五脏六腑,心腹满,腰背疼,饮食吐逆,寒热往来,小便不利,羸瘦少气,灸三焦俞,
随年壮。腹疾腰痛,膀胱寒 饮注下,灸下极俞,随年壮。三焦膀胱,肾中热气,灸水道,
随年壮,穴在挟屈骨,相去五寸。(屈骨在脐下五寸,屈骨端水道挟两边各二寸半)。三焦寒
热,灸小肠俞,随年壮。
(论二首 证四条
论曰∶原霍乱之为病也,皆因饮食,非关鬼神。夫饱食肫脍,复餐乳酪;海陆百品,无
所不啖;眠卧冷席,多饮寒浆;胃中诸食结而不消,阴阳二气,壅而反戾。阳气欲升,阴气
欲降,阴阳乖隔,变成吐痢。头痛似破,百节如解,遍体诸筋,皆为回转。论证虽小而卒病
之中最为可畏,虽临深履危,不足以喻之。养生者,宜达其旨,庶可免于夭横矣。
凡霍乱务在温和将息,若冷即遍体转筋。凡此病定一日不食为佳,须三日少少粥食,三
日以后可恣意食息,七日勿杂食为佳,所以养脾气也。
大凡霍乱,皆中食脍酪及饱食杂物过度不能自裁,夜卧失覆不善将息所致,以此殒命者
众。人生禀命,以五脏为主。夫五脏者,即是五行。内为五行,外为五味。五行五味,更宜
扶抑。所以春夏秋冬,逆调理之,食啖不可过度。凡饮食于五脏相克者,为病相生无他。
经曰∶春不食辛,夏不食咸,季夏无食酸,秋无食苦,冬无食甘。此不必全不食,但慎其太
甚耳。谚曰,百病从口生,盖不虚也。四时昏食不得太饱,皆能生病,从夏至秋分,忌食肥
浓,然热月人好冷食,更与肥浓,兼食果菜无节,极遂逐冷眠卧,冷水洗浴,五味更相克贼,
虽欲无病不可得也。所以病苦,人自作之,非关运也。书曰∶非天夭人,人中自绝命,此之
谓也。
凡诸霍乱,忌与米饮,胃中得米即吐不止,但与浓朴、葛根饮。若冬瓜叶饮,沾渍咽喉
而不可多与。若服汤时随服吐者,候吐定乃止,诊脉绝不通,以桂合葛根为饮,吐下心烦。
内热汗不出,不转筋脉急数者,可犀角合葛根为饮。吐下不止,发热心烦欲饮水,可少饮米
粉汁为佳。若不止,可与葛根、荠 饮服之。
问曰∶病有霍乱者何?师曰∶呕吐而利,此谓霍乱。
问曰∶病者发热头痛,身体疼,恶寒而复吐利,当属何病?师曰∶当为霍乱。霍乱吐利
止而复发热也。伤寒,其脉微涩,本是霍乱,今是伤寒却四五日,至阴经上转入阴必利。本
呕下利者,不可治也。霍乱吐多者,必转筋不渴,即脐上筑。霍乱而脐上筑者,为肾气动,
当先治其筑,治中汤主之,去术加桂心。去术者,以术壅故也。加桂者,恐作奔豚也。霍乱
而脐上筑吐多者,及下多者,霍乱而惊,霍乱而渴,霍乱而腹中痛,呕而吐利。呕而利欲得
水者,皆用治中汤主之。
五脏六腑,心腹部胀满,腰背部疼痛,饮食后呕吐逆出,寒热交替往来,小便不通利,身体消瘦且气短,艾灸三焦俞穴,灸量随患者年龄而定(每岁一壮)。腹部疾病伴腰痛,膀胱寒邪导致水饮下注,艾灸下极俞穴,灸量随患者年龄而定。三焦与膀胱有肾中热气,艾灸水道穴,灸量随患者年龄而定,穴位位于屈骨旁,相距五寸。(屈骨在脐下五寸处,屈骨端的水道穴在两侧各距二寸半)。三焦寒热,艾灸小肠俞穴,灸量随患者年龄而定。
(论述两篇 证候四条)
论述说:探究霍乱这种病的发生,都是由于饮食不当引起,与鬼神无关。如果饱食肉类生脍,又进食乳酪;海陆各种食物,无所不食;睡卧冷席,多饮冷水;胃中的各种食物凝结而不消化,阴阳二气,壅滞而逆乱。阳气想要上升,阴气想要下降,阴阳乖违阻隔,变成呕吐和泄痢。头痛欲裂,全身关节像要散开一样,遍体筋脉,都发生扭转痉挛。虽然论证看似微小,但在突发急病中最为可怕,即使面临深渊、踩在危崖上,也不足以比喻其危险程度。养生的人,应当通达其中的旨意,或许可以避免夭折横死。
凡是霍乱,务必注意温和调养,如果受冷就会导致遍体转筋。凡是这种病,确定一天不进食为佳,必须三天内少量喝粥,三天以后可以随意饮食休息,七天之内不要混杂饮食为佳,这是为了养护脾气。
