渴者之文义相属，岂有寒去
欲解，而更服小青龙汤之理乎？当移之。
阳明病，脉浮而紧者，必潮热，发作有时，但浮者，必「自」〔盗〕汗出。
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自汗是阳明证，盗汗乃少阳证，盗汗应是自汗，当改之。
阳明病，脉迟，汗出多，「发热」，微恶寒者，表未解也，可发汗，宜桂枝汤。
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汗出多之下，当有「发热」二字，若无此二字，脉迟汗出多，微恶寒乃表阳虚，桂枝
附子汤证也，岂有用桂枝汤发汗之理乎？当补之。
伤寒脉浮滑，此以表有热，里有「热」〔寒〕，白虎汤主之。
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里有寒之「寒」字，当是「热」字，若是「寒」字，非白虎汤证也，当改之。
伤寒若吐下后不解，不大便五、六日，上至十余日，日晡所发潮热，不恶寒，独语如
见鬼状。若剧者，发则不识人，循衣模床，惕而不安，微喘直视。脉「滑」〔弦〕者
生，涩者死。微者，但发热谵语者，大承气汤主之，若一服利，止后服。
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脉弦者生之「弦」字，当是「滑」字，弦为阴负之脉，岂有必生之理？惟滑脉为阳，
始有生理。况滑者通也，涩者塞也，凡物之理，未有不以通为生，而塞为死者，当改
之。
太阳病，寸缓关浮尺弱，其人发热汗出，复恶寒不呕，但心下痞者，此以医下之也，
如其不下者，病人不恶寒而渴者，此转属阳明也。小便数者，大便必□，不更衣十日
无所苦也，渴欲饮水，少少与之，「若小便不利」〔但以法救之〕，渴者宜五苓散。
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「但以法救之」五字，当是「若小便不利」五字，方与上文小便数，及下文渴者之义
相属。此条病势不急救之之文，殊觉无谓。昔王三阳亦云：此处五苓散难用，不然经
文渴者之下，当有缺文，当改之。
栀子柏皮汤方
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此方之甘草，当是茵陈蒿，必传写之误也。
太阳病，当恶寒发热，今自汗出，反不恶寒发热，关上脉细数者，以医吐之过也。一
、二日吐之者，腹中饥，口不能食，三、四日吐之者，不喜糜粥，欲食冷食，「五、
六日吐之者」，朝食暮吐，以医吐之所致也，此为小逆。
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欲食冷食之下，当有「五六日吐之者」六字，若无此一句，则不喜糜粥，欲食冷食，
与朝食暮吐之文不相联属。且以上文一、二日，三、四日之文细玩之，则可知必有「
五六日吐之」一句，由浅及深之义也，当补之。
寸口脉浮大，而医下之，此为大逆，浮则无血，大则为寒，寒气相抟，则为肠鸣，医
乃不知，而反饮冷水，〔令汗大出〕水得寒气，冷必相抟，其人必□。
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「令汗大出」四字，当是衍文，宜删之。
阳明病，□语有潮热，反不能食者，胃中必有燥屎五、六枚也，「宜大承气汤下之」
。若能食者，但□耳。〔宜大承气汤下之〕
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「宜大承气汤下之」句，应在必有燥屎五、六枚之下始合。若但便□即用大承气汤下
之，殊失仲景慎重误下之旨，当移之。
阳明中风，脉弦浮大而短气，腹都满，□下及心痛，久按之，气不通，鼻干，不得汗
，嗜卧，一身及面目悉黄，小便难，有潮热，时时哕，耳前后肿，刺之小差，外不解
，病过十日，脉续「弦」〔浮〕者，与小柴胡汤。但浮，无余证者，与麻黄汤，若不
尿，腹满加哕者，不治。
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续浮之「浮」字，当是「弦」字，始与小柴胡汤法之脉相合。若是「浮」字，则上之
浮即宜小柴胡汤，而下之浮又用麻黄汤，不自相矛盾耶？当改之。
发汗后，水药不得入口为逆，若更发汗，必吐〔下〕不止。
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必吐下不止之「下」字，衍文也，当删之。
Within the modification methods of the Xiao Qing Long Tang (Minor Blue Dragon Decoction) formula:
If there is slight diarrhea, remove Ephedrae Herba (Mahuang, 麻黄) and add Poria (Fuling, 茯苓) four liang. [Or add Wikstroemiae Caulis (Raohua, 荛花) the size of a chicken egg, stir-fried until reddish.]
