春温发热恶寒,腕痛拒按,舌黄便闭,呕恶脉
滑,此温邪挟积。宜用保和丸加藿香、薄荷、淡鼓、
黑栀等味,消食透邪也。
东垣云:腕痛舌黄便闭,右关脉滑,痛而拒按 此为食
积。若兼恶寒发热,且欲呕恶,是挟温邪,宜与两解。故用保
春温恶寒发热,头痛无汗,颈颔核肿,牙关不
宣,此温邪时毒。主以荆防败毒散,再按经加减,以
疏风热可也。
凡时毒初起,亦必发热头痛,恶寒无汗,与温邪仿佛。
但颈间核肿,名为时毒,须要辨明结在何经,而施主治。凡
肿在颔下者,属阳明,以升麻、葛根为主,在耳下者,厉少
阳,以柴胡、黄芩为主,在颈项者,属太阳,以羌活、独活
为主。此系风热上壅,蕴结而成。故用荆、防、薄荷以疏风
热,积壳、桔梗以开上焦,羌、独、升、葛,柴、芩为三阳
经消风化邪之主药。临症时,再能按经加减,则症无不痊
矣。
春温头痛,恶寒发热,面赤目红,咳逆嚏涕,咽
痛口渴,此麻疹也。宜用薄荷、大力、荆芥、杏仁、
蝉衣、桔梗、甘草、连翘、马勃、射干等味,疏风透
疹也。
风温犯肺,热壅上焦,故初起面目俱赤,咳涕咽疼,皆
手太阴见症。今头痛恶寨,发热无汗,是邪踞卫分,腠理不
开,郁化斑疹,苦不疏散,恐其内陷。故用薄荷、荆芥、蝉
Spring-warmth disease presents with fever, aversion to cold, wrist pain that is aggravated by pressure (refusal to be pressed), yellow tongue coating, constipation, vomiting, nausea, and a slippery pulse. This indicates warm pathogenic factors complicated by food stagnation. It is appropriate to use Baohe Wan (Preserve Harmony Pill) added with Huoxiang (Patchouli Herb), Bohe (Mint Herb), Danshi (Light Fermented Soybean), and Heizhi (Black Gardenia Fruit) to resolve food stagnation and expel pathogens.
Li Dongyuan stated: Wrist pain, yellow tongue coating, constipation, a slippery pulse at the right Guan position, and pain aggravated by pressure indicate food stagnation. If accompanied by aversion to cold, fever, and a desire to vomit or feel nauseous, it implies complication with warm pathogenic factors. In such cases, a simultaneous resolution of exterior and interior is indicated. Therefore, Baohe Wan is used to digest and guide out stagnation, while Huoxiang, Bohe, Danshi, and Heizhi are added to vent and drain the pathogen.
Spring-warmth disease presents with aversion to cold, fever, headache, absence of sweating, swelling of lymph nodes in the neck and submandibular region, and trismus (lockjaw). This indicates warm pathogenic factors combined with epidemic toxins. The primary treatment should be Jingfang Baidu San (Schizonepeta and Saposhnikovia Decoction for Overcoming Toxins), with modifications based on the affected meridians to disperse wind-heat.
When epidemic toxins first appear, they inevitably present with fever, headache, aversion to cold, and absence of sweating, resembling symptoms of warm pathogens. However, swelling of lymph nodes in the neck is termed "epidemic toxin," and it is crucial to distinguish which meridian the accumulation affects to apply specific treatments. Swelling below the jaw belongs to the Yangming Meridian, treated primarily with Shengma (Cimicifugae Rhizoma) and Gegen (Puerariae Lobatae Radix); swelling below the ear belongs to the Shaoyang Meridian, treated primarily with Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix); swelling in the neck and nape belongs to the Taiyang Meridian, treated primarily with Qianghuo (Notopterygii Rhizoma et Radix) and Duhuo (Angelicae Pubescentis Radix). This condition results from wind-heat congesting upwards and accumulating. Thus, Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), and Bohe are used to disperse wind-heat; Zhike (Aurantii Fructus Immaturus) and Jiegeng (Platycodonis Radix) are used to open the Upper Jiao; Qianghuo, Duhuo, Shengma, Gegen, Chaihu, and Huangqin are the main herbs for resolving wind-heat and eliminating pathogens in the three Yang meridians. During clinical practice, if modifications are made according to the meridians, the illness will surely be cured.
Spring-warmth disease presents with headache, aversion to cold, fever, flushed face, red eyes, cough with reverse qi flow, sneezing, runny nose, sore throat, and thirst. This indicates measles. It is appropriate to use Bohe, Dali (Burdock Fruit/Arctii Fructus), Jingjie, Xingren (Prunus Armeniaca Seed), Canyi (Cicada Slough), Jiegeng, Gancao (Licorice Root), Lianqiao (Forsythiae Fructus), Mabo (Polyporus Mass), and Shegan (Belamcandae Rhizoma) to disperse wind and reveal the rash.
Wind-warmth pathogenic factors invade the Lung, and heat congests the Upper Jiao. Therefore, initially, both the face and eyes become red, and symptoms include cough, runny nose, and sore throat, which are manifestations of the Hand-Taiyin Lung Meridian. The current presentation of headache, aversion to cold, fever, and absence of sweating indicates that the pathogen occupies the Wei (Defensive) level, the pores are closed, and stagnation transforms into macules and rashes. Due to the difficulty in dispersing them, there is a risk of the pathogen sinking inward. Therefore, Bohe, Jingjie, Canyi, and Dali are used to dispel wind; Lianqiao, Jiegeng, Mabo, and Shegan are used to clear heat. This allows the macules and rashes to emerge, preventing the pathogen from entering the Ying (Nutritive) level of the Heart and avoiding the danger of coma.