太阳寒水,内属膀胱,故脉来浮紧,外证头疼发热,腰脊强,惟服平胃散,至六七日,出汗而愈。盖胃气
不虚,传遍经络自愈也。仲景以为阳证,乃与凉药随经而解,反攻出他病,甚者变为阴证,六脉沉细,发厥而
死,急灸关元,乃可复生。如本经至六七日发战者,欲作解而阳气少也,服姜附汤出汗而愈。(仲景圆机活法,
论中救误者甚多,何尝能误人哉!其误人者,乃后人误用仲景法而误之耳,于仲景何尤。)
阳明燥金内属于胃,六脉浮紧而长,外证目痛发热,手足温,呻吟不绝,服当归柴胡汤、平胃散。仲景反
言热深厥亦深,此误也。若果发昏厥,两目枯陷不能升者,急灸中脘五十壮,渐渐省人事,手足温者生,否则
死。(仲景厥阴证中,有厥热多寡之论,不过验邪正之进退,察阴阳之消长,示人为治之活法,无偏无倚,何
误之有。)
太阴湿土内属于脾,其脉弦紧,外证不呻吟,四肢不痛,身不甚热,时自汗自利,手足冷多痰唾,服保元
丹、姜附汤,十日后汗出而愈。(此证温治若早,愈亦甚速,稍不审察,害人亦易。)又一证发黄生紫斑,咽
干燥噫气者,此名阴燥、阴黄,服钟乳粉,十日后汗出而愈。庸医或误认阳证,凉之即死。
少阴君火内属于肾,其脉弦大,外证肢节不痛,不呻吟,但好睡,足指冷,耳聋、口干、多痰唾,身生赤
黑靥,时发噫气,身重如山,烦躁不止。急灸关元三百壮,内服保元丹、姜附汤,过十日汗出而愈。若作阳证,
误服凉药,以致发昏谵语,循衣摸床,吐血脉细,乃真气虚,肾水欲涸也。仲景反曰∶急下之,以救肾水,此
误也。真气既虚,反用凉药,以攻其里,是促其死也。急灸关元三百壮,可保无虞。(少阴本热标寒而又中见
太阳,本热之证,固不易治,况标阴为病,千头万绪,变态百出,令人接应不暇。然只在初时体察真切,用灸
用温,亦非难事。良由初着一错,贻误到底,害人不少。至若无本热,而又无中见之太阳,一派阴寒,必死无
疑。或速灸关元,重投丹附,亦在于觉之早,庶望其生。少阴误治而变诸败逆证,诚为费手。先生之论,专属
形脏,故尚温补;仲景之论,惟言气化,故主承制。然论中用温者多,下者不过数条而已,况标本气化,今古
难明,非神于仲景之法者不能,倘于急下证而误温,杀人反掌;急温证而误下,冤沉海底。嗟!嗟!医之为道
诚难矣。)
太阳寒水之气,内应于膀胱,所以脉象表现为浮紧,外部症状为头痛、发热、腰脊僵硬,只需服用平胃散,到了第六七日,通过出汗即可痊愈。这是因为胃气不虚,病邪传遍经络后自然自愈。张仲景将其视为阳证,给予凉性药物随经而解,反而攻伐导致其他疾病产生,严重的转变为阴证,六脉沉细,出现四肢厥冷而死,此时急需艾灸关元穴,才可以恢复生机。如果本经到了第六七日出现战栗,这是正气欲驱邪外出但阳气不足的表现,服用姜附汤出汗即可痊愈。(张仲景的圆机活法,在《伤寒论》中关于救治误治的论述非常多,何曾能误人呢!那些误人的,是后人错误地运用张仲景的方法才导致的错误,这与张仲景本人有什么过错呢。)
阳明燥金之气,内应于胃,六脉浮紧而长,外部症状为目痛、发热、手足温暖、呻吟不止,服用当归柴胡汤和平胃散。张仲景反而说热深厥亦深,这是错误的。如果真的出现昏厥,两眼枯陷不能抬起的,急需艾灸中脘穴五十壮,逐渐神志清醒,手足温暖的可以存活,否则死亡。(张仲景在厥阴证中有厥与热多少的论述,不过是验证邪正进退,观察阴阳消长,展示给人治疗的灵活方法,没有偏颇倚靠,有什么错误呢。)
太阴湿土之气,内应于脾,其脉弦紧,外部症状为不呻吟,四肢不痛,身体不甚热,时常自汗、自利,手足寒冷多痰唾,服用保元丹、姜附汤,十日后出汗而痊愈。(此证若早期温治,痊愈也非常迅速,稍有不仔细审查,害人也容易。)又一证见发黄生紫斑,咽干燥、打嗝气的,这名叫阴燥、阴黄,服用钟乳粉,十日后出汗而痊愈。庸医有时误认为阳证,用凉药治疗即刻致死。
少阴君火之气,内应于肾,其脉弦大,外部症状为肢节不痛,不呻吟,只是嗜睡,脚趾冷,耳聋、口干、多痰唾,身上生赤黑色疮疡,时常打嗝气,身体沉重如山,烦躁不止。急需艾灸关元穴三百壮,内服保元丹、姜附汤,过十日出汗而痊愈。如果当作阳证,误服凉药,以致出现昏乱谵语,循衣摸床,吐血脉细,这是真气虚,肾水将要枯竭。张仲景反而说:急下之,以救肾水,这是错误的。真气既然虚弱,反而用凉药攻伐其里,这是加速其死亡。急需艾灸关元穴三百壮,可以保证无忧虑。(少阴本热标寒而又中见太阳,本热之证,本来就不易治疗,何况标阴为病,千头万绪,变态百出,令人接应不暇。然而只要在初时体察真切,用灸用温,也不是难事。良由起初错了一步,贻误到底,害人不小。至于如果没有本热,又没有中见的太阳,一派阴寒,必死无疑。或者速灸关元,重投丹附,也在于觉察得早,庶几希望其生存。少阴误治而变诸败逆证,确实费手。先生的论述,专属形脏,所以崇尚温补;张仲景的论述,惟言气化,所以主承制。然而在论中用温的多,用下的不过几条而已,况且标本气化,今古难明,不是精通张仲景之法的人不能做到,如果在急下证上误用温法,杀人反掌之间;在急温证上误用下法,冤沉海底。唉!唉!医学之道确实很难啊。)
