此由血气虚弱,若受风寒湿毒,与血并行肤腠,邪气盛,正气少,故血气涩,涩则痹,
虚则弱,故令痹弱也。
此由风湿毒瓦斯,与血气相搏,正气与邪气交击,而正气不宣散,故疼痛。邪在肤腠,血
气则涩,涩则皮肤浓,搔之如隔衣不觉知,是名为痹不仁也。
香港脚之病,有挟风毒,风毒则搏于筋,筋为挛。风湿乘于血,则痹,故令痹挛也。
此由风湿毒瓦斯,从脚上入于内,与脏气相搏,结聚不散,故心腹胀急也。
此由风湿毒瓦斯,搏于肾经。肾主于水,今为邪所搏,则肾气不能宣通水液,水液不传于
小肠,致壅溢腑脏,腑脏既浸渍,溢于皮肤之间,故肿满也。
夫温湿成香港脚,而挟风毒,毒少风多,则风证偏见。风邪之来,初客肤腠,后经腑脏,
脏虚,乘虚而入,经游五脏,与神气相搏,神气为邪所乘,则心惊悸也。
咳嗽者,肺感于寒,微者则成咳嗽也。肺主气,合于皮毛。邪之初伤,先客皮毛,故肺
先受之。五脏与六腑为表里,皆禀气于肺。以四时更王,五脏六腑皆有咳嗽,各以其时感于
寒而受病,故以咳嗽形证不同。
五脏之咳者,乘秋则肺先受之,肺咳之状,咳而喘息有音声,甚则唾血。乘夏则心先受
之,心咳之状,咳则心痛,喉仲介介如哽,甚则咽肿喉痹。乘春则肝先受之,肝咳之状,咳
则两胁下痛,甚则不可以转侧,两 下满。乘季夏则脾先受之,脾咳之状,咳则右胁
下痛,喑喑引于膊背,甚则不可动,动则咳剧。乘冬则肾先受之,肾咳之状,咳则腰背
相引而痛,甚则咳逆。此五脏之咳也。
五脏咳久不已,传与六腑。脾咳不已,则胃受之。胃咳之状,咳而呕,呕甚则长虫出。
肝咳不已,则胆受之,胆咳之状,咳呕胆汁。肺咳不已,则大肠受之。大肠咳之状,咳而遗
屎。心咳不已,则小肠受之。小肠咳之状,咳而失气,与咳俱出。肾咳不已,则膀胱受之。
膀胱咳之状,咳而遗尿。久咳不已,则三焦受之。三焦咳之状,咳而腹满,不欲食饮。此皆
聚于胃,关于肺,使人多涕唾而面浮肿,气逆也。
又有十种咳。一曰风咳,欲语因咳,言不得竟是也。二曰寒咳,饮冷食,寒入注胃,从
肺脉上气,内外合,因之而咳是也。三曰支咳,心下坚满,咳则引痛,其脉反迟是也。四曰
肝咳,咳而引胁下痛是也。五曰心咳,咳而唾血,引手少阴是也。六曰脾咳,咳而涎出,续
续不止,引少腹是也。七曰肺咳,咳而引颈项,而唾涎沫是也。八曰肾咳,咳则耳聋无所闻
,引腰、脐中是也。九曰胆咳,咳而引头痛口苦是也。十曰厥阴咳,咳而引舌本是也。
诊其右手寸口,名气口以前脉,手阳明经也。其脉浮则为阳,阳实者,病腹满,善喘咳
。微大为肝痹,咳引小腹也。咳嗽脉浮,喘者生,小沉伏匿者死。
又云∶脉浮直者生,沉硬者死。咳且呕,腹胀且泄,其脉弦急欲绝者死。咳,脱形发热
,脉小坚急者死。咳且羸瘦,脉形坚大者死。咳而尿血,羸瘦脉大者死。
这是由于风湿毒气,最初从脚部上行,随后转入腹部,进而侵袭气机,导致上气(气逆上冲)的症状。
这是由于血气虚弱,如果受到风寒湿毒的侵袭,邪气与血液并行于皮肤腠理之间,此时邪气盛而正气少,因此血气运行涩滞,涩滞则导致痹证,因虚而致衰弱,所以出现痹弱(麻木无力)的症状。
这是由于风湿毒气与血气相互搏结,正气与邪气交争,但正气不能宣散,因此产生疼痛。邪气停留在皮肤腠理,血气运行涩滞,涩滞则导致皮肤增厚,搔抓时感觉如同隔着衣服一样不知痛痒,这被称为痹不仁(麻木不仁)。
香港脚病中,有挟带风毒的情况,风毒搏结于筋脉,导致筋脉拘挛。风湿侵袭血脉,则导致痹证,因此出现痹证和拘挛的症状。
这是由于风湿毒气从脚部上行进入体内,与脏腑之气相互搏结,郁结聚积而不消散,从而导致心腹胀满急迫。
这是由于风湿毒气搏结于肾经。肾主水液代谢,现在被邪气所搏结,导致肾气不能宣通水液,水液无法传输至小肠,致使水液壅滞溢满于脏腑,脏腑既被水湿浸渍,水液又溢出到皮肤之间,因此出现肿胀满闷。
温湿形成香港脚,且挟带风毒,若毒轻风重,则风证表现偏侧明显。风邪来袭,起初客居于皮肤腠理,随后经过腑脏,因脏腑虚弱,邪气乘虚而入,游走于五脏,与神气相搏结,神气被邪气所乘,因此出现心惊悸。
咳嗽,是肺感受寒邪所致,轻微者则形成咳嗽。肺主气,外合皮毛。邪气初伤人体,先客居于皮毛,因此肺最先受邪。五脏与六腑互为表里,都禀受肺气。随着四季更替,五脏六腑皆可能发病,各在其对应的季节感受寒邪而致病,因此咳嗽的表现形式各不相同。
五脏之咳:在秋季,肺先受邪,肺咳的症状是咳嗽伴有喘息且有声音,严重时唾血。在夏季,心先受邪,心咳的症状是咳嗽时心痛,咽喉中有异物感如梗塞状,严重时咽肿喉痹。在春季,肝先受邪,肝咳的症状是咳嗽时两胁下疼痛,严重时身体不能转侧,两胁下胀满。在长夏(季夏),脾先受邪,脾咳的症状是咳嗽时右胁下疼痛,牵引肩背作痛,严重时不能活动,活动则咳嗽加剧。在冬季,肾先受邪,肾咳的症状是咳嗽时腰背相互牵引作痛,严重时咳逆。这就是五脏之咳。
