桂枝(一两十六铢去皮) 芍药 生姜(切) 甘草(炙) 麻黄(各一两去节)
大枣(四枚擘) 杏仁(二十四个汤浸去皮尖及两仁者)
上七味。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。
王宇泰云。首一节至寒少。为自初至今之证。下文皆拟病防变之辞。当分作三截看。
至欲愈也。是不须治。至吐也。是宜温之。至末。是小汗之。麻黄发。桂枝止。一发一
止。则汗不得大出矣。
太阳病。初服桂枝汤。反烦不解者。先刺风池风府。却与桂枝汤则愈。
烦者、热也。服桂枝汤后。当汗出而身凉和。若反烦不解者。风甚而未能散也。先
刺风池风府。以通太阳之经。而泄风气。却与桂枝汤解散则愈。
服桂枝汤。大汗出。脉洪大者。与桂枝汤如前法。若形如疟。日再发者。汗出必解。
宜桂枝二麻黄一汤。
经曰。如服一剂。病证犹在者。故当复作本汤服之。服桂枝汤汗出后。脉洪大者。
病犹在也。若形如疟。日再发者。邪气客于荣卫之间也。与桂枝二麻黄一汤。解散
荣卫之邪。
桂枝(一两十七铢去皮) 芍药(一两六铢) 麻黄(十六铢去节) 生姜(一两
六铢切) 杏仁(十六个去皮尖) 甘草(一两二铢炙) 大枣(五枚擘)
上七味。以水五升。先煮麻黄一二沸。去上沫。内诸药。煮取二升去滓。温服一升。
日再。
服桂枝汤。大汗出后。大烦渴不解。脉洪大者。白虎加人参汤主之。
大汗出、脉洪大而不渴。邪气犹在表也。可更与桂枝汤。若大汗出。脉洪大而烦渴
不解者。表里有热。不可更与桂枝汤。可与白虎加人参汤。生津止渴。和表散热。
桂枝(一两十六铢,去皮) 芍药 生姜(切片) 甘草(炙烤) 麻黄(各一两,去节)
大枣(四枚,掰开) 杏仁(二十四个,热水浸泡后去皮尖及双仁者)
以上七味药。用水五升。先煮麻黄一二沸。去掉水面上的浮沫。加入其余药物。煮取一升八合。去渣滓,温服六合。
王宇泰说。开头一节到“恶寒少”,是从发病至今的症状。下文都是推测病情防止变化的言辞。应当分作三部分来看。到了想要痊愈的时候,是不需要治疗的。到了呕吐的时候,是适宜用温法治疗的。到了最后,是小发汗的方法。麻黄主发散,桂枝主收敛止汗。一发一止,那么汗液就不会大量出透了。
太阳病(太阳经受邪所致的病证),初次服用桂枝汤(调和营卫、解肌发表之剂)后,反而出现烦闷且症状未解除的,先针刺风池穴和风府穴,然后再给予桂枝汤则能痊愈。
烦闷,是热象的表现。服用桂枝汤后,应当出汗而身体凉爽平和。如果反而烦闷不解,是风邪盛而不能散除。先针刺风池、风府穴,以疏通太阳经的气血,并泄除风气,然后再给予桂枝汤解散表邪则能痊愈。
服用桂枝汤后,大汗出,脉象洪大的,给予桂枝汤按前面的方法服用。如果身体像疟疾一样,一天发作两次的,出汗后必定能解除。适宜使用桂枝二麻黄一汤(桂枝汤与麻黄汤比例约为2:1的方剂)。
医经说。如果服用一剂药,病症仍在的,所以应当再制作本汤服用。服用桂枝汤出汗后,脉象洪大的,说明病邪仍在体表。如果身体像疟疾一样,一天发作两次的,是邪气客居在荣卫之间。给予桂枝二麻黄一汤,解散荣卫之间的邪气。
桂枝(一两十七铢,去皮) 芍药(一两六铢) 麻黄(十六铢,去节) 生姜(一两六铢,切片) 杏仁(十六个,去皮尖) 甘草(一两二铢,炙烤) 大枣(五枚,掰开)
以上七味药。用水五升。先煮麻黄一二沸。去掉水面上的浮沫。加入其余药物。煮取二升,去渣滓。温服一升。每天两次。
服用桂枝汤后,大汗出之后,出现严重烦渴且不能缓解,脉象洪大的,由白虎加人参汤(清热生津之剂)主治。
大汗出、脉象洪大但不口渴,说明邪气仍在体表。可以再次给予桂枝汤。如果大汗出,脉象洪大且烦渴不能缓解的,是表里都有热,不可再给予桂枝汤。可以给予白虎加人参汤,生津止渴,调和表里散热。
Guizhi (Cinnamon Twig) (one liang and sixteen zhu, bark removed), Shaoyao (Peony Root), Shengjiang (Fresh Ginger) (sliced), Gancao (Licorice Root) (roasted), Mahuang (Ephedrae Herba) (each one liang, nodes removed), Dazao (Jujubae Fructus) (four pieces, torn open), Xingren (Armeniacae Semen Amarum) (twenty-four seeds, soaked in hot water, skin and tips removed, and those with two kernels discarded).
