斑斑如锦纹。或面部、或胸背。或四肢红赤者、胃热也。紫黑者、胃烂也。赤者、五死一生。
治用玄参升麻汤。重者白虎加人参汤。(方见前)
【三因玄参升麻汤】
玄参(炒) 升麻 甘草(炙。各半两)
上锉。每服五钱。水一盏半。煎七分。温服。
斑如蚊蚤咬。痕稀少而微红。此下元阴火失守。聚在胃中。上熏于肺。肺主皮毛。故胸背皮肤
发此斑也。治用大建中汤。
桂心 芍药 黄 (各二钱) 人参
当归 甘草(炙。各一钱) 附子(炮。半两) 生姜(五钱)
半夏(二钱半)
上九味锉。每服酌量多少。水二盏。枣一枚。煎八分。去渣。温服。
发狂。如肌表虽或热。以手按之则冷透手。或肩背胸膈有斑十数点。脉弦沉细。治用干姜附子
汤加人参。(方见前)
(厥者。逆也。阴阳不相顺接。故手足逆冷。冷至臂腿。名曰四肢厥逆)
手足虽冷。有时或温。手足心必暖。脉虽沉伏。按之则滑。其证或畏热。或渴欲饮水。或扬手
掷足。烦躁不得眠。大便秘。小便赤。此名热厥。古人所谓阳极发厥也。治用白虎汤、大承气汤、
双解散、凉膈散。以上四方。详证轻重。选而用之。(方并见前)
四肢冷。身不热。恶心。蜷足卧。或引衣被自覆。不渴。或下利。或大便如常。脉沉微不数。
或虽沉实。按方则迟弱。此名冷厥。治用通脉。四逆汤。或当归四逆汤。或白通加猪胆汁汤。(方
并见前)
若病患寒热而厥。面色不泽。冒昧。两手忽无脉。或一手无脉。此是将有好汗。宜用麻黄附子
甘草汤以助其汗。汗出则愈。不用药助。亦好汗必自出。
麻黄(二两。去节) 甘草(炙。二两) 附子(一个。炮)
上锉。每服五钱。水二盏。煎至八分。不拘时。温服。
皮肤出现斑纹,如同锦绣花纹。出现在面部、胸部背部或四肢且颜色红赤的,属于胃热。颜色呈紫黑色的,属于胃烂(胃腑腐烂)。颜色鲜红的,预后不良,十死中仅存一生。
治疗使用玄参升麻汤。病情严重的,使用白虎加人参汤。(方剂见前文)
【三因玄参升麻汤】
玄参(炒制) 升麻 甘草(炙烤。各半两)
以上药材切碎。每次服用五钱。加水一盏半。煎煮至七分量。温服。
斑疹像被蚊虫跳蚤叮咬的痕迹,稀疏且微红。这是下元阴火失守,聚集在胃中,向上熏蒸于肺。肺主皮毛,所以胸背部的皮肤发出这种斑疹。治疗使用大建中汤。
桂心 芍药 黄芪(各二钱) 人参
当归 甘草(炙烤。各一钱) 附子(炮制。半两) 生姜(五钱)
半夏(二钱半)
以上九味药切碎。每次根据情况酌量服用。加水二盏。大枣一枚。煎煮至八分量。去渣滓。温服。
发狂躁动。烦躁不安。面色红赤。脉象实大。治疗使用调胃承气汤。(方剂见前文)
发狂躁动。虽然肌表可能有热感,但用手按压时感觉冷透手。或者肩背胸膈部位有十几处斑疹。脉象弦沉细。治疗使用干姜附子汤加入人参。(方剂见前文)
(厥证,就是逆乱的意思。阴阳之气不能顺利交接,所以手足逆冷。寒冷延伸至手臂和腿部,称为四肢厥逆)
手足虽然寒冷,但有时或温暖。手心脚心必定温暖。脉象虽然沉伏,但重按则滑利。症状可能表现为怕热,或口渴想喝水,或扬手掷足,烦躁无法入睡。大便秘结,小便色赤。这称为热厥。古人所说的阳极发厥。治疗使用白虎汤、大承气汤、双解散、凉膈散。以上四个方剂,需详细辨别证候轻重,选择使用。(方剂均见前文)
四肢寒冷,身体不发热。恶心。蜷缩着脚躺卧。或者拉着衣被覆盖自己。口不渴。或者腹泻。或者大便正常。脉象沉微且不数。或者虽然沉实,但重按时迟弱。这称为冷厥。治疗使用通脉四逆汤。或者当归四逆汤。或者白通加猪胆汁汤。(方剂均见前文)
如果病患寒热交替且出现厥逆,面色无光泽,头目昏花迷糊。两手突然摸不到脉搏,或者一只手没有脉搏。这是即将要出好汗的征兆。适宜使用麻黄附子甘草汤来助其发汗。汗出后病愈。如果不用药辅助,好的汗液也必然会自行排出。
麻黄(二两。去掉节) 甘草(炙烤。二两) 附子(一个。炮制)
以上药材切碎。每次服用五钱。加水二盏。煎煮至八分量。不拘泥时间。温服。
Macules and patches appear like brocade patterns. Located on the face, chest, back, or limbs; if red and bright, it indicates Stomach Heat (Wei Re). If purple-black, it indicates Stomach Rot (Wei Lan). If bright red, the prognosis is poor, with ten deaths for every one survival.
