雍曰。自此以下。皆仲景本论。更不设问。恐滋繁言。第曰仲
景曰。继则又曰而已。其他书所言。及有疑者。方设问以答之。本
论有仲景原答问者。则首曰仲景问曰是也。其次并根据仲景本论。
先后不复易云。
仲景曰。脉尺寸俱浮者。太阳受病也。当一二日发。以其上连风府。故头项痛。腰脊强。
又曰。太阳之为病。脉浮。头项强痛而恶寒。
又曰。太阳病。发热。汗出。恶风。脉缓（谓浮而缓）者。名曰中风。
又曰。太阳病。或已发热。或未发热。必恶寒。体痛。呕逆。脉阴
阳俱紧者。名曰伤寒。王叔和曰。太阳病。脉浮而数。可发其汗。属桂
枝汤。
又曰。太阳病未解。其脉浮弱。当以汗解。宜桂枝汤。
又曰。太阳病。头痛发热。汗出恶风。若恶寒。属桂枝证。汗出恶寒。亦属桂
枝。常颖士器之补治论曰。汗出恶风。宜桂枝汤。无汗恶寒。宜麻黄
汤。雍曰。中风伤寒二证。本以有汗无汗而分。桂枝麻黄二汤。亦分
有汗无汗而用。故汗出亦有恶寒者。亦属中风。王叔和亦用桂枝。不
以恶寒而改用麻黄者。谓其有汗也。
问曰。太阳一经。何其或有汗或无汗也。雍曰。系乎营卫之气
也。营行脉中。卫行脉外。亦以内外和谐而后可行也。风邪之气。中
浅则中卫。中卫则卫强。卫强不与营相属。其 悍之气。随空隙而外
出。则为汗矣。故有汗者。卫气遇毛孔而出者也。寒邪中深。则涉卫
中营。二气俱受病。无一强一弱之证。寒邪营卫相结而不行。则卫气
无自而出。必用药发其汗。然后邪去而营卫复通。故虽一经。有有汗
无汗二证。亦有桂枝解表麻黄发汗之治法不同也。仲景论营卫和不
和。俱见于后。
千金曰。伤寒一日。太阳脉弱。至四日。太阴脉大。
仲景曰。伤寒一日。太阳受之。脉若静者。为不传。颇欲吐。若躁
烦。脉数急者。为传也。常器之曰。宜辨中风伤寒。有汗无汗。用麻黄
桂技二汤。孙真人曰。太阳病三四日。不吐下。见芤。乃汗之。
又曰。太阳病。发热而渴。不恶寒者。为温病。若发汗已。身灼热
者。名风温。风温为病。脉阴阳俱浮。自汗出。身重。多眠睡。鼻息必
鼾。语言难出。若被下者。小便不利。直视失溲。若被火者。微发黄
色。剧则如惊痫。时螈 。若火熏之。一逆尚引日。再逆促命期。常器
之补治论曰。转下火熏。皆为逆也。可白虎加人参汤、桂枝柴胡各半
汤、桂枝去芍药加蜀漆龙骨牡蛎救逆汤。雍曰。救逆汤治被火熏则
无疑。桂枝柴胡各半汤。即柴胡桂枝汤也。然有三证。汗多亡阳。外
证未去。虽谵语。亦不可下。当和营卫。通津液。用柴胡桂枝汤。此未
被下时可用也。若已发汗。又复下之。小便不利。渴而不呕。此为未
解。宜柴胡桂枝干姜汤。此被下后。小便不利而渴者。可用也。若伤
寒八九日。下之。胸满烦惊。小便不利。用柴胡加龙骨牡蛎汤。此被
下后。小便不利。有烦惊证者。可用也。惟白虎加人参汤。治大渴饮
水。口干舌燥。无表证者。可服。脉浮。表未解者。不可服。今温病风
温。表未解者。皆脉浮。则不可服明矣。白虎加人参。本治里热太阳
发热而渴。非里热不可服。故今去之。
又曰。病有发热恶寒者。发于阳也。无热恶寒者。发于阴也。发
于阳者。七日愈。发于阴者。六日愈。以阳数七。阴数六故也。庞氏
曰。发于阳者。随证用汗药攻其表。发于阴者。用四逆辈温其内。
又曰。太阳病。头痛。至七日以上自愈者。以行其经尽故也。若
欲作再经者。针足阳明。（庞云补三里穴）使经不传则愈。问曰。经言
其死皆以六七日之间而论。言七日以上自愈何也。雍曰。感之重而
证有变异者死。感之轻而证无变异者自愈也。
又曰。风家表解而不了了者。十二日愈。（庞注云。方言曰。南楚疾愈。或谓之瘥。或谓之了。）
又曰。病患身大热。反欲得近衣者。热在皮肤。寒在骨髓也。身
大寒。反不欲近衣者。寒在皮肤。热在骨髓也。朱氏曰。热在皮肤者。
表热里寒。宜先与阴旦汤。寒已。次以小柴胡加桂以温其表。寒在皮
肤者。表寒里热。宜先以白虎加参汤除热。次以麻桂各半汤解其表。
大抵病有标本。治有先后。表热里寒。脉必沉而迟。手足微厥。下利
清谷也。所以阴证亦有发热者。四逆汤、通脉四逆汤主之。表寒里热
者。脉必滑而厥。口燥舌干也。所以少阴恶寒而蜷。时时自烦。不欲
浓衣。用大柴胡汤下之而愈。雍曰。皮肤固为表而骨髓为里。有二
说。所以仲景不直言表里。而曰皮肤骨髓也。夫表里者。人身之阴阳
也。灵枢六篇曰。内有阴阳。外亦有阴阳。在内者。五脏为阴。六腑为
阳。在外者。筋骨为阴。皮肤为阳。今朱氏虽从表里法治之。然是以
