瘟疫于今重达泉(槟榔二钱,草果、甘草各五分,浓朴、芍药、黄芩、知母各一钱,名达
泉饮,)休徇吴氏(吴又可达泉饮若燥灼阴,服之先涸汗源,不能作汗而剧)一偏言。鼻传秽气黄
涎吐,经受时邪壮热烦(谓但热而烦闷也。)败毒(散)藿香(正气散)分两道,散邪(人参败毒散,散邪方
也,令邪从经络解)解秽藿香正气散,解秽方也,今邪从口鼻解)各专门。防风通圣(散)神方外(表
证发解,里证又急,必用此散以两解之,)白虎三承虚实论(热渴自汗,表里不实者白虎汤,大
便不通者三承气汤。
阴虚盗汗为素禀不足。夜间发热,睡时汗出,醒即渐收,故曰盗汗,宜当归六黄汤。若
时常畏寒,一动则汗出,或不动而汗亦自出,名曰阳虚自汗,宜 附汤、参附汤、术附汤,
然阴阳互根,又有不可泥者,熟读《内经》,自得其治。景岳谓不治有六∶一、汗出而喘甚
;二、汗出而脉脱;三、汗出而身痛甚;四、汗出发润至巅;五、汗出如油;六、汗出如珠
。医者不得妄为用药。此症因汗从皮毛而出,故列于表证。
(经义)《阴阳应象大论》曰∶“阳之汗以天地之雨名之。”《宣明五气篇》曰∶“心为汗
。”《评热病论》曰∶“阴虚者,阳必凑之,故少气时热而汗出也。”《决气篇》曰∶“津
脱者腠理开,汗大泄。”《藏气发时论》曰∶“肺病者,肩背痛汗出;肾病者,寝汗出憎风
。”《脉要精微论》曰∶“阳气有余为身热无汗,阴气有余为多汗身寒,阴阳有余,则无汗
而寒。”
瘟疫病在当今要重视达泉饮(槟榔二钱,草果、甘草各五分,浓朴、芍药、黄芩、知母各一钱,名为达泉饮),不要盲从吴又可(吴又可的达泉饮如果导致燥热灼伤阴液,服用后会先耗竭汗源,导致无法出汗而病情加重)那种偏颇的说法。通过鼻窍传入的秽浊之气会导致吐出黄色涎沫,经受时行邪气会出现壮热和烦闷(指只有发热且感到烦闷)。败毒散(人参败毒散)和藿香正气散分为两条治疗途径:前者是散邪方(让人参败毒散等散邪方发挥作用,使邪气从经络解除),后者是解秽方(让藿香正气散发挥解秽作用,使邪气从口鼻解除),两者各有专长。防风通圣散是神方之外(当表证需要发汗解表,里证又很急迫时,必须用此散来表里双解),白虎汤和三承气汤需辨别虚实(热渴自汗、表里皆不实者用白虎汤;大便不通者用三承气汤)。
阴虚盗汗是由于先天禀赋不足。夜间发热,睡觉时出汗,醒来后汗逐渐停止,所以称为盗汗,适宜用当归六黄汤。如果时常怕冷,一动就出汗,或者不动也自然出汗,名叫阳虚自汗,适宜用附子汤、参附汤、术附汤。然而阴阳互根互用,又有不可拘泥的地方,熟读《黄帝内经》,自然能掌握治疗方法。张景岳认为有六种情况不宜治疗:第一,出汗且喘息严重;第二,出汗且脉搏微弱欲绝;第三,出汗且身体疼痛严重;第四,头发湿润直至头顶;第五,汗出如油;第六,汗出如珠。医生不得胡乱用药。此症因为汗从皮毛而出,所以列在表证中。
(经文含义)《素问·阴阳应象大论》说:“人的汗就像天地的雨一样命名。”《素问·宣明五气篇》说:“心主汗。”《素问·评热病论》说:“阴虚的人,阳气必定凑集于他,所以少气、时时发热并且出汗。”《素问·决气篇》说:“津液脱失则腠理开泄,大汗淋漓。”《素问·藏气法时论》说:“肺病的人,肩背疼痛并出汗;肾病的人,睡着出汗且厌恶风。”《素问·脉要精微论》说:“阳气有余表现为身体发热无汗,阴气有余表现为多汗身体寒冷,阴阳俱有余,则无汗且寒冷。”
Plague (Wenyi) in the present day requires attention to Daquan Yin (Betel Nut Decoction, containing Betel Nut 2 qian, Caoguo and Licorice Root each 0.5 qian, Magnolia Bark, Peony Root, Scutellaria Root, and Anemarrhena Rhizome each 1 qian). One should not blindly follow Wu Youke's (Wu Yike) one-sided assertion that his Daquan Yin, if it causes dryness and burns Yin, will first deplete the source of sweat, preventing sweating and exacerbating the condition. When foul qi enters through the nose, yellow saliva is vomited; contracting seasonal pathogens leads to high fever and irritability (referring to fever accompanied by mental restlessness). Baidu San (Ginseng Decoction for Overcoming Toxins) and Huoxiang Zhengqi San (Agastache Powder for Rectifying the Qi) represent two distinct therapeutic pathways: the former is a formula for dispersing pathogens (allowing formulas like Ginseng Decoction for Overcoming Toxins to disperse pathogens, resolving them via the meridians), while the latter is a formula for resolving filth (allowing Agastache Powder for Rectifying the Qi to resolve filth, expelling pathogens via the mouth and nose); each has its specific expertise. Fangfeng Tongsheng San (Saposhnikovia Universal Benefit Powder) is a miraculous formula used when external syndromes require diaphoresis and internal syndromes are urgent, necessitating simultaneous resolution of both exterior and interior. The use of Baihu Tang (White Tiger Decoction) and the three Chengqi Tangs (Descending the Surge Decoctions) depends on distinguishing deficiency and excess: for heat, thirst, spontaneous sweating, with no excess in the exterior or interior, use Baihu Tang; for constipation, use the three Chengqi Tangs.
