中。素有所偏恶者。所不胜之脏气虚也。忽反暴思之。则是此脏因邪气实之。故知其必发热也。首言得五脏
之性。则病者愈。次言失五脏之性。则不病者致病。末言变其素不喜、为暴喜。则可以占病。然则变其素所喜
者、为暴不喜。亦非细故也。
夫诸病在脏。欲攻之。当随其所得而攻之。如渴者与猪苓汤。余皆仿此。
所得、即五脏之各有得。详上条。随所得而攻之者。因所喜之气味。而各寓以攻病之药。则直走其脏。所谓将
欲取之。必姑与之之道也。古法古方中。猪苓汤之治渴。特其一耳。故曰。余皆仿此。汤义、见伤寒注。本汤下。
、窒也。拘也。有窒塞拘牵之义。前人俱谓痉字之讹。以内经但有痉而无 。且痉与 颇似。故后人传写致
讹耳。鄙见以为不然。尝按古人名病。或抉其病由。或肖其病状。不必尽仍从前之旧。即如仲景伤寒之名。并
其症之传变。原从热病论来。而现易其名为伤寒。然则以仲景伤寒等字。为热病之讹也得乎。当曰。 病、即
内经痉病为合。不必抹却 字。但其病由。殊多疑窦。几令后人不知所守。如内经、以痉为湿因矣。尔雅注痉
为风强病。则又为风因矣。及按本文诸条。并伤寒内所问及者。则又皆燥因也。反复思维。神明告我。始知内
经言湿。尔雅言风。俱言外来之因。而尚有所未备。仲景言燥。是言本身之因。而实总 病之全也。盖人身以
阴阳相得。则柔和通畅。即或中邪。尚赖阴阳滋息。以为捍御。若津液素短。一遇风寒暑湿之邪中之。则邪从
太阳阳经之性而化热。阳热相抟。津液不足以供其残暴。则窒塞拘牵而 矣。甚至反张抽掣者。风火燥。万
物之变动也。或曰。子以古人为湿因风因。是矣。仲景并不言燥。而子以为燥者。敢问何说也。答曰。以因致
之变病。遂以知 家之本病。且有方本三道可据也。夫本篇四条曰。发汗太多因致 。是 因汗多而液燥
也。五条曰。风家下之则致 。是 因误下而液燥也。六条曰。疮家汗之则致 。是 因冒汗下而液燥也。其
余除一条二条三条七条为正 。不列方外。十条泄营卫之邪热以救津液。十一条泄分肉之邪热以救津
液。十二条泻胃腑之邪热以救津液。则病 之因。治 之用。不昭然可想见乎。
一条 太阳病。发热。无汗。反恶寒者。名曰刚 。
太阳病。指头项强痛而言。太阳为寒邪所伤。邪从阳经之性而化热。故发热。寒邪凝闭。则毛窍实。故无汗。恶
寒者。太阳被邪之本症也。曰反恶寒者。正就 病而言。 病因津液短少。而阳热在经之症。理宜不该恶寒。
故曰反也。发热无汗。其经络之拘强。更甚于有汗者。故曰刚 也。此条之症。全是伤寒。却曰刚 者。当合后
文伏坚之脉而言。盖 与伤寒之外症颇同。惟伏坚与浮紧之脉为辨耳。此寒邪化热之 。 之正病也。
二条 太阳病。发热。汗出。不恶寒者。名曰柔 。
太阳病同上。太阳为风邪所伤。风为阳热。故发热。风性疏洞。故汗出。不恶寒者。阳热在经。而无阴气在上在
外故也。名柔 者。以汗出而经气之劲直。少逊于寒邪也。此条全是太阳伤风。略并阳明之候。而曰柔 者。
当合后条沉迟之脉而言。盖 与伤风之外症颇同。惟沉迟与浮缓之脉为辨耳。此风邪阳热之 。亦 之正病也。
三条 太阳病。发热。脉沉而细者。名曰 。为难治。
太阳病。发热。见上条。不言有汗无汗者。兼上二条之风寒而言。言太阳见发热之表症。其脉多浮者。以阴阳
之气两出。而与邪抟故也。若见表症。而脉又沉。是里阴短少。不出而附其阳。而经络独得干热之应。故 。然
治经表干热之邪。非发表不能散其势。若沉而更见细。细为无阳之诊。发表以去邪热。刚柔之阳 或解。而
厥逆泻利之阴 将复作矣。故曰难治。阴 、即俗所谓慢惊风者。是。详见后注。并有方治拟补。此亦 之正
病也。
四条 太阳病。发汗太多。因致 。
此及下文三条。俱非 病。因误治以伤阴。遂亦成 者也。发汗太多。不特火熨等治。令其大汗。凡表药过剂。
及发汗后更发汗者皆是。汗虽阳液。而经隧络脉。实赖以为和软。因致 者。木出津而劲。土去水而板之象。
五条 夫风病下之则 。复发汗。必拘急。
风家不特原燥。且疏泄而多自汗。其液已伤。下之。则津液更伤。亦上条因致 之义也。复发汗。当承风病言。
非下后成 。而复发汗也。盖谓风家津液已伤。下之固 。不下而复汗之。亦必拘急。拘急者。 之渐也。
六条 疮家虽身疼痛。不可发汗。汗出则 。
疮家素多脓血。脓血者。津液之所化也。夫身疼痛者。为邪在经络。法当发表。然其津液素伤于脓血。若再令
汗出。则其经血益枯。亦上文因致 之义也。
七条 病者身热足寒。颈项强急。恶寒。时头热。面赤。目赤。独头动摇。卒口噤。背反张者。 病也。若发
其汗者。寒湿相得。其表益虚。即恶寒甚。发其汗已。其脉如蛇。暴腹胀大者。为欲解。脉如故。反伏弦者。 。
此症须先详太阳隧道。则丝丝入扣。否则极力强解。终属隔靴搔痒。夫太阳者。从目内 。上头角。复下经牙
车。上绕脑后。历颈项。循背部之夹脊。而下走足外 之后侧者也。此条系太阳经血不足之人。寒湿浊邪。两
中于下。于是郁寒郁湿而两化为热。化热循太阳而上冲。太阳之经血不足以御之。故见种种干热之症。而
也。身热足寒者。本寒标热之应。玩下文寒湿相得。则言寒而湿在其中。故曰寒湿之浊邪。两中于下也。颈
项、头、面、目、与牙车、下至背部、俱太阳之所经。故颈项强急。头热。面目时赤。独头动摇。牙关卒噤。并背反张
者。俱经血不足。而干热逼之之应。故知为 也。恶寒为太阳之本症。时头热时字。与口之卒噤相应。盖化热之
邪。终不若风热之盛实。故但时热、时赤、时动摇、卒噤、卒反张也。以鄙见拟其方。或当主桂枝倍芍药汤。外加
花粉术附为合。盖桂枝本汤以解标热。加花粉以滋其经血之干。术附以逐其本寒本湿。倍芍药者。使之直
走足胫以上散也。若以为太阳表热。罔顾寒湿之本病。但发其汗。则寒湿之本气。以汗空而相得于表。表阳
之虚气。以汗疏而益虚于上。寒湿与虚阳。相薄于在上在表。故恶寒益甚也。此发汗而病不服之变动如此。
其脉如蛇。谓伏而坚直之脉。已如如有外出之势。暴腹胀长。是寒湿之邪。入腑为即愈。其愈于自下利乎。夫
之为病。如盛夏之时。阳热酷于上。逼阴气于下。而不得上升之象。若阳光少薄。则地气自腾矣。发汗以散
其在上在表之热。则下之阴液。有上滋之势。故脉起如阴蛇之外出。腹胀如岚雾之上浮。殆阴阳交泰之渐
乎。人气与天地之道相同。其欲解也宜矣。此发汗而病状之变动又如此。脉如故。即下文之伏脉也。犹言脉
伏如故。而反加弦之谓。夫弦为紧滑之合脉。紧为寒。滑为湿。寒湿伏于下。则阳热之不解于上可知。故曰
者。言 病之已成也。此发汗而病不理之变动又如此。全条总言寒湿病之常变。亦 之正病也。
八条 病有炙疮。难治。
炙疮之人。先受外火。次伤脓血。液愈热愈干。故难治也。
九条 脉经曰。 病。其脉伏坚。直上下行。
伏者。潜伏在下。坚者。凝敛之象。上下。指尺寸而言。直上下行。谓潜伏凝敛。单从傍骨而直行尺寸。并无浮起
之意。盖 之为病。虽在经络之阳热。而其所以为病。却在阴不与阳俱。而自沉伏也。若阴起而应阳。则入风
寒暑湿之正例。而非 矣。大概 病象盛夏。责在外无阴也。 脉象隆冬。责在里无阳也。其天地之不交。火
水之未济耶。若阳中有阴。则阳随阴精而下降。阴中有阳。则阴随阳气而上升。左右者。阴阳之道路。故 病
之死。多死于左肝右肺之不能升降也。此总言 病之脉。盖就 之正病。及因致 之兼症。而两言之也。
