太阳中风,以火劫发汗,阴阳俱虚竭,身体枯烦头汗至颈而还,腹满微喘,
口干咽烂不便,谵语至哕者死。
又不屎腹满加哕者死。
咳,嗽也,肺主也。肺主气,形寒饮冷则伤之,使气上而不下,逆而不收,
冲击膈咽,令喉中如痒,习习如梗,治宜发散。小便利者,不可发汗,发汗则四
肢厥冷,咳而发汗,蜷而苦满,腹复坚为逆。
肺寒而咳者,皮毛之寒内合饮食之寒,则为咳嗽。
停饮而咳者,伤寒表不解,心下有水气,干呕发热而咳,小青龙主之,此为
水饮与表寒相合也。
又有少阴病,腹痛小便不利,四肢沉重痛,自利,此为有水气,其咳者,真
武主之,此为水饮与里寒相合也。表传里而咳者。
少阴病四逆,其人或咳,四逆散加干姜五味子主之,此为阴邪动肺而咳也。
少阳证,其人或咳者,小柴胡去参加干姜五味子,此为阳邪动肺而咳也。
喘,肺主也。谓气逆而上行,息数、气急、张口、抬肩、摇身、滚肚。
有邪气在表而喘者,心腹必濡而不坚。
太阳恶风无汗而喘,桂枝加浓杏汤主之。
喘而汗出者,邪气在里也,且邪气内攻,气逆不利而喘,以葛根黄芩黄连汤以利之。
汗出而喘者,邪气在表也,邪气外盛,拥遏诸气不利而喘,与麻黄杏子甘草
石膏以发之。
有里证而喘者,心腹坚满短气,有潮热,此外欲解,可攻里也。
有水气而喘者,心下有水气,干呕发热而咳或喘,小青龙去麻黄加杏子主之。
又水停心下则胸膈满而喘,宜利其小便。
太阳中风证,若用火法强行发汗,会导致阴阳气血都虚损枯竭,身体干枯烦躁,头部出汗仅至颈部即止,腹部胀满且轻微气喘,口干燥、咽喉溃烂、大便不通,出现谵语甚至呃逆的,属于死证。
如果多日不大便,腹部胀满并伴有呃逆的,也属死证。
咳,就是嗽的意思,由肺所主。肺主管气,形体受寒或饮食生冷会损伤肺气,导致气机上逆而不能下行,气机逆乱而不能收敛,冲击膈膜和咽喉,使喉咙感到瘙痒,如有异物梗阻感,治疗宜用发散法。如果小便通畅,则不可发汗,因为发汗会导致四肢厥冷;咳嗽时误用发汗法,会导致身体蜷缩、苦于胸中满闷,腹部再次变得坚硬,这属于逆证(难治)。
肺寒引起的咳嗽,是皮毛感受风寒与体内饮食之寒相结合所致,从而引发咳嗽。
因水饮停聚引起的咳嗽,多见于伤寒表证未解,心下(胃脘部)有水气,表现为干呕、发热且咳嗽,用小青龙汤主治,这是水饮与表寒相结合的病证。
又有少阴病,表现为腹痛、小便不利、四肢沉重疼痛、自发性腹泻,这是体内有水气,如果伴有咳嗽,用真武汤主治,这是水饮与里寒相结合的病证。这是表邪传入里而引发的咳嗽。
少阴病出现四肢厥逆,如果患者伴有咳嗽,用四逆散加干姜、五味子主治,这是阴寒邪气扰动肺脏而引发的咳嗽。
少阳病证,如果患者伴有咳嗽,用小柴胡汤去掉半夏,加入干姜、五味子主治,这是阳热邪气扰动肺脏而引发的咳嗽。
喘,由肺所主。是指气机上逆向上冲,表现为呼吸频率快、气息急促、张口呼吸、耸肩、身体摇晃、腹部起伏滚动。
有邪气在体表而引发喘息的,心腹部必然柔软而不坚硬。
太阳病恶风、无汗而喘息,用桂枝加厚朴杏子汤主治。
喘息且伴有出汗的,说明邪气在体内,且邪气内攻,气机逆乱不畅而致喘,用葛根黄芩黄连汤来清利之。
出汗且喘息的,说明邪气在体表,邪气外盛,壅遏诸气不畅而致喘,用麻黄杏仁甘草石膏汤来发散之。
有里实证而喘息的,心腹部坚硬胀满、气短,伴有潮热,这说明表证已解,可以攻逐里实。
有水气而喘息的,心下有水气,表现为干呕、发热且咳嗽或喘息,用小青龙汤去掉麻黄,加入杏仁主治。
另外,水饮停聚在心下会导致胸膈满闷而喘息,适宜通利小便以治水。
Taiyang wind-stroke syndrome, if treated with fire therapy to forcibly induce sweating, will result in the deficiency and exhaustion of both Yin and Yang. The body becomes dry and restless, with sweat on the head stopping at the neck. Abdominal fullness, slight wheezing, dry mouth, ulcerated throat, constipation, delirium, and eventually hiccups indicate a fatal prognosis.
