治伤寒无汗。
麻黄（四钱） 桂枝尖（二钱） 甘草（一钱） 杏仁（二钱，去皮炒） 知母（三钱）
先煮麻黄五六沸，去上沫，纳诸药煮取一茶盅。温服复被，取微似汗，不须啜粥，余如桂枝法将息。
麻黄汤原方，桂枝下有去皮二字，非去枝上之皮也。古人用桂枝，惟取梢尖嫩枝折视之，内外如一，皮
骨不分。若见有皮骨可分辨者，去之不用，故曰去皮。陈修园之侄鸣岐曾详论之。
《伤寒论》太阳篇中麻黄汤，原在桂枝汤后。而麻黄证多，桂枝证不过十中之一二，且病名伤寒，麻
黄汤为治伤寒初得之主方，故先录之。
伤寒之证，先自背受之，背者足太阳所辖之部位也。是以其证初得，周身虽皆恶寒，而背之恶寒尤甚，
周身虽皆觉疼，而背下连腿之疼痛尤甚。其脉阴阳俱紧者，诚以太阳为周身外卫之阳，陡为风寒所袭，逼其阳
气内陷，与脉相并，其脉当有力，而作起伏迭涌之势。而寒气之缩力（凡物之体热则涨，寒则缩），又将外卫
之气缩紧，逼压脉道，使不得起伏成波澜，而惟现弦直有力之象。甚或因不能起伏，而至左右弹动。
凡脉之紧者必有力。夫脉之跳动，心脏主之。而其跳动之有力，不但心主之也；诸脏腑有热皆可助脉之
跳动有力，营卫中有热亦可助脉之跳动有力。特是脉之有力者，恒若水之有浪，大有起伏之势。而紧脉虽有力，
转若无所起伏，诚以严寒束其外表，
其收缩之力能逼营卫之热内陷与脉相并，以助其有力；而其收缩之力又能遏抑脉之跳动，使无起伏。是紧脉之
真相，原于平行中见其有力也。至于紧脉或左右弹者，亦蓄极而旁溢之象也。仲师治以麻黄汤，所以解外表所
束之寒也。
方中用麻黄之性热中空者，直走太阳之经，外达皮毛，借汗解以祛外感之寒。桂枝之辛温微甘者，偕同甘
草以温肌肉、实腠理，助麻黄托寒外出。杏仁之苦降者，入胸中以降逆定喘。原方止此四味，而愚为加知母者，
诚以服此汤后，间有汗出不解者，非因汗出未透，实因余热未清也。佐以知母于发表之中，兼寓清热之意，自
无汗后不解之虞。此乃屡经试验，而确知其然，非敢于经方轻为加减也。
或问∶喘为肺脏之病，太阳经于肺无涉，而其证多兼微喘者何也？答曰∶胸中亦太阳部位，其中所积之大
气，原与周身卫气，息息相通。卫气既为寒气所束，则大气内郁，必膨胀而上逆冲肺，此喘之所由来也。又风
寒袭于皮毛，必兼入手太阴肺经，挟痰涎凝郁肺窍，此又喘之所由来也。麻黄能兼入手太阴经，散其在经之风
寒，更能直入肺中，以泻其郁满。所以能发太阳之汗者不仅麻黄，而仲景独取麻黄，为治足经之药，而手经亦
兼顾无遗，此仲景制方之妙也。
凡利小便之药，其中空者，多兼能发汗， 蓄、木通之类是也。发汗之药，其中空者，多兼能利小便，麻
黄、柴胡之类是也。太阳经病，往往兼及于膀胱，以其为太阳之腑也。麻黄汤治太阳在经之邪，而在腑者亦兼
能治之。盖在经之邪，由汗而解，而在腑之邪，亦可由小便而解。彼后世自作聪明，恒用他药以代麻黄汤者，
于此义盖未之审也。
大青龙汤，治伤寒无汗烦躁。是胸中先有内热，无所发泄，遂郁而作烦躁，故于解表药中，加石膏以清内
热。然麻黄与石膏
并用，间有不汗之时。若用此方，将知母加重数钱，其寒润之性，能入胸中化合而为汁，随麻、桂以达于外，
而烦躁自除矣。
伤寒与温病，始异而终同。为其始异也，故伤寒发表，可用温热，温病发表必须辛凉。为其终同也，故病
传阳明之后，无论寒温，皆宜治以寒凉，而大忌温热。兹编于解表类中，略取《伤寒论》太阳篇数方，少加疏
解，俾初学知伤寒初得治法，原异于温病，因益知温病初得治法，不同于伤寒。至于伤寒三阴治法，虽亦与温
病多不同，然其证甚少。若扩充言之，则凡因寒而得之霍乱、痧证，又似皆包括其中。精微浩繁，万言莫罄，
欲精其业者，取原书细观可也。
治疗伤寒无汗。
麻黄（四钱） 桂枝尖（二钱） 甘草（一钱） 杏仁（二钱，去皮炒） 知母（三钱）
先煮麻黄五六沸，去掉上面的浮沫，加入其他药物煮取一茶盅药液。温服后覆盖被子，使身体微微似有汗出，不需要喝热粥，其余调养方法参照桂枝汤法。
