十五章
少阴病,脉细沉数,病在里,忌发其汗。
脉浮而紧,法当身体疼痛,当以汗解,假令尺中脉迟者,忌发其汗,何以知然,此为荣
气不足,血气微少故也。
少阴病,脉微,忌发其汗,无阳故也。
咽中闭塞,忌发其汗,发其汗即吐血,气微绝,逆冷。
厥忌发其汗,发其汗即声乱咽嘶舌萎。
太阳病,发热恶寒,寒多热少,脉微弱,则无阳也,忌复发其汗。
咽喉干燥者,忌发其汗。
亡血家,忌攻其表,汗出则寒栗而振。
衄家,忌攻其表,汗出,必额上促急。
汗家,重发其汗,必恍惚心乱,小便已阴疼。
淋家,忌发其汗,发其汗必便血。
疮家,虽身疼痛,忌攻其表,汗出则 。
冬时忌发其汗,发其汗必吐利,口中烂,生疮,咳而小便利,若失小便,忌攻其表,汗
则厥逆冷。
太阳病发其汗,因致 。
大法春夏宜发汗。
凡发汗,欲令手足皆周,涩涩一时间益佳,不欲流离。若病不解,当重发汗,汗多则
亡阳,阳虚不得重发汗也。
凡服汤药,发汗中病便止,不必尽剂也。
凡云∶宜发汗而无汤者,丸散亦可用,然不如汤药也。
凡脉浮者,病在外,宜发其汗。
太阳病,脉浮而数者,宜发其汗。
阳明病,脉浮虚者,宜发其汗。
阳明病,其脉迟,汗出多而微恶寒者,表为未解,宜发其汗。
太阴病,脉浮,宜发其汗。
太阳中风,阳浮而阴濡弱,浮者热自发,濡溺者,汗自出,涩涩恶寒,淅淅恶风,
翕翕发热,鼻鸣干呕,桂枝汤主之。
太阳,头痛发热,身体疼,腰痛,骨节疼痛,恶风,无汗而喘,麻黄汤主之。
太阳中风,脉浮紧,发热恶寒,身体疼痛,不汗出而烦躁,大青龙汤主之。
少阴病,得之二三日,麻黄附子甘草汤微发汗。
十五章
少阴病,脉象细、沉、数,病位在里,忌用发汗法。
脉象浮而紧,按照医理应当出现身体疼痛,应当用发汗法解除,假如尺部脉象迟滞的,忌用发汗法,为什么知道是这样?这是因为营气不足,气血微弱的原因。
少阴病,脉象微弱的,忌用发汗法,因为无阳的缘故。
咽喉闭塞不通的,忌用发汗法,如果发汗就会导致吐血,气息微弱欲绝,四肢逆冷。
四肢厥冷的忌用发汗法,如果发汗就会导致声音混乱、咽喉嘶哑、舌体萎软。
太阳病,发热恶寒,恶寒重发热轻,脉象微弱,这是无阳的表现,忌再次发汗。
咽喉干燥的,忌用发汗法。
失血患者,忌用攻表法(发汗),如果发汗会导致寒战颤抖。
经常鼻出血的患者,忌用攻表法(发汗),如果发汗,必然导致额头拘急紧绷。
多汗患者,如果再发其汗,必然导致心神恍惚、心中烦乱,小便结束后阴茎疼痛。
淋证患者,忌用发汗法,如果发汗必然导致尿血。
疮疡患者,虽然身体疼痛,忌用攻表法(发汗),如果发汗则会导致[原文缺字,通常指津液枯竭或变证]。
冬季忌用发汗法,如果发汗必然导致呕吐腹泻,口腔溃烂生疮,咳嗽且小便频数,如果小便失禁,忌用攻表法(发汗),如果发汗则会导致四肢厥逆冰冷。
太阳病发汗后,因此导致[原文缺字,通常指坏病或变证]。
大的原则是春夏季节适宜发汗。
凡是发汗,希望手足周身都微微湿润,持续一段时间效果更佳,不希望大汗淋漓。如果病邪未解,应当再次发汗,但汗出过多则会亡阳,阳气虚损不得再次发汗。
凡是服用汤药,发汗达到治愈目的就停止,不必服完全部药量。
凡是说适宜发汗但没有汤药的,丸剂、散剂也可以使用,然而不如汤药效果好。
凡是脉象浮的,病邪在体表,适宜发汗。
太阳病,脉象浮而数的,适宜发汗。
阳明病,脉象浮虚的,适宜发汗。
阳明病,脉象迟,出汗多且轻微恶寒的,表证未解,适宜发汗。
太阴病,脉象浮的,适宜发汗。
太阳中风证,脉象阳浮而阴濡弱,浮表示热自发,濡弱表示汗自出,淅淅恶寒,瑟瑟恶风,翕翕发热,鼻鸣干呕,用桂枝汤主治。
太阳病,头痛发热,身体疼痛,腰痛,骨节疼痛,恶风,无汗而气喘,用麻黄汤主治。
太阳中风证,脉象浮紧,发热恶寒,身体疼痛,无汗且烦躁,用大青龙汤主治。
少阴病,得病二三天,用麻黄附子甘草汤微发汗。
Chapter 15
Shaoyin disease, with a fine, deep, and rapid pulse, indicates the pathology is in the interior; sweating therapy is contraindicated.
