大黄系列

Chapter 3, Dahuang series

Dahuang is the root of plant named Rheum palmatum. Among many other functions, the Master used it to clear the blockage in the abdomen that caused fullness, hard and solid pain and difficult in the bowel movement.

Compared with the Shigao that removes fever from the body surface, Dahuang works to remove the fever from the stool. Compared with Guizhi and Mahuang, both of which remove the Cold and Wind Xieqi from the body surface, the Mahuang removes the fever from the stool. The fever can be due to the further deep invasion of the previous Cold and/or Wind into the body. The blockage in the abdomen can be hosting food, hosting stool.

  Dahuang (Radix et Rhizoma Rhei)

(1). 大承气汤

Da Chengqi Tang

大黄（酒洗）四两， 厚朴（炙，去皮）半斤， 枳实（炙）五枚， 芒硝三合Dahuang (washed with liquor) 60 gram, Houpo (processed, remove skin), 60 gram, Zhishi (processed) 72 gram, Manxiao 30 gram.

右四味，以水一斗，先煮二物，取五升去滓，内大黄更煮，取二升去滓，内芒硝，更上微火一两沸，分温再服，得下，馀勿服。

Add Houpo, Zhishi, and 2500 ml water into a herbal pot. Bring to boil then keep in mild boiling until there is 1250 ml water in it left. Remove the residue, add the Dahuang continue to boiling until there is 500 ml left. Add the Manxiao in, bring to mild boiling for minutes until it is dissolved. Separate it into several parts. Drink one part. Wait for one to two hours see if there is bowel movement. If yes, stop to drink. If not, drink another part until there is bowel movement.

19　病人烦热，汗出则解，又如疟状，日晡所发热者，属阳明也。脉实者，宜下之；脉浮虚者，宜发汗。下之与大承气汤，发汗宜桂枝汤。

If the person feels very hot and sweat, his hot subsides after the sweat, such condition repeated again and again as a malaria. If he also feels hot in the evening (about the sunset time), it indicates the disease is in Yangming stage already. If his pulse is strong, use herb Da Chengqi Tang; if his pulse is weak and floating, use sweat therapy: Guizhi Tang. [1]

24　阳明发热汗多者，急下之，宜大承气汤。

For person in the Yangming stage has hot and big sweat, try to remove the Fire from the stool by using Da Chengqi Tang. [2]

25　阳明病，下之，心中懊倄而烦，胃中有燥屎者，可攻。腹微满，初头硬，後必溏，不可攻之。若有燥屎者，宜大承气汤。

In the Yangming stage, and after the bowel-cleansing therapy, the person feels annoyed emotionally, has frequent urine but no bowel movement, Da Chengqi Tang can be used. If he feels milk fullness in the Stomach, and stool is hard in beginning part but loss in the later part, this herb tea should not be used.

26 得病二、三日，脉弱，无太阳柴胡证，烦躁心下硬，至四、五日，虽能食，以小承气汤，少少与微和之，令小安。至六日，与承气汤一升，若不大便六、七日，小便少者，虽不能食，但初头硬，硬後必溏，未定成硬，攻之必溏，须小便利，屎定硬，乃可攻之，宜大承气汤。

If a disease has been for two to three days, the pulse is weak and there is no sign for Taiyang or Shaoyang stages, if the person feels annoyed emotionally and physically, hard in the upper stomach area, and if on the day six or seven he has no bowel movement, even if he can still eat (has appetite), herb Xiao Chengqi Tang should be used little by little to harmonize the Stomach inside[3]. If the condition lasts to six days, give Xiao Chengqi Tang. If there is no bowel movement for six to seven days, the urine is little too, even if the person cannot eat, but the stool is hard in the beginning part, the latter part must be loss one. If the stool is not hard, the use of Chengqi Tang will cause diarrhea like stool (this is not a proper treatment). If the urine is easy and smooth, the stool then is hard. Then the Da Chengqi Tang can be used.

27　阳明病，脉迟，虽汗出，不恶寒者，其身必重，短气腹满而喘，有潮热者，此外欲解，可攻里也，手足濈然汗出者，此大便已硬也，大承气汤主之。若汗多，微发热恶寒者，外未解也，其热不潮，未可与承气汤。若腹大满不通者，可与小承气汤，微和胃气，勿令大泄下。

In Yangming stage, slow pulse, though sweat, no chilly, the body will be heavy, the person will feel short of breath, fullness in Stomach that cause asthma, if he has hot-wave, it means the disease is to recover from Taiyang stage. Bowel cleansing therapy can be used to clear the inside. Sweat in hands or feet suggest that the stool is hard, so the Da Chengqi Tang can be used. If the sweat is very heavy, the person feels mild hot and chilly, it means the disease is still in the Taiyang stage. If the hot is not as a wave, the Da Chengqi Tang should not be used. If the person feels strong fullness in the Stomach area without bowel movement at all, try Xiao Chengqi Tang first to harmonize the Stomach inside. Heavy bowel movement should be prevented.

