黄帝针经曰。卫气者。所以温分肉。充皮肤。实腠理。司开阖者也。风邪中于卫也。则
必恶
其实
比之
帏帐之内。则舒缓而无所畏也。一或用扇。一或当风。淅淅然而恶。此为恶风者也。恶寒则
有属于阳者。有属于阴者。及其恶风则悉属于阳。非若恶寒之有
无恶风者此也。恶风虽悉在表。而发散又自不同。若有汗而恶风
里证虽具。而恶风未罢者。皆当先解其外也。又有发汗多而亡阳
盖以发汗多漏不止则亡阳。外不固。是以恶风也。必以桂枝加附
湿相搏。骨节烦疼。湿胜自汗而皮腠不密。是以恶风也。必以甘
由是观之。恶风属乎卫者可知矣。
歌括曰。病患卫中分入风。脉缓而浮是本宗。自与伤寒分两证。不堪例作一般攻。宜服
桂枝
恶风汗出怯风吹。脉缓而浮但解肌。发汗亡阳成漏者。温经之法莫迟缓。恶风者见风则
怯。
微解
在皮
阳。
桂枝
节间
伤寒恶寒者。风寒客于营卫之中也。惟其风寒客于营卫。则洒洒然恶寒也。惟其营卫之
受风
恶。
去衣者是也。寒热之寒
于向火被覆。而犹不能
一切恶寒属表。虽里
乃可攻里也。经曰
热。或未发热。凡恶寒者。必继之以发热。此则发于阳也。若恶寒而蜷。脉沉细而滑者。此
则发于阴也。在阳
出而恶寒者。则为
恶寒者。背者胸
为阴。阳气不足。阴
寒者。阴寒气盛可知
子汤者是也。又或乘
热。口燥渴。心烦。
气内陷。又何以明之
内陷则热烁津液。故
者。于口中之润燥可
歌括云。恶寒发热发于阳。阴病憎寒身体凉。解表桂枝并越婢。温中须索理中汤。
又论曰。发热微恶寒者。柴胡桂枝汤。桂枝二越婢一汤。发汗后。反恶寒者虚也。太阳
或发
桂
多属表
少阴恶
又云。汗后恶寒宜芍药汤。脉沉发热。四肢倦疼。仍燥下利。厥逆。四逆汤。发汗后。复热
脉准前单疾。根据前寒热者。再须看脉候如何。若还有表。重加汗之。里证下之即除。汗之
致使病家多下则失血。发汗则损气。损气则脉微。故恶寒也。四逆汤或芍药甘草附子汤。
血则脉涩。故发热也。苦葶苈酒汤。此皆仲景所谓不当汗下。而误汗下。故有此二证也。
恶寒者皆为表证。或里证备具而微恶寒者。是表犹未解。当先解表。俟不恶寒。然后可以
剂。温而散之。汗后反恶寒者为虚。芍药甘草附子汤。不得复发其汗。心下痞而恶寒者。表
未解
遇
背
《黄帝针经》说：卫气，是用来温养肌肉、充实皮肤、致密腠理、主管汗孔开阖的。风邪侵袭卫气，就会出现恶风的症状。这好比在帷帐之内，身体舒缓而没有畏惧；一旦用扇子扇风，或者对着风吹，就会感到淅淅沥沥般的寒冷而厌恶，这就是恶风。
恶寒则分为属于阳证和属于阴证两种情况。至于恶风，则全部属于阳证，不像恶寒那样有属于阴证的情况。虽然恶风都在表证，但发散治疗的方法又各不相同。如果有汗出且恶风，即使里证具备，只要恶风未止，都应当先解除表邪。又有因发汗过多导致亡阳的，大概是因为发汗过多，汗漏不止从而亡阳，体表不固，所以出现恶风。必须使用桂枝加附子汤（Cinnamon Twig and Aconite Decoction）。还有风湿相搏，骨节烦痛，湿气胜则自汗且皮腠不致密，所以出现恶风。必须使用甘草附子汤（Licorice and Aconite Decoction）。由此看来，恶风属于卫气病变是显而易见的。
歌诀说：病患卫分中入风邪，脉象缓而浮是本证特征。自然与伤寒分为两证，不可一概而论作同样攻治。适宜服用桂枝汤（Cinnamon Twig Decoction）。
恶风汗出怕风吹，脉缓而浮只需解肌。发汗亡阳成漏者，温经之法莫迟缓。恶风者见风则怯，微解在皮阳。
伤寒恶寒，是风寒客居于营卫之中。正因为风寒客于营卫，所以会洒洒然地感到寒冷。凡是恶寒，脱去衣服或靠近火源、覆盖被子仍不能缓解的，就是恶寒。一切恶寒都属于表证，虽然里证具备，也必须等到表解之后，才可攻里。经文说：发热，或者尚未发热，凡是恶寒的，必定随后出现发热，这是发于阳证。如果恶寒且身体蜷缩，脉象沉细而滑，这是发于阴证。在阳证方面……背为胸之府，阳气不足，阴寒盛可知。若是阴寒，阴寒气盛可知，如附子汤（Aconite Decoction）之类。又或者乘热，口燥渴，心烦，气内陷，又何以明之？内陷则热烁津液，故口中润燥可辨。
歌诀云：恶寒发热发于阳，阴病憎寒身体凉。解表桂枝并越婢汤（Yuebi Decoction），温中须索理中汤（Regulate the Middle Decoction）。
