典藏书目

The *Classic of Internal Medicine* states: In spring, the pulse floats superficially, like a fish swimming in waves; in summer, it is at the skin level, abundant and flourishing like all things in growth; in autumn, it descends below the skin, like hibernating insects preparing to leave; in winter, it sinks into the bones, like hibernating insects tightly enclosed, while gentlemen stay indoors. Therefore, it is said: "Those who understand the interior press deeply to record [the pulse]; those who understand the exterior begin with light pressure and conclude." These six aspects constitute the general principles of pulse diagnosis. Examining them according to the meaning of the classics, one distinguishes the depth of the pathogenic location (superficial vs. deep) based on the seasonal pulses to make judgments. Regarding the distinction between interior and exterior: the floating pulse in spring, like a fish swimming, indicates the sprouting of Yang Qi; although the pulse is visible, it has not yet fully emerged from the skin. The pulse in summer at the skin level, abundant like all things, indicates the pulse is already at the skin layer. The pulse descending below the skin in autumn, as hibernating insects prepare to leave, indicates the arrival of Yin Qi in autumn; although the pulse has descended below the skin, it has not yet reached a deep sinking state. The pulse in the bones in winter, as hibernating insects are tightly enclosed, indicates the pulse has sunk deeply. From this, we know that "those who understand the interior press deeply to record" clarifies that the pulse is located in the interior, exemplified by the pulse descending below the skin in autumn and sinking into the bones in winter. "Those who understand the exterior begin with light pressure and conclude" clarifies that the pulse is located in the exterior, exemplified by the floating pulse in spring and the abundant pulse in summer. However, the reason for stating "those who understand the interior must press deeply to record" is that if the pulse is internal, only deep pressing can reveal its true nature. Stating "those who understand the exterior must begin with light pressure and conclude" implies that the pathology is revealed upon initial light pressing. Thus, by observing the pathology, one traces back to its root cause. Qixuanzi (Wang Bing) interpreted "understanding the interior" as pulse diagnosis and "understanding the exterior" as color observation, which significantly deviates from the great principle of pulse holding described by the Yellow Emperor. Detailed exposition follows: If the Heart pulse is firm and long, the patient should suffer from tongue retraction and inability to speak. Generally, a pulsing pulse indicates invasion by pathogens; if evil spirits prevail, the pulse becomes forceful. The firmness of the Heart pulse is caused by Kidney evil invading. The disease manifests as tongue retraction and inability to speak; although the tongue corresponds to the Heart, the root of the tongue is where the Shaoyin meridian disperses. The treatment method involves not only cooling the Heart but also warming the Kidneys. If the pulse is large and scattered, the condition should resolve spontaneously. If the Heart pulse presents as a *Kou* (hollow) pulse, even though it is hollow and soft, and even if there is blood loss, warm tonification should be used, supplemented with stomach-regulating herbs.

Perilla Seed (*Zisuzi*), Scutellaria Root (*Huangqin*), Peony Root (*Shaoyao*), Official Cinnamon Bark (*Guangui*) (each 10 zhu), Apricot Kernel (*Xingren*) (4 zhu, peeled and de-veined).
Grind the above ingredients into coarse powder. Decoct with ginger. Take at any time. Use one cup of water, decoct until seven-tenths remains.

If the Cun Kou pulse is deep and weak, it indicates cold-heat alternation, hernia masses (*Shanjia*), and lower abdominal pain. It is also stated that an urgent pulse indicates hernia masses and lower abdominal pain. Although the pathology is the same, the pulse differs. Qixuanzi mistakenly believed this was a transmission error in the text, failing to understand adaptability. Cold hernia (*Hanhan*) is a disease where cold qi condenses and connects to the lower abdomen to form a hernia. Hence, it is stated that the Cun Kou pulse is deep and weak, without distinguishing left or right, as both may be deep. Right-side deepness indicates Lung cold, with cold qi flowing inward; left-side deepness indicates insufficient Heart Qi, with blood invaded by cold evil causing lower abdominal pain. When an urgent pulse leads to hernia and lower abdominal pain, it refers to urgency in all six pulse positions. The classic once stated, "Diagnosing a Heart pulse that is urgent indicates hernia," which precisely refers to this. For hernia with a weak Cun pulse, warming the middle is appropriate; for hernia with an urgent pulse, soothing the middle is appropriate.

For hernia with a deep Cun pulse, use this formula.
Angelica Sinensis Root (*Danggui*), Achyranthes Bidentata Root (*Niuxi*) (each 0.5 liang), Lindera Aggregate Root (*Wuyao*), Costus Root (*Muxiang*) (each 1 fen), Peony Root (*Shaoyao*), Large Ligusticum Wallichii Rhizome (*Daxiong*) (each 10 zhu).
Grind the above ingredients into fine powder. Make pills with honey, sized like wu zi (Chinese chestnut seeds). Take 60-70 pills on an empty stomach with clear soup.

For hernia with an urgent pulse, use this formula.
Vitex Fruit (*Manjingzi*), Ephedra Stem (*Mahuang*), Ligusticum Chuanxiong Rhizome (*Xiong*), Curcuma Zedoaria Rhizome (*Peng'ezhu*) (each 10 zhu).
Grind the above ingredients into fine powder. Take 3 qian per dose with three slices of fresh ginger and one cup of water, decoct until seven-tenths remains. Take at any time.