（ 已见六经形证者，皆不重赘）
结胸（同类十一证）∶
大结胸∶不按而痛。因头疼恶寒，表证未罢，早用大黄等下药，致邪乘虚入里，心下坚满如石
。外用姜葱熨法，服大陷胸汤。
小结胸∶按之方痛，心胸硬满。亦用熨法，内服小陷胸汤。
热结胸∶实热结胸，懊 烦渴，心下满，脉实，宜三黄石膏汤。
寒结胸∶外无热证而内胀结，宜枳实理中丸（方见中寒。）
水结胸∶饮水过多， 有声，小半夏茯苓汤。小便不利，五苓散。
血结胸∶有衄血强止，蓄于上焦，胸满，漱水不欲咽，犀角地黄汤。
支结∶支结者，满而濡，心下妨闷也，小柴胡汤加桂枝。
脏结∶状如结胸，舌上有胎湿滑，饮食如故，时时下利，小柴胡倍姜，更灸关元。然素有痞，
连在脐旁，痛引小腹，控入阴筋者，死。
气结∶胸满刺痛，脉沉，二陈汤（方见痰门）加枳实、浓朴、槟榔。
痰结∶胸痞不痛，脉滑。二陈汤加枳、桔、前、贝；痰火，芩、连、粉、茹。
痞满∶按之不痛而硬。有表，枳桔汤最良；欲下，大柴胡汤。
呕吐哕∶有物无声曰吐。此胃寒不能司纳而自反，属太阳，藿香正气散（方见二卷）加羌活。
有物有声曰呕吐。此寒热交并于胃，郁郁不宁而上逆，属少阳，小柴胡。有声无物曰呕。此胃火冲
逆，属阳明表证。经曰∶呕多虽有阳明证，不可下，枳桔汤。渴甚，竹叶石膏汤。无物无声若呕状
、延颈开口名哕。此大便秘桔，膈上有寒，火伏于中，上下不得泄越所致，以小柴胡汤加黄连、竹
茹。
二痉∶项强头摇，面赤口噤，身反张是也，属太阳中风。重感寒湿，或发湿家汗及产后血虚，
宜如圣饮。有汗名柔 ，加桂枝、白术；无汗名刚 ，加麻黄、苍术。如脚挛切牙，皆里热，承气
汤下。
谵语（附∶郑声、独语）∶经曰∶实则谵语，虚则郑声。谵语属阳，郑声属阴。谵亦有虚实。
实者，胃中实热乘心，神识昏乱，身热躁渴，脉洪便秘，或旁流秽汁，肠有燥屎，三承气汤量轻重
用。虚者，误汗亡阳，或吐。下后利不止，脉沉微难治，柴胡桂枝汤。三阳合病，谵语，宜白虎汤
。大热，黄连解毒汤。男子失汗成瘀血，女人热入血室，桃仁承气汤。郑声者，气脱神竭也，或一
事言之不已。独语者，如见鬼状，
或睡中呢喃，脉沉肢冷，参附药温补或独参汤。
发黄（即瘅病）∶脾阴为湿热所蒸，则土色现外，茵陈五苓散。大便秘，茵陈大黄汤。初觉发黄
，瓜蒂为末，口含水，搐末三分入鼻，出黄水愈。
吐血（鼻衄、便血、溺血、下利脓血）∶阳邪在表，失汗致热毒蕴于经络，逼血妄行，火炎气逆则
吐血，犀角地黄汤加芩、连。烦躁目瞑必衄，因汗不出，得衄为汗也。有表证，葛根汤。衄不止，
生地芩连汤、茅花汤。便脓血，地榆散。溺血，延胡索散。
潮热∶阳明旺于未申，一日一发，如潮汛应时，此表欲解而里未和也，必大便秘，小承气汤下
。谵语自汗，大承气汤下。小便难，大便溏，小柴胡汤。热于寅卯属少阳，巳午属太阳。
四肢拘急∶拘急者，四肢屈伸不便，蜷卧恶寒之貌，乃诸阳本亏，过汗所致，宜芍药甘草附子
汤。误谓余邪，重发汗必死。
下利∶杂病下利当属沉寒，伤寒下利多缘协热。如手足冷，脉沉无大热属阴寒，用温经药，理
中汤。如头疼发热至四、五日，热邪传里，口大渴，频下秽水，经云∶火极反兼水化（若五金火炼
，亦化如水也），协热自利，旁流秽汁，桃花汤为丸。如绕脐硬痛，舌干有苔，乃肠中燥屎未下，
六一顺气汤下。热除利止，俗呼“漏底”，误用止泻热药（肉果之类），杀人多矣。太阳、阳明合病下
利，先服葛根汤。太阳、少阳下利，黄芩汤；呕甚加半夏、生姜。少阳、阳明合病下利，脉弦长者
，木邪克土也，名曰负，负者死。脉长不弦，余证皆属热，承气汤下。自利而大渴，白虎汤。里寒
下脱，桃花汤。三阴下利，先从阳经来者，通脉四
逆汤。下利，谵语，直视，舌白苔而滑，厥逆无脉，或脉反实者，不治。
发斑∶热则伤血，血热不散，里实表虚，出于皮肤为斑。轻如蚊迹，重如锦纹。或因失汗失下
，或过热药所致。已发斑忌汗，若汗，更加斑烂也。消斑，青黛饮；兼咽痛，玄参升麻汤。表证多
，防风通圣散去硝、黄；如大便利，短气，肢冷，斑青黑，小建中汤；甚者四逆汤。
短气∶谓呼吸之气不能接续也。心腹胀满短气，邪在里，为实，大柴胡汤下。心腹濡满，自汗
短气，邪在表，为虚，宜桂枝汤。无邪宜补。
喘∶喘者，表里不清，邪盛所致也。太阳无汗而喘，宜主方麻黄汤；阳明失下而喘，承气汤；
阴证喘，理中汤、四逆汤；水停心下，服五苓散。
烦躁∶心不安曰烦，身不宁曰躁。心热则烦，阳实阴虚为热轻；肾热则躁，阴实阳虚为热重。
分虚实治。太阳烦躁宜主方；阳明内实烦躁，承气汤；阳明经热，白虎汤，烦躁消渴，宜五苓散。
少阴烦躁，脉沉，肢冷，自利属寒，又不欲衣，欲水不能入口，宜中寒主方。吐利交作，脉如涌泉
者，死。结胸烦躁，肢冷自利，不得卧者，死。烦躁大渴，点水入口即呕不能咽，宜竹叶石膏汤或
大半夏汤加黄连、天粉、麦冬。
似疟∶寒热止作有时也。太阳似疟，桂枝汤；阳明似疟，柴葛解肌汤；少阳，小柴胡汤。恶寒
