（二十八）腹满不减。减不足言。当下之。宜大承气汤。
此申明上条而诀用治之意。
（二十九）伤寒。吐后腹胀满者。与调胃承气汤。
吐亦无津液而胃又伤。腹虽满而非热结。调胃承气者。阳明之正也。方见太阳下。
（三十）太阳病。若吐。若下。若发汗。微烦。小便数。大便因硬者。与小承气汤和之。愈。
此总亦胃实由于亡津液。而皆宜小和者。通该戒大下之意也。
（三十一）阳明病。其人多汗。以津液外出。胃中燥。大便必硬。硬则谵语。小承气汤主之。
若一服。谵语止。更莫复服。
此与上条互意。多汗见后。
（三十二）伤寒。若吐若下后不解。不大便五六日。上至十余日。日晡所发潮热不恶寒。独
语如见鬼状。若剧者。发则不识人。循衣摸床。惕而不安。微喘直视。脉弦者生。涩者死。微者。
但发热。谵语者。大承气汤主之。若一服利。止后服。
此以势重言。独。自也。与谵互意。循衣摸床。阳偏胜而躁动于手也。弦者阴气强。涩者阴
不足。阳热剧甚有余。阴以际之。故生可回也。阴不足而阳独治。故死可知也。
（三十三）汗出谵语者。以有燥屎在胃中。此为风也。须下之。过经乃可下之。下之若早。
语言必乱。以表虚里实故也。下之则愈。宜大承气汤。
过经。谓宁迟迟。非谓待十三日后也。言出于心。心为胃之母。子能令母虚。故下早则必乱也。
表虚里实。谓外邪悉入胃也。
（三十四）得病二三日。脉弱无太阳柴胡证。烦躁。心下硬。至四五日。虽能食。以小承气
汤少少与。微和之令小安。至六日。与承气汤一升。若不大便六七日。小便少者。虽不能食。但
初头硬。后必溏。未定成硬。攻之必溏。须小便利。屎硬。乃可攻之。宜大承气汤。
令。平声。太阳不言药。以有桂枝麻黄之不同也。柴胡不言证。以专少阳也。凡似此为文者。
皆互发也。以无太少。故知诸证属阳明。以脉弱。故宜微和。至六日以下。历叙可攻不可攻之节
度。
（三十五）阳明病。心下硬满者。不可攻之。攻之。利遂不止者。死。利止者。愈。
上条心下硬而用下者。以属阳明胃也。此谓心下硬满不可攻者。以邪聚阳明之膈也。所以然
者。阳明之脉。上至额颅。其支别者。从大迎前下人迎。循喉咙。入缺盆。下膈也。攻亦下也。
利遂不止。其人阴本虚也。利止者。其人阳气胜也。
（三十六）阳明病。不吐。不下。心烦者。可与调胃承气汤。
不由吐下而心烦。则发于胃实可知也。用调胃承气者。无杂故也。
（三十七）伤寒六七日。目中不了了。睛不和。无表里证。大便难。身微热者。此为实也。
急下之。宜大承气汤。
了了。犹 也。素问曰。阳明主肉。其脉挟鼻络于目。灵枢曰。足阳明之正。上循咽。出于
口。还系目系。合于阳明也。又曰。足阳明之筋。其支者上颈上挟口。合于 下。结于鼻。上合
于太阳。太阳为目上纲。阳明为目下纲。所以目中不了了。睛不和。知胃实也。急下者。任脉循
面入目。督脉上行两目中央。诸脉皆属于目。而人之精神注焉。是以如是其急也。
（三十八）伤寒呕多。虽有阳明证。不可攻之。
呕属太阳。故曰呕多。虽有阳明不可攻。以多则太阳犹有未除可知也。虽字当玩味。
（三十九）食谷欲呕者。属阳明也。吴茱萸汤主之。得汤反剧者。属上焦也。
吴茱萸汤方
吴茱萸（一升洗） 人参（三两） 生姜（六两） 大枣（十二枚擘）
上四味。以水七升。煮取二升。去滓。服七合。日三服。
食谷欲呕。胃寒也。故曰属阳明。言与恶寒呕逆不同也。茱萸辛温。散寒下气。人参甘温。固
气安中。大枣益胃。生姜止呕。四物者。所以为阳明安谷之主治也。上焦以膈言。亦戒下之意。
（四十）阳明病。谵语。有潮热。反不能食者。胃中必有燥屎五六枚也。若能食者。但硬尔。
宜大承气汤。
。与尔同。不能食。寒因也。故屎燥。能食。因于风也。故但硬 。
（四十一）伤寒脉浮而缓。手足自温者。是为系在太阴。太阴者。身当发黄。若小便自利者。不
能发黄。至七八日。大便硬者。为阳明病也。
伤寒脉浮而缓。见太阳下编。然缓以候脾。脾主四末。故手足自温。为系在太阴。身当发黄
者。脾为湿土。为胃之合。若不能为胃以行其津液。湿着不去。则郁蒸而身发黄。黄为土色。土
主肌肉故也。小便自利。津液行也。行则湿去矣。所以不能发黄。胃中干。大便硬。而为阳明病也。
（四十二）阳明中风。口苦。咽干。腹满。微喘。发热。恶寒。脉浮而紧。若下之。则腹满
小便难也。
阳明之脉。挟口环唇。然胆热则口苦。咽为胆之使。故口苦则咽干。腹满。热入阳明也。微
喘。发热。恶寒。脉浮而紧。风寒俱有。而太阳未除也。下之腹满者。误下则里虚。外邪未除者。
乘虚而尽入。内陷也。小便难。亡津液也。
（四十三）阳明病。脉浮而紧。咽燥而口苦。腹满而喘。发热汗出。不恶寒。反恶热。身重。
若发汗则燥。心愦愦。反谵语。若加烧针。必怵惕烦躁不得眠。若下之。则胃中空虚。客气动隔。
心中懊 。舌上苔者。栀子豉汤主之。
愦。匣伪切。怵。穿橘切。惕。透吉切。燥。亦干也。发热以上。与上条同。恶热。阳明血
气俱盛也。以当太阳时恶寒。今恶热。故曰反也。身重。阳明主肌肉。湿上重着也。汗出热在肌
肉。腠理反开也。以上三节。言汗下烧针皆不可。故着其变以示也。愦愦。心乱貌。怵惕。恐惧
貌。舌苔见太阳下编。彼以脏结。故为难治。此以膈热。故涌之以栀子豉。方见太阳中。
若渴欲饮水。口干舌燥者。白虎加人参汤主之。
此又以变渴更治言。方见太阳下。
若脉浮发热。渴欲饮水。小便不利者。猪苓汤主之。
猪苓汤方
