夫伤寒之说，始自黄帝以开其端，至于仲景方陈其条目，自后肤浅之学，莫知其数。立言者只云病在表可
发汗，病在里可下，或云不可汗、不可下，未尝有温中之说。仲景《伤寒例》云∶尺寸俱沉细，太阴受病也；
尺寸俱沉，少阴受病也；尺寸俱微缓，厥阴受病也。又辨太阴症云∶太阴病脉浮，可发汗，宜桂枝汤。又手足
温，自利不渴者，宜四逆汤。又腹满时痛，桂枝加芍药汤。辨少阴证云∶少阴病始得之，发热脉沉者，麻黄附
子细辛汤。又少阴病二三日，麻黄附子甘草汤。又少阴病，手足寒，身体痛，骨节疼，脉沉者，附子汤。又厥
阴病，吐利，手足逆冷，烦躁欲死者，吴茱萸汤。又少阴病，脉沉，急温之，宜四逆汤。今举仲景论中数条，
最是三阴病之良法，于今世用之，尚有未尽证者。愚常校之，自至和初岁迄于今三十余年，不以岁之太过、不
及为则，每至夏至以前，有病伤寒人十中七八，两手脉俱沉细数，多是胸膈满闷，或呕逆，或气塞，或肠鸣，
或腹痛，与仲景三阴病说理同而证不同，因兹不敢妄投仲景三阴药方。才见脉沉及胸膈满，便投下药下之，往
往不救。常斟酌仲景理中丸与服之，其病势轻者，胸中便快；其病势重者，半日许满闷依然。或有病患脉沉细
迟，投仲景四逆汤温之，多药力大热，后必发烦躁，因校量此形证，今别立方以治之，药多对证，不可不传焉。
病患但两手脉沉细数，或有力，或无力，或关脉短及力小，胸膈塞满，气短不能相接者，便可随脉证投温
中药以治之。病患两手脉沉迟，或紧，皆是胃中寒也。若寸脉短及力小于关尺者，此阴盛阳虚也。或胸膈满闷，
腹中胀满，身体拘急，手足逆冷，急宜温之。若立春以后至清明以前，宜温中汤主之。清明以后至芒种以前，
宜陈皮汤主之。芒种以后至立秋以前，宜七物理中丸主之。
温中汤
丁皮（一两） 干姜（炮） 白术 陈皮 丁香（各二钱） 浓朴（一两，制）
上为细末，每服二钱，水一盏，葱白三寸，荆芥五穗，煎至七分，去渣热服。如未快，手足尚逆，呕吐者，
加丁香、干姜各二钱。
陈皮汤
陈皮（一两） 藿香（三钱） 白术 葛根（各二钱） 浓朴（一两，制）
上为末，每服二钱，水一盏，姜一块，同煎至七分，去渣热服。如三服未快，手足尚逆，呕吐不定者，加
半夏、丁香、桂枝各半两，每服加葱白三寸，煎服。
七物理中丸
白术（五钱） 干姜（二钱半） 人参（七钱半） 桔梗（七钱） 干葛（七钱半） 藿香叶（五钱）
甘草（二钱，炙）
上为细末，炼蜜为丸如弹子大。每服一丸，水一盏，煎八分，和渣热服。如三服未快，手足尚逆，呕者，
加半夏、生姜各半两。
病患两手脉沉细无力，虽三部脉力停等，亦是阴气盛也，更不须候寸脉短治之。或胸胁满闷，身体拘急疼
痛，手足逆冷，速宜温中药和之。若立春以后至清明以前，宜浓朴丸主之。清明以后至芒种以前，宜白术汤主
之。芒种以后至立秋以前，宜橘皮汤主之。
浓朴丸
当归（半两） 丁皮（半两） 浓朴（一两，制） 细辛（二钱半） 人参（七钱半） 甘草（半两，炙） 干
姜（半两，炮）
上为末，炼蜜为丸弹子大，每服一丸，煎至六分，和渣热服。三服后脉尚细，及寸脉尚细无力者，
每服加葱白三寸，同煎服。
白术汤
白术 半夏 当归 浓朴（制） 干姜（炮。各半两） 丁香（七钱）
上为末，每服三钱，水一盏，姜一大片，煎至七分，去渣热服。三五服后，脉未有力，寸脉尚小者，加细
辛半两，每服加葱白三寸，同煎服。
橘皮汤
橘皮（半两） 藿香 葛根（各三钱） 半夏 浓朴（制。各半两）
上为末，每服三钱，水一盏，生姜如枣大，同煎至七分，去渣热服。三五服后，脉尚小，手足逆冷者，加
细辛半两。
病患胸膈满闷，时时呕逆，肢节痛，两胁下痛，腹中鸣，此是停饮。宜二苓汤。
赤茯苓 木猪苓 白术（各半两） 滑石（一两） 通草 白豆蔻（各二钱半） 丁香皮（七钱半） 陈皮（半两）
桂枝（五钱）
上为末，每服三钱，水一盏，煎至七分，去渣热服。小便未快，加瞿麦七钱半。呕未止，加半夏半两。淅
淅恶寒甚，每服加葱白三寸。
伤寒的理论，始于黄帝开启了先河，到了张仲景才详细阐述了其条理体系。此后那些肤浅的医术，不知有多少种。立论者只说病在表可以用发汗法，病在里可以用攻下法，或者说不可发汗、不可攻下，从未有过“温中”的说法。张仲景《伤寒例》中说：寸脉和尺脉都呈现沉细象，是太阴经受邪；寸脉和尺脉都呈现沉象，是少阴经受邪；寸脉和尺脉都呈现微缓象，是厥阴经受邪。又辨析太阴病症说：太阴病脉象浮，可以发汗，适宜用桂枝汤。又说手足温暖，自发性腹泻且不口渴的，适宜用四逆汤。又说腹部胀满且时常疼痛的，用桂枝加芍药汤。辨析少阴证说：少阴病初起，发热且脉象沉的，用麻黄附子细辛汤。又说少阴病二三天后，用麻黄附子甘草汤。又说少阴病，手足寒冷，身体疼痛，骨节疼痛，脉象沉的，用附子汤。