论曰∶伤寒热病，自古有之。名贤睿哲，多所防御。至于仲景，特有神功，寻思旨趣，
莫测其致。所以医人未能钻仰。尝见太医疗伤寒，惟大青知母等诸冷物投之，极与仲景本意
相反。汤药虽行，百无一效。伤其如此，遂披《伤寒大论》，鸠集要妙。以为其方行之以来，
未有不验。旧法方证，意义幽隐。乃令近智所迷览之者，造次难悟；中庸之士，绝而不思。
故使闾里之中，岁至夭枉之痛，远想令人慨然无已。今以方证同条，比类相附，须有检讨，
仓卒易知。夫寻方之大意，不过三种∶一则桂枝，二则麻黄，三则青龙。此之三方，凡疗伤
寒不出之也。其柴胡等诸方，皆是吐下发汗后不解之事，非是正对之法。术数未深，而天下
名贤，止而不学，诚可悲夫。又有仆隶卑下，冒犯风寒，天行疫疠，先被其毒。悯之酸心，
聊述兹意，为之救法。方虽是旧，弘之惟新。好古君子，嘉其博济之利。物嗤诮焉。
五十七证 方五首
论曰∶伤寒与 病湿病及热 相滥，故叙而论之。
太阳病，发热无汗，而反恶寒，是为刚 。
太阳病，发热汗出，而不恶寒，是为柔 。（一云恶寒。）
太阳病，发热，其脉沉细，是为 。
太阳病，发其汗，因致 。
病者身热足寒，颈项强，恶寒，时头热面赤，目脉赤，独头动摇，是为 。
上件 状。
太阳病而关节疼烦，其脉沉缓，为中湿。
病者一身尽疼烦，日晡即剧，此为风湿汗出所致也。
湿家之为病，一身尽疼，发热，而身色似熏黄也。
湿家之为病，其人但头汗出，而背强欲得被覆。若下之早，即嘁，或胸满，小便利，舌
上如胎。此为丹田有热，胸上有寒，渴欲饮则不能饮，而口燥也。
湿家下之，额上汗出，微喘，小便利者，死。下利不止者，亦死。
问曰∶病风湿相搏，身体疼痛，法当汗出而解。值天阴雨，溜下不止。师云此可发汗，
而其病不愈者，何故？答曰∶发其汗，汗大出者，但风气去，湿气续在，是故不愈。若治风
湿者，发其汗，微微似欲出汗者，则风湿俱去也。
病患喘，头痛鼻窒而烦，其脉大，自能饮食，腹中独和，无病。病在头中寒湿，故鼻窒。
纳药鼻中即愈。
上件湿状。
太阳中热， 是也，其人汗出恶寒，身热而渴也。
太阳中 ，身热疼重而脉微弱。此以夏月伤冷水，水行皮肤中也。
太阳中 ，发热恶寒，身重而疼痛，其脉弦细芤迟。小便已，洗然手足逆冷，小有劳热
，口前开板齿燥。若发其汗，恶寒则甚；加温针，发热益甚；数下之，淋复甚。
上件 状。
太阳之为病，头项强痛而恶寒。
太阳病，其脉浮。
太阳病，发热，汗出而恶风，其脉缓，为中风。
太阳中风，发热而恶寒。
太阳病，三四日不吐下，见芤，乃汗之。
夫病有发热而恶寒者，发于阳也；不热而恶寒者，发于阴也。发于阳者七日愈，发于阴
者六日愈。以阳数七、阴数六故也。
太阳病头痛，至七日以上自愈者，其经竟故也。若欲作再经者，针足阳明，使经不传则
愈。
太阳病，欲解时，从巳尽未。
风家表解而不了了者，十二日愈。
太阳中风，阳浮而阴濡，弱浮者热自发，濡弱者汗自出，涩涩恶寒，淅淅恶风，翕翕发
热，鼻鸣干呕者，桂枝汤主之。
太阳病，发热汗出，此为荣弱卫强，故使汗出，以救邪风，桂枝汤主之。
太阳病，头痛发热，汗出恶风，桂枝汤主之。
太阳病，项背强几几，而反汗出，恶风，桂枝汤主之。（本论云∶桂枝加葛根汤）
太阳病下之，其气上冲，可与桂枝汤；不冲，不可与之。
太阳病三日，已发汗、吐、下、温针，而不解，此为坏病，桂枝汤复不中与也。观其脉
证，知犯何逆，随证而治之。
桂枝汤本为解肌，其人脉浮紧，发热无汗，不可与也。常识此，勿令误也。
酒客不可与桂枝汤，得之则呕，酒客不喜甘故也。
喘家，作桂枝汤，加浓朴杏仁佳。
服桂枝汤吐者，其后必吐脓血。
太阳病，初服桂枝汤，而反烦不解者，当先刺风池风府，乃却与桂枝汤则愈。
太阳病，外证未解，其脉浮弱，当以汗解，宜桂枝汤。
太阳病，下之微喘者，表未解故也，宜桂枝汤。（一云麻黄汤。）
太阳病，有外证未解，不可下之，下之为逆，解外宜桂枝汤。
太阳病，先发汗，不解，而下之，其脉浮，不愈。浮为在外，而反下之。故令不愈，今
脉浮，故在外，当解其外则愈，宜桂枝汤。
病常自汗出，此为荣气和，卫气不和故也，荣行脉中，卫行脉外，复发其汗，卫和则愈，
宜桂枝汤。
病患脏无他病，时发热，自汗出而不愈，此卫气不和也，先其时发汗愈，宜桂枝汤。
伤寒，不大便六七日，头痛有热，与承气汤；其大便反青，此为不在里故在表也，当发
其汗，头痛者必衄，宜桂枝汤。
伤寒，发汗已解，半日许复烦，其脉浮数，可复发其汗，宜桂枝汤。
伤寒，医下之后，身体疼痛，清便自调，急当救表，宜桂枝汤。
太阳病未解，其脉阴阳俱停，必先振栗，汗出而解，但阳微者，先汗之而解，宜桂枝汤
太阳病未解，热结膀胱，其人如狂，其血必自下，下者即愈。其外未解，尚未可攻，当
先解其外，宜桂枝汤。
伤寒大下后，复发汗，心下痞，恶寒者，不可攻痞，当先解表，宜桂枝汤。
桂枝汤方∶
桂枝 芍药 生姜（各二两，切） 甘草（二两，炙） 大枣（十二枚，擘）
上五味， 咀，三味，以水七升，微火煮取三升，去滓。温服一升，须臾饮热粥一升余
，以助药力。温覆令汗出一时许，益善；若不汗再服如前，复不汗后服小促其间，令半日许
