瓜蒂（熬黄）一分 赤小豆（煮）一分
右二味，杵为散，以香鼓七合煮取汁，和散一钱匕温服之，不吐者少加之，以快吐为
度而止。亡血及虚者，不可与之。
@@@
脉紧如转索无常者，有宿食也。
【注】
转索无常，紧脉之状也。若浮紧伤寒，沉紧冷痛，冷犯胃脘，谷气不行，故曰：有宿
食也。
@@@
脉紧，头痛风寒，腹中有宿食不化也。（一云寸口脉紧）
【注】
脉紧头痛，是外伤风寒病也，脉紧腹痛，是内伤宿食病也。
【集注】
李□曰：按此脉与证，似伤寒而非伤寒者，以身不疼、腰脊不强故也。然脉紧亦有辨
浮而紧者，为伤寒；沉而紧者，为伤食。『甲乙经』曰：人迎紧甚伤于寒，气口紧甚
伤于食，则寒与食又以左右手为辨已，是以知腹中有宿食不化也。
@@@
肺中风者，口燥而喘，身运而重，冒而肿胀。
【按】
身运而重，当是「头运而身重」，冒而肿胀，当是「冒风而肿胀」，始与文义相合，
此必传写之□可知。
【注】
肺主气，外合皮毛，肺中风邪，风伤气则津结不行，故口燥；风伤肺则气逆上壅，故
喘咳。头运而身重者，气伤而力乏也；冒风而肿胀者，皮伤风水也。
【集注】
李□曰：肺主气，风邪中之，则气壅而津液不行，故口燥气逆而呼吸不利，故气喘也
。
@@@
肺中寒，吐浊涕。
【注】
肺中寒邪，胸中之阳气不治，则津液聚而不行，故吐浊涎如涕也。
【集注】
李□曰：五液入肺为涕，肺合皮毛，开窍于鼻，寒邪从皮毛而入于肺，则肺窍不利而
鼻塞涕唾，浊涎壅遏不通，吐出于口也。
@@@
肺死藏，浮之虚，按之弱如葱叶，下无根者，死。
【注】
肺中风寒之邪，脉若见浮之极虚，按之弱如葱叶之空下无根者，乃肺藏之死脉也。以
下五藏俱言浮者，是明外中之邪，应得之脉也。
【集注】
程林曰：真肺脉至，如以毛羽中人肤，非浮之虚乎？葱叶中空，按之弱如葱叶下又无
根，则浮毛虚弱是无胃气也。此真藏已见，故死。
@@@
肝中风者，头目□，两□痛，行常伛，令人嗜甘。
【注】
肝主风，外合于筋，肝中风邪，风胜则动，故头目□动也。两□肝之部，肝受病故两
□痛也。风伤筋，故行常伛偻也。肝苦急欲甘缓之，故令人嗜甘也。
【集注】
徐彬曰：高巅之上，惟风可到，风性动摇，故头目□动，肝脉上贯膈，今□肋有邪故
痛。肝主筋，风胜则筋急故伛。人以脾胃为主，木邪甚而土负，甘益脾，嗜甘所以自
救也。
@@@
肝中寒者，两臂不举，舌本燥，喜太息，胸中痛，不得转侧，食则吐而汗出也。
【按】
两臂不举，舌本燥二句，「而汗出」三字，文义不属，必是错简，不释。
【注】
肝性条达，气行于胸侧，肝中寒邪，故有气抑不伸，喜太息，气滞不行，痛不得转侧
也、食则吐，亦寒邪上逆也。
@@@
肝死藏，浮之弱，按之如索不来，或曲如蛇行者，死。
【注】
肝中风寒之邪，若脉见浮之极弱，按之不弦，是失其肝之本脉也。今按之如索不来，
曲如蛇行而去，夫索曲蛇行，去而不来，非皆肝藏之死脉乎！
【集注】
周扬俊曰：按之如索，则弦紧俱见，脉有来去，乃阴阳往复之理。今曰：不来但去，
是无胃气也。否则真气将散，出入强勉，有委而不前，屈且难伸之状，故曲如蛇行也
。
@@@
肝着，其人常欲蹈其胸上，先未苦时，但欲饮热，旋覆花汤主之。
【按】
「旋覆花汤主之」六字，与肝着之病不合，当是衍文。
【注】
肝着者，为肝气着而不行，致胸痞塞不快也。故其人常欲按摩其胸，以疏通其气也。
其先未曾痞塞苦时，但欲饮热者，乃寒气为病也。
【集注】
李□曰：肝主□泄，着则气郁不伸，常欲人蹈其胸上，以舒其气，又以寒气固结于中
，欲饮热以胜其寒也。
@@@
心中风者，翕翕发热，不能起，心中饥，食即呕吐。
【按】
翕翕发深，中风之本证也。不能起，心中饥，食即呕吐，文义不属，必是错简，不释
。
@@@
心中寒者，其人苦病心如啖蒜状，剧者心痛彻背，背痛彻心，譬如蛊注，其脉浮者，
自吐乃愈。
【注】
其人苦病心如啖蒜状，谓辛辣刺心之状也。剧者心痛彻背，背痛彻心，谓心背相应而
痛也。譬如蛊注，谓似虫之往来不已而痛也。此皆心中寒邪之证。若其脉浮，是心得
本脉，为寒邪上越之候，故自吐则邪去乃愈也。
【集注】
徐彬曰：寒则为阴邪，外束之则火内郁，故如啖蒜状，其似辣而非痛也。剧则邪盛，
故外攻背痛，内攻心痛，彻者相应也，譬如蛊注状，其绵绵不息。若脉浮，是邪未结
，故自吐而愈。
@@@
心伤者，其人劳倦，即头面赤而下重，心中痛而自烦，发热，当脐跳，其脉弦，此为
心藏伤所致也。
【按】
其脉弦之「弦」字，当「沉」字，沉为肾脉，文义相属，必是传写之□。
