脉数,身无热,内有痈也。一云腹无积聚身体(一本作无)热脉数此为肠有脓。薏苡附子败酱汤主之。
诸浮数脉,应当发热,而反洒淅恶寒,若有痛处,当发其痈。
脉微而迟,必发热,弱而数,为振寒,当发痈肿。
脉浮而数,身体无热,其形嘿嘿,胸中微燥,(一作胃中微燥)不知痛之所在,此人当发痈肿。
脉滑而数,数则为热,滑则为实,滑则主荣,数则主卫,荣卫相逢,则结为痈。热之所过,则为脓也。
师曰∶诸痈肿,欲知有脓与无脓,以手掩肿上,热者为有脓,不热者为无脓。
问曰∶官羽林妇病,医脉之,何以知妇人肠中有脓,为下之则愈?师曰∶寸口脉滑而数,滑则为实,数则为热,滑
则为荣,数则为卫,卫数下降,荣滑上升。荣卫相干,血为浊败,少腹痞坚,小便或涩,或时汗出,或复恶寒,脓为已
成。设脉迟紧,聚为瘀血,血下则愈。肠痈之为病,其身体甲错,腹皮(一作支)急,按之濡如肿状。肠痈者,少腹肿,
按之则痛,小便数如淋,时时发热,自汗出,复恶寒,其脉迟紧者,脓未成,可下之,当有血。脉洪数者,脓已成,不
可下也,大黄牡丹汤主之。
问曰∶寸口脉微而涩,法当亡血,若汗出,设不汗者云何?答曰∶若身有疮,被刀器所伤,亡血故也。侵淫疮,从
口起流向四肢者,可治;从四肢流来入口者,不可治。
脉象数,身体没有发热,说明体内有痈肿。另一种说法是:腹部没有积聚,身体不热,脉象数,这是肠中有脓液。用薏苡附子败酱汤主治。
凡是浮数脉,应当出现发热症状,反而感到洒淅恶寒,如果有疼痛的部位,将会发生痈肿。
脉象微而迟,必定会发热;脉象弱而数,会出现寒战,将要发生痈肿。
脉象浮而数,身体没有发热,神情沉默不语,胸中轻微干燥(一作胃中轻微干燥),不知道疼痛的具体位置,这个人将会发生痈肿。
脉象滑而数,数脉主热,滑脉主实,滑脉主营气,数脉主卫气,营卫之气相遇,就会凝结成痈。热邪所经过的地方,就会化生为脓。
老师说:对于各种痈肿,想要知道是否有脓液,可以用手按压在肿胀处,感觉发热的就是有脓,不发热的就是无脓。
问:有一位羽林官的妇人患病,医生诊脉后,怎么知道她肠中有脓,通过攻下法就能痊愈?老师说:寸口脉滑而数,滑脉主实,数脉主热,滑脉主营,数脉主卫,卫气之数下降,营气之滑上升。营卫相互干扰,血液变得浑浊败坏,少腹痞硬坚实,小便有时涩滞,有时出汗,有时又恶寒,这说明脓已经形成。如果脉象迟而紧,说明聚结的是瘀血,瘀血下行则病愈。肠痈这种疾病,身体皮肤粗糙如鳞甲交错,腹皮紧急,按之柔软似有肿胀状。肠痈的症状是少腹肿胀,按压则疼痛,小便频数像淋病一样,时常发热,自汗出,又伴有恶寒。如果脉象迟紧,说明脓未形成,可以用攻下法,应当排出瘀血。如果脉象洪数,说明脓已形成,不可用攻下法,用大黄牡丹汤主治。
问:寸口脉微而涩,按照医理应当是失血或汗出过多所致,如果不汗出是怎么回事?回答说:如果身上有疮疡,被刀器所伤,是因为失血的原因。侵淫疮,从口部开始流向四肢的,可以治疗;从四肢流来进入口部的,难以治疗。
The pulse is rapid, the body has no fever, indicating an internal abscess (abscess). Another version states: There are no accumulations in the abdomen, the body is not hot, and the pulse is rapid; this indicates pus in the intestines. Yiyi Fuzi Baijiang Tang (Coix Seed and Aconite Decoction with Patrinia) is the primary treatment.
For all floating and rapid pulses, fever should occur, but instead there is a shivering aversion to cold. If there is a painful area, an abscess will develop.
If the pulse is faint and slow, fever must occur; if it is weak and rapid, there will be chills, and an abscess will develop.
If the pulse is floating and rapid, the body has no fever, the demeanor is silent and taciturn, there is slight dryness in the chest (or stomach), and the location of pain is unknown; this person will develop an abscess.
If the pulse is slippery and rapid, rapidness indicates heat, and slipperiness indicates excess. Slipperiness governs Ying (Nutritive Qi), and rapidness governs Wei (Defensive Qi). When Ying and Wei meet, they knot together to form an abscess. Where heat passes, pus is formed.
The Master said: Regarding all abscesses, to determine whether pus is present or absent, place one's hand over the swelling. If it feels hot, there is pus; if not hot, there is no pus.
Question: A woman from the household of the Yu Lin official was ill. The physician palpated her pulse and determined that she had pus in her intestines, stating that purgation would cure her. Why? The Master said: The Cun Kou (inch position) pulse is slippery and rapid. Slipperiness indicates excess, and rapidness indicates heat. Slipperiness governs Ying, and rapidness governs Wei. The rapidity of Wei descends, and the slipperiness of Ying ascends. Ying and Wei interfere with each other, causing blood to become turbid and degenerated. There is fullness and hardness in the lower abdomen, urination may be obstructed, sweating occurs intermittently, or there is aversion to cold again. This indicates that pus has already formed. If the pulse is slow and tight, it indicates the accumulation of stagnant blood; if the blood is discharged, the disease resolves. In intestinal abscess, the body skin is rough like scales, the abdominal wall is tense, but feels soft upon pressure as if swollen. Symptoms of intestinal abscess include swelling in the lower abdomen, pain upon pressure, frequent urination resembling strangury, intermittent fever, spontaneous sweating, and aversion to cold. If the pulse is slow and tight, the pus has not yet formed; purgation can be used, and bloody discharge is expected. If the pulse is surging and rapid, the pus has already formed; purgation is contraindicated. Dahuang Mudan Tang (Rhubarb and Moutan Decoction) is the primary treatment.
Question: The Cun Kou pulse is faint and slippery. According to standard theory, this should indicate blood loss or excessive sweating. What if there is no sweating? Answer: If there is a wound on the body caused by blades or weapons, it is due to blood loss. For Qin Yin Chuang (spreading sores/eczema), if it starts at the mouth and flows toward the limbs, it is treatable; if it starts at the limbs and flows into the mouth, it is difficult to treat.