《针经》曰∶夺血者无汗。尺脉迟者，为荣血不足，故不可发汗。
脉浮者，病在表，可发汗，宜麻黄汤。
浮为轻手得之，以候皮肤之气。《内经》曰∶其在皮者汗而发之。
脉浮而数者，可发汗，宜麻黄汤。
浮则伤卫，数则伤荣，荣卫受邪，为病在表，故当汗散。
病常自汗出者，此为荣气和。荣气和者，外不谐，以卫气不共荣气和谐（赵本作“谐和”）故尔。以
荣行脉中，卫行脉外，复发其汗，荣卫和则愈，宜桂枝汤。
风则伤卫，寒则伤荣。卫受风邪而荣不病者，为荣气和也。卫既客邪，则不能与荣气和谐，亦不能卫
护皮腠，是以常自汗出。与桂枝汤解散风邪、调和荣卫则愈。
病患脏无他病，时发热，自汗出，而不愈者，此卫气不和也。先其时发汗则愈，宜桂枝汤主之。（赵本
无“主之”二字）
脏无他病，里和也。卫气不和表病也。《外台》云∶里和表病，汗之则愈。所谓先其时者，先其发
热汗出之时，发汗则愈。
伤寒脉浮紧，不发汗，因致衄者，麻黄汤主之。
伤寒脉浮紧，邪在表也，当与麻黄汤发汗；若不发汗，则邪无从出，拥甚于经，迫血妄行，因致衄也。
伤寒不大便六七日，头痛有热者，与承气汤。其小便清者，（赵本注“一云大便青”）知不在里，仍
在表也，当须发汗；若头痛者必衄，宜桂枝汤。
不大便六七日，头痛有热者，故宜当下。若小便清者，知里无热，则不可下。经曰∶小便数者，大便
必硬，不更衣十日无所苦也。况此不大便六七日，小便清者，不可责邪在里，是仍在表也，与桂枝汤以解外。
若头疼不已，为表不罢，郁甚于经，迫血妄行，上为衄也。
伤寒发汗，（赵本有“已”字）解半日许，复烦，脉浮数者，可更发汗，宜桂枝汤主之。（赵本无“主之”二字）
烦者，热也。发汗身凉为已解，至半日许，身复热，脉浮数者，邪不尽也，可更发汗，与桂枝汤。
凡病若发汗、若吐、若下、若亡（赵本有“血亡”二字）津液，阴阳自和者，必自愈。
重亡津液，则不能作汗，必待阴阳自和，乃自愈矣。
大下之后，复发汗，小便不利者，亡津液故也，勿治之，得小便利，必自愈。
因亡津液而小便不利者，不可以药利之，俟津液足，小便利必自愈也。
下之后，复发汗，必振寒脉微细。所以然者，以内外俱虚故也。
发汗则表虚而亡阳；下之则里虚而亡血，振寒者，阳气微也；脉微细者，阴血弱也。
下之后，复发汗，昼日烦躁，不得眠，夜而安静，不呕不渴，无表证，脉沉微，身无大热者，干姜附子汤主之。
下之虚其里，汗之虚其表，既下（医统本作“里申”）又汗，则表里俱虚。阳主于昼，阳欲复，虚不胜
邪，正邪交争，故昼日烦燥（医统本作“躁”）不得眠；夜阴为主，阳虚不能与之争，是夜则安静。
不呕不渴者，里无热也；身无大热者，表无热也。又无表证而脉沉微，知阳气大虚，阴寒气胜，与干姜附
子汤，退阴复阳。
干姜附子汤方∶
干姜（一两。味辛热） 附子（一枚生用，去皮，破，赵本作切，八片。味辛热）
《内经》曰∶寒淫所胜，平以辛热。虚寒大甚，是以辛热剂胜之也。
上二味，以水三升，煮取一升，去滓，顿服。
发汗后，身疼痛，脉沉迟者，桂枝加芍药生姜各一两人参三两新加汤主之。（赵本有“桂枝加芍药
生姜人参新加汤方”详见本书卷十）
汗后，身疼痛，邪气未尽也。脉沉迟，荣血不足也。经曰∶其脉沉者，荣气微也。又曰∶迟者，荣气
不足，血少故也。与桂枝汤以解未尽之邪，加芍药、生姜、人参，以益不足之血。
发汗后，不可更行桂枝汤。汗出而喘，无大热者，可与麻黄杏仁甘草石膏汤主之。（赵本“主之”
作“方”）
发汗后喘，当作桂枝加浓朴杏人汤，汗出则喘愈，今汗出而喘，为邪气拥甚，桂枝汤不能发散，故不可更
行桂枝汤。汗出而喘有大热者，内热气甚也；无大热者，表邪必甚也。与麻黄杏子（医统本作“人”）甘草
石膏汤，以散其邪。
麻黄杏人（赵本作“仁”）甘草石膏汤方∶
麻黄（四两，去节。味甘温） 杏人（人赵本作仁，五十个，去皮尖。味甘温） 甘草（二两，炙。味
甘平） 石膏（半斤，碎，绵裹。味甘寒）
《内经》曰∶肝苦急，急食甘以缓之。风气通于肝，风邪外甚，故以纯甘之剂发之。
上四味，以水七升，先（赵本无“先”字）煮麻黄，减二升，去上沫，内诸药，煮取二升，去滓，温