【注】
心伤者，谓心伤病之人也。因其人劳倦则扰其心，心之阳盛于上，故头面赤也，上盛
则下虚，故下重而无力也。心中痛，自烦发热，当脐跳，其脉沉，肾乘心伤之所致也
。
【集注】
尤怡曰：心伤者，其人劳倦，即头面赤而下重。盖心虚者，其阳易浮，上盛者，其下
必虚也。心中痛而自烦发热者，心虚失养而热动于中也。当脐跳者，心虚于上，而肾
动于下也。
@@@
邪哭使魂魄不安者，血气少也，血气少者，属于心，心气虚者，其人则畏，合目欲眠
，梦远行而精神离散，魂魄妄行，阴气衰者为癫，阳气衰者为狂。
【按】
阴气衰者为癫之「癫」字，当是「狂」字；阳气衰者为狂之「狂」字，当是「癫」字
。『内经』曰：重阴者癫，重阳者狂。必是传写之□。
【注】
邪哭，谓心伤之人无故而哭也。邪哭则使人魂魄不安，心之血气少也。血气少而心虚
，则令人畏，合目欲眠则梦远行，此是精神离散，魂魄妄行也。心之血阴也，阴过衰
则阳盛，阳盛则为病狂也；心之气阳也，阳过衰则阴盛，阴盛则病癫也。
@@@
心死藏，浮之实，如丸豆，按之益躁疾者，死。
【注】
心中风寒之邪，若脉见浮之极实，如丸豆之状，按之益劲躁疾乱动者，乃心藏死脉也
。
【集注】
李□曰：『难经』云：心脉浮大而散，若浮之实如麻豆，按之益躁疾，则真藏脉见，
胃气全无故死。『内经』云：真心脉至坚而搏，如寻薏苡子，累累然，即如麻豆，意
可与此同参。
@@@
脾中风者，翕翕发热，形如醉人，腹中烦重，皮目□□而短气。
【按】
脾缺中寒之文。必是简脱。
【注】
脾中风邪，翕翕发热，中风之本证也。形如醉人，亦风热攘乱于中，应有之证也。腹
中不快而烦，身体懈惰而重，皮目□□，动而气短，皆脾经证也。
【集注】
李□曰：风属阳邪而气疏泄，形如醉人。言其面赤而四肢软也。风气内扰，故腹中烦
重。皮目，上下眼胞也。
@@@
脾死藏，浮之大坚，按之如覆杯，洁洁状如摇者，死。
【注】
脾中风寒之邪，若脉见浮之大坚，失其和缓，按之状如覆杯，高章明洁，有力如摇，
乃脾藏之死脉也。
【集注】
李□曰：脉弱以滑，是有胃气，浮之大坚，则胃气绝，真藏脉见矣。覆杯则内空，洁
洁者，空而无有之象也。状如摇者，脉躁疾不宁，气将散也，故死。
@@@
趺阳脉浮而涩，浮则胃气强，涩则小便数，浮涩相搏，大便则坚，其脾为约，麻子仁
丸主之。
【按】
此条当在『腹满篇』中便难之下，必是错简在此。
【注】
趺阳胃脉也，若脉涩而不浮，脾阴虚也，则胃气亦不强，不堪下矣。今脉浮而涩，胃
阳实也，则为胃气强，脾阴亦虚也。脾阴虚不能为胃上输精气，水独下行，故小便数
也；胃气强，约束其脾，不化津液，故大便难也。以麻仁丸主之，养液润燥，清热通
幽，不敢恣行承气者，盖因脉涩终是虚邪也。
【集注】
徐彬曰：脾约病用丸不作汤者，取其缓以开结，不敢骤伤元气也。要知人至脾约，皆
因元气不充，津液不到所致耳。
李□曰：趺阳胃脉也。胃为水谷之海，浮为阳脉，故胃气强而能食，小便数则津液亡
，故脉涩。盖脾主为胃行津液，此以胃强脾弱，约束津液，不能四布，但输膀胱，致
小便数而大便坚也。麻子仁丸通幽润燥。
瓜蒂（炒至微黄）一分，赤小豆（煮熟）一分。
以上两味药，研成细散，用香豉七合煮取汁液，将散药一钱匕混入温服。若不呕吐，可稍加剂量，以产生畅快呕吐为度而停止。失血及体质虚弱者，不可服用。
@@@
脉象紧如转动绳索、变化无常的，是有宿食。
【注】
“转索无常”是紧脉的特征。如果是浮紧脉则是伤寒，沉紧脉则是冷痛。寒气侵犯胃脘，导致谷气运行不畅，所以说：有宿食。
@@@
脉紧，伴有头痛风寒，腹中有宿食不化。（另一种说法是寸口脉紧）
【注】
脉紧伴头痛，是外感风寒的病证；脉紧伴腹痛，是内伤宿食的病证。
【集注】
李□说：按此脉与证，看似伤寒而非伤寒，因为身体不疼、腰脊不强。然而脉紧也有区别：浮而紧的是伤寒；沉而紧的是伤食。《甲乙经》说：人迎脉紧甚伤于寒，气口脉紧甚伤于食，那么寒邪与食积又可以通过左右手来辨别了，因此知道腹中有宿食不化。
@@@
肺受中风邪，出现口干而喘，头晕且身重，头昏蒙而肿胀。
【按】
“身运而重”应当是“头晕而身重”，“冒而肿胀”应当是“冒风而肿胀”，这才符合文义，这必定是传抄过程中的错误，可以知晓。
【注】
肺主气，外合皮毛。肺受风邪侵袭，风伤气则津液凝结不行，所以口干；风伤肺则气逆上壅，所以喘咳。头晕而身重，是因为气受伤而乏力；冒风而肿胀，是因为皮伤风水。
