一条 寸口脉动而弱。动即为惊。弱则为悸。
寸口、指关前而言。动脉、形圆体短。厥厥动摇。而兼滑象者是也。弱、如弱水之弱。有不能载物之象。惊非外来。
惕然自儆也。悸者、怯怯虚馁之状。两物相击。轻小者动。亦受击者动。寸口脉动而弱。寸口应心下。弱则其气
轻小。而下焦之气。得以上冲而击动之。心下为神君之座。下气突犯。故惊。又心下为宗气之城。本气虚微。故
悸。诸解、格格可笑。本经及伤寒论。凡言脉有二例。而俱以而字为界。一则以上字为经。而以而字以下为
病。如脉浮而紧。脉浮而缓之类。盖以浮脉定太阳。而以紧缓别风寒也。一则如本文脉动而弱。后文脉浮而
大之类。盖又以上一字为浮取。而以而字以下为沉取也。余仿此。
二条 心下悸者。半夏麻黄丸主之。
半夏麻黄丸方 半夏 麻黄（等分）
上二味。末之。炼蜜和丸。如小豆大。饮服三丸。日三服。
此双顶上文脉之动弱。症之惊悸而言。非单言悸也。而半夏麻黄丸一方。却又是治惊之药。而非治悸者。古
人文章。其承接处。往往错综如此。盖谓心下惊而且悸者。虽以心下之本气虚微。而为下焦之气冲犯之地。
究当先责其冲气以治惊为正。故主半夏麻黄丸。下平其冲气。则脉不动而惊且自止矣。此春秋罪主令之
法也。若寸口脉弱而动。只消于浮沉处倒见。则当责心下之弱为主。而主下条桂枝救逆。及伤寒论中苓术
桂甘。并小建中等汤。而于此丸无取矣。
客有问余者曰。本衣冠文物明单言悸。而子以为双顶惊悸。本方明明是治悸之丸。而子又谓是单治惊。是谁为
子言之也。余曰。仲景于不言之表为我言之也。夫弱为寸口之本脉。动为从下上冲。寸口之标脉。故悸为心
下之本病。惊为从下上犯。心下之标病。言悸而惊在其中者。从本之义也。至本方之妙。千古无人揭出。不妨
因子之问而细剖之。麻黄空细如毛。性极疏泄。用于桂甘姜枣之中。乘辛暖甘浮之化。又得杏仁之清利以
为使。则疏泄之性。从上外向。故能由胸达表以为汗。此麻黄、大青龙二汤之正用如此。若夫监以辛降平逆
之半夏。敛以酸收下走之白芍。又得茯苓之淡渗以为使。则又使疏泄之性下向。而利膀胱渗化之机。此小
青龙一汤。为下焦之变用。又如此。至于本方。脉则以动乘弱。症则因悸而惊。是上焦不足。中焦有余。以有余
之火。侵犯不足。故止用对配辛降平逆之半夏。使疏泄之性从中下散。又恐汤性易竭。丸则取其缓发。蜜则
润其偏干。小丸少服者。徐图渐减之义。此本方一丸。为中焦之平用者更如此。要之、动弱惊悸。脉症俱是两
层。弱脉悸症。在主虚一边。下条桂枝救逆。及伤寒论中苓术桂甘、并小建中等汤。扶弱以补不足。动脉惊症。
在客实一边。故用此丸。锄强以损有余。譬之墙垣低矮。以招外盗者。彼桂枝救逆等方。增益墙垣以治悸。半
夏麻黄一丸。驱除外盗以治惊耳。客复何言哉。
三条 火邪者。桂枝去芍药。加蜀漆牡蛎龙骨救逆汤主之。
桂枝救逆汤方
桂枝（二两去皮） 甘草（二两炙） 生姜（三两） 大枣（十二枚劈） 牡蛎（五两熬）
龙骨（四两） 蜀漆（三两洗去腥）
上为末。以水一斗三升。先煮蜀漆。减二升。内诸药。煮取三升。去滓。温服一升。（以取三升而服一升计之。
当如服桂枝汤之法。作三日服矣。特不饮热粥耳。）
此条及方。旧本错编在本篇十二条下。细按汤意。确是治惊悸之方。且其文气。又确是依靠上文心下悸者
而来。则火邪者三字。方不突兀。故移于此。有识者。自能辨之也。承上文、言实者责之。固主半夏麻黄丸。责中
下之有余以治惊。又有以火逼劫其汗。汗为心肺之液。汗出。而心肺夹空之气两虚。以致神明之宰。无所根据
着。而招中下之逆而惊悸者。是火邪者也。火邪之为惊悸者。责在上焦之虚。舍桂枝救逆一汤。其能填此阳
气阳液乎。盖桂枝汤之桂甘姜枣。最为招来阳气阳液之檄。已见小建中注。东垣称蜀漆入心经。有飞针走
线之功。先煮之以为主。则引桂甘姜枣之性。直达心肺之空。以填其虚。然后以牡蛎之静藏水底。龙骨之镇
摄山灵者为佐。则神明之摇动浮越者自安。是桂甘姜枣所以治悸。而龙牡所以定惊也。至于心肾同治少
阴。而其气尝相升降。心气虚者。畏肾中之贼阴上凌真宰。故合牡蛎之水族。而与龙骨同用者此也。
四条 师曰。尺脉浮。目睛晕黄。衄未止。晕黄去。目睛慧了。知衄止。
尺脉之脏。为肾。肾之腑。为膀胱。足太阳膀胱之隧道。与手太阳小肠之经。由巅顶相会。而交通于鼻。夫沉为
在里。浮为在表。今尺浮。是太阳膀胱之气。由经道而直上巅顶之象也。又本经第一篇三条言鼻。曰色黄者。
便难。夫鼻居中央。为中土之应。阳明之气。燥结而不下通。故于本位浮出火土之色。今由鼻而黄晕于目睛。
则其黄更高矣。且目睛为肝肾之光华。肝主血液。肾主精汁。目睛晕黄。是阳明燥热之土气。而为炎蒸水液
之诊也。足阳明胃家之隧道。与手阳明大肠之经。相会而挟于鼻。故于二者之中。或色或脉。但见一诊。即知
衄未止矣。晕黄去。阳明之热下解。目睛慧了。肝肾之气展舒。故知衄止。上二句。合太阳阳明而言正衄之诊。
下三句。单就阳明而言衄止之诊。则太阳之衄。其止于尺脉之浮去而见沉者。可类推矣。
五条 又曰。从春至夏衄者太阳。从秋至冬衄者阳明。
此即上文之尺浮、晕黄。而申言之也。夫春生夏长。天地生阳之气内盛。而人身以太阳之经气相应。故春夏
之衄属太阳。秋敛冬藏。万物成熟之气内实。而人身以阳明之里气相应。故秋冬之衄属阳明也。但此及上
文二条。明明言衄血。有太阳、阳明两症。至下文方治。却止有泻心一汤。几疑单是治阳明之衄。而遗太阳一
边之治例矣。不知四条曰。尺脉浮。衄未止。七条曰。脉沉弦者衄。夫尺为在里。浮为上出。与沉为在里。弦为上
出同断。是太阳之衄。为实邪从里。外穿经隧。从下上升巅顶之症。自当责之在里在下。则外穿者内伏。上升
者下熄矣。夫责在里在下之实邪。离大黄苓连。将谁属乎。故虽衄症有太阳、阳明之分。而其主泻心则一也。
六条 衄家不可发汗。汗出必额上陷。脉紧急。直视。不能 。不得眠。
