脉双弦而迟者，必心下硬。脉大而紧者，阳中有阴也。可以下之，宜大承气汤。
世本俱作宜大承气汤，此传写之误也。按大柴胡方中，有半夏、生姜之辛温，涤饮散寒，故可以治阳中
伏匿之阴邪。若大承气纯属苦寒，徒伐中土之冲和，则痞结下利之变，殆所必至矣。（《伤寒缵论》）
此段诸注，随文傅会。或疑可以下之者，原文也，后人赘以方，此论颇通。盖六经篇中言可下而不出方者
甚多，意在临时施治者善体会耳。（《伤寒论义大全》）
脉双弦而迟者，必心下硬也。○脉大而紧者，阳中有阴也。
上二节，王叔和分类入可下之条，汇作一节，末有可以下之宜大承气汤句。今删正之，分作两节。（吴遵程）
阴阳相搏名曰动，阳动则汗出，阴动则发热。形冷恶寒者，
此三焦伤也。若数脉见于关上，上下无头尾，如豆大，厥厥动摇者，名曰动也。
按∶阳动则汗出二字，当是发热二字。阴动则发热二字，当是汗出二字。阳加于阳，岂有汗出之理？
《素问》曰∶阳加于阴谓之汗。遵《经》移之。（《医宗金鉴》）
假令脉来微去大，故名反，病在里也。脉来头小本大，故名覆，病在表也。上微头小者为阴盛，则汗出。下
微本大者为阳盛，则为关格不通，不得尿。头无汗者可治，有汗者死。
按∶脉来头小本大，当是脉来大去小。上微头小者，当是上微小者为阴盛。下微本大者，当是下微小者为
阳盛。始与上下文义相属。当改之、补之。（《医宗金鉴》）
寸口诸微亡阳，诸濡亡血，诸弱发热，诸紧为寒，诸乘寒者则为厥，郁冒不仁。以胃无谷气，脾涩不通，口急
不能言，战而栗也。
按∶诸濡亡血，当是诸濡卫虚。诸弱发热，当是诸弱营虚。濡浮而无力，候阳虚也。岂有亡血之理？弱沉
而无力，候阴虚也。岂止发热而已！当改之。（《医宗金鉴》）
趺阳脉伏而涩，伏则吐逆，水谷不化，涩则食不得入，名曰关格。
按∶水谷不化之化字，当是入字；若是化字，是能食也，何名曰格？食不得入，当是不得小便；若有小便，
是水道通也，何名曰关？悉改之。（《医宗金鉴》）
寸口脉弱而迟，弱者卫气微，迟者营中寒。营为血，血寒则发热；卫为气，气微者心内饥，饥而虚满，不能食也。
按∶条末心内饥，饥而虚满不能食句，此是论脾胃，不关营卫。故弱者卫气微，当是阳气微；迟者营中寒，
当是脾中寒，上下文义始属。营为血，岂有血寒发热之理？卫为气，气微者皆不成文。今悉易之。当是阳气微，
脾中寒者心内饥，阅下条言胃气有余自
知。当改之。（《医宗金鉴》）
太阳病，下之，其脉促，不结胸者，此为欲解也。脉浮者，必结胸也。脉紧者，必咽痛。脉弦者，必两胁拘
急。脉细数者，头痛未止。脉沉紧者，必欲呕。脉沉滑者，协热利。脉浮滑者，必下血。
按∶脉促当是脉浮，始与不结胸为欲解之文义相属。脉浮当是脉促，始与论中结胸、胸满同义。脉紧当是
脉细数，脉细数当是脉紧，始同论中二经本脉。脉浮滑当是脉数滑，浮滑是论中白虎汤证之脉，数滑是论中下
脓血之脉。均当改之。（《医宗金鉴》）
发汗后，身疼痛，脉沉迟者，桂枝去芍药、生姜，新加人参汤主之。
发汗后身疼是表虚，不得更兼辛散，故去生姜；沉为在里，迟为在脏，自当远阴寒，故去芍药；当存甘
温之品以和营，更兼人参以通血脉。里和而表自解矣。名曰新加者，见表未解无补中法。今因脉沉迟而始用之，
与用四逆汤治身疼、脉沉之法同义。○坊本作加芍药、生姜者误。（柯韵伯）
太阳中风，脉浮紧，发热恶寒，身疼痛，不汗出而烦躁者，大青龙汤主之。若脉微弱，汗出恶风者，不可服。
服之则厥逆，筋惕肉 ，此为逆也，大青龙汤主之。（以真武汤救之）。
末后旧本有大青龙汤主之六字。盖既曰不可服，服之为逆，则安得又复有大青龙汤主之之文？传写之误
甚明。黄氏正之甚是。后人又因其更改致疑，并六字皆删之，删之则上编二十五条无证书据，故存朱以备考。（魏荔彤）
汉之文法，用药诸方皆赘于条末，如大青龙汤证，既云脉微弱。汗出恶风者不可服，服之则厥逆，筋惕
