（太阳为寒水之经。主一身之表。）
何谓太阳经症。曰。头痛项强。发热恶寒是也。有虚邪实邪之辨。
脉缓。自汗恶风。为虚邪。宜桂枝汤。如八九日过经不解。如疟状。面热。身痒。以其不得小汗故也。宜桂
枝麻黄各半汤。因前此未汗。不得不发其汗。因日数颇久。故小发其汗。如服桂枝汤。大汗出后。形如
疟。日再发者。以余邪未尽故也。宜桂枝二麻黄一汤。大汗之后。不得再行大汗之法。而余邪未尽。不得
不从汗而竭之。但药品宜轻耳。
脉浮紧。无汗恶寒。为实邪。宜麻黄汤。如无汗烦躁者。加石膏姜枣。名大青龙汤。如干呕而咳。去杏
仁。加五味干姜半夏细辛芍药。名为小青龙汤。此二汤。即麻黄汤之加减。总不出麻黄汤之范围。
此二法。治表中之表也。
何谓太阳腑症。曰。表邪不去。必入于里。膀胱为表中之里也。有蓄水蓄血之辨。
太阳病。其人口渴。烦躁不得眠。脉浮。小便不利。水入即吐。为膀胱蓄水症。宜五苓散。
太阳病。其人如狂。小腹硬满。小便自利。脉沉。为膀胱蓄血症。宜桃仁承气汤。
此二法。治表中之里也。
何谓太阳变症。曰。汗下失宜。从阴从阳之不一也。
不应下而下之。续得下利清谷。身疼痛。宜四逆汤。以救清谷之里。又以桂枝汤。以救身疼痛之表。
病发热头痛。脉反沉。若不瘥。身体疼痛。当救其里。宜四逆汤。
大汗大下利而厥冷者。四逆汤主之。
太阳病。发汗太过。遂漏不止。其人恶风。小便难。四肢微急。难以屈伸。桂枝加附子汤主之。
太阳病。发汗太过。动其荣血。而卫邪反内伏。其人仍发热。心下悸。头眩身 动。振振欲擗地者。真武汤主之。
以上言汗下太过。伤正而虚其阳。阳虚则从少阴阴化之症多。以太阳少阴为表里也。
阳盛于内。误服桂枝汤。大汗出后。大烦大渴不解。脉洪大者。白虎加人参汤主之。
伤寒若吐若下后。七八日不解。热结在里。表里俱热。时时恶风。大渴。舌上干燥而烦。欲饮水数升者。白虎
加人参汤主之。
伤寒不大便六七日。为里症。头痛发热。为表症。外不解。由于内不通也。下之。里和而表自解矣。与承气汤。
病患烦热。汗出则解。又如疟状。日晡所发热。属阳明也。脉实者。宜下之。与大承气汤。脉虚者。宜发汗。与桂
枝汤。
发汗后恶寒者。虚故也。不恶寒但热者。实也。当和胃气。与调胃承气汤。
太阳病未解。脉阴阳俱停。停者沉滞不起也。阴阳者尺寸也。必先振栗。汗出乃解。但阳脉微者。先汗而解。
但阴脉微者。下之而解。若欲下之。宜调胃承气汤。按此脉微。即上文脉停也。
以上言汗下失宜。热炽而伤其阴。阴伤则从阳明阳化之症多。以太阳阳明递相传也。
何谓发汗利水为治太阳两大门。曰。邪伤太阳。病在寒水之经。驱其水气以外出则为汗。逐其水气以下
出。后为黄涎蓄水。前为小便长。
太阳为寒水之经。邪之初伤。必须发汗。麻黄汤发皮肤之汗。桂枝汤发经络之汗。葛根汤发肌肉之汗。
小青龙汤发心下之汗。大青龙汤发其内扰胸中之阳气而为汗。此发汗之五法也。
若汗之而不能尽者。则为水。水在心下。干呕而咳。宜小青龙汤。发热而烦。渴欲饮水。水入即吐。名曰水
逆。宜五苓散。汗后心下痞硬。干噫食臭。胁下有水气。腹中雷鸣下利者。病势虽在腹中。而病根犹在心
下。宜生姜泻心汤。此水气在上焦。在上者。汗而散之也。若妄下之后。自心上至小腹。硬满而痛不可近。
（水与气所结）脉迟。名大结胸。宜大陷胸汤。若项亦强。如柔 之状。宜大陷胸丸。盖病势连于下者主以汤。病
势连于上者主以丸是也。若其结止在心下。按之始痛。脉浮滑。名小结胸。邪气尚在脉络。宜小陷胸汤。
若无热症。名寒实结胸。宜三物白散。若心下痞硬满。引胁下痛。干呕。短气。汗出不恶寒。三焦升降之气。
阻格难通。宜十枣汤。此水气在中焦。中满。泻之于内也。若头痛项强。翕翕发热。无汗。心下满微痛。小便
不利者。因膀胱之水不行。营卫不调。不能作汗。宜以桂枝去桂加茯苓白术汤治之。是水气在下焦。在
下者。引而竭之是也。
内经云。太阳之上。寒气治之。所谓本也。本之下。中之见也。见之下。气之标也。又曰。太阳从本从标。又曰。
太
阳为开。又热病论曰。伤寒一日。巨阳受之。故头项痛。腰脊强。
伤寒论云。太阳之为病。脉浮。头项强痛而恶寒。
又云。太阳病。发热汗出。恶风脉缓者。名为中风。
又云。太阳中风。阳浮而阴弱。阳浮者。热自发。阴弱者。汗自出。啬啬恶寒。淅淅恶风。翕翕发热。鼻鸣干呕者。
桂枝汤主之。
又云。太阳病。头痛发热。身疼腰痛。骨节疼痛。恶风。无汗而喘者。麻黄汤主之。
太阳主一身之表。六经中最外一层。故表病俱属太阳。但有表中之表。病在肌腠则有汗。宜桂枝汤。病
在肤表则无汗。宜麻黄汤。两法用之得当。一剂可愈。又有脉微恶寒。面色反有热色而身痒。是邪欲出
而未得遽出。必得小汗而解。宜桂枝麻黄各半汤。又有服桂枝汤。大汗出后。形如疟。日再发。是肌病兼
见表病。宜桂枝二麻黄一汤。是二方。即上两法之佐也。然二方能治肌腠肤表之病。不能治经输之病。
太阳之经输在背。内经云。邪入于输。腰背乃强。论中以项背强KT KT 。无汗恶风。用葛根汤。项背强KT KT 。
反汗出恶风。用桂枝加葛根汤。二方亦上两法之佐也。但两法俱是太阳本寒之症。故方中取用辛热
之品。若太阳标热之自汗症。不得径用桂枝汤。宜用芍药甘草汤。以各症与桂枝症无异。惟脚挛急独
异。是太阳之标热合少阴之本热之病也。无汗症。不得用麻黄汤。宜用麻杏甘膏汤。以各症与麻黄证
相似。惟初起口渴发热而无恶寒。或发汗已身灼热不似。论虽另别为温病风温之证。然节首冠以太
阳病三字。盖指太阳之标热而言。明明为一隅之举。不读内经。不能解也。其云桂枝二越婢一汤。为标
内陷于里阴而化热。故热多寒少。而脉微弱。论曰无阳。言无在表之阳也。论曰不可发汗。言不可发太
阳之表汗也。故用此汤。直从里阴而外越之也。此又可借用为上两法之佐也。
然太阳为表而亦有里。膀胱即太阳之里也。如太阳病。发热无汗。而心下满。微痛。小便不利。不宜取汗。
宜桂枝去桂加茯苓白术汤。令小便利则愈。又有发汗后。脉浮。小便不利。微热消渴之症。又有中风发
热。六七日不解。而烦为表症。渴欲饮水为里症。论名曰表里症。水入则吐。论名曰水逆证。两证俱宜五
苓散。多饮暖水以出汗。此表中里症之治法也。至若大青龙汤。因脉浮紧。身疼痛。不汗出而烦躁。为麻
黄证之重者而设。小青龙汤。因表不解。水停心下而咳噎。变大青龙汤之大寒大散。而为发汗利水之
剂。即是麻黄汤之加减。总不出麻黄汤之范围。即若桂枝去芍药汤。因桂枝症误下。脉促胸满而设。桂
