凡七条方四
（一）伤寒阴阳易之为病。其人身体重。少气。少腹里急。或引阴中拘挛。热上冲胸。头重
不欲举。眼中生花。膝胫拘急者。烧 散主之。
烧 散方
上取妇人中 近隐处。剪。烧灰。以水和服方寸匕。日三服。小便即利。阴头微肿则愈。妇
人病。取男子 当烧灰。
少腹之少。去声。伤寒。包中风而言也。易。犹交易变易之易。言大病新瘥。血气未复。强
合阴阳。则二气交感。互相换易而为病也。身体重。少气。真元亏竭而困倦也。少腹里急。或引
阴中拘挛者。所易之气内攻也。热上冲胸。头不欲举。眼中生花者。虚阳生热而上蒸也。膝胫拘
急者。脉乱而筋伤也。 当近隐处。阴阳二气之所聚也。男女易用。物各归本也。
（二）大病瘥后劳复者。枳实栀子豉汤主之。若有宿食者。加大黄如博棋子五六枚。
枳实栀子豉汤方
枳实（三枚炙） 栀子（十四枚擘） 豉（一升绵裹）
上三味。以清浆水七升。空煮取四升。内枳实栀子煮取二升。下豉更煮五六沸。去滓。温。
分。再服。覆令微似汗。
大病。概言也。下仿此。劳。强力房劳。复。重复作病。盖大邪初退。血气新虚。作强劳伤。
虚而生热。犹之病复发。非实发初病也。枳实宽中破结。栀子散热除烦。香豉能解虚劳之热。清
浆则又栀子之监制。故协三物之苦寒。同主劳伤之复热。而与发初病之实热不同伦也。宿食。陈
宿之积食也。食能生热。故须去之。大黄者去陈以致新也。
（三）伤寒瘥已后。更发热者。小柴胡汤主之。脉浮者。以汗解之。脉沉者。以下解之。
此示病后不谨。调理小复之大法。脉浮。有所重感也。脉沉。饮食失节也。
（四）大病瘥后。从腰以下有水气者。牡蛎泽泻散主之。
牡蛎泽泻散方
牡蛎（熬） 泽泻 栝蒌根 蜀漆（洗去脚） 葶苈（熬） 商陆根 海藻（洗去咸以上各等分）
上七味。异捣下。筛为散。更入臼中治之。白饮和服方寸匕。小便利。止后服。
水气。肌肉肿满而虚浮。盖瘥后新虚。土未强而水无制也。从肿以下而不及上者。水性就下。
势之初起。故虽泛滥未至于横溢也。牡蛎泽泻海藻。咸以走肾。肾强则水行。葶苈商陆根。苦以
利湿。湿去则肿没。蜀漆辛而能散。故为诸品之佐也。栝蒌根苦能彻热。本乃蜀漆之使也。
（五）大病瘥后。喜唾。久不了了者。胃上有寒。当以丸药温之。宜理中丸。
唾。口液也。寒以饮言。不了了。谓无已时也。方见前。
（六）伤寒解后。虚羸少气。气逆欲吐者。竹叶石膏汤主之。
竹叶石膏汤方
竹叶（二把） 石膏（一斤） 半夏（半升洗） 人参（三两） 甘草（二两炙） 粳米
（半升） 麦门冬（一升去心）
上七味。以水一斗。煮取六升。去滓。内粳米。煮米熟。汤成。去米。温服一升。日三服。
羸。音雷。羸。病而瘦也。少气。谓短气不足以息也。气逆欲吐。饮作恶阻也。盖寒伤形。
故寒解则肌肉消削而羸瘦。热伤气。故热退则气衰耗而不足。病后虚羸。脾胃未强。饮食难化。
则痰易生。痰涌气逆。故欲吐也。竹叶清热。麦冬除烦。人参益气。甘草生肉。半夏豁痰而止
吐。粳米病后之补剂。石膏有彻上彻下之功。故能佐诸品而成补益也。
（七）病患脉已解。而日暮微烦。以病新瘥。人强与谷。脾胃气尚弱。不能消谷。故令微烦。
损谷则愈。
脉已解。邪悉去而无遗余也。日暮阳明之王时也。强与谷。谓压其进食也。损。言当节减之
也。盖饮食节。则脾胃和。脾胃和。则百体安。此调理病余之要法也。
上经十一篇。法三百九十七。方一百一十三。盖仲景氏之遗书。而叔和所诠次之者也。传谓
世称仲景
医圣。良以仲景者。集医哲之大成。而是书者。正医教之大训也。初学之士。舍是则无以为入道
之门。而敦进德之基矣。故夫笃志斯道者。亦曰必由是而学焉。则亦庶乎其不瘥。而于人亦不致