服一升。本云∶黄耳 。
发汗过多，其人叉手自冒心，心下悸，欲得按者，桂枝甘草汤主之。
发汗过多亡阳也。阳受气于胸中，胸中阳气不足，故病叉手自冒心。心下悸欲得按者，与桂枝甘草汤，
以调不足之气。
桂枝甘草汤方∶
桂枝（四两，去皮。味辛热） 甘草（二两，炙。味甘平）
桂枝之辛，走肺而益气；甘草之甘，入脾而缓中。
上二味，以水三升，煮取一升，去滓，顿服。
发汗后，其人脐下悸者，欲作奔豚，茯苓桂枝甘草大枣汤主之。
汗者，心之液。发汗后，脐下悸者，心气虚而肾气发动也。肾之积，名曰奔豚。发则从少腹上至心下，
为肾气逆欲上凌心。今脐下悸为肾气发动，故云欲作奔豚。与茯苓桂枝甘草大枣汤，以降肾气。
茯苓桂枝甘草大枣汤方∶
茯苓（半斤。味甘平） 甘草（二两，炙。味甘平） 大枣（十五枚，擘。味甘平） 桂枝（四两，去皮）
茯苓以伐肾邪；桂枝能泄奔豚；甘草、大枣之甘，滋助脾土，以平肾气；煎用甘烂水者，扬之无力，取
不助肾气也。
上四味，以甘烂水一斗，先煮茯苓，减二升，内诸药，煮取三升，去滓，温服一升，日三服。作甘烂水法，
取水二斗，置大盆内，以勺扬之，水上有珠子五六千颗相逐，取用之。
发汗后，腹胀满者，浓朴生姜甘草半夏人参汤主之。
吐后腹胀与下后腹满皆为实，言邪气乘虚入里为实。发汗后外已解也。腹胀满知非里实，由脾胃津液不
足，气涩不通，壅而为满，与此汤和脾胃而降气。
浓朴生姜甘草半夏人参汤方∶
浓朴（半斤，去皮，炙。味苦温） 生姜（半斤，切。味辛温） 半夏（半斤，赵本医统本并作“升”，
洗。味辛平） 人参（一两。味，医统本有“甘”字，温） 甘草（二两，炙。味甘平）
《内经》曰∶脾欲缓，急食甘以缓之，用苦泄之。浓朴之苦，以泄腹满；人参、甘草之甘，以益脾胃；
半夏、生姜之辛，以散滞气。
上五味，以水一斗，煮取三升，去滓，温服一升，日三服。
伤寒若吐若下后，心下逆满，气上冲胸，起则头眩，脉沉紧，发汗则动经，身为振振摇者，茯苓桂枝白
术甘草汤主之。
吐下后，里虚气。上逆者，心下逆满，气上冲胸；表虚阳不足，起则头眩；脉浮紧，为邪在表，当发
汗；脉沉紧，为邪在里，则不可发汗。发汗则外动经络，损伤阳气，阳气外虚，则不能
主持诸脉，身为振振摇也，与此汤以和经益阳。
茯苓桂枝白术甘草汤方∶
茯苓（四两。味甘平） 桂枝（三两，去皮。味辛热） 白术（二两。味苦甘温） 甘草（二两，炙。味甘平）
阳不足者，补之以甘，茯苓、白术，生津液而益阳也。里气逆者，散之以辛，桂枝、甘草，行阳散气。
上四味，以水六升，煮取三升，去滓，分温三服。
发汗，病不解，反恶寒者，虚故也，芍药甘草附子汤主之。
发汗病解，则不恶寒；发汗病不解，表实者，亦不恶寒。今发汗病且不解，又反恶寒者，荣卫俱虚也。汗
出则荣虚，恶寒则卫虚，与芍药甘草附子汤，以补荣卫。
芍药甘草附子汤方∶
芍药（三两。味酸，微寒） 甘草（三两，炙。味甘平） 附子（一枚，炮，去皮，破八片。味辛热）
芍药之酸，收敛津液而益荣；附子之辛温，固阳气而补卫；甘草之甘，调和辛酸而安正气。
以上（赵本作“右”）三味，以水五升，煮取一升五合，去滓，分温（赵本有“三”字）服，疑非仲景
意。（赵本作“方”）
发汗若下之，病仍不解，烦躁者，茯苓四逆汤主之。
发汗若下，病宜解也，若病仍不解，则发汗外虚阳气，下之内虚阴气，阴阳俱虚，邪独不解，故生烦
躁。与茯苓四逆汤，以复阴阳之气。
茯苓四逆汤方∶
茯苓（六，赵本作“四”两。味甘平） 人参（一两。味甘温） 甘草（二两，炙。味甘平） 干姜（
一两半。味辛热） 附子（一枚，生用，去皮，破八片。味辛热）
四逆汤以补阳，加茯苓、人参以益阴。
上五味，以水五升，煮取三升，去滓，温服七合，日三（赵本作“二”）服。
发汗后，恶寒者，虚故也；不恶寒，但热者，实也。
当和胃气，与调胃承气汤。（赵本有“调胃承气汤方”详见本书卷二。又赵本注∶“玉函云，与小承气汤”）
汗出而恶寒者，表虚也；汗出而不恶寒，但热者，里实也。经曰∶汗出不恶寒者，此表解里未和。与调
胃承气汤和胃气。
