足阳明胃经、乃两阳合明于前也。胃府者、府居中土,万物所归也。其脉起于鼻,上额,络于目,循于面,
行身之前,终于左足内踝。经曰、尺寸俱长,阳明受病也。若头额痛、目疼、鼻干、不得眠,此阳明经标病
也。不拘日数多少,即宜解肌,葛根汤。若身热烦渴,汗出恶热,此阳明经本病也,宜清邪热。若潮热自
汗,谵语发渴,不恶寒,反恶热,扬手掷足,斑黄便硬等症,此阳明胃本实也,急宜下之。故曰、在经当
解肌,在府当平热,府实则宜下。
足少阳胆经、乃前有阳明,后有太阳,居二阳之中,所以主半表半里,以胆为清净之府,无出入之路,
不论在经在府,治法俱同。其脉起于目锐皆,上头角,络耳中,循胸?行身之侧,终于右足外踝。经曰、
尺寸俱弦,少阳受病也。其症头角痛而目眩,胸?痛而耳聋,寒热呕而口苦,皆少阳症也。此经有三
禁,不可汗,不可下,不可利小便也。只宜小柴胡汤加减和之。
凡头角痛耳烘烘而鸣,耳之上下肿痛,皆少阳所主部分邪火为之也。
足太阴脾经、为三阴之首,其脉始于左足内踝大指,行至腹,络于嗌,连舌本,行身之前。若寒邪卒中,
直犯本经者,一时便发,腹痛、或吐、或利、俱宜温之。若四五日而发,腹满嗌干,此传经之邪也,又宜和
之。如不渴而利者,寒也,理中汤温之。渴而利者,热也,猪苓汤清之。
寒热二症,皆有腹满,以热陷于内,邪气盛而充塞也,寒盛于内,胃气虚而壅滞也。
足阳明胃经,是两阳之气在身体前部会合而显明之处。胃腑位居中土(脾胃属土,居中央),是万物归聚之所。其经脉起于鼻旁,上行至额部,联络眼部,沿面部行走,经过身体前面,终于左足内踝处。医经说:寸脉和尺脉都呈现长象,是阳明经受邪所致。如果出现头额疼痛、眼睛疼痛、鼻子干燥、无法安睡等症状,这是阳明经的标病(外在表现病症)。不论患病天数多少,都应当采用解肌的方法治疗,使用葛根汤。如果身体发热、心烦口渴、出汗且怕热,这是阳明经的本病(内在本质病症),应当清除邪热。如果出现定时发热、自然出汗、胡言乱语、口渴、不怕冷反而怕热、挥手踢脚、出现斑疹发黄、大便干硬等症状,这是阳明胃腑的实证,必须紧急使用攻下法治疗。所以说:病在经应当解肌,病在腑应当平抑热势,腑气实结则适宜用攻下法。
足少阳胆经,前面有阳明经,后面有太阳经,居于这两阳经之间,所以主管半表半里(病位介于表里之间)的病证。因为胆是清净之腑,没有直接出入的路径,无论病在经还是在腑,治疗方法基本相同。其经脉起于眼外角,上行至头角,联络耳中,沿胸部侧面行走于身体一侧,终于右足外踝处。医经说:寸脉和尺脉都呈现弦象,是少阳经受邪所致。其症状包括头角疼痛且目眩、胸胁疼痛且耳聋、寒热往来、呕吐且口苦,这些都是少阳病的症状。这条经脉有三项禁忌,不可发汗,不可攻下,不可利小便。只适宜用小柴胡汤加减来调和治疗。凡是头角疼痛、耳朵轰隆作响、耳朵上下肿痛,都是少阳经所主部位受到邪火侵袭所致。
足太阴脾经,是三阴经之首,其经脉始于左足内踝和大脚趾,行至腹部,联络咽喉,连接舌根,行走在身体前面。如果是寒邪突然中伤,直接侵犯本经,会立即发病,出现腹痛、或呕吐、或腹泻,都适宜用温法治疗。如果是四五日后才发病,出现腹部胀满、咽喉干燥,这是传经而来的邪气,又适宜用和法治疗。如不口渴且腹泻的,属于寒证,用理中汤温中散寒。如口渴且腹泻的,属于热证,用猪苓汤清热利湿。寒证和热证两种病症,都有腹部胀满的表现,热证是因为热邪陷入体内,邪气旺盛而充塞;寒证是因为寒邪盛于体内,胃气虚弱而壅滞不通。
The Foot-Yangming Stomach Meridian is where the two Yang energies combine and manifest in the anterior aspect of the body. The Stomach Fu-organ resides in the Central Earth (Spleen and Stomach belong to Earth, situated in the center), serving as the gathering place for all things. Its vessel originates from beside the nose, ascends to the forehead, connects with the eye, follows the face, travels along the anterior aspect of the body, and terminates at the medial malleolus of the left foot. The classics state: when both the Cun (inch) and Chi (cubit) pulses are long, it indicates disease in the Yangming channel. If there is pain in the forehead and temples, eye pain, dryness of the nose, and insomnia, this constitutes the *biao* disease (manifestation/exterior symptoms) of the Yangming channel. Regardless of the number of days since onset, one should employ the method of resolving the muscle layer (*jie ji*), using Ge Gen Tang (Pueraria Decoction). If there is fever, irritability, thirst, sweating, and aversion to heat, this constitutes the *ben* disease (root/interior symptoms) of the Yangming channel, and one should clear the pathogenic heat. If there is tidal fever, spontaneous sweating, delirium, thirst, aversion to cold being absent but aversion to heat present, waving hands and kicking feet, appearance of macules and jaundice, and hard stool, these are signs of excess syndrome in the Yangming Stomach Fu-organ; urgent purgation is required. Thus it is said: when the disease is in the channel, resolve the muscle layer; when in the Fu-organ, pacify the heat; when the Fu-organ is full/excess, purgation is appropriate.