【集注】
李□说：肺主气，风邪中伤它，则气壅滞而津液不行，所以口干；气逆而呼吸不利，所以气喘。
@@@
肺受中寒邪，吐出浑浊的鼻涕样分泌物。
【注】
肺受寒邪，胸中的阳气不能治理，则津液聚积而不行，所以吐出浑浊的涎沫像鼻涕一样。
【集注】
李□说：五液入肺化为涕，肺合皮毛，开窍于鼻。寒邪从皮毛进入肺，则肺窍不利而鼻塞流涕唾，浊涎壅遏不通，吐出于口。
@@@
肺的死脏脉，轻取虚浮，重按弱如葱叶，下部无根的，死。
【注】
肺受风寒之邪，脉若见轻取极虚，重按弱如葱叶中空、下部无根，这是肺脏的死脉。以下五脏都提到“浮”，是为了说明外感之邪应有的脉象。
【集注】
程林说：真肺脉到来，像羽毛中人皮肤，难道不是轻取虚浮吗？葱叶中空，重按弱如葱叶，下部又没有根，那么浮毛虚弱就是没有胃气。这是真脏脉已现，所以死。
@@@
肝受中风邪，头目□动，两胁痛，行走常弯腰，使人嗜吃甘味。
【注】
肝主风，外合于筋。肝受风邪，风胜则动，所以头目□动。两胁是肝的部位，肝受病所以两胁痛。风伤筋，所以行走常伛偻。肝苦急欲用甘味缓之，所以使人嗜甘。
【集注】
徐彬说：高巅之上，只有风能到达，风性动摇，所以头目□动。肝脉上贯膈，现在□肋有邪气所以痛。肝主筋，风胜则筋急所以伛。人以脾胃为主，木邪盛而土负，甘味益脾，嗜甘所以自救。
@@@
肝受中寒邪，两臂不能举起，舌根干燥，喜欢叹气，胸痛，不能翻身，进食则呕吐并出汗。
【按】
“两臂不举”、“舌本燥”两句，“而汗出”三字，文义不连贯，必定是错简，不解释。
【注】
肝性条达，气行于胸侧。肝受寒邪，所以气抑不伸，喜欢叹气；气滞不行，痛得不能翻身。进食则吐，也是寒邪上逆。
@@@
肝的死脏脉，轻取弱，重按如绳索不来，或弯曲如蛇行的，死。
【注】
肝受风寒之邪，若脉见轻取极弱，重按不弦，是失去了肝的本脉。现在重按如绳索不来，弯曲如蛇行而去，夫索曲蛇行，去而不来，不都是肝脏的死脉吗！
【集注】
周扬俊说：重按如索，则弦紧俱见，脉有来去，这是阴阳往复的道理。现在说：不来但去，是没有胃气。否则真气将散，出入强勉，有委顿不前、屈且难伸的状态，所以弯曲如蛇行。
@@@
肝着病，病人常想让人踩踏他的胸部上方，起初未痛苦时，只想喝热饮，用旋覆花汤主治。
【按】
“旋覆花汤主之”六字，与肝着之病不合，应当是衍文。
【注】
肝着病，是因为肝气着而不行，导致胸痞塞不快。所以病人常想按摩其胸，以疏通其气。其先前未曾痞塞痛苦时，只想喝热饮，乃是寒气致病。
【集注】
李□说：肝主疏泄，着则气郁不伸，常想让人踩踏其胸上，以舒其气，又因寒气固结于中，想喝热饮以胜其寒。
@@@
心受中风邪，翕翕发热，不能起床，心中饥饿，进食即呕吐。
【按】
“翕翕发深”（应为发热），是中风的根本证候。“不能起”、“心中饥”、“食即呕吐”，文义不连贯，必定是错简，不解释。
@@@
心受中寒邪，病人苦于心病，感觉像吃蒜一样辛辣刺心，严重时心痛彻背，背痛彻心，如同蛊注，如果脉浮，自吐后痊愈。
【注】
病人苦于心病，感觉像吃蒜一样辛辣刺心，是指辛辣刺心的状态。严重时心痛彻背，背痛彻心，是指心背相应而痛。如同蛊注，是指似虫往来不已而痛。这些都是心中寒邪的证候。如果脉浮，是心得本脉，为寒邪上越的征候，所以自吐则邪去乃愈。
【集注】
徐彬说：寒则为阴邪，外束之则火内郁，所以像吃蒜状，那种似辣而非痛的感觉。剧则邪盛，所以外攻背痛，内攻心痛，彻者是相应，如同蛊注状，绵绵不息。若脉浮，是邪未结，所以自吐而愈。
@@@
心伤者，其人劳倦，就头面红赤而下部沉重，心中痛而自烦，发热，肚脐跳动，脉弦，这是心脏受伤所致。
【按】
“其脉弦”的“弦”字，应当是“沉”字，沉为肾脉，文义相属，必定是传写之误。
【注】
心伤者，指心脏受伤的病人。因为劳倦则扰动其心，心之阳盛于上，所以头面红赤；上盛则下虚，所以下部沉重而无力。心中痛，自烦发热，当脐跳，脉沉，是肾乘心伤所致。
【集注】
尤怡说：心伤者，其人劳倦，就头面红赤而下重。盖心虚者，其阳易浮，上盛者，其下必虚也。心中痛而自烦发热者，心虚失养而热动于中也。当脐跳者，心虚于上，而肾动于下也。
@@@
无故哭泣使魂魄不安的，是血气少。血气少，属于心。心气虚的人，则畏惧，闭眼想睡，梦远行而精神离散，魂魄妄行。阴气衰者为癫，阳气衰者为狂。
【按】
“阴气衰者为癫”的“癫”字，应当是“狂”字；“阳气衰者为狂”的“狂”字，应当是“癫”字。《内经》说：重阴者癫，重阳者狂。必定是传写之误。