28　阳明病，潮热，大便微硬者，可与大承气汤，不硬者，不可与之。若不大便六、七日，恐有燥屎，欲知之法，少与小承气汤，汤入腹中，转失气者，此有燥屎也，乃可攻之。若不转失气者，此但初头硬，後必溏，不可攻之，攻之必胀满不能食也。欲饮水者，与水则哕，其後发热者，必大便复硬而少也，以小承气汤和之，不转失气者，慎不可攻也。

In Yangming stage, wave-hot, if the stool is mild hard (the whole part of the stool), the Da Chengqi Tang can be used. Otherwise it should not be used. If there is no bowel movement for six to seven days, it may suggest hard stool in Stomach. How to know it? Try Xiao Chengqi Tang. After drinking the it, the person has fart (from anus), it indicates the stool is hard inside, so Da Chengqi Tang can be used. If there is no gas, or the stool is only hard in the beginning, Da Chengqi Tang should not be given. Otherwise its use will cause big fullness in Stomach and affect the appetite. In this case, only use Xiao Chengqi Tang little by little to harmonize the Stomach. In addition, if the person wants to drink, drink will cause Yue syndrome[4]. If he later feels hot, his stool must turn to hard and little in amount. Try Xiao Chengqi Tang only. [5]

29　阳明病，曕语，发潮热，脉滑而疾者，小承气汤主之。因与承气汤一升，腹中转失气者，更服一升，若不转失气者，勿更与之。明日又不大便，脉反微涩者， 虚也，为难治，不可更与承气汤也。

In Yangming stage, if the person has chattering under unconsciousness, wave-hot, fast and slippery pulse[6], Xiao Chengqi Tang is to be used. After drinking, if the person has fart, drink one more times; if no fart, stop to take it. Wait to next day, if there is no stool, and the pulse is mild harsh, it suggests that the body condition is weak, it is hard to treat. Any Chengqi Tang should not be given. 　

30　伤寒若吐、若下後不解，不大便五、六日，上至十馀日，日晡所发潮热，不恶寒，独语如见鬼状。若剧者，发则不识，循衣摸床，惕而不安，微喘直视，脉滑[7]者生，涩者死。微者但发热曕语者，大承气汤主之，若一服利，则止後服。[8]

With Cold-invasion Shanghan disease, after using vomiting or bowel-cleansing therapy, the disease remains no improvement. The person has no bowel movement for five to six days, even up to ten days. He also has wave-hot in the evening (sunset time), no chilly, chattering as see a ghost. For severe case, the person may loss recognition to person, touch surrounding material, irritable and restless, mild asthma, and eye staring forwards[9]. For such person, if his pulse is as slippery, he will live. If it is harsh, die. For mild case, if the person only has hot and chattering under unconsciousness, give him Da Chengqi Tang to drink. If he has bowel movement, stop to drink it.

33　伤寒六、七日，目中不了了，睛不和，无表 证，大便难，身微热者，此为实也，急下之，宜大承气汤。

With Cold-invasion Shanghan disease for six or seven days, the person feels stirring and smear in eyes, even the eye does not move, has no sign for a Taiyang stage, but has hard bowel movement and feels mild hot. This is a Shi condition[10], an urgent bowel-cleansing therapy should be used – use Da Chengqi Tang. [11]

34　病人小便不利，大便乍难乍易，时有微热，喘冒不能卧者，有燥屎也，宜大承气汤。

If a person has difficulty in urine, bowel movement sometimes easy but sometimes hard, mild hot sometimes, asthma or cough or nausea that makes him hard to lie down, it means that he has hard stool in Stomach. Da Chengqi Tang should be used. [12]

36　大下後，六、七日不大便，烦不解，腹满痛者，此有燥屎也，所以然者，本有宿食故也，宜大承气汤。

If the person has had strong bowel-cleansing therapy and had big bowel movement, but stop bowel movement for six to seven days, has continuous annoyed feeling, has fullness and pain in the Stomach, it indicates there is hard stool due to previous hidden stool in the Stomach. Da Chengqi Tang should be used. 

75　汗出谵语者，以有燥屎在胃中，此为风也，须下者，过经乃可下之。下之若早，语言必乱，以表虚里实故也。下之愈，宜大承气汤。

If a sweat causes Chattering syndrome, it suggests a hard stool in the Stomach. It belongs to a Wind－invasion condition. It must be waited until there is no sign of the Wind in the Taiyang stage, to start a bowel-cleansing therapy. If the bowel-cleansing therapy is used too early, the one will have confused mind to Chattering syndrome. For such surface weak but inside Shi condition, Da Chengqi Tang is used.

76　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，但硬尔 （不必用药）。

With the Yangming disease, if the person has Chattering syndrome and wave-hot, he should remain appetite. If he loses appetite, it indicates the exist of several dry stools in the Stomach. Da Chengqi Tang should be used. If he still has appetite, the stool is only hard.

09 发汗不解，腹满痛者，急下之，宜大承气汤。腹满不减，减不足言，当下之，宜大承气汤。

If a sweat therapy does not work to release surface conditions, and the person further more has fullness and pain in the whole stomach, Da Chengqi Tang should be used as soon as possible. If it only reduces[13] the fullness very little, it should be repeated again. 

