（仲景）
治太阳中风，阳浮而阴弱，发热头痛，自汗，恶风恶寒，鼻鸣干呕（关前为阳，卫亦阳，
阳以
于风
强，
属表
风壅
伤寒
表未解也，可发汗（脉迟汗多属阳明证，以微恶寒尚兼太阳，仍当从外解肌，断其入胃腑之
路）。
桂枝 芍药 生姜（三两） 甘草（二两。炙） 大枣（十二枚。）热服。须臾啜稀热
粥，以
者，更作服。
此足太阳药也。仲景以发汗为重，解肌为轻，中风不可大汗，汗过则反动营血，虽有表
邪，
以酸
温能散（散寒止呕），枣甘温能和，此不专于发散，又以行脾之津液而和营卫者也。麻黄汤
专于发散，故不用姜枣，而津液得通矣（庞安时曰∶若无汗、小便数，或手足逆、身冷、不
恶寒、反恶热者，慎不可用。又自汗、小便数者，不可服。自汗为阳虚，小便数为下焦虚寒，
初病表里俱虚，病不在表，服此重汗，竭其津液，是虚虚也。经曰∶脉浮紧、发热、汗不出
者，不可与。脉紧为伤寒，与之则表益实而汗愈难出矣。《伤寒例》曰∶桂枝下咽，阳盛则
毙；承气入胃，阴盛则亡。周扬俊曰∶风既伤卫，则卫气疏，不能内护于营。而汗自出矣。
汗者，血之液也，苟非用血药，以桂枝和营散邪，以芍药护营固里，则不但外邪不出，且入
而为里患矣。然后知和营则外邪出，邪出则卫自密，更不必用固表之药，而汗自止矣。仲景
曰∶病常自汗出者，此为营气和，营气和者外不谐，以卫气不共营气和谐故耳，以营行脉中，
卫行脉外，复发其汗，营卫和则愈，宜桂枝汤。王好古曰∶或问桂枝止烦出汗，仲景治伤寒
发汗数处皆用桂枝汤，又曰无汗不得用桂枝，汗多者桂枝甘草汤，此又能闭汗也。二义相通
否乎？曰∶仲景云，太阳病发热汗出者，此为营弱卫强，阴虚阳必凑之，故用桂枝发其汗，
此乃调其营气，则卫气自和，风邪无所容，遂自汗而解，非若麻黄能开腠理发出其汗也。汗
多用桂枝者，以之调和营卫，则邪从汗出，而汗自止，非桂枝能闭汗孔也。
李东垣曰∶仲景治表虚制此汤，用桂枝为君，桂枝辛热发散，体轻助阳，芍药、甘草佐
之；若腹中急痛，乃制小建中汤，以芍药为君，芍药酸寒主收补中，桂枝、甘草佐之；一治
表虚，一治里虚。又曰∶以桂枝易肉桂；治感寒腹痛之神药；如中热腹痛，去桂加黄芩。许
叔微曰∶仲景一百一十三方，桂枝独冠其首，今人全不用，何也。昂按∶仲景治伤寒，用麻
黄、桂枝，而全不用羌活、防风，是古人亦有所未备也。故洁古制羌活汤、黄 汤、川芎汤，
海藏制神术散、白术汤，皆用羌活、防风以代之。黄 汤、川芎汤附补门。神术散、白术汤
见后。）
本方加白术、川芎、羌活、防风、饴糖，名疏邪实表汤（节庵）∶治同（陶氏制此，以
白术为君，以代桂枝汤。喻嘉言曰∶坐令外感内伤，混同论治矣。昂按∶节庵之君白术，亦
仿洁古之黄 汤，海藏之白术汤而来。又按∶节庵所着《伤寒六书》尽易仲景原方，参合后
贤治法，以代桂枝、麻黄、葛根、青龙等剂，在后人诚为便用，故世之嗜节庵者胜于仲景，
以节庵为快捷方式，以仲景为畏途，节庵之书行，而仲景之书晦，如节庵者，可谓洁古、海藏辈
之功臣，而在长沙实为操莽也。本集采节庵方论颇多，然不能无遗议者，以节庵之功罪，不
妨互见于世也）。本方去芍药、生姜，名桂枝甘草汤（仲景）∶治发汗过多，叉手冒心，心下
悸欲得按者（汗多则亡阳而耗血，故心虚悸而叉手自冒也。桂枝益气固表，甘草补中助阳。）
本方加附子，名桂枝加附子汤（仲景）∶治太阳病发汗，遂漏不止，恶风，小便难，四肢微
急（汗多亡阳，无以卫外，故恶风；汗多则便自少，兼膀胱无阳，不能化气，故便难；汗多
则无液以养筋，兼有风入而增其劲，故四肢微急；与桂枝汤以和营卫，加附子以助元阳）。
本方去芍药，加附子，名桂枝附子汤仲景∶治伤寒（八九日，风湿相搏身体痛烦，不能转侧，
不呕不渴，脉浮虚而涩八九日再经之时，邪多在里。而复身体痛烦者，风湿相搏也。烦，风
