肠 便血，身热则死，寒则生。（肠 ，滞下也，利而不利之谓。便血，赤利也。身热者，阳胜阴败，
故死；寒则荣气未伤，故生。）肠 下白沫，脉沉则生，脉浮则死。（白沫，白利也。病在阴而见
阴脉者为顺，故生见；阳脉者为逆，故死。）肠 下脓血，脉悬绝则死，滑大则生。（下脓血者，见白赤而言
也。悬绝者，谓太过则坚而搏，不足则微而脱，皆胃气去而真脏见也。邪实正虚，势相悬绝，故死。
滑因血盛，大以气充，血气未伤，故生。）肠 之属，身不热，脉不悬绝，亦得滑大者曰生，悬涩者曰死，
以脏期之。（以脏期之者，肝见庚辛死，心见壬癸死，肺见丙丁死，脾见甲乙死，肾见戊己死。肠
一症，即今之所谓痢疾也。自仲景而后，又谓之滞下，无有能治者，惟薛立斋独得其义，欲相资借，当读其书。）
病有少腹盛，上下左右皆有根，名曰伏梁。（伏，藏伏也。梁，强梁坚硬之谓。）裹大脓血，居肠
胃之外，不可治，治之每切按之致死。（按，抑也。切按之者，谓过于妄攻也，故必致死。）
何也？此下则因阴，必下脓血，上则迫胃脘，生膈挟胃脘内痈。（此病连居三阴、冲、带之间，裹大脓血而
伏于肠胃之外。其上下左右皆有根系，故下行者能下脓血，上行者能迫胃脘，致生膈胃间痈疡也。）
此久病也，难治。（此非一朝夕所致者，延积既久，根结日深，故不易治。）居齐上为逆，居齐下为从。（
居脐上则渐逼心肺，故为逆；在下者其势犹缓，故为从。心脉微缓为伏梁，在心下，上下行，时唾血；又手
少阴之筋病，内急，心承伏梁；又心之积名曰伏梁，起脐上，大如臂，上
至心下。然此既云齐上为逆，齐下为从，下文又云“环齐而痛，病名伏梁”，是不独以心积为伏梁也，盖
凡积有内伏而坚强者，皆得名之，独言伏梁者，其总诸积为言也。）勿动亟夺。（动，动大便也，夺，夺土
郁也。皆下之之谓。言勿得妄攻而数夺其胃气，不及于病，徒伤无益也。）有曰人有身体髀股 皆肿，环齐
而痛，病名伏梁。（此亦在冲脉之分，而结于脐腹者也。冲脉之在上者，出颃颡，循背里；在中者，挟齐
腹；在下者，伏行股足之间，故其为病如此。）此风根也，其气溢于大肠，而着于肓；肓之原在齐下，故环
齐而痛也。（风根，即寒气也，如积之始生得寒，乃生厥，乃成积，即此谓也。肓之原在齐下，即
下气海也，一名下肓，谓之脖 者即此，今病在冲脉，则与大、小肠相附，而当气海之间，故其为病如此。）
不可动之，动之为水溺涩之病。（不当动而妄下之，则反伤其阴，阴伤则积气愈壅于下，而水道为之不利也。）
病胁下满，气逆，二三岁不已，名曰息积。（积不在中而在胁之下者，初起微小，久而至大，则胁满、气
逆、喘促、息难，故曰“息积”。今人有积在胁之下，俗名为痞者，其即此症，惟小儿为尤多，盖以
胃之大络名曰虚里，贯膈胳肺，出于左乳下，其动应衣，为阳明宗气所出之道也。若饮食过伤，脾不及化，
则余气留滞而结聚于此，其根正在胁间。阳明病剧，则上连于肺，此其所以为息积也。）此不妨于食，不可
灸刺，积为导引、服药，药不能独治也。（积不在胃，故不妨于食。喘者忌灸，恐助火邪；羸者忌刺，恐泻
胃气，故必渐次积为导引，久久行之，以开其滞，仍用药饵以和其气，二者并行，斯病可愈；若专恃于
药，而不积为导引，则药亦不能独治之，可见治之不易也。）
人有尺脉数甚，筋急而见。（尺脉数甚，阴邪有余，而水不足也。筋急而见，筋脉拘急而形色外见也。
筋者肝之合，阴气不足则肝失所养，故筋急而见。）所谓疹筋，是人腹必急，白色黑色见，则病甚。
（疹筋者，病在筋也。尺外以候肾，尺里以候腹，故尺脉数甚则候当在腹。
腹者，太阴、阳明之所布，今其肝邪外见而腹为胀急，乃木贼伤脾之病也。若其色见白黑，则
阳气内亏，病为尤甚。）
肠澼（痢疾）患者出现便血，如果身体发热则预后不良会死亡，如果身体发凉则预后良好能生存。（肠澼，即痢疾，指排便不畅、里急后重的症状。便血，即赤痢。身体发热，说明阳邪亢盛而阴气败坏，所以致死；身体发凉，说明营气未受损伤，所以能生。）肠澼患者排出白色粘液，脉象沉伏则预后良好能生存，脉象浮取则预后不良会死亡。（白沫，即白痢。病位在阴分而见到阴脉为顺证，所以能生；见到阳脉为逆证，所以致死。）肠澼患者排出脓血，脉象悬绝（极度异常）则预后不良会死亡，脉象滑大则预后良好能生存。（排出脓血，是相对于白痢和赤痢而言的。悬绝，指脉象太过则坚硬搏指，不足则微弱欲脱，这都是胃气已去而真脏脉显现的表现。邪气实而正气虚，病情势态悬殊，所以致死。滑脉因血气旺盛所致，大脉因气机充盛所致，血气未受损伤，所以能生。）属于肠澼一类的疾病，如果身体不发热，脉象不悬绝，且脉象呈现滑大的，称为能生存；脉象悬涩的，称为死亡，可以根据五脏对应的日期来推测死期。（根据五脏对应日期推测死期，是指肝病患者在庚辛日死亡，心病患者在壬癸日死亡，肺病患者在丙丁日死亡，脾病患者在甲乙日死亡，肾病患者在戊己日死亡。肠澼这一病症，就是今天所说的痢疾。自从张仲景之后，又被称为滞下，没有人能治好，只有薛立斋独自掌握了其治疗要领，想要借鉴参考，应当阅读他的著作。）
