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。
太阳主一身之表，风寒外束，阳气不伸，故一身尽疼。太阳脉抵腰中，故腰痛。太阳主筋所生病，诸筋者，
皆属于节，故骨节疼痛。从风寒得，故恶风。风寒客于人则皮毛闭，故无汗。太阳为诸阳主气，阳气郁于内，故
喘。太阳为开，立麻黄汤以开之，诸症悉除矣。麻黄八症，头痛，发热、恶风，同桂枝症，无汗、身疼，同大青
龙症，本症重在发热、身疼、无汗而喘。
本条不冠伤寒，又不言恶寒而言恶风。先辈言麻黄汤主治伤寒不治中风，似非确论。盖麻黄汤、大青龙汤治
中风之重剂，桂枝汤、葛根汤治中风之轻剂，伤寒可通用之，非主治伤寒之剂也。
脉浮者，病在表，可发汗，麻黄汤。脉浮而数者，可发汗，宜麻黄汤。
前条论症，此条论脉。言浮而不言迟弱者，是浮而有力也。然必审其热在表，乃可用。若浮而大，有热属藏者，
当攻之，不令发汗矣。若浮数而痛偏一处者，身虽疼，不可发汗。
数者，急也，即紧也。紧则为寒，指受寒而言；数则为热，指发热而言。辞虽异而意则同。故脉浮紧者，
即是麻黄汤症。
脉浮而数，浮为风，数为虚。风为热，虚为寒，风虚相搏，则洒淅恶寒也。
脉浮为在表者何？以表有风邪故也。邪之所凑，其气必虚。数本为热，而从浮见，则数为虚矣。风为阳邪，
阳浮则热自发。数为阳虚，阳虚则畏寒。凡中风寒，必发热恶寒者，风虚相搏而然也。
诸脉浮数，当发热而洒淅恶寒，若有痛处、饮食如常者，蓄积有脓也。
浮数之脉，而见发热恶寒之症，不独风寒相同，而痈疡亦有然者。此浮为表而非风，数为实热而非虚矣。
发热为阳浮，而恶寒非阳虚矣。若欲知其不是风寒，当以内外症辨之。外感则头项痛、身痛、骨节痛、腰脊痛，
非痛偏一处也。外感则呕逆，或干呕，不得饮食如常。如此审之，有蓄积而成痈脓者，庶不致误作风寒治，
则举疮家一症例之。治伤寒者，见脉症之相同，皆当留意也。
疮家身虽疼，不可发汗，汗出则痉。
疮家病与外感不同，故治法与风寒亦异。若以风寒之法治之，其变亦不可不知也。疮虽痛偏一处，而血气
壅遏，亦有遍身疼者。然与风寒有别，汗之则津液越出，筋脉血虚，挛急而为痉矣。诸脉症之当审，正此故耳。
脉浮数者，法当汗出而愈。若身重心悸者，不可发汗，当自汗出乃解。所以然者，尺中脉微，此里虚，须
表里实，津液自和，便汗出愈。
脉浮数者，于法当汗，而尺中微，则不敢轻汗，以麻黄为重剂故也。此表指身，里指心，有指营卫而反遗
心悸者，非也。身重是表热，心悸是里虚，然悸有因心下水气者，亦当发汗。故必审其尺脉，尺中脉微为里虚。
里虚者，必须实里，欲津液和，须用生津液。若坐而待之，则表邪愈盛，心液愈虚，焉能自汗？此表是带言，
只重在里。至于自汗出，则里实而表和矣。
寸口脉浮而紧，浮则为风，紧则为寒。风则伤卫，寒则伤营，营卫俱病，骨肉烦疼，当发其汗也。
风寒本自相因，必风先开腠理，寒得入于经络。营卫俱伤，则一
身内外之阳不得越，故骨肉烦疼，脉亦应其象而变见于寸口也。紧为阴寒，而从浮见，阴盛阳虚，汗之则愈矣。
紧者，急也，即数也。紧以形象言，数以至数言。紧则为寒，指伤寒也；数则为热，指发热也。辞异而义则
同，故脉浮数浮紧者，皆是麻黄症。
脉法以浮为风，紧为寒，故提纲以脉阴阳俱紧者名伤寒。大青龙脉亦以浮中见紧，故名中风。则脉但浮者，
正为风脉，宜麻黄汤，是麻黄汤固主中风脉症矣。麻黄汤症发热、骨节疼，便是骨肉烦疼，即是风寒两伤，营
卫俱病。先辈何故以大青龙治营卫两伤？麻黄汤治寒伤营而不伤卫？桂枝汤治风伤卫而不伤营？曷不以桂枝症
之恶寒，麻黄症之恶风，一反勘耶？要之冬月风寒，本同一体。故中风伤寒，皆恶风恶寒，营病卫必病。中风
之重者，便是伤寒；伤寒之浅者，便是中风。不必在风寒上细分，须当在有汗无汗上着眼耳。
太阳病，脉浮紧、无汗、发热、身疼痛，八九日不解，表症仍在，此当发其汗，麻黄汤主之。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。
