疫症小便自遗,非肾虚不约,乃热毒流于膀胱。其人必昏沉谵语,遗不自知。
诸病喘满,皆属于热。五脏生成篇曰∶上气喘嗽,厥在胸中,遏在手阳明、太阴。胸中者,太阴肺之分
也,手阳明大肠为肺之表,二经之邪热逆于胸中,则为喘嗽也。
黄者中央戊己之色,属太阴脾经。脾经挟热,不能下输膀胱,小水不利,经气郁滞,其传为疸。周身
如金矣。
(撮空同)
在伤寒列于不治,疫疹有此,肝经淫热也。肝属木,四肢属土,肝有邪热,淫于脾经,此木来克土,
木动风摇,土自不安。
狐惑之状,其人默默欲眠,起卧不安,目牵不闭。虫蚀其肛为狐,蚀于喉为惑。大抵病患内热食少,肠
胃空虚,三虫求食不得,蚀人五脏。当验其上、下唇,上唇有疮,虫蚀其喉,下唇有疮,虫蚀其肛。
先寒后战,寒极而战,杂症则谓元阳将脱之象,而疫则热毒盘踞于内,外则遍体炎炎。热极之症,是必投
以寒凉,火被水克,其焰必伏。火伏于内,必生外寒,阴阳相搏则战,一战而经气输泄,大汗而解矣。
以上五十二症,疫症恶候,变态无常。以下二十症,有因失治于前者,有因不谨于后者。
瘥后四肢浮肿,因大病脾土受伤,脾虚不能制水,饮食骤进,气血滋荣,流于四肢,夜则如常,日
则浮肿。脾健自愈,误用温补,反添蛇足。
火邪极盛而生痰,这是肺热的征象。至于痰中带血,则是热势达到极点的表现。
疫病出现小便失禁,并非因为肾虚导致膀胱约束无力,而是热毒流注于膀胱所致。患者必定神志昏沉、胡言乱语,且对自己遗尿毫无知觉。
各种疾病出现的喘息胀满,都归属于热证。《五脏生成篇》说:上气喘促咳嗽,病机在于胸中,阻滞于手阳明大肠经和手太阴肺经。胸中是手太阴肺经所主的部位,手阳明大肠经是肺的表里配合经络,这两条经脉的邪热逆乱于胸中,就会导致喘息咳嗽。
黄色是中央戊己土的颜色,归属于手太阴脾经。脾经夹带热邪,不能将水液向下输布至膀胱,导致小便不利,经气郁滞,病情传变发展为黄疸。全身皮肤就会像金子一样发黄。
(撮空理线)症状在伤寒病中被列为不治之症,但在疫疹病中出现,则是肝经淫热所致。肝属木,四肢属土,肝有邪热,淫溢侵犯脾经,这就是木来克土,木气动摇生风,土(脾胃/四肢)自然不安稳。
狐惑病的症状,表现为患者沉默嗜睡,坐卧不安,眼睛牵引不适而难以闭合。虫蚀肛门称为“狐”,蚀喉部称为“惑”。大抵是因为病患体内热盛、饮食减少,导致肠胃空虚,体内的三虫(寄生虫)求食不得,从而侵蚀人的五脏。应当检查其上、下嘴唇,如果上唇有疮疡,说明虫蚀喉部;如果下唇有疮疡,说明虫蚀肛门。
先感到寒冷随后发生寒战,这是寒极的表现,杂病中常称之为元阳即将脱失的征象,但疫病则是热毒盘踞在体内,体表却遍体发热如火。对于这种热极的病症,必须投用寒凉药物,火被水克制,火势必然潜伏。火伏于内,必然产生外部的寒象,阴阳相互搏结则发生寒战,经过一次寒战,经气得以输泄,大汗出后病愈。以上五十二种症状,是疫病的危重恶候,变化无常。以下二十种症状,有的是因为前期治疗失误造成的,有的是因为后期护理不谨慎导致的。
病愈后出现四肢浮肿,是因为大病之后脾土受伤,脾虚不能制约水湿,此时若饮食骤进,气血滋生荣养,流注于四肢,夜间则正常,白天则出现浮肿。脾气健运则自愈,误用温补药物,反而是画蛇添足。
Fire reaching its extreme generates phlegm, which is a sign of Lung heat. As for blood in the sputum, it is a manifestation of extreme heat.
In epidemic plague (Yi Zheng), spontaneous urination occurs not due to Kidney deficiency failing to control the bladder, but because toxic heat flows into the Bladder. The patient must be stuporous and delirious, unaware of the involuntary urination.
All diseases presenting with wheezing and fullness belong to Heat. The *Chapter on the Generation of the Five Zang Organs* states: "Wheezing and coughing from above, the pathogenesis lies in the chest, obstructed in the Hand-Yangming and Hand-Taiyin meridians." The chest is the domain of the Hand-Taiyin Lung meridian; the Hand-Yangming Large Intestine meridian is the exterior-interior pair of the Lung. When pathogenic heat from these two meridians rebels into the chest, it results in wheezing and coughing.
Yellow is the color of Central Wu-Ji Earth, belonging to the Hand-Taiyin Spleen meridian. If the Spleen meridian harbors heat, it cannot transport fluids downward to the Bladder, leading to difficult urination, stagnation of meridian Qi, and transmission into jaundice. The entire body becomes yellow like gold.
(The symptom of grasping at empty air) In cold damage (Shang Han), this is listed as an untreatable condition. However, in epidemic plague (Yi Zhen), it indicates excessive heat in the Liver meridian. The Liver belongs to Wood, and the four limbs belong to Earth. When the Liver has pathogenic heat that overflows into the Spleen meridian, this is Wood overcoming Earth. Wood moves and wind shakes, causing Earth to become unstable.
The presentation of Hu-Huo disease involves the patient being taciturn and desiring sleep, restless in sitting and lying, with eyes pulling uncomfortably and unable to close fully. Parasites eroding the anus constitute "Hu"; eroding the throat constitutes "Huo." Generally, patients have internal heat and poor appetite, leaving the intestines and stomach empty. The three parasites seek food but cannot find it, thus eroding the five Zang organs. One should examine the upper and lower lips: sores on the upper lip indicate parasites eroding the throat; sores on the lower lip indicate parasites eroding the anus.
Initial chills followed by rigors occur when cold reaches its extreme. In miscellaneous diseases, this is termed a sign of impending collapse of Primordial Yang. However, in epidemic plague, toxic heat lodges internally while the body surface burns with heat. For such extreme heat conditions, cold-cooling herbs must be administered. Fire is controlled by Water, so its flame must subside. When fire subsides internally, external cold necessarily arises. The struggle between Yin and Yang causes rigors; after one episode of rigors, meridian Qi is vented, and recovery follows with profuse sweating. The aforementioned fifty-two symptoms are malignant signs of epidemic plague, varying unpredictably. The following twenty symptoms arise either from prior mismanagement or subsequent negligence.
Post-illness edema of the four limbs occurs because the Great Illness injures Spleen Earth. Spleen deficiency fails to control water. If diet is suddenly increased, Qi and Blood nourish and flow into the four limbs. It appears normal at night but swollen during the day. Strengthening the Spleen leads to self-healing; mistakenly using warming tonification is superfluous and counterproductive.