病患肉 并筋惕。汗过经虚真武敌。(仲景云。大青龙汤证云。若脉微弱。汗出恶风者。不可服之。服之则厥逆。筋
惕肉 。此为逆也。又云。太阳病发汗。汗出不解。其人仍发热。心下悸。头眩。身 动。振振欲擗地者。真武汤主之。)
不然邪入大经中。状如 惊痫疾。发汗动经身振摇。宜用茯苓桂枝术。(仲景云。伤寒若吐下后。心下逆满。气上冲胸。
起则头眩脉沉紧。发汗则动经。身为振摇者。茯苓桂枝白术甘草汤。又云。伤寒吐下后。汗虚。脉微。眩经脉动惕者。
久而成痿。)动气在左误下之。忽尔肉 最为逆。(仲景云。动气在左。不可发汗。发汗则头眩。汗不止。怵惕肉 。)
脾中有热胃干枯。口燥咽干津液无。阳明白虎加参证。少阳口苦小柴胡。(仲景云。阳明病。脉浮紧。咽干。口苦。
口干舌燥者。白虎汤。又云。少阳之为病。口苦咽干目眩者。宜小柴胡汤。)咽干慎不可发汗。发汗无津气愈虚。(仲景
云。咽喉干燥不可发汗。)少阴口燥急须下。肾经少水致焚如。(仲景云。少阴病。得之二三日。口燥咽干。急下之。宜
服承气汤。又云。少阴病二三日。咽痛者。与甘草汤。不瘥。与桔梗汤。此证切宜审用之。)虫蚀上部声嗄惑。咽干蚀脏
下(上声。)名狐。(仲景云。狐惑之病。虫蚀上下部。蚀上部则声嗄。蚀下部则咽干。)
患者出现肌肉跳动并伴有筋脉抽搐。这是因为发汗过度导致经气虚弱,此时应使用真武汤来对抗(仲景说:大青龙汤证中提到,如果脉象微弱,出汗且怕风,不可服用大青龙汤。若误服,会导致四肢厥冷、筋脉跳动和肌肉抽搐,这属于逆证。又说:太阳病经过发汗治疗后,汗出后病仍未解除,病人仍然发热,心慌心悸,头晕目眩,身体震颤动摇,站立不稳像要摔倒在地上,应用真武汤主治。)
如果不这样处理,邪气就会侵入大的经络中,症状类似惊痫疾病。发汗不当扰动经络,导致身体震颤摇晃,适宜使用茯苓桂枝白术甘草汤(仲景说:伤寒病如果在吐下之后,心下感觉逆满,气向上冲至胸部,起身时头晕目眩,脉象沉紧,若再发汗则会扰动经络,导致身体震颤摇晃,应用茯苓桂枝白术甘草汤。又说:伤寒病在吐下之后,因汗出导致虚损,脉象微细,眩晕且经脉跳动抽搐,时间久了会形成痿证。)
动气出现在左侧而误用攻下法,突然出现的肌肉跳动是最为逆乱的(仲景说:动气在左侧,不可发汗。若发汗则会导致头晕,汗出不止,惊恐不安且肌肉跳动。)
脾中有热,胃中津液干枯,导致口燥咽干,体内津液匮乏。这是阳明病的白虎加人参汤证;少阳病口苦,适用小柴胡汤(仲景说:阳明病,脉浮紧,咽干,口苦,口干舌燥者,用白虎汤。又说:少阳病的症状是口苦、咽干、目眩,宜用小柴胡汤。)咽干时务必不可发汗,因为发汗会耗伤津液,使正气更加虚弱(仲景说:咽喉干燥者不可发汗。)少阴病出现口燥,急需采用攻下法,因为肾经水少导致如火焚烧般的热盛(仲景说:少阴病,得病二三日,口燥咽干,需急下之,宜服用承气汤。又说:少阴病二三日,咽痛者,给予甘草汤,若不愈,给予桔梗汤。此证切需谨慎审察使用。)虫蚀上部导致声音嘶哑困惑,咽干蚀及下部(上声)名为狐惑病(仲景说:狐惑病,虫蚀上下部位。蚀上部则声音嘶哑,蚀下部则咽干。)
The patient presents with muscle twitching and tremors of the sinews. This occurs due to deficiency of the true yang after excessive sweating, and Zhenwu Tang (True Warrior Decoction) should be used to counteract it. (Zhongjing states: In the syndrome of Da Qing Long Tang (Major Blue Green Dragon Decoction), if the pulse is weak, there is spontaneous sweating and aversion to wind, it must not be administered. If taken inappropriately, it leads to cold extremities, tremors of the sinews, and twitching of muscles, which constitutes a adverse reaction. He also states: In Taiyang disease (Disease of the Taiyang/Supreme Yang stage), after sweating therapy, if the condition remains unresolved despite sweating, and the patient still has fever, palpitations in the heart region, dizziness, body trembling and shaking, feeling as if they are about to fall to the ground, Zhenwu Tang (True Warrior Decoction) is the primary treatment.)
