②柔痙：痙一作痓，是項背強直，角弓反張的證候名稱，有汗的叫“柔痙”，無汗的叫作“剛痙”。
鄭論：按（胸結）〔結胸〕而項亦強，有如柔痙狀者，此是邪結於胸，阻其任脈流行之氣機而言也。下之以大陷胸丸者，逐其胸中積聚，積聚亦去，任脈通而氣機複暢，故有自和之說也。但痙症則周身手足俱牽強，此獨項強，故稱為如柔痙狀，學者須知。
【闡釋】結胸的主證，本是心下鞕滿而痛，此證項強如柔痙狀，是病邪偏結於上，胸部鞕滿而不能俯，所以如同柔痙。這種項強是受胸部水熱結聚的影響，和筋脈失養的項強不同，水熱結聚一散，胸部脹滿自消，項強也就可以自愈，所以說下之則和。用大陷胸丸緩攻上部之邪，確為對證。鄭氏嫚與諸家不同：“此是邪結於胸，阻其任脈流行之氣機而言”。治之以大陷胸丸者，使藥力緩緩而行，驅邪而正不傷，乃峻藥緩攻之法也。胸中積聚去，任脈通而氣機複暢，故自和也。
大陷胸丸方（校補）
大黃半斤葶藶子半斤（熬）芒硝半升杏仁半升（去皮尖、熬黑）上四味，搗篩二味，內杏仁芒硝，合研如脂，和散，取如彈丸一枚，別搗甘遂末一錢匕，白蜜二合，水二升，煮取一升，溫頓服之，一宿乃下，如不下，更服，取下為效，禁如藥法。
【方解及其應用範圍】本方的藥物組成，為大陷胸湯更加入葶藶子杏仁白蜜而成。因其邪結在胸，胸為肺位，故加杏仁色白入肺，以利肺氣，用葶藶子佐甘遂破飲而瀉下，恐硝黃等藥下行甚速，故緩以白蜜之甘，使藥力緩行，留於胸中，熱結之水，得芒硝而解，葶藶甘遂逐水飲，隨大黃以下行，又為丸煮服，使藥力緩緩而行，驅邪而正不傷，乃峻藥緩攻之法。《醫宗金鑒》用以治水腫腸澼初起，形氣俱實者。
五十一、結胸證，其脈浮大者，不可下，下之則死。原文132
鄭論：按結胸而稱脈浮大者，明是陽邪結胸，理應清涼以解之、開之，方為合法，若攻下之，則引邪深入，結胸愈結而不解者，焉得不死。
【闡釋】此節乃結胸之虛證也。邪結於裏，脈當寸浮關沉，今脈通見浮大，是邪雖內結而未實，氣機仍有外達之象，若誤下之，則犯本論，脈浮大，而醫反下之，此為大逆之戒。亦即鄭氏所雲：“若攻下之，則引邪深入，結胸愈結而不解者，焉得不死”之謂也。
五十二、結胸證〔悉〕具，煩（燥）〔躁〕者〔亦〕死。原文133
鄭論：按證具結胸，阻其上下交通之機，故煩（燥）〔躁〕作。
蓋煩出於心，（燥）〔躁〕出於腎，病機正在坎離交會之處，不交則煩（燥）〔躁〕立作，故決之必死也。
【闡釋】結胸證悉具，邪結已深也，若更見煩躁，是正不勝邪，真氣散亂，病者必死。鄭氏以坎離立論謂：“煩出於心，躁出於腎，病機正在坎離交會之處，不交則煩躁立作，故決之必死也”。誠屬不刊之論。
五十三、太陽病，醫發汗，遂發熱惡寒，因複下之，心下痞，表裏俱虛，陰陽〔氣〕並竭①，無陽則陰獨②，複加燒針，因胸煩，面色青黃，膚瞤者，難治；今色微黃，手足溫者易愈。原文153
①陰陽氣並竭：就是表裏俱虛。發汗使表虛而陽氣竭，攻下使裏虛而陰氣竭。
②無陽則陰獨：謂表邪內陷成痞，表證罷而裏證獨具。
鄭論：按太陽證總要外邪未解，方可發汗，豈有無發熱惡寒，而反即汗之理？此言因發汗，遂見發熱惡寒，焉知非誤汗而逼陽外越乎？此症總緣汗下失宜，以致表裏俱虛，陰陽並竭，無陽則陰獨，此刻係純陰用事，痞塞之症所由生，後加燒針，因而胸煩，面色青黃，則土木相刑之機，全神畢露，故曰難治。若色微黃，而無青色，手足尚溫，是後天之根猶存，故純可治。
【闡釋】鄭氏所按：“豈有無發熱惡寒，而反即汗之理？此言因發汗，遂見發熱惡寒，焉知非誤汗而逼陽外越乎？”值得深思。總由汗下失宜，所以成痞，雖曰陰陽氣並竭，實由心下無陽，故陰獨痞塞也。複加燒針，以逼劫其陰陽，乃成此危候，自當扶陽散逆，溫中祛邪之法，可用附子理中加砂、半、吳茱萸等藥治之為當。
傷寒恒論卷二
太陽中篇
凡寒傷營之證，列於此篇，計五十八法（據舒本校增）
一、太陽病，或已發熱，或未發熱，〔必惡寒〕，體（重）〔痛〕，嘔逆，脈陰陽俱緊〔者〕①，名（曰）〔為〕傷寒②。原文3
①脈陰陽俱緊：指脈的浮沉，浮取為陽，沉取為陰。“緊脈”如切繩狀，是緊張的現象，與弦脈相似而轉索有力。這裏所說的緊脈，是浮緊的脈象，浮緊為表寒，常與發熱惡寒並見。
②名為傷寒：這裏的傷寒，不是指傷寒論之廣義傷寒，而是指麻黃湯證的狹義傷寒而言。
鄭論：按已發熱者，邪已拂郁於內也，未發熱者，邪入而未遏鬱也。據脈象，陰陽俱緊曰傷寒，論體（重）〔痛〕，則屬少陰，嘔逆則屬寒飲，似於此條內不切。以余細維，現有發熱、惡寒、身痛、脈浮緊者，乃為太陽傷寒之的候。若無頭痛、身痛、發熱、惡寒，而獨見身（重）〔痛〕，嘔逆，脈象見緊，乃為寒入少陰之征。蓋太陽底面，即是少陰，以此判其或已發熱，或未發熱二語，庶幾恰切。
【闡釋】本條乃太陽傷寒證之主證主脈。與太陽上篇中風條參之自別，主要不同點是脈緊無汗，此外體痛、嘔逆也是中風證所沒有的。中風因見風而惡寒，傷寒則無風而亦惡寒矣。鄭氏釋或已發熱，或未發熱，則不同於歷代注家之說，而曰“太陽底面，即是少陰，以此判其或已發熱，或未發熱，庶幾恰切”。必惡寒者，傷於寒則惡寒也。
二、太陽病，頭痛發熱，身（痛）〔疼〕腰痛，〔骨節疼痛〕，惡風，無汗而喘者，麻黃湯主之。原文35
鄭論：按此條乃寒傷太（過）〔陽〕之裏，裏寒太甚，閉束氣機，上逆而喘，此理之常，主以麻黃湯開其腠裏，俾邪外出，表裏通暢，一切證形，立即化為烏有，學者切勿以喘而即認為肺病也，須知。
【闡釋】本條為太陽傷寒的主要證狀，也是應用麻黃湯證的標準。鄭氏謂：“學者切勿以喘而即認為肺病。”蓋人身大氣，積於心中，上焦如霧也，而胸中為太陽所主，寒邪外束，榮衛閉固，氣不得泄，壅閼而為喘，于肺何有也。杏仁取其利氣，非治肺也，故麻黃湯實是治太陽傷寒之藥，而非治肺經之方也。
麻黃湯方（校補）
麻黃三兩（去節）桂枝二兩（去皮）甘草一兩（炙）杏仁七十個（去皮尖）上四味，以水九升，先煮麻黃，減二升，去上沫，內諸藥，煮取二升半，去滓，溫服八合，複取微似汗，不須啜粥，餘如桂枝法將息。
