表邪也,太阳证。
亦项强,因太阳中风加之寒湿,宜发散之。
结胸项亦强,如柔 状,宜大陷胸丸下之。
眩者非玄,而见其玄。
者非毛,而见其毛。
者,目摇动也。
运者,运转,世谓之头旋。
冒者,蒙冒,世谓之昏冒。
皆阳虚也。
风亦头眩。
属性原缺。
属性原缺。
属性原缺。
……虚气上逆也,旋复代赭石汤主之。痞与泻心不解,渴而小便不利为水饮内蓄,五苓散
主之,泻心汤并治痞虚气。
结胸证悉具而加之烦躁者死,邪胜也。
脏结亦如结胸,邪结于阴也。寸脉浮而关小细沉紧,饮食如故,而阴结阳不
结也。时自利,是阴乘阳虚而下也。舌上白胎滑者难治,白胎寒多也。脏结,于
法当下,若无阳证寒热,其人反静,胎滑,不可攻也,宜刺关元,小柴胡汤也。
又,病患胁下旧有痞,连在脐旁,痛引小腹入阴筋者死,积与真藏气结也。
大满大痛,或潮热大便不通,腹满不减者,实也,可下之。曰阳热为邪者,
腹满而咽干,方可下之。又曰,痛而不满为实,宜大柴胡、承气辈下之。满而且
痛,内外表里俱有证,宜桂枝加大黄汤,以和其内外,以上皆热病也。
有冷痛者,痛而大便利,手足冷,恶寒,脉细,面青者,温之,四逆也。
有下寒上热痛者,腹中痛,欲呕吐,黄连汤主之。
腹满不痛或时减者,为虚。此虚寒从上下也,当温之。盖虚气留滞,亦为之
胀,比之实,但不坚痛为异,宜桂枝半夏汤、小建中汤,以和之。又曰,阴寒为
邪者,腹满而吐,食不下,自利益甚,时腹自痛,属太阴也,可温之。
汗吐下后胀满。
发汗后不解,腹满痛者,急下之。
发汗后腹胀满(是膀胱虚也)者,浓朴生姜甘草半夏人参汤主之。此因表邪发散去
津液少,胃主津液,胃虚不能宣布诸气,当温散之。
吐后腹满者,邪气不去,下传入胃,承气主之。
太阳病反下,因而腹满时痛,桂枝加芍药主之。大实痛,桂枝加大黄主之。
伤寒下后,腹胀心烦,卧不安,热乘虚,郁于中,气不得上下,栀子浓朴汤主之。
真头痛,疼痛剧烈并牵连至头脑深处,同时出现手足冰冷的症状,属于死证。
这是表邪侵袭,表现为太阳病证候。
也伴有项部僵硬,这是因为太阳中风证又兼感寒湿之邪,适宜采用发散法治疗。
结胸证也会引起项部僵硬,症状类似柔痉(身体强直、角弓反张而无汗),适宜用大陷胸丸攻下。
眩,并非指玄妙,而是视物昏花模糊。
冒,并非指毛发,而是指头重如裹的感觉。
振,是指眼球或头部摇动不定。
运,是指天旋地转般的运转感,世俗称为“头旋”。
蒙,是指神志昏蒙,世俗称为“昏冒”。
这些症状多由阳气虚弱所致。
风邪侵袭也会导致头晕目眩。
属性原缺。
属性原缺。
属性原缺。
……这是虚气上逆的表现,主方为旋复代赭石汤。若痞证服用泻心汤后未解,且出现口渴、小便不利,说明是水饮内停蓄积,主方为五苓散;泻心汤也可用于治疗痞证及虚气上逆。
结胸证的典型症状全部具备,如果再出现烦躁不安,属于邪气亢盛,预后不良,为死证。
脏结的症状也像结胸一样,但邪气结聚在阴分。脉象寸部浮而关部小细沉紧,饮食正常,说明是阴结而阳不结。时常自发性腹泻,是因为阴寒乘阳气虚弱而下注。舌苔白滑者难治,因为白苔主寒,滑苔主水湿寒盛。对于脏结,按治法应当攻下,但如果患者没有阳证的寒热表现,反而神情安静,舌苔滑润,则不可攻下,适宜针刺关元穴,并服用小柴胡汤。
另外,如果患者胁下原有痞块,延伸至脐旁,疼痛牵引至小腹及阴筋部位,属于死证,这是积聚与真气败绝之脏气结聚所致。
腹部胀满且疼痛剧烈,或者伴有潮热、大便不通,腹部胀满持续不减的,属于实证,可以采用攻下法。所谓阳热为邪者,表现为腹部胀满且咽干,方可使用攻下法。又说,只有疼痛而没有胀满感的属于实证,适宜用大柴胡汤、承气汤类方剂攻下。既胀满又疼痛,表里内外均有证候表现的,适宜用桂枝加大黄汤,以调和表里内外,以上皆属热病范畴。
有冷痛的情况,表现为疼痛且大便通畅,手足冰冷,恶寒,脉象细弱,面色青暗,适宜温补,可用四逆汤。
有下寒上热导致疼痛的情况,表现为腹中痛,想呕吐,主方为黄连汤。
腹部胀满但不痛,或者有时减轻的,属于虚证。这是虚寒之气从上往下侵犯所致,应当温补。因为虚气留滞也会引起胀满,与实证的区别仅在于不坚硬且疼痛轻微,适宜用桂枝半夏汤或小建中汤来调和。又说,阴寒为邪者,表现为腹部胀满且呕吐,饮食不下,腹泻日益严重,时常腹部自痛,这属于太阴病,可以温补治疗。
经过发汗、催吐、攻下治疗后出现的胀满。
发汗后病未解除,出现腹部胀满疼痛的,需紧急攻下。
发汗后出现腹部胀满(这是由于膀胱气化功能虚弱)的,主方为浓朴生姜甘草半夏人参汤。这是因为表邪通过发汗散去,导致津液亏损,胃主司津液,胃气虚弱不能宣通布散诸气,应当温散治疗。
