太阴以理中丸为主，厥阴以乌梅丸为主。丸者，缓也。太阴之缓，所以和脾胃之气；厥阴之缓，所以制相
火之逆也。观所主诸方，治手足厥冷，脉微欲绝，而不用姜、附；下利、脉沉结，而用黄柏；心动悸、脉代结，
而用生地、麦冬。总因肝有相火，当泻无补，与肾中虚阳之发，当补当温者不同耳。夫三阴皆有本经之热∶
太阴之热，脾家实而行胃脘之阳也；少阴之热，肾阴虚而元阳发越也；厥阴之热，肝胆热而拂郁之火内热也。
举世误于传经热邪之说，遇三阴热症，漫无主张。见发热脉沉者，断为阳症，见阴脉而不治，中风下利者，妄呼
为漏底伤寒。不明仲景之论，因不敢用仲景之方，非不学无术乎？
乌梅丸∶
乌梅 干姜 桂枝 附子 蜀椒 黄连 黄柏 人参 当归 细辛
六经惟厥阴最为难治，其本阴而标热，其体风木，其用相火，以其具合晦朔之理。阴之初尽，即阳之初出，所
以一阳为纪，一阴为独，则厥阴病热，是少阳之相火使然也。火旺则水亏，故消渴；气有余便是火，故气上撞心；
心中疼热，木甚则克土，故饥不欲食，是为风化；饥则胃中空虚，蛔闻食臭则出，故吐蛔。此厥阴之火症，非厥
阴之伤寒也。《内经》曰∶“必伏其所主，而先其所因。或收或散，或逆或从，随所利而行之，调其中气，使之
和平。”是厥阴之治法也。仲景之方，多以辛甘、甘凉为君，独此方用酸收之品者，以厥阴主肝而属木。《洪
范》云∶“木曰曲直，曲直作酸。”《内经》曰∶“木生酸，酸入肝，以酸泻之，以酸收之。”君乌梅之大酸，
是伏其所主也。佐黄连泻心而除痞，黄柏滋肾以除渴，先其所因也。肾者肝之母，椒、附以温肾，则火有所归，
而肝得所养，是固其本也。肝欲散，细辛、干姜以散之；肝藏血，桂枝、当归引血归经也。寒热并用，五味兼
收，则气味不和，故佐以人参调其中气。以苦酒浸乌梅，同气相求，蒸之米下，资其谷气。加蜜为丸，少与而
渐加之，缓以治其本也。仲景此方，本为厥阴诸症之法，叔和编于吐蛔条下，令人不知有厥阴之主方。观其用
药，与诸症符合，岂只吐蛔一症耶？蛔为生冷之物，与湿热之气相成，故寒热互用以治之。且胸中烦而吐蛔，
则连、柏是寒因热用。蛔得酸则静，得辛则伏，得苦则下，杀虫之方，无更出其上者。久利则虚，调其寒热，
扶其正气，酸以收之，其利自止。愚按∶厥利发热诸症，诸条不立方治，当知治法不出此方矣。
当归四逆汤∶
桂枝 芍药 当归 细辛 通草 甘草 大枣
当归四逆加吴茱萸生姜汤∶
前方加吴茱萸 生姜 酒
此厥阴伤寒发散表邪之剂也。厥阴居两阴之交尽，名曰阴之绝阳。外伤于寒，则阴阳之气不相顺接，故手
足厥冷，脉微欲绝。然相火居于厥阴之脏，脏气实热，则寒邪不能侵，只外伤于经，而内不伤脏，故先厥者，后
必发热。凡伤寒初起，内无寒症，而外寒极盛者，但
当温散其表，勿遽温补其表。此方用桂枝汤以解外，而以当归为君者，因厥阴主肝为血室也。肝苦急，甘以缓
之，故倍加大枣，犹小建中加饴糖法。肝欲散，当以辛散之。细辛，其辛能通三阴之气血，外达于毫端，比麻
黄更猛，可以散在表之严寒。不用生姜，不取其横散也。通草即木通，能通九窍而通关节，用以开厥阴之阖，而
行气于肝。夫阴寒如此，而仍用芍药者，须防相火之为患也。是方桂枝得归、芍，生血于营；细辛同通草，行气
于卫；甘草得枣，气血以和。且缓中以调肝，则营气得至手太阴，而脉自不绝；温表以逐邪，则卫气行四末，
而手足自温。不须参、术之补，不用姜、桂之燥，此厥阴之四逆，与太、少不同治，而仍不失辛甘发散为阳之
理也。若其人内有久寒者，其相火亦不足。加吴萸之辛热，直达厥阴之脏；生姜之辛散，淫气于筋；清酒以温经
络，筋脉不沮弛。则气血如故，而四肢自温，脉息自至矣。此又治厥阴内外两伤于寒之剂也，冷结膀胱而少腹
满痛，手足厥冷者宜之。
小建中汤∶
桂枝 芍药 甘草 生姜 大枣 饴糖
厥阴为阖，外伤于寒，肝气不舒，热郁于下，致伤中气，故制此方以主之。凡六经外感未解者，皆用桂枝
汤解外。如太阳误下，而阳邪下陷于太阴者，桂枝汤倍加芍药，以泻木邪之干脾也。此肝火上逼于心脾，于桂
枝加芍药汤中更加饴糖，取酸苦以平肝脏之火，辛甘以调脾家之急，又资其谷气以和中也。此方安内攘外，泻
中兼补，故名曰建。外症未除，尚资姜、桂以散表，不全主中，故称曰小。所谓中者有二∶一曰心中，一曰腹
中。如伤寒二三日，心中悸而烦者，是厥阴之气逆上冲于心也。比心中疼热者稍轻，而有虚实之别。疼而热者
为实，当用苦寒以泻心火；悸而烦者为虚，当用甘温以保心气。是建腹中之宫城也。伤寒阳脉涩，阴脉弦，
腹中急痛者，是厥阴之逆气上侵脾胃也。比饥不欲食，食则吐蛔者为更重，而有形气之别。食即吐蛔为有形，
当用酸苦以安蛔；腹中急痛为无形，当用辛寒以止痛。是建腹中之都会也。世不明厥阴之为病，便不知仲景所
以制建中之理；不知胆藏肝内，则不明仲景先里后表之法。盖寒虽外来，而热从中发。必先开厥阴之阖，始得
转少阴之枢；先平厥阴阴脉之弦，始得通少阳阳脉之涩。此腹中痛者，先与小建中汤，不瘥者，继用小柴胡汤之
