（发热者无休止时也寒热者寒已而热热已而寒相继而发也潮热者有时热有时止如潮汛之不失其期也若发热不恶寒
而渴为温病发汗已身体灼热者为风温若发热手或微厥下利清谷此为阴证也夫下血气不通四肢逆冷却发热此热深厥亦深
也头痛发热恶寒身不疼痛此伤食证也不恶寒身不痛知非伤寒头不疼脉不紧知非里实但烦热者烦虚也）
中风即发热者风伤卫也伤寒不即发热者寒伤荣也经云伤寒一二日或已发热或未发热是也凡翕翕发热而有恶风恶寒
头痛脉浮者表证也此由风寒客于皮肤阳气怫郁所致宜汗之若小便黄非在外凡蒸蒸发热而兼有谵语大便秘小便赤腹满恶
热脉滑实者里热也此由阳气下陷入阴中所致宜下之若小便清非在内也其在少阴厥阴发热者谓之反发热惟太阴无发热之
候若脉阴阳俱盛热不止者死下利发热汗后复发热脉躁疾不为汗衰狂言不能食阴阳不交者死 兰台治例曰邪在三阳太阳
证多与潮热若同而异邪在三阴少阴证多与烦躁相类而非
发热恶寒脉浮者属表即太阳证也（方论见前太阳病条）发热汗出不恶寒反恶热者属里即阳明证也（方论见自汗）发
热脉弦细头痛者属半表半里即少阳证也（论见口苦咽干）发热而呕者小柴胡汤（论见呕）发热咳嗽表不解者小青龙汤兼
胁痛喜呕者小柴胡加干姜五味子汤（方论见咳）发热而喘表不解者小青龙去麻黄加杏仁汤兼胸满者麻黄汤（方论见喘）
发热口渴有属表者有属里者治法方论甚众（并见渴门）
发热汗解半日许复烦躁脉浮数大者可更发汗宜桂枝汤（详烦）
发汗后恶风寒者虚故也不恶寒但恶热者实也当和胃气宜调胃承气汤（经曰汗出不恶寒者此表解里未和与调胃承气汤
以和胃气）
太阳病三日发汗不解蒸蒸发热者属胃也调胃承气汤主之（海 大黄泄实芒硝软坚甘草和中必燥实坚三证全者可用）
调胃承气汤方
大黄（一两 海 宜酒浸盖邪气居高非酒不到譬如物在高巅人迹所不及必射而取之故用酒浸引上若生用苦泄峻下则
遗高分之邪热所以愈后或目赤或喉闭或头肿膈上反生热证） 甘草（半两炙 海 甘以缓之） 芒硝（九钱 海 辛以
润之咸以软之）上 咀水一盏煮大黄甘草至七分去滓入芒硝更上火微煮令沸少少温服
成 内经曰热淫于内治以咸寒佐以苦甘芒硝咸寒以除热大黄苦寒以荡实甘草甘平助二物推陈而缓中发热汗出不解
心下痞硬呕吐而利者大柴胡汤（论见痞）发汗后身灼热脉浮汗出身重多眠鼻鼾者风温（论见风温）发汗后仍发热心悸头
眩身 动振振欲擗地者宜真武汤（论见下利）汗出热不去内拘急四肢疼下利厥逆恶寒者宜四逆汤（论见下利）大汗出脉
阴阳俱盛不解者死（内经云温病汗彻复热而脉躁疾不为汗衰狂言不能食谓之阴阳交者必死也）
太阳病先发汗不解而复下之脉浮者不愈浮为在外而反下之故令不愈今脉浮故知在外当须解外则愈桂枝汤主之
汗下后仍头痛发热心下满小便不利者桂枝去桂加茯苓白术汤（论见结胸）大下后身热不去心中结痛者栀子豉汤主之（论
见心）大下后身热不去微烦者栀子干姜汤（方论见烦）阳明病下之其外有热手足温心中懊 饥不能食但头汗出者栀子豉
汤（论见烦）
太阳病当恶寒发热今自汗出不恶寒发热关上脉细数者以误吐之过也一二日吐之者腹中饥口不能食三四日吐之者不
喜糜粥欲食冷食朝食暮吐以误吐之所致也此为小逆（成 恶寒发热为太阳表病自汗出不恶寒发热者阳明证本太阳表病医
反吐之伤动胃气表邪乘虚传于阳明也以关脉细数知误吐之所致病一二日为表邪尚寒而未成热吐之则表寒传于胃中胃中
虚寒故腹中饥而口不能食病三四日则表邪已传成热吐之则表热乘虚入胃胃中虚热故不喜糜粥欲食冷食朝食暮吐也朝食
暮吐者晨食入胃胃虚不能克化故停久而复吐出者知为医误吐之胃虚所致本太阳病吐不为逆以传阳明故以为逆然阳明虽
为入腑犹是阳经故不为大逆而曰小逆也）
瘥后更热者小柴胡汤脉浮者以汗解脉沉者以下解（详劳复）
伤寒脉浮滑此表有热里有寒白虎汤主之（前篇云热结在里表里俱热者白虎汤主之又云其表不解不可与白虎汤此云脉
浮滑表有热里有寒者必表里字差矣又阳明一证云脉浮迟表热里寒四逆汤主之又少阴一证云里寒外热通脉四逆汤主之以
此见差明矣又阳明篇曰脉滑而疾者小承气汤既用承气是为里热也又厥阴篇曰脉滑而厥者里有热白虎汤主之是谓滑为里
热明矣况知母石膏性皆大寒岂应以水济水成氏随文释之非也）
白虎汤方
知母（六两） 石膏（一斤） 甘草（二两） 糯米（六合）上四味以水一斗煮米熟汤成去滓温服一升日三服
成 白虎西方金神也应秋而归肺热甚于内者以寒下之热甚于外者以凉解之其有中外俱热内不得泄外不得发非是汤
则不能解暑 之气得秋而止故曰处暑是汤以白虎名谓能止热也内经曰热淫所胜佐以苦甘又曰热淫于内以苦发之欲彻表热必以苦为主故以知母苦寒为君热则伤气寒以胜之甘以缓之热胜其气必以甘寒为助是以石膏甘寒为臣脾苦湿急食甘以
缓之热气内余消烁津液必以甘平之物缓其中故以甘草粳米为使是太阳中 得此汤则顿除即热见白虎而尽矣立秋后不可
服白虎为大寒剂秋时服之必多为哕逆虚羸者矣
垣 身以前胃之经也胸胃肺之室也邪在阳明肺受火制故用辛寒以清肺所以号为白虎汤也
海 夫伤寒表证发热恶热而渴与下杂证同但头痛身热目痛鼻干不得卧白虎主之乃阳明经病也正阳阳明气病脉洪大
先无形也杂病里证发热恶热而渴但目赤者病藏也手太阴气不足不能管领阳气也宜以枸杞生地黄熟地黄之类主之脉洪大
甚则呕血先有形也 气病在里误用血药无伤寒也为安血而益阴也血在里误用气药如白虎汤者非也为泻肺而损阴也
垣 辩误服白虎变证 昔西台掾葛君瑞二月中病伤寒发热以白虎汤主之病者面黑如墨本证遂不复见脉沉细小便不
禁东垣初不知也及诊之曰此立夏以前误服白虎白虎大寒非行经之药止能寒脏腑不善用之则伤善气本病曲隐于经络之间
或投以大热之药求以去阴邪他证必起非所以救白虎也可用温药升阳行经有难者曰白虎大寒非大热何以救君之治奈何东
垣曰病隐经络间阳道不升则经不行经行而本证见矣果如其言而愈
张 活人谓白虎汤治中 并汗后一解表药耳非正伤寒药也而夏月阴气在内白虎尤宜戒之夫白虎汤俱载仲景之书证
治昭然明白何为言非正伤寒之药也况伤寒论言无表证者可与白虎汤今云汗后一解表药耳于法既无表证何解之有又曰夏
月阴气在内白虎尤宜戒之而明理论又云立秋后不可服秋则阴气半矣而白虎大寒若不能禁服之而为哕逆不能食或虚羸者
多矣夫伤寒之法有是证则投是药安可拘于时而为治哉假如秋冬之间患伤寒身无表证而大烦渴于法合用白虎汤苟拘其时
何以措手若以白虎为大寒其承气又何行于冬令乎既以夏宜戒秋后不可行然则宜乎何时也虽然经云必先岁气无伐天和此
言常也假如贼邪变出阴阳寒热亦当舍时从证岂可以时令拘哉
伤寒脉浮发热无汗其表不解者不可与白虎汤若大渴欲饮水无表证者白虎加人参汤主之（成 伤寒脉浮发热无汗其表
不解不渴者宜麻黄汤渴者宜五苓散非白虎所宜大渴欲水无表证者乃可与白虎加人参汤以散里热临病之人大宜精别 张
经言可与某汤或言不可与者此设法御病也又云宜某汤此临证审决也言某汤主之乃对证施治也此三者方法之条目也包藏
深理非一言可以具述）
脉浮而迟表热里寒下利清谷者四逆汤（论见下利）下利厥逆汗出热不去者四逆汤
少阴病下利清谷厥逆里寒外热者通脉四逆汤（方论见下利）身热手足逆冷而脉虚当夏月发者为中暑（论见中暑）伤
寒表不解干呕发热而咳下利者小青龙去麻黄加芫花汤（论见咳）太阳与阳明合病必下利其证头痛腰疼身热鼻干脉浮大而
长者宜葛根汤（论见合病）发热下利脉微迟厥逆者通脉四逆汤 太阳与少阳合病自下利其证头寒胸满往来寒热脉浮大而
弦者宜黄芩汤（论见合病）下利清谷脉沉迟其人面赤微热而厥者必郁冒汗出自解发热下利厥逆躁不得卧者死 发热而利
汗不止者死（二论俱见下利）
发热吐利心下痞硬者大柴胡汤渴者五苓散不渴者理中汤（论并见痞及吐利门）
发热经水适来适断小柴胡汤刺期门（论见谵语疟状）发热脉数消谷不大便者有瘀血宜抵当汤（论见蓄血）
戴 诸阳发热已见前三阳经阴不发热惟少阴能发热然少阴发热有二证初得病即见少阴证发热恶寒头不疼宜麻黄细
辛附子汤 若下利清谷身热躁扰里寒外热仲景谓之反发热此乃阴盛隔阳宜四逆汤附子理中汤盖阳气传阴经而下利者乃
是热利阳陷入里外所以无热阴气入阴经而下利者乃是里寒自利寒既在里为主而阳气必客于外所以外反热要知阴证发热
