大便必硬。硬则谵语。此药主之。若一服谵语止者。更莫后服。○阳明病谵语潮热。脉
滑而疾者。此药主之。因与承气汤一升。腹中转气者。更服一升。若不转气者。勿更与
之。明日又不大便。脉反微涩者。里虚也。为难治。不可更与承气汤。○太阳病。若吐
。若下。若发汗后。微烦。小便数。大便硬者。与小承气汤和之愈。○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。
下利谵语者。有燥屎也。此主之。（属厥阴）
大黄（四两去皮） 浓朴（二两去皮姜汁炙） 枳实（四枚或作三枚。去穣炒
净秤半两也）
上锉如麻豆大。每服抄五钱匕。以水一大盏半。煎至八分。去滓温服。以利为度。
初服汤更衣者。止后服。不尔者。再服之。
调胃承气汤。（四十三） 发汗后。恶寒。虚故也。不恶寒。但热者。实也。当和胃
气。此主之。○太阳病未解。脉阴
阳俱停。必先振栗汗出而解。但阳脉微者。先汗之而解。但阴脉微者。下之而解。若欲
下之。宜服。○伤寒脉浮自汗出。小便数。心烦微恶寒。脚挛急。与桂枝汤欲攻其表。
此误也。得之便厥。咽中干。烦躁吐逆作。甘草干姜汤与之。以复其阳。若厥愈足温者
。更作芍药甘草汤与之。其脚即伸。若胃气不和谵语者。少与调胃承气汤。○伤寒十三
日。过经谵语者。以有热也。当以汤下之。若小便利者。大盒饭硬。而反下利。脉调和
者。知医以丸药下之。非其治也。若自下利者。脉当微厥。今反和者。此为内实也。此
主之。○太阳病过经十余日。心下温温欲吐。而胸中痛。大便反溏。腹微满。郁郁微烦
。先此时自极吐下者与服之。若不尔者。不可与。但欲呕。胸中痛微溏者。此非柴胡证
。以呕故知极吐下也。○阳明病不吐不下。心烦者可与服。○太阳病三日发汗不解。蒸
蒸热者。属胃也。此主之。○伤寒吐后。腹胀满者。与服。（以上属阳明）
甘草（一两） 大黄（二两去皮） 芒硝（一两三分。或作一两一分）
上锉如麻豆大。每服五钱。以水一大盏。煎至七分。去滓下硝。更上火二三沸。温
、顿服之。
桃核承气汤（四十四） 太阳病不解。热结膀胱。其人如狂。血自下。下者愈。其外
不解者。尚未可攻。当先解其外。外解已。但小腹结者。乃可攻之。宜用此药。（属太
阳）
大黄（四两） 桂枝（去皮二两） 甘草（二两炙） 芒硝（二两） 桃仁（
去皮尖双仁者五十个捶碎）
上锉如麻豆大。每服五钱匕。以水二大盏。煎至八分。去滓下硝煎化。温服。以微
利为度。未利。移时再服。
栀子豉汤（四十五） 发汗吐下后。虚烦不得眠。若剧者。必反复颠倒。心中懊 。
此主之。○发汗若下之，而
烦热。胸中窒者。此主之。○仲景云。凡用栀子汤。病患旧微溏者。不可与服之。○伤
寒五六日大下之后身热不去。心中结痛者。未欲解也。此主之。（以上属太阳）○阳
明病脉浮而紧。咽燥口苦。腹满而喘。发热汗出。不恶寒。反恶热。身重。若发汗则燥
。心愦愦反谵语。若加温针。必怵惕烦躁不得眠。若下之。则胃中空虚。客气动膈。心
中懊 。舌上苔者。此主之。○阳明病下之。外有热。手足温。不结胸。心中懊 。饥
不能食。但头汗出者。此主之。○下利后更烦。按之心下濡者。为虚烦也。此主之。（
属厥阴）
香豉（二两） 肥栀子（十六个擘碎或作十四个）
上锉如麻豆大。每服五钱。水二盏。先煮栀子至一盏。入豉煎至七分。去滓温服。
得快吐。止后服。
栀子甘草豉汤（四十六） 发汗吐下后。虚烦不得眠。若剧者。必反复颠倒。心中懊
。栀子豉汤主之。若少气者。此主之。（属太阳）
栀子（七枚） 甘草 豉（各一两）
上分二服。以水二盏。先煎栀子甘草至一盏。内豉同煎。取七分。去滓温服。得快
吐。止后服。
栀子生姜豉汤。（四十七） 发汗吐下后。虚烦不得眠。若剧者。必反复颠倒。心中
懊。栀子豉汤主之。若呕者。当主之。（属太阳）
栀子（七枚） 生姜（二两半） 豉（一两）
上分二服。以水二盏。先煮栀子生姜至一盏。内豉同煎。至七分。去滓温服。得快
吐。止后服。
The stool must become hard. Hardness leads to delirium (mental confusion with incoherent speech). This formula governs. If delirium ceases after one dose, do not take subsequent doses. ○ In Yangming disease, when delirium and tidal fever occur, and the pulse is slippery and rapid, this formula governs. Therefore, give Chengqi Tang (Cathartic Decoction) one sheng. If intestinal gas moves in the abdomen after taking it, administer another sheng. If there is no movement of gas, do not give more. If the patient does not have a bowel movement the next day, and the pulse becomes faint and choppy instead, this indicates interior deficiency; it is difficult to treat, and Chengqi Tang should not be administered again. ○ In Taiyang disease, if vomiting, purging, or sweating has been performed, leading to slight vexation, frequent urination, and hard stool, Xiao Chengqi Tang (Minor Cathartic Decoction) should be given to harmonize, resulting in recovery. ○ Two to three days after contracting the disease, if the pulse is weak, without signs of Taiyang or Shaoyang (Chaihu) patterns, accompanied by irritability and hardness in the epigastrium, even if the patient can eat on the fourth or fifth day, give Xiao Chengqi Tang (Minor Cathartic Decoction) in small amounts occasionally to mildly harmonize, allowing for slight relief. Diarrhea accompanied by delirium indicates the presence of dry fecal matter; this formula governs. (Belongs to Jueyin disease)
Dahuang (Rhubarb Radix et Rhizoma, 4 liang, peeled) Houpo (Magnolia Bark, 2 liang, peeled, processed with ginger juice) Zhishi (Immature Bitter Orange, 4 pieces, or 3 pieces, pith removed, stir-fried until clean, weighed at half liang)
