旋复花（三两） 人参（二两） 生姜（五两切） 代赭石（一两） 大枣（十二枚擘） 甘草（三两炙） 半夏
（半升洗）
上七味。以水一斗。煮取六升。去滓。再煎取三升。温服一升。日三服。
成注云。硬则气坚。咸味可以软之。旋复之咸。以软痞硬。怯则气浮。重剂可以镇之。代赭之重。以镇虚逆。辛
者散也。生姜半夏之辛。以散虚痞。甘者。缓也。人参甘草大枣之甘。以补胃弱。
琥按上方。仲景未尝云。治水气。成注但云。胃弱虚气上逆。独方氏条辩注云。伏饮为逆。何也。推方氏之意。
以本草经云。旋复花能治结气除水。故以此条之噫气不除。为伏饮为逆耳。殊不知仲景此方。专以人参甘草姜枣半夏等。
为补虚散逆气之剂。其用旋复者。虽云。软坚实以下气也。用赭石者。以镇逆也。
或问前生姜泻心汤证。及甘草泻心汤证。皆心下痞硬。二汤中不闻用软坚之药。今者。伤寒解后。心下痞硬。不
过是虚气作痞而硬。反用旋复花之咸以软之。何也。余答云。成注云。咸以软坚。非正解也。夫旋复花味辛气温。乃散
气开痞之药。痞气开散。则心下之硬自消。前二条证。泻心汤内有芩连。以泻心下之痞硬。此汤中药味。与泻心汤药味
相同。因无芩连。故以旋复为君也。且也。伤寒解后。心下已无邪热。所以不用芩连。又噫气不除。纯系虚气上逆。尚
论篇云。胃气全不下行。有升无降。故用代赭领人参下行。以镇安其逆气。因名为旋复代赭石汤也。
（重出例）下后不可更行。桂枝汤。若汗出而喘。无大热者可与麻黄杏子甘草石膏汤（正文与注并汤。见前第四卷
太阳篇中）
太阳病外证未除。而数下之。遂协热而利。利下不止。心下痞硬。表里不解者。桂枝人参汤主之。（太阳中风外证未
除。而数下之。数下者。下非一次也。数下则虚其里。里虚则邪热乘虚而入。遂协热利协。合也。犹言同也。里虚协合
外热。故作利也。利下不止。知其利非闭塞。几成洞泄之候矣。心下虽痞硬。此系虚痞虚硬可知。不与实热之证同也。
表不解。是在外之风邪不解。里不解。是在内之虚寒不解。故成注云。与桂枝人参汤。以和里解表。愚按此条论。协热
利。心下痞硬。虽云。数下里虚。然邪热业已乘虚而入。则是仲景云。里不解。恐系邪热未解。乃实热之证。非虚寒也。
桂枝人参汤。大都是叔和撰次时传写之误。愚于上注。虽随文勉强作解。诚恐有误后人。因以其汤表而出之。）
旋复花（三两） 人参（二两） 生姜（五两，切片） 代赭石（一两） 大枣（十二枚，掰开） 甘草（三两，炙烤） 半夏（半升，洗净）
以上七味药。用水一斗。煮取六升。滤去药渣。再次煎煮取三升。每次温服一升。每日服用三次。
成无己注解说：坚硬则气机坚实，咸味可以软化它。旋复花的咸味，用来软化痞块硬结；怯弱则气机上浮，重镇之剂可以镇压它。代赭石的沉重，用来镇压虚性上逆之气。辛味具有发散作用。生姜、半夏的辛味，用来消散虚性痞满。甘味具有缓急作用。人参、甘草、大枣的甘味，用来补益胃气的虚弱。
琥按：上述方剂中，张仲景未曾提及治疗水气病。成无己只说是胃气虚弱、虚气上逆。唯独方有执在《伤寒论条辨》中注释说：“伏留的饮邪导致气逆”，这是为什么呢？推测方有执的意思，是因为《神农本草经》记载旋复花能治疗结气、消除水气，所以将本条中的“噫气不除”（嗳气不止）解释为伏饮导致的逆气。殊不知张仲景的这个方子，专门用人参、甘草、生姜、大枣、半夏等药物，作为补虚散逆气的方剂。其中使用旋复花，虽然说是为了软化坚实并降下气机；使用代赭石，是为了镇压逆气。
有人问：前面的生姜泻心汤证，以及甘草泻心汤证，都是心下痞硬，但这两个方剂中并没有听说使用软化坚硬的药物。现在，伤寒病解后，出现心下痞硬，这不过是虚气造成痞塞而坚硬，反而使用旋复花的咸味来软化它，为什么呢？我回答说：成无己注解说“咸以软坚”，并非正确的解释。旋复花味道辛、气温，是疏散气机、开通痞塞的药物。痞气开散，那么心下的硬结自然消除。前两条证候，泻心汤内有黄芩、黄连，用来清泻心下的痞硬。此汤中的药味与泻心汤的药味相同，因为缺少黄芩、黄连，所以以旋复花为君药。况且，伤寒病解后，心下已经没有邪热，所以不用黄芩、黄连。另外，“噫气不除”纯粹是虚气上逆所致。《尚论篇》中说：胃气完全不能下行，只有升没有降，所以用代赭石带领人参下行，以镇压安定其逆气。因此命名为旋复代赭石汤。
