攻热太过。以致胃寒。因寒而咳逆者。橘皮干姜汤。或半夏生姜汤。咳逆就桔梗枳壳汤中加
半夏陈皮等分。生姜十片煎。亦治阴咳逆。阳证咳逆。乃胃家热。小柴胡汤。橘皮竹茹汤。
阳咳逆而又兼腹痛者。问其前后。知何部不利。前部猪苓汤。后部调胃承气汤。
发黄有阴阳二证。阳证发黄。留热蓄在脾胃。瘀热与宿谷相搏。蒸郁而黄。凡病患身体
发热
头面汗出。颈以下都无汗。渴饮水浆。小便不利。通身头目悉黄。身干无汗。溺又不利。
则热不外越。必蕴蓄而成黄证。宜五苓散
用茵陈煎汤调。或栀子汤调服。
又有瘀血一证。遍身亦黄。但瘀血则发狂。大便必黑。小腹按之急痛。而大便却自利以
蓄血不利小便也。宜桃核承气汤。
阴黄。乃太阳经中湿。体痛发热。身如熏黄。终不如阳黄之明如橘子色也。当叩其小便
之利与不利。小便自利。术附汤。小便不利。大便反快者。五苓散。
、有刚 。柔 。又有阴 。阳 。 有汗。为柔。无汗为刚。缘先因伤风。又感寒
湿致
然。外证俱能发热恶寒。头颈强急。腰背反张。或螈 口噤。状如发痫。又如产后角弓反张
风。小续命汤。皆可用。审是柔 。有汗者。桂枝汤加葛根一钱。重则附子防风散。
审是刚 无汗。宜葛根汤若胸满口噤。卧不着席。脚挛切牙。不恶寒者。大承气汤。
发狂。阳证有二。阴证有一。阳证蓄血如狂。已见发黄条中。阳毒发狂。躁而狂走。妄
言叫
骂。如见鬼状。面赤咽痛。鼻如烟煤。或身斑如锦。或下利赤黄。宜阳毒升麻汤。阴证。乃
是病发于少阴。不当正发汗。医见其恶寒。遂强发之。汗因漏不止。其人亡阳。故狂。大略
与阴极发躁同。南阳云、亦无此一证。当用阴躁之药。加以收汗之剂。玉屏风散。入熟附子
一钱。仍外以温粉敷之。或冷汗自出。手足逆冷。其人狂不止者。宜四逆汤冷进。（阴发狂
亡阳证。多死。）
医治伤寒。多问其小便利不利。赤不赤。以别其阴阳。亦有小便自利。遍数多。所出自
少。
色不甚清。不可因其利而遽谓之阴。必是小便如常。清而不赤。又无诸阳证。方信里之无
热。若病在太阳。身体热。太阳属膀胱未有小便不赤者。不可因其赤。遽谓之实热。必是小
便如灰汁。或如陈酒。或如血色。无诸表证。方见其热已入里。又有因发汗过多。津液
枯竭。以致小便不利。或涩而赤。医者往往利之。重竭其泽液。又阳明病。不大便。而小便
赤涩。或误利其小便。则津液愈无。胃愈干燥。此又利小便之戒。
不得眠。阴阳皆有之。正病于不得眠者。阳明也。若少阴当病于欲寐。今乃不得眠。缘
阳气
入少阴经。非少阴正病也。仲景云。二三日。身热、目疼、鼻干、不得卧者。阳明也。于前
阳明证中求药。少阴下利而渴。六七日。咳而呕。心烦不得眠。宜猪苓汤。若少阴病得之三
二日以上。心中烦。不得眠。黄连阿胶汤。外有因发汗大过。胸中烦躁。不得眠。欲饮水者
少少与之。其人发渴小便不利者。五苓散。若因吐下后。心烦气乏。昼夜不得眠。宜酸枣
汤。若下后复汗。昼夜烦躁。不得眠夜则安静、不呕不渴。身无大热者。是汗太过。阳气衰
遂成阴证。干姜附子汤。外有伤寒已解。或因饮食复剧。烦闷、干呕、口噪、呻吟、错语
、不得
眠。宜黄连解毒汤。又有病瘥后。自不得眠。宜温胆汤。或眠而精魂散乱。异梦惊悸者。温
胆汤尤宜。
古论鼻衄。属太阳经。风寒皆有之。既衄而表证仍在。于寒当用麻黄汤。于风当再用桂
枝汤
且谓发烦目瞑。极者必衄。既发烦目瞑。岂纯是太阳经。兼阳明之脉循鼻。是太阳侵入阳
明。汗下俱难。若衄已而热不退者。惟升麻葛根汤。败毒散。阳旦汤为稳。衄而烦渴。饮则
吐水。先服五苓散。次服竹叶石膏汤。大衄不止宜茅花汤。或黄芩芍药汤。加茅花一撮。
若少阴初得病。医误以正发汗之法。致迫血动经。妄行而衄。其血非独出于鼻。或从口
中。
或从耳目。又有阳陷入阴。四肢厥逆。医见其厥。谓寒邪在表。从而汗之。当下反汗。以致
动血。是谓下厥上竭。为难治。先哲云。桂枝下咽。阳盛则毙。正以此也要知汗不出彻。为
阳之衄。误发其汗。为阴之衄。二者大不同也。又云阳盛阴虚。汗之则死。
恶寒。阴阳皆有之。太阳经伤寒。病在表。故恶寒。少阳半在表半在里。亦微恶寒。阳
明在里。本不恶寒。阳明或恶寒者。与太阳合病。未可下。宜小柴胡汤。
三阴。惟少阴经有恶寒之证。太阴厥阴皆不恶寒然少阴恶寒。又有二证。发于少阴者。
无热
而恶寒。宜温之属。理中汤、四逆汤。少阴无热恶寒。似与前太阳经未即热一条相似。所谓
寒未即热者。为太阳证具而未热耳。此之无热恶寒。盖无太阳头痛等证知为少阴也。阳气传
入少阴者。或恶寒而倦。时时自烦。不欲浓衣。属大柴胡汤。
若太阳得汗后。大恶寒者。表虚也。芍药甘草附子汤。表虚恶寒。而筋惕肉 者。真武
汤。外有太阴自利不渴。厥阴下利厥逆。俱或恶寒。太阴宜理中汤
厥阴宜四逆汤
前既言二阴不恶寒。今又言或恶寒。要知太阴厥阴。皆不恶寒者。此阳传阴者也。三阴皆
能恶寒者。阴入阴者也。特在少阴为多耳。皆恶寒有二证。三阳合病。皆恶寒者。必口中不
仁。口燥舌干也。少阴病皆恶寒者。必口中和也。以此别之。合病白虎汤。少阴附子汤。（
仲景云。有热而恶寒者。发于阳也。无热而恶寒者发于阴也。与此理同。）
身体痛。阳证病在太阳。阴证病在少阴厥阴。在太阳宜汗。于前本经求药。自利而身体
痛。
无热证者。为阴病也。急当救里。宜四逆汤附子汤。真武汤。去芍药加干姜。或加官桂。如
其
数。若发汗后身大痛不止。宜小建中汤。和其荣卫。加以筋惕肉 者。真武汤。外有阴毒身
疼。如被杖。与中湿风湿等证。皆能身体痛重。活人书载之。以详兹不复述。
自汗九证。备见活人书。但少阴不得有汗。而或反自汗出以阳气衰少。无以固阴液。故
汗不
当出而出。宜真武汤。阳明病法多汗而或反无汗。如虫行皮中状者。以病患久虚。津液竭不
能为汗。宜用黄 建中汤。得津液既和。而阳明证仍在。徐用小柴胡汤。若太阳发汗多。遂
漏不止。其人恶风。宜桂枝汤。加熟附子一钱。漏汗而筋惕肉 。身欲振振擗地者。真武汤