发热，日二、三度，面赤身痒，主方加白术，微汗。妇人经水适来，热入血室似疟，小柴胡。
懊 ∶郁闷恼乱，甚于烦躁也，汗下之不当，正气内虚，宜栀子豆豉汤微吐之。胸满硬，大陷
胸汤。阳明有燥屎，承气汤。
咳嗽∶肺为邪所乘，气逆不下也。水逆射肺而嗽，大青龙汤主之。水与里寒相合而嗽，真武汤
温之。三阴嗽，四逆散，五味、干姜。
腹痛∶邪正相搏也。如阳邪传里而痛，止作不常，辛剂和之，小建中汤。阴寒在内而作，悠悠
常痛，热剂温之，宜理中汤。
筋惕肉 ∶经曰∶阳气者，精则养神，柔则养筋。发汗过极，阳虚津涸，筋肉失养所致。宜真
武汤救之，及温经益元汤调之。
阴阳易∶谓邪热之气，变相换易也。如伤寒男病新瘥与妇交，而妇反病，曰阳易；妇病新瘥与
男构，而男即病，曰阴易。其证身重腹痛，四肢不持，百节解散，宜逍遥汤、竹皮汤。失治，男阴挺、女舌出而死。
拂郁∶阳气蒸越，面赤若醉，汗不彻，主方微汗；便秘，承气汤。
蛔厥∶病患素有寒而妄发其汗，或过汗，致胃寒不食，食即吐蛔，静烦上下无定，蛔也。宜理
中汤、乌梅丸兼黄连、川椒、乌梅。
狐惑∶久病精气乏，热积本脏为虫。虫食肛曰狐，下唇生疮；虫食脏曰惑，上唇生疮。宜桃仁
汤、雄黄锐散或犀角地黄汤加黄连、桃仁。
咳逆（即呃、KT ，吃忒∶）才发声于喉间而遽止者是也。阳证失下，火热内郁，少与承气下。因汗、吐、下
太过，虚气冲逆，脉微，橘皮半夏生姜汤加竹茹；虚寒加桂、附或柿蒂汤（方见呃逆）；胃寒理中汤；
下利心烦，呃，导赤饮。以雄黄（一钱，研极细末，）温水下即止。或灸期门穴。
渴∶渴者，津液为里热耗涸也。太阳无汗，渴，忌白虎，宜小柴胡汤加减。阳明多汗，渴，忌
五苓，宜竹叶石膏汤。少阴自利而渴，导赤饮。汗后渴，白虎加人参汤。先呕后渴为欲解，可与水
；先渴后呕为停水，小半夏汤。小便不利，五苓散、六一散。
战栗∶六、七日，邪气外与正争为战；邪内与正气争为栗，乃病欲解。不必药，但宜浓盖，饮姜汤（见用药大法。）
发狂∶热毒在胃，并入于心，神不安而狂，独阳亢极所致，非大下不止。有失汗，脉洪面赤微
汗之。热瘀蓄血，上，犀角地黄；下，桃仁承气；热极，三黄石膏汤。阳狂，胆草一物汤，与水饮
，水 面。
厥逆∶初起手足冷，从中寒治。先微热后寒，亦有阴证，先大热后微寒，乃阳邪传入阴经，四
逆散。冷厥，四逆汤；热厥，白虎汤。若疑似难明，先以小剂理中汤倍甘草试之。
汗∶初起无汗属寒，有汗属风、暑、湿，根据主方服。汗后恶寒，黄 建中汤；大汗，小便难，
五苓散。汗多，大便秘，承气汤下。大汗脉洪，渴，人参白虎汤。头汗者，邪搏诸阳，则齐颈而还
，不可再汗。热郁于内而上达，或吐或下，以去其邪。如大便黑，蓄血也。手足汗者，手足，诸阳
之本，热聚胃则津液旁连四肢，承气汤下。盗汗者，睡出醒收，柴胡桂枝汤，或当归六黄汤（方见盗
汗。）
大便秘∶经曰∶脉浮而数，能食不大便为实，名曰阳结，大柴胡汤；甚者，承气汤。脉沉而迟
，身体重，大便反硬，名曰阴结，金液丹；甚者，从阴证治。发汗、利小便津耗，但宜蜜导，或猪
胆法。多
曰热秘，小承气。绕脐硬痛，大承气急下。脏结而厥，四逆汤冷服。三下不通，吐以提之。虚者，
皂荚烧烟熏，大便通；棕榈灰煎汤洗，亦通；或炒盐熨脐下。冷结不通，先服理中汤，次熨。
小便涩∶热邪聚于下焦，结而不散，脉浮，五苓散；脉沉，导赤饮。不通，五苓散合六一散加
栀子。汗后、汗多，戒利小便。
坏证∶十余日犹大热，口燥舌苔，诸药不效，谓之坏证，不可治。用药全以苦寒清热之饵，殊
不知阴气愈泄，热可退乎？盖受病之始，由寒伤荣，当以调荣养血、壮水滋阴之品，大剂、日数服
乃安。经曰∶壮水之主，以制阳光。宜鳖甲散。未效，归地养荣汤，更兼苦参汤。
百合∶谓百脉一宗，病久脏腑不平也。似寒非寒，似热非热，欲食不食，欲卧不卧，不知所以
，举身俱痛，柴胡百合汤。
瘥后昏沉∶初愈错语少神，属气血虚。似疟，可微汗。日轻夜重，宜归、地、芍、参、 、麦
冬、知母。余热遗胞络，导赤各半汤。
劳复∶新瘥，略有劳烦，忧怒复病，小柴胡汤加减。复感风寒，微汗之。复见胸满，腹痛、大
便秘，微下之。犯房室（方见阴阳易，）但初病易治，病后元气已虚，易于感病而难治，患人多坏于此
。
食复∶脏腑受伤，脾胃尚弱，不能健运，多食触助余热，仍以小柴胡加山楂、神曲、麦芽、砂
仁消食。腹胀，枳实、浓朴、陈皮、白芍。
热入血室∶妇人冲脉为血海，得热则妄行，寒热作而似疟，昼静夜剧，如见鬼祟，小柴胡加丹
皮、赤芍，合四物（妇科。）未安，针灸期门。
胎前∶血能养胎，凉则固而热则行。热邪传里，护胎为主，药宜条芩、白术，兼清凉，毋活血
、毋耗气，则胎气无犯。外用井底泥、靛青、灶心土频敷脐腹。遇大满大实证、黄龙汤下。大黄可
，芒硝禁。
产后∶虽云产后宜补，如感冒风寒，仍宜主方轻表微汗，不可大汗。食积遇下证，大柴胡轻剂
攻之，邪去兼补。产后风邪易侵，谨防为要。
