每年交夏至后,天上之暑热流动,地中之湿气蒸腾,人处天地间,适受交迫之郁气,
先侵肺胃,初病头觉裹痛,身困重而板疼,恶寒,午后微热,胸闷不作渴,舌苔白滑,面
色淡黄,脉濡而弦,甚则昏沉懒语。盖湿邪损人阳气,肺赖胃土以生,气主于肺,胃母
肺子,肺伤则气难化,子病传母,胃损则津不布,故神倦烦冤,以三白汤(方见后),开通肺
气,则湿自化也。医者每难捉摸为何病?若认暑热,使其辗转沉绵有日矣。
人至年老,未有气血不亏者。一染外感,则邪热蒸迫,使阳益衰而阴益涸,舌苔虽润,
则脏腑已燔炙难支。初宜用轻扬之品以疏表,如桔梗、杏仁、郁金、牛子、荆芥、桑叶、葛
根、豆豉。过虚者,量意稍加党参。若猛浪投(麻黄、白芷、羌活、防风、桂枝、细辛、独
活辛窜燥烈药,再伐其生气,纵表邪一时暂退,有旋变烦乱喘促晕脱者,司命者可不慎
欤?)
凡有外感诸症,入手总宜宣达肌表之药,使邪有路而出。若不详审,便与苦寒汤剂,则
经络日阻,邪气愈为局锢,无由外透,病之轻者转重,重者转危。但寒凉药,用于邪已
化热,舌现干裂,渴欲凉饮,脉象洪数,斯时为救液灵丹,犹旱魃之遇甘霖也。至有喜
以热药当先者,每遇病者,不究其何因,辄以熟识几味暖性填写纸上,其人果是寒邪,原
合病势,出乎偶尔幸中,不足为功。若疗温症,何异抱薪救火?更劫其阴,旋变狂躁喘
急之患。若极虚人生病不受重剂克伐,须于疏散方中微加党参,辅助正气,托邪易出,不
可拘执初病无补法。试观贫乏之辈,非济以资财,乌能支持家道乎?若夹食滞之病,非
添消导药不效。总之首贵辨症,辨症既明,投方无误。辨症不明,举手便错,误人匪轻矣。
每年到了夏至之后,天上的暑热之气流动,地下的湿气蒸腾,人处于天地之间,恰好受到这种交迫的郁滞之气的影响。病邪首先侵犯肺和胃,初起时感觉头部像被包裹一样疼痛,身体困重且伴有板滞疼痛感,怕冷,午后有轻微发热,胸闷但不口渴,舌苔白而滑腻,面色淡黄,脉象濡软而弦,严重时会出现神志昏沉、懒于说话的症状。这是因为湿邪损伤人的阳气,肺依靠胃土来滋生(土生金),气主要主管于肺,胃是肺的母脏,肺是胃的子脏,肺受伤则气难以化生,子病传母;胃受损则津液不能布散,所以出现精神疲倦、烦闷冤屈之感。治疗可用三白汤(方剂见后文),以开通肺气,那么湿气自然就会化解。医生们往往难以判断这是什么病?如果误认为是暑热证,让患者辗转缠绵患病多日了。
人到老年,没有气血不亏损的。一旦感染外感病邪,邪热蒸腾逼迫,使阳气更加衰微,阴液更加枯竭,虽然舌苔看起来湿润,但脏腑已经像被烧烤一样难以支撑。初期适宜使用轻扬升散的药材来疏解表邪,如桔梗、杏仁、郁金、牛蒡子、荆芥、桑叶、葛根、豆豉。对于过于虚弱的患者,酌情稍加党参。如果猛浪投用麻黄、白芷、羌活、防风、桂枝、细辛、独活等辛窜燥烈的药物,会进一步伐伤人的生气,即使表邪暂时退去,也会出现随即转变为烦躁混乱、气喘急促、晕厥脱证的情况,掌管生命的人能不谨慎吗?
