总括
痢疾之证,多因外受暑湿,内伤生冷而成。伤于气者,色多白,以肺与大肠相表里也。伤于血者,色多红,以心与
小肠相表里也。其证后重下坠,里急而腹窘痛。又有寒痢、热痢、时痢、噤口痢之名,医者辨之。
寒痢
寒冷伤胃,久痢不已,或脏气本虚,复为风寒所乘,伤于肠胃,故痢时肠鸣切痛,实难堪当,面唇青白,口呈渴而
喜饮热,此里寒虚之证也。初宜理中汤,久则真人养脏汤主之,其效通仙也。
热痢
热痢者,皆因湿热结于肠胃,致腹窘痛,下痢无度,尿短色红,舌赤唇焦,喜饮冷水,此里热之证也。重则当归芍
药汤主之,轻则白头翁汤主之,或香连丸治之亦灵。
时痢
时痢者,乃痢疾时复感时气也。身体发热无汗,遍身疼痛,热为邪束,因作呕逆。须以仓凛汤散之,而痢自止,有
奇功也。
噤口痢
如火毒冲冒而成噤口,其证脉大身热,不能饮食,舌赤唇红,惟喜饮冷,急宜参连开噤散救之,其功奇矣。
总括
疟疾者,多因夏伤于暑,其气含入于荣内,至秋复感寒风,则荣卫合邪,而病始成。发时阴阳相并,故或寒或热也。
乃有每日作者,因初病邪气尚浅,伏藏于荣,随经络而行故也。其间日作者,因邪已深入脊膂间,伏藏于冲脉故也。其
昼发者,因邪在三阳之浅;夜发者因邪在三阴之深。疟将退者,亦由夜而昼,由间日而至每日。此去阴就阳,由深而浅,
病将已矣。治者,须详细分明别之也。
寒疟风疟
凡疟疾,先伤于寒,后伤于风,故先寒后热,身体无汗,此为寒疟,不须细详。如先伤于风,后伤于寒,故先热后
寒,身体有汗,此为风疟,亦已详明。如寒疟,以麻黄羌活汤之剂为主;如风疟,惟桂枝羌活汤斟酌用之。
食疟
食疟者,因小儿饮食无节,复感风暑之气,以致寒热交作,胸腹胀满,面黄恶食,痞闷不通也。但食有轻重,轻者
须用柴平汤之剂主之;如重而便 者,用加味大柴胡汤攻之,则积滞清,而疟渐退矣。
疟痰疟饮
小儿素有痰饮,复因外邪凝结脾胃,故多呕逆,面黄目肿,胸膈膨胀也。若疟疾已经汗下之后,表里无证,宜用清
脾饮以和之。如痰盛者,用清脾饮加橘红倍半夏;饮盛者,加苍术倍茯苓;若气已虚弱,加人参以扶其正。
General Overview
Dysentery is mostly caused by external contraction of summer-heat and dampness, and internal injury from raw or cold food. When the Qi is injured, the stool color tends to be white, because the Lung and Large Intestine are exteriorly-interiorly related. When the Blood is injured, the stool color tends to be red, because the Heart and Small Intestine are exteriorly-interiorly related. The symptoms include tenesmus (a feeling of incomplete defecation with urgency), urgency, and abdominal distress and pain. There are also names such as Cold Dysentery, Heat Dysentery, Seasonal Dysentery, and Anorexic Dysentery, which physicians must differentiate.
Cold Dysentery
Cold damages the Stomach; if dysentery persists for a long time, or if the Zang-Fu Qi is originally deficient and further attacked by Wind-Cold, injuring the intestines and stomach, then during dysentery there will be borborygmus and cutting pain that is unbearable. The face and lips appear cyanotic and pale, and although there is thirst, the patient prefers hot drinks. This is a pattern of interior Cold deficiency. Initially, Lizhong Tang (Regulate the Middle Decoction) is suitable; for chronic cases, Zhiren Yangzang Tang (True Person Nourish Viscera Decoction) should be used as the main formula, with miraculous efficacy.
