痘出五藏主证形,呵欠顿嗽是肝经,肺证欬凉痰嚏涕,心证惊颊面赤红,
脾证喜睡肢热利,耳尻俱凉是肾征,肝泡肺脓心赤小,脾大黄浅肾黑形。
[注]
痘疮之毒伏于五藏,故内出何藏,外即应之,
如呵欠顿闷,此痘出肝经证也,
欬嗽有痰,喷嚏泣涕,此痘出肺经证也,
惊悸烦燥,面色红赤,此痘出心经证也,
喜睡自利,四肢发热,此痘出脾经证也,
惟肾经但见耳尻发凉者,是火不能胜水也,
肝痘之形为水泡,其包青而小,
肺痘之形为脓泡,其色白而大,
心痘之形色赤而小,
脾痘之形其色黄浅而大,
至于肾经不宜有证,若水不胜火,痘色黑者,非吉兆也。
%
额心颏肾鼻脾部,左颊肝位右肺方,周身分主面属胃,头背膀胱腰肾疆,
心肺胸膈肝胆胁,腹肢属脾大小肠,包络之络联藏府,三焦之气应无方.
[注]
小儿出痘,自头面以及周身,各有藏府所属部位,
治者须详察部位以定吉凶,
如额先见点者,是毒发于心也,
颏先见点者,毒发于肾也,
左颊先见点者,毒发于肝也,
右颊先见点者,毒发于肺也,
鼻先见点者,毒发于脾也,
面属胃经部位也,
头背属膀胱经部位也,
腰属肾经部位也,
胸膈属心肺二经部位也,
胁旁属肝胆二经部位也,
肚腹四肢属脾大小肠三经部位也,
至于包络乃周身脂膜之络联属百骸藏府者也,
三焦为周身水精之气,充满躯壳藏府者也,
凡周身发痘,俱从此出,无故一定部位也。
%
痘疮在五脏的表现及其主要证候形态如下:呵欠和突然咳嗽是肝经的证候;肺经的证候表现为咳嗽、怕冷、有痰、打喷嚏和流鼻涕;心经的证候表现为惊悸、脸颊和面色红赤;脾经的证候表现为嗜睡、四肢发热和腹泻;耳朵和尾骨(尻)都发凉,这是肾经的征象。肝经痘疮的形态为水泡,肺经痘疮的形态为脓泡,心经痘疮颜色红而小,脾经痘疮颜色黄且浅大,肾经痘疮颜色黑。
[注]
痘疮的毒邪潜伏在五脏,因此内里哪一脏受邪,外部就会相应出现症状。
比如呵欠和突然胸闷,这是痘疮出于肝经的证候;
咳嗽有痰,打喷嚏流泪流鼻涕,这是痘疮出于肺经的证候;
惊悸烦躁,面色红赤,这是痘疮出于心经的证候;
嗜睡且自发性腹泻,四肢发热,这是痘疮出于脾经的证候;
只有肾经仅见耳朵和尾骨发凉的,这是因为火不能战胜水(阳气不足,阴寒内盛);
肝经痘疮的形状是水泡,其包膜青色且较小;
肺经痘疮的形状是脓泡,其颜色白色且较大;
心经痘疮的形状和颜色是红色且较小;
脾经痘疮的形状颜色黄而浅且大;
至于肾经本不应有明显的证候,如果水不能胜火(此处原文逻辑似指阴阳失衡或毒邪深陷),痘色变黑的,不是吉兆。
额头、心区、下巴属肾,鼻子属脾部,左颊属肝位,右颊属肺方。周身分部中,面部属胃经管辖,头部和背部属膀胱经管辖,腰部属肾经疆域。心脏和肺部位于胸膈,肝脏和胆囊位于胁肋,腹部和肢体属脾、小肠和大肠管辖。心包络的络脉联系着脏腑,三焦之气遍布全身而无固定方位。
[注]
小儿出痘疮,从头部面部一直到周身,各有脏腑所属的部位。
治疗者必须详细察看病灶部位以判断吉凶预后。
比如额头先出现痘点的,是毒邪发于心;
下巴先出现痘点的,是毒邪发于肾;
左颊先出现痘点的,是毒邪发于肝;
右颊先出现痘点的,是毒邪发于肺;
鼻子先出现痘点的,是毒邪发于脾;
面部属于胃经的部位;
头部和背部属于膀胱经的部位;
腰部属于肾经的部位;
胸部和膈部属于心和肺二经的部位;
胁肋旁侧属于肝和胆二经的部位;
肚腹和四肢属于脾、小肠、大肠三经的部位;
至于心包络,它是周身脂膜的络脉,连接归属百骸和脏腑的;
三焦是周身水谷精微之气的通道,充满躯壳和脏腑的;
凡是周身发出的痘疮,都从此处发出,没有固定不变的特定部位对应关系。
The manifestations and main symptomatic forms of smallpox (or variola-like eruptions) in the Five Zang Organs are as follows: yawning and sudden coughing indicate a syndrome of the Liver Meridian; pulmonary symptoms include cough, aversion to cold, phlegm, sneezing, and runny nose; cardiac symptoms present with palpitations, flushed cheeks, and red complexion; splenic symptoms manifest as drowsiness, heat in the four limbs, and diarrhea; coolness in both the ears and the sacrum/coccyx region is a sign of the Kidney Meridian. The morphological form of liver eruptions is vesicles (water blisters); lung eruptions appear as pustules; heart eruptions are red and small; spleen eruptions are yellowish, pale, and large; kidney eruptions are black.
