疹出不透,脾胃有毒,邪正交攻,脏气相击,火毒郁结,凝滞而作腹痛。腹痛者毒郁于阴,脐以上属
太阴,当脐属少阴,小腹属厥阴,治直升发解利。《经》云∶痛以利减,毒以泻松,加枳壳、枳实、大黄、栝
蒌仁之味,胃口有热有痰而作干呕者,是为恶心,大便秘结忽作腹痛者,燥粪欲出也,用外导法,如平日原有
蛔痛之症,此为内热蛔不安而作痛也,宜用大黄、枳壳、栝蒌仁等味微微利之,泻出即安,切勿妄用使君子等酸药也。
毒瓦斯凝于胃,不能外越,而毒留于内,甚则气喘发厥,治宜升发解利散邪,使毒瓦斯分消,则胀自愈。
《经》云∶疼以利减,胀以自消。肺热生胀而大便秘结,仍用枳壳、大黄、栝蒌仁。胃热
生胀,小便赤涩,可用木通、川连、黄芩、石膏。乳食停积,可用升发加消导,又加枳壳、杏仁、桑皮、陈皮
之类,喘者加葶苈子。又方用田螺一个,将麝香、五味子、入于田螺内,覆脐中,布包,昼夜小水即利矣。
毒火流于肺金,气为火毒所郁也,治宜清金解毒,退火消
痰,顺气为主,如鼻塞咳嗽,乃风入皮毛,可加麻黄、杏仁。泄
泻久而喘者,虚喘也。不泄泻而喘者实喘也。实喘非伤食即便闭,宜陈皮、枳壳、苏子、前胡。疹后发喘者,
毒火绕肺也,宜用条芩、知母、大力子、石膏、桔梗、地骨、兜铃、杏仁、桑皮、葶苈、川贝。喘后腹胀者,
利小便而喘自止矣。气喘痰盛者,当服三子养亲汤,苏子、芥子、莱菔子,微炒黄。注云气有
余便是火,火升而痰亦升,气高而喘亦高,故用苏子降气以解之,芥子开气以理之,菔子利气以下之,气下
则火清而痰喘自止矣。再加竹沥、枇杷叶、绿豆更妙。
疹子发出不透彻,脾胃中有毒邪,正气与邪气相互交争,脏腑之气相互冲击,火毒郁结停滞,从而引发腹痛。腹痛是因为毒邪郁结于阴分,肚脐以上属于太阴经,正对肚脐处属于少阴经,小腹部位属于厥阴经,治疗应当采用升提发散、解表通利的方法。《黄帝内经》说:疼痛通过泻下可以减轻,毒邪通过泻下得以疏通,因此加入枳壳、枳实、大黄、瓜蒌仁等药物。如果胃口有热且有痰导致干呕,这就是恶心;大便秘结突然发生腹痛的,是燥屎欲出的表现,应采用外导法(如灌肠或塞肛);如果平时原有蛔虫疼痛的症状,这是因为内热导致蛔虫不安而作痛,适宜使用大黄、枳壳、瓜蒌仁等药物轻微通便,泻出后疼痛即止,千万不要胡乱使用使君子等酸性药物。
毒邪之气凝结在胃中,不能向外透发,而毒邪留滞于体内,严重时会导致气喘甚至昏厥,治疗宜用升提发散、解表散邪的方法,使毒邪之气分散消除,腹胀自然痊愈。《黄帝内经》说:疼痛通过泻下可以减轻,腹胀会自行消散。肺热导致腹胀且大便秘结的,仍使用枳壳、大黄、瓜蒌仁。胃热导致腹胀,小便赤红涩痛的,可用木通、黄连、黄芩、石膏。乳食停积导致的腹胀,可在升发散邪的基础上加入消食导滞的药物,再加枳壳、杏仁、桑白皮、陈皮之类;伴有喘息的,加葶苈子。另一方法是用一个田螺,将麝香、五味子放入田螺内,覆盖在肚脐上,用布包扎,昼夜之间小便即可通畅。
毒火流注于肺金,气机被火毒所郁遏,治疗宜清肃肺气、解毒,退火化痰,以顺气为主。如出现鼻塞咳嗽,这是风邪侵入皮毛所致,可加麻黄、杏仁。泄泻日久而出现喘息的,属于虚喘。不泄泻而喘息的,属于实喘。实喘如果不是因为伤食和大便闭结引起的,宜用陈皮、枳壳、苏子、前胡。麻疹后出现喘息,是毒火环绕肺部所致,适宜用黄芩、知母、牛蒡子、石膏、桔梗、地骨皮、款冬花、杏仁、桑白皮、葶苈子、川贝母。喘息之后出现腹胀的,通利小便后喘息自会停止。气喘且痰多的,应当服用三子养亲汤,由苏子、芥子、莱菔子组成,微炒至黄色。注释说:气有余便是火,火上升则痰也上升,气逆而上则喘息加剧,所以用苏子降气来化解它,用芥子开气来调理它,用莱菔子利气来下行它,气下行则火清而痰喘自然停止。再加上竹沥、枇杷叶、绿豆效果更好。
When the rash fails to erupt fully, toxic pathogens reside in the Spleen and Stomach. The righteous Qi and pathogenic factors contend with each other, causing the organ Qi to clash. Fire-toxin stagnates and condenses, resulting in abdominal pain. Abdominal pain indicates toxin stagnation in the Yin aspect: the area above the umbilicus belongs to the Taiyin (太阴), the area at the umbilicus belongs to the Shaoyin (少阴), and the lower abdomen belongs to the Jueyin (厥阴). Treatment should focus on lifting, dispersing, resolving, and unblocking. As stated in the *Classic* (*Huangdi Neijing*): "Pain is alleviated by purgation; toxins are dispersed by loosening the bowels." Therefore, add Zhiqiao (Fructus Aurantii), Zhishi (Immature Fructus Aurantii), Dahuang (Radix et Rhizoma Rhei), and Gualouren (Semen Benincasae) to the prescription. If there is heat and phlegm in the stomach causing dry retching, this is termed nausea (恶心). Sudden abdominal pain accompanied by constipation indicates the presence of dry feces attempting to pass; an external guiding method (such as enema or suppository) should be used. If the patient has a history of ascariasis pain, this pain arises from internal heat disturbing the roundworms. It is appropriate to use Dahuang, Zhiqiao, and Gualouren to induce mild purgation; once evacuated, relief will occur. Do not recklessly use acidic drugs such as Shijunzi (Fructus Quisqualis).
