发热恶风项强者，属太阳。（方论见发热太阳病条。）项强胁下满，苦身热恶风，手足温而渴者，小柴
胡汤。若下后不能食，身黄，小便难者，与柴胡汤必反重。（方论俱见胁痛。）
太阳与少阳并病，头项强痛，或眩冒时如结胸，心下痞鞭者，当刺大椎第一间肺俞、肝俞，慎勿发汗，如发
汗则谵语，脉弦，五六日谵语不止，当刺期门。
太阳与少阳并病，心下硬，头项强而眩者，当刺大椎、肺俞，慎勿下之，宜服桂枝汤。或下之仍头项强痛，
翕翕发热无汗，心下满，微痛，小便不利者，桂枝去桂加茯苓白术汤主之。（注云∶心下满痛，小便利者，
成结胸，小便不利，为停饮，故加苓、术以行之。）
桂枝去桂加茯苓白术汤方
芍药 生姜 茯苓 白术（各两半） 甘草（一两） 大枣（六枚）
上 咀，每服五钱，水煎温服，小便利即愈。
结胸，亦项强如柔 状者，大陷胸丸主之。
项强卒口噤，背反张为 。（方论见 。）
发热恶寒，身体痛者，属太阳病，麻黄汤、大青龙汤是也。若兼心下支结者，柴胡桂枝汤。若兼
下利清谷腹胀者，先以四逆温里，后以桂枝发表。（方论见发热太阳病条。）若尺脉迟者，血少，荣气不
足，《活人》先以黄 建中汤养其血，俟尺脉回，却用柴胡等汤和解之。身体疼痛，脉沉，发热头痛
不瘥者，四逆汤。（方论见发热。）若少阴但欲寐，手足寒者，附子汤。（方论见但欲寐。）发汗后，
身体痛，脉沉迟者，桂枝加芍药生姜人参新加汤主之。
桂枝 人参（各两半） 芍药 生姜（各二两） 甘草（一两） 大枣（六枚）
上 咀，每服五钱，水煎温服。
身体痛下利。（方论见下利条。）身体痛，吐利，为霍乱。（方论见吐利条。）身体痛，手足寒，若
脉沉，但欲寐者，附子汤。（方论见但欲寐。）若大汗出，热不去，内拘急，自利恶寒者，四逆汤。
（方论见下利。）若夏月中暑，脉虚而渴者，白虎加人参汤。（方论见中暑。）身痛如被杖，面目青，
咽痛者，为阴毒，升麻鳖甲去雄黄蜀椒汤。（方论见阴毒。）
太阳病，关节疼痛而烦，脉沉而细者，此名湿痹。湿痹之候，小便不利，大便反快，但当利其小便。
（《活人》“脉沉细”作“沉缓”。）湿家之为病，身尽痛，发热而烦，身黄如熏，可与麻黄加术汤
发其汗，慎不可以大剂攻之。
麻黄加术汤方
麻黄（三两，去节） 桂枝（二两） 甘草（一两，炙） 杏仁（十个，去皮尖） 白术（四两）
上 咀，先以水煮麻黄，去沫，入诸药煎，温服，覆取微汗。
湿家病身上疼痛，发热，面黄而喘，头痛，鼻塞而烦，其脉大，自能饮食，腹中和无病，病在头中寒湿，
故鼻塞，纳药鼻中则愈。（纳鼻药方见发热。）湿家其人但欲汗出，背强，欲得被覆向火，若下早则哕，
胸满，小便不利，舌上如胎者，以丹田有热，胸中有寒，渴欲得水而不能饮，则口烦躁也。湿家下之，
额上汗出，微喘，小便利者死，若下利不止者亦死。
上湿痹，《活人书》为中湿，脉沉细为沉缓，小便自利者，术附汤。小便不利者，甘草附子汤、
五苓散，而不及麻黄加术汤，并纳鼻药。盖麻黄、纳鼻，皆是表药，而非脉沉缓之剂故也。
风湿相搏，骨节烦疼掣痛，不能屈伸，近之则痛剧，汗出短气，小便不利，恶风不欲去衣，或身
微肿者。
甘草附子汤主之。
甘草 白术（各一两） 桂枝（二两） 附子（一枚，炮）
上 咀，水煎温服，作四剂。（《活人》云∶身肿者加防风一两，悸气小便不利者加白茯苓一两半。）
伤寒八九日，风湿相搏，身疼体烦，不能转侧，不呕不渴，脉浮虚而涩者，桂枝附子汤主之。若其
人大便硬，小便自利者，去桂加白术汤主之。
桂枝附子汤方
桂枝（一两二钱） 附子（一枚，炮） 甘草（六钱，炙） 大枣（四枚） 生姜（切，一两）
上 咀，每服五钱，水煎温服。
白术附子汤方
白术（三两） 附子（一枚，炮，去皮） 甘草（二两，炙） 生姜（两半） 大枣（六枚）
上 咀，水三升，煮一升，分三服，温服。一服觉身痒，半日许再服，三服都尽，其人如冒状，
勿怪，即是术附并走皮中，逐水气未得除故耳。
