大柴胡汤（三十） 太阳病过十余日。发汗吐下之后。四五日柴胡证仍在者。先与小柴胡。呕
不止。（一云呕止小安）心下急。郁郁微烦者为未解也。与大柴胡汤下之则愈。○伤寒十余
日。热结在里。往来寒热者与服。○伤寒发热汗出不解。心中痞硬。呕吐而下利者。此主之。
（以上属太阳）○阳明病汗多者。急下之。宜服。○少阴病下利清水。心下痛。口干者。可下之。
宜大柴胡、大承气汤。○病腹中满痛。此为实。当下之。宜大承气、大柴胡汤。○腹满不减。减不足
言。当下之。宜大柴胡、大承气汤。○伤寒后脉沉者。内实也。下之解。宜服。○伤寒六七日。目
中不了了。睛不和。无表里证。大便难。身微热者。实也。急下之。宜大承气、大柴胡汤。○太阳
病未解。脉阴阳俱停。必先振栗汗出而解。但阴脉微者。下之而解。宜服。○病患无表里证。发热
七八日。虽脉浮数者。可下之。大柴胡汤主之。○病患烦热。汗出则解。又如疟状。日晡所发热者
。属阳明。脉实者可下之。大柴胡大承气汤主之。（属可下病脉证）
柴胡（四两） 黄芩 芍药（各一两半） 半夏（一两一分洗） 枳实（二枚去穣炒。千金
云。枳实去穣一分准二枚）
上锉如麻豆大。每服抄五钱匕。生姜四片。枣子一枚。水一盏半。煮至八分。去滓温服。以利为度
。未利再服。（本方无大黄。欲下者。加大黄一两）
柴胡桂枝汤（三十一） 伤寒六七日。发热微恶寒。肢节烦。头疼微呕。心下支结。外证未去者
。此主之。（属太阳）
○发汗多亡阳谵语者。不可下。与此药和其营卫。以通津液。后自愈。（属发汗后病脉
证）
柴胡（一两三钱） 桂枝（去皮） 黄芩 人参 芍药（各半两） 半夏（
四钱一字洗） 甘草（三钱一字炙）
上锉如麻豆大。每服抄五钱匕。生姜四片。枣子一枚。水一盏半。煮至八分。去滓
温服。
柴胡桂枝干姜汤。（三十二） 伤寒五六日已发汗而复下之。胸胁满。微结。小便不
利。渴而不呕。但头汗出。往来寒热心烦者。此为未解也。宜服之（属太阳）
柴胡（四两） 桂枝（去皮） 黄芩（各一两半） 牡蛎（熬） 甘草（炙）
干姜（各一两） 栝蒌根（二两）
上锉如麻豆大。每服抄五钱匕。水一盏半。煮至八分。去滓温服。食顷再服。
柴胡加龙骨牡蛎汤（三十三） 伤寒八九日下之。胸满烦惊。小便不利。谵语。一身
尽重不可转侧者。此主之。（属太阳）
柴胡 黄芩 龙骨（各一两） 铅丹 人参 桂枝 半夏（半合汤洗） 牡蛎
（一分半 ）
上锉如麻豆大。每服抄五钱匕。生姜四片。枣子一枚。水一盏半。煮至八分。去滓
温服。（又见辨误）
柴胡加芒硝汤（三十四） 伤寒十三日不解。胸胁满而呕。日晡所发潮热已而微利。
此本柴胡下之。以不得利。今反利者。知医以丸药下之。此非其治也。潮热者实也。先
宜服小柴胡汤以解外。后以柴胡加芒硝主之。（属太阳）
黄芩 人参（各半两） 柴胡（一两三钱三字） 芒硝（一两） 甘草（炙
半两） 半夏（四钱一字汤洗）
上锉如麻豆大。每服抄五钱匕。生姜四片。枣子一枚。水一盏半。煮至八分。去滓
内芒硝。更微沸温服。
大青龙汤（三十五） 太阳中风。脉浮紧。发热恶寒。身疼痛。不汗出而烦躁者。此
药主之。若脉微弱。汗出恶风者。不可服之。服之则厥逆筋惕肉 。此为逆也。○伤寒
脉浮缓。身不疼。但重。乍有轻时。无少阴证者。此主之。（属太阳）
桂枝（去皮一两） 甘草（一两炙） 石膏（如半个鸡子大。碎） 杏仁（
二十枚去皮尖） 麻黄（三两去节汤泡。去黄汁。焙干秤）
上锉如麻豆大。每服抄五钱匕。生姜四片。枣子一枚。水一盏半。煮至八分。去滓
温服。取汗为度。若汗周身润。止后服。未周身润可停待相次服尽。不欲汗多。恐亡阳
故也。若汗多不止。用温粉扑之。
温粉方
白术 本 川芎 白芷（各等分）
上捣罗为细末。每末一两。入米粉三两和之。粉扑周身止汗。无 本亦得。若汗已
出后尽剂服。汗多亡阳。遂逆。恶风烦躁。不得眠也。
小青龙汤（三十六） 伤寒心下有水气。咳而微喘。发热不渴。服汤已。渴者此寒去
欲解也。此主之。○伤寒表不解。心下有水气。干呕发热而咳。或渴或利。或噎或小便
不利。小腹满。或喘者。此主之。
芍药 桂枝（去皮） 干姜（炮） 甘草（炙） 细辛（各一两半） 五味子
（一两。别本或加一分） 半夏（一两半。汤洗。若渴者。去半夏。加栝蒌根一两半
）麻黄（一两半。微利者去麻黄。加荛花如一弹子。熬令赤色。若噎者。去麻黄加附子半个炮。若小便不利。小腹满
者。去麻黄加茯苓二两。若喘者去麻黄加杏仁一两
半。去皮尖麻黄汤泡）
上锉如麻豆大。每服抄五钱匕。水一盏半。煮至八分。去滓温服。杏仁、半夏二
味。或各作一两一分。
小建中汤（三十七） 伤寒阳脉涩。阴脉弦。法当腹中急痛。先与小建中汤。不瘥者
。小柴胡汤主之。○伤寒二三日。心中悸而烦者宜服。
芍药（三两） 甘草（一两炙） 桂枝（一两半去皮） 胶饴（半升。旧有微溏
或呕者去胶饴。局方加黄 一两半为黄 建中汤）
上锉如麻豆大。每服抄五钱匕。水一盏半。生姜四片。大枣子一枚。煮至八分。去
滓下胶饴两匙许再煎化。温服。日三服。夜二服。尺脉尚迟。再作一剂。加黄 末一钱
。
煎造胶饴法
糯米（一升拣淘净） 大麦柏末（六两）
上米一如炊饭甑上至气溜。取下倾入一盆子。入柏末一合。并汤一盏来许。拌和。再
上甑至饭熟。却入盆子内。都以柏末拌和。入一瓷罐子。可容五升许。冬月罐子热。春
秋夏温。冬月用汤二升许入罐子内。约内面饭上汤三指许即得。布并纸三五重盖定。更
以绵或絮抱定近火。春秋夏即温和。至一宿。见米浮在水面上。即以布绞裂。取清汁。
银石器内煎。至面上有膜。即以木篦不住手搅。至稀糊。以瓷器收。夏月置井中。庶不
酸。
大陷胸汤（三十八） 太阳病脉浮而动。数浮则为风。数则为热。动则为痛。数则
为虚头痛发热。微盗汗出而反恶寒。表未解也。医反下之。动数变迟。膈内拒痛。胃中
空虚。客气动膈。短气躁烦。心中懊 。阳气内
陷。心下因硬。则为结胸。大陷胸汤主之。若不结胸。但头汗出。余处无汗。剂颈而还
。小便不利。身必发黄。○伤寒六七日。结胸热实。脉沉而紧。心下痛。按之石硬者。
宜服。○伤寒十余日。热结在里。复往来寒热者。与大柴胡汤。但结胸无大热者。此为
小结在胸胁也。但头微汗出者。此主之。○太阳病重发汗而复下之。不大便五六日。舌
上燥而渴。日晡所小有潮热。从心下至小腹硬满而痛。不可近者。此主之。○伤寒五六
日。呕而发热者。柴胡汤证具。而以他药下之。柴胡证仍在者。复与柴胡汤。此虽已下
之不为逆。必蒸蒸而振。却发热汗出而解。若心下满而硬痛者。此为结胸也。此主之。
（以上属太阳）
大黄（一两半。去皮锦文者为末） 甘遂（一字赤连珠者细罗为末） 芒硝（
五分）
上以水二盏。先煮大黄至一盏。去滓。下硝一沸。下甘遂末。温服。得快利。止
后服。
又大陷胸汤方
桂枝（一两） 甘遂（一两或作半两） 大枣（一两或作三枚） 人参（一两
