昧哉？孔子曰∶可与适道，未可与立，未可与权。是说也，亦在夫人权之而已矣。
治
足太阳膀胱经，头为诸阳之首，故多传变受病为先也。其脉起于目内 ，从头下后项，连风府，行身
之背，终于足之至阴也。其证头疼项强，腰痛骨节痛也。经曰∶太阳头痛脉浮，项背强而恶寒，若发
热汗出恶风，脉浮缓者为伤风；若脉阴阳俱紧，头痛恶寒，呕逆身
疼，或已发热，或未发热者，名曰伤寒。宜发汗，不可辄下之。表邪乘虚内陷，传变不可胜数，又不可利小便。
利之则引热入里，其害不浅。若本病烦热，小便不利者，乃利之，则不为禁也。如小
便自利如常，则不可利也。凡有汗不得再发汗，汗多不得利小便，有汗不可服麻黄，无汗不可服桂枝也。
足阳明胃经，乃两阳合明于前也。一曰府者，居中土也，万物所归也。其脉起于鼻 ，上头额，络于目，
循于面，行身之前，终于足之厉兑也。经曰∶伤寒三日，阳明脉大。又曰∶尺寸俱长者，
阳明受病也。其证头额痛，目痛、鼻干，身热不得卧，乃标病也。若本病，则身热汗出而恶热也。本实则
潮热大便不行也。在标者，当解肌，在本者，宜清热。本实者可下。夫阳明有三∶一曰太阳阳
明，大便难者，小承气汤主之。二曰正阳阳明，胃家实也，大承气汤下之。三曰少阳阳明，胃中燥热，不大
便者，大柴胡汤主之。
足少阳胆经，其脉起于目锐 ，上头角，络耳中，循胸胁，行身之侧，终于足之窍阴也。前有阳明，后有
太阳，居二阳之中，所以半表半里。经曰∶尺寸俱弦，少阳受病也。其证头痛目眩，口苦
耳聋，胸胁满痛也。或心烦喜呕，或胸中烦闷而不呕，或心下病硬，或寒热往来，或发热，寅申时尤盛，或
身微热者，皆少阳也。凡治有三禁，不可汗、下、利小便也。只宜和之，惟小柴胡汤出入
加减，用之神效，凡头角痛，耳中痛，耳中烘烘而鸣，耳之上下前后肿痛，皆少阳所主部分，其火为之也。
若口苦者，少阳之胆热；胁下硬者，少阳之结也。
足太阴脾经，为中宫之坤土也。其脉始于足大指之隐白，上行至腹，络于嗌，连舌本，行身之前也。若
寒邪卒中，直入本经者，一时便发腹痛，或吐或利，宜温之。如四日而发腹满嗌干者，
此传经之邪也，宜和之。若太阳病下之早，因尔腹痛者，此误下之
而传也。凡治太阴证，自利不渴；脉沉细，手足冷，急温之。若脉浮者，可发汗，宜桂枝汤主之。若发热
脉数者，少阳之邪未解，须以小柴胡汤主之。如自利不渴者。脏有寒也，宜理中汤。寒甚加附
子。腹痛呕吐不下食者，宜治中汤。手足冷，脉沉细者，宜四逆汤。若传经邪热内陷腹痛，宜桂枝芍药汤。
足少阴肾经，为人身之根蒂也。其脉始于足涌泉，上行贯脊，循喉，络舌本，散舌下，注心中，行身之前
也。若因欲事肾虚者，寒邪直中之也。其证一、二日便发，故发热脉沉足冷，或恶寒倦
怠，宜温经而散寒也。若五、六日而发，口燥舌干者，此传经之邪热，宜急下之，恐肾水干也。如其脉沉细，
足冷者，又不可下，急温之。脉沉疾有力者，乃可下之。凡少阴饮水小便色白者，下虚有寒，引水自救，非
热也，宜温之。盖夹阴伤寒，多因劳伤肾经所致。有紧有慢，其害甚速，不可以寒凉之药妄投之也。但脉沉足
冷，虽发热者，急宜温肾以扶元气。
足厥阴肝经，厥者，尽也，为六经之尾也。其脉始于足大指之大敦，上环阴器，抵小腹，循胁肋，上唇口，
与督脉会于巅顶，行身前之侧也。若寒邪直中本经，一日便发吐利，少腹痛，寒甚者唇
青、厥冷、囊缩，急宜温之，并着艾灸丹田、气海以温之。若六、七日发烦满囊拳者，此传经热邪，厥深
热亦深也。若脉沉疾有力者，宜急下之。若脉微细者，不可下也。凡伤寒传至厥阴经，则病热极矣。此生死
在于反掌，其可不谨察之也。大抵热深厥亦深，则舌卷囊缩。阴寒冷极，亦见舌卷囊缩，在乎仔细消详，
其冷热之治法，亦微矣。
一调治伤寒之法，先须识证，察得阴阳表里虚实寒热亲切，更审汗、吐、下、温、和解之法治之，庶无
差误。先观两目或赤或黄，次看口舌，有无胎状，后以手按其心胸至小腹有无痛满，再问
其所苦所欲，饮食起居，大小便通利若何，并服过何药，曾经汗下不，务使一一明白，脉证相对，然后用药
无瘥。若有一毫疑惑，
不可强治。故君子不强其所不能。或见利妄动，视人命如蝼蚁，非君子之用心也。慎之！
一看伤寒，先观两目，或赤或黄。赤为阳毒，六脉洪大有力。燥渴者，轻则三黄石膏汤，重则大承气汤。
一看口舌，黄白色者，邪未入腑，属半表半里，宜小柴胡汤和解。舌上黄苔者，胃腑有邪热，宜调胃承
气汤下之。大便燥实，脉沉有力而大渴者，方可下。舌上黑苔生芒刺者；是肾水克心火
也，不治。急用大承气下之。此邪热已极也，劫法用井水浸青布片子，舌上洗净，后以生姜片子浸水，时时刮
之，其苔自退。
一次以手按其心胸至小腹有无痛处。
若按心下硬痛，手不可近，燥渴谵语，大便实，脉沉实有力，为结胸证，急宜大陷胸汤加枳桔下之。量
元气虚实，缓而治之。反加烦躁者死。
若按之心胸虽满闷而不痛，未经下者，非结胸也。乃邪气填塞胸中。尚为在表，只以小柴胡汤加枳桔以
治其闷。如未效，本方对小陷胸，仍加枳桔。