太阳病，发汗后，大汗出，胃中干，烦躁（赵本作“躁”）不得眠，欲得饮水者，少少与饮之，令胃
气和则愈。若脉浮，小便不利，微热消渴者，与（赵本无“与”字）五苓散主之。（赵本注∶“即猪苓散是”）
发汗已解，胃中干，烦躁不得眠，欲饮水者，少少与之，胃气得润则愈。若脉浮者，表未解也。饮水
多，而小便少者，谓之消渴，里热甚实也；微热消渴者，热未成实，上焦燥也，与五苓散，生津液和表里。
五苓散方∶
猪苓（十八铢，去皮。味甘平） 泽泻（一两六铢半，赵本无“半”字，味酸咸） 茯苓（十八铢。味甘
平） 桂（赵本有“枝”字，半两，去皮。味辛热） 白术（十八铢。味甘平）
淡者一也。口入一而为甘，甘甚而反淡，甘缓而淡渗。猪苓、白术、茯苓三味之甘，润虚燥而利津液；咸
味下泄为阴，泽泻之咸，以泄伏水；辛甘发散为阳，桂枝之辛甘，以和肌表。
上五味为末，（赵本作“捣为散”）以白饮和，服方寸匕，日三服，多饮暖水，汗出愈。（赵本有“如
法将息”四字）
发汗已，脉浮数，烦渴者，五苓散主之。
发汗已，脉浮数者，表邪未尽也；烦渴亡津液，胃燥也，与五苓散和表润燥。
伤寒汗出而渴者，五苓散主之。不渴者，茯苓甘草汤主之。
伤寒汗出而渴者，亡津液胃燥，邪气渐传里也，五苓散以和表里。若汗出不渴者，邪气不传里，但在
表而表虚也，与茯苓甘草汤和表合卫。
茯苓甘草汤方∶
茯苓（二两。味甘平） 桂枝（二两，去皮。味辛热） 生姜（三两，切。味辛温） 甘草（一两，
炙。味甘平）
茯苓、甘草之甘，益津液而和卫；桂枝、生姜之辛，助阳气而解表。
上四味，以水四升，煮取二升，去滓，分温三服。
中风发热，六七日不解而烦，有表里证，渴欲饮水，水入则吐者，名曰水逆。五苓散主之。
中风发热，至六七日，则当解；若不解烦者，邪在表也。渴欲饮水，邪传里也。里热甚则能消（熊校记∶
里热甚则能水，汪本能下增消字。按能读如耐，古书多有之，迭见《内经》）水，水入则不吐；里热少
则不能消水，停积不散，饮而吐水也。以其因水而吐，故名水逆。与五苓散和表里、散停饮。
未持脉时，病患手叉自冒心，师因教试令咳而不咳者，此必两耳聋无闻也。所以然者，以重发汗，虚故如此。
发汗多亡阳，胸中阳气不足者，病患手叉自冒心。师见外证知阳气不足也；又试令咳而不即咳者，耳聋
也，知阳气虚明矣。耳聋者，阳气虚，精气不得上通于耳故也。
发汗后，饮水多，必喘，以水灌之，亦喘。
喘，肺疾。饮水多喘者，饮冷伤肺也；以冷水灌洗而喘者，形寒伤肺也。
发汗后，水药不得入口为逆，若更发汗，必吐下不
止。
发汗后，水药不得入口，为之吐逆。发汗亡阳，胃中虚冷也。若更发汗，则愈损阳气，胃气大虚，故吐下不止。
发汗吐下后，虚烦不得眠；若剧者，必反复颠倒，心中懊 ，栀子豉汤主之。
发汗吐下后，邪热乘虚客于胸中，谓之虚烦者热也，胸中烦热郁闷而不得发散者是也。热（医统本作
“无”）气伏于里者，则喜睡，今热气浮于上，烦扰阳气，故不得眠。心恶热，热甚则必神
昏，是以剧者反复颠倒而不安，心中懊 而愦闷。懊 者，俗谓鹘突是也。《内经》曰∶其高者因而越之。
与栀子豉汤以吐胸中之邪。
栀子豉汤方∶
栀子（十四枚，赵本作个，擘。味苦寒） 香豉（四合，绵裹。味苦寒）
酸苦涌泄为阴，苦以涌吐，寒以胜热，栀子豉汤相合，吐剂宜矣。
上二味，以水四升，先煮栀子，得二升半，内豉，煮取一升半，去滓，分为二服，温进一服。得吐者，
止后服。
若少气者，栀子甘草豉汤主之。（赵本有“栀子甘草豉汤方”详见本书卷十）若呕者，栀子生姜豉汤
主之。（赵本有“栀子生姜豉汤方”详见本书卷十）
The *Zhen Jing* (Needle Classic) states: Those who have lost blood should not undergo sweating therapy. A chi pulse that is slow indicates a deficiency of Ying blood, thus sweating therapy is contraindicated.
