凡六十六条方二十
太阳一经。风寒所始。营卫二道。各自中伤。风则中卫。故以卫中风而病者为上编。然风之为
风。其义不一。故其为病。最为居多。所谓中风者。乃风寒暑湿之风也。与诸家方书之所谓中风云
者。义不相同。诸家方书之所谓中风。盖素问曰阳之气以天地之疾风名之之风也。彼但以其所谓者
为中风云耳。其于在此之所谓中风云者则无闻焉。二义辨论精切。详悉分晓。惟有此书。自此以下。
知此义者。李明之而已。此义不明而欲求以言医。犹缘木求鱼耳。其如医何。（此篇旧本第五。而
次辨脉伤寒例痉湿 诸篇之下。然世传诸篇。皆叔和所述。今案伤寒例一篇。则又疑非叔和语。夫以
叔和编经。奚恁后经而先已。必后之赘附。遂致颠倒错乱。故条辨之。以复其初云。）
（一）太阳之为病。脉浮。头项强痛而恶寒。
强。群养切。恶。影固切。下皆仿此。太阳者。膀胱经也。其脉起于目内 。上额交巅。从
巅入络脑。还出。别下项。连风府。循肩膊内。挟脊。抵腰中。乃六经之首。主皮肤而统荣卫。
所以为受病之始也。难经曰。浮。脉在肉上行也。滑氏曰。脉在肉上行。主表也。表即皮肤。荣卫
丽焉。故脉见尺寸俱浮。知为病在太阳之诊也。项。颈后也。强痛者。皮肤荣卫一有感受。经络
随感而应。邪正争扰也。恶寒者。该风而言也。风寒初袭表而郁于表。故不胜。复被风寒外迕而
畏恶之。及其过表而入里。则不复恶。仇雠之义也。此揭太阳之总病。乃三篇之大纲。以下凡首称
太阳病者。皆指此而言之也。
（二）太阳病。发热。汗出。恶风。脉缓者。名为中风。
恶。与恶寒之恶同。中。音众。下皆同。太阳病。上条所揭云云者。是也。后皆仿此。发热。风邪
干于肌肤而郁蒸也。汗出。腠理疏。玄府开而不固也。恶风。大意见上。此以风邪郁卫。故卫逆
而主于恶风。缓。即下文阳浮而阴弱之谓。风性柔和。所以然也。中。当也。风。谓天之八风也。
言既有如上条所揭云云之太阳病。加之发热汗出恶风而脉缓者。则其病乃是触犯于风而当之也。
灵枢曰。夫天之生风者。非以私百姓也。其行公平正直。犯者得之。避者得无。殆非求人而人自
犯之。此之谓也。然风之为风。其性属阳。其中人也。从卫而入。卫气道也。风之所以从卫入者。
卫亦阳。从其类也。此承上条而又再揭太阳分病之纪一。乃此篇之小总。篇内凡首称太阳中风者。
则又皆指此而言也。下条乃释此条之义以出其治。余则或申此义与凡此条之众目耳。中篇下编。
其为证候。与此虽不同。其为节目。在彼则亦然。乃太阳之大三辨也。而各篇之中。其条目则各
自又有辨焉。皆风寒之分别也。学人诚能潜心涵泳。体认的当。则风寒之是非。 然明白矣。
尚何独断之难能哉。
（三）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。
桂枝汤方
桂枝（三两去皮） 芍药（三两） 甘草（二两。炙） 生姜（三两。切） 大枣（十二枚擘）
上五味。 咀。以水七升。微火煮取三升。去滓。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。病差。停后服。不必尽剂。
若不汗。更服。根据前法。又不汗。后服小促役其间。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。若汗不出者。乃服至二三剂。禁生冷粘滑肉面五辛
酒酪臭恶等物。
啬。审革切。淅。心吉切。翕。晓吉切。去。上声。滓。照儿切。 。与啜同。 。音石。差。
与瘥同。令。平声。臭恶之恶。如字。此申上条而详言之。释其义。以出其治。太阳中
风。乃掇上条所揭攒名以指称之。犹上条掇首条所揭。而以太阳病为首称。同一
意也。阳浮而阴弱。乃言脉状以释缓之义也。难经曰。中风之脉。阳浮而滑。阴濡而弱。是也。
阳浮者。热自发。阴弱者。汗自出。乃承上文而言。以释发热汗出之义。言惟其脉之阳浮。所以证
乃热自发也。惟其脉之阴弱。所以证乃汗自出也。关前阳。外为阳。卫亦阳也。风邪中于卫则卫实。
