古人云。汗多亡阳者。因发汗太过。身之阳气。随汗而走泄也。下多亡阴者。因屡下
而重伤阴血也。桂枝下咽。阳盛则毙者。因表实无汗。阳气内盛。误投桂枝。如抱薪
救火也。承气下咽。阴盛则亡者。症非阳明。不可攻下。误用硝黄。阳气灭绝也。要知
汗多亡阳。是卫气本虚之人。阳盛则毙。是阴液本亏之症也。下多亡阴。由其阳气
本盛。止伤阴分。阴盛则亡。由其阳气本衰。不禁阴药也。故论症于今。当以汗多亡
阳。下多亡阴为戒。盖汗本津液所化。而风药尤能燥其阴血。胃中本无热邪。而承
气即能销灭真阳。用录救误诸条。以佐古法所未逮。
伤寒如经发表多者。则津液内竭。血不荣筋。以致手足挛疼。二便艰涩。当以加味逍遥散。加熟地、枸杞、钩藤。
邵评∶过表汗多。阴液伤耗。而筋脉失养。则手足挛疼。津枯热结。则二便艰涩也。
养血荣筋。兼以疏利。的是正法。
伤寒过表。二候三候不解。大汗不止。舌卷而黑。气促似喘。六脉洪数无根者。已成
败症也。当以大剂左归合生脉投之。汗止喘定。有得生者。
伤寒过经不解。舌燥口渴。小便不利者。此发表风药太过。津液源竭也。宜左归饮
去茯苓。加麦冬、归、芍、以救津液。自然行矣。
伤寒过经不解。发表攻里不当。以致真阴耗竭。二便燥结不出。胃阴大伤。不纳不
饥。宜一味养正滋阴。使胃阴充足。自能纳谷知饥。宿垢自下。左归合生脉。或甘露加人参。
邵评∶病久元气已虚。复误表误攻。阴液耗而胃气受伤。致便闭不纳。治当滋阴养胃。大忌消导攻伐。
伤寒如遇过表。大汗不止。身肉 动。头眩不起。振振欲擗地者。此阳津阴液俱脱
也。急以左归合参、麦、五味挽之。
邵评∶表汗过多。阴伤而虚阳浮越。阴阳两脱之候也。用左归合参、麦。救阴扶元。
固是。但当参用和阳镇逆之品。如龙、蛎、龟版、白芍之类。更妥。
伤寒误表大汗不止。津液外泄。胃阴虚馁。以致呕恶不已。食入即吐者。宜金水六
君煎。加麦冬、沙参。和中以复津液。自然呕止而纳谷矣。
邵评∶此误表汗多。阴液耗而有痰热。胃气上逆之救误法。
如过表大汗。胃阴空乏。以致干呕呃逆不止。水浆不进。亦宜金水六君合生脉。加
丁香、柿蒂、胡桃肉、代赭石之类止之。如不应。宜都气饮加人参、胡桃肉、紫石英之
类以纳之。不用磁石者。因过表伤肺。恐吸其气也。
邵评∶此过表汗多。肺胃阴伤。气逆不降之救误法。
有阴虚挟感之症。误用柴、葛、犀角升提之药发表。以致虚阳上冒。膈闷呕恶。烦躁
不宁。六脉洪大。按之无力者。亦宜金水六君合参麦加代赭。和中以益少阴。则阴阳和。熟睡而解矣。
邵评∶阴虚受邪。误用升散。阴伤而阳不附阴。呕恶烦躁。脉大无根。当加育阴潜阳为是。
有营虚卫弱之人挟感。恶寒发热。腰疼骨痛。不可峻汗。误用表药。汗大泄反加恶
寒身痛。发热不止。当以归 建中汤调和营卫。则诸症自解矣。
邵评∶营卫虚而挟邪。当调和营卫治之。
凡遇外感表症。诊得两手脉寸软尺迟。舌润无苔者。营卫两虚之症也。当以黄 建中汤加防
风汗之。（以上误汗例）
邵评∶此凭脉用药。调和营卫。兼以散邪之良法。
如经攻里不当。以致下利不止。百骸解散。无气以动。用大剂补中益气加炮姜。温
之提之。如兼汗出而喘。急用参附汤加熟地。大温大补之。
邵评∶此误攻中气大伤。脾肾阳虚之救误法。
如经攻里太过。以致下焦受伤。肠胃并连。直漏直泄。利无关闭者。阳明关闸已撤
也。急用桃花汤。重加人参主之。
邵评∶此过用攻下。肾命火衰。胃肠亏乏。滑脱不守。用桃花汤涩以固脱。极是。
有胃中谷食未化。误下之。食为寒凝。以致胸膈高起。手不可近者。治宜温胃和中。
二陈汤、加炮姜、枳实、浓朴、楂肉之类。温以化之。（以上误下例）
邵评∶此下早伤中。寒药与之。食滞凝结。治以温中开化。亦属救误之正法。凡停
食症初起。所停之物。未化糟粕。在胃之上脘。大忌早下。宜运中导滞。误下则寒药与食互结。愈不
能化。症似结胸。必待其已化糟粕。停在胃之下脘。近肠腑者。方可攻下。切记切记。宿食在胃
之上脘。可用吐法。
古人说：发汗过多导致亡阳，是因为发汗太过，身体的阳气随着汗液外泄而耗散。泻下过多导致亡阴，是因为多次使用攻下法，严重损伤了阴血。桂枝汤（Cinnamon Twig Decoction）服下后，若阳气亢盛则会导致死亡，这是因为表实无汗，体内阳气本已亢盛，误用桂枝汤，如同抱柴救火。承气汤（Gastrointestinal-Regulating Decoction）服下后，若阴寒内盛则会导致死亡，这是因为病症并非阳明腑实证，不可攻下，误用芒硝、大黄等寒凉药物，会导致阳气灭绝。要知道，发汗过多导致亡阳，是卫气原本虚弱的人；阳气亢盛导致死亡，是阴液原本亏损的病症。泻下过多导致亡阴，是因为其阳气原本旺盛，只伤了阴分；阴寒内盛导致死亡，是因为其阳气原本衰微，不能耐受阴寒药物。所以论述病症于今日，应当以“发汗过多致亡阳”、“泻下过多致亡阴”为戒。因为汗是由津液化生，而风药尤其容易燥伤阴血。胃中本来没有热邪，但承气汤却能销灭真阳。现记录救治误治的各种条文，以补充古法的不足。
