师曰∶病患脉微而涩者，此为医所病也，大发其汗，又数大下之，其人亡血，病当恶寒而发热，无休止时。夏月盛
热而与（仲景作欲）着复衣，冬月盛寒而与（仲景作欲）裸其体。所以然者，阳微即恶寒，阴弱即发热，故（仲景作医）
发其汗，使阳气微，又大下之，令阴气弱。五月之时，阳气在表，胃中虚冷，以阳气内微，不能胜冷，故与（仲景作欲）
着复衣。十一月之时，阳气在里，胃中烦热，以阴气内弱，不能胜热，故与（仲景作欲）裸其体。又阴脉迟涩，故知亡
血。
太阳病三日，已发其汗，吐下、温针而不解，此为坏病，桂枝复不中与也。观其脉证，知犯何逆，随证而治之。脉
浮数，法当汗出而愈，而下之，则身体重，心悸，不可发其汗，当自汗出而解。所以然者，尺中脉微，此里虚，须表里
实，津液和，即自汗出愈。凡病若发汗，若吐，若下，若亡血，无津液而阴阳自和者，必自愈。大下后，发汗，其人小
便不利，此亡津液，勿治，其小便利，必自愈。下以后，复发其汗，必振寒，又其脉微细。所以然者，内外俱虚故也。
太阳病，先下而不愈，因复发其汗，表里俱虚，其人因冒。冒家当汗出自愈。所以然者，汗出表和故也。表和，然
后下之。得病，六、七日，脉迟浮弱，恶风寒，手足温。医再三下之，不能多（多一作食），其人胁下满，面目及身黄，
颈项强，小便难，与柴胡汤，后必下重，本渴，饮水而呕，柴胡汤复不中与也，食谷者哕。
太阳病，二、三日，终不能卧，但欲起者，心下必结，其脉微弱者，此本寒也。而反下之，利止者，必结胸；未止
者，四、五日复重下之。此挟热利也。
太阳病，下之，其脉促，不结胸者，此为欲解。其脉浮者，必结胸。其脉紧者，必咽痛。其脉弦者，必两胁拘急。
其脉细而数者，头痛未止。其脉沉而紧者，必欲呕。其脉沉而滑者，挟热利。其脉浮而滑者，必下血。
太阳少阳并病，而反下之，成结胸，心下坚，下利不复止，水浆不肯下，其人必心烦。脉浮紧，而下之，紧反入里，
则作痞，按之自濡，但气痞耳。伤寒吐下、发汗，虚烦，脉甚微，八、九日心下痞坚，胁下痛，气上冲咽喉，眩冒，经
脉动惕者，久而成痿。
阳明病，不能食，下之不解，其人不能食。攻其热必哕，所以然者，胃中虚冷故也。
阳明病，脉迟，食难用饱，饱即发烦、头眩者，必小便难，此欲作谷疸。虽下之，其腹满如故耳。所以然者，脉迟
故也。
太阳病，寸缓关浮尺弱，其人发热而汗出，复恶寒，不呕，但心下痞者，此为医下之也。伤寒，大吐大下之，极虚，
复极汗者，其人外气怫郁，复与之水，以发其汗，因得哕。所以然者，胃中寒冷故也。吐、下、发汗后，其人脉平，而
小烦者，以新虚不胜谷气故也。
太阳病，医发其汗，遂发热而恶寒，复下之，则心下痞，此表里俱虚，阴阳气并竭，无阳则阴独。复加火针，因而
烦，面色青黄，肤 ，如此者，为难治。今色微黄，手足温者，易愈。服桂枝汤，下之，头项强痛，翕翕发热，无汗，
心下满微痛，小便不利，属桂枝去桂加茯苓术汤。
太阳病，先发其汗，不解，而下之，其脉浮者，不愈。浮为在外，而反下之，故令不愈。今脉浮，故在外，当解其
外则愈，属桂枝汤。下以后，复发其汗者，则昼日烦躁不眠，夜而安静，不呕不渴，而无表证，其脉沉微，身无大热，
属干姜附子汤。伤寒吐、下、发汗后，心下逆满，气上撞胸，起即头眩，其脉沉紧，发汗即动经，身为振摇，属茯苓桂
枝术甘草汤。发汗、吐、下以后，不解，烦躁，属茯苓四逆汤。伤寒发汗、吐、下后，虚烦不得眠。剧者，反复颠倒，
心中懊 ，属栀子汤。若少气，栀子甘草汤。若呕，栀子生姜汤。若腹满者，栀子浓朴汤。发汗若下之，烦热，胸中塞
者，属栀子汤证。太阳病，过经十余日，心下温温欲吐而胸中痛，大便反溏，其腹微满，郁郁微烦，先时自极吐下者，
与承气汤。不尔者，不可与。欲呕，胸中痛，微溏，此非柴胡汤证，以呕故知极吐下也。太阳病，重发其汗，而复下之，
不大便五、六日，舌上燥而渴，日晡所小有潮热，从心下至少腹坚满，而痛不可近，属大陷胸汤。伤寒五、六日，其人
已发汗，而复下之，胸胁满微结，小便不利，渴而不呕，但头汗出，往来寒热，心烦，此为未解，属柴胡桂枝干姜汤。
伤寒汗出，若吐下，解后，心下痞坚，噫气不除者，属旋复代赭汤。大下以后，不可更行桂枝汤。汗出而喘，无大热，
可以麻黄杏子甘草石膏汤。伤寒大下后，复发其汗，心下痞，恶寒者，表未解也，不可攻其痞，当先解表，表解，乃攻
其痞。解表属桂枝汤，攻痞属大黄黄连泻心汤。伤寒吐下后，七、八日不解，热结在里，表里俱热，时时恶风，大渴，
舌上干燥而烦，欲饮水数升，属白虎汤。伤寒吐下后未解，不大便五、六日至十余日，其人日晡所发潮热，不恶寒，独
语如见鬼神之状。若剧者，发则不识人，循衣妄撮，怵惕不安，微喘直视。脉弦者生，涩者死。微者，但发热谵语，属
承气汤。若下者，勿复服。三阳合病，腹满身重，难以转侧，口不仁，面垢，谵语，遗溺。发汗则谵语，下之则额上生
汗，手足厥冷，自汗，属白虎汤证。
阳明病，其脉浮紧，咽干口苦，腹满而喘，发热汗出，而不恶寒，反偏恶热，其身体重，发其汗即躁，心愦愦而反
