太阳病，发热恶寒，热多寒少，脉微弱者，此无阳也，不可更（赵本医统本并作“发”）汗，宜桂枝二越
婢一汤方。
桂枝二越婢一汤方∶
桂枝（去皮） 芍药 甘草（各十八铢，赵本有“炙”字） 生姜（一两三钱，赵本作“二铢”，切，医
统本无“切”字） 大枣（四枚，擘
）麻黄（十八铢，去节，赵本无“去节”二字） 石膏（二十四铢，碎，绵裹）
胃为十二经之主，脾治水谷为卑脏若婢。《内经》曰∶脾主为胃行其津液。是汤所以谓之越婢者，以发越
脾气，通行津液。外台方，一名越脾汤，即此义也。
上七味， 咀。（赵本无“ 咀”二字）以五升水，（赵本作“水五升”）煮麻黄一二沸，去上沫，内
诸药，煮取二升，去滓，温服一升。本方（赵本作“云”）当裁为越婢汤、桂枝汤，合（赵
本有“之”字）饮一升，今合为一方，桂枝二越婢一。（赵本作“桂枝汤二分，越婢汤一分”。熊校记∶本方
至越婢一，按此廿六字，语欠明，赵本作本云当裁为越婢汤桂枝汤，合之饮一升，合今为一方，桂枝
汤二分，越婢汤一分，是赵本文义较完，当从订正。）
服桂枝汤，或下之，仍头项强痛，翕翕发热，无汗，心下满，微痛，小便不利者，桂枝汤（赵本医统本并无“
汤”字）去桂，加茯苓白术汤主之。（赵本有“桂枝去桂加茯苓白术汤方”详见本书卷十）
头项强痛，翕翕发热，虽经汗下，为邪气仍在表也。心下满，微痛，小便利者，则欲成结胸。今外证
未罢，无汗，小便不利，则心下满，微痛，为停饮也。与桂枝汤以解外，加茯苓白术利小便行留饮。
伤寒脉浮，自汗出，小便数，心烦，微恶寒，脚挛急，反与桂枝汤，（赵本无“汤”字，）欲攻其表，此
误也。得之便厥，咽中干，烦燥，（赵本作“躁”）吐逆者，作甘草干姜汤与之，以复其阳。若厥愈、足温者，
更作芍药甘草汤与之，其脚即伸。若胃气不和，谵语者，少与调胃承气汤。若重发汗，复加烧针者，四逆汤主之。
脉浮，自汗出，小便数而恶寒者，阳气不足也。心烦、脚挛
急者，阴气不足也。阴阳血气俱虚，则不可发汗，若与桂枝汤攻表，则又损阳气，故为误也。得之便厥，咽中
干，烦燥吐逆者，先作甘草干姜汤，复其阳气，得厥愈足温，乃与芍药甘草汤，益其阴血，则脚胫得伸。阴
阳虽复，其有胃燥、谵语，少与调胃承气汤微溏，以和其胃。重发汗为亡阳，加烧针则损阴，
《内经》曰∶荣气微者，加烧针则血不流行，重发汗，复烧针，是阴阳之气大虚，四逆汤以复阴阳之气。
甘草干姜汤方∶
甘草（四两，炙，味甘平） 干姜（二两，炮，味辛热）
《内经》曰∶辛甘发散为阳，甘草干姜相合，以复阳气。
上 咀，（赵本作“二味”）以水三升，煮取一升五合，去滓，分温再服。
芍药甘草汤方∶
白芍药（四两。味，医统本有“苦”字，酸，微寒） 甘草（四两，炙。甘平）
芍药，白补而赤泻，白收而赤散也。酸以收之，甘以缓之，酸甘相合，用补阴血。
上二味 咀，（赵本无“ 咀”二字）以水三升，煮取一升半，（赵本作“五合”）去滓，分温再服
之。（赵本无“之”字）
调胃承气汤方∶
大黄（四两，去皮，清酒浸。赵本作“洗”） 甘草（二两，炙，味甘平） 芒硝（赵本医统本并作“消
”，半斤，医统本作“升”，味咸苦，大寒）
《内经》曰∶热淫于内，治以咸寒，佐以苦甘。芒硝咸寒以除热，大黄苦寒以荡实，甘草甘平，助二
物，推陈而缓中。
上三味 咀，（赵本无“ 咀”二字）以水三升，煮取一升，
去滓，内芒硝更上火微煮，令沸，少少温服。（赵本医统本并有“之”字）
四逆汤方∶
甘草（二两，炙。味甘平） 干姜（一两半。味辛热） 附子（一枚，生用，去皮，破八片。辛，大热）
《内经》曰∶寒淫于内，治以甘热；又曰∶寒淫所胜，平以辛热。甘草姜附相合，为甘辛大热之剂，
乃可发散阴阳之气。
上三味 咀，（赵本无“ 咀”二字）以水三升，煮取一升二合，去滓，分温再服，强人可大附子一枚，
干姜三两。
问曰∶证象阳旦，按法治之而增剧，厥逆，咽中干，两胫拘急而谵语。师曰∶言夜半手足当温，两脚
当伸，后如师言。何以知此？答曰∶寸口脉浮而大，浮则（赵本无“则”字）为风，大则（赵本无“则”字）