理也。凡腹痛而用芍药者，因相火为患。若因于虚寒者，大非所宜，故有建中、理中之别。或问∶腹痛既与小建中温
之，更用小柴胡凉之，先热后寒，仲景亦姑试之乎？曰∶不瘥者，但未愈，非更甚也。先之以建中，是解肌而
发表，止痛在芍药；继之以柴胡，是补中以逐邪，止痛在人参。按柴胡加减法，腹中痛者，去黄芩加芍药，其
功倍于建中。可知阳脉仍涩，故用人参以助桂枝；阴脉仍弦，故用柴胡以助芍药。若一服建中而即瘥，则不必
人参之补，亦不须柴胡之散矣。
茯苓甘草汤∶
桂枝 生姜 茯苓 甘草
此厥阴伤寒发散内邪之汗剂。凡伤寒厥而心下悸者，宜先治水，后治其厥，不尔水渍入胃，必作利也。此
方本欲利水，反取表药为里症用，故虽重用姜、桂，而以里药名方耳。厥阴伤寒，先热者后必厥，先热时必消
渴。今厥而心下悸，是下利之源，斯时不热不渴可知矣。因消渴时饮水多，心下之水气不能入心为汗，蓄而不
消，故四肢逆冷而心下悸也。肺为水母，肺气不化，则水气不行。茯苓为化气之品，故能清水之源。然得猪苓、
泽泻，则行西方收降之令，下输膀胱而为溺。桂枝、生姜，则从辛入肺，使水气通于肺，以行营卫阴阳，则外
走肌表而为汗矣。佐甘草以缓之，汗出周身，而厥自止，水精四布，而悸自安。以之治水者，即所以治厥也。
凡厥阴之渴在未汗时，太阳之渴在发汗后。如伤寒心悸，汗出而渴者，是水气不行，而津液又不足，须小发汗
以散水气，故用五苓。伤寒心悸无汗而不渴者，津液未亏，故可用此方大发其汗。五苓因小发汗故少佐桂枝，
不用生姜用白术者，恐渍水入脾也。此用姜、桂与茯苓等分，而不用芍药、大枣，是大发其汗。佐甘草者，一
以协辛发汗，且恐水渍入胃也。厥阴厥而不利，与见厥复利者，因热少而不能消水，水渍入胃，故仲景言其症
而未及治法。与本方汗之则利自止，是下者举之之义也。本方为汗家峻剂，与麻黄汤义异，而奏捷则同。因水
气在心下而不在皮毛，故不用麻黄；悸而不喘，故不用杏仁；且外不热而内不渴，故不用小青龙。仲景化水发
汗之剂，不同如此。
按伤寒汗出而渴，是伤寒、温病分歧处，大宜着眼。要知不恶寒反恶热者，即是温病；有水气而心下悸，
尚是伤寒。若无水气，则五苓燥热，即温病发火之药矣。
炙甘草汤∶
炙甘草 人参 阿胶 麻仁 桂枝 麦冬 生姜 大枣 清酒 生地
厥阴伤寒，则相火内郁，肝气不舒，血室干涸，以致营气不调，脉道涩滞而见代结之象。如程郊倩所云∶“此
结者不能前而代替，非阴盛也。”凡厥阴病，则气上冲心，故心动悸。此悸动因于脉代结，而手足不厥，非水气
为患矣。不得甘寒多液之品以滋阴而和阳，则肝火不息，而心血不生。心不安其位，则悸动不止；脉不复其常，
则代结何以调？故用生地为君，麦冬为臣，炙甘草为佐，大剂以峻补真阴，开来学滋阴之一路也。反以甘草名
方者，藉其载药入心，补离中之虚以安神明耳。然大寒之剂，无以奉发陈、蕃秀之机，必须人参、桂枝，佐麦
冬以通脉，姜、枣佐甘草以和营，胶、麻佐地黄以补血，甘草不使速下，清酒引之上行，且生地、麦冬，得酒
力而更优也。
烧 散∶
男女交媾而病传焉，奇病也。其授者始因伤寒，而实种于欲火，其受者因于欲火，而实发于阴虚，此阴阳
易之病所由来也。无恶寒发热之表，无胃实自利之症。此因两精相搏，而当时即发，与冬不藏精，春必病温者
不同。夫邪之所凑，其气必虚。阴虚者阳必凑之，故少气而热上冲胸；气少不得运，故头重不举，身体皆重；
邪中于阴，故阴中拘挛；冲任脉伤，故少腹里急；精神散乱，故目中生花；动摇筋骨，故膝胫拘急；病由于肾，
毒侵水道，故小便不利。谅非金石所能愈，仍须阴阳感召之理以致之。 裆者，男女阴阳之卫。卫乎外者，
自能清乎内。感于无形者，治之以有形。取其隐内，烧而服之，形气相感，小便即利。阴头微肿，浊阴走下窍
而清阳出上窍，欲火平而诸症自息矣。男服女，女服男，然更宜六味地黄汤合生脉散治之。
太阴病以理中丸为主方，厥阴病以乌梅丸为主方。丸剂的作用在于缓和。太阴病用缓法，是为了调和脾胃之气；厥阴病用缓法，是为了制约相火（寄居于肝胆的生理之火）的上逆。观察该篇所列举的主要方剂，治疗手足冰冷、脉搏微弱几乎摸不到时，不使用干姜、附子；治疗下利、脉象沉而结滞时，使用黄柏；治疗心悸、脉象代而有间歇时，使用生地黄、麦冬。这总归是因为肝脏有相火，应当清泻而不宜温补，这与肾中虚阳外越，应当温补的情况不同。三阴经都有本经的热证：太阴的热证，是脾家实热而运行胃脘的阳气；少阴的热证，是肾阴虚而元阳发散；厥阴的热证，是肝胆热盛而郁结的火气在内发热。世人误信邪气传经化热的说法，遇到三阴经的热症，往往没有主张。见到发热而脉沉的，就断定为阳证；见到阴脉就不敢治疗；遇到中风兼下利的，就胡乱称为“漏底伤寒”。如果不明白张仲景的理论，因而不敢使用张仲景的方剂，难道不是不学无术吗？
乌梅丸：
乌梅、干姜、桂枝、附子、蜀椒、黄连、黄柏、人参、当归、细辛。
