甘草、大枣补脾精以滋肝血；芍药清营中之热；桂枝达营气之郁也。
桂枝（三两，去皮） 芍药（三两） 甘草（二两，炙） 生姜（三两） 大枣（十二枚，擘）
上五味， 咀，以水七升，微火煮，取三升，去渣。适寒温，服一升。服已，须臾， 热稀粥一升
余，以助药力。桂枝本不能
发汗，故须助以热粥。《内经》云∶“谷入于胃，以传于肺”。肺至皮毛，汗所从出，
粥充胃气以达于肺也。观此可知伤寒不禁食矣。温覆，令一时许，遍身 微似有汗者益佳，不可令如水流漓，病必
不除此解肌之法也。若如水流漓，则动营气，卫邪仍在。若一服汗出病瘥，停后服，不必
尽剂。若不汗，更服，根据前法。又不汗，后服小促其间，半日许令三服尽。若病重者，一日一夜服，周时
观之。服一剂尽，病证犹在者，更作服。若汗不出，乃服至二、三剂。桂枝汤全料，谓之一剂；三分之一，
谓之一服；古一两，今二钱零，则一剂之药，除姜枣，仅一两六钱零，一服不过五钱零矣。治伤寒大症，分
两不过如此。一服即汗，不再服；无汗，服至二、三剂，总以中病为主。后世见服药得效者，反令多服，无效
者，即疑药误，又复易方，无往不误矣！禁生冷粘滑、肉、面、五辛、酒酪及臭恶等物。
太阳中风，阳浮而阴弱。风在外，故阳脉浮；卫气有邪，则不能护营，故阴脉弱。阳浮者，热自发。风
为阳邪，故发热，桂枝之辛以散之。阴弱者，汗自出。芍药之酸以收之，甘草之甘以缓之。啬啬恶寒，淅淅
恶风。恶风未有不恶寒者，但恶寒甚轻，非若中寒及阴经之甚也。
翕翕发热，其热亦不如阳明之甚。鼻鸣干呕者，鼻鸣似属阳明；干呕似属少阳，盖三阳相近，故略有
兼病，但不甚耳。桂枝汤主之。
太阳病，头痛发热，汗出恶风者，桂枝汤主之。此桂枝汤总症。
以营性发扬，卫性敛闭。风伤卫气，泄其皮毛，故汗出也。
太阳病，下之后，其气上冲者，可与桂枝汤方，用前法。误治。若不上冲者，不可与之。此误下之症。
误下而仍上冲，则邪气犹在阳分，故仍用桂枝发表，若不上冲，则其邪已下陷，变病不一，当随宜施治。论
中误治诸法，详观自明。
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。此非误治，因风邪凝结于太阳
之要路，则药力不能流通，故刺以解其结。盖邪风太甚，不仅在卫，而在经。刺之以泄经气。风府一穴，
在项上入发际一寸，大筋内，宛宛中，督脉阳维之会，刺入四分，留三呼。风池二穴，在颞 后，发际陷
者中，穴在耳后，按之引于耳中，足少阳阳维之会，针入三分，留三呼。
太阳病，外证未解，脉浮弱者，当以汗解，宜桂枝汤。病虽过期，脉症属太阳，仍不离桂枝法。
太阳病，外证未解者，不可下也。此禁下总诀。下之为逆，欲解外者，宜服桂枝汤言虽有当下之症，
而外症未除，亦不可下，仍宜解外，而后下也。
太阳病，先发汗不解，而复下之，脉浮者不愈，浮为在外，而反下之，故令不愈。今脉浮，故知在外，
当须解外则愈，宜桂枝汤。脉浮而下，此为误下，下后仍浮，则邪不因误下而陷入，仍在太阳。不得因已
汗下，而不复用桂枝也。
病常自汗出者，此为荣气和，荣气和者，外不谐，以卫气不共荣气和谐故尔。荣气和者，言荣气不
病，非调和之和，故又申言之，以营行脉中，卫行脉外，复发其汗，营卫和则愈。宜桂枝汤。自汗与发汗
迥别。自汗乃营卫相离，发汗使营卫相合。自汗伤正，发汗驱邪。复发者，因其自汗而更发之，则荣卫和而