为虚，风则生微热，虚则两胫挛。病证（赵本作“形”）象桂枝，因加附子参其间，增桂令汗出，附子温经，
亡阳故也。厥逆咽中干，烦燥，（赵本作“躁”）阳明内结，谵语，烦乱，更饮甘草干姜汤。夜半阳气还，两
足当热，胫尚微拘急，重与芍药甘草汤，尔乃胫伸，以承气汤微溏，则止其谵语，故知病可愈。
阳旦，桂枝汤别名也。前证脉浮（医统本作“微”）自汗出，小便数，心烦，微恶寒，脚挛急，与桂枝
汤证相似，是证象阳旦也。与桂枝汤而增剧，得寸口脉浮大，浮为风邪，大为血虚，即于桂
枝汤加附子，温经以补虚，增桂令汗出以祛风。其有治之之逆而增厥者，与甘草干姜汤，阳复而足温，更与
芍药甘草汤，阴和而胫伸。表邪已解，阴阳已复，而有阳明内结，谵语烦乱，少与
调胃承气汤，微溏泄以和其胃，则阴阳之气皆和，内外之邪悉去，故知病可愈。
太阳病，出现发热、恶寒的症状，且发热多而恶寒少，脉象微弱，这是阳气不足（无阳），不可再使用发汗法，适宜使用桂枝二越婢一汤。
桂枝二越婢一汤方：
桂枝（去皮）、芍药、甘草（各十八铢，赵本有“炙”字）、生姜（一两三钱，赵本作“二铢”，切，医统本无“切”字）、大枣（四枚，掰开）、麻黄（十八铢，去节，赵本无“去节”二字）、石膏（二十四铢，捣碎，用绵布包裹）。
胃是十二经脉的主宰，脾处理水谷精微如同卑下的婢女。《内经》说：“脾主为胃运行津液。”这个方剂之所以叫越婢汤，是因为它能发越脾气，通行津液。《外台秘要》中的方子，一名越脾汤，就是这个意思。
以上七味药，锉碎。（赵本无“锉碎”二字）用五升水，（赵本作“水五升”）先煮麻黄一二沸，去掉上面的浮沫，加入其他药物，煮取二升药液，去掉药渣，温服一升。原方（赵本作“云”）应当裁减为越婢汤和桂枝汤，（赵本有“之”字）合起来喝一升，现在合并为一个方子，桂枝二份，越婢一份。（赵本作“桂枝汤二分，越婢汤一分”。熊校记：原方至越婢一，按这二十六个字，语意不够明确，赵本作“本云当裁为越婢汤桂枝汤，合之饮一升，合今为一方，桂枝汤二分，越婢汤一分”，赵本文义较完整，应当据此订正。）
服用桂枝汤后，或者经过泻下治疗，仍然头项强痛，像羽毛覆盖般发热（翕翕发热），无汗，心下部胀满，轻微疼痛，小便不利者，用桂枝汤去掉桂枝，加上茯苓和白术的方子主治。（赵本有“桂枝去桂加茯苓白术汤方”详见本书卷十）
头项强痛，翕翕发热，虽然经过发汗或泻下治疗，说明邪气仍在体表。心下部胀满，轻微疼痛，如果小便通畅，则可能形成结胸证。现在表证未解，无汗，小便不利，那么心下部胀满、轻微疼痛，是由于水饮停聚所致。给予桂枝汤以解除表邪，加入茯苓和白术以利小便、行留滞之水饮。
伤寒脉浮，自汗出，小便频数，心烦，轻微恶寒，脚部拘挛急迫，反而给予桂枝汤，想要攻逐表邪，这是误治。导致四肢厥冷，咽喉干燥，烦躁，（赵本作“躁”）呕吐逆气者，制作甘草干姜汤给予患者，以恢复其阳气。如果四肢厥冷痊愈、脚变暖了，再制作芍药甘草汤给予患者，他的脚就能伸直。如果胃气不和，出现谵语（胡言乱语），少量给予调胃承气汤。如果再次发汗，又加上烧针治疗，用四逆汤主治。
脉浮，自汗出，小便频数且恶寒，这是阳气不足。心烦、脚部拘挛急迫，这是阴气不足。阴阳气血都虚弱，则不可发汗，如果给予桂枝汤攻表，则会进一步损伤阳气，所以是误治。导致四肢厥冷，咽喉干燥，烦躁吐逆者，先制作甘草干姜汤，恢复其阳气，等到四肢厥冷痊愈、脚变暖，再给予芍药甘草汤，补充其阴血，那么小腿就能伸直。阴阳虽然恢复，如果有胃燥、谵语，少量给予调胃承气汤轻微通便，以调和胃气。过度发汗会导致亡阳，加上烧针则会损伤阴血，《内经》说：“营气微弱的人，加上烧针则血液运行不畅。”过度发汗，又加烧针，这是阴阳之气大虚，用四逆汤来恢复阴阳之气。
甘草干姜汤方：
甘草（四两，炙，味甘平）、干姜（二两，炮制，味辛热）。
《内经》说：“辛甘发散为阳”，甘草和干姜相合，用来恢复阳气。
以上两味药锉碎，（赵本作“二味”）用水三升，煮取一升五合，去掉药渣，分两次温服。
芍药甘草汤方：
白芍药（四两。味酸，医统本有“苦”字，微寒）、甘草（四两，炙。甘平）。
