栀子（十五个味苦寒） 甘草（一两味甘平） 黄柏（二两）
上三味。以水四升。煮取一升半。去滓。分温再服。
伤寒瘀热在里。身必发黄。麻黄连翘赤小豆汤主之。
湿热相交。民多病瘅。瘅、黄也。伤寒为寒湿在表。发黄为瘀热在里。与麻黄连翘
赤小豆汤。除热散湿。
麻黄（二两去节味甘温） 赤小豆（一升味甘平） 连翘（二两连翘根也苦寒）
杏仁（四十个去皮尖甘温） 大枣（十二枚味甘温） 生梓白皮（一升苦寒） 生姜
（二两切味辛温） 甘草（一两炙味甘平）
以上八味。以潦水一斗。先煮麻黄再沸。去上沫。内诸药。煮取三升。分温三服。
半日则尽。
内经曰。湿上甚而热。治以甘温。佐以甘平。以汗为故。正此之谓也。又煎用潦水
者。亦取其水味薄。则不助湿气。
娄氏云。栀子柏皮汤。麻黄连翘赤小豆汤。治身黄。小便利而身不疼者。海藏所谓
干黄是也。桂枝附子汤。去桂加白术汤。治身黄小便利而一身尽痛者。活人所谓中湿是也。
少阳之病。口苦、咽干、目眩也。
足少阳胆经也。内经曰。有病口苦者。名曰胆瘅。甲乙经曰。胆者。中精之府。五
藏取决于胆。咽为之使。少阳之脉。起于目锐 。少阳受邪。故口苦。咽干。目眩。
少阳中风。两耳无所闻。目赤。胸中满而烦者。不可吐下。吐下则悸而惊。
少阳之脉。起于目 。走于耳中。其支者。下胸中。贯膈。风伤风壅则为热。少阳
中
风。气壅而热。故耳聋目赤。胸满而烦。邪在少阳。为半表半里。以吐除烦。吐则伤气。
气虚者悸。以下除满。下则亡血。血虚者惊。
或云。少阳病。耳聋。目赤。胸满而烦。为中风。口苦。咽干。目眩。为伤寒。
王宇泰云。误吐气虚者悸。误下血虚者惊。
伤寒。脉弦细。头痛。发热者。属少阳。少阳不可发汗。发汗则谵语。此属胃。胃
和则愈。胃不和则烦而悸。
经曰。三部俱弦者。少阳受病。脉细者。邪渐传里。虽头痛发热。为表未解。以邪
客少阳。为半在表半在里。则不可发汗。发汗亡津液。胃中干燥。少阳之邪因传入胃。
必发谵语。当与调胃承气汤下之。胃和则愈。不下。则胃为少阳木邪干之。故烦而悸。
王宇泰云。凡头痛俱为在表。惟此头痛为少阳者何也。以脉弦细。可汗不可汗。当
以此为法。
王海藏云。少阳半表里。用小柴胡。名三禁汤。然亦须辨表里症孰多。假令头痛往
来寒热。脉浮。但有其一。即为表也。口失滋味而渴。胁下满。手足温。腹中不和。
大小便或秘而不通。或泄而不调。但有其一。即为里也。如无上下表里症。余皆虚
热也。是病在其中矣。
本太阳病不解。转入少阳者。胁下硬满。干呕。不能食。往来寒热。尚未吐下。脉
沉紧者。与小柴胡汤。
太阳转入少阳。是表邪入于里。胁下硬满。不能食。往来寒热者。邪在半表半里之间。
若已经吐下。脉沉紧者。邪气入腑。为里实。尚未可吐下。而脉沉紧。为传里虽深。未全
入腑。外犹未解也。与小柴胡汤以和解之。
若已吐下。发汗。温针。谵语。柴胡汤证罢。此为坏病。知犯何逆。以法治之。
少阳之邪。在表里之间。若妄吐下。发汗温针。损耗津液。胃中干燥木邪干胃。必
发谵语。若柴胡证不罢者。则不为逆。柴胡证罢者。坏病也。详其因何治之逆以法救之。
王宇泰云。救坏病。助荣卫。生津液。桂枝汤求之。
三阳合病。脉浮大。上关上。但欲眠睡。目合则汗。
关脉以候少阳之气。太阳之脉浮。阳明之脉大。脉浮大。上关上。知三阳合病。胆
热则睡。少阴病。但欲眠睡。目合则无汗。以阴不得有汗。但欲眠睡。目合则汗。知三
阳合病。胆有热也。
伤寒六七日。无大热。其人躁烦者。此为阳去入阴故也。
表为阳。里为阴。邪在表。则外有热。六七日。邪气入里之时。外无大热。内有躁
烦者。表邪传里也。故曰阳去入阴。
又云。所谓烦躁者。谓先烦。渐至躁也。所谓躁烦者。谓先发躁而迤逦复烦也。盖
内热曰烦。谓心中郁烦也。外热曰躁。谓气外热躁也。内热为有根之火。故但烦不躁。
及先烦后躁者。皆可治。外热为无根之火。故但躁不烦。及先躁后烦者。皆不可治。
伤寒三日。三阳为尽。三阴当受邪。其人反能食而不呕。此为三阴不受邪也。
