温病者,冬时感冒寒邪,不实时而病,藏于肌肉之中,至春温暖而发者是也。其症发热而渴,不恶寒
者为温病也。或用升麻葛根汤,或用葛根解肌汤。大抵治温病之法,无正汗之理,此怫郁之热,自内
达外,无表症明矣,宜辛平之剂发散之。
热病者,冬伤于寒不即发,至春又不发,郁而至夏发者是也。其病身热头痛,烦渴,不恶寒,脉洪而盛。
盖因夏月时热两盛,治宜苦辛寒,清解为主。寒邪郁久化热,经曰、热病者伤寒之类也,故主苦辛寒
法以救之。
温病热病,其脉洪大有力,此阳症见阳脉也,可治。若脉来沈微细小,此阳症见阴脉也,必死。经曰、温病攘攘,
大热脉小足冷者死。
晚发者,清明后、夏至前、而发者是也。其症身热头疼,或恶风恶寒,或有汗无汗,或烦躁脉来洪数。亦
由冬时感寒所致,比之温热二症稍轻耳。不宜峻剂,宜清解邪热,通用槴子生麻汤加减治之。
痉病者,太阳经伤风、重感寒湿而致也。又曰、大发湿家汗,则成痉。其症头项强直,身热恶寒,摇头噤
口,背反张者是也。外症发热恶寒,与伤寒相似,但其脉沈迟弦细,两目圆张,而项背反张强硬,如发
痫之状。当视其有汗、无汗,以分刚痉、柔痉,若无汗恶寒,名刚痉,宜葛根汤。有汗不恶寒,名柔痉,桂枝
加葛根汤,如汗下太过,重亡津液,以致筋脉失养,不柔和而变痉者,又宜补养气血为主。更有产后
或金疮一切去血过多之症,皆能成痉,亦当补养为先。此则似痉而非痉者,岂可一例,而用风药?
之。
Warm disease (Wen Bing) refers to a condition contracted by catching cold pathogens during winter, which does not manifest immediately but remains latent in the muscles, erupting when the weather warms up in spring. Its symptoms include fever and thirst without aversion to cold; this is defined as warm disease. Treatment may employ Shengma Gengen Tang (Ligusticum and Pueraria Decoction) or Gegen Jiexu Tang (Pueraria Muscle-Relieving Decoction). Generally, the principle of treating warm disease does not involve inducing normal sweating (Zheng Han), because the stifled heat (Fuyu Zhi Re) radiates from the interior to the exterior, clearly indicating the absence of exterior syndrome (Biao Zheng). It is appropriate to use acrid-neutral agents to disperse it.
Heat disease (Re Bing) refers to a condition where cold injury occurs in winter without immediate onset, fails to erupt in spring, and manifests in summer due to accumulation and stagnation. The pathology involves body heat, headache, irritability, thirst, absence of aversion to cold, and a surging and full pulse (Mai Hong Er Sheng). This is because the seasonal heat of summer is doubly abundant. Treatment should prioritize bitter-acrid-cold herbs to clear and resolve the pathogen. Since long-standing cold stagnation transforms into heat, the classics state: "Heat disease belongs to the category of cold damage." Therefore, the method of using bitter-acrid-cold formulas is advocated for rescue.
In both warm disease and heat disease, if the pulse is surging, large, and forceful, this represents a Yang syndrome presenting with a Yang pulse, which is treatable. If the pulse comes in a deep, faint, fine, and small manner, this represents a Yang syndrome presenting with a Yin pulse, which indicates certain death. The classics state: "In warm disease, if the patient is restless, has high fever, a small pulse, and cold feet, death will occur."
Late eruption (Wan Fa) refers to diseases that manifest after the Qingming Festival and before the Summer Solstice. Symptoms include body heat and headache, possibly accompanied by aversion to wind or cold, presence or absence of sweat, irritability, and a surging and rapid pulse. This is also caused by contracting cold in winter, but it is slightly milder than warm disease and warm-heat syndromes. Potent purgative or dispersing agents should not be used; instead, clearing and resolving pathogenic heat is appropriate. Zhizi Shengma Tang (Gardenia and Ephedra Decoction) modified is generally used for treatment.
Jing disease (Spasm Disease) is caused by wind injury to the Taiyang Meridian compounded by severe contraction of cold and dampness. It is also stated: "Excessive sweating in patients with dampness leads to Jing disease." Symptoms include stiffness and rigidity of the head and neck, body heat, aversion to cold, shaking of the head, trismus (lockjaw), and opisthotonos (backward arching of the back). The external symptoms of fever and aversion to cold resemble cold damage, but the pulse is deep, slow, wiry, and fine, with eyes wide open and rigid backward arching of the neck and back, resembling epilepsy. One must observe the presence or absence of sweat to distinguish between Gang Jing (Rigid Spasm) and Rou Jing (Flexible Spasm). If there is no sweat and aversion to cold, it is named Gang Jing, treated with Gegen Tang (Pueraria Decoction). If there is sweat and no aversion to cold, it is named Rou Jing, treated with Guizhi Jia Gegen Tang (Cinnamon Twig Plus Pueraria Decoction). If excessive sweating or purgation severely depletes body fluids, causing the sinews and vessels to lose nourishment and become non-pliable, resulting in spasm, the primary treatment should be tonifying Qi and Blood. Furthermore, conditions such as postpartum states or traumatic wounds involving excessive blood loss can all lead to spasm; these too require tonification as the priority. These cases are similar to Jing disease but are not true Jing disease; how can they all be treated uniformly with wind-dispelling herbs?