小儿伤寒∶治疗悉与大人同法，但剂轻小耳。（宜于幼科，伤寒参酌）伤寒阴、阳、表、里、虚、
实、寒、热，辩认不真，慎勿妄治。所谓不药为中医，病邪传尽，自能气复而安，误用药必死矣。
圣人悯生民病苦而医药兴，若不能精明至理而妄治，是不死于病而死于医药也。
(Those presenting with the manifestations of the Six Channels are not repeated here.)
Jie Xiong (Chest Binding) [including eleven similar syndromes]:
Da Jie Xiong (Major Chest Binding): Pain occurs without palpation. Due to headache and aversion to cold, with exterior syndrome unresolved, the premature use of purgatives such as Da Huang (Rhei Radix et Rhizoma) allows pathogenic factors to enter the interior due to deficiency, resulting in hardness and fullness in the epigastrium like a stone. Apply external moxibustion or hot compress with ginger and scallions; internally administer Da Xian Xiong Tang (Major Expelling Chest Decoction).
Xiao Jie Xiong (Minor Chest Binding): Pain occurs only upon palpation, with hardness and fullness in the chest and heart region. Also apply external compresses; internally administer Xiao Xian Xiong Tang (Minor Expelling Chest Decoction).
Re Jie Xiong (Heat Chest Binding): Excess heat binding in the chest and diaphragm, with mental restlessness and oppression (Ao Nao), thirst, epigastric fullness, and a surging pulse. San Huang Shi Gao Tang (Three Yellows and Gypsum Decoction) is appropriate.
Han Jie Xiong (Cold Chest Binding): No exterior heat signs, but internal distension and binding. Zhi Shi Li Zhong Wan (Immature Bitter Orange and Spleen-Nourishing Pill) is appropriate (formula see Cold Damage section).
Shui Jie Xiong (Water Chest Binding): Caused by excessive water intake, with splashing sounds in the stomach. Xiao Ban Xia Fu Ling Tang (Minor Pinellia and Poria Decoction) is used. If urination is difficult, Wu Ling San (Five-Ingredient Powder with Poria) is used.
Xue Jie Xiong (Blood Chest Binding): Nasal bleeding was forcibly stopped, causing blood to accumulate in the upper jiao, leading to chest fullness, desire to rinse the mouth but no desire to swallow. Xi Jiao Di Huang Tang (Rhino Horn and Rehmannia Decoction) is used.
