太阳之为病，脉浮，头项强痛而恶寒。
经曰∶尺寸俱浮者，太阳受病。太阳受病，太阳主表，为诸阳主气。脉浮，头项强痛而恶寒者，太阳表病也。
太阳病，发热，汗出，恶风，脉缓者，名为中风。
风，阳也。寒，阴也。风则伤卫，发热，汗出，恶风者，卫中风。（医统本有“也”字）荣病，发热，
无汗，不恶风而恶寒；卫病，则发热，汗出，不恶寒而恶风。以卫为阳，卫外者也，病则不能卫固
其外，而皮腠疏，故汗出而恶风也。伤寒脉紧，伤风脉缓者，寒性劲急而风性解缓故也。
太阳病，或已发热，或未发热，必恶寒，体痛，呕逆，脉阴阳俱紧者，名曰（赵本作“为”）伤寒。
经曰∶凡伤于寒，则为病热，为寒气客于经中，阳经怫结而成热也。中风即发热者，风为阳也。及伤
寒云，或已发热，或未发热，以寒为阴邪，不能即热，郁而方变热也。风则伤卫，寒则伤荣，卫虚者恶风，荣
虚者恶寒，荣伤寒者，必恶寒也。气病者则麻，血病者则痛。风令气缓，寒令气逆，体痛呕逆者，荣
中寒也。经曰∶脉盛身寒，得之伤寒，脉阴阳俱紧者，知其伤寒也。
伤寒一日，太阳受之，脉若静者为不传；颇欲吐。若燥（赵本作“躁”）烦，脉数急者，为传也。
太阳主表，一日则太阳受邪，至二日当传阳明，若脉气微而不传阳明，胃经受邪，则喜吐；寒
邪传里者，则变热，如颇欲吐，若烦燥，脉急数者，为太阳寒邪变热，传于阳明也。
伤寒二三日，阳明少阳证不见者，为不传也。
伤寒二三日，无阳明少阳证，知邪不传，止在太阳经中也。
太阳病，发热而渴，不恶寒者，为温病。
发热而渴，不恶寒者，阳明也。此太阳受邪，知为温病，非伤寒也。积温成热，所以发热而渴，不恶寒也。
若发汗已，身灼热者，名曰（赵本无“曰”字）风温。风温为病，脉阴阳俱浮，自汗出，身重，多眠
睡，鼻息必鼾，语言难出。若被下者，小便不利，直视，失溲；若被火者，微发黄色，剧则如惊痫，时螈 ；
若火熏之，一逆尚引日，再逆促命期。
伤寒发汗已，则身凉；若发汗已，身灼热者，非伤寒，为风温也。风伤于上，而阳受风气，风与温相合，
则伤卫。脉阴阳俱浮，自汗出者，卫受邪也。卫者气也，风则伤卫，温则伤气，身重，多眠睡者，卫受风温
而气昏也。鼻息必鼾，语言难出者，风温外甚，而气拥不利也。若被下者，则伤脏气，太阳膀胱经
也。内经曰∶膀胱不利为癃，不约为遗溺。癃者，小便不利也。太阳之脉起目内 ；内经曰∶瞳子高者，
太阳不足，戴眼者，太阳已绝。小便不利、直视、失溲，为下后竭津液，损脏气，风温外胜。经曰∶欲绝也
为难治。若被火者，则火助风温成热，微者热瘀而发黄；剧者热甚生风，如惊痫而时螈 也。先
曾被火为一逆，若更以火熏之，是再逆也。一逆尚犹延引时日而不愈，其再逆者，必致危殆，故云促命期。
病有发热恶寒者，发于阳也；无热恶寒者，发于阴也。发于阳者（赵本无“者”字）七日愈，发于阴者（
赵本无“者”字）六日愈。以阳数七，阴数六故也。
阳为热也，阴为寒也。发热而恶寒，寒伤阳也；无热而恶
寒，寒伤阴也。阳法火，阴法水。火成数七，水成数六。阳病七日愈者，火数足也；阴病六日愈者，水数足也。
太阳病，头痛至七日已（赵本作“以”）上自愈者，以行其经尽故也。若欲作再经者，针足阳明，使
经不传则愈。
伤寒自一日至六日，传三阳三阴经尽，至七日当愈。经曰∶七日太阳病衰，头痛少愈；若七日不愈，则
太阳之邪再传阳明，针足阳明为迎而夺之，使经不传则愈。
太阳病欲解时，从巳至未上。
巳为正阳，则阳气得以复也。始于太阳，终于厥阴。六经各以三时为解，而太阳从巳至未，阳明从申
至戌，少阳从寅至辰；至于太阴，从亥至丑，少阴从子至寅，厥阴从丑至卯者，以阳行也速，阴行也缓，阳
主（医统本作“生”）于昼。阴主（医统本作“生”）于夜。阳三经解时，从寅至戌，以阳道常饶也；阴三
经解时，从亥至卯，以阴道常乏也。《内经》曰∶阳中之太阳，通于夏气，则巳午未太阳乘王也。
风家，表解而不了了者，十二日愈。
中风家，发汗解后，未全快畅者，十二日大邪皆去，六经悉和则愈。
病患身大热，反欲得近（赵本无“近”字）衣者，热在皮肤，寒在骨髓也；身大寒，反不欲近衣者，寒
在皮肤，热在骨髓也。
皮肤言浅，骨髓言深；皮肤言外，骨髓言内。身热欲得衣者，表热里寒也；身寒不欲衣者，表寒里热也。
太阳中风，阳浮而阴弱。阳浮者，热自发；阴弱者，汗自出。啬啬恶寒，淅淅恶风，翕翕发热，鼻鸣干
呕者，桂枝汤主之。
阳以候卫，阴以候荣。阳脉浮者，卫中风也；阴脉弱者，荣气弱也。风并于卫，则卫实而荣虚，故发热汗
自出也。经曰∶太阳病，发热汗出者，此为荣弱卫强者是也。啬啬者，不足也，恶寒之貌也。淅淅者，洒淅也，
恶风之貌也。卫虚则恶风，荣虚则恶寒，荣弱卫强，恶寒复恶风者，以自汗出，则皮肤缓，腠
理疏，是亦恶风也。翕翕者， 然而热也，若合羽所覆，言热在表也。鼻鸣干呕者，风拥而气逆也。与桂枝
汤和荣卫而散风邪也。
桂枝汤方∶
