4、关于小脉经言：“小者血气皆少。小脉者：乃细小的脉象，可证明气的张力与血液的流量而共同运行不足，故诊得“小脉”为阴、阳平衡衰弱其气血双亏。故言：“小者血气皆少。
5、关于滑脉经言：“滑者阳气盛、微有热”诊得滑脉能证明体中的气、血通畅流利。气无血不附，血无气不行，前贤云：“气主煦之，血主濡之。”故血依气运行、气靠血濡养、若气血运行和平相宜，其脉象定不快不慢从容不迫。所以脉显往来流利的滑象知气必旺，故言：“阳气盛”，因滑脉的运行较速，虽然不能称为数脉而将接近于数脉，故言：“滑者阳气盛，微有热。”
6、关于涩脉经言：“涩者多血少气，微有寒。”脉显涩象，可测知体内的血液中缺乏阳气运通血脉，例如沟渠内本自有水，却因不能得到畅流，其内在的运行道理是与“滑脉”恰恰相反。放言：“多血少气”。其水常流者不易结冰，是水流生温之故。然而涩脉的血液并非不能流动，只是在流行之中尚缺乏一点阳气促使通畅即显涩滞不利。故经言：“澄者多血少气，微有寒。”
《灵枢经》对五脏、六腑的脉诊诊断，没有按“脉口、人迎”的寸、关、尺部来分配脏，腑定位，却只区别一倍、二倍、三倍的阴阳两面性以对照盛衰，以决定阴经、阳经的虚实，笔者按这种阴、阳两面性的诊断治疗，效果满意，并在多年的临床中发现有如下几种脉象情况：
1、关于诊候“脉口、人迎”的一倍、二倍、三倍现象，是古圣人对众人的大体概括，并非是所有人都以同样大，小之一倍、二倍、三倍的脉波出现，而是根据各人自身的生理及其动脉的现象再分别以大、中、小的比差、而确诊病在何脏、腑、经脉、才是因人制宜的脉诊规则。贫道经过测试：如脉诊十个健康无病之人的动脉现象，而各有内、外、阴、阳、左、右、上、下不同的脉象差别，因此就不可能取得统一的脉波现象。所以《灵枢·阴阳二十五人篇》论五五二十五种人的生理，各人有所不同的特生理征或缺限，故在脉诊中就不能得到统一的脉象。
2、有个别先天素质太差的人又与大众有别，其脉象似有不明，微涩难辨。还有肌肉丰厚特殊体胖之人的动脉被肌肉掩盖，特别是颈两侧的“人迎”动脉、难以辨别。
3、发现一部分四五十岁以上的老年人，其颈部的“人迎”动脉逐步增强；而手上的“寸口”动脉逐步减弱，是否与衰老和血压升高有关，有待研究。
4、比较单纯的病疾，易于用一倍、二倍、三倍明象辨明，如肝脏患病可按一倍的动脉显象诊断，如果肝脏患病，而肺脏又生病；或是脾脏有病、而心脏又患病，由此，在脉诊中易产生混淆。
实践证明利用阴、阳两性的脉象诊断，实是调治阴阳经脉的“指南方向盘”。但是若遇到以上数种特殊异常的脉象，所以还必须运用脏、腑辨证和望，闻、问辨证来综合诊断，才是祖国医学完整的诊断规则。
十四、简述脏俯辩证
中医脏腑辨证，是根据内在的脏、腑各有隶属，外在的经脉各有循行路线，各脏各腑的病证各有突出不同的症状表现作辨证分析。各脏腑的病变虽然复杂，但根据病因结合病症，细心分辨，自能得出诊断结果。
(一)肝脏
肝藏血，血舍魂，肝主筋，开窍于目，其荣在爪，与胆相表里。在体为筋，在色为青，在声为呼，在变动为握，在味为酸，在液为泪，在志为怒，怒伤肝，肝恶风，悲怒气逆则伤肝。酸走筋，筋病勿多食酸。肝欲散、急食辛以散之，用辛补之，酸泻之。肝苦急，急食甘以缓之这以上归纳不完全的“内经引言”以便在临床中归类分析病机病因，才能按五脏、六腑各有不同的生理特征及病症表现，而给予辨证施治。
经云：“诸风掉眩，皆属于肝”肝脏主筋、属风木，凡出现头目昏眩与筋脉抽搐动风，应考虑为肝经的病证。
肝经实证：有急躁易怒，头痛昏眩，两目混浊红赤，或产生吐血衄血。若肝阳上亢，其肝经炽热上冲巅顶，甚则引起瘛昏愦失知。治宜平肝熄风清理肝火。
肝气郁结：多因情志不畅所导致肝经运行郁阻，使肝气横逆于两胁下闷胀串痛，并牵连腹背疼痛，抑郁易怒，咽哽干呕，厌食、善叹息。两脉口之“寸部”当涩滞少脉，治宜疏肝理气血散郁结。
肝阴亏损：头昏头痛，耳鸣心烦，难以入眠，多梦，小便色黄，口舌干燥少津液。为阴血不足以养肝，治宜滋养肝阴兼培脾肺。
寒侵厥阴：如寒犯肝经而寒气留连，可引起小腹隐隐作痛，妇女易导致少腹气结瘤聚；男子侧痛连睾丸。脉当弦紧迟涩，治宜温经散寒通经。经云：“肝病者，两胁下痛引少腹，令人善怒。虚则自无所见，耳无所闻，善恐如人将捕之。”
附：中风偏废病理分析
关于中风偏废之病，现代医籍多列于肝脏，认为肝经主风，按中风偏废的症状，并非属肝经的一经受病，却是人体一个侧面的手，足之三阴三阳机能失调，而一时共虚所引起的突然发病。由于人体是左、右、阴、阳两性组成的一个整体，但人体的气，血可以左、右周流无处不到而灌溉全身，可是，人体左、右“十二经脉”的机能运动，是左侧手足的三阴三阳与左侧的阴阳经脉相交，右侧手足的三阴三阳、与右侧的阴阳经脉相交，故而中风只偏废人体的一侧。
关于中风偏废疾病，当参考前面“解释根、溜、注、人矛盾”章上，其论述的头、手、足三部之三阴三阳经脉的“机能伸，缩活动”，其头部的升、降屈伸机能以颈为界限，而形成在上的“天部。
手部的三阴三阳经脉之出，入屈伸机能以上半身的肘部为界限，而形成在中的“人部”：足部的三阴三阳经脉之出，入屈伸机能，以下半身的膝部为界限，而形成在下的“地部”。
例如现代医学定名为“颜面神经麻痹”的口眼歪斜病症，为邪风侵入了一侧面的“天部”，故症状以颈为界。
如果中风偏废，即是邪风侵入了人体一个侧面的天、地、人三部，所以症状表现则半侧偏废。
《灵枢·九宫八风篇》云：“其有三虚而偏中于邪风，则为击仆偏枯矣。”说明是人体一个侧面之上、中、下三部的经气共虚、才导致成中风偏废疾病。
由于人体的任脉与督脉，曾在“奇经八脉”章上说明，其任，督二脉都是左、右两条经脉相合并的，所以中风偏废的症状，即以任、督二脉的中线分界，其患侧废而健侧好。
(二)胆腑
胆腑实证：常有头昏目眩，甚则耳聋，两肋间疼痛气逆连背，并可导致胃气上冒而呕吐苦水，小便黄赤，或表现有寒热。人迎脉当弦而有力，治宜疏肝泻胆。
胆虚证：两目视物昏暗不明，胆虚易惊，常感畏惧自恐，头昏少寐，脉弦细无力。宜养肝以利股。经言：“徇蒙招尢，目瞑耳聋，下实上虚，过在足少阳厥阴，甚则入肝。”
(三)心脏
心藏脉：脉舍神，心主血，开窃干舌，其荣在面色，与小肠相表里。在体为脉，在色为赤，在声为笑，在变动为忧，在味为苦，在液为汗，在志为喜，喜伤心，心恶热，忧愁思虑则伤心。咸走血，血病勿多食咸。心欲软，急食咸以软之，用咸补之，甘泻之。心苦缓，急食酸以收之。
心脏如产生精神失常的疾病，则神志错乱，狂燥妄动，哭笑悲怒，语无伦次而行动反常。经言：“心气虚则悲，实则笑不休。”这说明临床诊疗神经疾病，既要诊候阴、阳脉象的虚实现象，又要观察患者的情志表现以确诊属实属虚。对治疗神经性的疾病用针灸治最宜。心脏主血，其血液的循环能通达脏腑内外上下周身无所不至，放心脏患病除精神疾病外，多为在血液运动上所造成病因。
