黄 当归（各一两半） 白芍药 桂枝 甘草（各一两）
上 咀。每服五钱。姜三片。枣一枚。水煎。日三。夜二服。如脉尚沉迟。再进一服。
琥按上方。即仲景桂枝汤中。加黄 当归也。大抵禀质素虚之人。外伤风寒。须以补养为主。兼行发散之法。所
以桂枝汤已属补虚之剂。因病患尺中迟弱。复益以黄 当归。许氏虽云。补血实。则气血兼补。此惟病患营卫俱弱。伤
风有汗者。宜用之。否则勿轻投也。
韩祗和云。病患两手脉浮数。或紧。或缓。寸脉短。反力小于关尺脉者。此名阴盛阳虚也。素问云阴气有余。为多
汗身寒。即可投消阴助阳表剂以治之。若立春以后。清明以前。宜六物麻黄汤主之。
麻黄（去节一两） 葛根 苍术（各七钱半） 人参 甘草（炙各半两）
上 咀。每服五钱。水一盏。枣二枚。煎七分。热服。如三五服后。汗未止。恶风者。加荆芥七钱。犹汗者。加丁
香皮半两
琥按上方。即仲景葛根汤中。去姜桂芍药。加苍术人参也。大抵气虚人。病太阳阳明二经伤寒KT KT 无汗者。
宜服此汤。有汗者。勿轻用也。上论云。阴盛阳虚。当是阴寒之邪。乘其表虚而客于营卫之间。病患周身阳气。不能外
达。法宜用助阳之剂以发表。使汗出表和。则阳气回复而阴邪消退。故上汤中。用麻黄葛根苍术之辛温。以透表而消阴。
因病患关前之脉短小。乃肺脾真气不足。复用人参炙甘草。甘温之品。以补中而助阳。此制方之变而周者也。盖前方治
虚人伤风。此方治虚人伤寒。同出一揆。谁谓伤寒无补法哉。
琥又按上论。引素问云。阴气有余为多汗。身寒此是真阳虚脱。阴寒直中之证。医人急投以参 熟附。犹恐阳亡而
未及。况敢用麻黄葛根等。重发其汗之药乎。且韩氏原论中复云。自汗出恶风。是邪气在表。为阴气有余。分三时用药。
连上共三方。方中皆有麻黄。彼独不知仲景法有汗不可服麻黄汤之义邪。可见韩氏方论。自相矛盾。至今微旨一书。世
无全本。盖其书之不传。由其言之无当也。又其方后云。汗未止。恶风。不去麻黄。而反加荆芥。又云。犹汗者。加丁
香皮。吾恐丁香皮辛温。虽与桂枝相似。不若竟加桂枝之为妙矣。韩氏因时和解法。大都莫解。故止摘上方。以见虚人
伤寒。自有宜用之药。学人仅取其方。毋泥其论可也。
刘河间治伤寒。表实无汗头项痛。腰脊强。身热恶寒。肩背拘急。手足指末微厥。脉浮数而紧者。为邪热在表。此
仲景麻黄汤证也。当以清解散。加天水散汗之。
黄耆、当归（各一两半），白芍药、桂枝、甘草（各一两）。
以上药物捣碎。每次服用五钱，生姜三片，大枣一枚，加水煎煮。白天服三次，晚上服两次。如果脉象仍然沉迟，再进一剂。
王琥按：上面的方子，就是张仲景的桂枝汤中，加入黄耆和当归。大抵体质素来虚弱的人，外感风寒，必须以补养为主，兼用发散的方法。所以桂枝汤已经属于补虚的药剂，因为患者尺部脉象迟弱，又补充了黄耆和当归。许氏虽然说是补血实，则是气血兼补，这仅适用于患者营卫都虚弱，伤风有汗的情况，适宜使用。否则不要轻易投用。
韩祗和说：患者两手脉象浮数，或紧，或缓，寸脉短，反而力量小于关、尺脉的，这名叫阴盛阳虚。《素问》说阴气有余，会导致多汗身寒，就可以投用消除阴邪、助阳解表的药剂来治疗。如果在立春以后，清明以前，适宜用六物麻黄汤主治。
麻黄（去节一两），葛根、苍术（各七钱半），人参、甘草（炙各半两）。
以上药物捣碎。每次服用五钱，水一盏，大枣二枚，煎至七分，热服。如果服用三五剂后，汗仍未止，恶风的，加荆芥七钱。仍然出汗的，加丁香皮半两。
王琥按：上面的方子，就是张仲景的葛根汤中，去掉生姜、桂枝、芍药，加入苍术、人参。大抵气虚的人，患太阳、阳明二经伤寒无汗的，适宜服用此汤。有汗的，不要轻易使用。上面论述说，阴盛阳虚，应当是阴寒之邪，乘其表虚而客居在营卫之间，患者周身阳气，不能外达，治法适宜用助阳的药剂以发表，使汗出表和，则阳气回复而阴邪消退。所以上面的汤中，用麻黄、葛根、苍术的辛温，以透表而消阴。因为患者关前之脉短小，是肺脾真气不足，又用人参、炙甘草，甘温的药品，以补中而助阳。这是制方的变化而周全啊。大概前方治疗虚人伤风，此方治疗虚人伤寒，同出一辙，谁说伤寒没有补法呢？
王琥又按：上面论述，引用《素问》说，阴气有余为多汗、身寒，这是真阳虚脱，阴寒直中的证候。医生急忙投用参、熟附子，还恐怕阳气亡失而来不及，何况敢用麻黄、葛根等，重发其汗的药物呢？况且韩氏原论中又说，自汗出恶风，是邪气在表，为阴气有余，分三个时辰用药，连上共三方，方中都有麻黄，他唯独不知道张仲景的法度是有汗不可服麻黄汤的道理吗？可见韩氏的方论，自相矛盾，至今《微旨》一书，世上没有全本。大概这本书的不流传，是因为它的言论不恰当。又他的方后说，汗未止，恶风，不去麻黄，反而加荆芥，又说，仍然出汗的，加丁香皮，我恐怕丁香皮辛温，虽然与桂枝相似，不如竟加桂枝更为妙啊。韩氏因时和解法，大多不能理解，所以只摘取上面的方子，以显示虚人伤寒，自有适宜使用的药物，学习的人仅取其方，不要拘泥于他的论述就可以了。
刘河间治疗伤寒，表实无汗头项痛，腰脊强，身热恶寒，肩背拘急，手足指末微厥，脉浮数而紧的，为邪热在表，这是张仲景麻黄汤证。应当用清解散，加天水散发汗。
Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix) (each 1.5 liang); Baishao (Paeoniae Radix Alba), Guizhi (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 liang).
Crush the above herbs. Take 5 qian per dose, with 3 slices of Shengjiang (Zingiberis Rhizoma Recens), 1 Zao (Jujubae Fructus), decoct in water. Take three times during the day and twice at night. If the pulse remains deep and slow, administer another dose.
Wang Hu notes: The above formula is essentially Zhang Zhongjing's Guizhi Tang (Cinnamon Twig Decoction) with Huangqi (Astragali Radix) and Danggui (Angelicae Sinensis Radix) added. Generally, for individuals with a constitution that has always been deficient, when affected by external wind-cold, the primary approach should be nourishment, supplemented by methods to disperse pathogens. Thus, Guizhi Tang (Cinnamon Twig Decoction) already belongs to tonifying deficiency formulas. Because the patient's chi (cun-kou) pulse is slow and weak, Huangqi (Astragali Radix) and Danggui (Angelicae Sinensis Radix) are added to supplement blood and qi. Although Xu Shi stated it supplements blood and solidifies, it actually supplements both qi and blood; this is suitable only when the patient's ying (nutritive) and wei (defensive) qi are both weak and there is sweating due to wind-strike. Otherwise, do not administer lightly.
Han Zhihe said: When a patient's pulses on both hands are floating and rapid, or tight, or relaxed, and the cun (inch) pulse is short, being weaker than the guan (bar) and chi (cubit) pulses, this is named Yin excess and Yang deficiency. The *Suwen* states that excess Yin leads to profuse sweating and coldness of the body; one may then administer exterior-releasing agents that eliminate Yin and assist Yang. If the time is after Lichun (Start of Spring) but before Qingming (Clear and Bright), Liuwu Mahuang Tang (Six-Ingredient Ephedra Decoction) is indicated as the main treatment.
Mahuang (Ephedrae Herba, tips removed, 1 liang); Gegen (Puerariae Lobatae Radix), Cangzhu (Atractylodis Rhizoma) (each 7.5 qian); Renshen (Ginseng Radix), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) (each 0.5 liang).
