禹余粮四两 人参三两 附子二枚 五味子三合 茯苓三两 干姜三两
右六味，蜜为丸，如梧子大，每服二十丸。
伤寒，未发汗，而复下之，此为逆也；若先发汗，治不为逆。本先下之，而反汗之为逆；若先下之，治不为逆。
伤寒医下之，续得下利清谷不止，身疼痛者，急当救里；后身疼痛，清便自调者，急当救表。救里宜四逆汤；救表宜桂枝汤。（方见上卷）
太阳病，先下而不愈，因复发汗，以此表里俱虚，其人因致冒，冒家汗自出愈，所以然者，表和故也，里未和然后复下之。
太阳病未解，脉阴阳俱微者，必先振栗汗出而解。但阳脉微者，先汗出而解；若阴脉实者，下之而解。若欲下之，宜调胃承气汤。（方见上卷）
太阳病，发热汗出者，此为荣弱卫强，故使汗出，欲救邪风者，宜桂枝汤。（方见上卷）
伤寒五六日，中风，往来寒热，胸胁苦满，嘿嘿不欲饮食，心烦喜呕，或胸中烦而不呕，或渴，或腹中痛，或胁下痞鞕，或心下悸，小便不利，或不渴，身有微热，或咳者，与小柴胡汤主之。
小柴胡汤方
柴胡半斤 黄芩三两 人参三两 半夏半升（洗） 甘草三两（炙） 生姜三两（切） 大枣十三枚（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。若胸中烦而不呕者，去半夏、人参，加栝蒌实一枚。若渴，去半夏，加人参合前成四两半，栝蒌根四两。若腹中痛者，去黄芩，加芍药三两。若胁下痞鞕，去大枣，加牡蛎四两。若心下悸，小便不利者，去黄芩，加茯苓四两。若不渴，外有微热者，去人参，加桂枝三两，温覆取微汗愈。若咳者，去人参、大枣，加五味子半升，去生姜，加干姜二两。
血弱气尽，腠理开，邪气因入，与正气相搏，结于胁下，正邪纷争，往来寒热，休作有时，嘿嘿不欲饮食。脏腑相连，其痛必下，邪高痛下，故使呕也。小柴胡汤主之。服柴胡汤已，渴者，属阳明也，以法治之。（方见上）
太阳病六七日，脉迟浮弱，恶风寒，手足温，医二三下之，不能食，胁下满痛，面目及身黄，颈项强，小便难者，与柴胡汤。后必下重，本渴而饮水呕者，柴胡不中与也。食谷者哕。
伤寒四五日，身热恶风，颈项强，胁下满，手足温而渴者，小柴胡汤主之。（方见上）
伤寒，阳脉涩，阴脉弦，法当腹中急痛，先与小建中汤；不差者，与小柴胡汤。（方见上）
小建中汤方
桂枝三两 芍药六两 甘草二两 生姜三两（切） 大枣十二枚（劈） 胶饴一升
右六味，以水七升，先煮五味取三升，去滓内饴更上微火消解，温服一升，日三服。呕家不可用，以甜故也。
伤寒与中风，有柴胡证，但见一证便是，不必悉具。凡柴胡汤病证而误下之，若柴胡证不罢者，复与柴胡汤，必蒸蒸而振，却复发热汗出而解。
太阳病，过经十余日，反二三下之，后四五日，柴胡证仍在者，先与小柴胡汤。呕不止，心下急，郁郁微烦者，为未解也，与大柴胡汤下之则愈。
大柴胡汤方
柴胡半斤 黄芩三两 芍药三两 半夏半升（洗） 生姜五两（切） 枳实四枚（炙） 大枣十二枚（劈） 大黄二两/font>
右八味，以水一斗二升，煮取六升，去滓，再煎，温服一升，日三服。
伤寒十三日不解，胸胁满而呕，日晡所发潮热，已而微利。此本柴胡证，下之以不得利，今反利者，知医以丸药下之，非其治也。潮热者实也，宜先服小柴胡汤以解外，后以柴胡加芒消汤主之。
柴胡加芒消汤方
柴胡二两十六铢 黄芩一两 人参一两 甘草一两（炙） 生姜一两（切） 芒硝二两 大枣四枚 半夏二十铢
右八味，以水四升，煮取二升，去滓，纳芒硝，更煮微沸，分温再服，不解更作。
伤寒十三日，过经，谵语者，以有热也，当以汤下之。若小便利者，大便当鞕，而反下利，知医以丸药下之，非其治也。若自下利者，脉当微厥，今反和者，此为内实也，调胃承气汤主之。（方见上）。
太阳病不解，热结膀胱，其人如狂，血自下，下者愈。其外不解者，尚未可攻，当先解外。外解已，但少腹急结者，乃可攻之，宜桃仁承气汤。
桃仁五十个（去皮尖） 大黄四两 桂枝二两 甘草二两（炙） 芒硝二两
右五味，以水七升，煮四味，取二升，去滓，纳芒硝，更上火微沸。下火，先食温服五合，日三服，当微利。
伤寒八九日，下之，胸满烦惊，小便不利，谵语，一身尽重，不可转侧，柴胡加龙骨牡蛎汤主之。
柴胡四两 龙骨一两半 黄芩一两半 生姜一两半 人参一两半 桂枝一两半（去皮） 茯苓一两半 半夏二合半 大黄二两 牡蛎一两半 大枣六枚（劈） 铅丹一两半
右十二味，以水八升，煮取四升，纳大黄切如棋子，更煮一二沸，去滓，温服一升，日三服，夜一服。
伤寒，腹满，谵语，寸口脉浮而紧，关上弦者，此肝乘脾也，名曰纵，刺期门。
伤寒发热，啬啬恶寒，大渴欲饮水，其腹必满，自汗出，小便不寸口脉浮而涩，关上弦急者，此肝乘肺也，名曰横，刺期门。
太阳病二日，烦躁，反熨其背，而大汗出，火热入胃，胃中水竭，躁烦，必发谵语，十余日，振栗、自下利者，此为欲解也。若其汗从腰以下不得汗，欲小便不得，反呕，欲失溲，足下恶风，大便鞕，小便当数，而反不数又不多，大便已，头卓然而痛，其人足心必热，谷气下流故也。
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。宜人参地黄龙骨牡蛎茯苓汤
右五味，以水一斗，煮取三升，分温三服。
伤寒脉浮，医以火迫劫之，亡阳，必惊狂，起卧不安者，桂枝去芍药加牡蛎龙骨救逆汤主之。
桂枝三两 甘草二两（炙） 生姜三两（切） 大枣十二枚（劈） 牡蛎五两（熬）龙骨四两
右六味，以水一斗二升，煮取三升，去滓，温服一升，日三服。
形似伤寒，其脉不弦紧而弱。弱者必渴，被火必谵语。弱而发热、脉浮者，解之当汗出愈。
太阳病，以火熏之，不得汗，其人必躁，到经不解，必清血，名为火邪。
脉浮热甚，反以火灸之，此为实。实以虚治，因火而动，必咽燥唾血。
