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）
上五味。 咀。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。不可令如水流漓。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。若汗不出者。乃服至二三剂。禁生冷。粘滑。肉面。五辛酒酪臭恶等物。（小促 。言催促煮药之人也。宋
版作少从容。此系传写之误。）
成氏明理论云。经曰。桂枝本为解肌。若其人脉浮紧。发热汗不出者。不可与也云云。盖桂枝汤本专主太阳中风。
其于腠理致密。营卫邪实。津液禁固。寒邪所胜者。则桂枝汤不能发散。必也皮肤疏凑。又自汗。风邪干于卫气者。乃
可投之也。仲景以解肌为轻。以发汗为重。是以发汗吐下后。身疼不休者。津液内耗也。虽有表邪而止。可解肌。故须
桂枝汤少和之也。桂味辛热。用之为君。桂犹圭也。宣导诸药。为之先聘。是谓辛甘发散为阳之意。盖发散风邪。必以
辛为主。故桂枝所以为君也。芍药味苦酸微寒。甘草味甘平。用以为臣佐者。内经所谓风淫所胜。平以辛佐以苦。以甘
缓之。以酸收之。是以芍药为臣。而甘草为佐也。生姜味辛温。大枣味甘温。二物为使者。内经所谓风淫于内。以甘缓
之。以辛散之。是用以为使也。姜枣之味辛甘。固能发散。而此又不特专于发散。以脾主为胃行其津液。姜枣之用。专
行脾之津液而和营卫者也。麻黄汤不用姜枣者。谓专于发汗。则不待行化而津液得通矣。
琥按上成论如此明畅。则仲景立桂枝汤方。似乎一味不可。增损。宜乎后人用之。无不效矣。予每见今医执此方。
而准投于冬月太阳病一二日有汗之伤风。及服之。非徒无益。反有害者。何也。愚以太阳伤风证。未必尽人皆真正营弱
者。内台方议云。使其人禀质素壮。气血有余。壮热不止。脉却阳浮而阴盛。其外证仍自汗恶风。本方中当用赤芍药。
以泻营中之邪实也。世传仲景桂枝汤方内用白芍药者。乃补营兼实卫之剂。在病患必体虚不任风寒。其脉浮缓微弱。其
热翕翕然不甚。其汗时出。无有止时。方可竟投桂枝。否则风邪始盛于表。而用白芍药之酸以收之。大枣炙甘草之甘温
以补之。吾恐虽有桂枝之辛热。生姜之辛温。其风寒之邪。何能尽由此二味而发散邪。当日仲景设立此方。必为正气虚
而表邪微者用耳。今之治伤寒者。必欲祖而行之。其误多矣。
琥又按中风发热。甚至鼻鸣干呕者。此邪热也。邪热之气。不能杀谷。言不能胜谷气也。仲景于桂枝汤方后云。服
已。须臾。 热稀粥一升余。必其人外虽病头项强痛。发热自汗恶风寒。内则饮食如故。胸膈未尝痞满。故令其 热稀
粥。且禁其勿食肉面等物也。予每见今人病风寒。必先挟食者多。故非惟不敢 热稀粥。并不敢投桂枝汤。恐炙甘草大
枣之甘温。反作胀满故也。后学如读书不明理。见证审脉不亲切。执一桂枝汤方。以治太阳中风证。差错不少。慎之慎
之。琥又按仲景于桂枝汤方下云。温覆令微汗若一服汗出。不必尽剂。若不汗。更作服。又不汗。服至汗出。则此是发
汗药也。成氏明理论又引经云。桂枝本为解肌。若脉浮紧。发热汗不出者。不可与之。又似止汗之药。何也。愚谓太阳
伤风。乃表虚为风寒所袭。其自汗必有时而出。有时又止。出不能透。所以发热不休。仲景用桂枝汤者。以辛甘发散肌
表之风邪。使邪去则表密而汗自止。热自休。乃发中有止之义。
太阳病头痛发热汗出恶风者。桂枝汤主之。（此言太阳病同是头痛发热。只要认其证。必汗出恶风。乃为中风。方可
投桂枝汤也。）
太阳病项背强KT KT 反汗出恶风者。桂枝加葛根汤主之。（KT 音殊。KT KT 者。鸟飞羽短伸颈之貌。太阳
病项背
强矣。复KT KT 然颈不得舒。颈之经属阳明。项背与颈KT KT 然其状当无汗矣。今反汗出恶风。仲景法。太阳
病汗出恶风者。桂枝汤主之。今因其KT KT 然。故加葛根于桂枝汤中。以兼祛阳明经之风也。成氏不解此义。而云
药味与桂枝汤同。且疑其有麻黄。为误甚矣。愚按此条。当是太阳阳明中风证。上桂枝句云云。当作桂枝汤加葛根主之。
其义始明。）
Cinnamon Twig (San Liang, peeled) Paeonia Root (San Liang) Licorice Root (Liang, roasted) Fresh Ginger (San Liang, sliced) Jujube (Twelve pieces, split open)
The above five herbs. Crushed. Boiled in seven Sheng of water with gentle heat until three Sheng remain. Strain. Take one Sheng when the temperature is suitable. Shortly after taking it, drink more than one Sheng of hot thin porridge to assist the medicinal power. Cover with warm blankets for about one hour. It is better if there is a slight sweat all over the body. Do not let the sweat flow profusely; otherwise, the disease will certainly not be eliminated. If after one dose, sweating occurs and the disease resolves, stop subsequent doses; there is no need to finish the entire decoction. If there is no sweating, administer again according to the previous method. If still no sweating, shorten the interval between subsequent doses. Within half a day, ensure three doses are completed. If the condition is severe, administer medicine throughout the day and night, observing for twenty-four hours. If symptoms persist after finishing