桂枝（三两去皮） 芍药（三两） 甘草（二两炙） 生姜（三两切） 大枣（十二枚擘）
上五味。 咀。以水七升。微火煮取三升。去滓。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 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。若汗不出者。乃服至二三剂。禁生冷。粘滑。肉面。五辛酒酪臭恶等物。（小促 。言催促煮药之人也。宋
版作少从容。此系传写之误。）
成氏明理论云。经曰。桂枝本为解肌。若其人脉浮紧。发热汗不出者。不可与也云云。盖桂枝汤本专主太阳中风。
其于腠理致密。营卫邪实。津液禁固。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。津液内耗也。虽有表邪而止。可解肌。故须
桂枝汤少和之也。桂味辛热。用之为君。桂犹圭也。宣导诸药。为之先聘。是谓辛甘发散为阳之意。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。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。是用以为使也。姜枣之味辛甘。固能发散。而此又不特专于发散。以脾主为胃行其津液。姜枣之用。专
行脾之津液而和营卫者也。麻黄汤不用姜枣者。谓专于发汗。则不待行化而津液得通矣。
琥按上成论如此明畅。则仲景立桂枝汤方。似乎一味不可。增损。宜乎后人用之。无不效矣。予每见今医执此方。
而准投于冬月太阳病一二日有汗之伤风。及服之。非徒无益。反有害者。何也。愚以太阳伤风证。未必尽人皆真正营弱
者。内台方议云。使其人禀质素壮。气血有余。壮热不止。脉却阳浮而阴盛。其外证仍自汗恶风。本方中当用赤芍药。
以泻营中之邪实也。世传仲景桂枝汤方内用白芍药者。乃补营兼实卫之剂。在病患必体虚不任风寒。其脉浮缓微弱。其
热翕翕然不甚。其汗时出。无有止时。方可竟投桂枝。否则风邪始盛于表。而用白芍药之酸以收之。大枣炙甘草之甘温
以补之。吾恐虽有桂枝之辛热。生姜之辛温。其风寒之邪。何能尽由此二味而发散邪。当日仲景设立此方。必为正气虚
而表邪微者用耳。今之治伤寒者。必欲祖而行之。其误多矣。
琥又按中风发热。甚至鼻鸣干呕者。此邪热也。邪热之气。不能杀谷。言不能胜谷气也。仲景于桂枝汤方后云。服
已。须臾。 热稀粥一升余。必其人外虽病头项强痛。发热自汗恶风寒。内则饮食如故。胸膈未尝痞满。故令其 热稀
粥。且禁其勿食肉面等物也。予每见今人病风寒。必先挟食者多。故非惟不敢 热稀粥。并不敢投桂枝汤。恐炙甘草大
枣之甘温。反作胀满故也。后学如读书不明理。见证审脉不亲切。执一桂枝汤方。以治太阳中风证。差错不少。慎之慎
之。琥又按仲景于桂枝汤方下云。温覆令微汗若一服汗出。不必尽剂。若不汗。更作服。又不汗。服至汗出。则此是发
汗药也。成氏明理论又引经云。桂枝本为解肌。若脉浮紧。发热汗不出者。不可与之。又似止汗之药。何也。愚谓太阳
伤风。乃表虚为风寒所袭。其自汗必有时而出。有时又止。出不能透。所以发热不休。仲景用桂枝汤者。以辛甘发散肌
表之风邪。使邪去则表密而汗自止。热自休。乃发中有止之义。
太阳病头痛发热汗出恶风者。桂枝汤主之。（此言太阳病同是头痛发热。只要认其证。必汗出恶风。乃为中风。方可
投桂枝汤也。）
太阳病项背强KT KT 反汗出恶风者。桂枝加葛根汤主之。（KT 音殊。KT KT 者。鸟飞羽短伸颈之貌。太阳
病项背
强矣。复KT KT 然颈不得舒。颈之经属阳明。项背与颈KT KT 然其状当无汗矣。今反汗出恶风。仲景法。太阳
病汗出恶风者。桂枝汤主之。今因其KT KT 然。故加葛根于桂枝汤中。以兼祛阳明经之风也。成氏不解此义。而云
药味与桂枝汤同。且疑其有麻黄。为误甚矣。愚按此条。当是太阳阳明中风证。上桂枝句云云。当作桂枝汤加葛根主之。
其义始明。）
桂枝（三两，去皮） 芍药（三两） 甘草（二两，炙） 生姜（三两，切） 大枣（十二枚，掰开）
