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.
桂枝一两十七铢 芍药一两六铢 麻黄 ( 去节 ) 十六铢 甘草一两
二铢 杏仁 ( 去皮, 尖 ) 十六个 生姜一两六铢 大枣 ( 擘 ) 五
枚,右七味, 以水五升, 先煮麻黄一, 二沸, 去上沫, 纳诸药, 煮取
二升, 去滓, 温服一升, 日再服.
【注】服桂枝汤大汗出, 脉洪大不解, 若烦渴者, 则表邪已入阳明,
白虎汤证也. 今脉虽洪大而不烦渴, 则为表邪仍在太阳, 故与桂枝汤
如前法也. 若脉不洪大, 壮热亦减, 惟寒热如疟, 日再发者, 虽属轻
邪,然终为微寒所持, 非汗出必不解也, 宜桂枝二麻黄一汤, 稍发营
卫之汗. 不用麻黄桂枝各半汤者, 盖因已大汗出, 不欲其发营卫汗,
欲其和营卫汗也.
太阳病, 发热恶寒, 热多寒少. 脉微弱者,
此无阳也, 不可更汗. 宜桂枝二越婢一汤.
桂枝一两六铢 芍药一两 甘草 ( 炙 ) 一两三铢 石膏二十四铢
麻黄十六铢 大枣 ( 擘 ) 五枚 生姜 ( 切 ) 一两六铢, 右七味,
以水五升, 煮麻黄一, 二沸, 去上沫, 纳诸药, 煮取二升, 去滓, 温
服一升, 日再服. 本方当裁为越婢汤, 桂枝汤, 各饮一升, 今合为一
方,桂枝二越婢一汤.
【注】桂枝二越婢一汤, 即大青龙以杏仁易芍药也. 名虽越婢辅桂枝
,实则大青龙之变制也. 去杏仁恶其从阳而辛散. 用芍药以其走阴而
酸收. 以此易彼, 裁而用之, 则主治不同也. 以桂枝二主之, 则不发
汗,可知越婢一者, 乃麻黄石膏二物. 不过取其辛凉之性, 佐桂枝二
中和表而清热, 则是寓微汗于不发之中亦可识也. 非若大青龙以石膏
佐麻黄, 而为发汗驱热之重剂也. 桂枝二麻黄一汤, 治若形如疟, 日
再发者, 汗出必解, 而无热多寒少, 故不用石膏之凉也. 桂枝麻黄各
半汤, 治如疟状, 热多寒少, 而不用石膏更倍麻黄者, 以其面有沸郁
热色, 身有皮肤作痒, 是知热不向里而向表, 令得小汗以顺其势, 故
亦不用石膏之凉里也. 桂枝二越婢一汤, 治发热恶寒, 热多寒少, 而
用石膏者, 以其表邪寒少, 肌里热多, 故用石膏之凉, 佐麻桂以和营
卫,非发营卫也. 今人一见麻桂, 不问轻重, 亦不问温覆不温覆, 取
汗不取汗, 总不敢用. 皆因未究仲景之旨. 麻桂只是营卫之药. 若重
剂温覆取汗, 则为发营卫之药; 轻剂不温覆取汗, 则为和营卫之药也
.
