黄炫活人大全云。或问发热恶寒。发于阳。无热恶寒。发于阴。且如伤寒。或发热。或未发热。必恶寒
体痛。二说皆曰恶寒。如何辨之。曰。伤寒或发热。或未发热。必恶寒体痛。呕逆。头痛项强。脉浮紧。此在
阳。可发汗。若阴证。则无头疼。无项强。但恶寒而倦。脉沉细。此在阴。可温里也。
太阳病。头痛至七日以上自愈者。以行其经尽故也。若欲作再经者。针足阳明。使经不传则愈。（玉函。
千金翼。无以行二字。尽。作竟。）
〔方〕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。〔周〕七日而云以上自愈者。明明邪留太阳。至七日则正气复。而邪气退也。所谓经尽。
盖六日之间。营卫流行。复至七日。而行受邪之经耳。岂诚一日太阳。二日阳明。六日间。六经证见。至七日
乃又显太阳经证也耶。针足阳明者。谓太阳将传阳明。
故于趺阳脉穴针之。以泄其邪。则邪散而自愈矣。〔柯〕旧说。伤寒日传一经。六日至厥阴。七日再传太阳。
八日再传阳明。谓之再经。自此说行。而仲景之堂。无门可入矣。夫仲景未尝有日传一经之说。亦未有传至三
阴。而尚头痛者。曰头痛者。是未离太阳可知。曰行。则与传不同。曰其经。是指本经而非他经矣。发于阳者。
七日愈。是七日。乃太阳一经。行尽之期。不是六经传变之日。岐伯曰。七日太阳病衰。头痛少愈。有明证也。
故不曰传足阳明。而曰欲再作经。是太阳过经不解。复病阳明。而为并病也。针足阳明之交。截其传路。使邪
气不得再入阳明之经。则太阳之余邪亦散。非归并阳明。使不犯少阳之谓也。
案成氏喻氏程氏钱氏及金鉴。并以六日传六经之说为注解。皆不可从。
太阳病欲解时。从巳至未上。（玉函。千金翼。至作尽。无上字。）
〔成〕巳为正阳。则阳气得以复也。始于太阳。终于厥阴。六经各以三时为解。而太阳从巳至未。阳明
从申至戌。少阳从寅至辰。至于太阴。从亥至丑。少阴从子至寅。厥阴从丑至卯者。以阳行也速。阴行也缓。
阳主于昼。阴主于夜。阳三经解时。从寅至戌。以阳道常饶也。阴三经解时。从亥至卯。以阴道常乏也。内经
曰。阳中之太阳。通于夏气。则巳午未。太阳乘王也。
风家表解。而不了了者。十二日愈。
〔方〕风家。谓中风之病也。表。外证也。解。罢也。了了。犹惺惺也。言中风之病。外证俱罢。大势
已除。余邪未尽。犹未复初也。十二日。经尽之时也。言至此时。则余邪当悉去。而初当复也。盖晓人当静养
以待。勿多事反扰之意。〔柯〕七日表解后。复过一候。而五脏元气始充。故十二日。
精神慧爽而愈。此虽举风家。伤寒概之矣。〔鉴〕不了了者。不清楚也。〔吴〕经中凡勿药。而俟其自愈之条
甚多。今人凡有诊视。无不与药。致自愈之证。反多不愈矣。
总病论。方言曰。南楚疾愈。或谓之瘥。或谓之了。
病患身大热。反欲得衣者。热在皮肤。寒在骨髓也。身大寒。反不欲近衣者。寒在皮肤。热在骨髓也。（成
本。得衣间。有近字。）
〔成〕皮肤言浅。骨髓言深。皮肤言外。骨髓言内。身热欲得衣者。表热里寒也。身寒不欲衣者。表寒里
热也。〔程〕病患身大热。反欲得近衣者。沉阴内锢。而阳外浮。此曰表热里寒。身大寒反不欲近衣者。阳邪
内菀。而阴外凝。此曰表寒里热。寒热之在皮肤者。属标属假。寒热之在骨髓者。属本属真。本真不可得而见。
而标假易惑。故直从欲不欲处断之。情则无假也。不言表里。言皮肤骨髓者。极其浅深。分言之也。〔汪〕或
云。此条非仲景论。系叔和所增入者。详其文义。与阳盛阴虚。汗之则死云云。又桂枝下咽。阳盛则毙云云同。
构此危疑之辞。以惊惑人耳。例宜从删。
案柯氏亦删此条。
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。（阴弱。玉函。脉经。千金翼。作阴濡弱。千金。啬啬。作涩涩。翕翕。作吸吸。）
〔方〕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。言外为阳。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
热。故曰阳浮者。热自发也。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。而但自不足于内。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。啬啬。言恶寒由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。而互言之也。翕翕发热。乃形容热候之轻微。翕。火炙也。翕为温热而不蒸。蒸。大热也。
