先吐泻而心腹绞痛者,其痧从秽气发者多,先心腹绞痛而吐泻者,从暑气发者多。心胸
昏闷,痰涎胶结,从伤伏热发者多。遍身肿胀疼痛,四肢不举,舌强不言,从寒气水过时,
郁为火毒而发者多。
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痧者,厉气也,入气分则作肿作胀,入血分则为蓄为瘀,遇食积痰火则气阻血滞,最忌
热汤热酒。不论犯者虚实,皆以有余治,绝无补法,用药克削,病自当之,中病即已。
分经络第三
腰背颠顶,连及风府,胀痛难忍,足太阳膀胱经痧。两目赤肿,唇干鼻燥,腹中绞痛,
足阳明胃经痧。胁肋肿胀,痛连两耳,足少阳胆经痧。腹胀板痛,不能屈伸,四肢无力,泄
泻不已,足太阴脾经痧。心胸吊痛,身重难移,作肿作胀,足厥阴肝经痧。痛连腰肾(外肾
也),小腹胀硬,足少阴肾经痧。咳嗽声哑,气逆发呛,手太阴肺经痧。半身疼痛麻木,左
足不能屈伸,手太阳小肠经痧。半身胀痛,废俯仰,右足不能屈伸,手阳明大肠经痧。病重
昏沉;或狂言不省人事,手少阴心经痧。或醒或寐,或独语一二句,手厥阴心包络经痧。胸
腹热胀,揭去衣被,干燥无极,手少阳三焦经痧。
按∶十二经受病见症,随症施治,其引经药亦不可少,今通列手足经脉后∶手少阴心循
手小指内侧出其端。手太阳小肠起手小指端,循外侧上行。手少阳三焦起手无名指端。手厥
阴心包络,又名手心主,出中指端。手阳明大肠起手食指端。手太阴肺出手大指端。足厥阴
肝起足大趾 毛上。足太阴脾起足大趾端。足阳明胃起足次趾外间。又一支亦入大趾端,又
一支入中趾外间。足少阳胆起足四趾间。足太阳膀胱起足小趾外侧端。足少阴肾起足小趾下
。阅此便于针刺。
膀小 柏羌些须,胃大葛朴芷区区,脾芍肾独盐酒俱。
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胆肝焦络柴丹青,川芎宜少再丁宁,肺葱桔芷心独辛。
羌芎白芷少为贵,胃肠脾肺升麻废,肾尤切戒毋加桂。
先出现呕吐腹泻,随后心腹部剧烈绞痛者,多因秽浊之气引发;先出现心腹部剧烈绞痛,随后发生呕吐腹泻者,多因暑热之气引发。心胸部位昏沉闷乱,痰涎黏稠胶结,多因伏热内伤引发。全身肿胀疼痛,四肢无法抬起,舌体僵硬不能言语,多因寒湿水气经过时,郁结化为火毒而引发。
痧症,属于疫疠之气。侵入气分则导致肿胀胀满,侵入血分则形成蓄积瘀滞。若遇到食积、痰火,则会导致气机阻滞、血液运行不畅,最忌讳饮用热汤和热酒。无论患者体质虚实如何,均按实证有余来治疗,绝对没有补益的方法。用药需峻猛攻削,病邪自会承受药力,一旦中病(药效达到治疗目的)即停止用药。
分经络第三
腰背部及头顶疼痛,牵连至风府穴,胀痛难以忍受,为足太阳膀胱经的痧症。两眼红肿,嘴唇干燥,鼻孔燥热,腹中绞痛,为足阳明胃经的痧症。胁肋部肿胀,疼痛牵连双耳,为足少阳胆经的痧症。腹部胀满且硬痛,身体不能屈伸,四肢无力,腹泻不止,为足太阴脾经的痧症。心胸部位如吊拉般疼痛,身体沉重难以移动,出现肿胀胀满,为足厥阴肝经的痧症。疼痛牵连腰部肾脏(包括外肾),小腹胀硬,为足少阴肾经的痧症。咳嗽声音嘶哑,气逆呛咳,为手太阴肺经的痧症。半身疼痛麻木,左脚不能屈伸,为手太阳小肠经的痧症。半身胀痛,无法做俯仰动作,右脚不能屈伸,为手阳明大肠经的痧症。病情严重出现昏沉;或胡言乱语、不省人事,为手少阴心经的痧症。或清醒或睡眠,或独自说一两句,为手厥阴心包络经的痧症。胸腹部热胀,掀去衣被,极度干燥,为手少阳三焦经的痧症。
按语:十二经脉受病出现的症状,应随症施治,引经药也不可缺少。现通列手足经脉走向如下:手少阴心经起于手小指内侧端。手太阳小肠经起于手小指端,沿外侧上行。手少阳三焦经起于手无名指端。手厥阴心包络,又名手心主,出于中指端。手阳明大肠经起于手食指端。手太阴肺经出于手大指端。足厥阴肝经起于足大趾丛毛处。足太阴脾经起于足大趾端。足阳明胃经起于足次趾外侧间。又一支脉进入大趾端,又一支脉进入中趾外侧间。足少阳胆经起于足四趾间。足太阳膀胱经起于足小趾外侧端。足少阴肾经起于足小趾下。阅读这些内容便于进行针刺治疗。
膀胱与小肠用柏子仁、羌活、细辛少许;胃与大肠用葛根、厚朴、白芷区区少量;脾用芍药,肾独用盐酒俱备。
[表格一]
[表格二]
Those who experience vomiting and diarrhea first, followed by severe cramping pain in the heart and abdomen, mostly suffer from Sha (Sha disease) triggered by foul qi. Those who experience severe cramping pain in the heart and abdomen first, followed by vomiting and diarrhea, mostly suffer from Sha triggered by summer-heat qi. Dizziness and stifling sensation in the chest and heart, with sticky and coagulated phlegm-saliva, mostly stem from internal injury by latent heat. Generalized swelling and pain of the whole body, inability to move the four limbs, stiff tongue and inability to speak, mostly arise when cold-damp water qi passes through, stagnating and transforming into fire-toxin.
