夫时毒者,为四时邪毒之气,而感之于人也。其候发于鼻、面、耳、项、咽喉,赤肿无
头,或结核有根,寒热头痛,恍惚不宁,状如伤寒,五七日之间,亦能杀人,治宜精辨之。若脉
浮数者,邪在表也,用葛根牛蒡子汤、解毒升麻汤之类以发之。脉沉涩者,邪在里也,用栀
子仁汤、大黄汤之类以下之。表里俱病者,犀角升麻汤。甚者,砭出恶血,并用通气散,
鼻内取嚏,以泄其毒,十日外自消。若搐药不嚏者,不可治之。如嚏出脓血者,治之必愈。
至七八日之间,大小便通利,头面肿起高赤者,可服托里散、黄 散,此病若五日以前,精
神昏乱,咽喉秘塞,语声不出,头面赤肿,食不知味者,必死之候。凶荒劳役患之,安里为
主,用普济消毒饮最善。然而此症有阴有阳,有可汗,有可下,若误认为热毒而用药,则谬
治验
少宰李蒲汀,用发散之药,托损元气,患处不消,体倦恶寒,食少口干,余用益气汤加
桔梗,及托里消毒散,而愈。
秋官陈同野,元气素弱,脉微细而伏,此形病俱虚也。用参、术、芎、归、陈皮、柴胡
、升麻、炙草,以升举阳气;用牛蒡、玄参、连翘、桔梗,以解热毒,二剂肿顿消,而脉亦复矣
。苟以脉微细为属阴,以肿赤为属阳而药之,鲜有不误者。
一妇人溃后,肿赤不消,食少体倦,脓清色白,乃脾肺气虚也。先用六君加桔梗、芎、
归,后用益气汤加桔梗而敛。
春官袁谷虚之妹,表散过度,肿硬不食,脉浮大,按之而短,此真气绝也。辞不治,后
Shidu (Seasonal Toxic Disease) refers to the pathogenic influence of evil toxic qi from the four seasons upon the human body. Its manifestations include redness and swelling without a head on the nose, face, ears, neck, and throat, or the formation of rooted nodules; accompanied by aversion to cold, fever, headache, mental confusion, and restlessness, resembling Taiyang disease (a syndrome caused by pathogenic invasion of the Taiyang channel). It can be fatal within five to seven days; therefore, treatment requires precise differentiation. If the pulse is floating and rapid, the pathogen is in the exterior; use Ge Gen Niu Bang Zi Tang (Kudzu and Burdock Seed Decoction) or Jie Du Sheng Ma Tang (Detoxifying and Cimicifuga Decoction) to disperse it. If the pulse is deep and choppy, the pathogen is in the interior; use Zhi Zi Ren Tang (Gardenia Seed Decoction) or Da Huang Tang (Rhubarb Decoction) to purge it. For simultaneous exterior and interior involvement, use Xi Jiao Sheng Ma Tang (Rhino Horn and Cimicifuga Decoction). In severe cases, use bian (stone lancet) therapy to release foul blood, combined with Tong Qi San (Ventilation Powder), administered nasally to induce sneezing, thereby venting the toxicity; spontaneous resolution occurs after ten days. If nasal irritants fail to induce sneezing, the condition is incurable. If sneezing expels pus and blood, the condition will surely heal. By the seventh or eighth day, if urination and defecation are unobstructed, and the head and face are swollen, elevated, and red, Tuo Li San (Support Interior Powder) or Huang Qi San (Astragalus Powder) may be taken. However, if before the fifth day, the patient exhibits mental confusion, throat obstruction, loss of voice, red and swollen head and face, and inability to taste food, these are signs of certain death. During times of famine and overwork, the primary approach is to stabilize the interior; Pu Ji Xiao Du Yin (Universal Benefit Detoxification Decoction) is most effective. Nevertheless, this condition presents as either Yin or Yang patterns, amenable to sweating or purging methods respectively. Misidentifying it merely as heat-toxin and prescribing accordingly leads to erroneous treatment.
Li Puting, Vice Minister, used dispersing medications that damaged Yuan Qi (Primal Energy). The affected area remained swollen, accompanied by fatigue, aversion to cold, poor appetite, and dry mouth. I treated him with Yi Qi Tang (Qi-Supporting Decoction) added with Jie Geng (Platycodon Root), along with Tuo Li Xiao Du San (Interior-Supporting and Toxin-Resolving Powder), resulting in recovery.
Chen Tongye, Official of Justice, had inherently weak Yuan Qi, with a faint, fine, and hidden pulse, indicating deficiency in both form and pathology. I prescribed Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala Rhizome), Xiong Qiong (Ligusticum Chuanxiong Rhizome), Dang Gui (Angelica Sinensis Root), Chen Pi (Citrus Reticulata Peel), Chai Hu (Bupleurum Root), Sheng Ma (Cimicifuga Rhizome), and Zhi Gan Cao (Prepared Licorice Root) to raise and lift Yang Qi; and Niu Bang Zi (Arctium Fruit), Xuan Shen (Scrophularia Root), Lian Qiao (Forsythia Fruit), and Jie Geng (Platycodon Root) to resolve heat-toxin. After two doses, the swelling subsided instantly, and the pulse normalized. Had one classified the faint pulse as Yin and the red swelling as Yang, treatment would likely have failed.
A female patient, post-ulceration, presented with persistent redness and swelling, poor appetite, fatigue, and clear, white pus, indicating deficiency of Spleen and Lung Qi. Initially, Liu Jun Zi Tang (Six Gentlemen Decoction) was administered with additions of Jie Geng (Platycodon Root), Xiong Qiong (Ligusticum Chuanxiong Rhizome), and Dang Gui (Angelica Sinensis Root); subsequently, Yi Qi Tang (Qi-Supporting Decoction) with Jie Geng (Platycodon Root) was used to promote wound closure.
The younger sister of Yuan Guxu, Official of Spring, suffered from excessive dispersing therapy, leading to hard swelling and anorexia. Her pulse was floating and large but short upon deep pressure, indicating exhaustion of True Qi (Zhen Qi). I declined treatment; subsequently...