《阳明脉解篇》曰∶足阳明之脉病,恶人与火,闻木音则惕然而惊。(胃热内郁,故恶人、恶火。
胃属土,故闻木音而惊。)病甚则弃衣而走,登高而歌,或至不食数日,逾垣上屋,所上之处,皆
非其素所能也。病反能者,何也?四肢者,诸阳之本也。阳盛则四肢实,实则能登高也。(阳受气于
四肢,故四肢为诸阳之本。)热盛于身,故弃衣欲走也。阳盛则使人妄言骂詈,不避亲疏,而不欲食
故妄走也。(言胃病所以能登高而歌,弃衣而走,妄言而骂詈者,皆以其邪气之盛也。邪盛故热盛,
热盛故阳盛,阳感三者之证由于此矣。)
《评热病论》曰∶有病温者,汗出辄复热,而脉躁急,不为汗衰,狂言不能食,病名为何?岐
伯曰∶病名阴阳交,交者,死也。(交,谓交合,阴阳气不分别也。)人所以汗出者,皆生于谷,
谷生于精,(言谷气化为精,精气胜乃为汗。)今邪气交争于骨肉,而得汗者,是邪却而精胜
也。(言初汗也。)精胜则当能食,而不复热。复热者,邪气也。汗者,精气也。今汗出而辄复
热者,是邪胜也。不能食者,精无俾也。(无俾,言无可使,为汗也。谷不化则精不生,精不化流
故无可使。)病而留者,其寿可立而倾也。(如是者,其人寿命立至倾危也。)汗出而脉尚躁
盛者,死。(汗出脉当迟静,而反躁急以盛满者,是真气竭而邪气盛,故知必死也。)今脉不与
汗相应,
此不胜其病矣,其死明矣。(脉不静而躁盛,是不相应。)狂言者,是失志,失志者,死。(志舍于
精,今精无可使,是志无所居,志不留居,则失志也。)今见三死,不见一生,虽愈必死也。(汗出脉躁
盛,一死。不胜其病,二死。狂言失志者,三死也。)
《阳明脉解篇》说:足阳明经发生病变时,患者厌恶人和火光,听到木器的声音就会惊恐不安。(这是因为胃热内郁,所以厌恶人、厌恶火。胃在五行中属土,所以听到属木的声音而惊恐。)病情严重时,患者会脱掉衣服乱跑,爬上高处唱歌,或者几天不吃东西,翻越墙垣登上屋顶,所到达的地方,都不是他平时所能做到的。为什么病反能做出这些举动呢?四肢是诸阳经的根本。阳气旺盛则四肢充实有力,充实有力就能登高。(阳气在四肢受气,所以四肢是诸阳经的根本。)热邪炽盛于身体,所以脱掉衣服想要奔跑。阳气旺盛使人胡言乱语、辱骂他人,不分亲疏,并且因为不想吃东西而胡乱奔走。(解释胃病之所以能登高而歌、弃衣而走、妄言骂詈,都是因为邪气亢盛。邪气盛故热盛,热盛故阳气亢盛,上述三种证候都源于此。)
《评热病论》说:有一种温病患者,出汗后随即又发热,脉搏躁动急数,不因出汗而减弱,胡言乱语且不能进食,这种病叫什么名字?岐伯说:这种病名叫阴阳交,所谓“交”,是指死亡。(“交”,指阴阳之气交合混杂,不再分明。)人之所以出汗,都是由于水谷精气化生,水谷精气又源于先天之精。(意思是谷气转化为精,精气充胜才能化为汗。)现在邪气与正气在骨肉之间交争,如果出了汗,这是邪气退却而精气胜利的表现。(指初次出汗的情况。)精气胜利就应当能够进食,且不再发热。如果再次发热,那是邪气作祟。汗液是由精气化生的。现在出汗后随即又发热,这是邪气胜过正气的表现。不能进食,说明精气得不到补充。(“无俾”,意为无可使令,即无法化生为汗。谷物不消化则精气不生,精气不化流则无法供给出汗所需。)疾病滞留不去,寿命就会立刻危殆。(像这种情况,人的寿命立刻就会陷入危险境地。)出汗后脉搏仍然躁动旺盛的,主死。(出汗后脉搏应当迟缓安静,反而躁动急盛满溢的,是真气竭尽而邪气亢盛,所以知道必然死亡。)现在脉搏与汗出情况不相适应,这说明正气不能战胜疾病,其死亡是明显的。(脉搏不静而躁盛,是与汗出不相应。)胡言乱语,这是神志丧失,神志丧失的,主死。(神志藏于精中,现在精气无法供给,神志无处安居,神志不能留居,就是神志丧失。)现在看到三种死征,看不到一丝生机,即使暂时痊愈,最终也必死无疑。(出汗后脉搏躁盛,是一死。正气不胜病邪,是二死。胡言乱语、神志丧失,是三死。)
The *Yangming Maijie Pian* (Chapter on the Explanation of the Yangming Pulse) states: When the Foot-Yangming meridian is diseased, the patient dislikes people and fire, and is startled by the sound of wood. (This is because stomach heat is internally constrained, hence the aversion to people and fire. The Stomach belongs to Earth in the Five Elements, hence the startle upon hearing the sound of Wood.) In severe cases, the patient discards their clothes and runs about, climbs high places and sings, or goes without food for several days, leaps over walls and climbs onto roofs. The places they ascend are beyond their usual capabilities. Why can the patient do these things contrary to their normal state? The four limbs are the root of all Yang meridians. When Yang qi is excessive, the four limbs become solid and strong, and thus the ability to climb high is achieved. (Yang qi receives its nourishment from the four limbs, therefore the four limbs are the root of all Yang.) Heat is excessive in the body, hence the desire to discard clothes and run. Excessive Yang causes one to speak wildly, curse others, disregarding kinship or distance, and due to the lack of desire to eat, one wanders aimlessly. (Explaining why stomach disease manifests as climbing high and singing, discarding clothes and running, speaking wildly and cursing, it is all due to the excess of pathogenic factors. Excess pathogens lead to excessive heat; excessive heat leads to hyperactive Yang; the three aforementioned syndromes all originate from this.)