十条 太阳病。其症备。身体强。KT KT 然。脉反沉迟。此为 。栝蒌桂枝汤主之。
栝蒌桂枝汤方
栝蒌根(二两) 桂枝(三两) 芍药(三两) 甘草(二两) 生姜(三两) 大枣(十二枚)
上六味。以水九升。煮取三升。分温三服。取微汗。汗不出。食顷。啜热粥发。
太阳病。其症备者。如头项强痛而恶风发热之谓。非指上文之 症备也。身体强三句。始入 病。身体指后
发际。及夹脊而言。KT KT 。惊禽伸颈之象。伤寒之阳明病。亦以此为状。但阳明之经脉在前。人迎以下邪盛。故
颈项支于前而KT KT 然。太阳之经脉在后。风池以下邪盛。故颈项强于后而KT KT 然也。见如此太阳症。脉若
见浮。则脉症相对。而为太阳中风正病。乃反见沉迟。沉为在里。迟为无阳。里无阳气。则不能领津液以上滋。
而此太阳诸症。为干热可知。故曰为 。主栝蒌桂枝汤者。以桂枝本汤。能解营分之热邪。使不至热枯阳液。
一也。且太阳之阳热。从汗涣散。使在下之阴津吸起。二也。栝蒌蔓生。性走经络。而气清滋润。且根善上行。是
从里阴而引其精汁于太阳之经脉者也。以之治有汗之柔 。宜矣。
十一条 太阳病。无汗。而小便反少。气上冲胸。口噤不能语。欲作刚 。葛根汤主之。
葛根汤方
葛根(四两) 麻黄(三两去节) 桂枝(二两去皮) 芍药(二两) 甘草(二两炙) 生姜(三两) 大枣(十
二枚)
上七味、 咀、以水一斗。先煮麻黄、葛根减二升。去沫。内诸药。煮取三升。去渣。温服一升。覆取微似汗。不
须啜粥。余如桂枝汤法将息及禁忌。
太阳病。同上条。无汗者。寒邪伤营而凝闭其卫气也。小便反少者。正照 病而言。盖谓伤寒化热之 病。热
邪盛于表分。逼阴气于下。理宜小便清利。而今反少也。气上冲胸者。人之毛窍。随呼吸而喑为开辟。今毛窍
为寒邪所闭。气机塞于旁引。但争胸分出入之路故也。口噤者。太阳经道。循牙车。寒邪能令筋惕。故口噤而
不得语也。以上俱太阳伤寒之症。而曰欲作刚 。必其脉不浮紧。而见沉伏。或且紧直可知矣。但以全症而
论。似当主麻黄汤以发表。加茯苓以利小便。加半夏以降逆气矣。即合沉伏之 脉而论。宜于麻黄汤中。加
升阴之品。如胶、麦、归、地。重以升麻等类矣。况 之为病。原系化热之邪在经。而津液不供之症。葛根轻浮渗
泄。最为燥家所忌。乃竟主葛根汤而无所顾忌者。神哉仲景。几令人不可思议矣。不知当日。一眼看定小便
反少。气上冲胸二症。随便用此。借水行舟。因粮杀贼之妙而已。盖 之所以为病。所虑者。天地不交。水火未
济耳。今小便反少。气上冲胸。其里阴之机。尚在向表。主葛根汤以发汗。则泄其上者。下气必从。疏其表者。里
阴自动。将津液之气可升。而沉伏之脉自起矣。且攻邪之法。自有层次。寒伤营分。为太阳之第二层。二门之
象也。则太阳卫气。为第一层之大门。阳明分肉。为第三层之堂陛。与其就第二层。即贼以驱贼。不如从三层
堂陛之间。振臂一呼。而贼易去耳。此不用麻黄汤而用葛根汤之深意也。至于直任葛根而不畏其疏泄者。
以其无汗。并小便反少二症故也。无汗而小便少。胃中必有积饮。借积饮以为汗。既不虞其损伤津液。且内
饮去而表热解。故曰借水行舟。因粮杀贼之妙也。详伤寒论太阳与阳明合病条下。参看自悉。
十二条 为病。胸满、口噤。卧不着席。脚挛急。必 齿。可与大承气汤。
此太阳病 。从胸中移热于胃腑而热实。凡太阳之表症俱罢者也。胃腑热实。故与大承气以下之。表症俱
罢。故不曰太阳病。而但曰 为病耳。胸满者。胃实而实气上浮之应。口噤者。胃系络唇口并齿中。实气上浮。
则胃系急。故口噤也。卧不着席者。反侧不宁之貌。胃实而神气不能归伏土中也。下焦足胫之气。尝休养于
大肠之空处。胃实而大肠亦实。肠实、则脚下之气血不容转舒。故挛急也。 齿者。即口噤之义。与大承以下
之。则热实去。而上下通和矣。或问曰。此条之症。子何以知其不属传经。而为胸中移热。且云太阳表症俱
罢者也。答曰。若系太阳传经。则阳明必有经络表病。何得单见胃腑内实。故曰此胸中移热也。若有头痛、发
热、恶寒等表症。必不径情攻下。致犯下早结胸之戒。故曰太阳表症俱罢者也。附录仲景具菩萨之慈。泄
神仙之秘。着此 病方论。以垂万世。后人不知为金科玉律之文。置之覆瓿。及遇此症。妄立惊风名色。除一
切香燥药外。惟是蜈蚣、全蝎之大毒。朱砂、金箔之重坠。巴豆、牵牛之猛悍。麝脐、冰片之犀利而已。讹以传讹。
杀人无算。呜呼、 病一灯。千年尘土。谁复知有净瓶甘露。玉液还丹也。夫 之为病。小儿十居其九。产妇十
居其一者。以小儿纯阳之体。津液未充。产妇亡血之余。津液未复。一遇风寒等邪。犯其太阳。则化热伤经。筋
中。素有所偏恶者。所不胜之脏气虚也。忽反暴思之。则是此脏因邪气实之。故知其必发热也。首言得五脏
之性。则病者愈。次言失五脏之性。则不病者致病。末言变其素不喜、为暴喜。则可以占病。然则变其素所喜
者、为暴不喜。亦非细故也。
夫诸病在脏。欲攻之。当随其所得而攻之。如渴者与猪苓汤。余皆仿此。
所得、即五脏之各有得。详上条。随所得而攻之者。因所喜之气味。而各寓以攻病之药。则直走其脏。所谓将
欲取之。必姑与之之道也。古法古方中。猪苓汤之治渴。特其一耳。故曰。余皆仿此。汤义、见伤寒注。本汤下。
、窒也。拘也。有窒塞拘牵之义。前人俱谓痉字之讹。以内经但有痉而无 。且痉与 颇似。故后人传写致
讹耳。鄙见以为不然。尝按古人名病。或抉其病由。或肖其病状。不必尽仍从前之旧。即如仲景伤寒之名。并
其症之传变。原从热病论来。而现易其名为伤寒。然则以仲景伤寒等字。为热病之讹也得乎。当曰。 病、即
内经痉病为合。不必抹却 字。但其病由。殊多疑窦。几令后人不知所守。如内经、以痉为湿因矣。尔雅注痉
为风强病。则又为风因矣。及按本文诸条。并伤寒内所问及者。则又皆燥因也。反复思维。神明告我。始知内
经言湿。尔雅言风。俱言外来之因。而尚有所未备。仲景言燥。是言本身之因。而实总 病之全也。盖人身以
阴阳相得。则柔和通畅。即或中邪。尚赖阴阳滋息。以为捍御。若津液素短。一遇风寒暑湿之邪中之。则邪从
太阳阳经之性而化热。阳热相抟。津液不足以供其残暴。则窒塞拘牵而 矣。甚至反张抽掣者。风火燥。万
物之变动也。或曰。子以古人为湿因风因。是矣。仲景并不言燥。而子以为燥者。敢问何说也。答曰。以因致
之变病。遂以知 家之本病。且有方本三道可据也。夫本篇四条曰。发汗太多因致 。是 因汗多而液燥
也。五条曰。风家下之则致 。是 因误下而液燥也。六条曰。疮家汗之则致 。是 因冒汗下而液燥也。其
余除一条二条三条七条为正 。不列方外。十条泄营卫之邪热以救津液。十一条泄分肉之邪热以救津
液。十二条泻胃腑之邪热以救津液。则病 之因。治 之用。不昭然可想见乎。
一条 太阳病(太阳经受邪所致的病证)。发热。无汗。反恶寒者。名曰刚 (表现为项背强直、口噤不开,甚至角弓反张的病症,伴有表实无汗者)。
太阳病。指头项强痛而言。太阳为寒邪所伤。邪从阳经之性而化热。故发热。寒邪凝闭。则毛窍实。故无汗。恶
寒者。太阳被邪之本症也。曰反恶寒者。正就 病而言。 病因津液短少。而阳热在经之症。理宜不该恶寒。
故曰反也。发热无汗。其经络之拘强。更甚于有汗者。故曰刚 也。此条之症。全是伤寒。却曰刚 者。当合后
文伏坚之脉而言。盖 与伤寒之外症颇同。惟伏坚与浮紧之脉为辨耳。此寒邪化热之 。 之正病也。
