王淑和傷寒例云今搜採仲景舊論, 錄其證候診脈聲色, 對病眞方, 擬防世急, 則知傷寒論當時已無成書. 乃叔和之所搜集者, 雖分定六經而語無詮次, 陽經中多陰經治法, 陰經中多陽經治法, 參錯不一. 後人各生議論, 每成一書, 必前後更易數條, 互相訾議, 各是其說, 愈更愈亂, 終無定論. 不知此書非仲景依經立方之書, 乃救誤之書也. 其自序云: 傷夭橫之莫救, 所以尋求古訓, 博採衆方. 蓋因誤治之後, 變症錯雜, 必無循經現症之理. 當時著書, 亦不過隨症立方, 本無一定之次序也. 余始亦疑其有錯亂, 乃探求三十年, 而後悟其所以然之故, 於是不類經而類方. 蓋方之治病有定, 而病之變遷無定, 知其一定之治, 隨其病之千變萬化而應用不爽. 此從流溯源之法, 病無遁形矣. 至於用藥, 卽各有條理, 解肌發汗, 攻邪散痞, 逐水驅寒, 溫中除熱, 皆有主方. 其加減輕重, 又各有法度, 不可分毫假借. 細分之不外十二類, 每類先定主方, 卽以同類諸方附焉. 其方之精思妙用, 又復一一注明, 條分而縷析之. 隨以論中用此方之症, 列於方後, 而更發明其所以然之故, 使讀者於病情藥性一目顯然. 不論從何經來, 從何經去, 而見症施治, 與仲景之意, 無不吻合, 豈非至便之法乎. 余纂集成帙之後, 又復鉆窮者七年, 而五易其稿, 乃無遺憾. 前宋朱肱活人書, 亦曾匯治法於方後, 但方不分類, 而又無所發明, 故閱之終不得其要領. 此書之成, 後之讀傷寒論者, 庶可以此爲津梁乎.

乾隆二十四年歲在屠維單閼陽月上浣洄溪徐大椿序

Wang Shuhe (王淑和) says in Shanghanlun (Treatise on Cold Damage) “Through collecting old comments of Zhang Zhongjing (張仲景), I recorded symptoms, diagnoses, pulses, and colors, and I want to prevent urgent disease with true formulas.” Judging from this, Shanghanlun was not written when Zhang Zhongjing lived. It can be recognized that Wang Shuhe (王淑和) just collected these treatments into this book. Although the six channels are apparently parted, such statements are illogical. There are many yin channel treatments in yang channel diseases, and there are many yang channel treatments in yin channel disease. Thus, yin and yang channels in fact overlap. Whenever arguments come out, physicians reverses the order of a few lines, find faults with other views. The more facts are changed, the more they are misinterpretated. Eventually, there is no established theory. This is because authors did not know that Shanghanlun is not the book for composing formula according to channel but for saving life after wrong treatment . Zhang Zhongjing (張仲景) says, "I feel sad of having been unable to save a life, so I have been searching for old lessons and collecting formulas that are useful but unknown in the word.” After treating patients erroneously, the desase is transmuted to various pattern so it is impossible for the present signs to exist on the affected channel. Therefore, the books in those times are nothing but mere ones containing formulas made according to a pattern, which are not presented in a particular order. I also had doubts about the inherent resulting confusion at first, but after studying for thirty years, I can now recognize the reason and was able to classify the texts not according to channel, but by formula. Although a treatment of a formula is fixed, the mutation of an illness can still vary. If you know the fixed treatments of formulas and can apply these to diseases according to various mutations well, you cannot make a mistake.

In composing formula there is logical sequence, and there is a chief formula individually in resolving the flesh and promoting sweating, attacking evil and dissipating a glomus tumor, expelling water and cold, and warming the center and eliminating heat. There is also a rule when adding or extracting of a medicinal or medicinals, and there should be no mistake in applying these.

This book is classified into twelve families. I selected a chief formula for each family and added similar formulas. I next comment on the deep meaning and use of the formula, and analyze the lines one by one. Then, I enumerate the signs of the formulas used in Shanghanlun and explain the reason why it is to be like that. And then the reader become clear about an illness and the medicinal (herbal) properties, without considering where the channels going to and coming from, if just treats a patient only according to signs, it will match Zhang Zhongjing’s intention. How could this not be most convenient method? After I collected and edited this book after seven years of studying, I emended the manuscript five times, so I have no regret any more on this book. Previously, Huorenshu(活人書) of Zhu Gong (朱肱) in the Song dynasty also collected treatments in the rear of formula, but there was neither classification nor explanation in these treatments, thus, even though one reads Huorenshu, one cannot understand Zhu Gong’s points. I hope this book will act as a bridge for the reader of Shanghanlun.

