葛根（八两） 龙胆 大青（各半两） 升麻 石膏 葳蕤（各一两） 甘草 桂心（当是桂枝。去外薄皮。故云
桂心。考外台秘要中。凡引仲景方。用桂枝者。皆云。桂心。亦是此义。若认以为肉桂。去外粗皮。误矣。） 芍药 黄
芩麻黄（各二两） 生姜（三两）
上十二味。 咀。以水一斗。煮葛根。取八升。内余药。煮取三升。分四服。日三。夜一。
琥按上方。即仲景葛根汤。又大青龙汤。二方去大枣杏仁。加龙胆大青升麻葳蕤黄芩。五味药也。上主疗云。身
体烦毒而热。故加此苦寒辛甘之味。以发泄之。又按大青。李氏纲目云。处处有之。高二三尺。茎圆。叶长三四寸。面
青背淡。对节而生。采得阴干。茎叶皆用。专治时气头痛大热。时行毒热。温疫寒热。诸家本草。功用相同。今方家罕
知之。良可慨也。又葳蕤。本草经名女葳。主治中风暴热。不能动摇。甄秘书用以治时疾寒热。今伤寒科罕用。惟疗虚
劳方用之。
治伤寒方
麻黄（十斤） 大黄（一斤十二两金色者） 杏人（三斗四升）
上三味。 咀。以雪水五斛。渍麻黄于东向灶釜中。三宿。内大黄。搅令调。炊以桑薪。煮得二斛汁。去滓。复内
釜中。捣杏人。内汁中。复炊之。可余六七斗汁。绞去滓。置铜器中。又以雪水三斗。合煎之。搅令调。得二斗四升。
药成可丸。冷凝。丸如弹丸。有病者。以三沸白汤五合。研一丸入汤中。适寒温服之。立汗出。若不愈者。复服一丸。
密盛药。勿令泄气。
琥按上方。乃治太阳经病。兼挟阳明府实。为汗下兼施之剂。犹之少阳阳明证。而用大柴胡汤。同一理耳。
葛根（八两） 龙胆 大青（各半两） 升麻 石膏 葳蕤（各一两） 甘草 桂心（应当是桂枝。去掉外面的薄皮。所以称为桂心。考证《外台秘要》中，凡是引用张仲景的方子，用到桂枝的，都称“桂心”。也是这个意思。如果误认为是肉桂，去掉外面的粗皮，就错了。） 芍药 黄芩 麻黄（各二两） 生姜（三两）
以上十二味药。切碎。用水一斗，先煮葛根，取八升药液，加入其余药物，再煮取三升药液。分四次服用。白天服三次，晚上服一次。
琥按：上面的方子，就是张仲景的葛根汤和大青龙汤两个方子，去掉大枣和杏仁，加上龙胆、大青、升麻、葳蕤、黄芩这五味药。上面主治说：身体烦闷毒热。所以加上这些苦寒辛甘的药味，来发散透泄邪气。又按：大青，李时珍《本草纲目》说：到处都有生长。高二三尺，茎圆，叶长三四寸，叶面青绿色背面淡色，对节而生。采得后阴干，茎叶都可以用。专门治疗时气头痛大热、时行毒热、温疫寒热等病。各家本草记载的功效相同。现在医生很少知道它，实在令人感慨。又按：葳蕤，《神农本草经》名为女葳。主治中风暴热，不能动摇。甄权《药性论》用它治疗时疾寒热。现在伤寒科很少使用，只有治疗虚劳的方子里才用。
治疗伤寒的方子
麻黄（十斤） 大黄（一斤十二两，以金色者为佳） 杏仁（三斗四升）
以上三味药。切碎。用雪水五斛，将麻黄浸泡在朝东的灶台上的釜中。浸泡三天三夜，加入大黄，搅拌使其调和。用桑木柴火煮，得到二斛汁液。去掉药渣，再次放入釜中。捣碎杏仁，加入汁液中，再次加热煮。大约剩下六七斗汁液。绞去药渣，放在铜器中。再用雪水三斗，合在一起煎煮。搅拌使其调和。得到二斗四升药液。药成后可以制成丸剂。冷却凝固后，做成如弹丸大小的丸子。有病的人，用刚煮沸的五合白开水，研化一丸药放入水中。待温度适宜时服用，立刻出汗。如果没好，再服一丸。密封保存药物，不要让药气泄漏。
琥按：上面的方子，是治疗太阳经病，兼夹阳明腑实证。属于汗法与下法同时使用的方剂。就像少阳阳明证，使用大柴胡汤一样，道理是相同的。
Ge Gen (Radix Puerariae, 8 liang) Long Dan (Radix Gentianae), Da Qing (Cortex Isatidis) (each 0.5 liang); Sheng Ma (Rhizoma Cimicifugae), Shi Gao (Gypsum Fibrosum), Wei Rui (Rhizoma Polygonati Odorati) (each 1 liang); Gan Cao (Radix Glycyrrhizae), Gui Xin (Bark of Cinnamon Twig; note: this should be Gui Zhi [Ramulus Cinnamomi], with the outer thin bark removed, hence called "Gui Xin". Examination of *Waitai Miyao* shows that whenever Zhang Zhongjing's formulas are cited using Gui Zhi, it is referred to as "Gui Xin", which carries the same meaning. If mistaken for Rou Gui [Cortex Cinnamomi] and the coarse outer bark is removed, it would be an error.) Shao Yao (Radix Paeoniae Alba), Huang Qin (Radix Scutellariae), Ma Huang (Herba Ephedrae) (each 2 liang); Sheng Jiang (Rhizoma Zingiberis Recens, 3 liang).
