寒多中荣,风多中卫,荣得寒则痛,卫得风则热,寒伤于荣,则无汗而为伤寒,风
伤于卫,则有汗而为伤风,荣卫惧虚,则必自汗。盖荣行脉中,卫行脉外,荣虚则不能
守脉中,气虚则不能卫脉外,以致汗出。汗者,血也。寒则凝滞,故痛。热则妄行,故
汗,汗出而渴者,主发疮痍。汗出而不渴者,主热将散也。如身热汗极,昏睡不言,
筋挛背强,其脉沉微,此是欲变风候也。如头有汗而身无汗,心胸懊 ,是中有停滞,
而津液不得下行也。若身热微微,昏沉多睡,身有汗而独头无,且寸口脉微者,是亡
阳之候。如阴症诸候俱备,但身首俱有微汗者,未可谓之纯阴,盖阴脉皆至颈而还,今
达阳部,故知非也。
劳复者,因伤寒初愈,血气未平,早作劳动,致损真气,触其余毒而病,谓之劳
复。食复者,因胃中稍和,即为倍食,胃气未充,不能消化,或邪热内伏,未经尽去。
因与谷气相搏而病,此谓食复。劳者调之。食者消之。更有伤寒口欲言,舌不能转,眼
睛不慧,反能食者,为除中。邪火杀谷之象也。
瘥后因交合而复者、名女劳复。其候体重少气,头重不举,目中生花,腰背痛,小
腹里急绞痛,或引阴中拘挛,或憎寒发热,时时阴火上冲,头面烘热,心胸烦闷者是
也,宜烧 散之类。小腹急痛,脉沉足冷,用当归四逆汤加熟附茱萸之类。若见卵缩入
腹,脉见离经者,死。然有男子病新瘥,未与妇人交接,感动其情,思其欲事,心切而
得病者,其治亦与女劳复同。
寒邪偏盛则损伤营气,风邪偏盛则损伤卫气。营气受寒则疼痛,卫气受风则发热。寒邪伤及营分,则无汗,称为伤寒;风邪伤及卫分,则出汗,称为伤风。若营气和卫气都虚弱,则必然出现自汗。这是因为营气运行于脉管之中,卫气运行于脉管之外。营气虚弱则不能固守于脉中,卫气虚弱则不能护卫于脉外,从而导致汗出。汗液属于血液的范畴。寒邪会导致气血凝滞,所以引起疼痛;热邪会导致气血妄行,所以引起出汗。出汗且伴有口渴的,主病为即将发生疮疡痈肿;出汗且不伴有口渴的,主病为热势将要消散。如果身体发热且出汗极多,昏睡不语,筋脉拘挛、背部僵硬,脉象沉微,这是病情即将转变为风证(中风)的征兆。如果只有头部出汗而身体无汗,心中烦闷懊恼,这是体内有停滞之物,导致津液不能向下输布所致。如果身体微微发热,神志昏沉嗜睡,身上有汗但唯独头部无汗,且寸口脉微弱的,这是阳气亡脱的征候。如果具备阴证的各种症状表现,只是头身都有微汗的,还不能说是纯阴证,因为阴经的脉气通常只到达颈部就返回了,现在脉气通达到了阳经部位,所以知道这不是纯阴证。
劳复,是因为伤寒刚刚痊愈,气血尚未平复,过早从事劳动,导致真气受损,触动残留的病邪而再次发病,称为劳复。食复,是因为胃气刚刚稍微调和,就加倍进食,此时胃气尚未充实,不能消化食物,或者体内的邪热潜伏在内,未曾完全清除。因食物与谷气相互搏结而发病,这称为食复。对于劳复,应当调理正气;对于食复,应当消导积食。更有甚者,伤寒后想说话却舌头不能转动,眼睛视物不清,反而能吃东西的,这叫“除中”。这是邪火消谷(加速消耗水谷精微)的现象。
病愈后因性交而复发者,名为女劳复。其症状表现为身体沉重、气短乏力,头部沉重抬不起来,眼前发黑或见花,腰背疼痛,小腹部拘急绞痛,或者牵引阴部拘挛,或者憎恶寒冷并伴有发热,时常有阴火上冲,头面部烘热,心胸烦闷等,适宜使用烧裈散之类的方剂。如果小腹部急痛,脉象沉迟,足部冰冷,使用当归四逆汤加入熟附子、吴茱萸之类的药物。如果出现睾丸收缩入腹,脉象出现离经(紊乱异常)的情况,预后不良,主死。然而也有男子病刚痊愈,并未与妇人交接,但因情欲感动,思念房事,心火炽盛而致病的,其治疗方法也与女劳复相同。
Excess cold damages Ying (Nutrient Qi), while excess wind damages Wei (Defensive Qi). When Ying is affected by cold, pain occurs; when Wei is affected by wind, heat occurs. Cold injuring the Ying level results in anhidrosis and is termed Shanghan (Cold Damage); wind injuring the Wei level results in sweating and is termed Shangfeng (Wind Strike). If both Ying and Wei are deficient, spontaneous sweating must occur. This is because Ying circulates within the vessels, while Wei circulates outside the vessels. Deficiency of Ying fails to secure the interior of the vessels, and deficiency of Wei fails to protect the exterior of the vessels, leading to sweat emission. Sweat is a manifestation of blood. Cold causes stagnation, hence pain; heat causes reckless movement, hence sweating. Sweating accompanied by thirst indicates a predisposition to sores and ulcers; sweating without thirst indicates that the pathogenic heat is about to dissipate. If there is high fever with profuse sweating, stupor with inability to speak, tendon spasms and stiffness of the back, and a deep and faint pulse, this is a sign that the condition