（此方自原论中第十卷采附于此）
于栀子豉汤内加入。甘草（二两）
余根据前法。得吐。止后服。
内台方议云。心烦懊 等证。属栀子豉汤。已主之矣。若其人少气者。为元气虚乏。热搏不能固也。加甘草之甘。
以缓其中而补其气。愚以少气者。乃热伤气而气促急。非真气虚乏也。加甘草者。以甘缓之之义。服汤后。宜徐徐吐之。
妙。
（此方自原论中第十卷采附于此）
于栀子豉汤方内加 生姜（五两）
余根据前法。得吐。止后服。
内台方议云。心烦懊 等证。与栀子豉汤吐之则已也。若又呕者。为热气搏逆不散。加生姜之辛以散其气。而止
其呕也。
发汗若下之。而烦热。胸中窒者。栀子豉汤主之。（窒塞也。汗下后。邪热未解。客于胸中。胸中窒塞。故生烦热。
与栀子豉汤者。以吐胸中之邪热也。愚以胸中窒者。内有物也。或问内有物。何以下之而不出。以其物在膈上。故宜用
吐法也。尚论篇以此条论为实烦证。非是故欤。）
伤寒五六日。大下之后。身热不去。心中结痛者。未欲解也。栀子豉汤主之。（伤寒五六日。若似乎可下矣。然此终
是太阳表证仍在。为不可下之时。所以大下之后。身热不去者。表受邪也。心中结痛者。邪客于胸也。成注云。若大下
后。身热去。心胸空者。为欲解。今者身热不去。心中结痛。是未欲解。与栀子豉汤。以吐胸中之邪热。盖吐中有发散
之义。故身热亦从此而去。按成注云。大下后。身热去心中结痛者。结胸也。身热不去。心中结痛者。虚烦也。彼以仲
景栀子豉汤第一条证。心中懊 者。为虚烦。故以此条用栀子豉汤。亦云虚烦证也。殊不知心中结痛。比上条胸中窒更
甚。当是实烦之证。但身热不去。此为热气未尽。收敛于内。比结胸证。为少轻耳。用药虽同证则迥异。）
（附例）下利后。更烦按之心下濡者。为虚烦也。宜栀子豉汤（濡当作软。此条自厥阴篇移附于此。下利后更烦者。
此非用药下后而发烦。乃自利之后而更烦也。盖阳经下利。本发烦热。但既下之后。则烦当减而邪欲解矣。若其烦比前
更加。及按之。心下却软而不硬不痛者。是为虚烦。成注云。此邪气乘虚。客于胸中也。与栀子豉汤。吐之则愈。或问
邪传三阴。则下利。子何得以厥阴下利之证。而移之太阳篇也。余答云。如厥阴病热下利。则不但烦而当见消渴证矣。
若谓阳经无下利之证。则是仲景葛根汤证。非太阳阳明合病之自下利乎。学人当以理格之。）
伤寒下后。心烦腹满卧起不安者。栀子浓朴汤主之。（本太阳伤寒。表邪未解而误下之。以致心烦腹满。心烦者。邪
入而壅于高分也。邪热壅于高分。则心以下之气不能宣越。因而腹满。既烦且满。故令卧起不安成注云。与栀子浓朴汤。
以吐烦泄满。）
（此方从原书《伤寒论》第十卷摘录并附于此）
在栀子豉汤中加入甘草（二两）。
其余按照前面的方法煎服。服药后若出现呕吐现象，则停止服用剩余的药液。
《内台方议》评论说：心烦懊憹等症状，属于栀子豉汤证，已经用该方主治了。如果患者伴有少气（元气不足、气息短促），这是因为元气虚乏，热邪搏结导致正气不能固摄。加入甘草的甘味，
是为了缓和其中焦之气并补益其气。我认为“少气”这一症状，是由于热邪损伤了气机而导致气促急迫，并非真气真正虚乏。加入甘草，是取“甘能缓急”的含义。服用汤药后，应当徐徐吐出。
这很精妙。
（此方从原书《伤寒论》第十卷摘录并附于此）
在栀子豉汤方中加入生姜（五两）。
其余按照前面的方法煎服。服药后若出现呕吐现象，则停止服用剩余的药液。
《内台方议》评论说：心烦懊憹等症状，用栀子豉汤催吐即可痊愈。如果又出现呕吐，是因为热气搏结上逆而不散，加入生姜的辛味以疏散其气，从而止住呕吐。
经过发汗或攻下治疗后，出现烦热、胸中窒塞感的，用栀子豉汤主治。（窒塞即阻塞感。发汗或攻下后，邪热未解，客居于胸中，导致胸中窒塞，所以产生烦热。
给予栀子豉汤，是为了吐出胸中的邪热。我认为胸中窒塞，是因为体内有实邪阻滞。有人问：体内有实邪，为什么不用泻下法而排出？因为病邪位于膈之上，所以适宜用吐法。《尚论篇》将这一条论述为实烦证，认为不是虚烦，是这样吗？）
伤寒病程到了五六天，经过猛烈攻下之后，身体发热不退，心中结聚疼痛的，说明病邪尚未解除，应用栀子豉汤主治。（伤寒五六天，看起来似乎可以攻下了。然而这终究是太阳表证仍在，是不可攻下的时机。所以在猛烈攻下之后，身体发热不退，是因为体表受邪。心中结聚疼痛，是因为邪气客居于胸中。成无己注解说：如果在猛烈攻下后，身热退去，心胸空虚，这是病情将要解除的表现。如今身热不退，心中结聚疼痛，说明病情尚未解除。给予栀子豉汤，是为了吐出胸中的邪热。大概吐法中包含发散的意义，所以身热也由此而去。按成无己所说：大下之后，身热退去但心中结痛，这是结胸证；身热不退且心中结痛，这是虚烦证。他根据张仲景栀子豉汤第一条证候中提到的“心中懊憹”，将其归为虚烦，因此认为本条使用栀子豉汤也是虚烦证。殊不知“心中结痛”比上一条的“胸中窒”更为严重，应当是实烦证。只是由于身热不退，这说明热气未尽，收敛于体内，比起结胸证来，稍微轻一些罢了。用药虽然相同，但证候则截然不同。）
