（此方自原论中第十卷采附于此）
葛根（四两） 芍药（二两） 甘草（二两炙） 生姜（三两切） 大枣（十二枚擘） 桂枝（二两去皮）
上六味。以水一斗。先煮葛根减二升。去上沫。内诸药。煮取三升。去滓。温服一升。覆取微似汗。不须 粥。余
如桂枝汤法。
琥按上方。乃桂枝汤中。加葛根一味药也。夫桂枝汤。仲景用以治太阳中风。汗出恶风之证。今者项背强。
又复KT KT 然而颈拘缩。夫KT KT 者。本为寒甚。寒甚者。当无汗。今则反汗出而恶风。此系太阳伤风证。因
多KT KT 然拘缩之状。故于桂枝汤中。加葛根为君。以祛风邪。解肌表。
太阳病。下之后。其气上冲者。可与桂枝汤方。用前法。若不上冲者。不可与之。（此条是误下。未至大坏之证。成
注云太阳属表。而反下之。则虚其里。阳邪乘虚入里。气当下陷。今者虽下而不至大坏。里气未虚。仍然上冲。是犹之
前条桂枝汤证。风壅气逆。欲作干呕之状也。故云可与桂枝汤方。用前法。若不上冲者。里气虚馁。阳邪入里。不复在
表。故云不可与桂枝汤方也。按条辩及尚论篇注云。可与桂枝汤方。用前下药法。合表里而两解之。如桂枝加大黄汤之
类是也。此言于义未合。学人宜从成注为是。）
（附后例）太阳病。三日。已发汗。若吐。若下。若温针。仍不解者。此为坏病。桂枝不中与也。观其脉证。知犯
何逆。随证治之。（此条是坏病。正文与注。见后第十二卷救逆论中。仲景论于此条之下。接桂枝本为解肌云云。愚考桂
枝证有杂入太阳中篇。麻黄青龙汤内者。因采附于下。以便学人记习。要于仲景原文。不敢前后倒乱也。）
（附例）太阳病。外证未解。脉浮弱者当以汗解。宜桂枝汤（外证未解。谓头痛项强恶寒等证犹在也。脉浮弱者。
即阳浮阴弱之谓。辩证据脉。则不论日久。犹当以微汗解肌。故云宜桂枝汤也。）
太阳病下之微喘者。表未解故也。桂枝加浓朴杏人汤主之。（下后气夺于下。呼吸不续而喘者。是为虚喘。今曰微喘。
此虽因误下。里气未夺。反上逆。而与表邪交错于胸中。故与桂枝汤以解表。加浓朴杏人。以下胸中之逆气也。尚论篇
以喘为真气亏乏。复加浓朴杏人。以泄气利喘。误矣。杏人之人。与仁同。外台千金皆从人。）
太阳病。外证未解者。不可下也。下之为逆。欲解外者。宜桂枝汤主之。（外证未解者。谓表证未全解也。王宇泰云。
但有一毫头痛恶寒。即为在表。表证未解。虽有可下之证。不可下也。下之为逆。逆者。为病在外。而反攻其内。于治
法为不顺也。若下之而外证仍未解者。仍当解外。故云宜桂枝汤主之也。）
太阳病先发汗不解。而复下之。脉浮者不愈。浮为在外。而反下之。故令不愈今脉浮。故知在外。当须解外。则愈
宜桂枝汤主之。（先发汗不解而复下之。是粗工死守汗下之法。不知脉理故也。汗后脉浮者。为不愈以脉浮为邪在外。医
人反下其内故令病不愈也。今止据脉浮知邪在外。不论既汗且下。须当以桂枝汤解其外邪。则自愈。愚按上文云先发汗
当是太阳病脉浮紧无汗。先用麻黄汤以发之。紧脉去而浮脉存。汗虽出而表不解。所以不论误下。但据脉浮。当须改用
桂枝汤以解其肌也。）
病常自汗出者。此为营气和。营气和者。外不谐。以卫气不共。营气和谐故尔。以营行脉中。卫行脉外。复发其汗。
营卫和。则愈。宜桂枝汤。（此明中风病。所以卫受风邪。营反汗出之理。病常自汗出者。谓时时汗自出也。伤寒无汗为
营气伤。今既有汗。则营气无伤而得和矣。营气虽和于内。而外不与卫气相谐。以卫中有客邪之气。所以不共营气和谐
故尔。营行脉中。为卫之守。卫行脉外。为营之护。未有卫病而营不病者。故汗亦营中之液。非但卫疏而后出也。病虽
常汗。治当复发其汗。使卫中客邪之气去。斯营与卫自相和谐。则愈故云宜桂枝汤。）
病患藏无他病时发热。自汗出而不愈者。此卫气不和也。先其时发汗则愈。宜桂枝汤主之。（藏无他病者。谓里和能
食。二便如常也。时发热。自汗出者。谓有时发热。有时不甚热。有时汗出。有时汗不出也。卫气不和。即前条云。不
共营气和谐之意。故自汗时出。而久不得愈先其时者。谓及其发热自汗之时。用桂枝汤以透发其汗。则愈。苟失其时。
则风邪入里。病热必深。桂枝汤非所宜矣。）
伤寒不大便。六七日。头痛有热者。与承气汤。其小便清者。知不在里。仍在表也。当须发汗。若头痛者。必衄。
宜桂枝汤。（六七日不大便。明系在里有热。故虽头痛。必是阳明热蒸。此可与承气汤。若其人小便清者。知热不在里。
仍在表也。虽不大便六七日。当须发其汗。以解其在表之热。若头痛不已者。为风寒之邪上壅。热甚于经。势必至衄。
须乘其未衄之时。宜用桂枝汤以汗解之。或问此条。乃伤寒头痛有热。当须发汗。何以不用麻黄汤。予曰。若麻黄汤证。