二条 太阳病。发热。汗出。不恶寒者。名曰柔 (表现为项背强直、口噤不开,甚至角弓反张的病症,伴有表虚汗出者)。
太阳病同上。太阳为风邪所伤。风为阳热。故发热。风性疏洞。故汗出。不恶寒者。阳热在经。而无阴气在上在
外故也。名柔 者。以汗出而经气之劲直。少逊于寒邪也。此条全是太阳伤风。略并阳明之候。而曰柔 者。
当合后条沉迟之脉而言。盖 与伤风之外症颇同。惟沉迟与浮缓之脉为辨耳。此风邪阳热之 。亦 之正病也。
三条 太阳病。发热。脉沉而细者。名曰 。为难治。
太阳病。发热。见上条。不言有汗无汗者。兼上二条之风寒而言。言太阳见发热之表症。其脉多浮者。以阴阳
之气两出。而与邪抟故也。若见表症。而脉又沉。是里阴短少。不出而附其阳。而经络独得干热之应。故 。然
治经表干热之邪。非发表不能散其势。若沉而更见细。细为无阳之诊。发表以去邪热。刚柔之阳 或解。而
厥逆泻利之阴 将复作矣。故曰难治。阴 、即俗所谓慢惊风者。是。详见后注。并有方治拟补。此亦 之正
病也。
四条 太阳病。发汗太多。因致 。
此及下文三条。俱非 病。因误治以伤阴。遂亦成 者也。发汗太多。不特火熨等治。令其大汗。凡表药过剂。
及发汗后更发汗者皆是。汗虽阳液。而经隧络脉。实赖以为和软。因致 者。木出津而劲。土去水而板之象。
五条 夫风病下之则 。复发汗。必拘急。
风家不特原燥。且疏泄而多自汗。其液已伤。下之。则津液更伤。亦上条因致 之义也。复发汗。当承风病言。
非下后成 。而复发汗也。盖谓风家津液已伤。下之固 。不下而复汗之。亦必拘急。拘急者。 之渐也。
六条 疮家虽身疼痛。不可发汗。汗出则 。
疮家素多脓血。脓血者。津液之所化也。夫身疼痛者。为邪在经络。法当发表。然其津液素伤于脓血。若再令
汗出。则其经血益枯。亦上文因致 之义也。
七条 病者身热足寒。颈项强急。恶寒。时头热。面赤。目赤。独头动摇。卒口噤。背反张者。 病也。若发
其汗者。寒湿相得。其表益虚。即恶寒甚。发其汗已。其脉如蛇。暴腹胀大者。为欲解。脉如故。反伏弦者。 。
此症须先详太阳隧道。则丝丝入扣。否则极力强解。终属隔靴搔痒。夫太阳者。从目内 。上头角。复下经牙
车。上绕脑后。历颈项。循背部之夹脊。而下走足外 之后侧者也。此条系太阳经血不足之人。寒湿浊邪。两
中于下。于是郁寒郁湿而两化为热。化热循太阳而上冲。太阳之经血不足以御之。故见种种干热之症。而
也。身热足寒者。本寒标热之应。玩下文寒湿相得。则言寒而湿在其中。故曰寒湿之浊邪。两中于下也。颈
项、头、面、目、与牙车、下至背部、俱太阳之所经。故颈项强急。头热。面目时赤。独头动摇。牙关卒噤。并背反张
者。俱经血不足。而干热逼之之应。故知为 也。恶寒为太阳之本症。时头热时字。与口之卒噤相应。盖化热之
邪。终不若风热之盛实。故但时热、时赤、时动摇、卒噤、卒反张也。以鄙见拟其方。或当主桂枝倍芍药汤。外加
花粉术附为合。盖桂枝本汤以解标热。加花粉以滋其经血之干。术附以逐其本寒本湿。倍芍药者。使之直
走足胫以上散也。若以为太阳表热。罔顾寒湿之本病。但发其汗。则寒湿之本气。以汗空而相得于表。表阳
之虚气。以汗疏而益虚于上。寒湿与虚阳。相薄于在上在表。故恶寒益甚也。此发汗而病不服之变动如此。
其脉如蛇。谓伏而坚直之脉。已如如有外出之势。暴腹胀长。是寒湿之邪。入腑为即愈。其愈于自下利乎?夫
之为病。如盛夏之时。阳热酷于上。逼阴气于下。而不得上升之象。若阳光少薄。则地气自腾矣。发汗以散
其在上在表之热。则下之阴液。有上滋之势。故脉起如阴蛇之外出。腹胀如岚雾之上浮。殆阴阳交泰之渐
乎。人气与天地之道相同。其欲解也宜矣。此发汗而病状之变动又如此。脉如故。即下文之伏脉也。犹言脉
伏如故。而反加弦之谓。夫弦为紧滑之合脉。紧为寒。滑为湿。寒湿伏于下。则阳热之不解于上可知。故曰
者。言 病之已成也。此发汗而病不理之变动又如此。全条总言寒湿病之常变。亦 之正病也。
八条 病有炙疮。难治。
炙疮之人。先受外火。次伤脓血。液愈热愈干。故难治也。
九条 脉经曰。 病。其脉伏坚。直上下行。
伏者。潜伏在下。坚者。凝敛之象。上下。指尺寸而言。直上下行。谓潜伏凝敛。单从傍骨而直行尺寸。并无浮起
之意。盖 之为病。虽在经络之阳热。而其所以为病。却在阴不与阳俱。而自沉伏也。若阴起而应阳。则入风
寒暑湿之正例。而非 矣。大概 病象盛夏。责在外无阴也。 脉象隆冬。责在里无阳也。其天地之不交。火
水之未济耶。若阳中有阴。则阳随阴精而下降。阴中有阳。则阴随阳气而上升。左右者。阴阳之道路。故 病
之死。多死于左肝右肺之不能升降也。此总言 病之脉。盖就 之正病。及因致 之兼症。而两言之也。
十条 太阳病。其症备。身体强。KT KT 然。脉反沉迟。此为 。栝蒌桂枝汤(Trichosanthes and Cinnamon Twig Decoction)主之。
栝蒌桂枝汤方
栝蒌根(二两) 桂枝(三两) 芍药(三两) 甘草(二两) 生姜(三两) 大枣(十二枚)
上六味。以水九升。煮取三升。分温三服。取微汗。汗不出。食顷。啜热粥发。
太阳病。其症备者。如头项强痛而恶风发热之谓。非指上文之 症备也。身体强三句。始入 病。身体指后
发际。及夹脊而言。KT KT 。惊禽伸颈之象。伤寒之阳明病。亦以此为状。但阳明之经脉在前。人迎以下邪盛。故
颈项支于前而KT KT 然。太阳之经脉在后。风池以下邪盛。故颈项强于后而KT KT 然也。见如此太阳症。脉若
见浮。则脉症相对。而为太阳中风正病。乃反见沉迟。沉为在里。迟为无阳。里无阳气。则不能领津液以上滋。
而此太阳诸症。为干热可知。故曰为 。主栝蒌桂枝汤者。以桂枝本汤。能解营分之热邪。使不至热枯阳液。
一也。且太阳之阳热。从汗涣散。使在下之阴津吸起。二也。栝蒌蔓生。性走经络。而气清滋润。且根善上行。是
从里阴而引其精汁于太阳之经脉者也。以之治有汗之柔 。宜矣。
十一条 太阳病。无汗。而小便反少。气上冲胸。口噤不能语。欲作刚 。葛根汤(Pueraria Decoction)主之。
葛根汤方
葛根(四两) 麻黄(三两去节) 桂枝(二两去皮) 芍药(二两) 甘草(二两炙) 生姜(三两) 大枣(十
二枚)
上七味、 咀、以水一斗。先煮麻黄、葛根减二升。去沫。内诸药。煮取三升。去渣。温服一升。覆取微似汗。不
须啜粥。余如桂枝汤法将息及禁忌。
太阳病。同上条。无汗者。寒邪伤营而凝闭其卫气也。小便反少者。正照 病而言。盖谓伤寒化热之 病。热
邪盛于表分。逼阴气于下。理宜小便清利。而今反少也。气上冲胸者。人之毛窍。随呼吸而喑为开辟。今毛窍
为寒邪所闭。气机塞于旁引。但争胸分出入之路故也。口噤者。太阳经道。循牙车。寒邪能令筋惕。故口噤而
不得语也。以上俱太阳伤寒之症。而曰欲作刚 。必其脉不浮紧。而见沉伏。或且紧直可知矣。但以全症而
论。似当主麻黄汤(Ephedra Decoction)以发表。加茯苓以利小便。加半夏以降逆气矣。即合沉伏之 脉而论。宜于麻黄汤中。加
升阴之品。如胶、麦、归、地。重以升麻等类矣。况 之为病。原系化热之邪在经。而津液不供之症。葛根轻浮渗
泄。最为燥家所忌。乃竟主葛根汤而无所顾忌者。神哉仲景。几令人不可思议矣。不知当日。一眼看定小便