【注】
邪哭，指心脏受伤的人无故而哭。邪哭使人魂魄不安，是心血气少。血气少而心虚，则令人畏惧，闭眼想睡则梦远行，这是精神离散，魂魄妄行。心之血阴也，阴过衰则阳盛，阳盛则为病狂；心之气阳也，阳过衰则阴盛，阴盛则病癫。
@@@
心的死脏脉，轻取实，如丸豆，重按更躁疾的，死。
【注】
心中风寒之邪，若脉见轻取极实，如丸豆之状，重按更劲躁疾乱动，这是心脏的死脉。
【集注】
李□说：《难经》云：心脉浮大而散，若轻取实如麻豆，重按更躁疾，则真脏脉见，胃气全无故死。《内经》云：真心脉至坚而搏，如寻薏苡子，累累然，即如麻豆，意思可与此同参。
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脾受中风邪，翕翕发热，形体像醉人，腹中烦重，眼皮跳动而短气。
【按】
脾缺中寒的文字。必定是简脱。
【注】
脾受风邪，翕翕发热，是中风的根本证候。形体像醉人，也是风热扰乱于中，应有的证候。腹中不快而烦，身体懈惰而重，眼皮跳动，动而气短，都是脾经证候。
【集注】
李□说：风属阳邪而气疏泄，形体像醉人。是说其面赤而四肢软。风气内扰，所以腹中烦重。皮目，指上下眼睑。
@@@
脾的死脏脉，轻取大坚，重按如覆杯，洁洁状如摇的，死。
【注】
脾受风寒之邪，若脉见轻取大坚，失去和缓，重按状如覆杯，高章明洁，有力如摇，这是脾脏的死脉。
【集注】
李□说：脉弱以滑，是有胃气，浮之大坚，则胃气绝，真脏脉见了。覆杯则内空，洁洁者，空而无有的象。状如摇者，脉躁疾不宁，气将散，所以死。
@@@
趺阳脉浮而涩，浮则胃气强，涩则小便数，浮涩相搏，大便则坚，其脾为约，用麻子仁丸主治。
【按】
此条应当在《腹满篇》中便难之下，必定是错简在此。
【注】
趺阳是胃脉，若脉涩而不浮，是脾阴虚，则胃气也不强，不堪攻下。现在脉浮而涩，是胃阳实，则为胃气强，脾阴也虚。脾阴虚不能为胃上输精气，水独下行，所以小便数；胃气强，约束其脾，不化津液，所以大便难。用麻仁丸主治，养液润燥，清热通幽，不敢恣行承气汤，是因为脉涩终归是虚邪。
【集注】
徐彬说：脾约病用丸不作汤，是取其缓以开结，不敢骤伤元气。要知道人至脾约，皆因元气不充，津液不到所致。
李□说：趺阳是胃脉。胃为水谷之海，浮为阳脉，故胃气强而能食，小便数则津液亡，故脉涩。盖脾主为胃行津液，此以胃强脾弱，约束津液，不能四布，但输膀胱，致小便数而大便坚。麻子仁丸通幽润燥。
Cautia (Gardenia Trichocarpa Fruit) [Gardeniae Fructus] (stir-fried until slightly yellow) 1 fen, Adzuki Bean (Vigna angularis Seed) [Adzuki Bean] (boiled) 1 fen.
The above two ingredients are pounded into a powder. Use seven he of Xiangchi (Prepared Soybean) [Perillae Fructus Preparatus] decoction to mix with one qianbi of the powder and take it warm. If vomiting does not occur, increase the dose slightly; stop when profuse vomiting is achieved as the limit. It is contraindicated for those with blood loss or deficiency.
@@@
When the pulse is tight like a turning rope and variable, there is retained food.
[Note]
"Turning rope and variable" describes the shape of a tight pulse. If floating and tight, it is Cold Damage (Shanghan); if deep and tight, it is cold pain. When cold invades the stomach region, causing grain qi to fail to move, it is said: there is retained food.
