湿家下之,额上汗出,微喘,小便利者死,若下利不止者,亦死。
大阳中暍者,身热疼重,而脉微弱,此亦夏月伤冷水,水行皮中所致也。
脉濡而弱,弱反在关,濡反在巅,微反在上,涩反在下,微则阳气不足,涩则无血,
阳气反微,中风汗出,而反躁烦,涩则无血,厥而且寒,阳微发汗,躁不得眠。
脉濡而弱,弱反在关,濡反在巅,弦反在上,微反在下,弦为阳运,微为阴寒,上实
下虚,意欲得温,微弦为虚,不可发汗,发汗则寒栗,不能自还。
厥,脉紧,不可发汗,发汗则声乱咽嘶,舌萎声不得前。
咳者则剧,数吐涎沫,咽中必干,小便不利,心中饥烦,晬时而发,其形似疟,有寒
无热,虚而寒栗,咳而发汗,蜷而苦满,腹中复坚。
脉濡而弱,弱反在关,濡反在巅,微反在上,涩反在下,微则阳气不足,涩则无血,
阳气反微,中风汗出,而反躁烦,涩则无血,厥而且寒,阳微不可下,下之则心下痞
□。
脉濡而弱,弱反在关,濡反在巅,弦反在上,微反在下,弦为阳运,微为阴寒,上实
下虚,意欲得温,微弦为虚,虚者不可下也。
脉濡而弱,弱反在关,濡反在巅,浮反在上,数反在下,浮为阳虚,数为无血,浮为
虚,数生热,浮为虚,自汗出而恶寒,数为痛,振而寒栗,微弱在关,胸下为急,喘
汗而不得呼吸,呼吸之中,痛在于□,振寒相抟,形如疟状,医反下之,故令脉数发
热,狂走见鬼,心下为痞,小便淋漓,少腹甚□,小便则尿血也。
脉濡而紧,濡则卫气微,紧则荣中寒,阳微卫中风,发热而恶寒,荣紧胃气冷,微呕
心内烦。医为有大热,解饥而发汗,亡阳虚烦躁,心下苦痞坚,表里俱虚竭,卒起而
头眩,客热在皮肤,怅怏不得眠,不知胃气冷,紧寒在关元,技巧无所施,汲水灌其
身,客热因时罢,栗栗而振寒,重被而覆之,汗出而冒巅,体惕而又振,小便为微难
,寒气因水发,清谷不容间,呕变反肠出,颠倒不得安,手足为微逆,身冷而内烦,
迟欲从后救,安可复追还。
脉浮而大,浮为气实,大为血虚,血虚为无阴,孤阳独下阴部者,小盒饭赤而难,胞
中当虚,今反小便利而大汗出,法应卫家当微,今反更实,津液四射,荣竭血尽,干
烦而不得眠,血薄肉消,而成暴液,医复以毒药攻其胃,此为重虚,客阳去有期,必
下如污泥而死。
伤寒,脉阴阳俱紧,恶寒发热,则脉欲厥,厥者,脉初来大,渐渐小,更来渐大,是
其候也。如此者恶寒,甚者翕翕汗出,喉中痛苦;热多者,目赤脉多,睛不慧;医复
发之,咽中则伤;若复下之,则两目闭,寒多便清谷,热多便脓血;若熏之,则身发
黄;若熨之,则咽燥;若小便利者,可救之;若小便难者,为危殆。
伤寒发热,口中勃勃气出,头痛目黄,衄不可制,贪水者必呕,恶水者厥。若下之,
咽中生疮,假令手足温者,必下重便脓血。头痛目黄者,若下之,则目闭。贪水者,
若下之,其脉必厥,其声嘤,咽喉塞;若发汗,则战栗,阴阳俱虚。恶水者,若下之
,则里冷不嗜食,大便完谷出;若发汗,则口中伤,舌上白胎,烦躁;脉数实,不大
便六、七日,后必便血;若发汗,则小便自利也。
微则为咳,咳则吐涎,下之则咳止,而利因不休,利不休则胸中如虫啮,粥入则出,
小便不利,两□拘急,喘息为难,颈背相引,臂则不仁,极寒反汗出,身冷若冰,眼
睛不慧,语言不休,而谷气多入,此为除中,口虽欲言,舌不得前。
脉数者久数不止,止则邪结,正气不能复,正气却结于藏,故邪气浮之,与皮毛相得
,脉数者不可下,下之必烦利不止。
伤寒发热头痛,微汗出,发汗则不识人。熏之则喘,不得小便,心腹满;下之则短气
,小便难,头痛背强;加温针则衄。
下利脉大者,虚也,以强下之故也。设脉浮革,因尔肠鸣者,属当归四逆汤。
对于患有湿病的人,如果误用攻下法治疗,出现额头出汗、轻微气喘、小便通利的,预后不良,属于死证;如果出现腹泻不止的,也属于死证。
太阳经受暑邪侵袭(中暍)的患者,身体发热且疼痛沉重,脉象微弱,这也是因为夏季贪凉饮冷或接触冷水,导致水气停留在皮肤腠理之间所导致的。
脉象濡软而弱,弱脉反而出现在关部,濡脉反而出现在巅部(寸部),微脉反而出现在上部,涩脉反而出现在下部。微脉表示阳气不足,涩脉表示无血。阳气反而微弱,中风后出汗,却反而出现躁动烦乱;涩脉表示无血,四肢厥冷并且发寒。阳气微弱时发汗,会导致躁动无法入睡。
脉象濡软而弱,弱脉反而出现在关部,濡脉反而出现在巅部(寸部),弦脉反而出现在上部,微脉反而出现在下部。弦脉代表阳气运行异常,微脉代表阴寒内盛,上实下虚,患者想要温暖。微弦脉象属于虚证,不可发汗,发汗则会导致寒战发抖,身体无法恢复常态。
四肢厥冷,脉象紧,不可发汗,发汗则会导致声音混乱、咽喉嘶哑、舌体萎软、声音不能发出。
咳嗽严重的,频繁吐出涎沫,咽喉必然干燥,小便不利,心中感到饥饿且烦乱,每昼夜固定时间发作,症状类似疟疾,只有寒冷没有发热,因虚寒而战栗。此时若对咳嗽患者发汗,会导致身体蜷缩且苦于胸满,腹部再次变得坚硬。
脉象濡软而弱,弱脉反而出现在关部,濡脉反而出现在巅部(寸部),微脉反而出现在上部,涩脉反而出现在下部。微脉表示阳气不足,涩脉表示无血。阳气反而微弱,中风后出汗,却反而出现躁动烦乱;涩脉表示无血,四肢厥冷并且发寒。阳气微弱时不可攻下,攻下则会导致心下痞塞。
