但头汗出，身无汗，剂颈而还者，热不得越也；小便不利，渴引水浆者，热甚于胃，津液内竭也；胃
为土而色黄，胃为热蒸，则色夺于外，必发黄也。与茵陈汤，逐热退黄。
茵陈蒿汤方∶
茵陈蒿（六两。苦微寒） 栀子（十四枚，擘。苦寒） 大黄（二两，去皮。苦寒）
小热之气，凉以和之；大热之气，寒以取之。茵陈、栀子之苦寒，以逐胃燥；宜下必以苦，宜补必
以酸。大黄之苦寒，以下瘀热。
上三味，以水一斗，（赵本医统本并有“二升”二字）先煮茵陈，减六升，内二味，煮取三升，去滓，
分温（赵本无“温”字）三服，小盒饭利，尿如皂角（赵本作“荚”）汁状，色正赤，一宿
腹减，黄从小便去也。
阳明证，其人喜忘者，必有蓄血。所以然者，本有久瘀血，故令喜忘，屎虽硬，大便反易，其色必黑，（
赵本有“者”字）宜抵当汤下之。（赵本有“抵当汤方”详见卷三）
《内经》曰∶血并于下，乱而喜忘，此下本有久瘀血，所以喜忘也。津液少，大便硬，以蓄血在内。屎
虽硬，大便反易，其色黑也。与抵当汤，以下瘀血。
阳明病，下之，心中懊 而烦，胃中有燥屎者可攻。腹微满，初头硬，后必溏，不可攻之。若有燥屎
者，宜大承气汤。
下后，心中懊 而烦者，虚烦也，当与栀子豉汤。若胃中有燥屎者，非虚烦也，可与大承气汤下之。其
腹微满，初硬后溏，是无燥屎，此热不在胃而在上也，故不可攻。
病患不大便五六日，绕脐痛，烦躁，发作有时者，此有燥屎，故使不大便也。
不大便五六（医统本作“六七”）日者，则大便必结为燥屎也。胃中燥实，（医统本作其）气不得下通，故
绕脐痛，烦躁，发作有时也。
病患烦热，汗出则解，又如疟状，日晡所发热者，属阳明也。脉实者宜下之；脉浮虚者，宜发汗。下之
与大承气汤，发汗宜桂枝汤。
虽得阳明证，未可便为里实，审看脉候，以别内外。其脉实者，热已入腑为实，可与大承气汤下之；其
脉浮虚者，是热未入腑，犹在表也，可与桂枝汤，发汗则愈。
大下后，六七日不大便，烦不解，腹满痛者，此有燥屎也。所以然者，本有宿食故也，宜大承气汤。
大下之后，则胃弱不能消谷，至六七日不大便，则宿食已
结不消，故使烦热不解而腹满痛，是知有燥屎也。与大承气汤以下除之。
病患小便不利，大便乍难乍易，时有微热，喘冒不能卧者，有燥屎也，宜大承气汤。
小便利，则大便硬；此以有燥屎，故小便不利，而大便乍难乍易。胃热者，发热，喘冒无时及嗜卧也；此
燥屎在胃，故时有微热，喘冒不得卧也，与大承气汤以下燥屎。
食谷欲呕者，（赵本无“者”字）属阳明也，吴茱萸汤主之。得汤反剧者，属上焦也。
上焦主内，胃为之市，食谷欲呕者，胃不受也，与吴茱萸汤以温胃气。得汤反剧者，上焦不内也，以治
上焦法治之。
吴茱萸汤方∶
吴茱萸（一升，洗。辛热） 人参（三两。甘温） 生姜（六两，切。辛温） 大枣（十二枚，擘。甘温）
《内经》曰∶寒淫于内，治以甘热，佐以苦辛。吴茱萸、生姜之辛以温胃，人参、大枣之甘以缓脾。
上四味，以水七升，煮取二升，去滓，温服七合，日三服。
太阳病，寸缓、关浮、尺弱，其人发热汗出，复恶寒，不呕，但心下痞者，此以医下之也。如其不下者，
病患不恶寒而渴者，此转属阳明也。小便数者，大便必硬，不更衣十日，无所苦也。渴欲饮水，少少与之，
但以法救之。渴者，宜五苓散。（赵本有“五苓散方”详见卷三）
太阳病脉阳浮阴弱，为邪在表；今寸缓、关浮、尺弱，邪气渐传里，则发热汗出，复恶寒者，表未解
也。传经之邪入里，里不和者必呕；此不呕但心下痞者，医下之早，邪气留于心下也。
如其不下者，必渐不恶寒而渴，太阳之邪转属阳明也。若吐、若下、若发汗后，小便数，大便硬者，当与小
承气汤和之；此不因吐下、发汗后，小便数，大便硬，若是无满实，虽不更衣十日无所苦也，候津液还入胃
中，小便数少，大便必自出也。渴欲饮水者，少少与之，以润胃气，但审邪气所在，以法救之。如渴
不止，与五苓散是也。
脉阳微而汗出少者，为自和（赵本注∶“一作如”）也；汗出多者，为太过。
脉阳微者，邪气少，汗出少者为适当，故自和；汗出多者，反损正气，是汗出太过也。
阳脉实，因发其汗出多者，亦为太过。太过（赵本有“者”字）为阳绝于里，亡津液，大便因硬也。
阳脉实者，表热甚也。因发汗，热乘虚蒸（医统本作“ ”）津液外泄，致汗出太过。汗出多者，亡