又说厥阴病，呕吐腹泻，手足逆冷，烦躁得快要死去的，用吴茱萸汤。又说少阴病，脉象沉，应当紧急温补，适宜用四逆汤。现在列举张仲景论述中的这几条，是最治疗三阴病的良法，但在当今世道使用它，还有未能完全涵盖的证候。我常加以校勘验证，自从至和初年到现在三十多年，不以岁运的太过或不及为标准，每到夏至以前，患伤寒的人十中有七八，两手脉象都呈现沉细数，多是胸膈部胀满闷塞，或者呕吐逆气，或者气机阻塞，或者肠鸣，或者腹痛，这与张仲景关于三阴病的理论相同但症状不同，因此我不敢妄自投用张仲景治疗三阴病的药方。只要见到脉沉及胸膈满闷，就投用下药攻下，往往导致无法救治。我常常斟酌使用张仲景的理中丸给患者服用，病情轻的，胸部顿时感到舒畅；病情重的，半天左右胀闷依然如故。有的患者脉象沉细迟，投用张仲景的四逆汤来温补，因为药力过于大热，之后必定会出现烦躁，因此我权衡这种形证，现在另外制定方剂来治疗，药物大多对症，不能不流传下去。
患者只要两手脉象沉细数，或者有力，或者无力，或者关脉短促且力量小，胸膈部堵塞满闷，气短不能接续的，就可以根据脉证投用温中药来治疗。患者两手脉象沉迟，或者紧，都是胃中寒邪所致。如果寸脉短促且力量小于关脉和尺脉，这是阴盛阳虚。或者胸膈满闷，腹部胀满，身体拘挛急迫，手足逆冷，应当紧急温补。如果在立春以后到清明以前，适宜用温中汤主治。清明以后到芒种以前，适宜用陈皮汤主治。芒种以后到立秋以前，适宜用七物理中丸主治。
温中汤
丁皮（一两） 干姜（炮制） 白术 陈皮 丁香（各二钱） 浓朴（一两，炮制）
以上药材研为细末，每次服用二钱，用水一盏，葱白三寸，荆芥五穗，煎煮至七分，去渣后热服。如果服药后未感舒畅，手足仍然逆冷，呕吐的，加丁香、干姜各二钱。
陈皮汤
陈皮（一两） 藿香（三钱） 白术 葛根（各二钱） 浓朴（一两，炮制）
以上药材研为细末，每次服用二钱，用水一盏，生姜一块，同煎煮至七分，去渣后热服。如果服用三次后未感舒畅，手足仍然逆冷，呕吐不止的，加半夏、丁香、桂枝各半两，每次服用时加葱白三寸，煎煮后服用。
七物理中丸
白术（五钱） 干姜（二钱半） 人参（七钱半） 桔梗（七钱） 干葛（七钱半） 藿香叶（五钱）
甘草（二钱，炙烤）
以上药材研为细末，用炼蜜制成如弹子大小的丸剂。每次服用一丸，用水一盏，煎煮至八分，连同药渣一起热服。如果服用三次后未感舒畅，手足仍然逆冷，呕吐的，加半夏、生姜各半两。
患者两手脉象沉细无力，虽然三部脉的力量相等，也是阴气旺盛的表现，更不需要等候寸脉短促再进行治疗。或者胸胁部满闷，身体拘挛疼痛，手足逆冷，应当迅速用温中药调和治疗。如果在立春以后到清明以前，适宜用浓朴丸主治。清明以后到芒种以前，适宜用白术汤主治。芒种以后到立秋以前，适宜用橘皮汤主治。
浓朴丸
当归（半两） 丁皮（半两） 浓朴（一两，炮制） 细辛（二钱半） 人参（七钱半） 甘草（半两，炙烤） 干姜（半两，炮制）
以上药材研为细末，用炼蜜制成如弹子大小的丸剂，每次服用一丸，煎煮至六分，连同药渣一起热服。服用三次后脉象仍然细，以及寸脉仍然细无力的，每次服用时加葱白三寸，同煎服用。
白术汤
白术 半夏 当归 浓朴（炮制） 干姜（炮制。各半两） 丁香（七钱）
以上药材研为细末，每次服用三钱，用水一盏，生姜一大片，煎煮至七分，去渣后热服。服用三五次后，脉象仍未有力，寸脉仍然小的，加细辛半两，每次服用时加葱白三寸，同煎服用。
橘皮汤
橘皮（半两） 藿香 葛根（各三钱） 半夏 浓朴（炮制。各半两）
以上药材研为细末，每次服用三钱，用水一盏，生姜如枣大小，同煎煮至七分，去渣后热服。服用三五次后，脉象仍然小，手足逆冷的，加细辛半两。
患者胸膈部满闷，时时呕吐逆气，肢节疼痛，两胁下疼痛，腹中肠鸣，这是水饮停聚所致。适宜用二苓汤。
赤茯苓 木猪苓 白术（各半两） 滑石（一两） 通草 白豆蔻（各二钱半） 丁香皮（七钱半） 陈皮（半两）
桂枝（五钱）
以上药材研为细末，每次服用三钱，用水一盏，煎煮至七分，去渣后热服。小便不通畅的，加瞿麦七钱半。呕吐未停止的，加半夏半两。恶寒明显的，每次服用加葱白三寸。
