建中者，建脾也。《内经》曰∶脾欲缓，急食甘以缓之。胶饴、大枣、甘草之甘以缓中也。辛润散也，荣
卫不足，润而散之，桂枝、生姜之辛，以行荣卫。酸收也、泄也，正气虚弱，收而行之，芍药之酸，以收正气。
上六味，以水七升，煮取三升，去滓，内胶（赵本无“胶”字）饴，更上微火，消解，温服一升，日
三服。呕家不可用建中汤，以甜故也。
伤寒中风，有柴胡证，但见一证便是，不必悉具。
柴胡证，是邪气在表里之间也，或胸中烦而不呕，或渴，或腹中痛，或胁下痞硬，或心下悸，小便不利，
或不渴，身有微热，或咳，但见一证，便宜与柴胡汤治之，不必待其证候全具也。
凡柴胡汤病证而下之，若柴胡证不罢者，复与柴胡汤，必蒸蒸而振，却（赵本有“复”字）发热汗出而解。
邪在半表半里之间，为柴胡证，即未作里实，医便以药下之；若柴胡证仍在者，虽下之不为逆，可复与柴
胡汤以和解之。得汤，邪气还表者，外作蒸蒸而热，先经下，里虚，邪气欲出，内
则振振然也。正气胜、阳气生，却复发热汗出而解也。
伤寒二三日，心中悸而烦者，小建中汤主之。
伤寒二三日，邪气在表，未当传里之时，心中悸而烦，是非邪气搏所致。心悸者，气虚也；烦者，血虚
也。以气血内虚，与小建中汤先建其里。
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。（赵本无“汤”字）呕不止，心下急，（赵本注∶“一云∶呕止小安”）郁郁
微烦者，为未解也，与大柴胡汤下之，则愈。
日数过多，累经攻下，而柴胡证不罢者，亦须先与小柴胡汤，以解其表。经曰∶凡柴胡汤疾，（医统本作“病
”）证而下之，若柴胡证不罢者，复与柴胡者，（医统本作“汤”）是也。呕止者，表里和
也；若呕不止，郁郁微烦者，里热已甚，结于胃中也，与大柴胡汤下其里热则愈。
大柴胡汤方∶
柴胡（半斤。味甘平） 黄芩（三两。味苦寒） 芍药（三两。味酸，微寒） 半夏（半升，洗。味辛
温） 生姜（五两，切。味辛温） 枳实（四枚，炙。味苦寒） 大枣（十二枚，擘。医统本有“味”字，甘
温） 大黄（二两。味苦寒，赵本无“大黄”一药）
柴胡、黄芩之苦，入心而折热；枳实、芍药之酸苦，涌泄而扶阴。辛者散也，半夏之辛，以散逆气；辛
甘和也，姜枣之辛甘，以和荣卫。
上八味，以水一斗二升，煮取六升，去滓，再煎，温服一升，日三服。一方用（赵本作“加”）大黄
二两。若不加大黄，（赵本无“大黄”二字）恐不为大柴胡汤也。（赵本无“也”字）
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，下之而（赵本作“以”）不得
利，今反利者，知医以丸药下之，（赵本有“此”字）非其治也。潮热者实也，先宜（赵本有“服”字）
小柴胡汤以解外，后以柴胡加芒硝汤主之。（赵本有“柴胡加芒硝汤方”详见本书卷十）
伤寒十三日，再传经尽，当解之时也。若不解，胸胁满而呕者，邪气犹在表里之间，此为柴胡汤证；
若以柴胡汤下之，则
更无潮热自利。医反以丸药下之，虚其肠胃，邪气（医统本作“热”）乘虚入腑，日晡所发潮热，热已
而利也。潮热虽为热实，然胸胁之邪未已，故先与小柴胡汤以解外，后以柴胡加芒硝以下胃热。
伤寒十三日不解，（赵本无“不解”二字）过经，谵语者，以有热也，当以汤下之。若小便利者，大便
当硬，而反下利，脉调和者，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。
伤寒十三日再传经尽，谓之过经。谵语者，阳明胃热也，当以诸承气汤下之。若小便利者，津液偏渗，
大盒饭硬，反下利者，知医以丸药下之也。下利，脉微而厥者，虚寒也，今脉调
和，则非虚寒，由肠虚胃热，协热而利也，与调胃承气汤以下胃热。
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（赵本有“其”字）
外。外解已，但少腹急结者，乃可攻之，宜桃核承气汤方。（赵本注∶“后云∶解外宜桂枝汤”）
太阳，膀胱经也。太阳经邪热不解，随经入腑，为热结膀胱，其人如狂者，为未至于狂，但不宁尔。经曰∶
