《活人书》云∶伤寒,阴盛隔阳,病患身冷,脉细沉疾,烦躁而不饮水者。又云∶大抵阴毒
,因肾气虚寒,或因冷物伤脾,外感风寒,则阳气不守,遂发头痛,腰重,腹痛,眼睛疼,身体
倦怠,四肢逆冷,汗不止,或多烦渴,精神恍惚。若误服凉药,则渴转甚,躁转急。有此病者,
便须急服辛热之药。或时郑声,指甲面色青黑。若阴毒已深,病势困重,六脉附骨,浮之则有
,按之则无,但于脐中用葱熨法,或着艾三百壮,以来手足不温者,不可治也。守真云∶或下后
热不退,或蓄热内甚,阳厥极深,以至阳气怫郁,不能营运于身表四肢,以致遍身清冷,痛甚不
堪,项背拘急,目睛赤痛,昏眩恍惚,咽干或痛,燥渴虚汗,呕吐下利,腹满实痛,烦冤闷乱,
喘急郑声,以其蓄热极深,而脉道不利,以脉沉细欲绝者,俗未明其造化之理,而反传为阴毒。
或失下热极,以致身冷脉微,而昏冒将死。若急下之,则残阴暴绝,阳气后竭而立死,不下亦死
。病患至此,命悬顷刻。然则治法当何如?曰∶此当凉膈散,或黄连解毒汤,养阴退阳,但欲蓄
热渐渐宣散,则心腹复暖,脉渐以生。至于脉复有力,可以三一承气汤微下之,或解毒加大承气汤
尤良。俗未明此故,认作阴证,是以失其治也。《素问·五营运大论》岐伯曰∶气
有余则制己所胜而侮所不胜,不及则己所不胜乘而侮之,己所胜轻而侮之。木余则制土,轻侮于
金,金气不争,故木恃其余而欺侮之也。又,木少金胜,土反伤木,以木不及,妄 之也。四
气本同。(侮,谓侮慢也,而凌忽之也。)又云∶以火炼金,热极反化为水。又云∶亢则害,承乃制。
《活人书》说:伤寒病中,阴气过盛格拒阳气,患者身体发冷,脉搏细弱、沉取且急数,烦躁不安但不想喝水。又说:大抵阴毒证,是因为肾气虚寒,或者因生冷食物损伤脾阳,外感风寒邪气,导致阳气不能固守,于是出现头痛、腰部沉重、腹痛、眼睛疼痛、身体倦怠、四肢逆冷、汗出不止,或者多烦渴、精神恍惚。如果误服寒凉药物,口渴会更严重,躁动更急促。患有这种病的人,必须立即服用辛热性质的药物。有时出现言语重复(郑声),指甲和面色青黑。如果阴毒已经深入,病情危重,六脉在骨上才能触及,轻取有感觉,重按则无,只能在肚脐中使用葱熨法,或者艾灸三百壮,如果这样手脚仍然不温暖,就是不可治愈的。刘完素(守真)说:或者攻下之后热势不退,或者体内蓄积热邪极甚,导致阳厥极深,以至于阳气郁结,不能在体表和四肢运行,导致全身清冷,疼痛剧烈难以忍受,颈项背部拘急,眼睛红痛,昏眩恍惚,咽喉干燥或疼痛,燥渴出虚汗,呕吐腹泻,腹部胀满实痛,烦闷混乱,气喘急促并伴有言语重复(郑声)。因为蓄热极深,脉道不通利,脉象沉细几乎摸不到,世俗之人不明白其中的造化机理,反而将其传变为阴毒证。或者失于攻下导致热极,以致身体冰冷、脉微细,神志昏迷濒临死亡。如果紧急攻下,残存的阴液会突然断绝,阳气随后竭尽而立即死亡;如果不攻下也会死亡。患者到了这种地步,生命悬于顷刻之间。那么治疗方法应当如何呢?回答说:这应当使用凉膈散,或者黄连解毒汤,滋养阴液退制阳热,只要让蓄积的热邪渐渐宣散,心腹就会恢复温暖,脉象逐渐恢复。等到脉象重新有力,可以用三一承气汤轻微攻下,或者使用解毒加大承气汤效果更好。世俗之人不明白这个道理,误认为是阴证,因此失去了正确的治疗时机。《素问·五营运大论》中岐伯说:气有余就会克制自己所能胜的脏气,并且欺侮自己不能胜的脏气;气不足,则自己不能胜的脏气会乘虚而入并欺侮它,自己所能胜的脏气也会轻视并欺侮它。木气有余就会克制土,轻慢欺侮金,金气不争辩,所以木凭借其有余之势而欺侮金。另外,木气少而金气胜,土反过来伤害木,这是因为木气不足而被妄加欺凌。(侮,意为傲慢,凌辱忽视。)又说:用火炼金,热极反而化为水。又说:亢盛就会产生危害,顺承规律才能制约。
The *Huoren Shu* (Book of Vitality) states: In cold damage diseases, when yin is excessive and repels yang, the patient's body becomes cold, the pulse is fine, deep, and rapid, accompanied by irritability but without a desire to drink. It further states: Generally speaking, Yin Toxin arises from deficiency-cold of kidney qi, or from spleen injury due to cold foods, combined with external contraction of wind-cold, causing yang qi to fail in its guarding function. This leads to headache, heavy sensation in the waist, abdominal pain, eye pain, bodily fatigue, cold extremities, incessant sweating, or excessive thirst with irritability, and mental confusion. If cooling medicines are mistakenly administered, thirst intensifies, and restlessness becomes more urgent. Patients with this condition must urgently administer acrid-hot medicines. Sometimes there is "zheng sheng" (repetitive speech), with cyanotic nails and dark complexion. If the Yin Toxin has penetrated deeply and the disease is critical, with six pulses palpable only upon deep pressure against the bone (present on light touch but absent on heavy press), one should apply the scallion moxibustion method at the umbilicus, or perform