大病后。从腰以下有水气。牡蛎泽泻散主之。(水气)
此脾胃气虚。土不能摄水。故溢下焦。腰以下为肿也。
腰以上肿者。当发汗。腰以下肿者。宜利小便。
大病瘥后。喜唾。久不了了。胃上有寒。当以丸药温之。宜理中丸。(喜唾)
邵评∶唾。涎沫也。中土阳虚。不能收摄津液。而冷涎上泛也。宜理中丸加益智仁温纳之。
胃中虚寒。则津液不能收摄。故喜唾。宜温胃。
伤寒解后。虚羸少气。气逆欲吐者。竹叶石膏汤主之。(欲吐)
此津液不足。故虚羸少气。虚火上炎。故气逆欲吐。宜养肺胃之阴。则津液复。诸
症自除矣。
邵评∶肺胃津亏气馁。余热挟胃火上升。竹叶石膏汤。却是正法。惟竹叶宜易竹茹。
病患脉已解。而日暮微烦。以病新瘥。人强与谷。脾胃气尚弱。不能消谷。故令人微
烦。损谷则愈。(日暮微烦)
阳明旺于申酉戌。宿食在胃。故日暮微烦。当小下之。以损宿谷。枳实栀子豉汤主之。
大病瘥后。劳复者。枳实栀子豉汤主之。若有宿食者。加大黄如博棋子大五六枚。
此劳复。因病后气虚。邪气又结于上焦。其症不一。故不着其病形。惟散其上焦之邪足矣。(劳复)
邵评∶正虚而复受外邪。病之变见不一。故不定症形。当随症治之。
有宿食加大黄。此指劳复之有宿食在肠胃者。故可下。非治食复也。若宿食在
胃脘。当消导。在上脘。吐之亦可。
大病初愈后,腰部以下出现水气停聚。主治牡蛎泽泻散(治疗水气停聚)。
这是因为脾胃之气虚弱,脾土不能制约水湿,导致水湿溢入下焦,从而引起腰部以下浮肿。
若腰部以上浮肿,应当采用发汗法;腰部以下浮肿,适宜采用利小便法。
大病痊愈后,患者喜欢吐唾沫,长时间不能停止,这是胃上有寒邪所致。应当用丸药温中散寒,适宜服用理中丸(治疗喜唾)。
邵评:唾,即涎沫。中焦脾胃阳气虚弱,不能收摄津液,导致冷涎上泛。适宜在理中丸中加入益智仁以温肾纳气。
胃中虚寒,则津液无法被收摄,所以喜欢吐唾沫。适宜温补胃气。
伤寒病解除后,身体虚弱消瘦、气息短少,且有气逆想呕吐症状的,主治竹叶石膏汤(治疗欲吐)。
这是因为津液不足,所以身体虚弱消瘦、气息短少;虚火上炎,所以气逆想呕吐。适宜滋养肺胃之阴,使津液恢复,各种症状自然消除。
邵评:肺胃津液亏损,肺气虚弱,余热挟带胃火上升。竹叶石膏汤是正治之法。只是竹叶宜改为竹茹。
患者的脉象已经平和正常,但傍晚时分轻微烦躁,因为病刚痊愈,人们强行给病人进食,脾胃之气尚且虚弱,不能消化食物,所以使人轻微烦躁。减少饮食量就会痊愈(治疗傍晚轻微烦躁)。
阳明经气旺于申时、酉时、戌时。宿食停留在胃中,所以在傍晚时分轻微烦躁。应当轻微攻下,以消除宿食,主治枳实栀子豉汤。
大病痊愈后因劳累而复发者,主治枳实栀子豉汤。如果有宿食停滞,加大黄如博棋子大小五六枚。
这是劳复,因病后正气虚弱,邪气又结聚在上焦,其症状不一,所以不具体描述病形,只要疏散上焦的邪气即可(治疗劳复)。
邵评:正气虚弱又感受外邪,病情变化不一,所以不固定症状形态。应当随证治疗。
有宿食的加大黄,这是指劳复伴有肠胃中有宿食的情况,所以可以攻下。并非治疗食复。如果宿食在胃脘部,应当使用消导法;如果在上脘,催吐也可以。
After a major illness, fluid accumulation occurs below the waist. Muli Zexie San (Oyster Shell and Alisma Powder) is the primary prescription. (Fluid accumulation)
This is due to deficiency of Spleen and Stomach Qi, where Earth fails to control Water, causing overflow into the Lower Jiao, resulting in edema below the waist.
For edema above the waist, sweating method should be used; for edema below the waist, promoting urination is appropriate.
After recovery from a major illness, if the patient frequently spits saliva without cessation for a long time, it indicates Cold in the Stomach. Pill medicine should be used to warm the interior; Lizhong Wan (Regulate the Middle Pill) is suitable. (Frequent spitting)
Shao's Commentary: Saliva refers to phlegm-saliva. Yang deficiency in the Middle Jiao fails to secure body fluids, leading to the reflux of cold saliva. It is advisable to add Yizhi Ren (Alpinia Oxyphylla Fruit) to Lizhong Wan to warm and grasp Qi.
Deficiency-Cold in the Stomach prevents the retention of body fluids, hence the tendency to spit. Warming the Stomach is indicated.
After the resolution of Shanghan (Cold Damage), if the patient presents with emaciation, shortness of breath, and rebellious Qi with a desire to vomit, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is the primary prescription. (Desire to vomit)
This is due to insufficiency of body fluids, causing emaciation and shortness of breath; Deficient Fire flaming upward causes rebellious Qi and desire to vomit. Nourishing the Yin of the Lung and Stomach will restore body fluids, and symptoms will resolve spontaneously.
Shao's Commentary: With deficiency of Lung and Stomach fluids and Qi, residual heat combined with Stomach Fire rises. Zhuye Shigao Tang is the correct method. However, Zhuye (Bamboo Leaf) should be replaced with Zhuru (Bamboo Shavings).
If the patient's pulse has normalized but they experience slight irritability at dusk, it is because the illness has just resolved, and people force-feed them. The Spleen and Stomach Qi are still weak and cannot digest food, causing slight irritability. Reducing food intake will lead to recovery. (Slight irritability at dusk)
The Yangming channel is vigorous during Shen, You, and Xu hours. Retained food in the Stomach causes slight irritability at dusk. A mild purgative action is needed to eliminate retained food; Zhishi Zhizi Chi Tang (Immature Bitter Orange, Gardenia, and Fermented Soybean Decoction) is the primary prescription.
For relapse due to overexertion after a major illness, Zhishi Zhizi Chi Tang is the primary prescription. If there is retained food, add Dahuang (Rhubarb Root) in pieces the size of chess cubes, five or six pieces.
This is relapse due to labor. Due to post-illness Qi deficiency, pathogenic factors re-accumulate in the Upper Jiao. Symptoms vary, so specific disease forms are not detailed; dispersing pathogenic factors in the Upper Jiao is sufficient. (Relapse due to labor)
Shao's Commentary: When Zheng Qi (Upright Qi) is deficient and external pathogens are contracted again, disease manifestations vary, so symptom patterns are not fixed. Treatment should follow the symptoms.
Adding Dahuang applies to cases of relapse due to labor with retained food in the intestines and stomach, allowing for purgation. This does not refer to treating relapse due to diet. If retained food is in the epigastrium, resolving methods should be used; if in the upper epigastrium, inducing vomiting is also an option.