脉症同大青龙，而异者外不恶寒，内不烦躁耳。发于阳者七日愈，八九日不解，其人阳气重可知。然脉紧、
无汗、发热、身疼，是麻黄症未罢。仍与麻黄，只微除在表之风寒，而不解内扰之阳气。其人发烦、目瞑，见不
堪之状，可知阳络受伤，必逼血上行而衄矣。血之与汗，异名同类，不得汗，必得血，不从汗解而从衄解。此与
热结膀胱血自下者，同一局也。
太阳脉，从自目内 络阳明脉于鼻。鼻者阳也，目者阴也，血虽阴类。从阳气而升，则从阳窍而出。故阳盛
则衄，阳盛则阴虚，阴虚则目瞑也。
解后复烦，烦见于内，此余邪未尽，故用桂枝更汗。微除发烦，是烦于外见，此大邪已解，故不可更汗，仲景
每有倒句法，前辈随文衍义，谓当再用麻黄以散余邪，不知得衄乃解句何处着落。
伤寒脉浮紧者，麻黄汤主之。不发汗，因致衄。
脉紧无汗者，当用麻黄汤发汗，则阳气得泄，阴血不伤，所谓夺汗
者无血也。不发汗，阳气内扰，阳络伤则衄血，是夺血者无汗也。若用麻黄汤再汗，液脱则毙矣。言不发汗因
致衄，岂有因致衄更发汗之理乎？观少阴病无汗而强发之，则血从口鼻而出，或从目出，能不惧哉！愚故亟为
校正，恐误人者多耳。
太阳病，脉浮紧、发热、身无汗，自衄者愈。
汗者心之液，是血之变，见于皮毛者也。寒邪坚敛于外，腠理不能开发，阳气大扰于内，不能出玄府而为
汗，故逼血妄行而假道于肺窍也。今称红汗，得其旨哉！
衄家不可发汗，汗出必额上陷，脉紧急，目直视，不能 不得眠。
太阳之脉，起自目内 ，上额。已脱血而复汗之，津液枯竭，故脉紧急，而目直视也，亦心肾俱绝矣。目不
转，故不能 ；目不合，故不得眠。
脉浮紧者，法当身疼痛，宜以汗解之。假令尺中迟者，不可发汗，以营气不足、血少故也。
脉浮紧者，以脉法论，当身疼痛，宜发其汗。然寸脉虽浮紧，而尺中迟，则不得据此法矣。尺主血，血少则
营气不足，虽发汗决不能作汗。正气反虚，不特身疼不除，而亡血、亡津液之变起矣。假令，是设辞，是深一
层看法，此与脉浮数而尺中微者同义。阳盛者不妨发汗，变症惟衄，衄乃解矣。阴虚者不可发汗，亡阳之变，恐
难为力。
太阳与阳明合病，喘而胸满者，不可下，麻黄汤主之。
三阳俱受气于胸中，而部位则属阳明。若喘属太阳，呕属少阳，故胸满而喘者，尚未离乎太阳。虽有阳明可
下之症，而不可下。如呕多，虽有阳明可攻之症，而不可攻，亦以未离乎少阳也。
阳明病，脉浮无汗而喘者，发汗则愈，宜麻黄汤。
太阳有麻黄症，阳明亦有麻黄症，则麻黄汤不独为太阳设也。见麻黄症即用麻黄汤，是仲景大法。
上论麻黄汤脉症。
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。
脉微细，但欲寐，少阴症也。浮细而嗜卧，无少阴症者，虽十日后。尚属太阳，此表解而不了了之谓。设
见胸满嗜卧，亦太阳之余邪未散；兼胁痛，是太阳少阳合病矣，以少阳脉弦细也。少阳为枢，枢机不利，一阳之
气不升，故胸满胁痛而嗜卧，与小柴胡和之。若脉浮而不细，是浮而有力也。无胸胁痛，则不属少阳。但浮而
不大，则不涉阳明，是仍在太阳也。太阳为开，开病反 ，故嗜卧。与麻黄汤以开之，使卫气行阳，太阳仍得主
外而喜寤矣。与太阳初病用以发汗不同，当小其制而少与之。
上论麻黄汤柴胡汤相关脉症。
麻黄汤∶
麻黄（二两，去节） 桂枝（二两） 甘草（一两，炙） 杏仁（七十个，去尖）
水九升，先煮麻黄减一升，去沫，内诸药，煮二升半，温服八合，覆取微似汗。不须啜粥，余如桂枝法。
麻黄色青入肝，中空外直，宛如毛窍骨节状。故能旁通骨节，除身疼，直达皮毛，为卫分驱风散寒第一品
药。然必藉桂枝入心通血脉，出营中汗，而卫分之邪乃得尽去而不留。故桂枝汤不必用麻黄，而麻黄汤不可无
桂枝也。杏为心果，温能散寒，苦能下气，故为驱邪定喘之第一品药。桂枝汤发营中汗，须啜稀热粥者，以营