实则太过。太过则强。然卫本行脉外。又得阳邪而助之强于外。则其气愈外浮。脉所以阳浮。阳
主气。气郁则蒸热。阳之性本热。风善行而数变。所以变热亦快捷。不待闭郁而即自蒸发。故曰。
阳浮者。热自发也。关后阴。内为阴。荣亦阴也。荣无故。则荣比之卫为不及。不及则不足。不足
则弱。然荣本行脉内。又无所助。而但是不足于内。则其气愈内弱。脉所以阴弱。阴主血。汗者血
之液。阴弱不能内守。阳强不为外固。所以致汗亦直易。不待覆盖而即自出泄。故曰阴弱者。汗
自出也。啬啬恶寒。淅淅恶风。乃双关之句。盖原太阳本恶寒。而明其所以亦恶风之情状也。
啬啬。言恶寒出于内气馁。不足以耽当其渗逼。而恶之甚之意。淅淅。言恶风由于外体疏。犹惊
恨雨水卒然淅沥其身。而恶之切之意。盖风动则寒生。寒生则肤粟。恶则皆恶。未有恶寒而不恶
风。恶风而不恶寒者。所以经皆互文而互言之。不偏此偏彼而立说也。翕翕发热。乃形容热候之
轻微。翕。火炙也。团而合也。言犹雌之伏卵。翕为温热而不蒸。蒸。大热也。鼻鸣干呕。乃详
上条之未备。鼻鸣者。气息不利也。干呕者。气逆不顺也。盖阳主气而上升。气通息
于鼻。阳热壅甚。故鼻窒塞而息鸣。气上逆而干呕也。然翕翕发热难晓。而鼻鸣干呕易见。有鼻
鸣干呕。则翕翕发热可征矣。方之为言。义之所在也。言中风之治。宜在是物也。主。主当也。
言以是为主当。而损益则存乎人。盖脉证无有不相兼而见者。所以经但活泼泼。不欲人拘执之意
也。桂枝。其性味虽辛甘而属乎阳。其能事则在固卫而善走阴也。芍药擅酸寒而下气。快收阴而
敛液。夫卫气实而腠理开疏矣。非桂枝其孰能固之。荣血虚而汗液自出矣。非芍药其谁能收之。
以芍药臣事桂枝而治中风。则荣卫无有不和谐者。佐之以甘草而和其中。则发热无有不退除者。
使之以大枣而益脾。使之以生姜而止呕。皆用命之士也。微火者。取和缓不猛而无沸溢之患也。滓。
淀也。古人药大剂。金铛中煮。绵绞漉汤。澄滤取清。故曰去滓。 。大饮也。热稀粥者。桂枝
汤劫敌之奇兵。应赤帜于必胜之阵也。助药力。微旨也。譬如释氏之禅机。老氏之玄关。儒家之心
法也。 。和润而欲汗之貌。微似二字。最为要紧。有影无形之谓也。不可。禁止之
词也。如水流漓。言过当也。病必不除。决言不遵节制。则不效验也。小促役。催速值事也。禁者。
若物皆病之反也。凡此事宜。皆责之医家耳。病家安能料理。今人之医。惟务拱默以自崖岸。至
不获效。则反疑猜而多口于桂枝。诸家集方。何尝见啜热稀粥四字。徒以发汗相授受。微似。视
为羡文。殊不知桂枝神算。捷在出奇。苟简之弊。牢不可破。吁。手足胼胝。禹稷之所以圣也。然
则任治君子。苟未至于胼胝。亦何惮而不然也。若曰。何如此其屑屑。则脱有不中。其咎将谁归与。
数变之数。音速。
（四）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。令勿误也。
为。去声。识。与志同。令。平声。此原所以用桂枝之奥义。因着其反而示禁。以见药有反
对。勉人当精其义以求的当之
意。解者。救护而释散之之谓也。肌。肤肉也。盖风中卫而卫不固。发热汗出而恶风。卫行脉外。
肤肉之分也。桂枝救护之。热粥释散之。病之所以解也。故曰。本为解肌。浮。病在太阳也。紧。
寒也。汗不出。亦寒也。不可与。言病不对。禁勿妄投也。然则桂枝汤之发汗云者。奥义也。识。
记也。记其政事谓之识。言当常常用心以记其事。勿忘勿怠。而不可使有一忽之失
误。盖有寒不得用桂枝。故致戒警如此。其言亦甚深切着明矣。而人犹自误。亦独何哉。
（五）凡服桂枝汤吐者。其后必吐脓血也。
桂枝辛甘大热。胃家湿热本甚者。复得桂枝之大热。则两热相搏于中宫。搏则必伤。甘又令
人中满壅气而上溢。所以胃不司纳。反上涌而逆出也。然胃属土。土者金之母。肺属金。金者土之
子。母病固传子。胃家湿热甚。则必传之肺。肺受胃之湿热。与邪热搏郁而蒸。久热为火。肺为金。
脓血者。金逢火化也。
（六）若酒客病不可与桂枝汤。得汤则呕。以酒客不喜甘故也。
