师曰病患家来请云病患发热烦极明日师到病患向壁卧此热退也设令脉不和处言已愈
发热烦极必不得卧向壁静卧此烦热已去也假令脉犹未和亦顷当自愈此可处言已愈也(此望知之法也)
设令向壁卧闻师到不惊起而盼视若三言三止脉之咽唾者此诈病也设令脉自和处言汝病太重当须服吐下药针灸数十百
处乃愈
向壁安卧是无病邪闻师到不惊起而盼视若三言三止脉之咽唾者此诈病也设令脉自和平亦处言汝病太重当须服大吐大
下之药针灸数十百处以恐怖之则立言自愈矣
师持脉病患欠者无病也脉之呻者病也言迟者风也摇头言者里痛也行迟者表强也坐而伏者短气也坐而下一脚者腰痛也
里实护腹如怀卵物者心痛也
平人神倦若睡则欠呵非病证也故欠者无病身有痛苦则呻故呻者有病内风者内湿外燥语言蹇涩故言迟为风心腹痛极则
头摇故头摇言者里痛也阳性轻清表郁气浊故言重而行迟短气者身仰则气愈短故坐而身伏腰痛则身弯不敢直故坐则下一脚
心痛则用手护腹形如怀抱卵物也(此望闻之法也)
问曰人病恐怖者其脉何状师曰脉形如循丝累累然其面白脱色也
肾主恐素问气厥论恐则气下下之极则肾也少阴之脉微细恐怖少阴之气动故脉细如丝累累然惊惧不安之象也恐主于肾
而六脉俱细盖诸脏夺气改而从肾也肝藏血而主色色者血之华也肝气下(恐则气下)而营血陷不能华也木虚而金气乘之故
色脱而面白白者金色也(此望切之法也)
老师说道:“有病人家属前来聘请,说病人发热、烦躁到了极点。第二天老师到达时,见病人面向墙壁静卧,这说明热势已退。假如脉象虽然尚不平和,但告知他病已痊愈。”
“发热烦躁到了极点,必然无法安卧;现在面向墙壁安静地躺着,说明烦热之邪已经去除。假使脉象仍然没有调和,不久也会自行痊愈,因此可以告诉他病已痊愈。(这是通过观察来诊断的方法)”
“假如病人面向墙壁静卧,听到老师到来并不惊慌起身,而是用眼角偷看,说话时三言三止,切脉时伴有吞咽口水的动作,这是装病的人。假如脉象自然平和,也告诉他说:‘你的病太重了,必须服用催吐或泻下的药物,并施以数十上百处的针灸治疗,才能痊愈。’”
“面向墙壁安稳静卧,是没有病邪的表现。听到老师到来并不惊慌起身,而是用眼角偷看,说话时三言三止,切脉时伴有吞咽口水的动作,这是装病的人。假如脉象自然和平,也告诉他说:‘你的病太重了,必须服用强烈的催吐和泻下药物,并施以数十上百处的针灸治疗,用恐惧心理吓唬他,他就会立刻声称病好了。’”
“老师诊脉时,如果病人打哈欠,说明没有病。切脉时病人呻吟,说明有病。说话迟缓的,是有风邪。摇头说话的,是体内疼痛。行走迟缓的,是表气强盛(肌表拘急)。坐着身体前伏的,是短气。坐着时一只脚垂下的,是腰痛。腹部实证,手护腹部像抱着蛋一样的是心痛。”
“正常人神志疲倦想睡觉时会打哈欠,这不是病证,所以打哈欠表示无病。身体有痛苦就会呻吟,所以呻吟表示有病。内有风邪,兼有外湿内燥,导致语言蹇涩,所以说话迟缓为风邪。心腹疼痛至极则头部摇晃,所以摇头说话是里痛。阳性质性轻清,表郁气浊,所以声音重浊且行走迟缓。短气的人,身体仰起则气更短,所以坐着时身体前伏。腰痛的人,身体弯曲不敢挺直,所以坐着时放下一只脚。心痛的人,用手护住腹部,形状如同怀抱卵物。(这是通过望诊和闻诊来诊断的方法)”
“问:人患惊恐病症时,脉象是什么样子?老师说:脉形像顺着丝线摸去,连绵不断的样子,面色苍白失血色。”
“肾主恐,《素问·气厥论》说:‘恐则气下’,下极则归于肾。少阴经脉微细,因恐怖导致少阴之气发动,所以脉象细如丝线,连绵不断,这是惊惧不安的征象。恐由肾所主,而六部脉都细,是因为各脏之气被夺,转而归属于肾。肝藏血而主色泽,色泽是血的荣华。肝气下陷(因为恐则气下),营血下沉,不能荣华于面。木虚而金气乘之,所以面色脱失而发白,白色属金。(这是通过望诊和切诊来诊断的方法)”
Teacher said: "A patient's family came to invite me, stating that the patient had a fever and extreme irritability. When I arrived the next day, I saw the patient lying quietly facing the wall, indicating that the heat has subsided. Even if the pulse is not yet harmonious, one may tell them the illness has healed."
