漏芦亦蒿类，而青蒿治疥疮痂痒，热在骨节间；此治湿痹之恶疮，热在肌肤。
青蒿芳香苦寒，合湿热而并除之，故宜于由湿转燥之疮。漏芦色黑咸寒，热散于肌表而
湿使
古方治发背以漏芦汤为称首者，背为太阳寒水部分，漏芦咸寒而有白茸，正与相合。且
热退
漏芦下乳汁，是下热结而不下之乳汁，能消乳内胀痛，非下乳汁之通剂也。
邹氏疏麻黄云∶麻黄之实，中黑外赤，其茎宛似脉络骨节，中央赤，外黄白。实者先天
，茎者后天。先天者物之性，其义为由肾及心；后天者物之用，其义为由心及脾肺。由肾及
心，所谓肾主五液，入心为汗也；由心及脾肺，所以分布心阳，外至骨节肌肉皮毛，使其间
留滞无不倾囊出也。故栽此物之地，冬不积雪，为其能伸阳气于至阴中，不为盛寒所凝耳。
此论麻黄性用，致为精审，远胜诸家。按灵枢本藏篇云∶“肾合三焦膀胱”。三焦膀胱者，腠
理毫毛其应。麻黄虽入肾而中空轻扬，故为太阳伤寒泄表发汗之要药。肺之合皮毛，入太阳
即入肺，入肺入心即入营卫。麻黄茎并不白，邹氏谓其入肺而有意装饰之，未免蛇足。又叶
天士、陈修园咸谓肝主疏泄，以麻黄发汗为疏泄为入肝，不知肝能下泄不能外泄，其亦武断
之至矣。
与麻黄相助为理之物，其最要者有六∶曰杏仁，曰桂枝，曰芍药，曰石膏，曰葛根，曰
细辛
杏仁者，所以为麻黄之臂助也。麻黄开肌腠，杏仁通肺络；麻黄性刚，杏仁性柔；麻黄
外扩，杏仁内抑；二者合而邪乃尽除。如麻黄汤治风寒，麻黄杏仁薏苡甘草汤治风湿之类皆
是。
桂枝者，所以补麻黄之不足也。麻黄泄营卫之邪，桂枝调营卫之气。桂枝得麻黄，不至
羁汗；麻黄得桂枝，即能节汗。二者合而正不受伤。此麻桂并用之方皆然。盖有视证候之重
轻，
芍药者，一方之枢纽也。一征之小青龙汤，外寒与内饮相搏，干呕发热而咳，是证之必
然非或然。麻桂散外寒，辛夏蠲内饮，姜味止咳逆，甘草合诸药以和之。寒则以汗解，饮则
随便去，惟麻黄入太阳而上行，膀胱之气亦因之而不下行，小便不利少腹满，固意中事。加
芍药者，所以驯麻黄之性而使水饮得下走也。若小便本不利，则麻黄直去之矣。全方蠲饮重
于散寒，故名之曰小青龙汤。再征之乌头汤，麻黄气轻，驱风寒在肌肤者多；乌头气重，驱
风寒在脏腑者多。麻黄除湿，是湿随风寒而去；乌头除湿，是风寒外散而湿则内消。麻黄伸
阳而不补，乌头补阳而即伸。此治历节不可屈伸疼痛，二物所以必并用之故。虽然二物皆出
汗而少内心，关节之病，非可一汗而愈者，故又以芍药从而敛之，使宛转于肢节而尽去其疾
。黄 疏营卫之气，则为芍药之前驱。甘草则培中土以和之者也。以其有芍药能使麻乌下达
，故
伤寒太阳病将入阳明，则石膏为必用之药。大青龙汤中风二字，是与小青龙汤伤寒二字
为互举之文。麻黄汤治伤寒，曰脉浮紧无汗，此亦浮紧无汗。大青龙别一条曰伤寒脉浮缓，
浮缓有伤寒，浮紧岂反无伤寒。况伤寒一日太阳受之，脉若静者为不传，颇欲吐若躁脉数
急者为传。此之烦躁，自因表实而邪不得泄，传入阳明所致。沈尧封以烦躁为内伏之 热，
不知阳明非腑实不至烦躁，安有内已腑实而外尚发热恶寒之理。以石膏治烦躁，谓之治太阳
传入阳明之烦躁，与仲圣诸说无不吻合，复有何疑。且烦躁在心肾而治则在阳明者，非无谓
也。太阳本寒标热，上与心下与肾为缘，太阳热闭，则心肾皆为之扰。太阳不治，则阳明亦
所必传。是烦躁非心肾之自病，而阳明乃去路之宜肃。泄其热于表，清其热于里，则烦躁不
治而自治。抑石膏者，泄肺即所以泄太阳也，太阳卫外之气，从皮毛而合肺，而石膏亦轻亦
重，泄肺清胃，两擅其长，故独用治汗出之热，佐麻黄又治不汗出之热。若离太阳入阳明而
成腑实之证，则石膏非所克任矣。
太阳将入阳明，葛根亦为必用之药。仲圣文义，多有参观互勘而后明者。葛根汤之证，