自汗反止矣。
病患脏无他病，时发热，自汗出，而不愈者，此卫气不和也，先其时未热之时发汗则愈。宜桂枝汤主
之。无他病，太阳诸症不必备，而惟发热自汗，故亦用桂枝汤。
伤寒不大便，六七日，宜下之候。头痛有热者，未可与承气汤。太阳症仍在，不得以日久不便而下也。
按“未可”二字，从《金匮》增入，《伤寒论》失此二字。其小便清者，知不在里，仍在表也，便赤为里
有热。当须发汗，若头痛者，必衄。汗出而头痛未解，则蕴热在经而血动矣。宜桂枝汤。
伤寒发汗已解，半日许复烦，脉浮数者，可更发汗。发汗未透，故烦。乃服药不及之故。宜桂枝汤。
伤寒医下之，续得下利清谷不止，里症。身疼痛者，表症。急当救里。此误下之症，邪在外而引之
入阴，故便清谷，阳气下脱可危，虽表症未除，而救里为急。
《伤寒论·不可下编》云∶误下寒多者，便清谷，热多者。便脓血。后身疼痛，清便自调者，急当救表。
清谷已止，疼痛未除，仍从表治，盖凡病皆当先表后里，惟下利清谷，则以扶阳为急，而表症为缓也。表里分
治而序不乱，后人欲以一方治数症，必至两误。救里宜四逆汤，救表宜桂枝汤。
太阳病，发热汗出者，此为荣弱卫强，故使汗出，欲救邪风者，宜桂枝汤。提出邪风二字，见桂枝为驱
风圣药。
阳明病，脉迟汗出多，微恶寒者，表未解也，可发汗，宜桂枝汤。阳明本自多汗，但不恶寒而恶热。
今多汗而犹恶寒，则仍在太阳矣，虽阳明病，而治从太阳。
太阴病，脉浮者，可发汗。宜桂枝汤。太阴本无汗法，因其脉独浮，则邪仍在表，故亦用桂枝，从脉
不从症也。
病患烦热，汗出则解，又如疟状。有时复热。日晡所发热者，属阳明也。日晡发热，则为阳明之潮热
而非疟矣。脉实者，宜下之。脉虚浮者，宜发汗。一症而治法迥别，全以脉为凭。此亦从脉而不从症之法。
下之与大承气汤，发汗宜桂枝汤。
下利腹胀满，里症。身疼痛者，表症。先温其里，乃攻其表，温里宜四逆汤，攻表宜桂枝汤。此节属厥
阴症，未必由误治而得，然既见表症，亦宜兼治。
吐利止而身痛不休者，当消息和解其外，宜桂枝汤小和之。里症除而表症犹在，仍宜用桂枝法，轻其剂
而加减之可也。
伤寒大下后，复发汗，再误。心下痞，邪入中焦。
恶寒者，表未解也，不可攻痞，当先解表，表解乃可攻痞。解表宜桂枝汤，攻痞宜大黄黄连泻心汤。苦寒开
降之法，详见后。
甘草、大枣能够补益脾精以滋养肝血；芍药能够清解营分中的热邪；桂枝能够通达营气之郁滞。
桂枝（三两，去皮） 芍药（三两） 甘草（二两，炙） 生姜（三两） 大枣（十二枚，掰开）
以上五味药，切碎，用水七升，用微火煮取三升，去渣滓。待温度适宜时，服用一升。服药后不久，喝热稀粥一升多，以助药力。桂枝本身并不能发汗，所以需要借助热粥来辅助。《内经》说：“食物进入胃中，其精气传送到肺。”肺气宣发到皮毛，汗由此而出，喝粥可以充实胃气并达于肺。从这一点可以看出，伤寒病并非绝对禁止进食。覆盖衣被，约一个时辰左右，全身微微似有汗出为最佳，不可让汗水像水流一样淋漓，否则病必不能除，这是解肌的方法。如果出汗如水流漓，则会扰动营气，卫分之邪仍在。如果服一次药后汗出病愈，就停止后续服药，不必喝完所有药液。如果没有出汗，再按前法服药。如果仍不出汗，缩短服药间隔时间，半天内让三次药服完。如果病情较重，一天一夜连续服药，观察二十四小时。