肉，此为逆也，又以大青龙汤主之，皆此例也。（张兼善）
伤寒，脉浮缓，身不疼，但重，乍有轻时，无少阴证者，小青龙汤发之。
世本作大青龙汤发之，从《内编》改正。（张路玉）
小青龙汤，坊本俱作大青龙。余幼读古本，实是小青龙。观条中脉证，总非大青龙病，宜世人有伤风见
寒之说。近并得友人张路玉一订其讹，喜其先得我心也。（程郊倩）
按∶此条必有错误。脉浮缓，邪轻易散；身不疼，外邪已退；乍有轻时，病未入阴。又别无少阴等证，
此病之最轻者，何必用青龙峻剂？此必另有主方，而误以青龙当之也。（徐灵胎）
伤寒，脉浮滑，此表有热，里有寒，白虎汤主之。
按∶里有寒之寒字，当是热字。若是寒字，非白虎汤证也。宜改之。（《医宗金鉴》）
此条明有误字，寒字乃热字明矣。以脉较之，浮为表热，滑为里热，若以滑为里寒，则白虎安敢投之！
岂有里寒而用白虎耶？（方咫园）
《经》文寒字，当作邪字解，亦热也。其说甚是。若是寒字，非白虎汤证矣。（王三阳）
《论》曰∶伤寒脉浮滑，表有热，里有寒，白虎汤主之。久久不知其说，夫表有热，而遽用白虎，已属
骤急，犹曰可也；里既有寒，而亦曰白虎，则断无是理矣。夫里寒外热，则外热为假热，里寒为真寒，乃内寒
外热，水极似火，阴盛格阳证也。四逆、理中，尚虑不及，其何可以白虎为耶？因遍考诸解，皆不画一，不是
顺文敷演，即是附会支吾。即喻子嘉言以寒为推原之辞，于理则通，于解则强。后爰会悟厥深热亦深、热甚兼
寒化之旨，始有旁通。表里二字，传写参错无疑。（《医补》）
太阳病，寸缓、关浮、尺弱，其人发热汗出，复恶寒，不呕，但心下痞者，此以医下之也。如其不下者，病
人不恶寒而渴者，此转属阳明也。小便数者，大便必硬，不更衣十日无所苦也。渴欲饮水，少少与之。但以法
救之，渴者，宜五苓散。
按∶但以法救之五字，当是若小便不利利五字，方与上文小
便数及下文渴者之义相属。此条病势不急救之之文，殊觉无谓。昔王三阳亦云此处五苓散难用，不然，《经》
文渴者之下当有缺文，当改之。（《医宗金鉴》）
伤寒五六日，头汗出，微恶寒，手足冷，心下满，口不欲食，大便硬，脉细者，此为阳微结，必有表，复有
里也。脉沉，亦在里也。汗出，为阳微；假令纯阴结，不得复有外证，悉入在里，此为半在里半在外也。脉虽
沉紧，不得为少阴病。所以然者，阴不得有汗，今头汗出，故知非少阴也，可与小柴胡汤；设不了了者，得屎而解。
按∶脉细当是脉沉细。观本条下文脉沉亦在里也之亦字自知。脉虽沉紧之紧字，当是细字。本条上文并无
紧字，如何说脉虽沉紧，虽字何所谓耶？必是传写之误。（《医宗金鉴》）
脉象双弦且迟缓的，必然心下硬满。脉象大而紧的，是阳证中兼有阴邪。可以用攻下法，适宜用大承气汤。
世传版本都写作“适宜用大承气汤”，这是传抄的错误。考察大柴胡汤方中，含有半夏、生姜的辛温之性，能涤除饮邪、散寒，所以可以治疗潜伏隐匿在阳证中的阴邪。如果大承气汤纯属苦寒之品，只会攻伐中焦脾胃的冲和之气，那么导致痞结、下利的变证，几乎是必然发生的。（《伤寒缵论》）
这段文字的各家注解，都是随文附会。有人怀疑“可以用攻下法”是原文，后人多余地加上了方剂名，这种观点颇为通达。大概六经篇中言说可用攻下法却不列出方剂的很多，意在让医者根据临时情况施治，善于体会罢了。（《伤寒论义大全》）
脉象双弦且迟缓的，必然心下硬满。○脉象大而紧的，是阳证中兼有阴邪。
以上两节，王叔和将其分类归入可攻下的条目，汇作一节，末尾有“可以用攻下法，适宜用大承气汤”这句话。现在删正，分为两节。（吴遵程）
阴阳相互搏结称为动脉，阳气发动则汗出，阴气发动则发热。形体寒冷、恶寒的，这是三焦受伤了。如果在关部出现数脉，上下没有头尾，像豆子一样大小，厥厥动摇的，称为动脉。
按：文中“阳气发动则汗出”六个字，应当是“发热”二字。“阴气发动则发热”六个字，应当是“汗出”二字。阳气施加于阳分，怎么会有汗出的道理？《素问》说：“阳气施加于阴分才称为汗。”遵循经典移正。（《医宗金鉴》）