六经之中，只有厥阴病最为难治。它的本质属阴而标象为热，其体为风木，其用为相火，因为它具备了晦朔交替的道理。阴气将尽时，就是阳气初生之时，所以以一阳为纪，一阴为独存。因此厥阴病的发热，是由少阳的相火导致的。火旺则水亏，所以出现消渴（口渴多饮）；气有余便是火，所以感觉气向上冲撞心脏；心中疼痛且发热，这是因为肝木过盛会克制脾土，所以虽然饥饿但不想吃东西，这是风邪作祟的表现；饥饿时胃中空虚，蛔虫闻到食物的气味就会出来，所以会出现吐蛔虫的现象。这是厥阴的火证，而不是厥阴的伤寒证。《内经》说：“必须制服疾病的主因，并先探寻其病因。或用收敛，或用发散，或用逆治，或用从治，顺着有利的方向施治，调理中气，使身体恢复平和。”这就是厥阴病的治疗方法。张仲景的方剂，大多以辛甘或甘凉的药物为君药，唯独这个方子使用酸收的药物，是因为厥阴主肝而属木。《洪范》说：“木的特性是曲直，曲直产生酸味。”《内经》说：“木生酸，酸入肝，用酸来泻肝，用酸来收敛肝。”以乌梅的大酸作为君药，就是制服疾病的主因。佐以黄连清泻心火并消除痞满，黄柏滋补肾阴以消除口渴，这是先探寻病因。肾是肝的母亲，用蜀椒、附子温补肾阳，那么火就有归宿，而肝得到滋养，这是巩固根本。肝喜疏散，用细辛、干姜来疏散它；肝藏血，用桂枝、当归引导血液回归经脉。寒热药物并用，五味兼收，因为气味不和，所以佐以人参调理中气。用醋浸泡乌梅，是同气相求；在米下蒸制，是借助谷气。加蜂蜜制成丸剂，少量服用并逐渐增加剂量，是用缓法治本。张仲景的这个方子，本来是治疗厥阴各种病症的方法，王叔和将其编排在吐蛔虫的条文之下，让人不知道这是厥阴的主方。看它的用药，与各种症状都符合，难道只是针对吐蛔虫这一种症状吗？蛔虫是生冷之物，与湿热之气相结合，所以寒热药物互用以治疗它。而且胸中烦闷并吐蛔虫，黄连、黄柏就是寒因热用的方法。蛔虫遇到酸味就安静，遇到辛味就潜伏，遇到苦味就下行，杀虫的方剂，没有能超过这个的了。久利导致虚弱，调理寒热，扶助正气，用酸味收敛，腹泻自然停止。我按语道：厥冷发热等各种症状，各条文中没有列出方剂治疗，应当知道治疗方法不出这个方子之外。
当归四逆加吴茱萸生姜汤：
前方加上吴茱萸、生姜、酒。
这是治疗厥阴伤寒发散表邪的方剂。厥阴位于两阴相交的尽头，名叫阴之绝阳。外伤于寒邪，阴阳之气不能顺接，所以手足冰冷，脉搏微弱几乎摸不到。然而相火居住在厥阴之脏，如果脏气实热，寒邪就不能侵入，只是外伤于经络，内里不伤及脏腑，所以先出现厥冷的，后来必定发热。凡是伤寒初起，体内没有寒证，而外寒极盛的，只应当温散表邪，不要急于温补。此方用桂枝汤来解表，而以当归为君药，是因为厥阴主肝，肝为血室。肝苦于拘急，用甘味来缓和它，所以加倍使用大枣，就像小建中汤加饴糖的方法一样。肝喜疏散，应当用辛味来疏散它。细辛，它的辛味能通达三阴经的气血，向外到达毫毛末端，比麻黄更猛烈，可以散除在表的严寒。不用生姜，是不取它横散的性质。通草即木通，能通九窍而通关节，用来开启厥阴的阖闭，而在肝中运行气机。阴寒如此严重，却仍然使用芍药，是为了防止相火的危害。这个方子中，桂枝配合当归、芍药，在营分中生血；细辛配合通草，在卫分中行气；甘草配合大枣，气血得以调和。并且通过缓中焦来调肝，营气就能到达手太阴肺经，脉搏自然不绝；温散表邪以驱逐病邪，卫气就能行于四肢末端，手足自然温暖。不需要人参、白术的补益，不用干姜、桂枝的燥烈，这是厥阴的四逆证，与太阴、少阴的治疗不同，但仍然不失辛甘发散为阳的原理。如果其人内部有久寒，那么他的相火也不足。加入吴茱萸的辛热，直达厥阴之脏；生姜的辛散，使气淫溢于筋脉；清酒温通经络，使筋脉不致弛缓。这样气血如常，四肢自然温暖，脉搏自然恢复。这又是治疗厥阴内外同时受寒的方剂，对于冷结膀胱而少腹满痛、手足冰冷的情况适宜使用。
厥阴主阖，外伤于寒邪，肝气不舒展，热郁结在下部，导致损伤中气，所以制定此方来主治。凡是六经外感未解的，都用桂枝汤解表。比如太阳病误用下法，导致阳邪陷入太阴的，用桂枝汤加倍芍药，以泻木邪对脾的克制。这里是肝火上逼于心脾，在桂枝加芍药汤中再加饴糖，取酸苦来平抑肝脏之火，辛甘来调治脾家的急迫，又资助谷气来和中。此方安内攘外，泻中兼补，所以名叫“建”。外症未除，还需要姜、桂来散表，不全主于中焦，所以称“小”。所谓“中”，有两个含义：一是心中，一是腹中。比如伤寒二三日，心中悸动而烦躁的，这是厥阴之气逆上冲于心。比心中疼热的情况稍轻，但有虚实之别。疼痛且有热感的为实证，应当用苦寒药清泻心火；悸动而烦躁的为虚证，应当用甘温药保护心气。这是建立腹中的宫城。伤寒见阳脉涩、阴脉弦，腹中急痛的，这是厥阴的逆气上侵脾胃。比饥饿不想吃东西、吃东西就吐蛔虫的情况更重，但有形气之别。吃食物就吐蛔虫是有形的病邪，应当用酸苦药安蛔；腹中急痛是无形的病邪，应当用辛寒药止痛。这是建立腹中的都会。世人不明白厥阴的病，就不知道张仲景制定建中汤的道理；不明白胆藏在肝内，就不明白张仲景先治里后治表的法则。