行阴嗜卧无表里,呼醒复睡不须惊,风温脉浮热汗出,多眠身重息鼾鸣。
【注】行阴欲寐嗜卧,少阴证也。若欲寐嗜卧无表里证,身和脉小,知已解也。然解
后之睡,呼之则醒,醒而又睡,是阴气来复,非阴盛困阳,不须惊也。风温亦欲寐多眠,则
有脉浮发热,汗出身重,鼻息鼾鸣之别也。
咽痛干肿为阳热,不干不肿属阴寒,阳用甘桔等汤治,阴用甘桔附姜攒。
【注】咽痛一证,寒热皆有。咽干肿痛,为三阳热证,宜甘桔、半夏、苦酒、猪肤等
汤调治。不干不肿而痛,为三阴寒证,宜四逆汤加桔梗主治也。
气撞吐蛔厥阴本,无蛔阳表桂枝汤,少腹急引烧 散,冲喉难息瓜蒂良。
【注】气撞吐蛔,谓厥阴本证也。无蛔,谓气撞不吐蛔,乃邪犹在阳表也,宜桂枝汤。
少腹急引,谓气上冲,更少腹引阴急痛,乃阴阳易病也,宜烧 散。冲喉难息,谓气上
冲喉,胸满难以布息,乃寒实在胸也,宜瓜蒂散。
饥不欲食吐蛔厥,下后不食属阳明,懊 头汗栀子豉,厥紧心烦邪在胸。
【注】饥不欲食吐蛔厥,谓厥阴本证也。下后饥不能食属阳明也。阳明病则懊 ,心
中烦甚,头上汗出,是热在胃中,宜栀子豉汤涌之。厥阴病则吐蛔、厥逆、脉微,今不
微而紧更心烦者,非寒虚邪,是寒实邪,而在胸中,宜瓜蒂散吐之。
在阴经运行中出现的嗜睡,既无表证也无里证,将其唤醒后随即又入睡,这无需惊慌。若是风温病,则表现为脉浮、发热、出汗,且伴有嗜睡、身体沉重和呼吸鼾鸣。
【注】“行阴欲寐”即嗜睡,属于少阴病证。如果既有嗜睡又无表证和里证,身体调和且脉象细小,说明病情已经解除。然而,病解后的睡眠,呼唤可以醒来,醒来后又睡去,这是阴气恢复的表现,并非阴盛阳困,所以不需要惊慌。风温病也会出现嗜睡多眠的情况,但其区别在于有脉浮、发热、出汗、身体沉重、鼻息鼾鸣等症状。
咽部疼痛且干燥肿胀属于阳热证,若不干燥也不肿胀则属于阴寒证。阳热证用甘桔汤等方剂治疗,阴寒证用甘草、桔梗、附子、干姜合用的方剂治疗。
【注】咽痛这一症状,寒证和热证都有。咽部干燥肿痛,属于三阳热证,适宜用甘桔汤、半夏散、苦酒汤、猪肤汤等方剂调理治疗。如果不干燥不肿胀而疼痛,属于三阴寒证,适宜用四逆汤加桔梗主治。
气上冲撞并吐出蛔虫是厥阴病的本证;若无蛔虫吐出,则是气上冲撞但邪气仍在阳经表位,宜用桂枝汤。少腹部拘急牵引疼痛,是指气上冲,且少腹部牵引阴部急痛,这是阴阳易病,宜用烧裈散。气上冲至喉部难以呼吸,是指气上冲喉,胸部满闷难以舒展呼吸,这是寒邪实结于胸中,宜用瓜蒂散。
饥饿但不想进食并伴有吐蛔虫和四肢厥冷是厥阴病的本证;攻下之后不能进食属于阳明病。阳明病会出现心中懊憹,心烦严重,头部出汗,这是热邪在胃中,适宜用栀子豉汤涌吐。厥阴病会出现吐蛔虫、四肢厥冷、脉象微弱,现在脉象不微弱反而紧,且更加心烦,这不是寒虚邪气,而是寒实邪气,位于胸中,适宜用瓜蒂散吐之。
Sleepiness and desire to lie down during the circulation of Yin [meridians], without exterior or interior syndromes, waking up only to fall back asleep immediately requires no alarm. In Wind-Warmth (Fengwen), there is floating pulse, fever, sweating, excessive sleepiness, heaviness of the body, and snoring respiration.
[Note] "Desire to sleep during Yin circulation" refers to lethargy and is a Shaoyin syndrome. If one desires to sleep but has no exterior or interior signs, with a harmonious body and small pulse, it indicates resolution. However, sleep after resolution, where one wakes upon being called but falls back asleep, signifies the recovery of Yin Qi, not an excess of Yin trapping Yang; thus, there is no need for alarm. Wind-Warmth also presents with excessive sleepiness, distinguished by floating pulse, fever, sweating, body heaviness, and snoring breath.
Throat pain with dryness and swelling belongs to Yang-Heat; lack of dryness and swelling belongs to Yin-Cold. Yang-Heat is treated with formulas such as Ganjie Tang (Licorice and Platycodon Decoction); Yin-Cold is treated with a combination of Licorice, Platycodon, Aconite, and Ginger.
[Note] Throat pain occurs in both cold and heat patterns. Dryness, pain, and swelling indicate a Three-Yang Heat syndrome, suitable for treatment with Ganjie Tang (Licorice and Platycodon Decoction), Banxia San (Pinellia Powder), Kujiu Tang (Bitter Wine Decoction), or Zhufu Tang (Pig Skin Decoction). Lack of dryness and swelling with pain indicates a Three-Yin Cold syndrome, suitable for treatment with Sini Tang (Frigid Extremities Decoction) added with Jiegeng (Platycodon Root).
Qi rushing upward with vomiting of roundworms is the fundamental syndrome of Jueyin. Absence of roundworms implies Qi rushing upward without vomiting worms, indicating the pathogen remains at the Yang exterior, suitable for Guizhi Tang (Cinnamon Twig Decoction). Urgent pulling pain in the lower abdomen refers to Qi rushing upward combined with urgent pain pulling from the lower abdomen to the yin region, known as Yinyang Yi disease (Exchange between Yin and Yang), suitable for Shao Kun San (Burnt Undergarment Powder). Qi rushing to the throat causing difficult breathing refers to Qi rushing to the throat with chest fullness and inability to breathe comfortably, indicating Cold Excess in the chest, suitable for Gouti San (Melon Sepal Powder).
Hunger without desire to eat, accompanied by vomiting roundworms and cold extremities, is the fundamental syndrome of Jueyin. Inability to eat after purgation belongs to Yangming. Yangming disease presents with Ao'ao (restlessness), severe mental vexation, and sweating on the head, indicating Heat in the Stomach, suitable for Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) to induce emesis. Jueyin disease presents with vomiting roundworms, cold extremities, and faint pulse; if the pulse is now tight rather than faint and accompanied by increased vexation, this is not Cold Deficiency but Cold Excess located in the chest, suitable for Gouti San (Melon Sepal Powder) to induce emesis.