1.肺中风者,口燥而喘,身运而重,冒而肿胀。
2.肺中寒,吐浊涕。
3.肺死脏,浮之虚,按之弱如葱叶,下无根者,死。
4.肝中风者,头目 两胁痛,行常伛,令人嗜甘。
5.肝中寒者,两臂不举,舌本燥,喜太息,胸中痛,不得转侧,食则吐而汗出也。(《脉经》、《千金》
云∶时盗汗咳,食已吐其汁。)
6.肝死脏,浮之弱,按之如索不来,或曲如蛇行者,死。
7.肝着,其人常欲蹈其胸上,先未苦时,但欲饮热,旋复花汤主之。(臣亿等校诸本旋复花汤,皆同。)
旋复花汤方
旋复花(三两) 葱(十四茎) 新绛(少许)
上三味,以水三升,煮取一升,顿服之。
8.心中风者,翕翕发热,不能起,心中饥,食即呕吐。
9.心中寒者,其人苦病心如啖蒜状,剧者心
痛彻背,背痛彻心,譬如蛊注,其脉浮者,自吐乃愈。
10.心伤者,其人劳倦,即头面赤而下重,心中痛而自烦,发热,当脐跳,其脉弦,此为心脏伤所致也。
11.心死脏,浮之实如丸豆,按之益躁疾者,死。
12.邪哭使魂魄不安者,血气少也。血气少者,属于心。心气虚者,其人则畏,合目欲眠,梦远行而精神离
散,魂魄妄行。阴气衰者为癫,阳气衰者为狂。
13.脾中风者,翕翕发热,形如醉人,腹中烦重,皮目 而短气。(臣亿等详五脏各有中风中寒,今脾只
载中风,肾中风、中寒俱不载者,以古文简乱极多,去古既远,无文可以补缀也。)
14.脾死脏,浮之大坚,按之如覆杯,洁洁状如摇者,死。
15.趺阳脉浮而涩,浮则胃气强,涩则小便数,浮涩相搏,大便则坚,其脾为约,麻子仁丸主之。
麻子仁丸方
麻子仁(二升) 芍药(半斤) 枳实(一斤) 大黄(一斤) 浓朴(一尺) 杏仁(一升)
上六味,末之,炼蜜和丸梧子大,饮服十丸,日三,以知为度。
16.肾着之病,其人身体重,腰中冷,如坐水中,形如水状,反不渴,小便自利,饮食如故,病属下焦。身
劳汗出,衣里冷湿,久久得之。腰以下冷痛,腹重如带五千钱,甘姜苓术汤主之。
甘草干姜茯苓白术汤方
甘草 白术(各二两) 干姜 茯苓(各四两)
上四味,以水五升,煮取三升,分温三服,腰中即温。
17.肾死脏,浮之坚,按之乱如转丸,益下入尺中者,死。
18.问曰∶三焦竭部,上焦竭善噫,何谓也?师曰∶上焦受中焦气,未和,不能消谷,故能噫耳。下焦竭,
即遗溺失便,其气不和,不能自禁制,不须治,久则愈。
19.师曰∶热在上焦者,因咳为肺痿;热在中焦者,则为坚;热在下焦者,则尿血,亦令淋秘不通。大肠有
寒者,多 溏;有热者,便肠垢小肠有寒者,其人下重便血;有热者,必痔。
20.问曰∶病有积、有聚、有馨气,何谓也?
