古之论杂病，必原于脏腑，观《金匮》第一篇而其义可见焉。孙真人书，以至宋代官撰医方，多遵其规式。
故今类脏腑诸证，以其总说列之于首。但其治方，则排列于后卷各门，使学人易就证检方云。
肝病证 肝脉沉之而急，浮之亦然，苦胁下痛，有气支满，引少腹而痛，时小便难，苦目眩头痛，腰背
痛，足为逆寒，时癃，女人月信不来，时亡时有，得之少时有所坠堕。肝主胸中喘怒骂，其脉沉，胸中必窒，欲
令人推按之，有热，鼻窒。肝伤者，其人脱肉，又卧口欲得张，时时手足青，目瞑瞳人痛，此为肝脏伤所致也。肺
乘肝，即为痈肿。心乘肝，必吐利。肝病，其色青，手足拘急，胁下苦满，或时眩冒，其脉弦长，此为可治。肝
病，胸满胁胀，善恚怒叫呼，身体有热而复恶寒，四肢不举，面目白，身体滑，其脉当弦长而急，今反短涩，其
色当青而反白者，此是金之克木，为大逆。十死不治。（《脉经》）
肝实 左手关上阴实者，肝实也，苦肉中痛动，善转筋。（《脉经》）（按∶辨脏腑虚实，宜以《素问·
藏气法时论》、《灵枢·经脉篇》及叔和说等为据，故具载于此。但原文附有刺法，今省不录。）
左手关上脉阴实者，足厥阴经也，病苦心下坚满，常两胁痛，自忿忿如怒状。（同上）（按∶《千金》曰，
名曰肝实热也。）
夫肝实则生热，热则阳气盛，致心下坚满，两胁痛引小腹，忿忿如怒，气逆头眩，为血有余，即目痛，眼
赤，生 肉，阳毒所攻，悒悒先寒而后热，颈直背强筋急，不得屈伸，诊其脉浮大而数者，此是肝气实也。
（《圣惠方》）
肝实（五证）善怒，怒则气上逆，甚则呕血及飧泄；善太息，忽忽不乐；胁痛呕血，属肝气逆，肝火盛，
肝血虚；发搐，属肝家邪热，热则生风，风主掉眩故也；口赤肿痛，属血热。（《神农本草经疏》）
肝虚 左手关上阴绝者，无肝脉也，苦癃遗溺难言，胁下有邪气，善吐。（《脉经》）
左手关上脉阴虚者，足厥阴经也，病苦胁下坚，寒热，腹满不欲饮食，腹胀，悒悒不乐，妇人月经不利，腰
腹痛。（同上）（《千金》曰∶名曰肝虚寒也。）
肝气若不足，远视目失力，两胁气胀满，上下连胸臆，四肢热复冷，肚痛不能食，眼前见火生，冷泪频频拭，
不疗恐失明，此为肝不足。（《五脏论》）
夫肝虚则生寒，寒则苦胁下坚胀，寒热，腹满不欲饮食，悒悒情不乐，如人将捕之，视物不明，眼生黑花，
口苦头疼，关节不利，筋脉挛缩，爪甲干枯，喜悲恐，不得太息，诊其脉沉滑细者，此是肝虚之候也。夫肝脏虚损，
气血不荣，内伤寒冷，致使两胁胀满，筋脉拘急，四肢厥冷，心腹疼痛，眼目昏暗，手足常青，胸中不利，不能
大息者，是肝气不足之候也。（《圣惠方》）
肝虚十证∶胸胁痛，属肝血虚，肝气实，因而上逆；转筋，属血虚；目光短，属肝血虚及肾水真阴不足；目昏，
属肝血虚，有热，兼肾水真阴不足；目翳，属肝热，兼肾水不足；亡血过多，角弓反张，属肝血虚，有热；少腹连阴作
痛，按之则止，属足厥阴经血虚；偏头痛，属血虚，肝家有热，不急治，久之必损目，目黑暗眩晕，属血虚，
兼肾水真阴不足；肥气，属气血两虚，肝气不和，逆气与瘀血相并而成。（《本草经疏》）
胆实 左手关上阳实者，胆实也。苦腹中实不安，身躯习习也。（《脉经》）
左手关上脉阳实者，足少阳经也，病苦腹中气满，饮食不下，咽干头重痛，洒洒恶寒，胁痛。（同上）（《千金》
曰∶名曰胆实热也。）
夫胆是肝之腑，若肝气有余则胆实，实则生热，热则神惊而不安，起卧不定，胸中冒闷，身体习习，眉头倾萎，
口吐苦汁，心烦咽干，此胆实之候。（《圣惠方》）
胆实二证∶口苦耳聋胁痛，往来寒热；鼻渊，属胆移热于脑。（本草经疏）
胆虚 左手关上阳绝者，无胆脉也，苦膝疼，口中苦，眯目，善畏如见鬼状，多惊少力。（《脉经》）
左手关上脉阳虚者，足少阳经也，病苦眩厥痿，足指不能摇， 坐不能起，僵仆，目黄失精KT KT 。（同上）
（《千金》曰∶名曰胆虚寒也。）
胆虚二证∶易惊，属胆气虚；病后不得眠，属胆虚。（《本草经疏》）
肝胆俱实 左手关上脉阴阳俱实者，足厥阴与少阳经俱实也，病苦胃胀呕逆，食不消。（《脉经》）
肝胆俱虚 左手关上脉阴阳俱虚者，足厥阴与少阳经俱虚也，病苦恍惚，尸厥不知人，妄见少气，不能
言，时时自惊。（《脉经》）
心病证 心脉沉之小而紧，浮之不喘，苦心下聚气而
痛，食不下，喜咽唾，时手足热烦满，时忘不乐，喜大息，得之忧思。肾乘心，必癃。心病，其色赤，心痛短
气，手掌烦热，或啼笑骂詈，悲思愁虑，面赤身热，其脉实大而数，此为可治。心病，烦闷少气大热，热上荡心，
呕吐咳逆，狂语，汗出如珠，身体厥冷，其脉当浮，今反沉濡而滑，其色当赤而反黑者，此是水之克火，为大
逆，十死不治。（《脉经》）
心烦热之病，手少阴经有余所致也。其不足，则亦能令人虚烦。《圣惠方》止及实热。大抵心属火而恶热，
其受病则易以生热，热则血气壅滞，故为烦躁，寝卧不得安宁，口舌生疮，头痛颊赤之类。虚则热气内收，心神
不宁，亦为烦躁也。（《圣济总录》）
心实 左手关前寸口阴实者，心实也，苦心下有水气，忧恚发之。（《脉经》）
左手寸口人迎以前脉阴实者，手厥阴经也（《千金》作手少阴经也），病苦闭，大便不利，腹满四肢重，
身热苦胃胀。（同上）（《千金》曰∶名曰心实热也。）
夫心实则生热，热则阳气盛，阳盛则卫气不行，荣气不通，遂令热毒稽留，心神烦乱，面赤身热，口舌生
疮，咽燥头疼，喜笑恐悸，手心热满，汗出衄血，其脉洪实相搏者，是其候也。（《圣惠方》）
心实即实火实热五证∶谵语，属心家邪热；舌破，属心火；烦躁，属心家邪热，及心火内炎；自笑，属心家
有热邪；发狂，属心家有邪热甚。（《本草经疏》）
心虚 左手关前寸口阴绝者，无心脉也，苦心下毒痛，掌中热，时时善呕，口中伤烂。（《脉经》）
左手寸口人迎以前脉阴虚者，手厥阴经也（《千金》作
手少阴经也），病苦悸恐不乐，心腹痛，难以言，心如寒状，恍惚。（同上）（《千金》曰∶名曰心虚寒也。）
心气若不足，衄血眼中黄，悲愁及喜怒，烦闷即慌忙，梦寤不自觉，心热须水浆，咽喉中满痛，舌强口夸张，
冷汗出不止，妄语忽惊忙，此为损心气，不疗转加伤。（《五脏论》）
夫心虚则生寒，寒则阴气盛，阴盛则血脉虚少而多恐畏，情绪不乐，心腹暴痛，时唾清涎，心膈胀满，好忘
多惊，梦寤飞扬，精神离散，其脉浮而虚者，是其候也。（《圣惠方》）
心虚八证∶惊邪，属心气虚；癫痫，属心气虚，有热；不得眠，属心血虚，有热；心烦，属心家有热；怔忡，
属心血不足；心淡淡动；盗汗，属心血虚，汗者，心之液也；伏梁，属心经气血虚，以致邪留不去。（《本草经
疏》）
小肠实 左手关前寸口阳实者，小肠实也，苦心下急痹（一作急痛），小肠有热，小便赤黄。（《脉经》）
