秋燥舌黑,昏谵妄笑,斑色紫黑,便闭腹胀,
频转矢气,此热结在腑。宜用生首乌,鲜生地,鲜
石斛、大黄、元明粉、甘草等味,逐邪养正也。
上条热入血分,而用凉血清热;此条血热不解,瘀结在
腑,其舌黑、昏谵虽同,但少腹胀而便闭,转矢气者,断非
清凉可解。故用首乌,生地,石斛、甘草保养真阴,兼大
黄、元明粉攻涤热邪,既不伤正,又能逐邪,庶为两全。
秋燥犯肺,其人素有咳血,更加身热头汗,舌
赤脉数,呛咳益剧,此热逼动血。宜用苇茎汤加西
瓜翠衣,杏仁、川贝、鲜荷叶、沙参,地骨皮等味,
两清太阴气血也。
素有咳血,肺气已伤,加以臭热头汗,舌赤脉数,呛
咳,是外来之燥火,消烁肺金而致动血。故用苇茎、桃仁、
东瓜仁,薏仁、杏仁、川贝、沙参、西瓜翠衣,地骨皮,清
肺通络。如再不止,以清燥汤育阴清金,方为妥贴。
秋燥犯肺,其人阴分素亏,加以身热汗多气喘,
脉洪无力,此燥火刑金。宜用玉女煎加地骨皮、百
合、麦冬、五味、西洋参等味,清金滋水也。
此言素禀阴亏,木火易炎,更加身热汗多气喘,脉洪,
燥热之状甚炽。故用玉女煎,滋养肾阴,又清肺热,俾肺得
清肃而能生水,水得滋养,而能制火焉。
秋燥病出现舌苔发黑,神志昏迷、胡言乱语、无故嬉笑,皮肤出现紫黑色的斑疹,大便闭塞不通、腹部胀满,频繁排气(放屁),这是热邪结聚在腑脏。适宜使用生首乌、鲜生地、鲜石斛、大黄、元明粉、甘草等药物,以驱逐邪气并养护正气。
上一条论述的是热邪进入血分,因此使用凉血清热的治法;这一条则是血热未解,瘀结在腑脏,虽然其舌苔发黑、神志昏迷胡言乱语的症状相同,但伴有小腹胀满和大便闭塞、频繁排气,这绝不是单纯清凉药物所能解决的。所以使用首乌、生地、石斛、甘草来保养真阴,同时配合大黄、元明粉攻逐涤荡热邪,这样既不损伤正气,又能驱逐邪气,才算两全其美。
秋燥侵犯肺脏,患者平素有咳血病史,又加上身体发热、头部出汗,舌质红赤、脉搏快速,呛咳更加剧烈,这是热邪逼迫血液妄行。适宜使用苇茎汤加入西瓜翠衣、杏仁、川贝母、鲜荷叶、沙参、地骨皮等药物,同时清理太阴经的气分和血分之热。
平素有咳血,说明肺气已经受损,再加上燥热之气导致头部出汗、舌质红赤、脉搏快速、呛咳,这是外来的燥火消耗灼伤肺金而导致动血。所以使用苇茎、桃仁、冬瓜仁、薏苡仁、杏仁、川贝母、沙参、西瓜翠衣、地骨皮,以清肺热、通经络。如果出血仍不止,改用清燥汤滋养阴液、清润肺金,方为稳妥恰当。
秋燥侵犯肺脏,患者素体阴分亏虚,又加上身体发热、汗多、气喘,脉象洪大但无力,这是燥火刑克肺金(木火刑金之变证,此处指燥热伤肺)。适宜使用玉女煎加入地骨皮、百合、麦冬、五味子、西洋参等药物,以清润肺金、滋补肾水。
这里说的是素体阴液亏虚,肝木之火容易上炎,又加上身体发热、汗多、气喘、脉象洪大,燥热症状非常炽盛。所以使用玉女煎,滋养肾阴,同时清泄肺热,使得肺脏得以清肃从而能生水,肾水得到滋养从而能制约火势。
Autumn-dryness disease presenting with a black tongue coating, coma, delirium, and inappropriate laughter; purpura of purple-black color; constipation and abdominal distension; frequent passage of flatus. This indicates heat accumulation in the fu-organs. It is appropriate to use Sheng Shouwu (Polygoni Multiflori Preparata Radix), Xian Shengdi (Rehmanniae Radix Recens), Xian Shihu (Dendrobii Nobile Caulis), Dahuang (Rhei Radix et Rhizoma), Yuanmingfen (Natrii Sulfas), and Gancao (Glycyrrhizae Radix et Rhizoma), etc., to expel pathogenic factors and nourish healthy qi.
The previous clause discussed heat entering the blood level, employing cooling-blood and clearing-heat methods; this clause involves unresolved blood-heat with stasis accumulating in the fu-organs. Although the symptoms of black tongue coating and delirious speech are similar, the presence of lower abdominal distension, constipation, and frequent flatus indicates that simple cooling agents are insufficient. Therefore, Shouwu, Shengdi, Shihu, and Gancao are used to preserve true yin, while Dahuang and Yuanmingfen are employed to attack and purge heat pathogens. This approach neither damages healthy qi nor fails to expel pathogens, achieving a balanced treatment.
Autumn-dryness invading the lung, in a patient with a history of hemoptysis, accompanied by fever, sweating on the head, red tongue, and rapid pulse, with aggravated dry cough. This indicates heat forcing blood to move recklessly. It is appropriate to use Weijing Tang (Euphorbiae Hirtae Decoction) added with Xigua Cuiyi (Citrulli Lanati Pericarpium), Xingren (Armeniacae Semen Amarum), Chuanbei (Fritillariae Cirrhosae Bulbus), Xian Heye (Nelumbinis Folium Recens), Shashen (Glehniae Radix), and Digupi (Lycii Cortex), to simultaneously clear heat from both the qi and blood levels of the Taiyin lung meridian.
A history of hemoptysis implies damage to lung qi. Combined with foul heat, head sweating, red tongue, rapid pulse, and dry cough, this results from external dryness-fire consuming and scorching lung metal, leading to bleeding. Thus, Weijing, Taoren (Persicae Semen), Donggua Ren (Benincasae Semen), Yiren (Coicis Semen), Xingren, Chuanbei, Shashen, Xigua Cuiyi, and Digupi are used to clear lung heat and unblock collaterals. If bleeding persists, Qingzao Tang (Clear Dryness Decoction) should be used to nourish yin and clear lung metal, which is more appropriate.
Autumn-dryness invading the lung, in a patient with inherent deficiency of yin, accompanied by fever, profuse sweating, panting, and a large but forceless pulse. This indicates dryness-fire punishing lung metal. It is appropriate to use Yunnv Jian (Jade Woman Decoction) added with Digupi, Baihe (Lilii Bulbus), Maidong (Ophiopogonis Radix), Wuwei Zi (Schisandrae Chinensis Fructus), and Yangshengshen (Panacis Quinquefolii Radix), to clear lung metal and nourish kidney water.
This refers to inherent yin deficiency, where liver fire tends to flare up. Combined with fever, profuse sweating, panting, and a large pulse, the dryness-heat condition is intense. Therefore, Yunnv Jian is used to nourish kidney yin and clear lung heat, allowing the lung to become clear and肃 (descending) so as to generate water, and enabling the kidney water to be nourished so as to control fire.