大法。春夏宜发汗。
春夏阳气在外。邪气亦在外。故可发汗。
凡发汗。欲令手足俱周。时出以 然一时间许。亦佳。不可令如水流漓。若病不
解。当重发汗。汗多必亡阳。阳虚不得重发汗也。
汗缓缓出。则表里之邪悉去。汗大出。则邪气不除。但亡阳也。阳虚为无津液。故不
可重发汗。
凡服汤发汗。中病便止。不必尽剂。
汗多则亡阳。
凡云可发汗无汤者。丸散亦可用。要以汗出为解。然不如汤。随证良验。
圣济经云。汤液主治。本乎腠理壅郁。除邪气者于汤为宜。金匮玉函曰。水能净万物。
故用汤也。
夫病脉浮大。问病者言但便硬尔。设利者。为大逆。硬为实。汗出而解何以故。脉浮
当以汗解。
经曰。脉浮大。应发汗。医反下之。为大逆。便硬难。虽为里实。亦当先解其外。若下
利药。是为大逆。结胸虽急。脉浮大。犹不可下。下之即死。况此便难乎。经曰。本发
汗而复下之。此为逆。若先发汗。治不为逆。
下利后。身疼痛。清便自调者。急当救表。宜桂枝汤发汗。
外台云。里和表病。汗之则愈。
发汗多。亡阳谵语者不可下。与柴胡桂枝汤。和其荣卫。以通津液。后自愈。
胃为水谷之海。津液之主。发汗多亡津液。胃中燥。必发谵语。此非实热。则不可
下。与柴胡桂枝汤。和其荣卫。通行津液。津液生则胃润。谵语自止。
此一卷第十七篇凡三十一证。前有详说。
治疗的大法。春夏季节适宜使用发汗法。
春夏季节阳气浮越于体表，邪气也停留在体表，所以可以使用发汗法。
凡是使用发汗法，要使手足周身都微微出汗，持续大约一顿饭的时间，这样也很好。不可以让汗水像水流一样淋漓不止。如果病邪没有解除，应当再次发汗，但汗出过多必然导致亡阳（阳气耗散脱失）。阳气虚弱的人禁止再次发汗。
汗液缓缓而出，则表里之邪都能去除；汗液大量涌出，则邪气不能除尽，只会导致亡阳。阳气虚弱意味着津液枯竭，所以不可再次发汗。
凡是服用汤药进行发汗，只要病症缓解就停止服药，不必服完整个药方。
汗出过多会导致亡阳。
凡是说可以发汗但没有现成汤药的，也可以使用丸剂或散剂，关键在于通过出汗来使病情缓解，然而效果不如汤药那样随证变化且疗效确切。
《圣济经》说：汤液主治，根本在于腠理（皮肤纹理及毛孔）的壅滞郁结，祛除邪气用汤药为宜。《金匮玉函》说：水能洁净万物，所以使用汤药。
如果病人脉象浮大，询问病人说只是大便干硬而已。假如医生使用了泻下法，就是犯了严重的错误。大便干硬属于实证，为什么说要通过出汗而解呢？因为脉浮应当用发汗法解除。
经典记载：脉象浮大，应当发汗，医生反而使用泻下法，这是严重的错误。导致大便干硬困难，虽然属于里实证，也应当先解除表证。如果使用泻下药，就是严重的错误。即使是结胸证（痰热互结于胸膈）虽然急迫，但如果脉象浮大，仍然不可使用泻下法，一旦误下就会导致死亡，何况只是大便困难呢？经典记载：本来应该先发汗却反而先使用泻下法，这是逆治。如果先发汗，治疗就不算逆治。
腹泻停止后，身体仍然疼痛，大小便正常的，应当紧急救治表证，适宜使用桂枝汤发汗。
《外台秘要》说：里气调和而表证未解，发汗就可以痊愈。
发汗过多，导致亡阳并出现谵语（神志不清，胡言乱语）的，不可使用泻下法。给予柴胡桂枝汤，调和营卫（营气和卫气），以通畅津液，之后自然痊愈。
胃是水谷汇聚的海，也是津液的主宰。发汗过多会耗伤津液，导致胃中干燥，必定会出现谵语。这并非实热证，所以不可使用泻下法。给予柴胡桂枝汤，调和营卫，通行津液。津液生成则胃中滋润，谵语自然停止。
这一卷第十七篇共有三十一证，前面已有详细说明。
General principles. In spring and summer, it is appropriate to induce sweating.
