此必肾气易动也。肾病治肾，桂枝自应四两，而亦用炙草二两者何哉？桂甘无他药，则辛甘
合化，心受其益；此以茯苓半斤先煮，大泻肾水，桂枝亦多，自随茯苓以入肾，伐肾邪而化
气。枣草皆中宫物，此际必协以御肾，无待言者。有甘草而又加大枣者，扶阳之后，宜以甘
润益阴，且不助肾也。曰桂枝芍药知母汤。是条尤氏误于知母一味，只知其能除热，遂谓温
温欲吐（金鉴云∶温温当是 ），是湿热从下上冲。生姜多用，是止呕降逆。唐容川则以
是条与下条合看，全归之于虚，其解方亦全属理虚。又云凡仲圣所称欲吐，多是火逆。不知
寒逆更多。温温欲吐四字，此见之少阴病，何以忘之。又以知母为清血中郁热，知母岂是血
药，似此武断杜撰，令人骇绝。就愚所见之书，惟赵氏以德风寒湿痹其营卫，与知母治脚肿
之说，实胜诸家，惜未发其所以然耳。夫风寒湿三气合而成痹，非各占一所，今约略指之∶
头眩者风淫于上，短气者湿阻于中，欲吐者寒逆其胃，湿易下流，故脚肿如脱。三气固结不
解，致三焦失其统御。水谷不能化精微而充肌肉，故诸肢节疼痛身体 羸，其为虚其不待言
矣。然风则阳受，痹则阴受，痹病未有能一汗而愈者；补则助邪，补亦未可以易言者。按桂
枝等九味，皆仲圣屡用之药。麻黄附子，有不以除寒者乎，白术有不以除湿者乎，防风有不
以除风者乎，桂枝汤有不以调阴阳和营卫者乎。附子除寒即属补阳，白术除湿即属补土，不
专为补计亦可见矣。凡桂枝汤所主之证，必有自汗；无汗用之，必非解表。麻黄汤有桂枝，
麻多于桂也；此桂多于麻，且约之以芍药，盖欲使诸治邪之药，以桂芍引之，甘草和之，留
连于营卫经络肢节，以成潜移默化之功，夫复何疑。去大枣者，润液则羁湿也。生姜加多者，
以能助术附升阳，为桂芍促驾，且性味与四物相得也。然则桂苓之功固不在小，知母何为而
亦与之同标方名也？夫知母者，赵氏所谓治脚肿，即本经所谓除邪气肢体浮肿下水者也。功
岂出桂芍下哉。
桂枝用五两之方，曰桂枝加桂汤。此与茯苓桂枝甘草大枣汤，皆所以制奔豚。而桂枝有
四两五两之分者，彼为脐下悸而尚未上冲，且已多用茯苓伐肾邪，故四两不为少。此则重伤
于寒，肾气从少腹上冲至心，桂枝散寒而更下其冲，故于桂枝汤再加桂枝二两。仲圣用桂只
是桂枝，盖即一物而加之减之，便各有功效不同，以诸方参考之自见，不必疑此之加桂为肉
桂也。
桂枝用六两之方，曰天雄散。桂枝用至六两，仅见是方。盖以天雄益肾精，更以桂枝化
肾气；以龙骨召自下上越之阳，更以桂枝扶自上下济之阳；以白术培土而守之，更以桂枝温
土而发之；是桂枝足以辅三物之不逮，非用之至多，则轻易之性，治上不能治中下也。
仲圣用桂枝之广大精微，愚已备陈其法。试更以桂枝汤推类言之∶夫桂枝汤不独治太阳
病也，治阳明病亦有之。如阳明病、脉迟、汗出多、微恶寒者，表未解也，可发汗，宜桂枝
汤。是桂枝汤用之于阳经外证，总以汗出为断。太阳表实者不汗出，汗出必表虚，故可以桂
枝汤调营卫。阳明病本自汗出，而汗出之证则有不同。汗出而恶热不恶寒，与得之一日不发
热而恶寒，二日寒自罢而发热者，阳明热病也。此汗出且多，脉复迟，则非热蒸之汗出，而
为表虚有寒邪之汗出。微恶寒而非背微恶寒，又无燥渴心烦之里证，则非解后之余邪，而为
表邪之未解。虽阳明之邪，较深于太阳，而宜以桂枝汤生正汗而发邪汗，则理实无二也。谨
按金鉴云∶汗出多之下，当有发热二字。若无此二字，脉迟汗出多微恶寒，乃是表阳虚，桂
枝附子汤证也，岂有用桂枝汤发汗之理乎。窃思仲圣此条，确切桂枝汤证，似无佚脱之字。
至桂枝附子汤以芍药易附子，正是汗出与不汗出分别紧要之处。风湿相搏之宜以附子扶阳，
与阳明中风之表虚只须用桂枝者，似亦有异。然欤非欤，姑谨志之。
用桂枝汤而非自汗出者亦有之。如太阴病脉浮者可发汗宜桂枝汤。按太阴之为病一条，
是太阴脏病提纲。此脉浮是经病，断无腹满而吐等证。然则太阴病三字从何着落。窃谓他条
太阴中风四肢烦疼，即属太阴经病之提纲。邪中阴经，讵能汗解，桂枝汤是和剂亦非汗剂。
注家不究桂枝汤发汗之所以然，而第执可发汗三字，模糊以辛甘发散释之。柯氏更误认脉浮
为风热。不思桂枝汤之发汗，是何等发汗，必其先表虚汗出，服汤后再 粥温复，然后邪汗
去而正汗以生。今太阴中风本不能有汗，阴经之表证，本不能以麻黄葛根等发汗，舍桂枝汤
解肌调营卫，尚有宜于是者乎。王宇泰云∶阴不得有汗，故不言无汗，三阴兼表病，俱不当
大发汗。非深明于仲圣法者，不能为此言。
用桂枝汤而但身体疼痛者亦有之。下利腹胀满身体疼痛者，先温其里，乃攻其表，温里
宜四逆汤。功表宜桂枝汤一条，金匮亦载入。窃疑本系杂证而复出于伤寒论者。下利之下，
金匮多一后字，盖太阴所受寒湿下利之后，脾阳式微，腹故胀满。外则经气亦虚，风邪乘之，
与里湿相搏，体为之痛。然经脏并治非法，以四逆汤先温其里，则寒湿去而表邪亦孤。后以
桂枝汤解肌散风而和营卫，自易如反掌。不云发汗者，即金匮所谓但微微似欲汗出者，风湿
俱去也。
更有用桂枝汤于妇人妊娠者，金匮妇人妊娠篇第一条，妊娠至六十日不能食，自属阻病。
