大法。春夏宜发汗。
此叔和推法外意。举大概以揭言之。春夏宜发汗者。顺阳事也。然伤寒。冬病也。可以此拘乎。
不可以此拘仲景肯言哉。
凡似此者。后学皆当别识。诚如此。则进道方为有益。
凡发汗。欲令手足俱周。时出。以 然一时间许。亦佳。不可令如水流漓。若病不解。当
重发汗。汗多必亡阳。阳虚不得重发汗也。
此叮咛发汗之节度。
凡服汤发汗。中病便止。不必尽剂。
此叮咛进汤之节度。
凡云可发汗。无汤者。丸散亦可用。要以汗出为解。然不如汤。随证良验。
此示人用汤丸经权应变之宜。以上五条。疑皆叔和语。
夫病脉浮大。问病者。言但便硬尔。设利者为大逆。硬为实。汗出而解。何以故。脉浮。当以汗解。
此言便虽硬。若脉见浮。犹当从汗解。盖互下不宜早。而曲致叮咛之意。
下利后。身疼痛。清便自调者。急当救表。宜桂枝汤发汗。
此互太阳中篇第二十三条末节。而曲致叮咛之意。
发汗多。亡阳。谵语者。不可下。与柴胡桂枝汤。和其荣卫。以通津液。后自愈。
此互误汗亡阳。而曲致其轻者之救法。
此一卷第十七篇。凡三十一证。前有详说。
合四证。已具太阳篇中。
以上二条。乃叔和类具篇目。指经中条册之不能分出者而言。勉人当精详经旨。务为通贯其
义。以期尽道之意。读者自会。则书之全求可言矣。
General Principles. In spring and summer, it is appropriate to use diaphoresis (sweating therapy).
This represents Wang Shuhe's deduction of meanings beyond the explicit text. It cites general principles to reveal the main idea. The appropriateness of diaphoresis in spring and summer is to conform to the physiological activity of Yang Qi. However, Shanghan (Cold Damage) is a disease occurring in winter; can one be constrained by this principle?
One should not be constrained by this when considering Zhang Zhongjing's statements.
For all such cases, students of later generations ought to possess distinct insights. If one truly achieves this, then progress in the Dao of medicine will indeed be beneficial.
Regarding any use of diaphoresis, one should aim for uniform sweating throughout the hands and feet, sustained for a period, approximately the time it takes to eat a meal, which is also good. One must not allow sweat to flow profusely like water. If the disease does not resolve, one may re-administer diaphoresis. However, excessive sweating will inevitably lead to Wang Yang (loss of Yang Qi). When Yang Qi is deficient, re-administration of diaphoresis is contraindicated.
This serves as a reiterated caution regarding the degree and measure of diaphoresis.
Whenever decoctions are taken to induce sweating, stop administration once the illness is addressed; there is no need to finish the entire dose.
This serves as a reiterated caution regarding the dosage regimen of administering decoctions.
Wherever it states that diaphoresis is permissible, if no decoction is available, pills or powders may also be used. The essential criterion is that resolution occurs with sweating. Nevertheless, this is inferior to decoctions, which offer better efficacy tailored to specific syndromes.
This demonstrates the appropriate flexibility in using decoctions versus pills/powders. The above five paragraphs are suspected to be the words of Wang Shuhe.
If the patient's pulse is floating and large, and upon inquiry, the patient states only that the stool is hard, assuming purgation would be a major error. Hardness indicates excess; the condition resolves through sweating. Why? Because a floating pulse indicates that the exterior should be resolved via diaphoresis.
This explains that even if the stool is hard, if the pulse presents as floating, one should still resolve the condition via diaphoresis. This likely reflects a concern against premature purgation, thereby conveying a nuanced admonition.
After diarrhea, if the body aches but bowel and bladder functions are normal, urgent treatment of the exterior syndrome is required. Guizhi Tang (Cinnamon Twig Decoction) is appropriate to induce diaphoresis.
This cross-references the end of Article 23 in the Taiyang Chapter, conveying a nuanced admonition.
Excessive sweating leading to Wang Yang (loss of Yang Qi), accompanied by delirium (incoherent speech), is contraindicated for purgation. Administer Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) to harmonize Ying and Wei (Nutritive and Defensive Qi), thereby facilitating the flow of Jin Ye (Body Fluids); the condition will subsequently heal spontaneously.
This cross-references the management of mild cases resulting from erroneous sweating causing loss of Yang Qi.
This volume, Chapter 17, contains thirty-one cases, which have been detailed previously.
These four cases are already included within the Taiyang Chapter.
The above two paragraphs reflect Wang Shuhe's classification and chapter arrangement, pointing out those sections of the classic text that cannot be distinctly separated. This encourages readers to meticulously study the intent of the classics and strive for a coherent understanding of their meaning, aiming to exhaust the true essence of the medical Dao. If readers can comprehend this independently, then a comprehensive grasp of the book can be said to be achieved.