阳脉浮滑阴脉濡弱者更遇于风变为风温(此前热未歇又感于风者也难经曰中风之脉阳浮而滑阴濡而弱风来乘热故变
风温)
若发汗以身灼热者名曰风温风温为病脉阴阳俱浮自汗出身重多眠睡鼻息必鼾语言难出若被下者小便不利直视失溲
若被火者微发黄色剧则如惊痫时螈 若火熏之一逆尚引日再逆促命期(成 伤寒发汗已则身凉若发汗已身灼热者非伤寒
为风温也风伤于上而阳受风气风与温相合则伤卫脉阴阳俱浮自汗出者卫受邪也卫者气也风则伤卫温则伤气身重多眠睡
者卫受风温而气昏也鼻息必鼾语言难出者风温外甚而气拥不利也若被下者则伤脏气太阳膀胱经也内经曰膀胱不利为癃
不约为遗溺癃者小便不利也太阳之脉起目内 内经曰瞳子高者太阳不足戴眼者太阳已绝小便不利直视失溲为下后竭津
液损脏气风温外胜经络欲绝也为难治若被火者则火助风温成热微者热瘀而发黄剧者热甚而生风如惊痫而时螈 也先曾
被火为一逆若更以火熏之是再逆也一逆尚犹延引时日而不愈其再逆者必致危殆故云促命期)
附
活 风温者脉尺寸俱浮头疼身热常自汗出体重其息必喘四肢不收嘿嘿但欲眠治在少阴厥阴不可发汗发即谵语独
语
内烦躁不得卧若惊痫目乱无精如此死者医杀之耳风温忌发汗宜葳蕤汤身灼热者知母干葛汤如渴甚者栝蒌根汤脉沉身重
汗出者汉防己汤
萎蕤汤 治风温兼疗冬温及春月中风伤寒发热头眩疼咽喉干舌强胸内疼痞腰背强
葛根 白芷 麻黄(用沸汤泡) 杏仁(去尖皮双仁者) 甘草(炙各半两) 萎蕤(七钱半) 石膏(杵碎) 羌
活(去芦各一两) 川芎(三钱) 青木香(一钱)上 咀每服五钱水一盏半煎半钟日三四服
又方
萎蕤 白薇 麻黄 独活 杏仁 川芎 青木香 甘草(各一两) 石膏(三两)上 咀以水八升煮取三升
去滓分三服取汗若一寒一热加朴硝二钱半大黄三两下之如无木香可用麝香一分短剧方云葳蕤汤治冬温春月中风伤寒则
发头脑疼痛咽喉干舌强肉疼心胸痞满腰背强
知母干葛汤 治风温身体灼热甚者
知母 葳蕤(各三钱) 天南星(生) 麻黄(去根节) 防风 杏仁 羌活(各二钱) 甘草 黄芩 木香 升
麻人参 川芎(各一钱) 石膏(六钱) 葛根(八钱)上 咀每服五钱水一盏半煎至一盏去滓服
防己汤 治风温脉浮身重汗出(一方无人参)
防己(四两) 甘草(炙) 黄 (蜜炙) 人参(各一两) 生姜(二两) 白术(三两)上 咀每服五钱水一
盏半煮取一中盏去滓饮讫仍坐被中汗出如虫行或被卧取汗出(许学士云风温误汗用防己黄 汤救之)
栝蒌根汤 治风温灼热大渴
石膏 人参 干葛(各二钱) 栝蒌根(三钱) 防风 知母(各一钱半) 甘草(一钱)上作一服水二钟煎至一
钟通口服滓再煎
葛根龙胆汤 治风温脉弱身重汗出
石膏(五分) 甘草(七分) 龙胆草 桂枝(各一钱无汗不用) 白芍药 大青(各一钱半) 葛根 升麻(各
二钱) 葳蕤(三钱) 生姜(三片)上煎服法同前
海 治风温活人本方葳蕤汤以有麻黄不敢用宜白术汤主之(方见前太阳病发热条)若头眩汗出筋惕肉 者加牡
蛎若
腰背强硬者加羌活若舌干发渴者加人参若身灼热甚者加知母若身体重多汗者加黄 若内伤冷者不加
If the Yang pulse is floating and slippery, and the Yin pulse is soggy and weak, and one is additionally affected by wind, it transforms into Wind-Warmth (this refers to a case where the previous heat has not subsided, and wind is contracted. The *Nan Jing* states: In stroke-wind, the Yang pulse is floating and slippery, while the Yin pulse is soggy and weak; when wind attacks heat, it transforms into Wind-Warmth).
