阳毒∶受恶毒之气,入于阳经,或失汗下,或热病误热药。其证大热,咽疼发斑,面赤谵语,
脉洪,宜阳毒升麻汤、青黛一物汤。咽痛,玄参升麻汤、三黄巨胜汤。甚至舌卷焦黑,鼻孔如煤,
宜水渍法。五日治,七日不治。
阴毒∶受深重之寒,伏于肾经,致阴气独盛。其证腹痛下利,咽闭呕逆,唇青面黑,手足厥冷
,身如被杖,短气难息,六脉沉微,宜服甘草汤、真武汤兼葱熨法、熏法,灸关元百壮。三日后不可治。
少阴咽痛,伏气病,三名一证也。因冬月受寒,伏于少阴肾经,或太阳传入,或感暴寒,多发
于春。本经循喉咙,挟舌本,故咽痛,后必下利,屡有误为火病,服凉药杀人,先宜甘桔汤(寒热皆
效)加玄参服。如觉恶寒拘急,服参苏饮,倍甘、桔,取微汗安。口疮赤烂,宜升麻六物汤之类。
可汗(失汗邪不出,变生为诸病)∶寒邪在表,头疼骨痛,发热恶寒,脉浮。一日至十三日或多
日,略有前证,皆宜主方随轻重发表。少阴脉沉身痛,麻黄附子细辛汤发汗,切勿太过。
不可汗(不宜汗而汗,夺血竭津液)∶因风暑湿,自有汗,勿再汗。脐上下左右有动气;疮家、衄
血、咽闭口疮、泻利清谷、妇人经行、小便淋涩,皆宜小柴胡加减和解。
可下(阳毒等证,失下伤人)∶热邪在里,大渴舌苔,大便秘,绕脐硬痛,协热自利,肢温,六乙
顺气汤下。结胸,大陷胸汤。
不可下(不当下而下,邪入损真气)∶凡有表证,无里证,小便涩,四肢冷,咽闭呕吐,有汗
,脐上下左右有动气,犯此而有下证,大柴胡汤微下。虚、老,黄龙汤。
可吐(痰食宜吐)∶初病有食,淡盐汤吐。气滞有痰,稀涎散吐。
不可吐(无食痰,伤胃气)∶伤风有汗,四肢冷,虚人皆忌。
可温(益火之源,以消阴翳)∶阴寒盛,脉沉迟,下利腹满身痛,发热,脉反沉,阴毒呃逆,四逆
汤。少阴寒呕,理中汤。
不可温(诸阳热,证似阴寒)∶脉虽沉而数,先头痛大热,后肢冷,禁温。
可补(邪出正虚)∶脉弱气虚,汗多肢冷,独语郑声,不眠不食,皆宜补。
不可补(余邪未尽)∶脉实头痛,身热,大渴舌苔,便秘,下利秽水,腹满。
可和解(大势已平)∶无汗、吐、下证,惟往来寒热,胸未清,宜小柴胡汤。
未可和解(表里未尽)∶表证未罢,里证犹甚,防风通圣散合六一散。
可水(以水济火)∶但要病患自思水饮,问欲几何,惟与其半饮之。
不可水(不思而与,水停心下)∶强与则成水结胸,阴证似阳,虽思不能饮。
阳毒:感受恶毒之气,侵入阳经,或因该发汗、攻下而未发汗、攻下,或热病误服热性药物所致。其症状表现为高热,咽喉疼痛,皮肤出现斑疹,面色红赤,胡言乱语,脉象洪大。适宜使用阳毒升麻汤、青黛一物汤。若伴有咽痛,可使用玄参升麻汤、三黄巨胜汤。甚至出现舌体卷缩、焦黑,鼻孔颜色如煤烟般黑,适宜采用水渍法治疗。发病五日内可治,七日以上则难以治愈。
阴毒:感受深重的寒邪,潜伏于肾经,导致阴气独盛。其症状表现为腹痛、腹泻,咽喉闭塞、呕吐逆气,嘴唇发青、面色发黑,手足厥冷,身体感觉如同被棍棒打过一般疼痛,呼吸短促且困难,六部脉象均沉微无力。适宜服用甘草汤、真武汤,并配合葱熨法、熏法,以及灸关元穴一百壮。发病三日之后则不可治愈。
少阴咽痛,属于伏气病,名称虽有三处不同,但实为同一证候。因冬季感受寒邪,潜伏于少阴肾经,或由太阳经传入,或感受暴寒,多在春季发作。足少阴肾经循行经过喉咙,挟持舌根,因此出现咽痛,随后必然出现腹泻。屡次有人误认为是火病,服用凉药导致患者死亡。起初适宜服用甘桔汤(寒证热证皆有效)加玄参服用。如果感到恶寒、肢体拘急,可服用参苏饮,加倍使用甘草和桔梗,取微汗以安愈。若出现口疮、红肿溃烂,适宜使用升麻六物汤之类的方剂。
可以发汗的情况(失于发汗则邪气不出,变生各种疾病):寒邪在体表,出现头痛、骨节疼痛,发热、恶寒,脉象浮。从发病一日至十三日或更久,只要略有上述症状,都适宜根据病情轻重,使用主方发表散邪。少阴病见脉沉、身痛,用麻黄附子细辛汤发汗,切勿发汗太过。
不可以发汗的情况(不宜发汗而强行发汗,会耗伤血液、枯竭津液):因风、暑、湿邪致病,本身已有汗出,不要再发汗。脐部上下左右有动气;疮疡患者、鼻衄血者、咽喉闭塞及口疮者、腹泻完谷不化者、妇女月经期间、小便淋沥涩痛者,都适宜用小柴胡汤加减进行和解治疗。
可以攻下的情况(阳毒等证候,失于攻下会伤害人体):热邪在体内,大渴、舌苔厚腻,大便秘结,绕脐硬痛,协热自利(热性腹泻),四肢温暖,可用六乙顺气汤攻下。若为结胸证,用大陷胸汤。
不可以攻下的情况(不应当攻下而攻下,会使邪气内入损伤真气):凡是有表证,没有里证,小便涩滞,四肢冰冷,咽喉闭塞呕吐,有汗出,脐部上下左右有动气,即使犯了这些禁忌却又有下证(需要攻下的指征),宜用大柴胡汤轻微攻下。对于虚证、年老体弱者,用黄龙汤。
可以催吐的情况(痰食停滞适宜催吐):初病时有饮食积滞,用淡盐汤催吐。气滞且有痰涎,用稀涎散催吐。
