太阳病。项背强KT KT 。无汗恶风。葛根汤主之。
（太阳病。项背强KT KT 。汗出恶风者。中风表虚也。项背强几几。无汗恶风者。
中风表实也
葛根汤方
葛根（四两） 麻黄（三两去节） 桂（二两去皮） 芍药（二两切） 甘草（二两炙）
生姜（三两
（本草云。轻可去实。麻黄、葛根之属是也。此以中风表实。故加二物于桂枝汤中也。）
上七
一升
太阳与阳明合病者。必自下利。葛根汤主之。
（伤寒有合病。有并病。本太阳病不解。并于阳明者。谓之并病。二经俱受邪。相合病
者。
病。
甚。
太阳与阳明合病。不下利但呕者。葛根加半夏汤主之。
（邪气外甚。阳不主里。里气不和。气下而不上者。但下利而不呕。里气上逆而不下者。
但
葛根加半夏汤方
葛根（四两） 麻黄（三两去节汤泡去黄汁焙干秤） 生姜（三两切） 甘草（二两炙）
芍药（二
斗。先煮葛根、
太阳病。桂枝证。医反下之。利遂不止。脉促者。表未解也。喘而汗出者。葛根黄连黄
芩汤
（经曰。不宜下而便攻之。内虚热入。胁热遂利。桂枝证者。邪在表也。而反下之。虚
其肠胃。为热所乘。遂利不止。邪在表。则见阳脉。邪在里。则见阴脉。下利脉微迟。邪在
里也
气外
除里
葛根黄芩黄连汤方
葛根（半斤） 甘草（二两炙味甘平） 黄芩（二两味苦寒） 黄连（三两味苦寒）
（内经曰。甘发散为阳。表未解者。散以葛根、甘草之甘。苦以坚里。气弱者。坚以黄
芩、
太阳病。头痛发热。身疼腰痛。骨节疼痛。恶风。无汗而喘者。麻黄汤主之。
（此太阳伤寒也。寒则伤营。头痛身疼腰痛。以至牵连骨节疼痛者。太阳经营血不利也。
内
者
喘
麻黄汤方
麻黄（三两味甘温去节） 桂枝（二两去皮味辛热） 甘草（一两炙味甘平） 杏仁（七
十个汤去皮
（内经曰。寒淫于内。治以甘热。佐以苦辛。麻黄、甘草。开肌发汗。桂枝、杏仁。散
寒下
温
太阳与阳明合病。喘而胸满者。不可下。宜麻黄汤主之。
（阳受气于胸中。喘而胸满者。阳气不宣发。壅而逆也。心下满。腹满。皆为实。当下
之。
太阳病。十日已去。脉浮细而嗜卧者。外已解也。设胸满胁痛者。与小柴胡汤。脉但浮
者。
（十日以去。向解之时也。脉浮细而嗜卧者。表邪已罢也。病虽已和解之。若脉但浮而
不细
太阳中风。脉浮紧。发热恶寒。身疼痛。不汗出而烦躁者。大青龙汤主之。若脉微弱。
汗出
（此中风见寒脉也。浮则为风。风则伤卫。紧则为寒。寒则伤营。营卫俱病。故发热恶
寒。
俱实
卫
大青龙汤方
麻黄（六两去节味甘温） 桂枝（二两去皮味辛热） 甘草（二两炙味甘平） 杏仁（四
十个去皮
大碎味甘微寒）
（辛甘均为发散。然风宜辛散。寒宜甘发汗。辛甘相合。乃能发散营卫之风寒。麻黄、
九升。先煮麻黄。减二升。去上沫。纳诸药。煮取三升。去滓。温服一升。取微似汗。汗出
多者。温粉粉之。一服汗者。停后服。汗多亡阳。遂虚恶风。烦躁不得眠也。
伤寒脉浮缓。身不疼。但重。乍有轻时。无少阴证者。大青龙汤发之。
（此伤寒见风脉也。伤寒者身疼。此以风胜。故身不疼。中风者。身重。此以兼风。故
乍有
伤寒表不解。心下有水气。干呕。发热而咳。或渴。或利。或噎。或小便不利。少腹满。
或
（伤寒表不解。心下有水饮。则水寒相搏。肺寒气逆。故干呕发热而咳。针经曰。形寒
饮冷
水
小青龙汤方
麻黄（三两去节味甘温） 芍药（三两味酸微寒） 干姜（三两味辛热） 甘草（三两
炙味甘平）
细辛（三两味辛
（寒邪在表。非甘辛不能散之。麻黄、桂枝、甘草之辛甘。以发散表邪。水停心下而不
行
咳逆而喘。则肺气逆。内经曰。肺欲收。急食酸以收之。芍药、五味子之酸。以收逆气而安
肺）。 上八味。以水一斗。先煮麻黄。减二升。去上沫。纳诸药。煮取三升。去滓。
温服一升。
加减法
若微利者。去麻黄。加荛花如鸡子。熬令赤色。
（下利者。不可攻其表。汗出。必胀满。麻黄发其阳。水渍入胃。必作利。荛花下十二
水。
若渴者。去半夏。加栝蒌根三两。
（辛燥而苦润。半夏味辛而燥津液。非渴者所宜。故去之。栝蒌味苦而生津液。故加之。）
若噎者。去麻黄。加附子一枚。炮。
（经曰。水得寒气冷必相搏。其人即。噎加附子温散水寒。病患有寒。复发汗。胃中
冷。必吐蛔。去麻黄。恶发汗。）
若小便不利。少腹满。去麻黄。加茯苓四两。
（水蓄下焦不行。为小便不利。少腹满。麻黄发津液于外。非所宜也。茯苓泄蓄水于下。
加所当也。）
若喘者。麻黄加杏仁半升。去皮尖。
（金匮要略曰。其人形肿。故不纳麻黄。纳杏仁。以麻黄发其阳故也。喘呼形肿。水气
标本
伤寒心下有水气。咳而微喘。发热不渴。服汤已。渴者。此寒去欲解也。小青龙汤主之。
（咳而微喘者。水寒射肺也。发热不渴者。表证未罢也。与小青龙汤发表散水。服汤已
渴者
太阳病。外证未解。脉浮弱者。当以汗解。宜桂枝汤。
（脉浮弱者。营弱卫强也。）
太阳病。下之微喘者。表未解故也。桂枝加浓朴杏仁汤主之。
（下后大喘。则为里气大虚。邪气传里。正气将脱也。下后微喘。则为里气上逆。邪不
能传
太阳病。外证未解者。不可下也。下之为逆。欲解外者。宜桂枝汤主之。
（经曰。本发汗而复下之。为逆也。若先发汗。治不为逆。）
太阳病。先发汗不解。而复下之。脉浮者。不愈。浮为在外。而反下之。故令不愈。今
脉浮
（经曰。柴胡汤证具。而以他药下之。柴胡汤证仍在者。复与柴胡汤。此虽已下之。不
为逆
太阳病。脉浮紧。无汗发热。身疼痛。八九日不解。表证仍在。此当发其汗。服药已。
微除
（脉浮紧。无汗发热。身疼痛。太阳伤寒也。虽至八九日而表证仍在。亦当发其汗。既
服温
经络
治。故
重也。
太阳病。脉浮紧。发热身无汗。自衄者愈。
（风寒在经。不得汗解。郁而变热。衄则热随血散。故云自衄者愈。）
二阳并病。太阳初得病时。发其汗。汗先出不彻。因转属阳明。续自微汗出。不恶寒。
若
表
乍在腹中。乍在四肢。按之不可得。其人短气。但坐以汗出不彻故也。更发汗则愈。何以知
汗出不彻。以脉涩故知也。
（太阳病未解。转并入阳明。而太阳证未罢者。名曰并病。续自微汗出。不恶寒者。为
太阳
先解表也。阳明之经循面。色缘缘正赤者。阳气怫郁在表也。当解之熏之。以取其汗。若发
汗不彻者。不足言阳气怫郁。止是当汗不汗。阳气不得越散。邪无从出。拥盛于经。故躁烦
也。邪循经行。则痛无常处。或在腹中。或在四肢。按之不可得而短气。但责以汗出不彻。
更发汗则愈。内经曰。证过者切之。涩者，阳气有余。为身热无汗。是以脉涩。知阳气拥郁
而汗出不彻。）
脉浮数者。法当汗出而愈。若下之。身重心悸者。不可发汗。当自汗出乃解。所以然者。
尺