伤寒四日。表邪传里。里不和。则不能食而呕。今反能食而不呕。是邪不传阴但在
阳也。
伤寒三日。少阳脉小者欲已也。
内经曰。大则邪至。小则平。伤寒三日。邪传少阳。脉当弦紧。今脉小者。邪气微
而
欲已也。
少阳病欲解时。从寅至辰上。
内经曰。阳中之少阳通于春气。寅卯辰少阳木王之时。
栀子（十五个，味苦，性寒） 甘草（一两，味甘，性平） 黄柏（二两）
以上三味药。用水四升。煮取药液一升半。滤去药渣。分两次温服。
伤寒病中，瘀滞之热邪蕴结在体内。身体必然出现发黄的症状。应当用麻黄连翘赤小豆汤来主治。
湿热相互交结。民众多患黄疸病（瘅、即黄）。伤寒是因为寒湿邪气在体表。发黄是因为瘀热郁结在体内。给予麻黄连翘赤小豆汤。以清除热邪、发散湿气。
麻黄（二两，去节，味甘，性温） 赤小豆（一升，味甘，性平） 连翘（二两，连翘根，味苦，性寒）
杏仁（四十个，去皮尖，味甘，性温） 大枣（十二枚，味甘，性温） 生梓白皮（一升，味苦，性寒） 生姜
（二两，切片，味辛，性温） 甘草（一两，炙过，味甘，性平）
以上八味药。用雨水（潦水）一斗。先煮麻黄，待再次沸腾时。去掉水面上的浮沫。加入其余药物。煮取药液三升。分三次温服。
半天内服完。
《内经》说。湿气在上部且伴有热邪。治疗用甘温的药物。佐以甘平的药。以出汗为痊愈的标志。正是说的这个意思。另外煎药使用雨水。也是取其水质淡薄。则不助长湿气。
娄氏说。栀子柏皮汤、麻黄连翘赤小豆汤。治疗身体发黄。小便通利且身体不痛的。是海藏所说的“干黄”。桂枝附子汤、去桂加白术汤。治疗身体发黄、小便通利且全身疼痛的。是《活人书》所说的“中湿”。
少阳病。表现为口苦、咽干、目眩。
这是足少阳胆经的病。《内经》说。有口苦病的。名叫胆瘅。《甲乙经》说。胆是中精之府。五脏取决于胆。咽喉是胆气的通道。少阳经脉。起于目外眦。少阳经受邪。所以口苦。咽干。目眩。
少阳中风。两耳听不见。眼睛发红。胸中满闷而烦躁。不可用吐法或下法。吐下则会导致心悸和惊骇。
少阳经脉。起于目外眦。进入耳中。其分支。下行胸中。贯穿膈肌。风邪伤风壅塞则生热。少阳中风。气机壅滞而生热。所以耳聋、目赤、胸满而烦。邪气在少阳。属于半表半里证。如果用吐法除烦。吐则损伤正气。气虚则悸。如果用下法除满。下则耗伤阴血。血虚则惊。
有人说。少阳病。耳聋、目赤、胸满而烦。属于中风。口苦、咽干、目眩。属于伤寒。
王宇泰说。误用吐法导致气虚者悸。误用下法导致血虚者惊。
伤寒。脉象弦细。头痛。发热。属于少阳病。少阳病不可发汗。发汗则会出现谵语。这属于胃的问题。胃气和顺则愈。胃气不和则烦闷而心悸。
经文说。三部脉都弦的。是少阳受病。脉细的。邪气逐渐传入里。虽然头痛发热。说明表证未解。但因为邪客居少阳。处于半在表半在里的位置。则不可发汗。发汗会亡失津液。胃中干燥。少阳的邪气因此传入胃。必定发生谵语。应当给予调胃承气汤攻下。胃气和顺则愈。如果不攻下。则胃会被少阳木邪所克伐。所以烦闷而心悸。
王宇泰说。凡是头痛都属于在表。唯独这种头痛属于少阳的为什么呢？因为脉象弦细。可汗不可汗。应当以此为准则。
王海藏说。少阳半表里证。用小柴胡汤。名为三禁汤。然而也必须辨别表里症状哪个更多。假如头痛、往来寒热、脉浮。只要有其中一项。就是表证。口中失去滋味且口渴。胁下胀满。手足温暖。腹中不和。大小便或者秘结不通。或者泄泻而不调和。只要有其中一项。就是里证。如果没有上下表里的症状。其余都是虚热。病位在其中了。
原本太阳病未解。转入少阳的。胁下硬满。干呕。不能进食。往来寒热。尚未用过吐法或下法。脉象沉紧的。给予小柴胡汤。
太阳转入少阳。是表邪入于里。胁下硬满。不能进食。往来寒热的。邪在半表半里之间。如果已经用过吐法或下法。脉象沉紧的。邪气入腑。成为里实证。尚不可用吐法或下法。而脉象沉紧。说明传里虽深。但未完全入腑。外证仍未解除。给予小柴胡汤以和解。
