夫伤寒不应发汗而汗之。遂致亡阳。津液内竭。胃中燥实。令谵语。此病或由津液不和。
内有燥屎。或三阳合病。或瘀热蓄血在里。或妇人热入血实。皆使谵语。凡身当有热。脉属
胃。胃者。足阳明经也。阳明为病。主身热。故谵语妄言。盖身当有热。脉当洪大。而洪
大亦阳脉也。故其病为顺。若谵语而手足四厥。脉而反沉细而微者。为逆也。然又有郑声者。
取其郑重之意。与谵语相类。盖古人以此分虚实。医者当以脉证参合别之。不可不慎。故谓
虚则郑声。实则谵语。伤寒四五日。脉沉。喘满。沉为在里。而反发汗。其津液越出。大便
为难。表虚里实。久久则成谵语。发汗后。重发其汗。亡阳亦为谵语。其脉反和者。不死。
阳明病。下血而谵语者。此为热入血室。但头汗出。当刺期门。随其实者而泻之。 然汗出
者。则愈。病若谵言妄语。人身热。脉当洪大者生。沉细而微。手足四逆者死也。伤寒谵语。
何
夫心藏神而主火。病则热气归焉。伤寒谓中热盛。上乘于心。心为热冒。则神昏乱。而语言
多出。热昏不知所以然。遂言失次。而成谵妄之语。轻者睡中呢喃。重者不睡。亦语言差谬
。有谵语者。有独语者。有狂语者。有语言不休者。有言乱者。此数者。见其热之轻重也。
谵语与独语。虽间有妄错之语。若与人言有次。是热未至于极者也。经曰。独语如见鬼。若
剧者。发则不识人。是病独语未为剧者。狂语者。热甚者也。由神昏而无所见觉。甚则至于
喊叫而言语也。言语不休者。又其甚也。至于言乱者。谓妄言骂詈善恶。不避亲疏。为神明
已乱也。经曰。诸逆发汗微者难瘥。剧者言乱。是难可复制也。谵语之由。又自不同。皆当
明辨之。有被火劫谵语者。有汗出谵语者。有下利谵语者。有下热谵语者。有燥屎在胃谵语
者。有三阳合病谵语者。有过经谵语者。有亡阳谵语者。经曰。大热入胃。水竭躁烦。必发
谵语。又腹满微喘。口干咽烂。或大便艰涩。久则谵语。是因被火劫谵语者。汗出谵语。此
为风也。须下之。过经可下之。下之若早。语言必乱。以表虚里实故也。是汗出谵语者也。
下利谵语者。有燥屎也。小承气汤主之。是下利谵语者也。下血谵语者。此为热入血室。当
刺期门。随其虚实而泻之。是下血谵语者也。谵语者。潮热不能食者。胃中必有燥屎五六枚
也。是谓燥屎在胃谵语者也。腹满身重。难以转侧。口不仁。面垢。谵语。遗屎。是三阳合
病谵语者也。过经谵语者。热也。当下之。是过经谵语者也。发汗多亡阳谵语者。不可与柴
胡桂枝汤。和其荣卫。是以有通津液后。自愈。是亡阳谵语也。诸如此。脉短则死。脉自和
则愈。又身微热。脉浮大者生。逆冷。脉沉细。不过一日死。实则谵语。气收敛在内。而实
者。本病也。或气上逆而喘满。或气下夺而自利者。为逆也。经曰。直视谵语。喘满者死。
下利者亦死。谓其正气脱绝也。能知虚实之诊。能识逆从之要。治病疗疾则不失矣。病患有
谵语。有郑声二证。郑声为虚。当用温药。白通汤主之。谵语为实。当须调胃承气汤主之。
服调胃承气汤。而谵语止。或更衣者。停后服。不尔。再与之。仲景云。实则谵语。虚则郑
声。郑声。重语也。多不别。然谵语郑声亦相似难辨。须更用外证与脉别之。若大小便利。
手足冷。脉微细者。必郑声也。大便秘。小便赤。手足温。脉洪数者。必谵语也。以相参。
然后用药万全矣。大抵伤寒不应发汗。发汗即谵语。谵语属胃。胃和则愈。不知。烦而躁。
宜服调胃承气汤。然亦有三阳合病谵语者。有胃实谵语者。或发汗多。亡阳谵语者。
下利谵语。为有燥屎。脉不微细。即须下之。用小承气汤。谵语而利不止。则不治。又
汗出谵语者。风也。须候其过经乃下之。瘀血谵语者。狂言漱水。大便黑。小便多。遍身黄。
小腹满。缘当汗。蓄热在里。热化为血故尔。轻者。犀角地黄汤。重者。桃仁承气汤。抵当
丸。有下后谵语者。有妇人热入血室谵语者。
发少阳汗。则谵语。经云。汗之则谵语甚。谓少阳也。下之则额上汗。手足逆冷。谓下
之早也。发汗多。亡阳谵语。不可下。柴胡桂枝汤主之。火劫谵语。口干烦躁。喘满。小柴
胡加黑豆主之。大便秘。谵语。不恶寒。反恶热。宜用白虎汤。又问仲景云。无犯胃气。何
也。答曰。热因经水适来。乘虚入实。故血室有热。遂令谵语。当以小柴胡解之。即与胃实
谵语不同。胃实有燥粪。故宜调胃承气汤下之。若血实有热谵语。非胃家实。仲景恐人作胃
实攻之。故曰。无犯胃气也。大抵谵语是热。属阳。反见阴证者逆。
方
枳实汤 治伤寒脉沉在里而反发汗。津液越出。大便难甚。表虚里实。遂发谵语。
其人如狂。
枳实（去瓤麸炒） 木香（各一分） 朴硝（三分） 大黄（锉微炒一两） 甘草（炙
半两） 上
粗捣筛。每服五钱。水一盏半。煎至七分。去滓。温服。
犀角汤 治伤寒邪热在胃。谵言妄语。身体壮热。
犀角（镑） 大青 人参（各三分） 远志（去心一分） 升麻（一两半） 柴胡（去
苗） 甘草
（炙锉半两） 黄芩（去黑心各一两） 上粗捣筛。每服五钱。水一盏半。入生姜半分。拍
碎。
芦
芎 汤 治伤寒里实。谵语狂妄。
芎 （三分） 大黄（炒锉一两） 甘草（炙锉半两） 上粗捣筛。每服五钱。水一盏
半。煎
七分。去滓。温服。
柴胡汤 治伤寒热实。烦躁谵语。
柴胡（去苗） 人参 黄芩（去黑心各一两） 犀角（镑） 朴硝 茯神（去木各三分）
甘草
（炙锉半两） 上粗捣筛。每服五钱。水一盏半。煎七分。去滓。温服。
人参柴胡汤 治伤寒经六七日不解。默默烦心。腹中干燥。大腹结涩。谵言妄语。
人参（三分） 柴胡（去苗一两） 芍药 知母 黄芩（去黑心） 大黄（锉微炒） 葳
蕤半
夏（汤洗七次焙） 甘草（炙各半两） 上粗捣筛。每服五钱。水一盏半。入生姜一分。拍
碎。
同
黄芩散 治伤寒烦热不解。谵言妄语。欲发狂走。
黄芩（去黑心） 甘遂（麸炒黄） 龙胆（去芦头各一两） 上粗捣。罗为散。每服一
钱。冷
水调下。更令病患饮水三两盏。腹满则吐之。此方药积热。甚之。
栝蒌散 治伤寒发热。烦躁。言语谵妄。目赤口干。心神恍惚。
栝蒌根（二两） 郁金 甘草（锉各一两） 上捣罗为散。每服一钱。生姜蜜水调下。
不拘
时候。
治伤寒发汗多。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。
柴胡（去苗四两） 桂（去粗皮） 黄芩（去黑心） 芍药 人参（各一两半） 半夏
（汤洗七
次焙） 甘草（炙各一两） 上锉如麻豆大。每服五钱。水一盏半。入生姜半分。拍碎。大
枣
三枚。擘破。同煎至七分。去滓。温服。日三。
人参汤 治厥阴病。亡阳谵语。惊狂者。
人参 茯苓（各二两） 甘草 菖蒲 当归 紫石英 熟地黄（各一两） 上以水五升。
煮
取二升。去滓。温服七合。
人参柴胡汤 治伤寒不分阳阴。汗下太早。为红靥。发大热。并谵语。不得安宁。
