病在阳,应以汗解之,反以冷水 之,若灌之,其热被却不得去,弥更益烦,肉上粟起,意欲饮水,反
不渴者,服文蛤散;若不瘥者,与五苓散。身热皮粟不解,欲引衣自覆者,若水以 之洗之,益令热被却不得
出,当汗而不汗则烦。假令汗出已,腹中痛,与芍药三两,如上法。
太阳病,二日,反躁,反熨其背,而大汗出,大热入胃,胃中水竭,躁烦,必发谵语,十余日,振栗自下
利者,此为欲解也。故其汗从腰以下不得汗,欲小便不得,反呕欲失溲,足下恶风,大便硬,小盒饭数,而反
不数,及多,大便已,头卓然而痛,其人足心必热,谷气下流故也。
下之后,复发汗,昼日烦躁不得眠,夜而安静,不呕不渴,无表证,脉沉微,身无大热者,干姜附子汤主之。
发汗若下之,病仍不解,烦躁者,茯苓四逆汤主之。
伤寒,腹满谵语,寸口脉浮而紧,此肝乘脾也,名曰纵,刺期门。
伤寒,发热,啬啬恶寒者,大渴欲饮水,其腹必满,自汗出,小便利,其病欲解。此肝乘肺也,名曰横,
刺期门。
病患无表里证,发热七八日,虽脉浮数者,可下之。假令以下,脉数不解,合热则消谷善饥,至六七日,
不大便者,有瘀血,宜抵当汤。若脉数不解,而下不止,必协热便脓血也。
脉浮而芤,浮为阳,芤为阴,浮芤相抟,胃气生热,其阳则绝。
阳明病,反无汗,而小便利,二三日,呕而咳,手足厥者,必苦头痛,若不咳不呕,手足不厥者,头不痛。
阳明病,但头眩,不恶寒,故能食而咳,其人咽必痛,若不咳者,咽不痛。
病邪在表(阳分),本应通过发汗的方法解除,反而用冷水浇淋或喷洒,导致体内的热邪被冷水遏制而不能散发,患者更加烦躁不安,皮肤上出现鸡皮疙瘩,虽然感觉想喝水,但实际上并不口渴,这种情况应当服用文蛤散;如果服药后病情没有好转,则给予五苓散。身体发热、皮肤起粟粒状颗粒的症状仍未解除,患者想要拉过衣物覆盖身体以保暖,如果再用冷水清洗,只会使热邪被遏制而无法排出,本该出汗却出不了汗,从而导致烦躁。假如出汗之后,出现腹部疼痛,应当给予芍药三两,按照上述方法处理。
太阳病发病第二天,反而出现躁动不安,错误地用熨背法治疗,导致大汗淋漓,大热之邪内传入胃,胃中津液枯竭,出现躁动烦乱,必定发生胡言乱语。过了十多天,如果出现战栗并自行腹泻的情况,这是病情将要解除的征兆。所以,如果患者腰部以下没有汗出,想要小便却排不出,反而呕吐、有失禁尿液的倾向,脚底怕冷,大便干硬,小便次数多且量多,但后来反而不频数了,等到大便通畅后,头部突然感到疼痛,这是因为人体正气(谷气)向下流动,足心必然发热的原因。
经过泻下治疗后,又再次发汗,白天烦躁不能入睡,夜间却安静,没有呕吐和口渴,也没有表证,脉象沉而微弱,身体没有明显高热的,应当用干姜附子汤主治。
发汗或泻下治疗后,病邪仍未解除,出现烦躁症状的,应当用茯苓四逆汤主治。
伤寒病,腹部胀满、胡言乱语,寸口脉浮而紧,这是肝木乘袭脾土,称为“纵”,应当针刺期门穴。
伤寒病,发热、啬啬恶寒,极度口渴想喝水,腹部必然胀满,自汗出,小便通畅,这是病情将要解除的表现。这是肝木乘袭肺金,称为“横”,应当针刺期门穴。
患者没有表证也没有里证,发热七八天,即使脉象浮数,也可以使用攻下法。假如用了攻下法,脉数不解,邪热与体内积滞相合,导致消化食物过快、容易饥饿,到了第六七天,仍然不大便的,说明有瘀血,适宜用抵当汤。如果脉数不解,反而出现腹泻不止,必定是协热下利,导致大便脓血。
脉象浮而芤,浮脉属阳,芤脉属阴,浮芤两种脉象相互搏结,导致胃气生热,阳气因此隔绝不通。
阳明病,反而无汗,而小便通畅,两三天后,出现呕吐和咳嗽,手脚厥冷的,必定会遭受头痛之苦;如果不咳嗽、不呕吐,手脚不厥冷的,头部就不会痛。
阳明病,只是头晕目眩,不怕冷,能够进食并且咳嗽,患者的咽喉必定疼痛;如果不咳嗽的,咽喉就不会痛。
When the pathogen is in the exterior (Yang level), it should be resolved by sweating. However, if cold water is splashed or poured on the patient, the heat is suppressed and cannot escape, causing increased irritability and gooseflesh on the skin. Although the patient feels thirsty for water, there is no actual thirst; in this case, Wenli San (Clam Shell Powder) should be administered. If the condition does not improve, Wuling San (Five-Ingredient Poria Pill) should be given. If body heat and cutaneous gooseflesh persist and the patient desires to cover themselves with clothing, washing them with cold water will further suppress the heat, preventing its release. The failure to sweat leads to irritability. If sweating occurs subsequently and abdominal pain arises, Shaoyao (Paeoniae Radix Alba, 3 liang) should be administered according to the aforementioned method.