）栝蒌实（一枚去皮只用四分之一）
上锉如麻豆大。每服五钱匕。水一盏。或作二盏。煮至八分。去滓温服。胸中无坚
物勿服之。
大陷胸丸。（三十九） （又见辩误）病发于阳而反下之。热入因作结胸。病发于
阴而反下之。（一作汗出）因作痞也。所以成结胸者。以下之太早故也。结胸者。项
亦强。如柔 状。下之则和。宜此药主之。（属太阳）
大黄（二两或作四两） 芒硝（三分） 杏仁（三分去皮尖熬黑） 苦葶苈
子（三钱熬）
上捣罗二味。纳杏仁芒硝合研。如脂丸如弹子大。每服一丸。抄甘遂末半钱匕。白
蜜一合。水二盏。煮取
一盏。顿服。一宿乃下。如不下。再服。（甘遂性猛宜斟量虚实服之）
小陷胸汤。（四十） （又见辩误）小结胸病正在心。按之则痛。脉浮滑者。此主
之。（属太阳）
半夏（汤洗秤一两半） 黄连（一两） 栝蒌（一枚去皮或作半枚）
上锉如麻豆大。水二盏。先煮栝蒌至一盏半。下诸药。煎至八分。去滓温服。未知
再服。微利黄涎便安。
大承气汤。（四十一） 阳明病脉迟。虽汗出不恶寒者。其身必重。短气腹满而喘。
有潮热者。此外欲解。可攻里也手足 然汗出者。此大便已硬也。此药主之。若汗多微
发热恶寒者。外未解也。（一法与桂枝汤）其热不潮。未可与承气汤。若腹大满不通
者。可与小承气汤。微和胃气。勿令大泄下。○阳明病潮热。大便微硬者。可与此药。
不硬者。不可与之。○伤寒若吐若下后不解。不大便五六日。上至十余日。日晡所发潮
热。不恶寒。独语如见鬼状。若剧者。发则不识人。循衣摸床。惕而不安。微喘直视。
脉弦者生。涩者死。微者但发热谵语者。此主之。若一服利。则止后服。○阳明病。谵
语有潮热。反不能食者。胃中必有燥屎五六枚也。若能食者。但硬耳。宜服。○阳明病
下血谵语者。此为热入血室。但头汗出者。刺期门。随其实而泻之。 然汗出则愈。汗
出谵语者。以为有燥屎在胃中。此为风也。须下者。过经乃可下之。下之若早。语言必
乱。以表虚里实故也。下之愈。宜服。○二阳并病。太阳证罢。但发潮热。手足 汗
出。大便难而谵语者。下之则愈。宜服。○阳明病下之。心下懊 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。宜服。○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。发
汗宜桂枝汤。○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。宜服。○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。宜服。○阳明病发热汗多者。急下之。宜服。○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。至六日与承气一升。若不大便。更六七日。小便少者。虽不大便。但初头硬。后
必溏。未定成硬攻之必溏。须小便利。屎定硬。此主之。○发汗不解。腹满痛者。急下
之。宜服。○腹满不减、减不足言。当下之。宜服。○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。宜服。○阳明少阳合病。必下利。其脉不负者为
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。宜服。（以
上属阳明）○少阴病二三日。口燥咽干者。急下之。宜服。○少阴病自利清水。色纯
青。心下必痛。口干燥者。可下之。宜服。○少阴病六七日。腹胀不大便者。急下之。
宜服。（以上属少阴）○下利三部脉皆平。按之心下硬者。急下之。宜服。○下利脉
迟而滑者。内实也。利未欲止。当下之。宜服。○寸口脉浮而大。按之反涩。尺中微而
涩。故知有宿食。当下之。宜服。○下利不欲食者。以有宿食故也。当下之。宜服。○
下利瘥。至其年月日时复发者。以病不尽故也。当下之。此主之。○下利脉反滑。当下
所去下乃愈。此主之。○脉双弦而迟者。必心下硬。脉大而紧者。阳中有阴也。可下之。
宜服。○病腹中满痛者。此为实也。当下之。宜服。此主之。（以上属可下病脉证）
大黄（二两。锦文者去皮生用酒洗过） 枳实（四枚或作三枚去穣炒净秤用半两
）浓朴（四两去皮姜汁炙） 芒硝（二两或作一合半。朴硝有芦头者亦得）
上锉如麻豆大。每服抄五钱匕。水二盏。先煮浓朴枳实至一盏余。下大黄。煮取六
分。去滓。入芒硝煎一
二沸。放温服。以利为度。未利再与一服。
小承气汤（四十二） 阳明病。潮热大便微硬者。可与大承气汤。不硬者。不可与之。
若不大便六七日。恐有燥屎。欲知之法。少与小承气汤。汤入腹中转失气者。此有燥屎
也。乃可攻之。若不转失气者。此但初头硬。后必溏。不可攻之。攻之必胀满。不能食
也。欲饮水者。与水则哕。其后发热者。必大便复硬而少也。以小承气汤和之。不转失
气者。不可攻也。○阳明病脉迟。虽汗出不恶寒。其气必重。短气腹满而喘。有潮热者
。此为外欲解。可攻里也。手足 然汗出者。此大便硬。大承气汤主之。若腹大满不通
者。与小承气汤微和胃气。勿令大泄下。○阳明病。其人多汗。以津液外出。胃中燥。
Dachaihu Decoction (Formula 30)
After Taiyang disease has persisted for more than ten days, following sweating, vomiting, or purging therapies, if the Shaoyang syndrome patterns persist after four to five days, Xiaochaihu Decoction should be administered first. If vomiting persists (another version states that if vomiting ceases, the condition temporarily stabilizes), accompanied by epigastric urgency, mental depression, and slight irritability, indicating unresolved pathogenic factors, Dachaihu Decoction should be given. Purging will lead to recovery. ○ In Shanghan (Cold Damage) lasting over ten days, with heat accumulation internally and alternating