此承上条所言。复举一端以申之。欲人推此以及其余。酒客者。酒性湿热。所谓胃家湿热甚者。
无逾此也。呕。亦吐也。得汤则呕。以不喜甘。见上。然即酒客不喜甘。得汤则呕而推之。则凡
服桂枝汤而吐者。其义皆可以比类而察识矣。触类而通之。亦存乎其人焉耳。
（七）发汗后。水药不得入口为逆。若更发汗。必吐下不止。
以上四条。皆言桂枝之不对。以严示禁之意。水药不得入口。言呕吐之甚也。夫中风服桂枝
汤以发汗。桂枝汤者。甘药也。伤寒服麻黄汤以发汗。麻黄汤中亦有桂枝。则亦甘药也。以发汗
药皆有桂枝之甘而言之。则此条曰。发汗后水药
不得入口者。乃承上二条复又通以得汤则呕之甚者言。而深寓戒警之意也。逆者。言悖于道也。
盖不通人之性气而逆治。则亦适足以致病逆而生变。故曰为逆也。必吐下者。言水药既不得入口。
则胃已伤。若仍与前汤而重伤。则必致大坏。大坏则大乱。夫胃。中腑也。苟大坏乱。则不惟复
上逆而仍呕吐。必将下加走泄而增泻利矣。不止。盖甚言害大。以深着致戒之意也。
（八）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。
此原中风伤寒之所以始。以要其所以终之意。凡在太阳。皆恶寒也。发热恶寒者。中风即发
热。以太阳中风言也。发于阳之发。起也。言风为阳。卫中之。卫亦阳。其病是起于阳也。无热
恶寒者。伤寒或未发热。故曰无热。以太阳伤寒言也。发于阴者。言寒为阴。荣伤之。荣亦阴。其病是起
于阴也。七。少阳之数也。六。老阴之数也。阳数。九为老。七为少。阴数。老六而
少八者。阳道顺。阴道逆。阳主进。阴主退也。愈。瘳也。风寒中伤人。渐次人身六经之部位而传
进。以一日一经言之。中风六日。经虽传遍。必七日阳进而病自愈者。阳主生也。伤寒六日。经传遍。
阴退极。病乃愈者。阴主杀也。然则中风伤寒之所以为病。其始也。各从其类而起。其既也。各
得其数而愈。二气相因。天人一致。道妙自然。其机如此。易曰。知机其神乎。
又曰。原始反终。故知死生之说。医有易道。至哉言也。孙思邈曰。不知太易。不足以言医。学
者不可不察。苟志于道。不可不勉。
（九）太阳病。头痛。至七日以上自愈者。以行其经尽故也。若欲再作经者。针足阳明。使经不传则愈。
传。音啭。见第五问。后仿此。此承上条下节之自愈者。复申其已然者之义。而又更着其未然者
之治。太阳头痛。首条已具言之。此又独言者举大意也。七日以上。该六日而言也。行。亦传也。
经尽。谓传遍也。欲作再经。谓病加进也。针足阳明。夺其传路而遏之也。传与阳明篇转互音
义。犹古之驿传。今之过所云也。
（十）太阳病欲解时。从巳至未上。
太阳者。盛阳也。故王于巳午未。经曰。自得其位而起者。此之谓也。
（十一）欲自解者。必当先烦。乃有汗而解。何以知之。脉浮。故知汗出解也。
此承上条复晓人以病解之机。烦字从火从页。说文。页。头也。然则烦者。热闷而头痛之谓也。
先烦。邪欲出而与正分争。作汗之兆也。乃有汗。谓不如此则汗不得出也。脉浮。邪见还表也。汗出。邪出也。
解者。邪散而病去也。
（十二）烧针令其汗。针处被寒。核起而赤者。必发奔豚。气从少腹上冲心者。灸其核上各一
壮。与桂枝加桂汤。更加桂二两。
桂枝加桂汤方
于桂枝汤方内更加桂二两成五两余根据桂枝汤法。
令。平声。少。去声。上冲之上。上声。此又承上条复着不喻者妄意攻之之变。与其救变之
治也。烧针者。针性寒。必须先烧。使之温。而后可用也。被寒。言寒遂从针穴反得又入也。核。
谓针穴处肉变红肿高起如核也。奔豚。肾之积名也。气从少腹上冲心。奔豚。证发作之状也。盖人
之素有肾积者。因针穴处寒得入之。其积遂发。则气自少腹上逆而冲心。状若
惊豚突前而奔走。故曰奔豚也。灸其核上者。所以散其寒也。与桂枝汤者。解其欲自解之肌也。
加桂者。桂走阴而能伐肾邪。故用之以泄奔豚之气也。然则所加者桂也。非枝也。方出增补。故有
There are twenty formulas in total for the sixty-six clauses.
