属阴虚元气不足。戴云∶秋初夏末,头痛脚软,食少体倦,身热者是,脉弦而大,补中益气汤去柴胡、升麻,加
炒柏;宜生脉散,麦门冬、五味子、人参,出《千金方》;或补中益气汤中去柴胡、升麻,加炒柏、芍药;挟痰加
半夏、南星、陈皮之类。
暑风是痰用吐。挟火、挟痰,实者可用吐法。夫治暑风用吐法者,即中暑是也。其人必内先有火热痰实之故,因
避暑纳凉,八风袭之,郁而成身热。或昏冒,吐中有汗,火郁得汗则解,风得汗则散,痰得汗涌则出,一举三得。此当
时治挟痰实者,非通治暑风大法也。夫暑风无所挟者,宜汗以散之。
胃风脉,右关弦而缓带浮,初饮食讫,乘风凉而致。其症饮食不下,形瘦腹大恶风,头多汗,膈塞不通,胃风
汤正治此。亦看挟症加减。
《本草》苍术治湿,上下都可用。二陈汤加酒芩、羌活、苍术、散风行湿。二陈汤治湿,加升提之药,能
使大便润,而小便长。上湿苍术功烈,下湿升提,外湿宜表散,内湿宜淡渗。淡渗治湿,在上中二焦,湿在
上,宜微汗而解,不欲汗多,故不用麻黄葛根辈。湿淫诸症治法,并见各病条下。戴云∶夫治湿之药,各有所入,
苟切于治功,便为要药,岂苍术一味便都可用哉。先生宁肯语此,以示人耶。戴云∶湿之为病,有自外入者,有自内
出者,必审其方土之病源。东南地下,多阴雨地湿,凡受必从外入,多自下起,是以重腿香港脚者多,治当汗散,久者
宜疏通渗泄;西北地高,人多食生冷湿面,或饮酒后寒气怫郁,湿不能越,作腹皮胀疼,甚则水鼓胀满,或周身
浮肿如泥,按之不起,此皆自内而出者也,审其元气多少,而通利其二便,责其根在内者也。然方土内外,亦互相
有之,但多少不同,须对证施治,不可执一也。一男子三十五岁,九月间早起,忽目无光,视物不见,急欲视,片
时才见人物,竟不能辨,饮食减平时之半,神思极倦,已病五日,脉之缓大四至之上,作受湿处治。询之,果因卧
湿地半月而得,以白术为君,黄 、陈皮为臣,附子为佐,十余帖而安。诸湿客于腰膝重痛,足胫浮肿,除湿丹方,
见香港脚条下。
属于阴虚且元气不足。戴元礼说:在夏末秋初之际,出现头痛、脚软、食欲减退、身体疲倦、身体发热等症状的,脉象弦而大,可用补中益气汤去掉柴胡、升麻,加入炒黄柏;适宜使用生脉散(由麦门冬、五味子、人参组成,出自《千金方》);或者用补中益气汤去掉柴胡、升麻,加入炒黄柏、芍药;如果夹杂痰湿,则加入半夏、南星、陈皮之类的药物。
暑风若因痰邪所致,可用涌吐法。若夹杂火邪或痰邪,实证者可以使用吐法。治疗暑风使用吐法的,其实就是中暑的情况。患者必定体内先有火热和痰实的原因,因为避暑纳凉时,受到八方风邪侵袭,导致气机郁结而产生身热。或者出现神志昏蒙,吐法后伴有出汗,火邪郁结得汗则解,风邪得汗则散,痰邪得汗涌出则排出,一举三得。这是当时针对夹杂痰实证候的治疗方法,并非治疗暑风的通用大法。对于暑风没有夹杂其他邪气的,适宜用发汗法来疏散它。
胃风的脉象,右关部弦而缓并带浮象,通常在饮食结束后,乘凉受风所致。其症状表现为饮食难下,形体消瘦但腹部胀大,怕风,头部多汗,胸膈堵塞不通,胃风汤是治疗此病的正治方剂。也可以根据夹杂的症状进行加减。
《本草》记载苍术可以治疗湿邪,上部和下部都适用。二陈汤加入酒制黄芩、羌活、苍术,可以疏散风邪、祛除湿邪。二陈汤治疗湿邪,加入升提的药物,能使大便滋润,小便通长。上部的湿邪苍术功效猛烈,下部的湿邪宜用升提法,外部的湿邪宜用解表发散法,内部的湿邪宜用淡味渗利法。淡渗法治疗湿邪,适用于上、中二焦。湿邪在上部,宜用微汗法解除,不希望出汗过多,所以不用麻黄、葛根这类药物。各种湿邪引起的病症治疗方法,均在各病条下可见。戴元礼说:治疗湿邪的药物,各有所入的经络脏腑,如果切合治疗功效,就是重要药物,难道只有苍术一味药就到处可用吗?先生您肯这样教导人,以此示人吗?戴元礼说:湿邪致病,有从外部侵入的,有从内部产生的,必须审察当地的气候病因。东南地区地势低洼,多阴雨潮湿,凡是受湿邪必定从外部侵入,多从下肢发起,因此患重腿、香港脚的人很多,治疗应当用汗法发散,久病者宜用疏通渗泄法;西北地区地势高,人多食用生冷湿面,或在饮酒后寒气郁结,湿气不能宣越,导致腹皮胀疼,甚至水鼓胀满,或周身浮肿如泥,按之不起,这些都是从内部产生的,需审察元气多少,从而通利大小便,追究根源在于内部。然而各地内外因素也是互相存在的,只是比例不同,必须对证施治,不可固执一端。有一个三十五岁的男子,九月间早起,忽然目光无神,视物不见,急于看东西,片刻才能看见人物,竟然无法辨认,饮食减少平时的一半,精神极度疲倦,已经病了五天,诊脉缓大而四至以上,判断为受湿邪所致。询问得知,确实是因为睡在湿地半个月而得的,以白术为君药,黄芪、陈皮为臣药,附子为佐药,服用十余帖后痊愈。各种湿邪客居于腰膝导致沉重疼痛,足胫浮肿,除湿丹方剂,见香港脚条目下。
It belongs to Yin deficiency and insufficient Yuan Qi (Original Qi). Dai Yunli stated: In the late summer and early autumn, when one experiences headache, weak legs, poor appetite, body fatigue, and fever, with a pulse that is wiry and large, one may use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) removing Chaihu (Bupleuri Radix) and Shengma (Cimicifugae Rhizoma), adding stir-fried Baicao (Phellodendri Cortex); it is suitable to use Shengmai San (Generate the Pulse Powder), composed of Maimendong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), and Renshen (Ginseng Radix et Rhizoma), from *Qianjin Fang*; or use Buzhong Yiqi Tang removing Chaihu and Shengma, adding stir-fried Baicao and Shaoyao (Paeoniae Radix); if complicated by phlegm, add Banxia (Pinelliae Rhizoma), Nanxing (Arisaematis Rhizoma prepared with alum), and Chenpi (Citri Reticulatae Pericarpium).