Taiyang Cold Water (Taiyang Cold Water, the physiological association of Taiyang with cold and water properties) internally corresponds to the Bladder (Bladder), thus the pulse comes as floating and tight (Floating-Tight Pulse). The external manifestations include headache (Headache), fever (Fever), and stiffness of the waist and spine (Stiffness of Waist and Spine). One need only administer Pingwei San (Pingwei Powder) [1]. By the sixth or seventh day, recovery occurs through sweating. This is because if Stomach Qi (Stomach Qi) is not deficient, the pathogen transmits through the meridians and heals itself. Zhang Zhongjing considered this a Yang Syndrome (Yang Syndrome), and administered cooling medicines to resolve it along the meridian; however, this counter-attacked and induced other diseases. In severe cases, it transformed into a Yin Syndrome (Yin Syndrome), characterized by six pulses being deep and fine (Deep-Fine Pulse), leading to death from cold limbs (Cold Limbs). Urgent moxibustion at Guanyuan (CV-4) can restore life. If the disease in its own meridian presents with shivering on the sixth or seventh day, it indicates an attempt at resolution but insufficient Yang Qi (Yang Qi); administering Jiangfu Tang (Ginger and Aconite Decoction) leads to recovery through sweating. (Zhang Zhongjing's flexible and adaptive methods are extensively discussed in his treatises regarding the correction of errors; how could they ever mislead people? Those who mislead are those who later misuse Zhang Zhongjing's methods, not Zhang Zhongjing himself.)
Yangming Dry Metal (Yangming Dry Metal, the physiological association of Yangming with dryness and metal properties) internally corresponds to the Stomach (Stomach). The six pulses are floating, tight, and long (Long Pulse). External manifestations include eye pain (Eye Pain), fever (Fever), warmth of the hands and feet (Warmth of Hands and Feet), and incessant groaning (Groaning). Administer Danggui Chaihu Tang (Angelica and Bupleurum Decoction) and Pingwei San (Pingwei Powder). Zhang Zhongjing stated that "the deeper the heat, the deeper the cold limbs," which is an error here. If one truly experiences coma and fainting (Coma and Fainting) with sunken eyes that cannot lift, urgent moxibustion at Zhongwan (CV-12) for fifty moxa cones should be performed. Gradual return of consciousness and warmth of the hands and feet indicate survival; otherwise, death ensues. (In the Jueyin Syndrome (Jueyin Syndrome) chapter, Zhang Zhongjing discusses the ratio of cold limbs to fever merely to verify the advance and retreat of pathogens versus healthy qi, and to observe the waxing and waning of Yin and Yang (Yin and Yang), demonstrating flexible treatment methods without bias. Where is the error?)
