前太阳兼肺。在寒邪一边。此阳明兼肺。在温邪一边。均以手太阴为治。
如遇发热恶寒。咳嗽喉燥。渴饮。舌苔白中带黄。或白而燥刺。或边红中白。脉来浮
数。此风温客于太阴手经。而内热发于阳明之表也。宜羚羊角、前胡、杏仁、连翘、薄荷、桔梗、黄
芩、豆豉、淡竹叶之类。以解风热。如兼烦闷呕恶。脉沉足冷者。欲发痧疹也。亦以此方加牛蒡、
防风透之。
邵评∶风温初入肺卫。在阳明之表。
如痧疹已透。尚有头胀心烦。脘闷咳嗽者。肺气不得宣畅也。宜栀豉、蒌仁、桔梗、黄
芩、连翘、牛蒡、川贝、郁金之类。使肺气通畅。痧疹透达。诸症自解。
若痧疹已透。仍然胸胁闷痛。咳嗽喘急者。此有伏痰也。其气口脉闭。是痰之验也。
宜豁痰利气。如前胡、杏仁、栝蒌、橘红、苏子、象贝、桔梗、枳壳、莱菔子、竹沥、姜汁之类
投之。痰自出矣。
凡风寒之入。由皮毛而腠理。腠理为阳明少阳之界。作表症看。非邪已入阳明之里。而复传于少
阳也。柯韵伯力辨阳明传少阳之谬。以此。
如身热口渴。微兼恶寒。舌苔中白边红。或根白尖红。脉来弦滑。此邪入肌肉腠理之间。阳明少
阳之表证也。宜解肌法。如柴葛、连翘、薄荷、黄芩、橘红之类。以取肌分之汗。热自退矣。（伤寒）
如见舌苔白少红多。初起微寒。即发热不已。此阳明轻而少阳重。气分少而营分多。宜犀角、连翘、
丹皮、钩丁、黄芩、薄荷、黑栀之类。以清营分之热。太忌汗散。（温邪）
邵评∶此条温邪自口鼻而受。由肺卫而入手少阳三焦。从心营肺卫治。用手经药。与上寒邪在足经
者。治法不同。大宜留意。
The previously discussed condition involves the Taiyang channel (Taiyang Channel) concurrent with lung involvement, belonging to the category of cold pathogen (Cold Pathogen) etiology. The present discussion concerns Yangming channel (Yangming Channel) concurrent with lung involvement, belonging to the category of warm pathogen (Warm Pathogen) etiology. Both conditions prioritize treatment via the Hand-Taiyin Lung Channel (Hand-Taiyin Lung Channel).
If one encounters fever (Fever), aversion to cold (Aversion to Cold), cough (Cough), dryness of the throat (Dry Throat), thirst with desire for drinks (Thirst), white tongue coating with yellow hues, or white coating that is dry and prickly, or red edges with a white center, and a floating and rapid pulse (Floating-Rapid Pulse), this indicates Wind-Warmth pathogen invading the Hand-Taiyin Lung Channel, causing internal heat to manifest on the exterior of the Yangming channel. It is appropriate to use Antelope Horn (Antelope Horn), Peucedani Radix (Peucedani Radix), Apricot Seed (Apricot Seed), Forsythia Fruit (Forsythia Fruit), Mint Herb (Mint Herb), Platycodon Root (Platycodon Root), Scutellaria Root (Scutellaria Root), Fermented Soybean (Fermented Soybean), and Bamboo Leaf (Bamboo Leaf) to resolve Wind-Heat. If accompanied by irritability, nausea, vomiting, deep pulse (Deep Pulse), and cold feet, it suggests the impending eruption of scarlet rash (Scarlet Rash). In such cases, add Bullace Seed (Bullace Seed) and Saposhnikovia Root (Saposhnikovia Root) to the aforementioned formula to promote eruption.
Shao’s Commentary: When Wind-Warmth initially enters the Lung-Wei (Lung-Wei) level, it resides at the exterior of the Yangming channel.