病者一身尽疼，发热，日晡而剧者，多风湿。此病伤于汗后当风，或久伤取冷所致也，可与麻黄杏仁薏苡汤。
麻黄杏仁薏苡汤方
薏苡仁 麻黄（各半两。去节，汤泡） 甘草（一两，炙） 杏仁（十枚，去皮尖）
上 咀，每服四钱，水煎温服。有微汗者避风。
风湿身重，脉浮汗出恶风者，防己黄 汤。（方见身重。）
问曰∶风湿相搏，一身尽疼痛，法当汗出而解，值天阴雨不止，医云此可发汗，汗之病仍不愈者，何也。
答曰∶发其汗，汗大出者，但风气去，湿气在，故不愈也。若治风湿者发其汗，但微微自欲汗出者，风湿俱
去也。
发热、怕风且项部僵硬者，属于太阳病。（方剂论述见“发热·太阳病”条目。）项部僵硬伴胁下胀满，身体发热怕风，手足温暖且口渴者，用小柴胡汤。若经过泻下治疗后出现不能进食、身黄、小便困难的情况，给予柴胡汤反而会使病情加重。（方剂论述均见“胁痛”条目。）
太阳病与少阳病同时发病（并病），表现为头项强痛，或者头晕目眩如物蒙蔽，有时感觉像结胸证那样心下痞硬者，应当针刺大椎穴第一间隙、肺俞穴、肝俞穴，严禁使用发汗法，如果误用发汗法导致谵语（神志不清、胡言乱语）、脉弦，五六天后谵语不止，应当针刺期门穴。
太阳病与少阳病并病，心下坚硬，头项强痛且眩晕者，应当针刺大椎穴、肺俞穴，严禁使用泻下法，适宜服用桂枝汤。如果误用泻下法后仍然头项强痛，发热如羽毛覆盖般轻微发热且无汗，心下胀满、微痛，小便不利者，主治方为桂枝去桂加茯苓白术汤。（注云：心下胀满疼痛，若小便通利者，为形成结胸；若小便不利者，为水饮停聚，因此加入茯苓、白术以行水利湿。）
桂枝去桂加茯苓白术汤方
芍药、生姜、茯苓、白术（各一两半） 甘草（一两） 大枣（六枚）
以上药材切碎，每次服用五钱，加水煎煮后温服，小便通利即痊愈。
项部僵硬突然牙关紧闭，背部反张呈角弓反张状为痓病。（方剂论述见相关条目。）
发热恶寒，身体疼痛者，属于太阳病，可用麻黄汤或大青龙汤治疗。若兼有心下支撑感且结滞者，用柴胡桂枝汤。若兼有腹泻完谷不化、腹胀者，先用四逆汤温补里虚，后用桂枝汤解表。（方剂论述见“发热·太阳病”条目。）若尺脉迟者，为血少，营气不足，《活人书》主张先用黄芪建中汤滋养血液，等到尺脉恢复后，再用柴胡等汤剂和解。身体疼痛，脉沉，发热头痛不愈者，用四逆汤。（方剂论述见“发热”条目。）若少阴病表现为只想睡觉、手足寒冷者，用附子汤。（方剂论述见“但欲寐”条目。）发汗后，身体疼痛，脉沉迟者，主治方为桂枝加芍药生姜人参新加汤。
桂枝 人参（各一两半） 芍药 生姜（各二两） 甘草（一两） 大枣（六枚）
以上药材切碎，每次服用五钱，加水煎煮后温服。
身体疼痛伴腹泻。（方剂论述见“下利”条目。）身体疼痛，呕吐腹泻，为霍乱。（方剂论述见“吐利”条目。）身体疼痛，手足寒冷，若脉沉，只想睡觉者，用附子汤。（方剂论述见“但欲寐”条目。）若大汗出，热势不退，体内拘急挛缩，自发性腹泻且恶寒者，用四逆汤。（方剂论述见“下利”条目。）若夏季中暑，脉虚且口渴者，用白虎加人参汤。（方剂论述见“中暑”条目。）身体疼痛如被棍棒打击，面目青黑，咽喉痛者，为阴毒证，用升麻鳖甲去雄黄蜀椒汤。（方剂论述见“阴毒”条目。）
太阳病，关节疼痛且烦躁，脉沉而细者，此名为湿痹。湿痹的证候，小便不利，大便反而通畅，只应当通利小便。（《活人书》中“脉沉细”作“沉缓”。）患有湿病的人，全身疼痛，发热且烦躁，面色黄如熏染，可与麻黄加术汤发汗，切记不可用大剂量攻下药。
麻黄加术汤方
麻黄（三两，去节） 桂枝（二两） 甘草（一两，炙） 杏仁（十个，去皮尖） 白术（四两）
以上药材切碎，先用水煮麻黄，去掉浮沫，再加入其他药物煎煮，温服，覆盖衣被取微汗。
