狐惑者,犹豫不决,进退之义也。有湿 ,皆虫证。腹中有热,食入无多,肠胃空虚,三虫求
食而食人五脏。其候四肢沉重,恶闻食气,默默欲眠,目闭,舌白齿晦,面目间赤、白、黑色变易
无常。虫食下部为狐,下唇有疮,其咽干。虫食
脏为惑,其声哑。二者通用黄连犀角地黄汤加桃仁,越人望而畏之。厥阴消渴,气上冲心,饥不欲
食,食即吐蛔。既曰胃寒,复有消渴。盖热在上焦,而中下焦则但寒而无热。又有大便实证,并用
理中汤加大黄,蜜少许,微利之。
百合者,百脉一宗,举皆受病,所谓无复经络传次也。大病虚劳之后,脏腑不平,变成此证。
似寒无寒,似热无热,欲食不食,欲坐不坐,欲行不行,口苦便赤,药入即吐利,其脉微数,每尿
则头痛者,六十日愈;不头痛,但淅然恶寒者,四十日愈。若尿快然,头眩者,二十日愈。俱用百
合知母地黄汤也。
蛔厥者,厥阴病患素有寒,妄发其汗,或汗后身热,又复汗之,以致胃中虚冷,饥不能食,食
即吐蛔,乍静乍烦,蛔或上或止。蛔闻食即出也,治法在前。
热盛而烦,手足自温,脉浮而紧,此伤风见寒也。不烦少热,四肢微厥,脉浮而缓,此伤寒见
风也。二者为荣卫俱病,法虽用大青龙汤,此汤峻险,不可轻用,须风寒俱盛,又加烦躁,方可与
之,不若羌活冲和汤为神药也。
狐惑病,名称取自犹豫不决、进退两难之意。此类病症多由湿邪引起,均属于虫证范畴。患者腹中有热,进食量不多,肠胃空虚,体内的三种寄生虫(蛔虫、白虫、肉虫)寻找食物而啃食人的五脏。其临床表现包括:四肢沉重,厌恶食物的气味,神情沉默想睡觉但眼睛紧闭,舌苔发白且牙齿晦暗,面部颜色在赤、白、黑之间无常变化。如果虫子侵蚀下部生殖器,称为“狐”,表现为下唇生疮,咽喉干燥;如果虫子侵蚀内脏,称为“惑”,表现为声音嘶哑。这两种情况通用黄连犀角地黄汤并加入桃仁治疗,即使是古代名医扁鹊(越人)看到也会感到畏惧。厥阴病的消渴症状,表现为气向上冲撞心脏,感觉饥饿但不想吃东西,吃东西就会吐出蛔虫。既然说是胃寒,为什么又有消渴(口渴多饮)的症状呢?这是因为热邪位于上焦,而中焦和下焦则只有寒邪而没有热邪。另外,对于有大便实结症状的患者,也使用理中汤加大黄,并加少许蜂蜜,使其轻微通下。
百合病,是因为全身百脉同属一气之源,整体都受到疾病影响,所以不再遵循经络传变的次序。这通常在大病或虚劳之后,脏腑功能失调而形成此证。患者表现出类似恶寒却没有明显的寒象,类似发热却没有明显的热象,想吃却吃不下,想坐却坐不住,想走却走不动,口苦,小便色红,药物入口即引发呕吐或腹泻,脉象微数。如果在排尿时出现头痛的,六十天可以痊愈;如果不头痛,只是感到阵阵怕冷的,四十天可以痊愈;如果排尿后感觉爽快,但出现头晕目眩的,二十天可以痊愈。这些情况都使用百合知母地黄汤治疗。
蛔厥病,是厥阴病患者素来体内有寒,医生错误地使用了发汗法,或者发汗后身体发热,又再次发汗,导致胃中虚冷。患者感觉饥饿却无法进食,进食就会吐出蛔虫,病情时而安静时而烦躁,蛔虫有时上行有时停止活动。这是因为蛔虫闻到食物的气味就会出来。治疗方法在前面章节已有论述。
热邪盛而心烦,手足自然温暖,脉象浮而紧,这是伤风兼见寒邪的表现。如果不心烦,仅有轻微发热,四肢微微发凉,脉象浮而缓,这是伤寒兼见风邪的表现。这两种情况都属于营卫同时患病,虽然理论上可以使用大青龙汤,但该药方峻猛危险,不可轻易使用。必须等到风寒之邪都强盛,并且加上烦躁症状时,才可以给予服用。相比之下,羌活冲和汤才是神效的药物。
Hu huo disease, named for the meaning of hesitation and indecision, refers to a state of being unable to advance or retreat. These conditions are mostly caused by dampness and all belong to the category of worm syndromes (worm-related disorders). There is heat in the abdomen, food intake is low, the intestines and stomach are empty, and the three types of worms (roundworms, white worms, flesh worms) seek food and devour the five zang organs. The manifestations include: heaviness in the four limbs, aversion to the smell of food, silence with a desire to sleep but eyes closed, white tongue coating, and dull teeth; the complexion changes unpredictably between red, white, and black. If the worms erode the lower part (genital area), it is called "Hu," characterized by sores on the lower lip and dry throat. If the worms erode the internal organs, it is called "Huo," characterized by hoarseness. For both conditions, Huanglian Xijiao Dihuang Tang (Coptis Rhizome, Rhinoceros Horn, and Rehmannia Decoction) added with Tao Ren (Peach Seed) is used universally; even Yue Ren (Bian Que, an ancient famous physician) would feel intimidated upon seeing it. In Jueyin disease, xiaoke (wasting-thirst syndrome) presents with qi rushing up to strike the heart, hunger without desire