桂枝二麻黄一汤∶
本桂枝汤二分，麻黄汤一分，合为二升，分再服。后人合
一方，失仲景异道同归之活法。
桂枝加附子汤∶
本方加附子（一枚，炮，去皮，破八片），煎服，不须啜粥。
桂枝去芍药生姜新加人参汤∶
本方去芍药、生姜，加人参（三两）。
芍药甘草附子汤∶
芍药、甘草（炙，各二两） 附子（一枚，炮，去皮，破八片）
水五升，煮一升五合，分温三服。
桂枝甘草汤∶
桂枝（四两，去皮） 甘草（二两，炙）
水二升，煮一升，顿服。
茯苓桂枝甘草大枣汤∶
茯苓（半斤） 桂枝（四两，去皮） 甘草（二两） 大枣（十二枚）
以甘澜水一斗，先煮茯苓减二升，内诸药，煮三升，温服一升，日三服。
桂枝去桂加茯苓白术汤∶
芍药 生姜 白术 茯苓（各三两） 甘草（炙，二两） 大枣（十二枚）。
水八升，煮三升，温服一升。
桂枝人参汤∶
桂枝（四两） 人参（四两） 甘草（四两，炙） 白术（三两） 干姜（五两）
水九升，先煮四味，取五升，内桂，煮三升，温服。日再服，夜一服。
葛根黄连黄芩汤∶
葛根（半斤） 黄连（三两） 黄芩（三两） 甘草（二两 炙）
水八升，先煮葛根减二升，内诸药，煮服二升，分温二服。
桂枝去芍药加附子汤∶
桂枝（四两） 生姜（三两） 甘草（二两，炙） 大枣（十二枚） 附子（三枚）
水六升，煮二升，分温三服。
桂枝加浓朴杏仁汤∶
本方加浓朴（二两，去皮），杏仁（五十枚）。
水七升，微火煮三升，温服一升，覆取微似汗。
桂枝加芍药汤∶
本方加芍药（三两）。
桂枝加大黄汤∶
本方加大黄（二两），芍药（三两）。
按∶论中无芍药，疑误。
茯苓桂枝白术甘草汤∶
茯苓（四两） 桂枝（三两） 白术、甘草（炙，各二两）
水六升，煮三升，分温三服。
桂枝加桂汤∶
本方加桂枝（二两）。
桂枝去芍药加蜀漆龙骨牡蛎救逆汤∶
桂枝 蜀漆 生姜（各三两） 甘草（二两） 大枣（十二枚） 龙骨（四两） 牡蛎（五两）
水一斗二升，煮蜀漆减二升，内诸药，煮取三升，温服一升。
桂枝甘草龙骨牡蛎汤∶
桂枝（一两） 甘草（炙） 龙骨 牡蛎（熬，各二两）
水五升，煮二升半，温服八合。
上方共一十八首。
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。
此非桂枝症，而形似桂枝症， 类玉，大宜着眼。
桂枝症以自汗出为提纲。然除头痛发热、恶寒恶风及鼻鸣干呕外，有一件不合桂枝者，即不得以自汗出为
主张矣。此条中脚挛急一件不合桂枝症，盒饭于其不合处推求；而自汗出是合桂枝症，盒饭于自汗出处推求。太
阳有自汗症，阳明亦有自汗症。则心烦、微恶寒，是阳明表症，小便数、脚挛急，是阳明里症，盒饭认为阳明
伤寒，而非太阳中风矣。然症不在表，不当用桂枝；症不在里，不当用承气汤。症在半表半里，法当去桂枝、姜、
枣之散，而任芍药、甘草之和矣。芍药酸寒，用以止烦、敛自汗而利小便；甘草甘平，用以泻心、散微寒而缓
挛急。斯合乎不从标本，从乎中治之法也。反用桂枝汤攻汗，津液越出，汗多亡阳，脚挛急者因而厥逆矣。咽
干、烦躁、吐逆，皆因胃阳外亡所致，必甘草干姜汤救桂枝之误，而先复其胃脘之阳，阳复则厥愈而足温矣。变
症虽除，而芍药甘草之症未罢，必更行芍药甘草汤滋其阴，而脚即伸矣。或胃实而谵语，是姜、桂遗热所致也，
少与调胃承气和之。仗硝、黄以对待乎姜、桂，仍不失阳明燥化之治法耳。问曰∶“六经皆始于足，脚挛急独归
阳明者何？”曰∶“阳明乃血所生病，血虚则筋急，且挛急为燥症，燥化又属阳明故也。”曰∶“太阳主筋，
所生病非太阳乎？”曰∶“太阳脉盛于背，故背中脉太阳居其四行；阳明脉盛于足，故两足脉阳明居其六行。
《内经》曰∶“身重难以行者，胃脉在足也。”是脚挛当属阳明矣。故头痛、项背强、腰脊强，凡身以后者属
太阳；颈动KT KT 、脚挛急，凡身以前者属阳明。即如痉病，项强急、时发热、独头摇、卒口噤、背反张者，
太阳也；胸满口噤、卧不着席、必 齿、脚挛急者，阳明也。愚谓仲景杂病论亦应分六经者，此类是与？
自汗、心烦、恶寒，皆阳虚症，独以脚挛急认是阴虚；咽干，烦躁，皆阳盛症，独以厥认为亡阳。独处藏
奸，惟仲景独能看破。曰反与，曰少与，是用成方；曰作，曰更作，是制新方。
两若字，有不必然意。
甘草干姜汤∶
炙草（四两） 干姜（二两）
水三升，煮一升五合，分温再服。
芍药甘草汤∶
芍药（四两） 炙草（四两） 法如前。
问曰∶“仲景每用桂、附以回阳，此只用芍药、干姜者何？”曰∶“斯正仲景治阳明之大法也。太阳少阴，
从本从标，其标在上，其本在下，其标在外，其本在内。所谓亡阳者，亡肾中之阳也，故用桂、附之下行者回
之，从阴引阳也。阳明居中，故不从标本，从乎中治。所谓阳者，胃阳也，用甘草、干姜以回之，从乎中也。
然太少之阳不易回，回则诸症悉解。阳明之阳虽易回，回而诸症仍在，变症又起，故更作芍药甘草汤继之，少与
调胃承气和之，是亦从乎中也。此两阳合明，气血俱多之部，故不妨微寒之而微利之，与他经亡阳之治不同，
此又用阴和阳之法。”
桂枝辛甘，走而不守，即佐以芍药，亦能亡阳；干姜辛苦，守而不走，故君以甘草，便能回阳。以芍药之
