经曰。桂枝本为解肌。若其人脉浮紧。发热汗不出者。不可与也。常须识此。勿令误
也。盖桂枝汤。本专主太阳中风。其于腠理致密。荣卫邪实。津液荣固。寒邪所胜者。
则桂枝汤不能发散。必也皮肤疏凑。又自汗。风邪干于卫气者。乃可投之也。仲景
以解肌为轻。以发汗为重。是以发汗吐下后。身疼不休者。必与桂枝汤。而不与麻
黄汤者。以麻黄汤专于发汗。其发汗吐下后。津液内耗。虽有表邪。而止可解肌。故
须桂枝汤小和之也。桂味辛热。用以为君。必谓桂犹圭也。宣道诸药。为之先聘。是
犹辛甘发散为阳之意。盖发散风邪。必以辛为主。故桂枝所以为君也。芍药味苦
酸微寒。甘草味甘平。二物用以为臣佐者。内经所谓风淫所胜。平以辛。佐以苦。以
甘缓之。以酸收之。是以芍药为臣。而甘草为佐也。生姜味辛温。大枣味甘温。二物
为使者。内经所谓风淫于内。以甘缓之。以辛散之。是以姜枣为使者也。姜枣味辛
甘。固能发散。而此又不特专于发散之用。以脾主为胃行其津液。姜枣之用。专行
脾之津液。而和荣卫者也。麻黄汤所以不用姜枣者。谓专于发汗。则不待行化。而
津液得通矣。用诸方者。请熟究之。
桂枝（君三两去皮） 芍药（臣佐三两） 甘草（臣佐二两炙） 大枣（使十二枚擘） 生姜（使三两切）
上五味 咀。以水七升。微火煮取三升。去渣。适寒温。服一升。服已须臾。 热稀
粥一升余。以助药力。温覆令一时许。遍身 微似有汗者益佳。不可令如水
流漓。病必不除。若一服汗出病瘥。停后服。不必尽剂。若不汗更服。根据前法。又不
汗。后服小促使其间。半日许令三服尽。若病重者。一日一夜服。周时观之。服一
剂尽。病证犹在者。更作服。若汗不出。乃服至二三剂。禁生冷粘滑肉麦五辛酒酪臭恶等物。
《内经》说：桂枝原本是用来解除肌表的邪气。如果病人的脉象浮紧，发热且无汗，就不能使用它。必须时刻牢记这一点，不要误用。桂枝汤主要主治太阳中风证。对于那些腠理致密、营卫邪气实盛、津液固守、寒邪占优势的情况，桂枝汤无法发散邪气。只有当皮肤腠理疏松，并且病人自汗出，风邪侵犯卫气时，才可以投用桂枝汤。张仲景认为“解肌”作用较轻，“发汗”作用较重。因此，在发汗、催吐或泻下之后，身体疼痛不止的，应当给予桂枝汤，而不给予麻黄汤。因为麻黄汤专门用于强力发汗，而在发汗、催吐或泻下之后，体内的津液已经消耗，即使有表邪，也只能采用解肌的方法，所以需要用桂枝汤轻微调和。
桂枝味辛性热，作为君药。所谓“桂”通“圭”，意指宣导诸药，如同先行聘问一样，这符合“辛甘发散为阳”的道理。发散风邪必须以辛味为主，所以桂枝被用作君药。芍药味苦、酸，微寒；甘草味甘，性平。这两味药作为臣药和佐药，正如《内经》所说：“风邪过胜，用辛味药来平抑，用苦味药来辅助，用甘味药来缓和，用酸味药来收敛。”因此芍药为臣药，甘草为佐药。生姜味辛性温，大枣味甘性温，这两味药作为使药。正如《内经》所说：“风邪在内，用甘味药来缓和，用辛味药来发散。”所以姜和大枣作为使药。姜和大枣味道辛甘，固然能发散，但此处不仅限于发散之用，因为脾主为胃传输津液，姜枣的作用在于专门运行脾的津液，从而调和营卫。麻黄汤中不使用姜枣，是因为它专于发汗，不需要通过行化津液来通利，津液自然就能通达。使用其他方剂的人，请仔细研究其中的道理。
桂枝（君药，三两，去皮） 芍药（臣佐药，三两） 甘草（臣佐药，二两，炙烤） 大枣（使药，十二枚，掰开） 生姜（使药，三两，切片）
以上五味药，捣碎。用水七升，用小火煮取三升，去渣滓。待温度适宜，服用一升。服药后不久，喝热稀粥一升多，以助药力。覆盖衣被约一顿饭的时间，全身微微似有汗出的效果最好，不可让汗水像水流一样淋漓而出，否则病必不能去除。如果服一次药后汗出病愈，停止后面的服药，不必喝完剩下的药汁。如果没有出汗，再按前法服用。如果仍不出汗，缩短后面两次服药之间的间隔时间，在半日左右让三次药服完。如果病情重的，一天一夜连续服药，观察二十四小时。如果一剂药服完，病证仍在，再重新制作服用。如果仍然不出汗，可以服用到两三剂。禁忌食用生冷、粘滑、肉类、小麦、五辛、酒类、乳酪及气味恶臭等食物。
The *Neijing* states: Guizhi (Cinnamon Twig) is originally used to resolve the muscle layer (*jieji*). If the patient's pulse is floating and tight, with fever but no sweating, it must not be administered. One must always keep this in mind to avoid errors. Guizhi Tang (Cinnamon Twig Decoction) primarily treats Taiyang Wind Strike syndrome (*Taiyang Zhongfeng*). In cases where the interstices are dense, Ying and Wei pathogenic factors are substantial, body fluids are consolidated, and Cold pathogen prevails, Guizhi Tang cannot disperse the pathogen. It can only be used when the skin pores are loose and the patient has spontaneous sweating, indicating that Wind pathogen has invaded the Wei Qi. Zhang Zhongjing considered "resolving the muscle layer" as a mild method and "inducing sweating" as a heavy method. Therefore, after inducing sweating, vomiting, or purging, if body pain persists, Guizhi Tang should be given rather than Mahuang Tang (Ephedra Decoction). This is because Mahuang Tang is specifically for strong diaphoresis; after sweating, vomiting, or purging, internal body fluids are depleted. Even if exterior pathogenic factors remain, only resolving the muscle layer is appropriate, so Guizhi Tang is used to gently harmonize.
