麻仁 牛蒡子 杞子 蔓荆子（各一两同炒） 白蒺藜 苦参 栝蒌根 防风（各五钱）
上药八味。为末。每用药末一两五钱。加入轻粉二钱。拌匀。大人用药末一钱。午前空
腹。
醉。
之后
广郁金（五钱） 生军（一两） 白丑（六钱半生半炒） 皂荚刺（一两）共为细末。
每服二
钱。临卧时冷酒调下。以净桶伺候。泄出黑虫。系多年也。如不黑而赤。
是近年之虫。越三日又进一服。以虫尽为度。则根绝矣。后用养血疏风之剂。调养百日。
又
中穴在腿弯上青筋处）
疠风之脉。 宜缓与和。 洪数为剧。 沉微则魔。 若遇牢革。 死也如何。 虽
良医。 不必摩挲。 中风之脉。 亦看斯歌。
（附类伤寒条辨）
伤寒者冬月伤寒之症也。凡霜降以后。天气严凝。万物收藏。人在气交之中。寒肃之气。
乘
故
再传。故伤寒二日。邪在足阳明胃经也。故目痛鼻干。唇燥。漱水不欲咽。脉长。宜葛根汤
以解肌达表则愈。如不愈。即传。故三日邪在足少阳胆经也。其目眩。口苦。耳聋。胸满
痛。寒热往来。头汗而欲呕。脉弦。宜小柴胡汤和解之。不愈。又传。故四日邪在足太阴
经也。腹满而痛。咽干。脉实者。宜大柴胡汤微利之。不愈。又传。故五日足少阴肾经受
口燥咽痛。渴而下利清谷。脉沉而紧。宜小承气汤下之。如咽痛甚。宜甘桔汤以开提陷
邪。又不愈。则又传矣。故六日足厥阴肝经受之。少腹满。烦躁。厥逆。消渴。舌卷囊
脉伏或沉而带弦。宜大承气汤下之。六日传经尽。病当愈。不愈。必至再传。传至十二
更不愈。势必又传而剧矣。若夫太阳伤风。与伤寒无异。惟恶风有汗与伤寒异耳。初起
枝汤以补表虚。其变症与传经证治小异也。因风伤卫。寒伤营。故治伤风必以桂枝汤为
其变症不出气分之病。宜疏达为稳。加减之药。以芩芍羌防桑叶钩藤之属可也。然仲景
风寒为两症。但以有汗为表虚。无汗为表实。脉缓为风。脉紧为寒。恶风为风。恶寒为
以此为辨。可见寒非风不作。风非寒不发。感之者有伤气伤营之不同耳。其脉缓自汗恶
虚邪。以桂枝汤治之。如八九日不解。如疟状面热身痒。以不得小汗故也。宜桂麻各半
如无汗恶寒脉浮紧者。宜大青龙汤主之。如干呕而咳烦躁者。不得安卧。宜小青龙汤主
又仲景金匮要略。有太阳病发热无汗。反恶寒者。名曰刚痉。太阳病。发热汗出而不恶
名曰柔痉。并不言麻黄桂枝之治法。大都脉不见紧。脉不见缓。故不立法也。又曰太阳
证备。身体强KT KT 然。脉反沉迟。此为痉。栝蒌桂枝汤主之。可以知沉脉为痉病之别
也
其刚痉柔痉两条不言脉。故不言方耳。又太阳病无汗而小便反少。气上冲胸。口噤不得
语。
两
乃
病
一
之乎
少者
之症
剂。
类伤
疫系
阴
皆
方
顺
世
而直中一症。虽未发明。于方论上 绎及之。胡为乎来哉。噫。仲景之绪。赖以不坠者。晋
太
学
者。取其法而已矣。如此。则可与言医尔。
愚按近世时医。必按节气以治病。当春时之病曰春温。或指曰风温。夏病曰热病。或指
为暑
病情
节之
不
邪
特
麻仁、牛蒡子、枸杞子、蔓荆子（各一两，共同炒制），白蒺藜、苦参、栝蒌根、防风（各五钱）。
以上八味药。研成细末。每次取药末一两五钱，加入轻粉二钱，搅拌均匀。成人每次服用药末一钱，在午前空腹时服用。
广郁金（五钱）、生大黄（一两）、白牵牛（六钱半，一半生用一半炒用）、皂角刺（一两）共研为细末。
每次服用二钱。临睡前用冷酒调服。旁边准备好干净的便桶。排出黑色的虫子，这是多年的老虫。如果排出的不是黑色而是红色，则是近年新得的虫。隔三天再服用一次，直到虫子排尽为止，这样就能断根了。之后使用养血疏风的方剂，调养一百天。
疠风（麻风病）的脉象，宜缓而调和。洪大数急则病情严重，沉细微弱则邪气深伏难治。如果遇到牢革脉，那是死证。即使是良医，也不必多言。中风病的脉象，也可以参考这首歌诀。