谵语。加温针，必怵惕，又烦躁不得眠。下之，即胃中空虚，客气动膈，心中懊 ，舌上苔者，属栀子汤证。
阳明病，下之，其外有热，手足温，不结胸，心中懊 ，若饥不能食。但头汗出，属栀子汤证。
阳明病，下之，心中懊 而烦，胃中有燥屎者，可攻。其人腹微满，头坚后溏者，不可下之。有燥屎者，属承气汤
证。
太阳病，吐下发汗后，微烦，小便数，大便因坚，可与小承气汤和之，则愈。
大汗若大下，而厥冷者，属四逆汤证。
太阳病，下之，其脉促胸满者，属桂枝去芍药汤。若微寒，属桂枝去芍药加附子汤。
伤寒五、六日，大下之，身热不去，心中结痛者，未欲解也，属栀子汤证。
伤寒下后，烦而腹满，卧起不安，属栀子浓朴汤。
伤寒，医以丸药大下之，身热不去，微烦，属栀子干姜汤。
伤寒，医下之，续得下利清谷不止。身体疼痛，急当救里。身体疼痛，清便自调，急当救表。救里宜四逆汤，救表
宜桂枝汤。
太阳病，过经十余日，反再三下之，后四、五日，柴胡证续在，先与小柴胡汤。呕止小安，（呕止小安一云∶呕不止，
心下急），其人郁郁微烦者，为未解，与大柴胡汤，下者止。伤寒，十三日不解，胸胁满而呕，日晡所发潮热，而微利，
此本当柴胡汤下之，不得利，今反利者，故知医以丸药下之，非其治也。潮热者，实也，先再服小柴胡汤，以解其外，
后属柴胡加芒硝汤。伤寒十三日，过经而谵语，内有热也，当以汤下之。小便利者，大盒饭坚，而反利，其脉调和者，
知医以丸药下之，非其治也。自利者，其脉当微厥，今反和者，此为内实，属承气汤证。伤寒八、九日，下之，胸满烦
惊，小便不利，谵语，一身不可转侧，属柴胡加龙骨牡蛎汤。火逆下之，因烧针烦躁，属桂枝甘草龙骨牡蛎汤。
太阳病，脉浮而动数，浮则为风，数则为热，动则为痛，数则为虚。头痛发热，微盗汗出，而反恶寒，其表未解。
医反下之，动数则迟，头痛即眩（一云膈内拒痛），胃中空虚，客气动膈，短气躁烦，心中懊 ，阳气内陷，心下因坚，
则为结胸，属大陷胸汤。若不结胸，但头汗出，其余无有，齐颈而还，小便不利，身必发黄。伤寒五、六日，呕而发热，
柴胡汤证具，而以佗药下之，柴胡证仍在，复与柴胡汤。此虽已下，不为逆也。必蒸蒸而振，却发热汗出而解。若心下
满而坚痛者，此为结胸，属大陷胸汤。若但满而不痛者，此为痞，柴胡复不中与也。属半夏泻心汤。本以下之，故心下
痞，与之泻心。其痞不解，其人渴而口燥，小便不利者，属五苓散。一方言忍之一日乃愈伤寒、中风，医反下之，其人
下利日数十行，谷不化，腹中雷鸣，心下痞坚而满，干呕而烦，不能得安。医见心下痞，为病不尽，复重下之，其痞益
甚，此非结热，但胃中虚，客气上逆，故使之坚，属甘草泻心汤。伤寒，服汤药，而下利不止，心下痞坚，服泻心汤已。
后以佗药下之，利不止，医以理中与之，利益甚。理中，理中焦，此利在下焦，属赤石脂禹余粮汤。若不止者，当利其
小便。
太阳病，外证未除，而数下之，遂挟热而利，不止，心下痞坚，表里不解，属桂枝人参汤。伤寒、吐后，腹满者，
与承气汤。病者无表里证，发热七、八日，脉虽浮数者，可下之。假令下已，脉数不解，今热则消谷喜饥，至六、七日
不大便者，有瘀血，属抵当汤。若脉数不解，而不止，必夹血，便脓血。
太阳病，医反下之，因腹满时痛，为属太阴，属桂枝加芍药汤。大实痛，属桂枝加大黄汤。伤寒六、七日，其人大
下后，脉沉迟，手足厥逆，下部脉不至，喉咽不利，唾脓血，泄利不止，为难治，属麻黄升麻汤。伤寒，本自寒下，医
复吐下之，寒格更遂吐，（一本作更逆吐下）食入即出，属干姜黄芩黄连人参汤。
老师说：病人脉象微细而涩，这是医生治疗失误造成的。因为大发其汗，又多次峻下，导致病人亡失血液。此时病情应当表现为恶寒与发热交替出现，且没有休止的时候。在夏季酷热之时，病人却想穿厚衣；在冬季严寒之时，病人却想裸露身体。之所以这样，是因为阳气微弱就会恶寒，阴气虚弱就会发热。所以，医生大发其汗，使阳气更微；又大下之，使阴气更弱。五月之时，阳气浮盛于体表，胃中虚冷，因为体内阳气微弱，不能抵御寒冷，所以病人想穿厚衣。十一月之时，阳气潜藏于体内，胃中烦热，因为体内阴气虚弱，不能抵御内热，所以病人想裸露身体。另外，阴脉迟涩，因此知道是亡血所致。
太阳病经过三天，已经发过汗，又用了吐法、下法、温针等治疗但病仍未解，这称为坏病，此时桂枝汤不再适用。应当观察病人的脉象和证候，了解犯了什么错误（逆治），然后随证进行治疗。如果脉象浮数，按照法度应当通过发汗而愈，但如果误用下法，就会导致身体沉重、心悸，此时不可再发汗，应当等待津液恢复，自然汗出而解。之所以这样，是因为尺中脉微，表示里虚，需要表里充实，津液调和，就能自然汗出痊愈。凡是疾病，无论经过发汗、催吐、泻下，还是亡血、津液亏损，只要阴阳能够自我调和，必定自愈。
大下之后，又发其汗，病人小便不利，这是亡失津液的表现，不要强行治疗，待小便利通，必能自愈。下法之后，又发其汗，必然出现战栗恶寒，且脉象微细。之所以这样，是因为内外俱虚的缘故。
