脉浮为风,脉紧为寒,仲景分为两涂,故有麻黄、桂枝之说,此误也。然伤寒乃太阳本气受伤,不可大汗,
但服姜附汤自愈,不必穿凿他求,以为精也。(浮风紧寒,古人通论,解肌发表,定法难磨,仲景不可訾也。
至若紧而劲急,或微,或沉,神志稍失其常,形气不能振作,则先生之法,断不可缓。伤风轻浅之证,初起咽
疼喉痛,鼻中火出,此风邪外伤毛腠,抑遏阳气,故现此耳。医者不明,误用寒凉,驯致重大。)
脉沉为胃气寒,紧为冷气盛,滑则食不消。其证头痛、发热、呕吐、心下痞,时或腹痛,服丁香丸、来复
丹;若冷物不消,荜澄茄散;胃虚者,平胃散、理中丸。
三四月间,人感潮湿之气,名曰湿病;或六七月,大雨时行,恣饮冰水冷物,亦名中湿,则令人寒热自汗。
阳则脉紧,肢节痛,足指温,服术附汤;阴则脉沉而紧,肢节不痛,身凉自利,足指冷,服姜附汤。不可发汗,
汗则必发烦躁,虚汗不止,或发黄肿。若服凉药,则泄泻而死。(先生于此证虽分阴阳,而用附子则一,今人
于六七月之交,不辨是寒、是湿,或阴、或阳,动辄云暑,专用寒凉,及至发肿泻泄,而犹云暑毒未清,又行
攻下,不至医杀不止,实可痛心。)
或肾虚人,或房事后,或胃发冷气,即腹痛烦躁,甚者囊缩,昏闷而死。急灸关元一百壮,内服姜附汤、
保元丹可救一二。若迟则气脱,虽灸亦无益矣。(审证的确,即当速救,不可因循,致归绝路。)
脉象浮表示风邪,脉象紧表示寒邪,张仲景将其分为两类,因此有了麻黄汤和桂枝汤的说法,这是错误的。然而伤寒是太阳经本气受损,不可大汗,只需服用姜附汤即可自愈,不必刻意寻求其他疗法,以为那样才精妙。(浮脉主风、紧脉主寒,是古人的通论;解肌发表是固定的法则,难以更改,张仲景是不可非议的。至于脉象紧而劲急,或微弱,或沉伏,神志稍失常,形体气息不能振作,那么窦先生的方法,断然不可迟缓。伤风轻浅的证候,初起时咽痛喉痛,鼻中感觉如火出,这是风邪外袭皮毛腠理,抑制阳气,所以出现这种现象。医生不明白,误用寒凉药物,逐渐导致病情加重。)
脉象沉表示胃气寒,紧表示冷气盛,滑表示食物不消化。其症状有头痛、发热、呕吐、心下痞满,有时腹痛,服用丁香丸、来复丹;如果冷物不消,服用荜澄茄散;胃虚者,服用平胃散、理中丸。
三四月间,人感受潮湿之气,名叫湿病;或者六七月,大雨流行,恣意饮用冰水冷物,也名叫中湿,这会让人寒热自汗。属阳证则脉紧,肢节痛,脚趾温暖,服用术附汤;属阴证则脉沉而紧,肢节不痛,身体凉,自利(腹泻),脚趾冷,服用姜附汤。不可发汗,发汗则必然发生烦躁,虚汗不止,或者发黄肿。如果服用凉药,则会因泄泻而死。(先生对于这个证候虽然分阴阳,但使用附子是一致的,现在人在六七月之交,不辨别是寒、是湿,是阴、是阳,动辄说是暑,专用寒凉药物,等到发生浮肿泄泻,还说暑毒未清,又进行攻下治疗,不到把人医死不停止,实在令人痛心。)
或者是肾虚的人,或者房事之后,或者胃发出冷气,立即腹痛烦躁,严重的睾丸收缩,昏闷而死。紧急灸关元穴一百壮,内服姜附汤、保元丹可以救活一二。如果延迟则气脱,即使艾灸也没有益处了。(审察证候确切,就应当迅速救治,不可拖延,致使病人走向绝路。)
Pulse floating indicates Wind, pulse tight indicates Cold. Zhang Zhongjing divided them into two categories, hence the theories of Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction); this is an error. However, Shanghan (Cold Damage) involves injury to the fundamental Qi of the Taiyang (Greater Yang) channel; it should not be treated with heavy sweating. One need only take Jiangfu Tang (Ginger and Aconite Decoction) for spontaneous recovery; there is no need to force other remedies in pursuit of sophistication. (Floating pulse governing Wind and tight pulse governing Cold are general principles of the ancients; releasing the muscle layer and expelling the pathogen is a fixed method, difficult to alter; Zhang Zhongjing cannot be disparaged. As for when the pulse is tight and vigorous, or faint, or deep, and mental consciousness is slightly abnormal, with physical energy unable to perk up, then Master Dou's methods must not be delayed. For mild and superficial Wind-Cold syndromes, initially presenting with sore throat and pain in the larynx, and a sensation of fire issuing from the nose, this is due to Wind pathogen attacking externally the hair follicles and interstices, suppressing Yang Qi, thus manifesting these signs. Physicians who do not understand this may mistakenly use cold-natured herbs, gradually leading to severe illness.)
