典藏书目

Although the pulse is deep, if there are exterior symptoms, such as aversion to wind and cold, or stiffness, pain, and spasmodic tightness in the head, back, neck, or waist, or vomiting, or abdominal distension that fluctuates between fullness and emptiness, or failure to pass flatus (loss of qi), or abdominal distension that feels comfortable upon palpation, or moving qi (throbbing sensation near the umbilicus), or borborygmus (rumbling sounds in the abdomen), or facial redness in Yangming disease, or a sensation of obstruction in the throat, or facial redness in Jia Yin disease, or hardness located at the epigastrium, or clear and white urine, or internal injury, or sexual exhaustion, or pre-pregnancy, or postpartum, or metrorrhagia and metrostaxis (profuse bleeding or prolonged spotting outside menstrual periods), or menstruation just starting or just stopping, or a deficient pulse, or a floating and large pulse, or a tight pulse, all these conditions contraindicate the use of purgation.

When the pathogen is above the diaphragm, characterized by chest fullness with excessive phlegm, food stagnation at the gastric opening, chest fullness with slight irritability, mental restlessness (ao nao) in the chest, chest pain relieved by pressure, a slippery pulse at the cunkou position, cold qi stagnating in the chest causing irritability and fullness, or a sunken and hidden pulse at the cun position, or dry huoluan (acute abdominal disorder with inability to vomit or defecate accompanied by stabbing heart and abdominal pain), emesis (vomiting induction) is appropriate.

When the pathogen is below the diaphragm, or when there is dry retching due to cold affecting the upper diaphragm, warming is indicated while emesis is contraindicated. Similarly, for the elderly and weak, those with constitutive deficiency, yin deficiency, sexual exhaustion, pre-pregnancy or postpartum states, menstruation just starting or stopping, or a thin and deficient pulse, emesis must not be used.

In cases of direct transmission to the Yin meridians, characterized by absence of fever but aversion to cold, incessant vomiting, cold pain with diarrhea, shivering and curling up in bed, a face appearing pale as if scraped by a knife, cold extremities, cyanosis of the face in Jia Yin disease, diarrhea persisting after purgation, tongue retraction and testicular contraction with cold limbs, or hiccups due to stomach cold with a deep, slow, and forceless pulse, warming methods should be employed universally.

For conditions involving dry thirst and dry throat, body heat, reddish urine, preference for cold drinks, constipation, or a rapid, large, and forceful pulse, warming methods are contraindicated.

(Five Urgent Purging Syndromes)
These refer to critical conditions where delay is inadvisable:
1. In Shaoyin disease, with a dry tongue and parched mouth, fearing that heat will consume kidney water, Da Cheng Qi Tang (Major Order the Yellow Decoction) should be administered urgently to purge.
2. In Shaoyin disease, with spontaneous diarrhea of pure clear water, hardness and pain in the epigastrium, dry thirst, Da Cheng Qi Tang (Major Order the Yellow Decoction) should be administered urgently to purge.
3. In Yangming disease, with profuse sweating and severe heat, fearing the drying of stomach fluids, Da Cheng Qi Tang (Major Order the Yellow Decoction) should be administered urgently to purge.
4. With blurred vision, indicating exhaustion of kidney water; combined with heat and constipation, Da Cheng Qi Tang (Major Order the Yellow Decoction) should be administered urgently to purge.
5. In Yangming disease, abdominal fullness and pain indicate Earth excess (Spleen/Stomach excess syndrome); Da Cheng Qi Tang (Major Order the Yellow Decoction) should be used urgently to purge.