（仲景）
治太阳病项背KT KT 音殊，无汗恶风（鸟之短羽者，动则引颈KT KT 然状，病
人项背难舒之貌也。无汗恶风，中风而表实也，阳明脉上颈而合于太阳，恐将传阳明，故加
葛根以断之。此证又名刚痉，乃风寒伤筋，故拘急而强直也，《金匮》治之，亦主此汤，刚
痉无汗，柔痉有汗。仲景又曰∶太阳发汗不彻，烦躁短气者，亦宜此汤更发其汗；经曰∶何
以知汗出不彻，以脉涩故也。按∶伤寒失于汗下而短气为实，汗下后短气者为虚，表实宜发
汗，表虚宜解肌）；亦治太阳阳明合病下利（伤寒有并病，有合病。本经未解，传入他经，
有催并之义，为并病；二经、三经同受邪者，为合病，合病者，邪气甚也。太阳阳明合病，
其证头痛、腰痛、肌热、鼻干、目痛、脉浮大而长。头、腰，太阳也；肌、目、鼻，阳明也；
浮、大，太阳也；脉长，阳明也。阳经合病，必自下利，邪并于阳，则阳实而阴虚，阳外实
而不主里，则里虚，故下利。吴鹤皋曰∶庸医便谓伤寒漏底不治，与此汤以散经中表邪，则
阳不实而阴气平，利不治而自止矣。按∶葛根能引胃中清阳上行，故凡下利多用之。赵嗣真
曰∶合病者，二阳经或三阳经同病不传者也；并病者，一经先受病，又过一经，病之传者也。
如太阳阳明若汗而未尽，是传未过，仲景所谓太阳证不罢，面赤阳气怫郁，在表不得越，烦
躁短气是也，犹当汗之，以各半汤；若并之已尽，是谓传过，仲景所谓太阳证罢，潮热，手
足汗出，大便硬而谵语是也，法当下之，以承气汤。是知传则入腑，不传则不入腑，并病传
变，有如此。仲景治太阳阳明合病，主葛根汤；太阳少阳合病，主黄芩汤；少阳阳明合病，
主承气汤。三阴有两感而无合病。《此事难知》云∶足太阳为诸阳之首，故多传变，太阳传
阳明，水传土也，谓之微邪，又谓巡经得度传；太阳传少阳，谓之越经传；太阳传太阴，谓
之误下传；太阳传少阴，谓之表里传。水胜火，火胜水，此南北二方之变，顷刻害人，辨之
不早，必成不救。太阳传厥阴，谓之首尾传，三阴不至于首，唯厥阴与督脉上行，与太阳相
接，又名巡经得度传，灾
葛根（四两） 麻黄 生姜（三两） 桂枝 芍药 甘草（二两。炙） 大枣（十二枚。）
此足太阳药也。成氏曰∶轻可去实，葛根、麻黄之属是也。此以中风表实，故加二物于
桂枝汤中（仲景以有汗无汗定伤风伤寒之别∶有汗为伤风，用桂枝加葛根汤，不用麻黄；无
汗为伤寒，用此汤。张元素曰∶二汤加葛根，所以断太阳入阳明之路，非太阳药也。若太阳
初病，便服升葛，是反引邪气入阳明也。周扬俊曰∶不去麻黄，复加葛根，大开肌肉之药，
不虑大汗无制乎，故以桂枝监之，且以芍药收之。喻嘉言曰∶仲景于太阳带阳明证，其风伤
卫，则桂枝汤中加葛根；寒伤营，则麻黄汤中加葛根。太阳带少阳证，其风伤卫，则桂枝汤
中加柴胡；寒伤营，则麻黄汤中加柴胡。合并之病亦然。则阳明以葛根为主药，少阳以柴胡
为主药矣。乃少阳经专用小柴胡汤，而阳明经全不用葛根汤何耶，此有二义∶太阳而略兼阳
明，则以方来之阳明为重，故加葛根；阳明而尚兼太阳，则以未罢之太阳为重，故不加葛根，
恐
根
下
根
不
本方除麻黄，名桂枝加葛根汤（仲景）∶治前证汗出恶风者。本方加半夏，名葛根加半
夏汤（仲景）∶治太阳阳明合病，不下利，但呕（此又以利、不利辨伤寒、伤风之不同也。
寒为阴，阴性下行，里气不和，故利而不呕；风为阳，阳性上行，里气逆而不下，故呕而不
利，加半夏以下
本方加黄芩，名葛根解肌汤；治发热恶寒，头痛项强，伤寒温病。
（张仲景）
