（隰草）发寒入太阳膀胱无汗
麻黄（专入膀胱。兼入肺）。辛温微苦。中空而浮。入足太阳膀胱。（足太阳为六经外藩。
总
经络而统营卫。其经之脉起目 。上脑下项。循肩挟脊抵腰。行于身后。故凡寒入是经。其
症必见头痛。发热恶寒。腰脊卒强。无汗。脉则尺寸俱紧。是为伤寒。若汗自出不止。及脉
不紧不浮。其症或不恶寒而止恶风。是为伤风。）兼入手太阴肺。（麻黄空虚似肺。故亦兼入
肺经
。）仲景用此以治寒入太阳无汗。其意甚深。盖缘津液为汗。汗即血也。在营则为血。在卫
则为汗。寒伤营。营血内涩。不能外通于卫。卫气固密。津液不行。故无汗发热而恶寒。方
用麻黄甘草同桂枝引出营分之邪达之肌表。佐以杏仁泄肺而利气。是麻黄虽太阳发汗重剂
。实散肺经火郁之邪。其在十剂。有曰轻可去实。葛根麻黄之属是也！（弘景曰。麻黄疗伤
寒解肌第一药。时珍曰。麻黄乃肺经专药。故治肺病多用之。张仲景治伤寒无汗用麻黄。有
汗用桂枝。未有究其精微者。时珍常思津液为汗。汗即血也。在营则为血。在卫则为汗。夫
寒伤营。营血内涩。不能外通于卫。卫气闭固。津液不行。故无汗发热而恶寒。夫风伤卫。
卫气外泄。不能内护于营。营气虚弱。津液不固。故有汗发热而恶风。然风寒之邪。皆由皮
毛而入。皮毛者肺之合也。肺主卫气。包罗一身。天之象也。是证虽属乎太阳。而肺实受邪
气。其症时兼面赤怫郁。咳嗽有痰。喘而胸满诸症。非肺病乎？盖皮毛外闭。则邪热内攻。
而肺气 郁。故用麻黄甘草同桂枝引出营分之邪达之肌表。佐以杏仁泄肺而利气。汗后无大
热
而喘者。加以石膏。朱肱活人书夏至加石膏知母者。是泄肺火之药。是则麻黄汤虽太阳发
汗重剂。实为发散肺经火郁之药也。腠理不密。则津液外泄。而肺气自虚。虚则补其母。故
用桂枝同甘草。外散风邪以救表。内伐肝木以防脾。佐以芍药。泄木而固脾。泄东所以补西
也。使以姜枣。行脾之津液而和营卫也。下后微喘者。加浓朴杏仁以利肺气也。汗后脉沉迟
者。加人参以益肺气也。朱肱加黄芩为阳旦汤。以泄肺热也。皆是脾肺之药。是则桂枝虽太
阳解肌轻剂。实为理脾救肺之药也。此千古未发之秘旨。愚因表而出之。又少阴病发热脉
沉。有麻黄附子细辛汤麻黄附子甘草汤。少阴与太阳为表里。赵嗣真所谓熟附配麻黄。补中
有
发也。）是以风寒郁肺而见咳逆上气痰哮气喘。则并载其能治。但用此之法。则在佐使之间
。或兼气药以助力。（人参）可得卫中之汗。或兼营药以助液。（当归）可得营中之汗。或兼
温
药以助阳。（附子）可除寒凝之寒毒。或兼寒药以助阴。（黄芩石膏知母）可解炎热之瘟邪。
此
实伤寒阴疟第一要药。至或有载不宜多用及夏月不宜用者。盖因过用则汗多亡阳。自汗表虚
则耗人元气。（张仲景曰。阳盛阴虚者。不可发汗。尺脉迟者。不可发汗。咽燥喉干者。不
可发汗。咳而小便利若失小便者。不可发汗。下利虽有表症。不可发汗。淋家不可发汗。衄
血亡血家不可发汗。疮家虽身疼痛。不可发汗。少阴病脉沉细数。不可发汗。少阴病但厥无
汗。不可发汗。脉动数微弱。不可发汗。脉沉迟不可发汗。汗家不可发汗。腹中上下左右有
动气。不可发汗。）夏月阳气外泄。不宜再发以夺元气耳！然果春夏值有深寒内入。则又何
不可用之有。至于手少阴心之风热斑疹。足厥阴之风痛目痛。审其腠理坚闭。病应用散。亦
