凡九条方无
少阳主半表半里。半。不也。不表不里者。隙地也。夫以表实则可汗。里实则可下。上实则
可吐。隙无实可言。故汗下吐皆无其法。而其合并之病。又皆已杂出于太阳阳明篇中。所以本篇
条目少。无可攻之道也。无可攻者。一则界限也。故表里分先后。自此而终始。然则隙地反当要
冲。无治最有关系。谓小柴胡汤为通行套药。不择地而可施。岂不悖哉。
(一)少阳之病。口苦。咽干。目眩也。
少。去声。下皆同。之下当有为字。少阳者胆经也。其脉起于目锐 。灵枢曰。足少阳之正。上
肝。贯心以上。挟咽出颐颔中。故又曰。是动则病口苦。苦。胆之味也。咽。胆之使也。口苦。咽
干。热聚于胆也。眩。目旋转而昏晕也。少阳属木。木生火而主风。风火扇摇而燔灼。所以然也。
(二)少阳中风。两耳无所闻。目赤。胸中满而烦者。不可吐下。吐下则悸而惊。
首句以攒名。揭总举大纲言。三阴篇中如此云云者皆然。少阳之脉。上抵头角。下耳后。其
支者从耳后入耳中。出走耳前。其支者下胸中。贯膈。肝主目。胆为之合。风为阳而主气。耳无
闻者。风塞则气塞也。目赤者。风热则气昏也。胸满而烦者。风郁则膈热也。少阳本无吐下法。
其经又多气少血。吐下复伤其经。则血愈少而虚。血虚则心虚。所以神识昏乱。怔忡而惊也。
(三)伤寒脉弦细。头痛。发热者。属少阳。少阳不可发汗。发汗则谵语。此属胃。胃和则愈。
胃不和。则烦而悸。
少阳属木。故其脉弦。细则欲入里也。谵语者。夺其血液而胃干。故心荒而乱也。胃和。以
未至实言。不和。言实也。然上条以风言。风主气。故禁吐下。此以寒言。寒主血。故禁汗。对
举以示教也。
(四)本太阳病不解。转入少阳者。胁下硬满。干呕不能食。往来寒热。尚未吐下。脉沉紧
者。与小柴胡汤。
少阳之脉。其支者下胸中。贯膈。络肝。属胆。循胁里。其直者。从缺盆下腋。
循胸。过季胁。故病则硬满。呕不能食也。往来寒热。见太阳上编。浮紧为弦。沉紧者得之寒因
也。方见太阳上。
若已吐。下。发汗。温针。谵语。柴胡证罢。此为坏病。知犯何逆。以法治之。
此承上文。复以乱治不对。而致变剧者言。与太阳上编第五十二条意同。以法即随证之互词。
(五)三阳合病。脉浮大。上关上。但欲眠睡。目合则汗。
太阳脉浮。阳明脉大。关上乃少阳之部位。故曰三阳合病。但欲眠睡者。热聚于胆也。目合
则汗出者。少阳少血。虚则不与阳和。寐属阴。故盗出也。
(六)伤寒三日。三阳为尽。三阴当受邪。其人反能食。不呕。此为三阴不受邪也。
阳以表言。阴以里言。能食。真阳胜而表邪散也。不呕。里气和而胃气回也。阴不受邪可知也。
(七)伤寒三日。少阳脉小者。欲已也。
小。谓不弦也。已。愈也。
(八)少阳病。欲解时。从寅至辰上。
寅卯辰。少阳木王之时也。邪虽不胜正。解必在乎得其时。道固如此也。外道而言意。岂不
谬哉。
(九)伤寒六七日。无大热。其人燥烦者。此为阴去。入阳故也。
去。往也。言表邪往而入于里。所以外无大热。而内则燥烦也。愚按太阳中伤。传阳明。转
少阳。阳去入阴。乃风寒之病。入自表而渐里。通章之大义。斯道之自然。仲景吃紧为人之要旨
也。读者最宜精思熟玩。
凡九条方无
少阳主半表半里。半,不也。不表不里者,隙地也。夫以表实则可汗,里实则可下,上实则可吐。隙无实可言,故汗、下、吐皆无其法。而其合并之病,又皆已杂出于太阳、阳明篇中。所以本篇条目少,无可攻之道也。无可攻者,一则界限也。故表里分先后,自此而终始。然则隙地反当要冲,无治最有关系。谓小柴胡汤为通行套药,不择地而可施,岂不悖哉。
(一)少阳之病,口苦,咽干,目眩也。
少,去声。下皆同。之下当有为字。少阳者胆经也。其脉起于目锐眦。灵枢曰:足少阳之正,上肝,贯心以上,挟咽出颐颔中。故又曰:是动则病口苦。苦,胆之味也。咽,胆之使也。口苦,咽干,热聚于胆也。眩,目旋转而昏晕也。少阳属木,木生火而主风,风火扇摇而燔灼,所以然也。
(二)少阳中风,两耳无所闻,目赤,胸中满而烦者,不可吐下。吐下则悸而惊。
首句以攒名,揭总举大纲言。三阴篇中如此云云者皆然。少阳之脉,上抵头角,下耳后。其支者从耳后入耳中,出走耳前。其支者下胸中,贯膈。肝主目,胆为之合。风为阳而主气,耳无闻者,风塞则气塞也。目赤者,风热则气昏也。胸满而烦者,风郁则膈热也。少阳本无吐下法,其经又多气少血,吐下复伤其经,则血愈少而虚。血虚则心虚,所以神识昏乱,怔忡而惊也。
(三)伤寒脉弦细,头痛,发热者,属少阳。少阳不可发汗。发汗则谵语。此属胃。胃和则愈,胃不和,则烦而悸。
少阳属木,故其脉弦。细则欲入里也。谵语者,夺其血液而胃干,故心荒而乱也。胃和,以未至实言。不和,言实也。然上条以风言,风主气,故禁吐下。此以寒言,寒主血,故禁汗。对举以示教也。
(四)本太阳病不解,转入少阳者,胁下硬满,干呕不能食,往来寒热,尚未吐下,脉沉紧者,与小柴胡汤。
少阳之脉,其支者下胸中,贯膈,络肝,属胆,循胁里。其直者,从缺盆下腋,循胸,过季胁。故病则硬满,呕不能食也。往来寒热,见太阳上编。浮紧为弦,沉紧者得之寒因也。方见太阳上。
若已吐、下、发汗、温针,谵语,柴胡证罢,此为坏病。知犯何逆,以法治之。
此承上文,复以乱治不对,而致变剧者言。与太阳上编第五十二条意同。以法即随证之互词。
(五)三阳合病,脉浮大,上关上,但欲眠睡,目合则汗。
太阳脉浮,阳明脉大,关上乃少阳之部位,故曰三阳合病。但欲眠睡者,热聚于胆也。目合则汗出者,少阳少血,虚则不与阳和。寐属阴,故盗出也。
(六)伤寒三日,三阳为尽,三阴当受邪。其人反能食,不呕,此为三阴不受邪也。
阳以表言,阴以里言。能食,真阳胜而表邪散也。不呕,里气和而胃气回也。阴不受邪可知也。
(七)伤寒三日,少阳脉小者,欲已也。
小,谓不弦也。已,愈也。
(八)少阳病,欲解时,从寅至辰上。
寅卯辰,少阳木王之时也。邪虽不胜正,解必在乎得其时,道固如此也。外道而言意,岂不谬哉。
(九)伤寒六七日,无大热,其人燥烦者,此为阴去,入阳故也。