The Taiyang (Greater Yang) channel is the initial site of invasion by wind and cold pathogens. The Ying (Nutrient) and Wei (Defensive) pathways are each independently injured. Wind pathogen easily invades the Wei level; therefore, conditions where the Wei level is affected by wind are listed in the Upper Treatise. However, the meaning of "wind" is not uniform, so diseases caused by wind are the most numerous. The "Zhong Feng" (Wind Strike) mentioned here refers to contracting the natural wind of wind, cold, summer-heat, and dampness, which differs from the "Zhong Feng" described in various medical texts. The "Zhong Feng" in those texts likely refers to the "wind" mentioned in the *Su Wen* (*Basic Questions*), which names the violent wind of heaven and earth as Yang Qi. They simply call that kind of wind "Zhong Feng," while having never heard of the "Zhong Feng" discussed here. These two meanings are distinguished with precision and clarity. Only this book achieves this distinction. From this point onward, only Li Dongyuan (Li Mingzhi) understood this principle. Attempting to discuss medicine without understanding this principle is like climbing a tree to catch fish; what use is it for medicine? (This section was originally placed fifth in old editions, following the sections on Pulse Differentiation, Cold Damage Examples, Spasm, Dampness, etc. However, these transmitted sections are all attributed to Wang Shuhe. Upon examining the "Cold Damage Examples" section, one suspects it may not be Wang Shuhe's words. Given Wang Shuhe's compilation of the classic, how could he place later sections before earlier ones? It must be later appended material that caused the disorderly sequence. Thus, I have analyzed and clarified the text to restore its original order.)
(1) The characteristic of Taiyang disease is a floating pulse, stiffness and pain in the head and nape, and aversion to cold.
"Qiang" (stiff) is pronounced qun-yang qie; "Wu" (aversion) is pronounced ying-gu qie; the pronunciation follows this pattern below. The Taiyang channel is the Bladder Meridian. Its vessel originates at the inner canthus, ascends to the forehead, intersects at the vertex, enters to connect with the brain, emerges again, descends separately through the nape, connects to the Fengfu (GV16) acupoint, runs along the medial aspect of the shoulder blades, flanks the spine, and reaches the middle of the waist. It is the head of the Six Channels, governing the skin and commanding the Ying and Wei levels, thus serving as the starting point for disease acquisition. The *Nan Jing* states: A floating pulse beats above the muscle layer. Hua Shou (Hua Shi) says: A pulse beating above the muscle layer indicates a Exterior syndrome. The Exterior is the skin, upon which Ying and Wei reside. Therefore, if the pulse is floating at both the Cun and Chi positions, it is known as the diagnostic sign of disease in the Taiyang. "Xiang" (nape) refers to the back of the neck. Stiffness and pain occur because once the skin, Ying, and Wei are invaded by external pathogens, the meridians respond accordingly, leading to conflict between evil and righteous Qi. Aversion to cold includes aversion to wind. When wind-cold initially attacks the exterior and stagnates there, the body cannot withstand it; additionally, it feels fear and aversion due to the external confrontation by wind-cold. Once the pathogen passes the exterior and enters the interior, aversion ceases, similar to the relationship with an enemy. This reveals the general syndrome of Taiyang and serves as the main outline for the three chapters. Henceforth, whenever "Taiyang Disease" is first mentioned, it refers to this clause.
(2) In Taiyang disease, if there is fever, sweating, aversion to wind, and a moderate pulse, it is named Zhong Feng (Wind Strike).
"Wu" (aversion) has the same pronunciation as in aversion to cold; "Zhong" (strike/injure) is pronounced zhong; the same applies below. Taiyang disease refers to the symptoms outlined in the previous clause. The subsequent text follows this example. Fever results from wind pathogen interfering with the muscles and skin, causing stagnation and steaming. Sweating occurs because the Cou Li (interstices) are loose and the Xuan Fu (pores) are open and insecure. Aversion to wind is largely the same as explained above. This is because wind pathogen stagnates in the Wei level, causing Wei Qi to become rebellious and primarily manifest as aversion to wind. "Huan" (moderate/relaxed) refers to what is described below as "Yang floating and Yin weak." This is due to the gentle nature of wind. "Zhong" means to encounter or correspond. "Feng" refers to the Eight Winds of Heaven. It means that if one has the Taiyang disease outlined above, plus fever, sweating, aversion to wind, and a moderate pulse, then the illness is indeed encountering wind. The *Ling Shu* states: Heaven produces wind not to favor common people; it moves fairly and uprightly. Those who encounter it get sick; those who avoid it do not. It is not that wind seeks humans but humans seek wind. This is what is meant. However, wind as a pathogen belongs to Yang. When it invades the human body, it enters via the Wei level. Wei Qi is the pathway of Qi movement. Wind enters via Wei because Wei also belongs to Yang, and like attracts like. This clause continues from the previous one and reiterates the first principle of differentiated Taiyang syndromes, serving as a minor summary of this chapter. Whenever "Taiyang Zhong Feng" is first mentioned in the chapter, it refers to this clause. The next clause explains the meaning of this clause and proposes treatment. The remaining clauses either elaborate on this meaning or list various manifestations related to this clause. Although the syndromes in the Middle and Lower Treatises differ from this, the principle of categorization remains the same. These constitute the three major differentiations of Taiyang. Within each chapter, the items are further differentiated, distinguishing between wind and cold. If students can immerse themselves in deep contemplation and achieve accurate understanding, the distinction between wind and cold will become clear, eliminating the difficulty of independent judgment.