左手寸口人迎以前脉阳实者，手太阳经也，病苦身热，热来去，汗出（一作汗不出）而烦，心中满，身重，
口中生疮。（同上）（《千金》曰∶名曰小肠实热也。）
小肠象火，王于夏，手太阳其经也，心之府也。水液之下行为溲便者，流于小肠。其气盛为有余，则病小
肠热，焦竭干涩，小肠 胀，是为小肠之气实也，则宜泻之。（《病源论》）
小肠实一证，小水不利及赤，或涩痛尿血。（《本草经疏》）
小肠虚 左手关前寸口阳绝者，无小肠脉也，苦脐痹，小腹中有疝瘕，王月（王字一本作五）即冷上抢心。
（《脉经》）
左手寸口人迎以前脉阳虚者，手太阳经也，病苦颅际偏头痛，耳颊痛。（同上）（《千金》曰∶名曰小肠
虚寒也。）
小肠不足，则寒气客之，肠病惊跳，不言，乍来乍去，是为小肠气之虚也，则宜补之。（《病源论》）
（《圣惠方》作肠中痛，惊跳，乍来乍去，小便数。）
小肠虚一证，遗尿，属小肠气虚，兼肾气虚。（《本草经疏》）
心小肠俱实 左手寸口人迎以前脉阴阳俱实者，手少阴与太阳经俱实也，病苦头痛身热，大便难，心腹
烦满，不得卧，以胃气不转，水谷实也。（《脉经》）（《千金》曰∶名曰心、小肠俱实也。）
心小肠俱虚 左手寸口人迎以前脉阴阳俱虚者，手少阴与太阳经俱虚也，病苦洞泄，苦寒少气，四肢寒，
肠。（《脉经》）（《千金》曰∶名曰心、小肠俱虚也。）
脾病证 寸口脉缓而迟，缓则为阳，其气长，迟则为阴，荣气促（按∶促字当考），荣卫俱和，刚柔相
得，三焦相承，其气必强。趺阳脉滑而紧，滑即胃气实，紧即脾气伤，得食而不消者，此脾不治也。能食而腹不
满，此为胃气有余。腹满而不能食，心下如饥，此为胃气不行，心气虚也，得食而满者，此为脾家不治。脾气
弱，病利下白肠垢，大便坚不能更衣，汗出不止，名曰脾气弱，或五液注下青黄赤白黑。病患鼻下平者，胃病也。
微赤者病发痈，微黑者有热，青者有寒，白者不治，唇黑者胃先病，微燥而渴者可治，不渴者不可治，脐反出
者此为脾先落（一云先终）。脾病，其色黄，饮食不消，腹苦胀满，体重节痛，大便不利，其脉微缓而长，此为
可治。脾病，其色黄体青，失溲直视，唇反张，爪甲青，饮食吐逆，体重节痛，四肢不举，其脉当浮大
而缓，今反弦急，其色当黄，今反青，此是木之克土，为大逆，十死不治。（《脉经》）
脾中寒热，则皆使人腹中痛，不下食。又脾病，则舌强语涩，转筋卵缩，牵阴股，引髀痛，身重不思食，鼓
胀，变则水泄，不能卧者，死不治也。脾正热，则面黄目赤，季胁痛满也。寒则吐涎沫而不食，四肢痛，滑泄
不已，手足厥，甚则颤栗如疟也。（《中藏经》）
脾实 右手关上阴实者，脾实也，苦肠中伏伏如坚状，大便难。（《脉经》）
右手关上脉阴实者，足太阴经也，病苦足寒胫热，腹胀满，烦扰不得卧。（同上）（《千金》曰∶名曰脾实
热也。）
夫脾实则生热，热则阳气盛，阳气盛则心胸烦闷，唇口干焦，身热烦疼，体重不能转侧，语声沉而心急，
咽喉痛而不利，舌本肿强，口内生疮，腹胁胀满，不得安卧，梦见歌乐，四肢怠惰，诊其脉紧实者，是脾实之候。
（《圣惠方》）（《圣济总录》更有语言謇难，面目黑黄证。）
脾实即湿热邪胜六证∶蛊胀，由于脾家湿热积滞，或内伤瘀血，停积而成；易饥，属脾家邪火，口唇生疮；
口糜；中消，属脾家实火，湿热腹痛，按之愈甚。（《本草经疏》）
脾虚 右手关上阴绝者，无脾脉也，苦少气下利，腹满身重，四肢不欲动，善呕。（《脉经》）
右手关上脉阴虚者，足太阴经也，病苦泄注，腹满气逆，霍乱呕吐，黄胆，心烦不得卧，肠鸣。（同上）
（《千金》曰∶名曰脾虚冷也。）
脾气若不足，令人面目黄，食即欲呕逆，唇干复口疮，气胀四肢重，意和并 惶，不欲闻人语，脾渴即须浆，
此为脾不足，急疗可为良。医人（《五脏论》）（医人二字衍。）
夫脾者，位居中央，王于四季，受水谷之精气，化气血以荣华，周养身形，灌溉脏腑者也。若虚则生寒，
寒则阴气盛，阴气盛则心腹胀满，水谷不消，喜噫吞酸，食则呕吐，气逆霍乱，腹痛肠鸣，时自泄利，四肢沉重，
常多思虑，不欲闻人声，梦见饮食不足，诊其脉沉细软弱者，是脾虚之候也。（《圣惠方》）
夫脾受水谷之精，化为气血，养于脏腑，充于肌肤。若其气不荣，则不能与胃行其精液，周养身形，致体重
懈惰，四肢不举，腹胁虚胀，胁满咽干，不能嗜食，纵食欲呕，水谷不化，泄利肠鸣，则是脾气不足之候也。
（同上）
脾虚十二证∶饮食劳倦，伤脾发热；饮食不消化，属脾气虚；伤食，必恶食；停饮，为恣饮汤水或冷茶、
冷酒所致；水肿，属脾气虚；脾虚中满，属脾气虚，兼脾阴虚（昼剧夜静，属脾气虚，夜剧昼静，属脾阴虚）；
噎膈，属气血两虚，由于血液衰少，而非痰气壅逆所成；脾泄，属气虚；健忘，属气血两虚；倦怠嗜卧，属脾
气不足；脾虚腹痛，按之则止，属血虚；痞气，属脾气虚，及气郁所致。（《本草经疏》）
胃病证 胃中有癖，食冷物者痛不能食，食热即能食。趺阳脉浮者，胃气虚也。趺阳脉浮大者，此胃
家微虚烦，圊必日再行。芤而有胃气者，脉浮之大而 ，微按之芤，故知芤而有胃气也。趺阳脉数者，胃中
有热，即消谷引食（按∶此《金匮·消渴篇》中文）。趺阳脉涩者，胃中有寒，水谷不化。趺阳脉粗粗而浮者，
其病难治。趺阳脉浮迟者，故久病。趺阳脉虚则遗溺，实则失气。动作头痛重，热气朝者，属胃。（《脉经》）
古代论述杂病，必定追溯其根源于脏腑，观察《金匮要略》的第一篇就可以明白其中的道理。孙思邈（孙真人）的著作，以及宋代的官方编纂医方，大多遵循这种体例规范。
因此，现在将脏腑各类证候分类，把总论部分列在卷首。但是具体的治疗方剂，则排列在后卷的各个门类中，以便学习者容易根据证候查找方剂。
肝病证 肝脉重按（沉取）而急迫，轻取（浮取）也是如此，患者苦于胁下疼痛，有气支撑胀满，牵引少腹疼痛，时常小便困难，苦于目眩头痛，腰背疼痛，足部逆冷，时常尿闭不通，女性月经不来或时断时续，这是由于年少时有过坠堕损伤所致。肝主司胸中的喘息、发怒和骂人，如果肝脉沉，胸中必然窒闷，想要让人推按胸部，如果有热邪，会导致鼻塞。肝脏受伤的人，肌肉消瘦脱失，睡觉时口张开，时常手足发青，眼睛昏花瞳孔痛，这是肝脏受伤所导致的。肺金乘袭肝木，就会发生痈肿。心火乘袭肝木，一定会呕吐腹泻。患肝病，面色发青，手足拘挛紧急，胁下苦于胀满，有时眩晕昏冒，脉象弦长，这是可以治疗的。患肝病，胸满胁胀，容易愤怒呼叫，身体发热却又怕冷，四肢不能举动，面目苍白，身体滑润，脉象应当弦长而急，现在反而短涩，面色应当青而反白，这是金克木，属于大逆证，十死无救。（出自《脉经》）
