李 曰。肺主皮毛。通膀胱。最易感冒。新咳嗽。恶风鼻塞。声重喷嚏是也。柴胡半夏汤、参苏饮。寒月。麻黄杏
仁饮。重者。头疼身痛寒热。咽干音哑。柴胡桂枝汤、防风冲和汤。头痛甚者。川芎茶调散。痰多者。金沸草散。挟热。
人参败毒散、升麻葛根汤。挟寒。十神汤。挟寒湿。消风百解散。挟湿。神术散。挟暑。香葛汤。时行。柴胡升麻汤。
服食过浓。素有痰火。时常鼻塞流涕。声重咳嗽。略被外感则甚者。防风通圣散。或大黄芩等分为丸。白水下。素虚者。
只用防风、羌活、川芎。随宜加入补药痰药。伤食。加白术、青皮、陈皮、山楂、麦芽。挟形寒饮冷。加姜、桂。挟房
劳。加参、术、归、地。挟劳役伤气者。补中益气汤加羌、防。风虚甚者。羌活丸、加味乌金丸。风中传里。一同伤寒
治法。风能燥血散气。故古用桂枝八物等汤。久不愈者。只宜三白汤加减敛之。切忌疏泄。虽初起。非寒月无汗。麻黄
禁用。
朱肱曰。有发热恶寒。躁烦。手足温。而脉反浮紧者。有寒多热少。不烦躁。手足微冷。而脉反浮缓者。此名伤风
见寒脉。伤寒见风脉也。盖发热恶寒烦躁手足温。为中风候。脉浮紧。为伤寒脉。是中风见寒脉也。寒多热少不烦躁手
足微厥。为伤寒候。脉浮缓。为中风脉。是伤寒见风脉也。中风见寒脉。伤寒见风脉。宜服大青龙汤。盖大青龙症。脉
似桂枝反无汗。病似麻黄反烦躁是也。(脉弱有汗。为桂枝症。脉紧不烦躁。为麻黄症。)大青龙汤治病。与麻黄汤症相
似。但病尤重。而又加烦躁者。用大青龙也。以其风寒俱盛。故青龙汤添麻黄作六两。又似合桂枝汤药味在内。添石膏。
所以为紧。此治荣卫俱病。若症不审。误用大青龙。则发汗多伤人。(以其有烦躁一症。故可用大青龙汤。)
陶华曰。热盛而烦。手足自温。脉浮而紧。此伤风见寒脉也。不烦少热。四肢微厥。脉浮而缓。
此伤寒见风脉也。二者为荣卫俱病。法虽用大青龙。此汤险峻。不可轻用。须风寒俱盛。又加烦
躁。方可与之。不若羌活冲和汤。为神药也。一法。用桂枝麻黄汤。
李氏说:肺主司皮毛,与膀胱相通,最容易感受外邪。表现为新近出现的咳嗽、怕风、鼻塞、声音沉重、打喷嚏等。可用柴胡半夏汤、参苏饮。在寒冷季节,用麻黄杏仁饮。病情较重的,出现头痛、身体疼痛、恶寒发热、咽喉干燥、声音嘶哑,可用柴胡桂枝汤、防风冲和汤。头痛剧烈的,用川芎茶调散。痰多的,用金沸草散。兼有热邪的,用人参败毒散、升麻葛根汤。兼有寒邪的,用十神汤。兼有寒湿的,用消风百解散。兼有湿邪的,用神术散。兼有暑邪的,用香葛汤。时行疫病(流行性感冒),用柴胡升麻汤。饮食过于浓腻,素有痰火,经常鼻塞流涕、声音沉重咳嗽,稍微受到外感就会加重的,用防风通圣散。或者将大黄、黄芩等分制成丸剂,白开水送服。体质素来虚弱的,只用防风、羌活、川芎,根据情况加入补益药或化痰药。伤食的,加白术、青皮、陈皮、山楂、麦芽。兼受形体寒冷、饮用冷物影响的,加生姜、肉桂。兼房劳过度的,加人参、白术、当归、地黄。兼劳累过度损伤元气的,用补中益气汤加羌活、防风。风气虚损严重的,用羌活丸、加味乌金丸。风邪传入体内,治疗同伤寒的方法相同。风能燥血散气,所以古人常用桂枝八物汤等方剂。久治不愈的,只宜用三白汤加减以收敛固涩。切忌使用疏泄之法。即使初起,如果不是寒冷季节无汗的情况,禁用麻黄。
朱肱说:有的患者发热、恶寒、烦躁、手足温暖,但脉象反而浮紧;有的患者寒多热少、不烦躁、手足微冷,但脉象反而浮缓。这叫做“伤风见寒脉”、“伤寒见风脉”。大概发热、恶寒、烦躁、手足温,是中风的症状;脉浮紧,是伤寒的脉象,这是中风见到寒脉。寒多热少、不烦躁、手足微厥,是伤寒的症状;脉浮缓,是中风的脉象,这是伤寒见到风脉。对于中风见寒脉、伤寒见风脉,适宜服用大青龙汤。因为大青龙汤证,脉象类似桂枝汤证却无汗,病症类似麻黄汤证却有烦躁。(脉弱有汗,是桂枝汤证;脉紧不烦躁,是麻黄汤证。)大青龙汤治疗的病,与麻黄汤证相似,但病情更重,并且加上烦躁症状,所以用大青龙汤。因为风寒都盛,所以大青龙汤中麻黄用量增加到六两,又似乎合入了桂枝汤的药味,并添加石膏,所以药力峻猛。这是治疗营卫俱病的方子。如果辨证不仔细,误用大青龙汤,会导致发汗过多而伤人。(因为有烦躁这一症状,所以可以用大青龙汤。)
陶华说:热盛而烦,手足自然温暖,脉浮而紧,这是伤风见寒脉。不烦躁、热少,四肢微冷,脉浮而缓,这是伤寒见风脉。这两者都是营卫俱病,虽然法度上可用大青龙汤,但此汤险峻,不可轻用。必须风寒俱盛,又加上烦躁,才可以给予服用。不如用羌活冲和汤,那是神效之药。另一种方法,用桂枝麻黄各半汤。
Li said: The Lung governs the skin and hair, connects with the Bladder, and is most susceptible to external pathogens. This manifests as new-onset cough, aversion to wind, nasal congestion, heavy voice, and sneezing. Chaihu Banxia Tang (Bupleurum and Pinellia Decoction) or Shen Su Yin (Ginseng and Perilla Drink) may be used. In cold months, Mahuang Xingren Yin (Ephedra and Apricot Seed Decoction) is indicated. For severe cases presenting with headache, body pain, aversion to cold, fever, dry throat, and hoarseness, Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) or Fangfeng Chonghe Tang (Saposhnikovia Harmonizing Decoction) may be administered. For severe headache, Chuanxiong Chatiao San (Ligusticum Tea-Regulating Powder) is