黃連三兩甘草三兩（炙）乾薑三兩桂枝三兩（去皮）人參二兩大棗十二枚（擘）半夏半升（洗）上七味，以水一鬥，煮取六升，去渣，溫服，晝三夜二。疑非仲景方。
【方解及其應用範圍】本方寒熱並用，以黃連清胃中之熱，乾薑以溫胃中之寒，桂枝通調營衛，半夏降逆，佐黃連嘔吐可止，人參、甘草、大棗和胃安中，但得寒熱平調，嘔吐腹痛自愈。筆者常用此方治胸腹胃中之寒熱錯雜諸證，療效卓著。
十六、傷寒腹滿譫語，寸口脈浮而緊，此肝乘脾也，名曰（橫）〔縱〕①，刺期門②。原文108
①縱：是五行順次反克的形式。
②期門：穴名，位在乳直下二寸處。
鄭論：按腹滿譫語，陽明之腑證也；脈浮而緊，太陽之表證也。此名曰（橫）〔縱〕，甚不解，定有錯誤。
【闡釋】鄭氏疑原文定有錯誤。筆者參閱諸家之注，而為匯解，或可釋鄭氏之疑。傷寒腹滿譫語而無潮熱，手足漐漐汗出等為陽明之實證，脈浮而緊獨見寸口，自與太陽、陽明之見證有別。《脈經》雲：“浮而緊者名曰弦，弦為肝脈”。《內經》雲：“脾主腹”“諸腹脹大，皆屬於熱。”又雲：“肝主語”。以此推之，肝木旺則侮脾土，則腹滿譫語，侮其所勝，故名曰縱。治法當刺期門，因期門為肝之募，故刺之以泄肝邪。邪去則腹滿譫語自愈。
十七、傷寒發熱，嗇嗇惡寒，大渴欲飲水，其腹必滿，自汗出，小便利，其病欲解，此肝乘（脾）〔肺〕也，名曰橫③，刺期門。原文109
④表不解：即太陽表證，還沒有解除。
鄭論：按發熱惡寒，太陽之表證也，大渴飲水，此由寒水逆中，阻其脾中升騰之機，真水不得上升，故大渴，其腹滿者，水溢於中也，幸而自汗與小便利，上下分消，邪有出路，故知其必解也。設若不自汗，不小便，未可言欲解也。原文言肝乘（脾）〔肺〕，不知從何看出，餘甚不解。
【闡釋】鄭氏說：“原文言肝乘肺，不知從何處看出，餘甚不解。”筆者亦從上例為之匯解，以釋鄭氏之疑，是否有當，高明正之。肺主皮毛，肺受肝邪則毛竅閉塞，所以發熱，嗇嗇惡寒；木火刑金，津液劫爍，故渴欲飲水；肺失通調水道之功能，所以小便不利而腹滿。肝邪乘肺，侮其所不勝，故名曰“橫”，刺期門，則肝邪得泄，肺不受侮，毛竅通暢，則自汗出，水道通調則小便利，故病可愈。
十八、傷寒表不解④，心下有水氣，幹嘔，發熱而咳，或渴、或利、或噎①、或小便不利，少腹滿，〔或喘者〕，小青龍湯主之。原文40
鄭論：按傷寒既稱表不解，心下有水氣，以致一切病情，緣由寒水逆中，阻滯氣機，理應發汗行水，水邪一去，則氣機流通，諸症立失。學者切不可執病執方，執一己之見，總要窺透病機，當何下手，治之為是。若原文之青龍湯，重在發汗行水，而諸症立失，可知非見咳治咳，見嘔治嘔也。
【闡釋】本條是傷寒表不解心下有水氣的證治。鄭氏說：“切不可執病執方，執一己之見，總要窺透病機，當何下手，治之為是。”此屬其治病之經驗，殊堪寶貴。故對治傷寒表不解，心下有水氣，所以用外散寒邪，內蠲水飲之小青龍湯治之，則幹嘔，發熱而咳等諸證自愈。教人不可見咳治咳，見嘔止嘔。
小青龍湯方（校補）
麻黃三兩（去節）芍藥三兩乾薑三兩五味子半升甘草三兩（炙）桂枝三兩（去皮）細辛三兩半夏半升（洗）上八味，以水一鬥，先煮麻黃減二升，去上沫，內諸藥，取三升，去渣，溫服一升。若渴，去半夏加栝萎根三兩，若微利，去麻黃加芫花，如一雞子大，熬令赤色，若噎者，去麻黃加附子一枚（炮），若小便不利，少腹滿者，去麻黃加茯苓四兩，若喘，去麻黃加杏仁半升去皮尖。且芫花不治利，麻黃主喘，今此語反之，疑非仲景意。
【方解及其應用範圍】本方即麻黃湯、桂枝湯合方，減去杏仁、生薑、大棗，而加乾薑、五味、細辛、半夏。考所增四藥功能：乾薑主溫中，治胸滿咳逆上氣。細辛辛溫，配麻黃能祛痰利水，散風寒外出而治咳逆上氣。五味收納肺氣以入腎，故治咳逆合乾薑同用，一開一閡，咳之來路去路，均告肅清，故仲景治咳，皆姜、辛、五味同用。半夏燥痰，降水氣，和胃，止咳逆嘔吐。麻黃湯辛溫發表，逐邪之峻劑。桂枝湯和營衛以祛風。合用之肌表可開散，然不去水飲停蓄之邪，非特不能廓清其源，即麻桂之功力，亦必被停聚之水飲所阻撓也。筆者常用本方治療外感寒邪，內挾水飲之咳喘，亦治水飲溢於皮膚而浮腫腹滿，小便不利之咳喘，與夫痰飲咳嗽，哮喘之偏於寒性者，療效卓著。近人則多以本方治療呼吸系統疾病，屢見於報導。
十九、傷寒心下有水氣，咳而微喘，發熱不渴，服湯已渴者，此寒去欲解也，小青龍湯主之。原文41
鄭論：按心下有水氣，阻其呼吸之氣，上觸而咳，以致微喘，發熱不渴，服湯已渴者，水氣去，而中宮升騰之機，仍舊轉輸，故知其欲解也。以小青龍湯主之，是隨機而導之意也。
【闡釋】本條是指服小青龍湯以後口渴的，此寒去疾病自愈的表現，非調解後仍用小青龍湯也。故曹穎甫訂正此條，在“發熱不渴”下，即移原文“小青龍主之”。則其義更為明白了然。
二十、服桂枝湯，大汗出後，大煩渴不解①脈洪大者，白虎加入參湯主之。原文26
①大煩渴不解：煩是心煩，渴是口渴，大是形容煩渴的厲害，不解是病未愈的意思。
鄭論：按服桂枝湯以致大汗，其人大渴者，由汗出過多，血液被奪，傷及胃中津液故也。原文主以人參白虎湯，取人參以救津液，取石膏以清內熱，的確之法也。
【闡釋】服桂枝湯後，只要微微有汗即得，現在汗出太多，肌表之邪雖去，而胃中津液反為耗傷，胃燥化熱，病已由太陽傳至陽明，出現心煩、渴飲的症狀，故用白虎湯以清陽明熾盛之熱，加人參以救胃中耗傷之液，此為不易之法也。
白虎加人參湯方知母六兩石膏一斤（碎，綿裹）甘草二兩（炙）粳米六合人參三兩上五味，以水一鬥，煮米熟，湯成去渣，溫服一升，日三服。