酸收，协甘草之平降，位同力均，则直走阴分，故脚挛可愈。甘草干姜汤得理中之半，取其守中，不须其补中；
芍药甘草汤得桂枝之半，用其和里，不许其攻表。
上论疑似桂枝症。
Gui Zhi Er Ma Huang Yi Tang (Cinnamon Twig Decoction with Twice the Amount of Ephedra Decoction):
Take two parts of the original Gui Zhi Tang (Cinnamon Twig Decoction) and one part of Ma Huang Tang (Ephedra Decoction), mix them to obtain two sheng (approx. 400ml) of liquid, and divide into two doses for administration. Later physicians who combined these two formulas into one lost Zhang Zhongjing's flexible method of "different paths leading to the same goal."
Gui Zhi Jia Fu Zi Tang (Cinnamon Twig Decoction with Added Aconite Root):
Add Fu Zi (Aconite Lateralis Radix Praeparata, one piece, processed, peeled, broken into eight pieces) to the base formula. Boil and administer; there is no need to drink hot porridge to assist sweating.
Gui Zhi Qu Shao Yao Sheng Jiang Xin Jia Ren Shen Tang (Cinnamon Twig Decoction without Peony and Fresh Ginger with Added Ginseng Root):
Remove Shao Yao (Paeoniae Radix Alba) and Sheng Jiang (Zingiberis Rhizoma Recens) from the base formula, and add Ren Shen (Ginseng Radix et Rhizoma, three liang).
Shao Yao Gan Cao Fu Zi Tang (Peony and Licorice Decoction with Added Aconite Root):
Shao Yao (Paeoniae Radix Alba), Gan Cao (Licorice Radix et Rhizoma, honey-fried, two liang each), Fu Zi (Aconite Lateralis Radix Praeparata, one piece, processed, peeled, broken into eight pieces).
Boil in five sheng (approx. 1000ml) of water until one sheng five he (approx. 300ml) remains. Divide into three warm doses.
Gui Zhi Gan Cao Tang (Cinnamon Twig and Licorice Decoction):
Gui Zhi (Cinnamomi Ramulus, four liang, peeled), Gan Cao (Licorice Radix et Rhizoma, honey-fried, two liang).
Boil in two sheng (approx. 400ml) of water until one sheng (approx. 200ml) remains. Administer as a single dose.
Fu Ling Gui Zhi Gan Cao Da Zao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction):
Fu Ling (Poria, half jin), Gui Zhi (Cinnamomi Ramulus, four liang, peeled), Gan Cao (Licorice Radix et Rhizoma, two liang), Da Zao (Jujubae Fructus, twelve pieces).
