及服桂枝汤已，须臾，当饮热稀粥一小碗，以助药力。且卧床温覆。一二时许，将遍身漐漐微似汗出，（似者，续也，非似乎也。）病乃悉去。此汗也，当名曰药汗，而别于前之病汗也。病汗常带凉意，药汗则带热意，病汗虽久，不足以去病，药汗瞬时，而功乃大著，此其分也。有桂枝证者来求诊，与桂枝汤，告之曰：服此汗出，病可愈矣。彼必曰：先生，我本有汗也。夫常人不知病汗药汗之分，不足为责。独怪一般医家尚有桂枝汤能发汗能止汗之辩，呶呶相争，无有已时。不知以中风证而服桂枝汤，先得药汗，是发汗也，病汗遂除，亦止汗也。是故发汗止汗二说，若以为非，则均非，若以为是，则均是，惜乎未观其通，尚差一筹耳！桂枝为阳药，内含挥发油，故能发散。芍药为阴药，内含安息酸，故能收敛。收敛之后，继以发散，发散之极，转又收敛。二者互为起讫，如环无端，依道运行，周而复始，是故收敛并无停滞之意；发散更非不复之谓。所以分名之者，盖但示其运行之方向不同已耳。由是可知桂芍之分工，实乃合作。况微丝血管之周布于身，无远勿届，与肌肉，神经，汗腺等杂沓而居。故动静脉血运加速之后，势必生热，较前此之发热尤甚。热蒸汗腺，势必汗出。与吾人剧烈运动之后，心脏鼓动加速，脉搏加速，血运加速，全身发热，因而汗出，理正相同。
惟此运动而生之汗，不必有若何毒素于其间，若夫先病后药，因而得汗，其汗必含毒素无疑。本汤煎服法中曰：遍身漐漐，微似有汗者益佳。……若不汗，更服，……又不汗，后服小促其间，……若汗不出，乃服至二三剂，……仲圣谆谆垂教，再三叮咛，以求一汗而后已者，抑亦何哉？曰：盖惟借此药汗方能排除一切毒素故耳！炎暑之日，汗流侠背，诚能畅进冰制饮料，汗乃遂止。所似然者，冰能凉胃故也。然则凉胃既可以止汗，今饮出汗，又何可不温胃？于是温胃之良药，兼可以止呕之生姜为必需之品矣。又恐汗出过多，将伤胃液，于是用大枣以摄持之。
又虑肠居胃下，胃失和，则肠有受传之虞，于是预用甘草以安之。要之。姜也，枣也，草也，同为温和胃肠之圣药。胃肠性喜微温，温则能和，故云。胃肠既受三药之扶护而和，血液循环又被桂芍之激励而急，表里两合，于是遍身漐漐汗出。
若其人为本汤证其一其二之表证者，随愈，即有本汤证其三之吐者，亦愈，或有本汤证其四之利者，亦无不愈。使更能明其孰轻孰重，加以权衡，则更善矣。
桂枝汤证其五（附列门人治验）
虞师舜臣尝日：一二八之前，闸北有一老妇。其子服务于邮局。妇患脑疽病，周围蔓延，其径近尺许。启其所盖膏药，则热气蒸蒸上冒。头项不能转侧。余与余鸿孙先生会诊之，三日不见大效。四日诊时，天色已晚，见病者伏被中，不肯出。询其故，侍者曰，每日此时恶寒发热汗出。余乃悟此为啬啬恶寒，翕翕发热之桂枝汤证。即用桂枝五分，芍药一钱，加姜草枣轻剂投之。次日，病大减。遂逐日增加药量，至桂枝三钱，芍药五钱，余三味亦如之，不曾加他药。数日后，竟告全愈云。
【按】脑疽，病也。虞余二先生先用治脑疽法治之，三日不见大效。及察知患者有挂枝汤证，试投桂枝汤。用桂枝不过五分，芍药不过一钱，姜草枣又皆和平之品，谅其为效也当仅矣。然而功出望外，毋怪虞师之惊奇。且用独方而竞全功，更可见惟能识证者方能治病。何况仲圣方之活用，初非限于桂枝一汤，仲圣所以于挂枝汤加减法独详者，示后人以楷模耳。果能将诸汤活而用之，为益不更大哉？由是细研，方知吾仲圣脉证治法之真价值。
曹颖甫曰：丁甘仁先生有言，脑疽属太阳，发背属太阳合少阴。二证妄投凉药必死。旨哉言乎！尝记予少时，居江阴东乡之后塍，有蒋昆田者，中医也，尝患脑疽，家居不出，三日。先考遇之于市上，问所患，曰，愈矣。问何法治之，曰，桂枝汤耳。问用桂枝几何，曰，四分耳。似四分之桂枝，能愈脑疽，宜虞生用五分之有特效也。惟蒋之证情轻，故四分已足。老妇之证重，故加至三钱。若狃于蒋之四分，而援以为例，设遇重证当用三四钱者则殆矣。
桂枝汤证其六（附列门人治验）
王右无表证，脉缓，月事后期而少，时时微恶寒，背部为甚，纳谷减，此为血运迟滞，胃肠虚弱故也，宜桂枝汤以和之。
【按】吾国旧式妇女平日缺少运动，每致食而难化。冬日限于设备，又未能勤行沐浴。而家庭组织庞杂，妯娌姑嫂每难和睦，因而私衷抑郁，影响气血。始则气逆脘痛，纳谷不畅，自称曰肝胃气，书则谓木侮土。名虽有雅俚显晦之分，实则无二致也。驯至头晕，心悸，经事不调，成俗所谓贫血症。按其脉，常缓而无力。若贫血甚者，反成细小而数。不待风寒之侵袭，而常萧瑟恶寒，尤其在冬日为甚。余逢此等证状，常投桂枝汤原方。病者服后，陡觉周身温暖，经脉舒畅，如曝冬日之下，如就沐浴之后。此无他，桂芍活血之功也。而向之大便难者，今乃得润滑而下，因甘草安肠，本有缓下之力。若大便仍坚据不动，不妨加大黄每剂一钱以微利之，生者固佳，制者亦可。二三剂后，便乃畅行，且胃开矣。其用甚妙，亲历者方能言之。若嫌大黄近于霸道，则不妨改用研麻仁每剂四五钱，亦可缓缓奏功。况又有姜枣以刺激其胃机能，令化谷食为精微，洲源既开，血乃渐滋。吾师常以简括之句表本汤之功，曰：桂枝汤功能疏肝补脾者也。盖肝主藏血，血行既畅，神经胥得涵养，可杜烦躁之渐，故曰疏肝，亦曰平肝。脾本概括消化系统而言，今肠胃既健，故曰补脾，善哉言乎。
于此有一要点须注意及者，即本案王右服桂枝汤后是否汗出是也。曰：不汗出，但觉周身温暖而已。然则桂枝汤果不能发汗乎？曰：发汗与否乃服后之现象。
服后之现象等于方药加病证之和，非方药可得而独专也。详言之，桂枝汤必加中风证，乃得药汗出，若所加者非中风证，而为如本案之里证（姑名此以别于太阳中风之表证），必不得汗出，或纵出而其量必甚微，甚至不觉也。吾人既知此义，可以泛应诸汤。例如服麻黄汤而大汗出者，必其人本有麻黄汤证，服承气汤而大下者，必其人本有承气汤证。反之，加麻黄汤于承气证，加承气汤于麻黄证，则欲下者未必剧汗，欲汗者未必剧下，有可断言者。然而病之形能既乱，于是坏病成矣。
或问曰：桂枝汤既能治表证，又能治里证，表里不一，方药却同，亦有仲圣之言可资证明乎？曰：师曰：妇人得平脉，阴脉小弱，其人渴，不能食，无寒热，名妊娠，桂技汤主之。夫曰无寒热，非即无表证之互辞乎？曰不能食而渴，非即胃肠虚寒，不能化谷食为精微乎？曰名妊娠，非即谓无病而更无表证乎？或又曰：若是论之，桂枝汤直是一首补方，纵令完全无病之人，亦可服此矣。
