小柴胡汤 治伤寒五六日，寒热往来，胸胁苦满，嘿嘿不欲饮食，心烦喜呕，口苦耳
聋，脉弦数者，此是少阳经半表半里之证，宜此汤以和解之。
柴胡（半斤 黄芩（三两） 人参（三两） 半夏（半升） 甘草（炙，三两） 生姜（切，三两）
大枣（擘，十二枚）
上七味，以水一斗二升，煮取六升，去滓再煎，取三升，温服一升，日三服。
若胸中烦而不呕，去半夏、人参，加栝蒌实。若渴者，去半夏加人参、栝蒌根。若
腹中痛，去黄芩加芍药。若胁下痞硬，去大枣加牡蛎。若心下悸、小便不利者，去黄芩
加茯苓。若不渴外有微热者，去人参加桂枝，温覆取微似汗愈。若咳者，去人参、大枣、生
姜，加五味子、干姜。
【集注】程应旄曰∶方以小柴胡名者，取配乎少阳之义也。至于制方之旨及加减法，则
所云上焦得通，津液得下，胃气因和尽之矣。何则？少阳脉循胁肋，在腹阳背阴两岐间，在
表之邪欲入里，为里气所拒，故寒往而热来。表里相拒而留于岐分，故胸胁苦满。神识以
拒而昏困，故嘿嘿。木受邪则妨土，故不欲食。胆为阳木而居清道，为邪所郁，火无从
泄，逼炎心分，故心烦。清气郁而浊，则成痰滞，故喜呕。呕则木火两舒，故喜之也。此
则少阳定有之证，其余或之云者，以少阳在人身为游部，凡表里经络之罅，皆能随其虚
而见之，不定之邪也。据证俱是太阳经中所有者，特以五六日上见，故属之少阳，半表
半里兼而有之，方是小柴胡证。方中以柴胡疏木，使半表之邪得从外宣，黄芩清火，使
半里之邪得从内彻。半夏豁痰饮，降里气之逆。人参补久虚，助生发之气。甘草佐柴、芩
调和内外。姜、枣佐参、夏通达营卫，相须相济，使邪无内向而外解也。至若烦而不呕
者，火成燥实而逼胸，故去人参、半夏加栝蒌实也。渴者，燥已耗液而逼肺，故去半夏
加栝蒌根也。腹中痛，木气散入土中，胃阳受困，故去黄芩以安土，加白芍以戢木也。胁
下痞硬者，邪既留则木气实，故去大枣之甘而泥，加牡蛎之咸而软也。心下悸、小便不
利者，水邪侵乎心矣，故去黄芩之苦而伐，加茯苓之淡而渗也。不渴身有微热者，半表之
寒尚滞于肌，故去人参加桂枝以解之也。咳者，半表之寒凑入于肺，故去参、枣加五味
子，易生姜为干姜以温之，虽肺寒不减黄芩，恐干姜助热也。总之，邪在少阳，是表寒里
热，两郁不得升之，故小柴胡之治，所谓升降浮沉则顺之也。
大柴胡汤 治热结在内，心下急呕不止，郁郁微烦，柴胡证仍在者，与大柴胡汤下之。
柴胡（半斤） 黄芩（三两） 半夏（半升） 芍药（三两） 枳实（四枚） 大黄（二两）
生姜（五两） 大枣（擘，十二枚）
上八味，以水一斗二升，煮取六升，去滓再煎，温服一升，日三服。
【注】柴胡证在，又复有里，故立少阳两解法也。以小柴胡汤加枳实、芍药者，仍解
其外以和其内也。去参、草者，以里不虚。少加大黄，以泻结热。倍生姜者，因呕不止也。
斯方也，柴胡得生姜之倍，解半表之功捷，枳、芍得大黄之少，攻半里之效徐，虽云下之，亦
下中之和剂也。
柴胡桂枝汤 伤寒六七日，发热微恶寒，肢节烦疼微呕，心下支结，此太阳少阳并病
也，柴胡桂枝汤主之。
柴胡（四两） 桂枝（一两半） 人参（一两半） 甘草（一两） 半夏（洗，二合半） 黄芩（一两半）
芍药（一两半） 大枣（擘，六枚） 生姜（切，一两半）
上九味，以水七升，煮取三升，去滓，分温服。
【集注】柯琴曰∶仲景书中最重柴、桂二方。以桂枝解太阳肌表，又可以调诸经之肌
表；小柴胡解少阳半表，亦可以和三阳之半表。故于六经病外，独有桂枝证、柴胡证之
称，见二方之任重不拘于经也。如阳浮阴弱条是仲景自为桂枝证之注释；血弱气虚条亦
仲景自为柴胡证之注释。桂枝有坏病，柴胡亦有坏病，桂枝有疑似证，柴胡亦有疑似证。
病如桂枝证而实非，若脚挛急与胸中痞硬者是已。病如柴胡证而实非，本渴而饮水呕食
谷呕，与但欲呕胸中痛微溏者是已。此条为伤寒六七日，正寒热当退之时，反见发热恶
寒诸表证，更见心下支结诸里证，表里不解，法当表里双解之。然恶寒微，发热亦微，可
知肢节烦疼，则一身骨节不疼；可知微呕，心下亦微结，故谓之支结。表证虽不去而已轻，
里证虽已见而未甚。故取桂枝之半，以散太阳未尽之邪；取柴胡之半，以解少阳微结之
证。口不渴、身有微热者，法当去人参；以六七日来，邪虽未解，而正已虚，故仍用之。
外证虽在，而病机已见于里，故方以柴胡冠桂枝之上，为双解两阳之轻剂也。
黄芩汤 治太阳、少阳合病，自下利者。若呕者，加半夏、生姜。
黄芩 甘草 芍药（各三两） 大枣（擘，十二枚）
上四味，以水一斗，煮取三升；去滓，温服一升，日再服，夜一服。
呕者，加半夏半升，生姜三两。
【集注】程应旄曰∶此之合病者，头痛，胸满口苦，咽干，目眩，或往来寒热，或脉
大而弦，半表之邪、不待太阳传递而即合。少阳里气失守，所以下利，阳热渐盛，所以上
呕。故用黄芩汤清热益阴，半里清而半表自解矣。
柯琴曰∶太阳、少阳合病，是热邪已入少阳之里。胆火下攻于脾，故自下利，上逆
于胃，故兼呕也。与黄芩汤，酸苦相济，调中以存阴也。热不在半表，故不用柴胡，今
热已入半里，故黄芩主之。虽非胃实，亦非胃虚，故不须人参以补中。兼呕者，故仍加
半夏、生姜，以降逆也。
黄连汤 治伤寒胸中有热，胃中有邪气，腹中痛欲呕吐者。
黄连（三两） 干姜（三两） 甘草（三两） 人参（二两） 桂枝（三两） 半夏（半升） 大枣（十二枚）
上七味，以水一斗，煮取六升；去滓，温服一升，日三服，夜二服。
【集注】程应旄曰∶热在胸中，有烦躁郁闷之证可知。胃中反有邪气，以寒邪被格在
下故也。此证寒热俱有，较之大青龙之寒热，已向近里一层，故其证不见之表里际，而只
见之上下际。腹中痛者，阴邪在胃而寒乃独治于下也。欲呕吐者，阳邪在胸、而热乃独
治于上也。此为上下相格治法，亦寒热并施，而辛寒易以苦寒，辛热加以苦热，更以人参、
半夏以补宣中气，升降阴阳。自此条而互及泻心诸汤，皆其法也。