当见身疼痛矣。且也。麻黄汤证。表热显然。虽不大便六七日。何至欲与承气汤。大抵桂枝证。有与承气证相似者。故
仲景云。桂枝下咽。阳盛则毙。承气入胃阴盛以亡也。二药错误。立至死亡。所以验小便实为仲景妙法。）
伤寒发汗解半日许。复烦。脉浮数者。可更发汗宜桂枝汤主之。（伤寒发汗者。谓太阳伤寒。服麻黄汤。发汗。身凉
为已解。至半日许。复烦者。身复发烦热也。脉浮数者。脉转浮数也。尚论篇云。此明系汗后表疏。邪风袭入所致。虽
仲景法。脉浮而数者。可发汗宜麻黄汤。然此条病。已曾用过麻黄汤发汗矣。故当更方以发其汗。宜桂枝汤以主之也。）
太阳病发热汗出者。此为营弱卫强。故使汗出。欲救邪风者。宜桂枝汤主之。（营弱卫强者。即前太阳中风桂枝汤说
注云。卫实而营虚之意。后条辩云。何以云弱。正气夺则虚。故云弱也。何以云强。邪气盛则实。故云强也。营中之阴
既正虚而不守。卫外之阳复邪实而失护。故使汗出而发热也。欲救卫间之邪风者。成注云。与桂枝汤。以解散风邪调和
营卫。）
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。（肌者。肤肉之间也。风邪伤卫。
卫行脉外。正当肤肉之间。方用桂枝汤以救解之。若其人脉浮而紧。发热汗不出者。此系太阳伤寒。寒伤营。乃麻黄汤
证。桂枝汤中有芍药。收敛寒邪。是药与病相反。不可与也。医者常须识认此证。勿令病家错误服之。）
若酒客病。不可与桂枝汤。得汤则呕。以酒客不喜甘故也。（成注云。酒客内热。其于无病时。热气熏蒸肤腠间。固
多汗矣。及其病风寒之邪。脉必浮缓。而汗出可知。医人不可据脉验证。执一桂枝汤与之。其得汤。必作呕而吐出。何
也。以酒客既伤于酒。又挟外邪胸中。必满而逆。若食甘则愈满。故不喜也。即一酒客病。则凡太阳中风而挟食者。桂
枝亦在所当禁可类推矣。）
喘家作桂枝汤。加浓朴杏子佳。（佳坊本作仁此云喘家者。乃太阳中风证。自汗而增喘也。喘为风甚气壅。故作桂枝
汤。必加浓朴杏人。以泄利逆气。）
凡服桂枝汤吐者。其后必吐脓血也。（桂枝之性本热。服汤之人。如系酒客之类。得之而吐者。以其人胸膈中素有湿
热。更服桂枝汤。则两热相搏。郁蒸既久。津液销败而为脓血。此为肺胃受伤。盖风寒之来。先伤肺。服汤之误。复败
胃故也。愚按此条证。仲景无治法。补亡论常器之云。可服类要芍药地黄汤。郭白云云。见脓血而后可服。）
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。（此条乃风寒之邪。始从
太阳。直中少阴其人肌表空疏。卫外之阳本虚。无热可郁。误投麻黄汤。大发其汗。成注云。亡阳脱液。系真寒之证。
正文与注并汤详见中寒论中。）
太阳病下之后。脉促胸满者。桂枝去芍药汤主之。若微恶寒者。去芍药方中。加附子汤主之。（此条太阳病。与上条
太阳病。同是真寒之证。医人不察。漫以桂枝加大黄汤。或以调胃承气汤下之后。成注云阳气已虚。故见脉促胸满。微
恶寒。此亦真寒证。正文与注并汤详见中寒论中）
太阳病得之八九日。如疟状。发热恶寒。热多寒少。其人不呕。清便欲自可。一日二三度发。脉微缓者。为欲愈也。
脉微而恶寒者。此阴阳俱虚。不可更发汗。更下。更吐也。面色反有热色者。未欲解也。以其不能得小汗出。身必痒。
宜桂枝麻黄各半汤。（太阳病。得之八九日者。盖言太阳经头项强痛。发热恶寒之证。虽日久而犹在也。但其时热多寒少。
渐渐变乱。故云如疟状也。赵嗣真云。此是首一节。为自初至今之证。下文皆拟病防变之辞。当分作三截看。其人不呕。
清便欲自可者。言风寒之邪。不传于里。里气和而不作热也。一日二三度发者。言寒热如疟之来而频数。邪气浅而欲衰。
脉亦微缓。此是向愈之证。不须治也。若其人脉气微矣。则知里热不甚。又复恶寒。此恶寒者。乃四肢及肌表间微觉怕
冷。盖病已八九日。非比初时发热恶寒之甚。则知表邪亦微。此为阴阳俱虚。表里无证。故知不可更发汗。及更吐下也。
此段论。仲景本无方治。活人释疑云。宜温之。缵论云。宜小建中汤。加黄 不在温经之例。若其人面反有热色者。乃
阳邪之气外薄。故面作赤色。虽八九日而表证尚在。未欲解也。阴寒之邪。束其阳热。以故不得小汗。营卫不和。身必
作痒。成注云。与桂枝麻黄各半汤。小发其汗以除表邪。）
（此方从原论第十卷摘录附于此）
葛根（四两） 芍药（二两） 甘草（二两，炙） 生姜（三两，切） 大枣（十二枚，掰开） 桂枝（二两，去皮）
以上六味药。用水一斗。先煮葛根，水量减少二升。去掉水面上的浮沫。加入其余药物。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。其余护理方法如同桂枝汤法。
