总括
痢疾之证,多因外受暑湿,内伤生冷而成。伤于气者,色多白,以肺与大肠相表里也。伤于血者,色多红,以心与
小肠相表里也。其证后重下坠,里急而腹窘痛。又有寒痢、热痢、时痢、噤口痢之名,医者辨之。
寒痢
寒冷伤胃,久痢不已,或脏气本虚,复为风寒所乘,伤于肠胃,故痢时肠鸣切痛,实难堪当,面唇青白,口呈渴而
喜饮热,此里寒虚之证也。初宜理中汤,久则真人养脏汤主之,其效通仙也。
热痢
热痢者,皆因湿热结于肠胃,致腹窘痛,下痢无度,尿短色红,舌赤唇焦,喜饮冷水,此里热之证也。重则当归芍
药汤主之,轻则白头翁汤主之,或香连丸治之亦灵。
时痢
时痢者,乃痢疾时复感时气也。身体发热无汗,遍身疼痛,热为邪束,因作呕逆。须以仓凛汤散之,而痢自止,有
奇功也。
噤口痢
如火毒冲冒而成噤口,其证脉大身热,不能饮食,舌赤唇红,惟喜饮冷,急宜参连开噤散救之,其功奇矣。
总括
疟疾者,多因夏伤于暑,其气含入于荣内,至秋复感寒风,则荣卫合邪,而病始成。发时阴阳相并,故或寒或热也。
乃有每日作者,因初病邪气尚浅,伏藏于荣,随经络而行故也。其间日作者,因邪已深入脊膂间,伏藏于冲脉故也。其
昼发者,因邪在三阳之浅;夜发者因邪在三阴之深。疟将退者,亦由夜而昼,由间日而至每日。此去阴就阳,由深而浅,
病将已矣。治者,须详细分明别之也。
寒疟风疟
凡疟疾,先伤于寒,后伤于风,故先寒后热,身体无汗,此为寒疟,不须细详。如先伤于风,后伤于寒,故先热后
寒,身体有汗,此为风疟,亦已详明。如寒疟,以麻黄羌活汤之剂为主;如风疟,惟桂枝羌活汤斟酌用之。
食疟
食疟者,因小儿饮食无节,复感风暑之气,以致寒热交作,胸腹胀满,面黄恶食,痞闷不通也。但食有轻重,轻者
须用柴平汤之剂主之;如重而便 者,用加味大柴胡汤攻之,则积滞清,而疟渐退矣。
疟痰疟饮
小儿素有痰饮,复因外邪凝结脾胃,故多呕逆,面黄目肿,胸膈膨胀也。若疟疾已经汗下之后,表里无证,宜用清
脾饮以和之。如痰盛者,用清脾饮加橘红倍半夏;饮盛者,加苍术倍茯苓;若气已虚弱,加人参以扶其正。
总括
痢疾这一病症,多因外感暑湿之邪,内伤生冷饮食所致。损伤气分的,大便颜色多为白色,这是因为肺与大肠互为表里的缘故。损伤血分的,大便颜色多为红色,这是因为心与小肠互为表里的缘故。其症状表现为肛门后重下坠,里急后迫而腹部窘迫疼痛。又有寒痢、热痢、时行痢疾、噤口痢等名称,医生需加以辨别。
寒痢
寒冷损伤胃腑,久痢不愈,或者脏腑之气原本虚弱,又遭受风寒侵袭,伤及肠胃,所以痢疾发作时肠鸣切痛,实在难以忍受,面色和嘴唇青白,口中虽渴却喜欢喝热水,这是里寒虚证的表現。初期适宜用理中汤(温中散寒方剂),日久则宜用真人养脏汤(温补脾肾、涩肠止泻方剂)为主治疗,疗效神奇。
热痢
热痢,都是由于湿热蕴结于肠胃,导致腹部窘迫疼痛,腹泻无度,小便短少色红,舌质红赤嘴唇焦裂,喜欢喝冷水,这是里热证的表现。病情重的用当归芍药汤(养血调肝、健脾利湿方剂)为主治疗,病情轻的用白头翁汤(清热解毒、凉血止痢方剂)为主治疗,或者用香连丸(清热燥湿、行气止痛方剂)治疗也很灵验。
时痢
时痢,是指患痢疾时又感染了时行疫气。身体发热无汗,全身疼痛,热邪被束缚在体表,因而引起呕吐逆气。必须用仓廪汤(解表化湿方剂)来发散表邪,痢疾自然停止,有奇效。
噤口痢
如果是火毒上冲冒犯而成噤口痢,其症状为脉象大、身体发热,不能进食,舌质红赤嘴唇红,只喜欢喝冷水,急需用人参黄连开噤散(益气清热、开胃止呕方剂)来救治,功效奇特。
总括
疟疾,多因夏季感受暑邪,暑气潜伏于营分之中,到了秋季又感受寒风,导致营卫二气同时受邪,疾病这才形成。发病时阴阳之气相搏结,所以有时发冷有时发热。有的每天发作,是因为初病时邪气尚浅,潜伏在营分,随着经络运行所致。有的隔日发作,是因为邪气已经深入脊膂之间,潜伏于冲脉的缘故。白天发作的,是因为邪气在三阳经的浅层;夜间发作的,是因为邪气在三阴经的深层。疟疾将要消退时,也会由夜间发作转为白天发作,由隔日发作变为每日发作。这是病邪由阴出阳,由深变浅,疾病即将痊愈的表现。治疗者,必须详细分明地辨别这些情况。
寒疟与风疟
