麻黄（六两去节） 桂枝（二两去皮） 甘草（二两炙） 杏人（四十个去皮尖） 生姜（三两切） 大枣（十二
枚擘） 石膏（如鸡子大碎）
上七味。以水九升。先煮麻黄。减二升。去上沫。内诸药。煮取三升。去滓温服一升。取微似汗。汗出多者。温粉
粉之。一服汗者。停后服。汗多亡阳。遂（一作逆）虚恶风。烦躁不得眠也。
成氏明理论云。青龙。东方甲乙木神也。应春而主肝。专发生之令。为敷荣之主。万物出甲。开甲则有两岐。肝
有两叶以应之。谓之青龙者。以发散营卫两伤之邪。是应肝木之体耳。桂枝汤主中风。麻黄汤主伤寒。发散之纯者也。
及乎大青龙汤虽为发汗之剂。而所主又不一。必也中风脉浮紧。为中风见寒脉。伤寒脉浮缓。为伤寒见风脉。是风寒两
伤也。风兼寒。寒兼风。虽欲与桂枝汤解肌以祛风。而不能已其寒。或欲以麻黄汤发汗以散寒。而不能去其风。兹仲景
所以特处大青龙汤以两解之也。麻黄味甘温。桂枝味辛热。寒则伤营。必以甘发之。风则伤卫。必以辛散之。此风寒两
伤。营卫俱病。故以甘辛相合而为发散之剂。表虚肤腠疏者。则以桂枝为主。此为表实腠理密。则以麻黄为主。是先麻
黄为君。后桂枝为臣也。甘草味甘平。杏仁味甘苦。苦甘为助。佐麻黄以发表。大枣味甘温。生姜味辛温辛甘相合。佐
桂枝以解肌。风阳邪也寒。阴邪也风则伤阳。寒则伤阴。营卫阴阳为风寒两伤。则非轻剂所能独散也。必须轻重之剂以
同散之。乃得阴阳之邪俱已。营卫之气俱和。是以石膏为使。味甘辛微寒。质重而又专达肌表者也。大青龙汤发汗之重
剂。用之稍过。则有亡阳之失。经曰。若脉微弱。汗出恶风者。不可服。服之。则厥逆筋惕肉 。此为逆也。又曰。一
服汗者。停后服若复服。汗多亡阳。遂虚恶风烦躁不得眠也。用者宜详审之。
琥按上成氏论云。风阳邪也。寒。阴邪也。风则伤阳。寒则伤阴。此阴阳即指人身营卫而言。非谓伤风。是阳热之
证。伤寒是阴寒之证也。恐后学不明。特为析辩。
琥又按上大青龙证。既云。脉浮。紧。发热恶寒。身疼痛。又不汗出。仍是太阳伤寒。但加烦躁耳。何以谓之中风。
及读金镜内台方。见黄伯荣曾议云。此一证中。全在不汗出一不字内藏机。且此不字。是微有汗而不能得出因生烦躁。
非若伤寒之全无汗也。以此不字。方是伤风。此乃古人智深议妙之处。
或问云。仲景制此方。以治伤风伤寒二证合病。其不用芍药者何也。愚以其证汗不得出。且兼烦躁。故方中去芍药。
加石膏。以石膏之味辛凉。能解肌疗烦若用芍药。恐过于收敛。风寒之邪不散。仲景以风寒两伤之病。即以桂枝麻黄二
汤。合为一方而独减芍药者。此制方之妙用也。或又问成氏云。大青龙汤发汗之重剂。病患同是服此汤而汗多亡阳。一
则厥逆筋惕肉 。一则恶风烦躁不得眠。二者之寒热迥然不同。何也。余答云。一则病患脉微弱。汗出恶风。是阳气本
虚也。故服之。则厥逆而虚冷之证生焉。一则病患脉浮紧。发热汗不出而烦躁。是邪热本甚也。故服之。则正气虽虚而
邪热未除。且也。厥逆之逆为重。以其人本不当服而误服之也。烦躁不得眠为犹轻。以其人本当服而过服之也。明乎此。
乃知仲景此汤。必欲审证而投之矣。
方氏条辩注解大青龙汤义云。青乃木色。龙乃木神。木主春。春热而烦躁。雷雨解而致和焉。人之汗以天地之雨名
之。龙与云。雨至发烦躁之汗。而营卫以和。龙之所以为汤。神汤之用也。愚按此言。实发成氏未发之义。
吴院判云。仲景用此汤。以发烦躁之汗。譬若亢热已极。一雨而凉。其理可见。若不晓此理。见其躁热。投以寒凉
之药。其害岂胜言哉。
节 陶氏议用大青龙汤法云。热盛而烦。手足自温。脉浮而紧。此伤风见寒脉也。不烦少热。四肢微厥。脉浮而缓。
此伤寒见风脉也。二者为营卫俱病。法宜大青龙汤。但此汤险峻。须风寒俱甚。又加烦躁。乃可与之。不如桂枝麻黄各
半汤为稳。尤不若九味羌活汤。加石膏知母枳壳也。琥按上陶氏云。大青龙。不若桂枝麻黄各半汤为稳。此论实本许学
士之说。犹为近理。其云。尤不若以九味羌活汤。加石膏知母枳壳。此论悖谬之极。盖此汤不分经络。错杂异常。且知
母过于苦寒。恐非风寒初入所宜加也。陶氏一生之误。不过一用药杂乱。不对证耳。杀车槌方。焉可宗乎。