（附类伤寒条辨）
伤寒是冬季感受寒邪所致的病症。凡是霜降以后，天气严寒凝肃，万物收藏，人处于天地气交之中，寒肃之气容易乘虚而入。
再次传变。所以伤寒第二天，邪气在足阳明胃经。所以出现眼睛痛、鼻子干、嘴唇燥、想漱口喝水但不想咽下、脉长。适宜用葛根汤来解肌发表则痊愈。如果不愈，就会传变。所以第三天邪气在足少阳胆经。出现眼睛昏花、口苦、耳聋、胸胁满闷疼痛、忽冷忽热、头出汗且想呕吐、脉弦。适宜用小柴胡汤和解。如果不愈，又传变。所以第四天邪气在足太阴脾经。腹部胀满且疼痛、咽喉干燥、脉实者，适宜用大柴胡汤轻微通利大便。如果不愈，又传变。所以第五天足少阴肾经受邪。出现口燥、咽喉痛、口渴且腹泻完谷不化、脉沉而紧。适宜用小承气汤攻下。如果咽喉痛得很厉害，适宜用甘桔汤来开提陷邪。如果又不愈，则会继续传变。所以第六天足厥阴肝经受邪。出现小腹胀满、烦躁、四肢厥冷、消渴、舌卷缩、睾丸上缩、脉伏或沉而带弦。适宜用大承气汤攻下。六天传经完毕，病应当痊愈。如果不愈，必定会再次传变。传到第十二天如果再不好，势必又会传变且病情加剧。至于太阳伤风，与伤寒没有太大区别，只是怕风且有汗与伤寒不同而已。初起时适宜用桂枝汤来补益表虚。其变症与传经证的治法略有不同。因为风伤卫气，寒伤营血，所以治疗伤风必须以桂枝汤为主。其变症不出气分的病，适宜疏达为稳妥。加减的药物，可以用黄芩、芍药、羌活、防风、桑叶、钩藤之类的。然而张仲景将风寒分为两种病症，只是以有汗为表虚，无汗为表实。脉缓为风，脉紧为寒。怕风为风，怕冷为寒。以此作为辨别。可见寒非风不作，风非寒不发，感邪的人有伤气、伤营的不同罢了。其脉缓自汗恶风的是虚邪，用桂枝汤治疗。如果八九日不解，像疟疾一样面热身痒，是因为不得小汗的缘故。适宜用桂枝麻黄各半汤。如果没有汗、恶寒、脉浮紧者，适宜用大青龙汤主治。如果有干呕而咳、烦躁、不能安卧者，适宜用小青龙汤主治。
另外张仲景《金匮要略》中，有太阳病发热无汗，反而恶寒的，名叫刚痉。太阳病，发热汗出而不恶寒的，名叫柔痉。都不提及麻黄、桂枝的治法。大抵是因为脉不见紧，脉不见缓，所以不立法度。又说太阳病，症状具备，身体强直僵仆，脉反而沉迟，这是痉病。用栝蒌桂枝汤主治。可以知道沉脉是痉病的特征。
其刚痉、柔痉两条没有提及脉象，所以没有提及方剂。又说太阳病无汗而小便反而少，气上冲胸，牙关紧闭不能说话。
这是一类疫病，系属阴邪，皆顺世而直中一症，虽然未发明，但在方论上演绎涉及到了它。为什么会出现这种情况呢？唉。张仲景的学术绪论，赖以不坠落的，是晋代太学医者，取其法而已。如此，则可以与之谈论医学了。
我按：近世当时的医生，一定按照节气来治病。春季时的病叫春温，或者指为风温。夏季的病叫热病，或者指为暑... [原文在此处截断]
Hemp Seed (Cannabis Fructus), Burdock Fruit (Arctii Fructus), Goji Berry (Lycii Fructus), and Thunberg Fleeceflower Seed (Viticis Semen) (each 1 liang, stir-fried together); White Tribulus Fruit (Tribuli Fructus), Sophora Root (Sophorae Flavescentis Radix), Trichosanthes Root (Trichosanthis Radix), and Saposhnikovia Root (Saposhnikoviae Radix) (each 5 qian).
