凡不渴而厥吐,是寒虚吐也,宜理中、吴茱萸辈。凡渴而得食即吐,是火吐也,实热宜大黄甘草汤,虚
热宜干姜黄连黄芩汤,或竹叶石膏汤。渴而饮,饮而吐,吐而复渴,水逆病也,宜五苓散。
自利不渴者,属太阴寒也。下利欲饮水者,以有热故也。此以渴不渴,辨寒热也。小便黄赤,大便秽气
稠粘者,皆热利也。小便清白,大便澄澈清谷者,皆寒利也。热利有表证,轻者宜升麻葛根汤,重者宜葛
根汤汗之。有里证者,量以三承气汤下之。无表里证,轻者宜黄芩汤,重者宜葛根黄连黄芩汤清之。寒利宜理
中汤,温而补之。若服理中汤不应者,此属下焦滑脱,宜赤石脂禹余粮汤固涩。仍然不应,此为清浊不分,
水走大肠,宜五苓散,或猪苓汤利之,可瘥也。
行阴欲寐,嗜卧,少阴证也。若欲寐嗜卧,无表里证,身和脉小,知已解也,然解后之睡,呼之则醒,
醒而又睡,是阴气来复,非阴盛困阳,不须惊也。风温亦欲寐多眠,则有脉浮发热,汗出身重,鼻息鼾鸣之别。
咽痛之证,寒热皆有,咽干肿痛,为三阳热证,宜甘桔、半夏、苦酒、猪肤等汤调治。不干不肿而痛,为
三阴寒证,宜四逆汤加桔梗主治。
气撞吐蛔,是厥阴本证也。若气撞不吐蛔,乃邪犹在阳,属表也,宜桂枝汤。气上冲,且少腹引阴急痛,
乃阴阳易病也,宜烧 散。气上冲喉,胸满难以布息,乃寒实在胸也,宜瓜蒂散。
凡是口不渴且出现四肢厥冷并呕吐的,属于寒性虚证呕吐,适宜使用理中汤、吴茱萸汤之类的方剂。凡是口渴且进食后立即呕吐的,属于火性呕吐,若是实热证适宜用大黄甘草汤,若是虚热证适宜用干姜黄连黄芩汤,或者竹叶石膏汤。
口渴想喝水,喝下去却吐出来,吐完又觉得渴,这是水逆病,适宜用五苓散。
自发腹泻且不口渴的,属于太阴经寒证。腹泻想要喝水的,是因为体内有热。这里通过是否口渴来辨别寒证和热证。小便颜色黄赤,大便气味秽浊、质地稠粘的,都是热性腹泻。小便颜色清白,大便清澈、含有未消化食物的,都是寒性腹泻。热性腹泻如果伴有表证(如恶寒发热),轻症适宜用升麻葛根汤,重症适宜用葛根汤发汗解表。如果有里证(如便秘腹痛),应酌情使用三承气汤攻下。如果没有表证也没有里证,轻症适宜用黄芩汤,重症适宜用葛根黄连黄芩汤清热止利。寒性腹泻适宜用理中汤,温中补虚。如果服用理中汤没有效果,这属于下焦滑脱不禁,适宜用赤石脂禹余粮汤固涩收敛。如果仍然没有效果,这是因为清浊不分,水液走注大肠,适宜用五苓散,或者猪苓汤利水渗湿,可以痊愈。
精神萎靡想睡觉,嗜睡懒卧,是少阴病证。如果想要睡觉或嗜睡,但没有表证和里证,身体调和、脉象细小,知道病情已经解除。然而病解后的睡眠,呼唤能醒,醒了又睡,这是阴气恢复的表现,并非阴盛阳衰导致的困顿,不必惊慌。风温病也会想睡觉或多眠,但会有脉浮、发热、出汗、身体沉重、鼻息鼾鸣的区别。
咽痛的病症,寒证和热证都有。咽喉干燥肿痛,是三阳经的热证,适宜用甘桔汤、半夏苦酒汤、猪肤汤等方剂调理治疗。咽喉不干也不肿但疼痛,是三阴经的寒证,适宜用四逆汤加桔梗主治。
气机上冲导致呕吐蛔虫,是厥阴病的本证。如果气机上冲但不吐蛔虫,说明邪气仍在阳分,属于表证,适宜用桂枝汤。气上冲至喉咙,且小腹部牵引阴部急痛,这是阴阳易病,适宜用烧裈散。气上冲至咽喉,胸部胀满难以呼吸,这是寒邪实结在胸中,适宜用瓜蒂散涌吐痰实。
Whenever there is vomiting accompanied by cold limbs without thirst, it is a cold-deficiency type of vomiting; Li Zhong Tang (Regulate the Middle Decoction) or Wu Zhu Yu Tang (Evodia Decoction) are appropriate. Whenever there is thirst and immediate vomiting after eating, it is a fire-type vomiting: for excess-heat patterns, Da Huang Gan Cao Tang (Rhubarb and Licorice Decoction) is indicated; for deficiency-heat patterns, Gan Jiang Huang Lian Huang Qin Tang (Dried Ginger, Coptis, and Scutellaria Decoction) or Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) are indicated. If one is thirsty and drinks, but vomits immediately after drinking, and then becomes thirsty again, this is Water-Reversal Disease (Shui Ni Bing); Wu Ling San (Five-Ingredient Powder with Poria) is indicated.
