江少微治黄三辅。年逾四旬。醉饮青楼。夜卧当风。患头痛发热。自汗盗汗。饮食不进
医治十余日罔效。诊得六脉浮洪。重按豁然。此饮酒当风。名曰漏风。投以白术、泽泻。
酒煎服而热退。汗仍不止。心口如水。此思虑所致。与归脾汤加麻黄根、桂枝。十服而愈。
头痛不已。用白萝卜汁吹入鼻中。立止。
张路玉治沈懋甫仲子。年十七。每伤风。即吐血梦泄。此肝脏有伏火。火动则招风也。
盖肝为藏血藏魂之地。肝不藏则血随火炎。魂不宁则精随梦泄。遂与桂枝汤加龙骨、牡蛎。
四剂而表解血止。桂枝汤主和营散邪。加龙、牡以镇肝安魂。封藏固则风不易入。魂梦安则
精不妄动矣。若以其火盛而用知、柏之属。鲜有不成虚损者。
震按伤风是轻病。然有伤风不醒即成痨之说。今人犯此者甚多。大约喜于色欲及常多梦
泄之辈。内经谓劳风法在肺下。太阳引精者三日。中年者五日。不精者七日。咳出青黄涕如
脓。不出则伤肺死。盖引精者肾脏充固。太阳引少阴以内守而自为外拒。邪从痰出。不致内
留伤肺也。不精即冬不藏精之义。肾脏亏乏。太阳馁而无援。邪留难去。伤风所由不醒也。
昧者峻用发散。不知人愈虚。邪更易入也。或竟用滋补。不知邪未清。补之适以助长也。此
中之权衡。在于医者。此际之调理。在于本人耳。
〔附伤风戴阳症〕石开晓病伤风咳嗽。未尝发热。自觉急迫欲死。呼吸不能相续。西昌
诊之。见其头面赤红。躁扰不歇。脉亦豁大而空。谓曰。此证颇奇。全似伤寒戴阳症。何以
伤风小恙亦有之。急宜用人参附子等药。温补下元。收回阳气。不然。子丑时一身大汗。脱
阳而死矣。渠不信。及日落。阳不用事。愈慌乱不能少支。忙服前药。服后。稍宁片刻。又
为床侧添同寝一人。逼出其汗如雨。再用一剂。汗止身安。咳嗽俱不作。询其所由。云连服
麻黄药四剂。遂尔躁急欲死。然后知伤风亦有戴阳证。与伤寒无别。总因其人平素下虚。是
以真阳易于上越耳。
江少微治疗黄三辅。患者年龄超过四十岁。因在青楼醉酒,夜间睡觉时对着风口,患上头痛、发热,伴有自汗和盗汗,饮食无法进入。医生治疗了十多天没有效果。诊察发现六脉浮洪,重按则豁然空虚。这是饮酒后受风所致,病名叫做漏风。投用白术、泽泻,用酒煎服,热退后,汗仍然不止,心口感觉像水一样冷。这是思虑过度所致。给予归脾汤加麻黄根、桂枝,服用十剂后痊愈。头痛不止,用白萝卜汁吹入鼻中,立即停止。
张路玉治疗沈懋甫的次子。年龄十七岁。每次伤风,就会吐血、梦遗。这是肝脏有伏火,火动则招致风邪。肝是藏血、藏魂的地方。肝不藏血,则血随火势上炎;魂不安宁,则精随梦境而泄。于是给予桂枝汤加龙骨、牡蛎。四剂后表证解除,出血停止。桂枝汤主要作用是调和营卫、疏散邪气;加入龙骨、牡蛎以镇摄肝气、安定神魂。封藏功能坚固,则风邪不易侵入;神魂安宁,则精气不妄动。如果因为火势旺盛而使用知母、黄柏这类药物,很少有不导致虚损的。
俞震按语:伤风是轻病,但有“伤风不醒即成痨”的说法。现在犯此病的人很多。大致喜欢色欲及经常多梦遗精的人,《内经》说劳风病位在肺下。太阳经引动精气者,三日发病;中年人五日发病;不射精者七日发病。咳出青黄色的鼻涕如脓状,如果不排出则会损伤肺部致死。所谓“引精者”,是指肾脏充盛坚固,太阳经引动少阴经以内守而自然抵御外邪。邪气随痰排出,不会内留损伤肺部。“不精”即冬天不藏精的含义。肾脏亏乏,太阳经气馁而无援助,邪气滞留难以去除,这就是伤风久治不愈的原因。愚昧的医生峻烈地使用发散药,不知道人越虚,邪气越容易侵入。或者干脆使用滋补药,不知道邪气未清,补益反而助长邪气。其中的权衡在于医生,此时的调理在于病人自己。
〔附:伤风戴阳症〕石开晓患伤风咳嗽,未曾发热,自觉急迫欲死,呼吸不能连续。西昌诊察他,见他头面赤红,躁扰不停,脉象豁大而空。说道:“这个病症很奇特,完全像伤寒戴阳症。为什么伤风小病也有这种情况?急宜用人参、附子等药,温补下元,收回阳气。不然,在子丑时(半夜)全身大汗,脱阳而死。”他不相信。等到日落,阳气不用事(衰退),更加慌乱不能支撑。急忙服用前面的药。服药后,稍微安静片刻。又在床边添一人同寝,逼出其汗如雨下。再用一剂,汗止身安,咳嗽都不再发作。询问其原因,他说连服麻黄药四剂,于是躁急欲死。这才知道伤风也有戴阳证,与伤寒没有区别。总是因为此人平素下焦虚损,所以真阳易于上越。
Jiang Shaowei treated Huang Sanfu. The patient was over forty years old. After drinking heavily at a brothel, he slept facing the wind at night and developed headache, fever, spontaneous sweating, and night sweats, with an inability to eat. Medical treatment for more than ten days yielded no effect. The pulse was floating and surging in all six positions, but hollow upon heavy pressure. This condition, caused by drinking and exposure to wind, is named "Lou Feng" (Leaking Wind). He was prescribed Baizhu (Atractylodis Macrocephalae Rhizoma) and Zexie (Alismatis Rhizoma), decocted with wine. After the fever subsided, the sweating continued, and the epigastrium felt cold like water. This was attributed to excessive mental worry. Guipi Tang (Restore the Spleen Decoction) was administered with added Mahuang Gen (Ephedrae Radix et Rhizoma) and Guizhi (Cinnamomi Ramulus). After ten doses, he recovered. For persistent headache, juice of white radish was insufflated into the nose, stopping the pain immediately.
