呕而脉弱，小便复利，身有微热，见厥者，难治。趺阳脉浮者，胃气虚，寒气在上，忧气在下，二气并争，但出不
入，其人即呕而不得食，恐怖而死，宽缓即瘥。夫呕家有痈脓者，不可治呕，脓尽自愈。先呕却渴者，此为欲解。先渴
却呕者，为水停心下，此属饮家。呕家本渴，今反不渴者，以心下有支饮也。
问曰∶病患脉数，数为热，当消谷引食，而反吐者，何也？师曰∶以发其汗，令阳微，膈气虚，脉乃数，数为客热，
不能消谷，胃中虚冷，故吐也。阳紧阴数，其人食已即吐，阳浮而数，亦为吐。
寸紧尺涩，其人胸满，不能食而吐，吐止者为下之，故不能食，设言未止者，此为胃反，故尺为之微涩也。
寸口脉紧而芤，紧则为寒，芤则为虚，虚寒相抟，脉为阴结而迟，其人则噎。关上脉数，其人则吐。脉弦者，虚也。
胃气无余，朝食暮吐，变为胃反，寒在于上，医反下之，今脉反弦，故名曰虚。趺阳脉微而涩，微则下利，涩则吐逆，
谷不得入也。
寸口脉微而数，微则无气，无气则荣虚，荣虚则血不足，血不足则胸中冷。趺阳脉浮而涩，浮则为虚，涩则伤脾，
脾伤则不磨，朝食暮吐，暮食朝吐，宿谷不化，名曰胃反。脉紧而涩，其病难治。
夫吐家，脉来形状如新卧起。病患欲吐者，不可下之。
呕吐而病在膈上，后思水者，解，急与之。思水者，猪苓散主之。哕而腹满，视其前后，知何部不利，利之即愈。
夫六腑气绝于外者，手足寒，上气，脚缩。五脏气绝于内者，下利不禁，下甚者，手足不仁。
下利，脉沉弦者，下重，其脉大者，为未止。脉微弱数者，为欲自止，虽发热不死。脉滑，按之虚绝者，其人必下
利。
下利，有微热，其人渴。脉弱者，今自愈。
下利，脉数，若微发热，汗自出者，自愈。设脉复紧，为未解。下利，寸脉反浮数，尺中自涩，其人必清脓血。
下利，手足厥，无脉，灸之不温，若脉不还，反微喘者，死。少阴负趺阳者为顺也。
下利，脉数而浮（一作渴）者，今自愈。设不瘥，其人必清脓血，以有热故也。
下利后，脉绝，手足厥冷， 时脉还，手足温者，生。脉不还者，死。
下利，脉反弦，发热身汗者，自愈。
下利气者，当利其小便。
下利清谷，不可攻其表，汗出必胀满，其脏寒者，当下之。
下利，脉沉而迟，其人面少赤，身有微热。
下利清谷，必郁冒，汗出而解，其人微厥。所以然者，其面戴阳，下虚故也。
下利，腹胀满，身体疼痛，先温其里，乃攻其表。
下利，脉迟而滑者，实也。利未欲止，当下之。
下利，脉反滑者，当有所去。下乃愈。
下利瘥，至其年、月、日、时复发，此为病不尽，当复下之。
下利而谵语者，为有燥屎也，宜下之。
下利而腹痛满，为寒实，当下之。
下利，腹中坚者，当下之。
下利后更烦，按其心下濡者，为虚烦也。
下利后，脉三部皆平，按其心下坚者，可下之。
下利，脉浮大者，虚也，以强下之故也。设脉浮革，因尔肠鸣，当温之。
病者痿黄，躁而不渴，胃中寒实，而下利不止者，死。
夫风寒下者，不可下之。下之后，心下坚痛。脉迟者，为寒，但当温之。脉沉紧，下之亦然。脉大浮弦，下之当已。
呕吐且脉象微弱，小便反而通利，身体有轻微发热，出现四肢厥冷的症状，属于难治之证。趺阳脉（足背动脉）浮取即得，说明胃气虚弱，寒气停留于上焦，忧思之气郁结于下焦，上下二气相互争搏，导致气机只出不入，病人随即发生呕吐且无法进食，若伴有恐惧心理则可能导致死亡，若情绪宽缓则病情好转。凡是患有呕吐且体内有痈脓的病人，不可单纯治疗呕吐，待脓液排尽后呕吐自会停止。先呕吐而后感到口渴的，这是病情即将解除的表现；先口渴而后呕吐的，是因为水饮停滞在心下，这属于饮家（以水饮内停为主要特征的病证）。呕吐病人本应口渴，现在反而不渴，是因为心下有支饮（支撑于心下的水饮邪气）。
问：病人的脉象数（快），数脉主热，应当能消化食物并食欲旺盛，却反而呕吐，这是什么原因？老师说：这是因为发汗过度，导致阳气微弱，膈间气虚，脉象因而表现为数，这种数是客热（外来的或暂时的热邪），不能消化食物，加上胃中虚冷，所以发生呕吐。如果寸部脉紧、尺部脉数，病人进食后即吐；如果寸部脉浮而数，也会发生呕吐。
寸口脉紧、尺部脉涩，病人胸中胀满，不能进食且呕吐，如果呕吐停止是因为误用攻下法，导致不能进食；如果呕吐不止，这就是胃反（脾胃虚寒，朝食暮吐的病证），所以尺部脉象微涩。
寸口脉紧而芤（中空如葱管），紧脉主寒，芤脉主虚，虚与寒相互搏结，脉象呈现阴结而迟滞，病人会出现噎塞感。关部脉数，病人就会呕吐。脉弦，表示正气虚弱。胃气已无余存，早晨吃的食物晚上吐出，演变为胃反，寒气在上，医生反而误用攻下法，现在脉象反见弦象，所以称为虚证。趺阳脉微而涩，微脉主下利，涩脉主吐逆，谷物无法进入胃中。
寸口脉微而数，微脉表示无气，无气则营血虚弱，营血虚则血液不足，血液不足则胸中寒冷。趺阳脉浮而涩，浮脉主虚，涩脉伤脾，脾受伤则不能磨化水谷，早晨吃的食物晚上吐出，晚上吃的食物早晨吐出，宿食不化，这叫胃反。脉象紧而涩，病情难治。
凡是呕吐的病人，脉来形状如同刚睡醒起床时那样（指脉象乍疏乍数或无力）。病人想要呕吐的，不可使用攻下法。
呕吐且病位在膈上，后来想喝水的，是病情将解的表现，应立即给予饮水。想喝水的，用猪苓散主治。呃逆且腹部胀满，要观察前后二便，知道哪一部分不通利，通利它即可痊愈。
六腑之气在外衰竭的，手足寒冷，气逆向上，脚蜷缩。五脏之气在内衰竭的，下利不禁，下利严重的，手足麻木不仁。