In spring and summer, Yang Qi (vital energy) floats on the exterior, and pathogenic factors also remain on the exterior; therefore, inducing sweating is permissible.
When inducing sweating, one should aim for a uniform, mild perspiration over the hands and feet, lasting approximately the time it takes to eat a meal, which is ideal. One must not allow sweat to flow profusely like water. If the disease does not resolve, sweating may be repeated, but excessive sweating will inevitably lead to the loss of Yang Qi (collapse of vital energy). Patients with deficient Yang Qi are contraindicated for repeated sweating.
If sweat emerges slowly, both exterior and interior pathogens will be eliminated; if sweat gushes out excessively, pathogens will not be removed, resulting only in the loss of Yang Qi. Deficient Yang implies a lack of body fluids (Jin Ye), so repeated sweating is prohibited.
When administering decoctions to induce sweating, stop medication once the condition improves; there is no need to finish the entire dose.
Excessive sweating leads to the loss of Yang Qi.
Wherever it is stated that sweating can be induced but no decoction is available, pills or powders may also be used, provided that sweating occurs to resolve the condition. However, this is not as effective as decoctions, which offer better efficacy tailored to specific syndromes.
The *Shengji Jing* states: Decoctions treat conditions rooted in the congestion and stagnation of the Cou Li (skin texture and pores); they are suitable for eliminating pathogenic factors. The *Jingui Yufan* states: Water can purify all things; hence, decoctions are used.
If the pulse is floating and large, and the patient reports only that their stool is hard, using purgatives would be a major error. Hard stool indicates excess; why should it resolve through sweating? Because a floating pulse requires resolution via sweating.
The classics state: A floating and large pulse indicates the need for sweating; if a physician instead uses purgatives, it constitutes a major error. Even if constipation is difficult and represents an interior excess syndrome, the exterior must be resolved first. Using purgatives in this context is a major error. Even in urgent cases of Jie Xiong (chest binding due to phlegm-heat accumulation), if the pulse is floating and large, purgatives must not be used; purging will result in death, let alone in cases of mere constipation. The classics state: Inducing sweating first and then purging is an incorrect treatment sequence. If sweating is induced first, the treatment is not incorrect.
After diarrhea ceases, if the body still feels painful but bowel and bladder functions are normal, the exterior syndrome should be urgently treated with Guizhi Tang (Cinnamon Twig Decoction) to induce sweating.
The *Waitai Miyao* states: When the interior is harmonious but the exterior remains diseased, inducing sweating leads to recovery.
If excessive sweating leads to the loss of Yang Qi accompanied by delirium (Zhen Yu, incoherent speech), purgatives are contraindicated. Administer Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) to harmonize Ying Wei (Nutritive and Defensive Qi) and facilitate the flow of Jin Ye (body fluids); the condition will subsequently resolve spontaneously.
The Stomach is the sea of water and grain and the master of Jin Ye (body fluids). Excessive sweating depletes Jin Ye, causing dryness in the Stomach, which inevitably leads to delirium. This is not a excess-heat syndrome; therefore, purgatives are contraindicated. Administer Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) to harmonize Ying Wei (Nutritive and Defensive Qi) and promote the circulation of Jin Ye (body fluids). Once Jin Ye (body fluids) are generated, the Stomach becomes moist, and delirium stops spontaneously.
This chapter, the Seventeenth, contains thirty-one syndromes, which have been detailed previously.