气疼皆因风邪干。内有余热与风抟。此症逢之休妄治。法当寒热分两般。
麻症气痛。皆因内热未泄。外为风寒所袭。食热相搏。内外夹攻。致有此候。然有寒热之分。
寒者易治。热者难为。治之者、先宜探其寒热而施治。方无差谬。凡遇此候。先以冷饭炒热。以绢
包裹乘热而揩其胸。喜揩而痛稍减者。此寒多热少。以香茱汤与之顿服。得吐。则寒邪外泄。而痛
即止。不吐亦即痊愈。若揩之而更加痛者。此内热已极。外感最深。热毒风寒。搏结胸中。吐之难
减。下之不利。温之增剧。凉之弗息。延经一二日。肺胃腐败而死。虽用清热保肺清胃之剂。亦仅
十全一二而已。
朱曰 试气痛寒热。法甚精。然炒热盐试之。亦未尝不可。腹痛不仅有寒热两证。因
气、因血、因痰、因食。且有虚痛。有实痛。原因不一。
香茱汤 治寒痛、绞肠痧等症。
香附米 吴茱萸 五灵脂(俱用醋炒) 台乌药(各三钱) 水煎浓汁。顿服。中病即止。
麻症属阳身宜温。身不温暖有灾 。首尾不温非美候。变症一见谒阎君。
头温脚冷症候逆。初出见之且莫急。正出正收脚仍冷。纵有神方也无益。
遍身发热麻之常。若不发热苦难当。收后下体冷过膝。此为肾败治无方。
四肢身体冷如雪。初热见之毒难出。正收收后逢斯症。脾胃败坏死可决。
痘症头温足冷为顺。如麻见头温足冷之症。则为逆候。然而麻症有下体冷者。亦有顺逆。但
有先后之分耳。何则。麻之为症。上膈主之。必从头上热至脚。其初热时。上身壮热。下体及脚凉
冷。必须壮热至足。麻方得出。故初发热之时。下体及脚凉冷。此为顺候。若出后及正收之时。则
上身下体。俱以不冷为佳。此时下体冷者。则为逆候。至于麻收之后。则宜遍体温凉如常。倘有
麻收之后。虽遍身温凉如常。独下体厥冷过膝上止者。此为肾败。不治之症。若初出之时。腰以下
不热。毒不能透。而反渐收者。亦为逆候。急当温养脾肾。或有得生者。温脾如白芍药、炙甘草之
类。果仁、白术等味。在所宜禁。养肾如熟地黄、当归之属。杜仲、枸杞等味。又在所必忌。只可用
养阴汤。(见三十二条)去麦冬、元参、薄荷、荆芥、川芎。加炙甘草。以补其脾、养其肾耳。夫麻乃
肺胃邪热所发。本属于阳。故四肢身体常宜温暖。若四肢身体反冷如冰者。则是大逆症矣。若初
出正出之时。四肢身体冷如冰者。则毒不得透。而麻必渐收。若正收及收后。肢体冷如冰者。此乃
脾胃败坏。气血大虚。毒必不尽。定不治矣。
气痛(因气机阻滞引起的疼痛)皆由风邪侵袭所致。体内有余热与风邪搏结。遇到这种病症不要胡乱治疗,治疗方法应当根据寒证和热证分为两类。
麻疹并发的气痛,都是因为体内热毒未能宣泄,外部又受到风寒的侵袭,饮食积滞与热邪相互搏结,内外夹攻,从而导致这种症状。然而,其中有寒证和热证的区别。
寒证容易治疗,热证难以处理。治疗的人,首先应当探明是寒证还是热证,然后施以相应的治疗,这样才不会出错。凡是遇到这种情况,先用冷饭炒热,用绢布包裹,趁热擦拭患者的胸部。如果患者喜欢被擦拭且疼痛稍微减轻的,这是寒多热少,给予香茱汤一次性服用。如果能呕吐出来,那么寒邪就会向外宣泄,疼痛随即停止;即使不呕吐,也会痊愈。如果擦拭后疼痛反而加剧的,这是体内热毒已经极盛,外感风寒最深,热毒与风寒搏结在胸中,催吐难以缓解,泻下不利,温补会加重病情,凉润也不能平息。拖延经过一两天,肺胃腐败而死亡,虽然使用清热保肺、清胃的药物,也仅仅能治愈一二例而已。
朱氏说:试探气痛的寒热属性,方法非常精妙。然而用炒热的盐来试探,也未尝不可。腹痛不仅有寒证和热证两种情况,还有因气滞、因血瘀、因痰湿、因食积引起的,且有虚痛和实痛之分,原因各不相同。
香茱汤:治疗寒性疼痛、绞肠痧等病症。
配方:香附米、吴茱萸、五灵脂(均用醋炒)、台乌药(各三钱)。用水煎煮成浓汁,一次性服用。病愈即止。
麻疹属于阳证,身体应当温暖。身体如果不温暖会有灾祸。头部和脚部都不温暖不是好的征象,一旦出现变症,恐怕就要见阎王了。
头温脚冷的症状属于逆证。在麻疹刚发出时见到这种情况不要着急。如果在正出期或收没期脚仍然冷,即使有神医方子也没有益处。
遍身发热是麻疹的常理,如果不发热则苦难难当。在收没之后,下体寒冷超过膝盖,这是肾气败坏,没有治疗办法。
四肢和身体冷如冰雪,在初热期见到这种症状,说明毒邪难以透出。在正出期或收没期遇到这种症状,可以断定脾胃败坏坏死,必死无疑。