自是不同发于阳而发热者头必疼发于阴而发热者头不痛此为验也 又发汗后只恶寒者为虚虚乃表虚发汗后只恶热者为
实实乃里实只恶寒者是发其汗或汗出太过所谓阳微则恶寒宜芍药甘草附子汤只发热者是表已解而里不消所谓阴微则发
热宜大柴胡汤或小承气汤 又有汗下后阴阳不相入水火不相济致余热未退不可更用冷药内外俱未可故宜小建中汤若其
人已虚虚能生热宜小建中汤加当归一钱或四君子汤加黄 半钱或十全大补汤调其荣卫虚者四柱汤真武汤 审其是邪热
未解虽经汗下却不畏虚而养病宜竹叶石膏汤
宋元诸贤表证发热治例
洁 有汗不得服麻黄无汗不得服桂枝然春夏汗孔疏虽有汗不当服桂枝宜用黄 汤和解之秋冬汗孔闭虽无汗不当服
麻黄宜用川芎汤和解之春夏有汗脉微而弱恶风恶寒者乃太阳证秋冬之脉也宜用黄 汤无汗亦用川芎汤秋冬有汗脉盛而
浮发热恶热者乃阳明证春夏之脉也宜用黄 汤无汗亦用川芎汤大抵有汗皆宜黄 汤无汗皆宜川芎汤主之
黄 汤 有汗则能止之
白术 黄 防风（各等分）上 咀每服五七钱至一两水煎温服汗多恶风甚者桂枝
川芎汤 无汗则能发之
川芎 苍术 羌活（各等分）上 咀每服五七钱至一两水煎热服无汗恶风甚者加麻黄一二钱
海 神术汤 治内伤冷冻饮料外感寒邪无汗者
苍术（制） 防风（各二两） 甘草（一两炒）上 咀加葱白生姜同煎服如太阳证发热恶寒脉浮而紧者加羌活二钱
如太阳证脉浮紧中带弦数者是兼少阳也加柴胡二钱如太阳证脉浮紧中带洪者是兼阳明也加黄芩二钱 妇人服者加当归
或加木香汤或加 本汤各二钱如治吹奶煎调六一散三五钱神效又神术六气加减例
太阳寒水司天 加羌活桂枝余岁非时变寒亦加冬亦加
阳明燥金司天 加白芷升麻余岁非时变凉湿亦加秋亦加
少阳相火司天 加黄芩地黄余岁非时变雨湿亦加夏亦加
太阴湿土司天 加白术 本余岁非时变热湿亦加夏末秋初亦加
少阴君火司天 加细辛独活余岁非时变热亦加夏末夏初亦加
厥阴风木司天 加川芎防风余岁非时变温和亦加夏亦加
以上神术汤六气加减法非止为司天之气设也至于岁之主气与月建日时同前应见者皆当随听见根据上例加减之按海藏
此论与戴人云病如不是当年气看与何年运气同便向此中求妙法方知皆在至真中之歌相表里实发前人之所未发也盖海藏
此论所谓某气司天加某药者治常气之法也所谓随所应见加减者治变气之法也戴人所谓看与何年同气求治法者亦治变气
之法也能将二公之法扩充行之则内经运气之本义灿然矣夫同经纶运气有常气有变气常气者有定纪如某年属某气司天当
寒某年属某气司天当热是也变气者无定纪如某年属某气司天当寒反热当热反寒是也王氏注文释以经无定纪之变气作有
定纪之常气使后学人皆以年岁占运气而其应者十无一二是以人莫之信而其道湮晦久矣二公生数千百里之后复启其端而
续之与程朱续孔孟不传之绪同功也今仆谨于海藏逐年司天加药之后申明余岁变常之义同志者幸究心焉
白术汤 治内伤冷物外感风寒有汗者
白术（三两） 防风（二两） 甘草（一两炙）上 咀每服五钱水一盏姜三片煎至七分温服一日止一二服待二三日
渐渐汗少为解
又白术汤 治伤寒上解三阳下安太阴
白术（如汗之改用苍术） 防风（各二两）每服五钱水煎七分温服用后方加减 若发热引饮加黄芩甘草头疼恶风者
加羌活散三钱羌活一两半川芎七钱细辛二钱半（去芦）若身热目痛者加石膏汤四钱石膏二两知母半两白芷七钱 腹中痛
加芍药汤三钱芍药二两桂枝半两 往来寒热而呕者加柴胡散三钱柴胡一两半夏半两 心下痞加枳实一钱 若有里证加
大黄一钱次二钱又次三钱邪去止之
洁古云有汗不得服麻黄无汗不得服桂枝若未瘥则其变不可胜言故立此法使不犯三阳禁忌解表神方
九味羌活汤 （陶尚文注云不问四时但有头疼骨节痛发热恶寒无汗脉浮紧者宜用此汤以代麻黄为稳当如头痛发热恶风自汗脉浮缓者宜用加减冲和汤即羌活汤中减苍术细辛加白术黄 是也）
（发热是指热度持续不断；寒热是指寒冷过后发热，发热过后又发冷，交替发作；潮热是指定时发热、定时停止，像潮汐一样有规律。如果发热但不怕冷且口渴，这是温病；发汗后身体灼热，这是风温；如果发热且手脚轻微厥冷、下利清谷，这是阴证。如果便血、气机不通、四肢逆冷却伴有发热，这是热邪深重导致四肢厥冷也深重。头痛、发热、恶寒但身体不疼痛，这是伤食证；不怕冷、身体不痛、头不疼、脉不紧，可知不是里实证；只是烦热的，是虚烦。）
中风即出现发热，是因为风邪伤了卫分；伤寒不立即发热，是因为寒邪伤了营分。经书说：伤寒一二天，有的已经发热，有的尚未发热，就是这个道理。凡是翕翕发热（如羽毛覆盖般的温热感）并伴有恶风、恶寒、头痛、脉浮的，属于表证。这是由于风寒客居皮肤，导致阳气郁结所致，应当用发汗法治疗。如果小便黄，说明病不在表。凡是蒸蒸发热（热气由内向外透发）并伴有谵语、大便秘结、小便赤、腹部胀满、恶热、脉滑实的，属于里热证。这是由于阳气陷入阴分所致，应当用攻下法治疗。如果小便清，说明病不在里。在少阴、厥阴经出现的发热，称为“反发热”，只有太阴经没有发热的症状。如果脉象寸关尺三部都盛大，热势不止，预后不良；下利发热，发汗后再次发热，脉象躁疾不因汗出而减缓，胡言乱语不能进食，这是阴阳离决，预后不良。
兰台治例说：邪气在三阳经，太阳证多与潮热相似但不同；邪气在三阴经，少阴证多与烦躁相似但不同。
发热、恶寒、脉浮的，属于表证，即太阳证。（方剂论述见前文太阳病条）
发热、汗出、不怕冷反而怕热的，属于里证，即阳明证。（方剂论述见自汗条）
发热、脉弦细、头痛的，属于半表半里证，即少阳证。（论述见口苦咽干条）
发热且呕吐的，用小柴胡汤。（论述见呕条）
发热咳嗽、表证未解的，用小青龙汤；兼有胁痛、喜欢呕吐的，用小柴胡加干姜五味子汤。（方剂论述见咳条）
发热气喘、表证未解的，用小青龙去麻黄加杏仁汤；兼有胸满的，用麻黄汤。（方剂论述见喘条）
发热口渴的，有属表的，有属里的，治疗方法及方剂论述很多。（并见于渴门）
发热通过汗法解除，半天左右又出现烦躁，脉象浮数大的，可以再次发汗，宜用桂枝汤。（详细论述见烦条）
发汗后仍恶风恶寒的，是正气虚弱；不怕冷只怕热的，是实证。应当调和胃气，宜用调胃承气汤。（经书说：出汗后不怕冷的，这是表证已解但里气未和，给予调胃承气汤以调和胃气）
太阳病三天，发汗后病未解，出现蒸蒸发热的，病位在胃，主方用调胃承气汤。（海藏注：大黄泻实，芒硝软坚，甘草和中。必须是燥、实、坚三个证候俱全者才可使用）
调胃承气汤方
大黄（一两，海藏注：宜酒浸。盖因邪气位置较高，非酒力不能到达，如同物品在高处，人迹难至，必须射取，所以用酒浸引药上行。若生用则苦泄峻下，会遗漏高位的邪热，所以愈后可能出现目赤、喉闭或头肿等膈上反生热证）
甘草（半两，炙，海藏注：甘味以缓急）
芒硝（九钱，海藏注：辛味以润燥，咸味以软坚）
以上药材切碎，用水一盏，煮大黄、甘草至七分，去渣，加入芒硝，再上火微煮令沸，少量多次温服。
成无己注：《内经》说：热邪盛于内，用咸寒药物治疗，佐以苦甘。芒硝咸寒以除热，大黄苦寒以荡涤实邪，甘草甘平辅助二药推陈出新并缓和药性。
发热、汗出不解、心下痞硬、呕吐而下利的，用大柴胡汤。（论述见痞条）
发汗后身体灼热、脉浮、汗出、身重、多眠、鼻鼾的，是风温。（论述见风温条）
发汗后仍发热、心悸、头晕、身体瞤动、振振欲倒地的，宜用真武汤。（论述见下利条）
汗出热不退、内部拘急、四肢疼痛、下利、四肢厥冷、恶寒的，宜用四逆汤。（论述见下利条）
大汗出、脉象寸关尺三部俱盛且病不解的，预后不良。（《内经》说：温病汗出透彻后复热，脉象躁疾不因汗出而减缓，胡言乱语不能进食，称为“阴阳交”，必死）
太阳病先发汗病未解，又用攻下法，脉仍浮的，病不愈。浮脉表示病邪在外，反而用攻下法，所以不愈。现在脉浮，故知病邪仍在表，应当解表则愈，主方用桂枝汤。
汗法和下法之后，仍头痛发热、心下满、小便不利的，用桂枝去桂加茯苓白术汤。（论述见结胸条）
大下法之后，身热不去、心中结痛的，主方用栀子豉汤。（论述见心条）
