论曰。伤寒之法。先言表里。及有缓急。三阳表当急。里当缓。三阴表当缓。里当急。又曰。脉浮当汗。
脉沉当下。脉浮汗急而下缓。谓三阳表也。脉沉下急而汗缓。谓三阴里也。麻黄汤谓之急。麻黄附子细辛汤谓
之缓。内经云。有渍形以为汗。为汗之缓。里之表也。又曰在皮者汗而发之。为汗之急。表之表也。急汗者太
阳。缓汗者少阴。是脏腑之输应也。假令麻黄附子细辛汤。是少阴证。始得发热脉沉里和无汗。故渍形以为汗。
假令麻黄汤。是太阳证。头项痛腰脊强。脉浮无汗里和是也。在皮者汗而发之也。经曰。治主以缓。治客以急。
此之谓也。
麻黄汤
麻黄（去节五钱） 桂枝（三钱） 甘草（二钱炙） 杏仁（去皮尖炒二十个）
上 咀。都作一服。水煎去滓温服。
假令得肝脉。其外证善洁。面青善怒。其三部脉俱弦而浮。恶寒里和。谓清便自调也。麻黄汤内加羌活
防风各三钱。谓肝主风。是胆经受病。大便秘。或泄下赤水无数。皆里不和也。
假令得心脉。其外证面赤口干善笑。其尺寸脉俱浮而洪。恶寒里和。谓清便自调也。麻黄汤内加黄芩石膏
各三钱。谓主心热。是小肠受病也。
假令得脾脉。其外证面黄善噫善思善味。尺寸脉俱浮而缓。里和恶寒。麻黄汤内加白术防己各五钱。谓脾
主湿。是胃经受病也。
假令得肺脉。其外证面白善嚏。悲愁不乐欲哭。其尺寸脉俱浮而涩。里和恶寒。麻黄汤内加桂枝生姜各三
钱。谓肺主燥。是大肠受病也。
假令得肾脉。其外证面黑善恐。其尺寸脉俱浮。而里和恶寒。其麻黄汤内加附子生姜。谓肾主寒。是膀胱
受病也。
以上各五证。皆表之表。谓在皮者急汗而发之也。皆腑受病。表之里者。下之当缓。谓随脏表证。外显尺
寸脉俱浮。而复有里证。谓发热饮水便利赤涩。或泄下赤水。按之内实或痛。麻黄汤去麻黄杏仁。与随脏元加
药同煎。作五服。每下一证。初一服加大黄半钱。邪尽则止。未尽第二服加大黄一钱。邪未尽第三服加大黄一
钱半。如邪未尽。又加之。邪尽则止。此所谓先缓而后急。是表之里证。下之当缓也。
麻黄附子细辛汤
麻黄（半两去根节） 细辛（半两去苗土） 附子（一钱二分半炮裂去皮脐）
上 咀。都作一服。水煎去滓温服。
假令得肝脉。其内证满闭淋溲便难转筋。其尺寸脉俱沉而弦。里和恶寒。肝经受病。麻黄附子细辛汤内。
加羌活防风各三钱。
假令得心脉。其内证烦心心痛。掌中热而哕。其尺寸脉俱沉。里和恶寒。心经受病。加黄芩石膏各三钱。
假令得脾脉。其内证腹胀满食不消。怠惰嗜卧。其尺寸脉俱沉。里和恶寒。脾经受病。加白术防己各三钱。
假令得肺脉。其内证喘咳洒淅寒热。其尺寸脉俱沉。里和恶寒。肺经受病。加生姜桂枝各三钱。
假令得肾脉。其内证泄如下重。足胫寒而逆。其尺寸脉俱沉。里和恶寒。肾经受病。更加附子生姜各三钱。
以上五证。里之表也。宜渍形以为汗。皆脏受病也。里者下之当急。谓随脏内证。已显尺寸脉俱沉。复有
里证者。谓大小便秘涩或泄下赤水。或泻无数。不能饮食。不恶风寒。发热引饮。其脉俱沉。或按之内实而痛。
此谓里实。宜速下之。麻黄附子细辛内去麻黄。与随脏元加药内。分作三服。每下一证。初一服加大黄三钱。
邪尽则止。如邪未尽。再一服加大黄二钱。又未尽。第三服加大黄一钱。此先急而后缓。谓里之里也。当速下
之也。
通解利伤寒。不问何经所受。皆能混然解之。谓不犯各经之受病。虽不解尽。亦无坏证。
羌活汤
羌活（二两） 防风（一两） 川芎（一两） 黄芩（一两） 细辛（三钱半） 甘草（一两炒）
黑地黄（一两炒） 白术（三两如无用苍术加一两）
上 咀。每服五七钱。水二盏。煎至一盏。无时温服清。如觉发热引饮。加黄芩甘草各一两。更随证。如
头痛恶风。于白术汤一两内。加羌活散三钱。都作一服。
羌活散
羌活（一两半） 川芎（七钱） 细辛根（二钱半）
如身热。根据前加石膏汤四钱。
石膏汤
石膏（二两） 知母（半两） 白芷（七钱）
如腹中痛者。加芍药散三钱。
芍药散
芍药（二两） 桂枝（五钱）
如往来寒热而呕。加柴胡散二钱半。
柴胡散
柴胡根（一两） 半夏（五钱洗）
加生姜煎。如心下痞。加枳实一钱。如有里证。加大黄。初一服一钱。次二钱。又三钱。邪尽则止。
论曰。有汗不得服麻黄。无汗不得服桂枝。然春夏汗孔疏。虽有汗不当用桂枝。宜用黄 汤和解。秋冬汗
孔闭。虽无汗不当用麻黄。宜用川芎汤和解。春夏有汗。脉乃微而弱。恶风恶寒者。乃太阳证。秋冬之脉也。
亦宜黄 汤。无汗亦宜川芎汤。秋冬有汗。脉盛而浮。发热身热者。乃阳明证。春夏之脉也。亦宜黄 汤。
无汗亦宜川芎汤。大抵有汗者。皆可用黄 汤。无汗者亦可用川芎汤。
黄 汤 有汗则可止也。
黄 白术 防风（各等分）
上 咀。每服五七钱。至十余钱。或半两一两。水煎温服清。汗多恶风甚者。加桂枝。
川芎汤 无汗则可发也。
川芎 白术 羌活（各等分）
上 咀。同黄 汤煎法。稍热服。恶寒甚及脉大浮可加麻黄。法云。五脏之脉。寸关尺也。今止言尺寸阴
阳也。如阳缓而阴急。表和而里病。阴缓而阳急。里和而表病也。
若伤寒食少发渴。只可和胃止渴。不可太凉药止之。然恐
凉药止之。损着胃气。必不能食也。
和胃白术汤
白术 茯苓
起卧不能谓之湿。身重是也。小柴胡汤黄芩芍药汤。
起卧不安。眠睡不稳。谓之烦。栀豉汤竹叶石膏汤。解利四时伤寒。混解六经。不犯禁忌。