阻病用桂枝汤，似有未合。徐氏谓桂枝汤内证得之为化气调阴阳，瘥胜诸家，而终未亲切。
窃思仲圣于病证但标数字，而即云宜某方者多有之，此或尚有的对之证，欲人就其方思之而
自得耳。按太阴中风四肢烦疼，太阴病脉浮者宜桂枝汤。而千金半夏茯苓汤治妊娠阻病，为
后世所宗，却有四肢烦疼恶寒汗出等证。方中橘姜辛夏，与桂枝汤亦颇有似处。就是测之，
妊娠阻病，必得有太阴外证者，以桂枝汤治之，方不致误。虽然，不知强解，儒者所戒，宜
金鉴谓有脱简而不加注也。绝之是绝其医药。娄全善治一妇，即遵此法而愈。又女科辑要载
一老妇劝人停药，后如其言。然则以绝之为绝其病根，或泥于安胎，治之而逆，是绝其妊娠
者，当爽然失矣。
这一定是肾气容易妄动。治疗肾病本应治肾，桂枝自然应当用四两，但这里又用了二两炙甘草，这是为什么呢？桂枝与甘草若无其他药物配合，则辛味与甘味化合，心脏受益；此处先用半斤茯苓煎煮，以大幅泻除肾水，桂枝用量也较多，便跟随茯苓进入肾脏，伐除肾中邪气并化生肾气。大枣和甘草都是入脾胃（中宫）的药物，此时必定协同它们来抵御肾邪，是不言而喻的。既然已有甘草而又加大枣，是因为在扶助阳气之后，适宜用甘润之品来滋养阴液，且不会助长肾邪。文中提到“桂枝芍药知母汤”。这一条中，尤氏对知母一味药产生了误解，只知道它能清热，于是认为“温温欲吐”（《医宗金鉴》说：“温温”应当是“愠愠”），这是湿热从下向上冲逆。生姜多用，是为了止呕降逆。唐容川则将这一条与下一条合并看待，完全归结为虚证，他对方剂的解释也全属于理虚范畴。他又说凡是张仲景所说的“欲吐”，多是火逆所致。却不知道寒逆更多见。“温温欲吐”这四个字，见于少阴病篇，为何被遗忘？他又认为知母是清血中郁热的，知母难道是血分药吗？像这样武断杜撰，令人惊骇至极。就我所见过的书籍而言，只有赵氏提出风寒湿痹阻营卫，以及知母治疗脚肿的说法，确实胜过各家，可惜未能阐明其所以然。风寒湿三气合而成为痹证，并非各占一处，现在大致指出：头眩是风邪淫溢于上，短气是湿邪阻滞于中，欲吐是寒邪逆犯胃腑，湿邪容易下行，所以脚肿如脱。三气固结不解，导致三焦失去统御功能。水谷不能化为精微以充养肌肉，所以肢体关节疼痛、身体消瘦羸弱，其为虚证是不言而喻的。然而风邪伤阳，痹邪伤阴，痹病没有能靠一次发汗就痊愈的；补益则会助长邪气，补法也不可以轻易使用。按桂枝等九味药，都是张仲景屡次使用的药物。麻黄、附子，难道不是用来除寒的吗？白术，难道不是用来除湿的吗？防风，难道不是用来除风的吗？桂枝汤，难道不是用来调和阴阳、和畅营卫的吗？附子除寒即属于补阳，白术除湿即属于补土，不专门为了补益也可以看出来了。凡桂枝汤所主治的证候，必定有自汗；无汗时使用，必定不是为了发表解肌。麻黄汤中有桂枝，但麻黄多于桂枝；此方中桂枝多于麻黄，并且用芍药加以制约，大概是希望让各种祛邪的药物，由桂枝和芍药引导，甘草调和，留恋于营卫经络肢节之间，从而达成潜移默化的功效，这还有什么可怀疑的呢？去掉大枣，是因为其滋润之性会羁留湿气。生姜加多，是因为它能协助白术、附子升发阳气，为桂枝、芍药驾车助力，且其性味与其余四味药物相协调。那么桂枝和茯苓的功效固然不小，知母为什么也与它们同列方名呢？夫知母，就是赵氏所说的治疗脚肿，也就是《神农本草经》所说的除邪气、肢体浮肿、下水的作用。功效难道在桂枝、芍药之下吗？
使用五两桂枝的方剂，称为桂枝加桂汤。这与茯苓桂枝甘草大枣汤，都是用来治疗奔豚病的。其中桂枝有四两和五两的区别，前者是因为脐下悸动而尚未上冲，且已多用茯苓伐除肾邪，所以四两不算少。后者则是重伤于寒邪，肾气从小腹上冲至心，桂枝散寒并更向下平抑冲逆之气，所以在桂枝汤基础上再加桂枝二两。张仲景用的桂只是桂枝，大概就是一种药物，加减不同，功效便各不相同，参考各方自然可见，不必怀疑此处的加桂是肉桂。
使用六两桂枝的方剂，称为天雄散。桂枝用到六两，仅见于此方。大概是用天雄来益肾精，再用桂枝来化肾气；用龙骨来召摄从下往上越出的阳气，再用桂枝来扶持从下往上济助的阳气；用白术培补脾土并守之，再用桂枝温煦脾土并发之；这说明桂枝足以辅助这三味药的不足，如果不是用得很多，其轻扬易散的性质，在治疗上部时就不能兼顾中下部。
张仲景运用桂枝的广大精微，我已经详尽陈述了其法则。试再推演桂枝汤的应用：桂枝汤不仅仅治疗太阳病，治疗阳明病也有应用。如阳明病，脉迟，汗出多，轻微恶寒者，说明表证未解，可以发汗，宜用桂枝汤。这说明桂枝汤用于阳经外证，总以汗出作为判断依据。太阳表实证无汗，汗出必属表虚，所以可以用桂枝汤调和营卫。阳明病本来自汗出，但汗出的证候有所不同。汗出且恶热不恶寒，或者得病一日不发热的恶寒，二日寒自罢而发热者，这是阳明热病。此处汗出且多，脉象又迟，这就不是热蒸腾而出的汗，而是表虚有寒邪导致的汗出。轻微恶寒而非背部微恶寒，又没有燥渴心烦的里证，就不是解表后的余邪，而是表邪未解。虽然阳明之邪比太阳深一层，但宜用桂枝汤生出正气之汗而发散邪气之汗，道理其实是一样的。谨按《医宗金鉴》说：在“汗出多”之下，应当有“发热”二字。如果没有这两个字，脉迟、汗出多、微恶寒，乃是表阳虚，属于桂枝附子汤的证候，哪里有用桂枝汤发汗的道理呢？我私下思考，张仲景这一条，确切地指出了桂枝汤证，似乎没有脱漏的字句。至于桂枝附子汤以芍药替换附子，正是汗出与无汗分别的关键之处。风湿相搏适宜用附子扶阳，与阳明中风表虚只需使用桂枝的情况，似乎也有差异。是这样还是不是这样，暂且谨慎记录于此。
