line 8-11 (wen bing tiao bian)

    8.  In  greater yin warm disease, the pules is floating, large, and hollow, there is copiouse sweating, mild pating, and even flaring nostrils, Bai Hu Jia Ren Shen Tang (白虎加人参汤 White Tiger plus Ginseng Decoction) govens this. If the pulse is dissipated and large, use this urgently with doubling of Ren Shen (人参).

    That the pulse is floating, large, and hollow is almost similar to dissipated pulse, this is because yin is vacuous and yang is insecure. Only the herbs which supplementing yin, cannot treate this. Only Bai Hu Tang (白虎湯) retreats evil heat, Ren Shen (人参) strengthens right yang. As like this, only the method of yang engdering yin is an excellent method for saving the origin of engendering transformation which is on the verge of expire. Eruting of sweating, flaring of nostrils, and dissipated pulse, these is the sign of the origin of engendering transformation which is on the verge of expire.

    Bai Hu Jia Ren Shen Tang (白虎加人参汤 White Tiger plus Ginseng Decoction)

 Ren Shen (人参, three qian) is added to Bai Hu Tang (白虎湯)

 

9. Bai Hu Tang (白虎湯) originally thrust out heat to the exterior. Therefore, if the person’s pulse is  若其人the pulsefloating, string-like, and fine, this cannot be given. And if there is absence of thirst, this cannot be given, if sweat dose not issue, it also cannot be given. Always keep these in mind in order not to mistake.

    This is the contraindication of Bai Hu Tang (白虎湯). Bai Hu Tang (白虎湯) is very harsh in nature, when evil is severe, without this, the evil cannot be treated. If this is used properly, one can take effect swiftly, but if this is used improperly, it is realy hard to control disaster. Most of weak minded man are afraid of using this so they miss a chance. Tough cookie person use this without asking of the pulse and signs, and evne they use Shi Gao (石膏) up to about one jin, so they sometimes take effect a lot but sometimes they gets to kill patient. Because both parts do not know the mechanism of how the medicine works. Therefore they have no yardstick for applying of drugs.

10. In greater yin warm disease, is evil is exuberant in the qi and blood part, Yu Nü Jian Qu Niu Xi Jia Yuan Shen (玉女煎去牛膝元参, Jade Woman Decoction Minus Radix Cyathulae seu Achyranthis Plus Radix Scrophulariae) governs this.

    When evil qi is exuberanat in both qi and blood, one cannot treat only one part, qi or blood.
Therefore Jia Yuan Jian (玉女煎 Jade Woman Decoction) which treat both qi and blood at one time are applied. Niu Xi (牛膝) is removed because this runs to lower burner so this is improper to greater yin pattern. Shu Di Huang (熟地黃) is changed to Sheng Di Huanh (生地黃), this is becauses Shu Di Huang (熟地黃) is heavy in quality and warm but Sheng Di Huanh (生地黃) has an action of outthrust of heat to the exterior. Yuan Shen (元参) invigorates water restrains fire, this prevents sore throat, loss of blood, and so on.

   

 Yu Nü Jian Qu Niu Xi Shu Di Jia Xi Sheng Di Yuan Shen (玉女煎去牛膝熟地加细生地元参, Jade Woman Decoction Minus Radix Cyathulae seu Achyranthis and Radix Rehmanniae Preparata Plus Radix Rehmanniae and Radix Scrophulariae)

    （: this formula mixes pungent and cool with sweet and cold.）

Shi Gao (石膏, one liang）Zhi Mu (知母, four qian）Yuan Shen (元参, four qian）Sheng Di (生地, six qian）Mai Men Dong (麦winter, six qian）

Decoct this until 8 cups of water become three cups, take this two times, 渣再煮一钟服.

 

Decoct this until 8 cups of water become 3 cup, take this two times a day. Decoct the dregs one more time, and take one cup.

11. In greater yin warm disease, if bloold spills outward through upper orifices, Xi Jiao Di Huang Tang (犀角地黄汤, Rhinoceros Horn and Rehmannia Decoction) with Yin Qiao San (银翘散, Honeysuckle and Forsythia Powder) governs this. If the disease is in middle burner, treat the disease according to the method for middle burner disease. If one vomits blood water which is pink color, the one cannot live. When blood spills upward through upper orifices and the pulse arrives seven or eight times during one time of breathing, if the complextion is black, this also cannot be treated, but the method of clearing networks and nourishing yin (清络育阴法) can be applied.

