当归（三两辛温） 桂枝（三两辛热） 芍药（三两酸寒） 细辛（二两辛热）
大枣（二十五个甘温） 甘草（二两炙甘平） 通草（二两甘平）
上七味。以水八升。煮取三升。去滓。温服一升。日三服。
内经曰。脉者。血之府也。诸血者。皆属心。通脉者。必先补心益血。苦先入心。
当归之苦。以助心血。心苦缓。急食酸以收之。芍药之酸。以收心气。肝苦急。急食甘
以缓之。大枣甘草通草之甘。以缓阴血。
若其人内有久寒者。宜当归四逆。加吴茱萸生姜汤主之。
茱萸辛温以散久寒。生姜辛温。以行阳气。
当归（三两） 芍药（三两） 甘草（二两炙） 通草（二两） 桂枝（三两去皮）
细辛（三两） 生姜（半斤切） 大枣（二十五枚擘） 吴茱萸（二升）
上九味。以水六升。清酒六升。和煮。取五升。去滓。温分五服。一方。水酒各四
升。
大汗出热不去。内拘急。四肢疼。又下利厥逆而恶寒者。四逆汤主之。
大汗出。则热当去。热反不去者。亡阳也。内拘急下利者。寒甚于里。四肢疼。厥
逆而恶寒者。寒甚于表。与四逆汤。复阳散寒。
大汗。若大下利而厥冷者。四逆汤主之。
大汗。若大下利内外虽殊。其亡津液。损阳气。则一也。阳虚阴胜。故生厥逆。与
四逆汤。固阳退阴。
病患手足厥冷。脉乍紧者。邪结在胸中。心中满而烦。饥不能食者。病在胸中。当
须
吐之。宜瓜蒂散。
手足厥冷者。邪气内陷也。脉紧牢者为实。邪气入腑则脉沉。今脉乍紧。知邪结在
胸中为实。故心下满而烦。胃中无邪则喜饥。以病在胸中。虽饥而不能食。与瓜蒂散。
以吐胸中之邪。
伤寒厥而心下悸者。宜先治水。当服茯苓甘草汤。却治其厥。不尔。水渍入胃。必作
利也。
金匮要略曰。水停心下。甚者则悸。厥虽寒胜。然以心下悸。为水饮内甚。先与茯
苓甘草汤治其水。而后治其厥。若先治厥。则水饮浸渍入胃。必作下利。
伤寒六七日。大下后。寸脉沉而迟。手足厥逆。下部脉不至。咽喉不利。唾脓血。
泄利不止者。为难治。麻黄升麻汤主之。
伤寒六七日。邪传厥阴之时。大下之后。下焦气虚。阳气内陷。寸脉迟。而手足厥
逆。下部脉不至。厥阴之脉。贯膈。上注肺。循喉咙。在厥阴。随经射肺。因亡津液。遂
成肺痿。咽喉不利。而吐脓血也。金匮要略曰。肺痿之病。从何得之。被快药下利。重
亡津液。故得之。若泄利不止者。为里气大虚。故云难治。与麻黄升麻汤。以调
肝肺之气。
当归（三两，性味辛温） 桂枝（三两，性味辛热） 芍药（三两，性味酸寒） 细辛（二两，性味辛热）
大枣（二十五个，性味甘温） 甘草（二两，炙后性味甘平） 通草（二两，性味甘平）
以上七味药。用水八升。煮取三升。去渣。每次温服一升。每日服用三次。
《内经》说：脉是血的府库。所有的血，都归属于心。调理血脉，必须先补益心脏、滋养血液。苦味药物先入心。
当归的苦味，用来助益心血。心气容易涣散，急需酸味食物来收敛它。芍药的酸味，用来收敛心气。肝气容易拘急，急需甘味食物来缓和它。大枣、甘草、通草的甘味，用来缓和阴血的凝滞。
如果患者体内有久久的寒邪，应当用当归四逆加吴茱萸生姜汤主治。
吴茱萸辛温，用来驱散久寒。生姜辛温，用来运行阳气。
当归（三两） 芍药（三两） 甘草（二两，炙） 通草（二两） 桂枝（三两，去皮）
细辛（三两） 生姜（半斤，切片） 大枣（二十五枚，掰开） 吴茱萸（二升）
以上九味药。用水六升，清酒六升，混合煎煮。取五升药液。去渣。分五次温服。另一法：水和酒各四升。
大汗出而热不退，腹部拘急，四肢疼痛，又伴有下利、手足厥冷且恶寒的，用四逆汤主治。
大汗出，热应当退去。热反而不退的，是亡阳证。腹部拘急且下利的，是里寒极盛；四肢疼痛，手足厥冷且恶寒的，是表寒极盛。给予四逆汤，以回复阳气、驱散寒邪。
大汗出，或者严重下利导致手足冰冷的，用四逆汤主治。
大汗出，或者严重下利，虽然内外症状不同，但损伤津液、损耗阳气的情况是一样的。阳气虚衰，阴气偏胜，所以产生手足厥冷。给予四逆汤，以固护阳气、消退阴寒。
病人手足厥冷，脉搏突然变紧的，邪气结聚在胸中，心中胀满且烦闷，饥饿但不能进食的，病位在胸中，应当使用涌吐法治疗。适宜用瓜蒂散。
手足厥冷，是邪气内陷的表现。脉搏紧而坚牢的是实证。邪气进入腑则脉搏沉。现在脉搏突然变紧，知道邪气结聚在胸中为实证。所以心下胀满且烦闷。胃中没有邪气则喜欢饥饿。因为病在胸中，虽然饥饿但不能进食。给予瓜蒂散，以涌吐胸中的邪气。
伤寒出现手足厥冷且心下悸动的，应当先治疗水饮。应当服用茯苓甘草汤，然后再治疗厥冷。如果不这样，水气浸渍入胃，必定会导致下利。