@@@
Tight pulse with headache and wind-cold indicates retained food in the abdomen that is not digesting. (Another version states: tight pulse at the Cun Kou position.)
[Note]
A tight pulse with headache indicates an external contraction of wind-cold disease; a tight pulse with abdominal pain indicates internal injury from retained food disease.
[Collected Notes]
Li □ says: According to this pulse and syndrome, it resembles Cold Damage but is not Cold Damage, because the body does not ache and the waist and spine are not stiff. However, tight pulses can be distinguished: floating and tight indicates Cold Damage; deep and tight indicates food injury. The *Jia Yi Jing* states: A very tight Ren Ying pulse indicates injury by cold; a very tight Qi Kou pulse indicates injury by food. Thus, cold and food can be distinguished by the left and right hands, leading to the knowledge that there is undigested retained food in the abdomen.
@@@
Wind striking the Lung causes dry mouth and panting, dizziness with heaviness of the body, vertigo, and swelling.
[Commentary]
"Heaviness of the body with dizziness" should likely be "dizziness of the head with heaviness of the body"; "vertigo and swelling" should likely be "vertigo due to wind and swelling". This aligns with the textual meaning, indicating a transcription error.
[Note]
The Lung governs Qi and connects externally with the skin and hair. When wind pathogen strikes the Lung, damaging Qi causes Jin-Ye (body fluids) to congeal and fail to circulate, resulting in dry mouth; wind damaging the Lung causes Qi to rebel and obstruct upwards, resulting in panting and coughing. Dizziness and heaviness indicate Qi damage and lack of strength; vertigo and swelling indicate skin damage by wind-water.