大下法之后，身热不去、微烦的，用栀子干姜汤。（方剂论述见烦条）
阳明病攻下后，体表有热、手足温暖、心中懊憹、饥饿但不能进食、仅头部出汗的，用栀子豉汤。（论述见烦条）
太阳病本当恶寒发热，现在自汗出、不怕冷、发热、关上脉细数，这是因为误用吐法造成的过失。发病一二天就吐的，腹中饥饿但口不能食；发病三四天吐的，不喜欢喝粥，想吃冷食，早晨吃的晚上吐出来，这都是误用吐法导致的。这称为“小逆”。（成无己注：恶寒发热是太阳表病。自汗出、不怕冷、发热是阳明证。本是太阳表病，医生反而用吐法，损伤了胃气，表邪乘虚传入阳明。从关上脉细数可知是误吐所致。病在一二日时，表邪尚寒而未化热，吐之则表寒传入胃中，胃中虚寒，所以腹中饥而口不能食。病在三四日时，表邪已传变化热，吐之则表热乘虚入胃，胃中虚热，所以不喜欢喝粥，想吃冷食，早晨吃的晚上吐出来。早晨吃的晚上吐出来，是因为早晨食物入胃，胃气虚弱不能消化，停留久而吐出，可知是医生误吐导致胃虚所致。本太阳病用吐法不为逆，因为邪气传入了阳明，所以称为逆。然而阳明虽为入腑，仍属阳经，所以不称为大逆而称为小逆。）
病愈后再次发热的，用小柴胡汤；脉浮的，用发汗法解表；脉沉的，用攻下法解里。（详细论述见劳复条）
伤寒脉浮滑，这是表有热、里有寒，主方用白虎汤。（前篇说：热结在里，表里俱热的，白虎汤主之。又说：表证未解，不可给予白虎汤。这里说脉浮滑，表有热里有寒，必定是“表里”二字有误。另外阳明一证说：脉浮迟，表热里寒，四逆汤主之。少阴一证说：里寒外热，通脉四逆汤主之。由此可以看出错误很明显。另外阳明篇说：脉滑而疾者，小承气汤主之。既然用承气汤，说明是里热。厥阴篇说：脉滑而厥者，里有热，白虎汤主之。这说明滑脉代表里热是很明显的。况且知母、石膏性皆大寒，岂能用冷水救火？成无己随文解释是不对的。）
白虎汤方
知母（六两） 石膏（一斤） 甘草（二两） 糯米（六合）
以上四味，用水一斗，煮米熟汤成，去渣，温服一升，每日三次。
成无己注：白虎是西方金神，对应秋季，归属于肺。热甚于内的，用寒凉药攻下；热甚于外的，用清凉药解散。如果有内外俱热，内不得泄，外不得发的情况，不用此汤就不能解除。暑气得秋气而止，所以叫处暑。此汤以白虎命名，谓能止热。《内经》说：热邪所胜，佐以苦甘。又说：热邪盛于内，用苦味发散。想要彻底解除表热，必须以苦味为主，所以用知母苦寒为君药。热则伤气，寒以胜之，甘以缓之，热胜其气，必须以甘寒为助，所以用石膏甘寒为臣药。脾苦湿，急食甘以缓之，热气内余，消烁津液，必须以甘平之物缓和其中，所以用甘草、粳米为使药。这是治疗太阳中暍（中暑）的方剂，得此汤则顿除，热见到白虎之气而尽矣。立秋后不可服用白虎汤，因为它是大寒之剂，秋季服用必然导致多为呃逆、虚羸等症状。
李东垣注：人身前面是胃的经络，胸部是胃和肺的居室。邪气在阳明，肺受火克制，所以用辛寒药以清肺，因此号称白虎汤。
张元素注：伤寒表证发热、恶热而渴，与杂病相同。但头痛、身热、目痛、鼻干、不得卧，白虎汤主之，这是阳明经病。正阳阳明气病，脉洪大，先无形质变化。杂病里证发热、恶热而渴，但目赤的，是病在脏。手太阴气不足，不能管领阳气，宜用枸杞、生地黄、熟地黄之类主治。脉洪大甚者则呕血，先有形质变化。气病在里，误用血药，没有伤寒的问题，是为了安血益阴。血病在里，误用气药如白虎汤者，不对，是为了泻肺损阴。
李东垣辨析误服白虎汤后的变证：昔日西台掾葛君瑞，二月中患伤寒发热，用白虎汤主治。病人面色黑如墨，原本的症状随即消失，脉沉细，小便不禁。李东垣起初不知道，诊察后说：这是在立夏以前误服白虎汤。白虎汤大寒，不是行经的药，只能寒凝脏腑，不善使用则会损伤善气。本病隐伏于经络之间，或者投以大热之药以求去除阴邪，其他病症必然兴起，这不是救治白虎汤副作用的方法。可以用温药升阳行经。有人问：白虎汤是大寒之药，不用大热之药怎么能救治？李东垣说：病隐伏在经络间，阳道不升则经脉不行，经脉通行而本证就会显现。果然像他说的那样痊愈了。
张元素注：《活人书》说白虎汤治疗中暑以及发汗后的一剂解表药罢了，不是正统的伤寒药。而且夏季阴气在内，尤其应该戒用白虎汤。但是白虎汤都记载在仲景书中，证治昭然明白，为什么说不是正统的伤寒药呢？况且《伤寒论》说无表证者可给予白虎汤。现在说发汗后是一剂解表药罢了，按法既无表证，有什么可解的呢？又说夏季阴气在内，白虎汤尤其应该戒用。而《明理论》又说立秋后不可服用。秋季阴气已过半，而白虎汤大寒，如果不能禁服，导致呃逆、不能食或虚羸的人很多。夫伤寒之法，有是证则投是药，怎么可以拘泥于时令来治疗呢？假如秋冬之间患伤寒，身无表证而大烦渴，按法合用白虎汤，如果拘泥于时令，怎么下手？如果认为白虎汤是大寒之药，那么承气汤又为何在冬季使用呢？既然说夏季宜戒、秋后不可行，那么什么时候适宜呢？虽然经书说必先岁气，无伐天和，这是常理。假如贼邪变出，阴阳寒热异常，也应当舍时从证，怎么可以拘泥于时令呢？
伤寒脉浮发热、无汗，表证未解的，不可与白虎汤。如果大渴欲饮水、无表证的，主方用白虎加人参汤。（成无己注：伤寒脉浮发热无汗，表证未解且不渴的，宜用麻黄汤；渴的，宜用五苓散，都不是白虎汤所适宜的。大渴欲水且无表证的，才可以与白虎加人参汤以散里热。临病之人尤其要精细辨别。张元素注：经书说可与某汤或说不可与，这是设立法则以御病。又说宜某汤，这是临证审决。说某汤主之，是对证施治。这三者是方法的条目，包藏深理，不是一句话可以详尽叙述的。）
脉浮而迟，表热里寒，下利清谷的，用四逆汤。（论述见下利条）
下利、四肢厥冷、汗出、热不退的，用四逆汤。
少阴病下利清谷、四肢厥冷、里寒外热的，用通脉四逆汤。（方剂论述见下利条）
身热、手足逆冷而脉虚，当夏季发作的是中暑。（论述见中暑条）
伤寒表不解，干呕、发热而咳、下利的，用小青龙去麻黄加芫花汤。（论述见咳条）
太阳与阳明合病，必下利，其证头痛、腰疼、身热、鼻干、脉浮大而长的，宜用葛根汤。（论述见合病条）
发热、下利、脉微迟、四肢厥冷的，用通脉四逆汤。
太阳与少阳合病，自下利，其证头寒、胸满、往来寒热、脉浮大而弦的，宜用黄芩汤。（论述见合病条）
下利清谷、脉沉迟、其人面赤、微热而厥的，必郁冒汗出而自愈。发热、下利、四肢厥冷、躁扰不得卧的，预后不良。
发热而利、汗不止的，预后不良。（两条论述俱见下利条）
发热、吐利、心下痞硬的，用大柴胡汤；渴的，用五苓散；不渴的，用理中汤。（论述并见于痞及吐利门）
发热、月经适来或适断的，用小柴胡汤，刺期门穴。（论述见谵语疟状条）
发热、脉数、消谷善饥、不大便的，有瘀血，宜用抵当汤。（论述见蓄血条）
戴元礼注：诸阳经发热已见前三阳经。阴经不发热，只有少阴能发热。然而少阴发热有两种证候：初得病即见少阴证，发热、恶寒、头不疼，宜用麻黄细辛附子汤。若下利清谷、身热躁扰、里寒外热，仲景称为“反发热”，这是阴盛格阳，宜用四逆汤、附子理中汤。大概阳气传入阴经而下利的是热利，阳陷入里，外所以无热；阴气入阴经而下利的是里寒自利。寒既在里为主，而阳气必客于外，所以外面反而热。要知道阴证发热自然是不同的。发于阳而发热，头必疼；发于阴而发热，头不痛，这是验证。
又，发汗后只恶寒的是虚证，虚乃表虚。发汗后只恶热的是实证，实乃里实。只恶寒的是发汗后或汗出太过，所谓阳微则恶寒，宜用芍药甘草附子汤。只发热的是表已解而里未消，所谓阴微则发热，宜用大柴胡汤或小承气汤。
又有汗下后阴阳不相入、水火不相济，导致余热未退，不可再用冷药，内外都未可，故宜用小建中汤。如果其人已虚，虚能生热，宜用小建中汤加当归一钱，或四君子汤加黄芪半钱，或十全大补汤调和营卫。虚者用四柱汤、真武汤。审察如果是邪热未解，虽然经过汗下却不畏惧虚证而养病，宜用竹叶石膏汤。
洁古注：有汗不得服麻黄，无汗不得服桂枝。然而春夏汗孔疏，虽有汗也不当服桂枝，宜用黄芪汤和解。秋冬汗孔闭，虽无汗也不当服麻黄，宜用川芎汤和解。春夏有汗、脉微而弱、恶风恶寒的，是太阳证兼秋冬之脉，宜用黄芪汤。无汗也用川芎汤。秋冬有汗、脉盛而浮、发热恶热的，是阳明证兼春夏之脉，宜用黄芪汤。无汗也用川芎汤。大抵有汗皆宜黄芪汤，无汗皆宜川芎汤主治。
