（仲景）
治太阳中风，脉浮紧，身疼痛，发热恶寒，不汗出而烦躁（成氏曰∶此中风见寒脉也。
浮为风，风伤卫；紧为寒，寒伤营；营卫俱病，故发热、恶寒、身痛也，烦为阳为风，躁为
阴为寒，风寒两伤，营卫俱实，故不出汗而烦躁也。仲景又曰∶若脉微弱、汗出恶风，不可
服此，服之则厥逆、筋惕肉 ，此为逆也。按此即少阴过汗亡阳之证，故仲景更立真武汤以
救其误）。又治伤寒脉浮数，身不痛但重，乍有轻时，无少阴证者（成氏曰∶此伤寒见风脉
也。伤寒者身痛，此风胜，故不痛；中风者身重，此兼寒，故有轻时。风寒外甚，故不吐利
厥逆，无少阴里证也。昂按∶成注非也，此汤必脉浮紧浮数，烦躁无汗，方可服之。仲景恐
少阴烦躁而误服此则逆，故加无少阴证一句。大法太阳烦躁宜汗，阳明烦躁宜下，阴证烦躁
宜温）。
麻黄（六两） 桂枝 甘草（二两。炙） 杏仁（四十枚。去皮尖） 石膏（鸡子大块）
生姜
此足太阳药也。成氏曰∶桂枝主中风，麻黄主伤寒，今风寒两伤，欲以桂枝解肌驱风，
而不
桂枝
杏仁甘苦，佐麻黄以发表；大枣甘温，生姜辛温，佐桂枝以解肌（姜枣又能行脾之津液而和
营卫）。营卫阴阳俱伤，则非轻剂所能独解，必须重轻之剂同散之，乃得阴阳之邪俱已，营
卫俱和，石膏辛甘微寒质重，而又专达肌表，为使也（风寒外盛，人身之阳必郁而为热。石
膏体重泻热，气轻解肌，故云重轻之别。足太阳膀胱经表病也，而表有营卫之不同，病有风
寒之各异。仲景治分三证，桂枝解肌驱风，麻黄发汗散寒，青龙风寒两解，各分疆界，鼎足
三大纲也。按大青龙为发汗之重剂，陶节庵曰∶此汤险峻，须风寒俱甚，又加烦躁，乃可与
之。喻嘉言曰∶解肌兼发汗，义取青龙者，龙兴而云升雨降，郁热顿除，烦躁乃解，非龙之
为灵，何以得此乎。青龙汤为太阳无汗而设，与麻黄证何异，因兼烦躁一证，烦为风，躁为
寒，非此法不解也。然不汗出之烦躁，与发汗后之烦躁迥别；下后之烦躁，与未下之烦躁亦
殊。若少阴烦躁而误服此，则有亡阳之变矣。又曰∶石膏一物，入甘温队中则为青龙，从清
凉同气则为白虎，夫风寒皆伤，宜从辛甘发散矣；而表里又俱热，则温热不可用，欲并风寒
表里之热而俱解之，故立白虎一法，以辅青龙之不逮也。按∶烦躁有在表者，此证不汗出而
烦躁是也；有在里者，不大便而烦躁是也；有阳虚者，汗下后病不去而烦躁是也；有阴盛者，
少阴病吐利厥逆、烦躁欲死是也。内热曰烦，为有根之火；外热曰躁，为无根之火；故但躁
不烦，
（张仲景）治疗太阳中风证，表现为脉象浮紧，身体疼痛，发热且恶寒，无汗并伴有烦躁不安。（成无己注解说：这是中风病却出现了寒邪的脉象。浮脉主风，风邪损伤卫气；紧脉主寒，寒邪损伤营气；营气和卫气都受病，所以出现发热、恶寒、身体疼痛的症状。“烦”属阳，由风邪引起；“躁”属阴，由寒邪引起。风寒两邪同时伤人，导致营卫俱实，因此不出汗而烦躁。张仲景又说：如果脉象微弱、有汗出且怕风，不可服用此方，若误服则会导致四肢厥冷、筋肉跳动抽搐，这属于逆治。按：这就是少阴病因过汗导致亡阳的证候，所以张仲景另外设立真武汤来救治这种误治）。又治疗伤寒病，脉象浮数，身体不痛只是沉重，偶尔感觉轻减，且没有少阴病证候的（成无己注解说：这是伤寒病却出现了风邪的脉象。伤寒病通常身体疼痛，此处因风邪偏胜，所以不痛；中风病通常身体沉重，此处兼夹寒邪，所以症状有时减轻。风寒在体表很盛，所以不会出现呕吐腹泻和四肢厥冷，也没有少阴病的里证。汪昂按：成无己的注解不对，此方必须见到脉象浮紧或浮数，且有烦躁、无汗的症状，才可以服用。张仲景担心如果是少阴病的烦躁而误服此方会造成危害，所以加上“无少阴证”这一句。大凡太阳病的烦躁适宜用发汗法，阳明病的烦躁适宜用攻下法，阴证的烦躁适宜用温补法）。
麻黄（六两） 桂枝 甘草（二两。炙） 杏仁（四十枚。去皮尖） 石膏（如鸡蛋大小的块状） 生姜
此药属于足太阳膀胱经的药物。成无己说：桂枝主治中风，麻黄主治伤寒，如今风寒两邪同时伤人，想用桂枝解肌驱散风邪，而不（使用麻黄单独发散？原文此处似有脱漏，依文意推测为配合使用），杏仁味辛甘苦，辅助麻黄以发表邪；大枣味甘性温，生姜味辛性温，辅助桂枝以解肌（姜和大枣又能运行脾脏的津液从而调和营卫）。如果营卫阴阳都受伤，那么轻剂的药力不能单独解决，必须用重剂与轻剂配合共同发散，才能使阴阳之邪都消除，营卫调和。石膏味辛甘微寒，质地沉重，而又专门直达肌表，作为使药（风寒在体表强盛，人体的阳气必然郁结而产生热。石膏体重能泻热，气轻能解肌，所以说有重剂和轻剂的区别。足太阳膀胱经受表病，但表证有营卫的不同，疾病有风寒的差异。张仲景治疗分为三种证型，桂枝解肌驱风，麻黄发汗散寒，大青龙汤风寒两解，各分界限，如同鼎之三足，是三大纲领。按：大青龙汤是发汗的重剂，陶节庵说：此汤险峻，必须风寒都很严重，再加上烦躁症状，才可以给予服用。喻嘉言说：解肌兼发汗，取义于青龙，龙兴则云升雨降，郁热顿时清除，烦躁得以解除，如果不是龙的灵性，怎么能达到这种效果呢。青龙汤是为太阳病无汗而设立的，与麻黄汤证有什么不同？因为兼有烦躁一证，烦由风引起，躁由寒引起，不用此法不能解除。然而不出汗引起的烦躁，与发汗后的烦躁截然不同；下法后的烦躁，与未下法的烦躁也有区别。如果是少阴病的烦躁而误服此方，就会有亡阳的变化。又说：石膏一味药，进入甘温的药队中就成为青龙汤（的一部分），跟随清凉同气的药物则成为白虎汤（的一部分）。既然风寒都受伤，应该从辛甘发散的角度考虑；但如果表里都有热，那么温热药不可用，想要一并解除风寒表里之热，所以确立白虎汤一法，以辅助青龙汤的不足。按：烦躁有在体表的，此证不出汗而烦躁就是；有在体内的，不大便而烦躁就是；有阳虚的，汗法和下法后病不去而烦躁就是；有阴盛的，少阴病呕吐腹泻四肢厥冷、烦躁欲死就是。内热称为烦，是有根的火；外热称为躁，是无根的火；所以只有躁而没有烦，