心火盛实证：多为心脏的血液运动过速而产生心火过甚，症现心烦不安，面赤脉数，小便赤涩，口渴不欲多饮，或产生吐衄及外渗出血等症。宜泻心火凉血。
寒证：若血分有寒则血液运行不畅，脉象弦紧而涩，或迟涩，面色青，心胸疼痛或腹痛头痛，妇女则行经不畅而痛经，饮食喜热畏凉。治宜温经行气血。
血瘀：心血运行瘀阻在内，常见面色晦暗，脉象沉涩，口唇爪甲青紫，舌紫红有瘀斑，心胸憋闷刺痛，痛引肩背内臂，时发时止，如血液循环瘀塞在体外，则发生痈疽疮疡，脉象滑数，或伴有发热，畏寒等症状。经言：“诸痛痒疮，皆属于心。”即是言心脏血液瘀阻于外的痈疽之病，前者，宜活血行瘀理气。后者，宜清热凉血解毒行瘀。
心血虚损：为血液量少则循环运行不足，心悸短气，面色无华，健忘失眠，精神疲乏，情志好悲伤，脉象虚弱无力。治宜培补气血，经言；“心病者，胸中痛胁支满，胁下痛，膺背肩胛间痛，两臂内痛。虚则胸腹大，胁下与腰相引而痛。
(四)小肠腑
小肠为受盛之府，主转化饮食糟粕并吸收营养，是食物分别清，浊的界限。小肠实热：则头痛心烦，少腹胀痛，小便黄赤不利，或耳前面发热口舌糜烂。宜清热利湿，小肠虚寒：小腹隐痛时痛时止，喜温热按则痛缓，或少腹痛时牵连腰背单丸而小便频数。宜理脾温气散寒。经曰：“心烦头痛，病在膈中，过在手巨阳少阴。”
(五)脾脏
脾藏营，营舍意，脾主肌肉，开窍于口，其荣在唇，与胃相表里，在体为肉，在色为黄，在声为歌，在变动为哕，在味为甘，在液为涎，在志为思，思伤牌，脾恶湿，饮食大饱则伤脾。甘走肉，肉病勿多食甘。脾欲缓，急食甘以缓之，用甘补之，苦泻之。脾苦湿，急食苦以燥之。
脾与胃，主中央土，中土运化木、火、金、水四方。胃土为水谷之海，脾土转输水谷以散精气而营养全身为生长后天之本，故从古达今的良医对治疗五脏六腑之病，无不注重脾胃和联系脾胃用药立方，主要由于中土是木、火、金、水的中枢核心。如《素问·太阴阳明篇》云“脾者土也，治中央，常以四时长四脏，各十八日寄治(於三、六、九、腊的辰、戌、丑、未之月各取十八日，而每一昼夜亦有辰、戌、丑、未之月亦属中土时辰)所以脾与胃、是人体后天的生化本源之核心。
脾胃不调：多为饮食不节所伤，引起中脘食积痞满，暧气呃逆甚则呕吐，腹痛绵绵不思饮食，宜健脾消食和胃。
脾胃中气下陷：为左肝右脾气机下陷，两脉口在正运之时而两寸部动脉特别显象虚而无力，肠鸣腹泄，气往下堕，呼吸短气懒言，饮食减少，四肢倦怠乏力，宜补益中气。
脾胃湿热：由湿热蕴郁中焦，院腹胀满，身重体困，面目暗黄，大便糖，小便黄而不利，或发热口渴。宜清热利湿。
脾肾两虚：形体畏寒，四肢清冷，腰酸腹痛虚满时轻时重，大便稀薄，脉象沉小，或下肢浮肿。宜温肾健脾化水气。经言：“诸湿肿满，皆属于脾。”又言：脾气虚则四肢不用，实则腹胀。
(六)胃腑
胃是容纳五谷之府，人以胃气为本，胃消化五谷以养人，故胃是人体最根本的生命资源。
胃寒：脘腹疼痛绵绵喜按摩，口常吐白沫清诞，舌苦白腻，喜热饮食嗜好香燥。治宜理中温胃。
胃热口渴喜凉饮，胃脘嘈杂，多食善饥，或反胃呕吐，舌红苔黄少津，治宜清胃泻火。
胃虚：脘腹虚满时胀时消，消化不良，饮食减量，大便泄，百质淡苔薄白。治宜补脾健胃。
胃实：目臭舌干，晚腹疼痛胀满按之痛增，大便干数日一便。脉象：两脉口的尺部沉而有力：两人迎的以动脉浮沉有力。治宜消导。经言：“腹满(月真)胀，支膈胠胁、下厥上冒，过在足太阴阳明。”
(七)肺脏
肺藏气，气舍魄，肺主皮，开窍于鼻，其荣在毛，与大肠相表里。在体为皮毛，在色为白，在声为哭，在变动为咳，在味为辛，在液为涕，在志为优，忧伤肺，肺恶寒，形寒饮冷则伤肺。辛走气，气病无多食辛。肺欲收，急食酸以收之。用酸补之，辛泻之。肺苦上气，急食苦以泻之。
肺脏主气，为诸脉朝会之所，司行呼吸节奏开阖上、中、下三焦的气机，以肃清内外通调周身而推陈致新，故肺脏喻为相傅制节的称号。肺脏若失去正常的气机生理，即产生疾病，病症表现多为呼吸道以及表皮的反映。经言：“邪在肺，则病皮肤痛，寒热上气喘汗出，咳动肩背。”
肺寒：肺如受到风寒外束，周身可发生肌肤疼痛，鼻塞无汗，呼吸气粗，咳嗽喘促，吐出清痰，脉当浮紧，治宜发汗解表。
肺热：若邪气入侵蕴肺多日化火，以致温邪内炽，咳嗽气喘，胸痛引背，咽喉肿痛，口干舌燥，甚则咳唾脓血有腥臭气味，脉当滑数。治宜泻肺清热清痰。
肺气虚证：肺气虚弱则生理功能减退，呼吸气短，咳嗽无力，痰液稀清白沫，畏寒怕冷，倦怠无力。或因肺气久虚导致心火移肺刑金而成肺痿，干咳短息，虚烦盗汗，手足心热、午后低烧，甚则痰中带血，声音嘶哑。前者、右脉口的寸部脉当不及。治宜培土益气化痰饮；后者，左脉口当浮数无力，右脉口沉数无力。宜滋阴降火益脾肺。经言：“肺气虚则鼻塞不利少气，实则喘喝胸盈仰息。
(八)大肠腑
4、关于小脉，《内经》说：“小脉意味着气血都少。”所谓小脉，是指细小的脉象，可以证明气的张力和血液的流量共同运行不足，因此诊得“小脉”说明阴阳平衡衰弱，气血双亏。所以说：“小脉意味着气血都少。”
5、关于滑脉，《内经》说：“滑脉意味着阳气旺盛，伴有轻微发热。”诊得滑脉能证明体内的气、血通畅流利。气依附于血而存在，血依靠气而运行，前贤说：“气主要起温煦作用，血主要起濡养作用。”所以血依赖气运行，气靠血濡养，如果气血运行平和适宜，其脉象一定不快不慢，从容不迫。因此脉象显现往来流利的滑象，可知气必旺盛，所以说：“阳气旺盛。”因为滑脉的运行速度较快，虽然不能称为数脉（快速脉），但接近于数脉，所以说：“滑脉意味着阳气旺盛，伴有轻微发热。”
6、关于涩脉，《内经》说：“涩脉意味着多血少气，伴有轻微寒冷。”脉象显现涩象，可测知体内的血液中缺乏阳气的运通，例如沟渠内本自有水，却因不能得到畅流，其内在的运行道理是与“滑脉”恰恰相反。故言：“多血少气。”水流常流者不易结冰，是水流生温的缘故。然而涩脉的血液并非不能流动，只是在流行之中尚缺乏一点阳气促使通畅，即显现涩滞不利。所以《内经》说：“涩脉意味着多血少气，伴有轻微寒冷。”
《灵枢经》对五脏、六腑的脉诊诊断，没有按“脉口、人迎”的寸、关、尺部来分配脏、腑的定位，却只区别一倍、二倍、三倍的阴阳两面性以对照盛衰，以决定阴经、阳经的虚实。笔者按照这种阴、阳两面性的诊断治疗，效果满意，并在多年的临床中发现有如下几种脉象情况：
