也。若自下利者。脉当微厥。今反和者。此为内实也。属调胃承气汤。
又曰。伤寒八九日。下之。胸满烦惊。小便不利。谵语。一身尽
重。不得转侧者。属柴胡加龙骨牡蛎汤。
又曰。火逆下之。因烧针。烦躁者。属桂枝甘草龙骨牡蛎汤。
又曰。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。而更恶寒。表未解也。医反下之。动数
变迟。膈内拒痛。（一作头痛即眩）胃中空虚。客气动膈。短气烦躁。
心中懊 。阳气内陷。心下因硬。则为结胸。属大陷胸证。若不结胸。
但头汗出。余处无汗。剂颈而还。小便不利。身必发黄。常氏云。可茵
陈蒿汤、调五苓散。
又曰。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。大陷胸汤主之。若
但满而不痛。此为痞。柴胡不中与之。属半夏泻心汤。
又曰。本以下之。故心下痞。与泻心汤。痞不解。其人渴而口燥
烦。小便不利者。属五苓散。（脉经云。一方言忍之一日乃愈。）
又曰。伤寒中风。医反下之。其人下利日数十行。谷不化。腹中
雷鸣。心下痞硬而满。干呕。心烦不得安。医见心下痞。谓病不尽。复
下之。其痞益甚。此非结热。但以胃中虚。客气上逆。故使硬也。属甘
草泻心汤。
又曰。伤寒。服汤药。下利不止。心下痞硬。服泻心汤已。复以他
药下之。利不止。医以理中与之。利益甚。理中者。理中焦。此利在下
焦。服赤石脂禹余粮汤。复利不止者。当利其小便。庞氏云。可五苓
散。
又曰。太阳病。外证未除而数下之。遂协热而利。利下不止。心
下痞硬。表里不解者。属桂枝人参汤。
又曰。下后。不可更行桂枝汤。汗出而喘。无大热者。属麻黄杏
子甘草石膏汤。
又曰。病患无表里证。发热七八日。脉虽浮数者。可下之。假令
已下。脉数不解。合热则消谷善饥。至六七日不大便者。有瘀血也。
属抵当汤。
又曰。若脉数不解。而下不止。必协热。便脓血。
又曰。本太阳病。医反下之。因而腹满时痛者。属太阴也。桂枝
加芍药汤主之。大实痛者。属桂枝加大黄汤。
又曰。伤寒六七日。大下后。寸脉沉而迟。手足厥冷。下部脉不
至。咽喉不利。吐脓血。泄利不止者。为难治。属麻黄升麻汤。
又曰。伤寒本是自寒下。医复吐下之。寒格。更逆吐下。若食入
口即出。属干姜黄芩黄连人参汤。此证根据脉经定。
千金翼曰。大下后。口燥者。里虚故也。
庞氏曰。因发汗时。汗出如水漏下。还复汗少。喘促不止。脉促
而按之濡者。合当汗而解。脉促而按之实者死。若脉浮。手足微厥。
面垢唇青。昏愦而喘者。阴阳未和。气阻升降。宜服顺阴阳五味子
汤。
又曰。发汗。或下后。痞满。或成结胸。气塞不通。宜槟榔散。
如果患者出现自发性腹泻，脉象应当表现为微弱或四肢厥冷。现在脉象反而平和，这是体内有实邪的表现，属于调胃承气汤证。
又说：伤寒病经过八九日，误用下法后，出现胸中满闷、烦躁惊悸、小便不利、胡言乱语、全身沉重、不能随意转侧的症状，属于柴胡加龙骨牡蛎汤证。
又说：因火疗逆治又误用下法，再加上烧针刺激，导致烦躁不安的，属于桂枝甘草龙骨牡蛎汤证。
又说：太阳病，脉象浮而动数。浮脉主风邪，数脉主热，动脉主痛，数脉也主虚。头痛发热，微微盗汗，却又恶寒，说明表证未解。医生反而误用下法，导致动数之脉变为迟脉，膈内拒按疼痛（一说为头痛即眩晕），胃中空虚，外邪乘虚扰动膈间，出现短气、烦躁、心中懊恼。阳气内陷，心下因此变硬，这就形成了结胸，属于大陷胸证。如果不形成结胸，仅见头部出汗，身体其他部位无汗，汗止于颈部，小便不利，身体必然发黄。常氏说，可用茵陈蒿汤、五苓散加减治疗。
又说：伤寒五六日，出现呕吐且发热的，具备小柴胡汤证的特征，却用了其他药物误下。若柴胡证仍在，可再次给予小柴胡汤。虽然已经误下，但不算逆证，患者必定会先蒸蒸而振栗，随后发热汗出而病愈。如果心下胀满且硬痛，这是结胸，由大陷胸汤主治。如果仅胀满而不疼痛，这是痞证，不可用小柴胡汤，属于半夏泻心汤证。
又说：原本因为误下导致心下痞，给予泻心汤治疗后，痞证未解，患者口渴、口燥烦扰、小便不利的，属于五苓散证。（《脉经》记载，有一种说法是忍耐一天即可痊愈。）
又说：伤寒中风，医生反而误用下法，导致患者每天腹泻数十次，完谷不化，腹中雷鸣，心下痞硬且满闷，干呕，心烦不得安宁。医生见心下痞，认为病邪未尽，再次误下，导致痞证更加严重。这不是热结，而是因为胃气虚弱，客气上逆，所以导致痞硬，属于甘草泻心汤证。
又说：伤寒，服用汤药后，腹泻不止，心下痞硬。服用泻心汤后，又用其他药物误下，腹泻仍不止。医生用理中汤治疗，腹泻反而更严重。理中汤是调理中焦的，此处的腹泻在下焦，应服用赤石脂禹余粮汤。如果服后腹泻仍不止，应当通利小便。庞氏说，可用五苓散治疗。
又说：太阳病，表证未除却多次误下，导致协热下利，腹泻不止，心下痞硬，表里同病不解的，属于桂枝人参汤证。
又说：下法之后，不可再使用桂枝汤。若出现汗出而喘，体表没有大热的，属于麻黄杏仁甘草石膏汤证。
又说：患者没有明显的表证或里证，发热七八日，脉象虽浮数，可以用下法。假如已经用过下法，脉数仍未解除，邪热与胃肠相合，导致消谷善饥，到了六七天不大便的，是有瘀血，属于抵当汤证。
又说：原本太阳病，医生反而误用下法，导致腹部胀满、时时作痛的，属于太阴病，由桂枝加芍药汤主治。若大实痛者，属于桂枝加大黄汤证。
又说：伤寒六七日，经过剧烈攻下后，寸脉沉而迟，手足厥冷，下部脉摸不到，咽喉不利，吐脓血，泄利不止的，为难治之证，属于麻黄升麻汤证。
又说：伤寒本是由寒邪直中引起，医生又误用吐下法，导致寒热格拒，加重吐下，若食物入口即吐出，属于干姜黄芩黄连人参汤证。此证依据《脉经》确定。
庞氏说：因发汗时，汗出如水漏下，后来汗出减少，但喘促不止，脉促而按之濡软的，应当通过发汗解表；脉促而按之坚实的预后不良（死）。若脉浮，手足微厥，面色垢浊、唇青，昏愦且喘息的，是阴阳未和，气机阻滞升降，宜服用顺阴阳五味子汤。
If spontaneous diarrhea occurs, the pulse should be faint or accompanied by cold extremities. Now that the pulse is instead harmonious, this indicates internal excess; it belongs to the category of Tiaowei Chengqi Tang (Regulate the Stomach and Purge Down Decoction).
