时疫临解,有忽手舞足蹈,跳床投榻而后作汗者,最为骇人。然须验其是否作汗,作汗之脉浮而缓,浮为
邪还于表,缓则胃气自和,待汗透自愈。脉若浮洪、浮数、浮滑、浮散、虽有汗,亦为发狂,非作汗也。
时疫头肿乃风热壅于上部,太阳之经脉郁滞巅顶,俗名大头伤寒。当视表里轻重加轻清疏风之品,以散其肿,
荆、防、薄荷、蝉蜕、川芎、蔓荆、菊花之类。如发热,舌苔白,表重于里也,合表药用九味羌活汤、人参败毒散
是也。如烦渴,舌苔黄者,里重于表也,合里药用三消饮、凉膈散、大柴胡汤、调胃承气汤是也。古有用三棱针
刺出恶血法亦可用。至发痈脓者,不在此例。
时疫面肿,风热溢于上部,阳明之经脉被郁也,赤肿者方是,治以白芷、防风、葛根、石膏散其风热,视表里
之轻重,合头肿条内诸方加减用之。若黄肿,乃水气也,当从水肿治之。
时疫颈项肿,乃阳明风热,俗名捻头瘟,又名蛤蟆
瘟,当按头肿条内表里诸方加葛根、桔梗、牛蒡、防风、玄参。痈脓发颐,不在此例。
当瘟疫即将痊愈时,患者有时会突然手舞足蹈,在床上跳跃翻滚,随后才出汗,这景象最为骇人。但必须验证其是否真的在作汗:若脉象浮而缓,浮表示邪气回归体表,缓表示胃气自然调和,待汗液透发后疾病自愈。如果脉象是浮洪、浮数、浮滑或浮散,即使有汗出,也属于发狂,并非真正的作汗。
瘟疫引起的头部肿胀,是由于风热壅滞于上部,导致太阳经脉(足太阳膀胱经)郁滞于头顶,俗称“大头伤寒”。应当根据表证和里证的轻重程度,加入轻清疏风的药物来消散肿胀,如荆芥、防风、薄荷、蝉蜕、川芎、蔓荆子、菊花等。如果出现发热、舌苔白,说明表证重于里证,应结合解表药使用九味羌活汤、人参败毒散。如果出现烦躁口渴、舌苔黄,说明里证重于表证,应结合治里药使用三消饮、凉膈散、大柴胡汤、调胃承气汤。古代也有用三棱针刺破皮肤放出恶血的方法,也可以使用。至于发展为痈脓的情况,不在此列。
瘟疫引起的面部肿胀,是风热溢于上部,导致阳明经脉(足阳明胃经)被郁遏所致,只有红肿才是此症,治疗用白芷、防风、葛根、石膏来疏散风热,根据表里轻重的不同,参照头肿条内的各方剂加减使用。如果是黄肿,则是水气所致,应当按照水肿病来治疗。
瘟疫引起的颈项肿胀,是阳明风热所致,俗称“捻头瘟”,又名“蛤蟆瘟”,应当参照头肿条内针对表里的各方剂,加入葛根、桔梗、牛蒡子、防风、玄参。若发生颐颌部痈脓,不在此例。
瘟疫引起的耳旁肿胀,是少阳风热所致,俗称“黄耳伤寒”,用小柴胡汤加入荆芥、防风、川芎、芍药、玄参,同时也应当参考头肿条的内容。
瘟疫引起的胸前一片红肿,起粟粒状皮疹类似麻疹,这是风热所致,俗称“赤膈伤寒”,也应在头面诸条及表里方剂中加入荆芥、防风、连翘、赤芍、牛蒡子、土贝母。
When an epidemic disease is about to resolve, patients may suddenly dance with hands and feet, jump on the bed and roll on the couch before sweating; this sight is most startling. However, one must verify whether true sweating is occurring. If the pulse is floating (Xuan) and moderate (Huan), floating indicates that the pathogen has returned to the exterior, while moderate indicates that the Stomach Qi is naturally harmonizing; after the sweat penetrates, the disease will heal itself. If the pulse is floating-hong (Hong), floating-rapid (Shu), floating-slippery (Hua), or floating-scattered (San), even if there is sweating, it constitutes mania rather than true sweating.
Head swelling in epidemic diseases results from wind-heat congesting the upper part of the body, causing stagnation of the Taiyang meridian (Foot-Taiyang Bladder Meridian) at the vertex; this is commonly known as "Big Head Cold" (Da Tou Shang Han). One should add light and clear wind-dispersing herbs according to the severity of the exterior and interior conditions to dissipate the swelling, such as Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Bohe (Menthae Haplocalycis Herba), Chantui (Cicadae Periostracum), Chuanxiong (Ligustici Chuanxiong Rhizoma), Manjingzi (Viticis Fructus), and Juhua (Chrysanthemi Flos). If fever and a white tongue coating are present, indicating that the exterior condition is heavier than the interior, combine with exterior-resolving formulas such as Jiwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction) or Renshen Baidu San (Ginseng Rescue the Damaged Powder). If irritability, thirst, and a yellow tongue coating are present, indicating that the interior condition is heavier than the exterior, combine with interior-resolving formulas such as Sanxiao Yin (Three-Elimination Drink), Liangge San (Cool the Diaphragm Powder), Da Chaihu Tang (Major Bupleurum Decoction), or Tiaowei Chengqi Tang (Regulate the Stomach and Purge the Intestines Decoction). The ancient method of using a three-edged needle to puncture and release foul blood is also applicable. Cases developing into carbuncles and pus are not included here.
Facial swelling in epidemic diseases occurs when wind-heat overflows to the upper part, depressing the Yangming meridian (Foot-Yangming Stomach Meridian); only red and swollen cases constitute this syndrome. Treatment involves dispersing wind-heat with Baizhi (Angelicae Dahuricae Radix), Fangfeng (Saposhnikoviae Radix), Gegen (Puerariae Lobatae Radix), and Shigao (Gypsum Fibrosum). Adjust these formulas based on the severity of exterior and interior conditions, referring to the modifications listed under the head swelling section. If the swelling is yellow, it is due to water qi and should be treated as edema.
Neck and nape swelling in epidemic diseases is caused by Yangming wind-heat, commonly known as "Twisted Head Plague" (Nian Tou Wen) or "Toad Plague" (Ham Wa Wen). Treat by adding Gegen (Puerariae Lobatae Radix), Jiegeng (Platycodonis Radix), Niubangzi (Arctii Fructus), Fangfeng (Saposhnikoviae Radix), and Xuanshen (Scrophulariae Radix) to the exterior-interior formulas listed under the head swelling section. Cases of parotid abscesses are not included here.
Swelling beside the ears in epidemic diseases is caused by Shaoyang wind-heat, commonly known as "Yellow Ear Cold" (Huang Er Shang Han). Use Xiao Chaihu Tang (Minor Bupleurum Decoction) added with Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shaoyao (Paeoniae Radix), and Xuanshen (Scrophulariae Radix). This should also be cross-referenced with the head swelling section.
A patch of red swelling on the chest, with millet-like eruptions resembling measles, is caused by wind-heat, commonly known as "Red Diaphragm Cold" (Chi Ge Shang Han). Add Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Lianqiao (Forsythiae Fructus), Chishao (Paeoniae Radix Rubra), Niubangzi (Arctii Fructus), and Tubei (Fritillariae Thunbergii Bulbus) to the formulas for the head and face, as well as the exterior-interior formulas.