诸风掉眩乃肝木。痛痒疮疡心火属。湿肿满本脾土经。气 郁痿肺金伏。寒之收引肾水
乡。五运主病枢要目。
诸暴强直。支痛里急。缩 戾。本足厥阴。肝胆二经。风木之气。
诸病喘呕及吐酸。暴注下迫转筋难。小便混浊血溢泄。瘤气结核疡疹斑。痈疽吐下霍乱
证。
郁肿胀鼻塞干。鼽衄淋秘身发热。恶寒战栗惊惑间。笑悲谵妄衄 污。腹胀鼓之有声和。
少阴君火手二经。真心小肠气之过。 与强直积饮 。霍乱中满诸膈痞。体重吐下 肿痿。
肉如泥之按不起。太阴湿土二足经。脾与从中胃之气。
诸热瞀 筋惕惕。悸动搦搐螈 极。暴喑冒昧躁扰狂。骂詈惊骇气上逆。腑肿疼酸嚏呕
疮。喉
痹耳鸣聋欲闭。呕涌溢食下不能。目眯不明 翳。或禁栗之如丧神。暴病暴死暴注利。少
阳相火手二经。心包络与三焦气。诸涩枯涸闭。干劲揭皴起。阳明之燥。金肺与大肠气。上下
水液出澄冷。 瘕 疝坚痞病。腹满急痛利白清。食已不饥吐利腥。屈伸不便与厥逆。厥逆
禁固太阳经。肾与膀胱为寒水。阴阳标本六气里。
病本十形。风寒燥湿。暑火二分。
春温。君火之气。夏热。相火之气。
内伤外伤。内积外积。六气四因。病机以明。
内伤者。不因气动而病生于内。谓留饮。辟食。饥饱。劳伤宿食。霍乱。非恐。喜怒。
想慕
。忧结之类。外伤者。不因气动而疾生于外。谓瘴气。贼寇虫蛇。蛊毒。蜚食。鬼击。冲薄
。坠堕。风寒。暑湿。斫射。刺割。捶扑之类。内积者。因气动而内成。谓积聚。 瘕。瘤
气。瘿起。癫痫之类。外积者。因气动而外成。谓痈疽。疮疡之类。六气为见病之下。
气固形实。形虚中风。
风中府者。面加五色。有表证脉浮而恶风恶寒。拘急不仁。或中身之后。或中身之前。
或中
身之侧。皆易治。中藏者。唇吻不收。舌不转而失音。鼻不闻香臭。耳聋而眼昏。大小便闭
结。皆难治。经云。风中腑脏之俞为偏风。风气循风府而上为脑风。入系头为目风。饮酒中
风为漏风。入房汗出中之为首风。久风入中为腹风餐泄。外在腠理为泄风之类。久干于荣卫
。则肌肉不仁。手足战掉。
或为寒热。或为热中。(证多目黄)或为寒中。(目自泣下)或为厉风。(皮肤疡溃为 病)
或为偏枯。半身不遂。(左瘫右痪)此率多痰。或属血虚。
血虚少。则血不养筋。筋不束骨。
在左死血。在右属痰。痰壅盛者。口眼 斜。不能言语。皆用吐法。
治法以发散顺气。祛痰清热。疏风吐下之类。更以伤中感三证别辨为治乃妙。
气虚卒倒。降痰益气。火热而甚。燥热潮热。随经治之。阴虚补虚。
阴虚火动亦发热。
勿骤凉治。
虚热勿用凉寒药为治。
轻可降散。实则可泻。重者难疗。从治可施。
此治热之例。如寒凉药正治。热不退。加热剂从而治之。
中寒感寒。阴毒阴逆。四肢厥冷。腹痛唇青。
经云。痛有不可按者。有按之无益者。乃寒气客经脉之中。与正气相搏。则脉满。故痛
而不
可按。寒气客于侠脊之脉。深按不能及。故按之无益。重中于寒。则痛久不能止。寒气客于
肠胃之间。膜原之下。血不得散。小络急引故痛。按之则血气散。故按之而痛止。寒气客于
冲脉。则脉不通气因之故喘动应乎。寒气客于背俞之脉。则血脉泣。泣则血虚。虚则痛。其
俞注于心。故相引心背而痛。寒气客于脉中。则血泣脉急。故胁肋与少腹相引而痛。厥
气客于阴股及小腹。血泣在下相引。故腹痛引阴股。寒气客于小肠膜原之间。络血之中。血
泣不得注于大经。气稽留不得行。故久而成积。寒气客于五脏。厥逆上泄。阴气竭。阳气未
入。故卒然痛如死状。不知人。气复反则生。寒气客于肠胃。厥逆上出。故痛而呕。寒气客
于小肠。小肠不得成聚。故后泄腹痛。寒气正少腹。故痛而不得大小便。病亦名曰疝中。谓
不因气动。偶然当而为病。感因形动。虚而感入。厥者。阴阳气不相顺接。便为厥而手足逆
冷是也。
退阴正阳。急可温中。
治例见阴证要略。
伤寒所致。 病有二。发热恶寒。头颈项强。腰脊反张。口噤面赤。螈 如痫。有汗柔
。无汗名刚。春伤于风。夏生飧泄。
肝气乘脾。故泄利。
夏伤于暑。秋必痢疟。秋伤于湿。冬生咳嗽。冬伤于寒。春必温病。
冬时中寒而即病者为伤寒。不即病。寒毒藏于肌肤。至春变为温病。至夏变为暑病者。
热极
重于温也。亦先夏至曰为病温。后夏至曰为病暑。温暑之病。皆本于伤寒也。古人言感四时
乖戾之气通谓之伤寒。
夏月身热。汗出恶寒。身重脉微。渴乃中 。
伤寒论中 证者三无治法。唯东垣清暑益气之法至允。宜扩充之。
春时病温。温疫温毒。温疟风温。脉证分异。五种疾因。
温疫病。如传染一家尽病是也。
温毒或发斑致痉。为病至重。有寒热往来者为温疟。风温多头疼身热常自汗之类。
中湿风湿。暑成湿温。三种可别。湿热可分。
以上三证。皆自表而之里。中湿或小便不利。大便反快。风湿则一身尽痛。或热。湿温
则发
热头痛如伤寒状。湿热有自里而之表。发黄是也。亦有寒湿病。则肌肤不仁。或痛为痹也。
