得病六、七日，脉迟浮弱，恶风寒，手足温，医二、三下之，不能食，而□下满痛，
面目及身黄，颈项强，小便难者，与柴胡汤，后必下重，本渴饮水而呕者，柴胡汤不
中与也。〔食谷者哕〕
【按】
「食谷者哕」四字，衍文也，食谷呕者有之，从无食谷哕者之证，当删之。
伤寒五、六日，头汗出，微恶寒，手足冷，心下满，口不欲食，大便□，脉「沉」细
者，此为阳微结，必有表复有里也，脉沉亦在里也。汗出为阳微，假令纯阴结，不得
复有外证，悉入在里，此为半在里，半在外也。脉虽沉「细」〔紧〕，不得为少阴病
，所以然者，阴不得有汗，今头汗出，故知非少阴也，可与小柴胡汤，设不了了者，
得屎而解。
【按】
脉细当是「脉沉细」，观本条下文脉沉亦在里也之「亦」字自知，当补之。脉虽沉紧
之「紧」字，当是「细」字。观本条上文并无「紧」字，如何说脉虽沉紧，此「虽」
字又何所谓耶？当改之 。
伤寒发热，汗出不解，心下痞□，呕吐而「不」〔下〕利者，大柴胡汤主之
【按】
下利之「下」字，当是「不」字，若是「下」字，岂有上吐下利，而犹以大柴胡汤下
之者乎？当改之。
太阳病，过经十余日，反二、三下之，后四、五日，柴胡证仍在者，先与小柴胡汤，
呕不止，心下急 ，郁郁微烦者，为未解也，与大柴胡汤下之则愈。
【按】
许叔微曰：大柴胡汤，一方无大黄，一方有大黄。盖大黄荡涤蕴热，伤寒中要药，王
叔和云：若不用大黄，恐不名大柴胡汤。且仲景曰：下之则愈。若无大黄，将何以下
心下之急乎？当从叔和为是，宜补之。
太阳病，过经十余日，心中「嗢嗢」〔温温〕欲吐，而胸中痛，大便反溏，腹微满，
郁郁微烦，先此时，自极吐下者，与调胃承气汤，若不尔者，不可与。但欲呕，胸中
痛，微溏者，此非柴胡证，以呕故极吐下也。
【按】
王肯堂曰：「温温」当是「嗢嗢」。又云以呕下，疑有阙文，当改之。
On the sixth or seventh day of illness, with a pulse that is slow, floating, and weak, aversion to wind and cold, and warm hands and feet, if the physician has performed purgation two or three times, leading to an inability to eat, fullness and pain in the hypochondriac region, yellowing of the face, eyes, and body, stiffness of the neck and nape, and difficulty in urination, administering Chaihu Tang (Bupleurum Decoction) will likely result in a sensation of heaviness and dragging at the anus afterward. For those who are thirsty and drink water but then vomit, Chaihu Tang (Bupleurum Decoction) is contraindicated. [Note: The four characters "Shi gu zhe yue" (hiccups after eating food) are superfluous text.]
[Commentary]
The phrase "Shi gu zhe yue" (hiccups after eating food) is extraneous. While vomiting after eating occurs, there is no such syndrome as hiccups specifically triggered by eating food; this phrase should be deleted.
In Taiyang disease (Exterior Syndrome), on the fifth or sixth day, if there is sweating only on the head, slight aversion to cold, cold hands and feet, fullness in the epigastrium, lack of desire to eat, constipation, and a deep, fine pulse, this is termed Yang Wei Jie (mild Yang constraint). There is both an exterior pattern and an interior pattern. A deep pulse indicates the pathology is interior. Sweating indicates mild Yang constraint. If it were a pure Yin constraint (Yin Cold accumulation), there would be no exterior symptoms remaining; all symptoms would be interior. This condition is half-interior and half-exterior. Although the pulse may be deep and fine (or tight), it cannot be diagnosed as Shaoyin disease (Lesser-Yang Disease). The reason is that Yin patterns typically do not present with sweating; since there is sweating on the head, we know this is not Shaoyin disease. Xiao Chaihu Tang (Minor Bupleurum Decoction) may be administered. If the patient remains uncomfortable after taking the medicine, relief can be achieved through defecation.
[Commentary]
"Fine pulse" should be read as "deep and fine pulse," as indicated by the character "yi" (also/even) in the subsequent sentence "Mai chen yi zai li ye" (A deep pulse also indicates interior involvement); it should be supplemented. The character "jin" (tight) in "mai sui chen jin" (although the pulse is deep and tight) should be "xi" (fine). Since the preceding text does not mention "tight," how can one say "although the pulse is deep and tight"? The use of "sui" (although) would be baseless; it should be corrected to "fine."
In Taiyang disease (Exterior Syndrome), if fever persists despite sweating, accompanied by epigastric stuffiness, vomiting, and absence of diarrhea, Da Chaihu Tang (Major Bupleurum Decoction) is the primary treatment.
[Commentary]
The character "xia" (down/below) in "xia li" (diarrhea) should be "bu" (not). If it were "xia li" (diarrhea), it would be illogical to use Da Chaihu Tang (Major Bupleurum Decoction) for purgation in a case presenting with both vomiting and diarrhea; this should be corrected.
In Taiyang disease (Exterior Syndrome), after the course has passed beyond its normal duration for more than ten days, if the physician incorrectly used purgation two or three times, and five days later the Chaihu syndrome (Bupleurum Pattern) still persists, administer Xiao Chaihu Tang (Minor Bupleurum Decoction) first. If vomiting continues unabated, accompanied by urgency and discomfort in the epigastrium, depression, and slight irritability, the pathogen has not yet resolved. In this case, Da Chaihu Tang (Major Bupleurum Decoction) should be used to purge the interior, leading to recovery.
[Commentary]
Xu Shuwei stated: Da Chaihu Tang (Major Bupleurum Decoction) exists in versions with and without Dahuang (Rhubarb Root). Dahuang (Rhubarb Root) clears accumulated heat and stagnation and is a crucial herb for treating Taiyang disease (Exterior Syndrome). Wang Shuhe said: Without Dahuang (Rhubarb Root), it hardly deserves the name Da Chaihu Tang (Major Bupleurum Decoction). Furthermore, Zhang Zhongjing stated: "Purge to achieve recovery." Without Dahuang (Rhubarb Root), what would purge the urgency in the epigastrium? We should follow Wang Shuhe's view and supplement Dahuang (Rhubarb Root).
In Taiyang disease (Exterior Syndrome), after the course has passed beyond its normal duration for more than ten days, if the patient feels nauseous ("Wawa") and desires to vomit, with chest pain, loose stools, slight abdominal fullness, depression, and slight irritability, if prior to this episode the patient had undergone extreme emetic or purgative treatments, Tiaowei Chengqi Tang (Regulating the Stomach and Releasing the Gangrene Decoction) should be given. If this was not the case, it should not be given. If the patient merely wants to vomit, has chest pain, and slightly loose stools, this is not a Chaihu syndrome (Bupleurum Pattern); the nausea resulted from previous extreme emetic or purgative treatments.
[Commentary]
Wang Kentang stated: "Wenwen" should be "Wawa." He also noted that the phrase "yi ou xia" (due to vomiting below) suggests missing text; this should be corrected.