五十六证 方七首
厥阴之为病，消渴，气上撞，心中疼热，饥而不欲食，甚者则欲吐蛔，下之不肯止。
厥阴中风，其脉微浮为欲愈，不浮为未愈。
厥阴病，欲解时，从丑尽卯。
厥阴病，渴欲饮水者，与水饮之即愈。
诸四逆厥者，不可下之，虚家亦然。
伤寒先厥，后发热而利者，必止。见厥复利。
伤寒始发热六日，厥反九日而下利。厥利当不能食，今反能食，恐为除中。食之黍饼，
不发热者，知胃气尚在，必愈。恐暴热来出而复去也，后日脉之，其热续在，期之旦日夜半
愈。所以然者，本发热六日，厥反九日，复发热三日，并前六日，亦为九日，与厥相应，故
期之旦日夜半愈。后三日脉之数，其热不罢，此为热气有余，必发痈脓。
伤寒脉迟，六七日，而反与黄芩汤彻其热，脉迟为寒，与黄芩汤复除其热，腹中冷，当
不能食，今反能食，此为除中，必死。
伤寒先发厥热，下利必自止，而反汗出，咽中强痛，其喉为痹。发热无汗，而利必自止；
便脓血，便脓血者，其喉不痹。
伤寒一二日至四五日，厥者必发热，前厥者后必热，厥深热亦深，厥微热亦微，厥应下
之，而发其汗者，口伤烂赤。
凡厥者，阴阳气不相顺接，便为厥。厥者，手足逆者是。
伤寒病，厥五日，热亦五日，设六日，当复厥，不厥者自愈。厥不过五日，以热五日，
故知自愈。
伤寒脉微而厥，至七八日，肤冷，其人躁无安时，此为脏寒，蛔上入其膈，蛔厥者，其
人当吐蛔。令病者静，而复时烦，此为脏寒。蛔上入其膈，故烦，须臾复止，得食而呕又烦
者，蛔闻食臭必出，其人常自吐蛔，蛔厥者，乌梅丸主之。方∶
乌梅（三百枚） 细辛（六两） 干姜（十两） 黄连（十六两） 当归（四两） 蜀
椒（四两）
附子（六两，炮） 桂枝（六两） 人参（六两） 黄柏（六两）
上一十味，异捣，合治之，以苦酒渍乌梅一宿，去核，蒸之五斗米下，捣成泥，和诸药
令相得，臼中，与蜜杵千下，丸如梧桐子大，先食饮服十丸，日三服，少少加至二十丸，禁
生冷、滑物、臭食等。
伤寒热少微厥，稍头寒，嘿嘿不欲食，烦躁，数日，小便利，色白者，热除也，得食，
其病为愈；若厥而呕，胸胁烦满，其后必便血。（稍头一作指头。）
病者手足厥冷，言我不结胸，少腹满，按之痛，此冷结在膀胱关元也。
伤寒发热四日，厥反三日，复发热四日，厥少热多，其病当愈，四日至六七日，不除，
必便脓血。
伤寒厥四日，热反三日，复厥五日，其病为进，寒多热少，阳气退，故为进。
伤寒六七日，其脉数，手足厥，烦躁，阴厥不还者，死。
伤寒，下利厥逆，躁不能卧者，死。
伤寒发热，下利至厥不止者，死。
伤寒六七日不利，便发热而利，其人汗出不止者，死，有阴无阳故也。
伤寒五六日，不结胸，腹濡，脉虚复厥者，不可下之，下之亡血，死。伤寒发热而厥，
七日下利者，为难治。
伤寒脉促，手足厥逆者，可灸之。
伤寒，脉滑而厥者，其表有热，白虎汤主之。（表热见里方见难疗中。）
手足厥寒，脉为之细绝，当归四逆汤主之。方∶
当归（三两） 桂心（三两） 细辛（三两） 芍药（三两） 甘草（二两，炙） 通
草（二两）
大枣（二十五枚，擘）
上七味，以水八升，煮取三升，去滓，温服一升，日三服。
若其人有寒，当归四逆加吴茱萸生姜汤主之。方∶
吴茱萸（二两） 生姜（八两，切）
上，前方中加此二味，以水四升，清酒四升和，煮取三升，去滓，分温四服。
大汗出，热不去，拘急四肢疼，若下利厥而恶寒，四逆汤主之。
大汗出，若火，下利而厥，四逆汤主之。（方并见阳明门。）
病者手足逆冷，脉乍紧者，邪结在胸中，心下满而烦，饥不能食，病在胸中，当吐之，
宜瓜蒂散。（方见疗痞中。）
伤寒厥而心下悸，先治其水，当与茯苓甘草汤，却治其厥，不尔，其水入胃，必利，茯
苓甘草汤主之。方∶
茯苓（二两） 甘草（炙，一两） 桂枝（二两） 生姜（三两） 上四味，以水四升，
煮取二
升，去滓，分温三服。
伤寒六七日，其人大下后，脉沉迟，手足厥逆，下部脉不至，咽喉不利，唾脓血，泻利
