汗已遍身，则邪从汗解。此汗生于谷，正所以调和营卫，濡腠理，充肌肉，泽皮毛者也。令如水流漓，使
阴不藏精，精不胜则邪不却，故病不除。世医只知大发其汗，即芍药亦不敢用，汗后再汗，岂不误人！
若不汗，更服根据前法。又不汗，后服小促其间。半日许，令三服尽。
前自汗，乃卫中邪汗。服汤后反无汗，是卫分之邪汗已尽，但谷
气未充，精气未敷于营分耳。根据前法便精胜而邪却，药势促则病除矣。
若病重者，一日一夜服，周时观之。服一剂尽，病症犹在者，更作服。若汗不出，乃服至二三剂。
言病重者，药必倍之。一日一夜，当作二服，病在即促后服，勿使间断，便服至三剂无妨。盖桂枝汤是调
和营卫，与麻黄汤专于发表不同，故可重汤叠剂以汗之，不必虑其亡阳也。若施之他方则误矣。
禁生冷、粘滑、肉面、五辛、酒酪、臭恶等物。
凡服药盒饭禁此。因桂枝为首方，故录其后。每见病家禁其谷味，反与麦饮，岂非大悖。
桂枝本为解肌，若其人脉浮紧，发热汗不出者，不可与也。当须识此，勿令误也。
解肌者，解肌肉之汗也。内肤之汗自出，故不用麻黄。若脉浮紧，是麻黄汤脉；汗不出，是麻黄汤症。桂枝
汤无麻黄开腠理而泄皮肤，有芍药敛阴津而制辛热。恐邪气凝结不能外解，势必内攻，为害滋大耳，故叮咛告
戒如此。
桂枝之去其皮，去其粗皮也，正合解肌之义。昧者有去肌取骨之可笑。
酒客病，不可与桂枝汤，得汤则呕，以酒客不喜甘故也。
平素好酒，湿热在中，故得甘必呕。仲景用方慎重如此，言外当知有葛根连芩以解肌之法矣。
凡服桂枝汤吐者，其后必吐脓血也。
桂枝汤不特酒客当禁，凡热淫于内者，用甘温辛热以助其阳，不能解肌，反能涌越热势，所过致伤阳络，
则吐脓血可必也。所谓桂枝下咽，阳盛则毙者以此。
上论桂枝汤十六条，凭脉辨症，详且悉矣。方后更制复方，大详服法，示人以当用；详药禁方，示人以不
当用。仲景苦心如此，读者须知其因脉症而立方，不特为伤寒中风设。亦不拘于一经，故有桂枝症、柴胡症等语。
汗出遍及全身，则邪气随汗而解。这种汗是由水谷精微化生的，正是用来调和营卫、滋润腠理、充实肌肉、润泽皮毛的。如果出汗像水流漓一样过多，会使阴精不能内藏，精气不足则无法抵御邪气，所以病不能痊愈。世间的医生只知道大发其汗，连芍药也不敢使用，发汗之后再次发汗，这难道不是误人吗！
如果服药后没有出汗，可以按照前面的方法继续服用。如果仍然不出汗，则缩短后续服药的时间间隔。在半日左右的时间里，让三剂药服完。
之前的自汗，是卫分中邪气的汗。服药后反而没有汗，说明卫分之分的邪汗已经排尽，只是谷气尚未充盈，精气还没有敷布到营分罢了。按照前面的方法服用，就会使精气胜而邪气退，药物作用急促则病除。
如果病情严重的，一天一夜连续服药，观察二十四小时的情况。服完一剂药，病症还在的，再重新煎服。如果汗不出，就服药直到二三剂。
说病情重的，药量必须加倍。一天一夜，应当分为两次服用，病势急迫就催促后服，不要让服药间断，即使服到三剂也没有妨碍。因为桂枝汤是调和营卫，与麻黄汤专门用于发表不同，所以可以重复煎煮叠加药剂来发汗，不必担心导致亡阳。如果用在其他方剂上则是错误的。
禁忌生冷、粘滑、肉类、面食、五辛（葱、蒜、韭、薤、兴渠）、酒酪、腐臭恶秽等食物。
凡是服药期间都应该禁止食用这些。因为桂枝汤是首要方剂，所以记录在方后。经常看到病人家属禁止病人吃谷物味道，反而给喝麦粥，这岂不是大大的违背医理。
桂枝本是用来解除肌表的邪气，如果病人脉象浮紧，发热且无汗的，不可以给予桂枝汤。应当认识到这一点，不要让它造成误治。
所谓“解肌”，是解除肌肉层面的邪气。体内肤层的汗自然流出，所以不用麻黄。如果脉浮紧，这是麻黄汤的脉象；无汗，这是麻黄汤的症状。桂枝汤中没有麻黄来开泄腠理和皮肤，却有芍药来收敛阴津并制约辛热之性。担心邪气凝结不能从外解除，势必向内攻伐，造成的危害就很大了，所以如此叮咛告诫。
桂枝去掉它的皮，就是去掉它粗糙的外皮，正符合“解肌”的含义。愚昧的人有“去肌取骨”的可笑说法。
平时喝酒的人患病，不可以给予桂枝汤，喝了桂枝汤就会呕吐，因为喝酒的人不喜欢甘味的原因。
平素喜欢喝酒，湿热蕴结在中焦，所以遇到甘味必然呕吐。张仲景用药如此慎重，言外之意应当知道有葛根黄芩黄连汤来解肌的方法了。
凡是服用桂枝汤出现呕吐的，其后必定会吐脓血。
桂枝汤不仅酒客应当禁用，凡是热邪炽盛于体内的，使用甘温辛热的药物来助长阳气，不能解除肌表邪气，反而会涌越热势，经过之处损伤阳络，那么吐脓血是必然的。这就是所谓的“桂枝下咽，阳盛则毙”的原因。
以上论述桂枝汤的十六条内容，凭借脉象辨别症状，详细且周全了。方后更制定了复方，非常详细地说明了服法，告诉人们应当如何使用；详细说明药物禁忌和方剂，告诉人们不应当如何使用。张仲景如此苦心孤诣，读者需要知道他是根据脉症来立方的，不仅仅是为伤寒中风设立的。也不拘泥于某一经络，所以有桂枝证、柴胡证等说法。
After sweating pervades the whole body, the pathogenic factor is resolved through sweat. This sweat is generated from grain (nutritive essence), and its function is precisely to harmonize Ying and Wei (Nutritive and Defensive levels), moisten the Cou Li (interstitial spaces between skin and muscle), fill the muscles, and nourish the skin and hair. If sweating is excessive like flowing water, it prevents Yin from storing essence; when essence is insufficient, it cannot overcome the pathogen, thus the disease remains unresolved. Physicians of the world only know how to induce heavy sweating, and dare not even use Shaoyao (Paeoniae Radix Alba); inducing sweat after sweat—would this not harm people?
