22.咽痛干肿为阳热, 不干不肿属阴寒, 阳用甘桔等汤治, 阴用甘桔
附姜攒.
【注】咽痛一证, 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. 不干不重而痛, 为三阴寒证, 宜四逆汤加桔
梗主治也.
23. 气撞吐蛔厥阴本, 无蛔阳表桂枝汤, 少腹急引烧?? 散, 冲喉难
息瓜蒂良.
【注】气撞吐蛔, 谓厥阴本证也. 无蛔, 谓气撞不吐蛔, 乃邪犹在阳
表也, 宜桂枝汤. 少腹急引, 谓气上冲, 更少腹引阴急痛, 乃阴阳易
病也, 宜烧?? 散. 冲喉难息, 谓气上冲喉, 胸满难以布息, 乃寒实
在胸也, 宜瓜蒂散.
24. 饥不欲食吐蛔厥, 下后不食属阳明, 懊?? 头汗栀子豉, 厥紧心
烦邪在胸.
【注】饥不欲食吐蛔厥, 谓厥阴本证也. 下后饥不能食属阳明也. 阳
明病则懊??, 心中烦甚, 头上汗出, 是热在胃中, 宜栀子豉汤涌之.
厥阴病则吐蛔, 厥逆, 脉微, 今不微而紧更心烦者, 非寒虚邪, 是寒
实邪, 而在胸中宜瓜蒂散吐之.
25.太阴手足温无厥, 少阴厥冷不能温, 厥阴寒厥分微甚, 热厥相因
辨浅深.
【注】太阴经无厥逆, 而有手足自温. 少阴经有寒厥, 而无热厥. 厥
阴经有寒、热二厥. 寒厥者, 只寒而不热也. 热厥者, 由热而厥, 由
厥而热, 热厥相因无休歇也. 当辨阴阳浅深, 以当归四逆、承气等汤
施治可也. 详厥阴篇.
22. 咽喉疼痛且红肿干燥属于阳热证，不干燥也不红肿则属于阴寒证。阳热证用甘桔汤等方剂治疗，阴寒证用甘桔附姜散（由甘草、桔梗、附子、干姜组成）治疗。
【注】咽喉疼痛这一病症，既有寒证也有热证。咽喉干燥、肿胀且疼痛，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。如果不干燥且疼痛不严重，则是三阴经的寒证，适宜用四逆汤加桔梗主治。
23. 气机上逆撞击伴有吐蛔虫是厥阴经的本证；若无蛔虫吐出，属阳气在表，用桂枝汤治疗；少腹部拘急牵引疼痛用烧裈散治疗；气冲咽喉导致呼吸困难用瓜蒂散疗效好。
【注】气机上逆撞击并吐蛔虫，说的是厥阴经的本证。没有蛔虫吐出，说的是气机上逆但不吐蛔虫，这是邪气仍在阳分肌表，适宜用桂枝汤。少腹部拘急牵引，说的是气机上冲，且少腹部牵引阴部剧烈疼痛，这是阴阳易病，适宜用烧裈散。气冲咽喉难以呼吸，说的是气上冲至咽喉，胸部胀满难以舒展呼吸，这是寒实邪气结聚在胸中，适宜用瓜蒂散。
24. 饥饿却不想进食、吐蛔虫且四肢厥冷是厥阴经的本证；攻下之后不能进食属于阳明经病；心中懊憹、头汗出用栀子豉汤治疗；四肢厥冷脉紧伴心烦，邪气在胸中。
【注】饥饿却不想进食、吐蛔虫且四肢厥冷，说的是厥阴经的本证。攻下之后感到饥饿但不能进食，属于阳明经病。阳明病会出现心中懊憹，心中烦闷至极，头上出汗，这是热邪在胃中，适宜用栀子豉汤涌吐治疗。厥阴病会出现吐蛔虫、四肢厥冷、脉象微弱，现在脉象不微弱反而紧，且更加心烦，这不是寒虚邪气，而是寒实邪气，且在胸中，适宜用瓜蒂散涌吐治疗。
25. 太阴经手足温暖而无厥冷，少阴经四肢厥冷无法回暖，厥阴经的寒厥分为轻微和严重，热厥与寒厥相互关联需辨别病情的浅深。
【注】太阴经没有厥冷症状，而是手足自然温暖。少阴经有寒厥，但没有热厥。厥阴经有寒厥和热厥两种。寒厥，只是寒冷而没有发热。热厥，是由热邪导致四肢厥冷，或由四肢厥冷转化为发热，热厥与寒厥交替出现无休止。应当辨别阴阳病位的浅深，使用当归四逆汤、承气汤等方剂施治即可。详见厥阴篇。
22. Sore throat with dryness and swelling indicates a Yang-heat syndrome; absence of dryness and swelling indicates a Yin-cold syndrome. The Yang-heat syndrome is treated with formulas such as Ganjie Tang (Licorice and Platycodon Decoction), while the Yin-cold syndrome is treated with Ganjie Fuzi Jiangxin San (Licorice, Platycodon, Aconite, and Dried Ginger Powder).