大概寒邪虽然从外来，但热邪从中而生。必须先开启厥阴的阖闭，才能转动少阴的枢机；先平抑厥阴阴脉的弦象，才能疏通少阳阳脉的涩象。这就是腹痛者，先用小建中汤，不好转的，继用小柴胡汤的道理。凡是腹痛而用芍药的，是因为相火为患。如果是由于虚寒引起的，就非常不适宜，所以有建中汤、理中汤的区别。有人问：腹痛既然用小建中汤温补，后来又用小柴胡汤凉解，是先热后寒吗？张仲景也是姑且试试吗？回答说：不好转，只是没痊愈，并不是更严重了。先用建中汤，是解肌发表，止痛靠的是芍药；继用柴胡，是补中逐邪，止痛靠的是人参。按柴胡汤的加减法，腹中痛的，去掉黄芩加芍药，其功效倍于建中汤。可知阳脉仍涩，所以用人参助桂枝；阴脉仍弦，所以用柴胡助芍药。如果服一次建中汤就好了，那么就不需要人参的补益，也不需要柴胡的疏散了。
这是治疗厥阴伤寒发散内邪的发汗剂。凡是伤寒出现厥冷且心下悸动的，应当先治水气，后治厥冷，否则水气浸渍入胃，必定会导致下利。此方本意是利水，反而取表药作为里证来用，所以虽然重用姜、桂，却以内服药命名方剂。厥阴伤寒，先发热的后来必定厥冷，先发热时必定消渴。现在出现厥冷且心下悸动，这是下利的源头，此时可知既不热也不渴。因为消渴时饮水过多，心下的水气不能入心化为汗，蓄积而不消散，所以四肢逆冷且心下悸动。肺为水之上源，肺气不化，则水气不行。茯苓是化气的药物，所以能清除水的源头。但如果配合猪苓、泽泻，则是行使西方收降的命令，向下输送到膀胱成为尿液。桂枝、生姜，则是从辛味入肺，使水气通于肺，以运行营卫阴阳，从而向外走肌表成为汗液。佐以甘草来缓和，汗出周身，厥冷自然停止，水精四布，悸动自然安宁。用它来治水，就是用来治厥冷。凡是厥阴的渴症在未发汗时出现，太阳的渴症在发汗后出现。比如伤寒心悸，出汗且口渴的，是水气不行，而津液又不足，须小发汗以散水气，所以用五苓散。伤寒心悸无汗且不口渴的，津液未亏损，所以可用此方大发其汗。五苓散因为是小发汗，所以少佐桂枝，不用生姜而用白术，是怕水气浸渍入脾。此方用姜、桂与茯苓等分，而不用芍药、大枣，是大发其汗。佐以甘草，一来协助辛味发汗，二来恐怕水气浸渍入胃。厥阴厥冷而下利，与见厥冷后又复利的，是因为热少而不能消水，水气浸渍入胃，所以张仲景言其症状而未提及治法。用本方发汗则下利自止，这是“下者举之”的意思。本方是发汗的峻剂，与麻黄汤意义不同，但奏效迅速则相同。因为水气在心下而不在皮毛，所以不用麻黄；悸动而不喘，所以不用杏仁；而且外不热内不渴，所以不用小青龙汤。张仲景化水发汗的方剂，不像这样。
按语：伤寒出汗且口渴，是伤寒与温病分歧的关键处，大应注意。要知道不恶寒反恶热的，就是温病；有水气且心下悸动的，还是伤寒。如果没有水气，那么五苓散就是燥热之药，也就是温病发火的药物了。
炙甘草汤：
炙甘草、人参、阿胶、麻仁、桂枝、麦冬、生姜、大枣、清酒、生地黄。
厥阴伤寒，则相火内郁，肝气不舒展，血室干涸，导致营气不调，脉道涩滞而出现代脉、结脉的现象。正如程郊倩所说：“这是结者不能前行而代替跳动，并非阴盛。”凡是厥阴病，气会上冲心脏，所以心动悸。这种悸动是由于脉象代结引起的，而手足不冷，不是水气为患。不得用甘寒多液的药物来滋阴和阳，那么肝火不息，心血不生。心不安其位，则悸动不止；脉搏不复常态，则代结如何调理？所以用生地黄为君药，麦冬为臣药，炙甘草为佐药，大剂量地峻补真阴，开创了后世滋阴的一路。反而以甘草命名方剂，是借它载药入心，补离中之虚以安神明的缘故。但是大寒的方剂，无法奉养发陈、蕃秀的生机，必须用人参、桂枝，佐麦冬以通脉，姜、枣佐甘草以和营，阿胶、麻仁佐地黄以补血，甘草不让药力速下，清酒引药上行，而且生地黄、麦冬，得到酒力而效果更好。
烧裈散：
男女交媾而病传染，这是一种奇病。接受病毒的人起初因伤寒，实则种于欲火；接受对方病毒的人因于欲火，实则发于阴虚，这就是阴阳易病的由来。没有恶寒发热的表证，没有胃实自利的里证。这是因为两精相搏，当时即发病，与冬天不藏精、春天必病温的情况不同。邪气聚集的地方，正气必定虚弱。阴虚者阳气必定凑集，所以少气且热气上冲胸部；气少不能运化，所以头重抬不起来，身体沉重；邪气中于阴分，所以阴部拘挛；冲任脉受伤，所以少腹里急；精神散乱，所以眼中生花；动摇筋骨，所以膝胫拘急；病源于肾，毒侵水道，所以小便不利。估计非金石类药物所能治愈，仍需依靠阴阳感召的道理来治疗。裆裤，是男女阴阳的卫护。卫护于外的，自然能清肃于内。感受于无形的病邪，用有形之物来治疗。取其隐处的裆裤，烧灰服用，形气相感，小便即利。阴头微肿，浊阴走下窍而清阳出上窍，欲火平息而诸症自然消失。男服女方的，女服男方的，但更宜用六味地黄汤合生脉散治疗。
