瘟疫愈后,调养之方,往往不讲,而抑知此乃后一段工夫,所关甚巨也。即如过饱者曰食复,
脑怒者曰气复,疲于筋力者曰劳复,伤于色欲者曰女劳复,载在经书,世皆知之,尚有时而触犯。
此外,人所最易忽者,犹有三焉,不在诸复之条者也。虽已愈多日,而气血苟不充足,犯之随有
酿成终身之患者焉。一曰淫欲,凡人房事,必撮周身之精华以泄,气血未充,七日未能来复,欲
事频数,势必积损成劳, 羸损寿。一曰劳顿,或远行或作苦,疲弊筋力,当时不觉,将来肢体
解,未老先衰,其苦有莫可名言者。一曰忍饥,愈后凡有觉饿,必得稍食,万毋强耐,过时反
不欲食,强食亦不能化,是饥时既伤于前,强食又伤于后,中州败而肺金损,则劳嗽,脾胃之病
成矣。三者人多忽之,故不可不谨。
头痛热渴
太阳以寒水主令,手太阳以丙火而化气于寒水,阴胜则壬水司气而化寒,阳胜则丙火违令而
化热,故太阳以寒水之经,而易于病热。冬不藏精,相火升泄,伤其寒水闭蛰之气,火旺水亏已
久,及春夏感病,卫闭营郁,寒水愈亏,故受病即发热作渴而不恶寒也。太阳在六经之表,是以
感则先病。其经自头下项,行身之背,故头项痛而腰脊强。肺主卫,肝主营,而总统于太阳。太
阳之经,在皮毛之部,营卫者,皆皮毛之所统辖。瘟病卫闭而营郁,法当清营热而泄卫闭。治宜
凉金补水而开皮毛,元霜丹主之。
元霜丹 治太阳头项痛,腰脊强,发热作渴。
浮萍(三钱) 麦冬(二钱,去心) 元参(二钱) 丹皮(二钱,酒洗) 芍药(一钱)
甘草(一钱) 生姜(三钱,切) 大枣(二枚,劈)
水煎,热服,覆衣取少汗。一方去元参、麦冬,治同。
身痛脉紧烦躁无汗
瘟疫在太阳,脉浮、头痛、发热、汗出,以风强而气不能闭也。若脉浮而紧,发热恶寒,身
痛腰疼,烦躁无汗而喘促者,是寒束而邪不能泄也。盖瘟疫有汗,寒疫无汗,以风性疏泄,而寒
性闭藏,卫阳过闭,邪不能泄,营郁莫达,则烦躁喘促。与伤寒同治,宜以浮萍黄芩,清散经络
之热也。
浮萍黄芩汤
浮萍(三钱) 黄芩(一钱) 杏仁(二钱,泡去皮、尖) 甘草(二钱,炙) 生姜(三钱)
大枣(二枚,劈) 流水煎大半杯,温服,覆衣。
烦热燥渴
(烦热燥渴与前发热作渴不同。故用白虎而不用元霜矣。)
病在太阳经,未入阳明之腑,不至遽生烦渴。若阳明燥盛之人,经热外遏,燥
气内应,则见烦渴。阳明从燥金化气,腑燥发作,故有燥热便难之症。今腑燥未作,胸燥先动,
是以烦渴生焉。其太阳表症未解,宜浮萍石膏汤清金而解表,绝其燥热入腑之源。表症已解,第
以白虎加元麦汤清燥生津。气虚者加人参以益气,因表解而阳虚,恐燥去而阳亡也。
白虎加元麦汤 治太阳经罢,烦热燥渴。
石膏(三钱, ) 知母(一钱) 甘草(一钱) 粳米(一撮) 元参(二钱) 麦冬(三钱,
去心)
流水煎至米熟,取大半杯,热服。
人参白虎加元麦汤 治太阳经罢,气虚烦渴。
石膏(三钱, ) 知母(钱半,酒炒) 炙草(一钱) 粳米(一撮) 人参(一钱) 元参(二钱)
麦冬(三钱,去心)
流水煎至米熟,取大半杯,热服。
瘟疫痊愈后的调养方法,往往不被重视,然而要知道这是病后恢复阶段的重要环节,关系非常重大。就像吃得太饱引起的叫“食复”,恼怒引起的叫“气复”,过度劳累筋骨引起的叫“劳复”,因色欲过度引起的叫“女劳复”,这些记载在医书中,世人皆知,但有时仍会触犯。此外,人们最容易忽视的,还有三种情况,不在上述各种“复”的条目中。虽然已经痊愈多日,但如果气血尚不充足,一旦触犯这些禁忌,随时可能酿成终身疾病。一是淫欲,凡是房事,必定调动全身精华进行泄耗,气血尚未充盈,七天之内未能恢复,如果房事频繁,势必导致积损而成虚劳,损害寿命。二是劳顿,或者远行或者从事重体力劳动,使筋骨疲惫,当时可能不觉得痛苦,将来会导致肢体懈惰,未老先衰,其中的痛苦难以言表。三是忍饥,痊愈后如果有饥饿感,必须适当进食,千万不要强行忍耐,过了时候反而不想吃东西,即使勉强吃下去也不能消化,这是在饥饿时已经受了损伤,勉强进食又在后面造成损伤,脾胃(中州)败坏而肺金受损,就会形成劳嗽,脾胃的疾病也就形成了。这三种情况人们常常忽视,所以不可不谨慎。
头痛、发热、口渴
太阳经由寒水主令,手太阳经以丙火之气化生于寒水之中,阴气胜则壬水司气而化为寒,阳气胜则丙火违背时令而化为热,所以太阳经虽然是寒水之经,却容易患热病。冬天没有藏精,相火升发外泄,损伤了寒水闭蛰之气,火旺水亏已久,到了春夏季节感受病邪,卫气闭塞营气郁滞,寒水更加亏损,所以患病即出现发热、口渴而不恶寒的症状。太阳经位于六经的最表层,所以感受邪气首先发病。其经脉从头部下行至项部,沿身体背部行走,所以会出现头项疼痛和腰脊僵硬。肺主管卫气,肝主管营气,而统辖于太阳经。太阳经的经脉,位于皮毛部位,营气和卫气,都是皮毛所统辖的。瘟疫病导致卫气闭塞而营气郁滞,治法应当清营分之热而解除卫气之闭。治疗宜用凉润肺金、滋补肾水并开通皮毛的方法,使用元霜丹主治。
元霜丹 治疗太阳经头项痛、腰脊强、发热口渴。
浮萍(三钱) 麦冬(二钱,去心) 元参(二钱) 丹皮(二钱,酒洗) 芍药(一钱)
甘草(一钱) 生姜(三钱,切片) 大枣(两枚,劈开)
