治太阳中风，脉浮紧，发热恶寒，身疼痛，不汗出而烦躁，无少阴证者。若脉微弱，汗
出恶风者，不可服，服之则厥逆筋惕肉 ，此为逆也。
麻黄（六两去节） 桂枝（去皮） 甘草（各二两炙） 杏仁（四十枚去皮尖） 生姜
（三两切） 大枣（十二枚） 石膏（鸡子大一块打） 以水九升，先煮麻黄减二升，去沫，
纳诸药，煮取三升，去滓，温服一升。取微似汗。汗出多者，温粉扑之。一服汗者，停后服。
汗多亡阳，遂虚
大青龙汤桂麻黄，杏草石膏姜枣藏。发热恶寒太阳病，无汗烦躁力能攘。（“发热恶寒无
汗烦躁”八字，是大青龙着眼。）一服汗出停后服，汗多温粉扑之良。（仲景温粉方失，成无
己《伤寒明理论》用白芷、 本、白术、川芎、米粉扑之。）寒之浅者仅伤卫，风而甚者营
亦伤。中风卫实因烦躁，清火发汗此方强。（按∶风伤卫，寒伤营，中风脉浮缓，伤寒脉浮
紧，是大法也。此大青龙脉证俱属伤寒，而去中风者，全在烦躁上看出。若寒邪，则但呕逆，
惟
盖风寒中伤，各有浅深，又各随其人之体气虚实而为病。是以寒之浅者，仅伤于卫，风
而甚者，并及于营；卫之实者，风亦难泄，卫而虚者，寒犹不固。正是互文见意处。此汤治
中风卫实之法，乃清火发汗之重剂也。）证较麻黄为尤重，预保阳明圣法彰。（柯韵伯《伤寒
来苏集》曰∶“此麻黄证之剧者，故于麻黄汤倍麻黄以发汗，加石膏以除烦。”“诸证全是麻
黄，而有喘与烦躁之别∶喘是寒郁其气，升降不得自如，故多用杏仁之苦以降气；烦躁是热
伤其气，无津不能作汗，故特加石膏之甘以生津。”“用石膏以清胃火，是仲景于太阳经中，
预保阳明之先着。加姜、枣以培中气，又虑夫转属太阴。”“一汗而表里双解，风热两除，此
大青龙清内攘外之功，所以佐麻、桂二方之不及也。”）少阴烦躁脉微弱，恶风汗出不相当。
（少阴亦有烦躁证，以脉微弱，汗出恶风为辨，不可服此。仲景立此方，即垂此戒，叮咛之
意深矣。）热因寒用方堪救，误服青龙阳必亡。（少阴烦躁，当热因寒用，如四逆汤加猪胆之
例，方可救其万一。若误服青龙，必召亡阳之祸，慎之。）
治疗太阳中风证，表现为脉象浮紧，发热且恶寒，身体疼痛，无汗并伴有烦躁不安，且没有少阴病证候的患者。如果脉象微弱，有汗出且怕风的情况，则不可服用此方；若误服，会导致四肢厥冷、筋脉跳动及肌肉瞤动，这属于误治的逆证。
麻黄（六两，去节） 桂枝（去皮） 甘草（各二两，炙） 杏仁（四十枚，去皮尖） 生姜（三两，切片） 大枣（十二枚） 石膏（如鸡蛋大小一块，打碎）。用水九升，先煮麻黄，水量减少二升，撇去浮沫，加入其余药物，煎煮至取药液三升，滤去药渣，温服一升。服药后以微微出汗为宜。若汗出过多，可用温粉扑洒身体。服用一次即出汗者，停止服用后续药物。汗出过多会导致亡阳，从而造成虚损。
大青龙汤由桂枝汤与麻黄汤加减而成，包含麻黄、杏仁、甘草、石膏、生姜、大枣。针对发热恶寒的太阳病，对于无汗且烦躁的症状具有强大的缓解作用。（“发热、恶寒、无汗、烦躁”这八个字，是大青龙汤辨证的关键所在。）服用一次若汗出，则停服余药；若汗多，用温粉扑身效果良好。（张仲景的温粉具体配方已失传，成无己在《伤寒明理论》中建议使用白芷、藁本、白术、川芎配合米粉扑身。）寒邪浅表仅伤及卫气，风邪严重则营气亦受损。中风导致卫气实盛因见烦躁，此方清火发汗之力最强。（按语：风伤卫，寒伤营，中风脉象浮缓，伤寒脉象浮紧，这是基本法则。此处大青龙汤的脉证均属于伤寒范畴，却区别于普通中风证，关键在于是否出现烦躁。若是纯寒邪，通常仅有呕吐逆气，唯有……盖风寒中伤人体，各有深浅，且随个人体质虚实而发病。因此寒邪浅者仅伤卫，风邪重者兼伤营；卫气实者，风邪难泄；卫气虚者，寒邪不固。这正是文中互文见意的地方。此汤是治疗中风卫实证的方法，属于清火发汗的重剂。）其证候较麻黄汤证更为严重，预先保护阳明经是圣明的法则。（柯韵伯在《伤寒来苏集》中说：“这是麻黄汤证的剧烈情况，所以在麻黄汤基础上倍用麻黄以发汗，加石膏以除烦。”“诸证类似麻黄汤证，但有喘与烦躁的区别：喘是寒邪郁闭肺气，升降失常，故多用杏仁之苦以降气；烦躁是热邪伤气，津液不足无法作汗，故特加石膏之甘以生津。”“使用石膏以清胃火，是张仲景在太阳经病中，预先保护阳明的先手棋。加姜、枣以培补中气，又担心病邪转属太阴。”“一汗而表里双解，风热两除，这是大青龙汤清内攘外的功效，所以弥补了麻黄、桂枝二方的不足。”）少阴病的烦躁脉象微弱，恶风汗出与此不相符合。（少阴病也有烦躁证，以脉微弱、汗出恶风为鉴别点，不可服用此方。张仲景设立此方，即是以此作为警戒，叮咛之意深远。）热因寒用的方法才能救治，误服大青龙汤阳气必亡。（少阴病烦躁，应当采用热因寒用的方法，如四逆汤加猪胆汁的例子，方可挽救万一。若误服大青龙汤，必然招致亡阳的祸患，务必谨慎。）
Treats Taiyang wind-stroke (Taiyang wind-stroke: a syndrome caused by wind pathogen invading the Taiyang channel) with floating-tight pulse, fever and aversion to cold, body pain, anhidrosis accompanied by irritability, provided there are no Shaoyin disease signs. If the pulse is faint and weak, with sweating and aversion to wind, this formula must not be administered; if taken in error, it will lead to cold extremities (Jue Ni), twitching of sinews, and fasciculation of muscles, which constitutes a therapeutic deviation (Ni).