伤寒脉浮缓。身不疼。但重。乍有轻时无少阴证者。大青龙汤发之。（成注云。此伤寒见风脉也。伤寒者身疼。此以
风胜。故身不疼。中寒者身重。此以兼风。故乍有轻时。无少阴证者。以身重一候。似少阴欲寐之证。今则身但重而不
欲寐。忽然又有身轻转动之时。故知其无少阴证。仍然病在太阳。而风寒之邪甚于表也。故仲景法。宜大青龙汤。以发
之。按内台方疑问云。何为伤寒见风脉。如无汗恶寒。乃伤寒证。脉当浮紧。今反浮缓者。乃伤风脉也。故曰伤寒见风
脉。若然则是上文云。伤寒。可见无汗恶寒之义。已该括其中。又问云。风寒二证皆见。若不烦躁者。此大青龙汤可用
乎。答云。既无烦躁。可除石膏勿用也。若然。则是上证无烦躁。汤中可除石膏。学人毋拘拘于仲景原方。而云。一味
不可增损也。）
伤寒表不解。心下有水气。干呕发热而咳。或渴。或利。或噎。或小便不利。少腹满。或喘者。小青龙汤主之。（表
不解者。谓太阳病在表之风寒正盛也。心下有水气。谓水饮停积心胸之间。因病气逆不得宁也。水与风寒之邪。相搏而
病。气不得宁。故曰干呕者。水犯于胃。气逆而作呕也。又干呕为太阳病桂枝汤之常候。曰发热而咳者。上云。表不解
则发热。咳则水犯于肺。气逆而作声也。以上云云。系小青龙汤之主证。其兼证。则或为渴。成注云。渴者。水蓄则津
液不行。气燥而渴也。或为利者。成注云。水下行。渍入肠间。则为利也。或噎者。成注引经云。水得寒气。冷必相搏
其人即KT KT 。与噎同犹言咽也。此亦胃中水寒而气作逆也。或小便不利。少腹满者成注云。水蓄下焦不行。故小
便不利形肿而少腹满也。或喘者。愚以喘为太阳病麻黄汤之常候。此则内更挟水。斯气上逆于肺。因作喘也。与小青龙
汤者。成注云。发汗兼散水也。水气内渍。则所传不一。故尚论篇云。或上。或下。或中。或热。或冷。但有一二证。
即水逆之应也。仲景法。总以小青龙汤为主。宜随证增损以解化之。）
Mahuang (Radix Ephedrae, six liang, nodes removed) Guizhi (Ramulus Cinnamomi, two liang, bark removed) Gancao (Radix Glycyrrhizae, two liang, honey-fried) Xingren (Semen Armeniacae Amarum, forty seeds, skin and tips removed) Shengjiang (Rhizoma Zingiberis Recens, three liang, sliced) Dazao (Fructus Jujubae, twelve pieces, torn apart) Shigao (Gypsum Fibrosum, size of a chicken egg, crushed)
The above seven ingredients. Use nine sheng of water. First decoct Mahuang, reduce by two sheng, remove the foam on the surface. Add the remaining herbs. Decoct to obtain three sheng of liquid. Remove the dregs, take one sheng warm. The goal is to achieve a slight sweating effect. If sweating is excessive, apply warm powder to the body. If sweating occurs after the first dose, stop subsequent doses. Because excessive sweating leads to Wang Yang (loss of Yang Qi), resulting in deficiency, aversion to wind, restlessness, and inability to sleep.
