脉法
大浮数动滑为阳也,沉涩弱弦微为阴也。凡阴病见阳脉者生,凡阳病见阴脉者死。
脉浮而数(阳脉也),能食不大便者,里实也,名曰阳结,期十七日当剧(为阳气固结,阴
脉不得而杂之,阳结为火,至十七日传少阴水当愈,水不能制火,故剧。)
脉沉而迟(阴也),不能食,身体重,大便反硬,阴病也,名曰阴结,期十四日当剧(阴病
见阴脉当下利,今反硬者,是阴气结固,阳不得而杂之,阴结属水,至十四日传阳明土,当愈,
土不制水故剧,此病要死。)
脉霭霭如车盖者,名阳结也;大而厌厌聂也,为阳气郁结于外,不与阴杂也。
脉累累如循长竿者,名曰阴结也;连连强直也,为阴气郁结于内,不与阳
杂也。
脉瞥瞥如羹上肥者(轻浮也),阳气微也,衰也。
脉萦萦如蜘蛛丝(萦萦惹之不利者至细也)。阳气衰也。
脉绵绵(缓而连绵)如泻漆之状者(前大后小也)亡其血也。
脉来缓,时一止复来,名曰结(结阴也)阴气胜而阳不能相续也。
脉来数,时一止复来,名曰促(促,阳也)阳气胜而阴不能相续也。
脉三部浮沉大小迟数同等,为阴阳和平,虽剧当愈。
脉浮而洪,邪气胜也;自汗如油,喘而不休,正气脱也;水浆不下,胃气尽也;形体不仁,
荣卫绝也;乍静乍乱,正邪交争,此为命绝。
汗出发润(津脱也),喘而不休(气脱也),此状为肺先绝也。
阳反独留,身体大热是血先绝,为气独在;形体如烟熏,身无精华,血不荣也;直视,心经
绝也;头摇,阴绝阳无根也,此为心先绝也,心主血。
唇吻反青,脾部见木色,四肢 习,手足振动,此为肝绝也。
环口黧黑,脾主口,无精华则黑;冷汗,阳脱也;发黄,此为脾绝也。
溲便遗屎,肾绝不能约制也;狂言,肾藏志,志不守也;目反直视,此为肾绝也。
脉阴阳(表里也)俱紧(紧为寒)口中气出,唇口干燥(阳气渐复也。)
倦卧足冷,鼻中涕出,舌上胎滑,知阴独在也,勿妄治也,自解。到七日微发热,手足温者,
阴气已绝,阳气得复,解矣。到八日以上,反大热者,阴极变热,邪气胜正,此为难治,设使恶
寒者,必欲呕也,寒邪发于上焦,腹内痛者,必欲利也,寒邪胜于下焦。
脉阴阳俱紧,至于吐利,其脉独不解,紧去乃安,为欲解矣。若脉迟,至六七日不欲食,为
吐利后脾胃大虚,此为脱,水停故也,为未解。食自可者(脾胃已和,寒邪已散)为欲解。
病六七日,手足三部脉皆至(阳正胜也,大烦热也,)而口噤不能言,其人躁扰者则阴阳争胜
也,此欲解也。
脉和,其人大烦,目内 皆黄者,欲解。
脉不和者,病进。脉浮(阳也)而紧(阴也)按之反芤(虚也),此为本虚,当战汗出而解。
脉浮而数(阳也),按之不芤(阳实也),不战而汗解矣。
脉自微(邪气弱正气微),此以曾经汗吐下亡血,内无津液,此阴阳自和,必不汗不战而自解。
风(伤阳),则浮虚(伤阴)则牢坚沉潜,水蓄支散也,饮急,弦动阴阳相搏则为痛,
数则热烦,设有不应知变所缘,三部不同,病各异端。
人恐怖,脉形如循丝累累然,面白脱色者,血气不足。
人愧,脉浮,面色乍白乍赤者,神气怯也。
人不饮食,脉自涩,涩阴也,主亡津液,唇口干燥也。
下利三部无脉,冷气在胸中,令脉不通,然尺中时一小见脉再举头者,肾气也,脾虚肾气所
以乘,若见损脉来,至为难治。
趺阳脉滑而紧,滑者胃气谷气实,紧者胃气阴气强特实,击强痛还自伤。
寸口脉浮而大,浮为正虚,大为邪实,在尺为关(邪关下焦),在寸为格(邪格上焦),关则
不得小便,格则吐逆。趺阳脉伏而涩,伏者胃气伏而不宣,则吐逆水谷不化;涩者,脾气涩而不
布,则食不入,名曰开格。
趺阳脉大而紧者,当即下利为难治,下利者脉微小,今反紧者,邪胜也。
寸口诸微亡阳,诸濡亡血,诸弱阴虚也发热,诸紧为寒。
诸寒乘虚,寒乘气虚,抑佚阳气,则为厥郁(昏也,胃不仁,强直不知人也),以胃无谷气,脾
涩不通(上下也),使口急不能言,战寒(在表也),栗寒(在里也)。病欠者(阴阳相引,故欠和也,)
无病言迟者,风也(风中经络,舌难运用,)摇头者,里痛也,行迟者,表强也(邪中经络也)。坐
而伏者,短气也;坐而一脚下者,腰痛也。裹实护腹如卵者,心痛也。
伤寒证治
冬时触冒杀厉之气,实时为病,名曰伤寒。寒毒藏于肌肤,伏留至春,再感乖戾之气,名曰
春温,至夏变为暑病。春湿者,至夏至以前也,脉数而大散,似太阳发热不恶寒,同中暑烦渴不
憎寒,治宜升麻葛根解肌类也;热多,小柴胡;发渴烦躁便秘,大柴胡微利之;脉实者可下之。
阳脉浮滑,阴脉濡弱,更遇于风,变为风温,以前热未歇,又感于风者也,又因发汗身犹灼
然,自汗喘息切忌再汗,亦不可下及烧针类也。又云∶寸尺俱浮,误则死矣。宜葳蕤汤、知母葛
根汤也。