催吐后出现腹部胀满的,说明邪气未去,向下传入胃部,主方为承气汤。
太阳病误用攻下法,因而导致腹部胀满、时作疼痛的,主方为桂枝加芍药汤。若疼痛剧烈属实证,主方为桂枝加大黄汤。
伤寒经攻下治疗后,出现腹胀、心烦、卧睡不安,这是热邪乘虚而入,郁结于中焦,导致气机升降失常,主方为栀子厚朴汤。
Zhen Tou Tong (True Headache), where pain is severe and extends into the brain, accompanied by cold hands and feet, indicates a fatal prognosis.
This is an exterior pathogenic factor manifesting as Taiyang Syndrome (Syndrome of the Bladder and Small Intestine channels).
It also presents with stiffness of the neck, caused by Taiyang Wind Strike (Wind Stroke) complicated by Cold-Dampness; dispersing treatment is indicated.
Jie Xiong (Chest Binding) may also cause neck stiffness, resembling Rou Jing (Soft Spasm - characterized by rigidity without sweat); Da Xian Xiong Wan (Major Inward-Draining Pill for Chest Binding) is indicated to purge.
Xuan (Dizziness/Blurred Vision) refers not to mystery, but to blurred vision.
Mao (Covering/Dizziness) refers not to hair, but to a sensation of heaviness covering the head.
Zhen (Tremor/Shaking) refers to shaking or trembling of the eyes or head.
Yun (Spinning) refers to a spinning sensation, commonly known as "head spinning" (vertigo).
Meng (Clouding) refers to mental clouding, commonly known as "mental fogginess" or syncope.
These are all due to Yang Deficiency.
Wind invasion can also cause dizziness.
Attribute originally missing.
Attribute originally missing.
Attribute originally missing.
... This is reversal of deficient Qi ascending; Xuan Fu Dai Zhe Shi Tang (Inula and Hematite Decoction) is the primary formula. If Pi (Glomus/Stagnation) persists after using Xie Xin Tang (Drain the Epigastrium Decoctions), and thirst and difficult urination occur, this indicates internal accumulation of Fluid Retention; Wu Ling San (Five-Ingredient Powder with Poria) is indicated. Xie Xin Tangs can also treat Pi and reversal of deficient Qi.
