栀子（十五个味苦寒） 甘草（一两味甘平） 黄柏（二两）
上三味。以水四升。煮取一升半。去滓。分温再服。
伤寒瘀热在里。身必发黄。麻黄连翘赤小豆汤主之。
湿热相交。民多病瘅。瘅、黄也。伤寒为寒湿在表。发黄为瘀热在里。与麻黄连翘
赤小豆汤。除热散湿。
麻黄（二两去节味甘温） 赤小豆（一升味甘平） 连翘（二两连翘根也苦寒）
杏仁（四十个去皮尖甘温） 大枣（十二枚味甘温） 生梓白皮（一升苦寒） 生姜
（二两切味辛温） 甘草（一两炙味甘平）
以上八味。以潦水一斗。先煮麻黄再沸。去上沫。内诸药。煮取三升。分温三服。
半日则尽。
内经曰。湿上甚而热。治以甘温。佐以甘平。以汗为故。正此之谓也。又煎用潦水
者。亦取其水味薄。则不助湿气。
娄氏云。栀子柏皮汤。麻黄连翘赤小豆汤。治身黄。小便利而身不疼者。海藏所谓
干黄是也。桂枝附子汤。去桂加白术汤。治身黄小便利而一身尽痛者。活人所谓中湿是也。
少阳之病。口苦、咽干、目眩也。
足少阳胆经也。内经曰。有病口苦者。名曰胆瘅。甲乙经曰。胆者。中精之府。五
藏取决于胆。咽为之使。少阳之脉。起于目锐 。少阳受邪。故口苦。咽干。目眩。
少阳中风。两耳无所闻。目赤。胸中满而烦者。不可吐下。吐下则悸而惊。
少阳之脉。起于目 。走于耳中。其支者。下胸中。贯膈。风伤风壅则为热。少阳
中
风。气壅而热。故耳聋目赤。胸满而烦。邪在少阳。为半表半里。以吐除烦。吐则伤气。
气虚者悸。以下除满。下则亡血。血虚者惊。
或云。少阳病。耳聋。目赤。胸满而烦。为中风。口苦。咽干。目眩。为伤寒。
王宇泰云。误吐气虚者悸。误下血虚者惊。
伤寒。脉弦细。头痛。发热者。属少阳。少阳不可发汗。发汗则谵语。此属胃。胃
和则愈。胃不和则烦而悸。
经曰。三部俱弦者。少阳受病。脉细者。邪渐传里。虽头痛发热。为表未解。以邪
客少阳。为半在表半在里。则不可发汗。发汗亡津液。胃中干燥。少阳之邪因传入胃。
必发谵语。当与调胃承气汤下之。胃和则愈。不下。则胃为少阳木邪干之。故烦而悸。
王宇泰云。凡头痛俱为在表。惟此头痛为少阳者何也。以脉弦细。可汗不可汗。当
以此为法。
王海藏云。少阳半表里。用小柴胡。名三禁汤。然亦须辨表里症孰多。假令头痛往
来寒热。脉浮。但有其一。即为表也。口失滋味而渴。胁下满。手足温。腹中不和。
大小便或秘而不通。或泄而不调。但有其一。即为里也。如无上下表里症。余皆虚
热也。是病在其中矣。
本太阳病不解。转入少阳者。胁下硬满。干呕。不能食。往来寒热。尚未吐下。脉
沉紧者。与小柴胡汤。
太阳转入少阳。是表邪入于里。胁下硬满。不能食。往来寒热者。邪在半表半里之间。
若已经吐下。脉沉紧者。邪气入腑。为里实。尚未可吐下。而脉沉紧。为传里虽深。未全
入腑。外犹未解也。与小柴胡汤以和解之。
若已吐下。发汗。温针。谵语。柴胡汤证罢。此为坏病。知犯何逆。以法治之。
少阳之邪。在表里之间。若妄吐下。发汗温针。损耗津液。胃中干燥木邪干胃。必
发谵语。若柴胡证不罢者。则不为逆。柴胡证罢者。坏病也。详其因何治之逆以法救之。
王宇泰云。救坏病。助荣卫。生津液。桂枝汤求之。
三阳合病。脉浮大。上关上。但欲眠睡。目合则汗。
关脉以候少阳之气。太阳之脉浮。阳明之脉大。脉浮大。上关上。知三阳合病。胆
热则睡。少阴病。但欲眠睡。目合则无汗。以阴不得有汗。但欲眠睡。目合则汗。知三
阳合病。胆有热也。
伤寒六七日。无大热。其人躁烦者。此为阳去入阴故也。
表为阳。里为阴。邪在表。则外有热。六七日。邪气入里之时。外无大热。内有躁
烦者。表邪传里也。故曰阳去入阴。
又云。所谓烦躁者。谓先烦。渐至躁也。所谓躁烦者。谓先发躁而迤逦复烦也。盖
内热曰烦。谓心中郁烦也。外热曰躁。谓气外热躁也。内热为有根之火。故但烦不躁。
及先烦后躁者。皆可治。外热为无根之火。故但躁不烦。及先躁后烦者。皆不可治。
伤寒三日。三阳为尽。三阴当受邪。其人反能食而不呕。此为三阴不受邪也。
伤寒四日。表邪传里。里不和。则不能食而呕。今反能食而不呕。是邪不传阴但在
阳也。
伤寒三日。少阳脉小者欲已也。
内经曰。大则邪至。小则平。伤寒三日。邪传少阳。脉当弦紧。今脉小者。邪气微
而
欲已也。
少阳病欲解时。从寅至辰上。
内经曰。阳中之少阳通于春气。寅卯辰少阳木王之时。
Zhi Zi (Gardeniae Fructus, fifteen pieces, bitter, cold) Gan Cao (Glycyrrhizae Radix et Rhizoma, one liang, sweet, neutral) Huang Bo (Phellodendri Cortex, two liang)
