问曰∶血痹从何得之?师曰∶夫尊荣人,骨弱肌肤盛,重因疲劳汗出,卧不时动摇,加被微风,遂得之。形如风状,
(巢原云其状如被微风所吹)但以脉自微涩,在寸口、关上小紧,宜针引阳气,令脉和紧去则愈。
血痹,阴阳俱微,寸口、关上微,尺中小紧,外证身体不仁,如风状,黄 桂五物汤主之。夫欲治病当先知其证何
趣乃当攻之耳。
男子平人,脉大为劳。极虚亦为劳。
男子劳之为病,其脉浮大,手足暖,春夏剧,秋冬瘥,阴寒精自出,酸削不能行,少阴虚满。
人年五十,六十,其病脉大者,痹挟背行,苦肠鸣,马刀侠瘿者,皆为劳得之。
男子平人,脉虚弱细微者,喜盗汗出也。
男子面色薄者,主渴及亡血。卒喘悸,其脉浮者,里虚也。
男子脉虚沉弦,无寒热,短气,里急,小便不利,面色白,时时目瞑,此人喜衄,少腹满,此为劳使之然。
男子脉微弱而涩,为无子,精气清冷。
夫失精家,少腹弦急,阴头寒,目眶痛(一云目眩),发落,脉极虚,芤迟,为清谷,亡血,失精。
脉得诸芤动微紧,男子失精,女子梦交通,桂枝加龙骨牡蛎汤主之。
脉沉小迟,名脱气。其人疾行则喘喝,手足逆寒,腹满,甚则溏泄,食不消化也。
脉弦而大,弦则为减,大则为芤,减则为寒,芤则为虚,寒虚相搏,此名为革。妇人则半产、漏下,男子则亡血、
失精。
问:血痹是如何产生的?老师回答:那些养尊处优的人,骨骼柔弱而肌肉丰盛,再加上因疲劳出汗,睡觉时身体不时翻动,受到微风的侵袭,于是便得了这种病。症状表现像中风的样子(巢元方说其状如被微风所吹),但脉象只是微涩,在寸口、关上部位略显紧象,适宜用针刺引导阳气,使脉象调和、紧象消失,病就能痊愈。
如果是血痹,阴阳脉气都微弱,寸口、关上脉微,尺中脉小紧,外在证候是身体麻木不仁,像中风的样子,用黄芪桂枝五物汤主治。想要治病,应当先知道证候属于哪一类,然后才能进行攻治。
男子平素健康,脉象大,这是虚劳的表现。脉象极虚,也是虚劳的表现。
男子患虚劳病,脉象浮大,手足温暖,春夏季节病情加重,秋冬季节病情减轻,阴寒导致精液自行滑出,肢体酸痛消瘦不能行走,少阴虚满。
人到了五十岁、六十岁,如果患病脉象大,这是痹症挟带背部行走,痛苦于肠鸣,以及出现马刀侠瘿(淋巴结结核类疾病),这些都是因为虚劳引起的。
男子平素健康,脉象虚弱细微的,容易盗汗。
男子面色淡白无华的,主渴及失血。突然气喘心悸,脉象浮的,是里虚。
男子脉象虚沉弦,没有寒热症状,短气,腹中急迫,小便不利,面色白,时常眼前发黑,这种人容易鼻出血,少腹胀满,这是虚劳导致的。
凡是经常失精的人,少腹弦急,阴头寒冷,眼眶痛(一说目眩),脱发,脉象极虚、芤迟,这是下利清谷、失血、失精的表现。
脉象出现各种芤、动、微、紧的,男子失精,女子梦交,用桂枝加龙骨牡蛎汤主治。
脉象沉小迟,称为脱气。病人疾走则喘息有声,手足逆冷,腹部胀满,严重时溏泄,食物不消化。
脉象弦而大,弦代表阳气减损,大代表中空如芤,减损则为寒,中空则为虚,寒与虚相互搏结,这叫做革脉。妇人则半产、漏下,男子则亡血、失精。
Question: How is Blood Bi (Blood Stasis Obstruction) acquired? The Master replied: Those who live in luxury have weak bones but abundant flesh. If they are further subjected to fatigue and sweating, and while sleeping their bodies move restlessly, allowing a slight breeze to invade them, they will contract this disease. The condition resembles Wind Strike (Zhong Feng), (Chao Yuanfang notes its appearance is like being blown by a slight breeze), but the pulse is merely slightly choppy and rough. At the Cun Kou (Radial Artery at the wrist) and Guan positions, there is a slight tightness. It is appropriate to use acupuncture to guide Yang Qi, so that the pulse becomes harmonious and the tightness disappears, leading to recovery.
If it is Blood Bi, both Yin and Yang pulses are minute. The pulses at Cun Kou and Guan are minute, while the Chi position is slightly tight. The external manifestation is numbness of the body, resembling Wind Strike. Huangqi Guizhi Wuwu Tang (Astragalus and Cinnamon Twig Five-Substance Decoction) is the primary formula. To treat a disease, one must first know the nature of the syndrome before applying therapeutic attacks.
In men who appear healthy, a large pulse indicates Lao (Consumptive Disease). An extremely deficient pulse also indicates Lao.
In men suffering from Lao, the pulse is floating and large; the hands and feet are warm; the condition worsens in spring and summer and improves in autumn and winter; cold in the lower jiao causes spontaneous emission of essence; the limbs are sore and emaciated, making walking difficult; there is deficiency-fullness in the Shaoyin (Kidney) channel.
When people reach fifty or sixty years of age, if the disease presents with a large pulse, it involves Bi obstruction along the back, distress from borborygmus (intestinal rumbling), and conditions such as "Ma Dao" and "Xia Ying" (types of scrofula/lymphadenopathy). All these are caused by Lao.
In men who appear healthy, a weak, deficient, and fine pulse suggests a tendency toward nocturnal sweating.
Men with a pale and thin complexion primarily suffer from thirst and blood loss. Sudden panting and palpitations with a floating pulse indicate interior deficiency.
Men with a pulse that is deficient, deep, and wiry, without chills or fever, experiencing shortness of breath, abdominal urgency, dysuria, a white complexion, and frequent dizziness/blackouts, are prone to epistaxis (nosebleeds) and lower abdominal fullness. This is caused by Lao.
A man with a faint and choppy pulse indicates infertility due to clear and cold Jing (Essence).
Those who habitually lose essence present with tense and urgent lower abdomen, coldness at the glans penis, orbital pain (or dizziness), hair loss, and an extremely deficient, knotted, slow pulse. These signs indicate loose stools with undigested food, blood loss, and loss of essence.
Pulses presenting various knotted, moving, faint, and tight characteristics in men indicate loss of essence; in women, they indicate dream intercourse. Guizhi Jia Longgu Muli Tang (Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell) is the primary formula.
A deep, small, and slow pulse is named Tuo Qi (Escaping Qi). The patient pants audibly when walking quickly, experiences reversed coldness in the hands and feet, abdominal fullness, and in severe cases, loose diarrhea and indigestion.
A wiry and large pulse: Wiry indicates reduction (deficiency); Large indicates hollow (Kou). Reduction implies Cold; Hollow implies Deficiency. The interaction of Cold and Deficiency is named Ge Pulse (Leather Pulse). In women, this indicates spontaneous abortion and dripping bleeding; in men, it indicates blood loss and loss of essence.