若病患自觉心胸满闷而不痛者，为痞满也，宜泻心汤加枳壳、桔梗。
若按之小腹硬痛，当问其小便通利不。如小水自利，大便黑，兼或身黄，谵语燥渴，脉沉实，则知蓄血
在下焦，宜桃仁承气汤，下尽黑物则愈。
若按之小腹胀满不痛，小便不利，则知津液留结，即溺涩也，宜五苓散加木通山栀子利之。亦不可大
利，恐耗竭津液也。
若按之小腹绕脐硬痛，渴而小水短少，大便实者，有燥粪也，大承气汤下之，劫法治心胸肋下有邪气
结实，满闷硬痛，用生姜一斤，捣渣去汁，炒微燥带润，用绢包于患处，款款熨之。稍可，又
将渣和匀前汁炒干，再熨许久，豁然宽快。一方用韭菜如前法熨之。
一治伤寒，若烦渴欲饮水者，因内水消渴，欲得外水自救。大渴欲饮一升，止可与一碗，宁令不足，不
可太过，若恣饮过量，使水停心下，则为水结胸。若水射于肺，为喘为咳。留于胃，为噎
为哕。溢于皮肤，为肿。蓄于下焦，为癃。渗于肠间，则为利下。皆饮水之过也。又不可不与，又不可强与。
经云∶若还不与非其治，强饮须教别病生，此之谓也。
一治伤寒，若有吐蛔者，虽有大热，忌下凉药，犯之必死。盖胃中有寒，则蛔上膈，大凶之兆，急用炮干
姜理中汤一服，加乌梅二个，川椒十粒，愈服。待蛔定，却以小柴胡汤退热。盖蛔闻酸则静，得苦则安矣。
一治伤寒，若经十余日以上，尚有表证宜汗者，以羌活冲和汤微汗之，十余日，若有里证宜下者，可以
大柴胡汤下之，盖伤寒过经，正气多虚，恐麻黄、承气太峻。误用麻黄，令人亡阳；误用承气，令人不禁。若
表证尚未除，而里证又急，不得不下者，只可用大柴胡汤通表里而缓治之。又老弱及气血两虚之人有下证者，
亦用大柴胡汤下之，不伤元气。如其年壮力盛者，不在此例，从病制宜。
一治伤寒，若先起头痛发热恶寒，以后传里，头痛恶寒悉除，反觉怕热，发渴谵语，或潮热自汗，大
便不通，或揭去衣被，扬手掷足，或发黄狂乱，或身如涂彩，脉沉有力，此为阳经自表传入阴
经之热证，俱当攻里之药下之。设或当下失下，而变出手足乍冷乍温者，因阳极发热，即阳证似阴，名曰阳厥。
外虽厥冷，内有热邪，三一承气汤下之。又有失于汗下，或本阳证，误投热药，使热毒入
深，阳气独盛，阴气暴绝，登高而歌，弃衣而走，骂詈叫喊，燥渴欲死，面赤眼红，身发斑黄，或下利纯青
水，或下利黄赤，六脉洪大，名阳毒证。轻则消斑青黛饮，重则三黄石膏汤去麻黄、豆豉、
加大黄芒硝下之，令阴气复而大汗解矣。
一初病起，无头疼，无身热，便就恶寒，四肢厥冷，腹痛吐泻，引衣蜷卧不渴，或战栗面如刀刮，口吐
涎沫，脉沉细无力，此为寒邪直中阴经，即真阴证。不从阳经传来，当用热药温之，如寒极手
足厥冷过肘膝者，因寒极发厥，谓之阴厥，宜四逆汤温之，凡腹满腹痛，皆是阴证，只有微甚不同，难以一概
施治。腹痛不大便，桂枝芍药汤；腹痛甚者，桂枝大黄汤；若自利腹满，小便清白，当温
之，理中四逆，看微甚用，轻者五积散；重者四逆汤。又有初病起，外感寒邪，内伤生冷，内既伏阴，内外
皆寒。或本真阴，误投凉药，使阴气独盛，阳气暴绝，以致病起。手足厥冷，腰背强重，头疼目痛，呕吐烦
闷，身如被杖，六脉沉细，汤饮不下。以后毒瓦斯渐深，入腹攻心，咽喉不利，腹痛转深，心下胀满，结硬如
石，燥渴欲死，冷汗不止。或时郑声，指甲面色青黑，此名阴毒。速灸关元、气海二三十壮。或葱熨脐中，
内服回阳救急汤，令阳气复而大汗解矣。
一看伤寒有口沃白沫，或睡多流冷涎，俱是有寒。吴茱萸汤、理中、真武汤之类，看轻重用，切忌凉
药。或用甘温补元气，四君子汤加附子。血虚用仲景八味丸，此条杂病亦然。
一伤寒头痛发热，恶寒微渴， 然汗出，身作痛，脚腿酸疼，无力沉倦，脉空浮无力，名曰劳力感寒。不可误
作正伤寒，大发其汗。故经云∶劳者温之。温能除大热，此之谓也，补中益气汤主之；有下证者，大柴胡汤主之。
一伤寒头痛发热，口干，口鼻血出，腹胀，午后昏沉，声哑耳
聋，胁痛，俗云血汗病也，犀角地黄汤合小柴胡汤。血盛加茅根、韭汁，汗出如雨随瘥。
一伤寒吐血不止，用韭汁磨京墨，其血见黑必止。如无韭之时，用鸡子清亦可，正谓赤属火而黑属水也。
一伤寒发黄，用生姜渣时时周身擦之，其黄自退。
一伤寒热邪传里，服转药后，用盐炒麸皮一升，将绢包于病患腹上，款款熨之，使药气得热则行，大便易通矣。
一伤寒发狂奔走，人难制伏，宜于病患卧室生火一盆，将好醋一大碗浇于火上，令病患闻之，即安。
一伤寒鼻衄不止，用水纸搭于顶门，再将山栀炒黑，为细末，吹入鼻内，其红即止。其成流久不止者，
方可用此法。如点滴不成流者，其邪在经未除，不必用此法。
一伤寒痰症，拥结胸中，用皂荚末、半夏末，生矾末，入麝少许，用姜水汁调服，其痰立吐。轻者用贝
母、皂荚、麝香、姜汁吐之。杂病吐之亦可。
一伤寒腹皮外痛，用炒麸皮布包，款款烙之，痛止。其自汗不止，亦用此法。如再不止，方可用温粉扑法。
方
十神汤
治时令不正，温疫妄行，感冒发热恶寒，头痛身疼，咳嗽喘急。阴阳两感伤寒，并能调治。