Yin-deficiency night sweats (Dao Han) stem from congenital insufficiency. Nighttime fever accompanied by sweating during sleep, which ceases gradually upon waking, is termed night sweats; Danggui Liuhuang Tang (Angelica Six-Huang Decoction) is appropriate. If there is frequent aversion to cold, sweating upon slight movement, or even spontaneous sweating without movement, it is named Yang-deficiency spontaneous sweating (Zi Han); Fuzi Tang (Aconite Decoction), Shenfu Tang (Ginseng-Aconite Decoction), and Zhufu Tang (Atractylodes-Aconite Decoction) are indicated. However, since Yin and Yang are mutually rooted, rigid adherence is inadvisable; thoroughly studying the *Huangdi Neijing* (Yellow Emperor's Inner Canon) will naturally reveal the appropriate treatment. Zhang Jingyue stated there are six conditions that should not be treated: 1. Sweating accompanied by severe asthma/dyspnea; 2. Sweating with pulse depletion; 3. Sweating with severe body pain; 4. Sweating with hair dampness extending to the vertex; 5. Sweating resembling oil; 6. Sweating resembling pearls. Physicians must not administer medication recklessly. This syndrome is classified under exterior syndromes because sweat exits through the skin pores.
(Interpretation of Classical Texts) The *Yin-Yang Yingxiang Dalun* (Great Treatise on the Correspondence of Yin and Yang) states: "Human sweat is named after the rain of heaven and earth." The *Xuanming Wuqi Pian* (Chapter on the Five Qi Manifested Clearly) states: "The Heart governs sweat." The *Ping Re Bing Lun* (Treatise on Evaluating Heat Diseases) states: "In cases of Yin deficiency, Yang inevitably congregates, resulting in shortness of breath, intermittent fever, and sweating." The *Jueqi Pian* (Chapter on Determining Essence and Qi) states: "When essence-fluids are depleted, the interstices open, leading to profuse sweating." The *Zangqi Fazhi Lun* (Treatise on the Timing of Organ Manifestations) states: "In Lung diseases, there is shoulder and back pain with sweating; in Kidney diseases, there is night sweating and aversion to wind." The *Maiyao Jingwei Lun* (Treatise on the Essentials of Pulse Diagnosis) states: "Excess Yang manifests as body heat without sweat; excess Yin manifests as excessive sweating with cold body; excess in both Yin and Yang results in no sweat and coldness."