[Commentary]
"Add Wikstroemiae Caulis (Raohua, 荛花) the size of a chicken egg" must be a transcription error. According to materia medica, Raohua belongs to the Daphne genus; when used to attack water retention, its power is extremely fierce. A dose of five fen can cause dozens of bowel movements. How could one use a dose as large as a chicken egg of Raohua to treat slight diarrhea caused by retained fluid? It should be changed to adding Poria (Fuling, 茯苓) four liang.
In Shanghan disease with water qi under the heart, accompanied by cough and slight wheezing, fever but no thirst, Xiao Qing Long Tang (Minor Blue Dragon Decoction) is the primary treatment. After taking the decoction, if the patient feels thirsty, this indicates that the cold pathogen has departed and the condition is about to resolve. [Xiao Qing Long Tang (Minor Blue Dragon Decoction) is the primary treatment.]
[Commentary]
The six characters "Xiao Qing Long Tang (Minor Blue Dragon Decoction) is the primary treatment" should be placed after "fever but no thirst" to align logically with the text regarding "thirst after taking the medicine." There is no logic in treating a condition where the cold has departed and resolution is imminent with Xiao Qing Long Tang (Minor Blue Dragon Decoction). The position should be moved.
In Yangming disease, if the pulse is floating and tight, tidal fever will certainly occur at regular intervals; if the pulse is only floating, spontaneous sweating will certainly occur.
[Commentary]
Spontaneous sweating is a syndrome of Yangming, while night sweating is a syndrome of Shaoyang. "Night sweating" should be corrected to "spontaneous sweating."
In Yangming disease, with a slow pulse, profuse sweating, fever, and slight aversion to cold, the exterior pattern remains unresolved. Sweating may be induced, and Guizhi Tang (Cinnamon Twig Decoction) is appropriate.
[Commentary]
The two characters "fever" should be added after "profuse sweating." Without these two characters, a slow pulse, profuse sweating, and slight aversion to cold indicate deficiency of exterior Yang, which corresponds to the Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) pattern. There is no rationale for using Guizhi Tang (Cinnamon Twig Decoction) to induce sweating in such a case. These characters should be supplemented.
In Shanghan disease, a floating and slippery pulse indicates heat in the exterior and heat in the interior. Baihu Tang (White Tiger Decoction) is the primary treatment.
[Commentary]
The character "cold" in "cold in the interior" should be "heat." If it were "cold," it would not be a Baihu Tang (White Tiger Decoction) pattern. This should be corrected.
After emesis or purgation in Shanghan disease, if the pathogen remains unresolved, and there is no bowel movement for five or six days, extending to ten or more days, tidal fever occurs around dusk. There is no aversion to cold, and the patient speaks alone as if seeing ghosts. In severe cases, the patient becomes unconscious during episodes, grasps clothing and bedrails, feels terrified and uneasy, has slight wheezing, and fixed staring eyes. If the pulse is slippery, survival is likely; if the pulse is choppy, death is likely. In milder cases, characterized only by fever and delirium, Dachengqi Tang (Major Order the Qi Decoction) is the primary treatment. If one dose results in relief, stop taking the remaining doses.
[Commentary]
The character "wiry" in "wiry pulse indicates survival" should be "slippery." A wiry pulse indicates Yin excess and negative prognosis, making survival unlikely. Only a slippery pulse, being Yang, suggests vitality. Furthermore, slippery implies flow, while choppy implies obstruction. By the principle of all things, flow leads to life, and obstruction leads to death. This should be corrected.
In Taiyang disease, with a slow pulse at the cun position, floating at the guan position, and weak at the chi position, the patient presents with fever, sweating, aversion to cold, no vomiting, but only epigastric fullness. This is due to the physician's erroneous use of purgation. If purgation had not been used, and the patient is not averse to cold but feels thirsty, the disease has transferred to Yangming. If urination is frequent, the stool will certainly be hard; even without a bowel movement for ten days, there will be no discomfort. If thirsty and desiring water, give small amounts. If there is difficulty in urination, Wuling San (Five-Ingredient Powder with Poria) is suitable for those who are thirsty.