宜服之。
人参（二两） 柴胡 麦门冬（去心各二两） 上 咀。分作三服。水一大碗。煎至七
分。
去滓。冷服。热亦可。滓再煎服。此方汗之轻剂。
犀角散（出圣惠方）治伤寒邪热在胃。谵语错乱。
犀角屑 川升麻 柴胡（去苗） 葛根（锉） 川芒硝（各一两一方用马牙硝） 甘草
（炙微
赤锉） 蓝叶（各半两） 上为散。每服四钱。以水一中盏。煎六分。去滓。不拘时候。温
服。
柴胡散（出同前）治伤寒谵语。头疼壮热。骨节疼痛。
柴胡（去苗） 赤芍药 知母 栀子仁（各一两） 川升麻 黄芩 大青 川大黄（锉
碎微
炒） 杏仁（汤浸去皮尖双仁麸炒微黄） 甘草（炙微赤锉各三分） 石膏（四两） 上粗
罗为
散。每服
黄药散 治伤寒发热。面目赤黄。烦躁欲走。如见鬼神。谵语不禁。
黄药 川大黄（锉碎微炒） 栀子仁 人参（去芦头） 槟榔 郁金 甘草（炙微赤锉）
龙
胆（去芦头） 犀角屑（各半两） 紫菀（一两） 川朴硝（二两） 上细罗为散。每服不
计时候。
以
汉防己散（出圣惠方）治伤寒热毒逼心。谵语见鬼神。不安。
汉防己（半两） 桂心 防风（去芦头各三分） 甘草（半两炙微赤锉） 地黄（二斤
研绞取
汁） 上捣罗为末。入地黄汁。更入水一大盏。调匀。入银器中盛。于甑中蒸半日。取出。
每服三合。以温水调下。不计时候。
又方（出同前）
犀角屑（一两） 黄连（半两） 茯神（三分） 甘草（半两炙微赤锉） 上粗为散。
每服五
钱。以水一大盏。煎五分。去滓。不计时候。温服。
生地黄散（出同前）治伤寒心膈热毒。烦闷。谵语失度。
生地黄（三两） 玄参 赤茯苓（各一两半） 麦门冬（去心） 川升麻（各一两） 甘
草（半
两炙微赤锉） 上捣筛为散。每服五钱。以水一大盏。煎五分。去滓。不计时。温服。
治伤寒经五六日。未经发汗。大便结涩。谵言妄语。烦躁不安。（出圣惠方）
前胡（去芦头） 葛根（锉各一两） 川大黄（二两锉碎微炒） 上为粗散。每服四钱。
以水
一中盏。煎至六分。去滓。不计时候。温服。以利为度。
葛根散（出圣惠方）治伤寒热毒在里。谵言妄语。体热心燥。
葛根（锉） 黄芩（各一两） 川大黄（二两锉碎微炒） 柴胡（去苗） 犀角（各一
两） 甘草
（半两炙微赤锉） 上为散。每服四钱。以水一盏半。煎至六分。去滓。不计时候。以通利
为
度
赤茯苓饮（出圣惠方）治伤寒心脏虚热。谵语。恍惚不定。
赤茯苓（一两半） 牡蛎（一两烧为粉） 龙骨（一两半） 黄芩（一两） 上为粗散。
先以水
二盏。入羊心一枚。煮熟。去羊心。次入药五钱。生姜半分。煎至七分。去滓。不计时候。
温服。分为二服。
大承气汤（出圣惠方）治伤寒阳明病。谵语。有潮热。不能食者。必有燥粪在
肠胃。若能食者。但硬耳宜服此汤下之。
川大黄（二两锉碎微炒） 川芒硝（一两半） 枳实（三分麸炒黄） 浓朴（一两去粗
皮涂生
姜汁炙令香熟） 上为散。每服四钱。以水一中盏。煎至六分。去滓。温服。如人行五里时。
再
铅霜散（出圣惠方）治伤寒得汗后。狂躁。谵语欲走。
铅霜（细研） 马牙硝 人参（去芦头） 郁金 茯神（各半两去木） 甘草（一分炙
微赤锉）
上细罗为散。每服不计时。煎麦门冬。温水服。调下二钱。
郁金散（出圣惠方）治伤寒发狂。谵语。大便不通。心腹胀满。欲走。
郁金（三分） 川大黄（一两半锉碎微炒） 栀子仁（三分） 柴胡（去毛半两） 甘
草（一分
微赤锉） 犀角屑（半两） 上细罗为散。每服煎葱豉汤下二钱。如人行十里。再服。大便
通
利为度。
朱砂散（出圣惠方）治伤寒伏热在心脾。谵言。状如痴人。\x
朱砂（细研） 太阴玄精（各半两细研） 犀角屑（一两） 铅霜（半两细研） 紫石
英（三分
细研水飞过） 人参（去芦头） 赤茯苓 防风（各一两去芦头） 诃黎勒皮（三分） 上
细罗为
散。入上件四味。同研令匀。每服不计时候。以葱汤调下二钱。
【背景信息】
书名：普济方 作者：朱梓 朝代：明·永乐四年 章节：伤寒谵语（附论） 类别：方剂
【原文翻译】
夫伤寒不应发汗而汗之。遂致亡阳。津液内竭。胃中燥实。令谵语。此病或由津液不和。内有燥屎。或三阳合病。或瘀热蓄血在里。或妇人热入血实。皆使谵语。凡身当有热。脉属胃。胃者。足阳明经也。阳明为病。主身热。故谵语妄言。盖身当有热。脉当洪大。而洪大亦阳脉也。故其病为顺。若谵语而手足四厥。脉而反沉细而微者。为逆也。然又有郑声者。取其郑重之意。与谵语相类。盖古人以此分虚实。医者当以脉证参合别之。不可不慎。故谓虚则郑声。实则谵语。
伤寒四五日。脉沉。喘满。沉为在里。而反发汗。其津液越出。大便为难。表虚里实。久久则成谵语。发汗后。重发其汗。亡阳亦为谵语。其脉反和者。不死。阳明病。下血而谵语者。此为热入血室。但头汗出。当刺期门。随其实者而泻之。然汗出者。则愈。病若谵言妄语。人身热。脉当洪大者生。沉细而微。手足四逆者死也。
伤寒谵语。何？夫心藏神而主火。病则热气归焉。伤寒谓中热盛。上乘于心。心为热冒。则神昏乱。而语言多出。热昏不知所以然。遂言失次。而成谵妄之语。轻者睡中呢喃。重者不睡。亦语言差谬。有谵语者。有独语者。有狂语者。有语言不休者。有言乱者。此数者。见其热之轻重也。谵语与独语。虽间有妄错之语。若与人言有次。是热未至于极者也。经曰。独语如见鬼。若剧者。发则不识人。是病独语未为剧者。狂语者。热甚者也。由神昏而无所见觉。甚则至于喊叫而言语也。言语不休者。又其甚也。至于言乱者。谓妄言骂詈善恶。不避亲疏。为神明已乱也。经曰。诸逆发汗微者难瘥。剧者言乱。是难可复制也。谵语之由。又自不同。皆当明辨之。
有被火劫谵语者。有汗出谵语者。有下利谵语者。有下热谵语者。有燥屎在胃谵语者。有三阳合病谵语者。有过经谵语者。有亡阳谵语者。经曰。大热入胃。水竭躁烦。必发谵语。又腹满微喘。口干咽烂。或大便艰涩。久则谵语。是因被火劫谵语者。汗出谵语。此为风也。须下之。过经可下之。下之若早。语言必乱。以表虚里实故也。是汗出谵语者也。下利谵语者。有燥屎也。小承气汤主之。是下利谵语者也。下血谵语者。此为热入血室。当刺期门。随其虚实而泻之。是下血谵语者也。谵语者。潮热不能食者。胃中必有燥屎五六枚也。是谓燥屎在胃谵语者也。腹满身重。难以转侧。口不仁。面垢。谵语。遗屎。是三阳合病谵语者也。过经谵语者。热也。当下之。是过经谵语者也。发汗多亡阳谵语者。不可与柴胡桂枝汤。和其荣卫。是以有通津液后。自愈。是亡阳谵语也。诸如此。脉短则死。脉自和则愈。又身微热。脉浮大者生。逆冷。脉沉细。不过一日死。实则谵语。气收敛在内。而实者。本病也。或气上逆而喘满。或气下夺而自利者。为逆也。经曰。直视谵语。喘满者死。下利者亦死。谓其正气脱绝也。能知虚实之诊。能识逆从之要。治病疗疾则不失矣。
