内伤寒之症，初起无热，不渴，止有胸膈 胀、满闷，面唇皆无光泽，或呕而胸腹急痛，手
足冷，自觉不舒快，少情绪，其脉沉细。此症总由过食生冷，伤于
脾胃所致，故方书名之为内伤寒，而以治中汤温散之。此症多感于夏月，而瘟疫盛行之时与瘟疫
甫愈之后，或感此症，昧者误认为瘟疫。而以疫法治之，鲜有不败事者，其弊必至于卒不能食，
泄泻不止，而酿成大患。唯用治中汤加减出入，寒甚则加熟附，食积则加麦芽、神曲，肉积则加
山楂。呕恶则加藿香、制半夏、鲜姜、砂仁，兼湿则加茯苓、苍术，胸胁痛闷则加枳壳、白芍、
柴胡。若内既伤生冷，而外复感风寒，则用藿香正气散或五积散、平胃散等加减治之。
治中汤 即理中汤加陈皮、青皮。
藿香正气散 治外感风寒，内伤饮食，憎寒壮热，头痛呕，胸膈满闷，咳嗽气喘，及伤冷
伤湿疟，暑，霍乱吐泻。凡感岚瘴不正之气者，并增减用之。
锦按∶疫初起用达原饮等不效者，用此方加减治之。
藿香 苏叶 白芷 陈皮 半夏（制） 茯苓 甘草 浓朴（姜汁炒） 桔梗 白术（泔浸，
土炒） 大腹皮（洗极净。鸩鸟好集其树，毛落皮上，洗不净杀人） 苍术（泔浸炒。原方无，
今加入，无汗者更宜）
又一方加木瓜，伤食加消导药，姜、枣煎。
五积散 治外感风寒，内伤生冷。其曰五积者，能散寒积、食积、气积、血积、痰积。凡身
热无汗，头身项背疼痛，拘急，胸满恶食，呕吐腹痛，寒热往来，并治。
苍术（泔浸，炒） 浓朴（姜汁炒） 陈皮 甘草 半夏（制） 当归（酒洗） 川芎（酒洗）
白芍（酒炒） 茯苓 枳壳（麸炒） 桔梗 白芷 苏叶（改，代麻黄） 干姜（表重用鲜）
肉桂（表重者用枝）
生葱、姜煎。
平胃散 治脾湿痰痞，宿食满闷，呕泻及岚瘴不服水土。
苍术（泔浸，炒） 浓朴（姜炒） 陈皮 炙草
姜、枣煎。如伤食加神曲、麦芽或枳实，湿胜加五苓散，痰多加制半夏，脾倦不思食加参、
术，痞闷加枳壳、木香、香附，大便结闭加熟军，小便赤涩加芩、泽，风寒加葱、豉、苏、芷、
防风。
The symptoms of internal cold damage (Nei Shang Han) at the onset involve no fever, no thirst, and only distension and fullness in the chest and diaphragm. The complexion and lips lack luster. There may be vomiting accompanied by acute pain in the chest and abdomen, cold hands and feet, a feeling of physical discomfort, low mood, and a deep, fine pulse. This condition is generally caused by excessive consumption of raw and cold foods, which injures the Spleen and Stomach. Therefore, formularies name it "internal cold damage" and treat it with Zhizhong Decoction (Cure Middle Decoction) to warm and disperse the pathogen. This syndrome is often contracted in summer, but can also occur during the peak of an epidemic or shortly after recovery from one. Uninformed practitioners may mistakenly diagnose it as plague (Yi Wen) and treat it with methods for epidemics; such errors rarely succeed and inevitably lead to an inability to eat and persistent diarrhea, resulting in severe complications. One must use Zhizhong Decoction with modifications: if cold is severe, add Prepared Aconite Root (Shu Fu Zi); if there is food stagnation, add Malt (Mai Ya) and Medicated Leaven (Shen Qu); if there is meat stagnation, add Hawthorn Fruit (Shan Zha). For vomiting and nausea, add Patchouli Herb (Huo Xiang), Processed Pinellia Tuber (Zhi Ban Xia), Fresh Ginger (Xian Jiang), and Amomum Fruit (Sha Ren); if dampness is present, add Poria (Fu Ling) and Atractylodes Rhizome (Cang Zhu); for chest and hypochondriac pain and oppression, add Bitter Orange Fruit (Zhi Ke), White Peony Root (Bai Shao), and Bupleurum Root (Chai Hu). If there is internal injury from raw/cold foods combined with external contraction of wind-cold, use Huoxiang Zhengqi Decoction (Patchouli Powder to Rectify the Qi), Wuji San (Five Accumulations Powder), or Pingwei San (Peace the Stomach Powder) with modifications.