也；痛，湿也；不呕不渴，里无邪也，故知风湿相搏脉浮，风也；涩，湿也，浮而涩，知寒
湿但在经。与桂枝汤以解表风。加附子以散寒湿）。本方加芍药、生姜各一两、人参三两，
名桂枝新加汤（仲景）∶治伤寒汗后身痛，脉来沉迟（沉迟，汗后血虚也，正气虚矣，外邪
岂能出乎，与桂枝汤以解未尽之邪，加芍药、人参敛阴以益营血）。本方减甘草一半，加芍
药一倍，名桂枝加芍药汤（仲景）∶治太阳误下腹痛，属太阴证。表证未罢而误下，表邪乘
虚而入里，当作结胸，则仍属太阳经，今不胸满而腹满，是邪已入太阴经；然但腹满时痛，
尚非大实之痛，故但用桂枝以安太阳，倍芍药以和太阴。本方加大黄，名桂枝加大黄汤仲景∶
治表证误下，大实痛者别见表里门。本方去桂加茯苓、白术，名桂枝去桂加茯苓白术汤仲景∶
治服桂枝汤，或下之，仍头项强痛，发无汗，心满微痛，小便不利（表证未退，复增满痛便
秘，邪已内陷，故去桂枝表药不用，而用芍药、甘草以除痛，生姜以散满祛寒，白术、茯苓
以生津导水，合姜枣以和胃，安内即所以攘外也）。本方加浓朴、杏仁，名桂枝加浓朴杏仁
汤（仲景）∶治太阳病下之微喘，表未解也（桂枝汤以解表，杏朴以下逆气）。本方去芍药、
生姜，加茯苓，名茯苓桂枝甘草大枣汤，甘澜水煎（仲景）∶治汗后脐下悸，欲作奔豚（汗
后脐下悸者，心虚而肾气发动也。肾积名奔豚。肾气逆，欲上凌心，故用茯苓伐肾邪，桂枝
治奔豚，甘草、大枣助脾而平肾，益土以制水。甘澜水者，用瓢扬万遍，水性咸而重，扬之
则甘而轻，取其不助肾气也）。本方合麻黄汤，名桂麻各半汤（仲景）∶治太阳证如疟状，热
多寒少寒多为病进，热多为病退，阳胜阴也。本方二分，合麻黄汤一分，名桂枝二麻黄一汤
（仲景）∶治太阳病已大汗，形如疟，日再发（再发者为轻）。本方二分，合越婢一分，名桂
枝二越婢一汤（仲景）∶治太阳病发热恶寒，热多寒少，脉微弱者，此无阳也，不可发汗（喻
嘉言曰∶此风多寒少之证。无阳二字，仲景言之不一，后人置为阙疑，不知乃亡津液之通称
也，故以发汗为戒。然非汗，风寒终不解，故服桂枝之二以治风，越婢之一以治寒，方为合
法。方中行曰∶此即桂枝麻黄之合剂，乃大青龙以芍药易杏仁之变制耳）。本方倍芍药，加
饴糖，名小建中汤（仲景）；再加黄 ，名黄 建中汤（《金匮》，并见寒门）；除饴糖，名桂
枝加黄 汤（《金匮》昂按∶小建中以饴糖为君，除饴糖即不名建中矣。今人用建中者，绝
不用饴糖，何欤∶治黄汗发热，两胫自冷，身痛身重，腰上有汗，腰下无汗，小便不利此阳
通而阴不通，上下痞隔，故用黄 以固阳，桂枝以通阴，阴阳通、营卫和，则正汗出，小便
利，而诸证悉退矣。）小建中加当归，名当归建中汤（《千金》）∶治妇人产后虚羸不足，腹
中痛，引腰背，小腹拘急（寒伤血分）；若崩伤不止，加地黄、阿胶。本方除甘草，加黄
三两，名桂枝五物汤（《金匮》）∶治血痹（身体不仁，如风痹状）。本方加栝蒌根，名栝蒌桂
枝汤（《金匮》）∶治太阳证备，身强KT KT ，脉反沉迟，此为痉（庞安时曰∶栝蒌根不
主项强KT KT ，其意以肺热，不令移于肾也，加于桂枝汤中则可，以彻热荣筋，调和营
卫矣。KT 字无钩，音殊，羽短难飞之状）。本方加龙骨、牡蛎，名桂枝加龙骨牡蛎汤（《金
匮》）∶治男子失精，女子梦交（桂枝、生姜之辛以润之，甘草、大枣之甘以补之，芍药之酸
以收之，龙骨、牡蛎之涩以固之）。
（张仲景）
治疗太阳中风证，脉象浮取有力而沉取无力，出现发热、头痛、自汗出、怕风怕冷、鼻鸣、干呕的症状。（关前脉位属阳，卫气亦属阳，阳气因受风邪侵袭而强盛，属于表证。若风寒壅滞于体表，导致伤寒表证未解，可以采用发汗法治疗。但如果脉象迟缓且汗多，则属于阳明证；如果仍有轻微恶寒，说明仍兼有太阳表证，应当继续从外部解肌发表，切断病邪传入胃腑的路径。）