桂枝（三两，去皮，味辛热，按∶下药性，赵本无，以后并同） 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）
《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。
上五味， 咀。（赵本有“三味”二字）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，遍身 ，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，后服小促HT （赵本无“ ”字）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，（赵本
无“者”字）乃服至二三剂。禁生冷、粘滑、肉面、五辛、酒酪、臭恶等物。
太阳病，头痛发热，汗出恶风者，（赵本无“者”字）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。（赵本有“桂枝加葛根汤方”详见本书卷十）
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（医统本作“日”。熊校记∶今日汗出，旧钞作曰，是也。汪本作自，非）汗出，恐不加麻黄，但加葛根也。
太阳病，下之后，其气上冲者，可与桂枝汤。方用前法。若不上冲者，不可（赵本作“得”）与之。
太阳病属表，而反下之，则虚其里，邪欲乘虚传里。若气上冲者，里不受邪，而气逆上，与邪争也，则
邪仍在表，故当复与桂枝汤解外；其气不上冲者，里虚不能与邪争，邪气已传里
也，故不可更与桂枝汤攻表。
太阳病三日，已发汗，若吐，若下，若温针，仍不解者，此为坏病，桂枝不中与（赵本有“之”字）也。
观其脉证，知犯何逆，随证治之。
太阳病，三日中，曾经发汗、吐下、温针，虚其正气，病仍不解者，谓之坏病，言为医所坏病也。不可
复与桂枝汤。审观脉证，知犯何逆，而治之逆者，随所逆而救之。
桂枝本为解肌，若其人脉浮紧，发热汗不出者，不
可与（赵本有“之”字）也。常须识此，勿令误也。
脉浮，发热，汗出恶风者，中风也，可与桂枝汤解肌；脉浮紧，发热，不汗（医统本作“汗不”）出者，伤
寒也，可与麻黄汤。常须识此，勿妄治也。
若酒客病，不可与桂枝汤，得汤（赵本作“之”）则呕，以酒客不喜甘故也。
酒客内热，喜辛而恶甘，桂枝汤甘，酒客得之，则中满而呕。
喘家作桂枝汤，加浓朴杏子佳。（医统本作“仁”）
太阳病，为诸阳主气，风甚气拥，则生喘也。与桂枝汤以散风，加浓朴、杏仁以降气。
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。（赵本有“
桂枝加附子汤方”详见本书卷十）
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。
太阳病，下之后，脉促（赵本注∶“一作纵”）胸满者，桂枝去芍药汤主之。（赵本有“桂枝去芍药汤方”
详见本书卷十）若微恶
（赵本无“恶”字）寒者，（赵本有“桂枝”二字）去芍药方中，（赵本无方中“二”字）加附子汤主之。（
赵本有“桂枝去芍药加附子汤方”详见本书卷十）
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（熊校记∶按论文据赵本无恶字，元刊误衍，然注中仍不误也，汪氏反增之以足成其误，非是）
寒，则必当温剂以散之，故加附子。
太阳病，得之八九日，如疟状，发热恶寒，热多寒少，其人不呕，清便欲自可，一日二三度发，脉微缓者，
为欲愈也。脉微而恶寒者，此阴阳俱虚，不可更发汗、更下、更吐也。面色反有热色者，未欲解也，以其不能
得小汗出，身必痒，宜桂枝麻黄各半汤。（赵本有“桂枝麻黄各半汤方”详见本书卷十）
伤寒八九日，则邪传再经又遍，三阳欲传三阴之时也。传经次第，则（医统本作“前”）三日传遍三阳，
至四日阳去入阴，不入阴者为欲解，其传阴经，第六日传遍三阴，为传经尽而当解。其不解传为再经者，至九
日又遍三阳，阳不传阴则解。如疟，发作有时也。寒多者为病进，热多者为病退。经曰∶厥少热多，
其病为愈；寒多热少，阳气退故为进也。今虽发热恶寒，而热多寒少，为阳气进，而邪气少也。里不和者，
呕而利，今不呕，清便自调者里和也。寒热间日发者，邪气深也；日一发者，邪气复常也；日再发者，
邪气浅也；日二三发者，邪气微也。《内经》曰∶大则邪至，小则平。言邪甚则脉大，邪少则脉微，今日
数多而脉微缓者，是邪气微缓也，故云欲愈。脉微而恶寒者，
表里俱虚也。阳表也，阴里也。脉微为里虚，恶寒为表虚，以表里俱虚，故不可更发汗、更下、更吐也。阴
阳俱虚，则面色青白，反有热色者，表未解也。热色为赤色也。得小汗则和。不得汗，则得邪气外散皮肤而为
痒也，与桂枝麻黄各半汤，小发其汗，以除表邪。