热病者,夏时发也,热极重于温也,治宜寒凉解其内外之烦毒也。如头疼恶寒身热,脉洪盛
有汗,夏至前,阳旦汤;夏至后,桂枝加石膏升麻汤。无汗,夏至前后,麻黄加知母石膏汤,烦
躁大青龙汤加黄芩,大热栀子升麻汤。
阳脉洪数,阴脉实大,更遇温热,变为温毒,以前热未已,又感温热,以其表里俱热,病之
最重者也。
阳脉濡弱,阴脉弦紧,更遇温气,变为温疫。
脉法
脉象大、浮、数、动、滑属于阳脉;脉象沉、涩、弱、弦、微属于阴脉。凡是阴病出现阳脉的,预后良好(生);凡是阳病出现阴脉的,预后不良(死)。
脉象浮而数(属于阳脉),患者能进食但大便不通,这是里实证,称为“阳结”。预计第十七天病情会加重(这是因为阳气固结,阴气无法干扰,阳结化为火邪,到了第十七天传变至少阴水经本应痊愈,但如果水不能制约火,所以病情加重)。
脉象沉而迟(属于阴脉),患者不能进食,身体沉重,大便反而干硬,这是阴病,称为“阴结”。预计第十四天病情会加重(阴病见阴脉应当下利,现在反而大便干硬,是因为阴气结固,阳气无法干扰,阴结属水,到了第十四天传变至阳明土经本应痊愈,如果土不能制约水,所以病情加重,此病通常会导致死亡)。
脉象像车盖一样轻浮散漫的,称为“阳结”;脉象大而软弱不振的,是阳气郁结于体表,不与阴气混杂。
脉象像顺着长竿摸索一样累累相连的,称为“阴结”;脉象连续强直,是阴气郁结于体内,不与阳气混杂。
脉象瞥瞥如羹汤表面漂浮的油花一样(轻浮),表示阳气微弱,正气衰败。
脉象萦萦如蜘蛛丝一样(纤细且牵拉不利),表示阳气衰败。
脉来迟缓,偶尔停止一次后又恢复跳动,称为“结”(结为阴脉),表示阴气盛而阳气不能相继。
脉来快速,偶尔停止一次后又恢复跳动,称为“促”(促为阳脉),表示阳气盛而阴气不能相继。
寸、关、尺三部脉象在浮沉、大小、迟数上都同等协调,说明阴阳平和,即使病情严重也会痊愈。
脉象浮而洪大,表示邪气胜;自汗出如油,喘息不止,表示正气脱失;饮食不进,表示胃气耗尽;形体麻木不仁,表示营卫之气断绝;时而安静时而混乱,表示正邪交争,这是生命终结之兆。
出汗后头发湿润(津液脱失),喘息不止(气脱失),这种征象表明肺气先绝。
阳气独留于外,身体大热,这是血先绝,表现为气独存;形体面色如烟熏,身体没有光泽,是血不能荣养的表现;两眼直视,是心经气绝;头部摇动,是阴绝而阳无根,这表示心脏先绝,因为心主血。
嘴唇和口角发青,脾部显现木色(青色),四肢抽搐,手足振动,这是肝气绝。
口周颜色黑黄,脾开窍于口,失去精华则显黑色;出冷汗,是阳气脱失;发黄,这是脾气绝。
大小便失禁,是肾气不能约束;胡言乱语,是肾藏志功能丧失,意志不守;眼睛反视直视,这是肾气绝。
脉象阴阳(表里)俱紧(紧脉主寒),口中呼出热气,嘴唇口干燥(表示阳气逐渐恢复)。
疲倦嗜卧,脚冷,鼻流清涕,舌苔滑润,可知只有阴气存在,不要胡乱治疗,疾病会自行缓解。到第七天微微发热,手足温暖,说明阴气已绝,阳气恢复,疾病解除。如果八日以上,反而大热,这是阴极变热,邪气胜过正气,这属于难治的情况。如果有恶寒症状,必定想呕吐,这是寒邪发于上焦;如果腹内疼痛,必定想腹泻,这是寒邪胜于下焦。
脉象阴阳俱紧,如果出现呕吐腹泻,唯独脉象不解,等到紧脉消失才会安宁,这是想要解除的迹象。如果脉迟,到了六七天不想吃东西,是因为呕吐腹泻后脾胃大虚,这是脱证,因为有水饮停聚,所以未解。如果能正常进食(表示脾胃已调和,寒邪已散),这是想要解除的迹象。
患病六七天,手足三部脉都明显有力(表示阳气正胜,会有大烦热),但是口噤不能说话,其人烦躁不安,这是阴阳争胜,这是疾病将要解除的迹象。
脉象平和,病人非常烦躁,眼白部分发黄,这是疾病将要解除。
脉象不和,表示病情进展。脉浮(阳)而紧(阴),按之反芤(虚),这是本虚,应当通过战栗出汗而解。
脉浮而数(阳),按之不芤(阳实),不需要战栗就会出汗而解。
脉象自微(邪气弱,正气也微),这是因为曾经经过发汗、催吐、泻下导致亡血,体内没有津液,这是阴阳自我调和,必然不会战栗出汗而自行解除。
风邪(损伤阳气),脉象浮虚(损伤阴气)则牢坚沉潜,水湿蓄积支散;饮邪急迫,脉弦动,阴阳相搏则产生疼痛;脉数则有热烦,如果有这些情况不应,需知变化的原因,三部脉不同,病因各异。
人感到羞愧,脉浮,面色乍白乍赤的,是神气怯弱。
下利(腹泻)时三部无脉,冷气在胸中,使脉道不通,然而尺中偶尔出现微小脉象,再举头(重按)时可见,这是肾气尚存,因脾虚肾气乘袭所致,如果见到损脉,到来时很难治疗。
趺阳脉滑而紧,滑表示胃气和谷气实,紧表示胃气和阴气强特实,击打强痛反而自伤。