1、关于诊候“脉口、人迎”的一倍、二倍、三倍现象，是古圣人对众人的大体概括，并非是所有人都以同样大小之一倍、二倍、三倍的脉波出现，而是根据各人自身的生理及其动脉的现象再分别以大、中、小的比差，而确诊病在何脏、腑、经脉，才是因人制宜的脉诊规则。贫道经过测试：如诊候十个健康无病之人的动脉现象，而各有内、外、阴、阳、左、右、上、下不同的脉象差别，因此就不可能取得统一的脉波现象。所以《灵枢·阴阳二十五人篇》论五五二十五种人的生理，各人有所不同的特殊生理特征或缺限，故在脉诊中就不能得到统一的脉象。
2、有个别先天素质太差的人又与大众有别，其脉象似有不明，微涩难辨。还有肌肉丰厚特殊体胖之人的动脉被肌肉掩盖，特别是颈两侧的“人迎”动脉，难以辨别。
3、发现一部分四五十岁以上的老年人，其颈部的“人迎”动脉逐步增强；而手上的“寸口”动脉逐步减弱，是否与衰老和血压升高有关，有待研究。
4、比较单纯的疾病，易于用一倍、二倍、三倍明象辨明，如肝脏患病可按一倍的动脉显象诊断，如果肝脏患病，而肺脏又生病；或是脾脏有病、而心脏又患病，由此，在脉诊中易产生混淆。
实践证明利用阴、阳两性的脉象诊断，实是调治阴阳经脉的“指南方向盘”。但是若遇到以上数种特殊异常的脉象，所以还必须运用脏、腑辨证和望、闻、问辨证来综合诊断，才是祖国医学完整的诊断规则。
中医脏腑辨证，是根据内在的脏、腑各有隶属，外在的经脉各有循行路线，各脏各腑的病证各有突出不同的症状表现作辨证分析。各脏腑的病变虽然复杂，但根据病因结合病症，细心分辨，自能得出诊断结果。
(一) 肝脏
肝藏血，血舍魂，肝主筋，开窍于目，其荣在爪，与胆相表里。在体为筋，在色为青，在声为呼，在变动为握，在味为酸，在液为泪，在志为怒，怒伤肝，肝恶风，悲怒气逆则伤肝。酸走筋，筋病勿多食酸。肝欲散，急食辛以散之，用辛补之，酸泻之。肝苦急，急食甘以缓之。这以上归纳不完全的“内经引言”以便在临床中归类分析病机病因，才能按五脏、六腑各有不同的生理特征及病症表现，而给予辨证施治。
经云：“诸风掉眩，皆属于肝。”肝脏主筋、属风木，凡出现头目昏眩与筋脉抽搐动风，应考虑为肝经的病证。
肝经实证：有急躁易怒，头痛昏眩，两目混浊红赤，或产生吐血衄血。若肝阳上亢，其肝经炽热上冲巅顶，甚则引起瘛疭昏愦失知。治宜平肝熄风清理肝火。
肝气郁结：多因情志不畅所导致肝经运行郁阻，使肝气横逆于两胁下闷胀串痛，并牵连腹背疼痛，抑郁易怒，咽哽干呕，厌食、善叹息。两脉口之“寸部”当涩滞少脉，治宜疏肝理气血散郁结。
肝阴亏损：头昏头痛，耳鸣心烦，难以入眠，多梦，小便色黄，口舌干燥少津液。为阴血不足以养肝，治宜滋养肝阴兼培脾肺。
寒侵厥阴：如寒犯肝经而寒气留连，可引起小腹隐隐作痛，妇女易导致少腹气结瘤聚；男子侧痛连睾丸。脉当弦紧迟涩，治宜温经散寒通经。经云：“肝病者，两胁下痛引少腹，令人善怒。虚则目无所见，耳无所闻，善恐如人将捕之。”
附：中风偏废病理分析
关于中风偏废之病，现代医籍多列于肝脏，认为肝经主风，按中风偏废的症状，并非属肝经的一经受病，却是人体一个侧面的手、足之三阴三阳机能失调，而一时共虚所引起的突然发病。由于人体是左、右、阴、阳两性组成的一个整体，但人体的气、血可以左、右周流无处不到而灌溉全身，可是，人体左、右“十二经脉”的机能运动，是左侧手足的三阴三阳与左侧的阴阳经脉相交，右侧手足的三阴三阳、与右侧的阴阳经脉相交，故而中风只偏废人体的一侧。
关于中风偏废疾病，当参考前面“解释根、溜、注、入矛盾”章上，其论述的头、手、足三部之三阴三阳经脉的“机能伸、缩活动”，其头部的升、降屈伸机能以颈为界限，而形成在上的“天部”。
手部的三阴三阳经脉之出、入屈伸机能以上半身的肘部为界限，而形成在中的“人部”：足部的三阴三阳经脉之出、入屈伸机能，以下半身的膝部为界限，而形成在下的“地部”。
例如现代医学定名为“颜面神经麻痹”的口眼歪斜病症，为邪风侵入了一侧面的“天部”，故症状以颈为界。
如果中风偏废，即是邪风侵入了人体一个侧面的天、地、人三部，所以症状表现则半侧偏废。
《灵枢·九宫八风篇》云：“其有三虚而偏中于邪风，则为击仆偏枯矣。”说明是人体一个侧面之上、中、下三部的经气共虚，才导致成中风偏废疾病。
由于人体的任脉与督脉，曾在“奇经八脉”章上说明，其任、督二脉都是左、右两条经脉相合并的，所以中风偏废的症状，即以任、督二脉的中线分界，其患侧废而健侧好。
(二) 胆腑
胆腑实证：常有头昏目眩，甚则耳聋，两肋间疼痛气逆连背，并可导致胃气上冒而呕吐苦水，小便黄赤，或表现有寒热。人迎脉当弦而有力，治宜疏肝泻胆。
胆虚证：两目视物昏暗不明，胆虚易惊，常感畏惧自恐，头昏少寐，脉弦细无力。宜养肝以利胆。经言：“徇蒙招尤，目瞑耳聋，下实上虚，过在足少阳厥阴，甚则入肝。”
(三) 心脏
心藏脉：脉舍神，心主血，开窍于舌，其荣在面色，与小肠相表里。在体为脉，在色为赤，在声为笑，在变动为忧，在味为苦，在液为汗，在志为喜，喜伤心，心恶热，忧愁思虑则伤心。咸走血，血病勿多食咸。心欲软，急食咸以软之，用咸补之，甘泻之。心苦缓，急食酸以收之。
心脏如产生精神失常的疾病，则神志错乱，狂躁妄动，哭笑悲怒，语无伦次而行动反常。经言：“心气虚则悲，实则笑不休。”这说明临床诊疗神经疾病，既要诊候阴、阳脉象的虚实现象，又要观察患者的情志表现以确诊属实属虚。对治疗神经性的疾病用针灸治最宜。心脏主血，其血液的循环能通达脏腑内外上下周身无所不至，放心脏患病除精神疾病外，多为在血液运动上所造成病因。
心火盛实证：多为心脏的血液运动过速而产生心火过甚，症现心烦不安，面赤脉数，小便赤涩，口渴不欲多饮，或产生吐衄及外渗出血等症。宜泻心火凉血。
寒证：若血分有寒则血液运行不畅，脉象弦紧而涩，或迟涩，面色青，心胸疼痛或腹痛头痛，妇女则行经不畅而痛经，饮食喜热畏凉。治宜温经行气血。
血瘀：心血运行瘀阻在内，常见面色晦暗，脉象沉涩，口唇爪甲青紫，舌紫红有瘀斑，心胸憋闷刺痛，痛引肩背内臂，时发时止，如血液循环瘀塞在体外，则发生痈疽疮疡，脉象滑数，或伴有发热，畏寒等症状。经言：“诸痛痒疮，皆属于心。”即是言心脏血液瘀阻于外的痈疽之病，前者，宜活血行瘀理气。后者，宜清热凉血解毒行瘀。
心血虚损：为血液量少则循环运行不足，心悸短气，面色无华，健忘失眠，精神疲乏，情志好悲伤，脉象虚弱无力。治宜培补气血，经言：“心病者，胸中痛胁支满，胁下痛，膺背肩胛间痛，两臂内痛。虚则胸腹大，胁下与腰相引而痛。”
(四) 小肠腑
小肠为受盛之府，主转化饮食糟粕并吸收营养，是食物分别清、浊的界限。小肠实热：则头痛心烦，少腹胀痛，小便黄赤不利，或耳前面发热口舌糜烂。宜清热利湿，小肠虚寒：小腹隐痛时痛时止，喜温热按则痛缓，或少腹痛时牵连腰背睾丸而小便频数。宜理脾温气散寒。经曰：“心烦头痛，病在膈中，过在手巨阳少阴。”
(五) 脾脏
