时疫愈后,发疮者极多,余热淫于肌肉也,多服清凉养气血药自愈。
时疫愈后,四肢不能动移者,热伤筋脉也,吴氏诸养荣汤酌用,轻者粥食调理自愈。
时疫愈后,身体枯瘦,皮肤甲错者。热伤其阴也,养阴为主,吴氏诸养荣汤酌用,亦有粥食调理自回者。
时疫愈后,有发骨蒸如劳瘵者,乃余热留于阴分也,不可以其羸瘦而遽用虚损门治法。必察其六府,有结邪,
则仍攻其邪为主,次察其经络;有壅瘀,则仍通其壅瘀为主,次察其气道;有痰涎,则仍利其痰涎为主。数者俱
无,然后以清热为主,或无邪而阴伤,方可纯用养阴之药,或分其余邪之轻重,亏损之多少,而兼用养阴清热
药,进退加减以和之更妙。
妇人时疫悉与男子同,惟当经期则治法略异,以其关乎血室也。凡遇感疫值经期者,治法必兼少阳,以少阳与
厥阴为表里,厥阴为血室,血室一动,邪必乘虚而犯之,须分适来因受病而止、适来受病而自行、适断
而受病三种,则虚实自见。
凡经水适来而受疫气遽止者,必有瘀血,要再察其胁、腰、少腹,有牵引作痛拒按者,必以清热、消瘀为
主,小柴胡加赤芍、延胡、桃仁、归尾、丹皮。
凡经水适来而受疫气,疫病虽发而经水照常自行者,不必治其经血,但治其疫邪而病自愈。盖病本未犯血室,
故经血自行如常也。仲景所谓∶勿犯胃气及上二焦,必自愈者。正指此,非谓总不用药也。
凡经水适断而受邪者,经行已尽则血海空虚,邪必乘虚而陷入血海,若见腰、胁及少腹满痛者,大柴
胡汤加桃仁、赤芍,逐其血室之邪始愈。
凡妇人受疫,但见昼日明了,至夜谵语,即当询其经
期,以防热入血室之渐。
时疫痊愈后,出现皮肤疮疡的情况非常多,这是因为余热侵扰肌肉所致,多服用具有清凉、滋养气血作用的药物即可自愈。
时疫痊愈后,四肢无法活动移动的,是热邪损伤了筋脉,可酌情使用吴氏各类养荣汤进行治疗,病情较轻的通过粥食调理即可自愈。
时疫痊愈后,身体枯瘦、皮肤粗糙如鳞甲错杂的,是热邪损伤了阴液,治疗以滋养阴液为主,酌情使用吴氏各类养荣汤,也有通过粥食调理而恢复的。
时疫痊愈后,有的出现骨蒸潮热如同虚劳病(痨瘵)的症状,这是余热留存在阴分所致,不能因为其形体消瘦就立即采用治疗虚损病的常规方法。必须首先检查六腑(胆、胃、大肠、小肠、膀胱、三焦),如果有结聚的邪气,则以攻逐邪气为主;其次检查经络,如果有壅滞瘀血,则以疏通壅滞瘀血为主;其次检查气道,如果有痰涎停滞,则以利化痰涎为主。如果上述几种情况都不存在,然后以清热为主;或者确认没有邪气仅是阴液损伤,才可以单纯使用滋养阴液的药物;或者根据残留邪气的轻重和亏损的程度,兼用滋养阴液和清热的药物,灵活进退加减以达到调和的目的更为巧妙。
妇女患时疫的治疗原则与男子基本相同,只有在月经期间,治疗方法略有不同,因为这关系到血室(子宫及冲任二脉)。凡是遇到感染疫病正值经期的,治疗方法必须兼顾少阳经(足少阳胆经),因为少阳与厥阴(足厥阴肝经)互为表里,厥阴主司血室,血室一旦变动,邪气必定乘虚而入侵犯它。需要区分三种情况:月经刚来因受病而停止、月经刚来受病但经血照常自行、月经刚断绝而受病,这样虚实情况自然显现。
凡是月经刚来受到疫气侵袭而突然停止的,必然有瘀血,要再检查胁部、腰部、小腹部,如果有牵引作痛且拒按的情况,必须以清热、消瘀为主,用小柴胡汤加赤芍、延胡索、桃仁、当归尾、牡丹皮。
凡是月经刚来受到疫气侵袭,疫病虽然发作但经血照常自行排出的,不必治疗经血,只要治疗疫邪,病就会自愈。因为病本未侵犯血室,所以经血像往常一样自行排出。这正是张仲景所说的:“不要损伤胃气及上中二焦,病必自愈”,正指这种情况,并非说完全不用药。
凡是月经刚断绝而受邪的,经期已尽则血海空虚,邪气必定乘虚陷入血海,如果见到腰部、胁部及小腹部胀满疼痛的情况,用大柴胡汤加桃仁、赤芍,驱逐血室中的邪气才能痊愈。
凡是妇女感染疫病,只要见到白天神志清楚,到了夜晚就说胡话(谵语),就应当询问其月经情况,以防热邪陷入血室的趋势发生。
After the recovery from epidemic febrile disease, many cases develop skin sores; this is due to residual heat invading the muscles. It usually heals spontaneously with frequent administration of cooling herbs that nourish Qi and Blood.