有一种病表现为小腹部胀满坚实，上下左右都有根结，名叫伏梁。（伏，指藏伏在内；梁，指强梁坚硬。）病灶包裹着大量的脓血，位于肠胃之外，无法治愈，如果强行治疗，每次切按都会导致患者死亡。（按，指按压。切按，指过度地妄用攻下法，所以必然导致死亡。）为什么呢？因为这种病向下发展就会损伤阴分，必然导致排出脓血；向上发展就会压迫胃脘，形成膈症并夹杂胃脘内部的痈疡。（此病连居三阴经、冲脉、带脉之间，包裹大量脓血而潜伏在肠胃之外。其上下左右都有根系连接，所以下行会导致排出脓血，上行会压迫胃脘，导致在膈胃之间产生痈疡。）这是久病，难以治愈。（这不是一朝一夕形成的，拖延积累已久，根结日益加深，所以不容易治疗。）病灶位于脐上为逆证，位于脐下为顺证。（位于脐上则逐渐逼近心肺，所以为逆证；位于下方则病势尚缓，所以为顺证。心脉微缓为伏梁，病位在心下，上下移动，时常唾血；另外手少阴心经的筋病，内部拘急，心脏承受伏梁之邪；还有心的积块名叫伏梁，起于脐上，大如手臂，上至心下。然而这里既然说脐上为逆，脐下为从，下文又说“环绕脐部疼痛，病名伏梁”，说明不仅仅以心之积块为伏梁，大概凡是积块内伏而坚硬的，都可以得名，单独说伏梁，是总括各种积块而言的。）不要随意触动或急于攻夺。（动，指扰动大便；夺，指剥夺脾胃之气。都是指攻下的方法。意思是不得妄用攻下法而多次剥夺胃气，这样不仅治不好病，反而徒然受伤无益。）有人说有人身体大腿和小腿都肿胀，环绕脐部疼痛，病名伏梁。（这也发生在冲脉分布的区域，结聚在脐腹部位。冲脉在上部的，出于颃颡，沿背部内侧下行；在中部的，挟持脐腹；在下部的，伏行于大腿小腿之间，所以发病时会出现这种情况。）这是风邪的根本，风气溢入大肠，并附着于肓膜；肓膜的根源在脐下，所以环绕脐部疼痛。（风根，即寒气，如积块开始生成时得到寒气，于是产生厥逆，进而形成积块，说的就是这个意思。肓膜的根源在脐下，即下气海，又名下肓，称为脖胦的就是这个部位，现在病在冲脉，则与大、小肠相邻，处于气海之间，所以发病时会出现这种情况。）不可触动它，一旦触动就会造成小便涩滞不通的病证。（不应当触动而妄用攻下法，则会反过来损伤阴气，阴气受损则积气更加壅塞于下，导致水道不利。）
病见胁下胀满，气机上逆，两三年不愈，名叫息积。（积块不在中焦而在胁下，初起时微小，时间久了变大，就会出现胁下胀满、气逆、喘促、呼吸困难的症状，所以说叫“息积”。现在有人积块在胁下，俗名为痞气的，就是这种病症，其中小儿更为多见，大概因为胃的大络名叫虚里，贯穿膈肌联络肺脏，出于左侧乳下，其跳动可见于衣服，这是阳明宗气发出的通道。如果饮食过度损伤，脾脏来不及运化，那么余气留滞而结聚在此处，其根本正在胁间。阳明病严重时，向上连及肺脏，这就是之所以称为息积的原因。）这种病不影响进食，但不可用灸法和针刺，积块需要通过导引术和服药来治疗，单靠药物不能单独治愈。（积块不在胃中，所以不影响进食。气喘者忌用灸法，恐怕助长火邪；体弱者忌用针刺，恐怕泻伤胃气，所以必须逐渐积累进行导引，长久施行，以开通滞气，同时用药饵调和气机，两者并行，这样病才能痊愈；如果专门依赖药物，而不积累进行导引，那么药物也不能单独治愈它，可见治疗是不容易的。）
有人尺部脉象数而且厉害，筋脉拘急并且显露出来。（尺脉数甚，说明阴邪有余而肾水不足。筋急而见，指筋脉拘急并且形色外现。筋是肝所合的，阴气不足则肝失所养，所以筋脉拘急外现。）这就叫疹筋，这种人腹部必然拘急，如果面色出现白色或黑色，则病情严重。（疹筋，指病在筋脉。尺部外侧候肾，尺部内侧候腹部，所以尺脉数甚则病候应当在腹部。腹部是太阴、阳明经脉所布散的部位，现在肝邪外现而导致腹部胀急，这是木气克制脾土的病证。如果面色出现白黑，则阳气内亏，病情尤为严重。）
