此汤成无己本有麻黄。非!有麻黄则为葛根汤矣。
桂枝汤原方,加葛根四两 桂枝芍药各减一两余同。上六味,以水一斗,先煮葛根,减二升,去
上沫,纳诸药,煮取三升,去渣,温服一升,覆取微似汗,不须啜粥,余如桂枝法将息。
太阳病,项背强KT KT ,反汗出恶风者“KT KT ”,伸颈之象,邪气渐深,故加葛根。桂枝加葛根汤主之。
桂枝汤原方芍药加一倍。上五味,以水七升,煮取三升,温服一升,日三服。
此二方俱治太阴症,而法不离乎桂枝。
桂枝汤原方,加大黄一两、芍药一倍,上六味,以水七升,煮取三升,去渣,温服一升,日三服。
本太阳病,医反下之,误治。因而腹满时痛,属太阴也。引邪入于太阴,故所现皆太阴之症。桂枝
加芍药汤主之。虽见太阴症,而太阳之症尚未罢,故仍用桂枝汤,只加芍药一倍,以敛太阴之症。
大实痛者,此句承上文腹满时痛言,腹满时痛,不过伤太阴之气,大实痛,则邪气结于太阴矣。桂枝加
大黄汤主之。此因误下而见太阴之症。大实痛,则反成太阴之实邪,仍用大黄引之,即从太阴出,不因误
下而禁下,见症施治,无不尽然。
按《活人书》云∶桂枝汤,自西北人四时行之,无不应验,江淮间惟冬及春可行之,春末及夏至以前,
桂枝症可加黄芩一分,谓之阳旦汤。夏至后可加知母半两,石膏一两或加升麻一分,若病患素虚寒者,不必加
减。
此方在成无己的版本中包含了麻黄。这是错误的!如果含有麻黄,那就变成葛根汤了。
桂枝汤原方,加入葛根四两,桂枝和芍药各减少一两,其余药物及煎服法相同。以上六味药,用水一斗,先煮葛根,水量减少二升,撇去上面的浮沫,再加入其他药物,煮取三升药液,滤去药渣,温服一升,服药后覆盖衣被使身体微微出汗,不需要喝热粥,其余调养方法同桂枝汤法。
太阳病,出现项背部僵硬拘急不适(“KT KT”形容伸颈的样子),反而汗出、恶风的,这是因为邪气逐渐深入,所以加入葛根。用桂枝加葛根汤主治。
桂枝汤原方,芍药增加一倍。以上五味药,用水七升,煮取三升,温服一升,每日服用三次。
桂枝汤原方,加入大黄一两、芍药增加一倍,以上六味药,用水七升,煮取三升,滤去药渣,温服一升,每日服用三次。
原本患太阳病,医生反而使用下法治疗,属于误治。因此出现腹部胀满、时时疼痛的症状,这属于太阴病。这是引邪入于太阴,所以表现的都是太阴病的症状。用桂枝加芍药汤主治。虽然见到太阴病的症状,但太阳病的症状尚未完全解除,所以仍然使用桂枝汤,只将芍药增加一倍,以收敛太阴的病势。
如果是大实痛的情况,这句话是承接上文“腹满时痛”而言的。“腹满时痛”不过是损伤了太阴之气,“大实痛”,则是邪气结聚在太阴所致。用桂枝加大黄汤主治。这是因为误用下法而出现了太阴病的症状。若出现大实痛,则反而形成了太阴的实邪,仍需用大黄来引导邪气排出,即让邪气从太阴外出,不能因为误用下法就禁止使用下法,应根据症状施治,没有不恰当的。
按《活人书》记载:桂枝汤,西北人在四季使用,无不灵验;江淮地区只有在冬季和春季可以使用,春末及夏至以前,如果是桂枝证可以加入一分黄芩,称为阳旦汤。夏至以后可以加入知母半两、石膏一两,或者加入一分升麻。如果病人素体虚寒,则不必加减。
This formula in Cheng Wuji's edition contains Ephedrae Herba (Mahuang, 麻黄). This is incorrect! If it contains Ephedrae Herba, it becomes Ge Gen Tang (Kudzu Decoction).
