太阳病, 得之八, 九日, 如疟状, 发热恶寒,
热多寒少, 其人不呕, 清便欲自可, 一日二, 三度发, 脉微缓者, 为
欲愈也. 脉微而恶寒者, 此阴阳俱虚, 不可更发汗更下更吐也. 面色
反有热色者, 未欲解也, 以其不能得小汗出, 身必痒, 宜桂枝麻黄各
半汤.
桂枝一两六铢 芍药一两 麻黄 ( 去节 ) 一两 生姜一两 甘草 (
炙) 一两 大枣 ( 擘 ) 四枚 杏仁 ( 去皮, 尖 ) 二十四个, 右
七味, 以水五升, 先煮麻黄一, 二沸, 去上沫, 纳诸药, 煮取一升八
合,去滓, 温服六合.
【注】太阳病, 得之八, 九日, 有如疟状之寒热. 热多寒少者, 其人
不呕, 小便清白, 此里和不受邪, 虽为欲自愈. 然必审其如疟状寒热
,一日二, 三度, 轻轻而发, 诊其脉微而且缓, 则知邪衰正复, 表里
将和, 始为欲愈也. 若脉微不缓, 正未复也, 更恶寒者, 邪未衰也,
虽不能自愈, 但已为前之汗, 吐, 下虚其表里, 故不可更发汗, 更吐
,更下也. 脉微恶寒, 表里俱虚, 面色当白, 今色反赤, 是犹有表邪
沸郁, 不能得小汗出宣发阳气, 故面赤身痒, 未欲解也. 宜桂枝麻黄
各半汤, 稍稍汗之以和营卫, 自可愈也.
太阳病,经过八、九天后,症状像疟疾一样,发热与恶寒交替出现,热多寒少,患者没有呕吐,大小便基本正常,一天发作两三次,脉象微缓的,是病情将要痊愈的表现。如果脉象微而伴有恶寒的,这是阴阳两虚,不可以再用发汗、攻下或催吐的方法治疗。面色反而发红热的,说明病邪尚未解除,因为不能通过微微出汗来宣泄阳气,身体必定发痒,适宜使用桂枝麻黄各半汤。
桂枝一两六铢,芍药一两,麻黄(去节)一两,生姜一两,甘草(炙)一两,大枣(掰开)四枚,杏仁(去皮尖)二十四个。以上七味药,用水五升,先煮麻黄,煮沸一两次后,去掉上面的浮沫,再加入其他药物,煮取药液一升八合,滤去药渣,温服六合。
【注】太阳病,经过八、九天,出现像疟疾一样的寒热症状。热多寒少的,患者不呕吐,小便清白,这说明里气调和而不受邪气干扰,虽然有望自愈。但是必须仔细审视这种像疟疾一样的寒热,一天发作两三次,且发作轻微,诊察其脉象微而缓,才知道邪气衰退、正气恢复,表里即将调和,这才算是将要痊愈。如果脉微但不缓,说明正气未恢复,再加上恶寒,说明邪气未衰退,虽然不能自愈,但因为之前的发汗、催吐、攻下法已经使表里虚弱,所以不可再用发汗、催吐、攻下的方法。脉微恶寒,表明表里俱虚,面色应当苍白,现在面色反而发红,这是因为还有表邪郁滞,不能通过微微出汗来宣发阳气,所以面红身痒,病邪尚未解除。适宜使用桂枝麻黄各半汤,稍微发汗以调和营卫,自然可以痊愈。
Taiyang disease (Disease of the Taiyang channel), after eight or nine days, presents with symptoms resembling malaria, characterized by alternating fever and aversion to cold, with more heat than cold. The patient does not vomit, and bowel movements and urination are basically normal. If the pulse is slightly slow and moderate, it indicates that the condition is about to heal. If the pulse is slight and accompanied by aversion to cold, this signifies a deficiency of both Yin and Yang, and methods such as sweating, purging, or vomiting should not be employed. If the face appears reddish and hot, the pathogen has not yet resolved; because little sweat cannot be produced to vent the Yang Qi, the body will likely itch. Guizhi Mahuang Ge Ban Tang (Cinnamon Twig and Ephedra Half-and-Half Decoction) is appropriate.
Guizhi (Cinnamomi Ramulus) 1 liang 6 zhu, Shaoyao (Paeoniae Radix Alba) 1 liang, Mahuang (Ephedrae Herba, removed nodes) 1 liang, Shengjiang (Zingiberis Rhizoma Recens) 1 liang, Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) 1 liang, Dazao (Ziziphi Jujubae Fructus, broken open) 4 pieces, Xingren (Armeniacae Semen Amarum, skin and tip removed) 24 pieces. These seven ingredients are boiled in 5 sheng of water. First, boil Mahuang until it boils one or two times, remove the foam on the surface, then add the remaining herbs. Boil until 1.8 sheng of liquid remains, strain the dregs, and take 0.6 sheng warm.
[Annotation] In Taiyang disease, after eight or nine days, chills and fever resembling malaria may occur. When there is more heat than cold, and the patient does not vomit, with clear urine, it indicates that the interior is harmonious and not invaded by pathogens; although self-healing is possible, one must carefully observe if the malaria-like chills and fever occur lightly two or three times a day. If the pulse is slight and slow, it confirms that the pathogenic factor is declining and the healthy Qi is recovering, suggesting that the exterior and interior are about to harmonize, marking the onset of recovery. If the pulse is slight but not slow, and aversion to cold persists, it indicates that the pathogen has not declined and the healthy Qi has not recovered. Although self-healing is unlikely, previous treatments involving sweating, vomiting, or purging have already weakened the exterior and interior; therefore, these methods should not be used again. A slight pulse and aversion to cold indicate deficiency in both exterior and interior, which should manifest as a pale face. However, if the face is red, it suggests that residual exterior pathogens are stagnating and preventing the production of slight sweat to vent Yang Qi, resulting in facial redness and body itching, indicating that the disease has not yet resolved. Guizhi Mahuang Ge Ban Tang (Cinnamon Twig and Ephedra Half-and-Half Decoction) should be used to induce slight sweating, thereby harmonizing Ying (Nutritive) and Wei (Defensive) Qi, leading to recovery.