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。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。〔程〕阴阳。以浮沉言。非以尺寸言。观伤寒条。只曰脉阴阳俱紧。并不着浮字可见。唯阳
浮同于伤寒。故发热同于伤寒。唯阴弱异于伤寒。故汗自出异于伤寒。虚实之辨在此。热自表发。故浮以候之。
汗自里出。故沉以候之。得其同与异之源头。而历历诸证。自可不爽。〔柯〕两自字。便见风邪之迅发。〔喻〕
风寒互言。后人相传。谓伤风恶风。伤寒恶寒。苟简率易。误人多矣。翕翕发热。乃气蒸湿润之热。比伤寒之
干热不同。
方氏或问云。啬。悭吝也。恶寒者。辟如悭吝啬细。惧事之人。恁的常常怯怯然畏恶也。淅。淅米也。
孟子。接淅而行是也。恶风者。辟如裸体之人。被人卒然以水洒淅于身。
蓦地惊恐。恨恨然畏恶也。然特迎风动扇则如此。间静坐卧则不恶。此二者。所以有大同小异之分也。顾氏溯
源集云。翕翕者。热在表也。如鸟翼之附外也。（方言。翕。炙也。又曰。翕。炽也。）
伤寒选录云。张氏曰。对病施治。乃根据方疗疾也。事理平正。无曲折可否之责。止对证而用药。即无疑难。
故曰主之。假如此条。理明而言筒。曰主之者当然。其他虽间有病证冗杂者。而理终归一途。别无差失相反。
方内凡言主之。理同一体也。
黄炫活人大全云。或问。经言用药。有言可与某汤。或言不可与。又有言宜某汤。及某汤主之。凡此数节。
旨意不同。敢问。曰。伤寒论中。一字不苟。观是书片言只字之间。当求古人之用意处。轻重是非。得其至理。
而后始可言医矣。所问有言可与某汤。或言不可与者。此设法御病也。又言宜某汤者。此临证审决也。言某汤
主之者。乃对病施药也。此三者。即方法之条目也。
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○玉函作劈）
上五味。 咀三味。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。不可令如水流离。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。肉面五辛。酒酪臭恶等
物。（成本。无三味二字。离。作漓。小促下 有役字。
不出下。有者字。金匮下利篇。流离。作淋漓。全书。遍身。作通身。小促上。有当字。玉函。亦有当字。周。
作。无禁以下十五字。若病重者以下。千金翼。作病重者。一日一夜乃瘥。当 时观之。服一剂汤。病证犹
在。当复作服之。至有不汗出。当服三剂乃解。外台。作若病重者。昼夜服。特须避风。若服一剂。 时不解。
病证不变者。当更服之。○王云。小促。宋版作少从容。案现行宋版。未有如此者。）
〔鉴〕名曰桂枝汤者。君以桂枝也。桂枝辛温。辛能发散。温通卫阳。芍药酸寒。酸能收敛。寒走阴营。
桂枝君芍药。是于发汗中寓敛汗之旨。芍药臣桂枝。是于和营中有调卫之功。生姜之辛。佐桂枝以解表。大枣
之甘。佐芍药以和中。甘草甘平。有安内攘外之能。用以和中气。即以调和表里。且以调和诸药。以桂芍之相
须。姜枣之相得。借甘草之调和。阳表阴里。气卫血营。并行而不悖。是刚柔相济。以相和也。而精义在服后
须臾啜稀粥。以助药力。盖谷气内充。不但易为酿汗。更使已入之邪。不能少留。将来之邪。不得复入也。又
妙在温覆令一时许。 微似有汗。是授人以微汗之法也。不可令如水流漓。病必不除。是禁人以不可过汗之
意也。此方为仲景群方之冠。乃解肌发汗。调利营卫之第一方也。凡中风伤寒。脉浮弱。汗自出。而表不解者。
皆得而主之。其他但见一二证即是。不必悉具也。此汤倍芍药生姜。加人参。名桂枝新加汤。用以治营表虚寒。
肢体疼痛。倍芍药。加饴糖。名小建中汤。用以治里虚心悸。腹中急痛。再加黄 。名黄 建中汤。用以治虚
损虚热。自汗盗汗。因知仲景之方。可通治百病也。若一服汗出病瘥。谓病轻者。初服一升。病即解也。停后
服。不必尽剂。谓不可再服第二升。恐其过也。若不汗更服根据前法。谓初服不汗出未解。再服一升。根据前法也。
又不汗后服。谓病仍不解。后服第三升也。小促其间。半日许令三服尽。谓服此第三升。当小促其服。亦不可太缓。
以半日三时许为度。令三服尽始适中。其服之宜也。若病重者。初服一剂三升尽。病不解。再服一剂。病犹不
