太阳发热恶风寒。汗出阳明胃燥干。(有燥屎而干枯)呕逆项疼身发热。医家当作少阳
看。(太阳当汗阳明当下少阳当和解)
太阴厥阴皆不热。惟有少阴间发热。阳经发热脉浮大。四肢遇暖便闭塞。阴经发热脉必
沉。下利四肢恒厥逆。
曾经下后身发热。渐觉胸中成痛结。香豉栀子却相宜。去病每如汤沃雪。
三阳往往病头痛。随证须知识病因。太阳恶寒宜解表。羌和汤中倍用芎。蒸蒸发热阳明
热。
调胃承气方最真。少阳受病脉弦细。痛连项角耳中疼。或加口苦兼寒热。小柴胡症自分明。
三阴本没头疼痛。头若疼时属厥阴。更有停痰能作祟。四肢厥逆痛难禁。
咽痛阴阳迥不同。咽喉肿痛热邪攻。脉浮散大或吐血。随方用药自然通。阴毒咽痛喉
不利
。寒邪伏在少阴中。脉来微弱当温散。半夏桂汤是先锋。须用四逆加桔梗。治不可紊自见功
。
少阳胆经循胁过。邪入此经痛无那。心下坚满引胁痛。十枣医治定须可。阳明坚满大便
结。项强不食并潮热。因而转入少阳经。惟小柴胡汤最功。
腹中满痛别阴阳。里实须知下最良。脉实有力阳明实。大柴小承总一方。三阳腹满而急
痛。
脉沉微细里寒藏。附子理中并四逆。对证服药自然康。三阴下利纯清谷。( 水泻洞泄完谷
也)里虚已极四神汤。肠鸣泄泻而腹痛。虚痛还宜小建良。
太阳经受邪,表现为发热、恶风、恶寒。若出现汗出,则提示阳明胃腑燥热津伤(若有燥屎内结则见干枯之象)。若见呕吐逆气、项部疼痛且身体发热,医生应当考虑为少阳病。(太阳病当用发汗法,阳明病当用攻下法,少阳病当用和解法)
太阴病和厥阴病通常不发热。只有少阴病偶尔会出现发热。阳经发热时,脉象多浮大;四肢遇暖反而闭塞不通。阴经发热时,脉象必然沉细;常伴有腹泻,四肢经常厥冷逆乱。
如果患者经过泻下治疗后仍然身热,逐渐感觉胸中形成痛结。此时使用香豉和栀子最为适宜,祛除病邪如同热水浇雪般迅速。
三阳经疾病往往伴有头痛,需根据症状辨别病因。太阳病恶寒,宜用解表法,羌活汤中应重用川芎。阳明病蒸蒸发热,调胃承气汤最为对症。少阳经受病,脉象弦细,疼痛牵连项角及耳中,或伴有口苦及寒热往来,小柴胡汤证候自然分明。三阴经本无头痛,若出现头痛则属厥阴经病变。此外,若有痰饮停滞作祟,也会导致四肢厥冷逆乱,疼痛难以忍受。
咽痛的阴阳性质截然不同。咽喉肿痛由热邪侵袭所致,脉象浮散大或伴有吐血,随证用药自然通畅。阴毒导致的咽痛,喉部不利,是寒邪潜伏在少阴经中。脉象微弱,应当采用温散法,半夏桂枝汤作为首选,必须配合四逆汤加桔梗使用,治疗不可紊乱,自然能见功效。
少阳胆经循行经过胁肋部位,邪气侵入此经,疼痛剧烈无法忍受。心下坚硬胀满并牵引胁肋疼痛,十枣汤治疗必定有效。阳明病坚满,大便干结,项强不能俯仰、不欲饮食并伴有潮热。若因此转入少阳经,唯有小柴胡汤疗效最佳。
腹中满痛需辨别阴阳。里实证须知攻下法最为良策。脉象实而有力,属阳明实证,大柴胡汤或小承气汤均可选用。三阳经腹满且急痛,若脉象沉微细,则为里寒证,附子理中汤和四逆汤对证服药自然康复。三阴经下利纯为完谷不化(即水泻洞泄,粪便中带有未消化食物),此为里虚至极,可用四神汤。肠鸣泄泻且腹痛,虚性疼痛适宜用小建中汤。
Taiyang (Greater Yang) channel pathogenesis presents with fever, aversion to wind, and aversion to cold. If sweating occurs, it indicates dryness and heat in the Stomach of the Yangming (Brightness Yang) organ system (if dry feces are accumulated internally, dryness manifests). If vomiting, regurgitation, neck pain, and body fever are present, the physician should consider Shaoyang (Lesser Yang) disease. (Taiyang disease requires diaphoresis; Yangming disease requires purgation; Shaoyang disease requires harmonization.)
