懊 者,郁闷不舒之貌。盖表证误下,正气内虚,阳邪内陷于心胸之间,重则
为结胸也。邪在心胸,则宜吐。热结胃腑,则宜下。发汗、吐、下后虚烦不得眠,懊 者,与夫短
气烦躁,心下渴,胸中懊 者,用栀子豉汤。阳明病,下后懊 而烦,胃中有燥屎,承气汤下之。
阳明无汗,小便不利,心懊 者,必发黄,茵陈汤利之。舌上白苔,饥不食,虚烦不眠,头汗出,
懊者,栀子豉汤也。
身体痛者,虽曰太阳表邪未解,又有温经发汗不同。如发热恶寒,头疼身体痛,脉浮紧者,表
未解也,冬月麻黄汤,余月羌活冲和汤汗之。或下利脉沉,身痛如被杖者,为阴寒证,宜四逆汤温
之。发汗后身痛,脉沉迟,桂枝芍药人参汤。下利烦满,身疼痛,先温其里,四逆汤,后攻其表,
桂枝汤。一身尽痛,发热面黄,七八日,热结在里,有瘀血也,桃仁承气汤下之。如身重痛者,属
阳明,有风也,葛根汤主治之。
拘急者,手足不能自如,屈伸不便,如蜷卧恶风之貌。四肢诸阳之本,因发汗
亡阳,阳虚而有此证。自汗,脉浮,小便数,心烦恶寒,足挛拳急,芍药甘草汤。太阳病,发汗,
遂漏不止,恶风,小便难,拘急者,桂枝加附子汤。吐利后汗出发热,恶寒拘急,手足厥冷者,四
逆汤温之也。
懊恼,是指心中郁闷、不畅快的状态。这是因为表证错误地使用了下法,导致正气内部虚弱,阳热邪气内陷于心胸部位,严重的会形成结胸证。邪气位于心胸,适宜用吐法;热邪结聚在胃腑,适宜用下法。经过发汗、催吐、泻下之后,出现虚烦不得入睡的懊恼感,以及短气烦躁、心下部口渴、胸中懊恼的症状,使用栀子豉汤。阳明病,经过泻下后出现懊恼且心烦,胃中有干燥的粪便,使用承气汤泻下。阳明病无汗,小便不利,心中懊恼的,必定会出现发黄,使用茵陈汤利湿退黄。舌苔白,感到饥饿却不想进食,虚烦失眠,头部出汗,懊恼的,使用栀子豉汤。
身体疼痛,虽然说是太阳经表邪未解,但也有温经发汗的不同治法。如发热恶寒,头痛身体痛,脉象浮紧的,是表证未解,冬季用麻黄汤,其他季节用羌活冲和汤发汗。或者腹泻脉沉,身体疼痛如同被棍棒打过一样,这是阴寒证,适宜用四逆汤温里。发汗后身体疼痛,脉象沉迟,使用桂枝芍药人参汤。腹泻伴烦闷胀满,身体疼痛,先温补其里,用四逆汤,然后再攻逐其表,用桂枝汤。全身都疼痛,发热面色黄,病程七八天,热邪结聚在体内,有瘀血,使用桃仁承气汤泻下。如果身体沉重疼痛,属于阳明病,有风邪,由葛根汤主治。
拘急,是指手足不能自如活动,屈伸不便,像蜷缩卧倒、怕风的样子。四肢是诸阳之本,因为发汗导致亡阳,阳气虚弱而出现此证。自汗,脉浮,小便频数,心烦恶寒,足部挛缩拳曲紧急,使用芍药甘草汤。太阳病,发汗后,汗出淋漓不止,怕风,小便困难,拘急的,使用桂枝加附子汤。呕吐腹泻后出汗发热,恶寒拘急,手足厥冷的,用四逆汤温之。
Ao (Restlessness), refers to the appearance of mental depression and discomfort. This occurs when exterior syndromes are incorrectly treated with purgation, causing internal deficiency of healthy Qi and the inward penetration of Yang pathogenic factors into the heart and chest region; in severe cases, it leads to Jie Xiong (Chest Binding). When pathogens are located in the heart and chest, emesis is indicated; when heat binds in the stomach fu organ, purgation is indicated. After sweating, vomiting, or purging, if there is empty irritability, insomnia, Ao (restlessness), shortness of breath, irritability, thirst below the heart, and Ao (restlessness) in the chest, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) should be used. In Yangming disease, if Ao (restlessness) and irritability occur after purgation, and dry feces are present in the stomach, Chengqi Tang (Purgative Decoction) should be used for purgation. In Yangming disease, if there is no sweat, ineffective urination, and Ao (restlessness) in the heart, jaundice will inevitably develop; Yinchen Tang (Artemisiae Scopariae Decoction) should be used to promote diuresis and resolve jaundice. If the tongue has a white coating, hunger without desire to eat, empty irritability, insomnia, head sweating, and Ao (restlessness) are present, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) is indicated.
Body pain: Although it is said that this is due to the unresolved exterior pathogen of the Taiyang (Greater Yang) channel, there are different treatments involving warming the channels and inducing sweating. For example, if there is fever and aversion to cold, headache, body pain, and a floating-tight pulse, the exterior is unresolved. In winter, Mahuang Tang (Ephedra Decoction) is used; in other months, Qianghuo Chonghe Tang (Notopterygium Harmonizing Decoction) is used to induce sweating. Alternatively, if there is diarrhea, a deep pulse, and body pain as if beaten by a stick, this is a Yin-cold syndrome, and Sini Tang (Frigid Extremities Decoction) is indicated for warming. After sweating, if body pain persists with a deep-slow pulse, Guizhi Shaoyao Renshen Tang (Cinnamon Twig, Peony, and Ginseng Decoction) is used. If there is diarrhea with irritability and fullness, accompanied by body pain, first warm the interior with Sini Tang (Frigid Extremities Decoction), then attack the exterior with Guizhi Tang (Cinnamon Twig Decoction). If the whole body hurts, with fever and yellowish complexion, persisting for seven to eight days, heat is bound internally with blood stasis; Taoren Chengqi Tang (Peach Kernel Purgative Decoction) is used for purgation. If the body feels heavy and painful, it belongs to Yangming with wind pathogen, and Gegen Tang (Kudzu Decoction) is the primary treatment.
Ju Ji (Tetany/Spasm): Refers to the inability of hands and feet to move freely, with difficulty in flexion and extension, resembling a posture of curling up, lying down, and aversion to wind. The four limbs are the root of all Yang channels. Due to sweating leading to the loss of Yang Qi, Yang deficiency causes this syndrome. With spontaneous sweating, floating pulse, frequent urination, heart irritability, aversion to cold, and cramping/clenching of the feet, Shaoyao Gancao Tang (Peony and Licorice Decoction) is used. In Taiyang disease, after sweating, if sweating continues unceasingly, with aversion to wind, difficult urination, and tetany, Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction plus Aconite) is indicated. After vomiting and diarrhea, if there is sweating with fever, aversion to cold, tetany, and cold extremities, Sini Tang (Frigid Extremities Decoction) is used for warming.