病患有谵语。有郑声二证。郑声为虚。当用温药。白通汤主之。谵语为实。当须调胃承气汤主之。服调胃承气汤。而谵语止。或更衣者。停后服。不尔。再与之。仲景云。实则谵语。虚则郑声。郑声。重语也。多不别。然谵语郑声亦相似难辨。须更用外证与脉别之。若大小便利。手足冷。脉微细者。必郑声也。大便秘。小便赤。手足温。脉洪数者。必谵语也。以相参。然后用药万全矣。大抵伤寒不应发汗。发汗即谵语。谵语属胃。胃和则愈。不知。烦而躁。宜服调胃承气汤。然亦有三阳合病谵语者。有胃实谵语者。或发汗多。亡阳谵语者。下利谵语。为有燥屎。脉不微细。即须下之。用小承气汤。谵语而利不止。则不治。又汗出谵语者。风也。须候其过经乃下之。瘀血谵语者。狂言漱水。大便黑。小便多。遍身黄。小腹满。缘当汗。蓄热在里。热化为血故尔。轻者。犀角地黄汤。重者。桃仁承气汤。抵当丸。有下后谵语者。有妇人热入血室谵语者。
发少阳汗。则谵语。经云。汗之则谵语甚。谓少阳也。下之则额上汗。手足逆冷。谓下之早也。发汗多。亡阳谵语。不可下。柴胡桂枝汤主之。火劫谵语。口干烦躁。喘满。小柴胡加黑豆主之。大便秘。谵语。不恶寒。反恶热。宜用白虎汤。又问仲景云。无犯胃气。何也。答曰。热因经水适来。乘虚入实。故血室有热。遂令谵语。当以小柴胡解之。即与胃实谵语不同。胃实有燥粪。故宜调胃承气汤下之。若血实有热谵语。非胃家实。仲景恐人作胃实攻之。故曰。无犯胃气也。大抵谵语是热。属阳。反见阴证者逆。
【方剂部分】
枳实汤：治疗伤寒脉象沉伏，病位在里，却误用发汗法，导致津液外泄，大便极度困难，表虚里实，从而引发谵语。患者出现类似发狂的症状。
组成：枳实（去瓤，麸炒）、木香（各一分），朴硝（三分），大黄（锉碎，微炒一两），甘草（炙半两）。
制法用法：将药材粗捣筛匀。每次服用五钱，加水一盏半，煎至七分，去渣，温服。
犀角汤：治疗伤寒邪热在胃，出现谵言妄语，身体壮热。
组成：犀角（镑片），大青，人参（各三分），远志（去心一分），升麻（一两半），柴胡（去苗），甘草（炙锉半两），黄芩（去黑心，各一两）。
制法用法：将药材粗捣筛匀。每次服用五钱，加水一盏半，加入生姜半分，拍碎，同煎。
芎汤：治疗伤寒里实，出现谵语狂妄。
组成：川芎（三分），大黄（炒锉一两），甘草（炙锉半两）。
制法用法：将药材粗捣筛匀。每次服用五钱，加水一盏半，煎至七分，去渣，温服。
柴胡汤：治疗伤寒热实，烦躁谵语。
组成：柴胡（去苗），人参，黄芩（去黑心，各一两），犀角（镑片），朴硝，茯神（去木，各三分），甘草（炙锉半两）。
制法用法：将药材粗捣筛匀。每次服用五钱，加水一盏半，煎至七分，去渣，温服。
人参柴胡汤：治疗伤寒病程六七日未解，默默心烦，腹中干燥，大腹结涩，谵言妄语。
组成：人参（三分），柴胡（去苗一两），芍药，知母，黄芩（去黑心），大黄（锉微炒），葳蕤，半夏（汤洗七次焙干），甘草（炙，各半两）。
制法用法：将药材粗捣筛匀。每次服用五钱，加水一盏半，加入生姜一分，拍碎，同煎。
黄芩散：治疗伤寒烦热不解，谵言妄语，欲发狂走。
组成：黄芩（去黑心），甘遂（麸炒黄），龙胆（去芦头，各一两）。
制法用法：将药材粗捣，罗筛为散。每次服用一钱，冷水调下。并让病患饮水三两盏，若腹满则催吐。此方用于积热甚重的情况。
栝蒌散：治疗伤寒发热，烦躁，言语谵妄，目赤口干，心神恍惚。
组成：栝蒌根（二两），郁金，甘草（锉，各一两）。
制法用法：将药材捣罗为散。每次服用一钱，用生姜蜜水调下，不拘时候。
治伤寒发汗过多导致亡阳谵语者，不可用下法。给予柴胡桂枝汤，调和营卫，待津液通畅后，自然痊愈。
组成：柴胡（去苗四两），桂（去粗皮），黄芩（去黑心），芍药，人参（各一两半），半夏（汤洗七次焙干），甘草（炙，各一两）。
制法用法：将药材锉如麻豆大。每次服用五钱，加水一盏半，加入生姜半分，拍碎，大枣三枚，擘破，同煎至七分，去渣，温服。每日三次。
人参汤：治疗厥阴病，亡阳谵语，惊狂者。
组成：人参，茯苓（各二两），甘草，菖蒲，当归，紫石英，熟地黄（各一两）。
制法用法：用水五升，煮取二升，去渣，温服七合。
人参柴胡汤：治疗伤寒不分阴阳，汗下太早，出现红靥，发大热，并谵语，不得安宁。宜服此方。
组成：人参（二两），柴胡，麦门冬（去心，各二两）。
制法用法：将药材咀碎，分作三服。用水一大碗，煎至七分，去渣，冷服，热服亦可。药渣再煎服。此方为发汗之轻剂。
犀角散（出自《圣惠方》）：治疗伤寒邪热在胃，谵语错乱。
组成：犀角屑，川升麻，柴胡（去苗），葛根（锉），川芒硝（各一两，一方用马牙硝），甘草（炙微赤锉），蓝叶（各半两）。
制法用法：将药材研为散。每次服用四钱，用水一中盏，煎至六分，去渣，不拘时候，温服。
柴胡散（出自同上）：治疗伤寒谵语，头疼壮热，骨节疼痛。
组成：柴胡（去苗），赤芍药，知母，栀子仁（各一两），川升麻，黄芩，大青，川大黄（锉碎微炒），杏仁（汤浸去皮尖双仁，麸炒微黄），甘草（炙微赤锉，各三分），石膏（四两）。
制法用法：将药材粗罗为散。每次服用...（原文此处截断，通常依前例煎服）
黄药散：治疗伤寒发热，面目赤黄，烦躁欲走，如见鬼神，谵语不禁。
组成：黄药，川大黄（锉碎微炒），栀子仁，人参（去芦头），槟榔，郁金，甘草（炙微赤锉），龙胆（去芦头），犀角屑（各半两），紫菀（一两），川朴硝（二两）。
制法用法：将药材细罗为散。每次服用不计时候...（原文此处截断，通常依前例调服）
汉防己散（出自《圣惠方》）：治疗伤寒热毒逼心，谵语见鬼神，不安。
组成：汉防己（半两），桂心，防风（去芦头，各三分），甘草（半两，炙微赤锉），地黄（二斤，研绞取汁）。
制法用法：将前四味捣罗为末，加入地黄汁，再加入水一大盏，调匀，放入银器中，于甑中蒸半日，取出。每次服用三合，用温水调下，不计时候。
又方（出自同上）：
组成：犀角屑（一两），黄连（半两），茯神（三分），甘草（半两，炙微赤锉）。
制法用法：将药材粗为散。每次服用五钱，用水一大盏，煎至五分，去渣，不计时候，温服。
生地黄散（出自同上）：治疗伤寒心膈热毒，烦闷，谵语失度。
组成：生地黄（三两），玄参，赤茯苓（各一两半），麦门冬（去心），川升麻（各一两），甘草（半两，炙微赤锉）。
制法用法：将药材捣筛为散。每次服用五钱，用水一大盏，煎至五分，去渣，不计时候，温服。
治伤寒经五六日，未经发汗，大便结涩，谵言妄语，烦躁不安。（出自《圣惠方》）
组成：前胡（去芦头），葛根（锉，各一两），川大黄（二两，锉碎微炒）。
