觉辛甘温暖之神。融成一片。化工春气。其与惟王建中。妖氛自息者。同功合德。此仲景命名之深意也。至其
汤后曰如一炊顷。可饮粥二升。又曰当一日食糜。温覆之。经曰。大气一转。其气乃散。所中之寒。其意欲如服
桂枝汤之法。将解于阳回之自汗乎。若但云恐中寒挟食。故饮粥食糜。恐感寒复寒。故令温覆。则犹得其浅
而未得其深者也。门人问曰。如法服大建中而不得自汗。所中之寒。将何所解散乎。并何变症耶。答曰。此
问亦不可少。夫脏腑与经络相通。口鼻及腹脐所感之寒。脾胃先受之。及中焦阳气一转。则内邪托出经络。
且从阳气之化。而发为表热者。常也。此条之症。因中气虚微。不能载出。故不一见表症。服大建中而解于自
汗。中气大振。一箭透重铠之力也。倘服此而不汗。如强努之末。不穿鲁缟。将内症消。而发为表热。变桂枝加
附子汤。或麻附细辛汤等症居多。否则不发表热。脾家实。腐秽当自去。解于自下利者。亦十之一二也。本
门是论腹满。每条当寻腹满处。腹中寒上冲。及上下痛而不可触近。俱有腹满在内。不可不知。
十五条 胁下偏痛。发热。其脉紧弦。此寒也。以温药下之。宜大黄附子汤。
大黄附子汤方 大黄（三两） 附子（三枚炮） 细辛（二两）
上三味。以水五升。煮取二升。分温三服。若强人煮取二升半。分温三服。服后如人行四五里。进一服。
此从首条不满、必便难。两 疼痛。此虚寒从上冲等句。而申言之也。人身之心胸。即天之太虚。其两胁、即天
之四垂也。心胸之真阳充满。有如日光暄赫。阴氛自化。不特太虚清明高远。即天之四垂。云消翳净。古诗晴
川历历汉阳树。颇能道出神境。复何胸满胁满之病乎。惟如首条趺阳脉微弦。微则阳光失德。弦则地气冒
明。故曰法当腹满者。岚浮氛起。直上以塞太虚之象也。否则、微为干健不施。弦为坤顺失正。故曰不满必便
难。两 疼痛者。云斜气横。旁分以阴四垂之象也。知此。则首节与本条。及各条之症。其病机偏正高下。可会
其全神矣。盖谓五脏中。惟肝居至阴之下。其性阴寒善逆。本脏中阳神秉政。则冲和调畅。故动则主生。而化
则为道。若其脏真之阳自虚。则阴寒之性。上逆而为祸矣。阳明之气虚。从胃外而上犯胃脘。则为腹满等症。
少阳之气虚。从膈旁而斜穿两 。则为胁满等症。太阳之气虚。从胃外而上侵宗气。则为胸满等症。夫腹满
胸满。除实症用下外。凡下寒上冲者。已立附子粳米。及大建中之法。其少阳之气虚。因而旁穿两 。以致胁
下偏痛。并膈气微而不能传送。先见便难。后则气浮于上而发表热。其脉紧弦。紧则为寒为痛。弦则主肝主
逆。紧从弦断。则寒而致痛者。由于肝脏阴寒之气上逆可知。故曰寒也。因便难而蒸为表热者。宜下之以通
其便难之气。则经络之热可解。膈气微而招阴脏之寒逆者。宜温之而填其上焦之气。则逆痛可下。温药下
之。两不相背矣。盖大黄之苦寒。与附子、细辛之辛热相偶。膈气喜附子、细辛之温。却暗得大黄以下泻其逆
满。贼阴亲大黄之性。却误吞附子、细辛而自化其阴翳。譬之帝王。德礼相成。恩威并济。譬之天地。春雷不怒。
伏雨长生之道也。至其煎法服法。另开生面。与寻常略不相同。寻常利药。必先煎大黄以为主。而后入诸药。
使随其攻下之性。此独同煎。其不注意用下。一也。寻常作三服者。多曰日三服。此独令如人行四五里。即进
一服。其罔顾虑并力峻下二也。盖以首节便难二字。不过因阳微不能传送。而难于便。与内实便闭者不同。
又此方以温药牵制大黄之性。而不十分寒下故耳。门人曰。夫子以本文为申言首条之症。本文虽无便
难字样。然以胁下偏痛及发热二症。便公然下以温药。其为申说首条似矣。但首条言脉曰趺阳微弦。此条
虽亦言弦。却曰紧弦。而并不言微。恐作承首条之语。或失之牵强耶。抑其中另有奥旨乎。答曰。首条兼言主
虚。故曰微弦。此条单言客实。故曰紧弦。且微弦。尚有主在。紧弦。则客代主人矣。由微而进于紧。即奥旨也。
十六条 寒气厥逆。赤丸主之。
赤丸方 茯苓（四两） 半夏（四两洗） 乌头（二两炮） 细辛（一两）
上六味。末之。内真朱为色。炼蜜丸如麻子大。先饮食。酒下三丸。日再。夜一服。不知。稍增之。以知为度。（方
内止四味。其曰右六味。则六字为四字之讹耶。抑本方失去二味耶、愚窃伤寒直中厥阴及少阴诸方之
意而拟补之。或可加干姜桂枝乎。盖干姜散寒愈厥。桂枝通阳、止逆故也。敢存此以质高明。）
厥。谓寒战。如头振齿介及浑身筋惕之类。此出于肝。肝中阳气自虚。又或为外寒所逼。微阳深伏至阴之下。
而逆阴自动。譬之严冬。真阳在泉。日光阴晦。阴风忽起鸣条走叶之象。故厥还者必发热。以阳气伏而必起。
阳起则阴伏也。厥不还者死。阳绝不能自还。故主死耳。四逆者。四肢逆冷。轻则在胫腕。重则至肘膝。此起于
胃。胃中饮食所生之精悍。由脾肺而贯手足之四末者为顺。胃为客寒所中。或肝肾之贼阴犯之。或停食贮
饮等类。皆能使胃系塞。而其阳自伏。不能外贯手足而逆冷。故曰逆也。若各因其邪而分别治之。令胃中之
精悍一通则愈。此厥逆之所由分也。然厥症必兼四逆。以肝木之阴邪。能贼胃气。故言厥者。必曰厥逆。四逆
之重症。亦有见厥者。以胃阳自虚而见伏。遂下招肝木之外侮。故言逆者。亦间曰四逆而厥云。要之因厥而
逆。则重在厥。厥愈而逆自通。因逆而厥。则重在逆。逆通而厥亦自愈。然则成氏谓厥甚于逆。自是定论。王履
乞乞议之。真盲人观剧。而妄述于妇人女子之前也。盖谓肝肾之虚寒上冲。而真阳下伏。因寒战及头振
齿介等症而厥。遂致木邪乘土。又趺阳负于少阴。而胃气中阻不贯手足而逆。此责在肝肾之虚寒。故当以
治厥为本。厥而致逆。不必责阳明之胃。前所谓厥温而逆自通也。赤丸温下焦之阳。其主之也。不亦宜乎。乌
头为隔年之老阳。较附子之性颇缓。而为下行旁行之品。且附子侧子。俱其所生。老阳之气坚定。性缓。则不
致水火相激。而厥逆愈张。下行旁行。则直达肝肾。附侧为其所生。则又能通脏真之气。而生之长之矣。阴气
上逆。寒饮必升。故用茯苓淡渗之。且即从小便而下泻其逆也。半夏降上焦之逆。细辛通经络之阳。故用以
为佐焉。真朱、即水银所烧之朱而不杂假者。水银为至阴之类。烧以为朱。则色红性重。取直走下焦而通阳
气。故内此以为色焉。酒性温而通经。盖温以愈厥。通经以愈逆。故以之为下药之使耳。
十七条 腹痛。脉弦而紧。弦则卫气不行。即恶寒。紧则不欲食。邪正相搏。即为寒疝。绕脐痛。若发
则白汗出。手足厥冷。其脉沉紧者。大乌头煎主之。