反少。气上冲胸二症。随便用此。借水行舟。因粮杀贼之妙而已。盖 之所以为病。所虑者。天地不交。水火未
济耳。今小便反少。气上冲胸。其里阴之机。尚在向表。主葛根汤以发汗。则泄其上者。下气必从。疏其表者。里
阴自动。将津液之气可升。而沉伏之脉自起矣。且攻邪之法。自有层次。寒伤营分。为太阳之第二层。二门之
象也。则太阳卫气。为第一层之大门。阳明分肉。为第三层之堂陛。与其就第二层。即贼以驱贼。不如从三层
堂陛之间。振臂一呼。而贼易去耳。此不用麻黄汤而用葛根汤之深意也。至于直任葛根而不畏其疏泄者。
以其无汗。并小便反少二症故也。无汗而小便少。胃中必有积饮。借积饮以为汗。既不虞其损伤津液。且内
饮去而表热解。故曰借水行舟。因粮杀贼之妙也。详伤寒论太阳与阳明合病条下。参看自悉。
十二条 为病。胸满、口噤。卧不着席。脚挛急。必 齿。可与大承气汤(Major Order the Yang Decoction)。
此太阳病 。从胸中移热于胃腑而热实。凡太阳之表症俱罢者也。胃腑热实。故与大承气以下之。表症俱
罢。故不曰太阳病。而但曰 为病耳。胸满者。胃实而实气上浮之应。口噤者。胃系络唇口并齿中。实气上浮。
则胃系急。故口噤也。卧不着席者。反侧不宁之貌。胃实而神气不能归伏土中也。下焦足胫之气。尝休养于
大肠之空处。胃实而大肠亦实。肠实、则脚下之气血不容转舒。故挛急也。 齿者。即口噤之义。与大承以下
之。则热实去。而上下通和矣。或问曰。此条之症。子何以知其不属传经。而为胸中移热。且云太阳表症俱
罢者也。答曰。若系太阳传经。则阳明必有经络表病。何得单见胃腑内实。故曰此胸中移热也。若有头痛、发
热、恶寒等表症。必不径情攻下。致犯下早结胸之戒。故曰太阳表症俱罢者也。附录仲景具菩萨之慈。泄
神仙之秘。着此 病方论。以垂万世。后人不知为金科玉律之文。置之覆瓿。及遇此症。妄立惊风名色。除一
切香燥药外。惟是蜈蚣、全蝎之大毒。朱砂、金箔之重坠。巴豆、牵牛之猛悍。麝脐、冰片之犀利而已。讹以传讹。
杀人无算。呜呼、 病一灯。千年尘土。谁复知有净瓶甘露。玉液还丹也。夫 之为病。小儿十居其九。产妇十
居其一者。以小儿纯阳之体。津液未充。产妇亡血之余。津液未复。一遇风寒等邪。犯其太阳。则化热伤经。筋
Zhong. If one has a long-standing aversion to certain things, it indicates that the Qi of the unconquering Zang organ is deficient. Suddenly desiring them violently implies that this Zang organ has become full due to pathogenic factors; therefore, one can know that fever will occur. The first statement says that obtaining the nature of the five Zang organs leads to recovery for the patient. The second states that losing the nature of the five Zang organs causes disease in those who were previously healthy. The final statement says that changing one's usual dislike into sudden liking allows one to predict illness. Therefore, changing one's usual liking into sudden dislike is also no trivial matter.
For all diseases located in the Zang organs, if one wishes to attack them, one should follow what they have obtained to attack them. For example, give Zhu Ling Tang (Polyporus Decoction) to those with thirst. The rest should follow this pattern.
"What they have obtained" refers to each of the five Zang organs having its specific acquisition, as detailed in the previous clause. To attack according to what they have obtained means to incorporate medicines that attack the disease into flavors and aromas that are preferred, so that the medicine goes directly to the target Zang organ. This is the method of "intending to take something, one must first give it." In ancient methods and prescriptions, Zhu Ling Tang's treatment of thirst is just one instance. Hence it says, "The rest should follow this pattern." The meaning of Tang (decoction) is seen in the commentary on Shanghan Lun under this prescription.
