凡风寒初感。便见头疼发热。恶风恶寒。腰疼骨痛。脉来浮紧。或浮缓。口不渴。舌润
无苔者。此风寒客于太阳阳明。营卫之间也。因非太阳正病。故项不强耳。治宜辛散。羌、防、芎、
芷、苏叶、朴陈、姜葱之类。温中散寒。则食化而表解矣。若恶寒甚。而寸关脉沉迟者。寒邪重也。
宜麻黄桂枝等。辛温汗之。若饱闷恶食。右关脉短滑者。胃中停食也。兼消导。楂肉、麦芽、
神曲之类。(风寒)
如见舌苔白而燥。或兼微黄。口渴便赤。脉来浮滑者。此太阳感寒。阳明有火也。或
风热之邪客于阳明之表也。均宜凉散。以羌、防、葛根、连翘、黄芩、栀子之类。清热解表。(风热)
如初起恶寒。即发热不已。目赤多眵。舌苔焦刺。口渴多饮。唇皴齿燥。脉来洪滑。此
内有伏火。外感新邪而发。当以阳明为主治。宜凉解之。如犀角、连翘、黄芩、薄荷、栀
子、豆豉、淡竹叶之类。如兼头痛恶寒。可加羌活。以撤太阳之邪。自能得汗而解。若
用风药发表。则液燥火炽。反无汗而加剧矣。(风火)
邵评∶此风火正治法。
凡人腠理疏豁。其邪即从太阳而入少阳。盖少阳本属相火。温邪与相火。同气相
招也。如见舌苔白中带红。外症头痛身热。口苦。眼赤。多眵。胁痛。耳鸣。脉浮弦而数。
此木火之邪。当从少阳治。宜柴、芩、连翘、栀子、牛蒡、薄荷、木通等解之。如未解。加鲜
生地、牡丹皮、钩藤、池菊之类清之。(风温)
邵评∶此风温入少阳经正治法。
凡是风寒之邪初感人体,立即出现头痛、发热、怕风、怕冷、腰痛、骨节疼痛的症状,脉象表现为浮紧或浮缓,口不渴,舌面湿润且无苔。这是风寒之邪客居于太阳病(太阳经受邪所致的病证)与阳明病(阳明经受邪所致的病证)之间,以及营气与卫气运行的层次。因为并非典型的太阳正病,所以颈部没有强直僵硬的表现。治疗应当采用辛味发散的方法,使用羌活、防风、川芎、白芷、紫苏叶、厚朴、陈皮、生姜、葱白等药物。通过温中散寒,使饮食得以消化,表邪随之解除。
如果恶寒症状严重,且寸口和关口的脉象呈现沉迟,说明寒邪较重。适宜使用麻黄汤(麻黄、桂枝等组成的方剂)、桂枝汤(桂枝、芍药等组成的方剂)等辛温发汗的方剂。
如果出现脘腹胀闷、厌恶进食,且右关脉短而滑,说明胃中有停滞的食物。需要兼用消食导滞的药物,如山楂肉、麦芽、神曲等。
如果见到舌苔白色且干燥,或者兼有微黄色,口渴,小便色赤,脉象浮滑,这是太阳经受寒邪侵袭,同时阳明经有火热的表现。或者是风热之邪客居于阳明经的体表。均适宜采用凉性发散的方法,使用羌活、防风、葛根、连翘、黄芩、栀子等药物,以清热解表。
如果在疾病初起时,虽然恶寒,但随即持续发热,眼睛发红且眼屎多,舌苔焦黑且有刺状突起,口渴且想多喝水,嘴唇干裂,牙齿干燥,脉象洪大滑数,这说明体内有潜伏的火邪,因外感新的邪气而诱发。治疗应当以调理阳明经为主,适宜采用凉性解表的方法。可以使用犀角、连翘、黄芩、薄荷、栀子、豆豉、淡竹叶等药物。如果兼有头痛、恶寒,可以加入羌活,以祛除太阳经的邪气,自然能够出汗而病愈。如果使用风药发表,会导致津液枯竭、火势更旺,反而无汗且病情加重。
凡是人的腠理(皮肤纹理及汗孔)疏松豁达,邪气就会从太阳经传入少阳经(少阳经受邪所致的病证)。因为少阳本属相火(胆与三焦之火),温邪与相火属于同气相求。如果见到舌苔白色中带红色,外部症状有头痛、身热、口苦、眼睛发红、眼屎多、胁肋疼痛、耳鸣,脉象浮弦且数,这是木火之邪,应当从少阳经进行治疗。适宜使用柴胡、黄芩、连翘、栀子、牛蒡子、薄荷、木通等药物来解除邪气。如果邪气未解,加入鲜生地、牡丹皮、钩藤、池菊(菊花的一种)等药物以清泄火热。
Whenever wind-cold pathogen initially invades the body, symptoms such as headache, fever, aversion to wind, and aversion to cold appear immediately, accompanied by lower back pain and bone ache. The pulse is floating-tight or floating-slow, with no thirst, a moist tongue surface, and no coating. This indicates that wind-cold has lodged between the Taiyang disease (disease pattern caused by pathogenic invasion of the Taiyang channel) and Yangming disease (disease pattern caused by pathogenic invasion of the Yangming channel), within the levels of Ying (Nutritive Qi) and Wei (Defensive Qi). Since it is not a typical Taiyang Zhengbing (standard Taiyang syndrome), there is no stiffness in the neck. Treatment should employ acrid dispersing methods, using herbs such as Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Ziye (Perillae Folium), Pouchen (Magnoliae Officinalis Cortex and Citri Reticulatae Pericarpium), Shengjiang (Zingiberis Rhizoma Recens), and Congbai (Allii Fistulosi Bulbus). By warming the middle and dispelling cold, food digestion will be facilitated, and the exterior pathogens will be resolved.