乌头煎方 乌头（大者五枚熬去皮不 咀）
上以水三升。煮取一升。去滓。内蜜二升。煎令水气尽。取二升。强人服七合。弱人服五合。不瘥。明日再
服。不可一日再服。
腹痛。指脐之上下而言。即下文绕脐痛是也。脉弦而紧。就下文卫气不行。不欲饮食观之。当单指阳明。不概
六部而言。以腹痛属阳明病。故就其部位诊之。是知篇首趺阳二字。一直贯至终篇也。弦从浮见。紧从按得。
故以而字断之。且下文言紧。即曰沉紧者此也。疝者。气病也。五脏俱有之。然肾为水脏。肝居至阴之下。故二
脏病此者独多。夫阴脏贵阳气。阳腑重阴津。此阴阳各喜配偶之性情。倘本脏之真阳自虚。则阴气与客寒
外湿。两相暗召。而伏结于杳冥。若他脏及别腑之阳气各胜。则如太平之世。非无匪类。而潜踪乡曲。不为民
害。倘阳明之气虚。则如本条之症。而入犯中州。故腹脐为病。少阳之气虚。则如次条之症。而旁据两辅。故胁
下为病。太阳之气虚。则如三条之症。从腹及胁。而又外侵边鄙。故为手足不仁。及身体疼痛等症。甚至阴气
上浮阳位。留连不去。变成假热。如四条之脉症。不下其寒。几几乎有怀宗流寇之祸矣。故其字从山。山之为
物。阳上实而阴下虚。其卦为艮。阴下连而阳上断。其变为泽。故晴明之候。清泉白石。艮止于覆盂。而阴晦之
时。冷雾寒云。兑张而吐气。此古人命名为疝。而从山之意也。仲景谓腹痛之人。诊其阳明之脉。举之见弦。而
按之得紧。弦为肝脉。又为气削之应。夫卫气者。阳明腑中谷气所化之精悍为之也。今见肝脉。是土受木邪。
其气削弱。不能行其精悍。而出为卫气。可知。故即当恶寒。紧为病脉。亦为寒诊。是虽应腹中之痛。而寒气在
胃。则胃阳之不能化物。又可知。故不欲饮食也。盖胃中正气略胜。则阴脏之邪下伏。胃中正气略负。则阴脏
之邪复起。故邪正相搏者。是寒疝之所以为病也。胃当脐之内。故其症绕脐而痛。以下又从邪正相搏句而
申言之。盖正胜。则有时不发。若发。则阴邪上乘。而虚阳上遁。故白汗出。肝肾之逆阴起。而胃阳中伏。不但不
行卫气而恶寒。且手足厥冷而逆矣。其脉沉紧。沉为在里。沉紧为在里之脏气阴寒。大乌头煎。其可已乎。以
老阳坚定之性。用甘缓之蜜。熬以为煎。而尽去其水气。不特柔以济刚。恐水气易渗。盖欲其留连胃中。独扶
阳明之意也。白汗。诸经无此名。江浙乡语呼大汗为白浮汗。道家黑白者。阴阳之别名。亦太极之图象也。
意者。黑满而白亏。其阴盛而格阳上浮之谓乎。录此备考。亦礼失而求诸野之意云尔。愚谓白与自颇形似。
白汗者或自汗之讹耶。
十八条 寒疝。腹中痛。及胁痛里急者。当归生姜羊肉汤主之。
当归生姜羊肉汤方 当归（三两） 生姜（五两） 羊肉（一斤）
上三味。以水八升。煮取三升。温服七合。日三服。若寒多者。加生姜成一斤。痛多而呕者。加橘皮二两。白术
一两。加生姜者。亦加水五升。煮取三升二合。服之。
寒疝、腹痛。详已见。少阳之气虚。疝气从腹而旁穿两胁。以致胁痛。并胀满而里气急切者。皆阳位不受阴邪
之应。羊肉甘温补气。为胃家之所喜。佐以辛温之生姜。不特功能散寒。且温胃而提其气以温肺。然后使以
苦温气重之当归。从胸注胁。盖又领肺金之暖气。以达肝胆之乡。因而遂消其寒疝者也。疝虽阴脏之邪。然
必合客寒以为内结上冲之势。寒多。谓客寒独重也。生姜既能温脏阴而使下消。尤能散客寒而使外出。本
方之外。加至十一两者。其亦通阳气以资自汗。而驱客寒外散乎。疝气逆甚。则痛多而呕。橘皮香细而气散。
味辛而性温。为走肝消逆之品。故加之。凡逆甚者必由膈虚。白术填上焦之空。故亦加之耳。
十九条 寒疝腹中痛。逆冷。手足不仁。若身疼痛。灸刺诸药。不能治。抵当乌头桂枝汤主之。
乌头桂枝汤方 乌头。
上一味。以蜜二斤。煎减半。去滓。以桂枝汤五合解之。令得一升后。初服二合。不知。即服三合。又不知。复加
至五合。其知者。如醉状。得吐者为中病。
寒疝腹痛逆冷。详已见。若其人太阳胸分之阳虚。则疝气从腹上胸。且从胸而外出太阳之经络矣。夫手足
为阳气之充。寒疝之邪逆之。则其中似有捍格。而为顽浓之状。是不仁也。身体有通阳之脉。寒疝之邪逆之。
则其中如有阻滞。而为胀满之状。故疼痛也。以灸刺治经。其如病之本在脏。以诸药治里。其如病之标又在
经。故皆不能治也。惟抵当乌头桂枝汤主之者。以乌头及蜜合煮。即前条乌头煎之义。所以温胃阳。而消寒
逆之疝。则腹痛逆冷内愈。此治其本也。以桂枝汤解而合服之者。桂枝本汤。为行阳走表之剂。且以乌头煎
为佐。则又能从手足身体。而除寒解疝。其不仁、疼痛等症。焉有不外愈者乎。此治其标也。合标本内外而并
治之。其主之也宜矣。如醉状。倦怠不宁之貌。盖将飞者翼伏。阳气缩而欲伸之象。得吐中病者。吐能提气。亦
大气一转。其病乃散。阳胜而阴自化之理也。名之曰抵当者。与伤寒之抵当汤丸同义。盖伤寒之汤丸。为抵
敌其热。而当住攻心之势。且泻热者宜下。故病去于利。此症之汤。为抵敌其寒。而拦当熄火之机。且温上者。
宜提。故中病于吐耳。乌头无枚数。以本方用蜜二斤。与乌头煎之用蜜二斤准之。当亦用五枚耶。或问
不仁字。医经之言手足皮肤不等。古人何不从痹重板滞等名。取其一而状之。而独曰不仁者。是何义也。前
贤既无确解。子又云似有捍格。而为顽浓之状。则与俗所云麻木者近似。而于不仁何取乎。答曰。少阴君主
之官。深藏奥府。而其所发之阳神。充周遍满中。复余灵醒昭觉之用。故虽麦芒隐刺。识痛楚于刀针。而蚤虱
微踪。辨驰驱于车马。此心君之阳德。仁被要荒之象。譬之天地阳春无迹。而草根树杪皆通。譬之父母慈爱
中悬。而儿隐女微必洞。此皆仁之为用也。若其素夙无病。而手足皮肤。一时但觉 格顽浓之状。则是心阳
感觉到辛甘温暖的神韵，融合成一片，如同化工春气。这与“惟王建中”（建立中气）、使妖氛自然平息的功效相同，功绩与德行相合。这是张仲景命名方剂的深意所在。至于服药后说“大约一顿饭的时间”，可以喝两升粥；又说应当一天内吃米粥，并覆盖衣物保暖。经典中说：“大气一转，其气乃散。”所感受的寒邪，其意图是想通过类似服用桂枝汤的方法，在阳气回复时的自汗中解除吗？如果只说是担心中焦受寒挟带食积，所以喝粥吃糜；担心感受寒邪再次受寒，所以令其保暖覆盖，那就只得到了浅层的意思，而未得到深层的含义。门人问道：“按照方法服用大建中汤却没有出现自汗，所感受的寒邪，将如何解散呢？又会有什么变证呢？”回答说：“这个问题也不可缺少。脏腑与经络相通，口鼻及腹脐所感受的寒邪，脾胃先受到侵害。等到中焦阳气运转，则内邪被托出至经络，并且随着阳气的化生，发为表热，这是常理。此条的症状，因为中气虚微，不能载出外邪，所以不出现表症。服用大建中汤后通过自汗而解，是中气大振，具有如一箭穿透重铠的力量。倘若服用此药而不汗出，就像强弩之末，连薄绢都穿不透，那么内症消除，而发为表热，变为桂枝加附子汤证，或者麻黄附子细辛汤证等居多。否则不发表热，脾家实，腐秽当自行排出，通过自下利而解的，也占十分之一二。本篇论述腹满，每条都应当寻找腹满之处。腹中寒邪上冲，以及上下疼痛且不可触碰靠近，都包含有腹满在内，不可不知。”