伤寒经过多次发汗解表后，津液在内枯竭，血液不能濡养筋脉，导致手足痉挛疼痛，大小便艰涩难通。应当使用加味逍遥散（Modified Free and Easy Wanderer Powder），加入熟地黄（Rehmanniae Radix Preparata）、枸杞子（Lycii Fructus）、钩藤（Uncariae Ramulus cum Uncis）。
邵评：过度发汗导致汗出过多，阴液耗损，筋脉失去滋养，所以手足痉挛疼痛。津液枯槁、热邪结聚，所以大小便艰涩。养血以荣养筋脉，兼以疏利，这是正确的治疗方法。
伤寒经过多次发汗解表，病程超过两候或三候仍未解除，大汗不止，舌头卷缩且色黑，气息急促似喘，六脉洪大数急且无根，这已成为败症（不治之症）。应当使用大剂量的左归丸（Zuo Gui Wan）合生脉散（Sheng Mai San）投服。若汗止喘定，有存活的可能。
伤寒病已过经而未解，舌燥口渴，小便不利，这是发表时风药使用太过，导致津液源头枯竭。宜用左归饮（Zuo Gui Yin）去掉茯苓（Poria），加入麦冬（Ophiopogonis Radix）、当归（Angelicae Sinensis Radix）、白芍（Paeoniae Radix Alba），以救助津液，津液恢复自然流通。
伤寒病已过经而未解，因发表和攻里方法不当，导致真阴耗竭，大小便燥结不通，胃阴严重受损，不进食也不感到饥饿。宜一味采用养正滋阴的方法，使胃阴充足，自然能进食知饥，宿垢自会排出。可用左归丸合生脉散，或者甘露饮（Gan Lu Yin）加人参（Ginseng Radix）。
邵评：病久元气已虚，又误用发汗和攻下，阴液耗损且胃气受伤，导致便秘和不思饮食。治疗应当滋阴养胃，大忌使用消导攻伐的药物。
伤寒如遇过度发汗，大汗不止，身体肌肉跳动，头晕目眩不能起身，身体震颤想要倒地，这是阳气和津液阴液都脱失的症状。急需使用左归丸合人参（Ginseng Radix）、麦冬（Ophiopogonis Radix）、五味子（Schisandrae Fructus）来挽回。
邵评：表证发汗过多，阴液损伤而虚阳浮越，属于阴阳两脱的证候。使用左归丸合人参、麦冬，救助阴液扶持元气，固然是正确的。但应当参用调和阳气、镇逆的药物，如龙骨（Fossilia Ossis Mastodi）、牡蛎（Concha Ostreae）、龟板（Carapax et Plastrum Testudinis）、白芍（Paeoniae Radix Alba）之类，更为妥当。
伤寒误用发汗法导致大汗不止，津液外泄，胃阴虚亏，导致呕吐恶心不已，吃进去就吐出来。宜用金水六君煎（Jin Shui Liu Jun Jian），加入麦冬（Ophiopogonis Radix）、沙参（Glehniae Radix），调和脾胃以恢复津液，自然呕吐停止并能进食。
邵评：这是误用发汗导致汗多，阴液耗损且有痰热，胃气上逆的救治误治方法。
如果过度发汗导致大汗，胃阴空乏，导致干呕呃逆不止，连水浆都无法进入，也宜用金水六君煎合生脉散，加入丁香（Caryophylli Flos）、柿蒂（Kaki Calyx）、胡桃肉（Juglandis Semen）、代赭石（Haematitum）之类的药物来止住。如果无效，宜用都气饮（Du Qi Yin）加人参（Ginseng Radix）、胡桃肉（Juglandis Semen）、紫石英（Fluoritum）之类的药物以纳气。不用磁石（Magnetitum）的原因，是因为过度发汗伤了肺，恐怕磁石会吸走肺气。
邵评：这是过度发汗导致汗多，肺胃阴伤，气逆不降的救治误治方法。
有阴虚兼感外邪的病症，误用柴胡（Bupleuri Radix）、葛根（Puerariae Lobatae Radix）、犀角（Rhinocerotis Cornu，现多用替代品）等升提发散的药物发汗，导致虚阳上冒，胸膈闷胀，呕吐恶心，烦躁不安，六脉洪大，按之无力。也宜用金水六君煎合人参（Ginseng Radix）、麦冬（Ophiopogonis Radix）加代赭石（Haematitum），调和脾胃以益少阴，则阴阳调和，熟睡后即可痊愈。