(3) In Taiyang Zhong Feng, the pulse is Yang floating and Yin weak. Yang floating indicates spontaneous heat generation; Yin weak indicates spontaneous sweating. Accompanied by shivering aversion to cold, chilliness aversion to wind, mild fever resembling warmth under cover, nasal congestion with humming sounds, and dry retching.
Gui Zhi Tang (Cinnamon Twig Decoction) is the primary treatment.
Formula for Gui Zhi Tang (Cinnamon Twig Decoction):
Gui Zhi (Cinnamomi Ramulus, 3 liang, bark removed), Shao Yao (Paeoniae Radix Alba, 3 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 liang, honey-fried), Sheng Jiang (Zingiberis Rhizoma Recens, 3 liang, sliced), Da Zao (Jujubae Fructus, 12 pieces, split).
Crush the above five herbs. Boil in seven sheng of water with low heat until reduced to three sheng. Remove the dregs. Take one sheng at a comfortable temperature. After taking the medicine, drink a little more than one sheng of hot thin porridge shortly thereafter to assist the medicinal power. Cover warmly for about the time it takes to cook a meal, aiming for a slight, generalized sweat. This is optimal. Do not allow profuse sweating like flowing water, or the disease will certainly not be resolved. If after one dose the patient sweats and the disease resolves, stop administering the remaining doses; there is no need to finish the entire decoction.
If there is no sweating, administer another dose according to the previous method. If still no sweating, shorten the interval between doses, ensuring all three doses are consumed within half a day. If the disease is severe, administer medicine over a full day and night, observing for twenty-four hours. If one full dose is consumed and the syndrome persists, prepare and administer another dose. If there is still no sweating, continue administration up to two or three doses. Avoid raw/cold foods, sticky/greasy foods, meat, wheat products, Five Pungent Spices, wine, dairy, and foul-smelling substances.
"Se" (shivering) is pronounced shen-ge qie; "Xi" (chilly) is pronounced xin-ji qie; "Xi" (mild/warm) is pronounced xiao-ji qie; "Qu" (remove) is pronounced with rising tone; "Zi" (dregs) is pronounced zhao-er qie; "Chuo" (drink) is synonymous with chuo; "Ci" (porridge) is pronounced shi; "Cha" (cured) is synonymous with chai; "Ling" (let/make) is pronounced with level tone; "E" (foul) in chou-e is pronounced as written. This elaborates on the previous clause, explaining the meaning and proposing treatment. "Taiyang Zhong Feng" is a condensed name derived from the previous clause, just as the previous clause used "Taiyang Disease" as a header from the first clause, sharing the same intent. "Yang floating and Yin weak" describes the pulse to explain "moderate." The *Nan Jing* states: The pulse of Zhong Feng is Yang floating and slippery, Yin soft and weak. This is correct. "Yang floating indicates spontaneous heat generation; Yin weak indicates spontaneous sweating" continues the context to explain fever and sweating. It means that because the pulse is Yang floating, the symptom is spontaneous heat; because the pulse is Yin weak, the symptom is spontaneous sweating. The anterior Guan position corresponds to Yang, the exterior corresponds to Yang, and Wei Qi also belongs to Yang. When wind pathogen strikes Wei, Wei becomes excess. Excess leads to hyperactivity. Hyperactivity leads to strength. However, Wei Qi naturally circulates outside the vessels. Assisted by Yang pathogen, it becomes stronger externally, causing its Qi to float outward more, hence the Yang floating pulse. Yang governs Qi; Qi stagnation causes steaming heat. Since Yang's nature is inherently hot, and wind moves swiftly and changes rapidly, heat generation is quick, occurring spontaneously without needing deep stagnation. Hence, "Yang floating indicates spontaneous heat generation." The posterior Guan position corresponds to Yin, the interior corresponds to Yin, and Ying Qi also belongs to Yin. Ying is undamaged, making it relatively deficient compared to Wei. Deficiency leads to insufficiency. Insufficiency leads to weakness. Ying Qi naturally circulates inside the vessels and lacks external support, becoming internally weak, hence the Yin weak pulse. Yin governs Blood; sweat is the fluid of Blood. Yin weakness fails to secure internally, while Yang strength fails to secure externally, leading to easy leakage of sweat without needing covering. Hence, "Yin weak indicates spontaneous sweating." "Shivering