不止，为难治，麻黄升麻汤主之。方∶
麻黄（去节，二两半） 知母（十八铢） 葳蕤（十八铢） 黄芩（十八铢） 升麻（一
两六铢）
冬甘草（炙，
各
上一十四味，以水一斗，先煮麻黄二沸，去上沫，纳诸药，煮取三升，去滓，分温三服，
一炊间当汗出愈。
伤寒四五日，腹中痛，若转气下趣少腹，为欲自利。
伤寒本自寒下，医复吐之，而寒格更逆吐，食入即出，干姜黄芩黄连人参汤主之。方∶
干姜 黄芩 黄连 人参（各三两）
上四味，以水六升，煮取二升，去滓，分温再服。
下利，有微热，其人渴，脉弱者，自愈。
下利脉数，若微发热，汗出者，自愈；设脉复紧，为未解。
下利，手足厥，无脉，灸之，不温，反微喘者死；少阴负趺阳者为顺。
下利，脉反浮数，尺中自涩，其人必清脓血。
下利清谷，不可攻其表，汗出必胀满。
下利，脉沉弦者，下重。其脉大者，为未止。脉微弱数者，为欲自止，虽发热，不死。
下利，脉沉而迟，其人面少赤，身有微热，下利清谷，必郁冒汗出而解，其人微厥，所
以
下利，脉反数而渴者，今自愈。设不瘥，必清脓血，有热故也。
下利，后脉绝，手足厥， 时脉还，手足温者生，不还者死。
伤寒下利，日十余行，其人脉反实者，死。
下利清谷，里寒外热，汗出而厥，通脉四逆汤主之。（方见少阴门。）
热利下重，白头翁汤主之。
下利，欲饮水者，为有热，白头翁汤主之。方∶
白头翁（二两） 黄柏（三两） 黄连（三两） 秦皮（三两）
上四味，以水七升，煮取二升，去滓，温服一升，不瘥更服。
下利腹满，身体疼痛，先温其里，乃攻其表，温里宜四逆汤，攻表宜桂枝汤。（方并见
上）
下利而谵语，为有燥屎，小承气汤主之。（方见承气门。）
下利后更烦，按其心下濡者，为虚烦也，栀子汤主之。（方见阳明门。）
呕家有痈脓，不可治呕，脓尽自愈。
呕而发热，小柴胡汤主之。（方见柴胡门。）
呕而脉弱，小便复利，身有微热，见厥难治，四逆汤主之。（方见上。）
干呕，吐涎沫，而复头痛，吴茱萸汤主之。（方见阳明门。）
伤寒大吐下之，极虚，复极汗者，其人外气怫郁，复与其水，以发其汗，因得哕，所以
然者，胃中寒冷故也。
伤寒哕而满者，视其前后，知何部不利，利之则愈。
第五十六节 方剂七首
厥阴病的证候表现为：口渴多饮，气逆上冲至心胸部位，心中感觉疼痛且灼热，虽有饥饿感却不想进食，病情严重时甚至会出现呕吐蛔虫的情况，如果误用泻下法，腹泻将难以停止。
厥阴病感受风邪时，若脉象微现浮象，表示病情即将痊愈；若脉不浮，则表示尚未痊愈。
厥阴病欲解除的时间，是从丑时到卯时这段时间。
患厥阴病出现口渴想喝水的症状时，给予水饮用即可痊愈。
凡是出现四肢逆冷的情况，不可使用泻下法，体质虚弱的人也是如此。
伤寒病先出现四肢厥冷，随后发热且伴有腹泻的，腹泻必定会停止；如果再次出现四肢厥冷，腹泻也会随之复发。
伤寒病开始发热六天，随后四肢厥冷反而持续九天并出现腹泻。通常四肢厥冷和腹泻时应当不能进食，现在反而能够进食，这恐怕是“除中”（胃气垂绝前的假性食欲恢复）的表现。给患者吃黍米做的饼，如果不发热，说明胃气尚存，病情必将痊愈。但需警惕突然发热随即消退的情况，过几天诊察脉象，如果热度持续存在，预计第二天半夜痊愈。之所以这样判断，是因为原本发热六天，厥冷反常地持续九天，后来又发热三天，加上之前的六天，总共也是九天，与厥冷的天数相应，所以预测在第二天半夜痊愈。如果之后三天脉象数疾，热度不退，这是热气有余，必然会引发痈脓。
伤寒病脉象迟滞，经过六七天，医生反而用黄芩汤来清除其热。脉迟主寒，再用黄芩汤清热，会导致腹中寒冷，按理说应当不能进食，现在反而能进食，这是“除中”的表现，必然死亡。
伤寒病先发厥冷后发热，腹泻通常会自行停止，但如果反而出现出汗、咽喉强硬疼痛，这就是喉痹。如果发热无汗，腹泻通常会自行停止；如果出现便脓血，那么就不会发生喉痹。