In Taiyang disease (Disease of the Taiyang Channel), on the second day, irritability appears unexpectedly. Incorrectly applying hot ironing to the back causes profuse sweating, allowing intense heat to enter the Stomach, depleting Stomach fluids. This results in restlessness and delirium. After more than ten days, if chills occur followed by spontaneous diarrhea, this indicates that the disease is about to resolve. Thus, if there is no sweating from the waist down, difficulty urinating, vomiting, a sensation of urinary incontinence, aversion to wind at the soles of the feet, hard stools, and frequent urination that later becomes less frequent, upon the passage of stool, sudden head pain may occur. This is because the Qi of grain (Gu Qi) flows downward, and the soles of the feet will feel warm.
After purgation and subsequent diaphoresis, if the patient experiences daytime irritability and insomnia but remains quiet at night, without vomiting or thirst, lacking exterior signs, with a deep and faint pulse, and no significant fever, Ganjiang Fuzi Tang (Ginger and Aconite Decoction) is indicated.
If diaphoresis or purgation fails to resolve the disease and irritability persists, Linggu Si Ni Tang (Poria and Four-Reversal Decoction) is indicated.
In Shanghan (Cold Damage), abdominal fullness and delirium accompanied by a floating and tight pulse at the Cun position indicate Liver Wood overacting on Spleen Earth, termed "Zong" (Vertical). Acupoint Qimen (LR14) should be punctured.
In Shanghan, symptoms include fever, mild aversion to cold, extreme thirst, abdominal fullness, spontaneous sweating, and free urination, indicating impending resolution. This represents Liver Wood overacting on Lung Metal, termed "Heng" (Horizontal). Acupoint Qimen (LR14) should be punctured.
A patient presents with neither exterior nor interior signs but has had fever for seven to eight days. Even if the pulse is floating and rapid, purgation may be used. If purgation is applied and the rapid pulse persists, combined heat may cause excessive hunger due to rapid digestion. By the sixth or seventh day, if constipation persists, blood stasis is present, and Didang Tang (Di Dang Decoction) is appropriate. If the rapid pulse persists and diarrhea ensues, it indicates heat-collateral dysentery with pus and blood in the stool.
A floating and hollow (Kou) pulse: Floating indicates Yang, while Hollow indicates Yin. When these two interact, Stomach Qi generates heat, leading to the isolation of Yang Qi.
In Yangming disease, absence of sweating with free urination, followed by vomiting, coughing, and cold extremities after two to three days, inevitably leads to severe headache. If there is no cough or vomiting, and extremities are not cold, the head will not hurt.
In Yangming disease, dizziness without aversion to cold, ability to eat, and coughing indicate inevitable throat pain. If there is no cough, there will be no throat pain.