半夏（二合洗） 大枣（六枚） 柴胡（四两） 生姜（一两半） 人参（一两半）
龙骨（一两半） 铅丹（一两半） 桂枝（一两半去皮）
茯苓（一两半） 大黄（二两） 牡蛎（一两半 ）
上十一味。以水八升煮取四升。内大黄。切如棋子。更煮一二沸。去滓、温服一升。
伤寒腹满谵语。寸口脉浮而紧。此肝乘脾也。名曰纵。刺期门。
腹满谵语者。脾胃疾也。浮而紧者。肝脉也。脾病见肝脉。木行乘土也。经曰。水行
乘火。木行乘土。名曰纵。此其类矣。期门者。肝之募。刺之以泻肝经盛气。
伤寒发热。啬啬恶寒。大渴。欲饮水。其腹必满。自汗出。小便利。其病欲解。此
肝乘肺也。名曰横。刺期门。
伤寒发热。啬啬恶寒。肺病也。大渴欲饮水。肝气胜也。玉函曰。作大渴。欲饮酢
浆。是知肝气胜也。伤寒欲饮水者愈。若不愈而腹满者。此肝行乘肺。水不得行也。
经曰。木行乘金。名横。刺期门。以泻肝之盛气。肝肺气平。水散而津液得通。外作
自汗出。内为小便利。而解也。
王宇泰云。按伤寒发热恶寒。表病也。至于自汗出。则表已解矣。大渴腹满。里病
也。至于小便利。则里自和矣。故曰其病欲解。
太阳病。二日。反躁。反熨其背。而大汗出。大热入胃。胃中水竭。躁烦。必发谵
语。十余
日。振栗。自下利者。此为欲解也。故其汗。从腰以下不得汗。欲小便不得。反呕。欲
失溲足下恶风。大便硬。小盒饭数而反不数。及不多大便已。头卓然而痛。其人足心
必热。谷气下流故也。
二日反躁。此阴气虚不当汗也。两故字照应。故字以下。正申言上文。不当发汗而
熨其背。则虽汗而腰以下不得汗。故不解而烦躁。以阴气不行于下故也。所以大便硬。
上呕逆而下恶风。至十余日。阴气复生。阳气行自下利而解者。以谷气下行故也。
太阳病。二日。则邪在表。不当发躁。而反躁者。热气行于里也。反熨其背而发汗。
大汗出。则胃中干燥。火热入胃。胃中燥热。躁烦而谵语。至十余日。振栗。自下利者。
火邪势微。阴气复生。津液得复也。故为欲解。火邪去。大汗出则愈。若从腰以下不得
汗。则津液不得下通。故欲小便不得。热气上逆而反呕也。欲失溲。足下恶风者。气不
得通于下而虚也。津液偏渗。令大便硬者。小盒饭数。经曰。小便数者。大便必硬也。
此以火热内燥。津液不得下通。故小便不数。及不多也。若火热消。津液和。则结硬之
便。得润。因自大便也。便已。头卓然而痛者。先大便硬。则阳
气不得下通。既得大便。则阳气降下。头中阳虚。故卓然而痛。谷气者。阳气也。先
阳气不通于下之时。足下恶风。今阳气得下。故足心热也。
太阳病中风。以火劫发汗。邪风被火热。血气流溢。失其常度。两阳相熏灼。其身
发黄。阳盛则欲衄。阴虚则小便难。阴阳俱虚竭。身体则枯燥。但头汗出。剂颈而还。腹
满、微喘、口干、咽烂、或不大便。久则谵语。甚者至哕手足躁扰。捻衣摸床。小便利
者。其人可治。
火劫发汗。则热盛火炽。以至阴阳俱竭。变症百出。慎之慎之。
风为阳邪。因火热之气。则邪风愈甚。迫于血气。使血气流溢。失其常度。风与火
气谓之两阳。两阳相熏灼。热发于外。必发身黄。若热搏于经络。为阳盛外热。迫血上行。
必衄。热搏于内者。为阴虚内热。必小便难。若热消血气。血气少。为阴阳俱虚。血气
虚少。不能荣于身体。为之枯燥。三阳经络至颈。三阴至胸中而还。但头汗出。剂颈而
还者。热气炎上。搏阳而不搏于阴也。内经曰。诸胀腹大。皆属于热。腹满微喘者。热
气内郁也。内经曰。火气内发。上为口干咽烂者。火热上熏也。热气上而不下者。则大
便不硬。若热气下入胃。消耗津液。则大便硬。故云或不
大便。久则胃中躁热。必发谵语。内经曰。病深者。其声哕。火气大甚。正气逆乱。则
哕。内经曰。四肢者。诸阳之本也。阳盛则四肢实。火热大甚。故手足躁扰。捻衣摸床
扰乱也。小便利者。为火未剧。津液未竭。而犹可治也。
伤寒脉浮。医以火迫劫之。亡阳。必惊狂。起卧不安者。桂枝去芍药。加蜀漆、牡
蛎、龙骨、救逆汤主之。
伤寒脉浮。责邪在表。医以火劫发汗。汗大出者。亡其阳。汗者心之液。亡阳则心
气虚。心恶热。火邪内迫。则心神浮越。故惊狂。起卧不安。与桂枝汤。解未尽表邪。去
芍药。以芍药益阴。非亡阳所宜也。火邪错逆。加蜀漆之辛以散之。阳气亡脱。加龙骨
牡蛎之涩以固之。本草云。涩可去脱。龙骨牡蛎之属是也。
Banxia (Erhe, washed) Dazao (Six fruits) Chaihu (Liangsi) Shengjiang (Yi liangban) Renshen (Yi liangban)
Longgu (Yi liangban) Qiandan (Yi liangban) Guizhi (Yi liangban, peeled)
Fuling (Yi liangban) Dahuang (Liang) Muli (Yi liangban)
The above eleven ingredients. Use eight sheng of water, boil until four sheng remain. Add Dahuang, cut into pieces the size of chessmen. Boil for one or two more boils. Strain the dregs, take one sheng warm.
Shanghan disease presents with abdominal fullness and delirium. The Cun Kou pulse is floating and tight. This is Liver Qi invading the Spleen. It is called "Zong" (Vertical). Acupuncture at Qimen point.
