一二日可发表而散。三四日宜和解而痊。五六日便实。方可议下。七八日不愈。又复
。日传二经。病名两感。经传六日。应无不痊。太阳无汗。麻黄为最。太阳有汗。桂枝为先
。小柴胡为少阳之要领。大柴胡行阳明之秘坚。至三阴则难拘定法。或可温而可下。宜数变
以曲全生意。或可方而可员。
恶寒发热身无汗。头痛腰痛属太阳。此是伤寒邪在表。急宜发散最为良。
按伤寒初起一二日内。乃足太阳膀胱经受之。其脉起于目内 睛明穴。上脑下项。
。挟脊。抵腰。行身之后。终于足小指。至阴穴也。其症则头项痛。腰脊强。以及周身病是
也。然太阳为表之表。其脉尺寸俱浮而紧者。寒伤荣。故无汗也。急宜发散。则汗出而
诸症愈矣。宜羌活汤及麻黄汤主之。若浮而缓者。风伤卫。故有汗也。宜桂枝汤主之。若伤
寒见风。伤风见寒。此为风寒兼受。荣卫两伤也。宜大青龙汤主之。他如发热烦渴。小便不利。此为热
入膀胱之本。宜五苓散主之。
麻黄汤中用桂枝。杏仁甘草四般见发热畏寒身体痛。须知一服汗淋漓。伤寒发表用
羌防。苏叶川芎白芷苍。甘草生姜葱共引。冬时无汗用麻黄。
按羌活防风。为足太阳发表药也。佐以苏叶川芎白芷苍术诸味之辛温。则能助阳气而发
表矣。和以甘草。使以姜葱。俾腠理通而寒邪散。至冬月伤寒。必须麻黄之辛热以汗之。断
不可少也。他如春夏秋。谓非时感冒。未可轻用。
发病一二日,可采用发汗解表的方法使邪气消散。发病三四日,适宜采用和解的方法以求痊愈。发病五六日,若出现大便干结实证,才可以考虑使用攻下法。发病七八日病情仍未好转,又再次出现……(原文此处有缺漏或脱字,依文意推测可能指病势反复或传变)。每日传递两经,病名称为“两感”。经络传递六天,应当没有不痊愈的。太阳病无汗,麻黄汤最为适宜;太阳病有汗,桂枝汤为首选。小柴胡汤是少阳病的要领方剂,大柴胡汤用于通行阳明腑实的秘结坚硬。到了三阴病则难以拘泥于固定治法,或许可以用温补法,或许可以用攻下法,应当灵活多变以保全生机。或者可以方正严谨,或者可以圆融变通。
恶寒发热、身体无汗、头痛腰痛,属于太阳病。这是伤寒邪气在体表,急需发散解表最为良策。
按:伤寒初起一两天内,是足太阳膀胱经受邪。其经脉起始于目内眦睛明穴,上行至脑,下行至项部,挟持脊柱,抵达腰部,行于身体后方,终于足小趾端的至阴穴。其症状表现为头项疼痛、腰脊僵硬,以及周身不适。然而太阳为表中之表,如果脉象尺寸两部都浮而紧,是寒邪伤及营分,所以无汗。急需发散解表,汗出后诸症即可痊愈。宜用羌活汤及麻黄汤主治。如果脉象浮而缓,是风邪伤及卫分,所以有汗。宜用桂枝汤主治。如果伤寒兼见风邪,或伤风兼见寒邪,这称为风寒兼受,营卫两伤。宜用大青龙汤主治。其他如发热烦渴、小便不利,这是热邪进入膀胱的本证,宜用五苓散主治。
麻黄汤中配合桂枝,加上杏仁、甘草共四味药,见到发热畏寒、身体疼痛的症状。须知服用一次后汗出淋漓,即可解除伤寒表证。
使用羌活、防风治疗伤寒发表。配合苏叶、川芎、白芷、苍术、甘草、生姜、葱白共同引导。冬季无汗时选用麻黄。
按:羌活、防风是足太阳经的发散解表药物。佐以苏叶、川芎、白芷、苍术等辛温之品,就能助长阳气而发散表邪。调和以甘草,引导以姜、葱,使得腠理通畅而寒邪解散。到了冬季伤寒,必须用麻黄的辛热之性来发汗,绝对不可省略。其他如春、夏、秋季,称为非时感冒,不可轻易使用(麻黄等峻烈之药)。
On the first or second day, the pathogenic factor can be dispersed by releasing the exterior. On the third or fourth day, harmonization is suitable for recovery. By the fifth or sixth day, if stool becomes dry and solid (excess syndrome), only then can purgation be considered. If the disease persists beyond the seventh or eighth day and recurs... (text missing/omitted in original). Transmission of two meridians daily is named "Liang Gan" (Double Meridian Involvement). After six days of meridian transmission, recovery should be expected without exception. For Taiyang disease with no sweating, Mahuang Tang (Ephedra Decoction) is most appropriate; for Taiyang disease with sweating, Guizhi Tang (Cinnamon Twig Decoction) is the primary choice. Xiaochaihu Tang (Minor Bupleurum Decoction) is the key formula for Shaoyang disease. Daxiehu Tang (Major Bupleurum Decoction) is used to unblock excess hardness in Yangming fu-organ obstruction. When reaching the Three Yin meridians, fixed methods cannot be rigidly applied; one may use warming or purging methods, adapting flexibly to preserve life. One may proceed with rigidity or flexibility.