曰太阳病项背强KT KT ，无汗恶风。病云太阳，而方则以葛根标名。葛根者，太阳阳明
交嬗药也。何以言之？阳明病身热多汗，而葛根治大热不治多汗，且更解肌出汗。虽出汗而
非散太阳初入之寒，所以为治太阳将入阳明之药。太阳寒邪化热，热烁其液，则项背为强，
葛根起阴气以滑泽之，则变强为柔，与麻黄治无汗恶风，可称伯仲。然则是证二物足了之矣，
复以桂枝汤何为？盖汗出表必虚，以和阳化阴之药继其后，则即攻即补，元气不过伤而易复，
此用药操纵之法，仲圣方类如是也。
细辛与杏仁，皆所以为麻黄之臂助，而有大不侔者在。杏仁佐麻黄而横扩，是为一柔一
刚；细辛佐麻黄而直行，是为一专一普。麻黄驱阴邪发阳气，不仅入少阴而用甚普。细辛则
色黑入肾，赤入心（或云赤黑，或云深紫，紫即赤黑相兼之色也），一茎直上，气味辛烈，
故其破少阴之寒凝，锐而能专。考仲圣方佐细辛以治上者不一∶如小青龙汤治水饮，浓朴麻
黄汤治咳逆，桂甘姜枣麻辛附子汤治气分，皆所易晓。独麻黄附子细辛汤，治少阴病用细辛，
则此义尘封久矣。试详言之∶少阴与太阳为表里，脏若中寒，必始得之，即吐利厥逆，不至
发热。今有但欲寐之少阴证而反发热，是无少阴之里证而有外连太阳之表证，自应以麻黄发
汗。脉沉者急温之，自应以附子温经。至细辛一味，柯韵伯谓散浮阳，邹氏谓无细辛为微发
汗，则有细辛为大发汗，唐容川更以脉沉为阳陷，用细辛以升之。实于细辛性用，与仲圣因
证制方之意，未经窥见。夫细辛与麻黄，同能彻上彻下，第麻黄中空轻扬，用以下行，非借
他药之力不可。细辛无发表出汗之能（本经麻黄发表出汗，细辛无之），而于风寒之在上在
下附于骨节九窍者，则专力以去之，绝不旁骛。故防己黄 汤，曰下有陈寒者加细辛，可见
细辛散少阴经气之寒，厥有专长，非麻黄可及。然则麻黄附子甘草汤无细辛，而此何以有细
辛，彼无里证而此何尝有里证，仲圣用麻黄必曰取微汗，此岂堪取大汗，则当于始得之与得
之二三日，及麻黄煎法之不同，详究其义矣。经云∶逆冬气则少阴不藏，肾气独沉。肾气沉
则脉无不沉，即仲圣所云脉微细、但欲寐之脉，亦未始非沉，此单言沉者，以其沉之甚耳。
脉沉自系少阴病本象，兹不云少阴病脉沉反发热，而云反发热脉沉，盖少阴病不应发热而反
发热，发热则当由太阳而外达矣，乃发热而兼脉沉，岂能无二三日变为里证之虞。于是以附
子专温其经，细辛佐麻黄，锐师直入以散在经之邪；麻黄先煮减二升者，欲其气之下注；不
加甘草者，恐其缓三物而中停；此发热脉沉始得时之治法。若至二三日而无里证，则不至或
有里证，不当以细辛先开其隙；故以麻黄附子治发热脉沉，而以甘草易细辛，且先煮麻黄只
一二沸，以节其入里之势，而和其散邪之气，此正合得之二三日之分际。彼不言无里证，此
不言发热脉沉者，互举之文也。仲圣之斟酌病机，可谓精矣。
更以仲圣用麻黄、杏仁、石膏而治法迥异者言之，大青龙汤三物并用，为发汗之峻剂，
麻杏甘膏汤亦三物并用，偏治汗出而喘无大热者何也？此节文义，是将汗出二字倒装在不可
更行桂枝汤下。惟其汗出，疑可行桂枝不可行麻黄。不知汗出而喘无大热，非桂枝证之汗出
而为发汗后表已解之汗出。表已解故无大热，喘则尚有余邪，桂枝汤不可行，而大青龙不变
其法亦不可行。夫是故变峻为和，以麻黄四两石膏倍之，俾麻黄之技不得逞，而余邪适因之
而尽。且石膏倍用，不特制麻黄之悍，泄汗出之热，即杏仁亦必抑其外达之势，以下气而止
喘。止喘非麻黄事耶，而汗出无大热之喘，则其喘为气逆多而表郁少，故麻黄减之而杏仁增
之，信乎药物多寡之所关，非细故也。
石膏以两计者，与麻黄多寡易见，麻杏甘膏汤，石膏多麻黄一倍，核之治法正合。若大
青龙汤石膏亦多于麻黄，则麻黄受制已甚，何至有汗多之虑。洄溪云∶大青龙汤一剂，除大
枣约共十六两，以今称计之，亦重三两有余，则发汗之重剂矣。虽少加石膏，终不足以相制
