大法秋宜下
凡宜下，以汤胜丸散。
凡服汤下，中病则止，不必尽三服。
阳明病，发热汗多者，急下之。
少阴病，得之二三日，口燥咽干者，急下之。
少阴病，五六日腹满不大便者，急下之。
少阴病，下利清水，色青者，心下必痛，口干者，宜下之。
下利，三部脉皆浮，按其心下坚者，宜下之。
下利，脉迟而滑者，实也，利未欲止，宜下之。
阳明与少阳合病，利而脉不负者为顺，脉数而滑者，有宿食，宜下之。
问曰∶人病有宿食，何以别之？答曰∶寸口脉浮大，按之反涩，尺中亦微而涩，故知有
宿食，宜下之。
下利，不欲食者，有宿食，宜下之。
下利瘥，至其时复发，此为病不尽，宜复下之。
凡病腹中满痛者为寒，宜下之。
腹满不减，减不足言，宜下之。
伤寒六七日，目中不了了，睛不和，无表里证，大便难，微热者，此为实，急下之。
脉双弦而迟，心下坚脉大而紧者，阳中有阴，宜下之。
伤寒有热，而少腹满，应小便不利，今反利，此为血，宜下之。
病者烦热，汗出即解，复如疟，日晡所发者，属阳明，脉实者，当下之。
大法冬宜服温热药。
师曰∶病发热头痛，脉反沉，若不瘥，身体更疼痛，当救其里，宜温药四逆汤。
下利，腹胀满，身体疼痛，先温其里，宜四逆汤。
下利，脉迟紧，为痛未欲止，宜温之。
下利，脉浮大者，此为虚，以强下之故也，宜温之，与水必哕。
少阴病下利，脉微涩，呕者，宜温之。
自利不渴者，属太阴，其脏有寒故也，宜温之。
少阴病，其人饮食入则吐，心中温温欲吐，复不能吐，始得之，手足寒，脉弦迟，若膈
上有寒饮，干呕，宜温之。
少阴病，脉沉者，宜急温之。
下利，欲食者，宜就温之。
General principle: In autumn, purgation is appropriate.
Whenever purgation is indicated, decoctions are superior to pills and powders.
When administering a purgative decoction, discontinue use once the disease is cured; there is no need to finish all three doses.
In Yangming disease, if there is fever and profuse sweating, urgent purgation is required.
In Shaoyin disease, if dry mouth and parched throat appear two or three days after onset, urgent purgation is required.
In Shaoyin disease, if abdominal fullness and constipation appear five or six days after onset, urgent purgation is required.
In Shaoyin disease, if there is diarrhea with clear watery stool of a bluish-green color, accompanied by pain in the epigastrium and dry mouth, purgation is indicated.
If there is diarrhea, the pulse at the cun, guan, and chi positions on both wrists is floating, and palpation of the epigastrium reveals hardness, purgation is indicated.
If there is diarrhea with a slow and slippery pulse, it indicates excess; the diarrhea will not cease, so purgation is indicated.
In combined Yangming and Shaoyang disease, if diarrhea occurs and the pulse is robust (not "defeated"), it is a favorable sign. If the pulse is rapid and slippery, it indicates retained food, and purgation is indicated.
Question: How can one distinguish retained food in a patient? Answer: If the pulse at the cun position is large and floating, but feels choppy upon pressure, and the chi position is also slightly choppy, this indicates retained food, and purgation is indicated.
If there is diarrhea accompanied by loss of appetite, it indicates retained food, and purgation is indicated.
If diarrhea recurs at the same time after remission, it indicates that the pathogen has not been fully eliminated, and purgation should be repeated.
Generally, if a patient experiences abdominal fullness and pain due to cold-excess accumulation, purgation is indicated.
If abdominal fullness does not decrease, or decreases insignificantly, purgation is indicated.
In Shanghan (Cold Damage) disease, if seven days have passed, vision becomes unclear and the eyes move stiffly, without obvious exterior or interior signs, but with difficult defecation and slight fever, this indicates excess, and urgent purgation is required.
If the pulse is double-string-like and slow, and the epigastrium is hard with a large and tight pulse, this indicates Yin within Yang (cold-excess binding), and purgation is indicated.
In Shanghan disease with fever and lower abdominal fullness, urination should normally be difficult; however, if urination is free, this indicates blood stasis, and purgation (to remove blood stasis) is indicated.
If a patient suffers from irritability and heat, which resolves temporarily with sweating but recurs like malaria, specifically occurring in the late afternoon (Ribu), this belongs to Yangming disease. If the pulse is solid, purgation is indicated.
General principle: In winter, it is appropriate to take warm and hot medicines.
The Master said: If a patient has fever and headache, but the pulse is unexpectedly deep, and if the condition does not improve, leading to increased body pain, one should first treat the interior deficiency-cold. Warm medicine, Sini Tang (Sini Decoction), is indicated.
If there is diarrhea, abdominal fullness, and body pain, one should first warm the interior. Sini Tang (Sini Decoction) is indicated.
If there is diarrhea with a slow and tight pulse, indicating that pain has not yet ceased, warming therapy is indicated.
If there is diarrhea with a floating and large pulse, this indicates deficiency caused by forced purgation. Warming therapy is indicated; providing water may induce hiccups.
In Shaoyin disease with diarrhea, a faint and choppy pulse, and vomiting, warming therapy is indicated.
Spontaneous diarrhea without thirst belongs to Taiyin disease, caused by cold in the zang organs. Warming therapy is indicated.
In Shaoyin disease, if food is vomited immediately upon ingestion, the patient feels nauseous and wants to vomit but cannot, starts with cold hands and feet, and has a string-tight and slow pulse, indicating cold-fluid retention above the diaphragm causing dry heaving, warming therapy is indicated.
In Shaoyin disease, if the pulse is deep, urgent warming therapy is indicated.
If there is diarrhea but the patient desires food, warming therapy should be applied accordingly.