阳脉浮滑,阴脉濡弱,更遇于风,变为风温。(论见大法。)
发汗已,身灼热者,名曰风温。风温为病,脉阴阳俱浮,自汗出,身重多眠睡,鼻息必鼾,语言难出。若
被下者,小便不禁,直视失溲。若被火者,微发黄色,剧则如惊痫,时螈 。若火熏之,一逆而引日,
再逆促命期。(经云∶伤寒发汗已,则身凉。若发汗已,身灼热者,非伤寒,乃风温也。)
〔《活》〕风温者,脉尺寸俱浮,头疼身热,常自汗出,体重,其息必喘,四肢不收,嘿嘿但欲眠,治在
少阴、厥阴。不可发汗,发即谵言独语,内烦躁不得卧。若惊痫,目乱无精,如此死者,医杀之耳。
风温忌发汗,宜葳蕤汤。身灼热者,知母干葛汤。如渴甚者,栝蒌根汤。脉沉,身重,汗出者,汉防己汤。
葳蕤汤 治风温,兼疗冬温及春月中风,伤寒,发热,头眩痛,喉咽干,舌强,胸内疼痞,腰背强。
葛根(半两) 葳蕤(三分) 石膏(一两,杵碎) 白芷(半两) 麻黄(用沸汤泡,半两)
羌活(去芦,一两) 川芎(三钱) 甘草(炙,半两) 杏仁(去皮、尖,双仁者半两) 青木香(一钱)
上 咀,每服五钱,水一盏半,煎半钟,日三四服。
知母干葛汤 治风温,身体灼热甚者。
知母(三钱) 葛根(八钱) 石膏(六钱) 甘草 黄芩 木香 升麻(各一钱) 葳蕤(三钱)
南星(二钱,生) 人参 川芎(各一钱) 麻黄(去节) 防风 杏仁 羌活(各二钱)
上 咀,每服五钱,水一盏半,煎至一钟,去渣服。
防己汤 治风温,脉浮、身重、汗出。(一方无人参)
防己(四钱) 甘草 黄 (各一两) 生姜(二两) 白术(三两) 人参(一两)
上 咀,每服五钱,水一盏半,煮取一中盏,去渣,饮讫,仍坐被中,汗出如虫行,或被卧取汗出。
(许学士云∶风温误汗,用防己黄 汤救之。)
〔海〕治风温。《活人》本方葳蕤汤,以有麻黄不敢用,宜白术汤主之。(方见前太阳病发热续法。)
若头眩汗出,筋惕肉 者,加牡蛎。若腰背强硬者,加羌活。若舌干发渴者,加人参。若身灼热甚者,
加知母。若身体重多汗者,加黄 。若内伤冷者,不加。
阳脉呈现浮滑之象,阴脉呈现濡弱之象,若再感受风邪,则演变为风温病。(相关论述见《大法》篇。)
经过发汗治疗后,身体反而出现灼热感的,称为风温。风温这种病症,其脉象寸关尺三部皆浮,患者自汗出,身体沉重,嗜睡多眠,呼吸时必然伴有鼾声,言语困难。如果误用攻下法,会导致小便失禁,两眼直视,大小便失禁。如果误用火疗(如艾灸、火熏等),轻者面色微黄,重者如同惊痫发作,时而出现抽搐痉挛。如果用火熏法治疗,一次误治会延长病程,两次误治则会危及生命。(经典记载:伤寒病经发汗后,身体应当凉爽。若发汗后身体依然灼热,这就不是伤寒,而是风温病。)
〔《活人书》〕风温病,脉象尺寸部俱浮,头痛身热,经常自汗出,身体困重,呼吸必然气喘,四肢无力收持,神情沉默只想睡觉。治疗应取少阴经和厥阴经的穴位。不可使用发汗法,若误用发汗,会导致胡言乱语、独自自语,内心烦躁无法安卧。若出现惊痫症状,目光混乱无神,如此导致死亡的,是医生害死了病人。
风温忌用发汗法,适宜使用葳蕤汤。身体灼热严重的,使用知母干葛汤。如果口渴严重的,使用栝蒌根汤。脉象沉,身体沉重,汗出的,使用汉防己汤。
葳蕤汤:治疗风温,兼治冬温以及春季中风、伤寒引起的发热、头晕痛、咽喉干燥、舌体僵硬、胸中疼痛痞闷、腰背强直。
药材:葛根(半两)、葳蕤(三分)、石膏(一两,捣碎)、白芷(半两)、麻黄(用沸水浸泡,半两)、羌活(去芦头,一两)、川芎(三钱)、甘草(炙制,半两)、杏仁(去皮尖,双仁者半两)、青木香(一钱)。
制法:将药物切碎,每次服用五钱,加水一盏半,煎至半钟,每日服用三四次。
知母干葛汤:治疗风温,身体灼热严重的。
药材:知母(三钱)、葛根(八钱)、石膏(六钱)、甘草、黄芩、木香、升麻(各一钱)、葳蕤(三钱)、南星(二钱,生用)、人参、川芎(各一钱)、麻黄(去节)、防风、杏仁、羌活(各二钱)。
制法:将药物切碎,每次服用五钱,加水一盏半,煎至一钟,去渣服用。
防己汤:治疗风温,脉浮、身体沉重、汗出。(另一版本方剂无人参)
药材:防己(四钱)、甘草、黄芪(各一两)、生姜(二两)、白术(三两)、人参(一两)。
制法:将药物切碎,每次服用五钱,加水一盏半,煮取一中盏药液,去渣,饮完后,仍坐在被中,感觉汗出如虫行皮中,或者卧床取汗。
(许学士说:风温误用发汗法,用防己黄芪汤来补救。)
〔海藏〕治疗风温。《活人书》中的原方葳蕤汤,因为含有麻黄而不敢使用,适宜用白术汤为主治。(方剂见前文太阳病发热续法。)
如果头晕汗出,筋惕肉瞤(肌肉跳动)的,加牡蛎。如果腰背强硬的,加羌活。如果舌干发渴的,加人参。如果身体灼热严重的,加知母。如果身体沉重多汗的,加黄芪。如果内伤冷证的,不加这些药。