Use one dou (approx. 2000ml) of Gan Lan Shui (Gentle Wave Water). First boil Fu Ling until the volume decreases by two sheng. Add other herbs, boil until three sheng remain. Take one sheng warm per dose, three times daily.
Gui Zhi Qu Gui Jia Fu Ling Bai Zhu Tang (Cinnamon Twig Decoction without Cinnamon Twig with Added Poria and Atractylodes Macrocephala Rhizome):
Shao Yao (Paeoniae Radix Alba), Sheng Jiang (Zingiberis Rhizoma Recens), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria, three liang each), Gan Cao (Licorice Radix et Rhizoma, honey-fried, two liang), Da Zao (Jujubae Fructus, twelve pieces).
Boil in eight sheng (approx. 1600ml) of water until three sheng remain. Take one sheng warm per dose.
Gui Zhi Ren Shen Tang (Cinnamon Twig and Ginseng Decoction):
Gui Zhi (Cinnamomi Ramulus, four liang), Ren Shen (Ginseng Radix et Rhizoma, four liang), Gan Cao (Licorice Radix et Rhizoma, honey-fried, four liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma, three liang), Gan Jiang (Zingiberis Rhizoma, five liang).
Boil the first four ingredients in nine sheng (approx. 1800ml) of water until five sheng remain. Add Gui Zhi, boil until three sheng remain. Take warm. Two doses during the day, one dose at night.
Ge Gen Huang Lian Huang Qin Tang (Kudzu Root, Coptis, and Scutellaria Decoction):
Ge Gen (Puerariae Lobatae Radix, half jin), Huang Lian (Coptidis Rhizoma, three liang), Huang Qin (Scutellariae Radix, three liang), Gan Cao (Licorice Radix et Rhizoma, honey-fried, two liang).
Boil Ge Gen in eight sheng (approx. 1600ml) of water until the volume decreases by two sheng. Add other herbs, boil until two sheng remain. Divide into two warm doses.
Gui Zhi Qu Shao Yao Jia Fu Zi Tang (Cinnamon Twig Decoction without Peony with Added Aconite Root):
Gui Zhi (Cinnamomi Ramulus, four liang), Sheng Jiang (Zingiberis Rhizoma Recens, three liang), Gan Cao (Licorice Radix et Rhizoma, honey-fried, two liang), Da Zao (Jujubae Fructus, twelve pieces), Fu Zi (Aconite Lateralis Radix Praeparata, three pieces).
Boil in six sheng (approx. 1200ml) of water until two sheng remain. Divide into three warm doses.
Gui Zhi Jia Nong Po Xing Ren Tang (Cinnamon Twig Decoction with Added Magnolia Bark and Apricot Seed):
Add Nong Po (Magnoliae Officinalis Cortex, two liang, peeled) and Xing Ren (Armeniacae Semen Amarum, fifty seeds) to the base formula.
Boil in seven sheng (approx. 1400ml) of water over low heat until three sheng remain. Take one sheng warm. Cover with blankets to induce slight perspiration.
Gui Zhi Jia Shao Yao Tang (Cinnamon Twig Decoction with Added Peony):
Add Shao Yao (Paeoniae Radix Alba, three liang) to the base formula.
Gui Zhi Jia Da Huang Tang (Cinnamon Twig Decoction with Added Rhubarb):
Add Da Huang (Rhei Radix et Rhizoma, two liang) and Shao Yao (Paeoniae Radix Alba, three liang) to the base formula.
Note: The original text does not mention Shao Yao here; it is suspected to be an error.
Fu Ling Gui Zhi Bai Zhu Gan Cao Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala Rhizome, and Licorice Decoction):
Fu Ling (Poria, four liang), Gui Zhi (Cinnamomi Ramulus, three liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Cao (Licorice Radix et Rhizoma, honey-fried, two liang each).
Boil in six sheng (approx. 1200ml) of water until three sheng remain. Divide into three warm doses.
Gui Zhi Jia Gui Tang (Cinnamon Twig Decoction with Added Cinnamon Twig):
Add Gui Zhi (Cinnamomi Ramulus, two liang) to the base formula.