Changpi (Dysentery) patients presenting with bloody stool will die if they have a fever, but will survive if their body temperature is low. (Changpi refers to dysentery, characterized by tenesmus and difficult defecation. Bloody stool refers to bloody dysentery. Fever indicates that Yang pathogen is hyperactive while Yin Qi is exhausted, leading to death; a cool body indicates that Ying Qi has not been damaged, allowing for survival.) Patients with Changpi discharging white mucus will survive if the pulse is deep (Chen), but will die if the pulse is floating (Fu). (White mucus refers to white dysentery. When the disease is in the Yin aspect and presents with a Yin pulse, it is a favorable sign indicating survival; presenting with a Yang pulse is an unfavorable sign indicating death.) Patients with Changpi discharging pus and blood will die if the pulse is Xuanjue (extremely abnormal), but will survive if the pulse is Slippery (Hua) and Large (Da). (Discharging pus and blood is mentioned in contrast to white or bloody dysentery alone. Xuanjue refers to a pulse that is either excessively hard and beating forcefully or too weak and faint, both indicating the departure of Stomach Qi and the manifestation of the True Zang pulse. With excess pathogen and deficient healthy Qi, the disparity is extreme, leading to death. A Slippery pulse indicates abundant Blood, and a Large pulse indicates充盈 Qi; since Blood and Qi are undamaged, survival is possible.) For diseases belonging to Changpi, if the body is not hot, the pulse is not Xuanjue, and the pulse is Slippery and Large, it indicates survival; if the pulse is Xuanjue and Choppy (Se), it indicates death. The time of death can be predicted based on the Zang organs. (Predicting based on Zang organs means: Liver disease leads to death on Geng-Xin days, Heart disease on Ren-Gui days, Lung disease on Bing-Ding days, Spleen disease on Jia-Yi days, and Kidney disease on Wu-Ji days. Changpi is what is now called dysentery. Since Zhang Zhongjing, it was also known as Zhixia, and no one could cure it, until Xue Lizhai alone grasped its therapeutic principles. For reference, one should read his works.)
