右四味，捣筛二味，纳杏仁、芒硝，合研如脂，和散，取如弹丸一枚，别捣甘遂末一方寸匙，白蜜二合，水二升，煮取一升，去滓，温顿服之，一宿乃下，如不下，更服，取下为度，禁忌如药法。
太阳病，脉浮而动数，浮则为风，数则为热，动则为痛，头痛发热，微盗汗出，而反恶寒者，表未解也，医反下之，动数变迟，膈内拒痛，胃中空虚，客气动膈，短气，躁烦，心中懊（忄农），阳气内陷，心下因鞕，则为结胸，大陷胸汤主之。若不结胸，但头汗出，余处无汗，剂颈而还，小便不利，身必发黄。五苓散主之。
大陷胸汤方
右三味，以水六升，先煮大黄，取二升，去滓，纳芒硝，煮二沸，纳甘遂末，温服一升，得快利，止后服。
五苓散方
猪苓十八铢(去皮)白术十八铢泽泻一两六铢茯苓十八铢桂枝半两(去皮)
右五味，为散，更于臼中杵之，白饮和方寸匙服之，日三服，多饮暖水，汗出愈，发黄者，加茵陈蒿十分。
伤寒六七日，结胸热实，脉沉紧而实，心下痛，按之石鞕者，大陷胸汤主之。(方见前)
但结胸无大热者，此为水结在胸肋也，但头微汗出者，大陷胸汤主之。(方见前)
大柴胡汤方
右八味，以水一斗二升，煮取六升，去滓，再煎，温服一升，日三服。
太阳病，重发汗，而复下之，不大便五六日，舌上燥而渴，日晡所小有潮热，从心下至少腹鞕满而痛不可近者，大陷胸汤主之。(方见前)
小陷胸汤方
右三味，以水六升，先煮括蒌取三升，纳诸药，煮取二升，去滓，分温三服。
太阳病，二三日，不能卧，但欲起，心下必结，脉微弱者，此本有寒分也，反下之，若利止，必作结胸；未止者，此作协热利也。
太阳病，下之后，其脉促，不结胸者，此为欲解也；脉浮者，必结胸；脉紧者，必咽痛，脉弦者，必两胁拘急；脉细数者，头痛未止，脉沉紧者，必欲呕；脉沉滑者，协热利；脉浮滑者，必下血。
病在阳，应以汗解之，反以冷水潠之，若灌之，其热被劫不得去，弥更益烦，肉上粟起，意欲饮水，反不渴者，服文蛤散；若不差者，与五苓散。寒实结胸，无热证者，与三物小陷胸汤，白散亦可服。(五苓散小陷胸汤方俱见前)
文蛤散方
五十粒(去皮尖)大枣十二枚(劈)
右七味，为散，以沸汤和一方寸匙，汤用五合，调服，假令汗出已，腹中痛者，与芍药三两
白散方
右三味为散，更于臼中杵之，以白饮和服，强人半钱匙，羸者减之。病在膈上必吐，在膈下必利；不利进热粥一杯，利不止进冷粥一杯。
太阳与少阳并病，头项强痛，或眩冒，时如结胸，心下痞鞕者，当刺大椎第一间、肺俞、肝俞，慎不可发汗，发汗则（言严）语，脉弦大，五日（言严）语不止，当刺期门。
妇人中风，发热恶风，经水适来，得之七八日，热除而脉迟身凉，胸胁下满，如结胸状，（言严）语者，此为热入血室也，当刺期门，随其实而泄之。
妇人中风，七八日，续得寒热，发作有时，经水适断者，此为热入血室，其血必结，故使如疟状，小柴胡汤主之。
小柴胡汤方
姜三两(切)大枣十二枚(劈)
右七味，以水一斗二升，煮取六升，去滓，再煎取三升，温
服一升，日三服。
伤寒六七日，发热微恶寒，支节烦疼，微呕，心下支结，外证未去者，柴胡桂枝汤主之。
柴胡挂枝汤方
伤寒五六日，已发汗而复下之，胸胁满，微结，小便不利，渴而不呕，但头汗出，往来寒热，心烦者，此为未解也，柴胡桂枝干姜汤主之。
二两(熬)甘草二两(炙)
右七味，以水一斗二升，煮取六升，去滓，再煎取三升，温服一升，日三服。初服微烦，复服，汗出便愈。
伤寒五六日，头汗出，微恶寒，手足冷，心下满，口不欲食，大便鞕，脉细者，此为阳微结，必有表复有里也，脉沉者，亦在里也，汗出为阳微。假令纯阴结，不得复有外证，悉入在里，此为半在里半在外也，脉虽沉细，不得为少阴病，所以然者，阴不得有汗，今头汗出，故知非少阴也，可与小柴胡汤。设不了了者，得屎而解。(小柴胡汤见前)
伤寒五六日，呕而发热者，柴胡汤证具，而以他药下之，柴胡证仍在者，复与柴胡汤，此虽已下之，不为逆，必蒸蒸而振，却发热汗出而解。若心下满而鞕痛者，此为结胸也，大陷胸汤主之，但满而不痛者，此为痞，柴胡不中与之，宜半夏泻心汤。
(大陷胸汤见前)
半夏半升(洗)黄芩三两干姜三两人参三两甘草三两(炙)黄连一两大枣十二枚(劈)
右七味，以水一斗，煮取六升，去滓，再煎取三升，温服一升，日三服。
太阳少阳并病，而反下之，成结胸，心下必鞕，若下利不止，水浆不下，其人必烦。
脉浮而紧，而复下之，紧反入里，则作痞，按之自濡，但气痞耳；小青龙汤主之。
小青龙汤方
麻黄三两芍药三两细辛三两干姜三两甘草三两(炙)桂枝三两半夏半升五味子半升