用水煎煮,热服,盖好衣服取微汗。另一方案去掉元参、麦冬,治疗相同。
身痛、脉紧、烦躁、无汗
瘟疫在太阳经,表现为脉浮、头痛、发热、出汗,这是因为风性疏泄而气不能闭塞所致。如果脉浮而紧,发热恶寒,身体疼痛腰痛,烦躁无汗且气喘急促,这是寒邪束表而邪气不能发散。大概瘟疫多有汗出,寒疫多无汗,因为风性疏泄,而寒性闭藏,卫阳过度闭塞,邪气不能发散,营气郁滞不能通达,就会出现烦躁气喘。治疗方法与伤寒相同,宜用浮萍黄芩汤,清散经络中的热邪。
浮萍黄芩汤
浮萍(三钱) 黄芩(一钱) 杏仁(二钱,泡去皮、尖) 甘草(二钱,炙) 生姜(三钱)
大枣(两枚,劈开) 用流水煎至大半杯,温服,盖好衣服。
烦热、燥渴
(烦热燥渴与前文的发热作渴不同。所以用白虎汤而不用元霜丹。)
病在太阳经,未传入阳明腑,不至于立刻产生烦渴。如果是阳明燥盛体质的人,经热被外遏,燥气在内相应,就会出现烦渴。阳明经从燥金化气,腑燥发作,所以有燥热便秘的症状。现在腑燥尚未发作,胸中燥气先动,所以产生烦渴。其太阳表证未解,宜用浮萍石膏汤清润肺金并解表,断绝燥热入腑的源头。表证已解,只用白虎加元麦汤清燥生津。气虚者加人参以益气,因为表解之后可能导致阳虚,担心燥热去除后阳气随之亡失。
白虎加元麦汤 治疗太阳经病罢,烦热燥渴。
石膏(三钱,打碎) 知母(一钱) 甘草(一钱) 粳米(一撮) 元参(二钱) 麦冬(三钱,去心)
用流水煎至米熟,取大半杯,热服。
人参白虎加元麦汤 治疗太阳经病罢,气虚烦渴。
石膏(三钱,打碎) 知母(钱半,酒炒) 炙甘草(一钱) 粳米(一撮) 人参(一钱) 元参(二钱)
麦冬(三钱,去心)
用流水煎至米熟,取大半杯,热服。
After recovery from plague, the methods for convalescence are often neglected, yet it should be known that this constitutes a crucial phase of post-illness recuperation with significant implications. For instance, relapse caused by overeating is termed "Food Relapse" (Shi Fu); one caused by anger is termed "Qi Relapse" (Qi Fu); one caused by excessive physical exertion is termed "Labor Relapse" (Lao Fu); and one caused by sexual excess is termed "Female Labor Relapse" (Nu Lao Fu). These are recorded in medical classics and widely known, yet violations still occur. Furthermore, there are three other aspects most easily overlooked by people, which do not fall under the categories of the aforementioned relapses. Even if many days have passed since recovery, if Qi and Blood are not yet sufficient, violating these precautions may readily lead to lifelong ailments. The first is sexual indulgence: sexual intercourse necessarily expels the essence of the whole body; if Qi and Blood are not replenished, they cannot recover within seven days. Frequent sexual activity will inevitably accumulate damage leading to deficiency exhaustion (Xu Lao) and shorten lifespan. The second is physical fatigue: whether traveling far or performing hard labor, exhausting the sinews and muscles may not feel painful at the time, but later leads to flaccidity of limbs and premature aging, with suffering beyond words. The third is