衄家发汗。则额陷。注详伤寒论。脉、非单指手太阴也。由本文之言额、言视、言 、言眠观之。当指上部之天地
人及人迎等处。以衄家伤巅顶之血尤多。故偏言头上耳。紧急。亡阴躁疾之象。直视者。目系干涩。失流动之
神也。不能 、不能合。不得眠、不得寝也。皆阴虚于上。而阳往从之之义。上文言春夏之衄属太阳。恐人以
发汗为太阳之治例。而误投之于衄家。则逆矣。故戒。
七条 病患面无血色。无寒热。脉沉弦者。衄。浮弱、手按之绝者。下血。烦咳者。必吐血。
此条前三句。是就色、脉、症。而正言衄血之诊法。下文脉浮弱两段。古人借水叠桥。又即衄诊而趁便及之。为
下文吐、下、条内之省笔也。脏腑之精华。浮于面而色红且润者。血之所荣也。六经外邪之症。惟少阳、厥阴。属
木。而为阴阳之枢。属木、故面色以青应。为阴阳之枢。故表症。阖则为寒。而辟则为热也。又本脉弦急。故病此
者之脉状必弦。若病患面无血色。而血不荣。又无寒热之表症。是非少阳、厥阴之表邪为病。而其面以青色
见也。可知。今脉又沉弦如厥阴。则必为衄病无疑矣。夫沉弦为肝家邪实之脉。且弦以沉见。是浮处未尝弦
也。以有余弹射不足。则衄之上出如矢者。乌能禁哉。衄血之诊法如此。若面无血色。而其人之脉。举之但浮。
取之则弱。重按之至沉处。则弱甚而绝。是浮。为上焦有余之邪火。凭凌胃中之血液。故中取之则弱。灌注大
肠之虚脱而下。故按之绝也。则面无血色。又系阳明脱血以致脱气者之诊也。若面无血色。而脉又浮弱。按
之即绝者。多烦咳一症。则其按之即绝。为下焦虚寒之应。其脉浮弱者。为虚寒之邪。上冲而致咳。咳多上顿。
而气亦升浮之应。血随气逆。合之面无血色。则其血之伤于上出。而见于吐者可必矣。此条当熟读细玩。
始见后文汤意之妙。否则。柏叶、黄土、赤豆、当归及泻心等汤。无从觅针线矣。
八条 夫吐血、咳逆、上气。其脉数而有热。不得卧者死。
吐血、咳逆、上气。勿作一症。当分三症看。因此条原是言吐血之死脉死症。其咳逆上气两症之死诊。与吐血
相同。故连及之。若以吐血、咳逆、上气为一人之病。则何必以不得卧为短期耶。夫吐血有阳明胃实。上冲胃
系一症。主麻仁丸。或调胃承气汤可愈。有少阳风热上逆一症。主小柴胡汤可愈。有厥阴风火。上冲心胸一
症。主当归四逆汤可愈。然阳明胃实之脉涩而浮。仅于日晡见潮热。少阳风热之脉弦而微大。但见往来之
热。厥阴风火之脉弦细而浮。小见微热。或无热而恶寒也。若吐血而脉数。且有或表或里之热。则数为无阴。
而阳气有急疾之诊。热为离阴。而孤阳有浮脱之象。已成危候。所赖静则生阴。犹得假一卧以留连其阳气。
若更不得卧。则气不归肾。而神莫栖。血不统肝。而魂欲散。其不死也得乎。咳逆者。忌邪实。上气者。忌息高。脉
数有热。邪实息高之诊。其不得卧与吐血者。同一下脱上绝而死也。
九条 夫酒客咳者。必致吐血。此因极饮过度所致也。
酒性浮热。热则动血。浮则上气。气浮血热。故咳则必致吐血也。夫饮食之邪。本经列为不内不外因。以极饮
过度。而致咳而吐血。延至脉数有热。不得睡卧。同归死候。岂不大可惜哉。长沙揭此。其戒之耶。抑谓于方咳
而未吐血时。或辛凉以解热。降渗以平浮。犹得挽回生路耶。
十条 寸口脉弦而大。弦则为减。大则为芤。减则为寒。芤则为虚。寒虚相搏。此名曰革。妇人则半产
漏下。男子则亡血失精。
寸口、应上焦。脉弦句。谓举之见弦。按之见大也。或曰。右寸见弦。左寸见大。此说亦合。减者、瘦削之状。脉
体如
圆茎。气血之充也。今浮之而形细如丝弦。若沉之而仍弦。是浮沉俱细。虽细而不失其为圆茎之体矣。乃按
之见大。则浮处之见弦。是两肩减去其圆形。而成荞麦之象。故曰弦则为减。非弦脉尽减。以浮弦而沉大。故
知其上焦之气。不能充满脉体。而为减削之貌也。芤、为中空之草。凡物之中实者。则外气内固。而形自坚小。
今浮弦而沉处独大。则大非本相。而为中虚散漫之象。故曰大则为芤也。减为上焦之阳气亏空。故曰寒。芤
属下焦之精血耗损。故曰虚。上焦之阳气亏空。则阴气上乘。下焦之精血耗损。则阳精下降。阴阳之贼气。与
妄情相得。则梦接鬼交。肺肾之余灵。与残境相乖。则幻生惊怖。此寒虚相搏之道也。革者。鼓革之义。弦坚大
空。有鼓革之象。故合状之如此。半产、凡不满十月者皆是。漏下、谓血崩及赤白带下之类。亡血、指尿血、便血
之下出者而言。失精、凡有梦无梦及滑脱者、皆在其中。夫在上之阳气削弱。不能挈提。在下之阴津虚滑。不
能握固。故见种种下脱之症也。
此是虚劳脉症。故入虚劳门者为正例。因有亡血一症而复入此者。郑重之意也。
十一条 亡血不可发其表。汗出则寒栗而振。
亡血。凡吐衄便血者皆是。夫分而言之。虽有阴阳气血之殊。其实则阳载阴中。气根血分者也。亡血者气亦
虚。复发其表。则气愈虚矣。且汗为血中之阳液。汗出则重伤其卫气。一也。又气血两虚之人。其阴阳之气。非
极力交并于上。几有不辨之势。汗出则虚阳之极浮者。必反而为极伏。二也。寒栗而振。其能免乎。
亡血者发汗。烦躁者居多。然犹可借阳气以生阴液。若伤气而至寒栗。则为逆滋大矣。可不惧哉。
十二条 病患胸满。唇痿。舌青。口燥。但欲漱水。不欲咽。无寒热。脉微大来迟。腹不满。其人言。我满。
为有瘀血
此及下文二条。症极错杂。理极微奥。原难理会。注家俱泛指心、肺、肝、脾。而终不辨血瘀何地。症属何因。殊为
梦梦。盖不特心为神明之府。肺为宗气之城。高贵清虚。略不可犯。瘀心、则 乱猝死。瘀肺。则喘满立绝。即或
瘀脾瘀肝。亦必肿胀晕眩。苟延旦夕。岂止胸满、唇痿等症已也。不知本衣冠文物明从上焦历叙诸症。故作疑案。
然后点出脉之微大来迟。而结穴于腹。夫大即洪脉。洪为阳明土腑之诊。又大为虚脉。虚为胃家伤血之形。
且腹本不满。而其人自以为满。则血之瘀于阳明胃络。络脉因阻而胀。故如腹满耳。此古地仙随龙而顺觅
穴之法。学人。便可得穴而逆步龙矣。胃之大络贯于胸。胃络胀而满。故贯其满于胸矣。唇痿者。谓重滞而不
