1 In disease of the Tai Yang, the pulse is floating, the head and nape are stiff and painful, and there is aversion to cold.
2 When in Tai Yang disease there is heat effusion, sweating, aversion to wind, and a pulse that is moderate, it is called wind strike.
3 Tai Yang diseases, whether heat has effused or not, as long as there is aversion to cold, with generalized pain, retching counter flow, and yin and yang pulses both tight, is called cold damage.
4 On the first day of cold damage. Tai Yang contracts the disease. If the pulse is tranquil, this means no passage, a strong desire to vomit, if there is agitation and vexation, and the pulse is rapid and urgent, means passage.
5 When on the second or third day of cold damage, Yang Ming and Shao Yang are absent; it means no passage had occurred.
6 When in Tai yang disease there is heat effusion and thirst, without aversion to cold, this is warm disease.
If after sweating has been promoted, there is generalized scorching heat, this is called wind-warmth. When wind –warmth causes disease, the yin and yang pulses are both floating, there is spontaneous sweating, generalized heaviness, a tendency to sleep, the breath from the nose will make a snoring sound, and the speech is difficult. If precipitation has used, there is inhibited urination, forward staring eyes, and fecal incontinence, if fire has been used, there is slight yellowing, and in acute cases there is fright epilepsy, periodic tugging and slackening, and the skin appears as if fumed by fire, one instance of adverse treatment will lengthen the time of disease, and further adverse treatment will lead to the term of life.
7 When an illness is characterized by heat effusion and aversion to cold, it is springing from yang, when an illness is characterized by the absence of heat effusion and the presence of aversion to cold, it is springing from yin. In illness springing from yang, the patient recovers in seven days. In illness springing from yin, the patient recovers in six days. This is because yang numbers seven and yin numbers six.
8 When in Tai Yang disease, a headache lasts for more than seven days, and then the patient spontaneously recovers, this is because the evil has gone right through the channel. If it is about to pass to another channel, and one needles foot Yang Ming to prevent passage, then the patient will recover.
9 The time when Tai yang disease is about to resolv is from si to wei.
10 Wind patients in whom the exterior has resolved, but not clearly, will recover in twelve days.
11 When the patient has generalized heat, but desires to put more clothes on, the heat is in the skin and the cold is in the bone marrow. When there is great generalized cold, but the patient has no desire for clothes, the cold is in the skin and the heat is in the bone marrow.
12 In Tai Yang wind strike with floating yang and weak yin, floating yang is spontaneous heat effusion and weak yin is spontaneous issue of sweat. If there is huddled aversion to cold, wetted aversion to wind, feather warm heat effusion, noisy nose, and a dry retching, gui zhi tang governs.
13 For Tai Yang disease with headache, heat effusion, sweating, and aversion to wind, gui zhi tang governs.
14 When in Tai Yang disease there is stretched stiff nape and back, but also sweating and aversion to wind, it is treated with gui zhi jia ge gen tang.
15 When in Tai Yang disease, after precipitation, qi surges upward, one may give gui zhi tang, according to the previously mentioned method. If there is no upsurge, one cannot give this formula.
16A When Tai Tang disease has lasted for three days and sweating has already been promoted, if vomiting, or precipitation, or if warm needling has been used and still there is no resolution, this is an aggravated disease in which gui zhi tang should not be given. Observe the pulse and signs, know what error you have committed, and then treat according to the signs.
16b Gui zhi tang is basically for resolving the flesh, if the persons pulse is tight and floating, and there is heat effusion, and sweating is absent, it cannot be given. One needs always to be aware of this, so as not to cause this error.
17 If a drinker is sick, gui zhi tang cannot be given, since it will cause retching. This is because drinkers do not like sweet things.
18 For panting patients suffering from gui zhi tang pattern, it is best to add hou po and xing ren.
19 Whenever taking gui zhi tang makes the person vomit, there will be vomiting of pus and blood afterwards.
20 When in Tai Yang disease, sweating is promoted and then gives way to incessant leaking, the person is adverse to wind, has difficult urination, and the limbs are tensed so that they bend and stretch with difficulty, gui zhi jia fu zi tang governs.
21 In Tai Yang disease, when after precipitation the pulse is skipping and there is fullness in the chest, gui zhi qu shao yao tang governs.