如果已经用过吐法、下法、发汗、温针。出现谵语。柴胡汤证已罢。这叫坏病。需查明犯了什么逆治错误。根据法则救治。
少阳的邪气。在表里之间。如果妄用吐法、下法、发汗、温针。损耗津液。胃中干燥。木邪干犯胃。必定发生谵语。如果柴胡证未罢的。则不为逆。柴胡证已罢的。就是坏病。详细考察因何治疗失误。用相应的方法救治。
王宇泰说。救治坏病。助益荣卫。生津液。可用桂枝汤寻求解决。
三阳合病。脉象浮大。关脉部位明显。只想睡觉。闭上眼睛就出汗。
关脉用来候察少阳之气。太阳脉浮。阳明脉大。脉浮大。出现在关脉部位。可知是三阳合病。胆热则嗜睡。少阴病。也是只想睡觉。闭上眼睛无汗。因为阴证不得有汗。只想睡觉。闭上眼睛就出汗。可知是三阳合病。胆有热。
伤寒六七天。没有大热。其人躁扰烦乱的。这是因为阳气退去、邪气入阴的缘故。
表为阳。里为阴。邪在表。则体外有热。六七天。是邪气入里的时间。体外无大热。体内有躁扰烦乱的。是表邪传里。所以说阳去入阴。
又说。所谓烦躁。是指先烦。逐渐发展到躁。所谓躁烦。是指先发躁。随后又转为烦。大概内部热叫烦。指心中郁结烦乱。外部热叫躁。指气机外越躁动不安。内部热是有根之火。所以只烦不躁。以及先烦后躁的。都可治。外部热是无根之火。所以只躁不烦。以及先躁后烦的。都不可治。
伤寒三日。三阳经的病已尽。三阴经应当受邪。其人反而能进食且不呕吐。这是三阴经不受邪的表现。
伤寒第四天。表邪传里。里气不和。则不能进食而呕吐。现在反而能进食且不呕吐。是邪气不传阴经而在阳经。
伤寒三日。少阳脉小的。是病欲愈的表现。
《内经》说。脉大则邪气盛。脉小则平和。伤寒三日。邪传少阳。脉应当弦紧。现在脉小的。是邪气微弱而病欲愈。
少阳病欲解的时间。从寅时至辰时。
《内经》说。阳中之少阳与春气相通。寅卯辰是少阳木旺之时。
Zhi Zi (Gardeniae Fructus, fifteen pieces, bitter, cold) Gan Cao (Glycyrrhizae Radix et Rhizoma, one liang, sweet, neutral) Huang Bo (Phellodendri Cortex, two liang)
The above three herbs. Decoct with four sheng of water. Reduce to one and a half sheng. Remove the dregs. Divide into two doses and take warm.
In Shanghan disease, stagnant heat is trapped in the interior. The body will inevitably develop jaundice. Ma Huang Lian Qiao Chi Xiao Dou Tang (Mahuang, Forsythia, and Adzuki Bean Decoction) is the primary treatment.
Damp-heat interacts mutually. The people often suffer from dan jaundice (dan refers to yellow). Shanghan is caused by cold-dampness at the exterior. Jaundice is caused by stagnant heat in the interior. Administer Ma Huang Lian Qiao Chi Xiao Dou Tang (Mahuang, Forsythia, and Adzuki Bean Decoction) to clear heat and scatter dampness.