在内治里之法。而治在外之里也。常器之只用桂枝麻黄各半汤。虽
亦有理。又疑麻黄虽能和营卫。而不至骨髓。朱氏似失之深。常氏似
失之浅。宜于二者之间消息用药。或用朱氏之药。则少与之。用常氏之药。则多与之可也。
又曰。太阳中风。阳浮而阴弱。阳浮者热自发。阴弱者汗自出。
啬啬恶寒。淅淅恶风。翕翕发热。鼻鸣干呕者。桂枝汤主之。千金翼曰。太阳中风。发热而恶寒。
又曰。太阳病。头痛发热。汗出恶风者。桂枝汤主之。
又曰。太阳病。项背强KT KT 。反汗出恶风者。桂枝加葛根汤主之。
又曰。太阳病。下之后。其气上冲者。可与桂枝汤。若不上冲者。不可与之。
又曰。太阳病三日。已发汗。若吐。若下。若温针。仍不解者。此为坏病。桂枝不中与也。观其脉证。知犯何逆。
随证治之。
又曰。桂枝本为解肌。若其人脉浮紧。发热汗不出者。不可与之。常须识此。勿令误也。常器之云。可麻黄汤。
又曰。若酒客病。不可与桂枝汤。得汤则呕。以酒客不喜甘故也。
又曰。喘家作桂枝汤。加浓朴杏子佳。
又曰。凡服桂枝汤吐者。其后必吐脓血也。常氏曰。可服类要芍药地黄汤。雍曰。见脓血而后可服。
又曰。太阳病。发汗。遂漏不止。其人恶风。小便难。四肢微急。难以屈伸者。桂枝加附子汤主之。千金云。桂枝
汤加附子一个炮即是。庞氏曰。若小便数。切不可行此汤。宜用芍药甘草汤。若误行桂枝加附子汤攻表。则咽干烦躁。
厥逆呕吐者。作甘草干姜汤与之。以复阳气。若厥愈足温。更与芍药甘草汤。其脚即伸。若胃气不和。谵
语者。少与调胃承气汤。微溏则谵语止。雍曰。此仲景治自汗小便数之法。庞氏以治发汗漏不止小便数。其证实一也。
又曰。太阳病。下之后。脉促胸满者。桂枝去芍药汤主之。若微恶寒者。桂枝去芍药方中加附子汤主之。
又曰。太阳病。得之八九日。如疟状。发热恶寒。热多寒少。其人不呕。清便欲自可。一日二三度发。脉微缓者。
为欲愈也。脉微而恶寒者。此阴阳俱虚。不可更发汗更下更吐也。面色反有热色者。未欲解也。以其不能得小汗出。身
必痒。宜桂枝麻黄各半汤。
又曰。太阳病。初服桂枝汤。反烦不解者。先刺风池风府。却与
桂枝汤则愈。雍曰。仲景云。太阳受病。上连风府。故治伤寒以风府
为要穴。风池次之。然风府近脑户。或疑不敢刺。在法又禁灸。风池则灸刺皆无禁也。
又曰。服桂枝汤。大汗出。脉洪大者。与桂枝汤如前法。若形似疟。日再发者。汗出必解。宜桂枝二麻黄一汤。
又曰。服桂枝汤。大汗出后。大烦渴不解。脉洪大者。白虎加人参汤主之。
又曰。太阳病。发热恶寒。热多寒少。脉微弱者。此无阳也。不可发汗。宜桂枝二越婢一汤。千金云。不可发汗。
又曰。服桂枝汤。或下之。仍头项强痛。翕翕发热。无汗。心下满。微痛。小便不利者。桂枝去桂加茯苓白术汤主
之。
又曰。伤寒脉浮。自汗出。小便数。心烦。微恶寒。脚挛急。反与
桂枝汤。欲攻其表。此误也。得之便厥。咽中干。烦躁吐逆者。作甘草
干姜汤与之。以复其阳。若厥愈足温者。更作芍药甘草汤与之。其脚
即伸。若胃气不和。谵语者。少与调胃承气汤。若重发汗。复加烧针者。四逆汤主之。（见九卷）
仲景问曰。证象阳旦。（阳旦即桂枝异名）按法治之而增剧。厥
逆。咽中干。两胫拘急而谵语。师言夜半手足当温。两脚当伸。后如
师言。何以知此。答曰。寸口脉浮而大。浮则为风。大则为虚。风则生
微热。虚则两胫挛。病证象桂枝。因加附子参其间。增桂令汗出。附
子温经。亡阳故也。厥逆。咽中干。烦躁。阳明内结。谵语烦乱。更饮
甘草干姜汤。夜半阳气还。两足当热。胫尚微拘急。重与芍药甘草
汤。尔乃胫伸。以承气汤微溏。则止其谵语。故知病可愈。雍曰。此一
段问答。重解释前段误用桂枝加附子之证。按法治之。谓令服桂枝
汤也。以此推之。则证象阳旦者。小便不利。则用桂枝加附子汤。小
便数。则用甘草干姜汤、芍药甘草汤。惟以小便为准耳。庞氏曰。两
胫挛。小便数。仍汗出。为津液少。不可误行桂枝汤。宜补虚退热。用
芍药甘草汤通治。
又曰。太阳病。项背强KT KT 。无汗恶风。葛根汤主之。
又曰。太阳与阳明合病者。必自下利。葛根汤主之。（一云。用葛根茯苓黄连汤。方未见。疑即葛根黄芩黄连汤。）
又曰。太阳与阳明合病。不下利。但呕者。葛根加半夏汤主之。千金云。葛根汤中加半夏半升。
又曰。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。葛根黄芩黄连汤主之。