治疗太阳病项背部拘急不舒，声音显得特殊（“KT KT”指鸟的短羽，活动时牵引颈部发出KT KT的声音，形容病人项背部难以舒展的样子）。无汗且怕风，这是中风而表实证。阳明经脉上行至颈部并与太阳经相合，担心病邪将传入阳明经，因此加入葛根以阻断其传变。这种证候又名为刚痉，是由于风寒损伤筋脉，导致拘挛紧急而强直。《金匮要略》治疗此证，也主用此汤。刚痉表现为无汗，柔痉表现为有汗。张仲景又说：太阳病发汗不彻底，出现烦躁、呼吸短促的，也适宜用此汤再次发汗；医经说：如何知道汗出不彻底？因为脉象涩的缘故。按语：伤寒因失于发汗或攻下而导致短气属于实证，发汗或攻下之后出现短气属于虚证，表实证适宜发汗，表虚证适宜解肌。
也治疗太阳与阳明合病引起的腹泻（伤寒中有并病和合病之分。本经病邪未解，传入他经，有相继传递的意思，称为并病；两经或三经同时受邪气的，称为合病，合病意味着邪气很盛。太阳与阳明合病，症状包括头痛、腰痛、肌肉发热、鼻干、目痛、脉浮大而长。头、腰属于太阳经；肌肉、眼睛、鼻子属于阳明经；脉浮大属于太阳经；脉长属于阳明经。阳经合病，必然出现自发性腹泻，邪气并入阳分，则阳实而阴虚，阳气外实而不能固守里部，导致里虚，所以发生腹泻。吴鹤皋说：庸医便认为伤寒漏底（腹泻不止）是不治之症，给予此汤以疏散经络中的表邪，那么阳气就不致过实而阴气平和，腹泻不治而自然停止。按语：葛根能引导胃中清阳之气上行，所以凡是腹泻多用葛根。赵嗣真说：合病是二阳经或三阳经同病但不传变的；并病是一经先受病，又波及另一经，是病邪的传变。如太阳与阳明，如果发汗未尽，是传变未过，即张仲景所说的太阳证未罢，面赤，阳气怫郁在表不得发散，出现烦躁、短气，此时仍应当发汗，用桂枝麻黄各半汤；如果并病已尽，是谓传变已过，即张仲景所说的太阳证已罢，潮热，手足出汗，大便硬结而谵语，此时法当攻下，用承气汤。由此可知，传变则入腑，不传变则不入腑，并病的传变情况如此。张仲景治疗太阳阳明合病，主用葛根汤；太阳少阳合病，主用黄芩汤；少阳阳明合病，主用承气汤。三阴经只有两感而没有合病。《此事难知》说：足太阳经为诸阳之首，所以多传变，太阳传阳明，是水传土，称为微邪，又称巡经得度传；太阳传少阳，称为越经传；太阳传太阴，称为误下传；太阳传少阴，称为表里传。水胜火，火胜水，这是南北二方的变化，顷刻间害人，辨别不早，必成不治之症。太阳传厥阴，称为首尾传，三阴不至于首，唯有厥阴与督脉上行，与太阳相接，又名巡经得度传，灾...
葛根（四两） 麻黄 生姜（三两） 桂枝 芍药 甘草（二两，炙） 大枣（十二枚）。
这是足太阳经的药物。成无己说：轻可去实，葛根、麻黄这类药物就是。此方针对中风表实证，所以在桂枝汤中加入这两味药（张仲景以有汗无汗来区分伤风和伤寒的区别：有汗为伤风，用桂枝加葛根汤，不用麻黄；无汗为伤寒，用此汤。张元素说：两方加葛根，是为了阻断太阳传入阳明的路径，并非单纯的太阳经药。如果太阳初病，就服用升提的葛根，反而是引邪气入阳明。周扬俊说：不去掉麻黄，再加葛根，这是大开肌肉腠理的药物，不怕大汗淋漓无法控制吗？所以用桂枝来监制它，并且用芍药来收敛。喻嘉言说：张仲景对于太阳兼阳明证，如果是风伤卫分，则在桂枝汤中加葛根；寒伤营分，则在麻黄汤中加葛根。太阳兼少阳证，如果是风伤卫分，则在桂枝汤中加柴胡；寒伤营分，则在麻黄汤中加柴胡。合并的病也是如此。那么阳明经以葛根为主药，少阳经以柴胡为主药了。然而少阳经专用小柴胡汤，而阳明经全不用葛根汤为什么呢？这有两层含义：太阳病略微兼夹阳明，则以将来的阳明为重，所以加葛根；阳明病尚且兼夹太阳，则以未罢的太阳为重，所以不加葛根，恐怕...