【方解及其應用範圍】麻黃辛溫，開腠理而發汗；杏仁苦溫，疏利肺氣而治喘；桂枝辛甘溫，協同麻黃，增強其發汗作用；甘草甘平，協和諸藥，藥雖四味，方義周匝。本方為開表逐邪發汗之峻劑，為太陽病表實證之主方。汪昂曰：“麻黃中空，辛溫氣薄，肺家專藥，而走太陽，能開腠散寒；桂枝辛溫，能引營分之邪達於肌表；杏仁苦甘，能散寒而降氣；甘草甘平，發散而和中。”麻黃與杏仁相配，可以解表散邪，降逆平喘。曹穎甫謂：“麻黃湯為傷寒之聖藥。獨怪近人畏忌麻黃，徒以荊芥、防風、豆豉、牛蒡等味，敷衍病家，病家亦以其平易而樂用之，卒之愈疾之功不見”。此為經驗有得之言。近代醫家惲鐵樵對用此方之標準謂：“除惡寒、發熱、頭痛、身痛等，更須注意兩點：第一是無汗，第二是口中和。如其有汗，麻黃是禁藥；如其口渴、舌幹、唇絳，桂枝也是禁藥。只要是真確無汗，口中和，此方是唯一無二的妙法，可以藥到病除。”（見惲著《傷寒論輯義按》）鄭氏在《醫法圓通》中說：“此太陽營分主方也。仲景原文治太陽病頭痛發熱，身疼腰痛，骨節疼痛，無汗惡寒而喘者。”隨即舉出其圓通應用法三條：（1）治痘初出而急隱，壯熱無汗者；（2）治肩背沉重、覺內冷者；（3）治兩腳彎發起紅塊，痛甚。
近代藥物之分析，麻黃有發汗、平咳、定喘諸作用，為辛溫發汗藥中效力最強大者。故凡一切感寒、傷寒諸疾病之無汗者，如頭痛、腰痛、身痛、關節痛等，無不可以用之。筆者多年來常用麻黃湯以治傷寒咳嗽，無不應手取效，而從未見發生副作用。近人推廣應用此方治療肺炎、上呼吸道感染屬表寒實證者，均獲良效。亦有用本方治療腎臟病的水腫，並不一定出汗，大都表現為小便增多而腫脹消。
三、傷寒一日①，太陽受之，脈若靜者為不（動）〔傳〕②，頗欲吐，若（煩燥）〔躁煩〕，脈數急者③，為傳也。傷寒二三日，陽明少陽證不見者，為不傳也。原文4、5
①傷寒：指廣義傷寒，包括中風在內，與上條名為傷寒有廣狹義之分。
②脈若靜：指脈與證符（傷寒脈緊，中風脈緩），無數急現象。傳：謂以此之所受，轉授之於彼也。
③脈數急：與脈靜相對而言。
鄭論：按傷寒本旨，以一日太陽，二日陽明，三日少陽，四日太陰，五日少陰，六日厥陰，此就六經流行之氣機而言也。至於邪入太陽，雖七八日，十徐日，只要脈靜而不動，別無他經證形足征，便不傳經。若脈見動，心煩欲吐，此為傳也。學者臨證，務要有別經證形可驗，脈象之動靜足征，則得傳與不傳之實也。
【闡釋】鄭氏將辨太陽病脈證並治上第四條、五條合併為一條。臨床上的病變，並不是一日太陽、二日陽明……這樣機械刻板，它既可以傳入陽明，又可以傳入少陽，甚至也有轉屬太陰、少陰的。但也可以在太陽七八日、十徐日不發生傳變。可以從脈證的變化來診斷其傳與不傳，更應以證候為主。如傷寒二日，並未見到不惡寒，但惡熱，口渴欲飲等陽明證，三日並未見到口苦、咽幹、目眩等少陽證，則可知病邪仍在太陽，而沒有傳變。于此充分說明了病情已否傳變，應以證候為主，決不可以日數來決定傳與不傳。亦即鄭氏說：“務要有別經證形可驗，則得傳與不傳之實也”。
四、傷寒二三日，心中悸而煩者①，小建中湯主之（嘔家不可用建中湯②，以甜故也）。原文102
②嘔家：指素有嘔吐症狀的人。
鄭論：按太陽司寒水之令，今二三日未見別經病情，只見心悸而煩，必是太陽失氣化之令，以致水停心下，為悸而煩，今主建中湯以化太陽之氣，氣化而行，則升降不乖，而心悸與煩，則立化為烏有。但嘔家不可用建中，以甘能上湧也，須知。
【闡釋】傷寒二三日，心中悸煩是屬裏虛，雖有表證，亦不可汗之，總以救裏為急，中氣得到扶助，正氣能發揮祛邪作用，表邪亦往往能隨之而解。其所以裏虛，如鄭氏所說：“是太陽失氣化之令，以致水停心下，為悸而煩”。建中湯足以化太陽之氣，氣化而行，則升降不乖，而心悸與煩可愈矣。小建中湯方後有“嘔家不可用桂枝湯，以甜故也”。鄭氏移在原文後，未知何故。
小建中湯方（校補）
桂枝三兩（去皮）甘草二兩（炙）大棗十二枚（擘）芍藥六兩生薑三兩（切）膠飴一升上六味，以水七升，煮取三升，去滓，內膠飴，更上微火消解，溫服一升，日三服。嘔家不可用建中湯，以甜故也。
【方解及其應用範圍】桂枝湯以桂枝為君，辛甘發散，以祛邪為主；本方以膠飴為君，配芍藥酸甘相合，以補中為主。桂枝、生薑，溫中通陽；芍藥斂陰和營，桂、姜之辛，與棗、草、膠飴之甘合，則辛甘化陽；芍之苦，與甘相合，則苦甘化陰。膠飴甘溫，大補脾胃，棗、草助之，以補脾胃之虛，使中宮建立，則陽氣化而上行，陰氣化而下降，營衛調和，陰陽不偏，則心悸與煩可愈矣。又方後有“嘔家不可用建中湯，以甜故也。”不知鄭氏何故，將此段移在原文之後。本方在《傷寒論》、《金匱要略》中凡五見。治裏虛腹痛，萎黃，心中悸煩，又治虛勞裏急、手足煩熱、夢遺失精等陰陽兩虛，寒熱錯雜諸症。近代推廣用之，治療慢性胃炎、胃、十二指腸潰瘍病、更年期綜合證、心律失常、腹痛、自汗、盜汗等。筆者用治營衛不調，食減神衰，咳嗽久不愈者，以此方健胃滋脾，從陽生陰，而咳自愈。
五、太陽傷寒者，加溫針必驚也。原文117
鄭論：按寒傷太陽，在營在衛，原有區別，此言加溫針必驚，是邪在營分加溫針而驚耶？是邪在衛分加溫針而驚耶？以理揆之，當其時邪必在衛分，衛分屬陽，斷不可用溫針之法，邪在營分，方可用溫針之法。若邪在衛分而用之，如火上添膏，邪焉有不振驚內藏也，如此處斷，學者方有趨向，萬不致有用溫針之害矣。
【闡釋】歷代注家對病傷寒之人，加以溫針，一定要發生驚惕的變證。鄭氏則分別在營在衛，衛分屬陽，斷不可用溫針之法；邪在營分，可用溫針之法。如此處斷，便不致有用溫針之害矣。
六、脈浮宜以汗解，用火灸之，邪無（出路）〔從出〕因火而盛①，病從腰以下必重而痹者，名〔水）〔火〕逆也②。原文116中段
①邪無從出：誤治後，表邪不能從汗而出。因火而盛：因誤用灸法，邪熱愈加熾盛。
②火逆：凡誤用火法治療，因而形成變證的，稱為火逆。
②柔痉：痉一作痓，是项背强直，角弓反张的证候名称，有汗的叫“柔痉”，无汗的叫作“刚痉”。
郑论：按结胸而项亦强，有如柔痉状者，此是邪结于胸，阻其任脉流行之气机而言也。下之以大陷胸丸者，逐其胸中积聚，积聚亦去，任脉通而气机复畅，故有自和之说也。但痉症则周身手足俱牵强，此独项强，故称为如柔痉状，学者须知。
