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《卷四十》
45  | 表裏王海藏云治傷寒須分表裏若表裏不分汗下差誤豈為上工且如均是發熱身熱不渇為表有熱小柴胡加桂枝主之厥而脈滑為裏有熱白虎加人參主之均是水氣乾嘔㣲利發熱而咳為表有水小青龍加芫花主之體涼表證罷欬而脇下痛為裏有水十棗湯主之均是惡寒有熱而惡寒者發於陽也麻黃桂枝小柴胡主之無熱而惡寒者發於隂也附子四逆主之均是身體痛脈浮發熱頭痛身體痛者為表未解麻黃湯主之脈沈自利身體痛者為裏不和四逆湯主之以此觀之仲景表裏之法甚詳學者宜深究心焉活人云發熱惡寒身體痛而脈浮者表證也表證者惡寒是也惡寒者屬太陽宜汗之 不惡寒反惡熱手掌心并腋下濈濈汗出胃中乾燥結聚潮熱大便鞭小便如常腹滿而喘或讝語脈浮而滑者裏證也裏證者內熱是也內熱者屬陽明宜下之 傷寒始發熱惡寒今汗後不惡寒但倍發熱而躁始脈浮而大今脈洪實或沈數細始惺靜今狂語此為胃實陽盛再汗即死須下之則愈亦有始得病便變陽盛之證須便下之不可拘以日數更有心胸連腹臍大段㾏悶腹中痛坐臥不安冒悶喘急極者亦不問他證便下之若失下則氣血不通四肢便厥醫人不知反疑是隂厥復進熱藥禍如反掌不可不察也 |
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