麻黄（去节）六两 桂枝二两 甘草（炙）二两 杏仁（去皮，尖）四十枚 生姜（
切）三两 大枣（擘）十二枚 石膏（碎，绵裹）如鸡子大。
右七味，以水九升，先煮麻黄，减二升，去上沫，内诸药，煮取三升，去滓，温服一
升，取微似汗，汗出多者，温粉扑之。一服汗者，停后服。若复服，汗多亡阳，遂虚
恶风，烦躁不得眠也。
【方解】
名大青龙者，取龙兴云雨之义也。治风不外乎桂枝，治寒不外乎麻黄，合桂枝麻黄二
汤以成剂，故为兼风寒中伤者之主剂也。二证俱无汗，故减芍药，不欲其收也；二证
俱烦躁，故加石膏以解其热也。设无烦躁，则又当从事于麻黄桂枝各半汤矣。仲景于
表剂中加大寒辛甘之品，则知麻黄证之发热，热全在表；大青龙证之烦躁，热兼肌里
矣。初病太阳即用石膏者，以其辛能解肌热，寒能清胃火，甘能生津液，是预保阳明
存津液之先着也。粗工疑而畏之，当用不用，必致热结阳明，斑黄狂冒，纷然变出矣
。观此，则可知石膏乃中风伤寒之要药，故得麻桂而有青龙之名，得知草而有白虎之
号也。服后取微汗，汗出多者，温粉扑之。一服得汗，停其后服，盖戒人即当汗之证
，亦不可过汗也。所以仲景桂枝汤中不用麻黄者，是欲其不大发汗也；麻黄汤中用桂
枝者，恐其过汗无制也。若不慎守其法，汗多亡阳，变生诸逆，表遂空虚，而不任风
，阴盛格阳，而更烦躁不得眠也。
【集解】
许叔微曰：仲景治伤寒，一则桂枝，二则麻黄，三则青龙。桂枝治风，麻黄治寒，青
龙兼治风寒，不拘时候，施与脉证相对者，无不应手而愈。今人皆能言之，而未晓前
人处方用药之意，多不敢用，无足怪也。
吴绶曰：大青龙汤，治伤寒发热，恶寒不得汗出，烦躁不安，脉浮紧或浮数者，急用
此汤发汗则愈，乃仲景之妙法也。譬若亢热已极，一雨而凉，其理可见也。若不晓此
理，见其躁热，投以寒凉之药，其害可胜言哉！若脉微弱汗出恶风者，不可用也；如
误用之，其害亦不浅。所以脉证不明者，多不敢用也。
脉浮而紧，浮则为风，紧则为寒，风则伤卫，寒则伤荣。荣卫俱病，骨节烦疼，当发
其汗而不可下也。
【注】
此发明风寒两伤，荣卫俱病之义也。浮，风邪脉也；风阳也，卫阳也。紧，寒邪脉也
；寒阴也，荣阴也，各从其类而伤之。荣卫俱病，骨节烦疼，是大青龙发汗之脉证，
虽发热烦躁，其热在肌而不在胃，不可下也。
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太阳病发汗，汗出不解，其人仍发热，心下悸，头眩身□动，振振欲擗地者，真武汤
主之。
【注】
此申首条，示人以救逆之法也。首条言误汗，此条言过汗，互文以明其义也。盖二证
皆属亡阳，故均当以真武汤主之，扶阳抑阴以救其逆也。大汗出，仍热不解者，阳亡
于外也；心下悸筑筑然动，阳虚不能内守也；头眩者，头晕眼黑，阳微气不能升也；
身□动者，蠕蠕然□动，阳虚液涸，失养于经也。振耸动也；振振欲擗地者，耸动不
已，不能兴起，欲堕于地，阳虚气力不能支也。
【集注】
张璐曰：此为误用大青龙因而致变者立法也。汗出虽多而热不退，则邪未尽而正已大
伤，况里虚为悸。上虚为眩，经虚为□，身振振摇，无往而非亡阳之象，所以用真武
，把关坐镇之法也。
汪琥曰：或问治不在表，何以方中尚用生姜？盖病自过汗而来，虽无郁热可发，其内
外寒邪犹在，用生姜者，乃温中有发也。
麻黄（去除节段）六两，桂枝二两，甘草（蜜炙）二两，杏仁（去皮、尖）四十枚，生姜（切片）三两，大枣（掰开）十二枚，石膏（打碎，用丝绵包裹）如鸡蛋大小。
以上七味药，用水九升，先煮麻黄，水量减少二升，撇去水面上的浮沫，加入其余药物，煎煮至取药液三升，滤去药渣，温服一升，以取得微微似有汗出的效果为宜。如果出汗过多，用温粉扑洒身体。服用一次后若已出汗，则停止后续服药。如果再次服药，会导致出汗过多而亡失阳气，进而出现虚弱、怕风、烦躁、无法入睡等症状。
【方解】
命名为“大青龙”，是取龙兴云雨的含义。治疗风邪不外乎使用桂枝，治疗寒邪不外乎使用麻黄，将桂枝汤和麻黄汤两方合用组成此剂，因此它是治疗风寒同时伤人的主要方剂。这两个证候都无汗，所以减去芍药，是不希望它收敛；两个证候都有烦躁，所以加入石膏来解除热邪。如果没有烦躁症状，则应当采用麻黄桂枝各半汤了。张仲景在表证剂型中加入大寒且味辛甘的药物，由此可知麻黄证的发热，热邪完全在体表；大青龙证的烦躁，热邪兼及肌肉深层。初病太阳经就使用石膏，是因为石膏味辛能解肌表之热，味寒能清胃火，味甘能生津液，这是预先保护阳明经、保存津液的先着策略。粗疏的医生怀疑并畏惧此法，当用时不用，必然导致热邪结聚于阳明经，出现斑疹、发黄、狂乱、昏冒等症，各种变证纷至沓来。观察这一点，就可以知道石膏是治疗中风和伤寒的重要药物，所以配合麻黄、桂枝就有“青龙”之名，配合甘草就有“白虎”之号。服药后以求得微汗为度，出汗多的，用温粉扑身。服用一次得到汗出，就停止后面的服药，这是告诫人们即使是应当发汗的证候，也不可以过度发汗。所以张仲景在桂枝汤中不用麻黄，是希望不要大发其汗；在麻黄汤中使用桂枝，是担心发汗过度而没有制约。如果不谨慎遵守这些法则，出汗过多导致亡阳，变生各种逆证，表气遂空虚，不能耐受风邪，阴盛格拒阳气，反而更加烦躁不得睡眠。
【集解】
许叔微说：张仲景治疗伤寒，一是桂枝汤，二是麻黄汤，三是青龙汤。桂枝汤治风邪，麻黄汤治寒邪，青龙汤兼治风寒，不拘泥于发病时间，只要施用于脉象与证候相符的患者，没有不立刻痊愈的。现在的人都能说出这个道理，但不理解前人处方用药的意图，大多不敢使用，这也没什么可奇怪的。