【阐释】结胸的主证，本是心下硬满而痛，此证项强如柔痉状，是病邪偏结于上，胸部硬满而不能俯，所以如同柔痉。这种项强是受胸部水热结聚的影响，和筋脉失养的项强不同，水热结聚一散，胸部胀满自消，项强也可以自愈，所以说下之则和。用大陷胸丸缓攻上部之邪，确为对证。郑氏谩与诸家不同：“此是邪结于胸，阻其任脉流行之气机而言”。治之以大陷胸丸者，使药力缓缓而行，驱邪而正不伤，乃峻药缓攻之法也。胸中积聚去，任脉通而气机复畅，故自和也。
大陷胸丸方（校补）
大黄半斤葶苈子半斤（熬）芒硝半升杏仁半升（去皮尖、熬黑）上四味，捣筛二味，内杏仁芒硝，合研如脂，和散，取如弹丸一枚，别捣甘遂末一钱匕，白蜜二合，水二升，煮取一升，温顿服之，一宿乃下，如不下，更服，取下为效，禁如药法。
【方解及其应用范围】本方的药物组成，为大陷胸汤更加入葶苈子杏仁白蜜而成。因其邪结在胸，胸为肺位，故加杏仁色白入肺，以利肺气，用葶苈子佐甘遂破饮而泻下，恐硝黄等药下行甚速，故缓以白蜜之甘，使药力缓行，留于胸中，热结之水，得芒硝而解，葶苈甘遂逐水饮，随大黄以下行，又为丸煮服，使药力缓缓而行，驱邪而正不伤，乃峻药缓攻之法。《医宗金鉴》用以治水肿肠澼初起，形气俱实者。
郑论：按结胸而称脉浮大者，明是阳邪结胸，理应清凉以解之、开之，方为合法，若攻下之，则引邪深入，结胸愈结而不解者，焉得不死。
【阐释】此节乃结胸之虚证也。邪结于里，脉当寸浮关沉，今脉通见浮大，是邪虽内结而未实，气机仍有外达之象，若误下之，则犯本论，脉浮大，而医反下之，此为大逆之戒。亦即郑氏所云：“若攻下之，则引邪深入，结胸愈结而不解者，焉得不死”之谓也。
五十二、结胸证〔悉〕具，烦（燥）〔躁〕者〔亦〕死。原文133
郑论：按证具结胸，阻其上下交通之机，故烦（燥）〔躁〕作。
盖烦出于心，（燥）〔躁〕出于肾，病机正在坎离交会之处，不交则烦（燥）〔躁〕立作，故决之必死也。
【阐释】结胸证悉具，邪结已深也，若更见烦躁，是正不胜邪，真气散乱，病者必死。郑氏以坎离立论谓：“烦出于心，躁出于肾，病机正在坎离交会之处，不交则烦躁立作，故决之必死也”。诚属不刊之论。
五十三、太阳病，医发汗，遂发热恶寒，因复下之，心下痞，表里俱虚，阴阳〔气〕并竭①，无阳则阴独②，复加烧针，因胸烦，面色青黄，肤瞤者，难治；今色微黄，手足温者易愈。原文153
①阴阳气并竭：就是表里俱虚。发汗使表虚而阳气竭，攻下使里虚而阴气竭。
②无阳则阴独：谓表邪内陷成痞，表证罢而里证独具。
郑论：按太阳证总要外邪未解，方可发汗，岂有无发热恶寒，而反即汗之理？此言因发汗，遂见发热恶寒，焉知非误汗而逼阳外越乎？此症总缘汗下失宜，以致表里俱虚，阴阳并竭，无阳则阴独，此刻系纯阴用事，痞塞之症所由生，后加烧针，因而胸烦，面色青黄，则土木相刑之机，全神毕露，故曰难治。若色微黄，而无青色，手足尚温，是后天之根犹存，故纯可治。
【阐释】郑氏所按：“岂有无发热恶寒，而反即汗之理？此言因发汗，遂见发热恶寒，焉知非误汗而逼阳外越乎？”值得深思。总由汗下失宜，所以成痞，虽曰阴阳气并竭，实由心下无阳，故阴独痞塞也。复加烧针，以逼劫其阴阳，乃成此危候，自当扶阳散逆，温中祛邪之法，可用附子理中加砂、半、吴茱萸等药治之为当。
伤寒恒论卷二
太阳中篇
凡寒伤营之证，列于此篇，计五十八法（据舒本校增）
一、太阳病，或已发热，或未发热，〔必恶寒〕，体（重）〔痛〕，呕逆，脉阴阳俱紧〔者〕①，名（曰）〔为〕伤寒②。原文3
①脉阴阳俱紧：指脉的浮沉，浮取为阳，沉取为阴。“紧脉”如切绳状，是紧张的现象，与弦脉相似而转索有力。这里所说的紧脉，是浮紧的脉象，浮紧为表寒，常与发热恶寒并见。
②名为伤寒：这里的伤寒，不是指伤寒论之广义伤寒，而是指麻黄汤证的狭义伤寒而言。
郑论：按已发热者，邪已拂郁于内也，未发热者，邪入而未遏郁也。据脉象，阴阳俱紧曰伤寒，论体（重）〔痛〕，则属少阴，呕逆则属寒饮，似于此条内不切。以余细维，现有发热、恶寒、身痛、脉浮紧者，乃为太阳伤寒之的候。若无头痛、身痛、发热、恶寒，而独见身（重）〔痛〕，呕逆，脉象见紧，乃为寒入少阴之征。盖太阳底面，即是少阴，以此判其或已发热，或未发热二语，庶几恰切。
【阐释】本条乃太阳伤寒证之主证主脉。与太阳上篇中风条参之自别，主要不同点是脉紧无汗，此外体痛、呕逆也是中风证所没有的。中风因见风而恶寒，伤寒则无风而亦恶寒矣。郑氏释或已发热，或未发热，则不同于历代注家之说，而曰“太阳底面，即是少阴，以此判其或已发热，或未发热，庶几恰切”。必恶寒者，伤于寒则恶寒也。
二、太阳病，头痛发热，身（痛）〔疼〕腰痛，〔骨节疼痛〕，恶风，无汗而喘者，麻黄汤主之。原文35
郑论：按此条乃寒伤太（过）〔阳〕之里，里寒太甚，闭束气机，上逆而喘，此理之常，主以麻黄汤开其腠理，俾邪外出，表里通畅，一切证形，立即化为乌有，学者切勿以喘而即认为肺病也，须知。
【阐释】本条为太阳伤寒的主要证状，也是应用麻黄汤证的标准。郑氏谓：“学者切勿以喘而即认为肺病。”盖人身大气，积于心，上焦如雾也，而胸中为太阳所主，寒邪外束，荣卫闭固，气不得泄，壅阏而为喘，于肺何有也。杏仁取其利气，非治肺也，故麻黄汤实是治太阳伤寒之药，而非治肺经之方也。
麻黄汤方（校补）
麻黄三两（去节）桂枝二两（去皮）甘草一两（炙）杏仁七十个（去皮尖）上四味，以水九升，先煮麻黄，减二升，去上沫，内诸药，煮取二升半，去滓，温服八合，复取微似汗，不须啜粥，余如桂枝法将息。
【方解及其应用范围】麻黄辛温，开腠理而发汗；杏仁苦温，疏利肺气而治喘；桂枝辛甘温，协同麻黄，增强其发汗作用；甘草甘平，协和诸药，药虽四味，方义周匝。本方为开表逐邪发汗之峻剂，为太阳病表实证之主方。汪昂曰：“麻黄中空，辛温气薄，肺家专药，而走太阳，能开腠散寒；桂枝辛温，能引营分之邪达于肌表；杏仁苦甘，能散寒而降气；甘草甘平，发散而和中。”麻黄与杏仁相配，可以解表散邪，降逆平喘。曹颖甫谓：“麻黄汤为伤寒之圣药。独怪近人畏忌麻黄，徒以荆芥、防风、豆豉、牛蒡等味，敷衍病家，病家亦以其平易而乐用之，卒之愈疾之功不见”。此为经验有得之言。近代医家恽铁樵对用此方之标准谓：“除恶寒、发热、头痛、身痛等，更须注意两点：第一是无汗，第二是口中和。如其有汗，麻黄是禁药；如其口渴、舌干、唇绛，桂枝也是禁药。只要是真确无汗，口中和，此方是唯一无二的妙法，可以药到病除。”（见恽著《伤寒论辑义按》）郑氏在《医法圆通》中说：“此太阳营分主方也。仲景原文治太阳病头痛发热，身疼腰痛，骨节疼痛，无汗恶寒而喘者。”随即举出其圆通应用法三条：（1）治痘初出而急隐，壮热无汗者；（2）治肩背沉重、觉内冷者；（3）治两脚弯发起红块，痛甚。