以上五味药。切碎。用水七升。用微火煮取三升。去渣。温度适宜时。服用一升。服完后不久。喝热稀粥一升多。以助药力。盖被保暖约一小时左右。全身微微似有汗出的。更好。不可让汗出如水流漓。否则病必不能除。如果服一次药。汗出病愈。停服后面的药。不必喝完所有药剂。如果没有出汗。再按前面的方法服药。仍然不出汗。缩短后两次服药的间隔时间。半天左右。让三次药服完。如果病情重的。一天一夜服药。观察二十四小时。服完一剂药。病症还在的。再重新煎服。如果不出汗的。就服到二三剂。禁食生冷、粘滑、肉类、面食、五辛、酒酪、臭恶等食物。（“小促”，意思是催促煮药的人。宋版作“少从容”，这是传写之误。）
成无己《明理论》说：经书说：桂枝本来是用来解肌的。如果病人脉浮紧。发热无汗的。不可给予云云。大概桂枝汤专门主治太阳中风证。对于腠理致密。营卫邪气实盛。津液固结。寒邪胜者的。则桂枝汤不能发散。必须皮肤疏松。又自汗。风邪侵犯卫气的。才可以投用。张仲景以解肌为轻。以发汗为重。所以发汗、吐下之后。身痛不止的。是津液内耗。虽然有表邪而止。只可解肌。所以需要桂枝汤轻微调和它。桂枝味辛热。作为君药。桂通圭。宣导诸药。作为先导。这是辛甘发散为阳的意思。大概发散风邪。必须以辛味为主。所以桂枝作为君药。芍药味苦酸微寒。甘草味甘平。作为臣佐药。内经所谓风淫所胜。用辛味平之。用苦味佐之。用甘味缓之。用酸味收之。所以芍药为臣。而甘草为佐。生姜味辛温。大枣味甘温。两物为使药。内经所谓风淫于内。用甘味缓之。用辛味散之。是用它们作为使药。姜枣的味道辛甘。固然能发散。但这里不专门用于发散。因为脾主为胃行其津液。姜枣的作用。专门运行脾的津液而调和营卫。麻黄汤不用姜枣。是因为专门发汗。则不需要行化而津液自然通畅了。
琥按：上面的成氏论述如此明畅。那么张仲景设立桂枝汤方。似乎一味药也不可增减。难怪后人使用。没有不有效的。我常见当今医生拿着这个方子。而在冬季太阳病一二日有汗的伤风中准确投用。以及服用后。不仅无益。反而有害的。为什么呢？我认为太阳伤风证。未必每个人都真正是营气虚弱者。《内台方议》说：假使这个人体质素来强壮。气血有余。壮热不止。脉象却阳浮而阴盛。外证仍然自汗恶风。本方中应当用赤芍药。以泻营中的邪气实盛。世传张仲景桂枝汤方内用白芍药的。是补营兼实卫的方剂。在病人必定体虚不耐风寒。其脉浮缓微弱。其热翕翕然不甚。其汗时出。无止时。才可以完全投用桂枝。否则风邪刚开始盛于表。而用白芍药的酸味来收敛。大枣炙甘草的甘温来补益。我恐怕虽有桂枝的辛热。生姜的辛温。风寒之邪。怎么能尽由这两味药而发散呢？当日张仲景设立此方。一定是为正气虚而表邪微者用的罢了。现在治疗伤寒的人。一定要效法并实行它。错误很多了。
琥又按：中风发热。甚至鼻鸣干呕的。这是邪热。邪热之气。不能消化谷物。意思是不能胜过谷气。张仲景在桂枝汤方后说：服完后。不久。喝热稀粥一升多。必定其人外虽病头项强痛。发热自汗恶风寒。内则饮食如故。胸膈未曾痞满。所以让他喝热稀粥。并且禁止他吃肉面等物。我常见今人病风寒。大多先挟带食积。所以不仅不敢喝热稀粥。也不敢投用桂枝汤。恐怕炙甘草大枣的甘温。反而导致胀满。后学如果读书不明理。见证审脉不亲切。执着一个桂枝汤方。来治太阳中风证。差错不少。谨慎啊谨慎。琥又按：张仲景在桂枝汤方下说：盖被保暖令微汗。如果一次服药汗出。不必喝完所有药剂。如果不汗。再煎服。还不汗。服到汗出。那么这个是发汗药。成氏《明理论》又引经书说：桂枝本来是用来解肌的。如果脉浮紧。发热无汗的。不可给予。又像是止汗的药。为什么呢？我认为太阳伤风。是表虚被风寒所袭。其自汗必然有时而出。有时又止。出而不能透达。所以发热不休。张仲景用桂枝汤。是用辛甘发散肌表的风邪。使邪去则表密而汗自止。热自休。乃是发中有止的含义。
太阳病头痛发热汗出恶风的。桂枝汤主治。（这里说太阳病同样是头痛发热。只要认清其证。必定汗出恶风。才是中风。才可以投用桂枝汤。）
