这一条还是讲津液虚的反应。This item still describes the reactions of body fluid deficiency.
太阳中风是津液虚，用火强发其汗属于误治。Taiyang wind-strike pattern indicates body fluid deficiency. Forcing sweating by fire - method is a wrong treatment.
下面的两句“邪风被火热，血气流溢，失其常度。两阳相熏灼，其身发黄。Regarding the following two sentences, "The pathogenic wind is affected by the fire - heat, the circulation of blood and qi overflows and loses its normal rhythm. The two yang scorch each other, and the body turns yellow.
阳盛则欲衄，阴虚小便难”。我怀疑是后人加上去了，何为“邪风”？仲景很少这样繁复地将概念。When yang is exuberant, there may be epistaxis; when yin is deficient, urination is difficult." I suspect they were added by later generations. What is "pathogenic wind"? Zhang Zhongjing rarely used such complex concepts.
“阳”这个概念，《伤寒论》里指的是津液，这里的“阳盛”显然不是指津液充足，而是指有热。用“阳”指有热，类后世之文，不类仲景之语境。The concept of "yang" in Treatise on Cold Damage refers to body fluids. Here, "exuberant yang" obviously does not mean sufficient body fluids, but rather the presence of heat. Using "yang" to refer to heat is more like the language of later generations, not in line with Zhang Zhongjing's context.
还是可以解释一下。“邪风被火热，血气流溢，失其常度”，邪风加上火热，于是血的运行失去了常度。However, it can still be explained. "The pathogenic wind is affected by the fire - heat, the circulation of blood and qi overflows and loses its normal rhythm." The combination of pathogenic wind and fire - heat causes the blood to lose its normal circulation rhythm.
关于这个血液妄行的原理是这样：津液消耗了，人体不能用汗来排邪气了，没办法只能动血，用出血的方式来排解邪气。The principle of this abnormal blood circulation is as follows: When body fluids are consumed, the body can no longer expel pathogenic factors through sweating. As a last resort, it has to mobilize the blood and expel the pathogenic factors through bleeding.
像条文中这样单纯地讲一个因为热所以血液妄行，那就是热和血直接发生关系了，这种理解方式貌似无差，却忽略了人体，引向的是见热清热，见病治病的后世之法。In the text, simply stating that abnormal blood circulation is due to heat, directly links heat and blood. This way of understanding seems correct, but it ignores the human body itself and leads to the treatment method of later generations, which is to clear heat when seeing heat and treat the disease directly when seeing the disease.
后世医学就是这样慢慢走歪了的，究其根源就是在研究病的时候忽略了人体自身的作为，然后直接用药物去对付病。This is how later-generation medicine gradually deviated from the right path. The root cause is that when studying diseases, it ignores the body's own actions and directly uses drugs to deal with the diseases.
“两阳相熏灼，其身发黄。”这里的“两阳相熏灼”属于似是而非的解释。"The two yang scorch each other, and the body turns yellow." The so-called "the two yang scorch each other" here is a specious explanation.
身黄的原理事实上是脾的气化功能受限，小便不通，淤而生热，体液中的黄色物质囤积在肌肉当中造成的。In fact, the principle of the body turning yellow is that the qi-transformation function of the spleen is restricted, urination is blocked, stagnation generates heat, and the yellow substances in the body fluids accumulate in the muscles.
“阳盛则欲衄，阴虚小便难。”不能将出血和阳盛直接画等号，原理前面解释过；“阴虚”可以理解为津液虚，所以小便少。"Exuberant yang leads to epistaxis, and yin deficiency causes difficult urination." One cannot directly equate bleeding with exuberant yang, as explained before. "Yin deficiency" can be understood as body fluid deficiency, so there is less urine.
这一条后面更不通了，“阴阳俱虚竭”如何如何，阴阳各指什么？如果按后世的解释，阳指热能，阴指阴血，后面又说有热象，怎么能说俱虚竭呢？不管它，往下解释---The later part of this item is even more illogical. What do "yin and yang both being deficient and exhausted" refer to? If according to the explanation of later generations, yang refers to heat energy and yin refers to yin - blood, and then it is said that there are heat symptoms later, how can it be said that both are deficient and exhausted? Ignore this for now and continue with the explanation.