（经曰。诸脉浮数。当发热。而淅洒恶寒。言邪气在表也。是当汗出愈。若下之。身重
心悸
今尺
则不可发汗。须里气实。津液足。便自汗出而愈。）
脉浮紧者。法当身疼痛。宜以汗解之。假令尺中迟者。不可发汗。何以知之。然。以营
气不
（针经曰。夺血者无汗。尺脉迟者。为营血不足。故不可发汗。）
脉浮者。病在表。可发汗。宜麻黄汤。
（浮为轻手得之。以候皮肤之气。内经曰。其在皮者。汗而发之。）
脉浮而数者。可发汗。宜麻黄汤。
（浮则伤卫。数则伤营。营卫受邪。为病在表。故当汗散。）
病常自汗出者。此为营气和。营气和者。外不谐。以卫气不共营气和谐故尔。以营行脉
中。卫行脉外。复发其汗。营卫和。则愈。宜桂枝汤。
（风则伤卫。寒则伤营。卫受风邪而营不病者。为营气和也。卫既客邪。则不能与营气
和。
病患脏无他病。时发热。自汗出而不愈者。此卫气不和也。先其时发汗。则愈。宜桂枝
汤主
（脏无他病。里和也。卫气不和。表病也。外台云。里和表病。汗之则愈。所谓先其时
者。
伤寒脉浮紧。不发汗。因致衄者。麻黄汤主之。
（伤寒脉浮紧。邪在表也。当与麻黄汤发汗。若不发汗。则邪无从出。拥甚于经。迫血
妄行
伤寒不大便六七日。头痛有热者。与承气汤。其小便清者。知不在里。仍在表也。当须
发汗
（不大便六七日。头痛有热者。故宜当下。若小便清者。知里无热。则不可下。经曰。
小便
里。
也。
伤寒发汗解。半日许复烦。脉浮数者。可更发汗。宜桂枝汤主之。
（烦者。热也。发汗身凉为已解。至半日许。身复热。脉浮数者。邪不尽也。可更发汗。
与
凡病若发汗。若吐。若下。若亡津液。阴阳自和者。必自愈。
（重亡津液。则不能作汗。必待阴阳自和。乃自愈矣。）
大下之后。复发汗。小便不利者。亡津液故也。勿治之。得小便利。必自愈。
（因亡津液而小便不利者。可以药利之。俟津液足。小便利。必自愈也。）
下之后。复发汗。必振寒。脉微细。所以然者。以内外俱虚故也。
（发汗。则表虚而亡阳。下之。则里虚而亡血。振寒者。阳气微也。脉微细者。阴血弱。）
下之后。复发汗。昼日烦躁不得眠。夜而安静。不呕不渴。无表证。脉沉微。身无大热
者。
（下之。虚其里。汗之。虚其表。既下又汗。则表里俱虚。阳至于昼。阳欲复。虚不胜
邪。
里
子汤
干姜附子汤方
干姜（一两味辛热） 附子（一枚生用去皮破八片味辛热）
（内经曰。寒淫所胜。平以辛热。虚寒太甚。是以辛热剂胜之也。） 上二味。以水
三升。煮取一升。去滓。顿服。
发汗后。身疼痛。脉沉迟者。桂枝加芍药生姜各一两。人参三两。新加汤主之。
（汗后身疼痛。邪气未尽也。脉沉迟。营血不足也。经曰。其脉沉者。营气微也。又曰。
迟
发汗后。不可更行桂枝汤。汗出而喘。无大热者。可与麻黄杏仁甘草石膏汤主之。
（发汗后喘。当作桂枝加浓朴、杏仁汤。汗出则喘愈。今汗出而喘。为邪气拥甚。桂枝
汤不
也。
麻黄杏仁甘草石膏汤方
麻黄（四两去节味甘温） 杏仁（五十个去皮尖味甘温） 甘草（二两炙味甘平） 石
膏（半
斤碎
（内经曰。肝苦急。急食甘以缓之。风气通于肝。风邪外甚。故以纯甘之剂发之。） 上
四味
黄耳
（发汗过多。亡阳也。阳气受于胸中。胸中阳气不足。故病患叉手自冒沁。心下悸。欲
得按
桂枝甘草汤方
桂枝（四两去皮味辛热） 甘草（二两炙味甘平）
（桂枝之辛。走肺而益气。甘草之甘。入脾而缓中。） 上二味。以水三升。煮取一升。
去滓
发汗后。其人脐下悸者。欲作奔豚。茯苓桂枝甘草大枣汤主之。
（汗者。心之液。发汗后。脐下悸者。心气虚而肾气发动也。肾之积。名曰奔豚。发则
从少腹上至心下。为肾气逆。欲上凌心。今脐下悸。为肾气发动。故云欲作奔豚。与茯苓桂
枝
茯苓桂枝甘草大枣汤方
茯苓（半斤味甘平） 甘草（二两炙味甘平） 桂枝（四两去皮） 大枣（十五枚擘味
甘平）
（茯苓以伐肾邪。桂枝能泄奔豚。甘草、大枣之甘。滋助脾土。以平肾水气。煎用甘澜
水者
煮
有珠子五六千颗。相逐取用之。发汗后。腹胀满者。浓朴生姜甘草半夏人参汤主之。
（吐后腹胀。与下后腹满。皆为实。言邪气乘虚入里为实。发汗后。外已解也。腹胀满。
知
浓朴生姜甘草半夏人参汤方
浓朴（半斤去皮炙味苦温） 生姜（半斤切味辛温） 半夏（半升洗味辛平） 人参（一
两味甘温）
（内经曰。脾欲缓。急食甘以缓之。用苦泄之。浓朴之苦。以泄腹满。人参、甘草之甘。
以
升
伤寒若吐。若下后。心下逆满。气上冲胸。起则头眩。脉沉紧。发汗则动经。身为振振
摇者
（吐下后。里虚。气上逆者。心下逆满。气上冲胸。表虚阳不足。起则头眩。脉浮紧。
为邪
虚。
茯苓桂枝白术甘草汤方
茯苓（四两味甘平） 桂枝（三两去皮味辛热） 白术（二两味苦甘温） 甘草（二两
炙味甘平）（阳不足者。补之以甘。茯苓、白术。生津液而益阳也。里气逆者。散之以辛。
桂枝、甘草
发汗。病不解。反恶寒者。虚故也。芍药甘草附子汤主之。
（发汗病解。则不恶寒。发汗病不解。表实者。亦不恶寒。今发汗。病且不解。又反恶
寒者
芍药甘草附子汤方
太阳病。项背强直拘急不舒。无汗怕风。用葛根汤主治。
（太阳病。项背强直拘急不舒。有汗怕风的，是中风表虚证。项背强直拘急不舒。无汗怕风的，是中风表实证。）
葛根汤方
葛根（四两） 麻黄（三两去节） 桂枝（二两去皮） 芍药（二两切） 甘草（二两炙）
生姜（三两切片） 大枣（十二枚擘开）
（《本草》说：轻清之品可以祛除实邪。麻黄、葛根这类药物就是。此证因中风表实，所以在桂枝汤中加了这两味药。）
以上七味药。用水一斗，先煮葛根、麻黄，减少二升水，去掉水面上的浮沫，加入其他药物，煮取三升药液，去掉药渣，温服一升。覆盖衣被使身体微微出汗。如果出汗过多，用温粉扑身。服一次药若已出汗，停后服。若出汗过多导致亡阳，出现虚弱怕风、烦躁不能入睡的症状。
太阳病与阳明经合病的，必然自行下利。用葛根汤主治。
（伤寒有合病，有并病。本是太阳病未解，邪气转入阳明的，叫做并病。两经同时受邪，相互结合而发病的，叫做合病。）
太阳与阳明合病，不下利但呕吐的，用葛根加半夏汤主治。
（邪气外盛，阳气不能主司里气，里气不和，气向下而不向上的，只是下利而不呕吐；里气上逆而不能向下的，只是呕吐而下利停止。）
葛根加半夏汤方
葛根（四两） 麻黄（三两去节，汤泡去黄汁焙干称量） 生姜（三两切片） 甘草（二两炙）
芍药（二两） 桂枝（二两去皮） 半夏（半升洗） 大枣（十二枚擘开）
以上八味药。用水一斗，先煮葛根、麻黄，减少二升水，去掉浮沫，加入其他药物，煮取三升药液，去掉药渣，温服一升。
太阳病。桂枝汤证。医生反而用攻下法。腹泻不止。脉急促的，说明表证未解。气喘且出汗的，用葛根黄连黄芩汤主治。
