治伤寒发汗不解。寒热往来。或中外诸邪热。口干烦渴。或下后热未愈。汗后劳复等证。
柴胡 人参 黄芩 甘草 大黄 当归 芍药（各半两）
上为末。每服钞三钱。水一盏。生姜三片。煎至七分。温服。日三。病热甚者。加减之。
琥按上方。即仲景大柴胡汤。去半夏枳实大枣。加人参当归也。以口干烦渴。故去半夏。复去大枣者。因烦渴一候。
必邪热甚而气上逆。恐大枣之甘。能壅气也。又以胃府但热而不实。故去枳实。或问热而不实。何以不去大黄。殊不知
方中用大黄者。止以除里热。又恐有伤阴。分之血。所以方中用芍药。复加当归也。愚又以方中惟人参一味。不宜与大
黄并用。有如中外邪热。或下后热未愈。则宜用大黄者。不宜加人参。恐人参甘温。反能助邪热也。又如汗后劳复。则
宜加人参者。不宜用大黄。以大黄苦寒。徒以致里虚也。且方后原云。病热甚者。加减之。夫热甚必实。寒甚必虚。若
热甚。还当加大黄。减人参也。后人不原制方之意。不知加减。一概并用。譬之陶氏黄龙汤。流祸至今而未已也。
疗伤寒少阳证。胸胁。痛往来寒热而呕。或咳而耳聋。脉尺寸俱弦。忌发汗。忌利小便。忌过大便。止宜和解。故
名三禁汤。
即仲景小柴胡汤七味。分两减半。其原方加减法
同。复有添加加减法。兹录于后。
如寒热往来。经水不调者。去半夏。加秦艽。芍药。当归知母。地骨皮。丹皮。川芎。白术。茯苓。妇人虚劳发热。
加蛤蚧。赤茯苓。如小柴胡汤。与四物汤各半。名调经汤。（愚以妇人伤寒。或中风。经水适来适断。寒热发作如疟者。
宜用此汤也。）无孕呕者。加半夏。无汗者。加柴胡。恶寒者。加桂。有汗者。加地骨皮。嗽者加紫菀。通经者。加京三
棱广茂。劳者加鳖甲。（按上加药法。系治妇人杂证法也。）
琥按上汤名三禁。而以利小便为一禁。其说盖自云。岐子保命集始。保命集云治少阳有三禁。不可汗。不可下。
不可利小便。此为三禁。独不观仲景辩少阳中风。首云。不可吐下。辩少阳伤寒。又云。不可发汗成无己明理论亦云。
少阳病邪在半表半里。既非发汗所宜。又非吐下所对。止宜和解。故云。三禁。若然。则是汗下之禁虽同。利小便与吐
大异先圣后贤其说。孰是孰非。愚曾细思之。而以仲景之言为是。若利小便。不在所禁也。据少阳篇坏病云。若已吐下。
发汗温针。谵语者。柴胡证罢。此为坏病。未闻云利小便而至坏也。又据柴胡汤后加减法云。若心下悸。小便不利者。
去黄芩。加茯苓。又内台方加药法云。如发热。小便不利者。和五苓散。益可见利小便。在所不禁矣。或云胆有上窍。
宜吐。木性曲直。风寒郁其经。则屈而不升。故宜用吐。以升发之。所以可吐篇云。大法。春宜吐。胆属少阳。而时应
乎春是。吐在所不禁。禁利小便者。以胆无下窍。且逆其性而导之也。其说近是。其理则非。断不可从。戒之慎之。
治疗伤寒发汗后病邪未解。寒热交替发作。或体内外的各种邪热。口干燥、心中烦闷且口渴。或者经过泻下治疗后热势仍未消退。发汗后因劳累而复发等证候。
柴胡 人参 黄芩 甘草 大黄 当归 芍药（各半两）
将上述药物研为细末。每次服用三钱。用水一盏。生姜三片。煎煮至七分满。温服。每日三次。若病情热势严重，根据情况加减药物。
