小青龙汤方加减法内
若微利者，去麻黄加{荛花如鸡子大，熬令赤色}〔茯苓四两〕。
【按】“加荛花如鸡子大”，此必传写之误。考《本草》荛花是芫花类也，每用之攻水其力甚峻，五分可
令人下行数十次，岂有治停饮之微利，用鸡子大之荛花者乎？当改加茯苓四两。
伤寒，心下有水气，咳而微喘，发热不渴，（小青龙汤主之）。服汤已，渴者，此寒去欲解也。
【按】“小青龙汤主之”六字，当在发热不渴之下，始与服汤已渴者之文义相属，岂有寒去欲解，而更服
小青龙汤之理乎？当移之。
阳明病，脉浮而紧者，必潮热，发作有时；但浮者，必{盗}〔自〕汗出。
【按】自汗是阳明证，盗汗乃少阳证，“盗汗”应是“自汗”，当改之。
阳明病，脉迟，汗出多，（发热），微恶寒者，表未解也，可发汗，宜桂枝汤。
【按】“汗出多”之下，当有“发热”二字。若无此二字，脉迟汗出多，微恶寒乃表阳虚，桂枝附子汤证
也，岂有用桂枝汤发汗之理乎？当补之。
伤寒脉浮滑，此以表有热，里有{寒}〔热〕，白虎汤主之。
【按】“里有寒”之“寒”字，当是“热”字。若是“寒”字，非白虎汤证也，当改之。
伤寒若吐、若下后不解，不大便五六日，上至十余日，日晡所发潮热，不恶寒，独语如见鬼状。若剧者，
发则不识人，循衣摸床，惕而不安，微喘直视。脉{弦}〔滑〕者生，涩者死。微者，但发热谵语者，大承气汤主
之。若一服利，止后服。
【按】“脉弦者生”之“弦”字，当是“滑”字，弦为阴负之脉，岂有必生之理？惟滑脉为阳，始有生
理。况滑者通也。涩者塞也，凡物之理，未有不以通为生，而塞为死者，当改之。
太阳病，寸缓关浮尺弱，其人发热汗出，复恶寒不呕，但心下痞者，此以医下之也；如其不下者，病患
不恶寒而渴者，此转属阳明也。小便数者，大便必硬，不更衣十日无所苦也，渴欲饮水，少少与之，{但以法
救之}〔若小便不利〕，渴者，宜五苓散。
【按】“但以法救之”五字，当是“若小便不利”五字，方与上文小便数，及下文渴者之义相属。此条
病势不急救之之文，殊觉无谓。昔王三阳亦云∶此处五苓散难用，不然经文渴者之下，当有缺文，当改之。
栀子柏皮汤
【按】此方之甘草，当是茵陈蒿，必传写之误也。
太阳病，当恶寒发热，今自汗出，反不恶寒发热，关上脉细数者，以医吐之过也。一二日吐之者，腹中
饥，口不能食；三四日吐之者，不喜糜粥，欲食冷食，（五六日吐之者），朝食暮吐，以医吐之所致也，此为小逆。
【按】“欲食冷食”之下，当有“五六日吐之者”六字，若无此一句，则不喜糜粥，欲食冷食，与朝食
暮吐之文不相联属。且以上文一二日、三四日之文细玩之，则可知必有“五六日吐之”一句，由浅及深之义也。
当补之。
寸口脉浮大，而医下之，此为大逆。浮则无血，大则为寒，寒气相抟，则为肠鸣，医乃不知，而反饮冷
水，{令汗大出}，水得寒气，冷必相抟，其人必KT 。
【按】“令汗大出”四字，当是衍文，宜删之。
阳明病，谵语有潮热，反不能食者，胃中必有燥屎五六枚也，（宜大承气汤下之）。若能食者，但硬耳。
【按】“宜大承气汤下之”句，应在“必有燥屎五六枚”之下始合。若但便硬即用大承气汤下之，殊失
仲景慎重误下之旨，当移之。
阳明中风，脉弦浮大而短气，腹都满，胁下及心痛，久按之，气不通，鼻干，不得汗，嗜卧，一身及面
目悉黄，小便难，有潮热，时时哕，耳前后肿，刺之小瘥，外不解，病过十日，脉续{浮}〔弦〕者，与小柴胡汤。
但浮，无余证者，与麻黄汤。若不尿。腹满加哕者，不治。
【按】“续浮”之“浮”字，当是“弦”字，始与小柴胡汤法之脉相合。若是“浮”字。则上之浮既宜
小柴胡汤，而下之浮又用麻黄汤，不自相矛盾耶？当改之。
发汗后，水药不得入口为逆，若更发汗，必吐{下}不止。
【按】“必吐下不止”之“下”字，衍文也，当删之。
小青龙汤方加减法内
如果患者有轻微腹泻，去掉麻黄，加入荛花（如鸡蛋大小，炒至变红）[改为茯苓四两]。
【按语】“加入荛花如鸡蛋大小”，这一定是传抄时的错误。考查《本草》，荛花属于芫花一类，每次用它攻逐水饮，药力非常猛烈，五分（约1.5克）就能让人腹泻几十次，哪有治疗停饮引起的轻微腹泻，却用鸡蛋大小的荛花的道理呢？应当改为加入茯苓四两。
伤寒病，心下有停饮，咳嗽且轻微气喘，发热但不口渴，（用小青龙汤主治）。服药后，感到口渴的，这是寒邪已去、病情将要解除的表现。
【按语】“用小青龙汤主治”这六个字，应当放在“发热不渴”之下，这样才与“服药后感到口渴”的文义相衔接，哪有寒邪已去、病情将解，反而再服用小青龙汤的道理呢？应当移动位置。
阳明病，脉象浮而紧的，一定会有潮热，发作有定时；如果脉象只浮而不紧的，一定会有{盗汗}〔自汗〕出。
【按语】自汗是阳明病的证候，盗汗则是少阳病的证候，“盗汗”应该是“自汗”，应当改正。
阳明病，脉象迟，出汗多，（发热），微微怕冷的，说明表证未解，可以发汗，适宜用桂枝汤。
【按语】在“出汗多”之下，应当有“发热”二字。如果没有这两个字，脉迟、出汗多、微微怕冷，这是表阳虚，属于桂枝附子汤的证候，哪有使用桂枝汤发汗的道理呢？应当补上。
伤寒病，脉象浮滑，这是因为表有热，里有{寒}〔热〕，用白虎汤主治。
【按语】“里有寒”的“寒”字，应当是“热”字。如果是“寒”字，就不是白虎汤的证候了，应当改正。
伤寒病，经过催吐或泻下治疗后，病仍未解除，不大便五到六天，甚至十几天，每天下午申时左右出现潮热，不怕冷，独自说话像看见鬼怪一样。如果病情严重的，发作时不认识人，手抓衣被和床沿，惊恐不安，轻微气喘，两眼直视。脉象{弦}〔滑〕的能生，脉象涩的死。病情较轻的，只是发热说胡话的，用大承气汤主治。如果服一次药后大便通利，就停止后面的服药。
