(正名 论初感 论两感 六经形证治例 阴阳似证 阴阳毒 肾伤寒 汗吐下等可不可治法 变证
辨证大要 察脉大要 用药大法 伤寒方法)
经曰∶风寒客于人,使人毫毛毕直,皮肤闭而为热。又曰∶凡伤于寒,则为病热,热虽甚,不
死。若两感于寒而为病者,必死。伤寒者,霜降后至春分前感寒,即病之名也。冬时寒伏于肌骨,
春时随阳气升发,或复感寒邪,发为温病。经曰∶冬伤于寒,春为温病是也。三、四月病名晚发。
郁而至五、六月为热病。夏月壮热,不恶寒为中 。头疼胫冷,腹满为湿温。身热足冷,项强恶寒
,头摇口噤,身背反张为 证。春宜温而反寒,夏宜热而反凉,秋宜凉而反热,冬宜寒而反温,感
之为病名时气。有沿家
遍户,长幼病同者,名疫疠。不时有暴感风寒而病者,名感冒。又有冬温、温毒、寒疫、风湿等,
同类一十四证。凡身热无汗属寒邪,可用主方发汗;身热有汗属风与湿,可根据加减方止汗而愈。
有类伤寒四证∶如头疼发热,身不痛,气口脉盛,恶食欲吐者,食积也。不头疼,身痛恶寒,
或烦热时头痛不眠者,虚烦也。憎寒发热,不头疼项强,气急胸满,脉滑大者,寒痰也。发热憎寒
,呕绿色水,腿脚红光肿痛,甚而冲心作痛者,香港脚也(各有门类)。有恶寒拘急,饮食作呕,甚则
心烦,眩晕气急,脉浮紧者,肿毒、疔痈也。或内生肺痈、肠痈之类(根据外科治)。有因跌损闪挫亦发
热者,瘀血也。妇人经脉不行及阴虚血少等证,亦恶寒发热拘急,切宜分别。如伤寒误食伤人,诸
证误作伤寒,断其谷食,尤至伤人,慎之。
【正名 论初感 论两感 六经形证治例 阴阳似证 阴阳毒 肾伤寒 汗吐下等可不可治法 变证 辨证大要 察脉大要 用药大法 伤寒方法】
经文说:风寒邪气侵袭人体,使人毫毛竖立,皮肤毛孔闭塞而发热。又说:凡是受寒邪伤害,就会表现为热病,即使热势很严重,也不会死亡。如果是“两感于寒”(同时感受表里两经之寒邪)而发病的,必定死亡。所谓“伤寒”,是指在霜降之后到春分之前感受寒邪,随即发病的疾病名称。冬季寒邪潜伏在肌肤骨骼之间,到了春季随着阳气的升发,或者再次感受寒邪,从而引发温病。经文说:“冬伤于寒,春必温病”正是这个意思。三、四月发病的称为“晚发”。郁结至五、六月发病的称为“热病”。夏季出现高热,不恶寒的,称为“中暍”(中暑)。头痛小腿冷,腹部胀满的,称为“湿温”。身体发热但脚冷,颈项强直恶寒,头部摇动、牙关紧闭、身体向后反折僵硬的,称为“痉证”。春季本该温暖却反而寒冷,夏季本该炎热却反而凉爽,秋季本该凉爽却反而炎热,冬季本该寒冷却反而温暖,因感受这种非时之气而发病的,称为“时气”。如果一家一户接连感染,无论长幼症状相同的,称为“疫疠”。不时突然感受风寒而发病的,称为“感冒”。此外还有冬温、温毒、寒疫、风湿等,同类共有十四种证候。凡是身体发热且无汗的,属于寒邪,可以使用主方发汗;身体发热且有汗的,属于风邪或湿邪,可以根据加减方止汗而痊愈。
有类似伤寒的四种证候:如头痛发热,身体不痛,寸口脉盛,厌恶饮食想呕吐的,是食积。不头痛,身体疼痛恶寒,或者心烦发热时常头痛不能入睡的,是虚烦。憎寒发热,不头痛颈项强直,呼吸急促胸部胀满,脉象滑大的,是寒痰。发热憎寒,呕吐绿色水液,腿脚红肿光亮疼痛,严重时痛连心胸的,是香港脚(脚气病)(各有专门门类)。如果有恶寒拘急,饮食作呕,严重时心烦,眩晕气急,脉象浮紧的,是肿毒、疔疮痈疽(根据外科方法治疗)。有因跌打损伤、闪挫扭伤而发热的,是瘀血。妇女月经不通以及阴虚血少等证候,也会出现恶寒发热拘急,务必仔细分辨。如果伤寒误食了致病食物,或者其他证候误当作伤寒治疗,断绝谷食,尤其会伤害人体,务必谨慎。
[Standard Names, Discussion on Initial Infection, Discussion on Double-Striking Cold, Examples of Manifestations and Treatments for the Six Meridians, Yin-Yang Similar Syndromes, Yin-Yang Toxins, Kidney Cold Damage, Discussable and Non-Discussable Methods of Sweating, Vomiting, and Purging, Changed Syndromes, Essentials of Syndrome Differentiation, Essentials of Pulse Examination, General Principles of Medication, Methods for Cold Damage]
The Classic states: When wind-cold pathogens invade the human body, they cause the fine hairs to stand erect, the skin pores to close, and heat to arise. It also states: Whenever one is injured by cold, it manifests as a heat disease; even if the heat is severe, death does not ensue. However, if one suffers from "double-striking cold" (simultaneous invasion of exterior and interior meridians by cold), death is inevitable. "Cold damage" refers to the disease contracted immediately after exposure to cold between the Frost Descent solar term and the Spring Equinox. In winter, cold lies latent in the muscles and bones; in spring, following the rising of yang qi, or upon re-exposure to cold pathogens, warm diseases are triggered. The Classic states: "Injury