使用桂枝汤但并非自汗出的情况也有。如太阴病脉浮者可发汗，宜用桂枝汤。按太阴病的一条，是太阴脏病的提纲。此处脉浮是经病，断不会有腹满而吐等症状。那么“太阴病”这三个字从何落实？我认为其他条文中的“太阴中风四肢烦疼”，即属于太阴经病的提纲。邪气侵入阴经，岂能通过发汗解除？桂枝汤是和剂，也不是单纯的汗剂。注家不探究桂枝汤发汗的原理，只执着于“可发汗”三个字，模糊地用辛甘发散来解释。柯琴更是错误地将脉浮认作风热。不考虑桂枝汤的发汗是何等发汗，必定是先有表虚汗出，服药后再喝热粥温覆，然后邪汗去而正汗生。如今太阴中风本来不能有汗，阴经的表证，本来不能用麻黄、葛根等发汗，舍弃桂枝汤解肌调和营卫，还有适宜于此的吗？王宇泰说：阴经不得有汗，所以不言无汗，三阴兼有表病，都不应当大发汗。不是深刻明白张仲景法度的人，不能说这样的话。
使用桂枝汤但仅有身体疼痛的情况也有。“下利腹胀满身体疼痛者，先温其里，乃攻其表，温里宜四逆汤，攻表宜桂枝汤”一条，《金匮要略》也载入其中。我怀疑这原本是杂病，后来出于《伤寒论》的。在“下利”之下，《金匮》多一个“后”字，大概是太阴所受寒湿下利之后，脾阳式微，腹部故胀满。外部则经气亦虚，风邪乘虚而入，与里湿相搏，身体为之疼痛。然而同时治疗经脏并非正法，先用四逆汤温其里，则寒湿去而表邪亦孤立。后用桂枝汤解肌散风而调和营卫，自然易如反掌。不说发汗，就是《金匮》所说的微微似欲汗出，风湿俱去的意思。
更有在妇人妊娠期间使用桂枝汤的。《金匮要略·妇人妊娠篇》第一条，妊娠六十日不能食，自属恶阻病。恶阻病用桂枝汤，似乎不太合适。徐灵胎说桂枝汤内证得之为化气调阴阳，胜过诸家，但最终不够亲切。我私下思考，张仲景在病证中只标数字，随即说宜某方的情况有很多，这或许还有对应的具体证候，想让医者通过方剂去思考而自行领悟罢了。按太阴中风四肢烦疼，太阴病脉浮者宜桂枝汤。而《千金方》半夏茯苓汤治疗妊娠恶阻病，被后世所尊崇，却有四肢烦疼、恶寒、汗出等症状。方中橘皮、生姜、辛夷、半夏，与桂枝汤颇有相似之处。由此推测，妊娠恶阻病，必须得有太阴外证者，才可用桂枝汤治疗，才不会误治。虽然如此，不知而强行解释，是儒者所忌讳的，宜采纳《医宗金鉴》所说有脱简而不加注的观点。“绝之”是断绝其医药。娄全善治疗一妇人，即遵循此法而痊愈。又《女科辑要》记载一位老妇劝人停药，后来如其所言。那么，“绝之”如果是断绝其病根，或者拘泥于安胎，治疗反而违背病情，这是断绝其妊娠者，应当感到怅然失若了。
This must be due to the kidney qi being prone to erratic movement. When treating kidney disease, one should treat the kidney; thus, Guizhi (Cinnamon Twig) should naturally be used in a dosage of four liang. However, why is also Erliang of Zhigancao (Prepared Licorice Root) used? Without other herbs, the combination of Guizhi and Zhigancao creates a synergy where acrid and sweet flavors transform together, benefiting the Heart. Here, Banxia (Pinellia Tuber) [Note: Text says Fuling/Poria, correction applied in translation based on context "Fuling ban jin xian zhu" - Poria] half a jin is decocted first to significantly drain kidney water. With a larger dose of Guizhi, it follows the Poria into the kidney to attack kidney pathogens and transform qi. Jujube and Licorice are substances entering the Middle Jiao (Spleen/Stomach); at this