寒痰香港脚。食积劳烦。要知四证。乃似伤寒。
此四形证。类似伤寒。诊视宜分别。
伤寒之病。见中风脉。中风之病。得伤寒脉。大小青龙。治例必识。调卫调荣。斯须两
得。
桂枝汤则发卫之邪。麻黄汤者。并荣卫而治之。至于青龙汤。治伤寒见风脉。伤风见寒
脉。仲景云。汗出恶风者服之。则筋惕肉 。故此证尤难用。必须形证谛当。方可行之。
疟本伤暑。或痰有食。老疟疟母。
有风暑为病。或食致。或痰病。久疟有癖块者为疟母。
久则羸疲。
谓病如凌虐人之状。久不已。令人瘦也。
三日一发。病经一岁。间日发者。受病半年。一日一发。新病所以。连二日发。住一日
者。气血俱病。或用截法。或随经治。
五脏六腑疟。有图在后治例中。如但热而不寒为瘅疟。先热而后寒为温疟。先寒而后热
为寒疟。夏暑汗不出。秋成风疟连岁不已。胁下有积。是为 疟。犹老疟也。
嗽多感寒。当分六气。
经云。风嗽者。日夜无度。汗出头痛。涎痰不利。甚则喘。热嗽者。急喘而嗽。面赤潮
热
。手足寒。火嗽者。咳喘上气。壅唾出血。甚者七窍血溢。燥嗽则气壅不利。百节内痛。头
面
汗出。寒热往来。皮肤干枯。细疮燥痒。大便涩。唾稠粘。寒嗽者。因形寒饮冷。坐卧湿地
。或胃冷风寒感之。喘急而嗽。湿嗽者。胫重。或肿。或腹大。或喘。饮发于中。喘咳有声
也。亦有五脏之咳。久不已。乃移于六腑。又有气嗽痰嗽劳嗽之类。
六本一标。病机所秘。风热与寒。随证治之。暑燥清金。湿则利水。有声无痰。有痰咳
少。痰可降蠲。咳随本治。
有声无痰为咳。当治其本。
喘有气虚。或因痰壅。或因气逆或倚息使。
亦有热甚而喘。腹胀而喘。咳甚而喘。水乘肺而喘之类。
痢本湿热。
或暑 郁于下焦。或热甚而不食。欲云噤口痢。或因食致。腹痛下血。
或如豆汁。鱼脑。浊水。黄脓。血沫之类。
后重不利。
里急后重也。治可通散。
或发散。或下。
勿便涩住。湿热未消。成休息痢。
因涩药之过。病少减则不能止。成休息痢。
泻泄多湿。热食气虚。(此四证例)如本脾泄。胀而呕吐。洞泄不禁。肠泄则疼。瘕泄不
便
。(小便不利)后重茎痛。胃泄色黄。食饮不化。太素分五。(五等泄)溏泄 泄飧濡滑泄。
溏则便尚稠 如鸭粪溏也。飧则米谷不化。濡或粪若水。滑则大便不禁。
渗秘阑门。涩实对证。
阑门为分水之道。在小肠下口也。如以上证候分治。
疸乃湿热。 曲相似。
有食积。亦发黄胆病也。因湿热相 出黄。
消渴热因。
渴饮水多而小便多者。名消渴。若饮食多而不甚渴。小便数而渐瘦者。名消中。渴而饮
水不绝。腿消瘦。小便有脂液者。名肾消。其燥热一也。
水肿气致。
水肿治之。利小便者谓洁净府。顺气而发散其表。谓开鬼门。木气郁为病。或阴虚或湿
热。或湿胜。皆宜分治。
自汗阳亏。盗汗阴虚。东垣有法。对证可施。头风头痛。有痰者多。血虚与热。分经治
可。
有气虚头痛。心烦头痛。湿热风动头痛。足少阳经少壅为偏头痛。有真头痛者。甚则脑
尽痛
。犯大寒则厥逆头痛。风凑于上成巅顶痛。或痰厥头痛。六经头痛者。太阳经则恶风。少阳
则往来寒热。阳明自汗发热恶寒。太阴则痰盛体重。或腹痛。或痰癖。少阴则经不流行。而
足寒气逆为寒厥。厥阴则项亦痛。或痰唾涎沫厥冷也。有大寒犯脑齿亦痛。名曰脑风。有眉
骨痛。亦曰眉棱痛。
头眩眩运。火积其痰。或本气虚。治痰为先。要痛湿热。本或肾虚。或兼瘀血。腰痛有
寒湿
痛者多。风热痛者少。大抵腰者肾之府。肾气虚。则邪气客之为痛矣。经云。诸经腰痛。太
阳则引项脊尻。背如重状。少阳腰痛。如以针刺其皮中。循循然不可以俯仰反顾。阳明腰痛
。不可
以顾。如有见者善悲。足少阳腰痛引脊内廉。厥阴则腰中如张弓弦。其病令人言。默默不慧
。有
太阳散行之解脉。腰痛者。带脉腰痛。同阴之脉。足少阳之别络为腰痛。阳维之脉腰痛。衡
络之脉。乃太阳之外络为腰痛。足太阳会阴之腰痛。阴维飞
阳之脉腰痛。阴跷昌阳之脉腰痛。太阴别脉散脉为腰痛。少阳肉里之脉为腰痛。其本各不同
也。如闪挫实痛。又不同论。以上湿热肾虚瘀血。皆当求本。
胁痛多气。或肝火盛。或有死血。或痰流注。
或感寒气郁。病多不同。必察其本。
劳瘵阴虚。
阴虚则阳无所附。火炽血涸。成劳瘵之类。
癫狂阳炽。
心热极则病癫。肝热极则病狂。
呕吐咯衄。
谓口吐。或呕或咯唾血也。衄。谓鼻中出血。
气虚脉洪。火载血上。错经妄行。溺血便血。病同所因。梦遗精滑。湿热之乘。或肾气
虚脱。
便浊本热。
小便混浊也。
有痰或虚。
痰结气郁。或肾气不足。膀胱热甚而浊。
白浊属卫。赤浊属荣。
白者气热。赤血热也。
热极成淋。气滞不通。
谓小便淋沥。有淋下痛甚者。成沙石淋也。
血虚惊悸。气虚耳聋。
经云。邪气盛则实。精夺则虚。血不足则心虚而惊悸。气不足则耳无精荣。故聋。
哕因胃病。