误。驯是以往。诚能至于仁熟义精。道久化成。不但人无枉命。而己亦无惭德。则帝伯之堂可升。
有农之神可继。岂不伟哉。
（三百九十七者。今移六条在第十五篇。）
凡七条，方剂四个。
（一）伤寒病后出现阴阳易这种病症。患者身体沉重，气短，小腹部拘急疼痛，或者牵引阴部痉挛，热气上冲至胸部，头部沉重不想抬起，眼前发黑视物模糊，膝盖和小腿拘挛僵硬。用烧裈散主治。
烧裈散方
取妇人中衣近隐处部分，剪下，烧成灰。用水调和服用一方寸匕。每日服三次。小便通畅，阴头轻微肿胀即愈。若是女子患病，取男子中衣裆部烧灰服用。
“少腹”的“少”字读去声。“伤寒”一词包含中风在内。“易”，如同交易、变易的“易”。指大病刚刚痊愈，气血尚未恢复，强行进行房事，则男女二气交感，互相交换而导致生病。身体沉重、气短，是真元亏竭而导致的困倦。小腹部拘急疼痛，或者牵引阴部痉挛，是所交换的病邪之气向内攻冲所致。热气上冲胸部，头部沉重不想抬起，眼前发黑视物模糊，是虚阳产生热邪而上蒸所致。膝盖和小腿拘挛僵硬，是脉象紊乱而筋脉受损。裈应当取靠近隐蔽处的部分，因为那是阴阳二气聚集的地方。男女可以互换使用，是因为万物各归其本。
（二）大病初愈后因劳累而复发的，用枳实栀子豉汤主治。如果有宿食停滞的，加大黄如博棋子大小的五六枚。
枳实栀子豉汤方
枳实（三枚，炙） 栀子（十四枚，掰开） 豆豉（一升，绵裹）
以上三味药，用清浆水七升，先空煮至四升，加入枳实和栀子，煮取二升，再加入豆豉，再煮五六沸，去渣。温服，分两次服用。服药后覆盖衣被使身体微微似有汗出。
“大病”是概而言之，下文仿照此例。“劳”，指强力劳作或房劳；“复”，指疾病重复发作。大概是大邪气刚刚退去，气血 newly 虚弱，因强力劳作损伤，虚而生热，犹如疾病复发，并非初次发病时的实热。枳实能宽中破结，栀子能散热除烦，香豉能解除虚劳之热，清浆水又能监制栀子，所以配合这三味药的苦寒之性，共同主治劳伤引起的复热，这与治疗初次发病的实热不同。宿食，是指陈旧的积食。食物能生热，所以需要去除它。大黄的作用是去陈致新。
（三）伤寒病愈之后，再次发热的，用小柴胡汤主治。脉浮的，用发汗法解表；脉沉的，用泻下法通里。
这是示人病后如果不谨慎调理，导致病情反复的大法。脉浮，说明有重感外邪；脉沉，说明饮食失节。
牡蛎泽泻散方
牡蛎（熬） 泽泻 栝蒌根 蜀漆（洗去脚） 葶苈子（熬） 商陆根 海藻（洗去咸味，以上各等分）
以上七味药，分别捣碎过筛成为散剂，再放入臼中研细。用白饮（米汤）调服一方寸匕。小便通畅后，停止后续服用。
水气，指肌肉肿满而虚浮。大概是大病初愈，正气 new 虚，脾土未强而不能制水。从腰部以下浮肿而不波及上部，是因为水性就下，且势在初起，所以虽然泛滥但还未至于横溢全身。牡蛎、泽泻、海藻，味咸能入肾走肾，肾气强健则水液运行；葶苈子、商陆根，味苦能利湿，湿气去除则肿胀消退；蜀漆辛散，所以作为诸药的佐使；栝蒌根苦能彻热，本是蜀漆的使药。
（五）大病初愈后，喜欢吐唾沫，长久不能好的，是胃上有寒，应当用丸药温补，宜用理中丸。
唾，指口液。寒，指由饮水不当引起。不了了，指没有休止的时候。方剂见前文。
（六）伤寒病解之后，身体虚弱消瘦，气短，气逆想呕吐的，用竹叶石膏汤主治。
竹叶石膏汤方
竹叶（二把） 石膏（一斤） 半夏（半升，洗） 人参（三两） 甘草（二两，炙） 粳米（半升） 麦门冬（一升，去心）
以上七味药，用水一斗，煮取六升，去渣，加入粳米，煮至米熟，汤成，去米。温服一升，每日三次。