假如脉来微弱而去势盛大，名叫反脉，病在里。脉来头小本大，名叫覆脉，病在表。上部微小头小的为阴盛，则汗出。下部微小本大的为阳盛，则为关格不通，不能排尿。头部无汗的可以治愈，有汗的死亡。
按：“脉来头小本大”，应当是“脉来大去小”。上部微小头小的，应当是“上部微小者为阴盛”。下部微小本大的，应当是“下部微小者为阳盛”。这才与上下文义相属。应当改正、补充。（《医宗金鉴》）
寸口脉微的亡阳，脉濡的亡血，脉弱的发热，脉紧的为寒，诸受寒邪的则为厥逆，郁冒不仁。因为胃中没有谷气，脾涩不通，口急不能言语，战栗发抖。
按：“诸濡亡血”，应当是“诸濡卫虚”。“诸弱发热”，应当是“诸弱营虚”。濡脉浮而无力，候的是阳虚。哪有亡血的道理？弱脉沉而无力，候的是阴虚。岂止是发热而已！应当改正。（《医宗金鉴》）
趺阳脉伏而涩，伏则吐逆，水谷不化，涩则食不得入，名叫关格。
按：“水谷不化”的“化”字，应当是“入”字；如果是“化”字，就是能食，何名叫格？“食不得入”，应当是“不得小便”；如果有小便，是水道通也，何名叫关？全部改正。（《医宗金鉴》）
寸口脉弱而迟，弱者是卫气微，迟者是营中有寒。营为血，血寒则发热；卫为气，气微者心内饥，饥而虚满，不能食。
按：条文末尾“心内饥，饥而虚满不能食”句，这是在论述脾胃，与营卫无关。所以“弱者是卫气微”，应当是“阳气微”；“迟者是营中有寒”，应当是“脾中寒”，上下文义才相属。营为血，哪有血寒发热的道理？卫为气，气微者皆不成文。现在全部更改。应当是阳气微，脾中寒者心内饥，阅读下一条言胃气有余自知。应当改正。（《医宗金鉴》）
太阳病，误用下法，其脉促，不结胸的，这是欲解的表现。脉浮的，必结胸。脉紧的，必咽痛。脉弦的，必两胁拘急。脉细数的，头痛未止。脉沉紧的，必欲呕。脉沉滑的，协热利。脉浮滑的，必下血。
按：“脉促”应当是“脉浮”，才与“不结胸为欲解”的文义相属。“脉浮”应当是“脉促”，才与论中结胸、胸满同义。“脉紧”应当是“脉细数”，“脉细数”应当是“脉紧”，才同论中二经本脉。“脉浮滑”应当是“脉数滑”，浮滑是论中白虎汤证的脉象，数滑是论中下脓血的脉象。均应当改正。（《医宗金鉴》）
发汗后，身体疼痛，脉沉迟的，用桂枝去芍药、生姜，新加人参汤主治。
发汗后身疼是表虚，不得再兼用辛散，所以去掉生姜；沉为在里，迟为在脏，自然应当远离阴寒，所以去掉芍药；应当保留甘温之品以调和营气，更兼用人参以通血脉。里气和而表自解了。名叫新加的，表示表未解时无补中之法。现在因为脉沉迟才开始使用它，与用四逆汤治身疼、脉沉的法度同义。○坊间版本作加芍药、生姜的是错误的。（柯韵伯）
太阳中风，脉浮紧，发热恶寒，身体疼痛，无汗而烦躁的，用大青龙汤主治。如果脉微弱，汗出恶风的，不可服用。服用了则会出现四肢厥逆，筋惕肉瞤，这是逆证，（应用真武汤救治）。
末尾旧本有大青龙汤主之六个字。既然说不可服用，服用即为逆证，怎么又会有大青龙汤主之的文字？传抄错误很明显。黄氏纠正得很对。后人又因其更改产生疑惑，连同这六个字都删除了，删除了则上编二十五条无证书据，所以保留朱笔以备考。（魏荔彤）
汉代的行文法则，用药诸方都赘述于条文末尾，如大青龙汤证，既说脉微弱、汗出恶风者不可服，服之则厥逆、筋惕肉瞤，此为逆证，又以大青龙汤主之，都是这个例子。（张兼善）
伤寒，脉浮缓，身体不疼，只是沉重，偶尔有减轻的时候，没有少阴证的，用小青龙汤发散。
世传版本作大青龙汤发散，从《内编》改正。（张路玉）
小青龙汤，坊间版本都作大青龙。我幼年读古本，确实是小青龙。观察条文中的脉证，总不是大青龙病，宜世人所谓伤风见寒的说法。近来又得到友人张路玉订正其讹误，高兴他先得我心意。（程郊倩）