Ma Huang (Ephedrae Herba, two liang, remove nodes, sweet, warm) Chi Xiao Dou (Adzuki Bean, one sheng, sweet, neutral) Lian Qiao (Forsythiae Fructum, two liang, root of Forsythia, bitter, cold)
Xing Ren (Prunus Armeniaca Seed, forty pieces, remove skin and tips, sweet, warm) Da Zao (Jujubae Fructus, twelve pieces, sweet, warm) Sheng Zi Bai Pi (Cortex Catalpae, one sheng, bitter, cold) Sheng Jiang (Zingiberis Rhizoma Recens, two liang, sliced, pungent, warm)
Gan Cao (Glycyrrhizae Radix et Rhizoma, one liang, honey-fried, sweet, neutral)
The above eight herbs. Decoct with ten dou of rainwater (Liao Shui). First decoct Ma Huang (Ephedrae Herba) until it boils again. Remove the foam on the surface. Add the remaining herbs. Decoct to obtain three sheng. Divide into three doses and take warm.
Finish within half a day.
The Nei Jing states: When dampness is excessive at the upper part accompanied by heat, treat with sweet-warm herbs, assisted by sweet-neutral herbs. Cure is achieved through sweating. This precisely refers to this principle. Furthermore, using rainwater for decoction is intended because its taste is thin, thus not assisting dampness.
Lou Shi says: Zhi Zi Bai Pi Tang (Gardenia, Phellodendron, and Licorice Decoction) and Ma Huang Lian Qiao Chi Xiao Dou Tang (Mahuang, Forsythia, and Adzuki Bean Decoction) treat body yellowing where urination is free and there is no body pain. This is what Hai Zang calls "dry jaundice." Gui Zhi Fu Zi Tang (Cinnamon Twig and Aconite Decoction) and Qu Gui Jia Bai Zhu Tang (Remove Cinnamon Twig, Add Atractylodes Macrocephala Decoction) treat body yellowing with free urination but whole-body pain. This is what the Huo Ren Shu calls "dampness strike."
Shaoyang disease manifests as bitter taste in the mouth, dry throat, and vertigo/dizziness.
This involves the Foot-Shaoyang Gallbladder Meridian. The Nei Jing states: Those suffering from bitter taste are named Dan Dan (Gallbladder Heat). The Jia Yi Jing states: The Gallbladder is the storehouse of essence. The five zang organs depend on the Gallbladder. The pharynx serves as its passage. The Shaoyang meridian originates at the outer canthus. When Shaoyang is invaded by pathogens, hence bitter taste, dry throat, and vertigo.
Shaoyang Wind-strike presents with deafness in both ears, red eyes, chest fullness, and irritability. Vomiting or purging must be avoided. Vomiting or purging leads to palpitations and fright.
The Shaoyang meridian originates at the outer canthus, enters the ear. Its branch descends through the chest, piercing the diaphragm. Wind pathogen obstructs and generates heat. In Shaoyang Wind-strike, qi stagnates and generates heat, hence deafness, red eyes, chest fullness, and irritability. The pathogen is in Shaoyang, which is the half-exterior, half-interior stage. Using vomiting to relieve irritability damages qi; qi deficiency causes palpitations. Using purging to relieve fullness consumes blood; blood deficiency causes fright.
Some say: Shaoyang disease with deafness, red eyes, chest fullness, and irritability is Wind-strike. Bitter taste, dry throat, and vertigo are Cold damage.
Wang Yu Tai says: Misuse of vomiting leading to qi deficiency causes palpitations. Misuse of purging leading to blood deficiency causes fright.
Shanghan with wiry-thin pulse, headache, and fever belongs to Shaoyang. Shaoyang disease cannot be treated with sweating. Sweating leads to delirious speech. This belongs to the Stomach. If the Stomach harmonizes, recovery occurs. If the Stomach does not harmonize, irritability and palpitations ensue.
The Classic states: When pulses at all three positions are wiry, Shaoyang is diseased. A thin pulse indicates the pathogen gradually transmitting inward. Although there is headache and fever, indicating the exterior is unresolved, because the pathogen resides in Shaoyang, being half-exterior and half-interior, sweating is contraindicated. Sweating depletes fluids, causing dryness in the Stomach. The Shaoyang pathogen then transmits into the Stomach, inevitably causing delirium. One should administer Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct Downward Decoction) to purge. If the Stomach harmonizes, recovery occurs. If not purged, the Stomach is attacked by the Shaoyang Wood pathogen, hence irritability and palpitations.
Wang Yu Tai says: Generally, headaches belong to the exterior. Why is this headache specifically Shaoyang? Because the pulse is wiry and thin, determining whether to sweat or not, this should be the criterion.