琥按：上面的方子，就是张仲景的大柴胡汤。去掉了半夏、枳实、大枣，加入了人参和当归。因为患者口干烦渴，所以去掉半夏。再次去掉大枣的原因，是因为“烦渴”这一症状，必然是邪热炽盛且气机上逆，担心大枣的甘味会阻滞气机。又因为胃腑只有热邪而没有积滞（实证），所以去掉枳实。有人问：热邪存在但没有积滞，为什么不去掉大黄？殊不知方中使用大黄，只是为了清除里的热邪。又担心大黄会损伤阴分和血液，所以在方中加入芍药，并额外加入当归。我进一步认为，方中唯独人参一味药，不宜与大黄同时使用。如果是体内的邪热，或者泻下后热势未退，这时适宜用大黄，就不宜加人参，担心人参的甘温之性反而助长邪热。如果是发汗后因劳累而复发，这时适宜加人参，就不宜用大黄，因为大黄苦寒，只会导致里虚。况且方后原本注明：“病热甚者，加减之”。热势严重必然属实，寒势严重必然属虚。如果热势严重，还应当加大黄，减少人参。后世的人不探究制方的本意，不懂得加减变化，一概同时使用这些药物。这就好比陶华的黄龙汤，流下的祸患至今没有停止。
治疗伤寒少阳证。胸胁部疼痛，寒热往来且呕吐。或者咳嗽且耳聋。脉象寸部和尺部都呈现弦脉。禁止发汗。禁止利小便。禁止过度通大便。只适宜和解表里。所以称为三禁汤。
这就是张仲景小柴胡汤的七味药，分量减半。其原方的加减方法与上面相同，另有添加和加减的方法，记录在后面。
如果出现寒热往来，月经不调的情况，去掉半夏，加入秦艽、芍药、当归、知母、地骨皮、丹皮、川芎、白术、茯苓。妇女因虚劳发热的，加入蛤蚧、赤茯苓。像小柴胡汤与四物汤各取一半，名为调经汤。（我认为妇女患伤寒，或者中风，月经适来或适断，寒热发作像疟疾一样的，适宜使用此汤。）没有怀孕而有呕吐的，加入半夏。没有汗出的，加入柴胡。怕冷的，加入桂枝。有汗出的，加入地骨皮。咳嗽的，加入紫菀。需要通经的，加入京三棱、广茂。身体虚弱的，加入鳖甲。（按：上面提到的加药方法，是治疗妇女杂病的方法。）
琥按：上面的汤剂名为三禁，而以利小便作为一禁。这种说法大概是从云岐子《保命集》开始的。《保命集》说治疗少阳有三禁，不可发汗，不可泻下，不可利小便。这是所谓的三禁。难道没看过张仲景辨析少阳中风时，首先说“不可吐下”，辨析少阳伤寒时，又说“不可发汗”吗？成无己在《明理论》中也说，少阳病的邪气在半表半里，既不是发汗所适宜的，也不是吐下所对应的，只适宜和解。所以说“三禁”。如果这样的话，那么对发汗和泻下的禁忌虽然相同，但利小便与吐法大相径庭。先圣和后贤的说法，谁是谁非呢？我曾仔细思考过，认为张仲景的话是正确的。如果利小便不在禁忌之列。依据少阳篇关于坏病的记载说：“如果已经经过吐、下、发汗、温针治疗，出现谵语的，柴胡证已罢，这称为坏病。”未曾听说因为利小便而导致坏病的。又依据柴胡汤后的加减法说：“如果心下悸动，小便不利的，去掉黄芩，加入茯苓。”还有《内台方》的加药法说：“如果发热，小便不利的，合用五苓散。”这更可见利小便是在不禁止之列的。有人说胆有上窍，适宜用吐法。木的特性是曲直，风寒郁闭经脉，则屈而不升，所以适宜用吐法来升发它。所以《可吐篇》说：大法则是春季适宜吐。胆属于少阳，而时令对应于春，所以吐法是不禁止的。禁止利小便，是因为胆没有下窍，而且违背其本性去引导它。这种说法接近正确，但道理却是错误的。绝对不可以听从，要警惕谨慎。
Treats conditions where the pathogenic factor of Shanghan (Cold Damage) has not been resolved after sweating therapy. Alternating chills and fever. Or various internal and external pathogenic heat. Dry mouth, vexation, and thirst. Or residual heat after purgative treatment. Recurrence due to overexertion after sweating, etc.
