以为中脏甚忧。请薛立斋先生视之。曰非也。若风既中脏。真气既脱。恶证既见。祸在反掌。焉能延至十日。
乃候其色。面目俱赤而或青。诊其脉左三部洪数。惟肝尤甚。乃知胸乳胀痛。肝经血虚。肝气痞塞
也。四肢不收。肝经血虚不能养筋也。自汗不止。肝经血热。津液妄泄也。小便自遗。肝经热甚。阴挺失职
也。大便不实。肝木炽盛克脾土也。遂用犀角散四剂。诸证顿愈。又用加味逍遥散调理而安。后因郁怒。前证
复作。兼发热呕吐。饮食少思。月经不止。此木盛克土而脾不能摄血也。用加味归脾为主。佐以逍
遥散而愈。后每遇怒。或睡中手足搐搦。复用前药即愈。
唐柳太后病风不能言。脉沉欲脱。群医束手相视。许胤宗曰。是饵阳药无及矣。即以黄 防风煮汤数十
斛。置床下。气腾腾如雾熏薄之。是夕语。更药之而起。
卢州王守道风噤不能语。王克明令炽炭烧地。上洒以药。置病者于其上。须臾小苏。
以上二法。病至垂绝。汤液不及。亦治法之变者也。
有人平居无疾苦。忽如死人。身不动摇。默默不知人。目闭不能开。口噤不能言。或微知人。恶闻人声。
但如眩冒。移时方寤。此由出汗过多。血少气并于血。阳独上而不下。气壅塞而不
行。故身如死。气过血还。阴阳复通。故移时方寤。名曰郁冒。亦名血厥。妇人多有之。宜白薇汤仓公散。
厥
此厥与伤寒二厥不同。不可不知分辨。
阳气衰乏者。阴必凑之。令人五指至膝上皆寒。名曰寒厥。是寒逆于下也。宜六物附子汤主之。阴退则阳
进。故阴气衰于下。则阳往凑之。故令人足下热也。热甚则循三阴而上逆。谓之热厥。宜六味地黄丸主之。肝
藏血而主怒。怒则火起于肝。载血上行。故令血菀于上。是血气乱于胸中。相搏而厥逆也。谓之搏厥。宜蒲黄
汤主之。诸动属阳。故烦劳则扰乎阳。而阳气张大。阳气张大。则劳火亢矣。火炎则水干。故令精绝。是
以迁延辟积至于夏月。内外皆热。水益亏而火益亢。孤阳厥逆。如煎如熬。故曰煎厥。宜人参固本丸主之。五
尸之气。暴注于人。乱人阴阳气血。上有绝阳之络。下有破阴之纽。形气相离。不相顺接。故令暴厥如死。名
曰尸厥。宜二十四味流气饮、苏合香丸主之。寒痰迷闷。四肢逆冷。名曰痰厥。宜姜附汤主之。胃
寒即吐蛔虫。名曰蛔厥。宜乌梅丸加理中汤主之。气为人身之阳。一有拂郁。则阳气不能四达。故令手足厥
冷。与中风相似。但中风身温。中气身冷耳。名曰气厥。宜八味顺气散主之。
余按常病阳厥补阴。壮水之主。阴厥补阳。益火之源。此阴厥阳厥。与伤寒之阴阳二厥不同。伤寒阳厥。
用推陈致新之法。阴厥则用附子理中。冰炭殊涂。死生反掌。慎之哉。慎之哉。
认为病邪侵入内脏非常令人担忧。于是请薛立斋先生诊治。薛先生说：“不对。如果风邪已经侵入内脏，真气已经脱失，恶证已经出现，死亡就在顷刻之间，怎么能拖延到十天呢？”
接着观察他的面色，面部和眼睛都发红，或者带有青色。诊察他的脉象，左手寸关尺三部脉洪大而数，其中肝脏的脉象尤为严重。由此得知：胸部和乳房胀痛，是因为肝经血虚，肝气痞塞所致；四肢无力收持，是因为肝经血虚不能滋养筋脉所致；自汗不止，是因为肝经血热，导致津液妄泄所致；小便失禁，是因为肝经热盛，阴器功能失职所致；大便不成形，是因为肝木炽盛克制脾土所致。于是使用犀角散服用四剂，各种症状立刻痊愈。随后又用加味逍遥散进行调理而安定下来。后来因为郁怒，之前的病症复发，兼有发热、呕吐、饮食减少、月经不止等症状。这是木气过盛克制土气，导致脾脏不能统摄血液。于是以加味归脾汤为主方，佐以逍遥散治疗而痊愈。此后每次遇到愤怒，或者在睡眠中手足抽搐，再次使用前药即可痊愈。
唐代的柳太后患风病不能说话，脉象沉微欲绝，众医生束手无策。许胤宗说：“这是服用阳药无效了。”于是就用黄芪、防风煮成几十斛的药汤，放在床下，热气腾腾如雾一般熏蒸病人。当天晚上病人就能说话了，再服药后便起身康复。
庐州的王守道患风病牙关紧闭不能说话。王克明让人烧红炭火铺在地上，上面洒上药物，让病人躺在上面。片刻之后病人稍微苏醒。
以上两种方法，病情危急到快要断绝，口服汤药来不及发挥作用，也是治疗方法中的变通之法。
有人平时没有疾病痛苦，忽然像死人一样，身体不动，沉默不知人事，眼睛闭合不能睁开，口噤不能说话。或者稍微知道人事，但厌恶听到人声，只觉得头晕目眩，过了好一会儿才清醒过来。这是由于出汗过多，血液亏少，气并入了血中，阳气独自上浮而不能下行，气机壅塞而不运行，所以身体像死了一样。当气机过后，血液回流，阴阳重新通畅，所以过了一会儿才清醒。这种病症名叫“郁冒”，也叫做“血厥”。妇女中多有此病。适宜使用白薇汤或仓公散。
这种厥证与伤寒中的两种厥证不同，不可不知道分辨。
阳气衰乏的人，阴气必定凑合上去，使人从十个手指到膝盖以上都寒冷，这叫做“寒厥”，是寒气逆乱于下部。适宜用六物附子汤主治。阴气退去则阳气进发，所以阴气在下部衰少，阳气就会前往凑合，所以使人脚底发热。如果热势很盛，就会沿着三条阴经向上逆乱，这叫做“热厥”。适宜用六味地黄丸主治。
肝脏储藏血液并且主管愤怒。发怒时，火气起于肝脏，携带血液上行，所以使血液郁积在上部。这是气血在胸中混乱，相互搏结而导致厥逆，这叫做“搏厥”。适宜用蒲黄汤主治。
所有的躁动都属于阳，所以烦劳会扰动阳气，使阳气张大。阳气张大，那么劳火就亢盛了。火炎上则水干涸，所以使人精血枯竭。因此拖延积累直到夏季，内外皆热，水更加亏虚而火更加亢盛，孤阳厥逆，如同煎熬一般。所以叫做“煎厥”。适宜用人参固本丸主治。
