本病中风 发热恶寒者发于阳也发于阳者七日愈身大寒反不欲近衣寒在皮肤热在骨髓也太阳病发热汗出恶风脉缓名
中风太阳病头疼发热汗出恶风(桂枝证)太阳病中风阳浮阴弱阳浮者热自发阴弱者汗自出恶风恶寒发热鼻鸣干呕(桂枝
证)太阳病发热汗出此营弱卫强故汗出欲救邪风者桂枝汤主之(桂枝证)脏无他病时发热汗出不愈者卫气不和也先于其
时发汗则愈(桂枝证)病常自汗出者此营气和营气和者外不谐以营行脉中卫行脉外复发其汗营卫和则愈(桂枝证)太阳
病服桂枝汤烦不解先刺风池风府却与桂枝汤则愈(桂枝证)太阳病外证未解脉浮弱当以汗解(桂枝证)太阳病外证未解
不可下欲解外者桂枝汤主之(桂枝证)脉浮大但言便硬设利之为大逆硬为实汗出而解(桂枝证)太阳病未解脉阴阳俱停
必先振栗汗出而解但阳脉微汗出解但阴脉微下之解若欲下之宜调胃承气汤(桂枝证)酒客病不可与桂枝汤得汤则呕(忌
桂枝证)服桂枝汤吐者其后必吐脓血(忌桂枝证)桂枝本为解肌若其人脉浮紧发热汗不出者不可与也(忌桂枝证)
本病伤寒 无热恶寒者发于阴也发于阴者六日愈身大热反欲得近衣热在皮肤寒在骨髓也太阳病或已发热或未发热必
恶寒体疼呕逆脉阴阳俱紧名伤寒 太阳病头痛发热身疼腰痛骨节疼痛恶寒无汗而喘(麻黄证)脉浮者病在表可发汗脉浮
而数可发汗(麻黄证)伤寒发汗宜解半日许复烦脉浮数可更发汗宜桂枝汤(麻黄证)伤寒不大便六七日头痛有热者与承
气汤其小便清者不在里仍在表也须发汗(此麻黄证)若头痛者必衄宜桂枝汤(麻黄证)太阳病脉浮紧发热身无汗自衄者
愈(麻黄证)伤寒脉浮紧不发汗因致衄者麻黄汤主之(麻黄证)太阳病脉浮紧无汗发热身疼痛八九日不解麻黄汤主之服
药已微除发烦目瞑剧者必衄衄乃解阳气重故也(麻黄症)
兼病 太阳之为病脉浮头项强痛而恶寒 太阳病得之八九日如疟发热恶寒热多寒少不呕清便自可一日二三度发脉浮
缓者为欲愈也脉微而恶寒者阴阳俱虚不可更发汗下吐也面色反有热色者未解也以不得小汗出身必痒(桂麻各半证)形作
伤寒脉不弦紧而弱弱必渴被火必谵语弱者发热脉浮解之汗出愈(桂枝越婢证)太阳病发热恶寒热多寒少脉微弱者此无阳
也不可更汗(桂枝越婢证)服桂枝汤大汗出脉洪大者与桂枝如前法若形如疟日再发者汗出必解(桂二麻一证)凡病若发
汗若吐若下若亡血若亡津液阴阳自和者自愈(传经)太阳头痛至七日以上自愈者以行其经尽也若欲再作经者针足阳明使
经不传则愈(传经)风家表解而不了了者十二日愈(传经)伤寒二三日阳明少阳证不见者为不传也(传经)伤寒一日太
阳受之脉若静者为不传颇欲吐若烦躁脉急数者为欲传也(传经)
阳盛入腑 太阳中风脉浮紧发热恶寒身疼痛不汗出而烦躁(大青龙证入阳明去路)伤寒脉浮缓身不疼但重乍有轻时
无少阴证者(大青龙证将入阳明)伤寒脉滑而厥者里有热也(白虎证入阳明去路)伤寒脉浮滑此里有热表有寒也(白虎
证入阳明)伤寒脉浮发热无汗表不解者不可与白虎汤渴欲饮水无表证者白虎加人参主之(白虎证)伤寒无大热口燥渴心
烦背微恶寒者白虎加人参主之(白虎证)太阳病不解热结膀胱其人如狂血自下下者愈外不解未可攻外解已但小腹急结者
乃可攻之(桃核承气证入阳明去路)太阳病六七日表证犹存脉微而沉反不结胸其人发狂以热在下焦少腹当硬满小便自利
者下血乃愈以太阳随经瘀热在里故也抵当汤主之(抵当证)太阳病身黄脉沉结少腹硬小便不利为无血也小便自利其人如
狂血证谛也(抵当证)伤寒有热少腹满应小便不利今反利者为有血当下之不可余药宜抵当丸(抵当证)
阴盛入脏 脉浮紧者法当身疼痛假令尺中迟不可发汗(忌麻黄证入少阴去路)中风脉微弱汗出恶风服大青龙汤厥逆
筋惕肉 此为逆也以真武汤救之(大青龙证入少阴去路)伤寒表不解心下有水气干呕发热而咳或渴或利或噫或小便不利
少腹满或喘者(小青龙证入太阴少阴去路)太阳病小便利者以饮水多必心下悸小便少者必苦里急也(小青龙证)伤寒心
下有水气咳而微喘发热不渴小青龙主之服汤已渴者寒去欲解也(小青龙证)中风发热六七日不解而烦有表里证渴欲饮水
水入则吐名曰水逆(五苓证入太阴去路)伤寒汗出而渴者五苓散主之不渴者茯苓甘草汤主之(五苓证)病在阳反以冷水
灌热被却不去益烦肉上粟起欲饮水反不渴者服文蛤散若不瘥与五苓散寒实结胸无热症者与三物小陷胸汤白散亦可(五
苓证)
坏病 太阳病三日已发汗若吐下若温针仍不解此为坏病桂枝不中与也知犯何逆随证治之 本发汗而复下之本先下之
而复发汗此为逆太阳病发汗不解而复下之脉浮者不愈当解外(桂枝证入阳明)大下后复发汗小便不利者亡津液也勿治之
得小便利自愈(发汗亡津证)发汗后不可更行桂枝若汗出而喘无大热者麻杏甘石汤主之(麻杏甘石证)发汗后饮水多者
必喘以水灌之亦喘(汗后作喘证)下后不可更行桂枝若汗出而喘无大热者麻杏甘石汤主之(麻杏甘石证)服桂枝汤大汗
出后大烦渴不解脉洪大者(人参白虎证)伤寒吐下后七八日不解热结在里表里俱热时时恶风大渴舌上干燥而烦欲饮水数
升者(人参白虎证)太阳病先下之不愈复发汗表里俱虚因致冒冒家汗出自愈表和故也得里未和然后下之(表里俱虚证)
发汗后恶寒者虚也不恶寒反恶热者实也当和胃气(调胃承气证)太阳病中风火劫发汗两阳熏灼其身发黄阳盛则欲衄阴虚
则小便难阴阳虚则身体枯燥但头汗出剂颈而还腹满微喘口干咽烂或不大便久则谵语甚者至哕手足躁扰捻衣摸床小便利者
可治(阴阳俱虚证)太阳病二日反躁反熨其背而大汗出火热入胃胃中水竭躁烦必发谵语十余日振栗自下利者为欲解也故
其汗从腰以下不得汗欲小便不得反呕欲失溲足下恶风大便硬小盒饭数而反不数及大便已头卓然痛足心必热谷气下流也
(火热入胃证)太阳病以火熏不得汗必躁到经不解必清血名为火邪(火邪圊血证)脉浮宜汗解用火灸之邪无从出因火而
盛腰以下重痹名火逆(火逆助邪症)脉浮热甚反灸之此为实实以虚治因火而动咽噪吐血(火逆吐血症)微数之脉慎不可
灸因火为邪则为烦逆追虚逐实血散脉中火气内攻焦骨伤筋血难复也(火邪内攻证)太阳病发汗后大汗出胃中干躁烦不得
眠欲饮水者少少与之令胃气和则愈(将成白虎)若脉浮小便不利热微消渴者五苓散主之(五苓证入太阴)发汗已脉浮数
烦渴者(五苓证)伤寒脉浮自汗小便数心烦微恶寒脚挛急反与桂枝汤得之便厥咽干躁烦吐逆者作甘草干姜汤与之若厥愈
足温者更作芍药甘草汤与之若胃气不和谵语者少与调胃承气汤若重发汗加烧针者四逆汤主之(甘草干姜症)证象阳旦按
法治之而增剧厥逆咽中干两胫拘急而谵语师言夜半手足当温两脚当伸何以知此曰寸口脉浮而大浮则为风大则为虚风则生
微热虚则两胫挛病证象桂枝因加附子参其间增桂令汗出附子温经亡阳故也厥逆咽中干烦躁阳明内结谵语烦乱更与甘草干
姜汤夜半阳气还两足当温胫尚微拘急重与芍药甘草汤尔乃胫伸以承气微溏则止其谵语故知病可愈(甘草干姜证)发汗后
水药不得入口为逆更发汗必吐下不止(汗后吐逆证)病患脉数为热当消谷引食反吐者以发汗脉乃数数为客热不能消谷胃
中虚冷故吐也(汗后吐逆证)太阳病当恶寒反不恶寒不欲近衣此为吐之内烦也(吐后生烦证)太阳病当恶寒发热今自汗