Treatment uses Xuanshen Shengma Tang (Scrophulariae Radix and Cimicifugae Rhizoma Decoction). For severe cases, use Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng). (Formula see previous section)
[San Yin Xuanshen Shengma Tang]
Xuanshen (Scrophulariae Radix, stir-fried) Shengma (Cimicifugae Rhizoma) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried). Each half liang.
The above herbs are sliced. Take five qian per dose. Add one and a half zhan of water. Decoct to seven-tenths volume. Take warm.
The macules resemble marks from mosquito or flea bites, sparse and slightly red. This is due to the failure of the lower yuan's Yin fire to remain in its proper place, gathering in the Stomach and steaming upward into the Lung. The Lung governs the skin and hair, thus causing these macules to appear on the skin of the chest and back. Treatment uses Dajianzhong Tang (Greatly Build the Middle Decoction).
Guixin (Cinnamomi Cortex) Shaoyao (Paeoniae Radix Alba) Huangqi (Astragali Radix). Each two qian. Renshen (Ginseng Radix et Rhizoma)
Danggui (Angelicae Sinensis Radix) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried). Each one qian. Fuzi (Aconiti Lateralis Radix Praeparata, processed). Half liang. Shengjiang (Zingiberis Rhizoma Recens). Five qian.
Banxia (Pinelliae Tuber). Two and a half qian.
The above nine ingredients are sliced. Take an appropriate amount per dose. Add two zhan of water and one jujube. Decoct to eight-tenths volume. Strain dregs. Take warm.
Mania and restlessness. Irritability. Red face. Excess pulse. Treatment uses Tiaowei Chengqi Tang (Regulate the Stomach and Purge the Qi Decoction). (Formula see previous section)
Mania and restlessness. Although the body surface may feel hot, pressing with the hand reveals cold penetrating through. Or there are a dozen spots of macules on the shoulders, back, chest, and diaphragm. The pulse is wiry, deep, and fine. Treatment uses Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction) added with Renshen (Ginseng). (Formula see previous section)
(Jue syndrome refers to reversal. When Yin and Yang qi fail to connect smoothly, the hands and feet become reversely cold. When the cold extends to the arms and legs, it is called Si Zhi Jue Ni [Reversal Cold of the Four Limbs].)
Although the hands and feet are cold, they may sometimes be warm. The palms and soles must be warm. The pulse may be deep and hidden, but slippery upon heavy pressure. Symptoms may include aversion to heat, thirst with desire to drink water, flinging of hands and feet, irritability, and inability to sleep. Constipation. Dark urine. This is named Re Jue (Heat Jue). What the ancients called "Jue caused by extreme Yang." Treatment uses Baihu Tang (White Tiger Decoction), Dachengqi Tang (Major Order the Qi Decoction), Shuangjie San (Double Release Powder), and Liangge San (Cool the Diaphragm Powder). Of the above four formulas, select and use based on a detailed assessment of the severity of the syndrome. (Formulas all see previous section)
Cold limbs. Body not hot. Nausea. Curling up the feet while lying. Pulling clothes and blankets to cover oneself. No thirst. Or diarrhea. Or stool normal. Pulse is deep, faint, and not rapid. Or although deep and solid, feels slow and weak upon heavy pressure. This is named Leng Jue (Cold Jue). Treatment uses Tongmai Sini Tang (Unblock the Vessels and Reverse the Cold Decoction). Or Danggui Sini Tang (Angelica Sinensis and Unblocking the Vessels Decoction). Or Baitong Zhu Danjiang Tang (Baitong with Pig Bile Decoction). (Formulas all see previous section)
If the patient has alternating chills and fever with Jue, lusterless complexion, and mental confusion. Suddenly no pulse in both hands, or no pulse in one hand. This indicates that a beneficial sweating is about to occur. It is suitable to use Mahuang Fuzi Gancao Tang (Ephedra, Aconite, and Licorice Decoction) to assist the sweating. After sweating, the disease will resolve. Without medicinal assistance, the beneficial sweat will also naturally emerge.
Mahuang (Ephedrae Herba). Two liang. Remove joints. Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried). Two liang. Fuzi (Aconiti Lateralis Radix Praeparata, processed). One piece.
The above herbs are sliced. Take five qian per dose. Add two zhan of water. Decoct to eight-tenths volume. Take at any time. Warm.