琥按：上述方剂，是在桂枝汤中加入葛根一味药而成。桂枝汤，是张仲景用来治疗太阳中风证，表现为汗出、恶风的病证。如今患者项背部僵硬，又出现KT KT（形容拘急不舒的样子），导致颈部拘挛收缩。所谓KT KT，原本是因为寒邪严重。寒邪严重时，应当无汗。现在反而汗出且恶风。这属于太阳伤风证，因为多伴有KT KT拘挛收缩的症状，所以在桂枝汤中加入葛根作为主药，以祛除风邪，解除肌表之邪。
太阳病，经过泻下治疗后，如果气机上冲的，可以给予桂枝汤方。使用前法。如果不气上冲的，不可给予。（这一条是误用下法，但未造成严重的坏病。成无己注解说：太阳属表，却反用下法，则使里气虚弱。阳邪乘虚入里，气机应当下陷。现在虽然用了下法，但未至大坏，里气未虚，仍然气机上冲。这与前条桂枝汤证类似，是风邪壅滞、气逆，欲作干呕的状态。所以说“可与桂枝汤方”，使用前法。若不上冲，说明里气虚馁，阳邪入里，不再在表，所以说“不可与桂枝汤方”。按《条辩》及《尚论篇》注解说：“可与桂枝汤方，使用前下药法”，合表里而两解之，如桂枝加大黄汤之类。这种说法在义理上不合，学习者应以成注为准。）
（附后例）太阳病，三天，已经发汗。如果用吐法、下法、温针等治疗，仍不解的，这叫坏病。桂枝汤不再适用。观察其脉象和证候，知道犯了什么错误，随证治之。（这一条是坏病，正文与注见后第十二卷救逆论中。张仲景论述在此条之下，接着说桂枝本为解肌云云。我考证桂枝证有杂入太阳中篇、麻黄青龙汤内的，因此摘录附于下面，以便学习者记习。对于张仲景原文，不敢前后颠倒错乱。）
（附例）太阳病，外证未解，脉浮弱的，应当以汗法解表，宜用桂枝汤。（外证未解，指头痛、项强、恶寒等症状仍在。脉浮弱，即阳浮阴弱的意思。辨证据脉，则不论病程多久，仍当以微汗解肌，所以说“宜桂枝汤”。）
太阳病，经过泻下后出现轻微喘息的，是因为表证未解。用桂枝加厚朴杏子汤主治。（下法之后，气夺于下，呼吸不续而喘的，这是虚喘。现在说微喘，这是因为虽因误下，但里气未夺，反而气机上逆，与表邪交错于胸中，所以给予桂枝汤以解表，加厚朴、杏人，以降泄胸中的逆气。《尚论篇》认为喘是真气亏乏，再加浓朴杏人以泄气利喘，这是错误的。杏人的“人”字，同“仁”字，《外台秘要》《千金方》都写作“人”。）
太阳病，外证未解的，不可用下法。用下法是逆治。想要解除表证的，宜用桂枝汤主治。（外证未解，指表证未完全解除。王宇泰说：只要有一毫头痛恶寒，即为在表。表证未解，即使有可下的证候，也不可下。用下法是逆治，逆治是指病在外，却反攻其内，在治疗法则上不顺。如果下之后外证仍未解，仍当解外，所以说“宜桂枝汤主之”。）
太阳病先发汗不解，而又用下法，脉浮的，病不愈。浮脉表示邪气在外，却反用下法，所以令病不愈。现在脉浮，所以知道邪气在外，应当须解外，则愈，宜桂枝汤主治。（先发汗不解而复下之，是庸医死守汗下之法，不知脉理。汗后脉浮者，为不愈，以脉浮为邪在外，医生反而下其内，所以令病不愈。现在只据脉浮知邪在外，不论既汗且下，须当以桂枝汤解其外邪，则自愈。我按：上文云先发汗，应当是太阳病脉浮紧无汗，先用麻黄汤以发之。紧脉去而浮脉存，汗虽出而表不解，所以不论误下，但据脉浮，当须改用桂枝汤以解其肌也。）
病人经常自汗出的，这是营气和。营气和者，外不谐，因为卫气不与营气和谐。因为营行脉中，卫行脉外。再发其汗，营卫和，则愈，宜桂枝汤。（这说明中风病，所以卫受风邪，营反汗出的道理。病人经常自汗出，谓时时汗自出。伤寒无汗为营气伤，现在既有汗，则营气无伤而得和矣。营气虽和于内，而外不与卫气相谐，因为卫中有客邪之气，所以不共营气和谐故尔。营行脉中，为卫之守；卫行脉外，为营之护。未有卫病而营不病的，所以汗也是营中之液，非但卫疏而后出也。病虽常汗，治当复发其汗，使卫中客邪之气去，斯营与卫自相和谐，则愈，所以说“宜桂枝汤”。）
病患脏腑没有其它病，时而发热，自汗出而不愈的，这是卫气不和。在其发热自汗之前发汗则愈，宜桂枝汤主治。（脏腑没有其它病，指里和能食，二便如常。时发热，自汗出，谓有时发热，有时不甚热，有时汗出，有时汗不出。卫气不和，即前条云不共营气和谐之意，故自汗时出，而久不得愈。先其时者，谓及其发热自汗之时，用桂枝汤以透发其汗，则愈。如果失其时，则风邪入里，病热必深，桂枝汤就不适宜了。）