太阳病，初服桂枝汤，反烦不解者，先刺风池、风府，却与桂枝汤则愈。
烦者，热也。服桂枝汤后，当汗出而身凉和；若反烦不解者，风甚而未能散也。先刺风池、风府，以
通太阳之经，而泄风气，却与桂枝汤解散则愈。
服桂枝汤，大汗出，脉洪大者，与桂枝汤如前法；若形如（赵本作“似”）疟，（赵本有“一”字）日再
发者，汗出必解，宜桂枝二麻黄一汤。（赵本有“桂枝二麻黄一汤方”详见本书卷十）
经曰∶如服一剂，病证犹在者，故当复作本汤服之。服桂枝汤汗出后，脉洪大者，病犹在也；若形如疟，
日再发者，邪气客于荣卫之间也。与桂枝二麻黄一汤，解散荣卫之邪。
服桂枝汤，大汗出后，大烦，渴不解，脉洪大者，白虎加人参汤主之。（赵本有“白虎加人参汤方”详
见本书卷十）
大汗出，脉洪大而不渴，邪气犹在表也，可更与桂枝汤。若大汗出，脉洪大，而烦渴不解者，表里有热，
不可更与桂枝汤。可与白虎加人参汤，生津止渴，和表散热。
The typical manifestation of Taiyang disease is: the pulse is floating, accompanied by headache, stiffness and pain in the neck and occiput, and aversion to cold.
The Classics state: "When the pulses at the cun, guan, and chi positions are all floating, it indicates that the Taiyang channel has been affected." Since the Taiyang channel governs the exterior and commands the qi of all yang channels, the presence of a floating pulse, headache, neck stiffness/pain, and aversion to cold signifies a pathogenic condition of the Taiyang exterior.
Among Taiyang diseases, if the manifestations include fever, sweating, aversion to wind, and a moderate (slow/relaxed) pulse, it is named Wind Strike (Zhong Feng).
Wind belongs to Yang pathogens, while Cold belongs to Yin pathogens. Wind pathogens easily damage the Defensive Qi (Wei Qi), presenting with fever, sweating, and aversion to wind; this indicates that the Defensive Qi has been struck by wind. (The Yitong edition adds the character "ye" here). If the Nutritive Qi (Ying Qi) is diseased, it presents with fever, absence of sweating, no aversion to wind but aversion to cold. If the Defensive Qi is diseased, it presents with fever, sweating, no aversion to cold but aversion to wind. Because Defensive Qi belongs to Yang and functions to protect the exterior, when diseased, it fails to secure the exterior, leading to loose skin and pores, thus causing sweating and aversion to wind. The pulse in Cold Damage (Shang Han) is tight, whereas the pulse in Wind Strike is moderate; this is because Cold has a stiff and urgent nature, while Wind has a loose and relaxed nature.