其人如狂者，以热在下焦，太阳多热，热在膀胱，必与血相搏，若血不为蓄，为热迫之则血自下，血下则热
随血出而愈。若血不下者，则血为热搏，蓄积于下，而少腹急结，乃可攻之，与桃核承气汤，下
热散血。《内经》曰∶从外之内而盛于内者，先治其外，后调其内。此之谓也。
桃核承气汤方∶
桃人（人赵本作仁，五十个，去皮尖。味甘平） 桂枝（二两，去皮。味辛热） 大黄（四两） 芒
硝（二两） 甘草（二两，炙）
甘以缓之，辛以散之。少腹急结，缓以桃人之甘；下焦蓄血，散以桂枝辛热之气，（医统本作“桂枝之辛，
大热之气”）寒以取之。热甚搏血，故加二物于调胃承气汤中也。
上五味，以水七升，煮取二升半，去滓，内芒硝，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，不可转侧者，柴胡加龙骨牡蛎汤主之。
伤寒八九日，邪气已成热，而复传阳经之时，下之虚其里而热不除。胸满而烦者，阳热客于胸中也；惊
者，心恶热而神不守也；小便不利者；里虚津液不行也；谵语者，胃热也；一身尽重不可转侧者，阳气内行
于里，不营于表也。与柴胡汤以除胸满而烦，加龙骨、牡蛎、铅丹，收敛神气而镇惊；加茯苓以行
津液、利小便；加大黄以逐胃热、止谵语；加桂枝以行阳气而解身重。错杂之邪，斯悉愈矣。
柴胡加龙骨牡蛎汤方∶
半夏（二合，赵本有半字，洗） 大枣（六枚，赵本有“擘”字） 柴胡（四两） 生姜（一两半，赵本
有“切”字） 人参（一两半，赵本有黄芩一两） 龙骨（一两半） 铅丹（一两半） 桂枝（一两半，去
皮） 茯苓（一两半） 大黄（二两） 牡蛎（一两半， ，赵本医统本并作“熬”字）
上十一（赵本作“二”）味，以水八升，煮取四升，内大黄切如棋子，更煮一二（赵本作“两”）沸，去
滓，温服一升。（赵本句下有“本云∶柴胡汤，今加龙骨等”十字）
伤寒腹满谵语，寸口脉浮而紧，此肝乘脾也，名曰纵，刺期门。
腹满谵语者，脾胃疾也。浮而紧者，肝脉也。脾病见肝脉，木行乘土也。经曰∶水行乘火，木行乘土，名
曰纵。此其类矣。期门者，肝之募，刺之以泻肝经盛气。
伤寒发热，啬啬恶寒，大渴欲饮水，其腹必满，自汗出，小便利，其病欲解，此肝乘肺也，名曰横，刺期门。
伤寒发热，啬啬恶寒，肺病也。大渴欲饮水，肝气胜也。《玉函》曰∶作大渴，欲饮酢浆，是知肝气
胜也。伤寒欲饮水者愈，若不愈而腹满者，此肝行乘肺，水不得行也。经曰∶木行乘金，名横，刺期门，以泻
肝之盛气，肝肺气平，水散而津液得通，外作自汗出，内为小便利而解也。
太阳病二日，反躁，反（赵本作“凡”）熨其背，而大汗出，大热入胃，（赵本注“一作二日内烧瓦熨背，
大汗出，火气入胃”）胃中水竭，躁烦，必发谵语，十余日，振栗、自下利者，此为欲解也。故其汗，从腰
已（赵本作“以”）下不得汗，欲小便不得，反呕，欲失溲，足下恶风，大便硬，小盒饭数而反
不数及不多，大便已，头卓然而痛，其人足心必热，谷气下流故也。
太阳病二日，则邪在表，不当发躁，而反躁者，热气行于里也。反熨其背而发汗，大汗出，则胃中干燥，
火热入胃，胃中燥热，躁烦而谵语，至十余日，振栗、自下利者，火邪势微，阴气复生，津液得复也，故为欲
解。火邪去，大汗出，则愈。若从腰以下不得汗，则津液不得下通，故欲小便不得，热气上逆而反呕也。欲失溲、
足下恶风者，气不得通于下而虚也。津液偏渗，令大便硬者，小盒饭数。经曰∶小便数者，大便必硬也。
此以火热内燥，津液不得下通，故小便不数及不多也。若
火热消，津液和，则结硬之便得润，因自大便也。便已，头卓然而痛者，先大便硬，则阳气不得下通，既得
大便，则阳气降下，头中阳虚，故卓然而痛。谷气者，阳气也。先阳气不通于下之时，足下恶风，今阳气得
下，故足心热也。
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，
阴虚则小便难，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。