师曰∶积者,脏病也,终不移;聚者,腑病也,发作有时,展转痛移,为可治。馨气者,胁下痛,按之则愈,复
发为馨气。诸积大法,脉来细而附骨者,乃积也。寸口,积在胸中;微出寸口,积在喉中;关上,积在脐旁;上
关上,积在心下;微下关,积在少腹;尺中,积在气冲;脉出左,积在左;脉出右,积在右;脉两出,积在中央。
各以其部处之。
1.肺脏感受风邪的,表现为口干、气喘,身体眩晕且沉重,头昏目眩并伴有肿胀。
2.肺脏感受寒邪的,吐出浑浊的鼻涕。
3.肺气已绝的死脉,轻取虚浮,重按软弱像葱叶一样,下部无根底的,主死。
4.肝脏感受风邪的,头部和眼睛两侧胁肋疼痛,行走时常弯腰曲背,使人喜欢吃甘甜的食物。
5.肝脏感受寒邪的,两臂不能抬起,舌根干燥,喜欢长叹气,胸中疼痛,不能翻身侧卧,进食后呕吐并出汗。(《脉经》、《千金方》说:时常盗汗咳嗽,吃完饭后吐出未消化的食物汁液。)
6.肝气已绝的死脉,轻取弱,重按如绳索般坚硬且不往来流动,或者弯曲像蛇行一样的,主死。
7.肝着病,病人常常想要别人踩踏他的胸部上方,在刚开始没有痛苦时,只想喝热饮,用旋复花汤主治。(臣亿等校勘各版本旋复花汤,内容都相同。)
旋复花汤方
旋复花(三两) 葱(十四茎) 新绛(少许)
以上三味药,用水三升,煮取一升,一次性服用。
8.心脏感受风邪的,发热轻微如羽毛覆盖之感,不能起床,心中感觉饥饿,吃东西就呕吐。
9.心脏感受寒邪的,病人痛苦得像吃了大蒜的感觉,严重的出现心痛放射到背部,背痛放射到心胸,如同蛊毒注病,如果脉象浮的,自己吐出来就好了。
10.心脏受损的,病人劳累疲倦,就会头面发红且下肢沉重,心中疼痛且自感烦闷,发热,肚脐周围跳动,脉象弦,这是心脏受伤所致。
11.心气已绝的死脉,轻取坚实如弹丸豆子,重按更加躁动急疾的,主死。
12.异常哭泣导致魂魄不安的,是血气不足。血气不足,归属于心。心气虚的人,则胆怯畏惧,闭眼想睡觉,梦见远行而精神离散,魂魄妄行。阴气衰弱的发为癫证,阳气衰弱的发为狂证。
13.脾脏感受风邪的,发热轻微如羽毛覆盖之感,形体像喝醉的人,腹中烦闷沉重,眼睑跳动且短气。(臣亿等详查五脏各有中风中寒,现在脾脏只记载中风,肾的中风中寒都不记载,是因为古文极其简略混乱,距离古代久远,没有文献可以补缀。)
14.脾气已绝的死脉,轻取大且坚,重按如倒扣的杯子,洁净摇动的样子,主死。
15.趺阳脉浮而涩,浮表示胃气强盛,涩表示小便频数,浮与涩相互搏结,大便则干硬,其脾被约束,用麻子仁丸主治。
麻子仁丸方
麻子仁(二升) 芍药(半斤) 枳实(一斤) 大黄(一斤) 浓朴(一尺) 杏仁(一升)
以上六味药,研成末,炼蜜调和做成梧子大小的丸剂,每次服十丸,每日三次,以见效为度。
16.肾着病,病人身体沉重,腰部寒冷,像坐在水中,外形像有水状,反而不渴,小便自利,饮食正常,病属下焦。身体劳累出汗,衣服里面冷湿,久而久之得此病。腰部以下冷痛,腹部沉重像带着五千枚铜钱,用甘姜苓术汤主治。
甘草干姜茯苓白术汤方
甘草 白术(各二两) 干姜 茯苓(各四两)
以上四味药,用水五升,煮取三升,分三次温服,腰部就会温暖。
17.肾气已绝的死脉,轻取坚硬,重按杂乱如转丸,向下进入尺部的,主死。
18.问:三焦功能衰竭的部位,上焦衰竭容易嗳气,这是什么意思?老师说:上焦受纳中焦之气,若不和顺,不能消化谷物,所以能嗳气。下焦衰竭,就会遗尿失禁,其气不和,不能自我控制,不需要治疗,久了就会痊愈。
19.老师说:热在上焦的,因咳嗽成为肺痿;热在中焦的,则为大便坚硬;热在下焦的,则尿血,也会引起淋证秘结不通。大肠有寒的,多便溏;有热的,排出的粪便带有黏垢。小肠有寒的,病人肛门重坠便血;有热的,必定生痔疮。
20.问:疾病有积、有聚、有馨气,是什么意思?