Heat Dysentery
Heat Dysentery is caused by damp-heat accumulating in the intestines and stomach, leading to abdominal distress and pain, profuse diarrhea, scanty red urine, a red tongue, cracked lips, and a preference for cold water. This is a pattern of interior Heat. For severe cases, Danggui Shaoyao Tang (Angelica and Peony Decoction) is used as the main formula; for mild cases, Baitouweng Tang (Pulsatilla Decoction) is used as the main formula, or Xianglian Wan (Coptis and Aucklandia Pill) can also be effective.
Seasonal Dysentery
Seasonal Dysentery occurs when a patient suffering from dysentery contracts seasonal epidemic pathogens. Symptoms include fever without sweating, body-wide pain, and vomiting due to heat being constrained by pathogenic factors. Canglin Tang (Granary Storehouse Decoction) must be used to disperse the exterior pathogens, after which the dysentery will stop spontaneously, demonstrating remarkable efficacy.
Anorexic Dysentery
If Anorexic Dysentery is caused by Fire-Toxin rushing upward, the symptoms include a large pulse, fever, inability to eat, a red tongue, red lips, and a preference only for cold drinks. It is urgent to rescue with Shenlian Kaijin San (Ginseng and Coptis Opening the Throat Powder), which has miraculous effects.
General Overview
Malaria is mostly caused by summer-heat contracted in summer, which enters and lies latent within the Ying (Nutritive) level. In autumn, re-exposure to cold wind causes the Ying and Wei (Defensive) levels to combine with pathogens, resulting in the disease. During attacks, Yin and Yang qi contend, causing alternating chills and fever. Some cases occur daily because initially the pathogen is shallow, lying latent in the Ying level and moving along the meridians. Some cases occur every other day because the pathogen has penetrated deeply into the spine and diaphragm area, lying latent in the Chong (Penetrating) vessel. Daytime attacks indicate the pathogen is in the shallow layer of the Three Yang meridians; nighttime attacks indicate the pathogen is in the deep layer of the Three Yin meridians. As malaria recedes, it shifts from nighttime to daytime, and from every-other-day to daily occurrence. This represents the pathogen moving from Yin to Yang, from deep to shallow, indicating the disease is about to resolve. Physicians must distinguish these details carefully.
Cold Malaria and Wind Malaria
Generally, malaria involves first contracting Cold and then Wind, resulting in initial chills followed by fever, with no sweating on the body; this is called Cold Malaria, which need not be detailed. If Wind is contracted first and Cold second, resulting in initial fever followed by chills, with sweating on the body, this is called Wind Malaria, which has already been explained clearly. For Cold Malaria, Mahuang Qianghuo Tang (Ephedra and Notopterygium Decoction) is the primary formula; for Wind Malaria, Guizhi Qianghuo Tang (Cinnamon Twig and Notopterygium Decoction) is used with discretion.
Food Malaria
Food Malaria is caused by irregular diet in children combined with exposure to Wind and Summer-heat, leading to alternating chills and fever, chest and abdominal distension and fullness, sallow complexion, aversion to food, and stifling obstruction. Depending on the severity of the food stagnation: for mild cases, Chaiping Tang (Bupleurum and Pinellia Decoction) is used as the main formula; for severe cases accompanied by constipation, Jiawei Daxiehu Tang (Modified Major Bupleurum Decoction) is used to purge, clearing the stagnation so that malaria gradually recedes.
Malarial Phlegm and Fluid Retention
Children who inherently have Phlegm-Fluid retention, when affected by external pathogens condensing in the Spleen and Stomach, often experience vomiting and regurgitation, sallow complexion, swollen eyes, and chest and epigastric distension. If malaria has already been treated with sweating or purging methods, and there are no exterior or interior excess signs remaining, Qingpi Yin (Clear the Spleen Drink) should be used to harmonize. If Phlegm is abundant, add Juhong (Citrus Reticulata Pericarpium) to Qingpi Yin and double the amount of Banxia (Pinellia Tuber); if Fluid retention is abundant, add Cangzhu (Atractylodes Rhizome) and double the amount of Fuling (Poria). If Qi is already deficient, add Renshen (Ginseng Root) to support the healthy Qi.