微数之脉，慎不可灸，因火为邪，则为烦逆，追虚逐实，血散脉中，火气虽微，内攻有力，焦骨伤筋，血难复也。
脉浮，宜以汗解，用火灸之，邪无从出，因火而盛，病从腰以下必重而痹，名火逆也。欲自解者，必当先烦，乃有汗而解。何以知之？脉浮故也。
烧针令其汗，针处被寒，核起而赤者，必发奔豚。气从少腹上冲心者，灸其核上各一壮，与桂枝加桂汤。
桂枝五两 芍药三两 生姜三两（切） 甘草二两（炙） 大枣十二枚（劈）
右五味，以水七升，煮取三升，去滓，温服一升，日三服。
右四味，以水五升，煮取三升，去滓，温服一升，日三服。甚者加人参三两。
太阳病，当恶寒发热，今自汗出，反不恶寒发热，关上脉细数者，以医吐之过也。一二日吐之者，腹中饥，口不能食；三四日吐之者，不喜糜粥，欲食冷食，朝食暮吐，此为小逆；若不恶寒，又不欲近衣者，此为内烦；皆医吐之所致也。
病人脉数，数为热，当消谷，今引食而反吐者，此以发汗令阳气微，隔气虚，脉乃数也。数为客热，故不能消谷，以胃中虚冷故吐也。
太阳病，过经十余日，心中温温欲吐，胸中痛，大便反溏，腹微满，郁郁微烦。先其时，自极吐下者，与调胃承气汤。若不尔者，不可与之。若但欲呕，胸中痛，微溏者，此非柴胡证，所以然者，以呕故知极吐下也。（调胃承气汤方见上卷）
太阳病六七日，表证仍在，脉微而沉，反不结胸，其人发狂者，以热在下焦，少腹当鞕满，小便自利者，下血乃愈，所以然者，以太阳随经，瘀热在里故也。抵当汤主之。
抵当汤方
水蛭三十个（熬） 虻虫三十个（去翅足熬） 桃仁二十个（去皮尖）大黄三两（酒洗）
右四味，以水五升，煮取三升，去滓，温服一升，不下更服。
太阳病，身黄脉沉结，少腹鞕，小便不利者，为无血也；小便自利，其人如狂者，血证谛也，抵当汤主之。（方见前）
伤寒有热，少腹满，应小便不利；今反利者，为有血也，当下之，可不余药，宜抵当丸。
抵当丸方
水蛭二十个（熬） 虻虫二十个（去翅足熬） 桃仁二十五个（去皮尖） 大黄三两（酒洗）
右四味，捣分为四丸，以水一升，煮一丸，取七合服之，晬时，当下血；若不下者，更服。
太阳病，小便利者，以饮水多，必心下悸。小便少者，必苦里急也。
问曰：病有脏结，有结胸，其状何如？师曰：寸脉浮，关脉小细沉紧者，名曰脏结也。按之痛，寸脉浮，关脉沉，名曰结胸也。
何谓脏结？师曰：脏结者，五脏各具，寒热攸分，宜求血分，虽有气结，皆血为之。假令肝脏结，则两胁痛而呕，脉沉弦而结者，宜吴茱萸汤。若发热不呕者，此为实，脉当沉弦而急，桂枝当归牡丹皮桃仁枳实汤主之。
吴茱萸汤方
右四味，以水七升，煮取二升，去滓，温服七合，日三服。
桂枝三两（去皮） 当归二两 牡丹皮三两 桃仁二十枚（去皮尖） 枳实二两
右五味，以水八升，煮取三升，去滓，温服一升，日三服。
心脏结，则心中痛，或在心下郁郁不乐，脉大而涩，连翘阿胶半夏赤小豆汤主之。若心中热痛而烦，脉大而弦急者，此为实也，黄连阿胶半夏桃仁茯苓汤主之。
右四味，以水四升，先煮三物，取二升，去滓，纳胶烊消，温服七合，日三服。
黄连三两 阿胶二两 半夏半升（洗） 桃仁二十枚（去皮尖） 茯苓三两
右五味，以水五升，先煮四味，取二升，去滓，纳胶烊消，温服一升，日再服。
肺脏结，胸中闭塞，喘，咳，善悲，脉短而涩，百合贝母茯苓桔梗汤主之。若咳而唾血，胸中痛，此为实，葶苈括萎桔梗牡丹汤主之。
右四味，以水七升，煮取三升，去滓，温服一升，日三服。
右四味，以水六升，煮取三升，去滓，温服一升，日三服。
脾脏结，腹中满痛，按之如覆杯，甚则腹大而坚，脉沉而紧，白术枳实桃仁干姜汤主之。若腹中胀痛，不可按，大便初溏后鞕，转失（疑为矢）气者，此为实，大黄厚朴枳实半夏甘草汤主之。
右四味，以水五升，煮取二升，去滓，分温再服。
右五味，以水六升，煮取三升，去滓，温服一升，日三服。
肾脏结，少腹鞕，隐隐痛，按之如有核，小便乍清乍浊，脉沉细而结，宜茯苓桂枝甘草大枣汤。若小腹急痛，小便赤数者，此为实，宜桂枝茯苓枳实芍药甘草汤。
右四味，以甘澜水一斗，先煮茯苓减二升，纳诸药，煮取三
升，去滓，温服一升，日三服。
右五味，以水六升，煮取三升，去滓，温服一升，日三服。
脏结，无阳证，不往来寒热，其人反静，舌上苔滑者，不可攻也；饮食如故，时时下利，舌上白苔滑者，为难治。
何谓结胸?师曰：病发于阳而反下之，热入于里，因作结胸。病发于阴，而早下之，因作痞。所以成结胸者，误下故也。
大陷胸丸方
Yu Yuliang (Mineral Hematite) 4 liang, Renshen (Ginseng Root) 3 liang, Fuzi (Prepared Aconite Lateralis Radix) 2 pieces, Wuweizi (Schisandra Fruit) 3 he, Fuling (Poria) 3 liang, Ganjiang (Dried Ginger Rhizome) 3 liang.
The above six herbs are processed with honey to form pills, the size of mulberry seeds. Each dose consists of 20 pills.
If a patient has internal cold and sweating is induced again, the stomach will become cold, inevitably leading to vomiting and regurgitation.