（经文说：不宜攻下却便用攻下，会导致内虚热入，胁间发热遂致下利。桂枝汤证，邪气在表。反而用攻下法，使其肠胃空虚，为热邪所乘，遂致下利不止。邪气在表，则见阳脉；邪气在里，则见阴脉。下利脉微迟，是邪气在里。）
除里热之外，还需解表。
葛根黄芩黄连汤方
葛根（半斤） 甘草（二两炙，味甘平） 黄芩（二两，味苦寒） 黄连（三两，味苦寒）
（《内经》说：甘味发散属于阳。表证未解者，用葛根、甘草的甘味来发散；苦味能坚里。气弱者，用黄芩、黄连的苦味来坚里。）
太阳病。头痛发热。身体疼痛腰痛。骨节疼痛。怕风。无汗且气喘的，用麻黄汤主治。
（这是太阳伤寒证。寒邪伤营血。头痛身疼腰痛，甚至牵连骨节疼痛的，是太阳经营血运行不利所致。）
内闭肺气，故喘。
麻黄汤方
麻黄（三两，味甘温，去节） 桂枝（二两，去皮，味辛热） 甘草（一两炙，味甘平） 杏仁（七十枚，汤浸去皮尖及双仁者）
（《内经》说：寒邪淫于内，用甘热药治疗，佐以苦辛药。麻黄、甘草，开腠理发汗；桂枝、杏仁，散寒降气。）
太阳与阳明合病。气喘且胸满的，不可用攻下法。宜用麻黄汤主治。
（阳气受气于胸中。气喘且胸满的，是阳气不宣发，壅滞而上逆。心下满、腹满，都属实证，当下之。此处胸满非实，故不可下。）
太阳病。十天过去了。脉浮细且想睡觉的，说明表邪已解。如果胸满胁痛的，给小柴胡汤。脉只浮的，给麻黄汤。
（十天过去，是即将痊愈的时候。脉浮细且想睡觉的，是表邪已罢。病虽已和解，但如果脉只浮而不细，说明邪气仍在表。）
中风。脉浮紧。发热恶寒。身体疼痛。不出汗且烦躁的，用大青龙汤主治。如果脉微弱。出汗怕风的，禁用大青龙汤。
（这是中风见到寒脉。浮则为风，风伤卫气；紧则为寒，寒伤营血。营卫俱病，所以发热恶寒。此为表里俱实。）
卫气郁闭。
大青龙汤方
麻黄（六两，去节，味甘温） 桂枝（二两，去皮，味辛热） 甘草（二两炙，味甘平） 杏仁（四十枚，去皮尖）
石膏（如鸡子大，碎，味甘微寒）
（辛甘均为发散之品。然而风宜辛散，寒宜甘发汗。辛甘相合，才能发散营卫之风寒。麻黄、桂枝、甘草、杏仁、石膏。用水九升，先煮麻黄，减少二升，去掉上面的浮沫，加入其他药物，煮取三升，去掉药渣，温服一升。取微似汗。出汗多的，用温粉扑身。服一次药若出汗，停后服。若出汗过多导致亡阳，遂致虚弱怕风、烦躁不得眠。）
伤寒脉浮缓。身体不疼。只是沉重。偶尔有减轻的时候。没有少阴证的，用大青龙汤发汗。
（这是伤寒见到风脉。伤寒者身疼，此因风胜，故身不疼。中风者身重，此因兼风，故乍有轻时。）
伤寒表证不解。心下有停饮。干呕。发热而咳嗽。或口渴。或下利。或噎塞。或小便不利。少腹胀满。或轻微喘息。用小青龙汤主治。
（伤寒表证不解。心下有饮水。则水寒相搏。肺寒气逆，所以干呕发热而咳。《针经》说：形寒饮冷则伤肺。）
水寒射肺。
小青龙汤方
麻黄（三两，去节，味甘温） 芍药（三两，味酸微寒） 干姜（三两，味辛热） 甘草（三两炙，味甘平）
细辛（三两，味辛温） 桂枝（三两，去皮，味辛热） 五味子（半升，味酸温） 半夏（半升洗，味辛平）
（寒邪在表，非甘辛不能散之。麻黄、桂枝、甘草的辛甘，以发散表邪。水停心下而不行，则咳逆而喘，这是肺气上逆。《内经》说：肺欲收，急食酸以收之。芍药、五味子的酸味，以收敛逆气而安肺。）以上八味药。用水一斗，先煮麻黄，减少二升，去掉上面的浮沫，加入其他药物，煮取三升，去掉药渣，温服一升。
加减法
如果有轻微下利的，去掉麻黄，加荛花如鸡蛋大，炒至赤色。
（下利者，不可攻其表。汗出，必致胀满。麻黄发越阳气，水渍入胃，必作下利。荛花可泻十二经之水。）
如果口渴的，去掉半夏，加栝蒌根三两。
（辛燥而苦润。半夏味辛而燥津液，不适合口渴者。所以去掉它。栝蒌根味苦而生津液，所以加上它。）
如果噎塞的，去掉麻黄，加附子一枚，炮制。
（经文说：水得寒气冷必相搏。其人即噎。噎加附子温散水寒。患有寒证，又复发汗，胃中冷，必吐蛔虫。去掉麻黄，是因为厌恶发汗。）
如果小便不利。少腹胀满，去掉麻黄，加茯苓四两。
（水蓄在下焦不行，导致小便不利。少腹胀满。麻黄发津液于体表，不适合这种情况。茯苓泄下焦蓄水，是应当加的。）
如果气喘的，麻黄加杏仁半升，去皮尖。
（《金匮要略》说：其人形肿，故不加麻黄。纳杏仁，因为麻黄发越阳气。喘呼形肿，是水气标本同病。）
伤寒心下有停饮。咳嗽且轻微气喘。发热不渴。服药后。感到口渴的，这是寒邪已去，病情将要解除的表现。用小青龙汤主治。
（咳嗽且轻微气喘的，是水寒射肺。发热不渴的，是表证未罢。与小青龙汤发表散水。服药后感到口渴的，说明寒邪已去，正气恢复，津液不足，故渴。此乃欲解之兆。）
太阳病。外证未解。脉浮弱的，应当用发汗法解表。宜用桂枝汤。
（脉浮弱的，是营弱卫强。）
太阳病。误用攻下法后轻微气喘的，是表证未解的缘故。用桂枝加厚朴杏子汤主治。
（下后大喘，则是里气大虚，邪气传里，正气将脱。下后微喘，则是里气上逆，邪气不能传里。）
太阳病。外证未解的，不可用攻下法。攻下是错误的。想要解外证的，宜用桂枝汤主治。
（经文说：本应发汗却反而用攻下法，这是逆治。如果先发汗，治疗就不算逆治。）
太阳病。先发汗未愈。又用攻下法。脉仍浮的，病不愈。浮脉表示病邪在外，反而用攻下法，所以令病不愈。现在脉浮，说明邪气仍在表。
（经文说：柴胡汤证具备，却用其他药攻下。柴胡汤证仍在的，再给柴胡汤。这虽然已经攻下，但不算逆治。）
太阳病。脉浮紧。无汗发热。身体疼痛。过了八九天未解。表证仍在。这应当发其汗。服药后。症状稍减。
（脉浮紧。无汗发热。身体疼痛。是太阳伤寒证。即使到了八九天，只要表证仍在，也应当发汗。既服温药发汗，经络之气得以通畅，治疗得当，所以病重亦轻。）
太阳病。脉浮紧。发热身体无汗。自鼻衄的会痊愈。
（风寒在经脉，不得汗解。郁而变热。衄血则热随血散。所以说自衄者愈。）
二阳并病。太阳初得病时。发其汗。汗先出不透彻。因而转属阳明。继续自微汗出。不恶寒。
若
表
乍在腹中。乍在四肢。按之不可得。其人短气。只是因为汗出不透彻的缘故。再次发汗则痊愈。怎么知道汗出不透彻。通过脉涩可知。
（太阳病未解。转并入阳明。而太阳证未罢的，名叫并病。继续自微汗出。不恶寒的，为太阳表邪未尽。先解表。阳明之经循行面部。面色缘缘正赤的，是阳气怫郁在表。应当解表熏蒸，以取其汗。如果发汗不透彻的，不足以说是阳气怫郁。只是当汗不汗。阳气不得越散。邪气无从出路。壅盛于经脉，所以躁烦。邪气循经行，则痛无常处。或在腹中。或在四肢。按之不可得而短气。只责之于汗出不透彻。再次发汗则痊愈。《内经》说：证过者切之。涩脉，阳气有余。为身热无汗。所以脉涩。知阳气拥郁而汗出不透彻。）