大白术汤
白术（二两） 防风 羌活 川芎（各一两） 黄芩（五钱） 细辛（三钱） 白芷（一两半） 石膏（二两）
知母（七钱） 甘草（五钱或一两） 枳实（五钱去穣）
上为粗末。每服半两水一盏半。煎至一盏。大温服清。未解更一服两服。药滓又作一服。春倍防风羌活。夏倍黄芩
知母。季夏雨淫倍白术白芷。秋加桂枝五钱。冬桂枝八钱或一两。立夏之后至立秋处暑之间伤寒者。身多微凉。
微有自汗。四肢沉重。谓之湿温。又谓之湿淫。宜苍术石膏汤。
苍术石膏汤
苍术（半两） 石膏（三钱） 知母（一钱半） 甘草（一钱）
上 细。同和均。都作一服。水二盏。煎至一盏。温服清。谓内有湿热也。多不欲饮水。如身热脉洪无汗
多渴者。是热在上焦。积于胸中。宜桔梗散治之。
桔梗散
薄荷 黄芩 甘草 山栀子（各一钱） 桔梗（半两） 连翘（二钱）
上 。每服五钱或七钱。秤半两水煎。加竹叶。如大便秘结。加大黄半钱。
论述说：治疗伤寒的方法，首先要分辨表证和里证，以及病势的缓急。三阳经的病，表证应当急治，里证应当缓治；三阴经的病，表证应当缓治，里证应当急治。又说：脉象浮的应当用发汗法，脉象沉的应当用攻下法。脉浮而发汗急、攻下缓，这是指三阳经的表证；脉沉而攻下急、发汗缓，这是指三阴经的里证。麻黄汤属于急汗法，麻黄附子细辛汤属于缓汗法。《内经》说：“通过浸渍形体来取汗”，这是缓汗法，适用于里证的表层（即半表半里或里之表）。又说：“病在皮肤的，用发汗法发散”，这是急汗法，适用于表证的表层（即太阳表证）。急汗对应太阳经，缓汗对应少阴经，这是脏腑经络输注相应的关系。假如是麻黄附子细辛汤证，这是少阴病，刚发病时发热、脉沉、里气平和但无汗，所以用浸渍形体取汗的方法。假如是麻黄汤证，这是太阳病，头项痛、腰脊强直、脉浮、无汗、里气平和，这就是“病在皮肤，用发汗法发散”。经文说：“治主证用缓法，治客邪用急法”，说的就是这个道理。
麻黄汤
麻黄（去节五钱） 桂枝（三钱） 甘草（二钱，炙） 杏仁（去皮尖，炒二十个）
以上药物捣碎，共为一服量。用水煎煮，去渣，温服。
假如诊得肝脉，其外证表现为爱干净、面色青、易怒，寸关尺三部脉都弦而浮，恶寒但里气平和（即大小便正常）。这是因为肝主风，胆经受病。如果大便秘结，或者泻下赤色水样便无数，都是里气不和的表现。此时在麻黄汤中加入羌活、防风各三钱。
假如诊得心脉，其外证表现为面色红、口干、易笑，寸尺脉都浮而洪大，恶寒但里气平和（即大小便正常）。这是因为心主热，小肠受病。此时在麻黄汤中加入黄芩、石膏各三钱。
假如诊得脾脉，其外证表现为面色黄、多嗳气、多思虑、味觉敏感，寸尺脉都浮而缓，里气平和但恶寒。这是因为脾主湿，胃经受病。此时在麻黄汤中加入白术、防己各五钱。
假如诊得肺脉，其外证表现为面色白、易打喷嚏、悲伤忧愁不乐想哭，寸尺脉都浮而涩，里气平和但恶寒。这是因为肺主燥，大肠受病。此时在麻黄汤中加入桂枝、生姜各三钱。
假如诊得肾脉，其外证表现为面色黑、易恐惧，寸尺脉都浮，里气平和但恶寒。这是因为肾主寒，膀胱受病。此时在麻黄汤中加入附子、生姜。
以上五种证候，都属于表证的表层，即“病在皮肤”，应当急汗发散。这些都是腑受病。如果是表证的里层（即半表半里或里之表），攻下应当缓治。表现为随脏病的表证，外部显现寸尺脉俱浮，但又伴有里证，如发热、口渴饮水、小便赤涩，或者泻下赤色水样便，按压腹部感觉内部坚实或疼痛。此时用麻黄汤去掉麻黄、杏仁，与随脏原加的药物同煎，分为五服。每针对一种证候，第一服加大黄半钱，邪气尽则停药；若邪未尽，第二服加大黄一钱；若邪未尽，第三服加大黄一钱半。如果邪气仍未尽，继续增加剂量，直到邪气尽则停药。这叫做先缓后急，是表证的里证，攻下应当缓治。
麻黄附子细辛汤
麻黄（半两，去根节） 细辛（半两，去苗土） 附子（一钱二分半，炮裂，去皮脐）
以上药物捣碎，共为一服量。用水煎煮，去渣，温服。
假如诊得肝脉，其内证表现为胸满闭塞、小便淋漓困难、大便难、转筋，寸尺脉都沉而弦，里气平和但恶寒。这是肝经受病。在麻黄附子细辛汤中加入羌活、防风各三钱。
假如诊得心脉，其内证表现为心烦心痛、手掌心热且呃逆，寸尺脉都沉，里气平和但恶寒。这是心经受病。加入黄芩、石膏各三钱。
假如诊得脾脉，其内证表现为腹胀满、食物不消化、倦怠嗜卧，寸尺脉都沉，里气平和但恶寒。这是脾经受病。加入白术、防己各三钱。
假如诊得肺脉，其内证表现为喘咳、洒淅恶寒发热，寸尺脉都沉，里气平和但恶寒。这是肺经受病。加入生姜、桂枝各三钱。
假如诊得肾脉，其内证表现为泄泻、肛门重坠感、足胫寒冷逆冷，寸尺脉都沉，里气平和但恶寒。这是肾经受病。再加附子、生姜各三钱。
以上五种证候，属于里证的表层（即半表半里或里之表），适宜用浸渍形体取汗的方法。这都是脏受病。如果是里证，攻下应当急治。表现为随脏的内证，已经显现寸尺脉俱沉，又伴有里证，如大小便秘涩或泻下赤色水样便，或者腹泻无数、不能饮食、不恶风寒、发热引饮，脉象都沉，或者按压腹部内部坚实而疼痛。这叫作里实证，应当迅速攻下。在麻黄附子细辛汤中去掉麻黄，与随脏原加的药物混合，分作三服。每针对一种证候，第一服加大黄三钱，邪气尽则停药；若邪未尽，再服加大黄二钱；若仍未尽，第三服加大黄一钱。这叫先急后缓，是里证的里层，应当速下。
