治伤寒五六日呕而发热者。柴胡证具。而以他药下之。柴胡证仍在者。复与
此虽以下之。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。大
陷胸汤主之。但满而不痛者。此为痞。柴胡不中与之。宜此汤。
半夏（半升 洗。） 黄芩（三两） 干姜（三两） 甘草（三两） 人参（三两） 黄
连（
上七味。以水一斗。煮取六升。去渣再煎。取三升。温服一升。日三服。
歌曰 三两姜参炙草芩。一连痞证呕多寻。半升半夏枣十二。去滓重煎守古箴。
蔚按。师于此证。开口即云伤寒五六日呕而发热柴胡证俱在者。五六日乃厥阴主气之期。
厥
结胸。但满而不痛者为痞。痞者否也。天气不降地气不升之义也。芩、连大苦以降天气。姜、
枣、人参辛甘以升地气。所以转否而为泰也。君以半夏者。因此证起于呕。取半夏之降逆止
呕如神。亦即小柴胡汤去柴胡加黄连。以生姜易干姜是也。古人治病。不离其宗如此。
结胸为阳邪。脏结与痞为阴邪。但脏结结于下。痞结结于上也。结于下者感下焦阴寒之
气化
治太阳中风。下利呕逆表解者。乃可攻之。其人 汗出。发作有时。头痛。心下
满引胁下痛。干呕短气。汗出不恶寒者。此表解里未和。此方主之。
芫花（熬。） 甘遂 大戟
上三味等分。各别捣为散。以水一升半。先煮大枣肥者十枚。取八合。去渣。内药末。
强人服一钱匕。羸者服半钱匕。温服之。平旦服。若下少病不除者。明目更服。加半钱匕。
得快下利后。糜粥自养。
歌曰 大戟芫花甘遂平。妙将十枣煮汤行。中风表证全除尽。里气未和此法程。
蔚按。太阳为天。天连于水。太阳中风。风动水气。水气淫于上则呕逆。水气淫于下则
下利。水气聚于心下。则为痞且硬满引胁而痛也。其人 汗出。头痛。干呕短气。汗出等
证。宜辨。若恶寒为表未解。不可攻之。若不恶寒为表解而里未和。宜用此汤。第三味皆辛
苦寒毒之品。直决水邪。大伤元气。柯韵伯谓参、术所不能君。甘草又与之相反。故选十枣
以君之。一以顾其脾胃。一以缓其峻毒。得快利后糜粥自养。一以使谷气内充。一以使邪不
复作。此仲景用毒攻病之法。尽美又尽善也。
<Treatment of Taiyang disease (Exterior Syndrome) for five or six days, presenting with vomiting and fever. If the Shaoyang syndrome (Lesser Yang Syndrome) signs are present, but it was mistakenly treated with purgatives, and the Shaoyang syndrome signs remain, administer this formula again. Although purged, it does not constitute a complication (Ni). It will inevitably result in a feeling of heat rising from within accompanied by chills, followed by fever, sweating, and resolution. If there is fullness and hardness with pain in the epigastrium, this is Jie Xiong (Chest Binding). Da Xian Xiong Tang (Major Downward Draining Decoction) should be used. If there is only fullness without pain, this is Pi (Stagnation/Blockage). Xiao Chai Hu Tang (Minor Chest Harmony Decoction) is not appropriate; this decoction is suitable.
Ban Xia (Pinelliae Rhizoma, half sheng, washed.) Huang Qin (Scutellariae Radix, three liang) Gan Jiang (Zingiberis Rhizoma, three liang) Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata, three liang) Ren Shen (Ginseng Radix, three liang) Huang Lian (Coptidis Rhizoma, one liang) Da Zao (Jujubae Fructus, twelve pieces, split open.)
Take these seven ingredients, add ten dou of water, boil to obtain six sheng of liquid, remove the dregs, and decoct again to obtain three sheng. Take one sheng warm, three times a day.
Song says: Three liang each of Ginger, Ginseng, Prepared Licorice, and Scutellaria; One liang of Coptidis seeks to find the remedy for Pi syndrome with much vomiting. Half sheng of Pinellia and twelve Jujubes; Remove dregs and decoct again to keep the ancient wisdom.
