〔《活》〕大抵太阳病必发热而恶寒,不可过覆衣被,及近火气,恐寒热相搏,脉道沉伏,愈令病患寒不可
遏。但去被彻火,兼饮以和表之药,自然不恶寒矣。若妇人恶寒,尤不可近火,恐寒气入腹,血室结聚,针药
所不能治矣。
发热恶风为表虚,属太阳病。(方论见发热太阳病条。)发汗后,遂汗漏不止,其症似风湿相搏症,背
恶风,汗出,小便不利,四肢难屈伸,但心下不满者,身不痛,用桂枝加附子汤。(方见自汗。)
风湿相搏者,骨节烦疼,掣痛,用甘草附子汤。(方见体痛。)身热恶风,项强胁满,手足温而渴者,
用小柴胡汤。
(方论见胁痛。)
〔成〕恶风者,见风至则恶矣。必居密室之内,帏帐之中,则坦然自舒。恶寒者,则不待风而自寒,虽身
大热而不欲去衣者是也。《活人》云∶恶寒者,不当风而自憎寒。恶风者,当风而憎寒也。
发热头痛恶风者,属太阳。(方论见发热太阳病。)大便不利六七日,头痛身热,小便赤者,宜承气汤。
若小便利者,知不在里仍在表也,宜桂枝汤。(论见胃实。)头痛发热,脉弦细者,属少阳,宜小柴胡汤。(论见口苦。)
若脉反沉者,当救里,宜四逆汤。(论见发热。)头痛兼心下痞硬满痛,苦眩冒,时如结胸者,刺大椎第
一间肺俞、肝俞。(论见项强。)若下后仍发热无汗,小便不利者,桂枝去桂加茯苓白术汤。(方论见项强。)若表解汗出,
胁痛
干呕者,宜十枣汤。(方论见胁痛。)头痛,干呕吐涎沫者,用吴茱萸汤。(方论见吐。)若表解汗出,
心下硬,引胁痛者,用十枣汤。若阳明胃实,反无汗而小便利,呕咳,手足厥者,为寒邪。(方论见胃实。)头痛
发热,吐利者,为霍乱。(方论见吐利。)湿家,病身痛发热,面黄而喘,头痛鼻塞而烦,其脉大能食者,
纳药鼻中则愈。(方论见身痛湿痹条。)
太阳病下之复脉细数者,头痛未止。
[From *Huo Ren Shu*] Generally, Taiyang disease (a syndrome caused by pathogenic factors invading the Taiyang channel) is characterized by fever and aversion to cold. One should not cover the patient excessively with blankets or place them near fire sources, lest the cold and heat qi clash, causing the pulse to sink and become imperceptible, thereby exacerbating the patient's uncontrollable sensation of cold. Simply remove the blankets, keep away from fire, and administer herbs that harmonize the exterior; the aversion to cold will naturally cease. If a female patient suffers from aversion to cold, she must especially avoid fire, as this may allow cold qi to enter the abdomen, causing stagnation in the Blood Chamber (referring to the uterus and Chong and Ren vessels), a condition beyond the reach of acupuncture and herbal medicine.
Fever accompanied by wind aversion indicates exterior deficiency and belongs to Taiyang disease. (Formula discussion see "Fever · Taiyang Disease" section.) After sweating therapy, if perspiration continues unceasingly, presenting symptoms similar to Wind-Dampness clashing—such as wind aversion on the back, sweating, difficulty in urination, and inability to flex or extend the limbs—but without fullness in the epigastrium and without body pain, Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction plus Aconite Root) should be used. (Formula see "Spontaneous Sweating" section.)
In cases of Wind-Dampness clashing, where there is severe pain and pulling pain in the bone joints, Gancao Fuzi Tang (Licorice Root and Aconite Root Decoction) should be used. (Formula see "Body Pain" section.) For those with body heat, wind aversion, stiffness in the neck and nape, distension in the hypochondrium, warm hands and feet, and thirst, Xiaochaihu Tang (Minor Bupleurum Decoction) is indicated.
(Formula discussion see "Hypochondriac Pain" section.)
[Cheng Wuji] "Wind aversion" refers to feeling discomfort and aversion upon encountering wind. The patient must reside in a tightly sealed room within curtains to feel at ease and comfortable. "Cold aversion," however, involves feeling cold even without wind exposure; even if the body is highly febrile, the patient does not wish to remove clothing. This is the definition of cold aversion. *Huo Ren Shu* states: Those with cold aversion hate the cold spontaneously without wind; those with wind aversion hate the cold only when exposed to wind.
Fever, headache, and wind aversion belong to the Taiyang stage. (Formula discussion see "Fever · Taiyang Disease".) If constipation persists for six or seven days, accompanied by headache, body heat, and reddish urine, Chengqi Tang (Purgative Decoction) is appropriate. If urination is free, it indicates the pathogen remains in the exterior rather than the interior, so Guizhi Tang (Cinnamon Twig Decoction) is suitable. (Discussion see "Stomach Excess" section.) Headache and fever with a wiry and fine pulse belong to the Shaoyang stage, indicating Xiaochaihu Tang (Minor Bupleurum Decoction). (Discussion see "Bitter Taste in Mouth" section.)
If the pulse is unexpectedly deep, the interior must be rescued urgently, using Sini Tang (Recovery Decoction). (Discussion see "Fever" section.) For headache accompanied by epigastric stuffiness, hardness, fullness, and pain, suffering from vertigo and dizziness, resembling Chest Binding Syndrome at times, needle the first interspace of Dazhui (GV14), Feishu (BL13), and Ganshu (BL18). (Discussion see "Neck Stiffness" section.) If after purgation there is still fever, no sweat, and difficulty in urination, Guizhi Qu Gui Jia Fuling Baizhu Tang (Cinnamon Twig Decoction minus Cinnamon Twig plus Poria and Atractodes Rhizome Decoction) should be used. (Formula discussion see "Neck Stiffness" section.) If the exterior is resolved with sweating, accompanied by hypochondriac pain and dry retching, Shizao Tang (Ten Jujubes Decoction) is indicated. (Formula discussion see "Hypochondriac Pain" section.) For headache with dry retching and vomiting of clear saliva, Wuzhuyu Tang (Evodia Fruit Decoction) is used. (Formula discussion see "Vomiting" section.) If the exterior is resolved with sweating, and there is epigastric hardness radiating to the hypochondrium with pain, use Shizao Tang (Ten Jujubes Decoction). In cases of Yangming Stomach Excess, if there is paradoxically no sweat, free urination, vomiting, coughing, and cold extremities, this is due to Cold Pathogens. (Formula discussion see "Stomach Excess" section.) Headache and fever accompanied by vomiting and diarrhea indicate Huoluan (Cholera-like disorder). (Formula discussion see "Vomiting and Diarrhea" section.) Patients suffering from Dampness Bi syndrome, presenting with body pain, fever, yellow complexion, wheezing, headache, nasal congestion, and irritability, with a large pulse and ability to eat, can be cured by insufflating medicine into the nose. (Formula discussion see "Body Pain and Dampness Bi" section.)
After purgation in Taiyang disease, if the pulse becomes fine and rapid, the headache has not yet ceased.