Library

The monk of Ganming Temple suffered from Shanghan (Cold Damage). His eyes were red, he was extremely thirsty, his throat was dry, and drinking water did not relieve the thirst. He had lower back pain, body heat, and a pulse that was deep, faint, and fine. This is Shaoyin syndrome (a pattern of disease involving the Kidney and Heart channels).

Due to indulgence and lack of caution regarding dietary restrictions, he drank excessive amounts of water, which led to the formation of Pi Qi (epigastric fullness/stagnation). The stagnation of Pi Qi caused his body to feel as if beaten with a stick. After several days, it transformed into Yin Du (Yin Toxin). The pulse appeared on the skin surface, large and deficient. His nostrils looked like soot or coal dust, his fingernails turned blue-black, and he suddenly developed panting. He died that evening.

Commentary: Bian Que stated that cyanosis under the fingernails and toenails indicates death. Song Di in "Jue of Yin Syndrome" stated that when Yin Toxin is rampant, the nails turn black and blue; once the disease reaches this stage, it is incurable.

Tian Zhongrong contracted Shanghan. After several days, he had body heat, intermittent coldness of the hands and feet, abdominal fullness, staring fixedly with wide eyes, delirious speech, and inability to recognize people. I diagnosed him as untreatable. Both the Heart and Kidney organs had exhausted their vital energy. He died that night.

Commentary: Zhang Zhongjing stated that fixed staring and head shaking indicate the exhaustion of Heart Qi. He also stated that delirious speech and reversed gaze with fixed staring indicate the exhaustion of Kidney Qi. The eyes are the gathering place of the essence of the five Zang organs. Now, since he stares fixedly without ability to move his eyes, we know that the five Zang organs are facing exhaustion and death. Therefore, it is untreatable.

A young man surnamed Li from a wealthy family in Jurong County initially contracted Shanghan. His hands and feet were cold, Qi rushed upward to strike his heart, he felt hungry but had no desire to eat, and his pulse was tight and wiry. I diagnosed that all symptoms of Jueyin syndrome (the final stage of Cold Damage) were present. The pulse indicated mutual punishment and restriction. The most feared signs are curled tongue and retracted testicles. The next day, his tongue curled up, and he died.

Commentary: The "Neijing" (Inner Canon) states that Jueyin corresponds to the Liver. The Liver governs the sinews (tendons), which gather at the genitalia and connect to the root of the tongue. The pathological Qi of the Jueyin channel causes the curling of the tongue and retraction of the testicles.

A woman in Yizhen contracted Shanghan. After eight or nine days, she had fever, mental confusion, and inability to recognize people. She picked at her clothes and touched the bed frame, spoke deliriously, and was unaware of her surroundings. Other physicians did not recognize the condition; some used sweating methods, others purgative methods. After ten days, the condition worsened. I diagnosed that her pulse was choppy and urination was difficult. It was untreatable. She died the next day.

Commentary: Hua Tuo stated that patients who pick at clothes and touch the air while speaking deliriously are untreatable. Zhang Zhongjing stated that after Shanghan is treated with vomiting or purging, if the disease persists, there is no bowel movement for five to six days, tidal fever occurs, the patient does not recognize people, picks at clothes, grasps at empty space, has slight panting, and fixed staring: if the pulse is wiry, there is life; if the pulse is choppy, there is death. He also stated that if urination is free, the condition is treatable. Now, with a choppy pulse and difficulty in urination, two signs of death are seen, and no sign of life is visible. I can do nothing more.