当审实以投。功与桂枝柴胡葛根芍药同为一类。但桂枝则解太阳风邪伤卫。（王好古曰。心
主营为血。肺主卫为气。故麻黄为手太阴肺之药。桂枝为手少阴心之药。）葛根则解阳明肌
热口渴。（时珍曰。麻黄太阳经药。兼入肺经。肺主皮毛。葛根阳明经药。兼入脾经。）柴胡
则发少阳阳邪寒热往来。此则能发太阳阴邪伤营。不可不细辨也。发汗用茎去节。止汗须用
根节。并蛤粉粟米等分为末。袋盛扑之。（时珍曰。麻黄发汗之气驶不能御。而根节止汗。
效如影响。物理之妙。不可测度如此。自汗有风湿伤风。风温气虚。血虚脾虚。阴虚胃热。
痰饮中暑。亡阳柔 诸症。皆可随症加而用之。当归六黄汤加麻黄根。治盗汗尤捷。盖其性
能
行周身肌表。故能引诸药外至卫分而固腠理也。本草但知扑之之法。而不知服饵之功尤良也
。宣明五气篇曰。心为汗。则知汗出于心。经脉别论曰。饮食饱甚。汗出于胃。惊而夺精。
汗出于心。持重远行。汗出于肾。疾走恐惧。汗出于肝。体摇劳倦。汗出于脾。本病篇曰。
醉饱行房。汗出于脾。）浓朴白薇为使。恶辛夷石苇。
（麻黄）能发散侵入足太阳膀胱经的寒邪，适用于无汗症状。
麻黄（专门入膀胱经，兼入肺经）。味辛、温，微苦。质地中空而轻浮，入足太阳膀胱经。（足太阳经是六经的外围屏障，统领经络并统摄营卫之气。其经脉起于目内眦，上行至脑部，下行至项部，沿肩部夹脊抵腰，行于身体后方。因此，凡是寒邪侵入此经，症状必然出现头痛、发热、恶寒、腰脊突然僵硬、无汗，脉象尺寸两部都紧，这称为伤寒。如果汗出不止，且脉不紧不浮，症状可能是不恶寒只恶风，这称为伤风。）兼入手太阴肺经。（麻黄质地空虚类似肺脏，所以也兼入肺经。）张仲景用此药治疗寒邪侵入太阳经导致的无汗，其用意非常深远。大概因为津液化为汗，汗即血也。在营分则为血，在卫分则为汗。寒邪损伤营分，导致营血内部涩滞，不能向外通达于卫分；卫气固密，津液运行不畅，所以出现无汗、发热而恶寒的症状。方剂中使用麻黄、甘草配合桂枝，引出营分之邪达于肌表；佐以杏仁宣泄肺气而利气机。这样看来，麻黄虽然是太阳经发汗的重剂，实际上也是疏散肺经火郁之邪的药物。在“十剂”分类中有说：“轻可去实”，葛根、麻黄这类药物就是代表！（陶弘景说：麻黄是治疗伤寒解肌的第一要药。李时珍说：麻黄是肺经的专药，所以治疗肺病多用它。张仲景治疗伤寒无汗用麻黄，有汗用桂枝，但没有人探究其中的精微之处。李时珍常思考：津液化为汗，汗即血也。在营分则为血，在卫分则为汗。寒邪伤营，营血内部涩滞，不能外通于卫分，卫气闭固，津液不行，所以无汗、发热而恶寒。风邪伤卫，卫气外泄，不能内护于营分，营气虚弱，津液不固，所以有汗、发热而恶风。然而风寒之邪，都是从皮毛而入。皮毛是肺的外合，肺主卫气，包罗一身，如同天之象。这个证候虽然属于太阳经，但肺实际上受到了邪气，症状时常兼见面赤怫郁、咳嗽有痰、喘促胸满等症状，这不是肺病吗？因为皮毛外闭，邪热内攻，导致肺气郁结，所以用麻黄、甘草同桂枝引出营分之邪达于肌表，佐以杏仁泄肺而利气。发汗后如果没有大热但仍有气喘，加上石膏。朱肱《活人书》中夏至加石膏、知母，这是泄肺火的药物。由此可见，麻黄汤虽然是太阳经发汗的重剂，实际上是发散肺经火郁之药的方剂。腠理不致密，则津液外泄，肺气自然虚弱。