three hundred moxa cones. If the limbs remain cold despite this, the condition is incurable. Liu Wansu (Zhenzhu) stated: After purgation, if heat persists, or if internal accumulated heat is extreme, leading to severe Yang Jue (Yang Reversal), yang qi becomes constrained and fails to circulate to the body surface and four limbs. This results in whole-body coldness, unbearable pain, stiffness and tension in the neck and back, red and painful eyes, dizziness and mental confusion, dry or painful throat, dry thirst with deficient sweating, vomiting and diarrhea, abdominal fullness and solid pain, vexation and mental disorder, panting, and repetitive speech. Because the accumulated heat is extremely deep and the pulse pathway is obstructed, the pulse is fine and deep, nearly imperceptible. Laypeople, unaware of the underlying mechanisms, mistakenly diagnose it as Yin Toxin. Alternatively, failure to purge early leads to extreme heat, resulting in a cold body and faint pulse, with coma approaching death. Urgent purgation would cause residual yin to abruptly cease and yang to exhaust subsequently, leading to immediate death; failing to purge also leads to death. At this stage, life hangs in the balance. So, what should the treatment be? The answer is: Use Liang Ge San (Cool the Chest Powder) or Huang Lian Jie Du Tang (Coptis Decoction for Detoxification) to nourish yin and subdue yang. As long as the accumulated heat is gradually dispersed, the heart and abdomen will warm up, and the pulse will gradually recover. Once the pulse regains strength, Yi San Cheng Qi Tang (Three-One Bowel-Regulating Decoction) can be used for mild purgation, or Jie Du Jia Da Cheng Qi Tang (Detoxification Plus Major Bowel-Regulating Decoction) is even better. Laypeople, misunderstanding this, mistake it for a yin syndrome, thereby missing the correct treatment. In the *Suwen: Wu Yun Yun Da Lun* (Basic Questions: Great Treatise on the Movement and Operation of the Five Phases), Qibo said: When qi is in excess, it controls what it normally overcomes and insults what it cannot overcome; when qi is deficient, what normally overcomes it takes advantage to insult it, and what it normally overcomes also lightly insults it. Excess wood controls earth and insults metal; since metal does not contend, wood relies on its excess to bully metal. Conversely, when wood is deficient and metal is strong, earth counter-injures wood, as wood is insufficient and subject to wrongful aggression. The four qi share the same origin. ("Insult" refers to arrogance and neglect.) It also states: Fire smelts metal; extreme heat transforms into water. It further states: Hyperactivity brings harm; only through succession/subordination can control be maintained.