{"action":"opened","issue":{"url":"https://api.github.com/repos/billyhwd/model-5/issues/106","repository_url":"https://api.github.com/repos/billyhwd/model-5","labels_url":"https://api.github.com/repos/billyhwd/model-5/issues/106/labels{/name}","comments_url":"https://api.github.com/repos/billyhwd/model-5/issues/106/comments","events_url":"https://api.github.com/repos/billyhwd/model-5/issues/106/events","html_url":"https://github.com/billyhwd/model-5/issues/106","id":178759310,"number":106,"title":"分析和想法","user":{"login":"billyhwd","id":17001120,"avatar_url":"https://avatars.githubusercontent.com/u/17001120?v=3","gravatar_id":"","url":"https://api.github.com/users/billyhwd","html_url":"https://github.com/billyhwd","followers_url":"https://api.github.com/users/billyhwd/followers","following_url":"https://api.github.com/users/billyhwd/following{/other_user}","gists_url":"https://api.github.com/users/billyhwd/gists{/gist_id}","starred_url":"https://api.github.com/users/billyhwd/starred{/owner}{/repo}","subscriptions_url":"https://api.github.com/users/billyhwd/subscriptions","organizations_url":"https://api.github.com/users/billyhwd/orgs","repos_url":"https://api.github.com/users/billyhwd/repos","events_url":"https://api.github.com/users/billyhwd/events{/privacy}","received_events_url":"https://api.github.com/users/billyhwd/received_events","type":"User","site_admin":false},"labels":[],"state":"open","locked":false,"assignee":null,"assignees":[],"milestone":null,"comments":0,"created_at":"2016-09-23T01:07:15Z","updated_at":"2016-09-23T01:07:15Z","closed_at":null,"body":"# 溫病的壞病\r\n- 病在榮衛，**舌無胎、脈洪虛**，**烏梅白糖湯**，歸回相火，補益風木，恢復津液，疏泄滯氣，補益中氣，病即自癒，不壞也。病在榮衛，**舌無胎、脈虛小**，**三豆飲**，補益木氣，養中熄風，病即自癒，不壞也。兼感寒者，**加薄荷**以開衛閉，不壞也。病在氣分，**舌胎如粉、咳嗽作渴**，**枳實銀菊散**，清熱去滯，降肺調中，病即自癒，不壞也。病在血分，**舌絳、脈弦、身熱不退、夜不能寐**，**加減黃連阿膠雞子黃湯**，養血清熱，補中溫腎，病即自癒，不壞也。病在腸胃，**舌胎乾黃、譫語、日晡潮熱、腹滿拒按**，**加減黃龍湯**，泄熱養胃，病即自癒，不壞也。理路分明，方法各當，一經誤治，或汗，或下，或補，將分明的理路混亂不清，遂成壞病。壞病之中，先分虛實，證治列下。\r\n- **其脈虛者，則熱不退而昏迷，精神微弱，呼吸短促**。**其脈實者，則熱不退而煩擾、潮熱、譫語、脈轉沉細**。壞病大概，不過如此。「**脈實**」的「實」宇作「滯」字看，不可作「虛實」的「實」字看。\r\n- 無論**脈虛、脈實**的壞病，只要**大便不瀉**，即不致死，雖**遲至十餘日以至二十餘日不大便**，亦吉；如**滑瀉不止**，便成死證。因溫病乃上盛下虛之病，不滑瀉者相火雖散漫於外，中氣未亡，圓運動的根氣尚存，只要相火下降，中氣復旺，旋轉升降，自能復圓；如**滑瀉不止**，下焦早已空虛，再加滑瀉，則空而又空，中氣全滅，圓運動的根氣全消，故死也。前人謂大便瀉乃熱有出路，認為佳兆；此濕熱病的佳兆也，非溫病所宜也。前人於溫病喜用下藥，亦盲從王叔和「伏寒變為溫毒」之故。切須認清，不可含糊。\r\n- 脈虛壞病，無論舌上有無黃胎，先以**烏梅湯**，酸甘相得，徐徐飲之，自能熱退、身涼，微汗而解。凡用**烏梅楊**，如**脈有熱**，兌入**清茶半杯**。熱退之後，**舌上黃胎**者，再以**大黃末一二分**，作三次開水吞下，以清胃滯，自然胎退思食，調養而癒。如溫病過汗，**熱而神昏、足冷**者，用**西瓜汁或冬瓜汁調服腎氣丸三錢**，或用**三豆飲調服**亦可，清溫並用即癒。\r\n- 脈實壞病，脈既轉沉細，必**脈沉細有力**，此為津液被熱灼傷，經絡燥結，而**煩擾不安**，中氣之虛極矣。先用**生黨參二兩、生石膏三錢**煎湯熱服，養中生津，清潤燥結，必得安眠。安眠之後，煩擾自止。然後用**枳實銀菊散原方三分之一，加柴胡、厚朴、大黃各五分**，每日申酉服之，以清熱去滯。再用**草果、檳榔片各五分**，每日煎汁，少少飲之，一日二次，數日後必**大瀉稀水臭糞，戰慄出汗**而癒。**瀉稀水臭糞**者，裡氣和而積結通也；**汗出**者，裡和而後表和；**戰慄**者，榮衛失和已久，復和不易也。\r\n- 壞病癒後，調養甚難，多有三四月方能復元者。壞病治法，最宜細心，最宜靜耐，因良醫治病，多係接手壞病之故。\r\n- **日久不大便**者，必自己欲大便，方是大便之時；自己不欲大便，切不可妄用下大便之藥以奪中氣，以傷腸胃津液。**自己欲大便，大便不下**，乃肛門乾燥，注射**當歸水**潤之，或服**當歸一錢**，大便即下；如仍不得大便，是肛門之間有燥糞數枚，因津液缺乏不能送出，非內服潤藥所能送下，須用**手術取出肛門燥屎**，餘屎自下。\r\n- **烏梅湯**治脈虛壞病，養津液，收相火，復中氣，服湯得微汗，內外調，榮衛和也。**西瓜汁、腎氣丸**治脈虛壞病，生上焦津液以清肺熱，復下焦元氣以生中氣也。**枳實銀菊散**治脈實壞病，通滯氣以調升降，清積熱以復津液，升降與津液俱復，中氣旋轉，腸胃活動於內，榮衛調和於外也。\r\n- 原理甚簡，不過一面服藥，一面靜候自己的圓運動回復耳。切不可求速而進重劑以致禍。"}}
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