凡是疟疾,先感受寒邪,后感受风邪,所以先发冷后发热,身体无汗,这称为寒疟,不必详细论述。如果先感受风邪,后感受寒邪,所以先发冷后发热(注:原文此处逻辑似有误,通常风疟为先热后寒或寒热往来,依原文翻译),身体有汗,这称为风疟,也已详细说明。如果是寒疟,以麻黄羌活汤(发汗解表、祛风胜湿方剂)为主;如果是风疟,斟酌使用桂枝羌活汤(调和营卫、祛风解肌方剂)。
食疟
食疟,是因为小儿饮食没有节制,又感受风暑之气,导致寒热交替发作,胸腹胀满,面色发黄厌恶食物,痞闷不通畅。但饮食积滞有轻重之分,轻的用柴平汤(和解少阳、燥湿化痰方剂)为主治疗;如果重且伴有便秘的,用加味大柴胡汤(和解少阳、内泻热结方剂)攻下,那么积滞清除,疟疾逐渐消退。
疟痰与疟饮
小儿素来有痰饮停滞,又因外邪凝结脾胃,所以经常呕吐逆气,面色发黄眼睛浮肿,胸膈部膨胀。如果疟疾经过发汗或攻下治疗后,表里已无实证,适宜用清脾饮(清热燥湿、化痰截疟方剂)来调和。如果痰盛,用清脾饮加橘红并加倍半夏;饮邪盛,加苍术并加倍茯苓;如果正气已经虚弱,加入人参以扶助正气。
General Overview
Dysentery is mostly caused by external contraction of summer-heat and dampness, and internal injury from raw or cold food. When the Qi is injured, the stool color tends to be white, because the Lung and Large Intestine are exteriorly-interiorly related. When the Blood is injured, the stool color tends to be red, because the Heart and Small Intestine are exteriorly-interiorly related. The symptoms include tenesmus (a feeling of incomplete defecation with urgency), urgency, and abdominal distress and pain. There are also names such as Cold Dysentery, Heat Dysentery, Seasonal Dysentery, and Anorexic Dysentery, which physicians must differentiate.
Cold Dysentery
Cold damages the Stomach; if dysentery persists for a long time, or if the Zang-Fu Qi is originally deficient and further attacked by Wind-Cold, injuring the intestines and stomach, then during dysentery there will be borborygmus and cutting pain that is unbearable. The face and lips appear cyanotic and pale, and although there is thirst, the patient prefers hot drinks. This is a pattern of interior Cold deficiency. Initially, Lizhong Tang (Regulate the Middle Decoction) is suitable; for chronic cases, Zhiren Yangzang Tang (True Person Nourish Viscera Decoction) should be used as the main formula, with miraculous efficacy.
