《病源》载从立春节后,其中无暴大寒,又不冰雪,而人有壮热病者,此属春时阳气,发于冬
时,伏寒变为温病也。从春分以后至秋分节前,天有暴寒,皆为时行寒疫也。三月、四月,或有暴
寒,其时阳气尚弱,为寒所折,病热犹轻;五月、六月,阳气已盛,为寒所折,病热则重;七月、八
月,阳气已衰,为寒所折,病热亦微,其病与温病、暑病相似,但治有殊耳。其治法初用摩膏火灸,
唯二日法针,用崔文行解散,汗出愈。不解,三日复发汗,若大汗而愈,不解者,勿复发汗也。四
日服藜芦丸,微吐愈;若病固,藜芦丸不吐者,服赤小豆瓜蒂散吐之,已解,视病尚未了了者,复
一法针之当解。不解者,六日热已入胃,乃与鸡子汤下之愈。无不如意,
但当谛视节度与病耳。食不消,病亦如时行,俱发热头痛,食病,当速下之;时病当待六七日。时
病始得,一日在皮,二日在肤,三日在肌,四日在胸,五日入胃,入胃乃可下也。热在胃外而下之,
热乘虚入胃,然要当复下之。不得下,多致胃烂发斑。微者赤斑出,五死一生;剧者黑斑出,十死一
生。人有强弱相倍也。病者过日不以时下之,热不得泄,亦胃烂斑出矣。若得病无热,但狂言烦躁
不安,精神言语不与人相主当者,治法在可水五苓散证中。(此巢氏载治时行寒疫之法焉。温病、暑
病相似,但治有殊者。据温病无摩膏火灸,又有冬温、疮豆,更有四时脏腑阴阳毒,又夏至后有五种
热病,时令盛暑,用药稍寒,故治有殊也。)
《诸病源候论》记载:从立春之后,如果没有突然的大寒天气,也没有冰雪,但有人出现高热病症,这属于春季的阳气在冬季时发动,潜伏的寒邪转化为温病。从春分以后到秋分节前,天空出现突然的寒冷,都属于时行寒疫(季节性流行性寒邪疾病)。三月、四月,或许会有突然的寒冷,此时阳气尚且微弱,被寒邪遏制,发病时的热象较轻;五月、六月,阳气已经旺盛,被寒邪遏制,发病时的热象则较重;七月、八月,阳气已经衰退,被寒邪遏制,发病时的热象也轻微,这些病症与温病、暑病相似,但治疗方法有所不同。其治疗方法初期使用摩膏和火灸,仅用两天的时间进行针刺疗法,采用崔文行的解散法,出汗后痊愈。如果未愈,第三天再次发汗,如果大汗后痊愈,仍未愈者,不要再发汗。第四天服用藜芦丸,通过轻微催吐而愈;如果病情顽固,藜芦丸不能引起呕吐的,服用赤小豆瓜蒂散进行催吐,如果已缓解,观察病情尚未完全消除的,再用一次针刺疗法应当解除。如果仍未解除,第六天热邪已进入胃腑,然后用鸡蛋汤送服泻下药使其痊愈。没有不遂人愿的,只是应当仔细审视节气节度和病症罢了。食物不消化,病症也像时行寒疫一样,都伴有发热头痛,这是食积病,应当迅速攻下;时行寒疫应当等待六七天。时行寒疫刚开始,第一天在皮肤,第二天在肌肤,第三天在肌肉,第四天在胸中,第五天进入胃腑,进入胃腑才可以攻下。热邪在胃外却进行攻下,热邪会乘虚进入胃腑,然而终究还是要再次攻下。如果不能攻下,大多导致胃烂发斑。轻的出红色斑点,五死一生;重的出黑色斑点,十死一生。这是因为人的体质强弱相差一倍以上。患病者过了日子不及时攻下,热邪不得宣泄,也会导致胃烂发斑。如果得病没有发热,只是胡言乱语、烦躁不安,精神言语不能与人正常对应,治疗方法参考五苓散证。(这是巢元方记载的治疗时行寒疫的方法。温病、暑病相似,但治疗方法不同。据温病不使用摩膏火灸,又有冬温、疮痘,更有四季脏腑阴阳毒,以及夏至后的五种热病,时令正值盛暑,用药稍偏寒凉,所以治疗方法不同。)
The *Zhu Bing Yuan Hou Lun* (Treatise on the Pathogenesis and Manifestations of All Diseases) records: After the Beginning of Spring, if there is no sudden severe cold or ice/snow, yet people suffer from high fever, this belongs to the spring yang qi activating during winter; latent cold transforms into warm disease (Wenbing). From after the Spring Equinox until before the Autumn Equinox, sudden cold weather constitutes seasonal epidemic cold plague (Shixing Hanyi). In March and April, sudden cold may occur; at this time, yang qi is still weak, suppressed by cold, so the heat manifestation in illness is mild. In May and June, yang qi is already abundant; suppressed by cold, the heat manifestation in illness is heavy. In July and August, yang qi is declining; suppressed by cold, the heat manifestation is also slight. These illnesses resemble warm disease (Wenbing) and summerheat disease (Shubing), but their treatments differ. The initial treatment involves using massage ointment and moxibustion/fire application. For only two days, needle therapy is employed using Cui Wenxing’s dispersing method; recovery occurs with sweating. If unresolved, induce sweating again on the third day. If resolved with profuse sweating, do not induce sweating again. On the fourth day, administer Lili Wan (Veratrum Pill); resolution occurs via mild emesis. If the condition is stubborn and Lili Wan fails to induce vomiting, administer Chixiaodou Guiti San (Adzuki Bean and Melon Peduncle Powder) for emesis. If resolved, observe if the illness is not fully cleared; apply needle therapy once more to resolve it. If still unresolved, on the sixth day when heat has entered the stomach, administer a purgative downed with egg soup for resolution. There is no case that does not meet expectations, provided one carefully observes the solar terms and disease progression. Regarding indigestion, the symptoms resemble seasonal epidemic cold plague, presenting with fever and headache; this is food retention disease (Shibing) and should be rapidly purged. Seasonal epidemic diseases should wait six to seven days. At the onset of seasonal epidemic disease, on the first day it is in the skin, second day in the superficial layers, third day in the muscles, fourth day in the chest, fifth day enters the stomach; only upon entering the stomach can purgation be applied. If purgation is used while heat is outside the stomach, heat enters the stomach vacuously; however, purgation must eventually be repeated. Failure to purge often leads to gastric ulceration and macular eruption. Mild cases present with red macules (five deaths, one life); severe cases present with black macules (ten deaths, one life). This variation depends on the doubling difference in human constitution strength. If patients are not purged in time as days pass, heat cannot vent, leading to gastric ulceration and macular eruption. If the patient has no fever but exhibits delirium, restlessness, and mental/spiritual disconnection where speech does not correspond appropriately, the treatment follows the pattern of Wuling San (Five-Ingredient Poria Pill). (This describes Niao Shi’s methods for treating seasonal epidemic cold plague. Warm disease and summerheat disease are similar but treated differently. Warm disease does not use massage ointment or fire application; additionally, there are winter warmth, pox/measles, four-season zang-fu yin-yang toxins, and five types of heat diseases after Summer Solstice. Given the intense summer heat, medications are slightly cooling, hence the differing treatments.)