Zhizhong Decoction is Lizhong Decoction (Regulate the Middle Decoction) plus Tangerine Peel (Chen Pi) and Green Tangerine Peel (Qing Pi).
Huoxiang Zhengqi Decoction treats external contraction of wind-cold and internal injury from diet, manifesting as aversion to cold with high fever, headache, vomiting, chest/diaphragmatic fullness, cough, and asthma, as well as malaria due to cold-damp injury, summerheat, and cholera-like vomiting and diarrhea. It is used with modifications for any condition caused by miasmic vapors and evil qi of mountainous regions.
Note by Jin: When Daoyin Yin (Reach the Origin Drink) and similar formulas are ineffective for early-stage plague, this formula with modifications should be used.
Ingredients: Patchouli Herb (Huo Xiang), Perilla Leaf (Su Ye), Angelica Dahurica Root (Bai Zhi), Tangerine Peel (Chen Pi), Processed Pinellia Tuber (Zhi Ban Xia), Poria (Fu Ling), Licorice Root (Gan Cao), Magnolia Bark (Nong Po, stir-fried with ginger juice), Platycodon Root (Jie Geng), Atractylodes Macrocephala Rhizome (Bai Zhu, soaked in rice water, stir-fried with soil), Areca Seed (Da Fu Pi, washed thoroughly; note: vulture birds gather on this tree, and feathers falling on the bark make it toxic if not washed clean), Atractylodes Rhizome (Cang Zhu, soaked in rice water and stir-fried; not in the original formula, added here, suitable for those without sweat).
Another variation adds Papaya (Mu Gua); for food injury, add digestive herbs, decocted with Ginger and Jujube.
Wuji San (Five Accumulations Powder) treats external contraction of wind-cold and internal injury from raw/cold foods. The term "Five Accumulations" refers to its ability to dissipate cold accumulation, food accumulation, qi accumulation, blood accumulation, and phlegm accumulation. It treats fever without sweat, pain in the head, body, neck, and back, stiffness, chest fullness, anorexia, vomiting, abdominal pain, and alternating chills and fever.
Ingredients: Atractylodes Rhizome (Cang Zhu, soaked in rice water and stir-fried), Magnolia Bark (Nong Po, stir-fried with ginger juice), Tangerine Peel (Chen Pi), Licorice Root (Gan Cao), Processed Pinellia Tuber (Zhi Ban Xia), Dang Gui Root (Dang Gui, washed with wine), Ligusticum Rhizome (Chuan Xiong, washed with wine), White Peony Root (Bai Shao, stir-fried with wine), Poria (Fu Ling), Bitter Orange Fruit (Zhi Ke, stir-fried with bran), Platycodon Root (Jie Geng), Angelica Dahurica Root (Bai Zhi), Perilla Leaf (Su Ye, replaces Ephedra Stem/Ma Huang), Dried Ginger (Gan Jiang; use fresh ginger for exterior emphasis), Cinnamon Twig (Rou Gui; use Cinnamon Twig rather than bark for exterior emphasis).
Decoct with Scallion Stem (Sheng Cong) and Ginger.
Pingwei San (Peace the Stomach Powder) treats spleen dampness with phlegm obstruction, fullness from retained food, vomiting, diarrhea, and maladaptation to local conditions in miasmatic areas.
Ingredients: Atractylodes Rhizome (Cang Zhu, soaked in rice water and stir-fried), Magnolia Bark (Nong Po, stir-fried with ginger), Tangerine Peel (Chen Pi), Honey-fried Licorice Root (Zhi Gan Cao).
Decoct with Ginger and Jujube. Modifications: Add Medicated Leaven (Shen Qu), Malt (Mai Ya), or Immature Bitter Orange (Zhi Shi) for food injury; add Wuling San (Five-Ingredient Powder with Poria) for excess dampness; add Processed Pinellia Tuber (Zhi Ban Xia) for excess phlegm; add Ginseng Root (Ren Shen) and Atractylodes Macrocephala Rhizome (Bai Zhu) for spleen fatigue and loss of appetite; add Bitter Orange Fruit (Zhi Ke), Costus Root (Mu Xiang), and Cyperus Rhizome (Xiang Fu) for oppression and fullness; add Prepared Rhubarb (Shu Jun) for constipation; add Scutellaria Root (Huang Qin) and Alisma Rhizome (Ze Xie) for red, scanty, or difficult urination; add Scallion, Fermented Soybean (Chi Dou), Perilla Leaf, Angelica Dahurica Root, and Saposhnikovia Root (Fang Feng) for wind-cold.