如果服完一剂药，病证仍在，就再配制服用。如果仍然不出汗，就服用到两、三剂。桂枝汤的全料称为一剂；三分之一称为一服；古代的一两相当于现在的二钱多一点，那么一剂的药量，除去姜、枣，仅有一两六钱多一点，一服的药量不过五钱多一点罢了。治疗伤寒重症，分量也不过如此。服一次药即出汗，就不再服；若无汗，服用至两、三剂，总以中病（药效对症）为主。后世医生见到服药有效者，反而令患者多服；无效者，就怀疑是药物错误，又更换方剂，结果没有不失误的！禁忌生冷、粘滑、肉类、面食、五辛、酒酪及腐臭恶秽等食物。
太阳中风证，脉象阳浮而阴弱。风邪在表，所以阳脉浮；卫气受邪，则不能护卫营气，所以阴脉弱。阳脉浮，说明热气自发。风为阳邪，所以发热，用桂枝的辛味来发散它。阴脉弱，说明汗自出。用芍药的酸味来收敛它，用甘草的甘味来缓和它。患者啬啬怕冷，淅淅怕风。怕风的人没有不怕冷的，只是怕冷很轻微，不像中寒及阴经病那样严重。
翕翕发热，其热度也不如阳明病严重。鼻鸣、干呕的，鼻鸣似乎属于阳明病；干呕似乎属于少阳病，因为三阳经相近，所以略有兼病，但并不严重。主治用桂枝汤。
太阳病，出现头痛、发热、汗出、恶风的症状，主治用桂枝汤。这是桂枝汤的总体证候。
因为营气性质发扬，卫气性质敛闭。风邪伤及卫气，使皮毛泄开，所以汗出。
太阳病，经过泻下治疗后，气机上冲的，可以给予桂枝汤方，使用前法。这是误治的情况。如果不气上冲的，不可给予此方。这是误下后的证候。
误下之后仍然气上冲，说明邪气仍在阳分，所以仍用桂枝发表；如果不气上冲，说明邪气已经下陷，变证不一，应当随宜施治。论中关于误治的各种方法，详细观察自然明白。
太阳病，初服桂枝汤，反而出现烦闷不解的，先针刺风池、风府穴，然后再给桂枝汤就会痊愈。这不是误治，是因为风邪凝结在太阳经的要路，导致药力不能流通，所以针刺以解开郁结。大概邪风太盛，不仅在卫分，而且深入经脉。针刺是为了泄除经气。风府穴，在项部入发际一寸处，大筋内侧，宛宛之中，是督脉与阳维脉交会之处，刺入四分，留针三呼的时间。风池穴两个，在颞部后方，发际凹陷处，穴位在耳后，按压时感觉引向耳中，是足少阳胆经与阳维脉交会之处，针入三分，留针三呼的时间。
太阳病，外证未解，脉象浮弱的，应当用发汗法解除，适宜用桂枝汤。病虽然过了期限，但脉症属于太阳病，仍然不离桂枝汤法。
太阳病，外证未解的，不可用泻下法。这是禁止泻下的总原则。泻下是逆治，想要解除表证，适宜服用桂枝汤。意思是即使有应当泻下的症状，而表证未除，也不可泻下，仍应先解表，然后再泻下。
太阳病，先发汗未愈，又用泻下法，脉仍浮的，病不愈。浮脉表示病邪在外，反而用泻下法，所以导致不愈。现在脉浮，所以知道病邪仍在表，应当须解表则愈，适宜用桂枝汤。脉浮而误用泻下，此为误下，下后脉仍浮，说明邪气不因误下而陷入，仍在太阳经。不能因为已经发汗、泻下，就不再用桂枝汤。
病人经常自汗出的，这是因为营气平和，营气平和的意思，是指外部不和谐，因为卫气不与营气和谐所致。所谓“营气平和”，是说营气没有生病，并非指调和之和，所以又申述说明：因为营行于脉中，卫行于脉外，再次发其汗，营卫和谐则痊愈。适宜用桂枝汤。自汗与发汗截然不同。自汗是营卫分离，发汗是使营卫相合。自汗损伤正气，发汗驱除邪气。所谓“复发”，是因其自汗而更发其汗，则营卫和而自汗反而停止。