[Note] Sore throat can be caused by both cold and heat pathogens. Dryness, swelling, and pain in the throat indicate a heat syndrome of the Three Yang meridians, which should be regulated with formulas such as Ganjie Tang (Licorice and Platycodon Decoction), Banxia Kujiu Tang (Pinellia and Vinegar Decoction), or Zhufu Tang (Pig Skin Decoction). Absence of dryness and mild pain indicate a cold syndrome of the Three Yin meridians, which should be primarily treated with Sini Tang (Frigid Extremities Decoction) added with Jiegeng (Platycodon Root).
23. Qi counterflow striking upward accompanied by vomiting of roundworms is the primary syndrome of the Jueyin (Terminal Yin) meridian. If no roundworms are vomited, it indicates the pathogen remains in the exterior of the Yang level, treated with Guizhi Tang (Cinnamon Twig Decoction). Urgent pulling pain in the lower abdomen is treated with Shao Kun San (Burnt Underwear Powder). Qi rushing to the throat causing difficult breathing is effectively treated with Gouti San (Melon Seed Powder).
[Note] "Qi counterflow striking upward accompanied by vomiting of roundworms" refers to the primary syndrome of the Jueyin meridian. "No roundworms vomited" means there is Qi counterflow but no vomiting of roundworms, indicating the pathogen is still in the Yang exterior, for which Guizhi Tang (Cinnamon Twig Decoction) is appropriate. "Urgent pulling pain in the lower abdomen" refers to Qi rushing upward combined with severe pulling pain from the lower abdomen to the genital region, known as the disease of exchange between Yin and Yang, for which Shao Kun San (Burnt Underwear Powder) is appropriate. "Qi rushing to the throat causing difficult breathing" refers to Qi rushing to the throat with chest fullness and difficulty in respiration, indicating excess cold pathogen stagnating in the chest, for which Gouti San (Melon Seed Powder) is appropriate.
24. Hunger without desire to eat, vomiting of roundworms, and cold extremities constitute the primary syndrome of the Jueyin meridian. Inability to eat after purgation belongs to the Yangming meridian. Mental restlessness (Ao Nao) and sweating on the head are treated with Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction). Cold extremities with a tight pulse and irritability indicate pathogen stagnation in the chest.
[Note] "Hunger without desire to eat, vomiting of roundworms, and cold extremities" refers to the primary syndrome of the Jueyin meridian. Feeling hungry but unable to eat after purgation belongs to the Yangming meridian. Yangming disease manifests as mental restlessness (Ao Nao), extreme irritability, and sweating on the head, indicating heat in the stomach, which should be treated with Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) to induce vomiting. Jueyin disease manifests as vomiting of roundworms, cold extremities, and a faint pulse. If the pulse is not faint but tight, accompanied by increased irritability, this is not due to cold deficiency but to excess cold pathogen stagnating in the chest, which should be treated with Gouti San (Melon Seed Powder) to induce vomiting.
25. The Taiyin (Greater Yin) meridian presents with warm hands and feet without cold extremities (Jue Ni). The Shaoyin (Lesser Yin) meridian presents with cold extremities that cannot be warmed. The Jueyin meridian’s cold extremities vary in severity, and its heat-induced cold extremities require differentiation based on depth.
[Note] The Taiyin meridian does not present with cold extremities but rather naturally warm hands and feet. The Shaoyin meridian presents with cold extremities (Han Jue) but not heat-induced cold extremities (Re Jue). The Jueyin meridian presents with both cold and heat-induced cold extremities. Cold extremities refer to coldness without heat. Heat-induced cold extremities involve alternating cycles of heat leading to cold extremities and cold extremities transforming into heat, occurring continuously without cessation. One must differentiate the depth of Yin and Yang pathology and treat accordingly with formulas such as Danggui Sini Tang (Angelica Sinensis Decoction for Frigid Extremities) or Chengqi Tang (Descending Qi Decoction). For details, see the Jueyin chapter.