脉浮数的。依法应当汗出而愈。如果用攻下法。身体沉重心悸的。不可发汗。应当等待自汗出乃解。之所以这样。是因为尺脉迟。
（经文说：诸脉浮数。应当发热。而淅洒恶寒。是说邪气在表。这是应当汗出愈。如果用攻下法。身重心悸。今尺脉迟。则不可发汗。须里气实。津液足。便自汗出而愈。）
脉浮紧的。依法应当身体疼痛。宜用汗法解之。假如尺中脉迟的。不可发汗。为什么知道呢。因为营气不足。
（《针经》说：夺血者无汗。尺脉迟的。为营血不足。所以不可发汗。）
脉浮的。病在表。可发汗。宜用麻黄汤。
（浮为轻手得之。以候皮肤之气。《内经》说：其在皮者。汗而发之。）
脉浮而数的。可发汗。宜用麻黄汤。
（浮则伤卫。数则伤营。营卫受邪。为病在表。所以当汗散。）
病常自汗出的。这是营气和。营气和者。外不谐。因为卫气不与营气和谐缘故。因为营行脉中。卫行脉外。再发其汗。营卫和。则愈。宜用桂枝汤。
（风则伤卫。寒则伤营。卫受风邪而营不病的。为营气和。卫既客邪。则不能与营气和谐。）
病患脏腑无其他病。时常发热。自汗出而不愈的。这是卫气不和。在其发热前发汗。则愈。宜用桂枝汤主治。
（脏无其他病。里和。卫气不和。表病。《外台秘要》说：里和表病。汗之则愈。所谓先其时的。是指发热之前。）
伤寒脉浮紧。不发汗。因而致鼻衄的。用麻黄汤主治。
（伤寒脉浮紧。邪在表。应当与麻黄汤发汗。若不发汗。则邪无从出。壅甚于经。迫血妄行。）
伤寒不大便六七日。头痛有热的。给承气汤。其小便清的。知不在里。仍在表。应当须发汗。
（不大便六七日。头痛有热的。故宜当下。若小便清的。知里无热。则不可下。经文说：小便清者。知不在里。仍在表也。）
伤寒发汗解。半天左右又烦。脉浮数的。可更发汗。宜用桂枝汤主治。
（烦者。热也。发汗身凉为已解。至半天左右。身复热。脉浮数的。邪不尽也。可更发汗。与桂枝汤。）
凡病若发汗。若吐。若下。若亡津液。阴阳自和的。必自愈。
（重亡津液。则不能作汗。必待阴阳自和。乃自愈矣。）
大下之后。复发汗。小便不利的。亡津液缘故。不要治疗。得小便利。必自愈。
（因亡津液而小便不利的。可以用药利之。俟津液足。小便利。必自愈也。）
下之后。复发汗。必振寒。脉微细。之所以这样。因为内外俱虚的缘故。
（发汗。则表虚而亡阳。下之。则里虚而亡血。振寒者。阳气微也。脉微细者。阴血弱。）
下之后。复发汗。昼日烦躁不得眠。夜而安静。不呕不渴。无表证。脉沉微。身无大热。的用干姜附子汤主治。
（下之。虚其里。汗之。虚其表。既下又汗。则表里俱虚。阳至于昼。阳欲复。虚不胜邪。故烦躁。夜而安静。无表证。脉沉微。身无大热。是阴盛格阳。用干姜附子汤回阳救逆。）
干姜附子汤方
干姜（一两，味辛热） 附子（一枚生用，去皮破八片，味辛热）
（《内经》说：寒淫所胜。平以辛热。虚寒太甚。是以辛热剂胜之也。）以上二味药。用水三升。煮取一升。去掉药渣。顿服。
发汗后。身体疼痛。脉沉迟的。用桂枝加芍药生姜各一两。人参三两。新加汤主治。
（汗后身体疼痛。邪气未尽。脉沉迟。营血不足。经文说：其脉沉者。营气微也。又说：迟则血少。）
发汗后。不可更行桂枝汤。汗出而喘。无大热的。可与麻黄杏仁甘草石膏汤主治。
（发汗后喘。当作桂枝加厚朴杏子汤。汗出则喘愈。今汗出而喘。为邪气壅甚。桂枝汤不能解。故用麻杏石甘汤清宣肺热。）
麻黄杏仁甘草石膏汤方
麻黄（四两，去节，味甘温） 杏仁（五十个，去皮尖，味甘温） 甘草（二两炙，味甘平） 石膏（半斤，碎，绵裹）
（《内经》说：肝苦急。急食甘以缓之。风气通于肝。风邪外甚。故以纯甘之剂发之。）以上四味药。用水六升。先煮麻黄。减二升。去上沫。纳诸药。煮取二升。去滓。温服一升。
（发汗过多。亡阳。阳气受于胸中。胸中阳气不足。所以病患叉手自冒心。心下悸。欲得按。）
桂枝甘草汤方
桂枝（四两，去皮，味辛热） 甘草（二两炙，味甘平）
（桂枝之辛。走肺而益气。甘草之甘。入脾而缓中。）以上二味药。用水三升。煮取一升。去滓。顿服。
发汗后。其人脐下悸的。欲作奔豚。用茯苓桂枝甘草大枣汤主治。
（汗者。心之液。发汗后。脐下悸的。心气虚而肾气发动。肾之积。名叫奔豚。发作则从少腹上至心下。为肾气逆。欲上凌心。今脐下悸。为肾气发动。所以说欲作奔豚。与茯苓桂枝甘草大枣汤温阳化饮，平冲降逆。）
茯苓桂枝甘草大枣汤方
茯苓（半斤，味甘平） 甘草（二两炙，味甘平） 桂枝（四两，去皮） 大枣（十五枚，擘，味甘平）
（茯苓以伐肾邪。桂枝能泄奔豚。甘草、大枣之甘。滋助脾土。以平肾水气。煎用甘澜水者。取其不助肾邪。）先煮茯苓。减二升。纳诸药。煮取三升。去滓。温服一升。
有珠子五六千颗。相逐取用之。发汗后。腹胀满的。用厚朴生姜半夏甘草人参汤主治。
（吐后腹胀。与下后腹满。皆为实。言邪气乘虚入里为实。发汗后。外已解。腹胀满。知为脾虚气滞。虚实夹杂。故用此方消补兼施。）
厚朴生姜半夏甘草人参汤方
厚朴（半斤，去皮炙，味苦温） 生姜（半斤，切，味辛温） 半夏（半升，洗，味辛平） 人参（一两，味甘温）
（《内经》说：脾欲缓。急食甘以缓之。用苦泄之。厚朴之苦。以泄腹满。人参、甘草之甘。以补脾气。半夏、生姜之辛。以散水气。共奏健脾消胀之功。）
伤寒若吐。若下后。心下逆满。气上冲胸。起则头眩。脉沉紧。发汗则动经。身为振振摇者的。用茯苓桂枝白术甘草汤主治。
（吐下后。里虚。气上逆的。心下逆满。气上冲胸。表虚阳不足。起则头眩。脉沉紧。为邪水内停。阳虚水泛。故用此方温阳利水。）
茯苓桂枝白术甘草汤方
茯苓（四两，味甘平） 桂枝（三两，去皮，味辛热） 白术（二两，味苦甘温） 甘草（二两炙，味甘平）
（阳不足者。补之以甘。茯苓、白术。生津液而益阳。里气逆者。散之以辛。桂枝、甘草。辛甘化阳。以温化水饮。）
发汗。病不解。反恶寒的。虚的缘故。用芍药甘草附子汤主治。
（发汗病解。则不恶寒。发汗病不解。表实者。亦不恶寒。今发汗。病且不解。又反恶寒者。是阴阳两虚。故用此方扶阳益阴。）
Taiyang disease (Disease of the Taiyang channel). Stiffness and tension in the nape and back. No sweating, aversion to wind. Ge Gen Tang (Pueraria Decoction) is the primary treatment.
