宣和戊戌。表兄秦云老病伤寒。身热。足寒。颈项螈 。医作中风治。见其口噤故也。予诊
其脉实而有力。而又脚挛。啮齿。大便不利。身燥无汗。予曰。此刚 也。先以承气汤下之。次以
续命汤调之。愈矣。
论曰。五常政大论曰。赫曦之纪。上羽与正征同。其收齐。其病 。盖戌太阳寒水羽也。戊
火运。正征也。太过之火。上见太阳。则天气且刚。故其收齐。而人病 者。过气然耳。火木遇故年病。此证多刚 。
里中一中表病。渴甚。饮水不止。胸中热疼。气冲心下。八九日矣。医者或作中 。或作贲
豚。予诊之曰。证似厥阴。曾吐虫否。曰昨曾吐蛔。予曰。审如是。厥阴证也。可喜者脉来沉而
缓迟耳。仲景云厥阴。为病消渴。气上撞心。饥不欲食。食则吐蛔。又曰厥阴病。渴欲饮水者。
少少与之愈。今病患饮水过多。乃以茯苓甘草白术桂枝汤治之。得止。后投以乌梅丸。数日愈。
论曰。病至厥阴。若太阳传者。三阴三阳皆已遍。惟恐脉强。则肝邪盛。脾土受克。故舌卷
囊缩而死。今脉来迟缓而沉。则土脉得气。脾不受克。故有可喜之道。仲景云卫气和。名曰缓。
营气和。名曰迟。迟缓相搏。名曰沉。又曰寸口脉。缓而迟。缓则阳气长。其色鲜。其颜光。其
声商。迟则阴气盛。骨髓满精血生。肌肉紧。营卫俱行。刚柔相济。岂非安脉耶。
In the Wuxu year of Xuanhe, my cousin Qin Yun suffered from Shanghan (Cold Damage). He had a fever in his body but cold feet, and spasms in his neck and nape. The physician treated it as Zhongfeng (Wind Stroke), due to observing his clenched jaw. I palpated his pulse, which was solid and forceful, accompanied by leg cramps, teeth grinding, constipation, dry skin without sweat. I said, "This is Gangjing (Rigid Spasm)." First, administer Chengqi Tang (Cassia Twig Decoction) to purge the interior. Then, regulate with Xuming Tang (Continuing Life Decoction). He recovered.
The commentary states: The *Wuchang Zheng Dalun* says: In the Ji of Hexi (Era of Exuberant Fire), the upper Yu corresponds to the Zheng Zheng. Its harvest is uniform, and its disease is chi zhong (spasms/clonic convulsions). This is because Xu belongs to Taiyang Cold Water (Yu), while Wu represents Fire Movement (Zheng Zheng). When excessive Fire meets Taiyang above, the heavenly qi becomes rigid. Thus, the harvest is uniform, and people suffer from chi zhong due to this excessive qi. When Fire and Wood encounter such years, diseases occur; this syndrome often manifests as Gangjing.
A relative in the village suffered from illness with extreme thirst, drinking incessantly, heat and pain in the chest, and Qi rushing to the epigastrium. It had been eight or nine days. Physicians either diagnosed it as Zhongye (Heat Stroke) or Bentun (Rushing Pig/Epigastric Rushing Sensation). I examined him and said, "The symptoms resemble Jueyin disease. Have you vomited worms?" He replied, "Yesterday I vomited roundworms." I said, "If so, it is indeed Jueyin disease. What is gratifying is that the pulse comes deep, slow, and delayed." Zhang Zhongjing stated that Jueyin disease presents with Xiao Ke (Consumption Thirst), Qi rushing up to strike the heart, hunger without desire to eat, and vomiting roundworms upon eating. He also said regarding Jueyin disease: if the patient desires water, give them small amounts to drink, and they will recover. Now, since the patient drank too much water, treat him with Fuling Gancao Baizhu Guizhi Tang (Poria, Licorice, Atractodes, and Cinnamon Twig Decoction) to stop the thirst. Later, administer Wumei Wan (Mume Pill). He recovered after several days.
The commentary states: When the disease reaches Jueyin, if transmitted from Taiyang, all three Yin and three Yang meridians have been traversed. One must fear a strong pulse, indicating Liver pathogen excess, which overcomes Spleen Earth, leading to death with curled tongue and retracted testicles. Now, the pulse is slow, delayed, and deep, indicating that Earth pulse has Qi, and Spleen is not overcome. Hence, there is reason for gratification. Zhang Zhongjing said: Harmony of Wei Qi is called Huan (Slow/Relaxed); harmony of Ying Qi is called Chi (Delayed). When Huan and Chi interact, it is called Chen (Deep). Furthermore, at the Cun Kou pulse position, if Huan and Chi are present: Huan indicates the growth of Yang Qi, resulting in fresh complexion, radiant face, and resonant voice; Chi indicates the abundance of Yin Qi, full marrow, generation of essence and blood, and firm muscles. When Ying and Wei Qi move together, and Gang (Yang) and Rou (Yin) support each other, is this not an An Mai (Peaceful/Safe Pulse)?