庞曰∶胸膈痞闷,痰壅塞碍,脉得浮或滑,并宜瓜蒂散吐之。(方在厥阴证中。)产后六七日
内下泻,诸药不效,得此脉与吐之,泻立止。
下利日数十行,其脉反迟,寸口微滑,吐之则止。
庞曰∶虚家当吐而不敢吐之,宜以枳实散压气毒痰水,过日毒入胃,乃可微下之也。
诸四逆脉微弱虚细,或弦迟,虽中满闷,不可吐,宜橘皮汤、枳实散之类。(橘皮汤在和表证
中,枳实散在叙论中。)
不可吐而强吐之,气筑心即死矣。
烧针令其汗,针处被寒,核起而赤者,必发贲豚,气从少腹上撞者,灸其核上一壮,与桂枝加
桂汤。(桂枝汤内加桂枝足成一两一分,如前法煎之。)
少阴病,其人吐利,手足不逆,反发热,不死,灸少阴七壮。
下利,手足厥无脉,灸之不暖,反微喘者死。
伤寒脉促,手足厥逆,可灸之。
合灸不灸,令病患冷结,久而弥固,气冲心而死。微数之脉,慎不可灸,因火为邪,则为烦逆,
追虚逐实,血散脉中,火气虽微,内攻有力,焦骨伤筋,血难复也。
脉浮,当以汗解,而反灸之,邪无从去,因火而盛,病从腰以下,必当重而痹,此为火逆。若
欲自解,当先烦,烦乃有汗,随汗而解。何以知之?脉浮,故以知汗出而解。
脉浮热甚而灸之,此为实。实以虚治,因火而动,咽燥必唾血。
不当灸而误灸,令火邪入腹,干错五脏,重加烦而死。
庞安石说:胸膈部痞塞胀闷,痰涎壅盛阻滞,脉象呈现浮或滑的,都适宜用瓜蒂散催吐。(该方剂记载在厥阴病证章节中。)产后六七天内出现腹泻,各种药物无效,若诊得上述脉象并采用催吐法,腹泻立刻停止。
下利(腹泻)每天几十次,脉象反而迟缓,寸口脉微滑,采用催吐法即可止住。
庞安石说:体质虚弱的人应当催吐却不敢催吐的,适宜用枳实散压制气机、毒邪、痰饮和水湿,待过了一两天,毒邪进入胃中,才可以轻微地攻下。
各种四逆证的脉象微弱虚细,或者弦迟,虽然伴有腹部胀满闷痛,不可催吐,适宜用橘皮汤、枳实散之类的方剂。(橘皮汤记载在和表证章节中,枳实散记载在叙论章节中。)
不可催吐而强行催吐,会导致气逆冲击心脏而死亡。
烧针(温针灸)令其出汗,针孔处受寒,起核状红肿的,必定发作奔豚病,气从少腹上冲心胸的,在红肿的核上灸一壮,并给予桂枝加桂汤。(在桂枝汤基础上增加桂枝用量至一两一分,按照之前的方法煎煮。)
少阴病,患者呕吐下利,手足不逆冷,反而发热,不会死亡,灸少阴经穴位七壮。
伤寒脉促,手足厥逆,可以施灸。
应当灸而未灸,导致病患体内冷结,时间久了更加坚固,气逆冲心而死亡。脉象微数(细微且快),千万不可施灸,因为火邪成为致病因素,会导致烦乱逆乱,追补虚损的同时追逐实邪,血液散乱于脉中,火气虽然微弱,但内攻的力量强大,会焦枯骨骼损伤筋脉,血液难以恢复。
脉浮,应当以发汗法解表,却反而施灸,邪气无从排出,因火邪而亢盛,疾病表现在腰部以下,必定沉重且麻木,这称为火逆。如果想要自行缓解,应当先感到烦热,烦热之后才有汗出,随着汗出而病解。怎么知道呢?因为脉浮,所以知道是汗出而解。
Pang Anshi stated: When there is chest and diaphragm fullness and oppression, with phlegm-fluid obstructing the qi mechanism, and the pulse is floating or slippery, Guadi San (Melon Seed Powder) should be used to induce vomiting. (The formula is recorded in the Jueyin Syndrome chapter.) If diarrhea occurs within six or seven days postpartum and various medicines are ineffective, obtaining this type of pulse indicates that inducing vomiting will stop the diarrhea immediately.
If diarrhea occurs dozens of times a day, and the pulse is surprisingly slow, with the cunkou (radial artery at the wrist) slightly slippery, inducing vomiting will stop it.
Pang Anshi said: For patients with deficiency constitutions who require vomiting but dare not undergo it, Zhishi San (Immature Bitter Orange Powder) should be used to suppress qi stagnation, toxic pathogens, phlegm, and water retention. After a day or two, when the toxin enters the stomach, mild purgation may then be performed.
In cases of various Sini patterns (Cold Extremities), where the pulse is weak, thready, deficient, and fine, or wiry and slow, even if accompanied by abdominal fullness and oppression, vomiting must not be induced. Instead, formulas such as Ju Pi Tang (Tangerine Peel Decoction) or Zhishi San should be used. (Ju Pi Tang is recorded in the Harmonizing Exterior Syndrome chapter; Zhishi San is recorded in the General Discussion chapter.)
If vomiting is contraindicated but forced, qi rebellion striking the heart will result in death.
When moxibustion on needles (burning needles) is used to induce sweating, and the needle sites become cold, resulting in nodular redness, Ben Tun disease (Running Piglet syndrome) will inevitably occur. If qi rushes upward from the lower abdomen to strike the chest, one moxa cone should be applied directly on each red nodule, followed by the administration of Guizhi Jia Gui Tang (Cinnamon Twig Decoction with Added Cinnamon Twig). (This involves adding sufficient Guizhi [Cinnamon Twig] to the original Guizhi Tang to make one tael and one fen, decocted according to the previous method.)
In Shaoyin disease, if the patient experiences vomiting and diarrhea, but the hands and feet are not cold, and fever is present instead, death will not occur; moxibustion should be applied to the Shaoyin meridians for seven cones.
If diarrhea is accompanied by cold extremities and absence of pulse, and after moxibustion the extremities do not warm up, but slight panting develops, death ensues.
In Shanghan (Cold Damage), if the pulse is rapid and intermittent (Cu) and the hands and feet are cold, moxibustion may be applied.
Failure to apply moxibustion when indicated causes cold accumulation in the body, which becomes firmly entrenched over time; qi rebellion striking the heart leads to death. If the pulse is fine and rapid, moxibustion must strictly be avoided. Because fire pathogenic factors cause irritability and rebellion, chasing deficiency while pursuing excess scatters blood within the vessels. Although the fire energy is subtle, its internal attacking power is strong, leading to scorched bones and injured sinews, making blood recovery difficult.
When the pulse is floating, the exterior should be resolved through sweating. If moxibustion is mistakenly applied instead, the pathogen has no outlet to exit, and due to fire, the condition exacerbates. The lower body from the waist down will become heavy and numb; this is called Fire Rebellion (Huo Ni). If spontaneous resolution is desired, the patient will first feel irritability; after this irritability, sweating will occur, and the disease resolves with the sweat. How do we know this? Because the pulse is floating, we know it resolves via sweating.
If the pulse is floating with severe heat, and moxibustion is applied, this constitutes an Excess pattern. Treating an Excess pattern as Deficiency, combined with fire disturbance, causes dryness of the throat and expectoration of blood.
Moxibustion applied erroneously when contraindicated allows fire pathogens to enter the abdomen, disturbing the five zang organs, leading to severe irritability and death.