Crush all ingredients to the size of hemp seeds. For each dose, scoop five qian bi. Add one dan and a half zhan of water, decoct until eight parts remain, remove dregs, and take warm. Stop when bowel movement occurs. If a normal bowel movement occurs after the first dose, stop subsequent administration. Otherwise, administer again.
Tiaowei Chengqi Tang (Harmonizing the Stomach Cathartic Decoction). (Formula 43) After sweating, aversion to cold indicates deficiency. Absence of aversion to cold but presence of heat indicates excess. One should harmonize the stomach qi; this formula governs. ○ When Taiyang disease is unresolved, and the pulses at cun, guan, and chi positions are all suspended (hidden), the patient will likely experience chills and sweating before resolving. If only the yang pulse (cun) is slightly weak, resolve via sweating first. If only the yin pulse (chi) is slightly weak, resolve via purging. If purging is intended, this formula is suitable. ○ In Shanghan (Cold Damage), with a floating pulse, spontaneous sweating, frequent urination, mental restlessness, slight aversion to cold, and cramped/tight calves, giving Guizhi Tang (Cinnamon Twig Decoction) to attack the exterior is an error. This leads to cold limbs, dry throat, irritability, and vomiting/nausea. Administer Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) to restore yang qi. Once cold limbs resolve and feet become warm, administer Shaoyao Gancao Tang (Peony and Licorice Decoction); the legs will extend. If disharmony of stomach qi causes delirium, give a small amount of Tiaowei Chengqi Tang (Harmonizing the Stomach Cathartic Decoction). ○ Thirteen days into Shanghan (Cold Damage), delirium after passing through meridians indicates heat; it should be treated with a decoction to purge. If urination is free, the stool should be hard; however, if diarrhea occurs instead, yet the pulse remains harmonious, it indicates the physician used pill-based purgatives, which was incorrect treatment. If diarrhea occurred naturally, the pulse should be faint and cold; since it is harmonious now, this indicates internal excess. This formula governs. ○ After more than ten days of Taiyang disease, if there is a sensation of warmth and urge to vomit in the epigastrium, chest pain, loose stools, mild abdominal fullness, and suppressed mild vexation, if the patient had previously undergone extreme vomiting or purging, this formula may be given. If not, it should not be given. If there is only an urge to vomit, chest pain, and slightly loose stools, this is not a Chaihu pattern. The vomiting indicates prior extreme vomiting/purging. ○ In Yangming disease, if there has been no vomiting or purging, but vexation exists, this formula may be given. ○ Three days into Taiyang disease, if sweating fails to resolve the condition and steaming heat persists, it belongs to the Stomach (Yangming excess); this formula governs. ○ After vomiting in Shanghan (Cold Damage), if abdominal distension and fullness occur, administer this formula. (Above belong to Yangming disease)
Gancao (Licorice Root, 1 liang) Dahuang (Rhubarb Radix et Rhizoma, 2 liang, peeled) Mangxiao (Mirabilite, 1 liang 3 fen, or 1 liang 1 fen)
Crush all ingredients to the size of hemp seeds. For each dose, use five qian. Add one dan zhan of water, decoct until seven parts remain, remove dregs, add Mangxiao (Mirabilite), boil for two or three boils, and take warm in one dose.