In Shanghan (Cold Damage), if purgation is used before sweating, this is an error; if sweating is induced first, the treatment is not erroneous. If purgation should have been used first but sweating was induced instead, this is an error; if purgation is used first, the treatment is not erroneous.
In Shanghan, if a physician mistakenly uses purgation, followed by persistent diarrhea with undigested food and body pain, the interior syndrome should be urgently rescued; subsequently, if body pain persists but bowel and bladder functions are normal, the exterior syndrome should be urgently rescued. To rescue the interior, Sini Tang (Four Reversal Decoction) is suitable; to rescue the exterior, Guizhi Tang (Cinnamon Twig Decoction) is suitable. (Formula see upper volume)
In Taiyang Disease, if purgation is used first without resolution, and then sweating is induced, both the exterior and interior become deficient. Consequently, the patient experiences Mao (dizziness or clouding of consciousness). Such patients recover when they sweat spontaneously. This occurs because the exterior harmonizes; only after the interior is unharmonized should purgation be reconsidered.
If Taiyang Disease is unresolved and the pulse is faint in all positions (Yin and Yang pulses), the patient will first experience chills and tremors, followed by sweating and resolution. If only the Yang pulse (superficial) is faint, sweating leads to resolution; if the Yin pulse (deep) is excess, purgation leads to resolution. If purgation is desired, Tiaowei Chengqi Tang (Stomach-Regulating Downward-Pouring Decoction) is suitable. (Formula see upper volume)
In Taiyang Disease, fever with sweating indicates Ying Qi (Nutritive Qi) deficiency and Wei Qi (Defensive Qi) excess, causing sweating. To address pathogenic wind, Guizhi Tang (Cinnamon Twig Decoction) is suitable. (Formula see upper volume)
In Shanghan or Zhongfeng (Wind Strike) for five to six days, symptoms include alternating chills and fever, fullness and distress in the chest and hypochondrium, silent desire not to eat, irritability, and frequent vomiting. Alternatively, there may be chest distress without vomiting, thirst, abdominal pain, hardness below the ribs, palpitations, difficulty urinating, no thirst with slight external heat, or cough. Xiao Chaihu Tang (Minor Bupleurum Decoction) is the primary formula.