羸，音雷，指因病而瘦弱。少气，指短气不足以呼吸。气逆欲吐，指痰饮作祟导致恶心阻滞。大概寒邪伤形，所以寒邪解除后肌肉消削而瘦弱；热邪伤气，所以热退后气衰耗而不足。病后身体虚弱消瘦，脾胃尚未强壮，饮食难以消化，则痰容易生成。痰涌气逆，所以想呕吐。竹叶清热，麦冬除烦，人参益气，甘草生肉，半夏豁痰止吐，粳米是病后的补剂，石膏有彻上彻下的功效，所以能辅助诸药而成补益之功。
（七）病人脉象已经平和，但傍晚时分轻微心烦，是因为病刚痊愈，人们强行给进食，脾胃之气尚弱，不能消化食物，所以导致轻微心烦。减少饮食量就会痊愈。
脉已解，指邪气完全去除而无遗留。日暮是阳明经旺盛的时候。强与谷，指强迫进食。损，指应当节减。大概饮食节制，则脾胃调和；脾胃调和，则全身安泰。这是调理病后余邪的重要方法。
以上经文共十一篇，法三百九十七条，方一百一十三首。大概是张仲景先生的遗书，由王叔和编次而成的。传说世人称仲景为医圣，确实因为仲景集医学哲理之大成，而这本书正是医学教育的大训诫。初学的士人，舍弃这本书就没有进入大道的门户，也没有增进德行的基础。所以立志于这门学问的人，也说必须通过此书来学习，那么或许就不会出错，对他人也不会造成误治。顺着这条路走下去，诚然能达到仁熟义精，道久化成，不仅使人不枉送性命，自己也没有惭愧的德行，那么就能登上帝王的殿堂，继承神农的神农氏的事业，难道不伟大吗？
（注：三百九十七条，今将六条移至第十五篇。）
Seven clauses in total, four formulas.
(1) The disease known as Yin-Yang Yi (Exchange of Yin and Yang) occurring after Shanghan (Cold Damage). The patient presents with a heavy body, shortness of breath, urgency and pain in the lower abdomen, or spasms drawing into the genitalia, heat rushing up to the chest, heaviness of the head making it unwilling to be lifted, visual disturbances such as seeing flowers before the eyes, and stiffness and cramping of the knees and shins. It is primarily treated with Shao Kun San (Burned Underwear Powder).
Formula for Shao Kun San
Take the part of the woman's undergarment near the genitals, cut it off, burn it to ash. Mix with water and administer one Fang Cun Bi (a square-inch measure) per dose. Take three times daily. When urination becomes smooth and there is slight swelling at the glans penis, the patient will recover. If the patient is a woman, take the crotch part of a man's undergarment and burn it to ash.
