(天行疫毒邪犯高巅分别三阳经而施治)
发于项上。并脑后目后赤肿。太阳也。(荆芥败毒散)发于鼻额。以至面目闭。阳明也。
(通圣消毒散)发于耳之上下前后。并头角者。少阳也。(小柴胡汤加荆芥芩连)三阳俱受邪。(普
济消毒饮)
(汗后热名曰风温脉浮自汗身重多眠鼻鼾不语此先受温热复感于风也)
风温忌汗。(葳蕤汤热加知母干葛汤加栝蒌)身重。汗出。(防己汤)
(身重痛小便不利与太阳伤寒相似但脉沉细为异耳)
一身尽痛。日晡发热。风湿也。(麻黄杏仁苡仁甘草汤)头汗出。背强。欲得被覆向火者
。寒湿。(理中汤合胃苓汤)关节痛而烦。脉沉细。当利小便。(甘草附子汤)
(先伤于湿复伤于暑名曰湿温腹满目痛多汗妄言足冷寸脉浮弱尺小而急)
湿温。(白虎加苍术汤)不可发汗。汗之名重 。必死。
(此伤寒坏病也前热未除复感寒邪变为温疟)
寒热往来。口苦胸满。(小柴胡加桂枝芍药汤烦渴用人参白虎汤)
(纳凉于广厦凉亭乘风挥扇多食冰冷瓜果静而得之名为中暑奔役于赤日炎威
之中负重远行不得休息动而得之名为中 脉虚汗多身热烦渴)中暑。面垢。自汗。烦渴。(人参白
虎加莲薷扁豆)心胞络受邪。热甚。昏而不醒。(香薷汤冷服须加黄连)足冷脉沉。(理中汤)
中。大热烦渴。(苍术白虎汤)
按中暑为阴症。阳气为阴寒壅遏。法当辛温。中 为阳症。热火熏灼。法当清凉。凡热
死。切勿便与冷水。及冷物逼其外。即不可救。须置于暖处。取路上热土于脐上作窝。溺热尿于
中。此为良法。或以晒热瓦。熨其心腹。亦佳。宜苏合香丸。汤调灌之。或热土大蒜同研。
热水调去渣灌之。
(天行疫毒邪气侵犯人体上部,需根据三阳经的不同表现分别施治)
邪气发于项部后方,连同脑后、目后出现红肿,这是太阳经受邪。(用荆芥败毒散治疗)
邪气发于鼻部和额头,直至面目肿胀闭合,这是阳明经受邪。
(用通圣消毒散治疗)邪气发于耳朵的上下前后及头角部位,这是少阳经受邪。(用小柴胡汤加荆芥、黄芩、黄连治疗)如果三阳经同时受邪。(用普济消毒饮治疗)
(发汗后热势不减称为风温,脉象浮,自汗出,身体沉重,嗜睡,鼻鼾声重,不能言语,这是因为先感受温热之邪,又复感风邪所致)
风温证忌用发汗法。(葳蕤汤热盛者加知母;干葛汤加瓜蒌)身体沉重,汗出。(用防己汤治疗)
(身体沉重疼痛,小便不利,与太阳伤寒相似,但脉象沉细是不同之处)
全身都疼痛,傍晚发热,这是风湿证。(用麻黄杏仁薏苡仁甘草汤治疗)头部出汗,背部强直,想要盖被子靠近火源取暖,这是寒湿证。(用理中汤合胃苓汤治疗)关节疼痛且心烦,脉象沉细,应当通利小便。(用甘草附子汤治疗)
(先感受湿邪,又感受暑邪,称为湿温,腹部胀满,面目疼痛,多汗,胡言乱语,脚冷,寸脉浮弱,尺脉小而急)
湿温证。(用白虎加苍术汤治疗)不可发汗,发汗则病情加重,必死无疑。
(这是伤寒误治后的坏病,前面的热邪未除,又感受寒邪,变为温疟)
寒热往来,口苦,胸中满闷。(用小柴胡汤加桂枝、芍药治疗;若见烦渴,用人参白虎汤治疗)
(在宽敞高大的凉亭里乘凉,乘风挥扇,多吃冰冷的瓜果,静坐时发病称为中暑;在烈日炎炎中奔走,负重远行不得休息,运动时发病称为中暍。脉象虚,汗多,身热,烦渴)
中暑,面色垢浊,自汗,烦渴。(用人参白虎汤加莲叶、香薷、扁豆治疗)心包络受邪,热势极盛,昏迷不醒。(用香薷汤冷服,必须加黄连)脚冷,脉象沉。(用理中汤治疗)中暍,大热,烦渴。(用苍术白虎汤治疗)
按:中暑属于阴症,阳气被阴寒之气壅遏阻滞,治法应当用辛温药物;中暍属于阳症,热火熏灼体内,治法应当用清凉药物。凡是因热致死的情况,千万不要立即给予冷水及冷物逼迫其外散热量,否则就无法救治了。必须将患者置于温暖处,取路上的热土在肚脐上堆成窝状,向其中溺入热尿,这是良法。或者用晒热的瓦片,熨烫其心腹部,也很好。适宜使用苏合香丸,用水调匀灌服。或者将热土与大蒜一同研磨,用热水调匀去渣后灌服。
(When epidemic toxic pathogens invade the high peak [head], treatment should be administered according to the differentiation of the three Yang meridians)
If the swelling and redness occur at the nape, extending to the back of the head and behind the eyes, it involves the Taiyang meridian. (Treat with Jingjie Baidu San / Schizonepeta Decoction for Resolving Toxins). If the swelling and redness occur at the nose and forehead, extending until the face and eyes are swollen shut, it involves the Yangming meridian. (Treat with Tongsheng Xiaodu San / Unimpeded Detoxification Decoction). If the swelling and redness occur above, below, in front, and behind the ears, as well as at the temporal angles, it involves the Shaoyang meridian. (Treat with Xiao Chaihu Tang / Minor Bupleurum Decoction plus Jingjie / Schizonepeta, Huangqin / Scutellaria, and Lianqiao / Forsythia [Note: Original says Qin Lian, likely Huangqin & Huanglian]). If all three Yang meridians are affected simultaneously. (Treat with Puji Xiaodu Yin / Universal Benefit Detoxification Decoction).