[Collected Notes]
Li □ says: The Lung governs Qi. When struck by wind pathogen, Qi becomes congested and Jin-Ye fails to circulate, causing dry mouth; Qi rebels and breathing is difficult, causing panting.
@@@
Cold striking the Lung causes expectoration of turbid mucus resembling nasal discharge.
[Note]
When cold pathogen strikes the Lung, the Yang Qi in the chest fails to regulate, causing Jin-Ye to accumulate and fail to move, resulting in the expectoration of turbid saliva resembling mucus.
[Collected Notes]
Li □ says: The five fluids transform into nasal discharge in the Lung. The Lung connects with the skin and hair and opens into the nose. When cold pathogen enters the Lung via the skin and hair, the Lung orifice becomes obstructed, causing nasal congestion and discharge of mucus and saliva. Turbid saliva accumulates and cannot flow freely, being vomited out from the mouth.
@@@
The dying organ pulse of the Lung is floating and empty on light pressure, weak like a scallion leaf on deep pressure, with no root below; this indicates death.
[Note]
When the Lung is struck by wind-cold pathogen, if the pulse is extremely empty on light pressure and weak like a hollow scallion leaf on deep pressure with no root below, it is the dying pulse of the Lung organ. The mention of "floating" for the following five organs clarifies the pulse corresponding to externally contracted pathogens.
[Collected Notes]
Cheng Lin says: The true Lung pulse arrives like a feather touching human skin; is this not floating and empty? A scallion leaf is hollow inside; feeling weak like a scallion leaf on deep pressure with no root below means the floating, feathery weakness indicates the absence of Stomach Qi. Since the Zang organ pulse has appeared, death ensues.
@@@
Wind striking the Liver causes twitching of the head and eyes, pain in both hypochondria, habitual stooping while walking, and a craving for sweet flavors.
[Note]
The Liver governs wind and connects externally with the sinews. When wind pathogen strikes the Liver, excess wind causes movement, resulting in twitching of the head and eyes. The hypochondria are the region of the Liver; Liver pathology causes pain in both hypochondria. Wind damages the sinews, causing habitual stooping. The Liver suffers from urgency and desires sweetness to relax it, hence the craving for sweet flavors.
[Collected Notes]
Xu Bin says: At the highest peaks, only wind can reach; the nature of wind is shaking, causing twitching of the head and eyes. The Liver meridian passes through the diaphragm; now evil in the hypochondrium causes pain. The Liver governs sinews; excess wind causes sinew tension, leading to stooping. Humans rely on the Spleen and Stomach; when Wood evil is excessive and Earth bears the burden, sweet flavor benefits the Spleen, and craving sweets is self-rescue.
@@@
Cold striking the Liver causes inability to raise both arms, dryness at the root of the tongue, frequent sighing, chest pain, inability to turn over, vomiting upon eating, and sweating.
[Commentary]
The phrases "inability to raise both arms" and "dryness at the root of the tongue," along with the three characters "and sweating," do not fit the context logically and are likely misplaced text (cuojian); they are not explained.
[Note]
The Liver's nature is free flow; Qi moves in the chest sides. When cold pathogen strikes the Liver, Qi is suppressed and cannot extend, causing frequent sighing; Qi stagnation and failure to move cause pain preventing turning over. Vomiting upon eating is also due to cold pathogen rebelling upward.
@@@
The dying organ pulse of the Liver is weak on light pressure, feels like a cord that does not return on deep pressure, or curves like a snake moving away; this indicates death.
[Note]
When the Liver is struck by wind-cold pathogen, if the pulse is extremely weak on light pressure and does not feel wiry on deep pressure, it has lost the fundamental pulse of the Liver. Now, feeling like a cord that does not return on deep pressure, curving like a snake moving away—going without returning—is indeed the dying pulse of the Liver organ!
[Collected Notes]
Zhou Yangjun says: Feeling like a cord on deep pressure shows both wiry and tight qualities. A pulse with coming and going follows the principle of Yin-Yang reciprocation. Now, saying "no coming, only going" indicates the absence of Stomach Qi. Otherwise, the True Qi is scattering, forced entry and exit, showing a state of reluctance to advance and difficulty extending, hence curving like a snake.
@@@
Liver Fixation (Gan Zhuo): The patient constantly desires someone to tread on their upper chest. Initially, before suffering, they only desire hot drinks. Xuan Fu Hua Tang (Inula Flower Decoction) is the primary treatment.