In Taiyang disease, some patients may already have fever, while others may not yet have fever, but they will certainly have aversion to cold, body pain, nausea/vomiting, and a pulse that is tight at both the yin and yang positions (cun and chi); this is named Cold Damage (Shang Han).
The Classics state: "Any contraction of cold pathogens results in a febrile disease, because cold qi lodges within the channels, causing the yang channels to become blocked and generate heat." Wind Strike immediately causes fever because wind is a Yang pathogen. In the discussion of Cold Damage, it says some have fever and some do not, because Cold is a Yin pathogen and cannot immediately transform into heat; it must stagnate before transforming into heat. Wind damages the Defensive Qi, while Cold damages the Nutritive Qi. Those with deficient Defensive Qi fear wind; those with deficient Nutritive Qi fear cold. When the Nutritive Qi is injured by Cold, there is certainly aversion to cold. Diseases of the Qi level cause numbness, while diseases of the Blood level cause pain. Wind causes Qi to relax, while Cold causes Qi to rebel upward. Body pain and vomiting/rebellion of Qi indicate Cold in the Nutritive level. The Classics state: "A full pulse with cold body indicates Cold Damage; a pulse that is tight at both yin and yang positions confirms Cold Damage."
On the first day of Cold Damage, the Taiyang channel is affected. If the pulse remains quiet (unchanged), it means the pathogen has not transmitted. If the patient frequently desires to vomit, or feels restless/agitated, and the pulse is rapid and urgent, it indicates transmission.
Taiyang governs the exterior. On the first day, Taiyang is affected; on the second day, it should transmit to the Yangming channel. If the pulse energy is weak and does not transmit to Yangming, but instead the Stomach channel is affected, the patient will desire to vomit. If Cold pathogens transmit to the interior, they transform into heat. For example, frequent desire to vomit, restlessness, and an urgent/rapid pulse indicate that Taiyang Cold pathogens have transformed into heat and transmitted to Yangming.
On the second or third day of Cold Damage, if there are no signs of Yangming or Shaoyang diseases, it indicates that the pathogen has not transmitted.
On the second or third day of Cold Damage, the absence of Yangming and Shaoyang symptoms indicates that the pathogen has not transmitted and remains only in the Taiyang channel.
In Taiyang disease, if there is fever, thirst, and no aversion to cold, it is named Warm Disease (Wen Bing).
Fever, thirst, and no aversion to cold belong to Yangming. Here, since Taiyang is affected, it is known as Warm Disease, not Cold Damage. This is because accumulated warmth transforms into heat, resulting in fever, thirst, and no aversion to cold.
If after inducing sweating, the body becomes burning hot, it is named Wind-Warmth (Feng Wen). In Wind-Warmth disease, the pulse is floating at both yin and yang positions, with spontaneous sweating, heavy body, excessive sleepiness, snoring during breathing, and difficulty speaking. If treated erroneously with purgation, it leads to difficult urination, fixed staring gaze, and loss of bowel/bladder control. If treated with fire therapy, mild cases result in yellowish discoloration, while severe cases resemble convulsive epilepsy with occasional spasms. If treated with fire moxibustion/fumigation, one error may prolong the illness, but two errors will hasten death.
After sweating for Cold Damage, the body should be cool; if the body remains burning hot after sweating, it is not Cold Damage but Wind-Warmth. Wind attacks from above, and Yang is susceptible to wind qi. When wind combines with warmth, it damages the Defensive Qi. A pulse floating at both yin and yang positions with spontaneous sweating indicates the Defensive Qi is affected. Defensive Qi is Qi; wind damages the Defensive Qi, and warmth damages Qi. Heavy body and excessive sleepiness indicate that the Defensive Qi has been affected by wind-warmth, causing Qi to become turbid. Snoring and difficulty speaking indicate that external wind-warmth is severe, obstructing Qi flow. Erroneous purgation damages Zang organ Qi, particularly the Taiyang Bladder channel. The Neijing states: "If the Bladder's transformation is impaired, it leads to strangury (long); if it cannot constrain, it leads to enuresis." Long refers to difficult urination. The Taiyang channel originates from the inner canthus; the Neijing states: "Eyes looking upward fixedly indicates deficiency of Taiyang; eyes rolling up indicates extinction of Taiyang." Difficult urination, fixed gaze, and incontinence result from purgation depleting fluids and damaging Zang Qi, compounded by external wind-warmth. The Classics state: "When vital qi is about to extinguish, it is difficult to treat." If fire therapy is used, fire aids wind-warmth to create heat. Mild heat stasis causes jaundice; severe heat generates wind, resembling convulsions and spasms. Previous fire therapy was one error; subsequent fumigation is a second error. One error may prolong the illness, but a second error leads to critical danger, hence "hastening death."
