阴证略例曰。阴毒本肾气虚寒。因欲事。或食生冷物。而后伤风。内既伏阴。外又感寒。或先感外寒。而后伏阴。
内外皆阴。则阳气不守。遂发头痛。腰重。眼睛疼。身体倦怠。不甚热。四肢厥。逆冷额上及手背。冷汗不止。或多烦
渴精神恍惚。如有所失。二三日间。或可起行。不甚觉重。诊之。则六脉沉细而疾。尺部短小。寸口或无。若服凉药。
则渴转甚。燥转急。有此证者。急服还阳退阴之药。即安。惟补虚和气而已。宜服正元散。退阴散。五胜散。阴证不宜
发汗。如气正脉大。身热而未瘥。用药发汗无妨。或寸口小而尺脉微大亦同积阴感于下。则微阳消于上。故其候沉重。
四肢逆冷。腹痛转甚。或喉不利。或心下胀满。结硬躁渴。虚汗不止。或时狂言。爪甲面色青黑。六脉沉细。而一息七
至以来。有此证者。速宜于气海关元二穴。灸三二百壮。以手足和暖为效。仍服金液丹。来复丹。玉女散。还阳散。退
阴散之类。随证用之。沉困之候。六脉附骨。取之方有。按之即无。一息八至以上。或不可数。至此。则药饵难为功矣。
但于脐中灼艾半枣大。三二百壮以来。手足不和暖。则以硫黄及热药助之。若阴气散。阳气来。渐减热药而和治之。
琥按上论云。头痛眼睛疼。此阳明经有风寒也。且内食生冷物。亦伤阳明之府。阳明之气上逆。故发头痛眼睛疼。
但其疼不甚。乃内伤重而外感轻也。若治外感。则误甚矣。至其云或多烦渴躁渴。必不能消水。喜饮热汤以自救。或喉
不利。必口中无热臭之气。或腹痛转甚。心下胀满结硬。必喜手按。及欲得热物以熨之。或时狂言。必声不甚扬。方为
内伤生冷。外中寒邪。不作郁热。全是阴寒之证。始宜服还阳退阴之药。及灼艾法。可无疑也。○正元退阴五胜等散。
方附后。又玉女散。还阳散。皆不可考。金液丹。出和剂局方。见本草石硫黄下。来复丹。亦出和剂局方。今从元戎中
采附于后。
《阴证略例》中说:阴毒证原本是由于肾气虚寒所致。因为房事过度,或者食用生冷食物,之后又感受风邪。体内既有潜伏的阴寒,体外又遭受寒邪侵袭;或者是先感受外寒,然后体内潜伏阴寒。
内外皆属阴寒,导致阳气不能固守,于是出现头痛、腰部沉重、眼睛疼痛、身体倦怠、发热不明显、四肢厥冷(手脚冰凉)、额头及手背冰冷、冷汗不止、或多烦渴、精神恍惚、如有失物之感等症状。发病二三天间,或许还能起身行走,自觉症状不重。诊察脉象时,六部脉象沉细而快速,尺部脉短小,寸口脉可能摸不到。如果服用凉性药物,口渴会加重,燥热感会更急迫。有这些症状的患者,应立即服用回阳退阴的药物,即可安定。治疗原则只是补虚和气罢了。适宜服用正元散、退阴散、五胜散。阴证不宜使用发汗法。如果正气尚存且脉象大,身体发热但病未愈,用药发汗是可以的。如果是寸口脉小而尺脉微大,情况也相同。
积聚的阴寒之气感于下部,则微弱的阳气消损于上部,所以症状表现为身体沉重、四肢逆冷、腹痛加剧,或者咽喉不利,或者心下胀满、结硬、烦躁口渴、虚汗不止,或者时而胡言乱语、指甲和面色青黑、六脉沉细,且一息跳动七次以上。有这些症状的患者,应迅速在气海、关元两个穴位艾灸三二百壮,以手足温暖为见效标准。同时服用金液丹、来复丹、玉女散、还阳散、退阴散等药物,根据具体证候选用。
对于沉困危重的证候,脉象必须按至骨才能触及,轻按即无,一息跳动八次以上,或者次数难以计数。到了这种地步,药物治疗就很难起作用了。只能在脐中用艾炷灸如半颗枣大小,三二百壮左右。如果手足仍不温暖,就用硫黄及热性药物来辅助。如果阴气消散,阳气回归,逐渐减少热性药物并调和治疗。
琥按:上述论述中提到“头痛、眼睛疼”,这是阳明经有风寒的表现。况且内食生冷食物,也会损伤阳明的腑。阳明之气上逆,所以引发头痛、眼睛疼痛。但是疼痛并不剧烈,这是因为内伤严重而外感轻微。如果只治疗外感,那就误得很厉害了。至于文中提到的“或多烦渴、躁渴”,一定是不能消化水液,喜欢喝热汤来自救。或者咽喉不利,一定是口中没有热臭的气味。或者腹痛加剧、心下胀满结硬,一定是喜欢用手按压,以及想要用热物熨烫。或者时而胡言乱语,一定是声音不高扬。这才是内伤生冷、外中寒邪,不形成郁热,完全是阴寒之证。这才适宜服用回阳退阴的药物,以及灼艾的方法,可以毫无疑问。○正元散、退阴散、五胜散等方剂附在后面。另外玉女散、还阳散,都已不可考证。金液丹,出自《太平惠民和剂局方》,见本草石硫黄条下。来复丹,也出自《太平惠民和剂局方》,现在从《儒门事亲》(注:此处原文为元戎,通常指张元素或其后学著作,结合语境保留原文表述或意译)中采集附录在后面。
The *Yin Zheng Lue Li* (Brief Examples of Yin Syndromes) states: Yin Du (Yin Toxin) syndrome originates from deficiency-cold of the Kidney Qi. It arises due to excessive sexual activity or consumption of raw and cold foods, followed by contraction of Wind pathogen. Internally, there is latent Yin-cold; externally, Cold pathogen is contracted. Alternatively, external Cold may be contracted first, followed by internal latent Yin-cold.