太阳病，先用下法而未愈，因而再次发汗，导致表里俱虚，病人出现头目昏蒙的症状。头目昏蒙的病人，当通过自然汗出而痊愈。之所以这样，是因为表气调和的缘故。表气调和后，然后再考虑使用下法。
患病六七天，脉象迟而浮弱，恶风寒，手足温暖。医生再三使用下法，导致病人不能多食（或进食），胁下胀满，面目及全身发黄，颈项强直，小便困难。若给予柴胡汤，随后必然出现排便时肛门重坠感。原本口渴，饮水则呕吐，此时柴胡汤也不适用，进食则会呃逆。
太阳病，二三日，始终不能卧倒，只想起身，说明心下必然痞结。如果脉象微弱，这是本有寒邪。反而使用下法，如果腹泻停止，必然形成结胸；如果腹泻未止，四五天后再重复使用下法。这是挟热利的情况。
太阳病，使用下法，脉象急促，不形成结胸的，这是病欲解的表现。脉象浮的，必然形成结胸。脉象紧的，必然咽痛。脉象弦的，必然两胁拘急。脉象细而数的，头痛不会停止。脉象沉而紧的，必然想要呕吐。脉象沉而滑的，是挟热利。脉象浮而滑的，必然便血。
太阳少阳并病，反而使用下法，形成结胸，心下坚硬，下利不止，水浆难以下咽，病人必然心烦。脉象浮紧，反而使用下法，紧脉反入里，则形成痞证，按之柔软，只是气痞而已。伤寒经过吐、下、发汗，出现虚烦，脉象甚微，八九天内心下痞硬，胁下痛，气上冲咽喉，眩晕昏冒，经脉跳动抽搐，日久会形成痿证。
阳明病，不能进食，使用下法未解，病人依然不能进食。攻伐其热必然导致呃逆，之所以这样，是因为胃中虚冷的缘故。
阳明病，脉象迟，饮食难以吃饱，饱食后即出现心烦、头眩，必然小便困难，这是将要发生谷疸。即使使用下法，其腹部胀满依然如故。之所以这样，是因为脉迟的缘故。
太阳病，寸脉缓、关脉浮、尺脉弱，病人发热而汗出，又恶寒，不呕吐，只是心下痞，这是医生误用下法造成的。伤寒，经过大吐大下，极度虚弱，又极汗出，导致病人外气怫郁，又给予水以发其汗，因而导致呃逆。之所以这样，是因为胃中寒冷的缘故。吐、下、发汗后，病人脉象平和，只是轻微烦躁，这是因为新虚不胜谷气的缘故。
太阳病，医生发其汗，遂致发热而恶寒，又使用下法，则心下痞，这是表里俱虚，阴阳之气都竭尽，无阳则阴独存。如果再加用火针，因而烦躁，面色青黄，皮肤干燥粗糙，像这样的，很难治愈。如果面色微黄，手足温暖的，容易治愈。服用桂枝汤后又下之，出现头项强痛，翕翕发热，无汗，心下满微痛，小便不利，属于桂枝去桂加茯苓白术汤证。
太阳病，先发其汗，病未解，又使用下法，脉象仍浮的，病不愈。浮脉表示病邪在外，反而使用下法，所以令病不愈。现在脉象浮，说明病邪仍在表，应当解表则愈，属于桂枝汤证。下法之后，又发其汗，则白天烦躁不得眠，夜间安静，不呕吐不口渴，且无表证，脉象沉微，身体无大热，属于干姜附子汤证。伤寒吐、下、发汗后，心下逆满，气上撞胸，起立即头眩，脉象沉紧，发汗则扰动经脉，身体振摇，属于茯苓桂枝白术甘草汤证。发汗、吐、下以后，病未解，烦躁，属于茯苓四逆汤证。伤寒发汗、吐、下后，虚烦不得眠。严重的，反复颠倒，心中懊恼，属于栀子豉汤证。若少气，用栀子甘草汤。若呕吐，用栀子生姜汤。若腹满，用栀子厚朴汤。发汗或下之，烦热，胸中塞闷者，属于栀子豉汤证。
太阳病，过经十余日，心下温温欲吐而胸中痛，大便反溏，腹部微满，郁郁微烦，先前曾自行剧烈吐下，可给予承气汤。否则，不可给予。想要呕吐，胸中痛，大便微溏，这不是柴胡汤证，因为呕吐可知是剧烈吐下所致。太阳病，重发其汗，又复下之，不大便五六日，舌上燥而渴，日晡时分小有潮热，从心下至少腹坚硬满痛，疼痛拒按，属于大陷胸汤证。伤寒五六日，病人已发汗，而复下之，胸胁满微结，小便不利，口渴而不呕吐，仅头部出汗，往来寒热，心烦，此为病未解，属于柴胡桂枝干姜汤证。
伤寒汗出，或吐下，病解后，心下痞硬，嗳气不除者，属于旋覆代赭汤证。大下以后，不可再用桂枝汤。汗出而喘，无大热，可以用麻黄杏仁甘草石膏汤。伤寒大下后，复发其汗，心下痞，恶寒者，表证未解，不可攻其痞，应当先解表，表解后，再攻其痞。解表属桂枝汤，攻痞属大黄黄连泻心汤。
伤寒吐下后，七八日不解，热结在里，表里俱热，时时恶风，大渴，舌上干燥而烦，欲饮水数升，属于白虎汤证。伤寒吐下后未解，不大便五六十日至十余日，病人日晡时分发潮热，不恶寒，独语如见鬼神之状。如果严重，发作时不识人，循衣摸床，惊恐不安，微喘直视。脉弦者生，脉涩者死。轻者，只是发热谵语，属于承气汤证。如果已经下过，不要再服。三阳合病，腹满身重，难以转侧，口不知味，面垢，谵语，遗尿。发汗则谵语加重，下之则额上生汗，手足厥冷，自汗，属于白虎汤证。
阳明病，脉象浮紧，咽干口苦，腹满而喘，发热汗出，而不恶寒，反偏恶热，身体沉重，发其汗即躁扰，心中昏乱而反谵语。加温针，必然惊恐，又烦躁不得眠。下之，即胃中空虚，客气动膈，心中懊恼，舌上有苔者，属于栀子豉汤证。
阳明病，下之，其外有热，手足温，不结胸，心中懊恼，若饥不能食，但头汗出，属于栀子豉汤证。
阳明病，下之，心中懊恼而烦，胃中有燥屎者，可攻下。其人腹部微满，头硬后溏者，不可下之。有燥屎者，属于承气汤证。
