凡治风之法,宜察浅深虚实及中经中脏之辨。盖中经者,邪在三阳,其病犹浅;中脏者
,邪入三阴,其病则甚。若在浅不治,则渐入于深;在经不治,则渐入于脏,此浅深之谓也
。又若正胜邪者,乃可直攻其邪;正不胜邪者,则必先顾其本,此虚实之谓也。倘不知此,
则未有不致败者。
一、大风大寒直中三阴致危者,必用《金匮》续命汤去石膏治之。若风寒在经,而头疼
恶寒,拘急身痛者,宜麻黄汤、麻桂饮随证加减主之。甚者亦宜续命汤。若头疼有汗恶风者
,宜桂枝汤,或五积散。若风邪在经,热多寒少,而为偏枯疼痛发热者,宜大秦艽汤主之。
甚者,愈风汤亦可。
一、风寒诸病,无非外感证也。如轻浅在肺者,则为伤风。稍深在表里之间者,则为疟
疾。留连经络者,则为寒热往来。遍传六经,彻内彻外者,则为伤寒、瘟疫。久留筋骨者,
则为风痹、痛风,或为偏风。风热上壅者,则为大头时毒。风湿相搏者,则为大风、疠风。
浮在肌肤者,则为斑疹、疮毒。感在岭南者,则为瘴气。凡此者皆外感风寒之病,俱有门类
,方论具载各条。舍此之外,但无表证者,均不得指为风也。
许胤宗治唐柳太后病风,脉沉欲脱,云∶服汤药无及矣。即以黄 防风煮汤数十斛,置
床下熏薄之。是夕果语,更药之而愈。
王克明治卢州王守道风噤不能语,以炽炭烧地热,洒以药汤,置病者于上,须臾小苏。
若此二者,以病至垂危,药不能及,亦治风之权变也。
凡是治疗风病的方法,应当辨别病位的浅深、正气的虚实,以及邪气是侵犯经络还是脏腑的区别。大致而言,邪气侵犯经络的,病邪位于三阳经,病情尚属轻浅;邪气侵犯脏腑的,病邪深入三阴经,病情则十分严重。如果在病位浅表时不进行治疗,病邪就会逐渐深入;如果在经络阶段不进行治疗,病邪就会逐渐传入脏腑,这就是所谓的浅深之分。另外,如果人体正气强盛能够战胜邪气,就可以直接攻逐邪气;如果正气虚弱不能战胜邪气,就必须先顾护人体的根本(正气),这就是所谓的虚实之分。如果不明白这些道理,就没有不导致治疗失败的。
一、如果是大风大寒之邪直中三阴经而导致危重情况的,必须使用《金匮要略》中的续命汤,去掉石膏这味药来治疗。如果风寒之邪停留在经络,出现头痛、恶寒、肢体拘急、身体疼痛的症状,适宜使用麻黄汤或麻桂饮,根据具体证候进行加减后主治。病情严重的,也适宜使用续命汤。如果头痛且伴有出汗、怕风的,适宜使用桂枝汤,或者五积散。如果风邪停留在经络,热象多于寒象,并出现半身不遂、疼痛发热的症状,适宜使用大秦艽汤主治。病情严重的,愈风汤也可以使用。
一、风寒引起的各种疾病,无非都是外感证候。如病情轻浅在肺系的,就是伤风。稍深处于表里之间的,就是疟疾。滞留于经络的,就是寒热往来。遍传六经,彻内彻外的,就是伤寒或瘟疫。久留于筋骨的,就是风痹、痛风,或者是偏风。风热上壅的,就是大头瘟(大头时毒)。风湿相互搏结的,就是大风、疠风(麻风)。浮在肌肤表面的,就是斑疹、疮毒。感染于岭南地区的,就是瘴气。凡此种种,都属于外感风寒的疾病,都有相应的门类,方剂和论述都详细记载在各条文中。除此之外,如果没有表证的,都不能指认为风病。
许胤宗治疗唐柳太后的风病,脉象沉微欲绝,他说:“服用汤药已经来不及了。”于是就用黄芪、防风煮成数十斛的药汤,放在床下熏蒸病人。当天晚上病人果然能说话了,再服药调理而痊愈。
王克明治疗庐州王守道的风病导致牙关紧闭不能说话,他用炽热的炭烧暖地面,洒上药汤,让病人躺在上面,不久病人稍微苏醒过来。像这两例,因为病情已到垂危地步,口服药物难以奏效,这也是治疗风病的权宜变通之法。
In general, the treatment of wind diseases requires distinguishing the depth and superficiality of the pathogen, the deficiency or excess of healthy Qi (Zheng Qi), and whether the pathogen has invaded the meridians (Jing) or the zang-fu organs. Generally speaking, when the pathogen invades the meridians, it affects the Three Yang meridians, and the disease is relatively shallow; when the pathogen invades the zang-fu organs, it penetrates the Three Yin meridians, and the disease is severe. If a disease at a superficial level is not treated, it will gradually deepen; if a disease in the meridians is not treated, it will gradually enter the zang-fu organs. This refers to the distinction between depth and superficiality. Furthermore, if healthy Qi is strong enough to overcome the pathogen, one can directly attack the pathogen; if healthy Qi is insufficient to overcome the pathogen, one must first protect the root (healthy Qi). This refers to the distinction between deficiency and excess. Failure to understand these principles will inevitably lead to therapeutic failure.