The above eight herbs. Grind into powder. For each dose, take 1.5 qian of the herb powder, add 2 qian of Calomel (Hydrargyri Chloridum Mite), and mix evenly. Adults take 1 qian of the herb powder before noon on an empty stomach.
Curcuma Aromatica Rhizome (Curcumae Rhizoma), Raw Rhubarb (Rhei Radix et Rhizoma), White Morning Glory Seed (Pharbitidis Semen, half raw, half stir-fried), and Gleditsia Spine (Gleditsiae Spina) (each 1 liang). Grind all together into fine powder.
Take 2 qian per dose. Mix with cold wine and take before going to bed. Have a clean chamber pot ready nearby. Black worms will be excreted, indicating old infestation for many years. If the excreted matter is red rather than black, it indicates a recent infestation. Take another dose after three days, until all worms are expelled, thereby eliminating the root cause. Afterwards, use formulas that nourish blood and disperse wind, and recuperate for one hundred days.
Pulse of Leprosy (Elephantiasis/Lepra): The pulse should be slow and harmonious. A surging and rapid pulse indicates severe condition; a deep, thin, and weak pulse indicates deep-seated pathogenic factors difficult to treat. If a firm and wiry pulse is encountered, it signifies death. Even for skilled physicians, further discussion is unnecessary. The pulse of Wind-Stroke (Zhong Feng) can also be understood through this verse.
(Attached: Differentiation of Similar Cold Damage Syndromes)
Cold Damage (Shang Han) refers to diseases contracted from cold pathogens in winter. After Frost's Descent, when the weather becomes severely cold and condensed, and all things store away energy, humans exist within the interaction of heaven and earth qi. The cold and肃 (solemn/chilling) qi easily takes advantage of deficiency.
Transmission occurs again. Thus, on the second day of Cold Damage, the pathogen is in the Foot-Yangming Stomach Meridian. Symptoms include eye pain, nasal dryness, lip dryness, desire to rinse mouth with water but no desire to swallow, and a long pulse. Ge Gen Tang (Kudzu Decoction) should be used to resolve the muscle layer and release the exterior for recovery. If not recovered, transmission continues. Thus, on the third day, the pathogen is in the Foot-Shaoyang Gallbladder Meridian. Symptoms include dizziness, bitter taste in the mouth, deafness, chest fullness and pain, alternating chills and fever, sweating on the head, and nausea. The pulse is wiry. Xiao Chai Hu Tang (Minor Bupleurum Decoction) should be used to harmonize. If not recovered, transmission continues. Thus, on the fourth day, the pathogen is in the Foot-Taiyin Spleen Meridian. Symptoms include abdominal fullness and pain, dry throat, and a solid pulse. Da Chai Hu Tang (Major Bupleurum Decoction) should be used to mildly purge. If not recovered, transmission continues. Thus, on the fifth day, the Foot-Shaoyin Kidney Meridian is affected. Symptoms include dry mouth, sore throat, thirst, and diarrhea with undigested food. The pulse is deep and tight. Xiao Cheng Qi Tang (Minor Order the Qi Decoction) should be used to purge. If the sore throat is severe, Gan Jie Tang (Licorice and Butterfly Bush Decoction) should be used to lift trapped pathogens. If still not recovered, transmission continues. Thus, on the sixth day, the Foot-Jueyin Liver Meridian is affected. Symptoms include lower abdominal fullness, irritability, cold extremities, excessive thirst, curled tongue, and retracted testicles. The pulse is hidden or deep and wiry. Da Cheng Qi Tang (Major Order the Qi Decoction) should be used to purge. After six days, the transmission of meridians is complete, and the disease should recover. If not, it