不恶寒发热关上脉细数者吐之过也一二日吐之饥不能食三四日吐之不喜粥欲食冷朝食暮吐为小逆(吐后作吐证)伤寒下
之续下利清谷不止身疼痛者急救里后身疼痛清便调者急救表救里宜四逆汤救表宜桂枝汤(身疼下利证)发汗后身疼痛脉
沉迟者(新加汤证)太阳病桂枝证反下之利遂不止脉促者表未解也喘而汗出者葛根连芩汤主之(葛根连芩证)太阳病下
之后脉促胸满者桂枝去芍药主之若微恶寒者去芍药方加附子主之(桂枝去芍药证)太阳病下之微喘者表未解故也(桂枝
浓朴杏子证)喘家作桂枝汤加浓朴杏子仁(桂枝浓朴杏子证)服桂枝汤或下之仍头项强痛发热无汗心下满微痛小便不利
者(桂枝去桂加茯苓白术证)发汗后腹胀满者(浓朴姜夏参甘证)伤寒下后心烦腹满卧起不安者(栀子浓朴证)伤寒医
以丸药大下之身热不去微烦者(栀子甘姜证)发汗若下之而烦热胸中窒者(栀子香豉证)发汗吐下后虚烦不得眠剧者必
反复颠倒懊 栀子豉汤主之若少气者栀子甘草豉汤主之若呕者栀子生姜豉汤主之(栀子香豉症)凡用栀子汤病患旧微溏
者不可与(忌栀子证)太阳病发汗遂漏不止其人恶风小便难四肢微急难以屈伸(入少阴桂枝附子证)发汗病不解反恶寒
者虚故也(芍药甘草附子证)下之后复发汗必振寒脉微细(内外俱虚证)伤寒若吐下后心下逆满气上冲胸起则头眩脉沉
紧发汗则动经身为振振摇者(苓桂术甘证)太阳病发汗汗出不解仍发热心下悸头眩身 动振振欲擗地者(真武证)发汗
多叉手自冒心心下悸欲得按者(桂枝甘草证)未持脉病患叉手自冒心令咳不咳此必耳聋以重发汗虚故(阳虚耳聋证)脉
浮数当汗愈若下之身重心悸者不可发汗若自汗出而解以尺中脉微此里虚须表里实津液和便汗出愈(身重心悸证)发汗后
脐下悸者欲作奔豚(桂苓甘枣证)烧针令汗针处被寒核起而赤必发奔豚气从少腹上冲心灸其核上各一壮与桂枝加桂汤(桂
枝加桂证)太阳病下之后气上冲者(桂枝加桂证)伤寒脉浮以火劫之亡阳必惊狂起卧不安(桂枝去芍药加蜀漆龙骨牡蛎
症)太阳伤寒加温针必惊也(温针亡阳症)火逆下之因烧针烦躁者(桂枝甘草龙骨牡蛎症)发汗若下之病仍不解烦躁者
(茯苓四逆症)下之复发汗昼日烦躁不得眠夜安静不呕不渴无表症脉微沉无大热者(干姜附子症)汗家重发汗必恍惚心
乱小便已阴疼与禹余粮丸(禹余粮症)病患有寒复发汗胃中冷必吐蛔(入厥阴胃冷吐蛔症)病发于阳而反下之热入因作
结胸病发于阴而反下之因作痞 太阳病脉浮而动数头痛发热微盗汗出反恶寒者表未解也反下之动数变迟膈内拒痛胃空虚
客气动膈短气烦躁懊 阳气内陷心下因硬则为结胸大陷胸主之若不结胸但头汗出剂颈而还小便不利者身必发黄(大陷胸
汤证)伤寒六七日结胸热实脉沉紧心下痛按之石硬者(大陷胸汤症)太阳病重发汗而复下之不大便五六日舌上燥而渴日
晡小有潮热从心下至少腹硬满而痛不可近者(大陷胸汤症)结胸者项强如柔痉状下之则和(大陷胸丸症)小结胸正在心
下按之则痛脉浮滑者(小陷胸汤症)太阳病下之其脉促不结胸者此欲解也脉浮者必结胸脉紧者必咽痛脉弦者必两胁拘急
脉细数者头痛未止脉沉紧者必欲呕脉沉滑者协热利脉浮滑者必下血(结胸脉法)太阳病二三日不得卧但欲起心下必结脉
微弱者此本有寒分也反下之若利止必作结胸未止者四日复下之此作协热利也(结胸变症)太阳病外未解而数下之遂协热
而利利不止心下痞硬表里不解者(痞症人参桂枝症)伤寒大下复发汗心下痞恶寒者表未解也当先解表方可攻痞解表宜桂
枝汤攻痞宜大黄黄连泻心汤(大黄黄连泻心症)脉浮紧复下之紧反入里则作痞按之濡但气痞耳痞濡其脉关上浮者大黄黄
连泻心汤主之痞而复恶寒汗出者附子泻心汤主之(附子泻心症)太阳中风下利呕逆表解者乃可攻之汗出发作有时头痛心
下痞硬满引胁下痛干呕短气汗出不恶寒此表解里未和也(十枣汤症)伤寒汗解后胃中不和心下痞硬干噫食臭胁下有水气
腹中雷鸣下利者(生姜泻心症)伤寒中风反下之下利日数十行腹中雷鸣心下痞硬而满干呕心烦不安医谓痞不尽复下之痞
益甚此非结热以胃中虚客气上逆故硬也(甘草泻心症)伤寒服汤药利不止心下痞硬服泻心汤已复以他药下之利不止以理
中与之利益甚理中者理中焦此利在下焦赤石脂禹余粮汤主之复利不止当利其小便(石脂禹粮症)本以下之故心下痞与泻
心汤痞不解渴而口烦躁小便不利(五苓症)伤寒发汗吐下解后心下痞硬噫气不除者(旋覆花代赭石症)病如桂枝症头不
痛项不强寸微浮胸中痞硬气冲咽喉不得息此胸有寒也当吐之宜瓜蒂散诸亡血家不可与(瓜蒂散症)伤寒吐下后发汗虚烦
脉甚微八九日心下痞硬胁下痛气冲咽喉眩冒经脉动惕者久而成痿(经脉动惕症)太阳病医发汗遂发热恶寒复下之心下痞
表里俱虚阴阳气并竭无阳则阴独复加烧针因胸烦面色青黄肤 者难治令色微黄手足温者易愈(表里俱虚症)太阳病欲解
时巳至未上
不治病 结胸证脉浮大者下之则死(结胸忌下证)结胸证悉具烦躁者死(结胸烦躁证)如结胸状饮食如故时时下利
寸脉浮关脉细小沉紧名曰脏结舌上白苔滑者难治(脏结证)病胁下素有痞连在脐旁痛引少腹入阴筋者此名脏结死(脏结
证)脏结无阳证不往来寒热其人反静舌上苔滑者不可攻也(脏结证)
方药
桂枝汤
本病中风,出现发热、恶寒症状的,属于发于阳经;发于阳经的病,七日可愈。身体极度寒冷却反而不想穿衣,这是因为寒邪在皮肤表面,而热邪深伏于骨髓之中。太阳病中,表现为发热、汗出、恶风、脉象缓弱的,称为中风。
太阳病中出现头痛、发热、汗出、恶风症状的,属于桂枝汤证。太阳病中风,脉象阳浮阴弱;阳浮者,热势自然发动;阴弱者,汗液自然外泄;伴有恶风、恶寒、发热、鼻鸣、干呕等症状的,也属于桂枝汤证。
太阳病出现发热、汗出,这是由于营气虚弱、卫气强盛所致,因此汗出。想要救治这种风邪侵袭,应以桂枝汤为主治方(桂枝汤证)。若脏腑没有其他病变,只是定时发热、汗出且久不痊愈,这是卫气不和的缘故。在其发作之前先给予发汗治疗,即可痊愈(桂枝汤证)。
病人经常自汗出,这是因为营气本身是调和的;营气调和的人,外部不协调,因为营行于脉中,卫行于脉外。再次发汗,使营卫调和,病即可愈(桂枝汤证)。
太阳病服用桂枝汤后,烦闷不解,应先针刺风池穴和风府穴,然后再给予桂枝汤,病即可愈(桂枝汤证)。
太阳病表证未解,脉象浮弱,应当用发汗法解除(桂枝汤证)。太阳病表证未解,不可使用下法;想要解除表证,应以桂枝汤为主治方(桂枝汤证)。
脉象浮大,只说大便硬结,如果误用下法导致腹泻,是大逆之症;若大便硬结属实证,通过发汗可以解除(桂枝汤证)。
太阳病未解,寸关尺三部脉象暂时停止搏动,病人必定先出现战栗,随后汗出而解;如果仅是阳脉微动,汗出即解;如果仅是阴脉微动,通过下法可解;如果想要使用下法,适宜用调胃承气汤(桂枝汤证)。
嗜酒之人患病,不可给予桂枝汤,服用后会呕吐(忌用桂枝汤证)。服用桂枝汤后发生呕吐的,其后必然会出现吐脓血的症状(忌用桂枝汤证)。桂枝汤本是解肌发表的药物,如果病人脉象浮紧、发热、无汗,不可给予(忌用桂枝汤证)。