本方除去麻黄，名为桂枝加葛根汤（张仲景）：治疗前述证候有汗、怕风的。本方加入半夏，名为葛根加半夏汤（张仲景）：治疗太阳阳明合病，不下利，只是呕吐（这也是通过利与不利来辨别伤寒、伤风的不同。寒为阴，阴性下行，里气不和，所以下利而不呕；风为阳，阳性上行，里气逆乱而不降，所以呕吐而下利止，加入半夏以降逆）。
(Zhang Zhongjing)
Treats Taiyang disease (disease of the Taiyang channel) presenting with stiffness and discomfort in the neck and back, where the voice sounds distinct ("KT KT" refers to the sound made by birds with short feathers when they stretch their necks, describing the appearance of the patient's inability to relax the neck and back). Absence of sweat and aversion to wind indicate Wind-strike with Exterior Excess syndrome. The Yangming channel ascends to the neck and intersects with the Taiyang channel; there is concern that the pathogen will transmit to the Yangming channel. Therefore, Puerariae Radix (Gegen) is added to block this transmission. This syndrome is also known as Gang-Jing (Stiff Spasm), caused by Wind-Cold damaging the sinews, leading to spasmodic tension and rigidity. *Jin Gui Yao Lue* treats this syndrome primarily with this decoction. Gang-Jing presents with absence of sweat, while Rou-Jing (Soft Spasm) presents with sweating. Zhang Zhongjing further states: If Taiyang disease sweating is incomplete, resulting in irritability and shortness of breath, this decoction should also be used to induce sweating again; the Classics state: How do we know sweating was incomplete? Because the pulse is choppy. Commentary: Shortness of breath due to failure to sweat or purge in Shanghan (Cold Damage) indicates an Excess pattern; shortness of breath after sweating or purging indicates a Deficiency pattern. Exterior Excess patterns are suitable for inducing sweating, while Exterior Deficiency patterns are suitable for resolving the muscle layer.
It also treats diarrhea caused by simultaneous involvement of the Taiyang and Yangming channels (In Shanghan, there are Bing-bing (concurrent diseases) and He-bing (combined diseases). When the pathogen in the primary channel has not resolved and transmits to another channel, it implies sequential transmission, called Bing-bing; when two or three channels are affected by pathogens simultaneously, it is called He-bing, indicating severe pathogenic factors. In Taiyang-Yangming He-bing, symptoms include headache, lower back pain, muscular fever, dry nose, eye pain, and a floating, large, and long pulse. Head and lower back belong to the Taiyang channel; muscles, eyes, and nose belong to the Yangming channel; floating and large pulses belong to Taiyang; a long pulse belongs to Yangming. In combined diseases of Yang channels, spontaneous diarrhea must occur. When pathogens merge into the Yang aspect, Yang becomes Excess and Yin becomes Deficient. Since Yang is Excess on the exterior and fails to govern the interior, the interior becomes Deficient, causing diarrhea. Wu Hegao said: Quack doctors often consider leakage-type diarrhea in Shanghan as incurable. Administering this decoction to disperse exterior pathogens in the channels will prevent Yang from becoming overly Excess and harmonize Yin, stopping the diarrhea without specific treatment for it. Commentary: Puerariae Radix can guide the clear Yang Qi of the Stomach upward; therefore, it is frequently used for diarrhea. Zhao Sizhen said: He-bing refers to simultaneous illness of two or three Yang channels without transmission; Bing-bing refers to one channel being diseased first, then spreading to another, representing disease transmission. For example, in Taiyang-Yangming, if sweating is incomplete, transmission has not fully occurred. This corresponds to Zhang Zhongjing's description: "Taiyang signs have not ceased, face is red, Yang Qi is constrained in the exterior and cannot vent out, causing irritability and shortness of breath." In such cases, sweating should still be induced using Guizhi Mahuang Banxia Tang (a combination formula); if the concurrent condition is complete, it means transmission has passed. This corresponds to Zhang Zhongjing's description: "Taiyang signs have ceased, tidal fever, sweating on hands and feet, hard stool, and delirium." In such cases, purgation is indicated using Chengqi Tang. Thus, we know that transmission leads to entry into the Fu organs, while lack of transmission prevents entry. The transmission changes in Bing-bing are thus. Zhang Zhongjing treats Taiyang-Yangming He-bing with Gegen Tang; Taiyang-Shaoyang He-bing with Huangqin Tang; Shaoyang-Yangming He-bing with Chengqi Tang. The Three Yin channels have Liang-gan (double contraction) but no He-bing. *Ci Shi Nan Zhi* states: Foot Taiyang is the head of all Yang channels, so it undergoes many transmissions. Taiyang transmitting to Yangming is Water transmitting to Earth, called Minor Evil, or Xun-jing De-du Chuan (transmission along the normal sequence); Taiyang transmitting to Shaoyang is Yue-jing Chuan (transmission skipping a channel); Taiyang transmitting to Taiyin is Wu-xia Chuan (transmission due to erroneous purgation); Taiyang transmitting to Shaoyin is Biao-li Chuan (Exterior-Interior transmission). Water overcoming Fire, Fire overcoming Water, these are variations between the North and South regions, harming people instantly. If differentiation is not early, it becomes incurable. Taiyang transmitting to Jueyin is Shou-wei Chuan (head-to-tail transmission). The Three Yin do not reach the head; only Jueyin ascends with the Du vessel, connecting with Taiyang, also called Xun-jing De-du Chuan, disaster...
