(无热虚劳乃阳虚症,其病自上而下,损之脉也,法宜温补)
《大全》云∶妇人冷劳属气血不足、脏腑虚寒,以致脐下冷痛,手足时寒,月经失常,
饮食不消,或时呕吐,恶寒发热,骨节酸疼,肌肤羸瘦,面色萎黄也。
薛氏曰∶前症有内外真寒者,有内外真热者。有内真热而外假寒者,有内真寒而外假热
者,
若饮食难化,大便不实,肠鸣腹痛,饮食畏寒,手足逆冷,面黄呕吐,畏见风寒,此内外真
寒之症也。宜用附子理中汤以回阳,八味地黄丸以壮火。若饮食如常,大便坚实,胸腹痞胀
,饮食喜冷,手足烦热,面赤,呕吐,不畏风寒,此内外真热之症也。宜用黄连解毒汤以消
阳,六味地黄丸以壮水。若饮食如常,大便坚实,胸腹痞胀,手足逆冷,面黄呕吐,畏见风
寒,此内真热而外假寒也,亦用解毒汤、六味丸。若饮食少思,大便不实,吞酸嗳气,胸腹
痞满,手足逆冷,面赤呕吐,畏见风寒,此内真寒而外假热也,亦用理中汤、八味丸。当求
其属而治之。经曰∶益火之源,以消阴翳,壮水之主,以镇阳光。使不知真水火之不足,泛
以寒热药治之,则旧疾未去,新病复生矣。夫所谓属者,犹主也,谓心肾也。求其属也者,
言水火不足而求之于心肾也。火之源者,阳气之根,即心是也。水之主者,阴气之根,即肾
是也,非谓火为心、源为肝、水为肾、主为肺也。
(Deficiency consumption without fever belongs to Yang deficiency syndrome. The disease progresses from above downwards, representing a pulse of organ damage; the treatment principle should be warming and tonifying.)
*Daquan* states: Women's cold consumption belongs to insufficiency of Qi and Blood, and deficiency-cold of the Zang-Fu organs, resulting in cold pain below the umbilicus, coldness of the hands and feet at times, irregular menstruation, indigestion, occasional vomiting, aversion to cold with fever, soreness and pain of the bone joints, emaciation of the skin and muscles, and sallow complexion.
Xue Ji said: The aforementioned symptoms include cases of true cold inside and outside, and cases of true heat inside and outside. There are cases of true heat inside with false cold outside, and cases of true cold inside with false heat outside. If digestion is difficult, stools are loose, there is borborygmus and abdominal pain, food intake is feared due to cold, the hands and feet are cold (reversal cold), the face is yellow with vomiting, and there is aversion to wind and cold, these are symptoms of true cold inside and outside. It is appropriate to use Fuzi Lizhong Tang (Aconite Decoction for Regulating the Middle) to restore Yang, and Bawei Dihuang Wan (Eight-Ingredient Pill with Rehmannia) to strengthen the Fire of the Gate of Vitality. If diet is normal, stools are firm, there is fullness and distension in the chest and abdomen, preference for cold drinks, vexatious heat in the hands and feet, red face, vomiting, and no aversion to wind and cold, these are symptoms of true heat inside and outside. It is appropriate to use Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) to clear excess Yang/Fire, and Liudihuang Wan (Six-Ingredient Pill with Rehmannia) to nourish Water/Yin. If diet is normal, stools are firm, there is fullness and distension in the chest and abdomen, reversal cold in the hands and feet, yellow face with vomiting, and aversion to wind and cold, this is true heat inside with false cold outside; also use Jiedu Tang (Decoction for Resolving Toxicity) and Liudihuang Wan (Six-Ingredient Pill with Rehmannia). If appetite is poor, stools are loose, there is acid regurgitation and belching, fullness and distension in the chest and abdomen, reversal cold in the hands and feet, red face with vomiting, and aversion to wind and cold, this is true cold inside with false heat outside; also use Lizhong Tang (Decoction for Regulating the Middle) and Bawei Dihuang Wan (Eight-Ingredient Pill with Rehmannia). One must seek the root attribute to treat it. The Classics state: "Enrich the source of Fire to dissipate Yin shadows; strengthen the master of Water to suppress excessive Yang." If one does not understand the insufficiency of True Water and True Fire, and indiscriminately uses cold or hot medicines for treatment, old diseases will not be eliminated, and new diseases will arise. What is meant by "attribute" is similar to "master," referring to the Heart and Kidney. "Seeking the attribute" means seeking the root in the Heart and Kidney when Water and Fire are insufficient. The source of Fire is the root of Yang Qi, which is the Heart. The master of Water is the root of Yin Qi, which is the Kidney. This does not mean that Fire corresponds to the Heart, Source to the Liver, Water to the Kidney, and Master to the Lung.