右八味，以水一斗，先煮麻黄减二升，去上沫，纳诸药，煮取三升，去滓，温服一升，日三服；若渴去半夏，加括萎根三两；若微利，若嘻者，去麻黄，加附子一枚炮；若小便不利，少腹满者，去麻黄，加茯苓四两，若喘者，加杏仁半升，去皮尖。
太阳中风，下利，呕逆，表解者，乃可攻之，若其人絷絷汗出，发作有时，头痛，心下痞满，引胁下痛，干呕短气，汗出不恶寒者，此表解里未和也，十枣汤主之。
十枣汤方
右三味，各等分，别捣为散，以水一升半，先煮大枣肥者十枚，取八合，去滓，纳药末，强人服一钱匙，羸人服半钱，温服之，平旦服，若下少，病不除者，明日更服，加半钱，得快下利后，糜粥自养。
太阳病，医发汗，遂发热恶寒，因复下之，心下痞，表里俱虚，阴阳气并竭，无阳则阴独，复加烧针，因胸烦，面色青黄，肤瞤（跳动）者，难治，今色微黄，手足温者易愈。
右四味，切三昧，以麻沸汤二升渍之。须臾绞去滓，纳附子汁，分温再服。
本以下之，故心下痞，与泻心汤。痞不解，其人渴，而口燥烦，小便不利者，五苓散主之。(方见前)
伤寒，汗出，解之后，胃中不和，心下痞鞕，干噫食臭，胁下有水气，腹中雷鸣，下利者，生姜泻心汤主之。
生姜四两甘草三两(炙)人参三两干姜一两黄芩三两半夏半升黄连一两大枣十二枚(劈)
右八味，以水一斗，煮取六升，去滓，再煎取三升，温服一升，日三服。
伤寒中风，医反下之，其人下利，日数十行，谷不化，腹中雷鸣，心下痞鞕而满，干呕，心烦不得安，医见心下痞，谓病不尽，复下之，其痞益甚，此非结热，但以胃中虚，客气上逆，故使鞕也，甘草泻心汤主之。
甘草四两(炙)黄芩三两干姜三两人参三两半夏半升黄连一两大枣十二枚(劈)
右七味，以水一斗，煮取六升，去滓，再煎取三升，温服一升，日三服。
伤寒，服汤药下之，利不止，心下痞鞕，服泻心汤不已，复以他药下之，利益甚，医以理中与之，利仍不止，理中者，理中焦，此利在下焦故也，赤石脂禹余粮汤主之，复不止者，当利其小便。
右二昧，以水六升，煮取三升，去滓，分温三服。
伤寒吐下后，发汗，虚烦，脉甚微，八九日，心下痞鞕，胁下痛，气上冲咽喉，眩冒，经脉动惕者，久而成痿。
伤寒，发汗，若吐，若下，解后，心下痞鞕，噫气不除者，旋覆代赭汤主之。
旋覆花三两人参二两生姜五两代赭石一两甘草三两(炙)半夏半升(洗)大枣十二枚(劈)
右七味，以水一斗，煮取六升，去滓，再煎取三升，温服一升，日三服。
太阳病，外证未除，而数下之，遂协热而利，利下不止，心下痞鞕，表里不解者，桂枝人参汤主之。
右五味，以水九升，先煮四味，取五升，纳桂枝，更煮取三升，去滓，温服一升，日再服，夜一服。
伤寒，大下后，复发汗，心下痞，恶寒者，表未解也，不可攻痞，当先解表，后攻其痞，解表宜桂枝汤；攻痞宜大黄黄连黄芩泻心汤。(方见前)
伤寒发热，汗出不解，心下痞鞕，呕吐而不利者，大柴胡汤主之。(方见前)
病如桂枝证，头不痛，项不强，寸脉微浮，胸中痞鞕，气上咽喉，不得息者，此为胸有寒也，当吐之，宜瓜蒂散。
瓜蒂散方
右二味，各别捣筛，为散已，合治之，取一钱匙，以香豉一合，用热汤七合，煮作稀糜，去津，取汁，和散温顿服之，不吐者，少少加，得快吐乃止。诸亡血虚家，不可与。
伤寒，若吐，若下后，七八日不解，热结在里，表里俱热，时时恶风，大渴，舌上干燥而烦，欲饮水数升者，白虎加人参汤主之。
伤寒，无大热，口燥渴，心烦，背微恶寒者，白虎加人参汤主之。(方见前)
伤寒，脉浮，发热，无汗，其表不解，当发汗，不可与白虎汤；渴欲饮，无表证者，白虎加人参汤主之。(方见前)
太阳少阳并病，心下鞕，颈项强而眩者，当刺大椎、肺俞、肝俞，慎不可下也，下之则痉。
太阳与少阳合病，自下利者，与黄芩汤；若呕者，黄芩加半夏生姜汤主之。
黄芩汤方
右四味，以水一斗，煮取三升，去滓，温服一升，日再服，夜一服。
黄芩三两芍药二两甘草二两(炙)半夏半升(洗)生姜一两半大枣十二枚(劈)
右六味，以水一斗，煮取三升，去滓，温服一升，日再服，夜一服。
黄连汤方
黄连三两甘草三两(炙)干姜三两桂枝三两人参二两半夏半升(洗)大枣十二枚(劈)
右七味，以水一斗，煮取六升，去滓，温服一升，日三服，夜三服。
白虎汤方
炙甘草汤方
甘草四两(炙)生姜三两(切)人参二两地黄半斤桂枝三两麦门冬半升阿胶二两麻仁半升大枣十二枚(劈)
右九味，以清酒七升，先煮八味，取三升，去滓，纳胶烊消尽，温服一升，日三服。
伤寒杂病论卷第九
辨阳明病脉证并治
问曰：病有太阳阳明，有正阳阳明，有少阳阳明，何谓也?