曰：何莫不然？惟严格言之，平素肠胃实热，血压亢进之人，究不甚宜，毋须一试。若夫素体虚寒之老人及妇女服此，诚有意想不到之效力。故仲圣以本汤为温补主方，加桂即治逆气冲心，加附子即治遂漏不止，加龙骨牡蛎即治盗汗失精，加白芍饴糖即治腹中痛，加人参生姜芍药即治发汗后身疼痛，更加黄耆当归即泛治虚劳，去白芍加生地麦冬阿胶人参麻仁，即治脉结代心动悸，无一非大补之方。
综计伤寒论中，共一百一十三方，由桂枝汤加减者乃占二十余方。然则仲圣固好用补者也。谁谓伤寒方徒以攻劫为能事乎？曹颖甫曰：本案桂枝汤证其六亦当属诸太阴。盖桂枝汤一方，外证治太阳，内证治太阴，仲师于两篇中既列有专条矣，此又何烦赘说！惟以此治太阳证，人所易知，以之治太阳病之系在太阴者，为人所不信，自有此验案，益可见仲师之言，初无虚设矣。夫仲师不云太阴病，腹满而吐，食不下，自利腹痛乎？设太阴病遇浮缓之太阳脉，即桂枝汤证矣。
麻黄汤证其一
范左伤寒，六七日，形寒发热，无汗，而喘，头项腰脊强痛，两脉浮紧，为不传也，麻黄汤主之。
【按】比吾师早年之方也，规其药量之轻，可以证矣。师近日所疏麻桂之量，常在三五钱之间，因是一剂即可愈疾。师常诏余侪曰：予之用大量，实由渐逐加而来，非敢以人命为儿戏也。夫轻剂愈疾也缓，重量愈病也迅。医者以愈病为职者也，然则予之用重量，又岂得已也哉？何公度作《悼恽铁樵先生》文中之一节云：……越年，二公子三公子相继病伤寒殇。先生痛定思痛，乃苦攻《伤寒论》。……如是者有年，而四公子又病伤寒。发热，无汗，而喘。遍请诸医家，其所疏方，仍不外乎历次所用之豆豉，山桅，豆卷，桑叶，菊花，薄荷，连翘，杏仁，象贝等味。服药后，热势依然，喘益加剧。先生乃终夜不寝，绕室踌躇。迨天微明，乃毅然曰：此非《伤寒论》太阳病，头痛，发热，身疼，腰痛，骨节疼痛，恶风，无汗，而喘者，麻黄汤主之。之病而何？乃援笔书：麻黄七分，桂枝七分，杏仁三钱，炙草五分。持方与夫人曰：吾三儿皆死于是，今四儿病，医家又谢不敏。与其坐而待毙，曷若含药而亡！夫人默然。嗣以计无他出，乃即配药煎服。先生则仍至商务印书馆服务。及归，见病儿喘较平，肌肤有润意，乃更续予药，竟得汗出喘平而愈。
四公子既庆更生，先生乃益信伤寒方。……（录《现代中医月刊》第二卷第九期）以上所引文字，不过寥寥数行。然而以吾观之，其中含蓄之精义实多。时医遇风热轻证，能以桑菊梔翘愈之，一遇伤寒重恙，遂不能用麻黄主方。罹其殃者，夫岂惟恽氏三儿而已哉？此其一义也。恽先生苦攻《伤寒论》有年，及用轻剂麻黄汤，尚且绕室踌躇，足见医学之难。此其二义也。然此诸义非吾所欲讨究，吾之所求者，借以表白麻黄汤全证耳。
麻黄汤之全部脉证，厥为喘，其甚者鼻扇，两脉浮紧，按之鼓指，头痛，恶寒，无汗，或已发热，或未发热，呕逆，身疼腰痛，骨节痠疼等等。考其简要病理，厥为寒气外犯皮毛，内侵肺藏。肺藏因寒而闭，呼吸不利，故上逆而作喘。
肺藏既失职，鼻管起代偿动作，故鼻扇。皮毛因寒而收，排泄失司，故凛冽而恶寒。血液循环起救济，故发热。血运呈紧张，故脉紧。胃受影响，故呕。神经不舒，故痛。若欲求其详，虽长篇累牍难以尽之。但凭脉证以施治，已足以效如桴鼓，此仲圣之教，所以为万世法也！
麻黄汤证其二
黄汉栋夜行风雪中，冒寒，因而恶寒，时欲呕，脉浮紧，宜麻黄汤。
生麻黄三钱川桂枝三钱光杏仁三钱生甘草钱半拙巢注：汉栋服后，汗出，继以桔梗五钱，生草三钱，泡汤饮之，愈。
【按】麻黄汤全部脉证固如前案拙按所云，但并不谓必如此诸状悉具，乃可用本汤，若缺其一，即不可施也。反之，若病者体内之变化，确属麻黄汤证之病理，则虽见证稍异，亦可以用之而效。缘病者体气不同，各如其面，加以受邪有轻重之别，时令有寒热之殊，故虽同一汤证，彼此亦有差池。若前按所引，有喘而无呕，本案所载，则有呕而无喘是也。大论曰：太阳病，或已发热，或未发热，必恶寒，体痛，呕逆，脉阴阳俱紧者，名为伤寒。窃谓此必字犹言多也，并非一定之谓。盖其人胃气本弱，或有湿痰，故牵引而作呕。若夫喘，则实为麻黄汤之主证，较呕著要多多，此吾人所当了然于胸中者也。
麻黄汤证其三
予友沈镜芙之房客某君，十二月起，即患伤寒。因贫无力延医，延至一月之久。沈先生伤其遇，乃代延余义务诊治。察其脉，浮紧，头痛，恶寒，发热不甚，据云初得病时即如是。因予：麻黄二钱桂枝二钱杏仁三钱甘草一钱又因其病久胃气弱也，嘱自加生姜三片，红枣两枚，急煎热服，盖被而卧。果一刻后，其疾若失。按每年冬季气候严寒之日，患伤寒者特多，我率以麻黄汤一剂愈之，谁说江南无正伤寒哉？
【按】《内经》一日太阳，二日阳明，三日少阳……之说，殊不足以为训。
若本案所示，其人作麻黄汤症，不服药者一月之久，而麻黄汤证依然存在。及投以麻黄汤，一剂而愈，其效又依然如响。是盖其人正气本旺，故能与邪久持也。
余在广益医院施诊，曾遇一小儿惊厥之恙。目膛神呆，大便不行，危在旦夕。迭用承气下之，白虎清之，数日方定。旋竞转为少阳寒热往来之证，予以小柴胡汤加味。如是数日，又略安，意其愈矣。某日偶巡视邻近某善堂，惊见此儿又在就医调理。予更细察其病情，则寒热日数度发，又是麻桂各半汤之证矣。屈指计之，距其起病之日，已近一月。观其病变曲折，仿佛离经叛道，是又岂一日二日之说，所得而限之哉？
麻黄汤证其四
等到服用桂枝汤之后，片刻间，应当喝一小碗热稀粥，以此来帮助药力。并且卧床用被子保暖覆盖。大约一个时辰左右，将会全身微微持续地出汗（“似”的意思是连续不断，而不是好像的意思），病邪于是全部去除。这种汗，应当称为药汗，以区别于之前的病汗。病汗通常带有凉意，药汗则带有热意；病汗即使出得很久，也不足以祛除疾病，药汗虽然瞬时而出，但功效却非常显著，这就是它们的区别所在。有桂枝汤证的患者来求诊，给予桂枝汤，并告知说：服用此药后出汗，病就可以痊愈了。患者必定会说：先生，我本来就有汗啊。普通人不知道病汗和药汗的区别，这不必责怪。唯独奇怪一般的医家还有关于桂枝汤既能发汗又能止汗的辩论，喋喋不休地争吵，没有停止的时候。不知道对于中风证而服用桂枝汤，先得到药汗，这是发汗，病汗随即被清除，这也是止汗。因此，发汗和止汗两种说法，如果认为不对，那么两者都不对；如果认为对，那么两者都对，可惜他们未能贯通理解，还差一筹呢！桂枝属于阳药，内含挥发油，所以能够发散。芍药属于阴药，内含安息酸，所以能够收敛。收敛之后，接着发散，发散到极点，又转为收敛。两者互为起止，像圆环一样没有尽头，依照规律运行，周而复始，所以收敛并没有停滞的意思；发散更不是不再恢复的说法。之所以分别命名，大概只是显示其运行的方向不同罢了。由此可知桂枝和芍药的分工，实际上是合作。况且微细血管遍布全身，无远弗届，与肌肉、神经、汗腺等混杂居住。所以动静脉血液循环加速之后，势必产生热量，比之前的发热更加严重。热气蒸腾汗腺，势必导致出汗。这与我们剧烈运动之后，心脏搏动加速，脉搏加速，血液循环加速，全身发热，因而出汗，道理完全相同。