成无己曰∶湿家下后，舌上如苔者，以丹田有热，胸中有寒，是邪气入里而为下热
上寒也。此伤寒传里而为下寒上热也。
喻昌曰∶阴阳悖逆，皆当和解法。
黄连阿胶汤 治少阴病，得之二三日以上，心中烦不得卧。
黄连（四两） 黄芩（一两） 芍药（二两） 鸡子黄（二枚） 阿胶（三两）
上五味，以水五升，先煮三物，取二升，
去滓，内胶烊尽，小冷，内鸡子黄，搅令相得，温服七合，日三服。
【集注】柯琴曰∶此少阴病之泻心汤也。凡泻心必藉连、芩，而导引有阴阳之别。病
在三阳，胃中不和，而心下痞硬者，虚则加参。甘补之，实则加大黄下之。病在少阴，而
心中烦不得卧者，既不得用参、甘以助阳，亦不得用大黄以伤胃矣。用芩、连以直折心火，
用阿胶以补肾阴，鸡子黄佐芩、连于泻心中补心血，芍药佐阿胶于补阴中敛阴气，斯则
心肾交合，水升火降。是以扶阴泻阳之方，变而为滋阴和阳之剂也。是则少阴之火，各归
其部，心中之烦不得卧可除矣。经曰∶阴平阳秘，精神乃治。斯方之谓欤！
理中汤丸 治中气不运，腹中不实，口失滋味，病久不食，脏腑不调，与伤寒直中
太阴，自利不渴，寒多而呕等证。
人参（三两） 白术（三两） 甘草（三两） 干姜（三两）
上四味，捣筛为末，蜜丸如鸡子黄大，以沸汤数合和一丸，研碎，温服之。日三四枚，
夜二枚；腹中未热，益至三四丸。然不及汤，汤法以四物根据两数切，用水八升，煮取三升，
去滓，温服一升，日三服。
若脐上筑者，肾气动也，去术加桂四两。多吐者，去术加生姜三两。下多者，还用术。
悸者，加茯苓二两。渴欲得水者，加术，足前成四两半。腹中痛者，加人参，足前成四
两半。寒者，加干姜，足前成四两半。腹满者，去术加附子一枚。服汤后如食顷，饮热
粥一升许，微自温勿发衣被。
【集注】程应旄曰∶阳之动始于温，温气得而谷精运，谷气升而中气赡，故名曰理中，
实以燮理之功，予中焦之阳也。若胃阳虚，则中气失宰，膻中无发宣之用，六腑无洒陈之
功，犹如釜薪失焰，故下致清谷，上失滋味，五脏凌夺，诸证所由来也。参、术、炙草，所
以守中州，干姜辛以温中，必假之以焰釜薪而腾阳气，是以谷入于阴，长气于阳，上输
华盖，下摄州都，五脏六腑，皆以受气，此理中之旨也。若水寒互胜，即当脾肾双温，加
以附子，则命门益土母温矣。白术补脾，得人参则壅气，故脐下动气；吐多腹满者，去
术也。加桂以伐肾邪，加生姜以止呕也。加附子以消阴也。下多者湿胜也，还用术燥湿
也。渴欲饮水饮渴也，加术使饮化津生也。心下悸停水也，加茯苓导水也。腹中痛倍人参，
虚痛也。寒者加干姜，寒甚也。
干姜附子汤 下后复发汗，昼日烦躁不得眠，夜而安静，不呕不渴，无表证，脉沉
微，身无大热者，干姜附子汤主之。
干姜（一两） 附子（去皮，生用，破八片，一枚）
上二味，以水三升，煮取一升，去滓，顿服。
茯苓四逆汤 伤寒厥而心下悸，发汗，若下之，病仍不解，烦躁者，茯苓四逆汤主之。
茯苓（六两） 人参（一两） 甘草（炙，一两） 干姜（一两） 附子（生用，破八片，一枚）
上五味，以水五升，煮取三升，去滓，温服七合，日三服。
【注】凡太阳病治不如法，汗后复下，或下后复汗，误而又误，变成坏病。若其人阳
盛而从热化，则转属三阳，阳衰而从寒化，则系在三阴。此二汤所治之烦躁，皆坏病也。烦
躁虽六经俱有，而多见于太阳、少阴者，太阳为真阴之标，少阴为真阳之本也。未经汗
下而烦躁，多属阳，其脉实大，其证渴热，是烦为阳盛，躁为阴虚。已经汗下而烦躁，多
属阴，其脉沉微，其证汗厥，是烦为阳虚，躁为阴极也。夫先下后汗，于法为逆，外无大
热，内不渴呕，似乎阴阳自和，而实妄汗亡阳，所以虚阳扰乱于阳分，故昼日烦躁不得
眠，盛阴偏安于阴分，故夜而安静。脉沉微，是真阳将脱而烦躁也。用干姜、附子壮阳以
配阴。姜、附者，阳中阳也，生用则力更锐，
不加甘草则势更猛，是方比四逆为峻，救其相离，故当急也。先汗后下，于法虽顺，若
病不解，厥悸仍然，骤增昼夜烦躁，似乎阴盛格阳，而实肾上凌心，皆因水不安其位，挟
阴邪而上乘，是阳虚有水气之烦躁也。用茯苓君四逆，抑阴以伐水。人参佐四逆，生气
而益阳。参、苓君子也，兼调以甘草，比四逆为缓，阴阳不急，故当缓也。一去甘草，一
加参、苓，而缓急自别，仲景用方之妙如此。
附子汤 治少阴病，身痛手足寒，骨节痛，口中和，背恶寒，脉沉者。
附子（生用，去皮，破八片，二枚） 茯苓（三两） 人参（二两） 白术（四两） 芍药（三两）
上五味，以水八升，煮取三升，去滓，温服一升，日三服。
【注】少阴为寒水之脏，故伤寒之重者多入少阴，所以少阴一经最多死证。方中君附
子二枚者，取其力之锐，且以重其任也。生用者，一以壮少火之阳，一以散中外之寒，则
恶寒自止，身痛自除，手足自温矣；所以固生气之原，令五脏六腑有本，十二经脉有根，
脉自不沉，骨节可和矣。更佐白术以培土，芍药以平木，茯苓以伐水。水伐火自旺，旺则
阴翳消，木平土益安，安则水有制，制则生化。此万全之术，其畏而不敢用，束手待毙
者，曷可胜计耶！
四逆汤 治脉沉厥逆等证。
甘草（炙，二两） 干姜（一两半） 附子（生用，去皮，破八片，一枚）
上三味，以水三升，煮取一升二合，去滓，分温再服。
强人可大附子一枚，干姜三两。
【注】方名四逆者，主治少阴中外皆寒，四肢厥逆也。君以炙草之甘温，温养阳气。臣
以姜、附之辛温，助阳胜寒。甘草得姜、附，鼓肾阳温中寒，有水中暖土之功；姜附得甘
草，通关节走四肢，有逐阴回阳之力。肾阳鼓寒，阴消则阳气外达而脉升手足温矣。
通脉四逆汤 治少阴下利清谷，里寒外热，手足厥逆，脉微欲绝，身反不恶寒，其
人面赤色，或腹痛，或干呕，或咽痛，或利止脉不出者。厥阴下利清谷，里寒外热，汗
出而厥者主之。
干姜（三两，强人可四两） 甘草（炙，二两） 附子（生用，去皮，大者一枚）
上三味，以水三升，煮取一升二合，去滓，分温再服，其脉即出者愈。