伤寒不大便六七日，头痛有热的，给予承气汤。如果小便清的，知道不在里，仍在表。应当须发汗。如果头痛的，必定衄血，宜桂枝汤。（六七日不大便，明系在里有热，所以虽头痛，必是阳明热蒸，此可与承气汤。如果其人小便清者，知道热不在里，仍在表。虽不大便六七日，当须发其汗，以解其在表之热。如果头痛不已，为风寒之邪上壅，热甚于经，势必至衄。须乘其未衄之时，宜用桂枝汤以汗解之。有人问：此条，乃伤寒头痛有热，当须发汗，何以不用麻黄汤？我说：如果是麻黄汤证，应当见身疼痛。而且，麻黄汤证，表热显然，虽不大便六七日，何至于要与承气汤。大体上桂枝证，有与承气证相似者，所以张仲景说：桂枝下咽，阳盛则毙；承气入胃，阴盛以亡。二药错误，立至死亡。所以验小便实为张仲景妙法。）
伤寒发汗解半日许，复烦，脉浮数的，可以再发汗，宜桂枝汤主治。（伤寒发汗者，谓太阳伤寒，服麻黄汤，发汗，身凉为已解。至半日许，复烦者，身复发烦热。脉浮数者，脉转浮数。《尚论篇》说：此明系汗后表疏，邪风袭入所致。虽然是张仲景法，脉浮而数者，可发汗宜麻黄汤，然而此条病，已曾用过麻黄汤发汗矣，故当更方以发其汗，宜桂枝汤以主之也。）
太阳病发热汗出的，这是营弱卫强，所以使汗出。想要救治邪风的，宜桂枝汤主治。（营弱卫强者，即前太阳中风桂枝汤说注云：卫实而营虚之意。后《条辩》说：何以云弱？正气夺则虚，故云弱也。何以云强？邪气盛则实，故云强也。营中之阴既正虚而不守，卫外之阳复邪实而失护，故使汗出而发热。想要救治卫间之邪风，成注说：与桂枝汤，以解散风邪调和营卫。）
桂枝本为解肌，如果其人脉浮紧，发热，汗不出，不可给予。常常须认识这一点，勿令错误。（肌者，肤肉之间。风邪伤卫，卫行脉外，正当肤肉之间，方用桂枝汤以救解之。如果其人脉浮而紧，发热汗不出，此系太阳伤寒，寒伤营，乃麻黄汤证。桂枝汤中有芍药，收敛寒邪，是药与病相反，不可给予。医者常须识认此证，勿令病家错误服之。）
如果是酒客病，不可给予桂枝汤，得到汤剂则会呕吐，因为酒客不喜欢甘味。（成注说：酒客内热，其在无病时，热气熏蒸肤腠间，固多汗。及其病风寒之邪，脉必浮缓，而汗出可知。医生不可据脉验证，执一桂枝汤与之。其得汤，必作呕而吐出。为什么呢？因为酒客既伤于酒，又挟外邪胸中，必满而逆，若食甘则愈满，故不喜。即一酒客病，则凡太阳中风而挟食者，桂枝亦在所当禁，可类推矣。）
素有喘疾的人患桂枝汤证，加浓朴杏子佳。（佳坊本作仁。此云喘家者，乃太阳中风证，自汗而增喘。喘为风甚气壅，故作桂枝汤，必加浓朴杏人，以泄利逆气。）
凡是服用桂枝汤呕吐的，其后必定吐脓血。（桂枝之性本热，服用汤剂之人，如系酒客之类，得之而吐者，以其人胸膈中素有湿热，更服桂枝汤，则两热相搏，郁蒸既久，津液销败而为脓血。此为肺胃受伤，盖风寒之来，先伤肺，服汤之误，复败胃。我按：此条证，张仲景无治法，《补亡论》常器之说：可服类要芍药地黄汤。郭白云说：见脓血而后可服。）
太阳病发汗，遂漏不止，其人恶风，小便难，四肢微急，难以屈伸的，桂枝加附子汤主治。（此条乃风寒之邪，始从太阳，直中少阴。其人肌表空疏，卫外之阳本虚，无热可郁，误投麻黄汤，大发其汗。成注说：亡阳脱液，系真寒之证。正文与注并汤详见中寒论中。）
太阳病下之后，脉促胸满的，桂枝去芍药汤主治。如果微恶寒的，去芍药方中，加附子汤主治。（此条太阳病，与上条太阳病，同是真寒之证。医生不察，漫以桂枝加大黄汤，或以调胃承气汤下之后。成注说：阳气已虚，故见脉促胸满，微恶寒。此亦真寒证。正文与注并汤详见中寒论中。）
太阳病得之八九日，如疟状，发热恶寒，热多寒少，其人不呕，清便欲自可，一日二三度发，脉微缓的，为欲愈。脉微而恶寒的，此阴阳俱虚，不可更发汗、更下、更吐。面色反有热色的，未欲解，因为其不能得小汗出，身必痒，宜桂枝麻黄各半汤。（太阳病，得之八九日者，盖言太阳经头项强痛，发热恶寒之证，虽日久而犹在。但其时热多寒少，渐渐变乱，故云如疟状。赵嗣真说：此是首一节，为自初至今之证，下文皆拟病防变之辞，当分作三截看。其人不呕，清便欲自可者，言风寒之邪，不传于里，里气和而不作热。一日二三度发者，言寒热如疟之来而频数，邪气浅而欲衰，脉亦微缓，此是向愈之证，不须治。若其人脉气微矣，则知里热不甚，又复恶寒，此恶寒者，乃四肢及肌表间微觉怕冷，盖病已八九日，非比初时发热恶寒之甚，则知表邪亦微。此为阴阳俱虚，表里无证，故知不可更发汗，及更吐下。此段论，张仲景本无方治，《活人释疑》说：宜温之。《缵论》说：宜小建中汤，加黄 [缺字] 不在温经之例。若其人面反有热色者，乃阳邪之气外薄，故面作赤色，虽八九日而表证尚在，未欲解。阴寒之邪，束其阳热，以故不得小汗，营卫不和，身必作痒。成注说：与桂枝麻黄各半汤，小发其汗以除表邪。）
(This prescription is excerpted from Volume 10 of the original treatise and attached here.)