42　少阴病得之二三日，口燥咽乾者，急下之，宜大承气汤

In Shaoyin stage, the person feels dry mouth and throat for two to three days, the treatment with Da Chengqi Tang is needed urgently. [14]

43　少阴病，自利清水，色纯青，心下必痛，口乾燥者，急下之，宜大承气汤。

In Shaoyin stage, if the person has diarrhea with clear and pure water in the stool[15], he will also feel pain in the upper stomach and feel dry mouth and throat. Da Chengqi Tang should be used as soon as possible. 

44　少阴病六七日，腹胀不大便者[16]，急下之，宜大承气汤。

In Shaoyin stage, if the person has fullness in stomach and no bowel movement, Da Chengqi Tang should be used urgently.

04　阳明、少阳合病，必下利，其脉不负者为顺也。负者失也，互相克贼，名为负也。脉滑而数者，有宿食也，当下之，宜大承气汤。

With co-exist of Shaoyang and Yangming stage, the person will have diarrhea[17]. The pulse should be big and string[18], indicating a co-responding condition. If the pulse is only string, not big, it suggests the Wood (the Shaoyang, the Liver, the Wood) is combating against the Soil (the Yangming stage, the Stomach, the soil), the disease will be hard to improve. If the pulse is only big, but not string, it suggests the Soil is not under attack by the Wood, the condition being easier to solve. If the pulse is slippery and frequent, it suggests he has old-dead stool in his Stomach. Da Chengqi Tang should be used. [19]

08　二阳并病，太阳证罢，但发潮热，手足絷絷汗出，大便难而谵语者，下之则愈，宜大承气汤。

Taiyang-Yangming developed condition. The person has hot wave, continuous mild sweat in the hands and feet, has constipation and Chattering. Bowel-cleansing therapy should be used, use Da Chengqi Tang. 

03　下利，三部脉皆平，按之心下硬者，急下之，宜大承气汤。

If a person has diarrhea, but his pulse is normal in the Chun, Guan and Chi positions, and his upper stomach feels hard when press, use bowel-cleansing therapy as soon as possible. [20]

04　下利，脉迟而滑者，内实也，利未欲止，当下之，宜大承气汤。

If a person has diarrhea, and his pulse is slow and slippery, it indicates a Fullness condition inside that causes the diarrhea. Use Da Chengqi Tang to remove the fullness condition to stop the diarrhea. 

05　问曰：人病有宿食，何以别之？师曰：寸口脉浮而大，按之反涩，尺中亦大[21]而涩，故知有宿食，当下之，宜大承气汤。

Asked: how to know if a person has hosting food in the abdomen? Master: the person has floating and big pulse in the Chun position, which feels harsh when pressed deep however. The pulse feels big and harsh in the Chi position as well. For such hosting food condition, use Da Chengqi Tang. 

06　下利不欲食者，以有宿食故也，当下之，宜大承气汤。

If a person has an acute diarrhea and dislike to eat, it means the digestive system is damaged by the improper diet. If a person has chronic diarrhea and has little appetite, it is the damage in the Spleen system. He should feel fullness in the stomach after eating. If a person has an acute diarrhea and has no appetite, it means he has hosting food in the abdomen, so need Da Chengqi Tang to remove the hosting food from the abdomen. 

07　下利差，至其年月日时复发者，以病不尽故也，当下之，宜大承气汤。

If a person has chronic diarrhea and it stops for a while, now after one full year, his diarrhea comes back again with the same clinic conditions, it means he has hosting stool in the abdomen. For the treatment, use Da Chengqi Tang. 

08　下利脉反滑，当有所去，下乃愈，宜大承气汤。

(continue the paragraph above) If he has the new diarrhea again and the pulse is slippery, and his general condition is pretty strong, diet is relatively normal, it indicates that he has hosting stool in the abdomen that needs to cleanse. Use Da Chengqi Tang.

09   病腹中满痛者，此为实也，当下之，宜大承气汤。

If a person feels fullness, hard and pain in the abdomen, it is a Fullness condition. Use bowel-cleansing therapy, Da Chengqi Tang. [22]

痉为病，胸满口噤，卧不着席，脚挛急，必齘齿，可与大承气汤。

For the Jing disease, the person feels fullness in the chest, tight in mouth, the body bends so it is hard to lie in a platen body condition on the bed, spasm in the feet. He will also bit his teetch. Use Da Chengqi Tang.

腹满不减，减不足言，当须下之，宜大承气汤。

If the person has had the warm herbal therapy, the abdomen fullness feeling does not reduce, or reduce very little, use bowel-cleansing therapy, use Da Chengqi Tang.

问曰：人病有宿食，何以别之？师曰：寸口脉浮而大，按之反涩，尺中亦大而涩，故知有宿食，大承气汤主之。

Asked: how do we know if a person has hosting food in the abdomen?[23] Master: if the pulse is floating and big in the Chun position, but it is harsh when pressed deep; the pulse is big and harsh on the Chi position, all indicating the hosting-food condition in the abdomen. Use Da Chengqi Tang.