面色赤者，加葱九茎。腹中痛者，去葱加芍药二两。呕者，加生姜二两。咽痛，去
小柴胡汤 治疗伤寒病经过五六天，出现忽冷忽热、胸胁部胀满不适、神情沉默不想吃东西、心烦且容易呕吐、口苦耳聋、脉象弦而数的症状。这是少阳经半表半里的证候，适宜用此汤来和解。
柴胡（半斤） 黄芩（三两） 人参（三两） 半夏（半升） 甘草（炙烤，三两） 生姜（切片，三两） 大枣（掰开，十二枚）
以上七味药，用水一斗二升，煮取六升药液，去掉药渣后再煎煮，取三升药液，每次温服一升，每天服用三次。
如果胸中烦闷但不呕吐的，去掉半夏、人参，加入栝蒌实。如果口渴的，去掉半夏，加入人参、栝蒌根。如果腹中疼痛的，去掉黄芩，加入芍药。如果胁下痞塞硬结的，去掉大枣，加入牡蛎。如果心下悸动、小便不利的，去掉黄芩，加入茯苓。如果不渴且体表有轻微发热的，去掉人参，加入桂枝，覆盖衣被使身体微微出汗即可痊愈。如果咳嗽的，去掉人参、大枣、生姜，加入五味子、干姜。
【集注】程应旄说：方剂命名为小柴胡，是取其与少阳经相配属的意义。至于制方的宗旨及加减法，就是前面所说的上焦通畅，津液下行，胃气因此调和的全部道理了。为什么呢？少阳经脉循行于胁肋，位于腹部阳面与背部阴面之间的分界处，在表的邪气想要入里，被里气所抗拒，所以寒往而热来。表里相互抗拒而停留在分界处，所以胸胁苦满。神志因抗拒而昏沉困倦，所以神情沉默。木受邪气侵犯则妨碍土（脾胃），所以不想进食。胆为阳木而居于清道，被邪气郁结，火气无处宣泄，逼迫炎上于心分，所以心烦。清气郁结而变浊，形成痰滞，所以喜欢呕吐。呕吐后木火之气得以舒展，所以患者感到舒适。这些是少阳经必然有的证候，其余带有“或”字的症状，是因为少阳在人体中游移不定，凡是表里经络的空隙，都能随着虚处而显现，是不固定的邪气。根据症状看，这些都是太阳经中可能出现的，只是因为发病在五六天后才出现，所以归属于少阳，兼有半表半里的特点，这才是小柴胡汤的适应证。方中用柴胡疏泄肝胆之气，使半表的邪气得以从外宣散；黄芩清泻火热，使半里的邪气得以从内透达。半夏豁除痰饮，降逆里气。人参补益久虚，助发生长之气。甘草辅助柴胡、黄芩调和内外。生姜、大枣辅助人参、半夏通达营卫，互相配合，使邪气不能向内传入而向外解除。至于烦闷但不呕吐的，是火邪已成燥实而逼迫胸膈，所以去掉人参、半夏，加入栝蒌实。口渴的，是燥邪已耗伤津液而逼迫肺脏，所以去掉半夏，加入栝蒌根。腹中疼痛的，是木气散入脾土中，胃阳受到困阻，所以去掉黄芩以安护脾土，加入白芍以收敛肝木。胁下痞塞硬结的，是邪气停留导致木气实证，所以去掉大枣的甘腻，加入牡蛎的咸软。心下悸动、小便不利的，是水邪侵扰心脏，所以去掉黄芩的苦寒伐气，加入茯苓的淡渗利水。不渴且身体有微热的，是半表的寒邪仍滞留于肌表，所以去掉人参，加入桂枝以解表。咳嗽的，是半表的寒邪凑入肺脏，所以去掉人参、大枣，加入五味子，将生姜改为干姜以温肺，虽然肺寒但不减去黄芩，恐怕干姜助热。总之，邪气在少阳，是表寒里热，两气郁结不得升发，所以小柴胡汤的治疗，所谓顺应升降浮沉的道理。
大柴胡汤 治疗热邪结聚在内，心下急迫呕吐不止，郁郁微烦，柴胡证仍在的，给予大柴胡汤攻下。
柴胡（半斤） 黄芩（三两） 半夏（半升） 芍药（三两） 枳实（四枚） 大黄（二两） 生姜（五两） 大枣（掰开，十二枚）
以上八味药，用水一斗二升，煮取六升药液，去掉药渣后再煎煮，温服一升，每天服用三次。
【注】柴胡证仍在，又复有里实，所以建立少阳表里双解的方法。用小柴胡汤加上枳实、芍药的，仍是解除表邪以调和内里。去掉人参、甘草的，是因为里不虚。稍加大黄的，是为了泻除结聚的热邪。加倍使用生姜的，是因为呕吐不止。这个方子，柴胡得到加倍的生姜，解除半表之功迅速；枳实、芍药得到少量的大黄，攻逐半里的效果较缓，虽然说它是攻下剂，也是攻下中的和剂。
柴胡桂枝汤 伤寒病六七天，发热轻微恶寒，肢体关节烦痛，轻微呕吐，心下部支撑结聚，这是太阳少阳并病，用柴胡桂枝汤主治。
柴胡（四两） 桂枝（一两半） 人参（一两半） 甘草（一两） 半夏（洗，二合半） 黄芩（一两半） 芍药（一两半） 大枣（掰开，六枚） 生姜（切片，一两半）
以上九味药，用水七升，煮取三升药液，去掉药渣，分次温服。
【集注】柯琴说：张仲景书中最重视柴胡、桂枝两个方剂。用桂枝解太阳肌表之邪，又可以调理各经的肌表；小柴胡解少阳半表之邪，也可以调和三阳的半表。所以在六经病之外，独有桂枝证、柴胡证的称呼，可见这两个方剂责任重大，不拘泥于某一经。如“阳浮阴弱”条是仲景自为桂枝证的注释；“血弱气尽”条也是仲景自为柴胡证的注释。桂枝证有坏病，柴胡证也有坏病；桂枝证有疑似证，柴胡证也有疑似证。病像桂枝证但其实不是，比如脚挛急与胸中痞硬的就是。病像柴胡证但其实不是，本来口渴但饮水即呕食谷即呕，以及只想呕吐胸痛大便微溏的就是。这一条是伤寒六七天，正是寒热应当退去的时候，反而出现发热恶寒等表证，更见心下部支撑结聚等里证，表里都不解，治法应当表里双解。然而恶寒轻微，发热也轻微，可知肢体关节烦痛，则全身骨节不疼；可知轻微呕吐，心下也轻微结聚，所以称为支结。表证虽然未去但已减轻，里证虽然已见但未严重。所以取桂枝的一半，以发散太阳未尽的邪气；取柴胡的一半，以解除少阳轻微结聚的证候。口不渴、身体有微热的，按法应当去掉人参；因为过了六七天，邪气虽未解，但正气已虚，所以仍然使用它。外证虽然在，但病机已见于里，所以方剂以柴胡冠名于桂枝之上，作为双解两阳的轻剂。
黄芩汤 治疗太阳、少阳合病，自发腹泻的。如果呕吐的，加半夏、生姜。
以上四味药，用水一斗，煮取三升药液；去掉药渣，温服一升，每天两次，夜间一次。
【集注】程应旄说：这种合病，表现为头痛，胸满口苦，咽干，目眩，或往来寒热，或脉大而弦，半表的邪气，不待太阳传递就立即合入。少阳里气失守，所以下利，阳热渐盛，所以上呕。所以用黄芩汤清热益阴，半里清了而半表自然解除。