【方解及其應用範圍】本方即白虎加人參湯，乃滅火救陰之神劑。有清熱、生津、止渴的作用。石膏辛寒，清三焦火熱，生津止渴；知母苦潤、泄火滋燥；甘草，梗米調和中宮；人參有補虛救逆，又有生津止渴之功。此方並非專為傷寒之陽明症立法，凡屬內裏之燥熱為病者，皆可服也。時人過畏石膏而不用，往往誤事。前人少有用本方治目疾者，今人加以推廣，不僅治赤、熱、腫、痛，外障、瘀滯較甚之目疾用之取效，並用以治肺炎、腦炎、糖尿病，尤其對夏月小兒高熱、多渴、多尿綜合症療效最好。一般認為凡屬裏熱傷津，氣陰兩虧之老年及諸不足者，皆可用白虎加人參湯治療，而本方的退熱作用，主要在於適當配伍了石膏。現將近代名醫張錫純用石膏的經驗，及筆者對本方的推廣應用附後。張著《醫學衷中參西錄》謂：“石膏其性涼而能散，有透表解肌之力，為清陽明胃腑實熱之聖藥，無論內傷、外感用之皆效，即他臟腑之實熱者用之亦效。……石膏醫者多誤認為大寒而煆用之，則宣散之性變為收斂，以治外感有實熱，竟將其痰火斂住，凝結不散，用至一兩即足傷人，是變金丹為鴆毒也。迨至誤用煆石膏僨事，流俗之見，不知其咎在煆不在石膏，轉謂石膏煆用之其猛烈猶足傷人，而不煆者更可知矣。於是一倡百和，遂視用石膏為畏途。……餘用以治外感實熱，輕症亦必用至兩許，若實熱熾盛，又恒重用至四、五兩或七、八兩。……蓋石膏生用以治外感實熱，斷無傷人之理，且放膽用之，亦斷無不退熱之理。惟熱實脈虛者，其人必實熱兼有虛熱，仿白虎加人參之義，以人參佐石膏，亦必能退熱。”又雲：“且嘗曆觀方書，前哲之用石膏，有一證而用十四斤者（見《筆花醫鏡》）；有一證而用至數十斤者（見吳鞠通醫案）；有產後亦重用石膏者（見徐靈胎醫案，然須用白虎加人參湯，以玄參代知母，生山藥代梗米）。然所用皆生石膏也。”筆者三十年來，對治外感風熱之邪，無論成人或小孩，身大熱（體溫39`以上），雖注射青、鏈黴素而身熱不退，即用白虎加人參湯治療，屢用屢驗。又治傷暑咳嗽，因高熱、煩渴、津傷、汗多，舌質鮮紅，舌上乾燥，苔幹黃，治以此方面獲效。又曾治尿崩證，患者一日一夜飲水達五十磅，石膏用量初服100克，一劑而飲水量減少五磅；二劑石膏增至200克，飲水又有所減少。其後石膏用量增至300克，連服五劑而痊癒。
二十一、傷寒脈浮滑，此裏有（熱）〔寒〕，表有（寒）〔熱〕，白虎湯主之。原文176
鄭論：按《脈象篇》雲：浮主風邪，滑主痰濕。此條只據二脈，即以白虎湯主之，實屬不當。況又未見有白虎症形，指為裏熱表寒，即果屬表寒裏熱，理應解表清裏，何獨重裏熱一面，而遺解表一面乎？疑有誤。
【闡釋】本條歷代注家，爭論極多，有認為此處表裏二字錯簡，亦有認為未錯簡，亦有認為寒字當邪解，亦熱也。但類皆自圓其說，不能使人信服。白虎湯證的病理，總歸是表裏俱熱，必須是陽明經熱熾盛的見證，才能用白虎湯。不能只憑脈以定病，而須結合證狀來定，如發熱汗出，煩渴引飲，此為陽明表裏俱熱之證，白虎湯乃對證之方。鄭氏疑有誤，值得深思考慮。
白虎湯方（校補）
知母六兩石膏一斤（碎）甘草二兩（炙）粳米六合上四味，以水一鬥，煮米熟，湯成，去渣，溫服一升，日三服。
【方解及其應用範圍】白虎湯《傷寒論》原文共三條，分見於太陽、陽明及厥陰三篇。其方解可參閱前條白虎加人參湯條。其治療目標是壯熱、大汗出、大煩渴、脈洪大、無表證。
因熱盛傷津灼陰，故汗渴飲冷。但邪初入陽明，熱而未實，急需滅火清熱以救陰，故以本方治之。鄭氏在《醫法圓通》中說：“此陽明腑分主方也。”隨即舉出其圓通應用法五條：（l）治上消證：（2）治心下一寸間發生瘡疾，紅腫痛甚；（3）治牙眼紅腫痛甚，飲冷；（4）治兩乳紅腫痛甚；（5）治譫語、遺尿、口不仁而面垢。此外有白虎湯證而挾濕者，則加蒼朮；挾風者，則加桂枝，亦極有效驗。筆者用此方治療傷熱咳嗽、哮喘，取得滿意效果。其症狀為咽喉幹痛，鼻孔出熱氣，口臭氣粗。咳嗽而痰難出，色黃且稠，有時成塊成沱，或帶血腥臭，面赤身熱，更兼煩燥不安，舌質紅絳，舌苔幹黃，脈洪大有力，全係熱盛之象，故以白虎湯治之而愈。現在白虎湯廣泛應用於各種急性熱病，更有用於挾熱之眼疾、痢疾亦獲良效，可見其應用範圍之廣泛。
二十二、傷寒脈浮，發熱無汗，其表不解（者），不可與白虎湯；渴欲飲水，無表證者，白虎加人參湯主之。原文170
鄭論：按發熱無汗，本應解表，原非白虎所宜，至於大渴飲冷，陽明症具，則以人參白虎施之，的確不易法也。
【闡釋】傷寒脈浮，發熱無汗，為傷寒麻黃湯證。若渴欲飲水，無表證者，是惡寒已罷，裏熱已熾，熱盛足以津傷，白虎人參湯以泄熱救陰。誠如鄭氏所言：大渴飲冷，陽明症具，則以人參白虎施之，是的確不易法也。
二十三、傷寒無大熱，口燥渴，心煩，背微惡寒者，白虎加人參湯主之。原文169
鄭論：按寒邪本由太陽而起，至背惡寒，亦可雲表未解，何得即以白虎湯主之。條中既稱無大熱，雖有燥渴心煩，未必即是白虎湯證。法中原有熱極邪伏，背心見冷，而用此方，但學者于此症，務要留心討究，相其舌之乾燥與不燥，氣之蒸（乎）〔手〕不蒸（乎）〔手〕，口渴之微盛，二便之利與不利，則得矣。
【闡釋】傷寒背微惡寒，可雲表未解，雖有燥渴心煩，但無大熱，即不能用白虎湯治療。鄭氏曰；“法中原有熱極邪伏，背心見冷，而用此方。”但必其舌乾燥，氣粗蒸手，口渴盛，二便不利，則可用白虎加人參湯治之。
二十四、傷寒若吐若下後，七八日不解，熱結在裏，表裏俱熱，（而）時時惡風，大渴，舌上乾燥而煩，欲飲水數升者，白虎加人參湯主之。原文168
鄭論：按吐下後而表不解，蓋吐則亡陽，下則亡陰，陰陽兩虛，更不能俾邪外出，故不解。以致表邪趨入陽明地界，遂隨陽明之氣化，而轉為熱邪，故現一切症形，全是白虎湯對症之法。至飲水多者，是由下而津液大傷，故乞水以為援也。主以白虎加人參，以救欲亡之陰，實的確不易之法也。
【闡釋】傷寒吐下後，津液被奪，以致表邪趨入陽明地界，轉為熱結在裏之證。裏熱大盛，所以表裏俱熱，時時惡風，舌上乾燥而煩，欲飲水以自救。此為陽明經證傷津，法當清泄裏熱，兼生津液。如鄭氏所言：主以白虎加人參，實的確不易之法也。
傷寒恒論卷四
陽明上篇
外邪初入陽明，太陽尚有未盡者，謂之太陽陽明，列於此篇計三十九法（據舒本較增）。
黄连三两，甘草三两（炙），干姜三两，桂枝三两（去皮），人参二两，大枣十二枚（掰开），半夏半升（洗）。以上七味药，用水一斗，煮取六升，去渣，温服，白天服三次，晚上服两次。怀疑这不是张仲景的原方。
【方解及其应用范围】本方寒热并用，以黄连清胃中之热，干姜以温胃中之寒，桂枝通调营卫，半夏降逆，佐黄连呕吐可止，人参、甘草、大枣和胃安中，只要寒热平调，呕吐腹痛自愈。笔者常用此方治胸腹胃中之寒热错杂诸证，疗效卓著。
