太阳头痛经七日。不愈再传成大疾。法中当刺足阳明。可使不传邪气出。(仲景玉函云。太阳病。头痛至七日。自当
愈。其经竞。故也。若欲再传者。刺足阳明。使经不传则愈也。)桂枝服了烦不解。风府风池刺无失。(仲景云。太阳病。
服桂枝汤。而反烦不解者。当先刺风池风府。却与桂枝汤服之。则愈也。)经来经断刺期门。正恐热邪居血室。(仲景云。
妇人中风。经水适来。又云。经水适断。热入血室者。刺期门。随其虚实而取之。)项强当刺大椎间。脉有纵横肝募吉。
(仲景云。太阳与少阳并病。心下痞。头项强而眩。当刺大椎第一间。又曰。肝乘脾。名纵。肝乘肺。名横。皆当刺期
门。期门肝募也。)妇人怀身及七月。从腰以下如水溢。当刺劳宫及关元。以利小便去心实。(仲景玉函云。妇人伤寒怀
身。腹满。从腰以下。重如水气状。怀身七月。太阴当养不养。此心实。当刺劳宫及关元穴。小便利则愈。)大怒大劳并
大醉。大饱大饥刺之逆。 之热漉漉汗。浑浑之脉安可失。(素问云。无刺 之热。漉漉之汗。浑浑之脉。)浅深分
寸自根据经。此道相传休秘密。
大抵冬宜热药温。(大法冬宜服温热药。)下利少阴有二门。(仲景云。法中可温者。有九证。皆下利与少阴两家而已。)
腹满身痛先救里。(仲景云。病发热头痛。脉反沉。若不瘥。身体更疼痛用救其里。四逆汤。又云。下利腹满。身体疼痛。
先温其里。宜四逆汤。)脉来迟紧痛仍存。(仲景云。下利脉迟紧。而痛未止者。当温之。得冷者。满而硬。肠垢。)少阴
膈上有寒饮。(仲景云。少阴病。其人饮食入。则吐。心中温温欲吐。复不得吐。始得之。手足寒。脉弦迟。若膈上有寒
饮。干哕者。切不可吐。当温之。)或加呕利病难分。脉沉微涩如斯证。四逆理中汤可温。(仲景云。少阴下利。脉微涩
者。即呕。行者必数更衣。反少。当温之。又云。脉沉者。急当温之。宜以四逆汤。仲景玉函云。诸温者。可与理中。
四逆。附子汤。热药治之。)
太阳病引起的头痛,如果经过七天没有痊愈,病情可能会进一步传变而加重。按照治疗法则,应当针刺足阳明经的穴位,这样可以阻止病邪传变并使其排出。(张仲景在《伤寒论·玉函经》中说:太阳病头痛,到了第七天,通常会自愈,这是因为该经的病气已经尽散。如果担心病邪继续传变,可以针刺足阳明经,使经脉之气不被传变,疾病即可痊愈。)服用桂枝汤后烦躁症状仍未解除,此时不应再服药,而应针刺风府穴和风池穴,切勿失误。(张仲景说:太阳病,服用桂枝汤后,反而出现烦躁不解的情况,应当先针刺风池穴和风府穴,然后再给予桂枝汤服用,疾病即可痊愈。)月经来潮或中断期间,若怀疑热邪侵入血室,应当针刺期门穴,主要是担心热邪停留在血室之中。(张仲景说:妇女患中风病,月经恰好来潮;又说:月经恰好中断。若有热邪侵入血室的情况,应当针刺期门穴,根据虚实情况采用相应的补泻手法。)颈部僵硬强直,应当针刺大椎穴之间的部位;脉象呈现纵横交错之象(肝乘脾为纵,肝乘肺为横),针刺肝之募穴期门穴是吉利的。(张仲景说:太阳病与少阳病同时发病,表现为心下痞塞、头项强痛且眩晕,应当针刺第一间的大椎穴。又说:肝气乘袭脾脏,称为“纵”;肝气乘袭肺脏,称为“横”。这两种情况都应当针刺期门穴,因为期门穴是肝脏的募穴。)妇女怀孕至第七个月,如果出现腰部以下浮肿如水溢出的症状,应当针刺劳宫穴和关元穴,以通利小便,去除心包的实热。(张仲景在《伤寒论·玉函经》中说:妇女患伤寒且怀孕,腹部胀满,腰部以下沉重像有水气的样子。怀孕第七个月时,太阴经应当滋养胎儿却未能正常滋养,这是心包实热的表现,应当针刺劳宫穴和关元穴,小便利则病愈。)大怒、大劳、大醉、大饱、大饥这些状态下,针刺属于逆治法,是错误的。面对高热、大汗淋漓、脉象浑乱的情况,不可误失针刺禁忌。(《素问》说:不要针刺那种热势盛大如沸的病症,不要针刺那种汗出如珠的病症,不要针刺那种脉象混乱无序的病症。)针刺的深浅分寸应当依据经络理论自行掌握,这一道理代代相传,不应保密。
大体而言,冬季适宜使用温热性质的药物进行温补。(一般原则是冬季适宜服用温热药。)下利证中,少阴病主要有两个治疗方向。(张仲景说:符合可温治法的有九种证候,都是关于下利和少阴病的。)腹部胀满、身体疼痛时,应当先救治里虚寒证。(张仲景说:病人发热头痛,脉象反而沉细,如果病情不缓解,身体更加疼痛,应用四逆汤救其里。又说:下利伴腹部胀满,身体疼痛,应先温补里阳,宜用四逆汤。)脉象迟而紧,疼痛仍然存在,也属寒证。(张仲景说:下利脉象迟而紧,且疼痛未停止的,应当温补。如果是因受冷导致的,会出现腹部胀满硬结及肠垢排泄物。)少阴病若膈上有寒饮停留,(张仲景说:少阴病,病人饮食入口即吐,心中感觉温暖泛恶想吐却又吐不出来。刚发病时手足寒冷,脉象弦迟。如果膈上有寒饮导致干呕,切不可使用催吐法,应当温补。)或者伴有呕吐下利难以区分,脉象沉微涩,遇到这种证候,可以使用四逆汤或理中汤进行温补。(张仲景说:少阴病下利,脉象微涩的,必然伴有呕吐,排便次数多但量少,应当温补。又说:脉象沉的,急当温补,宜用四逆汤。张仲景《伤寒论·玉函经》说:各种需要温补的情况,可以给予理中汤、四逆汤、附子汤等温热药物治疗。)
Headache caused by Taiyang disease, if it persists for seven days without resolution, may transmit further and become a severe illness. According to treatment principles, one should needle the Foot-Yangming meridian to prevent transmission and expel the pathogenic factor. (Zhang Zhongjing in *Shanghan Lun Yuyan* states: In Taiyang disease with headache, recovery is expected by the seventh day as the channel qi has exhausted. If transmission is anticipated, needling the Foot-Yangming channel prevents transmission and leads to cure.) After administering Guizhi Tang (Cinnamon Twig Decoction), if vexation remains unresolved, one must not miss the opportunity to needle Fengfu (GV16) and Fengchi (GB20). (Zhang Zhongjing states: In Taiyang disease, if vexation worsens or persists after taking Guizhi Tang, one should first needle Fengchi (GB20) and Fengfu (GV16), then administer Guizhi Tang (Cinnamon Twig Decoction) for cure.) When menstruation begins or ends, if there is fear of heat pathogens residing in the Blood Chamber (Xueshi), one should needle Qimen (LR14). (Zhang Zhongjing states: In women with Wind-Strike, if menstruation happens to begin or end, and heat enters the Blood Chamber, needle Qimen (LR14) according to deficiency or excess.) For neck stiffness, one should needle between Dazhui (GV14); regarding pulse patterns of "Zong" (vertical/longitudinal) and "Heng" (horizontal/lateral), needling the Liver's Mu-Alarm point, Qimen (LR14), is auspicious. (Zhang Zhongjing states: In concurrent Taiyang and Shaoyang disease with epigastric fullness, neck stiffness, and dizziness, needle the first interspace of Dazhui (GV14). Also, Liver overacting on Spleen is called "Zong," and Liver overacting on Lung is called "Heng"; both require needling Qimen (LR14), which is the Mu-Alarm point of the Liver.) For pregnant women at seven months presenting with edema-like heaviness below the waist, one should needle Laogong (PC8) and Guanyuan (CV4) to promote urination and drain Heart excess. (Zhang Zhongjing in *Shanghan Lun Yuyan* states: In pregnant women with Cold Damage presenting with abdominal fullness and heaviness below the waist resembling water accumulation, occurring at the seventh month when the Taiyin channel fails to nourish, this indicates Heart excess; needle Laogong (PC8) and Guanyuan (CV4), and cure follows urination.) Do not needle during states of great anger, great fatigue, great drunkenness, great satiety, or great hunger, as these are contraindicated. Regarding intense heat, profuse sweating, and chaotic pulses, one must not miss these prohibitions. (*Suwen* states: Do not needle intense heat, profuse sweating, or chaotic pulses.) Needle depth and distance should be based on meridian theory; this knowledge is passed down and should not be kept secret.
Generally, winter favors hot medicines for warming. (The general rule is that warm-hot medicines are suitable in winter.) Diarrhea cases involve two main pathways related to Shaoyin. (Zhang Zhongjing states: Among the nine conditions suitable for warming therapy, they all pertain to diarrhea and Shaoyin disease.) When there is abdominal fullness and body pain, prioritize rescuing the interior. (Zhang Zhongjing states: If fever, headache, and a contrary deep pulse persist, accompanied by worsening body pain, use Sini Tang (Frigid Extremities Decoction) to rescue the interior. Also, for diarrhea with abdominal fullness and body pain, warm the interior first with Sini Tang (Frigid Extremities Decoction)). If the pulse is slow and tight with persistent pain, warming is indicated. (Zhang Zhongjing states: In diarrhea with a slow and tight pulse where pain persists, warming is required. Cold-induced cases present with fullness, hardness, and intestinal mucus.) In Shaoyin disease, if cold-fluid retention exists above the diaphragm... (Zhang Zhongjing states: In Shaoyin disease, if food intake triggers vomiting, a sense of warmth and nausea in the heart without ability to vomit, initial cold hands and feet, and a string-tight slow pulse, indicating cold-fluid retention above the diaphragm causing dry retching, do not induce vomiting but warm instead.) Or when vomiting and diarrhea are difficult to distinguish, and the pulse is deep, faint, and choppy, Sini Tang (Frigid Extremities Decoction) or Lizhong Tang (Regulate the Middle Decoction) can be used for warming. (Zhang Zhongjing states: In Shaoyin diarrhea with a faint and choppy pulse, vomiting occurs, and frequent bowel movements yield little stool; warming is required. Also, a deep pulse requires urgent warming with Sini Tang (Frigid Extremities Decoction). *Shanghan Lun Yuyan* states: Various conditions requiring warming can be treated with Lizhong Tang (Regulate the Middle Decoction), Sini Tang (Frigid Extremities Decoction), or Fuzi Tang (Aconite Decoction) using hot medicines.)