邵评：阴虚感受邪气，误用升散药物，阴液损伤而阳气不能依附于阴，出现呕吐恶心、烦躁、脉大无根。应当加入育阴潜阳的药物才是正确的。
有营血虚弱、卫气不足的人兼感外邪，恶寒发热，腰疼骨痛，不可峻猛发汗。误用发汗药，汗大泄反而加重恶寒身痛，发热不止。应当用当归建中汤（Danggui Jianzhong Tang）调和营卫，则各种症状自然解除。
邵评：营卫虚弱而兼夹邪气，应当调和营卫进行治疗。
凡是遇到外感表证，诊得两手脉象寸部软弱、尺部迟缓，舌润无苔的，是营卫两虚的病症。应当用黄芪建中汤（Huangqi Jianzhong Tang）加防风（Saposhnikoviae Radix）发汗。（以上为误汗的例子）
邵评：这是凭脉用药，调和营卫兼以散邪的良好方法。
如果经过攻里方法不当，导致腹泻不止，全身骨骼松散无力，没有力气活动，使用大剂量补中益气汤（Buzhong Yiqi Tang）加炮姜（Zingiberis Rhizoma Preparatum），温补并提升中气。如果兼有出汗且气喘，紧急使用参附汤（Shen Fu Tang）加熟地黄（Rehmanniae Radix Preparata），大温大补。
邵评：这是误用攻下导致中气大伤，脾肾阳虚的救治误治方法。
如果经过攻里太过，导致下焦受伤，肠胃相连，直接漏泄，腹泻无法控制，这是阳明关闸已撤（肠道固摄功能丧失）。紧急使用桃花汤（Taohua Tang），重用人参（Ginseng Radix）为主药。
邵评：这是过度使用攻下药，肾命火衰，胃肠亏乏，滑脱不守。使用桃花汤涩肠固脱，非常正确。
有胃中谷食未消化，误用攻下法，食物被寒邪凝滞，导致胸膈高高隆起，手不可触碰的，治疗宜温胃和中。用二陈汤（Er Chen Tang）加炮姜（Zingiberis Rhizoma Preparatum）、枳实（Aurantii Fructus Immaturus）、厚朴（Magnoliae Officinalis Cortex）、山楂肉（Crataegi Fructus）之类的药物，温化积滞。（以上为误下的例子）
邵评：这是过早攻下损伤中气，寒药与食物互结，导致食滞凝结。治疗以温中开化，也属于救治误治的正确方法。凡是停食症初起，所停之物尚未化为糟粕，在胃的上脘，大忌过早攻下，宜运脾导滞。误用攻下则寒药与食物互结，更加不能消化，症状类似结胸。必须等待其已化为糟粕，停在胃的下脘，靠近肠腑的地方，方可攻下。切记切记。宿食在胃的上脘，可用吐法。
Ancient texts state: "Excessive sweating leading to the collapse of Yang" occurs because excessive diaphoresis causes the body's Yang Qi to dissipate along with the sweat. "Excessive purgation leading to the collapse of Yin" occurs because repeated use of purgatives severely damages Yin blood. If Guizhi Tang (Cinnamon Twig Decoction) is ingested when Yang is hyperactive, death may ensue; this is because in cases of exterior excess with no sweat, internal Yang is already abundant, and misusing Guizhi Tang is like adding firewood to a fire. If Chengqi Tang (Gastrointestinal-Regulating Decoction) is ingested when Yin cold is hyperactive, death may ensue; this is because if the syndrome is not of the Yangming organ stage, purgation