吴绶说：大青龙汤，治疗伤寒发热，恶寒且无汗出，烦躁不安，脉象浮紧或浮数的，急用此汤发汗即可痊愈，这是张仲景的妙法。譬如酷热到了极点，一场雨下来就凉爽了，其中的道理由此可见。如果不明白这个原理，看到患者躁热，就投以寒凉药物，其危害怎能说得尽呢！如果脉象微弱、有汗出、怕风的，不可使用；如果误用了，其危害也不浅。所以因为脉证不明的人，大多不敢使用。
脉象浮而紧，浮代表风邪，紧代表寒邪，风邪伤害卫气，寒邪伤害营血。营卫都生病，骨节烦痛，应当发汗而不可以攻下。
【注】
此处阐发了风寒两伤、营卫俱病的意义。浮脉，是风邪的脉象；风属阳，卫气属阳。紧脉，是寒邪的脉象；寒属阴，营血属阴，各自从其同类性质而受伤。营卫都生病，骨节烦痛，是大青龙汤发汗的脉证，虽然发热烦躁，但热在肌肉层面而不在胃腑，不可以攻下。
@@@
太阳病经过发汗治疗后，汗出后病仍不解，患者仍然发热，心下悸动，头晕眼花，身体筋肉跳动，震颤摇摆欲倒在地上者，用真武汤主治。
【注】
此处申述第一条的内容，向人们展示补救逆证的方法。第一条讲的是误汗，这一条讲的是过汗，通过互文见义来阐明其含义。大概这两个证候都属于亡阳，所以都应当用真武汤主治，扶助阳气、抑制阴寒以挽救逆证。大汗出，仍然发热不退的，是阳气亡失于外；心下悸动筑筑然跳动，是阳虚不能内守；头晕眩目的，是头晕眼黑，阳气微弱、气不能上升；身体筋肉跳动的，是蠕蠕然跳动，阳虚津液枯竭，经脉失去滋养。振耸即抖动；振振欲擗地，是指抖动不已，不能起身，想要堕落在地，这是阳虚气力不能支撑的表现。
【集注】
张璐说：这是针对误用大青龙汤因而导致变证所设立的治法。汗出虽多但热不退，说明邪气未尽而正气已大伤，况且里虚导致心悸，上虚导致眩晕，经络虚导致身体抽动，全身震颤摇摆，无处不是亡阳的迹象，所以使用真武汤，采取把关坐镇的方法。
汪琥说：有人问，治疗不在表证，为什么方中还要用生姜？大概病情是由于过汗而来，虽然没有郁热可以发散，但内外的寒邪仍然存在，使用生姜，是为了在温补中兼有发散的作用。
Ephedrae Herba (Mahuang, 麻黄) [removed nodes] liang (6), Cinnamomi Ramulus (Guizhi, 桂枝) liang (2), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [honey-fried] liang (2), Armeniacae Semen Amarum (Xingren, 杏仁) [peeled and tip removed] pieces (40), Zingiberis Rhizoma Recens (Shengjiang, 生姜) [sliced] liang (3), Jujubae Fructus (Dazao, 大枣) [broken open] pieces (12), Gypsum Fibrosum (Shigao, 石膏) [crushed, wrapped in silk] size of a chicken egg.
The above seven ingredients are decocted with nine sheng (approx. 1800 ml) of water. First, boil Ephedrae Herba until the volume reduces by two sheng, skim off the foam on the surface, then add the remaining herbs. Decoct to obtain three sheng (approx. 600 ml) of liquid, strain out the dregs, and take one sheng (approx. 200 ml) warm. The goal is to achieve a slight perspiration. If sweating is excessive, apply warm powder to the body. If perspiration occurs after the first dose, discontinue subsequent doses. If administered again, excessive sweating may lead to the loss of Yang Qi (vital energy), resulting in deficiency, aversion to wind, irritability, and insomnia.
[Formula Analysis]