外有头汗数证。引饮。小便不利。身必发黄。已见前发黄证。胸胁微痛。但头汗出、往来
寒热心烦者。小柴胡汤。心下紧满。无大热。但头有汗。此名为水结胸。以头汗别水结证。
小半夏茯苓汤。内加苓倍半夏。
白胎。舌上微白者。未可便为热证。必胎白而浓。其上如刺焦裂破纹。摸之略无小润
甚
成黑胎。方为热极。加以下证。悉具。无表里证。方可用小承气汤。大柴胡汤。亦有病属阴
证。下利清谷。阳气客于上焦。烦躁引饮。舌胎如前证。或鼻烟煤。欲去衣被。不可误以为
阳。附子理中汤。四逆汤。冷服。
阴阳之病。皆能发厥。故有阳厥。有阴厥。皆病之深也。二厥惟阳厥易误。当问其初得
病如
何。若初得病。头不痛。四肢逆冷。足多挛卧。而恶寒或汗。自引衣盖覆。或不渴。或利清
谷。或小便自调。人多惺惺而静此寒厥也。是为阴中之阴。宜四逆汤附子理中汤。若初得病
头痛身热。外别有阳证。至五六日方发厥。其人虽厥。或畏热或饮水。或扬手掷足烦躁不
得眠大便秘小便赤多昏愦者此热厥也是为阴中之阳宜白虎汤。或大承气汤。热厥。虽手足冷
而指甲暖不若寒厥。并指甲俱冷此辨阴阳要法也。
近有阳病。自腰以上极热。两脚常冷。盖三阴脉。上不至头、故头不疼。三阳脉。下不
至足故足冷也。
咽喉痛。有阴阳二证。面赤。身发斑如锦。睡脓血而咽喉痛者。此阳毒证。宜阳毒升麻
汤。手足厥冷。或吐利而咽喉痛者。此少阴证。宜通脉四逆汤。于中加桔梗一钱。
又有非是暴寒中人。伏气于少阴。经旬月方发。先咽痛而次下利。宜半夏桂甘汤。谓之
肾伤
寒（此证人罕知。）亦有初得病。头痛发热。无阳毒少阴诸证。而咽喉自痛者。此因感冒后。
顿浓衣被。或用蛮法。服生姜热酒即卧。遂成上壅。或先有壅热。欲取凉快。致为外邪所袭
既有风寒又有热壅。宜参苏饮倍桔梗加木香半钱。或消风百解散。或败毒散。或五积散。
败毒散。各半帖。名交加散。
腹肚满痛。有阴阳之别。腹痛属里。正太阳经腹不痛。少阳有胸胁痛而无腹痛。若有阳
明腹
满急而痛此为里实。宜大柴胡汤。小承气汤。此总论三阳经。阳中之阴。三阴下利清谷。而
又腹痛者。里寒故也。四逆汤。附子理中汤。阳气传太阴经。腹满而痛。其证有二。有实痛。
有虚痛。肠鸣泄利而痛者。虚痛也。此独论太阴经。阴中之阳。小建中汤即桂枝加芍药汤。
但桂有浓薄耳。不瘥则小柴胡汤。去芩加芍药如数。腹满大便秘。按之痛者。实痛也。桂枝
汤加大黄一钱。此之虚痛实痛。乃是以阳邪渐消为虚。阳气正大为实。又阳气传少阴。六七
日。腹胀满。不大便者当下。宜大承气汤。痞结胸。皆误下所致。按之胸膈石硬而痛。小结
胸也不按自痛者。大结胸也。心下满而不痛者。痞也。恶寒身热。病发于阳。未有下证而反
下之。则为结胸。恶寒无热病发于阴。不当下而反下之。则为痞。二证之中。又各分阴阳。
痞结胸皆应下。表未解尚恶寒者。且宜解表。用桔梗枳壳汤。和桂枝汤各半帖煎。如表已解
则可用小陷胸汤。以攻小结胸。大陷胸汤以攻大结胸。或先宜用桔梗枳壳汤。不效则用大
小陷胸汤。此大小结胸。乃为热结。其人必烦躁渴。心中懊 。（仲景云结胸证。脉尚浮。
未全结也。宜桂枝汤。）
又有寒实结胸。虽痛而无烦躁等证。此因下后虚逆。寒气独结。宜理中汤加枳实半钱茯
苓一钱。或枳实理中丸。（寒实结胸。仲景用三白散。）
又有水结胸。无大热证。头微汗出。宜小半夏茯苓汤。如寒痞。则用理中汤加枳实半钱
茯苓
一钱。或枳实理中丸。阳痞时有热证者。先用桔梗枳壳汤。次用黄连泻心汤。虽有热而复恶
寒汗出者。附子泻心汤。表解而胃中不和。心下痞硬。干噫食臭。腹中雷鸣。下利者。生姜
泻心汤。或甘草泻心汤。痞而有阴阳杂证。半夏泻心汤。痞而渴。饮水即吐者。五苓散。亦
有不因误下而自痞者。审在何经。且当治本经病痞。甚则攻其痞。
大结胸为阳。然亦有阴结。用理中热剂。痞则为阴。亦有阳痞。用三黄凉剂。此盖随阴
阳变
通。不可执也。喘嗽有阴阳。太阳经喘嗽。略于前本经言之。详见嗽门。少阳有嗽无喘。有
喘非少阳也。其见少阳证而嗽者。宜小柴胡汤。加北五味六分。干姜四分。阳明有喘。无嗽
有
嗽非正阳明也。其阳明证喘有潮热者。宜大承气汤。阴证喘。惟少阴有之。若四肢沉重疼痛
小便如常。大便自利而嗽者。真武汤去芍药。加北五味干姜各半钱、细辛三钱。此阴中之
阴。若四肢厥逆。腹中痛。泄利下重而咳。四逆汤加北五味干姜各半钱。下利呕渴。身烦不
得眠而咳嗽者。猪苓汤。此阴中之阳。诸阴喘促。最为危证。反阴丹。
谵语属阳。郑声属阴。经云实则谵语。虚则郑声。谵语者。颠倒错乱。言出无伦。常对
空独
语。如见鬼状。郑声者。郑重频繁、语虽谬而谆谆重复不自已。年老之人、遇事则谇语不休
以阳气虚故也。此谵语郑声。虚实之所以不同也。二者本不难辨。但阳盛里实。与阴盛隔
阳。皆能错语。须以他证别之。大便秘。小便赤身热烦渴而妄言者。乃里实之谵语也。小便
如
常。大便洞下。或发躁。或反发热而妄言者。乃阴隔阳之谵语也。里实宜下。调胃承气汤。
热躁甚而妄言不休大渴喜冷。宜理中汤。阴隔阳。宜温胆汤。四逆汤。附子理中汤。又有不
系正阳明。似困非困。间时有一二声谵语者。当随证施治。
外有已得汗。身和而言妄者。此是汗出后。津液不和。慎不可下。乃非阳非阴者宜小柴
胡汤
和建中汤各半帖。和荣卫。通津液。若阳传入阴。自利。手足厥逆。语或错乱。此虽已自
利。其中必燥屎。犹当下之。阴中之阳。宜调胃承气汤。瘀血在里。大便黑。小便利。小腹
痛。其人如狂。谵语者。桃核承气汤。妇人伤寒发热。经水隔断。此热入血室。其血必结。
亦能谵语。宜小柴胡汤。病后血气未复。精神未全多于梦寐中。不觉失声如魇。此不系谵语
郑声。宜温胆汤。去竹茹、入人参半钱。或用六君子汤。
多寐四证。风湿多寐。见活人书。不可更发汗。宜败毒散。属阳经。
久不得寐。一旦欲寐。别无余病。此为阴阳和而愈也。若少阴得病。但欲寝者。急投四
