主治呃逆也。旁治胸痹停痰。
考 证
橘皮竹茹汤证曰∶哕逆。（哕者呃之谓也）
以上一方，橘皮二斤。
橘皮枳实生姜汤证曰∶胸痹。（说在杏仁部中）
以上一方，橘皮一斤。
橘皮汤证曰∶哕。
以上一方，橘皮四两。
茯苓饮证曰∶心胸中有停痰。
以上一方，橘皮二两半。
上历观此诸方，主治呃逆也明。胸痹者，停痰者，其有呃逆之证，则橘皮所能治也。
品 考
橘皮 近世间以柑子代橘皮，非也，可选用焉。真橘树者，余观之于和州春日祠前，于
远州见附驿也。
主治呕而胸满也。
考 证
吴茱萸汤证曰∶呕而胸满。
以上一方，吴茱萸一斤。
品 考
吴茱萸 无赝物。
主治胸中有毒，欲吐而不吐也。
考 证
瓜蒂散证曰∶胸中痞硬、气上冲咽喉、不得息者。
又曰∶心中满而烦、饥而不能食者，病在胸中。
以上一方，瓜蒂一分。
品 考
瓜蒂 宗 、时珍，以为甜瓜蒂。试之，无寸效也。又有一种，名柿瓜。其种殊少，而
其形如柿。又有一种，如柿瓜而皮上有毛者，其始皆太苦，而不可食也。及熟，则尤甜美，
其蒂甚苦，有效可用。三才图会，所谓青瓜也，本邦越前之产，是为良也。
主治冲逆也，旁治奔豚头痛、发热恶风、汗出身痛。
考 证
桂枝加桂汤证曰∶气自少腹上冲心。
以上一方，桂枝五两。
桂枝甘草汤证曰∶其人叉手自冒心、心下悸、欲得按。
桂枝甘草附子汤，证不具也。（说在互考中）
苓桂甘枣汤证曰∶欲作奔豚。
苓桂五味甘草汤证曰∶气从少腹、上冲胸咽。
桂枝附子汤，证不具也。（说在互考中）
以上五方，桂枝皆四两。
桂枝汤证曰∶上冲。又曰∶头痛发热、汗出恶风。
苓桂术甘汤证曰∶气上冲胸。
以上二方，桂枝皆三两。
上历观此诸方，桂枝主治冲逆也明矣。头痛发热之辈，其所旁治也。仲景之治疾，用桂
枝者，居十之七八，今不枚举焉。
互 考
桂枝甘草汤证曰∶其人叉手自冒心。为则按∶叉手冒心者，以悸而上冲故也；桂枝甘草
附子汤条，无上冲证。为则按∶此方桂枝甘草汤，而加附子者也。桂枝甘草汤条，有上冲证。
然
桂枝附子汤，用桂枝多于桂枝加附子汤，而无上冲证，盖阙文也。桂枝加附子汤条，犹
有桂枝之证，况于此汤，而可无桂枝之证乎？
辨 误
范大成桂海志云∶凡木叶心皆一纵理，独桂有两道如圭形，故字从之。陆佃《埤雅》云∶
桂犹圭也，宣导百药，为之先聘通使，如执圭之使也。为则按∶制字之说，范为得之，盖以
其所见而言之也。陆则失矣，盖以臆测之，而强作之说也。不可从矣！
《伤寒论》曰∶桂枝本为解肌，非仲景氏之意也。不取，此盖注误入本文者也。
宗 曰∶汉张仲景，以桂枝汤治伤寒表虚。是不善读《伤寒论》之过也。《伤寒论》中
间说表里虚实，非疾医之言也，盖后人所搀入也。凡仲景之用桂枝，以治上冲也。桂枝汤条
曰∶上冲者，可与桂枝汤，若不上冲者，不可与之。桂枝加桂汤条曰∶气从少腹上冲心。又
按去桂加术汤条曰∶小便自利。由是观之，上冲则用桂，下降则否，斯可以见已。且虚实之
说，仲景所言，不失古训，而后人所搀入，则不合古训。宗 不善读书，而妄为之说，过矣！
品 考
桂枝 气味辛辣者，为上品也。李杲以气味浓薄分桂枝、肉桂。遂构上行下行之说，是
臆测也，不可从矣。桂枝也，肉桂也，桂心也，一物而三名也。桂心之说，陈藏器、李时珍
得之。
It primarily treats hiccups (hiccough). Secondly, it treats chest bi syndrome (obstruction in the chest) and retained phlegm.
