葛根（四两） 麻黄（三两去节汤泡去黄汁焙干秤） 生姜（三两切） 甘草（二两炙） 芍药（二两） 桂枝（二
两去皮） 大枣（十二枚擘） 半夏（半升洗）
上八味。以水一斗。先煮葛根麻黄。减二升。去白沫。内诸药。煮取三升。去滓。温服一升。覆取微似汗。
琥按上条病证与治法。诸家之注。亦不过随文作解。活人书但制小其剂。而于汤中药味不敢增损。愚以上条病。
既云呕矣。其人胸中能免满逆之证乎。汤中半夏固宜加矣。而甘草大枣之甘。能不相碍乎。愚注仲景书。发明仲景方。
究不敢执之以治病者。正为此耳。或云。方中止甘草二两。大枣十二枚。已有生姜三两。复加半夏半升。于呕家又何碍。
斯言实合仲景用药之旨。
太阳病。桂枝证。医反下之。利遂不止。脉促者。表未解也。喘而汗出者。葛根黄连黄芩汤主之。（本太阳桂枝证。
医人不投桂枝汤。反用药下之。成注云。虚其肠胃。为热所乘。遂利不止。按此亦非肠胃真虚证。乃胃有邪热。下通于
肠而作泄也。脉促者脉经云。脉来数时。一止复来曰促。此为阳独盛之脉也。脉促见阳。知表未解。但此言表。乃阳明
经病。非犹太阳桂枝之表证也。喘而汗出者。亦阳明胃腑。里热气逆所致。此非太阳风甚气壅之喘。亦非桂枝汤证之汗
出也。故与葛根黄连黄芩汤。以解阳明表邪。清胃腑里热。）
葛根（四两） 麻黄（三两，去节，用水浸泡后去除黄色汁液，焙干称重） 生姜（三两，切片） 甘草（二两，炙烤） 芍药（二两） 桂枝（二两，去皮） 大枣（十二枚，掰开） 半夏（半升，洗净）
以上八味药。用一斗水。先煮葛根和麻黄。水量减少二升。去掉表面的白色泡沫。加入其余药物。煮取三升药液。滤去药渣。温服一升。服药后覆盖衣被以取得微微似有汗出的效果。
琥按：上一条的病证与治法，各家注解，也不过是顺着文意进行解释。《活人书》只是将剂量制得较小，而在汤剂中的药味不敢增减。我认为上一条病证既然提到了呕吐，那么患者的胸部难道能避免胀满逆气之证吗？汤剂中确实应该加入半夏。但是甘草和大枣的甘缓之性，难道不会相互妨碍吗？我注释仲景的书，阐明仲景的方义，却不敢固执地用它来治病，正是因为这个原因。有人说：方中只有甘草二两、大枣十二枚，已有生姜三两，再添加半夏半升，对于呕吐患者又有什么妨碍呢？这番话确实符合仲景用药的宗旨。
太阳病，具有桂枝汤证的表现，医生反而使用下法治疗。腹泻随即不止。脉象急促的，说明表邪未解。气喘且出汗的，主治用葛根黄连黄芩汤。（原本是太阳桂枝证，医生不投用桂枝汤，反而用药进行攻下。成无己注解说：使肠胃虚弱，被热邪所乘，于是腹泻不止。按此观点，这也不是肠胃真正的虚证，而是胃中有邪热，向下传导至肠道而导致泄泻。脉象急促，《脉经》说：脉搏跳动快速时，偶尔停跳一次后又恢复跳动，称为促脉。这是阳气独盛的脉象。脉促见到阳脉特征，可知表邪未解。但此处所说的“表”，乃是指阳明经病，不再是像太阳桂枝那样的表证。气喘且出汗，也是由于阳明胃腑里热气逆所致。这不是太阳风邪盛导致的气机壅滞之喘，也不是桂枝汤证那种出汗。所以给予葛根黄连黄芩汤，以解除阳明表邪，清泄胃腑里的热邪。）
Ge Gen (Radix Puerariae, four liang) Ma Huang (Herba Ephedrae, three liang, remove nodes, soak in water, remove yellow juice, dry and weigh) Sheng Jiang (Rhizoma Zingiberis Recens, three liang, sliced) Gan Cao (Radix Glycyrrhizae Preparata, two liang, honey-fried) Shao Yao (Radix Paeoniae Alba, two liang) Gui Zhi (Cacumen Cinnamomi, two liang, bark removed) Da Zao (Fructus Jujubae, twelve pieces, split open) Ban Xia (Rhizoma Pinelliae Preparata, half sheng, washed)
The above eight ingredients. Use one dou of water. First decoct Ge Gen and Ma Huang. Reduce the volume by two sheng. Remove the white foam on the surface. Add the remaining herbs. Decoct to obtain three sheng of liquid. Strain to remove dregs. Take one sheng warm. Cover with blankets to induce a slight sweating effect.
Hu notes: Regarding the syndrome and treatment method of the previous clause, various commentators merely interpret the text literally. The *Huo Ren Shu* (Book for Saving Lives) only reduces the dosage but dares not add or subtract herbs from the decoction. I believe that since the previous clause mentions vomiting, can the patient's chest avoid symptoms of fullness and rebellious qi? It is indeed appropriate to add Ban Xia to the decoction. However, will the sweet nature of Gan Cao and Da Zao not interfere? When I annotate Zhang Zhongjing's works and elucidate his formulas, I dare not rigidly apply them to treat diseases, precisely for this reason. Some say: The formula contains only two liang of Gan Cao and twelve pieces of Da Zao; there is already three liang of Sheng Jiang, and adding another half sheng of Ban Xia, what harm does it do to those with vomiting? This statement truly aligns with the principle of herb usage by Zhang Zhongjing.
Tai Yang disease presenting with Gui Zhi Tang syndrome, the physician erroneously applied purgation. Diarrhea ensued and did not cease. If the pulse is rapid with occasional pauses (Cu Mai), the exterior pathogen has not yet resolved. If there is wheezing and sweating, Ge Gen Huang Lian Huang Qin Tang (Kudzu, Coptis, and Scutellaria Decoction) is the primary treatment. (Originally, it was Tai Yang Gui Zhi syndrome. The physician failed to administer Gui Zhi Tang and instead used purgatives. Cheng Wuji annotated: This empties the stomach and intestines, allowing heat pathogens to invade, resulting in persistent diarrhea. Note that this is not a true deficiency of the stomach and intestines, but rather evil heat in the stomach transmitting downward to the intestines causing diarrhea. A Cu pulse, as described in the *Mai Jing* (Classic of Pulse Diagnosis), refers to a rapid pulse with occasional pauses, indicating excessive Yang. The presence of a Cu pulse indicates Yang dominance, suggesting the exterior is unresolved. However, the "exterior" mentioned here refers to Yangming Meridian disease, not the exterior syndrome of Tai Yang Gui Zhi. Wheezing and sweating are caused by rebellious Qi due to interior heat in the Yangming Stomach organ. This is not wheezing due to severe wind and Qi stagnation in Tai Yang, nor is it the sweating characteristic of Gui Zhi Tang syndrome. Therefore, Ge Gen Huang Lian Huang Qin Tang is administered to resolve the Yangming exterior pathogen and clear the interior heat of the Stomach organ.)