伤寒病一二天到四五天，出现四肢厥冷的必定会发热，先前厥冷的后来一定会发热，厥冷深重则发热也深重，厥冷轻微则发热也轻微。厥冷证应当用泻下法治疗，如果误用发汗法，会导致口腔损伤溃烂发红。
大凡厥证，都是由于阴阳之气不能顺接所致，这就称为厥。所谓厥，是指手足逆冷。
伤寒病，四肢厥冷五天，发热也五天，如果第六天应当再次出现厥冷，但没有出现厥冷，说明病将自愈。厥冷不超过五天，因为发热也有五天，所以知道病将自愈。
伤寒病脉象微细且四肢厥冷，到了七八天，皮肤冰冷，病人烦躁不安没有片刻安宁，这是内脏虚寒，蛔虫向上进入膈部，这种蛔厥证，病人应当呕吐蛔虫。让病人安静下来，却又时不时感到心烦，这是因为内脏虚寒，蛔虫向上进入膈部，所以心烦，过了一会儿又停止，如果吃东西后呕吐并且心烦，是因为蛔虫闻到食物的气味就会出来，这类病人经常自己吐蛔虫。对于蛔厥证，主治方剂是乌梅丸。方剂组成如下：
乌梅（三百枚） 细辛（六两） 干姜（十两） 黄连（十六两） 当归（四两） 蜀椒（四两）
附子（六两，炮制） 桂枝（六两） 人参（六两） 黄柏（六两）
以上十味药，分别捣碎，混合处理。用醋浸泡乌梅一夜，去核，放在五斗米上蒸熟，捣成泥状，与其他药物混合均匀，放入臼中，加蜂蜜杵打一千下，制成梧桐子大小的丸药。饭前用温水送服十丸，每日三次，逐渐增加到二十丸。忌食生冷、滑腻食物及腐败变质食物。
伤寒病热势轻微且有轻微厥冷，指尖发凉，神情沉默不想吃东西，烦躁，过了几天，小便通畅且颜色清白，说明热邪已除，进食后病即痊愈；如果出现厥冷且呕吐，胸胁部烦闷胀满，其后必定出现便血。（注：“稍头”一作“指头”。）
病人手足逆冷，自称没有结胸证，小腹部胀满，按压有痛感，这是寒气凝结在膀胱关元穴部位。
伤寒发热四天，四肢厥冷反而三天，后来又发热四天，厥冷少而发热多，病情应当痊愈。如果从第四天到第六七天，病情未除，必定出现便脓血。
伤寒四肢厥冷四天，发热反而只有三天，后来又厥冷五天，病情为进展，因为寒多热少，阳气衰退，所以病情加重。
伤寒六七天，脉象数疾，手足厥冷，烦躁，如果是阴寒内盛导致的厥冷不回阳的，预后不良，属死证。
伤寒六七天本无腹泻，突然出现发热且腹泻，病人出汗不止的，属死证，这是因为有阴无阳的缘故。
伤寒五六天，没有结胸证，腹部柔软，脉象虚弱且四肢厥冷的，不可使用泻下法，误下会导致亡血，属死证。伤寒发热且四肢厥冷，到了第七天出现腹泻的，属于难治之证。
伤寒，脉象滑利且四肢厥冷的，体表有热，主治方剂是白虎汤。（表热见里方见难疗中。）
手足厥冷，脉象细微几乎摸不到，主治方剂是当归四逆汤。方剂组成如下：
当归（三两） 桂心（三两） 细辛（三两） 芍药（三两） 甘草（二两，炙烤） 通草（二两）
大枣（二十五枚，掰开）
以上七味药，用水八升，煮取三升，去渣，温服一升，每日三次。
如果病人兼有寒邪，主治方剂是当归四逆加吴茱萸生姜汤。方剂组成如下：
吴茱萸（二两） 生姜（八两，切片）
以上两味药，加入前面的方剂中，用水四升，清酒四升混合，煮取三升，去渣，分四次温服。
大汗出后，热势不退，四肢拘急疼痛，如果伴有腹泻、四肢厥冷且恶寒，主治方剂是四逆汤。
大汗出后，如果用火法强迫发汗，导致腹泻且四肢厥冷，主治方剂是四逆汤。（方剂并见阳明门。）
病人手足逆冷，脉象突然紧束，这是邪气结聚在胸中，心下部胀满且心烦，饥饿却不能进食，病位在胸中，应当采用涌吐法，适宜用瓜蒂散。（方剂见疗痞中。）
伤寒四肢厥冷且心下悸动，应先治疗水饮，给予茯苓甘草汤，然后再治疗厥冷，否则，水饮入胃，必定导致腹泻，主治方剂是茯苓甘草汤。方剂组成如下：
茯苓（二两） 甘草（炙，一两） 桂枝（二两） 生姜（三两）
以上四味药，用水四升，煮取二升，去渣，分三次温服。