虚则补其母，所以用桂枝同甘草，外散风邪以救表，内伐肝木以防脾土受克。佐以芍药，泄肝木而固护脾土。泄东方肝木所以补西方肺金。使以生姜、大枣，运行脾之津液而调和营卫。下法之后出现轻微气喘，加厚朴、杏仁以利肺气。发汗后脉沉迟，加人参以益肺气。朱肱加黄芩为阳旦汤，以泄肺热。这些都是调理脾肺的药物。由此可见，桂枝汤虽然是太阳经解肌的轻剂，实际上是调理脾脏、救助肺脏的方剂。这是千古未发的秘旨，我在此表白出来。另外少阴病发热脉沉，有麻黄附子细辛汤、麻黄附子甘草汤。少阴与太阳互为表里。赵嗣真所谓熟附子配麻黄，补中有发。）因此，对于风寒郁肺而见咳逆上气、痰哮、气喘等症状，一并记载其治疗能力。但使用此药的方法，在于佐使之间的搭配。或兼用补气药以助力（如人参），可得卫分之汗；或兼用补血药以助液（如当归），可得营分之汗；或兼用温阳药以助阳（如附子），可除寒凝之寒毒；或兼用寒凉药以助阴（如黄芩、石膏、知母），可解炎热之瘟邪。这确实是治疗伤寒阴疟的第一要药。至于有的记载说不宜多用及夏季不宜用，是因为过用则汗多亡阳，自汗表虚则耗损人体元气。（张仲景说：阳盛阴虚者，不可发汗。尺脉迟者，不可发汗。咽燥喉干者，不可发汗。咳嗽而小便失禁或漏尿者，不可发汗。下利虽有表症，不可发汗。淋家不可发汗。衄血、亡血家不可发汗。疮家虽身疼痛，不可发汗。少阴病脉沉细数，不可发汗。少阴病但厥无汗，不可发汗。脉动数微弱，不可发汗。脉沉迟不可发汗。汗家不可发汗。腹中上下左右有动气，不可发汗。）夏季阳气外泄，不宜再发汗以夺元气！但如果确实春夏季遇到深寒内入，又有什么不可以用的呢？至于手少阴心经的风热斑疹，足厥阴肝经的风痛目痛，审察其腠理坚闭，病应用散法，也应当审察实证后投药。功效与桂枝、柴胡、葛根、芍药同为一类。但桂枝则是解除太阳经风邪伤卫（王好古说：心主营为血，肺主卫为气，所以麻黄为手太阴肺之药，桂枝为手少阴心之药）。葛根则是解除阳明经肌热口渴（李时珍说：麻黄是太阳经药，兼入肺经，肺主皮毛；葛根是阳明经药，兼入脾经）。柴胡则是发越少阳阳邪之寒热往来。而麻黄能发太阳阴邪伤营之邪，不可不仔细辨别。发汗用茎，去掉节；止汗须用根节。并与蛤粉、粟米等分为末，装袋扑洒。（李时珍说：麻黄发汗之气迅猛无法抵御，而根节止汗，效果如影随形。物理之妙，不可测度如此。自汗症有风湿、伤风、风温、气虚、血虚、脾虚、阴虚胃热、痰饮、中暑、亡阳柔痉等各种症状，都可以随症加入使用。当归六黄汤加麻黄根，治疗盗汗尤其快捷。因为其性能行周身肌表，所以能引诸药外至卫分而固腠理。本草只知道扑洒之法，而不知道内服之功尤佳。《宣明五气篇》说：心为汗，则知汗出于心。《经脉别论》说：饮食饱甚，汗出于胃；惊而夺精，汗出于心；持重远行，汗出于肾；疾走恐惧，汗出于肝；体摇劳倦，汗出于脾。《本病篇》说：醉饱行房，汗出于脾。）以厚朴、白薇为使药。畏忌辛夷、石苇。
(Mahuang, Ephedrae Herba) can disperse cold pathogens invading the Foot-Taiyang Bladder Meridian (Foot-Taiyang Bladder Channel), applicable for symptoms of anhidrosis.