Shu Feng (Summerheat Wind) caused by phlegm can be treated with emesis. If complicated by fire or phlegm, excess patterns may utilize the vomiting method. The use of emesis for treating Shu Feng refers to Zhongshu (Summerheat Stroke). The patient must first have internal heat-fire and phlegm-excess conditions; due to seeking coolness and avoiding summerheat, they are attacked by the Eight Winds (pathogenic factors from eight directions), leading to stagnation and resulting in fever. Or there may be confusion and dizziness; after vomiting, sweating occurs. Fire stagnation resolves with sweat, wind dissipates with sweat, and phlegm is expelled through the surge of sweat, achieving three benefits at once. This was a treatment for those complicated by phlegm-excess at that time, not the general principle for treating all Shu Feng. For Shu Feng without complications, it is appropriate to use diaphoresis (sweating method) to disperse it.
The pulse of Wei Feng (Stomach Wind) is wiry, slow, and floating on the right Guan position. It is caused by eating and then exposing oneself to cool drafts. Symptoms include inability to swallow food, emaciation with abdominal distension, aversion to wind, excessive sweating on the head, and chest diaphragm obstruction. Weifeng Tang (Stomach Wind Decoction) is the principal treatment for this. Modifications should be made based on accompanying symptoms.
*Bencao* records that Cangzhu (Atractylodis Rhizoma) treats dampness and is applicable to both upper and lower parts. Erchen Tang (Two-Aged Decoction) added with Jiuhuangqin (Scutellariae Radix processed with wine), Qianghuo (Notopterygii Rhizoma et Radix), and Cangzhu can dispel wind and dry dampness. Erchen Tang treating dampness, when combined with lifting herbs, can moisten the stool and increase urination. For upper dampness, Cangzhu has strong effects; for lower dampness, lifting methods are preferred; for external dampness, surface-dispersing methods are suitable; for internal dampness, bland leaching methods are appropriate. Bland leaching treats dampness in the Upper and Middle Jiao (Burners). When dampness is in the upper part, mild diaphoresis is used to resolve it, avoiding excessive sweating; thus, herbs like Mahuang (Ephedrae Herba) and Gegen (Puerariae Lobatae Radix) are not used. Treatments for various dampness-induced symptoms are detailed under respective disease sections. Dai Yunli said: Herbs for treating dampness enter specific meridians and organs; if they effectively treat the condition, they are essential drugs. Is it true that only Cangzhu is universally applicable? Would your teacher speak thus to instruct others? Dai Yunli said: Diseases caused by dampness arise either from external invasion or internal generation. One must examine the local climatic sources. In the southeast, where the land is low and rainy, dampness enters externally, often starting from below; thus, heavy legs and Hongjiaojiao (Hong Kong Foot/Gout) are common, requiring dispersing via sweating, and chronic cases require dredging and leaching. In the northwest, where the land is high, people often consume cold, raw, or damp wheat noodles, or drink alcohol causing cold qi stagnation, preventing dampness from venting, leading to abdominal distension and pain, severe water drum distension, or whole-body edema like mud that does not rebound upon pressure; these arise internally. One must assess the amount of Yuan Qi and promote urination and defecation, addressing the root internally. However, external and internal factors interact everywhere, differing only in degree. Treatment must be symptomatic and not rigid. A thirty-five-year-old man, upon rising in September, suddenly lost vision clarity, unable to see objects clearly even after focusing for a moment, could not recognize figures, ate half his usual amount, felt extreme mental fatigue, and had been ill for five days. His pulse was slow, large, and slightly above four beats per breath cycle, indicating dampness exposure. Inquiry revealed he had slept on damp ground for half a month. Bai Zhu (Atractylodis Macrocephalae Rhizoma) was used as the Sovereign herb, Huangqi (Astragali Radix) and Chenpi as Ministers, and Fuzi (Aconiti Lateralis Radix Preparata) as an Assistant. After more than ten doses, he recovered. Various dampness pathogens lodging in the waist and knees causing heaviness and pain, and swelling of the calves, are treated with Chushi Dan (Dampness-Removing Pill), see the Hongjiaojiao section.