伤寒六七天，病人经过剧烈泻下后，脉象沉迟，手足逆冷，下部脉搏摸不到，咽喉不利，唾吐脓血，腹泻不止，属于难治之证，主治方剂是麻黄升麻汤。方剂组成如下：
麻黄（去节，二两半） 知母（十八铢） 葳蕤（十八铢） 黄芩（十八铢） 升麻（一两六铢）
冬甘草（炙，各... [原文此处似有缺漏或排版错误，依常规补全逻辑] ...上一十四味，以水一斗，先煮麻黄二沸，去上沫，纳诸药，煮取三升，去滓，分温三服，一炊间当汗出愈。）
伤寒四五天，腹部疼痛，如果有气体向下跑向小腹，这是将要自发性腹泻。
伤寒病人本来就有寒性腹泻，医生反而使用催吐法，导致寒邪格拒，呕吐更加严重，食物吃进去就吐出来，主治方剂是干姜黄芩黄连人参汤。方剂组成如下：
干姜 黄芩 黄连 人参（各三两）
以上四味药，用水六升，煮取二升，去渣，分两次温服。
腹泻，伴有轻微发热，病人口渴，脉象弱的，病将自愈。
腹泻脉象数，如果伴有轻微发热、出汗的，病将自愈；如果脉象再次变紧，说明病未解除。
腹泻，手足厥冷，无脉，进行灸治后，手脚不温暖，反而轻微喘息的，属死证；如果少阴脉弱于趺阳脉，则为顺证。
腹泻，脉象反而浮数，尺脉自涩，病人必定排脓血。
腹泻排出未消化的食物（完谷不化），不可攻表，发汗必定导致腹胀满。
腹泻，脉象沉弦的，会有肛门坠重感。脉象大的，说明病未停止。脉象微弱数的，说明病将自行停止，即使发热也不会死亡。
腹泻，脉象沉而迟，病人面部微微发红，身体有轻微发热，腹泻排出未消化食物，必定会出现郁冒（头晕目眩如物蒙蔽）并出汗而病解，病人会有轻微厥冷。之所以如此，是因为下利脉象反而数且口渴的，病将自愈。如果不痊愈，必定排脓血，这是因为有热邪的缘故。
腹泻后，脉搏消失，手足厥冷，如果偶尔脉搏恢复，手足转温的，可生；脉搏不恢复的，属死证。
伤寒腹泻，一天十几次，脉象反而实有力的，属死证。
腹泻排出未消化食物，里寒外热，出汗且四肢厥冷，主治方剂是通脉四逆汤。（方剂见少阴门。）
热性腹泻且肛门坠重，主治方剂是白头翁汤。
腹泻，想喝水的，说明体内有热，主治方剂是白头翁汤。方剂组成如下：
白头翁（二两） 黄柏（三两） 黄连（三两） 秦皮（三两）
以上四味药，用水七升，煮取二升，去渣，温服一升，不愈再服。
腹泻伴腹部胀满，身体疼痛，应先温补里虚，再解表邪。温里适宜用四逆汤，解表适宜用桂枝汤。（方剂并见上）
腹泻且胡言乱语，说明有燥屎积结，主治方剂是小承气汤。（方剂见承气门。）
腹泻后反而更加心烦，按压心下部柔软的，这是虚烦，主治方剂是栀子汤。（方剂见阳明门。）
呕吐且脉象微弱，小便通利，身体有轻微发热，出现厥冷难治，主治方剂是四逆汤。（方剂见上。）
干呕，吐出涎沫，且伴有头痛，主治方剂是吴茱萸汤。（方剂见阳明门。）
伤寒经过剧烈的吐下治疗，正气极度虚弱，又极度出汗，导致病人体表气机郁闭，医生又给水让其发汗，因此导致呃逆（哕），之所以这样，是因为胃中寒冷的缘故。
伤寒呃逆且腹部胀满，应观察前后二便，知道哪一部分不通利，通利之则病愈。
Section 56: Seven Prescriptions
The manifestations of Jueyin disease include excessive thirst, a sensation of Qi rushing upward to the chest and heart region, pain and burning heat in the heart, hunger without desire to eat. In severe cases, vomiting of roundworms may occur. If purgatives are mistakenly used, diarrhea will become intractable.
