伤寒，阴阳易之为病，其人身体重，少气，少腹里急，或引阴中拘挛，热上冲胸，头重不欲举，眼中生花，
（赵本注∶“一作眵”）膝胫拘急者，烧 散主之。
大病新瘥，血气未复，余热未尽，强合阴阳，得病者名曰易。男子病新瘥未平复，而妇人与之交，
得病，名曰阳易；妇人病新瘥未平腹，男子与之交，得病，名曰阴易。以阴阳相感动，其余毒相染着，
如换易也。其人病身体重，少气者，损动真气也；少腹里急，引阴中拘挛，膝胫拘急，阴气极也；热上冲胸，
头重不欲举，眼中生花者，感动之毒，所易之气，熏蒸于上也。与烧 散以道阴气。
烧 散方∶
上取妇人中 近隐处，剪烧（赵本有“作”字）灰，以水和服方寸匕，日三服。小便即利，阴头微肿，
则愈。（赵本作“此为愈矣”）妇人病，取男子 当烧灰。（赵本作“男子 烧服”）
大病瘥后，劳复者，枳实栀子汤主之。若有宿食者，加大黄如博棋子大五六枚。（赵本作“内加大
黄，如博棋子五六枚，服之愈”）
病有劳复，有食复。伤寒新瘥，血气未平，余热未尽，早作劳动病者，名曰劳复。病热少愈而强食之，
热有所藏，因其谷气留搏，两阳相合而病者，名曰食复。劳复，则热气浮越，与枳实栀子豉汤以解之；食复，
则胃有宿积，加大黄以下之。
枳实栀子豉汤方∶
枳实（三枚，炙。苦寒） 栀子（十四枚，赵本作个，擘。苦寒） 豉（一升，绵裹。苦寒）
枳实栀子豉汤，则应吐剂，此云覆令微似汗出者，以其热聚于上，苦则吐之；热散于表者，苦则发之。
《内经》曰∶火淫所胜，以苦发之。此之谓也。
上三味，以清浆水七升，空煮取四升，内枳实、栀
子，煮取二升，下豉，更煮五六沸，去滓，温分再服，覆令微似汗。
伤寒瘥已（赵本作“以”）后，更发热者，（赵本无“者”字）小柴胡汤主之。脉浮者，以汗解之；脉
沉实（赵本注∶“一作紧”）者，以下解之。（赵本有“小柴胡汤方”详见卷三）
瘥后余热未尽，更发热者，与小柴胡汤以和解之。脉浮者，热在表也，故以汗解；脉沉者，热在里也，
故以下解之。
大病瘥后，从腰已（赵本作“以”）下有水气者，牡蛎泽泻散主之。
大病瘥后，脾胃气虚，不能制约肾水，水溢下焦，腰以下为肿也。《金匮要略》曰∶腰以下肿，当利
小便。与牡蛎泽泻散，利小便而散水也。
牡蛎泽泻散方∶
牡蛎（熬。咸平） 泽泻（咸寒） 栝蒌根（苦寒） 蜀漆（赵本有“暖水”二字，洗，去脚。赵本医
统本并作腥。辛平） 葶苈（赵本有“子”字。熬。苦寒） 商陆根（熬。辛酸，咸平） 海藻（洗去咸，
以上各等分。咸寒）
咸味涌泄，牡蛎、泽泻、海藻之咸以泄水气。《内经》曰∶湿淫于内，平以苦，佐以酸辛，以苦泄之。蜀
漆、葶苈、栝蒌、商陆之酸辛与苦，以导肿湿。
上七味，异捣下筛为散，更入（赵本作“于”）臼中治之，白饮和，服方寸匕。小便利，止后服，
日三服。（赵本作“日三服”，在方寸匕下）
大病瘥后，喜唾，久不了了者，（赵本无“者”字）胃（赵本作“胸”）上有寒，当以丸药温之，宜理
中丸。（赵本有“理中丸方”详见卷七）
汗后，阳气不足，胃中虚寒，不内津液，故喜唾，不了了。与理中丸以温其胃。
伤寒解后，虚羸少气，气逆欲吐者，（赵本无“者”字）竹叶石膏汤主之。
伤寒解后，津液不足而虚羸，余热未尽，热则伤气，故少气，气逆欲吐，与竹叶石膏汤，调胃散热。
竹叶石膏汤方∶
竹叶（二把。辛平） 石膏（一斤。甘寒） 半夏（半升，洗。辛温） 人参（三。赵本作“二”两。
甘温） 甘草（二两，炙。甘平） 粳米（半升。甘微寒） 麦门冬（一升，去心。甘平）
辛甘发散而除热，竹叶、石膏、甘草之甘辛，以发散余热；甘缓脾而益气，麦门冬、人参、粳米之甘，
以补不足；辛者散也，气逆者，欲其散，半夏之辛，以散逆气。（医统本作“气逆”）
上七味，以水一斗，煮取六升，去滓，内粳米，煮米熟，汤成，去米，温服一升，日三服。
病患脉已解，而日暮微烦，以病新瘥，人强与谷，脾胃气尚弱，不能消谷，故令微烦，损谷则愈。
阳明王于申酉戌，宿食在胃，故日暮微烦，当小下之，以损宿谷。
In the context of Shanghan (Cold Damage), regarding the disease of Yin-Yang Exchange, if the patient presents with a heavy body, shortness of breath, urgency and pain in the lower abdomen, or sometimes spasm and contraction drawing into the genitalia, heat rushing up to the chest, heaviness of the head making one unwilling to lift it, blurred vision (Zhao's edition notes: "alternatively written as eye discharge"), and stiffness and cramping of the knees and shins, Shao Kun San (Burned Underwear Powder) is the primary treatment.
