三阳合病,腹满身重,难转侧,汗出者,白虎汤。(论见身重。)下后胸满烦惊,小便不利,谵语身重,
不可转侧者,柴胡牡蛎汤。(论见惊。)风湿相搏,身体烦疼,不能自转侧,不呕不渴,脉浮虚而涩者,
桂枝附子汤。(论见身疼。)
三阳合病,腹满身重,难转侧,谵语遗尿,汗出者,白虎汤。(论见身重。)
风温病,脉浮汗出者,身重多眠,若下之,则小便不利,直视失溲。(论见风温。)
寸口脉微而涩,微者卫气不行,涩者荣气不逮。荣卫不能相将,三焦无所仰,身体痹不仁。荣气不足则烦
疼,口难言;卫气虚则恶寒数欠,三焦不归其部。上焦不归者,噫而吞酢;中焦不归者,不能消谷引食;下焦
不归者,则遗溲。
咳而小便利,若失小便者,不可发汗,汗出则四肢厥冷。太阳病,火熨其背,大汗出,谵语十余日,振栗
下利,欲小便不得,反呕而失溲者,此为欲解也。(论见谵语。)遗溲狂言,目反直视者,此为肾绝。(论见大法。)
三阳合病,脉浮大见关上,但欲眠睡,目合则汗。阳明病,脉但浮者,必盗汗出。(论见胃实。成无己云∶
阳明病当作里实而脉浮者,云必盗汗是犹有表邪故也。)太阳病,脉浮而动数,头痛发热,微盗汗出,而反恶
寒者,表未解也。(论见结胸。)
〔成〕伤寒盗汗者,非若杂病之虚,是由邪气在半表半里使然也。何者?若邪气一切在表干于卫,则自然
汗出也。此则邪气浸行于里,外连表邪,及睡则卫气行于里,乘表中阳气不致,津液得泄,故但睡而汗出,觉
则气散于表而汗止矣,其证悉当和表而已。
三阳经同时受邪,出现腹部胀满、身体沉重、难以翻身转动、出汗的症状,使用白虎汤治疗。(相关论述参见“身重”条。)经过泻下治疗后,出现胸部胀满、烦躁惊悸、小便不利、胡言乱语、身体沉重、无法翻身的症状,使用柴胡加龙骨牡蛎汤治疗。(相关论述参见“惊悸”条。)风湿之邪相互搏结,身体剧烈疼痛,不能自行翻身转动,没有呕吐也没有口渴,脉象浮而虚涩的,使用桂枝附子汤治疗。(相关论述参见“身痛”条。)
三阳经同时受邪,出现腹部胀满、身体沉重、难以翻身转动、胡言乱语、遗尿、出汗的症状,使用白虎汤治疗。(相关论述参见“身重”条。)风温病,脉象浮、出汗,身体沉重、嗜睡,如果误用泻下法,会导致小便不利、两眼直视、大小便失禁。(相关论述参见“风温”条。)寸口脉微而涩,脉微说明卫气运行不畅,脉涩说明营气到达不足。营气和卫气不能相互协调,三焦失去依赖,导致身体麻木不仁。营气不足则感到烦扰疼痛,说话困难;卫气虚弱则怕冷、频繁打哈欠,三焦之气不能回归其正常部位。上焦之气不归位,会出现嗳气并吞酸水;中焦之气不归位,不能消化谷物和进食;下焦之气不归位,则会出现大小便失禁。
咳嗽且小便通畅,或者像大小便失禁一样的情况,不可使用发汗法,如果发汗会导致四肢厥冷。太阳病,用火熨背部,大汗出,胡言乱语十余日,寒战发抖并腹泻,想小便却解不出,反而呕吐并大小便失禁的,这是病情将要解除的表现。(相关论述参见“谵语”条。)遗尿、狂言乱语、眼睛反视直立的,这是肾气绝灭的表现。(相关论述参见“大法”条。)
三阳经同时受邪,脉象在关部呈现浮大,只想睡觉,闭上眼睛就出汗。阳明病,脉象只表现为浮的,一定会出现盗汗。(相关论述参见“胃实”条。成无己说:阳明病应当理解为里实证而脉象浮的,说是必定盗汗是因为还有表邪的缘故。)太阳病,脉象浮而动数,头痛发热,轻微盗汗,反而恶寒的,说明表证未解。(相关论述参见“结胸”条。)
〔成无己注〕伤寒引起的盗汗,不像杂病中的虚证那样,是由于邪气在半表半里造成的。为什么呢?如果邪气完全在体表干扰卫气,自然会出汗。这里是邪气逐渐侵入体内,外部连接表邪,等到睡眠时卫气行于体内,乘表中阳气不足之时,津液得以泄出,所以只是睡觉时出汗,醒来后气散于体表而汗止了,这些症状都应当通过调和表里来治疗。
In a combined disease of the three Yang meridians, characterized by abdominal fullness, heaviness of the body, difficulty in turning over, and sweating, Baihu Tang (White Tiger Decoction) is used. (See discussion under "Heaviness of Body".) After purgation, if there is chest fullness, irritability, fright, dysuria, delirium, heaviness of the body, and inability to turn over, Chaihu Muli Tang (Bupleurum and Oyster Shell Decoction) is used. (See discussion under "Fright".) When wind-dampness combats each other, causing severe bodily pain, inability to turn over independently, no vomiting, no thirst, and a floating, deficient, and choppy pulse, Guizhi Fuzi Tang (Cinnamon Twig and Aconite Root Decoction) is used. (See discussion under "Body Pain".)