[Character missing/obscured], meaning obstruction or constraint, implying a sense of blockage and pulling/tightness. Predecessors all considered it a corruption of the character Jing (Spasm/Stiff Neck), because Neijing only mentions Jing and not [this character]. Moreover, Jing and [this character] look similar, so later copyists caused errors. I do not agree. I have observed that ancients named diseases either by revealing their cause or by mimicking their symptoms, not necessarily retaining old names. For instance, Zhang Zhongjing's name for Shanghan (Cold Damage) and its transmission originally came from discussions on Re Bing (Heat Disease), but was now changed to Shanghan. So, can we consider Zhang Zhongjing's use of characters like Shanghan as corruptions of Re Bing? One should say that [this character] disease corresponds to Jing Bing (Spasm Disease) in Neijing, without erasing [this character]. However, the cause of this disease has many doubts, almost leaving later generations unsure of what to adhere to. For example, Neijing attributes Jing to dampness. Erya notes Jing as a wind-stiffness disease, attributing it to wind. Yet, examining the clauses in this text and those asked about in Shanghan Lun, they all attribute it to dryness. After repeated thinking, my spirit informed me: Neijing speaks of dampness, Erya speaks of wind; both speak of external causes, yet remain incomplete. Zhang Zhongjing speaks of dryness, which speaks of the internal cause, and truly encompasses the entirety of [this character] disease. Generally, when Yin and Yang in the human body harmonize, there is softness and smooth flow. Even if attacked by pathogens, one still relies on Yin and Yang nourishing each other for defense. If Jin Ye (Body Fluids) are inherently short, upon encountering Wind-Cold, Summerheat, or Dampness, the pathogen transforms into heat following the nature of the Taiyang Yang channel. Yang-heat struggles, and Jin Ye is insufficient to supply its brutality, leading to obstruction and tightness, i.e., [this character]. Even to the point of opisthotonos and convulsions, these are changes of Wind, Fire, and Dryness affecting all things. Someone might ask: You consider the ancients correct in attributing it to dampness and wind. But Zhang Zhongjing does not mention dryness, yet you think it is dryness. May I ask your reasoning? I answer: By observing the transformed diseases caused by these factors, we can understand the fundamental disease of [this character]. There are also three prescriptions based on this principle. Clause 4 of this chapter says: Excessive sweating leads to [this character]. This means [this character] is caused by fluid dryness due to excessive sweating. Clause 5 says: Purging a Wind-pattern patient leads to [this character]. This means [this character] is caused by fluid dryness due to erroneous purging. Clause 6 says: Sweating a Chuang Jia (Patient with sores/ulcers) leads to [this character]. This means [this character] is caused by fluid dryness due to exposure to sweating and purging. Apart from Clauses 1, 2, 3, and 7 which are true [this character] cases and have no formulas listed, Clauses 10, 11, and 12 drain pathogenic heat from Ying-Wei, muscle layers, and the Stomach Fu respectively to save Jin Ye. Thus, the cause of [this character] disease and the application of treatment are clearly visible.
