【纲】仲景曰。太阳病。发热汗出。恶风脉缓者。名为中风。太阳病。头痛发热。汗出恶风者。桂
枝汤主之。太阳中风。阳浮而阴弱。阳浮者热自发。阴弱者汗自出。啬啬恶寒。淅淅恶风。翕翕发
热。鼻鸣干呕者。桂枝汤主之。
【目】刘完素曰。恶寒有属阳。有属阴。恶风则悉属阳。三阴症并无恶风者。以此也。恶风虽
悉在表。而发散又不同。无汗恶风为伤寒。当发汗。汗出恶风为中风。当解肌。里症虽具。恶风未
罢。当先解外。
赵献可曰。恶风者。卫中四时之虚风。所以恶风也。其人当汗出而脉缓也。数与桂枝汤。桂枝
加葛根汤。使遍体微润连日。当自解矣。
王履曰。卫气者。所以温肌肉。充皮肤。肥腠理。司开阖者也。故风邪中于卫也。则必恶风。
恶寒恶风。俱为表症。但恶风比恶寒为轻耳。恶寒者。虽不当风而时自怯寒。恶风者。居密室帏
中。则无所畏。或当风。或挥扇。则淅淅然而恶也。
柯琴曰。风为阳邪。风中太阳。两阳相搏而阴气衰少。阳浮故热自发。阴弱故汗自出。中风恶
风。类相感也。风性散漫。脉应其象。故浮而缓。若太阳初受病。便见如此脉症。即可定其为中风
而非伤寒矣。二条。是桂枝汤本症。合此症即用此汤。不必问为伤寒中风杂病也。四症中。头痛是
太阳本症。头痛发热恶风。与麻黄症同。本方重在汗出。汗不出者。便非桂枝症。三条。乃太阳中
风之桂枝症。非谓凡中风者盒饭主桂枝也。（明了。）二条脉症。是概风寒杂病而言。三条加中风二字。
其脉其症。悉呈风象矣。
【纲】仲景曰。太阳病。发汗。遂漏不止。其人恶风。小便难。四肢微急。难以屈伸者。桂枝
加附子汤主之。
【目】朱肱曰。此症当温其经。故桂枝加附子也。
刘完素曰。汗多亡阳。则卫不固。是以恶风也。桂枝加附子。温其经而固其卫也。
陶华曰。恶风者。风邪伤卫。腠理不密。由是恶风悉属于阳。非比恶寒。乃有阴阳之别者。
鳌按。此四症并见。却以汗不止小便难为重。以二者由于心肾。故专治之。而恶风四肢急俱痊
也。盖太阳虽当汗。汗不止则亡阳。风乘虚入。故又恶风。汗多必津竭。故小便难。四肢者。诸阳
之本。阳亡则不能荣筋。故筋急而屈伸不利也。
【纲】仲景曰。风湿相搏。骨节烦疼。掣痛。不得屈伸。近之则痛剧。汗出短气。小便不利。
恶风。不欲去衣。或身微肿者。甘草
附子汤主之。
【目】刘完素曰。湿胜自汗。而皮腠不密。是以恶风也。甘草附子汤。所以散其湿而实其卫。
柯琴曰。身肿痛剧。不得屈伸。湿感于外也。恶风不欲去衣。风淫于外也。汗出短气。小便不
利。化源不清也。君桂枝以理上焦而散风邪。佐术、附、甘以除湿而调气。
鳌按。此风湿为病。而湿尤中于周身营卫之间。不能推布其患。为尤重者。故小便不利身肿二
句。最宜着眼。
【纲】张仲景说：太阳病，出现发热、出汗、怕风、脉象缓弱的症状，称为中风。太阳病，出现头痛、发热、出汗、怕风的症状，用桂枝汤主治。太阳中风证，脉象阳部浮而阴部弱，阳浮表示热气自然外发，阴弱表示汗液自然流出，伴有畏寒战栗、怕风吹、发热如羽毛覆盖般温和、鼻鸣、干呕等症状，用桂枝汤主治。
【目】刘完素说：恶寒有属于阳证的，也有属于阴证的；但恶风则全部属于阳证。这是因为三阴病都没有恶风的症状，所以如此。恶风虽然都在表证阶段，但发散治疗的方法又有所不同。无汗且怕风的是伤寒，应当发汗；出汗且怕风的是中风，应当解肌。即使里证已经具备，只要恶风未除，就应当先解除表邪。
赵献可说：恶风，是因为卫气中受到四季虚风的侵袭，所以才恶风。这类病人应当出汗且脉象缓弱。多次给予桂枝汤或桂枝加葛根汤，使全身微微湿润持续数日，病自然会痊愈。
王履说：卫气的作用是温养肌肉、充实皮肤、肥厚腠理、主管毛孔的开合。因此，风邪侵入卫分，必然导致恶风。恶寒和恶风都属于表证，但恶风比恶寒轻一些。恶寒的人，即使不在风口也会时常感到怯冷；恶风的人，居住在密闭的帷帐之中就没有畏惧，但如果对着风或者扇扇子，就会感到瑟瑟发抖而厌恶。
柯琴说：风是阳邪，风邪侵犯太阳经，两阳相搏导致阴气衰少，阳气浮越所以热气自发，阴气虚弱所以汗液自出。中风恶风，性质相互感应。风性散漫，脉象也应其形象，所以脉浮而缓。如果太阳病初起就见到这样的脉症，就可以确定其为中风而非伤寒了。第二条所述，是桂枝汤的本证，符合此症就用此汤，不必问是伤寒、中风还是杂病。四条症状中，头痛是太阳病的本证，头痛、发热、恶风与麻黄汤证相同，本方重在出汗，不出汗的就不是桂枝汤证。第三条所述，乃是太阳中风证的桂枝汤证，并非说凡是中风的人都必须主用桂枝汤。（意思明了。）第二条的脉症，是概括风寒杂病而言；第三条加上“中风”二字，其脉其症，完全呈现风邪的特征了。
【纲】张仲景说：太阳病，经过发汗治疗后，汗漏不止，病人怕风，小便困难，四肢轻微拘急，难以屈伸，用桂枝加附子汤主治。
刘完素说：汗多导致亡阳，卫气不固，所以恶风。桂枝加附子汤，能温通经脉并巩固卫气。
陶华说：恶风，是风邪损伤卫气，腠理不致密，因此恶风全属于阳证，不像恶寒那样有阴阳的区别。
沈金鳌按：这四个症状并见，却以汗漏不止和小便困难为重，因为这两者源于心和肾，所以专门治疗它们，而恶风和四肢拘急也随之痊愈。大概太阳病虽然应当发汗，但汗出不止则会导致亡阳，风邪乘虚而入，所以又出现恶风。汗多必然津液枯竭，所以小便困难。四肢是诸阳之本，阳气亡失则不能濡养筋脉，所以筋脉拘急而屈伸不利。
【纲】张仲景说：风湿相搏，骨节烦痛，牵引作痛，不能屈伸，触碰则疼痛剧烈，出汗、短气、小便不利、怕风、不想脱衣，或者身体轻微浮肿，用甘草附子汤主治。
【目】刘完素说：湿胜导致自汗，皮腠不致密，所以恶风。甘草附子汤，是用来驱散湿气并充实卫气的。
柯琴说：身体肿痛剧烈，不能屈伸，是湿气感于外部；恶风不想脱衣，是风邪淫溢于外部；出汗、短气、小便不利，是化源不清。以桂枝为君药来调理上焦并疏散风邪，佐以白术、附子、甘草来除湿并调气。
沈金鳌按：这是风湿致病，而湿气尤其阻滞在周身营卫之间，不能推布其患，情况尤为严重。所以“小便不利”和“身肿”两句，最值得关注。