麻黄汤原方中，桂枝下有“去皮”二字，并非指去除枝条上的皮。古人使用桂枝，只选取梢尖嫩枝，折断查看，内外颜色质地一致，皮与骨不分。如果见到皮和骨可以分辨的，就去除不用，所以称为“去皮”。陈修园的侄子陈鸣岐曾详细论述过这一点。
《伤寒论》太阳篇中的麻黄汤，原本排在桂枝汤之后。但麻黄汤证多见，桂枝汤证不过十中一二，且病名叫做伤寒，麻黄汤是治疗伤寒初起的主要方剂，所以先收录它。
伤寒的病证，先从背部受邪，背部分属足太阳膀胱经所管辖的部位。因此其证初起时，全身虽然都恶寒，但背部的恶寒尤其严重；全身虽然都感觉疼痛，但背部连及腿部的疼痛尤其严重。脉象阴阳俱紧，确实是因为太阳经为周身外卫之阳气，突然被风寒侵袭，逼迫其阳气内陷，与脉气相并，脉应当有力，呈现起伏迭涌之势。而寒气的收缩力（凡物体受热则膨胀，受寒则收缩），又将外卫之气收缩变紧，压迫脉道，使其不能起伏形成波澜，而只呈现弦直有力的形象。甚至可能因为不能起伏，而出现左右弹动的现象。
凡是脉紧的必然有力。脉搏的跳动，由心脏主宰。但其跳动有力，不仅由心脏主宰；各脏腑有热也可以助长脉搏跳动有力，营卫中有热也可以助长脉搏跳动有力。特别是脉有力的时候，常常像水有波浪一样，大有起伏之势。而紧脉虽然有力，反而似乎没有起伏，诚因严寒束缚外表，其收缩之力能逼迫营卫之热内陷与脉相并，以助其有力；而其收缩之力又能遏制抑制脉搏的跳动，使其没有起伏。这就是紧脉的真实情况，原来是在平行中显现出其有力。至于紧脉或左右弹动的，也是蓄积至极而从旁溢出的现象。张仲景用麻黄汤治疗，是为了解除外表所束缚的寒邪。
方中使用性热中空、直达足太阳经、外达皮毛的麻黄，借发汗来祛除外感之寒。桂枝辛温微甘，协同甘草以温暖肌肉、充实腠理，帮助麻黄将寒邪托出体外。杏仁苦降，入胸中以降逆定喘。原方只有这四味药，而我加入知母，实在是因为服用此汤后，间或有汗出而病不解的情况，这不是因为汗出未透，实在是因为余热未清。在发表之中佐以知母，兼寓清热之意，自然就没有汗后病不解的担忧。这是经过多次试验，确知其然，不敢对经方轻率加减。
有人问：喘是肺脏的疾病，太阳经与肺无关，但其证多兼见微喘，为什么呢？回答说：胸部也是太阳经部位，其中积聚的大气，原本与周身卫气息息相通。卫气既然被寒气束缚，那么大气就会内郁，必然膨胀而上逆冲犯肺脏，这就是喘产生的原因。另外，风寒侵袭皮毛，必定兼入手太阴肺经，挟带痰涎凝滞郁结于肺窍，这又是喘产生的原因。麻黄能兼入手太阴经，疏散其在经的风寒，更能直入肺中，以泻除其郁满。所以能发太阳经之汗的不只是麻黄，而张仲景独取麻黄，作为治疗足经的药物，而手经也兼顾无遗，这是张仲景制方的妙处。
凡是通利小便的药物，其中空的，多兼能发汗，如蓄草、木通之类是。发汗的药物，其中空的，多兼能通利小便，如麻黄、柴胡之类是。太阳经的病，往往兼及膀胱，因为膀胱是太阳经的腑。麻黄汤治疗太阳经在经之邪，而在腑的邪气也能兼治。大概在于经之邪，通过汗而解，而在腑之邪，也可以通过小便而解。那些后世自作聪明的人，常用其他药物代替麻黄汤的，对于这一道理大概没有审察清楚。
大青龙汤，治疗伤寒无汗烦躁。这是因为胸中先有内热，无处发泄，于是郁结而产生烦躁，所以在解表药中加入石膏以清内热。然而麻黄与石膏并用，间或有不出汗的时候。如果使用此方，将知母加重数钱，其寒润之性，能进入胸中化合而为汁液，随麻黄、桂枝到达体表，而烦躁自然消除。
伤寒与温病，开始不同而最终相同。因为其开始不同，所以伤寒发表，可用温热药，温病发表必须用辛凉药。因为其最终相同，所以病传阳明之后，无论寒温，都适宜用寒凉药治疗，而最忌用温热药。本编在解表类中，略取《伤寒论》太阳篇的数个方剂，稍加疏解，使初学者知道伤寒初起的治法，原本不同于温病，从而更知道温病初起的治法，不同于伤寒。至于伤寒三阴经的治法，虽然也与温病大多不同，但其证候很少。如果扩充来说，那么凡是因寒而得的霍乱、痧证，又似乎都包括在其中。精微浩繁，万言难以说尽，想要精通此业的人，取原书细看即可。
Treating cold damage (Shanghan) with no sweating.
