大汗
寒气入人肌肤，久则侵骨，头痛如劈，身热如火，浮热甚者，俱宜午时前发汗，午后阴分不宜。故曰∶
汗不太早，汗不厌早，紧急不拘晨夜。以衣被覆首裹足，向火服药，缓缓得汗，令手足澉遍为佳。如难汗，
将渣再服；或汗后不解，又可再汗；若急汗如水淋沥，则病邪不除而真阳脱亡。丸、散亦可发汗，不如汤药
为验。
麻黄汤 治太阳证，头疼发热恶寒，脊强身痛无汗，脉浮紧而喘。又治太阳八九日不解，以此发汗，
必衄乃解，及不得汗发衄。又治太阳阳明合病，喘而胸满，腹不满，邪在表分不可下者。又治阳明脉浮，无
汗而喘。凡脉起浮，无余证者，皆宜服之。
麻黄（三钱） 桂枝（二钱） 杏仁（十粒） 甘草（六分）
姜三片，葱二茎，水煎热服取汗。凡发汗药，一服中病即止，不必尽剂。如感寒深重，服汤不得汗，宜再
服之。半日连进二三剂而汗不出者，死。方意以寒伤荣，则荣盛而卫虚，荣脉
中寒邪盛，则血脉滞而头项背腰强痛，是用桂、杏之辛甘以散之；卫虚则恶寒无汗，气逆而喘，宜麻黄、甘草
之甘以大发之，充其卫分之阳。或疑无汗用桂枝者，盖荣行脉中，并卫气而犯之。经曰∶寒淫于内，治以甘热，
佐以苦辛。又曰∶辛甘发散为阳。凡寒淫者皆此例也。
陶氏麻黄汤 即前方加升麻、川芎、白芷、防风、羌活、 本、姜、葱、豆豉，煎热服。治法同上。如本经
寒热头痛，无汗而喘，去升麻加葛根；本经寒热身痛，去杏仁加苍术、芍药；本经寒热身痒，面赤不得小汗者，
去杏、芷、升麻加柴胡、芍药；本经寒热头痛，胸中饱闷，加枳壳、桔梗。凡陶氏方原无等分，以意酌量可也。
《活人大全》云∶太阳证，脉浮无汗，当以急汗，麻黄汤主之。肝之表见证者，加防风、羌活；心之表见证者，
加黄芩、石膏；脾之表见证者，加防己、白术；肺之表见证者，加桂枝、生姜；肾之表见证者，加熟附子、生
姜。
追魂汤 治卒厥暴死及客忤鬼击飞尸，奄忽气绝，口噤。麻黄三钱，杏仁二十五粒，甘草二钱，水煎，HT
口灌服。若更不下，分病患发，左右提搦肩引之，药下渐苏。一方有桂枝二钱。服后身和汗出则愈。若入脏，
唇青身冷即死。
三拗汤 治感冒风邪寒冷，鼻塞声重，语音不出，咳嗽多痰，胸满短气喘急。麻黄、杏仁、甘草各一钱，姜
三片，水煎温服，得汗为度。如胸紧加枳实，有痰加半夏，头痛加石膏、细茶。
五拗汤 即前方加荆芥、桔梗等分。如咽痛甚者，临服入芒硝少许。一方去荆芥、桔梗，用枳实、半夏。
麻黄附子细辛汤 麻黄、细辛各二钱，熟附半枚，寒甚者一枚，姜五片，枣二枚，水煎温服，取汗至
足乃愈。如呕吐去细辛，倍生姜。方意以伤寒无热恶寒者，阴经病也。今少阴病始得之，当无热而反发热，但
头不痛为异耳，乃邪在表也；脉虽沉以始得邪气未深，尤当温剂发汗以散之。是用附子、细辛之辛以温少阴之
经，麻黄之甘以散少阴之寒。经曰∶寒淫于内，治以甘热，佐以苦辛，以辛润之是也。凡房欲后伤寒者，多患
此证。《活人大全》云∶少阴证脉沉欲寐，始得之发热，肢厥无汗，为表病里和，当以此汤缓以汗之。随各脏
见证加药，同麻黄汤。若少阴外显前证，内见二便闭涩，或泻赤水，谓之有表复有里，宜本方去麻黄，名附子细
辛汤。随各脏见证，加药同麻黄汤，但更加大黄以微利之。
麻黄附子甘草汤 治少阴病得之二三日，发热脉沉细，邪犹在表，无吐利厥逆诸里证，宜此汤微汗以缓散
之。即前方去细辛，加甘草二钱，煎服。凡方以麻黄为主者，皆自麻黄汤而变之也。
解肌
微汗也。风伤卫，卫强则荣弱，故以补荣。不可大汗伤血，须半空心时，密室加衣静坐，宜热服药，得粘
汗即止。
桂枝汤 治太阳伤风，卫实荣虚，自汗头痛，鼻鸣项强干呕，啬啬恶寒，洒洒恶风，翕翕发热，或热多
寒少，面色光而不惨，烦躁身痛，手足不冷，脉浮缓，寸大尺弱者宜。如无汗溺数，手足冷，不恶寒者忌用。
夏月误服麻、桂，必发黄、发斑、狂闷而死。
桂枝（三钱） 白芍（三钱） 甘草（一钱）
姜三片，枣二枚，水煎热服微汗。方意以风伤卫，则卫盛而荣虚，卫脉外风邪盛，则发热自汗，气逆鼻鸣
干呕，宜桂、姜之辛以散之；荣虚宜恶寒而又恶风者，因自汗腠理疏也，宜芍药之酸以敛之；卫盛荣虚则争为
寒热，故用甘、枣之甘以和之。经曰∶风淫所胜，平以辛凉，佐以苦甘，以辛散之，以酸收之，以甘缓之是也。
或问《伤寒论》云∶阳虚阴盛，汗之则愈，下之则死。又云∶桂枝下咽，阳盛则毙。桂枝包麻黄而言，然则桂
枝亦发汗药乎？盖表
阳虚而后风邪得以乘之，客于荣卫之中，荣卫亦属皮毛表分也，非发散何由得愈？且桂枝虽能止汗，亦能和血
而令汗自出也。对肉桂而言，实为发汗；对麻黄而言，则为止汗。要之麻、桂皆表药也，一则大汗，一则解肌，
但有汗不得用麻黄，无汗不得用桂枝，实仲景格言也。
陶氏桂枝汤 即前方加防风、川芎、羌活、 本，姜、枣煎，临熟入饴糖二匙，温服。治法同前。如汗
多加白术，汗不止加黄 ，喘加柴胡、杏仁，胸中饱闷加枳、梗。《活人大全》云∶太阳表证外见，复有里证
