(眩者目黑暗而无常主也脑体空虚也眩冒者昏冒也少阳口苦咽干目眩者邪渐入里而
表
也若言乱目眩即为死症)
吐下后。逆满。头眩。脉沉紧。发汗则动其经。身为振摇。(茯苓桂枝白术甘草汤)吐下
后脉微。心下痞硬。胁痛。气上冲。眩冒动惕。久而成痿。(真武汤)阳明病。但目眩。不恶寒。
(葛根汤加天麻川芎)少阳病。口苦咽干。目眩。(小柴胡汤加天麻川芎)动气在左。误汗则头
眩。汗不止。筋惕肉 。(小建中汤)少阴下利。止而眩冒者死。
(有声无痰者咳也有声有痰者嗽也肺主气肺伤则气逆而咳或寒或热或表或里或半
表半里或停饮各常分剖古云咳为肺疾发散则愈然亦有不可发散者如经曰咳而小便不可发汗发汗则
肢厥又曰咳而发汗蜷而苦满腹坚为逆是也)
太阳表不解。心下有水气。干呕喘咳。(小青龙汤)少阳往来寒热。胸胁满。嘿嘿不欲饮
食。心烦呕咳。(小柴胡去人参加五味子干姜)少阴病。四逆而咳。(四逆散加五味子干姜)少阴病
。下利。咳而呕渴。心烦不眠。(猪苓汤)少阴病。腹痛。小便不利。肢重痛。自下利。为有水
气。其人咳者。(真武汤加五味子细辛干姜)
按表寒咳嗽者。三拗麻黄。里热咳嗽者。栀芩桑杏。少阳咳嗽。小柴胡加五味干姜。胸
中痞满。枳桔瓜杏。阴症脉沉。四逆加五味。细阅仲景治例。不分阴症阳症。必用五味干姜。盖
干姜辛温。散肺家逆气。五味甘酸。收肺家浮气故也。
眩,是指眼睛昏暗发黑且视物无常定之主(指视物模糊、头晕目眩)。脑体空虚所致。眩冒,是指昏沉眩晕。少阳病出现口苦、咽干、目眩,是因为邪气逐渐入里而表证未解。如果说言语错乱并伴有目眩,即为死症。
经过吐法或下法治疗后,出现气逆胀满、头晕目眩、脉象沉紧,若再发汗则会扰动经脉,导致身体震颤摇动。(适用茯苓桂枝白术甘草汤)经过吐法或下法治疗后,脉象微弱,心下部痞塞硬满,胁肋疼痛,气向上冲逆,眩晕昏冒,肢体跳动惕惧,日久将形成痿证。(适用真武汤)阳明病,仅见目眩,不恶寒。(适用葛根汤加天麻、川芎)少阳病,口苦、咽干、目眩。(适用小柴胡汤加天麻、川芎)动气在左侧,误用发汗法则导致头晕目眩,汗出不止,筋脉跳动、肌肉瞤动。(适用小建中汤)少阴病下利,若下利停止却出现眩晕昏冒者,为死症。
有声无痰称为咳,有声有痰称为嗽。肺主气,肺受伤则气机上逆而咳嗽。或因寒、或因热、或因表证、或因里证、或因半表半里证、或因停饮,需分别剖析。古人说咳嗽是肺的疾病,发散即可痊愈,然而也有不可使用发散法的。如经书所说:咳嗽而小便不利者,不可发汗,发汗则会导致四肢厥冷;又说:咳嗽而发汗后,出现蜷卧、胸满、腹部坚硬者,为逆证。
太阳表证未解,心下有停水之气,出现干呕、气喘、咳嗽。(适用小青龙汤)少阳病,往来寒热,胸胁满闷,神情默默不欲饮食,心烦、呕吐、咳嗽。(适用小柴胡汤去人参,加五味子、干姜)少阴病,四肢厥逆而咳嗽。(适用四逆散加五味子、干姜)少阴病,下利,咳嗽且呕吐、口渴、心烦不眠。(适用猪苓汤)少阴病,腹痛,小便不利,肢体沉重疼痛,自下利,这是有水气,其人咳嗽的。(适用真武汤加五味子、细辛、干姜)
按:表寒引起的咳嗽,用三拗汤及麻黄;里热引起的咳嗽,用栀子、黄芩、桑白皮、杏仁;少阳咳嗽,用小柴胡汤加五味子、干姜;胸中痞满,用枳壳、桔梗、瓜蒌、杏仁;阴证脉沉,用四逆汤加五味子。仔细研读张仲景的治疗案例,不分阴证阳证,必定使用五味子和干姜。因为干姜辛温,能疏散肺家逆气;五味子甘酸,能收敛肺家浮气。
Xuan (vertigo/dizziness) refers to the eyes appearing dark and dim with unstable vision. It is caused by the emptiness of the brain and body. Xuanmao (dizziness and faintness) refers to a state of dizziness and confusion. In Shaoyang disease (Disease of the Gallbladder and Triple Burner), bitter taste in the mouth, dry throat, and vertigo indicate that the pathogenic factor is gradually entering the interior while the exterior syndrome remains. If speech is disordered accompanied by vertigo, it is a fatal condition.
