桂枝一两十六铢 芍药一两 生姜一两 甘草（炙）一两 麻黄（去节）一两 大枣
（擘）四枚 杏仁（去皮、尖）二十四枚
右七味，以水五升，先煮麻黄一二沸，去上沫，内诸药，煮取一升八合，去滓，温服
六合。
@@@
脉浮而迟，面热赤而战惕者，六七日当汗出而解，反发热者差迟，迟为无阳，不能作
汗，其身必痒也。
【注】
此承上条，发明面赤身痒之义也。表阳气虚，故脉浮迟，邪气怫郁，故面热赤，正虚
邪盛相争，故战惕也。至六、七日，则邪当衰，应汗出而解，若反发热，是邪未衰，
故差迟也。迟者，正不胜邪也，阳微怫郁，其身必痒，以无阳气，不能宣发作汗故也
。
【集注】
程知曰：此言阳虚不能作汗之脉也。浮则邪在肌表，迟则阳虚，气怫郁而不得越，则
面热赤。正与邪争而不得出，则身战惕。至六、七日传经尽，当汗解之时，乃不得汗
，反发热者，其差必迟。盖阳虚不能领汗外出，其热邪浮于肌肤，必作身痒也。
@@@
太阳病，发热恶寒，热多寒少，脉微弱者，此无阳也，不可发汗，宜桂枝二越婢一汤
。
【注】
太阳病发热恶寒，热多寒少，此为荣卫兼病，风邪多而寒邪少也。若脉浮紧，或脉浮
数，是表有阳邪郁蒸，则为无汗热多之实邪，以大青龙汤汗之可也。今脉阳微阴弱，
乃为虚邪之诊，即有无汗热多之实邪，亦不可用大青龙汤更汗也。盖以脉微弱，是无
太阳表脉也，故不可更大汗也。然既有无汗，热多、寒少之表证，麻黄、桂枝、石膏
之药，终不可无，故只宜桂枝二越婢一汤之轻剂，令微微似汗，以解肌表而和荣卫也
。
【集注】
喻昌曰：此亦风多寒少之证。「无阳」二字，仲景言之不一，无阳乃无表、无津液之
通称也，故以不可更汗为戒。然非汗则风寒终不能解，惟取桂枝之二以治风，越婢之
一以治寒，乃为合法耳。
汪琥曰：「不可更汗」四字，当是不可更大发汗意，因其人脉微弱无阳也。此方比上
小发汗之方更轻。
吴人驹曰：微乃微甚之微，非微细之微，但不过强耳。既曰热多，脉安得微。无阳者
，谓表之阳邪微，故不可更大汗。热多者，谓肌之热邪甚，故佐以石膏。越婢者，发
越之力如婢子之职，狭小其制，不似大青龙之张大也。
桂枝一两十六铢，芍药一两，生姜一两，甘草（炙）一两，麻黄（去节）一两，大枣（擘开）四枚，杏仁（去皮、尖）二十四枚。
以上七味药，用水五升，先煮麻黄一两次沸腾，去掉水面上的浮沫，加入其余药物，煎取药液一升八合，滤去药渣，温服六合。
@@@
脉象浮而迟，面部发热发红且身体颤抖畏惧的，经过六七天应当出汗而病解，如果反而发热，则病愈的时间会推迟，这是因为阳气不足，不能发汗，身体必定会出现瘙痒。
【注】
此条承接上一条，阐发面赤身痒的含义。表部阳气虚弱，所以脉象浮迟；邪气郁结，所以面部发热发红；正气虚弱与邪气强盛相互抗争，所以出现身体颤抖畏惧。到了六、七天，邪气应当衰退，应该通过出汗而解除病邪，如果反而发热，说明邪气没有衰退，所以病愈迟缓。所谓“迟”，是正气不胜邪气，阳气微弱且郁结，身体必定瘙痒，因为缺乏阳气，不能宣发促使出汗的缘故。
【集注】
程知说：这是论述阳虚不能发汗的脉象。脉浮说明邪气在肌表，脉迟说明阳虚，气机郁结而不能发散，所以面部发热发红。正气与邪气相争但不能外出，所以身体颤抖畏惧。到了六、七天传经结束，是应当通过出汗解除病邪的时候，却不得出汗，反而发热，那么病愈必然迟缓。大概是因为阳虚不能引领汗液外出，热邪浮越于肌肤，必定导致身体瘙痒。
@@@
太阳病（太阳经受邪所致的病证），发热恶寒（怕冷），热多寒少，脉象微弱的，这是无阳（指表阳不足或津液亏损），不可使用发汗法，适宜用桂枝二越婢一汤。
【注】
太阳病表现为发热恶寒，热多寒少，这是营卫（营气和卫气）兼有病变，风邪多而寒邪少。如果脉象浮紧，或脉象浮数，这是表部有阳邪郁蒸，属于无汗热多的实邪，可以用大青龙汤发汗治疗。现在脉象寸部微弱尺部弱，这是虚邪的诊断，即使有无汗热多的实邪表现，也不可用大青龙汤再次发汗。因为脉象微弱，不是太阳病的典型表脉，所以不可再用大汗法。然而既然有无汗、热多、寒少的表证，麻黄、桂枝、石膏这些药物终究不可不用，所以只适宜用桂枝二越婢一汤这种轻剂，使身体微微似有汗出，以解除肌表邪气并调和营卫。
【集注】
喻昌说：这也是风多寒少的证候。“无阳”二字，张仲景多次提及，无阳是泛指无表证、无津液的通称，所以告诫不可再发汗。然而如果不发汗，风寒终究不能解除，只有取桂枝汤二分来治风，越婢汤一分来治寒，才是合法的治疗。
汪琥说：“不可更汗”四字，意思是不可以再大发汗，因为其人脉象微弱、无阳。此方比上一条的小发汗方剂更轻。
吴人驹说：这里的“微”是指轻微，不是微细的“微”，只是不过强罢了。既然说是热多，脉怎么可能是微？所谓无阳，是指体表的阳邪轻微，所以不可再大发汗。所谓热多，是指肌肉中的热邪严重，所以佐以石膏。越婢的意思是发越邪气的力量如同婢女之职，缩小其规模，不像大青龙汤那样张扬盛大。
Cinnamon Twig (Guizhi) 1 liang 16 zhu, White Peony Root (Shaoyao) 1 liang, Fresh Ginger (Shengjiang) 1 liang, Licorice Root (Zhi Gancao, roasted) 1 liang, Ephedra Stem (Mahuang, nodes removed) 1 liang, Jujube Fruit (Dazao, split open) 4 pieces, Apricot Seed (Xingren, skin and tip removed) 24 pieces.