枝去芍药加附子汤。又因前症脉不见促而见微。身复恶寒而设。桂枝加附子汤。因发汗太过。遂漏不
止。恶风。小便难。四肢微急难以屈伸而设。此因大汗以亡阳。因亡阳以脱液。取附子以固少阴之阳。固
阳即所以止汗救液也。推之汗后。病已解复烦。及桂枝症初服桂枝汤。反烦不解。刺风池风府。却再与
桂枝汤则愈。其用甚广。总不出于桂枝证头痛发热汗出恶风八个字之外。须知太阳治法。不外桂枝
麻黄二汤。服麻黄汤之后。复有再服桂枝汤之法。服桂枝汤之后。并无再服麻黄汤之法。更须知太阳
为寒水之经。病本寒者较多。病标热者较少。若标本兼病。亦以热多寒少为欲愈。治伤寒者当知所重
矣。此论太阳病。以桂枝麻黄二汤为主。一线到底。千古注家。无此明晰。外此亦即二汤之更进一步。非
离乎二汤之外而立法也。
太阳主一身最外一层。邪从外来。须要驱之使出。服上二汤。尚不能出。或留本经。或侵他经。必藉少阳
之枢转以达太阳之气而外出也。故小柴胡汤。为太阳篇之要剂。今人不知。擅改为少阳主方。失之远
矣。故无论桂枝证麻黄证。若值三日。九日。十五日。少阳主气之期。必藉其枢转而出。或又见往来寒热。
枢不转。现出开阖不利之象。胸胁苦满。胸乃太阳出入之部。胁为少阳所主之枢。默默不欲食。心烦。默
默必神机内郁。而心烦喜呕不欲食。必胃气不和而喜呕。呕则逆气少疏。故喜也。或涉于心而不涉于
胃。则胸中烦而不呕。或涉于阳明之燥气。则渴。或涉于太阴之脾气。则腹中痛。或涉于厥阴之肝气。则
胁下痞硬。或涉于少阴之肾气。则心下悸而小便不利。或太阳藉少阳之枢转已有向外之势。则不渴
身有微热。或涉于太阴之肺气。则咳者。皆以小柴胡为主。而随其或然之证。加减而治之。若太阳病过经
不解。先与小柴胡汤。呕不止心下急。郁郁微烦。与大柴胡汤下之。以平其胃则愈。凡太阳篇有柴胡
之方。或因其病象有从枢欲达之意。而以柴胡达之。抑因其久郁未解之邪。而以柴胡可以从枢达之。
无非乘机利导之法。亦即麻黄桂枝二汤进一步之佐也。
推而言之。太阳之气外行于胸膈。不能外而病于内。实则为大小陷胸汤证。虚则为诸泻心汤证。且太
阳之气。上行而至于头。下行而归于腹。不能上而病于下。从背而下结于胞室。则为桃仁承气汤证。从
胸而下瘀于胞室。则为抵当汤证。何莫非桂枝麻黄二汤应用不用。或用之失法所致哉。盖太阳经正
治法。不过二十余条而已。其他则皆权变法。斡旋法也。假使治伤寒者。审其脉之或缓或紧。辨其症之
有汗无汗。则从而汗之解之。如桂枝麻黄等法。则邪却而病除矣。其或合阳明。或合少阳。或合三阳者。
则从而解之清之。如葛根汤治太阳阳明合病下利。葛根加半夏汤治合病不下利而但呕者。黄芩汤
治太阳少阳合病而自利。黄芩加半夏生姜汤治合病而呕者。如白虎汤治三阳合病。其云腹满者。为
阳明经热合于前也。其云身重者。为太阳经热合于后也。其云难以转侧者。为少阳经热合于侧也。其
云口不仁而面垢者。热合少阳之腑也。其云谵语者。热合阳明之腑也。其云遗尿者。热合太阳之腑也。
既审其为三阳之合。又必得自汗出之的证。而后用白虎汤之的方。斯邪分而病解。此为正治之法。
顾人气体有虚实之殊。脏腑有阴阳之异。或素有痰饮痞气。以及咽燥淋疮汗衄之疾。或适当房室金
刃产后亡血之余。是虽同为伤寒之候。不得竟用麻桂之法矣。于是有旋覆代赭石汤。治伤寒汗吐下
解后。心下痞硬。噫气不除。是胃气弱而未和。痰气动而上逆之症。有茯苓桂枝白术甘草汤。治吐下后
邪解。而为饮发之证。金匮云。膈间支饮。其人喘满。心下痞坚。又云。心下有痰饮。胸胁支满。目眩。又云。其
人振振身 。剧者必有伏饮。其云发汗则动经者。言无邪可发。而反动其经气也。有承气汤。治伤寒六
七日不大便。头痛有热。必衄。以阳热太重。以此汤承在上之热气而使之下也。有小建中汤。以治伤寒
二三日。心悸而烦。补中气以生心血。有炙甘草汤。治脉结代。心动悸。启肾阴以行于脉道。有四逆汤。治
发热头痛。脉反沉。身体疼痛。扶肾阳以救其虚陷。是为权变之法。而用桂枝麻黄等法。又不能必其无
过与不及之弊。或汗出不彻。而邪不外散。则有传变他经。及发黄蓄血之病。如中风以火劫汗。则两阳
熏灼。其身发黄。阳盛则欲衄。阴虚则小便难。甚则见发哕谵语。捻衣摸床诸危症。服药得小便利者。方
可治之。如桂枝证外不解。而热结膀胱。其人如狂。血得自下乃愈。若小腹急结。有桃仁承气汤之轻攻
法。如麻黄证表不解。脉微而沉。其人狂。其邪反不结于胸。而直下于少腹而硬满。为瘀热在里。又身黄
脉沉结。小便自利。不为水而为血。其血不能自下。必攻而始下。又有抵当汤之峻攻法也。或汗出过多
而并伤其阳气。则有振振擗地。肉 筋惕。为真武汤之证。有发汗后血液内亡。身疼痛。脉沉迟者。为桂
枝加芍药生姜人参新加汤证。有发汗过多虚其心气。其人叉手冒心喜按者。为桂枝甘草汤证。有发
汗后虚其肾气。脐下悸。欲作奔豚。为茯苓桂枝甘草大枣汤证。有发汗后伤其中气。不能营运升降而
腹胀满。为浓朴生姜甘草人参半夏汤证。有发汗后反恶寒。阴阳两虚。为芍药甘草附子汤证。且有更
发汗。小发汗。论中有论而无方。亦可以意会之。是为斡旋之法。学人宜究心焉。
什么是太阳经的症状？回答说：头痛、项部僵硬、发热、恶寒就是太阳经的症状。其中有虚邪和实邪的区别。
脉象缓，自汗出，怕风，属于虚邪。适宜用桂枝汤。如果过了八九天，病邪未解，症状像疟疾一样，面部发热，身体发痒，这是因为没有微微出汗的缘故。适宜用桂枝麻黄各半汤。因为之前没有发汗，不得不发汗；但因为病程较长，所以只轻微发汗。如果服用桂枝汤后，大汗出，病情像疟疾，一天发作两次，这是因为残余的病邪未尽。适宜用桂枝二麻黄一汤。大汗之后，不能再行大汗之法，而余邪未尽，不得不通过发汗来彻底清除。只是药物剂量宜轻。
脉象浮紧，无汗，恶寒，属于实邪。适宜用麻黄汤。如果无汗且烦躁，加入石膏、生姜、大枣，名为大青龙汤。如果有干呕且咳嗽，去掉杏仁，加入五味子、干姜、半夏、细辛、芍药，名为小青龙汤。这两个方剂，就是麻黄汤的加减变化，总不出麻黄汤的范围。
这两种治法，是治疗表中之表。
什么是太阳腑证？回答说：表邪不去，必定入里。膀胱是表中之里。有蓄水证和蓄血证的区别。
太阳病，病人口渴，烦躁不能入睡，脉浮，小便不利，喝水即吐，这是膀胱蓄水证。适宜用五苓散。
太阳病，病人神志如狂，小腹硬满，小便自利，脉沉，这是膀胱蓄血证。适宜用桃仁承气汤。