Taiyin disease is primarily treated with Lizhong Wan, and Jueyin disease is primarily treated with Wu Mei Wan. Pills act to slow down. The "slowing" in Taiyin is used to harmonize the Qi of the Spleen and Stomach; the "slowing" in Jueyin is used to restrain the rebellion of Ministerial Fire (physiological fire residing in the Liver and Gallbladder). Observing the main formulas listed in this section: when treating cold hands and feet with a faint pulse almost imperceptible, Ginger Rhizome (Shengjiang) and Aconite Root (Fuzi) are not used; when treating diarrhea with a deep and knotted pulse, Phellodendron Bark (Huangbai) is used; when treating palpitations with a intermittent pulse (Dai pulse), Rehmannia Root (Shengdihuang) and Ophiopogon Tuber (Maidong) are used. This is all because the Liver possesses Ministerial Fire, which should be purged rather than tonified, unlike the deficiency Yang floating from the Kidney, which requires warming and tonification. All three Yin meridians have heat syndromes specific to their own channels: The heat in Taiyin is excess heat in the Spleen moving the Yang of the Stomach cavity; the heat in Shaoyin is Kidney Yin deficiency causing Yuan Yang to scatter; the heat in Jueyin is excessive heat in the Liver and Gallbladder with stifled fire generating internal heat. The world is misled by the theory of pathogenic heat transmitted through the meridians. When encountering heat syndromes of the three Yin meridians, they often lack direction. Seeing fever with a deep pulse, they diagnose it as a Yang syndrome; seeing a Yin pulse, they dare not treat it; encountering wind-stroke with diarrhea, they recklessly call it "Lou Di Shang Han" (leaky bottom cold damage). Not understanding Zhang Zhongjing's theories, and therefore daring not to use his formulas, is this not ignorance?
Wu Mei Wan:
Dark Plum (Wumei), Dried Ginger (Ganjiang), Cinnamon Twig (Guizhi), Prepared Aconite Child Lateral Root (Fuzi), Sichuan Pepper (Shuchuanjiao), Coptis Rhizome (Huanglian), Phellodendron Bark (Huangbai), Ginseng Root (Renshen), Angelica Sinensis Root (Danggui), Asarum Root (Xixin).