行脉中，食入于胃，浊气归心，淫精于脉故耳。麻黄汤发卫中汗，不须啜稀热粥者，此汗是太阳寒水之气，在皮
肤间，腠理开而汗自出，不须假谷气以生汗也。
一服汗者，停后服。汗多亡阳遂虚，恶风、烦躁不得眠也。汗多者，温粉扑之。
此麻黄汤禁也。麻黄汤为发汗重剂，故慎重如此。其用桂枝汤，若不汗更服，若病重更作服，若不出汗，
可服至二三剂。又刺后可复
汗，汗后可复汗。下后可复汗。此麻黄汤但云温服八合，不言再服，则一服汗者，停后服，汗出多者，温粉扑
之，自当列此后。大青龙烦躁在未汗先，是为阳盛。此烦躁在发汗后，是为阴虚。阴虚则阳无所附，宜白虎加
人参汤。若用桂、附以回阳，其不杀人者鲜矣。
Taiyang disease (Disease of the Taiyang Channel), characterized by headache, fever, body ache, lower back pain, joint pain, aversion to wind, anhidrosis (absence of sweating), and wheezing, should be primarily treated with Mahuang Tang (Ephedra Decoction).
The Taiyang channel governs the exterior of the entire body. When Wind-Cold pathogens bind externally, Yang Qi fails to extend, resulting in generalized body pain. The Taiyang meridian descends to the waist, hence lower back pain. The Taiyang channel governs diseases of the sinews; all sinews are associated with joints, hence joint pain. These symptoms arise from contracting Wind-Cold, leading to aversion to wind. When Wind-Cold invades the person, the skin pores close, causing anhidrosis. The Taiyang channel is the master Qi of all Yang channels; when Yang Qi is constrained internally, wheezing occurs. The Taiyang channel governs "opening"; Mahuang Tang is established to open the pores, thereby resolving all symptoms. Among the eight major symptoms of the Mahuang Tang syndrome—headache, fever, aversion to wind, anhidrosis, and body ache—the first three are shared with Guizhi Tang (Cinnamon Twig Decoction) syndrome, while anhidrosis and body ache are shared with Da Qing Long Tang (Major Blue Dragon Decoction) syndrome. This syndrome focuses on fever, body ache, anhidrosis, and wheezing.