这两种治法，是治疗表中之里。
什么是太阳变证？回答说：汗法和下法使用不当，导致从阴化或从阳化的不同情况。
不该用下法而下之，接着出现下利清谷（大便中有未消化的食物），身体疼痛。适宜用四逆汤，以救治下利清谷的里证；又用桂枝汤，以救治身体疼痛的表证。
病发热头痛，脉象反而沉，如果不好转，身体疼痛，应当先救其里。适宜用四逆汤。
太阳病，发汗太过，导致汗漏不止，病人怕风，小便困难，四肢微急，难以屈伸。由桂枝加附子汤主治。
太阳病，发汗太过，扰动营血，而卫分之邪反内伏，病人仍然发热，心下悸动，头晕，身体颤动，振振欲倒地者，由真武汤主治。
以上讲的是汗下太过，损伤正气而使其阳气虚弱。阳虚则多出现从少阴阴化的症状，因为太阳与少阴互为表里。
阳气盛于内，误服桂枝汤，大汗出后，大烦渴不解，脉洪大的，由白虎加人参汤主治。
伤寒若用吐法或下法后，七八天病不解，热结在里，表里俱热，时时怕风，大渴，舌上干燥而烦躁，想喝几升水的，由白虎加人参汤主治。
伤寒不大便六七天，这是里证；头痛发热，这是表证。外证不解，是由于内部不通畅。用下法，里气和顺了，表证自然解除。给予承气汤。
病人烦热，汗出则缓解，又像疟疾一样，傍晚发热，这属于阳明病。脉实的，适宜用下法，给予大承气汤。脉虚的，适宜用发汗法，给予桂枝汤。
发汗后怕冷的，是虚证。不怕冷只发热的，是实证。应当调和胃气，给予调胃承气汤。
太阳病未解，脉象寸关尺都沉滞不起。停，指沉滞不起。阴阳，指寸脉和尺脉。必须先战栗，然后出汗才能解除。如果只有阳脉（寸脉）微，先发汗而解。如果只有阴脉（尺脉）微，用下法而解。如果想用下法，适宜用调胃承气汤。按此处的“脉微”，就是上文说的“脉停”。
以上讲的是汗下失宜，热炽盛而伤阴。阴伤则多出现从阳明阳化的症状，因为太阳与阳明递相传变。
什么是发汗和利水是治疗太阳病的两大法门？回答说：邪气伤害太阳，病在寒水之经。驱除水气向外排出则为汗；逐除水气向下排出，后为黄涎蓄水，前为小便通长。
太阳是寒水之经，邪气初伤，必须发汗。麻黄汤发皮肤之汗，桂枝汤发经络之汗，葛根汤发肌肉之汗，小青龙汤发心下之汗，大青龙汤发其内扰胸中之阳气而为汗。这是发汗的五种方法。
如果发汗而不能尽除病邪，就会化为水饮。水在心下，干呕而咳，适宜用小青龙汤。发热而烦，渴欲饮水，水入即吐，名叫水逆，适宜用五苓散。发汗后心下痞硬，打嗝有食臭味，胁下有水气，腹中雷鸣下利者，病势虽在腹中，但病根还在心下，适宜用生姜泻心汤。这是水气在上焦。在上焦的，用发汗散之的方法。如果误用下法后，自心上至小腹，硬满而痛不可触碰。（这是水与气相结）脉迟，名叫大结胸，适宜用大陷胸汤。如果项部也强直，像柔痉的样子，适宜用大陷胸丸。大概病势连于下的，主用汤剂；病势连于上的，主用丸剂。如果结聚仅在心下，按压才痛，脉浮滑，名叫小结胸，邪气尚在脉络，适宜用小陷胸汤。如果没有热症，名叫寒实结胸，适宜用三物白散。如果心下痞硬满，牵引胁下痛，干呕，短气，汗出不恶寒，三焦升降之气，阻格难通，适宜用十枣汤。这是水气在中焦。中焦满闷，用泻之于内的方法。如果头痛项强，翕翕发热，无汗，心下满微痛，小便不利者，是因为膀胱之水不行，营卫不调，不能作汗。适宜用桂枝去桂加茯苓白术汤治疗。这是水气在下焦。在下焦的，用引而竭之的方法。
《内经》说：太阳之上，寒气治之，所谓本也。本之下，中之见也。见之下，气之标也。又说：太阳从本从标。又说：太阳为开。又《热病论》说：伤寒一日，巨阳受之，故头项痛，腰脊强。
又说：太阳中风，阳浮而阴弱。阳浮者，热自发。阴弱者，汗自出。啬啬恶寒，淅淅恶风，翕翕发热，鼻鸣干呕者，桂枝汤主之。
又说：太阳病，头痛发热，身疼腰痛，骨节疼痛，恶风，无汗而喘者，麻黄汤主之。
太阳主管一身之表，是六经中最外面的一层。所以表病都属于太阳，但有表中之表的区别。病在肌腠则有汗，适宜用桂枝汤；病在肤表则无汗，适宜用麻黄汤。两种方法使用得当，一剂可愈。又有脉微恶寒，面色反红而身痒，这是邪气欲出而未得遽出，必须得小汗而解，适宜用桂枝麻黄各半汤。又有服桂枝汤，大汗出后，形如疟，一天发作两次，这是肌病兼见表病，适宜用桂枝二麻黄一汤。这两个方剂，就是上述两法的辅助。然而这两个方能治肌腠肤表之病，不能治经输之病。
太阳的经输在背部。《内经》说：邪入于输，腰背乃强。《伤寒论》中以项背强几几，无汗恶风，用葛根汤；项背强几几，反汗出恶风，用桂枝加葛根汤。这两个方剂也是上述两法的辅助。但这两法都是太阳本寒的症状，所以方中取用辛热之品。如果是太阳标热的自汗症，不得径用桂枝汤，适宜用芍药甘草汤。因为各症与桂枝症无异，惟独脚挛急不同，这是太阳之标热合少阴之本热的病。无汗症，不得用麻黄汤，适宜用麻杏甘膏汤。因为各症与麻黄证相似，惟独初起口渴发热而无恶寒，或者发汗后身灼热不像麻黄证。《伤寒论》虽然另列为温病风温之证，但篇首冠以太阳病三字，大概是指太阳之标热而言。明明是一隅之举，不读《内经》，不能理解。其中提到的桂枝二越婢一汤，是为标热内陷于里阴而化热，所以热多寒少，而脉微弱。《伤寒论》说无阳，是指无在表之阳。《伤寒论》说不可发汗，是指不可发太阳之表汗。所以用此汤，直接从里阴而外越之。这又可以借用作为上述两法的辅助。
然而太阳为表，也有里。膀胱即是太阳之里。如太阳病，发热无汗，而心下满，微痛，小便不利，不宜取汗，适宜用桂枝去桂加茯苓白术汤，令小便通利则愈。又有发汗后，脉浮，小便不利，微热消渴之症。又有中风发热，六七天不解，而烦为表症，渴欲饮水为里症，《伤寒论》名叫表里症。水入则吐，《伤寒论》名叫水逆证。两个证都适宜用五苓散，多饮暖水以出汗。这是表中里症的治法。至于大青龙汤，因脉浮紧，身疼痛，不汗出而烦躁，是为麻黄证的重者而设。小青龙汤，因表不解，水停心下而咳噎，将大青龙汤的大寒大散，变为发汗利水的剂型。即是麻黄汤的加减，总不出麻黄汤的范围。又如桂枝去芍药汤，因桂枝证误下，脉促胸满而设。桂枝去芍药加附子汤，又因前症脉不见促而见微，身复恶寒而设。桂枝加附子汤，因发汗太过，遂汗漏不止，恶风，小便难，四肢微急难以屈伸而设。这是因为大汗亡阳，因亡阳脱液，取附子以固少阴之阳，固阳即所以止汗救液。推而言之，发汗后，病已解复烦，以及桂枝症初服桂枝汤，反烦不解，刺风池、风府，再给桂枝汤则愈。其用法很广，总不出于桂枝证头痛发热汗出恶风八个字之外。须知太阳治法，不外桂枝、麻黄二汤。服麻黄汤之后，还有再服桂枝汤的方法；服桂枝汤之后，并无再服麻黄汤的方法。更须知太阳是寒水之经，病本寒者较多，病标热者较少。如果标本兼病，也以热多寒少为欲愈。治伤寒者应当知道重点所在。此论太阳病，以桂枝、麻黄二汤为主，一线到底，千古注家，没有如此明晰。除此之外，也就是二汤的更进一步，并非离乎二汤之外而立法。