Qian Long 24^th year, at the beginning of early in October, Huixi, Written by Xu Dachun.

1. Cinnamon Twig Decoction. Gui Zhi Tang. 桂枝湯.

甘草大棗以滋肝血. 芍藥淸營中之熱. 桂枝達營氣之鬱也.

Gan Cao and Da Zao nourish the liver blood.

Shao Yao clears the heat in the construction.

Gui Zhi opens the depression of construction-qi.

cinnamon twig (桂枝gui zhi, Cinnamon Ramulus) 3 liang

peony (芍藥 shao yao, Paeoniae Radix) 3 liang

mix-fried licorice (甘草 gan cao, Glycyrrhizae Radix) 2 liang

fresh ginger (生薑 sheng jiang, Ziniberis Rhizoma Recens) 3 liang

jujube (大棗 da zao, Ziziphi Fructus) 12 pieces

1) 太陽中風, 陽浮而陰弱, 風在外故陽脈浮. 衛氣有邪, 則不能護營, 故陰脈弱. 陽浮者, 熱自發, 風爲陽邪, 故發熱, 桂枝之辛以散之. 陰弱者, 汗自出, 芍藥之酸以收之, 甘草之甘以緩之. 嗇嗇惡寒, 淅淅惡風, 惡風未有不惡寒者, 但惡寒甚輕, 非若中寒及陰經之甚也. 翕翕發熱, 其熱亦不如陽明之甚. 鼻鳴乾嘔者, 鼻鳴似屬陽明, 乾嘔似屬少陽. 蓋三陽相近, 故略有兼病, 但不甚耳. 桂枝湯主之.

1) When in greater yang wind strike, the pulse is floating in yang level and weak in yin level.; Floating pulse in yang level means wind staying in exterior. The defensive qi is attacked by evil so that the defensive qi cannot to protect the construction, therefore, the pulse in yin level is weak. Patients with floating pulse in yang level are prone to have spontaneous heat effusion.; Wind is yang evil so that heat effuses. The pungent taste of cinnamon twig (gui zhi) makes the wind dispers . Patients with weak pulse in yin level are prone to sweat spontaneously.; Sour flavor of peony (shao yao) contracts yin. Sweet flavor of mix-fried licorice (gan cao) relaxes yin. If there is huddled aversion to cold, wetted aversion to wind,; Aversion to wind is always accompanied with aversion to cold, but the aversion to cold is very mild and is not as severe as cold strike and aversion to cold in yin channels. feather-warm heat effusion,; The heat is not as severe as the heat in yang brightness. noisy nose, and dry retching,; Noisy nose seems like belonging to yang brightness, dry retching seems like belonging to lesser yang. Generally the three yang are close to each other, so there is almost combination disease.(such as greater yang and yang brightness combination disease, yang brightness and lesser yang combination disease), but it is not severe. Cinnamon Twig Decoction (gui zhi tang) governs.

2) 太陽病, 頭痛發熱, 汗出惡風者, 桂枝湯主之. 此桂枝湯總證. 以營性發揚, 衛性斂閉, 風傷衛氣, 泄其皮毛, 故汗出也.

2) When in greater yang disease, there is headache, heat effusion, sweating, and aversion to wind, Cinnamon Twig Decoction (gui zhi tang) governs.; This is a general pattern of this formula. The property of construction is prone to effuse and carry forward and the property of defense is prone to be astringent and close. Wind evil damages the defense qi which make the fleshy exterior (interstices) slack, therefore sweat issues.

3) 太陽病下之後, 其氣上衝者, 誤治, 可與桂枝湯方, 用前法. 若不上衝者, 不可與之. 此誤下之證. 誤下而仍上衝, 則邪氣猶在陽分, 故仍用桂枝發表. 若不上衝, 則其邪已下陷. 變病不一, 當隨宜施治.

3) When in greater yang disease, after precipitation, qi surges upward.; This is a wrong treatment. Cinnamon Twig Decoction (gui zhi tang) may be given, according to the previously mentioned method. If qi doesn't surge upward, this formula cannot be given.; This is a pattern shown after precipitating erroneously. Precipitation is applied erroneously and then qi surges upward. That means evil qi exists on Yang level. So Cinnamon Twig (gui zhi) that dispers the exterior can be used. If qi doesn't surge upward, that means the evil qi already fell downward. A transmutation of an illness is not same. One should treat the patient according to a transmuted disease.

