吐虫尤者,盖因伤寒胃虚之人,素有积冷,妄发其汗,以致胃中虚冷,饥不欲食,食即吐虫尤也。先用理中
汤,次用乌梅丸。待虫尤已定而热不退,或呕恶脉数者,方用小柴胡汤。此症身虽躁热,口虽燥渴,忌用
寒凉。
狐惑者,犹豫不决、进退之义也。盖伤寒失汗,邪热入腹,以致饮食少而肠胃空虚,三虫举而求食。其
候四肢沈重,精神困倦,恶闻食气,默默欲卧,目闭,舌白齿晦,面眉间赤白黑色变易无常。然虫蚀下
部为狐。下唇有疮,其咽干,虫蚀其藏,为惑。上唇有疮,其声恶,通用治蚕桃仁汤。
漱水不下咽有三。若见表症而不下咽者,必作?,以邪热在经,迫血妄行也。若无表症,加之腹满如
狂,此为瘀血停留也。若阴极发躁,渴欲饮水,水入即吐,此无根之火游于咽嗌之间,假作渴也。若能
尽饮不解渴,而睡卧不宁者,此实火作渴也。
饥不欲食者,由胃气虚、客热在胸中所致也,宜吐之。仲景曰、手足厥冷,脉乍紧,心烦,饥不欲食,病在
胸,瓜蒂散吐之。
伤寒,六日传六经,为一候,七日当解。若不解,再传,至十三日谓之过经。然去伤寒之邪,不过汗吐下
三法,三法得当,则随手而愈矣。若当汗失汗,则邪热内陷,当下失下,则邪热留滞,传变不已,过经而
不解也。亦有汗吐下后药力欠至,邪气未尽宿垢凝结于肠胃,余毒壅窒于经络,亦致过经而不解
也。大法,虚者视轻重而调养之,实者量怯弱而再下之。
吐虫尤(吐出蛔虫)这一症状,是因为伤寒病后胃气虚弱的人,体内素有积寒,医生误用发汗法,导致胃中虚冷。患者感到饥饿却不想进食,吃东西就会吐出蛔虫。治疗应先用理中汤,再用乌梅丸。待蛔虫病状稳定但发热不退,或者出现呕吐、恶心、脉象数疾的情况时,才使用小柴胡汤。此症虽然身体躁热、口燥口渴,但忌用寒凉药物。
狐惑病,取“犹豫不决、进退两难”之意。这是因为伤寒失于发汗,邪热陷入腹部,导致饮食减少而肠胃空虚,体内的三种寄生虫(如蛔虫、蛲虫等)躁动寻求食物。其症状表现为四肢沉重,精神困倦,厌恶闻到食物的气味,沉默想躺卧,眼睛闭合,舌苔白,牙齿晦暗,面部眉毛之间颜色赤白黑变化无常。然而,如果虫体侵蚀下部造成病变称为“狐”,表现为下唇有疮疡,咽喉干燥;如果虫体侵蚀内脏称为“惑”,表现为上唇有疮疡,声音嘶哑恶浊。通用方剂为治蚕桃仁汤。
漱水但不咽下有三种情况。如果伴有表证而不愿咽下的,必定会发展为斑疹或出血,因为邪热在经络中,逼迫血液妄行。如果没有表证,加上腹部胀满、神志如狂,这是瘀血停留所致。如果是阴寒至极引发烦躁,口渴想喝水,但水入即吐,这是无根之火游走在咽喉之间,假作口渴。如果能喝下水但不能解渴,且睡眠不安宁的,这是实火引起的口渴。
饥饿却不想进食,是由胃气虚弱、胸中有客热所致,适宜采用催吐法。张仲景说:手足厥冷,脉搏突然变紧,心烦意乱,饥饿但不想进食,病位在胸膈,可用瓜蒂散进行催吐。
伤寒病,六天传遍六经,为一个候期,第七天应当痊愈。如果不愈,再次传变,到第十三日称为“过经不解”。去除伤寒邪气,不过汗、吐、下三种方法。这三种方法运用得当,病就能随手而愈。如果该发汗而未发汗,则邪热内陷;该攻下而未攻下,则邪热留滞,传变不止,导致过经而不解。也有在汗、吐、下之后,药力不足,邪气未尽,宿垢凝结在肠胃,余毒壅塞在经络,也导致过经而不解。大原则是:虚证者根据轻重程度来调养,实证者衡量其虚弱程度再行攻下。
The symptom of vomiting worms (vomiting Ascaris lumbricoides) arises in individuals with weak Stomach Qi due to Cold Damage (Shanghan), who have a pre-existing accumulation of cold. Improper use of sweating methods leads to deficiency-cold in the Stomach. The patient feels hungry but has no desire to eat; upon eating, they vomit worms. Treatment should first employ Lizhong Tang (Regulate the Middle Decoction), followed by Wumei Wan (Mume Pill). Once the worm condition stabilizes but fever persists, or if there is vomiting, nausea, and a rapid pulse, Xiaochaihu Tang (Minor Bupleurum Decoction) may then be used. Although this syndrome presents with restlessness, heat, dry mouth, and thirst, cold-natured herbs are contraindicated.
Huhu disease (Fox-Gu Syndrome) implies hesitation and indecision. It occurs when failure to sweat during Cold Damage allows pathogenic heat to enter the abdomen, reducing food intake and leaving the intestines and stomach empty. This causes three types of parasites to become active and seek food. Symptoms include heaviness in the four limbs, mental fatigue, aversion to the smell of food, silence with a desire to lie down, closed eyes, white tongue coating, dull teeth, and unpredictable color changes (red, white, black) between the eyebrows. If parasites erode the lower part, it is called "Hu" (Fox), characterized by sores on the lower lip and dry throat. If parasites erode the viscera, it is called "Huo" (Gu), characterized by sores on the upper lip and hoarse voice. The general formula is Zhican Taoren Tang (Mulberry Twig and Peach Kernel Decoction).
Rinsing water without swallowing can occur in three scenarios. If accompanied by exterior symptoms and refusal to swallow, it will likely develop into macules or bleeding, as pathogenic heat in the meridians forces blood to move recklessly. Without exterior symptoms, combined with abdominal fullness and maniacal behavior, this indicates stagnant blood stasis. If extreme Yin cold triggers restlessness, thirst for water, but immediate vomiting after drinking, this is rootless fire wandering in the pharynx, simulating thirst. If drinking water does not quench thirst and sleep is restless, this is thirst caused by excess fire.
Hunger without desire to eat results from deficient Stomach Qi and guest-heat in the chest. Vomiting induction is appropriate. Zhang Zhongjing stated: When hands and feet are cold, the pulse suddenly becomes tight, there is irritability, hunger, but no desire to eat, the disease is located in the chest. Guadi San (Melon Seed Powder) should be used to induce vomiting.
In Cold Damage, transmission through the six meridians takes six days, constituting one period; resolution should occur on the seventh day. If unresolved, transmission continues until the thirteenth day, termed "passing the meridian without resolution." Eliminating Cold Damage pathogens relies on sweating, vomiting, and purging methods. If applied correctly, recovery is swift. Failure to sweat when indicated allows pathogenic heat to sink inward; failure to purge when indicated allows pathogenic heat to stagnate, leading to continuous transmission and passing the meridian without resolution. Alternatively, after sweating, vomiting, or purging, insufficient medicinal potency may leave pathogens unexhausted, causing old waste to congeal in the intestines and stomach, and residual toxins to block the meridians, also resulting in passing the meridian without resolution. The general principle is: for deficiency syndromes, regulate according to severity; for excess syndromes, assess weakness before purging again.