太阳病，吐下发汗后，微烦，小便数，大便因坚，可与小承气汤和之，则愈。
太阳病，下之，脉象促、胸满者，属于桂枝去芍药汤。若微恶寒，属于桂枝去芍药加附子汤。
伤寒五六日，大下之，身热不去，心中结痛者，病未欲解，属于栀子豉汤证。
伤寒，医生下之，续得下利清谷不止。身体疼痛，急当救里。身体疼痛，大便正常，急当救表。救里宜四逆汤，救表宜桂枝汤。
太阳病，过经十余日，反而再三下之，后四五天，柴胡证仍在，先与小柴胡汤。呕吐停止稍安（一说：呕吐不止，心下急），病人郁郁微烦者，为病未解，与大柴胡汤，下之则止。伤寒十三日不解，胸胁满而呕，日晡所发潮热，而微利，此本当用柴胡汤下之，但未得利，现在反利者，故知医生用丸药下之，非其治也。潮热者，属实证，先再服小柴胡汤，以解其外，后属柴胡加芒硝汤。
伤寒十三日，过经而谵语，内有热也，当以汤药下之。小便利者，大便应当坚硬，而反利，其脉调和者，知医生用丸药下之，非其治也。自利者，其脉当微厥，今反和者，此为内实，属于承气汤证。
伤寒八九日，下之，胸满烦惊，小便不利，谵语，一身不可转侧，属于柴胡加龙骨牡蛎汤。火逆下之，因烧针烦躁，属于桂枝甘草龙骨牡蛎汤。
太阳病，脉浮而动数，浮则为风，数则为热，动则为痛，数则为虚。头痛发热，微盗汗出，而反恶寒，其表未解。医生反而下之，动数则迟，头痛即眩（一说膈内拒痛），胃中空虚，客气动膈，短气躁烦，心中懊恼，阳气内陷，心下因坚，则为结胸，属于大陷胸汤。若不结胸，但头汗出，其余无有，齐颈而还，小便不利，身必发黄。
伤寒五六日，呕而发热，柴胡汤证具备，而以其他药下之，柴胡证仍在，复与柴胡汤。此虽已下，不为逆也。必蒸蒸而振，却发热汗出而解。若心下满而坚痛者，此为结胸，属于大陷胸汤。若但满而不痛者，此为痞，柴胡复不中与也。属于半夏泻心汤。本以下之，故心下痞，与之泻心。其痞不解，其人渴而口燥，小便不利者，属于五苓散。一方说忍之一日乃愈。
伤寒、中风，医生反而下之，其人下利日数十行，谷不化，腹中雷鸣，心下痞坚而满，干呕而烦，不能得安。医生见心下痞，认为病不尽，复重下之，其痞益甚，此非结热，但胃中虚，客气上逆，故使之坚，属于甘草泻心汤。
伤寒，服汤药，而下利不止，心下痞坚，服泻心汤后。后用其他药下之，利不止，医生用理中与之，利益甚。理中汤理中焦，此利在下焦，属于赤石脂禹余粮汤。若不止者，当利其小便。
太阳病，外证未除，而数下之，遂挟热而利，不止，心下痞坚，表里不解，属于桂枝人参汤。
伤寒、吐后，腹满者，与承气汤。病者无表里证，发热七、八日，脉虽浮数者，可下之。假令下已，脉数不解，今热则消谷喜饥，至六、七日不大便者，有瘀血，属于抵当汤。若脉数不解，而不止，必夹血，便脓血。
太阳病，医生反而下之，因腹满时痛，为属太阴，属于桂枝加芍药汤。大实痛，属于桂枝加大黄汤。
The Master said: If a patient's pulse is faint (Wei) and choppy (Se), this is due to medical error. Because of excessive sweating, followed by repeated severe purgation, the patient has lost blood. The condition should manifest as alternating aversion to cold and fever, without cessation. In the height of summer heat, the patient desires to wear thick clothes; in the depth of winter cold, the patient desires to expose the body. The reason for this is that when Yang Qi is deficient, there is aversion to cold; when Yin is weak, there is fever. Thus, excessive sweating makes Yang Qi even more deficient, and severe purgation makes Yin Qi even weaker. In the fifth month, Yang Qi floats on the exterior, while the Stomach is cold and empty. Because internal Yang Qi is deficient and cannot overcome cold, the patient desires to wear thick clothes. In the eleventh month, Yang Qi sinks into the interior, causing vexatious heat in the Stomach. Because internal Yin Qi is weak and cannot overcome heat, the patient desires to expose the body. Furthermore, a slow (Chi) and choppy (Se) pulse in the Yin positions indicates loss of blood.