制法用法：将药材为粗散。每次服用四钱，用水一中盏，煎至六分，去渣，不计时候，温服。以利为度。
葛根散（出自《圣惠方》）：治疗伤寒热毒在里，谵言妄语，体热心燥。
组成：葛根（锉），黄芩（各一两），川大黄（二两，锉碎微炒），柴胡（去苗），犀角（各一两），甘草（半两，炙微赤锉）。
制法用法：将药材为散。每次服用四钱，用水一盏半，煎至六分，去渣，不计时候，以通利为度。
赤茯苓饮（出自《圣惠方》）：治疗伤寒心脏虚热，谵语，恍惚不定。
组成：赤茯苓（一两半），牡蛎（一两，烧为粉），龙骨（一两半），黄芩（一两）。
制法用法：将药材为粗散。先用水二盏，入羊心一枚，煮熟，去羊心。次入药五钱，生姜半分，煎至七分，去渣，不计时候，温服。分为二服。
大承气汤（出自《圣惠方》）：治疗伤寒阳明病，谵语，有潮热，不能食者。必有燥粪在肠胃。若能食者，但硬耳，宜服此汤下之。
组成：川大黄（二两，锉碎微炒），川芒硝（一两半），枳实（三分，麸炒黄），浓朴（一两，去粗皮涂生姜汁炙令香熟）。
制法用法：将药材为散。每次服用四钱，用水一中盏，煎至六分，去渣，温服。如人行五里时，再服。
铅霜散（出自《圣惠方》）：治疗伤寒得汗后，狂躁，谵语欲走。
组成：铅霜（细研），马牙硝，人参（去芦头），郁金，茯神（各半两，去木），甘草（一分，炙微赤锉）。
制法用法：将药材细罗为散。每次服用不计时间，煎麦门冬，温水服，调下二钱。
郁金散（出自《圣惠方》）：治疗伤寒发狂，谵语，大便不通，心腹胀满，欲走。
组成：郁金（三分），川大黄（一两半，锉碎微炒），栀子仁（三分），柴胡（去毛半两），甘草（一分，微赤锉），犀角屑（半两）。
制法用法：将药材细罗为散。每次服用煎葱豉汤下二钱。如人行十里，再服。大便通利为度。
朱砂散（出自《圣惠方》）：治疗伤寒伏热在心脾，谵言，状如痴人。
组成：朱砂（细研），太阴玄精（各半两，细研），犀角屑（一两），铅霜（半两，细研），紫石英（三分，细研水飞过），人参（去芦头），赤茯苓，防风（各一两，去芦头），诃黎勒皮（三分）。
制法用法：将药材细罗为散，入上件四味（指朱砂、玄精、铅霜、紫石英），同研令匀。每次服用不计时候，以葱汤调下二钱。
[Background Information]
Book: Puji Fang (Universal Effective Prescriptions)
Author: Zhu Zi
Dynasty: Ming Dynasty, Yongle 4th Year
Chapter: Taiyang Cold Damage Delirium (With Discussion)
Category: Formulas
[English Translation]
Taiyang Cold Damage Delirium (With Discussion)
If sweating is induced in Taiyang Cold Damage when it is not indicated, it leads to the loss of Yang Qi (loss of Yang energy). The body fluids are exhausted internally, causing dryness and excess heat in the Stomach, resulting in delirium. This condition may arise from disharmony of body fluids, dry feces retained inside, a combined disease of the Three Yang meridians, stagnant heat with blood stasis in the interior, or in women, heat entering the Blood Chamber (uterus) with blood excess. All these can cause delirium. Generally, there should be fever on the body, and the pulse belongs to the Stomach. The Stomach corresponds to the Foot-Yangming Meridian. When the Yangming meridian is diseased, it primarily manifests as body heat; thus, delirious and nonsensical speech occurs. Since there is fever on the body, the pulse should be surging and large (Hongda), which is also a Yang pulse. Therefore, this indicates a favorable progression. However, if there is delirium accompanied by cold extremities (four reversals) and the pulse is instead deep, fine, and minute, this indicates an unfavorable progression. Furthermore, there is a condition called "Zhengsheng" (repetitive speech), characterized by a tone of earnestness, which resembles delirium. The ancients used this distinction to differentiate between deficiency and excess. Physicians must combine pulse diagnosis with symptomatology to distinguish them carefully. Thus, it is said that deficiency presents as Zhengsheng, while excess presents as delirium.
