【痰证】似伤寒证,憎寒壮热,恶风自汗,胸满,气上冲咽不得息,此中脘有痰,
但头不痛项不强为异。
若痰涎盛者,亦隐隐头疼,寸口脉浮,若有脉伏,以意参之,二陈汤、柴胡半夏
汤、大半夏汤、金沸草汤。气上冲者,瓜蒂散。
【食积】似伤寒发热恶寒,吐逆头疼,但身不痛为异。左手脉平和,右手脉紧
盛,是以知其伤食也。食在上脘,胸满呕吐者,宜吐之,瓜蒂散。心腹满痛,大柴胡汤
下之,或用治中汤,五积散,吞下木香槟榔丸。
【虚烦】惟烦热与伤寒相似,不恶寒不头痛不身疼为异。此烦热者,盖虚也。表既虚,
不可汗;里不实,不可下;若攻之者多死,惟宜竹叶石膏汤。虚烦不止者,栀子升麻汤、
白虎汤。呕吐者,大半夏加陈皮汤。内寒外热者,阴旦汤。惊悸痰盛虚烦者,温胆汤。伤寒
汗吐下后,虚烦不得眠者,栀子豉汤。上盛下虚,虚烦自利者,竹叶汤去石膏加附子,若既
济汤。妇人挟血虚而烦者,四物汤加人参、麦门冬、竹叶、甘草。
【香港脚】似伤寒头痛身热,大便秘,肢节痛,呕,但兼脚弱为异。或始因足肿疼痹,或
缓弱,小腹不仁,或心悸转筋,食则吐,胸满,此病多因寒湿伤足,毒邪冲心,发则类伤
寒,足膝必难动便。寒伤三阳,所患必冷,越婢汤、小续命入姜汁;暑中三阴,所患必热,
小续命汤去附加桂。脚肿者,木瓜散、槟榔散。大便秘者,脾约丸。
【痰证】症状类似伤寒,表现为怕冷且高热、恶风、自汗、胸中胀满、气逆上冲至咽喉导致呼吸不畅,这是因为中脘部位有痰饮所致,但与伤寒不同的是头部不痛、项部不强硬。
如果痰涎壅盛者,也会隐隐作痛,寸口脉浮,若出现脉伏的情况,需仔细辨证参详,可用二陈汤、柴胡半夏汤、大半夏汤、金沸草汤治疗。气逆上冲明显的,用瓜蒂散催吐。
【食积】症状类似伤寒的发热恶寒、呕吐逆气、头痛,但身体不疼痛是其特征。左手脉象平和,右手脉象紧盛,据此可知是伤食所致。食物停滞在上脘,出现胸满呕吐的,适宜采用吐法,用瓜蒂散。心腹满痛者,用大柴胡汤攻下,或者使用治中汤、五积散,并吞服木香槟榔丸。
【虚烦】只有烦热与伤寒相似,但不恶寒、不头痛、身体不疼痛是其特征。这种烦热,是因为正气虚弱所致。表虚,不可发汗;里不实,不可攻下;如果误用攻伐之法,大多致死,只适宜用竹叶石膏汤。虚烦不止的,用栀子升麻汤、白虎汤。伴有呕吐的,用大半夏加陈皮汤。内寒外热的,用阴旦汤。因惊悸、痰盛而致虚烦的,用温胆汤。伤寒经过发汗、催吐、攻下之后,出现虚烦不得眠的,用栀子豉汤。上盛下虚,虚烦且自发性腹泻的,用竹叶汤去掉石膏加上附子,即既济汤。妇女兼有血虚而烦的,用四物汤加入人参、麦门冬、竹叶、甘草。
【香港脚】(注:此处指中医病名“脚气”,非现代真菌感染)症状类似伤寒的头痛身热、大便秘结、肢节疼痛、呕吐,但兼有下肢软弱无力是其特征。有的起初因为足部肿胀疼痛麻木,或者腿部缓弱无力,小腹感觉迟钝,或者心悸抽筋,进食后呕吐,胸中胀满,此病多因寒湿损伤足部,毒邪上冲于心,发作时类似伤寒,足膝必定难以活动。寒邪损伤三阳经,患病部位必然寒冷,用越婢汤或小续命汤加入姜汁;暑邪侵入三阴经,患病部位必然发热,用小续命汤去掉附子加上桂枝。脚肿的,用木瓜散、槟榔散。大便秘结的,用脾约丸。
[Phlegm Syndrome] The symptoms resemble those of Taiyang disease (a syndrome caused by pathogenic factors affecting the Taiyang channel), characterized by aversion to cold with high fever, aversion to wind, spontaneous sweating, chest fullness, and Qi rushing upward to the throat causing dyspnea. This is due to phlegm accumulation in the Zhongwan region (CV12). The distinguishing feature is that there is no headache or stiffness of the neck.