按：这条必有错误。脉浮缓，邪轻易散；身体不疼，外邪已退；偶尔有轻时，病未入阴。又别无少阴等证，这是病中最轻的，何必用青龙峻剂？这必定另有主方，而误用青龙当之。（徐灵胎）
伤寒，脉浮滑，这是表有热，里有寒，用白虎汤主治。
按：“里有寒”的“寒”字，应当是“热”字。如果是“寒”字，就不是白虎汤证了。应当改正。（《医宗金鉴》）
这条明显有误字，“寒”字乃是“热”字明矣。以脉象比较，浮为表热，滑为里热，如果把滑当作里寒，那敢投用白虎汤吗？哪里有里寒而用白虎汤的道理！（方咫园）
《经》文中的“寒”字，当作“邪”字解，也是热。这种说法很对。如果是“寒”字，就不是白虎汤证了。（王三阳）
《论》说：伤寒脉浮滑，表有热，里有寒，白虎汤主之。久久不知其说，夫表有热，就遽然用白虎，已属骤急，犹曰可以；里既有寒，也说用白虎，则断无此理。夫里寒外热，则外热为假热，里寒为真寒，乃内寒外热，水极似火，阴盛格阳证也。四逆、理中，尚虑不及，怎么能用白虎呢？于是遍考诸解，都不一致，不是顺文敷演，即是附会支吾。即喻子嘉言以寒为推原之辞，于理则通，于解则强。后来领悟到厥深热亦深、热甚兼寒化的旨意，始有旁通。表里二字，传写参错无疑。（《医补》）
太阳病，寸缓、关浮、尺弱，其人发热汗出，复恶寒，不呕，但心下痞的，这是医生误用下法所致。如果不曾下法，病人不恶寒而渴的，这是转属阳明。小便频数的，大便必硬，不排便十日也无痛苦。想喝水，少量给予。只以法救之，口渴的，适宜用五苓散。
按：“但以法救之”五个字，应当是“若小便不利”五个字，才与上文小便数及下文渴者的意义相属。此条病势不急，非急救之文，殊觉无谓。昔王三阳也说此处五苓散难用，不然，《经》文渴者之下当有缺文，应当改正。（《医宗金鉴》）
伤寒五六日，头汗出，微恶寒，手足冷，心下满，口不欲食，大便硬，脉细的，此为阳微结，必有表，复有里。脉沉，也在里。汗出，为阳微；假如纯阴结，不得再有外证，悉入在里，此为半在里半在外。脉虽沉紧，不得为少阴病。之所以这样，是因为阴不得有汗，现在头汗出，故知非少阴，可与小柴胡汤；设不了了者，得屎而解。
按：“脉细”应当是“脉沉细”。看本条下文“脉沉亦在里也”的“亦”字自知。“脉虽沉紧”的“紧”字，应当是“细”字。本条上文并无“紧”字，怎么说脉虽沉紧，“虽”字何所谓耶？必定是传抄错误。（《医宗金鉴》）
When the pulse is double-string-like and slow, there must be hardness below the heart. When the pulse is large and tight, it indicates Yin within Yang. Purging may be used; Da Cheng Qi Tang (Major Order the Qi Decoction) is appropriate.
All versions in circulation read "Da Cheng Qi Tang is appropriate," which is a transcription error. Examining the formula for Xiao Chai Hu Tang (Minor Order the Qi Decoction), it contains the acrid-warm properties of Ban Xia (Pinelliae Rhizoma) and Sheng Jiang (Zingiberis Rhizoma Recens), which clear fluid retention and dispel cold; thus, it can treat Yin pathogens hidden