热病一日,病在太阳。太阳主表,表谓皮肤也。病在皮肤之间,故头项腰脊疼痛。
热病二日,阳明受病。病在肌肉,故肉热鼻干不得眠。故可摩膏火炙发汗而愈。
热病三日,少阳受病。诸阳相传病讫,病犹在表,未入于脏,故胸胁热而耳聋。故可发
汗而愈。
热病四日,太阴受病。太阴者,三阴之首也。三阳受病讫,传入于阴,故毒瓦斯已入胸膈
。其病喉干腹满,故可吐而愈。
热病五日,少阴受病。毒瓦斯入腹内,其病口舌干而引饮。故可下而愈。
热病六日,厥阴受病。毒瓦斯入肠胃,其人烦满而阴缩,故可下而愈。
热病七日,三阴三阳传病讫,病法当愈,今病不除者,欲为再经病也。再经者,谓经络
重受病也。
此谓得病三日已还,病法在表,故宜发汗。或病已经五六日,然其人喉口不焦干,心腹
不满,又不引饮,但头痛,身体壮热,脉洪大者,此为病证在表,未入于脏。故虽五六日,
犹须解肌发汗,不可苟根据日数,辄取吐下。
此由阳胜于阴,热气独盛,痞结于脏,则三焦隔绝,故身热而烦也。
夫热病 疮者,此由表虚里实,热气盛则发疮,重者周匝遍身。若疮色赤、头白、则毒
轻,色紫黑则毒重。其形如 豆,故名 豆疮。
热病第一天,病邪在太阳经。太阳经主管体表,体表指的就是皮肤。病邪在皮肤之间,所以出现头项、腰脊疼痛的症状。
热病第二天,阳明经受邪。病邪在肌肉层,所以肌肉发热、鼻干、无法安睡。此时可以用按摩膏药配合火灸来发汗,从而痊愈。
热病第三天,少阳经受邪。诸阳经的病传变完毕,病邪仍在体表,未进入脏腑,所以胸胁部发热且耳聋。此时可以通过发汗的方法使病痊愈。
热病第四天,太阴经受邪。太阴经是三阴经之首。三阳经的病传变完毕后,传入阴经,所以毒气已经侵入胸膈部位。其症状为喉咙干燥、腹部胀满,此时可以通过催吐的方法使病痊愈。
热病第五天,少阴经受邪。毒气进入腹内,其症状为口舌干燥且想喝水。此时可以通过泻下的方法使病痊愈。
热病第六天,厥阴经受邪。毒气进入肠胃,病人感到烦闷胀满且生殖器收缩,此时可以通过泻下的方法使病痊愈。
热病第七天,三阴三阳的病传变完毕,按照规律应当痊愈,现在病仍未消除的,是想发生“再经病”(病情重复发作)。所谓再经病,是指经络再次受邪。
热病第八、九日以上仍不解除的,都是因为毒气未尽,所以病症不能消除。
这说的是得病三天以内,病邪按理应在体表,所以适宜发汗。或者病已经五到六天,但是病人喉咙口腔不焦干,心腹部不胀满,也不想喝水,只是头痛,身体高热,脉象洪大,这是病证仍在体表,未进入脏腑。所以虽然过了五到六天,仍然需要解肌发汗,不可机械地根据天数,就随意采用催吐或泻下的方法。
这是由于阳气胜于阴气,热气独自旺盛,痞结在脏腑,导致三焦隔绝,所以身体发热且烦躁。
所谓热病并发疮疡,这是由表虚里实引起的,热气旺盛则引发疮疡,严重的会遍布全身。如果疮色红、顶端白色,则毒气轻;色紫黑则毒气重。其形状像豆子,所以名叫痘疮。
热病在体表,或者尚未发汗,或者已经经过发汗、催吐、泻下治疗后,表证仍未解除,毒气不散,出现烦热和口渴,口渴却不想喝水,表虚里实,所以身体出现斑疹,颜色如锦缎花纹般绚丽。
On the first day of febrile disease, the pathogen is in the Taiyang (Greater Yang) channel. The Taiyang channel governs the exterior, and the exterior refers to the skin. Since the pathogen is between the skin layers, pain occurs in the head, neck, lower back, and spine.
On the second day, the Yangming (Yang Brightness) channel is affected. The pathogen is in the muscles, resulting in muscle heat, dry nose, and insomnia. At this stage, one may apply massage ointments and use moxibustion to induce sweating for recovery.
On the third day, the Shaoyang (Lesser Yang) channel is affected. After the transmission among the Yang channels is complete, the pathogen remains in the exterior and has not entered the Zang organs; thus, there is heat in the chest and hypochondrium accompanied by deafness. Recovery can be achieved through diaphoresis (inducing sweating).
On the fourth day, the Taiyin (Greater Yin) channel is affected. The Taiyin is the head of the three Yin channels. After the transmission among the three Yang channels is complete, the pathogen transmits into the Yin, so the toxic factors have entered the chest and diaphragm. The symptoms include a dry throat and abdominal fullness; recovery can be achieved through emesis (inducing vomiting).
On the fifth day, the Shaoyin (Lesser Yin) channel is affected. The toxic factors enter the abdomen, causing dryness of the mouth and tongue with a desire to drink. Recovery can be achieved through purgation (draining downward).
On the sixth day, the Jueyin (Terminal Yin) channel is affected. The toxic factors enter the intestines and stomach, causing irritability, fullness, and retraction of the genitals. Recovery can be achieved through purgation.
On the seventh day, the transmission among the three Yin and three Yang channels is complete. According to the law of disease, it should resolve; if the disease persists, it indicates a recurrence involving another cycle of transmission ("Zai Jing"). "Zai Jing" means the meridians are affected again.
If the febrile disease persists beyond the eighth or ninth day without resolution, it is because the toxic factors have not been fully eliminated, hence the symptoms remain.
This refers to cases within three days of onset, where the pathogen is theoretically still in the exterior, making diaphoresis appropriate. Alternatively, even if five to six days have passed, if the patient’s throat and mouth are not scorched or dry, the heart and abdomen are not full, and there is no desire to drink, but only headache, high fever, and a flooding pulse, the pathogen remains in the exterior and has not entered the Zang organs. Therefore, even after five or six days, muscle-releasing diaphoresis is still required; one must not mechanically rely on the number of days to arbitrarily employ emesis or purgation.
This condition arises when Yang overcomes Yin, and heat qi dominates alone, becoming obstructed within the Zang organs, thereby isolating the Sanjiao (Triple Burner), resulting in body heat and irritability.
Regarding febrile diseases complicated by sores, this results from deficiency in the exterior and excess in the interior. When heat qi is vigorous, sores erupt; in severe cases, they cover the entire body. If the sores are red with white heads, the toxicity is mild; if purple or black, the toxicity is severe. Their shape resembles beans, hence the name "Dou Chuang" (Bean Sores/Smallpox).
When febrile disease is in the exterior, whether un-sweated or already treated with sweating, emesis, or purgation, if the exterior syndrome remains unresolved and toxic factors do not dissipate, leading to irritability, heat, and thirst that cannot be quenched by drinking, indicating exterior deficiency and interior excess, the body will develop macules resembling brocade patterns.