《灵枢·寒热病篇》曰∶皮寒热者,不可附席,毛发焦,鼻槁腊,不得汗。取三阳之络,以补手太阴。
络浅在皮,皮寒热者,邪闭皮肤而痛,故不可附席;皮毛肺之合也,肺开窍于鼻,以邪外闭,阳郁化热,
故毛发焦而鼻槁腊,腊者,焦燥也。此肺液已伤,久则必成肺痿,故当急取三阳经之络,以泄皮肤之邪,补
手太阴经,以救肺也。《灵枢·口问篇》岐伯曰∶寒气客于皮肤,阴气盛,阳气虚,故为振寒寒 。补诸阳。
是以阴盛阳虚,不能胜外寒而但寒 ,无内热证,故当补诸阳以散外寒,与上证有阴阳虚实之异也。
肌寒热者,肌痛,毛发焦而唇槁腊,不得汗。取三阳于下,以去其血者,补足太阴,以出其汗。
肌寒热,其邪从皮毛而深入矣。唇为肌肉之本,脾所主也,邪已侵脾,故毛发焦,肌肉痛而唇槁腊。取三
阳经下部以去其血者,是疏通营卫,以解肌肉之邪,以营卫气血行于肌肉之中也。营卫疏通,即补足太阴脾经,
以滋津液,助其出汗,则病退矣。
骨寒热者,病无所安,汗注不休。齿未槁,取其少阴于阴股之络;齿已槁,死不治。骨厥亦然。
骨寒热者,邪从肌肉而深入骨也。邪既深入,表分更伤,故病甚无少安时,而汗注不休,津气皆脱矣。齿
为骨之余,骨者肾所主,齿未槁,肾水未竭,故取少阴肾经所属阴股之络脉,以泻邪热;如齿槁,则肾水涸,死
不可治矣。骨厥者,骨中灼热而肢体厥冷,近世所云骨蒸劳病,亦当验其齿,以辨生死也。
《灵枢·寒热病篇》说:皮寒热(邪气侵袭皮肤引起的寒热证),患者身体疼痛,无法贴近席子,毛发干枯焦黄,鼻腔干燥萎缩,无汗。治疗应取足三阳经的络穴,并补益手太阴肺经。
络脉浅表位于皮下,皮寒热是邪气闭塞皮肤所致疼痛,所以患者不能贴近席子;皮毛与肺相合,肺开窍于鼻,因邪气外闭,阳气郁结化热,所以毛发干枯而鼻腔干燥萎缩,“腊”指焦燥之状。此时肺中津液已受损,日久必发展为肺痿(肺部慢性虚损性疾病),因此应当紧急取用三阳经的络穴以泄除皮肤之邪,同时补益手太阴经以救肺。
《灵枢·口问篇》中岐伯说:寒气客居于皮肤,导致阴气盛、阳气虚,从而出现战栗发冷(振寒)。治疗应补益诸阳经。这是因为阴盛阳虚,不能抵御外寒,仅表现为寒冷而无内热症状,所以应当补益诸阳经以驱散外寒,这与上述皮寒热证在阴阳虚实上有区别。
肌寒热(邪气侵袭肌肉引起的寒热证),表现为肌肉疼痛,毛发干枯,嘴唇干燥萎缩,无汗。治疗应在下部取足三阳经穴位放血以祛除瘀血,并补益足太阴脾经以促使出汗。
肌寒热的邪气从皮毛深入到了肌肉。嘴唇是肌肉的根本,由脾所主,邪气已经侵犯脾脏,所以毛发干枯,肌肉疼痛且嘴唇干燥萎缩。在下部取足三阳经穴位放血,是为了疏通营卫之气,解除肌肉中的邪气,因为营卫气血运行于肌肉之中。营卫疏通后,再补益足太阴脾经以滋养津液,帮助出汗,疾病即可消退。
骨寒热(邪气侵袭骨骼引起的寒热证),患者烦躁不安,无处安身,大汗淋漓不止。如果牙齿尚未干枯,可取足少阴肾经在大腿内侧的络穴进行治疗;如果牙齿已经干枯,则属死症,无法治愈。骨厥(肾气逆乱导致的骨中灼热、四肢厥冷)的情况也是如此。
骨寒热是邪气从肌肉进一步深入骨骼所致。邪气既然深入,体表分理更受损伤,所以病情严重,片刻不得安宁,大汗淋漓,津气和元气都已脱失。牙齿是骨骼的余气,骨骼由肾所主,如果牙齿未干枯,说明肾水未竭,因此取足少阴肾经所属大腿内侧的络脉以泻除邪热;如果牙齿干枯,则说明肾水枯竭,属于死症不可治愈。所谓骨厥,是指骨中灼热而肢体厥冷,即近代所说的骨蒸劳病(结核病等消耗性疾病),也应当通过观察牙齿来辨别生死预后。
The *Ling Shu · Han Re Bing Pian* states: In **Pi Han Re** (Skin Cold-Heat Disorder), the patient cannot lie close to the mat, hair becomes scorched and dry, the nose becomes atrophic and dry, and there is no sweating. Treatment involves selecting the collaterals of the Three Yang meridians and supplementing the Hand Taiyin Lung Meridian.