川芎 甘草 麻黄 紫苏 白芷 升麻 陈皮 赤芍药 干葛
上锉，每服一两，生姜煎热服。欲汗，以被覆之。如发热头痛，加葱白。潮热，加黄芩、麦门冬。咳喘，
加桔梗、桑白皮、半夏。心胸胀满，加枳实、半夏、枳壳。饮食不进，加炒仁、白
豆蔻。呕逆，加丁香、草果。鼻衄不止，加乌梅、干葛。冷气痛，加玄胡索、良姜。大便闭，加大黄、芒硝。
痢，加枳壳、当归。泄泻，加木通、滑石、肉豆蔻。
人参败毒散〔批〕（按此方治四时感冒，辛平发散之剂）
治伤寒头痛，壮热恶风，及风痰咳嗽，鼻塞声重。四时温疫热毒，头面肿痛，痢疾发热，诸般疮毒。
柴胡 甘草 桔梗 人参 羌活 独活 川芎 茯苓 枳壳 前胡
上锉，每服一两，生姜、薄荷煎服，咳嗽，加半夏。热毒，加黄连、黄芩、黄柏、山栀。风热，加荆
芥、防风名荆防败毒散；消风散和合，名消风败毒散。酒毒，加干葛、黄连。疮毒，
加金银花、连翘，去人参名连翘败毒散。
双解散〔批〕（按此方治内外两感，发表攻里之剂）
治风寒暑湿，饥饱劳役，内外诸邪所伤。以致气血怫郁，变成积热，发为汗病、杂病、非此不除。但觉
不快，便可用此通解。小儿疮疹，用此解去尤快。其大黄、芒硝、麻黄三味，对证旋入。自
利去大黄、芒硝，自汗去麻黄。（即防风通圣散、益元散和合）
羌活冲和汤〔批〕（按此方治太阳膀胱经，辛凉发散之剂）
治春、夏、秋非时感冒暴寒，恶寒头痛，发热无汗，腰脊项强，脉浮而紧。此足太阳膀胱经受邪，是
表证，宜发散，不与冬时正伤寒同治法。此法非独治三时暴寒。春可治温，夏可治热，秋可治
湿。治杂证，亦有神也。可代麻黄桂枝汤，青龙各半等汤，乃太阳经神药也，又名神解散。
羌活（三钱，治太阳肢节痛，大无不通，小无不入，乃拨乱反正之主也）
防风（一钱五分，治一身尽痛，听君将命令而行，随所使引而至）
苍术（一钱，米泔制，雄壮，上行之气能除湿气，下安太阴，使邪气不传脾经）
Confused? Confucius said, "One may be led to follow the Way, but not necessarily to uphold it; one may be led to uphold it, but not necessarily to adapt to circumstances." This statement also lies in whether a person can properly weigh and adapt.
Treatment:
The Foot-Taiyang Bladder Meridian: The head is the summit of all Yang meridians, so it is prone to being affected first and undergoing transmission. Its meridian originates from the inner canthus of the eye, descends from the head to the posterior neck, connects with Fengfu (GV16), runs along the back, and ends at Zhiyin (BL67) on the little toe. Its manifestations include headache, stiffness of the neck and nape, lower back pain, and pain in the bone joints. The Classics state: "Taiyang disease presents with headache, floating pulse, stiffness of the neck and back, and aversion to cold. If accompanied by fever, sweating, and aversion to wind, with a floating and moderate pulse, it is Wind Strike; if the pulses at both cun and chi positions are tight, accompanied by headache, aversion to cold, vomiting, and body pain, whether fever has already appeared or not, it is termed Cold Damage." Sweating therapy is appropriate; purgation should not be used rashly. Exterior pathogens