葛根(四两) 芍药(二两) 甘草(二两) 生姜(三两切) 大枣(十二枚擘)
桂枝(三两去皮) 麻黄(三两去节)
上七味。以水一斗。先煮麻黄葛根。减二升。去上沫。内诸药。煮取三升。去滓。
温服一升。覆取微似汗。不须啜粥。余如桂枝法。
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。
太阳病属表。而反下之。则虚其里。邪欲乘虚传里。若气上冲者。里不受邪。而气
逆上。与邪争也。则邪仍在表。故当复与桂枝汤解外。其气不上冲者。里虚不能与邪
争。邪气已传里也。故不可更与桂枝汤攻表。
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。
太阳病。三日中。曾经发汗、吐下、温针。虚其正气。病仍不解者。谓之坏病。言
为医所坏病也。不可复与桂枝汤。审观脉证。知犯何逆而治之。逆者、随所逆而救之。
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。
脉浮。发热、汗出、恶风者。中风也。可与桂枝汤解肌。脉浮紧。发热、不汗出者。
伤寒也。可与麻黄汤。常须识此。勿妄治也。
若酒客病。不可与桂枝汤。得汤则呕。以酒客不喜甘故也。
酒客内热。喜辛而恶甘。桂枝汤甘。酒客得之。则中满而呕。
喘家作桂枝汤。加浓朴杏子佳。
太阳病。为诸阳主气。风甚气壅。则生喘也。与桂枝汤以散风。加浓朴杏仁以降气。
葛根(四两) 芍药(二两) 甘草(二两) 生姜(三两,切) 大枣(十二枚,掰开)
桂枝(三两,去皮) 麻黄(三两,去节)
以上七味药。用水一斗。先煮麻黄和葛根。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。服药后覆盖衣被以取得微微似汗的效果。不需要喝热粥。其余护理方法参照桂枝汤法。
太阳病(太阳经受邪所致的病证),经过泻下治疗后,如果感觉气机上冲的,可以给予桂枝汤方。使用前法煎服。如果气不上冲的,不可给予此方。
太阳病属于表证,却反而使用泻下法,会导致里气虚弱。邪气想要乘虚传入里部。如果气机上冲的,说明里气不受邪气侵犯,而气逆向上,与邪气相争。那么邪气仍在表部,所以应当再次给予桂枝汤来解除表邪。如果气不上冲的,说明里气虚弱不能与邪气相争,邪气已经传入里部了。所以不可以再给予桂枝汤来攻表。
太阳病三天,已经发汗,或者用吐法、下法、温针治疗,仍然没有痊愈的,这叫做坏病(因误治导致的变证)。此时不宜再给桂枝汤。
观察患者的脉象和症状,知道犯了什么错误(逆治),根据证候进行治疗。
太阳病三天中,曾经发汗、吐下、温针,导致正气虚弱,病仍不愈的,称为坏病。意思是说这是被医生治坏了的病。不可以再给桂枝汤。仔细审察脉象和症状,知道犯了什么逆治错误而进行救治。所谓“逆”,就是针对所犯的错误进行补救。
桂枝汤本来是用于解肌(解除肌表之邪)的。如果患者脉象浮紧,发热且无汗的,不可给予桂枝汤。必须牢记这一点,不要弄错了。
脉象浮,发热、出汗、怕风的,是中风(风邪袭表)。可以给予桂枝汤解肌。脉象浮紧,发热、无汗的,是伤寒(寒邪束表)。可以给予麻黄汤。必须牢记这一点,不要胡乱治疗。
如果是嗜酒的人患病,不可给予桂枝汤。服用后会呕吐。因为嗜酒之人不喜欢甘味药的缘故。
Ge Gen (Radix Puerariae, four liang) Shao Yao (Radix Paeoniae Alba, two liang) Gan Cao (Radix Glycyrrhizae Preparata, two liang) Sheng Jiang (Rhizoma Zingiberis Recens, three liang, sliced) Da Zao (Fructus Jujubae, twelve pieces, split open)
Gui Zhi (Caulis Cinnamomi, three liang, bark removed) Ma Huang (Herba Ephedrae, three liang, nodes removed)
The above seven ingredients. Use one dou of water. First decoct Ma Huang and Ge Gen. Reduce the volume by two sheng. Remove the foam on the surface. Add the remaining herbs. Decoct to obtain three sheng of liquid. Strain off the dregs.