Cheng Wuji stated in *Minglunlun*: Qinglong (Azure Dragon) is the spirit of Wood in the East (Jia and Yi). It corresponds to Spring and governs the Liver. It exclusively executes the command of generation. It is the master of distributing Ying Qi (Nutritive Qi). All things emerge from the shell; opening the shell reveals two divisions. The liver has two lobes corresponding to this. It is called Qinglong because it can dissipate pathogens affecting both Ying and Wei (Defensive Qi) simultaneously. This conforms to the nature of Liver Wood. Guizhi Tang treats Zhongfeng (Wind Strike/Exogenous Wind Syndrome), and Mahuang Tang treats Shanghan (Cold Damage/Exogenous Cold Syndrome); these are pure dispersing agents. As for Daqinglong Tang, although it is also a sweating agent, its indications are not entirely the same. It must be that Zhongfeng presents with a floating-tight pulse, which is Zhongfeng showing a Cold pulse; Shanghan presents with a floating-slow pulse, which is Shanghan showing a Wind pulse. This is a dual injury of Wind and Cold. Wind combines with Cold, Cold combines with Wind. At this time, if one wishes to use Guizhi Tang to resolve the muscle layer and dispel Wind, it cannot eliminate the Cold; or if one wishes to use Mahuang Tang to induce sweating and scatter Cold, it cannot remove the Wind. Therefore, Zhang Zhongjing specially established Daqinglong Tang to resolve both pathogens simultaneously. Mahuang is sweet and warm. Cold injures Ying, so one must use sweet herbs to disperse it. Wind injures Wei, so one must use pungent herbs to scatter it. This is a dual injury of Wind and Cold, where both Ying and Wei are diseased. Thus, sweet and pungent flavors are combined to form a dispersing agent. For those with exterior deficiency and loose couli (pores), Guizhi is the principal herb. Here, with exterior excess and tight couli, Mahuang is the principal herb. This means Mahuang is used as the Jun (Emperor) herb first, followed by Guizhi as the Chen (Minister) herb. Gancao is sweet and neutral. Xingren is sweet and bitter. Bitter and sweet combine to assist, aiding Mahuang in releasing the exterior. Dazao is sweet and warm. Shengjiang is pungent and warm. Pungent and sweet combine, aiding Guizhi in resolving the muscle layer. Wind is a Yang pathogen, Cold is a Yin pathogen. Wind injures Yang, Cold injures Yin. When Ying, Wei, Yin, and Yang are injured by Wind and Cold, light agents alone cannot disperse them. One must use agents of varying heaviness to disperse together, so that Yin and Yang pathogens are all removed, and Ying and Wei Qi are harmonized. Therefore, Shigao is used as the Shi (Envoy) herb. Shigao is sweet, pungent, and slightly cold; it is heavy in texture and specifically reaches the muscle and exterior. Daqinglong Tang is a heavy sweating agent. If used excessively, it may cause Wang Yang. The Classic states: If the pulse is weak and faint, with sweating and aversion to wind, do not administer it. If administered, it will lead to Jue Ni (cold extremities) and Jin Ti Rou Sun (muscle twitching). This is a counter-indication. It also states: If sweating occurs after one dose, stop subsequent doses. If taken again, excessive sweating causes Wang Yang, leading to deficiency, aversion to wind, restlessness, and insomnia. Users should examine carefully.
Wang Hu notes: In Cheng's discussion above, it says: Wind is a Yang pathogen, Cold is a Yin pathogen. Wind injures Yang, Cold injures Yin. Here, Yin and Yang refer to the body's Ying and Wei. It does not mean that Zhongfeng is a Yang-heat syndrome, nor that Shanghan is a Yin-cold syndrome. Fearing that later students might not understand, I specifically clarify this.