太阳病项背强几几反汗出恶风的。桂枝加葛根汤主治。（几几音殊。几几的样子。像鸟飞羽短伸颈的姿态。太阳病项背强了。又几几然颈不得舒展。颈的经脉属阳明。项背与颈几几然其状应当无汗了。现在反汗出恶风。张仲景的法度。太阳病汗出恶风的。桂枝汤主治。现在因其几几然。所以加葛根于桂枝汤中。以兼祛阳明经的风邪。成氏不理解这个意义。而说药味与桂枝汤相同。并且怀疑其中有麻黄。错误很严重了。我按：这一条。应当是太阳阳明中风证。上桂枝句云云。当作桂枝汤加葛根主治。这个意义才明确。）
Cinnamon Twig (San Liang, peeled) Paeonia Root (San Liang) Licorice Root (Liang, roasted) Fresh Ginger (San Liang, sliced) Jujube (Twelve pieces, split open)
The above five herbs. Crushed. Boiled in seven Sheng of water with gentle heat until three Sheng remain. Strain. Take one Sheng when the temperature is suitable. Shortly after taking it, drink more than one Sheng of hot thin porridge to assist the medicinal power. Cover with warm blankets for about one hour. It is better if there is a slight sweat all over the body. Do not let the sweat flow profusely; otherwise, the disease will certainly not be eliminated. If after one dose, sweating occurs and the disease resolves, stop subsequent doses; there is no need to finish the entire decoction. If there is no sweating, administer again according to the previous method. If still no sweating, shorten the interval between subsequent doses. Within half a day, ensure three doses are completed. If the condition is severe, administer medicine throughout the day and night, observing for twenty-four hours. If symptoms persist after finishing one Ji (dose), prepare another. If there is no sweating, continue administering up to two or three Ji. Contraindicate consumption of cold/raw foods, sticky/slippery foods, meat, wheat products, Five Spices (garlic, chives, leeks, onions, asafoetida), wine, dairy, and foul-smelling substances. ("Xiao Cu" means urging the person boiling the medicine. Song edition reads "Shao Cong Rong", which is a transcription error.)