【按语】“脉弦的能生”的“弦”字，应当是“滑”字。弦脉是阴盛负衰的脉象，怎么会有必然能生的道理呢？只有滑脉属阳，才有生机。况且滑代表通畅，涩代表阻塞。大凡事物的道理，没有不通畅而能生存、阻塞而导致死亡的，应当改正。
太阳病，寸脉缓、关脉浮、尺脉弱，病人发热出汗，又怕冷，不呕吐，只是心下痞塞的，这是因为医生误用泻下法所致；如果医生没有用泻下法，病人不怕冷而且口渴的，这是病邪转属阳明。小便频数的，大便一定硬结，即使十天不上厕所也没有痛苦。想喝水，少量给予饮水，{但依法救治}〔若小便不利〕，口渴的，适宜用五苓散。
【按语】“但依法救治”这五个字，应当是“若小便不利”这五个字，这样才能与上文的小便频数，及下文口渴的意义相衔接。这一条关于病势不需要急救的说法，觉得毫无意义。以前王三阳也说：此处难以使用五苓散，不然经文在“口渴者”之下，应当有缺文，应当改正。
栀子柏皮汤
【按语】此方中的甘草，应当是茵陈蒿，一定是传抄时的错误。
太阳病，应当怕冷发热，现在病人自汗出，反而不怕冷发热，关上脉细数，是因为医生误用吐法造成的过失。发病一两天就用吐法的，腹中饥饿，但不能进食；发病三四天用吐法的，不喜欢喝稀粥，想吃冷食，（发病五六天用吐法的），早上吃的晚上吐出来，这是医生误用吐法导致的，这属于小逆。
【按语】在“想吃冷食”之下，应当有“发病五六天用吐法的”这六个字。如果没有这一句，那么“不喜欢喝稀粥，想吃冷食”与“早上吃晚上吐”的文义就不连贯。而且结合上文发病一两天、三四天的文义仔细推敲，就可以知道必定有“发病五六天用吐法”这一句，这是由浅入深的道理。应当补上。
寸口脉浮大，医生却用泻下法，这是大逆。浮脉表示血虚，大脉表示有寒，寒气相互搏结，就会引起肠鸣。医生不知道，反而让病人喝冷水，{令大汗出}，水遇到寒气，寒冷必然相互搏结，病人一定会KT（注：原文此处可能有脱漏或异体字，通常指身体浮肿或剧烈疼痛等症，依上下文推测为水寒相搏之变证）。
【按语】“令大汗出”这四个字，应当是衍文，应当删除。
阳明病，说胡话且有潮热，反而不能吃东西的，胃中一定有燥屎五六枚，（适宜用大承气汤攻下）。如果能吃东西的，只是大便硬罢了。
【按语】“适宜用大承气汤攻下”这句话，应当在“一定有燥屎五六枚”之下才合理。如果只是大便硬就用大承气汤攻下，严重违背了张仲景慎重对待误下的宗旨，应当移动位置。
阳明中风，脉象弦、浮、大且短气，腹部都胀满，胁下及心痛，久按之气不通，鼻干，无汗，嗜睡，全身及面目都发黄，小便困难，有潮热，时常呃逆，耳前后肿胀，针刺后稍好，但外证未解，病过十天，脉象继续{浮}〔弦〕的，给小柴胡汤。
如果只浮，没有其他证候的，给麻黄汤。如果不排尿，腹胀满加上呃逆的，属于不治之症。
【按语】“继续浮”的“浮”字，应当是“弦”字，才能与小柴胡汤法的脉象相符合。如果是“浮”字，那么上面的浮脉既宜用小柴胡汤，下面的浮脉又用麻黄汤，不是自相矛盾吗？应当改正。
Within the modification methods of the Xiao Qing Long Tang (Minor Blue Dragon Decoction) formula:
If there is slight diarrhea, remove Ephedrae Herba (Mahuang, 麻黄) and add {Euphorbiae Pekinensis Radix (Raogonghua, 荛花), size of a chicken egg, roasted until red} [change to Poria (Fuling, 茯苓), four liang].
【Note】"Add Euphorbiae Pekinensis Radix size of a chicken egg" is likely a transcription error. According to Materia Medica, Raogonghua belongs to the same category as Yuanhuahua (Genkwa Flos). When used to attack water retention, its power is extremely fierce; half a qian (approx. 1.5g) can cause dozens of bowel movements. How could one use a chicken-egg-sized dose of Raogonghua to treat slight diarrhea caused by retained fluid? It should be changed to adding four liang of Poria.
In Taiyang Cold Damage (Taiyang Shanghan, 太阳伤寒), with fluid retention in the epigastrium, coughing with slight wheezing, fever but no thirst, (Xiao Qing Long Tang is the primary treatment). After taking the decoction, if the patient feels thirsty, this indicates that the cold pathogen has departed and the disease is about to resolve.