Mahuang (Ephedrae Herba) (specifically enters the Bladder Meridian, also enters the Lung Meridian). Flavor is acrid, warm, slightly bitter. Texture is hollow and light/floating, enters the Foot-Taiyang Bladder Meridian. (The Foot-Taiyang Meridian serves as the outer barrier of the Six Channels, commanding the meridians and governing Ying and Wei Qi. Its meridian pathway originates from the inner canthus, ascends to the brain, descends to the nape, follows the shoulder along the spine to the waist, running along the posterior body. Therefore, whenever cold pathogens invade this meridian, symptoms must include headache, fever, aversion to cold, sudden stiffness of the lower back and spine, anhidrosis, and pulse tightness in both Cun and Chi positions; this is termed Shanghan (Cold Damage). If sweating is unceasing, and the pulse is neither tight nor floating, symptoms may present as aversion to wind only without aversion to cold; this is termed Shangfeng (Wind Strike).) It also enters the Hand-Taiyin Lung Meridian. (Mahuang's hollow texture resembles the lung, thus it also enters the Lung Meridian.) Zhang Zhongjing used this herb to treat anhidrosis caused by cold invading the Taiyang Meridian; his intent was profound. Generally speaking, body fluids transform into sweat, and sweat is blood. Within Ying it is blood; within Wei it is sweat. Cold injuring Ying causes Ying blood to become stagnant internally, unable to communicate externally with Wei; Wei Qi becomes dense and fixed, body fluids fail to circulate, resulting in anhidrosis, fever, and aversion to cold. In the formula, Mahuang and Gancao (Licorice Root) are combined with Guizhi (Cinnamon Twig) to draw out pathogenic factors from the Ying level to the muscle surface; Xingren (Apricot Seed) is added as an assistant to vent the Lung and benefit Qi mechanism. Thus, although Mahuang is a heavy agent for inducing sweating in the Taiyang channel, it is actually a drug for dispersing fire-stagnation pathogens in the Lung Meridian. In the "Ten Categories" classification, it is said: "Light agents can remove excess," drugs like Gegen (Kudzu Root) and Mahuang belong to this category! (Tao Hongjing stated: Mahuang is the primary drug for treating Shanghan and resolving the muscle layer. Li Shizhen stated: Mahuang is a specific drug for the Lung Meridian, hence often used for treating Lung diseases. Zhang Zhongjing used Mahuang for Shanghan with anhidrosis and Guizhi for those with sweating, but no one had investigated its subtleties. Li Shizhen often pondered: Body fluids transform into sweat, and sweat is blood. Within Ying it is blood; within Wei it is sweat. Cold injuring Ying causes Ying blood to be stagnant internally, unable to communicate externally with Wei, Wei Qi closes and fixes, body fluids do not flow, hence anhidrosis, fever, and aversion to cold. Wind injuring Wei causes Wei Qi to leak externally, unable to protect Ying internally, Ying Qi becomes weak, body fluids are not secure, hence sweating, fever, and aversion to wind. However, Wind-Cold pathogens enter through the skin and hair. Skin and hair are the exterior correspondence of the Lung; the Lung governs Wei Qi, encompassing the whole body, resembling the image of Heaven. Although this syndrome belongs to the Taiyang, the Lung actually receives the pathogenic qi. Symptoms often accompany flushed face, depression, cough with phlegm, panting, and chest fullness; is this not a Lung disease? Because the exterior pores are closed, pathogenic heat attacks inward, causing Lung Qi stagnation. Therefore, Mahuang, Gancao, and Guizhi