治伤寒内感拘急，三焦气虚自汗，及手足自汗，或手背偏多，
或肢
体振摇，腰腿沉重，面赤目红，但欲眠睡，头面壮热，两胁热甚，手足自温，两手心热，自
利不渴，大便或难，或如常度，或口干咽燥，或渴欲饮汤，不欲饮水，或少欲饮水，呕哕间
作，或心下满闷，腹中疼痛，或时喜笑，或时悲哭，或时太息（去声，）或语言错乱失志。世
疑作谵语狂言者，非也，神不守室耳！始得病，寤寐之间，或恐或悸，头项不甚痛，行步只
如旧，阴气盛阳气走也。两手脉浮沉不一，或左右往来无定，便有沉涩弱弦微五种
阴
脉形状，举按全无力，浮之损小，沉之亦损小，皆阴脉也。宜先缓而后急，缓宜黄 汤。
人参 黄 （味甘者） 白茯苓 白术 白芍药（以上各一两） 甘草（七钱半，炒）
呕吐者，加藿香半两，生姜半两，如无，干者代之。
上 咀，生姜水煎。量证大小，加减多少用之可也。如大便结者，宜调中丸主之。
白术 白茯苓（去皮） 干生姜 人参 甘草（炙）
上等分，为极细末，炼蜜丸，每两作十丸或五丸。每服一二丸，水少许，煎服之。
问三四日后渐重，必躁乱不宁者，何也？
经云∶阳盛则发厥，阴盛则发躁，物极则反也。《外台秘要》云∶阴盛发躁，名曰阴躁
，欲
坐井中。然阴躁一证，汗下后多有之。仲景云∶汗下后仍不解，烦躁者，茯苓四逆汤主之。
内感阴证，饮冷胃寒而躁者，与汗下后烦躁同。厥阴热上冲胸而发躁者，火独炎上故也。
若病重急治者，宜黄 汤内每服加干姜重一钱，与仲景理中汤同意。大便结者，理中丸
主之。
治疗伤寒因内伤导致的拘急痉挛，三焦气虚引起的自汗，以及手足部位自汗（其中手背出汗可能更多），或者肢体震颤摇动，腰部和腿部沉重感，面部发红、眼睛充血，只想睡觉，头面部高热，两侧胁肋部热感明显，手足保持温和，两手心发热，自行腹泻但不口渴，大便或者困难，或者正常，或者口干咽燥，或者想喝热水而不愿喝水，或者稍微想喝水，呕吐和呃逆交替出现，或者胃脘部胀满闷痛，腹部疼痛，或者时而喜欢笑，时而悲伤哭泣，时而长叹气（去声），或者言语错乱、神志不清。世人怀疑这是谵语狂言，其实不是，这是因为神志不能安守于心室！刚得病时，在醒着和睡着之间，或者恐惧或者心悸，头颈部不太痛，走路还是像往常一样，这是因为阴气盛而阳气外走。两手脉象浮沉不一，或者左右往来没有定数，便具备沉、涩、弱、弦、微这五种阴脉的形态，轻取重按都完全无力，轻取时脉象受损变小，重按时也受损变小，这些都是阴脉。治疗应当先缓后急，缓证适宜用黄汤。
人参、黄耆（味甘者）、白茯苓、白术、白芍药（以上各一两）、甘草（七钱半，炒制）。
如果有呕吐症状，加入藿香半两、生姜半两，如果没有生姜，可用干姜代替。
将药材切碎，用生姜水煎煮。根据病情轻重，加减用量服用即可。如果大便干结，适宜用调中丸主治。
白术、白茯苓（去皮）、干生姜、人参、甘草（炙烤）。
以上药材等分，研磨成极细粉末，用炼蜜制成丸药，每两药粉做成十丸或五丸。每次服用一到二丸，加少量水，煎煮后服用。
问：过了三四天病情逐渐加重，必然出现烦躁不安、不得安宁的情况，为什么呢？
经典记载：阳盛则发生厥逆，阴盛则发生躁动，事物发展到极端就会向反面转化。《外台秘要》记载：阴盛导致躁动，称为阴躁，患者想要坐在井中。然而阴躁这一证候，在发汗或攻下治疗后多有出现。张仲景说：发汗或攻下后仍然不解，出现烦躁的，用茯苓四逆汤主治。内伤导致的阴证，因饮冷导致胃寒而躁动的，与发汗攻下后的烦躁相同。厥阴热气上冲胸膈而引发躁动的，是因为火性独炎向上所致。如果病情严重紧急需要治疗的，适宜在黄汤中每服加干姜一钱，这与张仲景理中汤的意思一致。大便干结的，用理中丸主治。
Treating Taiyang disease (Sun-Yang Disease) complicated by internal injury leading to muscle tension and spasms, spontaneous sweating due to deficiency of Qi in the Triple Burner (San Jiao), and spontaneous sweating specifically on the hands and feet (with possibly more sweat on the back of the hands). It may also present with trembling or shaking of the limbs, heaviness in the waist and legs, redness of the face and eyes, a desire only to sleep, intense heat in the head and face, significant heat in the two hypochondriac regions, warmth of the hands and feet, heat in the palms of both hands, spontaneous diarrhea without thirst, stool that is either difficult to pass or normal, dry mouth and throat, desire to drink hot water but not cold water, or slight desire to drink water. Vomiting and hiccups may occur intermittently, epigastric fullness and oppression, abdominal pain, occasional laughter, occasional crying, occasional sighing (pronounced with departing tone), or disordered speech and loss of mental clarity. What the world suspects as delirious talk and wild words is incorrect; this is merely the Spirit failing to reside in its chamber (Heart). At the onset of the disease, during states of wakefulness and sleep, there may be fear or palpitations. The head and neck are not significantly painful, and walking remains as usual. This indicates