便闭溺涩，腹痛或泻赤水，谓之有表复有里，桂枝汤主之。随各脏见证，加药同麻黄汤，但更加大黄以微利之。
附∶六经伤风方
太阳，桂枝汤；少阳，柴胡桂枝汤；太阴，桂枝加芍药汤。
杏子汤 治足阳明伤风，恶食，口苦咽干，腹满微喘，发热恶寒，自汗嗜卧，身重溺难，潮热而哕，脉
浮弦数。桂枝、芍药∶甘草、细辛、干姜、大黄各六分，杏仁、半夏、五味子各七分，茯苓八分，水煎温服。
九味桂附汤 治足少阴伤风，胸满心烦，咽痛自汗，腰连胫骨酸痛，呕吐涎沫，头痛，脉沉而弦。桂枝、
芍药、甘草、干姜、生附、茯苓、桃仁各五分，水煎温服。如咽痛，加桔梗二分半。
八物散 治足厥阴伤风，恶风而倦，自汗，小腹急痛，寒热如疟，骨节烦疼，脉尺寸俱微而迟。桂枝、
当归、川芎、柴胡、防风各三分，芍药一钱半，甘草、茯苓各五分，姜五片，枣二枚，水煎温服。方论见伤风
条下。
葛根汤 治太阳阳明，无汗恶风，发热恶寒，头痛项背腰强，目痛鼻干，不眠，肢体拘急，骨节烦疼，胸
胁满闷。不问一切伤寒、温病、时行寒疫等证，兼治刚、柔二 。
葛根（三钱） 麻黄（二钱） 芍药（一钱半） 桂枝（一钱） 甘草（八分）
姜三片，枣二枚，水煎温服取汗。本草云∶轻可去实。故加麻、葛二味之轻于桂枝汤中，以去表实，甚有意
味。麻黄治太阳，葛根治阳明，所谓治阳明而不可弃太阳是也。
葛根解肌汤 即葛根汤加黄芩二钱，治同上，兼治春疫发热而渴，不恶寒。
陶氏解肌汤 即葛根解肌汤去麻、桂，加柴胡、羌活、白芷、桔梗、石膏、升麻，姜煎服。治阳明病将传
少阳等证。如无汗恶寒甚者，去芩加麻黄，夏秋换苏叶。
升麻葛根汤 治四时伤寒，时行疫疠表证，或已汗吐下，表证未解，热深毒甚，发为斑疹，春温尤妙。兼
治小儿疮疹欲发未发，及解伤酒膈热，口疮咽痛。葛根一钱半，升麻、芍药、甘草各一钱，水煎温服，以病
去身清凉为度。如表热加柴胡；内热加黄芩；有吐血、衄血，或斑紫赤，加生地、牡丹皮；热甚加山栀、黄
连，或加连翘、天花粉尤妙；大便硬加枳壳、大黄以利之；头痛加川芎；身痛加羌活；胸膈痞闷加枳、梗；咳
嗽加杏仁；有痰加半夏；发斑加玄参；如老人去芍药，加柴胡、茯苓、人参。
柴胡升麻汤 治时行瘟疫，壮热恶风，头痛体痛，鼻塞咽干，痰盛咳嗽，涕唾稠粘。葛根、芍药、柴胡、
前胡、荆芥、石膏各一钱，桑白皮、黄芩各六分，升麻五分、姜二片，豆豉十粒，水煎温服。凡方以桂枝、芍
药为主者，皆自桂枝汤而变之也。
九味羌活汤 不问伤风，伤寒，寒热，头项脊腰四肢强痛，并四时感冒、疫疠、晚发等证，杂病亦可通治。
此方不犯三阳经禁，解利神方。
羌活一钱半，治太阳肢节痛为君，大无不通，小无不入，如关节痛甚及无汗者倍之。防风一钱半，治少阳
一身尽痛，随佐使而引之，如有汗者倍防风减羌活。苍术一钱二分，雄壮上行，大能除湿，使邪气不传太阴，
如有汗者换白术。川芎一钱三分，治厥阴头痛
在脑。白芷一钱二分，治阳明头痛在额。细辛三分，治少阴苦头痛或连齿。黄芩一钱二分，治太阴肺热在胸。
生地一钱二分，治少阴心热，有热者可用，无热者去之。甘草五分，能缓里和中。述各药主治，用户详之。
生姜三片，大枣二枚，葱白二茎，水煎热服取汗，如无汗用热粥以助之。此方发春夏秋三时表证，代桂枝、麻
黄、青龙、各半四方。盖三时暄热，伤寒则不敢用冬月麻黄而发表，故代以羌活、苍术。伤风则不敢用冬月
桂枝而实表，故代以防风、白术。芎、芷、辛发表以代杏仁，地黄救血以代芍药，加黄芩以顺天时也。加减法∶
太阳证加羌活、 本；阳明证加升麻、葛根、白芷；少阳证加柴胡、黄芩、半夏；太阴证加苍术、浓朴，枳实；
少阴证加桔梗、知母、黄柏；厥阴证加川芎、柴胡；如夏月加石膏、知母；服此汤后不作汗加苏叶；恶风自汗
加桂枝；夏月去桂加芍药；汗后不解加大黄；呕逆加姜汁；有痰去地黄加半夏；肌热加柴胡、葛根；喘而恶寒
身热加杏仁、生地；虚烦加知母、麦门冬、竹茹；胸中饱闷加枳壳、桔梗；中风行经加附子；便闭加大黄；中
风兼五痹等证，各随十二经，内外上下，寒热温凉，四时六气加减补泻用之，炼蜜为丸尤妙。
羌活冲和汤 治伤寒无汗，脉浮紧。羌活、苍术各一钱半，防风、黄芩、川芎、白芷、生地、甘草各一
钱，细辛五分，水煎热服取汗。如渴加知母、石膏；湿土司天，倍苍术，久雨亦加。
防风冲和汤 治伤风有汗，脉浮缓。防风、白术、生地各一钱半，羌活、黄芩、白芷、甘草各一钱，川芎
五分，水煎温服。汗未止加黄 、芍药；仍未止用柴胡桂枝汤。
川芎汤 治犯房室感寒，头痛，发热恶寒，无汗，脉浮紧。川芎、白术、羌活各等分，水煎热服。
吐
凡胸中痰实热郁；或寒结胸中，郁而痛不能食，欲使人按之，而反有涎唾；或下利，寸口脉滑；或宿食在
上；或客气胸中，脉结，心下烦满而不能食者，并宜吐之。一服中病即止，不可过也。凡吐时先以布系腰腹，
