前言表里虚实寒热六字。病已尽在其中矣。而表里之中。又有内伤外感之治焉。内伤者里
症也。而有气血痰郁四字之分。外感者表症也。而有风寒暑湿燥火六字之别。再详其治法。
医无余蕴矣。
内伤 一曰气。气虚者四君子汤。若气实而滞者。宜香苏散、平胃散。二曰血。血虚者四物汤。若血实而
凝者。宜手拈散。三曰痰。痰轻者二陈汤、六君子。若顽痰胶固。变生怪症。或停饮膈间。宜滚痰丸、小半夏
加茯苓汤之类。四曰郁。凡喜怒忧思悲恐惊皆能致郁。郁小者越鞠丸、逍遥散。若五郁互结。腹膨肿满。
二便不通。宜神佑丸、承气汤之类。此内伤之治也。
外感 一曰风。真中风是也。非表治中之偶感风寒也。风有中腑中脏中血脉之殊。中腑者与伤寒同。
太阳用加味香苏散。阳明用葛根汤。少阳用小柴胡汤。中脏者眩仆昏冒。痰声如锯。内有热风寒风二
种。热闭则先用搐鼻散。次以牛黄丸灌之。便结胀用三花汤。冷脱则汗珠头摇。以附子理中汤急救之。
或三生饮。中血脉者。口眼 斜。半身不遂。大秦艽汤加竹沥、姜汁、钩藤。二曰寒。伤寒是也。寒在表。则与
风之中腑治同。寒入里。用附子理中汤法。详伤寒论。三曰暑。暑轻者但烦渴。益元散足矣。暑重者汗喘
昏闷。消暑丸灌之。寒包暑者。头痛恶寒而烦渴。四味香薷饮加荆芥、秦艽。若暑天受湿而霍乱。藿香正
气散主之。更有干霍乱症。吐泻不得。俗名绞肠痧。粥饮入口即败。危症也。陈香丸煎汤救之。四曰湿。或
受潮。或食冷。面黄身重。平胃散治之。若黄胆则目溺色黄。茵陈大黄汤、茵陈五苓散、茵陈姜附汤。若发
肿。五苓散、五皮饮。若渗入筋络。肩背臂痛。用秦艽天麻汤、蠲痹汤。五曰燥。此症惟秋冬时久晴有之。而
嗜鸦片者更易犯。其症鼻干口渴咽痛。舌燥目火。便秘干热。不宜发表。宜用生地、天冬、麦冬、花粉、沙参、
元参、归身、梨藕蔗汁之类以润之。六曰火。治法详于前热治中。更审其脏腑。投凉则得矣。然中寒则暴
痛。中暑则猝闷。中湿则痰塞。中火则窍闭。皆能猝然昏倒。非中风而似中风。谓之类中。勿概作中风治。
此外感之治也。
Summarizing the six characters of Exterior (Biao), Interior (Li), Deficiency (Xu), Excess (Shi), Cold (Han), and Heat (Re) encompasses the essence of all diseases. Within the categories of Exterior and Interior, there are further distinctions in treatment between Internal Injury (Nei Shang) and External Contraction (Wai Gan). Internal injuries belong to Interior syndromes and are differentiated into four aspects: Qi (Vital Energy), Blood (Xue), Phlegm (Tan), and Stagnation (Yu). External contractions belong to Exterior syndromes and are distinguished by the six pathogenic factors: Wind (Feng), Cold (Han), Summerheat (Shu), Dampness (Shi), Dryness (Zao), and Fire (Huo). If these treatment methods are elaborated in detail, a physician's knowledge will be comprehensive.
Internal Injuries: First is Qi. For Qi deficiency, Si Jun Zi Tang (Four Gentlemen Decoction) is used. If there is Qi excess with stagnation, Xiang Su San (Fragrant Perilla Powder) or Ping Wei San (Calm the Stomach Powder) are appropriate. Second is Blood. For Blood deficiency, Si Wu Tang (Four Substances Decoction) is used. If there is Blood excess with coagulation, Shou Nian San (Hand-Holding Powder) is appropriate. Third is Phlegm. For mild Phlegm, Er Chen Tang (Two Aged Ingredients Decoction) or Liu Jun Zi Tang (Six Gentlemen Decoction) are used. For stubborn Phlegm that is firmly consolidated, causing strange symptoms, or for retained fluid in the diaphragm, Gun Tan Wan (Rolling Phlegm Pill) or Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia Decoction plus Poria) are appropriate. Fourth is Stagnation. Joy, anger, worry, thought, sorrow, fear, and fright can all cause Stagnation. For mild Stagnation, Yue Ju Wan (Pill to Resolve Five Stagnations) or Xiao Yao San (Free and Easy Wanderer Powder) are used. If five types of Stagnation interlock, causing abdominal distension and fullness, and obstruction of urination and defecation, Shen You Wan (Divine Aid Pill) or Cheng Qi Tang (Order the Qi Decoction) are appropriate. These are the treatments for internal injuries.