本病伤寒,没有发热、只有恶寒症状的,属于发于阴经;发于阴经的病,六日可愈。身体极度发热却反而想要靠近衣物,这是因为热在皮肤表面,而寒邪深伏于骨髓之中。太阳病,或者已经发热,或者尚未发热,必定恶寒,身体疼痛,呕吐逆气,脉象阴阳俱紧,称为伤寒。
太阳病出现头痛、发热、身体疼痛、腰痛、骨节疼痛、恶寒、无汗且气喘的症状,属于麻黄汤证。脉象浮的,病在表,可以发汗;脉象浮而数的,也可以发汗(麻黄汤证)。
伤寒发汗,适宜在半日左右缓解;如果再次出现烦闷,脉象浮数,可以再次发汗,适宜用桂枝汤(麻黄汤证)。
伤寒不大便六七天,头痛且有发热,应给予承气汤;但如果小便清长,说明病不在里,仍在表,必须发汗(此为麻黄汤证)。如果头痛的,必然会流鼻血,适宜用桂枝汤(麻黄汤证)。
太阳病脉象浮紧、发热、身体无汗,如果自然流鼻血,病即可愈(麻黄汤证)。
伤寒脉象浮紧,如果不发汗导致流鼻血的,以麻黄汤为主治方(麻黄汤证)。
太阳病脉象浮紧、无汗、发热、身体疼痛,经过八九日仍未解除,以麻黄汤为主治方。服药后症状轻微减轻,出现烦闷、眼睛昏花,严重的必然流鼻血,鼻血流出后病才解除,这是因为阳气郁重所致(麻黄汤证)。
兼病:太阳病的特征是脉浮、头项强痛而恶寒。太阳病得病八九日,像疟疾一样,发热恶寒,热多寒少,不呕吐,大小便正常,一天发作两三次,脉象浮缓的,是即将痊愈的表现;脉象微弱且恶寒的,是阴阳俱虚,不可再用汗、下、吐法;面色反有红热的,病未解除,因为未能得到微小的汗出,身体必然发痒(桂枝麻黄各半汤证)。
形体像伤寒,但脉象不弦紧而软弱,脉弱必然口渴,如果被火疗,必然出现谵语;脉弱发热,通过发汗解表,汗出即愈(桂枝越婢汤证)。
太阳病发热恶寒,热多寒少,脉象微弱的,这是无阳(阳气虚),不可再发汗(桂枝越婢汤证)。
服用桂枝汤大汗出后,脉象洪大,仍按前法给予桂枝汤;如果像疟疾一样,一天发作两次,汗出必解(桂枝二麻黄一汤证)。
凡是疾病,如果用发汗、催吐、泻下等方法,或者亡血、亡失津液,只要阴阳自行调和,即可自愈(传经)。
太阳头痛,到七日以上自愈的,是因为邪气在经脉中运行完毕;如果想防止再次传经,可以针刺足阳明经,使经脉不再传变,病即可愈(传经)。
伤寒一日,太阳经受邪,脉象平静的,是不传经;如果很想呕吐,烦躁,脉象急数的,是欲传经(传经)。
阳盛入腑:太阳中风,脉象浮紧、发热、恶寒、身体疼痛、无汗且烦躁,是大青龙汤证,处于向阳明病转化的去路。
伤寒脉象浮缓,身体不疼但沉重,偶尔有轻的时候,没有少阴病症状的,是大青龙汤证,将入阳明。
伤寒脉象滑而四肢厥冷的,里有热,是白虎汤证,处于向阳明病转化的去路。
伤寒脉象浮、发热、无汗,表证未解的,不可给予白虎汤;如果口渴想喝水,且没有表证,以白虎加人参汤为主治方(白虎汤证)。
伤寒没有大热,口燥渴,心烦,背部微微恶寒的,以白虎加人参汤为主治方(白虎汤证)。
太阳病不解,热邪结于膀胱,病人神志如狂,如果瘀血自然下行,病可愈;如果表证未解,不可攻里;表证已解,仅小腹急结的,才可攻之(桃核承气汤证,入阳明去路)。
太阳病六七天,表证仍存在,脉象微而沉,反而不结胸,病人发狂,因为热在下焦,小腹应当硬满,如果小便自利,下血则愈,这是因为太阳随经,瘀热在里,以抵当汤为主治方(抵当汤证)。
太阳病身黄,脉象沉结,小腹硬,小便不利,是无血证;如果小便自利,病人如狂,才是确凿的血证(抵当汤证)。
伤寒有热,小腹满,应当小便不利,现在反而通利,是有瘀血,当下之,不可用其他药,适宜用抵当丸(抵当汤证)。
阴盛入脏:脉象浮紧,按理应当身体疼痛,假如尺中脉迟,不可发汗(忌用麻黄汤证,入少阴去路)。
中风,脉象微弱,汗出,恶风,如果服用大青龙汤,出现四肢厥冷、筋惕肉瞤,这是逆证,应用真武汤救治(大青龙汤证入少阴去路)。
伤寒表证未解,心下有停水,干呕,发热而咳,或者口渴,或者腹泻,或者嗳气,或者小便不利、小腹满,或者气喘的,是小青龙汤证,入太阴、少阴去路。
太阳病小便利的,因为饮水多,必然心下悸;小便少的,必然苦于里急(小青龙汤证)。
伤寒心下有停水,咳嗽且微喘,发热不渴,以小青龙汤为主治方。服药后感到口渴的,是寒邪已去,病欲解除(小青龙汤证)。
中风发热,六七天未解且烦躁,有表里证,口渴想喝水,水入则吐,名叫水逆,是五苓散证,入太阴去路。
伤寒汗出而渴的,以五苓散为主治方;不渴的,以茯苓甘草汤为主治方(五苓散证)。
病在阳分,反而用冷水浇灌,热被遏制不去,更加烦闷,皮肤起粟米状疙瘩,想喝水反而不渴的,服用文蛤散;如果不愈,给予五苓散。寒实结胸,无热症的,给予三物小陷胸汤,白散也可用(五苓散证)。
坏病:太阳病三天,已经发汗,或者催吐、泻下,或者温针,仍然不解除,这叫坏病。桂枝汤不再适用,需知道犯了什么错误,随证治疗。
本来应当发汗却反而下之,本来应当先下之却反而发汗,这叫逆治。
太阳病发汗后病不解,又用下法,脉象浮的,病不愈,应当解表(桂枝汤证入阳明)。
大下之后又发汗,小便不利的,是亡失津液,不要强行治疗,待小便通利,病自愈(发汗亡津证)。
发汗后,不可再行桂枝汤法;如果汗出而喘,没有大热的,以麻杏甘石汤为主治方(麻杏甘石汤证)。
发汗后,饮水多的,必然气喘;用水浇洗身体,也会气喘(汗后作喘证)。
下法后,不可再行桂枝汤法;如果汗出而喘,没有大热的,以麻杏甘石汤为主治方(麻杏甘石汤证)。
服用桂枝汤大汗出后,出现大烦渴不解,脉象洪大的,是人参白虎汤证。
伤寒吐下后七八日,病不解,热结在里,表里俱热,时时恶风,大渴,舌上干燥而烦躁,想喝几升水的,是人参白虎汤证。
太阳病先用下法不愈,又发汗,表里俱虚,导致头目昏冒。冒家汗出则自愈,因为表已和,得里未和,然后才可下之(表里俱虚证)。
发汗后恶寒的,是虚证;不恶寒反而恶热的,是实证。应当调和胃气(调胃承气汤证)。
太阳病中风,用火劫发汗,两阳熏灼身体,发黄。阳盛则欲流鼻血,阴虚则小便难,阴阳俱虚则身体枯燥,仅头部出汗,齐颈而还,腹满,微喘,口干咽烂,或者不大便,久则谵语,严重者至哕逆,手足躁扰,捻衣摸床,如果小便利的,可治(阴阳俱虚证)。
太阳病第二天,反而烦躁,反熨其背而大汗出,火热入胃,胃中水竭,躁烦必然发谵语。十余日后,振栗自下利的,是欲解。所以其汗从腰以下不得出,想小便不得,反而呕吐,想失溲,足下恶风,大便硬,次数不多但反而不快,及到大便已,头突然痛,足心必热,这是谷气下流(火热入胃证)。
太阳病用火熏,不得汗,必然烦躁,到经期不解,必然清血,名叫火邪(火邪圊血证)。
脉浮,宜汗解,用火灸之,邪无从出,因火而盛,腰以下重痹,名叫火逆(火逆助邪证)。
脉浮热甚,反灸之,这是实证实治,以虚法治之,因火而动,咽喉燥涩吐血(火逆吐血症)。
脉微数,慎不可灸,因火为邪,则为烦逆,追虚逐实,血散脉中,火气内攻,焦骨伤筋,血难复也(火邪内攻证)。
太阳病发汗后,大汗出,胃中干燥,烦不得眠,想喝水的,少量与之,令胃气和则愈(将成白虎汤证)。