If sweating therapy results in burning heat of the body, it is named Wind-Warmth. In Wind-Warmth disease, the pulses at all three positions (Cun, Guan, Chi) are floating, there is spontaneous sweating, heaviness of the body, excessive sleepiness, snoring in nasal breathing, and difficulty in speech. If purgation is incorrectly applied, it leads to difficult urination, fixed gaze, and incontinence of urine and feces. If fire therapy is incorrectly applied, mild cases present with slight yellowing of the skin, while severe cases resemble convulsive epilepsy with occasional spasms. If moxibustion or fumigation is used, this constitutes a therapeutic error ("Ni"); even one error may prolong the illness, but a second error will hasten death. (Cheng Wuji notes: After sweating therapy for Cold Damage, the body should be cool. If burning heat persists after sweating, it is not Cold Damage but Wind-Warmth. Wind pathogen affects the upper part, and Yang Qi is invaded by wind. When wind combines with warmth, it damages the Defensive Qi. Floating pulses at both Yin and Yang positions with spontaneous sweating indicate invasion of the Defensive Qi. The Defensive Qi belongs to Qi; wind damages the Defensive, and warmth damages the Qi. Heaviness and sleepiness occur because the Defensive Qi is confused by wind and warmth. Snoring and speech difficulties arise because external wind-warmth excess obstructs Qi flow. Incorrect purgation damages Zang-Fu Qi, particularly the Bladder meridian of Foot-Taiyang. The *Nei Jing* states: Impairment of bladder function leads to strangury (long), and loss of control leads to enuresis. Long refers to difficult urination. The Taiyang meridian originates from the inner canthus. The *Nei Jing* states: High pupils indicate deficiency of Taiyang Qi; upward deviation of eyes indicates exhaustion of Taiyang Qi. Difficult urination, fixed gaze, and incontinence result from purgation depleting fluids and damaging Zang Qi, allowing external wind-warmth to dominate and threaten the meridians; this is difficult to treat. Incorrect fire therapy aids wind-warmth to generate heat. Mildly, heat stasis causes jaundice; severely, extreme heat generates wind, resembling convulsive epilepsy with spasms. Previous fire therapy was one error; subsequent fumigation is a second error. One error prolongs the illness without cure; two errors lead to critical danger, hence "hastening the life period" means accelerating death).
Appendix:
The *Huo Ren Shu* discusses: In Wind-Warmth, the Cun and Chi pulses are both floating, accompanied by headache, fever, spontaneous sweating, heaviness of the body,必 panting in respiration, flaccidity of the four limbs, silence, and desire to sleep. Treatment should focus on the Shaoyin and Jueyin meridians; sweating must not be induced. If sweating is induced, it leads to delirium, muttering, internal irritability, and inability to lie down. If it resembles convulsive epilepsy with scattered gaze and lack of spirit, such death is caused by the physician's error. Wind-Warmth contraindicates sweating; Wei Yu Tang is suitable. For burning heat, Zhi Mu Gan Ge Tang is used. For severe thirst, Gua Lou Gen Tang is used. For sinking pulse, heaviness, and sweating, Han Fang Ji Tang is used.
Wei Yu Tang: Treats Wind-Warmth, and also Winter-Warmth and Wind-Cold-Damage in spring, presenting with fever, vertigo, headache, dry throat, stiff tongue, chest pain and fullness, and stiffness of the waist and back.
Ingredients: Gegen (Puerariae Radix), Baizhi (Angelicae Dahuricae Radix), Mahuang (Ephedrae Herba, soaked in boiling water), Xingren (Armeniacae Semen Amarum, remove tip and skin, use double kernels), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 0.5 liang), Weiyu (Polygonati Rhizoma, 7.5 qian), Shigao (Gypsum Fibrosum, crushed), Qianghuo (Notopterygii Rhizoma et Radix, remove rhizome, each 1 liang), Chuanxiong (Ligustici Chuanxiong Rhizoma, 3 qian), Qingmuxiang (Aucklandiae Radix, 1 qian).
