吴茱萸（一升洗味辛热） 人参（三两味甘温） 生姜（六两切味辛温） 大枣
（十二枚擘味甘温）
上四味。以水七升。煮取二升。去滓。温服七合。日三服。
内经曰。寒淫于内。治以甘热。佐以苦辛。吴茱萸生姜之辛以温胃。人参大枣之甘
以缓脾。
娄氏云。得汤反剧者。火也。当用生姜黄连治之。
太阳病。寸缓、关浮、尺弱。其人发热。汗出。复恶寒。不呕。但心下痞者。此以
医下之也。如其不下者。病患不恶寒而渴者。此转属阳明也。小便数者。大便必硬。不
更衣十日。无所苦也。渴欲饮水。少少与之。但以法救之。渴者。宜五苓散。
太阳病。脉阳浮阴弱。为邪在表。今寸缓关浮尺弱。邪气渐传里。则发热汗出复恶
寒者。表未解也。传经之邪入里。里不和者必呕。此不呕。但心下痞者。医下之早。邪
气留于心下也。如其不下者。必渐不恶寒而渴。太阳之邪。转属阳明也。若吐若下若发
汗后。小便数。大便硬者。当与小承气汤和之。此不因吐下发汗后。小便数。大便硬。若
是无满实。虽不更衣。十日无所苦也。候津液还入胃中。小便数少。大便必自出也。渴
欲饮水者。少少与之。以润胃气。但审邪气所在。以法救之。如渴不止。与五苓散是也。
张兼善云。十日不更衣而不用攻伐。何也。曰、此非结热。乃津液不足。夫不便者。
若有潮热谵语。可下之证者。然后可以攻之。其不大便而无诸下证者。此津液不足。当
须审慎。勿以日数久而辄为攻下也。
王三阳云。此处五苓散难用。不然。经文渴字上。当有缺文也。
脉阳微而汗出少者。为自和也。汗出多者为太过。
脉阳微者。邪气少。汗出少者为适当。故自和。汗出多者。反损正气。是汗出太过
也。
阳脉实。因发其汗。出多者亦为太过。太过为阳绝于里。亡津液。大便因硬也。
阳脉实者。表热甚也。因发汗。热乘虚蒸。津液外泄。致汗出太过。汗出多者亡其
阳。阳绝于里。肠胃干燥。大便因硬也。
脉浮而芤。浮为阳。芤为阴。浮芤相搏。胃气生热。其阳则绝。
浮芤相搏。阴阳不谐。胃气独治。郁而生热。消烁津液。其阳为绝。
趺阳脉浮而涩。浮则胃气强。涩则小便数。浮涩相搏。大便则难。其脾为约。麻仁
丸主之。
趺阳者。脾胃之脉。诊浮为阳。知胃气强。涩为阴。知脾为约。约者。俭约之约。
又约束之约。内经曰。饮入于胃。游溢精气。上输于脾。脾气散精。上归于肺。通调水
道。下输于膀胱。水精四布。五经并行。是脾主为胃行其津液者也。今胃强脾弱。约束
津液。不得四布。但输膀胱。致小便数大便难。与脾约丸。通肠润燥。
Evodiae Fructus (one sheng, washed, pungent and hot) Ren Shen (three liang, sweet and warm) Sheng Jiang (six liang, sliced, pungent and warm) Da Zao (twelve pieces, broken open, sweet and warm)
The above four ingredients. Use seven sheng of water. Boil to obtain two sheng of decoction. Remove the dregs. Take seven ge as a dose, warm. Administer three times daily.
The *Nei Jing* states: When cold pathogen invades the interior, treat with sweet and hot substances. Assist with bitter and pungent substances. The pungency of Evodiae Fructus and Sheng Jiang warms the Stomach. The sweetness of Ren Shen and Da Zao moderates the Spleen.
Lou states: If the condition worsens after taking the decoction, it is a fire syndrome. It should be treated with Sheng Jiang and Huang Lian.
Taiyang disease (disease of the Taiyang channel), Cun pulse slow, Guan pulse floating, Chi pulse weak. The patient has fever, sweating, and aversion to cold again, does not vomit, but only has epigastric fullness and stuffiness. This is due to the physician's premature use of purgation. If no purgation was used, and the patient is not averse to cold but thirsty, this indicates the pathogen has transferred to Yangming (Yangming channel pathology). In cases where urination is frequent, the stool must be hard. Even if there is no bowel movement for ten days, there is no distress. If thirsty for water, give small amounts at a time, and rescue according to the method. For thirst, Wu Ling San (Five-Ingredient Powder with Poria) is suitable.
