典藏书目

[From *Ji Yan Fang*] Typhoid fever with unobstructed defecation: Select Qimen (LR14) [alternative: Zhangmen, LR13], Zhaohai (KI6).
[Hai Cang's *Yi Han Wan*] Treats Yin syndrome patients who have taken Sini Tang but have not had a bowel movement for several days, accompanied by restlessness and thirst. (Formula recorded under the "Restlessness" section.)

Cheng Wuji: Spontaneous sweating refers to sweating naturally without the use of diaphoretic agents.
Q: What are the external manifestations of Yangming disease? A: The body is hot, there is spontaneous sweating, aversion to cold is absent, and there is an aversion to heat. Q: Why does a patient on the first day of illness have no fever but has aversion to cold? A: Although it is only the first day, the aversion to cold will cease spontaneously, followed immediately by spontaneous sweating and aversion to heat. Q: Why does the aversion to cold cease spontaneously? A: The Yangming channel resides in the center and belongs to Earth; it is where all things return, and pathogenic factors do not transmit further. Initially, there may be aversion to cold, but it stops by the second day. This constitutes Yangming disease. When typhoid fever pathogens transfer to Yangming, the person exhibits slight continuous sweating.
[From *Ben Cao Yan Yi* / or related texts] When Taiyang disease is first contracted, if sweating is induced but not thorough, the condition may transfer to Yangming. After sweating, if the body is hot, there is no aversion to cold, and delirium occurs, Chengqi Tang is appropriate. (Discussion found under "Delirium".)
In Yangming disease, if there is fever and profuse sweating, urgent purgation is required; Da Chengqi Tang is indicated.
[Xu Shuniwei] A patient suffered from typhoid fever with eye pain, dry nose, inability to sleep, and constipation. Both the Cun and Chi pulses were large, and this had persisted for several days. One night, he sweated. I advised immediate purgation using Dachaihu Tang. The physician was alarmed, saying, "Yangming spontaneous sweating implies fluids are already depleted. According to protocol, one should use honey suppositories. Why insist on purgatives?" I replied, "Although you know honey suppositories are safe, Dachaihu Tang is still necessary. This is a secret skill of Zhang Zhongjing that few understand. How could you know this?" I insisted, administered two doses of Dachaihu Tang, and the patient recovered. Zhang Zhongjing states that for Yangming disease with profuse sweating, urgent purgation is required. People argue that since there is already spontaneous sweating, purging would cause both exterior and interior deficiency. Similarly, regarding Shaoyin disease, it says if there is dry mouth and throat within one or two days, urgent purgation is required. People argue that since the disease originates in the Yin channels and the duration is short, seeing only dryness, purging would further damage Yin Qi. Citing these two points, doubts are countless because few people read Zhang Zhongjing's works carefully. I believe when Zhang Zhongjing says "urgent purgation," it is akin to "urgently rescue the exterior" or "urgently rescue the interior." There are three variations in cases labeled "urgent." It means if one detects sweating has begun but fluids are not yet dried up, one should purge quickly. This is direct and efficient, avoiding the need for honey suppositories. If one understands clearly, there is no doubt; if not, misusing this method is less safe than honey suppositories.

In Yangming disease, the pulse is floating and tight, with dry throat, bitter taste, abdominal fullness, wheezing, fever, sweating, absence of aversion to cold, preference for heat, and heaviness of the body. If sweat-inducing methods are used, the heart becomes confused and delirium ensues. If moxibustion (burning needle) is applied, fearfulness, palpitations, restlessness, and insomnia occur. If purgation is mistakenly applied, the stomach becomes empty, rebellious Qi disturbs the diaphragm, causing inner vexation, with a coated tongue; Zhizi Chi Tang is the primary treatment. If there is thirst for water, dry mouth, and parched tongue, Baihu Jia Renshen Tang is indicated. If the pulse is floating with fever, thirst for water, and difficult urination, Zhuling Tang is indicated. (Note: Floating pulse, fever, and bitter taste indicate pathogen in the exterior; tight pulse, spontaneous sweating, abdominal fullness, and absence of aversion to cold indicate pathogen in the interior. With pathogens in both, harmonization is suitable.)

In Yangming disease, if the patient desires food, urination is obstructed, but defecation is normal, and the person experiences joint pain, feels slightly feverish, suddenly becomes manic, and then breaks into continuous sweating leading to recovery, this is because water dampness cannot overcome Grain Qi, which exits with the sweat. A tight pulse indicates recovery.

In Yangming disease, if caused by Cold preventing eating, with difficulty in urination and continuous sweating on the hands and feet, this suggests the formation of a fixed mass (Gu Zha). Defecation will likely be hard initially and loose later. This is due to Cold in the Stomach causing separation failure between water and grain.

In Taiyang disease, fever with sweating and no aversion to cold indicates Rou Jing (Soft Spasm). (Discussion found under "Rou Jing".) In Taiyang disease, after vomiting, if there is sweating, no aversion to cold, fever, and a fine-rapid pulse at the Guan position, it is called Minor Reversal. (Discussion found under "Fever".)