十六、伤寒腹满谵语，寸口脉浮而紧，此肝乘脾也，名曰纵①，刺期门②。原文108
②期门：穴名，位在乳直下二寸处。
郑论：按腹满谵语，阳明之腑证也；脉浮而紧，太阳之表证也。此名曰纵，甚不解，定有错误。
【阐释】郑氏疑原文定有错误。笔者参阅诸家之注，而为汇解，或可释郑氏之疑。伤寒腹满谵语而无潮热，手足漐漐汗出等为阳明之实证，脉浮而紧独见寸口，自与太阳、阳明之见证有别。《脉经》云：“浮而紧者名曰弦，弦为肝脉”。《内经》云：“脾主腹”“诸腹胀大，皆属于热。”又云：“肝主语”。以此推之，肝木旺则侮脾土，则腹满谵语，侮其所胜，故名曰纵。治法当刺期门，因期门为肝之募，故刺之以泄肝邪。邪去则腹满谵语自愈。
十七、伤寒发热，啬啬恶寒，大渴欲饮水，其腹必满，自汗出，小便利，其病欲解，此肝乘肺也，名曰横③，刺期门。原文109
④表不解：即太阳表证，还没有解除。
郑论：按发热恶寒，太阳之表证也，大渴饮水，此由寒水逆中，阻其脾中升腾之机，真水不得上升，故大渴，其腹满者，水溢于中也，幸而自汗与小便利，上下分消，邪有出路，故知其必解也。设若不自汗，不小便，未可言欲解也。原文言肝乘肺，不知从何看出，余甚不解。
【阐释】郑氏说：“原文言肝乘肺，不知从何处看出，余甚不解。”笔者亦从上例为之汇解，以释郑氏之疑，是否有当，高明正之。肺主皮毛，肺受肝邪则毛窍闭塞，所以发热，啬啬恶寒；木火刑金，津液劫烁，故渴欲饮水；肺失通调水道之功能，所以小便不利而腹满。肝邪乘肺，侮其所不胜，故名曰“横”，刺期门，则肝邪得泄，肺不受侮，毛窍通畅，则自汗出，水道通调则小便利，故病可愈。
十八、伤寒表不解④，心下有水气，干呕，发热而咳，或渴、或利、或噎①、或小便不利，少腹满，〔或喘者〕，小青龙汤主之。原文40
郑论：按伤寒既称表不解，心下有水气，以致一切病情，缘由寒水逆中，阻滞气机，理应发汗行水，水邪一去，则气机流通，诸症立失。学者切不可执病执方，执一己之见，总要窥透病机，当何下手，治之为是。若原文之青龙汤，重在发汗行水，而诸症立失，可知非见咳治咳，见呕治呕也。
【阐释】本条是伤寒表不解心下有水气的证治。郑氏说：“切不可执病执方，执一己之见，总要窥透病机，当何下手，治之为是。”此属其治病之经验，殊堪宝贵。故对治伤寒表不解，心下有水气，所以用外散寒邪，内蠲水饮之小青龙汤治之，则干呕，发热而咳等诸证自愈。教人不可见咳治咳，见呕止呕。
小青龙汤方（校补）
麻黄三两（去节）芍药三两干姜三两五味子半升甘草三两（炙）桂枝三两（去皮）细辛三两半夏半升（洗）以上八味药，用水一斗，先煮麻黄减二升，去上沫，内诸药，取三升，去渣，温服一升。若渴，去半夏加栝楼根三两，若微利，去麻黄加芫花，如一鸡子大，熬令赤色，若噎者，去麻黄加附子一枚（炮），若小便不利，少腹满者，去麻黄加茯苓四两，若喘，去麻黄加杏仁半升去皮尖。且芫花不治利，麻黄主喘，今此语反之，疑非仲景意。
【方解及其应用范围】本方即麻黄汤、桂枝汤合方，减去杏仁、生姜、大枣，而加干姜、五味、细辛、半夏。考所增四药功能：干姜主温中，治胸满咳逆上气。细辛辛温，配麻黄能祛痰利水，散风寒外出而治咳逆上气。五味收纳肺气以入肾，故治咳逆合干姜同用，一开一阖，咳之来路去路，均告肃清，故仲景治咳，皆姜、辛、五味同用。半夏燥痰，降水气，和胃，止咳逆呕吐。麻黄汤辛温发表，逐邪之峻剂。桂枝汤和营卫以祛风。合用之肌表可开散，然不去水饮停蓄之邪，非特不能廓清其源，即麻桂之功，亦必被停聚之水饮所阻挠也。笔者常用本方治疗外感寒邪，内挟水饮之咳喘，亦治水饮溢于皮肤而浮肿腹满，小便不利之咳喘，与夫痰饮咳嗽，哮喘之偏于寒性者，疗效卓著。近人则多以本方治疗呼吸系统疾病，屡见于报道。
十九、伤寒心下有水气，咳而微喘，发热不渴，服汤已渴者，此寒去欲解也，小青龙汤主之。原文41
郑论：按心下有水气，阻其呼吸之气，上触而咳，以致微喘，发热不渴，服汤已渴者，水气去，而中宫升腾之机，仍旧转输，故知其欲解也。以小青龙汤主之，是随机而导之意也。
【阐释】本条是指服小青龙汤以后口渴的，此寒去疾病自愈的表现，非调解后仍用小青龙汤也。故曹颖甫订正此条，在“发热不渴”下，即移原文“小青龙主之”。则其义更为明白了然。
二十、服桂枝汤，大汗出后，大烦渴不解①脉洪大者，白虎加入参汤主之。原文26
①大烦渴不解：烦是心烦，渴是口渴，大是形容烦渴的厉害，不解是病未愈的意思。
郑论：按服桂枝汤以致大汗，其人大渴者，由汗出过多，血液被夺，伤及胃中津液故也。原文主以人参白虎汤，取人参以救津液，取石膏以清内热，的确之法也。
【阐释】服桂枝汤后，只要微微有汗即得，现在汗出太多，肌表之邪虽去，而胃中津液反为耗伤，胃燥化热，病已由太阳传至阳明，出现心烦、渴饮的症状，故用白虎汤以清阳明炽盛之热，加人参以救胃中耗伤之液，此为不易之法也。
白虎加人参汤方知母六两石膏一斤（碎，绵裹）甘草二两（炙）粳米六合人参三两以上五味药，用水一斗，煮米熟，汤成去渣，温服一升，日三服。
【方解及其应用范围】本方即白虎加人参汤，乃灭火救阴之神剂。有清热、生津、止渴的作用。石膏辛寒，清三焦火热，生津止渴；知母苦润、泄火滋燥；甘草，梗米调和中宫；人参有补虚救逆，又有生津止渴之功。此方并非专为伤寒之阳明症立法，凡属内里之燥热为病者，皆可服也。时人过畏石膏而不用，往往误事。前人少有用本方治目疾者，今人加以推广，不仅治赤、热、肿、痛，外障、瘀滞较甚之目疾用之取效，并用以治肺炎、脑炎、糖尿病，尤其对夏月小儿高热、多渴、多尿综合症疗效最好。一般认为凡属里热伤津，气阴两亏之老年及诸不足者，皆可用白虎加人参汤治疗，而本方的退热作用，主要在于适当配伍了石膏。现将近代名医张锡纯用石膏的经验，及笔者对本方的推广应用附后。张著《医学衷中参西录》谓：“石膏其性凉而能散，有透表解肌之力，为清阳明胃腑实热之圣药，无论内伤、外感用之皆效，即他脏腑之实热者用之亦效。……石膏医者多误认为大寒而煅用之，则宣散之性变为收敛，以治外感有实热，竟将其痰火敛住，凝结不散，用至一两即足伤人，是变金丹为鸩毒也。