寸口脉浮而大,浮为正虚,大为邪实,在尺部为关(邪气关闭下焦),在寸部为格(邪气格拒上焦),关则小便不通,格则呕吐逆反。趺阳脉伏而涩,伏表示胃气潜伏而不宣通,则呕吐逆反,水谷不化;涩表示脾气涩滞而不布散,则食物不入,称为“开格”。
趺阳脉大而紧的,应当立即下利,难以治疗;下利的病人脉微小,现在反而紧,是邪气胜。
寸口诸微脉主亡阳,诸濡脉主亡血,诸弱脉阴虚而发热,诸紧脉主寒。
各种寒邪乘虚而入,寒邪乘气虚,抑制逸散阳气,则为厥郁(昏厥,胃不知觉,强直不知人),因为胃无谷气,脾涩不通(上下不通),导致口急不能说话,战栗恶寒(在表),凛冽恶寒(在里)。病人呵欠的(阴阳相互牵引,故呵欠以调和),无病却言语迟缓的,是风邪(风中经络,舌头难以运用),摇头的,是里痛,行走迟缓的,是表强(邪中经络)。坐着身子前倾的,是短气;坐着并将一只脚翘起的,是腰痛。包裹腹部护住肚子像护着蛋一样的,是心痛。
伤寒证治
冬季触犯冒犯杀厉之气,随即发病,称为伤寒。寒毒潜伏在肌肤,停留到春季,再次感受乖戾之气,称为春温,到了夏季变为暑病。春湿者,是指夏至以前的时期,脉数而大散,类似太阳病发热但不恶寒,同中暑烦渴但不憎寒,治疗宜用升麻葛根汤等解肌类方剂;如果热多,用小柴胡汤;如果口渴烦躁便秘,用大柴胡汤轻微通下;脉实的可以用攻下法。
阳脉浮滑,阴脉濡弱,再遇到风邪,变为风温,这是因为之前的热邪未歇,又感受了风邪,又因为发汗后身体仍然灼热,自汗喘息,切忌再次发汗,也不可用攻下及烧针等方法。又说:寸脉尺脉都浮,误治则会致死。适宜用葳蕤汤、知母葛根汤。
热病者,是在夏季发作的,热势极重于温病,治疗宜用寒凉药解除内外的烦毒。如头疼恶寒身热,脉洪盛有汗,夏至前用阳旦汤;夏至后用桂枝加石膏升麻汤。无汗的,夏至前后用麻黄加知母石膏汤,烦躁的用大青龙汤加黄芩,大热的用栀子升麻汤。
Pulse Diagnosis Methods
A large, floating, rapid, surging, or slippery pulse belongs to Yang; a deep, choppy, weak, string-taut, or faint pulse belongs to Yin. Generally, if a Yin disease presents with a Yang pulse, the prognosis is good (life); if a Yang disease presents with a Yin pulse, the prognosis is poor (death).
A pulse that is floating and rapid (a Yang pulse), accompanied by the ability to eat but constipation, indicates an interior excess syndrome, termed "Yang Jie" (Yang Knotting). It is expected that the condition will worsen on the seventeenth day (This is because Yang Qi is firmly knotted, preventing Yin from interfering; Yang Jie transforms into Fire. By the seventeenth day, it transmits to the Shaoyin Water meridian and should heal; however, if Water cannot control Fire, the condition worsens.)
A pulse that is deep and slow (Yin), accompanied by inability to eat, heavy body, and conversely hard stool, indicates a Yin disease, termed "Yin Jie" (Yin Knotting). It is expected that the condition will worsen on the fourteenth day (In Yin diseases presenting with Yin pulses, diarrhea is