 脉数而滑者，实也，此有宿食，下之愈，宜大承气汤。

If the pulse is frequent and slippery, it is a Fullness condition, indicating a food-hosting condition.
Use bowel-cleansing therapy with Da Chengqi Tang.

下利不欲食者，有宿食也，当下之，宜大承气汤。

If a person has diarrhea but no appetite, it indicates a food-hosting condition, use bowel-cleansing therapy with Da Chengqi Tang. [24]

下利，三部脉皆平，按之心下坚者，急下之，宜大承气汤。

If the person has diarrhea, but the pulse is normal in all the positions, but feels hard and solid in the upper abdomen, urgent bowel-cleansing therapy is needed. Use Da Chengqi Tang.

下利，脉反滑者，当有所去，下乃愈，宜大承气汤。

If the person has diarrhea, and the pulse is slippery[25], this condition indicates that there is concrete and solid stuff in the abdomen. Use Da Chengqi Tang.

下利已差，至其年月日时复发者，以病不尽故也，当下之，宜大承气汤。

If a person has chronic diarrhea and it stops for a while, now after one full year, his diarrhea comes back again with the same clinic conditions, it means he has hosting stool in the abdomen. For the treatment, use Da Chengqi Tang. 

产妇郁冒，其脉微弱，不能食，大便反坚，但头汗出。所以然者，血虚而厥，厥而必冒，冒家欲解，必大汗出；以血虚下厥，孤阳上出，故头汗出。所以产妇喜汗出者，亡阴血虚，阳气独盛，故当汗出，阴阳乃复，大便坚，呕不能食，小柴胡汤主之。病解能食，七、八日更发热者，此为胃实，大承气汤主之。

For woman with Yumao disease, her pulse is weak, cannot eat, the stool is hard, but there is sweat on head. This is because the blood deficiency, which causes reverse cold in hands and feet. The later condition then causes the Yumao condition. Person with the Yumao will have sweat before the condition is to solve. The sweat is due to the floating Yangqi in the head (the cold in residue in the lower part of the body: cold feet). Woman who has easy sweat depleted the Yin and causes blood deficiency. If the woman has nausea and hard to eat, has hard stool, use Xiao Chaihu Tang. If the disorder has been solved but she has fever again after seven to eight days, this condition is fullness condition in the abdomen, use Da Chengqi Tang to solve it.  

产后七、八日，无太阳证，少腹坚痛，此恶露不尽，热在里，结在膀胱也。不大便，烦躁发热，切脉微实，再倍发热，日晡时烦躁者不食，食则谵语，至夜即愈，宜大承气汤主之。

If a women just had baby delivery for seven or eight days, no any signs of Taiyang stage, but feels pain and hard in the lower abdomen, this condition is due to hosting blood there that is due to the stick of Fire in the urine bladder. On the other side, there is also a situation in which a woman feels annoyed/impatient, fever, no bowel movement. Her pulse is mild strong. For this who feels annoyed/impatience in the evening also feels no appetite, and has Chattering syndrome after eating, which symptoms stop upon night. In this case, use Da Chengqi Tang.[26]

(2). 小承气汤

Xiao Chengqi Tang

大黄　四两， 厚朴（去皮，炙）二两， 枳实（大者，炙）三枚

Dahuang 60 gram, Houpo (remove skin, processed) 30 gram, Zhishi (processed) 45 gram.

已上三味，以水四升，煮取一升二合，去滓，分温二服。初服汤当更衣，不尔者，尽饮之。若更衣者，勿服之。

Add the herbs and 1000 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is about 300 ml liquid left in the pot. Collect the herbal tea, drink half of the tea to have a bowel movement. If yes, stop to drink the remaining tea, if not, repeat the remaining half.

20　太阳病，若吐、若下、若发汗後，微烦小便数，大便因硬者，与小承气汤和之愈。

During Taiyang stage, and after a vomiting therapy, bowel-cleansing therapy, or a sweat therapy, if the person feels mild annoyed emotionally and hard stool, herb Xiao Chengqi Tang should be used to harmonize the inside. [27]

26　得病二、三日，脉弱，无太阳柴胡证，烦躁心下硬，至四、五日，虽能食，以小承气汤，少少与微和之，令小安。至六日，与承气汤一升，若不大便六、七日，小便少者，虽不能食，但初头硬，硬後必溏，未定成硬，攻之必溏，须小便利，屎定硬，乃可攻之，宜大承气汤。

If a disease has been for two to three days, the pulse is weak and there is no sign for Taiyang or Shaoyang stages, if the person feels annoyed emotionally and physically, hard in the upper stomach area, and if on the day six or seven he has no bowel movement, even if he can still eat (has appetite), herb Xiao Chengqi Tang should be used little by little to harmonize the Stomach inside[28]. If the condition lasts to six days, give Xiao Chengqi Tang. If there is no bowel movement for six to seven days, the urine is little too, even if the person cannot eat, but the stool is hard in the beginning part, the latter part must be loss one. If the stool is not hard, the use of Chengqi Tang will cause diarrhea like stool (this is not a proper treatment). If the urine is easy and smooth, the stool then is hard. Then the Da Chengqi Tang can be used.

