太阳病发热汗出者此为营弱卫强故使汗出欲救邪风者桂枝汤主之
营弱卫强即上章阳浮阴弱之义卫闭而遏营血也邪风者经所谓虚邪贼风也风随八节而居八方自本方来者谓之正风不伤
人也自冲后来者谓之贼风伤人者也如夏至风自南来是正风也若来自北方是冲后也义详灵枢九宫八风篇
病患脏无他病时发热自汗出而不愈者此为卫气不和也先于其时发汗则愈桂枝汤主之
阳明腑病汗愈出而胃愈燥故发热汗出而病不愈病患脏气平和无他胃热之证时发热自汗出而不愈者此为卫气得风郁勃
而不和也当先于其时以桂枝发汗则愈迟恐变生他病也
病常自汗出者此为营气和营气和者外不谐以卫气不共营气和谐故耳以营行脉中卫行脉外复发其汗营卫和则愈宜桂枝
汤
病常自汗出者营气疏泄此为营气之和然营气自和者必外与卫气不相调谐以卫被风敛内遏营血不与营气和谐故耳以营
行脉中卫行脉外卫郁而欲内敛营郁而欲外泄究之卫未全敛而营未透泄是以有汗而风邪不解复发其汗使卫气不闭营气外达
二气调和则病自愈宜桂枝汤也卫闭而营郁则营不和卫未全闭而营得汗泄此为营气犹和然此之和者卫被风敛而未全闭也闭
则营气不和矣以卫常欲敛不与营气和谐终有全闭之时汗之令营郁透发则二气调和也
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
风池足少阳穴风府督脉穴在项后大椎之上督与太阳同行于背而足少阳经亦行项后两穴常开感伤最易感则传之太阳太
阳中风之病皆受自两穴服桂枝汤风应解矣反烦不解者风池风府必有内闭之风不能散也先刺以泄两穴之风再服桂枝无不愈
矣
太阳病出现发热、出汗的症状，这是因为营气虚弱而卫气亢盛，从而导致汗出。想要治疗这种风邪侵袭，应当以桂枝汤为主治方剂。
所谓“营弱卫强”，就是上一章所说的“阳浮阴弱”的含义，即卫气闭塞从而遏制了营血。所谓的“邪风”，就是经典中提到的“虚邪贼风”。风随着八个节气居住在八个方位，从本方（当令之方）吹来的称为正风，不伤害人；从对冲方向吹来的称为贼风，会伤害人。例如夏至时的风从南方来，这是正风；如果来自北方，那就是对冲方向，其义理详见《灵枢·九宫八风》篇。
如果病人内脏没有其他的疾病，只是定时发热、自发出汗且久不痊愈，这是因为卫气不和。应当在发热出汗之前先发汗，这样就能痊愈，主治方剂为桂枝汤。
如果是阳明腑实证，汗出越多胃越干燥，所以虽然发热汗出但病不愈。而当病人脏气平和，没有胃热等其他证候时，出现定时发热、自汗出而不愈的情况，这是因为卫气被风邪郁遏而躁动，导致不和。此时应当在发作前用桂枝汤发汗，才能痊愈；如果拖延时间，恐怕会产生其他病变。
经常自汗出的病人，这是因为营气本身是调和的。营气调和却仍然出汗，是因为外部与卫气不协调，由于卫气不能与营气和谐共处所致。因为营气行于脉中，卫气行于脉外，再次发汗后，营卫之气调和，病就能痊愈，适宜使用桂枝汤。
经常自汗出的病人，营气疏泄，这属于营气调和的表现。然而，既然营气自身调和，必然存在外部与卫气不相调谐的问题，因为卫气被风邪收敛，向内遏制营血，不与营气和谐。因为营行脉中，卫行脉外，卫气郁结想要内敛，营气郁结想要外泄。究其根本，卫气并未完全收敛，营气也未完全透发，所以虽然有汗但风邪未解。再次发汗，使卫气不再闭阻，营气得以外达，二气调和则病自愈，适宜使用桂枝汤。如果卫气完全闭阻而营气郁结，则营气不和；若卫气未完全闭阻而营气通过汗液泄出，这说明营气尚属调和。但这种调和是因为卫气被风邪收敛而未完全闭阻。一旦完全闭阻，营气就不和了。因为卫气常欲收敛，不与营气和谐，终将有完全闭阻的时候。发汗令营气郁结透发，则二气调和。
太阳病初次服用桂枝汤后，反而出现烦闷不解的症状，应当先针刺风池穴和风府穴，然后再给予桂枝汤，病就会痊愈。
风池穴是足少阳胆经的穴位，风府穴是督脉的穴位，位于项后大椎穴之上。督脉与太阳经同行于背部，而足少阳经也行于项后。这两个穴位经常处于开放状态，最容易感受外邪，一旦感邪就会传入太阳经。太阳中风病都受邪于这两个穴位。服用桂枝汤，风邪应当解除。如果反而烦闷不解，说明风池、风府两穴必有内部闭阻的风邪无法散发。先针刺以宣泄两穴的风邪，再服用桂枝汤，没有不痊愈的。
Taiyang disease (Disease of the Taiyang Channel) presenting with fever and sweating indicates that Ying Qi (Nutritive Qi) is weak while Wei Qi (Defensive Qi) is strong, causing the sweating. To treat this pathogenic wind, Guizhi Tang (Cinnamon Twig Decoction) should be administered as the primary formula.