Taiyang disease, with the exterior pulse floating and interior pulse weak, indicates the pathogen is in the exterior. Now, with Cun pulse slow, Guan pulse floating, and Chi pulse weak, the pathogen is gradually transmitting to the interior. Thus, fever, sweating, and aversion to cold indicate the exterior syndrome is unresolved. Pathogenic factors transmitted through the channels entering the interior cause disharmony in the interior, which necessarily leads to vomiting. Here, there is no vomiting, only epigastric fullness, because the physician used purgation too early, leaving the pathogen lingering in the epigastrium. If no purgation had been used, the patient would gradually cease to be averse to cold and become thirsty. The Taiyang pathogen transfers to Yangming. After emesis, purgation, or diaphoresis, if urination is frequent and stool is hard, Xiao Cheng Qi Tang (Minor Order the Qi Decoction) should be given to harmonize. This case does not involve frequent urination and hard stool resulting from prior emesis, purgation, or diaphoresis. If there is no fullness and excess, even without bowel movement for ten days, there is no distress. Wait for the body fluids to return to the Stomach; when urination frequency decreases, the stool will pass naturally. For those desiring water, give small amounts to moisten the Stomach qi. Examine the location of the pathogen and rescue according to the method. If thirst persists, administer Wu Ling San.
Zhang Jianshan asks: Why is no purgative therapy used for ten days without bowel movement? He answers: This is not accumulated heat, but insufficient body fluids. For constipation, if there are signs such as tidal fever and delirium that warrant purgation, then attack may be used. For those with constipation but without these purgative signs, this is due to insufficient body fluids; caution is required. Do not resort to purgation merely because many days have passed.
Wang Sanyang states: The use of Wu Ling San here is difficult to apply. Otherwise, there must be missing text before the character "thirst" in the classic.
If the exterior pulse is faint and sweating is slight, this indicates self-harmonization. Profuse sweating indicates excess.
A faint exterior pulse means the pathogen is scanty; slight sweating indicates appropriateness. Hence, self-harmonization. Profuse sweating damages the righteous qi, constituting excessive sweating.
If the exterior pulse is excess, and diaphoresis causes profuse sweating, this is also excess. Excess leads to the severance of yang within the interior and loss of body fluids, causing the stool to become hard.
An excess exterior pulse indicates severe exterior heat. Diaphoresis allows heat to steam into the deficiency, causing body fluids to escape externally, leading to excessive sweating. Profuse sweating leads to the loss of yang. Yang is severed within the interior, the intestines and stomach become dry, and the stool becomes hard.
If the pulse is floating and knotted (hollow like a scallion stalk), floating represents yang, and knotted represents yin. The interaction of floating and knotted generates heat in the Stomach qi, leading to the severance of its yang.
The interaction of floating and knotted indicates disharmony between yin and yang. Stomach qi acts independently, stagnating and generating heat, consuming body fluids, resulting in the severance of yang.
The Fuyang pulse (pulse at the dorsum pedis, reflecting Spleen and Stomach qi) is floating and choppy. Floating indicates strong Stomach qi; choppy indicates frequent urination. The interaction of floating and choppy makes defecation difficult; this is Spleen Constraint (Spleen dysfunction failing to distribute fluids for the Stomach). Ma Ren Wan (Hemp Seed Pill) is the primary formula.
Fuyang is the pulse of the Spleen and Stomach. A floating pulse indicates yang, revealing strong Stomach qi; a choppy pulse indicates yin, revealing Spleen constraint. "Constraint" implies frugality or restriction. The *Nei Jing* states: Food enters the Stomach, its essence overflows and is transported upward to the Spleen. The Spleen disperses essence, sending it upward to the Lung. The Lung regulates the water passages, transporting them downward to the Bladder. Water essence distributes in all directions, traversing the five meridians. This shows the Spleen primarily transports body fluids for the Stomach. Now, with strong Stomach and weak Spleen, body fluids are constrained and cannot distribute in all directions, but are only sent to the Bladder, causing frequent urination and difficulty in defecation. Administer Pi Yue Wan (Spleen Constraint Pill, i.e., Ma Ren Wan) to unblock the intestines and moisten dryness.