by cold in winter leads to warm diseases in spring." This is exactly what is meant. Diseases manifesting in the third and fourth months are named "late onset." Those郁结 (stagnant) until the fifth and sixth months are named "heat diseases." Summer fevers with high heat but no aversion to cold are termed "Zhong Yue" (Heatstroke). Headache with cold calves and abdominal fullness is termed "Damp-Warmth." Body heat with cold feet, neck stiffness with aversion to cold, head shaking, jaw clenching, and opisthotonos (backward arching of the body) are termed "Jing Syndrome" (Spasm). If spring should be warm but is cold, summer hot but cool, autumn cool but hot, and winter cold but warm, illness caused by such non-seasonal qi is named "Shi Qi" (Seasonal Qi Epidemic). If infection spreads through households, affecting all ages with identical symptoms, it is named "Yi Li" (Plague/Epidemic). Sudden onset of illness due to abrupt exposure to wind-cold is named "Gan Mao" (Common Cold). Additionally, there are Winter Warmth, Warm Toxin, Cold Epidemic, Wind-Dampness, etc., totaling fourteen syndromes of the same category. Generally, body heat without sweating belongs to cold pathogens and can be treated with the main formula to induce sweating; body heat with sweating belongs to wind or dampness and can be cured by stopping sweat according to modified formulas.
There are four syndromes resembling cold damage: Headache and fever with no body pain, flourishing pulse at the cunkou (radial artery), aversion to food, and desire to vomit indicate Food Stagnation. No headache, body pain with aversion to cold, or irritability with fever, frequent headaches, and insomnia indicate Deficient Irritability. Aversion to cold with fever, no headache or neck stiffness, rapid breathing, chest fullness, and slippery-large pulse indicate Cold Phlegm. Fever with aversion to cold, vomiting green water, red and swollen painful legs and feet, and pain radiating to the heart when severe indicate Hong Kong Foot (Beriberi/Foot Qi) (each has its own category). Aversion to cold with rigidity, vomiting after eating, severe irritability, dizziness, rapid breathing, and floating-tight pulse indicate Swelling Toxins, Ding Sores, or Carbuncles (treat according to surgical methods). Fever arising from falls, injuries, or sprains indicates Blood Stasis. Women with amenorrhea or yin deficiency and blood insufficiency may also present with aversion to cold, fever, and rigidity; these must be carefully distinguished. If cold damage patients mistakenly consume pathogenic food, or other syndromes are mistaken for cold damage and grain/food intake is cut off, it causes further harm to the body; caution is advised.