External Contractions: First is Wind. This refers to True Stroke (Zhen Zhong Feng), not merely an occasional exposure to Wind-Cold during exterior treatment. Wind can affect the Collaterals (Fu), Zang organs, or Blood vessels. When affecting the Collaterals, it is treated similarly to Cold Damage (Shang Han). For Tai Yang channel involvement, Jia Wei Xiang Su San (Modified Fragrant Perilla Powder) is used; for Yang Ming channel involvement, Ge Gen Tang (Kudzu Decoction); and for Shao Yang channel involvement, Xiao Chai Hu Tang (Minor Bupleurum Decoction). When affecting the Zang organs, symptoms include dizziness, collapse, coma, and rattling phlegm sounds like sawing. There are two types internally: Hot Closure and Cold Collapse. For Hot Closure, Chu Bi San (Nose-Stimulating Powder) is applied first, followed by灌 administration of Niu Huang Wan (Calculus Bovis Pill). For constipation and abdominal fullness, San Hua Tang (Three Flowers Decoction) is used. For Cold Collapse, characterized by sweat beads on the head and shaking, Fu Zi Li Zhong Tang (Aconite Decoction to Regulate the Middle) is used urgently for rescue, or San Sheng Yin (Three Lives Drink). When affecting the Blood vessels, symptoms include deviation of the mouth and eyes and hemiplegia; Da Qin Jiao Tang (Large Gentian Decoction) plus Zhu Li (Bamboo Sap), Jiang Zhi (Ginger Juice), and Gou Teng (Uncaria) is used. Second is Cold. This refers to Cold Damage. If Cold is in the Exterior, it is treated the same as Wind affecting the Collaterals. If Cold enters the Interior, the method of Fu Zi Li Zhong Tang is used. See *Shang Han Lun* (Treatise on Cold Damage) for details. Third is Summerheat. For mild Summerheat, characterized only by irritability and thirst, Yi Yuan San (Benefit Origin Powder) is sufficient. For severe Summerheat, characterized by sweating, panting, and confusion, Xiao Shu Wan (Summerheat-Relieving Pill) is administered. For Cold enveloping Summerheat, characterized by headache, aversion to cold, and thirst, Si Wei Xiang Ru Yin (Four-Ingredient Elsholtzia Decoction) plus Jing Jie (Schizonepeta) and Qin Jiao (Gentiana Macrophylla) is used. If Dampness is contracted during summer leading to Cholera-like disorder (Huo Luan), Huo Xiang Zheng Qi San (Agastache Powder to Rectify Qi) is the primary treatment. There is also Dry Cholera, where vomiting and diarrhea cannot occur, commonly known as "Intestinal Colic Miasma" (Jiao Chang Sha); any food or drink vomited immediately upon entry is a critical condition, rescued by decocting Chen Xiang Wan (Aged Agarwood Pill). Fourth is Dampness. Whether from damp environment or consuming cold foods, resulting in sallow complexion and heavy body, Ping Wei San is used. If Jaundice occurs, with yellow eyes and urine, Yin Chen Da Huang Tang (Rhubarb Decoction with Capillaris), Yin Chen Wu Ling San (Capillaris Five-Ingredient Powder), or Yin Chen Jiang Fu Tang (Capillaris Ginger and Aconite Decoction) are used. If edema develops, Wu Ling San (Five-Ingredient Powder with Poria) or Wu Pi Yin (Five-Peel Decoction) are used. If Dampness penetrates the sinews and collaterals, causing shoulder, back, arm, and pain, Qin Jiao Tian Ma Tang (Gentiana and Gastrodia Decoction) or Juan Bi Tang (Expel Bi Decoction) is used. Fifth is Dryness. This syndrome occurs only in autumn and winter after prolonged clear weather, and those addicted to opium are more susceptible. Symptoms include dry nose, thirst, sore throat, dry tongue, fiery eyes, constipation, and dry heat. Exterior-releasing methods are inappropriate; instead, Di Huang (Rehmannia), Tian Dong (Asparagus Root), Mai Dong (Ophiopogon), Hua Fen (Trichosanthes Root), Sha Shen (Glehnia), Yuan Shen (Scrophularia), Dang Gui Shen (Angelica Sinensis Root), and juices from pear, lotus root, and sugarcane should be used to moisten. Sixth is Fire. Treatment methods are detailed in the preceding section on Heat syndromes; one must examine the affected Zang-Fu organs and administer cooling herbs. However, Cold Strike causes sudden pain, Summerheat Strike causes sudden oppression, Dampness Strike causes phlegm obstruction, and Fire Strike causes orifice closure; all can lead to sudden fainting. This is not Stroke but resembles it, termed False Stroke (Lei Zhong). It should not be uniformly treated as Stroke. These are the treatments for external contractions.