猪苓（一两去皮） 茯苓（一两） 阿胶（一两） 滑石（一两） 泽泻（一两）
上五味。以水四升。先煮四味。取二升。去滓。内下阿胶烊消。温服七合。日三服。
此又以小便不利再出治。猪苓茯苓。从阳而淡渗。阿胶滑石。滑泽以滋润。泽泻盐寒。走肾
以行水。水行则热泄。滋润则渴除。
（四十四）阳明病。汗出多而渴者。不可与猪苓汤。以汗多胃中燥。猪苓汤复利其小便故也。
此承上条复以汗多不宜猪苓汤。申致戒谨之意。
（四十五）阳明病。脉浮而紧者。必潮热。发作有时。但浮者。必盗汗出。
浮而紧与前同。故申言必潮热。但浮则阳盛。阳盛则阴虚。阴虚。所以盗汗出也。
（四十六）太阳病。寸缓。关浮。尺弱。其人发热。汗出。复恶寒。不呕。但心下痞者。此
以医下之也。如其不下者。病患不恶寒而渴者。此转属阳明也。小便数者。大便必硬。不更衣。
十日无所苦也。渴欲饮水。少少与之。但以法救之。渴者宜五苓散。
数。音朔。以表证与脉在。故知痞为误下之所致。以表除而作渴。故知转属阳明。十日无所苦
者。以津液偏渗而致干。非热结也。以干而渴。故与水而宜五苓。方见太阳上。
（四十七）阳明中风。脉弦浮大而短气。腹都满。胁下及心痛。久按之气不通。鼻干。不得汗。
嗜卧。一身及面目悉黄。小便难。有潮热。时时哕。耳前后肿。剌之小瘥。外不解。病过十日。脉
续浮者。与小柴胡汤。脉但浮无余证者。与麻黄汤。若不尿。腹满加哕者。不治。
尿。与溺同。泥叫切。弦少阳。浮。太阳。大。阳明。胁下痛。少阳也。小便难。太阳之膀胱不利也。腹满鼻干
嗜卧。一身及面目悉黄。潮热。阳明也。时时哕。三阳俱见。而气逆甚也。耳前后肿。阳明之脉。
出大迎。循颊车。上耳前。太阳之脉。其支者。从巅至耳。少阳之脉。下耳后。其支者。从耳后
入耳中。出走耳前也。然则三阳俱见证。而曰阳明者。以阳明居多而任重也。风寒俱有。而曰中
风者。寒证轻而风脉甚也。续浮谓续得浮。故与小柴胡。从和解也。但浮无余证者。风虽外向。
终为微寒持也。故发之以麻黄。不尿腹满加哕者。邪盛于阳明而关格。所以无法可治也。小柴胡
汤。见太阳上。麻黄汤。见太阳
中。尿。南人。心崔切。
（四十八）阳明病。脉迟。食难用饱。饱则微烦头眩。必小便难。此欲作谷瘅。虽下之。腹
满如故。所以然者。脉迟故也。
瘅。广韵作疸。迟为寒。不化谷。故食难用饱。谷不化。则与热搏。湿郁而蒸。气逆而不下
行。故微烦头眩。小便难也。瘅。黄病也。谷瘅。水谷之湿。蒸发而身黄也。下则徒虚胃气。外
邪反乘虚陷入。所以腹满仍旧也。末乃申上文义。以致不可下之意。
（四十九）阳明病。若中寒不能食。小便不利。手足 然汗出。此欲作固瘕。必大便初硬后
溏。所以然者。以胃中冷。水谷不别故也。
瘕。匣牙切。固。坚固。瘕。积聚。以本寒因。水谷不化消。积聚成坚固也。末亦申上文。致
勿下之意。
（五十）阳明病。欲食。小便反不利。大便自调。其人骨节疼。翕翕如有热状。奄然发狂。
然汗出而解者。此水不胜谷气。与汗共并。脉紧则愈。
奄。影检切。欲食。胃气将回也。阳明以胃实为正。故小便不利。大便自调为反也。骨节疼
如有热。余表未除也。奄然。忽然也。发狂。阳明之所以作汗也。水不胜。以小便反不利言。谷
气以欲食言。盖谓所以汗出者。由小便不利。胃回不作实。故得汗。得汗则表并解。故曰脉紧则
亦愈也。
（五十一）阳明病。不能食。攻其热。必哕。所以然者。胃中虚冷故也。以其人本虚。故攻
其热必哕。
攻热。皆寒药。故知必哕。胃中虚。以不能食言。此亦戒谨之意。
（五十二）伤寒四五日。脉沉而喘满。沉为在里。而反发其汗。津液越出。大便为难。表虚
里实。久则谵语。
满。胃实也。逆溢则喘。越出。谓枉道而出也。表虚。津液越出也。里实。大便难也。
（五十三）脉浮而迟。表热里寒。下利清谷者。四逆汤主之。若胃中虚冷。不能食者。饮水
则哕。
此疑三阴篇错简。
（五十四）阳明病。但头眩不恶寒。故能食而咳。其人必咽痛。若不咳者。咽不痛。
眩。风旋而目晕也。风。故不恶寒。能食。咳。逆气。咽门。胃之系也。胃热而气逆攻咽则
咳。痛。咽伤也。
（五十五）阳明病。法多汗。反无汗。其身如虫行皮中状者。此以久虚故也。
法多汗。言阳明热郁肌肉。腠理反开。应当多汗。故谓无汗为反也。无汗则寒胜。而腠理反
秘密。所以身如虫行皮中状也。久虚寒胜。则不能食。胃不实也。
（五十六）阳明病。反无汗而小便利。二三日呕而咳。手足厥者。必苦头痛。若不咳不呕。
手足不厥者头不痛。
此亦寒胜。故小便利。呕。手足厥。手足为诸阳之本。三阳皆上头。故手足厥者。必苦头痛也。
（五十七）阳明病。下之。其外有热。手足温。不结胸。心中懊 。饥不能食。但头汗出者。
栀子豉汤主之。
下之。外有热。外者外散也。故手足温不结胸。心中懊 者。虽不结胸。而膈中则郁烦也。
头汗见太阳上。方见太阳中。
（五十八）阳明病。口燥。但欲漱水不欲咽。此必衄。
漱。音瘦。口为胃窍。胃热则口燥。漱水不欲咽者。阳明血气俱多。虽燥不渴也。衄者。以血
气俱多。而脉起于鼻。故热甚则血妄行。必由鼻而出也。
（五十九）脉浮。发热。口干。鼻燥。能食者则衄。
浮。因于风也。风为阳。所以证如此也。
（六十）脉浮而芤。浮为阳。芤为阴。浮芤相搏。胃气生热。其阳则绝。
芤。俗读丘。浮为气上行。故曰阳。芤为血肉损。故曰阴。胃中生热者。阴不足以和阳。津
液干而成枯燥也。阳绝即亡阳之互词。此上二条疑错简。