只是这种因运动而产生的汗，其中不一定含有毒素；至于先患病后服药，因而得到的汗，其中的汗必然含有毒素无疑。本汤剂的煎服法中说：全身微微持续地，像有汗出的样子最好。……如果没有出汗，再服用，……如果还不出汗，后续服药要稍微缩短间隔时间，……如果仍然不出汗，就服用到二三剂，……仲景先生谆谆教导，再三叮咛，以求得一汗才罢休，这是为什么呢？回答说：大概只有借助这种药汗才能排除一切毒素的缘故！炎暑的日子，汗流浃背，如果能畅饮冰镇饮料，汗就会停止。之所以这样，是因为冰能凉胃的缘故。既然凉胃既可以止汗，现在通过服药出汗，又怎么能不温胃呢？于是温胃的良药，兼有止呕作用的生姜就成了必需的物品了。又担心出汗过多，会损伤胃液，于是用大枣来摄持保护它。
又担心肠道位于胃之下，胃气不和，则肠道有受传病变的担忧，于是预先用甘草来安抚它。总之，姜、枣、草，同为温和胃肠的圣药。胃肠性喜微温，温则能和，所以这样说。胃肠既然受到这三味药的扶护而调和，血液循环又被桂枝和芍药的激励而加快，表里两相配合，于是全身微微持续地出汗。
如果是本汤证中其一或其二表证的患者，随之痊愈；即使有本汤证其三的呕吐症状，也痊愈了；或者有本汤证其四的下利症状，也没有不痊愈的。如果能更明白孰轻孰重，加以权衡，那就更好了。
桂枝汤证其五（附列门人治验）
虞舜臣老师曾经说：一二八事变之前，闸北有一位老妇人。她的儿子在邮局工作。老妇人患有脑疽病，周围蔓延，直径近一尺左右。揭开她所贴的膏药，则热气蒸蒸上冒。头项不能转动侧身。我和余鸿孙先生会诊，三天不见大效。第四天诊察时，天色已晚，见病人伏在被子里，不肯出来。询问原因，侍者说，每天这个时候恶寒发热出汗。我才领悟到这是啬啬恶寒、翕翕发热的桂枝汤证。立即使用桂枝五分，芍药一钱，加上姜、草、枣的小剂量投药。第二天，病情大减。于是逐日增加药量，直到桂枝三钱，芍药五钱，其余三味药也是如此，不曾添加其他药物。数日后，竟然宣告全愈。
【按】脑疽，是病名。虞、余二位先生先用治疗脑疽的方法治疗，三天不见大效。等到察觉患者有桂枝汤证，尝试投予桂枝汤。使用桂枝不过五分，芍药不过一钱，姜、草、枣也都是平和之品，料想它的疗效应该仅仅如此。然而功效出乎意料，难怪虞老师感到惊奇。而且只用单方竟能完成治愈，更可见只有能识别证候的人才能治病。何况仲景方剂的活用，原本就不局限于桂枝这一张汤，仲景之所以在桂枝汤加减法中特别详细，是示给后人以楷模。果真能将诸汤灵活应用，益处不是更大吗？由此细细研究，才知道我们仲景脉证治法的真正价值。
曹颖甫说：丁甘仁先生有句话，脑疽属太阳经，发背属太阳经合少阴经。这两证妄投凉药必死。这话真深刻啊！曾记得我年轻时，居住在江阴东乡的后塍，有个叫蒋昆田的人，是中医，曾经患脑疽，在家不出门，三天。先父在市场上遇到他，问他的病情，他说，已经好了。问用什么方法治疗的，他说，桂枝汤罢了。问用了多少桂枝，说，四分罢了。像四分这样的桂枝，能治愈脑疽，难怪虞生用五分会有特效。只是蒋某的证情轻，所以四分已经足够。老妇人的证情重，所以加至三钱。如果拘泥于蒋某的四分，而援引作为例子，假设遇到重症应当用三四钱的，那就危险了。
桂枝汤证其六（附列门人治验）
王姓女患者没有表证，脉缓，月经后期且量少，时常轻微恶寒，背部尤为严重，食欲减退，这是因为血运迟滞，胃肠虚弱所致，适宜桂枝汤来调和它。
川桂枝三钱 大白芍三钱 酒炒炙甘草三钱 生姜三片 大枣十二枚
【按】我国旧式妇女平日缺少运动，往往导致饮食难消化。冬天限于设备条件，又不能勤快沐浴。而且家庭组织庞杂，妯娌姑嫂往往难以和睦，因而内心抑郁，影响气血。起初则是气逆脘痛，饮食不畅，自称肝胃气，书中则称为木侮土。名称虽有雅俗显晦之分，实际上并无二致。逐渐发展到头晕，心悸，月经不调，成为俗称的贫血症。诊察其脉，常缓而无力。如果贫血严重，反而变成细小而数。不待风寒侵袭，而常常萧瑟恶寒，尤其在冬天更为严重。我遇到这些证状，常投予桂枝汤原方。病人服用后，陡然觉得周身温暖，经脉舒畅，如同曝晒在冬日阳光下，如同沐浴之后。这没有别的原因，是桂枝和芍药活血的功效。而以前大便困难的，现在却能润滑而下，因为甘草安肠，本有缓下的力量。如果大便仍然坚硬不动，不妨加大黄每剂一钱以轻微通下，生大黄固然好，制大黄也可以。二三剂后，大便乃畅通，而且胃口开了。这用法非常巧妙，亲历者才能说出来。如果觉得大黄过于霸道，不妨改用研碎的麻仁每剂四五钱，也可以缓缓奏效。况且又有姜枣来刺激其胃机能，令将谷食化为精微，水源既开，血液乃逐渐滋生。我的老师常用简括的句子表述本汤的功效，说：桂枝汤的功能是疏肝补脾的。盖肝主藏血，血行既通畅，神经都得到涵养，可以杜绝烦躁的渐起，所以说疏肝，也说平肝。脾本概括消化系统而言，现在肠胃既强健，所以说补脾，话说得好啊。
于此有一个要点必须注意，即本案王姓女患者服用桂枝汤后是否出汗的问题。回答是：不出汗，只觉得周身温暖而已。那么桂枝汤果然不能发汗吗？回答是：发汗与否是服药后的现象。
服药后的现象等于方药加上病证的总和，不是方药所能独自决定的。详细地说，桂枝汤必须加上中风证，才能得到药汗出，如果所加的并非中风证，而是如本案的里证（暂且命名以此区别于太阳中风的表证），必定不得汗出，或者即使出汗其量也必然很微小，甚至感觉不到。我们既然知道这个道理，可以泛用于诸汤。例如服用麻黄汤而大汗出的，必定其人本来有麻黄汤证，服用承气汤而大下的，必定其人本来有承气汤证。反之，将麻黄汤加于承气证，将承气汤加于麻黄证，那么想要下的未必剧汗，想要汗的未必剧下，这是可以断言的。然而病的形态既然混乱，于是坏病就形成了。
有人问：桂枝汤既能治表证，又能治里证，表里不一，方药却相同，也有仲景的话可以作为证明吗？回答是：老师说：妇人得平脉，阴脉小弱，其人渴，不能食，无寒热，名为妊娠，桂枝汤主之。说无寒热，不就是无表证的另一种说法吗？说不能食而渴，不就是胃肠虚寒，不能将谷食化为精微吗？说名为妊娠，不就是谓无病而且更没有表证吗？有人又说：按照这种论述，桂枝汤简直是一首补方，纵然完全无病之人，也可以服用此方了。