肝实 左手关部阴位脉实，是肝实证，苦于肌肉内部疼痛且跳动，容易转筋。（出自《脉经》）（按：辨别脏腑虚实，适宜以《素问·藏气法时论》、《灵枢·经脉篇》及王叔和的说法等为依据，所以全部记载在这里。但原文附有针刺方法，现在省略不录。）
左手关部脉阴实，是足厥阴肝经的病，病症苦于心下坚硬胀满，经常两胁疼痛，心中愤懑好像发怒的样子。（同上）（按：《千金方》说，这叫做肝实热证。）
肝实就会产生热，热则阳气盛，导致心下坚硬胀满，两胁痛牵引小腹，心中愤懑如怒，气逆头眩，这是血有余，就会眼痛，眼睛发红，长出息肉，被阳毒攻伐，情绪抑郁先寒后热，颈部僵硬背部强直筋脉紧急，不能屈伸，诊察其脉浮大而数的，这是肝气实的证候。（出自《圣惠方》）
肝实（五种证候）：容易发怒，怒则气上逆，严重时呕血及完谷不化的泄泻；喜欢叹气，精神恍惚不快乐；胁痛呕血，属于肝气逆，肝火盛，肝血虚；抽搐，属于肝家邪热，热则生风，风主掉眩的缘故；口唇红肿疼痛，属于血热。（出自《神农本草经疏》）
肝虚 左手关部阴位脉绝，是没有肝脉，苦于尿闭遗尿难言，胁下有邪气，容易呕吐。（出自《脉经》）
左手关部脉阴虚，是足厥阴肝经的病，病症苦于胁下坚硬，寒热往来，腹部胀满不想饮食，腹胀，情绪抑郁不快乐，妇女月经不利，腰腹痛。（同上）（《千金方》说：这叫做肝虚寒证。）
肝气如果不足，远视眼睛无力，两胁气胀满，上下连及胸臆，四肢发热又变冷，肚痛不能进食，眼前见火光闪烁，冷泪频频擦拭，不治疗恐怕失明，这就是肝不足。（出自《五脏论》）
肝虚就会产生寒，寒则苦于胁下坚硬胀满，寒热往来，腹部胀满不想饮食，情绪抑郁不快乐，像被人追捕一样恐惧，视物不明，眼生黑花，口苦头疼，关节不利，筋脉挛缩，指甲干枯，喜欢悲伤恐惧，不能深呼吸，诊察其脉沉滑细的，这是肝虚的证候。如果肝脏虚损，气血不能荣养，内伤寒冷，致使两胁胀满，筋脉拘急，四肢厥冷，心腹疼痛，眼目昏暗，手足常青，胸中不利，不能深呼吸的，是肝气不足的证候。（出自《圣惠方》）
肝虚十种证候：胸胁痛，属于肝血虚，肝气实，因而上逆；转筋，属于血虚；目光短浅，属于肝血虚及肾水真阴不足；目昏，属于肝血虚，有热，兼肾水真阴不足；目翳，属于肝热，兼肾水不足；亡血过多，角弓反张，属于肝血虚，有热；少腹连阴部作痛，按压则停止，属于足厥阴经血虚；偏头痛，属于血虚，肝家有热，不紧急治疗，久而久之必损眼睛，目黑暗眩晕，属于血虚，兼肾水真阴不足；肥气，属于气血两虚，肝气不和，逆气与瘀血相并而成。（出自《本草经疏》）
胆实 左手关部阳位脉实，是胆实证。苦于腹中充实不安，身体感觉习习不适。（出自《脉经》）
左手关部脉阳实，是足少阳胆经的病，病症苦于腹中气满，饮食不下，咽干头重痛，洒洒恶寒，胁痛。（同上）（《千金方》说：这叫做胆实热证。）
胆是肝的腑，如果肝气有余则胆实，实则生热，热则神志惊骇而不安，起卧不定，胸中冒闷，身体习习不适，眉头倾斜萎软，口吐苦汁，心烦咽干，这是胆实的证候。（出自《圣惠方》）
胆实两种证候：口苦耳聋胁痛，往来寒热；鼻渊，属于胆移热于脑。（《本草经疏》）
胆虚 左手关部阳位脉绝，是没有胆脉，苦于膝疼，口中苦，眯眼，容易害怕像看见鬼的样子，多惊少力。（出自《脉经》）
左手关部脉阳虚，是足少阳胆经的病，病症苦于眩晕厥逆痿软，脚趾不能摇动，坐起不能站起，僵仆倒地，目黄失精。（同上）（《千金方》说：这叫做胆虚寒证。）
胆虚两种证候：容易受惊，属于胆气虚；病后不能睡眠，属于胆虚。（《本草经疏》）
肝胆俱实 左手关部脉阴阳俱实，是足厥阴肝经与足少阳胆经俱实，病症苦于胃胀呕逆，食物不消化。（出自《脉经》）
肝胆俱虚 左手关部脉阴阳俱虚，是足厥阴肝经与足少阳胆经俱虚，病症苦于神情恍惚，尸厥不知人事，妄见幻听，少气，不能说话，时常自惊。（出自《脉经》）
心病证 心脉重按小而紧，轻取不喘，苦于心下聚气而痛，吃不下东西，喜欢吞咽唾液，时常手足热烦满，时常健忘不快乐，喜欢深呼吸，得病原因是忧思。肾水乘袭心火，一定会尿闭。患心病，面色赤红，心痛短气，手掌烦热，有时啼笑骂詈，悲思愁虑，面赤身热，脉象实大而数，这是可以治疗的。患心病，烦闷少气大热，热气上荡心胸，呕吐咳逆，胡言乱语，汗出如珠，身体厥冷，脉象应当浮，现在反而沉濡而滑，面色应当赤而反黑，这是水克火，属于大逆证，十死无救。（出自《脉经》）
心烦热的病，是手少阴心经有余所致。其不足，也能使人虚烦。《圣惠方》只涉及实热。大体中心属火而厌恶热，患病容易产生热，热则血气壅滞，所以烦躁，寝卧不得安宁，口舌生疮，头痛颊赤之类。虚则热气内收，心神不宁，也表现为烦躁。（出自《圣济总录》）
心实 左手关前寸口阴位脉实，是心实证，苦于心下有 Water Qi（水气），由忧恚引发。（出自《脉经》）
左手寸口人迎穴以前的脉阴实，是手厥阴心包经（《千金方》作手少阴心经），病症苦于闭塞，大便不利，腹部胀满四肢沉重，身热心苦胃胀。（同上）（《千金方》说：这叫做心实热证。）
心实就会产生热，热则阳气盛，阳盛则卫气不行，营气不通，于是热毒稽留，心神烦乱，面赤身热，口舌生疮，咽燥头疼，喜笑恐悸，手心热满，汗出衄血，脉象洪实相搏的，是其证候。（出自《圣惠方》）
心实即实火实热五种证候：谵语，属于心家邪热；舌破，属于心火；烦躁，属于心家邪热，及心火内炎；自笑，属于心家有热邪；发狂，属于心家有邪热甚。（出自《本草经疏》）
心虚 左手关前寸口阴位脉绝，是没有心脉，苦于心下毒痛，掌中热，时常容易呕吐，口中糜烂。（出自《脉经》）
左手寸口人迎穴以前的脉阴虚，是手厥阴心包经（《千金方》作手少阴心经），病症苦于心悸恐惧不快乐，心腹痛，难以说话，心里像寒冷一样，神情恍惚。（同上）（《千金方》说：这叫做心虚寒证。）
心气如果不足，流鼻血眼中发黄，悲伤忧愁及喜怒无常，烦闷即慌忙，梦醒不自觉，心热需要喝水浆，咽喉中满痛，舌强口张，冷汗出不止，胡言乱语忽而惊慌，这是损伤心气，不治疗会加重损伤。（出自《五脏论》）
心虚就会产生寒，寒则阴气盛，阴盛则血脉虚少而多恐惧畏惧，情绪不乐，心腹暴痛，时常唾清涎，心膈胀满，好忘多惊，梦醒飞扬，精神离散，脉象浮而虚的，是其证候。（出自《圣惠方》）
心虚八种证候：惊邪，属于心气虚；癫痫，属于心气虚，有热；不得眠，属于心血虚，有热；心烦，属于心家有热；怔忡，属于心血不足；心淡淡动（心跳微弱）；盗汗，属于心血虚，汗是心之液；伏梁，属于心经气血虚，以致邪气留恋不去。（出自《本草经疏》）
小肠实 左手关前寸口阳位脉实，是小肠实证，苦于心下急痹（一作急痛），小肠有热，小便赤黄。（出自《脉经》）