解。乃更服三剂。以一日一夜。周十二时为度。务期汗出病解而后已。后凡有曰根据服桂枝汤法者。即此之谓也。
〔三〕太阳病汗出。服桂枝。只使之似有汗者。邪已去矣。似字当细玩。不可认作发汗。与麻黄汤混看。〔方〕
微火者。取和缓不猛。而无沸溢之患也。滓。淀 也。古人药大剂。釜铛中煮。绵绞漉汤。澄滤取清。故曰去
滓。 。大饮也。 。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。〔锡〕汗。乃中焦水谷之津。故 粥以助药力。谷
精足而津液通矣。禁生冷等物者。恐中气虚。生冷之物。能伤胃气也。玉函方药炮制云。生姜。皆薄切之。大
枣擘去核。桂削去皮。用里黑润有味者。为佳。陶隐居云。凡用桂心浓朴杜仲秦皮木兰之辈。皆削去上虚软甲
错处。取里有味者秤之。总病论云。桂。刮去粗皮。直格云。削去皱皮。官桂是也。元戎云。去浮皮。○案方
氏云。桂去皮而用枝。张志聪谓用梢尖嫩枝。内外如一。而去皮骨。钱潢金鉴。删去皮二字。并失考耳。
陶氏本草序例云。 咀者。谓秤毕捣之如大豆。又使吹去细末。此于事殊不允当。药有易碎难碎。多末
少末。秤两则不复均平。今皆细切之。较略令如 咀者。乃得无末。而片粒调和也。吴遵程方注云。 咀。谓
碎之如大豆。其颗粒可以咀嚼。又吹去细末。煎取清汁也。后世制为饮片。煎之浓浓而不清。甚非法也。
五辛。楞严经。五种辛菜注。五辛者。谓大蒜。 葱。慈葱。兰葱。兴渠。本草纲目。大蒜。小蒜。韭。
胡荽。芸苔。堵
昌胤达生录。蒜。葱。薤。韭。姜。
柯琴伤寒附翼云。此为仲景群方之魁。乃滋阴和阳。调和营卫。解肌发汗之总方也。凡头痛发热。恶风恶
寒。其脉浮而弱。汗自出者。不拘何经。不论中风伤寒杂病。咸得用此。惟以脉弱自汗为主耳。愚常以此汤。
治自汗盗汗。虚疟虚痢。随手而愈。因知仲景方。可通治百病。与后人分门证类。使无下手处者。可同年而语耶。
总病论云。凡桂枝汤证。病者常自汗出。小便不数。手足温和。或手足指梢。露之则微冷。覆之则温。浑
身热。微烦而又憎寒。始可行之。若病者身无汗。小便数。或手足逆冷。不恶寒。反恶热。或饮酒后。慎不可
行桂枝汤也。
Huang Xuan, in the *Huoren Quan Shu* (Complete Works on Activating Life), stated: Someone asked, "Fever with aversion to cold indicates onset from Yang; absence of fever with aversion to cold indicates onset from Yin. For example, in Shanghan (Cold Damage) disease, some patients have fever, some do not yet have fever, but all must have aversion to cold and body pain. Both theories mention aversion to cold; how should they be distinguished?" The answer was: "In Shanghan disease, whether there is fever or not, there must be aversion to cold, body pain, vomiting and regurgitation, headache, stiffness of the neck, and a floating-tight pulse. This belongs to a Yang syndrome and can be treated with sweating methods. If it is a Yin syndrome, there is no headache or neck stiffness, only aversion to cold and fatigue, with a deep-thin pulse. This belongs to a Yin syndrome and can be treated with warming interior methods."