于无风处空心或半空心时，得天气清朗为妙。如风痰急病及伤食者不拘，以吐为度，如不吐，含砂糖一块下药，
涎出不损人，此皆自吐之法，不用手探，但药但汤皆可吐，虽杂病但宜升提其气便吐。通用防风、山栀、川芎、
桔梗芦、人参芦、茶芽、生姜、韭汁之类，加入二陈汤中吐之妙。
瓜蒂散 治寒邪不在表，亦不在里，而在胸中半表之分。故证如桂枝，但头不疼，项不强，寸脉微浮或大，
胸中痞硬，痰涎壅盛，气上冲咽不得息，或懊 烦躁不得眠。不经汗下，谓之实烦，宜用。如诸亡血及诸虚家，
不可用。
瓜蒂 赤小豆（各五分）
为末，用豆豉煎汤调服，或以盐汤一二碗顿服。服后宜卧片时，欲吐且忍之，良久用指探之随吐，得快乃止。
如不吐，饮热汤一碗以助药力。如服药过多者，饮水解之。未吐，次日又服之。
栀豉汤 治太阴病在胸膈，脉大多痰；及汗吐下后，虚烦发躁不得眠；甚则反复颠倒，心中懊 ；及身热
不去，心中结痛，或按之软者。又治阳明证下后，外有热，手足温，不结胸，心中懊 ，饥不能食，但头汗等
证。
山栀（四枚） 豆豉（六钱）
水煎服，得吐即止。经曰∶酸苦涌泄为阴。其高者越之，胸中痞硬，越以瓜、豉之苦；在上者涌之，痰涎壅
盛，涌以赤豆之酸。但瓜蒂性猛，不如栀豉汤更妙，栀豉之苦寒更入酸齑水少许，以吐胸中之邪。如表热加柴
胡；痞满加黄连；伤食加山楂、神曲；便闭加大黄。但病患微溏者，不可服，里虚而寒在下也。经云∶先泄
而后生他病者，治其本，必且调之，后乃治其他。治痰火于此而悟焉，其神乎！凡方以栀子为主者，皆自栀豉
汤而变之也。
下
凡下积聚、癫狂，须五鼓或平旦空心服药。伤寒潮热，不纳饮食者，巳时以后尤好。故曰∶下无太晚，
下不厌晚。杂病皆同。如不可通，用蜜导法。凡下药，用汤胜丸，水净万物故也。一服中病即止，不必尽剂，
通三五次后，以稀粥止之。
大承气汤 治阳明病，脉实身重，汗出不恶寒，谵语烦躁，五六日不大便，脐腹胀满硬痛，烦渴而喘，
手足心并腋下 汗出，少阴口燥咽干。晡热胃热当消谷引饮，今反不能食者，内必有燥屎，若能食者，但便
硬耳。又脉滑而数者有宿食。凡病大热大实大满者宜。
大黄 浓朴 芒硝 枳实（各二钱半）
Profuse Sweating
When cold qi invades the human skin and muscles, over time it may penetrate into the bones, causing headaches as if split by an axe, body heat like fire, and severe floating heat. All such cases are suitable for inducing sweating before noon; after noon, which belongs to the Yin aspect, it is not advisable. Thus it is said: Do not induce sweating too early, but do not dislike inducing it early; in emergencies, do not be restricted to morning or night. Cover the head and wrap the feet with clothes and blankets, take the medicine facing a fire, and allow sweat to come out slowly. It is best when sweat is evenly distributed throughout the hands and feet. If sweating is difficult, decoct and take the dregs again; or if the disease persists after sweating, induce sweating again. However, if one seeks rapid sweating leading to profuse dripping like being drenched, the pathogenic factors will not be eliminated, and the True Yang (vital energy) may collapse and perish. Pills and powders can also induce sweating, but they are not as effective as decoctions.