The character "Shao" in "Shao Fu" (Lower Abdomen) is pronounced with the departing tone. "Shanghan" encompasses Zhongfeng (Wind Strike). "Yi" means exchange or change, similar to trade or transformation. It refers to the condition where, shortly after recovery from a major illness when Qi and Blood have not yet restored, forced sexual intercourse causes the two Qi (of male and female) to interact and exchange pathogenic factors, resulting in disease. Heavy body and shortness of breath indicate exhaustion of True Yuan (True Origin/Essence) leading to fatigue. Urgency/pain in the lower abdomen or spasms drawing into the genitalia are caused by the exchanged pathogenic Qi attacking internally. Heat rushing to the chest, heaviness of the head, and visual disturbances are due to deficient Yang generating heat and steaming upward. Stiffness and cramping of the knees and shins result from chaotic pulse patterns damaging the sinews. The garment should be taken from the area near the genitals because this is where Yin and Yang Qi gather. Men and women can use each other's garments because things return to their origin.
(2) For recurrence of illness after a major illness due to overexertion (Lao Fu), Zhi Shi Zhi Zi Chi Tang (Immature Bitter Orange, Gardenia, and Fermented Soybean Decoction) is primarily used. If there is retained food stagnation, add Da Huang (Rhubarb Root) pieces the size of five or six chess pieces.
Formula for Zhi Shi Zhi Zi Chi Tang
Zhi Shi (Immature Bitter Orange Fruit): 3 pieces, roasted
Zhi Zi (Gardenia Fruit): 14 pieces, broken open
Chi (Fermented Soybean): 1 Sheng, wrapped in silk cloth
Crush the above three ingredients. Boil in 7 Sheng of Qing Jiang Shui (Clear Acidic Rice Water) until reduced to 4 Sheng. Add Zhi Shi and Zhi Zi, boil until reduced to 2 Sheng. Then add Chi, boil for 5-6 more boils. Strain. Take warm, divided into two doses. Cover the patient to induce a slight sweat.
"Major illness" is a general term; the following follows this example. "Lao" refers to strenuous labor or sexual exertion; "Fu" means recurrence of disease. Generally, after the major pathogen has initially retreated, Qi and Blood are newly deficient. Strenuous exertion damages this deficiency, generating heat. This is like a relapse of illness, not the initial onset of real heat. Zhi Shi broadens the middle and breaks stagnation; Zhi Zi dissipates heat and removes irritability; Xiang Chi (Fragrant Fermented Bean) resolves heat from deficiency and exhaustion; Qing Jiang Shui (Clear Acidic Rice Water) acts as a controller for Zhi Zi. Thus, coordinating the bitter-cold nature of these three substances, they jointly treat the recurrent heat from exhaustion, which differs from treating the real heat of the initial illness. Retained food refers to old accumulated food. Food generates heat, so it must be removed. Da Huang serves to remove the old to bring forth the new.
(3) After recovery from Shanghan, if fever recurs, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is primarily used. If the pulse is Floating, resolve via sweating; if the pulse is Deep, resolve via purging.
This demonstrates the general principle for managing minor recurrences due to lack of caution in post-illness care. A floating pulse indicates re-infection with external pathogens; a deep pulse indicates dietary irregularity.
(4) After recovery from a major illness, if there is fluid retention (Water Qi) below the waist, Mu Li Ze Xie San (Oyster Shell and Alisma Powder) is primarily used.
Formula for Mu Li Ze Xie San
Mu Li (Oyster Shell): roasted
Ze Xie (Alisma Rhizome)
Gua Lou Gen (Trichosanthes Root)
Shu Qi (Perilla Leaf/Root - specific variety): washed to remove foot-like structures
Ting Li (Descurainia Seed): roasted
Shang Lu Gen (Phytolacca Root)
Hai Zao (Sargassum Thallus): washed to remove saltiness
(Above ingredients in equal proportions)
Pulverize the seven ingredients separately, sift into powder, then further grind in a mortar. Mix with Bai Yin (plain rice gruel) and administer one Fang Cun Bi per dose. Stop subsequent doses once urination becomes smooth.
Fluid retention refers to muscle swelling that is full yet flaccid. Generally, after recovery, the body is newly deficient, Spleen Earth is not strong, and thus cannot control Water. Swelling starting from the waist down and not extending upwards occurs because water flows downward, and since it is in the early stage, although overflowing, it has not yet spread horizontally throughout the body. Mu Li, Ze Xie, and Hai Zao are salty and enter the Kidney; strengthening the Kidney allows water to move. Ting Li and Shang Lu Gen are bitter and promote dampness drainage; removing dampness eliminates swelling. Shu Qi is pungent and dispersing, serving as an assistant to the other herbs. Gua Lou Gen is bitter and clears heat thoroughly, acting as the envoy to Shu Qi.