三服。病重者，一日一夜乃瘥，当 时观之。服一剂汤病证犹在，当复作，服之，至有不汗
出，当服三剂乃解。
太阳病，发其汗，遂漏而不止，其人恶风，小便难，四肢微急，难以屈伸，桂枝加附子
汤主之。
桂枝中加附子一枚，炮，即是。
太阳病下之，其脉促胸满者，桂枝去芍药汤主之。若微寒者，桂枝去芍药加附子汤主之
。桂枝去芍药中加附子一枚即是。
太阳病，得之八九日，如疟，发热而恶寒，热多而寒少，其人不呕，清便欲自可，一日
再三发。其脉微缓者，为欲愈；脉微而恶寒者，此为阴阳俱虚，不可复吐下发汗也，面色反
有热者，为未欲解，以其不能得汗出，身必当痒，桂枝麻黄各半汤主之。
桂枝（一两十六铢） 芍药 生姜（切） 甘草（炙） 麻黄（去节，各一两） 大枣
（四枚，
擘） 杏仁（二十四枚，去皮尖两仁者）
上七味，以水五升，先煮麻黄一二沸，去上沫，纳诸药，煮取一升八合，去滓，温服六
合。本云∶桂枝汤三合，麻黄汤三合，并为六合，顿服。
服桂枝汤，大汗出，若脉洪大，与桂枝汤，其形如疟，一日再发，汗出便解，宜桂枝二
麻黄一汤方∶
桂枝（一两十七铢） 麻黄（十六铢） 生姜（切） 芍药（各一两六铢） 甘草（一
两二铢，
炙） 大枣（五枚，擘） 杏仁（十六枚，去皮尖两仁者）
上七味，以水七升，煮麻黄一二沸，去上沫，纳诸药，煮取二升，去滓，温服一升，日
再服。本云∶桂枝汤二分，麻黄汤一分，合为二升，分二服，今人合为一方。
太阳病，发热恶寒，热多寒少，脉微弱，则无阳也。不可发汗，桂枝二越婢一汤主之，
方∶
桂枝 芍药 甘草（炙） 麻黄（去节，各十八铢） 生姜（一两三铢，切） 石膏（二
十四
铢，碎） 大枣（四枚，擘）
上七味，以水五升，先煮麻黄一二沸，去上沫，纳诸药，煮取二升，去滓，温服一升
。本云∶当裁为越婢汤、桂枝合之，饮一升。今合为一方，桂枝汤二分。
服桂枝汤下之，颈项强痛，翕翕发热，无汗，心下满，微痛，小便不利，桂枝去桂加茯
苓白术汤主之方∶
茯苓 白术（各三两）
上，于桂枝汤中惟除桂枝一味，加此二味为汤，服一升小便即利。本云∶桂枝汤今去桂
枝加茯苓白术。
【论述】：伤寒热病，自古以来便已存在。历代贤明睿智之人，对此多有防范。到了张仲景，更是展现出神奇的医术，深入探究其旨趣奥妙，其精微之处难以测度。因此，一般医生未能深入钻研仰慕。我曾见到太医治疗伤寒，只用大青、知母等寒凉药物投治，这与张仲景的本意完全相反。汤药虽然服用，但百无一效。对此我感到悲伤，于是研读《伤寒大论》，收集其中精妙的方剂。自从我用这些方子来施行治疗，没有不灵验的。旧有的法规与方证，意义幽深隐晦。这使得近于智慧的人感到迷惑，仓促之间难以领悟；中等才智的人，则断绝了思考的念头。因而使得民间之中，每年都有夭折枉死的悲痛，远想此事令人感慨不已。现在我将方剂与证候列在同一条目下，通过类比进行归纳，需要检查时，在紧急情况下容易知晓。探寻方剂的大致意思，不过三种：一是桂枝汤，二是麻黄汤，三是小青龙汤。这三张方子，凡是治疗伤寒都不超出这个范围。至于柴胡汤等其他方剂，都是在使用吐法、下法、发汗法后病情未解的情况，并非正对之法。医术数度不深，而天下的名贤，停止不再学习，确实可悲啊。又有仆役卑贱之人，冒犯风寒，遭遇天行疫疠，先被毒邪侵袭。怜悯之心酸楚，姑且陈述此意，为此制定救治方法。方子虽然是旧的，但弘扬它却是新的。喜好古学的君子，赞赏其广泛救济的利益，却遭到物议嘲笑。
五十七种证候 五个方剂
【论述】：伤寒与湿病及热病相混淆，所以叙述并加以论述。
太阳病，发热无汗，反而恶寒，这是刚痓（一种以项背强直、角弓反张为特征的疾病）。
太阳病，发热汗出，而不恶寒，这是柔痓。（另一种说法是恶寒。）
太阳病，发热，脉象沉细，这是痤（指身体强直痉挛）。
太阳病，发汗后，导致痉病。
病人身体发热足部寒冷，颈项强直，恶寒，有时头部发热面红，眼目脉络赤红，只有头部动摇，这是痓病。
上述各种痓病的症状。
太阳病且关节疼痛烦扰，脉象沉缓，属于中湿。
病人全身都疼痛烦扰，傍晚时分加重，这是由于风湿汗出所致。
患有湿病的人，全身都疼痛，发热，且身体颜色像熏黄一样。
患有湿病的人，只有头部出汗，背部强直想要盖被子覆盖。如果过早使用下法，就会呃逆，或者胸满，小便通利，舌上苔如胎状。这是因为丹田有热，胸上有寒，口渴想喝水却不能喝，且口干燥。
湿病患者被误用下法，额头出汗，轻微气喘，小便通利的，死亡。腹泻不止的，也死亡。
问曰：患风湿相搏之病，身体疼痛，按理应发汗而解。正值阴雨天气，雨水流下不止。医生说此病可发汗，但病不愈，是什么缘故？答曰：发其汗，汗出过多的，只是风气去除，湿气继续留在体内，所以不愈。如果要治疗风湿，发其汗，微微似要出汗的样子，那么风湿俱去。
病人气喘，头痛鼻塞而烦躁，脉象大，能正常饮食，腹中平和，无病。病在头中寒湿，所以鼻塞。将药物纳入鼻中即可痊愈。
上述各种湿病的症状。
太阳中热，就是暍病（中暑），其人汗出恶寒，身热而口渴。
太阳中暍，身热疼重而脉微弱。这是因为夏天损伤冷水，水气行于皮肤中。
太阳中暍，发热恶寒，身体沉重而疼痛，脉象弦细芤迟。小便后，感觉手足逆冷，稍微劳作就发热，张口呼吸板齿干燥。如果发其汗，恶寒会更严重；加用温针，发热更严重；多次使用下法，淋证会更严重。