Mahuang Tang (Ephedra Decoction) treats Taiyang syndrome (disease of the Taiyang channel), characterized by headache, fever, aversion to cold, stiffness of the spine and body pain, absence of sweating, floating and tight pulse, and wheezing. It also treats Taiyang syndrome that has persisted for eight or nine days without resolution; inducing sweating with this formula will likely result in epistaxis (nosebleed) before resolution, or treat cases where inability to sweat leads to epistaxis. It further treats concurrent Taiyang and Yangming syndromes, presenting with wheezing and chest fullness but no abdominal fullness, where the pathogen is in the exterior layer and purgation is contraindicated. It also treats Yangming syndrome with a floating pulse, absence of sweating, and wheezing. For any case where the pulse rises at the floating position without other accompanying symptoms, this formula is appropriate.
Ephedrae Herba (Mahuang, 3 qian), Cinnamomi Ramulus (Guizhi, 2 qian), Armeniacae Semen Amarum (Xingren, 10 grains), Glycyrrhizae Radix et Rhizoma (Gancao, 6 fen).
Add three slices of Zingiberis Rhizoma Recens (Shengjiang, fresh ginger) and two stems of Allii Fistulosi (Congbai, green onion white). Decoct in water, take hot to induce sweating. For all diaphoretic medicines, stop after one dose once the illness is addressed; there is no need to finish the entire dosage. If the cold invasion is deep and severe, and sweating does not occur after taking the decoction, it is appropriate to take it again. If three or more doses taken within half a day still fail to produce sweating, the prognosis is fatal. The rationale of the formula is that cold injuring the Ying (Nutritive) Qi causes Ying to be excessive while Wei (Defensive) Qi is deficient. When cold pathogens are abundant in the Ying vessels, blood circulation stagnates, causing stiffness and pain in the head, neck, back, and waist. Therefore, the acrid-sweet properties of Guizhi and Xingren are used to disperse it. Wei deficiency leads to aversion to cold and absence of sweating, with rebellious Qi causing wheezing; thus, the sweet property of Mahuang and Gancao is used to vigorously induce sweating and replenish the Yang of the Wei division. Some may question the use of Guizhi in cases without sweating; this is because Ying Qi circulates within the vessels and travels together with Wei Qi, both being attacked. The Classics state: "For cold invading internally, treat with sweet-hot methods, assisted by bitter-acrid." It also states: "Acrid and sweet promote dispersal and belong to Yang." All cases of cold invasion follow this principle.
Tao's Mahuang Tang consists of the above formula plus Shengma (Cimicifugae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Gaoben (Ligustici Sinensis Rhizoma), Shengjiang, Congbai, and Douchi (Sojae Semen Praeparatum). Decoct and take hot. The treatment method is the same as above. If it is the Foot-Taiyang channel affected with cold-heat headache, absence of sweating, and wheezing, remove Shengma and add Gegen (Puerariae Lobatae Radix). If the channel is affected with cold-heat and body pain, remove Xingren and add Cangzhu (Atractylodis Rhizoma) and Shaoyao (Paeoniae Radix Alba). If the channel is affected with cold-heat, body itching, red face, and inability to sweat slightly, remove Xingren, Baizhi, and Shengma, and add Chaihu (Bupleuri Radix) and Shaoyao. If the channel is affected with cold-heat headache and chest fullness, add Zhike (Aurantii Fructus Immaturus) and Jiegeng (Platycodonis Radix). Tao's original formulas have no fixed proportions; adjust according to judgment.
Huore Daquan says: For Taiyang syndrome with floating pulse and absence of sweating, urgent sweating is required, primarily using Mahuang Tang. For Liver exterior manifestations, add Fangfeng and Qianghuo; for Heart exterior manifestations, add Huangqin (Scutellariae Radix) and Shigao (Gypsum Fibrosum); for Spleen exterior manifestations, add Fangji (Stephaniae Tetrandrae Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma); for Lung exterior manifestations, add Guizhi and Shengjiang; for Kidney exterior manifestations, add Fuzi (Aconiti Lateralis Radix Praeparata) and Shengjiang.
Zhuihun Tang (Soul-Chasing Decoction) treats sudden syncope, abrupt death, Ke Wu (hostile spirit invasion), Gui Ji (ghost strike), Fei Shi (flying corpse - sudden fainting spells), sudden cessation of breath, and locked jaw. Mahuang 3 qian, Xingren 25 grains, Gancao 2 qian. Decoct in water and administer via the teeth. If the medicine does not go down, part the patient's hair and pull the shoulders left and right to stretch; as the medicine enters, the patient gradually revives. Another version includes Guizhi 2 qian. Recovery occurs when the body harmonizes and sweats. If the pathogen enters the Zang organs, resulting in blue lips and cold body, death ensues.
