北方肾脉，其形何似？师曰∶肾者，水也，名曰少阴。其脉沉滑，是肾脉也。肾病自得沉滑而濡者，愈也。
按∶东、南、西方，皆有其文，惟缺北方，仿经文补之。（《医宗金鉴》）
太阳病，当恶寒发热。今自汗出，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，朝食暮吐，以医吐之所致，此为小逆。
按∶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。（《医宗金鉴》）
太阳病，下之后，脉促、胸满者，桂枝去芍药汤主之。若微恶寒者，去芍药方中加附子汤主之。
按∶微恶寒之上，当有汗出二字。若无此二字，乃表未解也，无加附子之理，当补之。（《医宗金鉴》）
太阳病不解，热结膀胱，其人如狂，血自下者，愈。其外不解者，尚未可攻，当先解外（宜桂枝汤）；
外解已，但少腹急结者，乃可攻之，宜桃仁承气汤。
宜桂枝汤四字，从《金匮》增入。（《伤寒类方》）
太阳病，六七日，表证仍在，脉微而沉，反不结胸，其人如狂者，以热在下焦，少腹当硬满，小便自利者，
下血乃愈。所以然者，以太阳随经，瘀热在里故也，抵当汤主之。
此亦病发于阳，误下热入之证也。表证仍在下，当有而反下之句。（柯韵伯）
发汗已，脉浮数，烦渴者，五苓散主之。
按∶脉浮数之下，当有小便不利四字。若无此四字，则为阳明内热口燥之烦渴，是白虎汤证也。惟其小便
不利而烦渴，斯为太阳水热瘀结之烦渴。始属五苓散证。若非小便不利而用五苓散，则犯重竭津液之禁矣。况
太阳上编类此证者数条，惟水入即吐一条，乃水不下行，故无小便不利之文。余皆有小便不利四字。今此四字
必是传写之遗，当补之。（《医宗金鉴》）
伤寒，汗出而渴者，五苓散主之；不渴者，茯苓甘草汤主之。
汗出下，当有心下悸三字。不然，汗出而渴，是白虎汤证。汗后不渴而无他证，是病已瘥，可勿药矣。（柯韵伯）
心下痞，按之濡，其脉关上浮者，大黄黄连泻心汤主之。濡当作硬。按之濡下，当有大便，不恶寒，反恶热句，故立此
汤。观泻心汤治痞，是攻补兼施，寒热并驰之剂，此则尽去温补，独任苦寒下泄之品，且用麻沸汤渍绞浓汁，
而生用之，利于急下。如此而不言及热结当攻诸证，谬矣！夫按之濡为气痞，是无形也，则不当下。且结胸证，
其脉浮大者，不可下，则心下痞而关上浮者，反可下乎？小结胸按之痛者，尚不用大黄，何此比陷胸汤更峻？
是必有当急下之证比结胸更甚者，故制此峻攻之剂也。学人用古方治今病，如据此条脉证而用此方，下咽即死
耳。勿以断简残文，尊为圣经，而曲护其说，以遗祸后人也。（柯韵伯）
心下痞，按之濡，其脉关上浮者，大黄黄连泻心汤主之。
按∶按之濡，当是按之不濡。若按之濡，乃虚痞也，补之不暇，岂有用大黄泻之之理乎？当补之。（《医宗金鉴》）
病发热头痛，脉反沉，若不瘥，身体疼痛，当温其里，宜四逆汤。
按∶身体疼痛之下，当有下利清谷四字。若无此四字，则当温其里之文竟无着落矣，未有表病而温里
之理也。阅后《太阴篇》中云∶伤寒医下之，续得下利清谷不止，身疼痛者，急当救里，宜四逆汤，其义益明。
遵《经》补之。（《医宗金鉴》）
伤寒，脉浮缓，身不痛，但重，乍有轻时，无少阴证者，大青龙汤发之。
脉浮缓下，当有发热、恶寒、无汗、烦躁等证。盖脉浮缓，身不痛，见表证同轻。但身重，乍有轻时，见
表证将罢。以无汗烦躁，故合用大青龙。无少阴证，仲景正为不汗出而烦躁之证，因少阴亦有发热恶寒无汗
烦躁之证，与大青龙同，法当温补；若反与麻黄之散，石膏之寒，真阳立亡矣。必细审其所不用，然后不失
其所当用也。（柯韵伯）
伤寒，不大便六七日，头痛有热者，（未可）与承气汤。其小便清者，知不在里，仍在表也，当须发汗，若头
痛者必衄。宜桂枝汤。
未可二字从《金匮》增入，《伤寒论》失此二字。（《伤寒类方》）
伤寒，若吐、若下后，七八日不解，热结在里，表里俱热，时时恶风，大渴，舌上干燥而烦，欲饮水数升者，
白虎加人参汤主之。
按∶伤寒之下，当有若汗二字。盖汗较吐下伤津液为多也。时时恶风，当是时汗恶风，若非汗字，则时时
恶风是表不解，白虎汤在所禁也。《论》中谓发热无汗，表不解者，不可与白虎汤；渴欲饮水，无表证者，
白虎加人参汤主之。细玩经文，自知当补之、改之。（《医宗金鉴》）
阳明病，脉迟，汗出多，微恶寒者，表未解也，可发汗，宜桂枝汤。
