《阳明脉解篇》曰∶足阳明之脉病,恶人与火,闻木音则惕然而惊,(胃热内郁,故恶
人、恶火。胃属土,故闻木音而惊。)病甚则弃衣而走,登高而歌,或至不食数日,逾垣上屋,
所上之处,皆非其素所能也。病反能者何也?四支者,诸阳之本也。阳盛则四支实,
实则能登高也。(阳受气于四支,故四支为诸阳之本。)热盛于身,故弃衣欲走也。阳盛则使人妄
言骂詈,不避亲疏,而不欲食,故妄走也。(言胃病所以能登高而歌,弃衣而走,妄言而骂者,皆以
其邪气之盛也。邪盛故热盛,热盛故阳盛,阳盛则三者之证由于此矣。)
《评热病论》曰∶有病温者,汗出辄复热,而脉躁疾不为汗衰,狂言不能食,病
名为何?岐伯曰∶病名阴阳交,交者死也。(交,谓交合,阴阳之气不分别也。)人所以汗出者,
皆生于谷,谷生于精,(言谷气化为精,精气胜乃为汗。)今邪气交争于骨肉而得汗者,是邪却
而精胜也,(言初汗也。)精胜则当能食而不复热。复热者邪气也,汗者精气也,今汗出
而辄复热者,是邪胜也,不能食者,精无俾也,(无俾,言无可使为汗也。谷不化则精不生,精
不化流,故无可使。)病而留者,其寿可立而倾
也。(如是者,其人寿命立致倾危也。)汗出而脉尚躁盛者死。(汗后脉当迟静,而反躁急以盛满者,是真气
竭而邪盛,故知必死也。)今脉不与汗相应,此不胜其病也,其死明矣。(脉不静而躁盛,是不相应。)
狂言者是失志,失志者死。(志舍于精,今精无可使,是志无所居,志不留居则失志也。)今见三死,不
见一生,虽愈必死也。(汗出脉躁盛,一死;不胜其病,二死;狂言失志者,三死也。)
《阳明脉解篇》说:足阳明经发生病变时,患者厌恶人和火光,听到木器的声音就会惊恐不安。(这是因为胃热内郁,所以厌恶人和火。胃在五行中属土,所以听到属木的声音而惊恐。)病情严重时,患者会脱掉衣服乱跑,爬上高处唱歌,甚至几天不吃饭,翻越墙垣、登上屋顶,所到达的地方,都不是他平时所能做到的。为什么病后反而能做出这些举动呢?四肢是诸阳经的根本所在。阳气旺盛则四肢充实,四肢充实就能登高。(阳气输布于四肢,所以四肢是诸阳经的根本。)体内热势炽盛,所以患者脱衣想要奔跑。阳气亢盛会导致人胡言乱语、骂詈他人,不分亲疏,并且不想进食,所以会胡乱奔跑。(这段话解释胃病之所以能登高而歌、弃衣而走、妄言骂人,都是因为邪气亢盛。邪气盛则热盛,热盛则阳盛,阳气亢盛就导致了这三种症状。)
《评热病论》说:有一种温病患者,出汗后立即再次发热,脉搏躁动疾速并不因出汗而减弱,出现胡言乱语且不能进食,这是什么病?岐伯回答说:这种病名叫“阴阳交”,阴阳交合的病症预后不良,主死。(“交”,是指阴阳之气混淆不清,不再分离。)人之所以出汗,都是源于水谷精微,水谷精微化生为精气。(意思是谷气转化为精气,精气充盛才能化为汗液。)现在邪气与正气在骨肉之间交争,如果此时出汗,说明邪气退却而精气占上风,(这是指初次出汗的情况。)精气占上风就应该能够进食且不再发热。再次发热的,是邪气在作祟;出汗的,是精气的外泄。现在出汗后随即再次发热,这是邪气胜过了精气;不能进食,说明精气得不到补充。(“无俾”,意思是无法使精气生成汗液。谷气不消化则精气不生,精气不化生流动,所以没有可供化汗的精气。)疾病滞留不去,患者的寿命很快就会终结。(像这样的情况,人的寿命立刻就会陷入危险境地。)出汗后脉搏仍然躁动旺盛的,主死。(出汗后脉象应当迟缓安静,反而急躁盛大,这是真气竭绝而邪气亢盛,所以知道必然死亡。)现在的脉象与汗出情况不相适应,这说明正气不能战胜疾病,死亡是显而易见的。(脉象不静而躁动盛大,这就是不相适应。)胡言乱语是神志丧失的表现,神志丧失者主死。(志藏于精中,现在精气无法化生,志就没有居所,志不能安居就是失志。)现在看到了三种死亡的征象,却没有看到一种生存的征象,即使暂时看似痊愈,最终也必定死亡。(出汗后脉象躁动盛大,这是一死;正气不胜邪气,是二死;胡言乱语导致失志,是三死。)
The *Yangming Maijie Pian* (Chapter on the Explanation of the Yangming Pulse) states: When the Foot-Yangming meridian is diseased, the patient dislikes people and fire, and is startled by the sound of wood. (This is because stomach heat is internally constrained, hence the aversion to people and fire. The Stomach belongs to Earth in the Five Elements, hence the startle upon hearing the sound of Wood.) In severe cases, the patient discards their clothes and runs about, climbs high places and sings, or goes without food for several days, crossing walls and climbing onto roofs. The places they reach are beyond what they were previously capable of. Why can they perform these actions contrary to their usual abilities? The four limbs are the root of all Yang meridians. When Yang is excessive, the four limbs become full; when full, one can climb high. (Yang receives its qi from the four limbs, therefore the four limbs are the root of all Yang meridians.) Heat is excessive in the body, so the patient discards clothes and wishes to run. Excessive Yang causes a person to speak wildly and curse, disregarding kinship and distance, and to lose appetite, thus running aimlessly. (This explains that the ability to climb high and sing, discard clothes and run, and speak wildly and curse due to stomach disease stems from the excess of pathogenic qi. Excess pathogenic qi leads to heat excess; heat excess leads to Yang excess; Yang excess gives rise to these three symptoms.)
