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，
（赵本有“桂枝加桂汤方”详见本书卷十）更加桂二两。（赵本有“也”字）
烧针发汗，则损阴血，而惊动心气。针处被寒，气聚而成核。心气因惊而虚，肾气乘寒气而动，发为
奔豚。《金匮要略》曰∶病有奔豚，从惊发得之。肾气欲上乘心，故其气从少腹上
冲心也。先灸核上，以散其寒，与桂枝加桂汤，以泄奔豚之气。
火逆，下之，因烧针烦躁者，桂枝甘草龙骨牡蛎汤主之。
先火为逆，复以下除之，里气因虚，又加烧针，里虚而为火热所烦，故生烦躁，与桂枝甘草龙骨牡蛎汤以散火邪。
桂枝甘草龙骨牡蛎汤方∶
桂枝（一两，赵本有“去皮”二字） 甘草（二两，赵本有“炙”字） 牡蛎（二两，熬） 龙骨（二两）
辛甘发散，桂枝、甘草之辛甘，以发散经中之火邪；涩可去脱，龙骨、牡蛎之涩，以收敛浮越之正气。
上为末，（赵本作“四味”）以水五升，煮取二升半，去滓，温服八合，日三服。
太阳伤寒者，加温针，必惊也。
寒则伤荣。荣气微者，加烧针，则血留不行。惊者温针，损荣血而动心气。《金匮要略》曰∶血气少者属于心。
太阳病，当恶寒发热，今自汗出，（赵本有“反”字）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，以医吐之所致也，此为小逆。
恶寒发热，为太阳表病；自汗出，不恶寒发热者，阳明证。本太阳表病，医反吐之，伤动胃气，表邪乘
虚传于阳明也。以关脉细数，知医吐之所致。病一二日，为表邪尚寒而未成热，
吐之则表寒传于胃中，胃中虚寒，故腹中饥而口不能食。病三四日，则表邪已传成热，吐之，则表热乘虚
入胃，胃中虚热，故不喜糜粥，欲食冷食，朝食暮吐也。朝食暮吐者，晨食入胃，胃虚不能克化，即知，至暮
胃气行里，与邪气相搏，则胃气反逆，而以胃气尚在，故止云小逆。
太阳病吐之，但太阳病当恶寒，今反不恶寒，不欲近衣，此为吐之内烦也。
太阳表病，医反吐之，伤于胃气，邪热乘虚入胃，胃为邪热内烦，故不恶寒，不欲近衣也。
病患脉数，数为热，当消谷引食，而反吐者，此以发汗，令阳气微，膈气虚，脉乃数也。数为客热，
不能消谷，以胃中虚冷，故吐也。
阳受气于胸中，发汗外虚阳气，是令阳气微、膈气虚也。数为热本，热则合消谷，客热则不能消谷，
因发汗外损阳气，致胃中虚冷，故吐也。
太阳病，过经十余日，心下温温欲吐，而胸中痛，大便反溏，腹微满，郁郁微烦。先此时，自极吐
下者，与调胃承气汤。若不尔者，不可与。但欲呕，胸中痛，微溏者，此非柴胡（赵本有“汤”字）证，以
呕故知极吐下也。
心下温温欲吐，郁郁微烦，胸中痛，当责邪热客于胸中。大便反溏，腹微满，则邪热已下于胃也。日
数虽多，若不经吐下，止是传邪，亦未可下，当与柴胡汤，以除上中二焦之邪。若曾吐下，伤损胃气，胃虚则
邪乘虚入胃为实，非柴胡汤所能去，（医统本有“与”字）调胃承气汤下胃热。以呕，知胃气先曾伤动也。
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，少腹当硬满，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。
太阳，经也。膀胱，腑也。此太阳随经入腑者也。六七日邪气传里之时，脉微而沉，邪气在里之脉也。
表证仍在者，则邪气犹浅，当结于胸中；若不结于胸中，其人发狂者，热结在膀胱也。经曰∶热结膀胱，其
人如狂。此发狂则热又深也。少腹硬满，小便不利者，为无血也；小便自利者，血证谛也，与抵当汤以下蓄血。
抵当汤方∶
水蛭（三十个，熬。味咸，苦寒） 虻虫（三十个，熬，去翅足。味苦，微寒） 桃人（赵本作仁，二十
个，去皮尖。味苦甘，平） 大黄（三两，酒浸，赵本作洗。味苦寒）
苦走血，咸胜血，虻虫、水蛭之咸苦，以除蓄血。甘缓结，苦泄热，桃人、大黄之苦，以下结热。
上四味为末，（赵本无“为末”二字）以水五升，煮取三升，去滓，温服一升，不下再（赵本作“更”）服。
太阳病，身黄脉沉结，少腹硬，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。
身黄脉沉结，少腹硬，小便不利者，胃热发黄也，可与茵陈汤。身黄，脉沉结，少腹硬，小便自利，其
人如狂者，非胃中瘀热，为热结下焦而为蓄血也，与抵当汤以下蓄血。
伤寒有热，少腹满，应小便不利；今反利者，为有血也，当下之，不可余药，宜抵当丸。
伤寒有热，少腹满，是蓄血于下焦；若热蓄津液不通，则小便不利，其热不蓄津液而蓄血不行，小便自
利者，乃为蓄血，当与桃人承气汤、抵当汤下之。然此无身黄屎黑，又无喜忘发
狂，是未至于甚，故不可余快峻之药也，可与抵当丸，小可下之也。
抵当丸方∶
水蛭（二十个，赵本有“熬”字。味苦寒） 虻虫（二十五个，赵本作二十个，去翅足，熬。味苦，
微寒） 桃人（人赵本作仁，二十个，赵本有“五”字，去皮尖） 大黄（三两）
上四味，杵（赵本作“捣”）分为（赵本无“为”字）四丸，以水一升，煮一丸，取七合服之， 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。
饮水多而小便自利者，则水不内蓄，但腹中水多，令心下悸。《金匮要略》曰∶食少饮多，水停心下，
甚者则悸。饮水多而小便不利，则水蓄于内而不行，必苦里急也。
