气味辛、温，无毒。主上气咳逆结气，喉痹吐吸，利关节，补中益气。久服通神
，轻身不老。
牡，阳也。牡桂者，即今之桂枝、桂皮也、菌根也。菌桂即今之肉桂、浓桂也。然生发
之机在枝干，故仲景方中所用俱是桂枝，即牡桂也。时医以桂枝发表，禁不敢用，而所用肉
桂，又必刻意求备，皆是为施治不愈，卸罪巧法。
张隐庵曰∶桂本凌冬不凋，气味辛温，其色紫赤，水中所生之木火也。肺肾不交，则为
上气咳逆之证；桂启水中之生阳，上交于肺，则上气平而咳逆除矣。结气喉痹者，三焦之气
不行于肌腠，则结气而为喉痹；桂禀少阳之木气，通利三焦，则结气通而喉痹可治矣。吐吸
者，吸不归根即吐出也；桂能引下气与上气相接，则吸之气直至丹田而后入，故治吐吸也。
关节者，两肘、两腋、两髀、两 皆机关之室，周身三百六十五节，皆神气之周行；桂助君
火之气，使心主之神气出入于机关，游行于骨节，故利关节也。补中益气者，补中焦而益上
下之气也。久服则阳气盛而光明，故通神明。三焦通会元真于肌腠，故轻身不老。
徐忠可曰∶近来肾气丸、十全大补汤俱用肉桂，盖杂温暖于滋阴药中，故无碍。至桂枝
汤，因作伤寒首方，又因有春夏禁用桂枝之说，后人除有汗发热恶寒一证，他证即不用，甚
至春夏则更守禁药不敢用矣。不知古人用桂枝，取其宣通血气，为诸药向导，即肾气丸古亦
用桂枝，其意不止于温下也。他如《金匮》论虚损十方，而七方用桂枝∶孕妊用桂枝汤安胎
；又桂苓丸去症；产后中风面赤，桂枝、附子、竹叶并用；产后乳子烦乱、呕逆，用竹皮大
丸内加桂枝治热烦。又附方，于建中加当归内补。然则，桂枝岂非通用之药？若肉桂则性热
下达，非下焦虚寒者不可用，而人反以为通用，宜其用之而多误矣。余自究心《金匮》以
后，其用桂枝取效，变幻出奇，不可方物，聊一拈出以破时人之惑。
陈修园曰∶《金匮》谓气短有微饮，宜从小便出之，桂苓甘术汤主之，肾气丸亦主之。
喻嘉言注∶呼气短，宜用桂苓甘术汤以化太阳之气；吸气短，宜用肾气丸以纳少阴之气；二
方俱借桂枝之力，市医不晓也。第桂枝为上品之药，此时却蹇于遇，而善用桂枝之人，亦与
之同病。癸亥岁，司马公之媳，孀居数载，性好静，长日闭户独坐，得咳嗽病，服生地、麦
冬、百合之类，一年余不效。延余诊之，脉细小而弦紧，纯是阴霾四布，水气滔天之象，断
为水饮咳嗽，此时若不急治，半月后水肿一作，卢扁莫何！言之未免过激，诊一次后，即不
复与商。嗣肿病大作，医者用槟榔、牵牛、葶苈子、浓朴、大腹皮、萝卜子为主，加焦白术
、熟地炭、肉桂、附子、茯苓、车前子、牛膝、当归、芍药、海金砂、泽泻、木通、赤小豆
、商陆、猪苓、枳壳之类，出入加减。计服二个月，其肿全消，人瘦如柴，下午气陷脚肿，
次早亦消，见食则呕，冷汗时出，子午二时烦躁不宁，咳嗽辄晕。医家以肿退为效，而病
人时觉气散不能自支。又数日，大汗、呕逆、气喘欲绝。又延余诊之，脉如吹毛，指甲黯，
四
前“此直言获咎，以致今日病不可为，余实不能辞其责也。但尊
恙一月，余进药三剂全愈，
迄今三载，尚守服旧方，精神逾健，
岂遂忘耶？兹两次遵命而来，未准一见，此症已束手无策，未知有何面谕？”渠少君云∶“但
求气喘略平。”所以然者，非人力也。余不得已，以《金匮》桂苓甘术汤小剂应之（茯苓二
钱、白术、桂枝、炙甘草各一钱。）次日又延，余知术拙不能为力，固辞之别延医治。后一
曰殁。旋闻医辈私议，桂苓甘术汤为发表之剂，于前证不宜。夫桂苓甘术汤岂发表剂哉！只
缘汤中之桂枝一味，由来被谤。余用桂枝，宜其招谤也。噫！桂枝之屈于不知己，将何时得
以大申其用哉！
桂枝性用，自唐宋以后，罕有明其旨者。叔父引张隐庵注，字字精确。又引徐忠可之论
，透发无遗。附录近日治案，几于痛哭垂涕而道之。其活人无己之心，溢于笔墨之外。吾知
