某(二七) 风伤卫。寒热头痛脘闷。(风伤卫)
苏梗(一钱) 淡豆豉(一钱) 杏仁(三钱) 桔梗(一钱) 浓朴(一钱半) 连翘(一钱半)
通草(一钱) 滑石(三钱)
某(二一) 风邪外袭肺卫。畏风发热。咳嗽脘闷。当用两和表里。
淡豆豉(一钱半) 苏梗(一钱) 杏仁(三钱) 桔梗(一钱半) 连翘(一钱半) 通草(一钱)
江(五六) 劳倦过月。气弱加外感。头痛恶风。营卫二气皆怯。嗽则闪烁筋掣而痛。大凡先治表后治
里。世间未有先投黄连清里。后用桂枝和表。此非医药。(风伤营卫误治) 当归建中汤。
沈 虚人得感。微寒热。(体虚感风) 参归桂枝汤加广皮。
经云。风为百病之长。盖六气之中。惟风能全兼五气。如兼寒则风寒。兼暑则曰暑风。兼湿
曰风湿。兼燥曰风燥。兼火曰风火。盖因风能鼓荡此五气而伤人。故曰百病之长也。其余
五气。则不能互相全兼。如寒不能兼暑与火。暑亦不兼寒。湿不兼燥。燥不兼湿。火不兼寒。
由此观之。病之因乎风而起者自多也。然风能兼寒。寒不兼风。何以辨之。如隆冬严寒之
时。即密室重帏之中。人若裸体而卧。必犯伤寒之病。此本无风气侵入。乃但伤于寒。而不
兼风者也。风能兼寒者。因风中本有寒气。盖巽为风。风之性本寒。即巽卦之初爻属阴
是也。因风能流动鼓荡。其用属阳。是合乎巽之二爻三爻。皆阳爻也。如炎 溽暑之时。若
使数人扇一人。其人必致汗孔闭。头痛恶寒骨节疼等。伤寒之病作矣。斯时天地间。固毫
无一些寒气。实因所扇之风。风中却有寒气。故令人受之。寒疾顿作。此乃因伤风而兼
伤寒者也。故有但伤寒而不伤风之症。亦有因伤风而致兼伤寒之症。又有但伤风而不
伤寒之症。有因伤风而或兼风温风湿风燥风火等症。更有暑湿燥火四气各自致伤。而
绝不兼风之症。故柯韵伯所注伤寒云。伤风之重者。即属伤寒。亦有无汗脉紧。骨节疼诸
症。此柯氏之书。所以能独开仲景生面也。至仲景所着伤寒书。本以寒为主。因风能兼寒。
故以风陪说。互相发明耳。学人看书。不可不知此理。若夫脏腑一切内外诸风。各有现症。
具载内经。尤当详考。(华岫云)
某(十七岁):风邪损伤卫气。出现寒热交替、头痛、胃脘部闷胀的症状。(风伤卫)
苏梗(一钱)、淡豆豉(一钱)、杏仁(三钱)、桔梗(一钱)、浓朴(一钱半)、连翘(一钱半)、通草(一钱)、滑石(三钱)。
某(二十一岁):风邪外袭肺与卫分。怕风、发热、咳嗽、胃脘部闷胀。应当采用调和表里的方法治疗。
淡豆豉(一钱半)、苏梗(一钱)、杏仁(三钱)、桔梗(一钱半)、连翘(一钱半)、通草(一钱)。
江(五十六岁):因过度劳累导致月经失调,正气虚弱又感受外邪。头痛、恶风。营气和卫气都虚弱。咳嗽时身体颤抖、筋脉抽搐而痛。大凡治病,先治表证后治里证。世间没有先用黄连清里热,后用桂枝汤调和表证的道理。这不是正确的医药治疗方法。(风伤营卫误治)当归建中汤。
沈:体质虚弱之人感受外邪。轻微恶寒发热。(体虚感风)参归桂枝汤加广皮(陈皮)。
《内经》说:风是百病之长。因为在六气(风、寒、暑、湿、燥、火)之中,只有风能完全兼夹其他五气。如兼夹寒邪则为风寒,兼夹暑邪则称为暑风,兼夹湿邪称为风湿,兼夹燥邪称为风燥,兼夹火邪称为风火。这是因为风能鼓荡这五气从而伤害人体,所以称其为百病之长。其余五气,则不能互相完全兼夹。如寒不能兼夹暑和火,暑也不兼夹寒,湿不兼夹燥,燥不兼夹湿,火不兼夹寒。由此看来,因病因为风而起的情况自然很多。然而风能兼夹寒,寒却不兼夹风,如何辨别呢?如在隆冬严寒之时,即使在密室厚帷之中,人若裸体而卧,必定患上伤寒病。这本来没有风气侵入,只是单纯被寒邪所伤,而不兼夹风邪。风能兼夹寒的原因,是因为风中本含有寒气。盖巽卦象征风,风的性质本属寒,即巽卦的初爻属阴的缘故。因为风能流动鼓荡,其作用属阳,这符合巽卦的二爻和三爻,皆属阳爻。如在炎热潮湿的暑天,如果让人用扇子扇一个人,此人必定导致汗孔闭塞,出现头痛、恶寒、骨节疼痛等症状,伤寒病就发作了。此时天地间固然毫无一丝寒气,实际上是因为所扇的风中却含有寒气,所以使人受之,寒疾顿时发作。这是因伤风而兼夹伤寒的情况。所以有只伤于寒而不伤于风的病症,也有因伤风而导致兼夹伤寒的病症,又有只伤于风而不伤于寒的病症,有因伤风而或兼夹风温、风湿、风燥、风火等病症。更有暑、湿、燥、火四气各自致病,而绝不兼夹风的病症。所以柯韵伯在注解《伤寒论》时说:伤风严重的,就属于伤寒,也有无汗、脉紧、骨节疼痛等各种症状。这就是柯氏的书之所以能独辟蹊径,展现仲景学术新面貌的原因。至于张仲景所著的《伤寒论》,原本以寒为主,因为风能兼夹寒,所以以风作为陪衬来说明,互相阐发罢了。学习的人看书,不可不知道这个道理。至于脏腑各种内外诸风,各有现症,详细记载在《内经》中,尤其应当详细考证。(华岫云评注)
Case 1 (Age 17): Wind pathogen damages the Wei (Defensive) Qi. Symptoms include alternating chills and fever, headache, and fullness in the epigastrium. (Wind damaging the Defensive level)
Perillae Caulis (Sugeng), Fermented Soybean (Douchi), Apricot Seed (Xingren), Platycodon Root (Jiegeng), Magnolia Bark (Noupu), Forsythia Fruit (Lianqiao), Tongcao, Talcum (Huashi).