回答是：何尝不是这样？只是严格来说，平素肠胃实热，血压亢进之人，终究不太适宜，无须一试。如果是素体虚寒的老人及妇女服用此方，确实有意想不到的效力。所以仲景以本汤为温补主方，加桂枝即治逆气冲心，加附子即治漏汗不止，加龙骨牡蛎即治盗汗失精，加白芍饴糖即治腹中痛，加人参生姜芍药即治发汗后身疼痛，再加黄芪当归即泛治虚劳，去白芍加生地麦冬阿胶人参麻仁，即治脉结代心动悸，无一不是大补之方。
总计《伤寒论》中，共一百一十三方，由桂枝汤加减者乃占二十余方。那么仲景固然是好用补方的。谁说伤寒方徒以攻劫为能事呢？曹颖甫说：本案桂枝汤证其六也当属太阴。盖桂枝汤一方，外证治太阳，内证治太阴，仲师在两篇中既列有专条了，这又何须赘说！只是以此治太阳证，人所易知，以之治太阳病之系在太阴者，为人所不信，自有此验案，更可见仲师之言，初无虚设矣。夫仲师不云太阴病，腹满而吐，食不下，自利腹痛乎？设太阴病遇浮缓之太阳脉，即桂枝汤证矣。
麻黄汤证其一
范左患伤寒，六七日，形寒发热，无汗，而喘，头项腰脊强痛，两脉浮紧，为未传变，麻黄汤主之。
【按】这是我老师早年的方子，看其药量的轻，就可以证明了。老师近日所开的麻黄、桂枝的量，常在三五钱之间，因此一剂即可痊愈疾病。老师常告诫我们说：我使用大量，实在是由逐渐增加而来，不敢以人命为儿戏。轻剂治愈疾病缓慢，重量治愈疾病迅速。医生以治愈疾病为职责，那么我使用重量，又难道是不得已的吗？何公度作《悼恽铁樵先生》文中的一节说：……过了一年，二公子、三公子相继患伤寒夭折。先生痛定思痛，于是苦攻《伤寒论》。……像这样过了几年，四公子又患伤寒。发热，无汗，而喘。遍请各位医家，他们所开的方子，仍不外乎历次所用的豆豉、山栀、豆卷、桑叶、菊花、薄荷、连翘、杏仁、象贝等味。服药后，热势依然，喘益加剧。先生于是整夜不睡，绕室踌躇。等到天微明，于是毅然说：这不是《伤寒论》太阳病，头痛，发热，身疼，腰痛，骨节疼痛，恶风，无汗，而喘者，麻黄汤主之。的病是什么？于是提笔写：麻黄七分，桂枝七分，杏仁三钱，炙草五分。拿着方子对夫人说：我的三个儿子都死于此，现在四儿子病了，医家又推辞不负责。与其坐以待毙，何不含药而亡！夫人沉默。后来因为计策没有其他出路，于是即刻配药煎服。先生则仍去商务印书馆服务。等到回家，见病儿喘较平，肌肤有润泽之意，于是继续给药，竟得汗出喘平而愈。
四公子既庆幸再生，先生于是更加相信伤寒方。……（录《现代中医月刊》第二卷第九期）以上所引文字，不过寥寥数行。然而在我看来，其中含蓄的精义实在很多。时医遇到风热轻证，能用桑菊梔翘治愈，一遇到伤寒重恙，遂不能用麻黄主方。遭受其祸害的，难道只有恽氏的三个儿子吗？这是其一义。恽先生苦攻《伤寒论》多年，及使用轻剂麻黄汤，尚且绕室踌躇，足见医学之难。这是其二义。然而这些义理不是我想要探讨的，我所追求的，借此表白麻黄汤全证罢了。
麻黄汤的全部脉证，主要是喘，严重的鼻翼扇动，两脉浮紧，按之鼓指，头痛，恶寒，无汗，或已发热，或未发热，呕逆，身疼腰痛，骨节酸痛等等。考察其简要病理，主要是寒气外犯皮毛，内侵肺脏。肺脏因寒而闭，呼吸不利，故上逆而作喘。
肺脏既失职，鼻管起代偿动作，故鼻翼扇动。皮毛因寒而收缩，排泄失司，故凛冽而恶寒。血液循环起救济作用，故发热。血运呈紧张状态，故脉紧。胃受影响，故呕。神经不舒，故痛。如果想要详尽，虽长篇累牍也难以尽述。但凭脉证以施治，已足以效如桴鼓，这是仲景的教诲，所以成为万世的法则！
麻黄汤证其二
黄汉栋夜行风雪中，冒寒，因而恶寒，时欲呕，脉浮紧，宜麻黄汤。
拙巢注：汉栋服用后，汗出，继以桔梗五钱，生草三钱，泡汤饮之，痊愈。
【按】麻黄汤全部脉证固然如前案拙按所说，但并不谓必须如此诸状悉具，才可用本汤，若缺其一，就不可施用。反之，如果病者体内的变化，确属麻黄汤证的病理，那么即使见证稍异，也可以用之而有效。因为病者体质不同，各如其面，加上受邪有轻重之别，时令有寒热之殊，所以即使是同一汤证，彼此也有差异。如前案所引，有喘而无呕，本案所载，则有呕而无喘。大论曰：太阳病，或已发热，或未发热，必恶寒，体痛，呕逆，脉阴阳俱紧者，名为伤寒。我认为这个“必”字犹言多也，并非一定之谓。盖其人胃气本弱，或有湿痰，故牵引而作呕。至于喘，则实为麻黄汤的主证，较呕重要多多，这是我们当了然于胸中的。
麻黄汤证其三
我的朋友沈镜芙的房客某君，从十二月起，就患伤寒。因贫穷无力延请医生，拖延了一个月之久。沈先生同情他的遭遇，于是代请我义务诊治。察其脉，浮紧，头痛，恶寒，发热不甚，据说是初得病时就是这样。于是给予：麻黄二钱 桂枝二钱 杏仁三钱 甘草一钱。又因其病久胃气弱，嘱其自加生姜三片，红枣两枚，急煎热服，盖被而卧。果然一刻后，其疾若失。按每年冬季气候严寒之日，患伤寒者特多，我率以麻黄汤一剂治愈，谁说江南无正伤寒哉？
【按】《内经》一日太阳，二日阳明，三日少阳……之说，殊不足以为训。
如本案所示，其人作麻黄汤症，不服药者一月之久，而麻黄汤证依然存在。及投以麻黄汤，一剂而愈，其效又依然如响。这是因为他正气本旺，故能与邪久持也。
我在广益医院施诊，曾遇一个小儿惊厥之恙。目膛神呆，大便不行，危在旦夕。迭用承气下之，白虎清之，数日方定。旋即转为少阳寒热往来之证，予以小柴胡汤加味。如是数日，又略安，意其愈矣。某日偶巡视邻近某善堂，惊见此儿又在就医调理。予更细察其病情，则寒热日数度发，又是麻桂各半汤之证矣。屈指计之，距其起病之日，已近一月。观其病变曲折，仿佛离经叛道，这又岂是一日二日之说，所得而限之哉？
麻黄汤证其四
