伤寒五六日，大下之后，身热不去，心中结痛者，未全解也，栀子豉汤主之。
阳明病，胃实脉弦浮大，短气，腹满，胁下及心痛，鼻干无汗，嗜卧身黄，小便难，有潮热，时时哕者，
小柴胡汤。（论见胃实。方见往来寒热。）
〔《摘》〕伤寒饮水过多，腹胀气喘，心下痛不可忍，宜灸中脘、气海二穴。如小腹有气上冲者，宜灸天枢、
气冲、三里、三阴交。（如无此症，只用前穴。）
伤寒脉迟六七日，而反与黄芩汤彻其热，脉迟为寒，今与黄芩汤复除其热，腹中应冷，当不能食，今反能
食，此名除中，必死。眼睛不慧，语言不出，而谷食反多者，此为除中，口虽欲言，舌不能语。凡手足厥冷而
利，不当食而食者，恐为除中，试与索饼食之，发热者除中，不发热者非也。（论是厥门。）
泄利下重，若少阴症欲寐四逆者，四逆汤加薤白散；若热者，白头翁汤。（方论见下利。）
脉浮宜以汗解，用火灸之，邪无从出，因火而盛，病从腰以下必重而痹，名火逆也。
脉迟浮弱，恶风寒者，表症，医反下之，遂不食，胁痛身黄，项强，小便难，复与柴胡汤，必下重。（论见胁痛。）
下利脉沉弦者，下重也。（论见下重。）
病患身大热，反欲得近衣者，热在皮肤，寒在骨髓也。（《活人》云∶先以桂枝汤治寒，次以小柴胡加
桂以温其表。）身大寒，反不欲近衣者，寒在皮肤，热在骨髓也。（《活人》云∶先与白虎汤加人参除热，
次以桂枝麻黄各半汤以解其外。）
伤寒病经过五六天，经过猛烈泻下治疗后，身体发热仍然没有消退，心中感觉郁结疼痛的，说明病邪尚未完全解除，应当用栀子豉汤主治。
阳明病，脉象弦、浮、大且有力（胃实），伴有呼吸短促、腹部胀满、胁肋部及心窝处疼痛、鼻干无汗、嗜睡、身体发黄、小便困难、有定时发热的潮热症状，以及时不时出现呃逆的，用小柴胡汤治疗。（相关论述见“胃实”篇，方剂用法见“往来寒热”篇。）
〔《医林摘玄》〕伤寒病人饮水过多，导致腹部胀满、气喘，心窝处疼痛难以忍受，适宜灸中脘穴和气海穴。如果感到小腹有气向上冲撞，适宜灸天枢穴、气冲穴、足三里穴和三阴交穴。（如果没有上述症状，只使用前面的穴位即可。）
伤寒脉象迟缓，病程六七天，反而给予黄芩汤来清其热。脉迟属于寒证，现在又用黄芩汤去除其热，腹中应当变冷，按理说应该不能进食，但现在反而能进食，这叫做“除中”，预后不良，必死无疑。眼睛昏暗无神，想说话却说不出来，而饮食量反而增多的，这也是“除中”。虽然嘴上想说话，但舌头僵硬无法言语。凡是手足厥冷并且伴有腹泻，本不该吃东西却想吃东西的，恐怕是“除中”，可以试着给病人吃些索饼（面条类食物）测试，如果吃完后发热，就是除中；如果不发热，就不是除中。（相关论述见“厥证”门。）
泄泻痢疾且伴有肛门重坠感，如果是少阴病表现为想睡觉的四肢厥冷症状，用四逆汤加薤白散治疗；如果是热证，用白头翁汤治疗。（方剂论述见“下利”篇。）
脉象浮，应当用发汗法解表，如果用火灸治疗，病邪无从排出，反而因火邪而亢盛，疾病会导致腰部以下必定沉重且麻木不仁，这叫做“火逆”。
脉象迟而浮弱，恶风怕冷的，属于表证，医生反而使用泻下法，导致病人不能进食、胁痛、身体发黄、颈项强直、小便困难，如果再给予柴胡汤，必然导致肛门重坠感。（相关论述见“胁痛”篇。）
下利（腹泻/痢疾）脉象沉弦的，会有肛门重坠感。（相关论述见“下重”篇。）
病人身体非常热，反而想要靠近衣物取暖的，这是热在体表（皮肤），寒在体内（骨髓）。（《活人书》说：先用桂枝汤治疗寒邪，再用小柴胡汤加桂枝以温煦体表。）身体非常寒冷，反而不想靠近衣物的，这是寒在体表，热在体内。（《活人书》说：先给予白虎汤加人参清除内热，再用桂枝麻黄各半汤解除表邪。）
After five or six days of Taiyang disease (Taiyang syndrome), following a severe purgative treatment, if the body heat persists and there is a sensation of knotting and pain in the heart region, it indicates that the pathogenic factor has not been completely resolved; Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) should be administered.