黄芪汤：有汗则能止之。
白术、黄芪、防风（各等分）。以上切碎，每服五七钱至一两，水煎温服。汗多恶风甚者，加桂枝。
川芎汤：无汗则能发之。
川芎、苍术、羌活（各等分）。以上切碎，每服五七钱至一两，水煎热服。无汗恶风甚者，加麻黄一二钱。
张元素注：神术汤：治疗内伤冷冻饮料、外感寒邪而无汗者。
苍术（制）、防风（各二两）、甘草（一两炒）。以上切碎，加葱白生姜同煎服。如太阳证发热恶寒、脉浮而紧的，加羌活二钱。如太阳证脉浮紧中带弦数的，是兼少阳，加柴胡二钱。如太阳证脉浮紧中带洪的，是兼阳明，加黄芩二钱。妇人服者加当归，或加木香汤，或加藁本汤各二钱。如治吹乳（乳腺炎），煎调六一散三五钱，神效。
又是神术六气加减例：
太阳寒水司天：加羌活、桂枝。其余年份非时变寒亦加。冬季亦加。
阳明燥金司天：加白芷、升麻。其余年份非时变凉湿亦加。秋季亦加。
少阳相火司天：加黄芩、地黄。其余年份非时变雨湿亦加。夏季亦加。
太阴湿土司天：加白术、藁本。其余年份非时变热湿亦加。夏末秋初亦加。
少阴君火司天：加细辛、独活。其余年份非时变热亦加。夏末夏初亦加。
厥阴风木司天：加川芎、防风。其余年份非时变温和亦加。夏季亦加。
以上神术汤六气加减法，不仅仅是为了司天之气设立的。至于岁之主气与月建日时相同应见的，都应当随听见根据上例加减。按张元素此论与戴元礼所说“病如不是当年气，看与何年运气同，便向此中求”，妙法方知皆在《至真要大论》中。表里实发前人之所未发。盖张元素此论所谓某气司天加某药者，是治常气之法。所谓随所应见加减者，是治变气之法。戴元礼所谓看与何年同气求治法者，也是治变气之法。能将二公之法扩充行之，则《内经》运气之本义灿然矣。夫同经纶运气，有常气，有变气。常气者有定纪，如某年属某气司天当寒，某年属某气司天当热，是也。变气者无定纪，如某年属某气司天当寒反热，当热反寒，是也。王氏注文释以经无定纪之变气作有定纪之常气，使后学人都以年岁占运气，而其应验者十无一二，是以人莫之信，其道湮晦久矣。二公生于数千百里之后，复启其端而续之，与程朱续孔孟不传之绪同功也。今仆谨于海藏逐年司天加药之后，申明余岁变常之义，同志者幸究心焉。
白术汤：治疗内伤冷物、外感风寒而有汗者。
白术（三两）、防风（二两）、甘草（一两炙）。以上切碎，每服五钱，水一盏，姜三片，煎至七分，温服。一日止一二服，待二三日渐渐汗少为解。
又白术汤：治疗伤寒上解三阳，下安太阴。
白术（如汗之改用苍术）、防风（各二两）。每服五钱，水煎七分，温服。用后方加减。
若发热引饮，加黄芩甘草；头疼恶风者，加羌活散三钱（羌活一两半、川芎七钱、细辛二钱半，去芦）。
若身热目痛者，加石膏汤四钱（石膏二两、知母半两、白芷七钱）。
腹中痛，加芍药汤三钱（芍药二两、桂枝半两）。
往来寒热而呕者，加柴胡散三钱（柴胡一两、半夏半两）。
心下痞，加枳实一钱。
若有里证，加大黄一钱，次二钱，又次三钱，邪去止之。
洁古云：有汗不得服麻黄，无汗不得服桂枝。如果未痊愈，则其变不可胜言，故立此法使不犯三阳禁忌，解表神方。
九味羌活汤：（陶尚文注云：不问四时，但有头疼骨节痛、发热恶寒、无汗、脉浮紧的，宜用此汤以代麻黄为稳当。如头痛发热恶风、自汗、脉浮缓的，宜用加减冲和汤，即羌活汤中减苍术、细辛，加白术、黄芪，是也。）
(Fa Re [Fever] refers to heat that persists without cessation. Han Re [Chills and Fever] refers to chills followed by fever, and fever followed by chills, occurring alternately. Chao Re [Tidal Fever] refers to fever that occurs at specific times and ceases at specific times, like the tide, without missing its schedule. If there is fever without aversion to cold accompanied by thirst, this is Wen Bing (Warm Disease). If body temperature becomes burning hot after sweating, this is Feng Wen (Wind-Warmth). If there is fever with slight coldness of the hands or feet and diarrhea with undigested food, this is Yin Zheng (Yin Syndrome). If there is hematochezia, qi stagnation, cold limbs, yet accompanied by fever, this indicates that the deeper the heat, the deeper the cold limbs (Re Shen Jue Ye Shen). Headache, fever, aversion to cold, but no body pain, indicates Shang Shi Zheng (Food Injury Syndrome). No aversion to cold, no body pain, no headache, and a non-tight pulse indicate it is not Li Shi (Interior Excess). Only feeling vexatious heat indicates Xu Fan (Deficiency Vexation).
If fever appears immediately with Zhong Feng (Wind Strike), it is because wind pathogen has injured the Wei (Defensive) level. If fever does not appear immediately with Shang Han (Cold Damage), it is because cold pathogen has injured the Ying (Nutritive) level. The Classics state: In the first or second day of Shang Han, some have already developed fever, while others have not; this is the case. Whenever there is Xi Xi Fa Re (feeling warm as if covered by feathers) accompanied by aversion to wind, aversion to cold, headache, and a floating pulse, it belongs to Biao Zheng (Exterior Syndrome). This is caused by wind-cold pathogens lodging in the skin, causing Yang Qi to be constrained and depressed; it should be treated