又曰。太阳病。头痛发热。身疼腰痛。骨节疼痛。恶风。无汗而喘者。麻黄汤主之。
又曰。太阳与阳明合病。喘而胸满者。不可下。宜麻黄汤主之。
又曰。太阳病。十日已去。脉浮细而嗜卧者。外已解也。设胸满胁痛者。与小柴胡汤。脉但浮者。与麻黄汤。
问曰。太阳病论有言至七日以上。有言十日已去。若此之类。未
知传经与不传经也。雍曰。究其意。义虽可见。又当以脉证辨之。且
如七日以上自愈者。谓六日传经已遍而无变异也。十日已去。设有
胸满胁痛者。是传阳明也。其脉浮而无他证者。只在太阳不传。故仲
景犹用麻黄也。所以朱氏言寒邪中人。不必皆始于太阳。兼有首尾
止在一经。或间传一二经。不可以一理推。但据脉与外证治之。若过
日多。脉大浮数。按之不足者。尚责太阳。发汗而愈。此即仲景十日
已去脉但浮者。服麻黄汤之意也。有汗者何如。曰。详证于诸桂枝汤
中选用之。朱又云。不必皆始于太阳者何如。曰。雍虽未之见。在理
应有之。须证脉可辨。如感疾头不甚痛。即非太阳也。盖感病之变异者也。如巨阳先受邪。则世俗谓之正伤寒也。
仲景曰。太阳中风。脉浮紧。发热恶寒。身疼痛。不汗出而烦躁
者。大青龙汤主之。若脉微弱。汗出恶风者。不可服。服之则厥逆。筋
惕肉 。此为逆也。雍曰。中风而脉浮紧。是中风见寒脉也。故可服。
若脉微弱。则非寒脉。又汗出恶风。亦皆中风证。故不可服。设服之。
则汗漏不止。筋惕肉 而死。筋惕肉 者。以亡阳故也。其详别见可汗门中。
又曰。伤寒脉浮缓。身不疼。但重。乍有轻时。无少阴证者。大青
龙汤发之。雍曰。伤寒而脉浮缓。是伤寒见风脉也。少阴里证。大青
龙发表药。故无少阴证者可服。少阴。口燥舌干而渴是也。庞氏云。
当作无太阴证。且仲景于不可发汗证中。已言少阴病不可发汗。况
用大青龙汤。尤为不可。则此用少阴字为无疑。而庞氏因脉证相似。
乃云当作太阴证。虽庞氏之误。然太阴病亦不可发汗。三阴皆不可
服。特少阴最为紧急耳。仲景大青龙汤。惟此两证。以其汗出亡阳太
暴。善医者复不敢用。往往临时审证。以他药代之。若用桂枝麻黄各半汤亦好。惟是力缓。宜多服和解之。
又曰。伤寒表不解。心下有水气。干呕发热而咳。或渴。或利。或噎。或小便不利少腹满。或喘者。小青龙
汤主之。
又曰。伤寒。心下有水气。咳而微喘。发热不渴。服汤已渴者。此寒气欲解也。小青龙汤主之。
又曰。太阳病。外证未解。脉浮弱者。当以汗解。宜桂枝汤。
又曰。太阳病。下之。微喘者。表未解故也。桂枝加浓朴杏子汤主之。千金云。宜桂枝汤。一云麻黄汤。
又曰。太阳病。外证未解者。不可下也。下之为逆。欲解外者。宜桂枝汤主之。
又曰。太阳病。先发汗不解。而复下之。脉浮者不愈。浮为在外。
而反下之。故令不愈。今脉浮。故知在外。当须解外则愈。宜桂枝汤主之。
又曰。太阳病。脉浮紧。无汗。发热。身疼痛。八九日不解。表证
仍在。此当发其汗。服药已。微除。其人发烦。目瞑。剧者必衄。衄乃解。所以然者。阳气重故也。麻黄汤主之。
又曰。太阳病。脉浮紧。发热身无汗。自衄者愈。
Guo Yong said: From this point onwards, all content belongs to Zhang Zhongjing's original treatise. No additional questions and answers are set up to avoid verbose language. It simply states "Zhang Zhongjing said," followed by "he also said." For content from other books or matters with doubts, questions and answers are established for clarification. Where the original treatise contains Zhang Zhongjing's original Q&A, it begins with "Zhang Zhongjing asked." The rest follows Zhang Zhongjing's original text without altering the sequence.