桂枝、芍药、生姜（三两）、甘草（二两，炙烤）、大枣（十二枚）。热服。服药后片刻，喝一些稀热的粥，以助药力。如果症状没有缓解，再按原法服用。
这是足太阳膀胱经的药物。张仲景认为发汗为重，解肌为轻。中风证不可大汗淋漓，汗出过多则会扰动营血，即使有表邪，也会因为酸收之性阻碍发散。温性能散寒止呕，枣味甘温能调和脾胃，此方不专门用于发散，而是通过运行脾的津液来调和营卫。麻黄汤专门用于发散，所以不用姜枣，但这样会导致津液不通畅。（庞安时说：如果没有汗、小便频数，或者手足逆冷、身体冷、不怕冷反而怕热的情况，千万不要使用。另外，自汗且小便频数的人，也不可以服用。自汗是阳气虚，小便频数是下焦虚寒，初病时表里都虚，病不在表，服用此方再次发汗，会耗尽津液，这是使虚者更虚的错误治法。经典记载：脉象浮紧、发热、无汗的人，不可以给予桂枝汤。脉紧属于伤寒，给予桂枝汤会使表邪更实，汗更难发出。《伤寒例》说：桂枝汤喝下去，如果体内阳热盛，会导致死亡；承气汤进入胃中，如果体内阴寒盛，会导致死亡。周扬俊说：风邪伤害了卫气，卫气疏松，不能在内保护营气，所以汗自然流出。汗是血的液体，如果不是用血分药物，用桂枝调和营气并疏散邪气，用芍药保护营气并固守里部，那么不仅外邪不能排出，而且邪气会内入成为里患。由此可知，调和营气则外邪排出，邪气排出则卫气自然密闭，更不需要用固表的药物，汗自然停止。张仲景说：病人经常自汗出的，这是因为营气平和，营气平和是因为外在不协调，由于卫气不与营气和谐所致，因为营气行于脉中，卫气行于脉外，再次发其汗，营卫和谐就好了，适宜用桂枝汤。王好古说：有人问桂枝既能止烦又能出汗，张仲景治疗伤寒发汗多处都用桂枝汤，又说无汗不得用桂枝，汗多时用桂枝甘草汤，这又能闭汗吗？这两种说法相通吗？回答说：张仲景说，太阳病发热汗出的，这是营弱卫强，阴虚阳必凑之，所以用桂枝发其汗，这是调理营气，则卫气自然和谐，风邪无处容身，于是自然汗出而解，不像麻黄能开泄腠理强行发出汗来。汗多用桂枝的，是用它来调和营卫，则邪气随汗而出，而汗自然停止，不是桂枝能关闭汗孔。
李东垣说：张仲景治疗表虚证制定此汤，用桂枝为君药，桂枝辛热发散，质地轻扬助阳，芍药、甘草作为佐药；如果腹中急痛，则制定小建中汤，以芍药为君药，芍药酸寒主收敛补中，桂枝、甘草作为佐药；一个治疗表虚，一个治疗里虚。又说：如果用桂枝代替肉桂，是治疗感寒腹痛的神药；如果是中热腹痛，去掉桂枝加上黄芩。许叔微说：张仲景的一百一十三首方剂中，桂枝汤独居首位，现在的人完全不用，为什么呢？汪昂按语：张仲景治疗伤寒，用麻黄、桂枝，而完全不用羌活、防风，这是古人也有不足之处。所以洁古先生制羌活汤、黄芪汤、川芎汤，海藏先生制神术散、白术汤，都用羌活、防风来替代它们。黄芪汤、川芎汤附在补益门。神术散、白术汤见后面。）
本方加入白术、川芎、羌活、防风、饴糖，名为疏邪实表汤（节庵）：治疗同前（陶氏制定此方，以白术为君药，用来替代桂枝汤。喻嘉言说：这使得外感和内伤混同论治了。汪昂按语：节庵以白术为君药，也是仿效洁古先生的黄芪汤、海藏先生的白术汤而来。又按语：节庵所著的《伤寒六书》完全改变了张仲景的原方，参合后世贤人的治法，用来替代桂枝、麻黄、葛根、青龙等方剂，在后人看来确实方便使用，所以世上喜欢节庵的人胜过喜欢张仲景，把节庵视为快捷方式，把张仲景视为畏途，节庵的书流传开来，而张仲景的书变得晦涩，像节庵这样的人，可以说是洁古、海藏等人的功臣，但在长沙（指张仲景）方面却是操弄权柄的莽夫。本集采录节庵的方论很多，但不能没有遗留的议论，因为节庵的功过，不妨让世人互见吧）。
本方去掉芍药、生姜，名为桂枝甘草汤（张仲景）：治疗发汗过多，双手交叉护住心口，心中悸动想要按压的症状（汗多则亡阳耗血，所以心虚悸动而双手交叉自护。桂枝益气固表，甘草补中助阳）。