病患脏腑无其他疾病，时常发热、自汗出，而不能痊愈的，这是卫气不和，在其未发热之时先发汗则痊愈。适宜用桂枝汤主治。无其他疾病，太阳病的各种症状不一定都具备，而只有发热自汗，所以也用桂枝汤。
伤寒不大便六七天，通常是应当泻下的候象。如果有头痛且发热的，不可立即给予承气汤。太阳证仍在，不得因为日久不便而用泻下法。
按：“未可”二字，是从《金匮要略》增入的，《伤寒论》原文缺失这二字。如果小便清利的，知道病不在里，仍在表；如果小便赤涩，则为里有热。应当须发汗，如果伴有头痛，必定会出现鼻衄。汗出而头痛未解，则蕴热在经脉而迫血妄行。适宜用桂枝汤。
伤寒发汗后病已解，半天左右又出现烦闷，脉象浮数的，可以再发汗。发汗不透，所以烦闷。这是服药不及的缘故。适宜用桂枝汤。
伤寒医生误用泻下法，随后出现下利清谷不止，这是里证。身体疼痛的，是表证。急当救里。这是误下导致的证候，邪气在外而被引入阴分，所以大便清谷，阳气下脱，情况危急，虽然表证未除，但救里为急务。
《伤寒论·不可下编》说：误下寒多者，大便清谷；热多者，大便脓血。后来身体疼痛，大小便正常的，急当救表。清谷已止，疼痛未除，仍从表治。大概凡病皆当先表后里，惟独下利清谷，则以扶阳为急，而表证为缓。表里分治而次序不乱，后人想用一方治数症，必然导致两处失误。救里适宜用四逆汤，救表适宜用桂枝汤。
太阳病，发热汗出的，这是因为营弱卫强，所以使汗出，想要救治邪风，适宜用桂枝汤。提出“邪风”二字，可见桂枝是驱风的圣药。
阳明病，脉迟、汗出多、微恶寒的，是表证未解，可以发汗，适宜用桂枝汤。阳明病本自多汗，但不恶寒而恶热。现在多汗而又恶寒，则病仍在太阳，虽然是阳明病，但治疗从太阳经论治。
太阴病，脉浮的，可以发汗。适宜用桂枝汤。太阴病本来没有发汗法，因为其脉独浮，说明邪气仍在表，所以也用桂枝汤，这是从脉而不从症。
病人烦热，汗出后缓解，又像疟疾状，有时再次发热。日晡时（下午3-5点）发热的，属于阳明病。日晡发热，就是阳明病的潮热而非疟疾了。脉实的，适宜用泻下法。脉虚浮的，适宜用发汗法。同一症状而治法截然不同，全凭脉象判断。这也是从脉而不从症的方法。泻下用大承气汤，发汗适宜用桂枝汤。
下利腹胀满，这是里证。身体疼痛的，是表证。先温其里，再攻其表。温里适宜用四逆汤，攻表适宜用桂枝汤。这一节属于厥阴病证，未必是由误治所得，但既然见表证，也适宜兼治。
吐利停止而身体疼痛不休的，应当斟酌和解其外，适宜用桂枝汤小和之。里证已除而表证犹在，仍适宜用桂枝汤法，减轻剂量并加减使用即可。
恶寒的，是表证未解，不可攻痞，应当先解表，表解之后才可攻痞。解表适宜用桂枝汤，攻痞适宜用大黄黄连泻心汤。苦寒开降的方法，详见后文。
Gancao (Licorice Root) and Dazao (Jujube Fruit) tonify Spleen essence to nourish Liver blood; Shaoyao (White Peony Root) clears heat in the Ying (Nutritive) level; Guizhi (Cinnamon Twig) unblocks stagnation of Ying Qi.
