当归（去土） 芍药（炒） 桂枝（各三两） 细辛（去土） 甘草（炙） 通草（各
二两） 大枣
（廿五枚） 吴茱萸（三钱，泡） 生姜（六钱）
论曰∶若其人内有久寒者，当归四逆加吴茱萸生姜汤主之。
此承上文言，虽有手足厥寒，脉细欲绝证候，若其人内有久寒，则加吴茱萸、生姜以散
久寒而行阳气。曰久寒者，陈久之寒，非时下直中之寒也明矣。
桂枝（三两，净洗） 芍药（六两，炒） 甘草（二两） 生姜（二两） 大枣（十二
枚）
本太阳病，医反下之，因而腹满时痛者，属太阴也，桂枝加芍药汤主之。
表证未罢，而医下之，邪乘里虚，当作结胸，今不作结胸，而作腹满时痛，是属于太阴
。里气不和，故腹满时痛耳。时痛者，有时而痛，非大实之痛也，故但与桂枝汤以解表，加
芍药以和里。
桂枝 芍药 生姜（各三两） 甘草（二两） 大枣（十二枚） 大黄（一两）
表证未罢，因误下而大实痛者，此方主之。
大凡表证未罢，仍当解表，若误下以虚其里，则余邪乘虚而入，内作大实痛。曰大实痛
，则非有时而痛者可例矣；故前方但倍芍药，而此则加大黄。加大黄者，取其苦寒能荡实也。
论又曰∶太阴为病，脉弱，其人续自便利，设当行大黄、芍药者，宜减之，以其人胃气弱，
易动故也。则夫俗医不辨虚实，而执方治病者，皆仲景之罪人矣！
Radix Angelicae Sinensis (Danggui, 当归) [cleansed of soil], Radix Paeoniae Alba (Baishao, 白芍) [stir-fried], Ramulus Cinnamomi (Guizhi, 桂枝) [each 3 liang], Herba Asari (Xixin, 细辛) [cleansed of soil], Radix Glycyrrhizae Preparata (Zhigancao, 炙甘草), Caulis Tetrastigminis (Tongcao, 通草) [each 2 liang], Fructus Jujubae (Dazao, 大枣) [25 pieces], Fructus Evodiae (Wuzhuyu, 吴茱萸) [3 qian, soaked], Rhizoma Zingiberis Recens (Shengjiang, 生姜) [6 qian].
Discussion: If the patient has chronic cold retained within, Danggui Sini Decoction plus Wuzhuyu and Shengjiang should be used as the primary treatment.
This statement follows the preceding text. Although there are symptoms of cold extremities and a fine pulse nearly imperceptible, if the patient harbors chronic cold internally, Wu Zhu Yu (Evodia Fruit) and Sheng Jiang (Fresh Ginger Root) are added to dispel the long-standing cold and promote the flow of Yang Qi. The term "chronic cold" refers to cold accumulated over a long period, not cold that directly attacks the body at the present moment; this is clear.
Ramulus Cinnamomi (Guizhi, 桂枝) [3 liang, washed clean], Radix Paeoniae Alba (Baishao, 白芍) [6 liang, stir-fried], Radix Glycyrrhizae (Gancao, 甘草) [2 liang], Rhizoma Zingiberis Recens (Shengjiang, 生姜) [2 liang], Fructus Jujubae (Dazao, 大枣) [12 pieces].
Originally, this was a Taiyang disease (disease of the Taiyang channel). The physician erroneously applied purgation, resulting in abdominal fullness and intermittent pain. This belongs to Taiyin disease (disease of the Taiyin channel), and Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction plus White Peony Root) should be used.
The exterior syndrome has not yet resolved, yet the physician used purgation. The pathogenic factor entered due to interior deficiency. One might expect it to form a Jie Xiong syndrome (chest binding syndrome); however, it did not form Jie Xiong but instead presented with abdominal fullness and intermittent pain, indicating an affiliation with Taiyin. Because the interior Qi is disharmonious, abdominal fullness and intermittent pain occur. "Intermittent pain" means pain that comes and goes, not the severe pain of excess accumulation. Therefore, only Guizhi Tang (Cinnamon Twig Decoction) is given to resolve the exterior, and Shaoyao (White Peony Root) is added to harmonize the interior.
Ramulus Cinnamomi (Guizhi, 桂枝), Radix Paeoniae Alba (Baishao, 白芍), Rhizoma Zingiberis Recens (Shengjiang, 生姜) [each 3 liang], Radix Glycyrrhizae (Gancao, 甘草) [2 liang], Fructus Jujubae (Dazao, 大枣) [12 pieces], Radix et Rhizoma Rhei (Dahuang, 大黄) [1 liang].
When the exterior syndrome has not yet resolved, and severe, persistent abdominal pain occurs due to erroneous purgation, this formula is indicated.
Generally, when the exterior syndrome has not resolved, the exterior should still be resolved first. If purgation is erroneously used, causing interior deficiency, residual pathogens will enter through the deficiency and cause severe internal excess pain. Since it is termed "severe excess pain," it cannot be categorized as mere intermittent pain; thus, while the previous formula merely doubled the dosage of Shaoyao (White Peony Root), this formula adds Dahuang (Rhubarb Root). Dahuang is added for its bitter-cold property, which can purge excess accumulation.
The discussion further states: In Taiyin disease, the pulse is weak, and the patient continues to have spontaneous loose stools. If one must use Dahuang (Rhubarb Root) or Shaoyao (White Peony Root), their dosages should be reduced because the patient's Stomach Qi is weak and easily disturbed. Thus, those worldly physicians who fail to distinguish between excess and deficiency yet rigidly apply formulas to treat diseases are sinners against Zhang Zhongjing!