风为阳邪。只伤三肠。不传三阴。由太阳而阳明。由阳明而少阳。亦有首尾
只在一经者。非若伤寒之传三阴也。肺为华盖。内通膀胱。而为气之主。所以太阳伤风。则肺亦咳。凡浑身酸痛。咽
干眼胀。或鼻之两旁迎香穴痛。不必咳嗽。汗出然后为风也。治分有汗无汗。无汗为感冒。有汗为伤风。伤风
之脉。浮细而缓。或前小后大。人身之中有卫气。有荣气。荣深而卫浅。风但伤卫。所以不可发表。发之则汗多亡阳。
或津液亏损。变生坏症。宜用参苏饮。微解其肌。仲景用稀粥以助汗者。因解肌之药不能达表。故与粥以助
之。若腹中有滞。此法又不宜用矣。解散之后。身热咳嗽者。此中伏有妙义。经云。外邪之入必与内邪相合。伤风之人。
平日有痰有火。火熏皮毛。腠理不密。风从火势。火借风威。互相鼓煽。不去其痰。屡痊屡发无有已也。此痰
伏于肺胃之间。胶粘固结。非半夏可除。宜用苏杏二陈汤。内有杏仁油以润之。金沸咸以软之。庶几痰消而火降也。如
耳中气闭。咳嗽口苦。邪传少阳胆经。宜用柴陈汤。亦加杏仁金沸之类。不可过用发散也。三阳既尽。咳
嗽宜愈。每见伤风久嗽不止者。其故何耶。真阴素虚。咳久伤气。肺叶不收。不治多成痨怯。宜用加味地黄汤。
敛而降之。若脉来细缓无力。或洪大无力者。中气大虚。土不生金。宜用加减补中汤。固其元气。曾见伤风气虚。随
治随作。后至气脱而死。病症虽小。亦可畏也。
伤风汗多者。卫气不固。风邪袭入荣中。以致四肢微冷。冷汗多出。脉来沉细如丝。宜用桂枝芍药汤。倍加黄
。若脉来洪大无力。身热汗出者。元气犹未大伤。但用桂枝汤可也。
伤风面肿者。咳嗽气急。脉多沉弦。风邪从呼吸而入。客于肺管。肺叶胀大不收。失其降下之令。气逆于头
面而为肿也。甚则上身俱肿。医者不识。呼为水肿。误人多矣。宜用芎苏散散之。咳血者。宜用茯苓补心汤治之(
肺逆失降而为肤肿且肺主皮毛故也岂可误为水哉)
无汗伤风者谓之感冒。因有咳嗽邪气。留连三阳。不传三阴。所以较伤寒为轻也。但当禁其饮食。与伤风不同。
宜用药芎散。或人参败毒散治之。其中在经在腑。悉从伤寒调治。无二法也。
参苏饮
陈皮 半夏 白茯 甘草 桔梗 枳壳 前胡 木香 紫苏 葛根 人参
风盛则气壅。气壅故痰聚。是方多用顺气之品。可见伤风以利气为第一
义矣。医者须识此意。咳嗽声哑者。宜加黄芩。(按黄芩宜用枯者取轻清之义原本未分晰特重订正)
苏杏二陈汤
陈皮 半夏 白茯 甘草 枳壳 桔梗 紫苏 杏仁 金沸草 桑皮
此方顺气化痰。于理是矣。而又用紫苏者。以其余邪未尽也。胸不宽加浓朴。
(按方中金沸草宜绢包不尔有毛射入肺而咳甚矣)
加味柴陈汤
柴胡 黄芩 半夏 甘草 陈皮 白茯 枳壳 杏仁 金沸草
加味地黄汤
熟地 山药 白茯 山萸 丹皮 泽泻 麦冬 五味 乌梅
加减益气汤
人参 白术 甘草 黄 当归 陈皮 麦冬 五味子
桂枝汤
桂枝(三钱) 白芍(生用三钱) 甘草(二钱) 大枣(三枚) 浮麦(一撮)
气虚脉细加黄 。
茯苓补心汤
陈皮 半夏 白茯 甘草 枳壳 桔梗 前胡 紫苏 干葛 当归 川芎 白芍 熟地(
万不可用以滋阴腻膈遏伏外邪当辨外风之有无是为至要)
此即参苏饮合四物汤是也。参苏一倍。四物汤原是两倍。不可轻重失伦。
咳血者。忌半夏。以花粉代之。川芎亦当议去。(按审邪正而用药如正虚邪重当用参苏饮二倍
四物汤一倍医贵变通而化裁之岂可执一以误人哉。)
芎苏散
紫苏 干葛 柴胡 川芎 陈皮 半夏 白茯 甘草 枳壳 桔梗
风属于阳邪。只损伤三阳经(太阳、阳明、少阳)。不传入三阴经(太阴、少阴、厥阴)。由太阳经传至阳明经,由阳明经传至少阳经。也有从头到尾只在一条经脉发病的。不像伤寒那样传入三阴经。肺为华盖(五脏六腑之盖,覆盖于上),内通膀胱,是气的主宰。所以太阳经受伤风,肺也会咳嗽。凡是全身酸痛,咽干眼胀,或者鼻旁迎香穴疼痛,不一定咳嗽,出汗后才算是伤风。治疗分为有汗和无汗两种情况。无汗称为感冒,有汗称为伤风。伤风的脉象,浮细而缓,或者前部小后部大。人体中有卫气,有营气。营气深在,卫气浅表。风邪只伤害卫气,所以不可用发汗解表法。发汗则汗多亡阳,或者津液亏损,变生坏证。宜用参苏饮。微微解除肌表之邪。张仲景用稀粥来助汗的原因,是因为解肌的药物不能到达体表,所以给喝粥来帮助它。如果腹中有积滞,这种方法又不宜使用了。解散之后,身体发热咳嗽的,这里面潜伏着奥妙的道理。医经说:外邪侵入必然与内邪相合。伤风的人,平时有痰有火,火熏蒸皮毛,腠理不紧密,风借火势,火借风威,互相鼓动煽动。不去除其痰,屡治屡发没有止境。这种痰伏在肺胃之间,胶粘固结,不是半夏可以去除的。宜用苏杏二陈汤。方内有杏仁油来润燥,金沸草味咸来软坚散结,这样才可以痰消而火降。如耳中气闭,咳嗽口苦,邪气传入少阳胆经,宜用柴陈汤。也加杏仁、金沸草之类。不可过用发散药。三阳经病既已尽,咳嗽应当痊愈。每见伤风久咳不止的,这是什么原因呢?真阴素来虚弱,咳嗽久了伤气,肺叶不收摄,不治大多成为痨怯(虚劳羸弱)。宜用加味地黄汤。收敛并降逆。如果脉来细缓无力,或者洪大无力的,中气大虚,土不生金(脾虚不能养肺),宜用加减补中汤。巩固其元气。曾见伤风气虚,随治随发作,后至气脱而死。病症虽小,也可畏惧啊。
伤风汗多的,卫气不固,风邪袭入营分,以致四肢微冷,冷汗多出,脉来沉细如丝,宜用桂枝芍药汤。倍加黄芪。如果脉来洪大无力,身体发热汗出的,元气还没有大伤,只用桂枝汤就可以了。
伤风面肿的,咳嗽气急,脉多沉弦。风邪从呼吸而入,客居于肺管,肺叶胀大不收,失去其降下的功能,气逆于头面而为肿。甚至上身都肿。医生不认识,称之为水肿,误人很多了。宜用芎苏散消散它。咳血的,宜用茯苓补心汤治疗。(肺逆失降而导致肤肿,且肺主皮毛,怎么可以误认为是水呢?)
无汗伤风叫做感冒。因为有咳嗽邪气,留连在三阳经,不传入三阴经。所以比伤寒轻。但应当禁忌饮食,与伤风不同。宜用药芎散,或人参败毒散治疗。其中在经在腑,全部按照伤寒调理治疗,没有两样的方法。