Clause 1: Taiyang Bing (Taiyang Pattern/Disease). Fever, no sweating, yet aversion to cold is present. This is called Gang Jing (Yang Spasm/Stiffness).
Taiyang Bing refers to stiffness and pain in the head and neck. Taiyang is injured by Cold pathogen. The pathogen transforms into heat following the nature of the Yang channel, hence fever. Cold pathogen condenses and closes, making pores solid, hence no sweating. Aversion to cold is the fundamental symptom of Taiyang being attacked by pathogens. Saying "yet aversion to cold" specifically refers to [this character] disease. Because [this character] disease involves short Jin Ye, and Yang-heat is in the channel, theoretically, there should be no aversion to cold. Hence it says "yet". With fever and no sweating, the constriction and stiffness of the channels are more severe than with sweating. Hence it is called Gang Jing (Yang Spasm). The symptoms of this clause are entirely Shanghan (Cold Damage), yet it is called Gang Jing; this should be combined with the deep and firm pulse mentioned later. Generally, the external symptoms of [this character] are quite similar to Shanghan, distinguished only by the pulse: deep and firm versus floating and tight. This is [this character] caused by Cold transforming into heat. It is the true form of [this character].
Clause 2: Taiyang Bing. Fever, sweating, no aversion to cold. This is called Rou Jing (Yin Spasm/Flaccidity).
Taiyang Bing is the same as above. Taiyang is injured by Wind pathogen. Wind is Yang-heat, hence fever. Wind nature is porous, hence sweating. No aversion to cold occurs because Yang-heat is in the channel, and there is no Yin Qi above or outside. It is called Rou Jing because with sweating, the rigidity of the channel Qi is slightly less than that of Cold pathogen. This clause is entirely Taiyang Wind Injury, slightly combining Yangming signs. It is called Rou Jing; this should be combined with the deep and slow pulse mentioned in the next clause. Generally, the external symptoms of [this character] are quite similar to Wind Injury, distinguished only by the pulse: deep and slow versus floating and moderate. This is [this character] caused by Wind pathogen and Yang-heat. It is also the true form of [this character].
Clause 3: Taiyang Bing. Fever, pulse is deep and fine. This is called [this character]. It is difficult to treat.
Taiyang Bing, fever, see previous clause. Not mentioning sweating or no sweating combines the Wind and Cold of the previous two clauses. It states that when Taiyang shows the exterior sign of fever, the pulse is mostly floating, because Yin and Yang Qi both emerge and struggle with the pathogen. If exterior signs appear, yet the pulse is deep, it indicates deficiency of interior Yin, which does not emerge but attaches to Yang, while the channels alone respond to dry-heat. Hence [this character]. To treat dry-heat pathogen in the channels and exterior, one must release the exterior to dissipate its momentum. If deep and additionally fine, fine indicates absence of Yang. Releasing the exterior to remove pathogenic heat might resolve the rigid or flaccid Yang [this character], but the Yin [this character] of cold limbs and diarrhea will reappear. Hence it is said to be difficult to treat. Yin [this character] is what is commonly known as Slow Convulsion Syndrome. See notes below for details and proposed treatments. This is also the true form of [this character].
Clause 4: Taiyang Bing. Excessive sweating leads to [this character].
This and the following three clauses are not [this character] disease per se, but due to erroneous treatment injuring Yin, they also become [this character]. Excessive sweating includes not only treatments like fire moxibustion causing heavy sweating, but also any exterior medication overdosed, or sweating again after sweating. Although sweat is Yang fluid, the meridians and collaterals rely on it for softness. Causing [this character] here represents Wood emerging from lack of Jin Ye becoming stiff, and Earth losing Water becoming hard.
Clause 5: If a Wind-pattern patient is purged, [this character] results. If sweating is repeated, there will surely be cramping and stiffness.
Wind-pattern patients are inherently dry, and due to dispersing and leaking, they often sweat spontaneously. Their fluids are already injured. Purging further injures Jin Ye, which is the same meaning as the previous clause regarding causing [this character] due to injury. "Repeated sweating" refers back to the Wind-pattern patient, not sweating after becoming [this character] from purging. It means that since the Wind-pattern patient's Jin Ye is already injured, purging certainly causes [this character]; even if not purged, repeating sweating will surely cause cramping and stiffness. Cramping and stiffness are the progression of [this character].
Clause 6: A Chuang Jia (Patient with sores/ulcers) may have body pain, but cannot be sweated. If sweating occurs, [this character] results.
Chuang Jia patients usually have much pus and blood. Pus and blood are transformations of Jin Ye. Body pain indicates pathogen in the channels and collaterals; the method should be releasing the exterior. However, their Jin Ye is already injured by pus and blood. If made to sweat again, their channel blood becomes increasingly withered. This is also the meaning of causing [this character] due to injury mentioned above.
Clause 7: A patient with body heat and cold feet, stiff and urgent neck and nape, aversion to cold, occasional head heat, red face, red eyes, independent head trembling, sudden jaw lock, and opisthotonos has [this character] disease. If sweating is induced, Cold and Dampness combine, the exterior becomes more deficient, and aversion to cold becomes severe. After sweating, if the pulse is like a snake, and sudden abdominal distension occurs, it indicates impending resolution. If the pulse remains unchanged, but becomes hidden and wiry, [this character] results.