左手寸口人迎穴以前的脉阳实，是手太阳小肠经的病，病症苦于身热，热来去不定，出汗（一作不出汗）而烦，心中满，身重，口中生疮。（同上）（《千金方》说：这叫做小肠实热证。）
小肠象火，旺于夏季，手太阳小肠经是其经脉，心的腑。水液下行成为溲便的，流注于小肠。其气盛为有余，就病小肠热，焦竭干涩，小肠胀，这是小肠之气实，则宜泻之。（出自《病源论》）
小肠实一种证候，小便不利及赤，或涩痛尿血。（《本草经疏》）
小肠虚 左手关前寸口阳位脉绝，是没有小肠脉，苦于脐痹，小腹中有疝瘕，五月（一本作五字）即冷上抢心。（出自《脉经》）
左手寸口人迎穴以前的脉阳虚，是手太阳小肠经的病，病症苦于颅际偏头痛，耳颊痛。（同上）（《千金方》说：这叫做小肠虚寒证。）
小肠不足，则寒气客居其中，肠病惊跳，不说话，乍来乍去，这是小肠气之虚，则宜补之。（出自《病源论》）（《圣惠方》作肠中痛，惊跳，乍来乍去，小便频数。）
小肠虚一种证候，遗尿，属于小肠气虚，兼肾气虚。（《本草经疏》）
心小肠俱实 左手寸口人迎穴以前的脉阴阳俱实，是手少阴心经与手太阳小肠经俱实，病症苦于头痛身热，大便难，心腹烦满，不得卧，因为胃气不转，水谷实积。（出自《脉经》）（《千金方》说：这叫做心、小肠俱实证。）
心小肠俱虚 左手寸口人迎穴以前的脉阴阳俱虚，是手少阴心经与手太阳小肠经俱虚，病症苦于洞泄，苦寒少气，四肢寒，肠鸣。（出自《脉经》）（《千金方》说：这叫做心、小肠俱虚证。）
脾病证 寸口脉缓而迟，缓则为阳，其气长，迟则为阴，荣气促（按：促字当考证），荣卫俱和，刚柔相得，三焦相承，其气必强。趺阳脉滑而紧，滑即胃气实，紧即脾气伤，吃了东西不消化的，这是脾不治。能食而腹部不满，这是胃气有余。腹部胀满而不能食，心下像饥饿感，这是胃气不行，心气虚，吃了东西就胀满的，这是脾家不治。脾气弱，病利下白肠垢，大便坚硬不能更衣，汗出不止，名叫脾气弱，或者五液注下青黄赤白黑。病患鼻下平的，是胃病。微赤的是病发痈，微黑的有热，青的有寒，白的不治，唇黑的胃先病，微燥而渴的可治，不渴的不治，脐反出的这是脾先落（一说先终）。脾病，面色黄，饮食不消，腹部苦于胀满，体重节痛，大便不利，脉象微缓而长，这是可以治疗的。脾病，面色黄体青，失溲直视，唇反张，爪甲青，饮食吐逆，体重节痛，四肢不举，脉象应当浮大而缓，现在反而弦急，面色应当黄，现在反青，这是木克土，属于大逆证，十死无救。（出自《脉经》）
脾中寒热，都会使人腹中痛，不下食。另外脾病，则舌强语涩，转筋卵缩，牵拉阴股，牵引髀痛，身重不思食，鼓胀，变则水泄，不能卧的，死不治。脾正热，则面黄目赤，季胁痛满。寒则吐涎沫而不食，四肢痛，滑泄不已，手足厥，甚至颤栗像疟疾。（出自《中藏经》）
脾实 右手关部阴位脉实，是脾实证，苦于肠中伏伏像坚硬状，大便难。（出自《脉经》）
右手关部脉阴实，是足太阴脾经的病，病症苦于足寒胫热，腹胀满，烦扰不得卧。（同上）（《千金方》说：这叫做脾实热证。）
脾实就会产生热，热则阳气盛，阳气盛则心胸烦闷，唇口干焦，身热烦疼，体重不能转侧，语声沉而心急，咽喉痛而不利，舌本肿强，口内生疮，腹胁胀满，不得安卧，梦见歌乐，四肢怠惰，诊察其脉紧实的，是脾实的证候。（出自《圣惠方》）（《圣济总录》更有语言謇难，面目黑黄证。）
脾实即湿热邪胜六种证候：蛊胀，由于脾家湿热积滞，或内伤瘀血，停积而成；易饥，属于脾家邪火，口唇生疮；口糜；中消，属于脾家实火，湿热腹痛，按之愈甚。（出自《本草经疏》）
脾虚 右手关部阴位脉绝，是没有脾脉，苦于少气下利，腹满身重，四肢不欲动，善呕。（出自《脉经》）
右手关部脉阴虚，是足太阴脾经的病，病症苦于泄注，腹满气逆，霍乱呕吐，黄疸，心烦不得卧，肠鸣。（同上）（《千金方》说：这叫做脾虚冷证。）
脾气如果不足，令人面目黄，食后即欲呕逆，唇干复口疮，气胀四肢重，意和并惶，不欲闻人语，脾渴即须浆，这是脾不足，急疗可为良。医人（《五脏论》）（“医人”二字衍文。）
脾者，位居中央，旺于四季，受水谷之精气，化气血以荣华，周养身形，灌溉脏腑。如果虚则生寒，寒则阴气盛，阴气盛则心腹胀满，水谷不消，喜噫吞酸，食则呕吐，气逆霍乱，腹痛肠鸣，时自泄利，四肢沉重，常多思虑，不欲闻人声，梦见饮食不足，诊察其脉沉细软弱者，是脾虚的证候。（出自《圣惠方》）
脾受水谷之精，化为气血，养于脏腑，充于肌肤。如果其气不荣，则不能与胃行其精液，周养身形，致体重懈惰，四肢不举，腹胁虚胀，胁满咽干，不能嗜食，纵食欲呕，水谷不化，泄利肠鸣，则是脾气不足的证候。（同上）
脾虚十二种证候：饮食劳倦，伤脾发热；饮食不消化，属于脾气虚；伤食，必恶食；停饮，为恣饮汤水或冷茶、冷酒所致；水肿，属于脾气虚；脾虚中满，属于脾气虚，兼脾阴虚（昼剧夜静，属于脾气虚，夜剧昼静，属于脾阴虚）；噎膈，属于气血两虚，由于血液衰少，而非痰气壅逆所成；脾泄，属于气虚；健忘，属于气血两虚；倦怠嗜卧，属于脾气不足；脾虚腹痛，按之则止，属于血虚；痞气，属于脾气虚，及气郁所致。（出自《本草经疏》）
胃病证 胃中有癖，吃冷物者痛不能食，吃热物即能食。趺阳脉浮的，是胃气虚。趺阳脉浮大的，这是胃家微虚烦，厕所必日再行。芤而有胃气的，脉浮之大而中空，微按之芤，故知芤而有胃气。趺阳脉数的，胃中有热，即消谷引食（按：此《金匮·消渴篇》中文）。趺阳脉涩的，胃中有寒，水谷不化。趺阳脉粗粗而浮的，其病难治。趺阳脉浮迟的，故久病。趺阳脉虚则遗溺，实则失气。动作头痛重，热气朝者，属于胃。（出自《脉经》）
Ancient discussions on miscellaneous diseases (Zabing) invariably trace their origins to the Zang-Fu organs. This principle can be understood by observing the first chapter of *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet). Sun Simiao's works and official medical formularies compiled in the Song Dynasty largely adhered to this structural model.