When both interior and exterior are characterized by Yin-cold, Yang Qi fails to maintain its position. Consequently, symptoms such as headache, heaviness in the waist, eye pain, bodily fatigue, slight fever, cold limbs (Jue Ni), coldness on the forehead and dorsum of hands, incessant cold sweating, frequent thirst with irritability, mental confusion, and a sensation of loss occur. Within two or three days, the patient might still be able to rise and walk, feeling that the condition is not severe. Upon pulse diagnosis, the six pulses (radial arteries at both wrists) are deep, fine, and rapid. The Chi (Cun-Che-Kuan) pulse at the distal position is short and small, while the Cun (Guan-Chi) pulse at the proximal position may be imperceptible. If cooling medicines are administered, thirst will intensify, and dryness/agitation will become more urgent. Patients presenting these signs should immediately take medicines that restore Yang and retreat Yin, which will bring stability. The treatment principle is merely to tonify deficiency and harmonize Qi. Suitable formulas include Zheng Yuan San (Upright Origin Powder), Tui Yin San (Retreat Yin Powder), and Wu Sheng San (Five Elements Powder). Yin syndromes are not suitable for diaphoresis (sweating therapy). However, if the healthy Qi remains intact and the pulse is large, and the body is hot but the illness has not resolved, using medicine to induce sweating is permissible. This also applies if the Cun pulse is small while the Chi pulse is slightly large.
Accumulated Yin-cold affecting the lower part causes the faint Yang to dissipate in the upper part. Therefore, the manifestations include heavy body, cold limbs, worsening abdominal pain, throat obstruction, fullness and hardness below the heart, agitation, thirst, incessant sweating, occasional delirious speech, cyanotic nails and complexion, deep and fine six pulses, and a rate of seven beats per respiration or more. For patients with these signs, moxibustion of 300-200 units should be rapidly applied to the Qihai (CV6) and Guanyuan (CV4) acupoints. The effect is achieved when the hands and feet become warm. Simultaneously, administer medicines such as Jin Ye Dan (Golden Fluid Pill), Lai Fu Dan (Return to Life Pill), Yu Nu San (Jade Maiden Powder), Huan Yang San (Restore Yang Powder), and Tui Yin San (Retreat Yin Powder), selecting according to the specific syndrome.
In cases of profound exhaustion where the pulse is only palpable upon pressing deeply to the bone and disappears with light pressure, with a rate of eight beats per respiration or more, or so rapid that it cannot be counted, medicinal administration becomes ineffective. In such instances, moxibustion using an egg-sized cone on the umbilicus (Shenque CV8), amounting to 300-200 units, should be performed. If the hands and feet remain cold, Sulfur (Liu Huang) and other hot-natured medicines should be used to assist. As Yin-cold dissipates and Yang returns, gradually reduce the hot medicines and treat harmoniously.
Hu notes: The aforementioned discussion mentions "headache and eye pain," indicating Wind-Cold in the Yangming Meridian. Furthermore, consuming raw and cold foods damages the Yangming Fu-organs. The rebellious Qi of Yangming ascends, causing headache and eye pain. However, the pain is not severe, indicating that internal injury is heavy while external contraction is light. Treating only the external contraction would be a significant error. Regarding the mentioned "frequent thirst and agitation," the patient certainly cannot metabolize water and prefers drinking hot soups to save themselves. Throat obstruction implies no foul breath from heat. Worsening abdominal pain and fullness/hardness below the heart imply a preference for manual pressure and hot compresses. Occasional delirious speech implies a low voice volume. These confirm internal injury from raw/cold food and external contraction of Cold pathogen, without forming stagnant heat, constituting a pure Yin-cold syndrome. Thus, administering Restore Yang/Retreat Yin medicines and moxibustion is undoubtedly appropriate. ○ The formulas for Zheng Yuan, Tui Yin, and Wu Sheng powders are attached later. Additionally, Yu Nu San and Huan Yang San are untraceable. Jin Ye Dan appears in the *Tai Ping Hui Min He Ji Ju Fang* (Imperial Bureau of Medicine Formulary), under the entry for Liu Huang (Sulfur). Lai Fu Dan also appears in the *He Ji Ju Fang*. It is now extracted from *Yuan Rong* and appended here.