It is also said: After eight or nine days of Shaoyang disease (Cold Damage), if purgatives are mistakenly administered, resulting in chest fullness, irritability, fright, dysuria, delirium, heaviness of the entire body, and inability to turn over, it belongs to the category of Chaihu Jia Longgu Muli Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction).
It is also said: Due to counterproductive fire therapy followed by purgation, compounded by burning needles, resulting in restlessness and irritability, it belongs to the category of Guizhi Gancao Longgu Muli Tang (Cinnamon Twig and Licorice Plus Dragon Bone and Oyster Shell Decoction).
It is also said: In Taiyang disease (Taiyang Syndrome), the pulse is floating, active, and rapid. Floating indicates wind; rapid indicates heat; active indicates pain; rapid also indicates deficiency. Headache, fever, slight night sweats, yet aversion to cold persists, indicating the exterior syndrome has not resolved. The physician mistakenly applies purgation. The active and rapid pulse changes to a slow one. Pain resists pressure within the diaphragm (alternatively described as headache with dizziness). The stomach becomes empty and deficient; pathogenic qi moves into the diaphragm, causing shortness of breath, irritability, and inner vexation (Ao Nao). Yang qi sinks inward, causing hardness below the heart, forming Jie Xiong (Chest Binding); this belongs to the Da Xianxiong Zheng (Major Chest Binding Syndrome). If Jie Xiong does not form, but there is only sweating on the head with no sweat elsewhere, stopping at the neck, along with dysuria, jaundice will inevitably develop. Chang Shi states that Yinchen Hao Tang (Artemisia Capillaris and Yellow Bean Decoction) and Wu Ling San (Five-Ingredient Powder with Poria) can be used.
It is also said: In Cold Damage lasting five or six days, vomiting and fever indicate that the Chaihu Tang (Bupleurum Decoction) pattern is complete. If other medicines are mistakenly used for purgation, and the Chaihu pattern remains, administering Chaihu Tang again is appropriate. Although purgation has been performed, it is not a counterproductive error. The patient will inevitably experience shivering and trembling, followed by fever and sweating, leading to resolution. If the epigastrium is full, hard, and painful, this is Jie Xiong (Chest Binding), treated primarily with Da Xianxiong Tang (Major Chest Binding Decoction). If it is merely full without pain, this is Pi (Glomus/Blockage); Chaihu Tang is not indicated. It belongs to the category of Banxia Xiexin Tang (Pinellia Drain the Epigastrium Decoction).