其阳，阳绝于里，肠胃干燥，大便因硬也。
脉浮而芤，浮为阳，芤为阴，浮芤相搏，胃气生热，其阳则绝。
浮芤相搏，阴阳不谐，胃气独治，郁而生热，消烁津液，其阳为绝。
趺阳脉浮而涩，浮则胃气强，涩则小便数，浮涩相搏，大便则难，（赵本作“硬”）其脾为约，麻（
赵本有“子”字）仁丸主之。
趺阳者，脾胃之脉，诊浮为阳，知胃气强；涩为阴，知脾为约。约者，俭约之约，又约束之约。《内经》
曰∶饮入于胃，游溢精气，上输于脾，脾气散精，上归于肺，通调水道，下输于膀胱，水精四布，五经并行，
是脾主为胃行其津液者也。今胃强
脾弱，约束津液，不得四布，但输膀胱，致小便数，大便难，与脾约丸，通肠润燥。
麻（赵本有“子”字）仁丸方∶
麻子仁（二升。甘平） 芍药（半斤。酸平） 枳实（半斤，炙。苦寒） 大黄（一斤，去皮。苦寒） 浓
朴（一斤。赵本医统本并作尺，炙，去皮。苦寒。医统本作温） 杏仁（一斤。赵本作升，去皮尖，熬，
别作脂。甘温）
《内经》曰∶脾欲缓，急食甘以缓之。麻仁、杏仁之甘，缓脾而润燥；津液不足，以酸收之，芍药之酸，
以敛津液；肠燥胃强，以苦泄之，枳实、浓朴、大黄之苦，下燥结而泄胃强也。
上六味，为末，炼蜜为丸，桐子大，（赵本作“右六味，蜜和丸，如梧桐子大”）饮服十丸，日三服，
渐加，以知为度。
太阳病三日，发汗不解，蒸蒸发热者，属胃也，调胃承气汤主之。
蒸蒸（医统本作“ ”）者，如热熏蒸，（医统本作“熏 ”）言甚热也。太阳病三日，发汗不解，
则表邪已罢，蒸蒸（医统本作“ ”）发热，胃热为甚，与调胃承气汤下胃热。
伤寒吐后，腹胀满者，与调胃承气汤。
《内经》曰∶诸胀腹大，皆属于热。热在上焦则吐，吐后不解，复腹胀满者，邪热入胃也，与调胃承气
汤下其胃热。
太阳病，若吐、若下、若发汗，（赵本有“后”字）微烦，小便数，大便因硬者，与小承气汤和之愈。
吐下发汗，皆损津液，表邪乘虚传里。大烦者，邪在表也；微烦者，邪入里也。小便数，大便因硬者，
其脾为约也。小承气汤和之愈。
得病二三日，脉弱，无太阳柴胡证，烦躁，心下硬，
至四五日，虽能食，以小承气汤少少与，微和之，令小安，至六日，与承气汤一升。若不大便六七日，小便少
者，虽不能（赵本作“受”）食，（赵本注∶“一云∶不大便”）但初头硬，后必溏，未定成硬，攻之必溏，
须小便利，屎定硬，乃可攻之，宜大承气汤。
《针经》曰∶脉软者，病将下。弱为阴脉，当责邪在里，得病二三日脉弱，是日数虽浅，而邪气已入
里也。无太阳证，为表证已罢；无柴胡证，为无半表半里之证。烦躁心下硬者，邪气内甚也。胃实热甚，则不
能食；胃虚热甚，至四五日虽能食，亦当与小承气汤微和之，至六日则热甚，与大承气汤一升。若
不大便六七日，小便多者，为津液内竭，大便必硬，则可下之。小便少者，则胃中水谷不别，必初硬后溏，
虽不能食，为胃实，以小便少则未定成硬，亦不可攻，须小便利，屎定硬，乃可攻之。
伤寒六七日，目中不了了，睛不和，无表里证，大便难，身微热者，此为实也。急下之，宜大承气汤。（赵
本注∶“一云∶大柴胡汤”）
《内经》曰∶诸脉者，皆属于目。伤寒六七日，邪气入里之时，目中不了了，睛不和者，邪热内甚上熏
于目也。无表里证，大便难者，里实也。身大热者，表热也，身微热者，里热也。《针经》曰∶热病目不明，
热不已者死。此目中不了了，睛不和，则证近危恶也，须急与大承气汤下之。
阳明，（赵本医统本皆有“病”字）发热汗多者，急下之，宜大承气汤。
邪热入腑，外发热汗多者，热迫津液将竭，急与大承气汤以下其腑热。
发汗不解，腹满痛者，急下之，宜大承气汤。
发汗不解，邪热传入腑，而成腹满痛者，传之迅也，是须急下之。
腹满不减，减不足言，当下之，宜大承气汤。
腹满不减，邪气实也。经曰∶大满大实，自可除下之。大承气汤，下其满实。若腹满时减，非内实也，则
不可下。《金匮要略》曰∶腹满时减复如故，此为寒，当与温药。是减不足言也。
阳明少阳合病，必下利，其脉不负者，（赵本有“为”字）顺也；负者，失也。互相克贼，名为负也。
脉滑而数者，有宿食也，当下之，宜大承气汤。
阳明土，少阳木，二经合病，气不相和，则必下利。少阳脉不胜，阳明不负，是不相克为顺也；若少阳
脉胜，阳明脉负者，是鬼贼相克，为正气失也。《脉经》曰∶脉滑者，为病食也。又