轻便。几有不能收摄之状。唇为胃之华。胃络滞。故唇亦以痿顿外应也。李注。谓枯燥无血色。非痿字之义。舌
第一条 寸口脉象动而弱。动脉主惊，弱脉主悸。
寸口，指关前（腕横纹桡侧端）而言。动脉，形态圆短，厥厥动摇，且兼有滑象。弱脉，像弱水一样，有不能承载物体的感觉。惊并非来自外部，而是内心惕然自警。悸，是怯懦、虚弱无力的状态。两者相互撞击，轻小的物体容易震动，被撞击的物体也会震动。寸口脉动而弱，寸口对应心下部位。弱脉表示心气轻小，而下焦之气得以向上冲撞并触动它。心下是神君（心神）的座位，下焦之气突然侵犯，所以产生惊。同时，心下也是宗气聚集的地方，本气虚弱微小，所以产生悸。各种解释，格格不入，令人发笑。《本经》及《伤寒论》中，凡是提到脉象有两个字的，都以“而”字为界限。一种情况是以“而”字以上的字为经（主脉），以“而”字以下的字为病（兼证）。例如脉浮而紧，脉浮而缓等。这是用浮脉确定太阳病，用紧或缓来区分风寒。另一种情况如本文的脉动而弱，后文的脉浮而大等。这是以上一个字为浮取（轻按），以“而”字以下的字为沉取（重按）。其余仿照此例。
第二条 心下悸动的，用半夏麻黄丸主治。
半夏麻黄丸方：半夏、麻黄（等分）
以上两味药，研成细末，用炼蜜调和做成丸子，大小如小豆。用水送服三丸，每日三次。
这一条是针对上文脉象的动与弱，症状的惊与悸而言的，不是单指悸。而半夏麻黄丸这一方子，却是治疗惊的药，而不是治疗悸的。古人的文章，在承接之处，往往错综复杂如此。意思是说心下既惊又悸，虽然是因为心下本气虚弱微小，成为下焦之气冲犯的地方，但终究应当先追究冲气以治疗惊为正治。所以用半夏麻黄丸。下行平抑冲气，那么脉就不动，惊自然也就停止了。这是春秋时期“罪主令”的方法。如果寸口脉弱而动，只在浮沉取法上颠倒来看，那么就应当以心下的弱为主，而采用下一条的桂枝救逆汤，以及《伤寒论》中的苓术桂甘汤、小建中汤等，而不再使用这个丸剂了。
有人问我：“原文明明只说了悸，你却认为双关惊和悸；原方明明是治悸的丸药，你又说是单治惊。是谁告诉你的？”我说：“张仲景在不言的表象中为我说明了。”弱是寸口的本脉，动是从下往上冲的标脉。寸口的标脉。所以悸是心下的本病，惊是从下往上侵犯心下的标病。说悸而惊包含在其中，这是从本的意义出发。至于本方的妙处，千古以来无人揭示出来，不妨借着你的问题详细剖析。麻黄中空细长如毛发，性质极其疏泄。用在桂枝、甘草、生姜、大枣之中，乘着辛温甘浮的化生作用，又得到杏仁的清利作为引导，那么疏泄的性质就从上向外发散，所以能由胸达表而出汗。这就是麻黄汤、大青龙汤的正用。如果用辛降平逆的半夏来监制，用酸收下走的白芍来收敛，又得到茯苓的淡渗作为引导，那么就使疏泄的性质向下，从而发挥利膀胱渗化的机能。这就是小青龙汤，作为下焦的变通用法。至于本方，脉象是动乘弱，症状是因悸而惊，这是上焦不足，中焦有余。用有余之火侵犯不足，所以只用对配的辛降平逆的半夏，使疏泄的性质从中下散开。又担心汤药性易尽，丸药取其缓慢释放，蜂蜜滋润其偏干的特性，小丸少服，是慢慢图谋逐渐减少的意思。这原本是一丸药，作为中焦的平调用法更是如此。总之，动弱惊悸，脉症都是两层意思。弱脉悸症，在主虚一边，下一条的桂枝救逆汤，以及《伤寒论》中的苓术桂甘、小建中等汤，扶弱以补不足。动脉惊症，在客实一边，所以用此丸，锄强以损有余。就像墙垣低矮，招致外盗一样。那些桂枝救逆等方，是增益墙垣以治悸；半夏麻黄一丸，是驱除外盗以治惊。客人还有什么话可说呢？
第三条 火邪引起的，用桂枝去芍药加蜀漆牡蛎龙骨救逆汤主治。
桂枝救逆汤方：桂枝（二两去皮）、甘草（二两炙）、生姜（三两）、大枣（十二枚劈开）、牡蛎（五两熬制）、龙骨（四两）、蜀漆（三两洗去腥味）
以上研成末。用水一斗三升，先煮蜀漆，减二升，加入其他药物，煮取三升，去渣，温服一升。（按照煮取三升服一升计算，应当像服桂枝汤的方法，分三天服完。只是不喝热粥罢了。）
这一条及方子，旧本错误地编排在本篇十二条之下。仔细推敲汤意，确实是治疗惊悸的方子。而且文气，确实是依靠上文“心下悸者”而来，那么“火邪者”三个字，方不突兀。所以移置于此。有见识的人，自然能辨别。承接上文，言实证责之，固然是主半夏麻黄丸，责中下之有余以治惊。又有用火逼劫出汗，汗是心肺的液体，汗出后，心肺夹空之气两虚，以致神明之主宰，无所依托，而招致中下之逆气而惊悸的，这就是火邪。火邪引起惊悸，责在上焦之虚。除了桂枝救逆一汤，谁能填补这些阳气和阳液呢？桂枝汤中的桂枝、甘草、生姜、大枣，最善于招来阳气阳液，已在小建中汤注中见过。东垣称蜀漆入心经，有飞针走线之功，先煮它作为主药，则引导桂枝、甘草、生姜、大枣的性质，直达心肺之空虚，以填补其虚。然后用牡蛎的静藏水底，龙骨的镇摄山灵作为佐药，那么神明的摇动浮越者自然安定。这是桂枝、甘草、生姜、大枣所以治悸，而龙齿、龙骨所以定惊的原因。至于心肾同治少阴，而其气常常相升降。心气虚者，畏惧肾中之贼阴上凌真宰，所以合用牡蛎的水族，而与龙骨同用，就是这个原因。
第四条 老师说：尺脉浮，眼睛周围晕黄，衄血未止。晕黄消退，眼睛明亮清澈，知道衄血已止。
尺脉对应的脏腑，是肾。肾的腑，是膀胱。足太阳膀胱的隧道，与手太阳小肠的经脉，由巅顶相会，而交通于鼻。沉主在里，浮主在表。现在尺脉浮，是太阳膀胱之气，由经络直接上达巅顶的现象。另外，《本经》第一篇三条讲鼻，说色黄的，大便难。鼻居中央，是中土的应象。阳明之气，燥结而不能下行，所以在本位浮出火土之色。现在由鼻而黄晕于目睛，那么其黄色更高了。而且目睛是肝肾的光华，肝主血液，肾主精汁。目睛晕黄，是阳明燥热之土气，作为炎蒸水液的诊候。足阳明胃家的隧道，与手阳明大肠的经脉，相会而挟持于鼻。所以在二者之中，无论是色还是脉，只要见到一个诊候，就知道衄血未止。晕黄消退，阳明之热下行解除，目睛明亮清澈，肝肾之气舒展，所以知道衄血已止。上两句，结合太阳阳明来说明正衄的诊法。下三句，单就阳明来说明衄止的诊法。那么太阳的衄血，其停止于尺脉之浮去而见沉的，可以类推了。
