太阳发热恶风寒,体痛,脉浮紧,无汗,其人若喘者,麻黄汤也。若烦躁者,大青龙汤也。若项背强者,
葛根汤也。(方论见发热。)若小便少,气冲胸,口噤者,为刚 ,亦葛根汤也。(论见 。)若自
衄者,必自愈。(论见衄。)
阳明病,胃家实,法当多汗,若反无汗者,有四证∶脉浮而喘者,邪尚在表,宜麻黄汗之;身如虫行痒者,
久虚,宜建中之类;小便利而厥者,寒邪,宜温之;小便不利发黄者,瘀热,宜茵陈利之也。(论见胃实。)
无汗身痒,其人若脉微恶寒,面反有热色者,桂枝麻黄各半汤也。(方论见发热。)若脉浮迟,面赤
战惕发热者,迟为无阳,不能作汗也。(论见面赤。)若阳明胃实,身如虫行者,久虚也。(论见胃实。)
无汗,小便不利,其人若身黄,头汗,渴饮水浆,或懊 者,宜茵陈汤。(方论见发热。)若身黄胁痛,
鼻干嗜卧,有潮热,脉浮者,柴胡汤。(方论见胃实。)若项强发热,心下满痛,桂枝去桂加茯苓白术也。(方
论见项强。)
无汗禁忌,若浮紧身痛者,忌桂枝。(论见大法。)脉浮发热,表不解者,忌白虎。(论见渴。)若少阴欲
寐但厥者,忌强发汗,必动其血也。(论见欲寐。)凡发汗,如服一剂,病症尤在,当再作本汤与之,至有
不肯汗出者,服三剂乃解,若汗不出者,死病也。(论见大法。)
太阳经受邪出现发热、恶风怕冷,身体疼痛,脉象浮紧,无汗,如果患者伴有气喘症状的,适用麻黄汤。如果出现烦躁不安的,适用大青龙汤。如果出现颈项及背部强直不舒的,适用葛根汤。(方剂论述参见“发热”章节)。如果小便量少,气逆冲胸,口噤不开(牙关紧闭)的,属于刚痉,也适用葛根汤。(论述参见相关章节)。如果患者自然鼻出血的,病一定会自愈。(论述参见“衄血”章节)。
阳明病,胃家实(胃肠燥热结实),按照常理应当多汗,如果反而无汗的,有四种证候:脉象浮且喘息的,说明邪气仍在体表,适宜用麻黄汤发汗;身体像虫子爬行一样瘙痒的,是由于久病体虚,适宜用建中汤之类的方剂调理;小便通利但四肢厥冷的,是寒邪所致,适宜用温法治疗;小便不利且面色发黄的,是瘀热内蕴,适宜用茵陈蒿汤利湿退黄。(论述参见“胃实”章节)。
无汗且身体瘙痒,如果患者脉象微弱、恶寒,面部反而有热色的,适用桂枝麻黄各半汤。(方剂论述参见“发热”章节)。如果脉象浮而迟滞,面部发红、战栗发热,脉迟表示阳气不足,无法作汗。(论述参见“面赤”章节)。如果是阳明胃实证,身体像虫子爬行一样的,是久病体虚。(论述参见“胃实”章节)。
无汗,小便不利,如果患者身体发黄,只有头部出汗,口渴想喝水浆,或者心中懊恼烦闷的,适宜用茵陈汤。(方剂论述参见“发热”章节)。如果身体发黄、胁肋疼痛,鼻干嗜睡,有潮热,脉象浮的,适用柴胡汤。(方剂论述参见“胃实”章节)。如果颈项强直、发热,心下痞满疼痛,适用桂枝去桂加茯苓白术汤。(方剂论述参见“项强”章节)。
无汗时的禁忌症:如果脉象浮紧、身体疼痛的,忌用桂枝汤。(论述参见“大法”章节)。脉象浮、发热,表证未解的,忌用白虎汤。(论述参见“渴”章节)。如果是少阴病,出现似睡非睡、只是四肢厥冷的,忌用强力发汗法,否则必定引动血分病变。(论述参见“欲寐”章节)。凡是使用发汗法,如果服用一剂药后,病症依然存在,应当再次制作原方给予服用,直到有不肯出汗的情况,服用三剂药才能解除病邪,如果仍然不出汗,则是死证。(论述参见“大法”章节)。
Taiyang (Greater Yang) channel disease presenting with fever, aversion to wind and cold, body pain, floating-tight pulse, and anhidrosis (absence of sweating), if accompanied by wheezing in the patient, is treated with Mahuang Tang (Ephedra Decoction). If irritability is present, Da Qinglong Tang (Major Green Dragon Decoction) is indicated. If there is stiffness in the neck and back, Gegen Tang (Kudzu Decoction) is used. (Formula discussion see "Fever"). If urine output is scant, qi rushes to the chest, and the jaw is locked (trismus), it constitutes Gang Jing (Yang Rigidity Spasm), also treated with Gegen Tang. (Discussion see relevant section). If spontaneous epistaxis (nosebleed) occurs, the disease will likely resolve spontaneously. (Discussion see "Epistaxis").