San'ao Tang (Three Unyielding Decoction) treats catching wind-cold pathogens, nasal congestion with heavy voice, loss of voice, cough with much phlegm, chest fullness, shortness of breath, and rapid breathing. Mahuang, Xingren, and Gancao each 1 qian, Shengjiang 3 slices. Decoct in water, take warm, aiming for sweating. If chest tightness, add Zhishi (Aurantii Fructus); if phlegm, add Banxia (Pinelliae Rhizoma); if headache, add Shigao and Xiacha (fine tea).
Wu'ao Tang (Five Unyielding Decoction) is the above formula plus Jingjie (Schizonepetae Spica) and Jiegeng in equal parts. If throat pain is severe, add a small amount of Mangxiao (Natrii Sulfas) just before taking. Another version removes Jingjie and Jiegeng, using Zhishi and Banxia instead.
Mahuang Fuzi Xixin Tang (Ephedra, Prepared Aconite Root, and Asarum Decoction) uses Mahuang and Xixin (Asari Radix et Rhizoma) each 2 qian, Shu Fuzi (Prepared Aconite Root) half a piece (one piece if cold is severe), Shengjiang 5 slices, and Dazao (Ziziphi Jujubae Fructus) 2 pieces. Decoct in water, take warm to induce sweating until the feet become warm for recovery. If vomiting occurs, remove Xixin and double the amount of Shengjiang. The rationale is that cold damage with no fever but aversion to cold indicates a Yin channel disease. In early Shaoyin disease, one should have no fever but instead has fever, differing only by the absence of headache; this indicates the pathogen is in the exterior. Although the pulse is sinking, since the pathogen has not yet penetrated deeply, it is especially important to use warm agents to induce sweating and disperse it. Thus, the acrid nature of Fuzi and Xixin is used to warm the Shaoyin channels, and the sweet nature of Mahuang is used to disperse Shaoyin cold. The Classics state: "For cold invading internally, treat with sweet-hot methods, assisted by bitter-acrid, using acrid to moisten." This applies. After sexual activity, those who catch cold often suffer from this syndrome. Huore Daquan says: For Shaoyin syndrome with sinking pulse and desire to sleep, initial fever, cold limbs, and absence of sweating, indicating exterior disease with interior harmony, use this decoction to gently induce sweating. Add herbs according to each Zang organ's manifestations, similar to modifications of Mahuang Tang. If Shaoyin disease shows the aforementioned exterior signs but also internal constipation of urine and feces, or passage of red watery stool, it is called having both exterior and interior involvement. Use this formula removing Mahuang, named Fuzi Xixin Tang. Add herbs according to each Zang organ's manifestations, similar to Mahuang Tang modifications, but additionally add Dahuang (Rhei Radix et Rhizoma) to mildly purge.
Mahuang Fuzi Gancao Tang (Ephedra, Prepared Aconite Root, and Licorice Decoction) treats Shaoyin disease occurring for two or three days, with fever, sinking and fine pulse, pathogen still in the exterior, and no interior signs such as vomiting, diarrhea, or cold limbs. Use this decoction to gently induce sweating and slowly disperse it. This is the previous formula removing Xixin and adding Gancao 2 qian. Any formula primarily using Mahuang is derived from Mahuang Tang.
Jieji (Releasing the Muscle Layer)
This refers to mild sweating. Wind injures the Wei Qi; when Wei is strong, Ying is weak, so tonify Ying. Do not induce profuse sweating to damage blood. Sit quietly in a windowless room with extra clothing during fasting or half-fasted state. Take hot medicine; stop when sticky sweat appears.
Guizhi Tang (Cinnamon Twig Decoction) treats Taiyang wind injury, where Wei is excess and Ying is deficient, presenting with spontaneous sweating, headache, nasal roaring, neck stiffness, dry retching, slight aversion to cold, slight aversion to wind, mild fever, or more heat than cold, bright complexion without pallor, irritability, body pain, warm hands and feet, floating and moderate pulse, larger Cun and smaller Chi positions. Contraindicated if there is no sweating, frequent urination, cold hands and feet, or absence of aversion to cold. Misusing Mahuang and Guizhi in summer will inevitably cause jaundice, macules, delirium, and death.
Cinnamomi Ramulus (Guizhi, 3 qian), Paeoniae Radix Alba (Baishao, 3 qian), Glycyrrhizae Radix et Rhizoma (Gancao, 1 qian).
Add Zingiberis Rhizoma Recens (Shengjiang, 3 slices) and Ziziphi Jujubae Fructus (Dazao, 2 pieces). Decoct in water, take hot to induce mild sweating. The rationale is that wind injures Wei, making Wei excessive and Ying deficient. Excess wind pathogen in Wei vessels causes fever and spontaneous sweating, with rebellious Qi causing nasal roaring and dry retching; the acrid nature of Guizhi and Shengjiang is used to disperse it. Ying deficiency leads to aversion to cold and wind due to open pores from sweating; the sour nature of Shaoyao is used to astringe. Wei excess and Ying deficiency contend causing cold and heat; thus, the sweet nature of Gancao and Dazao is used to harmonize them. The Classics state: "For wind invading excessively, level with acrid-cool, assisted by bitter-sweet, using acrid to disperse, sour to collect, and sweet to relax." Someone asks: The Shanghan Lun says, "In Yang deficiency and Yin excess, sweating cures, purging kills." And again, "Once Guizhi enters the throat, if Yang is excess, death follows." Guizhi encompasses the effects of Mahuang; is Guizhi also a diaphoretic? Because exterior Yang is deficient, allowing wind pathogens to invade and lodge in Ying and Wei, which belong to the exterior skin and muscle layers. How else can recovery occur without dispersal? Although Guizhi can stop sweating, it also harmonizes blood to allow natural sweating. Compared to Rougui (Cinnamomi Cortex), it is truly diaphoretic; compared to Mahuang, it stops sweating. Ultimately, both Mahuang and Guizhi are exterior drugs; one induces profuse sweating, the other releases the muscle layer. Those with sweating must not use Mahuang; those without sweating must not use Guizhi. This is indeed Zhang Zhongjing's golden rule.