如果脉浮,小便不利,热微消渴的,以五苓散为主治方(五苓散证入太阴)。
伤寒脉浮,自汗,小便数,心烦,微恶寒,脚挛急,反与桂枝汤,得之便厥,咽干,躁烦,吐逆的,制作甘草干姜汤与之;如果厥愈足温的,更制作芍药甘草汤与之;如果胃气不和谵语的,少量给予调胃承气汤;如果重发汗加烧针的,以四逆汤为主治方(甘草干姜汤证)。
证象阳旦,按法治之而增剧,厥逆,咽中干,两胫拘急而谵语。师言夜半手足当温,两脚当伸。何以知此?曰:寸口脉浮而大,浮则为风,大则为虚。风则生微热,虚则两胫挛。病证象桂枝,因加附子参其间,增桂令汗出。附子温经,亡阳故也。厥逆,咽中干,烦躁,阳明内结,谵语烦乱,更与甘草干姜汤。夜半阳气还,两足当温,胫尚微拘急,重与芍药甘草汤,尔乃胫伸。以承气微溏,则止其谵语,故知病可愈(甘草干姜汤证)。
病患脉数为热,当消谷引食,反吐的,因为发汗脉乃数,数为客热,不能消谷,胃中虚冷故吐也(汗后吐逆证)。
太阳病当恶寒,反不恶寒,不欲近衣,此为吐之内烦也(吐后生烦证)。
太阳病当恶寒发热,今自汗,不恶寒发热,关上脉细数者,是吐之过也。一二日吐之,饥不能食;三四日吐之,不喜粥,欲食冷,朝食暮吐,为小逆(吐后作吐证)。
伤寒下之,续下利清谷不止,身疼痛的,急救里;后身疼痛,清便调的,急救表。救里宜四逆汤,救表宜桂枝汤(身疼下利证)。
太阳病桂枝证,反下之,利遂不止,脉促的,表未解也;喘而汗出的,葛根芩连汤主之(葛根芩连汤证)。
太阳病下之后,脉促,胸满的,桂枝去芍药汤主之;如果微恶寒的,去芍药方加附子主之(桂枝去芍药汤证)。
服用桂枝汤或下之,仍头项强痛,发热,无汗,心下满,微痛,小便不利的(桂枝去桂加茯苓白术汤证)。
发汗后腹胀满的(厚朴生姜半夏甘草人参汤证)。
发汗吐下后,虚烦不得眠,剧者必反复颠倒懊恼,栀子豉汤主之;如果少气的,栀子甘草豉汤主之;如果呕的,栀子生姜豉汤主之(栀子豉汤证)。
太阳病发汗,遂漏不止,其人恶风,小便难,四肢微急,难以屈伸的(入少阴桂枝附子汤证)。
伤寒若吐下后,心下逆满,气上冲胸,起则头眩,脉沉紧,发汗则动经,身为振振摇的(苓桂术甘汤证)。
太阳病发汗,汗出不解,仍发热,心下悸,头眩,身动,振振欲擗地的(真武汤证)。
未持脉,病患叉手自冒心,令咳不咳,此必耳聋,以重发汗虚故(阳虚耳聋证)。
脉浮数,当汗愈,若下之,身重心悸的,不可发汗;如果自汗出而解,以尺中脉微,此里虚,须表里实,津液和,便汗出愈(身重心悸证)。
烧针令汗,针处被寒,核起而赤,必发奔豚,气从少腹上冲心,灸其核上各一壮,与桂枝加桂汤(桂枝加桂汤证)。
伤寒脉浮,以火劫之,亡阳必惊狂,起卧不安(桂枝去芍药加蜀漆龙骨牡蛎汤证)。
下之复发汗,昼日烦躁不得眠,夜安静,不呕,不渴,无表症,脉微沉,无大热的(干姜附子汤证)。
汗家重发汗,必恍惚心乱,小便已阴疼,与禹余粮丸(禹余粮汤证)。
太阳病脉浮而动数,头痛发热,微盗汗出,反恶寒的,表未解也。反下之,动数变迟,膈内拒痛,胃空虚,客气动膈,短气,烦躁懊恼,阳气内陷,心下因硬,则为结胸,大陷胸汤主之。若不结胸,但头汗出,齐颈而还,小便不利的,身必发黄(大陷胸汤证)。
伤寒六七日,结胸热实,脉沉紧,心下痛,按之石硬的(大陷胸汤证)。
太阳病重发汗而复下之,不大便五六日,舌上燥而渴,日晡小有潮热,从心下至少腹硬满而痛不可近的(大陷胸汤证)。
太阳病下之,其脉促,不结胸的,此欲解也;脉浮者必结胸;脉紧者必咽痛;脉弦者必两胁拘急;脉细数者头痛未止;脉沉紧者必欲呕;脉沉滑者协热利;脉浮滑者必下血(结胸脉法)。
太阳病二三日,不得卧,但欲起,心下必结,脉微弱者,此本有寒分也。反下之,若利止,必作结胸;未止者,四日复下之,此作协热利也(结胸变症)。
太阳病外未解而数下之,遂协热而利,利不止,心下痞硬,表里不解的(痞症人参桂枝汤证)。
伤寒大下复发汗,心下痞,恶寒的,表未解也。当先解表,方可攻痞。解表宜桂枝汤,攻痞宜大黄黄连泻心汤(大黄黄连泻心汤证)。
脉浮紧,复下之,紧反入里则作痞,按之濡,但气痞耳。痞濡,其脉关上浮的,大黄黄连泻心汤主之。痞而复恶寒汗出的,附子泻心汤主之(附子泻心汤证)。
太阳中风,下利,呕逆,表解者,乃可攻之。汗出发作有时,头痛,心下痞硬满,引胁下痛,干呕,短气,汗出,不恶寒,此表解里未和也(十枣汤证)。
伤寒汗解后,胃中不和,心下痞硬,干噫食臭,胁下有水气,腹中雷鸣,下利的(生姜泻心汤证)。
伤寒中风,反下之,下利日数十行,腹中雷鸣,心下痞硬而满,干呕,心烦不安。医谓痞不尽,复下之,痞益甚。此非结热,以胃中虚,客气上逆故硬也(甘草泻心汤证)。
伤寒服汤药,利不止,心下痞硬,服泻心汤已,复以他药下之,利不止,以理中与之,利益甚。理中者,理中焦,此利在下焦,赤石脂禹余粮汤主之。复利不止,当利其小便(赤石脂禹余粮汤证)。
本以下之故,心下痞,与泻心汤,痞不解,渴而口烦躁,小便不利的(五苓散证)。
病如桂枝症,头不痛,项不强,寸微浮,胸中痞硬,气冲咽喉,不得息,此胸有寒也,当吐之,宜瓜蒂散。诸亡血家不可与(瓜蒂散证)。
伤寒吐下后,发汗,虚烦,脉甚微,八九日,心下痞硬,胁下痛,气冲咽喉,眩冒,经脉动惕者,久而成痿(经脉动惕证)。
太阳病医发汗,遂发热恶寒,复下之,心下痞,表里俱虚,阴阳气并竭,无阳则阴独,复加烧针,因胸烦,面色青黄,肤瞤者,难治;令色微黄,手足温者,易愈(表里俱虚证)。
如结胸状,饮食如故,时时下利,寸脉浮,关脉细小沉紧,名曰脏结,舌上白苔滑者,难治(脏结证)。
病胁下素有痞,连在脐旁,痛引少腹,入阴筋者,此名脏结,死(脏结证)。
脏结无阳证,不往来寒热,其人反静,舌上苔滑者,不可攻也(脏结证)。
方药:桂枝汤
Wind-stroke (Taiyang Wind-Strike) of this disease, presenting with fever and aversion to cold, indicates onset in the Yang aspect; diseases starting in the Yang aspect resolve in seven days. The body is extremely cold yet there is a reluctance to wear clothes; this is because the cold is on the skin surface while the heat is deep within the marrow. In Taiyang disease, presenting with fever, sweating, aversion to wind, and a slow pulse, it is named Wind-stroke.
