九证
少阳之为病,口苦咽干目眩也。
少阳中风,两耳无所闻,目赤,胸中满而烦,不可吐下,吐下则悸而惊。
伤寒病,脉弦细,头痛而发热,此为属少阳。少阳不可发汗,发汗则谵语,为属胃。胃
和即愈,不和烦而悸。
太阳病不解,转入少阳,胁下坚满,干呕不能食饮,往来寒热,而未吐下,其脉沉紧,
可与小柴胡汤。若已吐下发汗温针,谵语,柴胡证罢,此为坏病。知犯何逆,以法治之。
三阳脉浮大,上关上,但欲寐,目合则汗。
伤寒六七日,无大热,其人躁烦,此为阳去入阴故也。
伤寒三日,三阳为尽,三阴当受其邪,其人反能食而不呕,此为三阴不受其邪。
伤寒三日,少阳脉小,欲已。
少阳病,欲解时,从寅尽辰。《千金翼云》卷第九
八证 方二首
太阴之为病,腹满吐,食不下,下之益甚,时腹自痛,胸下坚结,太阴病,脉浮,可发
其汗。
太阴中风,四肢烦疼,阳微阴涩而长,为欲愈。
太阴病,欲解时,从亥尽丑。
自利不渴者,属太阴,其脏有寒故也,当温之,宜四逆辈。
伤寒脉浮而缓,手足温,是为系在太阴,太阴当发黄;小便自利,利者不能发黄,至七
八日,虽烦,暴利十余行,必自止,所以自止者,脾家实,腐秽当去故也。
本太阳病,医反下之,因腹满时痛,为属太阴,桂枝加芍药汤主之。其实痛,加大黄汤
主之。方∶
桂枝(三两) 芍药(六两) 生姜(三两,切) 甘草(二两,炙) 大枣(十二枚,
擘)
上五味,以水七升,煮取三升,去滓,分温三服。
加大黄汤方∶
大黄(二两)
上,于前方中加此大黄二两即是。
人无阳证,脉弱,其人续自便利,设当行大黄芍药者,减之,其人胃气弱,易动故也。
Nine Manifestations
The Shaoyang disease is characterized by bitter taste in the mouth, dryness of the throat, and dizziness.
When wind-pathogen invades the Shaoyang channel, symptoms include deafness in both ears, redness of the eyes, fullness and irritability in the chest. Purging or emesis must not be used; if mistakenly applied, palpitations and fright will occur.
In cold damage disease, with a wiry and fine pulse, headache, and fever, this belongs to Shaoyang. Shaoyang disease prohibits sweating therapy; if sweating is induced, delirium occurs, indicating the pathogen has entered the Stomach. If the Stomach harmonizes, recovery ensues; if not, irritability and palpitations result.
If Taiyang disease remains unresolved and transmits to Shaoyang, presenting with hardness and fullness below the costal region, dry retching, inability to eat or drink, alternating chills and fever, and without prior purging or emesis, with a deep and tight pulse, Xiao Chai Hu Tang (Minor Bupleurum Decoction) may be administered. If vomiting, purging, sweating, or warm needle therapy have already been performed, resulting in delirium and the cessation of Chai Hu syndrome, this constitutes a damaged disease. One must identify the nature of the iatrogenic error and treat according to the specific condition.
When the pulses of the three Yang channels are floating and large, reaching above the Guan position, accompanied by somnolence and night sweats (sweating upon closing the eyes).
After six or seven days of cold damage, with no significant external heat but restlessness and irritability, this indicates the departure of Yang and entry of pathogen into Yin.
On the third day of cold damage, when the pathogen in the three Yang channels is exhausted, the three Yin channels should receive the pathogen. However, if the patient can eat and does not vomit, it indicates that the three Yin channels are not invaded.
On the third day of cold damage, if the Shaoyang pulse becomes small, the disease is about to resolve.
The time for Shaoyang disease to resolve is from Yin hour to Chen hour. Recorded in Volume Nine of *Qianjin Yi Fang*.
Eight Manifestations: Two Formulas
The Taiyin disease is characterized by abdominal fullness, vomiting, inability to ingest food, worsening symptoms after purging, spontaneous abdominal pain, and hardness/knotting below the chest. For Taiyin disease with a floating pulse, sweating therapy may be employed.
When wind-pathogen invades Taiyin, causing painful and heavy limbs, with a pulse that is faint, choppy, yet long, recovery is imminent.
The time for Taiyin disease to resolve is from Hai hour to Chou hour.
Spontaneous diarrhea without thirst belongs to Taiyin, caused by cold in the Zang organs. Warming therapy is indicated, preferably using Si Ni Tang (Four Counterflow Decoction) category formulas.
In cold damage, if the pulse is floating and slow, with warm hands and feet, the disease is associated with Taiyin, which typically leads to jaundice. However, if urination is free and unobstructed, jaundice will not develop. By the seventh or eighth day, even if there is irritability, sudden severe diarrhea more than ten times will cease spontaneously. This cessation occurs because the Spleen's healthy Qi has recovered (Spleen Excess), allowing foul turbid matter to be expelled.
Originally suffering from Taiyang disease, if the physician mistakenly uses purging, leading to abdominal fullness and intermittent pain, this belongs to Taiyin. Gui Zhi Jia Shao Yao Tang (Cinnamon Twig Decoction with Added Peony) is the primary formula. For severe pain indicating excess, Da Huang Tang (Rhubarb Decoction) is used. Formula composition:
Gui Zhi (Cinnamon Twig, 3 liang), Shao Yao (Peony Root, 6 liang), Sheng Jiang (Fresh Ginger, 3 liang, sliced), Zhi Gan Cao (Honey-fried Licorice Root, 2 liang), Da Zao (Jujube, 12 pieces, split).
These five ingredients are boiled in 7 sheng of water until reduced to 3 sheng. Strain and take warm in three divided doses.
Da Huang Tang (Rhubarb Decoction) Formula:
Da Huang (Rhubarb Root and Rhizome, 2 liang).
This is prepared by adding 2 liang of Da Huang to the previous formula.
In patients lacking Yang-excess signs, with a weak pulse and continuous spontaneous bowel movements, if Da Huang or Shao Yao were indicated, their dosages should be reduced because such patients have weak Stomach Qi and are prone to diarrhea.