桂枝(一两十七铢,去皮) 芍药(一两六铢) 甘草(一两二铢,炙) 杏仁(十六枚,去皮尖) 麻黄(十六
铢,去节) 生姜(一两六铢) 大枣(五枚,擘) 上七味,以水五升,先煮麻黄一、二沸,去上沫,纳诸药,煮取
二升,去渣,温服一升,日再服。一本云∶桂枝汤二升,麻黄汤一升,合为三升,分再服,今合为一方,将息
如前法。
服桂枝汤,大汗出,脉洪大者,汗虽出而邪未尽。与桂枝汤,如前法。此所谓邪不尽,行复如法者也。
若形如疟,日再发者,汗出必解,宜桂枝二麻黄一汤主之。此与桂枝麻黄各半汤,意略同,但此
因大汗出之后,故桂枝略重,而麻黄略轻。
桂枝汤加麻黄、石膏二味。
桂枝(去皮) 芍药 甘草(炙) 麻黄(去节,各十八铢) 大枣(四枚,擘) 生姜(一两二铢,切)
石膏(二十四铢,碎绵裹) 上七味,以水五升,煮麻黄一、二沸,去上沫,纳诸药,煮取二升,去渣,温服一
升。
附∶越婢方(麻黄六两,甘草二两,石膏半斤,生姜三两,大枣十五枚。)
太阳病,发热恶寒,热多寒少,脉微弱者,此无阳也,不可更汗。此无阳与亡阳不同,并与他处之阳
虚亦别,盖其人本非壮盛,而邪气亦轻,故身有寒热
而脉微弱。若发其汗。必至有叉手冒心,脐下悸等症,故以此汤清疏营卫,令得似汗而解。况热多寒少,热在
气分,尤与石膏为宜。古圣用药之审如此。
按以上三方,所谓一、二,各半之说,照方计算,并不对准,未知何说?或云∶将本方各煎,或一分,或
二分,相和服,此亦一法。但方中又各药注明分两,则何也?存考。
桂枝(一两十七铢,去皮) 芍药(一两六铢) 甘草(一两二铢,炙) 杏仁(十六枚,去皮尖) 麻黄(十六铢,去节) 生姜(一两六铢) 大枣(五枚,擘) 以上七味药,用水五升,先煮麻黄一至两沸,去掉水面上的浮沫,再加入其他药物,煎煮至取药液二升,滤去药渣,温服一升,每日服用两次。另一版本说:桂枝汤(Cinnamon Twig Decoction)二升,麻黄汤(Ephedra Decoction)一升,混合为三升,分两次服用,现在合并为一个方剂,调养护理方法如前所述。
服用桂枝汤后,大汗出,脉象洪大者,汗虽出但邪气未尽。给予桂枝汤,按照前述方法服用。这就是所谓邪气未尽,再次按此法治疗的意思。
如果症状像疟疾一样,一天发作两次,出汗后必然痊愈,适宜用桂枝二麻黄一汤主治。这与桂枝麻黄各半汤(Guizhi Mahuang Banji Tang)的意旨大致相同,只是这里因为大汗出之后,所以桂枝略重,而麻黄略轻。
桂枝汤加入麻黄、石膏两味药。
桂枝(去皮) 芍药 甘草(炙) 麻黄(去节,各十八铢) 大枣(四枚,擘) 生姜(一两二铢,切) 石膏(二十四铢,碎绵裹) 以上七味药,用水五升,煮麻黄一至两沸,去掉水面上的浮沫,再加入其他药物,煎煮至取药液二升,滤去药渣,温服一升。
附注:越婢方(麻黄六两,甘草二两,石膏半斤,生姜三两,大枣十五枚。)
太阳病(Taiyang Disease),发热恶寒,热多寒少,脉微弱者,这是无阳(absence of Yang)的表现,不可再发汗。这里的“无阳”与亡阳(Yang collapse)不同,与其他地方的阳虚(Yang deficiency)也不同,大概是因为其人本来就不壮盛,而邪气也轻,所以身体有寒热而脉微弱。如果发其汗,必定导致双手交叉护住心口、脐下悸动等症状,所以用这个汤剂清疏营卫(defensive and nutritive Qi),使其通过类似出汗的方式解除病症。况且热多寒少,热在气分(Qi level),尤其适合用石膏。古代圣人在用药上的审慎如此。
按上述三个方子,所谓的“一”、“二”、“各半”的说法,照方计算剂量,并不完全吻合,不知是什么说法?有人说:将本方分别煎煮,或一份,或两份,混合后服用,这也是一种方法。但方中又对各药的注明分量,这又是为什么呢?存疑待考。
Cinnamon Twig (Liangzhi Shiqi Zhu, peeled) Paeonia Root (Liangliu Zhu) Licorice Root (Liangliang Er Zhu, roasted) Apricot Seed (Shi Liu Mei, skin and tip removed) Ephedra Stem (Shiliu Zhu, nodes removed) Fresh Ginger (Liangliu Zhu) Jujube (Wu Mei, split) The above seven ingredients are decocted with five sheng of water. First, boil Ephedra Stem for one or two boils, remove the foam on the surface, then add the remaining herbs. Decoct until two sheng of liquid remain, strain, and take one sheng warm, twice a day. Another version states: Two sheng of Guizhi Tang (Cinnamon Twig Decoction) and one sheng of Mahuang Tang (Ephedra Decoction) are mixed to make three sheng, taken in two doses. Now combined into one formula, the regimen is as described previously.
After taking Guizhi Tang (Cinnamon Twig Decoction), if there is profuse sweating and a flooding pulse, although sweat is produced, the pathogenic factor is not yet exhausted. Administer Guizhi Tang (Cinnamon Twig Decoction) according to the previous method. This refers to the situation where the pathogen remains, and treatment should proceed according to this method again.