chills and fever, this formula is applicable. ○ In Shanghan with fever and sweating that does not resolve the condition, accompanied by a sensation of fullness and hardness in the heart region, vomiting, and diarrhea, this formula is indicated. (The above belong to Taiyang disease) ○ In Yangming disease with excessive sweating, urgent purging is required; this formula is suitable. ○ In Shaoyin disease presenting with watery diarrhea, pain in the epigastrium, and dry mouth, purging may be employed; Dachaihu Decoction or Dachengqi Decoction are suitable. ○ Abdominal fullness and pain indicate excess; purging is indicated. Dachengqi Decoction or Dachaihu Decoction are suitable. ○ Abdominal fullness that does not decrease, or decreases insignificantly, requires purging; Dachaihu Decoction or Dachengqi Decoction are suitable. ○ A deep pulse after Shanghan indicates internal excess; purging resolves it, and this formula is suitable. ○ After six or seven days of Shanghan, blurred vision and unsteady eye movements, without obvious exterior or interior signs, difficulty in defecation, and slight body heat indicate excess; urgent purging is required. Dachengqi Decoction or Dachaihu Decoction are suitable. ○ If Taiyang disease remains unresolved and the pulses at cun, guan, and chi positions are temporarily imperceptible, the patient will likely experience shaking chills followed by sweating and resolution. However, if only the chi pulse is slightly weak, purging leads to resolution, and this formula is suitable. ○ Patients without exterior or interior signs, febrile for seven to eight days, even with floating and rapid pulses, may undergo purging; Dachaihu Decoction is indicated. ○ Patients with irritability and heat who feel relief after sweating but then present with malaria-like symptoms and afternoon tidal fever belong to Yangming disease. If the pulse is excess, purging is indicated. Dachaihu Decoction and Dachengqi Decoction are indicated. (These belong to pulse and syndrome patterns amenable to purging)
Ingredients: Chaihu (Bupleuri Radix) (4 liang), Huangqin (Scutellariae Radix), Shaoyao (Paeoniae Radix) (each 1.5 liang), Banxia (Pinelliae Rhizoma) (1 liang 1 fen, washed), Zhishi (Aurantii Fructus Immaturus) (2 pieces, pith removed and stir-fried; *Qianjin Fang* notes that removing one part of the pith from two pieces equals the weight of two whole pieces).
Crush the ingredients to the size of hemp seeds. Each dose consists of 5 qianbi (a small scoop measure). Add 4 slices of Shengjiang (Zingiberis Rhizoma Recens), 1 Zao (Jujubae Fructus), and 1.5 sheng (a volume unit) of water. Boil until reduced to 0.8 sheng, strain, and take warm. Stop when bowel movement occurs; if not, administer again. (The original formula lacks Dahuang; to enhance purgation, add Dahuang (Rhei Radix et Rhizoma) 1 liang.)