In Yangming disease, with a pulse that is wiry, floating, large, and full (indicating stomach excess), accompanied by shortness of breath, abdominal fullness, pain in the hypochondrium and epigastrium, dry nose without sweat, lethargy, jaundice, difficulty in urination, tidal fever, and frequent hiccups, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is indicated. (See "Stomach Excess" for the discussion; see "Alternating Chills and Fever" for the formula.)
[From *Yi Lin Zhai Xuan*] If a patient with Taiyang disease drinks too much water, leading to abdominal distension, asthma, and unbearable pain in the epigastrium, moxibustion on Zhongwan (CV12) and Qihai (CV6) acupoints is appropriate. If there is a sensation of qi rushing upward from the lower abdomen, moxibustion on Tianshu (ST25), Qichong (ST30), Zusanli (ST36), and Sanyinjiao (SP6) acupoints is recommended. (If these symptoms are absent, only the previous acupoints should be used.)
In Taiyang disease, if the pulse is slow and the course lasts six or seven days, but one mistakenly administers Huang Qin Tang (Scutellaria Decoction) to clear heat: since a slow pulse indicates cold, using Huang Qin Tang to further remove heat should make the abdomen cold and result in an inability to eat. However, if the patient can eat, this condition is called Chu Zhong (Elimination of the Middle), which is fatal. If the eyes are dull, speech is inhibited, yet food intake increases, this is also Chu Zhong. Although the mouth desires to speak, the tongue cannot articulate. In cases where hands and feet are cold accompanied by diarrhea, if the patient desires food when they should not, it may be Chu Zhong. One may test this by offering Suo Bing (noodle-like food); if fever ensues after eating, it is Chu Zhong; if no fever occurs, it is not. (See the "Jue Syndrome" section for the discussion.)
For dysentery with a feeling of heaviness in the rectum, if it presents as Shaoyin disease with drowsiness and cold extremities (Si Ni pattern), Si Ni Tang (Frigid Extremities Decoction) added with Xie Bai (Macrostemon Bulb) is used; if it is a heat pattern, Bai Tou Weng Tang (Pulsatilla Decoction) is used. (See "Diarrhea/Dysentery" for the formula discussion.)
A floating pulse indicates that sweating should be used to resolve the exterior. If moxibustion is applied instead, the pathogen has no outlet and becomes exacerbated by fire. This will cause heaviness and numbness from the waist down, a condition known as Fire Reversal (Huo Ni).
A pulse that is slow, floating, and weak, accompanied by aversion to wind and cold, indicates an exterior pattern. If the physician mistakenly uses purgation, it leads to loss of appetite, hypochondriac pain, jaundice, neck stiffness, and difficulty in urination. Administering Chai Hu Tang again will inevitably cause rectal heaviness. (See "Hypochondriac Pain" for the discussion.)
In diarrhea/dysentery, a deep and wiry pulse indicates rectal heaviness. (See "Rectal Heaviness" for the discussion.)
When a patient has high body heat but desires to wrap themselves in clothes, it indicates heat at the skin level and cold in the bone marrow. (*Qin Ren Shu* states: First treat the cold with Gui Zhi Tang (Cinnamon Twig Decoction), then use Xiao Chai Hu Tang plus Gui Zhi (Cinnamon Twig) to warm the exterior.) When a patient has severe cold sensations but does not desire to wrap themselves in clothes, it indicates cold at the skin level and heat in the bone marrow. (*Qin Ren Shu* states: First administer Bai Hu Tang plus Ren Shen (Ginseng) to clear heat, then use Gui Zhi Ma Huang Ge Ban Tang (Half-Size Decoction of Cinnamon Twig and Ephedra) to resolve the exterior.)