Sha is a pestilential qi. When it enters the Qi level, it causes swelling and distension; when it enters the Blood level, it forms accumulation and stasis. If encountering food retention or phlegm-fire, it obstructs Qi flow and stagnates blood. It is most taboo to consume hot soup or hot wine. Regardless of whether the patient's constitution is deficient or excess, it should always be treated as an excess condition. There is absolutely no method of tonification. Medications must be harsh and reducing; the pathogen will naturally withstand the medicinal force. Stop medication once the disease is addressed (Zhong Bing).
Differentiation by Meridians, Chapter 3
Pain and distending pain in the lower back, back, and vertex, radiating to Fengfu (DU16), unbearable due to severity, indicates Sha of the Foot-Taiyang Bladder Meridian. Redness and swelling of both eyes, dry lips, dry nose, and cramping abdominal pain indicate Sha of the Foot-Yangming Stomach Meridian. Swelling of the hypochondrium, pain radiating to both ears, indicates Sha of the Foot-Shaoyang Gallbladder Meridian. Abdominal distension with board-like hardness, inability to flex or extend, weakness in the four limbs, and incessant diarrhea indicate Sha of the Foot-Taiyin Spleen Meridian. Hanging pain in the chest and heart, heavy body difficult to move, swelling and distension, indicate Sha of the Foot-Jueyin Liver Meridian. Pain radiating to the waist and kidneys (including external genitals), hard distension in the lower abdomen, indicates Sha of the Foot-Shaoyin Kidney Meridian. Cough with hoarse voice, rebellious Qi causing choking, indicates Sha of the Hand-Taiyin Lung Meridian. Numbness and pain in half of the body, inability to flex or extend the left foot, indicates Sha of the Hand-Taiyang Small Intestine Meridian. Distending pain in half of the body, inability to flex or extend the trunk, inability to flex or extend the right foot, indicates Sha of the Hand-Yangming Large Intestine Meridian. Severe illness with lethargy/coma, or delirium and loss of consciousness, indicates Sha of the Hand-Shaoyin Heart Meridian. Alternating between wakefulness and sleep, or speaking alone in one or two sentences, indicates Sha of the Hand-Jueyin Pericardium Meridian. Heat and distension in the chest and abdomen, removing clothes and blankets, extreme dryness, indicates Sha of the Hand-Shaoyang Sanjiao Meridian.
Note: The symptoms presented by diseases of the twelve meridians should be treated according to the specific manifestations. Channel-directing herbs are indispensable. The pathways of the hand and foot meridians are listed below for reference: The Hand-Shaoyin Heart Meridian originates at the ulnar end of the little finger. The Hand-Taiyang Small Intestine Meridian originates at the radial end of the little finger and ascends along the lateral side. The Hand-Shaoyang Sanjiao Meridian originates at the tip of the ring finger. The Hand-Jueyin Pericardium Meridian, also known as the Hand-Zhujin, emerges from the tip of the middle finger. The Hand-Yangming Large Intestine Meridian originates at the tip of the index finger. The Hand-Taiyin Lung Meridian emerges from the tip of the thumb. The Foot-Jueyin Liver Meridian originates above the hair on the big toe. The Foot-Taiyin Spleen Meridian originates at the tip of the big toe. The Foot-Yangming Stomach Meridian originates between the outer sides of the second toe. Another branch enters the tip of the big toe, and another branch enters the outer side of the middle toe. The Foot-Shaoyang Gallbladder Meridian originates between the fourth toes. The Foot-Taiyang Bladder Meridian originates at the lateral end of the little toe. The Foot-Shaoyin Kidney Meridian originates below the little toe. Reading this facilitates acupuncture treatment.
For Bladder and Small Intestine: Platycodon Root (Jiegeng), Notopterygium Rhizome (Qianghuo), and a few Pinellia Tuber (Banxia) [Note: Text says "Baixu" likely referring to specific preparation or typo for Banxia/Baizhi context, but literal translation used]. For Stomach and Large Intestine: Kudzu Root (Gegen), Magnolia Bark (Houpo), and Angelica Dahurica (Baizhi) in small amounts. For Spleen: Peony Root (Shaoyao). For Kidney: Salt and Wine together.
[Table 1]
[Table 2]
For Gallbladder, Liver, Sanjiao, and Pericardium: Bupleurum Root (Chaihu), Moutan Cortex (Danpi), and Qingdai. Use Chuanxiong Rhizome (Chuanxiong) sparingly, heed this warning again. For Lung: Scallion Stem (Congbai), Platycodon Root (Jiegeng), Angelica Dahurica (Baizhi). For Heart: Only Acrid/Warm herbs.
Qianghuo, Chuanxiong, and Baizhi should be used in precious small amounts. Shengma (Cimicifugae Rhizoma) is contraindicated for Stomach, Intestines, Spleen, and Lung. For Kidney, strictly avoid adding Cinnamon Twig (Guizhi).