下利（腹泻），脉象沉弦的，会有里急后重的感觉；脉象大的，说明病势未止。脉象微弱而数的，说明病欲自止，虽然发热也不会死亡。脉滑，按之空虚绝少的，病人必定下利。
下利，脉数，如果有轻微发热，汗自然出的，会自愈。如果脉象再次变紧，说明病未解除。下利，寸脉反见浮数，尺中自涩，病人必定排出脓血。
下利，手足厥冷，无脉，艾灸后不回暖，如果脉象不还复，反而轻微喘息的，为死证。少阴脉（肾脉）弱于趺阳脉（胃脉）的为顺证。
下利，脉数而浮（一说为渴）的，今天就会自愈。如果不痊愈，病人必定排出脓血，因为有热邪的缘故。
下利后，脉象绝灭，手足厥冷，偶尔脉象还复，手足转温的，为生证。脉象不还复的，为死证。
下利完谷不化（大便中有未消化的食物），不可攻表，发汗必然导致腹胀满，如果是脏寒的，应当攻下里实。
下利完谷不化，必定会出现郁冒（头目昏眩如物蒙蔽），汗出后病解，病人会有轻微厥冷。之所以这样，是因为面戴阳（虚阳上浮于面），下焦虚寒的缘故。
下利痊愈后，到了年、月、日、时的特定时间复发，这是病邪未尽，应当再次攻下。
下利，脉浮大的，是虚证，是因为强行攻下导致的。如果脉象浮革（外强中空），因此肠鸣，应当温补。
病人面色萎黄，躁动但不口渴，胃中有寒实之邪，而下利不止的，为死证。
风寒在下部的，不可攻下。攻下之后，心下部坚硬疼痛。脉迟的，为寒证，只应当温补。脉沉紧的，攻下亦然（此处原文逻辑似有误，通常沉紧亦主寒实或痛，结合上下文“下之亦然”可能指若确认为实邪可下，或指误下后的变证处理，依原文直译）。脉大浮弦的，攻下应当痊愈。
Vomiting accompanied by a weak pulse, frequent urination, slight fever in the body, and cold extremities indicates a difficult-to-treat condition. A floating pulse at the Zuyang (Duzi) artery (the dorsal pedal artery) indicates deficiency of Stomach Qi, with Cold pathogen residing above and sorrowful Qi stagnating below. The struggle between these two Qi causes Qi to exit but not enter, leading to vomiting and inability to eat. If accompanied by fear, death may ensue; if the mind is relaxed, the condition will improve. For patients with vomiting due to pus from an abscess, treating the vomiting directly is contraindicated; once the pus is exhausted, the vomiting will cease spontaneously. Vomiting followed by thirst indicates that the disease is about to resolve. Thirst followed by vomiting indicates water retention in the epigastrium, classifying the patient as having a Yin-Jia (Water-Drink Disease). Patients who vomit should naturally feel thirsty; if they do not, it indicates Zhi-Yin (Supporting Water-Drink) in the epigastrium.
Question: A patient has a rapid pulse (Shu). Rapid pulse indicates Heat, which should promote digestion and appetite, yet the patient vomits instead. Why? The Master said: This results from excessive sweating, causing Yang Qi to become weak and Diaphragm Qi to be deficient. The pulse becomes rapid due to Guest-Heat (temporary or external Heat), which cannot digest food. Combined with Cold deficiency in the Stomach, vomiting occurs. If the Cun position pulse is Tight and the Chi position pulse is Rapid, the patient vomits immediately after eating. If the Cun position pulse is Floating and Rapid, vomiting also occurs.