五脏之咳日久不愈,会传变给六腑。脾咳不愈,则胃受邪。胃咳的症状是咳嗽伴呕吐,呕吐严重时吐出蛔虫。肝咳不愈,则胆受邪,胆咳的症状是咳嗽并呕出胆汁。肺咳不愈,则大肠受邪。大肠咳的症状是咳嗽时大便失禁。心咳不愈,则小肠受邪。小肠咳的症状是咳嗽时放屁,与咳嗽同时排出。肾咳不愈,则膀胱受邪。膀胱咳的症状是咳嗽时遗尿。久咳不愈,则三焦受邪。三焦咳的症状是咳嗽伴腹部胀满,不想饮食。这些病症都是痰饮聚积于胃,病机关联于肺,使人多涕唾且面部浮肿,气机上逆。
又有十种咳嗽。一是风咳,想说话时因咳嗽而打断,话说不完。二是寒咳,饮用冷水或进食冷食,寒气注入胃中,沿肺脉上逆,内外合邪,因而引发咳嗽。三是支咳,心下坚硬胀满,咳嗽时牵引疼痛,脉象反而迟滞。四是肝咳,咳嗽牵引胁下疼痛。五是心咳,咳嗽时唾血,牵引手少阴心经部位。六是脾咳,咳嗽时流涎,连绵不断,牵引少腹。七是肺咳,咳嗽牵引颈项,并唾吐涎沫。八是肾咳,咳嗽时耳聋听不见声音,牵引腰部和脐中。九是胆咳,咳嗽牵引头痛、口苦。十是厥阴咳,咳嗽牵引舌本。
诊察右手寸口脉,名为气口之前的脉,属于手阳明大肠经。脉浮则为阳,阳气实者,病见腹部胀满,容易气喘咳嗽。脉微大者为肝痹,咳嗽牵引小腹。咳嗽脉浮,伴有气喘者生,脉小沉伏匿者死。
又说:脉浮直者生,脉沉硬者死。咳嗽且呕吐,腹胀且腹泻,脉象弦急欲绝者死。咳嗽,形体脱瘦发热,脉小坚急者死。咳嗽且消瘦,脉形坚大者死。咳嗽且尿血,消瘦脉大者死。
This condition arises from wind-dampness toxic qi, which initially ascends from the feet, then enters the abdomen, and subsequently attacks the qi mechanism, resulting in ascending qi (rebellious qi).
This is due to deficiency of blood and qi. If exposed to wind-cold-dampness toxicity, the pathogenic factors travel with the blood through the skin and interstices. When the pathogen is strong and the healthy qi is weak, the blood and qi become stagnant. Stagnation leads to bi-syndrome (obstruction syndrome), and deficiency leads to weakness; thus, numbness and weakness occur.
This is caused by wind-dampness toxic qi clashing with blood and qi. The healthy qi and pathogenic factors engage in conflict, but the healthy qi fails to disperse, resulting in pain. When the pathogen resides in the skin and interstices, the blood and qi become stagnant. Stagnation causes the skin to thicken; scratching feels like touching fabric without sensation, known as bi-numbness (numbness and insensitivity).
In Hong Kong foot disease, there are cases complicated by wind-toxicity. Wind-toxicity clashes with the sinews, causing sinew spasms. Wind-dampness invades the blood vessels, leading to bi-syndrome, hence presenting with bi-syndrome and spasms.
