伤寒郁冒者。盖郁为郁结而气不舒也。冒为昏冒而神不清也。世谓之昏迷者是也。郁冒
之来
不愈
知因
伤寒头眩者。 非毛而见其毛。眩非玄而见其玄。 为眼花。眩为眼黑。眩也。运也。
也
冒为
邪所
并病故眩者。责其虚也。伤寒有起即头眩与眩冒者。皆因发汗吐下后所致。是其阳虚也。故
针经
病。
皆非
虽神医其能治之耶。冒因虚极。有伤寒头疼胸坚属三阳。汗吐下后。脉沉自利者理中汤。冒
者蒙
妇人
而脱
胸中
汗吐
茯
以
眩
食。大便坚。盖血虚则厥而必冒也。
伤寒摇头者。盖头者诸阳之会也。诸阳之脉皆上于头。诸阴脉皆至颈胸中而还。阳脉不
至。
语言
风主
直视
下相
伐
其
盖
焉
根
盛
有痛。言则痛甚。痛则必摇。经所谓摇头言者里痛也。又曰言者为虚。不言者为实是也。合
而言之均是摇头。析而分之。曰实邪。曰虚邪。曰真病。又当明其脏痞云。摇头直视。形如
烟熏者心家绝也。为真病不治。太阳发痉摇头。口噤背反张。身热足冷。各有本条。摇头言
者。其里有病。言者虚也。可与如圣饼及芎辛汤服之。
伤寒项强者。盖太阳经脉起于目内 。上额交颠。上入络脑。还出别下项循肩膊内。挟
脊抵
颈为之急尔。伤寒颈项强急者。太阳表证也。必发散而解之可也。太阳病。项背强KT
KT。反汗出
根汤
主之。是皆发散之剂也。二者皆是项背强。而发散有轻重者。盖发热汗出恶风者。为表虚。
表虚者可解肌。无
是桂枝汤加麻黄、葛
实。正可发汗。则于
是桂枝汤中但加葛根
能飞腾。动则先引伸其
其或太阳中风。加之寒湿
头热面赤目赤。独头面摇
KTKT 。然脉反流动者此为痉。
又
有结胸病者。项亦强如痉状。下之
随证投汤则万全矣。
伤寒头项强急。太阳表证也。当发散而解之。若误下。则太阳邪风乘虚入里。则为结胸。
太
根
而
满
伤寒郁冒，是指气机郁结而不得舒展，神志昏蒙而不清晰。世人所说的昏迷就是这种情况。
伤寒头眩，并非看到毛发（幻觉），而是眼花；眩是指视物发黑。眩即转动之意。冒则是因邪气与正气相并导致疾病，所以出现眩晕，其根本原因在于虚证。伤寒中发病初期即出现头眩或眩冒的，都是由于发汗、催吐或泻下之后所致，这是阳气虚弱的原因。因此，《针经》中提到相关病症，虽然神医也难以治愈。冒是因为极度虚弱引起的。有伤寒头痛、胸部坚硬属于三阳经病证，如果在发汗、催吐、泻下后，出现脉沉且自发性腹泻的，应用理中汤治疗。妇人……（原文此处有脱漏）……血虚则发生厥逆，必然伴随昏冒。
伤寒摇头，头部是诸阳经汇聚的地方。所有阳经的脉气都上行至头部，所有阴经的脉气都到达颈胸中便返回。如果阳脉不能到达……（原文此处有脱漏）……风邪主……（原文此处有脱漏）……如果有疼痛，说话时疼痛加剧，因为疼痛必然导致头部摇动。《内经》所谓“摇头言语者，里有痛也”。又说“言语者为虚，不言语者为实”即是此意。综合来说都是摇头，但细分开来，有实邪、虚邪和真病的区别，还应当明确脏腑痞塞的情况。摇头且直视，形体如烟熏般晦暗的，是心气绝的表现，属于真病，无法治疗。太阳病发痉，表现为摇头、口噤、角弓反张、身热足冷，各有专门条文论述。摇头言语者，说明体内有病，言语者属虚，可以给予如圣饼及芎辛汤服用。
伤寒项强，太阳经脉起于目内眦，上行至额部，交会于头顶，深入联络脑部，复出别行下行至项部，沿肩膊内侧，夹脊柱抵达……（原文此处有脱漏）……颈部变得拘急。伤寒颈项强急，属于太阳表证，必须用发散的方法解除。太阳病，项背强几几，反而出汗恶风的，以桂枝加葛根汤主治。这些都是发散类的方剂。两者都是项背强急，但散邪的力度有轻重之分。发热、出汗、恶风，属于表虚证，表虚证可以用解肌的方法；无汗恶寒，属于表实证，正适合发汗，则在桂枝汤中加入麻黄、葛根。如果是桂枝汤中只加葛根……（原文此处有脱漏）……能够飞腾……（原文此处有脱漏）……动则先引伸其……（原文此处有脱漏）……或者是太阳中风，又加上寒湿……（原文此处有脱漏）……头热面赤目赤，只有头面部摇动……（原文此处有脱漏）……然而脉象反而流动的，这就是痉病。又有结胸病，项部也强直如同痉病状，如果用下法……（原文此处有脱漏）……随证投予汤药则万无一失。伤寒头项强急，属于太阳表证，应当用发散的方法解除。如果误用下法，则太阳邪风乘虚入里，就会形成结胸。
In Taiyang disease, Yu Mao (depression and dizziness) refers to the stagnation of Qi where it fails to circulate freely, accompanied by mental confusion and lack of clarity. What is commonly referred to as coma in the world corresponds to this condition.
