风温原自感春风,误汗灼热汗津生,阴阳俱浮难出语,身重多眠息鼾鸣,误下直视
失溲少,被火发黄螈 惊,葳蕤桂枝参白虎,一逆引日再命终。
【注】冬伤于寒不即病者,复感春寒,名曰温病;复感春风,名曰风温。风温有汗,不
可汗也。若误汗之,益助火邪,则身热如火,自汗津津不止,言语难出,身重多眠,鼻息
鼾鸣也。风温阴阳脉俱浮,不可下也。若误下之,热陷膀胱,竭其津液,则直视失溲,小
便少也。风湿热盛,若误以火熏蒸强汗,火旺津亡,则发黄色,螈 惊痫也。风温之证,
不可汗下,主以葳蕤汤。若脉虚汗多,主以桂枝合人参白虎汤。一逆引日再命终,谓一
逆尚可引日,若汗而又下,下而又火,则为再逆,是促命期也。
温疟得之冬中风,寒气藏于骨髓中,至春邪气不能发,遇暑烁髓消肌形,或因用力
腠发泄,邪汗同出故热生,衰则气复寒后作,证同温热治相同。
【注】经曰∶温疟得之冬中于风,寒气藏于骨髓之中,至春阳气尚微,邪气不能自出,
因值大暑,烁脑髓消肌肉,腠理发泄,或有所用力,邪气与汗同出,出则阴虚而阳盛,故
热生也,衰则气复入,入则阳虚而阴盛,故后作寒也。其证同温热,治亦相同也。
温复伤湿湿温病,身重胸满及头疼,妄言多汗两胫冷,白虎汤加苍术苓。
【注】温病复伤于湿,名曰湿温。其证则身重胸满,头疼妄言,多汗两胫逆冷,宜白
虎汤加苍术、茯苓,温、湿两治法也。
风温病原本是由于感受春风所致,若误用发汗法,会导致体内灼热、津液耗伤。此时阴阳脉象均呈现浮象,患者难以言语,身体沉重、嗜睡且呼吸伴有鼾声。若误用攻下法,会导致两眼直视、小便失禁或尿量减少;若被火疗所迫,则会出现发黄、抽搐和惊痫。治疗应以葳蕤汤为主,若兼见桂枝汤证与人参白虎汤证则合用。一旦误治(一逆)尚可拖延时日,若再次误治(再逆)则会导致死亡。
【注】冬季感受寒邪而未立即发病者,称为温病;若再感受春风,称为风温。风温病已有汗出,不可再用发汗法。如果误用发汗,会助长火邪,导致身体发热如火,自汗淋漓不止,言语困难,身体沉重、嗜睡,鼻息鼾鸣。风温病阴阳脉象俱浮,不可用攻下法。如果误用攻下,热邪陷入膀胱,耗尽津液,导致两眼直视、小便失禁或尿少。风湿热盛时,若误用火熏蒸强行发汗,火旺津亡,会导致发黄、抽搐和惊痫。风温病不可发汗攻下,主治方为葳蕤汤。若脉虚汗多,主治方为桂枝汤合人参白虎汤。“一逆引日再命终”意为:一次误治尚可延缓病情,若既发汗又攻下,或既攻下又用火疗,即为再次误治,这会加速死亡。
温疟是由于冬季感受风邪所致,寒气潜伏于骨髓中,到了春季邪气尚不能发出,遇到暑热煎熬骨髓、消耗肌肉形体,或者因为用力导致腠理开泄,邪气随汗同出从而产生热症。热势衰退后,气机恢复,随后出现寒战,其证候与温热病相同,治疗方法也相同。
【注】《内经》说:温疟得之于冬季中风,寒气藏于骨髓之中,到了春季阳气尚微弱,邪气不能自行排出,恰逢大暑天气,煎熬脑髓、消耗肌肉,腠理开泄,或者因用力劳作,邪气随汗同出,出则阴虚而阳盛,所以产生热症;热衰则气机复入,入则阳虚而阴盛,所以随后出现寒战。其证候与温热病相同,治疗也相同。
温热病复发并伤于湿邪,即成湿温病,症状包括身体沉重、胸膈满闷及头痛,胡言乱语、多汗且两小腿逆冷,治疗宜用白虎汤加苍术、茯苓。
【注】温热病再次伤于湿邪,称为湿温。其证候表现为身体沉重、胸膈满闷,头痛、胡言乱语,多汗且两小腿逆冷,适宜使用白虎汤加苍术、茯苓,这是同时治疗温与湿的方法。
Wind-warmth (Fengwen) originates from contracting the spring wind. If mistakenly treated with sweating methods, it causes burning heat and consumption of body fluids. The pulse at both Yin and Yang positions is floating, making speech difficult; the body feels heavy, there is excessive sleepiness, and snoring breaths are heard. If mistakenly treated with purgation, it leads to staring eyes and loss of bladder control or scanty urine. If subjected to fire therapy, jaundice, convulsions, and惊痫 (epileptic seizures) may occur. The primary treatment is Weirui Tang (Reed Rhizome Decoction); if accompanied by Guizhi Tang (Cinnamon Twig Decoction) and Renshen Baihu Tang (Ginseng White Tiger Decoction) patterns, they are combined. One error (one reversal) may prolong life, but two errors (two reversals) lead to death.