Textual Research
The pattern of Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction) is characterized by: hiccups. ("Yue" refers to hiccups.)
In the above formula, two jin of Jupi (Citri Reticulatae Pericarpium) are used.
The pattern of Jupi Zhishi Shengjiang Tang (Tangerine Peel, Aurantium Deciduum and Fresh Ginger Decoction) is characterized by: chest bi syndrome. (Discussed in the section on Xingren/Apricot Seed.)
In the above formula, one jin of Jupi is used.
The pattern of Jupi Tang (Tangerine Peel Decoction) is characterized by: hiccups.
In the above formula, four liang of Jupi are used.
The pattern of Fuling Yin (Poria Drink) is characterized by: retained phlegm in the heart and chest region.
In the above formula, two and a half liang of Jupi are used.
Having observed these formulas comprehensively, it is clear that Jupi's primary indication is hiccups. Regarding chest bi syndrome and retained phlegm, if accompanied by hiccups, these are conditions treatable by Jupi.
Product Examination
Jupi: In recent times, people often use the peel of mandarin oranges (Ganzi) as a substitute for Jupi, which is incorrect; one should select authentic Jupi. I have seen true orange trees in front of the Spring Shrine in Hezhou, and I also saw them attached to post stations in Yuanzhou.
It primarily treats vomiting accompanied by chest fullness.
Textual Research
The pattern of Wuzhuyu Tang (Evodia Decoction) is characterized by: vomiting with chest fullness.
In the above formula, one jin of Wuzhuyu (Evodiae Fructus) is used.
Product Examination
Wuzhuyu: There are no counterfeit products.
It primarily treats toxic pathogens in the chest, where there is an urge to vomit but inability to do so.
Textual Research
The pattern of Gudi San (Melon Seed Powder) is characterized by: epigastric hardness and fullness, qi rushing upward to the throat, and difficulty breathing.
It also states: mental fullness and irritability, hunger but inability to eat, indicating the disease is located in the chest.
In the above formula, one fen of Gudi (Cucumis Melo Fructus) is used.
Product Examination
Gudi: Zong (Tao Hongjing) and Shizhen (Li Shizhen) considered it to be the peduncle of sweet melon. Testing it yielded no effect whatsoever. There is another type named Shigua (Persimmon Melon). Its variety is rare, and its shape resembles a persimmon. There is yet another type, resembling Shigua but with hairs on the skin; initially, it is extremely bitter and inedible. Upon ripening, it becomes particularly sweet, but its peduncle remains very bitter and effective for use. The "Sancai Tuhui" mentions Qinggua (Green Melon); the produce from Yueqian in our country is considered excellent.
It primarily treats rebellious qi rushing upward (chongni), and secondarily treats Ben Tun (fleeing pig), headache, fever, aversion to wind, sweating, and body pain.
Textual Research
The pattern of Guizhi Jia Gui Tang (Cinnamon Twig Plus Cinnamon Twig Decoction) is characterized by: qi rushing from the lower abdomen upward to the heart.
In the above formula, five liang of Guizhi (Cinnamomi Ramulus) are used.
The pattern of Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction) is characterized by: the patient crossing hands over the heart area, palpitations in the epigastrium, and a desire for pressure.
Guizhi Gancao Fuzi Tang (Cinnamon Twig, Licorice and Aconite Decoction): The pattern description is incomplete. (See Mutual Verification section.)