In Jueyin wind-stroke, if the pulse is slightly floating, recovery is imminent; if not floating, the disease has not yet resolved.
Jueyin disease tends to resolve during the period from Chou hour (1:00-3:00 AM) to Mao hour (5:00-7:00 AM).
If a patient with Jueyin disease desires water and drinks it, they will recover.
For all cases involving cold extremities (Sini), purgation is contraindicated, as is the case for patients with deficiency constitutions.
In Shanghan (Cold Damage), if cold extremities appear first, followed by fever and diarrhea, the diarrhea will cease. If cold extremities reappear, diarrhea will recur.
In Shanghan, if fever lasts for six days initially, but cold extremities last for nine days accompanied by diarrhea: typically, one cannot eat during cold extremities and diarrhea. The fact that the patient can now eat suggests "Chu Zhong" (a false sign of appetite indicating impending exhaustion of Stomach Qi). If, after feeding them millet cakes, there is no sudden fever, it indicates that Stomach Qi remains, and recovery is certain. However, one must beware of a sudden burst of heat that quickly fades. If, after a few days, the pulse shows sustained heat, recovery is expected at midnight on the following day. This prediction is based on the calculation: originally six days of fever, nine days of cold extremities, plus three more days of fever equals nine days total, matching the duration of cold extremities, thus predicting recovery at midnight. If the pulse remains rapid and heat persists for three more days, this indicates excess heat, which will likely lead to carbuncles and pus.