通解利伤寒方，不问哪一经受病，都能浑然化解。即不触犯各经的禁忌，即使不能完全治愈，也不会出现坏证。
羌活汤
羌活（二两） 防风（一两） 川芎（一两） 黄芩（一两） 细辛（三钱半） 甘草（一两，炒）
地黄（一两，炒） 白术（三两，如无可用苍术加一两）
以上药物捣碎。每服五至七钱，用水二盏，煎至一盏，不拘时候温服清汁。如果觉得发热口渴，加黄芩、甘草各一两。再根据症状调整，如头痛恶风，在白术汤一两药中，加羌活散三钱，共为一服。
羌活散
羌活（一两半） 川芎（七钱） 细辛根（二钱半）
如果身体发热，按前法加石膏汤四钱。
石膏汤
石膏（二两） 知母（半两） 白芷（七钱）
如果腹中疼痛，加芍药散三钱。
芍药散
芍药（二两） 桂枝（五钱）
如果往来寒热且呕吐，加柴胡散二钱半。
柴胡散
柴胡根（一两） 半夏（五钱，洗）
加生姜煎煮。如果心下痞满，加枳实一钱。如果有里证，加大黄。第一服一钱，第二服二钱，第三服三钱，邪气尽则停药。
论述说：有汗者不得服用麻黄，无汗者不得服用桂枝。然而春夏季节汗孔疏松，即使有汗也不当用桂枝，宜用黄汤（玉屏风散类）和解。秋冬季节汗孔闭合，即使无汗也不当用麻黄，宜用川芎汤和解。春夏有汗，脉象微而弱，恶风恶寒，这是太阳病在秋冬季节出现的脉象特征，也宜用黄汤。无汗也宜用川芎汤。秋冬有汗，脉象盛大而浮，发热身热，这是阳明病在春夏季节出现的脉象特征，也宜用黄汤。无汗也宜用川芎汤。大体而言，有汗者皆可用黄汤，无汗者也可用川芎汤。
黄汤（玉屏风散）：有汗则可止汗。
黄芪 白术 防风（各等分）
以上药物捣碎。每服五至七钱，至十余钱，或半两、一两，用水煎煮，温服清汁。汗多恶风严重者，加桂枝。
川芎汤：无汗则可发汗。
川芎 白术 羌活（各等分）
以上药物捣碎，同黄汤煎法，稍热服。恶寒甚及脉大浮者可加麻黄。医法云：五脏之脉分寸关尺，这里只言寸尺阴阳。如阳缓而阴急，是表和而里病；阴缓而阳急，是里和而表病。
如果伤寒食少发渴，只可调和胃气止渴，不可用太凉的药止渴。否则恐怕凉药会损伤胃气，必然导致不能进食。
和胃白术汤
白术 茯苓
起卧不安称为湿，身体沉重即是此证。用小柴胡汤、黄芩芍药汤。
起卧不安稳，睡眠不稳，称为烦。用栀豉汤、竹叶石膏汤。
解利四时伤寒，混解六经，不犯禁忌。
大白术汤
白术（二两） 防风 羌活 川芎（各一两） 黄芩（五钱） 细辛（三钱） 白芷（一两半） 石膏（二两）
知母（七钱） 甘草（五钱或一两） 枳实（五钱，去瓤）
以上为粗末。每服半两，水一盏半，煎至一盏，大温服清汁。未解再服一两服，药渣再煎一服。春季加倍防风、羌活；夏季加倍黄芩、知母；长夏雨水过多加倍白术、白芷；秋季加桂枝五钱；冬季加桂枝八钱或一两。立夏之后至立秋处暑之间患伤寒者，身体多微凉，微有自汗，四肢沉重，称为湿温，又称湿淫。宜用苍术石膏汤。
苍术石膏汤
苍术（半两） 石膏（三钱） 知母（一钱半） 甘草（一钱）
以上药物研细，混合均匀，共为一服量。用水二盏，煎至一盏，温服清汁。这是内有湿热。大多不想喝水。如果身体发热、脉洪大、无汗、多口渴，这是热在上焦，积聚于胸中，宜用桔梗散治疗。
桔梗散
薄荷 黄芩 甘草 山栀子（各一钱） 桔梗（半两） 连翘（二钱）
以上药物捣碎。每服五钱或七钱，称半两，用水煎煮，加竹叶。如果大便秘结，加大黄半钱。
It is stated that the method for treating Shanghan (Cold Damage) first requires distinguishing between exterior and interior syndromes, as well as the urgency or slackness of the condition. For the Three Yang meridians, the exterior syndrome should be treated urgently, while the interior syndrome should be treated with caution/slowly; for the Three Yin meridians, the exterior syndrome should be treated with caution/slowly, while the interior syndrome should be treated urgently. It is also said: a floating pulse indicates the need for sweating therapy, while a deep pulse indicates the need for purgation therapy. A floating pulse with urgent sweating and slow purgation refers to the exterior syndrome of the Three Yang meridians; a