曰∶滑数则胃气实。下利者，脉当微厥；今脉滑数，知胃有宿食，与大承气汤以下除之。
病患无表里证，发热七八日，虽脉浮数者，可下之。假令已下，脉数不解，合热则消谷善（赵本医统本皆作
“喜”）饥，至六七日，不大便者，有瘀血，宜抵当汤。
七八日，邪入腑之时，病患无表里证，但发热，虽脉浮数，亦可与大承气汤下之。浮为热客于气，数为热
客于血，下之，邪热去，而浮数之脉，俱当解。若下后，数脉去而脉但浮，则是荣血间热并于卫气间也，当
为邪气独留，心中则饥，邪热不杀谷，潮热发渴之证。此下之后，浮脉去而数不解，则是卫气间
热合于荣血间也，热气合并，迫血下行，胃虚协热，消谷善（医统本作“喜”）饥。血至下焦，若大便利者，
下血乃愈。若六七日不大
便，则血不得行，蓄积于下为瘀血，与抵当汤以下去之。
若脉数不解，而下不止，必协热而（赵本无“而”字）便脓血也。
下后，脉数不解，而不大便者，是热不得泄，蓄血于下，为瘀血也。若下后，脉数不解而下利不止者，为
热得下泄，迫血下行，必便脓血。
伤寒，发汗已，身目为黄，所以然者，以寒湿（赵本注∶“一作温”）在里，不解故也。以为不可下
也，于寒湿中求之。
《金匮要略》曰∶黄家所起，从湿得之。汗出热去，则不能发黄。发汗已，身目为黄者，风气去湿气在
也。脾恶湿，湿气内着，脾色外夺者，身目为黄。若瘀血在里发黄者，则可下；此以寒湿在里，故不可下，
当从寒湿法治之。
伤寒七八日，身黄如橘子色，小便不利，腹微满者，茵陈蒿汤主之。
当热甚之时，身黄如橘子色，是热毒发泄于外。《内经》曰∶膀胱者，津液藏焉，气化则能出。小便不
利，小腹满者，热气甚于外而津液不得下行也，与茵陈汤，利小便，退黄逐热。
伤寒身黄发热者，（赵本无“者”字）栀子柏皮汤主之。
伤寒身黄，胃有瘀热，当须下去之；此以发热，为热未实，与栀子柏皮汤解散之。
栀子柏皮汤∶
（赵本“栀子上”有“肥”字）栀子（一十五个。赵本医统本皆有“擘”字。苦寒） 甘草（一两。
赵本有“炙”字。甘平） 黄柏（二两）
上三味，以水四升，煮取一升半，去滓，分温再服。
伤寒瘀热在里，身必发（赵本无“发”字）黄，麻黄连轺赤小豆汤主之。
湿热相交，民多病瘅。瘅，黄也。伤寒为寒湿在表，发黄为瘀热在里，与麻黄连轺赤小豆汤除热散湿。
麻黄连轺赤小豆汤方∶
麻黄（二两，去节。甘温） 赤小豆（一升。甘平） 连轺（二两，连翘根也。赵本作是。苦寒） 杏仁
（四十个，去皮尖。甘温） 大枣（十二枚。赵本医统本皆有“擘”字。甘温） 生梓白皮（一升。赵
本有“切”字。苦寒） 生姜（二两，切。辛温） 甘草（二两，炙。甘平）
《内经》曰∶湿上甚而热，治以苦温，佐以甘辛，以汗为故止。此之谓也。又煎用潦水者，亦取其水味
薄，则不助湿气。
以上（赵本医统本皆作“右”）八味，以潦水一斗，先煮麻黄再沸，去上沫，内诸药，煮取三升，（赵本
有“去滓”二字）分温三服，半日服尽。
Only the head sweats, the body has no sweat, and the sweating stops at the neck; this is because the heat cannot diffuse outward. If urination is difficult and there is thirst prompting the intake of water or fluids, it indicates that the heat is severe in the Stomach and the body fluids are exhausted internally. The Stomach belongs to Earth and its color is yellow. When the Stomach is steamed by heat, the color is revealed externally, leading to jaundice. Administer Yinchen Tang (Cinchona Decoction) to eliminate heat and resolve jaundice.