If the scarlet rash has already erupted, yet head distension, mental restlessness, epigastric stuffiness, and cough persist, it indicates that Lung Qi fails to diffuse and circulate freely. It is appropriate to use Gardenia Fruit (Gardenia Fruit), Fermented Soybean (Fermented Soybean), Trichosanthes Seed (Trichosanthes Seed), Platycodon Root (Platycodon Root), Scutellaria Root (Scutellaria Root), Forsythia Fruit (Forsythia Fruit), Bullace Seed (Bullace Seed), Fritillaria Bulb (Fritillaria Bulb), and Curcuma Tuber (Curcuma Tuber) to facilitate the free flow of Lung Qi, ensuring complete eruption of the rash, after which all symptoms will naturally resolve.
If the scarlet rash has erupted but chest and hypochondriac stuffiness/pain, cough, and wheezing/dyspnea persist, this indicates latent Phlegm (Phlegm). A closed pulse at the Qi Kou (Qi Kou - radial artery at the wrist) confirms the presence of Phlegm. It is appropriate to employ methods to resolve Phlegm and regulate Qi. One may administer Peucedani Radix (Peucedani Radix), Apricot Seed (Apricot Seed), Trichosanthes Fruit (Trichosanthes Fruit), Tangerine Peel (Tangerine Peel), Perilla Seed (Perilla Seed), Zhe Bei Mu (Zhe Bei Mu - Fritillaria Cirrhosa Bulb), Platycodon Root (Platycodon Root), Aurantium Fructus Immaturus (Aurantium Fructus Immaturus), Radish Seed (Radish Seed), Bamboo Sap (Bamboo Sap), and Ginger Juice (Ginger Juice). The Phlegm will then be expelled.
Generally, when Wind-Cold pathogens invade, they enter from the skin and hair into the Cou Li (Cou Li - interstices between skin and muscle). The Cou Li serves as the boundary between the Yangming and Shaoyang channels; thus, it should be viewed as an Exterior Syndrome (Exterior Syndrome), not as the pathogen having entered the interior of the Yangming channel and subsequently transmitted to the Shaoyang channel. Ke Yunbo vigorously refuted the fallacy of transmission from Yangming to Shaoyang based on this principle.
If body heat and thirst are present, slightly accompanied by aversion to cold, with a tongue coating that is white in the center and red on the edges, or white at the root and red at the tip, and a string-taut and slippery pulse (String-Taut-Slippery Pulse), this indicates the pathogen has entered the muscles and Cou Li, representing an Exterior Syndrome of both Yangming and Shaoyang channels. It is appropriate to apply the Muscle-Releasing Method (Muscle-Releasing Method). Using Bupleurum Root (Bupleurum Root) and Kudzu Root (Kudzu Root), Forsythia Fruit (Forsythia Fruit), Mint Herb (Mint Herb), Scutellaria Root (Scutellaria Root), and Tangerine Peel (Tangerine Peel) can induce sweating from the muscle layer, thereby resolving the heat. (This pertains to Cold Damage/Shanghan).
If the tongue coating shows less white and more red, with initial slight aversion to cold followed by persistent unremitting fever, this indicates mild Yangming involvement and severe Shaoyang involvement, with lesser Qi-level involvement and greater Ying-level (Nutrient Level) involvement. It is appropriate to use Rhinoceros Horn (Rhinoceros Horn - note: substitute with water buffalo horn in modern practice), Forsythia Fruit (Forsythia Fruit), Moutan Bark (Moutan Bark), Uncaria Ramulus cum Uncis (Uncaria Ramulus), Scutellaria Root (Scutellaria Root), Mint Herb (Mint Herb), and Charred Gardenia Fruit (Charred Gardenia Fruit) to clear Heat from the Ying level. Sweating and dispersing methods are strictly contraindicated. (This pertains to Warm Pathogens/Wenbing).
Shao’s Commentary: In this clause, the Warm Pathogen enters via the mouth and nose, transmitting from the Lung-Wei level to the Hand-Shaoyang Sanjiao Channel (Hand-Shaoyang Sanjiao Channel). Treatment should focus on the Heart-Ying and Lung-Wei levels using herbs targeting the Hand Channels. This therapeutic approach differs from that for Cold pathogens affecting the Foot Channels mentioned above. Great attention should be paid to this distinction.