脾藏营，营舍意，脾主肌肉，开窍于口，其荣在唇，与胃相表里，在体为肉，在色为黄，在声为歌，在变动为哕，在味为甘，在液为涎，在志为思，思伤脾，脾恶湿，饮食大饱则伤脾。甘走肉，肉病勿多食甘。脾欲缓，急食甘以缓之，用甘补之，苦泻之。脾苦湿，急食苦以燥之。
脾与胃，主中央土，中土运化木、火、金、水四方。胃土为水谷之海，脾土转输水谷以散精气而营养全身为生长后天之本，故从古达今的良医对治疗五脏六腑之病，无不注重脾胃和联系脾胃用药立方，主要由于中土是木、火、金、水的中枢核心。如《素问·太阴阳明篇》云“脾者土也，治中央，常以四时长四脏，各十八日寄治(於三、六、九、腊的辰、戌、丑、未之月各取十八日，而每一昼夜亦有辰、戌、丑、未之月亦属中土时辰)所以脾与胃、是人体后天的生化本源之核心。
脾胃不调：多为饮食不节所伤，引起中脘食积痞满，嗳气呃逆甚则呕吐，腹痛绵绵不思饮食，宜健脾消食和胃。
脾胃中气下陷：为左肝右脾气机下陷，两脉口在正运之时而两寸部动脉特别显象虚而无力，肠鸣腹泄，气往下堕，呼吸短气懒言，饮食减少，四肢倦怠乏力，宜补益中气。
脾胃湿热：由湿热蕴郁中焦，脘腹胀满，身重体困，面目暗黄，大便溏，小便黄而不利，或发热口渴。宜清热利湿。
脾肾两虚：形体畏寒，四肢清冷，腰酸腹痛虚满时轻时重，大便稀薄，脉象沉小，或下肢浮肿。宜温肾健脾化水气。经言：“诸湿肿满，皆属于脾。”又言：脾气虚则四肢不用，实则腹胀。
(六) 胃腑
胃是容纳五谷之府，人以胃气为本，胃消化五谷以养人，故胃是人体最根本的生命资源。
胃寒：脘腹疼痛绵绵喜按摩，口常吐白沫清涎，舌苔白腻，喜热饮食嗜好香燥。治宜理中温胃。
胃热：口渴喜凉饮，胃脘嘈杂，多食善饥，或反胃呕吐，舌红苔黄少津，治宜清胃泻火。
胃虚：脘腹虚满时胀时消，消化不良，饮食减量，大便泄，质地淡苔薄白。治宜补脾健胃。
胃实：口臭舌干，晚腹疼痛胀满按之痛增，大便干数日一便。脉象：两脉口的尺部沉而有力；两人迎的以动脉浮沉有力。治宜消导。经言：“腹满(真)胀，支膈胠胁、下厥上冒，过在足太阴阳明。”
(七) 肺脏
肺藏气，气舍魄，肺主皮，开窍于鼻，其荣在毛，与大肠相表里。在体为皮毛，在色为白，在声为哭，在变动为咳，在味为辛，在液为涕，在志为忧，忧伤肺，肺恶寒，形寒饮冷则伤肺。辛走气，气病无多食辛。肺欲收，急食酸以收之。用酸补之，辛泻之。肺苦上气，急食苦以泻之。
肺脏主气，为诸脉朝会之所，司行呼吸节奏开阖上、中、下三焦的气机，以肃清内外通调周身而推陈致新，故肺脏喻为相傅制节的称号。肺脏若失去正常的气机生理，即产生疾病，病症表现多为呼吸道以及表皮的反映。经言：“邪在肺，则病皮肤痛，寒热上气喘汗出，咳动肩背。”
肺寒：肺如受到风寒外束，周身可发生肌肤疼痛，鼻塞无汗，呼吸气粗，咳嗽喘促，吐出清痰，脉当浮紧，治宜发汗解表。
肺热：若邪气入侵蕴肺多日化火，以致温邪内炽，咳嗽气喘，胸痛引背，咽喉肿痛，口干舌燥，甚则咳唾脓血有腥臭气味，脉当滑数。治宜泻肺清热清痰。
肺气虚证：肺气虚弱则生理功能减退，呼吸气短，咳嗽无力，痰液稀清白沫，畏寒怕冷，倦怠无力。或因肺气久虚导致心火移肺刑金而成肺痿，干咳短息，虚烦盗汗，手足心热、午后低烧，甚则痰中带血，声音嘶哑。前者、右脉口的寸部脉当不及。治宜培土益气化痰饮；后者，左脉口当浮数无力，右脉口沉数无力。宜滋阴降火益脾肺。经言：“肺气虚则鼻塞不利少气，实则喘喝胸盈仰息。”
(八) 大肠腑
4. Regarding the Xiao pulse (Small Pulse), the *Neijing* states: "The Xiao pulse indicates a deficiency of both Qi and Blood." The Xiao pulse refers to a fine and thin pulse image, which demonstrates that the tension of Qi and the volume of Blood are insufficient in their joint circulation. Therefore, diagnosing a "Xiao pulse" indicates a decline in Yin-Yang balance and a dual deficiency of Qi and Blood. Hence it is said: "The Xiao pulse indicates a deficiency of both Qi and Blood."
5. Regarding the Hua pulse (Slippery Pulse), the *Neijing* states: "The Hua pulse indicates abundant Yang Qi with slight heat." Diagnosing a Hua pulse proves that Qi and Blood within the body are smooth and unobstructed. Qi cannot exist without Blood as its foundation, and Blood cannot move without Qi as its motive force. Ancient sages said: "Qi primarily provides warmth, while Blood primarily provides nourishment." Thus, Blood relies on Qi for movement, and Qi relies on Blood for nourishment. If the movement of Qi and Blood is harmonious and appropriate, the pulse image will be neither fast nor slow, but calm and unhurried. Therefore, when the pulse manifests a smooth and flowing Hua image, it indicates that Qi must be vigorous; hence it is said: "Yang Qi is abundant." Since the movement of the Hua pulse is relatively rapid, although it cannot be classified as the Shu pulse (Rapid Pulse), it approaches the Shu pulse; hence it is said: "The Hua pulse indicates abundant Yang Qi with slight heat."