按∶汗出多之下，当有发热二字。若无此二字，则脉迟、汗出多、微恶寒，乃表阳虚，属桂枝附子汤证也。
岂有用桂枝汤发汗之理乎？当补之。（《医宗金鉴》）
阳明病，若脉浮发热、渴欲饮水、小便不利者，猪苓汤主之。
按∶此浮字误也。《活人》云∶脉浮者，五苓散，脉沉者，猪苓汤。则知此证脉字下脱一不字也。据
《太阳篇》内五苓散，乃猪苓、泽泻、茯苓三味中加桂、白术也。《阳明篇》内猪苓汤，乃猪苓、泽泻、茯苓
三味中加阿胶、滑石也。桂与白术味甘辛为阳，主外，阿胶、滑石味甘寒为阴，主内。奉议之言，亦可谓不失
仲景之旨矣。第奉议欲区别二药分晓，不觉笔下以沉对浮，遂使后人致疑三阳证中不当言脉沉，更不复致疑经文
之有阙也。（《证治准绳》）
少阴病，始得之，反发热，脉沉者，麻黄附子细辛汤主之。
本条当有无汗、恶寒证。（柯韵伯）
伤寒，厥而心下悸者，（以饮水多），宜先治水，当服茯苓甘
草汤，却治其厥。不尔，水渍入胃，必作利也。
按∶厥而心下悸者之下，当有以饮水多四字。若无此四字，乃阴盛之厥悸，非停水之厥悸矣。何以即知是
水，而曰宜先治水耶？当补之。（《医宗金鉴》）
伤寒，脉迟，六七日，而反与黄芩汤彻其热，脉迟为寒，今与黄芩汤复除其热，腹中应冷，当不能食，今反
能食，此名除中，必死。
按∶伤寒脉迟六七日之下，当有厥而下利四字。若无此四字，则非除中证也。况有此四字，始与下文反
与黄芩汤之义相属，当补之。（《医宗金鉴》）
伤寒，发热，口中勃勃气出，头痛，目黄，衄不可制。贪水者，必呕；恶水者，厥。若下之，咽中生疮。假
令手足温者，必下重，便脓血；头痛目黄者，若下之，则两目闭。贪水者，（下之其）脉必厥，其声嘤，咽喉
塞；若发汗则战栗，阴阳俱虚。恶水者，若下之则里冷不嗜食，大便完谷出；若发汗则口中伤，舌上白苔，烦
躁，脉数实，不大便六七日，后必便血。若发汗则小便自利也。
下之其三字，从《玉函经》增入。（《伤寒缵论》）
Northern Kidney Pulse, what is its form? The Master said: The Kidney belongs to Water and is named Shaoyin (Lesser Yin). Its pulse is deep and slippery; this is the Kidney pulse. If a Kidney disease presents with a deep, slippery, and soft pulse, it indicates recovery.
Note: There are texts for the East, South, and West, but only the North is missing. This section has been supplemented imitating the classic text. (Yi Zong Jin Jian)
In Taiyang disease, there should be aversion to cold and fever. Now, if there is spontaneous sweating, no aversion to cold, no fever, and the Guan position pulse is fine and rapid, this is an error caused by the physician's misuse of emesis. If emesis was used on the first or second day, the patient feels hungry in the abdomen but does not wish to eat; if emesis was used on the third or fourth day, the patient dislikes congee, desires cold food, eats in the morning and vomits in the evening. This is caused by the physician's misuse of emesis and is considered a minor adverse reaction.