After a major illness has just resolved, when blood and qi have not yet recovered and residual heat remains, forcing sexual intercourse leads to a condition named "Exchange" (Yi). If a man, newly recovered from illness and not yet restored, engages in intercourse with a woman, and she becomes ill, it is named "Yang Exchange"; if a woman, newly recovered from illness and not yet restored, engages in intercourse with a man, and he becomes ill, it is named "Yin Exchange." This occurs because yin and yang mutually stimulate each other, and their residual toxic influences infect and adhere to one another, resembling an exchange. The patient's heavy body and shortness of breath indicate damage to the true qi; the urgency and pain in the lower abdomen, drawing into genital spasms, and stiffness of the knees and shins indicate extreme yin qi; the heat rushing to the chest, head heaviness, and blurred vision indicate that the stimulated toxin and exchanged qi are steaming upwards. Shao Kun San is administered to guide yin qi downwards.
Formula for Shao Kun San (Burned Underwear Powder):
Take the part of the woman's undergarment near the genitals, cut it off and burn it to ash (Zhao's edition has the character "make"), mix with water, and administer one fangcun bi (a square-inch measure) per dose, three times daily. When urination becomes smooth and the glans penis swells slightly, the patient will recover. (Zhao's edition reads: "This indicates recovery.") For women suffering from this condition, take the crotch of a man's undergarment and burn it to ash. (Zhao's edition reads: "Man's underwear burned and taken.")
For recurrence due to overexertion after a major illness resolves, Zhishi Zhizi Tang (Bitter Orange and Gardenia Decoction) is the primary treatment. If there is retained food stagnation, add Dahuang (Rhubarb Root), five or six pieces the size of a Go stone. (Zhao's edition reads: "Add Dahuang, five or six pieces the size of a Go stone, and take until cured.")
There are recurrences due to exertion (Laofu) and recurrences due to diet (Shifu). After Shanghan resolves, if blood and qi are not yet balanced and residual heat remains, engaging in labor too early causes Laofu. If fever subsides slightly but one forces eating, heat becomes trapped, and because grain qi lingers and struggles, two types of yang combine causing illness, this is called Shifu. In Laofu, heat floats upward, so Zhishi Zhizi Chi Tang (Bitter Orange, Gardenia, and Fermented Soybean Decoction) is used to resolve it; in Shifu, there is retained accumulation in the stomach, so Dahuang is added to purge it.
Formula for Zhishi Zhizi Chi Tang:
Zhishi (Immature Bitter Orange, 3 pieces, roasted. Bitter, Cold) Zhizi (Gardenia Fruit, 14 pieces, Zhao's edition says 'individual', broken open. Bitter, Cold) Chi (Fermented Soybean, 1 sheng, wrapped in silk. Bitter, Cold)
Zhishi Zhizi Chi Tang should theoretically be an emetic agent; here it states covering the patient to induce slight sweating because the heat gathers above, and bitter substances can induce vomiting; when heat disperses to the exterior, bitter substances can induce diaphoresis. The Neijing states: "When fire excess prevails, use bitter to disperse." This refers to such cases.
The above three ingredients are boiled in seven sheng of Qingjiangshui (clear sour rice water), first boiled empty to reduce to four sheng. Add Zhishi and Zhizi, boil to obtain two sheng. Then add Chi, boil for five or six more boils, remove dregs, and take warm, divided into two doses. Cover the patient to induce slight sweating.
After Shanghan resolves, if fever recurs, Xiaochaihu Tang (Minor Bupleurum Decoction) is the primary treatment. If the pulse is floating, resolve it by inducing sweating; if the pulse is deep and solid (Zhao's edition notes: "alternatively tight"), resolve it by purging. (Zhao's edition includes the formula for Xiaochaihu Tang, see Volume 3).
