中寒无汗肢僵仆,
伤寒循经渐入,中寒不问冬夏,或当风取凉,或坐地受冷,肃杀之气自皮肤卒于
脏腑。昏倒,四肢拘挛强直厥冷,与中风相似,牙紧,四肢不动为异耳。急用葱饼熨脐,并
灸气海,手足温暖则生。如极冷唇青,厥逆无脉,舌卷囊缩者,须臾即死。
急分三阴暖下元;
仓卒难分经络,急煎姜附理中救之。次审,中脘疼痛,中太阴者,理中汤;脉沉
足冷,中少阴者,四逆汤加吴萸,或脐腹疼痛,五积散加吴萸;小腹疼痛,中厥阴者,当归
四逆汤加吴萸或五味子。如阴盛烦躁,热药冷冻饮料,或加些凉药为引,温中散冷,补暖下
元
,阳气复而寒自消矣。切忌吐下。方兼补血者,寒泣血故也。
感冒寻常和表里,
西北苦寒,中伤者多;东南温和,中伤者少。寻常感冒,表证见者,九味羌活汤
、芎芷香苏散;寒入肠胃者,霍乱转筋,洞泄下利,干呕吐逆,藿香正气散或五积散;挟食
停痰者,人参养胃汤;夏秋暴寒,折热于里者,调中汤微下之。凡带漏、遗精、 疟、疝瘕
、香港脚、腰膝冷、虚劳、阴痿、诸痛,皆寒所为也。挟风,眩晕不仁;挟湿,四肢肿痛。
内伤补益加辛温。
内伤劳役,感寒困倦,补中益气汤加姜、附。如内伤生冷,感寒腹痛,脉脱,附
子理中汤;如内伤房室,感寒厥冷,四逆汤;
脉脱,三建汤,炼脐法。
中寒证表现为无汗、肢体僵硬甚至突然昏倒,
伤寒病邪是沿着经络逐渐深入体内的;而中寒证不分冬夏季节,无论是迎风取凉,还是坐在地上受冷,肃杀寒冷的邪气会突然从皮肤侵入脏腑。患者会出现昏倒、四肢拘挛强直、厥冷等症状,这与中风病相似,但区别在于中寒证牙关紧闭、四肢不能活动。此时急需用葱饼熨烫肚脐,并艾灸气海穴,待手足温暖后才有生机。如果病情极重,出现嘴唇发青、厥逆且无脉搏、舌体卷缩、阴囊收缩的情况,则很快就会死亡。
紧急情况下需分辨三阴经病变以温补下焦元气;
在仓促之间难以辨别具体是哪条经络受邪,应紧急煎煮干姜、附子等药物组成的理中汤来急救。随后再仔细审察:若中脘穴处疼痛,属于太阴经受邪,使用理中汤;若脉象沉细、足部寒冷,属于少阴经受邪,使用四逆汤加吴茱萸,或者若脐腹部疼痛,使用五积散加吴茱萸;若小腹部疼痛,属于厥阴经受邪,使用当归四逆汤加吴茱萸或五味子。如果出现阴寒内盛导致的烦躁不安,可将热药放凉后服用(反佐法),或者加入少量凉药作为引导,以达到温中散寒、补益下焦元气的目的,使阳气恢复而寒气自然消除。切忌使用催吐和泻下的方法。方剂中兼用补血药的原因,是因为寒邪会使血液凝滞运行不畅。
感冒寻常病症需调和表里,
西北地区气候苦寒,遭受寒邪伤害的人较多;东南地区气候温和,遭受寒邪伤害的人较少。对于普通的感冒,若表证显现,使用九味羌活汤、芎芷香苏散;若寒邪进入肠胃,出现霍乱转筋、剧烈腹泻、呕吐逆气等症状,使用藿香正气散或五积散;若兼有食积停滞或痰饮停留,使用人参养胃汤;若在夏秋季节遭遇突发寒邪,导致体内郁热被遏制,使用调中汤轻微通下。凡是带下漏血、遗精、疟疾、疝气瘕块、脚气病、腰膝寒冷、虚劳、阳痿以及各种疼痛,都是由寒邪引起的。若兼夹风邪,会出现眩晕、肢体麻木不仁;若兼夹湿邪,会出现四肢肿痛。
内伤劳损需补益并加入辛温药物。
因内伤劳役过度,感受寒邪而感到困倦乏力,使用补中益气汤加生姜、附子。如果是内伤生冷食物,感受寒邪导致腹痛、脉搏微弱欲绝,使用附子理中汤;如果是内伤房事过度,感受寒邪导致四肢厥冷,使用四逆汤;若脉搏微弱欲绝,使用三建汤,并结合炼脐法治疗。
Zhonghan (Cold Strike) presents with anhidrosis, limb stiffness, and sudden collapse.
