火入于肺烦也。火入于肾躁也。烦躁俱在上者。肾子通于肺母也。发润如油。喘
而不
休。总言肺绝。鼻者肺之外候。肺气通于鼻。鼻中气出粗大是肺也。发者血之余。肾气主
之。发润如油。火迫肾水至高之分。是水将绝也。仲景以发润喘大为肺绝。兼其肾而言之
发
在高巅之上虽属肾。肺为五脏之至高。故言肺绝兼肾也。太抵肺肾相通肺既已绝。则肾不言
而知其绝矣。或曰烦者。心为之烦。躁者心为之躁。何烦为肺躁为肾耶。夫心者君火也。与
邪热相接上下通。热金以之而燥水
以之而亏。独存者火尔。故肺肾与心合而为烦躁焉。此烦虽肺躁虽肾。其实心火为之也。
若有宿食而烦躁者。栀子大黄汤主之。
答曰。足阳明者胃也。岂有其言哉。伤寒
始自皮毛入是从肺中来。肺主声。入于心则为言。胃即戊也。戊为火化。下从肾肝。
伤寒表证。发热恶寒而渴。与下证同。但头痛身热目疼鼻干。不得卧(白虎汤)主之。乃
阳明
经病也。正阳阳明气病。脉洪大先无形也。杂病里证。发热恶热而渴。但目赤者病藏也。手
太阴肺不足不能管领阳气也。宜以枸杞生地黄熟地黄之类主之脉洪大甚则呕血先有形也。
When Fire pathogen enters the Lung, it causes *Fan* (restlessness/irritability). When Fire pathogen enters the Kidney, it causes *Zao* (agitation/restlessness). When both Fan and Zao occur in the upper body, it is because the Kidney (Child) connects with the Lung (Mother). The hair becomes moist like oil, and panting does not cease; this generally indicates the exhaustion of Lung Qi. The nose is the external manifestation of the Lung, and Lung Qi communicates with the nose. Coarse breathing from the nose indicates pathology in the Lung. Hair is the surplus of Blood, governed by Kidney Qi. Hair moist like oil indicates that Fire is forcing Kidney Water to the highest point, signifying that Water is about to be exhausted. Zhang Zhongjing considers moist hair and severe panting as signs of Lung exhaustion, also referring to the Kidney. Although hair is located at the highest point of the head and belongs to the Kidney, the Lung is the highest of the Five Viscera, so stating Lung exhaustion implies Kidney exhaustion as well. Generally, the Lung and Kidney are connected; if the Lung is already exhausted, the Kidney's exhaustion is known without saying. One might ask: Fan is caused by the Heart, and Zao is caused by the Heart. Why is Fan attributed to the Lung and Zao to the Kidney? The Heart is the Ministerial Fire (Monarch Fire). It connects with pathogenic heat, communicating up and down. Heat dries Metal (Lung) and depletes Water (Kidney), leaving only Fire remaining. Thus, the Lung, Kidney, and Heart combine to manifest as Fan and Zao. Although Fan manifests in the Lung and Zao in the Kidney, it is actually caused by Heart Fire. If Fan and Zao are caused by retained food, Zhizi Dahuang Tang (Gardenia and Rhubarb Decoction) should be used.
The response states: The Foot-Yangming Meridian is the Stomach. Is there such a statement? Shaoyang disease begins entering from the skin and hair, originating from the Lung. The Lung governs voice; when pathogen enters the Heart, it manifests as speech abnormalities. The Stomach corresponds to Wu Earth, which transforms into Fire, descending to connect with the Kidney and Liver.
In exterior syndromes of Shanghan (Cold Damage), there is fever, aversion to cold, and thirst, similar to interior excess syndromes. However, accompanied by headache, body heat, eye pain, nasal dryness, and inability to sleep, Baihu Tang (White Tiger Decoction) is indicated. This is a Yangming Meridian disease. In Zhengyang Yangming Qi-level disease, the pulse is surging and large, initially without tangible pathogens. In miscellaneous disease interior syndromes, there is fever, aversion to heat, and thirst. Only red eyes indicate pathology in the Zang organs. Insufficiency of Hand-Taiyin Lung fails to manage and lead the Yang Qi. Treatment should prioritize herbs such as Gouqi (Lycium Fruit), Sheng Dihuang (Rehmannia Root), and Shu Dihuang (Prepared Rehmannia Root). If the pulse is extremely surging and large, hematemesis may occur first, indicating a prior tangible pathology.
If Qi-level disease is in the exterior, mistakenly using blood-invigorating or blood-nourishing drugs causes no harm, as it benefits Yin to stabilize Blood. If Blood-level disease is in the interior, mistakenly using Qi-regulating drugs, such as Baihu Tang, is incorrect, as it drains the Lung and damages Yin.