4) 太陽病, 初服桂枝湯, 反煩不解者, 先刺風池風府, 却與桂枝湯則愈. 此非誤治. 因風邪凝結於太陽之要路, 則藥力不能流通, 故刺以解其結. 蓋邪風太甚, 不僅在衛而在經, 刺之以泄經氣.

4) When in greater yang disease, Cinnamon Twig Decoction (gui zhi tang) has been taken at first, but the patient is vexed and the exterior is not resolved. First needle Wind Pool (Feng Chi, GB-20) and Wind Mansion (Feng Fu, GV-16), then give Cinnamon Twig Decoction (Gui Zhi Tang) and the patient will recover.; This is not wrong treatment. Because wind evil congealed and bound at the major passway of the greater yang channel and the force of medicinals was not strong enough to make the qi at the greater yang channel flow normally, so needling is applied to resolve the bound. Wind evil is too severe, so it is not only located in defense (aspect) but also in channel, needling is used to slack channel qi.

5) 太陽病, 外證未解, 脈浮弱者, 當以汗解, 宜桂枝湯. 病雖過期, 脈證屬太陽, 仍不離桂枝法.

5) When in greater yang disease, the exterior pattern has not resolved and the pulse is floating and weak. This should be resolved through sweating. So Cinnamon Twig Decoction (gui zhi tang) is appropriate.; Although the disease lasts for long time, but the pulse and pattern still belong to greater yang, one should treat this according to the rule of Cinnamon Twig (gui zhi).

6) 太陽病, 外證未解者, 不可下也. 此禁下總訣. 下之爲逆. 欲解外者, 宜服桂枝湯. 言雖有當下之證, 而外證未除, 亦不可下, 仍宜解外而後下也.

6) Greater yang disease with unresolved exterior pattern cannot be precipitated.; This is a general key to judge whether precipitation can be used or not. Since precipitation is an adverse (wrong treatment). To resolve the exterior, Cinnamon Twig Decoction (gui zhi tang) is appropriate.; Although the pattern looks like to be appropriate to precipitate, but the exterior pattern has not eliminated, so it cannot be precipitated. First after the exterior is resolved and then precipitation should be applied.

7) 太陽病, 先發汗不解, 而復下之, 脈浮者不愈. 浮爲在外, 而反下之, 故令不愈. 今脈浮, 故知在外, 當須解外則愈, 宜服桂枝湯. 脈浮而下, 此爲誤下. 下後仍浮, 則邪不因誤下而陷入, 仍在太陽, 不得因已汗下, 而不復用桂枝也.

7) When in greater yang disease, initial promotion of sweating fails to resolve the disease and then precipitation is applied, so that pulse is floating and there is no recovery. Floating pulse means the disease evil located in exterior. But, on the contrary to the pattern, precipitation is used, therefore it prevents recovery. Now the pulse is floating so one can know that the disease evil is located in exterior. This requires resolution of the exterior to recover. Cinnamon Twig Decoction (gui zhi tang) is appropriate.; The pulse was floating but precipitation was used. That is an error. After precipitation, the pulse is still floating. That means evil dosen't fall into interior in spite of wrong precipitation and still is located in greater yang. In spite of being used of sweating and precipitation previously, Cinnamon Twig (gui zhi) must be given again.

8) 病常自汗出者, 此爲營氣和, 營氣和者, 外不諧, 以衛氣不共營氣和諧故爾. 營氣和者, 言營氣不病, 非調和之和, 故又申言之. 以營行脈中, 衛行脈外, 復發其汗, 營衛和則愈, 宜桂枝湯. 自汗與發汗迥別, 自汗乃營衛相離, 發汗使營衛相合. 自汗傷正, 發汗驅邪. 復發者, 因其自汗而更發之, 則營衛和而自汗反止矣.