服用桂枝汤后，大汗出，脉象洪大的，按照之前的方法继续给予桂枝汤。如果症状像疟疾一样，一天发作两次，出汗后必然痊愈，适宜使用桂枝二麻黄一汤。
桂枝一两十七铢，芍药一两六铢，麻黄（去节）十六铢，甘草一两二铢，杏仁（去皮、尖）十六个，生姜一两六铢，大枣（掰开）五枚。以上七味药，用水五升，先煮麻黄一至两沸，去掉上面的浮沫，加入其他药物，煮取二升，滤去药渣，温服一升，每天服用两次。
【注解】服用桂枝汤后大汗出，脉象洪大但病证未解，如果出现烦躁口渴，说明表邪已经传入阳明经，属于白虎汤证。现在脉象虽然洪大但没有烦躁口渴，说明表邪仍然在太阳经，所以按照之前的方法给予桂枝汤。如果脉象不洪大，壮热也减轻，只是寒热往来像疟疾一样，一天发作两次，这虽然属于轻浅的邪气，但最终仍被微寒所束缚，不出汗必然不能痊愈，适宜使用桂枝二麻黄一汤，稍微发一点营卫之汗。不使用桂枝麻黄各半汤的原因，是因为已经大汗出，不希望它强烈发散营卫之汗，而是希望调和营卫之汗。
太阳病，发热恶寒，热多寒少。脉象微弱的，这是阳气不足，不可以再次发汗。适宜使用桂枝二越婢一汤。
桂枝一两六铢，芍药一两，甘草（炙）一两三铢，石膏二十四铢，麻黄十六铢，大枣（掰开）五枚，生姜（切）一两六铢。以上七味药，用水五升，煮麻黄一至两沸，去掉上面的浮沫，加入其他药物，煮取二升，滤去药渣，温服一升，每天服用两次。本方应当裁减为越婢汤和桂枝汤，各饮一升，现在合为一个方剂，称为桂枝二越婢一汤。
【注解】桂枝二越婢一汤，就是大青龙汤用芍药替换杏仁而成。名字虽然叫越婢辅助桂枝，实际上是大青龙汤的变制方。去掉杏仁是厌恶它从阳而辛散的特性。使用芍药是因为它走阴而酸收的特性。用这个替换那个，裁剪后使用，主治功效就不同了。以桂枝二为主，就不会发汗，可知越婢一指的是麻黄和石膏两味药。不过是取其辛凉的性质，佐助桂枝二来调和表邪并清热，这样就能明白寓微汗于不发之中了。不像大青龙汤用石膏佐助麻黄，作为发汗驱热的重剂。桂枝二麻黄一汤，治疗像疟疾一样，一天发作两次的情况，出汗后必然痊愈，而没有热多寒少的症状，所以不用石膏的凉性。桂枝麻黄各半汤，治疗像疟疾状，热多寒少，而不用石膏且更倍加麻黄，是因为患者面部有郁热之色，身体皮肤作痒，由此可知热势不向里而向表，令其得小汗以顺应病势，所以也不用石膏的凉里作用。桂枝二越婢一汤，治疗发热恶寒，热多寒少，而使用石膏，是因为表邪寒少，肌理内部热多，所以用石膏的凉性，佐助麻黄、桂枝来调和营卫，而不是发散营卫。现在的人一见麻黄、桂枝，不问剂量轻重，也不问是否温覆取汗，总是不敢使用。这都是因为没有探究张仲景的本意。麻黄、桂枝只是调和营卫的药物。如果是重剂并温覆取汗，就是发散营卫的药物；如果是轻剂且不温覆取汗，就是调和营卫的药物。
After taking Guizhi Tang (Cinnamon Twig Decoction), if profuse sweating occurs and the pulse is flooding (Hongda), administer Guizhi Tang (Cinnamon Twig Decoction) according to the previous method. If the condition resembles malaria, occurring twice a day, it will resolve with sweating; Gui Zhi Er Ma Huang Yi Tang (Two Parts Cinnamon Twig and One Part Ephedra Decoction) is appropriate.
Guizhi (Cinnamon Twig) 1 liang 17 zhu, Shaoyao (White Peony Root) 1 liang 6 zhu, Mahuang (Ephedrae Herba, de-jointed) 16 zhu, Gancao (Licorice Root) 1 liang 2 zhu, Xingren (Prunus Armeniaca Seed, skin and tip removed) 16 pieces, Shengjiang (Fresh Ginger) 1 liang 6 zhu, Dazao (Jujube Fruit, broken open) 5 pieces. The above seven ingredients are boiled in five sheng of water. First, boil Mahuang (Ephedrae Herba) for one or two boils, remove the foam on the surface, then add the remaining herbs. Boil until two sheng remain, strain, and take one sheng warm, twice daily.
[Annotation] After taking Guizhi Tang (Cinnamon Twig Decoction), if profuse sweating occurs and the pulse is flooding but the syndrome does not resolve, and if irritability and thirst appear, it indicates that the exterior pathogen has entered the Yangming channel, which is a Baihu Tang (White Tiger Decoction) syndrome. Now, although the pulse is flooding, there is no irritability or thirst, indicating that the exterior pathogen remains in the Taiyang channel. Therefore, Guizhi Tang (Cinnamon Twig Decoction) is administered according to the previous method. If the pulse is not flooding, high fever also subsides, and only chills and fever resembling malaria occur twice a day, this, although belonging to mild pathogens, ultimately remains constrained by slight cold. It will not resolve without sweating. Gui Zhi Er Ma Huang Yi Tang (Two Parts Cinnamon Twig and One Part Ephedra Decoction) is appropriate to slightly induce sweating from the Ying and Wei levels. Guizhi Mahuang Ge Ban Tang (Equal Parts Cinnamon Twig and Ephedra Decoction) is not used because profuse sweating has already occurred; we do not wish to strongly disperse Ying and Wei sweating, but rather to harmonize Ying and Wei sweating.