（重复出现的条文示例）发汗后不可再用桂枝汤。如果出汗且气喘，没有大热的，可以与麻黄杏子甘草石膏汤（正文与注解及方剂，见前第四卷太阳篇中）。
太阳病表证未解除，却多次使用攻下法，于是导致协热利（伴随发热的下利），下利不止，心下痞硬，表里同病不解的，用桂枝人参汤主治。（太阳中风表证未解除，却多次攻下。“数下”指不是一次攻下。多次攻下会损伤里气，里气虚弱则邪热乘虚而入，于是形成协热利。“协”即合也，犹言同也。里虚与外热相合，故发生下利。下利不止，可知其利非闭塞不通，几乎成为洞泄的症状了。心下虽然痞硬，但这属于虚痞、虚硬，可知与实热证不同。表不解，是指体外的风邪未解；里不解，是指体内的虚寒未解。所以成无己注解说：给予桂枝人参汤，以调和里气、解除表邪。愚按：此条论述中，协热利、心下痞硬，虽然说是因多次攻下导致里虚，然而邪热已经乘虚而入，那么张仲景所说的“里不解”，恐怕是指邪热未解，乃是实热证，而非虚寒证。桂枝人参汤，大多是王叔和编次时传写造成的错误。愚在上方的注解中，虽然勉强随文解释，诚恐误导后人，因此将此方列出。）
Flos Inulae (3 liang) Ren Shen (2 liang) Rhizoma Zingiberis Recens (5 liang, sliced) Haematitum (1 liang) Fructus Jujubae (12 pieces, split) Radix Glycyrrhizae Preparata (3 liang, honey-fried) Rhizoma Pinelliae Preparatum (0.5 sheng, washed)
The above seven ingredients. Use one dou of water. Decoct to obtain six sheng. Remove the dregs. Decoct again to obtain three sheng. Take one sheng warm. Three times daily.
Cheng Wuji commented: Hardness implies firm qi; salty flavor can soften it. The salinity of Flos Inulae is used to soften palpable masses and hardness. Weakness implies floating qi; heavy agents can anchor it. The heaviness of Haematitum is used to anchor deficiency-type rebellious qi. Pungent flavor disperses. The pungency of Rhizoma Zingiberis Recens and Rhizoma Pinelliae Preparatum is used to dissipate deficiency-type fullness. Sweet flavor moderates. The sweetness of Ren Shen, Radix Glycyrrhizae Preparata, and Fructus Jujubae is used to tonify stomach deficiency.