迨至误用煅石膏败事，流俗之见，不知其咎在煅不在石膏，转谓石膏煅用之其猛烈犹足伤人，而不煅者更可知矣。于一倡百和，遂视用石膏为畏途。……余用以治外感实热，轻症亦必用至两许，若实热炽盛，又恒重用至四、五两或七、八两。……盖石膏生用以治外感实热，断无伤人之理，且放胆用之，亦断无不退热之理。惟热实脉虚者，其人必实热兼有虚热，仿白虎加人参之义，以人参佐石膏，亦必能退热。”又云：“且尝历观方书，前哲之用石膏，有一证而用十四斤者（见《笔花医镜》）；有一证而用至数十斤者（见吴鞠通医案）；有产后亦重用石膏者（见徐灵胎医案，然须用白虎加人参汤，以玄参代知母，生山药代梗米）。然所用皆生石膏也。”笔者三十年来，对治外感风热之邪，无论成人或小孩，身大热（体温39`以上），虽注射青、链霉素而身热不退，即用白虎加人参汤治疗，屡用屡验。又治伤暑咳嗽，因高热、烦渴、津伤、汗多，舌质鲜红，舌上干燥，苔干黄，治以此方面获效。又曾治尿崩证，患者一日一夜饮水达五十磅，石膏用量初服100克，一剂而饮水量减少五磅；二剂石膏增至200克，饮水又有所减少。其后石膏用量增至300克，连服五剂而痊愈。
二十一、伤寒脉浮滑，此里有（热）〔寒〕，表有（寒）〔热〕，白虎汤主之。原文176
郑论：按《脉象篇》云：浮主风邪，滑主痰湿。此条只据二脉，即以白虎汤主之，实属不当。况又未见有白虎症形，指为里热表寒，即果属表寒里热，理应解表清里，何独重里热一面，而遗解表一面乎？疑有误。
【阐释】本条历代注家，争论极多，有认为此处表里二字错简，亦有认为未错简，亦有认为寒字当邪解，亦热也。但类皆自圆其说，不能使人信服。白虎汤证的病理，总归是表里俱热，必须是阳明经热炽盛的见证，才能用白虎汤。不能只凭脉以定病，而须结合证状来定，如发热汗出，烦渴引饮，此为阳明表里俱热之证，白虎汤乃对证之方。郑氏疑有误，值得深思考虑。
白虎汤方（校补）
知母六两石膏一斤（碎）甘草二两（炙）粳米六合以上四味药，用水一斗，煮米熟，汤成，去渣，温服一升，日三服。
【方解及其应用范围】白虎汤《伤寒论》原文共三条，分见于太阳、阳明及厥阴三篇。其方解可参阅前条白虎加人参汤条。其治疗目标是壮热、大汗出、大烦渴、脉洪大、无表证。
因热盛伤津灼阴，故汗渴饮冷。但邪初入阳明，热而未实，急需灭火清热以救阴，故以本方治之。郑氏在《医法圆通》中说：“此阳明腑分主方也。”随即举出其圆通应用法五条：（l）治上消证：（2）治心下一寸间发生疮疾，红肿痛甚；（3）治牙眼红肿痛甚，饮冷；（4）治两乳红肿痛甚；（5）治谵语、遗尿、口不仁而面垢。此外有白虎汤证而挟湿者，则加苍术；挟风者，则加桂枝，亦极有效验。笔者用此方治疗伤热咳嗽、哮喘，取得满意效果。其症状为咽喉干痛，鼻孔出热气，口臭气粗。咳嗽而痰难出，色黄且稠，有时成块成沱，或带血腥臭，面赤身热，更兼烦躁不安，舌质红绛，舌苔干黄，脉洪大有力，全係热盛之象，故以白虎汤治之而愈。现在白虎汤广泛应用于各种急性热病，更有用于挟热之眼疾、痢疾亦获良效，可见其应用范围之广泛。
二十二、伤寒脉浮，发热无汗，其表不解（者），不可与白虎汤；渴欲饮水，无表证者，白虎加人参汤主之。原文170
郑论：按发热无汗，本应解表，原非白虎所宜，至于大渴饮冷，阳明症具，则以人参白虎施之，的确不易法也。
【阐释】伤寒脉浮，发热无汗，为伤寒麻黄汤证。若渴欲饮水，无表证者，是恶寒已罢，里热已炽，热盛足以津伤，白虎人参汤以泄热救阴。诚如郑氏所言：大渴饮冷，阳明症具，则以人参白虎施之，是的的确不易法也。
二十三、伤寒无大热，口燥渴，心烦，背微恶寒者，白虎加人参汤主之。原文169
郑论：按寒邪本由太阳而起，至背恶寒，亦可云表未解，何得即以白虎汤主之。条中既称无大热，虽有燥渴心烦，未必即是白虎汤证。法中原有热极邪伏，背心见冷，而用此方，但学者于此症，务要留心讨究，相其舌之干燥与不燥，气之蒸（乎）〔手〕不蒸（乎）〔手〕，口渴之微盛，二便之利与不利，则得矣。
【阐释】伤寒背微恶寒，可云表未解，虽有燥渴心烦，但无大热，即不能用白虎汤治疗。郑氏曰；“法中原有热极邪伏，背心见冷，而用此方。”但必其舌干燥，气粗蒸手，口渴盛，二便不利，则可用白虎加人参汤治之。
二十四、伤寒若吐若下后，七八日不解，热结在里，表里俱热，（而）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。原文168
郑论：按吐下后而表不解，盖吐则亡阳，下则亡阴，阴阳两虚，更不能俾邪外出，故不解。以致表邪趋入阳明地界，遂随阳明之气化，而转为热邪，故现一切症形，全是白虎汤对症之法。至饮水多者，是由下而津液大伤，故乞水以为援也。主以白虎加人参，以救欲亡之阴，实的确不易之法也。
【阐释】伤寒吐下后，津液被夺，以致表邪趋入阳明地界，转为热结在里之证。里热大盛，所以表里俱热，时时恶风，舌上干燥而烦，欲饮水以自救。此为阳明经证伤津，法当清泄里热，兼生津液。如郑氏所言：主以白虎加人参，实的确不易之法也。
伤寒恒论卷四
阳明上篇
Huanglian (Coptidis Rhizoma) 3 liang, Gancao (Glycyrrhizae Radix et Rhizoma) 3 liang (roasted with honey), Ganjiang (Zingiberis Rhizoma) 3 liang, Guizhi (Cinnamomi Ramulus) 3 liang (bark removed), Renshen (Ginseng Radix) 2 liang, Dazao (Jujubae Fructus) 12 pieces (split open), Banxia (Pinelliae Rhizoma) half sheng (washed). The above seven herbs are decocted in one dou of water, reduced to six sheng, dregs removed, taken warm. Taken three times during the day and twice at night. Suspected not to be an original formula by Zhang Zhongjing.
