（此方自原论中第十卷采附于此）
桂枝（一两十六铢去皮） 芍药 生姜（切） 甘草（炙） 麻黄（各一两去节） 大枣（四枚擘） 杏人（二十
四个汤浸去皮尖及双人者）
上七味。以水五升。先煮麻黄一二沸。去上沫。内诸药。煮取一升八合。去滓。温服六合。
琥按上方。乃治太阳病得之八九日。而病仍在太阳。因作如疟等状。内台方议云。如疟状者。乃先发表不尽。风
寒之邪。留滞于经。不能即出。故面反有热色。身必作痒。用麻黄桂枝之复方减其剂。以取小汗。是总风寒而两解之也。
或问伤寒八九日如疟状。发热恶寒。热多寒少。其人不呕。则是病患前已作呕过矣。方其呕时。焉知非少阳柴胡证。
纵其人尚有太阳头项强痛之候。焉知其不与少阳合病邪。若然则吾子于何证辩之。予曰于寒热时辩之。少阳之寒热。必
先寒而后热。或热已而复寒。方其寒之来也。必手足厥冷。面色青白。背上粟起。大作战栗。及其热之来也。必头面手
足四肢胸背蒸蒸然无处非热。或微汗出。甚则欲揭去衣被。热来则寒往。热往则寒又来。此方是少阳经病。今则于发热
之时随则恶寒。又热多于寒。其寒不甚。其人面上于恶寒时。反作赤热之色。故知其为太阳病无疑。尚论篇以寒热往来
作注。大谬之极。医人倘遇此证。于方药中宜权变取用。亦不可拘拘然但执一麻桂各半汤以投之也。
（附后例）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（服桂枝汤。反增烦热。此系风邪甚。
而汤药之力不能以即解也。故宜另用刺法。刺法与穴图俱见后第十四卷中。）
服桂枝汤。大汗出。脉洪大者。与桂枝汤如前法。若形如疟。日再发者。汗出必解。宜桂枝二麻黄一汤。（服桂枝汤
汗大出者。此出汗不得其法。所以中风之脉。本浮缓而反得洪大。可见病不除而风热愈盛。必再与桂枝汤如前法服之。
温覆令一时许。遍身 。微似有汗。则病自瘥也。若其人病不瘥。其形如疟者。大都是热多寒少之证。以其脉见洪大
故也。日再发者。邪气浅而欲散之候。愚按此条。是外寒束其风热。乃营卫俱伤之证。但风邪多而寒气少耳。法当微发
其汗。汗出必解。故成注云。与桂枝二麻黄一汤。以解散营卫之邪。）
（此方剂从《伤寒论》原书第十卷中摘录并附于此）
桂枝（一两十六铢，去皮） 芍药 生姜（切片） 甘草（炙烤） 麻黄（各一两，去节） 大枣（四枚，掰开） 杏仁（二十四个，热水浸泡后去皮尖及双仁者）
以上七味药。用水五升。先煮麻黄一两次沸腾。去掉水面上的浮沫。加入其余药物。煮取药液一升八合。滤去药渣。温服六合。
琥按：上方是治疗太阳病（太阳经受邪所致的病证）得病八九日，而病邪仍在太阳经，因而出现类似疟疾的症状。内台方议认为：所谓“如疟状”，是因为先前解表不彻底，风寒之邪留滞于经络，不能立即排出，所以面部反而有热色，身体必定发痒。使用麻黄汤与桂枝汤的复方但减少剂量，以取得微汗，这是同时解除风寒两邪的方法。
有人问：伤寒八九日出现类似疟疾的症状，发热恶寒，热多寒少，病人没有呕吐。那么病人之前已经发生过呕吐了。在他呕吐的时候，怎么知道不是少阳病（少阳经受邪所致的病证）的柴胡证呢？纵然他还有太阳病的头项强痛症状，怎么知道他不是太阳与少阳合病呢？如果是这样，您根据什么来辨证呢？我回答说：根据寒热发作时的表现来辨证。少阳病的寒热，一定是先恶寒而后发热，或者发热之后又转恶寒。当恶寒来临时，一定手足厥冷，面色青白，背上起鸡皮疙瘩，发生严重的战栗；当发热来临时，一定头面、手足、四肢、胸背蒸蒸发热，无处不热，或者微微出汗，甚至想要揭开衣服被子。热来时寒就退，热退时寒又来。这是少阳经的病。现在则是发热之时随即伴有恶寒，而且热多于寒，恶寒程度不重。病人在恶寒时，面部反而呈现赤热的颜色，所以知道这无疑是太阳病。《尚论篇》将“寒热往来”作为注解，极其荒谬。医生如果遇到这种证候，在方药运用上应当灵活变通，也不可拘泥地只使用麻黄桂枝各半汤来投治。
（附后例）太阳病，初服桂枝汤（Cinnamon Twig Decoction）后反而出现烦闷不解的，先针刺风池穴（Fengchi, GB20）和风府穴（Fengfu, GV16），然后再给予桂枝汤服用则痊愈。（服用桂枝汤后，反而增加烦热，这是因为风邪很盛，而汤药的力量不能立即解除病邪。所以适宜另外使用针刺法。针刺法和穴位图均见后第十四卷中。）
服用桂枝汤，大汗出，脉象洪大的，按照前面的方法给予桂枝汤。如果症状像疟疾一样，一天发作两次的，出汗后必然痊愈，适宜用桂枝二麻黄一汤（Guizhi Er Mahuang Yi Tang）。（服用桂枝汤后大汗出的，这是因为出汗不得法，所以中风病的脉象，本是浮缓的却反而得到洪大脉，可见病邪未除而风热更盛。必须再次按照前面的方法服用桂枝汤，覆盖衣被约一顿饭的时间，全身微微似有汗出，则病自然痊愈。如果病人病未愈，症状像疟疾的，大都是热多寒少的证候，因为其脉象见洪大。一天发作两次的，是邪气浅表且欲消散的征候。我认为这一条，是外寒束缚风热，属于营卫俱伤的证候，只是风邪多而寒气少罢了。治法应当微发其汗，汗出则病解。所以成无己注解说：给予桂枝二麻黄一汤，以解散营卫之邪。）
(This prescription is extracted from Volume 10 of the original *Shanghan Lun* and attached here.)
