寒客在上。胃寒肠热。水谷不化。痞胀而泄。热气居上。肠寒胃热。消谷善饥。腹胀便
涩。蕴热怫郁。乃生诸风。风寒与湿。合而成痹。
经云。风寒湿合疾为行痹。独阳胜者为痛痹。湿胜者为着痹。在血脉之中。乃周于身为
周痹。
小腹上按之内痛。若沃以汤。涩于小便上为清涕。者为胞痹。如多饮不得溲。时胀痛飧泄。
食不消。或气喘者。为肠痹。阳气多。阴气少。肌内热。上如鼠行。 然而闷为热痹。阳气
少。阴气多。与病相益为寒痹。湿胜则痹多汗。筋挛节痛不可行为筋痹。
骨痛不可举而酸疼者为骨痹。凡痹之客五脏者。肺痹则烦满喘而呕。心痹者。脉不通。烦则
心下鼓暴。上气而喘嗌干肝。痹者。夜卧则惊。数小便。肾痹则善胀。行踵不前。头不举。
脾
痹者。四肢怠堕。发咳呕汁。上为大。寒痹在于骨则重。在于脉则血凝而不流。在于筋则屈
不伸。在于肉则不仁。在于皮则寒。此五者。则又不痛也。凡痹之类。逢寒则屈。逢热则纵
也。膏粱之变。饶生大疔。
言饮食膏粱浓味之人。脏腑蕴积热毒。或服金石之药。毒瓦斯伤血。血结成诸疮肿也。如
疔疮有
发蛇眼疔者。则有两个。麻子疔。则如麻子。脐疔。多生脐上者是。刀镰疔者。因受伤成
疮
。茱萸疔。内凹外起。水泡疔。极痒透骨。搔则快然。红丝疔者。疮边有红络直上如线。火
疔极红。三日大发肿。墨疔者。如黑泡。樱桃疔。如樱桃之状。浮沤疔。半低半高。胁疔。
生胁上者是。烂疔。则疮水流到处便成疮。雌疔者。或又有一个在他处。以水 之则见
。有石疔。色黑如豆而硬。又每日添生三疔六疔之类。
荣气不从。逆于肉理。乃生痈肿。
诸恶毒肿生疮。大而浅者为痈。小而根深者为疽也。有发脑者。生头上。初如黍米。四
畔
赤肿硬。遍耳项。或发成痈也。如脑疽者。初如黄枳实。破后如盏底。深寸许。发背者。发
于背俞。亦搭背之类。热毒内聚。血气不行。结而成胃脘雍。或生肺痈。或肠痛。或有着骨
上生者为
附骨痈。贴骨痈也。或诸恶疮。有面露疮。作脓窠如香瓣类。髭须疮则有脓窠。金腮疮能蚀
透腮颊。初生如米豆大。鬈毛疮在头中。初生如葡萄。痛不能止。发际疮初生如黄米大。或
痒或痛。咽漏疮者。生结喉上。如痈肿。破后有眼子。绿唇疮。彻耳疮。鼻疳疮。能侵蚀鼻
柱也。睛漏疮。生目大 。必出脓汁。有孔子。颐颏疮。又名独骨疮。生腮后者是也。玉枕
疮。生枕骨上。如痈。破后有筋头。粉铃疮绕项赤烂。多汁。天柱疮。生脊大椎上。如钱大
。赤色。出黄汁不止。妇人为小儿吮乳所吹肿者。为吹乳。或热毒而成。乳头烈有乳痈。乳
崖。乳核。亦名乳 。有乳汁不出。蓄积内结成痈名妒也。有鱼眼疮。 疮。透掌漏疮
。反
花疮。破则肉反于外。浸淫疮生于身。初生微痒。后有水出。下注疮生于脚膝间。脓水不绝
。连年不愈。水毒 肿。因伤于湿。肌肉不仁成疮也。冷疮者。因经年不愈而成。热疮初发
。赤根白头瘭汁出。甚者腐为脓血。或痛或痒。月蚀疮小儿生于两耳上。及窍旁者是。或云
小儿指月而生。此未必然。盖风湿热毒也。冻烂肿疮者。因寒。气血凝聚不流。则皮肉不温
。成聚 赤肿痛而成疮也。俗谓之冻烂 疮者。赤根白头。相对并生。如小豆。或如茱萸子
。
浸淫痒痛。抓之汁出。有漆疮者。中漆毒也。有灸疮。因为火艾过多。 毒不根据六俞。及
食毒
不慎房室。肿痛久不瘥者。 疮者。疮久脓溃不止。内经谓陷脉为 也。有热肿。毒肿。气
肿。风肿。疮肿。小而出脓血者为疖。受风湿而肌肤中生中浸淫。或搔之汁者。或白屑起者
。为癣为疥。热毒莞于四肢而肿为结阳。筋骨热甚。爪甲成疮而脱落。名伐指丹毒者。热