Named "Da Qing Long Tang" (Major Blue Dragon Decoction), it derives its name from the imagery of the dragon raising clouds and rain. Treatment for Wind pathogen relies primarily on Cinnamomi Ramulus, while treatment for Cold pathogen relies primarily on Ephedrae Herba. By combining Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction) into this formula, it serves as the principal agent for injuries caused by both Wind and Cold simultaneously. Since both syndromes present with anhidrosis (absence of sweating), Paeoniae Radix Alba (Baishao, 白芍) is omitted to avoid its astringent properties; since both syndromes feature irritability (Fan Zao, 烦躁), Gypsum Fibrosum is added to clear heat. If irritability were absent, Mahuang Guizhi Ge Ban Tang (Half-Mahalf-Guizhi Decoction) would be appropriate instead. Zhang Zhongjing’s inclusion of a major cold herb with acrid and sweet flavors in exterior-resolving formulas indicates that in Mahuang Tang syndrome, the fever is entirely at the exterior level, whereas in Da Qing Long Tang syndrome, the irritability implies heat extending into the muscle layer. Using Gypsum Fibrosum early in Taiyang disease (Taiyang Bing, 太阳病) is because its acrid nature resolves muscle heat, its cold nature clears Stomach fire, and its sweet nature generates fluids, thereby pre-emptively protecting the Yangming channel and preserving body fluids. Inexperienced physicians, suspecting and fearing this approach, fail to use it when indicated, inevitably leading to heat binding in Yangming, manifesting as macules, jaundice, mania, and delirium, with various complications arising. Observing this, one can understand that Gypsum Fibrosum is a crucial herb for treating Wind-stroke and Cold damage; thus, combined with Ephedrae Herba and Cinnamomi Ramulus, it earns the name "Qing Long" (Blue Dragon), and combined with Glycyrrhizae Radix et Rhizoma, it bears the title "Bai Hu" (White Tiger). After administration, slight perspiration is sought; if sweating is excessive, apply warm powder. Obtaining sweat after one dose necessitates stopping further doses, warning that even for indications requiring diaphoresis, excessive sweating must be avoided. Therefore, Zhang Zhongjing omits Ephedrae Herba from Guizhi Tang to prevent excessive diaphoresis, but includes Cinnamomi Ramulus in Mahuang Tang to prevent uncontrolled sweating. Failure to adhere strictly to these methods results in excessive sweating and loss of Yang Qi, generating various adverse conditions. The exterior becomes deficient and unable to withstand Wind; Yin excess repels Yang, causing intensified irritability and insomnia.