sinking inward due to deficiency lead to countless variations of transmission, and diuresis should not be employed. Diuresis draws heat inward, causing significant harm. However, if the original condition involves irritability, heat, and difficulty urinating, diuresis is permissible. If urination is normal, diuresis is contraindicated. Generally, those with sweating should not undergo further sweating; those with excessive sweating should not undergo diuresis; those with sweating should not take Ephedrae Herba (Mahuang); those without sweating should not take Cinnamon Twig Decoction (Guizhi Tang).
The Foot-Yangming Stomach Meridian: It is where two Yangs combine and brighten at the front. Some say "Fu" organs reside in Central Earth, the gathering place of all things. Its meridian originates beside the nose, ascends to the forehead, links with the eyes, follows the face, runs along the anterior trunk, and ends at Lidui (ST45) on the second toe. The Classics state: "Three days after Cold Damage, the Yangming pulse is large." It also states: "If the pulses at cun, guan, and chi positions are all long, Yangming is affected." Manifestations include forehead pain, eye pain, dry nose, fever, and inability to lie down, which are superficial symptoms (Biao). For root symptoms (Ben), there is fever, sweating, and aversion to heat. For root excess, there is tidal fever and constipation. For superficial conditions, muscle-releasing therapy is indicated; for root conditions, clearing heat is appropriate. Root excess can be treated with purgation. There are three types of Yangming: 1. Taiyang-Yangming, characterized by difficult defecation, treated primarily with Minor Chengqi Decoction (Xiao Chengqi Tang). 2. Zhengyang-Yangming, characterized by fullness and excess in the stomach and intestines, treated with Major Chengqi Decoction (Da Chengqi Tang). 3. Shaoyang-Yangming, characterized by dryness and heat in the stomach with constipation, treated primarily with Major Bupleurum Decoction (Da Chaihu Tang).