27　阳明病，脉迟，虽汗出，不恶寒者，其身必重，短气腹满而喘，有潮热者，此外欲解，可攻里也，手足濈然汗出者，此大便已硬也，大承气汤主之。若汗多，微发热恶寒者，外未解也，其热不潮，未可与承气汤。若腹大满不通者，可与小承气汤，微和胃气，勿令大泄下。

In Yangming stage, slow pulse, though sweat, no chilly, the body will be heavy, the person will feel short of breath, fullness in Stomach that cause asthma, if he has hot-wave, it means the disease is to recover from Taiyang stage. Bowel cleansing therapy can be used to clear the inside. Sweat in hands or feet suggest that the stool is hard, so the Da Chengqi Tang can be used. If the sweat is very heavy, the person feels mild hot and chilly, it means the disease is still in the Taiyang stage. If the hot is not as a wave, the Da Chengqi Tang should not be used. If the person feels strong fullness in the Stomach area without bowel movement at all, try Xiao Chengqi Tang first to harmonize the Stomach inside. Heavy bowel movement should be prevented.

28　阳明病，潮热，大便微硬者，可与大承气汤，不硬者，不可与之。若不大便六、七日，恐有燥屎，欲知之法，少与小承气汤，汤入腹中，转失气者，此有燥屎也，乃可攻之。若不转失气者，此但初头硬，後必溏，不可攻之，攻之必胀满不能食也。欲饮水者，与水则哕，其後发热者，必大便复硬而少也，以小承气汤和之，不转失气者，慎不可攻也。

In Yangming stage, wave-hot, if the stool is mild hard (the whole part of the stool), the Da Chengqi Tang can be used. Otherwise it should not be used. If there is no bowel movement for six to seven days, it may suggest hard stool in Stomach. How to know it? Try Xiao Chengqi Tang. After drinking the it, the person has fart (from anus), it indicates the stool is hard inside, so Da Chengqi Tang can be used. If there is no gas, or the stool is only hard in the beginning, Da Chengqi Tang should not be given. Otherwise its use will cause big fullness in Stomach and affect the appetite. In this case, only use Xiao Chengqi Tang little by little to harmonize the Stomach. In addition, if the person wants to drink, drink will cause Yue syndrome[29]. If he later feels hot, his stool must turn to hard and little in amount. Try Xiao Chengqi Tang only. [30]

29 阳明病，曕语，发潮热，脉滑而疾者，小承气汤主之。因与承气汤一升，腹中转失气者，更服一升，若不转失气者，勿更与之。明日又不大便，脉反微涩者， 虚也，为难治，不可更与承气汤也。

In Yangming stage, if the person has chattering under unconsciousness, wave-hot, fast and slippery pulse[31], Xiao Chengqi Tang is to be used. After drinking, if the person has fart, drink one more times; if no fart, stop to take it. Wait to next day, if there is no stool, and the pulse is mild harsh, it suggests that the body condition is weak, it is hard to treat. Any Chengqi Tang should not be given. 　

74　阳明病，其人多汗，以津液外出，胃中燥，大便必硬，硬则谵语，小承气汤主之。若一服谵语止者，更莫复服。

With Yangming stage, if the person has lots of sweat, the depletion of Jingye through the sweat will cause dryness in the Stomach and hard stool that again causes Chattering syndrome. Xiao Chengqi Tang is used to harmonize the Stomach Qi. If the Chattering syndrome stops after one drinking, stop to drink more.

77 下利谵语者，有燥屎也，宜小承气汤。

If a person in the Yangming stage, has diarrhea[32] and Chattering syndrome, it suggests dry stools[33] in the Stomach. Xiao Chengqi Tang should be used.

下利谵语者，有燥屎也，小承气汤主之。

If a person in the Yangming stage, has diarrhea[34] and Chattering syndrome, it suggests dry stools[35] in the Stomach. Xiao Chengqi Tang should be used.

支饮腹满者，厚朴大黄汤主之。(支饮胸满，邪在肺也，宜用木防己汤、葶苈大枣汤。支饮腹满，邪在胃也，故用厚朴大黄汤，即小承气汤也。)

For Branch-water accumulation condition, use Houpo Dahuang Tang

(3). 调胃承气汤

TiaoWei Chengqi Tang

大黄（去皮，酒浸）四两 甘草（炙）二两 芒硝半升

Dahuang (remove skin, rinsed with liquor) 60 gram, Gancao (processed) 30 gram, Manxiao 60 gram.

右三味，以水三升，煮取一升，去滓，内芒硝，更煮两沸，少少温服之。

Add the Dahuang, Gancao and 750 ml water into a herbal pot. Bring to boil then keep in mild boiling until there is about 250 ml liquid left. Remove the herbal residue, add Manxiao in. Bring to boil for 1 min until it is dissolved. Drink little.