expected; conversely hard stool here indicates Yin Qi is firmly knotted, preventing Yang from interfering; Yin Jie belongs to Water. By the fourteenth day, it transmits to the Yangming Earth meridian and should heal; however, if Earth cannot control Water, the condition worsens, and this disease typically leads to death.)
A pulse that appears scattered like the canopy of a cart is named "Yang Jie"; a pulse that is large yet feeble and listless indicates Yang Qi knotted externally, not mingling with Yin.
A pulse that feels continuous like running along a long bamboo pole is named "Yin Jie"; a continuously stiff pulse indicates Yin Qi knotted internally, not mingling with Yang.
A pulse that flickers lightly like fat floating on soup broth (floating) indicates slight Yang Qi and declining Zheng Qi (Upright Qi).
A pulse that is slender and difficult to pull, like a spider's thread, indicates decline of Yang Qi.
A pulse that is continuous like the shape of pouring lacquer (large at first, small later) indicates loss of Blood.
A pulse that comes slowly and occasionally stops before resuming is named "Jie" (Knotted, Yin), indicating excess Yin where Yang cannot succeed continuously.
A pulse that comes rapidly and occasionally stops before resuming is named "Cu" (Surging, Yang), indicating excess Yang where Yin cannot succeed continuously.
When the three positions (Cun, Guan, Chi) show equal floating/sinking, large/small, and slow/rapid qualities, it indicates Yin-Yang harmony; even if severe, recovery is expected.
A floating and surging pulse indicates pathogenic excess; spontaneous sweating like oil and unceasing panting indicate collapse of Zheng Qi; inability to take fluids indicates exhaustion of Stomach Qi; insensitivity of the body indicates severance of Ying and Wei; alternating quietness and chaos indicates struggle between Zheng and Xie, which signifies the end of life.