This clause does not prefix "Shanghan" (Cold Damage) nor mention aversion to cold but only aversion to wind. Predecessors stated that Mahuang Tang treats Shanghan but not Zhongfeng (Wind Strike), which seems not to be a definitive conclusion. Essentially, Mahuang Tang and Da Qing Long Tang are heavy agents for treating severe Zhongfeng, while Guizhi Tang and Gegen Tang (Kudzu Root Decoction) are light agents for mild Zhongfeng; they can be used generally for Shanghan and are not exclusive agents for Shanghan.
If the pulse is floating (Fu, 浮), the disease is at the exterior, and sweating therapy is indicated; use Mahuang Tang. If the pulse is floating and rapid (Shu, 数), sweating therapy is indicated; Mahuang Tang is appropriate.
The previous clause discussed symptoms; this clause discusses pulses. Mentioning floating without mentioning slow or weak implies a floating pulse that is forceful. However, one must carefully verify that heat is at the exterior before using it. If the pulse is floating and large with heat belonging to the interior organs, purgation is required, not sweating. If the pulse is floating and rapid with pain localized to one area, despite body pain, sweating is contraindicated.
"Rapid" here means urgent, i.e., "wiry-tight" (Jin, 紧). Wiry-tight indicates Cold, referring to contracting Cold; Rapid indicates Heat, referring to fever. The terminology differs, but the meaning is the same. Thus, a floating and wiry-tight pulse indicates the Mahuang Tang syndrome.
A floating and rapid pulse: Floating indicates Wind, Rapid indicates Deficiency. Wind generates Heat, Deficiency generates Cold. When Wind and Deficiency struggle against each other, chills and shivering occur.
Why does a floating pulse indicate disease at the exterior? Because there are Wind pathogens at the exterior. Where pathogens gather, Qi must be deficient. Although Rapid normally indicates Heat, appearing with Floating makes it indicate Deficiency. Wind is a Yang pathogen; Yang floating leads to spontaneous Heat. Rapid indicates Yang Deficiency, leading to fear of Cold. Whenever Wind-Cold is contracted, fever and aversion to cold occur due to the struggle between Wind and Deficiency.
For all floating and rapid pulses, one expects fever and chills. If there is a fixed painful area and normal diet, it indicates accumulated pus.
With a floating and rapid pulse presenting fever and aversion to cold, this is not unique to Wind-Cold; abscesses also present this way. Here, Floating indicates Exterior but not necessarily Wind, and Rapid indicates Excess Heat rather than Deficiency. Fever is due to Yang floating, and aversion to cold is not due to Yang Deficiency. To distinguish this from Wind-Cold, differentiate via internal and external symptoms. External contraction causes headache, neck stiffness, body pain, joint pain, and back pain, not pain localized to one spot. External contraction causes vomiting or dry heaving, preventing normal eating. By careful examination, if accumulation leads to abscess/pus, one avoids mistreating it as Wind-Cold. This uses the case of a chronic sore patient as an example. Those treating Shanghan must pay attention when pulses and symptoms appear identical.
In patients with chronic sores, even if there is body pain, sweating is contraindicated; inducing sweat will lead to spasm (Jing, 痉).
The pathology of chronic sores differs from external contraction, so treatment differs from Wind-Cold. Treating it as Wind-Cold leads to complications that must be understood. Although sores cause localized pain, blood and Qi stagnation can cause generalized pain. However, this differs from Wind-Cold; sweating depletes fluids, causing sinew and vessel blood deficiency, leading to spasms. Careful examination of pulses and symptoms is crucial for this reason.
For a floating and rapid pulse, sweating should theoretically lead to recovery. But if there is heaviness of the body and palpitations, sweating is contraindicated; spontaneous sweating should resolve it. This is because the Chi position (cun-kou pulse at the wrist) is faint, indicating Interior Deficiency. The Interior and Exterior must become solid, fluids must harmonize, and spontaneous sweating will heal the condition.