也。夫所谓十六两者，已将石膏并计在内，所谓三两有余者，以古一两今二钱零计之，不知
鸡子大一块，洄溪究作今称几何。余将石膏碎为鸡子大称之，总不在三两之下。而洄溪谓一
剂共三两有余，真令人不解。王朴庄精于算学，谓伤寒方一两准今七分六厘，则更无洄溪二
钱零之多。今姑即二钱零为一两计之，麻黄六两，亦不过有今称两半；而石膏鸡子大一块，
则有
漏芦也属于蒿类植物，但青蒿治疗疥疮结痂瘙痒，其热邪位于骨节之间；而漏芦治疗湿痹引起的恶疮，其热邪位于肌肤表层。
青蒿气味芳香、性味苦寒，能同时清除湿热，因此适宜治疗由湿邪转化为燥邪的疮疡。漏芦色黑、味咸、性寒，能疏散肌表的热邪，而湿邪则……（原文此处似有脱漏或语意未完，依文意推测为“湿邪随之而去”或类似含义，但严格遵循不增添内容原则，仅翻译可见部分）古方中治疗发背（背部痈疽）以漏芦汤为首选，因为背部是太阳寒水经所主的部位，漏芦味咸性寒且带有白色茸毛，正与这一病机相合。并且热退后……（原文此处亦有脱漏）。
漏芦能通乳汁，它是通过下泄热结来起作用，而不是直接通利乳汁，能够消除乳房内部的胀痛，并非通用的通乳药剂。
邹氏在疏解麻黄时说：麻黄的果实，中间黑外部红，它的茎干宛如图画中的脉络和骨节，中央红色，外部黄白色。果实代表先天，茎干代表后天。先天代表事物的本性，其意义是由肾传至心；后天代表事物的功用，其意义是由心传至脾肺。由肾及心，这就是所说的“肾主五液，入心化为汗”；由心及脾肺，是为了分布心阳，向外到达骨节、肌肉、皮毛，使其中留滞的病邪无不倾囊而出。所以种植这种植物的地方，冬天不会积雪，因为它能在极阴之中伸展阳气，不被盛寒所凝滞。这段论述对麻黄的性质和功用的分析，非常精审，远胜于其他各家。按《灵枢·本藏》篇说：“肾合三焦膀胱”。三焦和膀胱，对应于腠理和毫毛。麻黄虽然入肾，但中空轻扬，所以是治疗太阳伤寒、发散表邪、发汗的重要药物。肺合皮毛，进入太阳经即进入肺经，进入肺经和心经即进入营卫系统。麻黄的茎并不白，邹氏说它入肺而有意装饰之，未免画蛇添足。另外叶天士、陈修园都说肝主疏泄，认为麻黄发汗就是疏泄，就是入肝，却不知道肝只能向下疏泄而不能向外疏泄，这真是武断到了极点。
与麻黄相互辅助治疗的药物，最重要的有六种：杏仁、桂枝、芍药、石膏、葛根、细辛。
杏仁，是用来作为麻黄的臂助的。麻黄开泄肌腠，杏仁疏通肺络；麻黄性刚猛，杏仁性柔和；麻黄向外扩张，杏仁向内抑制；两者配合，邪气才能彻底清除。如麻黄汤治疗风寒，麻黄杏仁薏苡甘草汤治疗风湿等，都是这个道理。
桂枝，是用来弥补麻黄不足的。麻黄泄出营卫中的邪气，桂枝调和营卫之气。桂枝得到麻黄，就不会导致汗出不止；麻黄得到桂枝，就能控制汗量。两者配合，正气就不会受伤。凡是麻黄和桂枝并用的方剂都是这样。大概要根据证候的轻重……（原文此处语意未完）。
芍药，是一个方剂的枢纽。以小青龙汤为例，外寒与内饮相互搏结，出现干呕、发热而咳嗽，这是必然的症状而非偶然的。麻黄和桂枝解散外寒，细辛和半夏祛除内饮，生姜和五味子止咳逆，甘草调和诸药。寒邪通过汗法解除，水饮则随证去除，只有麻黄进入太阳经而上行，膀胱的气也因之不能下行，导致小便不利、少腹胀满，这在意料之中。加入芍药，是为了驯服麻黄的药性，使水饮得以向下排出。如果小便本来就不利，那么就直接去掉麻黄了。全方重在祛除水饮而非散寒，所以名叫小青龙汤。再参考乌头汤，麻黄气轻，主要驱除停留在肌肤的风寒；乌头气重，主要驱除停留在脏腑的风寒。麻黄祛湿，是湿气随着风寒一起散去；乌头祛湿，是风寒从外散去而湿气从内消除。麻黄伸展阳气但不补阳，乌头补阳的同时也能伸展阳气。这是治疗历节病（关节疼痛不可屈伸）时，这两味药必须并用的原因。虽然这两味药都能出汗但很少进入内心，关节的疾病，不是一发汗就能痊愈的，所以又用芍药来收敛它们，使药力宛转作用于肢节，从而彻底去除疾病。黄（疑为黄芪或他药，原文残缺）疏理营卫之气，则是芍药的前驱。甘草则是培补中土以调和诸药的。因为有芍药能使麻黄和乌头的药力下达，所以……（原文此处语意未完）。
