桂枝（三两去皮味辛热） 芍药（三两味苦酸微寒） 甘草（二两炙味甘平） 生
姜（三两切味辛温） 大枣（十二枚擘味甘温）
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。通身 。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。
后服当小促其间。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。
内经曰。辛甘发散为阳。桂枝汤。辛甘之剂也。所以发散风邪。内经曰。风淫所胜。
平以辛。佐以苦甘。以甘缓之。以酸收之。是以桂枝为主。芍药甘草为佐也。内经曰。
风淫于内。以甘缓之。以辛散之。是以生姜大枣为使也。
成无己云。桂枝用姜枣。不特专于发散。以脾主为胃行其津液。姜枣之用。专行脾
之津液而和荣卫者也。麻黄汤不用姜枣者。谓专于发汗。不待行化而津液得通矣。
李东垣云。桂枝汤。是阴经荣药也。闭卫气使阴气不泄。此药为卫虚也。
又云。仲景治表虚制此汤。桂枝味辛热发散。助阳体轻。本乎天者亲上。故桂枝为
君。芍药甘草为佐。如阳脉涩。阴脉弦。法当腹中急痛。乃制小建中汤。以芍药为君。
桂枝甘草佐之。一则治其表虚。一则治其里虚。故各有主用也。后学当触类而长之。
王三阳云。太阳病。汗出服桂枝。只使之似有汗者。邪已去矣。似字当细玩。不可
认作发汗。与麻黄汤混看。
太阳病。头痛发热。汗出恶风者。桂枝汤主之。
头痛者。太阳也。发热汗出恶风者。中风也。与桂枝汤。解散风邪。
太阳病。项背强KT KT 。反汗出。恶风者。桂枝加葛根汤主之。
KT KT 者。伸颈之貌也。动则伸颈摇身而行。项背强者。动则如之。项背KT KT 者。当
无汗。反汗出。恶风者。中风表虚也。与桂枝汤以和表。加麻黄葛根以祛风。且麻黄主
表实。后葛根汤证云。太阳病。项背强KT KT 。无汗恶风。葛根汤主之。药味正与此方同。
其无汗者。当用麻黄。今自汗出。恐不加麻黄。但加葛根也。
Cinnamon Twig (Guizhi, *Ramulus Cinnamomi*) three liang, bark removed, pungent and hot; White Peony Root (Baishao, *Radix Paeoniae Alba*) three liang, bitter, sour, slightly cold; Licorice Root (Gancao, *Radix Glycyrrhizae*) two liang, honey-fried, sweet and neutral; Fresh Ginger (Shengjiang, *Rhizoma Zingiberis Recens*) three liang, sliced, pungent and warm; Jujube (Dazao, *Fructus Jujubae*) twelve pieces, torn open, sweet and warm.
The above five herbs. Crushed. Boiled in seven sheng of water with a gentle fire until three sheng remain. Strain the dregs. When the temperature is suitable, take one sheng. After taking the medicine, shortly thereafter drink more than one sheng of hot thin porridge to assist the medicinal power. Cover with warm clothing for about the time it takes to have a meal, aiming for a slight, uniform sweating over the whole body. This is optimal. Do not allow profuse sweating like flowing water, otherwise the disease will certainly not be eliminated. If after one dose sweat appears and the illness improves, stop subsequent doses; there is no need to finish the entire decoction. If no sweat occurs, administer again according to the previous method. If still no sweat, shorten the interval between subsequent doses slightly, completing three doses within half a day. For severe cases, administer continuously over one day and night, observing for twenty-four hours. If symptoms persist after finishing one decoction, prepare another dose. If still no sweat, continue administration up to two or three decoctions. Prohibit consumption of raw/cold foods, sticky/slippery foods, meat, wheat products, the "five pungents" (garlic, chives, leeks, onions, scallions), dairy/wine, and foul-smelling substances.
The *Neijing* states: Pungent and sweet agents disperse and belong to Yang. Guizhi Tang is a pungent-sweet formula, thus capable of dispersing wind pathogens. The *Neijing* states: When wind excess prevails, pacify with pungent, assist with bitter and sweet, soothe with sweet, and astringe with sour. Therefore, Cinnamon Twig is the sovereign herb, while White Peony Root and Licorice are minister herbs. The *Neijing* states: When wind invades internally, soothe with sweet and disperse with pungent. Therefore, Fresh Ginger and Jujube are envoy herbs.
Cheng Wuji stated: The use of Ginger and Jujube in Guizhi Tang is not solely for dispersion. Since the Spleen governs transporting fluids from the Stomach, the function of Ginger and Jujube is specifically to circulate the Spleen's fluids and harmonize Ying (Nutritive) and Wei (Defensive) Qi. Mahuang Tang does not use Ginger and Jujube because its primary action is diaphoresis; it does not rely on fluid transformation to ensure fluid passage.
Li Dongyuan stated: Guizhi Tang consists of nutritive herbs for Yin meridians. It closes the Wei Qi to prevent leakage of Yin Qi; this formula addresses Wei Qi deficiency.
He further stated: Zhang Zhongjing formulated this decoction for exterior deficiency. Cinnamon Twig is pungent and hot, possessing dispersive properties; being light in nature, it follows its heavenly origin and moves upward, hence Cinnamon Twig is the sovereign herb. White Peony Root and Licorice are minister herbs. In cases of superficial pulse choppy and deep pulse string-like, abdominal cramping pain is indicated by protocol. Thus, Xiao Jianzhong Tang was formulated with White Peony Root as the sovereign herb, assisted by Cinnamon Twig and Licorice. One treats exterior deficiency, the other interior deficiency; hence each has its specific primary indication. Students should apply this logic analogously.
Wang Sanyang stated: In Taiyang disease with sweating, administering Guizhi Tang aims only for a state of "slight sweating." Once this state is reached, the pathogen is expelled. The character "slight" (si) requires careful interpretation; do not mistake this for vigorous diaphoresis, nor confuse it with Mahuang Tang.
In Taiyang disease, characterized by headache, fever, sweating, and aversion to wind, Guizhi Tang is the primary treatment.
Headache indicates involvement of the Taiyang meridian. Fever, sweating, and aversion to wind indicate Wind Strike syndrome. Administer Guizhi Tang to dissipate the wind pathogen.
In Taiyang disease, characterized by stiffness and discomfort in the nape and back (Jiangbei Qiang Ji Ji), accompanied by sweating and aversion to wind, Guizhi Jia Gegen Tang (Guizhi Decoction plus Kudzu Root) is the primary treatment.
"Ji Ji" describes the appearance of extending the neck. Movement involves extending the neck and swaying the body. Those with stiff nape and back exhibit similar movement when active. Stiffness in the nape and back typically presents without sweating; however, the presence of sweating and aversion to wind indicates Exterior Deficiency due to Wind Strike. Administer Guizhi Tang to harmonize the exterior, adding Ephedra Stem (Mahuang) and Kudzu Root (Gegen) to dispel wind. Although Ephedra Stem primarily treats Exterior Excess patterns, the subsequent Gegen Tang clause states: In Taiyang disease, with stiffness in the nape and back, absence of sweating, and aversion to wind, Gegen Tang is used. The herbal composition is identical to this formula. For cases without sweating, Ephedra Stem should be used; since this patient presents with spontaneous sweating, Ephedra Stem is likely omitted, retaining only Kudzu Root.