太阳主管一身最外一层，邪从外来，须要驱之使出。服用上述二汤，尚不能出，或留本经，或侵他经，必藉少阳之枢转以达太阳之气而外出。所以小柴胡汤，是太阳篇的要剂。今人不知，擅自改为少阳主方，失之远矣。所以无论桂枝证还是麻黄证，若值三日、九日、十五日，少阳主气之期，必藉其枢转而出。或者又见往来寒热，枢机不转，现出开阖不利之象，胸胁苦满。胸乃太阳出入之部，胁为少阳所主之枢。默默不欲食，心烦。默默必神机内郁，而心烦喜呕不欲食，必胃气不和而喜呕，呕则逆气少疏，故喜也。或者涉于心而不涉于胃，则胸中烦而不呕。或者涉于阳明之燥气，则渴。或者涉于太阴之脾气，则腹中痛。或者涉于厥阴之肝气，则胁下痞硬。或者涉于少阴之肾气，则心下悸而小便不利。或者太阳藉少阳之枢转已有向外之势，则不渴身有微热。或者涉于太阴之肺气，则咳者，皆以小柴胡为主，而随其或然之证，加减而治之。若太阳病过经不解，先与小柴胡汤，呕不止心下急，郁郁微烦，与大柴胡汤下之，以平其胃则愈。凡太阳篇有柴胡之方，或因其病象有从枢欲达之意，而以柴胡达之，抑因其久郁未解之邪，而以柴胡可以从枢达之，无非乘机利导之法，亦即麻黄、桂枝二汤进一步之佐也。
推而言之，太阳之气外行于胸膈，不能外而病于内，实则为大小陷胸汤证，虚则为诸泻心汤证。且太阳之气，上行而至于头，下行而归于腹，不能上而病于下，从背而下结于胞室，则为桃仁承气汤证；从胸而下瘀于胞室，则为抵当汤证。何莫非桂枝、麻黄二汤应用不用，或用之失法所致哉？盖太阳经正治法，不过二十余条而已，其他则皆权变法、斡旋法也。假使治伤寒者，审其脉之或缓或紧，辨其症之有汗无汗，则从而汗之解之，如桂枝、麻黄等法，则邪却而病除矣。其或合阳明，或合少阳，或合三阳者，则从而解之清之，如葛根汤治太阳阳明合病下利，葛根加半夏汤治合病不下利而但呕者，黄芩汤治太阳少阳合病而自利，黄芩加半夏生姜汤治合病而呕者。如白虎汤治三阳合病。其云腹满者，为阳明经热合于前也。其云身重者，为太阳经热合于后也。其云难以转侧者，为少阳经热合于侧也。其云口不仁而面垢者，热合少阳之腑也。其云谵语者，热合阳明之腑也。其云遗尿者，热合太阳之腑也。既审其为三阳之合，又必得自汗出之的证，而后用白虎汤之的方，斯邪分而病解，此为正治之法。
顾人气体有虚实之殊，脏腑有阴阳之异。或素有痰饮痞气，以及咽燥淋疮汗衄之疾，或适当房室金刃产后亡血之余。是虽同为伤寒之候，不得竟用麻桂之法矣。于是有旋覆代赭石汤，治伤寒汗吐下解后，心下痞硬，噫气不除，是胃气弱而未和，痰气动而上逆之症。有茯苓桂枝白术甘草汤，治吐下后邪解，而为饮发之证。《金匮要略》云：膈间支饮，其人喘满，心下痞坚。又云：心下有痰饮，胸胁支满，目眩。又云：其人振振身瞤剧者，必有伏饮。其云发汗则动经者，言无邪可发，而反动其经气也。有承气汤，治伤寒六七日不大便，头痛有热，必衄，以阳热太重，以此汤承在上之热气而使之下也。有小建中汤，以治伤寒二三日，心悸而烦，补中气以生心血。有炙甘草汤，治脉结代，心动悸，启肾阴以行于脉道。有四逆汤，治发热头痛，脉反沉，身体疼痛，扶肾阳以救其虚陷。是为权变之法。而用桂枝、麻黄等法，又不能必其无过与不及之弊。或汗出不彻，而邪不外散，则有传变他经，及发黄蓄血之病。如中风以火劫汗，则两阳熏灼，其身发黄。阳盛则欲衄，阴虚则小便难，甚则见发哕谵语，捻衣摸床诸危症。服药得小便利者，方可治之。如桂枝证外不解，而热结膀胱，其人如狂，血得自下乃愈。若小腹急结，有桃仁承气汤之轻攻法。如麻黄证表不解，脉微而沉，其人狂，其邪反不结于胸，而直下于少腹而硬满，为瘀热在里，又身黄脉沉结，小便自利，不为水而为血，其血不能自下，必攻而始下，又有抵当汤之峻攻法也。或汗出过多而并伤其阳气，则有振振擗地，肉瞤筋惕，为真武汤之证。有发汗后血液内亡，身疼痛，脉沉迟者，为桂枝加芍药生姜人参新加汤证。有发汗过多虚其心气，其人叉手冒心喜按者，为桂枝甘草汤证。有发汗后虚其肾气，脐下悸，欲作奔豚，为茯苓桂枝甘草大枣汤证。有发汗后伤其中气，不能营运升降而腹胀满，为浓朴生姜甘草人参半夏汤证。有发汗后反恶寒，阴阳两虚，为芍药甘草附子汤证。且有更发汗、小发汗，《伤寒论》中有论而无方，亦可以意会之。是为斡旋之法。学人宜究心焉。
(The Taiyang channel is the channel of cold water. It governs the exterior of the entire body.)
What are the symptoms of the Taiyang channel? The answer is: headache, stiffness of the neck and nape, fever, and aversion to cold are the symptoms. There is a distinction between deficiency evil (Xu Xie) and excess evil (Shi Xie).