are used to draw out Ying-level pathogens to the muscle surface, assisted by Xingren to vent the Lung and benefit Qi. After sweating, if there is no high fever but wheezing remains, Shi Gao (Gypsum Fibrosum) is added. Zhu Gong's *Huoren Shu* adds Shi Gao and Zhimu (Anemarrhena Rhizome) during Summer Solstice; these are drugs that vent Lung fire. Thus, although Mahuang Tang is a heavy sweating agent for the Taiyang channel, it is essentially a formula for dispersing Lung Meridian fire-stagnation. When cou li (pores/skin texture) are not dense, body fluids leak outward, and Lung Qi naturally becomes deficient. Deficiency requires tonifying the mother element; therefore, Guizhi is combined with Gancao to externally disperse Wind pathogens to rescue the exterior, and internally attack Liver Wood to prevent Spleen Earth from being over-controlled. Shaoyao (White Peony Root) is added as an assistant to vent Liver Wood and consolidate Spleen Earth. Venting the East [Liver] supplements the West [Lung]. Ginger and Jujube are used as envoys to circulate Spleen fluids and harmonize Ying and Wei. After purgation, if slight wheezing occurs, Houpo (Magnolia Bark) and Xingren are added to benefit Lung Qi. After sweating, if the pulse is deep and slow, Renshen (Ginseng Radix) is added to benefit Lung Qi. Zhu Gong added Huangqin (Scutellaria Root) to create Yangdan Tang to vent Lung heat. These are all drugs regulating the Spleen and Lung. Thus, although Guizhi Tang is a light agent for resolving the muscle layer in the Taiyang channel, it is essentially a formula for regulating the Spleen and rescuing the Lung. This is a secret principle unexplored for millennia, which I hereby reveal. Additionally, for Shaoyin disease with fever and deep pulse, there are Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) and Mahuang Fuzi Gancao Tang (Ephedra, Aconite, and Licorice Decoction). Shaoyin and Taiyang are interior-exterior pairs. Zhao Sizhen stated that prepared Fuzi (Aconiti Lateralis Radix Praeparata) paired with Mahuang achieves release amidst tonification.) Therefore, for conditions where Wind-Cold stagnates in the Lung manifesting as cough, rebellious Qi, phlegm-wheezing, and asthma, its therapeutic capabilities are recorded. However, the method of using this drug lies in the coordination of assistants and envoys. Or combine with Qi-tonifying drugs to assist power (such as Renshen), to obtain Wei-level sweat; or combine with Blood-nourishing drugs to assist fluids (such as Danggui (Angelica Sinensis)), to obtain Ying-level sweat; or combine with Warm-Yang drugs to assist Yang (such as Fuzi), to eliminate cold-coagulation cold-toxins; or combine with Cold drugs to assist Yin (such as Huangqin, Shi Gao, Zhimu), to resolve hot-summer plague pathogens. This is indeed the first essential drug for treating Shanghan and Yin Malaria. Regarding records stating it should not be used excessively or avoided in summer, it is because excessive use leads to profuse sweating and loss of Yang; spontaneous sweating and exterior deficiency consume human Yuan Qi. (Zhang Zhongjing said: Those with Excess Yang and Deficient Yin cannot undergo sweating therapy. Those with a slow Chi pulse cannot undergo sweating therapy. Those with dry throat and parched mouth cannot undergo sweating therapy. Those with cough and urinary incontinence or leakage cannot undergo sweating therapy. Those with diarrhea, even if exterior symptoms exist, cannot undergo sweating therapy. Patients with stranguria cannot undergo sweating therapy. Patients with nasal bleeding or blood-loss cannot undergo