Among the Six Meridians, Jueyin disease is the most difficult to treat. Its root is Yin, its branch is Heat; its substance is Wind-Wood, its function is Ministerial Fire, embodying the principle of the waxing and waning moon. When Yin is about to exhaust, Yang begins to emerge. Thus, one Yang is recorded, and one Yin stands alone. Therefore, the fever in Jueyin disease is caused by the Ministerial Fire of Shaoyang. When Fire is excessive, Water is deficient, leading to Xiao Ke (wasting-thirst/polydipsia); when Qi is excessive, it becomes Fire, leading to a sensation of Qi rushing up to strike the Heart; pain and heat in the heart region occur because Wood overacts on Earth, leading to hunger without desire to eat, which is the manifestation of Wind. When hungry, the Stomach is empty, and roundworms smell food odor and emerge, leading to vomiting of worms. This is a Fire syndrome of Jueyin, not a Cold Damage syndrome of Jueyin. The *Neijing* states: "You must subdue what dominates the disease, and first address its cause. Use astringency or dispersion, counteraction or compliance, acting according to what is beneficial, regulate the Middle Qi, and bring it to peace." This is the treatment method for Jueyin. Zhang Zhongjing's formulas mostly use Pungent-Sweet or Sweet-Cool herbs as Sovereign drugs. Only this formula uses Sour-astringent herbs because Jueyin governs the Liver and belongs to Wood. The *Hongfan* says: "Wood is crooked and straight; crookedness and straightness produce Sour." The *Neijing* says: "Wood generates Sour; Sour enters the Liver; use Sour to purge the Liver, use Sour to astringe the Liver." Using the great Sourness of Dark Plum as the Sovereign drug is to subdue what dominates the disease. Assisting with Coptis Rhizome to purge Heart Fire and remove stuffiness, and Phellodendron Bark to nourish Kidney Yin and remove thirst addresses the cause first. The Kidney is the Mother of the Liver; using Sichuan Pepper and Prepared Aconite Child Lateral Root to warm the Kidney gives Fire a home, allowing the Liver to be nourished, thus securing the root. The Liver desires dispersion; Asarum Root and Dried Ginger disperse it; the Liver stores Blood; Cinnamon Twig and Angelica Sinensis Root guide blood back to the vessels. Cold and Hot herbs are used together, and Five Flavors are collected. Because the flavors do not harmonize, Ginseng Root is added to regulate Middle Qi. Soaking Dark Plum in vinegar seeks similar energies; steaming under rice utilizes grain Qi. Adding honey to make pills, taking small amounts and gradually increasing the dose, treats the root with slowness. Zhang Zhongjing's formula was originally the method for treating various Jueyin syndromes. Wang Shuhe placed it under the clause for vomiting worms, making people unaware that it is the master formula for Jueyin. Looking at its ingredients, they match various symptoms; does it only target vomiting worms? Roundworms are creatures of cold and rawness, formed with damp-heat, so Cold and Hot herbs are used mutually to treat them. Moreover, chest irritability with vomiting worms indicates Huanglian and Huangbai are used as "cold for hot" treatment. Worms become quiet with Sour, dormant with Pungent, and descend with Bitter. No vermifuge formula surpasses this. Chronic diarrhea leads to deficiency; regulating Cold and Heat, supporting healthy Qi, and using Sour to astringe will stop the diarrhea. My commentary: For various syndromes of Jue cold and fever where no formula is given in other clauses, one should know the treatment method lies within this formula.
Danggui Sini Tang:
Cinnamon Twig (Guizhi), White Peony Root (Shaoyao), Angelica Sinensis Root (Danggui), Asarum Root (Xixin), Thoroughwort Herb (Tongcao), Licorice Root (Gancao), Jujube Fruit (Dazao).
Danggui Sini Tang plus Evodia Fruit and Fresh Ginger Decoction:
The above formula plus Evodia Fruit (Wuzhuyu), Fresh Ginger (Shengjiang), and Wine.
This is a formula for dispersing exterior pathogens in Jueyin Cold Damage. Jueyin resides at the convergence and end of two Yins, named "Yin's Extinct Yang." Exterior invasion by Cold causes Yin and Yang Qi to fail to connect smoothly, resulting in cold hands and feet and a faint pulse almost imperceptible. However, Ministerial Fire resides in the Jueyin Zang organ. If the Zang Qi is solid and hot, Cold pathogens cannot invade. If only the meridians are injured externally and the Zang organs internally, then those who first experience Jue will later experience fever. In early stages of Cold Damage, if there is no interior Cold syndrome but extreme exterior Cold, one should only warm and disperse the exterior, not hastily tonify. This formula uses Guizhi Tang to resolve the exterior, with Danggui as the Sovereign drug because Jueyin governs the Liver, which is the Blood Chamber. The Liver suffers from tension; Sweet flavor relieves it, hence doubling the amount of Jujube Fruit, similar to the method of adding Maltose in Xiaojianzhong Tang. The Liver desires dispersion; it should be dispersed with Pungent flavor. Asarum Root's Pungency can unblock Qi and Blood of the three Yin meridians, reaching the hair follicles externally, more potent than Ephedra Herb, capable of dispersing severe Cold in the exterior. Fresh Ginger is not used to avoid horizontal dispersion. Thoroughwort Herb (i.e., Akebia Stem) opens the nine orifices and joints, opening the closure of Jueyin and moving Qi in the Liver. Despite such severe Yin Cold, Shaoyao is still used to prevent harm from Ministerial Fire. In this formula, Guizhi combined with Danggui and Shaoyao generates Blood in the Ying level; Xixin combined with Tongcao moves Qi in the Wei level; Gancao combined with Dazao harmonizes Qi and Blood. By relaxing the Middle to regulate the Liver, Ying Qi reaches the Hand-Taiyin Lung meridian, and the pulse naturally continues; warming the exterior to expel pathogens allows Wei Qi to circulate to the four extremities, and hands and feet naturally warm. There is no need for tonification by Codonopsis Root or Atractylodes Macrocephala Rhizome, nor drying effects of Dried Ginger and Cinnamon Twig. This Jueyin Ni (reversal cold) is treated differently from Taiyin and Shaoyin, yet still adheres to the principle that Pungent-Sweet dispersion is Yang. If the person has chronic interior Cold, their Ministerial Fire is also insufficient. Adding the Pungent-Hot Evodia Fruit reaches the Jueyin Zang directly; the Pungent dispersion of Fresh Ginger floods the sinews; clear wine warms the collaterals, preventing sinew flaccidity. Thus, Qi and Blood remain normal, limbs warm, and pulse returns. This is another formula for Jueyin suffering from both interior and exterior Cold, suitable for cold accumulation in the Bladder causing lower abdominal fullness and pain with cold limbs.