The original Gui Zhi Tang (Cinnamon Twig Decoction) is modified by adding Radix Puerariae (Gegen, 葛根) four liang, reducing both Ramulus Cinnamomi (Guizhi, 桂枝) and Radix Paeoniae Alba (Baishao, 芍药) by one liang each, while the remaining ingredients and preparation methods remain the same. Take the above six medicinal materials, add ten dou of water, first decoct Radix Puerariae (Gegen, 葛根), reduce the volume by two dou, remove the foam on the surface, then add the other medicines, decoct to obtain three sheng of liquid, filter out the dregs, take one sheng warm, cover with blankets to induce a slight sweat, no need to drink hot porridge, and follow the rest of the care instructions for Gui Zhi Tang (Cinnamon Twig Decoction).
In Tai Yang disease (Disease of the Tai Yang channel), characterized by stiffness and discomfort in the neck and back ("KT KT" describes the appearance of stretching the neck), accompanied by sweating and aversion to wind, this indicates that the pathogenic factor has gradually deepened; therefore, Radix Puerariae (Gegen, 葛根) is added. Treat with Gui Zhi Jia Ge Gen Tang (Cinnamon Twig Decoction plus Kudzu Root).
The original Gui Zhi Tang (Cinnamon Twig Decoction) formula uses double the amount of Radix Paeoniae Alba (Baishao, 芍药). Take the above five medicinal materials, add seven sheng of water, decoct to obtain three sheng, take one sheng warm, three times a day.
Both of these formulas treat Tai Yin syndromes (Syndromes of the Tai Yin organ system), but the treatment principle remains based on Gui Zhi Tang (Cinnamon Twig Decoction).
The original Gui Zhi Tang (Cinnamon Twig Decoction) formula is modified by adding Rhubarb (Dahuang, 大黄) one liang and doubling the amount of Radix Paeoniae Alba (Baishao, 芍药). Take the above six medicinal materials, add seven sheng of water, decoct to obtain three sheng, filter out the dregs, take one sheng warm, three times a day.
Originally suffering from Tai Yang disease (Disease of the Tai Yang channel), the physician incorrectly used purgation therapy. Consequently, abdominal fullness and intermittent pain occur, which belongs to Tai Yin syndrome (Tai Yin syndrome). This draws the pathogen into the Tai Yin system, hence presenting all symptoms of Tai Yin. Treat with Gui Zhi Jia Shao Yao Tang (Cinnamon Twig Decoction plus White Peony Root). Although Tai Yin symptoms are present, the Tai Yang symptoms have not yet resolved; therefore, Gui Zhi Tang (Cinnamon Twig Decoction) is still used, with only the amount of Radix Paeoniae Alba (Baishao, 芍药) doubled to restrain the Tai Yin pathology.
If there is severe pain due to excess accumulation, this sentence follows the previous mention of "abdominal fullness and intermittent pain." Abdominal fullness and intermittent pain merely indicate damage to Tai Qi (Vital Energy of the Spleen/Stomach); severe pain indicates that the pathogenic factor has accumulated in the Tai Yin system. Treat with Gui Zhi Jia Da Huang Tang (Cinnamon Twig Decoction plus Rhubarb). This arises because incorrect purgation led to Tai Yin symptoms. Severe pain implies the formation of an Excess pathogen in Tai Yin; thus, Rhubarb (Dahuang, 大黄) is still used to guide the pathogen out, allowing it to exit via Tai Yin. One should not prohibit purgation simply because it was previously misused; treatment must be adapted to the specific manifestations.
According to *Huo Ren Shu* (Book for Saving Lives): Gui Zhi Tang (Cinnamon Twig Decoction) is effective regardless of the season when used by people in the Northwest. In the Jianghuai region, it can only be used in winter and spring. Before late spring and before the Summer Solstice, if the pattern is a Gui Zhi pattern (Gui Zhi Zheng, 桂枝症), add one fen of Scutellariae Radix (Huangqin, 黄芩), known as Yang Dan Tang (Yang Dawn Decoction). After the Summer Solstice, add half a liang of Anemarrhenae Rhizoma (Zhimu, 知母) and one liang of Gypsum Fibrosum (Shigao, 石膏), or add one fen of Cimicifugae Rhizoma (Shengma, 升麻). If the patient has a constitution prone to deficiency-cold, no modifications are necessary.