The Foot-Shaoyang Gallbladder Meridian lies between the Yangming anteriorly and the Taiyang posteriorly, thus governing disorders of the half-exterior half-interior level. Since the Gallbladder is a pure and clear Fu-organ without direct pathways of entry or exit, the treatment principles are similar whether the disease is in the channel or the Fu-organ. Its vessel originates from the lateral canthus of the eye, ascends to the temporal angle, connects with the interior of the ear, follows the chest and hypochondrium along the lateral aspect of the body, and terminates at the lateral malleolus of the right foot. The classics state: when both the Cun and Chi pulses are wiry (*xian*), it indicates disease in the Shaoyang channel. Symptoms include pain in the temporal region and vertigo, chest and hypochondriac pain and deafness, alternating chills and fever, vomiting, and bitter taste in the mouth; these are all Shaoyang syndromes. This channel has three prohibitions: sweating is contraindicated, purgation is contraindicated, and promoting urination is contraindicated. One should only use Xiao Chai Hu Tang (Minor Bupleurum Decoction) with modifications to harmonize. Whenever there is pain in the temporal region, roaring tinnitus, and swelling and pain above and below the ear, these are caused by pathogenic fire affecting the areas governed by the Shaoyang channel.
The Foot-Taiyin Spleen Meridian is the head of the Three Yin channels. Its vessel begins at the medial malleolus and big toe of the left foot, travels to the abdomen, connects with the pharynx, links to the root of the tongue, and travels along the anterior aspect of the body. If cold pathogenic factors strike suddenly and directly invade this channel, symptoms appear immediately, such as abdominal pain, vomiting, or diarrhea; warming methods are appropriate. If symptoms appear after four or five days, with abdominal fullness and dryness of the pharynx, this is pathogenic qi transmitted via the channels, and harmonizing methods are appropriate. If there is no thirst accompanied by diarrhea, it is a cold syndrome, treated with Li Zhong Tang (Regulate the Middle Decoction) to warm the middle. If there is thirst accompanied by diarrhea, it is a heat syndrome, treated with Zhu Ling Tang (Polyporus Decoction) to clear heat and promote diuresis. Both cold and heat syndromes present with abdominal fullness. In heat syndromes, heat sinks inward, and pathogenic qi becomes excessive and obstructive. In cold syndromes, cold is excessive internally, and the Stomach Qi is deficient and stagnant.