(Taiyang disease. If there is stiffness and tension in the nape and back with sweating and aversion to wind, it is Exterior Deficiency Wind Strike (Zhong Feng). If there is stiffness and tension in the nape and back with no sweating and aversion to wind, it is Exterior Excess Wind Strike.)
Ge Gen Tang Formula
Puerariae Radix (Si Liang / 4 liang) Ephedrae Herba (San Liang / 3 liang, remove joints) Cinnamomi Ramulus (Liang / 2 liang, remove bark) Paeoniae Radix Alba (Liang / 2 liang, slice) Glycyrrhizae Radix et Rhizoma Preparata (Liang / 2 liang, honey-fried) Zingiberis Rhizoma Recens (San Liang / 3 liang, slice) Zizyphi Fructus (Twelve pieces, tear open)
(The *Bencao* states: Light substances can dispel excess. Ephedrae Herba and Puerariae Radix are examples. This condition is due to Exterior Excess Wind Strike, hence these two herbs are added to Gui Zhi Tang.)
The above seven ingredients. Use one dou of water. First decoct Puerariae Radix and Ephedrae Herba, reduce by two sheng, remove the foam on the surface. Add the remaining herbs. Decoct until three sheng remain. Remove the dregs. Take one sheng warm. Cover with blankets to induce a slight sweat. If sweating is excessive, apply warm powder to the body. If sweating occurs after one dose, stop taking the remaining medicine. Excessive sweating leads to Yang collapse, resulting in deficiency, aversion to wind, irritability, and insomnia.
Concurrent involvement of Taiyang and Yangming channels. Spontaneous diarrhea will occur. Ge Gen Tang is the primary treatment.
(Shanghan has concurrent diseases (He Bing) and combined diseases (Bing Bing). When Taiyang disease does not resolve and transitions to Yangming, it is called Bing Bing. When both channels are affected by pathogens simultaneously and combine to cause disease, it is called He Bing.)
In concurrent involvement of Taiyang and Yangming, if there is no diarrhea but only vomiting, Ge Gen Jia Ban Xia Tang (Pueraria Decoction plus Pinellia) is the primary treatment.
(Exterior pathogenic factors are severe, Yang cannot govern the interior, interior Qi is disharmonious. Qi moves downward but not upward, causing only diarrhea without vomiting. Interior Qi rebels upward but does not move downward, causing only vomiting while diarrhea stops.)
Ge Gen Jia Ban Xia Tang Formula
Puerariae Radix (Si Liang / 4 liang) Ephedrae Herba (San Liang / 3 liang, remove joints, soak in decoction, remove yellow juice, bake dry, weigh) Zingiberis Rhizoma Recens (San Liang / 3 liang, slice) Glycyrrhizae Radix et Rhizoma Preparata (Liang / 2 liang, honey-fried) Paeoniae Radix Alba (Liang / 2 liang) Cinnamomi Ramulus (Liang / 2 liang, remove bark) Pinelliae Rhizoma Preparatum (Ban Sheng / half sheng, wash) Zizyphi Fructus (Twelve pieces, tear open)
The above eight ingredients. Use one dou of water. First decoct Puerariae Radix and Ephedrae Herba, reduce by two sheng, remove the foam. Add the remaining herbs. Decoct until three sheng remain. Remove the dregs. Take one sheng warm.
Taiyang disease. Gui Zhi Tang syndrome. The physician incorrectly used purgation. Diarrhea persists. Pulse is rapid/crisp (Cu), indicating the exterior pattern has not resolved. Asthma and sweating indicate Ge Gen Huang Lian Huang Qin Tang (Pueraria, Coptis, and Scutellaria Decoction) is the primary treatment.
(The classic states: Purging when inappropriate causes internal deficiency and heat invasion, leading to diarrhea. In Gui Zhi Tang syndrome, the pathogen is at the exterior. Incorrect purgation empties the stomach and intestines, allowing heat to invade, causing persistent diarrhea. Pathogen at the exterior presents with Yang pulses; pathogen at the interior presents with Yin pulses. Diarrhea with faint/slow pulse indicates pathogen at the interior.)
Besides clearing interior heat, the exterior must be resolved.
Ge Gen Huang Lian Huang Qin Tang Formula
Puerariae Radix (Ban Jin / half jin) Glycyrrhizae Radix et Rhizoma Preparata (Liang / 2 liang, sweet and neutral) Scutellariae Radix (Liang / 2 liang, bitter and cold) Coptidis Rhizoma (San Liang / 3 liang, bitter and cold)
(The *Neijing* states: Sweet flavors disperse and belong to Yang. For unresolved exterior patterns, use the sweetness of Puerariae Radix and Glycyrrhizae Radix to disperse. Bitter flavors strengthen the interior. For weak Qi, use the bitterness of Scutellariae Radix and Coptidis Rhizoma to strengthen the interior.)
Taiyang disease. Headache, fever. Body ache, lower back pain. Bone and joint pain. Aversion to wind. No sweating and asthma indicate Ma Huang Tang (Ephedra Decoction) is the primary treatment.
(This is Taiyang Cold Damage (Shang Han). Cold injures the Ying (Nutrient) level. Headache, body ache, lower back pain, extending to bone and joint pain, indicates impaired circulation of Ying and Blood in the Taiyang channel.)
Internal blockage of Lung Qi causes asthma.
Ma Huang Tang Formula
Ephedrae Herba (San Liang / 3 liang, sweet and warm, remove joints) Cinnamomi Ramulus (Liang / 2 liang, remove bark, pungent and hot) Glycyrrhizae Radix et Rhizoma Preparata (Yi Liang / 1 liang, honey-fried, sweet and neutral) Armeniacae Semen Amarum (Seventy pieces, soak in decoction, remove skin and tips, double kernels removed)
(The *Neijing* states: When cold invades internally, treat with sweet-hot substances, assisted by bitter-pungent ones. Ephedrae Herba and Glycyrrhizae Radix open the pores and induce sweating. Cinnamomi Ramulus and Armeniacae Semen Amarum disperse cold and descend Qi.)
Concurrent involvement of Taiyang and Yangming channels. Asthma and chest fullness. Do not use purgation. Ma Huang Tang is suitable as the primary treatment.