答曰：太阳阳明者，脾约是也，正阳阳明者，胃家实是也；少阳阳明者，发汗，利小便已，胃中燥烦实，大便难是也。
问曰：何缘得阳明病?答曰：太阳病若发汗，若下，若利小便，此亡津液，胃中干燥，因转属阳明，不更衣，内实，大便难者，此名阳明也。
Rhizoma Rhei (Dahuang) half jin, Fructus Lepidii et Descurainiae (Tingli) half jin (stir-fried), Natrii Sulfas (Mangxiao) half jin, Semen Pruni Armeniacae (Xingren) half jin (skin and tips removed, stir-fried).
The above four herbs: crush and sift two of them, add Xingren and Mangxiao, grind together until fatty, mix with the powder. Take one pill-sized portion. Separately, crush Radix Kansui (Gansui) into powder, one square-inch spoonful. Use Honey (Baimi) two he, Water two sheng. Boil to obtain one sheng, remove dregs, take warm in one dose. Usually, bowel movement occurs after one night. If not, administer another dose. Stop when loose stool is achieved. Dietary restrictions follow standard medication protocols.
In Jie Xiong syndrome (Chest Binding Syndrome), if the pulse is floating and large, purgation is contraindicated; purging will lead to death.
If all symptoms of Jie Xiong syndrome are present and irritability (Fanzao) occurs, it is a fatal condition.
In Taiyang disease (Taiyang Syndrome), the pulse is floating, moving, and rapid. Floating indicates Wind pathogen, Rapid indicates Heat, Moving indicates Pain. Symptoms include headache, fever, slight nocturnal sweating, yet aversion to cold, indicating the exterior pattern is unresolved. The physician incorrectly uses purgation. The moving/rapid pulse changes to slow. There is resistance and pain in the diaphragm interior. The Stomach cavity becomes empty, allowing hostile Qi (external pathogen) to disturb the diaphragm. Shortness of breath, irritability, and inner restlessness (Ao Nong) occur. Yang Qi sinks inward, causing hardness below the heart, forming Jie Xiong syndrome. It is treated with Da Xian Xiong Tang (Major Decoction to Drain the Chest). If Jie Xiong does not form, but there is only sweating on the head, no sweat elsewhere, stopping at the neck, with dysuria, jaundice will inevitably develop. It is treated with Wu Ling San (Five-Ingredient Powder with Poria).
Da Xian Xiong Tang Formula:
Radix Rhei (Dahuang) six liang, Natrii Sulfas (Mangxiao) one sheng, Radix Kansui (Gansui) one qian chi (spoonful).
The above three herbs: Use Water six sheng. First boil Dahuang, obtain two sheng, remove dregs. Add Mangxiao, boil for two boils. Add Gansui powder. Take one sheng warm. When rapid loose stool is achieved, stop taking the remaining medicine.
Wu Ling San Formula:
Polyporus (Zhu Ling) eighteen zhu (skin removed), Atractylodis Macrocephalae Rhizoma (Baizhu) eighteen zhu, Alismatis Rhizoma (Zexie) one liang six zhu, Poria (Fuling) eighteen zhu, Cinnamomi Ramulus (Guizhi) half liang (skin removed).
The above five herbs: Grind into powder, pound again in a mortar. Mix with rice water (Bai Yin) one square-inch spoonful for administration. Take three times daily. Drink plenty of warm water after ingestion; recovery occurs with sweating. For those with jaundice, add Artemisiae Scopariae Herba (Yinchen Hao) ten fen.
After Shang Han (Cold Damage) for six or seven days, presenting as Jie Xiong heat-excess syndrome, with pulse deep, tight, and solid, pain in the epigastrium, hardness upon pressure like stone, treat with Da Xian Xiong Tang. (Formula seen previously).
After Shang Han for more than ten days, with heat binding internally and alternating chills and fever, administer Da Chai Hu Tang (Major Bupleurum Decoction).
If there is only Jie Xiong without significant heat, this is water binding in the chest and hypochondrium. With only slight sweating on the head, treat with Da Xian Xiong Tang. (Formula seen previously).
Da Chai Hu Tang Formula:
Bupleuri Radix (Chaihu) half jin, Immature Bitter Orange (Zhishi) four pieces (roasted), Zingiberis Rhizoma Recens (Shengjiang) five liang (sliced), Scutellariae Radix (Huangqin) three liang, Paeoniae Radix Alba (Shaoyao) three liang, Pinelliae Rhizoma Preparatum (Banxia) half sheng (washed), Jujubae Fructus (Dazao) twelve pieces (split), Radix Rhei (Dahuang) two liang.
