经曰。桂枝本为解肌。若其人脉浮紧。发热汗不出者。不可与也。常须识此。勿令误
也。盖桂枝汤。本专主太阳中风。其于腠理致密。荣卫邪实。津液荣固。寒邪所胜者。
则桂枝汤不能发散。必也皮肤疏凑。又自汗。风邪干于卫气者。乃可投之也。仲景
以解肌为轻。以发汗为重。是以发汗吐下后。身疼不休者。必与桂枝汤。而不与麻
黄汤者。以麻黄汤专于发汗。其发汗吐下后。津液内耗。虽有表邪。而止可解肌。故
须桂枝汤小和之也。桂味辛热。用以为君。必谓桂犹圭也。宣道诸药。为之先聘。是
犹辛甘发散为阳之意。盖发散风邪。必以辛为主。故桂枝所以为君也。芍药味苦
酸微寒。甘草味甘平。二物用以为臣佐者。内经所谓风淫所胜。平以辛。佐以苦。以
甘缓之。以酸收之。是以芍药为臣。而甘草为佐也。生姜味辛温。大枣味甘温。二物
为使者。内经所谓风淫于内。以甘缓之。以辛散之。是以姜枣为使者也。姜枣味辛
甘。固能发散。而此又不特专于发散之用。以脾主为胃行其津液。姜枣之用。专行
脾之津液。而和荣卫者也。麻黄汤所以不用姜枣者。谓专于发汗。则不待行化。而
津液得通矣。用诸方者。请熟究之。
桂枝(君三两去皮) 芍药(臣佐三两) 甘草(臣佐二两炙) 大枣(使十二枚擘) 生姜(使三两切)
上五味 咀。以水七升。微火煮取三升。去渣。适寒温。服一升。服已须臾。 热稀
粥一升余。以助药力。温覆令一时许。遍身 微似有汗者益佳。不可令如水
流漓。病必不除。若一服汗出病瘥。停后服。不必尽剂。若不汗更服。根据前法。又不
汗。后服小促使其间。半日许令三服尽。若病重者。一日一夜服。周时观之。服一
剂尽。病证犹在者。更作服。若汗不出。乃服至二三剂。禁生冷粘滑肉麦五辛酒酪臭恶等物。
The *Neijing* states: Guizhi (Cinnamon Twig) is originally used to resolve the muscle layer (*jieji*). If the patient's pulse is floating and tight, with fever but no sweating, it must not be administered. One must always keep this in mind to avoid errors. Guizhi Tang (Cinnamon Twig Decoction) primarily treats Taiyang Wind Strike syndrome (*Taiyang Zhongfeng*). In cases where the interstices are dense, Ying and Wei pathogenic factors are substantial, body fluids are consolidated, and Cold pathogen prevails, Guizhi Tang cannot disperse the pathogen. It can only be used when the skin pores are loose and the patient has spontaneous sweating, indicating that Wind pathogen has invaded the Wei Qi. Zhang Zhongjing considered "resolving the muscle layer" as a mild method and "inducing sweating" as a heavy method. Therefore, after inducing sweating, vomiting, or purging, if body pain persists, Guizhi Tang should be given rather than Mahuang Tang (Ephedra Decoction). This is because Mahuang Tang is specifically for strong diaphoresis; after sweating, vomiting, or purging, internal body fluids are depleted. Even if exterior pathogenic factors remain, only resolving the muscle layer is appropriate, so Guizhi Tang is used to gently harmonize.
Guizhi (Cinnamon Twig), pungent and hot, serves as the Sovereign drug. The character "Gui" is akin to "Gui" (jade tablet), signifying the guidance of other herbs, acting as a pioneer. This aligns with the principle that "pungent and sweet flavors disperse and belong to Yang." Dispersing Wind pathogen must primarily rely on pungent flavors, hence Guizhi is the Sovereign. Shaoyao (White Peony Root), bitter and sour, slightly cold, and Gancao (Licorice Root), sweet and neutral, serve as Minister and Assistant drugs. As stated in the *Neijing*: "When Wind excess prevails, pacify with pungent, assist with bitter, ease with sweet, and astringe with sour." Thus, Shaoyao is the Minister, and Gancao is the Assistant. Shengjiang (Fresh Ginger), pungent and warm, and Dazao (Jujube), sweet and warm, serve as Envoy drugs. As the *Neijing* states: "When Wind is internal, ease with sweet and disperse with pungent." Hence, Ginger and Jujube are Envoys. Although their pungent and sweet flavors allow for dispersion, their role here extends beyond mere dispersion. Since the Spleen governs transporting fluids for the Stomach, the function of Ginger and Jujube is to specifically move the Spleen's fluids and harmonize Ying and Wei. Mahuang Tang does not use Ginger and Jujube because its focus is solely on inducing sweating, which does not require fluid transformation for patency, as fluids naturally flow. Practitioners using various formulas should study these principles carefully.
Guizhi (Sovereign, 3 liang, bark removed) Shaoyao (Minister/Assistant, 3 liang) Gancao (Minister/Assistant, 2 liang, honey-fried) Dazao (Envoy, 12 pieces, split) Shengjiang (Envoy, 3 liang, sliced)
Crush the above five ingredients. Boil in 7 sheng of water over low heat until reduced to 3 sheng. Remove the dregs. When the temperature is suitable, drink 1 sheng. Shortly after ingestion, consume more than 1 sheng of hot thin porridge to assist the medicinal power. Cover with blankets for about one hour until the entire body shows slight perspiration, which is ideal. Do not allow profuse sweating like flowing water, otherwise the disease will not be resolved. If sweating occurs after the first dose and the illness resolves, stop subsequent doses; there is no need to finish the remaining decoction. If no sweating occurs, administer another dose according to the previous method. If still no sweating, shorten the interval between subsequent doses, aiming to complete three doses within half a day. For severe cases, administer continuously over day and night, observing for 24 hours. If symptoms persist after finishing one prescription, prepare and administer another. If sweating still does not occur, up to two or three prescriptions may be used. Avoid consuming raw/cold foods, sticky/greasy foods, meat, wheat, the "Five Pungents," alcohol, dairy products, and foul-smelling substances.