There is a condition where the lower abdomen is full and firm, with roots extending up, down, left, and right, named Fuliang (Hidden Beam). (Hidden implies concealed within; Beam implies strong and hard.) The lesion contains large amounts of pus and blood and resides outside the intestines and stomach. It is incurable; treatment involving palpation often leads to death. (Pressing refers to manual pressure. Excessive or reckless palpation constitutes inappropriate aggressive treatment, inevitably causing death.) Why? Because downward progression damages the Yin, leading to purging of pus and blood; upward progression compresses the epigastrium, causing Diaphragm syndrome and internal abscesses in the epigastrium. (This disease involves the three Yin meridians, Chong Mai, and Dai Mai, containing pus and blood hidden outside the intestines and stomach. Its roots extend in all directions; downward movement causes purging of pus and blood, while upward movement compresses the epigastrium, causing abscesses between the diaphragm and stomach.) This is a chronic disease and is difficult to treat. (It does not arise overnight; prolonged accumulation deepens the root and knots, making it hard to treat.) If located above the umbilicus, it is a adverse prognosis (Ni); if below the umbilicus, it is a favorable prognosis (Cong). (Location above the umbilicus approaches the heart and lungs, hence adverse; location below implies slower progression, hence favorable. A slightly slow pulse at the Heart position indicates Fuliang located below the heart, moving up and down with occasional hemoptysis. Additionally, tendon disorders of the Hand Shaoyin Meridian cause internal tension and heart bearing Fuliang. Also, an accumulation in the Heart named Fuliang starts above the umbilicus, arm-sized, extending to below the heart. However, since this text states above-umbilicus is adverse and below-umbilicus is favorable, and later mentions "pain circling the umbilicus named Fuliang," it implies Fuliang is not limited to Heart accumulations. Generally, any internal, hard accumulation can be termed Fuliang; here it serves as a general term for various accumulations.) Do not disturb or hastily deplete. (Disturb refers to disturbing bowel movements; Deplete refers to depriving Spleen Earth Qi. Both refer to purgative methods. One must not recklessly use purgatives to repeatedly deplete Stomach Qi without benefiting the disease, causing only harm.) It is said that some people have swelling in the thighs and legs, with pain circling the umbilicus, named Fuliang. (This also occurs in the distribution of the Chong Mai, knotting in the umbilical and abdominal region. The upper part of Chong Mai emerges from the pharynx, runs along the back interior; the middle part flanks the umbilical abdomen; the lower part runs伏ly between the thighs and legs, thus causing such symptoms.) This is the root of Wind pathogen. The Qi overflows into the large intestine and attaches to the Huang (Diaphragmatic Mound). The source of Huang is below the umbilicus, hence the pain circling the umbilicus. (Wind root refers to Cold pathogen. Accumulations begin with Cold, leading to Jue (reversal cold), forming accumulations. The source of Huang below the umbilicus is the Lower Qi Sea, also called Lower Huang or Bo Yang. Now that the disease is in Chong Mai, it adheres to the large and small intestines, situated between the Qi Sea, causing these symptoms.) Do not manipulate it; manipulation will lead to difficulty in urination. (Inappropriate manipulation via purgatives damages Yin. Yin damage causes further stagnation of accumulated Qi below, obstructing the water passages.)
The symptom of fullness under the hypochondrium with reverse flow of Qi persisting for two or three years is named Xi Ji (Breathing Accumulation). (Accumulations starting small in the hypochondrium grow large over time, causing hypochondriac fullness, Qi rebellion, panting, and breathing difficulty, hence "Xi Ji." Modern cases of hypochondriac accumulation, commonly called Pi Qi, match this description, especially in children. The Great Luo of the Stomach, named Xuli, pierces the diaphragm, connects to the lung, and emerges below the left breast, pulsating visibly, serving as the pathway for Yangming Zong Qi. Overeating damages the Spleen's transformation, causing residual Qi to stagnate and knot here, rooted in the hypochondrium. Severe Yangming disease extends upward to the Lung, explaining the name Xi Ji.) This condition does not affect eating, but moxibustion and acupuncture are contraindicated. Accumulations require Daoyin (guiding and pulling exercises) and herbal medicine; herbs alone cannot cure it. (Since the accumulation is not in the Stomach, eating is unaffected. Asthma patients avoid moxibustion to prevent aiding Fire pathogen; debilitated patients avoid acupuncture to prevent draining Stomach Qi. Gradual Daoyin opens stagnation, while herbs harmonize Qi. Both must be used together for recovery. Relying solely on herbs without Daoyin renders them ineffective, showing the difficulty of treatment.)
A person with a rapid and forceful Chi pulse, accompanied by tense and visible tendons, presents with Zhen Jin (Tendon Disease). (A rapid Chi pulse indicates excess Yin pathogen and insufficient Kidney Water. Visible tendon tension indicates external manifestation of tendon constraint. Tendons are associated with the Liver; insufficient Yin fails to nourish the Liver, causing tendon tension.) In Zhen Jin, the abdomen must be tight. If white or black color appears on the face, the disease is severe. (Zhen Jin indicates pathology in the tendons. The outer Chi reflects the Kidney, the inner Chi reflects the Abdomen. Thus, a rapid Chi pulse suggests abdominal pathology. The abdomen is governed by Taiyin and Yangming. Liver pathogen manifesting externally causes abdominal distension and tightness, a case of Wood overacting on Earth. Appearance of white or black facial colors indicates internal deficiency of Yang Qi, making the condition more severe.)