《金匮要略》说：水饮停聚在心下，严重的就会心悸。厥冷虽然是寒邪胜所致，但因为有心下悸动，说明水饮内盛。先用茯苓甘草汤治疗水饮，然后治疗厥冷。如果先治疗厥冷，则水饮浸渍入胃，必定导致下利。
伤寒六七天，经过猛烈攻下之后，寸脉沉而迟，手足厥冷，尺部脉搏摸不到，咽喉不利，唾脓血，泄利不止的，属于难治之证。用麻黄升麻汤主治。
伤寒六七天，是邪气传入厥阴经的时候。经过猛烈攻下之后，下焦气虚，阳气内陷。寸脉迟，且手足厥冷，下部脉搏摸不到。厥阴经脉，穿过膈肌，上注于肺，沿着喉咙走。在厥阴经，随经气影响肺部，因为津液耗伤，于是形成肺痿（肺叶枯萎），咽喉不利，并吐出脓血。《金匮要略》说：肺痿这个病，是怎么得的？是因为被峻猛的药物攻下，再次严重耗伤津液，所以得此病。如果泄利不止，说明里气极度虚弱，所以说难治。给予麻黄升麻汤，以调和肝肺之气。
Angelicae Sinensis Radix (3 liang, acrid and warm) Cinnamon Twig (3 liang, acrid and hot) Paeoniae Radix Alba (3 liang, sour and cold) Asari Radix et Rhizoma (2 liang, acrid and hot)
Jujubae Fructus (25 pieces, sweet and warm) Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (2 liang, sweet and neutral after honey-frying) Trogopterori Faeces (2 liang, sweet and neutral)
The above seven herbs. Boil with eight sheng of water. Decoct to obtain three sheng. Remove the dregs. Take one sheng warm each time. Administer three times daily.
The *Neijing* states: The vessels are the mansion of blood. All blood belongs to the Heart. To regulate the vessels, one must first tonify the Heart and benefit the blood. Bitter substances enter the Heart first.
The bitterness of Angelicae Sinensis Radix assists Heart blood. The Heart suffers from flaccidity; urgently consume sour substances to astringe it. The sourness of Paeoniae Radix Alba astringes Heart qi. The Liver suffers from tension; urgently consume sweet substances to relax it. The sweetness of Jujubae Fructus, Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, and Trogopterori Faeces relaxes Yin blood.
If there is chronic cold within the person, Danggui Sini Tang plus Wuzhuyu and Shengjiang Decoction should be used as the primary treatment.
Evodiae Fructus is acrid and warm to dissipate chronic cold. Zingiberis Rhizoma Recens is acrid and warm to circulate Yang qi.