Diseases manifesting with fever and aversion to cold originate in Yang channels; diseases manifesting without fever but with aversion to cold originate in Yin channels. Those originating in Yang heal in seven days; those originating in Yin heal in six days. This is due to the numerical attributes of Yang (seven) and Yin (six).
Yang represents heat, and Yin represents cold. Fever with aversion to cold indicates Cold injuring Yang; no fever with aversion to cold indicates Cold injuring Yin. Yang corresponds to Fire, and Yin corresponds to Water. The completion number of Fire is seven, and of Water is six. Yang diseases heal in seven days because the Fire number is complete; Yin diseases heal in six days because the Water number is complete.
In Taiyang disease, headache persisting until the seventh day or beyond heals spontaneously because the pathogen has completed its course through the channel. If it is about to enter the next channel, needling the Foot-Yangming channel prevents transmission and ensures recovery.
Cold Damage transmits through the Three Yang and Three Yin channels from day one to day six, and should heal on the seventh day. The Classics state: "On the seventh day, Taiyang disease declines, and headache lessens." If it does not heal by the seventh day, the Taiyang pathogen transmits again to Yangming. Needling the Foot-Yangming channel intercepts and drains the pathogen, preventing transmission and ensuring recovery.
The time when Taiyang disease tends to resolve is from Si hour (9-11 AM) to Wei hour (1-3 PM).
Si hour is the time of proper Yang, allowing Yang Qi to recover. Disease begins in Taiyang and ends in Jueyin. Each of the Six Channels has three hours for resolution: Taiyang from Si to Wei, Yangming from Shen to Xu, Shaoyang from Yin to Chen; Taiyin from Hai to Chou, Shaoyin from Zi to Yin, Jueyin from Chou to Mao. This is because Yang moves quickly and Yin moves slowly; Yang dominates the day, and Yin dominates the night. The resolution times for the Three Yang channels (Yin to Xu) reflect that Yang Dao is often abundant; the resolution times for the Three Yin channels (Hai to Mao) reflect that Yin Dao is often scarce. The Neijing states: "Sun among Yangs connects with Summer Qi," so during Si, Wu, and Wei hours, Taiyang Qi is prosperous.
Patients with Wind Strike who have resolved exterior symptoms but still feel unrefreshed/uncomfortable will heal after twelve days.
For Wind Strike patients, after sweating resolves the exterior, if they do not feel completely comfortable, after twelve days the major pathogen is eliminated, and the Six Channels harmonize, leading to recovery.
If a patient has high body heat but desires to wear clothes, the heat is superficial (skin) and the cold is deep (marrow). If a patient has low body temperature but does not desire to wear clothes, the cold is superficial and the heat is deep.
Skin refers to the shallow/exterior, while marrow refers to the deep/interior. Heat with desire for clothes indicates Exterior Heat and Interior Cold; Cold with no desire for clothes indicates Exterior Cold and Interior Heat.
In Taiyang Wind Strike, the Yang position (Cun) pulse is floating and the Yin position (Chi) pulse is weak. Floating Yang pulse indicates spontaneous heat generation; weak Yin pulse indicates spontaneous sweating. The patient shivers with aversion to cold, chills with aversion to wind, has mild fever, nasal congestion/murmur, and dry retching; Gui Zhi Tang (Cinnamon Twig Decoction) is indicated.
Yang pulse assesses Defensive Qi, and Yin pulse assesses Nutritive Qi. A floating Yang pulse indicates Wind striking the Defensive Qi; a weak Yin pulse indicates weak Nutritive Qi. Wind merges with Defensive Qi, making Defensive Qi excess and Nutritive Qi deficiency, thus causing fever and spontaneous sweating. The Classics state: "Taiyang disease with fever and sweating is due to weak Nutritive Qi and strong Defensive Qi." "Se se" describes a timid/shivering appearance of aversion to cold. "Xi xi" describes a chilly sensation of aversion to wind. Deficient Defensive Qi fears wind; deficient Nutritive Qi fears cold. With weak Nutritive Qi and strong Defensive Qi, fearing both cold and wind occurs because spontaneous sweating loosens the skin and opens the pores, also causing aversion to wind. "Xi xi" describes a warm, covered heat, like feathers covering the body, indicating heat in the exterior. Nasal murmur and dry retching indicate wind obstruction causing Qi rebellion. Gui Zhi Tang harmonizes Nutritive and Defensive Qi and disperses Wind pathogens.