After emesis or purgation, if there is rebellious Qi causing fullness, vertigo, and a deep-tight pulse, administering sweating will disturb the meridians, causing the body to tremble and shake. (Fuling Guizhi Baizhu Gancao Tang [Poria, Cinnamon Twig, Atractodes Macrocephala, and Licorice Decoction]) After emesis or purgation, if the pulse is faint, there is epigastric stuffiness and hardness, hypochondriac pain, Qi rushing upward, dizziness and faintness, and palpitations/trembling of the limbs, this may eventually develop into Wei syndrome (flaccidity syndrome). (Zhenwu Tang [True Warrior Decoction]) In Yangming disease (Disease of the Stomach and Large Intestine), there is only vertigo, without aversion to cold. (Gegen Tang [Kudzu Root Decoction] added with Tianma [Gastrodia Rhizome] and Chuanxiong [Ligusticum Rhizome]) In Shaoyang disease, there is bitter taste in the mouth, dry throat, and vertigo. (Xiaochaihu Tang [Minor Bupleurum Decoction] added with Tianma [Gastrodia Rhizome] and Chuanxiong [Ligusticum Rhizome]) If moving Qi is located on the left, mistaken sweating will cause vertigo; if sweating does not stop, there will be tendon twitching and muscle fasciculation. (Xiao Jianzhong Tang [Minor Construct the Middle Decoction]) In Shaoyin disease (Disease of the Heart and Kidney), if diarrhea stops but vertigo and faintness occur, it is a fatal condition.
Coughing with sound but no phlegm is called Ke (cough); coughing with sound and phlegm is called Sou (sputtering). The Lung governs Qi; when the Lung is injured, Qi rebels upward causing cough. This may be due to Cold, Heat, Exterior syndrome, Interior syndrome, Half-Exterior Half-Interior syndrome, or retained fluid retention, which must be analyzed separately. Ancients stated that cough is a Lung disease and can be cured by dispersing methods; however, there are cases where dispersing methods cannot be used. As stated in the classics: if one coughs and has difficulty urinating, sweating should not be administered, as sweating will lead to cold extremities. It also states: if one coughs and sweating is administered, resulting in curling up, chest fullness, and abdominal hardness, it is a counter-indication.
In Taiyang disease (Disease of the Bladder and Small Intestine) where the exterior is not resolved, and there is water-Qi in the epigastrium, there is dry retching, wheezing, and cough. (Xiao Qinglong Tang [Minor Blue Dragon Decoction]) In Shaoyang disease, there are alternating chills and fever, chest and hypochondriac fullness, silent demeanor with loss of appetite, irritability, vomiting, and cough. (Xiaochaihu Tang [Minor Bupleurum Decoction] with Ren Shen [Ginseng Root] removed, added with Wuweizi [Schisandra Fruit] and Ganjiang [Dried Ginger]) In Shaoyin disease, there are cold extremities and cough. (Sini San [Counterflow Powder] added with Wuweizi [Schisandra Fruit] and Ganjiang [Dried Ginger]) In Shaoyin disease, there is diarrhea, cough, vomiting, thirst, irritability, and insomnia. (Zhuling Tang [Polyporus Decoction]) In Shaoyin disease, there is abdominal pain, difficulty urinating, heavy and painful limbs, spontaneous diarrhea, indicating the presence of water-Qi; if the person also coughs, this is indicated. (Zhenwu Tang [True Warrior Decoction] added with Wuweizi [Schisandra Fruit], Xixin [Asarum Root], and Ganjiang [Dried Ginger])
According to analysis: For cough caused by exterior Cold, use San'ao Tang [Three Unblocking Decoction] and Mahuang [Ephedra Stem]; for cough caused by interior Heat, use Zhizi [Gardenia Fruit], Huangqin [Scutellaria Root], Sangbaipi [Mulberry Bark], and Xingren [Apricot Seed]; for Shaoyang cough, use Xiaochaihu Tang [Minor Bupleurum Decoction] added with Wuweizi [Schisandra Fruit] and Ganjiang [Dried Ginger]; for epigastric stuffiness and fullness, use Zhike [Aurantii Fructus Immaturus], Jiegeng [Platycodon Root], Gualou [Trichosanthes Fruit], and Xingren [Apricot Seed]; for Yin syndrome with deep pulse, use Sini Tang [Counterflow Decoction] added with Wuweizi [Schisandra Fruit]. Carefully studying Zhang Zhongjing's treatment examples, regardless of whether it is Yin or Yang syndrome, Wuweizi [Schisandra Fruit] and Ganjiang [Dried Ginger] are invariably used. This is because Ganjiang [Dried Ginger] is pungent and warm, dispersing rebellious Qi in the Lung; and Wuweizi [Schisandra Fruit] is sweet and sour, gathering floating Qi in the Lung.