少阴之为病,脉微细,但欲寐也。
按少阴从君火化气,其经起足小指,走足心,循内踝,贯脊上膈,入肺中,循喉咙而挟舌本。太阳
经病不解,自表传里,以至阳明、少阳、太阴,五日则传少阴之经。但传少阴之经,不入少阴之脏。此阳不
衰,阴亦非盛,阴盛则自经而入于脏,不化气于君火,而化气于寒水。盖少阴一气,水火同宫,病则水盛
而火负,故第有癸水之寒,而无丁火之热,阳亏阴旺,死灰不燃,是以脉沉细而好寐,身倦卧而恶寒也。
按少阴病,表里俱寒,以麻黄附子细辛汤,麻黄附子甘草汤主之。里寒而水盛,以四逆汤主之。里寒
而土败,以附子汤主之。里热升而咽痛,以甘草汤,桔梗汤主之。里阴逆而咽痛,以半夏散及汤主之。咽痛
而生
疮,声不出,以苦酒汤主之。咽痛而胸满心烦,以猪肤汤主之。里寒而土虚,以吴茱萸汤主之。里寒而
水泛,以真武汤主之,里热而有湿,以猪苓汤主之。里热而有郁,以四逆汤主之。里寒而阳微,以通脉
四逆汤主之。里寒而脉绝,以白通汤主之。里寒而无脉,呕烦,以白通加猪胆汁汤主之。里寒而下利脓血,
以桃花汤主之。里热而液耗,以黄连阿胶汤主之。里热而水涸,以大承气汤主之。
厥阴之为病,消渴,气上冲心,心中热疼,饥而不欲食,食则吐蛔,下之利不止。
按厥阴以风木主令,其经起足大指,循内跗,由内踝过阴器,抵小腹,上胸膈,布胁肋,循喉咙之后,
连目系,与督脉会于颠。太阳经病不解,日传一经,以至阳明,少阳,太阴,少阴,六日传于厥阴之经,
六日经尽矣。若但传厥阴之经,不入厥阴之脏,则经尽表解,自能汗愈。缘营卫郁遏,经脉莫容,既无内陷之
路,自然外发也。此虽传厥阴之经,而厥阴之厥热、吐利诸证,则概不发作。其诸证发作者,是脏病,而非
经病也。入脏则出入莫必,吉凶难料。阴盛则内传,而传无定日。阳复则外解,而解无定期。阴盛则为死机,
阳复则为生兆,厥热胜负之间,所关非小也。
按厥阴病,里寒而吐蛔,以乌梅丸主之。表寒而里虚,以当归四逆汤主之。若内有积寒,以当归四逆加
吴荣萸生姜汤主之。里寒而宜吐,以瓜蒂散主之。里寒而有水,以茯苓甘草汤主之。里寒而厥逆,以四逆
汤主之,里寒而阳郁,以通脉四逆汤主之。里寒而上有浮热,以干姜黄连黄芩人参汤主之。里寒而上虚,以
吴茱萸汤主之。阳回而里热下利,以白头翁汤主之。阳回而里热有燥屎,以小承气汤主之。阳复而里生烦
热,以栀子豉汤主之。
少阴经受邪所致的病证,表现为脉象微细,精神萎靡只想睡觉。
按:少阴经从君火化生为气,其经脉起于足小趾,经过足心,沿内踝上行,贯穿脊柱,向上穿过膈肌,进入肺中,沿喉咙而行并夹持舌根。太阳经受邪的病证若未解除,会从体表传入体内,依次传至阳明、少阳、太阴,到了第五天则传入少阴经。如果仅仅传入少阴经,而未深入少阴脏,说明阳气未衰,阴气也不盛;只有当阴气极盛时,病邪才会从经脉传入脏腑,此时不再由君火化气,而是由寒水化气。因为少阴一气之中,水火同居一宫,发病时则是水气盛而火气败,所以仅有癸水之寒,而无丁火之热,阳气亏损而阴气旺盛,如同死灰无法复燃,因此出现脉沉细且嗜睡,身体疲倦卧倒且恶寒的症状。
按:对于少阴病,若表里俱寒,以麻黄附子细辛汤、麻黄附子甘草汤为主治方剂。若里寒而水气盛,以四逆汤为主治方剂。若里寒而脾土败坏,以附子汤为主治方剂。若里热上炎导致咽痛,以甘草汤、桔梗汤为主治方剂。若里阴之气上逆导致咽痛,以半夏散及汤为主治方剂。若咽痛且生疮,声音不出,以苦酒汤为主治方剂。若咽痛且胸满心烦,以猪肤汤为主治方剂。若里寒而脾土虚弱,以吴茱萸汤为主治方剂。若里寒而水气泛滥,以真武汤为主治方剂。若里热兼有湿邪,以猪苓汤为主治方剂。若里热而有郁结,以四逆汤为主治方剂(注:此处原文逻辑似有误,通常里热郁结不用四逆,但依原文翻译)。若里寒而阳气微弱,以通脉四逆汤为主治方剂。若里寒而脉搏消失,以白通汤为主治方剂。若里寒而无脉,伴有呕吐和心烦,以白通加猪胆汁汤为主治方剂。若里寒而下利脓血,以桃花汤为主治方剂。若里热而津液耗伤,以黄连阿胶汤为主治方剂。若里热而肾水枯竭,以大承气汤为主治方剂。
厥阴经受邪所致的病证,表现为口渴多饮,气向上冲撞心脏,心中感觉灼热疼痛,感到饥饿却不想进食,进食则会吐出蛔虫,若误用攻下法则会导致腹泻不止。