【Note】The six characters "Xiao Qing Long Tang is the primary treatment" should be placed after "fever but no thirst" to align logically with the subsequent text regarding thirst after medication. There is no logic in administering Xiao Qing Long Tang again when the cold has already departed and the disease is resolving. The position should be moved.
In Yangming Disease, if the pulse is floating and tight, tidal fever must occur at specific times; if the pulse is only floating (without tightness), spontaneous sweating must occur.
【Note】Spontaneous sweating is a symptom of Yangming syndrome, while night sweating is a symptom of Shaoyang syndrome. "Night sweating" should be corrected to "spontaneous sweating."
In Yangming Disease, with a slow pulse, profuse sweating, (fever), and slight aversion to cold, the exterior pattern remains unresolved. Sweating may be induced, and Guizhi Tang (Cinnamon Twig Decoction) is appropriate.
【Note】The two characters "fever" should be added after "profuse sweating." Without these words, a slow pulse with profuse sweating and slight aversion to cold indicates deficiency of Exterior Yang, which corresponds to the indication for Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction). There is no rationale for using Guizhi Tang to induce sweating in this case. These characters should be supplemented.
In Cold Damage, with a floating and slippery pulse, this indicates heat in the exterior and {cold} [heat] in the interior. Bai Hu Tang (White Tiger Decoction) is the primary treatment.
【Note】The character "cold" in "cold in the interior" should be "heat." If it were cold, it would not be an indication for Bai Hu Tang. This should be corrected.
After purging or vomiting in Cold Damage, if the condition remains unresolved, with constipation for five to six days up to ten-plus days, tidal fever occurring around the Shen hour (3-5 PM), no aversion to cold, and muttering as if seeing ghosts: In severe cases, upon onset, the patient loses consciousness, grasps clothing and bedrails, is terrified and restless, with slight wheezing and fixed gaze. If the pulse is {wiry} [slippery], life is possible; if the pulse is choppy, death ensues. In milder cases, presenting only with fever and delirium, Da Cheng Qi Tang (Major Order the Qi Decoction) is the primary treatment. If one dose results in bowel movement, discontinue subsequent doses.