[Commentary]
The six characters "Xuan Fu Hua Tang is the primary treatment" do not match the disease of Liver Fixation and are likely interpolated text.
[Note]
Liver Fixation refers to Liver Qi being fixed and failing to move, causing chest fullness and discomfort. Hence, the patient constantly desires massage of the chest to unblock the Qi. When initially not suffering from fullness, desiring only hot drinks indicates the disease is caused by cold pathogen.
[Collected Notes]
Li □ says: The Liver governs free flow; fixation causes Qi depression and failure to extend. The patient constantly desires someone to tread on their chest to soothe the Qi. Additionally, cold pathogen is firmly knotted within, so they desire hot drinks to overcome the cold.
@@@
Wind striking the Heart causes slight fever, inability to rise, a sensation of hunger in the heart/chest, and vomiting immediately after eating.
[Commentary]
"Slight fever" is the fundamental syndrome of wind striking the Heart. "Inability to rise," "hunger in the heart," and "vomiting after eating" do not fit the context logically and are likely misplaced text; they are not explained.
@@@
Cold striking the Heart causes the patient to suffer from a sensation in the heart like eating garlic (spicy/stinging). In severe cases, heart pain radiates to the back, and back pain radiates to the heart, resembling Gu Zhu (parasitic affliction). If the pulse is floating, spontaneous vomiting leads to recovery.
[Note]
Suffering from a sensation like eating garlic refers to a spicy, stinging feeling in the heart. Severe heart pain radiating to the back and vice versa indicates corresponding pain between the heart and back. Resembling Gu Zhu means pain resembling insects moving incessantly. These are all syndromes of cold pathogen in the Heart. If the pulse is floating, it indicates the Heart has its fundamental pulse, signaling the expulsion of cold pathogen upwards; thus, spontaneous vomiting expels the evil and leads to recovery.
[Collected Notes]
Xu Bin says: Cold is a Yin pathogen; when constrained externally, Fire is depressed internally, hence the sensation like eating garlic, which is spicy-like but not painful. In severity, the evil is strong, attacking outward to cause back pain and inward to cause heart pain; "radiating" indicates correspondence. Resembling Gu Zhu, it is continuous. If the pulse is floating, the evil has not condensed, so spontaneous vomiting leads to recovery.
@@@
Those injured in the Heart, when fatigued or overworked, develop redness of the head and face and heaviness in the lower body. They experience heart pain, spontaneous irritability, fever, pulsation at the umbilicus, and a wiry pulse. This is caused by injury to the Heart organ.
[Commentary]
The character "wiry" (xian) in "pulse is wiry" should likely be "deep" (chen), as deep corresponds to the Kidney pulse, making the context coherent. This is likely a transcription error.
[Note]
"Injured in the Heart" refers to patients with Heart injury. Fatigue disturbs the Heart; Heart Yang is excessive upwards, causing redness of the head and face. Excess above leads to deficiency below, causing heaviness and weakness in the lower body. Heart pain, spontaneous irritability, fever, umbilical pulsation, and a deep pulse indicate the Kidney exploiting the injured Heart.
[Collected Notes]
You Yi says: Those injured in the Heart, when fatigued, develop redness of the head and face and heaviness in the lower body. When the Heart is deficient, its Yang easily floats; when excessive above, the lower must be deficient. Heart pain, spontaneous irritability, and fever result from Heart deficiency failing to nourish, causing heat to stir within. Umbilical pulsation occurs because the Heart is deficient above and the Kidney moves below.
@@@
Abnormal weeping causing insecurity of the Hun and Po spirits indicates insufficient Blood and Qi. Insufficient Blood and Qi belongs to the Heart. Those with Heart Qi deficiency fear easily, wish to sleep with eyes closed, dream of traveling far, have scattered spirit and essence, and wandering Hun and Po. Deficiency of Yin leads to Dian (depressive psychosis); deficiency of Yang leads to Kuang (manic psychosis).
[Commentary]
"Dian" in "deficiency of Yin leads to Dian" should likely be "Kuang"; "Kuang" in "deficiency of Yang leads to Kuang" should likely be "Dian". The *Nei Jing* states: Excess Yin leads to Dian, Excess Yang leads to Kuang. This is likely a transcription error.
[Note]
Abnormal weeping refers to crying without reason in those with Heart injury. Abnormal weeping makes Hun and Po insecure due to insufficient Blood and Qi of the Heart. Insufficient Blood and Qi and Heart deficiency cause fear; wishing to sleep with eyes closed and dreaming of far travel indicates scattered spirit and wandering Hun and Po. Blood of the Heart is Yin; excessive deficiency of Yin leads to excess Yang, causing Kuang (mania). Qi of the Heart is Yang; excessive deficiency of Yang leads to excess Yin, causing Dian (depression/psychosis).
