（此方自原论中第十卷采附于此）
小柴胡汤内。加芒硝六两。余根据前法。服不解。更服。
内台方议问曰。潮热者。实也。即实且热。何不用大柴胡。大小承气汤下之。却用芒硝。何也。答曰潮热虽实。
奈何先以丸药。伤动脏腑。再用大黄下之。则脾气伤而复成坏证。只得用芒硝以浸润之而取利也。
伤寒八九日下之。胸满烦惊。小便不利谵语。一身尽重。不可转侧者。柴胡加龙骨牡蛎汤主之。
此条乃太阳病并于少阳。兼入胃府之证。伤寒八九日。若似乎可下矣。既下之后。而胸满云云者此下之不得其宜。
阳热乘虚入里。而客于胸中。故烦满也。惊者。心恶热而神不安也。小便不利者。膀胱约而水不行也。惟烦满。故热入
于胃而谵语。惟小便不利。故湿渍于脾。脾困。则四肢不健运。而身重不可转侧。与柴胡加龙骨牡蛎汤者。外以解热邪。
内以除水湿。兼镇浮越之气而补其中州之虚也。上二条证并下方自太阳中篇移附于此。
半夏（二合洗） 大枣（六枚） 柴胡（四两） 生姜 人参 龙骨 铅丹 桂枝（去皮） 茯苓（各一两半） 大
黄（二两） 牡蛎（一两半熬）
上十一味。以水八升。煮取四升。内大黄。切如棋子。更煮一二沸。去滓。温服一升。
琥按上方用柴胡为君。专走少阳。以解胸膈之烦满。用人参半夏姜枣茯苓为臣。以健脾利小便而疗身重。用龙骨牡
蛎铅丹为佐。以镇心除惊热。辅以大黄者。乃涤胃实而止谵语也。使以桂枝者。兼入太阳而外行肢体也。要是方也。表
里齐走补泻兼施。通涩并用。恐非仲景之旧。或系叔和采辑时有差错者。若临是证而用是药。吾不敢也。何也。倘谓胸
满谵语。是实证。则当用大黄者。不当用人参。倘谓惊烦小便不利身重是虚证。则当用人参大枣茯苓龙骨等药者。不当
用大黄。况龙骨牡蛎铅丹。皆系重坠收涩阴毒之品。恐非小便不利身重所宜。尚论篇称此方有安内攘外。补天浴日之功。
余实愚蒙。不敢信以为是也。
伤寒六七日发热。微恶寒。支节烦疼。微呕。心下支结。外证未去者。柴胡桂枝汤主之。（此条系太阳病传入少阳之
证。少阳邪多。太阳邪少。故从少阳篇例。伤寒六七日。邪气传里之时。成注云支者。散也。谓邪气之结。虽起于心下。
而散于胁旁。后条辩以支字。解作撑。若有物支撑在胸胁间。其义甚明。兼之微呕者。此系少阳之邪正盛也。外证未去。
此指上文发热恶寒支节烦疼而言。夫寒热而曰微。支节疼而曰烦。此可征太阳之表邪已轻。其势渐趋于里矣。故以柴胡
合桂枝汤以两解之。）
（此方是从原书第十卷中摘录并附在此处）
小柴胡汤中加入芒硝六两，其余按照前面的方法煎服。如果服药后病证未解，再服用。
《内台方议》问道：出现潮热症状，属于实证。既然既是实证又有热象，为何不用大柴胡汤或大、小承气汤来攻下？反而使用芒硝呢？回答说：虽然潮热属实证，但奈何之前已经用丸药攻下，损伤了脏腑功能。如果再用大黄攻下，会导致脾气受损而再次形成坏病。因此只能使用芒硝来润燥软坚以取得通便的效果。
伤寒病程经过八九天，误用泻下法后，出现胸中胀满、烦躁惊悸、小便不利、说胡话、全身沉重、身体不能随意转动的症状，应当用柴胡加龙骨牡蛎汤主治。
这一条论述的是太阳病邪传入少阳，兼入胃腑的证候。伤寒经过八九天，看起来似乎可以攻下了。但在攻下之后，出现上述种种症状，这是因为攻下不得当。阳气与热邪乘虚入里，客居于胸中，所以出现烦闷胀满。惊悸是因为心恶热而神志不安。小便不利是因为膀胱约束导致水液运行不畅。正因为有烦闷胀满，所以热邪入胃导致说胡话；正因为小便不利，所以湿气浸渍于脾，脾受困则四肢运化无力，导致身体沉重、不能随意转动。给予柴胡加龙骨牡蛎汤，是为了在外部解除热邪，在内部清除水湿，同时镇摄浮越之气并补益中焦脾胃的虚弱。以上两条证候及下方剂是从《伤寒论》太阳病篇移附于此。
半夏（二合，洗净） 大枣（六枚） 柴胡（四两） 生姜 人参 龙骨 铅丹 桂枝（去皮） 茯苓（各一两半） 大黄（二两） 牡蛎（一两半，熬制）
以上十一味药，用水八升，煮取四升药液。加入大黄，切成棋子大小，再煮一两次沸腾，滤去药渣。温服一升。
琥按：上方以柴胡为君药，专门走少阳经，以解除胸膈的烦闷胀满。用人参、半夏、生姜、大枣、茯苓作为臣药，以健脾利小便从而治疗身体沉重。用龙骨、牡蛎、铅丹作为佐药，以镇心安神、清除惊热。辅以大黄，是为了涤荡胃中实热从而停止说胡话。使以桂枝，是兼入太阳经而在外部通行肢体经络。总之这个方剂，表里同治，补泻兼施，通涩并用，恐怕不是张仲景的原方，或者是王叔和采集编辑时出现了差错。如果在临床上遇到这种证候而使用这个方剂，我不敢苟同。为什么呢？如果说胸满、说胡话是实证，那么应当只用大黄，不应当用人参。如果说惊悸、烦闷、小便不利、身体沉重是虚证，那么应当用人参、大枣、茯苓、龙骨等药，不应当用大黄。况且龙骨、牡蛎、铅丹，都是重镇收涩的阴毒之品，恐怕不适合用于小便不利、身体沉重的情况。《尚论篇》称此方有安内攘外、补天浴日的功效，我实在愚昧蒙昧，不敢相信这是正确的。
