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卷下 论温疟证

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卷下 论温疟证

仲景云.若脉阴阳俱盛.重感于寒者.变成温疟.故朱肱初虞世以小柴胡白虎之类加桂以治之.此则仲景所谓温疟.疟之一证也.今庸医见前人有此治法.不问是何疟证.但见发寒发热.一概治之.疏矣.大抵疟证多端.有暑疟、有食疟、瘅疟、脾寒.而千金又有五脏所受不同.六腑之中止有胃疟一证.种类最多.安得一概而论.瘅疟者但热不寒.当用白虎.食疟者中有伏积.当下而去之.至于中暑、脾寒.此二证.若水火相反.素问曰.夏伤于暑.秋为疟.又曰.夏暑.汗不出者.秋成风疟.盖暑伏于中.得秋气乃发.故先热后寒.热多寒少.头昏痛.虚则发战.汗出.一时乃止.盖心恶暑.心不受邪.而包络受之.包络众涎所聚.暑伏于涎.心、岂若脾寒.浓朴草果所能祛也.岂若温疟.柴胡黄芩所能除也.非砒沙脑麝之属不能入.故暑疟脾寒.患者多.而医不识病.妄投以药.邪未退.真气先受病.所以连绵不瘥也.予曾精意深究疟病一科.须是辨脉察证.穷究得病之渊源.故十治十中.无有失者.众人以疟为难治.予独以为易.要在辨其种类.识其先后.素问疟论.甚有妙处.当思而得之.

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