Yinchen Hao Tang Formula:
Yin Chen Hao (Artemisiae Scopariae Herba, six liang, bitter, slightly cold) Zhi Zi (Gardeniae Fructus, fourteen seeds, broken open, bitter, cold) Da Huang (Rhei Radix et Rhizoma, two liang, peeled, bitter, cold)
For mild heat qi, use cool properties to harmonize it; for severe heat qi, use cold properties to drain it. The bitter and cold nature of Yin Chen and Zhi Zi eliminates stomach dryness and heat. When purgation is indicated, bitter drugs must be used; when tonification is indicated, sour drugs must be used. The bitter and cold nature of Da Huang drains stagnant heat.
Take the above three herbs, add ten dou of water, (Zhao edition and Yitong edition have an additional "two sheng") first decoct Yin Chen until the volume reduces by six sheng, then add the other two herbs, decoct to obtain three sheng of liquid, remove the dregs, divide into three warm doses. Urination should become smooth, urine resembling soap pod juice with a reddish color. After one night, abdominal distension decreases, and the jaundice exits via urination.
In Yangming syndrome, if the patient suffers from forgetfulness, there must be blood stasis. This is because there was pre-existing long-standing blood stasis, causing forgetfulness. Although the stool is hard, defecation is surprisingly easy, and the color is definitely black, (Zhao edition has the character "zhe") so Didang Tang (Ephedra and Asari Decoction) is suitable for purgation. (Zhao edition has "Didang Tang Formula" detailed in Volume 3).
The *Neijing* states: "When blood gathers below, confusion and forgetfulness occur." This is due to pre-existing long-standing blood stasis below, hence the forgetfulness. With insufficient body fluids, the stool becomes hard due to blood stasis inside. Although the stool is hard, defecation is easier, and the color is black. Administer Didang Tang to purge the blood stasis.
In Yangming disease, after purgation, if the patient feels inner restlessness (*aoni*) and irritability, and there is dry feces in the Stomach, purgation is permissible. If there is slight abdominal fullness, with the stool hard at the beginning but loose later, purgation is forbidden. If there is dry feces, Dachengqi Tang (Major Order the Qi Decoction) is suitable.
After purgation, if there is inner restlessness (*aoni*) and irritability, it is empty irritability (*xufan*), and Zhizi Chi Tang (Gardenia and Soybean Malt Decoction) should be given. If there is dry feces in the Stomach, it is not empty irritability, and Dachengqi Tang can be used for purgation. If there is slight abdominal fullness with hard initial stool and loose later stool, there is no dry feces; the heat is not in the Stomach but above, so purgation is contraindicated.
If the patient has not had a bowel movement for five to six days, has periumbilical pain, irritability, and symptoms occurring at specific times, this indicates dry feces, which causes the constipation.
If there is no bowel movement for five (Yitong edition says "six or seven") days, the stool must have formed dry feces. Due to dryness and excess in the Stomach, (Yitong edition says "its") qi cannot descend smoothly, causing periumbilical pain, irritability, and timed episodes.
If the patient has irritability and heat, relief occurs with sweating, but symptoms resemble malaria with afternoon fever (*ribu suo fa re*), this belongs to Yangming. If the pulse is solid, purgation is indicated; if the pulse is floating and deficient, diaphoresis is indicated. For purgation, use Dachengqi Tang; for diaphoresis, Guizhi Tang (Cinnamon Twig Decoction) is suitable.
