病在阳,应以汗解之,反以冷水噀之,若灌之,其热被却不得去,弥更益烦,肉上粟
起,意欲饮水,反不渴者,服文蛤散;若不差者,与五苓散。身热皮粟不解,欲引衣
自覆者,若水以噀之洗之,益令热被却不得出,当汗而不汗则烦。假令汗出已,腹中
痛,与芍药三两,如上法。
太阳病,二日,反躁,反熨其背,而大汗出,大热入胃,胃中水竭,躁烦,必发谵语
,十余日,振憟自下利者,此为欲解也。故其汗从腰以下不得汗,欲小便不得,反呕
欲失溲,足下恶风,大便□,小盒饭数,而反不数,及多,大便已,头卓然而痛,其
人足心必热,谷气下流故也。
下之后,复发汗,昼日烦躁不得眠,夜而安静,不呕,不渴,无表证,脉沉微,身无
大热者,干姜附子汤主之。
发汗若下之,病仍不解,烦躁者,茯苓四逆汤主之。
伤寒,腹满谵语,寸口脉浮而紧,此肝乘脾也,名曰纵,刺期门。
伤寒,发热,啬啬恶寒者,大渴欲饮水,其腹必满,自汗出,小便利,其病欲解,此
肝乘肺也,名曰横,刺期门。
病人无表里证,发热七、八日,虽脉浮数者,可下之,假令已下,脉数不解,合热则
消谷善饥,至六、七日,不大便者,有瘀血,宜抵当汤。若脉数不解,而下不止,必
协热便脓血也。
脉浮而芤,浮为阳,芤为阴,浮芤相抟,胃气生热,其阳则绝。
阳明病,反无汗,而小便利,二、三日,呕而咳,手足厥者,必苦头痛,若不咳不呕
,手足不厥者,头不痛。
阳明病,但头眩,不恶寒,故能食而咳,其人咽必痛,若不咳者,咽不痛。
病邪在阳分,本应通过发汗来解除,却反而用冷水喷洒或浇淋身体,导致体内的热邪被冷水遏制而不能散发,于是更加烦躁不安,皮肤上出现鸡皮疙瘩,虽然感觉想喝水,但实际上并不口渴,这种情况应当服用文蛤散;如果服药后病情没有好转,则给予五苓散。如果身体发热、皮肤起粟粒状颗粒的症状仍未解除,患者想要拉过衣物覆盖身体以保暖,此时若再用冷水喷洒或清洗,只会进一步使热邪被遏制而无法排出,本该出汗却出不了汗,从而导致烦躁。假如服药后已经出汗,但腹部疼痛,应当给予芍药三两,按照上述方法处理。
太阳病发病第二天,反而出现躁动不安,医生反而用熨背的方法治疗,导致大汗淋漓,大热之邪内传入胃,致使胃中津液枯竭,出现躁动烦乱,必然发生胡言乱语(谵语)。过了十多天,如果出现战栗并自行腹泻的情况,这是疾病将要痊愈的征兆。因此,如果汗液只从腰部以上流出,腰部以下无汗,想要小便却尿不出来,反而呕吐甚至想失禁,脚底怕冷,大便稀溏,小便次数多且量多,但在大便正常后,头部突然感到疼痛,这是因为人体正气(谷气)向下流动,足心必然发热。
经过攻下法治疗后,又再次发汗,导致白天烦躁不能入睡,夜间却安静,没有呕吐,没有口渴,也没有表证,脉象沉而微弱,身体没有明显高热,这种情况应当用干姜附子汤主治。
经过发汗或攻下治疗后,病邪仍未解除,出现烦躁症状的,应当用茯苓四逆汤主治。
伤寒病,出现腹部胀满、胡言乱语,寸口脉浮而紧,这是肝木乘克脾土的表现,称为“纵”,应当针刺期门穴。
伤寒病,出现发热、啬啬恶寒(形容恶寒轻微),极度口渴想喝水,腹部必然胀满,如果自然出汗、小便通畅,这是疾病将要痊愈的表现,这是肝木反侮肺金的表现,称为“横”,应当针刺期门穴。
病人没有明显的表证或里证,发热七八天,即使脉象浮数,也可以使用攻下法。假如已经使用了攻下法,脉数仍然不解,热邪与体内积滞结合,导致消化食物过快、容易饥饿,到了六七天,大便不通,说明体内有瘀血,适宜使用抵当汤。如果脉数仍不解,但出现下利不止,必然会导致伴随热邪的便脓血。
脉象浮而芤,浮脉属阳,芤脉属阴,浮脉与芤脉相搏结,导致胃气生热,阳气因而隔绝不通。
阳明病,反而没有汗,但小便通畅,两三天后,出现呕吐和咳嗽,手脚冰凉的人,必然遭受头痛之苦;如果不咳嗽、不呕吐,手脚也不冰凉,就不会头痛。
When the pathogen is in the Yang aspect, it should be resolved through sweating. However, if cold water is sprayed or poured over the body instead, the heat is suppressed and cannot escape, leading to increased irritability, gooseflesh on the skin, a desire to drink water but without actual thirst. In this case, Wenli San (Clam Shell Powder) should be administered; if there is no improvement, Wuling San (Five-Ingredient Powder with Poria) should be given. If the fever and gooseflesh persist, and the patient desires to cover themselves with clothing, using cold water to spray or wash them will further suppress the heat, preventing its release. The intended sweating fails to occur, resulting in irritability. If sweating does occur after treatment, but abdominal pain follows, three liang of Shaoyao (Paeoniae Radix Alba) should be administered according to the aforementioned method.