After three days of Taiyang disease, if sweating, emesis, purgation, or warm needle therapy have been applied but the disease remains unresolved, this is termed a "ruined disease" (Huai Bing). Guizhi Tang (Cinnamon Twig Decoction) is no longer applicable. One must observe the pulse and symptoms, determine what therapeutic error was committed, and treat according to the current pattern. If the pulse is floating (Fu) and rapid (Shu), the method dictates recovery through sweating. However, if purgation was mistakenly used, it leads to heaviness of the body and palpitations. Sweating is contraindicated at this stage; recovery will occur naturally through spontaneous sweating. This is because a faint pulse at the Chi position indicates interior deficiency. When both exterior and interior are solidified and fluids are harmonized, spontaneous sweating will lead to cure. Generally, whether a disease has undergone sweating, emesis, purgation, or involves blood/fluid loss, if Yin and Yang can self-harmonize, the disease will surely resolve on its own.
After severe purgation followed by sweating, if the patient experiences difficulty urinating, this is due to fluid depletion. Do not forcibly treat it; when urination resumes, the patient will likely recover spontaneously. After purgation followed by sweating, chills and tremors will inevitably occur, accompanied by a faint and fine pulse. This is due to deficiency in both the interior and exterior.
If Taiyang disease is first treated with purgation without resolution, and then sweating is induced, leading to deficiency in both exterior and interior, the patient may experience dizziness (Mao). Patients with dizziness will recover through spontaneous sweating, because the exterior harmony is restored. Once the exterior is harmonized, purgation may then be considered.