is about to transform into Fenghou (Wind Syndrome/Stroke). If only the head sweats while the body remains dry, accompanied by chest oppression and restlessness, it indicates internal stagnation preventing the downward flow of body fluids. If there is slight fever, drowsiness, sweating on the body but not on the head, and a faint pulse at the Cun Kou (radial artery), this is a sign of Yang collapse. If all symptoms of Yin syndrome are present, yet there is slight sweating on both the head and body, it cannot be considered pure Yin syndrome, as Yin meridians typically return at the neck; since the pulse now reaches the Yang regions, it is known to be otherwise.
Laofu (Relapse due to Labor) occurs when, shortly after recovery from Shanghan, the Qi and Blood have not yet stabilized, and premature physical exertion damages the True Qi, triggering residual pathogens to cause illness again. Shifu (Relapse due to Diet) occurs when the Stomach Qi has just slightly harmonized, but excessive food intake overwhelms the still-weak Stomach Qi, which lacks the capacity to digest, or when latent pathogenic heat has not been fully cleared. The interaction between food and grain Qi triggers the disease, termed Shifu. Laofu requires regulation of Qi; Shifu requires digestion of food accumulation. Furthermore, if after Shanghan the patient desires to speak but cannot move the tongue, has blurred vision, yet can eat, this is called Chuzhong (Elimination of the Middle). It is a sign of pathogenic fire consuming grain essence.
Nulaofu (Female Labor Relapse) refers to relapse following sexual intercourse after recovery. Symptoms include heavy body, shortness of breath, heaviness of the head making it difficult to lift, visual disturbances (seeing spots), lower back and waist pain, acute cramping pain in the lower abdomen, possibly radiating to spasm in the genitalia, aversion to cold with fever, frequent rising of Yin fire causing flushing of the head and face, and chest discomfort and irritability. Suitable treatments include formulas like Shaokun San (Burning Underwear Powder). For acute lower abdominal pain, deep pulse, and cold feet, Danggui Sini Tang (Angelica Decoction for Cold Extremities) added with prepared Fuzi (Aconite Lateral Root) and Wuzhuyu (Evodia Fruit) is used. If the testicles retract into the abdomen and the pulse becomes irregular (Li Jing), death ensues. However, if a male patient, newly recovered, has not engaged in intercourse but is emotionally stirred by thoughts of desire, causing heart fire to flare up and induce illness, the treatment is the same as for Nulaofu.