问曰。误火者其变亦有别否。答曰。太阳病脉浮者当以汗解。汗者心之液。心主营。必使
营与卫
和。则汗出津津而解。若以火迫汗。火气内攻。营气受灼。故或圊血。或发黄。或谵语。甚
至口干舌烂。骨焦筋伤。种种皆亡阴之象。此证之易辨者。又有其人心阳素虚。一遇火灼。
心阳随之外越。以致惊狂卧起不安者。亟亟挽飞越之阳神。间有可救。然亦危矣。同属误火
。其变证亦有亡阴亡阳之别。误火之弊。今人亦不敢妄试。然当太阳病时。习用辛热迫汗者
。其弊与误火等。可不慎哉。
问曰。何以识为阳明病。答曰。阳明之为病。胃家实是也。然泛言胃实。恰从何处辨证
而知
阳明之为病。此其间亦有经府之别。发热汗自出。不恶寒。反恶热。甚则舌上干燥而烦。渴
欲饮水者。此是阳明经证。若潮热不大便。谵语。腹满痛者。此属阳明府证。传经之邪。在
经则传。入府则不传。故曰阳明居中土也。万物所归。无所复传。惟有亟从下夺而解。其欲
作经者。阳明一经。来路自太阳。去路自少阳。其太阳证未罢。而阳明证已见者。亟当从太
阳领出其邪。以断阳明从入之路。若阳明证具。而少阳证未见者。当直折本经散漫之热。使
胃中津液和而愈。以断阳明从出之路。若阳明证未罢。而少阳证已见者。又当亟从少阳和解
之法。即以断从少阳转入三阴之路。此传经之邪。亟当相其人胃中之津液。前后照顾。预防
变逆。不必尽属可攻之证。至既入于府。无所复传。不予亟攻。津液随竭。则惟当急下以存
阴。更不必有所瞻顾。欲识阳明病。先要在经府上辨明真确而或谓病在阳明。概从清凉攻下
者。此非法也。
问：误用火疗法，其产生的变证是否有区别？
答：太阳病脉象浮的，应当用发汗的方法解除。汗是心液的体现。心主管营气，必须使营气与卫气调和，才会津液津津地出汗而病解。如果用火疗法强迫发汗，火气向内攻伐，营气受到灼烧，所以或者出现便血（圊血），或者出现发黄，或者出现胡言乱语（谵语），甚至出现口干舌烂、骨骼枯焦、筋脉损伤等种种症状，这些都是亡失阴液的征象。这种证候是容易辨别的。又有那种人心阳素来虚弱，一旦遇到火邪灼烧，心阳随之向外浮越，导致惊恐狂乱、卧起不安的症状。此时急需挽回飞越的心阳神气，间或还有可救的机会，但也十分危险了。同样属于误用火疗，其变证也有亡阴和亡阳的区别。误用火疗的弊端，现在的人也不敢妄自尝试。然而当处于太阳病阶段时，习惯性地使用辛热药物强迫发汗，其弊端与误用火疗相等，怎么能不谨慎呢？
问：如何识别为阳明病？
答：阳明病的特征，就是“胃家实”。然而泛泛地说胃实，究竟从何处辨证才能知道是阳明病呢？这中间也有经证和腑证的区别。发热、汗自出、不恶寒、反而恶热，甚至舌上干燥而烦躁、口渴想喝水的，这是阳明经证。如果出现潮热、不大便、胡言乱语、腹部胀满疼痛的，这属于阳明腑证。传入经络的病邪，在经则继续传变，入腑则不再传变。所以说阳明居中属土，万物所归，病邪无所复传。只有急切地从下面攻下才能解除。那些想要传入其他经的，阳明一经，来路自太阳，去路自少阳。如果太阳证未罢，而阳明证已见，应当急切地从太阳领出病邪，以切断阳明病邪内入的路径。如果阳明证具备，而少阳证未见，应当直接折损本经散漫的热邪，使胃中津液调和而痊愈，以切断阳明病邪外出的路径。如果阳明证未罢，而少阳证已见，又应当急切地从少阳采用和解的方法，以此切断病邪从少阳转入三阴的路径。这些传入经络的病邪，应当急切地根据患者胃中的津液情况，前后照顾，预防变逆发生，不一定全属于可以攻下的证候。至于病邪既已入腑，无所复传，如果不给予急切攻下，津液就会随之枯竭，那就只应当急下以保存阴液，更不必有所顾虑。想要识别阳明病，首先要在经证和腑证上辨别明确。有人谓病在阳明，一概从清凉攻下治疗，这不是正确的治法。
Question: Are there differences in the complications arising from erroneous fire therapy?