十五条 胁下偏侧疼痛，发热，脉象紧弦，这是寒邪所致，应用温药攻下，适宜用大黄附子汤。
大黄附子汤方：大黄（三两），附子（三枚，炮制），细辛（二两）。
以上三味药，用水五升，煮取二升，分三次温服。如果是体质强壮的人，煮取二升半，分三次温服。服药后如人行走四五里的时间，再进一服。
这是从首条“不满、必便难”、“两胁疼痛”、“此虚寒从上冲”等句，进而申述说明的。人身的心胸，就像天的太虚空间，两胁就像天的四垂边缘。心胸的真阳充满，有如日光炽热，阴氛自然化解，不仅太虚清明高远，就连天的四垂，云消翳净，古诗“晴川历历汉阳树”颇能道出这种神妙境界，还有什么胸满胁满的病呢？只有像首条趺阳脉微弦，微则阳光失德，弦则地气冒明，所以说“法当腹满”，是岚雾浮起，直上以堵塞太虚的景象。否则，微为干健不施，弦为坤顺失正，所以说“不满必便难”，两胁疼痛，是云斜气横，旁分以阴占据四垂的景象。知晓这些，那么首节与本条，及各条的症状，其病机的偏正高下，可以领会其全神了。大概五脏之中，只有肝居于至阴之下，其性阴寒善逆，本脏中阳神秉政，则冲和调畅，所以动则主生，而变化则为道。如果其脏真之阳自虚，则阴寒之性，上逆而为祸害。阳明之气虚，从胃外而上犯胃脘，则为腹满等症状。少阳之气虚，从膈旁而斜穿两胁，则为胁满等症状。太阳之气虚，从胃外而上侵宗气，则为胸满等症状。夫腹满胸满，除实证用下法外，凡是下寒上冲者，已经确立了附子粳米汤及大建中汤的法度。其少阳之气虚，因而旁穿两胁，以致胁下偏痛，并膈气微弱而不能传送，先见便难，后则气浮于上而发表热，其脉紧弦，紧则为寒为痛，弦则主肝主逆，紧从弦断，则寒而致痛者，由于肝脏阴寒之气上逆可知，所以说“寒也”。因便难而蒸为表热者，宜用下法以通其便难之气，则经络之热可解；膈气微而招致阴脏之寒逆者，宜用温法以填补其上焦之气，则逆痛可下。温药与下法并用，两不相背。盖大黄之苦寒，与附子、细辛之辛热相配合，膈气喜欢附子、细辛之温，却暗得大黄以下泻其逆满；贼阴亲近大黄之性，却误吞附子、细辛而自化其阴翳。这好比帝王，德礼相成，恩威并济；又好比天地，春雷不怒，伏雨长生之道。至于其煎法服法，另开生面，与寻常略不相同。寻常利药，必先煎大黄以为主，而后入诸药，使其随其攻下之性。此方独同煎，是不注意用下法，这是一点。寻常作三服者，多曰日三服，此独令如人行四五里，即进一服，这是罔顾虑并力峻下，这是第二点。大概以首节便难二字，不过因阳微不能传送，而难于大便，与内实便闭者不同。又此方以温药牵制大黄之性，而不十分寒下，所以如此。门人说：“夫子以本文为申言首条之症，本文虽无便难字样，然以胁下偏痛及发热二症，便公然下以温药，其为申说首条似矣。但首条言脉曰趺阳微弦，此条虽亦言弦，却曰紧弦，而并不言微，恐作承首条之语，或失之牵强耶？抑其中另有奥旨乎？”回答说：“首条兼言主虚，故曰微弦；此条单言客实，故曰紧弦。且微弦，尚有主在；紧弦，则客代主人矣。由微而进于紧，即是奥旨。”
十六条 寒气厥逆，赤丸主之。
赤丸方：茯苓（四两），半夏（四两，洗），乌头（二两，炮），细辛（一两）。
以上六味药，研为末，加入真朱为色，炼蜜丸如麻子大。先饮食，酒下三丸，每日两次，夜间一次。若无效，稍增加剂量，以见效为度。（方内止四味，其曰右六味，则六字为四字之讹耶？抑本方失去二味耶？愚窃伤寒直中厥阴及少阴诸方之意而拟补之，或可加干姜桂枝乎？盖干姜散寒愈厥，桂枝通阳、止逆故也。敢存此以质高明。）
厥，谓寒战，如头振齿介及浑身筋惕之类。此出于肝，肝中阳气自虚，又或为外寒所逼，微阳深伏至阴之下，而逆阴自动，譬之严冬，真阳在泉，日光阴晦，阴风忽起鸣条走叶之象。故厥还者必发热，以阳气伏而必起，阳起则阴伏也。厥不还者死，阳绝不能自还，故主死耳。四逆者，四肢逆冷，轻则在胫腕，重则至肘膝，此起于胃，胃中饮食所生之精悍，由脾肺而贯手足之四末者为顺。胃为客寒所中，或肝肾之贼阴犯之，或停食贮饮等类，皆能使胃系塞，而其阳自伏，不能外贯手足而逆冷，故曰逆也。若各因其邪而分别治之，令胃中之精悍一通则愈，此厥逆之所由分也。然厥症必兼四逆，以肝木之阴邪，能贼胃气，故言厥者，必曰厥逆。四逆之重症，亦有见厥者，以胃阳自虚而见伏，遂下招肝木之外侮，故言逆者，亦间曰四逆而厥云。要之因厥而逆，则重在厥，厥愈而逆自通；因逆而厥，则重在逆，逆通而厥亦自愈。然则成氏谓厥甚于逆，自是定论，王履乞乞议之，真盲人观剧，而妄述于妇人女子之前也。盖谓肝肾之虚寒上冲，而真阳下伏，因寒战及头振齿介等症而厥，遂致木邪乘土，又趺阳负于少阴，而胃气中阻不贯手足而逆，此责在肝肾之虚寒，故当以治厥为本，厥而致逆，不必责阳明之胃，前所谓厥温而逆自通也。赤丸温下焦之阳，其主之也，不亦宜乎。乌头为隔年之老阳，较附子之性颇缓，而为下行旁行之品，且附子侧子，俱其所生，老阳之气坚定，性缓，则不致水火相激，而厥逆愈张。下行旁行，则直达肝肾，附侧为其所生，则又能通脏真之气，而生之长之矣。阴气上逆，寒饮必升，故用茯苓淡渗之，且即从小便而下泻其逆也。半夏降上焦之逆，细辛通经络之阳，故用以为佐焉。真朱，即水银所烧之朱而不杂假者，水银为至阴之类，烧以为朱，则色红性重，取直走下焦而通阳气，故内此以为色焉。酒性温而通经，盖温以愈厥，通经以愈逆，故以之为下药之使耳。
十七条 腹痛，脉弦而紧，弦则卫气不行，即恶寒，紧则不欲食，邪正相搏，即为寒疝，绕脐痛，若发则白汗出，手足厥冷，其脉沉紧者，大乌头煎主之。
乌头煎方：乌头（大者五枚，熬去皮，不咀）。