The Yang pulse is floating and slippery, the Yin pulse is soggy and weak; if exposed to wind, it transforms into Wind-Warmth (Fengwen). (See "Da Fa" for discussion.)
After sweating therapy, if the body becomes burning hot, it is named Wind-Warmth. In Wind-Warmth disease, the pulses at all three positions (Cun, Guan, Chi) are floating; there is spontaneous sweating, heaviness of the body, excessive sleepiness, snoring in breathing, and difficulty in speech. If purgatives are wrongly applied, incontinence of urine, fixed staring, and loss of control over stool and urine will occur. If fire therapy is wrongly applied, slight jaundice may appear; in severe cases, symptoms resemble convulsive epilepsy with intermittent spasms. If fumigated with fire, one error prolongs the illness, and two errors hasten death. (The Classic states: After sweating therapy for Cold Damage, the body should be cool. If the body remains burning hot after sweating, it is not Cold Damage, but Wind-Warmth.)
[From *Huoren Shu*] In Wind-Warmth, the pulses at both Cun and Chi are floating; there is headache and fever, frequent spontaneous sweating, heavy body,必喘 (inevitable panting), flaccidity of the four limbs, silence with a desire to sleep. Treatment should focus on the Shaoyin and Jueyin meridians. Sweating therapy must not be used; if wrongly induced, it leads to delirious talking, muttering alone, internal restlessness, and inability to lie down. If convulsions and epilepsy occur, with chaotic vision and lack of spirit, such deaths are caused by the physician's error.
Wind-Warmth contraindicates sweating therapy; Weirui Tang (Jade Bud Decoction) is appropriate. For severe burning heat, Zhimu Gange Tang (Anemarrhena and Pueraria Decoction) is indicated. For extreme thirst, Gualougen Tang (Trichosanthes Root Decoction) is used. For sinking pulse, heavy body, and sweating, Hanfangji Tang (Stephania Decoction) is prescribed.