In Taiyang Bing (Taiyang Disease), if headache persists for more than seven days and resolves spontaneously, it is because the pathogenic factor has completed its course through the meridians. If it is about to transmit to the next meridian (transmit again), needling the acupoints of the Foot-Yangming Meridian will prevent transmission and lead to recovery. (*Yuhan Jing* and *Qianjin Yi Fang* omit the character 'Xing' (travel/operate). 'Jin' (end) is interpreted as 'Jing' (finish).)
[Fang's Commentary] Taiyang headache was already discussed in detail in the first clause. Mentioning it here again serves to summarize the main idea. "More than seven days" includes the six-day period. 'Xing' also means transmission. 'Jing Jin' (meridian exhaustion) refers to the completion of transmission through all meridians. 'Yu Zuo Zai Jing' (desiring to make another meridian) implies worsening of the condition. Needling the Foot-Yangming Meridian blocks the path of transmission to arrest the pathogen. 'Chuan' (transmit) shares phonetic and semantic interchangeability with 'Zhuan' (turn) in the Yangming chapter, similar to ancient postal relay systems or modern border crossings. [Zhou's Commentary] Saying "resolves spontaneously after seven days above" clearly indicates that the pathogen remains in the Taiyang meridian; by the seventh day, healthy Qi recovers and the pathogen retreats. The so-called 'Jing Jin' likely means that within six days, Ying and Wei circulate, and by the seventh day, the affected meridian completes its cycle. Could it truly be that Day 1 is Taiyang, Day 2 is Yangming, symptoms of all six meridians appear within six days, and only on the seventh day does the Taiyang meridian symptom reappear? Needling the Foot-Yangming Meridian implies that when Taiyang is about to transmit to Yangming, one needles the Fuyang pulse point to drain the pathogen, causing it to dissipate and heal naturally. [Ke's Commentary] Old theories claimed that Cold Damage transmits one meridian per day: reaching Jueyin on the sixth day, returning to Taiyang on the seventh, and Yangming on the eighth, called 'Zai Jing' (re-entering the meridian). Since this theory spread, the door to Zhang Zhongjing's teachings seems closed. However, Zhongjing never advocated 'daily transmission of one meridian,' nor did he describe headaches persisting after transmission to the Three Yin meridians. A headache indicates the disease has not left the Taiyang meridian. 'Xing' (travel) differs from 'Chuan' (transmit); 'Qi Jing' (its meridian) refers to the primary meridian, not others. 'Onset from Yang, resolving in seven days' means seven days is the period for the completion of the Taiyang meridian's cycle, not the days of Six-Meridian transmission. Qibo stated: "On the seventh day, Taiyang disease declines, and headache lessens slightly," which is clear evidence. Thus, it says 'desire to make another meridian' rather than 'transmit to Foot-Yangming.' This describes Taiyang exceeding its meridian without resolving, complicating into Yangming, forming a Bingbing (combined disease). Needling the intersection of Foot-Yangming intercepts the transmission path, preventing the pathogen from re-entering the Yangming meridian, thereby dispersing residual Taiyang pathogens, rather than merging into Yangming to avoid Shaoyang.
Note: Cheng Wuji, Yu Jiayan, Cheng Jiaoqian, Qian Huang, and *Yizong Jinjian* all interpret this using the 'Six-Day Transmission of Six Meridians' theory, which is unacceptable.
The time when Taiyang Bing tends to resolve is from Si hour to Wei hour. (*Yuhan Jing* and *Qianjin Yi Fang*: 'Zhi' becomes 'Jin', no 'Shang' character.)