以上一味药，用水三升，煮取一升，去滓，内蜜二升，煎令水气尽，取二升。强人服七合，弱人服五合。不瘥，明日再服，不可一日再服。
腹痛，指脐之上下而言，即下文绕脐痛是也。脉弦而紧，就下文卫气不行、不欲饮食观之，当单指阳明，不概六部而言，以腹痛属阳明病，故就其部位诊之，是知篇首趺阳二字，一直贯至终篇也。弦从浮见，紧从按得，故以“而”字断之。且下文言紧，即曰沉紧者此也。疝者，气病也，五脏俱有之，然肾为水脏，肝居至阴之下，故二脏病此者独多。夫阴脏贵阳气，阳腑重阴津，此阴阳各喜配偶之性情。倘本脏之真阳自虚，则阴气与客寒外湿，两相暗召，而伏结于杳冥。若他脏及别腑之阳气各胜，则如太平之世，非无匪类，而潜踪乡曲，不为民害。倘阳明之气虚，则如本条之症，而入犯中州，故腹脐为病。少阳之气虚，则如次条之症，而旁据两辅，故胁下为病。太阳之气虚，则如三条之症，从腹及胁，而又外侵边鄙，故为手足不仁，及身体疼痛等症。甚至阴气上浮阳位，留连不去，变成假热，如四条之脉症，不下其寒，几几乎有怀宗流寇之祸矣。故其字从山，山之为物，阳上实而阴下虚，其卦为艮，阴下连而阳上断，其变为泽，故晴明之候，清泉白石，艮止于覆盂，而阴晦之时，冷雾寒云，兑张而吐气，此古人命名为疝，而从山之意也。仲景谓腹痛之人，诊其阳明之脉，举之见弦，而按之得紧。弦为肝脉，又为气削之应。夫卫气者，阳明腑中谷气所化之精悍为之也。今见肝脉，是土受木邪，其气削弱，不能行其精悍，而出为卫气，可知，故即当恶寒。紧为病脉，亦为寒诊，是虽应腹中之痛，而寒气在胃，则胃阳之不能化物，又可知，故不欲饮食也。盖胃中正气略胜，则阴脏之邪下伏；胃中正气略负，则阴脏之邪复起，故邪正相搏者，是寒疝之所以为病也。胃当脐之内，故其症绕脐而痛。以下又从邪正相搏句而申言之。盖正胜，则有时不发；若发，则阴邪上乘，而虚阳上遁，故白汗出。肝肾之逆阴起，而胃阳中伏，不但不行卫气而恶寒，且手足厥冷而逆矣。其脉沉紧，沉为在里，沉紧为在里之脏气阴寒，大乌头煎，其可已乎？以老阳坚定之性，用甘缓之蜜，熬以为煎，而尽去其水气，不特柔以济刚，恐水气易渗，盖欲其留连胃中，独扶阳明之意也。白汗，诸经无此名，江浙乡语呼大汗为白浮汗，道家黑白者，阴阳之别名，亦太极之图象也。意者，黑满而白亏，其阴盛而格阳上浮之谓乎？录此备考，亦礼失而求诸野之意云尔。愚谓白与自颇形似，白汗者或自汗之讹耶？
十八条 寒疝，腹中痛，及胁痛里急者，当归生姜羊肉汤主之。
当归生姜羊肉汤方：当归（三两），生姜（五两），羊肉（一斤）。
以上三味药，用水八升，煮取三升，温服七合，日三服。若寒多者，加生姜成一斤。痛多而呕者，加橘皮二两，白术一两。加生姜者，亦加水五升，煮取三升二合，服之。
寒疝、腹痛，详已见。少阳之气虚，疝气从腹而旁穿两胁，以致胁痛，并胀满而里气急切者，皆阳位不受阴邪之应。羊肉甘温补气，为胃家之所喜，佐以辛温之生姜，不特功能散寒，且温胃而提其气以温肺，然后使以苦温气重之当归，从胸注胁，盖又领肺金之暖气，以达肝胆之乡，因而遂消其寒疝者也。疝虽阴脏之邪，然必合客寒以为内结上冲之势。寒多，谓客寒独重也。生姜既能温脏阴而使下消，尤能散客寒而使外出。本方之外，加至十一两者，其亦通阳气以资自汗，而驱客寒外散乎？疝气逆甚，则痛多而呕，橘皮香细而气散，味辛而性温，为走肝消逆之品，故加之。凡逆甚者必由膈虚，白术填上焦之空，故亦加之耳。
十九条 寒疝腹中痛，逆冷，手足不仁，若身疼痛，灸刺诸药，不能治，抵当乌头桂枝汤主之。
乌头桂枝汤方：乌头。
上一味药，以蜜二斤，煎减半，去滓，以桂枝汤五合解之，令得一升后。初服二合，不知，即服三合，又不知，复加至五合。其知者，如醉状，得吐者为中病。
寒疝腹痛逆冷，详已见。若其人太阳胸分之阳虚，则疝气从腹上胸，且从胸而外出太阳之经络矣。夫手足为阳气之充，寒疝之邪逆之，则其中似有捍格，而为顽浓之状，是不仁也。身体有通阳之脉，寒疝之邪逆之，则其中如有阻滞，而为胀满之状，故疼痛也。以灸刺治经，其如病之本在脏；以诸药治里，其如病之标又在经，故皆不能治也。惟抵当乌头桂枝汤主之者，以乌头及蜜合煮，即前条乌头煎之义，所以温胃阳，而消寒逆之疝，则腹痛逆冷内愈，此治其本也。以桂枝汤解而合服之者，桂枝本汤，为行阳走表之剂，且以乌头煎为佐，则又能从手足身体，而除寒解疝，其不仁、疼痛等症，焉有不外愈者乎？此治其标也。合标本内外而并治之，其主之也宜矣。如醉状，倦怠不宁之貌，盖将飞者翼伏，阳气缩而欲伸之象。得吐中病者，吐能提气，亦大气一转，其病乃散，阳胜而阴自化之理也。名之曰抵当者，与伤寒之抵当汤丸同义，盖伤寒之汤丸，为抵敌其热，而当住攻心之势，且泻热者宜下，故病去于利。此症之汤，为抵敌其寒，而拦当熄火之机，且温上者，宜提，故中病于吐耳。乌头无枚数，以本方用蜜二斤，与乌头煎之用蜜二斤准之，当亦用五枚耶？或问不仁字，医经之言手足皮肤不等，古人何不从痹重板滞等名，取其一而状之，而独曰不仁者，是何义也？前贤既无确解，子又云似有捍格，而为顽浓之状，则与俗所云麻木者近似，而于不仁何取乎？答曰：少阴君主之官，深藏奥府，而其所发之阳神，充周遍满中，复余灵醒昭觉之用，故虽麦芒隐刺，识痛楚于刀针，而蚤虱微踪，辨驰驱于车马，此心君之阳德，仁被要荒之象，譬之天地阳春无迹，而草根树杪皆通，譬之父母慈爱中悬，而儿隐女微必洞，此皆仁之为用也。若其素夙无病，而手足皮肤，一时但觉 格顽浓之状，则是心阳