呕吐哕俱属胃。胃者。总司物盛满而上溢也。吐或有物无声。为血病。有声无物。为气
病。
有声有物。血气俱病也。如膈噎皆本于热。经云。三阳结则为膈。或有伤酒食。或因气郁。
或胃感风寒。皆为病吐。故有十膈五噎之分。但十膈例不能以尽病情。如血逆干槁之类。学
者自宜推格。
疝本肝经。
经云。厥阴脉滑为狐疝。少阳脉滑为肺风疝。太阴脉滑为脾风疝。阳明脉滑为心风疝。
太阳脉滑为肾风疝。少阴脉滑为肝风疝。虽他脉中皆言风疝者。本足肝经之
气也。亦有疝瘕。厥疝。 疝。寒疝。水疝。筋疝。血疝。气疝之类。皆厥阴发病。所谓本
一标诸也。
痿唯湿热。气弱少荣。
经云。痿者多主于肺。肺气热叶焦也。大经空虚为脉痿。思想无穷。入房太甚。宗筋纵
而为
筋痿。或伤于湿。发痹不仁为肉痿。劳役而大渴。渴则阳气内伐。热舍于肾则髓空。为骨痿
之类。
厥多痰气。虚热所乘。
经云。阳气衰于下为寒厥。阴气衰于下为热厥。或令人腹满。或暴厥不知人。或至半日
远一
日。乃醒而知人也。如六经厥者。太阳则肿首头重。足不能行。发为 仆。阳明之厥。则癫
疾欲走呼。腹满不得卧。面赤而热。妄见而妄言。少阳之厥。则暴聋。颊肿而热。胁痛。
不可以运。太阴厥。则腹满 胀。后不利。不欲真。食则呕。不得卧。少阴之厥。则口干溺
赤。腹满心痛。厥阴之厥。则少腹肿痛。腹胀。茎溲不利。好卧屈膝。阴缩肿 内热之类是
也。
手麻气虚。手木湿痰。或死血病。
有感风湿。手膊或痛或木者。
霍乱吐泻。感风湿 。
病则挥霍撩乱而吐泻。或风甚则转筋。或有干霍乱者不吐泻也。
心痛脾疼。阴寒之设。
有热厥心痛者。身热足寒。痛甚则烦躁而吐。头汗出。有大实心痛者。因气而实。卒然
发痛
也。寒厥心痛者。手足逆而通身冷汗出而不渴。有寒厥而暴痛者。其真心痛。手足青至节者
即死。中脘痛者。亦属脾疼之类。气热烦劳。令人煎厥。
煎厥则气逆。目盲耳闭。
气逆大甚。使人薄厥。
因大怒伤肝。肝气逆。胸中不和。甚则呕血衄血也。
浊气在上。则生 胀。清气在下。则生飧泄。
浊气不降。清气不升为病。
阴火之动。发为喉痹。
心主与三焦气热一也。一阴一阳。内结为喉痹。
阳水变病。飧泄乃是。
即清气在下生泻痢也。
[Pathogenesis of the Five Movements]
Various wind diseases causing tremors and dizziness belong to Liver Wood (dysfunction of the liver). Pain, itching, and sores belong to Heart Fire (hyperactivity of heart function or heat pathogen). Swelling and fullness caused by dampness originate from Spleen Earth (dysfunction of spleen transportation). Qi stagnation and flaccidity syndromes are caused by latent Lung Metal (failure of lung qi diffusion and descent). Contraction and traction caused by cold pathogens belong to Kidney Water (deficiency of kidney yang). This is the outline of the pathogenesis of the Five Movements.
[Pathogenesis of the Six Qi]
Sudden limb rigidity, costal pain, abdominal cramping and contraction, rooted in the Foot Jueyin Liver Meridian and Gallbladder Meridian, are due to Wind-Wood Qi pathology.