上述各种中暍的症状。
太阳作为病，表现为头项强痛而恶寒。
太阳病，脉象浮。
太阳病，发热，汗出而恶风，脉象缓，属于中风。
太阳中风，发热而恶寒。
太阳病，三四日没有使用吐法和下法，出现芤脉，应当发汗。
凡是有发热而恶寒的病，发于阳经；不发热而恶寒的病，发于阴经。发于阳经的七日痊愈，发于阴经的六日痊愈。因为阳数七、阴数六的缘故。
太阳病头痛，到七日以上自愈的，是因为该经气尽的缘故。如果想要传入下一经，针刺足阳明经，使病经不传变则痊愈。
太阳病，想要解除的时间，从巳时到未时。
风家表证已解但精神尚不清爽者，十二日痊愈。
太阳中风，阳脉浮而阴脉濡弱，浮者热自发，濡弱者汗自出，涩涩恶寒，淅淅恶风，翕翕发热，鼻鸣干呕的，用桂枝汤主治。
太阳病，发热汗出，这是因为营弱卫强，所以使汗出，以救邪风，用桂枝汤主治。
太阳病，头痛发热，汗出恶风，用桂枝汤主治。
太阳病，项背强几几（形容拘紧不舒），反而汗出，恶风，用桂枝汤主治。（本论说：桂枝加葛根汤）
太阳病误用下法，气机上冲，可与桂枝汤；如果不冲，不可给予。
太阳病三日，已经发汗、吐、下、温针，而病不解，这叫坏病，桂枝汤也不再适用。观察其脉证，知道犯了什么逆乱，随证而治之。
桂枝汤本为解肌，如果病人脉浮紧，发热无汗，不可给予。常识这一点，不要弄错。
酒客（长期饮酒者）不可给予桂枝汤，得到后会呕吐，因为酒客不喜欢甘味。
喘家（素有喘疾者），制作桂枝汤，加厚朴、杏仁较好。
服用桂枝汤呕吐的，其后必定吐脓血。
太阳病，初服桂枝汤，反而烦闷不解的，应当先刺风池、风府穴，然后才给予桂枝汤则痊愈。
太阳病，外证未解，脉象浮弱，应当以汗法解，宜用桂枝汤。
太阳病，下法后轻微气喘的，表未解的缘故，宜用桂枝汤。（另一种说法是麻黄汤。）
太阳病，有外证未解，不可用下法，用下法是逆治，解外宜用桂枝汤。
太阳病，先发汗，病不解，而下法，脉象仍浮，病不愈。浮脉表示病在外，反而用下法。所以令病不愈，现在脉浮，说明病仍在表，应当解其表则愈，宜用桂枝汤。
病人经常自汗出，这是因为营气和，卫气不和的缘故，营行脉中，卫行脉外，再次发其汗，卫气调和则愈，宜用桂枝汤。
病人脏腑无其他病，时常发热，自汗出而不愈，这是卫气不和，在其发热之前发汗则愈，宜用桂枝汤。
伤寒，不大便六七日，头痛有热，给予承气汤；如果大便反青，这是因为不在里而在表，应当发其汗，头痛者必衄血，宜用桂枝汤。
伤寒，发汗后已解，半天左右又烦，脉象浮数，可再次发其汗，宜用桂枝汤。
伤寒，医生下之后，身体疼痛，大小便正常，急当救表，宜用桂枝汤。
太阳病未解，脉象阴阳俱停，必先振栗，汗出而解，但阳脉微者，先汗之而解，宜用桂枝汤。
太阳病未解，热结膀胱，其人如狂，其血必自下，下者即愈。其外证未解，尚未可攻，应当先解其外，宜用桂枝汤。
伤寒大下后，复发汗，心下痞，恶寒的，不可攻痞，应当先解表，宜用桂枝汤。
桂枝汤方：
桂枝、芍药、生姜（各二两，切）、甘草（二两，炙）、大枣（十二枚，擘）
以上五味药，切碎，三味药（注：原文此处可能有脱漏或特指，通常指前三味或整体，依文意理解为煎煮过程），用水七升，微火煮取三升，去渣滓。温服一升，一会儿喝热粥一升多，以助药力。温覆令汗出一小时左右，更好；如果不出汗再按前法服用，仍不出汗则缩短服药间隔，令半日内服完三剂。病重者，一日一夜才好转，当时应观察。服一剂汤药病证还在，应当再制作服用，甚至有不汗出的，应当服三剂才解。
太阳病，发其汗，遂漏出不止，其人恶风，小便难，四肢微急，难以屈伸，用桂枝加附子汤主治。
在桂枝汤中加入附子一枚，炮制，即是此方。
太阳病误用下法，脉促胸满的，用桂枝去芍药汤主治。如果微恶寒的，用桂枝去芍药加附子汤主治。在桂枝去芍药汤中加入附子一枚即是。
太阳病，得之八九日，像疟疾，发热而恶寒，热多而寒少，病人不呕，大小便基本正常，一天发作两三次。脉象微缓的，为欲愈；脉微而恶寒的，这是阴阳俱虚，不可再用吐下发汗，面色反有热的，为未欲解，因为不能得汗出，身体必定痒，用桂枝麻黄各半汤主治。
桂枝（一两十六铢）、芍药、生姜（切）、甘草（炙）、麻黄（去节，各一两）、大枣（四枚，擘）、杏仁（二十四枚，去皮尖双仁者）
以上七味药，用水五升，先煮麻黄一二沸，去掉上面泡沫，加入诸药，煮取一升八合，去渣滓，温服六合。原本说：桂枝汤三合，麻黄汤三合，合并为六合，一次性服用。
服用桂枝汤，大汗出，如果脉洪大，给予桂枝汤，其形如疟，一天发作两次，汗出便解，宜用桂枝二麻黄一汤方：
桂枝（一两十七铢）、麻黄（十六铢）、生姜（切）、芍药（各一两六铢）、甘草（一两二铢，炙）、大枣（五枚，擘）、杏仁（十六枚，去皮尖双仁者）
以上七味药，用水七升，煮麻黄一二沸，去掉上面泡沫，加入诸药，煮取二升，去渣滓，温服一升，每日两次服用。原本说：桂枝汤二分，麻黄汤一分，合为二升，分两次服用，现在人合为一方的。
太阳病，发热恶寒，热多寒少，脉微弱，则无阳也。不可发汗，用桂枝二越婢一汤主治，方：
桂枝、芍药、甘草（炙）、麻黄（去节，各十八铢）、生姜（一两三铢，切）、石膏（二十四铢，碎）、大枣（四枚，擘）