@@@
The dying organ pulse of the Heart is solid on light pressure, like pills or beans; on deep pressure, it becomes increasingly restless and rapid; this indicates death.
[Note]
When wind-cold pathogen strikes the Heart, if the pulse is extremely solid on light pressure, like pills or beans, and becomes increasingly vigorous, restless, and rapid on deep pressure, it is the dying pulse of the Heart organ.
[Collected Notes]
Li □ says: The *Nan Jing* states: The Heart pulse is floating, large, and scattered. If solid on light pressure like hemp seeds, and increasingly restless on deep pressure, the Zang organ pulse appears, and the complete absence of Stomach Qi leads to death. The *Nei Jing* states: The True Heart pulse is firm and beating, like searching for Coix seeds, numerous and piled up, i.e., like hemp seeds; the meaning can be referenced similarly here.
@@@
Wind striking the Spleen causes slight fever, appearance resembling drunkenness, abdominal烦重 (heaviness and vexation), eyelid twitching, and shortness of breath.
[Commentary]
Text regarding Cold striking the Spleen is missing. Likely lost in bamboo slips.
[Note]
Wind striking the Spleen causes slight fever, the fundamental syndrome of wind striking. Appearance resembling drunkenness is also a symptom of wind-heat disturbing internally. Abdominal discomfort and vexation, physical lassitude and heaviness, eyelid twitching, and shortness of breath upon movement are all Spleen meridian symptoms.
[Collected Notes]
Li □ says: Wind is a Yang pathogen causing dispersion and leakage; appearance resembling drunkenness refers to red face and soft limbs. Internal disturbance by wind Qi causes abdominal heaviness and vexation. Pi Mu refers to the upper and lower eyelids.
@@@
The dying organ pulse of the Spleen is large and firm on light pressure; on deep pressure, it feels like an overturned cup, clean and empty, shaking; this indicates death.
[Note]
When wind-cold pathogen strikes the Spleen, if the pulse is large and firm on light pressure, losing its harmonious and slow quality, and feels like an overturned cup on deep pressure—high, bright, clean, forceful, and shaking—it is the dying pulse of the Spleen organ.
[Collected Notes]
Li □ says: A pulse that is weak and slippery indicates the presence of Stomach Qi; floating, large, and firm indicates the extinction of Stomach Qi and the appearance of the Zang organ pulse. An overturned cup is hollow inside; "clean and empty" depicts the image of emptiness. Shaking indicates restless and agitated pulse, signifying dispersing Qi, hence death.
@@@
Fu Yang pulse is floating and choppy. Floating indicates strong Stomach Qi; choppy indicates frequent urination. The interaction of floating and choppy results in hard stool. The Spleen is constrained (Yue); Hemp Seed Pill (Mazi Ren Wan) is the primary treatment.
[Commentary]
This passage should belong under "Difficulty in Defecation" in the *Abdominal Fullness Chapter*; it is likely misplaced here.
[Note]
Fu Yang is the Stomach pulse. If the pulse is choppy but not floating, it indicates Spleen Yin deficiency, and Stomach Qi would also not be strong, making purgatives unsuitable. Now, the pulse is floating and choppy: Stomach Yang is excess, indicating strong Stomach Qi, while Spleen Yin is also deficient. Spleen Yin deficiency cannot transport essence and Qi to the Stomach; water descends alone, causing frequent urination. Strong Stomach Qi constrains the Spleen, failing to transform Jin-Ye, causing hard stool. Mazi Ren Wan is used to nourish fluids, moisten dryness, clear heat, and unblock the interior. One dares not use Chengqi Decoctions recklessly because the choppy pulse ultimately indicates deficiency evil.
[Collected Notes]
Xu Bin says: Using pills instead of decoctions for Spleen Constraint aims to gently resolve knotting without abruptly damaging Yuan Qi. One must know that Spleen Constraint arises from insufficient Yuan Qi and Jin-Ye failing to reach.
Li □ says: Fu Yang is the Stomach pulse. The Stomach is the sea of water and grain. Floating is a Yang pulse, so Stomach Qi is strong and appetite is good. Frequent urination depletes Jin-Ye, hence the choppy pulse. The Spleen governs transporting Jin-Ye for the Stomach. Here, strong Stomach and weak Spleen constrain Jin-Ye, preventing its distribution, sending it only to the Bladder, causing frequent urination and hard stool. Mazi Ren Wan unblocks the interior and moistens dryness.