The above seven ingredients are decocted with five sheng of water. First, boil Mahuang for one or two boils, remove the foam on the surface, then add the remaining herbs. Decoct until one sheng eight he remains. Strain the dregs, and take six he warm.
@@@
When the pulse is floating and slow, the face is hot and red, and there is trembling and fear, after six or seven days, sweating should occur leading to resolution. If fever persists instead, recovery will be delayed. This delay indicates a lack of Yang Qi, which prevents sweating, resulting in inevitable itching of the body.
[Annotation]
This passage follows the previous one to elucidate the meaning of facial redness and body itching. Deficiency of Yang Qi at the exterior causes the floating and slow pulse. Stagnation of pathogenic factors causes the hot and red face. The struggle between deficient healthy Qi and strong pathogenic factors leads to trembling and fear. By the sixth or seventh day, pathogens should weaken, and sweating should resolve the condition. If fever persists, it indicates that pathogens have not weakened, hence the delay in recovery. "Delay" means healthy Qi cannot overcome pathogens. With weak and stagnant Yang Qi, the body must itch because the lack of Yang Qi prevents its dissemination to induce sweating.
[Collected Notes]
Cheng Zhi states: This discusses the pulse associated with Yang deficiency preventing sweating. Floating indicates pathogens in the muscle layer; slow indicates Yang deficiency. Qi stagnates and cannot vent, causing the face to become hot and red. When healthy Qi struggles with pathogens but cannot exit, the body trembles. By the sixth or seventh day, when the transmission of meridians is complete and sweating should resolve the disease, if sweating does not occur and fever persists, recovery will inevitably be delayed. Generally, Yang deficiency cannot guide sweat outwards; heat pathogens float on the skin and muscles, inevitably causing body itching.
@@@
In Taiyang Disease (diseases caused by pathogenic invasion of the Taiyang meridian), characterized by fever and aversion to cold, with more heat than cold, and a faint pulse, this indicates a lack of Yang (referring to deficiency of exterior Yang or fluids). Sweating methods are contraindicated; Guizhi Er Yuebi Yi Tang (Two Parts Cinnamon Twig Decoction and One Part Yuebi Decoction) is appropriate.
[Annotation]
Taiyang Disease presenting with fever and aversion to cold, where heat exceeds cold, indicates concurrent disorders of Ying (Nutritive Qi) and Wei (Defensive Qi), with abundant Wind pathogen and scant Cold pathogen. If the pulse were floating-tight or floating-rapid, it would indicate Yang pathogens steaming at the exterior, constituting an excess pattern of no-sweat and high heat, treatable with Da Qing Long Tang (Major Blue Green Dragon Decoction) to induce sweating. However, a pulse that is faint in the Cun position and weak in the Chi position indicates a deficiency pattern. Even if symptoms of no-sweat and high heat exist, Da Qing Long Tang should not be used to induce further sweating. A faint pulse is not the typical exterior pulse of Taiyang, thus heavy sweating is contraindicated. Nevertheless, given the exterior signs of no-sweat, high heat, and low cold, herbs such as Mahuang, Guizhi, and Shigao (Gypsum Fibrosum) are necessary. Therefore, only the mild formula Guizhi Er Yuebi Yi Tang is suitable, inducing slight perspiration to relieve the muscle layer and harmonize Ying and Wei.
[Collected Notes]
Yu Chang states: This is also a pattern of abundant Wind and scant Cold. Zhang Zhongjing frequently uses the term "lack of Yang," which generally refers to the absence of exterior manifestation or fluids, hence the warning against further sweating. However, without sweating, Wind-Cold cannot be resolved. Taking two parts of Guizhi Tang to treat Wind and one part of Yuebi Tang to treat Cold is the correct approach.
Wang Hu states: "Do not induce further sweating" implies avoiding vigorous diaphoresis due to the patient's faint pulse and lack of Yang. This formula is milder than the previous mild diaphoretic formula.
Wu Renju states: The "faint" here refers to mildness, not fine/thin. It simply means not excessive. If heat is abundant, how can the pulse be faint? "Lack of Yang" means the exterior Yang pathogen is mild, so vigorous sweating is contraindicated. "Abundant heat" means heat pathogens in the muscles are severe, hence Gypsum is added. "Yuebi" refers to the power of venting pathogens being like the duty of a maid—small in scale, not as expansive as Da Qing Long Tang.