凡面赤目赤引饮,脉来七八至,按之则散者,此无根之脉也。并夹阴中寒,面色青
而脉沉厥冷,囊缩舌卷,下利清谷,里寒外热者,并身痛脉沉厥冷,脉微欲绝者,并用
四逆汤加喊主之,皆不可视为阳症。
凡身热面赤眼红,六脉无力,或豁大而空者,此下元虚惫,阳浮于上,谓戴阳之症
也。阳已戴于头面,若再加表散或寒凉,则孤阳浮越,危境立至矣。故陶节庵以人参、
附子等药,收归阳气于下源,而加葱白透表,以散外邪,此顾本逐客之妙用也。
夫痢之为症,有因热毒流入脏腑而成者,有因寒邪入胃而成者,有因药品迅攻而
成者,亦有结胸而下漏水者,更为凶症也。凡下痢,如表症已罢,即须下之,此通因通
用之法。至若腹中急痛而甚,时时干呕,火气上逆,唇鲜口渴,下如屋漏水,或如烂肉
汁者,并痢后而便血者,并皆不治。
失音之源不一,有因痰壅气闭,有因失血惊恐,有因邪热攻心,心气耗损,有因火
烁金伤,不能宣布,然咽喉音声如故,而舌不能转运者,为舌喑。如舌能转运言语,而
咽喉音声则无者,为喉喑,舌喑多因于心肾,喉喑多因于肺胃。
奔豚者,因过汗过下,而浊气上犯也。汗者,心之液,过汗则心虚,过下则脾损,
肾无所制水,不畏火,上逆凌心,必脐下悸动,发自少腹,止至心下,名曰奔豚。奔豚
者,肾积也,治宜补脾泻肾而已。
凡是面色发红、眼睛发红且想喝水,脉搏跳动极快(每呼吸一次脉跳七八次),重按则脉搏散乱无力的,这是无根之脉。如果同时伴有阴寒内盛(夹阴中寒),面色发青而脉搏沉伏、四肢厥冷,睾丸收缩、舌头卷曲,腹泻排出未消化的食物,体内寒冷而体表发热,或者全身疼痛、脉搏沉伏、四肢厥冷、脉搏微弱几乎摸不到的,都使用四逆汤加葱白来主治,这些情况都不能视为阳证。
凡是身体发热、面色发红、眼睛红赤,六脉无力,或者脉象豁大而空虚无力的,这是下元虚惫,阳气浮越于上,称为戴阳证。阳气已经浮越到头面,如果再使用发散表邪的药物或寒凉药物,就会导致孤阳进一步浮越,危险局面立刻出现。所以陶节庵用人参、附子等药物,将浮越的阳气收敛回归到下焦本源,并加入葱白透达表邪,以疏散外来的邪气,这是顾护根本、驱逐客邪的巧妙用法。
痢疾这种病症,有因热毒流入脏腑而形成的,有因寒邪侵入胃腑而形成的,有因药物猛烈攻伐而形成的,也有结胸证导致下部漏下水液的,这更是凶险的病症。凡是患痢疾,如果表证已经解除,就必须使用泻下法治疗,这是“通因通用”的治疗方法。至于那些腹部剧烈疼痛,频繁干呕,火气上逆,嘴唇鲜红口渴,大便像屋漏水一样稀薄,或者像烂肉汁一样的,以及痢疾停止后反而便血的,都属于无法治愈的情况。
失音的原因各不相同,有的因痰湿壅盛、气机闭塞所致,有的因失血、惊恐所致,有的因邪热攻心、心气耗损所致,有的因火邪灼伤肺金、肺气不能宣发所致。然而,如果咽喉发声功能正常,但舌头不能灵活转动言语的,称为舌喑。如果舌头能灵活转动言语,但咽喉不能发出声音的,称为喉喑。舌喑多因于心肾病变,喉喑多因于肺胃病变。
奔豚病,是因为过度发汗或过度泻下,导致浊气上犯所致。汗液是心的体液,过度发汗则心气虚弱,过度泻下则脾脏受损,肾脏失去制约水液的能力,不畏火邪,寒气上逆凌犯心脏,必然导致脐下悸动,气从少腹发起,向上冲至心下,命名为奔豚。奔豚属于肾积病,治疗应当补益脾土、泻除肾邪而已。
Whenever the face is red, eyes are red, and there is a desire to drink, with a pulse rate of seven or eight beats per breath, which becomes scattered when pressed heavily, this is a rootless pulse. If accompanied by cold invading the interior (Jia Yin Zhong Han), with a bluish complexion, deep pulse, cold extremities, retracted testicles, curled tongue, diarrhea of undigested food, internal cold with external heat, or body pain with deep pulse, cold extremities, and a faint pulse nearly imperceptible, all should be treated with Sini Tang (Four Reversal Decoction) plus Congbai (Scallion Stalk). These conditions must not be regarded as Yang syndromes.
Whenever there is feverish body heat, red face, red eyes, with weak six-position pulses, or pulses that are wide and empty, this indicates deficiency and exhaustion of the lower origin, with Yang floating upward, known as Dai Yang syndrome (Floating Yang). Since Yang has already floated to the head and face, if surface-releasing or cooling herbs are added, isolated Yang will float away further, leading to immediate danger. Therefore, Tao Jie'an used herbs such as Renshen (Ginseng Root) and Fuzi (Aconite Lateralis Radix Preparata) to gather the floating Yang back to its source in the lower burner, and added Congbai (Scallion Stalk) to penetrate the exterior and disperse external pathogens. This is a subtle application of protecting the root while expelling the guest pathogen.
Dysentery arises from various causes: some result from heat toxins entering the zang-fu organs; some from cold pathogens invading the stomach; some from violent purgative drugs; and some from Jie Xiong syndrome (Chest Binding) causing leakage of fluid from below, which is an even more ominous condition. For dysentery, if the exterior syndrome has resolved, purgation is required immediately; this is the method of "treating obstruction with unblocking" (Tong Yin Tong Yong). However, cases with severe abdominal cramping pain, frequent dry heaving, rebellious fire qi, bright red lips, thirst, stool resembling leaking roof water or rotten meat juice, or hematochezia occurring after the cessation of dysentery, are all considered untreatable.
The causes of aphonia vary. Some arise from phlegm obstruction and Qi closure; some from blood loss and fright; some from evil heat attacking the heart and depleting Heart Qi; some from fire scorching Metal (Lung), preventing its dissemination. However, if the throat can produce sound but the tongue cannot move for speech, it is called She Yin (Tongue Aphonia). If the tongue can move for speech but the throat cannot produce sound, it is called Hou Yin (Throat Aphonia). She Yin is mostly due to Heart and Kidney issues, while Hou Yin is mostly due to Lung and Stomach issues.
Ben Tun (Running Piglet) occurs due to excessive sweating or excessive purging, causing turbid Qi to rebel upward. Sweat is the fluid of the Heart; excessive sweating leads to Heart deficiency, and excessive purging damages the Spleen. The Kidney loses its ability to control water and does not fear Fire; Cold rebels upward to oppress the Heart, inevitably causing palpitations below the umbilicus, originating from the lower abdomen and rising to the epigastrium. This is named Ben Tun. Ben Tun is a type of Kidney accumulation (Ren Ji); treatment should focus on tonifying the Spleen and draining the Kidney.