第五条 又说：从春到夏衄血的属太阳，从秋到冬衄血的属阳明。
这就是上文尺浮、晕黄，进一步申述的意思。春生夏长，天地生阳之气内盛，而人身以太阳的经气相应。所以春夏的衄血属太阳。秋敛冬藏，万物成熟之气内实，而人身以阳明的里气相应。所以秋冬的衄血属阳明。但是这一条及上文两条，明明说衄血，有太阳、阳明两症。至下文方治，却只有泻心一汤。几乎怀疑单是治阳明的衄血，而遗漏了太阳一边的治法。不知道第四条说：尺脉浮，衄血未止。第七条说：脉沉弦者衄。尺主在里，浮主上出，与沉主在里，弦主上出同样判断。是太阳的衄血，为实邪从里，外穿经络隧道，从下上升巅顶的症状。自然应当责之在里在下，那么外穿的伏于内，上升的下熄。夫责在里在下之实邪，离大黄、黄芩、黄连，将归谁属呢？所以虽然衄症有太阳、阳明的区分，而其主泻心则一也。
第六条 经常衄血的人不可发汗。汗出必额上凹陷，脉紧急，直视，不能闭眼，不得眠。
衄血家发汗，则额陷。注详《伤寒论》。脉，不单指手太阴肺经。由本文之言额、言视、言闭眼、言眠观之，当指上部之天地人及人迎等处。因为衄血家损伤巅顶之血尤多，所以偏言头上。紧急，是亡阴躁疾的现象。直视，是目系干涩，失去流动的神采。不能闭眼，不能合眼，不得眠，不得寝。都是阴虚于上，而阳往从之的道理。上文言春夏之衄属太阳，恐怕人以发汗为太阳的治法，而误投之于衄血家，那就逆乱了。所以告诫。
第七条 病人面无血色，无寒热，脉沉弦者，衄血。脉浮弱，手按之绝者，下血。烦咳者，必吐血。
这一条前三句，是就色、脉、症，而正言衄血的诊法。下文脉浮弱两段，古人借水叠桥，又即衄诊而趁便提及，为下文吐、下、条内之省笔。脏腑之精华，浮于面而色红且润者，是血所荣养。六经外邪之症，惟少阳、厥阴，属木，而为阴阳之枢。属木，故面色以青应。为阴阳之枢，故表症，阖则为寒，而辟则为热。又本脉弦急，故病此者之脉状必弦。若病人面无血色，而血不荣，又无寒热之表症，这不是少阳、厥阴之表邪为病，而其面以青色见也，可知。今脉又沉弦如厥阴，则必为衄病无疑矣。夫沉弦为肝家邪实之脉，且弦以沉见，是浮处未尝弦也。以有余弹射不足，则衄之上出如矢者，乌能禁哉。衄血的诊法如此。若面无血色，而其人之脉，举之但浮，取之则弱，重按之至沉处，则弱甚而绝，是浮，为上焦有余之邪火，凭凌胃中之血液，故中取之则弱。灌注大肠之虚脱而下，故按之绝也。则面无血色，又是阳明脱血以致脱气者的诊候。若面无血色，而脉又浮弱，按之即绝者，多烦咳一症，则其按之即绝，为下焦虚寒之应。其脉浮弱者，为虚寒之邪，上冲而致咳。咳多上顿，而气亦升浮之应。血随气逆，合之面无血色，则其血之伤于上出，而见于吐者可必矣。此条当熟读细玩，始见后文汤意之妙。否则，柏叶、黄土、赤豆、当归及泻心等汤，无从觅针线矣。
第八条 凡吐血、咳逆、上气，其脉数而有热，不得卧者死。
吐血、咳逆、上气，不要当作一症，当分三症看。因此条原是言吐血之死脉死症，其咳逆上气两症之死诊，与吐血相同，故连及之。若以吐血、咳逆、上气为一人之病，则何必以不得卧为短期耶。夫吐血有阳明胃实，上冲胃系一症，主麻仁丸，或调胃承气汤可愈。有少阳风热上逆一症，主小柴胡汤可愈。有厥阴风火，上冲心胸一症，主当归四逆汤可愈。然阳明胃实之脉涩而浮，仅于日晡见潮热。少阳风热之脉弦而微大，但见往来发热。厥阴风火之脉弦细而浮，小见微热，或无热而恶寒也。若吐血而脉数，且有或表或里之热，则数为无阴，而阳气有急疾之诊。热为离阴，而孤阳有浮脱之象。已成危候。所赖静则生阴，犹得假一卧以留连其阳气。若更不得卧，则气不归肾，而神莫栖。血不统肝，而魂欲散。其不死也得乎。咳逆者，忌邪实。上气者，忌息高。脉数有热，邪实息高之诊。其不得卧与吐血者，同一下脱上绝而死也。
第九条 凡酒客咳者，必致吐血。此因极饮过度所致也。
酒性浮热，热则动血，浮则上气。气浮血热，故咳则必致吐血也。夫饮食之邪，《本经》列为不内不外因。以极饮过度，而致咳而吐血，延至脉数有热，不得睡卧，同归死候。岂不大可惜哉。长沙揭此，其戒之耶？抑谓于方咳而未吐血时，或辛凉以解热，降渗以平浮，犹得挽回生路耶？
第十条 寸口脉弦而大。弦则为减，大则为芤。减则为寒，芤则为虚。寒虚相搏，此名曰革。妇人则半产漏下，男子则亡血失精。
寸口，应上焦。脉弦句，谓举之见弦，按之见大也。或曰，右寸见弦，左寸见大。此说亦合。减者，瘦削之状。脉体如圆茎，气血之充也。今浮之而形细如丝弦，若沉之而仍弦，是浮沉俱细，虽细而不失其为圆茎之体矣。乃按之见大，则浮处之见弦，是两肩减去其圆形，而成荞麦之象。故曰弦则为减。非弦脉尽减，以浮弦而沉大，故知其上焦之气，不能充满脉体，而为减削之貌也。芤，为中空之草。凡物之中实者，则外气内固，而形自坚小。今浮弦而沉处独大，则大非本相，而为中虚散漫之象。故曰大则为芤也。减为上焦之阳气亏空，故曰寒。芤属下焦之精血耗损，故曰虚。上焦之阳气亏空，则阴气上乘。下焦之精血耗损，则阳精下降。阴阳之贼气，与妄情相得，则梦接鬼交。肺肾之余灵，与残境相乖，则幻生惊怖。此寒虚相搏之道也。革者，鼓革之义。弦坚大空，有鼓革之象。故合状之如此。半产，凡不满十月者皆是。漏下，谓血崩及赤白带下之类。亡血，指尿血、便血之下出者而言。失精，凡有梦无梦及滑脱者，皆在其中。夫在上之阳气削弱，不能挈提。在下之阴津虚滑，不能握固。故见种种下脱之症也。
此是虚劳脉症，故入虚劳门者为正例。因有亡血一症而复入此者，郑重之意也。
第十一条 亡血不可发其表。汗出则寒栗而振。
亡血，凡吐衄便血者皆是。夫分而言之，虽有阴阳气血之殊，其实则阳载阴中，气根血分者也。亡血者气亦虚，复发其表，则气愈虚矣。且汗为血中之阳液，汗出则重伤其卫气，一也。又气血两虚之人，其阴阳之气，非极力交并于上，几有不辨之势。汗出则虚阳之极浮者，必反而为极伏，二也。寒栗而振，其能免乎。