桂枝之功用，从此大彰矣！又按∶仲景书桂枝条下，有“去皮”二字；叶天士《医林指南》
方中，每用桂枝末，甚觉可笑。盖仲景所用之桂枝，只取梢尖嫩枝，内外如一，若有皮骨者
去之，非去枝上之皮也。诸书多未言及，特补之。（受业侄凤腾、鸣岐注。）
气味辛、温，无毒。主治上气咳逆结气，喉痹吐吸，利关节，补中益气。长期服用可通神，轻身不老。
牡，代表阳。牡桂，就是现在的桂枝、桂皮和菌根。菌桂就是现在的肉桂、浓桂。然而生发的机能在枝干，所以张仲景方剂中所用的都是桂枝，也就是牡桂。当时的医生认为桂枝用于发表（发散表邪），因禁忌而不敢使用，而所用的肉桂，又必定刻意追求完美，这都是因为治疗效果不佳，为了推卸责任而找的借口。
张隐庵说：桂树本就在冬天也不凋谢，气味辛温，颜色紫赤，是水中所生的木火之象。肺肾不交，就会成为上气咳逆的病证；桂能激发水中的生发之阳气，上交于肺，那么上气就平复，咳逆也就消除了。结气和喉痹，是因为三焦之气不能在肌腠运行，从而结气形成喉痹；桂禀受少阳的木气，通利三焦，那么结气通畅，喉痹就可以治疗了。吐吸，是指吸气不能归根反而吐出；桂能引导下气与上气相接，那么吸气之气一直直达丹田而后进入，所以能治疗吐吸。关节，两肘、两腋、两髀、两腘都是机关所在之处，周身三百六十五节，都是神气周行流通的地方；桂辅助君火之气，使心主的神气出入于机关，游行于骨节，所以能利关节。补中益气，是补益中焦而增益上下之气。长期服用则阳气旺盛而光明，所以能通神明。三焦通会元真之气于肌腠，所以能轻身不老。
徐忠可说：近来肾气丸、十全大补汤都使用肉桂，大概是把温暖药混杂在滋阴药中，所以没有妨碍。至于桂枝汤，因为是治疗伤寒的首方，又因为有春夏禁用桂枝的说法，后人除了对有汗、发热、恶寒这一证候外，其他证候就不使用了，甚至到了春夏季节更是坚守禁药不敢使用。不知道古人使用桂枝，是取其宣通血气，作为诸药的向导，即使是肾气丸古时也用桂枝，其用意不仅仅在于温下。其他的如《金匮要略》论述虚损十方，其中七方使用桂枝：孕妊使用桂枝汤安胎；又有桂苓丸去症；产后中风面赤，桂枝、附子、竹叶并用；产后哺乳期间烦乱、呕逆，用竹皮大丸内加桂枝治疗热烦。还有附方，在建中汤中加入当归进行内补。既然这样，桂枝难道不是通用之药吗？如果肉桂则性热下达，非下焦虚寒者不可用，而人们反而以为它是通用药，应该是因为使用它而多有误治。我自从钻研《金匮要略》以后，发现使用桂枝取得疗效，变幻出奇，不可名状，姑且列举出来以破除时人的困惑。
陈修园说：《金匮要略》说气短有微饮，宜从小便排出，桂苓甘术汤主治，肾气丸也主治。喻嘉言注释：呼气短，宜用桂苓甘术汤以化太阳之气；吸气短，宜用肾气丸以纳少阴之气；两个方剂都借助桂枝的力量，市井医生不懂这个道理。只是桂枝是上品之药，此时却遭遇蹇滞，而善于使用桂枝的人，也与它有同样的遭遇。癸亥年，司马公的儿媳，守寡数年，性格喜好安静，整天关户独坐，得了咳嗽病，服用生地、麦冬、百合之类的药物，一年多不见效。请我诊治，脉细小而弦紧，完全是阴霾四布，水气滔天的景象，断定为水饮咳嗽，此时如果不紧急治疗，半月后水肿发作，扁鹊再生也无能为力！说话未免过于激烈，诊察一次后，就不再与她商量。后来肿病大作，医生用槟榔、牵牛、葶苈子、厚朴、大腹皮、萝卜子为主，加上焦白术、熟地炭、肉桂、附子、茯苓、车前子、牛膝、当归、芍药、海金砂、泽泻、木通、赤小豆、商陆、猪苓、枳壳之类，出入加减。共计服用两个月，其肿全消，人瘦如柴，下午气陷脚肿，次日早晨也消退，见食则呕吐，冷汗时常流出，子午二时烦躁不宁，咳嗽辄晕。医家以肿退为有效，而病人时时觉得气散不能自持。又过几天，大汗、呕逆、气喘欲绝。又请我诊治，脉如吹毛，指甲暗，四肢冷。此前直言获罪，导致今日病不可为，我实在不能推卸责任。