凡是患有外感各种症状,入手总宜使用宣通达表的药物,使邪气有出路排出。如果不详细审察,就给予苦寒的汤剂,会导致经络日益阻滞,邪气更加被局限禁锢,无法从外部透发,病情轻的转重,重的转危。只有当寒凉药用于邪气已经化热,舌面出现干裂,口渴想喝凉水,脉象洪大数急时,此时作为救阴液的灵丹妙药,就像久旱遇甘霖一样。至于那些喜欢先用热性药的医生,每次遇到病人,不探究病因,就随意填写几味熟悉的暖性药物,如果那人确实是寒邪,原本符合病势,那是偶尔侥幸中的,不足以称为功劳。如果用治温热病症,这无异于抱薪救火?更会劫夺阴液,随即转变为狂躁、气喘急促的祸患。如果是极度虚弱的人生病,不能承受重剂的克伐,必须在疏散方中微微加入党参,辅助正气,托举邪气容易排出,不可拘泥于初病不能用补法的说法。试看贫穷匮乏的人家,如果不资助他们钱财,怎么能维持家道呢?如果夹杂食积停滞的病证,不添加消食导滞的药物就不会见效。总之首要贵在辨证,辨证既然明确,投方就不会有误。辨证不明确,举手投足便出错,误人害人不轻啊。
Every year after the Summer Solstice, the summer heat flows in the sky, and the dampness steams from the earth. Humans, situated between heaven and earth, are aptly subjected to this oppressive stagnant Qi (vital energy). The pathogenic factor first invades the Lung and Stomach. Initially, the patient feels a headache as if wrapped, body heaviness with stiff pain, aversion to cold, slight fever in the afternoon, chest fullness without thirst, a white and slippery tongue coating, pale yellow complexion, a soggy and wiry pulse, and in severe cases, mental confusion and reluctance to speak. This is because Dampness Evil damages the body's Yang Qi. The Lung relies on the Earth of the Stomach for its generation (Earth generates Metal); Qi is primarily governed by the Lung. The Stomach is the Mother of the Lung, and the Lung is the Child of the Stomach. If the Lung is injured, Qi transformation becomes difficult; disease transmits from Child to Mother. If the Stomach is damaged, Body Fluids cannot be distributed. Thus, one experiences mental fatigue and vexation. Treatment should employ Sanbai Tang (see formula later) to open up Lung Qi, so that Dampness will naturally transform. Physicians often find it difficult to grasp what disease this is. If mistaken for Summerheat-Heat, the patient may suffer from lingering illness for days.
When people reach old age, there is none whose Qi and Blood are not deficient. Once infected with an external contraction, the pathogenic heat steams and forces, causing Yang to become increasingly depleted and Yin increasingly dried up. Although the tongue coating may appear moist, the Zang-Fu organs are already scorched and hard to sustain. Initially, light and ascending herbs should be used to disperse the exterior, such as Platycodonis Radix (Jiegeng), Armeniacae Semen Amarum (Xingren), Curcumae Aromatae Rhizoma (Yujin), Arctii Fructus (Niuzi), Schizonepetae Spica (Jingjie), Mori Folium (Sangye), Puerariae Radix (Gegen), and Fermented Soybean (Douchi). For those who are excessively deficient, Codonopsis Radix (Dangshen) should be added moderately according to judgment. If one rashly administers pungent, acrid, and drying-hot drugs like Ephedrae Herba (Mahuang), Angelicae Dahuricae Radix (Baizhi), Notopterygii Rhizoma et Radix (Qianghuo), Saposhnikoviae Radix (Fangfeng), Cinnamomi Ramulus (Guizhi), Asari Radix et Rhizoma (Xixin), and Angelicae Pubescentis Radix (Duhuo), it will further attack the vital Qi. Even if the exterior pathogen temporarily retreats, it may suddenly transform into restlessness, dyspnea, dizziness, and collapse. Can those responsible for life not be cautious?
For all symptoms of external contractions, the initial approach should always involve medicines that disseminate and reach the muscle layer, allowing the pathogen to have a way out. If not carefully examined, bitter-cold decoctions are given, leading to daily obstruction of the meridians and channels, making the pathogen more confined and unable to penetrate outward. Mild diseases become severe, and severe ones become critical. Cold-cooling medicines are only appropriate when the pathogen has transformed into Heat, presenting with a dry and cracked tongue, thirst for cold drinks, and a surging and rapid pulse. At this time, they serve as miraculous elixirs to save Body Fluids, akin to sweet rain meeting a drought demon. As for those who prefer to use hot medicines first, upon encountering patients, they do not investigate the cause but casually write down familiar warming herbs. If the person indeed has Cold Evil, it coincidentally matches the disease trend, which is merely accidental success and not merit. To treat Warm diseases, this is no different than carrying firewood to put out a fire, further depleting Yin and suddenly causing mania, restlessness, and urgent dyspnea. For extremely deficient individuals who cannot tolerate heavy purgative or attacking doses, Codonopsis Radix (Dangshen) should be slightly added to dispersing formulas to assist Righteous Qi, helping to push out the pathogen easily. One must not rigidly adhere to the notion that tonification is forbidden in early-stage diseases. Consider poor families: without financial aid, how can they maintain their household? If the disease involves food stagnation, adding digestive and guiding-out herbs is necessary for efficacy. In short, the primary importance lies in syndrome differentiation. Once differentiation is clear, prescription administration will be error-free. If differentiation is unclear, every move is wrong, harming people significantly.