以上七味药，用水五升，先煮麻黄一二沸，去掉上面泡沫，加入诸药，煮取二升，去渣滓，温服一升。原本说：应当裁减为越婢汤、桂枝汤合之，饮一升。现在合为一方的，桂枝汤二分。
服用桂枝汤后用下法，颈项强痛，翕翕发热，无汗，心下满，微痛，小便不利，用桂枝去桂加茯苓白术汤主治方：
茯苓、白术（各三两）
以上，在桂枝汤中只除去桂枝一味，加入这两味为汤，服一升小便即利。原本说：桂枝汤现在去桂枝加茯苓白术。
[Discussion]: Cold damage and febrile diseases have existed since ancient times. Sages and wise men of the past had many preventive measures. It was Zhang Zhongjing who demonstrated miraculous medical skills; delving into his purport and interest, one cannot fathom its profundity. Therefore, physicians failed to study it deeply. I once observed that imperial physicians treated cold damage solely with cold-natured substances such as Qingdai (Indigo Naturalis) and Zhimu (Anemarrhenae Rhizoma), which is completely contrary to Zhang Zhongjing's original intent. Although decoctions were administered, there was hardly any efficacy. Grieved by this, I studied the "Treatise on Cold Damage" and collected its essential and subtle prescriptions. Since I began using these formulas in practice, none has failed to be effective. The old methods and formula-patterns had obscure meanings, confusing those of near-intelligence who found them difficult to comprehend in haste; people of average intelligence ceased to think about them. Thus, among the common people, there were yearly sorrows of premature death, which made me sigh endlessly upon reflection. Now, I align formulas with their corresponding patterns and group them by analogy, so that when inspection is needed, they can be easily understood in emergencies. In exploring the general intent of formulas, there are essentially three types: first, Guizhi Tang (Cinnamon Twig Decoction); second, Mahuang Tang (Ephedra Decoction); third, Xiao Qinglong Tang (Minor Blue Dragon Decoction). These three formulas cover all treatments for cold damage. Other formulas such as Chaihu Tang (Bupleurum Decoction) are used for cases where the disease persists after emesis, purgation, or diaphoresis, and are not the primary methods. With shallow medical knowledge, famous scholars of the world stopped learning, which is truly sad. There are also servants and