麻黄（四两去节味甘温） 杏仁（五十个去皮尖味甘温） 甘草（二两炙味甘平）
石膏（半斤碎绵裹味甘寒）
上四味。以水七升。先煮麻黄。减二升。去上沫。内诸药。煮取二升。去滓、温服
一升。
内经曰。肝苦急。急食甘以缓之。风气通于肝。风邪外甚。故以纯甘之剂发之。
张兼善云。余观仲景常言发汗后。乃表邪悉解。止余一证而已。故言不可行桂枝汤。
今汗出而喘。无大热。乃上焦余邪未解。当用麻黄杏仁甘草石膏汤以散之。夫桂枝
加浓朴杏仁汤。乃桂枝证悉具而加喘者用之。注言汗出而喘。以为邪气壅甚。非桂枝所
能发散。此误也。况身无大热。更无他证。何故复言表邪必甚。其后章下后不可更行桂
枝汤条下。注曰。汗下虽殊。既不当损正气则一。其言有至理存焉。可见汗后所注之误
矣。原其理。当时因事发机。前后失于照应。故有此等之弊也。
王文禄云。成注谓不可更行。以表解故。正恐贻之热耳。故复庵云。审知邪热未解。
虽经汗下。宜石膏竹叶汤。又云。太阳汗解后。不宜复行暖剂。
发汗过多。其人叉手自冒心。心下悸。欲得按者。桂枝甘草汤主之。
发汗过多。亡阳也。阳受气于胸中。胸中阳气不足。故病叉手自冒心。心下悸。欲
得按者。与桂枝甘草汤。以调不足之气。
Ephedrae Herba (Mahuang, 麻黄) [4 liang, remove nodes, sweet flavor, warm nature]
Semen Armeniacae Amarum (Xingren, 杏仁) [50 seeds, remove skin and pointed ends, sweet flavor, warm nature]
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [2 liang, honey-fried, sweet flavor, neutral nature]
Gypsum Fibrosum (Shigao, 石膏) [0.5 jin, crushed, wrapped in cotton cloth, sweet flavor, cold nature]
The above four ingredients. Use seven sheng of water. First decoct Ephedrae Herba (Mahuang, 麻黄). Reduce the volume by two sheng. Remove the foam on the surface. Add the remaining herbs. Decoct to obtain two sheng of liquid. Strain out the dregs. Take one sheng warm.
The *Neijing* states: When the Liver suffers from urgency, consume sweet substances to relax it. Wind Qi communicates with the Liver. When Wind pathogen is excessive on the exterior, pure sweet formulas are used to disperse it.
Zhang Jianshan said: I observe that Zhang Zhongjing often mentions "after sweating," indicating that the exterior pathogens have been completely resolved, leaving only one syndrome. Therefore, he states that Guizhi Tang (Cinnamon Twig Decoction) should not be used. Now, there is sweating and wheezing, without significant heat; this indicates that residual pathogens in the Upper Jiao (Upper Burner) have not yet been resolved. One should use Mahuang Xinggan Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) to dissipate them. Guizhi Jia Houpo Xingren Tang (Cinnamon Twig Decoction plus Magnolia Bark and Apricot Kernel) is used when all symptoms of the Guizhi Tang syndrome are present and accompanied by wheezing. The commentary claims that sweating and wheezing indicate severe pathogenic congestion, which Guizhi Tang cannot disperse. This is an error. Moreover, since there is no significant heat and no other syndromes, why assert that the exterior pathogens must be severe? In the later chapter under the clause "After purgation, Guizhi Tang should not be administered again," the commentary states: Although sweating and purgation differ, both should not damage the healthy Qi; this point is consistent. There is profound truth in these words. This reveals that the commentary on post-sweating conditions is erroneous. Tracing the principle, at that time, insights were generated based on specific events, lacking consistency between preceding and following sections, thus resulting in such flaws.
Wang Wenlu said: Cheng Wuji's commentary suggests that Guizhi Tang should not be used again because the exterior has resolved, fearing it might leave behind heat. Therefore, Fu'an stated: If it is determined that pathogenic heat has not resolved, even after sweating or purgation, Shigao Zhuye Tang (Gypsum and Bamboo Leaf Decoction) should be used. He also stated: After the Taiyang disease is resolved through sweating, warm agents should not be reused.
When excessive sweating occurs, and the patient crosses their hands over the heart region, experiencing palpitations and desiring pressure, Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction) is the primary treatment.
Excessive sweating leads to Yang collapse (Wang Yang). Yang Qi receives its Qi from the Chest Middle (Middle of the Chest). Insufficiency of Yang Qi in the Chest Middle causes symptoms such as crossing hands over the heart, palpitations, and a desire for pressure. Administer Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction) to regulate the insufficient Qi.