8) When illness is characterized by frequent spontaneous sweating, this means only construction qi is in harmony. In patient who only construction qi is in harmony, the outer body is not harmonious. It is because defense qi is not in harmony with construction qi.; Harmony in Construction qi means an absence of disease in construction qi but it does not mean the harmony in whole body. So this line says it again. Construction qi moves in the vessels and defense qi moves outside the vessels, by the promotion of sweating again, construction and defense will harmonize, bringing about recovery. Cinnamon Twig Decoction (gui zhi tang) is appropriate.; Spontaneous sweating is very different with promotion of sweating. Spontaneous sweating separates construction qi from defense qi, on the contrary, the promotion of sweating makes construction and defense get together (harmonized). Spontaneous sweating damages right qi and promotion of sweating expels evil qi. The reason of saying ‘the promoting of sweating again(fu,復)’ is because promotion of sweating is applied in spite of there being spontaneous sweating. If construction qi and defense qi become harmonized through the promotion of sweating, on the contrary, spontaneous sweating will stop.

9) 病人臟無他病, 時發熱, 自汗出, 而不愈者, 此衛氣不和也. 先其時, 未熱之時 發汗則愈, 宜桂枝湯主之. 無他病, 太陽諸證不必備, 而惟發熱自汗, 故亦用桂枝湯.

9) When the patient whose viscera has no other disease but has periodic heat effusion and spontaneous sweating, and do not get better, this means defence qi isn't in harmony. Ahead of the time,; The time is when there is absence of heat effusion. The promotion of sweating will bring about recovery. Cinnamon Twig Decoction (gui zhi tang) is appropriate.; Because there is no other disease in viscera, so there is no need to be present of all general signs of greater yang, the reason of being able to use this formula is due to just the presence of heat effusion and spontaneous sweating.

10) 傷寒不大便, 六七日, 宜下之候. 頭痛有熱者, 未可與承氣湯. 太陽證仍在, 不得以日久不便而下也. 其小便淸者, 知不在裏, 仍在表也, 便赤爲裏有熱. 當須發汗. 若頭痛者, 必衄. 汗出而頭痛未解, 則蘊熱在經而血動矣. 宜桂枝湯.

10) When in Cold damage with inability to defecate for six and seven days,; It is appropriate to precipitate. headache, and heat effusion. It's impossible to give a Qi-Coordinating Decoction (cheng qi tang).; In case greater yang pattern is still present, precipitation is banned in spite of inability to defecate for long time. If the urine is clear, one can know the disease is not located in the interior but is still in the exterior.; Reddish urine means there is heat in the interior. If the disease is located in the exterior, it should be treated by the promotion of sweating. If the person has headache, after taking the decoction, spontaneous external bleeding will occur.; After the promotion of sweating, headache has not resolved, that means accumulation of heat in channel, it stirs blood. Cinnamon Twig Decoction (gui zhi tang) is appropriate.

11) 傷寒發汗已解, 半日許復煩, 脈浮數者, 可更發汗. 發汗未透, 故煩, 乃服藥不及之故. 宜桂枝湯.

11) When in cold damage, sweating has already brought resolution, and then half a day or so there is again vexation and the pulse is floating and rapid, in that case it is possible to promote sweating again.; The promotion of sweating had not been done throughly, so this brought about vexation. Taking the decoction was not enough in dose aspect so vexation again occured. Cinnamon Twig Decoction (gui zhi tang) is appropriate.

12) 傷寒醫下之, 續得下利, 淸穀不止, 裏證. 身疼痛者, 表證. 急當救裏. 此誤下之證, 邪在外而引之入陰, 故便淸穀. 陽氣下脫, 可危. 雖表證未除, 而救裏爲急. 傷寒論不可下編云誤下寒多者, 便淸穀; 熱多者, 便膿血. 後身疼痛, 淸便自調者, 急當救表. 淸穀已止, 疼痛未除, 仍從表治. 蓋凡病皆當先表後裏, 惟下利淸穀則以扶陽爲急, 而表證爲緩也, 表裏分治而序不亂. 後人欲以一方治數證, 必至兩誤. 救裏宜四逆湯, 救表宜桂枝湯.