不可以催吐的情况(无食无痰,催吐会损伤胃气):伤风有汗出,四肢冰冷,体质虚弱者,都忌用催吐法。
可以用温法的情况(补益火之源,以消除阴寒之翳障):阴寒盛,脉象沉迟,腹泻、腹部胀满、身体疼痛,发热但脉象反而沉,阴毒呃逆,用四逆汤。少阴病寒性呕吐,用理中汤。
不可以用温法的情况(诸阳热证,症状类似阴寒):脉象虽然沉但数,先出现头痛、大热,后出现四肢冰冷,禁止使用温法。
可以用补法的情况(邪气已去,正气虚弱):脉弱、气虚,汗多、四肢冰冷,独自说话且声音低微(郑声),失眠、不想进食,都适宜用补法。
不可以用补法的情况(余邪未尽):脉实、头痛,身热,大渴、舌苔厚腻,便秘,腹泻排出秽臭污水,腹部胀满。
可以用和解法的情况(大势已平):没有无汗、呕吐、攻下的证候,只有往来寒热,胸中未清畅,适宜用小柴胡汤。
尚未可用和解法的情况(表里之邪未尽):表证未罢,里证仍然严重,用防风通圣散合六一散。
可以用水疗/饮水调节的情况(以水济火):只要病人自己想喝水,询问想喝多少,只给他一半的量让他喝。
Yang Poison: Contracting evil toxic qi, entering the Yang meridians, or due to failure to induce sweating or purge when indicated, or misusing hot herbs in febrile diseases. Its manifestations include high fever, sore throat, eruption of macules on the skin, red face, delirium, and a flooding pulse. It is suitable to use Yang Du Shengma Decoction (Cinnabar and Corydalis Decoction for Yang Poison) or Qing Dai Yi Wu Tang (Indigo Naturalis Single Herb Decoction). If accompanied by sore throat, Xuan Shen Shengma Tang (Scrophulariae Radix and Cimicifugae Rhizoma Decoction) or San Huang Ju Sheng Tang (Three Yellows and Sesame Decoction) may be used. In severe cases where the tongue curls and turns scorched black, and the nostrils appear coal-black, water immersion therapy is suitable. Treatment within five days is curable; after seven days, it is incurable.
Yin Poison: Contracting deep and heavy cold pathogens, lying dormant in the Kidney meridian, causing Yin qi to prevail exclusively. Its manifestations include abdominal pain and diarrhea, throat obstruction with vomiting and regurgitation, cyanotic lips and dark complexion, cold extremities, body pain as if beaten by a stick, shortness of breath and difficulty breathing, and sinking-micro pulses in all six positions. It is suitable to take Gan Cao Tang (Licorice Decoction) and Zhen Wu Tang (True Warrior Decoction), combined with Cong Wei Fa (Green Onion Moxibustion/Warming Therapy) and fumigation methods, and moxibustion on Guanyuan (CV4) for one hundred moxa cones. After three days, it is incurable.