This is due to wind-dampness toxic qi ascending from the feet into the interior, clashing with the qi of the zang-fu organs, accumulating and failing to dissipate, thereby causing abdominal distension and urgency.
This is due to wind-dampness toxic qi clashing with the Kidney Meridian. The Kidneys govern water metabolism. Now, being attacked by pathogens, the Kidney qi cannot circulate and unblock the water fluids. The water fluids fail to transmit to the Small Intestine, causing stagnation and overflow within the zang-fu organs. Once the organs are soaked by dampness, the fluid overflows between the skin, resulting in swelling and fullness.
Warm-dampness forms Hong Kong foot, complicated by wind-toxicity. If the toxicity is slight and the wind is abundant, the wind symptoms manifest predominantly on one side. When wind-pathogen arrives, it initially lodges in the skin and interstices, then passes through the fu-zang organs. Due to organ deficiency, the pathogen enters vacuously, wandering through the five zang organs and clashing with the shen-qi (spiritual qi). When the shen-qi is invaded by the pathogen, palpitations and fright occur.
Cough results from the Lung being affected by cold. Mild cases develop into cough. The Lung governs qi and connects with the skin and hair. When pathogens first injure the body, they lodge in the skin and hair, so the Lung is affected first. The five zang and six fu organs have exterior-interior relationships and all derive qi from the Lung. With the changing seasons, the five zang and six fu organs can all suffer disease; each contracts illness by feeling cold in its corresponding season, hence cough presentations vary.
Cough of the five zang organs: In autumn, the Lung is affected first. Symptoms of Lung cough include coughing with wheezing and audible sounds; severe cases involve spitting blood. In summer, the Heart is affected first. Symptoms of Heart cough include heart pain during coughing, a sensation of obstruction in the throat as if choked; severe cases involve swollen throat and throat obstruction. In spring, the Liver is affected first. Symptoms of Liver cough include pain under both hypochondria during coughing; severe cases make turning difficult, with fullness under both hypochondria. In late summer, the Spleen is affected first. Symptoms of Spleen cough include pain under the right hypochondrium during coughing, radiating to the shoulders and back; severe cases prevent movement, worsening the cough upon movement. In winter, the Kidney is affected first. Symptoms of Kidney cough include pulling pain between the waist and back during coughing; severe cases involve reverse qi (coughing upward). These are the coughs of the five zang organs.
If cough of the five zang organs persists for a long time, it transmits to the six fu organs. Unresolved Spleen cough affects the Stomach. Symptoms of Stomach cough include coughing with vomiting; severe cases expel roundworms. Unresolved Liver cough affects the Gallbladder. Symptoms of Gallbladder cough include coughing and vomiting bile. Unresolved Lung cough affects the Large Intestine. Symptoms of Large Intestine cough include coughing with fecal incontinence. Unresolved Heart cough affects the Small Intestine. Symptoms of Small Intestine cough include passing flatus along with coughing. Unresolved Kidney cough affects the Bladder. Symptoms of Bladder cough include urinary incontinence during coughing. Long-standing cough affects the Sanjiao (Triple Burner). Symptoms of Sanjiao cough include abdominal fullness and loss of appetite. All these conditions gather in the Stomach and relate to the Lung, causing excessive phlegm and saliva, facial edema, and rebellious qi.
There are also ten types of cough. 1. Wind cough: interrupted speech due to coughing, unable to finish sentences. 2. Cold cough: drinking cold liquids or eating cold food causes cold to enter the stomach, ascend via the Lung meridian, combining internally and externally to induce cough. 3. Branch cough: hardness and fullness below the heart, pain radiating during coughing, pulse is surprisingly slow. 4. Liver cough: coughing with radiating pain to the hypochondrium. 5. Heart cough: coughing with spitting blood, radiating to the Hand-Shaoyin channel. 6. Spleen cough: coughing with continuous salivation, radiating to the lower abdomen. 7. Lung cough: coughing with radiating pain to the neck and spitting frothy sputum. 8. Kidney cough: deafness during coughing, radiating to the waist and umbilicus. 9. Gallbladder cough: coughing with radiating headache and bitter taste. 10. Jueyin cough: coughing with radiating pain to the root of the tongue.
Diagnose the cunkou pulse on the right hand, known as the qikou pulse before the meridian, belonging to the Large Intestine Meridian of Hand-Yangming. A floating pulse indicates Yang; excess Yang presents with abdominal fullness and frequent wheezing/coughing. A slightly large pulse indicates Liver Bi-syndrome, with cough radiating to the lower abdomen. For cough, a floating pulse with wheezing indicates survival; a small, deep, hidden pulse indicates death.
It is also said: A straight floating pulse indicates survival; a deep and hard pulse indicates death. Cough with vomiting, abdominal distension with diarrhea, and a wiry, rapid pulse nearing extinction indicate death. Cough with emaciation and fever, and a small, firm, rapid pulse indicate death. Cough with emaciation and a firm, large pulse indicate death. Cough with hematuria, emaciation, and a large pulse indicate death.