凡伤寒宜吐者，必其上焦有滞，或食或痰，结聚胸膈，而邪不得散者，当吐也；或寒邪
浊气内陷膈间，而为痞为痛者，当吐也，盖吐中自有发散之意。若中气虚寒，脉弱无力，及
气短虚烦不宁者，皆不可吐。凡用吐药，中病即止，不必尽剂。
一、古方吐法多用独圣散及茶调散，凡上焦邪滞皆可用之。然不若新吐法为更捷也。又
凡诸药皆可吐，只随证用药，煎汤服，少顷，探而吐之，则轻重可酌，标本可兼，尤其善也。
凡伤寒、瘟疫宜下者，必阳明邪实于腑而秘结腹满者，乃可下之。或元气素强，胃气素
实者，亦可下之。若大便虽数日不行，而腹无胀满，及大便无壅滞不通之状，或连日不食，
而脐腹坦然，软而无碍者，此其阳明胃腑本无实邪，切不可妄下、妄导，以泄中气。又如伤
寒门忌下诸条，必当加意详察，不可误用。盖诸误之害，下为尤甚，不可忽也。今见时医有
妄下而亦不致死者，必其元气之素强，能胜攻下者也。若概引为证，必致杀人。
一、伤寒邪入阳明，便秘谵语，腹满烦热，脉证俱实者，宜大承气汤，或调胃承气汤。
若伤寒表证未除，里证又急，表里俱实者，宜大柴胡汤。若三焦六经邪火壅结，大便不通，
而表邪不解者，宜《局方》凉膈散。若伤寒热邪传里，当下而气血俱虚者，宜陶氏黄龙汤。
若伤寒热邪传里，而血虚秘结，腹胀作痛，邪不能解者，宜玉烛散。若时气瘟疫遍行，火邪
内蓄，三焦实热，大便秘结而邪不能退者，宜五瘟丹。若时行瘟疫发热，火浮于上，胸膈结
热者，宜大清丸。凡诸有宜通宜下者，但随证作引，送百顺丸一二三钱，最捷最妙。
凡是伤寒病适宜用吐法的，一定是上焦有阻滞，无论是食积还是痰饮，结聚在胸膈部位，导致邪气无法发散的情况，才应当使用吐法；或者是寒邪与浊气内陷于膈间，形成痞塞或疼痛的，也应当使用吐法，因为吐法中自然蕴含着发散邪气的意味。如果中气虚弱寒冷，脉象微弱无力，以及气短、虚烦不安的人，都不可使用吐法。凡是使用催吐药物，只要达到治疗效果就立即停止，不必服完全部剂量。
第一条：古代方剂中的吐法多使用独圣散和茶调散，凡是上焦邪气阻滞的情况都可以使用。然而，不如新的吐法更为快捷。此外，各种药物都可以用来催吐，只需根据证候选择药物，煎汤服用，过一会儿，用手指探喉引吐，这样可以根据病情轻重斟酌药量，兼顾标本，这是更好的方法。
凡是伤寒、瘟疫适宜用下法的，必须是阳明经邪气实盛于腑，导致大便秘结、腹部胀满的情况，才可以攻下。或者患者元气向来强盛，胃气向来充实的，也可以攻下。如果大便虽然几天没有排泄，但腹部没有胀满感，以及大便没有壅滞不通的状态，或者连续几天不进食，但脐腹部平坦柔软、没有阻碍感的，这说明阳明胃腑本来就没有实邪，千万不可妄用攻下或导泻之法，以免损伤中气。又如伤寒门中禁忌攻下的各种条款，必须加以仔细考察，不可误用。大概各种误治的危害中，误用攻下的危害最为严重，不可忽视。现在看到有些医生妄用攻下法而病人也没有死亡的，一定是其元气素来强盛，能够承受攻下药物的缘故。如果一概引用这种情况作为证据，必然会导致杀人。
第一条：伤寒邪气传入阳明，出现便秘、胡言乱语、腹部胀满、烦躁发热，脉象和证候都表现为实证的，适宜使用大承气汤，或者调胃承气汤。如果伤寒表证尚未解除，里证又很急迫，表里俱实的，适宜使用大柴胡汤。如果三焦和六经的邪火壅结，大便不通，且表邪未解的，适宜使用《局方》中的凉膈散。如果伤寒热邪传入体内，本应攻下但气血都虚弱的，适宜使用陶华（陶氏）的黄龙汤。如果伤寒热邪传入体内，而血虚导致便秘、腹部胀满作痛、邪气不能解散的，适宜使用玉烛散。如果时行瘟疫广泛流行，火邪内蓄，三焦实热，大便秘结且邪气不能退去的，适宜使用五瘟丹。如果时行瘟疫发热，火气浮越于上部，胸膈结热的，适宜使用大清丸。凡是有适宜通利、适宜攻下的情况，只需根据证候制作引药，送服百顺丸一两到三钱，最为快捷巧妙。
In cases of Shanghan (Cold Damage) where emesis is indicated, there must be stagnation in the Upper Jiao (Upper Burner), whether due to food retention or phlegm-dampness, accumulating in the chest and diaphragm, preventing the pathogenic factor from dispersing; such cases require emesis. Alternatively, if cold pathogens and turbid qi sink inward into the diaphragm, causing obstruction (Pi syndrome) or pain, emesis is also indicated, as the act of vomiting inherently contains the principle of dispersing pathogens. However, if the Middle Qi is deficient and cold, with a weak and powerless pulse, or if there is shortness of breath, deficiency-related irritability, and restlessness, emesis must not be used. When using emetic drugs, stop once the desired effect is achieved; it is not necessary to consume the entire dose.