Note: Below "desires cold food," the six characters "if emesis was used on the fifth or sixth day" should be present. Without this sentence, the text "dislikes congee, desires cold food" does not connect logically with "eats in the morning and vomits in the evening." Furthermore, carefully examining the preceding text regarding the first-second and third-fourth days reveals that the phrase "if emesis was used on the fifth or sixth day" must exist. This reflects the principle of progressing from shallow to deep, and it should be supplemented. (Yi Zong Jin Jian)
In Taiyang disease, after purgation, if the pulse is hurried and the chest is full, Gui Zhi Qu Shao Yao Tang (Cinnamon Twig Decoction without Paeonia) should be administered. If there is slight aversion to cold, Fu Zi Tang (Aconite Decoction) added to the formula without Shao Yao should be administered.
Note: Above "slight aversion to cold," the two characters "sweating" should be present. Without these two characters, the exterior syndrome remains unresolved, and there is no rationale for adding Fu Zi. It should be supplemented. (Yi Zong Jin Jian)
If Taiyang disease is unresolved and heat accumulates in the Bladder, the person may appear manic. If blood discharges spontaneously, the disease will heal. If the exterior syndrome is still unresolved, attack cannot yet be employed; one must first resolve the exterior (Gui Zhi Tang is appropriate). Once the exterior is resolved, if there is only urgency and binding in the lower abdomen, then attack can be employed, and Tao Ren Cheng Qi Tang (Peach Kernel Decoction to Order the Qi) is appropriate.
The four characters "Gui Zhi Tang is appropriate" were added from the Jin Gui Yao Lue. (Shang Han Lei Fang)
In Taiyang disease, after six or seven days, if the exterior symptoms remain, the pulse is faint and deep, and contrary to expectation, there is no Jie Xiong (Chest Binding), but the person appears manic, it is because heat is in the Lower Jiao. The lower abdomen should be hard and full, and urination should be normal. Healing occurs through blood discharge. The reason for this is that the Taiyang pathogen follows the meridians into the interior, resulting in stasis-heat in the interior; Di Dang Tang (Siege-Removing Decoction) should be administered.
This is also a syndrome where the disease originated in Yang, and mistaken purgation allowed heat to enter. Below "exterior symptoms remain," the phrase "but mistakenly used purgation" should be present. (Ke Yunbo)
After inducing sweating, if the pulse is floating and rapid, and there is irritability and thirst, Wu Ling San (Five-Ingredient Powder with Poria) should be administered.
Note: Below "pulse floating and rapid," the four characters "difficult urination" should be present. Without these four characters, this would be irritability and thirst due to internal heat in the Yangming channel, which is a Bai Hu Tang (White Tiger Decoction) syndrome. Because there is difficult urination accompanied by irritability and thirst, this is irritability and thirst due to water-heat binding in the Taiyang channel, belonging to the Wu Ling San syndrome. If Wu Ling San were used without difficult urination, it would violate the prohibition against further depleting body fluids. Moreover, in the Taiyang chapter, there are several similar cases; only the case of "water intake immediately followed by vomiting" lacks the text "difficult urination" because the water fails to descend. All others contain the four characters "difficult urination." These four characters here must have been lost during transcription and should be supplemented. (Yi Zong Jin Jian)
In Shanghan (Cold Damage), if there is sweating and thirst, Wu Ling San should be administered; if there is no thirst, Fu Ling Gan Cao Tang (Poria and Licorice Decoction) should be administered.