Sweating followed by fever and no aversion to cold indicates Interior Syndrome, as described in the previous Yangming case. Sweating followed by fever and aversion to wind-cold indicates Guizhi Tang. (Discussion found under "Fever".) If accompanied by stiffness and pain in the neck and back, Guizhi Jia Gegen Tang is indicated. (Discussion found under "Neck Stiffness".) If accompanied by painful joints, inability to flex or extend, and difficult urination, Gancao Fuzi Tang is indicated. (Discussion found under "Wind-Damp Fever".) If sweating leads to leakage that does not stop and aversion to wind, Guizhi Fuzi Tang is indicated. (Discussion found under subsequent sections.) If suffering from Summerheat in summer, with spontaneous sweating, fever, aversion to cold, weak pulse, thirst, and cold feet, Baihu Jia Renshen Tang is indicated. (Formula discussion found under "Summerheat".)

Typhoid fever with sweating and thirst is treated with Wuling San. Without thirst, Lingjiang Caofang Tang is indicated.

Epigastric fullness (Pi) after sweating presents in two patterns: If the fullness is soft upon pressure, painless, and accompanied by aversion to cold, Fuzi Xiexin Tang is indicated. If the fullness is hard upon pressure, radiates to the hypochondrium with pain, and there is no aversion to cold, Shizao Tang is indicated. (Formula discussion found under "Pi".)

In Taiyang disease, if sweating causes leakage that does not stop, with aversion to wind, difficult urination, stiff limbs, and inability to flex or extend, Guizhi Jia Fuzi Tang is indicated.
Guizhi Jia Fuzi Tang
Prepared Fuzi (one piece), Guizhi peeled (two liang), Shengjiang (one and a half liang), Zhi Gancao (one liang), Dazao (six pieces).
Chop the herbs. Take five qian per dose, decoct in water, and take warm.

[Xu Shuniwei] A patient presented with Taiyang symptoms. Due to excessive sweating, he experienced continuous sweating, aversion to wind, scanty urine, and leg spasms preventing extension. His pulse was floating and large. Floating indicates Wind; Large indicates Deficiency. I said, "In Zhang Zhongjing's formulas, there are two similar but distinct conditions: one with difficult urination, one with frequent urination. A slight error in medication leads to significant deviation. Condition 7 states: Taiyang sweating leads to leakage, aversion to wind, difficult urination, mild limb stiffness, and difficulty extending; treat with Guizhi Jia Fuzi Tang. Condition 16 states: Typhoid with floating pulse, spontaneous sweating, frequent urination, irritability, mild aversion to cold, and leg spasms; treating the exterior with Guizhi Tang is an error, leading to frequent urination, dry throat, irritability, and vomiting. One involves leaky sweating and difficult urination; the other involves spontaneous sweating and frequent urination. One has aversion to wind, the other aversion to cold. The diseases differ. I used Guizhi Jia Fuzi Tang from Condition 7. After three doses, sweating stopped. I supplemented with Gancao Shaoyao Tang, allowing the legs to extend."

Dual-Yang disease: Taiyang sweating was incomplete, transferring to Yangming. Continuous slight sweating occurs, with no aversion to cold, facial redness, restlessness, shortness of breath, and unknown pain locations. Proper sitting and continued sweating leads to recovery. (Discussion found under "Facial Redness".)

After sweating, if the body becomes burning hot, it is named Fengwen (Wind-Warmth). Fengwen presents with floating pulse, sweating, heavy body, and somnolence. Weirui Tang is indicated. (Discussion found under "Fengwen".)

After sweating, if profuse sweating occurs, drying the Stomach, causing irritability and insomnia, and desire for water, give small amounts of water frequently. (Discussion found under "Insomnia".)

If pulsation is felt on the left, sweating causes dizziness and continuous sweating, with twitching muscles and tendons. This is a counter-action and difficult to treat. (Treatment found in subsequent sections.)

After sweating and purging, if there is sweating and wheezing, Mahuang Xingren Gancao Shigao Tang is indicated. After purging, if diarrhea persists with a rapid pulse, wheezing, and sweating, Gegen Huangqin Huanglian Tang is indicated. (Discussions found under "Wheezing".)

Sweating with diarrhea, persistent heat, cold limbs, and aversion to cold: Sini Tang is indicated.
Diarrhea with undigested food: Tongmai Sini Tang is indicated. (Discussions found under "Diarrhea".)
Sweating with diarrhea and slight warmth: If the pulse is rapid, recovery is expected; if tight, not yet recovered. (Discussion found under "Diarrhea".)
After six or seven days, fever with diarrhea and continuous sweating indicates death. (Discussion found under "Diarrhea".)

Tight pulse with sweating, sore throat, vomiting, and diarrhea indicates Shaoyin disease with loss of Yang. Vomiting, diarrhea, sweating, cold limbs, and faint pulse: Sini Tang is indicated. If vomiting/diarrhea stop, but sweating and cold limbs persist with a faint pulse: Tongmai Sini Jia Zhuyedan Tang is indicated. (Formulas discussed under "Vomiting/Diarrhea".)

A weak pulse at the Yang position with sweating indicates self-harmonization. Excessive sweating indicates excess. In Yangming disease with profuse sweating and thirst, Zhuling Tang is contraindicated. With a floating pulse, spontaneous sweating, frequent urination, and leg spasms, Guizhi Tang is contraindicated.