毒
之气。暴发于皮肤。其色如涂丹之赤。流移不定。晕入腹即死。痱疮者。经谓汗出见湿。乃
生痤痱。俗谓之痱子。有恶脉者。其状赤络
忽起。茏苁而聚。若死 之状。有留气上结如核。多生于耳旁。此留气结核及为瘰 。有马
刀挟瘿疮。蝼蛄疮。则走串。樱桃疮者。有如颗粒高起。红赤。若其状若下垂疮。便毒天
疮。无名恶肿之类。故经云。营逆则血郁。血郁则热聚为脓。以上疮论治例。并出圣济总录
。
疮疡恁脉。治乃不惑。身重脉缓。湿胜除湿。身热脉大。躁热发肿。退热凉荣。眩运动
摇。
痛而脉弦。降痰去风。气涩卫滞。燥渴脉涩。补血泻气。食少恶寒。脉紧细者。宜泻寒水。
辨经部分。详审为治。
以上治疮脉诀也。
湿热生虫。
厥阴风水生虫。三焦阳火热甚。而肺多受克。金被火克。不能制木。木甚。兼脾胃湿热
。是以生虫如寸白长蛔血鳖之类。
水积痰饮。
如人素壮今瘦。水走肠间。历历有声。谓之痰饮。有饮后水流在胁下。咳唾引痛。谓之
悬饮
。水流于四肢。当汗出而不出汗。身体重痛。谓之溢饮。咳逆倚息。短气不得卧。其形如肿
。谓之支饮。又有留饮者。背寒如手大。或短气而渴。四肢历节疼。胁下痛引缺盆咳则转甚
。则伏饮者。膈满呕吐喘咳。发则寒热腰背痛。目注出。其人振振恶寒。身 惕。痰证如风
痰。热痰湿痰。酒痰。食痰。寒痰之类。
目痛赤肿。精散荣热。
目之五轮。乃脏腑之精华。宗脉之所聚。其白人属肺金。肉轮属脾土。赤脉属心火。黑
水神
光属肾水。兼属肝木。如白人变赤。火乘肺也。肉轮赤肿。火乘脾也。黑水神光被翳。火乘
肝与肾也。赤脉贯目。火自甚也。有雀目病。则不能夜视及内障。乃暴怒大忧所致。暴赤肿
痛。羞明隐涩。肿痛不已。眼匡红烂。生眵泪下。拳毛倒睫。视物昏花。翳膜遮睛。皆精荣
失守。
风热盛及血热也。
牙痛龈宣。寒热亦别。
牙有恶寒作痛者。有恶热作痛。有恶寒又恶热而作痛者。有恶寒饮少热饮多而作痛。有
恶热饮
少寒饮多而作痛。有牙齿动摇作痛。有齿袒而为痛。有齿龈为疳所蚀缺血出为痛。有齿龈肿
起为痛。有腺胃中有风邪。但觉风雨作痛。又有牙上多为虫所蚀。其齿缺少而色变为虫牙。齿
缝中
有血出不止为牙宣。有胃气少不能于寒。袒露其齿作痛。有痛而秽臭不可近者。盖手阳明之
脉。贯络下龈。恶寒饮而喜热。足阳明之脉。贯络上龈。喜寒饮而恶热。牙者肾之余。亦喜
寒。寒者坚牢。为病不一。热甚则齿动。龈龈相脱作臭。痛不已。有风热内甚而痛。有风寒
客之为痛。大寒犯脑赤连牙痛之类。
五脏本病。热争重HT (音捏)
经云。肝热病者。小便先黄。腹痛多卧。烦赤身热。热争则狂。胁下满而痛。烦躁不安
。心
热病。则心不乐乃热。热争心痛而烦闷善呕。头痛面赤。热而无汗。脾热则头重颊痛。颜青
欲呕。身热烦心。腹满泄泻。热争则腰痛。肺热则洒洒然恶寒。舌黄而身热。热争喘咳。痛
走胸背。不得太息。头痛不堪。汗出而恶寒。肾热病。则腰痛 酸。渴而身热。热争项强。
寒且酸。足热而言懒。头痛 然。如五气所病。心为意。肺为咳。肝为语。脾为吞。肾
为欠。胃为气逆。为哕为恐。大小腹为泄。下焦溢为水。膀胱不利为癃。
不约为遗溺。五病所发。五邪所乱之类。
六腑不和。留结为痈。五脏不和。九窍不通。腑脏相移。传变为病。不可胜纪。经云。
心移
寒于肺。则为肺消证。心移热于肺。则胸满烦心。烦躁引饮短气。鬲热为鬲消证。肝移寒于
心则狂。肝移热于心心病谓之生阳。不过四日死。脾寒移肝。痈肿而筋挛。肺寒移肾。其证