[Cheng Wuji's Annotation] Si hour is the time of True Yang, allowing Yang Qi to recover. Starting from Taiyang and ending at Jueyin, each of the Six Meridians has three hours for resolution. Taiyang resolves from Si to Wei, Yangming from Shen to Xu, Shaoyang from Yin to Chen, Taiyin from Hai to Chou, Shaoyin from Zi to Yin, and Jueyin from Chou to Mao. This is because Yang moves fast and Yin moves slowly. Yang governs the day, Yin governs the night. The resolution times for the three Yang meridians are from Yin to Xu, as the Yang path is often abundant. The resolution times for the three Yin meridians are from Hai to Mao, as the Yin path is often deficient. The *Neijing* states: "The Great Yang within Yang connects with the Qi of Summer." Therefore, during Si, Wu, and Wei hours, Taiyang is in its peak prosperity.
Patients suffering from Wind diseases, after the exterior syndrome resolves, may still feel uncomfortable and unclear. They will recover after twelve days.
[Fang's Commentary] 'Feng Jia' refers to Wind Strike disease. 'Biao' (Exterior) refers to external symptoms. 'Jie' (Resolve) means to cease. 'Liao Liao' means clear and awake. It means that in Wind Strike, although external symptoms have ceased and the major trend is removed, residual pathogens remain, and full recovery has not yet occurred. Twelve days is the time when the meridian cycle completes. By this time, residual pathogens should be eliminated, and initial health restored. This advises people to rest quietly and wait, avoiding excessive activity that might disturb recovery. [Ke Qin's Commentary] After the exterior resolves on the seventh day, passing another five-day period (one Hou), the Yuan Qi of the Five Viscera begins to fill up. Thus, by the twelfth day, mental clarity and health return. Although this mentions Wind Jia, it applies generally to Shanghan. [*Jinjian* Commentary] 'Liao Liao' means unclear. [Wu Qian's Commentary] There are many clauses in the *Shanghan Lun* advising against medication and waiting for spontaneous recovery. Nowadays, physicians always prescribe medicine upon diagnosis, causing conditions that would otherwise self-resolve to fail to heal.
*Zong Bing Lun* states that in dialects, curing illness is called 'Chai' or 'Liao'.
If a patient has high body heat but desires to wear clothes, the heat is in the skin (superficial) and the cold is in the bone marrow (deep). If a patient has low body temperature but does not desire to be near clothes, the cold is in the skin and the heat is in the bone marrow. (Cost text: adds 'near' between 'de yi'.)
[Cheng Wuji's Annotation] Skin refers to shallow/exterior; Bone Marrow refers to deep/interior. Body heat desiring clothes indicates Exterior Heat and Interior Cold. Body cold not desiring clothes indicates Exterior Cold and Interior Heat. [Cheng Jiaoqian's Annotation] High body heat desiring clothes indicates internal sinking of Yin and floating of Yang externally, termed Exterior Heat and Interior Cold. Low body temperature not desiring clothes indicates internal stagnation of Yang pathogens and coagulation of Yin externally, termed Exterior Cold and Interior Heat. Cold and heat in the skin belong to the branch (biao) and are false; cold and heat in the bone marrow belong to the root (ben) and are true. The root is invisible, while the branch is easily deceptive. Therefore, judgment is made directly based on the desire or non-desire, as the subjective feeling is never false. Not saying 'Exterior/Interior' but 'Skin/Bone Marrow' emphasizes the depth distinction. [Wang Hu's Annotation] Some argue this clause is not by Zhongjing but added by Wang Shuhe. Examining the text, it resembles phrases like "Yang excess and Yin deficiency, sweating leads to death" and "Guizhi Tang enters the throat, Yang excess leads to demise," constructing dangerous doubts to confuse people. It should ideally be deleted.
Note: Ke Qin also deleted this clause.
Taiyang Fengzhong (Wind Strike), with a pulse that is Floating at Yang and Weak at Yin. Floating at Yang indicates spontaneous heat; Weak at Yin indicates spontaneous sweating. Severe aversion to cold, sharp aversion to wind, mild fever, nasal congestion with roaring sounds, and dry vomiting are primarily treated with Guizhi Tang. ('Yin Ruo' in *Yuhan Jing*, *Maiching*, *Qianjin Yi Fang* is written as 'Yin Ru Ruo'. In *Qianjin Fang*, 'Se Se' is 'Se Se'; 'Xi Xi' is 'Xi Xi'.)