【Note】The character "wiry" in "wiry pulse indicates survival" should be "slippery." A wiry pulse indicates Yin excess and negative decline, which does not inherently suggest survival. Only a slippery pulse, being Yang, suggests vitality. Slippery implies flow, while choppy implies obstruction. Generally, flow leads to life and obstruction to death. This should be corrected.
In Taiyang Disease, with a slow pulse at the cun position, floating at the guan position, and weak at the chi position, the patient presents with fever, sweating, aversion to cold, no vomiting, but epigastric fullness/stuffiness. This is due to improper purging by the physician. If purging was not performed, and the patient is not averse to cold but is thirsty, the disease has transferred to Yangming. Frequent urination leads to hard stools; even without defecation for ten days, there is no distress. If thirsty and desiring water, give small amounts frequently. {But rescue according to method} [if urination is difficult], and if thirsty, Wu Ling San (Five-Ingredient Powder with Poria) is appropriate.
【Note】The five characters "but rescue according to method" should be "if urination is difficult" to connect with the preceding text on frequent urination and the following text on thirst. The current text suggesting no urgent rescue is nonsensical. Wang Sanyang previously stated that Wu Ling San is difficult to apply here; otherwise, there is missing text after "thirsty." This should be corrected.
Zhi Zi Bo Pi Tang (Gardenia and Phellodendron Bark Decoction)
【Note】The Licorice Root (Gancao, 甘草) in this formula should be Yinchen Hao (Artemisiae Scopariae Herba); this is a transcription error.
In Taiyang Disease, one should have aversion to cold and fever. Now, the patient sweats spontaneously and lacks aversion to cold and fever, with a fine and rapid pulse at the guan position. This is an error caused by the physician's improper use of emesis. If emesis is used on day one or two, the patient feels hungry in the abdomen but cannot eat; if used on day three or four, the patient dislikes congee and desires cold food. (If used on day five or six, morning food is vomited in the evening.) This is caused by the physician's improper emesis and is considered a minor deviation.
【Note】The six characters "if used on day five or six" should be added after "desires cold food." Without this sentence, the text regarding disliking congee and desiring cold food does not connect with "morning food vomited in the evening." Furthermore, analyzing the progression from day one/two to day three/four reveals the necessity of the "day five/six" phrase to illustrate the deepening pathology. This should be supplemented.
If the pulse at the cun kou is floating and large, but the physician uses purging, this is a major deviation. Floating indicates blood deficiency; large indicates cold. When cold qi contends, borborygmus occurs. Unaware of this, the physician gives cold water. {Causing profuse sweating}, the water meets the cold qi, causing them to contend. The patient will suffer from [swelling/pain - note: original text 'KT' is unclear/erroneous].
【Note】The four characters "causing profuse sweating" are likely interpolations (extraneous text) and should be deleted.
In Yangming Disease, with delirium and tidal fever, if the patient cannot eat, there must be dry feces (five or six pellets) in the stomach. (Da Cheng Qi Tang should be used to purge.) If the patient can eat, the stool is merely hard.
【Note】The phrase "Da Cheng Qi Tang should be used to purge" should follow "there must be dry feces." Using Da Cheng Qi Tang solely for hard stool contradicts Zhang Zhongjing's principle of caution against improper purging. The position should be moved.
In Yangming Wind Strike, with a wiry, floating, and large pulse, shortness of breath, abdominal fullness, pain in the hypochondrium and heart region, obstruction of qi upon prolonged pressure, dry nose, inability to sweat, lethargy, jaundice of the whole body and face, difficult urination, tidal fever, occasional hiccups, and swelling around the ears and temples: After acupuncture, symptoms improve slightly, but the exterior pattern remains unresolved. If the disease persists beyond ten days and the pulse continues to be {floating} [wiry], administer Xiao Chai Hu Tang (Minor Bupleurum Decoction).
If the pulse is only floating without other symptoms, administer Ma Huang Tang (Ephedra Decoction). If there is no urination, accompanied by abdominal fullness and hiccups, the condition is untreatable.
【Note】The character "floating" in "continues to be floating" should be "wiry" to match the pulse indication for Xiao Chai Hu Tang. If it were "floating," it would contradict the earlier statement that floating pulse warrants Xiao Chai Hu Tang, while later stating floating pulse warrants Ma Huang Tang. This should be corrected.
After inducing sweating, if water and medicine cannot be kept down, it is a adverse reaction. If sweating is induced again, vomiting will {and diarrhea} continue endlessly.
【Note】The character "diarrhea" in "vomiting and diarrhea will continue endlessly" is extraneous and should be deleted.