太阳病二日反躁反熨其背而大汗出火热入胃胃中水竭躁烦必发谵语十余日振栗自下利者此为欲解也故其汗从腰以下
不得汗欲小便不得反呕欲失溲足下恶风大便硬小盒饭数而反不数及大便已头卓然而痛其人足心必热谷气下流故也
太阳病皮毛被感表郁为热内尚无热俟其表热传胃日久失清乃见烦躁今二日之内方入阳明不应躁而反躁其胃阳素盛可
知乃不用清凉反熨其背而大汗出火炎就燥邪热入胃胃中水竭乃生烦躁燥热薰心必发谵语若十余日后微阴内复忽振栗而自
下利则胃热下泄此为欲解也方其熨背取汗火热蒸腾上虽热而下则寒故从腰以下绝无汗意外寒郁其内热故膀胱闭涩欲小便
而不得阳气升泄不根于水膀胱无约时欲失溲如此则小盒饭数而反不数者津液枯也水枯则大便干硬便干肠结胃热不得下达
故气逆作呕火热上逆故足下逆冷而恶风寒及振栗下利大便已行则谷气宣畅四达头痛而火从上散足热而阳从下达胃中燥热
解散无余缘谷气以便通而下流故也便通而头痛者如垆底壅塞火焰不升一通则火即上炎也
太阳病以火薰之不得汗其人必躁到经不解必清血名为火邪(清与圊同)
太阳病当以汗解乃以火薰之又不得汗内热愈增其人必躁到经尽之期当解而不解热伤血分必当圊血此名火邪也
脉浮宜以汗解用火灸之邪无从出因火而盛病从腰以下必重而痹名火逆也
脉浮宜以汗解乃用火灸之邪无从出因外火而更盛病从腰以下必重浊而痹塞此名火逆
太阳病发病两天,本不应烦躁,却反而出现烦躁。此时若用熨背法强行发汗,导致大汗淋漓,火热之邪随之入胃,致使胃中津液枯竭,患者会出现烦躁不安,必然发生胡言乱语(谵语)。若经过十余日,出现战栗并伴随自发性腹泻,这是病情即将解除的征兆。因此,如果出汗仅局限于腰部以上,而腰部以下无汗,想要小便却解不出,反而想呕吐,甚至出现大小便失禁,足底感觉恶风,大便干硬,虽然脉象数但实际并不快,等到大便排出时,头部突然感到疼痛,这是因为人体谷气向下流动,所以足心必然发热。
太阳病初期,皮毛受邪,表气郁滞而生热,体内尚无明显热邪。等待表热传入胃部,日久失去清肃,才会出现烦躁。现在才发病两天,邪气刚进入阳明经阶段,本不应烦躁却反而烦躁,可知其胃阳素来旺盛。此时不用清凉之法,反而用熨背法取汗,导致大汗出,火势炎上就燥,邪热入胃,胃中津液枯竭,从而产生烦躁;燥热熏蒸心神,必然发生谵语。若十余日后,微弱的阴气内复,忽然战栗并自下利,则胃热随之下泄,这是病情欲解的表现。当熨背取汗时,火热蒸腾,上部虽热但下部寒冷,所以腰部以下绝无汗出。外寒郁闭于内,导致膀胱气化不利,想要小便却解不出;阳气升散而无根,膀胱约束无力,想要大小便失禁。在这种情况下,虽然想频繁小便却反而尿少,是因为津液枯槁所致。水枯则大便干硬,肠结不通,胃热无法下达,故气逆作呕;火热上逆,故足底逆冷而恶风寒。等到战栗下利、大便通行后,谷气宣畅通达,头痛且火邪从上消散,足部发热且阳气从下通达,胃中燥热解散无余,这是由于谷气因大便通畅而下流的原因。大便通畅后出现的头痛,就像炉灶底部堵塞,火焰不能上升,一旦疏通,火气即向上炎升一样。
太阳病用火熏法治疗,若不得汗出,患者必然烦躁。若到经气传变周期结束仍未解除,必然会损伤血分而出血,这称为“火邪”(“清”与“圊”同义,指排便或出血)。
太阳病应当以发汗法解表,却用火熏法,又不得汗出,导致内热更加增加,患者必然烦躁。到了经气尽的时期,本该解除而未解除,热邪损伤血分,必然出现便血,这称为“火邪”。
脉浮,适宜用发汗法解表,若用火灸法,邪气无从外出,反而因火助长病势,导致身体腰部以下必定沉重且麻木不仁,这称为“火逆”。
脉浮,适宜用发汗法解表,却用火灸法,邪气无从外出,因外火相助而病势更盛,导致身体腰部以下必定沉重浑浊且痹塞不通,这称为“火逆”。
Taiyang disease (Disease of the Taiyang channel) for two days should not involve restlessness, yet restlessness occurs. If the back is ironed to force sweating, causing profuse perspiration, the pathogenic fire enters the Stomach, depleting stomach fluids. The patient will experience irritability and likely develop delirious speech (Zhenyu). After more than ten days, if chills occur followed by spontaneous diarrhea, this indicates the impending resolution of the disease. Therefore, if sweating is confined only above the waist, with no sweat below, accompanied by difficulty urinating, vomiting, incontinence, aversion to wind at the soles of the feet, hard stools, a rapid pulse that is actually not fast, and sudden headache upon defecation, it is because the grain qi flows downward, causing heat in the soles of the feet.
