温病是冬时严寒,人有触冒之,寒气入肌肉,当时不即发,至春得暖气而发,则头痛壮
热,谓之温病。又冬时应寒而反温,其气伤人,即发成病,谓之冬温病,并皆头痛壮热。凡
温热之病,四五日之后,热入里,内热腹满者,宜下之。若热未入里,而下之早者,里虚气
逆,热结胸上,则胸痞满短气,谓之结胸也。
斑毒之病,是热气入胃,而胃主肌肉,其热挟毒,蕴积于胃,毒瓦斯熏发于肌肉。状如蚊
蚤所啮,赤斑起,周匝遍体。此病或者伤寒,或时气,或温病,皆由热不时歇,故热入胃,
变成毒,乃发斑也。凡发赤斑者,十生一死,黑者,十死一生。
黄病者,是热入脾胃,热气蕴积,与谷气相搏,蒸发于外,故皮肤悉黄,眼亦黄。脾与
胃合,俱象土,候肌肉,其色黄,故脾胃内热积蒸发,令肌肤黄。此或者伤寒,或时行,或
温病,皆由热不时解,所以入胃也。
凡发黄而下利、心腹满者,死。诊其脉沉细者,死。
又有百日半岁小儿,非关伤寒、温病,而身微黄者,亦是胃热,慎不可灸也。灸之则热
甚。此是将息过度所为,微薄其衣,数与除热粉散,粉之自歇,不得妄与汤药及灸也。
黄胆之病,由脾胃气实,而外有温气乘之,变生热。脾与胃合,候肌肉,俱象土,其色
黄。胃为水谷之海,热搏水谷气,蕴积成黄。蒸发于外,身疼膊背强,大小便涩,皮肤
、面目、齿爪皆黄,小便如屋尘色,着物皆黄是也。小便宣利者,易治;若心腹满,小便涩
者,多难治也。不渴者易治,渴者难治。脉沉细而腹满者,死也。
温病,是由于冬季感受严寒之气,人体触犯冒受寒邪,寒气侵入肌肉之中,当时并未立即发病,到了春季遇到温暖的气候而发作,出现头痛、高热等症状,这种病称为温病。另外,冬季本应寒冷却反而温暖,这种反常的气候伤人,随即发病形成疾病,称为冬温病,这两种病都表现为头痛和高热。凡是温热性质的疾病,在四五日之后,热邪深入体内,导致内部发热、腹部胀满的,应当采用泻下的治法。如果热邪尚未深入体内,就过早地使用泻下法,会导致里气虚弱、气机逆乱,热邪结聚于胸膈之上,从而出现胸部痞塞胀满、呼吸短促等症状,这称为结胸证。
斑毒病,是热邪侵入胃中,因为胃主司肌肉,热邪挟带毒气,蕴结积聚在胃中,毒气熏蒸发散到肌肉层面。症状表现为皮肤像被蚊虫叮咬一样,出现红色的斑点,遍布全身周围。这种病有的由伤寒引起,有的由时行疫气引起,有的由温病引起,都是因为热邪长时间不消退,所以热邪进入胃中,转化为毒气,进而发为斑疹。凡是发出红色斑点的,十个人中九个能活下来,一个死亡;如果是黑色斑点,十个人中只有一个能活下来,九个死亡。
黄病,是热邪侵入脾胃,热气蕴结积聚,与饮食水谷之气相互搏结,向外蒸发,所以皮肤全部发黄,眼睛也发黄。脾与胃相表里配合,都象征土性,主管肌肉,其色为黄,所以脾胃内部热邪积聚并向上蒸发,导致肌肤发黄。这种病有的由伤寒引起,有的由时行疫病引起,有的由温病引起,都是因为热邪长时间不能解除,所以进入胃中。
凡是出现发黄且伴有腹泻、心腹部胀满的,预后不良(死证)。诊察其脉象沉细的,预后不良(死证)。
又有出生一百天到半岁的婴儿,并非因为伤寒或温病,但身体微微发黄的,这也是胃中有热,千万不可使用灸法。如果施灸,会使热势更盛。这是由于护理不当造成的,应当减少衣物,多次使用清热散粉涂抹,热势自然会平息,不要随意给予汤药及进行灸治。
黄疸病,是由于脾胃气实,外部有温邪乘虚侵袭,化生热邪。脾与胃相表里配合,主管肌肉,都象征土性,其色为黄。胃是水谷汇聚的海,热邪与水谷之气搏结,蕴结积聚而成黄疸。热邪向外蒸发,出现身体疼痛、肩背僵硬、大小便涩滞不畅,皮肤、面目、牙齿和指甲都发黄,小便颜色像屋尘一样,沾染衣物都会变黄。如果小便通畅利落的,容易治疗;如果心腹部胀满,小便涩滞的,大多难以治疗。口不渴的容易治疗,口渴的难以治疗。脉象沉细且腹部胀满的,预后不良(死证)。
Warm disease (Wen Bing) arises when, during the winter season of severe cold, a person is exposed to and contracts cold pathogenic factors. The cold qi enters the muscles but does not manifest immediately. When spring arrives and warmth prevails, the disease erupts, presenting with headache and high fever; this is termed Warm disease. Additionally, if winter should be cold but instead becomes warm, this abnormal climate injures the human body, causing immediate onset of illness, known as Winter-warm disease (Dong Wen). Both conditions present with headache and high fever. Generally, for warm-heat diseases, after four or five days, if the heat penetrates inward, resulting in internal heat and abdominal fullness, purgation (Xia Fa) is indicated. If the heat has not yet entered the interior and purgation is applied prematurely, it causes deficiency in the interior and rebellious Qi. The heat then knots in the chest region, leading to chest oppression, fullness, and shortness of breath; this is termed Jie Xiong (Chest Binding).