Xiao Chaihu Tang Formula
Chaihu (Bupleurum Root) half jin, Huangqin (Scutellaria Root) 3 liang, Renshen (Ginseng Root) 3 liang, Banxia (Pinellia Tuber) half sheng (washed), Gancao (Licorice Root) 3 liang (roasted), Shengjiang (Fresh Ginger Rhizome) 3 liang (sliced), Dazao (Jujube Fruit) 13 pieces (split).
The above seven herbs are boiled in 12 sheng of water to obtain 6 sheng. Strain, then boil again to obtain 3 sheng. Take 1 sheng warm, three times daily. If there is chest distress without vomiting, remove Banxia and Renshen, add one Gualou Shi (Trichosanthes Fruit). If thirsty, remove Banxia, increase Renshen to total 4.5 liang, and add 4 liang of Gualou Gen (Trichosanthes Root). If abdominal pain, remove Huangqin, add 3 liang of Shaoyao (Peony Root). If hardness below the ribs, remove Dazao, add 4 liang of Muli (Oyster Shell). If palpitations and difficulty urinating, remove Huangqin, add 4 liang of Fuling (Poria). If no thirst with slight external heat, remove Renshen, add 3 liang of Guizhi (Cinnamon Twig), cover with blankets to induce slight sweating for recovery. If coughing, remove Renshen and Dazao, add half sheng of Wuweizi (Schisandra Fruit), remove Shengjiang, add 2 liang of Ganjiang (Dried Ginger Rhizome).
When blood and qi are depleted, pores open, and pathogens enter, battling righteous qi, knotting at the hypochondrium, Zheng and Xie struggle, causing alternating chills and fever at intervals, silence, and loss of appetite. Zang organs are connected; pain radiates downward. Pathogens are high (chest/hypochondrium), pain is low (abdomen), causing vomiting. Xiao Chaihu Tang is indicated. After taking Chaihu formulas, if thirst develops, it belongs to Yangming Disease; treat accordingly. (Formula see upper volume)
In Taiyang Disease for six to seven days, with a slow, floating, weak pulse, aversion to wind and cold, and warm hands and feet, if physicians purge multiple times, leading to inability to eat, hypochondriac fullness and pain, jaundice of face and body, stiff neck, and difficult urination, give Chaihu Tang. Later, rectal heaviness will occur. If originally thirsty but vomiting upon drinking water, Chaihu Tang is contraindicated. If able to eat but belching occurs, it is also contraindicated.
In Shanghan for four to five days, with body heat, aversion to wind, stiff neck, hypochondriac fullness, warm hands and feet, and thirst, Xiao Chaihu Tang is indicated. (Formula see upper volume)
In Shanghan, if the Yang pulse is choppy and the Yin pulse is wiry, acute abdominal pain is expected according to principle. First give Xiao Jianzhong Tang (Minor Construct the Middle Decoction); if ineffective, give Xiao Chaihu Tang. (Formula see upper volume)
Xiao Jianzhong Tang Formula
Guizhi (Cinnamon Twig) 3 liang, Shaoyao (Peony Root) 6 liang, Gancao (Licorice Root) 2 liang, Shengjiang (Fresh Ginger Rhizome) 3 liang (sliced), Dazao (Jujube Fruit) 12 pieces (split), Jiaoyi (Maltose) 1 sheng.
The above six herbs are boiled in 7 sheng of water. Boil the first five herbs to obtain 3 sheng, strain, add Jiaoyi, and melt over low heat. Take 1 sheng warm, three times daily. Vomiting patients should not use this due to its sweetness.
In Shanghan and Zhongfeng, if Chaihu Syndrome (Bupleurum Syndrome) is present, observing one symptom is sufficient for diagnosis; not all need to be present. If Chaihu Syndrome is mistakenly purged, and the syndrome persists, administering Chaihu Tang again will cause steaming fever and trembling, followed by fever, sweating, and resolution.
In Shanghan for two to three days, with palpitations and irritability, Xiao Jianzhong Tang is indicated. (Formula see upper volume)
In Taiyang Disease, after more than ten days, if physicians mistakenly purge multiple times, and after four to five days Chaihu Syndrome persists, first give Xiao Chaihu Tang. If vomiting continues, epigastric urgency, and mild depression/irritability persist, the disease is unresolved; give Da Chaihu Tang (Major Bupleurum Decoction) to purge for cure.
Da Chaihu Tang Formula
Chaihu (Bupleurum Root) half jin, Huangqin (Scutellaria Root) 3 liang, Shaoyao (Peony Root) 3 liang, Banxia (Pinellia Tuber) half sheng (washed), Shengjiang (Fresh Ginger Rhizome) 5 liang (sliced), Zhishi (Immature Bitter Orange) 4 pieces (roasted), Dazao (Jujube Fruit) 12 pieces (split), Dahuang (Rhubarb Root) 2 liang.