juncture, they must assist in defending against kidney pathogens, which goes without saying. Since Licorice is already present, adding Jujube serves to nourish yin with sweet and moistening properties after supporting yang, and it does not aid the kidney pathogens. The text mentions the *Guizhi Shaoyao Zhimu Tang* (Cinnamon Twig, Peony, and Anemarrhena Decoction). In this clause, You Shi misunderstood the herb Zhimu (Anemarrhena Rhizome), knowing only its ability to clear heat, and thus interpreted "wen wen yu tu" (a sensation of nausea/retching) [The *Yizong Jinjian* states "wen wen" should be "yun yun"] as damp-heat rushing upward from below. Using a large amount of Shengjiang (Fresh Ginger) aims to stop vomiting and direct rebellious qi downward. Tang Rongchuan viewed this clause together with the next, attributing everything to deficiency, and his explanation of the formula entirely focused on tonifying deficiency. He further claimed that whenever Zhang Zhongjing mentioned "yu tu" (desire to vomit), it was mostly due to fire rebellion. He failed to realize that cold rebellion is more common. These four characters "wen wen yu tu" appear in the Shaoyin Disease chapter; why were they forgotten? He also considered Zhimu as clearing stagnant heat in the blood, but is Zhimu a blood-invigorating herb? Such arbitrary fabrication is shocking. Among the books I have seen, only Zhao's theory that wind-cold-dampness bi obstructs Ying and Wei, and Zhimu's treatment for foot swelling, truly surpasses other schools, though he failed to explain the rationale. Wind, cold, and dampness combine to form Bi syndrome, not occupying separate locations. Roughly speaking: dizziness indicates wind overflowing above; shortness of breath indicates dampness obstructing the middle; desire to vomit indicates cold rebelling against the stomach; dampness tends to flow downward, hence feet swell as if detached. The three pathogens knot firmly and do not resolve, causing the Sanjiao (Triple Burner) to lose its command. Water and grain cannot transform into essence to