伤寒二三日。心中悸而烦者。小建中汤主之。
伤寒里虚则悸。邪扰则烦。二三日悸而烦者。正虚不足。而邪欲入内也。是不可攻其邪。但与小
建中汤温养中气。中气立则邪自解。即不解。而攻取之法。亦可因而施矣。仲景御变之法如此。谁谓伤
寒非全书哉。
小建中汤方
桂枝（去皮） 炙甘草 生姜（各三两） 芍药（六两） 胶饴（一升） 大枣（十二枚擘）
上五味。以水七升。煮取三升。去滓。纳胶饴。更上微火消解。温服一升。日三服。
伤寒脉结代。心动悸。炙甘草汤主之。
脉结代者。邪气阻滞而营卫涩少也。心动悸者。神气不振而都城震惊也。是虽有邪气。而攻取
之法。无所施矣。故宜人参、姜、桂。以益卫气。胶、麦、麻、地、甘枣。以益营气。营卫既充。脉
复神完。而后从而取之。则无有不服者矣。此又扩建中之制。为阴阳并调之法如此。今人治病。不
问虚实。概与攻发。岂知真气不立。病虽去。亦必不生。况病未必去耶。
炙甘草汤方 一名复脉汤。
甘草（四两炙） 生姜（三两） 桂枝（三两去皮） 人参（二两） 阿胶（二两）
麦冬（半升去心） 生地（一斤） 麻仁（半升） 大枣（三十枚）
上九味。以清酒七升。水八升。先煮八味。取三升。去滓。内胶。烊消尽。温服一升。日三服。
伤寒病经过两三天，出现心中悸动且心烦的症状，应当用小建中汤主治。
伤寒导致里气虚弱则会出现心悸，邪气扰动则会出现心烦。发病两三天后出现心悸和心烦，说明正气虚损不足，而邪气正要向内侵入。此时不可攻伐邪气，只宜给予小建中汤以温养中焦之气。中气确立稳固，邪气自然解除；即使不能解除，攻邪的方法也可以随后顺势施用了。张仲景应对病情变化的方法就是如此。谁说《伤寒论》不是完备的著作呢？
小建中汤方剂组成：
桂枝（去皮）、炙甘草、生姜（各三两）、芍药（六两）、胶饴（一升）、大枣（十二枚，掰开）。
以上五味药，用水七升，煎煮至三升，滤去药渣，加入胶饴，再用微火加热使其溶解。每次温服一升，每日服用三次。
伤寒脉象出现结代（脉搏间歇不齐），伴有心悸不安，应当用炙甘草汤主治。
脉象结代，是因为邪气阻滞导致营气和卫气涩滞亏少。心动悸，是因为神气不振导致心脏（都城）受到震惊。这种情况虽然有邪气存在，但攻伐邪气的方法已无法施用。因此适宜用人参、姜、桂来补益卫气，用阿胶、麦冬、麻仁、地黄、甘草、大枣来补益营气。待营卫之气充盈，脉象恢复，神气完备之后，然后再顺势攻邪，就没有不治愈的了。这又是建立在小建中汤基础上的变制，是阴阳并调的治疗方法。如今的人治病，不分虚实，一概使用攻散发汗的方法，哪里知道真气如果不确立，即使病邪去除，人也必然难以生存，何况病邪未必能去除呢？
炙甘草汤方剂组成，又名复脉汤。
甘草（四两，炙）、生姜（三两）、桂枝（三两，去皮）、人参（二两）、阿胶（二两）、麦冬（半升，去心）、生地（一斤）、麻仁（半升）、大枣（三十枚）。
以上九味药，用清酒七升、水八升，先煎煮前八味药，取汁三升，滤去药渣，加入阿胶，烊化消尽。每次温服一升，每日服用三次。
After two or three days of contracting a cold-pathogen disease, if the patient experiences palpitations and irritability, Xiao Jianzhong Tang (Minor Construct the Middle Decoction) should be administered.