For a floating and rapid pulse, sweating is indicated by law, but if the Chi pulse is faint, one dare not lightly induce sweat, as Mahuang Tang is a heavy agent. Here, "Exterior" refers to the body surface, and "Interior" refers to the Heart. Saying it involves Ying and Wei while omitting palpitations is incorrect. Body heaviness indicates Exterior Heat; palpitations indicate Interior Deficiency. However, palpitations caused by water-Qi under the heart may still require sweating. Thus, one must examine the Chi pulse; a faint Chi pulse indicates Interior Deficiency. For Interior Deficiency, one must tonify the Interior. To harmonize fluids, one must generate fluids. Waiting passively allows Exterior pathogens to strengthen and Heart fluids to deplete, making spontaneous sweating impossible. The mention of the Exterior is incidental; the focus is on the Interior. Spontaneous sweating indicates Interior Solidity and Exterior Harmony.
At the Cun Kou (radial artery), a floating and wiry-tight pulse: Floating indicates Wind, Wiry-Tight indicates Cold. Wind injures Wei Qi (Defensive Qi); Cold injures Ying Qi (Nutritive Blood). When both Ying and Wei are diseased, causing bone and flesh restlessness and pain, sweating is indicated.
Wind and Cold naturally accompany each other; Wind opens the interstices first, allowing Cold to enter the meridians. When Ying and Wei are injured, the Yang Qi inside and outside the body cannot diffuse, causing bone and flesh restlessness and pain. The pulse reflects this change at the Cun Kou. Wiry-Tight is Yin Cold appearing with Floating, indicating Yin Excess and Yang Deficiency; sweating resolves it.
"Wiry-Tight" describes the shape; "Rapid" describes the frequency. Wiry-Tight indicates Cold (Shanghan); Rapid indicates Heat (fever). Different terms, same meaning. Thus, floating-rapid or floating-wiry-tight pulses are both Mahuang Tang syndromes.
Pulse theory states Floating is Wind, Wiry-Tight is Cold. Hence, the outline names Shanghan by pulses where Yin and Yang are both wiry-tight. Da Qing Long Tang's pulse also shows Wiry-Tight within Floating, hence named Zhongfeng (referring to the pulse pattern name). Therefore, a purely Floating pulse is the Wind pulse, suitable for Mahuang Tang, proving Mahuang Tang indeed governs Zhongfeng pulses and symptoms. Mahuang Tang syndrome features fever and joint pain, which is bone/flesh restlessness, indicating both Wind and Cold injuring Ying and Wei. Why do predecessors claim Da Qing Long Tang treats Ying-Wei dual injury, Mahuang Tang treats Cold injuring Ying but not Wei, and Guizhi Tang treats Wind injuring Wei but not Ying? Why not cross-examine Guizhi's aversion to cold versus Mahuang's aversion to wind? In winter, Wind and Cold are essentially one entity. Thus, Zhongfeng and Shanghan both feature aversion to wind and cold; Ying disease implies Wei disease. Severe Zhongfeng is Shanghan; mild Shanghan is Zhongfeng. One need not strictly separate Wind and Cold but should focus on the presence or absence of sweat.
In Taiyang disease, with a floating-wiry-tight pulse, anhidrosis, fever, and body pain persisting for eight to nine days without resolution, if exterior symptoms remain, sweating is indicated; treat with Mahuang Tang. After taking the medicine, symptoms may slightly improve. The patient may feel vexed and keep eyes closed; in severe cases, epistaxis (nosebleed) occurs, after which the condition resolves. This is because Yang Qi is heavily constrained.
The pulse and symptoms are similar to Da Qing Long Tang, except for the absence of external aversion to cold and internal vexation. Diseases originating from Yang recover in seven days; persistence beyond eight to nine days indicates heavy Yang constraint. However, tight pulse, anhidrosis, fever, and body pain show the Mahuang Tang syndrome has not ceased. Continuing Mahuang Tang only slightly releases exterior Wind-Cold but does not resolve internally disturbed Yang. Vexation and eye closure indicate unbearable distress, showing Yang collaterals are injured, forcing blood upward into epistaxis. Blood and sweat are different names for the same substance; if sweat cannot be released, blood must be released. Resolution via epistaxis parallels resolution via bleeding from the Bladder due to heat binding.