deep pulse with urgent purgation and slow sweating refers to the interior syndrome of the Three Yin meridians. Mahuang Tang (Ephedra Decoction) represents urgent sweating, while Mahuang Fuzi Xixin Tang (Ephedra, Prepared Aconite, and Asarum Decoction) represents slow sweating. The *Neijing* (Inner Canon) states: "Soaking the body to induce sweat" is a slow sweating method, applicable to the exterior of the interior (semi-exterior/semi-interior). It also states: "For pathogens in the skin, use sweating to disperse them," which is an urgent sweating method, applicable to the exterior of the exterior (Taiyang exterior syndrome). Urgent sweating corresponds to the Taiyang meridian, and slow sweating corresponds to the Shaoyin meridian; this reflects the correspondence of zang-fu organ meridians. For example, in Mahuang Fuzi Xixin Tang syndrome, this is a Shaoyin disease. Upon initial onset, there is fever, a deep pulse, harmonious interior qi but no sweat, so the method of soaking the body to induce sweat is used. For example, in Mahuang Tang syndrome, this is a Taiyang disease characterized by headache and stiffness of the head and neck, stiffness of the lower back and spine, a floating pulse, no sweat, and harmonious interior qi. This corresponds to "pathogens in the skin, use sweating to disperse." The classic says: "Treat the primary condition with a gentle approach, treat the pathogenic factor with an urgent approach." This is what is meant.
Mahuang Tang (Ephedra Decoction)
Ephedrae Herba (Mahuang, 麻黄) - five qian, remove joints; Cinnamomi Ramulus (Guizhi, 桂枝) - three qian; Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) - two qian, honey-fried; Armeniacae Semen Amarum (Xingren, 杏仁) - twenty seeds, remove skins and tips, stir-fried.
Crush the above herbs. Prepare as one dose. Decoct in water, remove dregs, and take warm.