If aversion to cold is severe, and the Cun (inch) and Guan (bar) pulses are deep and slow, it indicates heavy cold pathogen. It is appropriate to use Xinxin Han Zhi (acrid-warm sweating methods) such as Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction).
If epigastric fullness and distension occur with anorexia, and the right Guan pulse is short and slippery, it indicates food stagnation in the stomach. One should concurrently use digestive and guiding-out agents such as Zharon (Crataegi Fructus), Maiya (Hordei Fructus Germinatus), and Shenqu (Massa Medicata Fermentata).
If a white and dry tongue coating is observed, or one that is slightly yellow, along with thirst and dark urine, and a floating-slippery pulse, this indicates Taiyang cold invasion combined with Yangming fire heat. Alternatively, it may indicate wind-heat pathogen lodging on the exterior of the Yangming channel. In all cases, cool dispersing methods are suitable, using herbs such as Qianghuo, Fangfeng, Gegen (Puerariae Lobatae Radix), Lianqiao (Forsythiae Fructus), Huangqin (Scutellariae Radix), and Zhizi (Gardeniae Fructus) to clear heat and resolve the exterior.
If at the onset, aversion to cold is followed immediately by persistent fever, red eyes with excessive discharge, a scorched and prickly tongue coating, intense thirst with desire for drinking, cracked lips, and dry teeth, with a surging-slippery pulse, this indicates latent internal fire triggered by new external pathogenic invasion. Treatment should focus primarily on the Yangming channel, employing cool resolving methods. Herbs such as Xijiao (Rhinocerotis Cornu - note: substitute with legal alternatives in practice), Lianqiao, Huangqin, Bohe (Menthae Haplocalycis Herba), Zhizi, Douchi (Sojae Semen Praeparatum), and Danzhuye (Lophatheri Herba) may be used. If accompanied by headache and aversion to cold, Qianghuo can be added to expel Taiyang pathogens, allowing sweat to emerge naturally and the disease to resolve. If wind-dispersing drugs are used to release the exterior, fluids will dry up and fire will blaze, resulting in anhidrosis and exacerbation of the condition.
Shao's Commentary: This is the standard treatment for Wind-Fire patterns.
When a person's Couli (skin pores and interstices) are loose and open, pathogens enter from the Taiyang channel into the Shaoyang channel (Shaoyang channel disease pattern). Since Shaoyang belongs to Xianghuo (Ministerial Fire, associated with Gallbladder and Sanjiao), Wenxie (warm pathogens) and Xianghuo attract each other due to similar natures. If a white tongue coating with red tinges is seen, accompanied by external symptoms of headache, fever, bitter taste, red eyes, excessive eye discharge, hypochondriac pain, and tinnitus, with a floating-stringy-rapid pulse, this is Wood-Fire pathogen. Treatment should proceed via the Shaoyang channel. Suitable herbs include Chaihu (Bupleuri Radix), Huangqin, Lianqiao, Zhizi, Niubangzi (Arctii Fructus), Bohe, and Mutong (Akebiae Caulis) to resolve the pathogen. If unresolved, add Xiashengdi (Rehmanniae Radix Recens), Mudanpi (Moutan Cortex), Gouteng (Uncariae Ramulus cum Uncis), and Chiju (Chrysanthemi Flos) to clear heat.
Shao's Commentary: This is the standard treatment for Wind-Warmth entering the Shaoyang channel.