[Note] Those who contracted cold in winter without immediate illness are said to have Wenbing (Warm Disease); if they subsequently contract the spring wind, it is called Fengwen (Wind-Warmth). Fengwen presents with sweating and should not be treated with diaphoresis. If mistakenly sweated, it further aids the fire pathogen, causing body heat like fire, continuous spontaneous sweating, difficulty speaking, heaviness of the body, somnolence, and snoring respiration. In Fengwen, the pulses at both Yin and Yang positions are floating, so purgation is contraindicated. If mistakenly purged, heat sinks into the Bladder, exhausting body fluids, leading to staring eyes and loss of bladder control or scanty urination. When Wind-Damp-Heat is abundant, if mistakenly subjected to fire fumigation to force sweating, the fire flares up and fluids perish, causing jaundice, convulsions, and epileptic seizures. For Fengwen, neither sweating nor purging is indicated; the main formula is Weirui Tang. If the pulse is deficient and sweating is profuse, Guizhi Tang combined with Renshen Baihu Tang is used. "One reversal prolongs days, two reversals end life" means that one error may delay death, but if one both sweats and purges, or purges and then applies fire, it constitutes a second reversal, which accelerates the fatal outcome.
Wenmang (Warm Malaria) results from contracting wind in winter. Cold qi hides within the bone marrow. By spring, the pathogenic qi cannot emerge. When summer heat scorches the marrow and consumes muscle mass, or when physical exertion causes the couli (pores) to open, the pathogen exits with sweat, generating heat. As the heat declines, qi returns, leading to subsequent chills. The symptoms resemble those of Warm-Thermal diseases, and the treatment is the same.
[Note] The Classics state: "Warm malaria arises from winter wind-strike; cold qi hides in the bone marrow." By spring, Yang qi is still weak, so the pathogen cannot exit spontaneously. Encountering intense summer heat, it scorces the brain marrow and consumes muscles. The couli open due to heat or physical exertion, allowing the pathogen to exit with sweat. Exit leads to Yin deficiency and Yang excess, thus generating heat. Decline allows Qi to re-enter, leading to Yang deficiency and Yin excess, thus generating cold later. Its symptoms are identical to warm-thermal diseases, and its treatment is also the same.
When Warm disease recurs and is injured by Dampness, it becomes Shiwengang (Damp-Warmth). Symptoms include heavy body, chest fullness, headache, delirious speech, profuse sweating, and coldness in both lower legs. Treatment involves Baihu Tang (White Tiger Decoction) added with Cangzhu (Atractylodis Rhizoma) and Fuling (Poria).
[Note] When a Warm disease is re-injured by dampness, it is called Shiwengang (Damp-Warmth). Its manifestations include a heavy body, chest oppression, headache, delirium, profuse sweating, and coldness in the lower legs. It is appropriate to use Baihu Tang (White Tiger Decoction) augmented with Cangzhu (Atractylodis Rhizoma) and Fuling (Poria), employing a method that treats both Warmth and Dampness simultaneously.