The above eight herbs: Use Water one dou two sheng. Boil to obtain six sheng, remove dregs. Decoct again. Take one sheng warm, three times daily.
In Taiyang disease, after severe sweating and subsequent purgation, constipation for five to six days, dry tongue with thirst, slight tidal fever in the late afternoon, hardness and fullness from the epigastrium to the lower abdomen with pain intolerable to touch, treat with Da Xian Xiong Tang. (Formula seen previously).
In Xiao Jie Xiong Bing (Minor Chest Binding Disease), located exactly at the epigastrium, painful only upon pressure, with floating and slippery pulse, treat with Xiao Xian Xiong Tang (Minor Decoction to Drain the Chest).
Xiao Xian Xiong Tang Formula:
Coptidis Rhizoma (Huanglian) one liang, Pinelliae Rhizoma Preparatum (Banxia) half sheng, Fructus Trichosanthis (Gualou Shi) one large piece.
The above three herbs: Use Water six sheng. First boil Gualou to obtain three sheng. Add other herbs, boil to obtain two sheng. Remove dregs. Divide into three warm doses.
In Taiyang disease, on the second or third day, inability to lie down, desire to rise, epigastric binding, with weak pulse, this originally indicates Cold Fluid retention. Incorrect purgation leads to: if diarrhea stops, Jie Xiong will form; if diarrhea continues, it becomes Xie Re Li (Collateral Heat Diarrhea).
After purgation in Taiyang disease, if the pulse is hurried and Jie Xiong does not form, the condition is resolving. If the pulse is floating, Jie Xiong will definitely form. If tight, throat pain will occur. If wiry, bilateral hypochondriac spasm will occur. If fine and rapid, headache will persist. If deep and tight, vomiting will occur. If deep and slippery, Xie Re Li will occur. If floating and slippery, hematochezia will occur.
For disease in the Yang level, sweating should be used. Instead, cold water was sprayed or poured. Heat is trapped and cannot escape, increasing irritability, skin gooseflesh, desire to drink but no actual thirst. Administer Wen Sha San (Clam Shell Powder). If ineffective, use Wu Ling San. For Cold-Excess Jie Xiong without heat signs, use San Wu Xiao Xian Xiong Tang (Three-Ingredient Minor Decoction to Drain the Chest); Bai San (White Powder) may also be used. (Wu Ling San and Xiao Xian Xiong Tang formulas seen previously).
Wen Sha San Formula:
Veneris Concha (Wenge) five liang, Ephedrae Herba (Mahuang) three liang, Glycyrrhizae Radix et Rhizoma (Gancao) three liang, Zingiberis Rhizoma Recens (Shengjiang) three liang, Gypsum Fibrosum (Shigao) five liang, Semen Pruni Armeniacae (Xingren) fifty pieces (skin and tips removed), Jujubae Fructus (Dazao) twelve pieces (split).
The above seven herbs: Grind into powder. Mix one square-inch spoonful with boiling water (five he). Take warm. If sweating occurs and abdominal pain follows, add Paeoniae Radix Alba (Shaoyao) three liang.
Bai San Formula:
Belamcandae Rhizoma (Jiegeng) three parts, Crotonis Fructus (Badou) one part, Fritillariae Bulbus (Beimu) three parts.
The above three herbs: Grind into powder, pound in mortar. Mix with rice water. Strong individuals take half a qian chi; weak individuals reduce dosage. Disease above the diaphragm causes vomiting; below causes purging. If no purging, give one cup of hot porridge; if purging continues, give one cup of cold porridge.
In concurrent Taiyang and Shaoyang disease, with stiff and painful head/neck, vertigo, occasional sensation of chest binding, and epigastric hardness, puncture Dazhui (GV14), Feishu (BL13), Ganshu (BL18). Strictly avoid sweating. Sweating causes delirium (Yanyu). If pulse is wiry and large, and delirium persists for five days, puncture Qimen (LR14).
In women with Feng Zhong (Wind Strike), fever and aversion to wind, menstruation just began. After seven to eight days, fever subsides, pulse slows, body cools. Fullness in chest/hypochondrium resembling Jie Xiong, with delirium, indicates Re Ru Xue Shi (Heat Entering Blood Chamber). Puncture Qimen (LR14) to drain excess.
In women with Feng Zhong, after seven to eight days, continuous chills and fever occurring at intervals, menstruation just stopped. This is Re Ru Xue Shi. Blood must bind, causing malaria-like symptoms. Treat with Xiao Chai Hu Tang (Minor Bupleurum Decoction).
Xiao Chai Hu Tang Formula:
Bupleuri Radix (Chaihu) half jin, Scutellariae Radix (Huangqin) three liang, Ginseng Radix (Renshen) three liang, Pinelliae Rhizoma Preparatum (Banxia) half sheng, Glycyrrhizae Radix et Rhizoma (Gancao) three liang (roasted), Zingiberis Rhizoma Recens (Shengjiang) three liang (sliced), Jujubae Fructus (Dazao) twelve pieces (split).
The above seven herbs: Use Water one dou two sheng. Boil to obtain six sheng, remove dregs. Decoct again to obtain three sheng. Take one sheng warm, three times daily.