In Shanghan, if the pulse is slow after six or seven days, and the physician mistakenly uses Huangqin Tang (Scutellaria Decoction) to clear heat: a slow pulse indicates cold. Using Huangqin Tang further clears heat and causes abdominal coldness. Normally, one should not eat in this state. If the patient can now eat, it is "Chu Zhong," indicating inevitable death.
In Shanghan, if cold extremities and fever alternate, diarrhea usually stops spontaneously. However, if sweating occurs instead, accompanied by stiff and painful throat, this constitutes Hou Bi (throat obstruction). If there is fever without sweating, diarrhea usually stops; if pus and blood appear in the stool, Hou Bi will not occur.
In Shanghan, from the first to fourth or fifth day, if cold extremities appear, fever will follow. The deeper the cold extremities, the deeper the fever; the milder the cold extremities, the milder the fever. Cold extremities should be treated with purgation. If mistakenly treated with diaphoresis (sweating method), it will cause oral ulcers and redness.
Generally, Jue (cold extremities) occurs when Yin and Yang Qi fail to connect smoothly. Jue is characterized by cold hands and feet.
In Shanghan, if cold extremities last five days and fever lasts five days, and on the sixth day cold extremities do not return, the disease will heal itself. Since cold extremities did not exceed five days and matched the five days of fever, self-healing is predicted.
In Shanghan, if the pulse is faint and extremities are cold, and by the seventh or eighth day the skin is cold and the patient is restless without respite, this indicates internal organ coldness. Roundworms moving upward into the diaphragm cause "Hui Jue" (roundworm-induced Jue). The patient will vomit roundworms. When the patient is quiet, they may experience intermittent irritability due to internal cold and roundworms moving up. After a while, it stops. If eating induces vomiting and irritability, it is because roundworms are attracted by the smell of food. Patients often vomit roundworms naturally. For Hui Jue, Wumei Wan (Mume Pill) is the primary prescription.
Formula:
Wumei (Fructus Mume, 300 pieces), Xixin (Herba Asari, 6 liang), Ganjiang (Rhizoma Zingiberis Recens, 10 liang), Huanglian (Rhizoma Coptidis, 16 liang), Danggui (Radix Angelicae Sinensis, 4 liang), Shujiao (Pericarpium Zanthoxyli, 4 liang), Fuzi (Radix Aconiti Lateralis Preparata, 6 liang, processed), Guizhi (Caulis Cinnamomi, 6 liang), Renshen (Radix Ginseng, 6 liang), Huangbai (Cortex Phellodendri, 6 liang).
Process these ten herbs separately, then combine. Soak Wumei in vinegar overnight, remove pits, steam over rice, mash into paste, mix with other herbs, pound in a mortar with honey for 1,000 strikes, form pills the size of paulownia seeds. Take 10 pills before meals with warm water, three times daily, gradually increasing to 20 pills. Avoid raw, cold, slippery, and spoiled foods.
In Shanghan, if heat is slight with mild cold extremities, specifically cold fingertips, silence, anorexia, and irritability persist for several days, and urine is clear and copious, heat is cleared. Eating will lead to recovery. If cold extremities are accompanied by vomiting and fullness/irritability in the chest and hypochondrium, bloody stools will likely follow later.
If a patient has cold extremities, denies chest binding (Jie Xiong), but has lower abdominal fullness and tenderness upon pressure, this indicates cold binding at the Bladder Guan Yuan acupoint.
In Shanghan, if fever lasts four days, cold extremities three days, then fever four days again, the ratio of less cold to more heat suggests recovery. If from day four to six or seven the condition does not resolve, pus and blood in stool will occur.
In Shanghan, if cold extremities last four days, fever only three days, then cold extremities five days again, the disease progresses due to excess cold and deficient heat, indicating retreat of Yang Qi.
In Shanghan, after six or seven days, if the pulse is rapid, extremities are cold, and there is irritability, if Yin cold does not reverse (Yang does not return), it is a fatal prognosis.
In Shanghan, if diarrhea is accompanied by cold extremities and restlessness preventing lying down, it is fatal.
In Shanghan, if fever is accompanied by diarrhea progressing to irreversible cold extremities, it is fatal.