Tao's Guizhi Tang adds Fangfeng, Chuanxiong, Qianghuo, and Gaoben to the previous formula, decocted with Shengjiang and Dazao. Just before completion, add Yi Tang (Maltose) two spoons, take warm. Treatment is the same. If sweating is excessive, add Baizhu; if sweating does not stop, add Huangqi (Astragali Radix); if wheezing, add Chaihu and Xingren; if chest fullness, add Zhike and Jiegeng. Huore Daquan says: When Taiyang exterior signs appear alongside interior signs like constipation, dysuria, abdominal pain, or red watery diarrhea, it is called having both exterior and interior. Use Guizhi Tang as primary. Add herbs according to each Zang organ's manifestations, similar to Mahuang Tang modifications, but additionally add Dahuang to mildly purge.
Appendix: Six Channels Wind Injury Formulas
Taiyang: Guizhi Tang; Shaoyang: Chaihu Guizhi Tang; Taiyin: Guizhi Jia Shaoyao Tang.
Xingzi Tang (Apricot Seed Decoction) treats Foot-Yangming wind injury, anorexia, bitter taste in mouth, dry throat, abdominal fullness with slight wheezing, fever with aversion to cold, spontaneous sweating, lethargy, heavy body, difficult urination, tidal fever, and hiccups. Pulse is floating, wiry, and rapid. Guizhi, Shaoyao, Gancao, Xixin, Ganjiang (Dried Ginger), and Dahuang each 6 fen; Xingren, Banxia, and Wuweizi (Schisandrae Fructus) each 7 fen; Fuling (Poria) 8 fen. Decoct in water, take warm.
Jiuwei Guifu Tang (Nine-Ingredient Cinnamon and Aconite Decoction) treats Foot-Shaoyin wind injury, chest fullness,心烦 (restlessness), sore throat, spontaneous sweating, soreness and pain in lower back extending to shins, vomiting of saliva, headache, and sinking, wiry pulse. Guizhi, Shaoyao, Gancao, Ganjiang, Sheng Fuzi (Raw Aconite Root), Fuling, and Taoren (Pruni Semen) each 5 fen. Decoct in water, take warm. If sore throat, add Jiegeng 2.5 fen.
Bawu San (Eight-Ingredient Powder) treats Foot-Jueyin wind injury, aversion to wind with fatigue, spontaneous sweating, acute pain in lower abdomen, cold and heat alternating like malaria, painful joints, and sinking, slow pulse at both Cun and Chi. Guizhi, Danggui (Angelicae Sinensis Radix), Chuanxiong, Chaihu, and Fangfeng each 3 fen; Shaoyao 1.5 qian; Gancao and Fuling each 5 fen; Shengjiang 5 slices; Dazao 2 pieces. Decoct in water, take warm. See Wind Injury section for formula discussion.
Gegen Tang (Kudzu Root Decoction) treats concurrent Taiyang and Yangming, absence of sweating, aversion to wind, fever with aversion to cold, headache, neck/back/waist stiffness, eye pain, dry nose, insomnia, limb spasms, painful joints, and chest/hypochondriac fullness. Treats all cold damage, warm diseases, seasonal cold epidemics, etc., including Gang Jing (rigid spasm) and Rou Jing (flaccid spasm).
Gegen (3 qian), Mahuang (2 qian), Shaoyao (1.5 qian), Guizhi (1 qian), Gancao (8 fen).
Add Shengjiang 3 slices and Dazao 2 pieces. Decoct in water, take warm to induce sweating. Materia Medica states: "Light substances can remove excess." Thus, adding the light Mahuang and Gegen to Guizhi Tang removes exterior excess, which is significant. Mahuang treats Taiyang; Gegen treats Yangming. Treating Yangming without abandoning Taiyang is the principle.
Gegen Jieji Tang (Kudzu Root Releasing Muscle Decoction) is Gegen Tang plus Huangqin 2 qian. Same treatment, additionally treating spring epidemic fever with thirst and no aversion to cold.
Tao's Jieji Tang removes Mahuang and Guizhi from Gegen Jieji Tang, adding Chaihu, Qianghuo, Baizhi, Jiegeng, Shigao, and Shengma. Decoct with Shengjiang. Treats Yangming disease about to transmit to Shaoyang. If severe absence of sweating and aversion to cold, remove Huangqin and add Mahuang; in summer/autumn, substitute with Zisuye (Perillae Folium).