老师说:积,是脏的病,最终不移位;聚,是腑的病,发作有定时,辗转疼痛移动,是可以治疗的。馨气,胁下疼痛,按压则缓解,复发称为馨气。各种积病的总原则,脉象细而附骨的是积。寸口脉,积在胸中;微出寸口,积在喉中;关上脉,积在脐旁;上关上脉,积在心下;微下关脉,积在少腹;尺中脉,积在气冲;脉出现在左手,积在左边;脉出现在右手,积在右边;脉左右都出现,积在中央。分别根据脉出现的部位来诊治。
1. When the Lung is affected by Wind, symptoms include dry mouth and wheezing, dizziness with a sensation of heaviness in the body, vertigo, and swelling.
2. When the Lung is affected by Cold, turbid nasal mucus is expectorated.
3. In the case of terminal Lung Qi, the pulse is empty and floating on light pressure, weak like an onion leaf on heavy pressure, and lacking a root at the bottom; this indicates death.
4. When the Liver is affected by Wind, there is pain in the head, eyes, and hypochondriac regions, habitual stooping during walking, and a craving for sweet flavors.
5. When the Liver is affected by Cold, both arms cannot be raised, the root of the tongue feels dry, frequent sighing occurs, chest pain prevents turning over, and vomiting accompanied by sweating happens after eating. (The *Mai Jing* and *Qian Jin Fang* state: occasional night sweats and coughing, vomiting undigested food juice after meals.)
6. In the case of terminal Liver Qi, the pulse is weak on light pressure, hard like a cord without flow on heavy pressure, or curved like a snake moving; this indicates death.
7. In Gan Zhuo (Liver Fixation), the patient constantly desires someone to tread on their upper chest. Initially, when not yet painful, they only desire hot drinks. Xuan Fu Hua Tang (Inula Flower Decoction) is indicated. (Chen Yi et al. verified that all versions of Xuan Fu Hua Tang are identical.)
Xuan Fu Hua Tang Formula
Xuan Fu Hua (Inulae Flos, 3 liang), Cong Bai (Allii Fistulosi Bulbus, 14 stems), Xin Jiang (Safflower Stamen, a small amount).
These three ingredients are boiled in 3 sheng of water to obtain 1 sheng, taken in one dose.
8. When the Heart is affected by Wind, there is mild fever (as if covered by feathers), inability to rise from bed, a sensation of hunger in the heart region, and vomiting immediately after eating.
9. When the Heart is affected by Cold, the patient suffers as if having eaten garlic. In severe cases, heart pain radiates to the back, and back pain radiates to the heart, resembling Gu Zhu (Gu Poison Injection). If the pulse is floating, spontaneous vomiting leads to recovery.
10. When the Heart is injured, the patient experiences fatigue and lassitude, leading to redness of the face and head and heaviness of the lower body. There is heart pain with internal restlessness, fever, pulsation around the umbilicus, and a wiry pulse. This is caused by Heart injury.
11. In the case of terminal Heart Qi, the pulse is solid like pills or beans on light pressure, and becomes increasingly restless and rapid on heavy pressure; this indicates death.
12. Abnormal weeping causing insecurity of the Hun and Po is due to deficiency of Blood and Qi. Deficiency of Blood and Qi belongs to the Heart. When Heart Qi is deficient, the person is fearful, wishes to sleep with eyes closed, dreams of traveling far, and has scattered spirit and soul. Deficiency of Yin Qi leads to Dian syndrome (epilepsy-like depression); deficiency of Yang Qi leads to Kuang syndrome (mania).
13. When the Spleen is affected by Wind, there is mild fever, a demeanor resembling drunkenness, abdominal fullness and heaviness, twitching of the eyelids, and shortness of breath. (Chen Yi et al. note that while other Zang organs have records for Wind and Cold afflictions, the Spleen only records Wind, and the Kidney records neither, because ancient texts were extremely concise and chaotic, and no texts remain to supplement them.)
