太阳病，初服桂枝汤而反烦者，阳邪痹于阳而不散也，故先刺风池、风府，以通其痹。
阳邪被抑而未服者，仍当从阳因而去之。此桂枝汤去芍药之意。
病在阳而反下之，邪气被抑而未复，正气方虚而不振，是以其脉多促。然当辨其仍在表
者，
则纯以辛甘发之，桂枝去芍药汤是也；辨其兼入里者，则并以苦寒清之，葛根黄芩黄连汤是
也。
余寇未平，复合为乱；余邪未净，复集为病。伤寒发汗解，半日许复烦是也。
大下之下之后，复发汗三条，均是汗、下之后。然小便不利者，伤其阴也；振寒脉微细
者，
阴阳俱伤也；昼日烦躁不得卧者，伤阳而不伤阴也。于此见病变之不同。发汗则动经者，无
邪可发，而反动其经气也。余谓此条为饮症者，未必谬也。
发汗后，水、药不得入口者，是动其经气也。但阳脉微者，先汗之而解；但阴脉微者，
下之而解，逐坚攻瑕之法。
喘而汗出，有阳气虚脱者，亦有热气内迫者。太阳病下之，下利，脉促，喘而汗出，葛
根黄连黄芩汤主之是也。
利水、逐血，为热入膀胱两大法门。利水厘清、温，五苓、猪苓是也；逐血辨微、甚，
桃仁承气、抵当汤丸是也。
青龙汤主散表寒，而兼清里热，故麻黄多于石膏；麻杏甘石主清肺热，而兼散肺邪，故
石膏
多于麻黄。桂枝汤主散表邪，故桂枝倍芍药，而益生姜之辛；建中汤主立中气，故芍药倍桂
枝，而益饴糖之甘。品味相同，而君臣异用，表里、补泄，因之各异矣。
太阳转入阳明，其端有二∶一者汗出不彻，邪气不服而传。曰∶太阳初得病，时发其汗
，汗
先出不彻，因转属阳明也。一者汗出过多，胃中干燥而传。曰∶太阳病，若发汗、若吐、若
下、若利小便，此亡津液，胃中干燥，因转属阳明也。
经邪不能聚，故传入腑，则聚而不传。经邪未变，故恶寒；入腑，则变热而不寒。曰∶
阳明居中土也，万物所归，无所复传。始虽恶寒，二日自止，此为阳明入腑症也。
阳明病，法多汗，反无汗，其身如虫行皮中状者，气内蒸而津不从也。
痞症表未解者，宜先解表，不可便治其痞。若兼下利不止者，则不拘此例，宜合表里而
并治
。太阳病外症未除，而数下之，遂协热而利，利下不止，心下痞硬，表里不解者，桂枝人参
汤主之是也。
阳明津涸，舌干口燥者，不足虑也；若并亡其阳，则殆矣。少阴阳虚，汗出而厥者，不
足虑
也；若并伤其阴，则危矣。是以阳明燥渴，能饮冷者生，不能饮者死；少阴厥逆，舌不干者
生，干者死。
少阴病八九日，一身手足尽热者，邪自本而之标，自脏而入腑也，虽便血可治。
太阳病，初次服用桂枝汤后反而出现烦闷症状的，是阳邪阻滞在阳分而不能发散，所以先针刺风池穴、风府穴，以疏通其阻滞。
阳邪被抑制而未能解除的，仍然应当顺应阳气运行的趋势来驱除它。这就是桂枝汤去掉芍药的道理。
病位在表（阳），却反而使用攻下法，导致邪气被压制而不能恢复，正气刚刚虚弱且不能振奋，因此脉象多表现为促脉。然而应当辨别邪气是否仍在体表：如果邪气仍在表，则单纯用辛甘味的药物发汗解表，桂枝去芍药汤就是这类方剂；如果辨别出邪气兼入里，则并用苦寒药物清泄里热，葛根黄芩黄连汤就是这类方剂。
残余的邪寇尚未平定，又复合为乱；残留的邪气未净，又聚集致病。伤寒发汗后病解，半天左右又出现烦闷，就是这种情况。
大下之后，再发汗，以及三条关于汗下并用的条文，都是指在汗法和下法之后的情况。然而，小便不利的，是损伤了阴液；身体震颤怕冷、脉象微细的，是阴阳两伤；白天烦躁不得安卧的，是损伤了阳气而没有损伤阴液。从这里可以看出病变的不同。发汗导致动经气的，是因为没有邪气可发，反而扰动经气。我认为这一条属于饮邪病症的说法，未必是错误的。
发汗后，水药无法入口的，这是动摇了经气。如果是只有阳脉微弱的，先通过发汗来解除；如果是只有阴脉微弱的，通过攻下法来解除，这是驱逐坚积、攻逐瑕疵的方法。
气喘且出汗，有的是因为阳气虚脱，也有的是因为热气内迫。太阳病误用下法，导致腹泻，脉象促，气喘且出汗，用葛根黄芩黄连汤主治，就是这种情况。
利水和逐血，是热邪进入膀胱的两大治疗法则。利水方面区分清浊与温凉，五苓散、猪苓汤就是这类方剂；逐血方面辨别轻症与重症，桃仁承气汤、抵当汤丸就是这类方剂。
大青龙汤主要发散表寒，兼清里热，所以麻黄的用量多于石膏；麻杏甘石汤主要清泄肺热，兼散肺邪，所以石膏的用量多于麻黄。桂枝汤主要发散表邪，所以桂枝加倍于芍药，并增加生姜的辛散之力；小建中汤主要建立中气，所以芍药加倍于桂枝，并增加饴糖的甘缓之力。药味相同，但君臣配伍的作用不同，表里、补泻的效果也因此各异。
太阳病转入阳明病，其开端有两种情况：一种是发汗不彻底，邪气未被制服而传变。经文说：“太阳病初起时，经常发汗，汗先出不透彻，因而转属阳明。”另一种是发汗过多，胃中干燥而传变。经文说：“太阳病，如果用发汗、催吐、攻下、利小便等方法，导致津液亡失，胃中干燥，因而转属阳明。”
经络之邪不能聚结，所以传入腑，就会聚结而不继续传变。经络之邪未发生性质变化，所以仍恶寒；传入腑后，则化热而不恶寒。经文说：“阳明居中属土，是万物归聚之所，不再传变他经。开始虽然恶寒，到第二天自然停止，这是阳明病传入腑的症状。”
阳明病，按照常理应该多汗，反而无汗，身体感觉像虫子在皮肤中爬行一样，这是因为热气在内蒸腾而津液不能外达所致。
痞证如果表证未解，应当先解表，不可以立即治疗痞证。如果兼有腹泻不止的情况，则不拘泥于此例，应当表里同治。太阳病表证未除，却多次使用攻下法，导致协热下利，腹泻不止，心下痞硬，表里同病的，用桂枝人参汤主治，就是这种情况。