aversion to cold, chilliness aversion to wind" is a dual-meaning phrase. Originally, Taiyang disease involves aversion to cold; this clarifies the state of aversion to wind as well. "Se se" describes aversion to cold arising from internal Qi deficiency, unable to resist external penetration, indicating intense aversion. "Xi xi" describes aversion to wind due to external looseness, like being startled by sudden rain dripping on the body, indicating sharp aversion. Generally, wind movement generates cold; cold generation causes goosebumps. Aversion applies to both; one does not merely fear cold without fearing wind, nor fear wind without fearing cold. Thus, the classics use mutual textual references, not biasing toward one or the other. "Xi xi fa re" (mild fever) describes the mildness of heat. "Xi" means roasting with fire, gathering together. It resembles a hen brooding eggs: warm but not intensely hot; intense heat is called "zheng." "Bi ming gan ou" (nasal humming and dry retching) details aspects missing from the previous clause. Nasal humming indicates obstructed breathing; dry retching indicates rebellious Qi. Yang governs Qi and rises; Qi connects to respiration through the nose. Severe Yang heat obstruction causes nasal congestion and humming sounds, and rebellious Qi causes dry retching. While mild fever is hard to observe directly, nasal humming and dry retching are visible; their presence confirms mild fever. "Fang" (formula) implies the locus of principle. It means treatment for Zhong Feng should utilize these substances. "Zhu" (master/govern) means appropriate or primary. It means using this as the primary approach, with modifications left to the physician. Pulses and syndromes always appear together; thus, the text appears flexible, discouraging rigid adherence. Gui Zhi (Cinnamon Twig), though pungent-sweet and Yang in nature, functions to secure Wei and penetrate into Yin. Shao Yao (White Peony Root) excels in sour-cold properties, descending Qi, quickly collecting Yin, and astringing fluids. Since Wei Qi is excess and Cou Li are open, who else but Gui Zhi can secure it? Since Ying Blood is deficient and sweat leaks, who else but Shao Yao can collect it? Using Shao Yao to assist Gui Zhi in treating Zhong Feng ensures harmony between Ying and Wei. Using Gan Cao (Licorice Root) to harmonize the Middle Jiao ensures resolution of fever. Using Da Zao (Jujube) to benefit Spleen Qi and Sheng Jiang (Fresh Ginger) to stop vomiting are all troops executing orders. Low heat is used to ensure gentleness and prevent boiling over. "Zi" refers to sediment. Ancient prescriptions were large; boiled in bronze cauldrons, filtered through silk cloth, clarified, and the clear liquid taken, hence "remove dregs." "Chuo" means to drink heavily. Hot thin porridge is the surprise tactic of Gui Zhi Tang, responding like a red flag in a victorious battle. Assisting medicinal power is a subtle intention, akin to Buddhist Zen, Daoist mysteries, or Confucian mind-methods. "Wei si" (slightly seeming) describes a moist appearance desiring sweat. The words "wei si" (slight/subtle) are crucial, implying a shadow-like formlessness. "Bu ke" (must not) is prohibitive. "Ru shui liu li" (like flowing water dripping) indicates excess. "Bing bi bu chu" (disease surely not removed) firmly states that failing to follow moderation yields no effect. "Xiao cu yi" (shorten intervals slightly) means to hasten administration. "Jin" (prohibit) refers to things contrary to health. Such matters are the responsibility of the physician, not the patient. Modern physicians often remain silent to appear profound; when ineffective, they suspect and criticize Gui Zhi Tang. Why do collected formulas omit "drink hot thin porridge"? They merely transmit sweating methods, viewing "slight sweat" as superfluous. They fail to realize Gui Zhi Tang's brilliance lies in its unexpected efficacy. The弊 (drawback) of sloppiness is entrenched. Alas, calloused hands and feet were why Yu and Ji became sages. Therefore, practitioners responsible for healing, if not yet calloused, should fear nothing and act accordingly. If one asks, "Why be so meticulous?" and misses the mark, who bears the blame? The number "shu" in "shu bian" (rapid change) is pronounced su.
(4) Gui Zhi Tang is originally intended to resolve the muscles. If the pulse is floating and tight, with fever but no sweating, it must not be given. One must constantly remember this to avoid error.