亡血者发汗，烦躁者居多。然犹可借阳气以生阴液。若伤气而至寒栗，则为逆滋大矣。可不惧哉。
第十二条 病患胸满，唇痿，舌青，口燥，但欲漱水，不欲咽，无寒热，脉微大来迟，腹不满，其人言我满，为有瘀血。
此及下文二条，症极错杂，理极微奥，原难理会。注家俱泛指心、肺、肝、脾，而终不辨血瘀何地，症属何因，殊为梦梦。盖不特心为神明之府，肺为宗气之城，高贵清虚，略不可犯。瘀心，则神乱猝死。瘀肺，则喘满立绝。即或瘀脾瘀肝，亦必肿胀晕眩，苟延旦夕。岂止胸满、唇痿等症已也。不知本衣冠文物明从上焦历叙诸症，故作疑案，然后点出脉之微大来迟，而结穴于腹。夫大即洪脉，洪为阳明土腑之诊。又大为虚脉，虚为胃家伤血之形。且腹本不满，而其人自以为满，则血之瘀于阳明胃络，络脉因阻而胀，故如腹满耳。此古地仙随龙而顺觅穴之法，学人，便可得穴而逆步龙矣。胃之大络贯于胸，胃络胀而满，故贯其满于胸矣。唇痿者，谓重滞而不轻便，几有不能收摄之状。唇为胃之华，胃络滞，故唇亦以痿顿外应也。李注，谓枯燥无血色，非痿字之义。舌
Article 1 The pulse at the cunkou (radial artery at the wrist) is agitated and weak. Agitation indicates fright (Jing), and weakness indicates palpitations (Ji).
Cunkou refers to the area before the guan position (distal radial end). An agitated pulse is round and short in shape, trembling violently, and accompanied by a slippery quality. A weak pulse resembles weak water, having the sensation of being unable to bear weight. Fright does not come from outside but is a sudden internal alarm. Palpitations refer to a state of timidity and deficiency. When two things strike each other, the lighter one moves, and the struck one also moves. The cunkou pulse is agitated and weak; cunkou corresponds to the epigastrium. Weakness indicates that the heart qi is light and small, allowing qi from the lower jiao to rush upward and strike it. The epigastrium is the seat of the Spirit King (Shen); when lower qi suddenly invades, fright occurs. Furthermore, the epigastrium is the city of Zong Qi (Gathering Qi); since the original qi is weak and minute, palpitations occur. Various interpretations are格格不入 (incompatible) and laughable. In the *Classic of Difficult Issues* (*Nanjing*) and the *Treatise on Cold Damage* (*Shanghan Lun*), whenever a pulse description contains two characters, the character "er" (and) serves as the boundary. One pattern uses the character before "er" as the primary pulse (Jing) and the character after "er" as the pathological sign (Bing). For example, floating and tight, or floating and slow pulses. This uses the floating pulse to determine Taiyang disease and tightness or slowness to distinguish wind-cold. Another pattern, such as the agitated and weak pulse in this article, or the floating and large pulse later, uses the first character for superficial palpation (Fu Qu) and the character after "er" for deep palpation (Chen Qu). Other cases follow this analogy.
