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Some things to take note:

1. 大青龙汤 is compositionally 麻黄汤 plus 姜枣 plus 石膏
2. Quantity of 麻黄 double that of 小青龙汤 (6两 instead of just 3两)

(A) 大青龙汤 - the text (i):

“太阳中风，脉浮紧，发热恶寒，身疼痛，不汗出而烦躁者，大青龙汤主之。” (line 38a)

This line tells us symptoms similar to that of 麻黄汤. “vexation” (“烦躁”) due to the inability to perspire is added though. What does this tell us? That we really need to blast the heat out. And we could add 石膏, not just to counter the excess 麻黄 heat, but also to aid in the blasting… Here’s similar material concerning this formula.

“若脉微弱，汗出恶风者，不可服之。” (line 38b)

Put simply, this prescription is not for 表虚-type people.

“服之则厥逆，筋惕肉瞤，此为逆也。” (line 38c)

Yes, if you drink it, you will manifest 厥逆, whatever it is. Your tendons will go bonkers and your muscles will 瞤 (shun4) whatever that means…

(B) 大青龙汤 - the text (ii):

“伤寒脉浮缓，身不疼但重，乍(zha4)有轻时，无少阴证者，大青龙汤主之。” (line 39)

Here is a line that describes a situation where 大青龙汤 is indicated. The person appears to be deficient, not too different than a 少阴证 situation where water retention is a problem and prescriptions like 真武汤 are used. In a 真武汤 pattern, for example, “四肢沉重疼痛”, the commonality being the feeling of heaviness.

However, with 大青龙汤, the the pain is not longer there, and the pulse is 浮缓, not 微细, the typical 少阴证 pulse. One way to look at this is that the replete exterior characterized by 大青龙汤证 no longer is. Somehow or other, something has happened and the vexation and feeling of stuckness in the exterior has morphed into a feeling of dampness and heaviness. The person is not 虚 (as in 少阴-type deficiency), and so 四逆汤-type prescriptions are contraindicated. Rather, we need something to blast away the obstructed fluids, and 大青龙汤 will do the job, not just via perspiration, but also with the 麻桂 pair’s diuretic function.

(C) 小青龙汤 - the text:

“伤寒表不解，心下有水气 ，干呕发热而咳，

或渴，或利，或噎，或小便不利，少腹满，或喘者，小青龙汤主之。”