Crush the above herbs. Take 5 qian per dose, with 1 cup of water and 2 Zao (Jujubae Fructus), decoct until reduced to 70%, and take hot. If after 3–5 doses sweating has not ceased and aversion to wind persists, add Jingjie (Schizonepetae Spica) 7 qian. If sweating continues, add Dingxiangpi (Syzygii Armati Cortex) 0.5 liang.
Wang Hu notes: The above formula is essentially Zhang Zhongjing's Gegen Tang (Kudzu Decoction) with Shengjiang (Zingiberis Rhizoma Recens), Guizhi (Cinnamomi Ramulus), and Shaoyao (Paeoniae Radix) removed, and Cangzhu (Atractylodis Rhizoma) and Renshen (Ginseng Radix) added. Generally, for individuals with Qi deficiency suffering from Taiyang and Yangming meridians' Shanghan (Cold Damage) without sweating, this decoction is suitable. For those with sweating, do not use lightly. The preceding discussion states that Yin excess and Yang deficiency imply that Yin-cold pathogens, taking advantage of exterior deficiency, lodge between the ying (nutritive) and wei (defensive) levels. The patient's whole-body Yang qi cannot reach the exterior. The treatment method should employ Yang-assisting agents to release the exterior, allowing sweat to emerge so the exterior harmonizes; thus Yang qi recovers and Yin pathogens dissipate. Therefore, in the aforementioned decoction, the acrid-warm properties of Mahuang (Ephedrae Herba), Gegen (Puerariae Lobatae Radix), and Cangzhu (Atractylodis Rhizoma) are used to penetrate the exterior and eliminate Yin. Since the pulse anterior to the guan position is short and small, indicating insufficiency of the true Qi of the Lung and Spleen, Renshen (Ginseng Radix) and honey-fried Gancao (Glycyrrhizae Radix et Rhizoma), sweet-warm substances, are added to tonify the middle and assist Yang. This demonstrates the flexibility and comprehensiveness of formula formulation. Essentially, the former formula treats wind-strike in deficient persons, while this formula treats Shanghan (Cold Damage) in deficient persons; they follow the same principle. Who says there is no tonification method for Shanghan (Cold Damage)?
Wang Hu further notes: The preceding discussion cites the *Suwen*: "Excess Yin leads to profuse sweating and coldness of the body." This describes a syndrome of True Yang deficiency and collapse, with direct invasion by Yin-cold. Physicians urgently administering Renshen (Ginseng Radix) and Shufu (Aconiti Lateralis Radix Praeparata) might still fear failing to prevent Yang exhaustion; how could one dare use heavy diaphoretic drugs like Mahuang (Ephedrae Herba) and Gegen (Puerariae Lobatae Radix)? Moreover, Han Shi's original discussion also states: "Spontaneous sweating and aversion to wind indicate pathogenic factors in the exterior, attributed to excess Yin," and prescribes medication according to three seasonal periods. Including the previous ones, there are three formulas in total, all containing Mahuang (Ephedrae Herba). Does he not know Zhang Zhongjing's principle that Ma Huang Tang (Ephedra Decoction) is contraindicated in cases with sweating? It is evident that Han Shi's formula discussions are self-contradictory. To this day, the book *Weizhi* lacks complete copies in the world. Probably its transmission is hindered by its inappropriate statements. Furthermore, his post-formula notes say: "If sweating does not cease and there is aversion to wind, do not remove Mahuang (Ephedrae Herba) but instead add Jingjie (Schizonepetae Spica)." And again: "If sweating persists, add Dingxiangpi (Syzygii Armati Cortex)." I fear that although Dingxiangpi (Syzygii Armati Cortex) is acrid-warm and similar to Guizhi (Cinnamomi Ramulus), adding Guizhi (Cinnamomi Ramulus) directly would be superior. Han Shi's method of resolving according to time is largely misunderstood; thus, only the above formulas are excerpted to show that there are indeed suitable medicines for Shanghan (Cold Damage) in deficient persons. Students should merely adopt the formulas and not adhere rigidly to his theoretical discussions.
Liu Hejian treated Shanghan (Cold Damage) where the exterior was excess with no sweating, headache and stiff neck, stiffness of the waist and spine, fever and aversion to cold, tension and tightness of the shoulders and back, slight coldness of the fingertips, and a floating, rapid, and tight pulse. This indicates pathogenic heat in the exterior, which corresponds to Zhang Zhongjing's Mahuang Tang (Ephedra Decoction) syndrome. One should use Qingjie San (Clear and Release Powder) combined with Tianshui San (Heavenly Water Powder) to induce sweating.