Ge Gen (Radix Puerariae) (4 liang), Shao Yao (Radix Paeoniae Rubra) (2 liang), Gan Cao (Radix Glycyrrhizae Preparata with Honey) (2 liang, honey-fried), Sheng Jiang (Rhizoma Zingiberis Recens) (3 liang, sliced), Da Zao (Fructus Jujubae) (12 pieces, split open), Gui Zhi (Cacumen Cinnamomi) (2 liang, bark removed).
The above six ingredients. Use one dou of water. First decoct Ge Gen until the volume decreases by two sheng. Remove the scum floating on the surface. Add the remaining herbs. Decoct to obtain three sheng of liquid. Filter out the dregs. Take one sheng warm. Cover with blankets to induce a slight sweat. There is no need to drink hot porridge. The remaining care methods are the same as those for Guizhi Tang (Cinnamon Twig Decoction).
Hu notes: The above prescription consists of adding Ge Gen (Radix Puerariae) to Guizhi Tang (Cinnamon Twig Decoction). Guizhi Tang (Cinnamon Twig Decoction) is used by Zhang Zhongjing to treat Taiyang Wind Strike syndrome (Taiyang Wind Strike syndrome refers to a condition caused by wind pathogen attacking the Taiyang channel, characterized by sweating and aversion to wind), presenting with sweating and aversion to wind. Now, the patient presents with stiffness in the nape and back, accompanied by KT KT (describing a state of tension and discomfort), leading to neck spasms. The term KT KT originally refers to severe cold. When cold is severe, there should be no sweating. However, now there is sweating and aversion to wind. This belongs to Taiyang Wind Injury syndrome. Because it is often accompanied by KT KT spasmodic contraction, Ge Gen (Radix Puerariae) is added to Guizhi Tang (Cinnamon Twig Decoction) as the chief herb to dispel wind pathogen and relieve the muscle layer.
In Taiyang disease (Taiyang disease refers to diseases caused by pathogenic factors invading the Taiyang channel), after purgation, if there is an upward rush of Qi, Guizhi Tang (Cinnamon Twig Decoction) may be administered using the previous method. If there is no upward rush of Qi, it should not be given. (This clause refers to erroneous purgation that has not yet led to severe deterioration. Cheng Wuji's commentary states: Taiyang belongs to the exterior, but purgation was wrongly used, thus weakening the interior. Yang pathogen enters the interior due to deficiency, and Qi should sink. Although purgation was used, it did not reach a state of severe deterioration; the interior Qi is not deficient, and Qi still rushes upward. This is similar to the previous Guizhi Tang (Cinnamon Twig Decoction) syndrome, where wind pathogen stagnates and Qi rebels, resembling a desire to dry heave. Therefore, it says "may administer Guizhi Tang (Cinnamon Twig Decoction)," using the previous method. If there is no upward rush, it indicates interior Qi deficiency and weakness, and Yang pathogen has entered the interior, no longer remaining in the exterior. Therefore, it says "should not administer Guizhi Tang (Cinnamon Twig Decoction)." According to *Tiao Bian* and *Shang Lun Pian* commentaries: "May administer Guizhi Tang (Cinnamon Twig Decoction), using the previous purgative method," to resolve both exterior and interior simultaneously, such as Guizhi Jia Dahuang Tang (Cinnamon Twig Decoction plus Rhubarb Decoction). This interpretation is inconsistent with the principles; learners should follow Cheng's commentary.)
(Attached Example) In Taiyang disease (Taiyang disease refers to diseases caused by pathogenic factors invading the Taiyang channel), after three days, if sweating has already been induced, or if emesis, purgation, or warm needle therapy were used, and the condition remains unresolved, this is called a complicated disease (complicated disease refers to a disease state resulting from misdiagnosis or mistreatment). Guizhi Tang (Cinnamon Twig Decoction) is no longer applicable. Observe the pulse and symptoms, determine what error was made, and treat according to the syndrome. (This clause refers to complicated disease. The main text and commentary can be found in Volume 12, Treatise on Rescue from Reversal, later in the book. Zhang Zhongjing discusses below this clause, continuing with "Guizhi is originally for relieving the muscle layer..." I have examined that Guizhi syndrome cases are mixed into the Taiyang chapter and within Mahuang Qinglong Tang formulas. Therefore, they are excerpted and attached below for learners' convenience. Regarding Zhang Zhongjing's original text, I dare not rearrange the order.)
(Attached Example) In Taiyang disease (Taiyang disease refers to diseases caused by pathogenic factors invading the Taiyang channel), if the exterior syndrome is unresolved and the pulse is floating and weak, resolution through sweating is appropriate. Guizhi Tang (Cinnamon Twig Decoction) is suitable. (Exterior syndrome unresolved means symptoms such as headache, stiff neck, and aversion to cold persist. Floating and weak pulse refers to floating Yang and weak Yin. Based on pulse differentiation, regardless of duration, mild sweating to relieve the muscle layer is still indicated. Hence, it says "Guizhi Tang (Cinnamon Twig Decoction) is suitable.")
