项强太阳病也,项背强,太阳阳明病也。脉浮无汗,是从伤寒传来,宜葛根汤。脉浮有汗,是从中风传来,
宜桂枝加葛根汤。脉沉,邪已入里,宜栝蒌桂枝汤。结胸项强,背反张,有汗如柔痉之状,宜大陷胸丸。但
见太阳少阳并病之项强,不可汗下,宜柴胡去半夏加栝蒌主之。
未汗身痛属表实,宜麻黄汤。汗后身痛属表虚,宜桂枝新加汤。身痛尺脉迟,是血少营气不足,虽未经
汗,亦不可发汗,宜建中汤加黄 治之。身痛见少阴沉脉,四肢厥冷,宜附子汤。身痛见厥阴厥逆,汗出不
止,下利清谷,宜四逆汤。一身尽痛,不能转侧,掣引烦痛,是风湿病、宜桂枝附子汤。
身为热动而不安,谓之躁。心为热扰而不宁,谓之烦。烦则扰于内属阳,躁则动于外属阴。若懊 心中
,反复颠倒,烦不得眠。不与躁同见者,皆无冷病,惟躁则不然,当分表里阴阳取治。故太阳有不汗出之烦
躁,谓之在表,大青龙证也。阳明有心下硬之烦躁,谓之在阳,白虎汤证也。三阴有吐利手足
厥之烦躁,谓之在阴,四逆辈证也。诸烦无论汗吐下之前后,但大便不硬者,以竹叶石膏、温胆、栀子豉等
汤主治。便硬者,量其热之浅深,以白虎、三承气汤主治。躁同三阴证见者,便属阴寒,宜四逆、理中、吴
茱萸汤主治。
Stiffness of the neck is a Taiyang disease (disease of the Taiyang channel), while stiffness of the neck and back is a combined Taiyang and Yangming disease. If the pulse is floating without sweat, it has transmitted from Shanghan (Cold Damage), and Gegen Tang (Kudzu Decoction) is indicated. If the pulse is floating with sweat, it has transmitted from Fengzhong (Wind Strike), and Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Kudzu Root) is indicated. If the pulse is deep, the pathogenic factor has entered the interior, and Gualou Guizhi Tang (Trichosanthes Root and Cinnamon Twig Decoction) is indicated. In Jie Xiong (Chest Binding) with stiff neck and opisthotonos, sweating resembling Rou Jing (Soft Spasm), Daxiexion Wan (Major Chest-Draining Pill) is indicated. For stiff neck due to concurrent Taiyang and Shaoyang diseases, neither diaphoresis nor purgation should be used; Chaihu Qu Banxia Jia Gualou Tang (Bupleurum Decoction minus Pinellia plus Trichosanthes Root) is indicated.
Body pain before sweating belongs to Exterior Excess syndrome, and Mahuang Tang (Ephedra Decoction) is indicated. Body pain after sweating belongs to Exterior Deficiency syndrome, and Guizhi Xinjia Tang (Modified Cinnamon Twig Decoction) is indicated. Body pain with a slow Chi pulse indicates insufficient blood and Ying Qi (Nutritive Qi); even if no sweating has occurred, diaphoresis is contraindicated, and Jianzhong Tang (Establish the Middle Decoction) plus Huangqi (Astragali Radix) is indicated. Body pain accompanied by a deep pulse of Shaoyin disease and cold extremities indicates Fuzi Tang (Aconite Decoction). Body pain accompanied by Jueyin disease with reversal-cold, incessant sweating, and diarrhea with undigested food indicates Sini Tang (Frigid Extremities Decoction). Generalized body pain, inability to turn over, and pulling severe pain indicate Fengshi Bing (Wind-Damp Disease), and Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) is indicated.
Restlessness of the body due to heat agitation is called Zao (Agitation). Restlessness of the heart due to heat disturbance is called Fan (Vexation). Fan implies internal disturbance belonging to Yang, while Zao implies external movement belonging to Yin. If one feels Ao Nu (Oppressive Vexation) in the chest, tossing and turning, unable to sleep due to vexation, this differs from Zao and does not involve Cold syndromes; only Zao is different. Treatment should be selected based on distinguishing Exterior/Interior and Yin/Yang. Thus, Taiyang disease with non-sweating Fan and Zao is considered Exterior, corresponding to Da Qinglong Tang (Major Blue-Green Dragon Decoction) syndrome. Yangming disease with epigastric hardness and Fan/Zao is considered Yang (Excess Heat), corresponding to Baihu Tang (White Tiger Decoction) syndrome. Three Yin diseases with vomiting, diarrhea, and cold extremities with Fan/Zao are considered Yin, corresponding to Sini Tang (Frigid Extremities Decoction) category syndromes. For all Fan syndromes, regardless of whether they occur before or after diaphoresis, emesis, or purgation, if the stool is not hard, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction), Wendan Tang (Harmonize the Gallbladder Decoction), or Zhizi Chi Tang (Gardenia and Soybean Decoction) are primarily indicated. If the stool is hard, the depth of heat is assessed, and Baihu Tang (White Tiger Decoction) or the three Chengqi Tangs (Assist the Qi Decoctions) are indicated. When Zao appears concurrently with Three Yin syndromes, it belongs to Yin-Cold, and Sini Tang (Frigid Extremities Decoction), Lizhong Tang (Regulate the Middle Decoction), or Wuzhuyu Tang (Evodia Decoction) are indicated.