The Foot-Shaoyang Gallbladder Meridian: Its meridian originates from the outer canthus, ascends to the temporal angle, links with the middle ear, follows the chest and hypochondrium, runs along the lateral side of the body, and ends at Qiaoyin (GB44) on the fourth toe. With Yangming in front and Taiyang behind, it resides between the two Yangs, thus belonging to the Half-Exterior and Half-Interior. The Classics state: "If the pulses at cun and chi positions are wiry, Shaoyang is affected." Manifestations include headache, vertigo, bitter taste in the mouth, deafness, and fullness/pain in the chest and hypochondrium. Other symptoms may include irritability and frequent retching, or chest oppression without retching, epigastric hardness, alternating chills and fever, fever (especially severe at Yin and Shen hours), or slight body heat. All belong to Shaoyang disease. Treatment of Shaoyang has three prohibitions: no sweating, no purgation, and no diuresis. Harmonization is appropriate; only Minor Bupleurum Decoction (Xiao Chaihu Tang) with modifications yields miraculous results. Head/temple pain, ear pain, roaring tinnitus, and swelling/pain around the ears are all governed by the Shaoyang meridian and caused by Fire pathogen. Bitter taste indicates Shaoyang Gallbladder Heat; hardness under the ribs indicates Shaoyang Qi stagnation.
The Foot-Taiyin Spleen Meridian: It is the Kun Earth of the Central Palace. Its meridian begins at Yinbai (SP1) on the big toe, ascends to the abdomen, links with the pharynx, connects to the root of the tongue, and runs along the anterior trunk. If Cold pathogen strikes suddenly and enters the meridian directly, abdominal pain occurs immediately, possibly with vomiting or diarrhea, requiring warming. If abdominal fullness and dry throat appear on the fourth day, this is transmitted pathogen, requiring harmonization. If Taiyang disease was purged too early, causing abdominal pain, this is transmission due to mistaken purgation. For Taiyin syndrome, spontaneous diarrhea without thirst, deep/thin pulse, and cold extremities require urgent warming. If the pulse is floating, sweating is possible, using Guizhi Tang. If fever and rapid pulse indicate unresolved Shaoyang pathogen, Xiao Chaihu Tang is used. Spontaneous diarrhea without thirst indicates internal cold, treated with Lizhong Tang; add Aconite Root (Fuzi) for severe cold. Abdominal pain, vomiting, and inability to eat are treated with Zhizhong Tang. Cold extremities and deep/thin pulse require Sini Tang. Transmitted heat sinking inward causing abdominal pain is treated with Guizhi Shaoyao Tang.
The Foot-Shaoyin Kidney Meridian: It is the root of the human body. Its meridian begins at Yongquan (KI1) on the sole, ascends through the spine, follows the throat, links the root of the tongue, spreads under the tongue, injects into the heart, and runs along the anterior trunk. If kidney deficiency results from sexual activity, it is direct invasion by Cold pathogen. Symptoms appear within one or two days: fever, deep pulse, cold feet, aversion to cold, and fatigue, requiring warming the meridian and dispersing cold. If appearing on days five or six with dry mouth and tongue, this is transmitted heat, requiring urgent purgation to prevent depletion of Kidney Water. If the pulse is deep/thin and feet are cold, purgation is contraindicated; urgent warming is needed. If the pulse is deep, rapid, and forceful, purgation is allowed. Drinking water with white urine in Shaoyin disease indicates lower jiao deficiency-cold, drawing water for self-rescue, not heat; warming is appropriate. Jia Yin Cold Damage often results from labor injuring the Kidney meridian. Pulses may be tight or slow; harm is rapid. Do not recklessly use cold-cooling medicines. If the pulse is deep and feet are cold, even with fever, urgently warm the Kidney to support Yuan Qi.
The Foot-Jueyin Liver Meridian: "Jue" means end; it is the tail of the Six Meridians. Its meridian begins at Dazhun (LR1) on the big toe, circles the genitalia, reaches the lower abdomen, follows the costal region, ascends to the lips/mouth, meets the Du Meridian at the vertex, and runs along the lateral anterior trunk. Direct Cold invasion causes vomiting/diarrhea and lower abdominal pain within one day. Severe cold causes cyanotic lips, cold limbs, and retracted testicles; urgent warming and moxibustion at Shendian (CV8) and Qihai (CV6) are required. Irritation/fullness and retracted testicles appearing on days six or seven indicate transmitted heat ("deep Jue means deep heat"). Deep/rapid/forceful pulse requires urgent purgation; micro/thin pulse prohibits it. Transmission to Jueyin indicates extreme heat; life and death hang in the balance. Careful differentiation is essential. Generally, deep heat causes deep Jue, leading to curled tongue and retracted testicles. Extreme Yin cold also causes these signs. Differentiation of cold vs. heat is subtle.