伤寒六七天，发热，轻微怕冷，四肢关节烦痛，轻微呕吐，心下部感觉支撑结聚，外部表证仍未消除的，用柴胡桂枝汤主治。（这一条属于太阳病传入少阳的证候。少阳邪气多，太阳邪气少，所以遵循少阳篇的体例。伤寒六七天，是邪气传里的时期。成无己注解说“支”意为散，指邪气的结聚，虽然起于心下，但散在于胁旁。后世辨驳者将“支”字解释为撑，好像有物体支撑在胸胁之间，其义非常明确。加上轻微呕吐，这是少阳邪气正盛的体现。外部表证未去，这里指的是前文提到的发热、恶寒、四肢关节烦痛。寒热表现为轻微，关节疼痛表现为烦扰，这可以证明太阳表的邪气已经减轻，病势逐渐趋向于里。因此用柴胡汤合桂枝汤来同时解除两经的病邪。）
(This prescription is extracted from Volume 10 of the original treatise and attached here.)
Add six liang of Mangxiao (Natrii Sulfas) to Xiaochaihu Tang (Minor Bupleurum Decoction). Prepare and administer the remaining ingredients according to the previous method. If the condition does not resolve after administration, administer again.
*Neitai Fangyi* asks: "Tidal fever indicates an excess syndrome. Since it is both excess and heat, why not use Daxiehu Tang (Major Bupleurum Decoction) or Dachengqi Tang (Major Order the Qi Decoction) and Xiaochengqi Tang (Minor Order the Qi Decoction) to purge? Why use only Mangxiao?" The answer is: Although tidal fever is an excess syndrome, unfortunately, pill-based purgatives were used previously, damaging the zang-fu organs. Using Dahuang (Rhei Radix et Rhizoma) for further purging would damage the Spleen Qi and result in a complicated disease (Huai Zheng). Therefore, one can only use Mangxiao to moisten dryness and soften hardness to achieve bowel movement.
After eight or nine days of Shanghan (Cold Damage), if purgation is mistakenly applied, resulting in chest fullness, irritability, palpitations/fright, difficulty in urination, delirium, heaviness of the entire body, and inability to turn over, Chaihu Jia Longgu Muli Tang (Bupleurum Decoction with Dragon Bone and Oyster Shell) should be administered.