患湿病的人身上疼痛，发热，面黄且气喘，头痛，鼻塞且烦躁，脉象大，能正常饮食，腹部和合无病，这是病在头部感受寒湿，所以鼻塞，将药物纳入鼻中即可痊愈。（纳鼻药方见“发热”条目。）患湿病的人只想出汗，背部僵硬，想要盖被子靠近火源，如果过早使用泻下法会导致呃逆，胸满，小便不利，舌苔如胎状，这是因为丹田有热，胸中有寒，想喝水但不能喝，所以口中烦躁。对湿病患者误用泻下法，若额头出汗，微喘，小便通利的会死亡，若腹泻不止的也会死亡。
上述湿痹证，《活人书》称为中湿，脉沉细作沉缓，若小便自利者，用术附汤。若小便不利者，用甘草附子汤、五苓散，而未提及麻黄加术汤及纳鼻药。因为麻黄及纳鼻药均为表药，而非针对脉沉缓之证的药剂。
风湿相搏，骨节烦疼牵掣痛，不能屈伸，触碰则疼痛剧烈，汗出短气，小便不利，怕风不想脱衣，或者身体微肿者。
主治方为甘草附子汤。
甘草 白术（各一两） 桂枝（二两） 附子（一枚，炮制）
以上药材切碎，加水煎煮后温服，分为四次服用。（《活人书》云：身体肿胀者加防风一两，心悸气短小便不利者加白茯苓一两半。）
伤寒八九日，风湿相搏，身体疼痛烦躁，不能翻身转侧，不呕不渴，脉浮虚而涩者，主治方为桂枝附子汤。如果患者大便干硬，小便自利者，主治方为去桂加白术汤。
桂枝附子汤方
桂枝（一两二钱） 附子（一枚，炮制） 甘草（六钱，炙） 大枣（四枚） 生姜（切，一两）
以上药材切碎，每次服用五钱，加水煎煮后温服。
白术附子汤方
白术（三两） 附子（一枚，炮制，去皮） 甘草（二两，炙） 生姜（一两半） 大枣（六枚）
以上药材切碎，用水三升，煮取一升，分三次温服。第一次服药后觉得身体痒，约半天后再服第二次，三次服完，患者如有头昏目眩的感觉，不要奇怪，这就是白术和附子共同作用于皮中，驱逐水气尚未除去的缘故。
病人全身疼痛，发热，傍晚时加剧者，多为风湿。此病多因出汗后当风，或久处寒冷环境所致，可与麻黄杏仁薏苡汤。
麻黄杏仁薏苡汤方
薏苡仁 麻黄（各半两。去节，热水泡） 甘草（一两，炙） 杏仁（十枚，去皮尖）
以上药材切碎，每次服用四钱，加水煎煮后温服。若有微汗，需避风。
风湿导致身体沉重，脉浮、汗出、怕风者，用防己黄芪汤。（方剂见“身重”条目。）
问曰：风湿相搏，全身尽疼痛，按理应通过发汗而解，正值阴雨连绵不止，医生说此症可发汗，发汗后病仍不愈，为什么呢？
答曰：发其汗，若汗出过多，仅风气去除，湿气仍在，所以不愈。若治疗风湿，发其汗，只要微微持续出汗，风湿之气俱去。
Fever, aversion to wind, and stiffness of the neck belong to Taiyang disease (diseases affecting the Taiyang channel). (For formula discussions, see the entry "Fever · Taiyang Disease".) Stiffness of the neck with fullness in the hypochondrium, distress from feverish body and aversion to wind, warm hands and feet, and thirst are treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction). If, after purgation, one cannot eat, has a yellow complexion, and difficulty urinating, administering Chai Hu Tang will likely aggravate the condition. (Formula discussions are found under the entry "Hypochondriac Pain".)