风为阳邪，因火热之气，则邪风愈甚，迫于血气，使血气流溢，失其常度。风与火气，谓之两阳。两阳相
熏灼，热发于外，必发身黄。若热搏于经络为阳盛外热，迫血上行必衄；热搏于内者，为阴虚内热，必小便
难。若热消血气，血气少为阴阳俱虚，血气虚少，不能荣于身体，为之枯燥。三阳经络至颈，三阴
至胸中而还，但头汗出，剂颈而还者，热气炎上，搏阳而不搏于阴也。《内经》曰∶诸胀腹大，皆属于热。腹
满微喘者，热气内郁也。《内经》曰∶火气内发，上为口干咽烂者，火热上熏也。热气上而不下者，则大便
不硬。若热气下入胃，消耗津液，则大便硬，故云或不大便。久则胃中躁（医统本作“燥”）热，必发谵语。
《内经》曰∶病深者，其声哕。火气大甚，正气逆乱则哕。《内经》曰∶四肢者，诸阳之本也。阳盛则四肢实，
火热大甚，故手足躁扰，捻衣摸床，扰乱也。小便利者，为火未剧，津液未竭而犹可治也。
伤寒脉浮，医以火迫劫之，亡阳，必惊狂，起卧（赵本作“卧起”）不安者，桂枝去芍药加蜀漆牡蛎龙
骨救逆汤主之。
伤寒脉浮，责邪在表，医以火劫发汗，汗（熊校记∶医以火劫发汗，汗出，大出者亡其阳。汪本大上删“
出”字，非）大出者，亡其阳。汗者，心之液。亡阳则心气虚，心恶热，火邪内迫，则心神浮越，
故惊狂，起卧不安，与桂枝汤，解未尽表邪；去芍药，以芍药益阴，非亡阳所宜也；火邪错逆，加蜀漆之
辛以散之；阳气亡脱，加龙骨、牡蛎之涩以固之。《本草》云∶涩可去脱。龙骨、牡蛎之属是也。
桂枝去芍药加蜀漆龙骨牡蛎（赵本作“牡蛎龙骨”）救逆汤方∶
桂枝（三两，去皮） 甘草（二两，炙） 生姜（三两，切） 牡蛎（五两，熬。味酸咸） 龙骨（四
两。味甘平） 大枣（十二枚，擘） 蜀漆（三两，洗去脚，赵本医统本并作腥。味辛平）
上为末，（赵本作“七味”）以水一斗二升，先煮蜀漆，减二升，内诸药，煮取三升，去滓，温服一
升。（赵本有“本云∶桂枝汤，今去芍药，加蜀漆牡蛎龙骨”十六字）
形作伤寒，其脉不弦紧而弱。弱者必渴，被火者（赵本无“者”字）必谵语。弱者发热、脉浮，解之当
汗出。愈。
形作伤寒，谓头痛身热也。脉不弦紧，则无伤寒表脉也。经曰∶诸弱发热，则脉弱为里热，故云弱者必
渴。若被火气，两热相合，搏（熊校记∶传于胃中，汪本传改搏，非是）于胃中。胃中躁
烦，必发谵语。脉弱发热者，得脉浮，为邪气还表，当汗出而解矣。
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。
此火邪迫血而血下行者也。太阳病用火熏之，不得汗，则
热无从出。阴虚被火，必发躁也。六日传经尽，至七日再到太阳经，则热气当解。若不解，热气迫血下行，必
清血清厕也。
脉浮热甚，（赵本有“而”字）反灸之，此为实。实以虚治，因火而动，必咽燥唾血。
此火邪迫血而血上行者也。脉浮，热甚为表实，医以脉浮为虚，用火灸之，因火气动血，迫血上行，
故咽燥唾血。
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。
微数之脉，则为热也。灸则除寒，不能散热，是慎不可灸也。若反灸之，热因火则甚，遂为烦逆。灸本
以追虚，而复逐热为实，热则伤血，又加火气，使血散脉中，气主煦之，血主濡
之，气血消散，不能濡润筋骨，致骨焦筋伤，血散而难复也。
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。
脉浮在表，宜以汗解之。医以火灸取汗而不得汗，邪无从出，又加火气相助，则热愈甚，身半以上，
同天之阳，半身以下，同地之阴，火性炎上，则腰以下阴气独治，故从腰以下必重而痹也。
欲自解者，必当先烦，（赵本有“烦”字）乃有汗而解。何以知之？脉浮，故知汗出解也。（赵本无“也”字）
烦，热也。邪气还表，则为烦热，汗出而解。以脉浮，故为邪还表也。