Guizhi (San liang, bark removed), Shaoyao (San liang), Gancao (Liang, roasted), Shengjiang (San liang), Dazao (Shi er mei, broken open).
The above five herbs are crushed, boiled in seven sheng of water with mild fire until three sheng remain, then strained. When warm, drink one sheng. Shortly after taking the medicine, drink a little more than one sheng of hot thin porridge to assist the medicinal power. Guizhi itself cannot induce sweating, hence the need for hot porridge as an aid. The *Neijing* states: "When grain enters the stomach, its essence is transmitted to the lungs." Lung Qi disseminates to the skin and hair, from where sweat emerges. Porridge enriches Stomach Qi to reach the Lungs. From this, it can be seen that in Shanghan (Cold Damage), food intake is not strictly prohibited. Cover the patient with blankets for about one hour; slight, uniform perspiration over the whole body is ideal. Do not allow profuse sweating like a flowing stream, otherwise the disease will certainly not be resolved. This is the method of resolving the muscle layer. If sweating is profuse, it disturbs Ying Qi, and the pathogenic factor in the Wei (Defensive) level remains. If symptoms resolve after one dose, stop subsequent doses; there is no need to finish the entire prescription. If there is no sweating, administer again according to the previous method. If still no sweating, shorten the interval between doses so that three doses are completed within half a day. For severe cases, administer continuously day and night, observing for twenty-four hours. If symptoms persist after finishing one full prescription, prepare another. If there is still no sweating, continue up to two or three prescriptions. A full prescription of Guizhi Tang is called one ji (dose); one-third is called one fu (serving). One ancient liang equals slightly more than two qian today. Thus, excluding ginger and jujube, one prescription weighs only slightly more than one liang six qian, and one serving is no more than five qian plus. The dosage for treating major Shanghan conditions is thus modest. If sweating occurs after one serving, do not administer further; if no sweating, administer up to two or three servings, always aiming for the effect to match the condition. Later physicians, seeing effective results, often instructed excessive dosing; when ineffective, they suspected drug error and changed formulas, leading to inevitable mistakes. Consume cold, raw, sticky, slippery foods, meat, wheat products, the Five Pungents (Wuxin), dairy, alcohol, and foul-smelling substances.
Taiyang Zhongfeng (Wind Strike at Taiyang) presents with a floating Yang pulse and weak Yin pulse. Wind is external, hence the Yang pulse floats; Wei Qi is affected by pathogens and cannot protect Ying Qi, hence the Yin pulse is weak. Floating Yang indicates spontaneous heat generation. Wind is a Yang pathogen, causing fever; the pungency of Guizhi disperses it. Weak Yin indicates spontaneous sweating; the sourness of Shaoyao astringes it, and the sweetness of Gancao moderates it. The patient feels chilly (Sese) and shivery (Xixi) due to aversion to wind and cold. Aversion to wind invariably involves aversion to cold, but here it is mild, unlike the severity seen in Cold Strike or Yin channel diseases.
There is a mild fever (Xixi), less intense than in Yangming disease. Nasal congestion/sound (Biming) and dry retching (Gan'ou) seem to involve Yangming and Shaoyang respectively, as the Three Yang channels are close, leading to slight concurrent involvement, though not severe. The primary treatment is Guizhi Tang.
In Taiyang Bing (Taiyang Disease), presenting with headache, fever, sweating, and aversion to wind, Guizhi Tang is indicated. This summarizes the general syndrome for Guizhi Tang.