但尊恙一个月，我进药三剂全愈，迄今三年，还守着旧方服用，精神更加健壮，难道就忘记了吗？这次两次遵命而来，未准一见，此症已束手无策，不知有何面谕？”他的儿子说：“只求气喘略微平复。”之所以如此，非人力所能为。我不得已，用《金匮要略》桂苓甘术汤小剂来应对（茯苓二钱、白术、桂枝、炙甘草各一钱。）第二天又延请，我知道医术拙劣不能为力，坚决推辞并建议另请医生医治。后来一天去世了。随即听到医生们私下议论，桂苓甘术汤是发表之剂，对于前面的证候不宜。桂苓甘术汤难道是发表剂吗！只因为汤中的桂枝一味，由来被诽谤。我使用桂枝，招致诽谤是应该的。唉！桂枝被不了解自己的人委屈，什么时候才能大大伸张其作用呢！
桂枝的性能用途，自唐宋以后，很少有人阐明其旨意。叔父引用张隐庵的注释，字字精确。又引用徐忠可的论述，透彻发挥无遗。附录近日治案，几乎是在痛哭流涕中讲述的。他救活人的无私之心，溢于笔墨之外。我知道桂枝的功效，从此将大大彰显！另外按语：仲景书中桂枝条下，有“去皮”二字；叶天士《医林指南》方中，每用桂枝末，甚觉可笑。盖仲景所用的桂枝，只取梢尖嫩枝，内外如一，若有皮骨者去之，并非去掉枝上的皮。诸书大多未提及，特此补充。（受业侄凤腾、鸣岐注。）
Flavor: Acrid, Warm. Toxicity: Non-toxic. Indications: Governs upper qi, cough with reverse flow, stagnant qi, bi-syndrome of the throat (sore throat/dysphagia),吐吸 (abnormal breathing pattern where inhalation is difficult and exhalation is easy), benefits joints, tonifies the middle and supplements qi. Long-term use can enhance spiritual clarity, lighten the body, and prevent aging.
"Mǔ" represents Yang. Mǔguì (Cinnamon Twig/Bark) is what we now call Guizhi (Cinnamon Twig), Guipi (Cinnamon Bark), and Jungen. Jungui is what we now call Rougui (Cinnamon Bark) and Nonggui. However, the mechanism of growth and generation lies in the branches and trunk; therefore, all prescriptions by Zhang Zhongjing use Guizhi, which is Mǔguì. Contemporary physicians believe that Guizhi is used for releasing the exterior (dispersing pathogenic factors from the surface) and, due to taboos, dare not use it. Instead, they use Rougui, but insist on seeking perfection in its preparation. These are merely clever excuses to shift blame when treatments fail to cure.