[Commentary]
The five characters "but rescue according to method" should be "if there is difficulty in urination." This aligns with the preceding text on frequent urination and the following text on thirst. The current text regarding non-emergency treatment seems meaningless. Wang Sanyang previously stated that Wuling San (Five-Ingredient Powder with Poria) is difficult to apply here; otherwise, there should be missing text after "thirsty." This should be corrected.
Zigai Bopi Tang (Gardenia, Phellodendron, and Bark Decoction) Formula
[Commentary]
The Licorice Root (Gancao, 甘草) in this formula should be Artemisiae Scopariae Herba (Yinchenhao, 茵陈蒿); this is certainly a transcription error.
In Taiyang disease, there should be aversion to cold and fever. Now, the patient has spontaneous sweating and, conversely, no aversion to cold or fever. The pulse at the guan position is fine and rapid. This is an error caused by the physician's use of emesis. If emesis is used on day one or two, the patient feels hungry in the abdomen but cannot eat. If used on day three or four, the patient dislikes congee and desires cold food. If used on day five or six, morning food is vomited in the evening. This is caused by the physician's erroneous emesis and constitutes a minor adverse reaction.
[Commentary]
The six characters "day five or six, if emesis is used" should be added after "desires cold food." Without this sentence, the text describing "dislikes congee, desires cold food" does not connect logically with "morning food vomited in the evening." Careful examination of the progression from days one-two to three-four reveals that the phrase "day five or six, if emesis is used" must exist, reflecting a progression from mild to severe. This should be supplemented.
If the pulse at the cunkou position is floating and large, and the physician erroneously uses purgation, this is a major violation. Floating indicates blood deficiency; large indicates cold. When cold qi combats itself, borborygmus occurs. Unaware of this, the physician gives cold water. Water encountering cold qi causes cold to combat itself, and the patient will certainly...
[Commentary]
The four characters "causing profuse sweating" are superfluous and should be deleted.
In Yangming disease, with delirium and tidal fever, if the patient cannot eat, there must be dry feces in the stomach, five or six pieces. Dachengqi Tang (Major Order the Qi Decoction) should be used to purge. If the patient can eat, it is merely... [Dachengqi Tang (Major Order the Qi Decoction) should be used to purge.]
[Commentary]
The sentence "Dachengqi Tang (Major Order the Qi Decoction) should be used to purge" should follow "there must be dry feces in the stomach, five or six pieces" to be logical. Using Dachengqi Tang (Major Order the Qi Decoction) simply because of constipation contradicts Zhang Zhongjing's cautious approach against erroneous purgation. This should be moved.
In Yangming wind-stroke, with a wiry, floating, and large pulse, shortness of breath, general abdominal fullness, pain below the costal margin and in the heart region, obstruction of qi upon prolonged pressure, dry nose, inability to sweat, lethargy, jaundice of the whole body and face, difficulty in urination, tidal fever, occasional hiccups, and swelling around the ears and temples. Acupuncture provides slight relief. If the exterior pattern remains unresolved and the disease persists beyond ten days, if the pulse continues to be wiry, Xiaochaihu Tang (Minor Bupleurum Decoction) is given. If the pulse is only floating without other symptoms, Mahuang Tang (Ephedra Decoction) is given. If there is no urination, abdominal fullness increases, and hiccups worsen, the condition is untreatable.
[Commentary]
The character "floating" in "continues to be floating" should be "wiry" to align with the pulse indication for Xiaochaihu Tang (Minor Bupleurum Decoction). If it were "floating," the earlier floating pulse would warrant Xiaochaihu Tang (Minor Bupleurum Decoction), while the later floating pulse warrants Mahuang Tang (Ephedra Decoction), creating a contradiction. This should be corrected.
After inducing sweating, if water and medicine cannot be kept down, it is an adverse reaction. If sweating is induced again, vomiting will certainly not cease.
[Commentary]
The character "down" (referring to diarrhea) in "vomiting and diarrhea will certainly not cease" is superfluous and should be deleted.