If, after six or seven days of illness, the pulse is slow (Chi) and floating-weak (Fu Ruo), with aversion to wind and cold, and warm hands and feet, but the physician repeatedly uses purgation, the patient may suffer from inability to eat much, fullness in the hypochondrium, yellowing of the face and body, stiff neck, and difficult urination. Administering Chaihu Tang (Bupleurum Decoction) would subsequently cause a sensation of rectal heaviness. If the patient was originally thirsty and vomiting upon drinking water, Chaihu Tang is also contraindicated, and eating may induce hiccups.
In Taiyang disease lasting two to three days, if the patient cannot lie down and only wishes to rise, there must be obstruction in the epigastrium. If the pulse is faint, this indicates an underlying cold condition. If purgation is mistakenly used, and diarrhea stops, chest binding (Jie Xiong) will form. If diarrhea does not stop, and purgation is repeated on the fourth or fifth day, this constitutes diarrhea with attached heat.
If Taiyang disease is treated with purgation, and the pulse becomes urgent (Cu) without forming chest binding, the disease is about to resolve. If the pulse is floating, chest binding will form. If the pulse is tight (Jin), throat pain will occur. If the pulse is string-taut (Xian), bilateral hypochondriac stiffness will occur. If the pulse is fine and rapid, headache will persist. If the pulse is deep and tight, vomiting will ensue. If the pulse is deep and slippery, diarrhea with attached heat will occur. If the pulse is floating and slippery, hematochezia will occur.
In concurrent Taiyang and Shaoyang diseases, mistaken purgation leads to chest binding, hardness in the epigastrium, unceasing diarrhea, inability to swallow liquids, and mental restlessness. If a floating-tight pulse is treated with purgation, the tight pulse moves inward, resulting in epigastric fullness (Pi). It feels soft upon pressure, constituting merely Qi stagnation. After emesis, purgation, or sweating in Shanghan, if mental restlessness occurs with a very faint pulse, and after eight or nine days, epigastric hardness, hypochondriac pain, Qi rushing up to the throat, dizziness, and twitching of meridians occur, this may eventually develop into Wei syndrome (flaccidity syndrome).
In Yangming disease, if the patient cannot eat and purgation fails to resolve the condition, the patient remains unable to eat. Attacking the heat will induce hiccups because the Stomach is cold and deficient.
In Yangming disease, if the pulse is slow, and the patient cannot eat until full, experiencing vexation and dizziness after eating, and difficulty urinating, this indicates impending Gu Dan (Grass Jaundice). Even with purgation, abdominal fullness persists due to the slow pulse.
In Taiyang disease, if the Cun pulse is slow, Guan pulse floating, and Chi pulse weak, with fever, sweating, aversion to cold, no vomiting, but epigastric fullness, this is caused by mistaken purgation. After severe emesis and purgation in Shanghan, leading to extreme deficiency, followed by excessive sweating causing exterior Qi oppression, giving water to induce sweating results in hiccups due to cold in the Stomach. After emesis, purgation, and sweating, if the pulse is normal but slight irritability remains, it is because the newly deficient state cannot handle food Qi.
If Taiyang disease is treated with sweating, leading to fever and aversion to cold, followed by purgation causing epigastric fullness, this indicates deficiency in both exterior and interior, exhaustion of Yin and Yang Qi, where the absence of Yang leaves Yin alone. Adding fire needle therapy causes irritability, bluish-yellow complexion, and dry skin, making it difficult to treat. However, if the complexion is slightly yellow and hands and feet are warm, it is easy to cure. If Guizhi Tang is taken followed by purgation, resulting in stiff neck and head, mild fever, no sweating, epigastric fullness with slight pain, and difficulty urinating, this belongs to the pattern of Guizhi Qu Gui Jia Fuling Baizhu Tang (Cinnamon Twig Decoction minus Cinnamon Twig plus Poria and Atractylodes Macrocephala Decoction).
If Taiyang disease is first treated with sweating without resolution, followed by purgation, and the pulse remains floating, the disease will not resolve. Floating indicates the pathogen is external; purging externally prevents resolution. Since the pulse is floating, the pathogen is still external, and releasing the exterior with Guizhi Tang will cure it. After purgation followed by sweating, if the patient experiences daytime irritability and insomnia, nighttime quietness, no vomiting or thirst, no exterior signs, a deep-faint pulse, and no significant fever, this belongs to Ganjiang Fuzi Tang (Dried Ginger and Aconite Root Decoction). After Shanghan treated with emesis, purgation, and sweating, if there is epigastric rebellious fullness, Qi hitting the chest, dizziness upon standing, a deep-tight pulse, and body tremors upon sweating, this belongs to Fuling Guizhi Baizhu Gancao Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction). If unresolved after sweating, emesis, and purgation, with irritability, this belongs to Fuling Sini Tang (Poria and Four Reversal Decoction). After Shanghan treated with sweating, emesis, and purgation, if mental restlessness and insomnia occur, or severe tossing and turning with inner vexation, this belongs to Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction). If shortness of breath, use Zhizi Gancao Tang (Gardenia and Licorice Decoction). If vomiting, use Zhizi Shengjiang Tang (Gardenia and Fresh Ginger Decoction). If abdominal fullness, use Zhizi Houpo Tang (Gardenia and Magnolia Bark Decoction). If sweating or purgation leads to vexation, heat, and chest oppression, this belongs to the Zhizi Chi Tang pattern.