In women with Shang Han, fever, menstruation just began. Clear consciousness by day, delirium at night, seeing ghosts. This is Re Ru Xue Shi. Do not harm Stomach Qi or the Upper Two Jiaos. It will heal spontaneously.
After Shang Han for six to seven days, fever with slight aversion to cold, limb joint vexing pain, slight vomiting, epigastric support-binding, exterior signs unresolved. Treat with Chai Hu Gui Zhi Tang (Bupleurum and Cinnamon Twig Decoction).
Chai Hu Gui Zhi Tang Formula:
Cinnamomi Ramulus (Guizhi) one and a half liang, Scutellariae Radix (Huangqin) one and a half liang, Ginseng Radix (Renshen) one and a half liang, Glycyrrhizae Radix et Rhizoma (Gancao) one liang (roasted), Pinelliae Rhizoma Preparatum (Banxia) two he and a half, Paeoniae Radix Alba (Shaoyao) one and a half liang, Jujubae Fructus (Dazao) six pieces, Zingiberis Rhizoma Recens (Shengjiang) one and a half liang (sliced), Bupleuri Radix (Chaihu) four liang.
The above nine herbs: Use Water seven sheng. Boil to obtain three sheng, remove dregs. Take one sheng warm, three times daily.
After Shang Han for five to six days, having sweated then purged, chest/hypochondriac fullness, slight binding, dysuria, thirst without vomiting, only head sweating, alternating chills and fever, mental vexation. This is unresolved. Treat with Chai Hu Gui Zhi Gan Jiang Tang (Bupleurum, Cinnamon Twig, and Dried Ginger Decoction).
Chai Hu Gui Zhi Gan Jiang Tang Formula:
Bupleuri Radix (Chaihu) half jin, Cinnamomi Ramulus (Guizhi) three liang, Zingiberis Rhizoma (Ganjiang) two liang, Trichosanthis Radix (Gualou Gen) four liang, Scutellariae Radix (Huangqin) three liang, Oyster Shell (Muli) two liang (stir-fried), Glycyrrhizae Radix et Rhizoma (Gancao) two liang (roasted).
The above seven herbs: Use Water one dou two sheng. Boil to obtain six sheng, remove dregs. Decoct again to obtain three sheng. Take one sheng warm, three times daily. Initial dose causes slight vexation; subsequent doses cause sweating and cure.
After Shang Han for five to six days, head sweating, slight aversion to cold, cold hands/feet, epigastric fullness, lack of appetite, hard stool, fine pulse. This is Yang Wei Jie (Yang Micro-Binding), indicating both exterior and interior involvement. Deep pulse indicates interior. Head sweating indicates Yang Wei. Pure Yin Binding would have no exterior signs. This is half-exterior, half-interior. Despite deep/fine pulse, it is not Shao Yin disease because Yin patterns do not sweat. Head sweating confirms it is not Shao Yin. Administer Xiao Chai Hu Tang. If still uncomfortable, relief comes with stool passage. (Xiao Chai Hu Tang seen previously).
After Shang Han for five to six days, vomiting and fever indicate Chai Hu Tang syndrome is complete. However, purgation was used incorrectly. If Chai Hu syndrome persists, re-administer Chai Hu Tang. Although purged, this is not adverse. The patient will experience shaking/chills, followed by fever and sweating for resolution. If epigastric fullness and hardness/pain occur, it is Jie Xiong, treated with Da Xian Xiong Tang. If only fullness without pain, it is Pi (Glomus), Chai Hu Tang is inappropriate; use Ban Xia Xie Xin Tang (Pinellia Decoction to Drain the Epigastrium).
(Da Xian Xiong Tang seen previously).
Ban Xia Xie Xin Tang Formula:
Pinelliae Rhizoma Preparatum (Banxia) half sheng (washed), Scutellariae Radix (Huangqin) three liang, Zingiberis Rhizoma (Ganjiang) three liang, Ginseng Radix (Renshen) three liang, Glycyrrhizae Radix et Rhizoma (Gancao) three liang (roasted), Coptidis Rhizoma (Huanglian) one liang, Jujubae Fructus (Dazao) twelve pieces (split).
The above seven herbs: Use Water one dou. Boil to obtain six sheng, remove dregs. Decoct again to obtain three sheng. Take one sheng warm, three times daily.
In concurrent Taiyang and Shaoyang disease, incorrect purgation forms Jie Xiong. Epigastrium becomes hard. If diarrhea continues endlessly, inability to take fluids, irritability ensues.
Pulse floating and tight, incorrect purgation causes tight pulse to enter interior, forming Pi (Glomus). Soft upon pressure, it is merely Qi Glomus. Xiao Qing Long Tang (Minor Blue Dragon Decoction) is indicated. (Note: Textual anomaly likely exists here regarding formula indication for Pi, translated as per source).
Xiao Qing Long Tang Formula:
Ephedrae Herba (Mahuang) three liang, Paeoniae Radix Alba (Shaoyao) three liang, Asari Radix et Rhizoma (Xixin) three liang, Zingiberis Rhizoma (Ganjiang) three liang, Glycyrrhizae Radix et Rhizoma (Gancao) three liang (roasted), Cinnamomi Ramulus (Guizhi) three liang, Pinelliae Rhizoma Preparatum (Banxia) half sheng, Schisandrae Fructus (Wuweizi) half sheng.
