系真寒证。复误用汗下之法。故见昼烦夜静。脉沉微。表里无热。此为阴寒独胜。阳气大虚也。正文与注并。）
干姜附子汤方（俱见中寒论中）
发汗后。身疼痛。脉沉迟者。桂枝加芍药生姜各一两。人参三两。新加汤主之。（发汗后身疼痛。脉沉迟者。成注云。
邪气未尽。营血不足也。经曰。其脉沉者营气微又曰。脉迟者营中寒。营主血营中血少。兼有留邪。故脉沉迟而身疼痛。
此必是太阳伤寒。用麻黄汤发汗之后。寒邪已去八九。其人身虽疼痛。医者止宜据其脉。以血少治之。若其人寒邪不因
汗解。而身疼痛。则其脉当见浮紧矣。所以仲景法。用桂枝汤加芍药生姜。以益营血而解余寒。复大加人参者。以甘能
生血有备其不足也。汤名新加者。以桂枝驱邪。人参补正。旧例无有加人参于桂枝汤中者。神而明之。谓非仲景用药之
新法欤。）
（此方自原论中第十卷采附于此）
桂枝（三两去皮） 芍药（四两） 甘草（二两炙） 人参（三两） 生姜（四两切） 大枣（十二枚擘）
上六味。以水一斗二升。微火煮取三升。去滓。分温服。余根据桂枝汤法。
琥按上汤。乃仲景新加补药法。以治伤寒发汗之后。身疼痛而脉沉迟者。夫脉沉迟为血虚有寒。惟有寒。故用桂
枝汤加生姜以散寒。惟血虚。故桂枝汤中加芍药。更加人参三两以益血。内台方议以芍药为益血之药。若人参生姜。止
不过益其正气。散其余邪。殊不知仲景治血虚。妙在以人参补之。其后李东垣始悟其义云。血难骤补。加人参者。阳生
阴长。甘能益血也。要之仲景此汤。既加人参。则补正之力多。驱邪之功少。如病患寒邪盛而身疼痛。医用此汤。何异
操刀。张兼善云。寒邪盛则身疼。营血虚。则身亦疼。其脉浮紧者。邪盛也。沉微者。血虚也。证虽相同脉则大异。
或问脉沉迟。身疼痛。焉知非中寒证。余答云。中寒身疼痛如被杖。脉亦沉迟。与此证。略同。然此证自太阳伤寒
发汗后。身疼不止。脉变沉迟非中寒比也。即如病患在前。医工能悉心诊视。则寒热虚实。无不了然。如徒于书中认证
认脉。此等疑义实多。难尽述也。
发汗后。不可更行桂枝汤。汗出而喘。无大热者。可与麻黄杏人甘草石膏汤主之。（本太阳伤寒。用桂枝汤以发其汗。
汗后不解。不可更行桂枝汤。以汗虽出而喘益甚。是麻黄汤证仍在也。无大热者。谓里无大热。寒邪犹郁于表也。法宜
仍与麻黄汤。今则麻黄汤中减去桂枝。增石膏者。何也。以桂枝性辛热。寒伤营。营中已受辛热所伤。而强逼成汗故增
石膏之甘寒。以泄营中之热。而散其邪也。）
属于真寒证。又误用了发汗和攻下的治法。所以出现白天烦躁、夜间安静的症状，脉象沉而微弱，表里都没有热象。这是阴寒之气独盛，阳气极度虚弱的表现。（正文与注释合并在此。）
发汗之后，身体仍然疼痛，脉象沉迟的，用桂枝加芍药生姜各一两、人参三两的新加汤来主治。（发汗后身体疼痛，脉象沉迟的情况，成无己注解说：邪气尚未清除，营血不足。经典中说：脉象沉的，说明营气微弱；又说：脉象迟缓的，说明营中有寒。营主司血液，营中血液减少，兼有残留的邪气，所以脉象沉迟且身体疼痛。这必定是太阳伤寒证，使用了麻黄汤发汗之后，寒邪已经去除了八九成，病人身体虽然疼痛，医生只应当依据脉象，按照血少的情况来治疗。如果病人的寒邪没有因为发汗而解除，并且身体依然疼痛，那么脉象应当表现为浮紧。所以张仲景的法度，使用桂枝汤加入芍药和生姜，来补益营血并解散残余的寒邪。另外大量增加人参，是因为甘味药物能生血，以预备补充身体的不足。汤剂命名为“新加”，是因为桂枝驱除邪气，人参补益正气，旧的惯例中没有在桂枝汤中加入人参的，神妙而明察，难道不是张仲景用药的新方法吗？）