Usage: Coarsely powder the herbs. Take 5 qian per dose, add 1.5 cups of water, decoct to 0.5 cup. Take 3-4 times daily.
Another Formula:
Ingredients: Weiyu, Baiwei (Clerodendri Radix), Mahuang, Duhuo (Angelicae Pubescentis Radix), Xingren, Chuanxiong, Qingmuxiang, Gancao (each 1 liang), Shigao (3 liang).
Usage: Coarsely powder. Decoct in 8 sheng of water to obtain 3 sheng. Strain and divide into three doses. Induce sweating. If alternating chills and fever occur, add Poxiao (Mirabilitum, 2.5 qian) and Dahuang (Rhei Radix et Rhizoma, 3 liang) to purge. If Qingmuxiang is unavailable, use Shexiang (Moschus, 1 fen) instead. The *Duan Ju Fang* states Wei Yu Tang treats Winter-Warmth and Spring Wind-Cold-Damage, with symptoms of head pain, dry throat, stiff tongue, muscle pain, chest fullness, and back stiffness.
Zhi Mu Gan Ge Tang: Treats severe burning heat in Wind-Warmth.
Ingredients: Zhi Mu (Anemarrhenae Rhizoma), Weiyu (each 3 qian), Tiannanxing (Arisomatis Rhizoma, raw), Mahuang (remove roots and joints), Fangfeng (Saposhnikoviae Radix), Xingren, Qianghuo (each 2 qian), Gancao, Huangqin (Scutellariae Radix), Muxiang (Aucklandiae Radix), Shengma (Cimicifugae Rhizoma), Renshen (Ginseng Radix), Chuanxiong (each 1 qian), Shigao (6 qian), Gegen (8 qian).
Usage: Coarsely powder. Take 5 qian per dose, add 1.5 cups of water, decoct to 1 cup. Strain and take.
Fang Ji Tang: Treats Wind-Warmth with floating pulse, heaviness, and sweating. (Another version lacks Renshen).
Ingredients: Fangji (Stephaniae Tetrandrae Radix, 4 liang), Gancao (honey-fried), Huangqi (Astragali Radix, honey-fried), Renshen (each 1 liang), Shengjiang (Zingiberis Rhizoma Recens, 2 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 3 liang).
Usage: Coarsely powder. Take 5 qian per dose, add 1.5 cups of water, decoct to 1 cup. Strain and drink. After drinking, sit wrapped in blankets until sweat emerges as if insects are crawling, or lie down to induce sweating. (Xu Xueshi stated: If Wind-Warmth is mistakenly treated with sweating, Fang Ji Huang Qi Tang is used to rescue).
Gua Lou Gen Tang: Treats Wind-Warmth with burning heat and extreme thirst.
Ingredients: Shigao, Renshen, Gan Ge (Ge Gen, each 2 qian), Gualougen (Trichosanthis Radix, 3 qian), Fangfeng, Zhi Mu (each 1.5 qian), Gancao (1 qian).
Usage: Prepare as one dose. Add 2 zhong of water, decoct to 1 zhong. Drink thoroughly. Re-decoct the dregs.
Gegen Longdan Tang: Treats Wind-Warmth with weak pulse, heaviness, and sweating.
Ingredients: Shigao (5 fen), Gancao (7 fen), Longdancao (Gentianae Radix), Guizhi (Cinnamomi Ramulus, each 1 qian; omit if no sweating), Baishao (Paeoniae Radix Alba), Daqing (Isatidis Folium, each 1.5 qian), Gegen, Shengma (each 2 qian), Weiyu (3 qian), Shengjiang (3 slices).
Usage: Decoct and take as before.
Haizang's Commentary: To treat Wind-Warmth, based on the *Huo Ren Shu* formula Wei Yu Tang, Mahuang is avoided due to its diaphoretic nature; therefore, Baizhu Tang is primarily used (see formula under Taiyang Fever section earlier). If vertigo, sweating, and muscle twitching occur, add Muli (Concha Ostreae). If waist and back stiffness occur, add Qianghuo. If dry tongue and thirst occur, add Renshen. If severe burning heat occurs, add Zhi Mu. If heavy body and profuse sweating occur, add Huangqi. If there is internal cold injury, do not add [specific warming herbs implied by context, likely referring to avoiding cooling herbs or adjusting base].