Zhi Jie (Branch Binding): Characterized by fullness that is soft upon palpation and a feeling of obstruction and stuffiness in the epigastrium. Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Gui Zhi (Cinnamon Twig) is used.
Zang Jie (Organ Binding): Resembles Chest Binding, but the tongue has a white, moist coating, appetite remains normal, and there is frequent diarrhea. Xiao Chai Hu Tang with increased Sheng Jiang (Fresh Ginger) is used, along with moxibustion on Guan Yuan (CV4). However, if there is a pre-existing Pi (Glomus) connected to the side of the umbilicus, with pain radiating to the lower abdomen and pulling into the genital tendons, it is a death sign.
Qi Jie (Qi Binding): Chest fullness and stabbing pain, with a deep pulse. Er Chen Tang (Two-Cured Decoction) plus Zhi Shi (Immature Bitter Orange), Hou Po (Magnolia Bark), and Bing Lang (Areca Seed) is used (formula see Phlegm section).
Tan Jie (Phlegm Binding): Chest stuffiness without pain, with a slippery pulse. Er Chen Tang plus Zhi Ke (Aurantii Fructus), Jie Geng (Platycodon Root), Qian Hu (Peucedani Radix), and Bei Mu (Fritillaria Bulb); for Phlegm-Fire, add Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), Fen Dou (Taro Tuber), and Zhu Ru (Bamboo Shavings).
Pi Man (Stagnant Fullness): Hardness upon palpation without pain. If exterior syndrome exists, Zhi Jie Tang (Immature Bitter Orange and Platycodon Decoction) is best; if purgation is needed, Da Chai Hu Tang (Major Bupleurum Decoction) is used.
Ou Tu Yue (Vomiting and Hiccups): Vomiting with matter but no sound. This is due to Stomach Cold failing to receive and store, causing self-reversal, belonging to Tai Yang (Greater Yang). Huo Xiang Zheng Qi San (Agastache Powder to Rectify the Qi) plus Qiang Huo (Notopterygium Rhizome) is used.
Vomiting with both matter and sound. This is due to Cold and Heat clashing in the Stomach, causing depression and unrest leading to upward reversal, belonging to Shao Yang (Lesser Yang). Xiao Chai Hu Tang is used.
Omitting with sound but no matter. This is due to Stomach Fire rushing upward, belonging to Yang Ming (Yang Brightness) exterior syndrome. The Classic states: "Where vomiting is frequent, even if Yang Ming syndrome exists, do not purge." Use Zhi Jie Tang. If thirst is severe, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) is used.
Yue (Hiccups/Sobbing): No matter, no sound, resembling vomiting, stretching the neck and opening the mouth. This is caused by constipation, Cold in the Diaphragm, and Fire trapped within, preventing downward and upward release. Xiao Chai Hu Tang plus Huang Lian (Coptis Rhizome) and Zhu Ru (Bamboo Shavings) is used.
Er Jing (Two Types of Spasm): Neck stiffness, head shaking, red face, locked jaw, and opisthotonos belong to Tai Yang Wind Strike. Secondary contraction of Cold-Dampness, or improper sweating damaging those with Dampness or postpartum Blood deficiency, requires Ru Sheng Yin (Like-Sage Drink). With sweat, it is called Rou Jing (Soft Spasm); add Gui Zhi (Cinnamon Twig) and Bai Zhu (Atractylodes Macrocephala Rhizome). Without sweat, it is called Gang Jing (Hard Spasm); add Ma Huang (Ephedra Herb) and Cang Zhu (Atractylodes Lancea Rhizome). If legs cramp and teeth grind, indicating Interior Heat, Cheng Qi Tang (Order the Qi Decoction) is used to purge.
Chan Yu (Delirious Speech) [Attached: Zheng Sheng (Monotonous Repetition), Du Yu (Soliloquy)]: The Classic states: "Excess leads to delirious speech; Deficiency leads to monotonous repetition." Chan Yu belongs to Yang; Zheng Sheng belongs to Yin. Chan Yu also has excess and deficiency types. In excess, Stomach Excess Heat harasses the Heart, causing confused spirit, body heat, agitation, thirst, surging pulse, constipation, or foul liquid leakage from the anus, with dry feces in the intestines. Use the three Cheng Qi Tangs according to severity. In deficiency, mistaken sweating causes Yang collapse, or purging/vomiting leads to uncontrolled diarrhea with a deep, faint pulse; this is difficult to treat. Use Chai Hu Gui Zhi Tang (Bupleurum and Cinnamon Twig Decoction). In combined Three Yang syndrome with delirium, Bai Hu Tang (White Tiger Decoction) is appropriate. For high fever, Huang Lian Jie Du Tang (Coptis Decoction to Relieve Toxicity) is used. For men with blood stasis due to lack of sweating, or women with Heat entering the Blood Chamber, Tao Ren Cheng Qi Tang (Peach Kernel Order the Qi Decoction) is used. Zheng Sheng indicates Qi depletion and Spirit exhaustion, often repeating one topic endlessly. Du Yu resembles seeing ghosts or muttering in sleep, with deep pulse and cold limbs; Shen Fu Yao (Ginseng and Aconite Medicine) for warming and tonifying, or Du Shen Tang (Single Ginseng Decoction) is used.