When Taiyang and Shaoyang diseases occur simultaneously (Bing Bing), presenting with stiffness and pain in the head and neck, or dizziness and vertigo as if covered, sometimes feeling like Jie Xiong (Chest Binding) with epigastric hardness and fullness, one should needle the first interspace of the Dazhui (GV14) acupoint, Feishu (BL13), and Ganshu (BL18). Sweating must be strictly avoided; if sweating is induced, it may lead to delirium and a wiry pulse. If delirium persists for five to six days, Qimen (LR14) should be needled.
When Taiyang and Shaoyang diseases occur simultaneously, with epigastric hardness, stiffness and pain in the head and neck, and dizziness, one should needle Dazhui (GV14) and Feishu (BL13). Purging must be strictly avoided; Guizhi Tang (Cinnamon Twig Decoction) is appropriate. If purging is mistakenly used and stiffness/pain in the head and neck persist, along with slight fever (like a feather covering), anhidrosis, epigastric fullness, slight pain, and dysuria, Guizhi Qu Gui Jia Fuling Baizhu Tang (Guizhi Decoction without Cinnamon Twig plus Poria and Atractylodes Macrocephala Decoction) is the primary treatment. (Note: Epigastric fullness and pain with free urination indicates Jie Xiong (Chest Binding); with impaired urination, it indicates fluid retention, hence Poria and Atractylodes are added to promote diuresis.)
**Guizhi Qu Gui Jia Fuling Baizhu Tang Formula**
Shaoyao (White Peony Root), Shengjiang (Fresh Ginger), Fuling (Poria), Baizhu (Atractylodes Macrocephala Rhizome) (each 1.5 liang); Gancao (Licorice Root) (1 liang); Dazao (Jujube) (6 pieces).
Crush the herbs. Take 5 qian per dose, decoct in water, and take warm. Recovery occurs when urination becomes normal.
Jie Xiong (Chest Binding) also presenting with neck stiffness resembling Rou Ji (Soft Spasm) is treated with Da Xian Xiong Wan (Major Sinking into the Chest Pill).
Sudden stiffness of the neck, trismus (lockjaw), and opisthotonos (backward arching of the back) constitute Chi Disease (Spasm Disease). (Formula discussion see relevant entry.)
Fever, aversion to cold, and body pain belong to Taiyang disease, treatable with Mahuang Tang (Ephedra Decoction) or Da Qing Long Tang (Major Green Dragon Decoction). If accompanied by a sensation of support and binding in the epigastrium, Chai Hu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) is used. If accompanied by diarrhea with undigested food and abdominal distension, Si Ni Tang (Frigid Extremities Decoction) should be used first to warm the interior, followed by Guizhi Tang to release the exterior. (Formula discussion see "Fever · Taiyang Disease".) If the chi position of the radial pulse is slow, it indicates blood deficiency and insufficient Ying Qi (Nutritive Qi). *Ren Yuan* suggests using Huangqi Jianzhong Tang (Astragalus Decoction to Build the Middle) first to nourish the blood, and once the chi pulse recovers, use Chai Hu etc. decoctions to harmonize. Body pain with a deep pulse, fever, and headache that do not resolve are treated with Si Ni Tang. (Formula discussion see "Fever".) If Shaoyin disease presents with only wanting to sleep and cold hands/feet, Fuzi Tang (Aconite Decoction) is used. (Formula discussion see "Only Wanting to Sleep".) After sweating, if body pain persists with a deep and slow pulse, Guizhi Jia Shaoyao Shengjiang Renshen Xinjia Tang (Guizhi Decoction with Added White Peony, Fresh Ginger, and Ginseng New Addition Decoction) is the primary treatment.