If the Liver pulse is obtained, the external signs include a preference for cleanliness, bluish complexion, and irritability. The pulses at Cun, Guan, and Chi positions are all wiry and floating. There is aversion to cold but the interior is harmonious (i.e., normal urination and defecation). This is because the Liver governs Wind, and the Gallbladder meridian is affected. If there is constipation or profuse watery diarrhea with red color, it indicates disharmony of the interior. In this case, add Qianghuo (Notopterygii Rhizoma et Radix) and Fangfeng (Saposhnikoviae Radix), each three qian, to Mahuang Tang.
If the Heart pulse is obtained, the external signs include a ruddy complexion, dry mouth, and excessive laughter. The pulses at Cun and Chi positions are both floating and surging. There is aversion to cold but the interior is harmonious. This is because the Heart governs Heat, and the Small Intestine is affected. In this case, add Huangqin (Scutellariae Radix) and Shigao (Gypsum Fibrosum), each three qian, to Mahuang Tang.
If the Spleen pulse is obtained, the external signs include a sallow complexion, frequent belching, excessive thinking, and heightened taste sensitivity. The pulses at Cun and Chi positions are both floating and moderate. The interior is harmonious but there is aversion to cold. This is because the Spleen governs Dampness, and the Stomach meridian is affected. In this case, add Baizhu (Atractylodis Macrocephalae Rhizoma) and Fangji (Stephaniae Tetrandrae Radix), each five qian, to Mahuang Tang.
If the Lung pulse is obtained, the external signs include a pale complexion, frequent sneezing, sadness, sorrow, unhappiness, and a desire to cry. The pulses at Cun and Chi positions are both floating and choppy. The interior is harmonious but there is aversion to cold. This is because the Lung governs Dryness, and the Large Intestine is affected. In this case, add Guizhi (Cinnamomi Ramulus) and Shengjiang (Zingiberis Rhizoma Recens), each three qian, to Mahuang Tang.
If the Kidney pulse is obtained, the external signs include a dark complexion and excessive fear. The pulses at Cun and Chi positions are floating, and the interior is harmonious but there is aversion to cold. This is because the Kidney governs Cold, and the Bladder is affected. In this case, add Fuzi (Aconiti Lateralis Radix Praeparata) and Shengjiang (Zingiberis Rhizoma Recens) to Mahuang Tang.