The concept of "Ying weakness and Wei strength" corresponds to the meaning of "Yang floating and Yin weak" mentioned in the previous chapter, where Wei Qi becomes obstructed and restricts Ying Blood. The term "pathogenic wind" refers to what the classics call "empty evil and thief wind." Wind resides in eight directions according to the eight solar terms. Wind blowing from the current season's direction is called "proper wind" and does not harm humans; wind blowing from the opposite direction is called "thief wind" and harms humans. For instance, wind blowing from the south at the summer solstice is proper wind; if it comes from the north, it is from the opposing direction. This principle is detailed in the *Ling Shu: Nine Palaces and Eight Winds* chapter.
If a patient has no internal organ pathology but experiences periodic fever and spontaneous sweating that does not resolve, it is due to disharmony of Wei Qi. Sweating should be induced prior to the onset of symptoms to achieve cure, with Guizhi Tang (Cinnamon Twig Decoction) as the main prescription.
In Yangming Fu-organ syndrome, excessive sweating leads to greater dryness in the stomach, so fever and sweating do not resolve the disease. However, when a patient’s visceral qi is peaceful without other signs of stomach heat, yet they suffer from periodic fever and spontaneous sweating that persists, it is because Wei Qi is constrained by wind, becoming agitated and disharmonious. In such cases, inducing sweat with Guizhi Tang (Cinnamon Twig Decoction) before the onset of symptoms will lead to recovery; delaying treatment risks the development of other complications.
Patients who frequently experience spontaneous sweating have harmonious Ying Qi. The reason for sweating despite harmonious Ying Qi is external disharmony between Ying and Wei Qi, specifically because Wei Qi fails to harmonize with Ying Qi. Since Ying Qi circulates within the vessels and Wei Qi circulates outside the vessels, re-inducing sweating allows Ying and Wei Qi to harmonize, leading to recovery. Guizhi Tang (Cinnamon Twig Decoction) is appropriate.
Frequent spontaneous sweating indicates that Ying Qi is dispersing, which reflects a state of Ying Qi harmony. However, since Ying Qi is inherently harmonious, the issue lies in its lack of coordination with Wei Qi externally. Wei Qi is constricted by wind and internally suppresses Ying Blood, failing to harmonize with Ying Qi. As Ying moves inside the vessels and Wei moves outside, Wei Qi tends to contract inward while Ying Qi tends to disperse outward. Fundamentally, Wei Qi is not fully constricted, nor is Ying Qi fully dispersed, resulting in sweating without the resolution of wind pathogens. Re-inducing sweating prevents Wei Qi from closing up and allows Ying Qi to reach the exterior; when the two energies harmonize, the disease resolves spontaneously. Guizhi Tang (Cinnamon Twig Decoction) is indicated. If Wei Qi completely closes and Ying Qi becomes stagnant, Ying Qi is disharmonious. If Wei Qi is not fully closed and Ying Qi escapes through sweat, Ying Qi remains relatively harmonious. This relative harmony exists because Wei Qi is constrained by wind but not fully closed. Once fully closed, Ying Qi becomes disharmonious. Since Wei Qi naturally tends to contract and lacks harmony with Ying Qi, complete closure is inevitable. Inducing sweat causes Ying Qi to disperse, thereby harmonizing the two energies.
In Taiyang disease, if a patient feels aggravated or vexed after the first dose of Guizhi Tang (Cinnamon Twig Decoction) without relief, one should first needle Fengchi (GB20) and Fengfu (GV16), then administer Guizhi Tang (Cinnamon Twig Decoction) again for recovery.
Fengchi (GB20) is an acupoint of the Foot-Shaoyang Gallbladder Channel, and Fengfu (GV16) is an acupoint of the Du Mai (Governing Vessel). They are located above Dazhui (GV14) at the back of the neck. The Du Mai and Taiyang Bladder Channel both run along the back, while the Foot-Shaoyang Gallbladder Channel also traverses the back of the neck. These two points are often open and susceptible to pathogenic invasion; once invaded, the pathogen transmits to the Taiyang channel. Taiyang wind-stroke diseases originate from these two points. After taking Guizhi Tang (Cinnamon Twig Decoction), the wind should dissipate. If vexation persists, it indicates that wind pathogens are internally blocked in Fengchi and Fengfu and cannot be dispersed. Needling these points first to vent the wind, followed by Guizhi Tang (Cinnamon Twig Decoction), ensures recovery.