葛根 芍药 甘草 生姜 桂枝 大枣
主太阳病。项背强。KT KT 。及汗出。恶风。 按诗豳风野狼跋云。赤写KT KT 。注云。KT KT
拘貌。言不敢左右顾视也。借以喻项强之状也。表邪方盛。不当有汗。今反汗出。风伤卫也。故
以桂枝解肌。葛根发表。芍药和营。甘草甘平。姜枣和胃。
葛根 麻黄 桂枝 芍药 甘草 生姜 大枣
主太阳病。项背强。KT KT 。无汗恶风。KT KT 。注见前。旧释鸟羽。未当。今正之。此
方即
桂枝。无汗用麻黄。确乎不可易矣。此复以太阳无汗。用葛根汤。太阳有
汗。用桂枝葛根汤。何也。葛根本阳明经药。恐太阳病久。将传阳明。故用葛根。迎而夺之
。豫发其邪。勿令传入也。前用桂枝汤麻黄汤者。病方起也。今用此二方者。病已久也。又按
太阳病。脉静为不传。若烦躁脉数。为欲传也。意者既见其欲传之状。故用此二方。此未发
之秘旨。
桂枝 芍药 生姜 甘草 麻黄 大枣 杏仁
太阳病。八九日如疟状。热多寒少。 不呕清便。一日二三度发。脉微缓。为欲愈。
脉微。恶寒。不可汗吐下。面反有热色。未欲解也。以不得汗。身必痒。
此方论。当分作三段看。太阳病至寒少一段。为自初至今之症。下文皆拟病防变之辞。
至欲愈一段。言不必治也。至不可汗吐下。言宜温之也。至末一段。是小汗之。麻黄与桂枝。一
发一止。则汗不至大出矣。 桂枝二麻黄一汤不录。
主治太阳病(太阳经受邪所致的病证)。症见项背部僵硬拘急,[原文缺字,据上下文推测为“几几”之状]。以及汗出、恶风(怕风)。按《诗经·豳风·狼跋》记载:“赤舄几几”。注释说,“几几”是拘谨拘束的样子,形容不敢左右顾视。此处借用来比喻项背强直的状态。表邪正盛时,本不应有汗,现在反而汗出,这是风邪伤了卫气(护卫体表的阳气)。所以用桂枝(Cinnamon Twig)来解肌(解除肌表之邪),葛根(Puerariae Lobatae Radix)来发表(发散表邪),芍药(Paeoniae Radix Alba)来调和营血(滋养和调节体内的阴液与血液),甘草(Glycyrrhizae Radix et Rhizoma)味甘性平,生姜(Zingiberis Rhizoma Recens)和大枣(Ziziphi Jujubae Fructus)调和胃气。
葛根、麻黄(Ephedrae Herba)、桂枝、芍药、甘草、生姜、大枣。
主治太阳病。症见项背部僵硬拘急,[原文缺字]。无汗且恶风。[原文缺字]。注释见前文。旧的解释认为是鸟的羽毛,这不恰当,现在予以纠正。这个方子就是桂枝汤去掉桂枝?不,原文意指在桂枝汤基础上,若无汗则加用麻黄,这确实是不可更改的原则。这里再次说明,太阳病无汗,使用葛根汤;太阳病有汗,使用桂枝加葛根汤(即前文所述的桂枝葛根汤)。为什么呢?葛根本是阳明经(足阳明胃经)的药物,担心太阳病日久,将要传入阳明经,所以使用葛根,以迎击并截断病势,预先发散其邪气,防止它传入阳明经。之前使用桂枝汤或麻黄汤,是因为病刚开始;现在使用这两个方子(指葛根汤和桂枝加葛根汤),是因为病已经持续了一段时间。另外按:太阳病中,脉象平静是不传经的表现;如果烦躁、脉数,则是将要传经的迹象。推测是因为已经看到了欲传经的征兆,所以使用这两个方子。这是尚未公开的秘密旨意。
桂枝、芍药、生姜、甘草、麻黄、大枣、杏仁(Pruni Armeniaci Semen)。
太阳病经过八九天,症状像疟疾一样,发热多而恶寒少。没有呕吐,大小便正常。一天发作两三次。脉象微缓,这是将要痊愈的表现。若脉微且恶寒,不可使用发汗、催吐或泻下法。面部反而有热色,说明病未解除。因为不能出汗,身体必定发痒。
这段方论,应当分作三段来看。从“太阳病”到“寒少”这一段,是从发病至今的症状。下文都是预测病情变化以防变的言辞。直到“欲愈”一段,意思是无需治疗。直到“不可汗吐下”,意思是适宜温补。直到最后一段,是小发其汗。麻黄与桂枝,一发一止,那么汗就不会出得太多了。桂枝二麻黄一汤不收录。
Radix Puerariae Lobatae (Ge Gen), Radix Paeoniae Alba (Bai Shao), Radix Glycyrrhizae (Gan Cao), Rhizoma Zingiberis Recens (Sheng Jiang), Ramulus Cinnamomi (Gui Zhi), Fructus Ziziphi Jujubae (Da Zao).