The above three herbs. Decoct with four sheng of water. Reduce to one and a half sheng. Remove the dregs. Divide into two doses and take warm.
In Shanghan disease, stagnant heat is trapped in the interior. The body will inevitably develop jaundice. Ma Huang Lian Qiao Chi Xiao Dou Tang (Mahuang, Forsythia, and Adzuki Bean Decoction) is the primary treatment.
Damp-heat interacts mutually. The people often suffer from dan jaundice (dan refers to yellow). Shanghan is caused by cold-dampness at the exterior. Jaundice is caused by stagnant heat in the interior. Administer Ma Huang Lian Qiao Chi Xiao Dou Tang (Mahuang, Forsythia, and Adzuki Bean Decoction) to clear heat and scatter dampness.
Ma Huang (Ephedrae Herba, two liang, remove nodes, sweet, warm) Chi Xiao Dou (Adzuki Bean, one sheng, sweet, neutral) Lian Qiao (Forsythiae Fructum, two liang, root of Forsythia, bitter, cold)
Xing Ren (Prunus Armeniaca Seed, forty pieces, remove skin and tips, sweet, warm) Da Zao (Jujubae Fructus, twelve pieces, sweet, warm) Sheng Zi Bai Pi (Cortex Catalpae, one sheng, bitter, cold) Sheng Jiang (Zingiberis Rhizoma Recens, two liang, sliced, pungent, warm)
Gan Cao (Glycyrrhizae Radix et Rhizoma, one liang, honey-fried, sweet, neutral)
The above eight herbs. Decoct with ten dou of rainwater (Liao Shui). First decoct Ma Huang (Ephedrae Herba) until it boils again. Remove the foam on the surface. Add the remaining herbs. Decoct to obtain three sheng. Divide into three doses and take warm.
Finish within half a day.
The Nei Jing states: When dampness is excessive at the upper part accompanied by heat, treat with sweet-warm herbs, assisted by sweet-neutral herbs. Cure is achieved through sweating. This precisely refers to this principle. Furthermore, using rainwater for decoction is intended because its taste is thin, thus not assisting dampness.