[Formula Analysis and Scope of Application] This formula combines cold and hot properties. Huanglian clears heat in the stomach, Ganjiang warms cold in the stomach, Guizhi regulates Ying and Wei (Nutritive and Defensive Qi), Banxia directs rebellious Qi downward, assisting Huanglian to stop vomiting. Renshen, Gancao, and Dazao harmonize the Stomach and stabilize the Middle Jiao. Once cold and heat are balanced, vomiting and abdominal pain will resolve spontaneously. The author frequently uses this formula to treat various syndromes of mixed cold and heat in the chest, abdomen, and stomach, achieving remarkable efficacy.
16. In Shaoyang disease (Cold Damage), abdominal fullness and delirium occur; the pulse at Cun Kou (Radial artery location) is floating and tight. This is Liver Wood overacting on Spleen Earth, named "Zong" (Vertical/Reverse Subjugation)①. Treat by puncturing Qimen (LR-14)②. Original Text 108
① Zong: Refers to the form of reverse subjugation in the sequential order of the Five Elements.
② Qimen: Acupoint name, located two cun directly below the nipple.
Zheng's Commentary: Abdominal fullness and delirium constitute a Yangming Fu organ syndrome; a floating and tight pulse indicates a Taiyang exterior syndrome. The term "Zong" here is incomprehensible and likely contains an error.
[Explanation] Zheng suspected an error in the original text. The author has consulted various commentaries to provide a synthesis, which may resolve Zheng's doubts. In Cold Damage, abdominal fullness and delirium without tidal fever or sweating on the hands and feet indicate a Yangming excess syndrome. A floating and tight pulse appearing only at Cun Kou distinguishes it from typical Taiyang or Yangming presentations. The *Mai Jing* states: "Floating and tight is called Xian (Wiry); Xian is the Liver pulse." The *Nei Jing* states: "The Spleen governs the abdomen" and "All abdominal distensions and enlargements belong to Heat." It also states: "The Liver governs speech." Inferring from this, when Liver Wood is hyperactive, it insults Spleen Earth, causing abdominal fullness and delirium. Since it insults what it normally controls, it is named "Zong." The treatment method is to puncture Qimen, as Qimen is the Front-Mu point of the Liver, thereby draining Liver pathogenic factors. Once pathogens are expelled, abdominal fullness and delirium resolve spontaneously.
