凡病新瘥后,食猪肉及肠血,肥鱼脂腻,必大下利,医所不能复治也,必至于死。若食
饼饵、粢饴,哺炙脍、枣、栗诸果物脯,及牢实难消之物,胃气尚虚弱,不能消化,必结热
复病,还以药下之。
经言春气温和,夏气暑热,秋气清凉,冬气冰寒,此四时正气之序也。冬时严寒,万类
深藏,君子固密,则不伤于寒。触冒之者,乃为伤寒耳。其伤于四时之气,皆能为病,而以
伤寒为毒者,以其最为杀厉之气焉。即病者为伤寒;不即病者,为寒毒藏于肌骨中,至春变
为温病。是以辛苦之人,春夏必有温病者,皆由其冬时触冒之所致也。凡病伤寒而成温者,
先夏至日者为病温,后夏至日者为病暑。其冬复有非节之暖,名为冬温之毒,与伤寒大异也
。
有病温者,汗出辄复热,而脉躁疾,不为汗衰,狂言不能食,病名为何?曰∶病名阴阳
交,阴阳交者死也。人所以汗出者,皆生于谷,谷生于精,今邪气交争于骨肉之间而得汗者
,是邪却而精胜,则当食而不复热。复热者,邪气也,汗者,精气也。今汗出而辄复热者,
是邪胜也。汗出而脉尚躁盛者死。今脉不与汗相应,此不称其病也,其死明矣。狂言者是失
志,失志者死。今见三死,不见一生,虽愈必死。
凡皮肤热甚,脉盛躁者,病温也。其脉盛而滑者,汗且出也。凡温病患,二三日,身躯
热,腹满,头痛,食欲如故,脉直疾,八日死。四、五日,头痛,腹满而吐脉来细强,十二
日死,此病不治。八、九日,头不疼,身不痛,目不赤,色不变,而反利,脉来牒牒,按不
弹手,时大,心下坚,十七日死。病三、四日以下不得汗,脉大疾者生;脉细小难得者,死
不治也。下利,腹中痛甚者,死不治。其汤熨针石,别有正方,存神攘辟,今附于后。
《养生方·导引法》云∶常以鸡鸣时,存心念四海神名三遍,辟百邪止鬼,令人不病。
东海神名阿明 南海神名祝融 西海神名巨乘 北海神名禺强
又云∶存念心气赤,肝气青,肺气白,脾气黄,肾气黑,出周其身,又兼辟邪鬼。欲辟
却众邪百鬼,常存心为炎火如斗,煌煌光明,则百邪不敢干之。可以入温疫之中。
凡是疾病刚刚痊愈的人,如果食用猪肉、猪肠和猪血,以及肥肉、鱼油和油腻食物,必然会导致严重的腹泻,这是医生难以再治疗的,最终会导致死亡。如果食用饼饵、米糕麦芽糖,晚餐时的烤肉生鱼片,以及枣、栗等果脯,还有坚硬难消化的食物,由于胃气仍然虚弱,无法消化这些食物,必然导致热邪郁结而旧病复发,这时需要用泻下药来治疗。
经书说:春季气候温和,夏季气候暑热,秋季气候清凉,冬季气候冰寒,这是四季正常的气候顺序。冬季严寒,万物深藏,君子(指懂得养生的人)注意固护腠理,就不会受寒邪伤害。触犯冒犯寒邪的,才会患伤寒病。人体受到四时不正之气的侵袭,都能致病,但其中以伤寒最为毒烈,因为它是杀伤力最强的邪气。感邪后立即发病的称为伤寒;没有立即发病的,寒毒潜伏在肌肤骨骼之中,到了春天就转变为温病。因此,辛勤劳作的人,在春夏季节必定有人患温病,这都是因为冬天时触冒寒邪所导致的。凡是患伤寒病而转化为温病的,在夏至日之前发病的称为病温,在夏至日之后发病的称为病暑。如果冬季出现不合节令的温暖天气,这种毒气被称为“冬温”,它与伤寒大不相同。
有一种温病患者,出汗后随即又发热,脉搏躁动快速,出汗后热度并不减退,胡言乱语且不能进食,这种病叫什么名字?回答说:这种病名叫“阴阳交”,阴阳交的疾病是死证。人之所以出汗,是因为水谷精微化生的,水谷精微源于精气。现在邪气与正气在骨肉之间交争而得出汗,如果是正气战胜邪气,患者应当能进食且不再发热。再次发热的,是邪气在作祟;出汗的,消耗的是精气。现在出汗后随即又发热,说明邪气胜过了正气。出汗后脉搏依然躁动旺盛的,预后不良会死亡。现在的脉象与出汗的情况不相适应,这说明病情与脉象不符,死亡是显而易见的。胡言乱语是神志丧失的表现,神志丧失者会死亡。现在出现了三种死征,看不到一丝生机,即使暂时看似好转,最终也必死无疑。
凡是皮肤高热,脉搏盛大躁动的,是温病。如果脉搏盛大而滑利,说明汗液即将排出。凡是温病患者,发病二三天,身体发热,腹部胀满,头痛,食欲如常,脉搏直而快,八天后会死亡。发病四五天,头痛,腹部胀满并呕吐,脉搏细而强劲,十二天后会死亡,这种病难以治愈。发病八九天,头不痛,身体不痛,眼睛不红,面色无变化,反而出现腹泻,脉搏来势急促(牒牒),按压时不弹手,有时变大,心下部位坚硬,十七天后会死亡。患病三、四天以下不出汗,脉搏大而快的可以存活;脉搏细小难以触及的,死亡且难以治愈。如果出现腹泻,腹部疼痛剧烈的,也是死亡且难以治愈的。关于汤药熨贴、针刺砭石的治疗,另有专门的方剂,此处附在后面。
《养生方·导引法》说:经常在鸡鸣时分,存想心中默念四海神的名号三遍,可以辟除百邪、阻止鬼魅,使人不生病。东海神名阿明,南海神名祝融,西海神名巨乘,北海神名禺强。又说:存想心中意念心气为红色,肝气为青色,肺气为白色,脾气为黄色,肾气为黑色,使它们环绕周身,也可以兼辟邪鬼。想要辟却各种邪气和百鬼,经常存想心脏像斗大的炎火一样,辉煌光明,那么百邪就不敢侵犯。这样可以进入瘟疫流行的环境中而不受感染。
After a disease has just resolved, if the patient consumes pork, intestines, and blood, as well as fatty fish and greasy animal fats, severe diarrhea will inevitably occur. This condition is beyond the curative capacity of physicians and will ultimately lead to death. If the patient consumes cakes, malt sugar, roasted meat, raw fish slices served at dusk, dates, chestnuts, dried fruits, and other hard-to-digest foods, the stomach qi remains weak and unable to digest them. This will inevitably cause heat to accumulate and the old illness to recur; in such cases, purgative medicines should be used to treat it.