After taking Guizhi Tang (Cinnamon Twig Decoction), after a short while, one should drink a small bowl of hot thin porridge to assist the medicinal power. Then lie in bed and cover with warm blankets. After about one shichen (two hours), there will be a slight, continuous sweat all over the body ("si" here means continuous, not "as if"). The disease will then be completely eliminated. This sweat should be called "medicinal sweat," distinct from the previous "disease sweat." Disease sweat usually carries a cool sensation, whereas medicinal sweat carries a warm sensation. Although disease sweat may persist for a long time, it is insufficient to eliminate the disease; medicinal sweat, though instantaneous, achieves significant efficacy. This is the distinction between them. When a patient presenting with Guizhi Tang syndrome comes for consultation and is prescribed Guizhi Tang, and is told: "Sweating after taking this medicine will cure your illness," they will inevitably say: "Sir, I already have sweating." It is not blameworthy that ordinary people do not understand the difference between disease sweat and medicinal sweat. What is surprising is that some physicians still debate whether Guizhi Tang induces sweating or stops sweating, arguing endlessly without resolution. They fail to realize that for a Wind-Strike syndrome taking Guizhi Tang, obtaining medicinal sweat first constitutes inducing sweating, which subsequently clears the disease sweat, thereby also stopping sweating. Therefore, both the theories of inducing sweating and stopping sweating are either both incorrect or both correct, depending on perspective. Unfortunately, they fail to grasp the holistic connection, falling short by one step! Guizhi (Cinnamon Twig) is a Yang herb containing volatile oils, thus capable of dispersing. Shaoyao (Peony Root) is a Yin herb containing paeonic acid, thus capable of astringing. After astringency follows dispersion, and upon extreme dispersion, it turns back to astringency. The two interact as beginning and end, like a circle without start or finish, operating according to the Dao, cycling continuously. Thus, astringency does not imply stagnation; dispersion does not mean non-recovery. The reason for separate naming is merely to indicate different directions of operation. From this, we can see that the division of labor between Guizhi and Shaoyao is essentially cooperation. Moreover, capillaries are distributed throughout the body, reaching everywhere, intermingling with muscles, nerves, and sweat glands. Therefore, after accelerated arterial and venous blood circulation, heat must be generated, more intense than previous fever. Heat steams the sweat glands, inevitably causing sweating. This is exactly the same principle as when humans engage in vigorous exercise: heart beat accelerates, pulse quickens, blood circulation speeds up, the whole body heats up, and consequently sweating occurs.