脉象濡软而弱,弱脉反而出现在关部,濡脉反而出现在巅部(寸部),弦脉反而出现在上部,微脉反而出现在下部。弦脉代表阳气运行异常,微脉代表阴寒内盛,上实下虚,患者想要温暖。微弦脉象属于虚证,虚证不可攻下。
脉象濡软而弱,弱脉反而出现在关部,濡脉反而出现在巅部(寸部),浮脉反而出现在上部,数脉反而出现在下部。浮脉表示阳虚,数脉表示无血。浮脉表示虚,数脉生热。浮脉表示虚,自汗出且恶寒;数脉主痛,振颤且寒战。微弱脉在关部,胸下急迫,喘息出汗且呼吸困难,呼吸之中,疼痛在于[缺失字],振寒相互搏结,形态像疟疾。医生反而误用攻下法,所以导致脉数发热,狂跑见鬼,心下痞塞,小便淋漓不尽,少腹非常[缺失字],小便尿血。
脉象濡软而紧,濡脉表示卫气微弱,紧脉表示营分有寒。阳气微弱,卫分受风邪,发热且恶寒;营分紧束,胃气寒冷,轻微呕吐,心中烦乱。医生认为有大热,解衣发汗,导致亡阳虚烦躁,心下苦于痞硬,表里俱虚竭,突然起身则头晕目眩,客热在皮肤,惆怅不得眠,不知道胃气寒冷,紧寒在关元穴处,医术无处施展,汲水浇灌其身,客热暂时消退,战栗且振寒,盖上厚被覆盖,出汗且头昏目眩,身体惊恐又振颤,小便微难,寒气因水而发作,完谷不化不容间歇,呕吐并反肠外脱,颠倒不得安宁,手足微逆冷,身冷而内烦,迟了想从后面补救,怎么可以追回呢。
脉象浮而大,浮脉表示气实,大脉表示血虚。血虚即为无阴,孤阳独自下行至阴部的,小便应当赤涩困难,胞宫当虚。现在反而小便通利且大汗出,按理说卫气应当微弱,现在反而更实,津液四散流失,营血枯竭,干烦且不得眠,血液稀薄肌肉消瘦,而成暴渴之症。医生再用毒药攻伐其胃,这是重虚,客阳离去有期,必定下如污泥而死。
伤寒病,脉象寸关尺三部都紧,恶寒发热,则脉象欲现厥逆之象。厥者,脉初来时大,渐渐变小,再来时又渐大,这是其征候。像这样恶寒严重的,翕翕然出汗,喉中痛苦;热多的,眼睛红赤脉多,眼神不明亮;医生再发汗,咽喉则受伤;如果再攻下,则两目闭合。寒多的大便清谷,热多的大便脓血;如果用熏法,则身体发黄;如果用熨法,则咽燥;如果小便通利的,可救;如果小便困难的,为危殆。
伤寒发热,口中勃勃热气外出,头痛目黄,鼻衄不可控制,想喝水的必呕吐,不想喝水的必四肢厥冷。如果攻下,咽喉生疮,假如手足温的,必有下重感且大便脓血。头痛目黄的,如果攻下,则双目闭合。想喝水的,如果攻下,其脉必厥,其声音嘶哑,咽喉堵塞;如果发汗,则战栗,阴阳俱虚。不想喝水的,如果攻下,则里冷不欲食,大便完谷不化;如果发汗,则口中受伤,舌上白苔,烦躁;脉数实,不大便六七天,后来必便血;如果发汗,则小便自利。
脉微则为咳,咳则吐涎,攻下则咳止,但腹泻不停,腹泻不停则胸中如虫咬,粥入则吐出,小便不利,两[缺失字]拘急,喘息困难,颈背相引,手臂麻木不仁,极寒反而出汗,身冷如冰,眼睛不明亮,语言不休,而谷气多入,此为除中,口虽想说话,舌头不能向前伸出。
脉数的久数不止,停止则邪气结聚,正气不能恢复,正气退却结于脏腑,所以邪气浮越,与皮毛相合。脉数者不可攻下,攻下必烦乱腹泻不止。
For patients suffering from dampness (Shi Bing), if purgation is mistakenly applied, and sweating on the forehead, slight wheezing, and free urination occur, it indicates a fatal prognosis. If diarrhea persists without stopping, it is also fatal.
Patients with Summerheat-Stroke (Zhong Ye) affecting the Taiyang channel present with body heat and heaviness/pain, along with a weak pulse. This condition is caused by consuming cold water or being exposed to cold water in summer, leading to water qi stagnating within the skin and interstices.