Cheng Wuji's *Ming Lilun* states: The classics say: Cinnamon Twig is originally used to resolve the muscle layer. If the patient has a floating-tight pulse, fever, and no sweating, it should not be given... Essentially, Guizhi Tang (Cinnamon Twig Decoction) specifically treats Taiyang Wind Strike syndrome. For cases where the Cou Li (pores/interstices) are dense, Ying and Wei pathogenic factors are substantial, and Body Fluids are consolidated due to overcoming Cold Pathogen, Guizhi Tang cannot disperse. It can only be used when the skin is loose, spontaneous sweating exists, and Wind Pathogen invades the Wei Qi. Zhang Zhongjing considers resolving the muscle layer as mild and inducing sweating as heavy. Therefore, after sweating, vomiting, or purging therapies, if body pain persists, it indicates internal depletion of Body Fluids. Although there is exterior pathogen, only resolving the muscle layer is appropriate, so Guizhi Tang (Cinnamon Twig Decoction) is needed to gently harmonize. Cinnamon Twig is acrid and hot, serving as the Jun (Sovereign) herb. "Gui" corresponds to "Gui" (jade tablet), guiding other herbs as a pioneer. This embodies the principle that acrid and sweet disperse Yang. Generally, dispersing Wind Pathogen must primarily use acrid flavors, hence Cinnamon Twig is the Sovereign. Paeonia Root is bitter, sour, and slightly cold; Licorice Root is sweet and neutral, serving as Chen (Minister) and Zuo (Assistant). As stated in the *Neijing*: When Wind excess prevails, level it with acrid, assist with bitter, moderate with sweet, and astringe with sour. Thus, Paeonia is the Minister, and Licorice is the Assistant. Fresh Ginger is acrid and warm; Jujube is sweet and warm. These two serve as Shi (Envoy). As stated in the *Neijing*: When Wind invades internally, moderate with sweet and disperse with acrid. Hence, they are used as Envoys. The acrid-sweet nature of Ginger and Jujube naturally aids dispersion, but here it is not solely for dispersion. Since the Spleen governs transporting Body Fluids for the Stomach, the function of Ginger and Jujube is specifically to circulate Spleen Body Fluids and harmonize Ying and Wei. Mahuang Tang (Ephedra Decoction) does not use Ginger and Jujube because its purpose is solely to induce sweating, allowing Body Fluids to flow freely without needing specific transformation.
Hu notes: Cheng's explanation is so clear that Zhang Zhongjing's formulation of Guizhi Tang (Cinnamon Twig Decoction) seems impeccable, with no herb to add or remove. No wonder later practitioners find it effective. However, I often see contemporary physicians applying this formula accurately to Winter Taiyang disease cases presenting with sweating after one or two days of Wind Strike. Upon administration, it brings no benefit and causes harm. Why? I believe not all Taiyang Wind Strike cases involve true Ying deficiency. *Neitai Fangyi* states: If a person is constitutionally robust, with abundant Qi and Blood, persistent high fever, yet the pulse is floating on the Yang position and deep/excess on the Yin position, while external signs show spontaneous sweating and aversion to wind, Red Paeonia Root should be used in the formula to drain substantial pathogenic factors within the Ying. The widely transmitted Zhang Zhongjing Guizhi Tang (Cinnamon Twig Decoction) uses White Paeonia Root, which tonifies Ying and consolidates Wei. It is suitable for patients who are physically weak and intolerant to Wind-Cold, with a floating-slow and weak pulse, mild heat (Xi Xi Ran), continuous intermittent sweating. Only then can Guizhi Tang be fully administered. Otherwise, if Wind Pathogen is just beginning to prevail at the exterior, using the astringent sourness of White Paeonia Root and the sweet-warm nature of roasted Jujube and Licorice to tonify might hinder the acrid-hot Cinnamon Twig and acrid-warm Fresh Ginger from dispersing the Wind-Cold pathogen. Zhang Zhongjing likely established this formula for cases of deficient Righteous Qi and mild exterior pathogen. Those today who strictly follow this method make many errors.