nourish muscles, resulting in pain in all joints and emaciation of the body; their deficient nature is self-evident. However, wind affects Yang, and Bi affects Yin; Bi diseases rarely heal with a single sweating method; tonification aids pathogens, so tonification methods should not be employed lightly. According to the nine herbs including Guizhi, these are medicines frequently used by Zhang Zhongjing. Are Mahuang (Ephedra Herb) and Fuzi (Aconite Lateralis Radix Preparata) not used to dispel cold? Is Baizhu (Atractylodis Macrocephalae Rhizoma) not used to remove dampness? Is Fangfeng (Saposhnikoviae Radix) not used to dispel wind? Is *Guizhi Tang* (Cinnamon Twig Decoction) not used to harmonize Yin and Yang and regulate Ying and Wei? Fuzi dispelling cold belongs to tonifying Yang; Baizhu removing dampness belongs to tonifying Earth; it is evident that they are not solely for tonification. For any syndrome indicated by *Guizhi Tang*, there must be spontaneous sweating; using it without sweating is certainly not for releasing the exterior. *Mahuang Tang* (Ephedra Decoction) contains Guizhi, but Mahuang exceeds Guizhi in quantity; here Guizhi exceeds Mahuang, and it is restrained by Shaoyao (Peony Root), likely intending to guide the pathogen-dispelling herbs via Guizhi and Shaoyao, harmonized by Gancao (Licorice Root), to linger in the Ying, Wei, meridians, and joints, achieving a subtle transformative effect. What doubt could there be? Removing Dazao (Jujube Fruit) prevents its moistening property from retaining dampness. Increasing Shengjiang (Fresh Ginger) helps Baizhu and Fuzi raise Yang, assists Guizhi and Shaoyao, and its flavor and nature accord with the other four herbs. Thus, the efficacy of Guizhi and Fuling (Poria) is indeed significant; why is Zhimu (Anemarrhena Rhizome) listed under the same formula name? Zhimu, as Zhao stated, treats foot swelling, which corresponds to the *Shennong Bencao Jing* description of eliminating pathogenic factors, limb edema, and promoting urination. Is its efficacy inferior to Guizhi and Shaoyao?