A floating pulse indicates the disease is at the exterior; sweating therapy may be applied, and Mahuang Tang (Ephedra Decoction) is appropriate.
"Floating" refers to a pulse felt with light pressure, used to inspect the Qi at the skin level. The *Nei Jing* (Inner Canon) states: When pathogens are in the skin, they should be expelled through sweating.
A floating and rapid pulse allows for sweating therapy; Mahuang Tang (Ephedra Decoction) is appropriate.
A floating pulse injures Wei Qi; a rapid pulse injures Ying Qi. When Ying and Wei Qi are affected by pathogens, the disease is at the exterior, so dispersal through sweating is required.
When a patient frequently sweats spontaneously, it is because the Ying Qi is harmonious. If Ying Qi is harmonious but the exterior is disharmonious, it is because the Wei Qi fails to harmonize with the Ying Qi (Zhao edition writes "harmonious"). Since Ying Qi circulates within the vessels and Wei Qi circulates outside the vessels, inducing sweat again will restore harmony between Ying and Wei, leading to recovery; Guizhi Tang (Cinnamon Twig Decoction) is appropriate.
Wind pathogen injures Wei Qi, while Cold pathogen injures Ying Qi. If Wei Qi is invaded by Wind but Ying Qi remains unaffected, it signifies that Ying Qi is harmonious. Once Wei Qi harbors pathogens, it cannot harmonize with Ying Qi nor protect the skin and pores, resulting in frequent spontaneous sweating. Administering Guizhi Tang (Cinnamon Twig Decoction) to dissipate Wind pathogen and harmonize Ying and Wei Qi leads to recovery.
If a patient's internal organs have no other diseases, yet they experience intermittent fever and spontaneous sweating without improvement, this is due to disharmony of Wei Qi. Sweating before the onset of symptoms leads to recovery; Guizhi Tang (Cinnamon Twig Decoction) is indicated. (Zhao edition lacks the words "zhu zhi" - main treatment).
"No other diseases in the internal organs" implies interior harmony. Disharmony of Wei Qi indicates an exterior syndrome. The *Waitai Miyao* (Essential Prescriptions from the Imperial Cabinet) states: For interior harmony and exterior disease, sweating leads to recovery. "Before the time" refers to sweating prior to the onset of fever and sweating.
In Shanghan (Cold Damage) with a floating-tight pulse, if sweating is not induced, epistaxis (nosebleed) may occur; Mahuang Tang (Ephedra Decoction) is indicated.
In Shanghan (Cold Damage) with a floating-tight pulse, the pathogen is at the exterior, and Mahuang Tang (Ephedra Decoction) should be given to induce sweating. If sweating is not induced, the pathogen has no outlet, accumulates severely in the meridians, forces blood to move recklessly, and causes epistaxis.
In Shanghan (Cold Damage), if there is constipation for six or seven days accompanied by headache and fever, Chengqi Tang (Gut-Purging Decoction) may be given. However, if urination is clear, (Zhao edition notes "one version says stool is green"), it is known that the disease is not in the interior but remains in the exterior, requiring sweating. If headache persists, epistaxis is likely; Guizhi Tang (Cinnamon Twig Decoction) is appropriate.
Constipation for six or seven days with headache and fever initially suggests purgation. But if urination is clear, interior heat is absent, and purgation is contraindicated. The Classics state: Frequent urination leads to hard stools; even ten days without defecation causes no distress. Here, with six or seven days of constipation and clear urination, one should not blame the interior for the pathology; it remains in the exterior. Guizhi Tang (Cinnamon Twig Decoction) is given to resolve the exterior.
If headache persists, the exterior pathogen has not resolved; accumulation in the meridians becomes severe, forcing blood recklessly upward, causing epistaxis.
After sweating therapy for Shanghan (Cold Damage), (Zhao edition adds "yi" - already), after about half a day, if restlessness recurs and the pulse is floating and rapid, sweating may be repeated; Guizhi Tang (Cinnamon Twig Decoction) is indicated. (Zhao edition lacks "zhu zhi").
"Fan" (restlessness) indicates heat. Body cooling after sweating indicates resolution. Half a day later, recurrence of fever and a floating-rapid pulse indicate incomplete elimination of pathogens; sweating may be repeated with Guizhi Tang (Cinnamon Twig Decoction).
