伤寒瘥后还喜唾。胸里有寒实无那。此候唯宜服理中。胃暖病治痰自破。(仲景云。大病已后。其人喜唾。久久不了。
胸上有寒当温之。宜理中丸主之。)劳复枳实栀子汤。发热小柴胡亦可。(仲景云。大病已后。劳复。枳实栀子汤主之。
又云。伤寒瘥后发热。小柴胡汤主之。)腰下水气牡蛎散。(仲景云。大病已后。腰下有水气者。宜用牡蛎散主之也。)日
暮微烦脾不磨。要须损谷自然安。甘节吉兮必无祸。(仲景云。病患脉已解。日暮微烦者。以病新瘥。强与谷。食不消也。
损谷则愈。周易节卦。九五。甘节吉。往有尚。象曰甘节之吉居位中也。)
水浆不下汗如油。形体不仁喘不休。此为命绝终难治。更看何脏绝中求。汗出发润为肺绝。唇吻反青肝绝忧。脾绝
口黑并黄色。肾绝便失与遗溲。心绝身似烟薰黑。更兼直视与摇头。五脏皆绝无可疗。纵逢和缓亦难瘳。(仲景云。脉浮
而洪。身汗如油。喘而不休。水浆不下。形体不仁。乍静乍乱。此为命绝也。又未知何脏。先受其灾。若汗出发润。喘
而不休者。此肺先绝也。阳反独留。形体如烟薰。直视摇头。此心绝也。唇吻反青。四肢 习者。此肝先绝也。环口黧
黑。柔汗发黄。此脾绝也。溲便遗失。狂言。反目直视。此为肾绝也。)
伤寒病初愈后,患者仍喜欢吐唾液。这是因为胸中有寒邪停滞,无法消除。这种证候只适宜服用理中汤(温中散寒的方剂)。胃气温暖,疾病治愈,痰饮自然消散。(张仲景说:大病之后,病人喜欢吐唾液,久久不能痊愈。这是胸上有寒邪,应当用温法治疗,适宜用理中丸主治。)
劳复(因劳累导致的复发)可用枳实栀子汤。若伴有发热,小柴胡汤也可以使用。(张仲景说:大病之后,因劳累而复发,用枳实栀子汤主治。又说:伤寒病初愈后出现发热,用小柴胡汤主治。)
腰部以下有水气停滞,可用牡蛎散。(张仲景说:大病之后,腰部以下有水气的,适宜用牡蛎散主治。)
傍晚时分出现轻微烦躁,是因为脾胃运化功能减弱。必须减少饮食摄入,身体自然会安宁。甘节之吉,必定没有灾祸。(张仲景说:病人的脉象已经平和,傍晚时轻微烦躁,是因为病刚痊愈,强行进食,食物不消化。减少饮食就会痊愈。《周易》节卦九五爻辞:“甘节吉,往有尚。”象传说:甘节的吉祥,在于居位适中。)
水浆喝不下,出汗如油,形体麻木不仁,气喘不停。这是命绝之证,终究难以治疗。还需进一步观察是哪一脏的气绝,从中寻找依据。汗出而头发湿润,是肺绝;嘴唇和口角发青,是肝绝;脾绝则口周发黑并呈黄色;肾绝则大小便失禁与遗尿;心绝则身体像被烟熏黑一样,再加上两眼直视和摇头。五脏之气都绝,就无法治疗了,即使遇到扁鹊、仓公这样的神医也难以治愈。(张仲景说:脉象浮而洪大,身体出汗如油,气喘不停,水浆不进,形体麻木不仁,时而安静时而混乱,这是命绝之证。又不知哪一脏先受灾害。如果汗出头发湿润,气喘不停,这是肺先绝。阳气独留,身体如烟熏色,两眼直视摇头,这是心绝。嘴唇口角发青,四肢抽搐,这是肝先绝。口唇周围黧黑,冷汗发黄,这是脾绝。大小便失禁,胡言乱语,反眼直视,这是肾绝。)
After the recovery from a cold damage disease, the patient still tends to spit saliva frequently. This is due to the stagnation of cold pathogenic factors in the chest, which cannot be eliminated. For this syndrome, it is only appropriate to administer Lizhong Tang (Regulate the Middle Decoction). When the stomach qi becomes warm and the disease is cured, the phlegm-rheum will naturally dissipate. (Zhang Zhongjing stated: After a major illness, if the patient tends to spit saliva and it does not resolve for a long time, this indicates cold rheum in the upper chest. It should be treated with warming methods, and Lizhong Wan (Regulate the Middle Pill) is indicated.)
For relapse due to overexertion (Lao Fu), Zhishi Zhizi Tang (Immature Bitter Orange and Gardenia Decoction) may be used. If accompanied by fever, Xiaochaihu Tang (Minor Bupleurum Decoction) can also be employed. (Zhang Zhongjing stated: After a major illness, if there is relapse due to exertion, Zhishi Zhizi Tang is indicated. He further stated: If fever occurs after the recovery from cold damage disease, Xiaochaihu Tang is indicated.)
If there is water-rheum accumulation below the waist, Musan San (Oyster Shell Powder) is suitable. (Zhang Zhongjing stated: After a major illness, if there is water-rheum below the waist, Musan San is indicated.)
Slight restlessness occurring at dusk indicates that the spleen and stomach are failing to digest food properly. It is necessary to reduce dietary intake, and the body will naturally settle into peace. "Sweet regulation brings auspiciousness, ensuring no disaster." (Zhang Zhongjing stated: If the patient's pulse has returned to normal but slight restlessness occurs at dusk, it is because the illness has just recovered, and forcing food intake leads to indigestion. Reducing food intake will lead to recovery. The hexagram Jie (Limitation) in the I Ching, line nine at the fifth place, states: "Sweet regulation brings auspiciousness; going forward meets with esteem." The Image Commentary says: "The auspiciousness of sweet regulation lies in occupying the central position.")
Inability to take fluids or food, sweating like oil, numbness of the body, and ceaseless panting indicate the exhaustion of vital life force (Ming Jue), which is ultimately difficult to treat. One must further examine which zang organ has exhausted its qi to seek the cause. Sweating with wet hair indicates lung exhaustion; cyanosis of the lips and corners of the mouth indicates liver exhaustion; blackening around the mouth with yellowish discoloration indicates spleen exhaustion; incontinence of urine and feces indicates kidney exhaustion; blackening of the body as if smoke-stained, accompanied by fixed staring and shaking of the head, indicates heart exhaustion. If all five zang organs have exhausted their qi, treatment is futile; even if Bian Que or Cang Gong were present, they would hardly be able to cure it. (Zhang Zhongjing stated: A floating and surging pulse, sweating like oil, ceaseless panting, inability to take fluids or food, numbness of the body, alternating periods of quietness and chaos, indicate the exhaustion of vital life force. It is unknown which zang organ suffered first. If sweating wets the hair and panting is ceaseless, this indicates lung exhaustion first. If yang qi remains alone, the body appears smoke-stained, with fixed staring and head shaking, this indicates heart exhaustion. If the lips and mouth corners are cyanotic and the limbs twitch, this indicates liver exhaustion first. If the area around the mouth is dark black and cold sweat turns yellow, this indicates spleen exhaustion. If urine and feces are incontinent, there is delirious speech, and the eyes are fixed and staring backward, this indicates kidney exhaustion.)