Fa Huang (Jaundice/Yellowing) [i.e., Dan Bing]: Spleen Yin steamed by Damp-Heat causes Earth color to appear externally. Yin Chen Wu Ling San (Artemisia Capillaris and Five-Ingredient Powder with Poria) is used. For constipation, Yin Chen Da Huang Tang (Artemisia Capillaris and Rhubarb Decoction) is used. At the first sign of yellowing, powder the Ti (Melon Seed) and insufflate three fen into the nose while holding water in the mouth; yellow fluid discharge cures it.
Tu Xue (Spitting Blood) [including Bi Nu (Nasal Bleeding), Bian Xue (Blood in Urine), Niao Xue (Blood in Stool), Xia Li Nong Xue (Dysentery with Pus and Blood)]: Exterior Yang pathogens, neglected sweating, lead to Heat-Toxin accumulation in collaterals, forcing blood to move recklessly. Fire flaring and Qi reversing causes spitting blood; Xi Jiao Di Huang Tang plus Huang Qin (Scutellaria Root) and Huang Lian (Coptis Rhizome) is used. Restlessness and closing eyes indicate impending nasal bleeding; since sweat did not occur, nasal bleeding acts as sweat. With exterior syndrome, Ge Gen Tang (Kudzu Decoction) is used. For unceasing bleeding, Sheng Di Huang Scutellaria Lian Decoction and Mao Hua Tang (Mao Flower Decoction) are used. For pus and blood in stool, Di Yu San (Sanguisorba Powder) is used. For blood in urine, Yan Hu Suo San (Corydalis Powder) is used.
Chao Re (Tidal Fever): Yang Ming peaks at Wei and Shen hours. Once-daily fever, like tidal waves, indicates the Exterior is resolving but the Interior is not harmonized. Constipation is certain; Xiao Cheng Qi Tang (Minor Order the Qi Decoction) is used to purge. Delirium and spontaneous sweating require Da Cheng Qi Tang (Major Order the Qi Decoction). Difficulty urinating with loose stools requires Xiao Chai Hu Tang. Fever at Yin and Mao hours belongs to Shao Yang; at Si and Wu hours, to Tai Yang.
Si Zhi Ju Ji (Contraction and Cramping of Four Limbs): Contraction refers to difficulty flexing and extending limbs, curling up, and aversion to cold. This results from deficiency of all Yang channels due to excessive sweating. Shao Yao Gan Cao Fu Zi Tang (Peony, Licorice, and Aconite Decoction) is appropriate. Mistaking this for residual pathogens and sweating again will cause death.
Xia Li (Diarrhea/Dysentery): Miscellaneous disease diarrhea usually belongs to Deep Cold; Cold Damage diarrhea is often due to Combined Heat. If hands and feet are cold, pulse is deep, and there is no significant heat, it belongs to Yin Cold; use warming meridians medicine, Li Zhong Tang (Regulate the Middle Decoction). If headache and fever persist for four to five days, Heat pathogen transmits to the Interior, causing extreme thirst and frequent passage of foul water. The Classic states: "Extreme Fire reversely assumes Water transformation" (like smelting metal turning to water). Combined Heat spontaneous diarrhea with foul liquid leakage is treated with Tao Hua Tang (Peach Blossom Decoction) made into pills. If there is hard pain around the umbilicus, dry tongue with coating, indicating dry feces in the intestines have not passed, Liu Yi Shun Qi Tang (Six-One Smooth Qi Decoction) is used to purge. When Heat clears and diarrhea stops, commonly called "Leaky Bottom," mistakenly using astringent Heat-clearing drugs (such as Nutmeg) kills many. Tai Yang and Yang Ming combined disease with diarrhea: take Ge Gen Tang first. Tai Yang and Shao Yang combined disease with diarrhea: Huang Qin Tang (Scutellaria Decoction); if vomiting is severe, add Ban Xia (Pinellia Tuber) and Sheng Jiang (Fresh Ginger). Shao Yang and Yang Ming combined disease with diarrhea, string-long pulse: Wood evil overcoming Earth, named "Fu" (Defeat); Fu means death. Long pulse without string quality, other symptoms indicating Heat: Cheng Qi Tang to purge. Spontaneous diarrhea with extreme thirst: Bai Hu Tang. Interior Cold with sinking diarrhea: Tao Hua Tang. Three Yin diarrhea coming from Yang channels: Tong Mai Si Ni Tang (Unblock Pulse and Reverse Cold Decoction). Diarrhea with delirium, staring straight ahead, white slippery tongue coating, cold extremities without pulse, or reverse surging pulse: untreatable.
Fa Ban (Eruption of Macules/Purpura): Heat injures Blood; Blood Heat does not dissipate. Interior Excess and Exterior Deficiency cause eruptions on the skin as macules. Light cases resemble mosquito bites; heavy cases resemble brocade patterns. Caused by lack of sweating/purging or excessive hot medicines. After eruption, sweating is contraindicated; sweating worsens the macules. To resolve macules, Qing Dai Yin (Indigo Decoction); if accompanied by sore throat, Xuan Shen Sheng Ma Tang (Scrophularia and Cimicifuga Decoction). Many exterior symptoms: Fang Feng Tong Sheng San minus Xiao Shi (Niter) and Da Huang (Rhubarb); if stool is loose, shortness of breath, cold limbs, blue-black macules: Xiao Jian Zhong Tang (Minor Establish the Middle Decoction); severe cases: Si Ni Tang (Reverse Cold Decoction).