Otherwise, pathogenic factors enter the large meridians, presenting symptoms similar to epilepsy or fright disorders. Inappropriate sweating disturbs the meridians, causing body tremors and shaking; Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala and Licorice Decoction) is appropriate. (Zhongjing states: After purgation or emesis in Shanghan (Cold Damage), if there is fullness and rebellion in the epigastrium, Qi rushing up to the chest, dizziness upon rising, and a deep, tight pulse, further sweating will disturb the meridians, leading to body tremors and shaking; Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala and Licorice Decoction) should be used. He also states: After emesis and purgation in Shanghan (Cold Damage), if sweating causes deficiency, the pulse becomes faint, and dizziness with tendon twitching occurs, this may eventually develop into Wei syndrome (Flaccidity Syndrome).)
If Dongqi (Moving Qi) is located on the left and inappropriate purgation is applied, sudden muscle twitching is the most adverse outcome. (Zhongjing states: If Dongqi (Moving Qi) is on the left, sweating therapy is contraindicated. If sweating is induced, it leads to dizziness, incessant sweating, frightfulness, and muscle twitching.)
Heat in the Spleen and dryness of the Stomach lead to dry mouth and throat due to depletion of body fluids. This corresponds to the Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng) syndrome of Yangming disease; for Shaoyang disease with bitter taste, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is indicated. (Zhongjing states: In Yangming disease, with a floating-tight pulse, dry throat, bitter taste, dry mouth, and parched tongue, Bai Hu Tang (White Tiger Decoction) is used. He also states: The hallmark of Shaoyang disease (Disease of the Shaoyang/Half-Yang stage) includes bitter taste, dry throat, and dizziness; Xiao Chai Hu Tang (Minor Bupleurum Decoction) is suitable.) Dry throat strictly contraindicates sweating therapy, as sweating depletes fluids and further weakens Qi. (Zhongjing states: Those with dry throat and pharynx must not undergo sweating therapy.) For Shaoyin disease with dry mouth, urgent purgation is required, as water deficiency in the Kidney meridian leads to intense burning heat. (Zhongjing states: In Shaoyin disease (Disease of the Shaoyin/Kidney-Heart stage), if dry mouth and throat appear within two to three days, urgent purgation is needed, and Cheng Qi Tang (Order the Qi Decoction) should be taken. He also states: In Shaoyin disease lasting two to three days, if there is sore throat, administer Gan Cao Tang (Licorice Decoction); if ineffective, administer Jie Geng Tang (Platycodon Decoction). This syndrome requires careful examination and use.) If parasites erode the upper part, causing hoarseness and confusion, and dry throat with erosion of the lower part (pronounced 'hu'), it is named Hu Zhuo disease (Fox-Sore Disease). (Zhongjing states: In Hu Zhuo disease (Fox-Sore Disease), parasites erode both upper and lower parts. Erosion of the upper part causes hoarseness; erosion of the lower part causes dry throat.)