The formula using five liang of Guizhi is called *Guizhi Jia Gui Tang* (Cinnamon Twig Decoction with Added Cinnamon Twig). This, along with *Fuling Guizhi Gancao Dazao Tang* (Poria, Cinnamon Twig, Licorice, and Jujube Decoction), is used to control Ben Tun (Running Piglet). The difference between four liang and five liang of Guizhi lies in the former: umbilical palpitations have not yet rushed upward, and a large dose of Fuling has already been used to attack kidney pathogens, so four liang is not insufficient. In the latter, severe cold injury causes kidney qi to rush from the lower abdomen to the heart; Guizhi disperses cold and directs the rushing qi downward, so two additional liang of Guizhi are added to *Guizhi Tang*. Zhang Zhongjing uses "Gui" referring only to Guizhi; it is the same substance, but additions or reductions yield different effects, which can be seen by comparing various formulas. There is no need to suspect that the added Gui is Rougui (Cinnamon Bark).
The formula using six liang of Guizhi is *Tianxiong San* (Aconitum Lateralis Preparatum Powder). Guizhi reaching six liang appears only in this formula. Tianxiong (Aconitum Lateralis Preparatum) benefits kidney essence, while Guizhi transforms kidney qi; Longgu (Fossilized Bones) summons Yang yang escaping upward from below, while Guizhi supports Yang rising to nourish from below; Baizhu (Atractylodis Macrocephalae Rhizoma) cultivates Earth and secures it, while Guizhi warms Earth and activates it; thus, Guizhi sufficiently compensates for the deficiencies of the other three herbs. If not used in large quantities, its light and ascending nature would fail to treat the Middle and Lower Jiao when addressing the Upper Jiao.
I have fully expounded upon Zhang Zhongjing's extensive and profound use of Guizhi. Let us further deduce the application of *Guizhi Tang*: *Guizhi Tang* treats not only Taiyang Disease but also Yangming Disease. For instance, in Yangming Disease, if the pulse is slow, sweating is profuse, and there is slight aversion to cold, the exterior is unresolved; sweating may be induced, and *Guizhi Tang* is appropriate. This shows that when applying *Guizhi Tang* to exterior syndromes of Yang meridians, the presence of sweating is the key criterion. Taiyang exterior excess presents without sweating; sweating indicates exterior deficiency, allowing *Guizhi Tang* to harmonize Ying and Wei. Yangming Disease inherently involves sweating, but the nature of sweating varies. Sweating with aversion to heat but not cold, or initial aversion to cold without fever on day one, followed by fever on day two when cold resolves, characterizes Yangming Heat Disease. Here, sweating is profuse and the pulse is slow; this is not sweating from heat steaming, but sweating from exterior deficiency with cold pathogens. Slight aversion to cold, rather than slight aversion to cold on the back, and absence of interior signs like dry thirst and irritability, indicate that this is not residual pathogen after resolution, but unresolved exterior pathogen. Although Yangming pathogens are deeper than Taiyang, using *Guizhi Tang* to generate righteous sweat and disperse pathogenic sweat follows the same principle. According to *Yizong Jinjian*, the phrase "profuse sweating" should be followed by "fever." Without these two characters, slow pulse, profuse sweating, and slight aversion to cold indicate exterior Yang deficiency, corresponding to *Guizhi Fuzi Tang* (Cinnamon Twig and Aconite Decoction); how could *Guizhi Tang* be used to induce sweating? I privately believe this clause precisely identifies the *Guizhi Tang* syndrome, suggesting no missing characters. The substitution of Shaoyao for Fuzi in *Guizhi Fuzi Tang* highlights the critical distinction between sweating and non-sweating. The use of Fuzi to support Yang in Wind-Damp Bi differs from using only Guizhi for exterior deficiency in Yangming Wind Strike. Whether this is correct or not, I record it cautiously.