“身体则枯燥，但头汗出，剂颈而还”，于是人体枯燥了，津液不够了，出汗也只是头部出汗了，到脖子就没有了。"The body becomes dry. Only the head sweats, and the sweating stops at the neck." Thus, the body becomes dry due to insufficient body fluids. Sweating only occurs on the head and stops at the neck.
“腹满微喘，口干咽烂，或不大便，久则谵语，甚者至哕，手足躁扰，捻衣摸床。小便利者，其人可治”，这些说的都是阳明实热且津液虚的反应。"Abdominal fullness, slight panting, dry mouth, ulceration of the throat, or constipation. After a long time, there will be delirium. In severe cases, there will be hiccups, restlessness of the hands and feet, and the patient may pick at the clothes and touch the bed. If urination is normal, the patient can be treated." All these describe the reactions of Yangming excess - heat and body fluid deficiency.
“腹满微喘，口干咽烂，或不大便”；“谵语”；“手足躁扰，捻衣摸床”，这都是阳明实热证。"Abdominal fullness, slight panting, dry mouth, ulceration of the throat, or constipation." "Delirium." "Restlessness of the hands and feet, and the patient may pick at the clothes and touch the bed." These are all Yangming excess - heat syndromes.
这时候如果小便利了，说明津液自己回来了，这个病就好治了。 At this time, if urination is normal, it indicates that the body fluids have returned on their own, and the disease is easier to treat.
中间说的“哕”，应该是下焦不通，胃上逆而为“哕”。The "hiccups" mentioned in the middle should be due to the blockage of the lower jiao, causing the stomach qi to rebel upward and resulting in hiccups.
112．伤寒脉浮，医以火迫劫之，亡阳，必惊狂、卧起不安者，桂枝去芍药加蜀漆牡蛎龙骨救逆汤主之。In cold damage with a floating pulse, if the doctor forces sweating by fire-method, yang is lost. There will surely be fright, mania, and restlessness in lying down and getting up. Guizhi Qu Shaoyao Jia Shuqi Muli Longgu Jiuni Tang (Cinnamon Twig Decoction minus Peony Radix Alba plus Dichroa febrifuga, Oyster Shell, and Dragon Bone to Rescue from Collapse) should be used.
桂枝去芍药加蜀漆牡蛎龙骨救逆汤方Prescription of Guizhi Qu Shaoyao Jia Shuqi Muli Longgu Jiuni Tang:
桂枝三两(去皮) 甘草二两(炙) 生姜三两(切)大枣十二枚(擘) 牡蛎五两(熬) 蜀漆三两(洗去腥) 龙骨四两Three liang of Cinnamon Twig (with peel removed); two liang of Licorice Root (honey-fried); three liang of fresh Ginger (cut); twelve pieces of Chinese Date (broken); five liang of Oyster Shell (roasted); three liang of Dichroa febrifuga (washed to remove the fishy smell); four liang of Dragon Bone.
上七味，以水一斗二升，先煮蜀漆，减二升；内诸药，煮取三升，去滓，温服一升。本云桂枝汤，今去芍药，加蜀漆牡蛎龙骨。Use one dou and two sheng of water to decoct the above seven ingredients. First, decoct Dichroa febrifuga until the water is reduced by two sheng. Then add the other ingredients and decoct until three sheng of the decoction is obtained. Remove the dregs and take one sheng of the decoction warm. Originally, it was Guizhi Tang. Now, Peony Radix Alba is removed, and Dichroa febrifuga, Oyster Shell, and Dragon Bone are added.
这也是讲伤寒的误治。用火熏烤误发了汗，“亡阳”，阳是津液，津液消耗了，这时候会“惊狂”“卧起不安”，变成风温证了，也有可能是阳明里热证，这种情况应该用白虎汤或承气汤去热以存津。This also describes the wrong treatment of cold damage. Incorrect sweating is induced by fire-fumigation. "Loss of yang" means the consumption of body fluids. At this time, there will be "fright, mania" and "restlessness in lying down and getting up", turning into wind-warm syndrome or possibly Yangming interior-heat syndrome. In this case, Baihu Tang (White Tiger Decoction) or Chengqi Tang (Order-the-Qi Decoction) should be used to clear heat and preserve body fluids.