Case 2 (Age 21): External wind pathogen invades the Lung and Wei (Defensive) levels. Symptoms include aversion to wind, fever, cough, and epigastric fullness. Treatment should employ harmonizing the exterior and interior.
Fermented Soybean (Douchi), Perillae Caulis (Sugeng), Apricot Seed (Xingren), Platycodon Root (Jiegeng), Forsythia Fruit (Lianqiao), Tongcao.
Case 3 (Age 56): Due to overexertion leading to menstrual irregularities, Qi is weak and an external contraction occurs. Symptoms include headache and aversion to wind. Both Ying (Nutritive) and Wei (Defensive) Qi are deficient. Coughing causes tremors, muscle spasms, and pain. Generally, one must treat the exterior first and the interior later. There is no medical practice of using Coptis Rhizome (Huanglian) to clear the interior first, followed by Cinnamon Twig Decoction (Guizhi Tang) to harmonize the exterior. This is not correct medical treatment. (Mismanagement of Wind damaging Ying and Wei) Guizhi Jia Shaoyao Tang (or Danggui Jianzhong Tang as per text: Danggui Jianzhong Tang).
Shen: A person with deficiency constitution contracts an external pathogen. Mild chills and fever. (Weak body contracting wind) Shen Gui Guizhi Tang (Ginseng and Angelica Cinnamon Twig Decoction) plus Tangerine Peel (Guangpi).
The *Neijing* states: "Wind is the chief of a hundred diseases." Among the Six Qi (Wind, Cold, Summer-heat, Dampness, Dryness, Fire), only Wind can fully combine with the other five. For instance, combining with Cold becomes Wind-Cold; combining with Summer-heat is called Summer-heat Wind; combining with Dampness is Wind-Dampness; combining with Dryness is Wind-Dryness; combining with Fire is Wind-Fire. This is because Wind agitates these five Qi and harms the human body, hence it is called the chief of a hundred diseases. The other five Qi cannot mutually combine fully. For example, Cold cannot combine with Summer-heat and Fire; Summer-heat does not combine with Cold; Dampness does not combine with Dryness; Dryness does not combine with Dampness; Fire does not combine with Cold. From this, it is evident that many diseases originate from Wind. However, Wind can combine with Cold, but Cold does not combine with Wind. How to distinguish them? During severe winter cold, even in a sealed room with thick curtains, if a person lies naked, they will inevitably contract Cold Damage (Shanghan). This is because there was no Wind invasion, but merely injury by Cold alone, without combining with Wind. The reason Wind can combine with Cold is that Cold Qi exists within Wind. In I Ching, Xun (Wind) represents Wind; the nature of Wind is originally Cold, corresponding to the initial Yin line of the Xun hexagram. Because Wind flows and agitates, its function belongs to Yang, corresponding to the second and third lines of the Xun hexagram, which are Yang lines. During hot and humid summer, if several people fan one person, their pores close, leading to headache, aversion to cold, bone and joint pain, etc., and Cold Damage disease arises. At this time, there is absolutely no Cold Qi in heaven and earth, yet the wind being blown contains Cold Qi, causing the person to suffer, and Cold disease suddenly appears. This is contracting Wind and simultaneously contracting Cold. Thus, there are cases of only contracting Cold without Wind, cases of contracting Wind leading to combined Cold, cases of only contracting Wind without Cold, and cases of contracting Wind potentially combining with Wind-Warmth, Wind-Dampness, Wind-Dryness, or Wind-Fire. Furthermore, there are cases where Summer-heat, Dampness, Dryness, and Fire cause injury independently without combining with Wind. Therefore, Ke Yunbo, in his commentary on *Shanghan Lun*, stated: Severe Wind Strike belongs to Cold Damage, presenting symptoms such as anhidrosis, tight pulse, and bone/joint pain. This is why Ke's book opens a new perspective on Zhang Zhongjing's work. Zhang Zhongjing's *Treatise on Cold Damage* focuses primarily on Cold; since Wind combines with Cold, Wind is mentioned as a companion to elucidate the theory mutually. Students reading this must understand this principle. As for all internal and external Winds affecting the Zang-Fu organs, each has specific manifestations recorded in detail in the *Neijing*, which should be carefully examined. (Commentary by Hua Xiuyun)