enduring hunger: after recovery, when feeling hungry, one must eat moderately; one must never forcibly endure hunger. If the timing passes, appetite may disappear, and forced eating will fail to digest. Thus, injury occurs beforehand due to hunger, and further injury occurs afterwards due to forced eating. This damages the Spleen and Stomach (Zhong Zhou) and injures Lung Metal, leading to chronic cough (Lao Sou) and the formation of Spleen-Stomach diseases. People often neglect these three aspects, so caution is imperative.
Headache, Fever, and Thirst
The Taiyang (Greater Yang) channel is governed by Cold Water. The Hand-Taiyang channel transforms Qi via Bing Fire within Cold Water. When Yin prevails, Ren Water governs the Qi and transforms into Cold; when Yang prevails, Bing Fire violates the seasonal order and transforms into Heat. Therefore, although the Taiyang channel belongs to Cold Water, it is prone to Heat diseases. Failure to store Essence during winter causes Ministerial Fire to ascend and leak, damaging the closing and storing Qi of Cold Water. With Fire flourishing and Water deficient for a long time, contracting disease in spring or summer leads to closure of Defensive Qi (Wei Qi) and stagnation of Nutritive Qi (Ying Qi), further depleting Cold Water. Consequently, upon contracting disease, fever and thirst appear without aversion to cold. The Taiyang channel is on the exterior of the Six Channels, so pathogenic factors attack it first. Its meridian descends from the head to the neck and runs along the back of the body, hence headache, neck stiffness, and rigidity of the lower back and spine. The Lungs govern Wei Qi, the Liver governs Ying Qi, and both are commanded by the Taiyang channel. The Taiyang meridian resides in the region of skin and hair, which controls both Ying and Wei Qi. In plague diseases, Wei Qi is closed and Ying Qi is stagnant; the treatment method should clear Heat from the Ying level and open the closure of Wei Qi. Treatment should cool the Lung Metal, nourish Kidney Water, and open the skin and hair, using Yuan Shuang Dan as the primary prescription.