6. Regarding the Se pulse (Choppy Pulse), the *Neijing* states: "The Se pulse indicates abundant Blood but deficient Qi, accompanied by slight cold." A pulse manifesting a Se image allows one to infer that there is a lack of Yang Qi's transformative power to circulate the Blood within the body. For example, just as a canal may contain water but fail to flow freely due to obstruction, the internal mechanism is exactly opposite to that of the "Hua pulse." Thus it is said: "Abundant Blood but deficient Qi." Water that flows constantly does not easily freeze because the flowing water generates warmth. However, the Blood in a Se pulse is not immobile; rather, during its flow, it lacks a certain amount of Yang Qi to promote smoothness, resulting in a choppy and obstructed sensation. Therefore, the *Neijing* states: "The Se pulse indicates abundant Blood but deficient Qi, accompanied by slight cold."
(V) Practical Situations in Pulse Diagnosis
The *Lingshu Jing* (Spiritual Pivot) does not assign Zang and Fu organs to specific positions based on the Cun, Guan, and Chi locations of the "Maikou" (Radial artery at the wrist) and "Renying" (Carotid artery at the neck) for pulse diagnosis of the Five Zang and Six Fu organs. Instead, it distinguishes only the Yin-Yang duality in terms of one-fold, two-fold, and three-fold magnitudes to compare excess and deficiency, thereby determining the excess or deficiency of Yin and Yang meridians. The author has found satisfactory results using this diagnostic method based on Yin-Yang duality and has observed the following pulse conditions in years of clinical practice:
1. The phenomenon of observing one-fold, two-fold, and three-fold differences in the "Maikou" and "Renying" pulses is a generalization by ancient sages for the masses. It does not mean that everyone presents pulse waves of identical magnitude differing by one, two, or three folds. Rather, it depends on each individual's physiology and arterial phenomena, distinguishing differences in large, medium, and small ratios to diagnose which Zang, Fu, or meridian is diseased. This constitutes the principle of pulse diagnosis tailored to the individual. Through testing, I have observed: among ten healthy individuals without disease, there are differences in pulse images internally/externally, Yin/Yang, left/right, and upper/lower. Therefore, a unified pulse wave phenomenon cannot be obtained. Thus, the *Lingshu · Chapter on Yin-Yang Twenty-Five Person Types* discusses the physiology of twenty-five types of people, noting their unique physiological characteristics or deficiencies. Consequently, a unified pulse image cannot be achieved in pulse diagnosis.