The Taiyang meridian starts at the inner canthus and connects to the Yangming meridian at the nose. The nose is Yang, the eye is Yin. Although blood is Yin, it rises with Yang Qi and exits through Yang orifices. Thus, Yang Excess causes epistaxis; Yang Excess leads to Yin Deficiency, causing visual disturbance/closed eyes.
Vexation recurring after resolution, located internally, indicates residual pathogens; thus, Guizhi Tang is used to induce sweat again. Slight improvement with external vexation indicates major pathogens have resolved, so further sweating is contraindicated. Zhang Zhongjing often uses inverted syntax. Predecessors interpreting the text suggested using Mahuang Tang again for residual pathogens, failing to account for the phrase "resolution occurs via epistaxis."
For Shanghan with a floating-wiry-tight pulse, Mahuang Tang is indicated. Failure to induce sweat leads to epistaxis.
For tight pulse and anhidrosis, Mahuang Tang should induce sweat, allowing Yang Qi to vent and protecting Yin Blood ("He who loses sweat has no blood"). Failure to sweat allows Yang Qi to disturb internally, injuring Yang collaterals and causing epistaxis ("He who loses blood has no sweat"). Using Mahuang Tang to induce sweat again would deplete fluids and cause death. The statement "failure to sweat causes epistaxis" does not imply "epistaxis requires further sweating." Consider Shaoyin disease: forcing sweat in anhidrotic patients causes bleeding from mouth, nose, or eyes. Is this not terrifying? I correct this urgently to prevent harm.
In Taiyang disease, with floating-wiry-tight pulse, fever, and anhidrosis, spontaneous epistaxis leads to recovery.
Sweat is the fluid of the Heart, a transformation of blood, manifesting in the skin/hair. Cold pathogens constrain externally, preventing pore opening. Yang Qi is severely disturbed internally, unable to exit via pores as sweat, so it forces blood to wander and exit via the Lung orifice (nose). This is now called "red sweat," capturing its essence.
Patients prone to epistaxis (Nu Jia) must not undergo sweating therapy. Inducing sweat causes depression of the temporal arteries, tense pulses, staring eyes, inability to blink, and insomnia.
The Taiyang meridian rises from the inner canthus to the forehead. Having lost blood and then undergoing sweating depletes fluids, causing tense pulses and staring eyes, indicating Heart and Kidney exhaustion. Inability to blink and close eyes results in insomnia.
For a floating-wiry-tight pulse, body pain is expected, and sweating is indicated. However, if the Chi pulse is slow (Chi, 迟), sweating is contraindicated due to insufficient Ying Qi and blood deficiency.
Although the Cun pulse is floating-wiry-tight suggesting body pain and sweating, a slow Chi pulse invalidates this rule. The Chi pulse governs blood; blood deficiency means insufficient Ying Qi. Sweating will fail to produce sweat, damaging righteous Qi, worsening pain, and causing blood/fluid depletion. "Suppose" indicates a hypothetical deeper analysis, similar to floating-rapid pulse with faint Chi. Yang Excess allows sweating, with epistaxis as the complication/resolution. Yin Deficiency forbids sweating, as Yang collapse is difficult to reverse.
In combined Taiyang and Yangming disease, with wheezing and chest fullness, purgation is contraindicated; treat with Mahuang Tang.
The Three Yang channels receive Qi in the chest, but the location belongs to Yangming. Wheezing belongs to Taiyang, vomiting to Shaoyang. Chest fullness with wheezing remains within Taiyang. Even if Yangming purgation indications exist, purgation is forbidden. Similarly, frequent vomiting keeps the condition within Shaoyang, forbidding attack.
In Yangming disease, with floating pulse, anhidrosis, and wheezing, sweating leads to recovery; use Mahuang Tang.