逆汤。外有狐惑。忽忽喜寐。当于活人书求之。
攻伐热邪太过，导致胃中虚寒，因寒邪引起的咳嗽气逆，用橘皮干姜汤。或者使用半夏生姜汤。如果在桔梗枳壳汤中加入半夏和陈皮各等分，加生姜十片煎煮，也能治疗阴证引起的咳嗽气逆。阳证引起的咳嗽气逆，是胃中有热，用小柴胡汤或橘皮竹茹汤。
如果是阳证咳嗽气逆又兼有腹痛的，询问患者前后二便的情况，知道哪一部不通利。前部（小便）不利用猪苓汤；后部（大便）不利用调胃承气汤。
发黄分为阴黄和阳黄两种证候。阳证发黄，是余热蓄积在脾胃，瘀热与宿食相互搏结，蒸郁而发黄。凡是病人身体发热，头面部出汗，颈部以下无汗，口渴想喝水浆，小便不利，全身从头到眼目都发黄，身体干燥无汗，小便又不通利，那么热邪不能向外发散，必然蕴蓄而成发黄证。宜用五苓散，用茵陈煎汤调服，或者用栀子汤调服。
又有瘀血这一种证候，全身也会发黄，但瘀血证会发狂，大便必定发黑，小腹按压时急痛，而大便却自利（通畅），这是因为蓄血不需要通过利小便来治疗。宜用桃核承气汤。
阴黄，是太阳经中的湿邪所致，身体疼痛发热，身色像熏黄一样，终究不如阳黄那样鲜明如橘子色。应当叩问其小便的通利与否。如果小便自利，用术附汤；如果小便不利，大便反而快利，用五苓散。
还有刚痉、柔痉。又有阴痉、阳痉。有汗的叫柔痉，无汗的叫刚痉。这是因为先伤风，又感受寒湿导致的。外证都能发热恶寒，头颈强直僵硬，腰背反张，或者抽搐、口噤，症状像发癫痫，又像产后角弓反张的风症。小续命汤都可以使用。仔细辨别如果是柔痉且有汗的，用桂枝汤加葛根一钱，重的用附子防风散。仔细辨别如果是刚痉且无汗的，宜用葛根汤。如果胸满口噤，睡觉时背部不着席，脚部拘挛咬紧牙齿，不恶寒的，用大承气汤。
发狂，阳证有两种，阴证有一种。阳证的蓄血如狂，已经在发黄条文中见过。阳毒发狂，烦躁狂走，胡言乱语叫骂，像看见鬼怪的样子，面红咽痛，鼻子像烟煤一样黑，或者身上斑纹像锦缎，或者下利赤黄色，宜用阳毒升麻汤。阴证，是病发于少阴，本不应正发汗，医生见其恶寒，强行发汗，汗漏不止，其人亡阳，所以发狂。大致与阴极发躁相同。南阳说：也没有这一种证，应当用治阴躁的药，加上收汗的剂，玉屏风散，加入熟附子一钱，仍然外用温粉敷贴。或者冷汗自出，手足逆冷，其人发狂不止的，宜用四逆汤冷服。（阴证发狂亡阳证，大多死亡。）
医治伤寒，多询问其小便通利与否，颜色红不红，以此辨别阴阳。也有小便自利，次数多，量出自少，颜色不是很清的，不可因为小便通利就立刻说是阴证。必须是小便像平常一样，清而不红，又没有各种阳证，才相信里没有热。如果病在太阳，身体热，太阳属膀胱，没有小便不红的，不可因为小便红就立刻说是实热。必须是小便像灰汁，或者像陈酒，或者像血色，没有各种表证，才见到热已经入里。又有因为发汗过多，津液枯竭，以致小便不利，或者涩而红。医生往往用利小便的方法，严重耗竭其津液。又有阳明病，不大便，而小便赤涩，如果误用利小便的方法，那么津液更加没有，胃更加干燥，这又是利小便的禁忌。
不得睡眠，阴阳都有这种情况。真正病在不得睡眠的，是阳明病。如果少阴应当病在想睡觉，现在却是不得睡眠，是因为阳气进入少阴经，不是少阴的正病。仲景说：两三天，身体热、眼睛疼、鼻子干、不能卧的，是阳明病。在前面的阳明证中求药。少阴下利而渴，六七天，咳嗽而呕吐，心烦不得眠，宜用猪苓汤。如果少阴病得之二三天以上，心中烦，不得眠，用黄连阿胶汤。外面有因为发汗过大，胸中烦躁，不得眠，想喝水的，少量给予他喝。其人发渴小便不利的，用五苓散。如果因为吐下后，心烦气乏，昼夜不得眠，宜用酸枣仁汤。如果下后又发汗，昼夜烦躁，不得眠，夜间则安静，不呕不渴，身体没有大热的，这是汗出太过，阳气衰败遂成阴证，用干姜附子汤。外面有伤寒已解，或者因为饮食复发加重，烦闷、干呕、口燥、呻吟、错语、不得眠，宜用黄连解毒汤。又有病愈后，自己不得眠，宜用温胆汤。或者睡着但精神魂魄散乱，做异梦惊悸的，温胆汤尤其适宜。
古论鼻出血，属于太阳经，风寒都有这种情况。既然鼻出血而表证仍在，对于寒当用麻黄汤，对于风当再用桂枝汤。并且说发烦眼睛昏花，极度的必定鼻出血。既然发烦眼睛昏花，难道纯粹是太阳经吗？兼之阳明脉循行经过鼻子，是太阳侵入阳明，汗法和下法都难用。如果鼻出血后热不退的，只有升麻葛根汤、败毒散、阳旦汤比较稳妥。鼻出血而烦渴，喝水则吐水，先服五苓散，次服竹叶石膏汤。大量鼻出血不止宜用茅花汤，或者黄芩芍药汤，加茅花一撮。
如果少阴初得病，医生误用正发汗的方法，导致迫血动经，妄行而鼻出血。其血不仅从鼻子出，或者从口中出，或者从耳目出。又有阳陷入阴，四肢厥冷，医生见其厥，说寒邪在表，从而发汗，该下反汗，以致动血，这叫下厥上竭，为难治。先哲说：桂枝汤咽下，阳盛则死，正是这个意思。也要知道汗不出透，为阳证鼻出血；误发其汗，为阴证鼻出血。二者大不相同。又说阳盛阴虚，发汗则死。
恶寒，阴阳都有这种情况。太阳经伤寒，病在表，所以恶寒。少阳半在表半在里，也轻微恶寒。阳明在里，本来不恶寒。阳明有时恶寒的，是与太阳合病，不可下，宜用小柴胡汤。
三阴经，只有少阴经有恶寒的证候。太阴、厥阴都不恶寒。然而少阴恶寒，又有两种证候。发于少阴的，无热而恶寒，宜用温补类方剂，理中汤、四逆汤。少阴无热恶寒，似乎与前文太阳经未即热一条相似。所谓寒未即热，是指太阳证具备但未发热罢了。这里的无热恶寒，大概是没有太阳头痛等证，知道是少阴。阳气传入少阴的，或者恶寒而疲倦，时时自烦，不想穿厚衣服，属大柴胡汤证。
如果太阳得汗后，大恶寒的，是表虚，用芍药甘草附子汤。表虚恶寒，而筋惕肉瞤的，用真武汤。外面有太阴自利不渴，厥阴下利厥逆，都或许恶寒。太阴宜用理中汤，厥阴宜用四逆汤。