本方加入附子，名为桂枝加附子汤（张仲景）：治疗太阳病发汗后，汗漏不止，怕风，小便困难，四肢轻微拘急（汗多亡阳，无法护卫体表，所以怕风；汗多则小便自然减少，兼有膀胱无阳，不能化气，所以小便困难；汗多则没有津液滋养筋脉，兼有风邪侵入增加其劲急，所以四肢轻微拘急；给予桂枝汤来调和营卫，加入附子来辅助元阳）。
本方去掉芍药，加入附子，名为桂枝附子汤（张仲景）：治疗伤寒（八九日，风湿相搏，身体疼痛烦躁，不能翻身转动，不呕吐不口渴，脉象浮虚而涩。八九日是再经之时，邪气多在里。而又身体疼痛烦躁的，是风湿相搏。烦，是风邪所致；痛，是湿邪所致；不呕吐不口渴，说明里没有邪气，所以知道是风湿相搏。脉浮，是风邪；涩，是湿邪，浮而涩，知道寒湿仅在经络。给予桂枝汤来解除表风，加入附子来散寒湿）。
本方加入芍药、生姜各一两、人参三两，名为桂枝新加汤（张仲景）：治疗伤寒发汗后身体疼痛，脉象沉迟（沉迟，是发汗后血虚，正气虚弱了，外邪怎么能出来呢？给予桂枝汤来解除未尽的邪气，加入芍药、人参收敛阴气以补充营血）。
本方减少甘草一半，加入芍药一倍，名为桂枝加芍药汤（张仲景）：治疗太阳病误用下法导致腹痛，属于太阴证。表证未罢而误用下法，表邪乘虚而入里，当作结胸，则仍属于太阳经，现在不胸满而腹满，是邪气已入太阴经；然而只是腹满时痛，还不是大实的疼痛，所以只用桂枝来安定太阳，加倍芍药来调和太阴。
本方加大黄，名为桂枝加大黄汤（张仲景）：治疗表证误用下法，出现大实痛的，另见表里门。
本方去掉桂枝，加入茯苓、白术，名为桂枝去桂加茯苓白术汤（张仲景）：治疗服用桂枝汤，或者被误下后，仍然头项强痛，无汗，心下满微痛，小便不利（表证未退，又增加满痛便秘，邪气已内陷，所以去掉桂枝这个解表药不用，而用芍药、甘草来除痛，生姜来散满祛寒，白术、茯苓来生津导水，配合姜枣来和胃，安内即是为了攘外）。
本方加入浓朴、杏仁，名为桂枝加厚朴杏子汤（张仲景）：治疗太阳病误下后轻微气喘，表证未解（桂枝汤来解表，杏子、厚朴来降逆气）。
本方去掉芍药、生姜，加入茯苓，名为茯苓桂枝甘草大枣汤，用甘澜水煎煮（张仲景）：治疗发汗后脐下悸动，想要发作奔豚（发汗后脐下悸动的，是心虚而肾气发动。肾积名为奔豚。肾气上逆，想要上凌心，所以用茯苓伐肾邪，桂枝治奔豚，甘草、大枣助脾而平肾，益土以制水。甘澜水，是用瓢舀水扬万遍，水性咸而重，扬之则甘而轻，取其不助肾气）。
本方合麻黄汤，名为桂麻各半汤（张仲景）：治疗太阳证如疟疾状，热多寒少（寒多为病进，热多为病退，阳胜阴也）。
本方二分，合麻黄汤一分，名为桂枝二麻黄一汤（张仲景）：治疗太阳病已大汗，形体如疟疾，一天发作两次（再次发作的为轻症）。
本方二分，合越婢汤一分，名为桂枝二越婢一汤（张仲景）：治疗太阳病发热恶寒，热多寒少，脉微弱的人，这是无阳，不可发汗（喻嘉言说：这是风多寒少的证候。无阳二字，张仲景多次提到，后人将其作为疑问搁置，不知道这是亡失津液的通称，所以以发汗为戒。然而不发汗，风寒终究不解，所以服用桂枝的二分来治风，越婢的一分来治寒，方为合法。方中行说：这就是桂枝麻黄的合剂，是大青龙汤用芍药替换杏仁的变制罢了）。
本方倍用芍药，加入饴糖，名为小建中汤（张仲景）；再加黄芪，名为黄芪建中汤（《金匮要略》，并见寒门）；除去饴糖，名为桂枝加黄芪汤（《金匮要略》汪昂按语：小建中汤以饴糖为君药，除去饴糖就不叫建中了。现在的人用建中汤，绝对不用饴糖，为什么呢？治疗黄汗发热，两小腿自冷，身体疼痛身体沉重，腰部以上有汗，腰部以下无汗，小便不利，这是阳气通而阴气不通，上下痞隔，所以用黄芪以固阳，桂枝以通阴，阴阳通、营卫和，则正汗出，小便利，而各种症状都消退了。）