is contraindicated, and misusing rhubarb (Rhei Radix et Rhizoma) and mirabilite (Natrii Sulfas) extinguishes true Yang. One must understand that "excessive sweating leading to Yang collapse" applies to individuals whose defensive Qi (Wei Qi) is originally deficient, while "Yang hyperactivity leading to death" applies to syndromes where Yin fluids are originally depleted. "Excessive purgation leading to Yin collapse" occurs because their Yang Qi is originally robust, so only the Yin aspect is injured; "Yin cold hyperactivity leading to death" occurs because their Yang Qi is originally weak and cannot tolerate Yin-cold medications. Therefore, in discussing syndromes today, one should take "excessive sweating causing Yang collapse" and "excessive purgation causing Yin collapse" as warnings. Sweat is transformed from Jin-Ye (body fluids), and wind-dispelling herbs are particularly drying to Yin blood. The stomach normally lacks heat pathogens, yet Chengqi Tang can destroy true Yang. The following sections on correcting errors are recorded to supplement the inadequacies of ancient methods.
In typhoid fever (Shanghan), if too many diaphoretic treatments have been used, internal fluids will be exhausted, and blood will fail to nourish the sinews, resulting in spasmodic pain in the hands and feet, and difficulty in urination and defecation. One should administer Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) with added Shudi (Prepared Rehmannia Root), Gouqi (Goji Berry), and Gouteng (Uncaria with Hooks).
Commentary by Shao: Excessive sweating depletes Yin fluids, causing the sinews and vessels to lose nourishment, leading to spasmodic pain in the limbs. Dryness of fluids and heat accumulation cause difficulty in excretion. Nourishing blood to benefit the sinews, combined with promoting circulation, is indeed the correct method.
