春温诸恙悉平,不饥不食,舌干无苔,此胃阴大
伤用《金柜》麦门冬汤加乌梅、木瓜、谷芽、金
(1)代赭旋复花汤:《伤寒论·辨太阳病脉证并治下》原作"旋复代赭汤"。
柑皮等味,甘酸化阴也。
病后不饥不食,舌干无苔,乃热伤胃,胃气不复也。
然胃为阳土,非柔莫济。故用党参、麦冬、甘草、茯神(1)之
甘以养胃,乌梅、木爪之酸以制肝,且得甘酸化阴,甲已化
土之义,更兼半夏、谷芽辛温通阳,使胃可醒而食可进也。
春温病退,舌淡脉微,不饥不食,泛泛欲呕,此
胃阳大伤。宜用六君子汤加白蔻、吴萸、姜汁等味,
温补胃阳也。
上条舌赤无苔,不饥不食,伤及胃阴,宜用甘酸柔润,
以济其阴。此条舌淡脉微,不饥不色,伤及胃阳,宜用甘温
刚燥,以扶其阳。此胃中之阴阳偏损,不可不辨,医者慎
之。
春温发热恶寒,喘逆胁痛,此邪滞肺络。宜用
《金柜》旋复花汤加苏子、开肺、杏仁、郁金,川
贝、积壳、桔梗等味,开肺和络也。
发热恶寒者,表邪未散,喘逆胁痛者,肺气壅遏;若不
宣通,恐延痿廱缠绵。故用旋复,新绎、橘络以通络气,苏
子、杏仁、川贝以降肺气,枳壳、桔梗、枇杷叶以开上焦之
(1)茯神:《金柜要略》麦门冬汤原方无此药。
气,使邪从上散,不致传变为妙。
All symptoms of Spring-Warmth disease have subsided, yet the patient feels no hunger and has no desire to eat. The tongue is dry with no coating, indicating severe injury to Stomach Yin. One should use *Ma Men Dong Tang* (Ophiopogon Decoction) from *Jin Gui Yao Lue*, adding *Wu Mei* (Mume Fructus), *Mu Gua* (Chaenomeles Fructus), *Gu Ya* (Hordei Fructus Germinatus), and *Jin Gan Pi* (Citrus Reticulatae Pericarpium). This employs the combination of Sweet and Sour flavors to generate Yin.
Following illness, the absence of hunger and desire to eat, along with a dry tongue lacking coating, results from Heat injuring Stomach Qi, preventing its recovery. However, the Stomach is Yang Earth, which requires soft and moistening agents to nourish it. Therefore, the Sweet properties of *Dang Shen* (Codonopsis Radix), *Mai Dong* (Ophiopogonis Radix), *Gan Cao* (Glycyrrhizae Radix et Rhizoma), and *Fu Shen* (Poria cum Risus) are used to nourish the Stomach; the Sour properties of *Wu Mei* and *Mu Gua* are used to restrain Liver Wood. This aligns with the principles of "Sweet and Sour generating Yin" and "Jia-Ji transforming into Earth." Additionally, the acrid-warm nature of *Ban Xia* (Pinelliae Rhizoma) and *Gu Ya* unblocks Yang, allowing Stomach Qi to awaken and appetite to return.
After the retreat of Spring-Warmth disease, if the tongue is pale, the pulse is faint, there is no hunger or desire to eat, and there is a sensation of nausea, this indicates severe injury to Stomach Yang. It is appropriate to use *Liu Jun Zi Tang* (Six Gentlemen Decoction) added with *Bai Kou* (Amomi Fructus Rotundus), *Wu Zhu Yu* (Evodiae Fructus), and *Jiang Zhi* (Zingiberis Rhizoma Recens Juice) to warm and tonify Stomach Yang.
In the previous paragraph, a red tongue without coating, accompanied by anorexia, indicated injury to Stomach Yin, warranting Sweet-Sour and soft-moistening methods to assist Yin. In this paragraph, a pale tongue and faint pulse, accompanied by anorexia, indicate injury to Stomach Yang, warranting Sweet-Warm and drying-rigid methods to support Yang. This represents a bias in the damage of Yin and Yang within the Stomach, which must not fail to be distinguished; physicians must exercise caution.
Spring-Warmth disease presenting with fever, aversion to cold, wheezing, and hypochondriac pain indicates pathogenic stagnation in the Lung Collaterals. It is appropriate to use *Xuan Fu Dai Zhe Tang* (Inula and Hematite Decoction) from *Jin Gui Yao Lue*, added with *Su Zi* (Perillae Fructus), Kai Fei (likely referring to lung-opening herbs such as Jie Geng or Sang Ye, retained as per text), *Xing Ren* (Armeniacae Semen Amarum), *Yu Jin* (Curcumae Radix), *Chuan Bei Mu* (Fritillariae Cirrhosae Bulbus), *Zhi Ke* (Aurantii Fructus Immaturus), and *Jie Geng* (Platycodonis Radix) to open Lung Qi and harmonize the collaterals.
Fever and aversion to cold indicate that exterior pathogens have not yet dispersed; wheezing and hypochondriac pain indicate obstruction and stagnation of Lung Qi. If not unblocked and circulated, there is a risk of progression to wasting-thirst or paralysis, leading to lingering difficulties. Therefore, *Xuan Fu Hua* (Inulae Flos), Xin Yi (likely referring to a collateral-unblocking agent, retained as per text), and *Ju Luo* (Citri Reticulatae Pericarpium Retinervum) are used to unblock collateral Qi; *Su Zi* and *Xing Ren* are used to direct Lung Qi downward; *Zhi Ke*, *Jie Geng*, and *Pi Pa Ye* (Loquat Leaf) are used to open the Upper Jiao, allowing pathogens to dissipate from above, thereby preventing transmission, which constitutes the optimal approach.