Abdominal fullness and delirium are diseases of the Stomach and Spleen. A floating and tight pulse is the pulse of the Liver. When a Spleen disease shows a Liver pulse, it is Wood overcoming Earth. The Classics say: Water overcomes Fire, Wood overcomes Earth, this is called "Zong". This belongs to this category. Qimen is the Front-Mu point of the Liver; needling it drains the excess Qi of the Liver meridian.
Shanghan disease with fever, aversion to cold, extreme thirst, desire to drink water, abdominal fullness, spontaneous sweating, and free urination indicates the disease is about to resolve. This is Liver Qi invading the Lungs. It is called "Heng" (Horizontal). Acupuncture at Qimen point.
Shanghan disease with fever and aversion to cold is a Lung disease. Extreme thirst and desire to drink indicate Liver Qi prevailing. The *Yu Han Jing* says: appearing with extreme thirst, desiring to drink vinegar slurry, from this we know Liver Qi prevails. In Shanghan disease, those who desire to drink water will recover. If the disease does not resolve but instead presents with abdominal fullness, this is Liver Qi invading the Lungs, and fluids fail to circulate. The Classics say: Wood overcomes Metal, this is called "Heng". Needling Qimen drains the excess Qi of the Liver. When Liver and Lung Qi are balanced, fluids disperse and body fluids flow freely. Externally manifesting as spontaneous sweating, internally as free urination, the disease resolves.
Wang Yutai states: According to Shanghan, fever and aversion to cold are exterior syndromes. Spontaneous sweating means the exterior syndrome has resolved. Extreme thirst and abdominal fullness are interior syndromes. Free urination means the interior harmonizes itself. Therefore, it is said the disease is about to resolve.
Taiyang disease, on the second day, with restlessness contrary to expectation, was treated with back moxibustion/ironing causing profuse sweating. Great heat enters the Stomach, stomach fluids are exhausted, leading to restlessness and delirium. After more than ten days, if there is trembling and spontaneous diarrhea, this indicates the disease is about to resolve. Thus, the sweating is such that there is no sweat from the waist down, desire to urinate but inability to do so, vomiting, desire to lose urine, aversion to wind at the feet, hard stool, frequent urination but the pulse is not rapid, and after the stool passes, the head suddenly hurts, and the soles of the feet become hot, because grain Qi flows downward.