2. Some individuals with poor innate constitution differ from the general population, presenting unclear, slightly choppy, and difficult-to-distinguish pulses. Additionally, in individuals with thick muscles and special obesity, the arteries are obscured by muscle tissue, particularly the "Renying" arteries on both sides of the neck, making them difficult to distinguish.
3. It was found that in some elderly people over forty or fifty years old, the "Renying" artery in the neck gradually strengthens, while the "Cunkou" artery in the hand gradually weakens. Whether this is related to aging and increased blood pressure requires further study.
4. Relatively simple diseases are easy to distinguish using clear manifestations of one-fold, two-fold, and three-fold differences. For instance, liver disease can be diagnosed by the manifestation of the one-fold artery. However, if the liver is diseased and the lung is also diseased, or if the spleen is diseased and the heart is also diseased, confusion may arise in pulse diagnosis.
Clinical practice has proven that utilizing Yin-Yang pulse diagnosis serves as a "compass" for regulating Yin and Yang meridians. However, when encountering the aforementioned special and abnormal pulse conditions, one must integrate Zang-Fu differentiation with observation, listening/smelling, and inquiry for comprehensive diagnosis, which constitutes the complete diagnostic rules of Traditional Chinese Medicine.
XIV. Brief Description of Zang-Fu Differentiation
TCM Zang-Fu differentiation is based on the fact that internal Zang and Fu organs have their respective affiliations, external meridians have their own pathways, and diseases of each Zang and Fu organ present distinct symptom patterns for differentiation analysis. Although lesions of various Zang and Fu organs are complex, careful analysis combining etiology and symptoms will naturally lead to a diagnostic conclusion.
(I) Liver
The Liver stores Blood; Blood houses the Hun (Ethereal Soul). The Liver governs the sinews, opens into the eyes, and its flourishing aspect is manifested in the nails. It is exteriorly-interiorly paired with the Gallbladder. In the body, it corresponds to sinews; in color, green; in sound, calling out; in change, grasping; in taste, sour; in fluid, tears; in emotion, anger. Anger injures the Liver; the Liver fears wind. Sorrow and anger causing Qi rebellion injure the Liver. Sour flavor enters the sinews; those with sinew diseases should not consume excessive sour flavors. The Liver desires dispersion; urgently consume pungent flavors to disperse it. Use pungent flavors to tonify it, and sour flavors to drain it. The Liver suffers from urgency; urgently consume sweet flavors to relax it. The above summarized excerpts from the *Neijing* introduction facilitate the classification and analysis of pathogenesis and etiology in clinical practice, allowing for syndrome differentiation and treatment according to the distinct physiological characteristics and symptom manifestations of the Five Zang and Six Fu organs.
The Classics state: "All wind-induced tremors and vertigo belong to the Liver." The Liver governs sinews and belongs to Wind-Wood. Whenever dizziness and vertigo of the head and eyes occur, along with twitching and convulsions of sinews and vessels indicating wind, one should consider it a disease of the Liver Meridian.
Liver Meridian Excess Syndrome: Includes irritability and anger, headache and vertigo, turbid and red eyes, or hematemesis (vomiting blood) and epistaxis (nosebleed). If Liver Yang rises hyperactively, the intense heat of the Liver Meridian rushes upward to the vertex, potentially leading to spasms, coma, and loss of consciousness. Treatment should focus on pacifying the Liver, extinguishing Wind, and clearing Liver Fire.
Liver Qi Stagnation: Often caused by emotional distress leading to obstructed circulation in the Liver Meridian, causing Liver Qi to rebel horizontally beneath the hypochondrium with distension and radiating pain, extending to abdominal and back pain, depression, irritability, throat obstruction, dry retching, anorexia, and frequent sighing. The "Cun" position of both Maikou pulses should appear choppy and weak. Treatment should focus on soothing the Liver, regulating Qi and Blood, and dissipating stagnation.
Liver Yin Deficiency: Symptoms include dizziness and headache, tinnitus, restlessness, difficulty sleeping, vivid dreams, yellow urine, and dry mouth and tongue with scant fluids. This is due to insufficient Yin and Blood failing to nourish the Liver. Treatment should focus on nourishing Liver Yin while supporting the Spleen and Lungs.
Cold Invading Jueyin: If Cold invades the Liver Meridian and lingers, it can cause dull pain in the lower abdomen. In women, it may lead to Qi stagnation and mass formation in the lower abdomen; in men, it causes pain radiating to the testicles. The pulse should be wiry, tight, slow, and choppy. Treatment should focus on warming the meridians, dispelling Cold, and promoting circulation. The Classics state: "In Liver diseases, pain under the hypochondrium radiates to the lower abdomen, causing irritability. In deficiency, vision fails, hearing fails, and there is excessive fear as if being hunted."
Appendix: Pathological Analysis of Stroke Hemiplegia
Regarding stroke hemiplegia, modern medical texts often categorize it under the Liver, believing the Liver Meridian governs Wind. However, based on the symptoms of stroke hemiplegia, it is not merely a disease of one Liver Meridian branch. Instead, it is a sudden onset caused by dysfunction and simultaneous deficiency of the Three Yin and Three Yang meridians of the hands and feet on one side of the body. Although the human body is an integrated whole composed of left-right and Yin-Yang aspects, and Qi and Blood can circulate left and right to irrigate the entire body, the functional movement of the left and right "Twelve Regular Meridians" involves the intersection of the Three Yin and Three Yang of the left limbs with the Yin and Yang meridians on the left side, and similarly for the right side. Therefore, stroke only affects one side of the body.
Regarding stroke hemiplegia, reference should be made to the previous chapter "Explaining Root, Flow, Note, and Entry Contradictions," which discusses the "functional extension and contraction activities" of the Three Yin and Three Yang meridians in the head, hand, and foot regions. The ascending, descending, flexion, and extension functions of the head are bounded by the neck, forming the upper "Heaven Region."
The exiting, entering, flexion, and extension functions of the Three Yin and Three Yang meridians of the hands are bounded by the elbows of the upper body, forming the middle "Human Region." The exiting, entering, flexion, and extension functions of the Three Yin and Three Yang meridians of the feet are bounded by the knees of the lower body, forming the lower "Earth Region."
For example, the condition of facial deviation known in modern medicine as "facial nerve paralysis" is caused by evil Wind invading the "Heaven Region" on one side, so symptoms are bounded by the neck.
If stroke hemiplegia occurs, it means evil Wind has invaded the Heaven, Earth, and Human regions on one side of the body, resulting in hemiplegia on that half-side.
The *Lingshu · Chapter on Nine Palaces and Eight Winds* states: "When there are three deficiencies and the person is partially struck by evil Wind, it results in collapse and hemiplegia." This explains that stroke hemiplegia is caused by the simultaneous deficiency of meridian Qi in the upper, middle, and lower regions on one side of the body.