Commentary by Wei: The Master begins this discussion by stating "Taiyang disease for five or six days, vomiting and fever, Shaoyang signs are all present." Five or six days is the period governed by Jueyin (Greater Yin). When Jueyin qi fails to descend, it leads to Jie Xiong (Chest Binding); when there is only fullness without pain, it is called Pi (Stagnation). Pi implies "Pi" (Obstruction), meaning heaven's qi does not descend and earth's qi does not ascend. Scutellaria and Coptidis, being greatly bitter, descend heaven's qi; Dried Ginger, Jujube, and Ginseng, being acrid and sweet, ascend earth's qi. Thus, obstruction is transformed into harmony. Pinellia is used as the sovereign herb because this syndrome originates from vomiting, utilizing Pinellia's miraculous ability to direct rebellious qi downward and stop vomiting. This is essentially Xiao Chai Hu Tang (Minor Chest Harmony Decoction) with Chai Hu removed, Huang Lian added, and Sheng Jiang replaced by Gan Jiang. Ancient physicians treated diseases without departing from their fundamental principles.
Jie Xiong (Chest Binding) belongs to Yang pathogenic factors; Zang Jie (Visceral Binding) and Pi (Stagnation) belong to Yin pathogenic factors. However, Zang Jie binds in the lower part, while Pi binds in the upper part. Those binding in the lower part are affected by the yin-cold qi transformation of the Lower Jiao... [Text cuts off]
For Taiyang Zhong Feng (Wind Strike), if diarrhea and vomiting/reversal occur, and the exterior syndrome has resolved, then internal purging may be performed. If the patient has sweating that occurs at specific times, headache, fullness in the epigastrium radiating to the hypochondrium, dry retching, shortness of breath, sweating without aversion to cold, this indicates the exterior is resolved but the interior is not harmonized. This formula governs.
Yuan Hua (Genkwa Flos, processed.) Gan Sui (Kansui Radix) Da Ji (Euphorbiae Pekinensis Radix)
These three ingredients in equal parts, each separately pounded into powder. Add one sheng and half of water, first boil ten large Jujubes until eight ge remains, remove dregs, and add the medicinal powder. Strong persons take one cun bi (one square-inch spoonful); weak persons take half a cun bi. Take warm. Administer on an empty stomach at dawn. If the purgation is insufficient and the disease persists, take again the next day, increasing by half a cun bi. After rapid purgation, nourish oneself with millet porridge.
Song says: Euphorbia, Genkwa, and Kansui are equal; The wonder lies in boiling ten Jujubes to administer. When Wind Strike exterior signs are completely cleared, this method harmonizes the interior qi.
Commentary by Wei: Taiyang corresponds to Heaven, and Heaven connects to Water. In Taiyang Zhong Feng, wind moves the water qi. If water qi overflows upward, it causes vomiting and reversal; if it overflows downward, it causes diarrhea. If water qi gathers in the epigastrium, it forms Pi and hardness, radiating pain to the hypochondrium. Symptoms such as sweating, headache, dry retching, shortness of breath, and sweating must be differentiated. If there is aversion to cold, the exterior is not resolved, and purging is contraindicated. If there is no aversion to cold, the exterior is resolved but the interior is unharmonized, making this decoction suitable. The third category of herbs (Gan Sui, Da Ji, Yuan Hua) are acrid, bitter, cold, and toxic substances that directly drain water pathogens but severely damage primordial qi. Ke Yunbo stated that Ren Shen (Ginseng) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) cannot serve as sovereigns, and Gan Cao (Licorice) is incompatible (Eighteen Incompatibilities). Therefore, ten Jujubes are chosen as the sovereign. One purpose is to protect the Spleen and Stomach; another is to moderate the harsh toxicity. Nourishing with porridge after rapid purgation serves two purposes: to fill the interior with grain qi and to prevent the recurrence of pathogens. This is Zhang Zhongjing's method of using toxic substances to attack disease, perfect in both beauty and goodness.