within Yang syndromes. If Da Cheng Qi Tang consists purely of bitter-cold herbs, it will merely attack the harmonious Qi of the Middle Jiao (Middle Burner), making complications such as epigastric fullness and diarrhea inevitable. (from *Shanghan Zuanyuan*)
The annotations on this passage are all forced interpretations attached to the text. Some suspect that "purging may be used" is the original text, and the prescription was added later by subsequent generations; this argument is quite reasonable. Generally, in the Six Channels chapters, there are many instances where purging is indicated without specifying a formula, intending for physicians to apply treatment flexibly according to circumstances. (from *Shanghan Lun Yi Daquan*)
When the pulse is double-string-like and slow, there must be hardness below the heart. ○ When the pulse is large and tight, it indicates Yin within Yang.
Wang Shuhe classified the above two sections into the category of "purgeable conditions," merging them into one section with the concluding sentence: "Purging may be used; Da Cheng Qi Tang is appropriate." This has now been corrected and divided into two separate sections. (Wu Zuncheng)
When Yin and Yang struggle against each other, it is called a Moving Pulse (Dong Mai). When Yang moves, sweat occurs; when Yin moves, fever arises. A cold body and aversion to cold indicate injury to the San Jiao (Triple Burner). If a rapid pulse appears at the Guan position (middle position), without head or tail, about the size of a bean, quivering and moving vigorously, it is named a Moving Pulse.