In Taiyang Cold Damage, after four or five days, if the pulse is deep, with panting and fullness, deep indicates the pathogen is in the interior. If sweating is wrongly induced, body fluids leak out, making defecation difficult. This results in exterior deficiency and interior excess. Over time, this develops into delirium. After inducing sweating, if sweating is induced again, the loss of Yang Qi can also cause delirium. If the pulse returns to harmony, death does not ensue. In Yangming disease, if there is bleeding from the lower orifice accompanied by delirium, this is due to heat entering the Blood Chamber. There is only sweating on the head. One should puncture Qimen (LR14) and drain according to the excess. If sweating then occurs throughout the body, the patient will recover. If a patient speaks deliriously and nonsensically, has body heat, and the pulse is surging and large, they will survive. If the pulse is deep, fine, and minute, with cold extremities, they will die.
Why does Taiyang Cold Damage cause delirium? The Heart stores the Spirit (Shen) and governs Fire. When diseased, heat qi accumulates there. In Cold Damage, excessive internal heat rises to attack the Heart. The Heart is overwhelmed by heat, causing the Spirit to become confused and disordered, leading to excessive speech. Due to heat-induced confusion, the patient does not know why they speak out of turn, resulting in delirious and妄 (nonsensical) speech. Mild cases involve muttering in sleep; severe cases involve wakefulness and erroneous speech. There are types such as delirium, solitary talking, manic speech, incessant speech, and chaotic speech. These variations indicate the severity of the heat. Delirium and solitary talking, although occasionally containing nonsensical words, maintain some order when speaking to others, indicating the heat has not reached its extreme. The Classics state: "Solitary talking is like seeing ghosts." If severe, the patient does not recognize people upon onset. Thus, solitary talking is not yet the most severe stage. Manic speech is caused by extreme heat. Due to spiritual confusion and lack of awareness, it escalates to shouting and loud speech. Incessant speech is even more severe. Chaotic speech refers to cursing good and evil indiscriminately, ignoring kinship and distance, indicating that the Spirit and Mind have already been disrupted. The Classics state: "In all adverse conditions, if sweating is induced, mild cases are difficult to cure; severe cases present with chaotic speech, which is difficult to restore." The causes of delirium vary and must be clearly distinguished.
There is delirium caused by fire coercion, delirium with sweating, delirium with diarrhea, delirium with downward heat, delirium due to dry feces in the Stomach, delirium from combined disease of the Three Yang, delirium after the pathogen has passed through the stages, and delirium from loss of Yang Qi. The Classics state: "When great heat enters the Stomach and water is exhausted, restlessness and irritability will definitely lead to delirium." Also, abdominal fullness, slight panting, dry mouth, rotten throat, or difficult defecation, over time leading to delirium, are caused by fire coercion. Delirium with sweating is due to Wind. It requires purgation. Purging can be done after the pathogen has passed through the stages. If purged too early, speech will become chaotic due to exterior deficiency and interior excess. This is delirium with sweating. Delirium with diarrhea indicates the presence of dry feces. Xiao Chengqi Tang (Minor Order the Intestines Decoction) is the primary formula. This is delirium with diarrhea. Delirium with bleeding indicates heat entering the Blood Chamber. One should puncture Qimen (LR14) and drain according to deficiency or excess. This is delirium with bleeding. Delirium with tidal fever and inability to eat indicates there are definitely five or six pieces of dry feces in the Stomach. This is delirium due to dry feces in the Stomach. Abdominal fullness, heaviness of the body, difficulty turning over, insensitivity of the mouth, dirty complexion, delirium, and involuntary defecation constitute delirium from combined disease of the Three Yang. Delirium after passing through the stages is due to heat. It requires purgation. This is delirium after passing through the stages. Delirium from excessive sweating leading to loss of Yang Qi cannot be treated with Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) to harmonize Ying and Wei. After body fluids are unblocked, it heals itself. This is delirium from loss of Yang Qi. In such cases, if the pulse is short, death ensues; if the pulse is naturally harmonious, recovery occurs. If there is slight body heat and the pulse is floating and large, survival is expected. If there is cold reversal and the pulse is deep and fine, death occurs within one day. Excess presents as delirium. Qi converges inward, and excess is the root disease. Or Qi rebels upward causing panting and fullness, or Qi collapses downward causing spontaneous diarrhea, which is unfavorable. The Classics state: "Fixed gaze with delirium, panting and fullness, death. Diarrhea also means death," indicating the exhaustion of healthy Qi. Knowing the diagnosis of deficiency and excess, and recognizing the essentials of unfavorable and favorable progressions, ensures no error in treating diseases.