If Taiyang disease passes the meridian stage for over ten days, with epigastric nausea, chest pain, loose stools, slight abdominal fullness, and slight vexation, following previous extreme emesis or purgation, Chengqi Tang (Bowels Unblocking Decoction) may be given. Otherwise, do not give it. Vomiting, chest pain, and loose stools indicate this is not a Chaihu Tang pattern, but rather a result of extreme emesis/purgation. If Taiyang disease is heavily sweated and purged, leading to five to six days of constipation, dry tongue with thirst, slight afternoon tidal fever, and hardness/pain from epigastrium to lower abdomen, this belongs to Daxiexion Tang (Major Chest Binding Decoction). If Shanghan lasts five to six days, after sweating and purgation, with slight chest/hypochondriac fullness, difficulty urinating, thirst without vomiting, only head sweating, alternating chills/fever, and irritability, this is unresolved and belongs to Chaihu Guizhi Ganjiang Tang (Bupleurum, Cinnamon Twig, and Dried Ginger Decoction).
After Shanghan sweating, emesis, or purgation resolves, if epigastric hardness and persistent belching remain, this belongs to Xuanfuzhe Tang (Inula and Hematite Decoction). After severe purgation, Guizhi Tang is contraindicated. If sweating, wheezing, and lack of high fever occur, Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) may be used. After severe purgation followed by sweating, if epigastric fullness and aversion to cold persist, the exterior is unresolved. Do not attack the fullness; resolve the exterior first with Guizhi Tang, then attack the fullness with Dahuang Huanglian Xiexin Tang (Rhubarb, Coptis, and Scutellaria Heart-Clearing Decoction).
After Shanghan emesis/purgation, if unresolved after seven to eight days, with heat consolidated internally, exterior-interior heat, frequent aversion to wind, extreme thirst, dry irritable tongue, and desire to drink several liters of water, this belongs to Baihu Tang (White Tiger Decoction). If unresolved after emesis/purgation, with five to ten+ days of constipation, afternoon tidal fever, no aversion to cold, and delirious speech as if seeing spirits, severe cases involve unconsciousness, grasping at clothes, fearfulness, slight panting, and fixed gaze. A string-taut pulse indicates life; a choppy pulse indicates death. Mild cases with fever and delirium belong to Chengqi Tang. If purged, do not administer again. In concurrent San Yang disease, with abdominal fullness, body heaviness, difficulty turning, oral insensitivity, facial grease, delirium, and enuresis, sweating worsens delirium; purgation causes forehead sweating and cold extremities with spontaneous sweating. This belongs to Baihu Tang.
In Yangming disease, if the pulse is floating-tight, with dry throat, bitter taste, abdominal fullness, wheezing, fever, sweating, no aversion to cold but preference for heat, and body heaviness, sweating induces agitation and delirium. Warm needles cause fear and insomnia. Purgation empties the Stomach, allowing hostile Qi to disturb the Diaphragm, causing inner vexation and tongue coating, belonging to Zhizi Chi Tang.
In Yangming disease, after purgation, if exterior heat exists, hands/feet are warm, no chest binding, inner vexation, hunger but inability to eat, and only head sweating, this belongs to Zhizi Chi Tang.
In Yangming disease, after purgation, if inner vexation and irritability occur with dry feces in the Stomach, purgation is indicated. If the abdomen is slightly full but stool is hard at the beginning and loose at the end, purgation is contraindicated. Dry feces indicate the Chengqi Tang pattern.
After Taiyang disease treated with emesis/sweating/purgation, if slight irritability, frequent urination, and hard stool occur, Xiao Chengqi Tang (Minor Bowels Unblocking Decoction) may harmonize and cure.
After massive sweating or purgation, if cold extremities occur, this belongs to Sini Tang (Four Reversal Decoction).
In Taiyang disease, after purgation, if the pulse is urgent with chest fullness, this belongs to Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction minus Peony Decoction). If slight aversion to cold occurs, add Fuzi, becoming Guizhi Qu Shaoyao Jia Fuzi Tang.
After Shanghan five to six days, severe purgation leaves fever and heart-binding pain, indicating the disease is not resolving, belonging to Zhizi Chi Tang.
After Shanghan purgation, if irritability and abdominal fullness cause restlessness, this belongs to Zhizi Houpo Tang.
If a physician uses pill-based purgatives in Shanghan, leaving fever and slight irritability, this belongs to Zhizi Ganjiang Tang (Gardenia and Dried Ginger Decoction).
If a physician purges Shanghan, leading to continuous clear grain diarrhea, and body pain exists, urgently save the interior with Sini Tang. If body pain exists but stool is normal, urgently save the exterior with Guizhi Tang.