If moxibustion needles (a heat therapy method involving heating the needle) are used to induce sweating, and the puncture site is exposed to cold, resulting in nodular redness and swelling, Ben Tun (Rushing Pig Disease) will inevitably occur. The symptom manifests as Qi rushing from the lower abdomen up to the heart and chest. In this case, apply one moxa cone on each nodule, and administer Guizhi Jia Gui Tang (Cinnamon Twig Decoction with Added Cinnamon Twig). (The Zhao edition contains "Guizhi Jia Gui Tang Formula," see Volume 10 of this book), adding two liang of Guizhi (Cinnamon Twig). (The Zhao edition has an additional character "ye" [also]).
Using burning needles to induce sweating damages Yin Blood and startles Heart Qi. Cold at the puncture site causes Qi to gather and form nodules. Because Heart Qi is weakened by the startle, Kidney Qi takes advantage of the cold pathogen to move, triggering Ben Tun. *Jingui Yaolue* states: Ben Tun arises from being startled. Since Kidney Qi desires to ascend to the Heart, Qi rushes from the lower abdomen to the heart and chest. First, moxa the nodules to disperse the cold; administer Guizhi Jia Gui Tang to drain the Qi of Ben Tun.
If fire therapy leads to adverse reactions, followed by erroneous purgation, and subsequent restlessness due to burning needles, the primary treatment is Guizhi Gancao Longgu Muli Tang (Cinnamon Twig, Licorice, Dragon Bone, and Oyster Shell Decoction).
Fire therapy was previously an adverse treatment; using purgation afterward depleted Interior Qi. Adding burning needles further depletes the Interior, causing restlessness due to Heat disturbing the deficiency. Administer Guizhi Gancao Longgu Muli Tang to dissipate the Fire pathogen.
Formula for Guizhi Gancao Longgu Muli Tang:
Guizhi (Cinnamon Twig) (one liang, Zhao edition specifies "remove bark") Gancao (Licorice Root) (two liang, Zhao edition specifies "honey-fried") Muli (Oyster Shell) (two liang, cooked/roasted) Longgu (Dragon Bone/Fossilized Bone) (two liang)
Pungent and Sweet flavors disperse outward. The pungent and sweet properties of Guizhi and Gancao dissipate Fire pathogens within the channels. Astringency prevents collapse. The astringent nature of Longgu and Muli converges floating and hyperactive Zheng Qi (Upright Qi).
Grind the above four ingredients into powder. (Zhao edition says "four ingredients"). Boil in five sheng of water until reduced to two and a half sheng. Remove dregs. Warm dose eight he. Take three times daily.