Linggui Gan Zao Tang (Poria, Cinnamon Twig, Licorice and Jujube Decoction) is characterized by: impending Ben Tun.
Linggui Wuwei Gancao Tang (Poria, Cinnamon Twig, Schisandra and Licorice Decoction) is characterized by: qi rushing from the lower abdomen upward to the chest and throat.
Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction): The pattern description is incomplete. (See Mutual Verification section.)
In the above five formulas, Guizhi is consistently used in amounts of four liang.
The pattern of Guizhi Tang (Cinnamon Twig Decoction) is characterized by: upward rushing. It also states: headache, fever, sweating, and aversion to wind.
Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes and Licorice Decoction) is characterized by: qi rushing upward to the chest.
In the above two formulas, Guizhi is consistently used in amounts of three liang.
Having observed these formulas comprehensively, it is clear that Guizhi's primary indication is rebellious qi rushing upward. Headache, fever, etc., are secondary indications. Zhang Zhongjing used Guizhi in seven or eight out of ten cases of treating diseases; these are not enumerated here.
Mutual Verification
The pattern of Guizhi Gancao Tang is characterized by: the patient crossing hands over the heart area. Wei Ze notes: Crossing hands over the heart area occurs because palpitations cause qi to rush upward; the text for Guizhi Gancao Fuzi Tang lacks symptoms of upward rushing. Wei Ze notes: This formula is Guizhi Gancao Tang with added Fuzi (Aconiti Lateralis Radix Praeparata). The Guizhi Gancao Tang text includes upward rushing symptoms. However, Guizhi Fuzi Tang uses more Guizhi than Guizhi Jia Fuzi Tang (Cinnamon Twig Plus Aconite Decoction) but lacks upward rushing symptoms; this is likely a textual omission. The Guizhi Jia Fuzi Tang text still retains indications for Guizhi; how could this formula lack indications for Guizhi?
Correction of Errors
Fan Dacheng in "Guhai Zhi" stated: For all trees, the leaf veins run longitudinally down the center, except for Cassia, which has two lines like a gui (jade tablet) shape, hence the character structure. Lu Tian in "Pi Ya" stated: Gui is like a gui; it guides all herbs, acting as a pioneer envoy, similar to an envoy holding a jade gui. Wei Ze notes: Regarding etymology, Fan's view is correct as it is based on observation. Lu's view is erroneous, being speculative and forced interpretation; it should not be followed!
The statement in "Shanghan Lun" that "Guizhi is originally for resolving the muscle layer" does not reflect Zhang Zhongjing's intent. It is rejected; this was likely an annotation error that entered the main text.
Zong (Tao Hongjing) stated: Han dynasty Zhang Zhongjing used Guizhi Tang to treat exterior deficiency cold damage. This is an error resulting from poor reading of "Shanghan Lun". The discussions of exterior/interior and deficiency/excess in "Shanghan Lun" are not the words of ancient physicians but were likely interpolated by later authors. Whenever Zhang Zhongjing used Guizhi, it was to treat upward rushing. The Guizhi Tang text states: If there is upward rushing, give Guizhi Tang; if not, do not give it. The Guizhi Jia Gui Tang text states: Qi rushes from the lower abdomen to the heart. Furthermore, checking the Qu Gui Jia Zhu Tang text states: Urination is normal. From this, we see that upward rushing warrants the use of Guizhi, while downward movement does not. Moreover, if the discussion of deficiency and excess were spoken by Zhang Zhongjing, it would align with ancient teachings; if interpolated by later authors, it would not. Tao Hongjing failed to read carefully and made baseless comments; this is wrong!
Product Examination
Guizhi: Those with a pungent and spicy aroma are superior grade. Li Gao distinguished between Guizhi and Rougui (Cinnamomi Cortex) based on the strength of their aroma, constructing theories of ascending and descending movements; this is speculative and should not be followed. Guizhi, Rougui, and Guixin (Cinnamomi Cortex Centra) are three names for the same substance. Chen Cangqi and Li Shizhen clarified the concept of Guixin.