（桂枝汤见呕吐哕下利。） 治寒疝腹中痛。逆冷。手足不仁。若身疼痛。灸刺诸
能治者。抵当乌头桂枝汤主之。
乌头（五枚。）
上一味。以蜜二斤。煎减半。去滓。以桂枝汤五合解之。令得一升后。初服五合。不知。
即
歌曰 腹痛（内寒）身疼（外寒）肢不仁。（脾主四肢。不仁者寒盛于中。无阳气以温
之也。）药
方。）桂枝
按。解之者。溶化也。知。效也。如醉状。外寒方解。得吐者。内寒已伸。故为中病也。
道光庚辰岁。予大小儿年二十六岁。初病时少腹满。两旁相去有六寸远。结二痈。长三
寸。阔二寸。不红不痛。其气似相通状。大便不通。发作寒热。食少。医者纷纭不一。或以
托里发散。或用下法。药多不效。至二三日之后。少腹满。渐高胀及腹上。及胸胁。逆气冲
及咽喉。药物饮食不能下咽。气喘。冷汗出。四肢厥。有一时许竟目直口开。予不得已。用
大温回阳之剂灌之。其初不能下咽。后约进有四分之一。其气略平些。苏回。予查其病症。
云夜夜泄精。或有梦。或无梦。泄时知觉。以手捏之。有二三刻久方止。夜夜如是。后惊不
敢睡。至鸡鸣时亦泄。诊其脉弦细芤迟。余思良久。方觉阴寒精自出句。生二痈者。乃阴寒
聚结也。治之非大温大毒之品不能散阴寒之结。非大补元气不能胜阴邪之毒也。后用四逆、
白通理中、建中等汤数服。病症渐渐而瘥。此足见长沙之法。运用无穷。愿后之学人。深思
而
（桂枝汤的方义参见呕吐、哕逆、下利篇。）主治寒疝引起的腹中疼痛，伴有四肢逆冷、手足麻木不仁。如果兼有身体疼痛，对于通过灸法或针刺能够缓解的症状，应当使用乌头桂枝汤为主治方剂。
乌头（五枚）。
以上一味药，用蜂蜜二斤，煎煮至剩余一半量，滤去药渣。将滤出的药液与桂枝汤五合混合溶解，使总量达到一升。初次服用五合，若无反应（不知），
接着再服。
歌诀曰：腹痛（因内寒）身疼（因外寒）肢不仁。（脾主四肢，肢体麻木不仁是因为寒气盛于体内，缺乏阳气来温煦所致。）药物
方剂。）桂枝
按语：所谓“解之”，是指溶化之意。“知”，指见效。服药后出现如醉酒般的状态，说明外寒得以解除；若发生呕吐，说明内寒得以伸展，这都算是达到了治疗目的（中病）。
道光庚辰年，我的大儿子和小儿子当时二十六岁。初发病时，小腹部胀满，两侧相距六寸远，形成两个痈肿，长三寸，宽二寸，颜色不红，也不疼痛，但感觉气息似乎相通。大便不通，发作时忽冷忽热，食欲减退。医生们意见纷纭，有的采用托里发散法，有的使用攻下法，用药大多无效。到了两三天后，小腹胀满逐渐增高，波及腹部甚至胸胁部，逆气上冲至咽喉，导致药物和饮食无法咽下，气喘，出冷汗，四肢厥冷。有一段时间竟然眼睛直瞪、嘴巴张开。我不得已，用大剂量温阳回阳的药物灌服。起初无法咽下，后来大约喝下了四分之一，气息稍微平稳一些，患者苏醒过来。我询问其病情，他说每晚遗精，有时做梦，有时无梦，遗精时有知觉，用手捏住阴茎需两三刻钟才能停止，每晚都是如此。后来因为惊恐而不敢睡觉，直到鸡鸣时分也会遗精。诊察其脉象弦细芤迟。我沉思良久，才想起《金匮要略》中“阴寒导致精自出”的句子。生成两个痈肿，乃是阴寒之气聚结所致。治疗此症非用大温大毒之品不能消散阴寒之结，非大补元气不能抵御阴邪之毒。之后使用了四逆汤、白通汤、理中汤、建中等方剂数服，病症渐渐痊愈。这足以见到长沙太守张仲景的医术，运用无穷无尽。希望后来的学习者，深入思考并……
(The principles of Guizhi Tang are discussed in the chapter on Vomiting, Hiccups, and Diarrhea.) It treats abdominal pain caused by Cold-Hernia (Cold-type Hernia), accompanied by cold extremities and numbness/insensitivity of the hands and feet. If there is also body pain, for symptoms that can be alleviated by moxibustion or acupuncture, Wutou Guizhi Tang should be used as the primary formula.
