治伤寒若吐若下后。心下逆满。气上冲胸。起则头眩。脉沉紧。发汗
者。此方主之。
茯苓（四两） 桂枝（三两） 白术（二两） 甘草（二两 炙。）
上四味。以水六升。煮取三升。去滓。分温三服。
歌曰 病因吐下气冲胸。起则头眩身振从。茯四桂三术草二。温中降逆效从容。
张令韶曰。此治吐下后而伤肝气也。心下逆满者。心下为脾之部位。脾主中焦水谷之津。
吐
本脉本证。方
金匮所谓知肝之病当先实脾是也。
治发汗病不解。反恶寒者。虚故也。此汤主之。
芍药（三两） 甘草（三两 炙。） 附子（一枚 炮去皮。破八片）
以上三味。以水五升。煮取一升五合。去滓。温服。
歌曰 一枚附子胜灵丹。甘芍平行三两看。汗后恶寒虚故也。经方秘旨孰能攒。
男元犀按。各家以此证为发汗虚其表阳之气。似是而非。于病不解三字说不去。且虚故
也三
亦有大汗亡阳明之阳用白虎加人参法。亡少阴之阳用真武四逆法。论有明训也。今但云不解。
可
寒若系阳虚。四逆辈犹恐不及。竟以三两之芍药为主。并无姜、桂以佐之。岂不虑恋阴以扑
灭残阳乎。师恐人因其病不解而再行发汗。又恐因其恶寒而径用姜、附。故特切示曰虚故也。
言其所以不解。所以恶寒。皆阴阳素虚之故。补虚自足以胜邪。不必他顾也。方中芍药、甘
草。苦甘以补阴。附子、甘草。辛甘以补阳。附子性猛。得甘草而缓。芍药性寒。得附子而
和。且芍、草多而附子少。皆调剂之妙。此阴阳双补之良方也。论中言虚者。间于节中偶露
一二语。单言虚而出补虚之方者只一节。学人当从此隅反之。
Treats Taiyang disease (disease of the Taiyang channel) after emesis or purgation. Manifestations include fullness and rebellious qi in the epigastrium, qi rushing upward to the chest, dizziness upon standing, and a deep, tight pulse. If sweating therapy is mistakenly applied, this formula should be used as the primary treatment.
Fuling (Poria, 4 liang), Guizhi (Cinnamon Twig, 3 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 2 liang), Gancao (Licorice Root, 2 liang, honey-fried).
Take the above four herbs. Add six sheng of water. Decoct until three sheng remain. Remove the dregs. Divide into three warm doses.
The song states: The cause is qi rushing to the chest due to emesis and purgation; dizziness and body tremors occur upon rising. Use four parts Fuling, three parts Guizhi, two parts each of Baizhu and Gancao. Warming the middle and descending rebellious qi yields effective and从容 results.
Zhanglingshao says. This treats liver qi injury following emesis and purgation. "Fullness and rebellious qi in the epigastrium" refers to the epigastric region, which is the domain of the Spleen. The Spleen governs the fluids and essences of food and drink in the Middle Jiao.
Original pulse and original syndrome. Formula.
As stated in the *Jingui Yaolue*: Knowing that liver disease exists, one must first strengthen the Spleen.
Treats cases where Taiyang disease persists after sweating therapy, accompanied by aversion to cold. This indicates deficiency. This decoction is the primary treatment.
Shaoyao (Peony Root, 3 liang), Gancao (Licorice Root, 3 liang, honey-fried), Fuzi (Prepared Aconite Root, 1 piece, processed, skin removed, broken into eight pieces).
Take the above three herbs. Add five sheng of water. Decoct until one sheng and five he remain. Remove the dregs. Take warm.
The song states: One piece of Fuzi surpasses spiritual elixirs; consider Shaoyao and Gancao equally at three liang each. Aversion to cold after sweating is due to deficiency; who can grasp the secret principles of classic formulas?
Chen Yuanxi notes. Various schools interpret this syndrome as deficiency of exterior Yang qi due to sweating. This seems plausible but is incorrect, as it fails to explain the phrase "disease not resolved." Furthermore, the statement "due to deficiency"
There are also cases of massive sweating leading to loss of Yang Qi of the Yangming channel, treated with Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction). Cases of loss of Yang Qi of the Shaoyin channel are treated with Zhenwu Tang (True Warrior Decoction) or Sini Tang (Frigid Extremities Decoction). These are clearly stated in the treatise. Here, it only says "disease not resolved."
If the cold were due to Yang deficiency, Sini Tang category formulas might still be insufficient. Yet, this formula uses three liang of Shaoyao as the main herb, without Ginger or Cinnamon Twig to assist. Would one not worry about retaining Yin and extinguishing residual Yang? The Master (Zhang Zhongjing) feared people would re-sweat because the disease was not resolved, and feared they would directly use Ginger and Aconite because of aversion to cold. Thus, he specifically pointed out "due to deficiency."
He explains that the reason for the unresolved disease and the aversion to cold is due to inherent deficiency of both Yin and Yang. Tonifying deficiency is sufficient to overcome pathogenic factors; no other considerations are needed. In the formula, Shaoyao and Gancao use bitter and sweet flavors to tonify Yin. Fuzi and Gancao use pungent and sweet flavors to tonify Yang. Fuzi has a fierce nature, which becomes mild when combined with Gancao. Shaoyao has a cold nature, which becomes harmonious when combined with Fuzi. Moreover, the dosage of Shaoyao and Gancao is high while Fuzi is low, demonstrating the subtlety of formulation adjustment. This is an excellent formula for dual tonification of Yin and Yang. Mentions of "deficiency" in the treatise appear occasionally within sections. There is only one section that explicitly mentions "deficiency" and provides a formula for tonifying deficiency. Students should infer from this instance.