The above eight herbs: Use Water one dou. First boil Mahuang, reduce by two sheng, remove foam. Add other herbs, boil to obtain three sheng, remove dregs. Take one sheng warm, three times daily. Modifications: If thirsty, remove Banxia, add Trichosanthis Radix (Gualou Gen) three liang. If slight diarrhea or hiccup, remove Mahuang, add Prepared Aconite Root (Fuzi) one piece (roasted). If dysuria and lower abdominal fullness, remove Mahuang, add Poria (Fuling) four liang. If wheezing, add Semen Pruni Armeniacae (Xingren) half sheng (skin/tips removed).
Taiyang Feng Zhong (Wind Strike) with diarrhea and vomiting. If exterior is resolved, attack the interior. If dripping sweat, intermittent headache, epigastric fullness radiating to hypochondriac pain, dry retching, shortness of breath, sweating without aversion to cold. Exterior resolved, interior unharmonized. Treat with Shi Zao Tang (Ten Jujube Decoction).
Shi Zao Tang Formula:
Kadsurae Fructus (Yuanhua) (stir-fried), Radix Kansui (Gansui), Euphorbiae Pekinensis Radix (Daji).
The above three herbs, equal parts, separately ground to powder. Use Water one sheng half. First boil ten fat Jujubes (Dazao), obtain eight he, remove dregs. Add herb powder. Strong individuals take one qian chi; weak take half qian. Take warm at dawn. If stool is insufficient and disease remains, increase by half qian next day. After rapid purging, nourish with millet porridge.
Taiyang disease, physician sweats, leading to fever/aversion to cold, then purges, causing epigastric Pi. Exterior and Interior both deficient, Yin and Yang Qi exhausted. No Yang means Yin alone. Adding moxa needle causes chest irritability, blue-yellow complexion, muscle twitching. Difficult to treat. If complexion is slightly yellow and hands/feet warm, easy to cure.
Epigastric Pi, soft upon pressure, pulse floating and large at Guan position. Treat with Da Huang Huang Lian Huang Qin Xie Xin Tang (Rhubarb, Coptis, and Scutellaria Decoction to Drain the Epigastrium).
Da Huang Huang Lian Huang Qin Xie Xin Tang Formula:
Radix Rhei (Dahuang) two liang, Coptidis Rhizoma (Huanglian) one liang, Scutellariae Radix (Huangqin) one liang.
The above three herbs: Soak in "Ma Fei Tang" (boiling water) two sheng. Squeeze out dregs after a moment. Divide into two warm doses.
Epigastric Pi with aversion to cold. Treat with Fu Zi Xie Xin Tang (Aconite Decoction to Drain the Epigastrium).
Fu Zi Xie Xin Tang Formula:
Radix Rhei (Dahuang) two liang, Coptidis Rhizoma (Huanglian) one liang, Scutellariae Radix (Huangqin) one liang, Prepared Aconite Root (Fuzi) one piece (roasted, skin removed, broken, decocted separately for juice).
The above four herbs: Cut the first three. Soak in Ma Fei Tang two sheng. Squeeze out dregs. Add Fuzi juice. Divide into two warm doses.
Originally due to purgation, epigastric Pi formed. Given Xie Xin Tang. Pi unresolved, with thirst, dry mouth/vexation, dysuria. Treat with Wu Ling San. (Formula seen previously).
After Shang Han sweating resolves, Stomach disharmony causes epigastric Pi/hardness, belching with food odor, water qi in hypochondrium, borborygmus, diarrhea. Treat with Sheng Jiang Xie Xin Tang (Fresh Ginger Decoction to Drain the Epigastrium).
Sheng Jiang Xie Xin Tang Formula:
Zingiberis Rhizoma Recens (Shengjiang) four liang, Glycyrrhizae Radix et Rhizoma (Gancao) three liang (roasted), Ginseng Radix (Renshen) three liang, Zingiberis Rhizoma (Ganjiang) one liang, Scutellariae Radix (Huangqin) three liang, Pinelliae Rhizoma Preparatum (Banxia) half sheng, Coptidis Rhizoma (Huanglian) one liang, Jujubae Fructus (Dazao) twelve pieces (split).
The above eight herbs: Use Water one dou. Boil to obtain six sheng, remove dregs. Decoct again to obtain three sheng. Take one sheng warm, three times daily.
Shang Han/Feng Zhong, incorrect purgation causes frequent diarrhea (dozens times/day), undigested food, borborygmus, epigastric Pi/hardness/fullness, dry retching, mental vexation/inability to rest. Physician sees Pi, assumes incomplete disease, purges again, worsening Pi. This is not Heat Binding, but Stomach deficiency with hostile Qi counterflow causing hardness. Treat with Gan Cao Xie Xin Tang (Licorice Decoction to Drain the Epigastrium).
Gan Cao Xie Xin Tang Formula:
Glycyrrhizae Radix et Rhizoma (Gancao) four liang (roasted), Scutellariae Radix (Huangqin) three liang, Zingiberis Rhizoma (Ganjiang) three liang, Ginseng Radix (Renshen) three liang, Pinelliae Rhizoma Preparatum (Banxia) half sheng, Coptidis Rhizoma (Huanglian) one liang, Jujubae Fructus (Dazao) twelve pieces (split).