Taiyin Damp Earth (Taiyin Damp Earth, the physiological association of Taiyin with dampness and earth properties) internally corresponds to the Spleen (Spleen). Its pulse is string-tight (String-Tight Pulse). External manifestations include no groaning, no limb pain, body not significantly hot, spontaneous sweating (Spontaneous Sweating), spontaneous diarrhea (Spontaneous Diarrhea), cold hands and feet with excessive phlegm and saliva (Excessive Phlegm and Saliva). Administer Baoyuan Dan (Baoyuan Pill) and Jiangfu Tang (Ginger and Aconite Decoction). Recovery occurs through sweating after ten days. (If this syndrome is treated with warming methods early, recovery is very rapid; slight lack of careful examination can easily harm people.) Another syndrome involves yellowing of the skin (Jaundice) with purple spots, dry throat, belching (Belching). This is named Yin Dryness (Yin Dryness) and Yin Jaundice (Yin Jaundice). Administer Zhongru Fen (Zeolite Powder). Recovery occurs through sweating after ten days. Quack doctors sometimes mistake this for a Yang Syndrome (Yang Syndrome) and administer cooling medicines, causing immediate death.
Shaoyin Ministerial Fire (Shaoyin Ministerial Fire, the physiological association of Shaoyin with ministerial fire) internally corresponds to the Kidney (Kidney). Its pulse is string-large (String-Large Pulse). External manifestations include no joint pain, no groaning, but preference for sleep (Somnolence), cold toes, deafness (Deafness), dry mouth (Dry Mouth), excessive phlegm and saliva (Excessive Phlegm and Saliva), red-black sores on the body (Red-Black Sores), frequent belching (Belching), body heaviness like a mountain (Body Heaviness), and incessant irritability (Irritability). Urgent moxibustion at Guanyuan (CV-4) for three hundred moxa cones, combined with internal administration of Baoyuan Dan (Baoyuan Pill) and Jiangfu Tang (Ginger and Aconite Decoction), leads to recovery through sweating after ten days. If mistaken for a Yang Syndrome (Yang Syndrome) and cooling medicines are mistakenly taken, resulting in delirious speech (Delirium), picking at bedclothes (Picking at Bedclothes), vomiting blood (Hematemesis), and fine pulse (Fine Pulse), this indicates deficiency of True Qi (True Qi) and impending exhaustion of Kidney Water (Kidney Water). Zhang Zhongjing stated: "Urgently purge to save Kidney Water," which is an error. Since True Qi (True Qi) is already deficient, using cooling medicines to attack the interior accelerates death. Urgent moxibustion at Guanyuan (CV-4) for three hundred moxa cones ensures safety. (Shaoyin has Heat as its root and Cold as its surface, while simultaneously interacting with Taiyang. Root Heat syndromes are inherently difficult to treat; moreover, Surface Cold syndromes present with myriad complexities and variations, overwhelming the practitioner. However, if accurately assessed at the onset, using moxibustion and warming methods is not difficult. The tragedy lies in making an initial error, leading to fatal consequences throughout. If there is no Root Heat and no interaction with Taiyang, presenting purely as Yin Cold, death is certain. Or, if Guanyuan is moxibusted quickly and heavy doses of Baoyuan Dan and Aconite are given, survival depends on early detection. Treating Shaoyin incorrectly leading to various failure syndromes is indeed challenging. Mr. Dou's theory focuses on Form Zang Organs (Form Zang Organs), hence advocating warming and tonification; Zhang Zhongjing's theory focuses on Qi Transformation (Qi Transformation), hence emphasizing controlling mechanisms. However, in his treatise, warming methods are used frequently, while purging methods appear only in a few clauses. Furthermore, Root/Surface and Qi Transformation concepts are hard to clarify across ancient and modern times, requiring mastery of Zhang Zhongjing's methods. Mistaking a Purge-indication for Warming kills instantly; mistaking a Warm-indication for Purging sinks one into the abyss. Alas! The medical profession is truly difficult.)