lowly people who offend wind and cold, suffering from epidemic pestilences, being poisoned first. Moved with pity, I briefly state this intention and provide rescue methods. Although the formulas are old, promoting them is new. Gentlemen who love antiquity appreciate the benefit of broad relief, yet they are mocked by others.
Fifty-seven Patterns, Five Formulas
[Discussion]: Cold damage is often confused with dampness diseases and heat diseases, so I narrate and discuss them.
Taiyang disease (Disease of the Taiyang Channel), characterized by fever, absence of sweating, and aversion to cold, is called Gang Ji (Rigid Spasm).
Taiyang disease, characterized by fever, sweating, and no aversion to cold, is called Rou Ji (Soft Spasm). (Another version says aversion to cold.)
Taiyang disease, characterized by fever and a deep, fine pulse, is referred to as Cuo (Spasm).
After Taiyang disease is treated with diaphoresis, it leads to Jing Disease (Spasm).
The patient has body heat, cold feet, stiff neck and back, aversion to cold, occasional head heat and facial redness, red eye vessels, and isolated head tremor; this is Ji Disease (Spasm).
The above describe the manifestations of Ji/Cuo/Jing diseases.
In Taiyang disease with painful and vexatious joint pain and a deep, slow pulse, it is classified as Zhong Shi (Contracting Dampness).
The patient suffers from whole-body pain and vexation, worsening at dusk; this is caused by wind-dampness and sweating.
Patients with chronic dampness suffer from whole-body pain, fever, and a yellowish body color resembling smoked yellow.
Patients with chronic dampness sweat only on the head, have a stiff back, and desire to be covered. If purged prematurely, they may experience hiccups or chest fullness, free urination, and a tongue coating like a placenta. This indicates heat in the Dantian (Lower Abdomen) and cold in the chest, thirst wanting to drink but unable to do so, and dry mouth.
If a dampness patient is purged, leading to sweating on the forehead, slight asthma, and free urination, death ensues. If diarrhea persists without stopping, death also ensues.