Ephedrae Herba (Mahuang, 麻黄) (4 qian), Cinnamon Twig (Guizhi Jians, 桂枝尖) (2 qian), Licorice Root (Gancao, 甘草) (1 qian), Apricot Seed (Xingren, 杏仁) (2 qian, peeled and stir-fried), Anemarrhenae Rhizoma (Zhimu, 知母) (3 qian).
First decoct Ephedrae Herba for five or six boils, remove the foam on the surface, then add the remaining herbs and decoct to obtain one teacup of liquid. Take warm, cover with a blanket to induce slight perspiration; there is no need to drink hot porridge. The rest of the nursing care follows the method of Guizhi Tang (Cinnamon Twig Decoction).
In the original formula of Mahuang Tang (Ephedra Decoction), the instruction "remove skin" under Guizhi does not refer to removing the bark from the twig. In ancient times, when using Guizhi, only the tender tips and branches were selected. When broken, the interior and exterior appeared uniform, with no distinction between bark and wood. If bark and wood could be distinguished, they were discarded. Hence it is called "remove skin." Chen Xiuyuan's nephew, Chen Mingqi, discussed this in detail.
In the Taiyang Chapter of Shanghan Lun (Treatise on Cold Damage), Mahuang Tang originally appeared after Guizhi Tang. However, indications for Mahuang Tang are more common than those for Guizhi Tang, which account for only one or two out of ten cases. Moreover, since the disease is named "cold damage," and Mahuang Tang is the primary formula for treating early-stage cold damage, it is recorded first here.
The pathogenesis of cold damage begins with the back receiving the pathogen. The back is the area governed by the Foot-Taiyang Bladder Channel. Therefore, at the onset, although the whole body experiences aversion to cold, the aversion to cold in the back is particularly severe; although the whole body feels painful, the pain extending from the back down to the legs is particularly severe. A pulse that is tight and forceful at both cun and chi positions occurs because the Taiyang channel represents the defensive yang of the entire body. Sudden invasion by wind-cold forces the yang qi to sink inward, merging with the vessel, making the pulse forceful and exhibiting a surging, undulating momentum. However, the contracting power of cold (whereby matter expands when heated and contracts when cooled) tightens the defensive qi externally, compressing the vessels so they cannot undulate into waves, presenting instead as wiry, straight, and forceful. In extreme cases, due to the inability to undulate, the pulse may exhibit lateral flickering.
A tight pulse is invariably forceful. The beating of the pulse is governed by the Heart. However, its forcefulness is not solely determined by the Heart; heat in any zang-fu organ can assist in making the pulse beat forcefully, as can heat within the Ying and Wei (nutritive and defensive) levels. Specifically, a forceful pulse often resembles water with waves, showing significant undulation. Although a tight pulse is forceful, it appears to lack undulation. This is because severe cold binds the exterior; its contracting power forces the heat of Ying and Wei to sink inward and merge with the vessel, enhancing its forcefulness, while simultaneously suppressing the pulsation, preventing undulation. Thus, the true nature of a tight pulse manifests as forcefulness amidst parallel tension. Lateral flickering in a tight pulse is also a sign of accumulation reaching an extreme and overflowing laterally. Zhang Zhongjing treated this with Mahuang Tang to release the cold binding the exterior.