If typhoid fever persists beyond two or three stages despite extensive diaphoresis, with continuous profuse sweating, a curled and black tongue, rapid shallow breathing resembling asthma, and six pulses that are flooding, rapid, and rootless, it has become a critical condition (terminal syndrome). One should administer a large dose of Zuogui Wan (Left Restoring Pill) combined with Shengmai San (Generate the Pulse Powder). If sweating stops and breathing stabilizes, survival is possible.
If typhoid fever has passed its stage but remains unresolved, with a dry tongue, thirst, and dysuria, this is due to excessive use of wind-dispelling herbs for exterior release, exhausting the source of fluids. One should use Zuogui Yin (Left Restoring Decoction) removing Poria, and adding Maidong (Ophiopogon Root), Danggui (Angelica Sinensis Root), and Baishao (White Peony Root) to restore fluids; normal flow will return naturally.
If typhoid fever has passed its stage but remains unresolved, and improper exterior-releasing and interior-purging treatments have led to the exhaustion of true Yin, resulting in dry impaction of stool and urine, severe damage to Stomach Yin, anorexia, and lack of hunger, one should employ a single approach of nourishing righteousness and Yin. When Stomach Yin is sufficient, appetite will return naturally, and accumulated waste will pass. Use Zuogui Wan combined with Shengmai San, or Ganlu Yin (Sweet Dew Decoction) with Renshen (Ginseng Root).
Commentary by Shao: After prolonged illness, Yuan Qi (Original Qi) is deficient. Repeated errors in sweating and purging deplete Yin fluids and injure Stomach Qi, leading to constipation and anorexia. Treatment should focus on nourishing Yin and benefiting the Stomach. Strongly avoid digestive-promoting and attacking methods.
If typhoid fever involves excessive sweating with continuous profuse sweat, muscle twitching, dizziness preventing standing, and trembling desire to fall to the ground, this indicates the depletion of both Yang and Yin fluids. Urgently use Zuogui Wan combined with Renshen (Ginseng Root), Maidong (Ophiopogon Root), and Wuweizi (Schisandra Fruit) to rescue.
Commentary by Shao: Excessive sweating damages Yin, causing floating deficient Yang, representing a state of dual depletion of Yin and Yang. Using Zuogui Wan with Renshen and Maidong to rescue Yin and support Yuan Qi is correct. However, it would be more appropriate to combine herbs that harmonize Yang and suppress rebellion, such as Longgu (Fossilized Mammal Bone), Muli (Oyster Shell), Guiban (Turtle Shell), and Baishao (White Peony Root).
If typhoid fever was incorrectly treated with diaphoresis leading to continuous profuse sweating, external leakage of fluids, and deficiency of Stomach Yin, resulting in persistent nausea and vomiting, where food is vomited immediately upon ingestion, use Jinshui Liu Jun Jian (Six Gentlemen Decoction for Metal and Water) with added Maidong (Ophiopogon Root) and Shashen (Glehnia Root) to harmonize the middle and restore fluids; vomiting will cease and intake will resume naturally.
Commentary by Shao: This is a method to correct errors caused by excessive sweating damaging Yin fluids and generating phlegm-heat, leading to rebellious Stomach Qi.
If excessive sweating leads to empty Stomach Yin, causing persistent dry heaving and hiccups, inability to take even water, use Jinshui Liu Jun Jian combined with Shengmai San, adding Dingxiang (Clove), Shidi (Persimmon Calyx), Hetaoren (Walnut Kernel), and Daizheshi (Hematite) to stop the symptoms. If ineffective, use Duqi Yin (Nine-Ingredient Decoction) with Renshen (Ginseng Root), Hetaoren (Walnut Kernel), and Zhiyingshi (Fluorite) to guide Qi downward. Cishi (Magnetite) is not used because excessive sweating injures the Lung, and Magnetite might absorb Lung Qi.
Commentary by Shao: This is a method to correct errors where excessive sweating damages Lung and Stomach Yin, causing rebellious Qi that fails to descend.