柯琴说：太阳、少阳合病，是热邪已入少阳之里。胆火下攻于脾，所以自发腹泻，上逆于胃，所以兼呕吐。给予黄芩汤，酸苦相济，调和中焦以保存阴液。热不在半表，所以不用柴胡，现在热已入半里，所以黄芩为主药。虽然不是胃实，也不是胃虚，所以不需要人参来补中。兼呕吐的，所以仍加半夏、生姜，以降逆气。
黄连（三两） 干姜（三两） 甘草（三两） 人参（二两） 桂枝（三两） 半夏（半升） 大枣（十二枚）
以上七味药，用水一斗，煮取六升药液；去掉药渣，温服一升，每天三次，夜间两次。
【集注】程应旄说：热在胸中，有烦躁郁闷的证候可知。胃中反有邪气，是因为寒邪被格拒在下。此证寒热俱有，比之大青龙汤证的寒热，已向近里一层，所以其证不见于表里之间，而只见于上下之间。腹中疼痛的，是阴邪在胃而寒独治于下。想呕吐的，是阳邪在胸而热独治于上。这是上下格拒的治法，也是寒热并用，将辛寒改为苦寒，将辛热加上苦热，再加人参、半夏以补宣中气，升降阴阳。从此条互及泻心诸汤，都是这种方法。
成无己说：湿家下法之后，舌上如苔的，是因为丹田有热，胸中有寒，是邪气入里而为下热上寒。这是伤寒传里而为下寒上热。
黄连阿胶汤 治疗少阴病，得病二三天以上，心中烦乱不能入睡的。
黄连（四两） 黄芩（一两） 芍药（二两） 鸡子黄（二枚） 阿胶（三两）
以上五味药，用水五升，先煮前三味，取二升药液，
去掉药渣，放入阿胶烊化尽，稍凉后，放入鸡子黄，搅拌令均匀，温服七合，每天三次。
【集注】柯琴说：这是少阴病的泻心汤。凡泻心必借黄连、黄芩，而导引有阴阳的区别。病在三阳，胃中不和，而心下痞硬的，虚则加人参、甘草补之，实则加大黄下之。病在少阴，而心中烦乱不能入睡的，既不能用参、甘以助阳，也不能用大黄以伤胃。用芩、连以直折心火，用阿胶以补肾阴，鸡子黄佐芩、连于泻心中补心血，芍药佐阿胶于补阴中敛阴气，这样则心肾交合，水升火降。是以扶阴泻阳的方剂，变而为滋阴和阳的药剂。这样则少阴之火，各归其部，心中的烦乱不能入睡可消除了。经文说：阴平阳秘，精神乃治。说的就是这个方剂吧！
理中汤丸 治疗中气不运，腹中不实，口中失去滋味，病久不吃东西，脏腑不调，以及伤寒直中太阴，自发腹泻不渴，寒多而呕吐等证候。
以上四味药，捣筛为末，蜜丸如鸡子黄大小，用沸水几合和一丸，研碎，温服之。每天三四丸，夜间二丸；腹中未觉温热，增至三四丸。然而不如汤剂，汤剂的用法是将四味药按原剂量切碎，用水八升，煮取三升，去掉药渣，温服一升，每天三次。
如果脐上跳动的，是肾气动，去掉白术，加入桂枝四两。呕吐多的，去掉白术，加入生姜三两。腹泻多的，仍用白术。心悸的，加入茯苓二两。口渴想喝水的，增加白术，足前量成四两半。腹中疼痛的，加入人参，足前量成四两半。寒重的，加入干姜，足前量成四两半。腹满的，去掉白术，加入附子一枚。服药后如吃饭一顿的时间，喝热粥一升左右，微微保暖，不要发汗穿衣盖被。
【集注】程应旄说：阳气的发动始于温煦，温气得到发挥则谷精运化，谷气上升则中气充足，所以名叫理中，实际是用燮理的功效，给予中焦阳气。如果胃阳虚，则中气失主，膻中无发宣的作用，六腑无洒陈的功能，犹如锅灶失去火焰，所以下致完谷不化，上失滋味，五脏凌夺，各种证候由此而来。参、术、炙草，用来守住中州，干姜辛以温中，必须借助它以点燃釜薪而腾起阳气，所以谷入于阴，长气于阳，上输华盖，下摄州都，五脏六腑，都以此受气，这就是理中的宗旨。如果水寒互胜，就应当脾肾双温，加上附子，则命门益土母温矣。白术补脾，得人参则壅气，所以脐下动气；吐多腹满的，去掉白术。加桂以伐肾邪，加生姜以止呕。加附子以消阴。腹泻多的是湿胜，仍用白术燥湿。口渴想饮水是饮渴，加白术使饮化津生。心下悸是停水，加茯苓导水。腹中痛倍用人参，是虚痛。寒重者加干姜，是寒甚。
干姜附子汤 下法后又复发汗，白天烦躁不得眠，夜间安静，不呕不渴，无表证，脉沉微，身体没有大热的，用干姜附子汤主治。
以上两味药，用水三升，煮取一升，去掉药渣，一次性服下。
茯苓四逆汤 伤寒四肢厥冷且心下悸，发汗，或者下法，病仍不解，烦躁的，用茯苓四逆汤主治。
茯苓（六两） 人参（一两） 甘草（炙，一两） 干姜（一两） 附子（生用，破八片，一枚）
以上五味药，用水五升，煮取三升，去掉药渣，温服七合，每天三次。
【注】凡是太阳病治疗不当，汗后又下，或者下后又汗，误而又误，变成坏病。如果其人阳盛而从热化，则转属三阳，阳衰而从寒化，则系在三阴。这两个汤所治疗的烦躁，都是坏病。烦躁虽然六经都有，而多见于太阳、少阴的，太阳为真阴之标，少阴为真阳之本。未经汗下而烦躁，多属阳，其脉实大，其证渴热，是烦为阳盛，躁为阴虚。已经汗下而烦躁，多属阴，其脉沉微，其证汗厥，是烦为阳虚，躁为阴极。先下后汗，于法为逆，外无大热，内不渴呕，似乎阴阳自和，而实际上是妄汗亡阳，所以虚阳扰乱于阳分，故白天烦躁不得眠，盛阴偏安于阴分，故夜间安静。脉沉微，是真阳将脱而烦躁。用干姜、附子壮阳以配阴。姜、附，是阳中之阳，生用则力更锐，不加甘草则势更猛，这个方比四逆汤峻烈，救其相离，所以应当急用。先汗后下，于法虽顺，若病不解，厥悸仍然，骤增昼夜烦躁，似乎阴盛格阳，而实际上是肾上凌心，都是因为水不安其位，挟阴邪而上乘，是阳虚有水气的烦躁。用茯苓君四逆，抑阴以伐水。人参佐四逆，生气而益阳。参、苓君子也，兼调以甘草，比四逆汤缓和，阴阳不急，所以应当缓用。一去甘草，一加参、苓，而缓急自别，仲景用方的妙处如此。
附子汤 治疗少阴病，身体疼痛手足寒冷，骨节疼痛，口中和，背恶寒，脉沉的。
附子（生用，去皮，破八片，二枚） 茯苓（三两） 人参（二两） 白术（四两） 芍药（三两）
以上五味药，用水八升，煮取三升，去掉药渣，温服一升，每天三次。
