此由阴气少,阳气胜,故热而烦满也。少阴病,恶寒而拳,时自烦,欲去其衣被者,可
治也。病脉已解,而反发烦者,病新瘥又强与谷,脾胃气尚弱,不能消谷,故令微烦,损谷
即愈。少阴病,脉微细而沉,但欲卧,汗出不烦,欲自吐,五六日,自利后,烦躁不得卧寐
者死。发汗后下之,脉平而小烦,此新虚不胜谷气故也。
伤寒毒瓦斯攻胃,故烦闷。或服药以后,表不解,心下有水气,其人微呕,热满而烦闷也
伤寒渴者,由热气入于脏,流于少阴之经。少阴主肾,肾恶燥,故渴而引饮。厥阴,渴
欲饮水者,与之愈。
伤寒阳明病,热入胃,与谷气并,故令呕。或已经吐下,虚热在藏,必饮水,水入则胃
家虚冷,亦呕也。伤寒发热无汗,呕不能食,而反汗出 然,是为转在阳明。伤寒呕
多,虽有阳明证,不可攻也。少阴病,下利,脉微涩,呕而汗出,必数更衣,反少者当温
其上,灸之。
此谓热气在于脾胃也。或发汗解后,胃中不和,尚有蓄热,热气上熏,则心下痞结,故
干呕。
伤寒少阴病,其人饮食入口则吐,或心中温温,欲吐不能,当遂吐之。若始得之,手足
寒,脉弦迟,此中有寒饮,不可吐也,当温之。病患脉数,数为有热,当消谷引食,反吐者
,师发其汗,阳微,膈气虚,脉则为数,数为客阳,不能消谷,胃中虚冷故也。
这是因为阴气不足,阳气偏盛,所以出现发热和烦闷的症状。少阴病中,如果患者恶寒且身体蜷缩,偶尔自行感到烦热,想要脱去衣被,这是可以治疗的。如果疾病的脉象已经恢复正常,却反而出现烦热,这是因为病刚痊愈就强行进食,脾胃之气尚虚弱,不能消化食物,从而导致轻微烦热,减少饮食即可痊愈。少阴病中,如果脉象微细而沉,只想睡觉,出汗但不烦热,想要呕吐,到了五六天,自下利之后,出现烦躁不得卧睡的症状,这是死证。经过发汗后又攻下,脉象平和但略有烦热,这是因为新近体虚,不胜受谷气的缘故。
伤寒经过发汗、催吐、泻下治疗后,脏腑都虚弱,而热气未散,所以产生虚烦。
伤寒的毒邪侵袭胃部,导致烦闷。或者服药后,表证未解,心下有停水,患者轻微呕吐,胸中热满而烦闷。
伤寒口渴,是因为热气进入脏腑,流注于少阴经脉。少阴主肾,肾厌恶燥邪,所以口渴想喝水。厥阴病中,口渴想喝水的,给水喝就会好。
伤寒阳明病,热气入胃,与谷气相搏结,所以导致呕吐。或者已经经过吐下治疗,虚热在脏腑,必然想喝水,水入胃后,胃家变得虚冷,也会呕吐。伤寒发热无汗,呕吐不能进食,却反而汗出淋漓,这是病邪转属阳明的表现。伤寒呕吐多者,即使有阳明病的证候,也不可用攻下法。少阴病,下利,脉微涩,呕吐且出汗,大便次数频繁但量少,应当温补上部,用艾灸治疗。
这说的是热气停留在脾胃。或者发汗解表后,胃中不和,仍有蓄积的热气,热气上熏,导致心下痞塞结聚,所以干呕。
伤寒少阴病,患者饮食入口即吐,或者心中泛泛欲吐又吐不出来,应当立即催吐。如果是初起时,手足寒冷,脉弦迟,这说明中有寒饮,不可催吐,应当温里。患者脉数,数脉主热,应当能消化食物并食欲旺盛,反而呕吐的,是因为医生误发其汗,导致阳气微弱,膈气虚弱,脉象表现为数,这种数是客阳(假热),不能消化食物,是胃中虚冷的缘故。
This is due to a deficiency of Yin Qi (Yin Energy) and an excess of Yang Qi (Yang Energy), resulting in fever and vexation. In Shaoyin disease (disease of the Lesser Yin channel/organ system), if the patient experiences aversion to cold, curling up, occasional spontaneous vexation, and a desire to remove clothing or bedding, this condition is treatable. If the disease pulse has resolved but vexation reappears, it is because the illness has newly convalesced yet the patient was forced to eat; the Spleen and Stomach Qi are still weak and unable to digest food, causing slight vexation; reducing food intake will lead to recovery. In Shaoyin disease, if the pulse is faint, fine, and deep, the patient only desires to sleep, sweats without vexation, and feels like vomiting; by the fifth or sixth day, after spontaneous diarrhea, if vexation and inability to lie down occur, it indicates a fatal prognosis. After sweating followed by purging, if the pulse is calm but slight vexation remains, this is due to recent deficiency being unable to withstand the grain Qi.
After Han Syndrome (Cold Damage) has been treated with sweating, emesis, or purging, the Zang-Fu organs are all deficient, while heat pathogens remain unresolved, leading to deficiency vexation.
The toxic pathogenic factors of Han Syndrome attack the Stomach, causing vexation and oppression. Or, after taking medicine, if the exterior syndrome is not resolved and there is fluid retention below the heart, the patient may have slight vomiting, chest fullness with heat, and vexation.
Thirst in Han Syndrome occurs when heat pathogens enter the Zang organs and flow into the Shaoyin meridian. Shaoyin governs the Kidney, which dislikes dryness; thus, thirst and a desire to drink occur. In Jueyin disease (disease of the Greater Yin channel/organ system), if the patient is thirsty and desires water, giving them water will cure the condition.
In Han Syndrome Yangming disease (disease of the Yang Brightness channel/organ system), heat enters the Stomach and combines with grain Qi, causing vomiting. Or, if emesis or purging has already occurred, deficiency-heat resides in the Zang organs, inevitably leading to a desire for water; once water enters, the Stomach becomes deficient and cold, also causing vomiting. In Han Syndrome, if there is fever, no sweat, vomiting, inability to eat, yet profuse sweating occurs, this indicates the pathogen is transferring to Yangming. In Han Syndrome, if vomiting is frequent, even if Yangming symptoms are present, purgative methods should not be used. In Shaoyin disease, with diarrhea, faint and choppy pulse, vomiting, and sweating, frequent bowel movements with small volume indicate that the upper body should be warmed using moxibustion.
This refers to heat pathogens residing in the Spleen and Stomach. Or, after resolving the exterior through sweating, if the Stomach is disharmonious and residual heat remains, rising heat steams upward, causing epigastric痞结 (fullness and obstruction), leading to dry heaving.
In Han Syndrome Shaoyin disease, if food entering the mouth is immediately vomited, or if there is a sensation of nausea in the heart region with an inability to vomit, immediate emesis should be induced. However, if at the onset, the hands and feet are cold and the pulse is string-taut and slow, indicating internal cold-fluid retention, emesis is contraindicated; instead, warming treatment should be applied. If the patient’s pulse is rapid, indicating heat, they should normally digest food and have an appetite; if they instead vomit, it is because the physician previously induced sweating, causing Yang Qi to become weak and Diaphragm Qi to be deficient. The rapid pulse here represents "guest Yang" (false heat), which cannot digest food, resulting from a deficient and cold Stomach.