The pulse is soggy (Ru) and weak (Ruo). The weak pulse appears at the Guan position, while the soggy pulse appears at the Dian position (Cun/inch position). The faint (Wei) pulse appears at the upper positions, and the choppy (Se) pulse appears at the lower positions. A faint pulse indicates insufficiency of Yang Qi; a choppy pulse indicates lack of blood. With insufficient Yang Qi, wind-stroke leads to sweating, yet restlessness and irritability arise instead. Choppy pulse indicates lack of blood, leading to cold extremities (Jue) and chills. Applying diaphoresis when Yang Qi is faint causes restlessness and inability to sleep.
The pulse is soggy and weak. The weak pulse is at the Guan position, the soggy pulse at the Cun position. The wiry (Xian) pulse is at the upper position, and the faint pulse at the lower position. Wiry indicates abnormal movement of Yang; faint indicates Yin-cold. There is excess above and deficiency below, and the patient desires warmth. Faint and wiry indicate deficiency; diaphoresis is contraindicated. Diaphoresis will cause severe shivering and inability to recover.
With cold extremities and a tight (Jin) pulse, diaphoresis is contraindicated. Diaphoresis will cause voice disorder, hoarseness, tongue flaccidity, and inability to speak.
In severe coughing with frequent expectoration of saliva, dry throat, and dysuria, accompanied by hunger and irritability, occurring at fixed times resembling malaria but with chills rather than fever, this is deficiency-cold. Applying diaphoresis for coughing causes curling up, chest fullness, and abdominal hardness.
The pulse is soggy and weak. Weak at Guan, soggy at Cun. Faint at upper, choppy at lower. Faint indicates Yang insufficiency; choppy indicates blood deficiency. Yang deficiency with wind-stroke sweating leads to restlessness. Choppy indicates blood deficiency, causing cold extremities and chills. Purgation is contraindicated in Yang deficiency; it leads to epigastric stuffiness (Pi).
The pulse is soggy and weak. Weak at Guan, soggy at Cun. Wiry at upper, faint at lower. Wiry indicates Yang movement; faint indicates Yin-cold. Excess above, deficiency below, desiring warmth. Faint and wiry indicate deficiency; purgation is contraindicated in deficiency.