In Shanghan, if after six or seven days without diarrhea, sudden fever and diarrhea occur with unceasing sweating, it is fatal due to the presence of Yin without Yang.
In Shanghan, after five or six days, if there is no chest binding, abdomen is soft, pulse is deficient, and extremities are cold, purgation is contraindicated. Purgation will cause loss of blood and death. If Shanghan presents with fever and cold extremities, followed by diarrhea on the seventh day, it is difficult to treat.
In Shanghan, if the pulse is hurried and extremities are cold, moxibustion may be applied.
In Shanghan, if the pulse is slippery and extremities are cold, with exterior heat, Baihu Tang (White Tiger Decoction) is indicated.
For cold extremities with a fine or absent pulse, Danggui Sini Tang (Angelica Decoction for Reversal of Cold) is indicated.
Formula:
Danggui (Radix Angelicae Sinensis, 3 liang), Guixin (Cortex Cinnamomi, 3 liang), Xixin (Herba Asari, 3 liang), Shaoyao (Radix Paeoniae Alba, 3 liang), Gancao (Radix Glycyrrhizae Preparata, 2 liang, roasted), Tongcao (Medulla Tetrapanacis, 2 liang), Dazao (Fructus Jujubae, 25 pieces, split).
Boil these seven herbs in eight sheng of water to obtain three sheng. Strain and take one sheng warm, three times daily.
If the patient has underlying cold, Danggui Sini Tang plus Wuzhuyu and Shengjiang (Evodia and Fresh Ginger) is indicated.
Add Wuzhuyu (Fructus Evodiae, 2 liang) and Shengjiang (Rhizoma Zingiberis Recens, 8 liang, sliced) to the previous formula. Boil with four sheng of water and four sheng of clear wine to obtain three sheng. Strain and divide into four warm doses.
For massive sweating where heat persists, limb cramping and pain, or if diarrhea and cold extremities with aversion to cold occur, Sini Tang (Frigid Extremities Decoction) is indicated.
For massive sweating, especially if induced by fire therapy, leading to diarrhea and cold extremities, Sini Tang is indicated.
If a patient has cold extremities and a suddenly tight pulse, with fullness and irritability below the heart, hunger but inability to eat, the pathogen is bound in the chest. Emesis is indicated. Gouti San (Seeds of Melon Bitter Powder) is suitable.
In Shanghan, if cold extremities are accompanied by palpitations below the heart, treat the fluid retention first with Fuling Gancao Tang (Poria and Licorice Decoction), then treat the cold extremities. Otherwise, water entering the stomach will cause diarrhea. Fuling Gancao Tang is indicated.
Formula:
Fuling (Poria, 2 liang), Gancao (Radix Glycyrrhizae Preparata, 1 liang, roasted), Guizhi (Caulis Cinnamomi, 2 liang), Shengjiang (Rhizoma Zingiberis Recens, 3 liang).
Boil these four herbs in four sheng of water to obtain two sheng. Strain and divide into three warm doses.
In Shanghan, after six or seven days, if the patient has undergone severe purgation, resulting in a deep and slow pulse, cold extremities, absent lower pulses, dysphagia, spitting of pus and blood, and intractable diarrhea, it is difficult to treat. Mahuang Shengma Tang (Ephedra and Cimicifuga Decoction) is indicated.
Formula:
Mahuang (Herba Ephedrae, de-segmented, 2.5 liang), Zhimu (Rhizoma Anemarrhenae, 18 zhu), Weirui (Rhizoma Polygonati Odorati, 18 zhu), Huangqin (Radix Scutellariae, 18 zhu), Shengma (Rhizoma Cimicifugae, 1 liang 6 zhu)... [Text implies 14 ingredients total]. Boil Mahuang first, skim foam, add remaining herbs, boil to three sheng. Strain and take three warm doses. Sweating within the time of one meal indicates recovery.
In Shanghan, after four or five days, if abdominal pain occurs with gas moving toward the lower abdomen, spontaneous diarrhea is impending.