If all symptoms of Jie Xiong (Chest Binding) are present and restlessness (Fan Zao) is added, it indicates Excess Pathogen and is fatal.
Zang Jie (Organ Binding) resembles Jie Xiong, but the pathogen binds in the Yin. The pulse is floating at the Cun (inch) position and small, fine, deep, and tight at the Guan (middle) position; food intake remains normal, indicating Yin binding without Yang binding. Frequent spontaneous diarrhea occurs because Yin Cold attacks Yang Deficiency and descends. A white, slippery coating on the tongue indicates difficulty in treatment, as white coating signifies excess Cold. For Zang Jie, purging is theoretically indicated; however, if there are no Yang signs of Cold-Heat alternation, the patient is instead quiet, and the tongue coating is slippery, purging must not be used. Moxibustion or acupuncture at Guan Yuan (CV-4) is suitable, along with Xiao Chai Hu Tang (Minor Bupleurum Decoction).
Furthermore, if a patient has an old Pi mass under the hypochondrium extending to the side of the umbilicus, with pain radiating to the lower abdomen and genitalia, it is fatal; this represents accumulation and binding of True Zang Qi (Visceral Essence).
Severe fullness and pain, or tidal fever with constipation, and abdominal fullness that does not decrease, indicate Excess; purging is indicated. When Yang Heat acts as the pathogen, presenting with abdominal fullness and dry throat, purging may be used. It is also stated that pain without fullness indicates Excess, suitable for Da Chai Hu Tang (Major Bupleurum Decoction) or Cheng Qi (Ordering the Qi) formulas. Fullness combined with pain, with manifestations in both interior and exterior, suggests Gui Zhi Jia Huang Qi Tang (Cinnamon Twig Decoction plus Rhubarb) to harmonize interior and exterior; these are all Heat diseases.
Cold pain presents with pain but free stool, cold hands and feet, aversion to cold, thin pulse, and cyanotic complexion; warming is indicated, using Si Ni Tang (Frigid Extremities Decoction).
Pain due to Lower Cold and Upper Heat presents with abdominal pain and desire to vomit; Huang Lian Tang (Coptis Decoction) is indicated.
Abdominal fullness without pain, or pain that occasionally subsides, indicates Deficiency. This is Cold from Deficiency attacking from above and below; warming is indicated. Stagnant deficient Qi causes distension; unlike Excess, it is neither hard nor severely painful. Gui Zhi Ban Xia Tang (Cinnamon Twig and Pinellia Decoction) or Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) is indicated to harmonize. It is also stated that when Yin Cold acts as the pathogen, presenting with abdominal fullness, vomiting, inability to eat, worsening diarrhea, and occasional spontaneous abdominal pain, it belongs to Taiyin Syndrome; warming is indicated.
Distension following sweating, vomiting, or purging.
After sweating, if the disease is unresolved and abdominal fullness and pain occur, urgent purging is required.
After sweating, if abdominal fullness occurs (due to Bladder Qi deficiency), Nong Po Sheng Jiang Gan Cao Ban Xia Ren Shen Tang (Atractylodes Macrocephala, Ginger, Licorice, Pinellia, and Ginseng Decoction) is indicated. This results from exterior pathogens being dispersed by sweating, leading to fluid depletion. Since the Stomach governs fluids, Stomach Deficiency fails to distribute Qi properly; warming and dispersing is required.
After vomiting, if abdominal fullness occurs, the pathogen has not been expelled and has descended into the Stomach; Cheng Qi Tang (Ordering the Qi Decoction) is indicated.
If Taiyang Syndrome is incorrectly purged, resulting in abdominal fullness and intermittent pain, Gui Zhi Jia Shao Yao Tang (Cinnamon Twig Decoction plus Peony) is indicated. For severe pain indicating Excess, Gui Zhi Jia Huang Qi Tang (Cinnamon Twig Decoction plus Rhubarb) is indicated.
After purging in Shang Han (Cold Damage), if abdominal fullness, irritability, and restlessness occur, Heat has entered vacuity and stagnated in the Middle Jiao, preventing Qi from moving up and down; Zhi Zi Nong Po Tang (Gardenia and Magnolia Bark Decoction) is indicated.