Article 2 Epigastric palpitations should be treated with Banxia Mahuang Wan (Pinellia and Ephedra Pill).
Formula for Banxia Mahuang Wan: Banxia (Pinelliae Rhizoma) and Mahuang (Ephedrae Herba) in equal parts.
Grind the above two ingredients into powder. Mix with refined honey to form pills the size of small beans. Take three pills with water, three times a day.
This article addresses both the agitation and weakness of the pulse mentioned earlier, and the symptoms of fright and palpitations, not just palpitations alone. However, the Banxia Mahuang Wan formula is a medicine for treating fright, not palpitations. Ancient texts often use complex transitions. It implies that when there is both fright and palpitation in the epigastrium, although caused by the deficiency of epigastric qi allowing lower qi to invade, the primary treatment should address the rushing qi to treat the fright. Thus, Banxia Mahuang Wan is used to subdue the rushing qi downward. Once the pulse stabilizes and the qi no longer rushes, the fright will cease naturally. This is akin to the method of blaming the principal offender. If the cunkou pulse were merely weak and agitated, viewed inversely in superficial and deep palpation, one would focus on the epigastric weakness and use Guizhi Jiuni Tang (Cinnamon Twig Decoction to Rescue Deviation) from the next article, or Lingzhu Guigan Tang (Poria, Atractylodes, Cinnamon, and Licorice Decoction) and Xiaojianzhong Tang (Minor Construct the Middle Decoction) from the *Shanghan Lun*, rather than this pill.
A guest asked me, "The text explicitly mentions only palpitations, yet you claim it covers both fright and palpitations. The formula is clearly a pill for palpitations, yet you say it treats only fright. Who told you this?" I replied, "Zhang Zhongjing reveals this implicitly. Weakness is the fundamental pulse of cunkou, while agitation is the branch pulse rushing up from below. Therefore, palpitations are the fundamental disease of the epigastrium, while fright is the branch disease invading from below. Mentioning palpitations includes fright, following the principle of the root. As for the subtlety of this formula, it has been unexposed for millennia. Let me analyze it based on your question. Mahuang (Ephedrae Herba) is hollow and fine like hair, with a very dispersing nature. Used within Guizhi Tang (Cinnamon Twig Decoction) [Guizhi, Gancao, Shengjiang, Dazao], leveraging the acrid-warm and sweet-floating transformation, and guided by Xingren (Armeniacae Semen Amarum) for its clearing and draining properties, its dispersing nature acts outwardly from above. Thus, it induces sweating from the chest to the exterior. This is the correct application of Mahuang Tang and Da Qinglong Tang. If monitored by Banxia (Pinelliae Rhizoma) which descends and calms rebellion, constrained by Baishao (Paeoniae Radix Alba) which astringes and directs downward, and guided by Fuling (Poria) for its mild leaching, the dispersing nature is directed downward, facilitating bladder fluid metabolism. This is the variable application of Xiao Qinglong Tang for the lower jiao. Regarding this formula, the pulse shows agitation overcoming weakness, and symptoms show fright arising from palpitations. This indicates upper jiao insufficiency and middle jiao excess. Excess fire invades insufficiency. Therefore, only Banxia (Pinelliae Rhizoma) is paired to descend and calm rebellion, dispersing the dispersing nature from the middle and lower sections. To prevent the rapid exhaustion of decoction properties, pills are used for slow release. Honey moistens dryness. Small pills taken in small doses aim for gradual reduction. This single pill serves as a balancing agent for the middle jiao. In summary, agitation/weakness and fright/palpitations represent two layers. Weak pulse and palpitations belong to deficiency; Guizhi Jiuni Tang, Lingzhu Guigan Tang, and Xiaojianzhong Tang support weakness to supplement insufficiency. Agitated pulse and fright belong to excess; thus, this pill is used to weaken strength and reduce excess. It is like low walls inviting thieves. Guizhi Jiuni Tang etc. reinforce the walls to treat palpitations; Banxia Mahuang Wan expels external thieves to treat fright. What more can the guest say?
Article 3 Fire pathogen causing [symptoms] should be treated with Guizhi Qu Shaoyao Jia Shuqi Muli Longgu Jiuni Tang (Cinnamon Twig Decoction without Peony, plus Chinese Tallow Tree Root, Oyster Shell, and Dragon Bone to Rescue Deviation).
Formula for Guizhi Jiuni Tang: Guizhi (Cinnamomi Ramulus) 2 liang (peeled), Gancao (Glycyrrhizae Radix et Rhizoma) 2 liang (roasted), Shengjiang (Zingiberis Rhizoma Recens) 3 liang, Dazao (Ziziphi Jujubae Fructus) 12 pieces (split), Muli (Ostreae Concha) 5 liang (calcined), Longgu (Fossilia Ossis Mastodi) 4 liang, Shuqi (Asari Radix et Rhizoma Praeparatum - note: historically distinct from modern Asarum, likely referring to a specific herb for phlegm/fire here, often identified as Glehniae Radix or similar in some contexts, but WHO standard term usually maps Shuqi to Asari Radix/Rhizoma in broad terms or specifically noted. Given context of fire/phlegm, often interpreted as specific preparation. For translation, we use the name provided.) 3 liang (washed to remove fishy smell).
Grind all into powder. Use 1 dou 3 sheng of water. First boil Shuqi until reduced by 2 sheng. Add other herbs. Boil to obtain 3 sheng. Strain. Warm take 1 sheng. (Calculated as boiling to 3 sheng and taking 1 sheng per dose, this equals three days' supply, similar to Guizhi Tang administration, except no hot porridge is consumed.)
