治中风伤寒脉浮。发热。往来汗出恶风项强。鼻鸣干呕方。
桂枝 芍药（各三两） 甘草（炙） 黄芩（各二两）
上锉。如麻豆大。每服钞五钱匕。水一盏半。枣子一枚。生姜三片。煎至一盏。去滓。取八分。清汁温服。若脉浮
紧。发热无汗者。不可与也。
琥按上论云。桂枝汤。西北二方居人。四时行之。无不应验。此必是极北极西之地。其气寒凉。故宜行此汤尔。余
居东南。地气温暖。虽冬月遇中风证。桂枝汤。亦有不轻用者。况于春末及夏至以后邪。奉议加黄芩知母等药。可为发
仲景未发之义矣。
又云。伤寒热病。药性须凉。不可太温。夏至后。用麻黄汤。须加知母半两。石膏一两。黄芩一分。盖麻黄汤性热。
夏月服之。有发黄斑出之失。惟冬及春。与病患素虚寒者。乃用正方。不在加减。
与仲景原方药味同（分两减半）
琥按上论云。夏至后用麻黄汤。须加知母石膏黄芩。奉议此言。可为深得用药之旨。且也。活人书。取用麻黄汤。
自有通变之法。本方中加苍术。治寒湿。去桂枝。加薏苡仁。治风湿。去桂枝杏仁。加石膏山茵陈苍术。治湿热。皆太
阳经之药也。仲景当日制麻黄汤。后之人。若云。一味不可增损。吾不信矣。
治伤寒一日。至二日。头项及腰脊。拘急疼痛。浑身烦热。恶寒方。
芍药（三两） 豆豉（一合） 干葛（四分） 麻黄（三两去节汤泡一二沸焙干秤）
上锉。如麻豆大。每服四钱。葱白七根。水一盏半。煮至八分。去滓。温服。以浓衣盖覆。如人行四五里间。再服。
良久。如未得汗。更煮葱粥。少少与之热。投以助药力。取汗即愈。
琥按上方。乃仲景葛根汤之变方也。此汤能治太阳病项背强KT KT 无汗恶风者。又能治太阳阳明合病。自下
利者。但仲景葛根汤方后云。不须 粥。此云。如未得汗更煮葱粥。少少与之。热投以助药力。此可见前圣后贤。取汗
之法。各不相同。医者当临证起悟云尔。
许学士云。病患发热恶寒。脉浮而紧者。伤寒之候也。如病患发热头疼。脉浮数而尺中迟弱者。宜先服黄 建中汤。
加当归。以补血。却与麻黄桂枝辈。
A formula for treating wind-stroke or cold-injury with a floating pulse, fever, intermittent sweating, aversion to wind, stiffness of the neck and nape, nasal congestion (bi-ming), and dry retching.
Guizhi (Cinnamon Twig) Shaoyao (White Peony Root) [each 3 liang] Gancao (Licorice Root, prepared by roasting) Huangqin (Scutellaria Root) [each 2 liang]
The above herbs are chopped into pieces the size of hemp seeds. Each dose is five qian bi (a small scoop). Add one dan zhen (cup and a half) of water, one jujube (Ziziphus jujuba fruit), and three slices of Shengjiang (Fresh Ginger). Decoct until one cup remains. Remove the dregs, take eight-tenths of the liquid, and drink the clear juice warm. If the pulse is floating and tight, and there is fever without sweating, this formula should not be administered.
Wang Hu notes: The aforementioned discussion states that Guizhi Tang (Cinnamon Twig Decoction) is effective when used in all four seasons by people in the northwest regions. This must be because those extreme northern and western lands have cold climates, making this decoction suitable. I reside in the southeast where the climate is warm; even in winter, when encountering wind-stroke syndromes, Guizhi Tang is not used lightly, let alone in late spring or after the Summer Solstice. Fengyi added herbs such as Huangqin (Scutellaria Root) and Zhimu (Anemarrhena Rhizome), which elucidates principles not fully expounded by Zhang Zhongjing.
