篇名：上编 外治法
分类：经义
属性：『素问·脉要精微论』曰：肝脉搏坚而长，色不青，当病坠，若因血在胁
下，令人喘逆。
按、方剂：
注：[1]此言肝脉有刚柔，而病亦以异也。
[2]肝脉搏击于手，而且坚且长，其色又不青，当病或坠或搏，而血积于
胁下，令人喘逆不止也。
[3]正以厥阴之脉，布胁肋，循喉咙之后；其支别者，复从肝贯膈上注肺
，今血在胁下，则血之积气上熏于肺，故令人喘逆也。
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篇名：上编 外治法
分类：经义
属性：『金匮要略』曰：寸口脉浮，微而涩，然当亡血，若汗出。设不汗出者，
其身有疮，被刀斧所伤，亡血故也。
按、方剂：
注：[1]经言：夺血者无汗，夺汗者无血。盖二者皆当脉浮微而涩。
[2]今诊之如此，是有枯竭之象，而无汗出之证，非亡血而何？故知有金
伤或击扑而亡血之证也。
[3]又论曰：肝脉搏坚而色不变，必有击堕之事。
[4]因□肉无破，则恶血必留胁下，兼致呕逆，根据经针刺然谷足跗，或三
毛等穴出血，或饮利药使恶血开行，当自愈也。
[5]若脉浮微而涩，当知亡血过多，根据经于三结交关元穴灸之，或饮大补
气血之剂而调之，则病已矣。
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[Upper Compilation: External Treatment Methods - Classic Principles]
The *Suwen: Treatise on the Essential Subtleties of Pulse Diagnosis* states: When the Liver pulse (pulse of the Liver meridian) is firm and long upon palpation, yet the complexion is not green, it indicates a disease caused by falling or trauma, where blood accumulates beneath the hypochondrium, leading to wheezing and rebellious Qi.
Commentary and Formulas:
Annotations:
[1] This passage explains that the Liver pulse can manifest as either rigid or soft, and consequently, the diseases differ accordingly.
[2] When the Liver pulse beats firmly and is long under the fingers, and the complexion is not green, it indicates that the patient has likely suffered from a fall or blow, causing blood to accumulate beneath the hypochondrium, resulting in persistent wheezing and rebellious Qi.
[3] This is because the Foot-Jueyin Liver Meridian distributes along the hypochondriac region and ascends behind the throat; its branch diverges from the Liver, pierces the diaphragm, and flows upward into the Lungs. Now, with blood accumulating beneath the hypochondrium, the pathogenic qi generated by the stagnant blood steams upward to affect the Lungs, thus causing wheezing and rebellious Qi.
[Upper Compilation: External Treatment Methods - Classic Principles]
The *Jingui Yaolue* states: The Cun Kou pulse (pulse at the radial artery of the wrist) is floating, faint, and choppy. In such cases, there should be blood loss or sweating. If there is no sweating, but the body has sores or wounds inflicted by knives or axes, it is due to blood loss.
Commentary and Formulas:
Annotations:
[1] The classic texts state: "Those who have lost substantial blood should not be induced to sweat; those who have lost substantial sweat should not be depleted of blood." Generally, both conditions present with a floating, faint, and choppy pulse.
[2] Since the pulse diagnosis reveals this pattern, it indicates a sign of exhaustion without the symptom of sweating. How else could this be explained than by blood loss? Therefore, we know there are signs of blood loss caused by metal injuries or blows/falls.
[3] Furthermore, the classics discuss: "When the Liver pulse is firm and the complexion remains unchanged, there must have been an incident of beating or falling."
[4] Because the skin and muscles are not broken, the evil blood (stasis) must remain in the hypochondrium, accompanied by vomiting and rebellious Qi. According to the classics, one should puncture the Rangu point (KI2) and the Sanmao point (Dadun, LR1) on the dorsum of the foot to induce bleeding, or administer purgative medicines to promote the movement and expulsion of the stasis, which should lead to spontaneous recovery.
[5] If the pulse is floating, faint, and choppy, one should recognize excessive blood loss. Following the classics, moxibustion should be applied to the Sanjiaojie point (Guanyuan, CV4, referred to here in context of connection points), or large tonifying formulas for Qi and Blood should be administered to regulate the condition, thereby curing the disease.