治寒厥。
附子 肉桂 防己(各四钱) 炙甘草(二钱) 白术 茯苓(各三钱)。
治阴症用葱白一大握,如茶盏大,用纸卷紧,快刀切齐,一指浓片,安于脐中,以
热熨斗熨之,待汗出为度。一片未效,再一片熨之。内服附子理中汤。
辛散表寒,如防风、羌活、紫苏、川芎、细辛、全胡、麻黄、桂枝、生姜、葱白
之类,随候采用。
温散中寒,如泡姜、浓朴、草豆蔻、白豆蔻、丁香、益智仁、砂仁、草果、香附
子、炙甘草、煨木香、吴茱萸、藿香、紫苏、艾叶、煨姜、煨肉果之类,随候采用。
温补下寒,轻则如破故纸、巴戟天、吴茱萸、枸杞子、菟丝子、鹿茸、鹿角胶之
类;重则如肉桂、附子、人参、炮姜之类。人参性本温平,今列于桂附之内者,盖病有
虚而寒,有虚而热,未有寒而不虚者,未有虚寒而不温补相兼者也。
婴儿之患,夏秋为甚、盖火土旺于长夏,正当金水受伤,稚阳阴微,已失天和,
加之暑热阳气浮于外,生冷戕于中,夏失长养,则不能生金而病于秋,故《素问》有夏
伤于暑,秋必 疟。亦有即发为病,入心则身热头疼,心烦口渴,或喘或满,而不知
人;入肝则眩晕;入脾则嗜卧;入肺则喘满;入肾则消渴。更有面垢昏倦,毛耸恶
寒,吐利烦渴,状如伤寒,头疼身热,四肢厥冷,但身体不痛为异,兼暑能耗气,气耗
则脉虚散无力。然静而得之者为中暑,动而得之者为中热。更有冒暑以致五心烦热,头
额亦温,小便赤少,面合地卧,暑喜伤心,蒙蔽心窍则昏闷不醒,手足搐掣,角弓反
张,身热如冷,状似惊候,名为暑风者;或有吐泻不已,火性疾速,元阳骤亡,而变慢
惊者;有伤暑暴注洞泻;有伤暑作呕吐酸者,《经》曰∶诸呕吐酸,暴注下迫,皆属
于热。故虽时当长夏之令,实伏阴在内之时,调摄可不慎欤!
治疗寒厥证。
附子、肉桂、防己(各四钱),炙甘草(二钱),白术、茯苓(各三钱)。
治疗阴症时,取一大把葱白,粗细如茶盏大小,用纸卷紧,用快刀切齐,切成约一指厚的片,放置在肚脐中,用热熨斗熨烫,直到出汗为止。如果一片没有效果,再换一片继续熨烫。内服附子理中汤(Aconite and Poria Decoction)。
辛味发散以解除表寒,如防风、羌活、紫苏、川芎、细辛、全胡荽(此处指胡荽/香菜或泛指辛散药,依原文“全胡”可能为笔误或特指,保留原意)、麻黄、桂枝、生姜、葱白等药物,根据病情酌情选用。
温性发散以解除中焦寒邪,如炮姜、厚朴、草豆蔻、白豆蔻、丁香、益智仁、砂仁、草果、香附子、炙甘草、煨木香、吴茱萸、藿香、紫苏、艾叶、煨姜、煨肉豆蔻等药物,根据病情酌情选用。
温补下焦寒邪,轻症如破故纸(补骨脂)、巴戟天、吴茱萸、枸杞子、菟丝子、鹿茸、鹿角胶等;重症如肉桂、附子、人参、炮姜等。人参本性温和平和,现在将其列在肉桂和附子一类中,是因为疾病有虚而寒的,有虚而热的,但没有寒而不虚的,也没有虚寒而不需要温补兼施的。
婴儿患病,夏秋季节更为严重。因为火土之气旺盛于长夏,此时正当金水二脏受伤,稚嫩的阳气微弱,已经失去天和平衡,加之暑热使阳气浮越于外,生冷食物损伤于中,夏季未能正常生长养育,则不能生金而在秋季发病,所以《素问》说:夏季伤于暑气,秋季必定发生疟疾(Malaria-like fever)。也有立即发病的,邪气入心则身体发热、头痛、心烦口渴,或者气喘或者胸满,甚至神志不清;邪气入肝则眩晕;邪气入脾则嗜睡;邪气入肺则气喘胸满;邪气入肾则消渴。更有面色垢浊、昏沉疲倦、毛发竖立、恶寒、呕吐腹泻、烦躁口渴,症状类似伤寒,头痛身热,四肢冰冷,只是身体不痛作为区别,兼有暑气耗伤元气,气耗损则脉象虚散无力。然而,静处所得的为中暑(Heatstroke),动处所得的为中热(Heat exhaustion/Heat stroke due to exertion)。还有因冒受暑气导致五心烦热,头额也温热,小便赤少,面部贴地卧倒,暑气喜欢伤害心脏,蒙蔽心窍则昏闷不醒,手足抽搐,角弓反张,身体发热却感觉像冷一样,症状类似惊风,名为暑风(Summerwind);或者有呕吐腹泻不止,火性急骤,元阳突然亡失,而变为慢惊风(Slow convulsion);有伤暑导致的暴注洞泻(Sudden severe diarrhea);有伤暑引起的呕吐酸水,《内经》说:各种呕吐酸水,暴注下迫,都属于热证。所以虽然时令正值长夏,实际上是体内潜伏阴寒的时候,调摄护理能不谨慎吗!