Note: The phrase "When Yang moves, sweat occurs" should be "fever arises." The phrase "When Yin moves, fever arises" should be "sweat occurs." How could applying Yang to Yang result in sweating? The *Suwen* states: "Applying Yang to Yin is called sweat." Following the classic, these have been transposed. (from *Yizong Jinjian*)
Suppose the pulse comes weakly and departs strongly; this is named Fan (Reverse) pulse, indicating disease in the Interior. If the pulse comes small at the head and large at the root, it is named Fu (Cover) pulse, indicating disease in the Exterior. If the upper part is small and the head is small, it indicates Excess Yin, resulting in sweating. If the lower part is small and the root is large, it indicates Excess Yang, leading to Guan Ge (Obstruction and Rejection) syndrome where urination is impossible. If the head has no sweat, it is treatable; if there is sweat, death ensues.
Note: "Pulse comes small at the head and large at the root" should be "Pulse comes large and departs small." "Upper part small and head small" should be "Upper part minute indicates Excess Yin." "Lower part small and root large" should be "Lower part minute indicates Excess Yang." Only then does it connect with the context. Corrections and additions are necessary. (from *Yizong Jinjian*)
At the Cun Kou (Radial Artery) position, all Micro pulses indicate loss of Yang; all Soft pulses indicate loss of Blood; all Weak pulses indicate fever; all Tight pulses indicate Cold. All cases affected by Cold result in Jue (Cold extremities), Yu Mao (dizziness and fainting), and numbness. This is because the Stomach lacks Grain Qi, the Spleen is obstructed and unsmooth, causing mouth stiffness and inability to speak, trembling, and shivering.
Note: "All Soft pulses indicate loss of Blood" should be "All Soft pulses indicate Wei Qi deficiency." "All Weak pulses indicate fever" should be "All Weak pulses indicate Ying Qi deficiency." A Soft pulse is floating and forceless, indicating Yang deficiency. How could it indicate blood loss? A Weak pulse is sunken and forceless, indicating Yin deficiency. Could it be limited to just fever! Correction is required. (from *Yizong Jinjian*)
At the Zu Yang (Dorsalis Pedis Artery) position, if the pulse is Sunken and Choppy, Sunken indicates vomiting and regurgitation with undigested food and water; Choppy indicates inability to ingest food, named Guan Ge (Obstruction and Rejection).
Note: The character "Hua" (digest/transform) in "undigested food and water" should be "Ru" (enter); if it were "Hua," it would imply ability to eat, so why name it Ge (Rejection)? "Inability to ingest food" should be "inability to urinate"; if there were urine, the water pathway would be open, so why name it Guan (Obstruction)? All corrections are made. (from *Yizong Jinjian*)
At the Cun Kou position, if the pulse is Weak and Slow, Weak indicates deficient Wei Qi, and Slow indicates Cold in the Ying. Ying is Blood; Blood Cold causes fever. Wei is Qi; deficient Qi causes hunger in the heart/mind, emptiness and fullness due to hunger, and inability to eat.
Note: The ending sentence "hunger in the heart/mind, emptiness and fullness due to hunger, inability to eat" discusses the Spleen and Stomach, unrelated to Ying and Wei. Therefore, "Weak indicates deficient Wei Qi" should be "deficient Yang Qi"; "Slow indicates Cold in the Ying" should be "Cold in the Spleen," so the context connects. How could Blood Cold cause fever? Deficient Qi does not make sense here. All are changed. It should be: deficient Yang Qi, Cold in the Spleen leads to hunger in the heart/mind. Reading the next paragraph regarding excess Stomach Qi clarifies this. Correction is required. (from *Yizong Jinjian*)
In Taiyang disease, after mistaken purgation, if the pulse is Cui (Rapid-interrupted) and there is no Jie Xiong (Chest Binding), this indicates impending resolution. If the pulse is Floating, Jie Xiong will definitely occur. If the pulse is Tight, throat pain will definitely occur. If the pulse is Xian (Wiry), bilateral hypochondriac tension will definitely occur. If the pulse is Fine-Rapid, headache will persist. If the pulse is Sunken-Tight, vomiting will definitely occur. If the pulse is Sunken-Slippery, heat-collateral diarrhea will occur. If the pulse is Floating-Slippery, bleeding from the lower orifice will definitely occur.