伤寒太阳病即将传入阳明经时，石膏是必用的药物。大青龙汤中的“中风”二字，是相对于小青龙汤中的“伤寒”二字而言的互举之文。麻黄汤治疗伤寒，提到脉浮紧无汗，这里也是脉浮紧无汗。大青龙汤的另一条条文说伤寒脉浮缓，既然浮缓有伤寒，浮紧难道反而没有伤寒吗？况且伤寒第一天太阳经受邪，如果脉象平静说明没有传变，如果想吐、烦躁、脉数急说明已经传变。这里的烦躁，是因为表实导致邪气无法宣泄，传入阳明所致。沈尧封认为烦躁是内伏的热邪，不知道阳明腑实才会导致烦躁，哪有内部已经是腑实证而外部还发热恶寒的道理。用石膏治疗烦躁，称之为治疗太阳传入阳明的烦躁，这与仲景的所有说法无不吻合，还有什么可疑的呢？而且烦躁涉及心肾，但治疗重点在阳明，这不是没有道理的。太阳本寒标热，上与心相连，下与肾为缘，太阳热闭，则心肾都会受到干扰。太阳病不治，则必然会传入阳明。所以烦躁不是心肾自身的病变，而是阳明是需要肃清的出路。在表泄热，在里清热，则烦躁不治自愈。至于石膏，泄肺热也就是泄太阳经的热，太阳卫外的气，从皮毛与肺相合，而石膏既轻又重，既能泄肺又能清胃，两擅其长，所以单用可以治疗出汗后的热症，佐以麻黄又可以治疗无汗的热症。如果离开太阳进入阳明形成腑实证，那么石膏就不能胜任了。
太阳即将传入阳明，葛根也是必用的药物。仲景的文字义理，往往需要参照对比后才能明白。葛根汤的证候，说是太阳病项背强几几（KT KT 应为强几几的异体字或误录），无汗恶风。病名太阳，但方名却以葛根标示。葛根，是太阳和阳明转换的药物。为什么这么说呢？阳明病身热多汗，而葛根治疗大热却不治多汗，反而能解肌出汗。虽然出汗，但不是散发太阳初受的风寒，所以是治疗太阳即将传入阳明的药物。太阳寒邪化热，热邪灼伤津液，导致项背僵硬，葛根升起阴气以滋润它，则变僵硬为柔韧，与麻黄治疗无汗恶风，可谓不相上下。然而这个证候这两味药就够了，为什么还要用桂枝汤呢？大概因为出汗后表虚，用调和阴阳的药跟在后面，则攻补兼施，元气不过度损伤且容易恢复，这是用药操纵的法度，仲景的方剂大多如此。
细辛与杏仁，都是作为麻黄的臂助，但有巨大的不同。杏仁辅助麻黄横向扩张，这是一柔一刚；细辛辅助麻黄直行深入，这是一专一普。麻黄驱除阴邪、发越阳气，不仅入少阴而且用途广泛。细辛则色黑入肾，赤色入心（有人说赤黑色，有人说深紫色，紫就是赤黑相间的颜色），一茎直上，气味辛烈，所以它能攻破少阴的寒凝，锐利而专注。考察仲景的方剂中辅助细辛治疗上部病症的不少：如小青龙汤治水饮，厚朴麻黄汤治咳逆，桂甘姜枣麻辛附子汤治气分病，这些都是显而易见的。唯独麻黄附子细辛汤，治疗少阴病使用细辛，这一层含义被尘封已久。试详细说说：少阴与太阳互为表里，脏气如果中寒，必定在刚开始时就出现吐利、四肢厥冷，不会出现发热。现在有只想睡觉的少阴证却反而发热，这是没有少阴的里证而有外连太阳的表证，自然应该用麻黄发汗。脉沉的应当急温，自然应该用附子温经。至于细辛一味药，柯韵伯说是散浮阳，邹氏说没有细辛是微发汗，有了细辛是大发汗，唐容川更认为脉沉是阳陷，用细辛来提升它。实际上对于细辛的性质和功用，以及仲景因证制方的意图，他们都没有真正窥见。细辛与麻黄，同样能彻上彻下，只是麻黄中空轻扬，用于下行，非借助其他药力不可。细辛没有发表发汗的能力（《本经》说麻黄发表发汗，细辛没有此功能），但对于附着在骨节、九窍的风寒，在上或在下的，它就专心致力去去除，绝不旁骛。