This article and formula were incorrectly placed under Article 12 in old editions. Careful analysis confirms it treats fright and palpitations. The textual flow relies on the preceding "epigastric palpitations." Thus, "Fire Pathogen" fits logically here. Scholars can discern this. Following the previous discussion on excess, Banxia Mahuang Wan was used to address middle/lower excess causing fright. Here, fire逼迫 (forces) sweating. Sweat is the fluid of Heart and Lung. Sweating depletes the empty qi of Heart and Lung, leaving the Spirit King unsupported, inviting rebellious qi from middle/lower jiao, causing fright and palpitations. This is Fire Pathogen. Fire pathogen-induced fright/palpitations stem from upper jiao deficiency. Only Guizhi Jiuni Tang can fill this yang qi and fluid. Guizhi, Gancao, Shengjiang, and Dazao in Guizhi Tang attract yang qi and fluid, as noted in Xiaojianzhong Tang commentary. Dong Yuan stated Shuqi enters the Heart meridian, possessing swift action. Boiling it first as the chief ingredient guides the nature of Guizhi, Gancao, Shengjiang, and Dazao directly to the emptiness of Heart and Lung to fill the deficiency. Then, Muli (Oyster Shell) anchors stillness like water bottom, and Longgu (Dragon Bone) suppresses like mountain spirits as assistants. Thus, the shaking spirit settles. Guizhi, Gancao, Shengjiang, Dazao treat palpitations; Longgu and Muli stabilize fright. Heart and Kidney jointly treat Shaoyin, with qi ascending and descending. Heart qi deficiency fears Kidney yin evil attacking the true ruler. Hence, Muli (aquatic) is combined with Longgu.
Article 4 The Master said: If the chi (distal) pulse is floating, and there is yellow halo around the eyes, nasal bleeding (Xu) has not stopped. When the yellow halo disappears and the eyes become clear, know that nasal bleeding has stopped.
The chi pulse corresponds to the Kidney. The Kidney's fu organ is the Bladder. The channel of Foot-Taiyang Bladder meets the channel of Hand-Taiyang Small Intestine at the vertex, connecting to the nose. Deep indicates interior; floating indicates exterior. Chi floating indicates Taiyang Bladder qi rising directly along the channels to the vertex. Additionally, Article 3 of Chapter 1 of the *Classic* states regarding the nose: yellow color indicates difficult stool. The nose is central, corresponding to Earth. Yangming qi, dry and bound, fails to descend, showing fire-earth color at its location. Now, yellow halos appear around the eyes via the nose, indicating higher yellow. Eyes reflect Liver and Kidney essence. Liver governs blood; Kidney governs essence. Yellow halos indicate Yangming dry-heat earth qi steaming fluids. Foot-Yangming Stomach channels meet Hand-Yangming Large Intestine channels flanking the nose. In either, if color or pulse shows this sign, nasal bleeding persists. When yellow halos fade, Yangming heat resolves downward, eye clarity returns, Liver-Kidney qi expands, so nasal bleeding stops. The first two sentences combine Taiyang and Yangming for diagnosing active bleeding. The last three focus solely on Yangming for diagnosing cessation. Thus, Taiyang bleeding stopping when chi floating recedes to deep can be inferred.
Article 5 Also said: Nasal bleeding from Spring to Summer belongs to Taiyang; from Autumn to Winter belongs to Yangming.
This elaborates on the previous chi floating and yellow halos. Spring generates and Summer grows; heaven-earth yang qi is abundant internally, corresponding to human Taiyang channel qi. Thus, Spring-Summer bleeding belongs to Taiyang. Autumn gathers and Winter stores; myriad things mature internally, corresponding to human Yangming interior qi. Thus, Autumn-Winter bleeding belongs to Yangming. However, Articles 4 and 5 mention bleeding with Taiyang and Yangming signs, but the subsequent formula is only Xiexin Tang (Drain the Epigastrium Decoction). One might suspect it only treats Yangming bleeding, omitting Taiyang. But Article 4 says chi floating means bleeding continues. Article 7 says sinking-string pulse means bleeding. Chi indicates interior; floating indicates rising out. Sinking indicates interior; string indicates rising out. Taiyang bleeding is excess pathogen from interior, penetrating channels upward to the vertex. It should be addressed in the interior and lower. Penetrating ones settle inward; rising ones extinguish downward. Addressing interior/lower excess requires Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma). Thus, despite Taiyang/Yangming distinctions, Xiexin Tang is the primary treatment.
Article 6 Patients prone to nasal bleeding must not induce sweating. If sweat occurs, the forehead may sink, pulse becomes urgent/tight, eyes stare straight ahead, inability to close eyes, and insomnia.
Inducing sweat in nasal bleeders causes forehead sinking (see *Shanghan Lun*). Pulse here refers not just to Hand-Taiyin Lung. References to forehead, staring, closing eyes, and sleep point to upper Heaven-Earth-Man and Renying areas. Nasal bleeders lose much blood at the vertex. Urgent/tight pulse indicates yin depletion and restlessness. Straight staring indicates dry eye tendons and loss of fluid spirit. Inability to close eyes/sleep indicates yin deficiency above with yang following. Previous text linked Spring-Summer bleeding to Taiyang, warning against using sweating (a Taiyang method) on bleeders, which would be adverse. Hence the warning.
Article 7 Patient with pale face, no chills/fever, sinking-string pulse: nasal bleeding. Floating-weak pulse, disappearing upon heavy pressure: lower bleeding. Irritability and cough:必定吐血 (certainly hematemesis).
First three sentences diagnose nasal bleeding via color, pulse, symptoms. Subsequent floating-weak segments use metaphorical bridging, extending from nasal diagnosis to save space for subsequent vomiting/lowering articles. Essence floats on face as red/moist, nourished by blood. Among six-channel exterior pathogens, only Shaoyin and Jueyin belong to Wood, acting as pivot of Yin-Yang. Wood corresponds to green color. Pivot means closure is cold, opening is heat. String-tight pulse implies stringy pulse. Pale face without blood nourishment and no exterior chills/fever rules out Shaoyin/Jueyin exterior pathogens presenting with green face. Sinking-string pulse resembling Jueyin confirms nasal bleeding. Sinking-string is Liver excess pulse. String seen deeply means superficial is not string. Excess striking insufficiency makes upward shooting bleeding inevitable. Diagnosis of nasal bleeding is thus. If pale face, pulse floating on light touch, weak on medium, disappearing on deep touch: floating indicates upper jiao excess fire suppressing Stomach blood (medium weak). Leakage to Large Intestine causes disappearance (deep). Pale face indicates Yangming blood loss leading to qi collapse. If pale face, floating-weak pulse, disappearing on touch, accompanied by irritability/cough: disappearing indicates lower jiao deficiency-cold. Floating-weak indicates deficiency-cold pathogen rushing up causing cough. Cough involves upward qi movement. Blood follows rebellious qi. Combined with pale face, upper bleeding (hematemesis) is certain. Study this article carefully to understand subsequent formulas (Baie Tang, Huangtu Tang, Chidou Tang, Danggui, Xiexin Tang). Otherwise, their connections remain obscure.
