合病两三经同病,并病传归并一经。二阳合病满喘发,自利葛根呕半同。太少利芩
呕加半,明少弦负顺长生,滑数宿食大承气,三阳合病腹膨膨,口燥身重而谵语,欲眠合
目汗蒸蒸,遗尿面垢参白虎,浮大汗下禁当应。二阳并病汗不彻,面赤怫郁大青龙,表
罢潮热手足汗,便难谵语大承攻。太少头项痛眩冒,心下痞硬如结胸,禁汗吐下惟宜刺,
谵惊不食利多凶。
【注】一经未罢,又传一经,二经、三经同病,而不归并一经者,谓之合病。二经、三
经同病,而后归并一经自病者,谓之并病。二阳,谓太阳、阳明也。太阳则有头痛、发热、
恶寒、无汗,阳明则有肌热、恶热、心烦、不眠之证,相协议病也。满喘,谓二阳合病当
下利不下利,更加胸满而喘,宜麻黄汤发之。自利,谓二阳合病当有之证,宜葛根汤也。呕
半,谓二阳合病,不下利但加呕者,宜葛根汤加半夏也。同,谓二证同用葛根一方也。太
少,谓太阳、少阳合病也。太阳则有头痛发热,恶寒无汗;少阳则有寒热往来,口苦耳
聋,目眩胸胁痛之证,相协议病也。利芩,谓太阳、少阳合病当自下利,宜与黄芩汤也。呕
加半,谓太阳、少阳合病不自利,但加呕者,宜黄芩汤加半夏也。若不呕利而见太阳、少
阳之证,非合病也;宜用柴胡桂枝汤两解之。明少,谓阳明、少阳两经之证同见下利合病
也。弦负,弦为少阳木脉,木胜则土负,负则死也。顺长生,长为阳明土脉,土盛则木
不能灾为顺,顺则生也。滑数,谓阳明、少阳合病,下利粘秽者,脉必滑数,是宿食也,
宜大承气汤;呕酸苦者,宜大柴胡汤。三阳,谓太阳、阳明、少阳合病也。腹膨膨,谓腹
胀满也。口燥,谓口中干燥也。身重,谓身重难转侧也。谵语,谓妄乱言也。欲眠,谓
喜睡也。合目汗蒸蒸,谓合目出热汗也。遗尿,谓失尿不知也。面垢,谓面似有油垢也。
此皆三阳热盛,津液枯竭之证,设使脉浮,禁不可汗,脉大亦不可下,惟宜用白虎加人参,
益气生津清热可也。若未经汗下,津液未伤,三阳合病,轻证惟宜柴葛解肌汤,清解三阳
可也。二阳,谓太阳阳明并病也。汗不彻,谓邪在太阳,发汗未彻,又传阳明也。面赤,谓
邪犹怫郁于太阳、阳明之表,未并阳明之腑,宜大青龙汤解两经之热也。表罢,谓太阳证
罢也。潮热、手足汗、大便难、谵语,谓已归并阳明腑也,宜大承气汤,攻阳明实热也。
太少,谓太阳、少阳并病也。头项强痛,目眩昏冒,心下痞硬,如结胸证,谓太阳少阳
二经之证尚未归并,其邪未定,禁不可汗下,惟宜刺大椎、肝 、肺 ,以泻其热也。若
误发汗,则必发谵语。若误吐下,则必心烦而惊,水浆不入,下利不止。变此恶候,命
多凶也。义详合病并病篇。
He Bing (Combined Disease) refers to the simultaneous onset of pathogenic factors in two or three meridians, whereas Bing Bing (Consecutive Disease) refers to the transmission of pathogenic factors from one meridian to another, eventually consolidating into a single meridian.
In Taiyang and Yangming He Bing, if chest fullness, wheezing, and diarrhea occur, Gegen Tang (Kudzu Decoction) is indicated; if vomiting occurs, Gegen Jia Banxia Tang (Kudzu Decoction with Pinellia) is indicated.
In Taiyang and Shaoyang He Bing, if spontaneous diarrhea occurs, Huangqin Tang (Scutellaria Decoction) is indicated; if vomiting occurs, Huangqin Jia Banxia Tang (Scutellaria Decoction with Pinellia) is indicated.
Prognosis: A Xian (Wiry) pulse indicates adverse conditions (Ni), suggesting death; a Chang (Long) or Da (Large) pulse indicates favorable conditions (Shun), suggesting survival.
If the pulse is Hua Shuo (Slippery and Rapid), accompanied by sticky and foul diarrhea, it indicates retained food stagnation, and Dachengqi Tang (Major Order the Qi Decoction) is indicated for purging.
In San Yang (Three Yang) He Bing, symptoms include abdominal distension and fullness, dry mouth, heaviness of the body making turning difficult, delirious speech, somnolence, steaming sweat when closing the eyes, urinary incontinence, and a greasy appearance of the face. This condition is treated with Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng). If the pulse is Fu (Floating), sweating therapy is strictly contraindicated; if the pulse is Da (Large), purging therapy is strictly contraindicated.
In Taiyang and Yangming Bing Bing, due to incomplete sweating therapy, pathogenic factors remain constrained on the exterior, presenting with facial redness and restlessness (Fu Yu); Da Qinglong Tang (Major Green Dragon Decoction) is indicated to release heat from both meridians.
If the Taiyang exterior syndrome has resolved, and symptoms such as tidal fever, continuous sweating of the hands and feet, difficulty in defecation, and delirium appear, it indicates that the pathogen has consolidated into the Yangming Fu-organ excess heat; Dachengqi Tang (Major Order the Qi Decoction) is indicated for purging.
In Taiyang and Shaoyang Bing Bing, symptoms include stiffness and pain in the head and neck, dizziness and vertigo, and epigastric hardness resembling Jie Xiong (Chest Binding) syndrome. At this stage, sweating, emesis, and purging therapies are strictly contraindicated; only acupuncture treatment is suitable.
If sweating is mistakenly applied, delirium will inevitably occur; if emesis or purging is mistakenly applied, it will lead to vexation, palpitations, inability to take fluids, and incessant diarrhea, indicating a critical and dangerous prognosis.