In Taiyang disease (Taiyang disease refers to diseases caused by pathogenic factors invading the Taiyang channel), if slight wheezing occurs after purgation, it is because the exterior syndrome is unresolved. Guizhi Jia Houpo Xingren Tang (Cinnamon Twig Decoction plus Magnolia Bark and Apricot Kernel Decoction) is the primary treatment. (After purgation, Qi is depleted downwards, causing interrupted breathing and wheezing; this is deficiency wheezing. Now it says slight wheezing. Although caused by erroneous purgation, the interior Qi is not depleted. Instead, Qi rebels upwards and intertwines with exterior pathogen in the chest. Therefore, Guizhi Tang (Cinnamon Twig Decoction) is given to resolve the exterior, and Hou Po (Cortex Magnoliae Officinalis) and Xing Ren (Semen Armeniacae Amarum) are added to direct rebellious Qi downward. *Shang Lun Pian* argues that wheezing is due to deficiency of true Qi, and adding Hou Po and Xing Ren drains Qi to relieve wheezing; this is incorrect. The character "Ren" in Xing Ren is identical to "Ren" (kernel); *Wai Tai Mi Yao* and *Qian Jin Fang* both write it as "Ren".)
In Taiyang disease (Taiyang disease refers to diseases caused by pathogenic factors invading the Taiyang channel), if the exterior syndrome is unresolved, purgation must not be used. Using purgation is contrary to treatment principles. To resolve the exterior, Guizhi Tang (Cinnamon Twig Decoction) is the primary treatment. (Exterior syndrome unresolved means the exterior syndrome is not completely resolved. Wang Yutai said: As long as there is any headache or aversion to cold, the pathogen is in the exterior. If the exterior syndrome is unresolved, even if there are indications for purgation, purgation must not be used. Using purgation is contrary treatment, meaning attacking the interior when the disease is in the exterior, which is inappropriate. If purgation is used and the exterior syndrome remains unresolved, the exterior must still be resolved. Hence, it says "Guizhi Tang (Cinnamon Twig Decoction) is the primary treatment.")
In Taiyang disease (Taiyang disease refers to diseases caused by pathogenic factors invading the Taiyang channel), if initial sweating fails to resolve the condition and purgation is subsequently used, and the pulse is floating, the illness will not heal. A floating pulse indicates the pathogen is in the exterior. Using purgation in this case causes failure to heal. Since the pulse is now floating, we know the pathogen is in the exterior. Resolution of the exterior is required for healing. Guizhi Tang (Cinnamon Twig Decoction) is the primary treatment. (Initial sweating failing to resolve followed by purgation reflects a mediocre physician rigidly adhering to sweating and purgation methods without understanding pulse pathology. After sweating, if the pulse is floating, it indicates non-resolution because the floating pulse shows the pathogen is in the exterior. The physician wrongly purged the interior, causing the illness to persist. Now, relying solely on the floating pulse to identify the pathogen in the exterior, regardless of prior sweating and purgation, Guizhi Tang (Cinnamon Twig Decoction) must be used to resolve the exterior pathogen, leading to spontaneous recovery. Note: The earlier mention of initial sweating implies Taiyang disease with floating, tight pulse and no sweating, initially treated with Mahuang Tang (Ephedra Decoction) to induce sweating. When the tight pulse disappears and only the floating pulse remains, although sweating occurred, the exterior was not resolved. Therefore, regardless of erroneous purgation, based on the floating pulse, Guizhi Tang (Cinnamon Twig Decoction) should be switched to relieve the muscle layer.)
If a patient frequently sweats spontaneously, this indicates harmonious Ying Qi (Ying Qi refers to nutritive Qi circulating within the vessels). Harmonious Ying Qi means disharmony externally, because Wei Qi (Wei Qi refers to defensive Qi circulating outside the vessels) does not coordinate with Ying Qi (Ying Qi). Ying Qi circulates within the vessels, while Wei Qi circulates outside. Inducing sweating again will harmonize Ying and Wei, leading to recovery. Guizhi Tang (Cinnamon Twig Decoction) is suitable. (This explains why in Wind Strike syndrome, Wei receives wind pathogen while Ying exhibits sweating. Frequent spontaneous sweating means sweating occurs at times. In Cold Damage, lack of sweating indicates injured Ying Qi. Now, since there is sweating, Ying Qi is uninjured and harmonious. Although Ying Qi is harmonious internally, it does not coordinate externally with Wei Qi because Wei contains alien pathogenic Qi, preventing harmony between Ying and Wei. Ying Qi circulates within the vessels, guarding Wei; Wei Qi circulates outside, protecting Ying. It is impossible for Wei to be diseased without Ying being affected. Sweat is fluid from Ying Qi, not just emerging from loose Wei. Although sweating is frequent, treatment requires inducing sweating again to eliminate alien pathogenic Qi from Wei, allowing Ying and Wei to harmonize spontaneously, leading to recovery. Hence, "Guizhi Tang (Cinnamon Twig Decoction) is suitable.")
