治太阳病桂枝证。医反下之。利遂不止。脉促者。表未解也。喘而汗出者
葛根（半斤） 甘草（二两） 黄芩（二两） 黄连（二两）
上四味。以水八升。先煮葛根。减二升。纳诸药。煮取二升。去滓。分温再服。
歌曰 二两连芩二两甘。葛根八两论中谈。喘而汗出脉兼促。误下风邪利不堪。（一本。
黄连三两。）
蔚按。太阳桂枝证而反下之。邪由肌腠而内陷于中土。故下利不止。脉促与喘汗者。内
陷之
肺主皮毛而汗出。方主葛根。从里以达于表。从下以腾于上。辅以芩、连之苦。苦以坚之。
坚毛窍而止汗。坚肠胃以止泻。又辅以甘草之甘。妙得苦甘相合。与人参同味而同功。所以
补中土而调脉道。真神方也。许宏方议云。此方亦能治阳明大热下利者。又能治嗜酒之人热
喘者。取用不穷也。（蔚按。金桂峰之女患痢。身热如焚。法在不治。余断其身热为表邪。
用人参败毒散。继服此方全愈。益信长沙方之取用不穷也。）
治太阳病头疼发热。身疼腰痛。骨节疼痛。恶寒无汗而喘者。此方主之。
麻黄（三两 去节。） 桂枝（二两 去皮。） 杏仁（七十个 去皮尖。） 甘草（一
两炙。）
上四味。以水九升。先煮麻黄减二升。去上沫。内诸药。煮取二升半。去滓。温服八合。
覆
按。今医不读神农本草经。耳食庸医唾余。谓麻黄难用。而不知气味轻清。视羌、独、
荆
歌曰 七十杏仁三两麻。一甘二桂效堪夸。喘而无汗头身痛。温覆休教粥到牙。
蔚按。以上俱言桂枝证。至此方言麻黄证也。方下所列各证。皆兼经气而言。何谓经。
内经云。太阳之脉。上连风府。上头项。挟脊。抵腰。至足。循身之背是也。何谓气。内经
云。太阳之上。寒气主之。又云。三焦膀胱者。腠理毫毛其应。是太阳之气主周身之表而主
外也。桂枝证病在肌腠。肌腠实则肤表虚。故以自汗为提纲。此证病在肤表。邪在肤表则肤
表实。故以无汗为提纲。无汗则表气不通故喘。痛而曰疼痛之甚也。此经与气并伤。视桂枝
证较重。故以麻黄大开皮毛为君。以杏仁利气。甘草和中。桂枝从肌以达表为辅佐。覆取似
汗而不啜粥。恐其逗留麻黄之性。发汗太过也。
治疗太阳病桂枝证。医生反而使用攻下法。导致腹泻不止。脉象急促的。说明表证未解。出现气喘且出汗的症状，用葛根黄芩黄连汤主治：
葛根（半斤） 甘草（二两） 黄芩（二两） 黄连（二两）
以上四味药。用水八升。先煮葛根。水量减少二升后。加入其余药物。煎煮取汁二升。滤去药渣。分两次温服。
歌诀说：二两黄连二两黄芩二两甘草。葛根八两在医论中讨论。气喘且出汗脉象兼见急促。误用下法导致风邪内陷引起难以忍受的腹泻。（另一版本记载黄连为三两。）
陈蔚按语：太阳病桂枝证却反用攻下法，邪气由肌腠陷入中焦脾胃。所以腹泻不止。脉促与喘汗，是邪气内陷的表现。肺主皮毛而致出汗。方中以葛根为主药，从里达表，从下向上提升。辅以黄芩、黄连的苦味，苦能坚阴。坚固毛窍以止汗。坚固肠胃以止泻。又辅以甘草的甘味，妙在苦甘相合，与人参味道相同且功效相近。所以能补益中焦脾胃并调和脉道。真是神妙的方剂。许宏在《方议》中说：此方也能治疗阳明经大热引起的腹泻。又能治疗嗜酒之人因热致喘的情况。应用广泛无穷尽。（陈蔚按语：金桂峰的女儿患痢疾，身体发热如火烧，按照常规属于难治之症。我判断她的发热为表邪未解。让人参败毒散治疗后，继服此方完全痊愈。更加相信张仲景的方子应用无穷尽。）
治疗太阳病头痛发热。身体疼痛腰痛。骨节疼痛。恶寒无汗且气喘的。用麻黄汤主治：
麻黄（三两 去节。） 桂枝（二两 去皮。） 杏仁（七十个 去皮尖。） 甘草（一两 炙。）
以上四味药。用水九升。先煮麻黄减少二升。去掉水面上的浮沫。加入其余药物。煎煮取汁二升半。滤去药渣。温服八合。服药后覆盖衣被。
歌诀说：七十粒杏仁三两麻黄。一两甘草二两桂枝疗效值得夸耀。气喘而无汗头身痛。温覆取微汗不要喝粥到牙齿。
陈蔚按语：以上都讲的是桂枝证，到这里才讲麻黄证。方剂下列出的各种症状，都是结合经络之气而言的。什么叫经？《内经》说：太阳经脉，上连风府穴，上行至头项，夹脊背，抵腰部，至足部，循行于身体背部。什么叫气？《内经》说：太阳之上，寒气主令。又说：三焦和膀胱，对应腠理毫毛。这是太阳之气主管周身体表而主外的表现。桂枝证的病位在肌腠，肌腠实则肤表虚。所以以自汗作为提纲。此证病位在肤表，邪气在肤表则肤表实。所以以无汗作为提纲。无汗则表气不通所以气喘。疼痛是指疼痛得很厉害。这是经络与气同时受伤，比桂枝证病情较重。所以用麻黄大开毛孔作为君药。用杏仁利气。甘草和中。桂枝从肌腠通达体表作为辅佐药。覆盖衣被取似有汗的效果而不喝热粥，担心其逗留麻黄的药性，导致发汗太过。
Treats Taiyang disease (Taiyang syndrome) presenting with Guizhi Tang pattern. The physician erroneously applied purgation, resulting in persistent diarrhea. If the pulse is rapid (Cu), it indicates that the exterior syndrome remains unresolved. For cases accompanied by wheezing and sweating, Gegen Huangqin Huanglian Tang (Kudzu Root, Scutellaria, and Coptis Decoction) is indicated:
Gegen Radix Puerariae Lobatae (Gegen, Kudzu Root) - half jin (approx. 240g)
Gancao Radix Glycyrrhizae Preparata (Gancao, Prepared Licorice Root) - two liang (approx. 30g)
Huangqin Cortex Scutellariae (Huangqin, Scutellaria Root) - two liang (approx. 30g)
Huanglian Rhizoma Coptidis (Huanglian, Coptis Rhizome) - two liang (approx. 30g)
Take the above four herbs. Add eight sheng (approx. 1600ml) of water. First decoct Gegen until the volume reduces by two sheng. Then add the remaining herbs. Continue decocting to obtain two sheng (approx. 400ml) of liquid. Strain the dregs. Divide into two doses and take warm.