Establishing the middle (Jian Zhong) refers to strengthening the Spleen. The *Nei Jing* states: "The Spleen desires relaxation; urgently consume sweet flavors to relax it." The sweetness of Yili (Maltose), Dazao (Jujube), and Gancao (Licorice) relaxes the Middle Jiao. Pungent flavors disperse; when Ying and Wei are insufficient, use pungency to moisten and disperse them. The pungency of Guizhi (Cinnamon Twig) and Shengjiang (Fresh Ginger) circulates Ying and Wei. Sour flavors astringe and drain; when Zheng Qi (Upright Qi) is weak, use sourness to astringe and guide it. The sourness of Shaoyao (White Peony Root) astringes Zheng Qi.
The above six herbs, with seven sheng of water, are decocted to yield three sheng. Remove the dregs, add Yili (Maltose), heat gently over a low fire until dissolved, and take one sheng warm. Take three times daily. Patients with vomiting should not use Jianzhong Tang because sweetness promotes vomiting.
In Shanghan or Fengzhong, if Chaihu syndrome appears, seeing even one symptom is sufficient; it is not necessary for all symptoms to be present.
Chaihu syndrome indicates pathogenic factors located between the exterior and interior. Symptoms may include irritability in the chest without vomiting, thirst, abdominal pain, fullness and hardness in the hypochondrium, palpitations with dysuria, absence of thirst with slight fever, or cough. Seeing any one of these symptoms warrants treatment with Chaihu Tang; there is no need to wait for the complete syndrome to manifest.
If a patient with Chaihu syndrome is mistakenly treated with purgatives, and the Chaihu syndrome persists, administering Chaihu Tang again will likely result in a sensation of steaming heat accompanied by chills, followed by fever and sweating, leading to resolution.