When a patient's Zang organs have no other disease, but experiences intermittent fever and spontaneous sweating without resolution, this is disharmony of Wei Qi. Inducing sweating before the onset of fever and sweating leads to recovery. Guizhi Tang (Cinnamon Twig Decoction) is the primary treatment. (No other disease in Zang organs means the interior is harmonious, appetite is normal, and urination/defecation are regular. Intermittent fever and spontaneous sweating mean fever occurs sometimes, sometimes mildly; sweating occurs sometimes, sometimes not. Disharmony of Wei Qi refers to the previous statement about not coordinating with Ying Qi, hence spontaneous intermittent sweating persists without resolution. "Before its time" means during the episode of fever and sweating, use Guizhi Tang (Cinnamon Twig Decoction) to induce sweating for recovery. If this timing is missed, wind pathogen enters the interior, and heat deepens, making Guizhi Tang (Cinnamon Twig Decoction) unsuitable.)
In Cold Damage, if there is constipation for six to seven days, accompanied by headache and fever, Chengqi Tang (Purgative Decoction) may be given. If urine is clear, it indicates the pathogen is not in the interior but remains in the exterior. Sweating is required. If headache persists, epistaxis (nosebleed) is likely. Guizhi Tang (Cinnamon Twig Decoction) is suitable. (Constipation for six to seven days clearly indicates interior heat. Thus, despite headache, it must be Yangming heat steaming, allowing Chengqi Tang (Purgative Decoction). If urine is clear, heat is not in the interior but remains in the exterior. Even with six to seven days of constipation, sweating is required to resolve exterior heat. If headache persists, it is due to wind-cold pathogen obstructing upwards, with intense heat in the channels, inevitably leading to epistaxis. Before epistaxis occurs, Guizhi Tang (Cinnamon Twig Decoction) should be used to resolve via sweating. Question: This clause describes Cold Damage with headache and fever requiring sweating; why not Mahuang Tang (Ephedra Decoction)? Answer: If it were Mahuang Tang (Ephedra Decoction) syndrome, body pain would be present. Moreover, in Mahuang Tang (Ephedra Decoction) syndrome, exterior heat is obvious. With six to seven days of constipation, why consider Chengqi Tang (Purgative Decoction)? Generally, Guizhi syndrome cases resemble Chengqi syndrome cases. Hence Zhang Zhongjing said: "Once Guizhi enters the throat, excessive Yang leads to death; once Chengqi enters the stomach, excessive Yin leads to demise." Error in these two medicines leads immediately to death. Therefore, testing urine clarity is Zhang Zhongjing's brilliant method.)
In Cold Damage, after sweating resolves the condition, half a day later, restlessness recurs, and the pulse is floating and rapid. Another sweating induction is permissible. Guizhi Tang (Cinnamon Twig Decoction) is the primary treatment. (Cold Damage sweating refers to Taiyang Cold Damage taking Mahuang Tang (Ephedra Decoction) to induce sweating; body cooling indicates resolution. Half a day later, restlessness recurs means recurrent body heat and restlessness. Floating and rapid pulse means the pulse turns floating and rapid. *Shang Lun Pian* states: This clearly results from exterior looseness after sweating, allowing evil wind to invade. Although Zhang Zhongjing's method suggests that floating and rapid pulse allows sweating with Mahuang Tang (Ephedra Decoction), this case has already used Mahuang Tang (Ephedra Decoction) for sweating. Therefore, a different formula is needed to induce sweating again. Guizhi Tang (Cinnamon Twig Decoction) is appropriate.)
In Taiyang disease (Taiyang disease refers to diseases caused by pathogenic factors invading the Taiyang channel), if there is fever and sweating, this is weak Ying Qi and strong Wei Qi, causing sweating. To rescue from evil wind, Guizhi Tang (Cinnamon Twig Decoction) is the primary treatment. (Weak Ying Qi and strong Wei Qi refers to the previous commentary on Taiyang Wind Strike Guizhi Tang: solid Wei and deficient Ying. Later *Tiao Bian* asks: Why call it weak? Loss of healthy Qi leads to deficiency, hence "weak." Why call it strong? Excess of pathogenic Qi leads to excess, hence "strong." The Yin in Ying Qi is healthy-deficient and unguarded; the Yang defending the exterior is pathogen-excess and unprotected, causing sweating and fever. To rescue wind pathogen between Wei, Cheng's commentary says: Give Guizhi Tang (Cinnamon Twig Decoction) to dissipate wind pathogen and harmonize Ying and Wei.)
Guizhi is originally for relieving the muscle layer. If the pulse is floating and tight, with fever and no sweating, it must not be given. Always recognize this, do not make mistakes. ("Muscle layer" refers to the space between skin and flesh. Wind pathogen injures Wei, which circulates outside the vessels, precisely in the muscle layer. Only then should Guizhi Tang (Cinnamon Twig Decoction) be used to rescue and resolve. If the pulse is floating and tight, with fever and no sweating, this is Taiyang Cold Damage, where cold injures Ying, constituting Mahuang Tang (Ephedra Decoction) syndrome. Guizhi Tang (Cinnamon Twig Decoction) contains Shao Yao (Radix Paeoniae Rubra), which astringes cold pathogen. The medicine contradicts the disease and must not be given. Physicians must always recognize this syndrome to prevent patients from taking it erroneously.)
If a wine-drinker suffers from illness, Guizhi Tang (Cinnamon Twig Decoction) must not be given. Taking it causes vomiting because wine-drinkers dislike sweet flavors. (Cheng's commentary: Wine-drinkers have internal heat. Even when healthy, heat steams the skin and pores, causing much sweating. When afflicted by wind-cold, the pulse is necessarily floating and slow, and sweating is evident. Physicians must not rely solely on pulse and signs to rigidly prescribe Guizhi Tang (Cinnamon Twig Decoction). Upon taking it, vomiting will occur. Why? Because wine-drinkers, injured by alcohol and carrying external pathogen, experience fullness and rebellion in the chest. Sweet foods increase fullness, hence they dislike it. From this single case of wine-drinker illness, it can be inferred that for all Taiyang Wind Strike cases with food retention, Guizhi is also contraindicated.)