芍药，白色具有补益作用，赤色具有泻泄作用；白色具有收敛作用，赤色具有发散作用。酸味以收敛，甘味以缓急，酸甘相合，用于补益阴血。
以上两味药锉碎，（赵本无“锉碎”二字）用水三升，煮取一升半，（赵本作“五合”）去掉药渣，分两次温服。（赵本无“之”字）
调胃承气汤方：
大黄（四两，去皮，清酒浸泡。赵本作“洗”）、甘草（二两，炙，味甘平）、芒硝（赵本医统本并作“消”，半斤，医统本作“升”，味咸苦，大寒）。
《内经》说：“热邪盛于内，用咸寒药物治疗，佐以苦甘。”芒硝咸寒以清除热邪，大黄苦寒以荡涤实邪，甘草甘平，辅助这两味药，推陈出新并缓和药性。
以上三味药锉碎，（赵本无“锉碎”二字）用水三升，煮取一升，去掉药渣，加入芒硝，再上火稍微煮一下，令其沸腾，少量多次温服。（赵本医统本并有“之”字）
四逆汤方：
甘草（二两，炙。味甘平）、干姜（一两半。味辛热）、附子（一枚，生用，去皮，破成八片。辛，大热）。
《内经》说：“寒邪盛于内，用甘热药物治疗；又说：‘寒邪偏胜，用辛热药物平复它。’”甘草、干姜、附子相合，成为甘辛大热的方剂，才能发散阴阳之气（此处指驱散阴寒，恢复阳气）。
以上三味药锉碎，（赵本无“锉碎”二字）用水三升，煮取一升二合，去掉药渣，分两次温服，体质强壮的人可用大附子一枚，干姜三两。
问：症状像阳旦证，按照常规方法治疗却加重，出现四肢厥逆，咽喉干燥，两小腿拘挛急迫并且谵语。老师说：预计半夜手足会变暖，两脚会伸直，后来果然如老师所说。为什么能知道这一点？回答说：寸口脉浮而大，浮则（赵本无“则”字）代表风邪，大则（赵本无“则”字）代表虚证，风邪则产生轻微发热，虚证则两小腿拘挛。病证（赵本作“形”）象桂枝汤证，因此在其中加入附子，增加桂枝用量令其出汗，附子温经，这是因为亡阳的缘故。四肢厥逆，咽喉干燥，烦躁，（赵本作“躁”）阳明内结，谵语，烦乱，再饮用甘草干姜汤。夜半阳气回复，两足应当发热，小腿尚且轻微拘挛急迫，再次给予芍药甘草汤，然后小腿伸直，再用承气汤轻微通便，则停止谵语，所以知道病可以痊愈。
阳旦，是桂枝汤的别名。前面的证候脉浮（医统本作“微”），自汗出，小便频数，心烦，轻微恶寒，脚拘挛急迫，与桂枝汤证相似，这就是证象阳旦。给予桂枝汤后病情加重，诊得寸口脉浮大，浮为风邪，大为血虚，即在桂枝汤中加入附子，温经以补虚，增加桂枝令其出汗以祛风。其中有因治疗不当而加重厥逆的，给予甘草干姜汤，阳气回复则脚暖，再给予芍药甘草汤，阴气和顺则小腿伸直。表邪已解，阴阳已复，而有阳明内结，谵语烦乱，少量给予调胃承气汤，轻微通便泄热以调和胃气，则阴阳之气皆调和，内外之邪全部去除，所以知道病可以痊愈。
Taiyang disease, characterized by fever and aversion to cold, with more heat than cold, and a faint pulse, indicates a deficiency of Yang (deficiency of Yang Qi). Sweating methods should not be used; Guizhi Er Yuebi Yi Tang (Cinnamon Twig Twice and Pueraria Once Decoction) is appropriate.
Guizhi Er Yuebi Yi Tang Formula:
