治太阳病发汗太过,遂漏不止,其人恶风,小便难,四肢拘急,难以屈伸者;并治寒疝
腹痛,手足冷,身疼不仁。
桂枝汤原方加附子一枚(炮)。
桂枝加附(汤)急温经,止汗回阳即救津。(此治外亡阳而内脱液。熟附虽能补阳,终
属燥液。仲景以桂枝汤轻扬力薄,必借附子刚烈之性,直走内外,急急温经复阳,使汗不外
泄,正以救液也。)漏汗(汗出不止)仍复恶风(表邪未尽)者,溲难(津液少)肢急(阳
虚液脱,而骨属不利。)可回春。(“漏不止”与“大汗出”同,若无他变证,仍与桂枝汤。
若形如疟,是玄府反闭,故加麻黄。此玄府不闭,故加附子。若大汗出后而大烦渴,是阳陷
于里,急当滋阴,故用白虎加人参。此漏不止而小便难,四肢拘急,是阳亡于外,急当扶阳,
故用桂枝加附子。仲景辨证之确、用药之精如此。)
治黄汗发热,两胫自冷,身体疼重,汗出而渴,从腰以上有汗,腰下无汗,汗沾衣色正
黄如柏汁,腰 弛痛,如有物皮中状,剧者不能食,身重而烦躁,小便不利,宜此主之;并
治诸病黄家脉浮者。
桂枝汤原方加黄 三两。
桂枝加 (汤)治黄汗,(因汗色黄,故病即名黄汗。)身热胫冷心烦乱。(湿伤于下,
故胫冷。湿上甚为热,故身热心烦。)腰 弛痛(腰下无汗之故)小便难,(湿热交混,气机
不化。)汗出但从腰上半。和其营卫以祛邪,湿郁皮中从汗散。(此方治湿郁皮中,阳气内郁,
而又表气不固,故用黄 固表气,桂枝汤宣阳气和营卫,令黄从汗解也。)假令诸黄其脉浮,
此方亦可相参赞。(浮为在表,当从汗解。若脉沉者,又当利其小便。)黄汗沾衣色正黄,致
病之由湿热断。历节风水颇相同,临证推求理自判。(黄汗与历节相似,但历节一身尽热,
黄汗则身热而胫冷;又与风水相似,但风水恶风,黄汗不恶风为异。且历节、风水,汗色不
黄,为可辨也。)
治疗太阳病发汗过度,导致汗漏不止,患者怕风,小便困难,四肢拘挛僵硬,难以屈伸;同时也治疗寒疝引起的腹痛,手足冰冷,身体疼痛且感觉迟钝。
桂枝汤原方加上一枚炮附子。
桂枝加附子汤急温经脉,止汗回阳以挽救津液。(这是治疗阳气外亡而阴液内脱的情况。熟附子虽然能补阳,但终究性质燥烈伤津。张仲景认为桂枝汤药力轻扬薄弱,必须借助附子刚烈的药性,直达内外,紧急温经复阳,使汗不再外泄,这正是为了保存津液。)如果汗漏不止仍然怕风(表邪未尽),小便困难(津液不足),四肢拘急(阳虚液脱,导致骨骼关节不利),可以恢复生机。(“汗漏不止”与“大汗出”类似,如果没有其他变证,仍用桂枝汤。如果症状像疟疾一样时冷时热,说明玄府闭塞,所以加麻黄。这里玄府未闭,所以加附子。如果在大汗出后出现大烦渴,说明阳气陷入体内,急需滋阴,所以用白虎加人参汤。这里是汗漏不止且小便困难、四肢拘急,说明阳气亡于体表,急需扶阳,所以用桂枝加附子汤。张仲景辨证的准确、用药的精妙达到如此地步。)
治疗黄汗发热,两小腿自然发冷,身体沉重疼痛,出汗且口渴,腰部以上有汗,腰部以下无汗,汗水沾湿衣服颜色正黄如柏树汁,腰部弛缓作痛,好像有东西在皮中,病情严重的不能进食,身体沉重且烦躁,小便不利,适宜用此方主治;同时也治疗各种黄疸病患者脉象浮的病症。
桂枝汤原方加上黄芩三两。
桂枝加黄芩汤治疗黄汗,(因为汗色黄,所以病名即为黄汗。)身体发热小腿发冷心烦意乱。(湿气伤于下部,所以小腿发冷。湿气上盛化为热,所以身体发热心烦。)腰部弛缓作痛(因为腰部以下无汗)小便困难,(湿热交混,气机不化。)出汗仅从腰部以上发生。调和营卫以祛除邪气,郁结在皮中的湿气随汗消散。(此方治疗湿气郁结在皮中,阳气内郁,同时表气不固,所以用黄芩固表气,桂枝汤宣通阳气调和营卫,令黄汗随汗而解。)假如各种黄疸病脉象浮,此方也可以参考辅助使用。(浮脉表示病在表,应当从汗解。如果脉沉,又应当利小便。)黄汗沾衣颜色正黄,致病的原因断定为湿热。历节风和风水病与此颇相似,临证推求道理自然能判断。(黄汗与历节病相似,但历节病全身都热,黄汗则是身热而小腿冷;又与风水病相似,但风水病怕风,黄汗不怕风,这是区别所在。而且历节病和风水病的汗色不黄,是可以辨别出来的。)
Treats Taiyang disease (disease of the Taiyang channel) where excessive sweating has led to continuous leakage of sweat, with the patient experiencing aversion to wind, difficulty in urination, stiffness and spasms of the four limbs making flexion and extension difficult; it also treats abdominal pain caused by Cold Cramp (Han Shan), accompanied by cold hands and feet, body pain, and numbness.