Pathogenic factors located between the exterior and interior constitute Chaihu syndrome. At this stage, interior excess has not yet formed. If a physician erroneously uses purgatives, but the Chaihu syndrome remains, this is not considered a counter-indication (ni). One may re-administer Chaihu Tang to harmonize. After taking the decoction, as pathogenic factors retreat to the exterior, steaming heat manifests externally. Due to prior purgation causing interior deficiency, and pathogenic factors attempting to exit, internal trembling occurs. When Zheng Qi prevails and Yang Qi generates, fever and sweating ensue, resolving the disease.
In Shanghan, on the second or third day, if there are palpitations and irritability, Xiao Jianzhong Tang is indicated.
On the second or third day of Shanghan, pathogenic factors are at the exterior, before transmission to the interior. Palpitations and irritability here are not caused by pathogenic struggle. Palpitations indicate Qi deficiency; irritability indicates Blood deficiency. Due to internal deficiency of Qi and Blood, Xiao Jianzhong Tang is given first to establish the interior.
In Taiyang syndrome, after more than ten days, if mistakenly purged two or three times, and five or six days later the Chaihu syndrome persists, administer Xiao Chaihu Tang first. (Zhao edition lacks "Tang"). If vomiting continues incessantly, epigastric urgency, and mild depression/irritability occur, indicating unresolved disease, Da Chaihu Tang is given to purge, resulting in cure.
When many days have passed and repeated purgations have been performed, yet the Chaihu syndrome persists, one must first give Xiao Chaihu Tang to resolve the exterior. The Classics state: "For all Chaihu syndrome diseases, if treated with purgatives and the Chaihu syndrome does not cease, re-administer Chaihu Tang..." This applies. Cessation of vomiting indicates harmony of exterior and interior. If vomiting persists with depression and mild irritability, interior heat is severe and knotted in the Stomach. Da Chaihu Tang purges the interior heat, leading to cure.
Da Chaihu Tang Formula:
Chaihu (Half jin. Sweet, neutral) Huangqin (Three liang. Bitter, cold) Shaoyao (Three liang. Sour, slightly cold) Banxia (Half sheng, washed. Pungent, warm) Shengjiang (Five liang, sliced. Pungent, warm) Zhishi (Four pieces, roasted. Bitter, cold) Dazao (Twelve pieces, broken open. Sweet, warm) Dahuang (Two liang. Bitter, cold. Zhao edition omits Dahuang)
The bitterness of Chaihu and Huangqin enters the Heart to reduce heat. The sour-bitterness of Zhishi and Shaoyao induces vomiting/draining and supports Yin. Pungency disperses; the pungency of Banxia disperses rebellious Qi. Pungent and sweet combine to harmonize; the pungent-sweet nature of Jiang and Zao harmonizes Ying and Wei.
The above eight herbs, with twelve dou of water, are decocted to yield six sheng. Remove dregs, decoct again, and take one sheng warm, three times daily. Another version adds Dahuang two liang. Without Dahuang, it arguably cannot be called Da Chaihu Tang.
After thirteen days of unresolved Shanghan, with chest/hypochondriac fullness and vomiting, afternoon tidal fever, and subsequent mild diarrhea: This was originally a Chaihu syndrome. Purging failed to relieve constipation, but now diarrhea occurs. This indicates the physician used pill-based purgatives, which was incorrect. Tidal fever indicates interior excess. First, administer Xiao Chaihu Tang to resolve the exterior, then treat with Chaihu Jia Mangxiao Tang.
Thirteen days into Shanghan, after passing through the meridians twice, the time for resolution has arrived. If unresolved, with chest/hypochondriac fullness and vomiting, pathogenic factors remain between exterior and interior; this is a Chaihu Tang syndrome. If Chaihu Tang were used to purge, there would be no tidal fever or spontaneous diarrhea. Instead, the physician used pill purgatives, weakening the intestines and stomach. Pathogenic heat entered the fu organs due to deficiency, causing afternoon tidal fever followed by diarrhea. Although tidal fever indicates heat excess, the pathogenic factors in the chest/hypochondrium persist. Thus, Xiao Chaihu Tang is given first to resolve the exterior, followed by Chaihu Jia Mangxiao Tang to clear Stomach heat.