Chaihu Guizhi Decoction (Formula 31)
After six or seven days of Shanghan, with slight fever and aversion to cold, vexation and pain in the limbs and joints, slight headache and vomiting, and a sensation of support and binding in the epigastrium, while exterior signs remain, this formula is indicated. (Belongs to Taiyang disease)
○ In cases of excessive sweating leading to loss of Yang and delirium, purging is contraindicated. Administer this medicine to harmonize Ying and Wei (Nutritive and Defensive levels) and promote fluid circulation, after which the condition will self-resolve. (Belongs to post-sweating pulse and syndrome patterns)
Ingredients: Chaihu (Bupleuri Radix) (1 liang 3 qian), Guizhi (Cinnamomi Ramulus) (peeled), Huangqin (Scutellariae Radix), Renshen (Ginseng Radix), Shaoyao (Paeoniae Radix) (each 0.5 liang), Banxia (Pinelliae Rhizoma) (4 qian 1 zi, washed), Gancao (Glycyrrhizae Radix et Rhizoma) (3 qian 1 zi, honey-fried).
Crush the ingredients to the size of hemp seeds. Each dose consists of 5 qianbi. Add 4 slices of Shengjiang (Zingiberis Rhizoma Recens), 1 Zao (Jujubae Fructus), and 1.5 sheng of water. Boil until reduced to 0.8 sheng, strain, and take warm.
Chaihu Guizhi Ganjiang Decoction (Formula 32)
After five or six days of Shanghan, following sweating and subsequent purging, presenting with fullness in the chest and hypochondrium, slight binding, difficulty in urination, thirst without vomiting, sweating only on the head, alternating chills and fever, and irritability, indicating unresolved pathogenic factors, this formula is suitable. (Belongs to Taiyang disease)
Ingredients: Chaihu (Bupleuri Radix) (4 liang), Guizhi (Cinnamomi Ramulus) (peeled), Huangqin (Scutellariae Radix) (each 1.5 liang), Muli (Ostreae Concha) (calcined), Gancao (Glycyrrhizae Radix et Rhizoma) (honey-fried), Ganjiang (Zingiberis Rhizoma) (each 1 liang), Gualougen (Trichosanthis Radix) (2 liang).
Crush the ingredients to the size of hemp seeds. Each dose consists of 5 qianbi. Add 1.5 sheng of water. Boil until reduced to 0.8 sheng, strain, and take warm. Re-administer after a short interval following a meal.
Chaihu Jia Longgu Muli Decoction (Formula 33)
After eight or nine days of Shanghan, mistreated with purging, presenting with chest fullness, irritability, fright, difficulty in urination, delirium, and heaviness of the entire body making turning difficult, this formula is indicated. (Belongs to Taiyang disease)
Ingredients: Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Longgu (Fossilia Ossis Mastodi et Scapulae) (each 1 liang), Qiandan (Minium), Renshen (Ginseng Radix), Guizhi (Cinnamomi Ramulus), Banxia (Pinelliae Rhizoma) (0.5 he, washed in decoction), Muli (Ostreae Concha) (1.5 fen).