阳明病津液枯竭，舌干口燥的，还不足为虑；如果同时阳气也亡失，那就危险了。少阴病阳气虚弱，出汗且四肢厥冷的，还不足为虑；如果同时阴液也受损，那就危急了。因此，阳明病燥渴，能喝冷水的预后良好，不能喝的预后不良；少阴病四肢厥逆，舌不干润的预后良好，舌干的预后不良。
Taiyang disease, after initially taking Guizhi Tang (Cinnamon Twig Decoction), if there is a rebound of vexation, it indicates that Yang pathogenic factors are obstructed in the Yang aspect and cannot dissipate. Therefore, Fengchi (GB20) and Fengfu (GV16) acupoints should be needled first to unblock the obstruction.
When Yang pathogenic factors are suppressed but not resolved, they should still be expelled by following the trend of Yang. This explains the rationale behind removing Shaoyao (Paeoniae Radix Alba) from Guizhi Tang.
If the pathology is at the exterior (Yang) but purgation is mistakenly applied, the pathogenic factor is suppressed and fails to recover, while the healthy Qi is just weakened and unable to振奋 (stir up). Consequently, the pulse often presents as Cu Mai (Surging Pulse). However, differentiation is required: if the pathogen remains at the exterior, purely acrid-sweet herbs for diaphoresis should be used; Guizhi Qushaoyao Tang (Cinnamon Twig Decoction without Paeonia) is such a formula. If it is differentiated that the pathogen has entered the interior along with the exterior, bitter-cold herbs for clearing heat should be combined; Gegen Huangqin Huanglian Tang (Kudzu Root, Scutellaria and Coptis Decoction) is such a formula.
Residual pathogens remain unsettled and combine to cause chaos; lingering evil qi is not cleared and gathers to cause disease. For example, after sweating resolves Taiyang Shanghan (Cold Damage), vexation recurs after half a day.
The three scenarios involving severe purgation followed by sweating all refer to conditions after both sweating and purgation have been used. However, if there is difficulty in urination, Yin fluids are injured; if there is trembling chills and a faint, fine pulse, both Yin and Yang are injured; if there is daytime irritability and inability to lie down, Yang is injured but Yin is spared. From this, we can see the differences in pathological changes. Sweating causing disturbance of the meridians occurs when there is no pathogen to expel, yet the meridian Qi is disturbed. I believe that interpreting this scenario as related to Yin Syndrome (Fluid Retention) is likely not erroneous.