Perceiving the spirit of acrid, sweet, and warm properties, blending into one piece, like the spring qi of creative transformation. This shares the same efficacy and virtue with "Wei Jian Zhong" (Establishing the Middle), where evil influences naturally subside. This is the profound meaning behind Zhang Zhongjing's naming of the formula. Regarding the instruction after taking the decoction: "approximately in the time it takes to cook a meal," one may drink two sheng of porridge; it also says one should eat rice gruel for a day, covering oneself with warmth. The classic states: "When the great qi rotates, the pathogenic qi dissipates." The intent regarding the cold that has invaded seems to be desiring resolution through spontaneous sweating upon the return of yang, similar to the method of taking Guizhi Tang (Cinnamon Twig Decoction). If one were to say merely that it is feared the middle jiao is affected by cold mixed with food retention, hence drinking porridge and gruel; or that it is feared contracting cold again, hence keeping warm with coverings, then one would only grasp the superficial meaning and miss the deeper implication. A student asked: "If one follows the method of taking Da Jian Zhong Tang (Major Building the Middle Decoction) but does not experience spontaneous sweating, how will the invading cold be dispersed? What variable syndromes might arise?" The answer was: "This question is indispensable. The zang-fu organs are connected to the meridians and collaterals. Cold invading via the mouth, nose, abdomen, and umbilicus is first received by the Spleen and Stomach. Once the yang qi of the middle jiao rotates, internal pathogens are pushed out to the meridians and collaterals, and following the transformation of yang qi, manifest as exterior heat; this is the norm. In this clause, because the middle qi is deficient and weak, unable to carry pathogens outward, exterior symptoms do not appear. Taking Da Jian Zhong Tang leads to resolution through spontaneous sweating, indicating a vigorous resurgence of middle qi, possessing the power of an arrow piercing heavy armor. If one takes this medicine and does not sweat, it is like the end of a strong crossbow bolt, unable to penetrate thin silk. The internal symptoms may resolve, but exterior heat may emerge, transforming into Guijia Fuzi Tang (Guizhi Decoction with Added Aconite) syndrome, or more commonly Mahuang Fuxi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) syndrome. Otherwise, without releasing exterior heat, if the Spleen becomes full/real, filth and turbidity will expel themselves, resolving through spontaneous diarrhea; this accounts for one or two cases out of ten. This chapter discusses abdominal fullness; in each clause, one must identify the site of abdominal fullness. Cold rising from within the abdomen, and pain above and below that cannot be touched, all contain abdominal fullness internally; this must not be overlooked."