Ban Du (Plague-toxin disease) occurs when heat enters the Stomach. Since the Stomach governs the muscles, the heat carries toxin, which accumulates and stagnates within the Stomach. The toxic vapors fumigate and erupt into the muscles. The presentation resembles bites from mosquitoes or fleas, with red macules rising and covering the entire body circumference. This disease may originate from Cold Damage (Shang Han), seasonal epidemic Qi, or Warm disease. All result from persistent heat that does not cease, allowing heat to enter the Stomach, transform into toxin, and subsequently manifest as macules. For those developing red macules, nine out of ten survive and one dies; for black macules, one out of ten survives and nine die.
Huang Bing (Jaundice/Yellow Disease) occurs when heat enters the Spleen and Stomach. The heat qi accumulates and stagnates, battling with the Qi of food and grain, evaporating outward. Consequently, the skin becomes entirely yellow, and the eyes also turn yellow. The Spleen and Stomach are exterior-interior paired, both symbolizing Earth, governing the muscles, and corresponding to the color yellow. Thus, internal heat accumulation and evaporation in the Spleen and Stomach cause the skin and muscles to become yellow. This condition may stem from Cold Damage, seasonal epidemics, or Warm disease, all due to heat failing to resolve over time, thereby entering the Stomach.
If yellowing is accompanied by diarrhea and abdominal fullness, the prognosis is fatal. If the pulse is deep and fine, the prognosis is fatal.
Infants aged between 100 days and half a year who exhibit slight yellowing of the body, unrelated to Cold Damage or Warm disease, also suffer from Stomach heat. Moxibustion must strictly be avoided. Applying moxibustion will exacerbate the heat. This condition results from improper nursing care. One should reduce clothing layers and frequently apply cooling powder dispersants. Once the powder is applied, the heat will subside naturally. Do not arbitrarily administer decoctions or perform moxibustion.
Huang Dan (Jaundice) arises from excess Qi in the Spleen and Stomach, compounded by external warm pathogens invading and transforming into heat. The Spleen and Stomach are exterior-interior paired, governing the muscles, symbolizing Earth, and corresponding to the color yellow. The Stomach is the sea of water and grain. Heat battles with the Qi of water and grain, accumulating and stagnating to form jaundice. Evaporating outward, it causes body pain, stiffness in the shoulders and back, and difficulty in urination and defecation. The skin, face, eyes, teeth, and nails all turn yellow. The urine resembles the color of house dust, staining clothes yellow. If urination is smooth and free, the disease is easy to treat; if there is abdominal fullness and difficult urination, it is difficult to treat. If there is no thirst, it is easy to treat; if there is thirst, it is difficult to treat. A deep, fine pulse accompanied by abdominal fullness indicates a fatal prognosis.