春温诸恙悉平,不饥不食,舌干无苔,此胃阴大
伤用《金柜》麦门冬汤加乌梅、木瓜、谷芽、金
(1)代赭旋复花汤:《伤寒论·辨太阳病脉证并治下》原作"旋复代赭汤"。
柑皮等味,甘酸化阴也。
病后不饥不食,舌干无苔,乃热伤胃,胃气不复也。
然胃为阳土,非柔莫济。故用党参、麦冬、甘草、茯神(1)之
甘以养胃,乌梅、木爪之酸以制肝,且得甘酸化阴,甲已化
土之义,更兼半夏、谷芽辛温通阳,使胃可醒而食可进也。
春温病退,舌淡脉微,不饥不食,泛泛欲呕,此
胃阳大伤。宜用六君子汤加白蔻、吴萸、姜汁等味,
温补胃阳也。
上条舌赤无苔,不饥不食,伤及胃阴,宜用甘酸柔润,
以济其阴。此条舌淡脉微,不饥不色,伤及胃阳,宜用甘温
刚燥,以扶其阳。此胃中之阴阳偏损,不可不辨,医者慎
之。
春温发热恶寒,喘逆胁痛,此邪滞肺络。宜用
《金柜》旋复花汤加苏子、开肺、杏仁、郁金,川
贝、积壳、桔梗等味,开肺和络也。
发热恶寒者,表邪未散,喘逆胁痛者,肺气壅遏;若不
宣通,恐延痿廱缠绵。故用旋复,新绎、橘络以通络气,苏
子、杏仁、川贝以降肺气,枳壳、桔梗、枇杷叶以开上焦之
(1)茯神:《金柜要略》麦门冬汤原方无此药。
气,使邪从上散,不致传变为妙。
春温病的所有症状都已平息,但患者没有饥饿感且不想进食,舌面干燥且没有舌苔,这是胃阴受到严重损伤。应使用《金匮要略》中的麦门冬汤(Mai Men Dong Tang, Ophiopogon Decoction),加入乌梅、木瓜、谷芽、金柑皮等药物,利用甘味与酸味结合以化生阴液。
病后出现没有饥饿感且不想进食,舌面干燥无苔的情况,是因为热邪损伤了胃气,导致胃气无法恢复。然而,胃属阳土,非柔和之品不能滋养。因此使用党参、麦冬、甘草、茯神(Fu Shen, Poria with Hostwood)的甘味来养胃,用乌梅、木瓜(Mu Gua, Chaenomeles Fruit)的酸味来制约肝木,并且符合“甘酸化阴”以及“甲己化土”的理论意义;同时兼用半夏、谷芽的辛温之性以通阳,使胃气得以苏醒而食欲能够增进。
春温病退去后,舌色淡白、脉象微弱,没有饥饿感且不想进食,伴有泛泛欲呕的感觉,这是胃阳受到严重损伤。适宜使用六君子汤(Liu Jun Zi Tang, Six Gentlemen Decoction)加入白蔻、吴茱萸、姜汁等药物,以温补胃阳。
上一条文中提到舌赤红无苔,不饥不食,是伤及了胃阴,适宜使用甘酸柔润的方法,来济助其阴液。这一条文中提到舌淡脉微,不饥不食,是伤及了胃阳,适宜使用甘温刚燥的方法,来扶持其阳气。这是胃中阴阳偏颇受损的情况,不可不加以辨别,医生们务必谨慎。
春温病表现为发热恶寒,气喘逆上且胁肋疼痛,这是邪气滞留于肺络。适宜使用《金匮要略》中的旋复代赭汤(Xuan Fu Dai Zhe Tang, Inula and Hematite Decoction)加入苏子、开肺(此处疑为笔误或特定用法,通常指宣肺药如桔梗或桑叶等,依原文保留)、杏仁、郁金、川贝母、枳壳、桔梗等药物,以开宣肺气、调和肺络。
发热恶寒,说明表邪尚未消散;气喘逆上且胁肋疼痛,说明肺气壅塞遏阻;如果不进行宣通治疗,恐怕会延转为痿证或瘫痪缠绵难愈。因此使用旋复花、新绎(疑为某种络药或笔误,依原文保留)、橘络来通利络气,苏子、杏仁、川贝母来降泄肺气,枳壳、桔梗、枇杷叶来开宣上焦之气,使邪气从上焦发散,不致使病情传变,这才是妙法。
All symptoms of Spring-Warmth disease have subsided, yet the patient feels no hunger and has no desire to eat. The tongue is dry with no coating, indicating severe injury to Stomach Yin. One should use *Ma Men Dong Tang* (Ophiopogon Decoction) from *Jin Gui Yao Lue*, adding *Wu Mei* (Mume Fructus), *Mu Gua* (Chaenomeles Fructus), *Gu Ya* (Hordei Fructus Germinatus), and *Jin Gan Pi* (Citrus Reticulatae Pericarpium). This employs the combination of Sweet and Sour flavors to generate Yin.