Sweating until hair is wet (collapse of Jin Ye/Body Fluids) and unceasing panting (collapse of Qi) indicates that Lung Qi is failing first.
If Yang remains alone externally, causing high fever, this indicates Blood has failed first while Qi remains; a smoky complexion and lack of luster indicate Blood failing to nourish; fixed gaze indicates failure of the Heart Meridian; head shaking indicates Yin failure with Yang lacking root, signifying Heart Qi failure first, as the Heart governs Blood.
Blue-green lips and mouth corners, Wood color appearing in the Spleen area, twitching limbs, and trembling hands and feet indicate Liver Qi failure.
Dark black around the mouth (Spleen opens to the mouth; loss of essence turns black), cold sweat (Yang collapse), and jaundice indicate Spleen Qi failure.
Incontinence of urine and feces indicates Kidney Qi failing to restrain; delirium indicates Kidney failing to store Zhi (Will); reversed fixed gaze indicates Kidney Qi failure.
When Yin and Yang pulses are both tight (tightness indicates Cold), with warm breath from the mouth and dry lips/mouth, it indicates gradual recovery of Yang Qi.
Fatigue and desire to lie down, cold feet, runny nose, and slippery tongue coating indicate that only Yin remains; do not treat rashly, as it will resolve spontaneously. If there is slight fever and warmth in hands and feet by the seventh day, Yin has ended and Yang has recovered, indicating resolution. If after eight days there is instead high fever, this is extreme Yin transforming into heat, with pathogen overcoming Zheng, making it difficult to treat. If chills are present, vomiting is likely, indicating Cold pathogen affecting the Upper Jiao; if abdominal pain is present, diarrhea is likely, indicating Cold pathogen prevailing in the Lower Jiao.
With Yin and Yang pulses both tight, if vomiting and diarrhea occur but the pulse does not resolve, relief comes only when the tightness disappears, indicating impending resolution. If the pulse is slow and by the sixth or seventh day there is no desire to eat, this is due to great deficiency of Spleen and Stomach after vomiting/diarrhea, constituting a collapse with water retention, thus unresolved. If eating is normal (Spleen/Stomach harmonized, Cold dispersed), resolution is indicated.
After six or seven days of illness, if pulses in hand and foot三部 (Three Positions) are all prominent (Yang Zheng prevails, causing great irritability and heat), but the mouth is locked and speechless, and the person is restless, this is a struggle between Yin and Yang, indicating impending resolution.
If the pulse is harmonious, the person is greatly irritable, and the whites of the eyes turn yellow, resolution is indicated.
If the pulse is not harmonious, the disease progresses. A floating (Yang) and tight (Yin) pulse that feels hollow (Xu) upon pressure indicates underlying deficiency; resolution occurs through shivering and sweating. A floating and rapid (Yang) pulse that is not hollow upon pressure (Yang Excess) resolves through sweating without shivering.
A naturally faint pulse (weak pathogen and weak Zheng) often follows previous sweating, vomiting, or purging that caused blood loss and internal fluid depletion; this represents self-harmonization of Yin and Yang, resolving without shivering or sweating.
Wind (injures Yang) presents with floating and deficient pulses; injury to Yin presents with firm, deep, and submerged pulses, with water accumulation and dispersion; urgent fluid retention presents with string-taut and surging pulses, where Yin-Yang struggle causes pain; rapid pulses indicate heat and irritability. If these patterns do not match, one must understand the cause; different pulses in the three positions indicate different etiologies.
Fear manifests as a pulse feeling like continuous threads, with pale, colorless face, indicating insufficiency of Blood and Qi.
Shame manifests as a floating pulse with alternating white and red facial color, indicating timidity of Shen Qi (Spirit Qi).
Refusal to eat manifests as a naturally choppy pulse; choppy is Yin, governing loss of Jin Ye, manifesting as dry lips and mouth.
Diarrhea with absent pulses in all three positions, with cold Qi in the chest blocking the vessels, yet occasional tiny pulses felt at Chi upon lifting or pressing, indicates remaining Kidney Qi; Spleen deficiency allows Kidney Qi to overact. If deteriorating pulses appear, treatment is difficult.
Fuyang (Foot Yangming) pulse that is slippery and tight: slippery indicates fullness of Stomach Qi and Grain Qi; tight indicates strong and excessive Stomach Yin Qi; striking strength causes self-injury.
