此邪在上焦壅塞而不得散也。方用∶
栝萎（一个捣碎） 枳壳（三钱） 半夏（一钱） 栀子（三钱） 天花粉（三钱） 陈皮（三钱） 浓朴（一钱
五分） 甘草（一钱）
水煎服。
此方之妙，全在用栝蒌能祛胸膈之食，而消上焦之痰，况又佐以枳壳、天粉，同是消痰之圣药；又有浓朴、
半夏，以清胃口之痰；尤妙在甘草，使群药留中而不速下，则邪不能久存，自然散矣。
此症非大实，则大虚，当审其因，察其脉，参其症，而分黑白矣。
实而便秘者，大承气汤。虚而便滑者，独参汤。厥逆
者，加附子。
真热症∶口干极而呼水，舌燥极而开裂生刺，喉痛日夜不已，大热烙手而无汗也。方用∶
麻黄（三钱） 当归（五钱） 黄连（三钱） 黄芩（三钱） 生石膏（三钱） 知母（三钱） 半夏（三钱） 枳
壳（二钱） 甘
草（一钱）
水煎服，一剂轻，二剂愈。
真寒症∶手足寒，久而不回。色变青紫，身战不已，口噤出声而不可禁也。方用∶
附子（三钱） 肉桂（一钱） 干姜（一钱） 白术（五钱） 人参（一两）
水煎服，急救之。此乃真中寒邪，肾火避出躯壳之外，而阴邪之气直犯心宫，心君不守，肝气无根据，乃发战
发噤，手足现青色。然则用桂、附、干姜逐其寒邪足矣，何用参、术，即用何至多加？盖元阳飞越，只一线之气
未绝，纯用桂附、干姜一派辛辣之药，邪虽外逐而正气垂绝，若不多加参、术，何以反正气于若存若亡之际哉？
这种病邪在上焦壅塞而不能消散。方剂组成如下：
栝萎（一个，捣碎） 枳壳（三钱） 半夏（一钱） 栀子（三钱） 天花粉（三钱） 陈皮（三钱） 浓朴（一钱五分） 甘草（一钱）
用水煎煮后服用。
这个方子的妙处，全在于使用栝蒌能够祛除胸膈间的食积，并消除上焦的痰浊，况且又辅以枳壳、天花粉，它们同样是消痰的圣药；又有浓朴、半夏，来清除胃口的痰浊；尤其妙在甘草，使诸药停留在体内而不迅速下行，那么邪气就不能长久存留，自然就会消散了。
这种病症不是大实证，就是大虚证，应当审察病因，诊察脉象，参考症状，从而分辨清楚虚实。
如果是实证且伴有便秘，使用大承气汤。如果是虚证且伴有大便滑泄，使用独参汤。如果出现四肢厥逆，加入附子。
真热症：口干极度严重而呼叫要水喝，舌面极度干燥而开裂生刺，咽喉疼痛日夜不停，身体高热烫手且无汗。方剂组成如下：
麻黄（三钱） 当归（五钱） 黄连（三钱） 黄芩（三钱） 生石膏（三钱） 知母（三钱） 半夏（三钱） 枳壳（二钱） 甘草（一钱）
用水煎煮服用，服一剂病情减轻，服两剂痊愈。
真寒症：手足寒冷，长时间不能回暖。面色变为青紫色，身体颤抖不止，牙关紧闭发出声音且无法控制。方剂组成如下：
附子（三钱） 肉桂（一钱） 干姜（一钱） 白术（五钱） 人参（一两）
用水煎煮服用，以急救。这是真正的中受寒邪，肾阳被逼迫逃离躯壳之外，而阴寒邪气直接侵犯心宫，心主神志不能守持，肝气失去依附，于是发生战栗和牙关紧闭，手足呈现青色。既然这样，使用肉桂、附子、干姜驱逐寒邪就足够了，为什么还要用人参、白术？即使使用，为什么要加到这么多呢？这是因为元阳飞越，仅有一线之气未绝，如果纯用肉桂、附子、干姜这一派辛辣的药物，虽然邪气被外逐，但正气即将断绝，如果不多加人参、白术，怎么能在正气若存若亡之际使其恢复呢？
This pathogenic factor is obstructed in the Upper Jiao (Upper Burner) and cannot dissipate. The prescription is as follows:
Gualou Fructus (one fruit, crushed), Zhike Pericarpium Citri Reticulatae Viride (3 qian), Banxia Rhizoma Pinelliae Preparatum (1 qian), Zhizi Gardeniae Fructus (3 qian), Tianhuafen Trichosanthis Radix (3 qian), Chenpi Pericarpium Citri Reticulatae (3 qian), Houpo Magnoliae Officinalis Cortex (1.5 qian), Gancao Glycyrrhizae Radix et Rhizoma (1 qian).