Clause 15: Pain on one side of the hypochondrium, fever, with a tight and wiry pulse. This is cold. It should be treated with warm purgatives. Dahuang Fuzi Tang (Rhubarb and Aconite Decoction) is appropriate.
Dahuang Fuzi Tang Formula: Dahuang (3 liang), Fuzi (3 pieces, processed), Xixin (2 liang).
The above three herbs are boiled in 5 sheng of water until 2 sheng remains. Divide into three warm doses. For robust individuals, boil until 2.5 sheng remains, divide into three warm doses. After taking the dose, wait the time it takes for a person to walk four or five li before administering the next dose.
This elaborates on the phrases from the first clause: "no fullness, necessarily difficult defecation," "pain in both flanks," and "this deficiency-cold rushing up from below." The chest and heart of the human body correspond to the Great Void of heaven; the hypochondria correspond to the four corners of the sky. When the true yang of the chest and heart is full, like the blazing sun, yin mist naturally transforms. Not only is the Great Void clear and high, but the clouds and haze in the four corners of the sky dissipate. The ancient poem "Clear river, distinct trees of Hanyang" captures this spiritual state well. Why would there be chest or hypochondriac fullness? Only when, as in the first clause, the Fuyang pulse is faint and wiry: faint indicates the loss of solar virtue; wiry indicates earthly qi obscuring brightness. Thus, "legally there should be abdominal fullness," representing mist rising to block the Great Void. Otherwise, faint indicates lack of vigorous action; wiry indicates loss of kun-like submission. Thus, "no fullness but necessarily difficult defecation," and pain in the flanks represent slanting clouds and horizontal qi, with yin occupying the four corners. Understanding this allows one to grasp the complete spirit of the pathology—whether biased, upright, high, or low—in the first section, this clause, and other clauses. Generally, among the five zang organs, only the Liver resides at the lowest level of extreme yin. Its nature is yin-cold and prone to rebellion. When the yang spirit of the liver itself governs, flow is harmonious and smooth, movement generates life, and transformation follows the Dao. If the true yang of the liver is deficient, its yin-cold nature rebels upward, causing disaster. Deficiency of Yangming qi, attacking the stomach cavity from outside, causes abdominal fullness. Deficiency of Shaoyang qi, slanting through the hypochondria from the diaphragm, causes hypochondriac fullness. Deficiency of Taiyang qi, invading Zongqi from outside the stomach, causes chest fullness. For abdominal and chest fullness, except for excess syndromes treated with purgation, for lower cold rushing upward, formulas like Fuzi Jingmi Tang (Aconite and Rice Decoction) and Da Jian Zhong Tang have already been established. For Shaoyang qi deficiency, slanting through the hypochondria causing unilateral hypochondriac pain, and slight diaphragmatic qi failing to transport, initially presenting with difficult defecation, later floating qi manifests as exterior heat, with a tight and wiry pulse. Tight indicates cold and pain; wiry indicates the Liver and rebellion. Since tight breaks from wiry, pain caused by cold stems from the upward rebellion of yin-cold qi of the Liver. Hence, "it is cold." Because difficult defecation steams into exterior heat, purgation should be used to unblock the qi of difficult defecation, resolving meridian heat. Because slight diaphragmatic qi invites yin-cold rebellion from yin zang organs, warming should be used to fill the upper jiao qi, resolving rebellious pain. Warm medicines combined with purgation are not contradictory. The bitter-cold nature of Dahuang pairs with the acrid-hot nature of Fuzi and Xixin. The diaphragm favors the warmth of Fuzi and Xixin, while secretly benefiting from Dahuang's downward purging of rebellious fullness. The treacherous yin approaches the nature of Dahuang but inadvertently swallows Fuzi and Xixin, thereby transforming its own yin shadows. This is like an emperor where virtue and ritual complement each other, combining grace and authority. It is like heaven and earth: spring thunder does not rage, allowing hidden rain to nourish life. The decoction and administration methods are unique, differing slightly from the ordinary. Usually, purgative herbs require boiling Dahuang first as the main agent, then adding other herbs to follow its purgative nature. Here, they are boiled together, showing no emphasis on purgation (Point 1). Usually, three doses are taken as "three times a day"; here, one dose is taken every time a person walks four or five li, showing disregard for caution and concentrating force for severe purgation (Point 2). The phrase "difficult defecation" in the first section merely indicates difficulty due to yang deficiency failing to transport, different from internal excess constipation. Furthermore, this formula uses warm medicines to restrain the nature of Dahuang, avoiding extreme cold purgation. A student said: "Master treats this text as an elaboration of the first clause's symptoms. Although this text lacks 'difficult defecation,' openly using warm purgation for unilateral hypochondriac pain and fever seems to elaborate on the first clause. However, the first clause mentions the Fuyang pulse as faint and wiry; this clause mentions wiry but says tight-wiry, and does not mention faint. Could treating it as continuing the first clause be forced? Or is there another profound principle?" The answer was: "The first clause discusses both host deficiency, hence 'faint and wiry.' This clause discusses only guest excess, hence 'tight and wiry.' Moreover, 'faint and wiry' still has a host present; 'tight and wiry' means the guest replaces the host. Progressing from faint to tight is the profound principle."
Clause 16: Cold qi causing Jue (reversal cold), Chidan Wan (Red Pill) governs it.
Chidan Wan Formula: Fuling (4 liang), Banxia (4 liang, washed), Wutou (2 liang, processed), Xixin (1 liang).
The above six flavors (note: text lists four, claims six; author suggests possible error or missing herbs like Ganjiang and Guizhi) are powdered. Add Zhenzhu (Vermilion/Cinnabar) for color. Refine honey to make pills the size of hemp seeds. Take three pills with wine before eating. Twice daily, once at night. If ineffective, increase dosage slightly. Use effectiveness as the limit. (Note: The formula contains only four ingredients, yet states 'right six flavors.' Is 'six' a typo for 'four'? Or are two herbs lost? I speculate based on formulas for direct invasion of Jueyin and Shaoyin in Shanghan Lun, perhaps adding Ganjiang and Guizhi? Ganjiang disperses cold and cures Jue; Guizhi unblocks yang and stops reversal. I preserve this for discussion with experts.)
