伤寒酒病桂勿与，呕吐不已血脓鲜，尺迟服麻致漏汗，恶风肢急小便难，微弱汗风
青龙发，厥惕悸眩热仍然，身 振振欲擗地，桂加附子真武痊。
【注】伤寒，谓伤寒无汗之实邪也。酒病，谓病酒状似中风也。桂勿与，谓皆勿与桂枝
汤也。误与伤寒，则表气愈固，里气更逆，呕吐不已也。误与酒病，则湿热内酿，伤营吐
血脓也。此皆误用桂枝汤之变证，当随其变证治之可也。尺迟，谓伤寒尺中脉迟也。服
麻，谓服麻黄汤发汗，遂致汗出不止，名曰漏汗也。肢急，四肢拘急也。小便难，谓小
便少而难也。伤寒脉证，当用麻黄汤发汗，若尺中脉迟，是营气不足，不可发汗。若误发
之，则致漏汗恶风，四肢拘急，小便难等变证也。当以桂枝加附子汤救逆可也。微弱，谓
大青龙证脉微弱也，汗风，谓大青龙证自汗恶风也。大青龙证脉不浮紧，若浮缓而微弱
反汗出，是大青龙脉证未具也。误以大青龙发之，致其人厥冷筋惕，心悸头眩，热仍不
退，身肉 动也。振振欲擗地，谓耸动不已，不能兴起欲堕于地也，此皆误与大青龙汤发
汗之变证，当以真武汤救逆可也。详太阳篇。
伤寒一日太阳病，欲吐烦躁数急传、阳明少阳证不见，脉静身和为不传。
【注】伤寒一日太阳受病，二日阳明受病，三日少阳受病，此其传经之常也。若初病颇
欲吐，烦躁脉数急者，谓邪盛传经而不解也。二、三日阳明少阳证不见，脉静身无所苦者，
谓邪衰不传，欲自愈矣。
伤寒病中，若患者有饮酒史（酒病），则不可使用桂枝汤。若误用导致呕吐不止、吐出鲜血或脓液；若尺脉迟而服用麻黄汤，会导致汗出不止（漏汗），出现怕风、四肢拘急、小便困难等症状；若脉象微弱且自汗恶风却误用大青龙汤发汗，会导致四肢厥冷、惊恐悸动、头晕目眩、发热不退，身体肌肉跳动，甚至身体震颤欲倒在地上；此时应使用桂枝加附子汤或真武汤来救治逆证。
【注释】所谓“伤寒”，是指伤寒无汗的实证。所谓“酒病”，是指饮酒后症状类似中风的情况。“桂勿与”是指这些情况都不可给予桂枝汤。如果误用于伤寒实证，会使表气更加闭塞，里气更加上逆，导致呕吐不止。如果误用于酒病，会使湿热在体内酝酿，损伤营血，导致吐血或脓血。这些都是误用桂枝汤产生的变证，应当根据具体的变证进行治疗即可。所谓“尺迟”，是指伤寒病中尺部脉搏迟缓。所谓“服麻”，是指服用麻黄汤发汗，结果导致汗出不止，称为“漏汗”。所谓“肢急”，是指四肢拘挛紧急。所谓“小便难”，是指小便量少且排出困难。伤寒的脉证，本应使用麻黄汤发汗，但如果尺中脉迟，说明营气不足，不可发汗。如果误行发汗，就会导致漏汗、怕风、四肢拘急、小便难等变证。此时应当使用桂枝加附子汤来救治逆证。所谓“微弱”，是指大青龙汤证的脉象微弱；所谓“汗风”，是指大青龙汤证患者自汗且怕风。大青龙汤证的脉象不应是浮紧，如果是浮缓而微弱且反而出汗，说明大青龙汤的脉证并不具备。误用大青龙汤发汗，会导致患者四肢厥冷、筋脉跳动、心悸头晕、发热仍然不退、身体肌肉跳动。所谓“振振欲擗地”，是指身体耸动不停，无法起身，想要跌倒在地。这些都是误用大青龙汤发汗产生的变证，应当使用真武汤来救治逆证。详细内容可参考太阳病篇。
伤寒发病第一天，邪气传入太阳经，如果出现想吐、烦躁、脉象数而急促，说明传变迅速；如果不见阳明或少阳的病证，脉象平静、身体调和，说明邪气没有传变。
【注释】伤寒发病第一天太阳经受病，第二天阳明经受病，第三天少阳经受病，这是传经的常规规律。如果初起时颇想呕吐，烦躁且脉象数而急促，说明邪气盛实，正在传经而不能解除。到了第二、三天，如果没有出现阳明和少阳的病证，脉象平静、身体没有痛苦，说明邪气衰退，没有传变，即将自愈。
In cases of Taiyang disease (Taiyang syndrome) complicated by alcohol consumption, Guizhi Tang (Cinnamon Twig Decoction) should not be administered. If mistakenly used, it may lead to incessant vomiting and hematemesis or expectoration of blood and pus. If the pulse at the cun position is slow (Chi Chi) and Mahuang Tang (Ephedra Decoction) is administered, it may cause persistent sweating known as "Lou Han" (Leaking Sweat), accompanied by aversion to wind, stiffness and cramping of the limbs, and difficulty in urination. If the pulse is weak and faint with spontaneous sweating and aversion to wind, but Da Qing Long Tang (Major Blue Green Dragon Decoction) is mistakenly used to induce sweating, it may result in cold extremities, palpitations with fright, dizziness, persistent fever, muscle twitching, and a sensation of the body trembling and wanting to fall to the ground. In such cases, Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction plus Aconite) or Zhen Wu Tang (True Warrior Decoction) should be used to rescue from these adverse reactions.