Even if Yangming syndrome is present, one cannot immediately assume interior excess. Carefully examine the pulse to distinguish between exterior and interior. A solid pulse indicates heat has entered the Fu organs becoming excess; Dachengqi Tang can be administered for purgation. A floating and deficient pulse indicates heat has not entered the Fu organs and remains in the exterior; Guizhi Tang can be given, and diaphoresis will lead to recovery.
After severe purgation, if six or seven days pass without a bowel movement, irritability does not resolve, and there is abdominal fullness and pain, this indicates dry feces. This is because there was pre-existing retained food, so Dachengqi Tang is suitable.
After severe purgation, the Stomach becomes weak and unable to digest food. By the sixth or seventh day, without a bowel movement, the retained food has condensed and cannot be digested, causing unresolved irritability and heat, and abdominal fullness and pain. Thus, dry feces are known to exist. Dachengqi Tang is given to purge and eliminate them.
If the patient has difficult urination, alternating difficulty and ease of defecation, occasional slight fever, wheezing, dizziness, and inability to lie down, this indicates dry feces, and Dachengqi Tang is suitable.
When urination is free, the stool becomes hard. Here, due to dry feces, urination is difficult, and defecation alternates between difficulty and ease. Stomach heat causes continuous fever, wheezing, dizziness, and lethargy. Here, dry feces are in the Stomach, causing occasional slight fever, wheezing, dizziness, and inability to lie down. Dachengqi Tang is given to purge the dry feces.
If eating leads to a desire to vomit, (Zhao edition lacks "zhe") it belongs to Yangming, and Wuzhuyu Tang (Evodia Decoction) is the primary treatment. If symptoms worsen after taking the decoction, the pathology is in the Upper Jiao.
The Upper Jiao governs reception; the Stomach is like a market. A desire to vomit after eating means the Stomach rejects it. Wuzhuyu Tang is given to warm Stomach qi. If symptoms worsen after taking the decoction, the Upper Jiao fails to receive; treat according to methods for the Upper Jiao.
Wuzhuyu Tang Formula:
Wu Zhu Yu (Evodiae Fructus, one sheng, washed, acrid, hot) Ren Shen (Ginseng Radix, three liang, sweet, warm) Sheng Jiang (Zingiberis Rhizoma Recens, six liang, sliced, acrid, warm) Da Zao (Jujubae Fructus, twelve seeds, broken open, sweet, warm)
The *Neijing* states: "When cold floods internally, treat with sweet-hot drugs, assisted by bitter-acrid drugs." The acridity of Wu Zhu Yu and Sheng Jiang warms the Stomach; the sweetness of Ren Shen and Da Zao soothes the Spleen.
Take the above four herbs, add seven sheng of water, decoct to obtain two sheng, remove dregs, take seven he of warm dose, three times daily.
In Taiyang disease, if the Cun pulse is slow, Guan pulse floating, and Chi pulse weak, and the patient has fever, sweating, and aversion to cold, but no vomiting, only epigastric stuffiness, this is caused by the physician's inappropriate purgation. If purgation had not occurred, and the patient is not aversive to cold but thirsty, this is transitioning to Yangming. Frequent urination leads to hard stool; even if ten days pass without defecation, there is no discomfort. If thirsty for water, give small amounts frequently, treating according to principles. For thirst, Wuling San (Five-Ingredient Powder with Poria) is suitable. (Zhao edition has "Wuling San Formula" detailed in Volume 3).
Taiyang disease with a floating pulse at Yang and weak pulse at Yin indicates pathogenic factors in the exterior. Now, with slow Cun, floating Guan, and weak Chi pulses, the pathogen is gradually transmitting inward. Fever, sweating, and renewed aversion to cold indicate the exterior is not yet resolved. Pathogens transmitted through meridians entering the interior cause vomiting if interior harmony is lost; here, no vomiting but only epigastric stuffiness indicates premature purgation left the pathogen in the epigastrium.
If purgation had not occurred, the patient would gradually lose aversion to cold and develop thirst, as Taiyang pathogens transition to Yangming. After vomiting, purgation, or diaphoresis, if urination is frequent and stool is hard, Xiaochengqi Tang (Minor Order the Qi Decoction) should be given to harmonize. Here, since it is not post-vomit/purge/sweat, and there is no fullness/excess, even ten days without defecation brings no discomfort. Wait for fluids to return to the Stomach; as urination frequency decreases, stool will pass naturally. For thirst, give small amounts of water to moisten Stomach qi, treating based on pathogen location. If thirst persists, Wuling San is appropriate.