Puerariae Radix (4 liang), Ephedrae Herba (Mahuang), Zingiberis Rhizoma Recens (Shengjiang, 3 liang), Cinnamomi Ramulus (Guizhi), Paeoniae Radix Alba (Shaoyao), Glycyrrhizae Radix et Rhizoma (Gancao, 2 liang, honey-fried), Ziziphi Jujubae Fructus (Dazao, 12 pieces).
These are herbs for the Foot Taiyang channel. Cheng Wuji said: Light substances can remove excess; Puerariae Radix and Ephedrae Herba are examples. This formula targets Wind-strike with Exterior Excess, hence adding these two items to Guizhi Tang (Cinnamon Twig Decoction). Zhang Zhongjing distinguishes Wind-strike from Cold Damage by the presence or absence of sweat: Sweat indicates Wind-strike, treated with Guizhi Jia Gegen Tang, without Mahuang; no sweat indicates Cold Damage, treated with this decoction. Zhang Yuanyu said: Adding Gegen to both formulas blocks the path from Taiyang to Yangming; it is not merely a Taiyang herb. If Gegen, a rising herb, is taken at the onset of Taiyang disease, it may inadvertently lead pathogens into the Yangming channel. Zhou Yangjun said: Not removing Mahuang and adding Gegen constitutes strong diaphoretic action opening the muscle layer; is there not fear of uncontrolled profuse sweating? Hence, Guizhi is used to restrain it, and Shaoyao to astringe it. Yu Jiayan said: For Taiyang with concurrent Yangming signs, if Wind injures the Wei level, Gegen is added to Guizhi Tang; if Cold injures the Ying level, Gegen is added to Mahuang Tang. For Taiyang with concurrent Shaoyang signs, if Wind injures the Wei level, Chaihu is added to Guizhi Tang; if Cold injures the Ying level, Chaihu is added to Mahuang Tang. The same applies to combined diseases. Thus, Gegen is the chief herb for Yangming, and Chaihu for Shaoyang. However, why is Xiaochaihu Tang exclusively used for Shaoyang, while Gegen Tang is completely unused for Yangming? There are two reasons: In Taiyang with slight Yangming involvement, the impending Yangming is prioritized, so Gegen is added; in Yangming with residual Taiyang involvement, the unresolved Taiyang is prioritized, so Gegen is not added, lest...
Removing Mahuang from this formula yields Guizhi Jia Gegen Tang (Zhang Zhongjing): Treats the aforementioned syndrome with sweat and aversion to wind. Adding Banxia (Pinelliae Rhizoma) to this formula yields Gegen Jia Banxia Tang (Zhang Zhongjing): Treats Taiyang-Yangming He-bing without diarrhea, but with vomiting (This further distinguishes Cold Damage from Wind-strike based on diarrhea vs. vomiting. Cold is Yin, its nature descends; disharmony in the interior causes diarrhea without vomiting; Wind is Yang, its nature ascends; rebellion of interior Qi downward causes vomiting without diarrhea. Banxia is added to descend rebellious Qi).
Adding Huangqin (Scutellariae Radix) to this formula yields Gegen Jieji Tang; treats fever with aversion to cold, headache and neck stiffness, Shanghan and Wenbing (Warm Diseases).