冲脉为病逆气而里急上冲。作躁热咳吐。手足厥逆。气从少腹上冲胸腋。咽燥面翕然热如醉。下流阴股。小便难持。
暑月病甚。则传肾肝为痿厥。四肢如火。或如冰。心烦。寒气客脉不通。气因喘动。应手起关元。随腹直上。疝瘕遗溺
胁肢满烦。女子绝孕。运气在上下左右。不可发汗与下。
冲脉病凡数条。散见诸篇。及仲景书。合而观之。冲脉既为十二经之海。而下为血海。又与督脉为十二经之道路。
及与任脉阳明会于气冲。则举一身督任二脉皆冲也。要其主血海。是以为先天精气之主。能上灌诸阳。下渗诸阴。以至
足。故其治常在血海。唯其阴阳调和。而精气充足。则阳和之精自升。运于一身之间。若稍有不调。即本根不茂。必
逆而上僭。其为上僭有二。阴不足者火逆。火逆则咳吐躁热。上抢心眩仆。四肢如火。心烦恍惚狂痴。阳不足者寒逆。
寒逆则少腹痛。中满暴胀。瘕疝遗溺。胁支满烦。女子绝孕。而其脉之来也。若火逆则阴阳俱盛。两手浮之俱有阳。沉
之俱有阴。气逆则脉来中央实坚劲。至关尺寸俱牢。直上直下。证见胸中寒疝。大约皆冲之病。则见此等脉也。而仲景
云。动气在左右上下。俱不可发汗与下。发汗与下。右则犯肺。于上则气躁而逆。故衄渴苦烦气喘。饮水即吐。于下则
精竭而不止。故头眩咽燥。鼻干心悸。左则犯肝。于上则伤血。而引肝上逆。故头眩。筋惕肉 。难治。于下则伤气。
腹里拘急不止。动气反剧。虽有热而欲卷。上则犯心。汗之则气上冲在心端。下之则掌握热烦汗泄。欲水自灌。盖汗下
则心液泄。故如是也。下则犯肾。故汗之而寒起。且无汗大烦。骨节疼头痛。目眩恶寒。吐谷。太阳虚也。下之而气竭。
上下两隔。则腹满卒起。头运清谷。心下痞坚。亦少阴气不足且厥也。所以然者。冲治血海。治在脐之左右上下。大约
冲气不足。则阴精虚。阴精虚则阳气竭。其可发汗与下乎。然其气起少阴。发于厥阴。若三阴之开阖失职。则本源之真
水真火两虚。而为患种种。必犯于冲。则又不止痿厥二证为冲之致然矣。
When the Chong Mai (Penetrating Vessel) is diseased, it manifests as rebellious Qi ascending accompanied by abdominal tension and urgency. Symptoms include restlessness, heat, coughing, vomiting, and cold extremities (Jue Ni). Qi rushes from the lower abdomen up to the chest and hypochondrium; the throat becomes dry, and the face suddenly flushes with heat resembling drunkenness. Heat flows downward into the medial aspect of the thighs, urination is difficult and held back.
In the summer heat months, if the disease worsens, it transmits to the Kidney and Liver meridians, resulting in Wei Jue (Atrophy and Paralysis Syndrome with Cold Extremities). The four limbs feel like fire or like ice. There is mental restlessness. When Cold Qi lodges in the meridians causing obstruction, Qi moves due to panting. A sensation of movement rises from the Guanyuan CV-4 point, going straight up along the abdomen. This presents as Hernia (Shan), Masses (Jia), and enuresis.
There is fullness and vexation in the hypochondrium and limbs. Women may experience sterility. Depending on the location of the pathogenic influence (Upper, Lower, Left, Right), neither Diaphoresis (Sweating method) nor Purging (Downward-draining method) should be used.
