小便不利不可更利之。利之是谓犯本犯本则邪气入里不能解此犯之轻也。以是五苓散不
可妄
用大便不可易动。动之是谓动血动血是谓犯禁。此犯之重也。表在不可下。下之是为犯禁此
犯之尤重也。下之为恶风
咽干淋渴鼻衄小便不利已经发汗。不得重发如无以上忌证。虽发汗邪气未尽。亦得重发
之
其证为风寒所伤。阳气下陷入于内。而排寒水上行于经络之间。本当
发汗。因以彻其邪。医失汗之故生黄也。脾主肌肉四肢。寒湿与内热相合。而生黄也。
蓄血其证燥火也。当益津液为上。而反汗以亡其津液。其毒扰阳之极。则侵阴也。故燥
血而蓄于胸中也。
战而汗解者太阳也。不战有汗而解者。阳明也。
不战无汗而解者少阳也。若先瘥经必不尔矣。
太阳传阳明。其中或有下证。阳明证反退。而热兼不渴。却退显少阳证。是知可解也。
太阳证知可解者。为头不痛项不强肢节不痛则知表易解也。
阳明知可解者。为无发热恶寒。知里易解也。
少阳证知可解者。寒热日不移时。而作邪未退也。若
用柴胡而移其时。早移之于晏。晏移之于早气移之于血。血移之于气。是邪无可容之地知可
解也。
小便不通利时,不可再使用利尿的方法。强行利尿被称为“犯本”,一旦犯本,邪气就会内陷入里而无法解除,这是较轻的误治。因此,五苓散不可随意滥用。大便也不可轻易攻下。攻下大便被称为“动血”,动血被视为触犯禁忌,这是较重的误治。表证存在时不可使用泻下法。使用泻下法也是触犯禁忌,这是尤为严重的误治。若误用泻下法,会导致恶风、咽干、鼻衄(流鼻血)、淋证(小便涩痛)或口渴等症状。
如果出现咽干、淋证、口渴、鼻衄、小便不利等症状,且已经进行过发汗治疗,则不得再次发汗。如果没有上述禁忌证,虽然已经发汗但邪气尚未清除,也可以再次发汗。
病症是由风寒侵袭所致,阳气下陷于体内,导致寒水上行并滞留于经络之间。本应当通过发汗来彻底祛除邪气,但因医生失误未能及时发汗,从而产生了黄疸。脾主肌肉和四肢,寒湿与体内的热邪相结合,从而产生黄疸。
病症是因为发汗过度,导致腠理开泄,汗出淋漓不止,因此出现四肢拘急、难以屈伸的症状。
蓄血证的病机是燥火。此时应当补充津液为上策,反而通过发汗耗伤了津液。毒邪扰乱阳气至极点,进而侵犯阴分,导致血液干燥并在胸中蓄积。
太阳病传入膀胱经,表现为小便通利但颜色发红,这是蓄血证的表现。血液自行排出体外则疾病痊愈。
战栗后出汗而解病的,属于太阳病。不战栗但有汗出而解病的,属于阳明病。不战栗也无汗出而解病的,属于少阳病。如果病情先前已经好转,必然不会出现这种情况。
太阳病传变为阳明病,其中可能伴有可下的证候;阳明证反而消退,且发热兼见口不渴,转而显现少阳证,这表明病情可以解除。
判断太阳病可知可解的依据是:头部不痛、项部不强硬、肢体关节不疼痛,由此可知表邪容易解除。
判断阳明病可知可解的依据是:没有发热和恶寒,由此可知里邪容易解除。
判断少阳病可知可解的依据是:寒热往来每天发作的时间不再固定,说明邪气未退。如果使用柴胡汤使其发作时间发生转移,例如从早晨转移到傍晚,或从傍晚转移到早晨,气机由气分转入血分,或由血分转入气分,使得邪气无处容身,即可知病情可以解除。
When urination is difficult, diuretic methods should not be employed again. Forcing diuresis is termed "violating the root" (Fan Ben); once the root is violated, pathogenic factors will penetrate inward and cannot be resolved. This constitutes a minor error in treatment. Therefore, Wuling San (Five-Ling Powder) must not be used recklessly. Stool should not be easily purged. Purging stool is termed "disturbing blood" (Dong Xue); disturbing blood is considered a violation of contraindications, constituting a severe error. When exterior syndrome exists, purgative methods are contraindicated. Using purgatives when the exterior is affected is also a violation of contraindications, constituting an even more severe error. Improper use of purgatives may lead to aversion to wind, dry throat, epistaxis (nosebleed), strangury (painful/difficult urination), or thirst.
If urination is normal and sweating has not been previously induced, sweating therapy should be applied.
If symptoms such as dry throat, strangury, thirst, epistaxis, or difficulty in urination are present, and sweating has already been performed, re-sweating is prohibited. However, if none of the above contraindications exist, and although sweating has been performed, pathogenic factors remain unresolved, re-sweating may be permitted.
The condition is caused by injury from Wind-Cold, where Yang Qi sinks into the interior, causing Cold-Fluid to rise and accumulate between the collaterals. Sweating should originally have been induced to thoroughly expel the pathogen. Due to the physician's failure to induce sweating appropriately, jaundice develops. The Spleen governs the muscles and four limbs; the combination of Cold-Dampness with internal Heat generates jaundice.
The condition arises from excessive sweating, causing the pores to open and sweat to leak continuously, resulting in tetany of the four limbs and difficulty in flexion and extension.
In Blood Accumulation (Xu Xue) syndrome, the pathology involves Dryness-Fire. The priority should be to replenish Body Fluids (Jin Ye). Instead, sweating was used, depleting Body Fluids. The toxicity disturbs Yang to an extreme degree, subsequently invading Yin, leading to dried blood accumulating in the chest.
In Taiyang Disease (Taiyang Bing) transmitting to the Bladder, with free urination but red urine, this is Blood Accumulation syndrome. If blood passes spontaneously, the disease resolves.
Resolution through shivering followed by sweating indicates Taiyang syndrome. Resolution without shivering but with sweating indicates Yangming syndrome. Resolution without shivering and without sweating indicates Shaoyang syndrome. If the illness had previously improved, this would not occur.
When Taiyang transmits to Yangming, there may be indications for purgation. If Yangming symptoms recede, accompanied by fever but no thirst, and Shaoyang symptoms emerge, it indicates that resolution is possible.
For Taiyang syndrome, resolution is indicated if there is no headache, neck stiffness, or pain in the joints, suggesting that the exterior pathogens are easily resolved.
For Yangming syndrome, resolution is indicated by the absence of fever and aversion to cold, suggesting that interior pathogens are easily resolved.
For Shaoyang syndrome, resolution is indicated if the alternating chills and fever do not occur at fixed times daily, implying the pathogen has not yet retreated. If Chai Hu Tang (Bupleurum Decoction) is used to shift the timing of these episodes—for instance, shifting morning to evening or evening to morning—and Qi shifts into Blood, or Blood shifts into Qi, leaving no place for the pathogen to reside, it indicates that resolution is possible.