前面既说二阴不恶寒，现在又说或许恶寒。要知道太阴、厥阴，都是不恶寒的，这是阳传阴的。三阴都能恶寒的，是阴入阴的。特别在少阴比较多。都恶寒有两种证候。三阳合病，都恶寒的，必定口中不仁，口燥舌干。少阴病都恶寒的，必定口中和。以此区别。合病用白虎汤，少阴用附子汤。（仲景说：有热而恶寒的，发于阳；无热而恶寒的，发于阴。与此道理相同。）
身体痛，阳证病在太阳，阴证病在少阴、厥阴。在太阳宜发汗，在前面本经中求药。自利而身体痛，无热证的，是阴病。急当救里，宜用四逆汤、附子汤、真武汤。去芍药加干姜，或者加官桂，如前面的数量。如果发汗后身大痛不止，宜用小建中汤，调和荣卫。加上筋惕肉瞤的，用真武汤。外面有阴毒身疼，像被杖打一样，与中湿风湿等证，都能身体痛重，《活人书》记载了，这里不再详述。
自汗九证，备见于《活人书》。但少阴不得有汗，而或许反而自汗出，是因为阳气衰少，无以固摄阴液，所以汗不当出而出。宜用真武汤。阳明病法多汗而或许反而无汗，像虫子在皮中游走的样子的，是因为病人久虚，津液枯竭不能为汗。宜用黄芪建中汤。得到津液既和，而阳明证仍在，慢慢用小柴胡汤。如果太阳发汗多，遂漏汗不止，其人恶风，宜用桂枝汤，加熟附子一钱。漏汗而筋惕肉瞤，身体想要振振倒地般的，用真武汤。
外面有头汗数证。引饮，小便不利，身必发黄，已在前面发黄证中见过。胸胁微痛，但头汗出、往来寒热心烦的，用小柴胡汤。心下紧满，无大热，但头有汗，这名叫水结胸，以头汗区别水结证。用小半夏茯苓汤，内加茯苓倍于半夏。
白苔，舌上微白的，不可以立刻认为是热证。必须苔白而浓，上面像刺焦裂破纹，摸之略微没有一点湿润，甚至成黑苔，才是热极。加上以下证候，全部具备，无表里证，才可以用小承气汤、大柴胡汤。也有病属阴证，下利清谷，阳气客于上焦，烦躁引饮，舌苔如前证，或者鼻如烟煤，欲去衣被，不可误以为阳，用附子理中汤、四逆汤，冷服。
阴阳的病，都能发厥，所以有阳厥，有阴厥，都是病深了。二厥中只有阳厥容易误诊。应当问其初得病如何。如果初得病，头不痛，四肢逆冷，足多蜷缩卧倒，而恶寒或有汗，自己拉衣覆盖，或者不渴，或者下利清谷，或者小便自调，人多清醒而安静，这是寒厥。这是阴中之阴，宜用四逆汤、附子理中汤。如果初得病头痛身热，外别有阳证，到五六天才发厥。其人虽然厥，或者畏热或者饮水，或者扬手掷足烦躁不得眠，大便秘小便赤多昏愦的，这是热厥。这是阴中之阳，宜用白虎汤，或者大承气汤。热厥，虽然手脚冷但指甲暖，不像寒厥，并指甲都冷，这是辨别阴阳的重要方法。
近来有阳病，自腰以上极热，两脚常冷。盖三阴脉，上不到头，所以头不疼。三阳脉，下不到足，所以足冷。
咽喉痛，有阴阳两种证候。面赤，身发斑如锦，睡脓血而咽喉痛的，这是阳毒证，宜用阳毒升麻汤。手足厥冷，或者吐利而咽喉痛的，这是少阴证，宜用通脉四逆汤，在其中加桔梗一钱。
又有不是暴寒中人，伏气于少阴，经过旬月才发，先咽痛而次下利，宜用半夏桂甘汤。这叫肾伤寒（此证证人很少知道）。也有初得病，头痛发热，无阳毒少阴诸证，而咽喉自痛的，这是因为感冒后，顿然穿厚衣被，或者用蛮法，服生姜热酒就卧，遂成上壅。或者先有壅热，想取凉快，致为外邪所袭，既有风寒又有热壅，宜用参苏饮倍桔梗加木香半钱，或者消风百解散，或者败毒散，或者五积散。败毒散，各半帖，名叫交加散。
腹肚满痛，有阴阳的区别。腹痛属里，正太阳经腹不痛，少阳有胸胁痛而无腹痛。如果有阳明腹满急而痛，此为里实，宜用大柴胡汤、小承气汤。这是总论三阳经。阳中之阴，三阴下利清谷，而又腹痛的，是里寒，故也用四逆汤、附子理中汤。阳气传太阴经，腹满而痛，其证有二。有实痛，有虚痛。肠鸣泄利而痛的，是虚痛。这是独论太阴经，阴中之阳，用小建中汤即桂枝加芍药汤，只是桂枝有浓薄之分。不愈则用小柴胡汤，去黄芩加芍药如前数量。腹满大便秘，按之痛的，是实痛。桂枝汤加大黄一钱。这里的虚痛实痛，是以阳邪渐消为虚，阳气正大为实。又阳气传少阴，六七天，腹胀满，不大便的当下，宜用大承气汤。痞结胸，都是误下所致。按之胸膈石硬而痛，小结胸；不按自痛的，是大结胸。心下满而不痛的，是痞。恶寒身热，病发于阳，未有下证而反下之，则为结胸。恶寒无热病发于阴，不当下而反下之，则为痞。二证之中，又各分阴阳。痞结胸都应下，表未解尚恶寒的，暂且宜解表，用桔梗枳壳汤，和桂枝汤各半帖煎。如表已解则可用小陷胸汤，以攻小结胸；大陷胸汤以攻大结胸。或者先宜用桔梗枳壳汤，不效则用大小陷胸汤。此大小结胸，是为热结，其人必烦躁渴，心中懊憹。（仲景说结胸证，脉尚浮，未全结也，宜桂枝汤。）
又有寒实结胸，虽痛而无烦躁等证，这是因下后虚逆，寒气独结，宜用理中汤加枳实半钱、茯苓一钱，或者枳实理中丸。（寒实结胸，仲景用三白散。）
又有水结胸，无大热证，头微汗出，宜用小半夏茯苓汤。如寒痞，则用理中汤加枳实半钱、茯苓一钱，或者枳实理中丸。阳痞时有热证的，先用桔梗枳壳汤，次用黄连泻心汤。虽有热而复恶寒汗出的，用附子泻心汤。表解而胃中不和，心下痞硬，干噫食臭，腹中雷鸣，下利的，用生姜泻心汤，或者甘草泻心汤。痞而有阴阳杂证的，用半夏泻心汤。痞而渴，饮水即吐的，用五苓散。也有不因误下而自痞的，审在何经，暂且当治本经病痞，甚则攻其痞。
大结胸为阳，然而也有阴结，用理中热剂。痞则为阴，亦有阳痞，用三黄凉剂。这大概是随阴阳变通，不可固执。喘嗽有阴阳。太阳经喘嗽，略于前面本经言之，详见嗽门。少阳有嗽无喘，有喘非少阳也。其见少阳证而嗽的，宜用小柴胡汤，加北五味六分，干姜四分。阳明有喘，无嗽，有嗽非正阳明也。其阳明证喘有潮热的，宜用大承气汤。阴证喘，惟少阴有之。若四肢沉重疼痛，小便如常，大便自利而嗽的，用真武汤去芍药，加北五味干姜各半钱、细辛三钱。这是阴中之阴。若四肢厥逆，腹中痛，泄利下重而咳的，用四逆汤加北五味干姜各半钱。下利呕渴，身烦不得眠而咳嗽的，用猪苓汤。这是阴中之阳。诸阴喘促，最为危证，用反阴丹。