must transmit again. By the twelfth day, if still not recovered, transmission will continue and the condition will worsen. Regarding Taiyang Wind Injury (Shang Feng), it is similar to Cold Damage, differing only in aversion to wind and presence of sweating. At the onset, Gui Zhi Tang (Cinnamon Twig Decoction) should be used to tonify exterior deficiency. Its variant syndromes differ slightly from meridian transmission syndromes. Since wind injures Wei (Defensive) Qi and cold injures Ying (Nutritive) Blood, treatment for Wind Injury must prioritize Gui Zhi Tang. Variant syndromes do not exceed the Qi level; dispersing and unblocking is stable. Modified herbs may include Huang Qin (Scutellaria Root), Bai Shao (White Peony Root), Qiang Huo (Notopterygium Rhizome), Fang Feng (Saposhnikovia Root), Sang Ye (Mulberry Leaf), and Gou Teng (Uncaria Ramulus cum Uncis). However, Zhang Zhongjing distinguished Wind and Cold as two separate conditions, distinguishing exterior deficiency by sweating and exterior excess by absence of sweating. A slow pulse indicates Wind, a tight pulse indicates Cold. Aversion to wind indicates Wind, aversion to cold indicates Cold. This serves as differentiation. It is evident that Cold does not manifest without Wind, and Wind does not erupt without Cold. Those infected differ in whether they injure Qi or Ying. A slow pulse with spontaneous sweating and aversion to wind indicates deficient evil, treated with Gui Zhi Tang. If unresolved after eight or nine days, resembling malaria with facial heat and body itching due to lack of slight sweating, Gui Ma Ge Ban Tang (Half Gui Zhi Half Ma Huang Decoction) should be used. If there is no sweating, aversion to cold, and a floating-tight pulse, Da Qing Long Tang (Major Green Dragon Decoction) should be used. If there is dry retching, cough, irritability, and inability to lie down peacefully, Xiao Qing Long Tang (Minor Green Dragon Decoction) should be used.
Furthermore, in Zhang Zhongjing's *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), there is Taiyang syndrome with fever, no sweating, and paradoxical aversion to cold, named Gang Jing (Yang Spasm). Taiyang syndrome with fever, sweating, and no aversion to cold is named Rou Jing (Yin Spasm). Neither mentions treatments using Ma Huang (Ephedra) or Gui Zhi (Cinnamon Twig). Generally, because the pulse is neither tight nor slow, no specific formula laws are established. It also states: Taiyang syndrome with complete symptoms, stiff body, yet the pulse is surprisingly deep and slow, this is Spasm (Jing). Gua Lou Gui Zhi Tang (Trichosanthes and Cinnamon Twig Decoction) should be used. This reveals that a deep pulse is characteristic of Spasm.
The sections on Gang Jing and Rou Jing do not mention pulses, hence no formulas are listed. It also states: Taiyang syndrome with no sweating but surprisingly scanty urination, qi rushing to the chest, jaw stiffness preventing speech...
This is a category of epidemic disease, belonging to Yin evil, directly striking the interior following worldly trends. Although not fully elucidated, it is deduced in the formula discussions. Why does it arise? Alas. The legacy of Zhang Zhongjing, preserved from falling into obscurity, was taken up by physicians of the Jin Dynasty Taixue (Imperial Academy), who adopted his methods. Only thus can one discuss medicine.
I observe: Contemporary physicians of recent times insist on treating diseases according to solar terms. Diseases in spring are called Chun Wen (Spring Warmth) or referred to as Feng Wen (Wind Warmth). Diseases in summer are called Re Bing (Heat Disease) or referred to as Shu... [Text cuts off here]