The theory of Shanghan (Cold Damage) began with the Yellow Emperor, who opened the way, and reached its systematic formulation by Zhang Zhongjing. Since then, superficial medical practices have been countless. Those who formulate theories only state that diseases in the exterior can be treated with sweating methods, and diseases in the interior can be treated with purgative methods, or that neither sweating nor purging is indicated; there has never been a discussion on "warming the middle." Zhang Zhongjing's *Shanghan Example* states: When both the Cun (inch) and Chi (cubit) pulses are deep and fine, it indicates Taiyin disease; when both are deep, it indicates Shaoyin disease; when both are slightly slow and moderate, it indicates Jueyin disease. Furthermore, regarding Taiyin symptoms, he clarifies: In Taiyin disease, if the pulse is floating, sweating may be applied, preferably using Guizhi Tang (Cinnamon Twig Decoction). He also states: If the hands and feet are warm, accompanied by spontaneous diarrhea without thirst, Sini Tang (Frigid Extremities Decoction) is appropriate. For abdominal fullness with intermittent pain, Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction plus Peony Root) is used. Regarding Shaoyin signs: At the onset of Shaoyin disease, if there is fever and a deep pulse, Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) is indicated. After two to three days of Shaoyin disease, Mahuang Fuzi Gancao Tang (Ephedra, Aconite, and Licorice Decoction) is used. If Shaoyin disease presents with cold hands and feet, body pain, joint pain, and a deep pulse, Fuzi Tang (Aconite Decoction) is prescribed. For Jueyin disease, characterized by vomiting, diarrhea, cold extremities, and severe irritability bordering on death, Wuzhuyu Tang (Evodia Decoction) is indicated. Additionally, in Shaoyin disease with a deep pulse, urgent warming is required, favoring Sini Tang. I cite several passages from Zhang Zhongjing’s discussions as excellent methods for treating the Three Yin diseases. However, applying them in contemporary times reveals incomplete coverage of certain syndromes.