(Fever persisting after sweating is termed Fengwen [Wind-Warmth]. The pulse is floating, there is spontaneous sweating, heaviness of the body, somnolence, snoring, and inability to speak. This occurs because Warm-Heat was first contracted, followed by a secondary contraction of Wind.)
Fengwen contraindicates sweating therapy. (For Re Zhi Yu Tang / Reed Rhizome Decoction with intense heat, add Zhimu / Anemarrhena; for Gan Ge Tang / Pueraria Decoction, add Gualou / Trichosanthes). Heaviness of the body with sweating. (Treat with Fangji Tang / Stephania Decoction).
(Heaviness of the body and pain, with difficulty in urination, resembles Taiyang Shanghan [Cold Damage], but differs in that the pulse is deep and fine.)
Pain throughout the entire body with fever in the late afternoon indicates Fengshi [Wind-Dampness]. (Treat with Mahuang Xingren Yiren Gancao Tang / Ephedra, Apricot Seed, Coix Seed, and Licorice Decoction). Sweating only on the head, stiffness of the back, and a desire to cover oneself and face fire indicates Han Shi [Cold-Dampness]. (Treat with Lizhong Tang / Regulate the Middle Decoction combined with Weiling Tang / Stomach and Five Ling Decoction). Pain in the joints accompanied by vexation, with a deep and fine pulse, requires promoting diuresis. (Treat with Gancao Fuzi Tang / Licorice and Aconite Decoction).
(Injury from Dampness followed by injury from Summerheat is termed Wenwen [Damp-Warmth]. Symptoms include abdominal fullness, pain in the face and eyes, profuse sweating, delirious speech, cold feet, a weak and floating pulse at the cun position, and a small and rapid pulse at the chi position.)
Wenwen. (Treat with Baihu Jia Cangzhu Tang / White Tiger Decoction plus Cangzhu / Atractylodes). Sweating therapy is contraindicated; if sweating is induced, the condition becomes severe and fatal.
(This is a Huabing [ruined disease] resulting from improper treatment of Shanghan. The previous heat has not subsided, and Cold pathogen is newly contracted, transforming into Wen Nue [Warm Malaria].)
Alternating chills and fever, bitter taste in the mouth, and chest fullness. (Treat with Xiao Chaihu Tang plus Guizhi / Cinnamon Twig and Shaoyao / Peony; if vexation and thirst are present, use Renshen Baihu Tang / Ginseng White Tiger Decoction).
(Cooling off in large pavilions, fanning oneself while riding the wind, consuming excessive cold fruits and melons, and falling ill while at rest is termed Zhongshu [Summerheat Injury due to Rest]. Running under the scorching sun, carrying heavy loads over long distances without rest, and falling ill during exertion is termed Zhongyue [Summerheat Injury due to Exertion]. Pulse is deficient, with profuse sweating, fever, vexation, and thirst.)
Zhongshu presents with a dirty complexion, spontaneous sweating, and vexation/thirst. (Treat with Renshen Baihu Tang plus Lianye / Lotus Leaf, Xiangru / Elsholtzia, and Bian Dou / Hyacinth Bean). When the Pericardium Collateral is affected by extreme heat leading to coma and unconsciousness. (Treat with Xiangru Tang / Elsholtzia Decoction taken cold, must add Huanglian / Coptis). Cold feet with a deep pulse. (Treat with Lizhong Tang / Regulate the Middle Decoction). Zhongyue presents with high fever, vexation, and thirst. (Treat with Cangzhu Baihu Tang / Atractylodes White Tiger Decoction).
Commentary: Zhongshu is a Yin syndrome, where Yang Qi is obstructed by Yin-Cold; the method should employ Acrid-Warm herbs. Zhongyue is a Yang syndrome, caused by scorching Fire-Heat; the method should employ Cooling herbs. In cases of death by heat, never immediately give cold water or apply cold substances to force heat outwards, as this will render the patient incurable. The patient must be placed in a warm environment. Take hot earth from the road, form a depression around the umbilicus, and urinate hot urine into it; this is an excellent method. Alternatively, use tiles heated in the sun to moxa/iron the heart and abdomen; this is also good. Suhe Xiang Wan / Styrax Pills are suitable, administered by mixing with water and forcing down the throat. Or, grind hot earth together with garlic, mix with hot water, strain, and administer.