The *Ping Rebing Lun* (Chapter on Evaluating Heat Diseases) states: There is a type of warm disease where sweating is followed immediately by recurrent fever, the pulse is rapid and restless, does not diminish with sweating, accompanied by delirious speech and inability to eat. What is the name of this disease? Qibo replied: This disease is named "Yin-Jiao" (Yin-Yang Intersection). "Jiao" signifies death. (Intersection refers to the mingling of Yin and Yang Qi, which no longer remain distinct.) The reason humans sweat is that it originates from grain (food), and grain essence generates Jing (Essence). (Meaning that Grain Qi transforms into Essence; when Essence is sufficient, it becomes sweat.) Now, when pathogens contend with healthy Qi in the muscles and bones, if sweating occurs, it indicates that the pathogen is retreating and Essence is victorious. (Referring to the initial sweating.) If Essence is victorious, the patient should be able to eat and the fever should not recur. Recurrent fever indicates the presence of pathogens. Sweat is derived from Essence. Now, sweating followed immediately by fever indicates that the pathogen is victorious. The inability to eat means there is no assistance for the Essence. ("Wu bi" means there is nothing to assist or supply; without digestion of grain, Essence is not generated, and without transformed Essence flowing, there is nothing to supply for sweating.) If the disease lingers, life expectancy will collapse instantly. (In such cases, the person's lifespan will immediately face peril.) If the pulse remains rapid and vigorous after sweating, it indicates death. (After sweating, the pulse should be slow and quiet; if it is instead rapid, restless, and full, it indicates exhaustion of True Qi and excess of pathogenic factors, thus predicting certain death.) Now, if the pulse does not correspond with the sweating, it means the healthy Qi cannot overcome the disease, and death is evident. (A pulse that is not quiet but rapid and vigorous does not correspond with the expected post-sweat state.) Delirious speech indicates loss of Zhi (Will/Shen). Loss of Zhi indicates death. (Zhi resides in Essence; now that Essence cannot be supplied, Zhi has no abode. If Zhi does not reside, it is lost.) Currently, three signs of death are seen, and no sign of life is present. Even if there is temporary recovery, death is inevitable. (Sweating with a rapid, vigorous pulse is the first sign of death. Inability of healthy Qi to overcome the disease is the second sign of death. Delirious speech and loss of Zhi is the third sign of death.)