Unresolved Shanghan for thirteen days, having passed the meridian stages, with delirium indicates heat. Treatment requires purgative decoctions. If urination is free, stool should be hard; if diarrhea occurs instead with a harmonious pulse, it indicates erroneous pill purgation. If spontaneous diarrhea occurs, the pulse should be faint and cold; a harmonious pulse indicates interior excess. Treat with Tiaowei Chengqi Tang.
Thirteen days into Shanghan, passing through meridians twice is termed "passing the meridian." Delirium indicates Yangming Stomach heat, requiring Chengqi decoctions. Free urination diverts fluids, making stool hard; diarrhea indicates erroneous pill purgation. Diarrhea with faint/cold pulse indicates deficiency-cold. A harmonious pulse rules out deficiency-cold, indicating intestinal deficiency with Stomach heat causing heat-associated diarrhea. Tiaowei Chengqi Tang clears Stomach heat.
Taiyang syndrome unresolved, with heat knotting in the Bladder, results in mania-like behavior. If blood passes spontaneously, the patient cures. If exterior symptoms persist, attack is contraindicated; resolve the exterior first. Once the exterior is resolved, if only lower abdominal urgency/knotting remains, attack with Taohhe Chengqi Tang.
Taiyang refers to the Bladder meridian. Unresolved heat from the Taiyang meridian enters the fu organ, causing heat knotting in the Bladder. Mania-like behavior indicates unrest, not full madness. The Classics state: Mania-like behavior arises from heat in the Lower Jiao. Taiyang heat combines with blood in the Bladder. If blood is not retained but forced by heat, it passes spontaneously, carrying heat away. If blood does not pass, it is retained in the Lower Jiao, causing lower abdominal urgency. Taohhe Chengqi Tang purges heat and dissipates blood. The *Nei Jing* states: For pathology moving from exterior to interior and becoming excessive internally, treat the exterior first, then regulate the interior.
Taohhe Chengqi Tang Formula:
Taoren (Fifty kernels, peeled/sprouted. Sweet, neutral) Guizhi (Two liang, peeled. Pungent, hot) Dahuang (Four liang) Mangxiao (Two liang) Gancao (Two liang, roasted)
Sweetness relaxes; pungency disperses. Lower abdominal urgency is relaxed by Taoren's sweetness. Lower Jiao blood retention is dispersed by Guizhi's pungent-heat. Cold agents are used to address heat. Since heat severely binds blood, these two herbs are added to Tiaowei Chengqi Tang.
The above five herbs, with seven sheng of water, are decocted to yield two and a half sheng. Remove dregs, add Mangxiao, boil briefly. Stop fire. Take five he warm before meals, three times daily. Mild diarrhea is expected.
After eight or nine days of Shanghan, mistaken purgation leads to chest fullness, fright, dysuria, delirium, whole-body heaviness, and inability to turn. Treat with Chaihu Jia Longgu Muli Tang.
Eight or nine days into Shanghan, heat forms during transmission to Yang meridians. Mistaken purgation weakens the interior while heat remains. Chest fullness/irritability indicates Yang heat lodging in the chest. Fright indicates the Heart dislikes heat and Spirit is unsettled. Dysuria indicates interior deficiency with fluid stagnation. Delirium indicates Stomach heat. Whole-body heaviness/inability to turn indicates Yang Qi circulating internally rather than nourishing the exterior. Chaihu Tang removes chest fullness/irritability. Adding Longgu, Muli, and Qiandan收敛s Spirit and calms fright. Fuling moves fluids and promotes urination. Dahuang drives Stomach heat and stops delirium. Guizhi circulates Yang Qi and resolves heaviness. Mixed pathogens are thus cured.