22 When the pulse is faint and there is aversion to cold, gui zhi qu shao yao jia fuzi tang governs.
23 In Tai Yang disease lasting eight or nine days and resembling malaria, in which there is heat effusion and aversion to cold with the heat effusion more pronounced than the aversion to cold, and in which the person does not retch, the excretions are still normal, and episodes occur two or three times a day, then the following applies. If the pulse is slightly moderate this means that there is about to be recovery. If the pulse is faint and there is aversion to cold, this means that both yin and yang are vacuous and one cannot further promote sweating, further promote precipitate, or further cause vomiting. However, a facial complexion with the color of heat means that the disease is not about to resolve, and because the person cannot get up a light sweat, there will be generalized itching, therefore gui zhi ma huang ge ban tang governs.
24 When in Tai Yang disease , the patient has initially taken gui zhi tang, but is vexed and the exterior is unresolved, first needle wind pool, gb 20, and wind mansion , dm 16, then give gui zhi tang and the patient will recover.
25 When after taking gui zhi tang, there is great sweating and the pulse is surging and large, use gui zhi tang as before. If the disease resembles malaria, occurring twice a day, sweating will resolve the disease and therefore gui zhi er ma huang yi tang is appropriate.
26 When, after gui zhi tang is taken and a great sweat has issued, there is great vexation and thirst, and the disease is unresolved and the pulse is surging and large, bai hu jia ren shen tang governs.
27 When in Tai Yang disease there is heat effusion and aversion to cold with more heat and less cold a pulse that is faint and weak means that yang is absent and one cannot promote sweating, gui zhi er yue bi yi tang is appropriate.
28 When gui zhi tang is taken, or precipitation is used and there is still stiffness and pain of the head and nape, feather warm heat effusion, absence of sweating, fullness below the heart with slight pain, and inhibited urination, gui zhi qu gui jia fu ling bai zhu tang governs.
29 When in cold damage, the pulse is floating and there is spontaneous sweating, frequent urination, heart vexation, mild aversion to cold, and hypertonicity of the feet, but gui zhi tang is given in order to attack the exterior, this is an error.
If the person is given this formula, there will be reversal, dryness in the throat, vexation and agitation, and counter flow vomiting, so one should use gan cao gan jiang tang to restore yang. If a counter flow patient recovers, and the feet become warm, one can then use shao yao gan cao tang and the feet will then be able to stretch. If the stomach qi is disharmonious and there is delirious speech, give a little tiao wei cheng qi tang. If sweating has been promoted repeatedly, then red hot needling is used, si ni tang governs.
30 Question: In a pattern similar to yang dawn, if the physician treats the patient according to the appropriate method, but the disease becomes more acute, then there is reverse flow, dryness in the throat, hypertonicity of the lower legs, and delirious speech. The master says: In the middle of the night the extremities should be warm and the two legs should be able to extend. From here on proceed as the master said. How does one know this? Answer: The cun pulse is floating and large; floating means wind and large means vacuity. The wind engenders mild heat, and because of mild vacuity, there is hypertonicity of the lower legs. The form of the illness is like gui zhi tang pattern, and because fu zi is added, it increases the ability of gui zhi to cause sweat to issue, and fu zi also warms the channels, so there is yang collapse. When there is reverse flow, dryness in the throat, vexation and agitation, yang ming internal bind, delirious speech, and vexation and derangement, change to gan cao gan jiang tang. In the middle of the night, the yang returns, so the legs should become warm, but if there is still slight hypertonicity of the lower legs, give a large dose of shao yang an cao tang, so that the lower legs will be able to extend. Because cheng qi tang will cause slightly sloppy stools and then suppress the delirious speech, one knows the person can recover from the disease.
31 In Tai Yang disease with a stretched stiff nape and back, absence of sweating, and aversion to cold, ge gen tang governs.
32 In Tai Yang and Yang Ming combination disease, there will be spontaneous diarrhea, and therefore ge gen tang governs.
33 When in Tai Yang and Yang Ming combination disease, diarrhea is absent, and only retching is present, ge gen jia ban xia tang governs.
34 When in Tai Yang disease the condition is a gui zhi tang pattern, but the physician precipitates, causing incessant diarrhea and a pulse that is skipping, it means that the exterior has not yet resolved, when there is panting and sweating, ge gen huang qin huang lian tang governs.
35 When in Tai yang disease there is headache, heat effusion, generalized pain, lumbar pain, joint pain, aversion to wind, absence of sweating, and panting, ma huang tang governs.