去,往也。言表邪往而入于里,所以外无大热,而内则燥烦也。愚按太阳中伤,传阳明,转少阳,阳去入阴,乃风寒之病,入自表而渐里,通章之大义,斯道之自然,仲景吃紧为人之要旨也。读者最宜精思熟玩。
There are no formulas in these nine clauses.
Shaoyang governs the half-exterior and half-interior aspect. "Half" means not. That which is neither exterior nor interior is a gap or interstitial space. If the exterior is excess, sweating can be used; if the interior is excess, purgation can be used; if the upper jiao is excess, emesis can be used. There is no concept of excess in this gap, therefore methods of sweating, purging, and emesis have no application here. Furthermore, its combined diseases are already mixed into the chapters on Taiyang (Greater Yang) and Yangming (Yang Brightness). Therefore, there are few clauses in this chapter, and there is no path for direct attack. The reason there is no path for attack is, first, due to its boundaries. Thus, the sequence of exterior and interior is distinguished, starting from here and ending here. However, this interstitial space actually serves as a strategic hub, and treatment without specific methods is of utmost importance. To claim that Xiao Chai Hu Tang (Minor Bupleurum Decoction) is a universal remedy applicable regardless of location would indeed be absurd.
(1) Shaoyang disease manifests as bitter taste in the mouth, dryness of the throat, and vertigo/dizziness.
"Shao" is pronounced with the departing tone; the same applies below. There should be a verb like "is" after "Shao". Shaoyang refers to the Gallbladder Meridian. Its pulse originates at the outer canthus of the eye. The Ling Shu states: The regular pathway of Foot-Shaoyang goes up to the Liver, pierces the Heart, and ascends, flanking the pharynx, emerging in the cheek and jaw area. Hence it is also said: When this meridian is disturbed, disease manifests as bitter taste in the mouth. Bitterness is the flavor of the Gallbladder. The pharynx is the envoy of the Gallbladder. Bitter taste and dry throat indicate heat accumulating in the Gallbladder. Vertigo refers to the sensation of the eyes spinning and fainting. Shaoyang belongs to Wood; Wood generates Fire and governs Wind. Wind and Fire fan each other and cause burning, which explains this phenomenon.
(2) In Shaoyang wind-strike, where hearing is lost in both ears, the eyes are red, and there is fullness and vexation in the chest, vomiting and purging must not be used. Vomiting and purging will lead to palpitations and fright.