Shengma Gegen Tang (Cimicifuga and Kudzu Root Decoction) treats four-season cold damage, seasonal epidemic exterior signs, or unresolved exterior signs after sweating/vomiting/purging, with deep heat and severe toxin causing macules and papules, especially effective for spring warmth. Also treats pediatric exanthems about to erupt, resolves alcohol-induced diaphragmatic heat, mouth ulcers, and sore throat. Gegen 1.5 qian, Shengma, Shaoyao, and Gancao each 1 qian. Decoct in water, take warm, stopping when the body feels cool after illness resolves. If exterior heat, add Chaihu; if interior heat, add Huangqin; if hematemesis, epistaxis, or purple-red macules, add Shengdi (Rehmanniae Radix) and Mudanpi (Moutan Cortex); if severe heat, add Zhizi (Gardeniae Fructus) and Huanglian (Coptidis Rhizoma), or add Lianqiao (Forsythiae Fructus) and Tianhuafen (Trichosanthis Radix) for best effect; if hard stool, add Zhike and Dahuang to purge; if headache, add Chuanxiong; if body pain, add Qianghuo; if chest/diaphragm stuffiness, add Zhike and Jiegeng; if cough, add Xingren; if phlegm, add Banxia; if macules, add Xuanshen (Scrophulariae Radix); for elderly, remove Shaoyao, add Chaihu, Fuling, and Renshen (Ginseng Radix et Rhizoma).
Chaihu Shengma Tang (Bupleurum and Cimicifuga Decoction) treats seasonal epidemics, high fever with aversion to wind, headache, body pain, nasal congestion, dry throat, copious phlegm, cough, and thick sticky sputum. Gegen, Shaoyao, Chaihu, Qianhu (Peucedani Radix), Jingjie, and Shigao each 1 qian; Sangbaipi (Mori Cortex) and Huangqin each 6 fen; Shengma 5 fen; Shengjiang 2 slices; Douchi 10 grains. Decoct in water, take warm. Any formula primarily using Guizhi and Shaoyao is derived from Guizhi Tang.
Jiuwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction) treats wind injury, cold damage, cold-heat, stiffness/pain in head, neck, spine, waist, and limbs, four-season colds, epidemics, late-onset diseases, etc. It is a divine formula for resolving exterior issues without violating Three-Yang channel prohibitions.
Qianghuo 1.5 qian is the sovereign herb for Taiyang joint pain, penetrating everywhere. Double if joint pain is severe or no sweating. Fangfeng 1.5 qian treats Shaoyang whole-body pain, guiding other herbs. Double Fangfeng and reduce Qianghuo if sweating. Cangzhu 1.2 qian is vigorous and ascending, greatly dampening-drying to prevent transmission to Taiyin. Switch to Baizhu if sweating. Chuanxiong 1.3 qian treats Jueyin headache in the brain. Baizhi 1.2 qian treats Yangming forehead headache. Xixin 0.3 qian treats Shaoyin severe headache radiating to teeth. Huangqin 1.2 qian treats Taiyin lung heat in the chest. Shengdi 1.2 qian treats Shaoyin heart heat; use if heat exists, remove if none. Gancao 0.5 qian moderates the interior and harmonizes. Refer to individual herb indications for details.
Add Shengjiang 3 slices, Dazao 2 pieces, and Congbai 2 stems. Decoct in water, take hot to induce sweating. If no sweating, drink hot porridge to assist. This formula addresses exterior signs in spring, summer, and autumn, replacing Guizhi, Mahuang, Qinglong Tang, and Xiaoqinglong Tang. Due to warm weather, winter Mahuang is avoided for releasing exterior, replaced by Qianghuo and Cangzhu. Winter Guizhi is avoided for securing exterior in wind injury, replaced by Fangfeng and Baizhu. Chuanxiong, Baizhi, and Xixin replace Xingren for dispersal; Dihuang (Shengdi) replaces Shaoyao to save blood; Huangqin is added to accord with the season. Modifications: Taiyang add Qianghuo and Gaoben; Yangming add Shengma, Gegen, Baizhi; Shaoyang add Chaihu, Huangqin, Banxia; Taiyin add Cangzhu, Houpo (Magnoliae Officinalis Cortex), Zhishi; Shaoyin add Jiegeng, Zhimu (Anemarrhenae Rhizoma), Huangbo (Phellodendri Cortex); Jueyin add Chuanxiong, Chaihu; Summer add Shigao, Zhimu; if no sweating after taking, add Zisuye; if aversion to wind and spontaneous sweating, add Guizhi; Summer remove Guizhi add Shaoyao; if unresolved after sweating, add Dahuang; if vomiting, add Jiangzhi (Ginger Juice); if phlegm, remove Dihuang add Banxia; if muscular heat, add Chaihu, Gegen; if wheezing with aversion to cold and fever, add Xingren, Shengdi; if deficiency vexation, add Zhimu, Maidong (Ophiopogonis Radix), Zhuru (Bambusae Caulis in Taenia); if chest fullness, add Zhike, Jiegeng; if stroke affecting meridians, add Fuzi; if constipation, add Dahuang; for stroke combined with five bi syndromes, modify according to Twelve Meridians, interior/exterior, upper/lower, cold/heat, warm/cool, four seasons, and six qi, using tonification/reduction. Pill form refined with honey is excellent.
Qianghuo Chonghe Tang (Notopterygium Harmony Decoction) treats cold damage with no sweating and floating-tight pulse. Qianghuo and Cangzhu each 1.5 qian; Fangfeng, Huangqin, Chuanxiong, Baizhi, Shengdi, and Gancao each 1 qian; Xixin 5 fen. Decoct in water, take hot to induce sweating. If thirsty, add Zhimu and Shigao; if Wet Earth governs the year, double Cangzhu; also add after prolonged rain.
Fangfeng Chonghe Tang (Saposhnikovia Harmony Decoction) treats wind injury with sweating and floating-moderate pulse. Fangfeng, Baizhu, and Shengdi each 1.5 qian; Qianghuo, Huangqin, Baizhi, and Gancao each 1 qian; Chuanxiong 5 fen. Decoct in water, take warm. If sweating does not stop, add Huangqi and Shaoyao; if still not stopping, use Chaihu Guizhi Tang.
