伤寒腹满谵语。寸口脉浮而紧。此肝乘脾也。名曰纵。刺期门。
伤寒发热。啬啬恶寒。大渴欲饮水。其腹必满。自汗出。小便利。其病欲解。此肝乘肺也。
名曰横。刺期门。
腹满谵语。里之实也。其脉当沉实。而反浮紧。则非里实。乃肝邪乘脾。气窒而热也。纵、直也。
以肝木制脾土。于理为直。故曰纵。发热恶寒。表有邪也。其病不当有渴。而反大渴。则非内热。
乃肝邪乘肺。气郁而燥也。以里无热。不能消水。故腹满而汗出。小便利。则肺气以行。故愈。横
、不直也。以木畏金而反乘金。于理为曲。故曰横。二者俱泻肝邪则愈。故刺期门。期门、肝之募
也。设不知而攻其实热则误矣。此病机之变。不可不审也。
太阳与少阳并病。头项强痛。或眩冒。时如结胸。心下痞硬者。当刺大椎第一节、肺俞、肝俞
。慎不可发汗。发汗则谵语。脉弦。五六日。谵语不止。当刺期门。
太阳少阳并病。心下硬。颈项强而眩者。当刺大椎、肺俞、肝俞。慎勿下之。
太阳之脉。其直者。从巅入络脑。还出别下项。少阳之脉。起目锐 。上抵头角。其内行者。
由缺盆下胸中贯膈。络肝属胆。故头项强痛者。太阳之邪未罢。或眩冒。时如结胸。心下痞硬者。
少阳之邪方盛也。大椎在脊骨第一节上。刺之所以泻太阳邪气。而除颈项之强痛。肺俞在脊骨第三
节下两旁。肝俞在第九节下两旁。刺之所以泻少阳邪气。而除眩冒。时如结胸。及心下之痞硬。慎不
可发汗。以亡胃液。液亡胃燥。必发谵语。且恐少阳之邪得乘虚而干胃也。若脉弦。至五六日。谵语
不止。是少阳胜而阳明负。亦如阳明与少阳合病之为失也。故当刺期门。以泻少阳之邪。亦慎勿下
之。以虚其胃。胃虚邪陷。必作结胸。如本论云、太阳少阳并病。而反下之。成结胸也。
In typhoid fever, abdominal fullness and delirium occur. The pulse at the Cun Kou (radial artery) is floating and tight. This indicates Liver Qi invading the Spleen, named "Zong" (Vertical/Direct). Treatment involves puncturing the Qimen (LR-14) acupoint.
In typhoid fever, fever occurs, accompanied by shivering aversion to cold, extreme thirst with a desire to drink water, inevitable abdominal fullness, spontaneous sweating, and free urination. The disease is about to resolve. This indicates Liver Qi invading the Lung, named "Heng" (Horizontal/Indirect). Treatment involves puncturing the Qimen (LR-14) acupoint.
Abdominal fullness and delirium are signs of Interior Excess. The pulse should be deep and solid; however, it is floating and tight instead. This indicates not Interior Excess, but Liver Pathogen invading the Spleen, causing Qi obstruction and heat generation. "Zong" means direct. Since Liver Wood controls Spleen Earth, this follows the direct logic of control, hence called "Zong". Fever and aversion to cold indicate Exterior pathogenic factors. Thirst should not occur in such cases; extreme thirst indicates not Internal Heat, but Liver Pathogen invading the Lung, causing Qi stagnation and dryness. Because there is no Internal Heat to transform fluids, abdominal fullness and sweating occur. If urination is free, Lung Qi can circulate, leading to recovery. "Heng" means indirect (or curved). Since Wood fears Metal, Liver Wood invading Lung Metal goes against the normal order of control (rebellious invasion), hence called "Heng". Both conditions are cured by draining Liver Pathogen, thus puncturing Qimen (the Front-Mu point of the Liver meridian) is indicated. Ignoring this and attacking apparent Excess-Heat would be an error. These variations in disease mechanisms must be carefully examined.
When Taiyang and Shaoyang meridians present simultaneously (Bing Bing), with stiffness and pain in the head and neck, occasional dizziness or vertigo, sensations resembling Jie Xiong (Chest Binding Syndrome), and hardness and stuffiness below the heart, one should puncture the first segment of the Dazhui (GV-14) acupoint, Feishu (BL-13), and Ganshu (BL-18). Sweating therapy must be strictly avoided. If sweating is induced, delirium and a wiry pulse will result. After five to six days, if delirium persists, puncture Qimen (LR-14).
When Taiyang and Shaoyang meridians present simultaneously, with hardness below the heart, stiffness in the neck and back, and dizziness, one should puncture Dazhui (GV-14), Feishu (BL-13), and Ganshu (BL-18). Purging methods must be strictly avoided.
The Taiyang meridian runs straight from the vertex into the brain, emerges, and descends separately to the nape. The Shaoyang meridian originates at the outer canthus, ascends to the forehead/corner of the head, and internally travels from the Quepen (ST-12) region down through the chest, piercing the diaphragm, connecting to the Liver, and belonging to the Gallbladder. Therefore, stiffness and pain in the head and neck indicate unresolved Taiyang pathogens; occasional dizziness, sensations resembling Jie Xiong, and epigastric stuffiness/hardness indicate flourishing Shaoyang pathogens. Dazhui (located above the first thoracic vertebra) is punctured to drain Taiyang pathogens and relieve neck stiffness. Feishu (located bilaterally below the third thoracic vertebra) and Ganshu (located bilaterally below the ninth thoracic vertebra) are punctured to drain Shaoyang pathogens and relieve dizziness, Jie Xiong-like sensations, and epigastric stuffiness. Sweating must be avoided as it depletes Stomach fluids; fluid depletion leads to Stomach dryness and delirium, and risks Shaoyang pathogens invading the Stomach due to deficiency. If the pulse is wiry and delirium persists after five to six days, it indicates Shaoyang excess and Yangming deficiency, similar to the error in Yangming-Shaoyang combined disease. Thus, puncturing Qimen (LR-14) to drain Shaoyang pathogens is appropriate. Purging must also be avoided as it weakens the Stomach; Stomach weakness allows pathogens to sink inward, inevitably forming Jie Xiong syndrome, as stated in the original text: "In Taiyang-Shaoyang Bing Bing, contrary purging leads to Jie Xiong."