参苏饮
陈皮 半夏 白茯苓 甘草 桔梗 枳壳 前胡 木香 紫苏 葛根 人参
风盛则气壅,气壅故痰聚。这个方子多用顺气的药物。可见伤风以利气为第一要义。医生必须明白这个意思。咳嗽声哑的,宜加黄芩。(按:黄芩宜用枯者,取其轻清之义,原本未分晰,特重订正)
苏杏二陈汤
陈皮 半夏 白茯苓 甘草 枳壳 桔梗 紫苏 杏仁 金沸草 桑白皮
这个方子顺气化痰,于理是对的。而又用紫苏,是因为其余邪未尽。胸不宽加浓朴。(按:方中金沸草宜绢包,不然有毛射入肺而咳甚矣)
加味柴陈汤
柴胡 黄芩 半夏 甘草 陈皮 白茯苓 枳壳 杏仁 金沸草
加味地黄汤
熟地黄 山药 白茯苓 山茱萸 牡丹皮 泽泻 麦冬 五味子 乌梅
桂枝汤
桂枝(三钱) 白芍(生用三钱) 甘草(二钱) 大枣(三枚) 浮小麦(一撮)
气虚脉细加黄芪。
茯苓补心汤
陈皮 半夏 白茯苓 甘草 枳壳 桔梗 前胡 紫苏 干葛 当归 川芎 白芍 熟地黄
(万不可用以滋阴腻膈遏伏外邪,当辨外风之有无,是为至要)
这就是参苏饮合四物汤。参苏饮一倍,四物汤原是两倍。不可轻重失伦。
咳血的,忌半夏,以天花粉代之。川芎也应当议去。(按:审邪正而用药,如正虚邪重,当用参苏饮二倍,四物汤一倍,医贵变通而化裁之,岂可执一以误人哉。)
Wind is a yang pathogen. It only damages the three yang meridians (Taiyang, Yangming, Shaoyang). It does not transmit to the three yin meridians (Taiyin, Shaoyin, Jueyin). It transmits from Taiyang to Yangming, and from Yangming to Shaoyang. There are also cases where the disease remains in one meridian from beginning to end. This is unlike Cold Damage (Shanghan) which transmits to the three yin meridians. The Lung is the canopy (the covering organ of the five zang and six fu organs), internally connects with the Bladder, and is the master of Qi. Therefore, when Taiyang is affected by Wind, the Lung also coughs. Whenever there is whole-body soreness and pain, dry throat, distended eyes, or pain at the Yingxiang acupoint beside the nose, coughing is not necessarily present; sweating indicates Wind Strike (Shangfeng). Treatment is divided into cases with sweating and without sweating. Without sweating is called Cold Injury (Ganmao); with sweating is Wind Strike. The pulse of Wind Strike is floating, fine, and slow, or smaller at the front and larger at the back. Within the human body, there is Defensive Qi (Wei Qi) and Nutritive Qi (Ying Qi). Nutritive Qi is deep, while Defensive Qi is superficial. Wind pathogen only injures Defensive Qi, so it is inadvisable to use diaphoretic methods for releasing the exterior. Diaphoresis leads to excessive sweating and loss of Yang, or depletion of body fluids, resulting in complicated syndromes. Shen Su Yin (Ginseng and Perilla Decoction) should be used to slightly resolve the muscle layer. Zhang Zhongjing used thin rice gruel to assist sweating because muscle-resolving herbs cannot reach the exterior, hence the gruel is given to aid them. If there is stagnation in the abdomen, this method is also inappropriate. After resolution, if there is fever and coughing, there lies a