In cases of Yin deficiency complicated by external contraction, if mistakenly treated with ascending and dispersing herbs like Chaihu (Bupleurum Root), Gegen (Kudzu Root), or Xijiao (Rhinoceros Horn - now substituted), causing deficient Yang to float upward, chest oppression, nausea, restlessness, and flooding pulses that are forceless upon pressure, use Jinshui Liu Jun Jian combined with Renshen (Ginseng Root) and Maidong (Ophiopogon Root) plus Daizheshi (Hematite) to harmonize the middle and benefit Shaoyin. Then Yin and Yang will harmonize, and recovery will occur through sound sleep.
Commentary by Shao: Yin deficiency with pathogen invasion, mistakenly treated with ascending and dispersing methods, leads to Yin damage and Yang failing to attach to Yin, causing nausea, restlessness, and rootless large pulses. Adding herbs that nourish Yin and subdue Yang is correct.
For individuals with deficient Ying (Nutritive) and weak Wei (Defensive) Qi who contract an external pathogen, presenting with aversion to cold, fever, lower back pain, and bone pain, harsh diaphoresis is contraindicated. Misusing diaphoretic herbs causes massive sweating, worsening aversion to cold and body pain, and persistent fever. Use Danggui Jianzhong Tang (Angelica Sinensis Decoction to Establish the Middle) to harmonize Ying and Wei, after which all symptoms will resolve.
Commentary by Shao: When Ying and Wei are deficient with concurrent pathogen, treatment should harmonize Ying and Wei.
Whenever encountering exterior syndromes of external contraction, if the pulse at the Cun (inch) position of both wrists is soft and the Chi (cubit) position is slow, and the tongue is moist without coating, this indicates deficiency of both Ying and Wei. Use Huangqi Jianzhong Tang (Astragalus Decoction to Establish the Middle) with Fangfeng (Saposhnikovia Root) to induce mild sweating. (Above are examples of erroneous sweating.)
Commentary by Shao: This is an excellent method of prescribing based on pulse diagnosis to harmonize Ying and Wei while dispersing pathogens.
If improper purgation leads to continuous diarrhea, systemic weakness ("bones falling apart"), and lack of energy to move, use a large dose of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Paojiang (Prepared Ginger Rhizome) to warm and lift. If accompanied by sweating and asthma, urgently use Shenfu Tang (Ginseng and Aconite Decoction) with Shudi (Prepared Rehmannia Root) for strong warming and tonification.
Commentary by Shao: This is a method to correct errors where improper purgation severely injures Middle Qi, leading to Spleen and Kidney Yang deficiency.
If excessive purgation injures the Lower Jiao, connecting intestines and stomach, causing direct leakage and uncontrollable diarrhea, the "gate" of Yangming has collapsed. Urgently use Taohua Tang (Peach Blossom Decoction) with a heavy dose of Renshen (Ginseng Root) as the main ingredient.
Commentary by Shao: Overuse of purgatives leads to decline of Mingmen Fire (Kidney Yang) and deficiency of intestines and stomach, causing sliding and loss of control. Using Taohua Tang to astringe and secure against collapse is very correct.
If undigested food in the Stomach is mistakenly purged, causing food to congeal due to cold, resulting in high elevation of the chest and epigastrium that is tender to touch, treatment should warm the Stomach and harmonize the middle. Use Erchen Tang (Two-Aged Decoction) with Paojiang (Prepared Ginger Rhizome), Zhishi (Immature Bitter Orange), Houpo (Magnolia Bark), and Zharen (Hawthorn Flesh) to warm and transform. (Above are examples of erroneous purgation.)
Commentary by Shao: Premature purgation injures the Middle, and cold herbs cause food stagnation to congeal. Treatment with warming and resolving is a correct method for correcting errors. In early-stage food stagnation, the retained material has not yet turned into feces and resides in the upper Jiao of the Stomach. Early purgation is strictly forbidden; instead, promote middle Qi and guide out stagnation. Erroneous purgation causes cold herbs and food to bind together, making digestion harder, resembling Jie Xiong (Chest Binding) syndrome. One must wait until it has turned into feces and moved to the lower Jiao of the Stomach, near the intestines, before purging. Remember this well. For retained food in the upper Jiao of the Stomach, emesis may be used.