Zhang Zhongjing said: When both the Cun (inch) and Chi (cubit) pulses are floating, it indicates that the Taiyang (Greater Yang) channel has been affected. Symptoms typically appear within one or two days of onset. This is because the Taiyang channel connects superiorly to the Fengfu (GV16) acupoint, leading to headache, stiffness of the neck and occiput, and stiffness/pain in the lower back and spine.
He also said: The defining characteristics of a Taiyang disease are a floating pulse, headache, neck stiffness, and aversion to cold.
He also said: In Taiyang disease, if there is fever, sweating, aversion to wind, and a slow pulse (specifically floating and slow), it is named Wind Strike (Zhongfeng).
He also said: In Taiyang disease, whether fever has already appeared or not, there will inevitably be aversion to cold, body pain, vomiting, and reversal of qi, along with tight pulses in both Yin and Yang positions. This is named Cold Damage (Shanghan). Wang Shuhe stated: In Taiyang disease, if the pulse is floating and rapid, diaphoresis (sweating therapy) can be applied; this belongs to the Guizhi Tang (Cinnamon Twig Decoction) pattern.
He also said: If Taiyang disease remains unresolved and the pulse is floating and weak, it should be resolved through diaphoresis, making Guizhi Tang appropriate.
He also said: In Taiyang disease, presenting with headache, fever, sweating, and aversion to wind, if there is also aversion to cold, it belongs to the Guizhi pattern. Sweating with aversion to cold also belongs to the Guizhi pattern. Chang Qizhi, in his supplementary treatment theory, stated: Sweating with aversion to wind warrants Guizhi Tang; absence of sweating with aversion to cold warrants Mahuang Tang (Ephedra Decoction). Guo Yong commented: The distinction between Wind Strike and Cold Damage lies fundamentally in the presence or absence of sweating. The usage of Guizhi Tang and Mahuang Tang is also determined by sweating or no sweating. Therefore, even if there is aversion to cold, if sweating is present, it still belongs to Wind Strike. Wang Shuhe used Guizhi Tang and did not switch to Mahuang Tang due to aversion to cold because the patient was sweating.
Question: Why does Taiyang disease sometimes present with sweating and sometimes without? Guo Yong answered: This depends on the Ying (Nutrient) and Wei (Defensive) Qi. Ying Qi circulates within the vessels, while Wei Qi circulates outside. They can only function properly when interior and exterior are harmonious. Pathogenic Wind Qi, if shallow, affects only the Wei Qi. When Wei Qi is affected, it becomes hyperactive ("Wei Qiang"). Hyperactive Wei Qi fails to associate with Ying Qi, and its fierce nature escapes through the pores, resulting in sweating. Thus, sweating occurs when Wei Qi encounters the pores and disperses outward. Cold pathogenic factors penetrate deeply, affecting both Wei and Ying Qi. Both are diseased, without one being strong and the other weak. Cold pathogenic factors bind with Ying and Wei Qi, preventing their movement. Consequently, Wei Qi has no outlet and must be released via medicinal diaphoresis. Only then can pathogens be expelled and Ying-Wei circulation restored. Hence, although it is the same channel disease, there are two patterns: with sweating and without sweating, requiring different treatments: Guizhi Tang for releasing the exterior and Mahuang Tang for inducing sweating. Zhang Zhongjing's discussions on the harmony or disharmony of Ying and Wei are found in subsequent chapters.
*Qianjin Fang* (Prescriptions Worth a Thousand Gold) stated: On the first day of Cold Damage, the Taiyang pulse is weak; by the fourth day, the Taiyin pulse becomes large.
Zhang Zhongjing said: On the first day of Cold Damage, the Taiyang channel is affected. If the pulse remains calm, transmission has not occurred. If the patient desires to vomit frequently or experiences irritability/restlessness with a rapid and urgent pulse, transmission has occurred. Chang Qizhi stated: One must distinguish between Wind Strike and Cold Damage, and between sweating and non-sweating, using Mahuang Tang and Guizhi Tang accordingly. Sun Simiao stated: In Taiyang disease lasting three to four days, if purgation or emesis has not been used and a Kou (hollow) pulse appears, diaphoresis may be administered.
