(失汗失下蓄热而成吐血亦或误汗误下所致)
凡服桂枝汤吐者。其后必吐脓血。(黄芩汤)咽痛。吐血。面赤斑斑如锦纹。为阳毒。(
升
墨汁)
(便脓血皆是传经热邪或与微凉或用疏导阳症血色鲜红者易治阴症血色如猪肝
迟而有力者可治无力者难治凡下血脉小者生身热脉大者多死)
阳明下血谵语。夜则见鬼。为热入血室。(小柴胡汤加当归生地丹皮)少阴下利脓血。(
桃花汤)色紫黑。(理中汤主之)
(当汗不汗则为血结胸腹硬满手按则痛若小便不利乃水与气也若小便自利为有蓄
血许学士云蓄血在上其人喜忘蓄血在下其人如狂屎血身黄必蓄血)
太阳不解。热结膀胱。其人如狂。(桃仁承气汤)阳明病喜忘。大便黑为蓄血。在上。(
犀角地黄汤)在中。(桃仁承气汤)在下。(抵当汤)
(邪气传里先自胸而胁以次入腹也故胸满多带表症胁满多带半表
半里腹满多里症少腹满非溺即血也盖身半以上同天之阳身半以下同地之阴故在上满者无形之气也
在下满者有形之物也在上者因而越之故胸满宜吐在下者引而竭之故腹满宜下俱有阴阳之辨不
可不察)
下后脉促胸满。(桂枝去芍药汤)太阳与阳明合病。喘而胸满。(麻黄汤)汗下后。烦热胸
满。(栀子豉汤)胸满。气上冲喉。不得息者。此胸中有寒痰。(瓜蒂散)胸满胁痛。(小柴胡汤)太
阳不解。传入少阳。胁下硬满。干呕。寒热。脉沉紧。(小柴胡汤)太阳下利。呕逆。汗出。
头痛。胸胁硬满。不恶寒。表解里未和也。(十枣汤)胸胁腹满。唇青厥冷。脉沉细此生冷伤
脾。(理中汤去参术加香附)胁下素有痞。连在脐旁。痛引少腹。入阴筋者。名藏结。死。腹
满不减。为里实。(大柴胡汤)腹满时减。为里虚。(理中汤加木香浓朴)太阴误下。腹满痛。
(桂枝芍药汤)痛甚。(桂枝大黄汤)阳明潮热。谵渴喘秘满。(大柴胡汤)大实大满。(承气汤)
哕而腹满。小便难。(小柴胡加茯苓)三阳合病。腹满。身痛。难转侧。谵语。口中不仁。(
小柴胡汤)少阴六七日不大便。腹满胀痛。土不胜水。漉漉有声。(小半夏茯苓汤加桂)腹满
身痛。(先以四逆汤温里后以桂枝汤攻表)
小腹痛。小水自利。膀胱血结。其人如狂。(桃仁承气汤)太阴身黄。小腹满。小便难。
(五苓散)阴寒。小腹满痛。(茱萸四逆汤甚者灸关元)厥冷。脉沉小。腹满痛。冷结膀胱。(四
逆汤)生姜捣去汁。炒热揉熨。或满或痛。或痰或食。或寒或气。俱用此法。神良。
(因失于发汗或失于攻下,导致热邪蓄积而引发吐血;也有因误用发汗或误用攻下法所导致的。)
凡是服用桂枝汤后出现呕吐的,其后必定会吐出脓血。(可用黄芩汤治疗)咽痛、吐血、面部出现如锦纹般的红斑,这是阳毒证。(可用升麻和墨汁治疗)
(大便带脓血,都是传经而来的热邪所致。或用微凉之法,或用疏导之法。阳证血色鲜红者容易治疗;阴证血色像猪肝一样暗红,脉象迟而有力者可治,脉无力者难治。凡是大便下血,脉象细小的能生,身体发热且脉象大的多死亡。)
阳明病下血并伴有谵语,夜间看见鬼怪,这是热入血室证。(可用小柴胡汤加当归、生地、丹皮治疗)少阴病下利脓血。(可用桃花汤治疗)血色紫黑。(可用理中汤主治)
(应当发汗而未发汗,则形成血结胸,腹部硬满,手按则疼痛。如果小便不利,那是水饮与气滞;如果小便自利,则是内有蓄血。许学士说:蓄血在上部的人喜欢健忘;蓄血在下部的人神志如狂。排出瘀血,身体发黄,必定是蓄血证。)
太阳病不解,热邪结于膀胱,其人神志如狂。(可用桃仁承气汤治疗)阳明病喜欢健忘,大便黑色,这是蓄血证。蓄血在上部的。(可用犀角地黄汤治疗)在中部的。(可用桃仁承气汤治疗)在下部的。(可用抵当汤治疗)
(邪气传入体内,先从胸部传到胁部,再依次进入腹部。所以胸满多带有表证,胁满多带有半表半里证,腹满多属里证,少腹满要么是小便问题要么是瘀血问题。大概上半身同属于天之阳,下半身同属于地之阴。所以在上部的满是无形之气,在下部的满是形之物。在上部的应当用涌吐法使其越出,所以胸满宜用吐法;在下部的应当用疏导法使其竭尽,所以腹满宜用下法。这里都有阴阳的区别,不可不仔细考察。)
攻下之后脉象急促、胸满。(可用桂枝去芍药汤治疗)太阳病与阳明病合病,气喘且胸满。(可用麻黄汤治疗)发汗和攻下之后,烦热胸满。(可用栀子豉汤治疗)胸满,气向上冲至喉咙,呼吸不畅,这是胸中有寒痰。(可用瓜蒂散治疗)胸满胁痛。(可用小柴胡汤治疗)太阳病不解,传入少阳,胁下硬满,干呕,寒热往来,脉沉紧。(可用小柴胡汤治疗)太阳病下利,呕逆,出汗,头痛,胸胁硬满,不恶寒,这是表证已解但里气未和。(可用十枣汤治疗)胸胁腹满,嘴唇青紫,四肢厥冷,脉沉细,这是生冷食物损伤了脾脏。(可用理中汤去掉人参、白术,加入香附治疗)胁下素有痞块,连在脐旁,疼痛牵引少腹,甚至进入阴筋,名叫藏结,预后不良,致死。腹部胀满持续不减,这是里实证。(可用大柴胡汤治疗)腹部胀满有时减轻,这是里虚证。(可用理中汤加入木香、厚朴治疗)太阴病误用攻下,腹部胀满疼痛。(可用桂枝芍药汤治疗)疼痛剧烈的。(可用桂枝大黄汤治疗)阳明病潮热,谵语,口渴,气喘,便秘,腹满。(可用大柴胡汤治疗)大实大满。(可用承气汤治疗)呃逆且腹满,小便困难。(可用小柴胡汤加入茯苓治疗)三阳合病,腹满,身体疼痛,难以转侧,谵语,口中感觉麻木不仁。(可用小柴胡汤治疗)少阴病六七天不大便,腹部胀满疼痛,土不胜水,肠鸣漉漉有声。(可用小半夏茯苓汤加入桂枝治疗)腹满身痛。(先用四逆汤温里,后用桂枝汤攻表)