17. In Cold Damage, fever occurs with aversion to cold (se se e han), intense thirst desiring water, abdominal fullness, spontaneous sweating, and free urination. The disease is about to resolve. This is Liver invading Lung Metal, named "Heng" (Horizontal/Reverse Subjugation)③. Treat by puncturing Qimen. Original Text 109
③ Heng: Refers to the form of reverse subjugation in the reverse order of the Five Elements.
④ Biao bu jie: Indicates that the Taiyang exterior syndrome has not yet resolved.
Zheng's Commentary: Fever and aversion to cold are Taiyang exterior symptoms. Intense thirst for water results from cold-water counterflow obstructing the ascending mechanism of the Spleen, preventing True Water from rising, hence the intense thirst. Abdominal fullness is due to water overflowing into the interior. Fortunately, spontaneous sweating and free urination allow the pathogen to exit via upper and lower dispersion, indicating resolution. If there were no sweating or urination, resolution could not be claimed. The original text mentions Liver invading Lung; it is unclear how this is determined, leaving the author very puzzled.
[Explanation] Zheng stated: "The original text mentions Liver invading Lung, but I do not see how this is derived; I am very puzzled." The author provides a synthesis based on the previous example to address Zheng's doubt, awaiting correction from experts. The Lung governs skin and hair. When Lung is invaded by Liver pathogenic factors, pores close, causing fever and aversion to cold. Wood-Fire attacking Metal depletes body fluids, leading to thirst. Loss of Lung's function in regulating water passages results in difficult urination and abdominal fullness. Liver pathogenic factors invading Lung insult what it cannot normally control, hence named "Heng." Puncturing Qimen drains Liver pathogens, sparing the Lung from insult. With unblocked pores, spontaneous sweating occurs; with regulated water passages, urination becomes free, leading to recovery.
18. In Cold Damage, if the exterior is not resolved④, and there is fluid retention in the epigastrium (Xin Xia), causing dry retching, fever with cough, or thirst, diarrhea, choking sensation①, difficulty in urination with hypogastric fullness, [or wheezing], Xiao Qing Long Tang (Minor Blue Dragon Decoction) is indicated. Original Text 40
① Ye: Choking sensation with air reflux during eating.
Zheng's Commentary: Given that the exterior is unresolved and there is fluid retention in the epigastrium, all symptoms arise from cold-water counterflow obstructing Qi dynamics. Sweating and promoting water metabolism should be employed. Once water pathogens are eliminated, Qi flows freely, and symptoms vanish immediately. Scholars must not rigidly adhere to diseases or formulas based on personal views; one must penetrate the disease mechanism to determine the approach. Xiao Qing Long Tang focuses on sweating and moving water, eliminating symptoms instantly, proving it does not merely treat cough or vomiting symptomatically.
[Explanation] This section addresses the syndrome and treatment of Cold Damage with unresolved exterior and fluid retention in the epigastrium. Zheng said: "Do not rigidly adhere to diseases or formulas; always penetrate the disease mechanism to determine the approach." This valuable experience teaches treating Cold Damage with unresolved exterior and fluid retention using Xiao Qing Long Tang to disperse cold externally and eliminate water internally, resolving dry retching, fever, and cough. It instructs against treating cough only with antitussives or vomiting only with antiemetics.
Xiao Qing Long Tang Formula (Corrected Supplement)
Mahuang (Ephedrae Herba) 3 liang (nodes removed), Shaoyao (Paeoniae Radix Alba) 3 liang, Ganjiang (Zingiberis Rhizoma) 3 liang, Wuweizi (Schisandrae Fructus) half sheng, Gancao (Glycyrrhizae Radix et Rhizoma) 3 liang (roasted with honey), Guizhi (Cinnamomi Ramulus) 3 liang (bark removed), Xixin (Asari Radix et Rhizoma) 3 liang, Banxia (Pinelliae Rhizoma) half sheng (washed). The above eight herbs are decocted in one dou of water. First boil Mahuang to reduce volume by two sheng, remove foam, add remaining herbs, reduce to three sheng, remove dregs, take one sheng warm. For thirst, remove Banxia and add Gualougen (Trichosanthis Radix) 3 liang. For mild diarrhea, remove Mahuang and add Yuanhua (Kadsurae Flos) the size of a chicken egg, roasted until red. For choking, remove Mahuang and add Fuzi (Aconiti Lateralis Radix Praeparata) one piece (prepared). For difficult urination with hypogastric fullness, remove Mahuang and add Fuling (Poria) 4 liang. For wheezing, remove Mahuang and add Xingren (Armeniacae Semen Amarum) half sheng (skin and tips removed). Note: Yuanhua does not treat diarrhea, and Mahuang treats wheezing; the current text contradicts this, suspected not to be Zhang Zhongjing's intent.
[Formula Analysis and Scope of Application] This formula combines Ma Huang Tang and Gui Zhi Tang, removing Xingren, Shengjiang, and Dazao, adding Ganjiang, Wuwei, Xixin, and Banxia. The functions of the added four herbs are: Ganjiang warms the Middle, treating chest fullness and rebellious Qi with cough. Xixin is acrid and warm; combined with Mahuang, it resolves phlegm, promotes water metabolism, disperses wind-cold, and treats rebellious Qi with cough. Wuweizi gathers Lung Qi into the Kidney, treating rebellious Qi with cough; combined with Ganjiang, one opens and one closes, clearing both incoming and outgoing paths of cough, hence Zhang Zhongjing always uses Ginger, Asarum, and Schisandra together for cough. Banxia dries phlegm, descends water Qi, harmonizes the Stomach, and stops rebellious Qi with vomiting. Ma Huang Tang is an acrid-warm exterior-releasing harsh agent. Gui Zhi Tang harmonizes Ying and Wei to dispel wind. Combined, they open the muscle layer, but without eliminating stagnant water, neither can clear the source nor utilize the power of Mahuang and Guizhi, as it would be blocked by stagnant water. The author frequently uses this formula for cough and asthma caused by external cold with internal water retention, edema with abdominal fullness and difficult urination due to water overflowing into skin, and cold-type phlegm-fluid cough and asthma, achieving remarkable efficacy. Modern practitioners often use it for respiratory system diseases, frequently reported.