If there is no sweating, administer again according to the previous method. If still no sweating, shorten the interval between subsequent doses. Within about half a day, ensure all three doses are consumed.
The previous spontaneous sweating was sweat of the pathogen in the Wei level. After taking the decoction, if there is suddenly no sweating, it means the pathogenic sweat in the Wei level has been exhausted, but the Qi from grain is not yet full, and the Essence Qi has not yet spread to the Ying level. Following the previous method will lead to Essence Qi prevailing and pathogen retreating; accelerating the drug's action will resolve the disease.
For severe cases, administer medicine over one day and one night, observing for twenty-four hours. If symptoms persist after finishing one dose, prepare another dose. If sweating does not occur, continue administering until two or three doses are finished.
When stating that the case is severe, the dosage must be doubled. One day and one night should be divided into two administrations; if the disease is urgent, hasten the subsequent doses without interruption. It is permissible to take up to three doses. This is because Guizhi Tang (Cinnamon Twig Decoction) harmonizes Ying and Wei, which differs from Mahuang Tang (Ephedra Decoction) that specializes in releasing the exterior. Therefore, it can be repeatedly decocted and stacked in doses to induce sweating, without worrying about Yang collapse. Using it for other formulas would be an error.
Contraindications include cold/raw foods, sticky/slippery foods, meat, noodles, Five Pungent Spices (Wu Xin: garlic, chives, leeks, scallions, asafoetida), wine/cheese, and foul/rotten substances.
These contraindications apply to all patients taking the medicine. Because Guizhi Tang is the primary formula, these notes are recorded afterwards. I often see families forbidding their patients from eating grains but instead giving them wheat drink; is this not a great deviation?
Guizhi (Cinnamon Twig) is originally used to resolve the muscle layer. If the pulse is floating and tight, with fever and no sweating, it should not be given. One must recognize this to avoid errors.
"Resolving the muscle layer" refers to resolving pathogens at the muscle level. Since sweat naturally occurs within the inner skin/flesh, Mahuang (Ephedra) is not used. A floating and tight pulse is the pulse pattern for Mahuang Tang; absence of sweating is the symptom pattern for Mahuang Tang. Guizhi Tang lacks Mahuang to open the Cou Li and vent the skin, but contains Shaoyao to astringe Yin fluids and restrain pungent-heat properties. There is fear that pathogenic factors will coagulate and fail to resolve externally, inevitably attacking internally, causing significant harm. Hence, such earnest warnings are given.
Removing the bark of Guizhi refers to removing its rough outer bark, which aligns with the meaning of "resolving the muscle layer." Ignorant people have made the ridiculous claim of "removing the muscle to take the bone."
Patients who are habitual drinkers (Jiu Ke) should not be given Guizhi Tang; taking it will cause vomiting because drinkers dislike sweet flavors.
Those who habitually drink alcohol have damp-heat accumulating in the Middle Jiao; therefore, encountering sweet flavors inevitably causes vomiting. Zhang Zhongjing was so cautious in prescribing formulas; implicitly, one should understand the method of using Gegen Qinlian Tang (Kudzu, Scutellaria, and Coptis Decoction) to resolve the muscle layer.
Anyone who vomits after taking Guizhi Tang will subsequently vomit pus and blood.
Guizhi Tang is not only contraindicated for drinkers; for anyone with excessive heat blazing internally, using sweet-warm and pungent-hot drugs to assist Yang will not resolve the muscle layer but will instead surge the heat, damaging the Yang collaterals along its path. Thus, vomiting pus and blood is certain. This is what is meant by "Once Guizhi enters the throat, if Yang is excessive, death ensues."
The above sixteen discussions on Guizhi Tang thoroughly explain distinguishing symptoms via pulses. The post-formula section details compound prescriptions and administration methods, showing people how to use it correctly; it details drug contraindications and formulas, showing people how not to use it. Zhang Zhongjing’s painstaking effort is evident; readers must understand that he established formulas based on pulse and symptom patterns, not merely for Shanghan (Cold Damage) or Fengzhong (Wind Strike). It is not restricted to a single meridian, hence terms like "Guizhi Syndrome" and "Chaihu Syndrome" appear.