to eat, and vomiting roundworms immediately after eating. Although it is stated as stomach cold, why is there also xiaoke? This is because heat resides in the Upper Jiao, while the Middle and Lower Jiao present only with cold and no heat. Additionally, for patients with solid stool constipation, Lizhong Tang (Regulate the Middle Decoction) added with Dahuang (Rhubarb Root and Rhizome) and a small amount of honey is used to induce mild purgation.
Baihe disease occurs because the hundred vessels share one source, and the entire body is affected by the illness, meaning there is no longer a sequential transmission through the meridians. This condition arises after major illnesses or consumptive diseases when the zang-fu organs become imbalanced. It presents with symptoms resembling chills but without actual cold signs, resembling fever but without actual heat signs; desire to eat but inability to do so, desire to sit but inability to remain seated, desire to walk but inability to move. Other symptoms include bitter taste in the mouth, red urine, immediate vomiting or diarrhea after taking medicine, and a slightly rapid pulse. If headache occurs during urination, recovery takes sixty days; if there is no headache but only a sensation of chilliness, recovery takes forty days; if urination brings relief but dizziness occurs, recovery takes twenty days. All these scenarios are treated with Baihe Zhimu Dihuang Tang (Lily Bulb, Anemarrhena, and Rehmannia Decoction).
Hui jue (Roundworm syncope) occurs in Jueyin disease patients who inherently have cold. Erroneous use of sweating methods, or sweating again after fever persists post-sweating, leads to deficiency-cold in the stomach. Patients feel hungry but cannot eat; upon eating, they vomit roundworms. The condition alternates between quietness and irritability; roundworms may ascend or stop moving. Roundworms emerge upon smelling food. The treatment method is described in previous sections.
Excessive heat causing irritability, with naturally warm hands and feet, and a floating and tight pulse, indicates wind-injury accompanied by cold. Lack of irritability, slight fever, slightly cold four limbs, and a floating and moderate pulse indicate cold-injury accompanied by wind. Both conditions involve simultaneous disease of Ying (Nutritive Qi) and Wei (Defensive Qi). Although Da Qinglong Tang (Major Green Dragon Decoction) could theoretically be used, this formula is harsh and dangerous, and should not be used lightly. It is only suitable when both wind and cold pathogens are strong and accompanied by irritability. In comparison, Qianghuo Chonghe Tang (Notopterygium Harmonizing Decoction) is considered a miraculous remedy.