**Guizhi Jia Shaoyao Shengjiang Renshen Xinjia Tang Formula**
Guizhi (Cinnamon Twig), Renshen (Ginseng Radix et Rhizoma) (each 1.5 liang); Shaoyao (White Peony Root), Shengjiang (Fresh Ginger) (each 2 liang); Gancao (Licorice Root) (1 liang); Dazao (Jujube) (6 pieces).
Crush the herbs. Take 5 qian per dose, decoct in water, and take warm.
Body pain with diarrhea. (Formula discussion see "Diarrhea" entry.) Body pain with vomiting and diarrhea constitutes Huoluan (Cholera-like disorder). (Formula discussion see "Vomiting and Diarrhea" entry.) Body pain with cold hands/feet, deep pulse, and only wanting to sleep is treated with Fuzi Tang. (Formula discussion see "Only Wanting to Sleep".) If there is profuse sweating, heat does not subside, internal cramping/tightness, spontaneous diarrhea, and aversion to cold, Si Ni Tang (Frigid Extremities Decoction) is used. (Formula discussion see "Diarrhea".) If summerheat stroke occurs in summer with a deficient pulse and thirst, Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction) is used. (Formula discussion see "Summerheat Stroke".) Body pain as if beaten by a club, blue-black facial color, and sore throat indicate Yin Du (Yin Toxin), treated with Shengma Biejia Qu Xionghuang Shuzhuo Tang ( Cimicifuga and Turtle Shell Decoction minus Realgar and Sichuan Pepper). (Formula discussion see "Yin Toxin".)
In Taiyang disease, joint pain with irritability and a deep, thin pulse is named Shi Bi (Dampness Bi Syndrome). The manifestation of Shi Bi includes impaired urination and loose stools; the treatment should focus on promoting urination. (*Ren Yuan* states "deep and thin pulse" as "deep and moderate".) For patients with Dampness disease, general body pain, fever, irritability, and a yellow complexion like smoke can be treated with Mahuang Jia Zhu Tang (Ephedra plus Atractylodes Macrocephala Decoction) to induce sweating. Great caution must be exercised against using strong purgatives.
**Mahuang Jia Zhu Tang Formula**
Mahuang (Ephedrae Herba) (3 liang, remove joints), Guizhi (Cinnamon Twig) (2 liang), Gancao (Licorice Root) (1 liang, honey-fried), Xingren (Apricot Seed) (10 pieces, remove skin and tips), Baizhu (Atractylodes Macrocephala Rhizome) (4 liang).
Crush the herbs. First decoct Mahuang in water, remove foam, then add other herbs and decoct. Take warm, cover to obtain slight sweating.
Patients with Dampness disease experiencing body pain, fever, yellow face, asthma, headache, nasal congestion, and irritability, with a large pulse, normal appetite, and no abdominal pathology, have cold-dampness in the head causing nasal congestion. Inserting medicine into the nose will cure it. (Nasal medication formula see "Fever" entry.) Patients with Dampness who desire sweating, have stiff back, and want to be covered near fire, if purged prematurely, may experience hiccups, chest fullness, impaired urination, and a tongue coating resembling mold. This is due to heat in the lower abdomen and cold in the chest, causing thirst for water but inability to drink, leading to oral irritability. If Dampness patients are incorrectly purged, and forehead sweating, slight asthma, and free urination occur, death ensues. If unceasing diarrhea occurs, death also ensues.