Wang Hai Zang says: For Shaoyang half-exterior-half-interior syndrome, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is used, named San Jin Tang (Three Prohibitions Decoction). However, one must distinguish whether exterior or interior symptoms predominate. Suppose headache, alternating chills and fever, floating pulse—having any one of these constitutes an exterior syndrome. Loss of taste and thirst, hypochondriac fullness, warmth of hands and feet, abdominal disharmony, constipation or diarrhea—having any one of these constitutes an interior syndrome. If there are no exterior/interior symptoms, the rest are deficient heat. The disease lies within.
If original Taiyang disease remains unresolved and transmits to Shaoyang, presenting with hardness and fullness in the hypochondrium, dry retching, inability to eat, alternating chills and fever, without prior vomiting or purging, and with a deep-tight pulse, administer Xiao Chai Hu Tang (Minor Bupleurum Decoction).
Transmission from Taiyang to Shaoyang means exterior pathogen entering the interior. Hardness/fullness in hypochondrium, inability to eat, alternating chills and fever indicate the pathogen is between half-exterior and half-interior. If vomiting or purging has already occurred, and the pulse is deep-tight, the pathogen has entered the fu organs, constituting interior excess. Vomiting or purging is still contraindicated. The deep-tight pulse indicates transmission is deep but not fully into the fu organs; the exterior remains unresolved. Administer Xiao Chai Hu Tang (Minor Bupleurum Decoction) to harmonize.
If vomiting, purging, sweating, or moxibustion have already been applied, resulting in delirium, and the Chai Hu syndrome has ceased, this is called a complicated disease (Huai Bing). Determine what error was made and treat according to the method.
The Shaoyang pathogen is between exterior and interior. If vomiting, purging, sweating, or moxibustion are wrongly applied, fluids are depleted, Stomach becomes dry, and Wood pathogen attacks the Stomach, inevitably causing delirium. If the Chai Hu syndrome persists, it is not a complication. If the Chai Hu syndrome ceases, it is a complicated disease. Examine the cause of the therapeutic error and rescue with appropriate methods.
Wang Yu Tai says: To rescue complicated diseases, nourish Ying and Wei, generate fluids, seek recourse in Gui Zhi Tang (Cinnamon Twig Decoction).
San Yang He Bing (Combined Disease of the Three Yang) presents with floating-large pulse, prominent at the Guan position, somnolence, and sweating upon closing the eyes.
The Guan pulse monitors Shaoyang qi. Taiyang pulse is floating, Yangming pulse is large. Floating-large pulse at the Guan position indicates Combined Disease of the Three Yang. Gallbladder heat causes sleepiness. In Shaoyin disease, there is also sleepiness but no sweating upon closing eyes, because Yin syndromes do not sweat. Sleepiness with sweating upon closing eyes indicates Combined Disease of the Three Yang with Gallbladder heat.
After six or seven days of Shanghan, with no significant fever, if the patient is restless and irritable, this is because yang has departed and the pathogen has entered yin.
Exterior is Yang, Interior is Yin. Pathogen at the exterior causes external fever. At six or seven days, it is the time for pathogen to enter the interior. External absence of significant fever with internal restlessness indicates transmission of exterior pathogen to interior. Hence, "Yang departs, entering Yin."
Furthermore, "Fan Zao" (Irritability and Restlessness) means first irritability gradually developing into restlessness. "Zao Fan" (Restlessness and Irritability) means first restlessness followed by irritability. Internal heat is called Fan (irritability), referring to mental depression and vexation. External heat is called Zao (restlessness), referring to physical agitation. Internal heat is rooted fire; thus, only Fan without Zao, or Fan preceding Zao, is treatable. External heat is unrooted fire; thus, only Zao without Fan, or Zao preceding Fan, is untreatable.
On the third day of Shanghan, the Three Yang meridians are exhausted, and the Three Yin meridians should receive the pathogen. If the patient can eat and does not vomit, this indicates the Three Yin meridians are not receiving the pathogen.
On the fourth day of Shanghan, if exterior pathogen transmits to interior and interior harmony is lost, eating is impossible and vomiting occurs. Now, the ability to eat without vomiting indicates the pathogen does not transmit to Yin but remains in Yang.
On the third day of Shanghan, if the Shaoyang pulse is small, the disease is about to resolve.
The Nei Jing states: Large pulse indicates pathogen arrival; small pulse indicates peace. On the third day of Shanghan, pathogen transmits to Shaoyang, pulse should be wiry-tight. Now, a small pulse indicates weak pathogen and impending resolution.
The time when Shaoyang disease tends to resolve is from Yin hour to Chen hour.
The Nei Jing states: Shaoyang among Yang connects with Spring qi. Yin, Mao, Chen hours are when Shaoyang Wood prospers.