Formula: Gui Zhi Tang (Cinnamon Twig Decoction)
Gui Zhi (Cinnamomi Ramulus, 3 liang, bark removed, pungent and hot)
Bai Shao (Paeoniae Radix Alba, 3 liang, sour and bitter, slightly cold)
Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma, 2 liang, sweet and neutral)
Sheng Jiang (Fresh Zingiberis Rhizoma, 3 liang, sliced, pungent and warm)
Da Zao (Jujubae Fructus, 12 pieces, broken open, sweet and warm)
The Neijing states: "Pungent and sweet agents disperse and ascend, belonging to Yang." Gui Zhi Tang is a pungent-sweet agent, thus it disperses Wind pathogens. The Neijing states: "When Wind overcomes, soothe it with Pungent, assist with Bitter and Sweet, relax with Sweet, and astringe with Sour." Therefore, Gui Zhi is the sovereign herb, and Bai Shao and Gan Cao are minister/adjuvant herbs. The Neijing states: "When Wind invades internally, relax with Sweet and disperse with Pungent." Therefore, Sheng Jiang and Da Zao are envoy/herald herbs.
Crush the above five ingredients. (Zhao edition has "three ingredients"). Boil in 7 sheng of water with low heat until 3 sheng remain. Strain. Drink one sheng at a lukewarm temperature. Shortly after drinking, consume more than one sheng of hot thin rice porridge to assist the medicinal power. Cover with blankets for about one hour until the whole body has a slight sweat. Slight sweating is best; profuse sweating like flowing water will fail to cure the disease. If sweating after the first dose cures the disease, stop taking the remaining medicine; do not finish the entire decoction. If no sweating, take another dose according to the previous method. If still no sweating, shorten the interval between doses, finishing three doses within half a day. For severe cases, administer medicine day and night, observing for 24 hours. If symptoms persist after one dose, prepare another. If no sweating occurs, continue administering up to two or three doses. Avoid raw/cold, sticky/slippery, meat, wheat products, Five Pungents (garlic, chives, leek, onion, shallots), dairy/wine, and foul-smelling foods.
In Taiyang disease, with headache, fever, sweating, and aversion to wind, Gui Zhi Tang (Cinnamon Twig Decoction) is indicated.
Headache indicates Taiyang channel involvement; fever, sweating, and aversion to wind indicate Wind Strike. Administer Gui Zhi Tang to dissipate Wind pathogens.
In Taiyang disease, with stiffness and discomfort in the nape and back (Ke Ke), accompanied by sweating and aversion to wind, Gui Zhi Jia Ge Gen Tang (Cinnamon Twig Decoction plus Kudzu Root) is indicated. (See Zhao edition for formula details in Volume 10).
"Ke Ke" describes the appearance of extending the neck. Movement involves extending the neck and swaying the body. Stiffness in the nape and back manifests similarly upon movement. Normally, Ke Ke should present without sweating; however, sweating and aversion to wind indicate Wind Strike with Exterior Deficiency. Administer Gui Zhi Tang to harmonize the exterior, adding Ma Huang (Ephedrae Herba) and Ge Gen (Puerariae Radix) to dispel wind. Ma Huang primarily treats Exterior Excess patterns. Later, in the Ge Gen Tang pattern: "Taiyang disease, stiffness in nape/back, no sweating, aversion to wind, Ge Gen Tang is indicated." The ingredients are identical. For no sweating, Ma Huang should be used. Since there is spontaneous sweating here, Ma Huang is omitted, and only Ge Gen is added.
In Taiyang disease, after erroneous purgation, if Qi rebels upward, Gui Zhi Tang (Cinnamon Twig Decoction) may be administered using the previous method. If Qi does not rebel upward, it should not be administered.
Taiyang disease belongs to the exterior, but purgation was wrongly applied, weakening the interior and inviting pathogens to transmit inward. If Qi rebels upward, the interior rejects the pathogen, and Qi rises to contend with it, meaning the pathogen remains in the exterior. Thus, Gui Zhi Tang should be used to release the exterior. If Qi does not rebel upward, the interior is too weak to contend, and the pathogen has already transmitted inward; therefore, Gui Zhi Tang should not be used to attack the exterior.
In Taiyang disease, after three days, if sweating, emesis, purgation, or warm needle therapy have been used, yet the disease persists, this is called a "Ruined Disease" (Huai Bing), and Gui Zhi Tang is contraindicated.
Observe the pulse and symptoms, identify the iatrogenic error (reverse treatment), and treat according to the current syndrome.
