者,先太阳中风,重感于寒,无汗为刚 ;中风,重感于湿,有汗为柔 。俱身热足寒,颈
项强急,恶寒,头面赤,目脉赤,独头摇,卒口噤,背反张,手足挛搐,皆 病也。伤风头痛,常
自汗出而呕,若汗之,必发 。大发湿家汗,亦作 。新瘥血虚,汗出当风,亦成 。若脉沉而迟,
或紧,或散于指外者,皆死证也。有汗,加减冲和汤;无汗者,羌活冲和汤;口噤切牙者,大承气
汤下之。
螈 者, 则急而缩, 则缓而伸。热则生风,风主乎动,故筋脉相引而伸缩。伤寒至此证,
可谓死矣,能以去风涤热之剂,间有生者,是其幸也。治法 病同。
风温,尺寸俱浮,素伤于风,因时伤热,风与热搏,即为风温。其外证四肢不收,身热自汗,
头疼喘息,发渴昏睡,或体重不仁。慎不可汗,汗之则谵语躁扰,目乱无睛光,病在少阴、厥阴二
经,葳蕤汤、小柴胡选用。未醒者,柴胡桂枝汤。发汗复身灼热,知母葛根汤;渴者,栝蒌根汤。
脉浮身重,防己汤。误汗风温,防己黄 汤也。
湿温,寸濡而弱,尺小而急,素伤于湿,因时中暑,湿与热搏,即为湿温。其
状胸腹满,目痛,壮热妄言,自汗,两胫疼,倦怠恶寒。若发其汗,使人不能言,耳聋,不知痛处,
其身青,面色变,是医杀人耳。湿温在太阴,苍术白虎汤加桂。湿气胜,一身尽痛,发热身黄,小
便不利,大便尽快,五苓散加茵陈。脏虚自利,附子理中汤也。
The condition referred to as "Jing" (Spasm) occurs when one first contracts Wind-Strike at the Taiyang stage and is subsequently re-exposed to Cold. If there is no sweating, it is termed Gang-Jing (Rigid Spasm); if Wind-Strike is followed by re-exposure to Dampness with sweating present, it is termed Rou-Jing (Flaccid Spasm). Both present with fever in the body but cold feet, stiffness and tension in the neck and nape, aversion to cold, redness of the head and face, congestion of the eye vessels, isolated head tremor, sudden lockjaw, opisthotonos (backward arching of the back), and spasmodic contraction of the limbs. These are all manifestations of Jing disease. Headache due to Wind-Strike typically presents with spontaneous sweating and vomiting; if diaphoresis is incorrectly induced, Jing will inevitably develop. Excessive sweating in patients with chronic Dampness also induces Jing. Patients recovering from illness with blood deficiency who sweat and are exposed to wind will also develop Jing. If the pulse is deep and slow, or tight, or scattered beyond the finger pads, these are signs of death. For cases with sweating, use Modified Chonghe Decoction; for cases without sweating, use Qianghuo Chonghe Decoction; for those with lockjaw and teeth grinding, administer Da Chengqi Tang to purge.
"Chi Zong" (Clonic convulsions) refers to the alternating contraction (Chi) and extension (Zong) of tendons and vessels. Heat generates Wind, and Wind governs movement, causing the tendons and vessels to pull against each other, resulting in alternating contraction and extension. When Shanghan progresses to this stage, it is considered fatal; survival is only possible through the rare application of formulas that dispel Wind and clear Heat, which is merely a stroke of luck. The treatment method is the same as for Jing.
Fengwen (Wind-Warmth) presents with floating pulses at both the Cun and Chi positions. It arises from pre-existing Wind injury compounded by seasonal Heat exposure, where Wind and Heat contend to form Fengwen. External symptoms include inability to control the limbs, body heat, spontaneous sweating, headache, wheezing, thirst, drowsiness, or heavy sensation with numbness. Diaphoresis must strictly be avoided; inducing sweat leads to delirium, restlessness, chaotic vision with loss of luster, indicating pathology in the Shaoyin and Jueyin meridians. Wenyu Tang or Xiao Chaihu Tang should be selected. If consciousness is not restored, Chaihu Guizhi Tang is used. If body heat intensifies after sweating, Zhimu Gegen Tang is indicated; for severe thirst, Gualougen Tang is used. For floating pulse and heaviness, Fangji Tang is employed. For complications arising from incorrect sweating in Fengwen, Fangji Huangqi Tang is used.
Shiwen (Damp-Warmth) presents with a soggy and weak pulse at the Cun position and a small, rapid pulse at the Chi position. It results from pre-existing Damp injury compounded by seasonal Summerheat, where Damp and Heat contend to form Shiwen. Symptoms include fullness in the chest and abdomen, eye pain, high fever with delirious speech, spontaneous sweating, pain in both calves, fatigue, and aversion to cold. Inducing sweating in this condition renders the patient mute, deaf, unaware of pain locations, causes the body to turn blue, and alters facial complexion; this constitutes medical homicide. For Shiwen affecting the Taiyin meridian, Cangzhu Baizhu Tang (Cangzhu Baihu Tang) with Gui Zhi is used. For predominant Dampness presenting with generalized pain, fever, jaundice, difficult urination, and loose stools, Wuling San with Yinchen is administered. For deficiency of the Zang organs leading to spontaneous diarrhea, Fuzi Lizhong Tang is used.