Guizhi (Cinnamon Twig), pungent and hot, serves as the Sovereign drug. The character "Gui" is akin to "Gui" (jade tablet), signifying the guidance of other herbs, acting as a pioneer. This aligns with the principle that "pungent and sweet flavors disperse and belong to Yang." Dispersing Wind pathogen must primarily rely on pungent flavors, hence Guizhi is the Sovereign. Shaoyao (White Peony Root), bitter and sour, slightly cold, and Gancao (Licorice Root), sweet and neutral, serve as Minister and Assistant drugs. As stated in the *Neijing*: "When Wind excess prevails, pacify with pungent, assist with bitter, ease with sweet, and astringe with sour." Thus, Shaoyao is the Minister, and Gancao is the Assistant. Shengjiang (Fresh Ginger), pungent and warm, and Dazao (Jujube), sweet and warm, serve as Envoy drugs. As the *Neijing* states: "When Wind is internal, ease with sweet and disperse with pungent." Hence, Ginger and Jujube are Envoys. Although their pungent and sweet flavors allow for dispersion, their role here extends beyond mere dispersion. Since the Spleen governs transporting fluids for the Stomach, the function of Ginger and Jujube is to specifically move the Spleen's fluids and harmonize Ying and Wei. Mahuang Tang does not use Ginger and Jujube because its focus is solely on inducing sweating, which does not require fluid transformation for patency, as fluids naturally flow. Practitioners using various formulas should study these principles carefully.
Guizhi (Sovereign, 3 liang, bark removed) Shaoyao (Minister/Assistant, 3 liang) Gancao (Minister/Assistant, 2 liang, honey-fried) Dazao (Envoy, 12 pieces, split) Shengjiang (Envoy, 3 liang, sliced)
Crush the above five ingredients. Boil in 7 sheng of water over low heat until reduced to 3 sheng. Remove the dregs. When the temperature is suitable, drink 1 sheng. Shortly after ingestion, consume more than 1 sheng of hot thin porridge to assist the medicinal power. Cover with blankets for about one hour until the entire body shows slight perspiration, which is ideal. Do not allow profuse sweating like flowing water, otherwise the disease will not be resolved. If sweating occurs after the first dose and the illness resolves, stop subsequent doses; there is no need to finish the remaining decoction. If no sweating occurs, administer another dose according to the previous method. If still no sweating, shorten the interval between subsequent doses, aiming to complete three doses within half a day. For severe cases, administer continuously over day and night, observing for 24 hours. If symptoms persist after finishing one prescription, prepare and administer another. If sweating still does not occur, up to two or three prescriptions may be used. Avoid consuming raw/cold foods, sticky/greasy foods, meat, wheat, the "Five Pungents," alcohol, dairy products, and foul-smelling substances.