Wutou (Aconiti Lateralis Radix Praeparata) (5 pieces).
Take the above single herb, add two jin (approx. 1 kg) of honey, and decoct until the volume is reduced by half. Strain to remove the dregs. Mix the strained liquid with five he (approx. 200 ml) of Guizhi Tang (Cinnamon Twig Decoction) to dissolve it, resulting in a total volume of one sheng (approx. 200 ml). Initially administer five he. If there is no response (bu zhi),
then continue administering.
Song says: Abdominal pain (due to Internal Cold), Body pain (due to External Cold), Limb insensitivity (The Spleen governs the four limbs; insensitivity occurs because Cold is excessive internally, lacking Yang Qi to warm them.) Medicinal
Formula.) Guizhi
Annotation: The term "jie" (dissolve/mix) refers to dissolving. "Zhi" (know/perceive) refers to efficacy. Appearing in a state resembling drunkenness indicates that External Cold has been resolved; vomiting indicates that Internal Cold has been expelled. These are considered signs of hitting the target (zhong bing, i.e., therapeutic effect achieved).
In the Gengchen year of the Daoguang reign, my eldest son and youngest son were both twenty-six years old. At the onset of the illness, the lower abdomen was distended, with a distance of six cun between the sides, forming two abscesses (yong), each three cun long and two cun wide, without redness or pain, yet the qi seemed connected. There was constipation, alternating chills and fever, and poor appetite. Physicians offered conflicting opinions; some used methods to support the interior and disperse pathogens, while others used purgative methods, but most medications were ineffective. After two or three days, the lower abdominal distension gradually increased, spreading to the upper abdomen and chest/hypochondrium. Rebellious Qi rushed up to the throat, making it impossible to swallow medicine or food. There was panting, cold sweat, and cold extremities. For a period, the eyes stared straight and the mouth hung open. Reluctantly, I administered a large dose of warming and Yang-restoring agents via gavage. Initially, it could not be swallowed, but after approximately one-quarter was ingested, the breathing stabilized somewhat, and the patient regained consciousness. Upon reviewing the history, I learned that he experienced nocturnal emissions every night, sometimes during dreams, sometimes without, remaining conscious during emission. He had to manually compress the penis for two to three ke (approx. 30-45 minutes) to stop it, occurring nightly. Later, due to fright, he feared sleep, and emissions continued until dawn (Ji Ming time). His pulse was wiry (Xian), fine (Xi), hollow (Kou), and slow (Chi). After pondering for a long time, I recalled the phrase from *Jin Gui Yao Lue* regarding "Yin Cold causing spontaneous seminal emission." The formation of the two abscesses was due to the accumulation of Yin Cold. Treating this condition required potent warming and toxic herbs to dissipate the Yin Cold accumulation, and strong Qi-tonifying herbs to withstand the toxicity of the Yin pathogen. Subsequently, several doses of Sini Tang (Frigid Extremities Decoction), Baitong Tang (White Aconite Decoction), Lizhong Tang (Regulate the Middle Decoction), and Jianzhong Tang (Establish the Middle Decoction) were administered, and the symptoms gradually improved. This sufficiently demonstrates the boundless application of the methods of Changsha (Zhang Zhongjing). I hope future students will reflect deeply upon this...