风温初起,面赤口燥,身热神迷,鼻轩多寐,不
语不食,此风热上蒙。宜用葳蕤、知母、麦冬、桑
叶、薄荷、沙参、杏仁、鲜菖蒲、广郁金、青竹叶等
咪,疏风清热也。
风与温合,化为壮火,壮火食气,必伤肺金。故初起面
赤拂郁,鼻息如鼾,热犯少阴,则神迷多寐,犹仲景所谓少
阴症但欲寐之意相仿佛也。至默默不语,不思饮食,皆系风
热混扰,清阳蒙蔽。在幼稚为甚者,以体属纯阳,易于引
风。故用桑叶、薄荷疏风邪,杏仁、玉竹、沙参,麦冬,知
母清温热,毌使传变为要。
风温咽痛,神昏烦躁,目赤舌绛,丹疹,脉促模
糊,此风热内闭。宜用犀角地黄汤加羚羊角,鲜石
斛、元参心、连翘心、鲜菖蒲;银花、金汁、薄荷、
蝉衣,牛黄丸等味,表里两清也。
神迷舌绛,脉促模糊,乃热邪内逼,虚灵蒙蔽。更兼咽
痛丹疹,烦躁不安,则内闭之险已极,倘痉厥一至,事难为
矣。故用犀角、羚角清营络,生地、丹皮滋血热,连翘、元
参,麦冬、石斛养胃津,银花、金汁解毒,薄荷、蝉衣袪
风,更兼菖蒲,牛黄丸芳香宣窍,俾表里气血得以双清双
解,而转危为安也。
风温一二日后,神反清,语反出,舌黄口渴,烦
热脉洪,此温邪内蒸。宜用白虎汤加沙参、麦冬、杏
仁、鲜玉竹、鲜石斛、连翘等味,清气透邪也。
初起神迷语骞,状如中风。过一二日后,反觉神清语
出,是风邪外泄,并非中厥。若仍口渴舌黄,燔热脉洪,乃
温热内燔,邪尚在气。宜用白虎汤合杏仁、玉竹、石斛、连
翘、沙参、麦冬,一派甘寒之味,以清阳明气热为妙。
At the initial stage of Wind-Warmth (Fengwen), the patient presents with a red face, dry mouth and tongue, fever, and confused spirit. There is nasal flaring, excessive sleepiness, muteness, and anorexia. This indicates that Wind-Heat has ascended and clouded the clear orifices. It is appropriate to use Zhe Beimu (Fritillariae Bulbus), Zhimu (Anemarrhenae Rhizoma), Maidong (Ophiopogonis Radix), Sangye (Mori Folium), Bohe (Menthae Haplocalycis Herba), Shashen (Glehniae Radix), Xingren (Armeniacae Semen Amarum), Xian Changpu (Acori Tatarinowii Rhizoma), Guang Yujin (Curcumae Radix), and Qing Zhuye (Bambusae Caulis in Taenia) to disperse Wind and clear Heat.
When Wind combines with Warmth, it transforms into "Zhuang Huo" (excessive fire), which consumes Qi and inevitably damages Lung Metal (the Lung organ). Therefore, at the onset, one observes facial redness, stifled qi sensation, and snoring breath. If Heat invades the Shaoyin channel, confusion and somnolence occur, resembling Zhang Zhongjing's description of the Shaoyin syndrome characterized by "desire to sleep." The muteness and lack of appetite are caused by Wind-Heat mixing and disturbing, thereby obscuring the Clear Yang. In children, this condition is more severe because their constitution is purely Yang, making them prone to attracting Wind. Thus, Sangye and Bohe are used to disperse Wind pathogens, while Xingren, Yuzhu (Polygonati Odorati Rhizoma), Shashen, Maidong, and Zhimu are used to clear Warmth and Heat. The key lies in preventing the transmission of the disease.
In Wind-Warmth, symptoms such as sore throat, coma, irritability, red eyes, crimson tongue, scarlatiniform rash, and a rapid yet indistinct pulse indicate internal closure due to Wind-Heat. It is appropriate to use Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) added with Lingyangjiao (Saiga Antelope Horn), Xian Shihu (Dendrobii Caulis), Yuanshenxin (Scrophulariae Radix heart), Liaoqiaoxin (Forsythiae Flos heart), Xian Changpu, Yinhuajin (Lonicerae Japonicae Flos), Jinzhi (Gold Water), Bohe, Chanyi (Bombyx Batryticatus), and Niuhuang Wan (Calculus Bovis Pill) to clear both the exterior and interior.
Confusion, a crimson tongue, and a rapid, indistinct pulse signify that Heat pathogens are pressing inward, obscuring the spiritual clarity. Coupled with sore throat, rash, and restlessness, the danger of internal closure is extreme. If convulsions and cold limbs (Jue) occur, the situation becomes difficult to manage. Therefore, Xijiao (Rhinocerotis Cornu) and Lingyangjiao are used to clear Heat from the Ying (Nutrient) level and collaterals; Shengdihuang (Rehmanniae Radix) and Mudanpi (Moutan Cortex) nourish Blood and clear Blood Heat; Liaoqiao, Yuanshen, Maidong, and Shihu nourish Stomach fluids; Yinhuajin and Jinzhi detoxify; Bohe and Chanyi dispel Wind; combined with the aromatic orifice-opening properties of Changpu and Niuhuang Wan, this allows for the dual clearing and resolving of Qi and Blood in both the interior and exterior, turning danger into safety.
One or two days after the onset of Wind-Warmth, if the spirit becomes clear, speech returns, the tongue coating turns yellow, thirst appears, and there is vexatious heat with a surging pulse, this indicates that Warmth pathogens are steaming internally. It is appropriate to use Baihu Tang (White Tiger Decoction) added with Shashen, Maidong, Xingren, Xian Yuzhu, Xian Shihu, and Liaoqiao to clear Qi and vent pathogens.
Initially, confusion and slurred speech resemble Stroke. However, after one or two days, if the patient becomes clear-headed and able to speak, it indicates that Wind pathogens are being expelled outward, rather than being a case of Zhong Jue (Stroke-Cold Limb). If thirst, yellow tongue coating, blazing heat, and a surging pulse persist, it means Warmth-Heat is blazing internally, and the pathogen remains in the Qi level. It is advisable to use Baihu Tang combined with Xingren, Yuzhu, Shihu, Liaoqiao, Shashen, and Maidong. These herbs are predominantly sweet and cold in nature, effectively clearing Heat in the Qi level of the Yangming channel.