（六十一）趺阳脉浮而涩。浮则胃气强。涩则小便数。浮涩相搏。大便为难。其脾为约。麻仁丸主之。
麻仁丸方
麻子（二升） 芍药（半斤） 枳实（半斤） 大黄（一斤去皮） 浓朴（一斤去皮） 杏仁
（一斤去皮尖熬研脂）
上六味。为末。炼蜜为丸。桐子大。饮服十丸。日三服。渐加。以和为度。
数。音朔。趺阳。胃脉也。其脉在足趺上动脉处。去陷谷三寸。又曰冲阳。一名会元。浮为
盛阳。故主胃强。涩为阴虚。故小便数。约。约束也。胃为脾之合。脾主为胃以行其津液。胃强
则脾弱。脾弱。则不能为胃行其津液以四布。使其得以偏渗于膀胱。为小便数。大便干而胃实。
犹之反被胃家之约束。而受其制。故曰其脾为约也。麻子杏仁。能润干燥之坚。枳实浓朴。能导
固结之滞。芍药敛液以辅润。大黄推陈以致新。脾虽为约。此之疏矣。
（六十二）阳明病。发热。汗出。此为热越。不能发黄也。但头汗出。身无汗。剂颈而还。小便不
利。渴饮水浆者。此为瘀热在里。身必发黄。茵陈蒿汤主之。
茵陈蒿方
茵陈蒿（六两） 栀子（十四枚擘） 大黄（二两）
（二十八）腹部胀满持续不缓解，即使有减轻也微不足道。应当使用攻下法，适宜用大承气汤。
这是为了阐明上一条的内容并决断治疗的意思。
（二十九）伤寒病，呕吐之后出现腹部胀满的，给予调胃承气汤。
呕吐会损伤津液且伤害胃气，腹部虽然胀满但不是热邪结聚所致。调胃承气汤是治疗阳明病的正治方剂。该方见太阳病篇下方。
（三十）太阳病，如果经过催吐、泻下或发汗治疗后，出现轻微心烦，小便频数，大便因此变硬的，给予小承气汤调和它，病就好了。
这是总括说明胃实是由于亡失津液造成的，而都适宜用小剂量调和的方法，通盘包含告诫不可峻下的意思。
（三十一）阳明病，患者多汗，因为津液外泄，胃中干燥，大便必然坚硬，大便硬则会出现谵语，以小承气汤为主治。
如果服用一次后，谵语停止，就不要再继续服用。
这与上一条互文见义，多汗的情况在后面提到。
（三十二）伤寒病，经过催吐或泻下后病情未解，五六天甚至十多天不大便，在申时（下午3-5点）发作潮热，不恶寒，独自说话好像看见鬼怪一样。如果病情严重，发作时不认识人，手抓衣被摸弄床沿，惊恐不安，微微气喘，眼睛直视，脉象弦的能生，脉象涩的死。轻症的，只是发热、谵语的，以大承气汤为主治。如果服用一次后大便通畅，就停止后面的服药。
这里是从病情严重的角度论述。“独”意为“自”。与“谵语”互文见义。“循衣摸床”，是阳气偏胜而在手部躁动。脉弦表示阴气强盛，脉涩表示阴气不足。阳热极度亢盛有余，阴气与之相持，所以生机可回。阴气不足而阳气独治，所以死亡可知。
（三十三）出汗且谵语的，是因为胃中有燥屎，这是风邪所致。必须使用攻下法。要等到表证解除（过经）之后才可以攻下。如果攻下过早，语言必定错乱，这是因为表虚里实的缘故。攻下之后病就好了，适宜用大承气汤。
“过经”，意思是宁可迟缓，并非指等待十三天以后。言语出于心，心为胃之母，子能令母虚，所以下药过早必定导致神志错乱。
“表虚里实”，是指外邪全部进入胃中。
（三十四）得病两三天，脉弱，没有太阳病或少阳柴胡证的表现为烦躁，心下部硬满。到了四五天，虽然能进食，用小承气汤少量给予，轻微调和使病人稍微安宁。到了第六天，给予一升承气汤。如果六七天不大便，小便少的，虽然不能进食，但大便开头硬，后面一定稀溏，尚未确定完全变硬，攻下必然导致腹泻。必须等到小便通利，大便变硬，才可以攻下，适宜用大承气汤。
“令”，读平声。太阳病篇不讲具体药物，因为有桂枝汤和麻黄汤的不同。柴胡证不讲症状，因为专属于少阳病。凡是类似这种行文方式的，都是互相发明。因为没有太阳和少阳的病证，所以知道这些症状属于阳明病。因为脉弱，所以适宜轻微调和。从第六天以下的叙述，详细列举了可以攻和不可以攻的节度。
（三十五）阳明病，心下部硬满的，不可攻下。如果攻下，腹泻不止的，死亡；腹泻停止的，痊愈。
上一条中心下部硬满而用下法的，是因为属于阳明胃腑实证。这里说心下部硬满不可攻下的，是因为邪气聚集在阳明之膈。之所以这样，是因为阳明经脉，上行至额颅，其分支，从大迎穴前下行到人迎穴，沿着喉咙，进入缺盆，向下穿过膈肌。攻下也是下法的一种。腹泻不止，是因为此人阴气本来虚弱。腹泻停止，是因为此人气血旺盛。
（三十六）阳明病，没有经过催吐或泻下，却心烦的，可以给予调胃承气汤。
不是由吐下引起的心烦，则是发于胃实可知。使用调胃承气汤，是因为没有夹杂其他病邪的缘故。
（三十七）伤寒六七天，眼睛视物不清，眼球转动不灵活，没有表证也没有典型的里证，大便困难，身体微热的，这是实证。紧急攻下，适宜用大承气汤。
“了了”，清晰的意思。《素问》说：阳明主肌肉，其经脉挟鼻络于目。《灵枢》说：足阳明的正脉，向上沿咽喉，出于口，还联系目系，合于阳明。又说：足阳明的筋，其分支向上到颈部挟口，合于颏下，结于鼻，上合于太阳。太阳为目上纲，阳明为目下纲。所以眼睛视物不清，眼球转动不灵活，就知道是胃实。紧急攻下，是因为任脉循行面部入目，督脉上行至两眼中央，诸脉皆属于目，而人的精神注于此，所以如此紧急。
（三十八）伤寒呕吐多的，虽然有阳明病的证候，不可攻下。
呕吐属于太阳病范畴，所以说呕吐多。虽然有阳明病也不可攻下，因为呕吐多则说明太阳表邪还有未除去的，可知。这个“虽”字应当仔细玩味。