The above five syndromes all belong to the exterior of the exterior ("pathogens in the skin") and should be treated with urgent sweating to disperse them. These are all Fu-organ diseases. For the interior of the exterior (semi-exterior/semi-interior), purgation should be performed slowly. This presents as an exterior syndrome of the respective Zang organ, with floating pulses at Cun and Chi externally, accompanied by interior symptoms such as fever, thirst for drinking, dark and scanty urination, or profuse watery diarrhea with red color. Palpation reveals internal fullness or pain. In this case, remove Mahuang (Ephedrae Herba) and Xingren (Armeniacae Semen Amarum) from Mahuang Tang, decoct together with the original added herbs for the specific Zang organ, and divide into five doses. For each syndrome, start with Banxia (Pinelliae Rhizoma) half a qian in the first dose; stop if the pathogen is exhausted. If not exhausted, increase to one qian in the second dose; if still not exhausted, increase to one and a half qian in the third dose. Continue increasing if necessary, stopping when the pathogen is exhausted. This is called "first slow, then urgent," referring to the interior of the exterior syndrome, where purgation should be slow.
Mahuang Fuzi Xixin Tang (Ephedra, Prepared Aconite, and Asarum Decoction)
Ephedrae Herba (Mahuang, 麻黄) - half liang, remove roots and joints; Asari Radix et Rhizoma (Xixin, 细辛) - half liang, remove seedlings and soil; Aconiti Lateralis Radix Praeparata (Fuzi, 附子) - one qian two fen half, processed until cracked, remove skin and root end.
Crush the above herbs. Prepare as one dose. Decoct in water, remove dregs, and take warm.
If the Liver pulse is obtained, the internal signs include chest fullness and obstruction, dribbling dysuria, difficult defecation, and muscle spasms. The pulses at Cun and Chi positions are both deep and wiry. The interior is harmonious but there is aversion to cold. This is a Liver meridian disease. Add Qianghuo (Notopterygii Rhizoma et Radix) and Fangfeng (Saposhnikoviae Radix), each three qian, to Mahuang Fuzi Xixin Tang.
If the Heart pulse is obtained, the internal signs include vexation, heart pain, heat in the palms, and hiccups. The pulses at Cun and Chi positions are both deep. The interior is harmonious but there is aversion to cold. This is a Heart meridian disease. Add Huangqin (Scutellariae Radix) and Shigao (Gypsum Fibrosum), each three qian.
If the Spleen pulse is obtained, the internal signs include abdominal distension and fullness, indigestion, lethargy, and drowsiness. The pulses at Cun and Chi positions are both deep. The interior is harmonious but there is aversion to cold. This is a Spleen meridian disease. Add Baizhu (Atractylodis Macrocephalae Rhizoma) and Fangji (Stephaniae Tetrandrae Radix), each three qian.
If the Lung pulse is obtained, the internal signs include wheezing, coughing, chills, and alternating fever. The pulses at Cun and Chi positions are both deep. The interior is harmonious but there is aversion to cold. This is a Lung meridian disease. Add Shengjiang (Zingiberis Rhizoma Recens) and Guizhi (Cinnamomi Ramulus), each three qian.
If the Kidney pulse is obtained, the internal signs include diarrhea with a sensation of heaviness in the anus, and coldness with reversal in the calves and feet. The pulses at Cun and Chi positions are both deep. The interior is harmonious but there is aversion to cold. This is a Kidney meridian disease. Add Fuzi (Aconiti Lateralis Radix Praeparata) and Shengjiang (Zingiberis Rhizoma Recens), each three qian.
The above five syndromes belong to the exterior of the interior (semi-exterior/semi-interior) and are suitable for soaking the body to induce sweat. These are all Zang-organ diseases. For interior syndromes, purgation should be urgent. This presents as internal signs of the respective Zang organ, with deep pulses at Cun and Chi, accompanied by interior symptoms such as constipation or difficult urination/defecation, profuse watery diarrhea with red color, or endless diarrhea, inability to eat, absence of aversion to wind and cold, fever with thirst, deep pulses, or internal fullness and pain upon palpation. This is referred to as Interior Excess Syndrome, requiring rapid purgation. Remove Mahuang (Ephedrae Herba) from Mahuang Fuzi Xixin Tang, mix with the original added herbs for the specific Zang organ, and divide into three doses. For each syndrome, start with Dahuang (Rhei Radix et Rhizoma) three qian in the first dose; stop if the pathogen is exhausted. If not exhausted, increase to two qian in the next dose; if still not exhausted, increase to one qian in the third dose. This is called "first urgent, then slow," referring to the interior of the interior, requiring rapid purgation.