However, sweat produced by such exercise need not contain toxins. In contrast, sweat obtained after illness followed by medication undoubtedly contains toxins. The decoction and administration instructions of this formula state: "Slight, continuous sweating all over the body is best... If no sweat, administer again... If still no sweat, shorten the interval between doses... If still no sweat, continue until two or three doses..." Master Zhongjing earnestly teaches and repeatedly advises, seeking only one instance of sweating before stopping, why is this? The answer is: Only through this medicinal sweat can all toxins be expelled! On hot summer days, when sweating profusely down the back, drinking ice-cold beverages can stop sweating. This is because ice cools the Stomach. Since cooling the Stomach can stop sweating, how can warming the Stomach not be necessary when inducing sweating via medication? Thus, Shengjiang (Fresh Ginger), a fine herb for warming the Stomach and stopping vomiting, becomes essential. Fearing that excessive sweating might damage Stomach fluids, Dazao (Jujube Fruit) is used to preserve them.
Furthermore, fearing that since the Intestines reside below the Stomach, Stomach disharmony might transmit pathology to the Intestines, Gancao (Licorice Root) is preemptively used to pacify them. In summary, Jiang (Ginger), Zao (Jujube), and Cao (Licorice) are all sacred herbs for harmonizing the Stomach and Intestines. The Stomach and Intestines prefer mild warmth; warmth brings harmony, hence the saying. Once the Stomach and Intestines are protected and harmonized by these three herbs, and blood circulation is accelerated by the stimulation of Guizhi and Shaoyao, the interior and exterior combine, resulting in slight, continuous sweating all over the body.
If the patient presents with the exterior syndrome of Type 1 or 2 of this formula's indications, they will heal accordingly. Even if they present with vomiting (Type 3) or diarrhea (Type 4), they will also heal. If one can further discern the severity and weigh the symptoms, the outcome would be even better.
Guizhi Tang Syndrome Case 5 (Including Student's Clinical Record)
Master Yu Shunchen once said: Before the January 28th Incident, an old woman in Zhabei had a son working at the post office. She suffered from a carbuncle on the head (Naoju), spreading around with a diameter of nearly one chi. Upon removing her plaster, steam rose intensely. Her head and neck could not turn. Mr. Yu Hongsun and I consulted together. After three days, there was little effect. On the fourth day, late in the evening, we saw the patient lying buried under blankets, unwilling to emerge. Asking the reason, the attendant said she experienced chills, fever, and sweating at this time every day. I realized this was the Guizhi Tang syndrome characterized by "se se" (mild aversion to cold) and "xi xi" (mild fever). I immediately prescribed a light dose: Guizhi 5 fen, Shaoyao 1 qian, plus light doses of Jiang, Cao, and Zao. The next day, the condition greatly improved. I gradually increased the dosage daily until Guizhi reached 3 qian and Shaoyao 5 qian, adjusting the other three herbs accordingly, without adding any other medicines. After several days, she was completely cured.
[Commentary] Naoju (Carbuncle on Head) is a disease. Masters Yu and Yu initially treated it using methods for carbuncles, with little effect for three days. Upon recognizing the Guizhi Tang syndrome, they tried Guizhi Tang. Using no more than 5 fen of Guizhi and 1 qian of Shaoyao, along with mild Jiang, Cao, and Zao, one might expect only modest effects. Yet the result exceeded expectations, justifying Master Yu's surprise. That a single formula achieved complete cure further demonstrates that only those who can identify syndromes can treat diseases. Moreover, the flexible application of Zhongjing's formulas is not limited to Guizhi Tang alone. Zhongjing detailed the modifications of Guizhi Tang specifically to set an example for later generations. If one can apply various formulas flexibly, the benefits would be even greater. Through careful study, one realizes the true value of Zhongjing's pulse-syndrome-treatment methods.
Cao Yingfu said: Mr. Ding Garen stated, "Naoju belongs to the Taiyang channel; Fabei (carbuncle on back) belongs to Taiyang combined with Shaoyin. Misusing cold medicines for these two conditions will surely cause death." Profound words! I recall my youth in Hou Cheng, East Township, Jiangyin. A TCM practitioner named Jiang Kuntian suffered from Naoju, staying home for three days. My father met him in the market, asked about his condition, and he replied, "I am healed." Asked about the treatment, he said, "Guizhi Tang." Asked about the dosage of Guizhi, he said, "Only 4 fen." If 4 fen of Guizhi could cure Naoju, it explains why Yu Sheng's use of 5 fen was highly effective. However, Jiang's condition was mild, so 4 fen sufficed. The old woman's condition was severe, requiring an increase to 3 qian. If one rigidly adhered to Jiang's 4 fen as a precedent, it would be dangerous for severe cases requiring 3-4 qian.