It is also said: Originally due to mistaken purgation causing Pi (Glomus) below the heart, Xiexin Tang was given, but the Pi did not resolve. If the person is thirsty, has dry mouth and vexation, and experiences dysuria, it belongs to the category of Wu Ling San (Five-Ingredient Powder with Poria). (The Mai Jing states that one version suggests enduring it for a day leads to recovery.)
It is also said: In Cold Damage with Wind Strike, if the physician mistakenly uses purgation, the person may suffer from diarrhea dozens of times a day, undigested food, borborygmus in the abdomen, hardness and fullness below the heart, dry retching, and mental vexation preventing peace. Seeing the Pi below the heart, the physician assumes the pathogen is not exhausted and purges again, making the Pi worse. This is not heat binding, but rather deficiency in the stomach with rebellious pathogenic qi rising, causing hardness. It belongs to the category of Gancao Xiexin Tang (Licorice Drain the Epigastrium Decoction).
It is also said: In Cold Damage, after taking herbal medicine, diarrhea continues incessantly with hardness below the heart. After taking Xiexin Tang, other purgatives are mistakenly used, and diarrhea persists. The physician administers Lizhong Tang (Regulate the Middle Decoction), but the diarrhea worsens. Lizhong Tang regulates the Middle Jiao; this diarrhea is located in the Lower Jiao. One should take Chishizhi Yuyuliang Tang (Red Stone Lipid and Hematite Decoction). If diarrhea persists despite this, one should promote urination. Pang Shi states that Wu Ling San (Five-Ingredient Powder with Poria) can be used.
It is also said: In Taiyang disease, if the exterior syndrome remains but multiple purgations are applied, it leads to Xiere Li (Collateral Heat Diarrhea), with incessant diarrhea, hardness below the heart, and unresolved interior and exterior conditions. It belongs to the category of Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction).
It is also said: After purgation, Guizhi Tang (Cinnamon Twig Decoction) should not be used again. If there is sweating and wheezing without significant heat, it belongs to the category of Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction).
It is also said: If the patient has neither obvious exterior nor interior symptoms, but has had fever for seven or eight days, and although the pulse is floating and rapid, purgation may be considered. Suppose purgation has already been applied, but the rapid pulse remains unresolved. Combined heat consumes grain, leading to easy hunger. By the sixth or seventh day, if there is no bowel movement, there is blood stasis. It belongs to the category of Dandang Tang (Resist the Bull Decoction).
It is also said: If the rapid pulse remains unresolved and diarrhea continues, it must involve collateral heat, leading to pus and blood in the stool.
It is also said: Originally Taiyang disease, if the physician mistakenly uses purgation, resulting in abdominal fullness and intermittent pain, it belongs to the Taiyin syndrome. It is primarily treated with Guizhi Jia Shaoyao Tang (Cinnamon Twig Plus White Peony Root Decoction). For severe excessive pain, it belongs to Guizhi Jia Dahuang Tang (Cinnamon Twig Plus Rhubarb Decoction).
It is also said: In Cold Damage lasting six or seven days, after severe purgation, the Cun (Inch) pulse is deep and slow, with cold extremities, and the pulses at the lower position are absent. With difficulty opening the throat, expectoration of pus and blood, and incessant diarrhea, it is difficult to treat. It belongs to the category of Mahuang Shengma Tang (Ephedra and Ma-Huang Decoction).
It is also said: Cold Damage originally arose from cold descending internally. If the physician further applies emesis and purgation, it causes Han Ge (Cold Obstruction), exacerbating vomiting and diarrhea. If food is vomited immediately upon ingestion, it belongs to the category of Ganjiang Huangqin Huanglian Renshen Tang (Dried Ginger, Scutellaria, Coptis, and Ginseng Decoction). This pattern is determined based on the Mai Jing.
Qianjin Yi states: After severe purgation, dry mouth occurs due to interior deficiency.
Pang Shi states: During sweating therapy, if sweat pours out like leaking water, then later sweat decreases but wheezing continues incessantly, and the pulse is rapid but soft upon palpation, it should be resolved through sweating. If the pulse is rapid and firm upon palpation, death is likely. If the pulse is floating, with slightly cold extremities, greasy complexion, blue lips, stupor, and wheezing, yin and yang are not harmonized, and qi mechanism obstructs ascending and descending. One should take Shun Yin Yang Wuweizi Tang (Harmonize Yin and Yang with Schisandra Decoction).
It is also said: After sweating or purgation, if Pi Man (Glomus and Fullness) occurs, or Jie Xiong (Chest Binding) forms, with blocked qi flow, Binglang San (Areca Seed Powder) is suitable.