Patients presenting with delirium or Zhengsheng (repetitive speech) have two syndromes. Zhengsheng is deficiency and should be treated with warm medicines. Baitong Tang (White Through Decoction) is the primary formula. Delirium is excess and requires Tiaowei Chengqi Tang (Regulate the Stomach and Order the Intestines Decoction) as the primary formula. After taking Tiaowei Chengqi Tang, if delirium stops or defecation occurs, stop subsequent doses. Otherwise, administer again. Zhang Zhongjing stated: "Excess presents as delirium, deficiency presents as Zhengsheng." Zhengsheng means repetitive speech. They are often not distinguished. However, delirium and Zhengsheng are similar and difficult to differentiate. One must further use external signs and pulses to distinguish them. If urination and defecation are free, extremities are cold, and the pulse is minute and fine, it is definitely Zhengsheng. If stool is constipated, urine is red, extremities are warm, and the pulse is surging and rapid, it is definitely delirium. By comparing these, medication can be applied with complete safety. Generally, Taiyang Cold Damage should not induce sweating; if sweating is induced, delirium occurs. Delirium belongs to the Stomach. If the Stomach harmonizes, the patient recovers. Ignoring this, irritability and restlessness occur, suitable for Tiaowei Chengqi Tang. However, there is also delirium from combined disease of the Three Yang, delirium from Stomach excess, delirium from excessive sweating leading to loss of Yang Qi, and delirium with diarrhea due to dry feces. If the pulse is not minute and fine, purgation is required using Xiao Chengqi Tang. If delirium persists with continuous diarrhea, it is untreatable. Delirium with sweating is due to Wind. One must wait until the pathogen has passed through the stages before purging. Delirium from blood stasis involves manic speech, rinsing mouth with water but not swallowing, black stool, frequent urination, yellowing of the whole body, and lower abdominal fullness. Because sweating was indicated but heat accumulated in the interior, transforming into blood stasis. Mild cases use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction); severe cases use Tao Ren Chengqi Tang (Apricot Kernel and Order the Intestines Decoction) or Didang Wan (Definitely Breakthrough Pill). There is delirium after purgation and delirium in women from heat entering the Blood Chamber.
Inducing sweating in Shaoyang disease causes delirium. The Classics state: "Sweating makes delirium worse," referring to Shaoyang. Purging causes sweating on the forehead and cold extremities, referring to premature purging. Excessive sweating leading to loss of Yang Qi and delirium cannot be purged. Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) is the primary formula. Delirium from fire coercion, with dry mouth, irritability, panting, and fullness, is treated with Xiaochaihu Tang (Minor Bupleurum Decoction) plus black beans. Constipation, delirium, aversion to cold absent, but aversion to heat present, is suitable for Baihu Tang (White Tiger Decoction). Another question regarding Zhang Zhongjing's statement "Do not violate the Stomach Qi": The answer is that heat enters the Blood Chamber due to the arrival of menstruation, taking advantage of deficiency to fill excess, causing heat in the Blood Chamber and leading to delirium. It should be resolved with Xiaochaihu Tang (Minor Bupleurum Decoction). This differs from Stomach excess delirium. Stomach excess has dry feces, so Tiaowei Chengqi Tang (Regulate the Stomach and Order the Intestines Decoction) is suitable for purging. If there is blood excess with heat causing delirium, it is not Stomach excess. Zhang Zhongjing feared people would attack the Stomach thinking it is Stomach excess, hence he said "Do not violate the Stomach Qi." Generally, delirium is heat and belongs to Yang. Manifesting Yin syndromes is unfavorable.
[Formulas Section]
Zhishi Tang (Immature Bitter Orange Decoction): Treats Taiyang Cold Damage where the pulse is deep indicating interior location, but sweating was wrongly induced. Body fluids leaked out, causing severe difficulty in defecation, exterior deficiency, and interior excess, leading to delirium. The patient exhibits symptoms resembling mania.
Ingredients: Zhishi (Immature Bitter Orange, pulp removed, stir-fried with bran), Muxiang (Costus Root) (each 1 fen), Poxiao (Mirabilite) (3 fen), Dahuang (Rhubarb Root and Rhizome, sliced, lightly stir-fried) (1 liang), Gancao (Licorice Root, honey-fried) (0.5 liang).
Preparation and Administration: Coarsely grind and sieve. Take 5 qian per dose. Add 1.5 cups of water, decoct to 0.7 cups. Strain and take warm.
Xijiao Tang (Rhinoceros Horn Decoction): Treats Taiyang Cold Damage with pathogenic heat in the Stomach, manifesting as delirious speech, high fever.
Ingredients: Xijiao (Rhinoceros Horn, shaved), Daqing (Arnebiae Radix seu Rhizoma), Renshen (Ginseng Root) (each 3 fen), Yuanzhi (Polygalae Radix, heart removed) (1 fen), Shengma (Cimicifugae Rhizoma) (1.5 liang), Chaihu (Bupleuri Radix, sprouts removed), Gancao (Licorice Root, honey-fried and sliced) (0.5 liang), Huangqin (Scutellariae Radix, black heart removed) (1 liang).
Preparation and Administration: Coarsely grind and sieve. Take 5 qian per dose. Add 1.5 cups of water, add 0.5 slice of Shengjiang (Fresh Ginger), crushed.
Xiong Tang (Ligusticum Decoction): Treats Taiyang Cold Damage with interior excess, manifesting as delirium and madness.
Ingredients: Xiongyao (Ligusticum Chuanxiong Rhizome) (3 fen), Dahuang (Rhubarb Root and Rhizome, stir-fried and sliced) (1 liang), Gancao (Licorice Root, honey-fried and sliced) (0.5 liang).
Preparation and Administration: Coarsely grind and sieve. Take 5 qian per dose. Add 1.5 cups of water, decoct to 0.7 cups. Strain and take warm.
Chaihu Tang (Bupleurum Decoction): Treats Taiyang Cold Damage with heat excess, irritability, and delirium.
Ingredients: Chaihu (Bupleuri Radix, sprouts removed), Renshen (Ginseng Root), Huangqin (Scutellariae Radix, black heart removed) (each 1 liang), Xijiao (Rhinoceros Horn, shaved), Poxiao (Mirabilite), Fushen (Poria with Hostwood, wood removed) (each 3 fen), Gancao (Licorice Root, honey-fried and sliced) (0.5 liang).
Preparation and Administration: Coarsely grind and sieve. Take 5 qian per dose. Add 1.5 cups of water, decoct to 0.7 cups. Strain and take warm.
Renshen Chaihu Tang (Ginseng and Bupleurum Decoction): Treats Taiyang Cold Damage unresolved after six or seven days, with silent irritability, dry abdomen, tightness in the greater abdomen, and delirious speech.
Ingredients: Renshen (Ginseng Root) (3 fen), Chaihu (Bupleuri Radix, sprouts removed) (1 liang), Shaoyao (Peony Root), Zhimu (Anemarrhenae Rhizoma), Huangqin (Scutellariae Radix, black heart removed), Dahuang (Rhubarb Root and Rhizome, sliced and lightly stir-fried), Weirui (Polygonati Odorati Rhizoma), Banxia (Pinelliae Rhizoma, washed in hot water seven times and dried), Gancao (Licorice Root, honey-fried) (each 0.5 liang).