The above eight herbs are boiled in 12 sheng of water to obtain 6 sheng. Strain, boil again, take 1 sheng warm, three times daily.
In Shanghan unresolved for thirteen days, with chest/hypochondriac fullness and vomiting, afternoon tidal fever, followed by mild diarrhea: this is originally Chaihu Syndrome. Purging should not cause diarrhea; the current diarrhea indicates the physician used pill-based purgatives, which is incorrect. Tidal fever indicates interior excess. First administer Xiao Chaihu Tang to resolve the exterior, then treat with Chaihu Jia Mangxiao Tang (Bupleurum Plus Niter Decoction).
Chaihu Jia Mangxiao Tang Formula
Chaihu (Bupleurum Root) 2 liang 16 zhu, Huangqin (Scutellaria Root) 1 liang, Renshen (Ginseng Root) 1 liang, Gancao (Licorice Root) 1 liang (roasted), Shengjiang (Fresh Ginger Rhizome) 1 liang (sliced), Mangxiao (Natrii Sulfas) 2 liang, Dazao (Jujube Fruit) 4 pieces, Banxia (Pinellia Tuber) 20 zhu.
The above eight herbs are boiled in 4 sheng of water to obtain 2 sheng. Strain, add Mangxiao, boil briefly, divide into two warm doses. If unresolved, prepare another dose.
In Shanghan for thirteen days, having passed the meridian stage, with delirium due to heat, purgation with decoction is indicated. If urination is free, stool should be hard; if diarrhea occurs instead, it indicates the physician used pill purgatives incorrectly. If spontaneous diarrhea occurs, the pulse should be faint and cold; if the pulse is harmonious, it indicates interior excess. Tiaowei Chengqi Tang is indicated. (Formula see upper volume).
If Taiyang Disease is unresolved, heat knots in the Bladder, causing mania-like behavior. If blood passes spontaneously, the patient recovers. If exterior symptoms persist, attack cannot be attempted; resolve the exterior first. Once the exterior is resolved, if only lower abdominal urgency and binding remain, blood stasis can be attacked using Taoren Chengqi Decoction (Peach Kernel Downward-Pouring Decoction).
Taoren Chengqi Tang Formula
Taoren (Peach Seed) 50 pieces (skin and tip removed), Dahuang (Rhubarb Root) 4 liang, Guizhi (Cinnamon Twig) 2 liang, Gancao (Licorice Root) 2 liang (roasted), Mangxiao (Natrii Sulfas) 2 liang.
The above five herbs are boiled in 7 sheng of water. Boil the first four to obtain 2 sheng, strain, add Mangxiao, boil briefly. Stop fire. Take 5 he warm before meals, three times daily. Mild diarrhea is expected.
In Shanghan for eight to nine days, after mistaken purgation, presenting with chest fullness, irritability, fright, difficulty urinating, delirium, whole-body heaviness, and inability to turn, Chaihu Jia Longgu Muli Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction) is indicated.
Chaihu Jia Longgu Muli Tang Formula
Chaihu (Bupleurum Root) 4 liang, Longgu (Fossilized Mammal Bones) 1.5 liang, Huangqin (Scutellaria Root) 1.5 liang, Shengjiang (Fresh Ginger Rhizome) 1.5 liang, Renshen (Ginseng Root) 1.5 liang, Guizhi (Cinnamon Twig) 1.5 liang (bark removed), Fuling (Poria) 1.5 liang, Banxia (Pinellia Tuber) 2.5 he, Dahuang (Rhubarb Root) 2 liang, Muli (Oyster Shell) 1.5 liang, Dazao (Jujube Fruit) 6 pieces (split), Qiandan (Lead Oxide) 1.5 liang.
The above twelve herbs are boiled in 8 sheng of water to obtain 4 sheng. Add chopped Dahuang, boil for one or two boils, strain. Take 1 sheng warm, three times daily, once at night.
In Shanghan, with abdominal fullness, delirium, floating-tight pulse at Cun, and wiry pulse at Guan, this is Liver Wood overacting on Spleen Earth, named "Zong" (Vertical). Puncture Qimen acupoint.
In Shanghan with fever, severe aversion to cold, extreme thirst for water, inevitable abdominal fullness, spontaneous sweating, and difficulty urinating, with floating-choppy pulse at Cun and wiry-tense pulse at Guan, this is Liver Wood overacting on Lung Metal, named "Heng" (Horizontal). Puncture Qimen acupoint.
On the second day of Taiyang Disease, with irritability, if the back is moxa-warmed causing profuse sweating, fire-heat enters the Stomach, depleting fluids, causing agitation and delirium. After ten-plus days, if chills and spontaneous diarrhea occur, this indicates impending resolution. If sweating is limited to below the waist, inability to urinate, vomiting, urge to lose urine, aversion to cold at soles, hard stool, yet infrequent urination, after defecation, sudden head pain occurs, and soles become hot; this is due to Grain Qi flowing downward.