Question: In wind-dampness mutual binding causing body pain, diaphoresis should resolve it. However, during rainy weather with continuous rain, the physician suggests diaphoresis, yet the disease does not resolve. Why? Answer: If diaphoresis causes profuse sweating, only the wind pathogen leaves while dampness remains, hence no resolution. To treat wind-dampness, induce slight sweating, appearing as if just about to sweat, so that both wind and dampness are expelled.
The patient has asthma, headache, nasal congestion, and vexation, with a large pulse, normal appetite, and a harmonious abdomen, indicating no internal disease. The pathology is cold-dampness in the head causing nasal congestion. Inserting medicine into the nose will cure it.
The above describe dampness manifestations.
Sun Heat (Zhong Re), also known as Ye (Heat Stroke), involves sweating, aversion to cold, body heat, and thirst.
Sun Heat (Zhong Shu) presents with body heat, heavy pain, and a weak pulse. This results from injuring cold water in summer, with water qi circulating in the skin.
Sun Heat (Zhong Shu) presents with fever, aversion to cold, heaviness, and pain, with a string-taut, fine, knotted, and delayed pulse. After urination, there is coldness in the hands and feet; slight exertion brings heat, and opening the mouth reveals dry teeth. Diaphoresis worsens aversion to cold; moxibustion/warming needles worsen fever; repeated purgation worsens strangury.
The above describe Sun Heat manifestations.
Taiyang disease as a whole presents with stiffness and pain in the head and neck, and aversion to cold.
Taiyang disease presents with a floating pulse.
Taiyang disease, characterized by fever, sweating, aversion to wind, and a slow pulse, is Wind Strike (Zhong Feng).
Taiyang Wind Strike presents with fever and aversion to cold.
In Taiyang disease, if three to four days pass without emesis or purgation, and a knotted pulse appears, diaphoresis should be used.
Diseases with fever and aversion to cold originate in Yang; those without fever and with aversion to cold originate in Yin. Those originating in Yang heal in seven days; those originating in Yin heal in six days, due to the numbers of Yang (seven) and Yin (six).
Headache in Taiyang disease self-resolves after seven days because the channel qi has exhausted. If transmission to another channel is impending, needle the Foot-Yangming channel to prevent transmission and ensure healing.
Taiyang disease tends to resolve between Si hour (9-11 AM) and Wei hour (1-3 PM).
For wind patients whose exterior syndrome has resolved but who feel unwell, recovery occurs in twelve days.
In Taiyang Wind Strike, if the Yang pulse is floating and the Yin pulse is soft and weak, heat arises spontaneously, sweating occurs spontaneously, there is shivering aversion to cold and wind, mild fever, nasal wheezing, and dry vomiting, Guizhi Tang (Cinnamon Twig Decoction) is indicated.
In Taiyang disease with fever and sweating, this indicates Ying (Nutritive) weakness and Wei (Defensive) strength, causing sweating to expel evil wind; Guizhi Tang (Cinnamon Twig Decoction) is indicated.
In Taiyang disease with headache, fever, sweating, and aversion to wind, Guizhi Tang (Cinnamon Twig Decoction) is indicated.
In Taiyang disease with stiffness in the nape and back, accompanied by sweating and aversion to wind, Guizhi Tang (Cinnamon Twig Decoction) is indicated. (The Treatise states: Guizhi Jia Gegen Tang [Cinnamon Twig Decoction with Pueraria]).
If Taiyang disease is treated with purgation and Qi rushes upward, Guizhi Tang (Cinnamon Twig Decoction) may be given; if there is no rushing Qi, it should not be given.
If Taiyang disease persists for three days despite diaphoresis, emesis, purgation, and warming needles, and remains unresolved, it is termed a Ruined Disease (Huai Bing); Guizhi Tang (Cinnamon Twig Decoction) is no longer applicable. Observe the pulse and patterns, identify the deviation, and treat according to the pattern.
Guizhi Tang (Cinnamon Twig Decoction) is originally for releasing the muscle layer; if the pulse is floating and tight with fever and no sweating, it must not be given. Keep this in mind to avoid error.
Wine drinkers (Jiu Ke) should not receive Guizhi Tang (Cinnamon Twig Decoction); doing so causes vomiting because wine drinkers dislike sweet flavors.
For patients with chronic asthma, adding Houpo (Magnolia Bark) and Xingren (Apricot Seed) to Guizhi Tang (Cinnamon Twig Decoction) is beneficial.
Those who vomit after taking Guizhi Tang (Cinnamon Twig Decoction) will likely vomit pus and blood later.
In Taiyang disease, if initial administration of Guizhi Tang (Cinnamon Twig Decoction) causes increased vexation without resolution, first needle Fengchi (GB20) and Fengfu (GV16), then administer Guizhi Tang (Cinnamon Twig Decoction) for cure.