Chaihu Jia Longgu Muli Tang Formula:
Banxia (Two he, washed) Dazao (Six pieces, broken) Chaihu (Four liang) Shengjiang (One and a half liang, sliced) Renshen (One and a half liang. Zhao edition includes Huangqin one liang) Longgu (One and a half liang) Qiandan (One and a half liang) Guizhi (One and a half liang, peeled) Fuling (One and a half liang) Dahuang (Two liang) Muli (One and a half liang, roasted)
The above eleven herbs, with eight sheng of water, are decocted to yield four sheng. Add sliced Dahuang, boil one or two boils. Remove dregs, take one sheng warm.
Shanghan with abdominal fullness and delirium, with floating/tight Cun Kou pulse, indicates Liver attacking Spleen, termed "Zong" (Vertical). Acupuncture Qimen.
Abdominal fullness and delirium are Spleen/Stomach diseases. Floating/tight pulse is Liver pulse. Spleen disease showing Liver pulse indicates Wood attacking Earth. The Classics state: Water attacking Fire, Wood attacking Earth, is termed "Zong." Qimen is the Front-Mu point of the Liver; acupuncture drains excess Liver Qi.
Shanghan with fever, aversion to cold, extreme thirst for water, abdominal fullness, spontaneous sweating, and free urination indicates impending resolution. This is Liver attacking Lung, termed "Heng" (Horizontal). Acupuncture Qimen.
Fever and aversion to cold are Lung disease. Extreme thirst indicates Liver Qi excess. The *Yufan* states: Thirst for vinegar broth confirms Liver excess. Thirst in Shanghan indicates recovery. If unresolved with abdominal fullness, Liver attacks Lung, blocking water movement. The Classics state: Wood attacking Metal is "Heng." Acupuncture Qimen drains Liver excess. Harmonizing Liver/Lung allows water dispersion and fluid circulation. Spontaneous sweating and free urination indicate resolution.
On the second day of Taiyang syndrome, irritability is abnormal. Moxibustion/fanning on the back causes profuse sweating. Heat enters the Stomach, drying fluids. Irritability and delirium ensue. After ten-plus days, chills and spontaneous diarrhea indicate impending resolution. Sweat below the waist fails to appear. Urination is difficult. Vomiting occurs. Incontinence and cold feet indicate Qi deficiency below. Dry stool and frequent but scanty urination occur due to fluid diversion. The Classics state: Frequent urination leads to dry stool. Here, internal heat dries fluids, preventing downward flow, so urination is not frequent/scanty. As heat subsides and fluids harmonize, dry stool moistens and passes. Upon defecation, sudden head pain occurs because Yang Qi previously blocked from descending now drops, leaving Head Yang deficient. Gu Qi (Grain Qi) is Yang Qi. Previously, blocked Yang caused cold feet; now, descending Yang warms the soles.
Taiyang Wind-strike treated with fire-induced sweating causes wind and fire to scorch blood/Qi, disrupting normal flow. Two Yangs scorching each other causes jaundice. Excess Yang causes epistaxis; Yin deficiency causes dysuria. Exhaustion of blood/Qi leads to dryness. Only head sweats up to the neck because heat flares upward, affecting Yang but not Yin. Abdominal fullness/mild wheezing indicates internal heat stagnation. Dry mouth/throat ulceration indicates heat flaming upward. Constipation may occur if heat consumes fluids. Prolonged heat causes delirium. Severe cases cause hiccups. Restlessness and picking at clothes indicate extreme heat disturbing limbs. Free urination indicates treatability as fluids are not exhausted.
Wind is Yang pathogen; combined with fire, it intensifies. Blood/Qi flows excessively. Epistaxis results from heat forcing blood upward; dysuria from internal heat consuming Yin. Dryness results from blood/Qi depletion. Head-only sweat indicates heat affecting Yang meridians (to neck) but not Yin meridians (to chest). Abdominal fullness/wheezing is internal heat. Dry mouth/throat is heat flaming up. Constipation depends on heat location. Delirium results from prolonged Stomach heat. Hiccups indicate deep disease and rebellious Qi. Limb restlessness indicates extreme Yang heat. Free urination indicates recoverability.
