伤寒六七日无大热其人烦躁者此为阳去入阴也
伤寒六七日经尽之期外无大热而其人烦躁者此为阳去而入二阴之脏也脏阴旺则阳气离根而失归必至烦躁
妇人中风发热恶寒经水适来得之七八日热除而脉迟身凉胸胁下满如结胸状谵语者此为热入血室当刺期门随其实而泄
之
妇人中风发热恶寒而值经水适来之时及得病七八日后发热已除而脉迟身凉是当解矣乃胸胁之下胀满如结胸之状而作
谵语者此为热入血室热不在上而在下也当刺厥阴之期门随其经中之实处而泄之以肝主藏血肝胆同气此与阳明刺期门章义
同
妇人中风七八日续得寒热发作有时经水适断者此为热入血室其血必结故使如疟状发作有时小柴胡汤主之
妇人中风七八日后续得寒热往来发作有时之证而值经水适断之时者此为热入血室其血必当瘀结热结血分少阳之经气
不得外达阴阳交争互相束闭故使寒热如疟发作有时也小柴胡汤发少阳之经邪热去则血可自下不下然后用抵当攻之上章因
经水适来而热入是血实之时此因经水适断而热入是血虚之时实宜清泄虚宜凉补
妇人伤寒发热经水适来昼日明了暮则谵语如见鬼状者此为热入血室无犯胃气及上二焦则自愈
妇人伤寒发热而值经水适来之时昼日清白明了暮则谵语如见鬼状者此为热入血室以血为阴夜则阳气潜入阴分血热发
作故谵妄不明也热邪在下治之勿犯中焦胃气及上焦清气必自愈也
伤寒病经过六七天,体表没有明显高热,但患者出现烦躁不安的症状,这是阳气由表入里的表现,即阳证转入阴证。
伤寒病到了六七天,这是经气运行完毕的时期,体表没有明显高热,而患者却感到烦躁,这是阳气离开体表进入太阴、少阴等阴脏的表现。当阴脏的阴气旺盛时,阳气就会脱离根基而失去归依,必然导致烦躁。
妇女患中风病,出现发热、恶寒的症状,此时正值月经来潮。患病七八天后,发热消退,脉搏变慢,身体转凉,但胸胁部胀满,症状类似结胸证,并伴有说胡话(谵语)的情况,这是热邪陷入血室所致。应当针刺期门穴,根据实证的情况进行泻法治疗。
妇女患中风病,出现发热、恶寒,且正值月经来潮之时。患病七八日后,发热已除,脉搏迟缓,身体凉爽,这通常是病情即将解除的迹象。然而,如果胸胁之下胀满,感觉像结胸证一样,并且出现说胡话的症状,这是热邪陷入血室。热邪不在上部而在下部。应当针刺厥阴肝经的期门穴,顺着经脉中实邪所在之处进行泄热。因为肝脏主藏血,肝胆互为表里、气机相通,所以这与阳明病篇中关于刺期门治疗的原理相同。
妇女患中风病,过了七八天,随后出现忽冷忽热的症状,且有固定的发作时间,此时月经恰好停止。这是热邪陷入血室,血液必然瘀结,所以导致症状像疟疾一样定时发作。应当用小柴胡汤为主进行治疗。
妇女患中风病,过了七八天,随后出现寒热往来、定时发作的症状,且正值月经刚停止的时候,这是热邪陷入血室。此时血液必然瘀结,热邪郁结在血分,导致少阳经的气机不能向外通达,阴阳之气相互交争、互相束缚闭阻,因此出现像疟疾一样的寒热症状,且有固定发作时间。小柴胡汤可以发散少阳经的邪热,热邪去除后,血液自然下行;如果不行,然后再使用抵当汤攻逐瘀血。上一章是因为月经刚来,热邪趁虚而入,属于血实的阶段,适宜用清泄的方法;这一章是因为月经刚断,热邪陷入,属于血虚的阶段,适宜用清凉补益的方法。
妇女患伤寒病,出现发热,此时正值月经来潮。白天神志清楚,晚上却说胡话,好像看见鬼怪一样,这是热邪陷入血室。治疗时不要损伤胃气,也不要干扰上焦和中焦,疾病自然会痊愈。
妇女患伤寒病,出现发热,且正值月经来潮。白天神志清醒明白,晚上却说胡话,好像看见鬼怪一样,这是热邪陷入血室。因为血属阴,夜晚阳气潜入阴分,血分中的热邪发作,所以导致神志狂妄不清。热邪在下部,治疗时切勿侵犯中焦的胃气和上焦的清阳之气,疾病必能自愈。
Taiyang disease (disease of the Taiyang channel) persists for six or seven days, with no significant heat on the exterior, yet the patient is restless and irritable. This indicates that Yang has departed [the exterior] to enter Yin, signifying a transition from a Yang syndrome to a Yin syndrome.