Taiyang has Mahuang Tang syndrome; Yangming also has Mahuang Tang syndrome. Thus, Mahuang Tang is not exclusive to Taiyang. Applying Mahuang Tang whenever the syndrome appears is Zhang Zhongjing's general principle.
Above discusses Mahuang Tang pulses and symptoms.
After ten days of Taiyang disease, if the pulse is floating and fine, and the patient desires sleep, the exterior has resolved. If there is chest fullness and hypochondriac pain, administer Xiao Chai Hu Tang (Minor Bupleurum Decoction). If the pulse is merely floating, administer Mahuang Tang.
Faint and fine pulse with desire to sleep is Shaoyin syndrome. Floating and fine pulse with somnolence, lacking Shaoyin signs, indicates Taiyang persists post-ten days. This is "resolved but lingering." Chest fullness and somnolence suggest residual Taiyang pathogens. With hypochondriac pain, it is Taiyang-Shaoyang combined disease (Shaoyang pulse is wiry-fine). Shaoyang is the pivot; pivot dysfunction prevents rising of One Yang Qi, causing chest fullness, hypochondriac pain, and somnolence. Xiao Chai Hu Tang harmonizes. If the pulse is floating but not fine (forceful), and lacks hypochondriac pain, it is not Shaoyang. If floating but not large, it is not Yangming. It remains Taiyang. Taiyang governs "Opening"; disease reverses this to "Closing," causing somnolence. Mahuang Tang opens the exterior, moving Wei Qi into Yang, restoring Taiyang's exterior dominance and wakefulness. Unlike initial Taiyang sweating, the dose should be reduced.
Above discusses Mahuang Tang and Chai Hu Tang related pulses/symptoms.
Mahuang Tang Formula:
Mahuang (Ephedrae Herba, 2 liang, remove nodes)
Guizhi (Cinnamomi Ramulus, 2 liang)
Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, honey-fried)
Xingren (Armeniacae Semen Amarum, 70 seeds, remove tips)
Boil in 9 sheng of water. First boil Mahuang, reduce by 1 sheng, skim foam. Add other herbs. Boil to 2.5 sheng. Warm drink 8 ge. Cover to obtain slight perspiration. No hot porridge needed. Follow Guizhi Tang methods otherwise.
Mahuang is green, enters Liver, hollow inside and straight outside, resembling hair follicles and joints. It penetrates joints, relieves body pain, reaches the skin, and is the premier herb for dispelling Wind-Cold from the Wei level. However, it relies on Guizhi to enter the Heart, unblock vessels, and release Ying sweat, ensuring Wei pathogens are fully expelled. Thus, Guizhi Tang does not need Mahuang, but Mahuang Tang cannot lack Guizhi. Apricot is a Heart fruit; warmth disperses Cold, bitterness directs Qi downward, making it the premier herb for expelling pathogens and stopping wheezing. Guizhi Tang induces Ying sweat, requiring hot porridge because Ying flows in vessels; food enters Stomach, turbid Qi goes to Heart, essence enters vessels. Mahuang Tang induces Wei sweat, requiring no porridge because this sweat is Taiyang Cold-Water Qi in the skin; pores open, sweat comes naturally, without needing grain Qi.
After one dose, if sweat occurs, stop remaining doses. Excessive sweat causes Yang collapse and deficiency, leading to aversion to wind, vexation, and insomnia. For excessive sweat, apply warm powder.
This is the contraindication for Mahuang Tang. As a heavy sweating agent, caution is paramount. Guizhi Tang: if no sweat, repeat; if severe, prepare another dose; up to 2-3 doses. Acupuncture can precede/follow sweating. Purgation can precede/follow sweating. Mahuang Tang specifies warm drink of 8 ge, no mention of repeating. If one dose induces sweat, stop. For excessive sweat, apply warm powder. This follows later. Da Qing Long Tang's vexation precedes sweating (Yang Excess). Here, vexation follows sweating (Yin Deficiency). Yin Deficiency leaves Yang unanchored; Bai Hu Jia Ren Tang (White Tiger plus Ginseng Decoction) is indicated. Using Guizhi/Fuzi to restore Yang would likely kill.