(Zhang Zhongjing) Treats Taiyang Wind-Strike syndrome, characterized by a floating and tight pulse, body pain, fever with aversion to cold, anhidrosis (absence of sweating), and irritability/restlessness. (Cheng Wuji notes: This is Wind-Strike presenting with Cold pulses. A floating pulse indicates Wind, which injures the Wei (Defensive) Qi; a tight pulse indicates Cold, which injures the Ying (Nutritive) Qi. Since both Ying and Wei are diseased, fever, aversion to cold, and body pain occur. "Fan" (irritability) is Yang and caused by Wind; "Zao" (restlessness) is Yin and caused by Cold. When both Wind and Cold injure the body, causing Ying and Wei to be full/excess, anhidrosis and irritability/restlessness result. Zhang Zhongjing also states: If the pulse is weak and faint, with sweating and aversion to wind, this formula must not be used. Misuse will lead to limb reversal (cold extremities), tendon twitching, and muscle fasciculation, which constitutes a therapeutic error. Note: This corresponds to the syndrome of Yang depletion due to excessive sweating in Shaoyin disease, so Zhang Zhongjing established Zhenwu Tang to remedy such errors). It also treats Shanghan (Cold Damage) with a floating and rapid pulse, where the body is heavy but not painful, occasionally feeling lighter, provided there are no Shaoyin symptoms. (Cheng Wuji notes: This is Shanghan presenting with Wind pulses. Shanghan typically involves body pain; here, Wind is predominant, hence no pain. Wind-Strike typically involves body heaviness; here, it is complicated by Cold, hence symptoms fluctuate. With severe external Wind-Cold, there is no vomiting, diarrhea, or limb reversal, nor any interior Shaoyin syndrome. Wang Ang's note: Cheng's annotation is incorrect. This formula should only be administered when the pulse is floating-tight or floating-rapid, accompanied by irritability/restlessness and anhidrosis. Zhang Zhongjing added "no Shaoyin syndrome" to prevent misdiagnosis of Shaoyin irritability as Taiyang, which would be harmful. Generally, irritability in Taiyang is treated with diaphoresis; in Yangming, with purgation; and in Yin syndromes, with warming).