Guizhi (Cinnamomi Ramulus, peeled), Shaoyao (Paeoniae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, each 18 zhu, Zhao edition has "roasted"), Shengjiang (Zingiberis Rhizoma Recens, 1 liang 3 qian, Zhao edition makes it "2 zhu", sliced, Yitong edition lacks "sliced"), Dazao (Jujubae Fructus, 4 pieces, torn apart), Mahuang (Ephedrae Herba, 18 zhu, nodes removed, Zhao edition lacks "nodes removed"), Shigao (Gypsum Fibrosum, 24 zhu, crushed, wrapped in cotton gauze).
The Stomach is the master of the twelve meridians; the Spleen processes water and grain like a humble servant. The *Neijing* states: "The Spleen governs transporting and transforming fluids for the Stomach." This formula is called Yuebi Tang because it promotes the ascending function of the Spleen Qi and circulates body fluids. The formula in *Waitai Miyao*, also known as Yuemi Tang, shares this meaning.
The above seven herbs are coarsely crushed. (Zhao edition lacks "coarsely crushed") Boil with five sheng of water. (Zhao edition makes it "water five sheng") First boil Mahuang for one or two boils, remove the foam on the surface, then add the remaining herbs. Boil until two sheng of liquid remain, strain, and take one sheng warm. The original formula (Zhao edition makes it "says") should be divided into Yuebi Tang and Guizhi Tang, mixed and taken as one sheng. Now they are combined into one formula: two parts Guizhi Tang and one part Yuebi Tang. (Zhao edition makes it "Guizhi Tang two parts, Yuebi Tang one part". Xiong's collation note: From the original text to 'Yuebi Yi', these twenty-six characters are unclear in meaning. Zhao edition reads: 'Originally said to divide into Yuebi Tang and Guizhi Tang, mix them and drink one sheng, now combine into one formula, Guizhi Tang two parts, Yuebi Tang one part.' The meaning of Zhao edition is more complete and should be adopted for correction.)