If Taiyang disease exterior patterns remain unresolved and the pulse is floating and weak, diaphoresis is appropriate; Guizhi Tang (Cinnamon Twig Decoction) is indicated.
If Taiyang disease is purged resulting in slight asthma, the exterior remains unresolved; Guizhi Tang (Cinnamon Twig Decoction) is indicated. (Another version says Mahuang Tang [Ephedra Decoction]).
If Taiyang disease has unresolved exterior patterns, purgation is contraindicated as it is a reverse treatment; to resolve the exterior, Guizhi Tang (Cinnamon Twig Decoction) is indicated.
If Taiyang disease fails to resolve after initial diaphoresis and subsequent purgation, but the pulse remains floating, the disease persists. A floating pulse indicates the pathogen is external; purgation was inappropriate. Since the pulse is now floating, the pathogen is still external; resolve the exterior to cure, indicating Guizhi Tang (Cinnamon Twig Decoction).
Patients with spontaneous sweating have harmonious Ying (Nutritive) Qi but disharmonious Wei (Defensive) Qi. Ying circulates within the vessels, Wei outside. Inducing sweating again harmonizes Wei, curing the condition; Guizhi Tang (Cinnamon Twig Decoction) is indicated.
If a patient has no internal organ pathology but experiences periodic fever and spontaneous sweating without resolution, this is Wei (Defensive) Qi disharmony. Induce sweating before the fever onset to cure; Guizhi Tang (Cinnamon Twig Decoction) is indicated.
In cold damage, if there is constipation for six to seven days with headache and fever, Chengqi Tang (Gut-Clearing Decoction) is given. If the stool is unusually green, the pathology is not in the interior but in the exterior; induce diaphoresis. Headache may lead to epistaxis; Guizhi Tang (Cinnamon Twig Decoction) is indicated.
After cold damage is resolved by diaphoresis, if vexation returns half a day later with a floating and rapid pulse, diaphoresis may be repeated; Guizhi Tang (Cinnamon Twig Decoction) is indicated.
If a physician purges cold damage leading to body pain but normal bowel and bladder function, urgently rescue the exterior; Guizhi Tang (Cinnamon Twig Decoction) is indicated.
If Taiyang disease is unresolved and the pulse shows Yin and Yang cessation, chills and shaking precede sweating and resolution. If only the Yang pulse is micro, induce sweating first; Guizhi Tang (Cinnamon Twig Decoction) is indicated.
If Taiyang disease is unresolved with heat binding in the Bladder, the patient acts like a madman, and blood may pass spontaneously, leading to cure. If the exterior remains unresolved, attack is premature; resolve the exterior first with Guizhi Tang (Cinnamon Twig Decoction).
After severe purgation and subsequent diaphoresis in cold damage, if Pi (Glomus/Fullness) forms below the heart with aversion to cold, do not attack the Pi; resolve the exterior first with Guizhi Tang (Cinnamon Twig Decoction).
Formula: Guizhi Tang (Cinnamon Twig Decoction)
Guizhi (Ramulus Cinnamomi), Shaoyao (Radix Paeoniae Rubra), Shengjiang (Rhizoma Zingiberis Recens) [each 2 liang, sliced], Gancao (Radix Glycyrrhizae Uralensis) [2 liang, honey-fried], Dazao (Fructus Jujubae) [12 pieces, torn].
These five ingredients are chopped. Boil three ingredients (Note: Text implies standard preparation) in 7 sheng of water, simmer to obtain 3 sheng, remove dregs. Warm dose 1 sheng. Immediately drink over 1 sheng of hot porridge to assist medicinal power. Cover warmly to induce sweating for about an hour, which is better. If no sweat, repeat dosing. If still no sweat, shorten intervals, administering three doses within half a day. For severe cases, improvement takes one day and night; observe closely. If symptoms persist after one dose, prepare another. Even if no sweat occurs, three doses may resolve it.
If Taiyang disease diaphoresis leads to leakage that does not stop, with aversion to wind, difficulty urinating, slight stiffness in limbs making flexion and extension difficult, Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction with Aconite) is indicated.
Add one Pao Fuzi (Radix Aconiti Lateralis Preparata) to Guizhi Tang (Cinnamon Twig Decoction).
If Taiyang disease is purged leading to a hurried pulse and chest fullness, Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction Without Peony) is indicated. If there is slight aversion to cold, Guizhi Qu Shaoyao Jia Fuzi Tang (Cinnamon Twig Decoction Without Peony plus Aconite) is indicated. Add one Pao Fuzi (Radix Aconiti Lateralis Preparata) to Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction Without Peony).
