诸病在膈者,当用瓜蒂散(二十六)吐之。或表证罢,邪热入里,结于胸中,烦满而饥不能食,
四肢微厥而脉乍急者,宜瓜蒂散吐之。伤寒头疼久不愈,令人丧明,以胸膈有宿痰故也,当先涌之,次以
白虎汤(二十二)加减。
三阳合病∶腹满身重,难以转侧,口燥面垢,谵语遗尿,如误发汗则谵语益
甚,下之则便厥,额上汗出,后必发黄,白虎汤(二十二)。
两感谓一日太阳、少阴两症俱见,二日阳明与太阴俱病,三日少阳与厥阴俱病,前六经之证是也。小
柴胡汤(九)、凉膈散(二十三)、五苓散(二十四)、天水散(五十二)、通圣散(五十三)、双
解散(五十四)、大柴胡汤(八),可选用之。热势甚,欲可下者,三一承气汤(十三),或解毒(二十
一)合承气汤。
之为病∶发热腹满,口噤头摇,螈 不语,项强背直,腰身反强。或目痛,或目赤,或目闭,
或反目,或足温,或妄行,其脉沉弦而迟,或带紧者,无汗曰刚 ;有汗曰柔 。通宜三一承气汤
(十三)合解毒(二十一)下之。
头疼之证,无问风寒暑湿杂病,自汗头疼,俱宜白虎汤(二十二),或加川芎、荆芥尤妙。头疼
久不愈,必致丧明,宜先涌痰,次用白虎加减。风眩痰逆、喘嗽头疼,茯苓半夏汤(三十八),头疼、
肢体痛,黄连解毒汤(二十一);头疼、口干,桂苓甘露饮(三十四),风疾喘嗽头疼,白虎(二十二
)、半夏橘皮汤(三十七),风热头疼,心烦昏愦,人参石膏汤(三十五),伤寒壮热头疼,不卧散(四十五)。
凡是病邪位于膈部的,应当使用瓜蒂散进行催吐。如果表证已经解除,邪热内传入里,结聚在胸中,导致心中烦闷胀满且感到饥饿却无法进食,四肢轻微发凉而脉搏时而急促的,适宜用瓜蒂散催吐。伤寒引起的头痛经久不愈,会导致人失明,这是因为胸膈部位有停滞的痰饮所致,应当先使用涌吐法治疗,随后再根据情况加减使用白虎汤。
凡是热邪蓄积在下焦的,可以使用承气汤、抵当汤之类的方剂来泻下热结。
三阳合病:表现为腹部胀满、身体沉重、难以翻身转动,口干燥、面色污垢、说胡话、小便失禁。如果误用发汗法,说胡话的症状会更加严重;如果误用泻下法,则会出现四肢厥冷、额头出汗,之后必然出现黄疸,此时应使用白虎汤。
两感病是指第一天太阳经和少阴经的症状同时出现,第二天阳明经和太阴经同时发病,第三天少阳经和厥阴经同时发病,这是前六经病变的情况。可以选用小柴胡汤、凉膈散、五苓散、天水散、通圣散、双解散、大柴胡汤等方剂。如果热势非常猛烈,适合使用泻下法的,可以使用三一承气汤,或者将解毒汤与承气汤合用。
痉病(此处原文缺字,据上下文推断为“痉”)的表现:发热、腹部胀满、牙关紧闭、头部摇动、肢体抽搐、不能说话、颈项强直、背部挺直、腰身反张。或者眼睛疼痛,或者眼睛发红,或者眼睛闭合,或者眼球上翻,或者脚部温暖,或者行为狂乱。其脉象沉弦而迟缓,或者带有紧象。无汗的称为刚痉;有汗的称为柔痉。通常适宜使用三一承气汤合解毒汤进行泻下治疗。
头痛这一病症,无论是由风寒暑湿等杂病引起,只要是伴有自汗的头痛,都适宜使用白虎汤,或者加入川芎、荆芥效果更佳。头痛经久不愈,必然会导致失明,应当先使用涌吐法祛除痰饮,随后再使用白虎汤加减治疗。因风眩、痰逆引起的喘息咳嗽和头痛,使用茯苓半夏汤;因头痛、肢体疼痛,使用黄连解毒汤;因头痛、口干,使用桂苓甘露饮;因风疾引起的喘息咳嗽和头痛,使用白虎汤合半夏橘皮汤;因风热引起的头痛、心烦昏沉,使用人参石膏汤;因伤寒高热引起的头痛、无法安卧,使用不卧散。
For all diseases where the pathogen is located in the diaphragm region, Gouti San (Melon Seed Powder) should be used to induce vomiting. If the exterior syndrome has resolved and the evil heat has entered the interior, knotting in the chest, causing mental irritability, fullness, hunger but inability to eat, slight coldness of the four limbs, and a pulse that is intermittently rapid, it is appropriate to use Gouti San to induce vomiting. Headache caused by Shanghan (Cold Damage) that persists for a long time can lead to loss of vision; this is due to retained phlegm in the chest and diaphragm. One should first employ emesis (inducing vomiting), followed by modified Baihu Tang (White Tiger Decoction).