Answer: In Taiyang disease (Taiyang Syndrome), when the pulse is floating, it should be resolved by inducing sweating. Sweat is the fluid of the Heart. The Heart governs Ying-Nutritive Qi (Ying-Qi). It is necessary to harmonize Ying-Qi and Wei-Defensive Qi (Wei-Qi), so that sweat emerges gently and the disease resolves. If fire therapy is used to force sweating, the pathogenic fire attacks inward, scorching the Ying-Qi. Consequently, one may experience rectal bleeding (Qingxue), jaundice, or delirious speech (Zhanyu). In severe cases, dry mouth, ulcerated tongue, withered bones, and damaged sinews occur. All these are manifestations of Yin depletion. This type of syndrome is easy to differentiate. Furthermore, in individuals whose Heart Yang is inherently deficient, exposure to fire scorching causes Heart Yang to float outward, leading to palpitations, mania, restlessness, and inability to lie still. Urgent measures are needed to retrieve the fleeing Yang spirit; occasionally, rescue is possible, but the condition remains critical. Although both involve erroneous fire therapy, the resulting complications differ between Yin depletion and Yang depletion. Nowadays, people dare not recklessly attempt fire therapy due to its dangers. However, during Taiyang disease, habitually using acrid-warm herbs to force sweating has consequences equivalent to erroneous fire therapy. How can one not be cautious?
Question: How does one identify Yangming disease?
Answer: The defining characteristic of Yangming disease is "Stomach-Fullness" (Weijia Shi). However, speaking generally of Stomach-Fullness, from where does one differentiate to know it is Yangming disease? There is a distinction between Meridian syndromes (Jing) and Fu-Organ syndromes (Fu). Fever, spontaneous sweating, aversion to cold absent, but aversion to heat present, along with dryness on the tongue, irritability, and thirst with desire to drink water, constitute a Yangming Meridian syndrome. If tidal fever, constipation, delirious speech, abdominal fullness, and pain are present, it belongs to a Yangming Fu-Organ syndrome. Pathogenic factors transmitted via meridians continue to transmit while in the Meridian, but cease transmitting once they enter the Fu-Organ. Thus, it is said that Yangming resides in the center, corresponding to Earth, serving as the destination for all pathogens, where transmission ceases. Resolution requires urgent purgation from below. Regarding transmission pathways, Yangming comes from Taiyang and goes to Shaoyang. If Taiyang symptoms have not yet resolved but Yangming symptoms have appeared, one must urgently extract the pathogen from Taiyang to cut off the pathway into Yangming. If Yangming symptoms are fully present but Shaoyang symptoms are absent, one should directly suppress the scattered heat of this meridian, harmonizing the Stomach fluids to achieve cure, thereby cutting off the exit pathway from Yangming. If Yangming symptoms persist but Shaoyang symptoms appear, one must urgently employ the Harmonizing method for Shaoyang to cut off the pathway from Shaoyang into the Three Yin meridians. For such transmitted pathogens, one must urgently assess the patient's Stomach fluids, attend to both preceding and subsequent conditions, and prevent adverse transformations; not all cases are suitable for purgation. Once pathogens enter the Fu-Organ and transmission ceases, if urgent purgation is not administered, fluids will be exhausted. In such cases, only urgent purgation to preserve Yin is appropriate, without hesitation. To identify Yangming disease, one must first accurately differentiate between Meridian and Fu-Organ syndromes. Those who claim that any Yangming disease should be uniformly treated with cooling and purgative methods are employing incorrect methods.