After sweating, if water and medicine cannot enter the mouth, it indicates disturbance of meridian Qi. If only the Yang pulse is faint, resolution is achieved through sweating first; if only the Yin pulse is faint, resolution is achieved through purgation. This represents the method of driving out hardness and attacking flaws.
Wheezing accompanied by sweating may result from collapse of Yang Qi or from internal pressure of hot Qi. In Taiyang disease, mistaken purgation leads to diarrhea, a surging pulse, wheezing, and sweating; Gegen Huanglian Huangqin Tang (Kudzu Root, Coptis and Scutellaria Decoction) is indicated.
Promoting urination and dispelling blood stasis are the two major approaches for Heat entering the Bladder. For promoting urination, distinguishing between clear/turbid and warm/cool, Wuling San (Five-Ingredient Powder with Poria) and Zhuling Tang (Polyporus Decoction) are examples. For dispelling blood stasis, distinguishing between mild and severe cases, Tao Ren Chengqi Tang (Prunus Seed and Rhubarb Decoction) and Didang Tang/Wan (Toughness Overcoming Decoction/Pill) are examples.
Da Qing Long Tang (Major Blue Green Dragon Decoction) primarily disperses exterior cold and clears interior heat, hence Mahuang (Ephedra) dosage exceeds Shigao (Gypsum). Maxing Shigan Tang (Ephedra, Apricot Kernel, Ginseng, and Gypsum Decoction) primarily clears Lung heat and disperses Lung pathogens, hence Shigao (Gypsum) dosage exceeds Mahuang (Ephedra). Guizhi Tang (Cinnamon Twig Decoction) primarily disperses exterior pathogens, so Guizhi (Cinnamon Twig) doubles Shaoyao (Paeonia), enhancing the acridity of Shengjiang (Fresh Ginger); Jianzhong Tang (Middle-Building Decoction) primarily establishes Middle Qi, so Shaoyao (Paeonia) doubles Guizhi (Cinnamon Twig), enhancing the sweetness of Yitang (Maltose). Although the ingredients are similar, the roles of Sovereign and Minister herbs differ, leading to different effects on exterior/interior and tonification/draining.
The transition from Taiyang to Yangming has two beginnings: First, incomplete sweating allows the pathogen to persist and transmit. The text states: "When Taiyang disease is first acquired, frequent sweating is attempted; if the sweat is initially incomplete, it transforms into Yangming." Second, excessive sweating dries the Stomach, leading to transmission. The text states: "In Taiyang disease, if sweating, vomiting, purgation, or diuresis are used, resulting in loss of Jin-Ye (Body Fluids) and dryness in the Stomach, it transforms into Yangming."
Pathogenic factors in the meridians cannot gather, so upon transmitting to the Fu organs, they gather and cease transmitting. Since the meridian pathogen has not changed nature, chills persist; upon entering the Fu organs, it transforms into heat and chills cease. The text states: "Yangming resides in the center, belonging to Earth, where all things return and no further transmission occurs. Although chills occur initially, they stop spontaneously by the second day; this is the symptom pattern of Yangming entering the Fu organs."
In Yangming disease, profuse sweating is the norm; conversely, anhidrosis with a sensation like insects crawling under the skin indicates internal steaming of heat with failure of fluids to reach the surface.
For Pi Syndrome (Glomus) with unresolved exterior symptoms, the exterior should be resolved first, and one should not immediately treat the Pi. If accompanied by persistent diarrhea, this rule does not apply, and simultaneous treatment of exterior and interior is appropriate. In Taiyang disease, if exterior symptoms persist but multiple purgations are used, leading to diarrhea with fever, persistent loose stools, epigastric fullness/hardness, and simultaneous exterior-interior involvement, Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction) is indicated.
In Yangming disease, dry tongue and mouth due to fluid depletion are not alarming; however, if Yang Qi is also lost, it is dangerous. In Shaoyin disease, sweating and cold limbs due to Yang deficiency are not alarming; however, if Yin is also damaged, it is critical. Therefore, in Yangming dry thirst, those who can drink cold liquids survive, while those who cannot die; in Shaoyin cold limbs, those with non-dry tongues survive, while those with dry tongues die.
In Shaoyin disease lasting eight or nine days, if the whole body and extremities become hot, the pathogen has moved from the root (Zang) to the branch (Fu), from the Zang organs to the Fu organs. Even if hematochezia (blood in stool) occurs, it is treatable.