used. For excessive phlegm, Jinfeicao San (Boerhavia Powder) is applied. If accompanied by heat, Renshen Baidu San (Ginseng Resisting Toxins Powder) or Shengma Gegen Tang (Cimicifuga and Kudzu Root Decoction) are suitable. If accompanied by cold, Shishen Tang (Ten Deities Decoction) is used. If complicated by cold-dampness, Xiaofeng Baijie San (Wind-Dispersing Hundred-Resolving Powder) is indicated. If complicated by dampness, Shenzhu San (Divine Artisan Powder) is used. If complicated by summerheat, Xiangge Tang (Aromatic Kudzu Decoction) is prescribed. For epidemic diseases (Shixing Bing), Chaihu Shengma Tang (Bupleurum and Cimicifuga Decoction) is used. For those who consume rich foods, have chronic phlegm-fire, and suffer from frequent nasal congestion, runny nose, heavy voice, and cough, which worsen slightly upon external contraction, Fengtong Sheng San (Wind-Blocking Supreme Powder) is indicated. Alternatively, Dahuang Huangqin Wan (Rhubarb and Scutellaria Pills) in equal parts, taken with plain water, may be used. For those with inherent deficiency, only Fangfeng (Saposhnikovia Radix), Qianghuo (Notopterygii Rhizoma et Radix), and Chuanxiong (Chuanxiong Rhizoma) should be used, with tonifying or phlegm-resolving herbs added as appropriate. For food stagnation, add Baizhu (Atractodis Macrocephalae Rhizoma), Qingpi (Aurantii Fructus Immaturus Pericarpium), Chenpi (Citri Reticulatae Pericarpium), Shanzha (Crataegi Fructus), and Maiya (Hordei Fructus Germinatus). If complicated by exposure to cold and consumption of cold drinks, add Shengjiang (Zingiberis Rhizoma Recens) and Rougui (Cinnamomi Cortex). If complicated by sexual exhaustion, add Renshen (Ginseng Radix), Baizhu (Atractodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), and Dihuang (Rehmanniae Radix Praeparata). If complicated by overwork damaging Qi, Buzhong Yiqi Tang (Middle-Boosting Qi-Enriching Decoction) with Qianghuo and Fangfeng is used. For severe wind-deficiency, Qianghuo Wan (Notopterygium Pill) or Jiawei Wujin Wan (Modified Black Gold Pill) are indicated. If wind pathogen transmits inward, treatment follows the methods for Shanghan (Cold Damage). Wind can dry blood and disperse Qi; thus, ancient practitioners often used Guizhi Bawu Tang (Cinnamon Twig Eight-Substance Decoction) and similar formulas. For chronic non-resolving cases, Sanbai Tang (Three Whites Decoction) modified is suitable for astringency. One must strictly avoid dispersing and draining methods. Even at onset, if it is not cold weather with anhidrosis, Mahuang (Ephedrae Herba) is contraindicated.