In Taiyang disease, presenting with headache, fever, sweating, and aversion to wind, this is the Guizhi Tang (Cinnamon Twig Decoction) pattern. In Taiyang Wind-stroke, the pulse is floating at the superficial position and weak at the deep position; floating indicates spontaneous heat generation, while weak indicates spontaneous sweating; accompanied by aversion to wind, aversion to cold, fever, nasal congestion with roaring sound, and dry vomiting, this is also the Guizhi Tang pattern.
Taiyang disease presenting with fever and sweating occurs because Ying (Nutritive Qi) is weak and Wei (Defensive Qi) is strong, hence sweating. To treat this invasion of wind pathogen, Guizhi Tang should be the primary prescription (Guizhi Tang pattern). If the internal organs have no other pathology, but there is periodic fever and sweating that does not resolve, this is due to disharmony of Wei Qi. Administering diaphoresis before the onset time will lead to recovery (Guizhi Tang pattern).
When a patient frequently sweats spontaneously, it is because Ying Qi itself is harmonious; in those with harmonious Ying Qi, external harmony is lacking because Ying circulates within the vessels while Wei circulates outside. Re-inducing sweating to harmonize Ying and Wei leads to recovery (Guizhi Tang pattern).
In Taiyang disease, if after taking Guizhi Tang the vexation does not resolve, first puncture Fengchi (GB20) and Fengfu (GV16) acupoints, then administer Guizhi Tang for recovery (Guizhi Tang pattern).
In Taiyang disease, if exterior symptoms are unresolved and the pulse is floating and weak, diaphoresis should be used to resolve the exterior (Guizhi Tang pattern). In Taiyang disease, if exterior symptoms are unresolved, purgation must not be used; to resolve the exterior, Guizhi Tang should be the primary prescription (Guizhi Tang pattern).
If the pulse is floating and large, and only constipation is mentioned, inducing diarrhea through purgation is a major contraindication; if constipation is due to excess, resolution through sweating is possible (Guizhi Tang pattern).
In Taiyang disease that has not resolved, if the pulses at cun, guan, and chi positions temporarily cease, the patient will inevitably experience chills and tremors followed by sweating and resolution; if only the yang pulse is slightly active, sweating resolves it; if only the yin pulse is slightly active, purgation resolves it; if purgation is desired, Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction) is suitable (Guizhi Tang pattern).
Patients with a history of alcohol consumption should not be given Guizhi Tang; doing so will cause vomiting (Contraindicated Guizhi Tang pattern). If vomiting occurs after taking Guizhi Tang, pus and blood will likely be vomited subsequently (Contraindicated Guizhi Tang pattern). Guizhi Tang is originally for releasing the muscle layer; if the pulse is floating and tight, with fever and no sweating, it must not be administered (Contraindicated Guizhi Tang pattern).
Cold damage (Taiyang Cold Damage) without fever but with aversion to cold indicates onset in the Yin aspect; diseases starting in the Yin aspect resolve in six days. The body is extremely hot yet there is a desire to seek warmth; this is because heat is on the skin surface while cold is deep within the marrow. In Taiyang disease, whether fever has already appeared or not, there is invariably aversion to cold, body pain, vomiting and counterflow qi, and a pulse that is tight at both superficial and deep positions, named Cold Damage.
In Taiyang disease, presenting with headache, fever, body pain, lower back pain, bone and joint pain, aversion to cold, anhidrosis, and wheezing, this is the Mahuang Tang (Ephedra Decoction) pattern. A floating pulse indicates the disease is in the exterior, allowing for diaphoresis; a floating and rapid pulse also allows for diaphoresis (Mahuang Tang pattern).
For Cold Damage, diaphoresis is appropriate; relief should occur within half a day. If vexation recurs and the pulse is floating and rapid, diaphoresis can be repeated, preferably with Guizhi Tang (Mahuang Tang pattern).
In Cold Damage, if there is no bowel movement for six or seven days, accompanied by headache and fever, Chengqi Tang formulas may be considered; however, if urine is clear, the disease is not in the interior but remains in the exterior, requiring diaphoresis (This is a Mahuang Tang pattern). If there is a headache, epistaxis is likely, and Guizhi Tang is suitable (Mahuang Tang pattern).
In Taiyang disease, with a floating and tight pulse, fever, anhidrosis, and spontaneous epistaxis, the disease resolves (Mahuang Tang pattern).
In Cold Damage, if the pulse is floating and tight and diaphoresis is not performed leading to epistaxis, Mahuang Tang should be the primary prescription (Mahuang Tang pattern).
In Taiyang disease, with a floating and tight pulse, anhidrosis, fever, and body pain persisting for eight or nine days without resolution, Mahuang Tang should be the primary prescription. After medication, symptoms may slightly decrease, accompanied by vexation and blurred vision; in severe cases, epistaxis occurs, and the disease resolves upon bleeding due to excessive accumulation of Yang Qi (Mahuang Tang pattern).
Complicated Diseases: The characteristic of Taiyang disease is a floating pulse, stiffness and pain in the head and neck, and aversion to cold. In Taiyang disease lasting eight or nine days, resembling malaria with more heat than cold, no vomiting, normal urination and defecation, occurring two or three times a day with a floating and slow pulse, indicates impending resolution; a faint pulse with aversion to cold indicates deficiency of both Yin and Yang, prohibiting further diaphoresis, purgation, or emesis; a reddish complexion indicates the disease is unresolved due to lack of slight sweating, causing body itching (Guizhi Mahuang Ge Ban Tang / Cinnamon Twig and Ephedra Half-Half Decoction pattern).
The appearance resembles Cold Damage, but the pulse is not wiry and tight but weak; weakness implies thirst, and fire therapy would cause delirium; for weakness with fever, resolution through sweating is effective (Guizhi Yebibo Tang / Cinnamon Twig and Ma Bright Pill Decoction pattern).
In Taiyang disease with fever and aversion to cold, more heat than cold, and a weak pulse, this indicates absence of Yang (Yang deficiency), prohibiting further diaphoresis (Guizhi Yebibo Tang pattern).
