典藏书目

The pulse of malaria naturally presents as a *Xian* (Wiry) pulse. A pulse that is wiry and rapid indicates heat; a pulse that is wiry and slow indicates cold; a pulse presenting with intermittent stops (*Dai*) and scattering indicates a critical prognosis with potential for collapse. This section explains the need to distinguish the pulses associated with malaria syndromes. Malaria arises from wind pathogens and often manifests as alternating chills and fever, predominantly involving the Shaoyang Gallbladder channel. The Gallbladder belongs to Jia Wood, hence the pulse naturally becomes wiry. A wiry pulse combined with rapidity suggests that malaria is frequently accompanied by heat syndromes; a wiry pulse combined with slowness suggests that malaria is frequently accompanied by cold syndromes. If intermittent stops occur along with a scattering quality, this indicates the depletion of righteous Qi (*Zheng Qi*), excess of pathogenic factors, and decline of righteous Qi, definitively signaling a ominous outcome.

For diarrhea and dysentery, pulses that are deep (*Chen*), small (*Xiao*), slippery (*Hua*), or weak (*Ruo*) are auspicious, whereas pulses that are full/excess (*Shi*), large (*Da*), floating (*Fu*), or surging (*Hong*), especially when accompanied by fever, are ominous. This section explains the need to distinguish the pulses associated with diarrhea and dysentery syndromes. Diarrhea is categorized into five types: Spleen-Stomach, Large Intestine, Small Intestine, and Da Jia (Great Contraction). Diarrhea can be differentiated by causes such as cold, fire, wind, summerheat, dampness, or food stagnation. Dysentery is fundamentally a disease caused by damp-heat and ministerial fire. In cases of diarrhea and dysentery, if the pulse is deep, small, slippery, or weak, it is auspicious; if the pulse is full, large, floating, or surging, it is ominous. Fullness/largeness contrasts with deficiency; floating/surging contrasts with interior conditions. When pathogenic excess and righteous decline coincide with fever, it constitutes an ominous sign.

For vomiting and reverse flow of stomach contents, a floating and slippery pulse indicates a favorable prognosis (prosperity), whereas a wiry, rapid, tight, or choppy pulse, particularly when accompanied by intestinal obstruction (constipation), indicates an unfavorable prognosis (decline). This section explains the indications and contraindications of pulses in vomiting and reverse flow syndromes. Vomiting refers to expulsion with sound and matter; regurgitation refers to expulsion without sound but with matter. When food ingested remains in the stomach for a long time and is subsequently expelled, it is called reverse flow. Pathology in the Upper Jiao should correspond to a floating pulse; if the pulse is floating and slippery, it indicates that Stomach Qi is still present, hence a favorable prognosis. If the pulse is wiry, it signifies Wood overacting on Earth (Liver attacking Spleen/Stomach); if rapid, it signifies evil fire; if tight, it signifies cold pathogens; if choppy, it signifies blood deficiency. The Stomach is the sea of water and grain. Coupled with constipation of the Large Intestine, leading to a complete lack of Yin fluids and the exhaustion of the sea of water and grain, survival is impossible.

In cholera-like disorders (Huoluan), one should not be surprised if the pulse shows intermittent stops (*Dai*); however, if there is cold extremities (*Jue Ni*) and a slow, minute pulse, this is terrifying. This section explains the need to distinguish the pulses associated with Huoluan syndromes. Vomiting accompanied by diarrhea is termed Huoluan, representing a state of yin-yang disjunction. At this time, an intermittent pulse occurs due to sudden severe vomiting and profuse diarrhea causing abrupt injury to Yuan Qi; this need not cause alarm. However, if cold extremities extend above the elbows and below the knees, and the pulse is slow and minute, this indicates severe depletion of Yang Qi and impending collapse of Yuan Qi, definitely signaling multiple ominous signs; thus, it is described as terrifying.

Coughing typically presents with a floating pulse, with pathology gathered in the Lung; a Guan position pulse that is deep, tight, or small indicates danger, whereas a floating and soft pulse indicates ease of treatment. This section explains the need to distinguish the pulses associated with coughing syndromes. Coughs vary in etiology: wind-cold invades the skin and hair, while phlegm-fluid retention occurs in the chest and Stomach. Skin and hair are the exterior extensions of the Lung; when pathogens invade these extensions, Lung Qi responds, leading to upward rebellion and coughing. The Stomach resides below the Lung; cold phlegm and frozen beverages stagnate in the middle, also rebelling upward to cause coughing. As stated in the *Neijing*: "Cold damaging the form and cold drinks injuring the lungs." Cold damaging the form injures externally, while frozen beverages and cold phlegm gather in the Stomach. Since the Lung resides at the highest position, the pulse is often floating. A deep, tight, or small pulse is dangerous because deep indicates pathogen entering the interior, tight indicates cold not dispersing, and small indicates righteous Qi decline, all signaling critical illness. A floating and soft pulse indicates the pathogen is in the exterior, hence it is said to be easy to treat.