After taking Guizhi Tang, or after purgative treatment, if there is still stiffness and pain in the head and neck, mild fever (like being covered by feathers), no sweating, fullness below the heart with slight pain, and difficult urination, treat with Guizhi Tang minus Guizhi plus Fuling and Baizhu. (Zhao edition has "Guizhi Qu Gui Jia Fuling Baizhu Tang Formula" see Volume 10 of this book)
Stiffness and pain in the head and neck, and mild fever, persist despite sweating or purging, indicating that pathogenic factors remain in the exterior. Fullness below the heart and slight pain, if accompanied by free urination, suggest the formation of Jie Xiong (chest binding syndrome). Here, since exterior symptoms have not resolved, there is no sweating, and urination is difficult, the fullness below the heart and slight pain are due to retained fluid retention. Give Guizhi Tang to resolve the exterior, and add Fuling and Baizhu to promote urination and move retained fluids.
In Shanghan (Cold Damage), with a floating pulse, spontaneous sweating, frequent urination, vexation, slight aversion to cold, and cramped legs, giving Guizhi Tang to attack the exterior is an error. This leads to cold extremities, dry throat, restlessness, (Zhao edition makes it "agitation") and vomiting/nausea. Prepare Ganshao Ganjiang Tang (Licorice and Dried Ginger Decoction) to restore Yang Qi. If cold extremities resolve and feet become warm, prepare Shaoyao Gancao Tang (Peony and Licorice Decoction); the legs will then extend. If stomach Qi is disharmonious leading to delirium, give a small amount of Xiaochengqi Tang (Minor Order the Stomach Decoction). If excessive sweating is repeated and moxibustion with burning needles is added, treat with Sini Tang (Frigid Extremities Decoction).
Floating pulse, spontaneous sweating, frequent urition, and aversion to cold indicate insufficient Yang Qi. Vexation and cramped legs indicate insufficient Yin Qi. When both Yin and Yang, blood and Qi are deficient, sweating should not be induced. Giving Guizhi Tang to attack the exterior would further damage Yang Qi, hence it is an error. Cold extremities, dry throat, restlessness, and vomiting/nausea occur first; prepare Ganshao Ganjiang Tang to restore Yang Qi. Once cold extremities resolve and feet warm, give Shaoyao Gancao Tang to nourish Yin and Blood, allowing the calves to extend. Although Yin and Yang are restored, if there is stomach dryness and delirium, give a small amount of Tiaowei Chengqi Tang (Regulate the Stomach Order the Bowels Decoction) to mildly loosen the bowels and harmonize the Stomach. Excessive sweating leads to loss of Yang; adding burning needles damages Yin. The *Neijing* says: "In those with weak Ying Qi, adding burning needles causes blood circulation to stagnate." Excessive sweating followed by burning needles results in severe deficiency of both Yin and Yang Qi; Sini Tang is used to restore Yin and Yang Qi.
Ganshao Ganjiang Tang Formula:
Gancao (Licorice Root, roasted, four liang, sweet and neutral), Ganjiang (Dried Ginger, processed, two liang, acrid and hot).
The *Neijing* states: "Acrid and sweet disperse and generate Yang." Gancao and Ganjiang combined serve to restore Yang Qi.
Coarsely crush the above two herbs. (Zhao edition makes it "two herbs") Boil with three sheng of water until one sheng five he remains. Strain and take half warm, twice daily.
Shaoyao Gancao Tang Formula:
Baishaoyao (White Peony Root, four liang. Sour, Yitong edition adds "bitter", slightly cold), Gancao (Licorice Root, roasted, four liang. Sweet and neutral).
Shaoyao: White tonifies, Red drains; White astringes, Red disperses. Sour astringes, Sweet moderates. Sour and Sweet combined are used to tonify Yin and Blood.