Ying Qi has a nature of expansion, while Wei Qi has a nature of constriction. Wind damages Wei Qi, opening the pores, causing sweating.
After purgative treatment for Taiyang Bing, if Qi rushes upward, Guizhi Tang may be given using the prior method. This addresses mismanagement. If Qi does not rush upward, do not give it. This addresses post-purgative syndromes.
If Qi rushes upward after erroneous purgation, the pathogen remains in the Yang level, so Guizhi should still be used to release the exterior. If it does not rush upward, the pathogen has sunk inward, leading to various transformations requiring tailored treatment. The methods for managing mismanagement in the Treatise are clear upon detailed study.
In Taiyang Bing, if initial administration of Guizhi Tang causes irritability without resolution, first puncture Fengchi and Fengfu acupoints, then administer Guizhi Tang for cure. This is not mismanagement; rather, wind pathogens are condensed in key pathways of the Taiyang channel, blocking medicinal flow. Puncture resolves this condensation. Severe wind pathogens affect not just Wei but also the channels. Puncture drains channel Qi. Fengfu (DU16) is located one cun above the posterior hairline, inside the large tendons, in the depression, meeting point of Du Mai and Yangwei Mai. Insert four fen, retain for three breaths. Fengchi (GB20) consists of two points, located behind the temporal region in the depression at the hairline, behind the ear, where pressure radiates to the ear, meeting point of Foot-Shaoyang Gallbladder Channel and Yangwei Mai. Insert three fen, retain for three breaths.
For Taiyang Bing with unresolved exterior signs and a floating-weak pulse, sweating therapy is appropriate; Guizhi Tang is suitable. Even if the disease duration has passed, if pulse and signs belong to Taiyang, Guizhi method remains applicable.
For Taiyang Bing with unresolved exterior signs, purgation is contraindicated. This is the general rule against purgation. Purgation is contrary to treatment principles. To resolve the exterior, Guizhi Tang is indicated. Even if internal excess signs exist, if exterior signs persist, purgation must be avoided; resolve the exterior first, then address the interior.
In Taiyang Bing, if initial sweating fails and purgation follows, yet the pulse remains floating, the disease persists. Floating indicates the pathogen is external; erroneous purgation prevents resolution. Current floating pulse confirms the pathogen is still on the exterior; exterior resolution is required for cure, preferably with Guizhi Tang. Floating pulse followed by purgation is an error; persistence of floating pulse post-purgation indicates the pathogen did not sink but remains in Taiyang. Do not withhold Guizhi Tang simply because sweating and purgation have occurred.
Patients with chronic spontaneous sweating have harmonious Ying Qi. "Harmonious" here means Ying Qi is not diseased, not necessarily balanced externally. The lack of harmony arises because Wei Qi does not coordinate with Ying Qi. Ying circulates within the vessels, Wei outside. Re-inducing sweating restores harmony between Ying and Wei, curing the condition. Guizhi Tang is indicated. Spontaneous sweating differs fundamentally from therapeutic sweating. Spontaneous sweating represents separation of Ying and Wei; therapeutic sweating reunites them. Spontaneous sweating damages healthy Qi; therapeutic sweating expels pathogens. "Re-sweating" utilizes the mechanism of spontaneous sweating to restore Ying-Wei harmony, thereby stopping spontaneous sweating.
If a patient has no internal organ pathology but experiences periodic fever and spontaneous sweating without resolution, this indicates disharmony of Wei Qi. Induce sweating before the onset of fever to achieve cure. Guizhi Tang is indicated. Without other illnesses, not all Taiyang symptoms need be present; isolated fever and sweating warrant Guizhi Tang.