Weirui Tang (Jade Bud Decoction): Treats Wind-Warmth; also treats Winter-Warmth and Spring wind-stroke or Cold Damage presenting with fever, dizziness and pain, dry throat, stiff tongue, chest pain and stuffiness, and stiffness of the waist and back.
Ingredients: Ge Gen (Puerariae Lobatae Radix, 0.5 liang), Weirui (Polygonati Odorati Rhizoma, 0.3 fen), Shigao (Gypsum Fibrosum, 1 liang, crushed), Baizhi (Angelicae Dahuricae Radix, 0.5 liang), Mahuang (Ephedrae Herba, soaked in boiling water, 0.5 liang), Qianghuo (Notopterygii Rhizoma et Radix, de-rooted, 1 liang), Chuanxiong (Ligustici Chuanxiong Rhizoma, 3 qian), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 liang), Xingren (Armeniacae Semen Amarum, peeled and split, double-kernel type, 0.5 liang), Qingmuxiang (Aucklandiae Radix, 1 qian).
Preparation: Coarsely crush the herbs. Take 5 qian per dose, add 1.5 zhan of water, decoct to 0.5 zhong. Take 3-4 times daily.
Zhimu Gange Tang (Anemarrhena and Pueraria Decoction): Treats Wind-Warmth with severe burning heat.
Ingredients: Zhimu (Anemarrhenae Rhizoma, 3 qian), Gegen (Puerariae Lobatae Radix, 8 qian), Shigao (Gypsum Fibrosum, 6 qian), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqin (Scutellariae Radix), Muxiang (Aucklandiae Radix), Shengma (Cimicifugae Rhizoma, each 1 qian), Weirui (Polygonati Odorati Rhizoma, 3 qian), Nanting (Pinelliae Tuber, raw, 2 qian), Renshen (Ginseng Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma, each 1 qian), Mahuang (Ephedrae Herba, nodes removed), Fangfeng (Saposhnikoviae Radix), Xingren (Armeniacae Semen Amarum), Qianghuo (Notopterygii Rhizoma et Radix, each 2 qian).
Preparation: Coarsely crush the herbs. Take 5 qian per dose, add 1.5 zhan of water, decoct to 1 zhong. Strain and take.
Fangji Tang (Stephania Decoction): Treats Wind-Warmth with floating pulse, heavy body, and sweating. (Another version lacks Renshen.)
Ingredients: Fangji (Stephaniae Tetrandrae Radix, 4 qian), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqi (Astragali Radix, each 1 liang), Shengjiang (Zingiberis Rhizoma Recens, 2 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 3 liang), Renshen (Ginseng Radix, 1 liang).
Preparation: Coarsely crush the herbs. Take 5 qian per dose, add 1.5 zhan of water, decoct to 1 zhong. Strain and drink. Then sit wrapped in blankets until sweat emerges as if insects are crawling under the skin, or lie down to induce sweating.
(Scholar Xu stated: If Wind-Warmth is wrongly treated with sweating, Fangji Huangqi Tang (Stephania and Astragalus Decoction) can be used to rescue.)
[Hai Zang] Treats Wind-Warmth. The original Weirui Tang from *Huoren Shu* contains Mahuang, so it is not safe to use; Baizhu Tang (Atractylodes Macrocephala Decoction) should be used instead. (Formula see previous section on Sunyang Disease Fever Continuation.)
If there is dizziness and sweating, with muscle twitching (Routeng Rouyun), add Muli (Ostreae Concha).
If there is stiffness of the waist and back, add Qianghuo (Notopterygii Rhizoma et Radix).
If there is dry tongue and thirst, add Renshen (Ginseng Radix).
If there is severe burning heat, add Zhimu (Anemarrhenae Rhizoma).
If there is heavy body and excessive sweating, add Huangqi (Astragali Radix).
If there is internal cold injury, do not add these.