12) When cold damage is treated with precipitation, and this is followed by incessant clear-food diarrhea (that is watery and contains undigested food),; This belongs to the interior pattern. and generalized pain,; This belongs to the exterior pattern. one should urgently relieve the interior.; This is a pattern shown after precipitation erroneously, evil in the exterior is draged and enter yin, so this gives rise to clear-food diarrhea. Yang qi deserts downward, it is dangerous. Although the exterior pattern has not eliminated, but relieving of the interior is more urgent. "The part of contraindication on precipitation" in Shanghanlun says that when a person has more aversion to cold after wrong precipitation, the person will have clear-food diarrhea, and when a person has more heat effusion, the person will have pus and blood in the stool. After treating the interior, if there is generalized pain, and the excretions become regulated, one should urgently relieve the exterior.; The clear-food diarrhea has already ceased, but generalized pain has not yet been eliminated, therefore one should treat the exterior. Generally when in treating any disease, one should first treat the exterior and then treat the interior, but just in case there is clear-food diarrhea, supporting yang is urgent and the exterior pattern is moderate, therefore one should treat the exterior and interior separately, but the order in treatment shouldn't be mixed. People who has a desire to treat several pattern with one formula will inevitably make a mistake. Counterflow Cold Decoction (si ni tang) is appropriate for relieving of the interior and Cinnamon Twig Decoction (gui zhi tang) is appropriate for relieving of the exterior

13) 太陽病, 發熱汗出者, 此爲營弱衛强, 故使汗出, 欲救邪風者, 宜桂枝湯. 提出‘邪風’二字,

見桂枝爲驅風聖藥.

13) Greater yang disease with heat effusion and sweating means weakness in the construction and strength in the defence, which consequently causes sweat to issue. To eliminate the evil wind, Cinnamon Twig Decoction (gui zhi tang) is appropriate.; Through “xie feng” (the evil wind, 邪風) two letters, one can know that Cinnamon Twig (gui zhi) is particularly good at expelling wind.

14) 陽明病, 脈遲, 汗出多, 微惡寒者, 表未解也. 可發汗, 宜桂枝湯. 陽明本自多汗, 但不惡寒而惡熱. 今多汗而猶惡寒, 則仍在太陽矣, 雖陽明病而治從太陽.

14) Yang brightness disease with slow pulse, copious sweating, and mild aversion to cold means that the exterior has not resolved. In that case, one can promote sweating and therefore Cinnamon Twig Decoction (gui zhi tang) is appropriate.; Yang brightness disease is originally characterized by spontaneous and copious sweating with aversion not to cold but to heat. Now copious sweating and aversion to cold means disease is still located in greater yang channel, although it is yang brightness disease, but treatment should be based on greater yang.

15) 太陰病, 脈浮者, 可發汗, 宜桂枝湯. 太陰本無汗法, 因其脈獨浮, 則邪仍在表, 故亦用桂枝, 從脈不從症也.

15) When in greater yin disease with floating pulse, sweating can be promoted, Cinnamon Twig Decoction (gui zhi tang) is appropriate. Generally, there is no method of promotion of sweating in greater yin disease, but because the pulse is floating, that means the evil is located in the exterior, therefore one should use Cinnamon Twig (gui zhi) and the treatment should be based on pulse but not manifestations.

16) 病人煩熱, 汗出則解. 又如瘧狀, 有時復熱. 日晡所發熱者, 屬陽明也. 日晡發熱, 則爲陽明之潮熱而非瘧矣. 脈實者, 宜下之. 脈虛浮者, 宜發汗. 一症而治法迥別, 全以脈爲憑, 此亦從脈而不從症之法. 下之, 與大承氣湯. 發汗, 宜桂枝湯.

16) When the patient has heat vexation that resolves after sweating, and then has signs like malaria,; There is periodically repeated heat effusion. late afternoon heat effusion belongs to yang brightness,; Late afternoon heat effusion is tidal heat effusion of yang brightness but not malaria. If the pulse is replete, it is appropriate to precipitate, and if the pulse is floating and vacuous, it is appropriate to promote sweating. In spite of same manifestation, treatment is different, which is based on the pulse. This treatment is also based on a pulse but not manifestations. For precipitation, give Major-Qi-Coordinating Decoction (da cheng qi tang). To promote sweating, Cinnamon Twig Decoction (gui zhi tang) is appropriate.

17) 下利腹脹滿, 裏證. 身疼痛者, 表證. 先溫其裏乃攻其表, 溫裏, 宜四逆湯. 攻表, 宜桂枝湯. 此節屬厥陰證, 未必由誤治而得, 然旣見表證, 亦宜兼治.

17) Diarrhea with abdominal distention and fullness,; This belongs to the interior pattern. generalized pain,; This belongs to the exterior pattern. First warm the interior, and then attack the exterior. To warm the interior, Counterflow Cold Decoction (si ni tang) is appropriate. To attack the exterior, Cinnamon Twig Decoction (gui zhi tang) is appropriate.; This line belongs to reverting yin pattern, which dose not always occur owing to wrong-treatment, but the exterior pattern has already came out, therefore, the combination treatment of the interior and exterior is appropriate.