with diaphoresis. If urine is yellow, the disease is not on the exterior. Whenever there is Zheng Zheng Fa Re (steaming fever radiating from within) accompanied by delirium, constipation, dark urine, abdominal fullness, aversion to heat, and a slippery-excess pulse, it belongs to Li Re (Interior Heat). This is caused by Yang Qi sinking into the Yin; it should be treated with purgation. If urine is clear, the disease is not on the interior. Fever occurring in the Shao Yin (Lesser Yin) and Jue Yin (Terminal Yin) meridians is called Fan Fa Re (Counter Fever); only the Tai Yin (Greater Yin) meridian does not present with fever. If the pulse is excess at all three positions (Cun, Guan, Chi) and fever does not cease, the prognosis is poor. If there is diarrhea with fever, fever recurs after sweating, the pulse is rapid and restless and does not subside with sweating, there is delirium and inability to eat, this indicates a separation of Yin and Yang, and the prognosis is poor.
The Lan Tai Zhi Li states: When pathogens are in the Three Yang meridians, Tai Yang syndrome often resembles tidal fever but differs; when pathogens are in the Three Yin meridians, Shao Yin syndrome often resembles restlessness but differs.
Fever, aversion to cold, and a floating pulse belong to the Exterior, i.e., Tai Yang Syndrome. (Formula discussions see Tai Yang Disease section.)
Fever, sweating, no aversion to cold but aversion to heat belong to the Interior, i.e., Yang Ming Syndrome. (Formula discussions see Spontaneous Sweating section.)
Fever, wiry-thin pulse, and headache belong to Half-Exterior Half-Interior, i.e., Shao Yang Syndrome. (Discussions see Bitter Taste and Dry Throat section.)
Fever with vomiting is treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction). (Discussions see Vomiting section.)
Fever with cough and unresolved exterior syndrome is treated with Xiao Qing Long Tang (Minor Blue Dragon Decoction); if accompanied by hypochondriac pain and frequent belching/vomiting, it is treated with Xiao Chai Hu Tang plus Gan Jiang (Dried Ginger) and Wu Wei Zi (Schisandra). (Formula discussions see Cough section.)
Fever with wheezing and unresolved exterior syndrome is treated with Xiao Qing Long Tang minus Ma Huang (Ephedra) plus Xing Ren (Apricot Seed); if accompanied by chest fullness, it is treated with Ma Huang Tang (Ephedra Decoction). (Formula discussions see Wheezing section.)
Fever with thirst may belong to the Exterior or the Interior; treatment methods and formulas are numerous. (See the Thirst section.)
After fever resolves through sweating, if restlessness recurs after half a day, and the pulse is floating, rapid, and large, diaphoresis may be applied again, preferably Gui Zhi Tang (Cinnamon Twig Decoction). (Detailed discussion see Vexation section.)
After sweating, if aversion to wind and cold persists, it is due to deficiency; if there is no aversion to cold but only aversion to heat, it is an excess condition. One should harmonize the Stomach Qi, preferably using Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction). (The Classics state: After sweating, if there is no aversion to cold, the exterior is resolved but the interior is not harmonized; give Tiao Wei Cheng Qi Tang to harmonize the Stomach Qi.)