如果同时有热证和津液虚，解热就好了，不要特别去补津液。能发热，说明人体还有阳气，有阳气就有津液化生能力，一般来讲，热去了，津液也就够分配了。If there are both heat syndrome and body fluid deficiency, it is sufficient to clear the heat, and there is no need to specifically tonify the body fluids. The ability to generate heat indicates that the body still has yang qi. With yang qi, there is the ability to generate body fluids. Generally speaking, when the heat is cleared, the body fluids will be sufficient for distribution.
当然，如果津液很虚的话，用白虎汤、承气汤合人参，甚至滋阴药，临证上这种可能性也是有的，都可以随证灵活运用。后世的《温病条辨》里就有这样的方子。Of course, if the body fluids are very deficient, Baihu Tang, Chengqi Tang combined with Ginseng, or even yin-nourishing herbs can be used. Clinically, such possibilities exist, and they can be flexibly applied according to the syndromes. There are such prescriptions in the later-generation book Systematic Differentiation of Warm Diseases.
按照条文，这个方子似乎放错了地方。桂枝汤是治偏虚汗的证的，龙骨牡蛎虽定惊安神，但是用于阳明里热也非其治。According to the text, this prescription seems to be in the wrong place. Guizhi Tang is used to treat syndromes with relatively deficient sweating. Although Dragon Bone and Oyster Shell can calm the mind and relieve fright, they are not suitable for treating Yangming interior-heat.
蜀漆这个药不常用，是常山的苗，去痰湿的，放在这里也不知所云。Dichroa febrifuga is not commonly used. It is the sprout of Dichroa febrifuga Lour. and is used to remove damp-phlegm. Its placement here is rather puzzling.
113．形作伤寒，其脉不弦紧而弱。弱者必渴，被火必谵语，弱者发热，脉浮，解之当汗出愈。The appearance resembles cold damage, yet the pulse is not taut and tight but weak. Those with a weak pulse are bound to be thirsty. If treated by fire-related methods, delirium will occur. The person with a weak pulse has fever and a floating pulse. Recovery will be achieved when sweating occurs to resolve the condition.
看上去像伤寒，但是脉不弦紧，而是弱。弱为津液虚，那就要以桂枝汤为主方来治疗。The appearance is like cold damage, but the pulse is not taut and tight, but weak. A weak pulse indicates body fluid deficiency, and Guizhi Tang should be used as the main prescription for treatment.
脉弱津虚口会渴，这种情况多少有些标热，如果再无用火熏烤来治疗，势必津液更虚，且演变成严重的里热证，那就会谵语了。A weak pulse with body fluid deficiency may cause thirst. In this case, there is somewhat exterior heat. If fire-fumigation is used for treatment, it is bound to make the body fluids more deficient and evolve into a severe interior-heat syndrome, resulting in delirium.
脉弱的人发热脉浮有表证，应该是不能汗的，为什么又说“当汗出愈”呢？这是说如果人体的津液自己回来了，那就会汗出而愈。For a person with a weak pulse, fever, and a floating pulse, there is an exterior syndrome, and usually, sweating should be avoided. Why does it say "recovery will occur when sweating"? This means that if the body fluids return on their own, sweating will occur and the disease will be cured.
114．太阳病，以火熏之，不得汗，其人必躁；到经不解，必清血，名为火邪。In Taiyang disease, when fire-fumigation is used and no sweating occurs, the patient will surely be restless. If the disease does not resolve when it reaches a certain stage or level, there will surely be hematochezia. This is called fire-pathogen.
以上的几条都在讲用火熏烤的误治。用火熏了，又不出汗，热没有出路，那就会发躁，比烦更甚，这是热证。The above items all describe the wrong treatment of fire-fumigation. When fire-fumigation is used and no sweating occurs, the heat has no way out, and restlessness will occur, which is even more severe than annoyance. This is a heat syndrome.
“到经不解”。像这种受了熏烤之热的情况，如果到了一定的时间或是层面病还拍不出来，病就会转，就会便血。"If the disease does not resolve when it reaches a certain stage or level." In cases of being affected by the heat of fumigation, if the disease cannot be expelled after a certain period of time or at a certain level, the disease will transform, and there will be hematochezia.
因为热是会烧灼津液的，津液烧掉了，病还不解，人体就只得动血来解病了，所以患者会便血。这种情况属于火邪的范畴。Because heat can burn body fluids. When the body fluids are burned and the disease is still not resolved, the body has to mobilize the blood to resolve the disease, so the patient will have hematochezia. This situation belongs to the category of fire-pathogen.