Therefore, the various syndromes of the Zang-Fu organs are classified here, with the general discussion placed at the beginning. However, specific treatment formulas are arranged in the later volumes under respective categories, facilitating learners to easily locate prescriptions based on syndromes.
**Liver Disease Syndromes**
When the Liver pulse is pressed deeply (Chen), it feels rapid/tight; when lightly palpated (Fu), it is similarly so. The patient suffers from pain in the hypochondrium, a sensation of Qi distension and fullness radiating to the lower abdomen, frequent difficulty in urination, vertigo, headache, lower back and back pain, cold feet, intermittent urinary retention, amenorrhea or irregular menstruation in women. These conditions arise from falls or injuries sustained in youth. The Liver governs panting, anger, and cursing in the chest. If the Liver pulse is Chen, there must be chest oppression, creating a desire for someone to push or press upon the chest. With heat pathogen, nasal congestion occurs. When the Liver organ is injured, the person exhibits emaciation, sleeps with an open mouth, has cyanotic hands and feet, blurred vision, and painful pupils. This is caused by Liver injury. If Lung Metal overacts on Liver Wood, carbuncles and swellings occur. If Heart Fire overacts on Liver Wood, vomiting and diarrhea ensue. In Liver disease, the complexion is green, hands and feet are stiff and cramped, the hypochondrium is full and uncomfortable, sometimes accompanied by dizziness and fainting. The pulse is wiry and long; this is treatable. In Liver disease, if there is chest fullness, hypochondriac distension, irritability, shouting, body heat alternating with aversion to cold, inability to move limbs, pale face and eyes, and slippery body texture, but the pulse should be wiry, long, and rapid yet is instead short and choppy, and the color should be green yet is white, this represents Metal overcoming Wood, a major reversal (Ni), indicating ten deaths and no cure (*Mai Jing*).
**Liver Excess**
Excess at the Yin position of the Guan pulse on the left hand indicates Liver Excess. The patient suffers from deep muscle pain and twitching, prone to tendon cramps (*Mai Jing*). (Note: Differentiating Zang-Fu deficiency and excess should rely on *Su Wen: Zang Qi Fa Shi Lun*, *Ling Shu: Jing Mai Pian*, and Wang Shuhe's theories, hence recorded here. Acupuncture methods from the original text are omitted.)
Excess at the Yin position of the Guan pulse on the left hand corresponds to the Foot Jueyin Liver Meridian. Symptoms include hardness and fullness below the heart, frequent bilateral hypochondriac pain, and a mood resembling anger (*Ibid.*). (Note: *Qian Jin Fang* calls this Liver Excess Heat.)