In Tai Yang Disease, if after three days and sweating the disease is unresolved and steaming fever appears, the pathology is in the Stomach; Tiao Wei Cheng Qi Tang is the primary formula. (Haizang annotation: Da Huang (Rhubarb) drains excess, Mang Xiao (Mirabilite) softens hardness, Gan Cao (Licorice) harmonizes the middle. It can only be used when all three conditions—dryness, excess, and hardness—are present.)
**Tiao Wei Cheng Qi Tang Formula**
Da Huang (1 liang, Haizang annotation: Preferably soaked in wine. Since pathogens reside high, wine is needed to reach them, just as one must shoot to retrieve items from high places. Soaking in wine guides the medicine upward. If used raw, its bitter-draining nature is too harsh and may leave high pathogens behind, leading to post-recovery symptoms like red eyes, throat closure, or head swelling. Thus, wine soaking is used to guide upwards.)
Gan Cao (Ban liang, roasted, Haizang annotation: Sweetness relieves urgency.)
Mang Xiao (9 qian, Haizang annotation: Pungency moistens, saltiness softens.)
Crush the above ingredients, add one cup of water, boil Da Huang and Gan Cao to 70%, remove dregs, add Mang Xiao, boil briefly until boiling, and take warm in small amounts frequently.
Cheng Wuji annotation: The *Nei Jing* states: "When heat dominates internally, treat with salty-cold substances, assisted by bitter-sweet." Mang Xiao is salty-cold to remove heat; Da Huang is bitter-cold to purge excess; Gan Cao is sweet-neutral to assist the two herbs in pushing out the old and easing the middle.
Fever, sweating without resolution, epigastric stiffness/fullness, vomiting, and diarrhea are treated with Da Chai Hu Tang. (Discussions see Epigastric Fullness section.)
After sweating, if the body feels burning hot, pulse is floating, there is sweating, heaviness of the body, somnolence, and snoring, it is Feng Wen (Wind-Warmth). (Discussions see Wind-Warmth section.)
After sweating, if fever persists, palpitations occur, dizziness arises, the body trembles, and there is a sensation of wanting to fall, Zhen Wu Tang (True Warrior Decoction) is appropriate. (Discussions see Diarrhea section.)
If sweating leads to persistent heat, internal cramping, limb pain, diarrhea, cold limbs, and aversion to cold, Si Ni Tang (Frigid Extremities Decoction) is appropriate. (Discussions see Diarrhea section.)
If massive sweating occurs, the pulse is excess at all three positions, and the disease is unresolved, the prognosis is poor. (*Nei Jing* states: In Warm Disease, if sweating is thorough but fever returns, the pulse is rapid and restless and does not subside with sweating, there is delirium and inability to eat, this is called "Yin-Yang Intersection," which is fatal.)
In Tai Yang Disease, if initial sweating fails to resolve the disease and purgation is subsequently used, and the pulse remains floating, the disease is not cured. A floating pulse indicates the pathogen is still on the exterior; using purgation against this causes failure to cure. Since the pulse is now floating, we know the pathogen is still on the exterior; one must release the exterior to achieve cure, primarily using Gui Zhi Tang (Cinnamon Twig Decoction).
After sweating and purgation, if headache, fever, epigastric fullness, and dysuria persist, Gui Zhi Qu Gui Jia Fu Ling Bai Zhu Tang (Cinnamon Twig Decoction minus Cinnamon Twig plus Poria and Atractylodes Macrocephala Decoction) is used. (Discussions see Chest Binding section.)
After massive purgation, if body heat persists and there is a knotted pain in the heart region, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is the primary formula. (Discussions see Heart section.)
After massive purgation, if body heat persists and there is slight vexation, Zhi Zi Gan Jiang Tang (Gardenia and Dried Ginger Decoction) is used. (Formula discussions see Vexation section.)
In Yang Ming Disease, after purgation, if there is external heat, warm hands and feet, mental anguish (Ao Nao), hunger but inability to eat, and only head sweating, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is used. (Discussions see Vexation section.)
In Tai Yang Disease, one should expect aversion to cold and fever. Now, if there is spontaneous sweating, no aversion to cold, fever, and a fine-rapid pulse at the Guan position, this is due to the error of emesis. If emesis was induced on days 1-2, there is hunger in the abdomen but inability to eat; if induced on days 3-4, there is dislike for congee and desire for cold food, with morning food vomited in the evening. These are caused by erroneous emesis and are termed "Minor Deviation" (Xiao Ni). (Cheng Wuji annotation: Aversion to cold and fever are Tai Yang exterior signs. Spontaneous sweating, no aversion to cold, and fever are Yang Ming signs. Originally a Tai Yang exterior disease, the physician erroneously used emesis, damaging Stomach Qi and allowing exterior pathogens to transmit to Yang Ming. The fine-rapid Guan pulse indicates this error. On days 1-2, exterior pathogens were cold and untransformed; emesis transmitted cold to the Stomach, causing deficiency-cold, hence hunger but inability to eat. On days 3-4, exterior pathogens had transformed into heat; emesis transmitted heat to the Stomach, causing deficiency-heat, hence dislike for congee and desire for cold food. Morning food vomited in the evening indicates Stomach deficiency failing to digest food retained over time. This confirms the physician's error. Emesis in Tai Yang is not a deviation per se, but transmission to Yang Ming makes it a deviation. However, since Yang Ming is still a Yang meridian, it is a "Minor Deviation" rather than "Major Deviation.")
If fever recurs after recovery, use Xiao Chai Hu Tang (Minor Bupleurum Decoction). If the pulse is floating, resolve via sweating; if sinking, resolve via purgation. (Detailed discussion see Labor Recurrence section.)
Shang Han with a floating-slippery pulse indicates exterior heat and interior cold; Bai Hu Tang (White Tiger Decoction) is the primary formula. (Previous chapter stated: Heat knotting in the interior with exterior-interior heat uses Bai Hu Tang. Also: If exterior is unresolved, do not give Bai Hu Tang. Here, floating-slippery pulse with exterior heat and interior cold suggests a textual error in "exterior-interior." Another Yang Ming case states: Floating-slow pulse, exterior heat interior cold, uses Si Ni Tang. Another Shao Yin case states: Interior cold exterior heat, uses Tong Mai Si Ni Tang. This clarifies the error. Also, Yang Ming chapter states: Slippery-rapid pulse uses Xiao Cheng Qi Tang, indicating interior heat. Jue Yin chapter states: Slippery pulse with cold limbs indicates interior heat, treated with Bai Hu Tang. This clearly shows slippery pulse indicates interior heat. Moreover, Zhi Mu and Shi Gao are both very cold; how can water be used to extinguish water? Cheng Wuji's interpretation following the text is incorrect.)
**Bai Hu Tang Formula**
Zhi Mu (6 liang), Shi Gao (1 jin), Gan Cao (2 liang), Nu Mi (6 he).
Boil these four ingredients in 10 cups of water until the rice is cooked and the decoction is ready. Strain, take 1 sheng warm, three times daily.
Cheng Wuji annotation: Bai Hu is the Metal Spirit of the West, corresponding to Autumn and belonging to the Lung. For heat severe internally, use cold-purgatives; for heat severe externally, use cooling-resolvers. If there is heat both inside and outside, unable to vent inward or emit outward, this decoction is required to resolve it. Summer heat stops with Autumn air, hence "End of Heat" (Chu Shu). Named Bai Hu (White Tiger) because it can stop heat. *Nei Jing* states: "When heat dominates, assist with bitter-sweet." And: "Heat dominating internally, use bitter to disperse." To thoroughly resolve exterior heat, bitterness is primary; thus, Zhi Mu (bitter-cold) is the Sovereign herb. Heat damages Qi; cold conquers heat, sweetness moderates. To assist in overcoming heat-damaged Qi, use sweet-cold; thus, Shi Gao (sweet-cold) is the Minister herb. Spleen dislikes dampness; urgently eat sweet to moderate. Internal residual heat consumes fluids; use sweet-neutral substances to moderate the middle; thus, Gan Cao and Jing Mi (Rice) are the Envoys. This treats Tai Yang Zhong Shu (Sunstroke). With this decoction, heat is instantly removed, disappearing like the White Tiger. Do not use Bai Hu Tang after Start of Autumn, as it is a major cold agent; Autumn use causes hiccups, deficiency, and emaciation.
