葛根浮长表阳明,缘缘面赤额头疼,发热恶寒而无汗,目痛鼻干卧不宁。
【注】太阳未罢,又传阳明,太阳表邪怫郁,阳明肌热,为阳明经表病也。葛根表阳
明,谓葛根汤主治阳明表病也。浮长,谓阳明之表脉也。缘缘面赤连额头疼,发热恶寒
无汗,目痛鼻干卧不得宁,皆谓阳明经之表证也。用葛根汤解两经之邪也。详阳明篇。
白虎烦渴热阳明,汗出身热脉长洪,不恶寒兮反恶热,合柴兼见少阳经。
【注】太阳已罢,而传阳明不传少阳,亦未入腑,其热渐深,表里俱热,为阳明经热
病也。白虎热阳明,谓白虎汤主治阳明热病也。脉长洪,谓阳明之热脉也。烦躁口渴,引
饮汗出身热,不恶寒反恶热,皆谓阳明经热病之证也。用白虎汤解阳明表里俱热也。阳
明未罢,又传少阳,亦阳明热病也。合柴,谓白虎合小柴胡汤,治阳明经热证,兼见少阳
经弦脉,寒热往来,口苦耳聋,目眩而呕,胸胁痛之病也。详阳明少阳篇。
胃实脉大腑阳明,大便难兮脾约同,蒸蒸潮热 汗,满痛始可议三承。
【注】脉大腑阳明,谓热邪入腑,阳明当脉大也。曰胃实,曰大便难,曰脾约,谓腑
病受邪之不同也。脾约者,太阳阳明也。胃实者,正阳阳明也。大便难者,少阳阳明也。
皆为可下之证,不无轻重之别。然必蒸蒸潮热,身肢 然汗出,或满或痛,始可议其
微、甚,以三承气汤、麻仁丸下之可也。详阳明篇。
葛根汤证表现为脉浮长,病位在阳明经表。症状包括面色通红连及额头疼痛,发热、恶寒且无汗,眼睛疼痛、鼻干、睡眠不安。
【注】太阳病未愈,又传入阳明经。太阳表的邪气郁结,阳明肌表发热,这属于阳明经的表证。葛根用于解阳明经表之邪,意指葛根汤主治阳明经表病。脉象浮长,是阳明经表证的脉象。面色通红连及额头疼痛,发热恶寒无汗,眼痛鼻干卧睡不宁,都是阳明经表证的表现。使用葛根汤来解除太阳和阳明两经的邪气。详见阳明篇。
白虎汤证表现为烦躁、口渴、热盛在阳明经。症状包括出汗后身体仍发热,脉象长而洪大,不恶寒反而恶热。如果兼见少阳经症状,需配合小柴胡汤使用。
【注】太阳病已罢,病邪传入阳明而未传少阳,也未入腑。热势逐渐加深,表里俱热,这属于阳明经的热病。白虎汤用于清阳明经热,意指白虎汤主治阳明经热病。脉象长洪,是阳明经热病的脉象。烦躁口渴,饮水多,出汗后身热,不恶寒反恶热,都是阳明经热病的证候。使用白虎汤解除阳明经表里俱热。若阳明病未罢,又传入少阳,也属于阳明热病范畴。“合柴”指白虎汤合用小柴胡汤,治疗阳明经热证兼见少阳经弦脉,以及寒热往来、口苦、耳聋、目眩、呕吐、胸胁痛等症状。详见阳明少阳篇。
胃实证表现为脉大,病位在阳明腑。症状包括大便困难,与脾约证相同。若有蒸蒸潮热和汗出,腹部胀满疼痛,才可考虑使用三承气汤。
【注】脉大说明病在阳明腑,意指热邪入腑,阳明腑证当见脉大。所谓“胃实”、“大便难”、“脾约”,是指腑病受邪的不同情况。脾约证,属于太阳阳明;胃实证,属于正阳阳明;大便难证,属于少阳阳明。这些都属于可下法的证候,但轻重有别。然而,必须见到蒸蒸潮热,身体四肢濈然汗出,或者腹部胀满或疼痛,才能讨论其轻重的程度,从而决定使用三承气汤或麻仁丸进行攻下治疗。详见阳明篇。
Ge Gen Tang syndrome presents with a floating and long pulse, located at the exterior of the Yangming channel. Symptoms include facial flushing extending to the forehead and headache, fever, aversion to cold, absence of sweating, eye pain, nasal dryness, and restlessness.