Tongjie Li Shanghan (General Resolution for Cold Damage) can resolve conditions regardless of which meridian is affected, without violating the contraindications of each meridian. Even if not completely cured, it will not lead to complicated syndromes.
Qianghuo Tang (Notopterygium Decoction)
Notopterygii Rhizoma et Radix (Qianghuo, 羌活) - two liang; Saposhnikoviae Radix (Fangfeng, 防风) - one liang; Chuanxiong Rhizoma (Chuanxiong, 川芎) - one liang; Scutellariae Radix (Huangqin, 黄芩) - one liang; Asari Radix et Rhizoma (Xixin, 细辛) - three qian half; Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) - one liang, stir-fried; Rehmanniae Radix Preparata (Sheng Dihuang, 生地黄) - one liang, stir-fried; Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) - three liang (if unavailable, use Atractylodis Rhizoma/Cangzhu and add one liang).
Crush the above herbs. Take five to seven qian per dose. Decoct in two zhan of water until one zhan remains. Take warm clear liquid at any time. If fever and thirst occur, add Huangqin (Scutellariae Radix) and Gancao (Glycyrrhizae Radix et Rhizoma), each one liang. Further adjust according to symptoms. For headache and aversion to wind, add Qianghuo San (Notopterygium Powder) three qian to one liang of Baizhu Tang. Prepare as one dose.
Qianghuo San (Notopterygium Powder)
Notopterygii Rhizoma et Radix (Qianghuo, 羌活) - one liang half; Chuanxiong Rhizoma (Chuanxiong, 川芎) - seven qian; Asari Radix et Rhizoma (Xixin, 细辛) root - two qian half.
If there is body heat, add Shigao Tang (Gypsum Decoction) four qian according to the previous method.
Shigao Tang (Gypsum Decoction)
Gypsum Fibrosum (Shigao, 石膏) - two liang; Anemarrhenae Rhizoma (Zhimu, 知母) - half liang; Angelicae Dahuricae Radix (Baizhi, 白芷) - seven qian.
If there is abdominal pain, add Shaoyao San (Peony Powder) three qian.
Shaoyao San (Peony Powder)
Paeoniae Radix Alba (Shaoyao, 芍药) - two liang; Cinnamomi Ramulus (Guizhi, 桂枝) - five qian.
If there is alternating chills and fever with vomiting, add Chaihu San (Bupleurum Powder) two qian half.
Chaihu San (Bupleurum Powder)
Bupleuri Radix (Chaihu Gen, 柴胡根) - one liang; Pinelliae Rhizoma (Banxia, 半夏) - five qian, washed.
Decoct with fresh ginger. If there is epigastric stuffiness, add Zhi Shi (Aurantii Fructus Immaturus) one qian. If there are interior signs, add Dahuang (Rhei Radix et Rhizoma). First dose one qian, second dose two qian, third dose three qian. Stop when the pathogen is exhausted.
It is stated: Those with sweat should not take Mahuang; those without sweat should not take Guizhi. However, in Spring and Summer, pores are loose; even with sweat, Guizhi should not be used. Instead, use Huangqi Tang (Astragalus Decoction, likely referring to Yù Píng Fēng Sǎn variant) to harmonize. In Autumn and Winter, pores are closed; even without sweat, Mahuang should not be used. Instead, use Chuanxiong Tang (Chuanxiong Decoction) to harmonize. In Spring and Summer, with sweat, the pulse is slightly weak, with aversion to wind and cold; this is a Taiyang syndrome presenting with Autumn/Winter pulse characteristics. It is also suitable for Huangqi Tang. Without sweat, Chuanxiong Tang is also suitable. In Autumn and Winter, with sweat, the pulse is vigorous and floating, with fever and body heat; this is a Yangming syndrome presenting with Spring/Summer pulse characteristics. It is also suitable for Huangqi Tang. Without sweat, Chuanxiong Tang is also suitable. Generally, those with sweat can use Huangqi Tang, and those without sweat can use Chuanxiong Tang.
Huangqi Tang (Astragalus Decoction): Can stop sweat when present.
Astragali Radix (Huangqi, 黄芪); Atractylodis Macrocephalae Rhizoma (Baizhu, 白术); Saposhnikoviae Radix (Fangfeng, 防风) (equal parts).
Crush the above herbs. Take five to seven qian, up to ten-plus qian, or half liang to one liang per dose. Decoct in water, take warm clear liquid. For severe sweating and aversion to wind, add Guizhi (Cinnamomi Ramulus).
Chuanxiong Tang (Chuanxiong Decoction): Can induce sweat when absent.
