身疼之证,无问风寒,双解散(五十四)。表热甚,头项肢体疼痛,黄连解毒
汤(二十一)。伤寒瘟疫,遍身疼痛,少力,头旋,腰脚麻重,呕哕、壮热、减食,三一承气(十三)减
硝加贯众、紫河车,入金银煎,名银煎散。中湿一身尽痛,五苓散(二十四)。
腹胀满,脉沉者,以三一承气汤(十三)合解毒(二十一)下之。诸腹满实痛、烦渴谵妄、脉实
数而沉者,无问日数,三一承气汤。少阳证,腹中痛者,小柴胡(九)去黄芩加芍药汤。少阳证,胁
下痞硬者,小柴胡去枣子加牡蛎。太阴证,腹满时痛,桂枝(二)加芍药;痛甚桂枝加大黄。
往来寒热属少阳,一日二、三作,来往无期,用小柴胡汤(九)主之。
潮热属阳明,一日一发,日晡而作也。阳明里热极甚,或吐下后不解大便
五、六日至十余日,日晡潮热,心胸烦热而懊 ,如疟状,脉沉实者,三一承气
汤(十三)。阳明、少阳合病,下利,日晡发热如疟者,大柴胡汤(八)。通宜三一承气(十三)合解毒(二十一)。
自汗者,不发表解肌自出汗也,伤风自汗也。伤风自汗,桂枝汤。伤寒自汗,脉沉数而实,表里俱
热者,三阳合病自汗者,厥逆自汗者,头疼自汗者,伤寒自汗未解半入于里者,中暑自汗脉虚者,俱
宜白虎汤(二十二)。伤寒寝汗不止,白虎汤加麻黄根、浮麦。伤寒汗下后,自汗、脉虚、热不已,白
虎加人参、苍术服之,汗止身凉,通仙之法也。
中暑自汗,白虎汤,后以澹渗汤(二十五)调之。自汗多崔宣武人参石膏汤(三十六)。
身疼的证候,不分是风寒还是其他原因,均使用双解散(方剂编号五十四)。如果表热严重,出现头项及肢体疼痛,使用黄连解毒汤(方剂编号二十一)。如果是伤寒或瘟疫引起的遍身疼痛、乏力、头晕、腰脚麻木沉重、呕吐呃逆、高热、食欲减退,使用三一承气汤(方剂编号十三),减去芒硝,加入贯众、紫河车,并用金银煎煮,名为银煎散。如果是中湿导致的一身尽痛,使用五苓散(方剂编号二十四)。
腹部胀满,脉象沉的,用三一承气汤(方剂编号十三)合黄连解毒汤(方剂编号二十一)攻下。凡是腹部胀满结实疼痛、烦躁口渴、胡言乱语、脉象实数而沉的,不论患病天数多少,均使用三一承气汤。少阳病证,腹中疼痛的,用小柴胡汤(方剂编号九)去掉黄芩,加入芍药。少阳病证,胁下痞塞坚硬的,用小柴胡汤去掉大枣,加入牡蛎。太阴病证,腹部胀满且时发疼痛的,使用桂枝汤(方剂编号二)加入芍药;如果疼痛剧烈,则使用桂枝加大黄汤。
寒热往来属于少阳病,一天发作两三次,来去没有固定时间,以小柴胡汤(方剂编号九)为主治。
潮热属于阳明病,每天发作一次,在傍晚时分发作。阳明里热极盛,或者在吐下之后大便不通,从五六天到十余天,出现傍晚潮热,心胸烦热且懊恼不适,症状像疟疾一样,脉象沉实的,使用三一承气汤(方剂编号十三)。阳明病与少阳病合病,出现下利,傍晚发热像疟疾一样的,使用大柴胡汤(方剂编号八)。通常适宜使用三一承气汤(方剂编号十三)合黄连解毒汤(方剂编号二十一)。
自汗,是指不通过发汗解肌的方法而自然出汗,这是伤风引起的自汗。伤风引起的自汗,使用桂枝汤。伤寒引起的自汗,如果脉象沉数而实,表里都热的;三阳合病引起的自汗;厥逆引起的自汗;头痛引起的自汗;伤寒自汗未解,邪气半入于里的;中暑引起的自汗且脉象虚弱的,都适宜使用白虎汤(方剂编号二十二)。伤寒夜间盗汗不止的,在白虎汤中加入麻黄根、浮小麦。伤寒经过发汗或攻下治疗后,仍然自汗、脉象虚弱、热势不退的,服用白虎汤加人参、苍术,汗止身凉,这是通仙的治疗方法。
Symptoms of body pain, regardless of whether caused by wind-cold or other factors, are treated with Shuangjie San (Double-Resolution Powder) [Formula 54]. If exterior heat is severe, causing pain in the head, neck, and limbs, Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) [Formula 21] is used. In cases of cold damage or plague characterized by generalized body pain, weakness, dizziness, numbness and heaviness in the waist and legs, vomiting and hiccups, high fever, and reduced appetite, Sanyi Chengqi Tang (Three-One Purging Decoction) [Formula 13] is employed, with Mangxiao (Natrii Sulfas) removed, and Guanzhong (Cyatheae Spadix) and Ziheche (Placenta Hominis) added, decocted with Yinjin (Silver Thread), named Yinjian San (Silver Decoction Powder). For generalized body pain due to dampness obstruction, Wuling San (Five-Ingredient Powder with Poria) [Formula 24] is used.
