凡感外邪。头痛恶寒发热。而兼咳嗽者。此伤风之重症。伤寒之轻症也。盖肺主皮毛。太阳主一身
之表。原相联属。但兼咳嗽。则邪外传于肺而解。不致传里。故为轻症。主治以手太阴为主。如寒邪
重。则舌润不渴。宜六安煎。加羌活、苏叶之类。汗之。如寒天兼喘。气口脉闭。加麻黄。(肺受寒邪)
如发热头痛咳嗽。外虽恶寒。而口渴舌燥。此肺有火邪。而太阳感寒也。宜羌活、前
胡、桑、杏、羚羊、薄荷、黄芩、贝母、橘红、桔梗之类。外散寒邪。内清肺火。兼喘者。火为寒
郁。麻、杏、甘、石汤妙。(寒包火)
邵评∶开肺即是开太阳。此寒包火正治法。
凡人之胃阳充旺。则风寒之入。只在阳经盘旋。不致直入三阴。若胃阳一亏。则寒中太阳。而太阴脾
经。亦与之同时并受。如发热恶寒。即兼泄泻者是也。必舌润不渴。脉来沉缓。法当温中散寒。宜羌活、
紫苏、浓朴、焦曲、广皮、木香、茯苓、炙草之类。外散寒邪。内和脾胃。俾得微汗利止。身凉而愈。
如感之轻。则寒热泄泻。治法亦同。(伤寒)
胃阳为三阴之障。阳气一虚。则寒邪即能袭入三阴。然肾气不虚。则少阴不致受邪。若肾气一虚。
则坎中之阳。不足以御阴邪。即从太阳而入于肾。凡见太阳表证。而脉沉细。肩背恶寒。大便不实。小便
清白者。此即太阳与少阴俱病。重症也。法当温里散寒。宜桂枝汤加当归、(酒炒)山药、干姜、
独活、细辛、胡桃之类。温肾逐邪。若目戴眼上视。气促而喘。或角弓发痉。尤为危候。景岳所谓太阳
未解。少阴先溃是也。须大温中饮主之。冀其回阳作汗。庶有生机。(伤寒)
Whenever external pathogens are contracted, resulting in headache, aversion to cold, fever, and accompanied by coughing, this is a severe form of wind-cold injury (Shangfeng) but a mild form of cold damage (Shanghan). This is because the Lung governs the skin and hair, while the Taiyang channel governs the exterior of the entire body; originally, they are interconnected. However, since coughing is present, it indicates that the pathogen transmits outward to the Lung and is resolved, preventing transmission into the interior organs; thus, it is considered a mild condition. Treatment should primarily focus on the Hand-Taiyin Lung channel. If the cold pathogen is heavy, manifesting as a moist tongue without thirst, Liu'an Decoction (Six-Safe Decoction) is appropriate, added with herbs such as Qianghuo (Notopterygii Rhizoma et Radix) and Ziyeh (Perillae Folium), to induce sweating. If it occurs in cold weather accompanied by wheezing, and the radial pulse at the cunkou position is closed (imperceptible), Mahuang (Ephedrae Herba) should be added. (This is due to the Lung being invaded by cold pathogen.)
If fever, headache, and cough occur, and although there is aversion to cold externally, there is thirst and a dry tongue, this indicates fire pathogen in the Lung combined with cold invasion of the Taiyang channel. It is suitable to use herbs such as Qianghuo (Notopterygii Rhizoma et Radix), Qianhu (Peucedani Radix), Sangbaipi (Mori Cortex), Xingren (Armeniacae Semen Amarum), Lingyangjiao (Saigantong Cornu), Bohe (Menthae Haplocalycis Herba), Huangqin (Scutellariae Radix), Beimu (Fritillariae Bulbus), Juhong (Citri Reticulatae Pericarpium Rubrum), and Jiegeng (Platycodonis Radix) to disperse cold pathogen from the exterior and clear Lung fire from the interior. If accompanied by wheezing, it is because fire is constrained by cold; in this case, Mahxing Ganshi Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) is excellent. (This is the "Cold Wrapping Fire" pattern.)
Commentary by Shao: Opening the Lung is equivalent to opening the Taiyang channel; this is the correct treatment method for "Cold Wrapping Fire."
Generally, if a person's Stomach Yang is robust, when wind-cold invades, it only circulates within the Yang channels and does not directly enter the Three Yin channels. If Stomach Yang is deficient, however, cold will invade the Taiyang channel, and the Taiyin Spleen channel will simultaneously suffer. For example, fever and aversion to cold accompanied by diarrhea illustrate this. In such cases, the tongue must be moist without thirst, and the pulse must be deep and slow. The method should be to warm the middle and dispel cold, using herbs such as Qianghuo (Notopterygii Rhizoma et Radix), Zisu (Perillae Folium), Houpo (Magnoliae Officinalis Cortex), Jiaoqu (Stellerae Radix Fermented), Guangpi (Citri Reticulatae Pericarpium), Muxiang (Aucklandiae Radix), Fuling (Poria), and Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) to disperse cold from the exterior and harmonize the Spleen and Stomach internally, leading to slight sweating, cessation of diarrhea, cooling of the body, and recovery. If the contraction is mild, presenting with alternating chills and fever with diarrhea, the treatment method remains the same. (Belongs to Shanghan/Cold Damage)
Stomach Yang serves as a barrier for the Three Yin channels. Once Yang Qi is deficient, cold pathogen can invade the Three Yin channels. However, if Kidney Qi is not deficient, the Shaoyin channel will not be affected. If Kidney Qi becomes deficient, then the Yang within Kan (the Kidney/Ministerial Fire) is insufficient to resist Yin pathogen, and the pathogen enters the Kidney from the Taiyang channel. Whenever Taiyang exterior signs are seen, along with a deep and fine pulse, aversion to cold in the shoulder and back, loose stools, and clear urine, this constitutes simultaneous disease of the Taiyang and Shaoyin channels, which is a severe condition. The method should be to warm the interior and dispel cold, using Guizhi Tang (Cinnamon Twig Decoction) added with Danggui (Angelicae Sinensis Radix - wine-fried), Shanyao (Dioscoreae Rhizoma), Ganjiang (Zingiberis Rhizoma), Duhuo (Angelicae Pubescentis Radix), Xixin (Asari Radix et Rhizoma), and Hutao (Juglandis Semen) to warm the Kidney and drive out pathogen. If the eyes roll upward (Daiyan), breathing is rapid with wheezing, or opisthotonos with spasms occurs, these are particularly critical prognoses. This is what Zhang Jingyue referred to as "Taiyang not yet resolved, Shaoyin collapsing first." Da Wenzhong Yin (Great Middle-Warming Decoction) must be used as the primary treatment, hoping to restore Yang Qi and induce sweating, thereby offering a chance for survival. (Belongs to Shanghan/Cold Damage)