五尸之气，突然注入人体，扰乱人的阴阳气血。上部有断绝阳气的络脉，下部有破损阴气的纽结，形体与气分离，不相顺接，所以使人暴发性厥逆像死了一样，这叫做“尸厥”。适宜用二十四味流气饮或苏合香丸主治。
寒痰迷闷，四肢逆冷，这叫做“痰厥”。适宜用姜附汤主治。胃寒导致吐出蛔虫，这叫做“蛔厥”。适宜用乌梅丸加上理中汤主治。
气是人身的阳气，一旦有拂逆郁结，那么阳气就不能通达四肢，所以使人手足厥冷。这与中风相似，但中风患者身体温暖，中气（中脏腑之气）患者身体寒冷罢了。这叫做“气厥”。适宜用八味顺气散主治。
我按语：通常的病症，阳厥补阴，壮水之主；阴厥补阳，益火之源。这种阴厥阳厥，与伤寒中的阴阳二厥不同。伤寒的阳厥，使用推陈致新的方法；阴厥则使用附子理中汤。冰与炭截然不同，生死只在顷刻之间，务必谨慎啊！务必谨慎啊！
Thinking that the pathogen had invaded the Zang organs was a cause for great concern. [The patient] requested Master Xue Lizhai to examine him. Xue said, "Incorrect. If wind has already invaded the Zang organs, and the True Qi (vital energy) has already collapsed, and malignant signs are already manifest, death would occur in the blink of an eye. How could it last until ten days?"
Then he observed the complexion: the face and eyes were both red, or sometimes greenish. He palpated the pulse: the three positions (Cun, Guan, Chi) on the left hand were flooding and rapid, with the Liver pulse being particularly severe. From this, he understood: the distending pain in the chest and breasts was due to Blood deficiency in the Liver channel and Qi stagnation; the inability to control the four limbs was due to Liver Blood deficiency failing to nourish the sinews; the incessant spontaneous sweating was due to Heat in the Liver channel causing fluids to leak recklessly; the involuntary urination was due to excessive Heat in the Liver channel causing dysfunction of the Yin organ; the loose stools were due to exuberant Liver Wood overacting on Spleen Earth. Consequently, he prescribed Xi Jiao San (Rhinoceros Horn Decoction) for four doses, after which all symptoms suddenly resolved. Then, he used Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) for regulation, leading to stability. Later, due to depression and anger, the previous symptoms recurred, accompanied by fever, vomiting, poor appetite, and continuous menstruation. This was Wood exuberance overacting on Earth, causing the Spleen to fail to control the blood. He primarily used Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction), assisted by Xiao Yao San, resulting in recovery. Thereafter, whenever he encountered anger, or experienced convulsions of the hands and feet during sleep, repeating the previous medication led to recovery.