Yangming disease, characterized by Wei Jia Shi (Excess in the Stomach and Intestines), typically presents with profuse sweating; however, if anhidrosis occurs instead, there are four patterns: 1) Floating pulse with wheezing indicates pathogenic factors remaining at the exterior, suitable for Ma Huang Tang to induce sweating; 2) Pruritus resembling insect crawling on the skin indicates chronic deficiency, suitable for Jian Zhong class formulas (e.g., Li Zhong Wan variations); 3) Free urination but cold extremities (Jue) indicates Cold Pathogen, suitable for warming methods; 4) Inhibited urination with jaundice indicates Stagnant Heat, suitable for Yin Chen Hao Tang (Artemisia Capillaris Decoction) to promote diuresis and clear heat. (Discussion see "Stomach Excess").
Anhidrosis with body pruritus, if the pulse is faint and the patient has aversion to cold with a flushed face, is treated with Guizhi Mahuang Ge Ban Tang (Half-and-Half Decoction of Cinnamon Twig and Ephedra). (Formula discussion see "Fever"). If the pulse is floating and slow, with facial flushing, trembling, and fever, the slowness indicates lack of Yang Qi, preventing sweat production. (Discussion see "Facial Flushing"). If Yangming Stomach Excess presents with body pruritus like insect crawling, it indicates chronic deficiency. (Discussion see "Stomach Excess").
Anhidrosis with inhibited urination, if the patient presents with jaundice, sweating only on the head, thirst for fluids, or mental restlessness (Ao Nan), is treated with Yin Chen Tang (Artemisia Capillaris Decoction). (Formula discussion see "Fever"). If jaundice is accompanied by hypochondriac pain, dry nose, drowsiness, tidal fever, and a floating pulse, Chai Hu Tang (Bupleurum Decoction) is indicated. (Formula discussion see "Stomach Excess"). If neck stiffness with fever and fullness/pain below the heart occur, Guizhi Qu Gui Jia Fu Ling Bai Zhu Tang (Cinnamon Twig Decoction minus Cinnamon Twig plus Poria and Atractodes Decoction) is used. (Formula discussion see "Neck Stiffness").
Contraindications for anhidrosis: If the pulse is floating-tight with body pain, Guizhi Tang (Cinnamon Twig Decoction) is contraindicated. (Discussion see "General Principles"). If the pulse is floating with fever and the exterior syndrome is unresolved, Baihu Tang (White Tiger Decoction) is contraindicated. (Discussion see "Thirst"). If Shaoyin (Lesser Yin) disease presents with somnolence (Yu Mei) and only cold extremities, strong sweating methods are contraindicated as they may disturb the blood level. (Discussion see "Somnolence"). Generally, when using sweating methods, if symptoms persist after one dose, the original decoction should be administered again. It may take up to three doses to induce sweating and resolve the disease. If sweating still does not occur despite three doses, it is a fatal condition. (Discussion see "General Principles").