If the Yang pulse is faint and sweating is scant, it is self-harmonizing (Zhao edition note: "one version reads 'ru'"); excessive sweating is too much.
A faint Yang pulse indicates little pathogen; scant sweating is appropriate, hence self-harmony. Excessive sweating damages healthy qi, indicating too much sweating.
If the Yang pulse is solid, and diaphoresis causes excessive sweating, this is also too much. (Zhao edition has "zhe") Too much leads to Yang exhaustion internally, loss of body fluids, and consequently hard stool.
A solid Yang pulse indicates severe exterior heat. Diaphoresis allows heat to vaporize fluids outward, causing excessive sweating. Excessive sweating loses Yang, leading to Yang exhaustion internally, dry intestines/stomach, and hard stool.
A floating and hollow (Kou) pulse: Floating represents Yang, Hollow represents Yin. Their interaction generates heat in Stomach qi, leading to Yang exhaustion.
Floating and hollow interacting means Yin-Yang disharmony; Stomach qi acts alone, generating heat through stagnation, consuming fluids, and exhausting Yang.
At the Zuyang pulse, floating and coarse: Floating indicates strong Stomach qi; coarse indicates frequent urination. Their interaction makes defecation difficult, (Zhao edition reads "hard"), resulting in Spleen Constraint (*Pi Yue*), treated with Mahuang Wan (Hemp Seed Pill).
Zuyang is the pulse of Spleen and Stomach. Floating indicates Yang and strong Stomach qi; coarse indicates Yin and Spleen constraint. "Yue" means restraint or restriction. The *Neijing* states: "Food enters the Stomach, essence floats up, transports to Spleen, Spleen scatters essence to Lungs, regulates water passages, transports to Bladder, fluids distribute everywhere, meridians run together. The Spleen governs transporting fluids for the Stomach." Now, Stomach is strong, Spleen is weak, constraining fluids so they do not distribute but go only to the Bladder, causing frequent urination and difficult defecation. Pi Yue Wan (Spleen Constraint Pill) is given to unblock intestines and moisten dryness.
Mahuang Wan Formula:
Ma Zi Ren (Cannabis Fructus, two sheng, sweet, neutral) Shao Yao (Paeoniae Radix Alba, half jin, sour, neutral) Zhi Shi (Immature Bitter Orange, half jin, processed, bitter, cold) Da Huang (Rhei Radix et Rhizoma, one jin, peeled, bitter, cold) Hou Po (Magnoliae Officinalis Cortex, one jin, Zhao/Yitong editions say "chi", processed, peeled, bitter, cold; Yitong says warm) Xing Ren (Pruni Semen, one jin, Zhao edition says sheng, peeled, tip removed, roasted, made into fat separately, sweet, warm)
The *Neijing* states: "The Spleen desires relaxation; urgently feed sweet to relax it." The sweetness of Ma Ren and Xing Ren relaxes the Spleen and moistens dryness. With insufficient fluids, use sour to astringe; Shao Yao's sourness collects fluids. With intestinal dryness and Stomach excess, use bitter to drain; the bitterness of Zhi Shi, Hou Po, and Da Huang drains dryness and reduces Stomach excess.
Grind the above six herbs into powder, refine honey into pills, size of tung tree seeds, (Zhao edition: "Right six herbs, mix with honey into pills, size of tung tree seeds"), take ten pills with water, three times daily, gradually increase dosage until effect is achieved.
Taiyang disease for three days, diaphoresis fails to resolve, with steaming fever, belongs to Stomach, treated with Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction).
"Zheng zheng" (Yitong edition: " ") means like heat steaming, (Yitong edition: "xun "), indicating severe heat. Taiyang disease for three days, diaphoresis fails to resolve, exterior pathogen is gone, steaming fever indicates severe Stomach heat; Tiaowei Chengqi Tang is given to purge Stomach heat.
After Shanghan vomiting, if abdominal fullness occurs, give Tiaowei Chengqi Tang.
The *Neijing* states: "All bloating and abdominal enlargement belong to heat." Heat in Upper Jiao causes vomiting; if unresolved after vomiting, followed by abdominal fullness, pathogenic heat has entered the Stomach; Tiaowei Chengqi Tang is given to purge Stomach heat.
Taiyang disease, after vomiting, purgation, or diaphoresis, (Zhao edition has "hou") with slight irritability, frequent urination, and consequent hard stool, Xiaochengqi Tang harmonizes and cures.
Vomiting, purgation, and diaphoresis all damage fluids; exterior pathogens transmit inward via deficiency. Severe irritability indicates pathogen in exterior; slight irritability indicates pathogen in interior. Frequent urination and hard stool indicate Spleen Constraint. Xiaochengqi Tang harmonizes and cures.