one Ji (dose), prepare another. If there is no sweating, continue administering up to two or three Ji. Contraindicate consumption of cold/raw foods, sticky/slippery foods, meat, wheat products, Five Spices (garlic, chives, leeks, onions, asafoetida), wine, dairy, and foul-smelling substances. ("Xiao Cu" means urging the person boiling the medicine. Song edition reads "Shao Cong Rong", which is a transcription error.)
Cheng Wuji's *Ming Lilun* states: The classics say: Cinnamon Twig is originally used to resolve the muscle layer. If the patient has a floating-tight pulse, fever, and no sweating, it should not be given... Essentially, Guizhi Tang (Cinnamon Twig Decoction) specifically treats Taiyang Wind Strike syndrome. For cases where the Cou Li (pores/interstices) are dense, Ying and Wei pathogenic factors are substantial, and Body Fluids are consolidated due to overcoming Cold Pathogen, Guizhi Tang cannot disperse. It can only be used when the skin is loose, spontaneous sweating exists, and Wind Pathogen invades the Wei Qi. Zhang Zhongjing considers resolving the muscle layer as mild and inducing sweating as heavy. Therefore, after sweating, vomiting, or purging therapies, if body pain persists, it indicates internal depletion of Body Fluids. Although there is exterior pathogen, only resolving the muscle layer is appropriate, so Guizhi Tang (Cinnamon Twig Decoction) is needed to gently harmonize. Cinnamon Twig is acrid and hot, serving as the Jun (Sovereign) herb. "Gui" corresponds to "Gui" (jade tablet), guiding other herbs as a pioneer. This embodies the principle that acrid and sweet disperse Yang. Generally, dispersing Wind Pathogen must primarily use acrid flavors, hence Cinnamon Twig is the Sovereign. Paeonia Root is bitter, sour, and slightly cold; Licorice Root is sweet and neutral, serving as Chen (Minister) and Zuo (Assistant). As stated in the *Neijing*: When Wind excess prevails, level it with acrid, assist with bitter, moderate with sweet, and astringe with sour. Thus, Paeonia is the Minister, and Licorice is the Assistant. Fresh Ginger is acrid and warm; Jujube is sweet and warm. These two serve as Shi (Envoy). As stated in the *Neijing*: When Wind invades internally, moderate with sweet and disperse with acrid. Hence, they are used as Envoys. The acrid-sweet nature of Ginger and Jujube naturally aids dispersion, but here it is not solely for dispersion. Since the Spleen governs transporting Body Fluids for the Stomach, the function of Ginger and Jujube is specifically to circulate Spleen Body Fluids and harmonize Ying and Wei. Mahuang Tang (Ephedra Decoction) does not use Ginger and Jujube because its purpose is solely to induce sweating, allowing Body Fluids to flow freely without needing specific transformation.