[Fang's Commentary] 'Taiyang Fengzhong' extracts the title from the previous clause, similar to how the previous clause extracted 'Taiyang Bing' from the first. 'Floating at Yang and Weak at Yin' describes the pulse to explain the meaning of 'Slow'. The *Nanjing* states: "The pulse of Wind Strike is Floating and Slippery at Yang, and Moist and Weak at Yin." Floating at Yang means spontaneous heat; Weak at Yin means spontaneous sweating. The exterior is Yang, and Wei Qi is also Yang. When Wind pathogens attack the Wei level, Wei becomes Excess. Excess leads to overabundance and strength. Since Wei Qi travels outside the vessels and receives help from Yang pathogens, its Qi floats outward more strongly, resulting in a Floating Yang pulse. Yang governs Qi; Qi stagnation generates steaming heat. Yang nature is hot, and Wind moves quickly and changes frequently, so heat generation is rapid without needing blockage. Hence, "Floating Yang means spontaneous heat." The interior is Yin, and Ying Qi is also Yin. If Ying is unaffected, it is relatively deficient compared to Wei. Deficiency leads to weakness. Ying Qi travels inside the vessels and lacks support, becoming internally weak, resulting in a Weak Yin pulse. Yin governs Blood; sweat is the fluid of Blood. Weak Yin cannot hold inward, and strong Yang cannot secure outward, leading to easy sweating without covering. Hence, "Weak Yin means spontaneous sweating." 'Se Se' (aversion to cold) describes internal Qi deficiency failing to resist external penetration. 'Xi Xi' (aversion to wind) describes external body looseness, likened to sudden rain startling the body. Wind movement generates cold; cold causes goosebumps. One cannot dislike cold without disliking wind, or vice versa. Thus, the text uses parallel phrasing. 'Xi Xi Fa Re' (mild fever) describes slight heat. 'Xi' means roasting; it is warm but not steaming. Nasal roaring indicates obstructed breath; dry vomiting indicates rebellious Qi. Yang governs ascending Qi; Qi passes through the nose. Excessive Yang heat causes nasal obstruction and roaring, and rebellious Qi causes dry vomiting. 'Zhu Zhi' (primarily treat) means this is the appropriate treatment, though adjustments depend on the practitioner. Pulses and symptoms rarely appear alone; the text encourages flexibility rather than rigid adherence. [Cheng Jiaoqian's Annotation] 'Yin/Yang' here refers to Floating/Sinking pulses, not Cun/Cun positions. In Shanghan clauses, it says "Yin and Yang pulses are both tight," without specifying 'Floating'. Only Floating Yang matches Shanghan, hence matching fever. Only Weak Yin differs from Shanghan, hence differing in spontaneous sweating. This distinguishes Deficiency from Excess. Heat originates from the exterior, detected by Floating pulse; sweat originates from the interior, detected by Sinking pulse. Understanding these similarities and differences clarifies all symptoms. [Ke Qin's Commentary] The two 'Zi' (spontaneous) characters reveal the rapid onset of Wind pathogens. [Yu Jiayan's Commentary] Wind and Cold are discussed interchangeably. Later generations mistakenly believed Wind Strike causes aversion to wind and Cold Damage causes aversion to cold, misleading many. 'Xi Xi Fa Re' is moist, steaming heat, different from the dry heat of Cold Damage.
Fang's *Huo Wen* states: 'Se' means stingy. Aversion to cold is like a stingy person constantly fearful. 'Xi' refers to rinsing rice. *Mencius* mentions "walking while rinsing rice." Aversion to wind is like a naked person suddenly splashed with water, startled and hating it. This occurs only when facing wind/fans, not when sitting quietly. Thus, there are similarities and minor differences. Gu's *Su Yuan Ji* states: 'Xi Xi' means heat is in the exterior, like bird wings attached to the body. (*Fangyan*: 'Xi' means roasting or blazing.)