Two to three days after illness, weak pulse, no Taiyang or Chaihu syndrome, irritability, and epigastric hardness:
By four to five days, even if able to eat, give Xiaochengqi Tang in small amounts to gently harmonize, allowing slight relief. By the sixth day, give one sheng of Chengqi Tang. If no bowel movement for six to seven days and urination is scant, even if unable (Zhao edition: "receive") to eat, (Zhao edition note: "one version: no bowel movement") with hard initial stool and loose later stool, hardness is not certain; purging will cause loose stool. Must wait for free urination and definite hard stool before purging; Dachengqi Tang is suitable.
The *Zhenjing* states: "Soft pulse indicates disease descending." Weak is a Yin pulse, indicating pathogen in interior. Two to three days with weak pulse means although days are few, pathogen has entered interior. No Taiyang signs mean exterior is resolved; no Chaihu signs mean no half-exterior/half-interior syndrome. Irritability and epigastric hardness indicate severe internal pathogen. Severe Stomach excess heat prevents eating; Stomach deficiency with severe heat allows eating by day four-five, but Xiaochengqi Tang should still be given to gently harmonize. By day six, heat is severe, giving Dachengqi Tang one sheng. If no bowel movement for six-seven days and urination is abundant, fluids are exhausted internally, stool is hard, and purging is possible. If urination is scant, water and grain are not separated in Stomach, stool is hard initially but loose later. Even if unable to eat, due to scant urination, hardness is not certain, so purging is contraindicated. Wait for free urination and definite hard stool before purging.
Shanghan for six-seven days, unclear vision, fixed eyes, no exterior/interior signs, difficult defecation, slight body heat: this is excess. Urgently purge with Dachengqi Tang. (Zhao edition note: "one version: Dachaihu Tang").
The *Neijing* states: "All vessels connect to the eyes." At six-seven days of Shanghan, when pathogen enters interior, unclear vision and fixed eyes indicate severe internal heat steaming upward to eyes. No exterior/interior signs with difficult defecation indicates interior excess. High body heat is exterior heat; slight body heat is interior heat. The *Zhenjing* states: "Heat disease with unclear vision, if heat persists, death ensues." Unclear vision and fixed eyes indicate critical condition; urgently administer Dachengqi Tang for purgation.
Yangming disease, (Zhao/Yitong editions both have "bing") with fever and profuse sweating: urgently purge with Dachengqi Tang.
Pathogenic heat enters Fu organs, causing external fever and profuse sweating; heat forces fluids toward exhaustion. Urgently give Dachengqi Tang to purge Fu heat.
Diaphoresis fails to resolve, abdominal fullness and pain: urgently purge with Dachengqi Tang.
Diaphoresis fails to resolve, pathogenic heat transmits to Fu, causing abdominal fullness and pain; transmission is rapid, requiring urgent purgation.
Abdominal fullness does not decrease, nor is any decrease significant: must purge with Dachengqi Tang.
Abdominal fullness without decrease indicates pathogen excess. Classic says: "Great fullness and great excess can be purged." Dachengqi Tang purges fullness and excess. If abdominal fullness decreases intermittently, it is not interior excess, so purging is contraindicated. *Jingui Yaolue* states: "Abdominal fullness decreases then returns, this is cold, treat with warming drugs." This refers to insignificant decrease.
Yangming and Shaoyang combined disease always involves diarrhea. Pulse without "defeat" (Fu), (Zhao edition has "wei") is favorable; "defeat" is unfavorable. Mutual overcoming is called defeat.
Slippery and rapid pulse indicates retained food; must purge with Dachengqi Tang.
Yangming is Earth, Shaoyang is Wood. Combined disease with disharmony causes diarrhea. If Shaoyang pulse is weak and Yangming is not defeated, it is harmonious (no overcoming); if Shaoyang pulse wins and Yangming is defeated, it is pathological overcoming, losing healthy qi. *Mai Jing* states: "Slippery pulse indicates food disease." Also: "Slippery and rapid indicates Stomach excess." Diarrhea pulse should be faint/extremities cold; now slippery and rapid indicates Stomach retained food; Dachengqi Tang is given to purge.
Patient with no exterior/interior signs, fever for seven-eight days, even with floating-rapid pulse, can be purged. If already purged and rapid pulse persists, combined heat causes good digestion and hunger. By six-seven days, no bowel movement indicates blood stasis; Didang Tang is suitable.