(Qi receives its source in the chest. Asthma and chest fullness indicate Yang Qi is not disseminating, becoming stagnant and rebelling upward. Fullness in the epigastrium or abdomen indicates Excess and requires purgation. Here, chest fullness is not Excess, so purgation is contraindicated.)
Taiyang disease. Ten days have passed. Pulse is floating and fine, and the patient desires to lie down. The exterior has resolved. If there is chest fullness and hypochondriac pain, give Xiao Chai Hu Tang (Minor Bupleurum Decoction). If the pulse is only floating, give Ma Huang Tang.
(After ten days, recovery is imminent. Floating and fine pulse with desire to lie down indicates exterior pathogens have ceased. Although resolving, if the pulse is only floating and not fine, the pathogen remains at the exterior.)
Wind Strike. Pulse is floating and tight. Fever and aversion to cold. Body pain. No sweating and irritability indicate Da Qing Long Tang (Major Blue-Green Dragon Decoction) is the primary treatment. If the pulse is faint/weak, sweating, and aversion to wind, Da Qing Long Tang is contraindicated.
(This is Wind Strike presenting with Cold pulses. Floating indicates Wind, which injures Wei (Defensive) Qi. Tight indicates Cold, which injures Ying (Nutrient) Qi. Both Ying and Wei are diseased, hence fever and aversion to cold. This is Exterior and Interior Excess.)
Wei Qi is blocked.
Da Qing Long Tang Formula
Ephedrae Herba (Liu Liang / 6 liang, remove joints, sweet and warm) Cinnamomi Ramulus (Liang / 2 liang, remove bark, pungent and hot) Glycyrrhizae Radix et Rhizoma Preparata (Liang / 2 liang, honey-fried, sweet and neutral) Armeniacae Semen Amarum (Forty pieces, remove skin and tips) Gypsum Fibrosum (Size of a chicken egg, crushed, sweet and slightly cold)
(Pungent and sweet are both dispersing. However, Wind is best dispersed by pungency, and Cold is best released by sweating induced by sweetness. Pungent and sweet combined can disperse Wind-Cold from Ying and Wei. Ephedrae Herba, Cinnamomi Ramulus, Glycyrrhizae Radix, Armeniacae Semen Amarum, Gypsum Fibrosum. Use nine sheng of water. First decoct Ephedrae Herba, reduce by two sheng, remove the foam. Add other herbs. Decoct until three sheng remain. Remove dregs. Take one sheng warm. Induce a slight sweat. If sweating is excessive, apply warm powder. If sweating occurs after one dose, stop subsequent doses. Excessive sweating leads to Yang collapse, resulting in deficiency, aversion to wind, irritability, and insomnia.)
Cold Damage. Pulse is floating and slow. Body does not ache, but feels heavy. Occasionally feels lighter. No Shaoyin syndrome. Treat with Da Qing Long Tang to induce sweating.
(This is Cold Damage presenting with Wind pulses. Cold Damage causes body ache; here, Wind prevails, so no ache. Wind Strike causes heaviness; here, Wind is combined, so heaviness occasionally lightens.)
Cold Damage exterior pattern unresolved. Fluid retention in the Heart (Epigastrium). Dry retching. Fever and cough. Or thirst. Or diarrhea. Or choking sensation. Or difficulty urinating. Lower abdominal fullness. Or mild asthma. Xiao Qing Long Tang (Minor Blue-Green Dragon Decoction) is the primary treatment.
(Cold Damage exterior unresolved. Fluid retention in the Heart. Water and Cold contend. Lung Qi becomes cold and rebels, causing dry retching, fever, and cough. The *Zhenjing* states: External cold and cold drinks injure the Lung.)
Water-Cold shoots into the Lung.
Xiao Qing Long Tang Formula
Ephedrae Herba (San Liang / 3 liang, remove joints, sweet and warm) Paeoniae Radix Alba (San Liang / 3 liang, sour and slightly cold) Zingiberis Rhizoma (San Liang / 3 liang, pungent and hot) Glycyrrhizae Radix et Rhizoma Preparata (San Liang / 3 liang, honey-fried, sweet and neutral) Asari Radix et Rhizoma (San Liang / 3 liang, pungent and warm) Cinnamomi Ramulus (San Liang / 3 liang, remove bark, pungent and hot) Schisandrae Fructus (Ban Sheng / half sheng, sour and warm) Pinelliae Rhizoma Preparatum (Ban Sheng / half sheng, wash, pungent and neutral)
(Cold pathogen at the exterior cannot be dispersed without sweet-pungent substances. The pungent-sweet combination of Ephedrae Herba, Cinnamomi Ramulus, and Glycyrrhizae Radix disperses exterior pathogens. Water stagnates in the Heart and does not move, causing rebellious Qi, asthma, and Lung Qi rebellion. The *Neijing* states: The Lung desires constriction; urgently feed sour substances to constrict it. The sourness of Paeoniae Radix and Schisandrae Fructus constrains rebellious Qi and calms the Lung.) The above eight ingredients. Use one dou of water. First decoct Ephedrae Herba, reduce by two sheng, remove the foam. Add other herbs. Decoct until three sheng remain. Remove dregs. Take one sheng warm.
Modifications
If mild diarrhea: Remove Ephedrae Herba. Add Yuan Hua (Genkwa Flos) the size of an egg, stir-fry until red.
(Diarrhea patients should not attack the exterior. Sweating will cause abdominal fullness. Ephedrae Herba releases Yang; water infiltrates the Stomach, causing diarrhea. Yuan Hua drains water from twelve channels.)
If thirst: Remove Pinelliae Rhizoma. Add Tian Hua Fen (Trichosanthis Radix) San Liang / 3 liang.
(Pungent-drying and bitter-moistening. Pinelliae Rhizoma is pungent and dries fluids, unsuitable for thirst. Hence remove it. Trichosanthis Radix is bitter and generates fluids, hence add it.)
If choking sensation: Remove Ephedrae Herba. Add Fu Zi (Aconiti Lateralis Radix Praeparata) Yi Ming / 1 piece, processed.
(The classic states: Water encountering cold Qi contends. The patient chokes. Add Aconiti Lateralis Radix Praeparata to warm and disperse Water-Cold. Patients with Cold, if sweating is re-induced, Stomach Cold will cause vomiting of roundworms. Remove Ephedrae Herba because sweating is disliked.)
If difficulty urinating and lower abdominal fullness: Remove Ephedrae Herba. Add Fu Ling (Poria) Si Liang / 4 liang.
(Water accumulates in the Lower Jiao and does not move, causing difficulty urinating and lower abdominal fullness. Ephedrae Herba directs fluids outward, which is unsuitable here. Fu Ling drains accumulated water from below, which is appropriate.)
If asthma: Add Xing Ren (Armeniacae Semen Amarum) Ban Sheng / half sheng, remove skin and tips, to Ephedrae Herba.
(The *Jin Gui Yao Lue* states: If the patient has edema, do not add Ephedrae Herba. Add Armeniacae Semen Amarum because Ephedrae Herba releases Yang. Asthma and edema indicate Water-Qi affecting both root and branch.)
Cold Damage with fluid retention in the Heart. Cough and mild asthma. Fever without thirst. After taking the decoction, if thirst develops, this indicates Cold has gone and resolution is impending. Xiao Qing Long Tang is the primary treatment.
(Mild cough and asthma indicate Water-Cold shooting into the Lung. Fever without thirst indicates the exterior pattern has not ceased. Give Xiao Qing Long Tang to release the exterior and scatter water. Thirst after taking the decoction indicates Cold has gone, Zheng Qi recovers, and fluids are insufficient, hence thirst. This is a sign of impending resolution.)
Taiyang disease. Exterior pattern unresolved. Pulse is floating and weak. Resolve with sweating. Gui Zhi Tang (Cinnamon Twig Decoction) is suitable.
(Floating and weak pulse indicates Weak Ying and Strong Wei.)
Taiyang disease. Mild asthma after incorrect purgation. Indicates exterior pattern unresolved. Gui Zhi Jia Hou Po Xing Zi Tang (Cinnamon Twig Decoction plus Magnolia Bark and Apricot Kernel) is the primary treatment.