In Taiyang Shanghan (Cold Damage Syndrome of the Taiyang Channel), applying warm needles will inevitably cause fright.
Cold injures Ying Qi (Nutritive Qi). If Ying Qi is weak and burning needles are applied, blood stasis occurs. Fright results because warm needles damage Ying Blood and disturb Heart Qi. *Jingui Yaolue* states: Deficiency of Blood and Qi belongs to the Heart.
Taiyang disease should present with aversion to cold and fever. Now, if there is spontaneous sweating, without aversion to cold or fever, and the Guan pulse is fine and rapid, this is the fault of the physician using emesis.
If emesis is used on days one or two of illness, the patient feels hungry in the abdomen but cannot eat. If emesis is used on days three or four, the patient dislikes congee, desires cold food, and vomits what was eaten in the morning by evening. This is caused by the physician's erroneous use of emesis, constituting a minor adverse reaction (Xiao Ni).
Aversion to cold and fever indicates Taiyang Exterior syndrome. Spontaneous sweating without aversion to cold or fever indicates Yangming syndrome. Originally a Taiyang Exterior syndrome, the physician erroneously used emesis, damaging Stomach Qi, allowing Exterior pathogens to transmit into Yangming due to deficiency. The fine and rapid Guan pulse indicates this was caused by erroneous emesis. On days one or two, the Exterior pathogen is still cold and not yet transformed into heat. Emesis transmits Exterior cold into the Stomach, causing Stomach deficiency-cold, hence hunger but inability to eat. By days three or four, the Exterior pathogen has transmitted and transformed into heat. Emesis allows Exterior heat to enter the Stomach due to deficiency, causing Stomach deficiency-heat, hence dislike of congee, desire for cold food, and vomiting morning food by evening. Morning food vomited by evening occurs because morning food enters the Stomach, which is too weak to digest it. By evening, Stomach Qi moves inward and clashes with the pathogen, causing Stomach Qi to rebel upward. However, since Stomach Qi remains, it is called only a minor adverse reaction.
If emesis is used for Taiyang disease, although Taiyang disease typically involves aversion to cold, now there is no aversion to cold and a desire not to wear clothes. This is internal vexation caused by erroneous emesis.
Taiyang Exterior syndrome treated erroneously with emesis damages Stomach Qi. Pathogenic heat enters the Stomach due to deficiency, causing internal vexation in the Stomach. Thus, there is no aversion to cold and a desire not to wear clothes.
If the patient has a rapid pulse, rapidity indicates heat, which should promote digestion and appetite, yet vomiting occurs instead. This is because sweating induced slight Yang Qi and emptiness of Diaphragm Qi, resulting in a rapid pulse. This rapidity represents guest heat, which cannot digest food, due to Stomach deficiency-cold, hence vomiting.
Yang Qi receives Qi in the chest. Sweating causes exterior deficiency of Yang Qi, leading to slight Yang Qi and empty Diaphragm Qi. Rapidity is originally a sign of heat, which promotes digestion. Guest heat cannot digest food. Due to sweating damaging exterior Yang Qi, Stomach deficiency-cold results, causing vomiting.
After more than ten days of Taiyang disease, if the patient feels nauseous with warmth in the epigastrium, suffers chest pain, has loose stools, and mild abdominal fullness, along with slight depression and vexation: if prior to these symptoms the patient had undergone severe emesis or purgation, administer Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction). If not, do not administer it. If there is only slight desire to vomit, chest pain, and loose stools, this is not Chaihu syndrome. The vomiting indicates severe prior emesis or purgation.
Nausea with warmth in the epigastrium, slight depression and vexation, and chest pain suggest pathogenic heat lodged in the chest. Loose stools and mild abdominal fullness indicate pathogenic heat has moved downward to the Stomach. Although many days have passed, if no emesis or purgation occurred, it is merely transmitted pathogen, and purgation is not indicated. Chaihu Tang should be given to clear pathogens in the Upper and Middle Jiao. If emesis or purgation occurred, Stomach Qi was damaged. Stomach deficiency allows pathogens to enter and become excess. Chaihu Tang cannot remove this; Tiaowei Chengqi Tang is needed to purge Stomach heat. Vomiting indicates prior damage to Stomach Qi.