*Shanghan Xuanlu* cites Zhang: Treating diseases according to patterns relies on formulas. The logic is straightforward. Prescribing based on symptoms leaves no doubt. Hence, 'Zhu Zhi' (primarily treat) is used. For this clause, the logic is clear and concise, making 'Zhu Zhi' appropriate. Even in complex cases, the principle remains consistent. Whenever 'Zhu Zhi' is used, the principle is uniform.
Huang Xuan's *Huoren Quan Shu* asks: The classics use terms like "may give certain decoction," "must not give," "should give," and "primarily treat." These differ in intent. Answer: The *Shanghan Lun* is precise. Analyzing every word reveals the ancients' intent regarding severity and appropriateness. "May give" or "must not give" refers to preventive strategies. "Should give" refers to clinical decision-making. "Primarily treat" refers to pattern-specific prescription. These three constitute the methodological categories.
**Guizhi Tang Formula**
Guizhi (Cinnamon Twig, 3 liang, peeled)
Shaoyao (Peony Root, 3 liang)
Gancao (Licorice Root, 2 liang, honey-fried)
Shengjiang (Fresh Ginger, 3 liang, sliced)
Dazao (Jujube, 12 pieces, split open) (*Yuhan Jing* writes 'Pi').
Crush the five ingredients. Decoct in 7 sheng of water using gentle heat until 3 sheng remain. Strain. Drink warm, 1 sheng at a time. Shortly after drinking, consume more than 1 sheng of hot thin porridge to assist the medicinal power. Cover warmly for about one hour until a slight perspiration appears all over the body. This is ideal. Do not allow profuse sweating like flowing water, or the disease will not be eradicated. If sweating after the first dose cures the disease, stop subsequent doses; do not finish the entire decoction. If no sweating occurs, administer the next dose following the same method. If still no sweating, shorten the interval between doses slightly, aiming to complete three doses within half a day. For severe cases, administer over 24 hours, observing for 12 hours. If symptoms persist after one dose, prepare another. If no sweating occurs, continue up to two or three doses. Avoid raw/cold, sticky/slippery, meat/wheat, five pungents, alcohol, dairy, and foul-smelling foods. (Cost text omits 'three ingredients'. 'Li' is 'Li'. 'Xiao Cu' has 'Yi'. 'Bu Chu' has 'Zhe'. *Jinkui* diarrhea section writes 'Lin Li'. *Quan Shu* writes 'Tong Shen'. 'Xiao Cu' has 'Dang'. *Yuhan* has 'Dang'. 'Zhou' is 'Gui'. Omits last 15 characters. *Qianjin Yi Fang*: Severe cases resolve in 24 hours. Observe at 'Gui' time. Finish one dose. If symptoms persist, prepare again. May need up to three doses. *Waitai*: Severe cases, day and night administration. Avoid wind. If 'Gui' time passes without resolution and symptoms unchanged, administer again. Wang Ken-tang notes: Song edition reads 'Shao Cong Rong' for 'Xiao Cu'. Current Song editions do not show this.)
[*Jinjian* Commentary] Named Guizhi Tang because Guizhi is the Sovereign herb. Guizhi is Pungent and Warm, dispersing and warming Wei Yang. Shaoyao is Sour and Cold, astringing and entering Ying Yin. Guizhi (Sovereign) and Shaoyao (Minister) combine sweating with astringing. Shaoyao (Minister) and Guizhi (Sovereign) harmonize Ying while regulating Wei. Ginger assists Guizhi to release the exterior; Jujube assists Shaoyao to harmonize the middle. Gancao harmonizes the interior and exterior, regulates Qi, and harmonizes all herbs. The combination of Gui-Shao and Jiang-Zao, aided by Gancao, allows Wei/Qi and Ying/Blood to function together without conflict, achieving harmony through the balance of Hard and Soft. The essence lies in drinking hot porridge after ingestion to boost medicinal power. Grain Qi nourishes internally, facilitating sweat production, expelling existing pathogens, and preventing new ones. Covering warmly for an hour induces slight sweating, teaching the method of mild diaphoresis. Profuse sweating is prohibited as it fails to eliminate the disease. This is the premier formula of Zhongjing, the first choice for releasing the muscle layer, inducing sweating, and harmonizing Ying and Wei. It treats any Wind Strike or Cold Damage with Floating-Weak pulse and spontaneous sweating where the exterior is unresolved. It suffices to see one or two symptoms; all need not be present. Doubling Shaoyao and Ginger and adding Renshen creates Guizhi Xinjia Tang for Ying-Wei deficiency cold and limb pain. Doubling Shaoyao and adding Yitang creates Xiaojianzhong Tang for interior deficiency palpitations and abdominal cramping. Adding Huangqi creates Huangqi Jianzhong Tang for deficiency heat, spontaneous/diaphoretic sweating. Thus, Zhongjing's formulas treat all diseases. If one dose cures, stop; do not overdose. If no sweat, repeat. If still no sweat, shorten intervals. Complete three doses in half a day. For severe cases, continue dosing over 24 hours until sweating and resolution occur. "Follow Guizhi Tang method" refers to this protocol.