按:厥阴经以风木之气主令,其经脉起于足大趾,沿足背内侧上行,经过内踝,绕过生殖器,抵达小腹,向上到达胸膈,散布于胁肋部,沿喉咙后方行走,连接目系,与督脉在头顶交会。太阳经受邪的病证若未解除,每日传变一经,依次传至阳明、少阳、太阴、少阴,第六天传入厥阴经,至此六日经气传遍。如果仅仅传入厥阴经,而未深入厥阴脏,那么经气传尽后表邪自解,自然可以通过出汗而痊愈。这是因为营卫之气被郁遏阻滞,经脉无法容纳邪气,既然没有向内陷入的路径,自然会向外发散。这种情况虽然传入了厥阴经,但厥阴经特有的厥冷发热、呕吐腹泻等症状,一概不会发作。那些症状发作的,是脏病,而不是经病。一旦病邪入脏,则出入无常,吉凶难料。阴气盛则向内传变,且传变没有固定日期;阳气回复则向外解除,且解除没有定期。阴气盛则是死亡的征兆,阳气回复则是生存的吉兆,在厥冷与发热胜负交替之间,关系非比寻常。
按:对于厥阴病,若里寒而吐蛔,以乌梅丸为主治方剂。若表寒而里虚,以当归四逆汤为主治方剂。若内有积寒,以当归四逆加吴茱萸生姜汤为主治方剂。若里寒且适宜用吐法,以瓜蒂散为主治方剂。若里寒而有水饮,以茯苓甘草汤为主治方剂。若里寒而四肢厥逆,以四逆汤为主治方剂。若里寒而阳气郁结,以通脉四逆汤为主治方剂。若里寒而上部有浮热,以干姜黄连黄芩人参汤为主治方剂。若里寒而上部虚损,以吴茱萸汤为主治方剂。若阳气回复而里热导致下利,以白头翁汤为主治方剂。若阳气回复而里有燥屎,以小承气汤为主治方剂。若阳气回复而内生烦热,以栀子豉汤为主治方剂。
The disease of Shaoyin (Lesser Yin) is characterized by a faint and thin pulse, and a desire only to sleep.
Note: Shaoyin transforms into Qi from the Ministerial Fire. Its meridian originates at the little toe, travels through the sole of the foot, follows the medial malleolus, penetrates the spine, ascends through the diaphragm, enters the lungs, follows the throat, and flanks the root of the tongue. If the disease of Taiyang (Greater Yang) is not resolved, it transmits from the exterior to the interior, reaching Yangming (Yang Brightness), Shaoyang (Lesser Yang), and Taiyin (Greater Yin). On the fifth day, it transmits to the Shaoyin meridian. If it only transmits to the Shaoyin meridian and does not enter the Shaoyin zang-organ, this indicates that Yang Qi is not deficient, and Yin Qi is not excessive. Only when Yin Qi becomes excessively abundant will the pathogen enter the zang-organ from the meridian. In this state, it no longer transforms Qi via the Ministerial Fire but rather via Cold Water. Since Shaoyin contains both Water and Fire in the same palace, upon illness, Water becomes abundant while Fire is defeated. Thus, there is only the cold of Gui Water (Yin Water) without the heat of Ding Fire (Yin Fire). With Yang deficiency and Yin excess, like dead ash that cannot ignite, the pulse becomes deep and fine with a propensity for sleep, the body feels weary and prefers lying down, and there is aversion to cold.