In a combined disease of the three Yang meridians, characterized by abdominal fullness, heaviness of the body, difficulty in turning over, delirium, enuresis, and sweating, Baihu Tang (White Tiger Decoction) is used. (See discussion under "Heaviness of Body".) In Fengwen Bing (Wind-Warmth Disease), with a floating pulse and sweating, heaviness of the body, and somnolence; if purgation is mistakenly applied, it leads to dysuria, fixed gaze, and loss of bowel and bladder control. (See discussion under "Wind-Warmth".) If the Cun Kou (Radial Pulse at the wrist) is micro and choppy: micro indicates that Wei Qi (Defensive Qi) does not circulate; choppy indicates that Ying Qi (Nutritive Qi) fails to reach. When Ying and Wei cannot support each other, the San Jiao (Triple Burner) loses its reliance, resulting in numbness and bi-syndrome of the body. Deficiency of Ying Qi causes restlessness and pain, and difficulty in speaking; deficiency of Wei Qi causes aversion to cold and frequent yawning, and the San Jiao qi fails to return to its proper region. If the Upper Jiao fails to return, belching and acid regurgitation occur; if the Middle Jiao fails to return, inability to digest grains and food occurs; if the Lower Jiao fails to return, loss of bowel and bladder control occurs.
If coughing is accompanied by free urination, or symptoms resembling loss of urine control, diaphoresis (sweating therapy) is contraindicated; applying it will lead to cold limbs. In Taiyang Bing (Taiyang Disease), if the back is scalded with fire, leading to profuse sweating, delirium for more than ten days, shivering, diarrhea, inability to urinate, and conversely vomiting with loss of bowel and bladder control, this indicates the disease is about to resolve. (See discussion under "Delirium".) Enuresis, wild talking, and eyes staring straight upward indicate the extinction of Kidney Qi. (See discussion under "General Principles".)
In a combined disease of the three Yang meridians, with a pulse that is large and floating at the Guan position, drowsiness, and sweating when closing the eyes. In Yangming Bing (Yangming Disease), if the pulse is merely floating, spontaneous night sweats (Dao Han) will definitely occur. (See discussion under "Stomach Excess." Cheng Wuji stated: Yangming disease should be understood as an interior excess pattern with a floating pulse; stating that night sweats definitely occur implies the presence of exterior pathogenic factors.) In Taiyang Bing, with a floating, moving, and rapid pulse, headache, fever, slight night sweats, and conversely aversion to cold, the exterior has not yet resolved. (See discussion under "Jie Xiong" / Chest Binding.)
[Cheng Wuji's Commentary] Night sweats caused by Shanghan (Cold Damage) are not like the deficiency-type sweats in miscellaneous diseases; they result from pathogenic factors residing in the half-exterior and half-interior. Why? If pathogenic factors were entirely on the exterior interfering with Wei Qi, sweating would naturally occur. Here, pathogenic factors gradually penetrate inward while externally connecting with exterior pathogens. During sleep, Wei Qi moves inward; taking advantage of the insufficient Yang qi in the exterior-interior interface, body fluids are released. Thus, sweating occurs only during sleep, and stops upon waking when Qi disperses to the exterior. These symptoms should all be treated by harmonizing the exterior and interior.