气虚痘疹。或为饮食生冷。调理失宜。致伤脾胃。遂成泄泻。津液下陷。虚火上盛。必发而
为渴。元气下陷。虚阳上壅。下
气不续。必发而为喘。夫渴与喘。实证也。起于泄泻之后。斯为津液暴亡而渴。阴气暴逆而喘。
故治渴则宜钱氏白术散。渴泻不止。则用钱氏异功散。治喘则宜独参汤。不应。亦用钱氏异功散。
大便实者。少与生脉散调之。喘渴而泄。陈氏木香散、异功散选用。若至闷乱腹胀。毒瓦斯内攻。
眼合自语者。此名失志。庸医不察。谬认为实。而与耗气之剂。速其毙也。安有实热而渴。气拥
而喘。生于泄泻之后哉。
身发壮热。毛直皮燥。睡卧不宁。腮红睛赤。烦渴腹胀。便秘喘急。皆实热证。而复见呕吐者。
此热毒在内。不得伸越。或为寒冷所搏。乳食不节。冷热相拒。则上逆而为呕吐。病机所谓诸逆
冲上。皆属于火者是也。治当升提发散。兼辛以散之。如升麻汤加生姜、橘皮之类。吐逆势甚者。
更加猪苓、泽泻引之下行可也。又有泄泻兼见。似乎虚证。然因热毒郁盛。熏炙脾胃。不得外达。
则毒从下陷。寻窍而出。亦当升提发散。热毒外解。内泄自止。有食则兼消导。如枳壳、山楂之
类。又复有不思饮食。似乎内虚。不知郁热在内。不得伸越。二便秘结。腠理阻塞。热毒壅遏。
腹胀满急。不思饮食。必然之势。亦当升提发散。引毒达表。有热则兼清热。如山栀、黄连之类。
则热气有所升越。而脏腑和平。饮食自进矣。若误用丁、桂、半夏等热药于呕吐泄泻之证。用参、
、白术等补药于腹胀不思饮食之证。立能杀人。他如龙骨、豆蔻、曲、 、缩砂。皆热泻之戈戟也。
In cases of varicella or smallpox due to Qi deficiency, sometimes consumption of raw and cold food, combined with improper regulation, damages the Spleen and Stomach, leading to diarrhea. The descent of Body Fluids (Jin Ye) and the hyperactivity of Deficient Fire result in thirst. The sinking of Yuan Qi and the congestion of Deficient Yang, with the lower Qi failing to continue, result in panting. Although thirst and panting appear as Excess syndromes, their onset following diarrhea indicates that thirst arises from the sudden loss of Body Fluids, and panting from the sudden rebellion of Yin Qi. Therefore, for treating thirst, Qian's Baizhu San (White Atractylodes Powder by Dr. Qian) is appropriate; if thirst and diarrhea persist, Qian's Yigong San (Yi Gong Powder) should be used. For treating panting, Dushen Tang (Single Ginseng Decoction) is suitable; if ineffective, Qian's Yigong San may also be used. In cases where stool is solid, a small amount of Shengmai San (Generate the Pulse Powder) can be given for regulation. For symptoms of panting, thirst, and diarrhea, Chen's Muxiang San (Aucklandia Powder) or Yigong San can be selected. If the condition progresses to restlessness, abdominal distension, internal attack by toxic factors, closed eyes with muttering speech, this is named "Shi Zhi" (Loss of Will/Confusion). Unskilled physicians, failing to examine carefully, mistakenly diagnose it as an Excess syndrome and administer Qi-consuming agents, which accelerates death. How could there be thirst caused by Excess Heat and panting caused by Qi congestion arising after diarrhea?
High fever, erect hair, dry skin, restless sleep, red cheeks, red eyes, irritability, thirst, abdominal distension, constipation, and rapid panting are all signs of Excess Heat. However, if vomiting occurs additionally, it is because heat-toxin is trapped inside and cannot extend outward, or due to invasion by cold, irregular intake of milk and food, causing cold and heat to repel each other, leading to upward rebellion and vomiting. This corresponds to the pathological mechanism stating that various rebellious upward movements belong to Fire. Treatment should involve lifting and dispersing, combined with pungent herbs to scatter the pathogen, such as Shengma Tang (Cimicifuga Decoction) added with fresh ginger and tangerine peel. For severe vomiting and rebellious Qi, Zhuling (Polyporus) and Zexie (Alisma) can be added to guide the pathogen downward. In cases where diarrhea coexists, appearing like a Deficiency syndrome, it is actually due to abundant郁 (stagnant) heat-toxin scorching the Spleen and Stomach, preventing external release, causing the toxin to sink downward and exit through orifices. Treatment should still involve lifting and dispersing to resolve the heat-toxin externally, after which internal diarrhea will cease naturally. If food stagnation is present, digestive aids like Zhike (Bitter Orange Fruit) and Shanzha (Hawthorn Fruit) can be added. In cases of loss of appetite, appearing like internal Deficiency, it is unknown that stagnant heat is trapped inside, unable to extend outward, causing blockage of urination and defecation, obstruction of interstices (Cou Li), and congestion of heat-toxin, leading to abdominal distension, urgency, and loss of appetite. This is an inevitable trend. Treatment should involve lifting and dispersing to draw the toxin to the surface. If heat is present, clearing-heat herbs like Zhizi (Gardenia Fruit) and Huanglian (Coptis Rhizome) can be added, allowing the heat Qi to rise and disperse, restoring harmony to the Zang-Fu organs, and naturally improving appetite. If hot herbs such as Dingxiang (Clove), Rougui (Cinnamon Bark), and Banxia (Pinellia Tuber) are mistakenly used for vomiting and diarrhea, or tonifying herbs such as Renshen (Ginseng Root), [missing character], and Baizhu (Atractylodes Macrocephala Rhizome) are used for abdominal distension and loss of appetite, death will ensue immediately. Others such as Longgu (Fossilized Bones), Doukou (Cardamom Fruit), Qu (Medicated Leaven), [missing character], and Suansha (Amomum Fruit) are weapons against heat-type diarrhea.