近代药物之分析，麻黄有发汗、平咳、定喘诸作用，为辛温发汗药中效力最强大者。故凡一切感寒、伤寒诸疾病之无汗者，如头痛、腰痛、身痛、关节痛等，无不可以用之。笔者多年来常用麻黄汤以治伤寒咳嗽，无不应手取效，而从未见发生副作用。近人推广应用此方治疗肺炎、上呼吸道感染属表寒实证者，均获良效。亦有用本方治疗肾脏病的水肿，并不一定出汗，大都表现为小便增多而肿胀消。
三、伤寒一日①，太阳受之，脉若静者为不（动）〔传〕②，颇欲吐，若（烦躁）〔躁烦〕，脉数急者③，为传也。伤寒二三日，阳明少阳证不见者，为不传也。原文4、5
①伤寒：指广义伤寒，包括中风在内，与上条名为伤寒有广狭义之分。
②脉若静：指脉与证符（伤寒脉紧，中风脉缓），无数急现象。传：谓以此之所受，转授之于彼也。
③脉数急：与脉静相对而言。
郑论：按伤寒本旨，以一日太阳，二日阳明，三日少阳，四日太阴，五日少阴，六日厥阴，此就六经流行之气机而言也。至于邪入太阳，虽七八日，十徐日，只要脉静而不动，别无他经证形足征，便不传经。若脉见动，心烦欲吐，此为传也。学者临证，务要有别经证形可验，脉象之动静足征，则得传与不传之实也。
【阐释】郑氏将辨太阳病脉证并治上第四条、五条合并为一条。临床上的病变，并不是一日太阳、二日阳明……这样机械刻板，它既可以传入阳明，又可以传入少阳，甚至也有转属太阴、少阴的。但也可以在太阳七八日、十徐日不发生传变。可以从脉证的变化来诊断其传与不传，更应以证候为主。如伤寒二日，并未见到不恶寒，但恶热，口渴欲饮等阳明证，三日并未见到口苦、咽干、目眩等少阳证，则可知病邪仍在太阳，而没有传变。于此充分说明了病情已否传变，应以证候为主，决不可以日数来决定传与不传。亦即郑氏说：“务要有别经证形可验，则得传与不传之实也”。
四、伤寒二三日，心中悸而烦者①，小建中汤主之（呕家不可用建中汤②，以甜故也）。原文102
②呕家：指素有呕吐症状的人。
郑论：按太阳司寒水之令，今二三日未见别经病情，只见心悸而烦，必是太阳失气化之令，以致水停心下，为悸而烦，今主建中汤以化太阳之气，气化而行，则升降不乖，而心悸与烦，则立化为乌有。但呕家不可用建中，以甘能上涌也，须知。
【阐释】伤寒二三日，心中悸烦是属里虚，虽有表证，亦不可汗之，总以救里为急，中气得到扶助，正气能发挥祛邪作用，表邪亦往往能随之而解。其所以里虚，如郑氏所说：“是太阳失气化之令，以致水停心下，为悸而烦”。建中汤足以化太阳之气，气化而行，则升降不乖，而心悸与烦可愈矣。小建中汤方后有“呕家不可用桂枝汤，以甜故也”。郑氏移在原文后，未知何故。
小建中汤方（校补）
桂枝三两（去皮）甘草二两（炙）大枣十二枚（擘）芍药六两生姜三两（切）胶饴一升上六味，以水七升，煮取三升，去滓，内胶饴，更上微火消解，温服一升，日三服。呕家不可用建中汤，以甜故也。
【方解及其应用范围】桂枝汤以桂枝为君，辛甘发散，以祛邪为主；本方以胶饴为君，配芍药酸甘相合，以补中为主。桂枝、生姜，温中通阳；芍药敛阴和营，桂、姜之辛，与枣、草、胶饴之甘合，则辛甘化阳；芍之苦，与甘相合，则苦甘化阴。胶饴甘温，大补脾胃，枣、草助之，以补脾胃之虚，使中宫建立，则阳气化而上行，阴气化而下降，营卫调和，阴阳不偏，则心悸与烦可愈矣。又方后有“呕家不可用建中汤，以甜故也。”不知郑氏何故，将此段移在原文之后。本方在《伤寒论》、《金匮要略》中凡五见。治里虚腹痛，萎黄，心中悸烦，又治虚劳里急、手足烦热、梦遗失精等阴阳两虚，寒热错杂诸症。近代推广用之，治疗慢性胃炎、胃、十二指肠溃疡病、更年期综合征、心律失常、腹痛、自汗、盗汗等。笔者用治营卫不调，食减神衰，咳嗽久不愈者，以此方健胃滋脾，从阳生阴，而咳自愈。
五、太阳伤寒者，加温针必惊也。原文117
郑论：按寒伤太阳，在营在卫，原有区别，此言加温针必惊，是邪在营分加温针而惊耶？是邪在卫分加温针而惊耶？以理揆之，当其时邪必在卫分，卫分属阳，断不可用温针之法，邪在营分，方可用温针之法。若邪在卫分而用之，如火上添膏，邪焉有不振惊内藏也，如此处断，学者方有趋向，万不致有用温针之害矣。
【阐释】历代注家对病伤寒之人，加以温针，一定要发生惊惕的变证。郑氏则分别在营在卫，卫分属阳，断不可用温针之法；邪在营分，可用温针之法。如此处断，便不致有用温针之害矣。
六、脉浮宜以汗解，用火灸之，邪无（出路）〔从出〕因火而盛①，病从腰以下必重而痹者，名〔水）〔火〕逆也②。原文116中段
①邪无从出：误治后，表邪不能从汗而出。因火而盛：因误用灸法，邪热愈加炽盛。
②火逆：凡误用火法治疗，因而形成变证的，称为火逆。
② Rou Jing (Soft Spasm): "Jing" is also written as "Zhi". It refers to a syndrome characterized by stiffness and tension of the neck and back, and opisthotonos (arched back). When accompanied by sweating, it is called "Rou Jing"; when without sweating, it is called "Gang Jing" (Hard Spasm).