In Taiyang disease, if there is fever and aversion to cold, with more heat than cold, and the pulse is faint, this indicates a deficiency of Yang (Wei Qi). Sweating should not be induced again. Gui Zhi Er Yue Bi Yi Tang (Two Parts Cinnamon Twig and One Part Yuebi Decoction) is appropriate.
Guizhi (Cinnamon Twig) 1 liang 6 zhu, Shaoyao (White Peony Root) 1 liang, Gancao (Licorice Root, honey-fried) 1 liang 3 zhu, Shigao (Gypsum Fibrosum) 24 zhu, Mahuang (Ephedrae Herba) 16 zhu, Dazao (Jujube Fruit, broken open) 5 pieces, Shengjiang (Fresh Ginger, sliced) 1 liang 6 zhu. The above seven ingredients are boiled in five sheng of water. First, boil Mahuang (Ephedrae Herba) for one or two boils, remove the foam on the surface, then add the remaining herbs. Boil until two sheng remain, strain, and take one sheng warm, twice daily. This formula should theoretically be divided into Yuebi Tang (Yuebi Decoction) and Guizhi Tang (Cinnamon Twig Decoction), each taken as one sheng. Now combined into one formula, it is called Gui Zhi Er Yue Bi Yi Tang (Two Parts Cinnamon Twig and One Part Yuebi Decoction).
[Annotation] Gui Zhi Er Yue Bi Yi Tang (Two Parts Cinnamon Twig and One Part Yuebi Decoction) is essentially Da Qing Long Tang (Great Blue Dragon Decoction) with Xingren (Prunus Armeniaca Seed) replaced by Shaoyao (White Peony Root). Although named "Yuebi assisting Guizhi," it is actually a modified version of Da Qing Long Tang (Great Blue Dragon Decoction). Xingren (Prunus Armeniaca Seed) is removed because its acrid-dispersing nature tends to follow Yang. Shaoyao (White Peony Root) is used because its sour-astringent nature enters Yin. By substituting one for the other and adjusting the dosage, the primary indication changes. With Guizhi (Cinnamon Twig) as the major component (two parts), it does not induce sweating. Thus, "Yuebi one part" refers to Mahuang (Ephedrae Herba) and Shigao (Gypsum Fibrosum). It merely utilizes their acrid-cool properties to assist Guizhi (Cinnamon Twig) in harmonizing the exterior and clearing heat. This reveals that slight sweating is contained within non-sweating action. It is not like Da Qing Long Tang (Great Blue Dragon Decoction), where Shigao (Gypsum Fibrosum) assists Mahuang (Ephedrae Herba) as a heavy agent for inducing sweating and driving out heat. Gui Zhi Er Ma Huang Yi Tang (Two Parts Cinnamon Twig and One Part Ephedra Decoction) treats conditions resembling malaria occurring twice a day, resolving with sweating, but lacks the symptom of "more heat than cold"; therefore, the cooling property of Shigao (Gypsum Fibrosum) is not used. Guizhi Mahuang Ge Ban Tang (Equal Parts Cinnamon Twig and Ephedra Decoction) treats malaria-like symptoms with more heat than cold, using no Shigao (Gypsum Fibrosum) and doubling Mahuang (Ephedrae Herba), because the patient presents with flushed facial heat and pruritus of the skin, indicating that heat trends outward rather than inward. Allowing slight sweating follows this trend; thus, the internal-cooling property of Shigao (Gypsum Fibrosum) is also not used. Gui Zhi Er Yue Bi Yi Tang (Two Parts Cinnamon Twig and One Part Yuebi Decoction) treats fever and aversion to cold with more heat than cold, using Shigao (Gypsum Fibrosum) because exterior cold is slight while interior heat is abundant. Thus, the cooling property of Shigao (Gypsum Fibrosum) is used to assist Mahuang (Ephedrae Herba) and Guizhi (Cinnamon Twig) in harmonizing Ying and Wei, rather than dispersing them. Modern practitioners, upon seeing Mahuang (Ephedrae Herba) and Guizhi (Cinnamon Twig), often dare not use them regardless of dosage strength or whether warming covers are applied to induce sweating. This is due to a failure to investigate the intent of Zhang Zhongjing. Mahuang (Ephedrae Herba) and Guizhi (Cinnamon Twig) are merely herbs for harmonizing Ying and Wei. In heavy dosages with warming covers to induce sweating, they act as dispersants for Ying and Wei; in light dosages without warming covers, they act as harmonizers for Ying and Wei.