"Wei" (is) is pronounced with departing tone; "Shi" (remember) is synonymous with zhi; "Ling" (let/make) is pronounced with level tone. This explores the profound meaning of using Gui Zhi Tang, pointing out contraindications to show that drugs have opposing indications, urging practitioners to master the principles for accurate application. "Jie" (resolve) means to rescue and disperse. "Ji" (muscle) refers to flesh and skin. Generally, wind strikes Wei, Wei becomes insecure, leading to fever, sweating, and aversion to wind. Wei Qi circulates outside the vessels, corresponding to the flesh/skin layers. Gui Zhi rescues it; hot porridge disperses it; thus the disease resolves. Hence, "originally intended to resolve the muscles." Floating indicates disease in Taiyang. Tight indicates cold. No sweating also indicates cold. "Bu ke yu" (must not give) means the condition does not match; prohibit reckless administration. However, the sweating effect of Gui Zhi Tang is profound. "Shi" (remember) means to record. Recording affairs is called "shi." It means one must constantly keep this in mind, not forgetting or neglecting, avoiding even slight errors. Since cold pathogens preclude the use of Gui Zhi, such warnings are necessary. The words are deeply earnest and clear. Yet people still err. Why?
(5) Anyone who vomits after taking Gui Zhi Tang will subsequently vomit pus and blood.
Gui Zhi is pungent, sweet, and greatly hot. If the Stomach already has severe damp-heat, adding Gui Zhi's great heat causes two heats to clash in the Middle Jiao. Clashing inevitably causes injury. Sweetness also causes fullness and Qi stagnation, leading to upward overflow. Thus, the Stomach fails to receive food, instead pushing it up and out. The Stomach belongs to Earth; Earth is the mother of Metal. The Lung belongs to Metal; Metal is the child of Earth. Mother disease transmits to child. Severe Stomach damp-heat will necessarily transmit to the Lung. The Lung receives Stomach damp-heat, clashing and steaming with evil heat. Prolonged heat transforms into fire. Lung belongs to Metal; pus and blood result from Metal transforming under Fire.
(6) If a habitual drinker falls ill, Gui Zhi Tang must not be given. Taking it will cause vomiting because habitual drinkers dislike sweet flavors.
This continues the previous clause, adding another example to elaborate, encouraging readers to infer others from this. A "jiu ke" (habitual drinker) consumes alcohol, which is damp-heat in nature—the very definition of severe Stomach damp-heat. "Ou" (vomit) is also "tu" (spew). Vomiting after taking the decoction is due to disliking sweetness, as noted above. By inferring from the fact that drinkers dislike sweetness and vomit after taking the decoction, one can understand why anyone vomiting after taking Gui Zhi Tang reacts similarly. Applying analogical reasoning depends on the individual.
(7) After inducing sweating, if water and medicine cannot enter the mouth, it is a reversal (Ni). If sweating is induced again, vomiting and diarrhea will certainly not cease.
The above four clauses all indicate that Gui Zhi Tang is inappropriate, strictly showing prohibitions. "Water and medicine cannot enter the mouth" indicates severe vomiting. For wind strike, Gui Zhi Tang induces sweating; Gui Zhi Tang is a sweet/herbal formula. For cold damage, Ma Huang Tang induces sweating; Ma Huang Tang also contains Gui Zhi, making it a sweet/herbal formula. Speaking generally of sweating medicines containing Gui Zhi's sweetness, this clause states: After sweating, if water and medicine cannot enter, it continues the previous two clauses, extending the "vomiting after taking the decoction" to its severe form, deeply embedding warning. "Ni" (reversal) means going against the Way. Failing to understand human constitution and treating reversely leads to pathological reversal and complications, hence "becomes Ni." "Must vomit and diarrhea" means since water and medicine cannot enter, the Stomach is already damaged. If the previous decoction is given again, causing further injury, it will lead to severe collapse. Severe collapse leads to chaos. The Stomach is a Middle Fu organ. If severely collapsed and chaotic, not only will it rebel upward causing continued vomiting, it will also descend downward causing increased diarrhea. "Bu zhi" (not cease) exaggerates the severity to emphasize the warning.
(8) Diseases presenting with fever and aversion to cold originate in Yang. Diseases presenting with aversion to cold but no fever originate in Yin. Those originating in Yang heal in seven days; those originating in Yin heal in six days, because Yang number is seven and Yin number is six.