Dizziness (Xuan) in Taiyang disease involves visual disturbances such as seeing spots or darkness, rather than hallucinations. "Xuan" implies a sensation of spinning or rotating, while "Mao" indicates clouding of vision due to the pathogenic factor combining with healthy Qi, causing dizziness; its root cause is deficiency. In Taiyang disease, instances where dizziness or vertigo appears immediately upon onset are typically caused by improper use of sweating, vomiting, or purging therapies, leading to Yang deficiency. As mentioned in the *Ling Shu* (Needle Classic), although skilled physicians exist, treating such conditions can be challenging. Mao is often due to extreme deficiency. For Taiyang disease presenting with headache and chest rigidity belonging to the Three Yang stages, if pulse becomes deep and spontaneous diarrhea occurs after sweating, vomiting, or purging, Lizhong Tang (Regulate the Middle Decoction) should be used. [Text fragment missing regarding women]... Blood deficiency leads to Jue (cold extremities/reversal) and inevitably accompanies Mao.
Head shaking in Taiyang disease occurs because the head is the meeting point of all Yang meridians. All Yang meridians ascend to the head, while Yin meridians reach the neck and chest before returning. If Yang meridians fail to reach... [text fragment missing]... Wind pathogens dominate... [text fragment missing]... If there is pain, speaking exacerbates the pain, necessitating head shaking. The Classics state: "Shaking the head while speaking indicates interior pain." It is also said: "Speaking indicates deficiency, not speaking indicates excess." Generally, these are all forms of head shaking, but analytically, they can be distinguished into excess pathogens, deficient pathogens, and true diseases. One must also clarify organ blockages. Head shaking with fixed gaze and a complexion resembling smoke staining indicates the exhaustion of Heart Qi, representing a true disease that is untreatable. When Taiyang disease manifests as Jing (spasm), symptoms include head shaking, lockjaw, opisthotonos, fever in the upper body, and cold feet, each detailed in specific sections. Head shaking with speech suggests internal pathology; speech indicates deficiency. Such cases may be treated with Rusheng Bing (Rusheng Cake) and Xiongxin Tang (Szechwan Lovage and Asarum Decoction).
Neck stiffness (Xiang Qiang) in Taiyang disease arises from the Taiyang meridian originating at the inner canthus, ascending to the forehead, intersecting at the vertex, entering to connect with the brain, emerging again to descend along the nape, passing through the shoulder blades, and running alongside the spine to... [text fragment missing]... causing tension in the neck. Neck stiffness in Taiyang disease is a Taiyang exterior syndrome, which must be resolved through dispersing methods. In Taiyang disease, if there is stiffness in the neck and back (Jiang Jiang), accompanied by sweating and aversion to wind, Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Kudzu Root) is indicated. These are all dispersing formulas. Both conditions involve neck and back stiffness, but the intensity of dispersion varies. Fever, sweating, and aversion to wind indicate an Exterior Deficiency pattern, treatable by releasing the muscle layer; absence of sweat and aversion to cold indicate an Exterior Excess pattern, suitable for inducing sweating, requiring the addition of Mahuang (Ephedrae Herba) and Gegen (Puerariae Lobatae Radix) to Guizhi Tang. If only Gegen is added to Guizhi Tang... [text fragment missing]... allowing movement to first extend... [text fragment missing]... Or if Taiyang Wind Strike is compounded by Cold-Dampness... [text fragment missing]... heat in the head, red face, and red eyes, with isolated head tremors... [text fragment missing]... yet the pulse flows rapidly, this constitutes Jing (spasm). Additionally, Jie Xiong (Chest Binding) disease presents with neck stiffness resembling spasm; if purgatives are incorrectly applied... [text fragment missing]... prescribing decoctions according to the syndrome ensures complete safety. Head and neck stiffness in Taiyang disease is an exterior syndrome and should be resolved by dispersing. If mistakenly treated with purgatives, Taiyang pathogenic wind enters the interior due to deficiency, resulting in Jie Xiong (Chest Binding).