（三十九）进食后想要呕吐的，属于阳明病，用吴茱萸汤主治。喝了药反而加重的，属于上焦病。
吴茱萸汤方
吴茱萸（一升，洗净） 人参（三两） 生姜（六两） 大枣（十二枚，掰开）
以上四味药，用水七升，煮取二升，去渣，每次服七合，每日三次。
进食后想呕吐，是胃寒所致。所以说属于阳明病，是说它与恶寒呕逆不同。吴茱萸辛温，散寒下气；人参甘温，固气安中；大枣益胃；生姜止呕。这四味药，是用来治疗阳明病安和谷气的。上焦以膈而言，也是告诫不可攻下的意思。
（四十）阳明病，谵语，有潮热，反而不能进食的，胃中一定有燥屎五六枚。如果能进食的，只是大便硬罢了，适宜用大承气汤。
“尔”同“耳”。不能进食，是寒邪所致，所以大便干燥。能进食，是风邪所致，所以只是大便硬。
（四十一）伤寒脉浮而缓，手足自然温暖的，这是病系在太阴。太阴病，身体应当发黄。如果小便自利的，不会发黄。到了七八天，大便变硬的，就是阳明病了。
伤寒脉浮而缓，见太阳病篇编次中。然而缓脉候脾，脾主四肢末端，所以手足自然温暖，这是病系在太阴。身体应当发黄的，是因为脾为湿土，是胃的表里配合脏，如果不能为胃运行津液，湿气滞留不去，则郁蒸而身体发黄。黄色是土色，土主肌肉的缘故。小便自利，说明津液运行，运行则湿气去除，所以不会发黄。胃中干燥，大便变硬，就成为阳明病。
（四十二）阳明中风，口苦，咽干，腹满，微喘，发热，恶寒，脉浮而紧。如果误用攻下法，则会导致腹满和小便困难。
阳明经脉，挟口环唇。然而胆热则口苦，咽是胆的通道，所以口苦则咽干。腹满是热邪进入阳明。微喘、发热、恶寒、脉浮而紧，说明风寒都有，而太阳表邪未除。误下导致腹满，是因为误下导致里虚，外邪未除者，乘虚全部陷入，内陷于里。小便难，是因为亡失津液。
（四十三）阳明病，脉浮而紧，咽燥而口苦，腹满而喘，发热汗出，不恶寒，反恶热，身体沉重。如果发汗则烦躁，心中昏乱，反而谵语。如果加用烧针，必定惊恐烦躁不得睡眠。如果攻下，则胃中空虚，客气动膈，心中懊恼，舌上有苔的，用栀子豉汤主治。
“愦”，音匣伪切。“怵”，音穿橘切。“惕”，音透吉切。“燥”，也是干的意思。发热以上，与上一条相同。恶热，是因为阳明气血俱盛。因为在太阳病时恶寒，现在恶热，所以说“反”。身重，是因为阳明主肌肉，湿气重着。汗出热在肌肉，腠理反而开张。以上三节，说明汗、下、烧针都不可用，所以记载其变证以示警。“愦愦”，心乱的样子。“怵惕”，恐惧的样子。舌苔见太阳病篇编次中，那里因为脏结，所以为难治。这里因为膈热，所以用涌吐法用栀子豉汤。该方见太阳病篇中。
如果口渴想喝水，口干舌燥的，用白虎加人参汤主治。
这是又以变渴来进一步论述治疗方法。该方见太阳病篇下方。
如果脉浮发热，渴欲饮水，小便不利的，用猪苓汤主治。
猪苓汤方
猪苓（一两，去皮） 茯苓（一两） 阿胶（一两） 滑石（一两） 泽泻（一两）
以上五味药，用水四升，先煮前四味，取二升，去渣，加入阿胶烊化消溶，温服七合，每日三次。
这是又以小便不利再提出治疗方法。猪苓、茯苓，从阳而淡渗利水；阿胶、滑石，滑泽以滋润；泽泻咸寒，走肾以行水。水行则热泄，滋润则渴除。
（四十四）阳明病，出汗多且口渴的，不可给予猪苓汤。因为汗多导致胃中干燥，猪苓汤又利尿伤津的缘故。
这是承接上一条再次说明汗多不宜用猪苓汤，申明谨慎告诫的意思。
（四十五）阳明病，脉浮而紧的，必定有潮热，发作有时。只有脉浮的，必定有盗汗。
浮而紧与前文相同，所以申明必定有潮热。只有脉浮则阳气盛，阳气盛则阴虚，阴虚，所以盗汗出。
（四十六）太阳病，寸脉缓，关脉浮，尺脉弱，其人发热，汗出，又恶寒，不呕，只是心下痞塞的，这是医生误用下法导致的。如果不曾下法，病人不恶寒而口渴的，这是转属阳明病。小便频数的，大便必然硬，十天不上厕所也没有痛苦。想喝水的，少量给予，只按法治之。口渴的适宜用五苓散。
“数”，音朔。因为表证和脉象仍在，所以知道痞塞是误下所致。因为表邪解除而作渴，所以知道转属阳明。十天无所痛苦的，是因为津液偏渗而导致干燥，不是热邪结聚。因为干燥而渴，所以给水而适宜用五苓散。该方见太阳病篇上方。
（四十七）阳明中风，脉弦浮大而短气，腹部全面胀满，胁下及心痛，久按之气不通，鼻干，无汗，嗜睡，全身及面目都发黄，小便难，有潮热，时时呃逆，耳前后肿胀，针刺后稍微好转，外证未解，病过十天，脉继续浮的，给予小柴胡汤。脉只浮没有其他证候的，给予麻黄汤。如果不排尿，腹满加重呃逆的，无法治疗。
“尿”，同“溺”，音泥叫切。弦脉属少阳，浮脉属太阳，大脉属阳明。胁下痛，属少阳。小便难，是太阳膀胱气化不利。腹满、鼻干、嗜睡、全身及面目都发黄、潮热，属阳明。时时呃逆，是三阳证俱见，而气逆很严重。耳前后肿，阳明的经脉，出大迎，循颊车，上耳前；太阳的经脉，其分支，从头顶至耳；少阳的经脉，下耳后，其分支，从耳后入耳中，出走耳前。既然三阳证俱见，而称为阳明病，是因为阳明证居多且任重。风寒都有，而称为中风，是因为寒证轻而风脉甚。续浮谓持续得到浮脉，所以与小柴胡汤，从和解法治疗。只有脉浮没有其他证候的，风虽外向，终被微寒束缚，所以用麻黄汤发散。不排尿、腹满加重呃逆的，是邪气盛于阳明导致关格，所以无法治疗。小柴胡汤，见太阳病篇上方。麻黄汤，见太阳病篇中。尿，南方读音，心崔切。