The original Guizhi Tang (Cinnamon Twig Decoction) plus one fried Fuzi (Prepared Aconite Lateral Root).
Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction with Added Prepared Aconite) urgently warms the meridians, stops sweating, restores Yang Qi, and thereby rescues Body Fluids. (This treats the condition where Yang Qi is lost externally while Yin Fluids are depleted internally. Although Shu Fuzi (Prepared Aconite) can tonify Yang, its nature is ultimately drying and damaging to fluids. Zhang Zhongjing considered that Guizhi Tang has a light and mild action, so it must rely on the potent nature of Fuzi to penetrate both interior and exterior, urgently warming the meridians and restoring Yang Qi, preventing further sweat loss, which is precisely how it preserves fluids.) If sweat continues to leak and aversion to wind persists (indicating residual pathogenic factors at the exterior), difficulty in urination (due to fluid depletion), and limb stiffness (due to Yang deficiency and fluid loss leading to poor joint mobility) occur, recovery is possible. ("Continuous leaking sweat" is similar to "profuse sweating"; if there are no other complicated symptoms, Guizhi Tang should still be used. If symptoms resemble malaria [alternating chills and fever], it indicates that the Xuanfu [pores] are closed, hence Mahuang (Ephedra) is added. Here, since the Xuanfu are not closed, Fuzi is added. If after profuse sweating there is severe restlessness and thirst, it indicates Yang Qi sinking into the interior, requiring urgent nourishment of Yin, thus Baihu Jia Renshen Tang (White Tiger Decoction with Added Ginseng) is used. Here, with continuous leaking sweat, difficulty in urination, and limb stiffness, it indicates Yang Qi perishing at the exterior, requiring urgent support of Yang, thus Guizhi Jia Fuzi Tang is used. Such is the accuracy of diagnosis and precision of medication by Zhang Zhongjing.)
Treats Huanghan (Yellow Sweat) with fever, spontaneous coldness in both calves, heaviness and pain in the body, sweating accompanied by thirst, sweat only above the waist with none below, sweat staining clothes bright yellow like cypress juice, flaccid pain in the waist as if something were trapped under the skin, severe cases unable to eat, heavy body with irritability, and difficulty in urination; this formula is indicated. It also treats various cases of Jaundice (Huang Bing) where the pulse is floating.
The original Guizhi Tang plus three taels of Huangqin (Scutellaria Root).
Guizhi Jia Huangqin Tang (Cinnamon Twig Decoction with Added Scutellaria) treats Huanghan (because the sweat is yellow, the disease is named accordingly). The body feels hot while the calves are cold, accompanied by mental restlessness. (Dampness injuring the lower part causes cold calves. Dampness rising and becoming heat causes body heat and mental restlessness.) Flaccid pain in the waist (due to lack of sweat below the waist) and difficulty in urination (due to chaotic mixing of damp-heat and failure of Qi mechanism transformation). Sweating occurs only from the upper half of the waist. Harmonizing Ying and Wei (Nutritive and Defensive levels) to dispel pathogens, allowing dampness stagnating in the skin to dissipate through sweat. (This formula treats dampness stagnating in the skin with internal stagnation of Yang Qi and insecure exterior defense. Thus, Huangqin is used to secure the exterior, and Guizhi Tang promotes Yang Qi and harmonizes Ying and Wei, allowing the yellow sweat to resolve through sweating.) In cases of various jaundices with a floating pulse, this formula may also be consulted for assistance. (A floating pulse indicates the pathogen is at the exterior, requiring resolution through sweating. If the pulse is deep, promoting diuresis is required instead.) Yellow sweat staining clothes bright yellow indicates the cause is determined to be damp-heat. Li Jie Feng Shi (Bi Syndrome resembling joint pain due to wind-damp) and Feng Shui (Wind Water edema) are quite similar to this; upon clinical investigation, the principles can be distinguished. (Huanghan resembles Li Jie, but Li Jie involves heat throughout the whole body, whereas Huanghan presents with body heat and cold calves. It also resembles Feng Shui, but Feng Shui involves aversion to wind, while Huanghan does not. Furthermore, the sweat in Li Jie and Feng Shui is not yellow, which serves as a distinguishing feature.)