【注】少阴为寒水之脏，所以伤寒的重症多入少阴，所以少阴一经最多死证。方中君药附子二枚，取其力之锐，且以重其任。生用的，一是壮少火之阳，一是散中外之寒，则恶寒自止，身痛自除，手足自温了；所以固生气之原，令五脏六腑有本，十二经脉有根，脉自不沉，骨节可和了。更佐白术以培土，芍药以平木，茯苓以伐水。水伐火自旺，旺则阴翳消，木平土益安，安则水有制，制则生化。这是万全之术，那些畏惧而不敢用，束手待毙的，何能数计！
甘草（炙，二两） 干姜（一两半） 附子（生用，去皮，破八片，一枚）
以上三味药，用水三升，煮取一升二合，去掉药渣，分两次温服。
【注】方名四逆，主治少阴中外皆寒，四肢厥逆。君药以炙草之甘温，温养阳气。臣药以姜、附之辛温，助阳胜寒。甘草得姜、附，鼓动肾阳温中寒，有水中暖土之功；姜附得甘草，通关节走四肢，有逐阴回阳之力。肾阳鼓动寒邪消退，则阳气外达而脉升手足温了。
通脉四逆汤 治疗少阴下利清谷，里寒外热，手足厥逆，脉微欲绝，身体反而不恶寒，其人面色赤，或腹痛，或干呕，或咽痛，或利止脉不出者。厥阴下利清谷，里寒外热，汗出而厥者主之。
干姜（三两，体质强壮者可四两） 甘草（炙，二两） 附子（生用，去皮，大者一枚）
以上三味药，用水三升，煮取一升二合，去掉药渣，分两次温服，其脉即出者愈。
Xiao Chai Hu Tang (Minor Bupleurum Decoction) treats Taiyang disease (disease of the Taiyang channel) after five or six days, characterized by alternating chills and fever, fullness and distress in the chest and hypochondrium, a silent mood with loss of appetite, irritability and frequent vomiting, bitter taste in the mouth, deafness, and a wiry and rapid pulse. This is a syndrome of the Shaoyang channel at the half-exterior and half-interior level; this decoction should be used to harmonize.
Chai Hu (Bupleuri Radix, half jin), Huang Qin (Scutellariae Radix, three liang), Ren Shen (Ginseng Radix et Rhizoma, three liang), Ban Xia (Pinelliae Rhizoma, half sheng), Gan Cao (Licorice Radix et Rhizoma, roasted, three liang), Sheng Jiang (Zingiberis Rhizoma Recens, sliced, three liang), Da Zao (Jujubae Fructus, broken open, twelve pieces).
The above seven ingredients are boiled in ten dou two sheng of water to obtain six sheng of liquid. The dregs are removed, and the liquid is boiled again to obtain three sheng. One sheng is taken warm, three times a day.
If there is irritability in the chest but no vomiting, remove Ban Xia and Ren Shen, and add Gua Lou Shi (Trichosanthis Fructus). If there is thirst, remove Ban Xia and add Ren Shen and Gua Lou Gen (Trichosanthis Radix). If there is abdominal pain, remove Huang Qin and add Bai Shao (Paeoniae Radix Alba). If there is palpable hardness under the costal margin, remove Da Zao and add Mu Li (Ostreae Concha). If there is palpitation and difficulty in urination, remove Huang Qin and add Fu Ling (Poria). If there is no thirst but slight exterior heat, remove Ren Shen and add Gui Zhi (Cinnamomi Ramulus), cover with blankets to induce a slight sweat for cure. If there is cough, remove Ren Shen, Da Zao, and Sheng Jiang, and add Wu Wei Zi (Schisandrae Fructus) and Gan Jiang (Zingiberis Rhizoma).