Lou Shi says: Zhi Zi Bai Pi Tang (Gardenia, Phellodendron, and Licorice Decoction) and Ma Huang Lian Qiao Chi Xiao Dou Tang (Mahuang, Forsythia, and Adzuki Bean Decoction) treat body yellowing where urination is free and there is no body pain. This is what Hai Zang calls "dry jaundice." Gui Zhi Fu Zi Tang (Cinnamon Twig and Aconite Decoction) and Qu Gui Jia Bai Zhu Tang (Remove Cinnamon Twig, Add Atractylodes Macrocephala Decoction) treat body yellowing with free urination but whole-body pain. This is what the Huo Ren Shu calls "dampness strike."
Shaoyang disease manifests as bitter taste in the mouth, dry throat, and vertigo/dizziness.
This involves the Foot-Shaoyang Gallbladder Meridian. The Nei Jing states: Those suffering from bitter taste are named Dan Dan (Gallbladder Heat). The Jia Yi Jing states: The Gallbladder is the storehouse of essence. The five zang organs depend on the Gallbladder. The pharynx serves as its passage. The Shaoyang meridian originates at the outer canthus. When Shaoyang is invaded by pathogens, hence bitter taste, dry throat, and vertigo.
Shaoyang Wind-strike presents with deafness in both ears, red eyes, chest fullness, and irritability. Vomiting or purging must be avoided. Vomiting or purging leads to palpitations and fright.
The Shaoyang meridian originates at the outer canthus, enters the ear. Its branch descends through the chest, piercing the diaphragm. Wind pathogen obstructs and generates heat. In Shaoyang Wind-strike, qi stagnates and generates heat, hence deafness, red eyes, chest fullness, and irritability. The pathogen is in Shaoyang, which is the half-exterior, half-interior stage. Using vomiting to relieve irritability damages qi; qi deficiency causes palpitations. Using purging to relieve fullness consumes blood; blood deficiency causes fright.
Some say: Shaoyang disease with deafness, red eyes, chest fullness, and irritability is Wind-strike. Bitter taste, dry throat, and vertigo are Cold damage.
Wang Yu Tai says: Misuse of vomiting leading to qi deficiency causes palpitations. Misuse of purging leading to blood deficiency causes fright.
Shanghan with wiry-thin pulse, headache, and fever belongs to Shaoyang. Shaoyang disease cannot be treated with sweating. Sweating leads to delirious speech. This belongs to the Stomach. If the Stomach harmonizes, recovery occurs. If the Stomach does not harmonize, irritability and palpitations ensue.
The Classic states: When pulses at all three positions are wiry, Shaoyang is diseased. A thin pulse indicates the pathogen gradually transmitting inward. Although there is headache and fever, indicating the exterior is unresolved, because the pathogen resides in Shaoyang, being half-exterior and half-interior, sweating is contraindicated. Sweating depletes fluids, causing dryness in the Stomach. The Shaoyang pathogen then transmits into the Stomach, inevitably causing delirium. One should administer Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct Downward Decoction) to purge. If the Stomach harmonizes, recovery occurs. If not purged, the Stomach is attacked by the Shaoyang Wood pathogen, hence irritability and palpitations.
Wang Yu Tai says: Generally, headaches belong to the exterior. Why is this headache specifically Shaoyang? Because the pulse is wiry and thin, determining whether to sweat or not, this should be the criterion.
Wang Hai Zang says: For Shaoyang half-exterior-half-interior syndrome, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is used, named San Jin Tang (Three Prohibitions Decoction). However, one must distinguish whether exterior or interior symptoms predominate. Suppose headache, alternating chills and fever, floating pulse—having any one of these constitutes an exterior syndrome. Loss of taste and thirst, hypochondriac fullness, warmth of hands and feet, abdominal disharmony, constipation or diarrhea—having any one of these constitutes an interior syndrome. If there are no exterior/interior symptoms, the rest are deficient heat. The disease lies within.
If original Taiyang disease remains unresolved and transmits to Shaoyang, presenting with hardness and fullness in the hypochondrium, dry retching, inability to eat, alternating chills and fever, without prior vomiting or purging, and with a deep-tight pulse, administer Xiao Chai Hu Tang (Minor Bupleurum Decoction).