Jue refers to chills, such as head trembling, teeth chattering, and whole-body muscle twitching. This originates from the Liver. When liver yang is deficient, or forced by external cold, slight yang hides deeply under extreme yin, and rebellious yin moves spontaneously. Like severe winter, true yang is underground, sunlight is dim, and yin winds suddenly rise, shaking branches and leaves. Therefore, if Jue returns, there must be fever, because hidden yang must rise; when yang rises, yin is subdued. If Jue does not return, death occurs, as yang absolutely cannot return on its own. Si Ni (Four Reversals) refers to cold limbs. Mild cases affect calves and wrists; severe cases reach elbows and knees. This originates from the Stomach. The refined essence generated from food and drink in the Stomach, transmitted through Spleen and Lung to the extremities of hands and feet, is the normal order. If the Stomach is struck by guest cold, or attacked by treacherous yin from Liver/Kidney, or due to retained food/drink, the Stomach system becomes blocked, its yang hides, and it cannot transmit outward to the limbs, causing cold reversals. Hence called "Ni" (Reversal). Treating each according to its pathogen, once the refined essence in the Stomach flows freely, recovery occurs. This distinguishes Jue and Ni. However, Jue syndromes always accompany Si Ni, because Liver wood yin-pathogens can damage Stomach qi. Thus, speaking of Jue implies Si Ni. Severe Si Ni may also show Jue, because Stomach yang is deficient and hidden, inviting external attack from Liver wood. Thus, speaking of Ni sometimes includes Jue. Essentially, if Jue causes Ni, the focus is on Jue; curing Jue allows Ni to pass. If Ni causes Jue, the focus is on Ni; passing Ni cures Jue. Therefore, Cheng's statement that Jue is more severe than Ni is definitive. Wang Lü's debate is like a blind man watching a play and discussing it before women. It means deficiency-cold of Liver/Kidney rushes upward, while true yang hides below. Due to chills and head trembling, Jue occurs, leading to Wood pathogen attacking Earth. Also, Fuyang is negative relative to Shaoyin, and Stomach qi is blocked mid-way, failing to transmit to limbs, causing reversal. This fault lies in deficiency-cold of Liver/Kidney. Thus, treating Jue is fundamental. Jue causing Ni need not blame Yangming Stomach, as previously stated: when Jue warms, Ni passes naturally. Chidan Wan warms the yang of the Lower Jiao; governing it is appropriate. Wutou is old yang from the previous year, milder than Fuzi, acting downward and sideways. Fuzi and Cezhi are produced by it. Old yang is firm; mild nature prevents water-fire conflict, preventing worsening of Jue-Ni. Downward/sidward action reaches Liver/Kidney directly. Being their source, it also unblocks true zang qi, generating and growing it. Yin qi rebelling upward brings cold fluid; thus Fuling is used for its light leaching property, draining rebellious qi via urination. Banxia descends upper jiao rebellion; Xixin unblocks meridian yang, serving as assistants. Zhenzhu (Cinnabar/Vermilion), made from calcined mercury, is red and heavy, targeting the Lower Jiao to unblock yang, added for color. Wine is warm and unblocks meridians; warm cures Jue, unblocking meridians cures Ni, serving as the guide for the descending medicine.
Clause 17: Abdominal pain, pulse wiry and tight. Wiry means Wei Qi does not circulate, leading to aversion to cold. Tight means desire for food is absent. Pathogen and righteous qi struggle, forming Han Shan (Cold Spasm). Pain around the umbilicus. Upon onset, white sweat appears, hands and feet are cold, pulse is deep and tight. Dawu Tou Jian (Major Wutou Decoction) governs it.
Wutou Jian Formula: Wutou (5 large pieces, cooked, skin removed, not chewed).
One ingredient. Boil in 3 sheng of water until 1 sheng remains. Remove dregs. Add 2 sheng of honey. Decoct until water vapor is gone, yielding 2 sheng. Robust persons take 7 he; weak persons take 5 he. If not cured, take again tomorrow. Do not take twice in one day.
Abdominal pain refers to areas above and below the umbilicus, i.e., periumbilical pain mentioned later. Pulse wiry and tight, viewed against "Wei Qi does not circulate" and "loss of appetite," should refer solely to Yangming, not all six positions, because abdominal pain belongs to Yangming disease. Diagnosing by location shows the term "Fuyang" at the beginning of the chapter runs through to the end. Wiry is seen on superficial palpation; tight is felt on deep pressure. Hence the conjunction "er" (and). Later, tight is described as deep-tight. Shan (Spasm) is a Qi disease, existing in all five zang organs. However, Kidney is Water organ, Liver is at lowest extreme yin, so these two organs suffer this most. Yin zang favor yang qi; yang fu organs value yin fluids. This is the nature of yin-yang seeking partners. If true yang of the zang is deficient, yin qi, guest cold, and external dampness secretly attract each other, hiding in obscurity. If other zang/fu organs have sufficient yang, like a peaceful era with hidden criminals who do not harm people. If Yangming qi is deficient, as in this clause, it invades the Central State, causing abdominal/umbilical disease. If Shaoyang qi is deficient, as in the next clause, it occupies the flanks, causing hypochondriac disease. If Taiyang qi is deficient, as in the third clause, spreading from abdomen/hypochondrium to borders, causing numbness and body pain. Even if yin qi floats to yang positions, lingering and turning into false heat, as in the fourth clause's pulse/symptoms, failing to purge cold nearly leads to disaster like rebel bandits. Hence the character "Shan" comes from "Mountain." Mountain has solid yang above and empty yin below; its trigram is Gen (Keeping Still). Yin connects below, yang breaks above; its change is Lake (Dui). In clear weather, springs and rocks are visible; Gen stops like an overturned bowl. In dark weather, cold fog and clouds expand like Dui exhaling. This is why ancients named it Shan and derived it from Mountain. Zhang Zhongjing says for abdominal pain, diagnose Yangming pulse: lifting reveals wiry, pressing reveals tight. Wiry is Liver pulse, also response to qi depletion. Wei Qi is the refined essence transformed from grain qi in Yangming Fu. Seeing Liver pulse now means Earth is受 (affected) by Wood pathogen, qi is weakened, unable to transform refined essence into Wei Qi, hence aversion to cold. Tight is disease pulse, also cold diagnosis. Though corresponding to abdominal pain, cold in Stomach means Stomach yang cannot transform substances, hence loss of appetite. If Stomach righteous qi slightly wins, yin zang pathogens hide below; if Stomach righteous qi slightly loses, yin zang pathogens rise again. Thus, struggle between pathogen and righteous qi is the cause of Han Shan. Stomach is inside the umbilicus, hence periumbilical pain. Elaborating on "struggle": if righteous qi wins, symptoms may not flare. If they flare, yin pathogen surges upward, false yang escapes upward, causing white sweat. Rebellious yin of Liver/Kidney rises, Stomach yang hides inside, not only failing to circulate Wei Qi (aversion to cold) but also causing cold reversals in hands/feet. Deep-tight pulse: deep indicates interior; deep-tight indicates interior zang yin-cold. Can Dawu Tou Jian cure it? Using the firm nature of old yang with sweet-slow honey, cooking into a decoction to remove water vapor, not only softens hardness to aid rigidity (preventing water seepage), but intends for it to linger in Stomach to support Yangming alone. "White sweat" is not named in classics; Jiangsu/Zhejiang dialect calls heavy sweat "white floating sweat." Taoists use Black/White as aliases for Yin/Yang, images of Taiji. Perhaps black is full and white is deficient, meaning yin excess repels yang floating upward? Recorded for reference, seeking lost rites in folk customs. I think "Bai" (White) resembles "Zi" (Self); is "Bai Han" a corruption of "Zi Han" (Spontaneous Sweat)?