小腹疼痛,小便自利,这是膀胱血结,其人神志如狂。(可用桃仁承气汤治疗)太阴病身黄,小腹满,小便困难。(可用五苓散治疗)阴寒证,小腹满痛。(可用茱萸四逆汤,严重的灸关元穴)四肢厥冷,脉沉小,腹满痛,冷结膀胱。(可用四逆汤治疗)生姜捣烂取汁,炒热揉熨患处。无论是胀满还是疼痛,无论是痰湿还是食积,无论是寒邪还是气滞,都使用这种方法,效果神奇良好。
(Bleeding from the nose or vomiting blood caused by heat accumulation due to failure to sweat or failure to purge; also caused by erroneous sweating or purging.)
Those who vomit after taking Guizhi Tang (Cinnamon Twig Decoction) will subsequently vomit pus and blood. (Treat with Huangqin Tang, Scutellaria Decoction). Sore throat, hematemesis, and mottled red spots on the face like brocade patterns indicate Yang Du (Yang Toxin). (Treat with Shengma, Cimicifugae Rhizoma, and ink).
(Dysentery with pus and blood is all caused by heat pathogens transmitted through the meridians. Treatment may involve mild cooling or guiding methods. In Yang syndromes, fresh red blood indicates an easier prognosis; in Yin syndromes, dark red blood resembling pig liver suggests a difficult prognosis if the pulse is weak, but treatable if slow and forceful. Generally, for lower gastrointestinal bleeding, a fine pulse indicates survival, while fever with a large pulse often leads to death.)
Yangming disease with lower gastrointestinal bleeding accompanied by delirium, seeing ghosts at night, indicates Heat Entering the Blood Chamber. (Treat with Xiaochaihu Tang, Minor Bupleurum Decoction, plus Danggui, Radix Angelicae Sinensis, Shengdi, Rehmanniae Radix Preparata, and Danpi, Moutan Cortex). Shaoyin disease with dysentery of pus and blood. (Treat with Taohua Tang, Peach Blossom Decoction). Purple-black color. (Treat with Lizhong Tang, Regulate the Middle Decoction).
(Failure to sweat when indicated leads to Blood Stasis Chest Syndrome, characterized by abdominal hardness and fullness, painful upon pressure. If urination is difficult, it is water and qi stagnation; if urination is normal, there is Blood Accumulation. Scholar Xu stated: Blood accumulation in the upper part causes forgetfulness; in the lower part, it causes mania-like behavior. Passage of bloody stool and jaundice confirm Blood Accumulation.)