Xiaojianzhong Tang:
Cinnamon Twig (Guizhi), White Peony Root (Shaoyao), Licorice Root (Gancao), Fresh Ginger (Shengjiang), Jujube Fruit (Dazao), Maltose (Yitang).
Jueyin governs closure. Exterior invasion by Cold causes Liver Qi to stagnate, Heat to suppress below, damaging Middle Qi. Hence this formula is created. For unresolved exterior conditions in all six meridians, Guizhi Tang is used to resolve the exterior. For example, if Taiyin is affected by downward陷陷 of Yang pathogens due to mistaken purgation in Taiyang, Guizhi Tang with doubled Shaoyao is used to purge Wood pathogen attacking Spleen. Here, Liver Fire presses upon Heart and Spleen. In Guizhi Jia Shaoyao Tang, Maltose is added to take Sour-Bitter to calm Liver Fire, Pungent-Sweet to relieve Spleen urgency, and supplement Grain Qi to harmonize the Middle. This formula secures the interior and repels the exterior, purging while tonifying, hence named "Jian" (Establish). Since exterior symptoms remain, Ginger and Cinnamon are still used to disperse the exterior, not solely focusing on the interior, hence called "Xiao" (Small). "Middle" refers to two places: the Heart center and the Abdominal center. For instance, in Cold Damage after two or three days, palpitations and irritability in the Heart indicate Jueyin Qi rebelling upward to the Heart. This is slightly milder than pain and heat in the heart region, distinguishing between deficiency and excess. Pain with heat is Excess, requiring Bitter-Cold to purge Heart Fire; palpitations with irritability are Deficiency, requiring Sweet-Warm to protect Heart Qi. This establishes the palace city of the abdomen. In Cold Damage, if Yang pulse is choppy and Yin pulse is wiry, with acute abdominal pain, it indicates Jueyin rebellious Qi invading Spleen and Stomach. This is heavier than hunger without desire to eat or vomiting worms upon eating, distinguishing between substantial and insubstantial forms. Vomiting worms upon eating is substantial, requiring Sour-Bitter to calm worms; acute abdominal pain is insubstantial, requiring Pungent-Cold to stop pain. This establishes the metropolis of the abdomen. Those who do not understand Jueyin diseases do not understand Zhang Zhongjing's rationale for Jianzhong Tang; not knowing the Gallbladder resides within the Liver means not understanding the method of treating interior before exterior. Although Cold comes from outside, Heat originates from within. One must first open Jueyin's closure to turn Shaoyin's pivot; first calm the wiry Yin pulse of Jueyin to unblock the choppy Yang pulse of Shaoyang. This is why for abdominal pain, Xiaojianzhong Tang is given first, and if ineffective, Xiaochaihu Tang follows. Whenever Shaoyao is used for abdominal pain, it is due to Ministerial Fire pathology. If caused by deficiency-Cold, it is highly inappropriate, hence the distinction between Jianzhong Tang and Lizhong Tang. Question: If abdominal pain is warmed with Xiaojianzhong Tang and then cooled with Xiaochaihu Tang, is it first Heat then Cold? Is Zhang Zhongjing just testing? Answer: "Ineffective" means not yet cured, not worsened. First using Jianzhong Tang resolves muscle layer and releases exterior, stopping pain via Shaoyao; subsequently using Chaihu tonifies middle and expels pathogens, stopping pain via Renshen. According to Chaihu modification rules, for abdominal pain, Huangqin is removed and Shaoyao added, doubling the efficacy of Jianzhong Tang. Knowing Yang pulse remains choppy, Renshen aids Guizhi; Yin pulse remains wiry, Chaihu aids Shaoyao. If cured after one dose of Jianzhong Tang, neither Renshen's tonification nor Chaihu's dispersion is needed.
Fuling Gancao Tang:
Cinnamon Twig (Guizhi), Fresh Ginger (Shengjiang), Poria (Fuling), Licorice Root (Gancao).
