卫气循环不暂停。昼则行阳夜在阴。卫独留阳阳跷盛。阳盛阴虚夜不宁。忽若留阴阴跷满。阴满阳虚昼却争。(黄帝
针经云。卫气者。昼日行于阳。夜行于阴。卫气不得入于阴。常留于阳。留于阳则阳气满。满则阳跷盛而不得入于阴。
阴气虚则夜不得宁也。卫气留于阴。不得行于阳。留于阴。则阴盛。阴盛则阴跷满。不得入于阳。阳气虚。故昼则争而
不安。)暮谵昼了阴虚证。昼躁阳虚夜气清。(仲景云。妇人伤寒发热。经水适来。昼则明了。暮则谵语。为热入血室。
又云。下之后。复发汗。昼则烦躁不得眠。夜而安静。不呕不渴。无表里证。脉沉微身无大热者。干姜附子汤主之。热
入血室。以阴虚而邪入之也。故暮谵昼了。下而复汗。以亡阳而卫在阴也。故昼躁夜静。)要须调卫各归分。二气谐和可
渐平。
伤寒吐下仍不解。大便不利潮热在。循衣摸床惕不安。独语犹如见鬼怪。微喘直视不识人。谵语狂言还可骇。大承
服后脉弦生。忽若涩兮死何悔。(仲景云。伤寒吐下后。未解。不大便。五六日。至十余日。其人日晡所发潮热。不恶寒。
如见鬼神。状若剧者。发则不识人。循衣妄撮床惕不安。微喘直视。脉弦者生。涩者莫不死。仲景云。太阳中风以火劫
之。两阳相熏灼。其身发黄。鼻衄血。循衣摸床。小便利者。可治。华佗云。病患循衣缝。不可治。)
卫气在体内循环运行,昼夜不停。白天行于阳分,夜晚行于阴分。如果卫气单独停留在阳分,导致阳跷脉盛,就会出现阳气过盛而阴气不足,夜间不得安宁的情况。倘若卫气留滞于阴分,导致阴跷脉满,就会出现阴气过盛而阳气不足,白天反而争斗不安。(《黄帝针经》记载:卫气,白天行于阳分,夜晚行于阴分。如果卫气不能进入阴分,常停留于阳分;停留于阳分则阳气满溢,满溢则阳跷脉盛而不能进入阴分;阴气虚弱则夜间不得安宁。如果卫气停留于阴分,不能行于阳分;停留于阴分则阴气盛,阴气盛则阴跷脉满,不能进入阳分;阳气虚弱,所以白天争斗而不安。)傍晚出现谵语、白天神志清楚,这是阴虚证;白天烦躁、夜晚气息清静,这是阳虚证。(张仲景说:妇女患伤寒发热,月经适来,白天神志清楚,傍晚出现谵语,这是热入血室。又说:经过攻下之后,又发汗,白天烦躁不得眠,夜晚却安静,不呕不渴,没有表证和里证,脉象沉微,身体没有大热的,用干姜附子汤主治。热入血室,是因为阴虚而邪气侵入,所以傍晚谵语、白天清醒;攻下后又发汗,是因为亡阳而卫气在阴分,所以白天烦躁、夜晚安静。)必须调理卫气,使其各归其位,阴阳二气和谐,病情才能逐渐平复。
伤寒经过吐法或下法治疗后仍不解,大便不通利,潮热持续存在。患者出现循衣摸床、惊恐不安的症状,独自说话好像看见了鬼怪。轻微气喘、两眼直视、不认识人,胡言乱语令人惊骇。服用大承气汤后,如果脉象弦,说明还有生机;如果脉象涩,则死亡无可挽回。(张仲景说:伤寒经过吐下后,病未解除,不大便,从五六天到十几天,患者在日晡时(下午3-5点)发作潮热,不恶寒,像看见鬼神一样,症状严重时发作起来不认识人,手抓衣服、妄动床铺、惊恐不安,轻微气喘、两眼直视,脉象弦的有生机,脉象涩的多会死亡。张仲景说:太阳中风用火法劫汗,两阳相互熏灼,身体发黄,鼻出血,循衣摸床,小便利的可以治疗。华佗说:病人循衣缝的,不可治。)
The Wei Qi (Defensive Qi) circulates without pause. During the day, it travels through the Yang aspects; at night, it resides in the Yin aspects. If Wei Qi remains exclusively in the Yang, causing the Yang Qiao vessel to become excessive, Yang excess and Yin deficiency result, leading to restlessness at night. Conversely, if Wei Qi lingers in the Yin, filling the Yin Qiao vessel, Yin excess and Yang deficiency occur, resulting in agitation during the day. (The *Huangdi Zhenjing* [Yellow Emperor's Classic of Acupuncture] states: Wei Qi travels in the Yang during the day and in the Yin at night. If Wei Qi cannot enter the Yin, it often stays in the Yang. Staying in the Yang causes Yang Qi to become full; when full, the Yang Qiao vessel becomes excessive, preventing entry into the Yin. With deficient Yin Qi, one cannot find peace at night. If Wei Qi stays in the Yin and cannot travel to the Yang, staying in the Yin causes Yin to become excessive. When Yin is excessive, the Yin Qiao vessel is full, preventing entry into the Yang. With deficient Yang Qi, there is contention and unrest during the day.) Evening delirium with daytime clarity indicates a Yin deficiency syndrome. Daytime irritability with nighttime calmness indicates a Yang deficiency syndrome. (Zhang Zhongjing stated: In women suffering from Shanghan [Cold Damage] with fever, if menstruation occurs just then, they are clear-minded during the day but experience delirium at night; this is Heat entering the Blood Chamber [Xue Shi]. He also stated: After purgation followed by sweating, if the patient is irritable during the day unable to sleep, yet quiet at night, without vomiting or thirst, and lacking exterior or interior signs, with a deep, faint pulse and no significant heat on the body, Ganjiang Fuzi Tang [Dried Ginger and Aconite Decoction] should be administered. Heat entering the Blood Chamber occurs due to Yin deficiency allowing pathogenic invasion, hence evening delirium and daytime clarity. Purging followed by sweating leads to loss of Yang and Wei Qi remaining in the Yin, hence daytime irritability and nighttime calmness.) One must regulate Wei Qi so that each returns to its proper domain; when the two Qi harmonize, the condition can gradually subside.
Shanghan [Cold Damage] remains unresolved after emesis or purgation, accompanied by infrequent bowel movements and tidal fever. The patient exhibits behaviors such as grasping at clothing and bedrails, fearfulness, and unease, speaking alone as if seeing ghosts. There may be slight panting, fixed gaze, inability to recognize persons, and terrifying manic speech. If, after administering Dachengqi Tang [Major Order the Qi Decoction], the pulse becomes wiry, life is possible; if the pulse is choppy, death is inevitable with no regret. (Zhang Zhongjing stated: After Shanghan [Cold Damage] has been treated with emesis and purgation, if the disease is not resolved, and there is constipation for five to six days up to ten-plus days, the patient develops tidal fever at dusk [Bing Shi], does not fear cold, and behaves as if seeing spirits. In severe cases, upon onset, they do not recognize people, grasp at clothing and bedrails in妄动 [frantic movement], feel fearful and uneasy, have slight panting, fixed gaze. A wiry pulse indicates survival; a choppy pulse indicates death. Zhang Zhongjing stated: For Taiyang Wind Strike [Zhong Feng] treated with fire therapy, the combination of two Yangs scorching the body causes jaundice and nasal bleeding. With behaviors like grasping at clothing, if urination is free, treatment is possible. Hua Tuo stated: Patients exhibiting grasping at clothing seams are incurable.)