谵语属阳，郑声属阴。经云实则谵语，虚则郑声。谵语的，颠倒错乱，言出无伦，常对空独语，如见鬼状。郑声的，郑重频繁，语虽谬而谆谆重复不自已。年老之人，遇事则谇语不休，以阳气虚的缘故。此谵语郑声，虚实之所以不同。二者本不难辨，但阳盛里实，与阴盛隔阳，皆能错语，须以他证别之。大便秘，小便赤身热烦渴而妄言的，乃里实之谵语也。小便如常，大便洞下，或者发躁，或者反发热而妄言的，乃阴隔阳之谵语也。里实宜下，用调胃承气汤。热躁甚而妄言不休大渴喜冷的，宜用理中汤。阴隔阳，宜用温胆汤、四逆汤、附子理中汤。又有不系正阳明，似困非困，间时有一二声谵语的，当随证施治。
外面有已得汗，身和而言妄的，这是汗出后，津液不和，慎不可下，乃非阳非阴者，宜用小柴胡汤和建中汤各半帖，和荣卫，通津液。若阳传入阴，自利，手足厥逆，语或错乱，此虽已自利，其中必燥屎，犹当下之，阴中之阳，宜用调胃承气汤。瘀血在里，大便黑，小便利，小腹痛，其人如狂，谵语的，用桃核承气汤。妇人伤寒发热，经水隔断，此热入血室，其血必结，亦能谵语，宜用小柴胡汤。病后血气未复，精神未全，多于梦寐中，不觉失声如魇，这不系谵语郑声，宜用温胆汤，去竹茹、入人参半钱，或者用六君子汤。
多寐四证。风湿多寐，见《活人书》，不可更发汗，宜用败毒散，属阳经。
久不得寐，一旦欲寐，别无余病，此为阴阳和而愈也。如果少阴得病，但欲寝的，急投四逆汤。外面有狐惑，忽忽喜寐，当于《活人书》求之。
If heat-clearing is excessive, it leads to cold in the stomach. For cough and regurgitation caused by cold, use Jupi Ganjiang Tang (Tangerine Peel and Dried Ginger Decoction). Alternatively, Banxia Shengjiang Tang (Pinellia and Fresh Ginger Decoction) may be used. If Banxia (Pinelliae Rhizoma) and Chenpi (Citri Reticulatae Pericarpium) are added in equal parts to Jiegeng Zhike Tang (Platycodon and Aurantium Decoction), along with ten slices of Shengjiang (Fresh Ginger) for decoction, it also treats Yin-type cough and regurgitation. Yang-type cough and regurgitation results from heat in the stomach; use Xiaochaihu Tang (Minor Bupleurum Decoction) or Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction).
If Yang-type cough and regurgitation is accompanied by abdominal pain, inquire about the patency of the anterior (urination) and posterior (defecation) orifices. If the anterior orifice is obstructed, use Zhuling Tang (Polyporus Decoction); if the posterior orifice is obstructed, use Tiaowei Chengqi Tang (Regulating the Stomach and Purging Down Decoction).
Jaundice presents as two syndromes: Yang Jaundice and Yin Jaundice. Yang Jaundice occurs when residual heat accumulates in the Spleen and Stomach; stagnant heat combats with retained food, steaming and郁 (stagnating) to cause yellowing. When a patient has fever, sweating on the head and face but no sweat below the neck, thirst for fluids, and dysuria, with the whole body including the head and eyes turning yellow, dry skin without sweat, and obstructed urination, the heat cannot vent outward and must accumulate to form jaundice. Use Wuling San (Five-Ingredient Powder with Poria), mixed with decoction of Yinchin (Artemisiae Scopariae Herba), or taken with Zhizi Tang (Gardenia Decoction).