18) 吐利止而身痛不休者, 當消息和解其外, 宜桂枝湯小和之. 裏證除而表證猶在, 仍宜用桂枝法, 輕其劑, 而加減之可也.

18) When vomiting and diarrhea cease and there is persistent generalized pain, resolve the exterior according to the patient's condition, Cinnamon Twig Decoction (gui zhi tang) is appropriate for resolving mildly.; Although the interior pattern is eliminated, but the exterior pattern has still been present, therefore Cinnamon Twig (gui zhi) method should be used, herbs can be added and lessened in the formula.

19) 傷寒大下後, 復發汗, 再誤. 心下痞, 邪入中焦. 惡寒者, 表未解也. 不可攻痞, 當先解表. 表解, 乃可攻痞. 解表, 宜桂枝湯. 攻痞, 宜大黃黃連瀉心湯. 苦寒開降之法, 詳見後.

19) When in cold damage, after great precipitaion has been applied, the promotion of sweating is then used,; This made mistakes twice. This gives rise to a glomus below the heart,; That means evil enters the center burner. Aversion to cold means the exterior has not yet been resolved. One cannot attack the glomus, first one should resolve the exterior. After the exterior being resolved, then one can attack the glomus. To resolve the exterior, Cinnamon Twig Decoction (gui zhi tang) is appropriate. To attack the glomus, Rhubarb and Coptis Heart-Draining Decoction (da huang huang lian xie xin tang) is appropriate.; This is opening and descending method with bitter and cold properties. Details are given in a later paragraph.

1. Ephedra Decoction. Ma Huang Tang. 麻黃湯.

ephedra (麻黃 ma huang Ephedrae Herba) 3 liang

cinnamon twig (桂枝 gui zhi, Cinnamon Ramulus) 2 liang

mix-fried licorice (甘草 gan cao, Glycyrrhizae Radix) 1 liang

apricot kernel (杏仁 xing ren, Armeniacae Semen) 70 pieces

1) 太陽病, 頭痛發熱, 身疼腰痛, 骨節疼痛, 此痛處, 比桂枝證尤多而重, 因營衛俱傷故也. 惡風, 無汗而喘者, 此二症, 乃肺氣不舒之故. 麻黃治無汗, 杏仁治喘. 桂枝甘草, 治太陽諸證, 無一味不緊切, 所以謂之經方. 麻黃湯主之.

1) When in greater yang disease, there is headache, heat effusion, generalized pain, lumbar pain, joint pain; These pains in region and degree are wider and severe than those of Cinnamon Twig pattern (gui zhi zheng), this is because both the construction qi and defense qi are all damaged. aversion to wind, and absence of sweating with panting,; These two signs are because the Lung qi is not soothed. Ephedra (ma huang) treats absence of sweating, Apricot kernel (xing ren) treats panting, Cinnamon Twig (gui zhi) and Mix-fried Licorice (gan cao) treat all manifestations of greater yang. All ingredients are important so it is called Classical Prescriptions (Jing fang). Ephedra Decoction (ma huang tang) governs.

2) 太陽與陽明合病, 陽明之病象甚多, 如身熱不惡寒, 口苦鼻乾之類, 但見一二症卽是, 不必全具也. 太陽病卽上文所指者. 喘而胸滿者, 不可下, 病俱在上焦. 宜麻黃湯主之. 喘而胸滿, 此麻黃證之太陽合陽明也.

2) When in greater yang and yang brightness combination disease,; The signs of yang brightness disease are relatively a lot, such as generalized heat effusion without aversion to cold, bitter taste in the mouth, dry nose, and so on. If one or two of those sings are present, it is taken as a belonging to yang brightness disease, it dose not need to be all of those signs to be diagnosed as yang brightness pattern. Grater yang disease has been already said on the former line. here is panting and fullness in the chest, precipitation is banned,; Because disease is located in the upper burner. so Ephedra Decoction (ma huang tang) is appropriate.; Panting and fullness in the chest is the pattern of greater yang and yang brightness combination disease.

3) 太陽病, 十日以去, 過經. 脈浮細, 邪已退. 而嗜臥者, 正漸復. 外已解也. 設胸滿脇痛者, 與小柴胡湯, 胸滿脇痛, 病延日久, 邪留少陽, 故與此湯. 脈但浮者, 與麻黃湯. 若果邪在少陽, 脈必帶弦, 今但浮則尙在太陽矣, 故仍用麻黃湯. 此亦從脈不從症之法.