又论述说：发热微恶寒者，用柴胡桂枝汤（Bupleurum and Cinnamon Twig Decoction）、桂枝二越婢一汤（Two Parts Cinnamon Twig and One Part Yuebi Decoction）。发汗后，反而恶寒的是虚证。太阳病……多属表证。少阴病恶寒……又云：汗后恶寒宜用芍药甘草附子汤（Peony, Licorice, and Aconite Decoction）。脉沉发热，四肢倦疼，仍燥下利，厥逆，用四逆汤（Four Reversal Decoction）。发汗后，复热，脉准前单疾，根据前寒热者，再须看脉候如何。若还有表证，重加汗法；里证下之即除。汗之致使病家多下则失血，发汗则损气，损气则脉微，故恶寒也。四逆汤或芍药甘草附子汤。血则脉涩，故发热也。苦葶苈酒汤（Bitter Shepherd's Purse Wine Decoction）。此皆仲景所谓不当汗下，而误汗下，故有此二证也。
恶寒者皆为表证，或里证备具而微恶寒者，是表犹未解，当先解表，俟不恶寒，然后可以剂，温而散之。汗后反恶寒者为虚，芍药甘草附子汤，不得复发其汗。心下痞而恶寒者，表未解……遇……背……
The *Huangdi Zhenjing* (Yellow Emperor's Classic of Acupuncture) states: Wei Qi (Defensive Qi), which warms the flesh, fills the skin, consolidates the Cou Li (pores and interstices), and controls the opening and closing of pores. When Wind Evil invades Wei Qi, aversion to wind occurs. This is like being inside a tent; the body is relaxed and without fear. But if one uses a fan or faces the wind directly, feeling a chill as if rain were falling, this is aversion to wind.
Aversion to cold is divided into those belonging to Yang syndromes and those belonging to Yin syndromes. However, aversion to wind belongs entirely to Yang syndromes, unlike aversion to cold which can also belong to Yin. Although aversion to wind is always in the Exterior, the methods for dispersing it differ. If there is sweating and aversion to wind, even if Interior symptoms are present, as long as aversion to wind has not ceased, the Exterior must be resolved first. There are also cases where excessive sweating leads to the collapse of Yang Qi. This is because excessive sweating causes leakage that does not stop, leading to Yang collapse and failure of the exterior to consolidate, thus resulting in aversion to wind. One must use Guizhi Jia Fuzi Tang (Cinnamon Twig and Aconite Decoction). In cases where Dampness and Wind contend, causing severe pain in the bone joints, and Dampness prevails leading to spontaneous sweating and loose Cou Li, aversion to wind results. One must use Gancao Fuzi Tang (Licorice and Aconite Decoction). From this, it is evident that aversion to wind belongs to Wei Qi disorders.