Li Dongyuan annotation: The anterior part of the body is the pathway of the Stomach meridian; the chest is the chamber of the Stomach and Lung. Pathogens in Yang Ming constrain the Lung with Fire; thus, pungent-cold herbs clear the Lung, earning the name Bai Hu Tang.
Zhang Yuansu annotation: Exterior syndrome fever, aversion to heat, and thirst in Shang Han are similar to miscellaneous diseases. However, headache, body heat, eye pain, nasal dryness, and insomnia are treated with Bai Hu Tang; this is Yang Ming Meridian disease. Positive Yang Yang Ming Qi disease presents with a洪大 (Huge-Large) pulse, initially formless. Miscellaneous disease interior syndrome fever, aversion to heat, and thirst with red eyes indicate disease in the Zang organs. Insufficiency of Hand Tai Yin Qi fails to manage Yang Qi; treat with Gou Qi, Sheng Di Huang, Shu Di Huang. Pulse huge-large with vomiting blood indicates prior formation of form. Qi disease in the interior misusing Blood medicines addresses An Xue Yi Yin (calming blood and benefiting Yin). Blood disease in the interior misusing Qi medicines like Bai Hu Tang is incorrect, as it clears Lung and damages Yin.
Li Dongyuan discusses complications of mistaken Bai Hu Tang use: Formerly, Ge Junrui suffered Shang Han fever in mid-spring, treated with Bai Hu Tang. His face turned black as ink, original symptoms vanished, pulse became deep-fine, and urination was incontinent. Li Dongyuan initially did not understand, but upon diagnosis said: This was mistaken Bai Hu Tang use before Start of Summer. Bai Hu Tang is major-cold, not a meridian-moving drug; it only freezes the Zang-Fu. Misuse injures beneficial Qi. The original disease hides in the meridians. One might try major-hot drugs to remove Yin pathogens, but other syndromes would arise, failing to rescue the Bai Hu Tang side effects. Use warm drugs to raise Yang and move meridians. Question: How can major-hot drugs rescue major-cold injury? Answer: Disease hides in meridians; if Yang Dao does not rise, meridians do not flow. Once meridians flow, original symptoms reappear. He healed exactly as predicted.
Zhang Yuansu annotation: *Huo Ren Shu* says Bai Hu Tang treats Zhong Shu (Sunstroke) and is merely a post-sweating exterior-resolving agent, not a proper Shang Han drug. Especially in summer, when Yin Qi is internal, Bai Hu Tang should be strictly avoided. Yet Bai Hu Tang is recorded in Zhang Zhongjing's works with clear indications. Why call it improper? *Shang Han Lun* states those without exterior syndrome may receive Bai Hu Tang. Now saying it is merely a post-sweating exterior resolver contradicts the law: if no exterior syndrome exists, what is to be resolved? Also, *Ming Li Lun* states do not use after Start of Autumn. Autumn Yin Qi is half-present; Bai Hu Tang is major-cold. Failure to avoid it causes hiccups, anorexia, or deficiency. Shang Han law dictates treating according to syndrome, not season. If in winter/autumn one has Shang Han without exterior syndrome but with great vexation/thirst, Bai Hu Tang is indicated. Clinging to season prevents treatment. If Bai Hu Tang is major-cold, why use Cheng Qi in winter? If summer avoids it and autumn forbids it, when is it suitable? Although *Jing* says respect seasonal Qi and do not violate Heaven's Harmony, this is the general rule. If treacherous pathogens cause abnormal Yin-Yang/Cold-Heat, one must abandon season for syndrome.
Shang Han with floating pulse, fever, no sweat, and unresolved exterior cannot receive Bai Hu Tang. If there is great thirst for water and no exterior syndrome, Bai Hu Jia Ren Shen Tang (White Tiger Plus Ginseng Decoction) is primary. (Cheng Wuji annotation: Floating pulse, fever, no sweat, unresolved exterior without thirst suits Ma Huang Tang; with thirst suits Wu Ling San, not Bai Hu Tang. Great thirst for water without exterior syndrome allows Bai Hu Jia Ren Shen Tang to scatter interior heat. Clinicians must distinguish carefully. Zhang Yuansu annotation: Classics say "may give" or "do not give" to set rules for disease defense; "suitable for" implies clinical judgment; "primary formula" implies targeted treatment. These three are method categories containing deep principles, not fully explicable in one sentence.)
Floating-slow pulse, exterior heat interior cold, diarrhea with undigested food: Si Ni Tang (Frigid Extremities Decoction). (Discussions see Diarrhea section.)
Diarrhea, cold limbs, sweating, persistent heat: Si Ni Tang.
Shao Yin Disease with diarrhea, undigested food, cold limbs, interior cold exterior heat: Tong Mai Si Ni Tang (Pulse-Recovering Frigid Extremities Decoction). (Formula discussions see Diarrhea section.)
Body heat, cold limbs, deficient pulse, occurring in summer: Zhong Shu (Sunstroke). (Discussions see Sunstroke section.)
Shang Han with unresolved exterior, dry retching, fever, cough, diarrhea: Xiao Qing Long Tang minus Ma Huang plus Yuan Hua (Genkwa). (Discussions see Cough section.)
Tai Yang and Yang Ming Combined Disease with inevitable diarrhea, headache, back pain, body heat, nasal dryness, floating-large-long pulse: Ge Gen Tang (Kudzu Decoction). (Discussions see Combined Disease section.)
Fever, diarrhea, micro-slow pulse, cold limbs: Tong Mai Si Ni Tang.
Tai Yang and Shao Yang Combined Disease with spontaneous diarrhea, cold head, chest fullness, alternating chills/fever, floating-large-wiry pulse: Huang Qin Tang (Scutellaria Decoction). (Discussions see Combined Disease section.)
Diarrhea with undigested food, deep-slow pulse, red face, slight heat, cold limbs: Must have Yu Mao (depression/dizziness) with sweating for self-resolution. Fever, diarrhea, cold limbs, restlessness, inability to lie down: Poor prognosis.
Fever with diarrhea and incessant sweating: Poor prognosis. (Both discussions see Diarrhea section.)
Fever, vomiting/diarrhea, epigastric stiffness: Da Chai Hu Tang (Major Bupleurum Decoction). With thirst: Wu Ling San (Five-Ingredient Powder with Poria). Without thirst: Li Zhong Tang (Regulate the Middle Decoction). (Discussions see Epigastric Fullness and Vomiting/Diarrhea sections.)
Fever with menstruation arriving or stopping: Xiao Chai Hu Tang (Minor Bupleurum Decoction) and puncture Qi Men (Liver 14). (Discussions see Delirium/Malaria-like Symptoms section.)
Fever, rapid pulse, excessive digestion, constipation: Blood stasis; Di Dang Tang (Assault the Accumulation Decoction) is appropriate. (Discussions see Blood Accumulation section.)
Dai Yuanli annotation: All Yang meridians show fever as seen in the Three Yang. Yin meridians do not show fever, except Shao Yin. However, Shao Yin fever has two patterns: Immediate Shao Yin syndrome with fever, aversion to cold, no headache: Ma Huang Xi Xin Fu Zi Tang (Ephedra, Asarum, and Aconite Decoction). If diarrhea with undigested food, body heat, restlessness, interior cold exterior heat: Zhang Zhongjing calls this "Counter Fever," caused by Yin excess repelling Yang; use Si Ni Tang or Fu Zi Li Zhong Tang. Generally, Yang Qi transmitting to Yin meridian causing diarrhea is Heat Diarrhea (Yang sinks inside, so no external heat). Yin Qi entering Yin meridian causing diarrhea is Interior Cold Self-Draining. Cold dominates inside, so Yang guests outside, causing external heat. Know that Yin syndrome fever is different. Fever originating in Yang causes headache; fever originating in Yin does not cause headache; this is a verification.