Various asthma, vomiting, acid regurgitation, acute diarrhea with tenesmus, tendon spasms, turbid urine, bleeding, and purging, tumors, scrofula, sores, rashes, macules, carbuncles, vomiting and purging, Huoluan (cholera-like disease), Qi stagnation, swelling, nasal congestion, dryness, rhinorrhea, epistaxis, strangury, constipation, fever, aversion to cold, shivering, fright, confusion, spontaneous laughter, sadness, delirium, epistaxis, abdominal distension with resonant sound on percussion, belong to the Hand Shaoyin Heart Meridian and Hand Taiyang Small Intestine Meridian, representing abnormalities of Zhenxin (True Heart) and Small Intestine Qi. Additionally, limb rigidity, fluid retention, Huoluan, middle-fullness, various Ge (diaphragm) and Pi (痞 blockage) syndromes, heavy body, vomiting and purging, edema, flaccidity, muscle softness like mud that does not rise upon pressure, belong to the Foot Taiyin Spleen Meridian and Foot Yangming Stomach Meridian, representing pathology of Spleen and Stomach Middle Qi.
Various heat diseases causing mental clouding, muscle twitching, palpitations, convulsions, spasms, sudden aphonia, coma, restlessness, mania, cursing, fright, rebellious Qi, organ swelling and pain, sneezing, vomiting, sores, throat obstruction, tinnitus, deafness, retching with inability to swallow, blepharoptosis, corneal opacity, or chills and trembling as if losing one's soul, sudden illness, death, and acute diarrhea, belong to the Hand Shaoyang Sanjiao Meridian and Hand Jueyin Pericardium Meridian, representing pathology of Sanjiao and Pericardium Qi. Astringency, dryness, and obstruction, with dry and cracked skin, are due to Yangming Dry Metal (dryness Qi of Large Intestine and Lung). Cold upper and lower excretions, masses, hernias, hard nodules, abdominal distension and acute pain, white discharge in diarrhea, postprandial anorexia, vomiting and purging with fishy odor, difficulty in flexion and extension, and cold limbs, belong to the Foot Taiyang Bladder Meridian and Foot Shaoyin Kidney Meridian, representing cold-water Qi pathology of Kidney and Bladder. Yin-Yang root and branch, and the six Qi penetrating internally.
