桂枝汤方内。更加桂二两。成五两。上五味以水七升。煮取三升。去滓。
温服一升。
桂枝汤治太阳中风。乃两和营卫之圣药。今照原方加桂。便另立汤名。主治之病。迥然
不同。
可见先圣立方之严。即分两亦不可苟也。经云。太阳伤寒者。加温针必惊也。又云。烧针令
其
汗。针处被寒。核起而赤者。必发奔豚。气从少腹上冲心者。灸其核上各一壮。与桂枝加桂
汤更加桂。按奔豚乃少阴肾水凌心之证。何以主用桂枝太阳之方。盖太阳为诸阳主气。而行
太阳之令者。心主是也。太阳伤寒。理应发汗。汗为心之液。全赖心主之一点真阳。以化气
而
逐邪。误用温针。则寒邪不外出而内入。内入则扰动心营。心阳受寒邪所迫。君主孤危。肾
水得
而乘之矣。核起而赤。心阳不能内固。色已外见。气从少腹上冲心。水邪上逆。真火将受其
扑灭。故亟灸核上。先使温经而复阳。而方中重用桂枝者。以桂枝能直入营分。扶阳化气。
得此重兵以建赤帜。则君主得自振拔。而肾水自降。泄北补南。一举两得。此为制胜之师。
按此方加桂。或作桂枝外另加肉桂。但有成五两三字。当仍属桂枝。且此证本因太阳病
误治所致。重用桂枝。正以一物而全收安内攘外之功。
于桂枝汤方内。加附子一枚。炮去皮。破八片。余根据前法。
此治汗出漏风之方也。经云。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。此方主之。按太阳病当取 微似有汗者佳。不可令如水流漓。大发其汗。卫撤
藩篱。营不能守。遂至漏不止矣。腠理既开。风无所御。而津液尽随阳气外泄。无复渗膀胱
而
柔筋脉。乃至小便难。四肢微急。难以屈伸。种种变证。皆因卫气撤护。致在内之津液。直
趋
于外。有莫御之势。亟当乘津液尚未全涸之时。固其卫气。使趋外之津液。还返于内。故主
桂枝汤加附子。以固卫之法。为救液之法也。此证全是卫气外泄。津液内夺之象。而附子乃
燥液之品。仲景偏用之救液。此何义也。盖卫
阳将脱。非得附子之大力。必不能迅走卫分以回阳。今但使卫阳亟固。先断其外泄之路。则
就
吾身固有之津液。还返于内。阳回而津自复。更无藉他药生津润燥之力。此其立方之所以圣
也
。按此方之加附子。与亡阳证之用真武同义。喻嘉言曰。此阳气与阴津两亡。更加外风复入
。与亡阳证微细有别。故主桂枝加附子。以固表驱风。而复阳敛液也。
在桂枝汤的方剂组成中，再增加桂二两，使总量达到五两。以上五味药，用七升水，煎煮至三升，滤去药渣。每次温服一升。
桂枝汤用于治疗太阳中风证，是和调营卫的圣药。现在按照原方加入桂，便另立汤名，其主治的病证截然不同。由此可见，古代圣贤创立方剂的严谨性，即使是药物的分量也不可以马虎。经典记载：“太阳伤寒证，如果加用温针，必然会引起惊悸。”又说：“烧针强迫发汗，针刺部位受寒，出现肿块且发红，必然引发奔豚病，气从少腹上冲心脏。”此时应在红肿处各灸一壮，并给予桂枝加桂汤（即桂枝汤加重桂的用量）。按奔豚病是少阴肾水凌犯心脏的证候，为什么主用属于太阳经的桂枝汤呢？这是因为太阳经统摄诸阳之气，而执行太阳经令的是心主。太阳伤寒理应发汗，汗为心之液，完全依赖心主的真阳之气来化气以驱除邪气。误用温针，则寒邪不向外排出反而向内侵入。内侵则扰动心营，心阳受到寒邪逼迫，君主（心）孤立危险，肾水得以乘虚侵犯。红肿处突起且发红，说明心阳不能在内固守，色泽已显露于外；气从少腹上冲心脏，是水邪上逆，真火即将被扑灭。所以急需在红肿处施灸，先使经脉温暖而恢复阳气。方中重用桂枝，是因为桂枝能直接入营分，扶助阳气、化气行水。得到这重兵建立旗帜，则君主得以自我振作拔起，肾水自然下降。这是泻北方（水）补南方（火），一举两得。这是制胜的军队。按此方加桂，有的说法是在桂枝之外另加肉桂，但既然有“总量五两”的说法，应当仍指桂枝。况且此证本因太阳病误治所致，重用桂枝，正是为了凭借一味药而全收安内攘外的功效。
在桂枝汤方剂中，加入附子一枚，炮制后去皮，破成八片。其余依照前面的方法煎服。
这是治疗汗出漏风证的方剂。经典记载：“太阳病，发汗后，汗漏不止，病人怕风，小便困难，四肢轻微拘急，难以屈伸者，此方主治。”按太阳病应当取微似有汗的效果为佳，不可令汗出如水流漓般大发其汗。卫气撤去藩篱，营阴不能守持，遂导致汗漏不止。腠理既已开放，风邪无所抵御，津液全部随着阳气外泄，不再渗入膀胱以濡养筋脉，以至于小便困难，四肢轻微拘急，难以屈伸。种种变证，都是因为卫气撤去护卫，导致体内的津液直趋向外，有无法抵御的势头。亟应当在津液尚未完全枯竭之时，巩固卫气，使趋向体外的津液返还体内。所以主用桂枝汤加附子，以固护卫气的方法，作为救阴液的方法。此证完全是卫气外泄、津液内夺的现象，而附子是燥烈伤阴的药物，张仲景偏偏用它来救阴液，这是什么道理呢？因为卫阳即将脱失，非得附子的强大力量，一定不能迅速进入卫分以回阳。如今只要使卫阳迅速固密，先切断其外泄的路径，那么身体固有的津液就能返还体内。阳气回复而津液自然恢复，更不需要借助其他药物生津润燥的力量。这就是此方立法之所以神圣的原因。按此方加附子，与亡阳证使用真武汤的意义相同。喻嘉言说：此证是阳气与阴津两亡，再加上外风再次侵入，与亡阳证略有区别。所以主用桂枝加附子汤，以固表驱风，回复阳气并收敛津液。
In the prescription of Guizhi Tang (Cinnamon Twig Decoction), add two liang of Gui (Cassia Bark/Cinnamon Twig) more, making the total five liang. Take the above five medicinal materials, boil in seven sheng of water, reduce to three sheng, remove the dregs. Take one sheng warm.