In Taiyang disease, if within three days, sweating, emesis, purgation, or warm needles were used, damaging righteous Qi, and the disease persists, it is termed Ruined Disease, meaning the physician caused the deterioration. Gui Zhi Tang is no longer suitable. Carefully examine the pulse and symptoms to identify the error, and treat the consequences of that error accordingly.
Gui Zhi Tang is originally for releasing the muscle layer. If the pulse is floating and tight, with fever and no sweating, it is contraindicated. Remember this constantly to avoid error.
Floating pulse, fever, sweating, and aversion to wind indicate Wind Strike; Gui Zhi Tang (Cinnamon Twig Decoction) may be used to release the muscle layer. Floating-tight pulse, fever, and no sweating indicate Cold Damage; Ma Huang Tang (Ephedra Decoction) may be used. Remember this constantly to avoid reckless treatment.
For patients with chronic alcohol consumption ("Wine Guests"), Gui Zhi Tang (Cinnamon Twig Decoction) is contraindicated. Taking it will cause vomiting because Wine Guests dislike sweet flavors.
Wine Guests have internal heat, preferring pungent flavors and disliking sweet ones. Gui Zhi Tang is sweet; taking it causes middle-jiao fullness and vomiting.
For patients with chronic asthma, adding Hou Po (Magnoliae Officinalis Cortex) and Xing Ren (Armeniacae Semen Amarum) to Gui Zhi Tang (Cinnamon Twig Decoction) is beneficial. (Yitong edition writes "Ren").
Taiyang disease governs the Qi of all Yang channels. Severe wind causes Qi obstruction, leading to asthma. Gui Zhi Tang disperses wind, while Hou Po and Xing Ren descend Qi.
For anyone who vomits after taking Gui Zhi Tang (Cinnamon Twig Decoction), pus and blood will eventually be vomited later.
Those with internal heat, such as Wine Guests, will vomit after taking Gui Zhi Tang. Having lost fluids and being constrained by heat, pus and blood will eventually be vomited. Vomiting pus and blood is called Lung萎 (Fei Wei / Lung Atrophy).
The Jingui Yaolue states: "Heat in the Upper Jiao causes Lung Atrophy." This results from excessive sweating or vomiting leading to severe fluid depletion.
In Taiyang disease, after sweating, if sweating continues incessantly (leaking), with aversion to wind, difficult urination, slight stiffness in the four limbs making flexion and extension difficult, Gui Zhi Jia Fu Zi Tang (Cinnamon Twig Decoction plus Prepared Aconite Root) is indicated. (See Zhao edition for formula details in Volume 10).
In Taiyang disease, due to sweating, if sweating leaks incessantly with aversion to wind, it indicates insufficient Yang Qi. Sweating further depletes Yang, failing to secure the skin and pores. The Neijing states: "The Bladder is the official of the reservoir, storing fluids; transformation allows them to exit." Difficult urination results from fluid loss via sweating and weak Yang Qi unable to transform. The four limbs are the root of all Yang. Slight stiffness and difficulty in limb movement indicate Yang depletion and fluid loss. The Zhenjing states: "Fluid depletion leads to inability to flex and extend bone joints." Gui Zhi Jia Fu Zi Tang warms the channels and restores Yang.
In Taiyang disease, after erroneous purgation, if the pulse is Cui (Surging/Rapid with intermittent pauses) and there is chest fullness, Gui Zhi Qu Shao Yao Tang (Cinnamon Twig Decoction minus White Peony Root) is indicated. (See Zhao edition for formula details in Volume 10). If there is slight aversion to cold, add Fu Zi (Prepared Aconite Root) to the formula, making Gui Zhi Qu Shao Yao Jia Fu Zi Tang (Cinnamon Twig Decoction minus White Peony Root plus Prepared Aconite Root). (See Zhao edition for formula details in Volume 10).
A pulse that is rapid but occasionally pauses and then resumes is named Cui (Surging). Cui usually indicates Yang Excess, occurring without prior purgation. However, post-purgation Cui pulse does not indicate Yang Excess.
In Taiyang disease, after purgation, if the pulse is Cui but there is no Jie Xiong (Chest Binding), the disease is resolving. Here, post-purgation Cui pulse with chest fullness indicates non-resolution. This is due to Yang deficiency from purgation, allowing exterior pathogens to gradually enter and lodge in the chest. Gui Zhi Tang disperses lodged pathogens and promotes Yang Qi circulation. Shao Yao nourishes Yin, which is unsuitable for Yang deficiency, so it is removed. If Yang is deficient and slight aversion to cold appears, warming agents are needed to dispel cold, so Fu Zi is added.