In Taiyang Zhongfeng, if fire coercion is used to induce sweating, pathogenic wind combined with fire causes blood and qi to overflow abnormally. Two Yangs (wind and fire) scorch the body, causing jaundice. Excess Yang leads to epistaxis; Yin deficiency leads to difficult urination. If both Yin and Yang are exhausted, the body becomes dry. Only head sweating up to the neck, abdominal fullness, slight wheezing, dry mouth/throat, constipation, delirium, severe cases of hiccups, restlessness, picking at clothes/bed, indicate severity. If urination is free, the patient is treatable. Ren Shen Di Huang Long Gu Mu Li Fu Ling Tang (Ginseng, Rehmannia, Dragon Bone, Oyster Shell, Poria Decoction) is indicated.
Ren Shen Di Huang Long Gu Mu Li Fu Ling Tang Formula
Renshen (Ginseng Root) 3 liang, Dihuang (Rehmannia Root) half jin, Longgu (Fossilized Mammal Bones) 3 liang, Muli (Oyster Shell) 4 liang, Fuling (Poria) 4 liang.
The above five herbs are boiled in 10 sheng of water to obtain 3 sheng. Divide into three warm doses.
In Shanghan with floating pulse, if fire coercion is used causing Yang collapse, resulting in fright, mania, and restlessness, Guizhi Qu Shaoyao Jia Muli Longgu Jiuni Tang (Cinnamon Twig Decoction Removing Peony Plus Oyster Shell and Dragon Bone for Rescue from Emergency) is indicated.
Guizhi Qu Shaoyao Jia Muli Longgu Jiuni Tang Formula
Guizhi (Cinnamon Twig) 3 liang, Gancao (Licorice Root) 2 liang (roasted), Shengjiang (Fresh Ginger Rhizome) 3 liang (sliced), Dazao (Jujube Fruit) 12 pieces (split), Muli (Oyster Shell) 5 liang (calcined), Longgu (Fossilized Mammal Bones) 4 liang.
The above six herbs are boiled in 12 sheng of water to obtain 3 sheng. Strain. Take 1 sheng warm, three times daily.
Resembling Shanghan, but pulse is weak rather than wiry-tight. Weak pulse implies thirst; fire treatment leads to delirium. Weak pulse with fever and floating pulse indicates resolution via sweating.
In Taiyang Disease, if fire fumigation fails to induce sweating, the patient becomes irritable. If unresolved by the cycle, hematochezia occurs, termed Fire Pathogen.
With floating pulse and intense heat, if moxibustion is applied, this is an Excess condition. Treating Excess as Deficiency, fire moves blood, causing dry throat and bloody sputum.
With faint-rapid pulse, moxibustion must be avoided. Fire becomes pathogenic, causing irritability and rebellion, chasing deficiency and pursuing excess, scattering blood in vessels. Though fire energy is slight, its internal attack is powerful, scorching bones and injuring sinews, making blood restoration difficult.
With floating pulse, sweating is indicated. Using moxibustion traps pathogen, exacerbating it. Disease manifests as heaviness and bi-syndrome below the waist, termed Fire Reversal. Spontaneous resolution requires initial irritability followed by sweating. This is known because the pulse is floating.
If needle-cauterization induces sweating, and the needle site catches cold, forming red nodules, Ben Tun (Running Piglet) will develop. If Qi rushes from lower abdomen to heart, apply one moxa cone on each nodule, and administer Guizhi Jia Gui Tang (Cinnamon Twig Decoction Plus Cinnamon Twig).
Guizhi Jia Gui Tang Formula
Guizhi (Cinnamon Twig) 5 liang, Shaoyao (Peony Root) 3 liang, Shengjiang (Fresh Ginger Rhizome) 3 liang (sliced), Gancao (Licorice Root) 2 liang (roasted), Dazao (Jujube Fruit) 12 pieces (split).
The above five herbs are boiled in 7 sheng of water to obtain 3 sheng. Strain. Take 1 sheng warm, three times daily.
For Fire Reversal, if purgation is mistakenly used, and irritability follows cauterization, Guizhi Gancao Longgu Muli Tang (Cinnamon Twig and Licorice Plus Dragon Bone and Oyster Shell Decoction) is indicated.
Guizhi Gancao Longgu Muli Tang Formula
Guizhi (Cinnamon Twig) 1 liang, Gancao (Licorice Root) 2 liang (roasted), Longgu (Fossilized Mammal Bones) 2 liang, Muli (Oyster Shell) 2 liang (calcined).
The above four herbs are boiled in 5 sheng of water to obtain 3 sheng. Strain. Take 1 sheng warm, three times daily. In severe cases, add 3 liang of Renshen.
In Taiyang Shanghan, adding warm needles causes fright.
In Taiyang Disease, aversion to cold and fever are expected. If spontaneous sweating occurs without aversion to cold/fever, and the Guan pulse is fine-rapid, this is iatrogenic error from emesis. Emesis on day 1-2 causes hunger but inability to eat; on day 3-4, dislike of congee, desire for cold food, morning eating/evening vomiting, termed Minor Reversal. No aversion to cold and desire to discard clothing indicates Internal Irritation; all caused by improper emesis.