For chronic asthmatics suffering from Guizhi syndrome, adding Hou Po (Cortex Magnoliae Officinalis) and Xing Zi (Semen Armeniacae Amarum) is better. (Jia edition writes "Ren". "Chronic asthmatic" refers to Taiyang Wind Strike syndrome with spontaneous sweating and increased wheezing. Wheezing is due to severe wind and Qi stagnation. Thus, when making Guizhi Tang (Cinnamon Twig Decoction), Hou Po and Xing Ren must be added to drain and direct rebellious Qi downward.)
Anyone who vomits after taking Guizhi Tang (Cinnamon Twig Decoction) will subsequently vomit pus and blood. (Guizhi has a hot nature. If a person taking the decoction, such as a wine-drinker, vomits, it is because they have damp-heat in the chest and diaphragm. Taking Guizhi Tang (Cinnamon Twig Decoction) causes two heats to clash. Long-term stagnation consumes fluids, turning them into pus and blood. This injures Lung and Stomach. Wind-cold first injures Lung; erroneous medication damages Stomach. Note: Zhang Zhongjing provides no treatment for this clause. *Bu Wang Lun* Chang Qizi says: Ke Yi Yao Shaoyao Dihuang Tang may be taken. Guo Baiyun says: Take it only after pus and blood appear.)
In Taiyang disease (Taiyang disease refers to diseases caused by pathogenic factors invading the Taiyang channel), if sweating induces continuous leakage without stopping, with aversion to wind, difficult urination, slight stiffness in the four limbs, and difficulty bending and extending, Fuzi Jia Guizhi Tang (Aconite Added Cinnamon Twig Decoction) is the primary treatment. (This clause involves wind-cold pathogen entering directly from Taiyang to Shaoyin. The patient's exterior is loose, and defensive Yang is inherently deficient, with no heat to stagnate. Erroneous administration of Mahuang Tang (Ephedra Decoction) induces heavy sweating. Cheng's commentary: Loss of Yang and depletion of fluids constitute a true cold syndrome. Main text, commentary, and prescription are detailed in the Treatise on Middle Cold.)
In Taiyang disease (Taiyang disease refers to diseases caused by pathogenic factors invading the Taiyang channel), after purgation, if the pulse is hurried and there is chest fullness, Shaoyao Qu Guizhi Tang (Cinnamon Twig Decoction without Peony) is the primary treatment. If there is slight aversion to cold, add Fuzi (Radix Aconiti Lateralis Preparata) to the Shaoyao Qu Guizhi Tang (Cinnamon Twig Decoction without Peony). (This Taiyang disease clause, like the previous one, represents a true cold syndrome. Physicians failed to observe and incorrectly used Guizhi Jia Dahuang Tang (Cinnamon Twig Decoction plus Rhubarb Decoction) or Tiaowei Chengqi Tang (Regulating the Stomach Purgative Decoction) for purgation. Cheng's commentary: Yang Qi is already deficient, hence hurried pulse, chest fullness, and slight aversion to cold. This is also a true cold syndrome. Main text, commentary, and prescription are detailed in the Treatise on Middle Cold.)
In Taiyang disease (Taiyang disease refers to diseases caused by pathogenic factors invading the Taiyang channel), after eight or nine days, resembling malaria, with fever and aversion to cold, more heat than cold, no vomiting, normal bowel movements, occurring two or three times a day, and a slightly slow pulse, indicates impending recovery. If the pulse is faint and there is aversion to cold, this indicates deficiency of both Yin and Yang; further sweating, purgation, or emesis must not be used. If the face appears flushed, recovery is not yet desired, because small sweating cannot be achieved, and the body will itch. Guizhi Mahuang Ban Tang (Half-Guizhi Half-Mahuang Decoction) is suitable. (Taiyang disease lasting eight or nine days implies that Taiyang channel symptoms of stiff neck, headache, fever, and aversion to cold persist despite the duration. However, with more heat than cold and gradual disorder, it resembles malaria. Zhao Sizhen said: This first section describes symptoms from beginning to now; the following text anticipates changes. It should be read in three parts. No vomiting and normal bowel movements indicate wind-cold pathogen has not transmitted to the interior; interior Qi is harmonious without generating heat. Occurring two or three times a day indicates frequent paroxysms like malaria, shallow pathogen wanting to decline, and slightly slow pulse, indicating recovery without need for treatment. If the pulse is faint and there is aversion to cold, interior heat is not severe. This aversion to cold is slight fear of cold in limbs and muscle layer. Having lasted eight or nine days, unlike initial severe fever and aversion to cold, exterior pathogen is also mild. This is deficiency of both Yin and Yang, with no exterior or interior syndromes, so further sweating, emesis, or purgation must not be used. In this discussion, Zhang Zhongjing provided no prescription. *Huo Ren Shi Yi* suggests warming. *Zuan Lun* suggests Xiao Jianzhong Tang (Minor Construct the Middle Decoction) plus Huang [missing character], which is not in the category of warming meridians. If the face appears flushed, it is due to Yang pathogen pressing outward, causing redness. Despite eight or nine days, exterior syndrome persists, so recovery is not yet desired. Yin-cold pathogen binds Yang-heat, preventing small sweating. Ying and Wei are disharmonious, causing body itching. Cheng's commentary: Give Guizhi Mahuang Ban Tang (Half-Guizhi Half-Mahuang Decoction) to induce slight sweating to remove exterior pathogen.)