[Outline] Zhang Zhongjing said: In Taiyang disease (Disease of the Taiyang/Bladder Channel), characterized by fever, sweating, aversion to wind, and a slow pulse, it is named Wind Strike (Zhongfeng). In Taiyang disease, characterized by headache, fever, sweating, and aversion to wind, Guizhi Tang (Cinnamon Twig Decoction) is the primary treatment. In Taiyang Wind Strike, the pulse is floating on the superficial level (Yang) and weak on the deeper level (Yin). Floating Yang indicates spontaneous heat emission; weak Yin indicates spontaneous sweating. The patient experiences shivering aversion to cold, chilly aversion to wind, mild fever resembling a feather covering, nasal congestion with roaring sounds, and dry retching. Guizhi Tang (Cinnamon Twig Decoction) is the primary treatment.
[Commentary] Liu Wansu said: Aversion to cold can belong to Yang syndromes or Yin syndromes. However, aversion to wind belongs entirely to Yang syndromes. This is because there are no cases of aversion to wind in the Three Yin diseases. Although aversion to wind always occurs in exterior syndromes, the method of dispersal differs. Aversion to wind without sweating is Cold Damage (Shanghan) and requires diaphoresis (sweating therapy); aversion to wind with sweating is Wind Strike and requires muscle-relieving therapy. Even if interior syndromes are fully present, if aversion to wind has not ceased, the exterior must be resolved first.
Zhao Xianke said: Aversion to wind results from deficiency winds of the four seasons invading the Wei Qi (Defensive Qi). Therefore, the patient sweats and has a slow pulse. Administering Guizhi Tang (Cinnamon Twig Decoction) or Guizhi Jia Gegen Tang (Cinnamon Twig and Pueraria Decoction) repeatedly, until the whole body is slightly moist for several days, will lead to spontaneous resolution.
Wang Lü said: Wei Qi (Defensive Qi) warms the muscles, fills the skin, thickens the interstices (Couli), and controls the opening and closing of pores. Therefore, when Wind Evil invades the Wei level, aversion to wind inevitably occurs. Both aversion to cold and aversion to wind are exterior syndromes, but aversion to wind is milder than aversion to cold. Those with aversion to cold feel timidly cold even when not exposed to wind. Those with aversion to wind feel no fear when residing in a closed room or curtains, but feel chilly and aversive when exposed to wind or fanned.