Coarsely crush the above two herbs. (Zhao edition lacks "coarsely crushed") Boil with three sheng of water until one sheng half remains. (Zhao edition makes it "five he") Strain and take half warm, twice daily. (Zhao edition lacks "daily")
Tiaowei Chengqi Tang Formula:
Dahuang (Rhei Radix et Rhizoma, four liang, peeled, soaked in clear wine. Zhao edition makes it "washed"), Gancao (Licorice Root, roasted, two liang, sweet and neutral), Mangxiao (Natrii Sulfas, Zhao/Yitong editions make it "Xiao", half jin, Yitong edition makes it "sheng", salty, bitter, very cold).
The *Neijing* states: "When heat dominates internally, treat with salty-cold substances, assisted by bitter-sweet." Mangxiao is salty-cold to clear heat; Dahuang is bitter-cold to purge accumulation; Gancao is sweet-neutral, assisting these two to push out the old and moderate the middle.
Coarsely crush the above three herbs. (Zhao edition lacks "coarsely crushed") Boil with three sheng of water until one sheng remains. Add Mangxiao, boil briefly over fire until boiling. Take small amounts warm. (Zhao/Yitong editions both have "daily")
Sini Tang Formula:
Gancao (Licorice Root, roasted, two liang, sweet and neutral), Ganjiang (Dried Ginger, one and a half liang, acrid and hot), Fuzi (Aconiti Lateralis Radix Preparata, raw use, one piece, peeled, broken into eight slices. Acrid, very hot).
The *Neijing* states: "When cold dominates internally, treat with sweet-hot substances"; also: "When cold prevails, pacify with acrid-hot substances." Gancao, Ganjiang, and Fuzi combined form a sweet-acrid very hot preparation capable of dispersing Yin-Cold and restoring Yang.
Coarsely crush the above three herbs. (Zhao edition lacks "coarsely crushed") Boil with three sheng of water until one sheng two he remains. Strain and take half warm, twice daily. Strong individuals may use one large Fuzi and three liang of Ganjiang.
Question: The symptoms resemble Yangdan syndrome. Following standard treatment worsened the condition, causing cold extremities, dry throat, cramped calves, and delirium. The Master said: "By midnight, hands and feet will warm, and legs will extend." Later, this happened exactly as predicted. How was this known? Answer: Cun Kou pulse is floating and large. Floating indicates Wind; Large indicates Deficiency. Wind generates mild heat; Deficiency causes calf cramping. The pathology resembles Guizhi Tang syndrome, so Fuzi was added, and Guizhi dosage increased to induce sweating. Fuzi warms the channels due to Yang loss. Cold extremities, dry throat, restlessness, Yangming internal binding, delirium, and confusion require drinking Ganshao Ganjiang Tang again. By midnight, Yang Qi returns, feet become warm. Calves are still slightly cramped; administer Shaoyao Gancao Tang again, then calves extend. Use Chengqi Tang to mildly loosen bowels, stopping delirium. Thus, recovery is known.
Yangdan is another name for Guizhi Tang. The previous symptoms—floating pulse (Yitong edition makes it "faint"), spontaneous sweating, frequent urination, vexation, slight aversion to cold, and leg cramps—are similar to Guizhi Tang syndrome, hence "resembling Yangdan." After giving Guizhi Tang, the condition worsened. Pulse at Cun Kou became floating and large: floating indicates Wind pathogen, large indicates Blood deficiency. Therefore, Fuzi was added to Guizhi Tang to warm channels and tonify deficiency; Guizhi was increased to induce sweating and dispel Wind. For worsening cold extremities due to incorrect treatment, Ganshao Ganjiang Tang was given; Yang returned, feet warmed. Then Shaoyao Gancao Tang was given; Yin harmonized, calves extended. Exterior pathogens resolved, Yin and Yang restored, but Yangming internal binding remained with delirium and confusion. A small amount of Tiaowei Chengqi Tang was given to mildly purge and harmonize the Stomach. With Yin and Yang harmonized and external/internal pathogens eliminated, recovery was predicted.