（四十八）阳明病，脉迟，进食难以吃饱，饱则轻微心烦头眩，必定小便难，这是将要发生谷疸。即使攻下，腹满如故。之所以这样，是因为脉迟的缘故。
“瘅”，《广韵》作“疸”。迟脉为寒，不消化谷物，所以进食难以吃饱。谷不消化，则与热搏结，湿郁而蒸腾，气逆而不下降，所以轻微心烦头眩，小便难。瘅，是黄病。谷疸，是水谷之湿，蒸发而身体发黄。攻下则徒然损伤胃气，外邪反而乘虚陷入，所以腹满依旧。最后申明上文含义，以致不可攻下的意思。
（四十九）阳明病，如果中寒不能进食，小便不利，手足濈然汗出，这是将要发生固瘕，必定大便开头硬后面稀溏。之所以这样，是因为胃中冷，水谷不分的原因。
“瘕”，音匣牙切。固，坚固。瘕，积聚。因为本有寒邪，水谷不化消，积聚成坚固。最后也申明上文，致勿攻下的意思。
（五十）阳明病，想吃东西，小便反而不利，大便正常。其人骨节疼痛，翕翕像有发热的样子，忽然发狂，濈然汗出而病解的，这是水不胜谷气，与汗共同并出，脉紧则愈。
“奄”，音影检切。欲食，说明胃气将恢复。阳明以胃实为正治，所以小便不利、大便正常是反常现象。骨节疼像有热，是余表未除。奄然，忽然也。发狂，是阳明作汗的表现。水不胜，是因为小便反而不利。谷气是因为欲食而言。大概意思是说之所以汗出，是由小便不利，胃气回复不作实，所以得汗。得汗则表证一并解除，所以说脉紧则亦愈。
（五十一）阳明病，不能进食，攻其热，必定呃逆。之所以这样，是因为胃中虚冷的缘故。因为此人本来虚弱，所以攻其热必定呃逆。
攻热，都用寒药，所以知道必定呃逆。胃中虚，是因为不能进食。这也是谨慎告诫的意思。
（五十二）伤寒四五天，脉沉而喘满，沉为在里，反而发其汗，津液越出，大便为难，表虚里实，久了则谵语。
“满”，胃实也。气逆溢则喘。越出，谓枉道而出也。表虚，津液越出也。里实，大便难也。
（五十三）脉浮而迟，表热里寒，下利清谷的，用四逆汤主治。如果胃中虚冷，不能进食的，喝水则呃逆。
这怀疑是三阴篇的错简。
（五十四）阳明病，只是头晕不恶寒，所以能进食且咳嗽，其人必定咽痛。如果不咳嗽的，咽不痛。
“眩”，风旋而目晕也。风邪所致，所以不恶寒。能食，咳，是气逆。咽门，是胃的系带。胃热气逆攻咽则咳。痛，是咽受伤。
（五十五）阳明病，法当多汗，反而无汗，身体像虫行皮中状的，这是因久虚的缘故。
法当多汗，是说阳明热郁肌肉，腠理反开，应当多汗。所以说无汗为反常。无汗则寒胜，而腠理反秘密，所以身体像虫行皮中状。久虚寒胜，则不能进食，胃不实。
（五十六）阳明病，反无汗而小便利，二三日呕而咳，手足厥冷的，必定苦头痛。如果不咳不呕，手足不厥冷的，头不痛。
这也是寒胜，所以小便利。呕，手足厥，手足是诸阳之本，三阳皆上头，所以手足厥冷的，必定苦头痛。
（五十七）阳明病，下之，其外有热，手足温，不结胸，心中懊恼，饥不能食，但头汗出的，用栀子豉汤主治。
下之，外有热，外者是外散也，所以手足温不结胸。心中懊恼的，虽然不结胸，而膈中则郁烦。头汗见太阳病篇上方。该方见太阳病篇中。
（五十八）阳明病，口燥，但想漱水不欲咽的，这必定衄血。
“漱”，音瘦。口为胃窍，胃热则口燥。漱水不欲咽的，是因为阳明血气俱多，虽燥不渴。衄血，是因为血气俱多，而脉起于鼻，所以热甚则血妄行，必由鼻而出。
（五十九）脉浮，发热，口干，鼻燥，能食的则衄血。
浮，是因为风邪。风为阳，所以证候如此。
（六十）脉浮而芤，浮为阳，芤为阴，浮芤相搏，胃气生热，其阳则绝。
“芤”，俗读丘。浮为气上行，故曰阳。芤为血肉损，故曰阴。胃中生热，是阴不足以和阳，津液干而成枯燥。阳绝即亡阳的互词。这两条怀疑是错简。
（六十一）趺阳脉浮而涩，浮则胃气强，涩则小便数，浮涩相搏，大便为难，其脾为约，用麻仁丸主治。
麻仁丸方
麻子（二升） 芍药（半斤） 枳实（半斤） 大黄（一斤，去皮） 浓朴（一斤，去皮） 杏仁（一斤，去皮尖，熬研脂）
以上六味药，为末，炼蜜为丸，梧桐子大，饮服十丸，每日三次，逐渐增加，以和为度。
“数”，音朔。趺阳，是胃脉。其脉在足背动脉处，去陷谷三寸。又说冲阳，一名会元。浮为盛阳，故主胃强。涩为阴虚，故小便数。约，约束也。胃为脾之合，脾主为胃运行津液。胃强则脾弱，脾弱，则不能为胃运行津液以四布，使其得以偏渗于膀胱，为小便数。大便干而胃实，犹如反被胃家之约束，而受其制，故曰其脾为约。麻子、杏仁，能润干燥之坚；枳实、浓朴，能导固结之滞；芍药敛液以辅润；大黄推陈以致新。脾虽为约，此方疏之矣。
（六十二）阳明病，发热，汗出，此为热越，不能发黄。只是头汗出，身无汗，齐颈而还，小便不利，渴饮水浆的，此为瘀热在里，身体必定发黄，用茵陈蒿汤主治。
茵陈蒿方
茵陈蒿（六两） 栀子（十四枚，掰开） 大黄（二两）
(28) Abdominal fullness persists without relief; even if there is some reduction, it is negligible. Purging should be employed, and Da Cheng Qi Tang (Great Order the Qi Decoction) is indicated.
This clarifies the preceding clause and determines the therapeutic intent.