A floating and tight pulse typically presents with body pain and should be resolved by sweating. However, if the cunian (尺中) pulse is slow, sweating therapy is contraindicated. Why is this known? This is due to insufficiency of Ying Qi (Nutritive Qi) and slight deficiency of Blood and Qi.
In Shaoyin disease, if the pulse is faint, sweating therapy is contraindicated because there is a lack of Yang.
If there is obstruction in the throat, sweating therapy is contraindicated; inducing sweat will lead to hematemesis, faintness of breath, and cold extremities.
In cases of Jue (cold extremities), sweating therapy is contraindicated; inducing sweat will result in disordered voice, hoarseness, and tongue flaccidity.
In Taiyang disease, with fever and aversion to cold, where aversion to cold predominates over fever, and the pulse is weak, this indicates a lack of Yang; re-sweating is contraindicated.
If the throat is dry, sweating therapy is contraindicated.
Patients who have suffered blood loss are contraindicated from exterior-attacking therapies (sweating); inducing sweat will cause chills and tremors.
Patients prone to epistaxis are contraindicated from exterior-attacking therapies (sweating); inducing sweat will inevitably cause tension and tightness on the forehead.
Patients prone to spontaneous sweating: if their sweat is induced again, it will inevitably lead to mental confusion and restlessness, and pain in the genitalia after urination.
Patients with Lin syndrome (stranguria) are contraindicated from sweating therapy; inducing sweat will inevitably lead to hematuria.
Patients with sores and ulcers: although they may have body pain, exterior-attacking therapies (sweating) are contraindicated; inducing sweat will lead to [text missing].
During winter, sweating therapy is contraindicated; inducing sweat will inevitably lead to vomiting and diarrhea, oral ulceration, coughing, and frequent urination. If urinary incontinence occurs, exterior-attacking therapies (sweating) are contraindicated; inducing sweat will lead to cold reversal and cold extremities.
After inducing sweat in Taiyang disease, complications may arise [text missing].
The general principle is that sweating therapy is suitable in spring and summer.
When inducing sweat, one desires uniform moisture throughout the hands and feet, maintained for a while, which is optimal; profuse sweating is undesirable. If the disease does not resolve, sweating may be repeated, but excessive sweating leads to loss of Yang; when Yang is deficient, sweating must not be repeated.
When taking herbal decoctions, stop administering once sweating achieves the therapeutic effect; it is not necessary to finish the entire dose.
Wherever it states that sweating is indicated but no decoction is available, pills or powders may also be used, though they are less effective than decoctions.
Whenever the pulse is floating, the pathology is at the exterior, and sweating is indicated.
In Taiyang disease, if the pulse is floating and rapid, sweating is indicated.
In Yangming disease, if the pulse is floating and deficient, sweating is indicated.
In Yangming disease, if the pulse is slow, there is profuse sweating and slight aversion to cold, indicating the exterior pathogen has not yet been resolved, and sweating is indicated.
In Taiyin disease, if the pulse is floating, sweating is indicated.
In Taiyang Wind Strike syndrome, with a floating exterior pulse and soft/weak interior pulse: floating indicates spontaneous heat; soft/weak indicates spontaneous sweating; there is shivering aversion to cold, chilly aversion to wind, mild fever, nasal congestion with roaring sounds, and dry retching. Gui Zhi Tang (Cinnamon Twig Decoction) is the primary treatment.
In Taiyang disease, with headache, fever, body pain, lower back pain, joint pain, aversion to wind, anhidrosis, and wheezing, Ma Huang Tang (Ephedra Decoction) is the primary treatment.
In Taiyang Wind Strike syndrome, with a floating-tight pulse, fever, aversion to cold, body pain, anhidrosis, and irritability, Da Qing Long Tang (Major Green Dragon Decoction) is the primary treatment.
In Shaoyin disease, within two to three days of onset, Ma Huang Fu Zi Gan Cao Tang (Ephedra, Aconite, and Licorice Decoction) is used to induce mild sweating.