19. In Cold Damage, fluid retention in the epigastrium causes cough with slight wheezing, fever without thirst. After taking the decoction, if thirst occurs, this indicates cold is departing and the disease is about to resolve. Xiao Qing Long Tang is indicated. Original Text 41
Zheng's Commentary: Fluid retention in the epigastrium obstructs respiratory Qi, touching upwards causing cough and slight wheezing. Fever without thirst; after taking the decoction, thirst indicates water qi is gone, and the ascending mechanism of the Middle Palace resumes transport, indicating resolution. Using Xiao Qing Long Tang follows the principle of guiding according to circumstances.
[Explanation] This section refers to thirst occurring after taking Xiao Qing Long Tang, indicating cold departure and spontaneous disease resolution, not continuing Xiao Qing Long Tang after regulation. Therefore, Cao Yingfu corrected this section by moving "Xiao Qing Long Tang is indicated" under "fever without thirst," making the meaning clearer.
20. After taking Gui Zhi Tang, if heavy sweating occurs followed by severe restlessness and thirst that does not resolve, and the pulse is flooding (Hong Da), Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng) is indicated. Original Text 26
① Severe restlessness and thirst not resolving: Restlessness refers to mental agitation, thirst refers to dry mouth, severe describes the intensity, not resolving means the disease is not cured.
Zheng's Commentary: Taking Gui Zhi Tang leading to heavy sweating, resulting in intense thirst, is due to excessive sweating depriving blood and damaging Stomach fluids. The original text prescribes Renshen Bai Hu Tang, using Renshen to save fluids and Shigao to clear internal heat, a precise method.
[Explanation] After taking Gui Zhi Tang, slight sweating is sufficient. Now, excessive sweating removes exterior pathogens but consumes Stomach fluids. Stomach dryness transforms into heat, and the disease transmits from Taiyang to Yangming, presenting with mental agitation and thirst. Thus, Bai Hu Tang clears blazing Yangming heat, and Renshen saves consumed Stomach fluids, an unchangeable method.
Bai Hu Jia Ren Shen Tang Formula
Zhimu (Anemarrhenae Rhizoma) 6 liang, Shigao (Gypsum Fibrosum) 1 jin (crushed, wrapped in cloth), Gancao (Glycyrrhizae Radix et Rhizoma) 2 liang (roasted with honey), Jingmi (Oryza Sativa Germ) 6 he, Renshen (Ginseng Radix) 3 liang. The above five herbs are decocted in one dou of water. Boil until rice is cooked, decoction ready, remove dregs, take one sheng warm, three times daily.
[Formula Analysis and Scope of Application] This formula, Bai Hu Jia Ren Shen Tang, is a divine agent for extinguishing fire and saving Yin. It clears heat, generates fluids, and stops thirst. Shigao is acrid and cold, clearing San Jiao fire, generating fluids, and stopping thirst; Zhimu is bitter and moist, draining fire and nourishing dryness; Gancao and Jingmi harmonize the Middle Palace; Renshen tonifies deficiency, rescues collapse, generates fluids, and stops thirst. This formula is not exclusively for Yangming syndrome of Cold Damage but applies to any internal dry-heat pathology. People today fear Shigao too much and avoid it, often causing errors. Few predecessors used this formula for eye diseases; modern practitioners have expanded its use, effective for red, hot, swollen, painful eye diseases with significant external obstruction and stasis, pneumonia, encephalitis, and diabetes. Especially effective for summer pediatric high fever, polydipsia, and polyuria syndrome. Generally, for elderly patients with Yin and Qi deficiency due to interior heat damaging fluids, Bai Hu Jia Ren Shen Tang is applicable. The antipyretic effect mainly lies in the appropriate combination of Shigao. Below attaches the experience of modern famous doctor Zhang Xichun using Shigao and the author's expanded application. Zhang's *Yi Xue Zhong Zhong Can Xi Lu* states: "Shigao is cool and dispersing, possessing the power to penetrate the exterior and resolve the muscle layer, being the holy medicine for clearing excess heat in the Yangming Stomach Fu organs. Effective for both internal injuries and external infections, and even excess heat in other Zang-Fu organs... Many doctors mistakenly consider it extremely cold and calcine it for use, changing its dispersing nature to astringent. Treating external excess heat with calcined Shigao traps phlegm-fire, causing condensation. One liang is enough to harm people, turning golden elixir into poison. When calcined Shigao causes failure, vulgar views blame calcination rather than Shigao itself, assuming raw Shigao is even more harmful. Thus, using Shigao became a taboo... For external excess heat, I use at least one liang for mild cases, and heavily use four, five, or seven, eight liang for blazing heat... Raw Shigao for external excess heat certainly does not harm people; bold use surely reduces fever. Only when heat is excess and pulse is deficient, indicating concurrent deficiency heat, following the principle of Bai Hu Jia Ren Shen Tang, assisting Shigao with Renshen can also reduce fever." He also said: "Observing medical texts, predecessors used Shigao up to fourteen jin for one syndrome (see *Bi Hua Yi Jing*), dozens of jin for one syndrome (see Wu Jutong's medical records), and even postpartum women used heavy doses (see Xu Lingtai's medical records, requiring Bai Hu Jia Ren Shen Tang, replacing Zhimu with Xuanshen, and Jingmi with raw Shan Yao). All used raw Shigao." For thirty years, the author has treated external wind-heat in adults and children with high fever (above 39°C), unresponsive to penicillin/streptomycin injections, using Bai Hu Jia Ren Shen Tang with consistent success. Also effective for summerheat cough with high fever, restlessness, thirst, fluid damage, and profuse sweating, presenting with bright red tongue, dry coating, and yellow dry fur. Treated diabetes insipidus where a patient drank fifty pounds of water daily; initial Shigao dose 100g reduced intake by five pounds per dose; second dose increased Shigao to 200g, further reducing intake; later increased to 300g, curing after five doses.
21. In Cold Damage, pulse is floating and slippery. This indicates heat inside and cold outside (or vice versa depending on textual variant), Bai Hu Tang is indicated. Original Text 176
Zheng's Commentary: The *Mai Xiang Pian* states: Floating indicates wind pathogen, slippery indicates phlegm-dampness. Prescribing Bai Hu Tang based solely on these two pulses is inappropriate. Moreover, without typical Bai Hu syndrome manifestations, labeling it interior heat and exterior cold—if indeed exterior cold and interior heat—should require releasing the exterior and clearing the interior. Why focus only on interior heat while neglecting the exterior? Suspected error.