Guizhi (Cinnamon Twig) [1 liang 16 zhu, bark removed], Shaoyao (White Peony Root), Shengjiang (Fresh Ginger, sliced), Gancao (Licorice Root, honey-fried), Mahuang (Ephedrae Herba) [each 1 liang, nodes removed], Dazao (Jujubae Fructus) [4 pieces, torn open], Xingren (Prunus Armeniacae Semen] [24 pieces, soaked in hot water, skin and tips removed, excluding double-kernel ones].
The above seven herbs. Use five sheng of water. First boil Mahuang for one or two boils. Remove the foam on the surface. Add the remaining herbs. Boil to obtain one sheng eight he of decoction. Strain off the dregs. Take six he warm.
Hu notes: The above prescription treats Taiyang disease (disease syndrome caused by pathogenic factors invading the Taiyang channel) that has persisted for eight or nine days, with the pathogen still residing in the Taiyang channel, thereby presenting symptoms resembling malaria. The *Neitai Fangyi* states: "Symptoms resembling malaria" occur because the initial release of the exterior was incomplete, allowing Wind-Cold pathogens to stagnate in the channels without being expelled immediately. Consequently, the face appears flushed with heat, and the body itches. Using a combined formula of Mahuang Tang and Guizhi Tang but with reduced dosage induces slight sweating, thereby resolving both Wind and Cold pathogens simultaneously.
A question arises: In Shanghan (Cold Damage) after eight or nine days, if there are symptoms resembling malaria, with fever and aversion to cold, where heat predominates over cold, and the patient does not vomit. This implies the patient had previously experienced vomiting. At the time of vomiting, how can one rule out Shaoyang disease (disease syndrome caused by pathogenic factors invading the Shaoyang channel), specifically the Chaihu pattern? Even if the patient retains Taiyang symptoms such as stiffness and pain of the head and neck, how can one be sure it is not a concurrent Taiyang and Shaoyang disease? If so, upon what basis do you differentiate the diagnosis? I reply: Differentiation is based on the manifestation during chills and fever. In Shaoyang disease, chills must precede fever, or fever may be followed by chills. When chills arrive, there is invariably cold extremities, a bluish-white complexion, gooseflesh on the back, and severe rigors. When fever arrives, there is steaming heat in the head, face, hands, feet, limbs, chest, and back, everywhere hot, possibly with slight sweating, or even a desire to remove clothing and bedding. Heat comes while chills go; chills come while heat goes. This characterizes Shaoyang channel disease. However, in the current case, aversion to cold accompanies fever, heat exceeds cold, and the chills are mild. During the aversion to cold, the patient's face appears red and hot. Therefore, it is undoubtedly Taiyang disease. The *Shanglun Pian* annotates this as "alternating chills and fever," which is extremely erroneous. Physicians encountering this pattern should exercise flexibility in prescription selection and should not rigidly adhere solely to administering Mahuang Guizhi G Ban Tang.
(Attached subsequent example:) In Taiyang disease, if after the first administration of Guizhi Tang (Cinnamon Twig Decoction) vexation persists without relief, first puncture Fengchi (GB20) and Fengfu (GV16 acupoints), then administer Guizhi Tang, which will result in cure. (After taking Guizhi Tang, increased vexation and heat indicate that the Wind pathogen is strong and the herbal power cannot resolve it immediately. Thus, acupuncture is appropriate. Acupuncture methods and acupoint diagrams are found in Volume 14 later.)
If, after taking Guizhi Tang, there is profuse sweating and a surging pulse, administer Guizhi Tang according to the previous method. If the condition resembles malaria, occurring twice daily, resolution will follow sweating; Guizhi Er Mahuang Yi Tang (Guizhi Two Ephedra One Decoction) is indicated. (Profuse sweating after taking Guizhi Tang results from improper technique. The pulse for Wind-strike is originally floating and moderate, yet here it becomes surging, indicating that the pathogen remains and Wind-Heat intensifies. One must again administer Guizhi Tang as before, covering with blankets for about the duration of a meal until slight perspiration covers the whole body, at which point the illness will naturally heal. If the illness persists and resembles malaria, it is largely a pattern of excess heat and deficient cold, evidenced by the surging pulse. Occurring twice daily indicates shallow pathogen depth and impending dispersion. I believe this clause describes external Cold binding internal Wind-Heat, a pattern of simultaneous injury to Ying and Wei nutrients, where Wind pathogen predominates and Cold is minor. The treatment method should induce slight sweating; upon sweating, the disease resolves. Hence, Cheng Wuji's commentary states: Administer Guizhi Er Mahuang Yi Tang to disperse the pathogens in Ying and Wei.)