Guizhi Tang treats Taiyang Wind-Strike syndrome (Taiyang Wind-Strike); it is a sacred medicine for harmonizing Ying and Wei. Now, adding Gui to the original formula establishes a new decoction name, and its indicated disease is completely different. This shows the strictness with which ancient sages established prescriptions; even the dosage must not be careless. The Classics state: "In Taiyang Cold Damage, if warming needle therapy is added, palpitations will surely occur." It also states: "If burning needles are used to induce sweating, and the needle site is exposed to cold, causing nodules to rise and turn red, Ben Tun (Running Piglet) will surely develop, with Qi rushing from the lower abdomen up to the heart." In such cases, moxa should be applied once on each nodule, and Guizhi Jia Gui Tang (Guizhi Decoction plus Cinnamon) should be administered. Ben Tun is a syndrome where Kidney Water overacts upon the Heart. Why use a Taiyang formula like Guizhi Tang? Because Taiyang governs the Qi of all Yang meridians, and the Heart Master executes the command of Taiyang. Taiyang Cold Damage should theoretically be treated by inducing sweating. Sweat is the fluid of the Heart, relying entirely on the True Yang of the Heart Master to transform Qi and expel pathogens. Misusing warming needles causes Cold pathogens not to exit outward but to enter inward. Once inside, they disturb the Ying level of the Heart. Heart Yang is forced by Cold pathogens, leaving the Monarch (Heart) isolated and in danger, allowing Kidney Water to take advantage. Nodules rising and turning red indicate that Heart Yang cannot consolidate internally, and its color manifests externally. Qi rushing from the lower abdomen to the heart indicates Water pathogen counterflow, threatening to extinguish the True Fire. Therefore, urgent moxibustion on the nodules is needed to first warm the meridians and restore Yang. Reusing Gui Zhi (Cinnamon Twig) in the formula works because Gui Zhi can directly enter the Ying level, support Yang and transform Qi. With this heavy reinforcement raising the banner, the Monarch can振奋 itself, and Kidney Water naturally descends. This drains North (Water) and supplements South (Fire), achieving two goals with one stroke. It is a victorious army. Regarding adding Gui to this formula, some interpret it as adding Rou Gui (Cinnamon Bark) in addition to Gui Zhi. However, given the phrase "total five liang," it likely still refers to Gui Zhi. Moreover, since this condition arises from mismanagement of Taiyang disease, heavily using Gui Zhi aims to achieve both internal pacification and external expulsion through a single herb.
To the Guizhi Tang formula, add one Fuzi (Prepared Aconite Root), processed, peeled, broken into eight pieces. Follow the previous method for the rest.
This is a formula treating sweating leakage due to wind exposure. The Classics state: "In Taiyang disease, after inducing sweating, if sweating continues unceasingly, the patient feels aversion to wind, has difficulty urinating, slight stiffness in the four limbs, and difficulty bending and extending them, this formula is indicated." Taiyang disease should ideally result in only a slight sweat; one must not induce profuse sweating like flowing water. When Wei Qi withdraws its defense, Ying Yin cannot hold, leading to unceasing leakage. With pores open, Wind has no resistance, and body fluids are entirely lost along with Yang Qi, failing to seep into the Bladder to moisten sinews. This leads to difficult urination, slight limb stiffness, and inability to bend or extend. All these complications arise because Wei Qi's protection has collapsed, causing internal fluids to rush outward uncontrollably. Urgently, while fluids are not yet exhausted, one must consolidate Wei Qi so that outward-flowing fluids return inward. Thus, Guizhi Tang plus Fuzi is used; the method of consolidating Wei Qi serves as the method of saving Yin fluids. This condition presents entirely as Wei Qi leaking outward and Yin fluids being deprived internally. Fuzi is a drying agent, yet Zhang Zhongjing uses it to save fluids. What is the rationale? Since Wei Yang is about to collapse, only the powerful force of Fuzi can swiftly enter the Wei level to restore Yang. By rapidly consolidating Wei Yang and cutting off the path of outward leakage, the body's inherent fluids can return inward. Once Yang returns, fluids naturally recover, without needing other herbs to generate fluids and moisten dryness. This is why the prescription is considered sagely. Adding Fuzi to this formula shares the same principle as using Zhenwu Tang (True Warrior Decoction) for Yang Collapse syndrome. Yu Jiayan stated: This condition involves the simultaneous loss of Yang Qi and Yin fluids, compounded by re-entry of external Wind, differing slightly from pure Yang Collapse. Therefore, Guizhi Jia Fuzi Tang (Guizhi Decoction plus Prepared Aconite) is used to consolidate the exterior, expel Wind, restore Yang, and astringe fluids.