This clause describes a syndrome where Taiyang disease merges into Shaoyang and involves the Stomach Fu organ. After eight or nine days of Shanghan, it might seem appropriate to apply purgation. However, the appearance of the aforementioned symptoms after purgation indicates that the purgation was inappropriate. Yang-heat enters the interior by taking advantage of the deficiency and lodges in the chest, causing irritability and fullness. Fright occurs because the Heart dislikes heat and the Spirit becomes unsettled. Difficulty in urination arises because the Bladder's constriction prevents water flow. Due to irritability and fullness, heat enters the Stomach causing delirium; due to difficulty in urination, dampness infiltrates the Spleen. When the Spleen is constrained, the four limbs fail to transport and transform effectively, leading to body heaviness and inability to move freely. Chaihu Jia Longgu Muli Tang is given to release exterior heat pathogens internally and eliminate damp-water, while simultaneously anchoring floating and hyperactive Qi and tonifying the deficiency of the Middle Jiao. The above two clauses and the following prescription are transferred from the Taiyang chapter of the original text and attached here.
Banxia (Pinelliae Rhizoma, 2 he, washed)
Dazao (Jujubae Fructus, 6 pieces)
Chaihu (Bupleuri Radix, 4 liang)
Shengjiang (Zingiberis Rhizoma Recens)
Renshen (Ginseng Radix)
Longgu (Fossilia Ossis Mastodi)
Qiandan (Lapis Plumbi Subacetatis)
Guizhi (Cinnamomi Ramulus, bark removed)
Fuling (Poria, each 1.5 liang)
Dahuang (Rhei Radix et Rhizoma, 2 liang)
Muli (Ostreae Concha, 1.5 liang, calcined)
Take the above eleven herbs. Boil in eight sheng of water until reduced to four sheng. Add Dahuang, cut into chess-piece sized chunks. Boil for one or two more boils. Strain the dregs. Take one sheng warm.
Hu notes: In the above formula, Chaihu serves as the Sovereign herb, specifically targeting the Shaoyang channel to relieve chest and diaphragm fullness and irritability. Renshen, Banxia, Shengjiang, Dazao, and Fuling serve as Minister herbs to strengthen the Spleen, promote urination, and treat body heaviness. Longgu, Muli, and Qiandan serve as Assistant herbs to calm the Heart, eliminate fright, and clear heat. Dahuang is added as an Adjunct to cleanse gastric excess and stop delirium. Guizhi acts as the Envoy, entering the Taiyang channel to circulate in the limbs externally. Essentially, this formula treats both exterior and interior, combines tonification and purgation, and uses both unblocking and astringent methods. It is likely not Zhang Zhongjing’s original prescription, but rather an error during Wang Shuhe’s compilation. I dare not recommend using this formula for such conditions. Why? If chest fullness and delirium are considered excess syndromes, then Dahuang should be used alone, without Renshen. If fright, irritability, difficulty in urination, and body heaviness are considered deficiency syndromes, then Renshen, Dazao, Fuling, and Longgu should be used, without Dahuang. Moreover, Longgu, Muli, and Qiandan are heavy, astringent, and yin-toxic substances, which are likely unsuitable for cases involving difficulty in urination and body heaviness. *Shanglun Pian* claims this formula has the merit of stabilizing the interior, repelling the exterior, and replenishing heaven and earth. I am too ignorant to believe this assertion.
If, after six or seven days of Shanghan, there is fever, slight aversion to cold, discomfort and pain in the limbs and joints, slight vomiting, a sensation of support and accumulation below the heart (epigastrium), and the exterior signs have not yet resolved, Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) should be administered. (This clause belongs to the syndrome of Taiyang disease transmitting to Shaoyang. With more pathogenic factors in Shaoyang and fewer in Taiyang, it follows the examples of the Shaoyang chapter. During the sixth or seventh day of Shanghan, when pathogenic factors transmit inward, Cheng Wuji’s commentary states that 'zhi' means scattered, indicating that although the pathogenic knot originates in the epigastrium, it scatters to the hypochondriac region. Later commentators interpret 'zhi' as 'supporting,' implying a sensation of something propping up between the chest and hypochondrium, which is very clear. Additionally, slight vomiting indicates that Shaoyang pathogenic factors are flourishing. 'Exterior signs not yet resolved' refers to the fever, aversion to cold, and limb/joint pain mentioned earlier. The fact that chills and fever are slight, and joint pain is described as uncomfortable/distressing, indicates that the exterior pathogenic factors of Taiyang have lightened and the trend is gradually moving inward. Therefore, Chaihu Tang is combined with Guizhi Tang to resolve both channels simultaneously.)