Note: "Cui pulse" should be "Floating pulse" to align with "no Jie Xiong indicates impending resolution." "Floating pulse" should be "Cui pulse" to align with the discussion of Jie Xiong and chest fullness in the treatise. "Tight pulse" should be "Fine-Rapid pulse," and "Fine-Rapid pulse" should be "Tight pulse" to match the primary pulses of the two channels discussed. "Floating-Slipper pulse" should be "Rapid-Slippery pulse"; Floating-Slippery is the pulse for Bai Hu Tang syndrome, while Rapid-Slippery is the pulse for purulent bloody stool. All corrections are made. (from *Yizong Jinjian*)
After sweating, if body pain persists and the pulse is Sunken and Slow, Gui Zhi Qu Shao Yao Jia Shen Shen Zhu Xin Jia Ren Tang (Cinnamon Twig Decoction minus Peony and Fresh Ginger, plus Ginseng and New Additions) is the principal treatment.
Body pain after sweating indicates Exterior deficiency; acrid-dispersing herbs should not be used further, hence Fresh Ginger is removed. Sunken indicates Interior involvement, and Slow indicates Zang organ involvement; thus, Yin-Cold should be avoided, hence Peony is removed. Sweet-Warm herbs should be retained to harmonize Ying Qi, and Ginseng is added to unblock the vessels. When the Interior harmonizes, the Exterior resolves naturally. Named "New Additions" because there is no method of tonifying the Center when the Exterior is unresolved. Now, because of the Sunken-Slow pulse, it is used, sharing the same principle as using Si Ni Tang for body pain with a Sunken pulse. ○ Version errors reading "add Peony and Fresh Ginger" are incorrect. (Ke Yunbo)
In Taiyang Wind Strike, if the pulse is Floating-Tight, with fever, aversion to cold, body pain, anhidrosis, and irritability, Da Qing Long Tang (Major Blue Dragon Decoction) is the principal treatment. If the pulse is Weak-Fine, with sweating and aversion to wind, it must not be taken. Taking it results in Jue Ni (cold extremities) and Jin Ti Rou Tiao (twitching muscles and fascicles); this is a counteraction. (It should be treated with Zhen Wu Tang to rescue).
The old editions contain the six characters "Da Qing Long Tang is the principal treatment" at the end. Since it states "must not be taken" and taking it causes counteraction, how could there be text saying "Da Qing Long Tang is the principal treatment"? The transcription error is obvious. Huang's correction is excellent. Later generations, doubting this change, deleted these six characters entirely. Deleting them leaves the twenty-five articles in the Upper Compilation without textual evidence, so the vermilion ink version is preserved for reference. (Wei Litong)
Han dynasty writing style often appended prescriptions at the end of clauses. For example, in the Da Qing Long Tang clause, it says "if pulse is weak-fine, sweating, aversion to wind, do not take; taking it causes Jue Ni, twitching muscles, this is counteraction," yet follows with "Da Qing Long Tang is the principal treatment." This is the same pattern. (Zhang Jianshan)
In Shang Han (Cold Damage), if the pulse is Floating-Slow, body is not painful but heavy, occasionally lighter, and there are no Shao Yin signs, Xiao Qing Long Tang (Minor Blue Dragon Decoction) should be used to disperse.
World versions read "Da Qing Long Tang," corrected from the *Nei Bian*. (Zhang Luyu)
Xiao Qing Long Tang, all workshop versions read Da Qing Long. I read ancient editions in my youth, which truly said Xiao Qing Long. Observing the pulse and symptoms in the clause, they do not fit Da Qing Long disease at all. It suits the popular saying of "wind strike seeing cold." Recently, I received corrections from my friend Zhang Luyu, pleased that he anticipated my thoughts. (Cheng Jiaoqian)
Note: This clause must contain an error. Floating-Slow pulse means pathogenic ease dispersal; no body pain means exterior pathogen has retreated; occasional lightness means disease has not entered Yin. With no other Shao Yin signs, this is the mildest disease. Why use the harsh Qing Long agents? There must be another principal formula mistakenly attributed to Qing Long. (Xu Lingtai)
In Shang Han, if the pulse is Floating-Slippery, this indicates Heat in the Exterior and Cold in the Interior; Bai Hu Tang (White Tiger Decoction) is the principal treatment.