Cunkou (Radial) pulse that is floating and large: floating indicates Zheng deficiency, large indicates Pathogen excess. At Chi, it is "Guan" (Closing, pathogen closing Lower Jiao); at Cun, it is "Ge" (Blocking, pathogen blocking Upper Jiao). Guan results in inability to urinate; Ge results in vomiting and regurgitation. Fuyang pulse that is submerged and choppy: submerged indicates Stomach Qi hidden and not disseminating, causing vomiting and undigested food/water; choppy indicates Spleen Qi stagnant and not distributing, causing inability to ingest food, termed "Kai Ge".
Fuyang pulse that is large and tight indicates immediate diarrhea and difficulty in treatment; in diarrhea, the pulse should be minute and small; if tight, it indicates pathogen excess.
All faint Cunkou pulses indicate Yang collapse; all soggy pulses indicate Blood loss; all weak pulses indicate Yin deficiency with fever; all tight pulses indicate Cold.
Various Cold pathogens attacking deficiency suppress and dissipate Yang Qi, leading to Jue Yu (fainting, stomach insensitivity, rigidity, unconsciousness) due to lack of Grain Qi in Stomach and stagnation in Spleen (blocking upper and lower), causing tight mouth and inability to speak, shivering chills (exterior), and trembling chills (interior). Yawning indicates Yin-Yang attraction for harmony; delayed speech in healthy people indicates Wind (Wind invading collaterals, tongue difficult to move); head shaking indicates interior pain; slow walking indicates exterior stiffness (pathogen invading collaterals). Sitting leaning forward indicates shortness of breath; sitting with one leg raised indicates waist pain; guarding the abdomen like protecting an egg indicates Heart pain.
Treatment of Cold Damage Syndromes
Touching the killing Qi in winter causes immediate illness, named Shanghan (Cold Damage). Cold toxin hides in skin and muscles, lingering until spring; re-exposure to chaotic Qi names Chunwen (Spring Warmth); transforming in summer becomes Shubing (Summer Heat). Spring Dampness refers to the period before Summer Solstice; pulse is rapid, large, and scattered, resembling Taiyang fever without aversion to cold, similar to Zhongshu (Summerheat Stroke) irritability and thirst without aversion to cold. Treatment should use Shengma Gegen Tang (Rhizoma Cimicifugae and Radix Puerariae Decoction) or similar muscle-relieving formulas; if heat is predominant, use Xiaochaihu Tang (Minor Bupleurum Decoction); if thirsty, irritable, and constipated, use Daxiehu Tang (Major Bupleurum Decoction) to mildly purge; if pulse is excess, purgation is applicable.
Yang pulse floating and slippery, Yin pulse soft and weak, combined with wind exposure, transforms into Fengwen (Wind Warmth), as previous heat had not subsided and wind was contracted. After sweating, if body remains burning with spontaneous sweating and panting, avoid further sweating, purgation, or moxibustion. It is said: if Cun and Chi pulses are both floating, misdiagnosis leads to death. Use Weiyu Tang (Polygonatum Decoction) or Zhimu Gen Tang (Anemarrhena and Pueraria Decoction).
Rebing (Heat Disease) occurs in summer, with heat more severe than Wen. Treatment uses cold-cooling herbs to resolve internal and external irritant toxins. For headache, aversion to cold, fever, surging pulse with sweating: before Summer Solstice, use Yangdan Tang; after Summer Solstice, use Guizhi Jia Shigao Shengma Tang (Cinnamon Twig Decoction plus Gypsum and Rhizoma Cimicifugae). Without sweating, before/after Summer Solstice, use Mahuang Jia Zhimu Shigao Tang (Ephedra Decoction plus Anemarrhena and Gypsum); for irritability, use Daqinglong Tang (Major Green Dragon Decoction) plus Huangqin; for high fever, use Zhizi Shengma Tang (Gardenia and Rhizoma Cimicifugae Decoction).
Yang pulse surging and rapid, Yin pulse solid and large, combined with warm-heat exposure, transforms into Wendu (Warm Toxicity), as previous heat persisted and warm-heat was contracted, resulting in exterior-interior heat, the most severe condition.
Yang pulse soft and weak, Yin pulse string-taut and tight, combined with warm Qi, transforms into Wenyi (Warm Epidemic).