小建中汤加当归，名为当归建中汤（《千金方》）：治疗妇人产后虚弱羸瘦不足，腹中痛，牵引腰背，小腹拘急（寒伤血分）；如果崩漏损伤不止，加入地黄、阿胶。
本方除去甘草，加入黄芪三两，名为桂枝五物汤（《金匮要略》）：治疗血痹（身体麻木不仁，如风痹状）。
本方加入栝蒌根，名为栝蒌桂枝汤（《金匮要略》）：治疗太阳证具备，身体强直KT KT，脉象反沉迟，这是痉病（庞安时说：栝蒌根不主治项强KT KT，其意在于肺热，不让热移于肾，加入桂枝汤中可以，以清除热邪荣养筋脉，调和营卫。KT字无钩，音殊，是羽翼短难飞的样子）。
本方加入龙骨、牡蛎，名为桂枝加龙骨牡蛎汤（《金匮要略》）：治疗男子失精，女子梦交（桂枝、生姜的辛味来润之，甘草、大枣的甘味来补之，芍药的酸味来收之，龙骨、牡蛎的涩味来固之）。
(Zhang Zhongjing)
Treats Taiyang Wind-Strike syndrome (Taiyang Wind-Strike), where the pulse is floating and forceful on superficial pressure but weak on deep pressure, presenting with fever, headache, spontaneous sweating, aversion to wind and cold, nasal congestion with roaring sound, and dry retching. (The position before the cun is Yang; Wei Qi also belongs to Yang. Yang becomes strong due to wind pathogen invasion, belonging to exterior syndrome. If wind-cold obstructs the exterior causing Taiyang Cold Damage syndrome not yet resolved, diaphoresis can be used. However, if the pulse is slow and sweating is profuse, it belongs to Yangming syndrome; if there is still slight aversion to cold, it indicates concurrent Taiyang exterior syndrome, so one should continue to resolve the muscle layer from the exterior to cut off the path of the pathogen entering the stomach fu.)
Guizhi (Cinnamon Twig), Shaoyao (White Peony Root), Shengjiang (Fresh Ginger, 3 liang), Gancao (Licorice Root, 2 liang, honey-fried), Dazao (Jujube, 12 pieces). Take hot. Shortly after taking the medicine, drink some thin, hot porridge to assist the medicinal effect. If symptoms do not relieve, administer again according to the original method.