Zheng's Commentary: Regarding Jie Xiong (Chest Binding) where the neck and back are also stiff, resembling the appearance of Rou Jing, this is due to pathogenic factors binding in the chest, obstructing the flow of Qi mechanism along the Ren Mai (Conception Vessel). The use of Da Xian Xiong Wan (Major Intractable Chest Pill) to purge aims to drive out the accumulation in the chest. Once the accumulation is removed, the Ren Mai becomes unobstructed and the Qi mechanism flows freely again, hence the saying that self-harmonization occurs. However, in true Jing syndromes, the entire body and limbs are pulled and stiff; here only the neck and back are stiff, thus it is described as "resembling Rou Jing." Students must be aware of this distinction.
[Elucidation]: The main manifestation of Jie Xiong (Chest Binding) is hardness, fullness, and pain in the epigastrium. In this case, the neck stiffness resembling Rou Jing indicates that the pathogenic factor is bound predominantly in the upper jiao, causing hardness and fullness in the chest that prevents bending forward, thus resembling Rou Jing. This neck stiffness is influenced by the accumulation of water-heat in the chest, differing from neck stiffness caused by malnourishment of the sinews. Once the water-heat accumulation dissipates, the chest fullness subsides naturally, and the neck stiffness heals itself; therefore, it is said that purging leads to harmony. Using Da Xian Xiong Wan to gently attack the pathogen in the upper part is indeed appropriate. Zheng's view differs from other scholars: "This is pathogenic binding in the chest, obstructing the Qi flow of the Ren Mai." Treating with Da Xian Xiong Wan allows the medicinal power to act slowly, expelling the pathogen without damaging healthy Qi, which is the method of using harsh medicines for slow purging. With the removal of chest accumulation, the Ren Mai opens and Qi flows smoothly, leading to self-harmony.
Da Xian Xiong Wan Formula (Corrected and Supplemented)
Da Huang (Rhubarb Root and Rhizome) half jin, Ting Li Zi (Descurainiae Semen / Lepidii Semen) half jin (stir-fried), Mang Xiao (Mirabilite) half sheng, Xing Ren (Apricot Seed) half sheng (skin and tips removed, stir-fried until black). The above four ingredients: crush and sift two of them, add Xing Ren and Mang Xiao, grind together until paste-like, mix with powder. Take one pill size of a bullet. Separately crush Gan Sui (Kansui Root) into fine powder, one qian bi, Bai Mi (White Honey) two he, Water two sheng. Boil to obtain one sheng. Take warm in one dose. Stool will pass after one night. If not, take another dose. Passing stool is the effect. Follow dietary restrictions as per medication rules.