(29) In cold damage, if abdominal fullness occurs after vomiting, Tiao Wei Cheng Qi Tang (Regulate the Stomach Order the Qi Decoction) should be administered.
Vomiting depletes body fluids and injures the stomach. Although the abdomen is full, it is not due to heat accumulation. Tiao Wei Cheng Qi Tang is the correct formula for Yangming disease. See below in the Taiyang chapter.
(30) In Taiyang disease, if mild irritability, frequent urination, and consequent hard stools occur after emesis, purgation, or sweating, Xiao Cheng Qi Tang (Minor Order the Qi Decoction) should be given to harmonize, leading to recovery.
This summarizes that gastric excess results from fluid depletion and advocates mild harmonization, implicitly warning against harsh purgation.
(31) In Yangming disease, profuse sweating leads to external loss of body fluids, causing dryness in the stomach and hard stools, which may result in delirium. Xiao Cheng Qi Tang (Minor Order the Qi Decoction) is the primary treatment.
If delirium ceases after one dose, do not administer further doses.
This complements the previous clause; profuse sweating is discussed later.
(32) In cold damage, if the condition remains unresolved after emesis or purgation, and constipation persists for five to six days or up to ten-plus days, with tidal fever at Shen hour (3–5 PM), aversion to cold absent, and solitary muttering as if seeing ghosts, severe cases may present with inability to recognize people, grasping at clothes and bedrails, fearfulness and restlessness, slight panting, and fixed gaze. A wiry pulse indicates survival; a choppy pulse indicates death. In milder cases presenting only with fever and delirium, Da Cheng Qi Tang (Great Order the Qi Decoction) is indicated. If bowel movement occurs after one dose, stop subsequent administration.
This describes severe progression. "Du" (solitary) means self. It complements "delirium." Grasping at clothes and bedrails indicates excessive yang agitation in the hands. A wiry pulse suggests strong yin qi; a choppy pulse indicates insufficient yin qi. When yang heat is excessively abundant and yin qi contends with it, recovery is possible. When yin is insufficient and yang reigns alone, death is certain.
(33) Profuse sweating accompanied by delirium indicates dry feces in the stomach due to wind pathogen. Purging is required but must wait until the exterior syndrome has passed ("Guo Jing"). Premature purging will cause speech confusion due to exterior deficiency and interior excess. After purging, the disease resolves; Da Cheng Qi Tang (Great Order the Qi Decoction) is indicated.
"Guo Jing" implies caution and delay, not necessarily waiting thirteen days. Speech originates from the Heart, which is the mother of the Stomach; if the child (Stomach) is depleted by premature purging, the mother (Heart) becomes deficient, causing confusion.
"Exterior deficiency and interior excess" means external pathogens have fully entered the Stomach.
(34) Two to three days after contracting disease, if the pulse is weak, and there are no Taiyang or Shaoyang Chai Hu patterns, but rather irritability and hardness below the heart: by day four or five, even if the patient can eat, give Xiao Cheng Qi Tang (Minor Order the Qi Decoction) in small amounts to mildly harmonize and provide slight relief. By day six, administer one sheng of Cheng Qi Tang. If there is no bowel movement for six or seven days and urine is scanty, even if the patient cannot eat, if the stool is hard at the beginning but loose at the end, it is not yet fully hardened; purging will cause diarrhea. Wait until urine flows freely and stool is hard before purging; Da Cheng Qi Tang (Great Order the Qi Decoction) is indicated.
"Ling" is pronounced with the level tone. Taiyang chapter omits specific drugs due to variations like Guizhi Tang and Mahuang Tang. Chai Hu patterns omit symptoms because they specifically belong to Shaoyang. Such parallel texts mutually explain each other. Absence of Taiyang and Shaoyang signs indicates Yangming involvement. Weak pulse necessitates mild harmonization. The narrative from day six onwards details the degrees of when to purge and when not to.
(35) In Yangming disease, hardness and fullness below the heart contraindicate purging. If purged and diarrhea continues uncontrollably, death ensues; if diarrhea stops, recovery occurs.
The previous case used purging for hardness below the heart because it belonged to Yangming Stomach excess. This case states that hardness/fullness below the heart should not be purged because the pathogen gathers at the diaphragm of the Yangming channel. The Yangming channel ascends to the forehead; its branch descends from Daying to Ying, follows the throat, enters Quepen, and passes through the diaphragm. Uncontrollable diarrhea indicates inherent yin deficiency; cessation indicates sufficient yang qi.
(36) In Yangming disease, if irritability arises without prior emesis or purgation, Tiao Wei Cheng Qi Tang (Regulate the Stomach Order the Qi Decoction) may be given.
Irritability not caused by emesis or purgation indicates origin in gastric excess. Tiao Wei Cheng Qi Tang is used because there are no mixed pathogens.
(37) Six or seven days into cold damage, if vision is unclear and eyes are unresponsive, with no exterior or typical interior signs, difficult defecation, and slight body heat, this is an excess pattern. Urgent purging is required; Da Cheng Qi Tang (Great Order the Qi Decoction) is indicated.
"Liaoliao" means clear. Suwen states: Yangming governs flesh, and its channel connects to the nose and eyes. Lingshu states: The main branch of Foot-Yangming ascends via the pharynx, emerges at the mouth, and connects to the eye system. Another branch ascends the neck, joins the mouth, knots at the nose, and combines with Taiyang. Taiyang is the upper eyelid governor; Yangming is the lower. Unclear vision and unresponsive eyes indicate gastric excess. Urgent purging is necessary because Ren Mai enters the eyes, Du Mai ascends between the eyes, and all channels connect to the eyes where spirit resides.
(38) In cold damage, if vomiting is frequent, purging is contraindicated even if Yangming signs are present.
Vomiting belongs to Taiyang. Frequent vomiting suggests residual Taiyang pathogen despite Yangming signs. The word "even if" requires careful consideration.
(39) Desire to vomit after eating belongs to Yangming; Wu Zhu Yu Tang (Evodia Decoction) is indicated. If symptoms worsen after taking the decoction, the pathology belongs to the Upper Jiao.
Wu Zhu Yu Tang Formula
Evodiae Fructus (Wuzhuyu) (1 sheng, washed)
Codonopsis Radix (Renshen) (3 liang)
Zingiberis Rhizoma Recens (Shengjiang) (6 liang)
Jujubae Fructus (Dazao) (12 pieces, split)
Boil the four ingredients in 7 sheng of water to obtain 2 sheng. Strain. Take 7 ge per dose, three times daily.