所以防己黄芪汤中说下有陈寒者加细辛，可见细辛散少阴经气之寒，确有专长，不是麻黄能比的。那么麻黄附子甘草汤没有细辛，而这个方子为什么有细辛？那个方子没有里证，这个方子又何尝有里证？仲景用麻黄一定说要取微汗，这里怎么能取大汗？应当在始得病与得病二三日，以及麻黄煎煮方法的不同处，详细探究其义理了。经书说：逆冬气则少阴不藏，肾气独沉。肾气沉则脉无不沉，即使是仲景所说的脉微细、但欲寐的脉，也未尝不是沉，这里单说沉，是因为沉得很厉害。脉沉自然是少阴病的本象，这里不说少阴病脉沉反发热，而说反发热脉沉，大概是少阴病不应发热而反发热，发热则应当由太阳向外达，现在发热兼脉沉，岂能没有二三天变为里证的担忧。于是用附子专门温经，细辛辅助麻黄，精锐之师直入以散在经之邪；麻黄先煮减二升，是想让它的药气下行；不加甘草，是怕它减缓三药的作用而中途停止；这是发热脉沉在始得时的治法。如果到二三天而没有里证，则不至于或有里证，不应当用细辛先开其隙；所以用麻黄附子治疗发热脉沉，而以甘草代替细辛，且先煮麻黄只一二沸，以节制其入里的势头，调和其散邪的气机，这正符合得病二日三日的分寸。那个方子不言无里证，这个方子不言发热脉沉，是互举之文。仲景斟酌病机，可谓精妙啊。
再用仲景用麻黄、杏仁、石膏而治法截然不同的例子来说明，大青龙汤三药并用，是发汗的峻剂，麻杏甘膏汤也是三药并用，却偏治汗出而喘、无大热的情况，为什么呢？这一节的文字义理，是将“汗出”二字倒装，放在“不可更行桂枝汤”之下。正因为有汗出，让人怀疑可行桂枝汤而不可行麻黄汤。不知道汗出而喘、无大热，不是桂枝汤证的汗出，而是发汗后表已解的汗出。表已解故无大热，喘则还有余邪，桂枝汤不可用，而大青龙汤不变其法也不可。因此变峻剂为平和之剂，用麻黄四两，石膏加倍，使得麻黄的猛烈之技不得逞，而余邪恰好因此尽除。而且石膏加倍使用，不仅制约麻黄的悍烈，泄出汗出的热，就连杏仁也必须抑制其外达之势，以下气而止喘。止喘不是麻黄的事吗？但汗出无大热的喘，则是气逆多而表郁少，所以减少麻黄而增加杏仁，确实药物的多少关系重大，绝非小事。
石膏以两计算的，与麻黄的多少容易看清，麻杏甘膏汤中，石膏比麻黄多一倍，核对治法正好符合。如果大青龙汤中石膏也多于麻黄，那么麻黄已被严重制约，怎么会担心汗多呢？徐洄溪说：大青龙汤一剂，除去大枣约共十六两，以现在的秤计算，也有三两有余，则是发汗的重剂了。虽然少加石膏，终究不足以制约它。所谓十六两，已经将石膏计算在内，所谓三两有余，是按古一两等于今二钱零计算，不知道鸡蛋大的一块石膏，徐洄溪究竟算作现在的多少重量。我将石膏碎成鸡蛋大块称量，总不在三两之下。而徐洄溪说一剂共三两有余，真令人不解。王朴庄精通算学，认为伤寒方一两准今七分六厘，则更没有徐洄溪说的二钱零那么多。现在姑且按二钱零为一两计算，麻黄六两，也不过有现在的半斤多一点；而石膏鸡蛋大一块，则有……（原文此处中断）
Loulou (Radix Euphorbiae Humifusae) also belongs to the Artemisia genus, but Qinghao (Herba Artemisiae Annuae) treats scabies with crusting and itching, where the heat is located between the bone joints; whereas Loulou treats malignant sores caused by damp-bi syndrome, where the heat is located in the skin and muscles.