痘症出现头温足冷是顺证。如果是麻疹出现头温足冷的症状,则是逆证。然而麻疹也有下体发冷的情况,也有顺证和逆证之分,只是有先后时间的区别罢了。为什么呢?麻疹这种病症,主要在上膈,必须从头部发热传导至脚部。在初热阶段,上身壮热,下体及脚凉冷,必须让壮热传导至足部,麻疹才能发出。所以在初发热的时候,下体及脚凉冷,这是顺证。如果在出疹后及正收时期,那么上身和下体都应当不冷为佳。此时如果下体发冷,就是逆证。至于麻疹收没之后,应当全身温度凉爽如常人。倘若麻疹收没之后,虽然全身温度凉爽如常人,唯独下体厥冷超过膝盖以上,这是肾气败坏,是不治之症。如果在初出之时,腰部以下不热,毒邪不能透发,反而逐渐收没,也是逆证。此时应当紧急温养脾肾,或许还有生存的可能。温补脾脏可用白芍药、炙甘草之类的药物,果仁、白术等味道,应当在禁忌之列。滋养肾脏可用熟地黄、当归之类的药物,杜仲、枸杞等味道,又在绝对禁忌之列。只可以使用养阴汤。(见第三十二条),去掉麦冬、元参、薄荷、荆芥、川芎,加入炙甘草,以此来补益脾脏、滋养肾脏。麻疹乃是肺胃邪热所引发,本属于阳证,所以四肢和身体常常应当保持温暖。如果四肢和身体反而冷如冰,这就是大逆症了。如果在初出或正出时期,四肢和身体冷如冰,那么毒邪不得透发,麻疹必然逐渐收没。如果在正收期及收没后,肢体冷如冰,这是脾胃败坏,气血极度虚弱,毒邪必定不能完全排出,一定是不治之症了。
Qi pain (pain caused by qi stagnation) is all due to the invasion of wind pathogen. Internal residual heat combats with wind. When encountering this syndrome, do not treat it recklessly; the method should be divided into two categories based on cold and heat syndromes.
Qi pain complicating measles is all because internal heat has not been vented, and externally the body is attacked by wind-cold. Food stagnation combats with heat, attacking from both inside and outside, leading to this condition. However, there is a distinction between cold and heat syndromes.
Cold syndromes are easy to treat; heat syndromes are difficult to manage. The practitioner must first probe whether it is a cold or heat syndrome before applying treatment, so as to avoid errors. Whenever this condition occurs, first stir-fry cold rice until hot, wrap it in silk cloth, and rub the patient's chest while it is still hot. If the patient enjoys the rubbing and the pain slightly subsides, this indicates more cold than heat. Administer Xiangzhu Tang (Cinnamon Twig and Evodia Decoction) for immediate ingestion. If vomiting occurs, the cold pathogen will be expelled outward, and the pain will stop immediately; even if no vomiting occurs, recovery will follow. If the pain intensifies after rubbing, this indicates that internal heat toxicity is extremely severe and external wind-cold penetration is deepest. Heat toxicity and wind-cold are knotted in the chest. Vomiting is difficult to reduce it, purgatives are ineffective, warming aggravates it, and cooling fails to subside it. After one or two days, the lungs and stomach rot, leading to death. Even with agents that clear heat, protect the lungs, and clear the stomach, only one or two out of ten may survive.
