当各随三阳本证。表药发之。发之表解。下利自愈。若不愈者。方可以利药治之。
太阳病下之其脉促。不结胸者。此为欲解也。
脉浮者必结胸。 脉紧者。必咽痛。
脉弦者。必两胁拘急。脉细数者。头痛不止。
脉沉紧。必欲呕。 脉沉滑者。胁热利。
脉浮滑者。必下血。
太阳病反下之。因而腹满时痛者。属太阴也。桂枝加芍药汤主之。至于大实痛者胃也。
桂枝加大黄汤主之。巳传戊妇告夫也。所以为里传表即名误下传也。
或问曰。伤寒杂证一体。若误下之。甚者变大。答曰。非一体
也。伤寒误下变无定体。杂病误下变有定体。何以然。伤寒自外而入阳也。阳主动。杂病自
内而出阴也。阴主静。动者犯之。其变无穷。静者犯之。其变止痞与腹胁痛而已。故变无穷
者为重。痞与腹胁痛者为轻也。
五苓散为下药。乃太阳里之下药也。太阳高则汗发之。下则引而竭之。
渴者邪入太阳本也。当下之。使从膀胱出也。
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肾燥膀胱热。小便不利。此药主之。小便利者不宜用。然太阳病热而渴。小便虽利。亦
宜(五苓散)下之。
Treatment should follow the primary syndromes of the three Yang meridians. Administer exterior-releasing medications to induce sweating; once the exterior syndrome is resolved, the diarrhea will heal spontaneously. If it does not resolve, only then can medications for treating diarrhea be used.
If a Taiyang disease (Taiyang Syndrome) is mistakenly treated with purgation and the pulse becomes rapid (Cu Mai), without forming Jie Xiong (Chest Binding), this indicates that the condition is about to resolve.
If the pulse is floating (Fu Mai), Jie Xiong (Chest Binding) will definitely form.
If the pulse is tight (Jin Mai), throat pain will definitely occur.
If the pulse is wiry (Xian Mai), bilateral hypochondriac stiffness and urgency will definitely occur; if the pulse is fine and rapid (Xi Shu Mai), headache will persist incessantly.
If the pulse is deep and tight (Chen Jin), vomiting will definitely be desired; if the pulse is deep and slippery (Chen Hua), heat in the hypochondrium with diarrhea will occur.
If the pulse is floating and slippery (Fu Hua), hematochezia (blood in stool) will definitely occur.
If Taiyang disease is mistakenly subjected to purgation, resulting in abdominal fullness and intermittent pain, it belongs to the Taiyin (Taiyin Syndrome) category. Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction plus Peony Root) should be the primary treatment. As for cases of severe solid pain (Da Shi Tong), the pathology lies in the Stomach (referring to Yangming excess-heat/stagnation). Guizhi Jia Dahuang Tang (Cinnamon Twig Decoction plus Rhubarb) should be the primary treatment. This analogy describes the transmission from Wu Earth (Stomach) to Ji Earth (Spleen), informing the wife then the husband, signifying pathogenic factors transmitting from exterior to interior due to mistaken purgation, termed "transmission due to mistaken purgation."
A question was asked: Are Shanghan (Cold Damage) and Zaben (Miscellaneous Diseases) essentially one entity? If mistakenly purged, severe cases transform into other conditions. The answer is: They are not one entity. When Shanghan is mistakenly purged, the transforming syndromes have no fixed form; when Zaben is mistakenly purged, the transforming syndromes have a fixed form. Why is this? Shanghan pathogens enter from the exterior and belong to Yang; Yang is dynamic. Zaben pathogens emerge from the interior and belong to Yin; Yin is static. When the dynamic (Yang) is violated, its transformations are infinite. When the static (Yin) is violated, its transformations are limited only to Pi (Glomus/Fullness) and abdominal/hypochondriac pain. Therefore, infinite transformations indicate a severe condition, while Pi and abdominal/hypochondriac pain indicate a mild condition.
Wuling San (Five-Ingredient Powder with Poria) belongs to purgative medications and is specifically a purgative for Taiyang Interior syndromes. For Taiyang diseases located high in the exterior, sweating should be induced to release them; for those located low in the interior, guiding methods should be used to exhaust them.
Thirst occurs because pathogens have entered the root organ of the Taiyang meridian (the Bladder). At this point, purgation (specifically diuresis/drainage) should be employed to allow pathogens to exit via the Bladder.
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Dryness in the Kidney and Heat in the Bladder causing difficult urination are primarily treated by this formula. It is not suitable if urination is already free. However, in Taiyang disease with heat and thirst, even if urination is free, it is still appropriate to use Wuling San (Five-Ingredient Powder with Poria) to drain the pathogens via diuresis.
The answer states: If the medication should have been taken but was not, grain essence will dissipate, water fluids will depart, and the physical form will perish, inevitably leading towards Yangming Dryness-Fire. The Wu Earth (Stomach) may manifest as jaundice, thus presenting the Zhengwei Chengqi Tang (Regulate the Stomach Decoction) syndrome. This results from failing to apply purgation when Taiyang disease transmitted to its root organ, specifically because Wuling San was not administered.