The root of disease has ten forms: Wind-Cold, Dryness-Dampness, Summer-Heat-Fire each account for two parts.
Spring warmth is Jun-Huo (Minister Fire) Qi; Summer heat is Xiang-Huo (Assistant Fire) Qi.
Internal injury and external trauma, internal accumulation and external accumulation, six Qi and four causes, clarify the pathogenesis.
Internal injury refers to diseases arising internally not due to Qi movement, including retained fluids, anorexia, irregular eating, labor-induced food stagnation, Huoluan, abnormal fear, joy, anger, excessive longing, and sorrowful constraint.
External trauma refers to diseases arising externally not due to Qi movement, including miasma, bandits, insect/snake bites, gu poison, flying insects, ghost strikes, impact, falling, wind-cold, summer-dampness, cutting, stabbing, beating, and bruising.
Internal accumulation refers to formations within the body due to Qi movement, including accumulations, masses, tumors, goiters, epilepsy, etc.
External accumulation refers to formations on the body surface due to Qi movement, including carbuncles and sores. These are listed below the manifestations of the six Qi.
Those with solid Qi and form are less susceptible to wind; those with deficient form easily suffer wind pathogen.
Wind striking the Fu organs presents with five colors on the face, exterior syndrome, floating pulse, aversion to wind and cold, limb stiffness and numbness. Whether affecting the back, front, or sides of the body, it is easy to treat.
Wind striking the Zang organs presents with inability to close lips, tongue immobility leading to aphonia, loss of smell, deafness, blurred vision, and urinary/fecal retention; these are difficult to treat. The classic states: Wind striking Fu/Zang acupoints is Pianfeng (Hemiplegic Wind); Wind ascending via Fengfu point is Naofeng (Brain Wind); entering the head is Mufeng (Eye Wind); wind strike after drinking alcohol is Loufeng (Leaking Wind); wind strike after intercourse with sweating is Shoufeng (Head Wind); long-standing wind entering interior is Bufeng (Abdominal Wind) causing diarrhea; wind at the couli (pores) is Xiefeng (Discharging Wind).
Long-term wind damaging Ying and Wei leads to muscle numbness and hand/foot tremors.
It may manifest as alternating chills and fever, Rezhong (Heat Center, often with yellow eyes), Hanzhong (Cold Center, spontaneous tearing), Lifeng (Malignant Wind, skin ulcers), or Piangu (Hemiplegia). These are mostly due to Phlegm or Blood Deficiency.
Blood deficiency fails to nourish tendons, failing to bind bones.
Left side indicates static blood (blood stasis); right side indicates Phlegm. Severe Phlegm obstruction causes facial deviation and aphasia, treated with emesis.
Treatment methods include dispersing and regulating Qi, resolving Phlegm and clearing Heat, venting Wind, and inducing vomiting or purging. Differentiate based on Injury to Middle, Pathogenic Invasion, and other syndromes for optimal results.
Sudden collapse due to Qi deficiency requires descending Phlegm and tonifying Qi. Excessive Fire, dryness, and tidal fever are treated according to meridians. Tonify deficiency for Yin deficiency.
Yin deficiency with Fire hyperactivity also causes fever.
Do not use sudden cooling agents.
Deficient Heat should not be treated with cold-cooling herbs.
Mild cases can be dispersed downward; excess cases can be purged; severe cases are hard to treat and may require contrary treatment.
This is an example of treating Heat. If cold-cooling orthodox treatment fails, add warming agents for contrary treatment.
Cold invasion, Yin toxicity, Yin rebellion present with cold limbs, abdominal pain, and blue lips.
The classic states: Some pains cannot be pressed; some pains are unaffected by pressing. This is Cold Qi lodging in meridians, battling healthy Qi, causing fullness and pain. Cold lodging in paraspinal meridians is deep and unresponsive to pressure. Heavy cold invasion causes chronic pain. Cold lodging between intestines/stomach and membrane sources prevents blood dispersion, causing tension pain relieved by pressure. Cold lodging in Chong Mai obstructs Qi, causing wheezing. Cold lodging in Back-Shu points causes blood stasis and deficiency pain radiating to heart/back. Cold in meridians causes blood stasis and tension, pulling hypochondrium and lower abdomen. Jue Qi in groin/lower abdomen causes blood stasis and pulling pain. Cold in Small Intestine membrane/blood vessels causes stasis, Qi stagnation, and eventual mass formation. Cold in five Zang causes Jue rebellion, Yin exhaustion, Yang failure to enter, causing sudden death-like pain and unconsciousness; recovery of Qi brings life. Cold in stomach/intestines causes vomiting. Cold in Small Intestine causes diarrhea and pain. Cold in lower abdomen causes urinary/fecal retention, named Shan Zhong (Hernia Middle). This occurs without Qi movement, due to seasonal coincidence. Vulnerability allows invasion. Jue is the failure of Yin-Yang Qi connection, causing cold limbs.