A slow pulse (Mai Huan), spontaneous sweating (Zi Han), and aversion to wind (E Feng) indicate deficiency evil. Guizhi Tang (Cinnamon Twig Decoction) is appropriate. If after eight or nine days the disease has passed its time but remains unresolved, resembling malaria (Ru Nie Zhuang), with facial heat (Mian Re) and body itching (Shen Yang), this is because there was no slight perspiration. Guizhi Mahuang Ge Ban Tang (Guizhi and Mahuang Half-Half Decoction) is appropriate. Because sweating was not performed previously, it is necessary to induce sweating; however, since the duration is quite long, only slight sweating should be induced. If after taking Guizhi Tang, profuse sweating occurs, and the condition resembles malaria, occurring twice a day, this is because residual pathogenic factors remain. Guizhi Er Mahuang Yi Tang (Guizhi Twice Mahuang Once Decoction) is appropriate. After profuse sweating, the method of profuse sweating cannot be used again, yet residual pathogenic factors must be exhausted through sweating. However, the dosage of medicinal materials should be light.
A floating and tight pulse (Mai Fu Jin), absence of sweating (Wu Han), and aversion to cold (E Han) indicate excess evil. Mahuang Tang (Ephedra Decoction) is appropriate. If there is no sweating accompanied by irritability (Fan Zao), add Shigao (Gypsum Fibrosum), Shengjiang (Zingiberis Rhizoma Recens), and Dazao (Jujubae Fructus), named Da Qinglong Tang (Major Blue-Green Dragon Decoction). If there is dry retching (Gan Ou) and cough (Ke), remove Xingren (Armeniacae Semen Amarum), and add Wuweizi (Schisandrae Fructus), Ganjiang (Zingiberis Rhizoma), Banxia (Pinelliae Rhizoma), Xixin (Asari Radix et Rhizoma), and Shaoyao (Paeoniae Radix Alba), named Xiao Qinglong Tang (Minor Blue-Green Dragon Decoction). These two decoctions are modifications of Mahuang Tang and generally fall within the scope of Mahuang Tang.
These two methods treat the "exterior of the exterior."
What are the Fu-organ syndromes of Taiyang? The answer is: if exterior pathogenic factors do not resolve, they must enter the interior. The Bladder (Pang Guang) is the interior of the exterior. There is a distinction between Water Accumulation Syndrome (Xu Shui Zheng) and Blood Accumulation Syndrome (Xu Xue Zheng).
In Taiyang disease, if the patient has thirst (Kou Ke), irritability (Fan Zao), inability to sleep (Bu De Mian), a floating pulse (Mai Fu), difficulty in urination (Xiao Bian Bu Li), and vomiting immediately after drinking water (Shui Ru Ji Tu), this is Bladder Water Accumulation Syndrome. Wuling San (Five-Ling Powder) is appropriate.
In Taiyang disease, if the patient appears delirious (Ru Kuang), has hardness and fullness in the lower abdomen (Xiao Fu Ying Man), normal urination (Xiao Bian Zi Li), and a deep pulse (Mai Chen), this is Bladder Blood Accumulation Syndrome. Taoren Chengqi Tang (Peach Kernel Descending Qi Decoction) is appropriate.