In Taiyang disease, after eight or nine days, if the presentation resembles malaria with fever and aversion to cold, where heat predominates over cold, the patient does not vomit, and stool/urine are relatively normal, with episodes occurring two or three times a day, and the pulse is slightly slow and gentle, recovery is imminent. If the pulse is faint and there is aversion to cold, this indicates simultaneous deficiency of Yin and Yang, and sweating, purgation, or emesis are contraindicated. If the face shows a red/hot color, the disease has not resolved because small sweating could not be achieved, leading to body itching. Gui Zhi Ma Huang Ge Ban Tang (Half-Gui Zhi Half-Ma Huang Decoction) is appropriate.
After eight or nine days of Cold Damage, the pathogen transmits through another cycle, approaching the transition from Three Yang to Three Yin. Transmission order: first three days cover Three Yang; fourth day, Yang goes to Yin. Not entering Yin indicates resolution. Entering Yin covers Three Yang in three days, and Three Yin in three days (total six days), completing transmission and resolving. If unresolved and transmitting again, by the ninth day it covers Three Yang again; if Yang does not transmit to Yin, it resolves. Resembling malaria means periodic发作. More cold indicates progression; more heat indicates regression. The Classics state: "More heat in Jueyin indicates healing; more cold indicates regression due to declining Yang." Although there is fever and aversion to cold, heat predominating indicates advancing Yang and declining pathogen. Interior disharmony presents with vomiting and diarrhea; here, no vomiting and normal stool/urine indicate interior harmony. Intermittent fever indicates deep pathogen; daily once indicates normalizing pathogen; twice daily indicates shallow pathogen; two to three times daily indicates minimal pathogen. The Neijing states: "Large pulse indicates pathogen arrival; small pulse indicates peace." Large pulse means strong pathogen; small pulse means weak pathogen. A frequent but faint/gentle pulse indicates minimal and gentle pathogen, hence impending resolution. Faint pulse with aversion to cold indicates simultaneous Exterior and Interior deficiency. Yang governs Exterior, Yin governs Interior. Faint pulse indicates Interior deficiency; aversion to cold indicates Exterior deficiency. Due to simultaneous deficiency, sweating, purgation, and emesis are contraindicated. Simultaneous Yin-Yang deficiency usually presents with blue-white complexion; a red/hot color indicates unresolved Exterior. Red color is heat. Small sweating brings harmony. Without sweating, pathogen scatters on skin causing itching. Gui Zhi Ma Huang Ge Ban Tang induces slight sweating to remove exterior pathogens.
In Taiyang disease, if after initially taking Gui Zhi Tang (Cinnamon Twig Decoction), vexation worsens and does not resolve, first needle Feng Chi (GB20) and Feng Fu (GV16) points, then administer Gui Zhi Tang to achieve recovery.
Vexation indicates heat. After taking Gui Zhi Tang, sweating should occur and the body should become cool and harmonious. If vexation worsens, it indicates severe wind that cannot be dispersed. Needle Feng Chi and Feng Fu to unblock the Taiyang channel and vent wind qi, then administer Gui Zhi Tang to dissipate the pathogen.
After taking Gui Zhi Tang (Cinnamon Twig Decoction), if massive sweating occurs and the pulse becomes Hong Da (Great/Large), administer Gui Zhi Tang according to the previous method. If the condition resembles malaria, occurring twice a day, sweating will resolve it; Gui Zhi Er Ma Huang Yi Tang (Two-Parts Gui Zhi One-Part Ma Huang Decoction) is appropriate. (See Zhao edition for formula details in Volume 10).
The Classics state: "If symptoms persist after one dose, prepare the same decoction again." After taking Gui Zhi Tang and sweating, a Great/Large pulse indicates the disease persists. If resembling malaria with twice-daily episodes, the pathogen lodges between Nutritive and Defensive levels. Gui Zhi Er Ma Huang Yi Tang disperses Nutritive and Defensive pathogens.
After taking Gui Zhi Tang (Cinnamon Twig Decoction), if massive sweating occurs followed by extreme vexation, unquenchable thirst, and a Great/Large pulse, Bai Hu Jia Ren Shen Tang (White Tiger Plus Ginseng Decoction) is indicated. (See Zhao edition for formula details in Volume 10).
Massive sweating with a Great/Large pulse but no thirst indicates the pathogen remains in the exterior; Gui Zhi Tang may be given again. If massive sweating, Great/Large pulse, and extreme vexation/thirst persist, there is heat in both Exterior and Interior, and Gui Zhi Tang is contraindicated. Bai Hu Jia Ren Shen Tang generates fluids, stops thirst, harmonizes the exterior, and dissipates heat.