This is a formula for the Foot-Taiyang Bladder Meridian. Zhang Zhongjing considered diaphoresis as heavy and resolving the muscle layer as light. In Wind-Strike syndrome, excessive sweating must be avoided; if sweating is too much, it will disturb Ying Blood. Even if there are exterior pathogens, the astringent nature may hinder dispersion. Warm nature can disperse cold and stop vomiting; Jujube's sweet and warm nature can harmonize the spleen. This formula does not specialize in dispersion but moves Spleen fluids to harmonize Ying and Wei. Mahuang Tang specializes in dispersion, thus it does not use Ginger and Jujube, which may lead to obstruction of fluids. (Pang Anshi said: If there is no sweating, frequent urination, or cold extremities, cold body, aversion to heat rather than cold, it must not be used. Furthermore, those with spontaneous sweating and frequent urination cannot take it. Spontaneous sweating indicates Yang deficiency; frequent urination indicates lower jiao cold-deficiency. In early disease with both exterior and interior deficiency, when the pathology is not in the exterior, using this formula to induce heavy sweating exhausts fluids, which is making deficiency more deficient. The Classics state: For those with floating-tight pulse, fever, and no sweating, Guizhi Tang cannot be given. Tight pulse indicates Cold Damage; giving Guizhi Tang makes the exterior more solid and sweating harder to achieve. "Shanghan Example" states: If Guizhi Tang enters the throat and Yang is excess, death ensues; if Chengqi Tang enters the stomach and Yin is excess, death ensues. Zhou Yangjun said: Wind damages Wei Qi, making Wei Qi loose and unable to protect Ying internally, leading to spontaneous sweating. Sweat is the fluid of blood. If blood-nourishing herbs are not used, with Guizhi to harmonize Ying and disperse pathogens, and Shaoyao to protect Ying and secure the interior, not only will exterior pathogens not exit, but they will enter and cause interior disorders. Thus, harmonizing Ying causes exterior pathogens to exit; once pathogens exit, Wei naturally becomes dense, eliminating the need for surface-stabilizing herbs, and sweating stops spontaneously. Zhang Zhongjing said: Patients who often have spontaneous sweating have harmonious Ying Qi. Harmonious Ying Qi means external disharmony because Wei Qi does not harmonize with Ying Qi. Since Ying moves within the vessels and Wei moves outside, inducing sweat again restores harmony, suitable for Guizhi Tang. Wang Haogu said: Someone asked if Guizhi can stop vexation and induce sweating. Zhang Zhongjing uses Guizhi Tang in many places for sweating in Cold Damage, yet says no-sweating cases cannot use Guizhi, and for profuse sweating, Guizhi-Gancao Decoction is used, which can close sweating. Are these two meanings compatible? Answer: Zhang Zhongjing said, Taiyang syndrome with fever and sweating indicates weak Ying and strong Wei. Yin deficiency allows Yang to encroach, so Guizhi is used to induce sweating. This regulates Ying Qi, so Wei Qi naturally harmonizes, leaving no room for wind pathogens, resulting in spontaneous sweating and resolution. It is not like Mahuang opening pores to forcibly induce sweat. For profuse sweating, Guizhi is used to harmonize Ying and Wei, so pathogens exit with sweat and sweating stops spontaneously; it is not that Guizhi closes pore openings.
Li Dongyuan said: Zhang Zhongjing formulated this decoction for exterior deficiency, using Guizhi as the sovereign herb. Guizhi is pungent and hot, dispersing, with light texture aiding Yang; Shaoyao and Gancao act as ministers. If there is abdominal urgency and pain, Xiaojianzhong Tang is formulated with Shaoyao as sovereign. Shaoyao is sour and cold, governing astringency and middle-jiao tonification; Guizhi and Gancao act as ministers. One treats exterior deficiency, the other interior deficiency. He also stated: Replace Guizhi with Rougui (Cinnamon Bark); it is a divine medicine for cold-induced abdominal pain. For heat-induced abdominal pain, remove Guizhi and add Huangqin (Scutellaria Root). Xu Shuwei said: Among Zhang Zhongjing's 113 formulas, Guizhi Tang ranks first, yet modern people do not use it at all, why? Ang notes: Zhang Zhongjing treated Cold Damage using Mahuang and Guizhi, completely avoiding Qianghuo (Notopterygium Rhizome) and Fangfeng (Saposhnikovia Root), indicating ancient methods were incomplete. Therefore, Jieguzi formulated Qianghuo Tang, Huangqi Tang, and Chuanxiong Tang; Haicang formulated Shenzhu San and Baizhu Tang, all using Qianghuo and Fangfeng as substitutes. Huangqi Tang and Chuanxiong Tang are attached to the Tonification Section. Shenzhu San and Baizhu Tang are seen later.)
Adding Baizhu (Atractylodes Macrocephala Rhizome), Chuanxiong (Ligusticum Chuanxiong Rhizome), Qianghuo (Notopterygium Rhizome), Fangfeng (Saposhnikovia Root), and Yitang (Maltose) to this formula creates Shuxu Shibiao Tang (Jie'an): Treats the same condition (Tao Shi formulated this, using Baizhu as sovereign to replace Guizhi Tang. Yu Jiayan said: This conflates exterior contraction and interior injury in treatment. Ang notes: Jie'an using Baizhu as sovereign imitates Jieguzi's Huangqi Tang and Haicang's Baizhu Tang. Also: Jie'an's "Six Books of Cold Damage" entirely replaces Zhang Zhongjing's original formulas, integrating later masters' methods to substitute Guizhi, Mahuang, Gegen, Qinglong, etc. While convenient for later generations, leading many to prefer Jie'an over Zhang Zhongjing, viewing Jie'an as a shortcut and Zhang as a daunting path, causing Jie'an's books to prevail while Zhang's become obscure. Such figures as Jie'an are indeed meritorious to Jieguzi and Haicang, but represent usurpation in the context of Changsha (Zhang Zhongjing). This collection adopts much of Jie'an's theory, though criticism remains necessary, as his merits and faults should be visible to the world.)