36 When in Tai Yang and Yang Ming combination disease there is panting and fullness in the chest, one cannot use precipitation, but instead Ma Huang Tang is appropriate.
37 When in Tai Yang disease, after ten days have passed, the pulse is floating and fine, and there is somnolence, the outer body has already been resolved. If there is fullness in the chest and rib side pain, give xiao chai hu tang, if the pulse is floating only give ma huang tang.
38 When in Tai Yang (could be cold) wind strike the pulse is floating and tight, and there is heat effusion, aversion to cold, generalized pain, absence of sweating, and vexation and agitation, da qing long tang governs. If the pulse is faint and weak and there is sweating and aversion to wind, the person cannot take this formula. If he takes it there will be reverse flow and jerking sinews and twitching flesh, indicating an adverse treatment.
39 When in cold damage, the pulse is floating and moderate, and there is no generalized pain, only generalized heaviness, with sudden periods of lightness, and there is no Shao Yin disease, da qing long tang will promote sweating and resolve the disease.
40 When in cold damage the exterior has not resolved and there is water qi below the heart, with dry retching, heat effusion and cough, and possibly thirst or diarrhea, or dysphagia, or inhibited urination and lesser abdominal fullness, or panting, Xiao Qing Long tang governs.
41 When in cold damage, there is water qi below the heart, cough, mild panting, and heat effusion without thirst, thirst after taking the decoction means the cold is going and the disease is about to resolve Xiao Qing Long tang governs.
42 When in Tai Yang disease the exterior pattern has not resolved and the pulse is floating and weak, this should be resolved through the promotion of sweating, therefore gui zhi tang is appropriate.
43 When in Tai Yang disease, there is mild panting following precipitation, it means that the exterior has not been resolved; therefore gui zhi jia hou po xing ren governs.
44 Tai Yang disease in which the exterior pattern has not resolved cannot be precipitated since precipitation would be an adverse treatment. When one desires to resolve the exterior gui zhi tang is appropriate.
45 When in Tai Yang disease initial promotion of sweating fails to resolve the disease and precipitation then is used, so that the pulse is floating, there will be no recovery. A pulse that is floating means location in the outer body, and if instead precipitation is used, it will prevent recovery. The pulse is now floating so we know that the disease is located in the outer body and this requires resolution of the outer body to achieve recovery, therefore, gui zhi tang is appropriate.
46 In Tai Yang disease, when a pulse that is floating and tight, absence of sweating, heat effusion, and generalized pain are un resolved after 8 or 9 days, the exterior pattern is still present and one should promote sweating. After taking medicine, the condition is slightly relieved, and the person is vexed and the eyes are heavy. If it is acute, there will be spontaneous external bleeding, which will bring about resolution. Why this is so is because the yang qi is weighted. Ma huang tang governs.
47 When in Tai Yang disease, the pulse is floating and tight, and there is heat effusion and absence of sweating, spontaneous external bleeding will bring about recovery.
48 In drag over disease of the two yang, the disease begins in Tai Yang, sweating is promoted and the sweating is incomplete, which causes the disease to shift to Yang Ming and there is continuous slight spontaneous sweating, and the absence of aversion to cold. If the Tai Yang disease pattern has not ceased, one cannot precipitate, because precipitation would be an adverse treatment and in this case, one can promote sweating mildly, If facial complexion is continuously full red, the yang qi is depressed in the exterior and one should resolve the exterior fume. If sweating is promoted incompletely, that is to say insufficiently to speak of, the yang qi is depressed and cannot pass out so there should be sweating but there is not. The person is agitated and vexed and does not know where the pain is located, now it is in the abdomen, now it is in the extremities, and when pressing one cannot find it. The person is short of breath and can only sit. This is because sweating was incomplete and further promoting of sweating will lead to recovery. How can one know that the sweating was incomplete? One knows because the pulse is rough.
49 When the pulse is floating and rapid, as a rule there should be sweating and then recovery. If precipitation is used, and there is generalized heaviness and heart palpitations, one cannot promote sweating, the person must sweat spontaneously so that the illness is resolved. Why this is so is because the pulse at the cubit is faint, which indicates interior vacuity. Exterior and interior need to be made replete, so that liquid and humor naturally become harmonious and then spontaneous sweating will bring about recovery.
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