Gui Zhi Qu Shao Yao Jia Shu Qi Long Gu Mu Li Jiu Ni Tang (Cinnamon Twig Decoction without Peony with Added Pinellia Sprout, Dragon Bone, and Oyster Shell for Rescue from Reversal):
Gui Zhi (Cinnamomi Ramulus), Shu Qi (Pinelliae Sprout), Sheng Jiang (Zingiberis Rhizoma Recens, three liang each), Gan Cao (Licorice Radix et Rhizoma, two liang), Da Zao (Jujubae Fructus, twelve pieces), Long Gu (Fossilia Ossis Mastodi et Scapulae, four liang), Mu Li (Ostreae Concha, five liang).
Boil Shu Qi in one dou two sheng (approx. 2400ml) of water until the volume decreases by two sheng. Add other herbs, boil until three sheng remain. Take one sheng warm per dose.
Gui Zhi Gan Cao Long Gu Mu Li Tang (Cinnamon Twig, Licorice, Dragon Bone, and Oyster Shell Decoction):
Gui Zhi (Cinnamomi Ramulus, one liang), Gan Cao (Licorice Radix et Rhizoma, honey-fried), Long Gu (Fossilia Ossis Mastodi et Scapulae), Mu Li (Ostreae Concha, roasted, two liang each).
Boil in five sheng (approx. 1000ml) of water until two sheng five he (approx. 500ml) remain. Take eight ge (approx. 160ml) warm per dose.
There are eighteen formulas in total above.
In Shaoyin disease (Cold Damage), presenting with floating pulse, spontaneous sweating, frequent urination, mental restlessness, slight aversion to cold, and acute cramping of the foot, administering Gui Zhi Tang to attack the exterior is an error. If this leads to limb reversal coldness (Jue), dryness in the throat, irritability, and vomiting/reversal of qi, prepare Gan Cao Gan Jiang Tang (Licorice and Dried Ginger Decoction) to restore Yang Qi. If the reversal coldness resolves and feet become warm, prepare Shao Yao Gan Cao Tang (Peony and Licorice Decoction); the foot cramping will then resolve. If stomach Qi is disharmonious leading to delirium (Chan Yu), administer a small amount of Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct Downward Decoction).
This condition is not a typical Gui Zhi Syndrome but resembles it superficially; like jade resembling stone, it demands careful attention.
The hallmark of Gui Zhi Syndrome is spontaneous sweating. However, excluding headache, fever, aversion to cold/wind, nasal congestion with rattling, and dry retching, if even one symptom does not fit Gui Zhi Syndrome, one cannot claim spontaneous sweating alone constitutes Gui Zhi Syndrome. In this case, "acute foot cramping" does not fit Gui Zhi Syndrome; one must investigate where it diverges. "Spontaneous sweating" fits Gui Zhi Syndrome; one must investigate where it aligns. Taiyang (Greater Yang) has spontaneous sweating, and Yangming (Yang Brightness) also has spontaneous sweating. Thus, mental restlessness and slight aversion to cold belong to Yangming Exterior Syndrome; frequent urination and acute foot cramping belong to Yangming Interior Syndrome. It should be diagnosed as Yangming Cold Damage, not Taiyang Wind Strike. However, since the pathogen is not purely in the exterior, Gui Zhi Tang is inappropriate; since it is not purely in the interior, Cheng Qi Tang is inappropriate. The pathogen is in the semi-exterior/semi-interior region. The method should discard the dispersing actions of Gui Zhi, Sheng Jiang, and Da Zao, and rely on the harmonizing action of Shao Yao and Gan Cao. Shao Yao is sour and cold, used to stop restlessness, consolidate spontaneous sweating, and promote urination. Gan Cao is sweet and neutral, used to drain Heart Heat, disperse slight cold, and relieve cramping. This complies with the principle of treating from the middle rather than following the root or branch. Using Gui Zhi Tang to induce sweating causes fluid loss; excessive sweating leads to Yang collapse, causing foot cramping to progress to limb reversal coldness. Dry throat, irritability, and vomiting result from the external loss of Stomach Yang. Gan Cao Gan Jiang Tang must rescue the error of Gui Zhi Tang by first restoring the Yang of the epigastrium. Once Yang is restored, reversal coldness resolves and feet warm. Although complications cease, the Shao Yao Gan Cao Tang pattern persists; thus, Shao Yao Gan Cao Tang must be administered again to nourish Yin, allowing the foot to extend. If constipation and delirium occur due to residual heat from Ginger and Cinnamon, a small amount of Tiao Wei Cheng Qi Tang is used to harmonize. Using Shi Hui Xiao Ming Fan (Mirabilite) and Da Huang (Rhei Radix et Rhizoma) counters the heat from Ginger and Cinnamon, adhering to the treatment method for Yangming Dryness Transformation. Question: "All six meridians begin in the foot; why is foot cramping attributed solely to Yangming?" Answer: "Yangming diseases arise from blood disorders; blood deficiency leads to tendon tension. Furthermore, cramping is a Dryness syndrome, and Dryness transformation belongs to Yangming." Question: "Taiyang governs tendons; are its diseases not Taiyang?" Answer: "Taiyang pulse is vigorous in the back, so Taiyang pulses occupy four rows in the back; Yangming pulse is vigorous in the feet, so Yangming pulses occupy six rows in the feet. The *Nei Jing* states: 'Heaviness of body and difficulty walking indicate the Stomach pulse is in the feet.' Therefore, foot cramping belongs to Yangming. Thus, headache, stiff neck/back, and stiff waist/spine (posterior body symptoms) belong to Taiyang; pulsating neck arteries and foot cramping (anterior body symptoms) belong to Yangming. For example, in Spasm Disease (Jing Bing), stiff neck/back, intermittent fever, isolated head shaking, sudden lockjaw, and opisthotonos belong to Taiyang; chest fullness, lockjaw, inability to lie flat (back not touching bed), grinding teeth, and foot cramping belong to Yangming. I believe Zhang Zhongjing's Treatise on Mixed Diseases should also be divided into six meridians; such cases provide evidence.