Article 8 Hematemesis, coughing/reversing qi, ascending qi, with rapid pulse, fever, and inability to lie down: death.
Hematemesis, coughing/reversing qi, and ascending qi are three separate conditions, not one. This article discusses fatal pulse/symptoms for hematemesis, linking similar fatal diagnoses for the other two. If they were one disease, why specify inability to lie down as a short-term prognosis? Hematemesis due to Yangming Stomach excess rushing up Stomach system: treated with Maren Wan or Tiaowei Chengqi Tang. Hematemesis due to Shaoyang Wind-Heat reversing up: treated with Xiaochaihu Tang. Hematemesis due to Jueyin Wind-Fire rushing Heart/Chest: treated with Danggui Sini Tang. Yangming excess pulse is choppy-floating, tidal fever at dusk. Shaoyang wind-heat pulse is string-mildly large, alternating fever. Jueyin wind-fire pulse is string-fine-floating, slight fever or aversion to cold. If hematemesis with rapid pulse and exterior/interior heat: rapid indicates yin absence, yang urgency. Heat indicates separation from yin, solitary yang floating/detaching. Critical condition. Rest generates yin; lying down preserves yang. Inability to lie down means qi fails to return to Kidney, spirit has no abode, blood fails to control Liver, soul scatters. Death is inevitable. Coughing/reversing qi fears excess pathogen. Ascending qi fears high breathing. Rapid pulse with heat indicates excess/high breathing. Inability to lie down mirrors hematemesis: lower depletion and upper severance lead to death.
Article 9 Wine drinkers who cough will inevitably vomit blood. This is caused by excessive drinking.
Wine is floating and hot. Heat moves blood; floating raises qi. Floating qi and hot blood cause coughing to result in hematemesis. Dietary pathogens are classified as neither internal nor external. Excessive drinking leads to cough/hematemesis, progressing to rapid pulse, heat, and insomnia, all fatal. Regrettable. Changsha (Zhang Zhongjing) highlights this as a warning. Or perhaps, during early cough before hematemesis, acrid-cool to resolve heat and descending-leaching to calm floating might save life?
Article 10 Cunkou pulse is string-like and large. String-like indicates reduction; large indicates hollow. Reduction indicates cold; hollow indicates deficiency. Cold and deficiency interact, named Ge (Leather) pulse. Women: spontaneous abortion and dripping blood. Men: blood loss and seminal emission.
Cunkou corresponds to upper jiao. "String-like" means string felt on superficial palpation, large on deep. Some say right cunkou string, left cunkou large; this also fits. "Reduction" means emaciation. Pulse body like round stem, full of qi/blood. Superficial feels thin like string. If deep remains string, both superficial/deep are thin, retaining round stem shape. But deep feels large. Superficial string shows shoulders losing roundness, becoming buckwheat-shaped. Hence "string indicates reduction." Not that string pulse is entirely reduced, but superficial string/deep large shows upper jiao qi failing to fill pulse body, appearing emaciated. "Hollow" is hollow grass. Solid objects have firm exterior and small shape. Superficial string/deep large shows large is not original form, but inner deficiency/scattering. Hence "large indicates hollow." Reduction is upper jiao yang qi deficit (Cold). Hollow is lower jiao essence/blood loss (Deficiency). Upper yang deficit allows yin to ascend. Lower essence loss allows yang essence to descend. Yin-yang evil qi matches delusion, causing dreams of intercourse. Lung/Kidney residual spirit conflicts with remnants, causing hallucinations/fear. This is cold-deficiency interaction. Ge (Leather) means drum skin. String-firm-large-empty resembles drum skin. Spontaneous abortion: less than ten months. Dripping blood: metrorrhagia and leukorrhea. Blood loss: hematuria/melena. Seminal emission: nocturnal emission, spermatorrhea, slipping. Upper yang weakness cannot lift; lower yin fluid slips cannot grip. Hence various lower depletion symptoms.
This describes Xu Lao (Deficiency Consumption) pulse/symptoms, fitting the Xu Lao chapter. Re-inclusion here emphasizes blood loss.
Article 11 Blood loss patients must not release the exterior. Sweating causes chills and tremors.
Blood loss includes hematemesis, nasal bleeding, melena. Distinctly, yin/yang/qi/blood differ, but fundamentally yang carries yin, qi roots in blood. Blood loss implies qi deficiency. Releasing exterior further depletes qi. Sweat is yang fluid in blood; sweating severely damages Wei Qi (one reason). In dual qi/blood deficiency, yin/yang qi fail to merge above, nearly indistinguishable. Sweating causes extreme floating deficient yang to collapse inward (second reason). How can chills/tremors be avoided?
Sweating blood losers often cause irritability. Yet yang qi can still generate yin fluid. If qi damage leads to chills/tremors, the reversal is severe. Must one not fear this?
Article 12 Patient with chest fullness, withered lips, blue tongue, dry mouth, desire to rinse mouth but not swallow, no chills/fever, slightly large pulse coming late, abdomen not full but patient claims fullness: Blood Stasis.
These and next two articles have complex symptoms and subtle principles, hard to grasp. Commentators generally cite Heart/Lung/Liver/Spleen without locating stasis or cause, remaining confused. Heart houses Spirit; Lung houses Zong Qi. Noble, pure, and void, they are inviolable. Stasis in Heart causes spirit chaos and sudden death. Stasis in Lung causes wheezing/fullness and immediate extinction. Even Stasis in Spleen/Liver causes swelling/dizziness, lingering briefly. Chest fullness/withered lips are insufficient. The text lists symptoms from upper jiao, creating doubt, then points to slightly large-late pulse, concluding with abdomen. Large equals Hong (Surging) pulse, diagnostic of Yangming Earth Fu. Large also indicates Deficiency pulse, shape of Stomach blood injury. Abdomen is not actually full, but patient feels full. This indicates blood stasis in Yangming Stomach collaterals. Collateral obstruction causes distension, feeling like abdominal fullness. This is like ancient geomancers following dragon veins to find穴位 (acupoints). Students can find the point and trace back. Stomach's large collateral pierces chest. Stomach collateral distension/fullness transmits to chest. Withered lips mean heavy/stiff, lacking lightness, seemingly uncontrollable. Lips are flower of Stomach. Stomach collateral stagnation manifests as withered lips. Li's commentary says dry/colorless, missing the meaning of "withered." Tongue...