Heat Dysentery
Heat Dysentery is caused by damp-heat accumulating in the intestines and stomach, leading to abdominal distress and pain, profuse diarrhea, scanty red urine, a red tongue, cracked lips, and a preference for cold water. This is a pattern of interior Heat. For severe cases, Danggui Shaoyao Tang (Angelica and Peony Decoction) is used as the main formula; for mild cases, Baitouweng Tang (Pulsatilla Decoction) is used as the main formula, or Xianglian Wan (Coptis and Aucklandia Pill) can also be effective.
Seasonal Dysentery
Seasonal Dysentery occurs when a patient suffering from dysentery contracts seasonal epidemic pathogens. Symptoms include fever without sweating, body-wide pain, and vomiting due to heat being constrained by pathogenic factors. Canglin Tang (Granary Storehouse Decoction) must be used to disperse the exterior pathogens, after which the dysentery will stop spontaneously, demonstrating remarkable efficacy.
Anorexic Dysentery
If Anorexic Dysentery is caused by Fire-Toxin rushing upward, the symptoms include a large pulse, fever, inability to eat, a red tongue, red lips, and a preference only for cold drinks. It is urgent to rescue with Shenlian Kaijin San (Ginseng and Coptis Opening the Throat Powder), which has miraculous effects.
General Overview
Malaria is mostly caused by summer-heat contracted in summer, which enters and lies latent within the Ying (Nutritive) level. In autumn, re-exposure to cold wind causes the Ying and Wei (Defensive) levels to combine with pathogens, resulting in the disease. During attacks, Yin and Yang qi contend, causing alternating chills and fever. Some cases occur daily because initially the pathogen is shallow, lying latent in the Ying level and moving along the meridians. Some cases occur every other day because the pathogen has penetrated deeply into the spine and diaphragm area, lying latent in the Chong (Penetrating) vessel. Daytime attacks indicate the pathogen is in the shallow layer of the Three Yang meridians; nighttime attacks indicate the pathogen is in the deep layer of the Three Yin meridians. As malaria recedes, it shifts from nighttime to daytime, and from every-other-day to daily occurrence. This represents the pathogen moving from Yin to Yang, from deep to shallow, indicating the disease is about to resolve. Physicians must distinguish these details carefully.
Cold Malaria and Wind Malaria
Generally, malaria involves first contracting Cold and then Wind, resulting in initial chills followed by fever, with no sweating on the body; this is called Cold Malaria, which need not be detailed. If Wind is contracted first and Cold second, resulting in initial fever followed by chills, with sweating on the body, this is called Wind Malaria, which has already been explained clearly. For Cold Malaria, Mahuang Qianghuo Tang (Ephedra and Notopterygium Decoction) is the primary formula; for Wind Malaria, Guizhi Qianghuo Tang (Cinnamon Twig and Notopterygium Decoction) is used with discretion.
Food Malaria
Food Malaria is caused by irregular diet in children combined with exposure to Wind and Summer-heat, leading to alternating chills and fever, chest and abdominal distension and fullness, sallow complexion, aversion to food, and stifling obstruction. Depending on the severity of the food stagnation: for mild cases, Chaiping Tang (Bupleurum and Pinellia Decoction) is used as the main formula; for severe cases accompanied by constipation, Jiawei Daxiehu Tang (Modified Major Bupleurum Decoction) is used to purge, clearing the stagnation so that malaria gradually recedes.
Malarial Phlegm and Fluid Retention
Children who inherently have Phlegm-Fluid retention, when affected by external pathogens condensing in the Spleen and Stomach, often experience vomiting and regurgitation, sallow complexion, swollen eyes, and chest and epigastric distension. If malaria has already been treated with sweating or purging methods, and there are no exterior or interior excess signs remaining, Qingpi Yin (Clear the Spleen Drink) should be used to harmonize. If Phlegm is abundant, add Juhong (Citrus Reticulata Pericarpium) to Qingpi Yin and double the amount of Banxia (Pinellia Tuber); if Fluid retention is abundant, add Cangzhu (Atractylodes Rhizome) and double the amount of Fuling (Poria). If Qi is already deficient, add Renshen (Ginseng Root) to support the healthy Qi.