He also said: In Taiyang disease, if there is fever accompanied by thirst but no aversion to cold, it is termed Warm Disease (Wenbing). If diaphoresis is applied and the body becomes burning hot, it is named Wind-Warmth (Fengwen). In Wind-Warmth disease, the Yin and Yang pulses are both floating, spontaneous sweating occurs, the body feels heavy, somnolence is frequent, nasal breathing is snoring, and speech is difficult. If mistakenly treated with purgation, urination becomes difficult, eyes stare fixedly, and incontinence occurs. If mistakenly treated with fire therapy, slight jaundice may appear; severely, it resembles convulsions or epilepsy with occasional spasms. If fire fumigation is applied again, one error prolongs the illness, while a second error shortens life expectancy. Chang Qizhi, in his supplementary treatment theory, stated: Switching to purgation or fire fumigation constitutes medical error. One may use Baihu Jia Renshen Tang (White Tiger plus Ginseng Decoction), Guizhi Chaihu Ban Tang (Half-Half Guizhi and Chaihu Decoction), or Guizhi Qu Shaoyao Jia Shujie Longgu Muli Jiuni Tang (Guizhi Decoction minus Shaoyao plus Shujie, Longgu, and Muli to Rescue Deviation Decoction). Guo Yong commented: Jiuni Tang is undoubtedly indicated for complications from fire fumigation. Guizhi Chaihu Ban Tang is essentially Chaihu Guizhi Tang. However, there are three scenarios: 1) Excessive sweating leads to Yang collapse with exterior symptoms persisting; despite delirium, purgation is contraindicated. Instead, harmonize Ying and Wei and unblock fluids using Chaihu Guizhi Tang, applicable before purgation. 2) If diaphoresis was already performed followed by purgation, resulting in difficult urination, thirst, but no vomiting, the disease is unresolved. Guizhi Chaihu Jiang Tang (Guizhi, Chaihu, and Ginger Decoction) is appropriate, applicable after purgation when difficult urination and thirst occur. 3) If Cold Damage lasts eight to nine days and is purged, leading to chest fullness, fright, difficult urination, Chaihu Jia Longgu Muli Tang (Chaihu plus Longgu and Muli Decoction) is used, applicable after purgation with difficult urination and fright symptoms. Only Baihu Jia Renshen Tang treats excessive thirst, dry mouth, and tongue, provided there are no exterior symptoms. If the pulse is floating indicating an unresolved exterior, it is contraindicated. Currently, in Warm Disease and Wind-Warmth, if the exterior is unresolved, the pulse is floating, so it is clearly contraindicated. Baihu Jia Renshen Tang originally treats interior heat in Taiyang disease with fever and thirst; it is not for non-interior heat cases. Therefore, it is excluded here.
He also said: Diseases manifesting with fever and aversion to cold originate in the Yang. Diseases manifesting with no fever and aversion to cold originate in the Yin. Those originating in Yang heal in seven days; those originating in Yin heal in six days, based on the numerical values of Yang (seven) and Yin (six). Pang Anshi stated: For diseases originating in Yang, use diaphoretic agents according to the syndrome to attack the exterior. For diseases originating in Yin, use Sini Tang (Four Counterflow Decoction) category formulas to warm the interior.
He also said: In Taiyang disease, if headache persists beyond seven days and heals spontaneously, it is because the pathogen has exhausted its course in the channel. If it is about to transmit to the next channel, needle the Foot-Yangming channel (Pang Anshi suggested tonifying Zusanli ST36) to prevent transmission and ensure healing. Question: Medical classics discuss death occurring between six and seven days, yet mention healing after seven days. Why? Guo Yong answered: Severe infection with symptom variation leads to death; mild infection without variation leads to spontaneous healing.
He also said: Patients with Wind disease, once the exterior is resolved but feeling unwell/lingering discomfort, will heal in twelve days. (Pang Anshi noted: In dialects, recovery in southern Chu is called 'chai' or 'liao'.)