If phlegm and saliva are abundant, there may be a dull headache, and the pulse at the Cun position (distal end of the radial artery) is floating. If the pulse is hidden (deep and difficult to palpate), careful differentiation is required. Treatments include Erchen Tang (Two-Aged Decoction), Chaihu Banxia Tang (Bupleurum and Pinellia Decoction), Dabansha Tang (Large Pinellia Decoction), and Jinfeicao Tang (Sonchus Decoction). For cases with prominent upward rushing of Qi, Gengti San (Melon Sepal Powder) is used to induce vomiting.
[Food Stagnation] Symptoms resemble Taiyang disease with fever and aversion to cold, regurgitation, and headache, but the body does not ache. The pulse on the left hand is peaceful, while the pulse on the right hand is tight and vigorous, indicating food stagnation. If food is stagnant in the upper Jiao (Upper Burner) causing chest fullness and vomiting, emesis is indicated; use Gengti San. For abdominal fullness and pain, Da Chaihu Tang (Major Bupleurum Decoction) is used to purge, or Zhizhong Tang (Regulate the Middle Decoction) and Wuji San (Five Accumulations Powder) can be taken along with Muxiang Binglang Wan (Aucklandia and Betel Nut Pill) swallowed.
[Deficiency Irritability] Only irritability and heat resemble Taiyang disease, distinguished by the absence of aversion to cold, headache, or body ache. This irritability and heat stem from deficiency. Since the exterior is deficient, sweating is contraindicated; since the interior is not excess, purging is contraindicated. Misapplication of attacking methods often leads to death; only Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is suitable. For persistent deficiency irritability, Zhizi Shengma Tang (Gardenia and Cimicifuga Decoction) or Baihu Tang (White Tiger Decoction) is used. If accompanied by vomiting, Dabansha Tang added with Chenpi (Tangerine Peel) is prescribed. For internal cold and external heat, Yindan Tang (Yin Dawn Decoction) is used. For deficiency irritability accompanied by palpitations and abundant phlegm, Wendan Tang (Warm Gallbladder Decoction) is indicated. After Taiyang disease has been treated with sweating, vomiting, or purging, resulting in deficiency irritability and insomnia, Zhichi Tang (Gardenia and Fermented Soybean Decoction) is used. For upper excess and lower deficiency with deficiency irritability and spontaneous diarrhea, Zhuye Tang (Bamboo Leaf Decoction) with Shigao (Gypsum) removed and Fuzi (Aconite) added, also known as Ji Ji Tang (Already Intersected Decoction), is used. For women with deficiency irritability due to blood deficiency, Siwu Tang (Four Substance Decoction) is modified with Renshen (Ginseng), Maidong (Ophiopogon Tuber), Zhuye (Bamboo Leaf), and Gancao (Licorice Root).
[Hongjiao / Jiaoqi] (Note: In this context, "Hongjiao" refers to the traditional Chinese medicine condition "Jiaoqi" or Beriberi, not modern fungal infection.) Symptoms resemble Taiyang disease with headache, body heat, constipation, joint pain, and vomiting, but are distinguished by weakness in the lower limbs. It may initially present with swelling, pain, and numbness in the feet, or flaccidity and weakness, insensitivity in the lower abdomen, palpitations, muscle cramps, postprandial vomiting, and chest fullness. This disease is mostly caused by cold-dampness injuring the feet, with toxic pathogens rushing to the Heart. Upon onset, it resembles Taiyang disease, and the feet and knees become difficult to move. If Cold injures the Three Yang channels, the affected areas will be cold; treat with Yeshabi Tang (Wild Chicken Skin Decoction) or Xiao Xuming Tang (Minor Continuation of Life Decoction) added with Ginger Juice. If Summerheat invades the Three Yin channels, the affected areas will be hot; treat with Xiao Xuming Tang with Fuzi (Aconite) removed and Guizhi (Cinnamon Twig) added. For foot swelling, Mugua San (Papaya Powder) or Binglang San (Areca Seed Powder) is used. For constipation, Piyue Wan (Spleen Restriction Pill) is prescribed.