Liver Excess generates heat; heat causes Yang Qi to flourish, leading to subcardiac hardness and fullness, hypochondriac pain radiating to the lower abdomen, irritability akin to anger, Qi rebellion causing dizziness. This is "Blood Surplus," manifesting as eye pain, red eyes, and growth of fleshy obstructions (pterygium/plica). Attacked by Yang Toxin, the patient feels depressed, experiencing chills followed by fever, neck stiffness, back rigidity, and tendon tightness preventing flexion and extension. A floating, large, and rapid pulse confirms Liver Qi Excess (*Sheng Hui Fang*).
Five Syndromes of Liver Excess: Irritability, where anger causes Qi to rebel upward, potentially leading to hematemesis or undigested stool diarrhea; frequent sighing and melancholy; hypochondriac pain and hematemesis due to Liver Qi rebellion, excessive Liver Fire, and Liver Blood deficiency; convulsions due to Evil Heat in the Liver generating Wind (Wind causes tremors and dizziness); red and swollen painful lips due to Blood Heat (*Shen Nong Ben Cao Jing Shu*).
**Liver Deficiency**
Absence (Jue) of the pulse at the Yin position of the Guan on the left hand indicates no Liver pulse. The patient suffers from urinary retention, enuresis, difficulty speaking, evil Qi in the hypochondrium, and frequent vomiting (*Mai Jing*).
Deficiency (Xu) at the Yin position of the Guan on the left hand corresponds to the Foot Jueyin Liver Meridian. Symptoms include hardness in the hypochondrium, alternating chills and fever, abdominal fullness, anorexia, depression, menstrual irregularities in women, and lumbar/abdominal pain (*Ibid.*). (*Qian Jin Fang* calls this Liver Deficiency Cold.)
If Liver Qi is insufficient, distant vision becomes weak, hypochondriac Qi distends connecting to the chest, limbs feel hot then cold, abdominal pain prevents eating, visual hallucinations of fire occur, and cold tears flow frequently. Untreated, blindness may result. This is Liver Insufficiency (*Wu Zang Lun*).
Liver Deficiency generates cold; cold causes hardness and distension in the hypochondrium, alternating chills and fever, abdominal fullness, anorexia, depression, fearfulness as if being hunted, blurred vision, floaters (black flowers), bitter taste, headache, joint stiffness, tendon contraction, dry nails, sadness, fear, inability to sigh deeply. A sinking, slippery, and fine pulse indicates Liver Deficiency. If the Liver organ is damaged, Qi and Blood fail to nourish, internal cold injury causes hypochondriac distension, tendon cramping, cold limbs, cardiac/abdominal pain, dim vision, persistent cyanosis of hands/feet, chest discomfort, and inability to take a deep breath. This is Liver Qi Insufficiency (*Sheng Hui Fang*).
Ten Syndromes of Liver Deficiency: Hypochondriac pain due to Liver Blood Deficiency and Liver Qi Excess rebelling upward; tendon cramps due to Blood Deficiency; short-sightedness due to Liver Blood Deficiency and Kidney True Yin insufficiency; blurred vision due to Liver Blood Deficiency with Heat and Kidney True Yin insufficiency; corneal opacity due to Liver Heat and Kidney Water Deficiency; excessive blood loss leading to opisthotonos due to Liver Blood Deficiency with Heat; lower abdominal pain radiating to the genitals, relieved by pressure, due to Foot Jueyin Meridian Blood Deficiency; unilateral headache due to Blood Deficiency and Liver Heat (untreated, damages eyes leading to darkness/dizziness); Fei Qi (mass) due to dual Qi and Blood Deficiency, Disharmonious Liver Qi, and confluence of rebellious Qi and Stasis (*Ben Cao Jing Shu*).
**Gallbladder Excess**
Excess at the Yang position of the Guan pulse on the left hand indicates Gallbladder Excess. The patient suffers from abdominal fullness and unease, and a sensation of skin tingling (*Mai Jing*).
Excess at the Yang position of the Guan pulse on the left hand corresponds to the Foot Shaoyang Gallbladder Meridian. Symptoms include abdominal Qi distension, inability to eat, dry throat, heavy painful head, aversion to cold, and hypochondriac pain (*Ibid.*). (*Qian Jin Fang* calls this Gallbladder Excess Heat.)
The Gallbladder is the Fu organ of the Liver. If Liver Qi is surplus, Gallbladder becomes Excess, generating Heat. Heat startles the Spirit causing unrest, restlessness, chest oppression, skin tingling, drooping eyebrows, bitter regurgitation, cardiac irritability, and dry throat. This is Gallbladder Excess (*Sheng Hui Fang*).
Two Syndromes of Gallbladder Excess: Bitter taste, deafness, hypochondriac pain, and alternating chills/fever; Nasal sinusitis (Bi Yuan) due to Gallbladder Heat transferring to the Brain (*Ben Cao Jing Shu*).
**Gallbladder Deficiency**
Absence (Jue) of the pulse at the Yang position of the Guan on the left hand indicates no Gallbladder pulse. The patient suffers from knee pain, bitter taste, squinting, fear resembling seeing ghosts, and frequent fright with weakness (*Mai Jing*).
Deficiency (Xu) at the Yang position of the Guan on the left hand corresponds to the Foot Shaoyang Gallbladder Meridian. Symptoms include vertigo, syncope, flaccidity, inability to move toes, difficulty rising from sitting, collapse, jaundice, and loss of essence (*Ibid.*). (*Qian Jin Fang* calls this Gallbladder Deficiency Cold.)
Two Syndromes of Gallbladder Deficiency: Fright susceptibility due to Gallbladder Qi Deficiency; insomnia after illness due to Gallbladder Deficiency (*Ben Cao Jing Shu*).
**Dual Excess of Liver and Gallbladder**
Excess at both Yin and Yang positions of the Guan pulse on the left hand indicates Dual Excess of the Foot Jueyin and Shaoyang meridians. Symptoms include gastric distension, regurgitation, and indigestion (*Mai Jing*).
**Dual Deficiency of Liver and Gallbladder**
Deficiency at both Yin and Yang positions of the Guan pulse on the left hand indicates Dual Deficiency of the Foot Jueyin and Shaoyang meridians. Symptoms include mental confusion, corpse-like syncope (Shi Jue) with unconsciousness, hallucinations, shortness of breath, aphasia, and frequent self-startle (*Mai Jing*).
**Heart Disease Syndromes**
The Heart pulse is small and tight when pressed deeply (Chen), and non-panting when lightly palpated (Fu). The patient suffers from Qi accumulation and pain below the heart, inability to eat, desire to swallow saliva, periodic heat/irritation in hands and feet, forgetfulness, unhappiness, and frequent sighing. Etiology involves worry and overthinking. Kidney Water overacting on Heart Fire causes urinary retention. In Heart disease, the complexion is red, cardiac pain with shortness of breath, hot palms, erratic laughter/cursing, sorrowful thoughts, red face and body heat. A solid, large, and rapid pulse is treatable. If there is irritability, shortness of breath, high fever, heat rushing to the heart, vomiting, coughing/reversal, delirium, bead-like sweat, and cold limbs, but the pulse should be Floating yet is instead Sinking, Soft, and Slippery, and the color should be Red yet is Black, this represents Water overcoming Fire, a major reversal (Ni), indicating ten deaths and no cure (*Mai Jing*).
