于桂枝汤方内。加浓朴二两。杏仁五十个。去皮尖。余根据前法。
凡服桂枝汤吐者。其后必吐脓血也。
内热者。服桂枝汤则吐。如酒客之类也。既亡津液。又为热所搏。其后必吐脓血。
吐脓血。谓之肺痿。金匮要略曰。热在上焦为肺痿。谓或从汗。或从呕吐。重亡津液。
故得之。
太阳病。发汗。遂漏不止。其人恶风。小便难。四肢微急。难以屈伸者。桂枝加附
子汤主之。
太阳病。因发汗。遂汗漏不止而恶风者。为阳气不足。因发汗。阳气益虚。而皮腠
不固也。内经曰。膀胱者。州都之官。津液藏焉。气化则出。小便难者。汗出、亡津液。
阳气虚弱。不能施化。四肢者。诸阳之本也。四肢微急。难以屈伸者。亡阳而脱液也。针
经曰。液脱者。骨属屈伸不利。与桂枝加附子汤。以温经复阳。
于此方内。去桂枝。加白术四两。根据前法。
太阳病下之后。脉促、胸满者。桂枝去芍药汤主之。若微恶寒者。去芍药。方中加
附子汤主之。
脉来数时一止、复来者。名曰促。促为阳盛。则不因下后而脉促者也。此下后脉促。
不得为阳盛也。太阳病下之。其脉促不结胸者。此为欲解。此下后脉促。而复胸满。则
不得为欲解。由下后阳虚。表邪渐入而客于胸中也。与桂枝汤。以散客邪。通行阳气。
芍药益阴。阳虚者非所宜。故去之。阳气已虚。若更加之微恶寒。则必当温剂以散之。
故加附子。
In the prescription of Guizhi Tang (Cinnamon Twig Decoction), add Houpo (Magnolia Bark) two liang, and Xingren (Apricot Seed) fifty pieces, with the skin and tips removed. The remaining preparation and administration methods follow those previously described.
For those who vomit after taking Guizhi Tang (Cinnamon Twig Decoction), pus and blood will inevitably be vomited subsequently.
Individuals with internal heat, such as habitual drinkers, will vomit upon taking Guizhi Tang (Cinnamon Twig Decoction). Since their body fluids have already been depleted and are further constrained by heat pathogens, pus and blood will inevitably be vomited later.
Vomiting pus and blood is termed Fei Wei (Lung Withering). As stated in *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet): Heat located in the upper jiao (upper burner) leads to Lung Withering. This occurs due to excessive sweating or frequent vomiting, resulting in severe depletion of body fluids.
In Taiyang disease (Disease of the Taiyang/Bladder channel), after treatment with diaphoresis (sweating method), sweating continues incessantly. The patient experiences aversion to wind, difficulty in urination, slight stiffness of the four limbs, and difficulty in flexion and extension. This condition should be treated with Guizhi Jia Fuzi Tang (Guizhi Decoction with Aconite).
In Taiyang disease, due to diaphoresis, sweating continues incessantly accompanied by aversion to wind. This indicates a deficiency of Yang Qi. The act of sweating further depletes Yang Qi, causing the skin and pores to become insecure. As stated in *Nei Jing* (Inner Canon): The Bladder is the official of the capital, storing body fluids; they are excreted through Qi transformation. Difficulty in urination arises because sweating has depleted body fluids, and weak Yang Qi cannot perform Qi transformation. The four limbs are the root of all Yang meridians. Slight stiffness and difficulty in flexion and extension of the limbs indicate the loss of Yang Qi and depletion of fluids. As stated in *Zhen Jing* (Needle Classic): When fluids are depleted, bone joints become difficult to flex and extend. Administer Guizhi Jia Fuzi Tang (Guizhi Decoction with Aconite) to warm the meridians and restore Yang Qi.
To the Guizhi Tang (Cinnamon Twig Decoction) formula, add one Fuzi (Prepared Aconite Root), which is processed, peeled, and broken into eight pieces. The remaining methods follow those previously described.
In this formula, remove Guizhi (Cinnamon Twig) and add Baizhu (Atractylodes Macrocephala Rhizome) four liang. Follow the previous methods.
After purgation (downward draining method) for Taiyang disease, if the pulse is rapid with intermittent stops (Cu Mai, Hasty Pulse) and there is chest fullness, treat with Guizhi Qu Shaoyao Tang (Guizhi Decoction without Paeonia). If there is slight aversion to cold, use the formula that removes Shaoyao (Paeonia) and adds Fuzi (Prepared Aconite Root), known as Guizhi Qu Shaoyao Jia Fuzi Tang (Guizhi Decoction without Paeonia with Aconite).
When the pulse beats rapidly but stops occasionally before resuming, it is named Cu Mai (Hasty Pulse). Generally, Cu Mai indicates excess Yang, occurring not necessarily after purgation. However, in this case, the Cu Mai appears after purgation and cannot be attributed solely to Yang excess. In Taiyang disease, if purgation results in a Cu Mai (Hasty Pulse) without Jian Xiong (Chest Binding/Syndrome), it suggests the disease is about to resolve. But here, purgation leads to Cu Mai (Hasty Pulse) accompanied by chest fullness, so it does not indicate resolution. This is because purgation has damaged Yang Qi, allowing exterior pathogens to gradually penetrate and lodge in the chest. Administer Guizhi Tang (Cinnamon Twig Decoction) to disperse the lodged pathogens and promote the circulation of Yang Qi. Shaoyao (Paeonia Root) nourishes Yin and is unsuitable for cases of Yang deficiency; therefore, it is removed. Since Yang Qi is already deficient, if slight aversion to cold is added, warming agents must be used to dispel the pathogen. Therefore, Fuzi (Prepared Aconite Root) is added.