For abdominal distension and fullness with a deep pulse, Sanyi Chengqi Tang [Formula 13] combined with Jiedu Tang [Formula 21] is used to purge. For all cases of abdominal fullness, solidity, and pain, accompanied by irritability, thirst, delirium, and a rapid, deep, and forceful pulse, regardless of the number of days since onset, Sanyi Chengqi Tang is indicated. In Shaoyang syndrome with abdominal pain, Xiao Chaihu Tang (Minor Bupleurum Decoction) [Formula 9] is modified by removing Huangqin (Scutellariae Radix) and adding Shaoyao (Paeoniae Radix). In Shaoyang syndrome with stuffiness and hardness under the hypochondrium, Xiao Chaihu Tang is modified by removing Zao (Jujubae Fructus) and adding Muli (Ostreae Concha). In Taiyin syndrome with abdominal fullness and intermittent pain, Guizhi Tang (Cinnamon Twig Decoction) [Formula 2] is modified by adding Shaoyao; if pain is severe, Guizhi Dahuang Tang (Cinnamon Twig and Rhubarb Decoction) is used.
Alternating chills and fever belong to Shaoyang syndrome, occurring two or three times a day without a fixed schedule, treated primarily with Xiao Chaihu Tang [Formula 9].
Tidal fever belongs to Yangming syndrome, occurring once daily, typically arising in the late afternoon. When Yangming interior heat is extremely severe, or after emesis or purgation, if constipation persists from five to six days up to ten or more days, presenting with late-afternoon tidal fever, mental restlessness and oppression in the chest and heart, symptoms resembling malaria, and a deep, solid pulse, Sanyi Chengqi Tang [Formula 13] is used. In combined Yangming and Shaoyang disease with diarrhea and late-afternoon fever resembling malaria, Da Chaihu Tang (Major Bupleurum Decoction) [Formula 8] is indicated. Generally, it is appropriate to use Sanyi Chengqi Tang [Formula 13] combined with Jiedu Tang [Formula 21].
Spontaneous sweating refers to sweating that occurs naturally without the use of diaphoretic or muscle-releasing methods, often caused by wind-strike. For spontaneous sweating due to wind-strike, Guizhi Tang is used. For spontaneous sweating due to cold damage, if the pulse is deep, rapid, and forceful, indicating heat in both exterior and interior; or for spontaneous sweating due to combined disease of the Three Yang syndromes; or due to jue-ni (cold extremities); or associated with headache; or when cold damage spontaneous sweating has not resolved and pathogenic factors have partially entered the interior; or for spontaneous sweating due to summerheat with a deficient pulse, Baihu Tang (White Tiger Decoction) [Formula 22] is suitable. For night sweats (sleeping sweat) persisting in cold damage, Baihu Tang is modified by adding Mahuang Gen (Ephedrae Radix et Rhizoma) and Fumai (Tritici Fructus Levigatus). After cold damage treatment with sweating or purgation, if spontaneous sweating continues, the pulse is deficient, and heat persists, taking Baihu Tang with Renshen (Ginseng Radix) and Cangzhu (Atractylodis Rhizoma) stops the sweat and cools the body, which is the method of Tongxian.
For spontaneous sweating due to summerheat, Baihu Tang is used first, followed by adjustment with Danshen Tang (Lightly Percolating Decoction) [Formula 25]. For excessive spontaneous sweating, Cui Xuanwu's Renshen Shigao Tang (Ginseng and Gypsum Decoction by Cui Xuanwu) [Formula 36] is used.