秋燥汗出,不恶寒,而但发热,咳痰不爽,鼻
衄口干,舌白转黄,此邪热伤肺。宜用沙参,花粉、
地骨皮、知母、甜杏、玉竹、元参,甘草,连翘、
枇杷叶、西爪翠衣等味,清肺泄热也。
上条无汗恶寒,例宜透解。此条汗出不恶寒,而但发
热,乃邪不肯解,而渐传乎肺,故咳痰、舌黄、鼻衄,已现
热逼肺营之状。必用沙参、花粉、骨皮、杏仁、知母、玉
竹、元参、连翘,清肺金而解热邪也。
秋燥热不解,舌赤黄燥,呛咳胸痛,朝凉暮热,
此肺热传营。宜用沙参、麦冬、鲜石斛、鲜生地、
桑叶、甜杏、川贝、花粉、连翘等味,清营却热也。
此言热不解,而舌赤心黄少津,是邪渐入营,肺犹未
清。故呛咳胸痛,朝凉暮热,入络之形已着,不得不借沙
参,麦冬、斛、地、杏、贝,花粉、连翘,两清气血也。
秋燥烦热口渴,舌赤无苔,夜则热甚,咳唾痰
血,此热伤肺络。宜用喻氏清燥汤,育阴清热也。
此条热既入络,伤及气血。故烦热夜甚,口渴舌赤,咳
痰带血。若非喻氏清燥汤中之沙参、麦冬、甜杏、川贝、桑
叶、石膏清气分,兼生地,阿胶滋血液,则恐邪难泄越,而
滋蔓难图焉。
秋燥经旬不解,舌绎焦黑,神昏谵妄,斑疹累
累,此热入血分。宜用犀角地黄汤加鲜石斛、元参
心、连翘心、鲜菖蒲、青竹叶、牛黄丸等昧,清络
宜窍也。
此条营热不谆,必致入血。舌绎焦黑、昏谵烦乱,斑疹
俱现,此血热甚也。故用犀角、生地、丹皮,赤芍、元参、
连翘,皆凉血清热之品,又兼菖蒲、竹叶,牛黄丸,芳香宣
窍逐秽也。
秋燥病出现汗出,不恶寒,仅发热,咳嗽痰液排出不畅,鼻出血,口干,舌苔由白转黄,这是邪热损伤肺脏。适宜使用沙参、天花粉、地骨皮、知母、甜杏仁、玉竹、玄参、甘草、连翘、枇杷叶、西瓜翠衣等药物,以清泄肺热。
上一条(指前文)无汗恶寒,按照常规应当透散解表。这一条汗出而不恶寒,仅发热,说明邪气不肯解散,逐渐传入肺脏,因此出现咳嗽痰多、舌苔变黄、鼻衄等症状,已经显现出热邪逼迫肺营的征象。必须使用沙参、天花粉、地骨皮、杏仁、知母、玉竹、玄参、连翘,来清肃肺金并解除热邪。
秋燥病热势不解,舌色红赤且干燥发黄,呛咳胸痛,早晨凉爽傍晚发热,这是肺热传入营分。适宜使用沙参、麦冬、鲜石斛、鲜生地、桑叶、甜杏仁、川贝母、天花粉、连翘等药物,以清营退热。
这里说的是热势不解,舌色红赤中心黄而少津液,说明邪气逐渐进入营分,肺中余热尚未清除。因此出现呛咳胸痛,朝凉暮热的症状,入络的形证已经明显,不得不借助沙参、麦冬、石斛、生地、杏仁、贝母、天花粉、连翘,来气血两清。
秋燥病烦热口渴,舌色红赤无苔,夜间发热加重,咳嗽唾痰中带血,这是热邪损伤肺络。适宜使用喻嘉言的清燥汤,以滋养阴液、清泄热邪。
这一条热邪既然进入络脉,损伤了气血。所以出现烦热夜间加重,口渴舌红,咳嗽痰中带血的症状。如果不是用喻氏清燥汤中的沙参、麦冬、甜杏仁、川贝母、桑叶、石膏来清气分热,兼用生地黄、阿胶来滋养血液,恐怕邪气难以宣泄,从而蔓延难治。
秋燥病经过十天以上仍未解除,舌苔焦黑起刺,神志昏迷胡言乱语,斑疹接连出现,这是热邪深入血分。适宜使用犀角地黄汤加入鲜石斛、玄参心、连翘心、鲜石菖蒲、青竹叶、牛黄丸等药物,以清泄络热、开窍醒神。
这一条营分热邪不止,必然会导致热入血分。舌苔焦黑起刺,神昏谵语烦躁混乱,斑疹全部出现,这是血热非常严重的表现。因此使用犀角、生地黄、牡丹皮、赤芍药、玄参、连翘,这些都是凉血清热的药物,又兼用石菖蒲、竹叶、牛黄丸,以芳香之性宣通窍道、驱逐秽浊。
In autumn-dryness disease, with sweating, aversion to cold absent but fever present, cough with difficult expectoration, epistaxis, dry mouth, and tongue coating turning from white to yellow, this indicates pathogenic heat injuring the Lung. It is appropriate to use Glehniae Radix (Shashen), Trichosanthis Radix (Huafen), Lycii Cortex (Gugupi), Anemarrhenae Rhizoma (Zhimu), Sweet Apricot Kernel (Tianxing), Polygonati Odorati Rhizoma (Yuzhu), Scrophulariae Radix (Yuanshen), Glycyrrhizae Radix et Rhizoma (Gancao), Forsythiae Fructus (Lianqiao), Loquat Leaf (Pipaye), and Watermelon Rind (Xizhuang Cuiyi) to clear Lung heat and drain fire.