Pulse deep indicates Cold Stomach Qi; tight indicates abundant Cold Qi; slippery indicates indigestion. The symptoms include headache, fever, vomiting, epigastric fullness (Pi syndrome), and occasional abdominal pain. Treat with Dingxiang Wan (Clove Pill) and Laifu Dan (Reviving Life Pellet); if cold substances remain undigested, use Bichengqie San (Bladder Cherry Powder); for Spleen/Stomach deficiency, use Pingwei San (Calm the Stomach Powder) and Lizhong Wan (Regulate the Middle Pill).
During the third and fourth months, humans contract damp Qi, named Shibi (Damp Disease); or during the sixth and seventh months, when heavy rains prevail, indulging in ice water and cold foods is also called Zhongshi (Strike by Dampness), causing chills, fever, and spontaneous sweating. If Yang pattern: pulse is tight, limb joints hurt, toes are warm, treat with Shufu Tang (Atractylodes and Aconite Decoction). If Yin pattern: pulse is deep and tight, limb joints do not hurt, body is cool with spontaneous diarrhea, toes are cold, treat with Jiangfu Tang (Ginger and Aconite Decoction). Do not induce sweating; doing so will inevitably cause restlessness, unremitting deficiency sweating, or jaundice and edema. If cold-natured medicines are taken, death will result from diarrhea. (Although the Master distinguishes between Yin and Yang patterns for this condition, the use of Fuzi (Prepared Aconite Root) remains consistent. Nowadays, at the junction of the sixth and seventh months, people fail to distinguish between Cold and Damp, Yin and Yang, casually attributing it to Summerheat, exclusively using cold-natured herbs. When edema and diarrhea occur, they still claim the Summerheat toxin is unclarified and proceed with purgative treatments, continuing until the patient is killed by medical error, which is truly heartbreaking.)
In cases of Kidney deficiency, or after sexual intercourse, or when Cold Qi emanates from the Stomach, immediate abdominal pain and irritability occur; in severe cases, retraction of the scrotum leads to coma and death. Urgently moxa the Guan Yuan (CV-4) acupoint 100 moxibustions, and internally administer Jiangfu Tang (Ginger and Aconite Decoction) and Baoyuan Dan (Protect Origin Pill) to save one or two out of ten. If delayed, Qi will collapse; even moxibustion will be of no benefit. (Once the syndrome is accurately diagnosed, rescue must be swift; do not procrastinate, lest the patient reach a dead end.)