Taiyin (Greater Yin) and Jueyin (Terminal Yin) diseases typically do not present with fever. Only Shaoyin (Lesser Yin) disease occasionally presents with fever. When Yang channels are affected by fever, the pulse is often floating and large; limbs become obstructed when warmed. When Yin channels are affected by fever, the pulse must be deep and fine; diarrhea is common, and limbs are frequently cold and reversed (Jue-ni).
If a patient remains febrile after undergoing purgation, they gradually feel a painful knot forming in the chest. Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) is most appropriate for this condition; eliminating the pathogen is as swift as snow melting in hot water.
Diseases of the Three Yang channels often involve headache; one must identify the etiology based on symptoms. Taiyang disease with aversion to cold is suitable for exterior-releasing methods; Xianghe Tang (Qianghuo and Ligusticum Decoction) should use Chuanxiong (Ligustici Rhizoma et Radix) in increased dosage. Yangming disease presenting with steaming-hot fever is best treated with Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction). Shaoyang channel disease presents with a string-taut and thin pulse; pain radiates to the temporal angle and ears, possibly accompanied by bitter taste and alternating chills and fever; the Xiao Chaihu Tang (Minor Bupleurum Decoction) syndrome becomes clear. The Three Yin channels inherently lack headaches; if headache occurs, it belongs to Jueyin pathology. Furthermore, retained phlegm can cause disturbances, leading to cold limbs and unbearable pain.
Sore throat differs significantly between Yin and Yang patterns. Swelling and pain of the throat and pharynx are attacked by heat pathogens; if the pulse is floating, scattered, and large, or accompanied by hemoptysis, medication according to the syndrome will naturally restore smoothness. Yin-toxin sore throat with throat obstruction is caused by cold pathogens lurking within the Shaoyin channel. With a weak pulse, warming and dispersing methods should be used; Banxia Guizhi Tang (Pinellia and Cinnamon Twig Decoction) serves as the vanguard, but Sini Tang (Frigid Extremities Decoction) plus Jiegeng (Platycodon Root) must be employed. Treatment must not be disordered to achieve efficacy.
The Shaoyang Gallbladder channel traverses the hypochondrium. When pathogens enter this channel, pain is severe and intolerable. Fullness and hardness below the heart radiating to the hypochondrium are effectively treated with Shizao Tang (Ten Jujube Decoction). Yangming disease presents with firm fullness, constipation, stiff neck, anorexia, and tidal fever. If this transitions into the Shaoyang channel, only Xiao Chaihu Tang yields the best results.
Abdominal fullness and pain require differentiation between Yin and Yang. For interior excess syndromes, purgation is the optimal strategy. A solid and forceful pulse indicates Yangming excess; Dachaihu Tang (Major Bupleurum Decoction) or Xiaochengqi Tang (Minor Order the Qi Decoction) may be selected. Abdominal fullness and acute pain in the Three Yang channels, if accompanied by a deep, micro, and fine pulse, indicate interior cold; Fuzi Lizhong Tang (Aconite and Magnolia Bark Regulate the Middle Decoction) and Sini Tang are indicated, and correct administration leads to recovery. Diarrhea in the Three Yin channels consisting purely of undigested food (watery diarrhea with complete retention of original grain form) indicates extreme interior deficiency; Sishen Tang (Four Miracles Decoction) is used. Intestinal borborygmus, diarrhea, and abdominal pain due to deficiency cramps are suitably treated with Xiaojianzhong Tang (Minor Establish the Middle Decoction).