Following illness, the absence of hunger and desire to eat, along with a dry tongue lacking coating, results from Heat injuring Stomach Qi, preventing its recovery. However, the Stomach is Yang Earth, which requires soft and moistening agents to nourish it. Therefore, the Sweet properties of *Dang Shen* (Codonopsis Radix), *Mai Dong* (Ophiopogonis Radix), *Gan Cao* (Glycyrrhizae Radix et Rhizoma), and *Fu Shen* (Poria cum Risus) are used to nourish the Stomach; the Sour properties of *Wu Mei* and *Mu Gua* are used to restrain Liver Wood. This aligns with the principles of "Sweet and Sour generating Yin" and "Jia-Ji transforming into Earth." Additionally, the acrid-warm nature of *Ban Xia* (Pinelliae Rhizoma) and *Gu Ya* unblocks Yang, allowing Stomach Qi to awaken and appetite to return.
After the retreat of Spring-Warmth disease, if the tongue is pale, the pulse is faint, there is no hunger or desire to eat, and there is a sensation of nausea, this indicates severe injury to Stomach Yang. It is appropriate to use *Liu Jun Zi Tang* (Six Gentlemen Decoction) added with *Bai Kou* (Amomi Fructus Rotundus), *Wu Zhu Yu* (Evodiae Fructus), and *Jiang Zhi* (Zingiberis Rhizoma Recens Juice) to warm and tonify Stomach Yang.
In the previous paragraph, a red tongue without coating, accompanied by anorexia, indicated injury to Stomach Yin, warranting Sweet-Sour and soft-moistening methods to assist Yin. In this paragraph, a pale tongue and faint pulse, accompanied by anorexia, indicate injury to Stomach Yang, warranting Sweet-Warm and drying-rigid methods to support Yang. This represents a bias in the damage of Yin and Yang within the Stomach, which must not fail to be distinguished; physicians must exercise caution.
Spring-Warmth disease presenting with fever, aversion to cold, wheezing, and hypochondriac pain indicates pathogenic stagnation in the Lung Collaterals. It is appropriate to use *Xuan Fu Dai Zhe Tang* (Inula and Hematite Decoction) from *Jin Gui Yao Lue*, added with *Su Zi* (Perillae Fructus), Kai Fei (likely referring to lung-opening herbs such as Jie Geng or Sang Ye, retained as per text), *Xing Ren* (Armeniacae Semen Amarum), *Yu Jin* (Curcumae Radix), *Chuan Bei Mu* (Fritillariae Cirrhosae Bulbus), *Zhi Ke* (Aurantii Fructus Immaturus), and *Jie Geng* (Platycodonis Radix) to open Lung Qi and harmonize the collaterals.
Fever and aversion to cold indicate that exterior pathogens have not yet dispersed; wheezing and hypochondriac pain indicate obstruction and stagnation of Lung Qi. If not unblocked and circulated, there is a risk of progression to wasting-thirst or paralysis, leading to lingering difficulties. Therefore, *Xuan Fu Hua* (Inulae Flos), Xin Yi (likely referring to a collateral-unblocking agent, retained as per text), and *Ju Luo* (Citri Reticulatae Pericarpium Retinervum) are used to unblock collateral Qi; *Su Zi* and *Xing Ren* are used to direct Lung Qi downward; *Zhi Ke*, *Jie Geng*, and *Pi Pa Ye* (Loquat Leaf) are used to open the Upper Jiao, allowing pathogens to dissipate from above, thereby preventing transmission, which constitutes the optimal approach.