二之气为病,多发风温、风热。经曰∶风伤于阳,湿伤于阴。微头痛身热,
发作风温之候。风伤于卫气也,湿伤于脾气也。是以风温为病,阴阳俱自浮,汗出,身重,多眠
,鼻息,语言难出。此以上二证,不宜下。若与巴豆大毒丸药,热证并生,重者必死。二之
气病,宜以桂枝麻黄汤,发汗而已。
三之气为病,多发热,皆传足经者多矣。太阳、阳明、少阳、太阴、少阴、厥阴
。太阳者,发热恶寒、头项痛、腰脊强;阳明者,身热、目疼、鼻干、不得卧;少阳者,胸胁痛、耳聋、
口苦、寒热往来而呕。此三阳属热。太阴者,腹满、咽干、手足自温、自利不渴,或腹满时痛
;少阴者,故口燥舌干而渴;厥阴者,腹满囊缩、喘热闷乱、四肢厥冷、爪甲青色。三之气
病,宜以清凉,上温下养,不宜用巴豆丸下之。
四之气为病,多发暑气、头痛、身热、发渴。不宜作热病治,宜以白虎汤。得此
病不传染,次发脾泄、胃泄、大肠泄、小肠泄、大瘕泄、霍乱吐泻、下痢及赤白相杂、水
谷不分消、肠鸣切痛、面浮足肿、目黄口干、胀满气痞、手足无力。小儿亦如此。四之气病
,宜渗泄,五苓散之类也。
第二阶段的气候致病,多引发风温、风热病。医经说:风邪伤害属阳的部位,湿邪伤害属阴的部位。(患者出现)轻微头痛、身体发热,发作成风温的证候。这是风邪伤及卫气,湿邪伤及脾气。因此风温为病,阴阳脉象都呈现浮象,出汗,身体沉重,嗜睡,鼻息声重,说话困难。以上两种证候,不宜使用泻下法。如果误用巴豆这种大毒性的丸药,会导致热证并生,病情重的必然死亡。第二阶段的气候病,适宜用桂枝麻黄汤,通过发汗来治疗即可。
第三阶段的气候致病,多表现为发热,且大多传变至足部经络。涉及太阳经、阳明经、少阳经、太阴经、少阴经、厥阴经。太阳经受邪,表现为发热恶寒、头项疼痛、腰脊僵硬;阳明经受邪,表现为身体发热、眼睛疼痛、鼻子干燥、无法安卧;少阳经受邪,表现为胸胁疼痛、耳聋、口苦、寒热往来且呕吐。这三条阳经的病都属于热证。太阴经受邪,表现为腹部胀满、咽喉干燥、手脚自然温暖、自发性腹泻且不口渴,或者腹部胀满且时而疼痛;少阴经受邪,表现为原本就口干舌燥且渴;厥阴经受邪,表现为腹部胀满、阴囊收缩、气喘烦闷扰乱、四肢厥冷、指甲青紫。第三阶段的气候病,适宜采用清凉之法,上焦温补下焦滋养,不宜使用巴豆丸剂进行泻下。
第四阶段的气候致病,多引发暑气病,症状包括头痛、身体发热、口渴。不应当当作普通热病来治疗,适宜用白虎汤。得了这种病不会传染,随后会引发脾泄、胃泄、大肠泄、小肠泄、大瘕泄、霍乱吐泻、痢疾以及赤白相杂、水谷不分、肠鸣剧痛、面部浮肿脚部肿胀、眼睛发黄口干、腹胀气滞、手脚无力。小儿也会如此。第四阶段的气候病,适宜采用渗湿泄浊之法,如五苓散之类的方剂。
第五阶段的气候致病,多引发喘息、呕吐逆气、咳嗽以及妇人寒热往来、(此处原文缺失或模糊,通常指月经不调或相关妇科症状,但依规则不推测,故略过或视为未明确实体)、小儿斑疹疮疡。第五阶段的气候病,适宜用大柴胡汤或小柴胡汤,适宜采用和解表里的治疗方法。
The pathogenic factors of the second Qi stage often induce Wind-Warmth (Fengwen) and Wind-Heat (Fengre). The Classics state: "Wind damages the Yang, Dampness damages the Yin." Symptoms include slight headache, body heat, manifesting as Wind-Warmth syndrome. This is because Wind damages the Wei Qi (Defensive Qi), and Dampness damages the Spleen Qi. Therefore, in Wind-Warmth disease, both Yin and Yang pulses are floating, accompanied by sweating, heaviness of the body, somnolence, heavy nasal breathing, and difficulty speaking. For the above two syndromes, purgation is contraindicated. If toxic pills containing Crotonis Fructus (Badou, 巴豆) are administered, heat syndromes will arise concurrently, and severe cases will result in death. For diseases of the second Qi stage, Guizhi Mahuang Tang (Cinnamon Twig and Ephedra Decoction) should be used to induce sweating.
Diseases of the third Qi stage mostly present with fever and have largely transmitted to the Foot meridians: Taiyang (Greater Yang), Yangming (Yang Brightness), Shaoyang (Lesser Yang), Taiyin (Greater Yin), Shaoyin (Lesser Yin), and Jueyin (Terminal Yin). Taiyang involvement manifests as fever, aversion to cold, pain in the head and nape, and stiffness of the lower back and spine; Yangming involvement manifests as body heat, eye pain, dry nose, and inability to lie down; Shaoyang involvement manifests as hypochondriac pain, deafness, bitter taste in the mouth, alternating chills and fever, and vomiting. These three Yang meridians belong to Heat syndromes. Taiyin involvement manifests as abdominal fullness, dry throat, naturally warm hands and feet, spontaneous diarrhea without thirst, or abdominal fullness with intermittent pain; Shaoyin involvement manifests as pre-existing dry mouth, dry tongue, and thirst; Jueyin involvement manifests as abdominal fullness, retraction of the scrotum, panting, stifling heat and confusion, cold extremities, and cyanotic fingernails. For diseases of the third Qi stage, cooling methods are appropriate, warming the upper and nourishing the lower; purgation with Crotonis Fructus pills is contraindicated.
Diseases of the fourth Qi stage often induce Summer-Heat (Shuqi), headache, body heat, and thirst. It should not be treated as a common Heat disease; Baihu Tang (White Tiger Decoction) is appropriate. This disease is not contagious. Subsequently, it may develop into Pi-xie (Spleen Diarrhea), Wei-xie (Stomach Diarrhea), Dachang-xie (Large Intestine Diarrhea), Xiaochang-xie (Small Intestine Diarrhea), Dajia-xie (Major Mass Diarrhea), Huoluan (Cholera-like disorder with vomiting and diarrhea), dysentery with red and white mixture, indistinguishable water and grain in stool, borborygmus with cutting pain, facial edema and foot swelling, yellow eyes, dry mouth, abdominal distension and Qi stagnation, and weakness of the hands and feet. Children suffer similarly. For diseases of the fourth Qi stage,渗泄 (percolating and draining dampness) is appropriate, such as Wuling San (Five-Ingredient Powder with Poria).
Diseases of the fifth Qi stage often induce panting, vomiting and rebellious Qi, cough, alternating chills and fever in women, and infantile maculopapular rashes. For diseases of the fifth Qi stage, Da Chaihu Tang (Major Bupleurum Decoction) or Xiao Chaihu Tang (Minor Bupleurum Decoction) is appropriate, employing harmonizing methods for the exterior and interior.