Mahuang (Ephedrae Herba, 6 liang) Guizhi (Cinnamomi Ramulus) Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang, honey-fried) Xingren (Armeniacae Semen Amarum, 40 seeds, skin and tip removed) Shigao (Gypsum Fibrosum, size of a chicken egg) Shengjiang (Zingiberis Rhizoma Recens)
This prescription belongs to the Foot-Taiyang Bladder channel. Cheng Wuji states: Guizhi treats Wind-Strike, Mahuang treats Shanghan. Now that both Wind and Cold injure the body, Guizhi is used to release the muscle layer and expel Wind, while... [text fragment] Xingren, with acrid, sweet, and bitter properties, assists Mahuang to release the exterior; Dazao, with sweet and warm properties, and Shengjiang, with acrid and warm properties, assist Guizhi to release the muscle layer (Ginger and Jujube can also circulate Spleen fluids to harmonize Ying and Wei). If Ying, Wei, Yin, and Yang are all injured, light agents alone cannot resolve the condition; heavy and light agents must be combined to disperse the pathogens, thereby eliminating Yin-Yang evils and harmonizing Ying and Wei. Shigao, with acrid, sweet, and slightly cold properties and heavy substance, specifically reaches the muscle layer, serving as the guiding herb (When external Wind-Cold is strong, human Yang Qi inevitably stagnates and generates heat. Shigao's heavy weight clears heat, and its light qi releases the muscle layer, hence the distinction between heavy and light agents. The Foot-Taiyang Bladder channel suffers from exterior diseases, yet the exterior differs in Ying-Wei status, and diseases differ in Wind-Cold nature. Zhang Zhongjing divides treatment into three syndromes: Guizhi releases the muscle layer and expels Wind; Mahuang induces sweating and disperses Cold; Da Qing Long Tang resolves both Wind and Cold. They have distinct boundaries, forming the tripod of three major principles. Note: Da Qing Long Tang is a heavy diaphoretic agent. Tao Jian'an says: This decoction is dangerous and峻烈 (pungent/strong); it should only be given when both Wind and Cold are severe and accompanied by irritability/restlessness. Yu Jiayan says: Releasing the muscle layer combined with inducing sweating takes its meaning from the Azure Dragon; when the dragon rises, clouds ascend and rain falls, clearing stagnant heat instantly and resolving irritability. How else could this be achieved without the dragon's spirit? Qing Long Tang is established for Taiyang anhidrosis, differing little from Mahuang Tang syndrome, except for the additional symptom of irritability/restlessness. Fan is caused by Wind, Zao by Cold; this method is required for resolution. However, irritability/restlessness due to anhidrosis is distinctly different from that after sweating; irritability/restlessness after purgation differs from that before purgation. If Shaoyin irritability/restlessness is mistakenly treated with this, it leads to Yang depletion. Furthermore: Gypsum, when entering a group of sweet-warm herbs, becomes part of Qing Long Tang; when paired with cool-cold herbs, it becomes part of Bai Hu Tang. Since both Wind and Cold injure the body, one should follow acrid-sweet dispersal methods; but if exterior and interior are both hot, warm-hot herbs are contraindicated. To resolve both Wind-Cold exterior-interior heat simultaneously, Bai Hu Tang was established to supplement the insufficiency of Qing Long Tang. Note: Irritability/restlessness can be in the exterior (this case: anhidrosis with irritability/restlessness); in the interior (constipation with irritability/restlessness); due to Yang deficiency (illness persists after sweating/purgation with irritability/restlessness); or due to Yin excess (Shaoyin disease with vomiting, diarrhea, limb reversal, and extreme irritability/restlessness). Internal heat is called "Fan," representing rooted fire; external heat is called "Zao," representing unrooted fire. Therefore, if there is only Zao without Fan,