When Taiyang disease reaches the sixth or seventh day, which marks the completion of the meridian cycle, there is no significant heat on the exterior, but the patient experiences restlessness. This signifies that Yang Qi has departed from the exterior and entered the Yin organs (such as the Taiyin and Shaoyin). When Yin Qi within the organs becomes vigorous, Yang Qi loses its root and fails to return, inevitably leading to restlessness.
A woman suffering from Wind-stroke (a type of exogenous febrile disease caused by wind pathogen) presents with fever and aversion to cold. At this time, her menses have just begun. Seven or eight days after contracting the illness, the fever subsides, the pulse becomes slow, and the body cools down. However, she experiences fullness and distension in the chest and hypochondrium, resembling the presentation of Jie Xiong (Chest Binding), accompanied by delirium. This is Heat entering the Blood Chamber (Xue Shi). The Qimen acupoint should be needled, applying the reducing method according to the excess condition.
In a woman with Wind-stroke presenting with fever and aversion to cold, coinciding with the onset of menstruation, if seven or eight days later the fever has ceased, the pulse is slow, and the body is cool—indicating an impending resolution—if she nevertheless experiences distension and fullness below the chest and hypochondrium, similar to Chest Binding, along with delirium, this indicates Heat entering the Blood Chamber. The heat is not in the upper part but in the lower part. The Qimen acupoint of the Jueyin Liver channel should be needled to drain the excess along the channel. Since the Liver stores Blood, and the Liver and Gallbladder share the same Qi (being interior-exterior partners), this principle is consistent with the treatment involving needling Qimen described in the chapter on Yangming disease.
A woman with Wind-stroke, after seven or eight days, subsequently develops alternating chills and fever with regular periodicity, while her menses have just stopped. This is Heat entering the Blood Chamber; the blood must be congealed, causing symptoms resembling malaria with regular paroxysms. Xiao Chai Hu Tang (Minor Bupleurum Decoction) should be administered as the primary formula.
After seven or eight days of Wind-stroke, if the patient subsequently develops alternating chills and fever with regular timing, coinciding with the cessation of menstruation, this indicates Heat entering the Blood Chamber. The blood will likely become stasis-bound. Heat constrained in the blood compartment prevents the Qi mechanism of the Shaoyang channel from reaching the exterior. Yin and Yang contend and bind each other, resulting in alternating chills and fever resembling malaria with regular intervals. Xiao Chai Hu Tang disperses the pathogenic heat of the Shaoyang channel. Once the heat is cleared, the blood will flow naturally; if it does not, then Di Dang Tang (Ephedra and Ground Beetle Decoction) should be used to attack the stasis. In the previous case, Heat entered because menses had just started, representing a state of Blood Excess, suitable for clearing and draining. In this case, Heat entered because menses had just stopped, representing a state of Blood Deficiency, suitable for cooling and tonifying.
A woman with Cold Damage (Shang Han) presents with fever, coinciding with the onset of menstruation. During the day, her mind is clear and lucid; at night, she becomes delirious, seeing visions as if ghosts were present. This is Heat entering the Blood Chamber. Do not injure the Stomach Qi, nor disturb the Upper and Middle Jiao (Triple Burners); the condition will resolve spontaneously.
In a woman with Cold Damage presenting with fever, coinciding with the onset of menstruation, she is clear-minded during the day but delirious at night, seeing visions as if ghosts were present. This is Heat entering the Blood Chamber. Since Blood is Yin, and Yang Qi enters the Yin compartments at night, the heat in the Blood compartment flares up, causing delirium and confusion. As the pathogenic heat is located in the lower part, treatment must avoid violating the Stomach Qi of the Middle Jiao and the Clear Qi of the Upper Jiao; the disease will heal itself.