First: Ancient formulas for emesis mostly used Dusheng San (Solely Holy Powder) and Chatiao San (Tea-Regulating Powder), which can be applied to any stagnation of pathogens in the Upper Jiao. However, the new method of emesis is even more rapid. Furthermore, various herbs can be used for emesis; one simply selects herbs according to the pattern, decocts them into a soup, and after a short while, induces vomiting by stimulating the throat. This allows for adjusting the dosage based on the severity of the condition and addressing both the root and branch simultaneously, which is superior.
In cases of Shanghan or Wenyi (Plague-like diseases) where purgation is indicated, it must be that Yangming pathogenic excess has accumulated in the Fu organs, resulting in constipation and abdominal fullness; only then can purgation be employed. Or, if the patient's Yuan Qi (Original Qi) has always been strong and the Stomach Qi solid, purgation may also be used. If stool has not passed for several days but the abdomen is not distended, and there are no signs of fecal impaction or blockage, or if the patient has not eaten for consecutive days but the umbilical and abdominal regions are flat, soft, and unobstructed, this indicates that the Yangming Stomach Fu organ lacks excess pathogens. In such cases, one must absolutely not recklessly use purgatives or cathartics, so as not to drain the Middle Qi. Furthermore, all contraindications for purgation listed in the Shanghan section must be carefully examined to avoid misuse. Among the harms of various treatment errors, incorrect purgation is particularly severe and cannot be ignored. It is observed that some contemporary physicians use purgatives recklessly without causing death; this is likely because the patient's Yuan Qi was originally strong enough to withstand the attacking nature of the purgatives. If one generalizes this as evidence, it will inevitably lead to fatal consequences.
First: When Shanghan pathogens enter the Yangming stage, presenting with constipation, delirium, abdominal fullness, irritability, and heat, with both pulse and symptoms indicating excess, Dachengqi Tang (Major Order the Qi Decoction) or Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) is appropriate. If the exterior syndrome of Shanghan has not yet resolved, and the interior syndrome is urgent, with both exterior and interior being excess, Dachaihu Tang (Major Bupleurum Decoction) is appropriate. If pathogenic fire from the Three Jiao and Six Channels is congested and knotted, causing constipation, while the exterior pathogen remains unresolved, Liangge San (Cool the Diaphragm Powder) from the Ju Fang (Formulas of the Bureau) is appropriate. If Shanghan heat pathogens have transmitted inward, requiring purgation, but both Qi and Blood are deficient, Huanglong Tang (Yellow Dragon Decoction) by Tao Hua (Tao Shi) is appropriate. If Shanghan heat pathogens have transmitted inward, and blood deficiency causes constipation, abdominal fullness, and pain, with pathogens unable to resolve, Yuzhu San (Jade Candle Powder) is appropriate. If seasonal epidemics are widespread, with internal accumulation of fire pathogens, excess heat in the Three Jiao, severe constipation, and pathogens unable to recede, Wuwen Dan (Five Plagues Pill) is appropriate. If seasonal epidemics cause fever, with fire floating upward and heat knotting in the chest and diaphragm, Daqing Wan (Great Clearing Pill) is appropriate. For all conditions suitable for unblocking or purging, one should prepare an appropriate guiding agent according to the pattern and administer 1 to 3 qian of Baishun Wan (Hundred Compliance Pill); this is the most rapid and excellent method.