呕吐而利名霍乱。(仲景云。病有霍乱者。何也。答曰呕吐而利。此名霍乱。)四肢逆冷诚斯患。寒多不饮理中丸。
热多而渴五苓散。(仲景云。霍乱而头痛发热。身体疼痛。热多。欲饮水。五苓散。寒多不饮水者。理中丸主之。又云。
吐利汗出。发热恶寒。四肢拘急。手足厥。四逆汤主之。)暑月忽然心撮痛。两脚转筋多冷汗。上吐下利并躁烦。水沉香
薷煎数盏。(暑月阴阳不和。清浊相干。食饮饫饱。伤于脾胃。而又取凉就冷。阴阳交错。变成吐利。三焦溷乱。腹中撮
痛。大渴而烦。两脚转筋者。当用香薷散主之。)
三阳往往病头疼。随证医治(平声。)各异能。(三阳经络上至于头。三阴至胸中而还。故三阳之邪至头。必头疼也。)
太阳身热麻黄证。(仲景云。太阳病头疼发热。身疼。无汗而喘者。麻黄汤主之。)无热阳明胃气蒸。(仲景云。阳明病。
手足若厥者。其人头必痛。若不呕不饮。手足不厥者。其头不痛。)少阳受病脉弦细。小柴胡证自分明。(仲景云。伤寒。
其脉弦细。头痛发热。此为属少阳。少阳不可发汗。则谵语为属胃。胃和则愈。不和则烦而悸。)三阴太少无头痛。为是
厥阴之证形。(三阴之中。太阴少阴无头痛。惟厥阴有也。)非时忽有 首疾。( 音消。出周礼。)必是停痰湿气并。(停
痰湿气。亦令人头痛。)
呕吐并伴有腹泻称为霍乱。(张仲景说:患有霍乱的病证,是怎么回事呢?回答说:呕吐并且腹泻,这就叫做霍乱。)四肢逆冷确实是这种疾病的祸患。寒邪偏盛、不想喝水的,用理中丸治疗。
热邪偏盛且口渴的,用五苓散治疗。(张仲景说:霍乱伴有头痛、发热、身体疼痛,热象较多,想喝水的,用五苓散;寒象较多、不想喝水的,用理中丸主治。又说:呕吐腹泻、出汗、发热恶寒、四肢拘挛紧急、手足厥冷的,用四逆汤主治。)暑天忽然出现心窝部撮痛,两脚抽筋且多冷汗,上吐下泻并伴有烦躁不安,用水沉香和薷煎煮数杯服用。(暑天阴阳不和,清浊之气相互干扰,饮食过饱,损伤脾胃,又贪凉受冷,导致阴阳交错,变成呕吐腹泻,三焦混乱,腹中撮痛,大渴而烦闷,两脚抽筋的,应当用香薷散主治。)
三阳经往往会出现头疼,随证医治(平声)各不相同才能见效。(三阳经络上行至头部,三阴经上行至胸中即返回,所以三阳经的邪气侵犯头部,必然会导致头疼。)太阳经受邪,身热无汗,是麻黄汤的主治证候。(张仲景说:太阳病,头痛发热,身体疼痛,无汗而喘的,用麻黄汤主治。)阳明经受邪,若无发热则是胃气蒸腾之象。(张仲景说:阳明病,如果手足厥冷的,其头必定疼痛;如果不呕吐、不口渴、手足不厥冷的,其头不痛。)少阳经受邪,脉象弦细,小柴胡汤证自然分明。(张仲景说:伤寒病,脉象弦细,头痛发热,这属于少阳病。少阳病不可发汗,若误汗则谵语属于胃家实,胃气和顺则痊愈,不和则烦闷心悸。)三阴经中的太阴、少阴没有头痛,只有厥阴经有这种证候表现。(在三阴经中,太阴、少阴没有头痛,只有厥阴经有。)非正常时节突然发生头痛。(“消”音,出自《周礼》。)必定是停痰湿气所致。(停痰湿气,也会让人头痛。)
Vomiting accompanied by diarrhea is named Huoluan (Huo Luan, Cholera-like syndrome). (Zhang Zhongjing said: Regarding the disease of Huoluan, what is it? The answer is: vomiting and diarrhea, this is named Huoluan.) Cold reversal in the four limbs is indeed a calamity of this condition. For cases with excess cold and no desire to drink, Lizhong Wan (Regulate the Middle Pill) is indicated.
For cases with excess heat and thirst, Wuling San (Five-Ingredient Powder with Poria) is indicated. (Zhang Zhongjing said: In Huoluan with headache, fever, body pain, and excess heat, with a desire to drink water, Wuling San is used; for those with excess cold and no desire to drink, Lizhong Wan is the primary treatment. He also stated: In cases of vomiting and diarrhea with sweating, fever, aversion to cold, tetanic contraction of the four limbs, and cold hands and feet, Sini Tang (Frigid Extremities Decoction) is used.) In the summer months, sudden pinching pain in the heart region, spasms in both legs with profuse cold sweat, upper vomiting and lower diarrhea accompanied by restlessness, should be treated by decocting Chensiang (Aquilaria Wood) and Yishu (Mosla Herb) and drinking several cups. (In summer, yin and yang are disharmonious, clear and turbid qi interfere with each other. Overeating damages the spleen and stomach, and seeking coolness exposes one to cold. Yin and yang become intermixed, resulting in vomiting and diarrhea, chaos in the Triple Burner, pinching abdominal pain, extreme thirst and vexation, and leg spasms. Xiangru San (Elsholtzia Powder) should be used.)
The Three Yang meridians often suffer from headaches; treating according to symptoms (Ping Sheng, level tone) varies and must be distinct to be effective. (The Three Yang meridians ascend to the head, while the Three Yin meridians ascend only to the chest and return. Therefore, pathogenic factors in the Three Yang meridians reaching the head inevitably cause headaches.) Taiyang (Greater Yang) presentation with body heat is the indication for Mahuang Tang (Ephedra Decoction). (Zhang Zhongjing said: In Taiyang disease with headache, fever, body pain, absence of sweating, and wheezing, Mahuang Tang is indicated.) Yangming (Yang Brightness) presentation without fever indicates steaming of Stomach Qi. (Zhang Zhongjing said: In Yangming disease, if the hands and feet are cold, the head must hurt; if there is no vomiting, no thirst, and the hands and feet are not cold, the head does not hurt.) Shaoyang (Lesser Yang) disease presents with wiry and fine pulses, and the Xiao Chaihu Tang (Minor Bupleurum Decoction) pattern is clearly defined. (Zhang Zhongjing said: In Shanghan (Cold Damage), a wiry and fine pulse with headache and fever indicates involvement of Shaoyang. Shaoyang should not be induced to sweat; if mistakenly sweated, delirium indicates involvement of the Stomach. If the Stomach harmonizes, recovery occurs; if not, vexation and palpitations ensue.) The Three Yin meridians, specifically Taiyin and Shaoyin, do not typically present with headaches; only Jueyin (Terminal Yin) has this manifestation. (Among the Three Yin meridians, Taiyin and Shaoyin do not have headaches; only Jueyin does.) Sudden onset of headache at an inappropriate time. ("Xiao" sound, from Rites of Zhou.) It must be due to retained phlegm and dampness. (Retained phlegm and dampness can also cause headaches.)