Below "sweating," the three characters "epigastric palpitations" should be present. Otherwise, sweating with thirst indicates a Bai Hu Tang syndrome. Sweating followed by no thirst and no other symptoms indicates the disease has healed, and medication is unnecessary. (Ke Yunbo)
If there is epigastric stuffiness, which is soft upon pressure, and the Guan position pulse is floating, Da Huang Huang Lian Xie Xin Tang (Rhubarb and Coptis Decoction to Drain the Epigastrium) should be administered. "Soft" should read "hard." Below "soft upon pressure," the sentence "constipation, no aversion to cold, but aversion to heat" should be present, which is why this decoction was established. Observing that Xie Xin Tang treats epigastric stuffiness as a formula combining attack and tonification, and cold and heat, this specific prescription removes all warming and tonifying herbs, relying solely on bitter-cold draining agents, and uses boiling water to soak and squeeze out a concentrated juice, used raw, facilitating urgent draining. To state this without mentioning the syndromes of heat-binding requiring attack is erroneous! Epigastric stuffiness that is soft upon pressure is Qi stuffiness, which is formless, and thus should not be drained. Furthermore, in Jie Xiong syndrome, if the pulse is large and floating, draining is contraindicated; so, how can epigastric stuffiness with a floating Guan pulse be drained? Xiao Jie Xiong (Minor Chest Binding), which is painful upon pressure, does not use Da Huang; why is this formula more severe than Xian Xiong Tang? There must be syndromes requiring urgent draining that are more severe than Jie Xiong, hence this severe draining formula was created. Students using ancient formulas for modern diseases, if they use this formula based on this pulse and symptom presentation, will die upon ingestion. Do not regard fragmented texts as sacred scriptures and distort their meaning to protect them, thereby bringing disaster to future generations. (Ke Yunbo)
If there is epigastric stuffiness, which is soft upon pressure, and the Guan position pulse is floating, Da Huang Huang Lian Xie Xin Tang should be administered.
Note: "Soft upon pressure" should read "not soft upon pressure." If it is soft upon pressure, it is deficiency stuffiness, for which tonification is insufficiently applied; how could there be a rationale for using Da Huang to drain? It should be supplemented. (Yi Zong Jin Jian)
If the patient has fever and headache, but the pulse is contrary, sinking, and if the condition does not improve, with body pain, one should warm the interior, and Si Ni Tang (Decoction to Reverse the Collapse) is appropriate.
Note: Below "body pain," the four characters "diarrhea with undigested food" should be present. Without these four characters, the statement "one should warm the interior" has no basis; there is no rationale for warming the interior when there is only an exterior disease. Reading the subsequent Taiyin chapter states: In Shanghan, if the physician mistakenly uses purgation, leading to continuous diarrhea with undigested food, and body pain, one must urgently rescue the interior, and Si Ni Tang is appropriate. This clarifies the meaning. Follow the classic and supplement. (Yi Zong Jin Jian)
In Shanghan, if the pulse is floating and slow, the body is not painful but heavy, occasionally feeling lighter, and there are no Shaoyin signs, Da Qing Long Tang (Major Green Dragon Decoction) should be used to induce sweating.
Below "pulse floating and slow," signs such as fever, aversion to cold, absence of sweating, and irritability should be present. A floating and slow pulse with no body pain indicates a mild exterior syndrome. However, body heaviness with occasional relief indicates the exterior syndrome is about to cease. Due to the absence of sweating and presence of irritability, Da Qing Long Tang is combined. The absence of Shaoyin signs refers specifically to the syndrome of non-sweating with irritability; since Shaoyin also presents with fever, aversion to cold, absence of sweating, and irritability, similar to Da Qing Long Tang, the treatment should be warming and tonifying. If one instead uses the dispersing nature of Ma Huang and the cooling nature of Shi Gao, true Yang will perish instantly. One must carefully examine what is contraindicated to avoid missing what is indicated. (Ke Yunbo)
In Shanghan, if there is constipation for six or seven days, with headache and fever, (do not give) Cheng Qi Tang. If the urine is clear, one knows the disease is not in the interior but remains in the exterior, and sweating should be induced. If there is headache, nasal bleeding will likely occur. Gui Zhi Tang is appropriate.
The two characters "do not" were added from the Jin Gui Yao Lue; they were lost in the Shang Han Lun. (Shang Han Lei Fang)
In Shanghan, if after emesis or purgation, the disease remains unresolved after seven or eight days, with heat binding in the interior, exterior and interior both hot, occasional aversion to wind, extreme thirst, dry tongue with irritability, and desire to drink several liters of water, Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng) should be administered.
Note: Below "Shanghan," the two characters "if sweating" should be present. Sweating damages body fluids more than emesis or purgation. "Occasional aversion to wind" should be "occasional sweating and aversion to wind." Without the character "sweating," occasional aversion to wind would indicate unresolved exterior syndrome, making Bai Hu Tang contraindicated. The Treatise states: For fever with no sweating and unresolved exterior, Bai Hu Tang is forbidden; for thirst desiring water with no exterior syndrome, Bai Hu Jia Ren Shen Tang is administered. Carefully studying the text reveals what needs to be supplemented and corrected. (Yi Zong Jin Jian)
In Yangming disease, if the pulse is slow, sweating is profuse, and there is slight aversion to cold, the exterior is unresolved, and sweating can be induced; Gui Zhi Tang is appropriate.