Qinghao has an aromatic and bitter-cold nature, clearing both dampness and heat simultaneously, thus it is suitable for sores transforming from dampness to dryness. Loulou is black in color, salty in taste, and cold in nature; it disperses heat from the muscle surface, while the dampness... [The original text here appears incomplete or fragmented, implying the dampness is resolved]. In ancient formulas for treating "Fabei" (back carbuncle), Loulu Tang (Loulou Decoction) is considered the premier choice because the back is the domain of the Taiyang Cold-Water meridian. Loulou's salty and cold nature, combined with its white fuzz, perfectly corresponds to this pathology. And after the heat subsides... [Text fragment].
Loulou promotes lactation by draining heat accumulation, rather than directly promoting milk flow; it can relieve breast distension and pain, but it is not a general galactagogue.
Zou, in his commentary on Mahuang (Ephedrae Herba), stated: The fruit of Mahuang is black inside and red outside; its stem resembles meridians and bone joints, being red in the center and yellowish-white on the outside. The fruit represents congenital essence (Xiantian), and the stem represents acquired function (Houtian). Congenital essence represents the nature of things, meaning transmission from Kidney to Heart; acquired function represents utility, meaning transmission from Heart to Spleen and Lung. From Kidney to Heart refers to "Kidney governs the five fluids, which transform into sweat upon entering the Heart"; from Heart to Spleen and Lung serves to distribute Heart Yang outward to the bone joints, muscles, and skin/hair, expelling all stagnation. Therefore, land planted with this herb does not accumulate snow in winter, as it can extend Yang Qi within extreme Yin, resisting condensation by severe cold. This discussion on Mahuang's properties and functions is extremely precise, surpassing other schools. According to the *Lingshu · Ben Cang* chapter: "Kidney harmonizes with Sanjiao and Bladder." Sanjiao and Bladder correspond to the Couli (interstices) and body hair. Although Mahuang enters the Kidney, its hollow and light-yang nature makes it a key herb for releasing the exterior and inducing sweating in Taiyang Cold Damage. The Lung governs the skin and hair; entering the Taiyang meridian means entering the Lung meridian, and entering the Lung and Heart means entering the Ying and Wei systems. Mahuang stems are not white; Zou's claim that it enters the Lung and is intentionally decorated is superfluous. Furthermore, Ye Tianshi and Chen Xiuyuan both stated that the Liver governs Shuxie (free flow and drainage), considering Mahuang's sweating action as Shuxie and entry into the Liver. However, they did not realize that the Liver can drain downward but not outward; this is extremely arbitrary.
The substances that assist Mahuang in treatment are primarily six: Xingren (Semen Armeniacae Amarum), Guizhi (Ramulus Cinnamomi), Shaoyao (Radix Paeoniae Alba/Rubra), Shigao (Gypsum Fibrosum), Gegen (Radix Puerariae), and Xixin (Radix Asari).
Xingren serves as an assistant to Mahuang. Mahuang opens the Couli, while Xingren unblocks the Lung collaterals; Mahuang is rigid in nature, while Xingren is soft; Mahuang expands outward, while Xingren suppresses inwardly; together, they eliminate pathogens completely. Examples include Mahuang Tang (Ephedra Decoction) for Wind-Cold, and Mahuang Xingyi Gancao Tang (Ephedra, Coix Seed, and Licorice Decoction) for Wind-Damp.
Guizhi compensates for Mahuang's insufficiency. Mahuang drains pathogens from Ying and Wei, while Guizhi harmonizes Ying and Wei Qi. With Guizhi, Mahuang prevents excessive sweating; with Mahuang, Guizhi regulates sweating. Together, they protect healthy Qi. This applies to all formulas using both. Generally, one must consider the severity of the syndrome... [Text fragment].