The pulse is soggy and weak. Weak at Guan, soggy at Cun. Floating (Fu) at upper, rapid (Shu) at lower. Floating indicates Yang deficiency; rapid indicates blood deficiency. Floating indicates deficiency, rapid generates heat. Deficiency leads to spontaneous sweating and aversion to cold; rapid indicates pain, tremors, and chills. Weakness at Guan causes urgency below the chest, panting, sweating, and difficulty breathing. Pain occurs during respiration. Chills and tremors resemble malaria. Mistaken purgation causes rapid pulse, fever, mania, hallucinations, epigastric stuffiness, dribbling urination, severe lower abdominal [symptom], and hematuria.
The pulse is soggy and tight. Soggy indicates deficient Wei Qi; tight indicates Cold in Ying. Yang deficiency and Wind in Wei cause fever and aversion to cold. Ying tightness and Stomach Cold cause mild vomiting and internal irritability. Misinterpreting this as excessive heat and inducing sweating leads to Yang collapse, deficiency-induced irritability, and hard epigastric stuffiness. Both exterior and interior are exhausted. Rising suddenly causes dizziness. External heat remains in the skin, causing insomnia. Ignoring the internal Cold at the Guan Yuan point renders treatment ineffective. Pouring cold water on the body temporarily suppresses external heat but causes severe chills. Covering with heavy blankets induces sweating and dizziness. Tremors persist. Urination becomes difficult. Cold pathogen triggered by water causes unformed stools, vomiting with evisceration, restlessness, cold extremities, and internal irritability. Delayed rescue cannot restore life.
The pulse is floating and large. Floating indicates Qi excess; large indicates Blood deficiency. Blood deficiency implies Yin deficiency. Solitary Yang descending into the Yin aspect should cause difficult, red urination and uterine emptiness. However, free urination and profuse sweating occur. The Wei Qi should be weak but appears replete. Fluids scatter, Ying and Blood are exhausted. Dry irritability and insomnia ensue. Blood thins, muscles waste, and sudden thirst develops. Using toxic drugs to attack the Stomach constitutes double deficiency. Departure of external Yang is imminent; death follows with stool like mud.
In Cold Damage, if the pulse is tight at all three positions with aversion to cold and fever, the pulse exhibits Jue characteristics: initially large, then small, then gradually large again. Severe aversion to cold presents with slight sweating and throat pain. Excessive heat presents with red eyes and dull vision. Further diaphoresis injures the throat. Further purgation closes the eyes. Cold predominance leads to unformed stools; heat predominance leads to pus and blood in stool. Moxibustion causes jaundice; cupping/warming causes dry throat. If urination is free, recovery is possible; if difficult, the condition is critical.
Cold damage with fever, breathlessness, headache, yellow eyes, and uncontrollable epistaxis. Those craving water vomit; those rejecting water have cold extremities. Purgation causes throat sores. If hands and feet are warm, tenesmus and bloody stools occur. Headache and yellow eyes worsen with purgation (eyes close). Craving water + purgation leads to Jue pulse, hoarse voice, and throat obstruction. Sweating causes tremors and dual deficiency. Rejecting water + purgation causes interior cold, anorexia, and undigested stools. Sweating causes mouth injury, white tongue coating, and irritability. Rapid, solid pulse with constipation for 6-7 days may lead to rectal bleeding. Sweating leads to free urination.
Faint pulse indicates cough with saliva expectoration. Purgation stops cough but causes persistent diarrhea. Persistent diarrhea causes chest discomfort like insect bites, regurgitation of food, dysuria, limb spasms, difficult breathing, neck/back牵引, arm numbness. Extreme cold with sweating and ice-cold body, dull eyes, incessant speech, and intake of food indicates Chu Zhong (extinction of stomach Qi). Though wanting to speak, the tongue cannot protrude.
Persistent rapid pulse that stops indicates pathogen accumulation and failure of Zheng Qi to recover. Pathogen floats with skin/hair. Rapid pulse contraindicates purgation; purgation causes irritability and persistent diarrhea.
Cold damage with fever, headache, and slight sweating. Diaphoresis causes confusion. Moxibustion causes wheezing, urinary retention, and abdominal fullness. Purgation causes shortness of breath, difficult urination, headache, and stiff back. Warm needle therapy causes epistaxis.
Diarrhea with a large pulse indicates deficiency due to forced purgation. If the pulse is floating and革 (Ge), with borborygmus, it belongs to Danggui Sini Decoction.