春温面晦肢冷,心腹热甚,舌卷囊缩,神迷如
寐,默不思饮,此邪伏跃厥阴。宜用误吴又可三甲散加柴
胡梢、僵蚕、川芎、桃仁·丹皮、郁金、鲜菖蒲等
味,升泄阴邪也。
邪伏厥阴,漫无泄越,气血沉混,阳反如阴·所以面反
青晦;肢反逆冷,心腹反热,舌卷缩。此邪深入络,清浊
混淆,以致清阳蒙蔽,如醉如痴,机窍不灵,·默默如寐,与
饮则饮,不与亦不思,一如脱症也。斯时权衡,既非清凉可
解,又非温燥所宜·惟仿吴氏三甲散法,用醋炒鳖甲、土炒
山甲、酒浸地鳖虫以搜剔厥阴伏之邪,更兼柴胡、川芎、
僵蚕以升发少阳清阳之气,桃仁、丹皮以破血,郁金·菖蒲
以清心。服后茍得肢温面赤,语出思食,反觉烦扰欠安,则
邪得升泄之意,而病有转化之机矣。
春温头痛,发热恶寒,烦躁神昏,舌白尖赤,此
邪着表里。宜用杏仁、薄荷·蒌皮、连翘、橘红,羚
角、淡豉、桑叶、郁金、菖蒲等味,表里两解也。
凡头痛发热,无汗恶寒,乃温邪初袭肺卫之间。而兼烦
躁神昏,舌白尖赤,则有已犯心营之界矣。若仅与开泄,则
表邪虽解,而营热难清。故用杏仁、薄荷,桑叶,淡豉以疏
卫,连翘、羚角、蒌皮、郁金、菖蒲以清营。此为泄卫透营
之法,表俾里之邪有两解而无传陷也。
春温病出现面色晦暗、四肢厥冷,心中和腹部灼热严重,舌体卷缩、阴囊收缩,神志昏迷如同熟睡,沉默不想饮水,这是邪气潜伏在厥阴经。适宜使用吴又可的三甲散,加入柴胡梢、僵蚕、川芎、桃仁、丹皮、郁金、鲜石菖蒲等药物,以升发透泄阴分邪气。
邪气潜伏在厥阴经,弥漫无处宣泄,气血沉滞混浊,阳气反而表现出阴寒之象,所以面色反而青暗晦滞;四肢反而逆冷,心腹反而发热,舌体卷缩。这是邪气深入络脉,清浊之气混淆,导致清阳之气被蒙蔽,人处于如醉如痴的状态,机窍不灵敏,默默如同睡眠,给水喝就喝,不给也不想着喝,完全像脱证一样。此时权衡病情,既不能用清凉药解除,也不适合用温燥药,只有仿照吴氏三甲散的方法,用醋炒鳖甲、土炒穿山甲、酒浸地鳖虫来搜剔清除潜伏在厥阴经的邪气,再加上柴胡、川芎、僵蚕来升发少阳经的清阳之气,桃仁、丹皮来破血行瘀,郁金、石菖蒲来清心开窍。服药后如果得到四肢转温、面色红润、能说话并想进食,反而觉得烦躁不安,那么这就是邪气得以上升透泄的迹象,疾病有了转化的转机。
春温病出现头痛、发热、恶寒、烦躁、神志昏蒙,舌苔白而舌尖红,这是邪气附着在表里之间。适宜使用杏仁、薄荷、瓜蒌皮、连翘、橘红、羚羊角、淡豆豉、桑叶、郁金、石菖蒲等药物,以表里双解。
凡是头痛发热,无汗恶寒,是温邪刚刚侵袭肺卫之间。如果兼有烦躁神昏,舌苔白而舌尖红,说明已经侵犯了心营的界限。如果仅仅给予开泄表邪的药物,虽然表邪解除了,但营分的热邪难以清除。所以用杏仁、薄荷、桑叶、淡豆豉来疏解卫分,用连翘、羚羊角、瓜蒌皮、郁金、石菖蒲来清解营分。这是泄卫透营的方法,使得表里之邪能够两解而不发生传变内陷。
In Spring-Warmth disease, if the complexion is dull and limbs are cold, with intense heat in the heart and abdomen, tongue curling and scrotal retraction, mental confusion resembling sleep, silence without desire to drink, this indicates pathogenic factors latent in the Jueyin (Liver and Pericardium) channel. It is appropriate to use Wu Youke's Sanjia Powder (Three Shells Decoction) added with Chaihu Shao (Bupleurum Root Tip), Jiangcan (Bombyx Batryticatus), Chuanxiong (Ligusticum Chuanxiong), Taoren (Prunus Persica Seed), Danpi (Moutan Cortex), Yujin (Curcuma Longa Rhizome), and Xian Changpu (Acorus Tatarinowii Rhizome fresh), to raise and vent the Yin-pathogenic factors.
When pathogenic factors are latent in the Jueyin channel, spreading diffusely without venting, qi and blood become stagnant and turbid, and Yang qi manifests as Yin-cold; thus, the complexion becomes greenish and dull, limbs become reversely cold, heart and abdomen become reversely hot, and the tongue curls and shrinks. This signifies that pathogens have deeply penetrated the collaterals, causing a confusion of clear and turbid qi, leading to the obscuration of Clear Yang. The patient appears intoxicated or foolish, orifices are unresponsive, silently resembling sleep; they drink if offered but do not seek water if not offered, resembling a collapse syndrome. At this juncture, weighing the condition, neither cooling nor warming-drying methods are suitable. One should imitate Wu’s Sanjia Powder method: using vinegar-processed Biejia (Trionyx Carapax), soil-processed Shanjiā (Manis Pentadactyla Scale), and wine-soaked Dibiechong (Eupolyphaga Steleophaga) to search out and eliminate latent pathogens in the Jueyin channel; combined with Chaihu, Chuanxiong, and Jiangcan to raise the Clear Yang qi of the Shaoyang (Gallbladder and Triple Burner) channel; Taoren and Danpi to break blood stasis; and Yujin and Changpu to clear the Heart. After administration, if the limbs become warm, the face reddens, speech resumes, appetite returns, and the patient feels restless and uneasy, this indicates that pathogens are being raised and vented, and the disease has a mechanism for transformation.
In Spring-Warmth disease, presenting with headache, fever, aversion to cold, irritability, and mental confusion, with a white tongue coating and red tip, this indicates pathogenic factors attaching to both the exterior and interior. It is appropriate to use Xingren (Armeniacae Semen Amarum), Bohe (Menthae Haplocalycis Herba), Loupi (Benincasae Exocarpium), Lianqiao (Forsythiae Fructus), Juhong (Citri Reticulatae Pericarpium Rubrum), Lingyangjiao (Saigae Tataricae Cornu), Danshi (Sojae Semen Praeparatum), Sangye (Mori Folium), Yujin, and Changpu, to resolve both exterior and interior simultaneously.
Generally, headache and fever with anhidrosis and aversion to cold indicate that Warm pathogens have initially invaded the Lung-Wei (Defensive) level. If accompanied by irritability and mental confusion, with a white tongue coating and red tip, it signifies that the Xin-Ying (Pericardium-Nutrient) boundary has been breached. If only exterior-releasing agents are used, although the exterior pathogens may be resolved, the Ying-level heat will be difficult to clear. Therefore, Xingren, Bohe, Sangye, and Danshi are used to disperse the Wei level, while Lianqiao, Lingyangjiao, Loupi, Yujin, and Changpu are used to clear the Ying level. This is the method of venting the Wei and revealing the Ying, ensuring that exterior and interior pathogens are resolved simultaneously without transmitting inward.