General regulation of Cold Damage: First, identify the syndrome, clearly distinguishing Yin/Yang, Exterior/Interior, Deficiency/Excess, and Cold/Heat. Then apply sweating, emesis, purgation, warming, or harmonizing therapies accordingly to avoid errors. Observe eyes (red/yellow), check tongue coating, palpate chest/abdomen for pain/fullness, ask about suffering/desires, diet/sleep, bowel/bladder function, previous medications, and history of sweating/purgation. Ensure pulse and symptoms match before prescribing. If any doubt exists, do not treat forcibly. Gentlemen do not force what cannot be done. Acting for profit while disregarding life is ungentlemanly. Be cautious!
Observation 1: Eyes. Red indicates Yang Toxin with forceful, flooding pulses. Dryness/thirst: mild cases use Sanhuang Shigao Tang; severe cases use Da Chengqi Tang.
Observation 2: Tongue/Mouth. Yellow-white coating indicates pathogen not yet in Fu organs, half-exterior/half-interior; treat with Xiao Chaihu Tang. Yellow coating indicates Stomach Fu heat; treat with Tiaowei Chengqi Tang. Dry stool, deep/forceful/large pulse, and great thirst allow purgation. Black coating with prickles indicates Kidney Water overcoming Heart Fire; untreatable. Urgently use Da Chengqi Tang. This is extreme heat. Use "Jie" method: wash tongue with well-water-soaked green cloth, then scrape with water-soaked ginger slices until coating recedes.
Palpation: Check chest/abdomen for pain.
Epigastric hardness/pain, intolerance to touch, dryness/thirst, delirium, solid stool, deep/forceful pulse indicate Jie Xiong (Chest Binding); urgently use Daxianxiong Tang plus Zhike and Jiegeng. Treat gently based on Yuan Qi status. Aggravated restlessness indicates death.
Chest fullness without pain, untreated, is not Jie Xiong but pathogen blocking the chest, still exterior; use Xiao Chaihu Tang plus Zhike and Jiegeng. If ineffective, combine with Xiaoxianxiong Tang plus Zhike and Jiegeng.
Patient-perceived chest fullness without pain is Pi Man (Stagnant Fullness); use Xiexin Tang plus Zhike and Jiegeng.
Lower abdominal hardness/pain: Ask about urination. Clear urine, black stool, jaundice, delirium, dryness/thirst, deep/forceful pulse indicate Blood Stasis in Lower Jiao; use Taoren Chengqi Tang until black material passes.
Lower abdominal distension without pain, difficulty urinating, indicates fluid retention; use Wuling San plus Mutong and Shanzhizi. Do not over-diurese to avoid depleting fluids.
Periumbilical hardness/pain, thirst, scanty urine, solid stool indicate dry feces; use Da Chengqi Tang. For stubborn pathogen binding in chest/flanks causing fullness/pain, use 1 jin fresh ginger, crushed, juice removed, stir-fried until slightly dry but moist, wrapped in silk, and ironed over the area. Repeat with reheated residue mixed with juice until relief. Alternatively, use leeks similarly.
Therapy 1: Thirst. Irritability/thirst indicates internal fluid depletion seeking external water. If desiring one sheng, give only one bowl. Better insufficient than excessive. Excessive drinking causes Water Jie Xiong (fluid in heart), asthma/cough (fluid in lung), choking/hiccups (fluid in stomach), edema (fluid in skin), strangury (fluid in lower jiao), or diarrhea (fluid in intestines). These are faults of drinking. Do not withhold water, but do not force it. As stated: "Giving when inappropriate is wrong; forcing drinking creates new diseases."
Therapy 2: Vomiting roundworms. Despite high heat, avoid cold medicines; doing so is fatal. Cold in stomach causes worms to ascend, a dire sign. Urgently use Pao Ganjiang Lizhong Tang with two Wu Mei and ten Chuanjiao. After worms settle, use Xiao Chaihu Tang to reduce heat. Worms calm with sourness and find peace with bitterness.