Chuanxiong Tang (Ligusticum Decoction) treats cold damage after sexual intercourse, headache, fever with aversion to cold, no sweating, and floating-tight pulse. Chuanxiong, Baizhu, and Qianghuo in equal parts. Decoct in water, take hot.
Vomiting
For phlegm-heat stagnation in the chest, or cold binding in the chest causing pain and inability to eat, desire for pressure but producing saliva, or diarrhea with slippery Cun pulse, or food retention in the upper jiao, or hostile qi in the chest with knotted pulse, fullness below the heart, and inability to eat, emesis is indicated. Stop after one dose if effective; do not overdose. Before inducing vomiting, tie a cloth around the waist and abdomen. Perform in a draft-free area on an empty stomach or half-empty stomach, preferably during clear weather. Exceptions apply for acute wind-phlegm or food poisoning; vomit until relieved. If unable to vomit, hold a piece of rock sugar in the mouth before taking medicine; this expels saliva without harming the person. These are self-vomiting methods, avoiding manual stimulation. Both pills and decoctions can induce vomiting; even miscellaneous diseases can be treated by raising the Qi. Commonly used herbs include Fangfeng, Zhizi, Chuanxiong, Jiegeng Lu (Radix Platycodonis), Renshen Lu (Radix Ginseng), Cha Ya (Tea Buds), Shengjiang, and Jiu Zhi (Leek Juice). Adding these to Erchen Tang (Two-Aged Decoction) for vomiting is highly effective.
Gua Di San (Melon Seed Powder) treats cold pathogens neither in the exterior nor interior, but in the semi-exterior chest region. Symptoms resemble Guizhi Tang syndrome but without headache or neck stiffness, with slightly floating or large Cun pulse, chest oppression and hardness, copious phlegm-saliva, Qi rushing to the throat causing breathing difficulty, or inner restlessness and insomnia. Indicated for "excess vexation" not caused by sweating or purging. Contraindicated for hemorrhage patients and deficiency constitutions.
Cucumeris Fructus (Gua Di, 5 fen), Vigna Angularis (Chi Xiaodou, 5 fen).
Grind into powder. Mix with Dou Chi (Fermented Soybean) decoction to take, or drink one to two bowls of salt water at once. Lie down for a moment after taking; endure the urge to vomit, then stimulate the throat with a finger to induce vomiting. Stop when relief is achieved. If no vomiting, drink a bowl of hot water to boost efficacy. If overdosed, drink water to antidote. If not vomited, repeat the next day.
Zhichi Tang (Gardenia and Fermented Soybean Decoction) treats Taiyin disease in the chest-diaphragm with large pulse and much phlegm; or deficiency vexation and agitation with insomnia after sweating/vomiting/purging; even tossing and turning with inner restlessness; or persistent fever, chest knotting pain, or soft upon palpation. Also treats Yangming syndrome after purging, with external heat, warm hands/feet, no chest knotting, inner restlessness, hunger but inability to eat, and sweating only on the head.
Gardeniae Fructus (Zhizi, 4 pieces), Sojae Semen Praeparatum (Dou Chi, 6 qian).
Decoct in water. Stop if vomiting occurs. The Classics state: "Sour and bitter promote upward discharge and belong to Yin." High pathogens are vented; chest oppression/hardness is vented by the bitterness of Gua Di and Dou Chi. Upper pathogens are expelled; copious phlegm is expelled by the sourness of Chi Xiaodou. However, Gua Di is harsh; Zhichi Tang is superior. The bitter-cool nature of Zhichi and Dou Chi, with a little sour vinegar water, effectively vents chest pathogens. If exterior heat, add Chaihu; if oppression/fullness, add Huanglian; if food retention, add Shanzha (Crataegi Fructus) and Shenqu (Medicated Leaven); if constipation, add Dahuang. Contraindicated for patients with loose stools, as it indicates interior deficiency and cold below. The Classics say: "If diarrhea precedes other illnesses, treat the root first, regulate, then treat others." Understanding phlegm-fire treatment here reveals its profundity. Any formula primarily using Zhizi is derived from Zhichi Tang.
Purgation
For accumulating masses and mania, take medicine at dawn (Wu Gu) or early morning on an empty stomach. For tidal fever in cold damage with anorexia, taking medicine after Si hour (9-11 AM) is best. Thus it is said: Purging is never too late; do not dislike purging late. Applies to miscellaneous diseases similarly. If unresponsive, use Honey Suppository method. Decoctions are superior to pills for purgatives because water cleanses all things. Stop after one dose if effective; do not finish the dose. After 3-5 bowel movements, stop with thin rice gruel.
Da Chengqi Tang (Major Order the Qi Decoction) treats Yangming syndrome with solid pulse, heavy body, sweating without aversion to cold, delirious speech, irritability, no bowel movement for 5-6 days, umbilical/abdominal fullness, hardness, and pain,烦渴 (vexation/thirst), wheezing, sweating in palms/soles/axillae, and Shaoyin dry mouth/throat. Tidal fever and stomach heat should digest food and increase thirst; inability to eat suggests dry feces inside. Ability to eat implies only hard stool. Slippery and rapid pulse indicates food retention. Suitable for severe heat, excess, and fullness.
Rhei Radix et Rhizoma (Dahuang), Magnoliae Officinalis Cortex (Houpo), Natrii Sulfas (Mangxiao), Aurantii Fructus Immaturus (Zhishi) (each 2.5 qian).