This symptom requires first detailing the Taiyang pathway, otherwise forcing an explanation is like scratching an itch through a boot. Taiyang starts from the inner canthus, goes up to the temple, descends past the masseter, winds around the back of the head, passes through the neck and nape, follows the paraspinal muscles of the back, and descends behind the lateral malleolus of the foot. This clause concerns a person with insufficient Taiyang channel blood. Cold-Damp turbid pathogens strike the lower part. Thus, Cold and Dampness stagnate and transform into heat. Transforming into heat, it rushes upward along Taiyang. Taiyang channel blood is insufficient to resist it, hence various dry-heat symptoms appear, resulting in [this character]. Body heat and cold feet correspond to root Cold and marked Heat. Reading "Cold and Dampness combine" below implies Cold with Dampness within, hence "Cold-Damp turbid pathogens striking the lower part". Neck, nape, head, face, eyes, masseter, down to the back, are all pathways of Taiyang. Hence stiff neck, head heat, intermittent red face and eyes, independent head trembling, sudden jaw lock, and opisthotonos are all responses to dry-heat pressing due to insufficient channel blood. Hence we know it is [this character]. Aversion to cold is the fundamental symptom of Taiyang. The word "occasional" in "occasional head heat" corresponds to "sudden jaw lock". Pathogens transforming into heat are ultimately not as vigorous as Wind-Heat excess. Hence only occasional heat, occasional redness, occasional trembling, sudden lock, and sudden opisthotonos. Based on my view, the formula should perhaps be Gui Zhi Tang doubled with Shao Yao, plus Hua Fen (Trichosanthes Root), Bai Zhu (Atractylodes Macrocephala), and Fu Zi (Aconite Lateralis Radix Preparata). Gui Zhi Tang resolves marked heat. Hua Fen moistens dry channel blood. Bai Zhu and Fu Zi drive away root Cold and Dampness. Doubling Shao Yao directs it to descend and disperse above the calves. If one considers it Taiyang exterior heat, ignoring the root disease of Cold-Damp, and merely induces sweating, the root Qi of Cold-Damp meets in the exterior due to empty pores. The deficient Qi of Exterior Yang becomes more deficient above due to open pores. Cold-Damp and deficient Yang clash in the upper and exterior parts, hence aversion to cold becomes severe. This is how the disease changes when sweating is induced but fails. "Pulse like a snake" refers to a hidden, firm, and straight pulse, appearing as if moving outward. Sudden abdominal distension means Cold-Damp pathogen enters the Fu organs, indicating immediate healing. Does it heal via spontaneous diarrhea? The disease of [this character] is like midsummer: Yang-heat is intense above, forcing Yin Qi down, unable to rise. If sunlight is slightly thin, earth Qi naturally rises. Inducing sweating to dissipate heat above and in the exterior gives the Yin fluid below a tendency to nourish upwards. Hence the pulse rises like a Yin snake emerging, and abdominal distension floats up like mountain mist. This is likely the gradual harmony of Yin and Yang. Human Qi is consistent with the Way of Heaven and Earth; thus, resolution is appropriate. This is how the disease state changes when sweating is induced. "Pulse remains unchanged" refers to the hidden pulse mentioned below, meaning the pulse remains hidden and additionally becomes wiry. Wiry is a combination of tight and slippery. Tight is Cold, slippery is Dampness. Cold-Damp hidden below means Yang-heat unresolved above is evident. Hence it says "[this character]" indicates the completion of [this character] disease. This is how the disease changes when sweating is induced but not managed properly. This entire clause summarizes the normal and variable aspects of Cold-Damp disease, and is also the true form of [this character].
Clause 8: Patients with moxibustion sores are difficult to treat.
Patients with moxibustion sores first suffer external fire, then injure pus and blood. Fluids become drier as heat increases, hence difficult to treat.
Clause 9: Mai Jing says: In [this character] disease, the pulse is hidden and firm, going straight up and down.
Hidden means潜伏 (latent) below. Firm means condensed and gathered. Up and down refer to Cun and Chi positions. Going straight up and down means latent and condensed, running straight along the bone from Cun to Chi, with no intention of floating. Generally, although [this character] disease involves Yang-heat in the channels, the reason for the disease lies in Yin not accompanying Yang, but sinking and hiding itself. If Yin rises to respond to Yang, it enters the normal examples of Wind, Cold, Summerheat, and Dampness, and is not [this character]. Generally, [this character] disease resembles midsummer, blaming the exterior for lacking Yin. [this character] pulse resembles winter, blaming the interior for lacking Yang. Is this the non-interaction of Heaven and Earth, and the unfulfilled interaction of Fire and Water? If Yang contains Yin, Yang descends following Yin essence. If Yin contains Yang, Yang ascends following Yang Qi. Left and Right are the pathways of Yin and Yang. Hence death in [this character] disease often results from the inability of the Liver on the left and Lung on the right to ascend and descend. This generally discusses the pulse of [this character] disease, speaking of both the true form of [this character] and the concurrent symptoms caused by injury.
Clause 10: Taiyang Bing. Symptoms are complete. Body is stiff, [sound representing stiffness/tremor]. Pulse is unexpectedly deep and slow. This is [this character]. Gua Lou Gui Zhi Tang (Trichosanthes and Cinnamon Twig Decoction) governs it.
Gua Lou Gui Zhi Tang Formula
Gua Lou Gen (Trichosanthes Radix) - 2 liang
Gui Zhi (Cinnamomi Ramulus) - 3 liang
Shao Yao (Paeoniae Radix Alba) - 3 liang
Gan Cao (Glycyrrhizae Radix et Rhizoma) - 2 liang
Sheng Jiang (Zingiberis Rhizoma Recens) - 3 liang
Da Zao (Jujubae Fructus) - 12 pieces
These six ingredients. Boil in 9 sheng of water, reduce to 3 sheng. Divide into three warm doses. Aim for slight sweating. If no sweat, after a meal interval, drink hot porridge to induce sweat.
When Taiyang Bing symptoms are complete, it refers to stiffness/pain in head and neck, aversion to wind, and fever, not referring to the completeness of [this character] symptoms above. The three phrases "body stiff..." begin entering [this character] disease. "Body" refers to the posterior hairline and paraspinal area. [Sound] represents the image of startled birds stretching their necks. Yangming Bing in Shanghan also presents this way. But Yangming channels are anterior; pathogen excess below Renying causes neck stiffness anteriorly with [sound]. Taiyang channels are posterior; pathogen excess below Fengchi causes neck stiffness posteriorly with [sound]. Seeing such Taiyang symptoms, if the pulse is floating, pulse and symptoms correspond, constituting the true form of Taiyang Wind Strike. But unexpectedly, it is deep and slow. Deep indicates interior; slow indicates absence of Yang. Interior lacks Yang Qi, thus cannot lead Jin Ye to nourish upwards. Hence these Taiyang symptoms are known to be dry-heat. Hence it says "is [this character]". Governing with Gua Lou Gui Zhi Tang: Gui Zhi Tang can resolve heat pathogen in the Ying level, preventing heat from withering Yang fluids. First, Taiyang Yang-heat dissipates through sweat, drawing up Yin Jin from below. Second, Gua Lou grows vines, moves through channels/collaterals, has clear and moistening Qi, and its root tends to ascend. Thus, it draws essence from interior Yin to Taiyang channels. It is suitable for treating Rou Jing with sweating.
Clause 11: Taiyang Bing. No sweating, yet urine is unexpectedly scanty. Qi rushes to the chest. Jaw lock prevents speech. About to develop Gang Jing. Ge Gen Tang (Pueraria Decoction) governs it.