Duan Qi (Shortness of Breath): Inability to connect respiratory qi. Abdominal distension and shortness of breath, pathogen in Interior, Excess type: Da Chai Hu Tang to purge. Soft abdominal fullness, spontaneous sweating, shortness of breath, pathogen in Exterior, Deficiency type: Gui Zhi Tang (Cinnamon Twig Decoction). Without pathogen, tonify.
Chuan (Wheezing/Asthma): Caused by unclear Exterior/Interior and excess pathogen. Tai Yang without sweat and wheezing: Main formula Ma Huang Tang (Ephedra Decoction). Yang Ming neglecting purgation and wheezing: Cheng Qi Tang. Yin syndrome wheezing: Li Zhong Tang, Si Ni Tang. Water retention under the Heart: Wu Ling San.
Fan Zao (Restlessness and Agitation): Unease of Heart is Fan; unease of Body is Zao. Heart Heat causes Fan; Yang Excess and Yin Deficiency result in mild Heat. Kidney Heat causes Zao; Yin Excess and Yang Deficiency result in severe Heat. Treat by distinguishing Excess and Deficiency. Tai Yang Fan Zao: Main formula. Yang Ming Interior Excess Fan Zao: Cheng Qi Tang. Yang Ming Channel Heat: Bai Hu Tang. Fan Zao with thirst: Wu Ling San. Shao Yin Fan Zao, deep pulse, cold limbs, spontaneous diarrhea indicating Cold, unwilling to wear clothes, desiring water but unable to swallow: Middle Cold main formula. Simultaneous vomiting and diarrhea, pulse like a geyser: death. Jie Xiong Fan Zao, cold limbs, spontaneous diarrhea, inability to lie down: death. Fan Zao with extreme thirst, water induces immediate vomiting and cannot be swallowed: Zhu Ye Shi Gao Tang or Da Ban Xia Tang plus Huang Lian (Coptis Rhizome), Tian Hua Fen (Trichosanthes Root), and Mai Dong (Ophiopogon Tuber).
Si Nüe (Malaria-like Syndrome): Chills and fever occurring at intervals. Tai Yang Si Nüe: Gui Zhi Tang. Yang Ming Si Nüe: Chai Ge Jie Ji Tang (Bupleurum and Kudzu Decoction to Release the Muscle Layer). Shao Yang: Xiao Chai Hu Tang. Chills and fever, two to three times daily, red face, itchy body: Main formula plus Bai Zhu (Atractylodes Macrocephala Rhizome), induce slight sweat. Women with menstruation onset, Heat entering Blood Chamber resembling malaria: Xiao Chai Hu Tang.
Ao Nao (Mental Oppression/Restlessness): Depressed and agitated, worse than Fan Zao. Due to inappropriate sweating/purging and Interior Deficiency of Healthy Qi. Zhi Zi Chi Ci Tang (Gardenia and Fermented Soybean Decoction) induces slight emesis. Chest fullness and hardness: Da Xian Xiong Tang. Yang Ming dry feces: Cheng Qi Tang.
Ke Sou (Cough): Lung attacked by pathogen, Qi reversing instead of descending. Water reversing to attack Lung causing cough: Da Qing Long Tang (Major Green Dragon Decoction) governs. Water combining with Interior Cold causing cough: Zhen Wu Tang (True Warrior Decoction) warms it. Three Yin cough: Si Ni San (Reverse the Cold Powder), Wu Wei Zi (Schisandra Fruit), Gan Jiang (Dried Ginger).
Fu Tong (Abdominal Pain): Struggle between Pathogen and Healthy Qi. If Yang pathogen transmits to Interior causing pain, irregular onset and cessation: Harmonize with Acrid-Pungent agents, Xiao Jian Zhong Tang. Cold in Interior causing pain, lingering constant pain: Warm with Hot agents, Li Zhong Tang.
Jin Ti Rou Dun (Muscle Twitching and Trembling): The Classic states: "Yang Qi nourishes the Spirit when refined, and nourishes the Tendons when soft." Extreme sweating causes Yang Deficiency and Fluid depletion, leading to loss of nourishment for muscles and flesh. Zhen Wu Tang saves it; Wen Jing Yi Yuan Tang (Warm Meridians and Benefit Origin Decoction) regulates it.
Yin Yang Yi (Yin-Yang Exchange): Pathogenic Heat changes form and exchanges. If a man recovers from Cold Damage and has intercourse with a woman, and she falls ill, it is called Yang Yi; if a woman recovers and has intercourse with a man, and he falls ill, it is called Yin Yi. Symptoms include heavy body, abdominal pain, inability to support limbs, sensation of joints disintegrating. Xiao Yao Tang (Roaming Decoction) and Zhu Pi Tang (Bamboo Peel Decoction) are appropriate. Neglect leads to male prolapsed penis or female protruding tongue, resulting in death.
Fu Yu (Depression/Stagnation): Yang Qi steaming and overflowing, red face like drunkenness, incomplete sweating. Main formula induces slight sweat. Constipation: Cheng Qi Tang.