There are cases using *Guizhi Tang* without spontaneous sweating. For example, in Taiyin Disease, if the pulse is floating, sweating may be induced, and *Guizhi Tang* is suitable. The clause defining Taiyin Disease is the outline for Taiyin Zang disease. Here, a floating pulse indicates Jing (Meridian) disease; symptoms like abdominal fullness and vomiting are absent. How then does "Taiyin Disease" apply? I propose that "Taiyin Wind Strike causing painful and uncomfortable limbs" serves as the outline for Taiyin Jing disease. Can pathogens invading Yin meridians be resolved by sweating? *Guizhi Tang* is a harmonizing formula, not purely a diaphoretic. Commentators who do not investigate the mechanism of sweating in *Guizhi Tang* merely cling to "can induce sweating," vaguely explaining it as acrid-sweet dispersion. Ke Qin mistakenly identified floating pulse as wind-heat. One must consider what kind of sweating *Guizhi Tang* induces: it requires prior exterior deficiency with sweating; after taking the decoction, drinking warm millet porridge and covering for warmth allows pathogenic sweat to leave and righteous sweat to arise. Taiyin Wind Strike inherently lacks sweating; exterior syndromes of Yin meridians cannot be treated with diaphoretics like Mahuang or Gegen. Excluding *Guizhi Tang* for resolving muscle layer and harmonizing Ying and Wei, what else would be suitable? Wang Yutai said: "Yin meridians do not have sweating, hence 'no sweating' is not mentioned. Three Yin meridians with concurrent exterior syndromes should not undergo heavy sweating." Only those deeply understanding Zhang Zhongjing's methods could make such a statement.
There are cases using *Guizhi Tang* for body pain alone. "In diarrhea with abdominal fullness and body pain, first warm the interior, then attack the exterior; warming the interior suits *Sini Tang* (Frigid Extremities Decoction), attacking the exterior suits *Guizhi Tang*." This clause is also recorded in *Jinkui Yaolue*. I suspect this originally belonged to miscellaneous diseases and was later included in *Shanghan Lun*. In *Jinkui*, a "after" character is added after "diarrhea," implying that after Taiyin cold-damp diarrhea, Spleen Yang declines, causing abdominal fullness. Externally, Jing Qi is also deficient, allowing Wind Pathogens to invade and contend with interior dampness, causing body pain. Simultaneously treating Jing and Zang is not the standard method; first warming the interior with *Sini Tang* eliminates cold-dampness, isolating the exterior pathogen. Subsequently using *Guizhi Tang* to resolve the muscle layer, disperse wind, and harmonize Ying and Wei becomes easy. It does not mention inducing sweating because, as *Jinkui* states, slight perspiration suffices to eliminate both wind and dampness.
Furthermore, *Guizhi Tang* is used in pregnant women. The first clause of the *Jinkui* Pregnancy Chapter states that inability to eat at sixty days of pregnancy constitutes Zu Bing (Morning Sickness). Using *Guizhi Tang* for Zu Bing seems inappropriate. Xu Lingtai argued that internally, *Guizhi Tang* transforms Qi and harmonizes Yin and Yang, surpassing other schools, yet remains imprecise. I speculate that Zhang Zhongjing often lists brief symptoms and prescribes a formula, perhaps leaving specific corresponding symptoms implicit for practitioners to deduce. Given that Taiyin Wind Strike with painful limbs and Taiyin Disease with floating pulse suit *Guizhi Tang*, and *Qianjin Fang* Banxia Fuling Tang treats pregnancy Zu Bing with symptoms like painful limbs, aversion to cold, and sweating—containing Citrus Peel, Ginger, Pinellia, and Bupleurum similar to *Guizhi Tang*—it can be inferred that *Guizhi Tang* is suitable for pregnancy Zu Bing presenting with Taiyin exterior syndromes. However, forced interpretation is discouraged by scholars; adopting *Yizong Jinjian*'s view of missing text without annotation is prudent. "Jue zhi" means discontinuing medication. Lou Quanshan cured a woman by following this method. *Nuke Jiyao* records an old woman advising cessation of medicine, which proved effective. Thus, "Jue zhi" might mean cutting off the root of the disease; or, adhering rigidly to fetal preservation might lead to adverse treatments, effectively terminating the pregnancy, causing regret.