1. In cases where severe wind and cold pathogens directly invade the Three Yin meridians causing critical conditions, one must use Xu Ming Tang (Cure Wind Decoction) from *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), removing Shi Gao (Gypsum Fibrosum). If wind-cold remains in the meridians, presenting with headache, aversion to cold, limb stiffness, and body pain, Ma Huang Tang (Ephedra Decoction) or Ma Gui Yin (Ephedra and Cinnamon Twig Drink) should be used, modified according to the specific syndrome. For severe cases, Xu Ming Tang is also appropriate. If there is headache accompanied by sweating and aversion to wind, Gui Zhi Tang (Cinnamon Twig Decoction) or Wu Ji San (Five Accumulations Powder) is suitable. If wind-pathogen remains in the meridians, with heat predominating over cold, presenting with hemiplegia, pain, and fever, Da Qin Jiao Tang (Large Notopterygium Decoction) is indicated. For severe cases, Yu Feng Tang (Wind-Extinguishing Decoction) may also be used.
1. Various diseases caused by wind and cold are essentially exterior syndromes. Mild cases affecting the Lung system constitute Shang Feng (Wind-Cold Invasion). Cases slightly deeper, situated between the exterior and interior, constitute Nue Ji (Malaria). Pathogens lingering in the meridians manifest as alternating chills and fever. Pathogens spreading through all six meridians, penetrating both inside and outside, constitute Shang Han (Cold Damage) or Wen Yi (Plague). Pathogens remaining long-term in the sinews and bones result in Feng Bi (Wind-Bi Syndrome), Tong Feng (Gout-like Pain), or Pian Feng (Hemiplegic Wind). Wind-heat congesting upwards results in Da Tou Shi Du (Big Head Plague). Wind-dampness intertwining results in Da Feng or Li Feng (Leprosy/Malignant Wind). Pathogens floating on the skin and muscles present as Ban Zhen (Macules and Papules) or Chuang Du (Sores and Toxins). Infections in the Lingnan region constitute Zhang Qi (Miasma). All these belong to exterior wind-cold diseases, each categorized under specific headings, with formulas and discussions detailed in their respective sections. Outside of these categories, any condition lacking exterior signs cannot be classified as a wind disease.
Xu Yinzong treated Empress Dowager Liu of the Tang Dynasty for wind disease. Her pulse was deep and nearly imperceptible. He stated, "Administering decoctions orally is no longer effective." Therefore, he boiled Huang Qi (Astragali Radix) and Fang Feng (Saposhnikoviae Radix) into dozens of hu (a unit of volume) of medicinal soup, placed it under the bed, and fumigated the patient with the steam. That evening, the patient indeed regained the ability to speak. After further medication, she recovered.
Wang Keming treated Wang Shoudao of Luzhou for wind disease resulting in trismus and inability to speak. He heated the ground with hot charcoal, sprinkled medicinal soup upon it, and placed the patient on top. The patient soon regained slight consciousness. These two cases illustrate that when a disease reaches a critical stage where oral medications cannot reach the site of action, such methods represent expedient variations (Quan Bian) in the treatment of wind diseases.