Zhu Gong said: There are cases where patients present with fever, aversion to cold, restlessness, warm hands and feet, yet the pulse is surprisingly floating and tight. There are also cases where there is more cold than heat, no restlessness, slightly cold hands and feet, yet the pulse is surprisingly floating and slow. These are named "Shangfeng Jian Hanmai" (Wind-Injury exhibiting Cold-Damage Pulse) and "Shanghan Jian Fengmai" (Cold-Damage exhibiting Wind-Injury Pulse). Generally, fever, aversion to cold, restlessness, and warm extremities indicate Zhongfeng (Wind-Strike); a floating-tight pulse indicates Shanghan (Cold-Damage). Thus, Zhongfeng exhibits a Cold-Damage pulse. Conversely, more cold than heat, no restlessness, and slightly cold extremities indicate Shanghan; a floating-slow pulse indicates Zhongfeng. Thus, Shanghan exhibits a Wind-Injury pulse. For these presentations, Daqinglong Tang (Great Azure Dragon Decoction) is appropriate. The Daqinglong syndrome resembles Guizhi Tang pattern but without sweating, and resembles Mahuang Tang pattern but with restlessness. (Weak pulse with sweating indicates Guizhi Tang pattern; tight pulse without restlessness indicates Mahuang Tang pattern.) The disease treated by Daqinglong Tang is similar to Mahuang Tang pattern but more severe, compounded by restlessness, hence Daqinglong Tang is used. Because both wind and cold are abundant, the dosage of Mahuang is increased to six liang, and the formula incorporates ingredients resembling Guizhi Tang along with Shigao (Gypsum Fibrosum), making it potent. This treats simultaneous Ying and Wei pathology. If the syndrome is not carefully differentiated and Daqinglong Tang is mistakenly used, excessive sweating will damage the body. (The presence of restlessness justifies the use of Daqinglong Tang.)
Tao Hua said: Excessive heat with restlessness, naturally warm hands and feet, and a floating-tight pulse indicate Shangfeng Jian Hanmai (Wind-Injury exhibiting Cold-Damage Pulse). No restlessness, less heat, slightly cold limbs, and a floating-slow pulse indicate Shanghan Jian Fengmai (Cold-Damage exhibiting Wind-Injury Pulse). Both conditions involve simultaneous Ying and Wei pathology. Although Daqinglong Tang is theoretically applicable, this decoction is hazardous and should not be used lightly. It is only suitable when both wind and cold are abundant and restlessness is present. It is preferable to use Qianghuo Chonghe Tang (Notopterygium Harmonizing Decoction), which is a miraculous remedy. Another method involves using Guizhi Mahuang Tang (Cinnamon Twig and Ephedra Decoction).