In this formula, Mahuang, characterized by its hot nature and hollow structure, directly travels along the Taiyang channel, reaches the exterior skin and hair, and expels external cold through diaphoresis. Guizhi, being acrid, warm, and slightly sweet, works together with Gancao to warm the muscles and solidify the cou li (interstices), assisting Mahuang in pushing the cold outward. Xingren, being bitter and descending, enters the chest to direct rebellious qi downward and calm wheezing. The original formula contains only these four herbs. I added ZhiMu because, after taking this decoction, there are occasional cases where sweating fails to resolve the condition. This is not due to incomplete sweating, but rather because residual heat remains unclarified. By adding ZhiMu among the dispersing herbs, the intention of clearing heat is incorporated, eliminating the risk of unresolved symptoms after sweating. This conclusion is based on repeated clinical trials and confirmed efficacy; I dare not lightly modify classical formulas.
One might ask: Wheezing is a disease of the Lung, yet the Taiyang channel has no direct connection to the Lung, why do many cases present with mild wheezing? The answer is: The chest is also part of the Taiyang region. The great qi accumulated there communicates continuously with the defensive qi of the body. Once the defensive qi is bound by cold, the great qi becomes internally stagnant, inevitably expanding and rebelling upward to rush against the Lung, causing wheezing. Furthermore, wind-cold invading the skin and hair necessarily affects the Hand-Taiyin Lung Channel, carrying phlegm-fluids to condense and obstruct the lung orifices, which is another cause of wheezing. Mahuang can enter the Hand-Taiyin channel to disperse wind-cold within it and can also penetrate directly into the Lung to drain stagnation and fullness. Thus, Mahuang is not the only herb capable of inducing sweating in the Taiyang channel. Zhang Zhongjing uniquely selected Mahuang, primarily a drug for the Foot channels, while ensuring comprehensive coverage of the Hand channels. This demonstrates the subtlety of Zhang Zhongjing's formula construction.
Herbs that promote urination and have a hollow structure often also induce sweating, such as Plantaginis Semen (Cheqianzi, 车前子 - *Note: Text says 'Xu' likely referring to Cheqiancao/Plantago leaf or similar, but standard translation for context of hollow/diuretic often implies Plantago or similar. Given 'Xu' might be a typo for 'Cheqian' or specific local herb, I will translate generally as herbs promoting urination*) and Tongcao (Mutong, 木通). Conversely, diaphoretic herbs with a hollow structure often also promote urination, such as Mahuang and Chaihu (Bupleuri Radix, 柴胡). Diseases of the Taiyang channel often involve the Bladder, as the Bladder is the fu-organ of the Taiyang. Mahuang Tang treats pathogens in the Taiyang channel; it also addresses pathogens in the fu-organ. Pathogens in the channel are resolved through sweating, while pathogens in the fu-organ can be resolved through urination. Later generations, acting cleverly, often substitute other herbs for Mahuang Tang, failing to fully appreciate this principle.
Da Qing Long Tang (Major Blue Green Dragon Decoction) treats cold damage with no sweating and irritability. This indicates pre-existing internal heat in the chest that has no outlet, leading to stagnation and irritability. Therefore, Shi Gao (Gypsum Fibrosum, 石膏) is added to the exterior-releasing herbs to clear internal heat. However, when Mahuang and Shi Gao are used together, sweating may occasionally fail to occur. If using this formula, increasing the dose of ZhiMu by several qian allows its cold and moistening nature to enter the chest, combine into fluid, and travel outward with Mahuang and Guizhi, thereby resolving irritability.
Cold damage (Shanghan) and warm diseases (Wenbing) start differently but end similarly. Because they start differently, exterior-releasing treatment for cold damage can use warm-hot herbs, whereas for warm diseases, acrid-cool herbs must be used. Because they end similarly, once the disease transmits to the Yangming stage, regardless of whether it originated as cold or warm, cold-cool herbs should be used, and warm-hot herbs are strictly contraindicated. In this compilation, within the exterior-releasing category, I have briefly selected several formulas from the Taiyang Chapter of Shanghan Lun and provided some explanations, so that beginners understand that the treatment for early-stage cold damage differs from that of warm diseases, thereby further realizing that the treatment for early-stage warm diseases differs from that of cold damage. As for the treatment of the Three Yin stages in cold damage, although it differs significantly from warm diseases, such cases are rare. If expanded upon, conditions such as cholera and sand-stroke caused by cold seem to be included within this scope. The principles are profound and extensive, impossible to exhaust in thousands of words. Those wishing to master this field should study the original text carefully.