Ke Qin said: Wind is a Yang pathogen. When Wind Evil attacks the Taiyang channel, the two Yangs contend, causing Yin Qi to decline. Floating Yang causes spontaneous heat; weak Yin causes spontaneous sweating. Wind Strike involves aversion to wind due to mutual resonance of nature. Wind is diffuse in nature, so the pulse reflects this image as floating and slow. If these pulse and symptom patterns appear immediately upon the onset of Taiyang disease, it can be determined as Wind Strike rather than Cold Damage. The second clause describes the primary syndrome of Guizhi Tang (Cinnamon Twig Decoction); if these symptoms are present, use this decoction, regardless of whether it is Cold Damage, Wind Strike, or miscellaneous disease. Among the four symptoms, headache is the primary symptom of Taiyang. Headache, fever, and aversion to wind are similar to Mahuang Tang (Ephedra Decoction) syndrome, but this formula focuses on sweating; if there is no sweating, it is not a Guizhi Tang syndrome. The third clause refers specifically to the Guizhi Tang syndrome of Taiyang Wind Strike, not implying that all Wind Strike cases must primarily use Guizhi Tang. The meaning is clear. The pulse and symptoms in the second clause generally refer to Wind-Cold miscellaneous diseases. Adding "Wind Strike" to the third clause makes the pulse and symptoms fully present the characteristics of Wind.
[Outline] Zhang Zhongjing said: In Taiyang disease, after diaphoresis (sweating therapy), sweating continues unceasingly (leaking). The patient feels aversion to wind, has difficulty urinating, slight stiffness in the four limbs making flexion and extension difficult. Guizhi Jia Fuzi Tang (Cinnamon Twig and Aconite Decoction) is the primary treatment.
[Commentary] Zhu Gong said: This syndrome requires warming the meridians; hence, Guizhi Jia Fuzi Tang (Cinnamon Twig and Aconite Decoction) is used.
Liu Wansu said: Excessive sweating leads to loss of Yang Qi, causing Wei Qi (Defensive Qi) to fail in its securing function, resulting in aversion to wind. Guizhi Jia Fuzi Tang (Cinnamon Twig and Aconite Decoction) warms the meridians and consolidates the Wei Qi (Defensive Qi).
Tao Hua said: Aversion to wind occurs when Wind Evil injures the Wei Qi (Defensive Qi), causing the interstices (Couli) to be loose. Thus, aversion to wind belongs entirely to Yang syndromes, unlike aversion to cold which has distinctions between Yin and Yang.
Shen Jin'ao commented: These four symptoms appear together, but the emphasis is placed on unceasing sweating and difficulty urinating, as these stem from the Heart and Kidney. By treating them specifically, aversion to wind and limb stiffness also resolve. Generally, although Taiyang disease warrants diaphoresis, unceasing sweating leads to loss of Yang Qi. Wind Evil enters through the deficiency, causing aversion to wind. Excessive sweating depletes Body Fluids (Jinye), leading to difficulty urinating. The four limbs are the root of all Yang Qi. Loss of Yang Qi prevents nourishment of the sinews, causing stiffness and limited mobility.
[Outline] Zhang Zhongjing said: When Wind and Dampness contend with each other, there is severe pain in the bone joints, pulling pain, inability to flex or extend, and intensified pain upon touch. There is sweating, shortness of breath, difficulty urinating, aversion to wind, reluctance to remove clothing, or slight bodily swelling. Gancao Fuzi Tang (Licorice and Aconite Decoction) is the primary treatment.
[Commentary] Liu Wansu said: Excess Dampness causes spontaneous sweating, and the skin and interstices become loose, leading to aversion to wind. Gancao Fuzi Tang (Licorice and Aconite Decoction) disperses Dampness and solidifies the Wei Qi (Defensive Qi).
Ke Qin said: Severe bodily swelling and pain, inability to flex or extend, indicate Dampness affecting the exterior. Aversion to wind and reluctance to remove clothing indicate Wind excess at the exterior. Sweating, shortness of breath, and difficulty urinating indicate unclear source of transformation. Gui Zhi (Cinnamomi Ramulus) is used as the sovereign herb to regulate the Upper Jiao (Upper Burner) and disperse Wind Evil. Atractylodis Macrocephalae Rhizoma (Baizhu), Aconiti Lateralis Radix Praeparata (Fuzi), and Glycyrrhizae Radix et Rhizoma (Gancao) are used as assistants to dispel Dampness and harmonize Qi.
Shen Jin'ao commented: This is a disease caused by Wind and Dampness, where Dampness particularly obstructs the Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) throughout the body, failing to distribute properly, making the condition more severe. Therefore, the phrases "difficulty urinating" and "bodily swelling" deserve the most attention.