[Formula Analysis and Scope of Application]: The composition of this formula is Da Xian Xiong Tang (Major Intractable Chest Decoction) plus Ting Li Zi, Xing Ren, and Bai Mi. Since the pathogen binds in the chest, and the chest is the domain of the Lung, Xing Ren (which is white and enters the Lung) is added to benefit Lung Qi. Ting Li Zi assists Gan Sui to break fluid retention and purge downwards. Fearing that Mang Xiao and Da Huang descend too rapidly, the sweetness of Bai Mi is used to slow the action of the medicine, keeping it in the chest. The heat-bound water is resolved by Mang Xiao, while Ting Li Zi and Gan Sui drive out fluid retention, descending with Da Huang. Taking it as pills boiled in water ensures the medicinal power acts slowly, expelling the pathogen without harming healthy Qi, embodying the method of harsh drugs used for slow purging. *Yi Zong Jin Jian* uses it for early-stage edema and intestinal dysentery where both form and Qi are excess.
51. In Jie Xiong syndrome, if the pulse is floating and large, purging is contraindicated; purging will lead to death. Original Text 132
Zheng's Commentary: Regarding Jie Xiong with a floating and large pulse, it clearly indicates Yang pathogen binding in the chest. It should be treated with cooling methods to resolve and open it, which is the correct approach. If purged, it draws the pathogen deeper, making the binding tighter and unresolved, how can death not ensue?
[Elucidation]: This section describes the deficiency type of Jie Xiong. Pathogen binding in the interior should present with a floating pulse at the Cun position and sunken at the Guan position. Now the pulse is generally floating and large, indicating that although the pathogen is internally bound, it is not yet solid, and the Qi mechanism still shows signs of moving outward. If mistakenly purged, it violates the principles discussed earlier: "Pulse floating and large, yet physician purges," which is a great reversal warning. This aligns with Zheng's statement: "If purged, it draws the pathogen deeper, making the binding tighter and unresolved, how can death not ensue?"
52. In Jie Xiong syndrome, if all symptoms are present, and there is restlessness (Zao), death [also] ensues. Original Text 133
Zheng's Commentary: When Jie Xiong symptoms are fully present, it obstructs the communication mechanism between the upper and lower, causing restlessness (Zao).
Restlessness (Fan) originates from the Heart, while agitation/restlessness (Zao) originates from the Kidney. The disease mechanism lies precisely at the intersection of Kan (Water/Kidney) and Li (Fire/Heart). If they do not intersect, Fan and Zao arise immediately, thus determining death is inevitable.
[Elucidation]: When all symptoms of Jie Xiong are present, the pathogen binding is deep. If restlessness (Fan-Zao) appears additionally, it means healthy Qi cannot overcome the pathogen, and True Qi is scattered; the patient will surely die. Zheng bases his argument on Kan and Li: "Fan originates from the Heart, Zao from the Kidney. The disease mechanism is at the intersection of Kan and Li. Without intersection, Fan and Zao arise immediately, thus determining death." This is indeed an irrefutable theory.
53. In Taiyang Bing, if the physician induces sweating, followed by fever and aversion to cold, and then purges, resulting in Pi (Glomus/Fullness) below the heart, both exterior and interior are deficient, Yin and Yang Qi are exhausted simultaneously, absence of Yang leads to Yin alone, adding moxibustion causes chest irritability, greenish-yellow complexion, and twitching of the skin makes it difficult to treat; if the complexion is slightly yellow and hands and feet are warm, it is easy to heal. Original Text 153
① Yin and Yang Qi exhausted simultaneously: Means both exterior and interior are deficient. Sweating causes exterior deficiency and exhaustion of Yang Qi; purging causes interior deficiency and exhaustion of Yin Qi.
② Absence of Yang leads to Yin alone: Refers to exterior pathogen sinking inward forming Pi, exterior syndrome ceases, and interior syndrome stands alone.
Zheng's Commentary: Regarding Taiyang syndrome, external pathogen must not be resolved before inducing sweating. How could one induce sweating without fever and aversion to cold? This text says sweating led to fever and aversion to cold; how do we know it wasn't mistaken sweating forcing Yang to escape outward? This syndrome arises from improper sweating and purging, leading to simultaneous deficiency of exterior and interior, and exhaustion of Yin and Yang. "Absence of Yang leads to Yin alone" means pure Yin is dominant at this moment, giving rise to Pi obstruction. Subsequent addition of burning needle causes chest irritability and greenish-yellow complexion, revealing the mechanism of Wood and Earth punishing each other, exposing the vital spirit completely; thus it is said to be difficult to treat. If the complexion is slightly yellow without green, and hands and feet remain warm, the root of Post-Heaven existence remains, thus it can be treated.
[Elucidation]: Zheng's commentary: "How could one induce sweating without fever and aversion to cold? This text says sweating led to fever and aversion to cold; how do we know it wasn't mistaken sweating forcing Yang to escape outward?" This deserves deep thought. It is generally due to improper sweating and purging that Pi forms. Although it is said Yin and Yang Qi are exhausted, it is actually because there is no Yang below the heart, so Yin alone obstructs. Adding burning needle to force and劫 (rob) Yin and Yang creates this critical state. One should employ methods to support Yang, disperse rebellion, warm the middle, and dispel pathogen. Attaching Lizhong Decoction with Sha Ren, Ban Xia, and Wu Zhu Yu would be appropriate.
Shanghan Heng Lun Volume 2
Taiyang Middle Chapter
All syndromes of Cold injuring Ying are listed in this chapter, totaling fifty-eight methods (added according to Shu edition)
1. Taiyang Bing, whether fever has already appeared or not, [must have aversion to cold], body [pain], vomiting and reversing, pulse Yin and Yang both tight [is] named [as] Shang Han. Original Text 3
① Pulse Yin and Yang both tight: Refers to the floating and sinking of the pulse. Floating taking is Yang, sinking taking is Yin. "Tight pulse" feels like cutting a rope, a tense phenomenon, similar to Wiry pulse but with stronger twisting force. The Tight pulse mentioned here is a Floating-Tight pulse image. Floating-Tight indicates Exterior Cold, often seen with fever and aversion to cold.
② Named Shang Han: Here, Shang Han does not refer to the broad sense of Shang Han Lun, but specifically to the narrow sense Shang Han corresponding to Ma Huang Tang syndrome.
Zheng's Commentary: Those who have already developed fever, the pathogen has already been suppressed internally; those who have not yet developed fever, the pathogen has entered but not yet suppressed. According to pulse image, Yin and Yang both tight is called Shang Han. Discussing body [pain], it belongs to Shaoyin; vomiting and reversing belongs to Cold Fluid Retention, seemingly not fitting this clause well. From my careful observation, currently having fever, aversion to cold, body pain, and floating-tight pulse is the exact indication of Taiyang Shang Han. If without headache, body pain, fever, aversion to cold, but solely seeing body [pain], vomiting/reversing, and tight pulse, it is a sign of Cold entering Shaoyin. The bottom surface of Taiyang is exactly Shaoyin; using this to judge the phrases "whether fever has already appeared or not" is quite appropriate.