On the sixth or seventh day of Taiyang disease, if Exterior signs remain, the pulse is faint and deep, there is no Jie Xiong (Chest Binding), but the patient goes mad, this is because Heat is in the Lower Jiao. The lower abdomen should be hard and full. If urination is normal, blood must be evacuated for recovery. This is because Taiyang pathogens followed the channels into the Fu organs, causing stasis-heat in the interior. Didang Tang (Mantis Egg Case Decoction) is the primary treatment.
Taiyang refers to the channels; Bladder refers to the Fu organ. This is Taiyang pathogens entering the Fu organ via the channels. On days six or seven, when pathogens transmit to the interior, a faint and deep pulse indicates interior pathogens. If Exterior signs remain, pathogens are still shallow and should bind in the chest. If they do not bind in the chest but the patient goes mad, Heat binds in the Bladder. The classic states: Heat binding in the Bladder causes the patient to act like a madman. Here, going mad indicates deeper heat. Lower abdominal hardness and fullness with difficulty urinating indicate no blood stasis; normal urination confirms blood stasis. Didang Tang is administered to purge accumulated blood.
Formula for Didang Tang:
Shuizhi (Leech) (thirty pieces, roasted. Salty, bitter, cold) Mengchong (Dragonfly Larva) (thirty pieces, roasted, wings and feet removed. Bitter, slightly cold) Taoren (Peach Seed) (twenty pieces, Zhao edition writes Ren, skin and tips removed. Bitter, sweet, neutral) Dahuang (Rhubarb Root) (three liang, soaked in wine, Zhao edition writes washed. Bitter, cold)
Bitter enters Blood; Salty overcomes Blood. The salty and bitter nature of Mengchong and Shuizhi removes accumulated blood. Sweet moderates binding; Bitter drains heat. The bitter nature of Taoren and Dahuang purges bound heat.
Grind the above four ingredients. (Zhao edition lacks "grind into powder"). Boil in five sheng of water until reduced to three sheng. Remove dregs. Warm dose one sheng. If blood is not evacuated, take again.
In Taiyang disease, if the body is yellow, pulse is deep and knotted, lower abdomen is hard, and urination is difficult, there is no blood stasis. If urination is normal and the patient acts like a madman, blood stasis is confirmed. Didang Tang is the primary treatment.
Body yellow, deep and knotted pulse, hard lower abdomen, and difficult urination indicate Yellowing due to Stomach Heat. Yinchen Tang may be given. Body yellow, deep and knotted pulse, hard lower abdomen, normal urination, and acting like a madman indicate not Stomach stasis-heat, but Heat binding in the Lower Jiao causing accumulated blood. Didang Tang is given to purge accumulated blood.
In Shanghan with fever and lower abdominal fullness, urination should be difficult. If urination is now normal, there is blood stasis. It must be purged. Do not use other medicines; Didang Wan (Mantis Egg Case Pill) is appropriate.
Fever and lower abdominal fullness in Shanghan indicate accumulated blood in the Lower Jiao. If heat accumulates fluids preventing flow, urination is difficult. If heat does not accumulate fluids but accumulates blood preventing flow, and urination is normal, it is accumulated blood. Tao Ren Cheng Qi Tang or Didang Tang should be used to purge. However, this case lacks body yellow, black stool, forgetfulness, or madness, indicating the condition is not severe. Therefore, overly harsh drugs are contraindicated. Didang Wan is given for mild purgation.
Formula for Didang Wan:
Shuizhi (Leech) (twenty pieces, Zhao edition has "roasted". Bitter, cold) Mengchong (Dragonfly Larva) (twenty-five pieces, Zhao edition twenty pieces, wings and feet removed, roasted. Bitter, slightly cold) Taoren (Peach Seed) (Zhao edition writes Ren, twenty pieces, Zhao edition has "five", skin and tips removed) Dahuang (Rhubarb Root) (three liang)
Grind the above four ingredients. (Zhao edition writes "pound"). Divide into four pills. Boil one pill in one sheng of water until reduced to seven she. Take. At that time, blood should be evacuated. If not, take again.
In Taiyang disease, if urination is free, excessive drinking will likely cause palpitations in the epigastrium. If urination is scanty, there will be distressing urgency in the interior.
If drinking is excessive and urination is free, water does not accumulate internally. Excess water in the abdomen causes palpitations in the epigastrium. *Jingui Yaolue* states: Eating little and drinking much causes water to stop in the epigastrium; severely, it causes palpitations. If drinking is excessive and urination is difficult, water accumulates internally and does not circulate, causing distressing urgency in the interior.