These two methods treat the "interior of the exterior."
What are the transformed syndromes of Taiyang? The answer is: improper use of sweating and purging methods leads to transformations following Yin or Yang.
If purging is used when it should not be, followed by diarrhea with undigested food (Xia Li Qing Gu) and body pain (Shen Teng Tong), Sini Tang (Frigid Extremities Decoction) is appropriate to rescue the interior syndrome of diarrhea with undigested food, and Guizhi Tang is used to rescue the exterior syndrome of body pain.
If the disease presents with fever and headache (Fa Re Tou Tong), but the pulse is unexpectedly deep (Mai Fan Chen), and if it does not improve, with body pain (Shen Ti Teng Tong), the interior should be rescued first. Sini Tang is appropriate.
For profuse sweating, severe diarrhea, and cold extremities (Jue Leng), Sini Tang is the primary treatment.
In Taiyang disease, excessive sweating leads to continuous leakage of sweat (Lou Bu Zhi), aversion to wind (E Feng), difficulty in urination (Xiao Bian Nan), slight stiffness of the four limbs (Si Zhi Wei Ji), and difficulty in flexion and extension. Guizhi Jia Fuzi Tang (Guizhi Decoction with Added Aconite) is the primary treatment.
In Taiyang disease, excessive sweating disturbs the Ying-Blood (Rong Xue), while the Wei-pathogen retreats inward. The patient still has fever (Fa Re), palpitations in the heart region (Xin Xia Ji), dizziness (Tou Xuan), body tremors (Shen Dong), and a sensation of trembling as if wanting to fall to the ground (Zhen Zhen Yu Pi Di). Zhenwu Tang (True Warrior Decoction) is the primary treatment.
The above discusses how excessive sweating and purging damage healthy Qi and cause Yang deficiency. When Yang is deficient, many symptoms transform according to Shaoyin Yin. This is because Taiyang and Shaoyin are exterior-interior pairs.
When Yang is abundant internally, and Guizhi Tang is mistakenly taken, leading to profuse sweating, severe irritability and thirst that do not resolve, and a flooding pulse (Mai Hong Da), Bait Hu Jia Renshen Tang (White Tiger Decoction with Added Ginseng) is the primary treatment.
After Shanghan (Cold Damage) is treated with vomiting or purging, if it remains unresolved for seven to eight days, heat accumulates in the interior (Re Jie Zai Li), both exterior and interior are hot, there is occasional aversion to wind (Shi Shi E Feng), severe thirst (Da Kou), dry tongue with irritability (She Shang Zao Gan Er Fan), and a desire to drink several liters of water, Bait Hu Jia Renshen Tang is the primary treatment.
If Shanghan involves constipation for six or seven days, this is an interior syndrome; headache and fever are exterior syndromes. The exterior remains unresolved due to internal blockage. Purging resolves the interior harmony, and the exterior resolves spontaneously. Give Chengqi Tang.
If the patient has irritability and heat (Fan Re), which resolves with sweating, or resembles malaria with afternoon fever (Ri Bu Suo Fa Re), this belongs to Yangming. If the pulse is solid (Mai Shi), purging is appropriate; give Dachengqi Tang (Major Order the Qi Decoction). If the pulse is deficient (Mai Xu), sweating is appropriate; give Guizhi Tang.
If aversion to cold (E Han) occurs after sweating, it is due to deficiency. If there is no aversion to cold but only heat, it is due to excess. Harmonize the Stomach Qi; give Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction).
In Taiyang disease, if unresolved, the pulses at Yin and Yang positions are both stagnant (Yin Yang Ju Ting). "Ting" means stagnant and unable to rise. Yin and Yang refer to the Cun and Chi positions. First, there will be chills and shivering (Zhen Li), followed by sweating for resolution. If only the Yang pulse (Cun) is slightly weak (Wei), resolve via sweating first. If only the Yin pulse (Chi) is slightly weak, resolve via purging. If purging is desired, Tiaowei Chengqi Tang is appropriate. Note that "pulse slightly weak" here refers to the "pulse stagnation" mentioned earlier.
The above discusses how improper sweating and purging lead to intense heat damaging Yin. When Yin is damaged, many symptoms transform according to Yangming Yang. This is because Taiyang and Yangming transmit sequentially.
What are the two major gates for treating Taiyang: sweating and promoting urination? The answer is: when evil damages Taiyang, the disease is in the Cold Water channel. Driving out water qi outward results in sweating; driving out water qi downward results in yellow phlegm/saliva accumulation anteriorly and prolonged urination posteriorly.
Taiyang is the Cold Water channel. At the initial stage of injury, sweating must be induced. Mahuang Tang induces sweating from the skin (Pi Fu); Guizhi Tang induces sweating from the meridians (Jing Luo); Gegen Tang induces sweating from the muscles (Ji Rou); Xiao Qinglong Tang induces sweating from below the heart (Xin Xia); Da Qinglong Tang induces sweating by releasing the Yang qi disturbed in the chest. These are the five methods of inducing sweating.
If sweating fails to eliminate all pathogens, water forms. If water is below the heart, causing dry retching and cough, Xiao Qinglong Tang is appropriate. If there is fever and irritability, thirst for water, and vomiting immediately after drinking, it is called Water Reversal (Shui Ni); Wuling San is appropriate. After sweating, if there is epigastric hardness and fullness (Xin Xia Pi Ying), belching with food odor (Yi Qi Shi Chou), water qi under the flanks (Xie Xia You Shui Qi), borborygmus and diarrhea (Fu Zhong Lei Ming Xia Li), although the pathology is in the abdomen, the root is in the heart region. Shengjiang Xiexin Tang (Fresh Ginger Drain the Epigastrium Decoction) is appropriate. This is water qi in the Upper Jiao. For conditions in the upper, disperse via sweating. If mistaken purging causes hardness and fullness from the heart to the lower abdomen, painful to touch (Shui Yu Qi Suo Jie), with a slow pulse (Mai Chi), it is called Major Chest Binding (Da Jie Xiong); Dayanxiong Tang (Major Inward-Sinking Chest Decoction) is appropriate. If the neck is also stiff, resembling soft spasm (Rou Dou Zheng), Dayanxiong Wan (Major Inward-Sinking Chest Pill) is appropriate. Generally, if the pathology extends downward, use decoctions; if it extends upward, use pills. If binding is only in the heart region, painful only on pressure, with a floating and slippery pulse (Mai Fu Hua), it is called Minor Chest Binding (Xiao Jie Xiong); the pathogen is still in the meridians. Xiaoxianxiong Tang (Minor Inward-Sinking Chest Decoction) is appropriate. If there are no heat signs, it is called Cold Excess Chest Binding (Han Shi Jie Xiong); Sanwu Baisan (Three-Material White Powder) is appropriate. If there is epigastric hardness and fullness, pain radiating to the flanks, dry retching, shortness of breath (Duan Qi), sweating without aversion to cold, and obstruction of the ascending and descending Qi of the Three Jiao, Shizao Tang (Ten Jujubes Decoction) is appropriate. This is water qi in the Middle Jiao. For middle fullness, drain internally. If there is headache, neck stiffness, mild fever (Xi Xi Fa Re), no sweating, epigastric fullness and slight pain, and difficulty urinating, it is because Bladder water does not move, Ying and Wei are unharmonized, and sweating cannot occur. Guizhi Qu Gui Jia Fuling Baizhu Tang (Guizhi Decoction with Cinnamon Removed and Poria and Atractylodes Macrocephala Added) is appropriate. This is water qi in the Lower Jiao. For conditions in the lower, drain via guiding.