In any disease, whether treated with sweating, vomiting, purgation, or involving loss of body fluids, if Yin and Yang achieve self-harmony, spontaneous recovery occurs.
Severe loss of body fluids prevents sweating; recovery depends on the self-harmonization of Yin and Yang.
After severe purgation followed by sweating, if urination is difficult, it is due to fluid loss. Do not treat it medicinally; once urination normalizes, spontaneous recovery occurs.
Urinary difficulty due to fluid loss should not be treated with diuretics. Wait for fluid replenishment; urinary flow will normalize, leading to spontaneous recovery.
After purgation followed by sweating, chills and a faint-thin pulse inevitably appear. This is because both interior and exterior are deficient.
Sweating causes exterior deficiency and loss of Yang; purgation causes interior deficiency and loss of Blood. Chills indicate weak Yang; faint-thin pulse indicates weak Yin blood.
After purgation followed by sweating, if the patient experiences daytime irritability and insomnia, but quietness at night, without vomiting, thirst, exterior signs, with a deep-faint pulse and no significant fever, Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction) is indicated.
Purgation empties the interior; sweating empties the exterior. Both procedures lead to dual deficiency. Yang dominates the day; when Yang attempts to recover, its weakness cannot resist pathogens, leading to Zheng-pathogen conflict and daytime irritability/insomnia. Night is dominated by Yin; Yang deficiency prevents conflict, resulting in nighttime quietness.
No vomiting or thirst indicates no interior heat; lack of significant fever indicates no exterior heat. Absence of exterior signs with a deep-faint pulse confirms severe Yang deficiency and excess Yin-Cold. Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction) is given to dispel Yin and restore Yang.
**Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction) Formula:**
Ganjiang (Dried Ginger, 1 liang, Pungent-Hot) | Fuzi (Prepared Aconite Root, 1 piece, raw, peeled, broken, Zhao edition: cut into 8 slices, Pungent-Hot)
The *Nei Jing* states: When Cold prevails, use Pungent-Hot agents to pacify it. Severe deficiency-cold requires Pungent-Hot agents to overcome it.
These two ingredients are boiled in 3 sheng of water to yield 1 sheng. Strain and take all at once.
After sweating, if body pain persists with a deep-slow pulse, Guizhi Jia Shaoyao Shengjiang Renshen Xinjia Tang (Guizhi Decoction Augmented with Additional Shaoyao, Shengjiang, and Renshen) is indicated. (Zhao edition lists the full formula name, detailed in Vol. 10).
Body pain after sweating indicates residual pathogens. Deep-slow pulse indicates Ying blood deficiency. The Classics state: A deep pulse signifies weak Ying Qi. Also: A slow pulse indicates Ying Qi deficiency and scanty blood. Guizhi Tang (Cinnamon Twig Decoction) resolves residual pathogens; adding Shaoyao (Peony Root), Shengjiang (Fresh Ginger), and Renshen (Ginseng Root) tonifies deficient blood.
After sweating, Guizhi Tang (Cinnamon Twig Decoction) should not be used again. If sweating is accompanied by wheezing without high fever, Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) is indicated. (Zhao edition reads "fang" instead of "zhu zhi").
Wheezing after sweating should typically be treated with Guizhi Jia Houpo Xingren Tang (Guizhi Decoction Augmented with Houpo and Xingren); sweating resolves wheezing. Current sweating with wheezing indicates severe pathogen congestion; Guizhi Tang (Cinnamon Twig Decoction) cannot disperse it, hence it is contraindicated. Sweating with wheezing and high fever indicates intense internal heat; sweating with wheezing without high fever indicates severe exterior pathogen. Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) disperses the pathogen.
**Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) Formula:**
Mahuang (Ephedra Stem, 4 liang, remove joints, Sweet-Warm) | Xingren (Apricot Seed, 50 pieces, Zhao edition: Ren, remove skin/tips, Sweet-Warm) | Gancao (Licorice Root, 2 liang, honey-fried, Sweet-Neutral) | Shigao (Gypsum Fibrosum, 0.5 jin, crushed, wrapped in silk, Sweet-Cold)
The *Nei Jing* states: When Liver suffers from urgency, eat Sweet to relax it. Wind Qi connects to the Liver; severe external Wind requires pure Sweet agents to disperse.
These four ingredients are boiled in 7 sheng of water. First (Zhao edition omits "first") boil Mahuang, reduce by 2 sheng, remove foam, add remaining herbs, boil to 2 sheng. Strain and take 1 sheng warm. Originally called: Huang Er.
Excessive sweating causing the patient to cross hands over the heart, with palpitations and desire for pressure, is treated with Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction).
Excessive sweating leads to Yang loss. Yang Qi originates in the chest; insufficiency here causes the desire to press the heart area. Palpitations relieved by pressure indicate need for Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction) to tonify deficient Qi.
**Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction) Formula:**
Guizhi (Cinnamon Twig, 4 liang, remove bark, Pungent-Hot) | Gancao (Licorice Root, 2 liang, honey-fried, Sweet-Neutral)
Guizhi's Pungency enters Lung to benefit Qi; Gancao's Sweetness enters Spleen to moderate middle.
These two ingredients are boiled in 3 sheng of water to yield 1 sheng. Strain and take all at once.
After sweating, if palpitations occur below the umbilicus, indicating impending Ben Tun (Running Piglet), Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction) is indicated.
Sweat is the fluid of the Heart. Post-sweating subumbilical palpitations indicate Heart Qi deficiency and Kidney Qi activation. Kidney accumulation is named Ben Tun (Running Piglet), rising from lower abdomen to heart, representing rebellious Kidney Qi threatening the Heart. Subumbilical palpitations signal Kidney Qi activation, hence "impending Ben Tun." Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction) descends Kidney Qi.
**Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction) Formula:**
Fuling (Poria, 0.5 jin, Sweet-Neutral) | Gancao (Licorice Root, 2 liang, honey-fried, Sweet-Neutral) | Dazao (Jujube Fruit, 15 pieces, split, Sweet-Neutral) | Guizhi (Cinnamon Twig, 4 liang, remove bark)
Fuling attacks Kidney pathogens; Guizhi drains Ben Tun; Gancao and Dazao's Sweetness nourishes Spleen Earth to calm Kidney Qi. Boiling in Ganlan Shui (Stirred Water) uses water agitated until bubbles form, chosen for not aiding Kidney Qi.
These four ingredients are boiled in 1 dou of Ganlan Shui. First boil Fuling, reduce by 2 sheng, add others, boil to 3 sheng. Strain and take 1 sheng warm, three times daily. Method for Ganlan Shui: Take 2 dou water, place in large basin, stir with ladle until 5-6 thousand bubbles chase each other on surface; use this water.
After sweating, abdominal fullness is treated with Houpo Shengjiang Gancao Banxia Renshen Tang (Magnolia Bark, Fresh Ginger, Licorice, Pinellia, and Ginseng Decoction).
Abdominal fullness after vomiting or purgation is Excess, caused by pathogens entering interior due to deficiency. Post-sweating, exterior is resolved. Abdominal fullness is not interior Excess but results from insufficient Spleen-Stomach fluids, stagnant Qi, and obstruction. This formula harmonizes Spleen-Stomach and directs Qi downward.
**Houpo Shengjiang Gancao Banxia Renshen Tang (Magnolia Bark, Fresh Ginger, Licorice, Pinellia, and Ginseng Decoction) Formula:**
Houpo (Magnolia Bark, 0.5 jin, peel, fry, Bitter-Warm) | Shengjiang (Fresh Ginger, 0.5 jin, sliced, Pungent-Warm) | Banxia (Pinellia Tuber, 0.5 jin, Zhao/Yitong editions: 1 sheng, wash, Pungent-Neutral) | Renshen (Ginseng Root, 1 liang, Warm; Yitong adds "Sweet") | Gancao (Licorice Root, 2 liang, honey-fried, Sweet-Neutral)
The *Nei Jing* states: Spleen desires relaxation; eat Sweet to relax, Bitter to drain. Houpo's Bitterness drains abdominal fullness; Renshen and Gancao's Sweetness tonifies Spleen-Stomach; Banxia and Shengjiang's Pungency disperses stagnant Qi.
These five ingredients are boiled in 1 dou of water to yield 3 sheng. Strain and take 1 sheng warm, three times daily.
In Shanghan (Cold Damage), after vomiting or purgation, if there is subepigastric rebellion/fullness, Qi rushing to chest, dizziness upon standing, and deep-tight pulse, sweating disturbs meridians causing tremulous swaying; Fuling Guizhi Baizhu Gancao Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction) is indicated.
Post-vomit/purge interior deficiency leads to Qi rebellion (subepigastric fullness, chest rush). Exterior deficiency/Yang insufficiency causes dizziness on standing. Floating-tight pulse indicates exterior pathogen (sweat indicated); deep-tight pulse indicates interior pathogen (sweat contraindicated). Sweating disturbs exterior meridians, damages Yang, leading to inability to govern pulses and body tremors. This formula harmonizes meridians and benefits Yang.
**Fuling Guizhi Baizhu Gancao Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction) Formula:**
Fuling (Poria, 4 liang, Sweet-Neutral) | Guizhi (Cinnamon Twig, 3 liang, remove bark, Pungent-Hot) | Baizhu (Atractylodes Macrocephala Rhizome, 2 liang, Bitter-Sweet-Warm) | Gancao (Licorice Root, 2 liang, honey-fried, Sweet-Neutral)
Yang deficiency is supplemented with Sweet; Fuling and Baizhu generate fluids and benefit Yang. Interior Qi rebellion is dispersed with Pungent; Guizhi and Gancao move Yang and disperse Qi.
These four ingredients are boiled in 6 sheng of water to yield 3 sheng. Strain and divide into three warm doses.