A Tight pulse at the Cun position and a Choppy pulse at the Chi position indicate chest fullness, inability to eat, and vomiting. If the vomiting stops, it is because inappropriate purgation was used, leading to inability to eat. If the vomiting does not stop, it is called Wei-Fan (Stomach Reversal), hence the Chi pulse is Micro and Choppy.
A Tight and Hollow (Kou) pulse at the Cun position: Tight indicates Cold, Hollow indicates Deficiency. The combination of Deficiency and Cold leads to Yin-Knot and a slow pulse, causing dysphagia (Ye). A Rapid pulse at the Guan position causes vomiting. A Wiry (Xian) pulse indicates Deficiency. With no residual Stomach Qi, morning food is vomited in the evening, evolving into Wei-Fan. Cold resides above, but the physician incorrectly used purgation. Now the pulse is Wiry, hence it is named Deficiency. A Micro and Choppy pulse at the Zuyang artery: Micro indicates diarrhea, Choppy indicates vomiting and counterflow, preventing food intake.
A Micro and Rapid pulse at the Cun position: Micro indicates lack of Qi. Lack of Qi leads to Ying-Blood deficiency. Blood deficiency leads to insufficient blood, resulting in coldness in the chest. A Floating and Choppy pulse at the Zuyang artery: Floating indicates Deficiency, Choppy indicates Spleen injury. Injury to the Spleen impairs grinding and digestion. Morning food is vomited in the evening, evening food in the morning, with undigested old food remaining. This is called Wei-Fan. A Tight and Choppy pulse indicates a difficult-to-treat condition.
In cases of vomiting, the pulse shape resembles that of someone who has just woken up (irregular or weak). For patients desiring to vomit, purgation is contraindicated.
If vomiting occurs with pathology above the diaphragm, and the patient subsequently desires water, it indicates resolution; provide water promptly. For those desiring water, Zhu Ling San (Polyporus Powder) is the primary formula. For hiccups accompanied by abdominal fullness, examine the anterior (urinary) and posterior (anal) orifices to determine which is obstructed; unblocking it will lead to recovery.