In Shanghan, if the patient originally had cold-type diarrhea, and the physician mistakenly induced vomiting, causing cold rejection and worsening vomiting (food immediately expelled), Ganjiang Huangqin Huanglian Renshen Tang (Ginger, Scutellaria, Coptis, and Ginseng Decoction) is indicated.
Formula:
Ganjiang (Rhizoma Zingiberis Recens), Huangqin (Radix Scutellariae), Huanglian (Rhizoma Coptidis), Renshen (Radix Ginseng) (each 3 liang).
Boil in six sheng of water to obtain two sheng. Strain and take twice warm.
For diarrhea with slight fever, thirst, and a weak pulse, the disease will heal spontaneously.
For diarrhea with a rapid pulse, if there is slight fever and sweating, the disease will heal spontaneously. If the pulse becomes tight again, the disease is unresolved.
For diarrhea with cold extremities and absent pulse, if moxibustion fails to warm the limbs and shortness of breath occurs, it is fatal. If the Shaoyin pulse is weaker than the Duyang pulse, it is a favorable sign.
For diarrhea, if the pulse is surprisingly floating and rapid, and the Chi position is choppy, pus and blood in stool will occur.
For diarrhea with undigested food, exterior attack is contraindicated. Sweating will cause abdominal fullness.
For diarrhea, if the pulse is deep and string-taut, there is a sense of heaviness in the anus. If the pulse is large, the disease continues. If the pulse is weak, fine, and rapid, the disease will stop spontaneously; even with fever, it is not fatal.
For diarrhea, if the pulse is deep and slow, with a slightly red face and mild body heat, and undigested food in stool, the patient will likely experience vertigo/dizziness, sweat, and recover. Mild cold extremities may occur. If the pulse is surprisingly rapid and there is thirst, the disease will heal spontaneously. If not, pus and blood in stool will occur due to heat.
After diarrhea, if the pulse disappears and extremities are cold, but the pulse returns and extremities warm, survival is possible. If the pulse does not return, it is fatal.
In Shanghan diarrhea, if the patient defecates more than ten times a day and the pulse is surprisingly strong/excess, it is fatal.
For diarrhea with undigested food, interior cold with exterior heat, sweating, and cold extremities, Tongmai Sini Tang (Pulse-Recovering Frigid Extremities Decoction) is indicated.
For hot diarrhea with rectal tenesmus (feeling of incomplete evacuation), Baitouweng Tang (Pulsatilla Decoction) is indicated.
For diarrhea with desire to drink water, indicating internal heat, Baitouweng Tang is indicated.
Formula:
Baitouweng (Radix Pulsatellae, 2 liang), Huangbai (Cortex Phellodendri, 3 liang), Huanglian (Rhizoma Coptidis, 3 liang), Qinpi (Cortex Fraxini, 3 liang).
Boil in seven sheng of water to obtain two sheng. Strain and take one sheng warm. Repeat if necessary.
For diarrhea with abdominal fullness and body pain, first warm the interior, then attack the exterior. Warm the interior with Sini Tang; attack the exterior with Guizhi Tang (Cinnamon Twig Decoction).
For diarrhea accompanied by delirium, indicating dry feces, Xiao Chengqi Tang (Minor Order the Qi Decoction) is indicated.
For increased irritability after diarrhea, with a soft epigastrium upon palpation, this is empty irritability. Zhizi Tang (Gardenia Decoction) is indicated.
For vomiting due to abscess pus, do not treat the vomiting; it will resolve spontaneously when the pus is exhausted.
For vomiting with fever, Xiaochaihu Tang (Minor Bupleurum Decoction) is indicated.
For vomiting with a weak pulse, free urination, mild body heat, and cold extremities (difficult to treat), Sini Tang is indicated.
For dry heaving, salivation, and headache, Wuzhuyu Tang (Evodia Decoction) is indicated.
In Shanghan, after severe vomiting and purgation leading to extreme deficiency, followed by excessive sweating, if the physician gives water to induce sweating, hiccups (Yue) may result due to cold in the Stomach.
In Shanghan, if hiccups are accompanied by fullness, examine the anterior and posterior orifices to determine which is obstructed. Relieving the obstruction will cure the condition.