Decoct with water and take orally.
The efficacy of this formula lies entirely in the use of Gualou to dispel food stagnation in the chest and diaphragm, and to resolve phlegm in the Upper Jiao. Moreover, it is assisted by Zhike and Tianhuafen, which are also holy medicines for resolving phlegm; there are also Houpo and Banxia to clear phlegm from the stomach; especially wonderful is Gancao, which keeps the herbs in the middle jiao without allowing them to descend too quickly, so that the pathogen cannot remain for long and will naturally dissipate.
This syndrome is either a severe Excess pattern or a severe Deficiency pattern. One must examine the cause, inspect the pulse, and correlate the symptoms to distinguish clearly between the two.
If it is an Excess pattern accompanied by constipation, use Dachengqi Tang (Major Order the Qi Decoction). If it is a Deficiency pattern accompanied by loose stools or fecal incontinence, use Dushen Tang (Single Ginseng Decoction). If there is cold extremities (Jue Ni), add Fuzi Aconiti Lateralis Radix Preparata.
True Heat Syndrome: Extreme dryness of the mouth leading to calls for water, extreme dryness of the tongue causing cracking and prickling sensations, continuous sore throat day and night, high fever burning to the touch without sweating. The prescription is as follows:
Mahuang Ephedrae Herba (3 qian), Danggui Angelicae Sinensis Radix (5 qian), Huanglian Coptidis Rhizoma (3 qian), Huangqin Scutellariae Radix (3 qian), Shigypsum Fibrosum (3 qian), Zhimu Anemarrhenae Rhizoma (3 qian), Banxia Rhizoma Pinelliae Preparatum (3 qian), Zhike Pericarpium Citri Reticulatae Viride (2 qian), Gancao Glycyrrhizae Radix et Rhizoma (1 qian).
Decoct with water and take orally. Symptoms alleviate after one dose and resolve after two doses.
True Cold Syndrome: Cold hands and feet that do not warm up for a long time. Complexion turns cyanotic or purplish, continuous body tremors, trismus (lockjaw) with involuntary sounds. The prescription is as follows:
Fuzi Aconiti Lateralis Radix Preparata (3 qian), Rouguai Cinnamomi Cortex (1 qian), Ganjiang Zingiberis Rhizoma (1 qian), Baizhu Atractodis Macrocephalae Rhizoma (5 qian), Renshen Ginseng Radix et Rhizoma (1 liang).
Decoct with water and take orally for emergency rescue. This is true invasion by cold pathogen. The Kidney Fire (Kidney Yang) is forced out of the body shell, and Yin-Cold pathogenic qi directly invades the Heart Palace. The Heart Spirit fails to maintain its residence, and Liver Qi loses its foundation, resulting in tremors and trismus, with hands and feet appearing cyanotic. Since this is the case, using Rougui, Fuzi, and Ganjiang to expel the cold pathogen should suffice. Why use Renshen and Baizhu? And why add such large amounts? It is because the Primal Yang has fled and scattered, with only a thread of Qi remaining unbroken. If one uses purely pungent and hot herbs like Rougui, Fuzi, and Ganjiang, although the pathogen may be expelled outward, the Righteous Qi (Zheng Qi) will approach extinction. Without adding substantial amounts of Renshen and Baizhu, how can one restore the Righteous Qi when it is on the verge of disappearing?