Indicated for Taiyang disease (disease pattern caused by pathogenic factors affecting the Taiyang channel). The main symptoms are stiffness and tightness in the nape and back, [original text missing characters, inferred as "jiji" describing stiffness], along with sweating and aversion to wind. According to the *Book of Songs* (Shijing), Ode of Bin, "Wolf Treading": "The red shoes are stiff." The commentary states that "jiji" describes a constrained or rigid posture, implying an unwillingness to look left or right. This is borrowed here to metaphorically describe the state of neck and back stiffness. When exterior pathogens are vigorous, sweating should not occur; however, sweating is present here, indicating that wind pathogen has injured the Wei Qi (Defensive Qi). Therefore, Gui Zhi (Ramulus Cinnamomi) is used to resolve the muscle layer (Jie Ji), Ge Gen (Radix Puerariae Lobatae) is used to release the exterior (Fa Biao), Bai Shao (Radix Paeoniae Alba) is used to harmonize the Ying (Nutritive) level, Gan Cao (Radix Glycyrrhizae) is sweet and neutral in nature, and Sheng Jiang (Rhizoma Zingiberis Recens) combined with Da Zao (Fructus Ziziphi Jujubae) harmonizes the Stomach Qi.
Radix Puerariae Lobatae (Ge Gen), Herba Ephedrae (Ma Huang), Ramulus Cinnamomi (Gui Zhi), Radix Paeoniae Alba (Bai Shao), Radix Glycyrrhizae (Gan Cao), Rhizoma Zingiberis Recens (Sheng Jiang), Fructus Ziziphi Jujubae (Da Zao).
Indicated for Taiyang disease. Symptoms include stiffness and tightness in the nape and back, [original text missing characters]. There is no sweating and there is aversion to wind. [Original text missing characters]. The commentary is cited from the previous section. Old interpretations described it as bird feathers, which is incorrect; this is corrected here. This formula essentially modifies the Guizhi Tang (Cinnamon Twig Decoction); when there is no sweating, Ma Huang (Herba Ephedrae) is added, which is an unchangeable principle. This reiterates that for Taiyang disease without sweating, Gegen Tang (Kudzu Root Decoction) is used; for Taiyang disease with sweating, Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Kudzu Root) is used. Why? Ge Gen (Radix Puerariae Lobatae) is primarily a herb for the Yangming channel (Foot-Yangming Stomach Channel). It is feared that if Taiyang disease persists, it may transmit to the Yangming channel. Therefore, Ge Gen is used to intercept the pathogen proactively, dispersing the evil beforehand to prevent transmission. Previously, Guizhi Tang (Cinnamon Twig Decoction) or Mahuang Tang (Ephedra Decoction) were used because the disease was just beginning. Now, these two formulas (Gegen Tang and Guizhi Jia Gegen Tang) are used because the disease has persisted for some time. Furthermore: In Taiyang disease, a calm pulse indicates no transmission. If there is irritability and a rapid pulse, it indicates impending transmission. It is surmised that because signs of impending transmission are already visible, these two formulas are employed. This reveals the secret intent not previously disclosed.
Ramulus Cinnamomi (Gui Zhi), Radix Paeoniae Alba (Bai Shao), Rhizoma Zingiberis Recens (Sheng Jiang), Radix Glycyrrhizae (Gan Cao), Herba Ephedrae (Ma Huang), Fructus Ziziphi Jujubae (Da Zao), Semen Pruni Armeniacae (Xing Ren).
Taiyang disease lasting eight or nine days presents like malaria, with more heat and less cold. There is no vomiting, and urination and defecation are normal. The condition occurs two or three times a day. A slightly slow pulse indicates the disease is about to heal. If the pulse is faint and there is aversion to cold, sweating, purging, or emesis methods must not be used. The face shows a reddish hue, indicating the disease has not resolved. Due to the inability to sweat, the body likely feels itchy.
This discussion on the formula should be divided into three parts. From "Taiyang disease" to "less cold," this section describes the symptoms from onset to the present. The following text consists of prognostic statements regarding potential changes in the disease. The section mentioning "about to heal" implies that no treatment is necessary. The section stating "cannot use sweating, emesis, or purging" implies that warming methods are appropriate. The final section describes inducing slight sweating. Ma Huang (Herba Ephedrae) and Gui Zhi (Ramulus Cinnamomi) work together, one releasing and one restraining, ensuring that sweating does not become excessive. The formula Guizhi Er Mahuang Yi Tang (Two Parts Cinnamon Twig Decoction and One Part Ephedra Decoction) is not recorded here.