There are numerous descriptions of Chong Mai diseases scattered throughout various chapters of the *Neijing* and in the works of Zhang Zhongjing. Viewing them together: The Chong Mai is the Sea of the Twelve Meridians and, inferiorly, the Sea of Blood. It also serves as the pathway for the Twelve Meridians. It intersects with the Du Mai (Governing Vessel), Ren Mai (Conception Vessel), and Yangming Stomach Meridian at the Qichong ST-30 point. Thus, the entire body's Du and Ren vessels are encompassed by the Chong Mai. Its primary function is governing the Sea of Blood, acting as the master of congenital Essence and Qi. It can irrigate the Yang meridians superiorly and seep into the Yin meridians inferiorly, reaching down to the feet. Therefore, treatment of Chong Mai disorders often focuses on the Sea of Blood. Only when Yin and Yang are harmonious and Essence and Qi are sufficient will the warm essence of Yang naturally ascend and circulate throughout the body. If there is even slight disharmony, the root foundation becomes unstable, inevitably leading to rebellious Qi usurping upwards. This usurpation has two forms: Fire Reversal due to Yin deficiency, and Cold Reversal due to Yang deficiency.
Fire Reversal leads to coughing, vomiting, restlessness, and heat. Qi rushes upward to harass the Heart, causing dizziness and collapse. The four limbs feel like fire, with mental restlessness, confusion, mania, and dementia. Cold Reversal leads to pain in the lower abdomen, sudden abdominal distension, hernias, enuresis, hypochondriac fullness and vexation, and female sterility.
Regarding pulse diagnosis: In Fire Reversal, both Yin and Yang are excessive. Palpating superficially reveals Yang characteristics in both hands; palpating deeply reveals Yin characteristics. In Qi Reversal, the pulse comes solid, firm, and forceful at the center. At the Guan position and Cun-Chi positions, the pulse is deep and taut, moving straight up and straight down. Clinical manifestations include Cold Hernia in the chest. Generally, these are Chong Mai diseases, hence these pulses appear. Zhang Zhongjing stated that if "Moving Qi" (abnormal pulsation indicating Chong Qi disturbance) is present in the left, right, upper, or lower regions, neither diaphoresis nor purging should be employed.
If diaphoresis or purging is mistakenly applied:
To the right, it damages the Lung. Superiorly, it causes Qi to become restless and rebellious, leading to epistaxis, thirst, severe vexation, asthma, and vomiting immediately after drinking water. Inferiorly, it exhausts Essence and fluids uncontrollably, leading to dizziness, dry throat, dry nose, and palpitations.
To the left, it damages the Liver. Superiorly, it injures Blood and draws Liver Qi upward, causing dizziness and muscle twitching (Rou Yu), which is difficult to treat. Inferiorly, it injures Qi, causing persistent abdominal tension and exacerbating the Moving Qi. Although there is internal heat, the patient desires to curl up.
Superiorly, it invades the Heart. Diaphoresis causes Qi to rush upward to the tip of the heart. Purging causes heat and vexation in the palms, sweating, and a desire to pour water over oneself. This occurs because sweating and purging deplete Heart Fluids.
Inferiorly, it invades the Kidney. Diaphoresis causes Cold to arise internally, anhidrosis, extreme vexation, bone and joint pain, headache, dizziness, aversion to cold, and vomiting of undigested food. This indicates Taiyang Deficiency. Purging exhausts Qi, causing separation between Upper and Lower, leading to abdominal fullness, dizziness upon sudden rising, diarrhea with undigested food, and epigastric hardness. This also indicates Shaoyin Qi deficiency and Jue Ni.
The reason for this is that the Chong Mai governs the Sea of Blood, and its therapeutic area is around the umbilicus (left, right, upper, lower). Generally, if Chong Qi is insufficient, Yin Essence becomes deficient. If Yin Essence is deficient, Yang Qi is exhausted. Under such conditions, how can one use diaphoresis or purging? However, this Qi originates from Shaoyin and emerges from Jueyin. If the opening and closing functions of the Three Yin meridians fail, the True Water and True Fire of the root source become doubly deficient, causing various ailments. Once it invades the Chong Mai, the pathology extends beyond just Wei Jue syndromes caused by the Chong Mai.