There is also a syndrome of Blood Stasis where the whole body turns yellow, but unlike other types, it involves mania, black stools, and acute tenderness upon pressing the lower abdomen, yet defecation remains free. This is because blood stasis does not require promoting diuresis. Use Taohe Chengqi Tang (Peach Kernel and Magnolia Bark Decoction).
Yin Jaundice is caused by dampness in the Taiyang Channel. It presents with body pain and fever, and the skin color resembles smoky yellow, which is never as bright as the orange-yellow of Yang Jaundice. Inquire whether urination is patent or obstructed. If urination is spontaneous and patent, use Shu Fu Tang (Atractylodes and Aconite Decoction). If urination is obstructed and defecation is loose, use Wuling San (Five-Ingredient Powder with Poria).
There are also Gang Jing (Rigid Spasm) and Rou Jing (Soft Spasm), as well as Yin Jing and Yang Jing. Spasm with sweating is Rou Jing; without sweating is Gang Jing. This arises from initial Wind injury followed by Cold-Damp invasion. Externally, all present with fever and aversion to cold, stiff neck, opisthotonos, convulsions, trismus, resembling epilepsy or postpartum opisthotonos. Xiao Xuming Tang (Minor Continuation Life Decoction) can be used for all. Carefully distinguish: if it is Rou Jing with sweating, use Guizhi Tang (Cinnamon Twig Decoction) plus Ge Gen (Puerariae Lobatae Radix) 1 qian; for severe cases, use Fuzi Fangfeng San (Aconite and Saposhnikovia Powder). If it is Gang Jing without sweating, use Gegen Tang (Kudzu Root Decoction). If there is chest fullness, trismus, inability to lie flat, leg cramps, teeth grinding, and no aversion to cold, use Dachengqi Tang (Major Order the Qi Decoction).
Mania has two Yang syndromes and one Yin syndrome. Yang syndrome of Blood Stasis causing mania was described under Jaundice. Yang Du (Yang Toxin) causing mania presents with restlessness, running wildly, delirious shouting, hallucinations, red face, sore throat, nose like soot, skin spots like brocade, or bloody/yellow diarrhea. Use Yangdu Shengma Tang (Yang Toxin Corydalis Decoction). The Yin syndrome occurs when the disease originates in Shaoyin; sweating should not be induced. If the physician sees aversion to cold and forces sweating, leading to continuous leakage of sweat and loss of Yang, mania ensues. This is similar to extreme Yin causing restlessness. Nanyang states this syndrome is rare; treat with herbs for Yin restlessness combined with sweat-astringents. Use Yupingfeng San (Jade Screen Powder) with 1 qian of Shu Fuzi (Prepared Aconite Root), and apply warm powder externally. If cold sweat flows and limbs are cold with unceasing mania, use Sini Tang (Frigid Extremities Decoction) administered cold. (Yin mania with Yang loss often proves fatal.)
In treating Cold Damage, frequently ask about urine volume and color to distinguish Yin and Yang. Some have spontaneous patent urination with frequent small amounts of slightly cloudy urine; do not immediately diagnose as Yin based on patent urination alone. Only if urine is normal, clear, non-red, and devoid of Yang symptoms, can interior heat be ruled out. If the disease is in Taiyang with fever, since Taiyang corresponds to the Bladder, urine is rarely non-red. Do not immediately diagnose excess heat just because urine is red. Only if urine resembles gray juice, old wine, or blood, and exterior symptoms are absent, can interior heat be confirmed. Also, excessive sweating depletes fluids, causing dysuria or red, astringent urine. Physicians often mistakenly promote diuresis, further depleting fluids. In Yangming disease with constipation and red, astringent urine, mistaken diuresis dries the Stomach further. This is a warning against promoting diuresis.
Insomnia occurs in both Yin and Yang. True insomnia belongs to Yangming. Shaoyin typically presents with desire to sleep; if insomnia occurs, it is due to Yang Qi entering Shaoyin, not a primary Shaoyin disease. Zhang Zhongjing states: Fever, eye pain, dry nose, and inability to sleep after two to three days indicate Yangming. Seek remedies among previous Yangming syndromes. For Shaoyin with diarrhea and thirst, cough, vomiting, irritability, and insomnia after six to seven days, use Zhuling Tang (Polyporus Decoction). If Shaoyin disease persists for two to three days with irritability and insomnia, use Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction). Externally, if excessive sweating causes chest irritability and insomnia, give water sparingly. If thirsty with dysuria, use Wuling San (Five-Ingredient Powder with Poria). After vomiting/purging, if irritability and fatigue cause day-and-night insomnia, use Suanzaoren Tang (Ziziphus Seed Decoction). If purging followed by sweating causes day-and-night irritability and insomnia, but quiet at night, no vomiting/thirst, and no high fever, this is Yang deficiency from excessive sweating, forming a Yin syndrome; use Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction). If Cold Damage resolves but worsens due to diet, causing oppression, dry retching, dry mouth, groaning, delirium, and insomnia, use Huanglian Jiedu Tang (Coptis Detoxification Decoction). After recovery, if insomnia persists, use Wendan Tang (Warm Gallbladder Decoction). For disturbed sleep with scattered spirit, vivid dreams, and palpitations, Wendan Tang is especially suitable.
Ancient texts attribute epistaxis to the Taiyang channel, occurring in both Cold and Wind injuries. If epistaxis occurs but exterior symptoms persist, use Mahuang Tang (Ephedra Decoction) for Cold, or Guizhi Tang (Cinnamon Twig Decoction) again for Wind. It is said that severe irritability and blurred vision lead to epistaxis. Since the Yangming channel traverses the nose, Taiyang invading Yangming makes both sweating and purging difficult. If heat persists after epistaxis, Shengma Gegen Tang (Corydalis and Kudzu Root Decoction), Baidu San (Hundred-Rescue Powder), or Yangdan Tang (Yang Dawn Decoction) are stable choices. For epistaxis with irritability and thirst, vomiting water upon drinking, first use Wuling San (Five-Ingredient Powder with Poria), then Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). For massive epistaxis, use Maohua Tang (Cattail Pollen Decoction) or Huangqin Shaoyao Tang (Scutellaria and Peony Decoction) with Maohua.
If Shaoyin disease is initially treated with improper sweating, forcing blood to move in the channels and causing epistaxis, blood may come from the nose, mouth, ears, or eyes. If Yang sinks into Yin causing cold limbs, and the physician mistakes this for exterior Cold and induces sweating, leading to bleeding, this is "Lower Cold and Upper Exhaustion," a difficult case. Ancients say: "If Guizhi Tang enters the throat and Yang is excessive, death follows." Note that epistaxis from incomplete sweating is Yang-type; epistaxis from forced sweating is Yin-type. They are vastly different. Also, "Excess Yang and Deficient Yin: sweating leads to death."