Seven-eight days is when pathogen enters Fu. No exterior/interior signs, just fever, even with floating-rapid pulse, Dachengqi Tang can be given. Floating indicates heat in Qi level, rapid indicates heat in Blood level. After purging, pathogen heat leaves, floating-rapid pulse should resolve. If after purging, rapid pulse leaves but floating remains, heat in Ying/Blood combines with Wei/Qi, indicating pathogen retention, hunger, heat failing to digest food, tidal fever, and thirst. If after purging, floating pulse leaves but rapid persists, Wei heat combines with Ying blood heat, merging heat forces blood downward, Stomach deficiency with heat causes good digestion and hunger. Blood reaches Lower Jiao; if stool is free, bleeding heals. If no bowel movement for six-seven days, blood cannot move, accumulates below as stasis; Didang Tang is given to purge.
If rapid pulse persists and diarrhea continues, heat combines with blood causing pus and blood in stool.
After purging, if rapid pulse persists and no bowel movement, heat cannot vent, blood stasis accumulates below as stasis. If after purging, rapid pulse persists and diarrhea continues, heat vents downward, forcing blood down, causing pus and blood in stool.
Shanghan, after diaphoresis, body and eyes turn yellow. Reason: Cold-dampness (Zhao edition note: "one version: Warm") in interior, unresolved. Purging is contraindicated; seek treatment within cold-dampness methods.
*Jingui Yaolue* states: "Jaundice arises from dampness." Sweating removes heat, preventing jaundice. After diaphoresis, body/eyes yellow means wind pathogen gone, dampness remains. Spleen dislikes dampness; internal dampness steals Spleen color, causing jaundice. If blood stasis in interior causes jaundice, purging is allowed; here, cold-dampness in interior means purging is contraindicated; treat according to cold-dampness methods.
Shanghan seven-eight days, yellow skin like orange peel, difficult urination, slight abdominal fullness: Yinchen Hao Tang is primary.
When heat is severe, yellow skin like orange peel indicates heat toxin venting externally. *Neijing* states: "Bladder stores fluids, Qi transformation allows exit." Difficult urination and lower abdominal fullness indicate severe external heat and fluids failing to descend. Yinchen Tang is given to promote urination, resolve jaundice, and purge heat.
Shanghan with jaundice and fever: (Zhao edition lacks "zhe") Zhizi Bo Pi Tang (Gardenia and Phellodendron Bark Decoction) is primary.
Shanghan jaundice with Stomach stagnant heat requires draining; here, fever indicates heat is not yet solid; Zhizi Bo Pi Tang is given to disperse.
Zhizi Bo Pi Tang Formula:
(Zhao edition has "fei" before "Zhi Zi") Zhi Zi (Gardeniae Fructus, fifteen seeds, Zhao/Yitong editions have "break open", bitter, cold) Gan Cao (Licorice Radix, one liang, Zhao edition has "roasted", sweet, neutral) Huang Bai (Phellodendri Cortex, two liang)
Take the above three herbs, add four sheng of water, decoct to obtain one and a half sheng, remove dregs, divide into two warm doses.
Shanghan with stagnant heat in interior causes jaundice; Mahlian Lianqiao Chixiaodou Tang (Ephedra, Forsythia Root, and Adzuki Bean Decoction) is primary.
Damp-heat interaction causes many cases of jaundice. "Dan" means yellow. Shanghan is cold-damp in exterior; jaundice is stagnant heat in interior. Mahlian Lianqiao Chixiaodou Tang is given to clear heat and scatter dampness.
Mahlian Lianqiao Chixiaodou Tang Formula:
Ma Huang (Ephedrae Herba, two liang, remove joints, sweet, warm) Chi Xiao Dou (Adzuki Bean, one sheng, sweet, neutral) Lian Qiao (Forsythiae Fructus, two liang, root of Forsythia, Zhao edition says "shi", bitter, cold) Xing Ren (Pruni Semen, forty seeds, remove tips, sweet, warm) Da Zao (Jujubae Fructus, twelve seeds, Zhao/Yitong editions have "break open", sweet, warm) Sheng Zi Bai Pi (Morus Alba Cortex, one sheng, Zhao edition has "cut", bitter, cold) Sheng Jiang (Zingiberis Rhizoma Recens, two liang, sliced, acrid, warm) Gan Cao (Licorice Radix, two liang, roasted, sweet, neutral)
*Neijing* states: "Dampness upper severe with heat, treat with bitter-warm, assist with sweet-acrid, stop when sweating occurs." This applies. Using rainwater (Liao Shui) for decoction takes advantage of its thin taste, not aiding dampness.
Above (Zhao/Yitong editions both say "You") eight herbs, use one dou of rainwater, first boil Ma Huang until boiling again, remove foam, add other herbs, decoct to obtain three sheng, (Zhao edition has "remove dregs"), divide into three warm doses, finish within half a day.