Treatment for Cold Jue (Cold Reversal Syndrome).
Fuzi (Prepared Aconite Root), Rougui (Cinnamon Bark), Fangji (Stephania Root) (each 4 qian); Zhi Gancao (Honey-fried Licorice Root) (2 qian); Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria) (each 3 qian).
For the treatment of Yin Syndrome, take a large handful of Congbai (Scallion White), with a diameter similar to a tea cup. Roll it tightly in paper, trim the ends evenly with a sharp knife, cut into slices about one finger thick, place them on the umbilicus, and apply heat using a hot ironing pot until sweating occurs. If one slice is ineffective, apply another. Internally administer Fuzi Lizhong Tang (Aconite and Poria Decoction).
Acrid-dispersing agents to release exterior cold, such as Fangfeng (Saposhnikovia Root), Qianghuo (Notopterygium Rhizome), Zisu (Perilla Leaf), Chuanxiong (Ligusticum Rhizome), Xixin (Asarum Root), Quan Hu (likely referring to Coriander or a specific acrid herb, retained as per text), Mahuang (Ephedra Stem), Guizhi (Cinnamon Twig), Shengjiang (Fresh Ginger), Congbai (Scallion White), etc., should be selected according to the condition.
Warm-dispersing agents to resolve middle-jiao cold, such as Paoyang (Baked Ginger), Houpo (Magnolia Bark), Caodoukou (Black Cardamom), Baidoukou (White Cardamom), Dingxiang (Clove), Yizhiren (Alpinia Oxyphylla Fruit), Sharen (Amomum Fruit), Caoguo (Tsaoko Fruit), Xiangfu (Cyperus Rhizome), Zhi Gancao (Honey-fried Licorice Root), Wei Muxiang (Baked Costus Root), Wuzhuyu (Evodia Fruit), Huoxiang (Patchouli Herb), Zisu (Perilla Leaf), Aiye (Mugwort Leaf), Weijiang (Baked Ginger), Weirouguo (Baked Nutmeg), etc., should be selected according to the condition.
Warm-tonifying agents for lower-jiao cold: For mild cases, such as Poguzhi (Kuzhenzi/Bonebreaker Seed), Bajitian (Morinda Root), Wuzhuyu (Evodia Fruit), Gouqizi (Goji Berry), Tiansizi (Dodder Seed), Lurong (Deer Antler Velvet), Lu Jiaojiao (Deer Antler Glue); for severe cases, such as Rougui (Cinnamon Bark), Fuzi (Prepared Aconite Root), Renshen (Ginseng Root), Paoyang (Baked Ginger). Renshen (Ginseng Root) is naturally warm and neutral; it is listed here with Rougui and Fuzi because diseases can be deficient-cold or deficient-heat, but there is no cold without deficiency, nor is there deficient-cold that does not require combined warming and tonification.
Infants' illnesses are more severe in summer and autumn. This is because Fire and Earth qi are prosperous in late summer, at which time Metal and Water organs are injured. The tender Yang is weak, and harmony with Heaven has already been lost. Additionally, summer heat causes Yang qi to float outward, while raw and cold foods damage the interior. Failure to nourish properly in summer leads to an inability to generate Metal, resulting in illness in autumn. Thus, *Suwen* states: "Injury by summer heat in summer leads to malaria in autumn." Some may develop illness immediately. If the pathogen enters the Heart, there is body heat, headache, vexation, thirst, possibly panting or fullness, and loss of consciousness; if it enters the Liver, there is dizziness; if it enters the Spleen, there is lethargy; if it enters the Lung, there is panting and fullness; if it enters the Kidney, there is Xiao Ke (Wasting-Thirst). There are also cases with greasy complexion, drowsiness, hair standing on end, aversion to cold, vomiting and diarrhea, irritability, and thirst, resembling Taiyang disease (Exterior Syndrome), with headache, body heat, and cold limbs, but distinguished by the absence of body pain. Furthermore, summer heat consumes Qi; when Qi is consumed, the pulse becomes deficient, scattered, and forceless. However, those who contract it while resting suffer from Zhong Shu (Heatstroke), while those who contract it while exerting themselves suffer from Zhong Re (Heat Exhaustion). There are also cases of being exposed to summer heat leading to heat in the five centers (palms, soles, chest), warmth of the head and forehead, scanty dark urine, lying face down, where summer heat harms the Heart, clouding the Heart orifices causing coma and unresponsiveness, twitching of hands and feet, opisthotonos, body heat feeling like cold, resembling Jing Hou (Convulsive Disorder), named Shu Feng (Summerwind); or persistent vomiting and diarrhea, where the rapid nature of Fire causes sudden loss of Yuan Yang (Primordial Yang), transforming into Man Jing Feng (Slow Convulsion); there is sudden severe diarrhea due to summer heat injury; there is vomiting of sour fluid due to summer heat injury. The Classics state: "All vomiting of sour fluids and sudden severe diarrhea with tenesmus belong to Heat." Therefore, although the season is late summer, it is actually a time when Yin cold lurks within; must one not be cautious in care and regulation!