    That bloold spills outward through upper orifices means that warm evil distresses blood to overflow into clear way and come out through clear orifice, therefore Yin Qiao San (银翘散, Honeysuckle and Forsythia Powder) is used to remove warm toxin and Xi Jiao Di Huang Tang (犀角地黄汤, Rhinoceros Horn and Rehmannia Decoction) is used to clear hidden heat of blood part. Saving water is to save metal. Pink water is neither blood nor fluids, in fact, this is that blood contending [mixing] with fluids comes out by evil heat. This is that evil heat is exuberant so that heat spreads fully as the fire of field. This is that the origin for engendering and transforming is about to expire. That When blood spills upward through upper orifices and the pulse arrives seven or eight times during one time of breathing and the complextion is black,: extreme fire shows the image of water, fire changes into water which restrains fire itself, and this reaches in that condition in which the force of evil heat is so excessive that cannot be restrained. The fluids in lower burner is damged extremely so that are unable to help sovereign fire in the upper part, on the contrary, sovereign fire combines with the evil of warm and heat, how can lung metal endure this? Therefore both is related with dead sign. Zhong Zi (仲子) asked “What is death?” Kong Zi answered that enve one does not know the principle of birth, how one can know death? In my opinion, how can doctor save person without knowing of dead signs. The dying case of warm disease is various, but main signs are not beyond five categories. There is two things related with upper burner, first, if the origin of transforming and engendering in the lung expires, death occurs. Second, if heart sprit get to block internally and this brings about internal block and external collapse, this occurs death. There is two things related with middle burner. First, the replete evil of yang brightness gets exuberant greatly, and then earth restrains water, at that time, this is dead sign. Second, stagnant spleen causes jaundice and extreme jaundice gets to block every orifices, foul turbidity blocks orifices, this causes death. In the dead sign related with lower sign, evil heat gets to enter deep, so evil gets to burns out and exhaust fluid, then death occurs.

   

 Xi Jiao Di Huang Tang (犀角地黄汤, Rhinoceros Horn and Rehmannia Decoction)

 （in the chapter of lower burner）

 

Yin Qiao San (银翘散, Honeysuckle and Forsythia Powder)

If formulas for exterior have already used a lot, remove Dou Chi (豆豉), Jing Jie Sui (荊芥穗), and Bo He (薄荷).

 

 

 

 

 

    八、太阴温病，脉浮大而芤，汗大出，微喘，甚至鼻孔扇者，白虎加人参汤主之；脉若散大者，急用之；倍人参。

    浮大而芤，几于散矣，阴虚而阳不固也。补阴药有鞭长莫及之虞，惟白虎退邪阳，人参固正阳。使阳能生阴，乃救化源欲绝之妙法也。汗涌，鼻扇，脉散，皆化源欲绝之征兆也。

   

    白虎加人参汤方

    即于前方内加人参（三钱）。

    九、白虎本为达热出表，若其人脉浮弦而细者，不可与也；脉沉者，不可与也；不渴者，不可与也，汗不出者，不可与也；常须识此，勿令误也。

    此白虎之禁也；按白虎剽悍，邪重非其力不举，用之得当，原有立竿见影之妙，若用之不当，祸不旋踵。懦者多不敢用，未免坐误事机；孟浪者，不问其脉证之若何，一概用之，甚至石膏用至斤余之多，应手而效者固多，应手而毙者亦复不少。皆未真知确见其所以然之故，故手下无准的也。

    十、太阴温病，气血两燔者，玉女煎去牛膝加元参主之。

    气血两燔，不可专治一边，故选用张景岳气血两治之玉女煎。去牛膝者，牛膝趋下，不合太明证之用。改熟地为细生地者，亦取其轻而不重，凉而不温之义，且细生地能发血中之表也。加元参者。

    取其壮水制火，预防咽痛失血等证也。

   

    玉女煎去牛膝熟地加细生地元参方

    （辛凉合甘寒法）生石膏（一两）知母（四钱）元参（四钱）细生地（六钱）麦冬（六钱）水八杯，煮取三杯，分二次服，渣再煮一钟服。

    十一、太阴温病，血从上溢者，犀角地黄汤合银翘散主之。其中焦病者，以中焦法治之。若吐粉红血水者，死不治；血从上溢，脉七、八至以上，面反黑者，死不治，可用清络育阴法。

    血从上溢，温邪逼迫血液上走清道，循清窍而出，故以银翘散败温毒，以犀角地黄清血分之伏热，而救水即所以救金也。至粉红水非血非液，实血与液交迫而出，有燎原之势，化源速绝。血从上溢，而脉至七、八至，面反黑，火极而似水，反兼胜己之化也，亦燎原之势莫制，下焦津液亏极，不能上济君火，君火反与温热之邪合德，肺金其何以堪，故皆主死。化源绝，乃温病第一死法也。仲子曰∶敢问死？孔子曰∶未知生，焉知死。瑭以为医者不知死，焉能救生。细按温病死状百端，大纲不越五条。在上焦有二∶一曰肺之化源绝者死；二曰心神内闭，内闭外脱者死。在中焦亦有二∶一曰阳明太实，土克水者死；二曰脾郁发黄，黄极则诸窍为闭，秽浊塞窍者死。在下焦则无非热邪深入，消铄津液，涸尽而死也。

   

    犀角地黄汤方

    （见下焦篇）

    银翘散

    （方见前）已用过表药者，去豆豉、芥穗、薄荷。