Toxic vapors condense in the Stomach and cannot vent outward, remaining trapped inside. In severe cases, this leads to panting and syncope. Treatment should employ lifting, dispersing, and resolving methods to scatter the pathogens, allowing the toxic vapors to dissipate, after which the distension will resolve spontaneously. The *Classic* states: "Pain is alleviated by purgation; distension resolves itself." For distension caused by Lung heat accompanied by constipation, continue using Zhiqiao, Dahuang, and Gualouren. For distension caused by Stomach heat with red, scanty, and painful urination, use Mutong (Herba Akebiae), Chuanlian (Rhizoma Coptidis), Huangqin (Radix Scutellariae), and Shigao (Gypsum Fibrosum). For distension due to retention of milk and food, combine lifting and dispersing agents with digestive aids, adding Zhiqiao, Xingren (Semen Pruni), Sangpiae (Cortex Mori Radicis), and Chenpi (Pericarpium Citri Reticulatae). If panting is present, add Tinglizi (Semen Lepidii). Another method involves taking one field snail, placing Muxiang (Radix Aucklandoniae) and Wuweizi (Fructus Schisandrae) inside it, covering the umbilicus, and wrapping with cloth; urine will flow freely within a day and night.
Fire-toxin flows into the Lung Metal, obstructing the Qi mechanism. Treatment should focus on clearing the Lungs, detoxifying, reducing fire, and resolving phlegm, primarily regulating Qi. If nasal congestion and coughing occur due to wind invading the skin and hair, add Mahuang (Herba Ephedrae) and Xingren. Chronic diarrhea leading to panting indicates deficiency panting (Xu Chuan). Panting without diarrhea indicates excess panting (Shi Chuan). Excess panting, if not caused by food retention or constipation, should be treated with Chenpi, Zhiqiao, Su Zi (Fructus Perillae), and Qianhu (Radix Peucedani). Panting occurring after the measles is due to fire-toxin surrounding the Lungs; appropriate herbs include Tiaohuangqin (Radix Scutellariae), Zhimu (Rhizoma Anemarrhenae), Dalizi (Fructus Arctii), Shigao, Jiegeng (Radix Platycodonis), Digupi (Cortex Lycii Radicis), Doulou (Flos Farfarae), Xingren, Sangpiai, Tinglizi, and Chuanbei (Bulbus Fritillariae Cirrhosae). If distension follows panting, promoting urination will stop the panting. For panting with profuse phlegm, administer Sanzi Yangqin Tang (Three-Seed Decoction for Nourishing the Elderly), composed of Su Zi, Jiezi (Semen Sinapis Albae), and Laifuzi (Semen Raphani), lightly stir-fried until yellow. The annotation notes: "Excess Qi becomes fire; as fire rises, phlegm rises; as Qi ascends, panting intensifies." Therefore, Su Zi is used to descend Qi, Jiezi to open Qi, and Laifuzi to benefit Qi and direct it downward. When Qi descends, fire clears, and panting and phlegm cease spontaneously. Adding Zhuli (Nodus Bambusae in Taenia), Pipaye (Folium Loquats), and Lvdou (Semen Phaseoli Radiati) yields even better results.