The above seven ingredients. Use five sheng of water. First boil Mahuang for one or two boils. Remove the foam on the surface. Add the remaining herbs. Boil to obtain one sheng and eight he. Strain the dregs. Take six he warm.
Wang Yutai said. The first section up to "aversion to cold is slight" refers to the symptoms from the beginning until now. The following text consists of speculative statements regarding the prevention of disease progression. It should be read as divided into three sections. When it reaches the point of desiring recovery, no treatment is needed. When it reaches vomiting, warming methods are appropriate. At the end, it refers to inducing a mild sweat. Mahuang induces sweating, while Guizhi stops it. One induces and one stops, so sweat will not discharge excessively.
Taiyang disease (disease pattern caused by pathogenic invasion of the Taiyang channel), after initially taking Guizhi Tang (Decoction for Harmonizing Ying and Wei and Resolving the Exterior), if vexation occurs and the condition does not resolve, first puncture Fengchi (GB20) and Fengfu (GV16 acupoints), then administer Guizhi Tang for recovery.
Vexation indicates heat. After taking Guizhi Tang, sweating should occur leading to a cool and harmonious body state. If vexation persists instead, it signifies excessive wind pathogen that cannot be dispersed. First puncture Fengchi and Fengfu to unblock the Taiyang channel and vent wind qi, then administer Guizhi Tang to disperse the exterior pathogen for recovery.
After taking Guizhi Tang, if profuse sweating occurs accompanied by a flooding pulse, administer Guizhi Tang according to the previous method. If the condition resembles malaria, occurring twice a day, resolution will follow sweating. Guizhi Er Mahuang Yi Tang (Two Parts Guizhi Decoction and One Part Ephedra Decoction) is indicated.
The classics state: If after taking one dose, the symptoms persist, the original decoction should be prepared and taken again. After taking Guizhi Tang and sweating, if the pulse is flooding, the pathogen remains at the exterior. If the condition resembles malaria, occurring twice a day, the pathogenic factor resides between Ying (Nutritive) and Wei (Defensive) levels. Administer Guizhi Er Mahuang Yi Tang to disperse the pathogen between Ying and Wei.
Guizhi (Cinnamon Twig) (one liang and seventeen zhu, bark removed), Shaoyao (Peony Root) (one liang and six zhu), Mahuang (Ephedrae Herba) (sixteen zhu, nodes removed), Shengjiang (Fresh Ginger) (one liang and six zhu, sliced), Xingren (Armeniacae Semen Amarum) (sixteen seeds, skin and tips removed), Gancao (Licorice Root) (one liang and two zhu, roasted), Dazao (Jujubae Fructus) (five pieces, torn open).
The above seven ingredients. Use five sheng of water. First boil Mahuang for one or two boils. Remove the foam on the surface. Add the remaining herbs. Boil to obtain two sheng. Strain the dregs. Take one sheng warm. Twice daily.
After taking Guizhi Tang, if profuse sweating leads to severe vexation and thirst that do not resolve, accompanied by a flooding pulse, Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng Root) is the primary treatment.
Profuse sweating and a flooding pulse without thirst indicate the pathogen remains at the exterior. Guizhi Tang may be administered again. However, if profuse sweating results in a flooding pulse accompanied by unresolved vexation and thirst, there is heat in both the interior and exterior. Guizhi Tang should not be used. Instead, Baihu Jia Renshen Tang may be administered to generate fluids, relieve thirst, harmonize the exterior, and dissipate heat.