太阳病欲解时从巳至未上
巳午未太阳得令之时故解于此
太阳风寒有正治之法桂枝麻黄是也阳偏盛者恐异日之入阳明则有大青龙白虎汤早清其燥热阴偏胜者恐异日之入三阴
则有小青龙五苓散预去其湿寒处治不瘥病在太阳一经自当应药而解不成坏病医不知此实其实而虚其虚若汗若吐若下若温
针补泻异施遂成坏病非复太阳本色矣坏病者即后日之阳明与三阴也阳盛而泄其阴则入阳明阴盛而亡其阳则入三阴桂枝麻
黄之证变为亢阳孤阴是以曰坏至于阳明俟其腑热内实一下而愈犹为逆中之顺然而腑邪伤阴失于急下亦伏死机则顺中之逆
正自不少若夫三阴阴盛阳负动惧危亡则逆居强半而顺不十且仲景于是有救逆之法随证处治转逆为从元通微妙良工苦心矣
桂枝麻黄太阳风寒主方也若至三日之久正将入阳明太阴之期业经汗下温针而病仍不解则事当大坏未必犹在太阳即太
阳未罢而亦未必尚属太阳桂麻之证是宜审观脉证另立新法故总立坏病之纲详开救逆之门也
太阳病三日已发汗若吐若下若温针仍不解者此为坏病桂枝不中与也观其脉证知犯何逆随证治之
太阳病治之得法当解于本经不至入腑传脏而成坏病若至三日之久已经发汗吐下温针诸治而病不解则不在太阳定缘误
治入别经而成坏病当观其脉证知其所犯何逆随证治之曰坏病者非太阳之本病故也
The time when a Taiyang disease (disease of the Taiyang channel) is likely to resolve is from Si hour to Wei hour.
Since Si, Wu, and Wei hours are the times when the Taiyang channel is in command, the disease resolves during this period.
There are standard treatments for wind-cold affecting the Taiyang channel, namely Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction).
If yang qi is predominant, fearing that the pathogen may later enter the Yangming channel, Da Qinglong Tang (Major Blue Green Dragon Decoction) or Baihu Tang (White Tiger Decoction) should be used early to clear dryness-heat;
If yin qi is predominant, fearing that the pathogen may later enter the Three Yin channels, Xiao Qinglong Tang (Minor Blue Green Dragon Decoction) or Wuling San (Five-Ling Powder) should be used in advance to dispel dampness-cold.
If proper management fails to cure the disease, it indicates that the pathogen remains in the Taiyang channel alone, and it should have resolved after taking medicine, failing to become a "Huai Bing" (ruined/complicated disease).
If the physician does not understand this principle, treating excess as deficiency and deficiency as excess, or erroneously applying sweating, vomiting, purging, or moxibustion therapies with incorrect tonification and sedation methods, a Huai Bing is formed, no longer retaining the original characteristics of a Taiyang disease.
A Huai Bing refers to diseases that subsequently transfer to the Yangming channel and the Three Yin channels.
If yang is predominant and yin fluids are mistakenly drained, the pathogen enters the Yangming channel; if yin is predominant and yang qi is mistakenly lost, the pathogen enters the Three Yin channels.
Syndromes originally indicated for Guizhi Tang or Mahuang Tang transform into hyperactive yang or isolated yin due to mismanagement, hence termed "Huai."
Regarding diseases transferred to the Yangming channel, waiting for internal heat and solidification in the fu organs, followed by a single purgative treatment can lead to recovery; this is still considered a favorable outcome within an adverse situation.
However, if fu organ pathogens damage yin fluids and urgent purging is neglected, a latent risk of death exists; this represents an unfavorable outcome within a seemingly favorable situation, which is quite common.
As for diseases entering the Three Yin channels, where yin is excessive and yang is deficient, danger looms constantly, with adverse conditions accounting for the majority and favorable ones less than ten percent.
Zhang Zhongjing therefore established methods for rescuing adverse conditions, treating according to specific syndromes to transform adversity into compliance, embodying subtle principles and the diligent effort of skilled physicians.
Guizhi Tang and Mahuang Tang are the principal formulas for treating wind-cold of the Taiyang channel.
If the disease persists for three days, approaching the period when qi transitions to Yangming and Taiyin, and has already undergone sweating, purging, and moxibustion treatments without resolution, the condition must have severely deteriorated and may no longer belong to the Taiyang channel;
Even if Taiyang symptoms have not completely ceased, they may no longer fit the typical patterns for Guizhi Tang or Mahuang Tang.
At this stage, one must carefully examine the pulse and syndromes and establish new treatment strategies.
Therefore, a general outline for Huai Bing is established, detailing doors to rescue adverse conditions.
After three days of Taiyang disease, if sweating, vomiting, purging, or moxibustion have been applied but the disease remains unresolved, this is called a Huai Bing.
Guizhi Tang should no longer be administered.
One must observe the pulse and syndromes, identify what error (adverse treatment) was committed, and treat according to the current syndrome.
If Taiyang disease is treated correctly, it should resolve within its own channel, preventing transmission to the zang-fu organs and formation of a Huai Bing.
If after three days, various treatments such as sweating, vomiting, purging, and moxibustion have been employed without resolution, the disease definitely no longer resides in the Taiyang channel but has entered other channels due to mismanagement, forming a Huai Bing.
One must observe the pulse and syndromes, determine the nature of the error committed, and treat based on the syndrome.
It is termed a Huai Bing because it is no longer the original disease pattern of the Taiyang channel.