Note: For Shaoyin disease where both exterior and interior are cold, Mahuang Fuzi Xixin Tang (Ephedra, Prepared Aconite, and Asarum Decoction) or Mahuang Fuzi Gancao Tang (Ephedra, Prepared Aconite, and Licorice Decoction) are indicated. For interior cold with abundant water, Sini Tang (Frigid Extremities Decoction) is indicated. For interior cold with failing Earth (Spleen/Stomach), Fuzi Tang (Aconite Decoction) is indicated. For interior heat rising causing sore throat, Gancao Tang (Licorice Decoction) or Jiegeng Tang (Platycodon Decoction) are indicated. For interior Yin rebellion causing sore throat, Banxia San Ji Tang (Pinellia Powder and Decoction) is indicated. For sore throat with sores and loss of voice, Kujie Tang (Bitter Wine Decoction) is indicated. For sore throat with chest fullness and mental restlessness, Zhufu Tang (Pig Skin Decoction) is indicated. For interior cold with weak Earth, Wuzhuyu Tang (Evodia Decoction) is indicated. For interior cold with flooding water, Zhenwu Tang (True Warrior Decoction) is indicated. For interior heat with dampness, Zhuling Tang (Polyporus Decoction) is indicated. For interior heat with stagnation, Sini Tang (Frigid Extremities Decoction) is indicated. For interior cold with minute Yang, Tongmai Sini Tang (Pulse-Restoring Frigid Extremities Decoction) is indicated. For interior cold with absent pulse, Baitong Tang (White Congee Decoction) is indicated. For interior cold with absent pulse accompanied by vomiting and irritability, Baitong Jia Zhu Danjiang Tang (White Congeo Decoction plus Pig Bile) is indicated. For interior cold with bloody purulence in diarrhea, Taohua Tang (Peach Blossom Decoction) is indicated. For interior heat with fluid consumption, Huanglian Ejiao Tang (Coptis and Donkey-Hide Glue Decoction) is indicated. For interior heat with dried-up water (Kidney Yin exhaustion), Dachengqi Tang (Major Order the Qi Decoction) is indicated.
The disease of Jueyin (Terminal Yin) is characterized by excessive thirst, Qi rushing up to the heart, burning pain in the heart region, hunger without desire to eat, vomiting of roundworms after eating, and unceasing diarrhea if purgatives are incorrectly used.
Note: Jueyin governs with Wind-Wood. Its meridian originates at the big toe, follows the medial dorsum of the foot, passes the medial malleolus, circumvents the genitalia, reaches the lower abdomen, ascends to the chest and diaphragm, spreads along the costal regions, follows the posterior aspect of the throat, connects to the eye system, and meets the Du Meridian at the vertex. If Taiyang disease is not resolved, transmitting one meridian per day until reaching Yangming, Shaoyang, Taiyin, and Shaoyin, on the sixth day it transmits to the Jueyin meridian, completing the six-day cycle. If it only transmits to the Jueyin meridian and does not enter the Jueyin zang-organ, then upon completion of the meridian transmission, the exterior resolves, and natural sweating leads to recovery. This is because Ying (Nutritive) and Wei (Defensive) Qi are constrained, and the meridians cannot accommodate the pathogen; lacking a path inward, it naturally emerges outward. Although the disease has transmitted to the Jueyin meridian, symptoms specific to Jueyin such as alternating cold and heat, vomiting, and diarrhea do not occur. The occurrence of these symptoms indicates zang-organ disease, not meridian disease. Once entering the zang-organs, exit and entry become unpredictable, making prognosis difficult. Abundant Yin transmits internally without fixed days; recovering Yang resolves externally without fixed timing. Abundant Yin signifies death, while recovering Yang signifies life. The balance between cold and heat is of great significance.
Note: For Jueyin disease with interior cold and vomiting of roundworms, Wu Mei Wan (Mume Pill) is indicated. For exterior cold with interior deficiency, Danggui Sini Tang (Angelica Sinensis and Cinnamon Twig Decoction) is indicated. For accumulated cold within, Danggui Sini Jia Wuzhuyu Shengjiang Tang (Angelica Sinensis, Cinnamon Twig, Evodia, and Fresh Ginger Decoction) is indicated. For interior cold requiring emesis, Gouti San (Melon Seed Powder) is indicated. For interior cold with water retention, Fuling Gancao Tang (Poria and Licorice Decoction) is indicated. For interior cold with cold extremities, Sini Tang (Frigid Extremities Decoction) is indicated. For interior cold with constrained Yang, Tongmai Sini Tang (Pulse-Restoring Frigid Extremities Decoction) is indicated. For interior cold with floating heat above, Ganjiang Huanglian Huangqin Renshen Tang (Ginger, Coptis, Scutellaria, and Ginseng Decoction) is indicated. For interior cold with upper deficiency, Wuzhuyu Tang (Evodia Decoction) is indicated. For returning Yang with interior heat causing diarrhea, Baitouweng Tang (Pulsatilla Decoction) is indicated. For returning Yang with interior dry stool, Xiao Chengqi Tang (Minor Order the Qi Decoction) is indicated. For returning Yang generating internal irritability and heat, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) is indicated.