Chai Hu (Bupleuri Radix), Ren Shen (Ginseng Radix), Huang Qin (Scutellariae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Da Huang (Rhei Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix), Shao Yao (Paeoniae Radix Alba) (each half liang).
Grind the above herbs into powder. Take three qian per dose. Add one sheng of water and three slices of fresh ginger. Decoct until reduced to seven-tenths. Take warm. Three times daily. If the heat syndrome is severe, modify according to circumstances.
Hu notes: The above formula is essentially Zhang Zhongjing's Da Chai Hu Tang (Major Bupleurum Decoction), with Ban Xia (Pinelliae Rhizoma), Zhi Shi (Aurantii Fructus Immaturus), and Da Zao (Jujubae Fructus) removed, and Ren Shen (Ginseng Radix) and Dang Gui (Angelicae Sinensis Radix) added. Because of dry mouth and vexation/thirst, Ban Xia (Pinelliae Rhizoma) is removed. Da Zao (Jujubae Fructus) is further removed because the symptom of "vexation and thirst" indicates intense pathogenic heat and rebellious qi; it is feared that the sweet nature of Da Zao (Jujubae Fructus) may obstruct qi flow. Furthermore, since the stomach fu organ presents with heat but no excess accumulation (shi), Zhi Shi (Aurantii Fructus Immaturus) is removed. One might ask: if there is heat without excess, why is Da Huang (Rhei Radix et Rhizoma) not removed? It should be understood that Da Huang (Rhei Radix et Rhizoma) is used in this formula solely to clear interior heat. Additionally, to prevent injury to yin fluids and blood, Shao Yao (Paeoniae Radix Alba) is included, along with the addition of Dang Gui (Angelicae Sinensis Radix). I further argue that among the herbs in this formula, only Ren Shen (Ginseng Radix) should not be combined with Da Huang (Rhei Radix et Rhizoma). In cases of internal/external pathogenic heat or residual heat after purgation, Da Huang (Rhei Radix et Rhizoma) is appropriate, but Ren Shen (Ginseng Radix) should be avoided, as its sweet-warm nature might inadvertently assist the pathogenic heat. Conversely, in cases of recurrence due to overexertion after sweating, Ren Shen (Ginseng Radix) is appropriate, but Da Huang (Rhei Radix et Rhizoma) should be avoided, as its bitter-cold nature would merely cause interior deficiency. Moreover, the original text states: "If the heat syndrome is severe, modify." Severe heat implies excess; severe cold implies deficiency. If heat is severe, one should increase Da Huang (Rhei Radix et Rhizoma) and decrease Ren Shen (Ginseng Radix). Later practitioners, failing to understand the original intent of the formula formulation and lacking knowledge of modification, indiscriminately use all ingredients together. This is akin to Tao Hua's Huang Long Tang (Yellow Dragon Decoction), whose detrimental effects persist to this day.
Treats Shaoyang syndrome of Shanghan (Cold Damage). Pain in the chest and hypochondrium, alternating chills and fever with vomiting. Or coughing and deafness. Pulse is wiry at both cun and chi positions. Sweating therapy is contraindicated. Promoting urination is contraindicated. Profuse purgation is contraindicated. Only harmonizing (he jie) is suitable. Hence it is named San Jin Tang (Three Prohibitions Decoction).
This consists of the seven herbs from Zhang Zhongjing's Xiao Chai Hu Tang (Minor Bupleurum Decoction), with dosages halved. Its original modification methods are the same as above. Additional modification methods are recorded below.
