葛根(半斤) 黄连(三两) 黄芩(二两) 甘草(二两炙)
上四味以水八升先煎葛根减二升入诸药煮取二升去滓分温再服
太阳病下之后脉促胸满者桂枝去芍药汤主之若微恶寒者去芍药方中加附子汤主之
下后脉促表邪未解是宜桂枝而益以胸满则阳衰胃逆浊气冲塞去芍药之酸寒以解表邪若微恶寒者则不止脾阳之虚而肾
阳亦败加附子之辛温以驱里寒也
桂枝(三两) 甘草(二两) 生姜(三两) 大枣(十二枚)
于桂枝方内去芍药余根据前法
桂枝(三两) 甘草(二两) 大枣(十二枚) 生姜(三两) 附子(一枚炮去皮)
于桂枝汤方内去芍药加附子一枚去皮破八片余根据前法
太阳病下之微喘者表未解故也桂枝加浓朴杏子汤主之
表病而攻其里里阴上逆而表邪未解肺气郁阻是以发喘桂枝加浓朴杏子降冲逆而破壅塞也
桂枝(三两) 芍药(三两) 甘草(二两) 大枣(十二枚) 生姜(三两) 浓朴(二两) 杏仁(五十枚去
皮尖)
于桂枝汤方内加浓朴二两杏仁五十枚去皮尖余根据前法
喘家作桂枝汤加浓朴杏子仁
平素喘家胃逆肺阻作桂枝汤解表宜加朴杏降逆而破壅也
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
服桂枝汤后或又下之仍复头项强痛发热无汗甚似表证未解而加以心下满痛小便不利是非风邪之外束实缘湿邪之内动
也盖土虚湿旺脾陷而肝郁不能泄水故小便不利胃逆而胆郁不能降浊故心下满痛浊气冲塞故头痛发热桂枝去桂枝之解表加
茯苓白术泄湿而燥土也
Radix Puerariae (Ge Gen, 葛根) (half jin), Rhizoma Coptidis (Huang Lian, 黄连) (three liang), Radix Scutellariae (Huang Qin, 黄芩) (two liang), Radix Glycyrrhizae (Gan Cao, 甘草) (two liang, honey-fried).
The above four ingredients are decocted with eight sheng of water. First, boil the Radix Puerariae until the volume decreases by two sheng, then add the remaining herbs. Continue boiling to obtain two sheng of liquid, strain off the dregs, and divide into two doses for warm administration.
In Taiyang disease (disease pattern caused by pathogenic invasion of the Taiyang channel) treated with purgation, if the pulse is rapid (cui, 促) and there is chest fullness, Guizhi Qushaoyao Tang (Cinnamon Twig Decoction without Paeonia) is the primary formula. If there is slight aversion to cold, Fuzi Tang (Aconite Decoction) with the addition of Rhizoma Aconiti Preparata (Fuzi, 附子) to the formula without Shaoyao is indicated.
After purgation, a rapid pulse indicates that the exterior pathogen has not yet resolved, making Guizhi Tang suitable. However, the accompanying chest fullness suggests yang deficiency, rebellious Stomach Qi, and obstruction by turbid Qi. Therefore, Sour and Cold Paeonia (Shaoyao, 芍药) is removed to resolve the exterior pathogen. If slight aversion to cold occurs, it indicates not only Spleen Yang deficiency but also Kidney Yang failure; thus, Acrid and Warm Aconite (Fuzi, 附子) is added to dispel interior cold.
Ramulus Cinnamomi (Guizhi, 桂枝) (three liang), Radix Glycyrrhizae (Gan Cao, 甘草) (two liang), Rhizoma Zingiberis Recens (Sheng Jiang, 生姜) (three liang), Fructus Jujubae (Dazao, 大枣) (twelve pieces).
Remove Paeonia (Shaoyao, 芍药) from the original Guizhi Tang formula; prepare the rest according to the previous method.
Ramulus Cinnamomi (Guizhi, 桂枝) (three liang), Radix Glycyrrhizae (Gan Cao, 甘草) (two liang), Fructus Jujubae (Dazao, 大枣) (twelve pieces), Rhizoma Zingiberis Recens (Shing Jiang, 生姜) (three liang), Rhizoma Aconiti Preparata (Fuzi, 附子) (one piece, processed, skin removed).
Remove Paeonia (Shaoyao, 芍药) from the original Guizhi Tang formula and add one piece of Aconite (Fuzi, 附子), peeled and broken into eight pieces; prepare the rest according to the previous method.
In Taiyang disease treated with purgation, if slight wheezing occurs, it is because the exterior pathogen has not yet resolved. Guizhi Houpo Xingzi Tang (Cinnamon Twig Decoction with Magnolia Bark and Apricot Kernel) is the primary formula.
When an exterior condition is treated with interior purgation, interior Yin rebels upward while the exterior pathogen remains unresolved, causing Lung Qi stagnation and resulting in wheezing. Guizhi Houpo Xingzi Tang descends rebellious Qi and breaks through congestion.
Ramulus Cinnamomi (Guizhi, 桂枝) (three liang), Radix Paeoniae Alba (Shaoyao, 芍药) (three liang), Radix Glycyrrhizae (Gan Cao, 甘草) (two liang), Fructus Jujubae (Dazao, 大枣) (twelve pieces), Rhizoma Zingiberis Recens (Sheng Jiang, 生姜) (three liang), Cortex Magnoliae Officinalis (Houpo, 厚朴) (two liang), Semen Pruni Armeniacae (Xingren, 杏仁) (fifty pieces, skin and tips removed).
Add two liang of Magnolia Bark (Houpo, 厚朴) and fifty pieces of Apricot Kernel (Xingren, 杏仁) with skin and tips removed to the original Guizhi Tang formula; prepare the rest according to the previous method.
For patients with a chronic history of wheezing, when administering Guizhi Tang, add Magnolia Bark (Houpo, 厚朴) and Apricot Kernel (Xingren, 杏仁).
Patients with a chronic tendency toward wheezing often suffer from rebellious Stomach Qi and obstructed Lung Qi. When using Guizhi Tang to resolve the exterior, it is appropriate to add Magnolia Bark and Apricot Kernel to descend rebellious Qi and break through congestion.
After taking Guizhi Tang, or following subsequent purgation, if symptoms such as stiffness and pain in the head and neck, feverish sensation like feathers covering (xi xi fa re, 翕翕发热), absence of sweating, fullness below the heart with mild pain, and difficulty in urination persist, Guizhi QuGui Jia Fuling Baizhu Tang (Cinnamon Twig Decoction without Cinnamon Twig plus Poria and Atractylodes Macrocephala Decoction) is the primary formula.
After taking Guizhi Tang and subsequently undergoing purgation, the persistence of stiffness and pain in the head and neck, fever, and absence of sweating may superficially resemble unresolved exterior syndrome. However, accompanied by epigastric fullness/pain and dysuria, this is not due to external wind-pathogen constraint but rather internal dampness activation. Likely, Earth deficiency leads to excessive Dampness, Sinking of the Spleen, and Liver Stagnation, preventing the free flow of water metabolism, hence dysuria. Rebellious Stomach Qi and Gallbladder Stagnation prevent the descent of turbidity, causing epigastric fullness and pain. Turbid Qi obstructing the head causes headache and fever. In this case, remove Cinnamon Twig (Guizhi, 桂枝) which releases the exterior, and add Poria (Fuling, 茯苓) and Atractylodes Macrocephala (Baizhu, 白术) to drain dampness and dry the Earth (Spleen/Stomach).