大凡霍乱,都是因为食用肉脍乳酪以及饱食杂物过度而不能自我节制,夜间睡觉失去覆盖、不善调养所致,因此丧命的人很多。人生禀赋性命,以五脏为主。所谓五脏,就是五行。内部对应五行,外部对应五味。五行与五味,更宜扶持抑制。所以春夏秋冬四季,逆着规律调理,饮食不可过度。凡是饮食中克制五脏的,会导致疾病相生而无其他变数。经书说:春天不吃辛味,夏天不吃咸味,长夏不吃酸味,秋天不吃苦味,冬天不吃甘味。这并非完全不吃,只是谨慎不过度罢了。谚语说,百病从口入,确实不虚。四季晚餐不得太饱,都能生病,从夏至秋分,忌食肥腻浓厚之物,然而炎热月份人喜欢冷食,再加上肥腻,兼吃果菜没有节制,极度放纵地冷眠卧、冷水洗浴,五味互相克贼,虽然想不得病也不可能。所以病人痛苦,是人自己造成的,与命运无关。书说:不是上天使人夭折,是人自己断送性命,说的就是这个道理。
凡是各种霍乱,忌讳给予米汤饮用,胃中得到米就会吐个不停,只给厚朴、葛根煎饮。如果用冬瓜叶煎饮,沾湿咽喉则不可多给。如果服药时随着服用就呕吐,等待呕吐停止后再止服,诊察脉搏绝而不通,用桂枝合葛根煎饮,吐出后心中烦热。体内热汗不出,不出现筋脉拘急快速者,可用犀角合葛根煎饮。吐泻不止,发热心烦想喝水,可少量饮用米粉汁为佳。如果仍不止,可给葛根、荠菜煎饮服用。
问:什么是霍乱?老师说:呕吐并且腹泻,这就叫霍乱。
问:病人发热头痛,身体疼痛,恶寒而又呕吐腹泻,属于什么病?老师说:应当是霍乱。霍乱吐泻停止后又发热。伤寒,脉象微涩,本来是霍乱,现在是伤寒过了四五天,传入阴经转入阴分必定腹泻。原本呕吐并腹泻的,不可治愈。霍乱吐多的,必然转筋且不渴,即脐上跳动如筑物。霍乱且脐上跳动的,是肾气动,应当先治疗脐上跳动,用治中汤主治,去掉白术加上桂心。去掉白术,是因为白术壅滞的缘故。加上桂心,是担心发作奔豚病。霍乱且脐上跳动吐多,以及泻多,霍乱惊恐,霍乱口渴,霍乱腹中痛,呕吐并腹泻。呕吐并腹泻想要喝水的,都用治中汤主治。
The five zang and six fu organs, fullness in the heart and abdomen, pain in the waist and back, vomiting and regurgitation after eating, alternating aversion to cold and fever, difficult urination, emaciation with shortness of breath, moxa on Sanjiaoshu (BL-22, Triple Energizer Shu), one moxa cone per year of age. Abdominal disease with lower back pain, cold fluid pouring down due to Bladder cold, moxa on Xiajishu (EX-B15, Lower Pole Shu), one moxa cone per year of age. Heat qi in the Kidney affecting the Sanjiao and Bladder, moxa on Shuidao (ST-28, Water Path), one moxa cone per year of age; the point is located beside the flexed bone, five cun apart. (The flexed bone is five cun below the umbilicus; the Shuidao points at both ends of the flexed bone are each two and a half cun from the midline). Cold and heat in the Sanjiao, moxa on Xiaochangshu (BL-27, Small Intestine Shu), one moxa cone per year of age.