Shaoyin Sore Throat belongs to Fuqi Disease (Latent Qi Disease); although there are three names, it is essentially one syndrome. It arises from contracting cold in winter, which lies dormant in the Shaoyin Kidney meridian, transmits from the Taiyang meridian, or results from sudden exposure to cold, often occurring in spring. The Shaoyin meridian traverses the throat and attaches to the root of the tongue, hence sore throat occurs, followed inevitably by diarrhea. It has frequently been mistaken for Fire disease, leading to death from administering cooling herbs. Initially, Gan Jie Tang (Licorice and Platycodon Decoction) [effective for both cold and heat syndromes] with added Xuan Shen (Scrophulariae Radix) is suitable. If chills and stiffness are felt, Shen Su Yin (Ginseng and Perilla Drink) with doubled Gan Cao (Licoricae Radix et Rhizoma) and Jie Geng (Platycodi Radix) should be taken to induce slight sweating for relief. For mouth ulcers with redness and erosion, Sheng Ma Liu Wu Tang (Cimicifugae Rhizoma Six-Ingredient Decoction) or similar formulas are suitable.
Sweating Indicated (Failure to sweat allows pathogen retention, generating various diseases): Cold pathogen in the exterior presents with headache, bone pain, fever, aversion to cold, and floating pulse. From one day to thirteen days or longer, provided these symptoms persist slightly, the main formula should be used according to severity to release the exterior. For Shaoyin presenting with sinking pulse and body pain, Ma Huang Fu Zi Xi Xin Tang (Ephedra, Aconite, and Asarum Decoction) is used to induce sweating; excessive sweating must be avoided.
Sweating Contraindicated (Inappropriate sweating depletes blood and dries fluids): Due to Wind, Summerheat, or Dampness, where sweating already exists, do not induce further sweating. Pulsatile sensations above, below, left, or right of the umbilicus; patients with sores/ulcers, epistaxis, throat obstruction and mouth ulcers, diarrhea with undigested food, women during menstruation, and dysuria with dribbling and astringency, are all suitable for Xiao Chai Hu Tang (Minor Bupleurum Decoction) modified for harmonization.
Purging Indicated (Failure to purge in Yang Poison etc. harms the body): Heat pathogen in the interior presents with intense thirst, coated tongue, constipation, hard and painful abdomen around the navel, diarrhea with heat, warm limbs, treated with Liu Yi Shun Qi Tang (Six Yi Qi-Regulating Decoction). For Jie Xiong (Chest Binding/Fixed Mass), Da Xian Xiong Tang (Major Chest-Binding Decoction) is used.
Purging Contraindicated (Inappropriate purging allows pathogen entry and damages True Qi): Whenever there are exterior signs without interior signs, astringent urine, cold limbs, throat obstruction with vomiting, sweating, and pulsatile sensations around the umbilicus, even if lower indications exist, Da Chai Hu Tang (Major Bupleurum Decoction) should be used for mild purging. For deficiency and elderly patients, Huang Long Tang (Yellow Dragon Decoction) is used.
Emesis Indicated (Phlegm and food stagnation require emesis): Early illness with food stagnation is treated with light salt water emesis. Qi stagnation with phlegm is treated with Xi Xian San (Thin Saliva Powder) for emesis.
Emesis Contraindicated (No food/phlegm; emesis damages Stomach Qi): Wind strike with sweating, cold limbs, and deficient constitutions are all contraindications for emesis.
Warming Indicated (Tonifying the source of Fire to eliminate Yin shadows): Excessive Yin-cold, sinking-slow pulse, diarrhea, abdominal fullness, body pain, fever with a paradoxically sinking pulse, Yin Poison hiccups, treated with Si Ni Tang (Frigid Extremities Decoction). Shaoyin cold vomiting is treated with Li Zhong Tang (Regulate the Middle Decoction).
Warming Contraindicated (Yang-Heat syndromes mimicking Yin-Cold): Although the pulse is sinking, if preceded by headache and high fever followed by cold limbs, warming is prohibited.
Tonification Indicated (Pathogen expelled, Zheng-Qi deficient): Weak pulse, Qi deficiency, profuse sweating, cold limbs, isolated murmuring (Zheng Sheng), insomnia, and anorexia are all suitable for tonification.
Tonification Contraindicated (Residual pathogen not yet cleared): Full pulse, headache, body heat, intense thirst, coated tongue, constipation, diarrhea of foul fluid, and abdominal fullness.
Harmonization Indicated (Major pathogenic factors resolved): Absence of no-sweat, emetic, or purgative signs, only alternating chills and fever, and unclear chest, are suitable for Xiao Chai Hu Tang (Minor Bupleurum Decoction).
Harmonization Not Yet Indicated (Exterior and Interior not fully cleared): Exterior signs unresolved, interior signs still severe, treated with Fang Feng Tong Sheng San (Saposhnikovia Releasing the Exterior Powder) combined with Liu Yi San (Six-to-One Powder).
Water Therapy/Drinking Indicated (Using Water to counteract Fire): Only if the patient desires to drink water, ask how much they want, and give them only half that amount to drink.
Water Therapy/Drinking Contraindicated (Forcing water when not desired leads to Water accumulation in the Heart area): Forcing water intake leads to Shui Jie Xiong (Water-bound Chest Binding); in Yin syndromes resembling Yang, although the patient may desire to drink, they cannot actually drink.