(5) After recovery from a major illness, if the patient frequently spits saliva and the condition persists without resolution for a long time, it is due to Cold in the Stomach. It should be treated with pill medicine to warm it; Li Zhong Wan (Regulate the Middle Pill) is suitable.
Spitting refers to oral saliva. Cold here refers to cold induced by drinking. "Bu liao liao" means having no end or cessation. See formula mentioned previously.
(6) After the resolution of Shanghan, if the patient is weak and emaciated, has shortness of breath, and experiences rebellious Qi with a desire to vomit, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) is primarily used.
Formula for Zhu Ye Shi Gao Tang
Zhu Ye (Bamboo Leaves): 2 handfuls
Shi Gao (Gypsum Fibrosum): 1 Jin
Ban Xia (Pinellia Tuber): half Sheng, washed
Ren Shen (Ginseng Radix): 3 Liang
Gan Cao (Licorice Root): 2 Liang, roasted
Jing Mi (Rice Grain): half Sheng
Mai Men Dong (Ophiopogon Tuber): 1 Sheng, heart removed
Boil the above seven ingredients in 10 Dou of water until reduced to 6 Sheng. Strain. Add Jing Mi. Cook until the rice is tender and the decoction is ready. Remove the rice. Take 1 Sheng warm, three times daily.
Emaciation (Lei) is pronounced 'Lei', meaning thinness due to illness. Shortness of breath (Shao Qi) refers to insufficient respiration. Rebellious Qi with desire to vomit refers to nausea and obstruction caused by phlegm-fluids. Generally, Cold damages the形体 (Form/Body), so after Cold resolves, muscles waste away leading to emaciation. Heat damages Qi, so after Heat retreats, Qi declines and becomes insufficient. Post-illness weakness and emaciation occur because the Spleen and Stomach are not yet strong, food is difficult to digest, and Phlegm easily generates. Rising Phlegm and rebellious Qi cause the desire to vomit. Zhu Ye clears heat; Mai Dong removes irritability; Ren Shen tonifies Qi; Gan Cao promotes flesh growth; Ban Xia resolves Phlegm and stops vomiting; Jing Mi is a tonic for post-illness recovery; Shi Gasm has the function of clearing heat from top to bottom. Thus, it assists the other herbs to achieve a tonifying effect.
(7) When the patient's pulse has normalized, but there is slight irritability in the late afternoon, it is because the illness has just resolved, people force-feed them, the Spleen and Stomach Qi are still weak, unable to digest food, hence causing slight irritability. Reducing food intake will lead to recovery.
"Pulse resolved" means all pathogens have been eliminated with no residue. Late afternoon is the time when the Yang Ming channel is prosperous. "Forcing food" means compelling eating. "Sun" (reduce/damage) implies that one should ration/reduce intake. Generally, regulated diet harmonizes the Spleen and Stomach; harmonized Spleen and Stomach ensures peace in the whole body. This is a key method for regulating residual conditions after illness.
The above classics comprise eleven chapters, 397 methods, and 113 formulas. These are likely the遗书 (posthumous writings) of Mr. Zhang Zhongjing, edited and arranged by Wang Shuhe. Legends say the world calls Zhongjing the Sage of Medicine, truly because Zhongjing gathered the great achievements of medical philosophy, and this book is indeed the great instruction of medical education. For novice scholars, abandoning this leaves no door to enter the Way, nor a foundation to advance virtue. Therefore, those dedicated to this path also say they must learn through this; then perhaps they will not err, nor cause harm to others. Proceeding along this path, one can certainly reach maturity in Benevolence and precision in Righteousness, allowing the Way to transform over time. Not only will people not die unjustly, but one will also have no shame in virtue. Then one can ascend to the hall of Emperors and Kings, succeeding the divine work of Nong Shen (Divine Farmer/Shennong). Is this not magnificent?
(Note: The 397 items now have six moved to Chapter Fifteen.)