Restlessness on the second day indicates deficiency of Yin Qi, which should not be treated with sweating. The two "fan" (contrary) characters correspond. The text following "gu" (therefore) elaborates on the previous statement. Not sweating when appropriate but using back ironing causes sweating only above the waist, failing to resolve the restlessness, because Yin Qi cannot descend. Hence hard stool. Vomiting above and aversion to wind below. After ten days, Yin Qi regenerates, Yang Qi moves, resolving through diarrhea because grain Qi descends.
Taiyang disease on the second day, pathogen is in the exterior, should not have restlessness. Restlessness indicates heat moving inward. Back ironing induces sweating, drying the Stomach, allowing fire-heat to enter, causing dryness-heat, restlessness, and delirium. After ten days, trembling and spontaneous diarrhea indicate the fire-pathogen's power is waning, Yin Qi returns, and fluids restore. Thus, resolution. If heat dissipates and fluids harmonize, hard stool moistens and passes naturally. After stool passage, sudden head pain occurs because previously Yang Qi could not descend; now that stool passes, Yang Qi descends, leaving the head deficient in Yang, hence sudden pain. Grain Qi is Yang Qi. Previously, when Yang Qi did not reach the lower part, feet were cold; now Yang Qi descends, so soles are hot.
Taiyang Wind strike, treated with fire coercion to induce sweating, pathogenic wind is damaged by fire, blood and Qi overflow, losing their normal rhythm. Two Yangs scorch each other, causing jaundice. Excess Yang leads to epistaxis, deficiency of Yin leads to difficult urination. Both Yin and Yang are depleted, body becomes dry and rough. Only head sweats, stopping at the neck. Abdominal fullness, slight wheezing, dry mouth, throat ulceration, or constipation. Prolonged, delirium occurs. Severe cases show hiccups, restless limbs, picking at clothes and bed. Free urination indicates treatability.
Fire coercion causes intense heat, depleting Yin and Yang, leading to myriad complications. Be cautious.
Wind is a Yang pathogen; combined with fire, it intensifies, forcing blood and Qi to overflow. Wind and fire are called Two Yangs. Scorching externally causes jaundice. Heat binding meridians causes Yang excess external heat, forcing blood upward causing epistaxis. Heat binding internally causes Yin deficiency internal heat, leading to difficult urination. Heat consuming blood and Qi leads to dual deficiency of Yin and Yang, causing dryness. Three Yang meridians reach the neck, Three Yin reach the chest. Head-only sweating stopping at the neck indicates heat flaring upward, affecting Yang but not Yin. *Nei Jing* states: all distension and abdominal enlargement belong to heat. Abdominal fullness and slight wheezing indicate internal heat stagnation. *Nei Jing* states: internal fire manifests as dry mouth and throat ulceration due to heat steaming upward. Heat rising without descending keeps stool soft; heat descending to Stomach consumes fluids, hardening stool. Prolonged heat causes delirium. *Nei Jing* states: deep disease manifests as hiccups due to chaotic Zheng Qi. *Nei Jing* states: limbs are the root of Yang; Yang excess makes limbs solid; severe fire causes restless limbs and picking behaviors. Free urination indicates mild fire and preserved fluids, thus treatable.
Shanghan with floating pulse, treated by doctor with fire coercion, leading to collapse of Yang, resulting in fright, mania, and restlessness, is treated with Guizhi Tang minus Shaoyao plus Shuqi, Muli, and Longgu, named Jiuni Tang.
Floating pulse indicates pathogen in the exterior. Fire coercion causes profuse sweating, collapsing Yang. Sweat is the fluid of the Heart; collapsing Yang deficiences Heart Qi. Heart dislikes heat; internal fire forces Shen to float, causing fright, mania, and restlessness. Give Guizhi Tang to resolve remaining exterior pathogen. Remove Shaoyao as it nourishes Yin, unsuitable for Yang collapse. Add Shuqi's acridity to scatter fire-pathogen chaos. Add Longgu and Muli's astringency to secure collapsed Yang. Materia Medica states: astringents treat collapse, exemplified by Longgu and Muli.