The Classics state: The qi of spring is mild and harmonious, the qi of summer is hot and sultry, the qi of autumn is cool and clear, and the qi of winter is icy cold. These constitute the normal sequence of the four seasons. In winter, when the cold is severe, all things hide deeply. A gentleman who firmly secures his exterior (consolidates his defensive qi) will not be injured by cold. Those who are exposed to and冒犯ed by the cold will suffer from Shanghan (Cold Damage). Exposure to the qi of the four seasons can cause various diseases, but among them, Shanghan is considered the most toxic because it is the most lethal pathogenic factor. Diseases that manifest immediately after exposure are called Shanghan; those that do not manifest immediately involve cold toxicity hiding within the muscles and bones, which transforms into Wenbing (Warm Disease) in spring. Therefore, laborers often contract Wenbing during spring and summer, caused by their exposure to cold during winter. For those who contracted Shanghan and transformed into warmth, those who fall ill before the Summer Solstice are diagnosed with Bingwen (Disease of Warmth), while those who fall ill after the Summer Solstice are diagnosed with Bingshu (Disease of Summerheat). If there is unseasonable warmth in winter, this toxic qi is named Dongwen (Winter Warmth), which is vastly different from Shanghan.
In cases of Wenbing, the patient sweats but fever returns immediately, the pulse is rapid and restless, and the fever does not subside with sweating. The patient speaks deliriously and cannot eat. What is the name of this disease? It is said: The disease is named Yin-Yang Jiao (Interaction of Yin and Yang), and Yin-Yang Jiao indicates a fatal prognosis. Human sweat originates from grain (food), and grain essence generates jing (essence). When pathogenic factors contend with healthy qi between the muscles and bones, resulting in sweat, it implies that the pathogen is retreating and jing is prevailing; thus, the patient should be able to eat and not have recurrent fever. Recurrent fever indicates the dominance of pathogenic factors; sweat represents the consumption of jing. Now, since sweat is followed immediately by fever, it signifies that the pathogen has overcome the jing. If the pulse remains rapid and vigorous after sweating, death is imminent. The current pulse does not correspond to the sweating, indicating a mismatch between the disease and the pulse, making death evident. Delirious speech indicates loss of zhi (will/shen), and loss of zhi leads to death. Seeing three signs of death without any sign of life, even if there is temporary improvement, death is inevitable.
When the skin is extremely hot and the pulse is full and restless, it is a case of Wenbing. If the pulse is full and slippery, sweat is about to appear. In patients with Wenbing, if on the second or third day of illness, the body is hot, the abdomen is distended, there is headache, appetite remains normal, and the pulse is straight and rapid, death will occur on the eighth day. On the fourth or fifth day, if there is headache, abdominal distension with vomiting, and the pulse is fine and strong, death will occur on the twelfth day; this disease is difficult to treat. On the eighth or ninth day, if the head does not hurt, the body does not ache, the eyes are not red, the complexion does not change, but diarrhea occurs instead, and the pulse comes rapidly (die die), feels non-resilient upon pressure, sometimes becomes large, and the area below the heart is firm, death will occur on the seventeenth day. If no sweat occurs within three to four days of onset, and the pulse is large and rapid, survival is possible; if the pulse is fine, small, and difficult to feel, death is certain and untreatable. If there is diarrhea with severe abdominal pain, it is also fatal and untreatable. Regarding treatments using decoctions, moxibustion/ironing, acupuncture, and stone needles, there are separate specific formulas, which are attached hereafter.
The "Yangsheng Fang · Daoyin Fa" states: At the time of the rooster's crow (early morning), one should visualize and silently recite the names of the Four Seas deities three times to repel hundred evils and ghosts, preventing illness. The deity of the East Sea is named Aming; the deity of the South Sea is named Zhurong; the deity of the West Sea is named Jucheng; the deity of the North Sea is named Yuqiang. It further states: Visualize the heart qi as red, liver qi as green, lung qi as white, spleen qi as yellow, and kidney qi as black, circulating around the body, which also helps repel evil spirits. To repel various evils and ghosts, one should constantly visualize the heart as a blazing fire like a dipper, shining brightly, so that hundred evils dare not interfere. This practice allows one to enter areas affected by epidemic fevers safely.