After sweating, if disease persists with worsening aversion to cold, it is Deficiency; Shaoyao Gancao Fuzi Tang (Peony, Licorice, and Aconite Decoction) is indicated.
Resolution of disease post-sweating means no aversion to cold. Persistence without aversion indicates Exterior Excess. Current persistence with worsening aversion indicates dual Ying-Wei deficiency. Sweating depletes Ying; aversion depletes Wei. Shaoyao Gancao Fuzi Tang (Peony, Licorice, and Aconite Decoction) tonifies Ying and Wei.
**Shaoyao Gancao Fuzi Tang (Peony, Licorice, and Aconite Decoction) Formula:**
Shaoyao (Peony Root, 3 liang, Sour, Slightly Cold) | Gancao (Licorice Root, 3 liang, honey-fried, Sweet-Neutral) | Fuzi (Prepared Aconite Root, 1 piece, processed, peeled, broken into 8 slices, Pungent-Hot)
Shaoyao's Sourness astringes fluids and benefits Ying; Fuzi's Pungent-Warmth secures Yang and benefits Wei; Gancao's Sweetness harmonizes Sour/Pungent and stabilizes Righteous Qi.
These three ingredients (Zhao: "Right") are boiled in 5 sheng of water to yield 1.5 sheng. Strain and divide into three warm doses (Zhao adds "three"). Suspected not to be Zhongjing's intent. (Zhao: "fang").
After sweating or purgation, if disease persists with irritability, Fuling Sini Tang (Poria and Four Reversals Decoction) is indicated.
Sweating/purgation should resolve disease. Persistence indicates sweating depleted exterior Yang and purgation depleted interior Yin, causing dual deficiency and unresolved pathogens, leading to irritability. Fuling Sini Tang (Poria and Four Reversals Decoction) restores Yin and Yang.
**Fuling Sini Tang (Poria and Four Reversals Decoction) Formula:**
Fuling (Poria, 6 liang, Zhao: 4 liang, Sweet-Neutral) | Renshen (Ginseng Root, 1 liang, Sweet-Warm) | Gancao (Licorice Root, 2 liang, honey-fried, Sweet-Neutral) | Ganjiang (Dried Ginger, 1.5 liang, Pungent-Hot) | Fuzi (Prepared Aconite Root, 1 piece, raw, peeled, broken into 8 slices, Pungent-Hot)
Sini Tang tonifies Yang; adding Fuling and Renshen benefits Yin.
These five ingredients are boiled in 5 sheng of water to yield 3 sheng. Strain, take 0.7 sheng warm, twice (Zhao: three) daily.
Post-sweating aversion to cold indicates Deficiency; absence of aversion with only heat indicates Excess.
Harmonize Stomach Qi with Tiaowei Chengqi Tang (Regulate Stomach Gut-Purging Decoction). (Zhao lists formula in Vol. 2. Note: Yukan text suggests Xiaochengqi Tang).
Sweating with aversion indicates Exterior Deficiency; sweating without aversion with only heat indicates Interior Excess. Classics state: Sweating without aversion means exterior resolved, interior unharmonized. Tiaowei Chengqi Tang (Regulate Stomach Gut-Purging Decoction) harmonizes Stomach Qi.
In Taiyang disease, after excessive sweating causing dry stomach, irritability, insomnia, and thirst, small sips of water harmonize Stomach Qi for recovery. If pulse is floating, urination difficult, slight fever, and thirst, Wuling San (Five-Ingredient Powder with Poria) is indicated. (Zhao omits "yu"; note: "This is Zhuling San").
Resolved sweating with dry stomach/irritability/thirst improves with small water sips. Floating pulse indicates unresolved exterior. Excess drinking with low urine is Xiao Ke (Wasting-Thirst), indicating intense interior heat. Slight fever/thirst indicates unconsolidated heat and upper Jiao dryness. Wuling San (Five-Ingredient Powder with Poria) generates fluids and harmonizes interior/exterior.
**Wuling San (Five-Ingredient Powder with Poria) Formula:**
Zhuling (Polyporus, 18 zhu, peel, Sweet-Neutral) | Zexie (Alisma Rhizome, 1 liang 6 zhu 0.5, Zhao: no 0.5, Sour-Salty) | Fuling (Poria, 18 zhu, Sweet-Neutral) | Gui (Cinnamon, Zhao: adds "Zhi", 0.5 liang, peel, Pungent-Hot) | Baizhu (Atractylodes Macrocephala Rhizome, 18 zhu, Sweet-Neutral)
Dan (bland) is one. Entering as Sweet, extreme Sweet becomes Dan; Sweet moderates, Dan promotes drainage. Zhuling, Baizhu, Fuling's Sweetness moistens dryness and promotes fluids; Zexie's Saltyness drains hidden water; Guizhi's Pungent-Sweetness harmonizes muscle/exterior.
Grind five ingredients to powder (Zhao: pound to powder). Mix with rice water, take 1 cun bi dose, three times daily. Drink warm water abundantly; sweating leads to recovery. (Zhao adds "ru fa jiang xi").