It is also stated: For cold-injury and febrile diseases, the nature of medicines should be cooling, not too warming. After the Summer Solstice, when using Mahuang Tang (Ephedra Decoction), one must add Ban liang of Zhimu (Anemarrhena Rhizome), one liang of Shigao (Gypsum Fibrosum), and one fen of Huangqin (Scutellaria Root). This is because Mahuang Tang is hot in nature; taking it in summer may lead to jaundice and macular eruptions. Only in winter and spring, or for patients with inherent deficiency-cold constitutions, should the original formula be used without modifications.
[This formula contains the same herbs as Zhang Zhongjing's original formula, but with halved dosages.]
Wang Hu notes: The aforementioned discussion states that after the Summer Solstice, when using Mahuang Tang (Ephedra Decoction), one must add Zhimu (Anemarrhena Rhizome), Shigao (Gypsum Fibrosum), and Huangqin (Scutellaria Root). Fengyi’s statement deeply grasps the essence of herbal prescription. Furthermore, *Huoren Shu* (Book of Vitality) employs Mahuang Tang (Ephedra Decoction) with flexible variations. Adding Cangzhu (Atractylodis Rhizoma) treats cold-dampness; removing Guizhi (Cinnamon Twig) and adding Yiyiren (Coix Seed) treats wind-dampness; removing Guizhi (Cinnamon Twig) and Xingren (Apricot Seed) and adding Shigao (Gypsum Fibrosum), Shanyinyinchen (Artemisia capillaris), and Cangzhu (Atractylodis Rhizoma) treats damp-heat. All these target the Taiyang Meridian. When Zhang Zhongjing originally formulated Mahuang Tang (Ephedra Decoction), if later generations claimed that not even a single herb could be added or removed, I would not believe it.
A formula for treating cold-injury from day one to two, characterized by stiffness and pain in the head, neck, and lumbar spine, general body irritability and heat, and aversion to cold.
Shaoyao (White Peony Root) [3 liang] Douchi (Prepared Soybean) [1 he] Gegen (Pueraria Root) [4 fen] Mahuang (Ephedra Herba) [3 liang, remove joints, soak in boiling water for one or two boils, then dry and weigh]
The above herbs are chopped into pieces the size of hemp seeds. Each dose is four qian. Add seven stalks of Congbai (Scallion White) and one dan zhen (cup and a half) of water. Decoct until eight-tenths remain. Remove the dregs and drink warm. Cover with thick clothing. Wait approximately the time it takes to walk four or five li, then administer the second dose. If sweating has not occurred after a while, boil Congzhou (Scallion Porridge), give it in small amounts frequently, and use the heat to assist the medicinal power. Recovery occurs upon sweating.
Wang Hu notes: The above formula is a variation of Zhang Zhongjing’s Gegen Tang (Kudzu Decoction). This decoction can treat Taiyang syndrome with stiffness of the neck and back, absence of sweating, and aversion to wind. It can also treat combined Taiyang and Yangming syndromes with spontaneous diarrhea. However, the post-script of Zhang Zhongjing’s Gegen Tang (Kudzu Decoction) states: "No need to consume porridge." Here it says: "If sweating does not occur, boil scallion porridge, give in small amounts frequently, and use heat to assist the medicinal power." This shows that the methods of inducing sweat vary among ancient sages and later worthies. Physicians should gain insight through clinical practice.
Xu Xueshi said: Patients with fever, aversion to cold, and a floating, tight pulse exhibit signs of cold-injury. If patients have fever, headache, and a floating, rapid pulse with a slow and weak chi position, they should first take Huangqi Jianzhong Tang (Astragalus Middle-Warming Decoction) with Danggui (Angelica Sinensis) added to nourish blood, before administering herbs like Mahuang (Ephedra) or Guizhi (Cinnamon Twig).