In Taiyang disease (Disease of the Taiyang Channel), on the second day, restlessness appears contrary to expectation. If the back is moxibustion-treated (ironed/warmed), causing profuse sweating, intense heat enters the Stomach, depleting stomach fluids. This leads to restlessness and irritability, inevitably resulting in delirious speech (Chan Yu). After more than ten days, if tremors and spontaneous diarrhea occur, this indicates that the disease is about to resolve. Therefore, if sweating occurs only from the waist up, while the lower body remains dry, accompanied by difficulty urinating, vomiting, a sensation of losing control of urine, aversion to wind at the soles of the feet, loose stools, and frequent urination, but after normal bowel movements, sudden head pain occurs, this is due to the downward flow of Gu Qi (Grain Qi/Vital Energy derived from food), and the soles of the feet will likely feel warm.
After purgation followed by sweating, the patient experiences irritability and insomnia during the day, but remains quiet at night. With no vomiting, no thirst, no exterior syndrome, a deep and faint pulse, and no significant body heat, Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction) is indicated.
If the disease persists despite sweating or purgation, and irritability is present, Fuling Sini Tang (Poria and Four-Reversal Decoction) is indicated.
In Shanghan (Cold Damage) with abdominal fullness and delirious speech, and a floating and tight pulse at the Cun position, this represents Liver Wood overacting on Spleen Earth, termed "Zong" (Vertical/Unrestrained). The Qimen acupoint should be needled.
In Shanghan with fever and mild aversion to cold (Se Se E Han), extreme thirst, and inevitable abdominal fullness, if spontaneous sweating and free urination occur, the disease is about to resolve. This represents Liver Wood counter-rebelling against Lung Metal, termed "Heng" (Horizontal/Excessive). The Qimen acupoint should be needled.
The patient presents with neither clear exterior nor interior syndromes, yet has had fever for seven or eight days. Even if the pulse is floating and rapid, purgation may be used. If purgation has been applied but the rapid pulse persists, combined heat causes rapid digestion and hunger. By the sixth or seventh day, if constipation occurs, blood stasis is present, and Didang Tang (Mighty Decoction) is appropriate. If the rapid pulse persists but diarrhea ensues, bloody pus in the stool due to accompanying heat will likely result.
A floating and hollow (Kou) pulse: floating indicates Yang, hollow indicates Yin. When floating and hollow pulses interact, Stomach Qi generates heat, causing Yang energy to become isolated.
In Yangming disease, if there is an absence of sweating but free urination, and after two or three days, vomiting and coughing occur with cold extremities, severe headache must be suffered. If there is no coughing or vomiting, and extremities are not cold, there will be no headache.
In Yangming disease, if there is only dizziness, no aversion to cold, ability to eat, and coughing, the throat will necessarily hurt. If there is no coughing, the throat will not hurt.