Guizhi Tang Syndrome Case 6 (Including Student's Clinical Record)
Ms. Wang presented with no exterior syndrome, a slow pulse, delayed menstruation with scant flow, occasional mild aversion to cold (especially on the back), and reduced appetite. This is due to sluggish blood circulation and weak Stomach and Intestines. Guizhi Tang is suitable to harmonize.
Chuan Guizhi 3 qian, Da Bai Shao 3 qian, Jiu Chao Zhi Gancao 3 qian, Shengjiang 3 slices, Dazao 12 pieces.
[Commentary] Traditional Chinese women often lack exercise, leading to indigestion. In winter, limited facilities prevent frequent bathing. Complex family structures, often involving disharmony among sisters-in-law, lead to internal depression affecting Qi and Blood. Initially, this manifests as Qi rebellion and epigastric pain, poor appetite, self-diagnosed as Liver-Stomach Qi stagnation, or described in texts as Wood insulting Earth. Despite differences in terminology, the essence is the same. Eventually, it develops into dizziness, palpitations, and irregular menstruation, commonly known as anemia. The pulse is typically slow and weak. In severe anemia, it may become fine, rapid, and weak. Without wind-cold invasion, patients often feel chilly, especially in winter. I frequently prescribe the original Guizhi Tang for such cases. Patients report sudden warmth throughout the body and smooth meridians, akin to basking in winter sun or after bathing. This is due to the blood-invigorating properties of Guizhi and Shaoyao. Previously difficult bowel movements now pass smoothly because Gancao pacifies the Intestines and has a mild laxative effect. If stools remain hard, adding 1 qian of Dahuang (Rhubarb Root) per dose can gently promote evacuation. Raw Dahuang is preferred, but processed is acceptable. After 2-3 doses, bowels move freely, and appetite improves. This usage is subtle and best understood by experience. If Dahuang is considered too harsh, Huren (Hemp Seed) 4-5 qian can be used for gradual effect. Additionally, Jiang and Zao stimulate gastric function, transforming food into essence. Once the source opens, blood nourishes gradually. My teacher summarized the formula's function concisely: "Guizhi Tang soothes the Liver and tonifies the Spleen." Since the Liver stores blood, smooth blood flow nourishes nerves, preventing irritability, hence "soothing the Liver" or "calming the Liver." The Spleen encompasses the digestive system; healthy intestines and stomach mean "tonifying the Spleen." Excellent words!
A key point to note is whether Ms. Wang sweated after taking Guizhi Tang. Answer: No sweating, only feeling warm. Does this mean Guizhi Tang cannot induce sweating? The presence or absence of sweating is a post-medication phenomenon.
The post-medication phenomenon equals the combination of the formula and the syndrome; it is not determined solely by the formula. Specifically, Guizhi Tang induces sweating only when combined with a Wind-Strike syndrome. If combined with an interior syndrome (like in this case, distinguished from Taiyang Wind-Strike exterior syndrome), sweating will likely not occur, or will be minimal and imperceptible. Understanding this allows generalization to other formulas. For example, profuse sweating after Mahuang Tang indicates the patient originally had a Mahuang Tang syndrome; profound purgation after Chengqi Tang indicates an original Chengqi Tang syndrome. Conversely, applying Mahuang Tang to a Chengqi syndrome, or Chengqi Tang to a Mahuang syndrome, will not necessarily cause profuse sweating or purgation, respectively. However, confusing the disease pattern leads to complicated illnesses.
Question: Guizhi Tang treats both exterior and interior syndromes, yet the formula remains the same despite differing locations. Is there evidence from Zhongjing? Answer: The Master said: "In women, if the pulse is level, the Yin pulse is slightly weak, the patient feels thirsty and cannot eat, without chills or fever, this is named Pregnancy, and Guizhi Tang governs it." Saying "no chills or fever" implies no exterior syndrome. Saying "cannot eat and thirsty" implies Stomach-Intestine deficiency-cold, inability to transform food into essence. Saying "named Pregnancy" implies no disease and certainly no exterior syndrome. Another question: By this logic, Guizhi Tang is purely a tonic formula; even perfectly healthy people could take it? Answer: Indeed. However, strictly speaking, those with chronic Stomach-Intestine excess-heat or hypertension should avoid it. For elderly or female patients with constitutional deficiency-cold, it yields unexpected results. Thus, Zhongjing regards this formula as a primary warming-tonic base. Adding Guizhi treats rebellious Qi rushing to the heart; adding Fuzi treats persistent leakage; adding Longgu and Muli treats night sweats and seminal emission; adding Shaoyao and Yitang treats abdominal pain; adding Renshen, Shengjiang, and Shaoyao treats body ache after sweating; adding Huangqi and Danggui treats general deficiency-wasting; removing Shaoyao and adding Shengdi, Maidong, Ejiao, Renshen, and Huren treats knotted pulse and palpitations. None are not major tonic formulas.
Counting the 113 formulas in Shanghan Lun, over 20 are modifications of Guizhi Tang. Thus, Zhongjing indeed favored tonic formulas. Who says Shanghan formulas are only for attacking pathogens? Cao Yingfu said: This Guizhi Tang Syndrome Case 6 also belongs to Taiyin. Guizhi Tang treats Taiyang exterior syndromes and Taiyin interior syndromes. Zhongjing dedicated sections to both. It is well-known for treating Taiyang, but less believed for treating Taiyin-related Taiyang diseases. This clinical record proves Zhongjing's words were not empty. Did Zhongjing not say Taiyin disease involves abdominal fullness, vomiting, inability to eat, spontaneous diarrhea, and abdominal pain? If Taiyin disease presents with a floating-slow Taiyang pulse, it becomes a Guizhi Tang syndrome.
Mahuang Tang Syndrome Case 1
Fan Zuo contracted Cold Damage (Shanghan). After six or seven days, he exhibited aversion to cold, fever, anhidrosis, wheezing, stiffness and pain in the head, neck, waist, and spine. Both pulses were floating and tight. The pathogen had not transmitted. Mahuang Tang governs.
Mahuang 1 qian, Guizhi 1 qian, Zhi Cao 8 fen, Xingren 3 qian.