Aversion to cold occurs in both Yin and Yang. Taiyang Cold Damage is exterior, hence aversion to cold. Shaoyang is half-exterior, half-interior, with mild aversion to cold. Yangming is interior and normally has no aversion to cold. If Yangming has aversion to cold, it is a combined disease with Taiyang, not ready for purging; use Xiaochaihu Tang (Minor Bupleurum Decoction).
Among the Three Yin channels, only Shaoyin presents with aversion to cold; Taiyin and Jueyin do not. However, Shaoyin aversion to cold has two types. Originating in Shaoyin: no fever but aversion to cold, use warming formulas like Lizhong Tang (Regulate the Middle Decoction) or Sini Tang (Frigid Extremities Decoction). This resembles the Taiyang phase before heat appears. Here, "no fever" means absence of Taiyang headache, identifying it as Shaoyin. If Yang Qi transmits to Shaoyin, presenting with aversion to cold, fatigue, occasional irritability, and dislike of heavy clothing, use Da Chaihu Tang (Major Bupleurum Decoction).
After sweating in Taiyang, severe aversion to cold indicates exterior deficiency; use Shaoyao Gancao Fuzi Tang (Peony, Licorice, and Aconite Decoction). If exterior deficiency with aversion to cold is accompanied by muscle twitching, use Zhenwu Tang (True Warrior Decoction). Taiyin with spontaneous diarrhea and no thirst, or Jueyin with diarrhea and cold limbs, may have aversion to cold. Taiyin uses Lizhong Tang (Regulate the Middle Decoction); Jueyin uses Sini Tang (Frigid Extremities Decoction). Previously stated that Two Yin do not have aversion to cold; now stating they might. Taiyin and Jueyin generally do not have aversion to cold when Yang transmits to Yin. All Three Yin can have aversion to cold when Yin invades Yin, especially in Shaoyin. Combined disease of Three Yang with aversion to cold implies oral insensitivity and dry tongue. Shaoyin disease with aversion to cold implies a neutral mouth. Differentiate thus: Combined disease uses Baihu Tang (White Tiger Decoction); Shaoyin uses Fuzi Tang (Aconite Decoction). (Zhongjing: Fever with aversion to cold originates in Yang; no fever with aversion to cold originates in Yin.)
Body pain: Yang syndrome in Taiyang, Yin syndrome in Shaoyin/Jueyin. Taiyang requires sweating. For spontaneous diarrhea with body pain and no fever, it is a Yin syndrome; urgently rescue the interior with Sini Tang (Frigid Extremities Decoction), Fuzi Tang (Aconite Decoction), or Zhenwu Tang (True Warrior Decoction) removing Shaoyao and adding Ganjiang (Dried Ginger) or Guizhi (Cinnamon Twig). If severe pain persists after sweating, use Xiaojianzhong Tang (Minor Construct the Middle Decoction) to harmonize Ying and Wei. With muscle twitching, use Zhenwu Tang (True Warrior Decoction). Yin toxicity causing body pain like being beaten, or dampness/rheumatism causing heavy body pain, are detailed in Huoren Shu.
Spontaneous sweating has nine syndromes in Huoren Shu. Shaoyin should not sweat; if it does, it is due to deficient Yang failing to secure Yin fluids. Use Zhenwu Tang (True Warrior Decoction). Yangming usually sweats; if it doesn't and feels like insects crawling on skin, it is due to chronic deficiency and fluid exhaustion. Use Huangqi Jianzhong Tang (Astragalus Construct the Middle Decoction). Once fluids harmonize but Yangming symptoms persist, slowly use Xiaochaihu Tang (Minor Bupleurum Decoction). If Taiyang sweating leads to continuous leakage, wind aversion, use Guizhi Tang (Cinnamon Twig Decoction) with 1 qian Shu Fuzi (Prepared Aconite Root). With leakage, muscle twitching, and trembling, use Zhenwu Tang (True Warrior Decoction).
Head sweating syndromes: Thirst with dysuria leads to jaundice (see Jaundice). Chest/hypochondriac slight pain, head sweating, alternating chills/fever, irritability: Xiaochaihu Tang (Minor Bupleurum Decoction). Epigastric tightness, no high fever, only head sweating: Water Accumulation in the Chest. Differentiate by head sweating. Use Xiaobanxia Fuling Tang (Minor Pinellia and Polyporus Decoction) with double Fuling (Polyporus).
White tongue coating: Slight white is not necessarily heat. Thick white coating with prickly, cracked, dry texture, or black coating, indicates extreme heat. If accompanied by interior excess signs and no exterior signs, use Xiaochengqi Tang (Minor Order the Qi Decoction) or Daxiebai Tang (Major Bupleurum and Rhubarb Decoction - *Note: Text says Daxiebai but context implies Daxiachaihu or similar, sticking to text*). Yin syndrome with clear grain diarrhea, Yang floating in upper Jiao causing irritability and thirst, white/black coating, soot-like nose, desire to remove clothes: Do not mistake for Yang. Use Fuzi Lizhong Tang (Aconite Regulate Middle Decoction) or Sini Tang (Frigid Extremities Decoction) administered cold.
Both Yin and Yang diseases can cause Jue (Cold Extremities). Yang Jue is easily misdiagnosed. Ask initial symptoms. If no headache, cold limbs, curled legs, aversion to cold/sweating, covering self, no thirst, clear grain diarrhea, or normal urine, with clarity and quietness: Cold Jue (Yin within Yin). Use Sini Tang (Frigid Extremities Decoction) or Fuzi Lizhong Tang (Aconite Regulate Middle Decoction). If initial headache/fever, external Yang signs, Jue appearing on day 5-6, fear of heat, drinking water, tossing limbs, irritability, insomnia, constipation, red urine, confusion: Heat Jue (Yang within Yin). Use Baihu Tang (White Tiger Decoction) or Dachengqi Tang (Major Order the Qi Decoction). Heat Jue: hands/feet cold but nails warm; Cold Jue: all nails cold. This distinguishes Yin/Yang.
Recent cases: Yang disease, hot above waist, cold feet. Yin channels don't reach head (no headache); Yang channels don't reach feet (cold feet).
Sore throat: Two syndromes. Red face, skin spots like brocade, pus/blood sputum, sore throat: Yang Du Syndrome. Use Yangdu Shengma Tang (Yang Toxin Corydalis Decoction). Cold limbs, vomiting/diarrhea, sore throat: Shaoyin Syndrome. Use Tongmai Sini Tang (Unblocking Frigid Extremities Decoction) plus 1 qian Jiegeng (Platycodon Root).
Latent Qi in Shaoyin causing delayed onset sore throat followed by diarrhea: Banxia Guigan Tang (Pinellia and Cinnamon-Ginger-Licorice Decoction), called Kidney Cold Injury. Initial headache/fever, no Yang Du/Shaoyin signs, but sore throat: Caused by overdressing or drinking ginger/wine after cold, creating upper obstruction. Or pre-existing heat exposed to wind-cold. Use Shen Su Yin (Ginseng and Perilla Drink) with doubled Jiegeng and 0.5 qian Muxiang (Aucklandia Root), or Xiaofeng Baijie San (Wind-Dispersing Hundred-Resolve Powder), Baidu San (Hundred-Rescue Powder), or Wuji San (Five-Accumulations Powder). Half dose each of Baidu San is called Jiajia San.