The *Ping Rebing Lun* (Treatise on Evaluating Heat Diseases) states: There is a condition where a patient with a warm disease sweats, but fever returns immediately; the pulse is rapid and restless and does not diminish after sweating; the patient speaks deliriously and cannot eat. What is this disease called? Qibo replied: This disease is named "Yin-Yang Jiao" (Yin-Yang Intermingling). "Jiao" implies intermingling, where Yin and Yang qi do not remain distinct. (Intermingling refers to the confusion of Yin and Yang qi, which no longer separate.) Human sweat originates from grain (food), and grain generates essence. (This means grain qi transforms into essence; only when essence is abundant can it transform into sweat.) Now, if pathogenic qi and healthy qi contend in the muscles and bones, and sweating occurs, it indicates that the pathogen is retreating and essence is prevailing. (This refers to the initial sweating.) If essence prevails, the patient should be able to eat and not have recurrent fever. Recurrent fever indicates the presence of pathogenic qi; sweat represents the loss of essence. Now, if sweating is followed immediately by recurrent fever, it signifies that the pathogen has prevailed over the essence. The inability to eat means there is no assistance for the essence. ("Wu bi" means there is nothing to assist in generating sweat. If grain is not digested, essence is not produced; if essence does not transform and flow, there is nothing available to generate sweat.) If the disease lingers, the patient's lifespan will come to an abrupt end. (In such cases, the person's life is immediately imperiled.) If the pulse remains rapid and vigorous after sweating, death ensues. (After sweating, the pulse should be slow and quiet; if it is instead rapid and full, it indicates exhaustion of true qi and excess of pathogenic qi, thus predicting certain death.) The current pulse does not correspond with the sweating, indicating that the healthy qi cannot overcome the disease; death is evident. (A pulse that is not quiet but rapid and vigorous is non-corresponding.) Delirious speech indicates the loss of Zhi (Will/Shen). Loss of Zhi leads to death. (Zhi resides in essence; now that essence cannot be generated, Zhi has no residence. If Zhi does not reside, it is lost.) Currently, three signs of death are observed, with no sign of life. Even if recovery seems possible, death is inevitable. (Sweating with a rapid and vigorous pulse is the first sign of death; failing to overcome the disease is the second; delirious speech leading to loss of Zhi is the third.)