If the symptoms resemble malaria, occurring twice a day, resolution will occur through sweating; Gui Zhi Er Ma Huang Yi Tang (Two Parts Cinnamon Twig and One Part Ephedra Decoction) is indicated. This shares a similar intent with Guizhi Mahuang Banji Tang (Half-Part Cinnamon Twig and Half-Part Ephedra Decoction), but because it follows profuse sweating, the dosage of Cinnamon Twig is slightly heavier, while that of Ephedra Stem is slightly lighter.
This formula consists of Guizhi Tang (Cinnamon Twig Decoction) plus Ephedra Stem and Gypsum.
Cinnamon Twig (peeled) Paeonia Root Licorice Root (roasted) Ephedra Stem (nodes removed, each eighteen zhu) Jujube (four pieces, split) Fresh Ginger (Liangliang Er Zhu, sliced) Gypsum (Ershi Si Zhu, crushed and wrapped in cotton) The above seven ingredients are decocted with five sheng of water. Boil Ephedra Stem for one or two boils, remove the foam, add the other herbs, and decoct until two sheng remain. Strain and take one sheng warm.
Appendix: Yuespi Fang (Yuebi Decoction): Ephedra Stem six liang, Licorice Root two liang, Gypsum half jin, Fresh Ginger three liang, Jujube fifteen pieces.
In Taiyang Disease (Disease of the Taiyang Channel), characterized by fever and aversion to cold, with more heat than cold and a faint pulse, this indicates Wu Yang (Absence of Yang). Sweating should not be induced further. This "Wu Yang" differs from Wang Yang (Yang Collapse) and also from general Yang Xu (Yang Deficiency) mentioned elsewhere. It implies that the patient's constitution was never robust, and the pathogenic factor is mild, resulting in alternating chills and fever with a faint pulse. If sweating were induced, it would likely lead to symptoms such as crossing hands over the heart and palpitations below the umbilicus. Therefore, this decoction clears and disperses the Ying and Wei (Nutritive and Defensive levels), allowing resolution through slight perspiration. Moreover, since heat predominates over cold and the heat resides in the Qi Fen (Qi Level), Gypsum is particularly suitable. Such is the prudence of ancient sages in prescribing herbs.
Regarding the above three formulas, the terms "one," "two," and "half-part" do not align precisely when calculating dosages based on the prescriptions. The reason for this discrepancy is unknown. Some suggest that the base formulas are decocted separately and mixed in ratios of one part or two parts before administration, which is another valid method. However, given that specific weights are noted for each herb within the formula, the rationale remains unclear. This point is preserved for further study.