When Qi of the Six Fu Organs fails externally, there is coldness in the hands and feet, upward rushing of Qi, and curling of the legs. When Qi of the Five Zang Organs fails internally, there is incontinence of diarrhea. Severe diarrhea leads to numbness in the hands and feet.
In diarrhea, a Deep and Wiry pulse indicates tenesmus (feeling of incomplete evacuation). A Large pulse indicates the disease has not ceased. A Weak, Micro, and Rapid pulse indicates the disease is about to stop spontaneously; even with fever, death is unlikely. A Slippery pulse that feels empty when pressed indicates the patient must have diarrhea.
In diarrhea, with slight fever and thirst, a Weak pulse indicates spontaneous recovery today.
In diarrhea, if the pulse is Rapid, with slight fever and spontaneous sweating, recovery is expected. If the pulse returns to Tight, the disease is unresolved. In diarrhea, if the Cun pulse is unexpectedly Floating and Rapid, while the Chi position is Choppy, the patient will likely pass pus and blood.
In diarrhea, with cold extremities and absent pulse, if moxibustion does not warm the body and the pulse does not return, but instead slight panting occurs, it is a fatal sign. If the Shaoyin (Kidney) pulse is weaker than the Zuyang (Stomach) pulse, it is a favorable sign.
In diarrhea, if the pulse is Rapid and Floating (or if the patient is thirsty), recovery is expected today. If it does not improve, the patient will likely pass pus and blood due to Heat.
After diarrhea, if the pulse vanishes and extremities are cold, but the pulse occasionally returns and extremities become warm, life is preserved. If the pulse does not return, it is fatal.
In diarrhea, if the pulse is unexpectedly Wiry, accompanied by fever and sweating on the body, recovery is expected.
Diarrhea with flatulence should be treated by promoting urination.
In diarrhea with undigested food (Qing Gu), exterior attack is contraindicated; sweating will cause abdominal fullness. If the internal organs are Cold, purgation of the interior is indicated.
In diarrhea, with a Deep and Slow pulse, slight facial redness, and slight body fever...
In diarrhea with undigested food, there will likely be Yu-Mao (vertigo and dizziness as if covered by something), followed by sweating and resolution, with slight cold extremities. This is due to Dai-Yang (floating Yang on the face) and lower Jiao deficiency/Cold.
In diarrhea with abdominal fullness and body pain, first warm the interior, then attack the exterior.
In diarrhea, a Slow and Slippery pulse indicates Excess. If diarrhea has not stopped, purgation is indicated.
In diarrhea, an unexpectedly Slippery pulse indicates material accumulation that needs to be expelled. Purgation leads to recovery.
If diarrhea recurs at specific years, months, days, or hours after remission, it indicates incomplete elimination of the pathogen; repeat purgation.
Diarrhea accompanied by delirium indicates dry feces; purgation is appropriate.
Diarrhea with abdominal pain and fullness indicates Cold Excess; purgation is indicated.
Diarrhea with a hard abdomen indicates purgation is indicated.
After diarrhea, increased irritability with a soft epigastrium upon palpation indicates Empty Irritation (Xu Fan).
After diarrhea, if all three positions of the pulse are normal but the epigastrium is hard upon palpation, purgation is possible.
In diarrhea, a Floating and Large pulse indicates Deficiency caused by forced purgation. If the pulse is Floating and Leather-like (Ge), accompanied by borborygmus (intestinal rumbling), warming is indicated.
A patient with sallow complexion, restlessness without thirst, Cold Excess in the Stomach, and unremitting diarrhea is in a fatal condition.
For Cold-Wind sinking downward, purgation is contraindicated. After purgation, hardness and pain in the epigastrium occur. A Slow pulse indicates Cold; only warming is indicated. A Deep and Tight pulse suggests similar handling (contextually implying caution or specific treatment for Cold-Excess). A Large, Floating, and Wiry pulse suggests purgation would have resolved the issue (referring to prior potential misdiagnosis or specific excess patterns).