白瘖既见,随汗出没,舌赤少苔,脉数,不饥不
食,轻旬不退,此胃虚邪恋。宜用佩兰叶、谷芽、杏
仁,霍山斛、麦冬,川贝、豆卷,通草,枇杷叶,藿
香叶等味,轻清宣气。
上条白瘖未见,理宜疏泄,此条白瘖既见,随汗出没,
舌赤少苔,胃津消无正气已虚矣,且不饥不食,胃气未和
至经旬而热不解,阴液亦枯矣。斯时补之则邪愈逗留,疏之
则正气消耗。为宜杏仁、川贝、枇杷叶清肺气,麦冬、霍
斛、谷芽养胃气,佩兰、藿香化浊气,豆卷、通草泄湿气,
合轻清之品,以宣余邪,不可偏偏补,反致病去元伤也。
日瘖已多,大热不退,口渴不食,时作郑声,脉
大无力,此气虚液耗。宜用黄祗、党参、甘草、麦
冬,白芍、细生地、川石斛、地骨皮、佩兰叶、左牡
蛎、鲜荷叶等味,益气养阴也。
瘖已见多,热犹不退,口渴不食,乃阳津阴液俱伤,更
兼语声如重,脉大无力,此元神大伤,不克自持。故用参、
祗、甘草益气液,牡蛎、地、芍固营液,麦冬、石斛祛虚
热,佩兰,荷叶化余邪,务得阴阳并固,不致延为虚脱,勿
谓瘖犹未尽,禁用固补,而投疏泄,致误人性命也。
白瘖汗多,瘖密,脉虚肢冷,神情恍惚,此气液
外脱。宜用黄祗、白术、附子、当归、白芍、甘草、
麦冬,五味、龙骨、牡蛎、远志、酸枣仁等味,甘温
敛撮也。 "-
瘖出已多,汗亦不少,脉虚无神,四肢逆冷,乃阳气外
脱之象。兼之神情恍惚,梦寐惊惕,心肺失交,神难守舍,
此内外将脱,阴阳并越。(内经)所谓阴阳偏则病,离则死
也。斯死生交关之候,急宜祗、术、甘、附子气,当归、白
芍养血,麦冬、五味敛液,龙骨、牡蛎、远志、酸枣镇神,
使精气神不致越脱,即挽回造化之机也。
白瘖(白色小疱疹)出现后,随汗液进出而显现,舌质红而苔少,脉象数,不思饮食,病程迁延旬日不退,这是胃气虚弱、邪气留恋的表现。适宜使用佩兰叶、谷芽、杏仁,霍山石斛、麦冬,川贝母、大豆黄卷,通草,枇杷叶,藿香叶等药物,以轻清之品宣发肺气。
上一条所述白瘖未见时,理应用疏泄之法;本条所述白瘖既已出现,随汗出没,舌赤少苔,说明胃津耗伤、正气已虚,加之不思饮食,胃气未和,历经旬日热势不解,阴液也已枯竭。此时若补益则邪气更加逗留,若疏泄则正气进一步消耗。因此适宜用杏仁、川贝母、枇杷叶清肃肺气,麦冬、霍山石斛、谷芽养胃气,佩兰、藿香化浊气,大豆黄卷、通草泄湿气,合用轻清之品,以宣散余留之邪,不可偏执于补益,反而导致病去而元气受伤。
白瘖较多,大热不退,口渴不食,时而发出郑声(神志不清时的重复言语),脉象大而无力,这是气虚液耗的表现。适宜使用黄芪、党参、甘草、麦冬,白芍、细生地、川石斛、地骨皮、佩兰叶、左牡蛎、鲜荷叶等药物,以益气养阴。
白瘖已见较多,热势仍不退,口渴不食,乃阳津与阴液俱伤,再加上语声低微重浊,脉象大而无力,这是元神大伤,不能自我维持。所以用人参、黄芪、甘草益气生津,牡蛎、地黄、白芍固护营阴,麦冬、石斛清除虚热,佩兰、荷叶化解余邪,务必使阴阳并固,不致使病情延宕发展为虚脱,不要认为白瘖尚未出尽,就禁用固补之法,而投用疏泄之剂,以致误人性命。
白瘖汗多,瘖点密集,脉象虚软,四肢冰冷,神情恍惚,这是气液外脱的表现。适宜使用黄芪、白术、附子、当归、白芍、甘草、麦冬,五味子、龙骨、牡蛎、远志、酸枣仁等药物,以甘温之品收敛固摄。
白瘖出得很多,汗出也不少,脉象虚无神气,四肢逆冷,这是阳气外脱的征象。兼有神情恍惚,睡梦中惊惕不安,心肺失于交济,神志难以守舍,这是内外即将脱绝,阴阳并越。(《内经》)所谓“阴阳偏则病,离则死”。这是生死攸关的时刻,急宜用黄芪、白术、甘草、附子补气,当归、白芍养血,麦冬、五味子收敛津液,龙骨、牡蛎、远志、酸枣仁镇摄神志,使精气神不致越脱,这就是挽回造化生机的关键。
After the appearance of Baiyin (white miliary rash), which emerges and disappears with sweating, accompanied by a red tongue with scanty coating and a rapid pulse, anorexia, and fever persisting for ten days without resolution, this indicates Stomach Qi deficiency with lingering pathogenic factors. It is appropriate to use Eupatorium Folium (Peilan Ye), Oryzae Fructus Germinatus (Guya), Armeniacae Semen Amarum (Xingren), Dendrobii Caulis Huoshanensis (Huoshanhu), Ophiopogonis Radix (Maidong), Fritillariae Bulbus (Chuanbei), Sojae Seminum Praeparatum (Doujuan), Tectonae Herba (Tongcao), Loquat Folium (Pipaye), and Agastache Folium (Huoxiang) to lightly and clearly ventilate the Lung Qi.
