28.循衣摸床有二因, 太阳火劫热伤阴, 小便利生不利死, 阳明热极
热弥深, 皆缘三法失成坏, 脉实堪下弱难禁, 虚实阴阳难辨处, 独参
六味可回春.
【注】循衣摸床, 危恶之证也. 一因太阳火劫取汗, 致阳盛伤阴. 阴
若未竭, 则小便利, 多生; 阴若已竭, 则小便难, 多死. 一因阳明热
极,汗, 吐, 下三法失宜, 致成坏证. 其热弥深, 脉实者, 堪下则可
治;脉弱者, 不堪下则难治. 此已成危恶坏证, 往往阴阳虚实, 医莫
能辨, 无下手处, 当以大剂独参, 六味, 干生地黄汤, 时时与之, 每
获生也.
29.太阳阳邪有水逆, 消渴发热汗出烦, 小便不利水入吐, 脉浮而数
五苓攒.
【注】太阳阳邪, 有水逆消渴之病, 谓太阳中风, 有渴欲饮水, 水入
即吐者, 名曰水逆; 饮水多而小便少者, 名曰消渴. 发热汗出, 风邪
也.烦, 热也. 小便不利, 水入则吐, 饮停也. 浮数, 风热脉也. 均
宜五苓散, 多服暖水, 令微汗出, 外解太阳, 内利停水则愈. 若不能
饮暖水, 欲饮冷水者, 是热盛也, 以五苓散加寒水石, 石膏, 滑石可
也. 详太阳上篇.
28. 循衣摸床（手指无意识地摸弄衣被和床沿）有两种病因：一是太阳病误用火法劫汗，导致热邪损伤阴液；二是小便通利者预后较好，小便不通利者预后不良。二是阳明病热势极盛，热邪深入体内。这都是因为发汗、催吐、攻下三种治疗方法使用不当，导致病情恶化。脉象实大者可考虑使用攻下法，脉象虚弱者则难以承受攻下。在虚实和阴阳难以辨别的情况下，可以使用独参汤或六味地黄丸来挽回生机。
【注】循衣摸床是一种危重恶性的证候。一种原因是太阳病误用火法强行发汗，导致阳热亢盛而损伤阴液。如果阴液尚未枯竭，则小便通利，大多能生还；如果阴液已经枯竭，则小便困难，大多死亡。另一种原因是阳明病热势极盛，因汗、吐、下三法使用不当，导致形成坏证（变证）。其热邪更加深入，脉象实大的，可以攻下治疗；脉象虚弱的，不能攻下，则难以治疗。这已经成为危重恶性的坏证，往往阴阳虚实难辨，医生不知从何下手，应当用大剂量的独参汤、六味地黄丸或干生地黄汤，频繁给予服用，常常能获得生机。
29. 太阳病阳邪兼有水饮内停，出现水逆证，表现为消渴、发热、汗出、心烦，小便不利，饮水即吐，脉象浮数，宜用五苓散治疗。
【注】太阳病阳邪所致的水逆消渴病，是指太阳中风证中，有口渴想喝水，但水喝进去就吐出的情况，称为水逆；饮水多而小便少的情况，称为消渴。发热汗出，是风邪的表现；心烦，是热邪的表现；小便不利，饮水后呕吐，是水饮停聚的表现。脉象浮数，是风热的脉象。这些症状均适宜使用五苓散，并多喝温开水，使身体微微出汗，外解太阳表邪，内利停聚之水饮，即可痊愈。如果不能喝温开水，想要喝冷水的，说明热势炽盛，可以在五苓散中加入寒水石、石膏、滑石即可。详见《医宗金鉴》太阳篇上卷。
28. Grasping at clothes and bedrails (involuntary finger movements touching clothing and bed) has two etiologies: one is the damage to Yin fluids caused by heat pathogen due to improper fire therapy forcing sweat in Taiyang disease; the other involves Yangming disease where extreme heat penetrates deeply into the body. In the former case, if urination is free, prognosis is good; if difficult, prognosis is poor. These conditions arise from the failure or mishandling of the three therapeutic methods: sweating, vomiting, and purging. If the pulse is excess (Shi), purging may be considered; if the pulse is deficient (Ruo), it cannot withstand purging. When differentiation between deficiency/excess and Yin/Yang is difficult, Dushen Tang (Single Ginseng Decoction) or Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) can be used to restore vitality.
[Annotation] Grasping at clothes and bedrails is a critical and malignant syndrome. One etiology is that Taiyang disease was treated with fire therapy to force sweating, leading to hyperactive Yang damaging Yin. If Yin fluids are not exhausted, urination will be free, and survival is likely; if Yin fluids are exhausted, urination will be difficult, and death is likely. The other etiology is extreme heat in Yangming disease resulting from improper use of sweating, vomiting, and purging methods, leading to "Huai Zheng" (complicated/ruined syndrome). The heat penetrates deeper. If the pulse is excess, purging is feasible and treatable; if the pulse is weak, purging is contraindicated and difficult to treat. This has become a critical Huai Zheng, often making differentiation of Yin/Yang and deficiency/excess impossible for physicians. Large doses of Dushen Tang (Single Ginseng Decoction), Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), or Gan Shengdi Huang Tang (Fresh Rehmannia Root Decoction) should be administered frequently, often resulting in recovery.
29. Taiyang disease with Yang pathogen combined with internal water retention presents as Shui Ni (Water Regurgitation) syndrome, characterized by Xiao Ke (wasting-thirst/polydipsia), fever, sweating, irritability, difficulty in urination, vomiting immediately after drinking, and a floating and rapid pulse. Wuling San (Five-Ingredient Poria Powder) is indicated.
[Annotation] The Shui Ni and Xiao Ke diseases caused by Yang pathogens in Taiyang disease refer to cases in Taiyang Wind Strike syndrome where there is thirst and desire to drink, but vomiting occurs immediately after ingestion, termed Shui Ni (Water Regurgitation); and cases with excessive drinking but scanty urination, termed Xiao Ke (Wasting-Thirst). Fever and sweating indicate Wind pathogen. Irrability indicates Heat pathogen. Difficulty in urination and vomiting after drinking indicate stagnation of fluid retention. A floating and rapid pulse indicates Wind-Heat. All these symptoms are suitable for treatment with Wuling San (Five-Ingredient Poria Powder). Patients should drink plenty of warm water to induce slight sweating, thereby releasing the exterior Taiyang pathogen and promoting diuresis of retained water internally, leading to cure. If the patient cannot tolerate warm water and desires cold water, it indicates intense heat. In this case, Han Shui Shi (Halloysitum Rubrum), Shi Gao (Gypsum Fibrosum), and Hua Shi (Talcum) can be added to Wuling San. See Volume 1 of the Taiyang Chapter in detail.