Crush the ingredients to the size of hemp seeds. Each dose consists of 5 qianbi. Add 4 slices of Shengjiang (Zingiberis Rhizoma Recens), 1 Zao (Jujubae Fructus), and 1.5 sheng of water. Boil until reduced to 0.8 sheng, strain, and take warm. (Also seen in the Chapter on Correcting Errors)
Chaihu Jia Mangxiao Decoction (Formula 34)
Shanghan unresolved for thirteen days, with chest and hypochondriac fullness and vomiting, afternoon tidal fever, followed by slight diarrhea. Originally a Dachaihu Decoction purgation case, but since purgation failed to produce stool and diarrhea occurred instead, it is known that the physician used pill-based purgatives, which was incorrect treatment. Tidal fever indicates excess. First, administer Xiaochaihu Decoction to resolve the exterior, then use Chaihu Jia Mangxiao Decoction. (Belongs to Taiyang disease)
Ingredients: Huangqin (Scutellariae Radix), Renshen (Ginseng Radix) (each 0.5 liang), Chaihu (Bupleuri Radix) (1 liang 3 qian 3 zi), Mangxiao (Natrii Sulfas), Gancao (Glycyrrhizae Radix et Rhizoma) (honey-fried, 0.5 liang), Banxia (Pinelliae Rhizoma) (4 qian 1 zi, washed in decoction).
Crush the ingredients to the size of hemp seeds. Each dose consists of 5 qianbi. Add 4 slices of Shengjiang (Zingiberis Rhizoma Recens), 1 Zao (Jujubae Fructus), and 1.5 sheng of water. Boil until reduced to 0.8 sheng, strain, add Mangxiao (Natrii Sulfas), boil briefly, and take warm.
Daqinglong Decoction (Formula 35)
Taiyang Wind Strike, with floating and tight pulse, fever and aversion to cold, body pain, anhidrosis, and irritability, is indicated by this formula. If the pulse is weak and faint, with sweating and aversion to wind, it is contraindicated. Administration would lead to cold extremities and muscle twitching, constituting a counter-action. ○ Shanghan with floating and slow pulse, body heaviness without pain, occasionally lightening, and absence of Shaoyin signs, is indicated by this formula. (Belongs to Taiyang disease)
Ingredients: Guizhi (Cinnamomi Ramulus) (peeled, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (1 liang, honey-fried), Shigao (Gypsi Fibrosus) (size of half an egg, crushed), Xingren (Armeniacae Semen Amarum) (20 pieces, peeled and de-veined), Mahuang (Ephedrae Herba) (3 liang, nodes removed, soaked in hot water, yellow juice drained, dried and weighed).
Crush the ingredients to the size of hemp seeds. Each dose consists of 5 qianbi. Add 4 slices of Shengjiang (Zingiberis Rhizoma Recens), 1 Zao (Jujubae Fructus), and 1.5 sheng of water. Boil until reduced to 0.8 sheng, strain, and take warm. The goal is sweating. If the body becomes moist, stop administration. If the body is not fully moist, pause and administer sequentially. Avoid excessive sweating to prevent loss of Yang. If sweating is excessive and unceasing, apply warm powder to the body.
Warm Powder Formula
Baizhu (Atractylodis Macrocephalae Rhizoma), Bencao (Ligustici Rhizoma et Radix), Chuanxiong (Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix) (equal parts).
Grind into fine powder. Mix 1 liang of powder with 3 liang of rice flour. Apply to the body to stop sweating. Bencao (Ligustici Rhizoma et Radix) may be omitted. If sweating has ceased after taking the decoction, excessive sweating leads to loss of Yang, resulting in counter-actions such as aversion to wind, irritability, and insomnia.
Xiaoqinglong Decoction (Formula 36)
Shanghan with fluid retention in the epigastrium, cough with slight wheezing, fever without thirst. Thirst after taking the medicine indicates cold elimination and impending resolution. This formula is indicated. ○ Shanghan with unresolved exterior and fluid retention in the epigastrium, dry heaving, fever, and cough, or possibly thirst, diarrhea, choking sensation, difficulty in urination, lower abdominal fullness, or wheezing, is indicated by this formula.
Ingredients: Shaoyao (Paeoniae Radix), Guizhi (Cinnamomi Ramulus) (peeled), Ganjiang (Zingiberis Rhizoma) (processed), Gancao (Glycyrrhizae Radix et Rhizoma) (honey-fried), Xixin (Asari Radix et Rhizoma) (each 1.5 liang), Wuweizi (Schisandrae Chinensis Fructus) (1 liang; other editions add 1 fen), Banxia (Pinelliae Rhizoma) (1.5 liang, washed in decoction. If thirsty, remove Banxia and add Gualougen (Trichosanthis Radix) 1.5 liang), Mahuang (Ephedrae Herba) (1.5 liang. If slight diarrhea, remove Mahuang and add Raohua (Edgeworthiae Cortex) the size of a bullet, calcined red; if choking, remove Mahuang and add Fuzi (Aconiti Lateralis Radix Praeparata) half a piece, processed; if difficulty in urination and lower abdominal fullness, remove Mahuang and add Fuling (Poria) 2 liang; if wheezing, remove Mahuang and add Xingren (Armeniacae Semen Amarum) 1.5 liang, peeled and de-veined, soaked in Mahuang decoction).