sweating therapy. Patients with sores/ulcers, even with body pain, cannot undergo sweating therapy. Shaoyin disease with deep, fine, and rapid pulse cannot undergo sweating therapy. Shaoyin disease with cold limbs and no sweat cannot undergo sweating therapy. Pulse that is agitated, rapid, weak, or faint cannot undergo sweating therapy. Deep and slow pulse cannot undergo sweating therapy. Those who already sweat cannot undergo sweating therapy. Pulsations moving up, down, left, or right in the abdomen cannot undergo sweating therapy.) In summer, Yang Qi leaks outward; it is inappropriate to induce further sweating to deprive Yuan Qi! However, if deep cold invades internally during spring and summer, why would it not be usable? As for Wind-Heat macules and rashes of the Hand-Shaoyin Heart Meridian, and Wind-pain and eye pain of the Foot-Jueyin Liver Meridian, after examining that the cou li are firm and closed, and the disease requires dispersion, one must also examine for excess patterns before administering. Its efficacy is similar to that of Guizhi, Chaihu (Bupleuri Radix), Gegen, and Shaoyao. But Guizhi resolves Wind pathogens injuring Wei in the Taiyang channel (Wang Haogu stated: The Heart governs Ying as Blood, the Lung governs Wei as Qi; thus Mahuang is a drug of the Hand-Taiyin Lung, and Guizhi is a drug of the Hand-Shaoyin Heart). Gegen resolves Muscle Heat and thirst in the Yangming channel (Li Shizhen stated: Mahuang is a Taiyang channel drug, entering the Lung Meridian; the Lung governs skin and hair. Gegen is a Yangming channel drug, entering the Spleen Meridian). Chaihu releases the alternating chills and fever of Shaoyang Yang pathogens. Whereas Mahuang can release Yin pathogens injuring Ying in the Taiyang channel; this distinction must be carefully made. For inducing sweating, use the stem and remove the nodes; for stopping sweating, use the root nodes. Grind equally with Ge Fen (Clam Shell Powder) and Su Mi (Millet) into powder, place in bags, and apply topically. (Li Shizhen stated: The Qi of Mahuang inducing sweat is swift and uncontrollable, whereas the root nodes stop sweating with effect like shadow following form. The wonder of physical principles is immeasurable. Spontaneous sweating syndromes include Wind-Damp, Wind-Strike, Wind-Warmth, Qi deficiency, Blood deficiency, Spleen deficiency, Yin deficiency with Stomach heat, Phlegm-fluids, Summerheat, Yang collapse, and Rou Ji (soft spasm); all can be treated by adding Mahuang according to symptoms. Danggui Liu Huang Tang (Six-Ingredient Rehmannia with Gold Decoction) added with Mahuang Gen (Ephedrae Radix et Rhizoma) treats night sweats especially effectively. Because its nature can circulate throughout the body surface, it can guide other drugs to the Wei level to consolidate the cou li. Materia Medica only knows the topical application method, unaware that internal administration is even more beneficial. *Xuan Ming Wu Qi Pian* states: The Heart is associated with sweat, thus knowing sweat originates from the Heart. *Jing Mai Bie Lun* states: After excessive eating, sweat comes from the Stomach; when startled and essence is lost, sweat comes from the Heart; carrying heavy loads and traveling far, sweat comes from the Kidney; running fast and fearing, sweat comes from the Liver; body shaking and fatigue, sweat comes from the Spleen. *Ben Bing Pian* states: Intoxication, overeating, and intercourse cause sweat to come from the Spleen.) Use Houpo and Baiwei (Cynanchum Atratum Root) as envoys. Adverse reactions with Xin Yi (Magnolia Flower) and Shi Wei (Pyrrosiae Folium).