The above seven herbs: Use Water one dou. Boil to obtain six sheng, remove dregs. Decoct again to obtain three sheng. Take one sheng warm, three times daily.
Shang Han, purgation causes endless diarrhea, epigastric Pi/hardness. Xie Xin Tang fails. Further purgation worsens diarrhea. Lizhong Tang (Middle-Regulating Decoction) fails because it regulates Middle Jiao, but diarrhea is in Lower Jiao. Treat with Chi Shi Zhi Yu Yi Liang Tang (Red Halloysite and Metastone Decoction). If still uncontrolled, promote urination.
Chi Shi Zhi Yu Yi Liang Tang Formula:
Halloysitum Rubrum (Chi Shi Zhi) one jin (crushed), Metastone (Yu Yi Liang) one jin (crushed).
The above two herbs: Use Water six sheng. Boil to obtain three sheng, remove dregs. Divide into three warm doses.
After Shang Han vomiting/purgation and sweating, deficiency vexation, very faint pulse. After eight/nine days, epigastric Pi/hardness, hypochondriac pain, Qi rushing to throat, vertigo, meridian twitching. Long-term leads to flaccidity syndrome.
After Shang Han sweating/vomiting/purgation resolution, epigastric Pi/hardness, persistent belching. Treat with Xuan Fu Dai Zhe Tang (Belamcanda and Hematite Decoction).
Xuan Fu Dai Zhe Tang Formula:
Belamcandae Flos (Xuanfu Hua) three liang, Ginseng Radix (Renshen) two liang, Zingiberis Rhizoma Recens (Shengjiang) five liang, Haematitum (Daizhe Shi) one liang, Glycyrrhizae Radix et Rhizoma (Gancao) three liang (roasted), Pinelliae Rhizoma Preparatum (Banxia) half sheng (washed), Jujubae Fructus (Dazao) twelve pieces (split).
The above seven herbs: Use Water one dou. Boil to obtain six sheng, remove dregs. Decoct again to obtain three sheng. Take one sheng warm, three times daily.
Taiyang disease, exterior signs unresolved, multiple purgations lead to Xie Re Li (Collateral Heat Diarrhea). Endless diarrhea, epigastric Pi/hardness, exterior/interior unresolved. Treat with Gui Zhi Ren Shen Tang (Cinnamon Twig and Ginseng Decoction).
Gui Zhi Ren Shen Tang Formula:
Cinnamomi Ramulus (Guizhi) four liang, Glycyrrhizae Radix et Rhizoma (Gancao) four liang (roasted), Atractylodis Macrocephalae Rhizoma (Baizhu) three liang, Ginseng Radix (Renshen) three liang, Zingiberis Rhizoma (Ganjiang) three liang.
The above five herbs: Use Water nine sheng. First boil four herbs, obtain five sheng. Add Guizhi, boil to obtain three sheng, remove dregs. Take one sheng warm. Twice daily, once at night.
Shang Han, major purgation then sweating. Epigastric Pi, aversion to cold. Exterior unresolved. Do not attack Pi directly. Resolve exterior first, then treat Pi. Exterior: Gui Zhi Tang (Cinnamon Twig Decoction). Pi: Da Huang Huang Lian Huang Qin Xie Xin Tang. (Formulas seen previously).
Shang Han fever, sweating unresolved, epigastric Pi/hardness, vomiting without diarrhea. Treat with Da Chai Hu Tang. (Formula seen previously).
Symptoms resemble Gui Zhi Tang pattern, but no headache/stiff neck. Cun pulse slightly floating. Chest Pi/hardness, Qi rushing to throat, breathing difficulty. Cold in Chest. Induce vomiting. Use Gua Di San (Melon Sepal Powder).
Gua Di San Formula:
Momordicae Fructus (Gua Di) one part (stir-fried), Adzuki Bean (Chi Xiao Dou) one part.
The above two herbs: Separate grind/sift, mix. Take one qian chi. Use Black Soybean Seed (Xiang Chi) one he, hot water seven he. Cook into thin paste, remove dregs, mix with powder. Take warm in one dose. If no vomiting, increase slightly. Stop when vigorous vomiting occurs. Contraindicated in blood-loss or deficiency cases.
Chronic Pi under hypochondrium connecting to umbilicus, pain radiating to lower abdomen and genital tendons. Named Zang Jie (Organ Binding). Fatal.
Shang Han, after vomiting/purgation, unresolved for seven/eight days. Heat binding internally, exterior/interior both hot, occasional aversion to wind, great thirst, dry tongue/vexation, desire to drink several sheng of water. Treat with Bai Hu Jia Ren Shen Tang (White Tiger plus Ginseng Decoction).
Bai Hu Jia Ren Shen Tang Formula:
Anemarrhenae Rhizoma (Zhimu) six liang, Gypsum Fibrosum (Shigao) one jin (crushed), Glycyrrhizae Radix et Rhizoma (Gancao) two liang (roasted), Oryza Sativa (Jingmi) six he, Ginseng Radix (Renshen) two liang.
The above five herbs: Use Water one dou. Cook rice until done, strain. Take one sheng warm, three times daily.
Shang Han, no high fever, dry mouth/thirst, mental vexation, slight back aversion to cold. Treat with Bai Hu Jia Ren Shen Tang. (Formula seen previously).