The first sentence uses a collective name to summarize the general outline. This pattern appears similarly in the Three Yin chapters. The Shaoyang meridian ascends to reach the corner of the head and descends behind the ear. Its branch enters the ear from behind the ear and emerges in front of the ear. Another branch descends through the chest, piercing the diaphragm. The Liver governs the eyes, and the Gallbladder is its paired organ. Wind is Yang and governs Qi. Loss of hearing indicates that wind obstruction leads to Qi obstruction. Red eyes indicate that wind-heat leads to Qi turbidity. Chest fullness and vexation indicate that wind stagnation leads to heat in the diaphragm. Shaoyang originally has no methods for vomiting or purging. Its meridian contains abundant Qi but little Blood. Vomiting and purging further damage this meridian, causing the Blood to become even more deficient and empty. Blood deficiency leads to Heart deficiency, resulting in mental confusion, palpitations, and fright.
(3) In cold damage, if the pulse is wiry and fine, accompanied by headache and fever, it belongs to Shaoyang. Shaoyang cannot be treated with sweating. Sweating will lead to delirious speech. This condition then involves the Stomach. If the Stomach harmonizes, the patient recovers; if the Stomach does not harmonize, there will be vexation and palpitations.
Shaoyang belongs to Wood, hence its pulse is wiry. Fine indicates a tendency to move inward. Delirious speech results from the depletion of blood and fluids, leading to a dry Stomach, causing the Heart to become chaotic and disordered. "Stomach harmonizes" refers to a state not yet reaching excess. "Does not harmonize" refers to a state of excess. The previous clause discussed wind; wind governs Qi, hence vomiting and purging are prohibited. This clause discusses cold; cold governs Blood, hence sweating is prohibited. They are presented in contrast to demonstrate teaching.
(4) If an original Taiyang disease does not resolve and transfers to Shaoyang, manifesting as hardness and fullness under the hypochondrium, dry retching, inability to eat, alternating chills and fever, and if no vomiting, purging, or other treatments have been applied yet, and the pulse is deep and tight, administer Xiao Chai Hu Tang (Minor Bupleurum Decoction).
The Shaoyang meridian's branch descends through the chest, pierces the diaphragm, connects to the Liver, belongs to the Gallbladder, and follows along the interior of the hypochondrium. Its main pathway descends from the supraclavicular fossa under the axilla, follows the chest, and passes over the costal margin. Hence, disease manifests as hardness and fullness, and retching with inability to eat. Alternating chills and fever are seen in the earlier part of the Taiyang chapter. Floating and tight becomes wiry; deep and tight arises from cold etiology. The formula is found in the Taiyang chapter.
If vomiting, purging, sweating, or warm needle therapy have already been applied, and delirious speech occurs, and the Chai Hu syndrome ceases, this is called a damaged disease. Determine what error was made and treat according to the syndrome.
This continues from the above text, discussing cases where improper treatment leads to severe changes. It shares the same intent as Clause 52 in the earlier Taiyang chapter. "Treating according to method" is synonymous with "treating according to syndrome."
(5) In a combined disease of the Three Yang, the pulse is floating and large, located at the Guan position. The patient desires sleep, and sweats when closing the eyes.
Taiyang pulse is floating; Yangming pulse is large. The Guan position is the location of Shaoyang, hence it is called a combined disease of the Three Yang. Desire for sleep indicates heat accumulating in the Gallbladder. Sweating upon closing the eyes occurs because Shaoyang has little Blood; deficiency prevents harmony with Yang. Sleep belongs to Yin, hence night sweats occur.
(6) After three days of cold damage, the Three Yang are exhausted, and the Three Yin should receive the pathogen. If the person can instead eat and does not vomit, this indicates that the Three Yin do not receive the pathogen.
Yang refers to the exterior; Yin refers to the interior. Ability to eat indicates that true Yang prevails and exterior pathogens dissipate. Absence of vomiting indicates that interior Qi is harmonious and Stomach Qi returns. It is known that Yin does not receive the pathogen.
(7) After three days of cold damage, if the Shaoyang pulse is small, the disease is about to resolve.
Small means not wiry. Resolve means cured.
(8) Shaoyang disease tends to resolve during the hours of Yin to Chen (3 AM to 7 AM).
Yin, Mao, and Chen are the times when Shaoyang Wood is prosperous. Although pathogens may not overcome righteous Qi, resolution must occur at the appropriate time. This is the natural way. To speak of meaning outside of this principle would indeed be erroneous.
(9) After six or seven days of cold damage, if there is no significant external heat, but the person is restless and vexed, this is because Yin departs and enters Yang.
Depart means go. It means that exterior pathogens move inward. Therefore, there is no significant external heat, but internal restlessness and vexation exist. I observe that Taiyang injury transmits to Yangming, then to Shaoyang. Yang departing and entering Yin refers to wind-cold diseases entering from the exterior and gradually moving inward. This is the major principle of this chapter and the natural law. Zhang Zhongjing's urgent concern for people is his key point. Readers should ponder and study this carefully.