Hu notes: In the aforementioned formula, Zhang Zhongjing did not mention treating water qi pathology. Cheng Wuji only stated it was due to stomach weakness and rebellious deficiency qi. Only Fang Youzhi, in his commentary "Shanghan Lun Tiaobian," noted: "Retained fluid retention causes rebellion." Why? Inferring Fang's intent, he cited that the *Shennong Bencao Jing* records Flos Inulae as capable of treating constrained qi and eliminating water qi. Thus, he interpreted the "intractable belching" in this clause as rebellion caused by retained fluid retention. Little did he know that Zhang Zhongjing's formula specifically uses Ren Shen, Radix Glycyrrhizae Preparata, Rhizoma Zingiberis Recens, Fructus Jujubae, and Rhizoma Pinelliae Preparatum as a formula to tonify deficiency and dissipate rebellious qi. The use of Flos Inulae, although said to soften firmness and descend qi; the use of Haematitum is to anchor rebellion.
A question arises: In the preceding patterns of Shengjiang Xiexin Tang and Gancao Xiexin Tang, both presented with epigastric fullness and hardness, yet neither formula is heard to use agents that soften hardness. Now, after the resolution of Cold Damage, epigastric fullness and hardness occur, which is merely deficiency qi causing fullness and hardness. Why use the salinity of Flos Inulae to soften it? I reply: Cheng Wuji's comment "salty to soften hardness" is not the correct interpretation. Flos Inulae has a pungent taste and warm temperature; it is an herb that disperses qi and opens fullness. When the qi of fullness is dispersed, the hardness under the heart naturally resolves. In the previous two patterns, the Xiexin Tangs contain Huang Qin and Huang Lian to clear and drain epigastric fullness and hardness. The herbal composition of this decoction is identical to that of the Xiexin Tangs; because Huang Qin and Huang Lian are absent, Flos Inulae serves as the sovereign herb. Moreover, after the resolution of Cold Damage, there is no longer pathogenic heat in the epigastrium, hence Huang Qin and Huang Lian are not used. Additionally, "intractable belching" is purely due to rebellious deficiency qi. The *Shanglun Pian* states: Stomach qi fails to descend entirely, rising without descending. Therefore, Haematitum is used to lead Ren Shen downward to anchor and pacify the rebellious qi. Hence it is named Xuanfu Daizhe Shi Tang.
(Repeated Clause Example) After purgation, Guizhi Tang should not be administered again. If sweating and wheezing occur without significant fever, Mahuang Xingren Gancao Shigao Tang may be given (main text, annotations, and formula are found in the preceding Volume 4, Taiyang Chapter).
In Taiyang disease, when exterior symptoms remain unresolved, but frequent purgation is applied, it leads to diarrhea accompanied by fever (Xiere Li), with unceasing diarrhea, epigastric fullness and hardness, and simultaneous unresolved exterior and interior conditions. Guizhi Renshen Tang is the primary treatment. (Taiyang Wind Strike exterior symptoms remain unresolved, but frequent purgation is applied. "Frequent purgation" means more than once. Frequent purgation damages the interior; interior deficiency allows pathogenic heat to enter via deficiency, leading to Xiere Li. "Xie" means combination, i.e., together. Interior deficiency combines with exterior heat, thus causing diarrhea. Unceasing diarrhea indicates it is not obstructed constipation, nearly becoming a symptom of profuse watery diarrhea. Although the epigastrium presents fullness and hardness, this is known to be deficiency-type fullness and hardness, distinct from excess-heat patterns. Exterior unresolved refers to the wind pathogen outside not resolving; interior unresolved refers to interior deficiency-cold not resolving. Thus, Cheng Wuji commented: Administer Guizhi Renshen Tang to harmonize the interior and resolve the exterior. This author notes: Regarding this clause on Xiere Li and epigastric fullness/hardness, although attributed to interior deficiency from frequent purgation, pathogenic heat has already entered via deficiency. Thus, Zhang Zhongjing's statement "interior unresolved" likely refers to unresolved pathogenic heat, constituting an excess-heat pattern, not deficiency-cold. Guizhi Renshen Tang is mostly a transcription error during Wang Shuhe's compilation. Although this author reluctantly explained it following the text above, fearing it might mislead future generations, this formula is hereby presented.)