Shanghan with floating pulse, treated with fire-induced sweating, causes Yang loss. Palpitations, mania, and restlessness occur. Treat with Guizhi Qu Shaoyao Jia Shuji Muli Longgu Jiuni Tang.
Floating pulse indicates exterior pathogen. Fire-induced sweating causes excessive loss of Yang. Sweat is Heart fluid. Yang loss weakens Heart Qi. Heart dislikes heat; fire forces Spirit outward, causing palpitations/mania/restlessness. Guizhi Tang resolves remaining exterior pathogen. Removing Shaoyao avoids Yin-nourishing properties unsuitable for Yang loss. Adding Shuji disperses rebellious fire. Adding Longgu/Muli astringes and secures lost Yang. The *Ben Cao* states: Astringents treat collapse.
Guizhi Qu Shaoyao Jia Shuji Muli Longgu Jiuni Tang Formula:
Guizhi (Three liang, peeled) Gancao (Two liang, roasted) Shengjiang (Three liang, sliced) Muli (Five liang, roasted. Sour, salty) Longgu (Four liang. Sweet, neutral) Dazao (Twelve pieces, broken) Shuji (Three liang, washed. Pungent, neutral)
The above seven herbs, with twelve dou of water, boil Shuji first, reducing by two dou. Add other herbs, decoct to three sheng. Remove dregs, take one sheng warm.
Appearance resembling Shanghan, but pulse is weak rather than string-tight. Weak pulse indicates thirst. Fire treatment causes delirium. Weak pulse with fever and floating indicates pathogen returning to exterior; sweating resolves it.
Resembling Shanghan means headache and fever. Absence of string-tight pulse rules out exterior Shanghan. Classics state: Weak pulse with fever indicates interior heat, hence thirst. Fire adds heat, combining with Stomach heat to cause delirium. Floating pulse indicates pathogen returning to exterior; sweating resolves it.
Taiyang syndrome treated with fire fumigation without sweating causes irritability. If unresolved by the seventh day, hematochezia occurs, termed "Fire Pathogen."
This is fire forcing blood downward. Lack of sweating traps heat. Yin deficiency plus fire causes irritability. By the seventh day, heat should resolve. If not, heat forces blood downward, causing rectal bleeding.
Floating pulse with severe heat, treated with moxibustion, is an excess condition treated as deficiency. Fire agitates blood, causing dry throat and spitting blood.
This is fire forcing blood upward. Floating/severe heat is exterior excess. Mistaking it for deficiency and applying fire agitates blood upward, causing dry throat and hemoptysis.
Weak-rapid pulse contraindicates moxibustion. Fire becomes pathogen, causing irritability/rebellion. It pursues deficiency and exaggerates excess. Blood scatters in vessels. Though fire is subtle, its internal attack is powerful, scorching bones and injuring sinews, making blood recovery difficult.
Weak-rapid pulse indicates heat. Moxibustion dispels cold but cannot clear heat. Applying it exacerbates heat, causing irritability. Moxibustion treats deficiency but here aggravates excess heat, damaging blood. Qi warms, Blood moistens; scattering prevents nourishment of bones/sinews, causing scorching/injury and difficult blood recovery.
Floating pulse requires sweating. Moxibustion blocks pathogen exit. Fire strengthens pathogen. Disease becomes heavy/numb below the waist, termed "Fire Reversal."
Floating pulse is exterior; requires sweating. Moxibustion fails to induce sweat. Pathogen trapped, aided by fire, increases heat. Upper body corresponds to Heaven/Yang; lower to Earth/Yin. Fire flares upward, leaving Yin dominant below, causing heaviness/numbness below waist.
Spontaneous resolution begins with irritability, followed by sweating. How do we know? Floating pulse indicates pathogen returning to exterior; sweating resolves it.
Irritability is heat. Pathogen returning to exterior causes irritability/heat; sweating resolves it. Floating pulse confirms pathogen return.