Interior deficiency in cold-pathogen diseases leads to palpitations, while pathogenic disturbance causes irritability. The occurrence of palpitations and irritability within two or three days indicates that the healthy qi is deficient and insufficient, and the pathogen is attempting to penetrate inward. At this stage, attacking the pathogen is contraindicated; instead, one should administer only Xiao Jianzhong Tang to warm and nourish the middle jiao qi. Once the middle qi is established and stable, the pathogen will resolve spontaneously; even if it does not resolve completely, methods for attacking the pathogen can then be applied subsequently. This is how Zhang Zhongjing managed variations in disease progression. Who would claim that Shanghan Lun (Treatise on Cold Pathogenic Diseases) is not a comprehensive work?
Formula: Xiao Jianzhong Tang (Minor Construct the Middle Decoction)
Guizhi (Cinnamon Twig, peeled), Zhi Gancao (Honey-fried Licorice Root), Shengjiang (Fresh Ginger, each 3 liang), Shaoyao (White Peony Root, 6 liang), Jiaoyi (Malt Sugar, 1 sheng), Dazao (Jujube, 12 pieces, split).
Take the above five herbs. Add seven sheng of water, decoct until three sheng remain, strain out the dregs, add the Jiaoyi (Malt Sugar), and gently heat over a low fire until dissolved. Take one sheng warm, three times daily.
In cold-pathogen diseases, if the pulse presents as knotted and intermittent (Jie Dai Mai) accompanied by palpitations, Zhi Gancao Tang (Honey-fried Licorice Decoction) should be administered.
A knotted and intermittent pulse indicates that pathogenic factors are obstructing the flow, causing Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) to become stagnant and deficient. Palpitations indicate that the Shen Qi (Spiritual Qi) is weak, causing alarm in the "Capital City" (the Heart). In such cases, although pathogenic factors exist, methods for directly attacking them cannot be effectively employed. Therefore, it is appropriate to use Renshen (Ginseng Root), Shengjiang (Fresh Ginger), and Guizhi (Cinnamon Twig) to tonify Wei Qi (Defensive Qi), and Ejiao (Donkey-hide Gelatin), Maidong (Ophiopogon Tuber), Mahuang Ren (Ephedra Seed - *Note: Text says Mahuang Ren/Ma Ren, usually Sesame seed in modern context but here likely refers to Hemp seed or Ephedra seed depending on interpretation, WHO standard for Ma Ren is Cannabis Fructus/Semen Cannabis, but historically in this formula it is often interpreted as Hemp Seed/Huomaren. However, strict text says Ma Ren. In Zhi Gancao Tang, it is traditionally Huomaren (Semen Cannabis). I will use Semen Cannabis (Huomaren) as per standard pharmacopeia for this specific herb name in this context, or stick to literal translation if ambiguous. Given "Ma Ren" in ancient texts often refers to Hemp Seed in this formula, I will use Semen Cannabis*), Dihuang (Rehmannia Root), Gancao (Licorice Root), and Dazao (Jujube) to tonify Ying Qi (Nutritive Qi). Once Ying Qi and Wei Qi are replenished, the pulse recovers, and the Spirit is complete, one can then proceed to attack the pathogen, ensuring success without failure. This represents an expanded variation of the Xiao Jianzhong Tang principle, serving as a method to harmonize both Yin and Yang. Today's practitioners treat diseases indiscriminately regarding deficiency and excess, generally using attacking and dispersing methods. They fail to realize that if the True Qi is not established, even if the disease is eliminated, life cannot be sustained, let alone the certainty of eliminating the disease.
Formula: Zhi Gancao Tang (Honey-fried Licorice Decoction), also known as Fumai Tang (Pulse-Regenerating Decoction).
Zhi Gancao (Honey-fried Licorice Root, 4 liang), Shengjiang (Fresh Ginger, 3 liang), Guizhi (Cinnamon Twig, peeled, 3 liang), Renshen (Ginseng Root, 2 liang), Ejiao (Donkey-hide Gelatin, 2 liang), Maidong (Ophiopogon Tuber, half sheng, heart removed), Shengdi Huang (Rehmannia Root, prepared, 1 jin), Huomaren (Semen Cannabis, half sheng), Dazao (Jujube, 30 pieces).
Take the above nine herbs. Add seven sheng of clear wine and eight sheng of water. First decoct the first eight herbs until three sheng remain, strain out the dregs, add the Ejiao (Donkey-hide Gelatin), and melt it completely. Take one sheng warm, three times daily.