时疫愈后,发疮者极多,余热淫于肌肉也,多服清凉养气血药自愈。
时疫愈后,四肢不能动移者,热伤筋脉也,吴氏诸养荣汤酌用,轻者粥食调理自愈。
时疫愈后,身体枯瘦,皮肤甲错者。热伤其阴也,养阴为主,吴氏诸养荣汤酌用,亦有粥食调理自回者。
时疫愈后,有发骨蒸如劳瘵者,乃余热留于阴分也,不可以其羸瘦而遽用虚损门治法。必察其六府,有结邪,
则仍攻其邪为主,次察其经络;有壅瘀,则仍通其壅瘀为主,次察其气道;有痰涎,则仍利其痰涎为主。数者俱
无,然后以清热为主,或无邪而阴伤,方可纯用养阴之药,或分其余邪之轻重,亏损之多少,而兼用养阴清热
药,进退加减以和之更妙。
妇人时疫悉与男子同,惟当经期则治法略异,以其关乎血室也。凡遇感疫值经期者,治法必兼少阳,以少阳与
厥阴为表里,厥阴为血室,血室一动,邪必乘虚而犯之,须分适来因受病而止、适来受病而自行、适断
而受病三种,则虚实自见。
凡经水适来而受疫气遽止者,必有瘀血,要再察其胁、腰、少腹,有牵引作痛拒按者,必以清热、消瘀为
主,小柴胡加赤芍、延胡、桃仁、归尾、丹皮。
凡经水适来而受疫气,疫病虽发而经水照常自行者,不必治其经血,但治其疫邪而病自愈。盖病本未犯血室,
故经血自行如常也。仲景所谓∶勿犯胃气及上二焦,必自愈者。正指此,非谓总不用药也。
凡经水适断而受邪者,经行已尽则血海空虚,邪必乘虚而陷入血海,若见腰、胁及少腹满痛者,大柴
胡汤加桃仁、赤芍,逐其血室之邪始愈。
凡妇人受疫,但见昼日明了,至夜谵语,即当询其经
期,以防热入血室之渐。
After the recovery from epidemic febrile disease, many cases develop skin sores; this is due to residual heat invading the muscles. It usually heals spontaneously with frequent administration of cooling herbs that nourish Qi and Blood.
After recovery from epidemic febrile disease, if the limbs cannot move, it is because heat has damaged the sinews and vessels. Wu’s various Yangrong Decoctions (Nourishing Nutrient Decoctions) should be used as appropriate. In mild cases, healing occurs spontaneously through dietary regulation with porridge.
After recovery from epidemic febrile disease, if the body becomes emaciated and the skin is rough like fish scales (jiacuo), it is because heat has injured Yin. The treatment focuses on nourishing Yin, using Wu’s various Yangrong Decoctions as appropriate. Some cases also recover through dietary regulation with porridge.
After recovery from epidemic febrile disease, some patients present with bone-steaming fever resembling consumptive disease (laozai); this is due to residual heat lingering in the Yin aspect. One must not immediately apply the treatment methods for deficiency diseases simply because the patient is emaciated. First, examine the Six Fu Organs (Gallbladder, Stomach, Large Intestine, Small Intestine, Bladder, Sanjiao); if there are bound pathogens, the primary treatment is to attack the pathogens. Second, examine the meridians; if there is stagnation and blood stasis, the primary treatment is to unblock the stagnation and stasis. Third, examine the Qi pathways; if there is phlegm-fluid retention, the primary treatment is to promote the discharge of phlegm-fluid. If none of these exist, then focus on clearing heat. Only if there are no pathogens but only Yin injury can pure Yin-nourishing herbs be used. Alternatively, depending on the severity of residual pathogens and the degree of deficiency, combine Yin-nourishing and heat-clearing herbs, adjusting the dosage flexibly to harmonize the condition, which is more effective.
The treatment of epidemic febrile disease in women is generally the same as in men, except during menstruation when the approach differs slightly because it involves the Blood Chamber (Xueshi). Whenever a woman contracts an epidemic during her menstrual period, the treatment must involve the Shaoyang Meridian (Foot-Shaoyang Gallbladder Meridian), as Shaoyang and Jueyin (Foot-Jueyin Liver Meridian) are exterior-interior pairs, and Jueyin governs the Blood Chamber. Once the Blood Chamber is disturbed, pathogens will inevitably take advantage of the deficiency to invade. One must distinguish between three scenarios: menstruation just started and stopped due to illness, menstruation just started and illness contracted but menstruation continues normally, and menstruation just ended and illness contracted. In doing so, the excess or deficiency nature will become clear.
If menstruation just started and was abruptly stopped upon contracting epidemic qi, blood stasis must be present. Further examination of the hypochondrium, lower back, and lower abdomen is required; if there is pulling pain that refuses pressure, the treatment must focus on clearing heat and resolving stasis, using Xiaochaihu Tang (Minor Bupleurum Decoction) plus Chishao (Radix Paeoniae Rubra), Yanhusuo (Rhizoma Corydalis), Taoren (Semen Persicae), Guiwei (Radix Angelicae Sinensis Caulis), and Danpi (Cortex Moutan).
If menstruation just started and was accompanied by epidemic contraction, but the menstrual flow continues normally despite the onset of epidemic symptoms, there is no need to treat the menstrual blood; one only needs to treat the epidemic pathogens, and the disease will heal spontaneously. This is because the pathology has not yet invaded the Blood Chamber, so the menstrual flow proceeds as usual. This refers precisely to Zhang Zhongjing’s statement: "Do not injure the Stomach Qi and the Upper and Middle Jiaos, and the disease will surely heal." This does not mean that no medicine should be used at all.
If illness is contracted just after menstruation has ceased, the Sea of Blood is empty after the period ends, and pathogens will inevitably sink into the Sea of Blood taking advantage of the deficiency. If fullness and pain in the lower back, hypochondrium, and lower abdomen are observed, use Dachaihu Tang (Major Bupleurum Decoction) plus Taoren (Semen Persicae) and Chishao (Radix Paeoniae Rubra) to expel the pathogens from the Blood Chamber before recovery can occur.
Whenever a woman contracts an epidemic, if she presents with clarity during the day but delirious speech (shanyu) at night, one must inquire about her menstrual status to prevent the gradual invasion of heat into the Blood Chamber.