I have observed and verified this over more than thirty years since the beginning of the Zhihe era, regardless of whether the annual climatic influence was excessive or deficient. Before the Summer Solstice, seven or eight out of ten patients suffering from Shanghan present with deep, fine, and rapid pulses in both hands. They commonly experience chest and diaphragm fullness and oppression, or vomiting and regurgitation, qi stagnation, borborygmus, or abdominal pain. While the underlying theory aligns with Zhang Zhongjing’s description of Three Yin diseases, the clinical manifestations differ. Therefore, I dare not recklessly administer Zhang Zhongjing’s formulas for Three Yin diseases. Physicians who see a deep pulse and chest fullness and immediately apply purgatives often fail to save the patient. I frequently prescribe Lizhong Wan (Regulate the Middle Pill) based on Zhang Zhongjing’s formula. For mild cases, the chest feels relieved quickly; for severe cases, the fullness persists after half a day. Some patients with deep, fine, and slow pulses were given Sini Tang for warming, but due to the excessive heat of the medication, they subsequently developed irritability. Weighing these clinical presentations, I have now formulated new prescriptions for treatment, which prove highly effective. These must be transmitted.
If a patient presents with deep, fine, and rapid pulses in both hands—whether forceful or weak—or a short Guan (bar) pulse with weak strength, accompanied by chest and diaphragm blockage and fullness, and shortness of breath where inhalation cannot connect smoothly, one should administer warming-middle herbs according to the pulse and syndrome. Deep and slow or tight pulses in both hands indicate Cold in the Stomach. If the Cun pulse is short and weaker than the Guan and Chi pulses, this signifies Yin Excess and Yang Deficiency. Symptoms such as chest and diaphragm fullness, abdominal distension, bodily stiffness, and cold extremities require urgent warming. From after Li Chun (Start of Spring) until before Qingming (Clear and Bright), Wenzhong Tang (Warm the Middle Decoction) is indicated. From after Qingming until before Mangzhong (Grain in Ear), Chenpi Tang (Tangerine Peel Decoction) is indicated. From after Mangzhong until before Liqiu (Start of Autumn), Qiwu Lizhong Wan (Seven-Ingredient Regulate-the-Middle Pill) is indicated.
Wenzhong Tang
Dingpi (Pericarpium Citri Reticulatae Viride, 1 liang), Ganjiang (Prepared Rhizoma Zingiberis, prepared), Baizhu (Rhizoma Atractylodis Macrocephalae), Chenpi (Pericarpium Citri Reticulatae), Dingxiang (Flos Caryophylli, each 2 qian), Houpo (Cortex Magnoliae Officinalis, 1 liang, processed).
Grind into fine powder. Take 2 qian per dose, decoct with one sheng of water, three cun of scallion white, and five spikes of Jingjie (Herba Schizonepetae) until reduced to 0.7 parts. Strain and take hot. If relief is not achieved and extremities remain cold with vomiting, add 2 qian each of Dingxiang and Ganjiang.
Chenpi Tang
Chenpi (1 liang), Huoxiang (Herba Agastaches, 3 qian), Baizhu, Gegen (Radix Puerariae, each 2 qian), Houpo (1 liang, processed).