Clause 18: Han Shan, abdominal pain, and hypochondriac pain with internal tension. Danggui Shengjiang Yangrou Tang (Angelica, Ginger, and Mutton Decoction) governs it.
Danggui Shengjiang Yangrou Tang Formula: Danggui (3 liang), Shengjiang (5 liang), Yangrou (1 jin).
Three ingredients. Boil in 8 sheng of water until 3 sheng remains. Warm take 7 he, three times daily. If cold is severe, add Shengjiang to total 1 jin. If pain is severe with vomiting, add Jupi (2 liang) and Baizhu (1 liang). If adding Shengjiang, add 5 sheng water, boil until 3.2 sheng remains, take.
Han Shan and abdominal pain are detailed earlier. Shaoyang qi deficiency, spasm qi passes from abdomen to flanks, causing hypochondriac pain, distension, and internal tension. These are responses of yang positions rejecting yin pathogens. Mutton is sweet and warm, tonifying qi, favored by Stomach. Assisted by acrid-warm Shengjiang, not only disperses cold but warms Stomach, lifts qi to warm Lung. Then guided by bitter-warm, heavy-air Danggui from chest to flanks, leading Lung metal warm qi to reach Liver/Gallbladder home, thereby eliminating Han Shan. Although Shan is yin zang pathogen, it must combine with guest cold to form internal knotting and upward rushing momentum. "Cold severe" means guest cold is particularly heavy. Shengjiang warms zang yin to dissolve downward, and especially disperses guest cold outward. Adding up to 11 liang of ginger in this formula likely unblocks yang qi to assist spontaneous sweating and drive guest cold outward. Severe spasm qi reversal causes severe pain and vomiting. Jupi is fragrant, fine, airy, acrid, warm, moving to Liver to eliminate reversal, hence added. Severe reversal often stems from diaphragm deficiency; Baizhu fills upper jiao emptiness, hence added.
Clause 19: Han Shan abdominal pain, cold reversals, numbness of hands and feet, if body pain, moxibustion, acupuncture, and various medicines cannot cure. Didang Wutou Guizhi Tang (Wutou and Guizhi Decoction for Resistance) governs it.
Wutou Guizhi Tang Formula: Wutou.
One ingredient. Decoct in 2 jin of honey until reduced by half. Remove dregs. Dissolve in 5 he of Guizhi Tang to yield 1 sheng. Initial dose 2 he. If no effect, take 3 he. If still no effect, increase to 5 he. Those who feel effect become like drunk. Vomiting indicates hitting the target.
Han Shan abdominal pain and cold reversals are detailed. If Taiyang chest-division yang is deficient, spasm qi rises from abdomen to chest, then exits Taiyang meridians. Hands and feet are filled with yang qi. Han Shan pathogen rebels against them, creating obstruction and hard/stiff sensation, termed "numbness" (Bu Ren). Body has yang-unblocking meridians. Han Shan pathogen rebels, creating blockage and distension, hence pain. Moxibustion/acupuncture treat meridians, but root is in zang. Medicines treat interior, but branch is in meridian. Hence neither works. Only Didang Wutou Guizhi Tang works. Wutou and honey boiled together follows the meaning of previous Wutou Jian, warming Stomach yang and eliminating cold-reversal spasm, curing internal abdominal pain and cold reversals (Treating Root). Dissolving and taking with Guizhi Tang: Guizhi Tang is an agent moving yang to exterior. With Wutou Jian as assistant, it removes cold and resolves spasm from hands/feet/body. Numbness and pain will heal externally (Treating Branch). Combining root/branch, interior/exterior, governance is appropriate. "Like drunk" means lethargic and restless, like wings folding before flight, yang shrinking then wanting to extend. Vomiting hitting target: vomiting lifts qi, also "Great Qi Rotates, Disease Disperses," yang wins, yin transforms. Named "Didang" (Resist/Block) same as Shanghan Dun Dang Tang/Wan. Shanghan Dun Dang resists heat and stops attacking Heart momentum; purging heat requires downward release, so disease goes via stool. This decoction resists cold and blocks fire-extinguishing mechanism; warming upper requires lifting, so hitting target is via vomiting. Wutou has no specified count; since this formula uses 2 jin honey, matching Wutou Jian's 2 jin honey, it should also use 5 pieces? Question: Medical classics describe unequal hand/foot skin. Why did ancients not use names like Bi (Obstruction) or Ban Zhi (Stiffness) to describe it, but uniquely use "Bu Ren" (Not Benevolent/Numb)? What is the meaning? Previous sages had no definite explanation. You said it feels like obstruction and stiffness, similar to common numbness. How does this relate to "Ren" (Benevolence)? Answer: Shaoyin, the Sovereign Official, hides deep in inner chambers. Its emitted yang spirit fills the center, retaining spiritual clarity and awareness. Thus, even a wheat awn pricking recognizes pain from needles, and flea/louse traces distinguish galloping horses. This is the yang virtue of the Heart Monarch, benevolence extending to remote lands. Like spring sun leaving no trace yet reaching grass roots and tree tips; like parental love hanging in mid-air, penetrating hidden sons and subtle daughters. This is the function of Ren. If one is usually healthy, but suddenly feels stiff/hard sensation in hand/foot skin, it is Heart Yang...