Therapy 3: Duration >10 days. If exterior syndrome persists, use Qianghuo Chonghe Tang for mild sweating. If interior syndrome requires purgation after 10 days, use Da Chaihu Tang. Pathogens lingering deplete Zheng Qi; Mahuang and Chengqi decoctions are too harsh. Misuse of Mahuang causes loss of Yang; misuse of Chengqi causes uncontrollable purgation. If exterior remains but interior urgency demands purgation, use Da Chaihu Tang to harmonize exterior/interior gently. Elderly/weak/Qi-Blood deficient patients with purgation indications also use Da Chaihu Tang to spare Yuan Qi. Robust young patients follow standard protocols.
Therapy 4: Transmission to Interior. Initial headache/fever/aversion to cold transitions to interior: aversion to cold disappears, replaced by heat intolerance, thirst, delirium, tidal fever, spontaneous sweating, constipation, restlessness, yellowing, mania, painted appearance, deep/forceful pulse. This is Yang channel heat transmitting to Yin channels; treat with interior-purgative drugs. If purgation is missed and limbs alternate cold/warm, it is Yang Jue (Yang Reversal): exterior cold, interior heat; use Sanyi Chengqi Tang. If sweating/purgation were missed, or Yang syndrome was mistakenly treated with hot medicines, causing deep heat toxin, solitary Yang flourishing, and sudden Yin extinction, symptoms include singing/climbing, discarding clothes, cursing, extreme thirst, red face/eyes, macules/yellowing, pure green diarrhea, or yellow-red diarrhea, with flooding pulses. This is Yang Du (Yang Toxin). Mild cases: Xiaoban Qingdai Yin; severe cases: Sanhuang Shigao Tang minus Mahuang/Douchi, plus Dahuang/Mangxiao to purge, restoring Yin and resolving with sweat.
Therapy 5: Initial Yin Syndrome. No headache/fever, immediate aversion to cold, cold limbs, abdominal pain/vomiting/diarrhea, curling up, no thirst, trembling/scraped-face appearance, salivation, deep/thin/weak pulse. This is Cold directly invading Yin channels (True Yin Syndrome), not from Yang transmission. Use hot medicines to warm. If cold is extreme with limbs cold past elbows/knees, it is Yin Jue; use Sini Tang. Abdominal fullness/pain are Yin syndromes, varying in severity. Abdominal pain with constipation: Guizhi Shaoyao Tang; severe pain: Guizhi Dahuang Tang. Spontaneous diarrhea with fullness and clear urine: warm with Lizhong/Sini Tang based on severity; mild: Wuji San; severe: Sini Tang. External Cold + Internal Raw/Cold damage leads to internal Yin伏 (hidden) and exterior/interior cold. Mistaken cold medicine use in True Yin causes solitary Yin flourishing and Yang extinction. Symptoms: cold limbs, stiff back/waist, headache/eye pain, vomiting/irritation, body feeling like beaten, deep/thin pulses, inability to swallow. Later, toxin deepens, attacking heart: throat obstruction, deepening abdominal pain, epigastric fullness/hardness, extreme thirst, cold sweat, muttering, cyanotic nails/face. This is Yin Du. Urgently moxa Guanyuan (CV4) and Qihai (CV6) 20-30 moxa cones. Or onion-iron umbilicus. Internally use Huiyang Jiujii Tang to restore Yang and resolve with sweat.
Observation 6: White foam in mouth or cold saliva during sleep indicates Cold. Use Wuzhuyu Tang, Lizhong Tang, or Zhenwu Tang based on severity. Avoid cold medicines. Use sweet-warm to tonify Yuan Qi: Sijunzi Tang plus Fuzi. Blood deficiency: Zhang Zhongjing's Bawei Wan. Applies to miscellaneous diseases too.
Syndrome 1: Labor-induced Cold. Headache, fever, aversion to cold, slight thirst, sweating, body pain, leg soreness, weakness/fatigue, empty/floating/weak pulse. Do not mistake for regular Cold Damage and induce heavy sweating. Classics: "Treat exhaustion with warmth." Warmth removes great heat. Use Buzhong Yiqi Tang; if purgation indication exists, use Da Chaihu Tang.
Syndrome 2: Blood Sweat Disease. Headache, fever, dry mouth, nose/mouth bleeding, abdominal distension, afternoon lethargy, hoarseness/deafness, hypochondriac pain. Use Xijiao Dihuang Tang combined with Xiao Chaihu Tang. Add Maogen and Jiuzhi for heavy bleeding; sweating如雨 resolves it.
Syndrome 3: Persistent Hematemesis. Use Jiuzhi ground with Jingmo ink; blood stops upon turning black. Without Jiuzhi, use egg white. Red belongs to Fire, Black to Water.
Syndrome 4: Jaundice. Rub body frequently with fresh ginger residue; jaundice recedes.