[Note]
The toxic pathogen of the eruptions lies dormant within the Five Zang Organs. Therefore, whichever internal organ is affected, corresponding external signs will appear.
For instance, yawning and sudden chest oppression indicate that the eruptions are emerging from the Liver Meridian.
Coughing with phlegm, sneezing, tearing, and rhinorrhea indicate that the eruptions are emerging from the Lung Meridian.
Palpitations, irritability, and a red facial complexion indicate that the eruptions are emerging from the Heart Meridian.
Drowsiness with spontaneous diarrhea and heat in the four limbs indicate that the eruptions are emerging from the Spleen Meridian.
Only when the Kidney Meridian is involved, presenting solely with coolness in the ears and sacrum, does it signify that Fire cannot overcome Water (Yang deficiency leading to Yin-cold excess).
The shape of liver eruptions is vesicular, with a greenish hue and small size.
The shape of lung eruptions is pustular, with a white color and large size.
The shape and color of heart eruptions are red and small.
The shape and color of spleen eruptions are yellowish, pale, and large.
Regarding the Kidney Meridian, significant symptoms should ideally not appear. If Water fails to control Fire (indicating pathological imbalance or deep-seated toxin), and the eruption color turns black, this is an inauspicious omen.
The forehead, the central area of the face (heart zone), and the chin correspond to the Kidney; the nose corresponds to the Spleen; the left cheek corresponds to the Liver; the right cheek corresponds to the Lungs. In the distribution of the whole body, the face is governed by the Stomach Meridian; the head and back are governed by the Bladder Meridian; the waist belongs to the Kidney Meridian. The Heart and Lungs reside in the chest and diaphragm; the Liver and Gallbladder are located in the hypochondriac region. The abdomen and limbs are governed by the Spleen, Small Intestine, and Large Intestine. The Pericardium Collateral connects with the Zang-Fu organs, while the San Jiao Qi permeates the entire body without fixed boundaries.
[Note]
When children develop eruptions, from the head and face down to the entire body, each area corresponds to specific Zang-Fu organs.
Practitioners must carefully examine the location of the lesions to determine prognosis.
For example, if spots first appear on the forehead, the toxin is erupting from the Heart.
If spots first appear on the chin, the toxin is erupting from the Kidney.
If spots first appear on the left cheek, the toxin is erupting from the Liver.
If spots first appear on the right cheek, the toxin is erupting from the Lungs.
If spots first appear on the nose, the toxin is erupting from the Spleen.
The face belongs to the Stomach Meridian territory.
The head and back belong to the Bladder Meridian territory.
The waist belongs to the Kidney Meridian territory.
The chest and diaphragm belong to the territories of the Heart and Lung meridians.
The hypochondriac sides belong to the territories of the Liver and Gallbladder meridians.
The abdomen and four limbs belong to the territories of the Spleen, Small Intestine, and Large Intestine meridians.
As for the Pericardium, its collaterals are networks of adipose tissue throughout the body, connecting and belonging to the bones and Zang-Fu organs.
The San Jiao is the pathway for the essence and Qi of water and grain throughout the body, filling the trunk and Zang-Fu organs.
Eruptions appearing anywhere on the body emerge from these pathways; there is no rigid, fixed correspondence between specific body parts and specific organs in all cases.