an excess of Yin and the departure of Yang. The pulses in both hands vary in floating and sunken qualities, moving left and right without certainty, exhibiting the five shapes of Yin pulses: deep (Chen), choppy (Se), weak (Ruo), wiry (Xian), and fine (Wei). They are completely powerless upon both light and heavy pressure; superficially they appear damaged and small, and deeply they also appear damaged and small—all characteristics of Yin pulses. Treatment should proceed from slow/gradual to rapid/urgent. For the gradual presentation, Huang Tang is appropriate.
Ren Shen (Ginseng Radix et Rhizoma), Huang Qi (Astragali Radix - sweet variety), Bai Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bai Shao Yao (Paeoniae Radix Alba) (each 1 liang), Gan Cao (Licorice Root, 7 qian 5 fen, stir-fried).
If vomiting occurs, add Huo Xiang (Agastache Herba) 0.5 liang and Sheng Jiang (Zingiberis Rhizoma Recens) 0.5 liang. If fresh ginger is unavailable, dried ginger (Gan Jiang) may substitute.
Crush the herbs and decoct with water containing fresh ginger. Adjust the dosage according to the severity of the condition. If constipation is present, Tiao Zhong Wan is indicated.
Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bai Fu Ling (Poria, peeled), Gan Jiang (Zingiberis Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Gan Cao (Licorice Root, honey-fried).
Equal parts of the above, ground into an extremely fine powder. Form pills using refined honey, making ten or five pills per liang of powder. Take one or two pills at a time, decocted with a small amount of water.
Question: After three or four days, the condition gradually worsens, inevitably leading to restlessness and agitation. Why?
The Classics state: Excess of Yang leads to Jue Ni (Cold Extremities); Excess of Yin leads to Zao (Restlessness). When things reach their extreme, they reverse. *Waitai Miyao* states: Yin excess causing restlessness is called Yin Zao (Yin Restlessness), where the patient desires to sit in a well. However, this syndrome of Yin Zao often appears after sweating or purging treatments. Zhang Zhongjing stated: If after sweating or purging the condition remains unresolved and irritability/restlessness occurs, Fu Ling Si Ni Tang is the primary treatment. In cases of internal injury with Yin syndrome, restlessness caused by drinking cold liquids and resulting stomach cold is identical to the irritability following sweating and purging. Restlessness caused by Heat rushing up from the Jue Yin (Liver Channel) to the chest is due to Fire flaming upward alone. If the disease is severe and urgent requiring treatment, it is appropriate to add 1 qian of Gan Jiang (Zingiberis Rhizoma) to each dose of Huang Tang, which aligns with the principle of Zhang Zhongjing's Li Zhong Tang. If constipation is present, Li Zhong Wan is the primary treatment.