Yuan Shuang Dan treats Taiyang headache and neck pain, rigidity of the lower back and spine, fever, and thirst.
Floating Duckweed (San Qian) Ophiopogon Tuber (Er Qian, heart removed) Scrophularia Root (Er Qian) Moutan Bark (Er Qian, wine-washed) Peony Root (Yi Qian) Licorice Root (Yi Qian) Fresh Ginger (San Qian, sliced) Jujube (Two fruits, split)
Decoct in water, take hot, cover with clothing to induce slight sweating. Another formula removes Scrophularia Root and Ophiopogon Tuber, with identical treatment indications.
Body Pain, Tight Pulse, Restlessness, and Anhidrosis
When plague affects the Taiyang channel, symptoms include floating pulse, headache, fever, and sweating, because Wind nature is dispersing and Qi fails to close. If the pulse is floating and tight, accompanied by fever, aversion to cold, body pain, lower back pain, restlessness, anhidrosis, and panting, this indicates Cold binding the exterior preventing the expulsion of pathogens. Generally, plague involves sweating, while Cold plague involves anhidrosis, because Wind nature is dispersing while Cold nature is closing and storing. Excessive closure of Defensive Yang prevents pathogen expulsion, causing Ying stagnation and failure to reach the surface, resulting in restlessness and panting. Treat similarly to Cold Damage (Shang Han), using Fuping Huangqin Tang to clear and disperse Heat in the meridians.
Fuping Huangqin Tang
Floating Duckweed (San Qian) Scutellaria Root (Yi Qian) Apricot Seed (Er Qian, soaked, skin and tip removed) Licorice Root (Er Qian, honey-fried) Fresh Ginger (San Qian) Jujube (Two fruits, split)
Decoct in flowing water until half a cup remains, take warm, cover with clothing.
Vexing Heat, Dryness, and Thirst
(Vexing heat, dryness, and thirst differ from the previous fever and thirst. Hence, Baihu Tang is used instead of Yuan Shuang Dan.)
When the disease is in the Taiyang channel and has not entered the Yangming Fu organs, vexing thirst does not arise abruptly. However, in individuals with strong Yangming Dryness, if Channel Heat is constrained externally and Dryness responds internally, vexing thirst appears. The Yangming channel transforms Qi via Dryness Metal; when Fu Dryness manifests, symptoms of Dry Heat and difficult defecation occur. Now, although Fu Dryness has not yet manifested, Chest Dryness moves first, giving rise to vexing thirst. Since the Taiyang exterior syndrome is unresolved, use Fuping Shigao Tang to moisten Lung Metal and resolve the exterior, cutting off the source of Dry Heat entering the Fu organs. Once the exterior syndrome is resolved, use Baihu Jia Yuanmai Tang alone to clear Dryness and generate fluids. For Qi deficiency, add Ginseng to tonify Qi, as resolving the exterior may lead to Yang deficiency, fearing that clearing Dryness might cause Yang collapse.
Baihu Jia Yuanmai Tang treats post-Taiyang vexing heat, dryness, and thirst.
Gypsum (San Qian, crushed) Anemarrhena Rhizome (Yi Qian) Licorice Root (Yi Qian) Rice (A pinch) Scrophularia Root (Er Qian) Ophiopogon Tuber (San Qian, heart removed)
Decoct in flowing water until rice is cooked, take half a cup, hot.
Renshen Baihu Jia Yuanmai Tang treats post-Taiyang Qi deficiency with vexing thirst.
Gypsum (San Qian, crushed) Anemarrhena Rhizome (Qian Ban, wine-fried) Honey-fried Licorice Root (Yi Qian) Rice (A pinch) Ginseng Root (Yi Qian) Scrophularia Root (Er Qian) Ophiopogon Tuber (San Qian, heart removed)
Decoct in flowing water until rice is cooked, take half a cup, hot.