Removing Shaoyao and Shengjiang from this formula creates Guizhi Gancao Tang (Zhang Zhongjing): Treats excessive sweating leading to crossing hands over the heart, palpitations desiring pressure (Profuse sweating causes Yang loss and blood consumption, leading to heart deficiency, palpitations, and self-protection by crossing hands. Guizhi benefits Qi and secures the exterior; Gancao tonifies the middle and aids Yang.)
Adding Fuzi (Prepared Aconite Lateral Root) to this formula creates Guizhi Jia Fuzi Tang (Zhang Zhongjing): Treats Taiyang syndrome after sweating, resulting in continuous leakage of sweat, aversion to wind, difficulty urinating, and slight stiffness of the four limbs (Profuse sweating causes Yang loss, failing to guard the exterior, hence aversion to wind; sweating reduces urine volume, and with Bladder lacking Yang to transform Qi, urination is difficult; sweating depletes fluids nourishing sinews, combined with wind invading increasing tension, causing slight limb stiffness. Give Guizhi Tang to harmonize Ying and Wei, add Fuzi to assist Yuan Yang.)
Removing Shaoyao and adding Fuzi to this formula creates Guizhi Fuzi Tang (Zhang Zhongjing): Treats Cold Damage (After eight or nine days, wind-dampness intertwines, causing body pain and irritability, inability to turn over, no vomiting, no thirst, pulse floating, deficient, and choppy. Eight or nine days marks the second circulation; pathogens are mostly interior. Body pain and irritability indicate wind-dampness intertwining. Irritability stems from wind; pain from dampness. No vomiting/thirst indicates no interior pathogens, confirming wind-dampness intertwining. Floating pulse indicates wind; choppy indicates dampness. Floating and choppy suggest cold-dampness remains in the meridians. Give Guizhi Tang to resolve exterior wind; add Fuzi to dispel cold-dampness.)
Adding Shaoyao and Shengjiang (1 liang each) and Renshen (Ginseng Root, 3 liang) to this formula creates Guizhi Xinjia Tang (Zhang Zhongjing): Treats body pain after Cold Damage sweating, with sinking and slow pulse (Sinking and slow indicate blood deficiency post-sweating; righteous Qi is deficient, preventing exterior pathogens from exiting. Give Guizhi Tang to resolve remaining pathogens; add Shaoyao and Renshen to astringe Yin and benefit Ying Blood.)
Reducing Gancao by half and doubling Shaoyao in this formula creates Guizhi Jia Shaoyao Tang (Zhang Zhongjing): Treats abdominal pain after erroneous purgation in Taiyang syndrome, belonging to Taiyin syndrome. Exterior syndrome unresisted leads to erroneous purgation; exterior pathogens enter the interior via deficiency. If it were Jiezhong (Constraint Accumulation), it would remain in Taiyang channel. Now, instead of chest fullness, there is abdominal fullness, indicating pathogens entered Taiyin channel. However, intermittent abdominal pain is not severe excess pain. Thus, use Guizhi to pacify Taiyang and double Shaoyao to harmonize Taiyin.
Adding Dahuang (Rhubarb Root and Rhizome) to this formula creates Guizhi Jia Dahuang Tang (Zhang Zhongjing): Treats severe excess pain after erroneous purgation of exterior syndrome. See Exterior-Interior Section separately.
Removing Guizhi and adding Fuling (Poria) and Baizhu (Atractylodes Macrocephala Rhizome) to this formula creates Guizhi Qu Gui Jia Fuling Baizhu Tang (Zhang Zhongjing): Treats persistent head/neck stiffness, anhidrosis, mild epigastric fullness/pain, and dysuria after taking Guizhi Tang or erroneous purgation (Exterior syndrome persists, adding fullness/pain/constipation indicates pathogen sinking inward. Remove Guizhi (exterior-resolving herb); use Shaoyao and Gancao to relieve pain, Shengjiang to disperse fullness and dispel cold, Baizhu and Fuling to generate fluids and guide water, combined with Jiang/Zao to harmonize Stomach. Securing the interior serves to repel the exterior.)
Adding Houpo (Magnolia Bark) and Xingren (Apricot Seed) to this formula creates Guizhi Jia Houpo Xingren Tang (Zhang Zhongjing): Treats slight wheezing after erroneous purgation in Taiyang syndrome, with unresolved exterior (Guizhi Tang resolves exterior; Xingren and Houpo direct rebellious Qi downward.)