This is a sweating agent for dispersing interior pathogens in Jueyin Cold Damage. Whenever Cold Damage presents with Jue and palpitations below the heart, water should be treated first, then Jue; otherwise, water will infiltrate the Stomach and cause diarrhea. This formula intends to promote urination but uses exterior-releasing herbs for interior syndromes, hence named with an interior herb despite heavy use of Ginger and Cinnamon. In Jueyin Cold Damage, those who first have fever will later have Jue, and during fever, they will have Xiao Ke. Now presenting with Jue and palpitations below the heart indicates the source of diarrhea; at this time, there is no heat or thirst. Because excessive drinking during Xiao Ke phase led to water Qi below the heart failing to transform into sweat, accumulating and not dissipating, causing cold limbs and palpitations. The Lung is the mother of Water; if Lung Qi fails to transform, Water Qi does not move. Poria transforms Qi, clearing the source of water. Combined with Polyporus and Alisma Rhizome, it executes Western descending command,输输 to Bladder as urine. Cinnamon Twig and Fresh Ginger enter Lung via Pungent flavor, allowing Water Qi to communicate with Lung, moving Ying-Wei and Yin-Yang, exiting to muscle surface as sweat. Assisted by Gancao to moderate, whole-body sweating stops Jue, water essence distributes, and palpitations settle. Treating water is treating Jue. Jueyin thirst occurs before sweating; Taiyang thirst occurs after sweating. For Cold Damage with palpitations, sweating, and thirst, water Qi does not move and fluids are deficient; mild sweating disperses water Qi, hence Wuling San. For Cold Damage with palpitations, no sweating, and no thirst, fluids are intact; strong sweating is possible, hence this formula. Wuling San uses mild sweating, so little Guizhi is added, and Baizhu replaces Shengjiang to fear water infiltrating Spleen. This formula uses equal parts Ginger, Cinnamon, and Fuling, without Shaoyao and Dazao, for strong sweating. Gancao assists Pungent sweating and fears water infiltrating Stomach. Jueyin Jue without diarrhea, or Jue followed by diarrhea, occurs because weak Heat cannot transform water, water infiltrates Stomach. Zhang Zhongjing mentions symptoms but not treatment. Sweating with this formula stops diarrhea, following the principle of "lifting those that sink." This formula is a harsh sweating agent, differing from Mahuang Tang in intent but similar in rapid effect. Because water Qi is below the heart, not in skin/hair, Mahuang is not used; palpitation without panting, Xingren is not used; exterior not hot, interior not thirsty, Xiao Qinglong Tang is not used. Zhang Zhongjing's water-transforming sweating agents are not like this.
Commentary: Cold Damage with sweating and thirst is the divergence point between Shanghan and Wenbing, deserving attention. Know that non-chills but aversion to heat is Wenbing; having water Qi and palpitations below heart is still Shanghan. Without water Qi, Wuling San becomes drying-hot, a fire-stoking medicine for Wenbing.
Zhigancao Tang:
Roasted Licorice Root (Zhigancao), Ginseng Root (Renshen), Donkey-hide Gelatin (Ejiao), Hemp Seed (Haren), Cinnamon Twig (Guizhi), Ophiopogon Tuber (Maidong), Fresh Ginger (Shengjiang), Jujube Fruit (Dazao), Clear Wine, Rehmannia Root (Shengdihuang).
In Jueyin Cold Damage, Ministerial Fire is suppressed internally, Liver Qi stagnates, Blood Chamber dries up, causing Ying Qi imbalance and choppy pulse with Dai/Jie characteristics. As Cheng Jiaoqian said: "This is knotting unable to advance, replaced by beating, not Yin excess." In Jueyin disease, Qi rushes to Heart, causing palpitations. This palpitation stems from Dai/Jie pulse, without cold limbs, not caused by water Qi. Without Sweet-Cold abundant fluids to nourish Yin and harmonize Yang, Liver Fire persists, Heart Blood fails to generate. Heart unsettled, palpitations continue; pulse abnormal, how to regulate Dai/Jie? Thus, Shengdihuang is Sovereign, Maidong is Minister, Zhigancao is Assistant, heavily tonifying True Yin, opening the path for Yin-nourishing schools. Named after Gancao to carry drugs to Heart, tonifying Empty Li to calm Shenming. However, large Cold agents cannot support sprouting and flourishing mechanisms. Renshen and Guizhi assist Maidong to unblock pulse; Ginger and Dazao assist Gancao to harmonize Ying; Ejiao and Haren assist Dihuang to tonify Blood; Gancao prevents rapid descent; Clear Wine guides upward. Shengdihuang and Maidong benefit from Wine power.
Shao Kun San:
Transmission via sexual intercourse is a rare disease. The transmitter initially had Cold Damage but planted Desire Fire; the receiver had Desire Fire but manifested as Yin deficiency. This is the origin of Yin-Yang Yi disease. No exterior chills/fever, no interior excess/diarrhea. Caused by interaction of essences, manifesting immediately, different from winter failing to store Essence leading to spring Warmth disease. Where pathogens gather, Qi is deficient. Yin deficiency attracts Yang, causing shortness of breath and heat rushing to chest; Qi insufficient to move, head heavy and body heavy; Pathogen strikes Yin, genital cramping; Chong-Ren meridians injured, lower abdominal urgency; Spirit scattered, visual spots; Sinews/bones shaken, knee/shin cramping; Disease from Kidney, toxin invades water pathways, difficulty urinating. Minerals likely cannot cure; must rely on Yin-Yang resonance. Underwear guards male/female Yin-Yang. Guarding outside clears inside. Formless pathogens treated with form. Taking hidden underwear, burning and ingesting, form-Qi resonates, urination resumes. Glans slight swelling, turbid Yin exits lower orifice, clear Yang exits upper orifice, desire fire calms, symptoms cease. Male takes female's, female takes male's. Better treated with Liuwei Dihuang Wan combined with Shengmai San.