Diseases of cardiac irritability and heat are caused by surplus in the Hand Shaoyin Meridian. Deficiency also causes empty irritability. *Sheng Hui Fang* only covers Excess-Heat. Generally, the Heart belongs to Fire and dislikes Heat; pathology easily generates Heat, causing Qi/Blood stagnation, resulting in irritability, restless sleep, oral ulcers, headache, and red cheeks. Deficiency causes internal retention of Heat, disturbing the Spirit, also manifesting as irritability (*Sheng Ji Zong Lu*).
**Heart Excess**
Excess at the Yin position of the Cun Kou pulse before the Guan on the left hand indicates Heart Excess. The patient suffers from Water Qi below the heart, triggered by grief/resentment (*Mai Jing*).
Excess at the Yin position of the Cun Kou pulse anterior to the Ren Ying point corresponds to the Hand Jueyin Pericardium Meridian (*Qian Jin Fang* says Hand Shaoyin Heart Meridian). Symptoms include obstruction, constipation, abdominal fullness, heavy limbs, fever, and gastric distension (*Ibid.*). (*Qian Jin Fang* calls this Heart Excess Heat.)
Heart Excess generates Heat; Heat flourishes Yang Qi. Yang Excess blocks Wei Qi and Ying Qi, causing Heat Toxin retention, mental chaos, red face/body heat, oral ulcers, dry throat/headache, manic laughter/fear/palpitations, hot/full palms, sweating, and epistaxis. A surging and solid pulse confirms this (*Sheng Hui Fang*).
Five Syndromes of Heart Excess (Real Fire/Heat): Delirium due to Evil Heat in the Heart; tongue ulceration due to Heart Fire; irritability due to Evil Heat and internal flaming Heart Fire; spontaneous laughter due to Heat Evil in the Heart; mania due to severe Evil Heat in the Heart (*Ben Cao Jing Shu*).
**Heart Deficiency**
Absence (Jue) of the pulse at the Yin position of the Cun Kou before the Guan on the left hand indicates no Heart pulse. The patient suffers from toxic pain below the heart, hot palms, frequent vomiting, and oral erosion (*Mai Jing*).
Deficiency (Xu) at the Yin position of the Cun Kou pulse anterior to the Ren Ying point corresponds to the Hand Jueyin Pericardium Meridian (*Qian Jin Fang* says Hand Shaoyin Heart Meridian). Symptoms include palpitations, fear, unhappiness, cardiac/abdominal pain, aphasia, feeling of cold in the heart, and mental confusion (*Ibid.*). (*Qian Jin Fang* calls this Heart Deficiency Cold.)
If Heart Qi is insufficient, epistaxis and yellowing of eyes occur, along with sadness/worry and emotional instability, irritability/haste, unawareness in dreams/waking, thirst for water due to Heart Heat, throat fullness/pain, stiff tongue/open mouth, continuous cold sweat, delirium, and sudden fright. This is Heart Qi Damage; untreated, it worsens (*Wu Zang Lun*).
Heart Deficiency generates Cold; Cold flourishes Yin Qi. Yin Excess leads to deficient/bloodless vessels, fear, unhappiness, acute cardiac/abdominal pain, clear salivation, chest/diaphragm fullness, forgetfulness, fright, flighty dreams, scattered spirit. A floating and deficient pulse confirms this (*Sheng Hui Fang*).
Eight Syndromes of Heart Deficiency: Startle/Evil due to Heart Qi Deficiency; Epilepsy due to Heart Qi Deficiency with Heat; Insomnia due to Heart Blood Deficiency with Heat; Cardiac Irritability due to Heat in the Heart; Palpitations (Zheng Chong) due to Heart Blood Insufficiency; Weak heartbeat; Night sweats due to Heart Blood Deficiency (Sweat is the fluid of the Heart); Fu Liang (mass) due to Heart Meridian Qi/Blood Deficiency allowing Evil to linger (*Ben Cao Jing Shu*).
**Small Intestine Excess**
Excess at the Yang position of the Cun Kou pulse before the Guan on the left hand indicates Small Intestine Excess. The patient suffers from acute Bi obstruction (or pain) below the heart, Small Intestine Heat, and dark yellow urine (*Mai Jing*).
Excess at the Yang position of the Cun Kou pulse anterior to the Ren Ying point corresponds to the Hand Taiyang Small Intestine Meridian. Symptoms include fever (intermittent), sweating (or lack thereof) with irritability, chest fullness, heaviness, and oral ulcers (*Ibid.*). (*Qian Jin Fang* calls this Small Intestine Excess Heat.)
The Small Intestine resembles Fire, prospers in Summer, is the Hand Taiyang Meridian, and the Fu organ of the Heart. Fluids descending as urine pass through the Small Intestine. Qi surplus causes Small Intestine Heat, drying/scorching, and distension. This is Small Intestine Qi Excess, requiring purgation (*Bing Yuan Lun*).
One Syndrome of Small Intestine Excess: Difficult, dark, or painful bloody urination (*Ben Cao Jing Shu*).
**Small Intestine Deficiency**
Absence (Jue) of the pulse at the Yang position of the Cun Kou before the Guan on the left hand indicates no Small Intestine pulse. The patient suffers from umbilical Bi, hernia/masses in the lower abdomen, and cold Qi rushing to the heart in the fifth month (*Mai Jing*).
Deficiency (Xu) at the Yang position of the Cun Kou pulse anterior to the Ren Ying point corresponds to the Hand Taiyang Small Intestine Meridian. Symptoms include lateral headache at the skull base and ear/cheek pain (*Ibid.*). (*Qian Jin Fang* calls this Small Intestine Deficiency Cold.)
Small Intestine insufficiency allows Cold Qi to lodge, causing intestinal jumping/fright, muteness, and intermittent symptoms. This is Small Intestine Qi Deficiency, requiring tonification (*Bing Yuan Lun*). (*Sheng Hui Fang* adds abdominal pain, jumping, intermittent symptoms, frequent urination.)
One Syndrome of Small Intestine Deficiency: Enuresis due to Small Intestine Qi Deficiency combined with Kidney Qi Deficiency (*Ben Cao Jing Shu*).
**Dual Excess of Heart and Small Intestine**
Excess at both Yin and Yang positions of the Cun Kou pulse anterior to the Ren Ying point indicates Dual Excess of the Hand Shaoyin and Taiyang meridians. Symptoms include headache, fever, difficult defecation, cardiac/abdominal irritability/fullness, and inability to lie down due to stagnant Stomach Qi and food/water accumulation (*Mai Jing*). (*Qian Jin Fang* calls this Dual Excess of Heart and Small Intestine.)
**Dual Deficiency of Heart and Small Intestine**
Deficiency at both Yin and Yang positions of the Cun Kou pulse anterior to the Ren Ying point indicates Dual Deficiency of the Hand Shaoyin and Taiyang meridians. Symptoms include profuse diarrhea, aversion to cold, shortness of breath, cold limbs, and borborygmus (*Mai Jing*). (*Qian Jin Fang* calls this Dual Deficiency of Heart and Small Intestine.)