Removing Shaoyao and Shengjiang, adding Fuling (Poria) to this formula creates Fuling Guizhi Gancao Dazao Tang, decocted with Ganlan Water (Zhang Zhongjing): Treats sub-umbilical palpitations and impending Ben Tun (Running Piglet) after sweating (Sub-umbilical palpitations post-sweating indicate Heart deficiency and Kidney Qi activation. Kidney accumulation named Ben Tun. Rebellious Kidney Qi threatens to ascend to the Heart. Use Fuling to suppress Kidney pathogen, Guizhi to treat Ben Tun, Gancao and Dazao to aid Spleen and calm Kidney, benefiting Earth to control Water. Ganlan Water is made by scooping and throwing water thousands of times; water is salty and heavy, becoming sweet and light after tossing, taken to avoid aiding Kidney Qi.)
Combining this formula with Mahuang Tang creates Guima Ge Ban Tang (Zhang Zhongjing): Treats Taiyang syndrome resembling malaria, with more heat than chills (Chills predominance indicates disease progression; heat predominance indicates disease regression, Yang overcoming Yin.)
Two parts of this formula combined with one part Mahuang Tang creates Guizhi Er Mahuang Yi Tang (Zhang Zhongjing): Treats Taiyang syndrome after heavy sweating, resembling malaria, occurring twice daily (Twice-daily occurrence indicates milder severity.)
Two parts of this formula combined with one part Yuebi Tang creates Guizhi Er Yuebi Yi Tang (Zhang Zhongjing): Treats Taiyang syndrome with fever, aversion to cold, more heat than chills, and weak pulse, indicating "No Yang," contraindicating diaphoresis (Yu Jiayan said: This is a pattern with more wind than cold. "No Yang" appears frequently in Zhang Zhongjing's texts; later scholars left it as a doubt, not knowing it is a general term for fluid exhaustion, thus warning against sweating. However, without sweating, wind-cold cannot resolve. Thus, taking two parts Guizhi to treat wind and one part Yuebi to treat cold is lawful. Fang Zhongxing said: This is a combination of Guizhi and Mahuang, a variation of Da Qing Long Tang replacing Xingren with Shaoyao.)
Doubling Shaoyao and adding Yitang (Maltose) to this formula creates Xiaojianzhong Tang (Zhang Zhongjing); adding Huangqi (Astragalus Root) creates Huangqi Jianzhong Tang (Jinkui Yaolue, see Cold Section); removing Yitang creates Guizhi Jia Huangqi Tang (Jinkui Yaolue). Ang notes: Xiaojianzhong Tang uses Yitang as sovereign; removing Yitang negates the name Jianzhong. Modern practitioners rarely use Yitang in Jianzhong formulas, why? Treating Huang Han (Yellow Sweat) with fever, cold calves, body pain/heaviness, sweating above waist but none below, and dysuria indicates Yang通畅 but Yin blocked, upper/lower stagnation. Use Huangqi to secure Yang, Guizhi to unblock Yin. Once Yin-Yang are connected and Ying-Wei harmonized, normal sweating occurs, urination improves, and symptoms resolve.)
Xiaojianzhong Tang plus Danggui (Angelica Sinensis Root) creates Danggui Jianzhong Tang (Qianjin Fang): Treats postpartum women with deficiency, emaciation, insufficiency, abdominal pain radiating to back/waist, and lower abdominal tension (Cold damaging Blood aspect). If metrorrhagia/hemorrhage persists, add Dihuang (Rehmannia Root) and Ejiao (Donkey-hide Gelatin).
Removing Gancao and adding Huangqi (3 liang) to this formula creates Guizhi Wuwu Tang (Jinkui Yaolue): Treats Xue Bi (Blood Bi) (Body numbness and insensitivity, resembling Feng Bi.)
Adding Gualougen (Trichosanthes Root) to this formula creates Gualou Guizhi Tang (Jinkui Yaolue): Treats complete Taiyang syndrome, stiff body, pulse sinking and slow, indicating Jing (Spasm) syndrome (Pang Anshi said: Gualougen does not primarily treat neck stiffness; its intent is to clear Lung heat to prevent transmission to Kidney. Added to Guizhi Tang, it clears heat, nourishes sinews, and harmonizes Ying-Wei. "KT" character has no hook, pronounced 'shu', depicting short wings unable to fly.)
Adding Longgu (Fossilized Bones) and Muli (Oyster Shell) to this formula creates Guizhi Jia Longgu Muli Tang (Jinkui Yaolue): Treats seminal emission in men and dream intercourse in women (Guizhi and Shengjiang's pungency moistens; Gancao and Dazao's sweetness tonifies; Shaoyao's sourness astringes; Longgu and Muli's astringency secures.)