Take one sheng warm. Cover with blankets to induce a slight sweating. There is no need to drink hot porridge. The rest of the care instructions follow the method for Gui Zhi Tang.
Tai Yang Bing (Disease of the Tai Yang channel), after undergoing purgation therapy, if there is a sensation of Qi rushing upward, Gui Zhi Tang (Cinnamon Twig Decoction) may be administered. Use the previous decoction and administration method. If there is no upward rush of Qi, it should not be given.
Tai Yang Bing belongs to exterior syndromes. However, if purgation is incorrectly applied, it will weaken the interior. Pathogenic factors desire to transmit into the interior due to this deficiency. If Qi rushes upward, it indicates that the interior does not accept the pathogen, but rather the Qi rebels upward to contend with the pathogen. Thus, the pathogen remains in the exterior. Therefore, Gui Zhi Tang (Cinnamon Twig Decoction) should be administered again to resolve the exterior. If Qi does not rush upward, it indicates that the interior deficiency prevents contention with the pathogen, and the pathogenic factors have already transmitted into the interior. Hence, Gui Zhi Tang (Cinnamon Twig Decoction) should not be used to attack the exterior.
After three days of Tai Yang Bing, if sweating therapy has been performed, or emesis, purgation, or warm needle therapy has been used, yet the condition remains unresolved, this is termed Huai Bing (Damaged Disease/Complication due to Mismanagement). Gui Zhi Tang (Cinnamon Twig Decoction) is contraindicated.
Observe the pulse and symptoms. Determine what error (Ni, adverse treatment) was committed, and treat according to the current syndrome pattern.
Within three days of Tai Yang Bing, if sweating, emesis, purgation, or warm needle therapy were previously employed, weakening the healthy Qi, and the disease persists, it is called Huai Bing (Damaged Disease). This implies the disease was damaged by medical intervention. Gui Zhi Tang (Cinnamon Twig Decoction) should not be re-administered. Carefully examine the pulse and symptoms to identify the nature of the adverse treatment and provide appropriate rescue therapy. "Adverse treatment" refers to correcting the specific errors made.
Gui Zhi Tang (Cinnamon Twig Decoction) is originally intended for Jie Ji (releasing the muscle layer). If the patient's pulse is floating and tight, accompanied by fever and absence of sweating, it must not be given. This point must always be kept in mind to avoid error.
A floating pulse, fever, sweating, and aversion to wind indicate Zhong Feng (Wind Strike/Exterior Deficiency Syndrome). Gui Zhi Tang (Cinnamon Twig Decoction) can be used to release the muscle layer. A floating-tight pulse, fever, and absence of sweating indicate Shang Han (Cold Damage/Excess Exterior Syndrome). Ma Huang Tang (Ephedra Decoction) can be used. This distinction must always be kept in mind to avoid reckless treatment.
If the patient is a habitual wine drinker, Gui Zhi Tang (Cinnamon Twig Decoction) should not be given. Administration will cause vomiting because wine drinkers generally dislike sweet substances.
Habitual wine drinkers possess internal heat; they prefer pungent flavors and dislike sweet ones. Since Gui Zhi Tang (Cinnamon Twig Decoction) is sweet, its administration to such patients causes middle-jiao fullness and vomiting.
For patients with a chronic history of asthma (Chuan Jia), adding Hou Po (Cortex Magnoliae Officinalis) and Xing Ren (Semen Armeniacae Amarum) to Gui Zhi Tang (Cinnamon Twig Decoction) is advisable.
Tai Yang Bing governs the Qi of all Yang channels. Excessive wind leads to Qi stagnation, resulting in wheezing or panting. Gui Zhi Tang (Cinnamon Twig Decoction) is used to disperse wind, while Hou Po (Cortex Magnoliae Officinalis) and Xing Ren (Semen Armeniacae Amarum) are added to direct Qi downward.