3) When in greater yang disease, ten days have passed.; This means channel passage. (eleventh day after ten days is governed by lesser yin). The pulse is floating and fine,; This means the evil has already retreated. there is somnolence; It means the right qi gets better gradually. The exterior is resolved. If there is fullness in the chest and rib-side pain, give Minor Bupleurum Decoction (xiao chai hu tang): Fullness in the chest and rib-side pain mean that disease is lasting long and evil stays in lesser yang so this decoction is given. If the pulse is only floating, give Ephedra Decoction (ma huang tang): If evil is in lesser yang, the pulse will definitely represent stringlike (pulse). But the pulse is floating and the evil rather locates in greater yang, therefore Ephedra Decoction (ma huang tang) is used. This also corresponds to 'the method of following pulse not manifestation.

4) 太陽病, 脈浮緊, 無汗, 發熱, 身疼痛, 此乃太陽傷寒的證, 經云: 諸緊爲寒. 八九日不解, 表證仍在. 此當發其汗. 宜麻黃湯. 服藥已微除, 其人發煩目瞑, 陽鬱而不能外達. 劇者必衄, 衄乃解. 熱甚動血, 血由肺之淸道而出, 與汗從皮毛而泄同, 故熱邪亦解. 俗語所云紅汗也. 經云陽明病口燥, 但欲漱水不欲咽者, 此必衄. 所以然者, 陽氣重故也. 風鬱固爲熱, 寒鬱亦爲熱. 內經云, 熱病者, 皆傷寒之類也. 麻黃湯主之. 此言未衄之前, 可用麻黃. 非衄後更用麻黃也.

4) When in greater yang disease, the pulse is floating and tight, and there is absence of sweating, heat effusion, and generalized pain,; This belongs to the pattern of the greater yang cold damage, Shanghanlun says that every tight pulse belongs to cold. these manifestations are unresolved in eight and nine days, this means that the exterior pattern is still present, and one should promote sweating.; Ephedra Decoction (ma huang tang) is appropriate. After taking medicine, the symptoms is slightly removed, and the person is vexed and the eyes are heavy,; Yang is depressed so it is not able to outthrust to the exterior. If it is acute, there will be spontaneous external bleeding,; Heat stirs blood severely and then the blood come out through the clear pathway of the Lung, this is like that sweat leaks through skin so the heat evil can be resolved. This is red sweat as common saying. Shanghanlun says that when in yang brightness disease there is dry mouth and only a desire to rinse the mouth with water, but no desire to swallow, there will be spontaneous external bleeding. Why this is so is because the yang qi weighted once again,; Wind depression originally becomes heat, cold depression also becomes heat. Nei jing says that heat disease belongs to the group of cold damage. Ephedra Decoction (ma huang tang) governs.; This means that one can use Ephedra Decoction (ma huang tang) before spontaneous external bleeding, but not after spontaneous external bleeding.

5) 脈浮者, 病在表, 可發汗, 宜麻黃湯. 此脈浮必帶緊.

5) Floating pulse means that the disease is in the exterior, so one can promote sweating, Ephedra Decoction (ma huang tang) is appropriate.; This pulse is definitely combined with tight one.

6) 脈浮而數者, 可發汗, 宜麻黃湯. 數爲陽氣欲出.

6) When the pulse is floating and rapid, one can promote sweating, Ephedra Decoction (ma huang tang) is appropriate.; Rapid pulse means the yang qi is about to come out.

7) 傷寒, 脈浮緊, 不發汗, 失治. 因致衄者, 麻黃湯主之. 前段衄後而解, 則不必復用麻黃. 衄後尙未解, 則仍用此湯.

7) When in cold damage with floating and tight pulse, sweating is not promoted,; This mens a failure of treatment. and this gives rise to spontaneous external bleeding, Ephedra Decoction (ma huang tang) governs.; The former is resolved after spontaneous external bleeding so there is no need to use Ephedra Decoction (ma huang tang) again. But if there is no resolving after spontaneous external bleeding, this Decoction should be used.

8) 陽明病, 脈浮無汗而喘者, 陽明本脈大自汗, 今乃脈浮無汗而喘, 則爲麻黃湯證矣. 發汗則愈, 宜麻黃湯.