[Commentary] This is my teacher's early prescription; the light dosage is evident. Recently, his dosages of Mahuang and Guizhi are often 3-5 qian, curing the disease in one dose. He often admonished us: "My use of large doses resulted from gradual increases; I dare not treat human life as a game." Light doses cure slowly; heavy doses cure rapidly. Doctors aim to cure disease; thus, my use of heavy doses is necessary. He Gongdu wrote in "Eulogy for Mr. Yun Tieqiao": "...A year later, his second and third sons died of Shanghan. Grief-stricken, he studied Shanghan Lun intensively... Years later, his fourth son fell ill with Shanghan. Fever, anhidrosis, wheezing. Physicians prescribed Dou Chi, Shan Zhi, Dou Juan, Sang Ye, Ju Hua, Bo He, Lian Qiao, Xingren, Xiang Bei, etc. Fever persisted, wheezing worsened. He paced all night. At dawn, he declared: 'This is not just any illness; it matches Shanghan Lun Taiyang disease: headache, fever, body ache, waist/back pain, joint pain, aversion to wind, anhidrosis, wheezing—Mahuang Tang governs.' He wrote: Mahuang 7 fen, Guizhi 7 fen, Xingren 3 qian, Zhi Cao 5 fen. He gave the prescription to his wife: 'My three sons died from this; now my fourth is sick, and doctors refuse. Rather than waiting to die, let us try medicine!' His wife agreed. He continued working at Commercial Press. Returning home, he saw the boy's breathing stabilized and skin moist. He administered more medicine, resulting in sweating, cessation of wheezing, and recovery.
Having saved his fourth son, Mr. Yun firmly believed in Shanghan formulas.... (Excerpt from Modern TCM Monthly, Vol 2, Issue 9). These few lines contain profound meaning. Contemporary physicians can treat mild Wind-Heat with Sang Ju Zhi Qiao, but fail to use Mahuang Tang for severe Shanghan. Victims include not only the Yun family. This is the first lesson. Mr. Yun studied Shanghan Lun for years yet hesitated even with a light Mahuang Tang dose, proving the difficulty of medicine. This is the second lesson. However, these are not my focus; I seek to clarify the full syndrome of Mahuang Tang.
The complete pulse-syndrome of Mahuang Tang includes wheezing (severe cases show nasal flaring), floating-tight pulses beating strongly against the finger, headache, aversion to cold, anhidrosis, fever (present or absent), vomiting/reversal, body ache, waist/back pain, and joint soreness. Its brief pathology is external Cold invading the skin/hair and internally affecting the Lung. The Lung closes due to Cold, obstructing respiration, causing upward reversal and wheezing. With Lung dysfunction, the nose compensates, causing flaring. Skin contracts due to Cold, losing excretion control, causing chilliness and aversion to cold. Circulation compensates, causing fever. Blood flow tension causes tight pulses. Stomach is affected, causing vomiting. Nerves are uncomfortable, causing pain. Detailing this fully would require volumes. But treating based on pulse and syndrome is sufficient for immediate effect, which is why Zhongjing's teachings are eternal models!
Mahuang Tang Syndrome Case 2
Huang Handong walked in wind and snow at night, exposed to Cold, resulting in aversion to cold, occasional nausea, and floating-tight pulse. Mahuang Tang is suitable.
Sheng Mahuang 3 qian, Chuan Guizhi 3 qian, Guang Xingren 3 qian, Sheng Gancao 1.5 qian.
Zhuochao Note: After taking this, Handong sweated. He then drank a decoction of Jiegeng 5 qian and Sheng Cao 3 qian, and recovered.
[Commentary] While the full syndrome of Mahuang Tang is as described above, it is not required that all symptoms be present to use this formula. Missing one symptom does not preclude its use. Conversely, if the internal pathology matches Mahuang Tang, even with slight variations in presentation, it can be effective. Patient constitutions vary, pathogenic factors differ in severity, and seasons vary in cold/heat. Thus, even within the same syndrome, presentations differ. For instance, the previous case had wheezing but no vomiting; this case has vomiting but no wheezing. The Great Treatise states: "Taiyang disease, whether fever is present or not, must involve aversion to cold, body pain, vomiting/reversal, and Yin-Yang pulses both tight; this is named Cold Damage." I interpret "must" as "often," not "always." Weak Stomach Qi or damp-phlegm may trigger vomiting. Wheezing, however, is the primary symptom of Mahuang Tang, far more important than vomiting. This must be clear in our minds.
Mahuang Tang Syndrome Case 3
My friend Shen Jingfu's tenant contracted Shanghan starting in December. Due to poverty, he delayed medical care for a month. Sympathizing with his plight, Shen invited me to consult free of charge. His pulse was floating-tight, with headache and aversion to cold; fever was mild, consistent with initial onset. I prescribed: Mahuang 2 qian, Guizhi 2 qian, Xingren 3 qian, Gancao 1 qian. Given his prolonged illness weakened Stomach Qi, I advised adding Shengjiang 3 slices and Hong Zao 2 pieces, decocting quickly and drinking hot, then covering with blankets to sleep. Indeed, after one quarter-hour, the illness vanished. In winter's coldest days, many contract Shanghan; I routinely cure them with one dose of Mahuang Tang. Who says there is no true Shanghan in Jiangnan?
[Commentary] The Neijing theory of "Day 1 Taiyang, Day 2 Yangming, Day 3 Shaoyang..." is insufficient as a rule.
As shown in this case, the patient maintained Mahuang Tang syndrome for a month without medication. Upon administering Mahuang Tang, he recovered in one dose, effectively echoing the diagnosis. This is because his righteous Qi was strong, allowing prolonged resistance against the pathogen.
While consulting at Guangyi Hospital, I treated a child with convulsions. Eyes glazed, constipation, critical condition. Multiple doses of Chengqi formulas to purge, and Baihu to clear, took days to stabilize. Subsequently, it transformed into Shaoyin alternating chills and fever, treated with Xiaochaihu Tang modified. After several days, slight improvement suggested recovery. One day, visiting a nearby charity clinic, I was shocked to see the child receiving care again. Examining closely, he had recurrent chills and fever multiple times daily, indicating Mahuang-Guizhi Half-Dose Tang syndrome. Counting from onset, nearly a month had passed. Observing the complex progression, seemingly deviating from standard patterns, how could it be limited by the "one or two days" theory?
Mahuang Tang Syndrome Case 4
Yu Right Residing at No. 1 Weide Li, Gaochang Temple, contracted Shanghan. Symptoms: stiffness and pain in head/neck, aversion to cold, occasional nausea, tight pulse. Mahuang Tang is suitable.
Mahuang 5 qian, Guizhi 5 qian, Xingren 3 qian, Sheng Cao 3 qian.