He also said: If a patient has high body heat but desires to wrap themselves in clothes, the heat is superficial (skin) and the cold is deep (marrow). If a patient has low body temperature but refuses to wrap themselves, the cold is superficial and the heat is deep. Zhu Shi stated: Heat in the skin indicates Exterior Heat and Interior Cold, warranting Yindan Tang first. After the cold resolves, use Xiaochaihu Tang plus Guizhi to warm the exterior. Cold in the skin indicates Exterior Cold and Interior Heat, warranting Baihu Jia Renshen Tang first to clear heat, followed by Mahuang Guizhi Ban Tang to resolve the exterior. Generally, diseases have root and branch aspects, and treatment has a sequence. Exterior Heat with Interior Cold presents with sinking and slow pulses, slight cold extremities, and diarrhea with undigested food. Thus, Yin syndromes can also present with fever, treated with Sini Tang or Tongmai Sini Tang. Exterior Cold with Interior Heat presents with slippery pulses and cold extremities, dry mouth and tongue. Thus, Shaoyin disease with aversion to cold, curling up, frequent irritation, and dislike of thick clothing is treated with Daxiehu Tang to purge and cure. Guo Yong commented: Skin is indeed exterior, marrow is interior. There are two interpretations, which is why Zhang Zhongjing said "skin and marrow" rather than just "exterior and interior." Exterior and interior refer to Yin and Yang of the human body. *Lingshu Chapter 6* states: There is Yin and Yang inside, and Yin and Yang outside. Inside, Zang organs are Yin, Fu organs are Yang. Outside, sinews and bones are Yin, skin is Yang. Although Zhu Shi treats according to exterior-interior principles, he applies methods for internal interior to external interior. Chang Qizhi uses only Mahuang Guizhi Ban Tang, which has merit, but one might doubt that Mahuang, while harmonizing Ying and Wei, cannot reach the marrow. Zhu Shi's view seems too profound, Chang Qizhi's too shallow. One should mediate between the two. If using Zhu Shi's herbs, give less; if using Chang Qizhi's, give more.
He also said: In Taiyang Wind Strike, the Yang pulse is floating and the Yin pulse is weak. Floating Yang generates spontaneous heat; weak Yin allows spontaneous sweating. With chilly aversion to cold, shivering aversion to wind, lukewarm fever, nasal congestion, and dry vomiting, Guizhi Tang is primary. *Qianjin Yifang* stated: Taiyang Wind Strike presents with fever and aversion to cold.
He also said: In Taiyang disease, with headache, fever, sweating, and aversion to wind, Guizhi Tang is primary.
He also said: In Taiyang disease, with stiff neck and back (*Jie Jie*) and paradoxical sweating with aversion to wind, Guizhi Jia Gegen Tang (Guizhi Decoction plus Pueraria Decoction) is primary.
He also said: In Taiyang disease, if purgation is used and Qi rushes upward, Guizhi Tang may be given. If Qi does not rush upward, do not give it.
He also said: In Taiyang disease lasting three days, if diaphoresis, emesis, purgation, or warm needle therapy have been used and the condition remains unresolved, this is a "Ruined Disease" (Huai Bing). Guizhi Tang is no longer suitable. Observe the pulse and symptoms, identify the error, and treat according to the syndrome.
He also said: Guizhi Tang is primarily for resolving the muscle layer. If the pulse is floating and tight, with fever and no sweating, do not give it. Remember this always to avoid error. Chang Qizhi stated: Mahuang Tang may be used.
He also said: For patients who consume alcohol regularly (Jiu Ke), Guizhi Tang is contraindicated as it causes vomiting due to their dislike of sweet flavors.
He also said: For asthmatics using Guizhi Tang, adding Houpo (Magnolia Bark) and Xingren (Apricot Seed) is beneficial.
He also said: Anyone who vomits after taking Guizhi Tang will subsequently vomit pus and blood. Chang Shi stated: Leiyao Shaoyao Dihuang Tang may be taken. Guo Yong commented: It should only be taken after pus and blood appear.
He also said: In Taiyang disease, if diaphoresis leads to continuous leakage of sweat, aversion to wind, difficult urination, slight rigidity of the four limbs, and difficulty bending/extending, Guizhi Jia Fuzi Tang (Guizhi Decoction plus Aconite Decoction) is primary. *Qianjin Fang* stated: Add one roasted Fuzi to Guizhi Tang. Pang Anshi stated: If urination is frequent, this decoction is strictly contraindicated; Shaoyao Gancao Tang should be used. If Guizhi Jia Fuzi Tang is mistakenly used to attack the exterior, causing dry throat, irritability, cold extremities, and vomiting, prepare Gancao Ganjiang Tang to restore Yang Qi. Once extremities warm, administer Shaoyao Gancao Tang to extend the legs. If stomach Qi disharmony causes delirium, give a small amount of Tiaowei Chengqi Tang; slight loose stool stops delirium. Guo Yong commented: This is Zhang Zhongjing's method for treating spontaneous sweating and frequent urination. Pang Anshi applied it to post-diaphoresis leakage and frequent urination, where the syndrome is identical.
He also said: In Taiyang disease, if purgation leads to a hurried pulse and chest fullness, Guizhi Qu Shaoyao Tang (Guizhi Decoction minus Shaoyao) is primary. If there is slight aversion to cold, add Fuzi to the formula.
He also said: In Taiyang disease lasting eight to nine days, resembling malaria with fever and aversion to cold, more heat than cold, no vomiting, normal bowel/bladder function, occurring two to three times a day, with a slightly slow pulse, indicates impending healing. If the pulse is slightly weak with aversion to cold, both Yin and Yang are deficient; do not use diaphoresis, purgation, or emesis. If the face shows redness, the disease is not resolved due to inability to produce slight sweating, causing body itching. Guizhi Mahuang Ban Tang is appropriate.