14. In the case of terminal Spleen Qi, the pulse is large and firm on light pressure, hard like an inverted cup on heavy pressure, and shaking cleanly; this indicates death.
15. The Duyang pulse is floating and choppy. Floating indicates strong Stomach Qi; choppy indicates frequent urination. The interaction of floating and choppy pulses leads to hard stool. The Spleen is constrained (Pi Yue); Ma Zi Ren Wan (Hemp Seed Pill) is indicated.
Ma Zi Ren Wan Formula
Ma Zi Ren (Cannabis Fructus, 2 sheng), Shao Yao (Paeoniae Radix Alba, 0.5 jin), Zhi Shi (Aurantii Fructus Immaturus, 1 jin), Da Huang (Rhei Radix et Rhizoma, 1 jin), Hou Po (Magnoliae Officinalis Cortex, 1 chi), Xing Ren (Armeniacae Semen Amarum, 1 sheng).
These six ingredients are powdered, mixed with refined honey to form pills the size of wutou seeds. Take 10 pills with water, three times daily, adjusting dosage until efficacy is achieved.
16. In Shen Zhuo (Kidney Fixation) disease, the body feels heavy, the waist feels cold as if sitting in water, though the appearance resembles edema, there is no thirst, urination is normal, and appetite is unchanged. The pathology is in the Lower Jiao. It results from long-term exposure to cold dampness in clothing after labor-induced sweating. Cold pain below the waist and heaviness in the abdomen as if carrying 5,000 coins are present. Gan Jiang Ling Zhu Tang (Glycyrrhiza, Dried Ginger, Poria, and Atractylodes Macrocephala Decoction) is indicated.
Gan Jiang Ling Zhu Tang Formula
Gan Cao (Glycyrrhizae Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma, each 2 liang), Gan Jiang (Zingiberis Rhizoma Recens dried), Fu Ling (Poria, each 4 liang).
These four ingredients are boiled in 5 sheng of water to obtain 3 sheng, taken warm in three doses. The waist will become warm.
17. In the case of terminal Kidney Qi, the pulse is firm on light pressure, chaotic like rolling balls on heavy pressure, extending downwards into the Chi position; this indicates death.
18. Question: What does it mean when the San Jiao functions fail in specific areas, such as the Upper Jiao failing leading to belching? Master says: The Upper Jiao receives Qi from the Middle Jiao. If unharmonized, it cannot digest grains, hence belching occurs. If the Lower Jiao fails, urinary incontinence and fecal incontinence occur due to unharmonized Qi unable to self-restrain. No treatment is needed; it will resolve spontaneously over time.
19. Master says: Heat in the Upper Jiao causes Fei Wei (Lung萎/Flaccidity) due to coughing; heat in the Middle Jiao causes hardness (constipation); heat in the Lower Jiao causes hematuria and also leads to Lin syndrome (dysuria) and retention of urine. Cold in the Large Intestine causes loose stools; heat causes foul-smelling mucoid stools. Cold in the Small Intestine causes tenesmus and bloody stools; heat causes hemorrhoids.
20. Question: What are Ji (Accumulation), Ju (Gathering), and Xin Qi (Fragrant Qi)?
Master says: Ji is a disease of the Zang organs, fixed in place and not moving. Ju is a disease of the Fu organs, occurring at intervals, with migrating pain, and is treatable. Xin Qi involves pain in the hypochondrium that relieves upon pressure but recurs upon release. The general rule for Ji is a fine pulse adhering to the bone. At the Cun Kou position, accumulation is in the chest; slightly beyond Cun Kou, in the throat; at Guan, beside the umbilicus; above Guan, below the heart; slightly below Guan, in the lower abdomen; at Chi, at Qichong. If the pulse appears on the left, accumulation is on the left; on the right, on the right; on both sides, in the center. Treat according to the location indicated by the pulse.