The *Neijing* states: Above Taiyang, Cold Qi governs, which is the Root (Ben). Below the Root is the Manifestation (Jian). Below the Manifestation is the Mark (Biao). It also states: Taiyang follows both Root and Mark. It also states: Taiyang is the Opening. The *Lingshu·Re Bing Lun* states: On the first day of Shanghan, Juyang receives the pathogen, hence headache, neck pain, and stiffness of the waist and spine.
The *Shanghan Lun* states: For Taiyang disease, the pulse is floating, with headache, neck stiffness, and aversion to cold.
It also states: In Taiyang disease, with fever, sweating, aversion to wind, and a slow pulse, it is named Wind Strike (Zhong Feng).
It also states: In Taiyang Wind Strike, the Yang pulse floats and the Yin pulse is weak. Floating Yang indicates spontaneous heat; weak Yin indicates spontaneous sweating. With chilly aversion to cold, shivery aversion to wind, mild fever, nasal congestion (Bi Ming), and dry retching, Guizhi Tang is the primary treatment.
It also states: In Taiyang disease, with headache, fever, body pain, waist pain, joint pain, aversion to wind, no sweating, and wheezing, Mahuang Tang is the primary treatment.
Taiyang governs the exterior of the body, being the outermost layer of the Six Channels. Therefore, all exterior diseases belong to Taiyang, but there is a distinction between the "exterior of the exterior." Disease in the muscle interstices with sweating requires Guizhi Tang; disease in the skin surface without sweating requires Mahuang Tang. If these two methods are applied correctly, one dose can cure. If there is a faint pulse, aversion to cold, reddish face, and body itching, the pathogen desires to exit but cannot emerge abruptly; slight sweating is required for resolution. Guizhi Mahuang Ge Ban Tang is appropriate. If after taking Guizhi Tang, profuse sweating occurs, and the condition resembles malaria, occurring twice a day, this is muscle disease combined with exterior disease. Guizhi Er Mahuang Yi Tang is appropriate. These two formulas serve as assistants to the aforementioned two methods. However, they treat muscle and skin diseases, not meridian-acupoint diseases.
The meridian-acupoints of Taiyang are on the back. The *Neijing* states: When evil enters the acupoints, the waist and back become stiff. The *Shanghan Lun* uses Gegen Tang for neck/back stiffness without sweating and aversion to wind; and Guizhi Jia Gegen Tang (Guizhi Decoction with Added Kudzu Root) for neck/back stiffness with sweating and aversion to wind. These two formulas are also assistants to the aforementioned two methods. However, these two methods address the original Cold nature of Taiyang, using acrid-warm substances. If it is the marked Heat nature of Taiyang with spontaneous sweating, Guizhi Tang should not be used directly; Shaoyao Gancao Tang (Peony and Licorice Decoction) is appropriate. Since the symptoms are identical to Guizhi syndrome except for calf cramping, this is a combination of Taiyang marked heat and Shaoyin root heat. For no-sweating cases, Mahuang Tang should not be used; Maxing Ganji Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) is appropriate. Since the symptoms resemble Mahuang syndrome except for initial thirst, fever, and lack of aversion to cold, or burning heat after sweating, although classified separately as Warm Disease or Wind-Warmth, the prefix "Taiyang Disease" refers to Taiyang marked heat. This is clearly a specific case; without reading the *Neijing*, it cannot be understood. The mention of Guizhi Er Yuespi Tang is for marked heat sinking into interior Yin and transforming into heat, resulting in more heat than cold and a faint pulse. The text says "no Yang," meaning no exterior Yang. It says "do not sweat," meaning do not induce Taiyang exterior sweating. Thus, this decoction directs the pathogen outward from interior Yin. This can also serve as an assistant to the aforementioned two methods.
However, Taiyang is exterior but also has an interior aspect; the Bladder is the interior of Taiyang. For example, in Taiyang disease, with fever, no sweating, epigastric fullness, slight pain, and difficulty urinating, sweating is inappropriate. Guizhi Qu Gui Jia Fuling Baizhu Tang is appropriate; promoting urination leads to recovery. After sweating, if there is a floating pulse, difficulty urinating, slight fever, and polydipsia, or if Wind Strike with fever persists for six to seven days with irritability (exterior syndrome) and thirst for water (interior syndrome), termed Exterior-Interior Syndrome in the text, and vomiting after drinking water (Water Reversal Syndrome), both require Wuling San. Drinking warm water promotes sweating. This is the treatment for Exterior-Interior syndrome. As for Da Qinglong Tang, it is designed for heavy Mahuang syndrome with floating-tight pulse, body pain, no sweating, and irritability. Xiao Qinglong Tang is for unresolved exterior with water retention below the heart causing cough and choking, transforming the cold-dispersing nature of Da Qinglong Tang into a sweating-and-diuretic formula. It is a modification of Mahuang Tang, staying within its scope. Guizhi Qu Shaoyao Tang (Guizhi Decoction with Peony Removed) is for mistaken purging in Guizhi syndrome causing rapid pulse and chest fullness. Guizhi Qu Shaoyao Jia Fuzi Tang adds Aconite when the pulse becomes faint instead of rapid and aversion to cold returns. Guizhi Jia Fuzi Tang is for excessive sweating causing leakage, aversion to wind, difficulty urinating, and limb stiffness. This addresses Yang loss from profuse sweating and fluid depletion from Yang loss; Aconite secures Shaoyin Yang, stopping sweating and preserving fluids. Pushing further, if irritability recurs after disease resolution post-sweating, or if irritability worsens initially after taking Guizhi Tang, punctling Fengchi and Fengfu points and then giving Guizhi Tang resolves it. Its application is broad, essentially covering the eight characters of Guizhi syndrome: headache, fever, sweating, aversion to wind. Note that Taiyang treatment revolves around Guizhi and Mahuang Tangs. After Mahuang Tang, Guizhi Tang may follow; after Guizhi Tang, Mahuang Tang does not. Taiyang is a Cold Water channel; root-cold cases are common, marked-heat cases are rare. If both root and mark are involved, more heat than cold indicates recovery. Practitioners must prioritize this. This discussion centers Taiyang disease on Guizhi and Mahuang Tangs consistently, clearer than any ancient commentator. Other methods are extensions of these two, not separate laws.