Chuanxiong Rhizoma (Chuanxiong, 川芎); Atractylodis Macrocephalae Rhizoma (Baizhu, 白术); Notopterygii Rhizoma et Radix (Qianghuo, 羌活) (equal parts).
Crush the above herbs. Decoct using the same method as Huangqi Tang. Take slightly warm. For severe aversion to cold and large, floating pulse, Mahuang (Ephedrae Herba) can be added. The method states: The pulses of the Five Zang organs are divided into Cun, Guan, and Chi. Here, only Cun and Chi Yin-Yang are mentioned. If Yang is slack and Yin is tight, the exterior is harmonious and the interior is diseased. If Yin is slack and Yang is tight, the interior is harmonious and the exterior is diseased.
If Shanghan presents with poor appetite and thirst, only harmonize the Stomach and stop thirst. Do not use overly cold medicines to stop thirst, lest they damage Stomach Qi, leading to inability to eat.
Hewei Baizhu Tang (Stomach-Harmonizing Atractylodes Decoction)
Atractylodis Macrocephalae Rhizoma (Baizhu, 白术); Poria (Fuling, 茯苓).
Restlessness in rising and lying down is called Dampness, manifested as heavy body. Use Xiaochaihu Tang (Minor Bupleurum Decoction) and Huangqin Shaoyao Tang (Scutellaria and Peony Decoction).
Restlessness in rising and lying down, unstable sleep, is called Vexation. Use Zhichi Tang (Gardenia and Soybean Decoction) and Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction).
To resolve Four Seasons Shanghan, harmonize the Six Meridians generally, without violating contraindications.
Dabaizhu Tang (Major Atractylodes Decoction)
Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) - two liang; Saposhnikoviae Radix (Fangfeng, 防风); Notopterygii Rhizoma et Radix (Qianghuo, 羌活); Chuanxiong Rhizoma (Chuanxiong, 川芎) (each one liang); Scutellariae Radix (Huangqin, 黄芩) - five qian; Asari Radix et Rhizoma (Xixin, 细辛) - three qian; Angelicae Dahuricae Radix (Baizhi, 白芷) - one liang half; Gypsum Fibrosum (Shigao, 石膏) - two liang; Anemarrhenae Rhizoma (Zhimu, 知母) - seven qian; Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) - five qian or one liang; Aurantii Fructus Immaturus (Zhi Shi, 枳实) - five qian, remove pith.
Grind into coarse powder. Take half liang per dose, decoct in one and a half zhan of water until one zhan remains. Take very warm clear liquid. If unresolved, take another one or two doses. The dregs can be decocted again once. In Spring, double Fangfeng and Qianghuo. In Summer, double Huangqin and Zhimu. In Late Summer with excessive rain, double Baizhu and Baizhi. In Autumn, add Guizhi (Cinnamomi Ramulus) five qian. In Winter, add Guizhi eight qian or one liang. For Shanghan occurring after Start of Summer until Start of Autumn and End of Heat, the body is often slightly cool, with slight spontaneous sweating and heavy limbs. This is called Wet-Warmth or Damp-Influence. Use Cangzhu Shigao Tang (Atractylodis Rhizoma and Gypsum Decoction).
Cangzhu Shigao Tang (Atractylodis Rhizoma and Gypsum Decoction)
Atractylodae Rhizoma (Cangzhu, 苍术) - half liang; Gypsum Fibrosum (Shigao, 石膏) - three qian; Anemarrhenae Rhizoma (Zhimu, 知母) - one qian half; Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) - one qian.
Grind finely, mix evenly. Prepare as one dose. Decoct in two zhan of water until one zhan remains. Take warm clear liquid. This indicates internal Damp-Heat. There is usually no desire to drink. If there is body heat, surging pulse, no sweat, and excessive thirst, this is Heat in the Upper Jiao, accumulated in the chest. Treat with Jiegeng San (Platycodon Powder).
Jiegeng San (Platycodon Powder)
Menthae Haplocalycis Herba (Bohe, 薄荷); Scutellariae Radix (Huangqin, 黄芩); Glycyrrhizae Radix et Rhizoma (Gancao, 甘草); Gardeniae Fructus (Shanzhizi, 山栀子) (each one qian); Platycodonis Radix (Jiegeng, 桔梗) - half liang; Forsythiae Fructus (Lianqiao, 连翘) - two qian.
Crush the above herbs. Take five or seven qian per dose, weigh half liang, decoct in water, add Bamboo Leaves (Zhuye, 竹叶). If severe constipation, add Dahuang (Rhei Radix et Rhizoma) half a qian.