Since the Ren Mai (Conception Vessel) and Du Mai (Governing Vessel) were explained in the "Eight Extraordinary Vessels" chapter, and these two vessels are formed by the merging of left and right meridians, the symptoms of stroke hemiplegia are divided by the midline of the Ren and Du vessels, with the affected side paralyzed and the healthy side functioning normally.
(II) Gallbladder
Gallbladder Excess Syndrome: Often presents with dizziness and vertigo, severe deafness, pain between the ribs with Qi rebellion radiating to the back, and can lead to stomach Qi rebelling upward causing vomiting of bitter fluid, yellow-red urine, or alternating chills and fever. The Renying pulse should be wiry and forceful. Treatment should focus on soothing the Liver and draining the Gallbladder.
Gallbladder Deficiency Syndrome: Dim and unclear vision, gallbladder deficiency leading to fright, constant feeling of fear and self-dread, dizziness, insomnia, wiry-thin and weak pulse. Treatment should focus on nourishing the Liver to benefit the Gallbladder. The Classics state: "Dizziness, visual disturbances, eye closing, and deafness indicate excess below and deficiency above, with the fault lying in the Foot Shaoyang and Jueyin, and in severe cases, affecting the Liver."
(III) Heart
The Heart stores the Mai (Vessels); the Vessels house the Shen (Spirit). The Heart governs Blood, opens into the tongue, and its flourishing aspect is manifested in the complexion. It is exteriorly-interiorly paired with the Small Intestine. In the body, it corresponds to vessels; in color, red; in sound, laughter; in change, worry/grief; in taste, bitter; in fluid, sweat; in emotion, joy. Joy injures the Heart; the Heart fears heat. Sorrow and worry injure the Heart. Salty flavor enters Blood; those with Blood diseases should not consume excessive salty flavors. The Heart desires softness; urgently consume salty flavors to soften it. Use salty flavors to tonify it, and sweet flavors to drain it. The Heart suffers from flaccidity; urgently consume sour flavors to astringe it.
If the Heart produces mental disorders, there will be confusion of spirit, mania, wild movements, crying and laughing, sadness and anger, incoherent speech, and abnormal behavior. The Classics state: "Heart Qi deficiency leads to sorrow; excess leads to incessant laughter." This shows that in clinical diagnosis of neurological diseases, one must observe the deficiency/excess of Yin-Yang pulses and monitor the patient's emotional manifestations to confirm whether the condition is excess or deficiency. Acupuncture and moxibustion are most suitable for treating neurological diseases. The Heart governs Blood; its blood circulation can reach all internal and external organs, upper and lower parts of the body. Apart from mental diseases, Heart diseases are mostly caused by issues in blood movement.
Excessive Heart Fire Excess Syndrome: Mostly caused by excessively rapid blood movement in the Heart leading to severe Heart Fire. Symptoms include restlessness, red face, rapid pulse, red and scanty urine, thirst without desire to drink much, or hematemesis, epistaxis, and subcutaneous bleeding. Treatment should focus on draining Heart Fire and cooling Blood.
Cold Syndrome: If there is Cold in the Blood level, blood circulation is unsmooth. The pulse is wiry, tight, and choppy, or slow and choppy. The complexion is blue-green, with chest-heart pain, abdominal pain, or headache. In women, menstruation is unsmooth with dysmenorrhea. Diet prefers hot foods and fears cold. Treatment should focus on warming the meridians and promoting Qi and Blood circulation.
Blood Stasis: Blood movement in the Heart is obstructed internally. Common signs include dark complexion, deep and choppy pulse, purple lips and nail beds, purple-red tongue with stasis spots, stifling and stabbing pain in the chest and heart radiating to the shoulder, back, and inner arm, occurring intermittently. If blood circulation is blocked externally, carbuncles, ulcers, and sores occur. The pulse is slippery and rapid, possibly accompanied by fever and aversion to cold. The Classics state: "All pain, itching, and sores belong to the Heart." This refers to carbuncle diseases caused by Heart Blood stasis externally. For the former (internal stasis), treatment should focus on activating Blood, resolving stasis, and regulating Qi. For the latter (external sores), treatment should focus on clearing Heat, cooling Blood, detoxifying, and resolving stasis.
Heart Blood Deficiency: Due to low blood volume, circulation is insufficient. Symptoms include palpitations, shortness of breath, pale complexion, forgetfulness, insomnia, mental fatigue, and tendency toward sadness. The pulse is weak and powerless. Treatment should focus on tonifying Qi and Blood. The Classics state: "In Heart diseases, there is pain in the chest, fullness and pain under the hypochondrium, pain in the chest, back, and scapula, and pain in the inner arms. In deficiency, the chest and abdomen are enlarged, and pain is felt drawing from the hypochondrium to the waist."
(IV) Small Intestine
The Small Intestine is the palace of reception and transformation, responsible for transforming food waste and absorbing nutrients, serving as the boundary for separating the clear and turbid aspects of food.
Small Intestine Excess Heat: Headache, restlessness, lower abdominal distension and pain, yellow-red and difficult urination, or heat behind the ears and mouth/tongue ulceration. Treatment should focus on clearing Heat and promoting diuresis.
Small Intestine Deficiency Cold: Dull pain in the lower abdomen, intermittent pain relieved by warmth and pressure, or lower abdominal pain radiating to the lower back and testicles with frequent urination. Treatment should focus on regulating the Spleen, warming Qi, and dispelling Cold. The Classics state: "Restlessness and headache indicate disease in the diaphragm, with the fault lying in the Hand Taiyang and Shaoyin."
(V) Spleen
The Spleen stores Ying (Nutritive Qi); Ying houses Yi (Intellect). The Spleen governs muscles, opens into the mouth, and its flourishing aspect is manifested in the lips. It is exteriorly-interiorly paired with the Stomach. In the body, it corresponds to flesh; in color, yellow; in sound, singing; in change, hiccups; in taste, sweet; in fluid, saliva; in emotion, pensiveness. Pensiveness injures the Spleen; the Spleen fears dampness. Overeating injures the Spleen. Sweet flavor enters flesh; those with flesh diseases should not consume excessive sweet flavors. The Spleen desires relaxation; urgently consume sweet flavors to relax it. Use sweet flavors to tonify it, and bitter flavors to drain it. The Spleen suffers from dampness; urgently consume bitter flavors to dry it.
The Spleen and Stomach govern Central Earth, transforming Wood, Fire, Metal, and Water in the four directions. The Stomach Earth is the sea of water and grain; the Spleen Earth transports water and grain to distribute essence and Qi to nourish the whole body, serving as the root of postnatal growth. Therefore, since ancient times, good physicians have always emphasized the Spleen and Stomach and prescribed medications targeting them when treating diseases of the Five Zang and Six Fu organs, mainly because Central Earth is the core hub of Wood, Fire, Metal, and Water. As stated in the *Suwen · Chapter on Taiyin and Yangming*: "The Spleen is Earth, governing the Center, and typically nourishes the Four Zang organs throughout the four seasons, ruling for eighteen days each (taking eighteen days in the Chen, Xu, Chou, and Wei months of the third, sixth, ninth, and twelfth lunar months, and also considering the Chen, Xu, Chou, and Wei hours of each day as belonging to Central Earth time). Thus, the Spleen and Stomach are the core of the postnatal biochemical origin."