He also said: In Taiyang disease, if initial Guizhi Tang administration increases irritability without resolution, needle Fengchi (GB20) and Fengfu (GV16) first, then administer Guizhi Tang for cure. Guo Yong commented: Zhang Zhongjing stated Taiyang connects to Fengfu, making it a key acupoint for Cold Damage, with Fengchi secondary. Fengfu is near Naohu and some fear needling it; moxibustion is prohibited there. Fengchi has no prohibitions for needling or moxibustion.
He also said: After taking Guizhi Tang, if massive sweating occurs and the pulse becomes洪大 (large and surging), continue Guizhi Tang as previously directed. If symptoms resemble malaria, recurring twice daily, sweating will resolve it; Guizhi Er Mahuang Yi Tang (Two Parts Guizhi, One Part Mahuang Decoction) is appropriate.
He also said: After taking Guizhi Tang, if massive sweating leads to severe irritability and unquenchable thirst with a large pulse, Baihu Jia Renshen Tang is primary.
He also said: In Taiyang disease, with fever, aversion to cold, more heat than cold, and a weak pulse, this indicates "No Yang" (Yang deficiency); do not induce sweating. Guizhi Er Yuebi Yi Tang (Two Parts Guizhi, One Part Yuebi Decoction) is appropriate. *Qianjin Fang* states: Do not induce sweating.
He also said: After taking Guizhi Tang or purgation, if head/neck stiffness, lukewarm fever, no sweating, epigastric fullness, slight pain, and difficult urination persist, Guizhi Qu Gui Jia Fuling Baizhu Tang (Guizhi Decoction minus Cinnamon plus Poria and Atractylodes Macrocephala Decoction) is primary.
He also said: In Cold Damage with floating pulse, spontaneous sweating, frequent urination, irritability, slight aversion to cold, and leg cramps, giving Guizhi Tang to attack the exterior is an error. This leads immediately to cold extremities, dry throat, irritability, and vomiting. Prepare Gancao Ganjiang Tang to restore Yang. Once extremities warm, prepare Shaoyao Gancao Tang to extend the legs. If stomach disharmony causes delirium, give a small amount of Tiaowei Chengqi Tang. If excessive sweating and burning needles were added, Sini Tang is primary. (See Volume 9).
Zhang Zhongjing asked: The syndrome resembles Yangdan (another name for Guizhi). Following standard treatment worsened the condition, causing cold extremities, dry throat, calf cramps, and delirium. The master said hands and feet would warm and legs extend by midnight, which happened. How was this known? Answer: The Cun-Kou pulse is floating and large. Floating indicates Wind; large indicates Deficiency. Wind generates slight heat; deficiency causes calf cramps. The syndrome resembles Guizhi Tang pattern, so Fuzi was added, and Guizhi increased to induce sweating. Fuzi warms the channels due to Yang collapse. Cold extremities, dry throat, irritability, Yangming internal binding, and delirium require Gancao Ganjiang Tang. By midnight, Yang returns, feet warm, calves still slightly cramped. Re-administer Shaoyao Gancao Tang to extend calves. Use Chengqi Tang to mildly loosen bowels, stopping delirium. Thus, healing is predicted. Guo Yong commented: This Q&A explains the previous error of misusing Guizhi Jia Fuzi Tang. Standard treatment refers to Guizhi Tang. Inferring from this, for Yangdan-like syndromes: if urination is difficult, use Guizhi Jia Fuzi Tang; if frequent, use Gancao Ganjiang Tang and Shaoyao Gancao Tang. Urination status is the criterion. Pang Anshi stated: Calf cramps, frequent urination, and sweating indicate fluid deficiency; Guizhi Tang is contraindicated. Tonify deficiency and clear heat with Shaoyao Gancao Tang.
He also said: In Taiyang disease, with stiff neck/back (*Jie Jie*), no sweating, and aversion to wind, Gegen Tang (Kudzu Decoction) is primary.
He also said: In combined Taiyang and Yangming disease with spontaneous diarrhea, Gegen Tang is primary. (One version suggests Gegen Fuling Huanglian Tang, likely Gegen Huangqin Huanglian Tang).
He also said: In combined Taiyang and Yangming disease without diarrhea but with vomiting, Gegen Jia Banxia Tang (Gegen Decoction plus Pinellia Decoction) is primary. *Qianjin Fang* states: Add half a sheng of Banxia to Gegen Tang.
He also said: In Taiyang disease with Guizhi pattern, if mistakenly purged, diarrhea continues. If the pulse is hurried, the exterior is unresolved. With wheezing and sweating, Gegen Huangqin Huanglian Tang is primary.
He also said: In Taiyang disease, with headache, fever, body pain, lower back pain, joint pain, aversion to wind, no sweating, and wheezing, Mahuang Tang is primary.
He also said: In combined Taiyang and Yangming disease with wheezing and chest fullness, do not purge. Mahuang Tang is primary.