21　太阳病三日，发汗不解，蒸蒸发热者，属胃也，调胃承气汤主之。

When the disease is in Taiyang stage for three days and if the person has had sweat therapy, but still feels continuous fever, it means that the disease has past into Yangming stage. Tiaowei Chengqi Tang should be the main formula.

09　发汗後恶寒者，虚故也；不恶寒但热者，实也，当和胃气，与调胃承气汤。

After sweat therapy, if the person feels chilly, it means that he is weak. If the person does not feel chilly but hot, it indicates that his condition is not weak but extensive. Tiaowei Chengqi Tang should be used, to harmony stomach Qi.

22　伤寒吐後，腹胀满者，与调胃承气汤。

After vomiting therapy for a Cold-invasion Shanghan disease, and if the person feels bloating or fullness in the Stomach, herb Tiaowei Chengqi Tang shold be given.[36]　

23　阳明病，不吐不下，心烦者，可与调胃承气汤。

In a Yangming stage, if the person feels annoyed emotionally without vomiting or diarrhea, herb Tiaowei Chengqi Tang should be used. [37]

20　太阳病未解，脉阴阳俱停，必先振栗，汗出而解，但阳脉微者，先汗出而解，但阴脉微者，下之而解，若欲下之，宜调胃承气汤。

The disease remains in the Taiyang stage. The pulse is hard to feel in any of the three position or the three levels in each position. In this condition, the person must have tremor and sweat, then get recovery. This is because for one with weak pulse in the Chun position, he will have a sweat, then recover. If his pulse is weak on the Chi position, he needs to have a bowel movement, before to get recovered. To create the bowel-cleansing, herb Tiaowei Chingqi Tang is needed.　

21　太阳病，过经十馀日，心中温温欲吐，而胸中痛，大便反溏，腹微满，郁郁微烦，先此时，自极吐下者，与调胃承气汤，若不尔者，不可与。但欲呕，胸中痛，微溏者，此非柴胡证。以呕，故知极吐、下也。

Previously in Taiyang stage, the disease has passed for more than ten days, the person feels a mild feeling of wiling to vomit, has chest pain, loss bowel movement, mild fullness in stomach, mild and slight annoyed/impatience, if asked, he admits that he has had strong vomiting therapy before. In this case, use Tiaowei Chengqi Tang. If the conditions are not due to vomiting, this herb should not be used. The condition of willingness to nausea, has chest pain but mild diarrhea, all together is not a Chaihu Tang condition, so Chaihu Tang should not be given either. The nausea here is caused by heavy vomiting or bowel-cleansing therapy.[38] (This is a combined condition of Taiyang and Shaoyang. If the person has diarrhea with vomiting, Huangqin jia Banxia Shengang Tang can be used.)

23　伤寒十三日不解，过经谵语者，以有热也，当以汤下之。若小便利者，大便当硬，而反下利，脉调和者，知医以丸药下之，非其治也。若自下利者，脉当微厥，今反和者，此为内实也，调胃承气汤主之。

With a Cold-invasion Shanghan disease for thirteen days, the person has Chattering syndrome. This indicates he has Fire in the body. Bowel-cleansing therapy should be used. If he has easy urine, his bowel movement should be hard. If his bowel movement is unexpectedly easy, and his pulse is pretty normal, he must have had a bowel-cleaning therapy before, which is a wrong medication. If he was not given a bowel-cleansing therapy, his diarrhea will suggest a weakness condition inside, so his pulse should be weak and has Jue condition. If he has no cold hands and/or feet, the condition will suggests a Shi condition inside. Tiaowei Chengqi Tang is to be used.

05  伤寒脉浮，自汗出，小便数，心烦，微恶寒，脚挛急, (当与桂枝增桂加附子汤，以温经止汗) 反与桂枝汤，欲攻其表，此误也，得之便厥。咽中乾，烦燥吐逆者，作甘草乾姜汤与之，以复其阳。若厥愈足温者，更作芍药甘草汤与之，其脚即伸；若胃气不和，谵语者，少与调胃承气汤；若重发汗，复加烧 者，四逆汤主之。

With Shanghan disease, the pulse is floating and the person has sweat and frequent urine, annoyed/impatience, slight chilly, spasm in feet[39]. (It should use Guizhi jia Guizhi jia Fuzi Tang to warm up the body and stop the sweat). If Guizhi Tang aloe is given to deplete the Xieqi from the body surface, it is a wrong treatment. It will cause reverse Jue condition (cold hands and feet). If the person feels dry in mouth, annoyed/impatience, vomiting, give Gancao Ganjiang Tang to restore his Yangqi. If his hands and feet return to warm, give Shaoyao Gancao Tang to release feet spasm. If the person has non-harmonized stomach, has Chattering syndrome, give Tiaowei Chengqi Tang. If he was given repeated sweat therapy and warm-acupuncture, use Sini Tang.