Spontaneous diarrhea without thirst belongs to Taiyin Cold syndrome. Diarrhea accompanied by a desire to drink water indicates the presence of heat. Thus, the presence or absence of thirst is used to differentiate between cold and heat patterns. Yellowish-red urine combined with foul-smelling, thick, and sticky stool indicates Heat Diarrhea (Re Li). Clear white urine combined with clear stool containing undigested food indicates Cold Diarrhea. For Heat Diarrhea with exterior symptoms, mild cases are treated with Sheng Ma Ge Gen Tang (Kudzu Root and Cimicifuga Decoction), while severe cases are treated with Ge Gen Tang (Kudzu Root Decoction) to induce sweating. For those with interior symptoms, San Cheng Qi Tang (Three Bowel-Purging Decoctions) should be used appropriately to purge. For cases without either exterior or interior symptoms, mild cases are treated with Huang Qin Tang (Scutellaria Decoction), while severe cases are treated with Ge Gen Huang Lian Huang Qin Tang (Kudzu, Coptis, and Scutellaria Decoction) to clear heat. Cold Diarrhea is treated with Li Zhong Tang (Regulate the Middle Decoction) to warm and tonify. If Li Zhong Tang is ineffective, this indicates slipping and unconsolidation in the Lower Jiao; Chi Shi Zhi Yu Liang Tang (Red Halloysite and Yuchang Decoction) is indicated to astringe. If there is still no improvement, this indicates a failure to separate the clear from the turbid, with water flowing into the Large Intestine; Wu Ling San (Five-Ingredient Powder with Poria) or Zhu Ling Tang (Polyporus Decoction) are indicated to promote urination, which can lead to recovery.
Lethargy and a desire to sleep, along with excessive drowsiness, characterize Shaoyin Syndrome. However, if there is a desire to sleep or drowsiness without exterior or interior symptoms, and the body feels harmonious with a small pulse, it indicates that the disease has resolved. The sleep following resolution, where the patient wakes upon being called but falls back asleep, represents the restoration of Yin Qi, not an oppression of Yang by excess Yin; thus, there is no need for alarm. Wind-Warmth diseases also present with lethargy and excessive sleep, but they are distinguished by floating pulse, fever, sweating, heavy body, and snoring breath.
Sore throat can result from both cold and heat patterns. Dryness, swelling, and pain of the throat indicate a Heat pattern of the Three Yang channels; Gan Jie Tang (Licorice and Platycodon Decoction), Ban Xia Ku Jiu Tang (Pinellia and Vinegar Decoction), or Zhu Fu Tang (Pig Skin Decoction) are indicated for treatment. Pain without dryness or swelling indicates a Cold pattern of the Three Yin channels; Si Ni Tang (Frigid Extremities Decoction) added with Jie Geng (Platycodon Root) is indicated.
Qi rushing upward causing vomiting of roundworms is the fundamental manifestation of Jueyin Disease. If Qi rushes upward but roundworms are not vomited, the pathogen remains in the Yang aspect, belonging to the exterior; Gui Zhi Tang (Cinnamon Twig Decoction) is indicated. Qi rushing upward to the throat, accompanied by pulling acute pain in the lower abdomen extending to the genitalia, characterizes the Yi Yang Huan Disease (Mutual Transformation of Yin and Yang); Shao Kun San (Burnt Undergarment Powder) is indicated. Qi rushing upward to the throat, with chest fullness and difficulty breathing, indicates Excess Cold stagnating in the Chest; Gua Di San (Melon Sepal Powder) is indicated to induce vomiting.