In Shanghan, constipation for six to seven days usually suggests indications for purgation. However, if accompanied by headache and fever, Chengqi Decoctions should not be used immediately. With Taiyang signs persisting, purgation is inappropriate despite prolonged constipation. Note: The phrase "should not" (Weike) was added from *Jingui Yaolue*; it is missing in some versions of *Shanghan Lun*. Clear urine indicates the pathogen is not in the interior but remains on the exterior; dark urine suggests interior heat. Sweating is required. If headache persists, epistaxis (Nü) may occur. If sweating fails to resolve headache, accumulated heat in the channels may force blood out. Guizhi Tang is indicated.
After Shanghan sweating resolves symptoms, recurrence of irritability after half a day with a floating-rapid pulse indicates the need for further sweating. Incomplete initial sweating caused irritability due to insufficient medication. Guizhi Tang is indicated.
If a physician erroneously purges Shanghan, leading to continuous diarrhea with undigested food (Qinggu), this is a Interior Syndrome. Body pain indicates an Exterior Syndrome. Urgent rescue of the Interior is required. Erroneous purgation drew external pathogens into the Yin, causing Qinggu diarrhea and risking Yang collapse. Although exterior signs persist, rescuing the Interior is urgent.
The *Shanghan Lun · Chapter on Contraindications to Purgation* states: Excessive cold from erroneous purgation leads to Qinggu diarrhea; excessive heat leads to pus and blood in stool. Subsequent body pain with normal bowel movements requires urgent exterior rescue. Once Qinggu stops but pain persists, treat the exterior. Generally, exterior should be treated before interior, except in cases of Qinggu diarrhea where supporting Yang is urgent and exterior treatment is secondary. Treating exterior and interior separately maintains order; attempting to treat multiple syndromes with one formula leads to errors. Rescue Interior with Sini Tang; rescue Exterior with Guizhi Tang.
Taiyang Bing with fever and sweating indicates weak Ying and strong Wei, causing sweating. To counteract wind pathogens, Guizhi Tang is indicated. Mentioning "wind pathogens" highlights Guizhi as a premier herb for dispelling wind.
Yangming Bing with slow pulse, profuse sweating, and slight aversion to cold indicates unresolved exterior. Sweating is permissible; Guizhi Tang is indicated. Yangming typically presents with profuse sweating but aversion to heat, not cold. Profuse sweating with aversion to cold indicates the pathogen remains in Taiyang. Although diagnosed as Yangming, treatment follows Taiyang principles.
Taiyin Bing with a floating pulse allows for sweating. Guizhi Tang is indicated. Taiyin typically lacks sweating methods, but a solitary floating pulse indicates the pathogen remains on the exterior. Thus, Guizhi is used, prioritizing pulse over symptoms.
Patients with irritability and heat who improve after sweating, resembling malaria with recurrent fevers, may experience afternoon (Ribu) fever, indicating Yangming. Afternoon fever signifies Yangming tidal fever, not malaria. Solid pulse indicates purgation is suitable; deficient-floating pulse indicates sweating is suitable. Treatment varies entirely based on pulse, prioritizing pulse over symptoms. Purgation uses Dachengqi Tang; sweating uses Guizhi Tang.
Diarrhea with abdominal fullness is an Interior Syndrome; body pain is an Exterior Syndrome. Warm the Interior first, then attack the Exterior. Warm Interior with Sini Tang; attack Exterior with Guizhi Tang. This section pertains to Jueyin syndromes, possibly not resulting from mismanagement, but since exterior signs are present, concurrent treatment is appropriate.
If vomiting and diarrhea cease but body pain persists, gently harmonize the exterior. Guizhi Tang in a mild dosage is indicated. With interior resolved but exterior signs remaining, Guizhi method is appropriate, using reduced dosage and modifications.
Following severe purgation and subsequent sweating in Shanghan (double mismanagement), epigastric stuffiness (Pi) indicates pathogen entering the Middle Jiao. Aversion to cold indicates unresolved exterior; attacking Pi is contraindicated. Resolve exterior first, then treat Pi. Resolve exterior with Guizhi Tang; treat Pi with Dahuang Huanglian Xiexin Tang. Methods of bitter-cold descending are detailed later.