Desire to vomit after eating indicates stomach cold, hence belonging to Yangming (specifically stomach cold), distinct from aversion to cold and vomiting. Evodia is acrid-warm, dispersing cold and directing qi downward; Codonopsis is sweet-warm, consolidating qi and calming the middle; Jujube benefits the stomach; Ginger stops vomiting. These four herbs treat Yangming stomach cold to restore appetite. "Upper Jiao" refers to the diaphragm, also warning against purging.
(40) In Yangming disease, delirium with tidal fever and inability to eat indicates dry feces (five to six pellets) in the stomach. If the patient can eat, the stool is merely hard. Da Cheng Qi Tang (Great Order the Qi Decoction) is indicated.
"Erl" means "merely." Inability to eat indicates cold, leading to dry stool. Ability to eat indicates wind, leading to merely hard stool.
(41) In cold damage, a floating and moderate pulse with warm extremities indicates the disease is linked to Taiyin. Taiyin disease typically presents with jaundice. If urination is free, jaundice does not develop. By day seven or eight, if stools become hard, it transforms into Yangming disease.
Floating and moderate pulse is seen in Taiyang. Moderate pulse diagnoses Spleen; Spleen governs extremities, hence warm hands and feet link to Taiyin. Jaundice occurs because Spleen is damp-earth, paired with Stomach; if it fails to transport fluids, dampness stagnates and steams, causing yellow discoloration (earth color governing muscle). Free urination indicates fluid circulation, removing dampness, thus preventing jaundice. Dry stomach and hard stools constitute Yangming disease.
(42) Yangming wind-strike presents with bitter taste, dry throat, abdominal fullness, slight panting, fever, aversion to cold, and floating-tight pulse. Purging will cause abdominal fullness and difficult urination.
Yangming channel circles the lips. Gallbladder heat causes bitter taste; throat is the Gallbladder's conduit, hence dry throat. Abdominal fullness indicates heat entering Yangming. Slight panting, fever, aversion to cold, and floating-tight pulse indicate both wind-cold and unresolved Taiyang. Purging causes interior deficiency, allowing external pathogens to sink inward, worsening fullness. Difficult urination results from fluid depletion.
(43) Yangming disease with floating-tight pulse, dry throat, bitter taste, abdominal fullness, panting, fever, sweating, aversion to heat (not cold), and heavy body. Sweating causes irritability and mental confusion, potentially delirium. Moxibustion causes fear, restlessness, and insomnia. Purging empties the stomach, allowing hostile qi to disturb the diaphragm, causing deep irritation and tongue coating. Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is indicated.
"Kui" (mental confusion), "Chu" (fear), "Ti" (alarm) are pronunciation guides. Fever matches the previous clause. Aversion to heat indicates abundant Yangming qi-blood. Heavy body reflects dampness in muscles governed by Yangming. Sweating opens pores. These sections warn against sweating, purging, and moxibustion. Tongue coating is discussed in Taiyang (difficult due to organ binding); here it is diaphragmatic heat, treated by emesis with Zhi Zi Chi Tang. See Taiyang chapter.
If thirst with dry mouth and tongue occurs, Bai Hu Jia Ren Shen Tang (White Tiger Plus Ginseng Decoction) is indicated.
This addresses transformed thirst. See Taiyang chapter below.
If floating pulse, fever, thirst, and oliguria occur, Zhu Ling Tang (Polyporus Decoction) is indicated.
Zhu Ling Tang Formula
Polypori Sclerotium (Zhuling) (1 liang, peeled)
Poria Cocos (Fuling) (1 liang)
Equisetum Hiemale? No, Asini Corii Colla (Ejiao) (1 liang)
Talcum (Huashi) (1 liang)
Alismatis Rhizoma (Zexie) (1 liang)
Boil five ingredients in 4 sheng water. First boil four items to get 2 sheng, strain, then dissolve Ejiao. Take 7 ge warm, three times daily.
This addresses oliguria. Polyporus and Poria promote diuresis via yang; Ejiao and Talcum moisten; Alisma is salty-cold, guiding water via Kidney. Water flow clears heat; moisture relieves thirst.
(44) In Yangming disease with profuse sweating and thirst, Zhu Ling Tang (Polyporus Decoction) is contraindicated because sweating already dries the stomach, and this formula further promotes urination.
This reiterates caution against Zhu Ling Tang in cases of profuse sweating.
(45) In Yangming disease, floating-tight pulse indicates inevitable tidal fever at regular intervals. Only floating pulse indicates night sweats.
Floating-tight implies tidal fever. Only floating indicates excess yang and deficient yin, causing night sweats.
(46) Taiyang disease with slow cun, floating guan, and weak chi pulses, fever, sweating, aversion to cold, no vomiting, but epigastric stuffiness, results from physician-induced purging. If not purged, and the patient is thirsty without aversion to cold, it transforms into Yangming. Frequent urination leads to hard stools; ten days without defecation causes no distress. Thirst requires small sips of water; treat according to principles. Wuling San (Five-Ingredient Powder with Poria) is indicated for thirst.
"Shuo" is the pronunciation for frequency. Persistent exterior signs and pulse indicate epigastric stuffiness from erroneous purging. Thirst after exterior resolution indicates transformation to Yangming. Ten days without distress implies fluid deviation causing dryness, not heat binding. Water and Wuling San address this. See Taiyang chapter above.
(47) Yangming wind-strike with wiry-floating-large pulse, shortness of breath, generalized abdominal fullness, hypochondriac and heart pain unrelieved by pressure, dry nose, anhidrosis, lethargy, generalized jaundice, difficult urination, tidal fever, frequent hiccups, and swelling around ears. Acupuncture provides slight relief, but exterior remains unresolved. After ten days, if pulse remains floating, give Xiao Chai Hu Tang (Minor Bupleurum Decoction). If only floating pulse without other signs, give Mahuang Tang (Ephedra Decoction). Anuria, worsening abdominal fullness, and hiccups are untreatable.
"Wu" is same as "Niao". Wiry indicates Shaoyang; Floating indicates Taiyang; Large indicates Yangming. Hypochondriac pain is Shaoyang. Difficult urination is Taiyang Bladder dysfunction. Abdominal fullness, dry nose, lethargy, jaundice, tidal fever are Yangming. Hiccups indicate severe qi reversal across all three yang channels. Ear swelling involves Yangming, Taiyang, and Shaoyang channels. Called Yangming because it predominates. "Wind-strike" implies light cold and prominent wind pulse. Continued floating pulse allows Xiaochaihu Tang (harmonizing). Only floating pulse allows Mahuang Tang (releasing). Anuria, fullness, and hiccups indicate extreme Yangming pathogen causing Guan-Ge obstruction, making it untreatable. See Taiyang chapter for formulas.