"Extreme fever and irritability necessarily prevent sleep; now lying quietly facing the wall indicates that the vexatious heat pathogen has departed. Even if the pulse remains unharmonious, it will likely heal spontaneously soon; thus, one may inform them that the illness has healed. (This is the method of diagnosis through observation)"
"If the patient lies facing the wall, does not startle up upon hearing my arrival, but looks out of the corner of their eye, speaks with hesitation ('three words then stops'), and swallows saliva during pulse-taking, this is feigned illness. Even if the pulse itself is harmonious, one should still say: 'Your illness is severe; you must take emetic or purgative medicines, and undergo dozens or hundreds of acupuncture points treatments to be cured.'"
"Lying quietly facing the wall indicates no pathogenic evil. Hearing my arrival without startling up, looking out of the corner of the eye, speaking with hesitation, and swallowing saliva during pulse-taking indicates feigned illness. Even if the pulse is naturally peaceful, one should still say: 'Your illness is severe; you must take strong emetic and purgative medicines, and undergo dozens or hundreds of acupuncture point treatments. Use fear to frighten them, and they will immediately claim to be healed.'"
"When taking the pulse, if the patient yawns, there is no illness. If the patient groans during pulse-taking, there is illness. Sluggish speech indicates Wind syndrome. Shaking the head while speaking indicates interior pain. Slow walking indicates exterior rigidity (stiffness of the muscle layer). Sitting with the body bent forward indicates shortness of breath. Sitting with one leg hanging down indicates lower back pain. Abdominal excess condition, protecting the abdomen with hands as if holding an egg, indicates Heart pain."
"A normal person yawning due to mental fatigue and drowsiness is not a pathological sign; thus, yawning indicates no illness. Physical pain causes groaning; thus, groaning indicates illness. Internal Wind combined with external dampness and internal dryness leads to clumsy speech; therefore, sluggish speech indicates Wind. Extreme Heart or abdominal pain causes head shaking; thus, head shaking while speaking indicates interior pain. Yang nature is light and clear, while exterior stagnation makes Qi turbid; thus, heavy speech and slow walking occur. Those with shortness of breath find breathing harder when extending the body upright, so they sit bent forward. Those with lower back pain cannot straighten their bodies, so they sit with one leg lowered. Those with Heart pain protect their abdomen with hands, resembling someone holding an egg. (This is the method of diagnosis through observation and listening/smelling)"
"Question: What is the appearance of the pulse in a person suffering from fear? Teacher said: The pulse feels like tracing a continuous thread, fine and connected; the complexion is pale and devoid of color."
"The Kidney governs Fear. In *Su Wen: Qi Jue Lun*, it states: 'Fear causes Qi to descend.' At its extreme, it affects the Kidney. The Shaoyin meridian pulse is fine and subtle; because fear activates Shaoyin Qi, the pulse becomes fine like threads, continuous, which is a sign of alarm and unease. Fear is governed by the Kidney, and all six pulses become fine because the Qi of various organs is depleted and turns to the Kidney. The Liver stores Blood and governs complexion; complexion is the brilliance of Blood. Due to Fear causing Qi to descend, Liver Qi sinks, Ying Blood descends, and fails to manifest brilliance on the face. Wood deficiency allows Metal Qi to invade, resulting in loss of color and a white face; White corresponds to Metal. (This is the method of diagnosis through observation and palpation)"