Note: The character "Han" (Cold) in "Cold in the Interior" should be "Re" (Heat). If it were Cold, it would not be a Bai Hu Tang syndrome. Correction is required. (from *Yizong Jinjian*)
This clause clearly has a wrong character; "Cold" is undoubtedly "Heat." Comparing the pulse, Floating indicates Exterior Heat, Slippery indicates Interior Heat. If Slippery were interpreted as Interior Cold, how dare one administer Bai Hu Tang! Is there any case of Interior Cold using Bai Hu Tang? (Fang Zhiyuan)
The character "Han" (Cold) in the Classic should be interpreted as "Xie" (Pathogen), which also implies Heat. This explanation is very correct. If it were Cold, it would not be a Bai Hu Tang syndrome. (Wang Sanyang)
The Treatise says: In Shang Han, pulse Floating-Slippery, Heat in the Exterior, Cold in the Interior, Bai Hu Tang is principal. For a long time, its meaning was unknown. Using Bai Hu Tang abruptly for Exterior Heat is already urgent, yet acceptable; but if there is Interior Cold and still Bai Hu Tang is used, this is absolutely unreasonable. Interior Cold with Exterior Heat means Exterior Heat is false heat and Interior Cold is true cold; this is Internal Cold External Heat, Water Extreme resembling Fire, Yin Excess Repelling Yang syndrome. Si Ni Tang and Li Zhong Wan are still feared insufficient; how can Bai Hu Tang be used? Having examined all explanations, none are consistent; some simply expound the text, others are forced interpretations. Even Yu Jiayan interpreting Cold as a term of origin is logical but forced in explanation. Later, realizing the principle that deep Jue leads to deep Heat, and extreme Heat involves Cold transformation, understanding broadened. The characters Exterior and Interior are undoubtedly mixed up in transcription. (from *Yibu*)
In Taiyang disease, Cun is Slow, Guan is Floating, Chi is Weak. The person has fever, sweating, and recurring aversion to cold, no vomiting, but only epigastric fullness; this is caused by the physician's mistaken purgation. If purgation had not been used, and the patient is not averse to cold but thirsty, this has transferred to Yangming. Frequent urination implies hard stools; even if not defecating for ten days, there is no distress. If desiring water, give small amounts. Rescue only by method; for thirst, Wu Ling San (Five-Ingredient Powder with Poria) is appropriate.
Note: The five characters "Rescue only by method" should be "If urination is difficult," to align with the preceding frequent urination and following thirst. This clause describes a non-emergency condition, making "rescue" language meaningless. Wang Sanyang previously stated Wu Ling San is difficult to use here; otherwise, there must be missing text after "thirst" in the Classic. Correction is required. (from *Yizong Jinjian*)
In Shang Han, five or six days later, with head sweating, slight aversion to cold, cold hands and feet, epigastric fullness, lack of desire to eat, hard stools, and Fine pulse, this is Yang Wei Jie (Yang Minor Binding). There must be Exterior involvement and Interior involvement. Sunken pulse also indicates Interior involvement. Sweating indicates Yang Wei; if it were Pure Yin Binding, there would be no exterior signs, all entering the Interior; this is half in the Interior, half in the Exterior. Although the pulse is Sunken-Tight, it cannot be Shao Yin disease. The reason is that Yin cannot have sweating; now there is head sweating, therefore it is known not to be Shao Yin. Xiao Chai Hu Tang (Minor Order the Qi Decoction) may be given; if unsettled, resolution comes with stool.
Note: "Fine pulse" should be "Sunken-Fine pulse." Knowing this from the "also" in the following text "Sunken pulse also indicates Interior." The "Tight" in "Although Sunken-Tight" should be "Fine." There is no "Tight" mentioned earlier in this clause; how can one say "Although Sunken-Tight"? What is the basis for "Although"? It must be a transcription error. (from *Yizong Jinjian*)