夫卫气一日一夜大会于风府,则腠理开,腠理开则邪入,邪入则病作。当其时,阴阳相
并,随其所胜,故生寒热,故动作皆有早晏者。若腑脏受邪,内外失守,邪气妄行,所以休
作无时也。
夫疟,皆由伤暑及伤风所为,热盛之时,发汗吐下过度,腑脏空虚,荣卫伤损,邪气伏
藏,所以引日不瘥,仍故休作也。夫疟岁岁发,至三岁发,连月发不解,胁下有痞,治之不
得攻其痞,但得虚其津液。先其时发其汗,服汤已,先小寒者,引衣自温覆汗出,小便自引
黄病者,一身尽疼,发热,面色洞黄。七、八日后,壮热在里,有血当下之法如
肝状。其人少腹内急。
若其人眼睛涩疼,鼻骨疼,两膊及项强,腰背急,即是患黄。多大便涩,但令得小便快
,即不虑死。不用大便多,多即心腹胀不存。此由寒湿在表,则热蓄于脾胃,腠理不开,瘀
热与宿谷相搏,烦郁不得消,则大小便不通,故身体面目皆变黄色。
凡黄候,其寸口近掌无脉,口鼻冷气,并不可治也。
脾胃有热,谷气郁蒸,因为热毒所加,故卒然发黄,心满气喘,命在顷刻,故云急黄也
。有得病即身体面目发黄者,有初不知是黄,死后乃身面黄者。其候,得病但发热心战者,
是急黄也。
黄汗之为病,身体洪肿,发热,汗出不渴,状如风水,汗染衣,色正黄,如柏汁,其脉
自沉。此由脾胃有热,汗出而入水中浴,若水入汗孔中,得成黄汗也。
卫气在一天一夜中会在风府穴汇聚一次,此时腠理(皮肤纹理及汗孔)开放,腠理开放则外邪容易侵入,邪气侵入则疾病发作。在这个时刻,阴气和阳气相互搏结,随着各自所胜的方面变化,从而产生寒热交替的症状,因此疾病发作的时间有早有晚。如果脏腑受到邪气侵袭,内外失去固守能力,邪气妄行,所以疾病发作没有固定的时间规律。
疟疾,都是由伤暑和伤风引起的。在热盛的时候,如果发汗、催吐或泻下过度,导致脏腑空虚,营卫之气受损,邪气潜伏藏匿,所以病程迁延不愈,仍然按时发作。疟疾每年发作,到了第三年发作频繁,连续几个月不解,胁下有痞块,治疗时不能直接攻伐痞块,只能使津液虚损。在发作之前使其发汗,服药后,如果先感到轻微寒冷,就拉过衣服自我保暖以助汗出,小便自然通畅。
患黄疸病的人,全身疼痛,发热,面色深黄。七八天后,体内壮热,有瘀血应当用下法排出,症状类似肝脏病变。其人小腹部内部拘急不适。
如果其人眼睛涩痛,鼻骨疼痛,两臂及颈部僵硬,腰部背部拘急,这就是患黄疸病。大多大便干涩,只要让小便通利顺畅,就不用担心死亡。不需要大便次数多,多了就会导致心腹胀满不适。这是由于寒湿停留在体表,导致热邪蓄积于脾胃,腠理不开,瘀热与宿食相互搏结,烦闷郁结无法消散,导致大小便不通畅,所以身体和面目都变成黄色。
凡是黄疸病的候证,如果寸口脉靠近手掌处无脉,口鼻出冷气,都是不可治疗的死证。
脾胃有热,谷气郁结蒸腾,再加上热毒的侵害,所以突然发黄,心胸胀满气喘,生命危在旦夕,所以称为急黄。有的得病后立即身体面目发黄,有的起初不知道是黄疸,死后才发现身体面目发黄。其候证,得病后只是发热且心中战栗的,就是急黄。
黄汗这种病,身体高度浮肿,发热,出汗但不口渴,症状像风水病,汗水染衣,颜色正黄,像柏树汁一样,脉象自沉。这是由于脾胃有热,出汗后进入水中沐浴,如果水从汗孔进入体内,就会形成黄汗。
Wei Qi (Defensive Qi) converges at the Fengfu point (GV16) once every day and night. At this time, the Cou Li (skin texture and pores) open; when the Cou Li open, pathogenic factors enter, and upon entry, the disease manifests. At that moment, Yin and Yang Qi contend with each other, shifting according to their respective strengths, thus generating alternating chills and fever. Consequently, the onset of symptoms varies in timing. If the Zang-Fu organs are invaded by pathogens, internal and external defenses fail, and pathogenic factors act recklessly, resulting in irregular intervals between symptom episodes.
Malaria is caused by damage from summerheat and wind. During periods of intense heat, excessive sweating, vomiting, or purging can lead to emptiness in the Zang-Fu organs and damage to Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi). Pathogenic factors then lie dormant, causing the illness to persist for a long time without recovery, yet still recurring periodically. Malaria may recur annually; if it persists for three years with frequent attacks lasting months, and a mass forms under the hypochondrium, treatment should not directly attack the mass but rather deplete the body fluids. Induce sweating before the onset of an attack. After taking the decoction, if the patient initially feels slightly cold, they should cover themselves with clothing to warm up and induce sweating, allowing urination to flow freely.
Patients with Jaundice suffer from generalized body pain, fever, and a deep yellow complexion. After seven or eight days, intense heat accumulates internally, and there is a method to purge blood stasis, resembling liver pathology. The patient experiences urgency and tightness in the lower abdomen.
If the patient has sore, gritty eyes, pain in the nasal bone, stiffness in both arms and the neck, and tightness in the waist and back, they are suffering from Jaundice. Stool is often dry and difficult to pass; ensuring smooth urination prevents death. Frequent bowel movements are not necessary; excessive frequency leads to abdominal distension and fullness. This condition arises from cold-dampness lingering on the exterior, causing heat to accumulate in the Spleen and Stomach. With the Cou Li closed, stagnant heat combats retained food, causing vexation and stagnation that cannot be resolved, leading to obstruction of both stool and urine. Thus, the body and face turn yellow.
In all cases of Jaundice, if the Cun Kou pulse (radial artery near the wrist crease) is imperceptible near the palm, and cold air emanates from the mouth and nose, the condition is incurable.
Heat in the Spleen and Stomach causes grain qi to stagnate and steam. Combined with the addition of toxic heat, sudden jaundice occurs, accompanied by chest fullness and panting, with life hanging in the balance; hence it is called Ji Huang (Acute Jaundice). Some patients develop immediate yellowing of the body and face upon falling ill, while others do not realize they have Jaundice until after death. A symptom pattern characterized solely by fever and mental tremors indicates Acute Jaundice.
The disease known as Huang Han (Yellow Sweat) presents with severe edema of the body, fever, sweating without thirst, and symptoms resembling Feng Shui (Wind-Water edema). The sweat stains clothes yellow, resembling cypress sap, and the pulse is deep. This results from heat in the Spleen and Stomach combined with bathing in water while sweating; if water enters through the pores, Yellow Sweat is formed.