Ephedrae Herba (Mahuang, 6 liang, nodes removed), Cinnamon Twig (Guizhi, bark removed), Licorice Root (Gancao, 2 liang each, honey-fried), Apricot Seed (Xingren, 40 seeds, skin and tips removed), Fresh Ginger (Shengjiang, 3 liang, sliced), Jujube (Dazao, 12 pieces), Gypsum Fibrosum (Shigao, one piece the size of a chicken egg, crushed). Use nine sheng of water, first decoct Ephedrae Herba until the volume reduces by two sheng, skim off the foam, then add the remaining herbs. Decoct to obtain three sheng of liquid, filter out the dregs, and take one sheng warm. The goal is a slight perspiration. If sweating is excessive, apply warm powder to the body. If sweating occurs after the first dose, discontinue subsequent doses. Excessive sweating leads to loss of Yang Qi (Wang Yang), resulting in deficiency.
Da Qing Long Tang consists of modifications of Gui Zhi Tang and Ma Huang Tang, containing Mahuang, Xingren, Gancao, Shigao, Shengjiang, and Dazao. It addresses Taiyang disease characterized by fever, aversion to cold, anhidrosis, and irritability, possessing strong efficacy in resolving these symptoms. ("Fever, aversion to cold, anhidrosis, and irritability" are the key diagnostic points for Da Qing Long Tang.) Stop subsequent doses if sweating occurs after one administration; applying warm powder is beneficial if sweating is excessive. (Zhang Zhongjing's original recipe for warm powder is lost; Cheng Wuji in *Shanghan Mingli Lun* suggested using Angelica Dahurica (Baizhi), Ligusticum Wallichii (Qubai), Atractylodes Macrocephala (Baizhu), Ligusticum Chuanxiong (Chuanxiong), mixed with rice flour.) When cold pathogen is superficial, it only injures Wei Qi (Defensive Qi); when wind pathogen is severe, Ying Qi (Nutritive Qi) is also injured. Wind-stroke causing excess in Wei Qi manifests as irritability; this formula is potent for clearing heat and inducing sweating. (Note: Wind injures Wei, Cold injures Ying. Wind-stroke presents with floating-slow pulse, while Cold-pathogen presents with floating-tight pulse, which is the general principle. The pulse and symptoms here belong to Cold-pathogen, yet differ from typical wind-stroke due to the presence of irritability. Pure cold pathogen typically causes only vomiting and regurgitation... Cold and wind pathogens invade at varying depths and manifest according to individual constitutional deficiency or excess. Thus, shallow cold injures only Wei, while severe wind injures both Ying and Wei. In Wei excess, wind is hard to dissipate; in Wei deficiency, cold fails to consolidate. This illustrates the literary device of mutual implication. This decoction treats wind-stroke with Wei excess, being a heavy agent for clearing heat and inducing sweating.) Its syndrome is more severe than that treated by Ma Huang Tang; preserving the Yangming stage preemptively is a sage method. (Ke Yunbo in *Shanghan Laisu Ji* stated: "This is a severe form of Ma Huang Tang syndrome, hence doubling Mahuang to induce sweating and adding Shigao to remove irritability." "The symptoms resemble Ma Huang Tang, but differ in wheezing versus irritability: Wheezing is due to cold stagnating Qi, impairing ascending and descending functions, thus Bitter Apricot Seed is used to descend Qi; Irritability is due to heat injuring Qi and lack of fluids preventing sweating, thus Sweet Gypsum is added to generate fluids." "Using Shigao to clear Stomach fire is Zhang Zhongjing's preemptive move to protect Yangming within the Taiyang stage. Adding Shengjiang and Dazao to support Middle Qi prevents transmission to Taiyin." "One sweat resolves both exterior and interior, dispelling both wind and heat; this demonstrates Da Qing Long Tang's merit in clearing internal heat and expelling external pathogens, supplementing the deficiencies of Ma Huang Tang and Gui Zhi Tang.") Shaoyin irritability with faint-weak pulse, aversion to wind and sweating, does not match this indication. (Shaoyin disease also presents with irritability, differentiated by faint-weak pulse, sweating, and aversion to wind; this formula is contraindicated. Zhang Zhongjing established this formula as a warning, conveying deep cautionary intent.) Using heat to treat cold conditions can save the patient; misusing Da Qing Long Tang will inevitably cause loss of Yang. (For Shaoyin irritability, one should use heat to treat cold, such as Si Ni Tang with Porcine Bile, to salvage the situation. Misuse of Da Qing Long Tang will inevitably invite the disaster of Yang collapse; exercise extreme caution.)