[Three Annotations] In Taiyang disease with sweating, Guizhi Tang aims for slight sweating; once achieved, the pathogen is gone. The word 'Si' (seem/approximate) must be carefully studied; do not confuse it with the forceful sweating of Mahuang Tang. [Fang's Commentary] Gentle heat prevents boiling over. 'Zi' refers to dregs. Ancient large doses were boiled in cauldrons, filtered through silk, and clarified. 'Se' means drinking heavily. 'Se' describes a moist, sweating appearance. 'Wei Si' (slightly seeming) is crucial, implying subtle presence. 'Bu Ke' (must not) is prohibitive. 'Shui Liu Li' means excessive. 'Bing Bi Bu Chu' warns that violating limits ensures failure. [Xi's Commentary] Sweat is the fluid of grain and water from the Middle Jiao. Porridge aids this process. Avoiding raw/cold protects Stomach Qi. *Yuhan Fang Yao Pao Zhi*: Slice ginger thinly, split jujubes removing pits, peel cinnamon using the dark, fragrant inner bark. Tao Hongjing: Peel soft/scaly outer layers of Cinnamon Heart, Polygala, Eucommia, Phellodendron, Magnolia, using the fragrant inner part. *Zong Bing Lun*: Scrape rough bark from Cinnamon. Zhige: Peel wrinkled bark, i.e., Guan Gui. Yuanrong: Remove floating skin. Note: Fang says use branches with peeled bark. Zhang Zhizhong suggests tender tips, removing bark/bone. Qian Huang and *Jinjian* deleting 'peel' is erroneous. Tao's *Bencao Xuli*: 'Ju' means crushing to soybean size and blowing away dust. This is impractical due to varying hardness affecting weight accuracy. Modern slicing is better for uniformity. Wu Zun-cheng: 'Ju' means crushing to soybean size for chewing, blowing away dust, and decocting clear liquid. Modern decoctions are too thick and impure, which is incorrect.
Five Pungents (*Leng Yan Jing*): Garlic, Scallion, Chinese Leek, Allium Macrostemon, Asafoetida. *Bencao Gangmu*: Garlic, Small Garlic, Chinese Chives, Coriander, Rapeseed. Du Changyin *Dasheng Lu*: Garlic, Scallion, Welsh Onion, Chives, Ginger.
Ke Qin *Shanghan Fuyi*: This is the chief formula of Zhongjing, harmonizing Yin/Yang, Ying/Wei, releasing muscles, and inducing sweating. It treats headache, fever, aversion to wind/cold, Floating-Weak pulse, and spontaneous sweating, regardless of meridian or disease type (Wind Strike, Cold Damage, miscellaneous). The key indicators are Weak pulse and spontaneous sweating. I have successfully used it for spontaneous/diaphoretic sweating, deficiency malaria, and deficiency dysentery. Zhongjing's formulas treat all diseases, unlike later classifications that hinder application.
*Zong Bing Lun*: For Guizhi Tang indications, patients typically have spontaneous sweating, normal urination frequency, warm hands/feet (cool when exposed, warm when covered), whole-body heat, slight irritability, and aversion to cold. It is contraindicated if the patient has no sweating, frequent urination, cold extremities, no aversion to cold but aversion to heat, or after drinking alcohol.