This explores the origin of Zhong Feng and Shang Han, summarizing their conclusion. All Taiyang conditions involve aversion to cold. Fever and aversion to cold refer to Zhong Feng immediately featuring fever, discussing Taiyang Zhong Feng. "Fa" (originate/rise) in "fa yu yang" means rise. Wind is Yang; striking Wei, and Wei is Yang, so the disease arises from Yang. No fever and aversion to cold refers to Shang Han possibly lacking fever initially, hence "no fever," discussing Taiyang Shang Han. "Fa yu yin" means Cold is Yin; injuring Ying, and Ying is Yin, so the disease arises from Yin. Seven is the number of Young Yang. Six is the number of Old Yin. Yang numbers: Nine is Old, Seven is Young. Yin numbers: Old is Six, Young is Eight. Yang path is smooth/proceeding; Yin path is reverse/retreating. Yang governs advancement; Yin governs retreat. "Yu" (heal) means recovery. Wind-cold invading humans gradually transmits through the Six Channels' locations. Considering one channel per day, Zhong Feng transmits through six days. Although transmission completes, it heals on the seventh day as Yang advances and disease resolves, because Yang governs life. Shang Han transmits through six days. When Yin retreats to its extreme, the disease resolves, because Yin governs destruction. Thus, the origin of Zhong Feng and Shang Han diseases begins according to their categories and resolves according to their numbers. The two Qi interact; Heaven and Man are consistent; the mystery of the Dao is natural. Its mechanism is thus. The *I Ching* says: To know the mechanism is divine. It also says: Tracing origin and returning to end allows knowledge of life and death. Medicine possesses the Dao of Change. How true these words are! Sun Simiao said: Not knowing Tai Yi (Great Simplicity/Change) makes one unfit to discuss medicine. Scholars must examine this. If aspiring to the Dao, one must strive.
(9) In Taiyang disease, headache resolving spontaneously after seven days or more occurs because the pathogen has exhausted its course through the channels. If it is about to transmit to another channel, acupuncture at the Foot-Yangming channel can prevent transmission and cure the disease.
"Chuan" (transmit) is pronounced zhuan, see Question 5, following this pattern below. This continues the self-healing aspect of the previous clause, restating the meaning of the completed course, and further addressing the prevention of future transmission. Taiyang headache was detailed in the first clause; mentioning it again here highlights the general principle. "Seven days or more" includes the six days. "Xing" (walk/travel) also means transmit. "Jing jin" (exhaustion of channel) means transmission is complete. "Yu zuo zai jing" (desire to make another channel) means the disease progresses. Acupuncture at Foot-Yangming intercepts the transmission route to block it. "Chuan" shares phonetic and semantic interchangeability with the Yangming chapter's "zhuan," similar to ancient postal relay stations or modern travel permits.
(10) The time when Taiyang disease tends to resolve is from Si hour to Wei hour.
Taiyang is盛 (abundant) Yang. Therefore, it prospers during Si, Wu, and Wei hours. The classic states: Rising when in its own position—this is what is meant.
(11) When a disease is about to resolve spontaneously, there must first be irritability (Fan), followed by sweating and resolution. How do we know this? Because the pulse is floating, we know it will resolve with sweating.
This continues the previous clause, informing people of the mechanism of disease resolution. The character "Fan" (irritability) consists of Fire and Head (Ye). *Shuo Wen*: Ye means head. Thus, Fan means heat oppression and headache. First Fan indicates evil Qi attempting to exit and contending with Righteous Qi, a sign of impending sweat. "Nai you han" (then there is sweat) means without this prior state, sweat cannot emerge. Floating pulse indicates evil Qi returning to the Exterior. Sweating indicates evil Qi exiting. Resolution means evil dissipates and disease departs.
(12) If moxibustion or heated needles are used to induce sweating, and cold invades the needle site, causing nodules to rise and turn red, Ben Tun (Running Piglet) will certainly develop. If Qi rushes from the lower abdomen up to the heart, moxibustion should be applied to each nodule (one mound), and Gui Zhi Jia Gui Tang (Cinnamon Twig Plus Cinnamon Decoction) should be administered, adding two liang more Gui Zhi.
Formula for Gui Zhi Jia Gui Tang (Cinnamon Twig Plus Cinnamon Decoction):
Add two liang more Gui Zhi to the Gui Zhi Tang formula, totaling over five liang. Follow the Gui Zhi Tang preparation method.
"Ling" (let/make) is pronounced with level tone; "Shao" (less/lower) is pronounced with departing tone; "Shang" (upward) in "shang chong" is pronounced with rising tone. This continues the previous clause, addressing complications from ignorant aggressive treatment and their remedies. Heated needles: Needle nature is cold; must be heated first to become warm before use. "Bei han" (invaded by cold) means cold enters retroactively through the needle aperture. "He" (nodule) refers to flesh at the needle site swelling, reddening, and rising like a kernel. "Ben Tun" is the name of a Kidney accumulation. "Qi rushing from lower abdomen to heart" describes the manifestation of Ben Tun attack. Generally, individuals with pre-existing Kidney accumulations, upon cold entering through the needle site, trigger the accumulation. Qi rebels upward from the lower abdomen to the heart, resembling a startled pig charging forward, hence "Ben Tun." Moxibustion on the nodules disperses the cold. Administering Gui Zhi Tang resolves the muscular exterior seeking self-resolution. Adding Gui Zhi: Gui penetrates Yin and can suppress Kidney evil; thus it is used to drain Ben Tun Qi. Note that what is added is Gui (Cinnamon Bark), not Zhi (Twig). The formula appears in supplementary additions, hence...