Taiyang disease unresolved, with heat binding in the Bladder, results in mania-like behavior. (Treat with Tao Ren Cheng Qi Tang, Peach Kernel Cathartic Decoction). Yangming disease with forgetfulness and black stools indicates Blood Accumulation. For accumulation in the upper part. (Treat with Xi Jiao Di Huang Tang, Rhinoceros Horn and Rehmannia Decoction). For accumulation in the middle part. (Treat with Tao Ren Cheng Qi Tang). For accumulation in the lower part. (Treat with Di Dang Tang, Expectant Decoction).
(When pathogens transmit inward, they move from the chest to the hypochondrium, then sequentially to the abdomen. Thus, chest fullness often carries exterior symptoms; hypochondriac fullness often carries half-exterior/half-interior symptoms; abdominal fullness often indicates interior symptoms; suprapubic fullness relates either to urination or blood. Generally, the upper half of the body corresponds to Heaven's Yang, and the lower half to Earth's Yin. Therefore, fullness in the upper part is formless Qi, while fullness in the lower part is formed matter. Fullness above should be resolved by emesis ("yielding upwards"), so chest fullness is treated with emetics; fullness below should be drained downwards, so abdominal fullness is treated with purgatives. There are distinctions between Yin and Yang here that must not be overlooked.)
After purging, if the pulse is rapid and there is chest fullness. (Treat with Guizhi Qu Shaoyao Tang, Cinnamon Twig Decoction without Paeonia). Taiyang and Yangming combined disease with wheezing and chest fullness. (Treat with Mahuang Tang, Ephedra Decoction). After sweating and purging, restlessness, heat, and chest fullness. (Treat with Zhizi Chi Tang, Gardenia and Fermented Soybean Decoction). Chest fullness with Qi rushing up to the throat and dyspnea indicates Cold Phlegm in the Chest. (Treat with Gou Ti San, Melon Spicule Powder). Chest fullness and hypochondriac pain. (Treat with Xiaochaihu Tang). Taiyang disease unresolved, transmitting to Shaoyang, with hardness and fullness under the hypochondrium, dry retching, alternating chills and fever, and a deep-tight pulse. (Treat with Xiaochaihu Tang). Taiyang disease with dysentery, retching, sweating, headache, hardness and fullness in the chest and hypochondrium, without aversion to cold, indicating the exterior is resolved but the interior is not harmonized. (Treat with Shizao Tang, Ten Jujube Decoction). Chest, hypochondriac, and abdominal fullness, cyanotic lips, cold extremities, and a deep-thin pulse indicate Cold-Raw Food damaging the Spleen. (Treat with Lizhong Tang, removing Renshen and Baizhu, adding Xiangfu, Cyperi Rhizoma). A pre-existing mass under the hypochondrium connected to the side of the umbilicus, pain radiating to the lower abdomen and entering the genital tendons, is named Zang Jie (Visceral Knotting), which is fatal. Abdominal fullness that does not decrease indicates Interior Excess. (Treat with Da Chaihu Tang, Greater Bupleurum Decoction). Abdominal fullness that decreases intermittently indicates Interior Deficiency. (Treat with Lizhong Tang, adding Muxiang, Aucklandiae Radix and Houpo, Magnolia Bark). Taiyin disease erroneously purged, resulting in abdominal fullness and pain. (Treat with Guizhi Shaoyao Tang, Cinnamon Twig and Paeonia Decoction). Severe pain. (Treat with Guizhi Dahuang Tang, Cinnamon Twig and Rheum Decoction). Yangming tidal fever, delirium, thirst, wheezing, constipation, and abdominal fullness. (Treat with Da Chaihu Tang). Major excess and fullness. (Treat with Chengqi Tang, Cathartic Decoctions). Hiccups with abdominal fullness and difficult urination. (Treat with Xiaochaihu Tang, adding Fuling, Poria). Combined disease of the Three Yang, with abdominal fullness, body pain, difficulty turning the body, delirium, and numbness in the mouth. (Treat with Xiaochaihu Tang). Shaoyin disease for six or seven days without bowel movement, abdominal fullness and distending pain, Earth failing to control Water, with gurgling sounds. (Treat with Xiao Banxia Fuling Tang, Minor Pinellia and Poria Decoction, adding Guizhi, Cinnamon Twig). Abdominal fullness and body pain. (First warm the interior with Sini Tang, Frozen Extremity Decoction, then attack the exterior with Guizhi Tang).
Lower abdominal pain with normal urination indicates Bladder Blood Stasis, with mania-like behavior. (Treat with Tao Ren Cheng Qi Tang). Taiyin disease with jaundice, lower abdominal fullness, and difficult urination. (Treat with Wuling San, Five-Ingredient Powder with Poria). Yin-Cold syndrome with lower abdominal fullness and pain. (Treat with Zhuyu Sini Tang, Cornus and Frozen Extremity Decoction; severe cases moxa Guanyuan CV-4). Cold extremities, deep-thin pulse, abdominal fullness and pain, Cold Binding in the Bladder. (Treat with Sini Tang). Ginger, mashed and juice removed, stir-fried hot and rubbed/warmed on the affected area. Whether due to fullness or pain, phlegm or food retention, cold or Qi stagnation, this method is universally applicable and highly effective.