In the previous clause, when Baiyin had not yet appeared, the treatment principle should have been to vent and drain. In this clause, since Baiyin has appeared and fluctuates with sweat, along with a red tongue and scanty coating, it indicates that Stomach Yin fluids are consumed and Righteous Qi is already deficient. Furthermore, anorexia suggests that Stomach Qi is not harmonized. After ten days, the heat remains unresolved, indicating that Yin fluids are also exhausted. At this stage, tonification would cause the pathogen to linger further, while venting would deplete the Righteous Qi. Therefore, it is suitable to use Armeniacae Semen Amarum (Xingren), Fritillariae Bulbus (Chuanbei), and Loquat Folium (Pipaye) to clear Lung Qi; Ophiopogonis Radix (Maidong), Dendrobii Caulis Huoshanensis (Huoshanhu), and Oryzae Fructus Germinatus (Guya) to nourish Stomach Qi; Eupatorium Folium (Peilan) and Agastache Folium (Huoxiang) to transform turbidity; Sojae Seminum Praeparatum (Doujuan) and Tectonae Herba (Tongcao) to drain dampness. Combined with light and clear agents to ventilate residual pathogens, one must not偏执 (stubbornly adhere) to tonification, lest the disease be expelled but the Primordial Qi be injured.
When Baiyin is abundant, high fever persists, thirst and anorexia are present, and there is occasional Zhengsheng (repetitive speech due to confusion), with a large but forceless pulse, this indicates Qi deficiency and fluid consumption. It is appropriate to use Astragali Radix (Huangqi), Codonopsis Radix (Dangshen), Glycyrrhizae Radix et Rhizoma (Gancao), Ophiopogonis Radix (Maidong), Paeoniae Radix Alba (Baishao), Rehmanniae Radix (Xi Shengdi), Dendrobii Caulis (Chuan Shihu), Lycii Cortex (Digupi), Eupatorium Folium (Peilan Ye), Ostrea Concha Zuo (Zuo Muli), and Nelumbinis Folium Recens (Xian Heye) to benefit Qi and nourish Yin.
Since Baiyin has appeared in large quantities and the heat still does not subside, accompanied by thirst, anorexia, hoarse or heavy voice, and a large but forceless pulse, this indicates injury to both Yang fluids and Yin fluids, and further damage to the Primordial Spirit, which cannot maintain itself. Therefore, Ginseng Radix (Renshen), Astragali Radix (Huangqi), and Glycyrrhizae Radix et Rhizoma (Gancao) are used to benefit Qi and generate fluids; Ostrea Concha (Muli), Rehmanniae Radix (Di), and Paeoniae Radix Alba (Shao) to secure Ying fluids; Ophiopogonis Radix (Maidong) and Dendrobii Caulis (Shihu) to dispel deficiency heat; Eupatorium Folium (Peilan) and Nelumbinis Folium (Heye) to resolve residual pathogens. The goal is to simultaneously secure Yin and Yang to prevent progression to collapse. One must not forbid solidifying tonification because Baiyin is not fully erupted, nor should one administer venting and draining agents, as this could prove fatal.
With abundant Baiyin, profuse sweating, dense rash, a deficient pulse, cold limbs, and mental confusion, this indicates external collapse of Qi and fluids. It is appropriate to use Astragali Radix (Huangqi), Atractylodis Macrocephalae Rhizoma (Baizhu), Aconiti Lateralis Radix Preparata (Fuzi), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Glycyrrhizae Radix et Rhizoma (Gancao), Ophiopogonis Radix (Maidong), Schisandrae Fructus (Wuweizi), Draconis Os (Longgu), Ostrea Concha (Muli), Polygalae Radix (Yuanzhi), and Ziziphi Spinosae Semen (Suanzaoren) to use sweet-warm properties to gather and consolidate.
When Baiyin has erupted extensively and sweating is also considerable, with a void and spiritless pulse and cold extremities, this is a sign of external collapse of Yang Qi. Accompanied by mental confusion and startle during sleep, indicating failure of communication between Heart and Lung, and the Spirit failing to reside within, this represents impending internal and external collapse with simultaneous floating of Yin and Yang. As stated in the *Neijing* (Inner Canon): "If Yin and Yang are unbalanced, there is disease; if they separate, there is death." This is a critical juncture of life and death. Urgently, Astragali Radix (Huangqi), Atractylodis Macrocephalae Rhizoma (Baizhu), Glycyrrhizae Radix et Rhizoma (Gancao), and Aconiti Lateralis Radix Preparata (Fuzi) should be used to benefit Qi; Angelicae Sinensis Radix (Danggui) and Paeoniae Radix Alba (Baishao) to nourish Blood; Ophiopogonis Radix (Maidong) and Schisandrae Fructus (Wuweizi) to astringe fluids; Draconis Os (Longgu), Ostrea Concha (Muli), Polygalae Radix (Yuanzhi), and Ziziphi Spinosae Semen (Suanzaoren) to calm the Spirit. This ensures that Essence, Qi, and Spirit do not leak away, representing the mechanism to reverse fate and restore vitality.