The verse states: When patients have Wind entering the Wei level, the pulse is slow and floating, which is the fundamental characteristic. Naturally, this differs from Shanghan (Cold Damage) and constitutes two distinct syndromes; it cannot be treated identically. It is appropriate to administer Guizhi Tang (Cinnamon Twig Decoction).
Aversion to wind with sweating and fear of drafts, with a slow and floating pulse, requires only resolving the muscle layer. If sweating caused Yang collapse and persistent leakage, do not delay the method of warming the meridians. Those with aversion to wind feel timid when exposed to wind; slight resolution affects the skin and Yang.
In Shanghan, aversion to cold occurs because Wind-Cold lodges within Ying Qi (Nutritive Qi) and Wei Qi. Precisely because Wind-Cold lodges in Ying and Wei, there is a shivering sensation of cold. Any aversion to cold, where removing clothes or seeking warmth under blankets fails to alleviate it, is true aversion to cold. All aversion to cold belongs to the Exterior. Even if Interior symptoms are complete, one must wait until the Exterior is resolved before attacking the Interior. The Classics state: Regarding fever, or before fever appears, any aversion to cold will inevitably be followed by fever; this indicates onset in Yang. If there is aversion to cold accompanied by curling up, and the pulse is deep, fine, and slippery, this indicates onset in Yin. In Yang syndromes... The back is the mansion of the chest; insufficient Yang Qi implies excess Yin Cold, which can be known. For Yin Cold, excess Yin Cold is evident, such as in Fuzi Tang (Aconite Decoction). Or alternatively, taking advantage of heat, dry mouth and thirst, vexation, Qi sinking inward—how is this clarified? Sinking inward causes Heat to scorch Body Fluids, so the moisture or dryness in the mouth can distinguish it.
The verse says: Aversion to cold and fever indicate onset in Yang; Yin disease involves loathing cold and a cool body. To resolve the Exterior, use Guizhi Tang or Yuebi Tang (Yuebi Decoction); to warm the Middle, seek Lizhong Tang (Regulate the Middle Decoction).
Furthermore, it is discussed: Fever with slight aversion to cold calls for Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) or Guizhi Er Yuebi Yi Tang (Two Parts Cinnamon Twig and One Part Yuebi Decoction). After sweating, if aversion to cold appears instead, it is a deficiency syndrome. Taiyang disease... mostly belongs to the Exterior. Shaoyin disease aversion to cold... Also stated: After sweating, if aversion to cold persists, Shaoyao Gancao Fuzi Tang (Peony, Licorice, and Aconite Decoction) is suitable. If the pulse is deep with fever, limbs are weak and painful, still dry with diarrhea, and cold extremities, use Sini Tang (Four Reversal Decoction). After sweating, if fever recurs, and the pulse matches the previous rapidity, based on prior cold/heat patterns, one must re-examine the pulse. If Exterior signs remain, reinforce sweating; if Interior signs exist, purging removes them. Improper purging after sweating causes blood loss; improper sweating damages Qi. Damaged Qi leads to a faint pulse, hence aversion to cold. Use Sini Tang or Shaoyao Gancao Fuzi Tang. Blood stasis leads to a choppy pulse, hence fever. Kutongli Jiutang (Bitter Shepherd's Purse Wine Decoction). These are all cases where Zhang Zhongjing stated that sweating and purging were inappropriate, but due to mistaken treatment, these two syndromes arose.
Aversion to cold is always an Exterior syndrome. If Interior symptoms are complete but there is only slight aversion to cold, the Exterior has not yet resolved; one must first resolve the Exterior. Wait until aversion to cold ceases, then proceed with medication, warming and dispersing. If aversion to cold appears after sweating, it is deficiency; use Shaoyao Gancao Fuzi Tang, and do not induce sweating again. If there is epigastric fullness with aversion to cold, the Exterior has not resolved... encounter... back...