After taking Guizhi Tang with heavy sweating, if the pulse becomes flooding and large, continue with Guizhi Tang as before; if symptoms resemble malaria occurring twice a day, sweating will resolve it (Guizhi Er Mahuang Yi Tang / Cinnamon Twig Two Parts Ephedra One Part Decoction pattern).
Generally, if diseases are treated with diaphoresis, emesis, or purgation, or if there is blood loss or fluid depletion, self-healing occurs when Yin and Yang naturally harmonize (Transmission of Channels).
Headache from Taiyang disease resolving after seven days occurs because the pathogen has exhausted its course in the channel; to prevent recurrence and transmission, acupuncture at the Foot-Yangming channel can stop transmission and cure the disease (Transmission of Channels).
For patients with wind disorders, if the exterior is resolved but discomfort persists, healing occurs in twelve days (Transmission of Channels).
In Cold Damage, if after two or three days there are no Yangming or Shaoyang symptoms, transmission has not occurred (Transmission of Channels).
On the first day of Cold Damage, the Taiyang channel is affected; a quiet pulse indicates no transmission; frequent urge to vomit, irritability, and an urgent, rapid pulse indicate impending transmission (Transmission of Channels).
Excess Yang Entering the Fu Organs: Taiyang Wind-stroke with a floating and tight pulse, fever, aversion to cold, body pain, anhidrosis, and restlessness is the Da Qinglong Tang (Great Blue Dragon Decoction) pattern, representing a pathway towards Yangming transformation.
Cold Damage with a floating and slow pulse, body heaviness without pain, occasionally lighter, and no Shaoyin symptoms is the Da Qinglong Tang pattern, approaching Yangming.
Cold Damage with a slippery pulse and cold limbs indicates internal heat, the Baihu Tang (White Tiger Decoction) pattern, a pathway towards Yangming.
Cold Damage with a floating and slippery pulse indicates internal heat and exterior cold, the Baihu Tang pattern, entering Yangming.
In Cold Damage with a floating pulse, fever, and anhidrosis, if the exterior is unresolved, Baihu Tang must not be given; if there is thirst for water and no exterior syndrome, Baibu Jia Renshen Tang (White Tiger Plus Ginseng Decoction) is the primary prescription (Baihu Tang pattern).
In Cold Damage without significant fever, dry mouth and throat, irritability, and slight aversion to cold on the back, Baibu Jia Renshen Tang is the primary prescription (Baihu Tang pattern).
If Taiyang disease is unresolved and heat binds in the Bladder, causing mental agitation like madness, spontaneous passage of blood leads to recovery; if the exterior is unresolved, interior attack is prohibited; once the exterior is resolved and only urgency and binding in the lower abdomen remain, attack is permissible (Taohhe Chengqi Tang / Peach Pit Regulate the Qi Decoction pattern, pathway to Yangming).
In Taiyang disease lasting six or seven days, if exterior signs persist, the pulse is faint and sinking, there is no chest binding, but the patient is manic due to heat in the lower jiao causing hardness and fullness in the lower abdomen; if urination is free, passing blood resolves the condition because Taiyang follows the channels and blood stasis with heat resides in the interior; Dandang Tang (Dredge the Reservoir Decoction) is the primary prescription (Dandang Tang pattern).
In Taiyang disease with yellowing of the body, a sinking and knotted pulse, hardness in the lower abdomen, and difficulty urinating, there is no blood stasis; if urination is free and the patient is manic, blood stasis is confirmed (Dandang Tang pattern).
In Cold Damage with heat, fullness in the lower abdomen, and expected difficulty urinating, but actual free urination indicates blood stasis requiring purgation; Dandang Wan (Dredge the Reservoir Pill) is suitable (Dandang Tang pattern).
Excess Yin Entering the Zang Organs: A floating and tight pulse typically indicates body pain; however, if the chi position pulse is slow, diaphoresis is prohibited (Contraindicated Mahuang Tang pattern, pathway to Shaoyin).
In Wind-stroke with a faint pulse, sweating, and aversion to wind, administering Da Qinglong Tang causes cold limbs, twitching muscles, and palpitations, which is a reverse reaction; Zhenwu Tang (True Warrior Decoction) should be used to rescue (Da Qinglong Tang pattern entering Shaoyin).
In Cold Damage, if the exterior is unresolved and there is fluid retention in the epigastrium, causing dry heaving, fever, and cough, or thirst, diarrhea, belching, difficulty urinating with lower abdominal fullness, or wheezing, this is the Xiao Qinglong Tang (Minor Blue Dragon Decoction) pattern, entering Taiyin and Shaoyin pathways.
In Taiyang disease, if urination is frequent due to excessive drinking, palpitations in the epigastrium occur; if urination is scant, internal urgency occurs (Xiao Qinglong Tang pattern).
In Cold Damage with fluid retention in the epigastrium, cough with slight wheezing, fever, and no thirst, Xiao Qinglong Tang is the primary prescription. Thirst after taking the medicine indicates cold has gone and the disease is resolving (Xiao Qinglong Tang pattern).
In Wind-stroke, fever persisting for six or seven days with vexation, presenting with exterior and interior signs, thirst for water, and vomiting after drinking, named Water Counterflow, is the Wuling San (Five-Ling Powder) pattern, entering Taiyin.
In Cold Damage, sweating with thirst is treated with Wuling San; without thirst, Fuling Gancao Tang (Poria and Licorice Decoction) is used (Wuling San pattern).
If a disease in the Yang stage is wrongly cooled with cold water, suppressing the heat causes increased vexation and goosebumps; wanting water but not being thirsty is treated with Wenli San; if ineffective, Wuling San is given. For Cold-Excess Chest Binding without heat signs, Sanwu Xiantong Tang (Three-Item Small Trap Decoction) or Baisan (White Powder) may be used (Wuling San pattern).
Ruined Disease: After three days of Taiyang disease, if diaphoresis, emesis, purgation, or warm needle therapy fail to resolve the condition, it is called Ruined Disease. Guizhi Tang is no longer applicable; one must identify the error and treat according to the syndrome.
Originally indicating diaphoresis but using purgation, or originally indicating purgation but using diaphoresis, constitutes a reverse treatment.
In Taiyang disease, if sweating fails to resolve the condition and purgation is used, and the pulse remains floating, the disease is unresolved and exterior release is needed (Guizhi Tang pattern entering Yangming).
After severe purgation and subsequent diaphoresis, if urination is difficult, fluids are depleted; do not forcibly treat, wait for natural urination to restore health (Fluid Depletion from Diaphoresis).
After diaphoresis, Guizhi Tang method should not be used; if sweating occurs with wheezing and no high fever, Maxing Gan Shi Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) is the primary prescription (Maxing Gan Shi Tang pattern).
After diaphoresis, excessive water intake causes wheezing; cooling the body with water also causes wheezing (Wheezing after Sweating).
After purgation, Guizhi Tang method should not be used; if sweating occurs with wheezing and no high fever, Maxing Gan Shi Tang is the primary prescription (Maxing Gan Shi Tang pattern).
After taking Guizhi Tang and sweating heavily, if severe vexation and thirst persist with a flooding pulse, this is the Renshen Baihu Tang (Ginseng White Tiger Decoction) pattern.
After Cold Damage emesis and purgation, if unresolved after seven or eight days, with heat bound in the interior, exterior and interior both hot, occasional aversion to wind, extreme thirst, dry tongue, vexation, and desire to drink several liters of water, Renshen Baihu Tang is the primary prescription (Renshen Baihu Tang pattern).
In Taiyang disease, if purgation is used first and fails, followed by diaphoresis, causing interior and exterior deficiency and dizziness, sweating resolves the dizziness as the exterior harmonizes; if the interior is not yet harmonized, purgation may follow (Interior and Exterior Deficiency).
After diaphoresis, aversion to cold indicates deficiency; lack of aversion to cold but presence of aversion to heat indicates excess. Harmonize the Stomach Qi (Tiaowei Chengqi Tang pattern).
In Taiyang Wind-stroke, if fire therapy is used, dual Yang scorches the body causing jaundice. Excess Yang leads to epistaxis, deficiency Yin leads to difficult urination, dual deficiency leads to dryness, only head sweating up to the neck, abdominal fullness, slight wheezing, dry mouth and throat, or constipation, eventually delirium, or worse, hiccups, restlessness, picking at clothes, and touching beds; if urination is free, it is treatable (Dual Yin and Yang Deficiency).