Hui Jue (Roundworm Cold-Reversal): Patient has chronic Cold, mistaken sweating or excessive sweating causes Stomach Cold and anorexia; eating triggers expulsion of roundworms. Quiet irritability moving up and down indicates roundworms. Li Zhong Tang and Wu Mei Wan (Mume Pill) plus Huang Lian (Coptis Rhizome), Chuan Jiao (Sichuan Pepper), and Wu Mei (Mume Fruit) are used.
Hu He (Fox-Glomerus Syndrome): Chronic illness depletes Essence and Qi; Heat accumulates in the Zang organs generating worms. Worms eating the anus is Hu (Fox), sores on lower lip; worms eating Zang organs is He (Glomerus), sores on upper lip. Tao Ren Tang (Peach Kernel Decoction), Xiong Huang Rui San (Realgar Sharp Powder), or Xi Jiao Di Huang Tang plus Huang Lian and Tao Ren are used.
Ke Ni (Hiccups/Inverted Che): Sound arises in the throat and stops abruptly. Yang syndrome neglecting purgation, Fire-Heat trapped inside: Small dose of Cheng Qi Tang to purge. Due to excessive sweating, vomiting, or purging, Deficient Qi rushes upward, faint pulse: Ju Pi Ban Xia Sheng Jiang Tang (Tangerine Peel, Pinellia, and Ginger Decoction) plus Zhu Ru (Bamboo Shavings); for Deficient Cold, add Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Root), or Shi Di Tang (Persimmon Calyx Decoction); Stomach Cold: Li Zhong Tang; Diarrhea with irritability and hiccups: Dao Chi Yin (Direct to Heart Decoction). Xiong Huang (Realgar, one qian, ground to fine powder) taken with warm water stops it immediately. Or moxa Qi Men (LR14).
Ke (Thirst): Thirst is due to Fluids depleted by Interior Heat. Tai Yang without sweat, thirst: Avoid Bai Hu Tang; use Xiao Chai Hu Tang modified. Yang Ming with much sweat, thirst: Avoid Wu Ling San; use Zhu Ye Shi Gao Tang. Shao Yin spontaneous diarrhea with thirst: Dao Chi Yin. Post-sweating thirst: Bai Hu Jia Ren Shen Tang (White Tiger Plus Ginseng Decoction). Vomiting then thirst indicates resolution; give water. Thirst then vomiting indicates Water Retention: Xiao Ban Xia Tang. Difficulty urinating: Wu Ling San, Liu Yi San (Six-One Powder).
Zhan Li (Shivering and Trembling): On day six or seven, Pathogen fighting Healthy Qi externally is Zhan (Shivering); Pathogen fighting Healthy Qi internally is Li (Trembling). This indicates the disease is resolving. No medicine needed; cover thickly and drink Ginger Soup (see General Principles of Medication).
Fa Kuang (Mania): Heat-Toxin in Stomach enters Heart, disturbing Spirit causing mania, due to Extreme Yang Hyperactivity. Only major purgation works. Neglected sweating, surging pulse, red face, slight sweat. Heat-Stasis Blood Accumulation: Upper uses Xi Jiao Di Huang Tang; Lower uses Tao Ren Cheng Qi Tang; Extreme Heat uses San Huang Shi Gao Tang. Yang Mania: Dan Cao Yi Wu Tang (Single Gardenia Decoction); give water, splash water on face.
Jue Ni (Cold Extremities): Initial cold hands and feet: Treat as Middle Cold. Slight Heat then Cold: Can be Yin syndrome. Great Heat then slight Cold: Yang pathogen transmitting to Yin channels. Si Ni San. Cold Jue: Si Ni Tang. Heat Jue: Bai Hu Tang. If uncertain, test with small dose of Li Zhong Tang doubled with Gan Cao (Licorice).
Han (Sweating): Initial no sweat indicates Cold; with sweat indicates Wind, Summerheat, or Dampness. Follow main formula. Post-sweating aversion to cold: Huang Qi Jian Zhong Tang (Astragalus Establish the Middle Decoction); Profuse sweating, difficulty urinating: Wu Ling San. Much sweating, constipation: Cheng Qi Tang to purge. Profuse sweating, surging pulse, thirst: Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction). Head sweat: Pathogen combats all Yang, stopping at the neck; do not sweat again. Heat trapped inside reaching upward: Induce vomiting or purging to remove pathogen. Black stool indicates Blood Stasis. Hand and foot sweat: Hands and feet are root of all Yang; Heat gathering in Stomach causes Fluids to spread to four limbs. Cheng Qi Tang to purge. Night sweat: Occurs during sleep, stops upon waking. Chai Hu Gui Zhi Tang, or Dang Gui Liu Huang Tang (Angelica Six-Huang Decoction) (formula see Night Sweat section).
Da Bian Mi (Severe Constipation): Classic states: Floating and rapid pulse, able to eat but no bowel movement indicates Excess, named Yang Jie (Yang Binding). Da Chai Hu Tang; severe cases, Cheng Qi Tang. Deep and slow pulse, heavy body, stool reversely hard, named Yin Jie (Yin Binding). Jin Ye Dan (Golden Liquid Pill); severe cases, treat as Yin syndrome. Sweating and promoting urination deplete fluids: Use Honey Suppository or Pig Gallbladder method. Mostly Heat Binding: Xiao Cheng Qi Tang. Hard pain around umbilicus: Da Cheng Qi Tang urgent purge. Zang Jie with Jue: Si Ni Tang taken cold. Three purges fail to pass stool: Induce vomiting to lift. Deficiency: Burn Soap Pod to smoke; passes stool. Palm Ash decoction wash; also passes stool. Or stir-fried salt hot compress below umbilicus. Cold Binding not passing: First take Li Zhong Tang, then hot compress.