Hu further notes: Wind Strike with fever, even accompanied by nasal congestion sounds and dry retching, indicates pathogenic heat. Pathogenic heat cannot digest grain, meaning it cannot overcome Grain Qi. Zhang Zhongjing adds after the Guizhi Tang (Cinnamon Twig Decoction) instructions: After taking the medicine, shortly thereafter, drink more than one Sheng of hot thin porridge. This applies to patients who externally have head and neck stiffness, fever, spontaneous sweating, and aversion to wind/cold, but internally eat normally, with no chest/diaphragm fullness. Hence, they are instructed to drink hot porridge and avoid meat/wheat products. I often see modern patients with Wind-Cold having concurrent food stagnation. Therefore, they dare not drink hot porridge nor take Guizhi Tang (Cinnamon Twig Decoction), fearing the sweet-warm nature of roasted Licorice and Jujube will cause bloating. Students who do not understand principles through reading, fail to carefully examine signs and pulses, and rigidly apply Guizhi Tang (Cinnamon Twig Decoction) to Taiyang Wind Strike will make many errors. Be cautious. Hu also notes: Zhang Zhongjing states under Guizhi Tang (Cinnamon Twig Decoction): Cover with warm blankets to induce slight sweating. If sweating occurs after one dose, do not finish the remaining medicine. If no sweating, administer again. If still no sweating, continue until sweating occurs. Thus, it is a sweating-inducing medicine. Cheng's *Ming Lilun* cites the classics: Cinnamon Twig resolves the muscle layer; if pulse is floating-tight, fever, no sweating, do not give it. This seems like an anti-sweating medicine. Why? I argue Taiyang Wind Strike involves exterior deficiency attacked by Wind-Cold. Spontaneous sweating comes and goes intermittently but fails to penetrate thoroughly, causing persistent fever. Zhang Zhongjing uses Guizhi Tang (Cinnamon Twig Decoction) to use acrid-sweet properties to disperse Wind Pathogen from the muscle/exterior. Once the pathogen leaves, the exterior closes, sweating stops, and fever ceases. This embodies the meaning of "dispersing within stopping."
Taiyang Disease presenting with headache, fever, sweating, and aversion to wind is treated with Guizhi Tang (Cinnamon Twig Decoction). (This indicates that although Taiyang Disease shares headache and fever, one must identify the specific pattern: only if sweating and aversion to wind are present, confirming Wind Strike, should Guizhi Tang (Cinnamon Twig Decoction) be administered.)
Taiyang Disease presenting with stiff neck and back, [Ji Ji] sensation, contrary sweating, and aversion to wind is treated with Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Kudzu Root). ([Ji Ji] sounds like 'shu'. [Ji Ji] describes the posture of a bird stretching its neck due to short wings. In Taiyang Disease, the neck and back are stiff, and the [Ji Ji] sensation prevents neck extension. The neck meridian belongs to Yangming. Typically, stiff neck/back with [Ji Ji] implies no sweating. Now, however, there is sweating and aversion to wind. According to Zhang Zhongjing's method, Taiyang Disease with sweating and aversion to wind is treated with Guizhi Tang (Cinnamon Twig Decoction). Due to the [Ji Ji] sensation, Ge Gen (Kudzu Root) is added to Guizhi Tang (Cinnamon Twig Decoction) to simultaneously dispel Wind from the Yangming meridian. Cheng Wuji misunderstood this, claiming the ingredients are identical to Guizhi Tang (Cinnamon Twig Decoction) and suspecting Ephedra was included, which is a significant error. I analyze this clause as a Taiyang-Yangming Wind Strike syndrome. The preceding sentence regarding Guizhi Tang (Cinnamon Twig Decoction) should read "Guizhi Tang plus Ge Gen (Kudzu Root) is indicated" for clarity.]