The song states: Two liang each of Huanglian, Huangqin, and Gancao are discussed in theory. Wheezing, sweating, and a rapid pulse indicate that erroneous purgation has trapped wind-pathogen, causing unbearable diarrhea. (Another version records Huanglian as three liang.)
Chen Wei notes: When Taiyang Guizhi pattern is erroneously treated with purgation, the pathogen sinks from the muscle layer (Ji Cou) into the Middle Jiao (Spleen and Stomach). Hence, diarrhea persists. The rapid pulse, wheezing, and sweating are signs of internalized pathogen. The Lung governs the skin and hair, leading to sweating. Gegen is the chief herb in this formula, drawing pathogen from the interior to the exterior, and lifting from below upwards. It is assisted by the bitter properties of Huangqin and Huanglian; bitterness can "firm" (astringe/strengthen). It firms the pores to stop sweating and firms the intestines and stomach to stop diarrhea. It is further assisted by the sweet property of Gancao. The combination of bitter and sweet mirrors the action of Renshen (Ginseng Root), thereby tonifying the Middle Jiao and regulating the pulse channels. Truly a miraculous formula. Xu Hong in *Fang Yi* states: This formula can also treat severe heat-induced diarrhea in Yangming disease, and wheezing caused by heat in alcoholics. Its applications are boundless. (Chen Wei notes: Miss Jin Guifeng suffered from dysentery with high fever resembling burning fire, which was considered incurable by standard methods. I diagnosed her fever as residual exterior pathogen. After treatment with Renshen Baidu San, she recovered completely after taking this formula. This further confirms the boundless utility of Zhang Zhongjing's formulas.)
Treats Taiyang disease presenting with headache, fever, body pain, lower back pain, joint pain, aversion to cold, absence of sweating, and wheezing. Ma Huang Tang (Ephedra Decoction) is indicated:
Mahuang Herba Ephedrae (Mahuang, Ephedra Stem) - three liang (approx. 45g), remove joints.
Guizhi Ramulus Cinnamomi (Guizhi, Cinnamon Twig) - two liang (approx. 30g), remove bark.
Xingren Semen Armeniacae Amarum (Xingren, Apricot Seed) - seventy kernels, remove skin and tips.
Gancao Radix Glycyrrhizae Preparata (Gancao, Prepared Licorice Root) - one liang (approx. 15g), honey-fried.
Take the above four herbs. Add nine sheng (approx. 1800ml) of water. First decoct Mahuang until the volume reduces by two sheng. Remove the foam on the surface. Then add the remaining herbs. Continue decocting to obtain two and a half sheng (approx. 500ml) of liquid. Strain the dregs. Take eight ge (approx. 160ml) warm. Cover with blankets after ingestion.
The song states: Seventy Xingren, three liang Mahuang, one liang Gancao, and two liang Guizhi yield praiseworthy efficacy. Wheezing without sweat, headache, and body pain require warming coverage to induce slight sweating; do not drink hot porridge to avoid excessive sweating.
Chen Wei notes: The preceding text discusses Guizhi patterns; here, we discuss Ma Huang patterns. The symptoms listed under the formula relate to the Qi of the meridians. What is the Meridian? *Neijing* states: The Taiyang meridian connects to Fengfu (GV16), ascends to the head and nape, flanks the spine, reaches the waist, descends to the feet, and runs along the back of the body. What is Qi? *Neijing* states: On top of Taiyang, Cold Qi dominates. It also states: The Sanjiao and Bladder correspond to the interstices and body hair. Thus, Taiyang Qi governs the entire exterior surface. In Guizhi pattern, the pathology lies in the muscle layer (Ji Cou); when the muscle layer is full, the superficial surface is deficient. Hence, spontaneous sweating is the guiding symptom. In this pattern, the pathology lies in the superficial surface; when pathogen is in the superficial surface, it is solid/full. Hence, absence of sweating is the guiding symptom. Absence of sweating leads to obstruction of exterior Qi, causing wheezing. "Pain" refers to severe pain. This involves injury to both the meridian and the Qi, making it more severe than Guizhi pattern. Therefore, Mahuang is used as the Chief herb to vigorously open the pores. Xingren is used to promote Qi movement. Ganzhong harmonizes the Middle Jiao. Guizhi acts as an Assistant, reaching the exterior from the muscle layer. Coverage is used to induce slight sweating without drinking hot porridge, to prevent Mahuang's acrid-warm nature from becoming too potent and causing excessive sweating.