Preparation and Administration: Coarsely grind and sieve. Take 5 qian per dose. Add 1.5 cups of water, add 1 slice of Shengjiang (Fresh Ginger), crushed.
Huangqin San (Scutellaria Powder): Treats Taiyang Cold Damage with unresolved irritability and heat, delirious speech, and urge to run away madly.
Ingredients: Huangqin (Scutellariae Radix, black heart removed), Gansui (Euphorbiae Kansui Radix, stir-fried with bran until yellow), Longdan (Gentianae Radix, radix removed) (each 1 liang).
Preparation and Administration: Coarsely grind and sieve into powder. Take 1 qian per dose, mixed with cold water. Have the patient drink three cups of water; if the abdomen becomes full, induce vomiting. This formula is for severe accumulation of heat.
Gualou San (Trichosanthes Powder): Treats Taiyang Cold Damage with fever, irritability, delirious speech, red eyes, dry mouth, and vague mental state.
Ingredients: Gualougen (Trichosanthis Radix) (2 liang), Yujin (Curcumae Radix), Gancao (Licorice Root, sliced) (each 1 liang).
Preparation and Administration: Grind and sieve into powder. Take 1 qian per dose, mixed with water containing ginger and honey. Take at any time.
For Taiyang Cold Damage with excessive sweating leading to loss of Yang Qi and delirium, do not use purgation. Administer Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) to harmonize Ying and Wei. After body fluids are unblocked, it heals spontaneously.
Ingredients: Chaihu (Bupleuri Radix, sprouts removed) (4 liang), Gui (Cinnamomi Cortex), Huangqin (Scutellariae Radix, black heart removed), Shaoyao (Peony Root), Renshen (Ginseng Root) (each 1.5 liang), Banxia (Pinelliae Rhizoma, washed in hot water seven times and dried), Gancao (Licorice Root, honey-fried) (each 1 liang).
Preparation and Administration: Slice like hemp seeds. Take 5 qian per dose. Add 1.5 cups of water, add 0.5 slice of Shengjiang (Fresh Ginger), crushed, and three Dazao (Jujubae Fructus), split. Decoct to 0.7 cups. Strain and take warm. Three times daily.
Renshen Tang (Ginseng Decoction): Treats Jueyin disease with loss of Yang Qi, delirium, and fright/manic behavior.
Ingredients: Renshen (Ginseng Root), Fuling (Poria cocos) (each 2 liang), Gancao (Licorice Root), Changpu (Acori Tatarinowii Rhizoma), Danggui (Angelicae Sinensis Radix), Zhiyingshi (Psilomeli Pulvis), Shudihuang (Rehmanniae Radix Preparata) (each 1 liang).
Preparation and Administration: Add 5 sheng of water, decoct to obtain 2 sheng. Strain and take 7 che of warm liquid.
Renshen Chaihu Tang (Ginseng and Bupleurum Decoction): Treats Taiyang Cold Damage regardless of Yin/Yang differentiation, where sweating or purgation was performed too early, resulting in red spots (hongye), high fever, delirium, and restlessness. Suitable for this formula.
Ingredients: Renshen (Ginseng Root) (2 liang), Chaihu (Bupleuri Radix), Maidong (Ophiopogonis Radix, heart removed) (each 2 liang).
Preparation and Administration: Cut into small pieces. Divide into three doses. Add one large bowl of water, decoct to 0.7 parts. Strain. Take cold or warm. Decoct the dregs again. This is a mild sweating formula.
Xijiao San (Rhinoceros Horn Powder) (from Shenghui Fang): Treats Taiyang Cold Damage with pathogenic heat in the Stomach, causing delirium and confusion.
Ingredients: Xijiaoxie (Rhinoceros Horn chips), Chuanshengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix, sprouts removed), Gegen (Puerariae Lobatae Radix, sliced), Chuanmangxiao (Natrii Sulfas) (each 1 liang; one prescription uses Mayaxiaoxiao/Mare's Tooth Niter), Gancao (Licorice Root, honey-fried until slightly red and sliced), Lanye (Isatidis Folium) (each 0.5 liang).
Preparation and Administration: Make into powder. Take 4 qian per dose. Add one medium cup of water, decoct to 0.6 parts. Strain. Take warm at any time.
Chaihu San (Bupleurum Powder) (from same source): Treats Taiyang Cold Damage with delirium, headache, high fever, and joint pain.
Ingredients: Chaihu (Bupleuri Radix, sprouts removed), Chishao (Red Peony Root), Zhimu (Anemarrhenae Rhizoma), Zhizi (Gardeniae Fructus) (each 1 liang), Chuanshengma (Cimicifugae Rhizoma), Huangqin (Scutellariae Radix), Daqing (Arnebiae Radix seu Rhizoma), Chuan Dahuang (Rhubarb Root and Rhizome, sliced and lightly stir-fried), Xingren (Pruni Semen, soaked in hot water, skin and tips removed, double-kernel, lightly stir-fried with bran), Gancao (Licorice Root, honey-fried until slightly red and sliced) (each 3 fen), Shigao (Gypsum Fibrosum) (4 liang).
Preparation and Administration: Coarsely sieve into powder. Take... (text cuts off, typically decocted as per previous examples).
Huangyao San (Yellow Herb Powder): Treats Taiyang Cold Damage with fever, red and yellow face, irritability, urge to run, hallucinations of ghosts, and uncontrollable delirium.
Ingredients: Huangyao (Dioscorea bulbifera), Chuan Dahuang (Rhubarb Root and Rhizome, sliced and lightly stir-fried), Zhizi (Gardeniae Fructus), Renshen (Ginseng Root, radix removed), Binglang (Arecae Semen), Yujin (Curcumae Radix), Gancao (Licorice Root, honey-fried until slightly red and sliced), Longdan (Gentianae Radix, radix removed), Xijiaoxie (Rhinoceros Horn chips) (each 0.5 liang), Ziwan (Adenophorae Radix) (1 liang), Chuan Poxiao (Natrii Sulfas) (2 liang).
Preparation and Administration: Finely sieve into powder. Take at any time... (text cuts off, typically mixed with water).
Hanfangji San (Podopterygium Powder) (from Shenghui Fang): Treats Taiyang Cold Damage with heat-toxin pressing on the Heart, causing delirium, hallucinations of ghosts, and restlessness.
Ingredients: Hanfangji (Podopterygii Caulis et Folium) (0.5 liang), Guixin (Cinnamomi Ramulus), Fangfeng (Saposhnikoviae Radix, radix removed) (each 3 fen), Gancao (Licorice Root, honey-fried until slightly red and sliced) (0.5 liang), Dihuang (Rehmanniae Radix) (2 jin, ground and juice extracted).
Preparation and Administration: Grind the first four herbs into powder. Add Dihuang juice and one large cup of water, mix well. Place in a silver vessel and steam in a steamer for half a day. Remove. Take 3 he per dose, mixed with warm water. At any time.