[Collected Annotations] Cheng Yingmao said: The formula is named Xiao Chai Hu because it corresponds to the Shaoyang principle. As for the purport of the formulation and the methods of modification, they are fully explained by the statement that when the Upper Jiao (Upper Burner) is unobstructed, body fluids descend, and the Stomach Qi harmonizes. Why? The Shaoyang pulse circulates along the costal region, located between the Yang aspect of the abdomen and the Yin aspect of the back. Exterior pathogens attempting to enter the interior are rejected by interior Qi, causing cold to recede and heat to come. The rejection between exterior and interior leaves pathogens lingering in the dividing space, causing chest and hypochondriac fullness. Mental confusion due to rejection causes silence. Wood pathogen affects Earth (Spleen/Stomach), causing anorexia. Gallbladder is Yang Wood residing in clear pathways; when depressed by pathogens, Fire has no outlet, forcing inflammation into the Heart region, causing irritability. Clear Qi stagnates and becomes turbid, forming phlegm obstruction, leading to a tendency to vomit. Vomiting releases Wood and Fire, hence the relief. These are fixed symptoms of Shaoyang. The "or" symptoms occur because Shaoyang is a wandering part in the body; wherever there is a gap in the meridians of exterior and interior, pathogens appear according to deficiency, representing unstable pathogens. Although these symptoms exist in Taiyang disease, appearing after five or six days, they belong to Shaoyang, combining half-exterior and half-interior aspects, which constitutes the Xiao Chai Hu syndrome. In the formula, Chai Hu soothes Wood, allowing half-exterior pathogens to disperse outward; Huang Qin clears Fire, allowing half-interior pathogens to penetrate inward. Ban Xia resolves phlegm-fluids and directs rebellious interior Qi downward. Ren Shen tonifies long-standing deficiency and assists generating Qi. Gan Cao assists Chai Hu and Huang Qin to harmonize interior and exterior. Sheng Jiang and Da Zao assist Ren Shen and Ban Xia to unblock Ying and Wei, mutually supporting each other so that pathogens do not move inward but resolve outward. Regarding irritability without vomiting, Fire has become dry and solid, pressing on the chest, so Ren Shen and Ban Xia are removed and Gua Lou Shi is added. Regarding thirst, Dryness has consumed fluids and presses on the Lung, so Ban Xia is removed and Gua Lou Gen is added. Regarding abdominal pain, Wood Qi scatters into Earth, trapping Stomach Yang, so Huang Qin is removed to calm Earth, and Bai Shao is added to restrain Wood. Regarding hardness under the ribs, pathogens have lingered making Wood Qi excess, so the cloying sweetness of Da Zao is removed and the softening saltiness of Mu Li is added. Regarding palpitation and difficult urination, Water Pathogen invades the Heart, so the bitter-draining nature of Huang Qin is removed and the bland-leaching nature of Fu Ling is added. Regarding no thirst but slight body heat, half-exterior Cold still lingers in the muscles, so Ren Shen is removed and Gui Zhi is added to resolve it. Regarding cough, half-exterior Cold gathers in the Lung, so Ren Shen and Da Zao are removed, Wu Wei Zi is added, and Sheng Jiang is replaced by Gan Jiang to warm; although Lung Cold exists, Huang Qin is not reduced for fear that Gan Jiang might aid Heat. In summary, when pathogens are in Shaoyang, there is exterior Cold and interior Heat, both stagnant and unable to ascend. Thus, the treatment of Xiao Chai Hu follows the principle of following ascending, descending, floating, and sinking.
Da Chai Hu Tang (Major Bupleurum Decoction) treats internal binding of Heat, urgent incessant vomiting below the heart, slight depression and irritability, where the Chai Hu syndrome persists. Give Da Chai Hu Tang to purge.
Chai Hu (half jin), Huang Qin (three liang), Ban Xia (half sheng), Bai Shao (three liang), Zhi Shi (Immature Bitter Orange Fruit, four pieces), Da Huang (Rhei Radix et Rhizoma, two liang), Sheng Jiang (five liang), Da Zao (twelve pieces, broken open).
The above eight ingredients are boiled in ten dou two sheng of water to obtain six sheng. Remove dregs, boil again, take one sheng warm, three times a day.
[Note] Since the Chai Hu syndrome persists and there is interior excess, a method to resolve both Shaoyang exterior and interior is established. Using Xiao Chai Hu Tang plus Zhi Shi and Bai Shao still resolves the exterior to harmonize the interior. Removing Ren Shen and Gan Cao is because the interior is not deficient. Slightly adding Da Huang is to purge binding Heat. Doubling Sheng Jiang is because vomiting is incessant. In this formula, Chai Hu with doubled Sheng Jiang acts swiftly to resolve the half-exterior; Zhi Shi and Bai Shao with slight Da Huang act slowly to attack the half-interior. Although called a purgative, it is a harmonizing purgative.
Chai Hu Gui Zhi Tang (Bupleurum and Cinnamon Twig Decoction) Treats Taiyang disease for six or seven days, with slight fever and aversion to cold, painful limbs and joints, slight vomiting, and support-like binding below the heart. This is a concurrent disease of Taiyang and Shaoyang; Chai Hu Gui Zhi Tang governs.
Chai Hu (four liang), Gui Zhi (one and a half liang), Ren Shen (one and a half liang), Gan Cao (one liang), Ban Xia (washed, two he and a half), Huang Qin (one and a half liang), Bai Shao (one and a half liang), Da Zao (six pieces, broken open), Sheng Jiang (sliced, one and a half liang).
The above nine ingredients are boiled in seven sheng of water to obtain three sheng. Remove dregs, divide into warm doses.
[Collected Annotations] Ke Qin said: Among Zhang Zhongjing's books, the Chai Hu and Gui Zhi formulas are most valued. Gui Zhi resolves Taiyang muscle-surface pathogens and can regulate the muscle-surface of all channels; Xiao Chai Hu resolves Shaoyang half-exterior pathogens and can harmonize the half-exterior of the Three Yang. Thus, outside the Six Channels diseases, there are only references to Gui Zhi syndrome and Chai Hu syndrome, showing these two formulas bear heavy responsibility and are not confined to one channel. For example, the "Yang Floating Yin Weak" clause is Zhongjing's own annotation for Gui Zhi syndrome; the "Blood Weak Qi Exhausted" clause is his annotation for Chai Hu syndrome. Gui Zhi syndrome has corrupted diseases, and Chai Hu syndrome also has corrupted diseases; Gui Zhi syndrome has ambiguous cases, and Chai Hu syndrome also has ambiguous cases. Diseases resembling Gui Zhi syndrome but actually not so include leg cramping and chest fullness/hardness. Diseases resembling Chai Hu syndrome but actually not so include thirst with vomiting upon drinking/eating, and desire to vomit with chest pain and slight diarrhea. This clause describes Taiyang disease for six or seven days, when chills and fever should subside, yet exterior signs like fever and aversion to cold appear, along with interior signs like support-binding below the heart. Both exterior and interior are unresolved, requiring simultaneous resolution of both. However, since aversion to cold and fever are slight, limb pain implies whole-body joint pain is absent; slight vomiting implies slight binding below the heart, hence "support-binding." Exterior signs are light though present; interior signs are visible but not severe. Thus, half of Gui Zhi is taken to scatter remaining Taiyang pathogens; half of Chai Hu is taken to resolve slight Shaoyang binding. With no thirst and slight body heat, Ren Shen should theoretically be removed; but after six or seven days, although pathogens remain, Zheng Qi is deficient, so it is retained. Although exterior signs persist, the disease mechanism appears in the interior. Thus, the formula places Chai Hu before Gui Zhi, serving as a light agent to simultaneously resolve Two Yangs.
Huang Qin Tang (Scutellaria Decoction) Treats concurrent disease of Taiyang and Shaoyang with spontaneous diarrhea. If vomiting occurs, add Ban Xia and Sheng Jiang.
Huang Qin, Gan Cao, Bai Shao (each three liang), Da Zao (twelve pieces, broken open).
The above four ingredients are boiled in one dou of water to obtain three sheng. Remove dregs, take one sheng warm, twice daily, once at night.
For vomiting, add Ban Xia (half sheng) and Sheng Jiang (three liang).
[Collected Annotations] Cheng Yingmao said: This concurrent disease presents with headache, chest fullness, bitter taste, dry throat, vertigo, or alternating chills and fever, or large and wiry pulse. Half-exterior pathogens combine immediately without passing through Taiyang. Shaoyang interior Qi loses control, causing diarrhea; Yang Heat gradually increases, causing vomiting. Thus, Huang Qin Tang clears Heat and benefits Yin; clearing the half-interior naturally resolves the half-exterior.