Crush the ingredients to the size of hemp seeds. Each dose consists of 5 qianbi. Add 1.5 sheng of water. Boil until reduced to 0.8 sheng, strain, and take warm. In some versions, Xingren (Armeniacae Semen Amarum) and Banxia (Pinelliae Rhizoma) are each 1 liang 1 fen.
Xiaojianzhong Decoction (Formula 37)
In Shanghan, with a涩 (choppy) pulse at the Yang position and 弦 (wiry) pulse at the Yin position, acute abdominal pain is expected according to the method. First, administer Xiaojianzhong Decoction. If ineffective, Xiaochaihu Decoction is indicated. ○ In Shanghan after two or three days, palpitations and irritability in the heart region indicate suitability for this formula.
Ingredients: Shaoyao (Paeoniae Radix) (3 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (1 liang, honey-fried), Guizhi (Cinnamomi Ramulus) (1.5 liang, peeled), Yitang (Maltose) (0.5 sheng. Old formulas remove Yitang if there is slight diarrhea or vomiting; Bureau Formulas add Huangqi (Astragali Radix) 1.5 liang for Huangqi Jianzhong Decoction).
Crush the ingredients to the size of hemp seeds. Each dose consists of 5 qianbi. Add 1.5 sheng of water, 4 slices of Shengjiang (Zingiberis Rhizoma Recens), and 1 Dazao (Jujubae Fructus). Boil until reduced to 0.8 sheng, strain, add approximately two spoons of Yitang (Maltose), re-boil to dissolve, and take warm. Take three times daily and twice at night. If the chi pulse remains slow, prepare another dose adding 1 qian of Huangqi (Astragali Radix) powder.
Method for Preparing Yitang (Maltose)
Nuomi (Glutinous Rice) (1 sheng, selected and washed clean), Damai Bai Mo (Barley Bran Powder) (6 liang).
Steam the rice as for cooking. Upon steam rising, remove and pour into a basin. Add 1 he of barley bran powder and about 1 sheng of water, mix well. Steam again until cooked. Remove and place in a basin, mixing thoroughly with barley bran powder. Place in a ceramic jar holding about 5 sheng. Heat the jar in winter, keep warm in spring/autumn/summer. In winter, add about 2 sheng of hot water to the jar, ensuring the water level is about three finger-widths below the rice surface. Cover tightly with 3-5 layers of cloth and paper, wrap in cotton or wadding, and keep near fire. Maintain warmth in spring/autumn/summer. After one night, when rice floats on the water, squeeze through cloth to extract clear juice. Boil in silver or ceramic ware until a film forms on the surface. Stir continuously with a wooden spatula until thick and paste-like. Store in ceramic ware. In summer, place in a well to prevent souring.
Daxiexiong Decoction (Formula 38)
Taiyang disease with floating and moving pulse: floating indicates wind, rapid indicates heat, moving indicates pain, rapid indicates deficiency. Headache and fever with slight nocturnal sweating but paradoxical aversion to cold indicate unresolved exterior. Mistaken purging causes the moving/rapid pulse to become slow, causing rejection pain in the diaphragm, emptiness in the stomach, disturbance of pathogenic qi in the diaphragm, shortness of breath, irritability, and mental restlessness. Yang qi sinks internally, causing hardness in the epigastrium, forming Jie Xiong (Binding Chest). Daxiexiong Decoction is indicated. If Jie Xiong does not form, but only head sweating occurs (no sweat elsewhere, stopping at the neck), with difficulty in urination, jaundice will develop. ○ After six or seven days of Shanghan, with heat-excess Jie Xiong, deep and tight pulse, epigastric pain, and stone-hard palpation, this formula is suitable. ○ After ten-plus days of Shanghan, with heat accumulation internally and alternating chills and fever, Dachaihu Decoction is given. But if Jie Xiong presents without significant heat, it is minor Jie Xiong in the chest/hypochondrium, with slight head sweating, indicated by this formula. ○ After severe sweating and purging in Taiyang disease, constipation for five-six days, dry tongue with thirst, slight afternoon tidal fever, hardness/fullness/pain from epigastrium to lower abdomen intolerable to touch, is indicated by this formula. ○ After five-six days of Shanghan, vomiting and fever indicate Chaihu syndrome. If treated with other purgatives and Chaihu signs persist, re-administer Chaihu Decoction. Although purged, this is not a counter-action; the patient will likely experience shaking chills followed by fever and sweating for resolution. If epigastric fullness and hard pain occur, it is Jie Xiong, indicated by this formula. (The above belong to Taiyang disease)
Ingredients: Dahuang (Rhei Radix et Rhizoma) (1.5 liang, peeled, "brocade pattern" preferred, powdered), Gansui (Kansui Radix) (one character weight, red bead-like, finely sifted), Mangxiao (Natrii Sulfas) (5 fen).