Zhang Yin'an stated: Cinnamon trees do not shed their leaves in winter. Its flavor is acrid and warm, and its color is purple-red, representing Wood-Fire generated within Water. When Lung and Kidney Qi do not interact, symptoms of upper qi and cough with reverse flow occur. Cinnamon stimulates the life-giving Yang Qi within Water, sending it upward to the Lung, thereby calming upper qi and eliminating cough. Stagnant qi and throat bi-syndrome arise because Sanjiao (Triple Burner) Qi fails to circulate in the muscle interstices, leading to stagnation and throat obstruction. Cinnamon possesses the Wood Qi of Shaoyang (Lesser Yang), unblocking and benefiting the Sanjiao; thus, stagnant qi clears, and throat bi-syndrome can be treated. "Tu Xi" refers to a condition where inhalation fails to root and instead results in exhalation. Cinnamon can guide lower Qi to connect with upper Qi, allowing inhaled Qi to reach the Dantian before entering, thus treating Tu Xi. The joints—two elbows, two axillae, two thighs, and two popliteal fossae—are chambers of mechanical movement. The 365 joints throughout the body are pathways for the circulation of Shen Qi (Spiritual Qi). Cinnamon assists the Qi of Jun Huo (Ministerial Fire/Heart Fire), enabling the Shen Qi of the Heart Master to enter and exit the joints and circulate through them, thereby benefiting joint mobility. Tonifying the middle and supplementing Qi means nourishing the Middle Jiao to benefit the Qi above and below. Long-term use leads to abundant Yang Qi and brightness, thus enhancing spiritual clarity. The Sanjiao integrates Yuan Zhen (Primal True Qi) in the muscle interstices, resulting in a light body and prevention of aging.
Xu Zhongke stated: Recently, Shengqi Wan (Kidney Qi Pill) and Shiquan Dabu Tang (Ten Significant Decoction for Great Tonification) both use Rougui. This is likely because the warming properties are mixed with yin-nourishing herbs, causing no harm. As for Guizhi Tang (Cinnamon Twig Decoction), since it is the primary formula for treating Shanghan (Cold Damage), and given the saying that Guizhi should be avoided in spring and summer, later practitioners only use it for syndromes characterized by sweating, fever, and aversion to cold, avoiding it for other conditions. In spring and summer, they strictly adhere to this taboo. They do not realize that ancients used Guizhi to promote the free flow of blood and Qi, acting as a guide for other herbs. Even Shengqi Wan historically used Guizhi, with an intention beyond merely warming the lower jiao. For instance, in the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), ten formulas address deficiency consumption, seven of which use Guizhi. Guizhi Tang is used to calm the fetus during pregnancy; Guiling Wan treats specific symptoms; for postpartum wind-stroke with facial redness, Guizhi, Fuzi (Aconite Root), and Zhuye (Bamboo Leaf) are used together; for postpartum restlessness and vomiting during lactation, Guizhi is added to Zhupi Da Wan (Large Bamboo Peel Pill) to treat heat-induced irritability. Additionally, in supplementary formulas, Danggui (Angelica Sinensis) is added to Jianzhong Tang (Middle-Joint Building Decoction) for internal nourishment. Thus, is Guizhi not a universally applicable herb? Rougui, however, has a hot nature that directs downward and should only be used for deficiency-cold in the lower jiao, yet people mistakenly consider it universal, leading to frequent errors in its use. Since I devoted myself to studying the *Jingui Yaolue*, I have found that using Guizhi yields miraculous and unpredictable effects. I briefly list these to dispel contemporary confusion.