When heat accumulates in the lower jiao (Lower Burner), purgatives such as Chengqi Tang (Gastro-Intestinal Replenishment Decoction) and Didang Tang (Defeat Stasis Decoction) can be used to purge the heat.
Combined disease of the three Yang channels: Abdominal fullness, heaviness of the body, difficulty in turning over, dry mouth, dirty complexion, delirium, and urinary incontinence. If sweating therapy is mistakenly applied, delirium will worsen; if purgation is mistakenly applied, it leads to cold extremities, sweating on the forehead, and subsequently jaundice. In such cases, Baihu Tang (White Tiger Decoction) is indicated.
Lianggan (Double Exposure) refers to the condition where symptoms of the Taiyang (Greater Yang) and Shaoyin (Lesser Yin) channels appear on the first day, Yangming (Bright Yang) and Taiyin (Greater Yin) on the second day, and Shaoyang (Lesser Yang) and Jueyin (Terminal Yin) on the third day. These are the syndromes of the first six channels. Xiao Chaihu Tang (Minor Bupleurum Decoction), Liangge San (Cooling Diaphragm Powder), Wuling San (Five Ingredient Powder with Poria), Tianshui San (Heavenly Water Powder), Tongsheng San (Universal Salvation Powder), Shuangjie San (Double Resolution Powder), and Da Chaihu Tang (Major Bupleurum Decoction) may be selected for use. If the heat intensity is severe and purgation is suitable, Sanyi Chengqi Tang (Three-One Gastro-Intestinal Replenishment Decoction) or a combination of Jiedu Tang (Detoxification Decoction) and Chengqi Tang (Gastro-Intestinal Replenishment Decoction) may be used.
Jing (Spasm) disease manifests as fever, abdominal fullness, trismus (lockjaw), head shaking, convulsions, inability to speak, neck stiffness, back rigidity, and opisthotonos (arching of the back). Alternatively, there may be eye pain, red eyes, closed eyes, or upward deviation of the eyes; warm feet; or erratic behavior. The pulse is deep, wiry, and slow, or tight. Absence of sweat is termed Gang Jing (Rigid Spasm); presence of sweat is termed Rou Jing (Soft Spasm). Generally, Sanyi Chengqi Tang (Three-One Gastro-Intestinal Replenishment Decoction) combined with Jiedu Tang (Detoxification Decoction) should be used to purge.
Regarding headache syndromes, regardless of whether they arise from mixed pathogens such as wind, cold, summerheat, or dampness, self-sweating headaches are all suitable for treatment with Baihu Tang (White Tiger Decoction), or adding Chuanxiong Rhizome (Chuanxiong) and Schizonepeta Spike (Jingjie) for better effect. Headaches that persist for a long time will inevitably lead to loss of vision; one should first induce vomiting to expel phlegm, then use modified Baihu Tang (White Tiger Decoction). For dizziness due to wind, rebellious phlegm, asthma, cough, and headache, Lingban Banxia Tang (Poria and Pinellia Decoction) is indicated; for headache and limb pain, Huanglian Jiedu Tang (Coptis Detoxification Decoction) is used; for headache and dry mouth, Guiling Ganlu Yin (Cinnamon and Atractylodes Sweet Dew Drink) is prescribed; for wind-disease-induced asthma, cough, and headache, Baihu Tang (White Tiger Decoction) combined with Banxia Jupi Tang (Pinellia and Tangerine Peel Decoction) is used; for wind-heat induced headache, mental restlessness, and confusion, Renshen Shigao Tang (Ginseng and Gypsum Decoction) is indicated; for Shanghan (Cold Damage) high fever, headache, and inability to lie down, Buwo San (Non-Sleep Powder) is used.