profound principle within. The classics state: "External pathogens entering must combine with internal pathogens." Patients with Wind Strike usually have phlegm and fire internally. Fire steams the skin and hair, making the interstices (cou li) loose. Wind follows the fire's momentum, and fire borrows wind's power; they mutually incite each other. If the phlegm is not removed, recovery will be recurrent without end. This phlegm hides between the Lung and Stomach, sticky and firmly consolidated, which Banxia (Pinellia Rhizome) cannot eliminate. Su Xing Er Chen Tang (Perilla and Apricot Kernel Er Chen Decoction) should be used. It contains Xingren (Apricot Seed) oil to moisten, and Feicao (Boilweed Herb) which is salty to soften hardness. Thus, phlegm can be eliminated and fire descended. If there is ear blockage, coughing, and bitter taste in the mouth, the pathogen has transmitted to the Shaoyang Gallbladder Meridian. Chai Chen Tang (Bupleurum and Phlegm-Resolving Decoction) should be used, adding Xingren and Feicao. Do not overuse diaphoretic herbs. Once the three yang meridians are exhausted, coughing should heal. Often, one sees prolonged coughing after Wind Strike. What is the reason? True Yin was originally deficient. Prolonged coughing injures Qi, causing the Lung lobes to fail to contract. If untreated, it often becomes consumptive weakness (Lao Qie). Jia Wei Di Huang Tang (Modified Rehmannia Pill) should be used to astringe and descend. If the pulse is fine, slow, and forceless, or large and forceless, Middle Qi is severely deficient. Earth fails to generate Metal (Spleen deficiency failing to nourish Lung). Jia Jian Bu Zhong Tang (Modified Tonify the Middle Decoction) should be used to consolidate Yuan Qi. I have seen cases of Wind Strike with Qi deficiency, recurring despite treatment, eventually leading to death from Qi collapse. Though the illness is minor, it is formidable.
For Wind Strike with excessive sweating, Defensive Qi is not secure, and Wind pathogen invades the Ying level, causing slight coldness in the four limbs and profuse cold sweating. The pulse is deep, fine, and thread-like. Guizhi Shaoyao Tang (Cinnamon Twig and Peony Decoction) should be used, with increased Huangqi (Astragalus Root). If the pulse is large and forceless, with fever and sweating, Yuan Qi is not yet severely damaged; only Guizhi Tang (Cinnamon Twig Decoction) is needed.