Transmission from Taiyang to Shaoyang means exterior pathogen entering the interior. Hardness/fullness in hypochondrium, inability to eat, alternating chills and fever indicate the pathogen is between half-exterior and half-interior. If vomiting or purging has already occurred, and the pulse is deep-tight, the pathogen has entered the fu organs, constituting interior excess. Vomiting or purging is still contraindicated. The deep-tight pulse indicates transmission is deep but not fully into the fu organs; the exterior remains unresolved. Administer Xiao Chai Hu Tang (Minor Bupleurum Decoction) to harmonize.
If vomiting, purging, sweating, or moxibustion have already been applied, resulting in delirium, and the Chai Hu syndrome has ceased, this is called a complicated disease (Huai Bing). Determine what error was made and treat according to the method.
The Shaoyang pathogen is between exterior and interior. If vomiting, purging, sweating, or moxibustion are wrongly applied, fluids are depleted, Stomach becomes dry, and Wood pathogen attacks the Stomach, inevitably causing delirium. If the Chai Hu syndrome persists, it is not a complication. If the Chai Hu syndrome ceases, it is a complicated disease. Examine the cause of the therapeutic error and rescue with appropriate methods.
Wang Yu Tai says: To rescue complicated diseases, nourish Ying and Wei, generate fluids, seek recourse in Gui Zhi Tang (Cinnamon Twig Decoction).
San Yang He Bing (Combined Disease of the Three Yang) presents with floating-large pulse, prominent at the Guan position, somnolence, and sweating upon closing the eyes.
The Guan pulse monitors Shaoyang qi. Taiyang pulse is floating, Yangming pulse is large. Floating-large pulse at the Guan position indicates Combined Disease of the Three Yang. Gallbladder heat causes sleepiness. In Shaoyin disease, there is also sleepiness but no sweating upon closing eyes, because Yin syndromes do not sweat. Sleepiness with sweating upon closing eyes indicates Combined Disease of the Three Yang with Gallbladder heat.
After six or seven days of Shanghan, with no significant fever, if the patient is restless and irritable, this is because yang has departed and the pathogen has entered yin.
Exterior is Yang, Interior is Yin. Pathogen at the exterior causes external fever. At six or seven days, it is the time for pathogen to enter the interior. External absence of significant fever with internal restlessness indicates transmission of exterior pathogen to interior. Hence, "Yang departs, entering Yin."
Furthermore, "Fan Zao" (Irritability and Restlessness) means first irritability gradually developing into restlessness. "Zao Fan" (Restlessness and Irritability) means first restlessness followed by irritability. Internal heat is called Fan (irritability), referring to mental depression and vexation. External heat is called Zao (restlessness), referring to physical agitation. Internal heat is rooted fire; thus, only Fan without Zao, or Fan preceding Zao, is treatable. External heat is unrooted fire; thus, only Zao without Fan, or Zao preceding Fan, is untreatable.
On the third day of Shanghan, the Three Yang meridians are exhausted, and the Three Yin meridians should receive the pathogen. If the patient can eat and does not vomit, this indicates the Three Yin meridians are not receiving the pathogen.
On the fourth day of Shanghan, if exterior pathogen transmits to interior and interior harmony is lost, eating is impossible and vomiting occurs. Now, the ability to eat without vomiting indicates the pathogen does not transmit to Yin but remains in Yang.
On the third day of Shanghan, if the Shaoyang pulse is small, the disease is about to resolve.
The Nei Jing states: Large pulse indicates pathogen arrival; small pulse indicates peace. On the third day of Shanghan, pathogen transmits to Shaoyang, pulse should be wiry-tight. Now, a small pulse indicates weak pathogen and impending resolution.
The time when Shaoyang disease tends to resolve is from Yin hour to Chen hour.
The Nei Jing states: Shaoyang among Yang connects with Spring qi. Yin, Mao, Chen hours are when Shaoyang Wood prospers.