After recovery from epidemic febrile disease, if the limbs cannot move, it is because heat has damaged the sinews and vessels. Wu’s various Yangrong Decoctions (Nourishing Nutrient Decoctions) should be used as appropriate. In mild cases, healing occurs spontaneously through dietary regulation with porridge.
After recovery from epidemic febrile disease, if the body becomes emaciated and the skin is rough like fish scales (jiacuo), it is because heat has injured Yin. The treatment focuses on nourishing Yin, using Wu’s various Yangrong Decoctions as appropriate. Some cases also recover through dietary regulation with porridge.
After recovery from epidemic febrile disease, some patients present with bone-steaming fever resembling consumptive disease (laozai); this is due to residual heat lingering in the Yin aspect. One must not immediately apply the treatment methods for deficiency diseases simply because the patient is emaciated. First, examine the Six Fu Organs (Gallbladder, Stomach, Large Intestine, Small Intestine, Bladder, Sanjiao); if there are bound pathogens, the primary treatment is to attack the pathogens. Second, examine the meridians; if there is stagnation and blood stasis, the primary treatment is to unblock the stagnation and stasis. Third, examine the Qi pathways; if there is phlegm-fluid retention, the primary treatment is to promote the discharge of phlegm-fluid. If none of these exist, then focus on clearing heat. Only if there are no pathogens but only Yin injury can pure Yin-nourishing herbs be used. Alternatively, depending on the severity of residual pathogens and the degree of deficiency, combine Yin-nourishing and heat-clearing herbs, adjusting the dosage flexibly to harmonize the condition, which is more effective.
The treatment of epidemic febrile disease in women is generally the same as in men, except during menstruation when the approach differs slightly because it involves the Blood Chamber (Xueshi). Whenever a woman contracts an epidemic during her menstrual period, the treatment must involve the Shaoyang Meridian (Foot-Shaoyang Gallbladder Meridian), as Shaoyang and Jueyin (Foot-Jueyin Liver Meridian) are exterior-interior pairs, and Jueyin governs the Blood Chamber. Once the Blood Chamber is disturbed, pathogens will inevitably take advantage of the deficiency to invade. One must distinguish between three scenarios: menstruation just started and stopped due to illness, menstruation just started and illness contracted but menstruation continues normally, and menstruation just ended and illness contracted. In doing so, the excess or deficiency nature will become clear.
If menstruation just started and was abruptly stopped upon contracting epidemic qi, blood stasis must be present. Further examination of the hypochondrium, lower back, and lower abdomen is required; if there is pulling pain that refuses pressure, the treatment must focus on clearing heat and resolving stasis, using Xiaochaihu Tang (Minor Bupleurum Decoction) plus Chishao (Radix Paeoniae Rubra), Yanhusuo (Rhizoma Corydalis), Taoren (Semen Persicae), Guiwei (Radix Angelicae Sinensis Caulis), and Danpi (Cortex Moutan).
If menstruation just started and was accompanied by epidemic contraction, but the menstrual flow continues normally despite the onset of epidemic symptoms, there is no need to treat the menstrual blood; one only needs to treat the epidemic pathogens, and the disease will heal spontaneously. This is because the pathology has not yet invaded the Blood Chamber, so the menstrual flow proceeds as usual. This refers precisely to Zhang Zhongjing’s statement: "Do not injure the Stomach Qi and the Upper and Middle Jiaos, and the disease will surely heal." This does not mean that no medicine should be used at all.
If illness is contracted just after menstruation has ceased, the Sea of Blood is empty after the period ends, and pathogens will inevitably sink into the Sea of Blood taking advantage of the deficiency. If fullness and pain in the lower back, hypochondrium, and lower abdomen are observed, use Dachaihu Tang (Major Bupleurum Decoction) plus Taoren (Semen Persicae) and Chishao (Radix Paeoniae Rubra) to expel the pathogens from the Blood Chamber before recovery can occur.
Whenever a woman contracts an epidemic, if she presents with clarity during the day but delirious speech (shanyu) at night, one must inquire about her menstrual status to prevent the gradual invasion of heat into the Blood Chamber.