**Spleen Disease Syndromes**
The Cun Kou pulse is slow (Huan) and delayed (Chi). Slow indicates Yang, its Qi is long; Delayed indicates Yin, Ying Qi is hurried (Note: 'Cu' character needs verification). Ying and Wei are harmonious, Gang and Rou complement each other, San Jiao connects, and Qi is strong. The Zu Yang pulse is slippery (Hua) and tight (Jin). Slippery indicates Stomach Qi Excess; Tight indicates Spleen Qi Injury. Indigestion after eating indicates Spleen failure. Ability to eat without abdominal fullness indicates Stomach Qi surplus. Abdominal fullness with inability to eat, hunger sensation below the heart, indicates Stomach Qi stagnation and Heart Qi Deficiency. Fullness after eating indicates Spleen failure. Spleen Qi weakness causes dysentery with white intestinal mucus, hard stool, and unceasing sweating. Named Spleen Qi Weakness, or five fluids draining as blue/yellow/red/white/black. Flatness below the nose indicates Stomach disease. Slight red indicates abscess formation; slight black indicates Heat; blue indicates Cold; white indicates untreatable; black lips indicate prior Stomach disease; slight dryness/thirst is treatable; no thirst is untreatable. Protruding navel indicates Spleen failure (or end). In Spleen disease, the complexion is yellow, digestion fails, abdominal distension is uncomfortable, body weight/joint pain, difficult defecation. A slightly slow and long pulse is treatable. If the complexion is yellow with blue undertones, incontinence, fixed gaze, retracted lips, cyanotic nails, vomiting food, body/joint pain, limb paralysis, but the pulse should be Floating, Large, and Slow yet is instead Wiry and Rapid, and the color should be Yellow yet is Blue, this represents Wood overcoming Earth, a major reversal (Ni), indicating ten deaths and no cure (*Mai Jing*).
Spleen Cold/Heat causes abdominal pain and anorexia. Spleen disease causes stiff tongue/slurred speech, tendon cramps, testicular retraction, pulling of inner thighs, hip pain, heaviness, anorexia, tympanites. Transformation into watery diarrhea and inability to lie down indicates death. Spleen proper Heat causes yellow face/red eyes and costal pain. Cold causes spittle regurgitation/anorexia, limb pain, loose stools, cold limbs, even shivering like malaria (*Zhong Zang Jing*).
**Spleen Excess**
Excess at the Yin position of the Guan pulse on the right hand indicates Spleen Excess. The patient suffers from a deep, hard sensation in the intestines and difficult defecation (*Mai Jing*).
Excess at the Yin position of the Guan pulse on the right hand corresponds to the Foot Taiyin Spleen Meridian. Symptoms include cold feet with hot calves, abdominal distension, and irritability preventing sleep (*Ibid.*). (*Qian Jin Fang* calls this Spleen Excess Heat.)
Spleen Excess generates Heat; Heat flourishes Yang Qi. Yang Excess causes chest/heart irritability, dry/scorched lips, body heat/pain, heaviness preventing turning, deep voice with anxious mind, sore throat, swollen/stiff tongue root, oral ulcers, abdominal/hypochondriac distension, insomnia, dreaming of singing/laughing, limb lethargy. A tight and solid pulse confirms Spleen Excess (*Sheng Hui Fang*). (*Sheng Ji Zong Lu* adds slurred speech and dark-yellow face.)
Six Syndromes of Spleen Excess (Damp-Heat/Evil Surplus): Gu Distension due to Damp-Heat/Stagnation or Internal Blood Stasis; Hunger due to Evil Fire in Spleen with lip ulcers; Oral thrush; Middle Xiao (Thirst/Polydipsia) due to Real Fire in Spleen with damp-heat abdominal pain worsening on pressure (*Ben Cao Jing Shu*).
**Spleen Deficiency**
Absence (Jue) of the pulse at the Yin position of the Guan on the right hand indicates no Spleen pulse. The patient suffers from shortness of breath, diarrhea, abdominal fullness, heaviness, limb inactivity, and frequent vomiting (*Mai Jing*).
Deficiency (Xu) at the Yin position of the Guan pulse on the right hand corresponds to the Foot Taiyin Spleen Meridian. Symptoms include watery diarrhea, abdominal fullness/Qi rebellion, cholera/vomiting, jaundice, irritability preventing sleep, and borborygmus (*Ibid.*). (*Qian Jin Fang* calls this Spleen Deficiency Cold.)
Spleen Qi insufficiency causes yellow face/eyes, postprandial nausea, dry lips/oral ulcers, Qi distension/heavy limbs, anxiety/fear, aversion to sound, thirst requiring fluids. This is Spleen Insufficiency; urgent treatment is beneficial (*Wu Zang Lun*). (Note: "Yi Ren" characters are superfluous.)
The Spleen resides centrally, prospers in all four seasons, receives Essence-Qi from grain/water, transforms it into Qi/Blood to nourish the body and irrigate Zang-Fu. Deficiency generates Cold; Cold flourishes Yin Qi. Yin Excess causes chest/abdominal fullness, indigestion, belching/acid regurgitation, vomiting after eating, Qi rebellion/cholera, abdominal pain/borborygmus, spontaneous diarrhea, heavy limbs, excessive thinking, aversion to sound, dreaming of insufficient food. A sinking, fine, weak pulse confirms Spleen Deficiency (*Sheng Hui Fang*).
If Spleen receives grain/water essence to transform Qi/Blood for nourishment, but Qi fails to nourish, it cannot transport fluids with the Stomach. This results in body heaviness/lethargy, limb paralysis, vacuous abdominal/hypochondriac distension, fullness/dry throat, anorexia, vomiting despite appetite, indigestion, diarrhea/borborygmus. This is Spleen Qi Insufficiency (*Ibid.*).
Twelve Syndromes of Spleen Deficiency: Fever from diet/labor fatigue damaging Spleen; Indigestion due to Spleen Qi Deficiency; Food stagnation causing aversion to food; Fluid retention from excessive drinking of tea/alcohol; Edema due to Spleen Qi Deficiency; Central Fullness due to Spleen Qi Deficiency combined with Spleen Yin Deficiency (worse day/Spleen Qi, worse night/Spleen Yin); Dysphagia due to dual Qi/Blood Deficiency (blood depletion, not phlegm-Qi rebellion); Spleen Diarrhea due to Qi Deficiency; Forgetfulness due to dual Qi/Blood Deficiency; Fatigue/sleepiness due to Spleen Qi Insufficiency; Abdominal pain relieved by pressure due to Blood Deficiency; Pi Qi (mass) due to Spleen Qi Deficiency and Qi Stagnation (*Ben Cao Jing Shu*).
**Stomach Disease Syndromes**
Gastric Pizhi (accumulation): Pain/inability to eat cold food; ability to eat hot food. Floating Zu Yang pulse indicates Stomach Qi Deficiency. Floating and Large Zu Yang pulse indicates mild Stomach Deficiency/Irritability, frequent defecation (twice daily). Kou pulse with Stomach Qi (Floating/Large/Hollow) indicates Hollow pulse with underlying Stomach Qi. Rapid Zu Yang pulse indicates Stomach Heat, leading to efficient digestion and increased appetite (from *Jin Gui: Xiao Ke*). Choppy Zu Yang pulse indicates Stomach Cold, indigestion. Rough and Floating Zu Yang pulse indicates difficult-to-treat disease. Floating and Delayed Zu Yang pulse indicates chronic illness. Deficient Zu Yang pulse causes enuresis; Excess causes flatulence. Headache/heaviness upon movement, morning heat belong to the Stomach (*Mai Jing*).