（此方从原论第十卷采录附于此）
桂枝（三两，去皮） 芍药（四两） 甘草（二两，炙） 人参（三两） 生姜（四两，切） 大枣（十二枚，掰开）
以上六味药，用水一斗二升，用小火煮取三升，去掉药渣。分三次温服。其余服用方法依照桂枝汤的法度。
琥按：上述汤剂，是张仲景新加的补益药物治法，用于治疗伤寒发汗之后，身体疼痛且脉象沉迟的情况。脉象沉迟表示血虚且有寒。因为有寒，所以用桂枝汤加入生姜来散寒；因为血虚，所以在桂枝汤中加入芍药；再增加人参三两来益血。内台方的议论认为芍药是益血的药物，至于人参和生姜，只不过是为了补益正气、疏散残余邪气罢了。殊不知张仲景治疗血虚的妙处，在于用人参来补益。后来李东垣才领悟到其中的含义，说：血液难以迅速补益，加入人参的原因，是阳生则阴长，甘味能益血。总之，张仲景的这个汤剂，既然加入了人参，那么补益正气的力量就多，驱除邪气的功效就少。如果病患寒邪强盛且身体疼痛，医生使用这个汤剂，这与拿着刀乱砍有什么区别呢？张兼善说：寒邪强盛则身体疼痛，营血虚弱也导致身体疼痛。脉象浮紧的，是邪气强盛；脉象沉微的，是血虚。证候虽然相同，但脉象差异很大。有人问：脉象沉迟，身体疼痛，怎么知道不是中寒证？我回答说：中寒证的身体疼痛像被棍棒打过一样，脉象也是沉迟的，与此证大致相同。然而此证是从太阳伤寒发汗后，身体疼痛不止，脉象变为沉迟，不能与中寒证相比。就像病人在前，医生若能悉心诊视，那么寒热虚实的情况就没有不明了的。如果仅仅依靠书本上的证候和脉象来辨识，这种疑难之处实在很多，难以全部叙述清楚。
发汗之后，不可再用桂枝汤。如果出汗且气喘，体内没有大热的，可以用麻黄杏仁甘草石膏汤来主治。（原本是太阳伤寒证，用桂枝汤来发汗。发汗后病情未解，不可再用桂枝汤，因为虽然汗出，但气喘反而加重，这说明麻黄汤证依然存在。所谓“无大热”，是指体内没有大热，寒邪仍然郁结在体表。治法适宜仍给予麻黄汤。现在则在麻黄汤中减去桂枝，增加石膏，为什么呢？因为桂枝性味辛热，寒邪伤及营分，营分中已经受到辛热药物的伤害，强行逼迫出汗，所以增加石膏的甘寒之性，来清泄营分中的热邪，并疏散邪气。）
It belongs to a true cold syndrome. After mistakenly using sweating and purging methods, symptoms such as restlessness during the day and quietness at night appear, with a deep and faint pulse (Shen Wei Mai), and no heat in the exterior or interior. This indicates that Yin-cold is exclusively prevalent, and Yang-qi is severely deficient. (Main text and annotations combined here.)
Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction) [See also in *Zhonghan Lun*]
After sweating therapy, if body pain persists and the pulse is deep and slow (Chen Chi), Guizhi Jia Shaoyao Shengjiang Renshen Xinjia Tang (Cinnamon Twig Decoction with Added Peony, Fresh Ginger, and Ginseng, New Formula) should be used. (Regarding body pain after sweating with a deep and slow pulse, Cheng Wuji's annotation states: The pathogenic factor has not been fully cleared, and Ying-blood is insufficient. The Classics state: A deep pulse indicates weak Ying-qi; a slow pulse indicates cold in the Ying. Ying governs blood; when blood in the Ying is scant and residual pathogens remain, the pulse becomes deep and slow accompanied by body pain. This must be a Taiyang Shanghan (Cold Damage) syndrome where Mahuang Tang was used for sweating. Eight or nine parts of the cold pathogen have been expelled. Although the patient still experiences body pain, the physician should rely on the pulse and treat based on blood deficiency. If the cold pathogen had not resolved through sweating and body pain persisted, the pulse would likely be floating and tight. Therefore, Zhang Zhongjing's method employs Guizhi Tang with added Shaoyao (Peony Root) and Shengjiang (Fresh Ginger) to nourish Ying-blood and resolve residual cold. Furthermore, a large amount of Renshen (Ginseng Root) is added because sweet flavors can generate blood to prepare for insufficiency. The name "Xinjia" (New Addition) signifies that while Guizhi expels pathogens, Renshen tonifies healthy Qi. Previously, there was no precedent for adding Renshen to Guizhi Tang. Is this not a novel medication method by Zhang Zhongjing?)
(This formula is extracted from Volume 10 of the original treatise and attached here.)
Guizhi (3 liang, bark removed), Shaoyao (4 liang), Gancao (2 liang, honey-fried), Renshen (3 liang), Shengjiang (4 liang, sliced), Dazao (12 pieces, split).
Take these six ingredients, add 12 sheng of water, and simmer over low heat until reduced to 3 sheng. Remove the dregs. Divide into three warm doses. Follow the administration instructions of Guizhi Tang for the remainder.
Hu notes: The above decoction represents Zhang Zhongjing's new method of adding tonifying herbs to treat body pain with a deep and slow pulse after sweating therapy for Shanghan. A deep and slow pulse indicates blood deficiency with cold. Because of the cold, Guizhi Tang is used with added Shengjiang to disperse cold; because of blood deficiency, Shaoyao is added to Guizhi Tang; additionally, 3 liang of Renshen is added to benefit blood. The Neitai Fang commentary suggests that Shaoyao benefits blood, while Renshen and Shengjiang merely tonify healthy Qi and scatter residual pathogens. However, it fails to realize that Zhang Zhongjing's brilliance in treating blood deficiency lies in using Renshen for tonification. Later, Li Dongyuan realized this principle, stating: Blood is difficult to replenish rapidly; Renshen is added because Yang generation promotes Yin growth, and sweet flavors benefit blood. In summary, since this decoction includes Renshen, its power to tonify healthy Qi outweighs its efficacy in expelling pathogens. If a patient suffers from severe cold pathogens causing body pain, using this decoction would be akin to wielding a knife indiscriminately. Zhang Jianshan stated: Severe cold pathogens cause body pain; Ying-blood deficiency also causes body pain. A floating and tight pulse indicates excess pathogens; a deep and faint pulse indicates blood deficiency. Although the manifestations are similar, the pulses differ greatly. One might ask: How do we know that a deep and slow pulse with body pain is not a Zhonghan (Mid-Cold) syndrome? I reply: In Zhonghan, body pain feels like being beaten with a staff, and the pulse is also deep and slow, which is slightly similar to this syndrome. However, this syndrome arises from persistent body pain after sweating for Taiyang Shanghan, with the pulse changing to deep and slow, which differs from Zhonghan. If a physician carefully examines the patient, the nature of cold, heat, excess, and deficiency will be clear. Relying solely on textual diagnosis leads to many doubts that cannot be fully enumerated.
After sweating therapy, Guizhi Tang should not be administered again. If the patient sweats and wheezes without significant internal heat, Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) may be used. (Originally a Taiyang Shanghan syndrome treated with Guizhi Tang to induce sweating. If the condition does not resolve after sweating, Guizhi Tang should not be repeated. Although sweat occurs, wheezing worsens, indicating that the Mahuang Tang syndrome persists. "No significant internal heat" means there is no severe heat in the interior, but cold pathogens remain constrained in the exterior. The appropriate method would be to administer Mahuang Tang. However, in this case, Guizhi is removed from Mahuang Tang, and Shigao (Gypsum Fibrosum) is added. Why? Because Guizhi is acrid and hot. Since cold injured the Ying level, and the Ying level has already been affected by the acrid-hot nature of the previous medication forcing sweat, Shigao's sweet and cold property is added to clear heat in the Ying level and disperse the pathogen.)