(Moderate asthma after purgation indicates severe interior deficiency, pathogen transmitting inward, and impending collapse of Zheng Qi. Mild asthma after purgation indicates interior Qi rebelling upward, but pathogen not transmitting inward.)
Taiyang disease. Exterior pattern unresolved. Do not use purgation. Purgation is contrary to principle. To resolve the exterior, Gui Zhi Tang is the primary treatment.
(The classic states: Initiating purgation instead of sweating is contrary. Initiating sweating first is not contrary.)
Taiyang disease. Initial sweating fails to resolve. Subsequent purgation. Pulse is still floating. Disease does not resolve. Floating indicates pathogen is external. Incorrect purgation causes non-resolution. Current floating pulse indicates pathogen remains at the exterior.
(The classic states: If Chai Hu Tang syndrome is present and purgation is incorrectly used, if Chai Hu Tang syndrome persists, administer Chai Hu Tang again. Even after purgation, this is not contrary.)
Taiyang disease. Pulse floating and tight. No sweating, fever. Body pain. Unresolved after eight or nine days. Exterior pattern persists. Induce sweating. After medication, symptoms slightly decrease.
(Pulse floating and tight, no sweating, fever, body pain is Taiyang Cold Damage. Even after eight or nine days, if exterior pattern persists, sweating is indicated. Taking warm medicines to induce sweating unblocks meridians. Treatment is appropriate, so even severe disease lightens.)
Taiyang disease. Pulse floating and tight. Fever, no sweating. Spontaneous nasal bleeding (Xu) leads to recovery.
(Cold and Wind in the channels, unable to resolve via sweating, become stagnant and transform into Heat. Nasal bleeding allows Heat to dissipate with blood. Hence, spontaneous nasal bleeding leads to recovery.)
Two-Yang Combined Disease. At the onset of Taiyang disease, sweating was induced. Sweat was initially incomplete. Consequently, it transitions to Yangming. Continued mild spontaneous sweating. No aversion to cold.
If
Exterior
Sensation shifts between abdomen and limbs. Cannot be palpated. Shortness of breath. Due to incomplete sweating. Re-induce sweating for recovery. How to know sweating was incomplete? By choppy pulse.
(Taiyang disease unresolved, transitioning to Yangming, while Taiyang pattern persists is called Bing Bing. Continued mild sweating and no aversion to cold indicate residual Taiyang exterior pathogens. Resolve the exterior first. Yangming channel traverses the face. Uniform redness indicates Yang Qi stagnation at the exterior. Resolve and fumigate to induce sweat. Incomplete sweating is not merely Yang stagnation, but failure to sweat when indicated. Yang Qi cannot diffuse, pathogen has no exit, congests in channels, causing irritability. Pathogen follows channels, pain has no fixed location. Abdominal or limb pain, unpalpable, shortness of breath. Blame incomplete sweating. Re-induce sweating for recovery. The *Neijing* states: Choppy pulse indicates excess Yang. Body heat and no sweating. Thus, choppy pulse indicates Yang congestion and incomplete sweating.)
Floating and rapid pulse. Methodologically, sweating should lead to recovery. If purged, body heaviness and palpitations occur. Do not induce sweating. Wait for spontaneous sweating to resolve. Why? Because Chi pulse is slow.
(The classic states: All floating-rapid pulses indicate fever and aversion to cold, meaning pathogen is at the exterior. Sweating leads to recovery. If purged, body heaviness and palpitations occur. Current Chi pulse is slow. Do not induce sweating. Interior Qi must be solid, fluids sufficient, then spontaneous sweating resolves.)
Floating and tight pulse. Methodologically, body pain is expected. Resolve with sweating. If Chi pulse is slow, do not induce sweating. Why? Because Ying Qi is insufficient.
(The *Zhenjing* states: Those who lose blood have no sweat. Slow Chi pulse indicates Ying-Blood deficiency. Hence, do not induce sweating.)
Floating pulse. Disease is at the exterior. Induce sweating. Ma Huang Tang is suitable.
(Floating is felt lightly, assessing Qi at the skin. The *Neijing* states: What is in the skin, release via sweating.)
Floating and rapid pulse. Induce sweating. Ma Huang Tang is suitable.
(Floating injures Wei. Rapid injures Ying. Ying and Wei receive pathogens, disease is at the exterior. Hence, disperse via sweating.)
Constant spontaneous sweating. This is Harmonious Ying. Harmonious Ying means exterior disharmony. Because Wei Qi does not harmonize with Ying Qi. Ying moves within vessels, Wei moves outside vessels. Re-induce sweating. Ying and Wei harmonize, then recover. Gui Zhi Tang is suitable.
(Wind injures Wei. Cold injures Ying. Wei receives Wind pathogen while Ying is unaffected, indicating Harmonious Ying. Once Wei hosts pathogen, it cannot harmonize with Ying.)
Patient has no internal organ disease. Periodic fever and spontaneous sweating without recovery. This is Disharmonious Wei Qi. Induce sweating before the fever starts, then recover. Gui Zhi Tang is the primary treatment.
(No internal organ disease means Interior Harmony. Disharmonious Wei Qi means Exterior Disease. *Wai Tai Mi Yao* states: Interior harmony, exterior disease, sweating leads to recovery. "Before the time" refers to before fever onset.)
Cold Damage. Pulse floating and tight. Not sweating. Leads to nasal bleeding. Ma Huang Tang is the primary treatment.
(Cold Damage, pulse floating and tight, pathogen at exterior. Should give Ma Huang Tang to induce sweating. If not, pathogen has no exit, congests in channels, forces blood to bleed recklessly.)
Cold Damage. Constipation for six or seven days. Headache with fever. Give Cheng Qi Tang. If urine is clear, know pathogen is not in the interior, but remains at the exterior. Must induce sweating.
(Constipation for six or seven days with headache and fever suggests purgation. If urine is clear, know there is no interior heat, so purgation is contraindicated. Classic states: Clear urine indicates pathogen is not in the interior, but remains at the exterior.)
Cold Damage resolves with sweating. Half a day later, irritability returns. Pulse floating and rapid. Can re-induce sweating. Gui Zhi Tang is the primary treatment.
(Irritability indicates Heat. Body cooling after sweating indicates resolution. Half a day later, body heats up again, pulse floating and rapid, indicates pathogen is not exhausted. Can re-induce sweating. Give Gui Zhi Tang.)
Generally, if sweating, vomiting, purgation, or loss of fluids occurs, if Yin and Yang self-harmonize, the disease will surely resolve itself.
(Severe loss of fluids prevents sweating. Must wait for Yin and Yang self-harmony for recovery.)
After severe purgation, followed by sweating. Difficulty urinating. Due to loss of fluids. Do not treat directly. When urination improves, it will surely resolve itself.
(Difficulty urinating due to fluid loss can be treated with diuretics. Wait for fluids to replenish and urination to improve, then it will resolve itself.)
After purgation, followed by sweating. Chills. Pulse faint and thin. Why? Because both interior and exterior are deficient.
(Sweating causes exterior deficiency and Yang loss. Purgation causes interior deficiency and Blood loss. Chills indicate weak Yang. Faint-thin pulse indicates weak Yin-Blood.)
After purgation, followed by sweating. Irritability during the day, inability to sleep. Quiet at night. No vomiting, no thirst. No exterior pattern. Pulse deep and faint. No significant heat. Gan Jiang Fu Zi Tang (Dried Ginger and Aconite Decoction) is the primary treatment.
(Purgation empties the interior. Sweating empties the exterior. Both purged and sweated, interior and exterior are deficient. Yang reaches daytime, Yang desires to recover, but deficiency cannot overcome pathogen, hence irritability. Quiet at night, no exterior pattern, deep-faint pulse, no significant heat, indicates Yin excess repelling Yang. Gan Jiang Fu Zi Tang restores Yang and saves from collapse.)