If there is no bowel movement for several days accompanied by abdominal fullness and hiccups, it is also considered fatal.
Cough (Ke) refers to the act of clearing the throat or expelling phlegm, governed by the Lung. The Lung governs Qi. Cold affecting the exterior or consumption of cold drinks damages the Lung, causing Qi to rebel upward instead of descending, leading to rebellious and uncollected Qi that impacts the diaphragm and throat. This causes an itching sensation in the throat, as if obstructed by a foreign body. Treatment should focus on dispersing the pathogen. If urination is clear and frequent, sweating should not be induced; inducing sweating would lead to cold limbs. If sweating is induced during a cough, the patient may curl up, suffer from chest fullness, and develop a hard abdomen, which constitutes a adverse condition (Ni).
Cough due to Lung cold results from the combination of external cold affecting the skin and hair and internal cold from diet.
Cough due to retained fluid occurs when the exterior syndrome of Cold Damage has not resolved, and fluid retention exists below the heart (epigastrium), presenting with dry retching, fever, and cough. It is treated with Xiao Qing Long Tang (Minor Blue Green Dragon Decoction), representing the combination of fluid retention and exterior cold.
In Shaoyin disease, symptoms include abdominal pain, difficulty in urination, heavy and painful limbs, and spontaneous diarrhea, indicating the presence of fluid retention. If cough is present, Zhen Wu Tang (True Warrior Decoction) is used, representing the combination of fluid retention and interior cold. This describes cough resulting from the transmission of exterior pathogens into the interior.
In Shaoyin disease with cold extremities (Si Ni), if cough is present, Si Ni San (Four Counterflow Powder) combined with Gan Jiang (Dried Ginger) and Wu Wei Zi (Schisandra Fruit) is used. This represents cough caused by Yin pathogenic factors disturbing the Lung.
In Shaoyang syndrome, if cough is present, Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Ban Xia (Pinellia Tuber) removed and Gan Jiang (Dried Ginger) and Wu Wei Zi (Schisandra Fruit) added is used. This represents cough caused by Yang pathogenic factors disturbing the Lung.
A scattered pulse indicates death, signifying Heart Fire insulting Lung Metal (Fire overcoming Metal).
Wheezing (Chuan) is governed by the Lung. It is characterized by rebellious Qi moving upward, rapid breathing, shortness of breath, open-mouth breathing, shoulder lifting, body rocking, and abdominal rolling.
When wheezing is caused by pathogenic factors in the exterior, the epigastrium and abdomen will be soft and not hard.
In Taiyang disease, if there is aversion to wind, absence of sweat, and wheezing, Gui Zhi Jia Hou Po Xing Zi Tang (Cinnamon Twig Decoction plus Magnolia Bark and Apricot Kernel) is indicated.
If wheezing is accompanied by sweating, the pathogen is in the interior. Due to internal attack by the pathogen and rebellious, obstructed Qi, Ge Gen Huang Qin Huang Lian Tang (Kudzu Root, Scutellaria, and Coptis Decoction) is used to clear and purify.
If sweating accompanies wheezing, the pathogen is in the exterior. Excessive exterior pathogen obstructs Qi flow, causing wheezing. Ma Huang Xing Zi Gan Cao Shi Gao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) is used to disperse.
If wheezing is associated with interior excess syndromes, characterized by a hard and full epigastrium/abdomen, shortness of breath, and tidal fever, the exterior syndrome has likely resolved, and purging the interior is appropriate.
If wheezing is caused by fluid retention, where fluid accumulates below the heart with dry retching, fever, cough, or wheezing, Xiao Qing Long Tang with Ma Huang (Ephedra) removed and Xing Zi (Apricot Kernel) added is indicated.
Furthermore, water stagnation below the heart causes chest and diaphragmatic fullness and wheezing; promoting urination is the appropriate treatment.