In early Taiyang disease, the skin and hair are affected, causing exterior constraint and heat, while interior heat is absent. Restlessness appears only after exterior heat transmits to the Stomach over time. At day two, when the pathogen just enters the Yangming stage, restlessness should not occur; its occurrence suggests inherent excess of Stomach Yang. Instead of using cooling methods, ironing the back causes profuse sweating. Fire rises following dryness, pathogenic heat enters the Stomach, depleting fluids, leading to irritability. Dry-heat steams the Heart Spirit, causing delirium. If, after ten-plus days, slight Yin recovers internally, sudden chills and spontaneous diarrhea indicate the downward discharge of Stomach heat, signaling resolution. During ironing, heat steams upward, leaving the lower body cold, hence no sweat below the waist. Exterior cold constrains interior heat, obstructing Bladder Qi transformation, causing urinary retention. Yang Qi ascends without root, losing Bladder control, leading to incontinence. Although frequent urination is desired, urine output is low due to fluid depletion. Dehydrated fluids lead to hard stools and intestinal blockage, preventing Stomach heat from descending, causing rebellious Qi and vomiting. Fire rebels upward, causing cold feet and aversion to wind. Once chills, diarrhea, and bowel movement occur, Grain Qi circulates freely. Headache resolves as fire dissipates upward, and foot warmth indicates Yang descending. Stomach dry-heat is resolved because Grain Qi flows downward via bowel movement. The headache after bowel movement resembles a blocked furnace: once cleared, fire flares upward.
If Taiyang disease is treated with moxibustion or fumigation without inducing sweat, the patient becomes restless. If unresolved by the end of the meridian cycle, heat injures the Blood level, causing bleeding, known as "Fire Pathogen" (Qing refers to purging/bleeding).
Taiyang disease should be treated with diaphoresis. Using fire fumigation without sweating increases interior heat, causing restlessness. When the meridian cycle ends without resolution, heat injures the blood level, causing hematochezia, known as "Fire Pathogen."
A floating pulse indicates treatment with diaphoresis. Using moxibustion prevents pathogen exit and exacerbates the condition due to fire, causing heaviness and numbness below the waist, known as "Fire Reversal" (Huo Ni).
A floating pulse requires diaphoresis. Using moxibustion traps the pathogen and intensifies the disease with external fire, causing heavy obstruction and bi-syndrome below the waist, known as "Fire Reversal."