（附例：腹泻之后，烦躁加重，按压心下部感觉柔软的，属于虚烦，适宜用栀子豉汤。（“濡”字应当解释为“软”。此条原本自厥阴篇移附于此。腹泻后更加烦躁，
这并不是用药攻下后引发的烦躁，而是自然腹泻之后出现的烦躁。一般来说，阳经病变导致的下利，本来就会引发烦热。但是既然已经腹泻，烦躁应当减轻，邪气也欲解除。如果烦躁比以前更加严重，且按压心下部却柔软而不硬不痛的，这就是虚烦。成无己注解说：这是邪气乘虚客居于胸中。给予栀子豉汤，吐出邪气即可痊愈。有人问：邪气传入三阴经，则会导致下利，您为何能将厥阴下利的证候移附到太阳篇呢？我回答说：如果是厥阴病的热性下利，那么不仅会有烦躁，还当见到消渴的症状。如果说阳经没有下利的证候，那么张仲景葛根汤证，不就是太阳阳明合病的自下利吗？学习的人应当以医理来推敲。）
伤寒经过攻下治疗后，出现心烦、腹部胀满、卧起不安的，用栀子厚朴汤主治。（原本是太阳伤寒，表邪未解而误用攻下法，导致心烦腹满。心烦，是因为邪气入里壅滞于高分（上部）；邪热壅滞于上部，导致心以下的气机不能宣通发散，因而出现腹满。既烦且满，所以令人卧起不安。成无己注解说：给予栀子厚朴汤，是为了吐出烦热、泄除胀满。）
(This prescription is extracted from Volume 10 of the original *Shanghan Lun* and appended here.)
Add Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*) (two liang) to Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction).
Prepare and administer the remaining herbs according to the previous method. If vomiting occurs after taking the medicine, stop administering the remainder.
The commentary in *Neitai Fangyi* states: Symptoms such as vexation and restlessness (Xin Fan Ao Nao) belong to the Zhizi Chi Tang pattern and have already been treated with this formula. If the patient also presents with "shao qi" (shortness of breath or deficiency of vital energy), it is due to a deficiency of primordial qi, where heat binds and fails to secure the qi. The addition of the sweet flavor of Gancao serves to moderate the middle jiao and tonify the qi. I believe that "shao qi" in this context refers to急促 breathing caused by heat damaging the qi, rather than a true deficiency of primordial qi. The addition of Gancao follows the principle that "sweetness moderates urgency." After taking the decoction, one should expect a gradual expulsion of pathogens via vomiting. This is ingenious.
(This prescription is extracted from Volume 10 of the original *Shanghan Lun* and appended here.)
Add Shengjiang (Fresh Ginger, *Zingiberis Rhizoma Recens*) (five liang) to the Zhizi Chi Tang formula.
Prepare and administer the remaining herbs according to the previous method. If vomiting occurs after taking the medicine, stop administering the remainder.