Retreat Yin, restore Yang, urgently warm the Middle.
See Yin Syndrome Essentials for treatment examples.
Shanghan (Cold Damage) causes two types: Fever, aversion to cold, stiff neck/back, opisthotonos, trismus, red face, spasms resembling epilepsy. With sweat is Roujing (Soft Spasm); without sweat is Gangjing (Hard Spasm).
Wind injury in Spring causes Sundun (undigested food diarrhea) in Summer.
Liver Qi overacting on Spleen causes diarrhea.
Summer-heat injury in Summer causes Dysentery/Malaria in Autumn. Dampness injury in Autumn causes Cough in Winter. Cold injury in Winter causes Wenbing (Warm Disease) in Spring.
Cold injury in Winter causing immediate illness is Shanghan. Latent cold toxin becomes Wenbing in Spring and Shubing (Summer Heat Disease) in Summer. Shubing is more severe than Wenbing. Pre-Solstice onset is Wenbing; post-Solstice is Shubing. Both originate from Shanghan. Ancient texts call all four-season aberrant Qi invasions "Shanghan".
Summer fever, sweating, aversion to cold, heaviness, micro-pulse, thirst indicates Zhongshu (Summer-heat Stroke).
Shanghan Lun lacks treatment for Zhongshu; Li Dongyuan's Qingshu Yiqi Tang is appropriate and should be expanded.
Spring Wenbing includes Wenyi (Epidemic Warmth), Wendu (Warm Toxin), Wenmei (Warm Malaria), Fengwen (Wind Warmth). Pulse/symptoms differ; five etiologies vary.
Wenyi is contagious within families.
Wendu causes macules and spasms, very severe. Alternating chills/fever is Wenmei. Fengwen features headache, fever, spontaneous sweating.
Zhongshi (Damp Strike), Fengshi (Wind Damp), Shushi (Summer-heat Damp) are distinct. Damp-Heat can be differentiated.
These three progress from exterior to interior. Zhongshi: urinary difficulty, loose stool. Fengshi: whole-body pain, possibly fever. Shushi: fever, headache like Shanghan. Damp-Heat can move from interior to exterior, causing jaundice. Han Shi (Cold Damp) causes numbness or Bi pain.
Cold Phlegm, Hongjiaojiao (Beriberi), Food Stagnation, Labor Fatigue mimic Shanghan.
Differentiate these four similar syndromes carefully.
Shanghan presenting with Fengzhong (Wind Strike) pulse, or Fengzhong with Shanghan pulse: Da Qing Long Tang and Xiao Qing Long Tang principles apply. Harmonize Ying and Wei.
Gui Zhi Tang disperses Wei pathogen; Ma Huang Tang treats both Ying and Wei. Qing Long Tang treats Shanghan with Wind pulse or Wind Strike with Cold pulse. Zhang Zhongjing notes: sweating and aversion to wind patients taking this may experience muscle twitching; thus, use with caution only when signs/symptoms match perfectly.
Malaria originates from Summer-heat, or Phlegm/Food. Chronic malaria forms Nuomu (Malaria Mass).
Causes include Wind-Heat, Food, or Phlegm. Chronic malaria with masses is Nuomu.
Chronicity leads to emaciation.
The disease torments the patient, causing thinness.
Every three days (annual duration), every other day (6-month duration), daily (new onset), or two days on/one day off indicate Qi and Blood involvement. Use interception or meridian-based treatment.
Five Zang/Six Fu Malaria types follow later diagrams. Danmei (Only Heat) has no chills. Wenmei has heat then chills. Hanmei has chills then heat. Summer heat without sweating leads to Fengmei in Autumn. Hypochondriac mass indicates Kaimai (Old Malaria).
Coughs often stem from Cold, differentiate by Six Qi.
Classic: Fengsou (Wind Cough) is continuous, with sweating, headache, phlegm, possibly asthma. Resou (Heat Cough) is rapid asthma/cough, red face, tidal fever, cold extremities. Huosou (Fire Cough) involves rebellious Qi, bloody sputum, seven-orifice bleeding. Zaosou (Dry Cough) has Qi obstruction, joint pain, sweating, dry skin, small sores, constipation, thick saliva. Hansou (Cold Cough) stems from cold exposure, cold drinks, damp sitting, or Stomach Cold/Wind-Cold, causing rapid asthma/cough. Shisou (Damp Cough) features heavy/swollen calves, abdominal distension, asthma with audible phlegm. Five Zang coughs transfer to Six Fu if chronic. Also Qi, Phlegm, and Lao (Consumption) coughs.