Syndrome 5: Post-Purgation Care. After administering purgatives for interior heat, wrap 1 sheng salt-fried bran in silk and iron over patient's abdomen to promote drug action and ease defecation.
Syndrome 6: Mania/Wandering. Place fire basin in bedroom, pour vinegar on fire. Patient inhaling fumes calms down.
Syndrome 7: Epistaxis. Apply wet paper to Baihui (GV20). Blow roasted black Gardenia powder into nostrils. Stop bleeding. Only for continuous flow, not dripping. Dripping indicates pathogen in meridian; do not use.
Syndrome 8: Phlegm Binding. Gypsum powder, Banxia powder, raw alum powder, plus musk, mixed with ginger juice to induce expectoration. Mild cases: Beimu, Zaoguo, musk, ginger juice. Also applicable to miscellaneous diseases.
Syndrome 9: Abdominal Wall Pain. Iron fried bran wrapped in cloth. Stops pain. Also for spontaneous sweating. If persistent, use warm powder dusting.
Formula:
Shishen Tang
Treats seasonal irregularities, epidemic spread, cold/flu with fever/aversion to cold, headache/body pain, cough/asthma. Yin-Yang dual infection Cold Damage.
Chuanxiong Radix (Chuanxiong), Licorice Root (Gancao), Ephedra Herb (Mahuang), Perilla Leaf (Zisu), Angelica Dahurica (Baizhi), Cimicifuga Rhizome (Shengma), Tangerine Peel (Chenpi), Red Peony Root (Chishao), Kudzu Root (Gegen).
Decoct each dose (1 liang) with fresh ginger. Cover with blanket to induce sweat. Add Congbai for fever/headache; Huangqin/Maimendong for tidal fever; Jiegeng/Sangbaipi/Banxia for cough/asthma; Zhishi/Banxia/Zhike for chest fullness; Fried Ren/Baidoukou for poor appetite; Dingxiang/Caoguo for vomiting; Wumei/Gegen for epistaxis; Yanhusuo/Liangjiang for cold pain; Dahuang/Mangxiao for constipation; Zhike/Danggui for dysentery; Mutong/Huashi/Roudoukou for diarrhea.
Renshen Baidu San [Note] (Acrid-neutral dispersant for four-season colds)
Treats Cold Damage headache, high fever/aversion to wind, wind-phlegm cough, nasal congestion/heavy voice. Four-season epidemic heat-toxin, head/face swelling/pain, dysentery fever, various sores/toxins.
Chaihu, Gancao, Jiegeng, Renshen, Qianghuo, Duhuo, Chuanxiong, Fuling, Zhike, Qianhu.
Decoct each dose (1 liang) with fresh ginger and Bohe. Add Banxia for cough; Huanglian/Huangqin/Huangbai/Shanzhi for heat-toxin; Jingjie/Fangfeng for wind-heat (name: Jingfang Baidu San); combine with Xiaofeng San (name: Xiaofeng Baidu San); Ganegen/Huanglian for alcohol toxicity; Jinyinhua/Lianqiao minus Renshen for sores (name: Lianqiao Baidu San).
Shuangjie San [Note] (Releases exterior and purges interior for dual infections)
Treats injury by Wind-Cold-Damp-Heat, hunger/fullness, labor. Causes Qi-Blood stagnation and accumulated heat, resulting in sweat diseases/miscellaneous diseases. Use whenever discomfort arises. Fast resolution for pediatric rashes. Add Dahuang/Mangxiao/Mahuang as indicated. Remove Dahuang/Mangxiao for spontaneous diarrhea; remove Mahuang for spontaneous sweating. (Combination of Fangfeng Tongsheng San and YiYuan San).
Qianghuo Chonghe Tang [Note] (Acrid-cool dispersant for Taiyang Bladder Meridian)
Treats non-seasonal acute cold in Spring/Summer/Autumn, aversion to cold/headache, fever/no sweat, stiff waist/spine/neck, floating/tight pulse. Taiyang exterior syndrome; requires dispersion, different from Winter Zheng Shanghan. Treats spring-warmth, summer-heat, autumn-dampness. Effective for miscellaneous diseases. Replaces Mahuang Guizhi Tang, Qinglong Ge Ban Tang. Divine medicine for Taiyang, also named Shenjiesan.
Qianghuo (3 qian): Treats Taiyang limb/joint pain; penetrates large and small; corrects chaos.
Fangfeng (1.5 qian): Treats whole-body pain; follows commands; guides pathogen out.
Cangzhu (1 qian, rice water processed): Potent; ascending Qi dries dampness; stabilizes Taiyin; prevents pathogen transmission to Spleen.