22  形作伤寒，其脉不弦紧而数，数者必渴，被火者必谵语，数者，发热脉浮，解之当汗出愈[40]。(【注】若脉浮数，发热，解之当以汗，汗出可愈，宜大青龙汤。脉沉数发热，解之当以下，下之可愈，宜调胃承气汤。若脉数无表 证，惟发热而渴谵语者，不可汗下，宜白虎汤、黄连解毒汤，清之可也。)

The person’s condition appears as Shanghan disease. The pulse is not string and tight, but frequent. Person with a frequent pulse must have thirsty. The person will have also Chattering syndrome if he is roasted with fire. Person with the frequent pulse has hot and floating pulse too. Use sweat therapy. If the pulse is floating and frequent, the person has hot, use Da Qinglong Tang to create sweat therapy; if the pulse is deep and frequent, the person has hot, use Tiaowei Chengqi Tang to create a bowel-cleansing therapy; if the pulse is frequent but no Taiyang or Yangming inside condition, the person has only hot and thirsty and Chattering syndrome, use Baihu Tang, Huanglian Jiexu Tang to clear the Xieqi).

(4). 大黄甘草汤

Dahuang Gancao Tang

大黄  四两，甘草  一两

Dahuang 60 gram, Gancao 15 gram.

右二味，以水三升，煮取一升，分温再服。

Add the herbs and 750 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is about 250 ml left. Drink one third of the tea each time, three times a day.

食已即吐者，大黄甘草汤主之。

With vomit after eating[41], use Dahuang Gancao Tang

(5). 厚朴三物汤

Houpo Sanwu Tang

厚朴  八两，大黄  四两，枳实  五枚

Houpo 125 gram, Dahuang 60 gram, Zhishi 5 badges

右三味，以水一斗二升，先煮二味，取五升，内大黄，煮取三升，温服一升，以利为度。

Add the Houpo and Zhishi and 3000 ml water in a herbal pot. Bring to boil and keep in mild boiling until there is about 1250 ml herbal tea left. Add the Dahuang in. Continue to boiling until there is about 750 ml left. Collect the tea. Drink one third of the tea each time, three times a day, until there is bowel movement.

(腹)痛而闭者，厚朴三物汤主之。

支饮腹满者，厚朴大黄汤主之。(支饮胸满，邪在肺也，宜用木防己汤、葶苈大枣汤。支饮腹满，邪在胃也，故用厚朴大黄汤，即小承气汤也。)

For Branch-water accumulation condition, use Houpo Dahuang Tang

(6). 厚朴七物汤

Houpo Qiwu Tang

厚朴  半斤，甘草  三两，大黄  二两，大枣  十枚，枳实  五枚，桂枝  二两，生姜  五两

Houpo 125 gram, Gancao 45 gram, Dahuang 30 gram, Chinese date 10 badges, Zhishi 5 badges, Guizhi 30 gram, fresh ginger 78 gram.

右七味，以水一斗，煮取四升，温服八合，日三服。呕者加半夏五合。下利去大黄。
寒多者，加生姜至半斤。

Add the herbs and 2500 ml water into a herbal pot. Bring to boil and keep it in mild boiling until there is about 1000 ml herbal tea left. Drink 200 ml of the tea each time, three times a day. If there is nausea, add Banxia 65 gram; whit diarrhea, remove Dahuang; with more cold, add the fresh ginger to 125 gram.

病腹满，发热，十日脉浮而数，饮食如故，厚朴七物汤主之。

If the person has fullness in the abdomen and has fever, such condition lasts up to ten days with floating and frequent pulse, normal appetite, use Houpo Qiwu Tang.

(7). 麻仁丸

Maren Wan

麻仁二升， 芍药半斤， 枳实半斤， 大黄（去皮）一斤， 厚朴（去皮）一斤， 杏仁（去皮、尖，熬，别作脂）一升．

Maren 260 gram, Shaoyao 90 gram, Zhishi 90 gram, Dahuang (remove skin) 150 gram, Houpo (remove skin) 150 gram, Xinren (remove skin and tips, processed but not to oil) 130 gram. 

右六味，蜜合丸，如桐子大。饮服十丸，日三服，渐加、以和为度。

Grind all ingredients into powder, mix with honey to make herbal pill, a size of 1 diameter. Drink ten pills each time, three times a day. Increase the number of the pills taken each time, until the bowel movement becomes normal.

21　趺阳脉浮而涩，浮则胃气强，涩则小便数，浮涩相搏，大便则硬，其脾为约，麻仁丸主之。

If the pulse in front of the ankle is floating and harsh (not slippery), floating pulse suggests that the Stomach Qi is strong, harsh means frequent urine. With both floating and harsh pulse, the person will have hard stool, which is called Piyue syndrome. Herb Maren Wan should be used.

（8）. 桃核承气汤

Taohe Chengqing Tang

桃核（去皮、尖）五十个， 桂枝三两， 大黄四两， 芒硝二两， 甘草（炙）二两

Taohe (remove skin and tips) 20 gram, Guizhi 45 gram, Dahuang 60 gram, Mangxiao 30 gram, Gancao (processed) 30 gram.

右五味，以水七升，煮取二升半，去滓，内芒硝，更上火微沸，下火，先食温服五合，日三服，当微利。

Add the herbs (except Mangxiao) and 1750 ml water in a herbal pot. Bring to boil and keep in mild boiling until there is about 625 ml liquid left. Remove the herbal residues, add the Mangxiao in and stirring to dissolve. Drink one third of the herbal tea each time, three times a day. After drinking of the tea, the person should has slight diarrhea.