Aversion to cold, fever, absence of sweating, headache, and lower back pain belong to Taiyang disease. This indicates the pathogen of Shanghan (Cold Damage) is at the exterior; urgent dispersal and release of the exterior are the best treatments.
Note: At the onset of Shanghan within one or two days, it affects the Foot-Taiyang Bladder Meridian. The meridian originates at Jingming (BL1, Eye Inner Canthus), ascends to the brain, descends to the nape, flanks the spine, reaches the waist, runs along the posterior aspect of the body, and terminates at Zhiyin (BL67, Little Toe). Symptoms include headache and stiffness of the neck and occiput, stiffness of the lumbar spine, and general malaise. Since Taiyang is the outermost layer of the exterior, if the pulse is floating and tight at both Cun and Chi positions, it indicates Cold injuring Ying (Nutritive Qi), resulting in anhidrosis. Urgent dispersal is required; once sweat appears, all symptoms will resolve. Qianghuo Tang (Notopterygium Decoction) and Mahuang Tang (Ephedra Decoction) are indicated. If the pulse is floating and slow, it indicates Wind injuring Wei (Defensive Qi), resulting in diaphoresis. Guizhi Tang (Cinnamon Twig Decoction) is indicated. If Shanghan presents with Wind symptoms, or Wind-Cold presents with Cold symptoms, this is termed "Wind-Cold combined invasion," injuring both Ying and Wei. Da Qinglong Tang (Major Green Dragon Decoction) is indicated. Other symptoms such as fever, irritability, thirst, and dysuria indicate Heat entering the root of the Bladder. Wuling San (Five-Ingredient Powder with Poria) is indicated.
Mahuang Tang (Ephedra Decoction) uses Guizhi (Cinnamon Twig); together with Xingren (Apricot Seed) and Gancao (Licorice Root), these four ingredients address fever, aversion to cold, and body pain. It is known that after one dose, profuse sweating occurs, resolving the exterior of Shanghan.
For releasing the exterior in Shanghan, use Qianghuo (Notopterygium Rhizome) and Fangfeng (Saposhnikovia Root). Assist with Suye (Perilla Leaf), Chuanxiong (Ligusticum Rhizome), Baizhi (Angelica Dahurica Root), Cangzhu (Atractylodes Rhizome), Gancao (Licorice Root), Shengjiang (Fresh Ginger), and Congbai (Scallion Stem) to guide. In winter, when there is no sweating, use Mahuang (Ephedra Herb).
Note: Qianghuo (Notopterygium Rhizome) and Fangfeng (Saposhnikovia Root) are exterior-releasing herbs for the Foot-Taiyang Meridian. Assisted by the acrid-warm properties of Suye (Perilla Leaf), Chuanxiong (Ligusticum Rhizome), Baizhi (Angelica Dahurica Root), and Cangzhu (Atractylodes Rhizome), they assist Yang Qi to release the exterior. Harmonized with Gancao (Licorice Root) and guided by Jiang (Ginger) and Cong (Scallion), the Couli (pores) become open and Cold Pathogens disperse. In winter Shanghan, the acrid-hot nature of Mahuang (Ephedra Herb) is essential for inducing sweating and must not be omitted. However, in spring, summer, and autumn, for non-seasonal common colds, these strong agents should not be used lightly.