Ge Gen Tang Formula
Ge Gen (Puerariae Lobatae Radix) - 4 liang
Ma Huang (Ephedrae Herba) - 3 liang, remove joints
Gui Zhi (Cinnamomi Ramulus) - 2 liang, remove bark
Shao Yao (Paeoniae Radix Alba) - 2 liang
Gan Cao (Glycyrrhizae Radix et Rhizoma) - 2 liang, honey-fried
Sheng Jiang (Zingiberis Rhizoma Recens) - 3 liang
Da Zao (Jujubae Fructus) - 12 pieces
These seven ingredients. Crush. Boil in 1 dou of water. First boil Ma Huang and Ge Gen, reduce by 2 sheng, skim foam. Add remaining herbs. Boil to 3 sheng. Remove dregs. Warm dose 1 sheng. Cover to achieve slight sweat. No need to drink porridge. Rest follow Gui Zhi Tang care and contraindications.
Taiyang Bing, same as above. No sweating means Cold pathogen injures Ying and condenses/closes Wei Qi. Urine unexpectedly scanty directly relates to [this character] disease. It means Shanghan transforming into heat [this character] disease: Heat pathogen is abundant in the exterior, forcing Yin Qi downward. Normally, urine should be clear and profuse, but now it is unexpectedly scanty. Qi rushing to the chest: Human pores open and close with respiration. Now pores are closed by Cold pathogen. Qi mechanism is blocked and diverted sideways, competing for the path in/out of the chest. Jaw lock: Taiyang channel follows the masseter. Cold pathogen causes sinew tremor, hence jaw lock and inability to speak. Above are all Taiyang Shanghan symptoms. Saying "about to develop Gang Jing" implies the pulse is not floating and tight, but hidden and deep, or possibly tight and straight. Considering all symptoms, one might seem to prefer Ma Huang Tang (Ephedra Decoction) to release the exterior, add Fu Ling (Poria) to promote urination, and Ban Xia (Pinelliae Rhizoma) to direct rebellious Qi downward. Even considering the hidden/deep [this character] pulse, one should add Yin-raising substances like Jiao (Gelatin), Mai Dong (Ophiopogonis Radix), Dang Gui (Angelicae Sinensis Radix), and Di Huang (Rehmanniae Radix) to Ma Huang Tang, heavily using Sheng Ma (Cimicifugae Rhizoma). Moreover, [this character] disease originates from heat-transforming pathogen in the channel and insufficient Jin Ye. Ge Gen is light, floating, and draining, most taboo for dryness-patterns. Yet Zhongjing governs with Ge Gen Tang without hesitation. How divine! Almost incomprehensible. Unknown at that time, he saw clearly the two symptoms of "urine unexpectedly scanty" and "Qi rushing to chest", casually using this, borrowing water to float the boat, using grain to kill the thief. The concern with [this character] disease is the non-interaction of Heaven and Earth, and unfulfilled Water-Fire. Now urine is scanty, Qi rushes to chest; the mechanism of interior Yin is still turning towards the exterior. Governing with Ge Gen Tang to induce sweating drains the upper, so lower Qi must follow. Releasing the exterior makes interior Yin move automatically. The Qi of Jin Ye can ascend, and the hidden pulse will rise. Also, attacking pathogens has its own hierarchy. Cold injuring Ying is the second layer of Taiyang, symbolizing the second gate. Taiyang Wei Qi is the first gate. Yangming muscle layers are the third hall steps. Rather than fighting bandits with bandits at the second layer, it is better to call out from between the third hall steps, making bandits easy to remove. This is the deep meaning of using Ge Gen Tang instead of Ma Huang Tang. As for relying solely on Ge Gen without fearing its draining nature, it is due to the two symptoms of no sweating and scanty urine. No sweating and scanty urine imply accumulated fluid in the Stomach. Borrowing accumulated fluid for sweat avoids damaging Jin Ye. Moreover, removing interior fluid resolves exterior heat. Hence "borrowing water to float the boat, using grain to kill the thief". See Shanghan Lun under Taiyang and Yangming Combined Disease for details.
Clause 12: For [this character] disease. Chest fullness, jaw lock, lying unable to touch the mat, leg cramps, definitely grinding teeth. Da Cheng Qi Tang (Major Order the Yang Decoction) may be given.
This is Taiyang Bing [this character] where heat shifts from the chest to the Stomach Fu, becoming heat-excess. All Taiyang exterior symptoms have ceased. Stomach Fu heat-excess, hence give Da Cheng Qi Tang to purge. Exterior symptoms ceased, hence not called Taiyang Bing, but simply "[this character] disease". Chest fullness is the response to Stomach excess and rising excess Qi. Jaw lock: The Stomach meridian connects lips, mouth, and teeth. Rising excess Qi makes the Stomach meridian tense, hence jaw lock. Lying unable to touch the mat: Restlessness turning side to side. Stomach excess prevents Shen Qi from returning to Earth. Qi of lower jiao legs/shins rests in the emptiness of Large Intestine. Stomach excess makes Large Intestine excess. Intestinal excess prevents Qi and Blood underfoot from relaxing, hence cramps. Teeth grinding is the meaning of jaw lock. Giving Da Cheng Qi Tang removes heat-excess, and upper/lower become harmonious. Question: Why do you know these symptoms do not belong to transmitted disease, but heat shifting from chest, and claim Taiyang exterior symptoms have ceased? Answer: If it were Taiyang transmission, Yangming would have channel/exterior disease. How could one see only Stomach Fu interior excess? Hence "heat shifting from chest". If there were exterior symptoms like headache, fever, aversion to cold, one would not rashly purge, violating the warning against premature purging leading to Jie Xiong (Knotted Chest). Hence "Taiyang exterior symptoms have ceased". Appendix: Zhongjing possesses Bodhisattva's compassion, reveals Immortal secrets, writing this [this character] disease formula discussion to last ten thousand generations. Later generations did not know it as golden rules, placing it in overturned pots. When encountering this disease, they falsely created names like Convulsion Syndrome. Except for fragrant-drying medicines, they only used highly toxic Centipede and Scorpion, heavy-sinking Cinnabar and Gold Leaf, fierce Croton and Pharbitis Seed, and sharp Musk and Borneol. Error passed on, killing countless people. Alas, the lamp of [this character] disease has been covered in dust for a millennium. Who knows of the Pure Vase Nectar and Jade Liquid Returning Elixir? [this character] disease accounts for nine-tenths of children and one-tenth of postpartum women. Children have pure Yang bodies and unfull Jin Ye. Postpartum women have depleted blood and unrecovered Jin Ye. Upon encountering Wind-Cold etc. pathogens invading Taiyang, they transform into heat, injuring channels, and sinews...