桂枝（三两去皮） 甘草（三两炙） 大枣（十二枚擘） 芍药（六两） 生姜（二两切） 胶饴（一升）
上六味。以水七升。煮取三升。去滓。内胶饴。更上微火。消解。温服一升。日三服。呕家不可用建中汤。以甜故
也。（呕家必胃有邪热。而胸中作满。中满者。勿食甘。若用建中汤之甜。是助其满。内经云实实者。是也。）
（成氏明理论云。脾者。土也。应中央。处四藏之中。为中州。治中焦。生育营卫。通行津液。一有不调。则营卫
失所育。津液失所行。必以此。汤温建中。藏是以建中名焉。胶饴味甘温。甘草味甘平。脾欲缓。急食甘以缓之。建脾
者。必以甘为主。故以胶饴为君。甘草为臣。桂味辛热。辛散也。润也。营卫不足。润而散之。芍药味酸。微寒。酸。
收也。泄也。津液不逮。收而行之。是以桂枝芍药。为佐。生姜味辛温。大枣味甘温。胃者卫之源。脾者营之本。黄帝
针经曰营出中焦。卫出上焦是矣。卫为阳。不足者。益之必以辛营为阴。不足者补之必以甘。辛甘相合。脾胃健而营卫
通。是以姜枣为使。琥按小建中汤。补中有发散之义。大抵中气虚寒者宜用之。倘伤寒家有水气冲心而悸。热邪壅膈而
烦者。上汤不宜轻用也。内台方议或问曰。建中汤方。与桂枝汤同。只多胶饴。所主之病。全然不同。何也。答曰。桂
枝汤中。桂枝芍药等分。以芍药佐桂枝而治卫气也。建中汤中。芍药多半。而桂枝减少。以桂枝佐芍药。而益其营气也。
是以大有不同愚以上言。犹为未尽其义。盖桂枝汤中。以芍药佐桂枝。则辛甘相合。散而助表。建中汤中。以桂枝佐芍
药。则酸甘相合。敛而补中。能达此义。斯仲景制方之意无余蕴矣。）
（附后例）太阳病过经十余日。反二三下之。后四五日。柴胡证仍在者。先与小柴胡汤。呕不止（云云至）与大柴
胡汤下之。则愈。（按此条证云。太阳病过经十余日。其时已传少阳。为柴胡证矣。故以下之为反。先与小柴胡汤也。正
文与注并。）
Cinnamon Twig (Guizhi, 3 liang, bark removed) Licorice Root (Gancao, 3 liang, honey-fried) Jujube (Dazao, 12 pieces, split open) White Peony Root (Shaoyao, 6 liang) Fresh Ginger (Shengjiang, 2 liang, sliced) Maltose (Jiaoyi, 1 sheng)
The above six ingredients. Use seven sheng of water. Decoct to obtain three sheng of liquid. Strain out the dregs. Add the maltose. Heat gently over a low fire until dissolved. Take one sheng warm. Administer three times daily. Patients with vomiting should not use Jianzhong Tang (Middle-Jian Decoction). This is due to the sweet taste. (Patients with vomiting necessarily have pathogenic heat in the stomach, causing fullness in the chest. When there is fullness in the middle jiao, one should not consume sweet foods. Using the sweetness of Jianzhong Tang would exacerbate the fullness. This corresponds to the "reinforcing excess" error mentioned in the *Neijing*.)
(Cheng Wuji stated in *Minglun Lun*: The Spleen belongs to Earth, corresponds to the Center, resides among the four zang organs, occupies the central region, governs the middle jiao, generates Ying and Wei qi, and circulates body fluids. Once dysfunctional, Ying and Wei lose their source of generation, and body fluids lose their pathway of circulation. One must use this decoction to warm and establish the middle qi. Because it establishes the middle, it is named Jianzhong Tang. Maltose is sweet and warm; Licorice Root is sweet and neutral. The Spleen desires relaxation; when urgent, consume sweet substances to relax it. To establish the Spleen, one must primarily use sweet substances. Therefore, Maltose is used as the Sovereign herb, and Licorice Root as the Minister. Cinnamon Twig is pungent and hot; pungency disperses and moistens. When Ying and Wei are deficient, moisten and disperse them. White Peony Root is sour, slightly cold; sourness collects and drains. When body fluids do not reach, collect and circulate them. Thus, Cinnamon Twig and White Peony Root serve as Assistant herbs. Fresh Ginger is pungent and warm; Jujube is sweet and warm. The Stomach is the source of Wei qi; the Spleen is the root of Ying qi. The *Huangdi Zhenjing* states that Ying qi emerges from the middle jiao and Wei qi emerges from the upper jiao, which is correct. Wei qi is Yang; when deficient, it must be augmented with pungent substances. Ying qi is Yin; when deficient, it must be tonified with sweet substances. Pungent and sweet combine to strengthen the Spleen and Stomach and unblock Ying and Wei. Thus, Ginger and Jujube serve as Envoy herbs. Hu notes: Xiao Jianzhong Tang contains the principle of dispersion within tonification. It is generally suitable for those with deficiency-cold of the middle qi. If a Taiyang disease patient has fluid retention rushing to the heart causing palpitations, or pathogenic heat obstructing the diaphragm causing irritability, the aforementioned decoction should not be used lightly. *Neitai Fangyi Huowen* asks: The Jianzhong Tang formula is identical to Guizhi Tang, except for the addition of Maltose, yet the diseases they treat are completely different. Why? The answer is: In Guizhi Tang, Cinnamon Twig and White Peony Root are equal in dosage; White Peony assists Cinnamon Twig to treat issues of Wei qi. In Jianzhong Tang, the dosage of White Peony is doubled, and Cinnamon Twig is reduced; Cinnamon Twig assists White Peony to tonify Ying qi. Hence, there is a significant difference. My previous explanation was still incomplete. Generally, in Guizhi Tang, White Peony assists Cinnamon Twig, so pungent and sweet combine to disperse and assist the exterior. In Jianzhong Tang, Cinnamon Twig assists White Peony, so sour and sweet combine to astringe and tonify the middle. Understanding this principle reveals the complete intent of Zhang Zhongjing's formula creation.)
(Attached Example) Taiyang disease persists for more than ten days, and contrary treatment involves purging two or three times. After another four or five days, if the Chaihu syndrome remains, first administer Xiao Chaihu Tang. Vomiting continues... (content omitted)... administer Da Chaihu Tang to purge. Then it heals. (Note: This syndrome description states that after Taiyang disease persists for ten-plus days, it has transmitted to Shaoyang, becoming a Chaihu syndrome. Therefore, purging is a contraindicated treatment. First, administer Xiao Chaihu Tang. The main text and commentary are presented together.)