Post-sweating floating-rapid pulse with irritability/thirst is treated with Wuling San (Five-Ingredient Powder with Poria).
Floating-rapid pulse indicates residual exterior pathogen; irritability/thirst indicates fluid loss and stomach dryness. Wuling San (Five-Ingredient Powder with Poria) harmonizes exterior and moistens dryness.
Shanghan sweating with thirst is treated with Wuling San (Five-Ingredient Powder with Poria); without thirst, Fuling Gancao Tang (Poria and Licorice Decoction) is indicated.
Thirst after sweating indicates fluid loss, stomach dryness, and pathogen transmitting to interior; Wuling San (Five-Ingredient Powder with Poria) harmonizes interior/exterior. No thirst indicates no interior transmission, only exterior deficiency; Fuling Gancao Tang (Poria and Licorice Decoction) harmonizes exterior and unites Wei.
**Fuling Gancao Tang (Poria and Licorice Decoction) Formula:**
Fuling (Poria, 2 liang, Sweet-Neutral) | Guizhi (Cinnamon Twig, 2 liang, remove bark, Pungent-Hot) | Shengjiang (Fresh Ginger, 3 liang, sliced, Pungent-Warm) | Gancao (Licorice Root, 1 liang, honey-fried, Sweet-Neutral)
Fuling/Gancao's Sweetness benefits fluids and harmonizes Wei; Guizhi/Shengjiang's Pungency aids Yang and resolves exterior.
These four ingredients are boiled in 4 sheng of water to yield 2 sheng. Strain and divide into three warm doses.
Wind-stroke fever persisting 6-7 days with irritability, exterior-interior signs, thirst, and vomiting water upon drinking is named Shui Ni (Water Rebellion). Wuling San (Five-Ingredient Powder with Poria) is indicated.
Fever persisting 6-7 days with irritability indicates exterior pathogen. Thirst indicates interior transmission. Intense interior heat consumes water (Xiong note: original "neng shui", Wang adds "xiao"; "neng" read as "nai", common in ancient texts including Nei Jing); water enters without vomiting. Mild interior heat cannot consume water, leading to stagnation and vomiting upon drinking. Hence "Water Rebellion." Wuling San (Five-Ingredient Powder with Poria) harmonizes interior/exterior and dissipates retained fluid.
Before pulse diagnosis, if patient crosses hands over heart, and doctor instructs coughing without result, bilateral deafness is certain. This results from heavy sweating causing deficiency.
Heavy sweating depletes Yang; chest Yang insufficiency causes hand-crossing. Doctor sees exterior signs of Yang deficiency; failure to cough immediately indicates deafness, confirming Yang deficiency. Deafness results from Yang deficiency preventing Essence-Qi from ascending to ears.
Post-sweating excessive drinking causes wheezing; cold water bathing also causes wheezing.
Wheezing is a Lung disease. Wheezing from excessive drinking is cold injury to Lung; wheezing from cold bathing is shape-cold injury to Lung.
Post-sweaving inability to keep water/medicine down is adverse; further sweating causes incessant vomiting/diarrhea.
Inability to retain water/medicine post-sweating is vomiting/rebellion. Sweating depletes Yang, causing stomach cold. Further sweating damages Yang further, causing great Stomach Qi deficiency and incessant vomiting/diarrhea.
Post-sweating/vomiting/purgation, empty irritability and insomnia; if severe, tossing turning and mental confusion (Ao Nan) occur; Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) is indicated.
Post-treatment, pathogenic heat enters chest deficiency, called "empty irritability," heat郁闷 (depressed) unable to disperse. Heat (Yitong: "no") lying deep causes sleepiness; current heat floating above disturbs Yang, causing insomnia. Heart dislikes heat; severe heat causes spirit confusion, leading to tossing/turning and mental confusion (Ao Nan). Ao Nan means vague/confused sensation. *Nei Jing* states: High pathology, induce vomiting. Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) vomits chest pathogens.
**Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) Formula:**
Zhizi (Gardenia Fruit, 14 pieces, Zhao: ge, split, Bitter-Cold) | Xiangchi (Fermented Soybean, 4 he, wrapped in silk, Bitter-Cold)
Sour-Bitter induces vomiting/drainage (Yin); Bitter induces vomiting, Cold conquers heat. Combination is suitable emetic.
Boil two ingredients in 4 sheng water. First boil Zhizi to 2.5 sheng, add Chi, boil to 1.5 sheng. Strain, divide into two doses. Take 1 dose warm. If vomiting occurs, stop subsequent doses.
For shortness of Qi, Zhizi Gancao Chi Tang (Gardenia, Licorice, and Fermented Soybean Decoction) is indicated. (Zhao lists formula in Vol. 10). For vomiting, Zhizi Shengjiang Chi Tang (Gardenia, Fresh Ginger, and Fermented Soybean Decoction) is indicated. (Zhao lists formula in Vol. 10).