Angelicae Sinensis Radix (3 liang) Paeoniae Radix Alba (3 liang) Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (2 liang) Trogopterori Faeces (2 liang) Cinnamon Twig (3 liang, bark removed)
Asari Radix et Rhizoma (3 liang) Zingiberis Rhizoma Recens (half jin, sliced) Jujubae Fructus (25 pieces, torn open) Evodiae Fructus (2 sheng)
The above nine herbs. Boil with six sheng of water and six sheng of clear wine together. Decoct to obtain five sheng. Remove the dregs. Divide into five warm doses. Another method: four sheng of water and four sheng of wine each.
Profuse sweating with heat not subsiding, internal cramping, pain in the four limbs, accompanied by diarrhea, cold extremities, and aversion to cold, is treated primarily with Sini Tang (Four Counterflow Decoction).
Profuse sweating should cause heat to subside. If heat does not subside but persists, it indicates collapse of Yang. Internal cramping and diarrhea indicate severe cold in the interior. Pain in the four limbs, cold extremities, and aversion to cold indicate severe cold in the exterior. Administer Sini Tang to restore Yang and dissipate cold.
Profuse sweating, or severe diarrhea leading to cold extremities, is treated primarily with Sini Tang (Four Counterflow Decoction).
Profuse sweating, or severe diarrhea, although the external and internal symptoms differ, both result in the loss of body fluids and damage to Yang qi. Yang deficiency and Yin excess lead to cold extremities. Administer Sini Tang (Four Counterflow Decoction) to consolidate Yang and retreat Yin.
When a patient has cold extremities and the pulse suddenly becomes tight, the pathogenic factor is knotted in the chest. There is fullness and irritability in the heart region, hunger but inability to eat. The disease is located in the chest and requires emesis. Genti San (Thistle Powder) is suitable.
Cold extremities indicate the inward sinking of pathogenic factors. A tight and firm pulse indicates excess. When pathogenic factors enter the Fu organs, the pulse becomes deep. Now that the pulse suddenly becomes tight, it is known that the pathogenic factor is knotted in the chest as an excess condition. Hence, there is fullness and irritability below the heart. Since there is no pathogen in the Stomach, there is desire for food. However, because the disease is in the chest, despite hunger, eating is impossible. Administer Genti San (Thistle Powder) to induce vomiting and expel the pathogen from the chest.
In Shaoyang disease, if there are cold extremities and palpitations in the epigastrium, treat the water retention first. Fuling Jiangzhi Tang (Poria, Ginger, and Licorice Decoction) should be taken, and then treat the cold extremities. Otherwise, water will infiltrate the Stomach, inevitably causing diarrhea.
The *Jingui Yaolue* states: Water stagnating below the Heart causes palpitations when severe. Although cold extremities are due to cold excess, the presence of palpitations below the Heart indicates severe internal water retention. First administer Fuling Jiangzhi Tang to treat the water, then treat the cold extremities. If the cold extremities are treated first, the water retention will infiltrate the Stomach, inevitably causing diarrhea.
After six or seven days of Shanghan (Cold Damage), following a severe purgation, if the Cun (inch) pulse is deep and slow, there are cold extremities, the pulse at the lower position is imperceptible, there is throat obstruction, expectoration of pus and blood, and unceasing diarrhea, this is difficult to treat. Mahuang Shengma Tang (Ephedra and Ma Huang Shen Decoction) is indicated.
At six or seven days of Shanghan, when the pathogen transmits to the Jueyin channel, severe purgation leads to Qi deficiency in the Lower Jiao and sinking of Yang qi internally. The Cun pulse is slow, and there are cold extremities with an imperceptible lower pulse. The Jueyin channel passes through the diaphragm, ascends to the Lung, and follows the throat. In Jueyin, following the meridian to affect the Lung, combined with the loss of body fluids, Fei Wei (Lung萎/Withered Lung) forms. This causes throat obstruction and expectoration of pus and blood. The *Jingui Yaolue* states: How is Fei Wei obtained? It is caused by being subjected to harsh purgatives, which severely depletes body fluids again. If diarrhea is unceasing, it indicates extreme deficiency of interior Qi, hence it is said to be difficult to treat. Administer Mahuang Shengma Tang to harmonize the Qi of the Liver and Lung.