Wang Hu further notes: Regarding the Daqinglong syndrome described above, since it mentions floating-tight pulse, fever, aversion to cold, body pain, and anhidrosis, it remains Taiyang Shanghan (Taiyang Cold Damage Syndrome), merely adding restlessness. Why is it referred to as Zhongfeng? Reading *Jingjing Neitai Fangyi*, Huang Borong argued: The key to this syndrome lies hidden in the character "Bu" (not/not having). Moreover, this "Bu" refers to having slight sweat but unable to release it, causing restlessness. It is not like Shanghan where there is absolutely no sweat. Because of this "Bu", it is indeed Shangfeng (Wind Injury). This is where the ancients' wisdom was profound and arguments subtle.
A question arises: Zhang Zhongjing formulated this prescription to treat the combined disease of Shangfeng and Shanghan. Why is Shaoyao (Radix Paeoniae Alba) not used? I believe that because the syndrome involves inability to sweat and is accompanied by restlessness, Shaoyao is removed from the formula, and Shigao is added. Because Shigao is pungent and cool, it can resolve the muscle layer and treat restlessness. If Shaoyao were used, its astringent property might prevent the dispersion of Wind-Cold pathogens. Zhang Zhongjing, for diseases of dual Wind-Cold injury, combined Guizhi Tang and Mahuang Tang into one formula but uniquely reduced Shaoyao. This is the subtle application of formula formulation. Another question: Cheng said Daqinglong Tang is a heavy sweating agent. Patients taking this same soup experience excessive sweating leading to Wang Yang, some developing Jue Ni and muscle twitching, while others develop aversion to wind, restlessness, and insomnia. These cold and heat manifestations are vastly different. Why? I answer: In one case, the patient has a weak pulse, sweating, and aversion to wind, indicating inherent Yang deficiency. Thus, upon administration, cold extremities and deficiency-cold syndromes arise. In the other case, the patient has a floating-tight pulse, fever, anhidrosis, and restlessness, indicating severe pathogenic heat. Thus, upon administration, although Zheng Qi (Upright Qi) is deficient, the pathogenic heat remains. Furthermore, Jue Ni (reversal/cold extremities) is a severe condition because the person should not have taken it and took it erroneously. Restlessness and insomnia are milder because the person should have taken it but took it in excess. Understanding this, one knows that Zhang Zhongjing's Tang requires careful syndrome differentiation before administration.
Fang Youzhi, in his commentary on Daqinglong Tang, stated: Qing (Green/Azure) is the color of Wood. Long (Dragon) is the spirit of Wood. Wood governs Spring. Spring heat causes restlessness; rain and thunder bring harmony. Human sweat is named after heaven and earth's rain. Dragon and clouds, when rain arrives, induce sweating from restlessness, harmonizing Ying and Wei. The reason Long becomes a Tang is the divine use of the Tang. I consider this statement to truly elucidate meanings Cheng had not previously expressed.
Wu Yuanpan said: Zhang Zhongjing uses this Tang to induce sweating from restlessness. It is like extreme dry heat being cooled by a single rain; the principle is visible. If one does not understand this principle and sees restlessness and heat, administering cold-cooling medicines would cause harm beyond words.
Tao discussed the method of using Daqinglong Tang: Heat excess with restlessness, hands and feet naturally warm, floating-tight pulse—this is Shangfeng showing a Cold pulse. No restlessness, slight heat, slight coldness in four limbs, floating-slow pulse—this is Shanghan showing a Wind pulse. Both belong to Ying and Wei dual disease. The method should be Daqinglong Tang. However, this Tang is dangerous and峻烈 (harsh/potent). It should only be given when Wind and Cold are both severe, plus restlessness. It is less stable than Guizhi Mahuang Ge Ban Tang (Guizhi and Mahuang Half-Dose Decoction). Even less advisable is Jiwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction) with added Shigao, Zhimu, and Zhike. Wang Hu notes: Tao's claim that Daqinglong Tang is less stable than Guizhi Mahuang Ge Ban Tang is based on Xu Xueshi's theory and is relatively reasonable. His claim that Jiwei Qianghuo Tang with Shigao, Zhimu, and Zhike is superior is extremely erroneous. This Tang does not distinguish meridians and is exceptionally mixed. Moreover, Zhimu is too bitter and cold, likely unsuitable for early-stage Wind-Cold invasion. Tao's lifelong error lay in chaotic medication and mismatched syndromes. How can the "Sha Che Chui" formula be emulated?