If patient pulse is rapid indicating heat, digestion should be enhanced. If eating causes vomiting, it is due to sweating depleting Yang, causing Diaphragm Qi deficiency, making pulse appear rapid. Rapid pulse here is Guest Heat, unable to digest food due to Cold-Stomach deficiency causing vomiting.
In Taiyang Disease, after ten-plus days, with nausea, chest pain, loose stool, mild abdominal fullness, and mild depression/irritability: if the patient previously underwent extreme emesis/purgation, give Tiaowei Chengqi Tang. Otherwise, do not give. If only nausea, chest pain, and loose stool exist, this is not Chaihu Syndrome, as vomiting indicates prior extreme emesis/purgation. (Tiaowei Chengqi Tang formula see upper volume)
In Taiyang Disease for six to seven days, if exterior signs persist, pulse is faint-deep, no Chest Binding, but mania occurs, heat is in Lower Jiao. Lower abdomen should be hard/full. If urination is free, bleeding resolves the issue. This is because Taiyang follows the meridian, and Blood-Heat knots internally. Didang Tang is indicated.
Didang Tang Formula
Shuizhi (Leech) 30 pieces (calcined), Mengchong (Blue Bottle Fly Larva) 30 pieces (wings/legs removed, calcined), Taoren (Peach Seed) 20 pieces (skin/tip removed), Dahuang (Rhubarb Root) 3 liang (wine-washed).
The above four herbs are boiled in 5 sheng of water to obtain 3 sheng. Strain. Take 1 sheng warm. If no evacuation, take more.
In Taiyang Disease, with jaundice, deep-knotted pulse, hard lower abdomen, and difficulty urinating, there is no blood stasis. If urination is free and patient is mania-like, blood stasis is confirmed. Didang Tang is indicated. (Formula see previous)
In Shanghan with heat and lower abdominal fullness, urination should be difficult. If urination is free, blood stasis exists. Purge without residual medicine; Didang Wan is suitable.
Didang Wan Formula
Shuizhi (Leech) 20 pieces (calcined), Mengchong (Blue Bottle Fly Larva) 20 pieces (wings/legs removed, calcined), Taoren (Peach Seed) 25 pieces (skin/tip removed), Dahuang (Rhubarb Root) 3 liang (wine-washed).
The above four herbs are crushed into four pills. Boil one pill in 1 sheng of water to obtain 7 he. Take. Within 24 hours, blood should pass. If not, take more.
In Taiyang Disease, if urination is free due to excessive water intake, palpitations occur below the heart. If urination is scarce, interior urgency/distress occurs.
Shanghan Zabing Lun Volume 8
Differentiating Pulse, Signs, and Treatment of Taiyang Disease - Part 2
Question: What are Zang Jie (Zang Knotting) and Jie Xiong (Chest Binding)? Master says: Floating pulse at Cun, small-fine-deep-tight pulse at Guan is Zang Jie. Pain on pressure, floating pulse at Cun, sinking pulse at Guan is Jie Xiong.
What is Zang Jie? Master says: Zang Jie involves knotting in the Five Zang organs, distinguishing cold and heat. Seek in the Blood aspect. Although Qi knots exist, they are caused by Blood. For example, Liver Knotting causes bilateral hypochondriac pain and vomiting, with deep-wiry-knotted pulse. Wuzhuyu Tang is suitable. If fever without vomiting, it is Excess, with deep-wiry-tense pulse. Guizhi Danggui Mudanpi Taoren Zhishi Tang is indicated.
Wuzhuyu Tang Formula
Wuzhuyu (Evodia Fruit) 1 sheng, Renshen (Ginseng Root) 3 liang, Shengjiang (Fresh Ginger Rhizome) 6 liang, Dazao (Jujube Fruit) 12 pieces (split).
The above four herbs are boiled in 7 sheng of water to obtain 2 sheng. Strain. Take 7 he warm, three times daily.
Guizhi Danggui Mudanpi Taoren Zhishi Tang Formula
Guizhi (Cinnamon Twig) 3 liang (bark removed), Danggui (Angelica Sinensis Root) 2 liang, Mudanpi (Tree Peony Bark) 3 liang, Taoren (Peach Seed) 20 pieces (skin/tip removed), Zhishi (Immature Bitter Orange) 2 liang.
The above five herbs are boiled in 8 sheng of water to obtain 3 sheng. Strain. Take 1 sheng warm, three times daily.
Heart Knotting causes heart pain or oppression/unhappiness below the heart, with large-choppy pulse. Lianqiao Ejiao Banxia Chixiaodou Tang is indicated. If heart heat-pain with irritability, large-wiry-tense pulse, it is Excess. Huanglian Ejiao Banxia Taoren Fuling Tang is indicated.
Lianqiao Ejiao Banxia Chixiaodou Tang Formula
Lianqiao (Forsythia Fruit) 2 liang, Ejiao (Donkey-hide Gelatin) 1.5 liang, Banxia (Pinellia Tuber) half sheng (washed), Chixiaodou (Adzuki Bean) 3 liang.