On the second day of Taiyang disease, sudden irritability and back moxibustion causing heavy sweating allow fire heat to enter the Stomach, depleting fluids, causing irritability and delirium. After ten days, chills and spontaneous diarrhea indicate resolution. Sweat below the waist is absent, urination is difficult, vomiting occurs, fear of incontinence, and foot aversion to cold with hard stool indicate grain Qi flowing downward (Fire Heat Entering Stomach).
In Taiyang disease, fire fumigation without sweating causes irritability; if unresolved by the end of the cycle, rectal bleeding occurs, named Fire Pathogen (Fire Pathogen Rectal Bleeding).
A floating pulse requires diaphoresis; using fire moxibustion traps the pathogen, causing heaviness and numbness below the waist, named Fire Reverse (Fire Reverse Assisting Pathogen).
A floating pulse with intense heat, if moxibusted, treats excess as deficiency, causing throat dryness and hematemesis (Fire Reverse Hematemesis).
A faint and rapid pulse prohibits moxibustion; fire becomes a pathogen causing vexation and counterflow, chasing deficiency and pursuing excess, scattering blood and damaging bones and tendons (Fire Pathogen Internal Attack).
After Taiyang disease diaphoresis with heavy sweating, stomach dryness causes vexation and insomnia; small sips of water harmonize the Stomach (Impending Baihu Pattern).
If the pulse is floating, urination is difficult, heat is mild, and thirst occurs, Wuling San is the primary prescription (Wuling San pattern entering Taiyin).
After diaphoresis, if the pulse is floating and rapid with vexation and thirst (Wuling San pattern).
In Cold Damage with a floating pulse, spontaneous sweating, frequent urination, irritability, slight aversion to cold, and leg cramps, giving Guizhi Tang causes cold limbs, dry throat, vexation, and vomiting; prepare Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction); if limbs warm, prepare Shaoyao Gancao Tang (Peony and Licorice Decoction); if Stomach disharmony causes delirium, give small amounts of Tiaowei Chengqi Tang; if heavy sweating and fire needles were used, Sini Tang (Counterflow Cold Decoction) is primary (Gancao Ganjiang Tang pattern).
Syndrome resembling Yang Dan, treated correctly but worsening with cold limbs, dry throat, leg cramps, and delirium: The master says hands and feet will warm and legs extend at midnight. Why? Cun and Guan pulses are floating and large; floating indicates wind generating mild heat, large indicates deficiency causing leg cramps. The syndrome resembles Guizhi Tang, so Fuzi (Aconite) is added, and Gui (Cinnamon) increased to induce sweating. Fuzi warms the channels; Yang was lost. With cold limbs, dry throat, vexation, Yangming internal binding, and delirium, give Gancao Ganjiang Tang again. At midnight, Yang returns, legs warm; if cramps persist, give Shaoyao Gancao Tang again, then legs extend. Use Chengqi lightly to stop delirium, knowing the disease will heal (Gancao Ganjiang Tang pattern).
After diaphoresis, inability to keep food or water down is reverse; further diaphoresis causes continuous vomiting and diarrhea (Vomiting and Diarrhea after Sweating).
A patient with a rapid pulse has heat and should digest food, but vomits because sweating made the pulse rapid, indicating guest heat unable to digest food due to Stomach deficiency and cold (Vomiting after Sweating).
Taiyang disease should have aversion to cold; lack thereof and dislike for clothing indicates internal vexation from vomiting (Vexation after Vomiting).
Taiyang disease should have aversion to cold and fever; now with spontaneous sweating, no aversion to cold/fever, and fine, rapid pulse at the Guan position, it is due to excessive vomiting. Vomiting on days 1-2 causes hunger without appetite; days 3-4 causes dislike for porridge, desire for cold food, and evening vomiting of morning food, a minor reverse (Vomiting after Vomiting).
In Cold Damage purgation, if diarrhea with undigested food persists and body pain exists, urgently tonify the interior; later, if stool normalizes and body pain persists, urgently release the exterior. Tonify interior with Sini Tang, release exterior with Guizhi Tang (Body Pain and Diarrhea).
After diaphoresis, body pain with a sinking and slow pulse (Xinji Tang / New Supplement Decoction pattern).
In Taiyang Guizhi Tang pattern, if purgation is wrongly used causing persistent diarrhea with a hurried pulse, the exterior is unresolved; wheezing with sweating is treated with Gegen Qinlian Tang (Kudzu and Coptis Decoction) (Gegen Qinlian Tang pattern).
In Taiyang disease, after purgation, if the pulse is hurried and there is chest fullness, Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction Without Peony) is primary; if slightly aversive to cold, add Fuzi (Guizhi Qu Shaoyao Tang pattern).
In Taiyang disease, after purgation, slight wheezing indicates the exterior is unresolved (Guizhi Houpo Zizi Tang / Cinnamon Twig, Magnolia Bark, and Apricot Kernel Decoction pattern).
Chronic wheezers should take Guizhi Tang plus Houpo (Magnolia Bark) and Xingren (Apricot Kernel) (Guizhi Houpo Zizi Tang pattern).
After taking Guizhi Tang or purgation, if headache, neck stiffness, fever, anhidrosis, epigastric fullness, slight pain, and difficulty urinating persist (Guizhi Qu Gui Ji Fuling Baizhu Tang / Cinnamon Twig Decoction Without Cinnamon Twig plus Poria and Atractylodes Macrocephala Decoction pattern).
Abdominal fullness after diaphoresis (Houpo Jiangxia Renshen Gancao Tang / Magnolia Bark, Ginger, Pinellia, Ginseng, and Licorice Decoction pattern).
After Cold Damage purgation, irritability and abdominal fullness with restlessness (Zhizi Houpo Tang / Gardenia and Magnolia Bark Decoction pattern).
After severe purgation with pills in Cold Damage, persistent low-grade heat and slight irritability (Zhizi Ganjiang Tang / Gardenia and Dried Ginger Decoction pattern).
After diaphoresis or purgation, irritability and chest oppression (Zhizi Chidao Tang / Gardenia and Fermented Soybean Decoction pattern).
After diaphoresis, emesis, or purgation, empty vexation preventing sleep, severe restlessness is treated with Zhizi Chidao Tang; with shortness of breath, Zhizi Gancao Chidao Tang; with vomiting, Zhizi Shengjiang Chidao Tang (Zhizi Chidao Tang pattern).
Zhizi Tang is contraindicated in patients with chronic loose stools (Contraindicated Zhizi).
In Taiyang disease, heavy diaphoresis causing continuous leakage, aversion to wind, difficulty urinating, and slight limb stiffness (Entering Shaoyin Guizhi Fuzi Tang pattern).
Diaphoresis failing to resolve the disease with increased aversion to cold indicates deficiency (Shaoyao Gancao Fuzi Tang / Peony, Licorice, and Aconite Decoction pattern).
After purgation and diaphoresis, chills and faint, thin pulses indicate interior and exterior deficiency (Interior and Exterior Deficiency).
After Cold Damage emesis/purgation, epigastric fullness with qi rushing to the chest, dizziness upon standing, and a sinking, tight pulse; diaphoresis damages the channels causing trembling (Linggui Zhugan Tang / Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction pattern).
In Taiyang disease, diaphoresis failing to resolve fever, with palpitations, dizziness, body tremors, and feeling like falling (Zhenwu Tang / True Warrior Decoction pattern).
Heavy diaphoresis causing hand placement over the heart, palpitations seeking pressure (Guizhi Gancao Tang / Cinnamon Twig and Licorice Decoction pattern).
Before taking the pulse, if the patient covers their heart, and coughing tests reveal deafness, it is due to heavy diaphoresis causing Yang deficiency (Yang Deficiency Deafness).
A floating and rapid pulse requires diaphoresis; if purgation causes heaviness and palpitations, diaphoresis is prohibited; spontaneous sweating resolves it if the chi pulse is faint, indicating interior deficiency requiring restoration of fluids and harmony (Heaviness and Palpitations).
After diaphoresis, palpitations below the navel indicate impending Ben Tun (Rushing Pig) (Guiling Gan Zao Tang / Poria, Cinnamon Twig, and Jujube Decoction pattern).