[Note] "Shanghan" refers to excess pathogenic factors in Shanghan characterized by absence of sweating. "Jiu Bing" refers to a condition resembling Wind-stroke caused by alcohol intoxication. "Gui Wu Yu" means that Guizhi Tang should not be given in these situations. Mistakenly using it for Shanghan will further consolidate the exterior Qi and reverse the interior Qi, leading to incessant vomiting. Mistakenly using it for Jiu Bing will cause damp-heat to brew internally, damaging Ying Blood and causing hematemesis or purulent blood. These are all adverse reactions due to the mistaken use of Guizhi Tang; treatment should follow the specific adverse manifestations. "Chi Chi" refers to a slow pulse at the Chi position in Shanghan. "Fu Ma" refers to taking Mahuang Tang to induce sweating, resulting in unceasing sweat, termed "Lou Han". "Zhi Ji" refers to stiffness and cramping of the four limbs. "Xiao Bian Nan" refers to scanty and difficult urination. The pulse and symptoms of Shanghan typically require Mahuang Tang to induce sweating; however, if the pulse at the middle of the Chi position is slow, it indicates deficiency of Ying Qi, and sweating should not be induced. Mistaken sweating leads to adverse reactions such as leaking sweat, aversion to wind, limb stiffness, and difficult urination. At this point, Guizhi Jia Fuzi Tang should be used to rescue the adverse reaction. "Wei Ruo" refers to a weak and faint pulse in Da Qing Long Tang syndrome; "Han Feng" refers to spontaneous sweating and aversion to wind in Da Qing Long Tang syndrome. The pulse for Da Qing Long Tang should not be floating and tight; if it is floating, moderate, weak, and faint with spontaneous sweating, the indications for Da Qing Long Tang are not met. Mistakenly inducing sweating with Da Qing Long Tang causes cold extremities, tendon twitching, palpitations, dizziness, persistent fever, and muscle tremors. "Zhen Zhen Yu Pi Di" describes continuous body shaking, inability to rise, and a desire to fall to the ground. These are all adverse reactions from mistakenly using Da Qing Long Tang to induce sweating; Zhen Wu Tang should be used to rescue the adverse reaction. See the Taiyang Chapter for details.
On the first day of Shanghan, the disease enters the Taiyang channel. If there is an urge to vomit, irritability, and a rapid and urgent pulse, it indicates rapid transmission of the pathogen. If no Yangming or Shaoyang symptoms appear, and the pulse is calm and the body feels harmonious, it indicates that the pathogen has not transmitted.
[Note] On the first day of Shanghan, the Taiyang channel is affected; on the second day, the Yangming channel; on the third day, the Shaoyang channel. This is the normal pattern of transmission. If initially there is a strong urge to vomit, irritability, and a rapid, urgent pulse, it signifies that the pathogen is abundant and transmitting without resolving. By the second and third days, if no Yangming or Shaoyang symptoms are present, and the pulse is calm with no bodily discomfort, it signifies that the pathogen is waning, not transmitting, and the patient is likely to recover spontaneously.