For Wind Strike with facial swelling, accompanied by coughing and rapid breathing, the pulse is mostly deep and wiry. Wind pathogen enters through respiration and lodges in the lung passages. The lung lobes become distended and fail to contract, losing their descending function. Qi rebels upward to the head and face, causing swelling. In severe cases, the upper body swells entirely. Physicians who do not recognize this call it Edema (Shui Zhong), misleading many. Xiong Su San (Ligusticum and Perilla Powder) should be used to dissipate it. For hemoptysis (coughing blood), Fuling Buxin Tang (Poria Heart-Nourishing Decoction) should be used. (Lung rebellion and failure to descend lead to skin swelling; since the Lung governs skin and hair, how can it be mistaken for water?)
Wind Strike without sweating is called Ganmao (Cold Injury). Because the pathogenic factor of coughing lingers in the three yang meridians and does not transmit to the three yin meridians, it is milder than Shanghan. However, dietary restrictions are necessary, differing from typical Wind Strike. Yao Xiong San (Medicinal Ligusticum Powder) or Renshen Baidu San (Ginseng Toxin-Overcoming Powder) should be used. Whether the pathogen is in the meridians or fu organs, it is treated according to Shanghan protocols; there is no different method.
Shen Su Yin (Ginseng and Perilla Decoction):
Chenpi (Tangerine Peel), Banxia (Pinellia Rhizome), Baifu (White Poria), Gancao (Licorice Root), Jiegeng (Platycodon Root), Zhike (Aurantium Fruit), Qianhu (Peucedani Radix), Muxiang (Aucklandiae Radix), Zisu (Perilla Leaf), Gegen (Puerariae Radix), Renshen (Ginseng Radix et Rhizoma).
Excessive wind causes Qi stagnation, and Qi stagnation causes phlegm accumulation. This formula uses many Qi-regulating herbs. Thus, regulating Qi is the primary principle in treating Wind Strike. Physicians must understand this. For hoarse coughing, add Huangqin (Scutellaria Root). (Note: Dried Huangqin should be used for its light and clear properties; the original text did not distinguish this, specifically revised here.)
Su Xing Er Chen Tang (Perilla and Apricot Kernel Er Chen Decoction):
Chenpi, Banxia, Baifu, Gancao, Zhike, Jiegeng, Zisu, Xingren (Prunus Armeniaca Seed), Jinfeicao (Veronica Herba), Sangpi (Morus Bark).
This formula regulates Qi and resolves phlegm, which is logical. Zisu is added because residual pathogen remains. If the chest feels tight, add Houpo (Magnolia Bark). (Note: Jinfeicao in the formula should be wrapped in silk cloth; otherwise, its hairs may enter the lungs and worsen coughing.)
Jia Wei Chai Chen Tang (Modified Bupleurum and Phlegm-Resolving Decoction):
Chaihu (Bupleuri Radix), Huangqin, Banxia, Gancao, Chenpi, Baifu, Zhike, Xingren, Jinfeicao.
Jia Wei Di Huang Tang (Modified Rehmannia Pill):
Shudi (Rehmanniae Radix Preparata), Shanyao (Dioscoreae Rhizoma), Baifu, Shanzhuyu (Corni Fructus), Danpi (Moutan Cortex), Zexie (Alismatis Rhizoma), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), Wumei (Mume Fructus).
Jia Jian Yiqi Tang (Modified Qi-Tonifying Decoction):
Renshen, Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao, Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Chenpi, Maidong, Wuweizi.
Guizhi Tang (Cinnamon Twig Decoction):
Guizhi (Cinnamomi Ramulus) - 3 qian, Baishao (Paeoniae Radix Alba, raw) - 3 qian, Gancao (Glycyrrhizae Radix et Rhizoma) - 2 qian, Dazao (Ziziphi Jujubae Fructus) - 3 pieces, Fumai (Triticum Aestivum Levigate) - a pinch.
If Qi deficiency and fine pulse, add Huangqi.
Fuling Buxin Tang (Poria Heart-Nourishing Decoction):
Chenpi, Banxia, Baifu, Gancao, Zhike, Jiegeng, Qianhu, Zisu, Gange (Puerariae Radix), Danggui, Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao, Shudi.
(Never use this for nourishing Yin as it is cloying and obstructs the middle jiao, trapping external pathogens. It is crucial to differentiate the presence of external wind.)
This is essentially Shen Su Yin combined with Siwu Tang (Four Substances Decoction). Shen Su Yin is doubled, Siwu Tang is originally doubled. One must not lose balance in dosage.
For hemoptysis, Banxia is contraindicated; replace it with Huafen (Trichosanthis Radix). Chuanxiong should also be considered for removal. (Note: Medication should be chosen based on the examination of pathogen and healthy Qi. If healthy Qi is deficient and pathogen is heavy, use double Shen Su Yin and single Siwu Tang. Medicine values flexibility and modification; how can one stick rigidly and mislead patients?)
Xiong Su San (Ligusticum and Perilla Powder):
Zisu, Gange, Chaihu, Chuanxiong, Chenpi, Banxia, Baifu, Gancao, Zhike, Jiegeng.