If Taiyang disease passes the meridian stage for ten+ days, and is repeatedly purged, and after four to five days Chaihu patterns persist, start with Xiao Chaihu Tang (Minor Bupleurum Decoction). If vomiting stops and comfort returns (or vomiting continues with epigastric urgency), and vexation persists, give Da Chaihu Tang (Major Bupleurum Decoction) to purge. If Shanghan persists thirteen days with chest/hypochondriac fullness, vomiting, afternoon tidal fever, and slight diarrhea, although Chaihu purgation was indicated, the diarrhea suggests the physician used pill purgatives incorrectly. Tidal fever indicates excess. First, take Xiao Chaihu Tang to release the exterior, then use Chaihu Jia Mangxiao Tang (Bupleurum plus Mirabilite Decoction).
If Shanghan persists thirteen days, passes the meridian, with delirium indicating internal heat, purgation with decoction is needed. If urination is free, stool should be hard; if loose with a harmonious pulse, it indicates incorrect pill purgation. Spontaneous loose stool usually implies a faint/cold pulse; a harmonious pulse here indicates internal excess, belonging to Chengqi Tang.
After Shanghan eight to nine days, purgation leads to chest fullness, fright, difficulty urinating, delirium, and inability to turn the body, belonging to Chaihu Jia Longgu Muli Tang (Bupleurum plus Dragon Bone and Oyster Shell Decoction). Fire-negativity followed by purgation and fire-needle induced irritability belongs to Guizhi Gancao Longgu Muli Tang (Cinnamon Twig, Licorice, Dragon Bone, and Oyster Shell Decoction).
In Taiyang disease, a floating-moving-rapid pulse indicates Wind, Heat, Pain, and Deficiency respectively. Headache, fever, slight night sweat, and aversion to cold indicate the exterior is unresolved. Mistaken purgation changes the moving-rapid pulse to slow, causing dizziness or diaphragmatic pain. Empty Stomach allows hostile Qi to disturb the Diaphragm, causing shortness of breath, irritability, inner vexation, and sinking of Yang Qi into the epigastrium, forming chest binding (Daxiexion Tang). If no chest binding, but only head sweating stopping at the neck, with difficulty urinating, jaundice will develop.
If Shanghan five to six days presents with vomiting and fever, and Chaihu patterns are complete, mistaken purgation leaves Chaihu patterns intact. Re-administering Chaihu Tang is not adverse. The patient will shiver and sweat out the fever to resolve. If epigastric fullness is hard and painful, it is chest binding (Daxiexion Tang). If full but not painful, it is Pi (epigastric fullness), Chaihu Tang is contraindicated; use Banxia Xiexin Tang (Pinellia Heart-Clearing Decoction). If purgation caused epigastric fullness, give Xiexin Tang. If unresolved with thirst, dry mouth, and difficulty urinating, use Wuling San (Five-Ingredient Powder with Poria). Some say enduring it for one day cures it.
In Shanghan or Fengzhong, mistaken purgation causes frequent diarrhea with undigested food, borborygmus, epigastric hardness/fullness, dry retching, and vexation. Seeing epigastric fullness, the physician mistakenly purges again, worsening the fullness. This is not heat binding, but Stomach deficiency with hostile Qi reversing upward, belonging to Gancao Xiexin Tang (Licorice Heart-Clearing Decoction).
If Shanghan medication causes continuous diarrhea and epigastric hardness, and Xiexin Tang fails, subsequent purgation worsens diarrhea. Lizhong Tang treats the Middle Jiao, but this diarrhea is in the Lower Jiao; use Chishizhi Yuyuliang Tang (Red Halloysite and Illite Decoction). If unresolved, promote diuresis.
If Taiyang exterior signs persist and repeated purgation causes heat-attached diarrhea, epigastric hardness, and unresolved exterior-interior, this belongs to Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction).
After Shanghan emesis, if abdominal fullness occurs, give Chengqi Tang. If a patient has no exterior-interior signs, fever for seven to eight days, and a floating-rapid pulse, purgation may be used. If purgation fails to resolve the rapid pulse, and heat causes hunger with digestion, followed by constipation after six to seven days, blood stasis exists, belonging to Didang Tang (Di Dang Decoction). If the rapid pulse persists with bleeding, pus and blood in stool will occur.
If Taiyang disease is mistakenly purged, causing intermittent abdominal fullness and pain, it belongs to Taiyin, treated with Guizhi Ji Shaoyao Tang (Cinnamon Twig plus Peony Decoction). Severe pain belongs to Guizhi Jia Dahuang Tang (Cinnamon Twig plus Rhubarb Decoction).
After Shanghan six to seven days, severe purgation leads to deep-slow pulse, cold extremities, absent lower pulses, sore throat, spitting pus/blood, and continuous diarrhea, making it difficult to treat; use Mahuang Shengma Tang (Ephedra and Cyathula Decoction).
If Shanghan originally involved cold purgation, and the physician re-emetics/purges, causing cold rejection and immediate vomiting upon eating, use Ganjiang Huangqin Huanglian Renshen Tang (Dried Ginger, Scutellaria, Coptis, and Ginseng Decoction).