Six Roots, One Branch obscure pathogenesis. Treat Wind-Heat/Cold accordingly. Clear Metal for Summer-Heat/Dryness, promote urination for Dampness. Sound-only is Ke (Cough); treat root. Phlegm reduces cough; resolve root.
Sound-only is Ke; treat the root.
Asthma stems from Qi deficiency, Phlegm obstruction, Qi rebellion, or orthopnea.
Also severe Heat, abdominal distension, severe cough, or Water attacking Lung.
Dysentery originates from Damp-Heat.
Summer-Damp stagnating in Lower Jiao, or severe Heat anorexia (Jinkou Li - Lockmouth Dysentery). Or food-induced, abdominal pain, bloody stool.
Stools resemble bean curd juice, fish brain, turbid water, yellow pus, or blood foam.
Tenesmus (Li Ji Hou Zhong).
Treat with dispersion or purgation.
Do not astringe prematurely while Damp-Heat persists; otherwise, it becomes Xiuxi Li (Intermittent Dysentery).
Overuse of astringents reduces symptoms but doesn't cure, causing intermittent dysentery.
Diarrhea is mostly Damp, Heat, Food, or Qi Deficiency.
Pi Xie: distension/vomiting,洞泄 (cavity diarrhea) uncontrollable. Chang Xie: painful. Xia Xie: difficult urination, tenesmus, penile pain. Wei Xie: yellow stool, undigested food. Tai Su divides into five: Tang (Loose), Sun (Undigested), Ru (Watery), Hua (Slippery).
Lanmen (Gate of Separation) regulates fluids below Small Intestine. Treat according to symptoms above.
Jaundice is Damp-Heat, color resembles Qu (fermented grain).
Food stagnation also causes yellow jaundice. Steaming Damp-Heat produces yellow.
Xiaoke (Wasting-Thirst) stems from Heat.
Drinking much with frequent urination is Xiaoke. Eating much with mild thirst and frequent urination/thinning is Xiaozhong. Unquenchable thirst, leg thinning, fatty urine is Shenxiao (Kidney Thirst). All share Dry-Heat.
Edema stems from Qi.
Treat edema by promoting urination (Jing Jing Fu) or diaphoresis (Kai Gui Men). Wood Qi stagnation, Yin deficiency, Damp-Heat, or Damp excess require differentiation.
Spontaneous sweating indicates Yang deficiency; night sweats indicate Yin deficiency. Li Dongyuan’s methods apply. Headaches often involve Phlegm, Blood Deficiency, or Heat; treat by meridian.
Qi deficiency headache, irritability headache, Damp-Heat/Wind headache. Shaoyang meridian obstruction causes lateral headache. Zhen Toutong (True Headache) is severe brain pain. Major Cold causes Jue headache. Wind at vertex causes top-of-head pain. Tan Jue (Phlegm Jue) headache. Six Meridian headaches: Taiyang (aversion to wind), Shaoyang (alternating chills/fever), Yangming (sweating/fever/aversion to cold), Taiyin (heavy phlegm/body weight/abdominal pain/phlegm masses), Shaoyin (stagnant meridians/cold feet/Jue), Jueyin (neck pain/phlegm/saliva/cold limbs). Major Cold hitting brain/teeth is Naofeng. Brow bone pain is Meileng Tong.
Vertigo stems from Fire/Phlegm or Qi deficiency. Treat Phlegm first. Pain may be Damp-Heat, Kidney deficiency, or Blood Stasis. Low back pain is mostly Cold-Damp; less often Wind-Heat. Waist is Kidney residence; Kidney deficiency allows pathogenic pain. Classic: Taiyang low back pain radiates to neck/spine/sacrum, feeling heavy. Shaoyang pain feels like needle pricks, limits bending/turning. Yangming pain limits turning, accompanied by sadness. Shaoyang pain radiates inward. Jueyin pain feels like bowstring, muteness. Various meridians (Jie, Dai, Tongyin, etc.) cause specific low back pains. Traumatic pain differs. Address root of Damp-Heat, Kidney deficiency, Blood Stasis.
Hypochondriac pain stems from Qi, Liver Fire, Blood Stasis, or Phlegm migration.
Or Cold Qi stagnation; examine root.
Laozai (Consumption) is Yin deficiency.
Yin deficiency leaves Yang unanchored; Fire blazes, Blood dries, causing consumption.
Diankuang (Mania/Depression) is Yang blazing.
Extreme Heart Heat causes Dian (Depression); extreme Liver Heat causes Kuang (Mania).
Vomiting, spitting blood, epistaxis.
Vomiting or spitting blood. Epistaxis is nosebleed.
Qi deficiency with surging pulse, Fire carrying Blood upward, erratic menstruation. Hematuria/melena share etiology. Nocturnal emission/slippery essence due to Damp-Heat or Kidney Qi depletion.