Ke Qin said: Concurrent disease of Taiyang and Shaoyang means Heat pathogens have entered the Shaoyang interior. Gallbladder Fire attacks the Spleen from below, causing spontaneous diarrhea; rebels upward to the Stomach, causing vomiting. Huang Qin Tang uses sour and bitter together to regulate the middle and preserve Yin. Heat is not in the half-exterior, so Chai Hu is not used; now Heat has entered the half-interior, so Huang Qin governs. It is neither Stomach Excess nor Stomach Deficiency, so Ren Shen is not needed to tonify the middle. For vomiting, Ban Xia and Sheng Jiang are added to direct rebellion downward.
Huang Lian Tang (Coptis Decoction) Treats Taiyang disease with Heat in the Chest, pathogens in the Stomach, abdominal pain, and desire to vomit.
Huang Lian (Coptidis Rhizoma, three liang), Gan Jiang (Zingiberis Rhizoma, three liang), Gan Cao (three liang), Ren Shen (two liang), Gui Zhi (three liang), Ban Xia (half sheng), Da Zao (twelve pieces).
The above seven ingredients are boiled in one dou of water to obtain six sheng. Remove dregs, take one sheng warm, three times daily, twice at night.
[Collected Annotations] Cheng Yingmao said: Heat in the Chest implies irritability and oppression. Pathogens in the Stomach are due to Cold pathogens being blocked below. This case has both Cold and Heat, closer to the interior than Da Qing Long Tang. Symptoms manifest not between exterior and interior, but between upper and lower. Abdominal pain indicates Yin Cold in the Stomach dominating below. Desire to vomit indicates Yang Heat in the Chest dominating above. This is a treatment for upper-lower blockage, using both Cold and Heat, changing acrid-cold to bitter-cold, and acrid-hot to bitter-hot, plus Ren Shen and Ban Xia to tonify and disseminate Middle Qi, regulating Yin and Yang. From this clause, we can infer the methods of the Xie Xin (Drain the Epigastrium) formulas.
Cheng Wuji said: After purging a Dampness patient, if the tongue looks like coated, it is because there is Heat in the Lower Dan Tian and Cold in the Chest, meaning pathogens have entered the interior causing lower Heat and upper Cold. This is Taiyang disease transmitting to the interior causing lower Cold and upper Heat.
Yu Chang said: When Yin and Yang rebel, Harmonization methods should be used.
Huang Lian E Jiao Tang (Coptis and Donkey-Hide Gelatin Decoction) Treats Shaoyin disease, occurring after two or three days, with irritability in the Heart preventing sleep.
Huang Lian (four liang), Huang Qin (one liang), Bai Shao (two liang), Ji Zi Huang (Egg Yolk, two pieces), E Jiao (Donkey-Hide Gelatin, three liang).
The above five ingredients are boiled in five sheng of water. First boil the first three ingredients to obtain two sheng. Remove dregs, dissolve E Jiao completely. Let cool slightly, add Egg Yolks, stir until mixed. Take seven ge warm, three times a day.
[Collected Annotations] Ke Qin said: This is the Xie Xin Tang for Shaoyin disease. All Xie Xin formulas rely on Lian and Qin, but guidance differs by Yin/Yang. In Three Yang diseases, Stomach disharmony with epigastric fullness/hardness: if deficient, add Ren Shen/Gan Gan to tonify; if excess, add Da Huang to purge. In Shaoyin disease, with irritability and insomnia, neither Ren Shen/Gan Gan (to aid Yang) nor Da Huang (to injure Stomach) can be used. Use Qin/Lian to directly suppress Heart Fire; use E Jiao to tonify Kidney Yin; Egg Yolk assists Qin/Lian to tonify Heart Blood while draining; Bai Shao assists E Jiao to gather Yin Qi while tonifying Yin. Thus Heart and Kidney interact, Water ascends and Fire descends. A formula for supporting Yin and draining Yang transforms into one for nourishing Yin and harmonizing Yang. Thus, Shaoyin Fire returns to its place, and irritability/insomnia are eliminated. The Classic says: "When Yin is balanced and Yang is firm, Spirit is governed." This formula exemplifies this!
Li Zhong Tang Wan (Regulate the Middle Decoction/Pill) Treats failure of Middle Qi movement, loose abdomen, loss of taste, prolonged illness with anorexia, disharmony of Zang-Fu, and Taiyin disease directly struck by Cold with spontaneous diarrhea without thirst, much Cold with vomiting.
Ren Shen (three liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma, three liang), Gan Cao (three liang), Gan Jiang (three liang).
The above four ingredients are pounded and sifted into powder. Honey pills the size of egg yolks. Dissolve one pill in several he of boiling water, crush, and take warm. Three to four pills daily, two at night. If the abdomen does not feel warm, increase to three or four pills. However, decoction is superior. Decoction method: cut four ingredients according to weight, boil in eight sheng of water to obtain three sheng. Remove dregs, take one sheng warm, three times a day.
If there is pulsation above the navel, Kidney Qi is moving; remove Bai Zhu, add Gui Zhi (four liang). If vomiting is excessive, remove Bai Zhu, add Sheng Jiang (three liang). If diarrhea is excessive, use Bai Zhu again. If palpitation, add Fu Ling (two liang). If thirsty and wanting water, increase Bai Zhu to total four and a half liang. If abdominal pain, add Ren Shen to total four and a half liang. If Cold, add Gan Jiang to total four and a half liang. If abdominal fullness, remove Bai Zhu, add Fu Zi (one piece). After taking the decoction, about the time of a meal, drink one sheng of hot porridge to keep slightly warm; do not undress or uncover blankets.
[Collected Annotations] Cheng Yingmao said: Yang movement begins with warmth. When Warm Qi functions, grain essence moves; when Grain Qi rises, Middle Qi suffices. Hence named Li Zhong (Regulate Middle), actually bestowing regulation power to Middle Jiao Yang. If Stomach Yang is deficient, Middle Qi loses control, Shan Zhong lacks dispersing function, Six Fu lack distribution function, like a stove losing fire, leading to undigested stool below and loss of taste above, with Five Zang encroachment causing various symptoms. Ren Shen, Bai Zhu, Roasted Gan Cao guard the Central State; Gan Jiang is acrid-warm to warm the middle, needing it to ignite the stove fire and raise Yang Qi. Grain enters Yin, grows in Yang, transports to Hua Gai (Lungs) above, controls Zhou Du (Bladder/Kidneys) below; Five Zang and Six Fu receive Qi. This is the purport of Li Zhong. If Water and Cold compete, Spleen and Kidney must be warmed together; adding Fu Zi warms the Life Gate and Earth Mother. Bai Zhu tonifies Spleen; combined with Ren Shen it causes Qi stagnation and umbilical pulsation; thus removed for vomiting/fullness. Add Gui Zhi to attack Kidney pathogens; add Sheng Jiang to stop vomiting. Add Fu Zi to eliminate Yin. Excessive diarrhea indicates Dampness excess; use Bai Zhu to dry Dampness. Thirst for water indicates fluid retention; add Bai Zhu to transform fluids and generate Jin. Palpitation indicates water retention; add Fu Ling to drain water. Abdominal pain requires doubling Ren Shen for deficiency pain. Cold requires adding Gan Jiang for severe Cold.