8) When in yang brightness disease, there is floating pulse, absence of sweating, and panting,; Yang brightness is originally characterized by large pulse and spontaneous sweating. Now there is floating pulse, absence of sweating, and panting, this is the pattern of Ephedra Decoction (ma huang tang). If sweating is promoted, recovery will happen. Ephedra Decoction (ma huang tang) is appropriate.

1. White Tiger Decoction. Bai Hu Tang. 白虎湯.

anemarrhena知母 zhi mu Anemarrhenae Rhizoma 6 liang

gypsum 石膏 shi gao Gypsum 1 jin

mix-fried licorice 甘草 gan cao Glycyrrhizae Radix 2 liang

rice 粳米 geng mi Oryzae Semen 6 ge

1) 傷寒脈浮滑, 此表有熱, 裏有寒, 此寒熱二字必倒誤, 乃表有寒, 裏有熱也. 白虎湯主之.

1) When in cold damage the pulse is floating and slippery, this means there is heat in the exterir and cold in the interior.; These two letters of cold and heat are surely an error. It should be like that there is cold in the exterior and heat in the interior. White Tiger Decoction (bai hu tang) governs.

2) 傷寒脈滑而厥者, 熱厥. 裏有熱也, 白虎湯主之.

2) When in cold disease the pulse is slippery and there is reversal, ; This means that there is heat in the interior.

White Tiger Decoction governs.

3) 三陽合病, 腹滿身重, 難以轉側, 口不仁而面垢, 譫語遺尿. 以上皆陽明熱證之在經者, 以三陽統於陽明也. 但身重腹滿, 則似風濕, 宜用朮附; 面垢譫語, 則似胃實, 宜用承氣. 此處一惑, 生死立判, 如何辨別, 全在參觀脈證, 使有顯據方不誤投. 發汗則譫語, 陽從此越. 下之則額上生汗, 手足逆冷. 陰從此脫. 若自汗者, 白虎湯主之. 自汗則熱氣盛於經, 非石膏不治.

3) In combination disease of the three yang, there is abdominal fullness, generalized heaviness, difficulty turning sides, insensitivity of the mouth, grimy face, delirious speech and enuresis,; All of these belong to yang brightness heat pattern on channel, this is because yang brightness controls three yang. But generalized heaviness and abdominal fullness are similar with wind dampness signs, ovate artactylodes (bai zhu) and aconite (fu zi) should be used. Grimy face and delirious speech are similar with the stomach repletion signs, cheng qi decoction should be used. If one is confused in identifying patterns even just once, this could be a dividing line between life and death. The exact distinguishing depends on the observing of the pulse and signs, only clear evidence can prevent from mistake. if sweating is promoted, there will be delirous speech,; Yang gets to effuse following the promotion of sweating. if precipatation is used, sweat will arise on the forehead and there will be reveral cold of the extremities.; Yin gets to collapse owing to precipitation. If sweat spontaneously issues, White Tiger Decoction governs.; Spontaneous sweating is because heat qi exuberates in channel, so without gypsum (shi gao) it is unable to be recovered

Table of Contens

preface 序

(1). Cinnamon Twig Decoction family. 桂枝湯類.

1. Cinnamon Twig Decoction. Gui Zhi Tang. 桂枝湯.

2. Cinnamon Twig Decoction Plus Aconite. Gui Zhi Jia Fu Zi Tang. 桂枝加附子湯

3. Cinnamon Twig Decoction Plus Extra Cinnamon. Gui Zhi Jia Gui Tang. 桂枝加桂湯

4. Cinnamon Twig Decoction Minus Peony. Gui Zhi Qu Shao Yao Tang. 桂枝去芍藥湯

5. Cinnamon Twig Decoction Minus Peony Plus Aconite. Gui Zhi Qu Shao Yao Jia Fu Zi Tang. 桂枝去芍藥加附子湯

6. Cinnamon Twig Decoction Plus Magnolia Bark and Aricot Kernel. Gui Zhi Jia Hou Po Xing Zi Tang. 桂枝加厚朴杏仁湯

7. Minor Center-Fortifying Decoction. Xiao Jian Zhong Tang. 小建中湯.

8. Cinnamon Twig Decoction Newly supplemented with Peony, Fresh Ginger, and Ginseng. Gui Zhi Jia Shao Yao Sheng jiang Ren Shen Xin Jia Tang. 桂枝加芍藥生薑人蔘新加湯.

9. Cinnamon Twig and Licorice Decoction. Gui Zhi Gan Chao Tang. 桂枝甘草湯.