If residual heat remains after a major illness resolves and fever recurs, Xiaochaihu Tang is given to harmonize. A floating pulse indicates heat in the exterior, hence resolving by sweating; a deep pulse indicates heat in the interior, hence resolving by purging.
After a major illness resolves, if there is fluid retention below the waist, Mulie Zexie San (Oyster Shell and Alisma Powder) is the primary treatment.
After a major illness resolves, spleen and stomach qi are deficient, unable to control kidney water, causing water to overflow into the lower jiao, resulting in edema below the waist. The Jingui Yaolue states: "Edema below the waist should be treated by promoting urination." Mulie Zexie San is given to promote urination and dissipate water.
Formula for Mulie Zexie San:
Mulie (Oyster Shell, roasted. Salty, Neutral) Zexie (Alisma Rhizome. Salty, Cold) Gualougen (Trichosanthes Root. Bitter, Cold) Shuqi (Prepared Bark of Sophora Root, Zhao's edition has "warm water", wash, remove roots. Zhao's edition and Yitong edition both write 'Xing'. Acrid, Neutral) Tingli (Descurainia Seed, Zhao's edition has 'zi'. Roasted. Bitter, Cold) Shanglugen (Phytolacca Root, roasted. Acrid, Pungent, Salty, Neutral) Haizao (Seaweed, washed to remove saltiness. All equal parts. Salty, Cold)
Salty flavors induce vomiting and purging; the salinity of Mulie, Zexie, and Haizai drains fluid retention. The Neijing states: "When dampness prevails internally, treat with bitterness, assist with acridity and pungency, and drain with bitterness." The acrid-pungent and bitter properties of Shuqi, Tingli, Gualou, and Shanglu guide out swelling and dampness.
The above seven ingredients are crushed separately, sifted into powder, then further ground together in a mortar. Mix with Baiyin (rice water) and administer one fangcun bi per dose. Stop subsequent doses once urination is smooth. Take three times daily. (Zhao's edition places "three times daily" after "fangcun bi").
After a major illness resolves, if there is excessive salivation that persists for a long time without resolution, Zhao's edition lacks "zhe", it is cold in the stomach (Zhao's edition writes "chest"); pills should be used to warm it, Li Zhong Wan (Regulate the Middle Pill) is suitable. (Zhao's edition includes the formula for Li Zhong Wan, see Volume 7).
After sweating, yang qi is insufficient, leading to deficiency-cold in the stomach, inability to retain fluids, thus causing excessive salivation and prolonged lack of resolution. Li Zhong Wan is given to warm the stomach.
After Shanghan resolves, if the patient is weak and emaciated, has shortness of breath, and experiences rebellious qi with nausea, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is the primary treatment.
After Shanghan resolves, fluid deficiency leads to weakness and emaciation; residual heat remains. Heat injures qi, causing shortness of breath; rebellious qi causes nausea. Zhuye Shigao Tang is given to regulate the stomach and dissipate heat.
Formula for Zhuye Shigao Tang:
Zhuye (Bamboo Leaf, 2 bunches. Acrid, Neutral) Shigao (Gypsum Fibrosum, 1 jin. Sweet, Cold) Banxia (Pinellia Tuber, half sheng, washed. Acrid, Warm) Renshen (Ginseng Root, 3 liang, Zhao's edition makes "2" liang. Sweet, Warm) Gancao (Licorice Root, 2 liang, roasted. Sweet, Neutral) Jingmi (Rice Grain, half sheng. Sweet, Slightly Cold) Maidong (Ophiopogon Tuber, 1 sheng, heart removed. Sweet, Neutral)
Acrid-sweet disperses and eliminates heat; the sweet-acrid nature of Zhuye, Shigao, and Gancao disperses residual heat; sweet soothes the spleen and boosts qi; the sweetness of Maidong, Renshen, and Jingmi supplements insufficiency; acrid disperses, and for rebellious qi, dispersion is desired; the acrid nature of Banxia disperses rebellious qi. (Yitong edition writes "rebellious qi").
The above seven ingredients are boiled in ten dou of water to obtain six sheng. Remove dregs, add Jingmi, boil until rice is cooked and decoction is ready. Remove rice, take one sheng warm, three times daily.
If the patient's pulse has normalized but they experience slight vexation at dusk, it is because the illness has just resolved, and people force them to eat. Spleen and stomach qi are still weak and cannot digest food, causing slight vexation. Reducing food intake will lead to recovery.
Yangming flourishes during Shen, You, and Xu hours. Retained food in the stomach causes slight vexation at dusk; mild purging should be performed to eliminate retained grain.