The above twelve ingredients. Coarsely crush them. Use one dou of water, first boil Ge Gen until eight sheng of liquid remains. Add the remaining herbs and boil until three sheng of liquid remains. Divide into four doses. Take three times during the day and once at night.
Hu notes: The above formula is essentially a combination of Zhang Zhongjing's Ge Gen Tang (Pueraria Decoction) and Da Qing Long Tang (Major Green Dragon Decoction), with Da Zao (Fructus Jujubae) and Xing Ren (Semen Armeniacae Amarum) removed, and Long Dan, Da Qing, Sheng Ma, Wei Rui, and Huang Qin added (five herbs in total). The indications state: "body feels vexed, toxic, and hot." Therefore, these bitter-cold and acrid-sweet herbs are added to vent and dissipate the pathogenic factors. Furthermore, regarding Da Qing, Li Shizhen's *Bencao Gangmu* states: It grows everywhere. It is two or three chi tall, has round stems, leaves three to four cun long, green on the upper surface and pale on the lower, growing opposite each other on the nodes. After harvesting, it is dried in the shade, and both stems and leaves are used. It specifically treats epidemic headaches with high fever, epidemic toxic heat, and warm epidemics with chills and fever. Various materia medica texts record similar functions. However, contemporary physicians rarely know of it, which is truly lamentable. Regarding Wei Rui, known as Nu Wei in the *Shennong Bencao Jing*, it treats sudden wind-stroke with fever and inability to move. Zhen Quan's *Yaoxing Lun* uses it to treat epidemic chills and fever. Currently, it is rarely used in the treatment of cold damage diseases, appearing only in formulas treating deficiency consumption.
Formula for Treating Cold Damage
Ma Huang (Herba Ephedrae, 10 jin); Da Huang (Radix et Rhizoma Rhei, 1 jin 12 liang, preferring golden-colored pieces); Xing Ren (Semen Armeniacae Amarum, 3 dou 4 sheng).
The above three ingredients. Coarsely crush them. Soak Ma Huang in a cauldron placed on an east-facing stove using five hu of snow water for three nights. Add Da Huang and stir to mix well. Cook using mulberry wood fire until two hu of juice is obtained. Remove the dregs and return the liquid to the cauldron. Crush Xing Ren and add it to the juice. Cook again until approximately six or seven dou of juice remains. Strain to remove dregs and place in a copper vessel. Add three dou of snow water and decoct together. Stir to mix well until two hu 4 sheng of liquid remains. The medicine can be formed into pills. Allow to cool and solidify, forming pills the size of bullet seeds. For patients, take half a sheng of freshly boiled plain water, dissolve one pill in it, and drink when the temperature is suitable. Profuse sweating will occur immediately. If not cured, administer another pill. Store the medicine tightly sealed to prevent loss of medicinal qi.
Hu notes: The above formula treats Taiyang channel disease complicated by Yangming fu-organ excess. It is a formula that simultaneously applies sweating and purging methods. This is analogous to the Shaoyang-Yangming syndrome treated with Da Chai Hu Tang (Major Bupleurum Decoction); the principle is the same.