Spontaneous sweating, mental restlessness, and aversion to cold are all signs of Yang deficiency, yet foot cramping alone is recognized as Yin deficiency. Dry throat and irritability are signs of Yang excess, yet limb reversal coldness alone is recognized as Yang collapse. 'Hidden evil lies in the solitary sign'; only Zhang Zhongjing could perceive this clearly. The terms 'fan yu' (contrary administration) and 'shao yu' (small dose administration) refer to using established formulas; 'zuo' (prepare) and 'geng zuo' (prepare again) refer to formulating new prescriptions.
The two instances of 'ruo' (if) imply contingency, not inevitability.
Gan Cao Gan Jiang Tang (Licorice and Dried Ginger Decoction):
Zhi Gan Cao (Honey-fried Licorice Radix et Rhizoma, four liang), Gan Jiang (Dried Zingiberis Rhizoma, two liang).
Boil in three sheng (approx. 600ml) of water until one sheng five he (approx. 300ml) remains. Divide into two warm doses.
Shao Yao Gan Cao Tang (Peony and Licorice Decoction):
Shao Yao (Paeoniae Radix Alba, four liang), Zhi Gan Cao (Honey-fried Licorice Radix et Rhizoma, four liang). Preparation method as described above.
Question: "Zhang Zhongjing often uses Gui Zhi and Fu Zi to restore Yang; why use only Shao Yao and Gan Jiang here?" Answer: "This is precisely Zhang Zhongjing's major method for treating Yangming. Taiyang and Shaoyin follow both root and branch; their branch is superior, root is inferior, branch is exterior, root is interior. What is called 'Yang collapse' refers to the collapse of Kidney Yang; thus, descending Gui Zhi and Fu Zi are used to restore Yang, drawing Yang from Yin. Yangming resides in the center, so it does not follow root or branch but treats from the middle. The 'Yang' referred to here is Stomach Yang; Gan Cao and Gan Jiang are used to restore it, treating from the middle. However, Taiyang and Shaoyin Yang are difficult to restore; once restored, all symptoms resolve. Yangming Yang is easier to restore, but after restoration, symptoms may persist and complications may arise. Thus, Shao Yao Gan Cao Tang is administered subsequently to nourish Yin, and a small amount of Tiao Wei Cheng Qi Tang is used to harmonize. This is also treating from the middle. This is a region where two Yangs combine and Qi and Blood are abundant, so mild cooling and mild purging are permissible, differing from the treatment of Yang collapse in other meridians. This is another method of harmonizing Yin and Yang."
Gui Zhi is pungent and sweet, moving without staying; even with Shao Yao, it can cause Yang collapse. Gan Jiang is pungent and bitter, staying without moving; thus, with Gan Cao as sovereign, it can restore Yang. Utilizing Shao Yao's sour astringency and Gan Cao's neutral descent, with equal status and power, the medicinal force moves directly into the Yin aspect, so foot cramping heals. Gan Cao Gan Jiang Tang possesses half the efficacy of Li Zhong Tang, taking its stabilizing middle action without needing its tonifying middle action. Shao Yao Gan Cao Tang possesses half the efficacy of Gui Zhi Tang, using its interior-harmonizing action without permitting its exterior-attacking action.
The above discusses conditions resembling Gui Zhi Syndrome.