Gan Jiang Fu Zi Tang Formula
Zingiberis Rhizoma (Yi Liang / 1 liang, pungent and hot) Aconiti Lateralis Radix Preparata (Yi Ming / 1 piece, raw, remove skin, break into eight pieces, pungent and hot)
(The *Neijing* states: Where Cold prevails, balance with pungent-hot. Severe deficiency-Cold is overcome by pungent-hot agents.) The above two ingredients. Use three sheng of water. Decoct until one sheng remains. Remove dregs. Take all at once.
After sweating. Body pain. Pulse deep and slow. Gui Zhi Jia Shao Yao Sheng Jiang Ren Shen Xin Jia Tang (Cinnamon Twig Decoction plus additional Paeonia, Ginger, and Ginseng, New Added Decoction) is the primary treatment.
(Body pain after sweating indicates residual pathogen. Deep-slow pulse indicates Ying-Blood deficiency. Classic states: Deep pulse indicates weak Ying Qi. Also: Slow pulse indicates Blood deficiency.)
After sweating. Do not use Gui Zhi Tang again. Sweating and asthma. No significant heat. Ma Huang Xing Gan Shi Gao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) may be given as the primary treatment.
(Asthma after sweating should be treated with Gui Zhi Jia Hou Po Xing Zi Tang. Sweating cures asthma. Now sweating with asthma indicates severe pathogen congestion. Gui Zhi Tang cannot resolve it. Hence, Ma Huang Xing Gan Shi Gao Tang clears and diffuses Lung Heat.)
Ma Huang Xing Gan Shi Gao Tang Formula
Ephedrae Herba (Si Liang / 4 liang, remove joints, sweet and warm) Armeniacae Semen Amarum (Fifty pieces, remove skin and tips, sweet and warm) Glycyrrhizae Radix et Rhizoma Preparata (Liang / 2 liang, honey-fried, sweet and neutral) Gypsum Fibrosum (Ban Jin / half jin, crushed, wrapped in cloth)
(The *Neijing* states: Liver suffers from urgency; urgently feed sweet substances to relax it. Wind Qi connects to the Liver. Severe exterior Wind pathogen, hence use pure sweet agent to release it.) The above four ingredients. Use six sheng of water. First decoct Ephedrae Herba, reduce by two sheng, remove foam. Add other herbs. Decoct until two sheng remain. Remove dregs. Take one sheng warm.
(Excessive sweating leads to Yang collapse. Yang Qi originates in the chest. Insufficient Yang Qi in the chest causes the patient to cross hands over the heart. Palpitations. Desire to press.)
Gui Zhi Gan Cao Tang (Cinnamon Twig and Licorice Decoction) Formula
Cinnamomi Ramulus (Si Liang / 4 liang, remove bark, pungent and hot) Glycyrrhizae Radix et Rhizoma Preparata (Liang / 2 liang, honey-fried, sweet and neutral)
(Sweetness of Cinnamomi Ramulus enters Lung and benefits Qi. Sweetness of Glycyrrhizae Radix enters Spleen and moderates Middle.) The above two ingredients. Use three sheng of water. Decoct until one sheng remains. Remove dregs. Take all at once.
After sweating. Palpitations below the umbilicus. Impending Ben Tun (Rushing Pig). Fu Ling Gui Zhi Gan Cao Da Zao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction) is the primary treatment.
(Sweat is the fluid of the Heart. After sweating, palpitations below the umbilicus indicate Heart Qi deficiency and Kidney Qi activation. Kidney accumulation is named Ben Tun. Upon onset, it rises from lower abdomen to epigastrium. Kidney Qi rebels, attempting to overwhelm the Heart. Current palpitations below umbilicus indicate Kidney Qi activation, hence "impending Ben Tun." Fu Ling Gui Zhi Gan Cao Da Zao Tang warms Yang, transforms fluid, and calms rushing.)
Fu Ling Gui Zhi Gan Cao Da Zao Tang Formula
Poria (Ban Jin / half jin, sweet and neutral) Glycyrrhizae Radix et Rhizoma Preparata (Liang / 2 liang, honey-fried, sweet and neutral) Cinnamomi Ramulus (Si Liang / 4 liang, remove bark) Zizyphi Fructus (Fifteen pieces, tear open, sweet and neutral)
(Poria attacks Kidney pathogen. Cinnamomi Ramulus drains Ben Tun. Sweetness of Licorice and Jujube nourishes Spleen Earth to calm Kidney Water. Decoct using Gan Lan Shui (Agitated Water) to avoid assisting Kidney pathogen.) First decoct Poria, reduce by two sheng. Add other herbs. Decoct until three sheng remain. Remove dregs. Take one sheng warm.
There are five or six thousand pearl-like bubbles. Collect them for use. After sweating. Abdominal fullness. Hou Po Sheng Jiang Ban Xia Gan Cao Ren Shen Tang (Magnolia Bark, Ginger, Pinellia, Licorice, and Ginseng Decoction) is the primary treatment.
(Abdominal fullness after vomiting or purgation is Excess, meaning pathogen enters interior due to deficiency. After sweating, exterior is resolved. Abdominal fullness indicates Spleen deficiency with Qi stagnation. Mixed deficiency and excess. Hence this formula tonifies and reduces simultaneously.)
Hou Po Sheng Jiang Ban Xia Gan Cao Ren Shen Tang Formula
Magnoliae Officinalis Cortex (Ban Jin / half jin, remove bark, process with honey, bitter and warm) Zingiberis Rhizoma Recens (Ban Jin / half jin, slice, pungent and warm) Pinelliae Rhizoma Preparatum (Ban Sheng / half sheng, wash, pungent and neutral) Ginseng Radix et Rhizoma (Yi Liang / 1 liang, sweet and warm)
(The *Neijing* states: Spleen desires relaxation; urgently feed sweet to relax. Use bitter to drain. Bitterness of Magnoliae Officinalis Cortex drains abdominal fullness. Sweetness of Ginseng and Licorice tonifies Spleen Qi. Pungency of Pinellia and Ginger disperses fluid. Together they benefit Spleen and reduce distension.)
Cold Damage. After vomiting or purgation. Reverse fullness in epigastrium. Qi rushes to chest. Dizziness upon standing. Pulse deep and tight. Sweating disturbs meridians, body trembles and sways. Fu Ling Gui Zhi Bai Zhu Gan Cao Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction) is the primary treatment.
(After vomiting/purgation, interior is deficient. Rebelling Qi causes reverse fullness in epigastrium and Qi rushing to chest. Exterior deficiency and Yang insufficiency cause dizziness upon standing. Deep-tight pulse indicates internal water retention. Yang deficiency and Water flooding. Hence this formula warms Yang and promotes diuresis.)
Fu Ling Gui Zhi Bai Zhu Gan Cao Tang Formula
Poria (Si Liang / 4 liang, sweet and neutral) Cinnamomi Ramulus (San Liang / 3 liang, remove bark, pungent and hot) Atractylodis Macrocephalae Rhizoma (Liang / 2 liang, bitter-sweet and warm) Glycyrrhizae Radix et Rhizoma Preparata (Liang / 2 liang, honey-fried, sweet and neutral)
(For Yang insufficiency, supplement with sweet. Poria and Atractylodis Macrocephalae Rhizoma generate fluids and benefit Yang. For interior Qi rebellion, disperse with pungent. Cinnamomi Ramulus and Licorice pungent-sweet transform Yang to warm and transform water dampness.)
After sweating. Disease unresolved. Instead, aversion to cold indicates deficiency. Shao Yao Gan Cao Fu Zi Tang (Paeonia, Licorice, and Aconite Decoction) is the primary treatment.
(If sweating resolves disease, there is no aversion to cold. If sweating fails to resolve disease and exterior is Excess, there is also no aversion to cold. Now, sweating fails to resolve disease AND aversion to cold appears, indicating Yin and Yang both deficient. Hence this formula supports Yang and benefits Yin.)
Shao Yao Gan Cao Fu Zi Tang Formula