Note: Below "profuse sweating," the two characters "fever" should be present. Without these two characters, slow pulse, profuse sweating, and slight aversion to cold indicate deficiency of Exterior Yang, belonging to the Gui Zhi Fu Zi Tang syndrome. How could there be a rationale for using Gui Zhi Tang to induce sweating? It should be supplemented. (Yi Zong Jin Jian)
In Yangming disease, if the pulse is floating with fever, thirst desiring water, and difficult urination, Zhu Ling Tang (Polyporus Decoction) should be administered.
Note: The character "floating" here is erroneous. The Huo Ren Shu states: Floating pulse indicates Wu Ling San; sinking pulse indicates Zhu Ling Tang. Thus, we know a "not" character is missing below the word "pulse" in this syndrome. According to the Taiyang chapter, Wu Ling San consists of Zhu Ling, Ze Xie, and Fu Ling plus Gui Zhi and Bai Zhu. In the Yangming chapter, Zhu Ling Tang consists of Zhu Ling, Ze Xie, and Fu Ling plus E Jiao and Hua Shi. Gui Zhi and Bai Zhu are sweet and acrid, belonging to Yang, acting externally; E Jiao and Hua Shi are sweet and cold, belonging to Yin, acting internally. Pang Anshi's words can be said to not deviate from Zhongjing's intent. However, Pang Anshi wished to clearly distinguish these two prescriptions, inadvertently contrasting sinking with floating in his writing, causing later generations to doubt the mention of a sinking pulse in the Three Yang syndromes, rather than doubting the omission in the classic text. (Zheng Zhi Zhun Sheng)
In Shaoyin disease, at the onset, if there is contrary fever and a sinking pulse, Ma Huang Fu Zi Xi Xin Tang (Ephedra, Aconite, and Asarum Decoction) should be administered.
This clause should include signs of absence of sweating and aversion to cold. (Ke Yunbo)
In Shanghan, if there is cold extremities and epigastric palpitations, (due to excessive water intake), one should first treat the water retention, administering Fu Ling Gan Cao Tang, and subsequently treat the cold extremities. Otherwise, water will infiltrate the stomach,必然 causing diarrhea.
Note: Below "cold extremities and epigastric palpitations," the four characters "due to excessive water intake" should be present. Without these four characters, it would be cold extremities and palpitations due to Yin excess, not due to retained water. How would one know it is water and say "first treat water"? It should be supplemented. (Yi Zong Jin Jian)
In Shanghan, with a slow pulse for six or seven days, if one mistakenly administers Huang Qin Tang (Scutellaria Decoction) to clear the heat, noting that a slow pulse indicates cold, and now clearing the heat with Huang Qin Tang, the abdomen should become cold, and the patient should be unable to eat. If the patient can suddenly eat, this is named Chu Zhong (Elimination of the Middle), indicating certain death.
Note: Below "Shanghan, slow pulse for six or seven days," the four characters "cold extremities and diarrhea" should be present. Without these four characters, it is not a Chu Zhong syndrome. Moreover, with these four characters, it connects logically with the following text "mistakenly administer Huang Qin Tang." It should be supplemented. (Yi Zong Jin Jian)
In Shanghan, with fever, breath rushing out vigorously from the mouth, headache, yellow eyes, and uncontrollable nasal bleeding. Those who crave water will surely vomit; those who abhor water will have cold extremities. If purged, ulcers will form in the throat. If the hands and feet are warm, there will be rectal heaviness and pus-blood in the stool. For headache and yellow eyes, if purged, the eyes will close. For those craving water, (after purging) the pulse will surely become choppy/collapsed, the voice will be hoarse, and the throat blocked; if sweated, there will be shivering, and both Yin and Yang will be deficient. For those abhorring water, if purged, there will be interior cold, loss of appetite, and undigested food in the stool; if sweated, there will be oral injury, white coating on the tongue, irritability, a rapid and solid pulse, constipation for six or seven days, and subsequent bloody stool. If sweated, urination will be spontaneous.
The three characters "(after purging)" were added from the Yu Han Jing. (Shang Han Zuan Lun)