Taiyang governs the outermost layer. Pathogens enter from outside and must be expelled. If the first two decoctions fail, pathogens may remain in the channel or invade others, requiring Shaoyang pivot transformation to reach Taiyang and exit. Thus, Xiao Chaihu Tang (Minor Bupleurum Decoction) is a key formula in the Taiyang chapter. Modern practitioners mistakenly designate it as the primary Shaoyang formula, which is far off. Whether Guizhi or Mahuang syndrome, on days 3, 9, or 15 (Shaoyang ruling periods), pivot transformation is needed. Alternating chills and fever indicate pivot failure and open-close dysfunction, with chest-hypochondriac fullness. The chest is the passage of Taiyang; the hypochondrium is the pivot of Shaoyang. Silence, anorexia, and irritability indicate depressed Shen mechanism and disharmonious Stomach Qi causing retching. If affecting Heart but not Stomach, there is chest irritability without retching. If affecting Yangming Dryness, there is thirst. If affecting Taiyin Spleen Qi, abdominal pain. If affecting Jueyin Liver Qi, hypochondriac hardness. If affecting Shaoyin Kidney Qi, palpitations and difficulty urinating. If Taiyang借助 Shaoyang pivot shows outward trend, there is no thirst and slight body heat. If affecting Taiyin Lung Qi, cough. All are treated primarily with Xiao Chaihu Tang, modified based on optional symptoms. If Taiyang disease passes its time unresolved, start with Xiao Chaihu Tang. If retching continues, epigastric urgency, and slight vexation, use Dachengqi Tang to purge and calm the Stomach. Any Chaihu formula in the Taiyang chapter either guides pathogen seeking pivot exit or resolves long-standing stagnation via pivot guidance. This is facilitating natural flow, an advanced assistant to Mahuang and Guizhi Tangs.
Expanding further, Taiyang Qi moves externally to the chest and diaphragm; if it cannot go out, it affects the interior, manifesting as Major/Minor Chest Binding syndromes (excess) or various Xiexin (Drain the Epigastrium) syndromes (deficiency). Taiyang Qi ascends to the head and descends to the abdomen; if it cannot ascend, it affects the lower, binding in the uterus from the back (Taoren Chengqi Tang) or from the chest (Didang Tang). Are these not due to misapplication or non-application of Guizhi and Mahuang Tangs? The direct treatment of Taiyang meridian has only about twenty clauses; others are adaptive (Quan Bian) and mediating (Wo Xuan) methods. If practitioners examine pulse (slow/tight) and symptoms (sweating/no sweating) and apply sweating methods like Guizhi/Mahuang, pathogens are expelled. If combining with Yangming, Shaoyang, or all three Yang channels, clear and resolve using Gegen Tang (for Taiyang-Yangming diarrhea), Gegen Jia Banxia Tang (for vomiting without diarrhea), Huangqin Tang (for Taiyang-Shaoyang diarrhea), Huangqin Jia Banxia Shengjiang Tang (for vomiting), or Bait Hu Tang (for all three Yangs). Abdominal fullness indicates Yangming heat; heaviness indicates Taiyang heat; difficulty turning indicates Shaoyang heat; foul mouth/facial grease indicates Shaoyang Fu heat; delirium indicates Yangming Fu heat; enuresis indicates Taiyang Fu heat. Confirming three-Yang combination and spontaneous sweating justifies Bait Hu Tang. This is direct treatment.
Considering individual constitution differences (deficiency/excess, Yin/Yang organ disparities), pre-existing phlegm-fluids,痞气 (Pi Qi), throat dryness, strangury, sores, sweating, nosebleeds, or post-coital/post-traumatic/post-partum blood loss, one cannot simply use Mahuang/Guizhi methods. Instead, Xuanfu Daizhe Shi Tang treats epigastric hardness and belching after sweating/vomiting/purging due to weak Stomach Qi and rebellious Phlegm-Qi. Linggui Zhugan Tang (Poria, Cinnamon, Atractylodes, and Licorice Decoction) treats fluid retention after vomiting/purging. *Jinkui Yaolue* states: Fluid retention in the diaphragm causes wheezing/fullness and hard epigastrium; phlegm-fluid in the heart causes hypochondriac fullness and dizziness; severe tremors indicate hidden fluid. Sweating agitates the meridians because there is no pathogen to expel, only disturbing meridian Qi. Chengqi Tang treats constipation, headache, fever, and nosebleeds by directing upward heat downward. Xiaojianzhong Tang treats palpitations and irritability in early Shanghan by tonifying Middle Qi to generate Heart Blood. Zhigancao Tang treats knotted/intermittent pulse and palpitations by activating Kidney Yin into the vessels. Sini Tang treats deep pulse with fever/headache/body pain by supporting Kidney Yang to rescue collapse. These are adaptive methods. Using Guizhi/Mahuang may still have errors of excess or deficiency. Incomplete sweating allows pathogen transmission to other channels, causing jaundice or blood accumulation. Fire-induced sweating in Wind Strike causes yellowing, nosebleeds, difficult urination, hiccups, delirium, and grasping movements; treatment is possible only after urination improves. If Guizhi syndrome exterior remains with heat binding in Bladder and delirium, blood discharge cures it. If lower abdomen is tense/knot-like, Taoren Chengqi Tang offers mild purging. If Mahuang syndrome exterior remains with faint/deep pulse and delirium, pathogen binds in lower abdomen causing hardness/fullness (Blood-Heat in Interior), jaundice, deep-knotted pulse, normal urination (blood not water); if blood cannot discharge spontaneously, strong purging with Didang Tang is needed. Excessive sweating damaging Yang causes trembling and muscle twitching (Zhenwu Tang syndrome). Blood loss after sweating with body pain and deep-slow pulse requires Guizhi Jia Shaoyao Shengjiang Renshen Xinjia Tang (Newly Added Guizhi Decoction with Peony, Ginger, and Ginseng). Heart Qi deficiency after sweating with hand-over-heart preference for pressure requires Guizhi Gancao Tang. Kidney Qi deficiency after sweating with umbilical palpitation and impending Ben Tun requires Fuling Guizhi Gancao Dazao Tang. Middle Qi damage after sweating causing bloating requires Houpo Shengjiang Gancao Renshen Banxia Tang. Aversion to cold after sweating indicating dual Yin-Yang deficiency requires Shaoyao Gancao Fuzi Tang. Further sweating methods are discussed conceptually without formulas. These are mediating methods; students should study them carefully.