Shanghan (Cold Damage) pathogens enter gradually along the meridians; whereas Zhonghan occurs regardless of season. Whether one exposes oneself to wind while cooling off or sits on cold ground, the austere cold qi suddenly invades the Zang-Fu organs from the skin. Patients may experience fainting, spasms, rigidity, and cold extremities of the limbs, resembling Fengzhong (Wind Stroke); however, it is distinguished by clenched teeth and immobility of the four limbs. Urgently apply a scallion cake to warm the navel area and moxa the Qihai (CV-6) acupoint. Survival is possible once the hands and feet become warm. If the condition is extremely severe, presenting with cyanotic lips, Jue-ni (cold reversal) without a pulse, curled tongue, and retracted testicles, death will occur shortly.
Urgently differentiate among the Three Yin meridians to warm the lower Yuan Qi;
In emergencies, it is difficult to distinguish specific meridians; urgently decoct Li Zhong Tang (Regulate the Middle Decoction) containing Ganjiang (Dried Ginger) and Fuzi (Prepared Aconite Root) for rescue. Subsequently, examine carefully: if pain is located at the Zhongwan (CV-12) point, indicating Taiyin Meridian involvement, use Lizhong Tang; if the pulse is deep and feet are cold, indicating Shaoyin Meridian involvement, use Sini Tang (Frigid Extremities Decoction) plus Wuzhuyu (Evodia Fruit); or if there is pain in the umbilical and abdominal region, use Wuji San (Five Accumulations Powder) plus Wuzhuyu; if there is pain in the lower abdomen, indicating Jueyin Meridian involvement, use Danggui Sini Tang (Angelica Decocture for Frigid Extremities) plus Wuzhuyu or Wuweizi (Schisandra Berry). If restlessness occurs due to excessive Yin-cold, administer hot medicines cooled down (reverse adjuvant method), or add a small amount of cool medicine as a guide, to warm the middle and dispel cold, tonify and warm the lower Yuan Qi, allowing Yang Qi to recover and cold to dissipate naturally. Emetic and purgative methods are strictly contraindicated. Formulas include blood-tonifying herbs because Cold causes Blood to stagnate.
Common colds require harmonizing the exterior and interior;
The northwest suffers from bitter cold, so many are injured by it; the southeast is mild, so few are injured. For common colds presenting with exterior syndromes, use Jiuwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction) or Xiong Zhi Xiang Su San (Ligusticum, Chrysanthemum, Perilla, and Sophora Powder); if cold enters the stomach and intestines causing Huoluan (Cholera-like disorder) with muscle cramps, profuse diarrhea, dry heaving, and vomiting, use Huoxiang Zhengqi San (Patchouli Powder to Rectify the Qi) or Wuji San; if accompanied by food retention and phlegm accumulation, use Renshen Yangwei Tang (Ginseng Decoction to Nourish the Stomach); if sudden cold in summer or autumn traps heat inside, use Tiaozhong Tang (Regulate the Middle Decoction) with mild purgation. All conditions such as leukorrhea, spermatorrhea, Nue (Malaria), Shanxia (Hernia and Masses), Hongjiao (Beriberi), coldness of waist and knees, Xu Lao (Deficiency Consumption), Yinwei (Impotence), and various pains are caused by Cold. If complicated by Wind, dizziness and numbness occur; if complicated by Dampness, swelling and pain of the four limbs occur.
Internal injuries require tonification supplemented with Acrid-Warm herbs.
For internal injury due to overwork, feeling cold and fatigued, use Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) plus Shengjiang (Fresh Ginger) and Fuzi. If internal injury results from consuming raw/cold foods, leading to cold-induced abdominal pain and absent pulse, use Fuzi Lizhong Tang (Aconite Regulate-the-Middle Decoction); if internal injury results from sexual excess, leading to cold-induced Jue-leng (cold extremities), use Sini Tang; if the pulse is absent, use Sanjian Tang (Three Jian Decoction) combined with Lianqi Fa (Navel Refining Method).