Abdominal fullness/pain: Abdominal pain is interior. Taiyang abdomen doesn't hurt; Shaoyang has chest/hypochondriac pain but no abdominal pain. Yangming abdominal fullness/acute pain is interior excess: use Dachengqi Tang (Major Order the Qi Decoction) or Xiaochengqi Tang (Minor Order the Qi Decoction). Three Yin clear grain diarrhea with abdominal pain is interior cold: use Sini Tang (Frigid Extremities Decoction) or Fuzi Lizhong Tang (Aconite Regulate Middle Decoction). Yang transmitting to Taiyin causes fullness/pain: Real pain vs. Deficient pain. Bowel sounds/diarrhea pain is deficient: Xiaojianzhong Tang (Minor Construct the Middle Decoction) or Xiaochaihu Tang (Minor Bupleurum Decoction) removing Huangqin and adding Shaoyao. Fullness, constipation, tender on pressure is real pain: Guizhi Tang (Cinnamon Twig Decoction) plus 1 qian Dahuang (Rhubarb Root). Deficient/Real here refers to declining Yang pathogen vs. strong Yang Qi. Yang transmitting to Shaoyin, day 6-7, abdominal fullness, constipation: purge with Dachengqi Tang (Major Order the Qi Decoction). Pi (Glomus) and Jie Xiong (Chest Binding) result from mistaken purging. Chest hard/tender: Jie Xiong. Non-tender fullness: Pi. Exterior unresolved with aversion to cold: resolve exterior with Jiegeng Zhike Tang (Platycodon and Aurantium Decoction) + Guizhi Tang (Cinnamon Twig Decoction). Once exterior resolved, use Xiaoxianxiong Tang (Minor Chest-Breaking Decoction) for minor Jie Xiong, or Daxianxiong Tang (Major Chest-Breaking Decoction) for major. Cold-Real Jie Xiong (pain without irritability): Lizhong Tang (Regulate Middle Decoction) + Zhishi (Immature Bitter Orange) + Fuling (Polyporus), or Zhishi Lizhong Wan. Water Accumulation in Chest (no high fever, slight head sweat): Xiaobanxia Fuling Tang (Minor Pinellia and Polyporus Decoction). Cold Pi: Lizhong Tang + Zhishi + Fuling. Yang Pi with heat: Jiegeng Zhike Tang then Huanglian Xiexin Tang (Coptis Drain Heart Decoction). Heat with aversion to cold/sweat: Fuzi Xiexin Tang (Aconite Drain Heart Decoction). Exterior resolved, Stomach disharmony, epigastric hardness, belching food odor, borborygmus, diarrhea: Shengjiang Xiexin Tang (Fresh Ginger Drain Heart Decoction) or Gancao Xiexin Tang (Licorice Drain Heart Decoction). Mixed Yin/Yang Pi: Banxia Xiexin Tang (Pinellia Drain Heart Decoction). Pi with thirst/vomiting water: Wuling San (Five-Ingredient Powder with Poria). Spontaneous Pi: treat primary channel. Major Jie Xiong is Yang (can be Yin, use Lizhong); Pi is Yin (can be Yang, use Sanhuang cooling agents). Adapt to Yin/Yang changes.
Wheezing/Cough: Taiyang wheezing/cough (see Taiyang section). Shaoyang coughs but doesn't wheeze; if wheezing, not Shaoyang. Shaoyang cough: Xiaochaihu Tang (Minor Bupleurum Decoction) + Wuweizi (Schisandra) + Ganjiang (Dried Ginger). Yangming wheezes but doesn't cough; if coughing, not pure Yangming. Yangming wheezing with tidal fever: Dachengqi Tang (Major Order the Qi Decoction). Yin wheezing only in Shaoyin. Heavy limbs, pain, normal urine, loose stool, cough: Zhenwu Tang (True Warrior Decoction) removing Shaoyao, adding Wuweizi, Ganjiang, Xixin (Asarum). Cold limbs, abdominal pain, heavy diarrhea, cough: Sini Tang (Frigid Extremities Decoction) + Wuweizi, Ganjiang. Diarrhea, vomiting, thirst, irritability, insomnia, cough: Zhuling Tang (Polyporus Decoction). Severe Yin wheezing: Fanyin Dan (Reverse Yin Pill).
Delirium (Zhanyu) is Yang; muttering (Zhengsheng) is Yin. Excess causes Delirium; deficiency causes Muttering. Delirium: chaotic speech, talking to empty air, hallucinations. Muttering: repetitive, weak speech. Elderly with Yang deficiency mutter. Differentiate: Constipation, red urine, fever, thirst, delirium = Interior Excess. Normal urine, loose stool, irritability/fever, delirium = Yin blocking Yang. Treat Excess with Tiaowei Chengqi Tang (Regulating Stomach Decoction). Treat severe heat/restlessness/thirst with Lizhong Tang (Regulate Middle Decoction). Treat Yin blocking Yang with Wendan Tang (Warm Gallbladder Decoction), Sini Tang (Frigid Extremities Decoction), or Fuzi Lizhong Tang (Aconite Regulate Middle Decoction). Occasional delirium not strictly Yangming: treat per syndrome. Post-sweat calm but delirious: fluid disharmony, do not purge. Use Xiaochaihu Tang (Minor Bupleurum Decoction) + Jianzhong Tang (Construct Middle Decoction) to harmonize Ying/Wei. Yang transmitting to Yin, diarrhea, cold limbs, delirium: likely dry feces inside, still purge with Tiaowei Chengqi Tang (Regulating Stomach Decoction). Blood stasis: black stool, patent urine, lower abdominal pain, mania, delirium: Taohe Chengqi Tang (Peach Kernel Decoction). Women with Cold Damage, fever, stopped menses: Heat entering Blood Chamber, blood clots, delirium: Xiaochaihu Tang (Minor Bupleurum Decoction). Post-illness Qi/Spirit deficiency, dream-disturbance: not Delirium/Muttering. Use Wendan Tang (Warm Gallbladder Decoction) removing Zhuru (Bamboo Shavings) adding Renshen (Ginseng), or Liujunzi Tang (Six-Gentlemen Decoction).
Excessive Sleep: Four syndromes. Wind-Damp excessive sleep (Huoren Shu): do not sweat, use Baidu San (Hundred-Rescue Powder). Long-term insomnia suddenly desiring sleep without other illness: Yin/Yang harmony, recovery. Shaoyin desiring sleep: urgently use Sini Tang (Frigid Extremities Decoction). Huoxuo syndrome: sudden drowsiness, see Huoren Shu.