[Elucidation]: This clause is the main symptom and main pulse of Taiyang Shang Han syndrome. Comparing it with the Wind Strike clause in the Upper Taiyang chapter, the main difference is Tight pulse without sweating. Additionally, body pain and vomiting/reversing are also absent in Wind Strike syndrome. Wind Strike has aversion to cold due to wind; Shang Han has aversion to cold even without wind. Zheng's explanation of "whether fever has already appeared or not" differs from历代 commentators, stating "The bottom surface of Taiyang is exactly Shaoyin; using this to judge 'whether fever has already appeared or not' is quite appropriate." "Must have aversion to cold" means injury by Cold causes aversion to cold.
2. Taiyang Bing, headache, fever, body [ache], lower back pain, [bone and joint pain], aversion to wind, no sweating and wheezing, Ma Huang Tang governs it. Original Text 35
Zheng's Commentary: This clause is Cold injuring the interior of Taiyang. Interior Cold is too severe, closing and binding the Qi mechanism, reversing upward causing wheezing. This is the normal logic. Governing with Ma Huang Tang opens the Cou Li (pores/skin interstices), allowing pathogen to exit outward, making exterior and interior smooth, and all symptom forms immediately vanish. Students must not consider wheezing immediately as Lung disease; be aware.
[Elucidation]: This clause represents the main symptoms of Taiyang Shang Han and is the standard for applying Ma Huang Tang. Zheng states: "Students must not consider wheezing immediately as Lung disease." The Great Qi of the human body accumulates in the Heart; the Upper Jiao is like mist. The chest is governed by Taiyang. External Cold binds, Ying and Wei close tightly, Qi cannot vent, stagnates and causes wheezing. What does this have to do with the Lung? Xing Ren is taken for its ability to benefit Qi, not to treat the Lung. Thus, Ma Huang Tang is truly a medicine for treating Taiyang Shang Han, not a formula for treating the Lung Meridian.
Ma Huang Tang Formula (Corrected and Supplemented)
Ma Huang (Ephedrae Herba) three liang (remove joints), Gui Zhi (Cinnamomi Ramulus) two liang (remove bark), Gan Cao (Glycyrrhizae Radix et Rhizoma) one liang (honey-fried), Xing Ren (Armeniacae Semen Amarum) seventy pieces (skin and tips removed). The above four ingredients: with nine sheng of water, first boil Ma Huang, reduce by two sheng, remove foam on top, add other medicines, boil to obtain two and a half sheng, remove dregs, take warm eight ge. Induce slight sweat. No need to drink porridge. Rest follow Gui Zhi Tang care instructions.
[Formula Analysis and Scope of Application]: Ma Huang is Acrid-Warm, opens Cou Li and induces sweating; Xing Ren is Bitter-Warm, disperses and benefits Lung Qi and treats wheezing; Gui Zhi is Acrid-Sweet-Warm, cooperates with Ma Huang to enhance its sweating action; Gan Cao is Sweet-Ping, harmonizes all medicines. Although four ingredients, the formula meaning is comprehensive. This formula is a harsh agent for opening the exterior, driving out pathogen, and inducing sweating; it is the main formula for Taiyang Bing Exterior Excess Syndrome. Wang Ang said: "Ma Huang is hollow, acrid-warm, thin qi, special medicine of the Lung family, walking to Taiyang, can open Cou Li and scatter Cold; Gui Zhi is acrid-warm, can guide Ying-level pathogen to reach muscle surface; Xing Ren is bitter-sweet, can scatter Cold and descend Qi; Gan Cao is sweet-ping, disperses and harmonizes middle." Ma Huang paired with Xing Ren can release exterior and scatter pathogen, descend rebellion and calm wheezing. Cao Yingfu said: "Ma Huang Tang is the sacred medicine for Shang Han. Strange that modern people fear and avoid Ma Huang, merely using Jing Jie, Fang Feng, Dou Chi, Niu Bang etc. to敷衍 (perfunctorily treat) patients, patients also use them happily because they are mild, ultimately failing to see the merit of curing disease." These are words gained from experience. Modern physician Yun Tieqiao stated the criteria for using this formula: "Besides aversion to cold, fever, headache, body pain, etc., pay attention to two points more: First is no sweating, second is mouth and throat comfortable. If there is sweating, Ma Huang is prohibited; if thirsty, dry tongue, crimson lips, Gui Zhi is also prohibited. As long as it is truly no sweating and mouth/throat comfortable, this formula is the unique wonderful method, medicine arrives and disease removes." (See Yun's *Shanghan Lun Ji Yi An*). Zheng in *Yi Fa Yuan Tong* said: "This is the main formula of Taiyang Ying level. Zhongjing's original text treats Taiyang Bing headache, fever, body ache, lower back pain, bone/joint pain, no sweating, aversion to cold, and wheezing." Immediately listing three flexible application methods: (1) Treat acne initially erupting and suddenly hiding, high fever without sweating; (2) Treat heavy shoulders and back, feeling internal cold; (3) Treat red patches rising on the backs of both legs, very painful.
Modern drug analysis shows Ma Huang has effects of inducing sweating, calming cough, and stopping wheezing, being the most powerful among Acrid-Warm sweating medicines. Therefore, for all diseases contracting Cold or Shang Han without sweating, such as headache, lower back pain, body pain, joint pain, etc., none cannot be treated with it. I have commonly used Ma Huang Tang to treat Shang Han cough for many years, always effective, never seeing side effects. Modern people promoted using this formula to treat pneumonia and upper respiratory tract infections belonging to Exterior Cold Excess Syndrome, all achieving good results. Some also used this formula to treat edema in kidney disease, not necessarily sweating, mostly manifesting as increased urination and reduction of swelling.
3. Shang Han one day①, Taiyang receives it, if pulse is quiet, it is not (moving) [transmitting]②, greatly wanting to vomit, or (restlessness) [agitation], pulse rapid and urgent③, is transmitting. Shang Han two or three days, Yangming and Shaoyang symptoms not seen, is not transmitting. Original Text 4, 5
① Shang Han: Refers to broad sense Shang Han, including Wind Strike, differing in broad/narrow sense from the previous clause named Shang Han.
② Pulse if quiet: Means pulse matches syndrome (Shang Han pulse tight, Wind Strike pulse slow), no rapid/urgent phenomena. Transmitting: Means transferring what was received here to there.
③ Pulse rapid and urgent: Opposite to pulse quiet.
Zheng's Commentary: According to the original intent of Shang Han, one day Taiyang, two days Yangming, three days Shaoyang, four days Taiyin, five days Shaoyin, six days Jueyin, this speaks of the Qi mechanism flowing through the Six Meridians. As for pathogen entering Taiyang, even after seven or eight days, ten or more days, as long as pulse is quiet and unmoving, with no other meridian symptoms sufficient evidence, it does not transmit meridians. If pulse moves, heart vexation wanting to vomit, this is transmitting. Students in clinical practice must have other meridian symptoms to verify, and pulse movement/stillness sufficient evidence, then obtaining the reality of transmitting or not transmitting.