The above four herbs are boiled in 4 sheng of water. Boil first three to obtain 2 sheng, strain, add Ejiao to melt. Take 7 he warm, three times daily.
Huanglian Ejiao Banxia Taoren Fuling Tang
Huanglian (Coptis Rhizome) 3 liang, Ejiao (Donkey-hide Gelatin) 2 liang, Banxia (Pinellia Tuber) half sheng (washed), Taoren (Peach Seed) 20 pieces (skin/tip removed), Fuling (Poria) 3 liang.
The above five herbs are boiled in 5 sheng of water. Boil first four to obtain 2 sheng, strain, add Ejiao to melt. Take 1 sheng warm, twice daily.
Lung Knotting causes chest obstruction, wheezing, cough, sadness, with short-choppy pulse. Baihe Beimu Fuling Jiegeng Tang is indicated. If coughing with bloody sputum and chest pain, it is Excess. Tingli Kua Wei Jiegeng Mudan Tang is indicated.
Baihe Beimu Fuling Jiegeng Tang Formula
Baihe (Lily Bulb) 7 pieces (washed, foam removed), Beimu (Fritillaria Bulb) 3 liang, Fuling (Poria) 3 liang, Jiegeng (Platycodon Root) 2 liang.
The above four herbs are boiled in 7 sheng of water to obtain 3 sheng. Strain. Take 1 sheng warm, three times daily.
Tingli Kua Wei Jiegeng Mudan Tang Formula
Tingli (Perilla Seed) 3 liang (calcined), Kua Wei (Trichosanthes Fruit) 1 large piece (crushed), Jiegeng (Platycodon Root) 3 liang, Mudanpi (Tree Peony Bark) 2 liang.
The above four herbs are boiled in 6 sheng of water to obtain 3 sheng. Strain. Take 1 sheng warm, three times daily.
Spleen Knotting causes abdominal fullness/pain, feeling like an inverted cup on pressure, possibly large/firm abdomen, with deep-tight pulse. Baizhu Zhishi Taoren Ganjiang Tang is indicated. If distending pain, tenderness, initial loose then hard stool, passing gas, it is Excess. Dahuang Houpo Zhishi Banxia Gancao Tang is indicated.
Baizhu Zhishi Taoren Ganjiang Tang Formula
Baizhu (Atractylodes Macrocephala Rhizome) 2 liang, Zhishi (Immature Bitter Orange) 2 liang, Taoren (Peach Seed) 27 pieces (skin/tip removed), Ganjiang (Dried Ginger Rhizome) 1 liang.
The above four herbs are boiled in 5 sheng of water to obtain 2 sheng. Strain, divide into two warm doses.
Dahuang Houpo Zhishi Banxia Gancao Tang Formula
Dahuang (Rhubarb Root) 3 liang, Houpo (Magnolia Bark) 3 liang, Zhishi (Immature Bitter Orange) 3 liang, Banxia (Pinellia Tuber) 1 sheng, Gancao (Licorice Root) 1 liang (roasted).
The above five herbs are boiled in 6 sheng of water to obtain 3 sheng. Strain. Take 1 sheng warm, three times daily.
Kidney Knotting causes hard lower abdomen, dull pain, nodular sensation on pressure, intermittent clear/cloudy urine, with deep-fine-knotted pulse. Fuling Guizhi Gancao Dazao Tang is suitable. If lower abdominal urgent pain, red-frequent urination, it is Excess. Guizhi Fuling Zhishi Shaoyao Gancao Tang is suitable.
Fuling Guizhi Gancao Dazao Tang Formula
Fuling (Poria) half jin, Guizhi (Cinnamon Twig) 4 liang, Gancao (Licorice Root) 2 liang (roasted), Dazao (Jujube Fruit) 15 pieces (split).
The above four herbs are boiled in 10 sheng of Ganlan Water (Agitated Water). Boil Fuling first, reducing by 2 sheng, add other herbs, boil to obtain 3 sheng. Strain. Take 1 sheng warm, three times daily.
Guizhi Fuling Zhishi Shaoyao Gancao Tang Formula
Guizhi (Cinnamon Twig) 3 liang (bark removed), Fuling (Poria) 2 liang, Zhishi (Immature Bitter Orange) 2 liang, Shaoyao (Peony Root) 3 liang, Gancao (Licorice Root) 1 liang (roasted).
The above five herbs are boiled in 6 sheng of water to obtain 3 sheng. Strain. Take 1 sheng warm, three times daily.
Zang Jie without Yang signs, no alternating chills/fever, patient is quiet, slippery tongue coating: do not purge. Normal diet with frequent diarrhea, white slippery tongue coating: difficult to treat.
What is Jie Xiong? Master says: Disease starting in Yang, mistakenly purged, heat enters interior, causing Jie Xiong. Disease starting in Yin, early purging, causes Pi (Fullness). Jie Xiong results from mistaken purging.
In Jie Xiong Disease, with stiff neck resembling Rou Jing (Soft Spasm), purging harmonizes. Da Xianxiong Wan is suitable.
Da Xianxiong Wan Formula