于桂枝汤方内。去芍药。加附子一枚。炮去皮。破八片。余根据前法。
太阳病。得之八九日。如疟状。发热、恶寒、热多、寒少、其人不呕。清便欲自可。
一日二
三度发。脉微缓者。为欲愈也。脉微而恶寒者。此阴阳俱虚。不可更发汗、更下、更吐
也。面色反有热色者。未欲解也。以其不能得小汗出。身必痒。宜桂枝麻黄各半汤。
伤寒八九日。则邪传再经。又遍三阳。欲传三阴之时也。传经次第。则三日传遍三
阳。至四日。阳去入阴。不入阴者。为欲解。其传阴经。第六日。传遍三阴。为传经尽
而当解。其不解。传为再经者。至九日。又遍三阳。阳不传阴则解。如疟发作有时也。
寒多者为病进。热多者为病退。经曰。厥少热多。其病为愈。寒多热少。阳气退。故为
进也。今虽发热恶寒。而热多寒少。为阳气进而邪气少也。里不和者。呕而利。今不呕。
清便自调者。里和也。寒热间日发者。邪气深也。日一发者。邪气复常也。日再发者。邪
气浅也。日二三发者。邪气微也。内经曰。大则邪至。小则平。言邪甚则脉大。邪少则
脉微。今日数多而脉微缓者。是邪气微缓也。故云欲愈。脉微而恶寒者。表里俱虚也。
阳、表也。阴、里也脉微为里虚。恶寒为表虚。以表里俱虚。故不可更发汗、更下、更吐
也。阴阳俱虚。则面色青白。反有热色者。表未解也。热色、为赤色也。得小汗则和。不
得汗。则不得邪气外散皮肤而为痒也。与桂枝麻黄各半汤。小、发其汗。以除表邪。
In the prescription of Guizhi Tang (Cinnamon Twig Decoction), remove Shaoyao (Paeoniae Radix Alba). For the remaining preparation and administration methods, follow the previous instructions.
In the prescription of Guizhi Tang (Cinnamon Twig Decoction), remove Shaoyao (Paeoniae Radix Alba) and add one Fuzi (Aconiti Lateralis Radix Praeparata), which has been processed (pao), peeled, and broken into eight pieces. For the remaining preparation and administration methods, follow the previous instructions.
Taiyang disease (disease pattern caused by pathogenic invasion of the Taiyang channel), after eight or nine days of onset, presents with symptoms resembling malaria: fever and aversion to cold, with more heat than cold. The patient does not vomit, and bowel movements are relatively normal. The episodes occur two or three times a day. If the pulse is slightly slow and relaxed (wei huan), it indicates that recovery is imminent. If the pulse is faint and accompanied by aversion to cold, this signifies deficiency of both Yin and Yang; in such cases, sweating, purging, and emetic therapies should not be employed again. If the facial complexion appears reddish, the condition has not yet resolved because slight perspiration could not be induced to disperse the pathogen, leading to body itching. In this scenario, Guizhi Mahuang Ge Ban Tang (Half-and-Half Decoction of Cinnamon Twig and Ephedra) is appropriate.
After eight or nine days of Shanghan (Cold Damage), the pathogen has transmitted to another stage and circulated through all three Yang channels, at which point it is about to transmit to the three Yin channels. According to the sequence of transmission, the three Yang channels are fully traversed within three days. By the fourth day, Yang Qi departs and enters Yin. If it does not enter Yin, the disease is about to resolve. If it transmits to the Yin channels, by the sixth day, the three Yin channels are fully traversed, marking the end of transmission and expected resolution. If unresolved and transmitting to another stage, by the ninth day, it circulates through the three Yang channels again. If Yang does not transmit to Yin, the disease resolves, similar to the periodicity of malaria. More cold indicates disease progression; more heat indicates disease regression. The classic states: "Less Jue (cold extremities) and more heat indicates recovery; more cold and less heat indicates decline of Yang Qi, hence progression." Although there is currently fever and aversion to cold, the predominance of heat over cold indicates advancing Yang Qi and diminishing pathogen. Internal disharmony manifests as vomiting and diarrhea; since there is no vomiting and excretions are regulated, the interior is harmonious. Intermittent chills and fever suggest deep-seated pathogen; daily occurrence suggests normalization of the pathogen; twice-daily occurrence suggests superficial pathogen; two-to-three times daily suggests minimal pathogen. The Neijing states: "Large pulse indicates pathogen presence; small pulse indicates peace." This means a large pulse reflects severe pathogen, while a faint pulse reflects minimal pathogen. Now, despite the prolonged duration, the faint and relaxed pulse indicates minimal and缓和 (harmonious) pathogen. Hence, it is said that recovery is imminent. A faint pulse with aversion to cold indicates deficiency of both exterior and interior. Yang corresponds to the exterior, and Yin to the interior. A faint pulse indicates interior deficiency, and aversion to cold indicates exterior deficiency. Due to dual deficiency of exterior and interior, sweating, purging, and emetic therapies are contraindicated. Dual deficiency of Yin and Yang typically results in a bluish-white complexion; a reddish complexion instead indicates unresolved exterior pathogen. Redness refers to crimson color. Slight perspiration leads to harmony; lack of perspiration prevents the pathogen from dispersing through the skin, causing itching. Administer Guizhi Mahuang Ge Ban Tang (Half-and-Half Decoction of Cinnamon Twig and Ephedra) to induce slight sweating and eliminate exterior pathogens.