[Elucidation]: Zheng merged Articles 4 and 5 of "Distinguishing Taiyang Bing Pulse and Symptoms" into one article. Clinical pathological changes are not mechanically rigid like "one day Taiyang, two days Yangming..." It can transmit to Yangming, can transmit to Shaoyang, and even transfer to Taiyin or Shaoyin. But it also may not undergo transmission after seven or eight days, ten or more days in Taiyang. One can diagnose transmission or non-transmission from pulse and symptom changes, but should prioritize symptoms more. For example, Shang Han on the second day, did not see no aversion to cold but aversion to heat, thirst wanting to drink, etc., Yangming symptoms; on the third day did not see bitter taste, dry throat, dizzy eyes, etc., Shaoyang symptoms, then one knows pathogen is still in Taiyang, without transmission. This fully illustrates whether condition has transmitted should be based on symptoms, absolutely cannot decide transmission by days. Also as Zheng said: "Must have other meridian symptoms to verify, then obtaining the reality of transmitting or not transmitting."
4. Shang Han two or three days, heart palpitations and vexation①, Xiao Jian Zhong Tang governs it (Vomit-prone persons cannot use Jian Zhong Tang②, due to sweetness). Original Text 102
① Heart palpitations and vexation: Palpitating sensation in heart and restless/vexed state.
② Vomit-prone person: Refers to person with chronic vomiting symptoms.
Zheng's Commentary: Taiyang governs the command of Cold Water. Now two or three days, no other meridian condition seen, only seeing heart palpitations and vexation, must be Taiyang losing its Qi transformation command, causing Water stopping below heart, leading to palpitations and vexation. Now governing with Jian Zhong Tang to transform Taiyang Qi, Qi transforms and moves, then ascending/descending not abnormal, and heart palpitations and vexation immediately vanish. But vomit-prone persons cannot use Jian Zhong, because Sweet can surge upward, be aware.
[Elucidation]: Shang Han two or three days, heart palpitations and vexation belong to Interior Deficiency. Even if there are exterior symptoms, sweating is contraindicated; total priority is saving the interior. Middle Qi supported, Healthy Qi can exert anti-pathogen effect, exterior pathogen often resolves with it. The reason for interior deficiency, as Zheng said: "Is Taiyang losing Qi transformation command, causing Water stopping below heart, leading to palpitations and vexation." Jian Zhong Tang is sufficient to transform Taiyang Qi, Qi transforms and moves, ascending/descending not abnormal, heart palpitations and vexation can heal. Xiao Jian Zhong Tang formula notes say "Vomit-prone persons cannot use Gui Zhi Tang, due to sweetness." Zheng moved it after the original text, unknown why.
Xiao Jian Zhong Tang Formula (Corrected and Supplemented)
Gui Zhi (Cinnamomi Ramulus) three liang (remove bark), Gan Cao (Glycyrrhizae Radix et Rhizoma) two liang (honey-fried), Da Zao (Jujubae Fructus) twelve pieces (split), Shao Yao (Paeoniae Radix Alba) six liang, Sheng Jiang (Zingiberis Rhizoma Recens) three liang (sliced), Jiao Yi (Malt Sugar) one sheng. The above six ingredients: with seven sheng of water, boil to obtain three sheng, remove dregs, add Jiao Yi, further place on slight fire to dissolve, take warm one sheng, three times daily. Vomit-prone persons cannot use Jian Zhong Tang, due to sweetness.
[Formula Analysis and Scope of Application]: Gui Zhi Tang takes Gui Zhi as Sovereign, Acrid-Sweet dispersing, mainly expelling pathogen; this formula takes Jiao Yi as Sovereign, paired with Shao Yao Sour-Sweet combining, mainly tonifying Middle. Gui Zhi, Sheng Jiang, warm middle and unblock Yang; Shao Yao gathers Yin and harmonizes Ying. Acridity of Gui/Zheng combined with Sweetness of Zao/Cao/Jiao Yi, then Acrid-Sweet transforms Yang; Bitterness of Shao combined with Sweetness, then Bitter-Sweet transforms Yin. Jiao Yi is Sweet-Warm, greatly tonifies Spleen and Stomach, Zao/Cao assist it, to tonify Spleen/Stomach deficiency, making Middle Palace established, then Yang Qi transforms and ascends, Yin Qi transforms and descends, Ying and Wei harmonized, Yin and Yang not biased, then heart palpitations and vexation can heal. Again formula notes say "Vomit-prone persons cannot use Jian Zhong Tang, due to sweetness." Don't know why Zheng moved this paragraph after original text. This formula appears five times in *Shanghan Lun* and *Jinkui Yaolue*. Treats Interior Deficiency abdominal pain, sallow complexion, heart palpitations/vexation, also treats Deficiency Labor interior urgency, hot palms/soles, nocturnal emission, spermatorrhea, etc., Yin-Yang dual deficiency, Cold-Heat complex various syndromes. Modern promotion uses it to treat chronic gastritis, gastric/duodenal ulcer disease, menopause syndrome, arrhythmia, abdominal pain, spontaneous sweating, night sweats, etc. I used it to treat Ying-Wei disharmony, reduced appetite, mental fatigue, chronic cough not healing, using this formula to strengthen stomach and nourish spleen, generating Yin from Yang, and cough heals itself.
5. Taiyang Shang Han, adding warm needle must cause fright. Original Text 117
Zheng's Commentary: Cold injuring Taiyang, in Ying or in Wei, originally has distinction. This says adding warm needle must cause fright, is pathogen in Ying level adding warm needle causing fright? Or pathogen in Wei level adding warm needle causing fright? Reasoning logically, at that time pathogen must be in Wei level. Wei level belongs to Yang, absolutely cannot use warm needle method. Pathogen in Ying level, can use warm needle method. If pathogen in Wei level uses it, like adding fat to fire, how can pathogen not cause fright disturbing internal organs? Judging thus, students have direction, never causing harm from using warm needle.
[Elucidation]:历代 commentators believe that adding warm needle to someone sick with Shang Han must cause frightful change. Zheng distinguishes between Ying and Wei. Wei level belongs to Yang, absolutely cannot use warm needle method; pathogen in Ying level, can use warm needle method. Judging thus, one avoids harm from using warm needle.
6. Pulse floating suitable to resolve with sweating, using fire moxa, pathogen has no (exit) [from exiting] thus fire becomes excessive①, disease from waist downward must be heavy and numb, named [Water) [Fire] Ni (Reversal) also②. Original Text 116 middle segment
① Pathogen has no exit: After mistaken treatment, exterior pathogen cannot exit via sweat. Due to fire becoming excessive: Due to mistaken use of moxibustion, pathogen heat becomes more intense.
② Fire Ni (Reversal): Any mistaken use of Fire method treatment, thereby forming changed syndrome, is called Fire Ni.