Taohé Chengqi Tang (Peach Kernel Cathartic Decoction) (Formula 44) When Taiyang disease is unresolved, heat binds in the Bladder. The person appears manic-like. If blood descends spontaneously, descent leads to cure. If exterior symptoms remain unresolved, attacking blood stasis is premature; one must first resolve the exterior. Once the exterior is resolved, if only lower abdominal binding remains, then attack it. This formula is appropriate. (Belongs to Taiyang disease)
Dahuang (Rhubarb Radix et Rhizoma, 4 liang) Guizhi (Cinnamon Twig, 2 liang, peeled) Gancao (Licorice Root, 2 liang, honey-fried) Mangxiao (Mirabilite, 2 liang) Taoren (Peach Seed, 50 kernels with skin and tip removed, double-kernel preferred, crushed)
Crush all ingredients to the size of hemp seeds. For each dose, use five qian bi. Add two large zhan of water, decoct until eight parts remain, remove dregs, add Mangxiao (Mirabilite) and dissolve. Take warm. The goal is mild laxation. If no laxation occurs, wait a while and take again.
Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) (Formula 45) After sweating, vomiting, or purging, deficiency-vexation prevents sleep. If severe, the patient tosses and turns repeatedly, feeling deeply restless and stifled (ao-nao). This formula governs. ○ After sweating or purging, if vexation-heat and chest oppression occur, this formula governs. ○ Zhang Zhongjing stated: Whenever using Zhizi Tang (Gardenia Decoction), if the patient habitually has loose stools, it should not be taken. ○ Five to six days into Shanghan (Cold Damage), after severe purging, if body heat persists and there is painful knotting in the heart/chest, the disease is not yet resolved. This formula governs. (Above belong to Taiyang disease) ○ In Yangming disease, with a floating-tight pulse, dry throat, bitter taste, abdominal fullness with panting, fever, sweating, aversion to heat rather than cold, and heavy body: If sweating is induced, it causes dryness, mental cloudiness, and delirium. If moxa-needling is added, it causes fear, palpitations, irritability, and insomnia. If purging is used, the stomach becomes empty, pathogenic qi disturbs the diaphragm, causing mental restlessness/stifled feeling (ao-nao) and tongue coating. This formula governs. ○ After purging in Yangming disease, if there is external heat, warm hands and feet, no formation of Jie Xiong (Chest Binding), mental restlessness/stifled feeling (ao-nao), hunger but inability to eat, and sweating only on the head, this formula governs. ○ After diarrhea, if vexation increases and pressing the epigastrium yields softness, it is deficiency-vexation. This formula governs. (Belongs to Jueyin disease)
Xiangchi (Prepared Fermented Soybean, 2 liang) Fei Zhizi (Plump Gardenia Fruit, 16 pieces, broken open, or 14 pieces)
Crush all ingredients to the size of hemp seeds. For each dose, use five qian. Add two zhan of water, decoct Zhizi (Gardenia Fruit) first until one zhan remains, then add Chi (Fermented Soybean) and decoct until seven parts remain. Remove dregs and take warm. If rapid vomiting occurs, stop subsequent administration.
Zhizi Gancao Chi Tang (Gardenia, Licorice, and Fermented Soybean Decoction) (Formula 46) After sweating, vomiting, or purging, deficiency-vexation prevents sleep. If severe, the patient tosses and turns repeatedly, feeling deeply restless/stifled (ao-nao). Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) governs. If there is shortness of breath/qi deficiency, this formula governs. (Belongs to Taiyang disease)
Zhizi (Gardenia Fruit, 7 pieces) Gancao (Licorice Root) Chi (Prepared Fermented Soybean) (Each 1 liang)
Divide into two doses. Add two zhan of water, decoct Zhizi (Gardenia Fruit) and Gancao (Licorice Root) first until one zhan remains, add Chi (Fermented Soybean) and decoct together until seven parts remain. Remove dregs and take warm. If rapid vomiting occurs, stop subsequent administration.
Zhizi Shengjiang Chi Tang (Gardenia, Ginger, and Fermented Soybean Decoction). (Formula 47) After sweating, vomiting, or purging, deficiency-vexation prevents sleep. If severe, the patient tosses and turns repeatedly, feeling deeply restless/stifled (ao-nao). Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) governs. If vomiting occurs, this formula should govern. (Belongs to Taiyang disease)
Zhizi (Gardenia Fruit, 7 pieces) Shengjiang (Fresh Ginger, 2.5 liang) Chi (Prepared Fermented Soybean, 1 liang)
Divide into two doses. Add two zhan of water, decoct Zhizi (Gardenia Fruit) and Shengjiang (Fresh Ginger) first until one zhan remains, add Chi (Fermented Soybean) and decoct together until seven parts remain. Remove dregs and take warm. If rapid vomiting occurs, stop subsequent administration.