Zhang Luyu treated the second son of Shen Maofu. At seventeen years old, every time he contracted Shang Feng (Wind-Cold Invasion), he experienced hemoptysis and nocturnal emission. This indicated latent fire in the Liver. When the fire stirs, it attracts wind. The Liver stores blood and houses the Hun (Ethereal Soul). If the Liver fails to store blood, blood flares up with the fire; if the Hun is unsettled, essence leaks during dreams. Therefore, Guizhi Tang (Cinnamon Twig Decoction) was given with Longgu (Fossilized Bones) and Muli (Oyster Shell). After four doses, the exterior syndrome resolved and bleeding stopped. Guizhi Tang harmonizes Ying (Nutritive Qi) and disperses pathogenic factors; adding Longgu and Muli calms the Liver and stabilizes the Hun. When the sealing and storing functions are solid, wind pathogens find it difficult to enter; when the Hun and dreams are peaceful, essence does not move recklessly. If one were to use Zhi Mu (Anemarrhenae Rhizoma) or Huang Bai (Phellodendri Cortex) due to perceived excess fire, few would avoid resulting in deficiency damage.
Yu Zhen’s commentary: Shang Feng (Wind-Cold Invasion) is a mild disease, yet there is a saying that "if Shang Feng is not cured, it becomes Lao (Consumption)." Many people today suffer from this. Generally, those who indulge in sexual desire and frequently experience nocturnal emissions are prone to it. The *Neijing* states that Lao Feng (Labor Wind) pathology lies below the lungs. In cases where the Taiyang channel draws on Jing (Essence), symptoms appear in three days; in middle-aged individuals, in five days; in those without ejaculation, in seven days. They cough up green-yellow sputum resembling pus. If not expelled, it damages the lungs and leads to death. "Drawing on Essence" refers to robust Kidney Jing. The Taiyang channel draws on the Shaoyin channel to maintain internal stability and naturally repel external pathogens. Pathogens exit with phlegm and do not remain internally to damage the lungs. "Not having Essence" implies failing to store Jing during winter. With deficient Kidneys, the Taiyang channel lacks support, making it difficult to expel pathogens, which explains why Shang Feng lingers. Ignorant physicians harshly use diaphoretic agents, unaware that as the person becomes more deficient, pathogens invade more easily. Alternatively, some use purely tonifying herbs, unaware that if pathogens are not cleared, tonification only aids their growth. The balance lies with the physician, and the regulation at this time depends on the patient himself.
[Appendix: Shang Feng Dai Yang Syndrome] Shi Kaixiao suffered from Shang Feng with coughing, without fever. He felt urgent distress, nearly dying, with discontinuous breathing. Xi Chang examined him and observed redness in the head and face, restlessness without cessation, and a pulse that was vast, empty, and hollow. He said, "This case is peculiar, resembling Dai Yang Syndrome (Floating Yang) of Shang Han (Cold Damage). Why does a minor Shang Feng present thus? Urgently administer Ren Shen (Ginseng Radix et Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata) to warm and tonify the Lower Yuan, retrieving Yang Qi. Otherwise, profuse sweating will occur during the Zi and Chou hours (11 PM - 3 AM), leading to death from Yang collapse." He did not believe it. As sunset approached and Yang Qi waned, his panic increased, unable to sustain himself. He hastily took the previous medicine. After taking it, he rested briefly. Another person was added to his bed to induce sweating, which came down like rain. A subsequent dose stopped the sweating, stabilized the body, and ceased the cough. Upon inquiry, he stated that after taking four doses of Mahuang (Ephedrae Herba) medicines, he became extremely restless and near death. Thus, it was realized that Shang Feng can also present Dai Yang Syndrome, indistinguishable from Shang Han. It is generally because the person has chronic Lower Jiao deficiency, causing True Yang to easily float upward.