Add 2 sheng of water. Boil Dahuang (Rhei Radix et Rhizoma) first until reduced to 1 sheng, strain. Add Mangxiao (Natrii Sulfas), boil once. Add Gansui (Kansui Radix) powder. Take warm. Stop after achieving brisk purgation.
Another Daxiexiong Decoction Formula
Guizhi (Cinnamomi Ramulus) (1 liang), Gansui (Kansui Radix) (1 liang, or 0.5 liang), Dazao (Jujubae Fructus) (1 liang, or 3 pieces), Renshen (Ginseng Radix) (1 liang), Gualoushi (Trichosanthis Fructus) (1 piece, peel removed, use only 1/4).
Crush to hemp seed size. Each dose 5 qianbi. Add 1 sheng (or 2 sheng) of water. Boil to 0.8 sheng, strain, take warm. Do not use if there is no hard mass in the chest.
Daxiexiong Pill (Formula 39)
(Also in Chapter on Correcting Errors) Disease originating in Yang mistreated with purging leads to heat entering and forming Jie Xiong (Binding Chest). Disease originating in Yin mistreated with purging (or sweating) leads to Pi (Stagnation). Jie Xiong forms because purging was done too early. Jie Xiong patients have stiff necks resembling Rou Jing (Soft Spasm). Purging brings harmony; this formula is indicated. (Belongs to Taiyang disease)
Ingredients: Dahuang (Rhei Radix et Rhizoma) (2 liang, or 4 liang), Mangxiao (Natrii Sulfas) (3 fen), Xingren (Armeniacae Semen Amarum) (3 fen, peeled, de-veined, roasted black), Tinglizi (Descurainiae Semen seu Lepidii Semen) (3 qian, roasted).
Sift the first two ingredients. Mix with Xingren (Armeniacae Semen Amarum) and Mangxiao (Natrii Sulfas) until paste-like. Form pills the size of bullets. Each dose: one pill, 0.5 qianbi of Gansui (Kansui Radix) powder, 1 he of white honey, 2 sheng of water. Boil to 1 sheng, take in one dose. Stool passes overnight. If not, repeat. (Gansui (Kansui Radix) is potent; adjust dosage based on excess/deficiency.)
Xiaoxiexiong Decoction (Formula 40)
(Also in Chapter on Correcting Errors) Minor Jie Xiong (Binding Chest) disease located exactly in the epigastrium, painful upon pressure, with floating and slippery pulse, is indicated by this formula. (Belongs to Taiyang disease)
Ingredients: Banxia (Pinelliae Rhizoma) (washed in decoction, weighed 1.5 liang), Huanglian (Coptidis Rhizoma) (1 liang), Gualou (Trichosanthis Fructus) (1 piece, peeled, or half a piece).
Crush to hemp seed size. Add 2 sheng of water. Boil Gualou (Trichosanthis Fructus) first to 1.5 sheng. Add other herbs. Boil to 0.8 sheng, strain, take warm. Repeat if necessary. Mild purgation of yellow phlegm brings relief.
Dachengqi Decoction (Formula 41)
Yangming disease with slow pulse, sweating without aversion to cold, body heaviness, shortness of breath, abdominal fullness and wheezing, and tidal fever indicate the exterior is resolving and interior can be attacked. Hand and foot sweating indicates hardened stool. This formula is indicated. If sweating is excessive with slight fever and aversion to cold, exterior is unresolved (one method uses Guizhi Tang). Without tidal fever, do not give Chengqi Decoction. If abdominal fullness and obstruction are severe, Xiao Chengqi Decoction may be given to mildly harmonize stomach qi, avoiding drastic purgation. ○ Yangming disease with tidal fever and slightly hardened stool may receive this drug. If not hardened, do not give. ○ After Shanghan vomiting or purging, unresolved condition, constipation for 5-6 days up to 10+ days, afternoon tidal fever, no aversion to cold, solitary muttering as if seeing ghosts. Severe cases: confusion, picking at clothes/bed, fright, restlessness, slight wheezing, fixed gaze. Wiry pulse indicates survival; choppy pulse indicates death. Mild cases with only fever and delirium are indicated by this formula. If one dose produces relief, stop subsequent doses. ○ Yangming disease with delirium and tidal fever, inability to eat, indicates 5-6 pieces of dry feces in the stomach. Ability to eat indicates only hardness. Suitable to take. ○ Yangming disease with bloody stool and delirium indicates heat entering the Blood Chamber. Only head sweating: puncture Qimen acupoint to drain excess. Sweating leads to recovery. Sweating with delirium indicates dry feces in stomach due to wind. Purging is required only after passing through meridians. Premature purging causes speech disorder due to deficient exterior and excess interior. Purging heals; suitable to take. ○ Two-Yang concurrent disease, Taiyang signs resolved, only tidal fever, hand/foot sweating, difficulty defecating and delirium: purging heals, suitable to take. ○ Yangming disease after purging, epigastric restlessness and irritability, dry feces in stomach: attackable. Mild abdominal fullness, hard head but loose