Zhu stated: The method for testing the cold or heat nature of Qi pain is very refined. However, using stir-fried hot salt for testing is also acceptable. Abdominal pain is not limited to just cold and heat syndromes; it can be caused by qi, blood, phlegm, and food, and includes deficiency pain and excess pain, with various causes.
Xiangzhu Tang: Treats cold pain, intestinal colic (Jiaochang Sha), etc.
Ingredients: Xiangfu Mi (Cyperi Rhizoma), Wuzhuyu (Evodiae Fructus), Wulingzhi (Trogopteri Dung), Taiwuyao (Linderae Radix) (each 3 qian, all stir-fried with vinegar). Decoct in water to make a concentrated juice. Take once. Stop when the disease is cured.
Measles belongs to Yang syndromes, and the body should be warm. If the body is not warm, disaster ensues. If neither the head nor the feet are warm, it is an unfavorable sign; once complications appear, death is imminent.
Head warmth with foot coldness is a reverse syndrome. Do not panic if seen when measles first erupts. If the feet remain cold during the full eruption or resolution phase, even divine prescriptions are useless.
Generalized fever is common in measles; without fever, suffering is unbearable. If the lower body becomes cold below the knees after resolution, this indicates kidney failure, which is untreatable.
Limbs and body cold as snow/ice: if seen during initial fever, toxin cannot emerge. If encountered during full eruption or resolution, spleen and stomach failure and necrosis are certain, leading to death.
In smallpox, head warmth with foot coldness is a favorable (shun) syndrome. In measles, however, head warmth with foot coldness is a reverse (ni) syndrome. Yet, measles cases with cold lower bodies can be either favorable or reverse, distinguished by timing. Why? Measles pathology is primarily located in the upper jiao (diaphragm area). Heat must spread from the head down to the feet. During initial fever, the upper body is intensely hot while the lower body and feet are cool. It is necessary for intense heat to reach the feet for measles to erupt. Therefore, cool lower body and feet during initial fever are a favorable sign. However, after eruption and during resolution, it is best for both upper and lower bodies to be non-cold. Coldness in the lower body at this stage is a reverse sign. After measles resolution, the whole body should be lukewarm as normal. If, after resolution, the whole body is lukewarm but the lower body is cold above the knees, this is kidney failure, an untreatable condition. If during initial eruption, the waist and below are not hot, preventing toxin transparency, and instead gradually resolving, this is also a reverse sign. Urgently warm and nourish the spleen and kidney; survival is possible. To warm the spleen, use Baishao Yao (Paeoniae Radix Alba), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata); Guoren (Pruni Semen) and Baizhu (Atractylodis Macrocephalae Rhizoma) are contraindicated. To nourish the kidney, use Shudihuang (Rehmanniae Radix Preparata), Danggui (Angelicae Sinensis Radix); Duzhong (Eucommiae Cortex) and Gouqi (Lycii Fructus) are strictly contraindicated. Only Yangyin Tang (Nourishing Yin Decoction) [see Article 32] should be used, removing Maidong (Ophiopogonis Radix), Yuanshen (Scrophulariae Radix), Bohe (Menthae Haplocalycis Herba), Jingjie (Schizonepetae Spica), and Chuanxiong (Ligustici Chuanxiong Rhizoma), adding Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) to tonify the spleen and nourish the kidney. Measles originates from evil heat in the lungs and stomach, belonging inherently to Yang. Thus, limbs and body should generally remain warm. If limbs and body become cold as ice, it is a major reverse syndrome. If limbs and body are cold as ice during initial or full eruption, toxin cannot penetrate, and measles will gradually resolve prematurely. If limbs and body are cold as ice during resolution or after resolution, this indicates spleen and stomach failure, extreme deficiency of qi and blood, and incomplete expulsion of toxin; it is definitely untreatable.