(48) Yangming disease with slow pulse, difficulty eating to satiety, mild irritability and vertigo after eating, and difficult urination suggests impending Gu Dan (Gravel Jaundice). Purging will not relieve abdominal fullness because of the slow pulse.
"Dan" is variant for "Dan" (jaundice). Slow pulse indicates cold and poor digestion. Undigested grain conflicts with heat, causing damp stagnation and qi reversal, leading to irritability, vertigo, and oliguria. Dan is jaundice; Gu Dan is jaundice from grain-damp evaporation. Purging damages stomach qi, allowing external pathogens to sink, maintaining fullness. This concludes the argument against purging.
(49) Yangming disease with cold invasion, inability to eat, oliguria, and continuous sweating on extremities suggests Gu Jia (Solid Mass), likely presenting with hard initial stool followed by loose stool. This is due to stomach cold and failure to separate water and grain.
"Jia" refers to accumulation. Cold prevents digestion, forming solid masses. This reiterates the warning against purging.
(50) Yangming disease with desire to eat, contrary oliguria, normal stool, bone joint pain, slight feverish sensation, sudden mania, followed by sweating and resolution, indicates water failing to overcome grain qi, combining with sweat. Tight pulse indicates recovery.
"Yan" means suddenly. Desire to eat shows returning stomach qi. Oliguria and normal stool are contrary to expectation. Joint pain and slight fever indicate residual exterior. Mania is Yangming generating sweat. Water failing to overcome grain explains sweating despite oliguria. Returning stomach qi allows sweating, resolving exterior. Tight pulse confirms recovery.
(51) Yangming disease with inability to eat, treating heat with cold methods, causes hiccups due to stomach deficiency and cold. Given inherent deficiency, attacking heat induces hiccups.
Attacking heat uses cold herbs, inevitably causing hiccups. Inability to eat indicates stomach deficiency. This serves as a caution.
(52) Cold damage at four or five days with sinking pulse and panting/fullness. Sinking indicates interior. Erroneous sweating causes fluid leakage, difficult defecation, exterior deficiency, and interior excess. Prolonged, this leads to delirium.
"Man" is gastric excess. Reverse overflow causes panting. Leakage means abnormal exit. Exterior deficiency is fluid loss; interior excess is difficult stool.
(53) Floating-slow pulse, exterior heat, interior cold, and diarrhea with undigested food indicate Si Ni Tang (Four Reversal Decoction). If stomach cold prevents eating, drinking water causes hiccups.
This passage is suspected to be misplaced from the Three Yin chapters.
(54) Yangming disease with only vertigo, no aversion to cold, ability to eat, and cough indicates inevitable sore throat. Without cough, there is no sore throat.
Vertigo is wind-spinning dizziness. Wind causes no aversion to cold. Cough indicates qi reversal. Throat is connected to Stomach; stomach heat reversing upward causes cough and throat injury.
(55) Yangming disease typically involves profuse sweating; absence of sweating with a sensation of insects crawling under the skin indicates chronic deficiency.
Typically, Yangming heat in muscles opens pores, causing sweating. Absence indicates cold dominance closing pores, creating the crawling sensation. Chronic deficiency and cold prevent eating; stomach is not excess.
(56) Yangming disease with absence of sweating but free urination, followed by vomiting, cough, and cold extremities within two to three days, indicates severe headache. Absence of these symptoms means no headache.
Cold dominance causes free urination. Extremities are root of yang; all three yang channels ascend to head. Cold extremities lead to headache.
(57) Yangming disease after purging, with exterior heat, warm extremities, no chest binding, epigastric irritation, hunger but inability to eat, and only head sweating, is treated with Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction).
Post-purging exterior heat indicates dispersion, hence warm extremities and no chest binding. Epigastric irritation indicates diaphragmatic oppression. Head sweating is noted in Taiyang. See Taiyang chapter for formula.
(58) Yangming disease with dry mouth, desiring to rinse water but not swallow, indicates inevitable epistaxis.
Mouth is Stomach orifice; heat causes dryness. Rinsing without swallowing indicates abundant blood/qi in Yangming; dryness exists without thirst. Epistaxis occurs because abundant blood/qi and nasal vessel origins cause heat-induced bleeding.
(59) Floating pulse, fever, dry mouth, dry nose, and ability to eat indicate epistaxis.
Floating indicates wind. Wind is yang, producing these signs.
(60) Floating-kou pulse: floating is yang, kou is yin. Their interaction generates stomach heat, severing yang.
"Fou" (kou) is vulgarly read as Qiu. Floating indicates ascending qi (yang); Kou indicates blood/fluid loss (yin). Stomach heat arises from yin failing to harmonize yang, drying fluids. Yang severance is synonymous with yang collapse. These two clauses are suspected misplacements.
(61) Fuyang pulse floating and choppy: floating indicates strong stomach qi; choppy indicates frequent urination. Their interaction causes difficult defecation and constrained spleen. Ma Ren Wan (Hemp Seed Pill) is indicated.
Ma Ren Wan Formula
Cannabis Semen (Hua Ren/Ma Ren) (2 sheng)
Paeoniae Radix Alba (Shaoyao) (0.5 jin)
Immature Bitter Orange (Zhishi) (0.5 jin)
Rhei Radix et Rhizoma (Dahuang) (1 jin, peeled)
Magnoliae Officinalis Cortex (Houpo/Nongpu) (1 jin, peeled)
Pruni Semen (Xingren) (1 jin, peeled, toasted, ground)
Grind six ingredients, mix with honey, form pills size of wutong seeds. Take 10 pills with water, three times daily, increasing gradually until harmonized.
"Shuo" is pronunciation for frequency. Fuyang is stomach pulse. Floating indicates strong yang/stomach excess; choppy indicates yin deficiency/frequent urination. "Yue" means constraint. Stomach pairs with Spleen; Spleen transports fluids. Stomach excess weakens Spleen, preventing fluid distribution, causing diversion to bladder (frequent urination) and dry stool. Spleen is constrained by Stomach. Hemp and Apricot seeds moisten dryness; Immature Bitter Orange and Magnolia bark guide stagnation; Paeonia retains fluid; Rhubarb eliminates excess. This formula loosens the constraint.
(62) Yangming disease with fever and sweating indicates heat venting, preventing jaundice. Only head sweating, no body sweat up to the neck, oliguria, and thirst for drinks indicate trapped heat in interior, leading to jaundice. Yin Chen Hao Tang (Artemisia Scoparia Decoction) is indicated.
Yin Chen Hao Formula
Artemisiae Scopariae Herba (Yinchenhao) (6 liang)
Gardeniae Fructus (Zhizi) (14 pieces, split)
Rhei Radix et Rhizoma (Dahuang) (2 liang)