The commentary in *Neitai Fangyi* states: For symptoms such as vexation and restlessness, inducing vomiting with Zhizi Chi Tang will resolve them. If vomiting additionally occurs, it is because pathogenic heat binds and rebels upward without dispersing. The addition of the pungent flavor of Shengjiang disperses the qi and stops the vomiting.
After treatment with sweating or purging methods, if vexation-heat and a sensation of obstruction in the chest appear, Zhizi Chi Tang should be administered. (Obstruction refers to a feeling of blockage. After sweating or purging, if pathogenic heat remains unresolved and lodges in the chest, causing chest obstruction, vexation-heat arises. Zhizi Chi Tang is given to induce vomiting and expel the pathogenic heat from the chest. I consider that "chest obstruction" implies the presence of tangible pathogenic factors within. One might ask: If there are tangible factors inside, why use vomiting instead of purgation? Because the pathogen is located above the diaphragm, the vomiting method is appropriate. *Shanglun Pian* classifies this clause as an excess vexation pattern, questioning whether it is not so.)
In Shaoyang disease progressing for five to six days, after severe purging, if body heat persists and there is a knotted pain in the heart region, the condition has not yet resolved; Zhizi Chi Tang should be administered. (At five to six days of Shaoyang disease, it may seem appropriate to purge. However, this ultimately remains a Taiyang exterior pattern, making it a time when purging is contraindicated. Therefore, after severe purging, if body heat persists, it is because the exterior was affected by pathogens. Knotted pain in the heart region indicates pathogens lodging in the chest. Cheng Wuji's annotation states: If after severe purging, body heat subsides and the chest feels empty, resolution is imminent. Now, since body heat persists and there is knotted pain in the heart, resolution has not occurred. Zhizi Chi Tang is given to vomit out pathogenic heat from the chest. Generally, the vomiting method contains the meaning of dispersion, so body heat also departs thereby. According to Cheng Wuji: After severe purging, if body heat subsides but knotted pain in the heart remains, it is Jie Xiong (Chest Binding); if body heat persists and knotted pain in the heart remains, it is Xu Fan (Deficiency Vexation). He based this on the first clause of Zhang Zhongjing's Zhizi Chi Tang, where "vexation and restlessness" is classified as deficiency vexation, thus considering this clause using Zhizi Chi Tang as also deficiency vexation. Little does he know that "knotted pain in the heart" is more severe than the "chest obstruction" in the previous clause and should be considered an excess vexation pattern. However, since body heat persists, it indicates that heat is not fully exhausted and has contracted inward. Compared to Jie Xiong, it is slightly milder. Although the medication is the same, the patterns are distinctly different.)
(Attached Example: After diarrhea, if vexation increases and palpation of the epigastrium reveals softness, it is deficiency vexation; Zhizi Chi Tang is appropriate. ("Ru" should be interpreted as "soft". This clause was originally moved from the Jueyin chapter and appended here. Diarrhea followed by increased vexation is not vexation induced by medicinal purging, but vexation arising spontaneously after natural diarrhea. Generally, diarrhea from Yang meridians naturally induces vexation-heat. But once diarrhea has occurred, vexation should decrease, and pathogens should desire to resolve. If vexation becomes worse than before, and palpation of the epigastrium reveals softness without hardness or pain, this is deficiency vexation. Cheng Wuji annotates: This is pathogenic qi taking advantage of deficiency to lodge in the chest. Giving Zhizi Chi Tang and inducing vomiting will cure it. One might ask: When pathogens transmit to the Three Yin meridians, diarrhea occurs. Why do you move a Jueyin diarrhea pattern to the Taiyang chapter? I reply: If Jueyin disease involves heat-induced diarrhea, one would not only see vexation but also thirst and excessive drinking. If one claims that Yang meridians have no diarrhea patterns, then isn't Zhang Zhongjing's Gegen Tang syndrome simply spontaneous diarrhea from a combined Taiyang-Yangming disease? Learners should reason through this medically.)
After Shaoyang disease is treated with purging, if vexation, abdominal fullness, and restlessness (unable to lie down or sit up comfortably) occur, Zhizi Houpo Tang (Gardenia and Magnolia Bark Decoction) should be administered. (Originally Taiyang Shaoyang disease, where exterior pathogens remained unresolved, mistaken purging led to vexation and abdominal fullness. Vexation arises because pathogens entered and obstructed the upper portion (high fen); pathogenic heat obstructing the upper portion prevents the qi below the heart from circulating freely, resulting in abdominal fullness. With both vexation and fullness, one becomes restless. Cheng Wuji annotates: Zhizi Houpo Tang is given to vomit out vexation and drain fullness.)