Shanghan with floating-slow pulse, body not painful but heavy, occasionally lighter, without Shaoyin syndrome, should be dispersed with Daqinglong Tang. (Cheng's annotation: This is Shanghan showing a Wind pulse. Shanghan causes body pain; here Wind prevails, so no pain. Middle Cold causes heaviness; here Wind is combined, so it occasionally lightens. No Shaoyin syndrome: Body heaviness resembles Shaoyin Yu Mei (desire to sleep) syndrome. Now, however, the body is heavy but there is no desire to sleep, and suddenly there is a time when the body feels light and movable. Thus, we know there is no Shaoyin syndrome; the disease remains in Taiyang, and Wind-Cold pathogens are severe at the exterior. Therefore, Zhang Zhongjing's method is to use Daqinglong Tang to disperse it. According to *Neitai Fangyi Wenyi*: What is Shanghan showing a Wind pulse? If there is anhidrosis and aversion to cold, it is Shanghan, and the pulse should be floating-tight. Now it is floating-slow, which is a Shangfeng pulse. Hence, Shanghan showing a Wind pulse. If so, then the Shanghan mentioned above implies anhidrosis and aversion to cold, which encompasses the meaning. Question: If both Wind and Cold syndromes are present, but without restlessness, can Daqinglong Tang be used? Answer: Since there is no restlessness, Shigao can be omitted. If so, then for the above syndrome without restlessness, Shigao can be removed from the Tang. Scholars should not rigidly adhere to Zhang Zhongjing's original formula, claiming not a single herb can be added or removed.)
Shanghan with unresolved exterior, Water Qi under the Heart, dry retching, fever, and cough, or thirst, or diarrhea, or dysphagia/choking sensation, or difficulty urinating with lower abdominal fullness, or wheezing, should be treated with Xiao Qinglong Tang. (Unresolved exterior means the Wind-Cold at the Taiyang exterior is vigorous. Water Qi under the Heart means fluid retention accumulates between the chest and heart, causing pathological Qi to rebel and lack peace. Water and Wind-Cold pathogens contend, disturbing Qi, hence dry retching: Water invades the Stomach, Qi rebels causing vomiting. Dry retching is also a common symptom of Taiyang syndrome treated with Guizhi Tang. Fever and cough: As stated above, unresolved exterior causes fever; cough indicates Water invading the Lung, Qi rebelling causing sound. The above are the main symptoms of Xiao Qinglong Tang. Its accompanying symptoms include thirst. Cheng's note: Thirst occurs because water retention prevents Jin Ye (Body Fluids) from circulating, causing Qi dryness and thirst. Or diarrhea: Cheng's note: Water flows downward, soaking into the intestines, causing diarrhea. Or choking: Cheng cites classics: Water meets Cold Qi, cold contends, causing a sensation similar to choking (Yan). This is also Stomach Water-Cold causing Qi rebellion. Or difficulty urinating and lower abdominal fullness: Cheng's note: Water stagnates in the Lower Jiao and does not move, causing difficulty urinating, edema, and lower abdominal fullness. Or wheezing: I consider wheezing a common symptom of Taiyang syndrome treated with Mahuang Tang. Here, internal Water complicates it, causing Qi to rebel upward to the Lung, inducing wheezing. Administering Xiao Qinglong Tang: Cheng's note: Induces sweating and scatters Water. Internal infiltration of Water Qi leads to varied transmission. Thus, *Shanglun Pian* states: Up, down, middle, heat, cold. If one or two symptoms appear, it is a response of Water Rebellion. Zhang Zhongjing's method always prioritizes Xiao Qinglong Tang, adjusting and modifying according to symptoms to resolve and transform.)