35太阳病不解，热结膀胱，其人如狂，血自下，下者愈，其外不解者，尚未可攻，当先解其外，外解已，但少腹急结者，乃可攻之，宜桃核承气汤。

If the Taiyang stage continues, the disease may attack and invade further deeper into the urine bladder system. If this is true, the person will feel mad, and has bleeding in urine. After the urine bleeding, the clinic condition will cure. If no bleeding, and there is evidence suggesting the disease remains also in the surface meridian, the priority for the treatment is to solve the disease in the surface meridian (by using Mahuang Tang). After that, if the person still feels tight, urgent, hard feeling in the lower stomach, the herbal Taohe Chengqing Tang is to be considered.[43]

(9). 大黄蟅虫方

Dahuang Zhechong Wan

大黄（蒸）十分,，黄芩二两，甘草三两，桃仁一升，杏仁一升，芍药四两，干漆一两，汒虫一升，水蛭百枚，蟅虫半升，蛴螬一升，干地黄十两

Dahuang, Huangqin, Gancao, Taoren, Xinren, Shaoyao, Ganqi, Mangchong, Shuizhi, Zhechong, Qicao, Shendihuang

右十二味，末之，炼蜜为丸，小豆大，酒饮服五丸，日三服。

Prepare the herbs into pills as 0.5 cm in diameter. Drink five pills each time with the help of wine to swallow. Three times a day.

五劳极虚，羸瘦腹满，不能饮食，食伤、忧伤、饮伤、房室伤、饥伤、劳伤，经络荣卫气伤，内有干血，肌肤甲错，两目黯黑，缓中补虚，大黄蟅虫丸主之。(本条以热伤干血为言)

If the exhausting condition is very severe, the person is very wasting, skinny, fullness in abdomen, hard to eat, and the conditions are caused by improper eating, depression, drinking, sexual activity, hungry, extreme labor work, and his Weiwi, Rongqi and meridian systems have been damaged. He has dead blood[44] inside of the body, dry skin which looks as a fish skin, dark around the eyes. To adjust, balance the body inside and nourish the body inside, use Dahuang Zhechong Wan.

(10). 茵陈蒿汤

Yinchenhao Tang

茵陈蒿六两， 栀子（擘）十四枚， 大黄（去皮）二两

Yinchenhao 90 gram, Zhizi 22 gram, Dahuang (remove skin) 30 gram.

右三味，以水一斗二升，先煮茵陈，减六升，纳二味，煮取三升，去滓，分三服，小便当利，尿如皂荚汁状，色正赤，一宿腹减，黄从小便出也。

Add yinchenhao and 1750 ml water into a herbal pot. Bring to boil and keep in mild boiling until the total liquid in the pot is about 1500 ml. Add the remaining two herbs in, continue to boil until there is about 750 ml left. Collect the herbal tea. Drink one third each time, three times a day.

55  伤寒七、八日，身黄如橘子色，小便不利，腹微满者，茵陈蒿汤主之。

With Cold-invasion Shanghan disease for seven to eight days, the person has fresh yellow skin, difficult in urine, mild fullness in Stomach, herb Yinchenhao Tang should be the main choice. [45]

60　阳明病，发热汗出，此为热越，不能发黄也。但头汗出，身无汗，剂颈而还，小便不利，渴饮水浆者，此为瘀热在里，身必发黄，茵陈蒿汤主之。

If the person is in Yangming stage and feels hot and sweat, it means the Xieqi is depleting through the hot. He will have no jaundice. If the person has sweat only on the head but not in other part of the body, the sweat stops on the neck level, and if he has difficulty in urine[46], feels thirsty and want to drink water, it means the Hot is accumulated in the inside. He then will have jaundice. In this case, herb Yinchinhao Tang is the main choice.

谷疸之为病，寒热, 不食，食即头眩，心胸不安．久久发黄为谷疸，茵陈蒿汤主之。

With Food jaundice disease, the person is hard to eat, has hot or cold feeling, and feels dizzy and annoyed in the chest after eat. After a long time, he will have jaundice. In this case, use Yinchenhao Tang.

(11). 大黄附子汤

Dahuang Fuzi Tang

大黄  三两，附子（炮）三枚，细辛  二两

Dahuang 45 gram, Fuzi (processed) 3 badges, Xixin 30 gram

右三味，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。

Add the herbs and 1250 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 500 ml herbal tea left. Collect the tea. Drink one third of the tea each time, three times a day. For person with strong body ship, collect 600 ml herbal tea, separate it into four parts. Drink one fourth of the tea each time for three time with 2 to 3 hours interval. After about 1 hour, drink the last part.

(肋)下满痛，发热，其脉紧弦，此寒也，宜温药下之，以大黄附子汤。

If the person feels fullness and pain in the side of upper abdomen and his pulse is tight and string, it is a Cold condition. Use warm therapy with Dahuang Fuzi Tang