If Taiyang disease persists for eight to nine days, resembling malaria with fever and aversion to cold, more heat than cold, no vomiting, relatively normal bowel/bladder function, occurring two to three times a day: if the pulse is slightly slow and gentle, recovery is imminent; if the pulse is micro with aversion to cold, both Yin and Yang are deficient, and emesis/purgation/diaphoresis are contraindicated. If the face shows redness, resolution is not imminent due to inability to sweat, and the body will likely itch; Guizhi Mahuang Ge Ban Tang (Half-and-Half Cinnamon Twig and Ephedra Decoction) is indicated.
Guizhi (Ramulus Cinnamomi) [1 liang 16 zhu], Shaoyao (Radix Paeoniae Rubra), Shengjiang (Rhizoma Zingiberis Recens) [sliced], Gancao (Radix Glycyrrhizae Uralensis) [fried], Mahuang (Herba Ephedrae) [de-jointed, each 1 liang], Dazao (Fructus Jujubae) [4 pieces, torn], Xingren (Semen Armeniacae Amarum) [24 pieces, skin and pointed ends removed, double-kernel seeds].
Boil these seven ingredients in 5 sheng of water. First boil Mahuang (Herba Ephedrae) for one or two boils, remove foam. Add other herbs, boil to obtain 1.8 sheng, remove dregs. Warm dose 0.6 sheng. Originally: Mix 0.3 sheng of Guizhi Tang (Cinnamon Twig Decoction) and 0.3 sheng of Mahuang Tang (Ephedra Decoction) to make 0.6 sheng, take at once.
If Guizhi Tang (Cinnamon Twig Decoction) causes profuse sweating, and the pulse becomes洪大 (surging and large), giving Guizhi Tang (Cinnamon Twig Decoction) again, if the condition resembles malaria occurring twice a day, sweating resolves it. Guizhi Er Mahuang Yi Tang (Two Parts Cinnamon Twig and One Part Ephedra Decoction) is indicated:
Guizhi (Ramulus Cinnamomi) [1 liang 17 zhu], Mahuang (Herba Ephedrae) [16 zhu], Shengjiang (Rhizoma Zingiberis Recens) [sliced], Shaoyao (Radix Paeoniae Rubra) [each 1 liang 6 zhu], Gancao (Radix Glycyrrhizae Uralensis) [1 liang 2 zhu, fried], Dazao (Fructus Jujubae) [5 pieces, torn], Xingren (Semen Armeniacae Amarum) [16 pieces, skin and pointed ends removed, double-kernel seeds].
Boil these seven ingredients in 7 sheng of water. First boil Mahuang (Herba Ephedrae) for one or two boils, remove foam. Add other herbs, boil to obtain 2 sheng, remove dregs. Warm dose 1 sheng, twice daily. Originally: Mix two parts Guizhi Tang (Cinnamon Twig Decoction) and one part Mahuang Tang (Ephedra Decoction) to make 2 sheng, divide into two doses. Modern practitioners combine them into one formula.
In Taiyang disease with fever and aversion to cold, more heat than cold, and a weak pulse indicating absence of Yang, diaphoresis is contraindicated. Guizhi Er Yuebi Yi Tang (Two Parts Cinnamon Twig and One Part Yuebi Decoction) is indicated:
Guizhi (Ramulus Cinnamomi), Shaoyao (Radix Paeoniae Rubra), Gancao (Radix Glycyrrhizae Uralensis) [fried], Mahuang (Herba Ephedrae) [de-jointed, each 18 zhu], Shengjiang (Rhizoma Zingiberis Recens) [1 liang 3 zhu, sliced], Shigao (Lapis Gypsi Fibrosus) [24 zhu, crushed], Dazao (Fructus Jujubae) [4 pieces, torn].
Boil these seven ingredients in 5 sheng of water. First boil Mahuang (Herba Ephedrae) for one or two boils, remove foam. Add other herbs, boil to obtain 2 sheng, remove dregs. Warm dose 1 sheng. Originally: Reduce to Yuebi Tang (Yuebi Decoction) and Guizhi Tang (Cinnamon Twig Decoction) combined, drink 1 sheng. Now combined into one formula, using two parts Guizhi Tang (Cinnamon Twig Decoction).
If Guizhi Tang (Cinnamon Twig Decoction) is followed by purgation, leading to neck stiffness, mild fever, no sweating, chest fullness, slight pain, and dysuria, Guizhi Qu Guizi Jia Fuling Baizhu Tang (Cinnamon Twig Decoction Without Cinnamon Twig plus Poria and Atractylodes Macrocephala) is indicated:
Fuling (Poria), Baizhu (Rhizoma Atractylodis Macrocephalae) [each 3 liang].
Take Guizhi Tang (Cinnamon Twig Decoction), remove Guizhi (Ramulus Cinnamomi), add these two herbs to make a decoction. Drink 1 sheng; urination will become free. Originally: Guizhi Tang (Cinnamon Twig Decoction) with Guizhi (Ramulus Cinnamomi) removed and Fuling (Poria) and Baizhu (Rhizoma Atractylodis Macrocephalae) added.