In cases of alternating chills and fever with irregular menstruation, remove Ban Xia (Pinelliae Rhizoma), add Qin Jiao (Gentianae Macrophyllae Radix), Shao Yao (Paeoniae Radix Alba), Dang Gui (Angelicae Sinensis Radix), Zhi Mu (Anemarrhenae Rhizoma), Di Gu Pi (Lycii Cortex), Dan Pi (Moutan Cortex), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria). For women suffering from deficiency-labor fever, add Ge Jie (Geckus), Chi Fu Ling (Poria cum Rubro). Combining Xiao Chai Hu Tang (Minor Bupleurum Decoction) and Si Wu Tang (Four Substances Decoction) in equal parts is named Tiao Jing Tang (Regulate Menstruation Decoction). (I believe that for women with Shanghan (Cold Damage) or wind-stroke, where menstruation has just started or stopped, presenting with alternating chills and fever like malaria, this decoction is suitable.) For non-pregnant individuals with vomiting, add Ban Xia (Pinelliae Rhizoma). For those without sweat, add Chai Hu (Bupleuri Radix). For those with aversion to cold, add Gui Zhi (Cinnamomi Ramulus). For those with spontaneous sweating, add Di Gu Pi (Lycii Cortex). For cough, add Zi Wan (Asterni Radix). To unblock meridians, add Jing San Leng (Curcumae Radix) and Guang Mao (Zedoary Rhizoma). For weakness, add Bie Jia (Testudinis Carapax et Plastrum). (Note: The aforementioned herb additions are methods for treating miscellaneous gynecological conditions.)
Hu notes: The above decoction is named San Jin Tang (Three Prohibitions Decoction), listing promoting urination as one prohibition. This theory likely originates from Yun Qizi's Bao Ming Ji (Collection for Preserving Life). Bao Ming Ji states that treating Shaoyang involves three prohibitions: no sweating, no purgation, no promoting urination. These are the three prohibitions. Have we not seen Zhang Zhongjing state regarding Shaoyang wind-strike that "vomiting and purgation are contraindicated," and regarding Shaoyang cold damage that "sweating is contraindicated"? Cheng Wuji in Ming Li Lun also states that Shaoyang pathogenic factors reside between exterior and interior; neither sweating nor vomiting/purgation is suitable, only harmonizing is appropriate. Thus, "three prohibitions" are mentioned. If so, while prohibitions against sweating and purgation align, promoting urination differs significantly from vomiting. Whose interpretation, that of the ancient sages or later worthies, is correct? I have pondered this carefully and side with Zhang Zhongjing. Promoting urination is not prohibited. According to the Shaoyang chapter on complicated diseases: "If vomiting, purgation, sweating, or warm needling have already been performed, resulting in delirium, the Chai Hu syndrome has ceased; this is called a complicated disease." There is no mention of promoting urination leading to complicated diseases. Furthermore, according to the modification rules after Chai Hu Tang: "If there is palpitation under the heart and difficulty urinating, remove Huang Qin (Scutellariae Radix) and add Fu Ling (Poria)." Also, according to Nei Tai Fang modifications: "If there is fever and difficulty urinating, combine with Wu Ling San (Five-Ingredient Powder with Poria)." This further confirms that promoting urination is not prohibited. Some argue that the Gallbladder has an upper orifice and vomiting is suitable. Wood naturally tends to curve and straighten; when wind-cold stagnates the meridian, it bends downward rather than ascending, so vomiting is suitable to promote ascent. Thus, Ke Tu Pian states: "The general principle is that spring favors vomiting." The Gallbladder belongs to Shaoyang, corresponding to spring, so vomiting is not prohibited. Promoting urination is prohibited because the Gallbladder lacks a lower orifice, and doing so goes against its nature. This argument seems plausible but is fundamentally incorrect. Do not follow it; beware and be cautious.