tail: not attackable. If dry feces exist, suitable to take. ○ Patient with irritability/heat relieved by sweating, malaria-like afternoon fever belongs to Yangming. Excess pulse: purge. Floating/deficient pulse: induce sweating. Purge with Dachengqi Decoction; sweat with Guizhi Tang. ○ After severe purging, 6-7 days constipation, unresolved irritability, abdominal fullness/pain indicates dry feces due to retained food. Suitable to take. ○ Shanghan 6-7 days, blurred vision, unsteady eyes, no exterior/interior signs, difficulty defecating, slight body heat indicates excess; urgent purging, suitable to take. ○ Yangming fever with excessive sweating: urgent purging, suitable to take. ○ Disease day 2-3, weak pulse, no Taiyang/Chaihu signs, irritability, epigastric hardness. Day 4-5, able to eat: give small amount of Xiao Chengqi Decoction to mildly harmonize. Day 6: give 1 sheng of Chengqi Decoction. If no stool, wait 6-7 more days. If urine is scant, although no stool, head is hard but tail is loose; attacking will cause loose stool. Wait for free urination and definite hardness; this formula is indicated. ○ Post-sweating unresolved, abdominal fullness/pain: urgent purging, suitable to take. ○ Abdominal fullness without decrease: purge, suitable to take. ○ Patient with difficulty urinating, alternating hard/loose stool, slight fever, wheezing/dizziness unable to lie down indicates dry feces; suitable to take. ○ Yangming-Shaoyang combined disease with diarrhea: smooth pulse is favorable; unfavorable pulse indicates defeat/clash. Slippery/rapid pulse indicates retained food; purge, suitable to take. (Above belong to Yangming) ○ Shaoyin disease day 2-3, dry mouth/throat: urgent purging, suitable to take. ○ Shaoyin spontaneous watery diarrhea, pure green color, epigastric pain, dry mouth: purge, suitable to take. ○ Shaoyin day 6-7, abdominal distension, constipation: urgent purging, suitable to take. (Above belong to Shaoyin) ○ Diarrhea with flat pulses at all three positions, hard epigastrium on pressure: urgent purging, suitable to take. ○ Diarrhea with slow/slippery pulse indicates internal excess; diarrhea will not stop; purge, suitable to take. ○ Cun/Kou floating/large, pressing choppy, Chi micro/choppy indicates retained food; purge, suitable to take. ○ Diarrhea with loss of appetite indicates retained food; purge, suitable to take. ○ Diarrhea cured but recurring at specific time/year/month indicates incomplete resolution; purge, this formula is indicated. ○ Diarrhea with reverse slippery pulse: purge, removal leads to recovery, this formula is indicated. ○ Double-wiry/slow pulse indicates hard epigastrium. Large/tight pulse indicates Yin within Yang; purge, suitable to take. ○ Abdominal fullness/pain indicates excess; purge, suitable to take, this formula is indicated. (Above belong to purgable pulse/syndrome patterns)
Ingredients: Dahuang (Rhei Radix et Rhizoma) (2 liang, brocade pattern, peeled, raw, wine-washed), Zhishi (Aurantii Fructus Immaturus) (4 pieces, or 3, pith removed, stir-fried clean, weighed 0.5 liang), Houpo (Magnoliae Officinalis Cortex) (4 liang, peeled, ginger-juice fried), Mangxiao (Natrii Sulfas) (2 liang, or 1.5 he; Puxiao with root is acceptable).
Crush to hemp seed size. Each dose 5 qianbi. Add 2 sheng of water. Boil Houpo (Magnoliae Officinalis Cortex) and Zhishi (Aurantii Fructus Immaturus) first to slightly over 1 sheng. Add Dahuang (Rhei Radix et Rhizoma), boil to 0.6 sheng. Strain, add Mangxiao (Natrii Sulfas), boil 1-2 times. Take warm. Stop when purged; if not, give another dose.
Xiao Chengqi Decoction (Formula 42)
Yangming disease with tidal fever and slightly hardened stool: Dachengqi Decoction may be given. If not hardened, do not give. If no stool for 6-7 days, suspecting dry feces, test by giving small amount of Xiao Chengqi Decoction. Passing gas after ingestion indicates dry feces; attack is possible. No gas indicates hard head but loose tail; do not attack. Attacking causes bloating and anorexia. Thirst with water causes hiccups. Subsequent fever indicates recurrence of hard/stool reduction. Harmonize with Xiao Chengqi Decoction. No gas: do not attack. ○ Yangming slow pulse, sweating without aversion to cold, heavy breathing, shortness of breath, abdominal fullness/wheezing, tidal fever indicate exterior resolving, interior attackable. Hand/foot sweating indicates hard stool; Dachengqi Decoction is indicated. If severe abdominal fullness/obstruction, give Xiao Chengqi Decoction to mildly harmonize stomach qi, avoid drastic purgation. ○ Yangming disease with excessive sweating leads to fluid loss and dry stomach...