He also said: In Taiyang disease, ten days later, if the pulse is floating and fine with drowsiness, the exterior is resolved. If chest fullness and hypochondriac pain exist, give Xiaochaihu Tang. If the pulse is merely floating, give Mahuang Tang.
Question: The Taiyang chapter mentions healing after seven days and ten days passing. Does this indicate transmission or not? Guo Yong answered: Investigating the intent reveals the principle, but pulse and symptoms must differentiate. Healing after seven days implies six days of transmission without variation. Ten days passing with chest/hypochondriac pain indicates transmission to Yangming. If the pulse is floating without other symptoms, it remains in Taiyang, so Zhang Zhongjing uses Mahuang. Zhu Shi stated cold pathogens don't always start in Taiyang; they may stay in one channel or skip channels. Treatment relies on pulse and exterior symptoms. If many days pass, pulse is large, floating, rapid, but empty upon pressure, still target Taiyang with diaphoresis. This aligns with Zhang Zhongjing's instruction for ten-day-floating-pulse cases to use Mahuang Tang. For sweating cases, select from various Guizhi Tang formulas. Regarding "not always starting in Taiyang": theoretically possible, identifiable by pulse/symptoms. Mild headache suggests non-Taiyang origin, representing variant infections. Direct Taiyang infection is "True Cold Damage."
Zhang Zhongjing said: In Taiyang Wind Strike, if the pulse is floating-tight, with fever, aversion to cold, body pain, no sweating, and irritability, Da Qinglong Tang (Great Blue Dragon Decoction) is primary. If the pulse is weak-micro with sweating and aversion to wind, it is contraindicated. Administration causes cold extremities and muscle twitching (*Rou Li*). This is an adverse reaction. Guo Yong commented: Wind Strike with floating-tight pulse shows Cold signs, so it is permissible. Weak-micro pulse is not a Cold sign; sweating and aversion to wind are Wind Strike signs, so it is contraindicated. Misuse causes sweating leakage, muscle twitching, and death due to Yang collapse. See the Diaphoresis Chapter for details.
He also said: In Cold Damage with floating-slow pulse, no body pain but heaviness, occasionally lighter, and no Shaoyin syndrome, Da Qinglong Tang induces sweating. Guo Yong commented: Cold Damage with floating-slow pulse shows Wind signs. Shaoyin is an interior syndrome; Da Qinglong Tang releases the exterior, so it is permissible if no Shaoyin syndrome exists. Shaoyin involves dry mouth/tongue/thirst. Pang Anshi suggested reading "no Taiyin syndrome." Zhang Zhongjing stated Shaoyin cannot be diaphoresed; using Da Qinglong is even more contraindicated. Thus, "Shaoyin" is correct. Pang's error aside, Taiyin also forbids diaphoresis; all Three Yin channels forbid it, with Shaoyin being most critical. Da Qinglong Tang is used only for these two patterns because sweating/Yang collapse is violent. Skilled physicians hesitate, substituting other drugs. Guizhi Mahuang Ban Tang is acceptable but milder, requiring frequent dosing for harmonization.
He also said: In Cold Damage with unresolved exterior and water-Qi in the heart region, presenting with dry heaving, fever, cough, optionally thirst, diarrhea, choking, difficult urination with lower abdominal fullness, or wheezing, Xiao Qinglong Tang (Minor Blue Dragon Decoction) is primary.
He also said: In Cold Damage with water-Qi in the heart region, cough with slight wheezing, fever without thirst. If thirst develops after medication, it indicates Cold Qi is resolving. Xiao Qinglong Tang is primary.
He also said: In Taiyang disease with unresolved exterior symptoms and a floating-weak pulse, diaphoresis is indicated. Guizhi Tang is appropriate.
He also said: In Taiyang disease, if purgation leads to slight wheezing, the exterior is unresolved. Guizhi Jia Houpo Xingzi Tang (Guizhi Decoction plus Magnolia and Apricot Seed Decoction) is primary. *Qianjin Fang* suggests Guizhi Tang; another version suggests Mahuang Tang.
He also said: In Taiyang disease with unresolved exterior, purgation is contraindicated as it is adverse. To resolve the exterior, Guizhi Tang is primary.
He also said: In Taiyang disease, if initial diaphoresis fails and purgation is repeated, a floating pulse indicates non-healing. Floating indicates the pathogen is exterior; purgation failed. Current floating pulse confirms exterior location; exterior resolution is required. Guizhi Tang is primary.
He also said: In Taiyang disease, with floating-tight pulse, no sweating, fever, body pain, unresolved after eight-nine days, with exterior signs persisting, diaphoresis is required. After medication, symptoms subside slightly, patient feels irritable, eyes close/dizzy. Severely, nosebleed (*Xu*) occurs, resolving the disease. This is due to heavy Yang Qi. Mahuang Tang is primary.
He also said: In Taiyang disease, with floating-tight pulse, fever, no sweating, spontaneous nosebleed leads to healing.