[Explanation] Commentators have debated this section extensively. Some believe "interior/exterior" characters are misplaced, others say they are correct, some interpret "cold" as "pathogen" or "heat." All arguments are self-consistent but unconvincing. The pathology of Bai Hu Tang syndrome is essentially interior and exterior heat. It requires evidence of blazing Yangming channel heat to use Bai Hu Tang. Disease cannot be determined by pulse alone but must combine symptoms. For example, fever, sweating, mental agitation, and thirst for drinking indicate Yangming interior-exterior heat syndrome; Bai Hu Tang is the corresponding formula. Zheng's suspicion of error warrants deep consideration.
Bai Hu Tang Formula (Corrected Supplement)
Zhimu (Anemarrhenae Rhizoma) 6 liang, Shigao (Gypsum Fibrosum) 1 jin (crushed), Gancao (Glycyrrhizae Radix et Rhizoma) 2 liang (roasted with honey), Jingmi (Oryza Sativa Germ) 6 he. The above four herbs are decocted in one dou of water. Boil until rice is cooked, decoction ready, remove dregs, take one sheng warm, three times daily.
[Formula Analysis and Scope of Application] Bai Hu Tang appears in three original texts in *Shang Han Lun*, found in Taiyang, Yangming, and Jueyin chapters. Formula analysis refers to the previous Bai Hu Jia Ren Shen Tang section. Treatment targets are high fever, profuse sweating, severe thirst, flooding pulse, and absence of exterior syndrome.
Due to heat damaging fluids and burning Yin, sweating and thirst for cold drinks occur. However, since pathogens just entered Yangming, heat exists without accumulation, urgently requiring fire-extinguishing and heat-clearing to save Yin, hence this formula. Zheng in *Yi Fa Yuan Tong* said: "This is the main formula for Yangming Fu branch." He listed five flexible applications: (1) Treating Upper Xiao syndrome; (2) Treating sores arising one cun below the heart, with severe redness, swelling, and pain; (3) Treating severely red, swollen, painful gums desiring cold drinks; (4) Treating severely red, swollen, painful breasts; (5) Treating delirium, urinary incontinence, oral insensitivity, and facial dirtiness. Additionally, for Bai Hu Tang syndrome with dampness, add Cangzhu; with wind, add Guizhi, both highly effective. The author used this formula for heat-injury cough and asthma with satisfactory results. Symptoms included dry sore throat, hot breath from nostrils, foul breath, difficult expectoration of thick yellow sputum forming clumps or bloody odor, red face, body heat, restlessness, crimson tongue, dry yellow coating, and strong flooding pulse, all indicating heat excess, cured by Bai Hu Tang. Currently, Bai Hu Tang is widely applied in acute febrile diseases, and effectively for eye diseases and dysentery with heat, showing broad application scope.
22. In Cold Damage, pulse is floating, fever without sweating, if exterior is not resolved, Bai Hu Tang is contraindicated; if desiring water to drink without exterior syndrome, Bai Hu Jia Ren Shen Tang is indicated. Original Text 170
Zheng's Commentary: Fever without sweating should be treated by releasing the exterior, originally unsuitable for Bai Hu. Regarding intense thirst for cold drinks with complete Yangming syndrome, applying Renshen Bai Hu is indeed an unchangeable method.
[Explanation] Cold Damage with floating pulse, fever, and no sweating constitutes Ma Huang Tang syndrome. If desiring water to drink without exterior syndrome, aversion to cold has ceased, interior heat is blazing, and heat severity damages fluids. Bai Hu Jia Ren Shen Tang drains heat and saves Yin. As Zheng stated: Intense thirst for cold drinks with complete Yangming syndrome makes Renshen Bai Hu an indeed unchangeable method.
23. In Cold Damage, no high fever, dry mouth and thirst, mental agitation, slight aversion to cold on the back, Bai Hu Jia Ren Shen Tang is indicated. Original Text 169
Zheng's Commentary: Cold pathogens originate from Taiyang. Aversion to cold on the back suggests exterior unresolved. How can Bai Hu Tang be prescribed? Although calling it "no high fever," despite dry thirst and agitation, it may not necessarily be Bai Hu Tang syndrome. Methods include extreme heat with hidden pathogens causing cold sensation on the back, using this formula. But scholars must carefully investigate: check tongue dryness, whether breath steams hands, severity of thirst, and bowel/bladder function.
[Explanation] Cold Damage with slight back aversion to cold suggests exterior unresolved. Despite dry thirst and agitation, without high fever, Bai Hu Tang cannot be used. Zheng said: "Methods include extreme heat with hidden pathogens causing cold sensation on the back, using this formula." But tongue must be dry, breath steaming hands, intense thirst, and difficult urination/bowel movements must be present to use Bai Hu Jia Ren Shen Tang.
24. In Cold Damage, after purging or vomiting, unresolved after seven to eight days, heat binds in the interior, interior and exterior both hot, occasional aversion to wind, intense thirst, dry tongue with agitation, desiring several sheng of water, Bai Hu Jia Ren Shen Tang is indicated. Original Text 168
Zheng's Commentary: After vomiting and purging, if exterior remains unresolved, vomiting loses Yang, purging loses Yin, dual deficiency prevents pathogen expulsion, hence unresolved. Exterior pathogens enter Yangming territory, transforming into heat pathogens following Yangming Qi transformation, presenting all symptoms matching Bai Hu Tang indications. Excessive drinking is due to massive fluid loss from purging/vomiting, seeking water as support. Prescribing Bai Hu Jia Ren Shen Tang saves impending Yin loss, truly an unchangeable method.
[Explanation] After vomiting and purging in Cold Damage, fluids are deprived, exterior pathogens enter Yangming territory, transforming into interior heat binding. Interior heat is blazing, causing interior-exterior heat, occasional aversion to wind, dry tongue with agitation, desiring water for self-rescue. This is Yangming channel syndrome damaging fluids; method requires clearing interior heat and generating fluids. As Zheng stated: Prescribing Bai Hu Jia Ren Shen Tang is truly an unchangeable method.
Shang Han Heng Lun Volume Four
Yangming Upper Chapter
When external pathogens first enter Yangming, if Taiyang remnants remain, it is called Taiyang-Yangming, listed in this chapter totaling thirty-nine methods (increased according to Shu edition).
1. Yangming disease, pulse is slow, sweating is profuse, slight aversion to cold, exterior is unresolved, can induce sweating, Gui Zhi Tang is suitable. Original Text 234