治伤寒六七日。发热微恶寒。肢节烦疼。微呕。心下支结。外证未去者。此汤
主之。又发汗多。亡阳谵语。不可下。与柴胡桂枝汤和其营卫以通津液。后自愈。
柴胡（四两） 黄芩（一两半） 人参（一两半） 半夏（二合半） 甘草（一两） 桂
枝
上九味。以水七升。煮取三升。去滓温服。
歌曰 小柴原方取半煎。桂枝汤入复方全。（生姜、大枣、甘草二方俱有。只取桂枝汤
之半
蔚按。小柴胡汤解见本方。此言伤寒六七日。一经已周。又当太阳主气之期。其气不能
从胸
以转出。
治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。此汤主之。
柴胡（半斤） 桂枝（三两） 干姜（二两） 黄芩（三两） 牡蛎（二两） 甘草（二
两
上七味。以水一斗二升。煮取六升。去渣再煎。取三升。温服一升。日三服。初服微烦。
复
歌曰 八柴二草蛎干姜。芩桂宜三括四尝。不呕渴烦头汗出。少阳枢病要精详。
张令韶曰。伤寒五六日。厥阴主气之期也。厥阴之上。中见少阳。已发汗而复下之。则
逆其
故渴。无枢转外出之机。故不呕。但头汗出者。太阳之津液不能旁达惟上蒸于头也。少气欲
枢转而不能。故有往来寒热之象也。厥阴内属心包而主脉络。故心烦。此病在太阳而涉厥阴
之气。不得少阳之枢以外出。故曰此为未解也。用柴胡、桂枝、黄芩。转少阳之枢而达太阳
之气。
牡蛎启厥阴之气以解胸胁之结。蒌根引水液之上升而止烦渴。汗下后中气虚矣。故用干
姜、
Treats Taiyang disease (disease of the Taiyang channel) progressing for six or seven days, presenting with fever and slight aversion to cold, vexatious pain in the limbs and joints, slight vomiting, a sensation of fullness and binding below the heart (epigastric region), where the exterior syndrome has not yet resolved; this decoction is indicated. Furthermore, if excessive sweating leads to loss of Yang Qi (vital energy) accompanied by delirious speech, purgation is contraindicated. Instead, Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) should be administered to harmonize Ying and Wei (nutritive and defensive qi) to unblock body fluids, after which the condition will heal spontaneously.
Chai Hu (Radix Bupleuri, 4 liang), Huang Qin (Radix Scutellariae, 1.5 liang), Ren Shen (Radix Ginseng, 1.5 liang), Ban Xia (Rhizoma Pinelliae, 2.5 he), Gan Cao (Radix Glycyrrhizae, 1 liang), Gui Zhi (Ramulus Cinnamomi).
The above nine ingredients are boiled in seven sheng of water until three sheng remain. The dregs are removed, and the liquid is taken warm.
Song says: Take half of the original Xiao Chai Hu Tang (Minor Bupleurum Decoction) for decoction; add Gui Zhi Tang (Cinnamon Twig Decoction) to complete the compound formula. (Sheng Jiang (Rhizoma Zingiberis Recens), Da Zao (Fructus Jujubae), and Gan Cao are present in both formulas; only half of Gui Zhi Tang is taken.)
Commentary by Yu: The explanation of Xiao Chai Hu Tang is found earlier in this section. This passage refers to Taiyang disease lasting six or seven days, marking the completion of one cycle of the channels, coinciding with the period when Taiyang governs the Qi. The pathogenic Qi cannot transform and exit from the chest.
Treats Taiyang disease lasting five or six days, where sweating has already been applied followed by purgation, resulting in fullness and slight binding in the chest and hypochondrium, difficulty in urination, thirst without vomiting, sweating only on the head, alternating chills and fever, and vexation; this indicates the pathogen has not yet resolved, and this decoction is indicated.
Chai Hu (Radix Bupleuri, 0.5 jin), Gui Zhi (Ramulus Cinnamomi, 3 liang), Gan Jiang (Rhizoma Zingiberis, 2 liang), Huang Qin (Radix Scutellariae, 3 liang), Mu Li (Concha Ostreae, 2 liang), Gan Cao (Radix Glycyrrhizae, 2 liang).
The above seven ingredients are boiled in twelve sheng of water until six sheng remain. The dregs are removed, and the liquid is boiled again until three sheng remain. One sheng is taken warm each time, three times a day. After the first dose, slight vexation may occur, then...
Song says: Eight liang of Chai Hu, two liang of Gan Cao, Mu Li, and Gan Jiang; Huang Qin and Gui Zhi at three liang each are suitable; four liang of Gua Lou Gen (Radix Trichosanthis) should be tasted. No vomiting, thirst, vexation, and sweating on the head indicate a disorder of the Shaoyang pivot mechanism, requiring precise and detailed differentiation.
Zhang Lingshao states: Taiyang disease lasting five or six days corresponds to the period when Jueyin governs the Qi. Above Jueyin lies Shaoyang. Excessive sweating followed by purgation disrupts the... hence the thirst. Without the mechanism of pivot transformation to the exterior, there is no vomiting. Sweating only on the head occurs because the fluids of Taiyang cannot reach the sides and only steam upward to the head. With deficient Qi unable to pivot, there is a phenomenon of alternating chills and fever. Jueyin internally belongs to the Pericardium and governs the collaterals, hence the vexation. This disease originates in Taiyang but involves Jueyin Qi, failing to exit via the Shaoyang pivot; thus it is said that the pathogen has not yet resolved. Using Chai Hu, Gui Zhi, and Huang Qin turns the Shaoyang pivot to reach the Taiyang Qi. Mu Li opens Jueyin Qi to resolve the binding in the chest and hypochondrium. Gua Lou Gen guides the ascent of fluids to relieve vexation and thirst. After sweating and purgation, the Middle Qi is deficient, hence Gan Jiang is used...