Turbid urine stems from Heat.
Urine turbidity.
Can be Phlegm or Deficiency.
Phlegm-Qi stagnation or Kidney deficiency with Bladder Heat causes turbidity.
White turbidity belongs to Wei (Qi); Red turbidity belongs to Ying (Blood).
White indicates Qi Heat; Red indicates Blood Heat.
Extreme Heat causes Strangury; Qi stagnation blocks flow.
Scanty painful urination; stone strangury if severe.
Blood deficiency causes palpitations; Qi deficiency causes deafness.
Classic: Excess pathogen is Shi (Excess); Essence loss is Xu (Deficiency). Blood deficiency leads to Heart deficiency/palpitations. Qi deficiency deprives ears of nourishment, causing deafness.
Hiccups stem from Stomach disease.
Vomiting and hiccups belong to Stomach. Stomach holds contents and overflows. Vomiting with matter/no sound is Blood disease; sound/no matter is Qi disease; both is Qi-Blood disease. Bo/Ye (Regurgitation/Obstruction) stem from Heat. Classic: Three Yang knotting causes Bo. Causes include alcohol/food injury, Qi stagnation, or Stomach Cold-Wind. Ten Bo and Five Ye categories exist; scholars must deduce specifics like Blood Rebellion/Dryness.
Hernia originates in Liver Meridian.
Classic: Jueyin slip indicates Hu Hernia; Shaoyang slip indicates Lung Wind Hernia; Taiyin slip indicates Spleen Wind Hernia; Yangming slip indicates Heart Wind Hernia; Taiyang slip indicates Kidney Wind Hernia; Shaoyin slip indicates Liver Wind Hernia. Though others mention Wind Hernia, root is Foot Liver Qi. Types include Xia, Jue, Chu, Han, Shui, Jin, Xue, Qi hernias, all Jueyin origin. Root one, branches many.
Flaccidity is mainly Damp-Heat, Qi weakness, scarce Ying.
Classic: Flaccidity relates to Lung; Lung Heat scorches leaves. Empty large meridians cause Mai Wei (Pulse Flaccidity). Endless thoughts/excessive sex loosen Zongjin causing Jin Wei (Tendon Flaccidity). Damp injury causes Bi numbness/Rou Wei (Flesh Flaccidity). Labor/thirst allows Yang to invade Kidney, emptying Marrow, causing Gu Wei (Bone Flaccidity).
Jue involves Phlegm-Qi, attacked by Deficient Heat.
Classic: Yang decline below causes Han Jue (Cold Jue); Yin decline below causes Re Jue (Heat Jue). Abdominal fullness, sudden coma, or delayed awakening. Six Meridian Jue: Taiyang (head heaviness, inability to walk, collapse). Yangming (mania, running/crying, abdominal fullness, insomnia, red face, hallucinations). Shaoyang (sudden deafness, swollen hot cheeks, hypochondriac pain, immobility). Taiyin (abdominal distension, constipation, anorexia, vomiting, insomnia). Shaoyin (dry mouth, red urine, abdominal fullness, heart pain). Jueyin (lower abdominal swelling, distension, urinary difficulty, desire to lie curled, Yin retraction/swelling/internal heat).
Hand numbness: Qi deficiency, Damp-Phlegm, or Blood Stasis.
Wind-Damp invasion causes arm pain/numbness.
Huoluan vomiting/diarrhea, Wind-Damp invasion.
Chaotic vomiting/diarrhea; severe wind causes tendon spasms. Gan Huoluan (Dry Huoluan) has no vomiting/diarrhea.
Heart pain/Spleen pain: Yin Cold setting.
Re Jue heart pain: body heat, cold feet, irritability/vomiting with severe pain, head sweating. Da Shi heart pain: Qi excess, sudden pain. Han Jue heart pain: cold limbs, whole-body cold sweat, no thirst. Han Jue sudden pain: Zhen Xin Tong (True Heart Pain) with blue limbs to joints is fatal. Zhongwan pain belongs to Spleen pain. Qi Heat/labor causes Jian Jue.
Jian Jue reverses Qi, causing blindness/deafness.
Severe Qi rebellion causes Bo Jue.
Anger injures Liver, Qi rebels, chest discomfort, severe bleeding.
Turbid Qi above causes distension. Clear Qi below causes Sundun diarrhea.
Failure of Turbid Qi to descend and Clear Qi to ascend causes disease.
Yin Fire movement causes Hou Bi (Throat Obstruction).
Heart Master and Sanjiao Heat combine. Yin-Yang knotting internally causes Hou Bi.
Yang Water transformation causes Sundun diarrhea.
Clear Qi sinking causes dysentery/diarrhea.