Also, after sweating, only aversion to cold indicates deficiency (Exterior Deficiency). After sweating, only aversion to heat indicates excess (Interior Excess). Only aversion to cold results from excessive sweating ("Yang Micro leads to aversion to cold"); use Shao Yao Gan Cao Fu Zi Tang (Peony, Licorice, and Aconite Decoction). Only fever indicates exterior resolved but interior not cleared ("Yin Micro leads to fever"); use Da Chai Hu Tang or Xiao Cheng Qi Tang.
After sweating and purgation, if Yin-Yang do not enter each other and Water-Fire do not harmonize, leaving residual heat, do not use cold drugs; neither interior nor exterior is ready, so use Xiao Jian Zhong Tang (Minor Construct the Middle Decoction). If the person is already deficient, deficiency generates heat; use Xiao Jian Zhong Tang plus Dang Gui (Angelica Sinensis) or Si Jun Zi Tang (Four Gentlemen Decoction) plus Huang Qi (Astragalus), or Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) to harmonize Ying-Wei. For deficiency, use Si Zhu Tang or Zhen Wu Tang. If determining it is unresolved pathogenic heat, despite sweating/purgation, do not fear deficiency but nourish the disease; use Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction).
Song-Yuan Experts' Treatment Examples for Exterior Fever
Jiegu annotation: Those with sweat should not take Ma Huang; those without sweat should not take Gui Zhi. However, in Spring/Summer, pores are loose; even with sweat, Gui Zhi is inappropriate; use Huang Qi Tang (Astragalus Decoction) to harmonize. In Autumn/Winter, pores are closed; even without sweat, Ma Huang is inappropriate; use Chuan Xiong Tang (Ligusticum Decoction) to harmonize. Spring/Summer with sweat, micro-weak pulse, aversion to wind/cold: Tai Yang syndrome with Autumn/Winter pulse; use Huang Qi Tang. Without sweat, also use Chuan Xiong Tang. Autumn/Winter with sweat, strong-floating pulse, fever, aversion to heat: Yang Ming syndrome with Spring/Summer pulse; use Huang Qi Tang. Without sweat, also use Chuan Xiong Tang. Generally, with sweat suit Huang Qi Tang; without sweat suit Chuan Xiong Tang.
**Huang Qi Tang**: Stops sweat.
Bai Zhu, Huang Qi, Fang Feng (equal parts). Crush, take 5-7 qian to 1 liang, decoct in water, take warm. If sweat is profuse with severe aversion to wind, add Gui Zhi.
**Chuan Xiong Tang**: Releases sweat.
Chuan Xiong, Cang Zhu, Qiang Huo (equal parts). Crush, take 5-7 qian to 1 liang, decoct in water, take hot. If no sweat with severe aversion to wind, add Ma Huang 1-2 qian.
Zhang Yuansu annotation: Shen Shu Tang: Treats internal injury from cold drinks and external cold pathogen without sweat.
Zhi Cang Zhu, Fang Feng (2 liang each), Chao Gan Cao (1 liang). Crush, decoct with Cong Bai (Green Onion White) and Sheng Jiang (Fresh Ginger). If Tai Yang syndrome with fever, aversion to cold, floating-tight pulse, add Qiang Huo 2 qian. If floating-tight with wiry-rapid pulse, combined Shao Yang, add Chai Hu 2 qian. If floating-tight with surging pulse, combined Yang Ming, add Huang Qin 2 qian. For women, add Dang Gui, or Mu Xiang Tang, or Gao Ben Tang 2 qian each. For mastitis, mix Liu Yi San 3-5 qian, miraculous effect.
Six Qi Additions/Subtractions for Shen Shu Tang:
Tai Yang Han Shui Si Tian: Add Qiang Huo, Gui Zhi. Other years with abnormal cold also add. Winter also add.
Yang Ming Zao Jin Si Tian: Add Bai Zhi, Sheng Ma. Other years with abnormal cool/damp also add. Autumn also add.
Shao Yang Xiang Huo Si Tian: Add Huang Qin, Di Huang. Other years with abnormal rain/damp also add. Summer also add.
Tai Yin Shi Tu Si Tian: Add Bai Zhu, Gao Ben. Other years with abnormal heat/damp also add. Late Summer/Early Autumn also add.
Shao Yin Jun Huo Si Tian: Add Xi Xin, Du Huo. Other years with abnormal heat also add. Late Summer/Early Summer also add.
Jue Yin Feng Mu Si Tian: Add Chuan Xiong, Fang Feng. Other years with abnormal mild/warm also add. Summer also add.
These Six Qi additions/subtractions are not only for Si Tian Qi. They apply to Year Master Qi, Month, Day, and Hour correspondences. See Zhang Yuansu's theory with Dai Yuanli's "If the disease does not match the current year's Qi, find which year's Qi matches and seek treatment here." This reveals the essence of *Zhi Zhen Yao Da Lun*. Their theory on exterior-interior development surpasses predecessors. Zhang Yuansu's "Add herb for Si Tian Qi" treats Constant Qi; "Add/Subtract based on appearance" treats Variable Qi. Dai Yuanli's "Match year Qi" also treats Variable Qi. Expanding these methods clarifies *Nei Jing*运气 (Yun Qi) principles. Yun Qi has Constant Qi (fixed cycles, e.g., certain years cold/hot) and Variable Qi (no fixed cycle, e.g., expected cold turns hot). Wang Shi's commentary confused Variable Qi with Constant Qi, causing students to rely on year prediction with low accuracy, leading to loss of faith and obscurity of the doctrine. These two scholars revived it after millennia, akin to Cheng-Zhu reviving Confucius-Mencius. I respectfully clarify the meaning of Variable Qi after Haizang's annual additions for colleagues to study.
**Bai Zhu Tang**: Treats internal injury from cold food and external wind-cold with sweat.
Bai Zhu (3 liang), Fang Feng (2 liang), Zhi Gan Cao (1 liang). Crush, take 5 qian, 1 cup water, 3 slices ginger, boil to 70%, take warm. 1-2 times daily. Wait 2-3 days for gradual reduction of sweat as resolution.
**Another Bai Zhu Tang**: Treats Shang Han by resolving Three Yang above and calming Tai Yin below.
Bai Zhu (use Cang Zhu if sweating), Fang Feng (2 liang each). Take 5 qian, decoct to 70%, take warm. Modify as follows:
If fever with thirst, add Huang Qin Gan Cao; headache/aversion to wind, add Qiang Huo San 3 qian (Qiang Huo 1.5 liang, Chuan Xiong 7 qian, Xi Xin 2.5 qian, remove roots).
If body heat/eye pain, add Shi Gao Tang 4 qian (Shi Gao 2 liang, Zhi Mu 0.5 liang, Bai Zhi 7 qian).
If abdominal pain, add Shao Yao Tang 3 qian (Shao Yao 2 liang, Gui Zhi 0.5 liang).
If alternating chills/fever with vomiting, add Chai Hu San 3 qian (Chai Hu 1 liang, Ban Xia 0.5 liang).
If epigastric fullness, add Zhi Shi 1 qian.
If interior syndrome exists, add Da Huang 1 qian, then 2 qian, then 3 qian; stop when pathogen is gone.
Jiegu stated: No Ma Huang with sweat; no Gui Zhi without sweat. If unresolved, variations are countless. Thus, this method avoids Three Yang taboos, a divine exterior-resolving formula.
**Jiu Wei Qiang Huo Tang**: (Tao Shangwen annotation: Regardless of season, if headache, bone/joint pain, fever, aversion to cold, no sweat, floating-tight pulse exist, use this instead of Ma Huang for stability. If headache, fever, aversion to wind, spontaneous sweat, floating-slow pulse, use Modified Chong He Tang, i.e., Qiang Huo Tang minus Cang Zhu/Xi Xin plus Bai Zhu/Huang Qi.)