(Two Treatises, Four Symptom Patterns)
The treatise states: The origin of Huoluan (Cholera-like disease) lies entirely in dietary indiscretion, not in ghosts or spirits. If one eats until full, consuming raw meat slices, followed by dairy products; eats indiscriminately from all kinds of land and sea delicacies; sleeps on cold mats, and drinks large amounts of cold water; the various foods in the stomach congeal and fail to digest. The Qi of Yin and Yang becomes obstructed and rebellious. The Yang Qi desires to ascend, while the Yin Qi desires to descend. Due to the separation and conflict of Yin and Yang, vomiting and dysentery ensue. The headache feels as if the head will split, the joints feel as if they are disintegrating, and the tendons throughout the body undergo torsion and spasms. Although the symptoms may appear minor, among sudden acute diseases, it is the most terrifying; even facing an abyss or treading on a precipice cannot adequately describe its danger. Those who practice health preservation should understand this principle, so as to avoid premature death.
In cases of Huoluan, it is essential to maintain warmth and rest. If exposed to cold, it leads to generalized tendon spasms. For this disease, it is best to abstain from food for one day. For three days, consume small amounts of rice gruel. After three days, one may resume normal diet and rest. It is advisable to avoid mixed foods for seven days to nourish the Spleen Qi.
Generally, Huoluan results from overindulgence in meat, dairy, and miscellaneous foods without self-restraint, combined with poor sleep cover and inadequate care at night, leading to death. Human life relies primarily on the Five Zang organs. These Zang organs correspond to the Five Elements. Internally, they are the Five Elements; externally, they relate to the Five Flavors. The Five Elements and Five Flavors require balancing and regulation. Therefore, in spring, summer, autumn, and winter, one must regulate according to the season and avoid excessive eating. Foods that clash with the Zang organs cause disease. As the classics state: In spring, do not eat pungent flavors; in summer, do not eat salty flavors; in late summer, do not eat sour flavors; in autumn, do not eat bitter flavors; in winter, do not eat sweet flavors. This does not mean complete abstinence, but rather avoiding excess. As the proverb says, "A hundred diseases arise from the mouth," which is true. Overeating at any time can cause illness. From Summer Solstice to Autumn Equinox, avoid rich and greasy foods. However, people often prefer cold food in hot weather, combined with greasy food, unregulated consumption of fruits and vegetables, sleeping in the cold, bathing in cold water, and conflicting flavors, making it impossible to avoid disease. Thus, suffering is self-inflicted, not determined by fate. The book says: "It is not Heaven that kills people, but people who kill themselves." This refers to such cases.
For all types of Huoluan, avoid giving rice water, as it causes continuous vomiting. Instead, provide decoctions of Houpo (Magnoliae Officinalis Cortex) and Gegen (Puerariae Lobatae Radix). If using Dongguaye (Benincasae Caulis et Folium), it moistens the throat but should not be given in large quantities. If vomiting occurs immediately after taking the decoction, wait until vomiting subsides before stopping. If the pulse is absent and unobtainable, use Guizhi (Cinnamomi Ramulus) combined with Gegen as a drink. If vomiting stops but irritability remains, and there is internal heat without sweating, and no rapid tendon spasms, use Xijiao (Rhinocerotis Cornu) combined with Gegen. If vomiting and diarrhea persist, accompanied by fever, irritability, and thirst, a small amount of rice flour juice is best. If it continues, administer Gegen combined with Jiqing (Capsellae Fructus).
Question: What constitutes Huoluan?
Master said: Vomiting and diarrhea constitute Huoluan.
Question: A patient has fever, headache, body pain, aversion to cold, and recurrent vomiting and diarrhea. To which disease does this belong?
Master said: This belongs to Huoluan. Huoluan involves vomiting and diarrhea, followed by recurrence of fever. In Shaoyin disease, the pulse is faint and choppy. Originally Huoluan, now after four or five days of Taiyang disease, it transfers to the Yin meridians and causes diarrhea. If there was originally vomiting and diarrhea, it is difficult to treat. In Huoluan with predominant vomiting, there is likely tendon spasm without thirst, and a sensation of movement above the umbilicus. If Huoluan presents with movement above the umbilicus, it indicates Kidney Qi moving; treat the movement first with Zhizhong Tang (Regulate the Middle Decoction), removing Baizhu (Atractylodis Macrocephalae Rhizoma) and adding Guixin (Cinnamomi Cortex). Baizhu is removed because it causes stagnation. Guixin is added to prevent Ben Tun (Running Piglet syndrome). For Huoluan with movement above the umbilicus, predominant vomiting, or predominant diarrhea, Huoluan with fright, Huoluan with thirst, Huoluan with abdominal pain, vomiting and diarrhea, and those desiring water due to vomiting and diarrhea, all are treated with Zhizhong Tang.