Spleen-Stomach Disharmony: Mostly caused by irregular diet, leading to food accumulation and fullness in the middle jiao, belching, hiccuping, even vomiting, continuous abdominal pain, and loss of appetite. Treatment should focus on strengthening the Spleen, digesting food, and harmonizing the Stomach.
Spleen-Stomach Middle Qi Sinking: Caused by sinking of Qi mechanism in the Left Liver and Right Spleen. At normal operation times, the Cun positions of both Maikou pulses appear particularly deficient and weak. Symptoms include borborygmus, diarrhea, sinking of Qi, shortness of breath, reluctance to speak, reduced diet, and fatigue in the four limbs. Treatment should focus on tonifying Middle Qi.
Spleen-Stomach Damp-Heat: Caused by damp-heat accumulating in the middle jiao. Symptoms include abdominal distension, heavy body and lethargy, dark yellow complexion, loose stools, yellow and difficult urination, or fever and thirst. Treatment should focus on clearing Heat and promoting diuresis.
Spleen-Kidney Dual Deficiency: Fear of cold in the body, cold limbs, soreness and pain in the lower back and abdomen with fluctuating fullness, loose stools, deep-small pulse, or edema in the lower limbs. Treatment should focus on warming the Kidney, strengthening the Spleen, and transforming water Qi. The Classics state: "All dampness, swelling, and fullness belong to the Spleen." It also states: "Spleen Qi deficiency leads to inability to use the four limbs; excess leads to abdominal distension."
(VI) Stomach
The Stomach is the palace that receives the five grains. Humans rely on Stomach Qi as their foundation. The Stomach digests the five grains to nourish humans; thus, the Stomach is the most fundamental life resource of the human body.
Stomach Cold: Continuous pain in the epigastrium and abdomen, preferring massage. Frequent spitting of white foam and clear saliva. White greasy tongue coating. Preference for hot drinks and aromatic/dry foods. Treatment should focus on regulating the Middle and warming the Stomach.
Stomach Heat: Thirst preferring cold drinks. Gastric discomfort (burning sensation), polyphagia and hunger. Or regurgitation and vomiting. Red tongue with yellow coating and scanty fluids. Treatment should focus on clearing the Stomach and draining Fire.
Stomach Deficiency: Empty fullness in the epigastrium and abdomen, alternating bloating and relief. Indigestion, reduced diet. Loose stools. Pale substance with thin white coating. Treatment should focus on tonifying the Spleen and strengthening the Stomach.
Stomach Excess: Bad breath, dry tongue. Abdominal pain and distension worsening upon pressure. Dry stool, defecating once every few days. Pulse: The Chi positions of both Maikou pulses are deep and forceful; the Renying pulses are floating and deep but forceful. Treatment should focus on guiding out stagnation. The Classics state: "Abdominal fullness and distension, support against the diaphragm and hypochondrium, reversal below and冒 above, with the fault lying in the Foot Taiyin and Yangming."
(VII) Lung
The Lung stores Qi; Qi houses the Po (Corporeal Soul). The Lung governs the skin/hair, opens into the nose, and its flourishing aspect is manifested in the hair. It is exteriorly-interiorly paired with the Large Intestine. In the body, it corresponds to skin and hair; in color, white; in sound, weeping; in change, coughing; in taste, pungent; in fluid, nasal mucus; in emotion, sorrow/grief. Sorrow/grief injures the Lung; the Lung fears cold. Physical coldness and drinking cold liquids injure the Lung. Pungent flavor enters Qi; those with Qi diseases should not consume excessive pungent flavors. The Lung desires收敛 (astringency/restraint); urgently consume sour flavors to astringe it. Use sour flavors to tonify it, and pungent flavors to drain it. The Lung suffers from rebellious Qi; urgently consume bitter flavors to drain it.
The Lung governs Qi and is the gathering place of all vessels. It regulates the rhythm of respiration and the opening/closing of Qi mechanisms in the Upper, Middle, and Lower Jiao, clearing the interior and exterior, regulating the whole body, and eliminating the old to bring forth the new. Thus, the Lung is metaphorically titled "The Minister Chancellor who regulates and controls." If the Lung loses normal Qi mechanism physiology, disease arises, usually manifesting as respiratory tract and skin reflections. The Classics state: "When evil is in the Lung, there is skin pain, chills and fever, asthma, sweating, coughing moving to the shoulders and back."
Lung Cold: If the Lung is bound by Wind-Cold externally, the whole body may experience muscle and skin pain, nasal congestion without sweat, coarse breathing, coughing and wheezing, expectoration of clear phlegm. The pulse should be floating and tight. Treatment should focus on inducing sweating and releasing the exterior.
Lung Heat: If evil pathogens invade and accumulate in the Lung, turning into fire after many days, leading to intense internal warm evil. Symptoms include coughing and wheezing, chest pain radiating to the back, swollen and painful throat, dry mouth and tongue, and in severe cases, coughing up pus and blood with a foul odor. The pulse should be slippery and rapid. Treatment should focus on draining the Lung, clearing Heat, and resolving phlegm.
Lung Qi Deficiency Syndrome: Weak Lung Qi leads to decreased physiological function, shortness of breath, weak cough, thin white foamy sputum, aversion to cold, and fatigue. Long-term Lung Qi deficiency may lead to Heart Fire transferring to the Lung (destroying Metal), resulting in Lung萎 (Atrophy), dry cough, short breath, empty restlessness, night sweats, hot palms and soles, afternoon low-grade fever, and in severe cases, blood in sputum and hoarseness. For the former, the Cun position of the right Maikou pulse should be insufficient. Treatment should focus on cultivating Earth (Spleen) to benefit Qi and resolve phlegm-fluids. For the latter, the left Maikou pulse should be floating, rapid, and weak, and the right Maikou pulse deep, rapid, and weak. Treatment should focus on nourishing Yin, descending Fire, and benefiting the Spleen and Lung. The Classics state: "Lung Qi deficiency leads to nasal congestion, difficulty breathing, and shortness of breath; excess leads to panting, loud breathing, chest fullness, and仰息 (breathing with difficulty lying flat)."
(VIII) Large Intestine
The Large Intestine is the palace of conduction and transport. Food enters the Stomach, moves down to the Small Intestine, then transfers to the Large Intestine, where the Large Intestine eliminates food residues from the body.
Deficiency Cold Syndrome: When the Large Intestine is affected by Cold, there is abdominal pain and borborygmus. Stools are clear and watery. Preference for warm drinks. Inability to stand for long periods. Preference for curling legs and lying on the side. Treatment should focus on warming the Middle, dispelling Cold, and regulating Qi.