Another Prescription (from same source):
Ingredients: Xijiaoxie (Rhinoceros Horn chips) (1 liang), Huanglian (Coptidis Rhizoma) (0.5 liang), Fushen (Poria with Hostwood) (3 fen), Gancao (Licorice Root, honey-fried until slightly red and sliced) (0.5 liang).
Preparation and Administration: Coarsely make into powder. Take 5 qian per dose. Add one large cup of water, decoct to 0.5 parts. Strain. Take warm at any time.
Shengdihuang San (Rehmannia Powder) (from same source): Treats Taiyang Cold Damage with heat-toxin in the Heart and diaphragm, irritability, and inappropriate delirium.
Ingredients: Shengdihuang (Rehmanniae Radix) (3 liang), Xuanshen (Scrophulariae Radix), Chi Fuling (Red Poria) (each 1.5 liang), Maidong (Ophiopogonis Radix, heart removed), Chuanshengma (Cimicifugae Rhizoma) (each 1 liang), Gancao (Licorice Root, honey-fried until slightly red and sliced) (0.5 liang).
Preparation and Administration: Grind and sieve into powder. Take 5 qian per dose. Add one large cup of water, decoct to 0.5 parts. Strain. Take warm at any time.
Treat Taiyang Cold Damage after five or six days, without prior sweating, with constipation, delirious speech, and irritability. (From Shenghui Fang)
Ingredients: Qianhu (Peucedani Radix, radix removed), Gegen (Puerariae Lobatae Radix, sliced) (each 1 liang), Chuan Dahuang (Rhubarb Root and Rhizome) (2 liang, sliced and lightly stir-fried).
Preparation and Administration: Make into coarse powder. Take 4 qian per dose. Add one medium cup of water, decoct to 0.6 parts. Strain. Take warm at any time. Stop when bowel movement occurs.
Gegen San (Pueraria Powder) (from Shenghui Fang): Treats Taiyang Cold Damage with heat-toxin in the interior, delirious speech, body heat, and dryness.
Ingredients: Gegen (Puerariae Lobatae Radix, sliced), Huangqin (Scutellariae Radix) (each 1 liang), Chuan Dahuang (Rhubarb Root and Rhizome) (2 liang, sliced and lightly stir-fried), Chaihu (Bupleuri Radix, sprouts removed), Xijiao (Rhinoceros Horn) (each 1 liang), Gancao (Licorice Root, honey-fried until slightly red and sliced) (0.5 liang).
Preparation and Administration: Make into powder. Take 4 qian per dose. Add 1.5 cups of water, decoct to 0.6 parts. Strain. Take warm at any time. Stop when bowel movement occurs.
Chi Fuling Yin (Red Poria Drink) (from Shenghui Fang): Treats Taiyang Cold Damage with deficient-heat in the Heart, delirium, and mental vagueness.
Ingredients: Chi Fuling (Red Poria) (1.5 liang), Muli (Concha Ostreae, calcined to powder) (1 liang), Longgu (Fossilia Ossis Mastodi) (1.5 liang), Huangqin (Scutellariae Radix) (1 liang).
Preparation and Administration: Make into coarse powder. First, add 2 cups of water and one Yangxin (Sheep Heart), cook until done. Remove the sheep heart. Then add 5 qian of the herbal powder and 0.5 slice of Shengjiang (Fresh Ginger). Decoct to 0.7 cups. Strain. Take warm at any time. Divide into two doses.
Da Chengqi Tang (Major Order the Intestines Decoction) (from Shenghui Fang): Treats Taiyang Cold Damage Yangming disease with delirium, tidal fever, and inability to eat. Indicates dry feces in the intestines and stomach. If able to eat, it is merely hard stool; this decoction is suitable for purging.
Ingredients: Chuan Dahuang (Rhubarb Root and Rhizome) (2 liang, sliced and lightly stir-fried), Chuan Mangxiao (Natrii Sulfas) (1.5 liang), Zhishi (Immature Bitter Orange, stir-fried with bran until yellow) (3 fen), Nongpo (Magnoliae Officinalis Cortex, bark removed, coated with fresh ginger juice, fried until fragrant) (1 liang).
Preparation and Administration: Make into powder. Take 4 qian per dose. Add one medium cup of water, decoct to 0.6 parts. Strain. Take warm. Repeat after walking for five li.
Qianshuang San (Lead Frost Powder) (from Shenghui Fang): Treats Taiyang Cold Damage after sweating, with mania, delirium, and urge to run.
Ingredients: Qianshuang (Plumbum Nitricum, finely ground), Maxiaoxiao (Mare's Tooth Niter), Renshen (Ginseng Root, radix removed), Yujin (Curcumae Radix), Fushen (Poria with Hostwood, wood removed) (each 0.5 liang), Gancao (Licorice Root, honey-fried until slightly red and sliced) (1 fen).
Preparation and Administration: Finely sieve into powder. Take at any time. Decoct Maidong (Ophiopogonis Radix), mix with warm water, and take 2 qian.
Yujin San (Curcuma Powder) (from Shenghui Fang): Treats Taiyang Cold Damage with mania, delirium, constipation, abdominal distension and fullness, and urge to run.
Ingredients: Yujin (Curcumae Radix) (3 fen), Chuan Dahuang (Rhubarb Root and Rhizome) (1.5 liang, sliced and lightly stir-fried), Zhizi (Gardeniae Fructus) (3 fen), Chaihu (Bupleuri Radix, hairs removed) (0.5 liang), Gancao (Licorice Root, slightly red and sliced) (1 fen), Xijiaoxie (Rhinoceros Horn chips) (0.5 liang).
Preparation and Administration: Finely sieve into powder. Take 2 qian per dose with Congchi Tang (Green Onion and Soybean Decoction). Repeat after walking for ten li. Stop when bowel movement occurs.
Zhusha San (Cinnabar Powder) (from Shenghui Fang): Treats Taiyang Cold Damage with latent heat in the Heart and Spleen, delirious speech, appearing like a fool.
Ingredients: Zhusha (Cinnabar, finely ground), Taiyin Xuanjing (Natron, finely ground) (each 0.5 liang), Xijiaoxie (Rhinoceros Horn chips) (1 liang), Qianshuang (Plumbum Nitricum, finely ground) (0.5 liang), Zhiyingshi (Psilomeli Pulvis, finely ground and water-washed) (3 fen), Renshen (Ginseng Root, radix removed), Chi Fuling (Red Poria), Fangfeng (Saposhnikoviae Radix, radix removed) (each 1 liang), Helilepi (Terminalia Chebula Pericarpium) (3 fen).
Preparation and Administration: Finely sieve into powder. Mix with the four ingredients above (Zhusha, Xuanjing, Qianshuang, Zhiyingshi) and grind evenly. Take at any time, mixed with Green Onion Water, 2 qian per dose.