Shaoyao acts as the pivot of a formula. Taking Xiao Qinglong Tang (Minor Green Dragon Decoction) as an example: external Cold combats internal fluid retention, causing dry heaving, fever, and cough—these are necessary symptoms, not optional ones. Mahuang and Guizhi scatter external Cold, Xixin and Banxia dispel internal fluids, Ginger and Wuweizi stop cough reversal, and Gancao harmonizes the herbs. Cold is resolved via sweating, fluids are removed according to the condition. However, Mahuang enters Taiyang and ascends, causing Bladder Qi to fail to descend, leading to difficult urination and lower abdominal fullness, which is expected. Adding Shaoyao tames Mahuang's nature, allowing fluids to drain downward. If urination were already difficult, Mahuang would be removed entirely. Since the formula prioritizes dispelling fluids over scattering Cold, it is named Xiao Qinglong Tang. Referencing Wutou Tang (Aconite Decoction): Mahuang is light in qi, driving out Wind-Cold in the skin/muscles; Wutou (Radix Aconiti Lateralis Preparata) is heavy in qi, driving out Wind-Cold in the Zang-Fu. Mahuang removes dampness as it leaves with Wind-Cold; Wutou removes dampness as Wind-Cold scatters externally and dampness dissipates internally. Mahuang extends Yang without tonifying; Wutou tonifies Yang while extending it. These two must be used together for Li Jie syndrome (painful inability to flex/extend joints). Although both induce sweating and rarely enter the interior, joint diseases cannot be cured by a single sweat; thus, Shaoyao is added to收敛 (astringe/gather) them, allowing the medicinal force to circulate through the limbs and eliminate the disease. Huang [missing character] disperses Ying-Wei Qi, serving as Shaoyao's vanguard. Gancao cultivates the Middle Earth to harmonize. Because Shaoyao allows Mahuang and Wutou to descend... [Text fragment].
When Taiyang Cold Damage is about to transmit to Yangming, Shigao (Gypsum Fibrosum) is essential. The term "Zhong Feng" (Wind Strike) in Da Qing Long Tang (Major Green Dragon Decoction) is presented in parallel with "Shang Han" (Cold Damage) in Xiao Qinglong Tang. Mahuang Tang treats Shang Han, noting floating-tight pulse and no sweat; this case also has floating-tight pulse and no sweat. Another clause in Da Qing Long Tang mentions Shang Han with floating-slow pulse. If floating-slow implies Shang Han, how could floating-tight lack it? Moreover, on day one of Shang Han, if the pulse is quiet, there is no transmission; if there is desire to vomit, irritability, and rapid pulse, there is transmission. This irritability arises from exterior excess preventing pathogen release, transmitting to Yangming. Shen Yaofeng attributed irritability to latent heat, not realizing Yangming Fu-excess causes irritability; it is illogical to have internal Fu-excess while still having exterior fever and aversion to cold. Using Shigao to treat irritability as resulting from Taiyang transmitting to Yangming aligns with Zhongjing's theories. Irritability involves Heart and Kidney, but treatment focuses on Yangming, which is not meaningless. Taiyang is fundamentally Cold with superficial Heat, connecting to Heart above and Kidney below. Taiyang heat closure disturbs Heart and Kidney. Untreated Taiyang inevitably transmits to Yangming. Thus, irritability is not a primary disease of Heart/Kidney, but Yangming is the pathway that needs clearing. Clearing heat from the exterior and interior resolves irritability spontaneously. Shigao clears Lung heat, thereby clearing Taiyang heat; Taiyang's defensive Qi combines with the Lung via the skin/hair. Shigao is both light and heavy, clearing Lung and Stomach, making it effective alone for post-sweat heat and with Mahuang for non-sweating heat. If it enters Yangming to form Fu-excess, Shigao is insufficient.
As Taiyang approaches Yangming, Gegen (Radix Puerariae) is also essential. Zhongjing's texts require cross-referencing. Ge Gen Tang (Kudzu Decoction) syndrome is described as Taiyang syndrome with stiff neck/back, no sweat, and aversion to wind. Though named Taiyang, the formula is named after Gegen. Gegen is the herb for transition between Taiyang and Yangming. Why? Yangming syndrome features body heat and profuse sweating, yet Gegen treats high heat without addressing profuse sweating, instead resolving the muscle layer and inducing sweat. Although it induces sweat, it does not scatter initial Taiyang Cold; hence, it treats Taiyang approaching Yangming. Taiyang Cold transforms to Heat, consuming fluids, causing stiffness. Gegen raises Yin Qi to lubricate, turning stiffness to flexibility, comparable to Mahuang's treatment of no-sweat/aversion-to-cold. However, these two herbs suffice for this syndrome; why add Guizhi Tang? Sweating indicates exterior deficiency; following with harmonizing Yin-Yang herbs ensures attack and tonification occur simultaneously, preserving Yuan Qi. This is the method of manipulation in Zhongjing's formulas.