The preceding clause described no sweating and aversion to cold, which typically requires dispersing and resolving the exterior. This clause describes sweating without aversion to cold, but only fever, indicating that the pathogen refuses to resolve and gradually transmits to the Lung; thus, cough with phlegm, yellow tongue coating, and epistaxis appear, showing signs of heat forcing into the Lung Ying (Nutritive Level). One must use Glehniae Radix (Shashen), Trichanthis Radix (Huafen), Cortex Lycii (Gupi), Apricot Kernel (Xingren), Anemarrhenae Rhizoma (Zhimu), Polygonati Odorati Rhizoma (Yuzhu), Scrophulariae Radix (Yuanshen), and Forsythiae Fructus (Lianqiao) to clear Metal (Lung) and resolve pathogenic heat.
In autumn-dryness disease, if heat persists unresolved, with a red and dry yellow tongue, violent cough, chest pain, coolness in the morning and fever in the evening, this indicates Lung heat transmitting to the Ying (Nutritive) level. It is appropriate to use Glehniae Radix (Shashen), Ophiopogonis Radix (Maidong), fresh Dendrobii Caulis (Xianshihu), fresh Rehmanniae Radix (Xiandihuang), Mori Folium (Sangye), Sweet Apricot Kernel (Tianxing), Fritillariae Thunbergii Bulbus (Chuanbei), Trichosanthis Radix (Huafen), and Forsythiae Fructus (Lianqiao) to clear the Ying level and repel heat.
This refers to persistent heat where the tongue is red with a yellow center lacking fluids, indicating the pathogen gradually entering the Ying level while Lung heat remains uncleared. Thus, violent cough, chest pain, and alternating coolness/fever manifest, showing established signs of pathogen entering collaterals. One cannot help but rely on Glehniae Radix (Shashen), Ophiopogonis Radix (Maidong), Dendrobii Caulis (Shihu), Rehmanniae Radix (Dihuang), Apricot Kernel (Xingren), Fritillariae Bulbus (Beimu), Trichosanthis Radix (Huafen), and Forsythiae Fructus (Lianqiao) to clear both Qi and Ying levels.
In autumn-dryness disease, with vexatious heat, thirst, a red tongue without coating, intensified fever at night, and coughing up blood-streaked sputum, this indicates heat injuring Lung collaterals. It is appropriate to use Yu's Qingzao Tang (Clear Dryness Decoction) to nourish Yin and clear heat.
Since the heat has entered the collaterals and injured Qi and Blood, symptoms include vexatious heat worsening at night, thirst, red tongue, and bloody sputum. If not using Glehniae Radix (Shashen), Ophiopogonis Radix (Maidong), Sweet Apricot Kernel (Tianxing), Fritillariae Thunbergii Bulbus (Chuanbei), Mori Folium (Sangye), and Gypsum Fibrosum (Shigao) from Yu's Qingzao Tang to clear the Qi level, combined with Rehmanniae Radix (Di Huang) and Asini Corii Colla (Ejiao) to nourish blood, the pathogen would be difficult to vent, leading to uncontrollable spread.
If autumn-dryness persists for ten days or more, with a scorched black prickly tongue, coma and delirium, and successive macules and rashes, this indicates heat entering the Xue (Blood) level. It is appropriate to use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) added with fresh Dendrobii Caulis (Xianshihu), Scrophulariae Radix Heart (Yuanshenxin), Forsythiae Fructus Heart (Lianqiaoxin), fresh Acori Tatarinowii Rhizoma (Xianchangpu), Menthae Haplocalycis Herba (Qingzhuye), and Niuhuang Wan (Calculus Bovis Pill) to clear collateral heat and open orifices.
Unresolved Ying-level heat will inevitably lead to entry into the Xue (Blood) level. A scorched black prickly tongue, confusion, delirium, restlessness, and appearance of macules and rashes indicate severe Blood heat. Therefore, Rhinoceros Horn (Xijiao), Rehmanniae Radix (Dihuang), Paeoniae Radix Rubra (Danpi), Red Peony Root (Chishao), Scrophulariae Radix (Yuanshen), and Forsythiae Fructus (Lianqiao) are used as cooling-blood and clearing-heat agents, supplemented by Acori Rhizoma (Changpu), Mint Leaf (Zhuye), and Calculus Bovis Pill (Niuhuang Wan) to use aromatic properties to unblock orifices and expel turbidity.