脉浮热甚反灸之此为实实以虚治因火而动故咽燥吐血
脉浮热甚当汗之以泄其热反灸之此为实证实证而用灸是实以虚治也内之实热因外火而大动必伤阴气故咽燥而吐血
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
微数之脉营血虚亏慎不可灸误灸而因火为邪则为烦躁而气逆追阴气之已虚逐阳火之原实因令血散脉中耗亡失守一灸
之火虽微而其煎熬内攻则甚有力焦骨伤筋日就枯槁营血消烁终难复旧也
太阴以湿土主令阴盛之人病在太阳表郁则湿动然不经误治则胃阳未亏湿气之作犹俟渐成及夫汗下温针阳亡阴旺湿邪
勃兴土败水侮危证叠出防微杜渐之法不可不亟讲也
太阳病发汗后大汗出胃中干躁烦不得眠欲得饮水者少少与之令胃气和则愈(此太阳入阳明去路将成白虎证者)若脉
浮小便不利热微消渴者五苓散主之(方在太阳四十一)
发汗后阳盛之人阴亡土燥则入阳明而成白虎证阴盛之人阳亡土湿则入太阴而成五苓证如汗后胃中干燥烦不得眠欲得
饮水此将来之人参白虎证也宜少少与饮以在大汗之后阳气新虚也设燥热已甚少水不救盛火则用白虎若燥热未甚得少水和
胃则烦渴自愈无事白虎也若汗后脉浮小便不利热微消渴则太阴之象已见端倪宜以五苓燥土而行水盖阳格于外表证未解是
以脉浮湿动于内木气不达是以小便不利木郁风动耗伤肺津是以消渴此之消渴消少水而频饮不能大消以其湿盛而热微也
脉象浮而发热严重,反而使用艾灸治疗,这是实证误用补法(实实),因火邪扰动导致咽喉干燥、吐血。
脉象浮而发热严重,应当通过发汗来宣泄其热邪;反而使用艾灸治疗,这是将实证当作虚证来治。体内的实热因外部火邪的激发而剧烈动荡,必然损伤阴气,所以出现咽喉干燥和吐血的症状。
脉象微细且数,绝不可使用艾灸。因为火邪会成为致病因素,导致烦躁和气逆;艾灸会进一步耗伤本已虚弱的阴气,追逐并加剧原本就实的阳火,导致血液在脉中散乱。虽然火气看似微弱,但其向内攻伐的力量很强,会导致骨骼枯焦、筋脉受损,血液难以恢复。
太阴脾土主司湿气,阴盛体质的人如果患太阳表证,郁滞则会引起湿气发动。然而,如果没有经过误治,胃阳就不会亏损,湿气的形成还需要逐渐积累。一旦经过发汗、泻下或温针等错误治疗,导致阳气亡失、阴寒旺盛,湿邪便会勃然兴起,脾土败坏,水气反侮,各种危重证候接连出现。因此,防微杜渐的方法不可不紧急研讨。
太阳病经过发汗后,如果大汗出,导致胃中干燥、烦躁、无法入睡,想要喝水,应该少量多次地给予饮水,使胃气调和即可痊愈。(这种情况是太阳病转入阳明病,即将形成白虎汤证的阶段)。如果脉象浮,小便不利,发热轻微但有消渴症状,则主治方剂为五苓散。(方剂见太阳篇第四十一节)。
发汗后,阳气偏盛的人,阴液亡失,脾胃燥热,则会转入阳明病而形成白虎汤证;阴气偏盛的人,阳气亡失,脾胃湿困,则会转入太阴病而形成五苓散证。如果在发汗后出现胃中干燥、烦躁、无法入睡、想要饮水的情况,这是将来可能发展为白虎加人参汤证的先兆。适宜少量多次给予饮水,这是因为在大汗之后,阳气刚刚虚弱。假设燥热已经很严重,少量饮水无法挽救旺盛的火势,则应使用白虎汤;如果燥热尚不严重,通过少量饮水调和胃气,那么烦躁口渴自然会自愈,无需使用白虎汤。如果在发汗后出现脉浮、小便不利、发热轻微、消渴的症状,则是太阴病的迹象已经显现。适宜使用五苓散来燥湿健脾并利水。这是因为阳气被格拒于体表,表证未解,所以脉象浮;湿气在体内发动,肝木之气不达,所以小便不利;肝木郁结化风,耗伤肺津,所以出现消渴。这里的“消渴”是指喝少量的水却频繁饮用,并不能真正消除口渴,这是因为湿气盛而热邪轻微的缘故。
The pulse is floating and the heat is severe; to apply moxibustion in this case constitutes treating a excess syndrome as deficiency (shí shí), causing fire pathogenic factors to disturb the body, resulting in dry throat and hematemesis.
When the pulse is floating and heat is severe, sweating should be employed to vent the heat. Applying moxibustion instead treats an excess syndrome as a deficiency syndrome. The internal excess heat, agitated by external fire, severely damages Yin Qi, leading to dry throat and hematemesis.
A pulse that is fine and rapid must never be treated with moxibustion. Fire becomes a pathogenic factor, causing irritability and rebellious Qi. Moxibustion pursues the already deficient Yin and chases the originally excess Yang, scattering blood within the vessels. Although the fire Qi seems weak, its internal attack is powerful, scorching bones and damaging sinews, making blood recovery difficult.
Taiyin Spleen Earth governs dampness. In individuals with Yin excess, if they contract a Taiyang exterior constraint, dampness may stir. However, without mismanagement, Stomach Yang remains intact, and dampness formation requires gradual accumulation. Once mistreated via sweating, purging, or warm needle therapy, Yang collapses while Yin flourishes, causing damp pathogens to rise vigorously. Spleen Earth fails, Water insults [the Spleen], and critical syndromes emerge. Therefore, methods for preventing disease progression from subtle signs must be urgently studied.
After Taiyang disease is treated with sweating, if profuse sweating occurs, causing dryness in the Stomach, irritability, insomnia, and thirst, water should be given in small amounts frequently to harmonize Stomach Qi, which leads to recovery. (This represents the transition from Taiyang to Yangming, potentially forming a Baihu Tang syndrome). If the pulse is floating, urination is difficult, heat is slight, but thirst is prominent, Wuling San (Five-Ingredient Powder with Poria) is the primary formula. (Formula found in Taiyang Section 41).
After sweating, individuals with Yang excess lose Yin fluids and develop Spleen-Stomach dryness, transitioning into Yangming and forming a Baihu Tang syndrome. Individuals with Yin excess lose Yang Qi and develop Spleen-Stomach dampness, transitioning into Taiyin and forming a Wuling San syndrome. Symptoms of Stomach dryness, irritability, insomnia, and thirst after sweating indicate a precursor to a future Baizhu Jia Renshen Tang syndrome. It is appropriate to give small amounts of water because Yang Qi is newly deficient after profuse sweating. If dryness and heat are severe and small amounts of water cannot control the blazing fire, Baihu Tang should be used. If dryness and heat are not severe, harmonizing the Stomach with small amounts of water will resolve irritability and thirst naturally, without needing Baihu Tang. If after sweating the pulse is floating, urination is difficult, heat is slight, and thirst is present, signs of a Taiyin syndrome are emerging. Wuling Tang should be used to dry dampness and promote water metabolism. This is because Yang is constrained at the exterior with unresolved exterior symptoms, hence the floating pulse; dampness stirs internally obstructing Liver Wood Qi, hence difficulty in urination; Liver Wood stagnation generates wind, consuming Lung Jin (fluids), hence thirst. This "thirst" involves drinking small amounts frequently without relief, due to abundant dampness and slight heat.