Empress Dowager Liu of the Tang Dynasty suffered from wind disease and could not speak. Her pulse was deep and nearly imperceptible. The assembled physicians stood helpless. Xu Yinzong said, "This is because Yang-tonifying medicines have been ineffective." He immediately boiled Huang Qi (Astragali Radix) and Fang Feng (Saposhnikoviae Radix) into dozens of hu (a unit of volume) of decoction, placed it under the bed, and let the steaming vapor, like fog, envelop the patient. That evening, she could speak. After further medication, she recovered.
Wang Shoudao from Luzhou suffered from wind disease with jaw stiffness and could not speak. Wang Keming ordered charcoal to be heated until red and spread on the floor, sprinkled medicine upon it, and placed the patient on top. In a short while, the patient slightly regained consciousness.
These two methods apply when the condition is critical and near death, where oral decoctions are too slow to take effect; they represent variations in treatment methods.
There was someone who, in daily life, had no illness or discomfort, but suddenly appeared as if dead: body motionless, silent and unaware of others, eyes closed and unable to open, mouth clenched and unable to speak. Or perhaps slightly aware, but averse to hearing voices, feeling only dizzy and faint, recovering after some time. This was caused by excessive sweating, leading to Blood deficiency, with Qi merging into the Blood. Yang alone floated upward without descending, causing Qi obstruction and failure to circulate, so the body appeared dead. When the Qi movement passed and Blood returned, Yin and Yang connected again, so recovery occurred after some time. This condition is named Yu Mao (Depression and Dizziness), also known as Xue Jue (Blood Jue). It is common in women. Bai Wei Tang (Bletilla Decoction) or Cang Gong San should be suitable.
This type of Jue differs from the two types of Jue in Shang Han (Cold Damage); this distinction must be known.
In those with deficient and weak Yang Qi, Yin Qi inevitably gathers, causing coldness from the ten fingers up to the knees. This is called Han Jue (Cold Jue), where cold rebels in the lower part. Liu Wu Fu Zi Tang (Six-Ingredient Aconite Decoction) should be used. When Yin retreats, Yang advances. Thus, when Yin Qi is deficient in the lower part, Yang moves to gather there, causing heat in the soles of the feet. If the heat becomes severe, it follows the Three Yin channels upward and rebels, called Re Jue (Heat Jue). Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) should be used.
The Liver stores Blood and governs anger. Anger causes Fire to arise in the Liver, carrying Blood upward, causing Blood to stagnate in the upper part. This means Qi and Blood are chaotic in the chest, clashing and causing Jue Ni (rebellious Jue). This is called Bo Jue (Clashing Jue). Pu Huang Tang (Polygoni Orientalis Decoction) should be used.
All movements belong to Yang. Therefore, fatigue disturbs Yang, causing Yang Qi to expand. Expanded Yang Qi leads to hyperactive Fire from labor. Rising Fire dries Water, causing essence depletion. Thus, through prolongation and accumulation, by summer, both internal and external conditions become hot. Water becomes increasingly deficient, and Fire increasingly hyperactive. Solitary Yang rebels, as if frying and boiling. Hence, it is called Jian Jue (Frying Jue). Ren Shen Gu Ben Wan (Ginseng Solidify Root Pill) should be used.
The Qi of the Five Corpses (Shi) suddenly enters the person, disrupting Yin and Yang Qi and Blood. Above, there are meridians severing Yang; below, there are knots breaking Yin. Form and Qi separate, failing to connect smoothly, causing sudden Jue resembling death. This is called Shi Jue (Corpse Jue). Er Shi Si Wei Liu Qi Yin (Twenty-Four-Ingredient Moving Qi Decoction) or Su He Xiang Wan (Styrax Pill) should be used.
Cold Phlegm confusing and stifling, with cold extremities, is called Tan Jue (Phlegm Jue). Jiang Fu Tang (Ginger and Aconite Decoction) should be used. Stomach Cold causing vomiting of roundworms is called Hui Jue (Roundworm Jue). Wu Mei Wan (Mume Pill) combined with Li Zhong Tang (Regulate the Middle Decoction) should be used.
Qi is the Yang of the human body. Once obstructed, Yang Qi cannot reach the four extremities, causing cold hands and feet. This resembles Zhong Feng (Wind Stroke), but Zhong Feng patients have warm bodies, whereas those with Zhong Qi (Qi Strike) have cold bodies. This is called Qi Jue (Qi Jue). Ba Wei Shun Qi San (Eight-Ingredient Smooth Qi Powder) should be used.
My commentary: For ordinary diseases, Yang Jue requires tonifying Yin, strengthening the source of Water; Yin Jue requires tonifying Yang, benefiting the source of Fire. This Yin/Yang Jue differs from the Yin/Yang Jue in Shang Han. For Shang Han Yang Jue, methods of pushing out the old and generating the new are used; for Yin Jue, Fu Zi Li Zhong Tang is used. Ice and charcoal follow different paths; life and death differ in a moment. Be cautious! Be cautious!