Collaterals are superficially located in the skin. Pi Han Re is caused by pathogenic factors closing off the skin and causing pain, hence the inability to lie close to the mat; the skin and hair are associated with the Lung, and the Lung opens into the nose. Due to external closure of pathogens, Yang Qi stagnates and transforms into heat, resulting in scorched hair and a dry, atrophic nose ("La" refers to scorched dryness). At this stage, Lung fluids are already damaged, and if prolonged, it will inevitably develop into Fei Wei (Lung萎/Flaccidity Syndrome). Therefore, one should urgently select the collaterals of the Three Yang meridians to drain pathogenic factors from the skin, and supplement the Hand Taiyin Meridian to rescue the Lung.
In the *Ling Shu · Kou Wen Pian*, Qibo stated: When cold qi lodges in the skin, Yin Qi becomes excessive and Yang Qi deficient, leading to Zhen Han (Shivering Chills). Treatment involves supplementing the various Yang meridians. This is because Yin excess and Yang deficiency prevent the body from overcoming external cold, resulting only in cold sensations without internal heat symptoms. Thus, one should supplement the various Yang meridians to disperse external cold, which differs from the aforementioned Pi Han Re disorder in terms of Yin-Yang and Deficiency-Excess patterns.
In Ji Han Re (Muscle Cold-Heat Disorder), there is muscle pain, scorched hair, dry and atrophic lips, and no sweating. Treatment involves selecting points on the lower part of the Three Yang meridians to remove blood stasis, and supplementing the Foot Taiyin Spleen Meridian to induce sweating.
Ji Han Re occurs when pathogens deepen from the skin and hair into the muscles. The lips are the root of the muscles and are governed by the Spleen; since pathogens have invaded the Spleen, hair becomes scorched, muscles hurt, and lips become dry and atrophic. Selecting points on the lower part of the Three Yang meridians for bloodletting serves to unblock Ying and Wei Qi to resolve pathogens in the muscles, as Ying and Wei Qi circulate within the muscles. Once Ying and Wei are unblocked, supplementing the Foot Taiyin Spleen Meridian nourishes Jin Ye (Body Fluids) and assists in sweating, thereby resolving the disease.
In Gu Han Re (Bone Cold-Heat Disorder), the patient feels unsettled and unable to find comfort, with continuous profuse sweating. If the teeth have not yet become dry, one should select the collateral of the Foot Shaoyin Kidney Meridian in the inner thigh; if the teeth are already dry, it is a fatal condition that cannot be treated. Gu Jue (Bone Jue) presents similarly.
Gu Han Re occurs when pathogens deepen from the muscles into the bones. Since the pathogens have penetrated deeply, the exterior layers are further damaged, resulting in severe illness with no moments of rest and continuous profuse sweating, indicating depletion of Jin Qi (Fluids and Qi). Teeth are the surplus of bones, and bones are governed by the Kidney. If the teeth are not dry, it indicates that Kidney Water has not been exhausted; thus, one selects the collateral of the Foot Shaoyin Kidney Meridian in the inner thigh to drain pathogenic heat. If the teeth are dry, it indicates exhaustion of Kidney Water, constituting a fatal condition. Gu Jue refers to burning heat in the bones accompanied by cold extremities, commonly known in modern times as Gu Zheng Lao Bing (Bone-steaming Consumption Disease/Tuberculosis). One should also examine the teeth to distinguish between life and death prognoses.