Regarding the above Shi Bi, *Ren Yuan Shu* calls it Zhong Shi (Middle Dampness). With a deep/moderate pulse and free urination, Shu Fu Tang (Atractylodes and Aconite Decoction) is used. With impaired urination, Gancao Fuzi Tang (Licorice and Aconite Decoction) or Wu Ling San (Five-Ingredient Powder with Poria) are used, excluding Mahuang Jia Zhu Tang and nasal medications. This is because Mahuang and nasal medications are exterior-releasing agents, not suitable for deep/moderate pulses.
When Wind-Dampness combats, causing severe bone/joint pain, pulling pain, inability to flex/extend, exacerbated by touch, sweating, shortness of breath, impaired urination, aversion to wind (not wanting to remove clothes), or slight body swelling, Gancao Fuzi Tang (Licorice and Aconite Decoction) is the primary treatment.
**Gancao Fuzi Tang Formula**
Gancao (Licorice Root), Baizhu (Atractylodes Macrocephala Rhizome) (each 1 liang); Guizhi (Cinnamon Twig) (2 liang); Fuzi (Prepared Aconite Lateralis Radix) (1 piece, processed).
Crush the herbs, decoct in water, take warm, divided into four doses. (*Ren Yuan* notes: Add Fangfeng (Saposhnikovia Root) 1 liang for body swelling; add Baifuling (Poria) 1.5 liang for palpitations and impaired urination.)
After eight to nine days of Shanghan (Cold Damage), if Wind-Dampness combats, causing body pain, restlessness, inability to turn over, no vomiting/thirst, and a floating, deficient, and choppy pulse, Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) is the primary treatment. If the patient has hard stool and free urination, Qu Gui Jia Baizhu Tang (Remove Cinnamon Twig, Add Atractylodes Macrocephala Decoction) is used.
**Guizhi Fuzi Tang Formula**
Guizhi (Cinnamon Twig) (1.2 qian), Fuzi (Prepared Aconite Lateralis Radix) (1 piece, processed), Gancao (Licorice Root) (6 qian, honey-fried), Dazao (Jujube) (4 pieces), Shengjiang (Fresh Ginger) (1 liang, sliced).
Crush the herbs. Take 5 qian per dose, decoct in water, take warm.
**Baizhu Fuzi Tang Formula**
Baizhu (Atractylodes Macrocephala Rhizome) (3 liang), Fuzi (Prepared Aconite Lateralis Radix) (1 piece, processed, peeled), Gancao (Licorice Root) (2 liang, honey-fried), Shengjiang (Fresh Ginger) (1.5 liang), Dazao (Jujube) (6 pieces).
Crush the herbs. Use 3 sheng of water, boil down to 1 sheng, divide into three warm doses. After the first dose, if the body feels itchy, take the second dose after half a day. After all three doses, if the patient feels dizzy, do not be alarmed; this is because Baizhu and Fuzi are working together in the skin to expel water qi which has not yet been fully removed.
If a patient has general body pain, fever, worsening in the late afternoon, it is mostly Wind-Dampness. This illness often results from exposure to wind after sweating or prolonged exposure to cold. Mahuang Xingren Yiyi Ren Tang (Ephedra, Apricot Seed, and Coix Seed Decoction) can be administered.
**Mahuang Xingren Yiyi Ren Tang Formula**
Yiyiren (Coicis Semen), Mahuang (Ephedrae Herba) (each 0.5 liang, remove joints, soak in hot water), Gancao (Licorice Root) (1 liang, honey-fried), Xingren (Apricot Seed) (10 pieces, remove skin and tips).
Crush the herbs. Take 4 qian per dose, decoct in water, take warm. Avoid wind if slight sweating occurs.
For Wind-Dampness causing heavy body, floating pulse, sweating, and aversion to wind, Fangji Huangqi Tang (Stephania and Astragalus Decoction) is used. (Formula see "Heavy Body" entry.)
Question: When Wind-Dampness combats, causing general body pain, it is methodologically correct to resolve via sweating. However, during continuous rainy weather, if the physician prescribes sweating and the disease does not resolve, why?
Answer: If sweating induces excessive perspiration, only the Wind pathogen is expelled while Dampness remains, hence no resolution. In treating Wind-Dampness, inducing sweating should result only in slight, continuous perspiration, at which point both Wind and Dampness are expelled.