Grind into powder. Take 2 qian per dose, decoct with one sheng of water and a piece of Shengjiang (Rhizoma Zingiberis Recens) until reduced to 0.7 parts. Strain and take hot. If unsatisfied after three doses, with persistent cold extremities and不定 vomiting, add Banxia (Rhizoma Pinelliae), Dingxiang, and Guizhi (Ramulus Cinnamomi) each 0.5 liang. Add three cun of scallion white per dose during decoction.
Qi Wu Lizhong Wan
Baizhu (5 qian), Ganjiang (2.5 qian), Renshen (Radix Ginseng, 7.5 qian), Jiegeng (Radix Platycodonis, 7 qian), Gange (Radix Puerariae Lobatae, 7.5 qian), Huoxiangye (Folium Agastaches, 5 qian), Gancao (Radix Glycyrrhizae, 2 qian, honey-fried).
Grind into fine powder and mix with refined honey to form pills the size of a bullet. Take one pill per dose, decoct with one sheng of water until reduced to 0.8 parts. Consume the liquid and dregs hot. If unsatisfied after three doses, with cold extremities and vomiting, add 0.5 liang each of Banxia and Shengjiang.
If the patient’s pulses in both hands are deep, fine, and weak, even if the three positions (Cun, Guan, Chi) are equal in strength, it still indicates Excess Yin. There is no need to wait for a short Cun pulse to initiate treatment. Symptoms such as chest and hypochondriac fullness, bodily stiffness and pain, and cold extremities require prompt harmonization with warming-middle herbs. From after Li Chun until before Qingming, Houpo Wan (Magnolia Bark Pill) is indicated. From after Qingming until before Mangzhong, Baizhu Tang (Atractylodes Macrocephala Decoction) is indicated. From after Mangzhong until before Liqiu, Jupi Tang (Tangerine Peel Decoction) is indicated.
Houpo Wan
Danggui (Radix Angelicae Sinensis, 0.5 liang), Dingpi (0.5 liang), Houpo (1 liang, processed), Xixin (Herba Asari, 2.5 qian), Renshen (7.5 qian), Gancao (0.5 liang, honey-fried), Ganjiang (0.5 liang, prepared).
Grind into powder and mix with refined honey to form pills the size of a bullet. Take one pill per dose, decoct until reduced to 0.6 parts. Consume the liquid and dregs hot. If the pulse remains fine after three doses, or if the Cun pulse remains fine and weak, add three cun of scallion white per dose during decoction.
Baizhu Tang
Baizhu, Banxia, Danggui, Houpo (processed), Ganjiang (prepared, each 0.5 liang), Dingxiang (7 qian).
Grind into powder. Take 3 qian per dose, decoct with one sheng of water and a large slice of Shengjiang until reduced to 0.7 parts. Strain and take hot. If after three to five doses the pulse lacks strength and the Cun pulse remains small, add 0.5 liang of Xixin. Add three cun of scallion white per dose during decoction.
Jupi Tang
Jupi (Pericarpium Citri Reticulatae, 0.5 liang), Huoxiang, Gegen (each 3 qian), Banxia, Houpo (processed, each 0.5 liang).
Grind into powder. Take 3 qian per dose, decoct with one sheng of water and a piece of Shengjiang the size of a jujube until reduced to 0.7 parts. Strain and take hot. If after three to five doses the pulse remains small and extremities are cold, add 0.5 liang of Xixin.
When a patient experiences chest and diaphragm fullness, frequent vomiting and regurgitation, limb and joint pain, pain in both hypochondria, and borborygmus, this indicates retained fluid (Phlegm-Fluid). Er Ling Tang (Two-Poria Decoction) is indicated.
Chi Fuling (Poria Cum Radice, 0.5 liang each with Zhu Ling and Baizhu), Huashi (Talcum, 1 liang), Tongcao (Medulla Tetrapanacis), Baixiudoukou (Fructus Cardamomi Albii, each 2.5 qian), Dingxipi (Pericarpium Citri Reticulatae Viride, 7.5 qian), Chenpi (0.5 liang), Guizhi (5 qian).
Grind into powder. Take 3 qian per dose, decoct with one sheng of water until reduced to 0.7 parts. Strain and take hot. If urination is not smooth, add Qumai (Herba Descurainiae, 7.5 qian). If vomiting does not cease, add 0.5 liang of Banxia. If aversion to cold is pronounced, add three cun of scallion white per dose.