Gan Jiang Fu Zi Tang (Dried Ginger and Aconite Decoction) After purging and then sweating, daytime irritability preventing sleep, nighttime quietness, no vomiting/thirst, no exterior syndrome, deep and faint pulse, no significant body heat. Gan Jiang Fu Zi Tang governs.
Gan Jiang (one liang), Fu Zi (Aconiti Lateralis Radix Praeparata, peeled, raw, broken into eight pieces, one piece).
The above two ingredients are boiled in three sheng of water to obtain one sheng. Remove dregs, take in one dose.
Fu Ling Si Ni Tang (Poria and Four Reversals Decoction) Taiyang disease with cold extremities and epigastric palpitations. After sweating or purging, disease unresolved, with irritability. Fu Ling Si Ni Tang governs.
Fu Ling (Poria, six liang), Ren Shen (one liang), Gan Cao (roasted, one liang), Gan Jiang (one liang), Fu Zi (raw, broken into eight pieces, one piece).
The above five ingredients are boiled in five sheng of water to obtain three sheng. Remove dregs, take seven ge warm, three times a day.
[Note] Improper treatment of Taiyang disease, sweating then purging, or purging then sweating, errors compounding errors, leads to corrupted disease. If Yang is excess and transforms to Heat, it transfers to Three Yang; if Yang is deficient and transforms to Cold, it attaches to Three Yin. The irritability treated by these two formulas are both corrupted diseases. Irritability occurs in all Six Channels but is common in Taiyang and Shaoyin. Taiyang is the mark of True Yin; Shaoyin is the root of True Yang. Irritability without prior sweating/purging is mostly Yang, with strong/large pulse and thirst/heat; Fan is Yang excess, Zao is Yin deficiency. Irritability after sweating/purging is mostly Yin, with deep/faint pulse and sweating/cold extremities; Fan is Yang deficiency, Zao is Yin extremity. Purging then sweating is contrary to method. No external heat, no internal thirst/vomiting seems like self-harmonizing Yin/Yang, but actually reckless sweating destroys Yang. Thus Deficient Yang disturbs Yang division, causing daytime irritability/insomnia; Excess Yin rests in Yin division, causing nighttime quietness. Deep/faint pulse indicates True Yang about to collapse with irritability. Use Gan Jiang and Fu Zi to strengthen Yang to match Yin. Jiang/Fu are Yang within Yang; raw use makes them sharper; without Gan Cao, their force is fiercer. This formula is more峻 (severe) than Si Ni Tang, saving separation, so it must be urgent. Sweating then purging is orderly method, but if disease persists with cold extremities/palpitations and sudden day-night irritability, seeming like Yin excess repelling Yang, it is actually Kidney attacking Heart due to Water not resting in its position, carrying Yin pathogens upward. This is Yang deficiency with Water Qi irritability. Use Fu Ling as sovereign of Si Ni to suppress Yin and attack Water. Ren Shen assists Si Ni to generate Qi and benefit Yang. Ren/Shen are Junzi (gentlemen), harmonized with Gan Cao, milder than Si Ni, so it should be slow. Removing Gan Cao vs adding Ren/Shen distinguishes speed. Such is the subtlety of Zhongjing's formulas.
Fu Zi Tang (Aconite Decoction) Treats Shaoyin disease with body pain, cold hands/feet, bone/joint pain, neutral mouth, aversion to cold on back, deep pulse.
Fu Zi (raw, peeled, broken into eight pieces, two pieces), Fu Ling (three liang), Ren Shen (two liang), Bai Zhu (four liang), Bai Shao (three liang).
The above five ingredients are boiled in eight sheng of water to obtain three sheng. Remove dregs, take one sheng warm, three times a day.
[Note] Shaoyin is the organ of Cold Water; thus severe Taiyang disease often enters Shaoyin, making Shaoyin the channel with most fatal cases. The formula uses two pieces of Fu Zi as sovereign for sharp power and heavy responsibility. Raw use strengthens Shaohuo (Minister Fire) Yang and dispels interior/exterior Cold, stopping aversion to cold, removing body pain, warming hands/feet. It secures the source of Living Qi, giving root to Five Zang/Six Fu and Twelve Channels, so pulse is no longer deep, bones/joints harmonize. Assisted by Bai Zhu to cultivate Earth, Bai Shao to calm Wood, Fu Ling to attack Water. Attacking Water makes Fire prosperous; prosperity eliminates Yin shadow. Calming Wood stabilizes Earth; stability controls Water; control allows transformation. This is a perfect strategy. Those who fear using it and wait helplessly are countless.
Si Ni Tang (Four Reversals Decoction) Treats deep pulse and cold extremities.
Gan Cao (roasted, two liang), Gan Jiang (one and a half liang), Fu Zi (raw, peeled, broken into eight pieces, one piece).
The above three ingredients are boiled in three sheng of water to obtain one sheng and two he. Remove dregs, divide into two warm doses.
Strong individuals may use one large Fu Zi and three liang Gan Jiang.
[Note] Named Si Ni because it treats Shaoyin interior/exterior Cold and cold extremities. Sovereign is Roasted Gan Cao's sweet-warmth to nourish Yang. Ministers are Jiang/Fu's acrid-warmth to assist Yang overcoming Cold. Gan Cao with Jiang/Fu drums Kidney Yang to warm Middle Cold, having the function of warming Earth in Water; Jiang/Fu with Gan Cao unblock joints, travel to limbs, have power to expel Yin and return Yang. Drumming Kidney Yang eliminates Cold, Yang reaches exterior, pulse rises, hands/feet warm.
Tong Mai Si Ni Tang (Pulse-Returning Four Reversals Decoction) Treats Shaoyin spontaneous diarrhea with undigested food, interior Cold exterior Heat, cold extremities, faint pulse nearly imperceptible, body actually not averse to cold, facial redness, or abdominal pain, dry vomiting, sore throat, or cessation of diarrhea with non-emerging pulse. Governs Jueyin spontaneous diarrhea with undigested food, interior Cold exterior Heat, sweating with cold extremities.
Gan Jiang (three liang, strong individuals four liang), Gan Cao (roasted, two liang), Fu Zi (raw, peeled, one large piece).
The above three ingredients are boiled in three sheng of water to obtain one sheng and two he. Remove dregs, divide into two warm doses. Cure if pulse emerges.
For red face, add Cong Bai (Allii Fistulosae Bulbus, nine stems). For abdominal pain, remove Cong Bai, add Bai Shao (two liang). For vomiting, add Sheng Jiang (two liang). For sore throat, remove