Fire needle diaphoresis causing cold at the needle site with red nodules triggers Ben Tun, with qi rushing from the lower abdomen to the heart; moxa each nodule once, then Guizhi Jia Gui Tang (Cinnamon Twig Decoction plus Cinnamon Twig) (Guizhi Jia Gui Tang pattern).
After Taiyang purgation, qi rushing upward (Guizhi Jia Gui Tang pattern).
In Cold Damage with a floating pulse, if fire coercion causes Yang loss with panic, mania, and restlessness (Guizhi Qu Shaoyao Jia Shuji Longgu Muli Tang / Cinnamon Twig Decoction Without Peony plus Coix Seed, Dragon Bone, and Oyster Shell Decoction pattern).
Taiyang Cold Damage with warm needles causes panic (Warm Needle Yang Loss).
Fire reverse with purgation and fire needle causing irritability (Guizhi Gancao Longgu Muli Tang / Cinnamon Twig, Licorice, Dragon Bone, and Oyster Shell Decoction pattern).
Diaphoresis or purgation failing to resolve irritability (Fuling Sini Tang / Poria and Counterflow Cold Decoction pattern).
Purgation and diaphoresis causing daytime irritability and nighttime calmness, no vomiting/thirst/exterior signs, faint/sinking pulse, and no significant heat (Ganjiang Fuzi Tang / Dried Ginger and Aconite Decoction pattern).
Heavy diaphoresis in a person prone to sweating causes mental confusion and post-urination genital pain; Yu Yuliang Wan (Halloysite Pill) is given (Yu Yuliang pattern).
Cold disease with recurrent diaphoresis causing Stomach cold and vomiting of roundworms (Entering Jueyin Stomach Cold Worm Vomiting).
Disease starting in Yang wrongly purged leads to heat entering and forming Chest Binding; disease starting in Yin wrongly purged leads to Pi (Glomus).
In Taiyang disease with a floating, moving, and rapid pulse, headache, fever, slight night sweat, and aversion to cold, the exterior is unresolved. Purging changes the pulse to slow, causing diaphragmatic pain, empty Stomach, and guest qi disturbing the diaphragm, shortness of breath, and vexation. Yang Qi sinks internally, causing epigastric hardness, forming Chest Binding, treated with Daxiexiong Tang (Major Trap Chest Decoction). If no Chest Binding but only head sweating up to the neck and difficulty urinating, jaundice ensues (Daxiexiong Tang pattern).
Cold Damage after six or seven days with Chest Binding heat-excess, sinking and tight pulse, epigastric pain, and stone-hard palpation (Daxiexiong Tang pattern).
In Taiyang disease, heavy diaphoresis and purgation leading to five or six days of constipation, dry thirsty tongue, late afternoon tidal fever, and hardness/pain from epigastrium to lower abdomen unapproachable to touch (Daxiexiong Tang pattern).
Chest Binding with neck stiffness resembling Rou Jing (Soft Spasm), resolved by purgation (Daxiexiong Wan / Major Trap Chest Pill pattern).
Minor Chest Binding located in the epigastrium, painful on pressure, with a floating and slippery pulse (Xiao Xiantong Tang / Minor Trap Decoction pattern).
After Taiyang purgation, a hurried pulse without Chest Binding indicates resolution; floating pulse indicates Chest Binding; tight pulse indicates sore throat; wiry pulse indicates hypochondriac tension; fine-rapid pulse indicates persistent headache; sinking-tight pulse indicates urge to vomit; sinking-slippery pulse indicates協热利 (Heat-Collateral Diarrhea); floating-slippery pulse indicates hematochezia (Chest Binding Pulse Methods).
Taiyang disease for two or three days with inability to lie down, desire to rise, epigastric binding, and faint pulse indicates pre-existing cold-fluid. Purging stops diarrhea but causes Chest Binding; if diarrhea continues and purging repeats on the fourth day, it becomes Heat-Collateral Diarrhea (Chest Binding Variations).
Taiyang exterior unresolved with multiple purgations leads to Heat-Collateral Diarrhea, persistent diarrhea, epigastric hardness, and unresolved interior/exterior (Pi Syndrome Ren Shen Guizhi Tang pattern).
Severe purgation and diaphoresis in Cold Damage causing epigastric Pi and aversion to cold indicates unresolved exterior; release exterior first with Guizhi Tang, then attack Pi with Dahuang Huanglian Xiexin Tang (Rhubarb, Coptis, and Heart-Draining Decoction) (Dahuang Huanglian Xiexin Tang pattern).
Floating-tight pulse after purgation enters the interior causing Pi, soft on pressure, merely Qi Pi; if the Guan pulse is floating, Dahuang Huanglian Xiexin Tang is primary. If Pi is accompanied by aversion to cold and sweating, Fuzi Xiexin Tang (Aconite Heart-Draining Decoction) is primary (Fuzi Xiexin Tang pattern).
Taiyang Wind-stroke with diarrhea and vomiting; if the exterior is resolved, attack the interior. Periodic sweating, headache, epigastric hardness/fullness radiating to hypochondrium, dry heaving, shortness of breath, sweating without aversion to cold indicates resolved exterior and unharmonized interior (Shizao Tang / Ten Date Powder pattern).
After Cold Damage resolution, Stomach disharmony causing epigastric hardness, belching with food odor, fluid retention in hypochondrium, borborygmus, and diarrhea (Shengjiang Xiexin Tang / Fresh Ginger Heart-Draining Decoction pattern).
Cold Damage/Wind-stroke wrongly purged causing frequent diarrhea, borborygmus, epigastric hardness/fullness, dry heaving, and irritability. The physician assumes incomplete Pi and purges again, worsening Pi. This is not heat-binding but Stomach deficiency with guest qi counterflow (Gancao Xiexin Tang / Licorice Heart-Draining Decoction pattern).
After Cold Damage herbal medicine, persistent diarrhea and epigastric hardness; after Xiexin Tang and further purgation, diarrhea persists. Lizhong Tang regulates the middle jiao, but this diarrhea is in the lower jiao; Chishizhi Yuyuliang Tang (Red Halloysite and Halloysite Decoction) is primary. If diarrhea persists, promote urination (Chishizhi Yuyuliang Tang pattern).
Epigastric Pi due to prior purgation, unresponsive to Xiexin Tang, with thirst, irritability, and difficulty urination (Wuling San pattern).
After Cold Damage diaphoresis/emesis/purgation, epigastric hardness and persistent belching (Xuanfuhua Daizheshi Tang / Inula Flower and Hematite Decoction pattern).
Symptoms resembling Guizhi Tang but without headache/neck stiffness, faint floating Cun pulse, epigastric hardness, qi rushing to throat causing breathing difficulty, indicating cold in the chest; induce emesis with Gouti San (Melon Tip Powder). Contraindicated in blood-loss patients (Gouti San pattern).
After Cold Damage emesis/purgation/diaphoresis, empty vexation, very faint pulse, epigastric hardness, hypochondriac pain, qi rushing to throat, dizziness, and meridian trembling for eight or nine days, leading to atrophy over time (Meridian Trembling).
Taiyang disease diaphoresis causing fever/aversion to cold, followed by purgation causing epigastric Pi, interior/exterior deficiency, exhaustion of Yin/Yang Qi, and Yang deficiency leaving Yin alone. Adding fire needles causes chest vexation, bluish complexion, and skin twitching (difficult to treat); if complexion turns slightly yellow and hands/feet warm, easy to treat (Interior/Exterior Deficiency).
Taiyang disease resolves between Si (9-11 AM) and Wei (1-3 PM).
Untreatable Conditions: Chest Binding with a floating and large pulse, purgation leads to death (Chest Binding Contraindicated Purgation).
Chest Binding with all symptoms present and irritability leads to death (Chest Binding Irritability).
Resembling Chest Binding but with normal diet and intermittent diarrhea, floating Cun pulse, fine/sinking/tight Guan pulse, named Zang Jie (Zang Knot), with white slippery tongue coating, difficult to treat (Zang Jie Pattern).
Pre-existing hypochondriac mass connected to the umbilicus, pain radiating to the lower abdomen and genitals, named Zang Jie, leads to death (Zang Jie Pattern).
Zang Jie without Yang signs, no alternating chills/fever, patient is calm, with slippery tongue coating, cannot be attacked (Zang Jie Pattern).
Prescriptions: Guizhi Tang