Shang Han, floating pulse, fever, no sweat, exterior unresolved. Should sweat. Do not give Bai Hu Tang. Thirst with desire to drink, no exterior signs. Treat with Bai Hu Jia Ren Shen Tang. (Formula seen previously).
Concurrent Taiyang/Shaoyang disease, epigastric hardness, stiff neck/vertigo. Puncture Dazhui, Feishu, Ganshu. Strictly avoid purgation; purgation causes spasms.
Taiyang/Shaoyang combined disease with spontaneous diarrhea. Give Huang Qin Tang (Scutellaria Decoction). If vomiting, Huang Qin Jia Ban Xia Sheng Jiang Tang (Scutellaria plus Pinellia and Fresh Ginger Decoction).
Huang Qin Tang Formula:
Scutellariae Radix (Huangqin) three liang, Paeoniae Radix Alba (Shaoyao) two liang, Glycyrrhizae Radix et Rhizoma (Gancao) two liang, Jujubae Fructus (Dazao) twelve pieces (split).
The above four herbs: Use Water one dou. Boil to obtain three sheng, remove dregs. Take one sheng warm. Twice daily, once at night.
Huang Qin Jia Ban Xia Sheng Jiang Tang Formula:
Scutellariae Radix (Huangqin) three liang, Paeoniae Radix Alba (Shaoyao) two liang, Glycyrrhizae Radix et Rhizoma (Gancao) two liang (roasted), Pinelliae Rhizoma Preparatum (Banxia) half sheng (washed), Zingiberis Rhizoma Recens (Shengjiang) one and a half liang, Jujubae Fructus (Dazao) twelve pieces (split).
The above six herbs: Use Water one dou. Boil to obtain three sheng, remove dregs. Take one sheng warm. Twice daily, once at night.
Shang Han, Heat in Chest, Evil Qi in Stomach, abdominal pain, desire to vomit. Treat with Huang Lian Tang (Coptis Decoction).
Huang Lian Tang Formula:
Coptidis Rhizoma (Huanglian) three liang, Glycyrrhizae Radix et Rhizoma (Gancao) three liang (roasted), Zingiberis Rhizoma (Ganjiang) three liang, Cinnamomi Ramulus (Guizhi) three liang, Ginseng Radix (Renshen) two liang, Pinelliae Rhizoma Preparatum (Banxia) half sheng (washed), Jujubae Fructus (Dazao) twelve pieces (split).
The above seven herbs: Use Water one dou. Boil to obtain six sheng, remove dregs. Take one sheng warm, three times daily, three times at night.
Shang Han, floating/slippery pulse. Heat inside, no Cold outside. Treat with Bai Hu Tang (White Tiger Decoction).
Bai Hu Tang Formula:
Anemarrhenae Rhizoma (Zhimu) six liang, Gypsum Fibrosum (Shigao) one jin (crushed), Glycyrrhizae Radix et Rhizoma (Gancao) two liang (roasted), Oryza Sativa (Jingmi) six he.
The above four herbs: Use Water one dou. Cook rice until done, strain. Take one sheng warm, three times daily.
Shang Han, knotted/hurried pulse, palpitations. Treat with Zhi Gan Cao Tang (Honey-Fried Licorice Decoction).
Zhi Gan Cao Tang Formula:
Glycyrrhizae Radix et Rhizoma (Gancao) four liang (roasted), Zingiberis Rhizoma Recens (Shengjiang) three liang (sliced), Ginseng Radix (Renshen) two liang, Rehmanniae Radix Preparata (Dihuang) half jin, Cinnamomi Ramulus (Guizhi) three liang, Ophiopogonis Tuber (Maidong) half sheng, Donkey-hide Gelatin (Ejiao) two liang, Sesame Seed (Huma) half sheng, Jujubae Fructus (Dazao) twelve pieces (split).
The above nine herbs: Use Rice Wine (Qingjiu) seven sheng. First boil eight herbs, obtain three sheng, remove dregs. Add Ejiao, melt completely. Take one sheng warm, three times daily.
Guilin Ancient Edition of Shanghan Zabing Lun Volume II
Chinese Medical Treasure Pavilion: Guilin Ancient Edition of Shanghan Zabing Lun Volume II
Shanghan Zabing Lun Volume 9
Differentiation of Yangming Disease Pulse and Syndromes
Question: Diseases include Taiyang Yangming, Zhengyang Yangming, Shaoyang Yangming. What are these?
Answer: Taiyang Yangming is Pi Yue (Spleen Restriction). Zhengyang Yangming is Wei Jia Shi (Stomach Family Excess). Shaoyang Yangming results from sweating and promoting urination, leading to dry, vexed, excess Stomach interior and difficult defecation.
The defining characteristic of Yangming disease is Wei Jia Shi (Stomach Family Excess).
Question: How does one contract Yangming disease?
Answer: In Taiyang disease, if sweating, purgation, or promoting urination depletes body fluids, causing Stomach dryness, it transfers to Yangming. Failure to defecate, internal excess, and difficult defecation constitute Yangming disease.
Question: What are the exterior signs of Yangming disease?
Answer: Body heat, spontaneous sweating, no aversion to cold, but aversion to heat.
Question: Some diseases present on the first day with aversion to cold but no fever. Why?
Answer: Even if contracted one day ago, aversion to cold will cease spontaneously, followed by spontaneous sweating and aversion to heat.