Xixin (Radix Asari) and Xingren assist Mahuang but differ greatly. Xingren assists Mahuang in lateral expansion (Yin-Yang balance); Xixin assists Mahuang in direct penetration (specialized vs. universal). Mahuang drives out Yin pathogens and releases Yang Qi, widely used including in Shaoyin. Xixin is black (enters Kidney) and red/purple (enters Heart), growing straight up with pungent aroma, sharply breaking Shaoyin Cold congealment. Zhongjing uses Xixin for upper disorders: Xiao Qinglong Tang for fluid retention, Houpo Mahuang Tang for cough/reversal, Guigan Jiangzao Maxing Fuzi Tang for Qi-level disorders. Only Mahuang Fuzi Xixin Tang uses Xixin for Shaoyin syndrome, a meaning long obscured. Shaoyin and Taiyang are exterior-interior. If Zang Cold occurs, vomiting/diarrhea/cold limbs appear immediately without fever. Here, Shaoyin syndrome (desire to sleep) with fever indicates no interior Shaoyin syndrome but exterior connection to Taiyang, requiring Mahuang for sweating. Deep pulse requires urgent warming with Fuzi. Ke Yunbo said Xixin scatters floating Yang; Zou said Xixin increases sweating; Tang Rongchuan said deep pulse indicates sinking Yang, raised by Xixin. They missed Zhongjing's intent. Both Mahuang and Xixin reach upper and lower levels. Mahuang is hollow/light, needing assistance to descend. Xixin lacks exterior-releasing/sweating power (per *Ben Jing*), but specifically targets Wind-Cold attached to bone joints/orifices. Fangji Huangqi Tang adds Xixin for chronic Cold below, showing Xixin's specialty in dispersing Shaoyin meridian Cold, unmatched by Mahuang. Mahuang Fuzi Gancao Tang lacks Xixin; why does this one have it? Neither has interior syndrome. Zhongjing specifies "slight sweat" for Mahuang; this formula risks heavy sweat. One must examine the timing (initial vs. 2-3 days) and decoction methods. Classics state: violating Winter Qi causes Shaoyin failure to store, Kidney Qi sinks. Sinking Qi causes deep pulse. Even "fine/deep pulse, desire to sleep" implies deepness. "Deep" here emphasizes severity. Deep pulse is Shaoyin's characteristic. Saying "fever with deep pulse" rather than "deep pulse with fever" implies Shaoyin shouldn't fever; if it does, it should emerge via Taiyang. Fever with deep pulse risks becoming interior syndrome in 2-3 days. Thus, Fuzi warms the meridian, Xixin assists Mahuang to penetrate meridian pathogens. Mahuang boiled first to reduce volume directs Qi downward. No Gancao to avoid slowing the three herbs. This is the treatment for fever/deep pulse at onset. By day 2-3 without interior syndrome, Xixin is replaced by Gancao, and Mahuang boiled briefly to moderate interior entry and harmonize dispersion. This matches the 2-3 day stage. The omission of details in one formula versus another is parallel writing. Zhongjing's pathological consideration is exquisite.
Regarding Zhongjing's use of Mahuang, Xingren, and Shigao with different treatments: Da Qing Long Tang uses all three as a harsh sweating agent. Ma Xing Gan Shi Tang also uses all three but treats sweating, wheezing, and no significant heat. The text structure places "sweating" before "cannot use Guizhi Tang." Sweating suggests Guizhi might be appropriate, but this sweating is post-sweating resolution, not Guizhi syndrome sweating. Exterior resolved means no significant heat; wheezing indicates residual pathogen. Guizhi Tang is contraindicated; Da Qing Long Tang is also inappropriate. Thus, harshness is moderated: Mahuang 4 liang, Shigao doubled. This restrains Mahuang, allowing residual pathogens to clear. Doubled Shigao not only checks Mahuang's ferocity and clears sweat-heat but also forces Xingren to suppress upward movement, descending Qi to stop wheezing. Wheezing is usually Mahuang's domain, but here, Qi rebellion is high while exterior constraint is low, so Mahuang is reduced and Xingren increased. Herb dosage is critical.
In Ma Xing Gan Shi Tang, Shigao is double Mahuang, matching the treatment. In Da Qing Long Tang, Shigao also exceeds Mahuang, heavily restraining it, yet Xu Huixi worried about excessive sweating. Xu calculated Da Qing Long Tang (excluding dates) as ~16 taels, approx. 3+ taels modern weight, a heavy sweating agent. He felt slight Shigao was insufficient. Xu included Shigao in the 16 taels. Modern conversion varies: Wang Puzhuang calculated 1 ancient tael = 7.6 cun (approx. 2.8g). 6 liang Mahuang ≈ 1.5 modern jin? No, 6 liang ≈ 220g. Xu's "3 taels" calculation seems inconsistent with the "egg-sized" Shigao block, which I weighed at over 3 taels. Xu's total weight estimate is puzzling. Assuming 1 tael = 2 qian (approx. 7.5g), 6 liang Mahuang is substantial. Shigao egg-sized block is... [Text ends abruptly].