Hu notes: Cheng's explanation is so clear that Zhang Zhongjing's formulation of Guizhi Tang (Cinnamon Twig Decoction) seems impeccable, with no herb to add or remove. No wonder later practitioners find it effective. However, I often see contemporary physicians applying this formula accurately to Winter Taiyang disease cases presenting with sweating after one or two days of Wind Strike. Upon administration, it brings no benefit and causes harm. Why? I believe not all Taiyang Wind Strike cases involve true Ying deficiency. *Neitai Fangyi* states: If a person is constitutionally robust, with abundant Qi and Blood, persistent high fever, yet the pulse is floating on the Yang position and deep/excess on the Yin position, while external signs show spontaneous sweating and aversion to wind, Red Paeonia Root should be used in the formula to drain substantial pathogenic factors within the Ying. The widely transmitted Zhang Zhongjing Guizhi Tang (Cinnamon Twig Decoction) uses White Paeonia Root, which tonifies Ying and consolidates Wei. It is suitable for patients who are physically weak and intolerant to Wind-Cold, with a floating-slow and weak pulse, mild heat (Xi Xi Ran), continuous intermittent sweating. Only then can Guizhi Tang be fully administered. Otherwise, if Wind Pathogen is just beginning to prevail at the exterior, using the astringent sourness of White Paeonia Root and the sweet-warm nature of roasted Jujube and Licorice to tonify might hinder the acrid-hot Cinnamon Twig and acrid-warm Fresh Ginger from dispersing the Wind-Cold pathogen. Zhang Zhongjing likely established this formula for cases of deficient Righteous Qi and mild exterior pathogen. Those today who strictly follow this method make many errors.
Hu further notes: Wind Strike with fever, even accompanied by nasal congestion sounds and dry retching, indicates pathogenic heat. Pathogenic heat cannot digest grain, meaning it cannot overcome Grain Qi. Zhang Zhongjing adds after the Guizhi Tang (Cinnamon Twig Decoction) instructions: After taking the medicine, shortly thereafter, drink more than one Sheng of hot thin porridge. This applies to patients who externally have head and neck stiffness, fever, spontaneous sweating, and aversion to wind/cold, but internally eat normally, with no chest/diaphragm fullness. Hence, they are instructed to drink hot porridge and avoid meat/wheat products. I often see modern patients with Wind-Cold having concurrent food stagnation. Therefore, they dare not drink hot porridge nor take Guizhi Tang (Cinnamon Twig Decoction), fearing the sweet-warm nature of roasted Licorice and Jujube will cause bloating. Students who do not understand principles through reading, fail to carefully examine signs and pulses, and rigidly apply Guizhi Tang (Cinnamon Twig Decoction) to Taiyang Wind Strike will make many errors. Be cautious. Hu also notes: Zhang Zhongjing states under Guizhi Tang (Cinnamon Twig Decoction): Cover with warm blankets to induce slight sweating. If sweating occurs after one dose, do not finish the remaining medicine. If no sweating, administer again. If still no sweating, continue until sweating occurs. Thus, it is a sweating-inducing medicine. Cheng's *Ming Lilun* cites the classics: Cinnamon Twig resolves the muscle layer; if pulse is floating-tight, fever, no sweating, do not give it. This seems like an anti-sweating medicine. Why? I argue Taiyang Wind Strike involves exterior deficiency attacked by Wind-Cold. Spontaneous sweating comes and goes intermittently but fails to penetrate thoroughly, causing persistent fever. Zhang Zhongjing uses Guizhi Tang (Cinnamon Twig Decoction) to use acrid-sweet properties to disperse Wind Pathogen from the muscle/exterior. Once the pathogen leaves, the exterior closes, sweating stops, and fever ceases. This embodies the meaning of "dispersing within stopping."
Taiyang Disease presenting with headache, fever, sweating, and aversion to wind is treated with Guizhi Tang (Cinnamon Twig Decoction). (This indicates that although Taiyang Disease shares headache and fever, one must identify the specific pattern: only if sweating and aversion to wind are present, confirming Wind Strike, should Guizhi Tang (Cinnamon Twig Decoction) be administered.)
Taiyang Disease presenting with stiff neck and back, [Ji Ji] sensation, contrary sweating, and aversion to wind is treated with Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Kudzu Root). ([Ji Ji] sounds like 'shu'. [Ji Ji] describes the posture of a bird stretching its neck due to short wings. In Taiyang Disease, the neck and back are stiff, and the [Ji Ji] sensation prevents neck extension. The neck meridian belongs to Yangming. Typically, stiff neck/back with [Ji Ji] implies no sweating. Now, however, there is sweating and aversion to wind. According to Zhang Zhongjing's method, Taiyang Disease with sweating and aversion to wind is treated with Guizhi Tang (Cinnamon Twig Decoction). Due to the [Ji Ji] sensation, Ge Gen (Kudzu Root) is added to Guizhi Tang (Cinnamon Twig Decoction) to simultaneously dispel Wind from the Yangming meridian. Cheng Wuji misunderstood this, claiming the ingredients are identical to Guizhi Tang (Cinnamon Twig Decoction) and suspecting Ephedra was included, which is a significant error. I analyze this clause as a Taiyang-Yangming Wind Strike syndrome. The preceding sentence regarding Guizhi Tang (Cinnamon Twig Decoction) should read "Guizhi Tang plus Ge Gen (Kudzu Root) is indicated" for clarity.]