Xiao Bian Se (Astringent/Urethral Discomfort): Heat pathogen gathers in Lower Jiao, binds and does not dissipate. Floating pulse: Wu Ling San. Deep pulse: Dao Chi Yin. Obstruction: Wu Ling San combined with Liu Yi San plus Zhi Zi (Gardenia Fruit). Post-sweating or profuse sweating: Avoid promoting urination.
Huai Zheng (Ruined Syndrome): Ten-plus days still high fever, dry mouth and tongue coating, all medicines ineffective, called Huai Zheng, untreatable. Using only Bitter-Cold Heat-clearing drugs depletes Yin further; how can Heat retreat? Initially, Cold injures Ying (Nutrient); should use herbs to regulate Ying, nourish Blood, strengthen Water, and yin-nourish. Large doses over several days bring peace. Classic states: "Strengthen the Master of Water to control the Sunlight." Bie Jia San (Turtle Shell Powder) is appropriate. If ineffective, Gui Di Yang Rong Tang (Angelica and Rehmannia Nourishing Glory Decoction), combined with Ku Shen Tang (Sophora Decoction).
Bai He (Lily Disease): All vessels share one origin; long illness disturbs Zang-Fu. Resembles Cold but not Cold, resembles Heat but not Heat, desire to eat but cannot, desire to lie down but cannot, confusion, whole body pain. Chai Hu Bai He Tang (Bupleurum and Lily Decoction).
Chai Hou Hun Chen (Post-Recovery Drowsiness): Just recovered, confused speech and low spirit, indicates Qi-Blood Deficiency. Malaria-like: Can induce slight sweat. Lighter by day, heavier by night: Gui (Angelica), Di (Rehmannia), Shao (Peony), Shen (Ginseng), Qi (Astragalus), Mai Dong (Ophiopogon), Zhi Mu (Anemarrhena). Residual Heat remaining in Bao Luo (Uterus/Collaterals): Dao Chi Ge Ban Tang (Half Dao Chi Decoction).
Lao Fu (Relapse due to Overexertion): Newly recovered, slight labor or worry/anger causes relapse. Xiao Chai Hu Tang modified. Relapse with Wind-Cold: Induce slight sweat. Recurrence of chest fullness, abdominal pain, constipation: Mild purgation. Sexual activity (formula see Yin-Yang Exchange): Early disease easy to treat; post-illness Yuan Qi is deficient, prone to relapse and hard to treat. Many patients deteriorate here.
Shi Fu (Relapse due to Diet): Zang-Fu injured, Spleen-Stomach weak, unable to transport. Overeating aids residual Heat. Xiao Chai Hu Tang plus Shan Zha (Hawthorn), Shen Qu (Medicated Leaven), Mai Ya (Barley Sprout), Sha Ren (Amomum Fruit) to digest food. Abdominal distension: Zhi Shi (Immature Bitter Orange), Hou Po (Magnolia Bark), Chen Pi (Tangerine Peel), Bai Shao (White Peony Root).
Re Ru Xue Shi (Heat Entering Blood Chamber): Woman's Chong Mai is Sea of Blood; Heat causes reckless flow. Chills and fever resembling malaria, quiet by day, severe by night, hallucinations. Xiao Chai Hu Tang plus Mu Dan Pi (Moutan Cortex), Chi Shao (Red Peony Root), combined with Si Wu Tang (Four Substances Decoction - Gynecology). If unsettled, moxa/acupuncture Qi Men (LR14).
Tai Qian (Before Pregnancy): Blood nourishes fetus; Cold consolidates, Heat moves. Heat transmitting to Interior: Protect fetus primarily. Herbs: Tiao Qin (Scutellaria), Bai Zhu (Atractylodes), combined with Cooling. Do not invigorate Blood or consume Qi, so Fetal Qi is not disturbed. External application: Well bottom mud, Indigo, Hearth Soil frequently applied to umbilicus and abdomen. Encounter severe fullness/excess: Huang Long Tang (Yellow Dragon Decoction) to purge. Da Huang (Rhubarb) allowed; Mang Xiao (Mirabilite) forbidden.
Chan Hou (After Childbirth): Although postpartum requires tonification, if contracted Wind-Cold, follow main formula for light exterior release and slight sweat, never profuse sweating. Food stagnation with purgation indication: Da Chai Hu Tang light dose to attack, tonify after pathogen removal. Postpartum Wind-Evil easily invades; prevention is key.
Xiao Er Shang Han (Pediatric Cold Damage): Treatment identical to adults, but dosage is lighter and smaller. (Refer to Pediatrics, consult Cold Damage). Differentiate Yin, Yang, Exterior, Interior, Deficiency, Excess, Cold, Heat accurately; do not treat rashly. "Not treating is the middle doctor." When pathogen transmission completes, Qi restores and peace returns; mistaken medication causes death. Sages pity people's suffering, hence medicine arose. If principles are not understood and treatment is rash, one dies not from disease but from medicine.