[Note] When the Taiyang disease has not resolved and transmits to the Yangming channel, with exterior pathogens of Taiyang constrained and heat in the Yangming muscle layer, this is classified as an exterior syndrome of the Yangming channel. Ge Gen (Kudzu Root) releases the exterior of the Yangming channel, meaning that Ge Gen Tang (Pueraria Decoction) treats exterior diseases of the Yangming channel. A floating and long pulse indicates the exterior pulse of the Yangming channel. Facial flushing extending to the forehead, headache, fever, aversion to cold, absence of sweating, eye pain, nasal dryness, and inability to sleep peacefully are all manifestations of the exterior syndrome of the Yangming channel. Ge Gen Tang is used to resolve pathogens from both the Taiyang and Yangming channels. See the Yangming chapter for details.
Bai Hu Tang syndrome presents with irritability, thirst, and heat in the Yangming channel. Symptoms include persistent body heat after sweating, with a long and surging pulse. There is no aversion to cold but rather an aversion to heat. If Shaoyang channel symptoms are also present, it should be combined with Xiao Chai Hu Tang.
[Note] When the Taiyang disease has ceased and transmits to the Yangming but not to the Shaoyang, and has not yet entered the fu organs, with heat gradually deepening and affecting both interior and exterior, this is classified as a heat disease of the Yangming channel. Bai Hu Tang clears heat in the Yangming channel, meaning that Bai Hu Tang (White Tiger Decoction) treats heat diseases of the Yangming channel. A long and surging pulse indicates the heat pulse of the Yangming channel. Irritability, thirst, excessive drinking, body heat after sweating, lack of aversion to cold but presence of aversion to heat, are all signs of heat disease in the Yangming channel. Bai Hu Tang is used to resolve the heat affecting both the exterior and interior of the Yangming channel. If the Yangming disease has not resolved and transmits to the Shaoyang, it is still considered a Yangming heat disease. "Combining Chai" refers to combining Bai Hu Tang with Xiao Chai Hu Tang (Minor Bupleurum Decoction) to treat Yangming channel heat syndromes accompanied by Shaoyang channel wiry pulse, alternating chills and fever, bitter taste in the mouth, deafness, dizziness, vomiting, and hypochondriac pain. See the Yangming and Shaoyang chapters for details.
Wei Shi (Stomach Excess) syndrome presents with a large pulse, located in the Yangming fu organs. Symptoms include difficult defecation, similar to Pi Yue (Spleen Constraint). If there is steaming tidal fever and sweating, along with abdominal fullness and pain, then the use of the Three Cheng Qi Decoctions may be considered.
[Note] A large pulse indicates pathology in the Yangming fu organs, meaning that when heat pathogens enter the fu organs, the Yangming fu syndrome typically presents with a large pulse. Terms such as "Wei Shi" (Stomach Excess), "Da Bian Nan" (Difficulty in Defecation), and "Pi Yue" (Spleen Constraint) refer to different types of fu organ pathologies. Pi Yue belongs to Taiyang-Yangming; Wei Shi belongs to Zheng Yang-Yangming (True Yang-Yangming); Da Bian Nan belongs to Shaoyang-Yangming. All these are indications for purgative therapy, though they vary in severity. However, one must observe steaming tidal fever, profuse sweating over the body and limbs, or abdominal fullness or pain, before discussing the degree of severity and deciding to use the Three Cheng Qi Decoctions (Cheng Qi Decoctions) or Ma Ren Wan (Hemp Seed Pill) for purgation. See the Yangming chapter for details.