[Collected Explanations]
Xu Shuwei stated: Zhang Zhongjing’s treatment of Cold Damage (Shanghan, 伤寒) involves three main approaches: first Guizhi Tang, second Mahuang Tang, third Qing Long Tang. Guizhi Tang treats Wind, Mahuang Tang treats Cold, and Qing Long Tang treats both Wind and Cold. Regardless of the time of onset, if applied to patients whose pulse and symptoms correspond, recovery is immediate. While many can recite this principle today, few understand the rationale behind the ancients' prescription and medication choices, leading to widespread reluctance to use it, which is hardly surprising.
Wu Shou stated: Da Qing Long Tang treats Cold Damage presenting with fever, aversion to cold, anhidrosis, irritability, and a floating-tight or floating-rapid pulse. Urgent application of this decoction to induce sweating leads to cure, representing Zhang Zhongjing’s brilliant method. It is akin to extreme heat being cooled instantly by rain. Those who do not grasp this principle and administer cold-cooling herbs upon seeing restlessness and heat cause immeasurable harm. Conversely, if the pulse is weak, there is sweating, and aversion to wind, this formula is contraindicated; misuse causes significant harm. Hence, due to uncertainty in pulse and symptom differentiation, many hesitate to use it.
A floating and tight pulse indicates that floating represents Wind and tight represents Cold. Wind injures Wei Qi (Defensive Qi), and Cold injures Ying Blood (Nutritive Blood). When both Ying and Wei are diseased, causing severe bone and joint pain, diaphoresis should be induced, but purgation is contraindicated.
[Annotation]
This section elucidates the concept of simultaneous injury by Wind and Cold, affecting both Ying and Wei. A floating pulse is characteristic of Wind pathogen; Wind is Yang, and Wei Qi is Yang. A tight pulse is characteristic of Cold pathogen; Cold is Yin, and Ying Blood is Yin. They injure according to their respective natures. Ying and Wei disease with severe bone and joint pain constitutes the pulse and symptom indication for Da Qing Long Tang to induce sweating. Although fever and irritability are present, the heat resides in the muscles, not the Stomach, so purgation is contraindicated.
@@@
In Taiyang disease, if diaphoresis fails to resolve the condition, and the patient still has fever, palpitations in the epigastric region, vertigo, tremors of the body muscles, and a sensation of trembling and swaying as if about to fall to the ground, Zhen Wu Tang (True Warrior Decoction) is the primary treatment.
[Annotation]
This passage elaborates on the first article, demonstrating methods to rescue adverse conditions. The first article discusses erroneous sweating, while this one discusses excessive sweating; they illuminate each other through parallel text. Both syndromes belong to the category of Yang Qi depletion; therefore, Zhen Wu Tang is used in both cases to support Yang, suppress Yin, and rescue the adverse condition. Profuse sweating with persistent fever indicates Yang Qi escaping to the exterior; palpitations described as "zhuzhu" (throbbing) indicate Yang deficiency failing to maintain interior stability; vertigo (dizziness and blurred vision) indicates Yang Qi weakness and failure of Qi to ascend; body muscle tremors indicate Yang deficiency leading to fluid exhaustion and lack of nourishment to the meridians. "Zhen song" refers to shaking; "zhen zhen yu pi di" describes continuous trembling where the patient cannot rise and feels like falling, indicating Yang deficiency and insufficient Qi and strength to support the body.
[Collected Annotations]
Zhang Lu stated: This establishes the treatment for complications arising from the erroneous use of Da Qing Long Tang. Although sweating is profuse, fever persists, indicating that pathogens remain while Zheng Qi (Upright Qi) is severely damaged. Furthermore, interior deficiency causes palpitations, upper deficiency causes vertigo, and meridian deficiency causes muscle twitching. Whole-body trembling and swaying are all signs of Yang Qi depletion. Thus, Zhen Wu Tang is used to secure the foundation and stabilize the situation.
Wang Hu stated: One might ask, if the pathology is no longer in the exterior, why is Zingiberis Rhizoma Recens included in the formula? The illness arises from excessive sweating. Although there is no constrained heat to release, internal and external Cold pathogens may still exist. Zingiberis Rhizoma Recens is used to provide warmth while facilitating mild dispersion.