Chen Xiuyuan stated: The *Jingui Yaolue* mentions that shortness of breath due to slight fluid retention should be resolved via urination, treated with Guiling Gan Zhu Tang (Poria, Paeonia, Licorice, and Atractylodes Macrocephala Decoction); Shengqi Wan also treats this. Yu Jiayan annotated: Shortness of breath upon exhalation should be treated with Guiling Gan Zhu Tang to transform Taiyang Qi; shortness of breath upon inhalation should be treated with Shengqi Wan to grasp Shaoyin Qi. Both formulas rely on the power of Guizhi, which city physicians fail to understand. Although Guizhi is a superior-grade herb, it currently suffers from neglect, and those who skillfully use it share this same plight. In the year Guihai, the daughter-in-law of Sima Gong, having been a widow for several years, preferred quietness, sitting alone behind closed doors all day, developed a cough. She took herbs such as Shengdi (Rehmannia Root), Maidong (Ophiopogon Tuber), and Baihe (Lily Bulb) for over a year without effect. Upon my consultation, her pulse was fine, small, wiry, and tight, indicating widespread yin-cold and surging water qi. I diagnosed it as cough due to fluid retention. If not urgently treated, edema would develop within half a month, at which point even Bian Que could not help! My words may have seemed too harsh, and after one consultation, she ceased consulting me. Subsequently, the edema worsened significantly. Physicians used Binglang (Areca Seed), Qianniu (Morning Glory Seed), Tinglizi (Descurainia Seed), Houpo (Magnolia Bark), Dafupi (Betel Nut Rind), Luobozhong (Radish Seed) as main ingredients, adding Jiaobaizhu (Charred Atractylodes), Shuditan (Charred Prepared Rehmannia), Rougui, Fuzi, Fuling (Poria), Cheqianzi (Plantago Seed), Niuxi (Achyranthes Root), Danggui, Shaoyao (Peony Root), Haijinsha (Lygodium Spores), Zexie (Alisma), Mutong (Akebia Stem), Chixiaodou (Adzuki Bean), Shangling (Phytolacca Root), Zhuling (Polyporus), and Zhike (Bitter Orange) in varying combinations. After two months of medication, the edema subsided completely, but the patient became emaciated. She experienced sinking qi and swollen feet in the afternoon, which resolved by morning. She vomited upon seeing food, had spontaneous cold sweats, felt irritable and restless during Zi and Wu hours (11 PM-1 AM and 11 AM-1 PM), and fainted upon coughing. Physicians considered the reduction of edema as efficacy, while the patient felt her Qi dissipating and unable to sustain herself. A few days later, she suffered profuse sweating, vomiting, and gasping for breath. I was called again to consult. Her pulse was like blowing on goose down, her fingernails were dark, and her four limbs were cold. Previously, I had spoken frankly about the error, leading to the current incurable state; I cannot escape responsibility. However, regarding your illness one month ago, I prescribed three doses which cured you completely. For three years since, you have continued taking the old prescription, and your spirit has become even stronger. Have you forgotten? You came twice following orders but refused to see me. Now the condition is untreatable. What instructions do you have?" His son replied, "I only ask for slight relief of the asthma." This outcome was not due to human effort. Reluctantly, I used a small dose of Guiling Gan Zhu Tang from the *Jingui Yaolue* (Fuling 2 qian, Baizhu, Guizhi, and Zhi Gancao each 1 qian). The next day, I was consulted again, but knowing my limited ability to help further, I firmly declined and advised seeking another physician. She died the following day. Soon after, I heard physicians privately discussing that Guiling Gan Zhu Tang is a formula for releasing the exterior and was inappropriate for the previous condition. Is Guiling Gan Zhu Tang really an exterior-releasing formula! It is solely because the single herb Guizhi in the decoction has long been slandered. My use of Guizhi naturally invites slander. Alas! When will Guizhi, wronged by those who do not understand it, finally have its functions fully realized!
Since the Tang and Song dynasties, few have clarified the true nature and application of Guizhi. My uncle quoted Zhang Yin'an's annotations, which are precise in every word. He also quoted Xu Zhongke's discussion, which thoroughly expounds the subject. I append recent case records, narrated almost with tears of grief. His heart for saving lives knows no bounds, overflowing beyond the written words. I know that the merits of Guizhi will henceforth be greatly manifested! Note: Under the branch of Guizhi in Zhang Zhongjing's books, there are the characters "remove skin." In Ye Tianshi's *Yilin Zhinan* (Guide to the Medical Forest), formulas often use Guizhi powder, which seems ridiculous. The Guizhi used by Zhang Zhongjing referred only to the tender tips of the branches, uniform inside and out. If there were bark or woody parts, they were removed; it did not mean removing the skin from the twig itself. Most books do not mention this, so I specifically add this clarification. (Annotated by disciples/nephews Feng Teng and Ming Qi.)