如囊裹浆。或遍身肿满。按腹不坚。疾行则濯濯有声。或咳不定。为涌水证。脾热移肝。则
血溢为惊衄证。胆受胃热。鼻中血妄行为衄。或血污不止。胆移热于脑。脑热渗下。则浊涕
不止。久而不已。成衄血疾。肾热移脾。则传为虚肠 。死不治。膀胱本热则为癃。病溺血
。膀胱移热于小肠。隔肠不便。上为口縻证。大肠移热于胃。则善食而瘦。胃热移胆。俱为
食证。肾寒移脾。则痈肿少气。肠有积热。则津液壅滞腹痛而便涩。为 瘕证。病几治例
。见宣明论。间藏者存。传其所生。
经云。假令心病传脾。脾传肺。肺传肾。肾传肝。肝传心。是传其所生。故有病虽重必
生。
七传者死。传其所制。
如心病传肺。肺传肝。肝传脾。脾传肾。肾传心。火受水之传一也。肺金复受火之传再
也。
自心而始。以次相传。至肺之再。是七传也。故七传者死。一脏不受再伤也。是传其所胜尔
。
五脏有积。肝曰肥气。在左胁下。大如覆杯。或有头足。久则变病。咳逆 疟。
连岁不已。心积伏粱。病起脐上。其大如臂。上至心下。如久不愈。令人烦心。脾积痞
气。
其在胃脘。覆大如盘。久而不愈。四肢不举。乃发黄胆。虽食而瘦。肺积息贲。在右胁下。
覆大如杯。如久不已。令人寒热。喘发肺痈。肾积奔豚。发于小腹。上至心下。乃若豚状。
下上无时。如久不已。令人喘逆。骨痿少气。经云。积者。一脏因受胜己之邪。而传干己之
所胜。适当旺时。拒而不受。复还于胜己者不肯受。因结为积也。有食积。则酸心腹满。酒
积。目黄口干。气积。噫气痞寒。涎积。咽如拽锯。痰积。涕唾稠粘。癖积。两胁刺痛。水
积。足胫胀满。血积。打扑肭瘀。及肉面一切物食所积之类。在六腑为聚。鼓胀发蛊。
有腹胀。寒胀。热胀。气胀。大热胀。水肿而胀。甚则为蛊。夫胀者。由脾胃之气虚弱。不
能运化精微而制水谷。聚而不散。而成胀也。有心腹胀满。旦食不能暮食。致胃逆不散者名
鼓胀。有小腹急痛。便溺失精。溲而出白液。亦名为蛊病。中满郁痞。
经云。脏寒生满病。如太阴所至为中满。为蓄满。湿土之化。脾湿有余。腹满食不消。
无阳则不能生化也。如胀之类郁。如气不能消散升降为结聚而痞闷也。心下满而不痛为虚痞。积
饮隔滞为实痞也。
开提其气。升降是宜。
此治郁闭痞满之大法。
人身之本。脾胃为主。头痛耳鸣。九窍不利。胀胃所生。胃气之虚。虚极变病。五乱互
作。
五脏五行之气不和。更相传变为病也。
东垣所论。王道之学。
东垣李明之先生。述脾胃盛衰论。一虚一实。
气乱于卫。血逆于经。血气不和。故一虚一实。乃气血之并也。见素问调经论。五实
五虚。
五实者。脉盛为心。皮热为肺。腹胀为脾。前后不通为肾。闷瞀为肝也。五虚者。脉细
为心。皮寒为肺。气少为肝。前后泄利为肾。饮食不入为脾也。谓一病五者悉具。
五劳七伤。六极乃HT 。
久视伤血。久卧伤气。久坐伤肉。久立伤骨。久行伤筋。又志思忧心与疲劳为五劳也。肝伤
善梦。心伤善忘。脾伤善饮。肺伤善痿。肾伤善唾。骨伤善饥。脉伤善嗽。为七伤也。伤劳
为六极。气血筋骨髓精病也。
五郁七情。九气所为。怒则气上。喜则气缓。悲则气消。恐则气下。寒则气收。炅则气
泄。
惊则气乱。劳则气耗。思则气结。(此为九气)忧愁思虑。甚则伤心。形寒饮冷。过则伤脾。
恚怒气逆。过则伤肝。饮食劳倦。甚乃伤脾。坐卧湿地。强力入水。故乃伤肾。(次为七情)
此因气动。形神自病。喜怒不节。劳形厥气。气血偏盛阴阳相乘。阴胜阳病。阳胜阴病。阳
胜则热。阴胜则寒。重寒则热。重热则寒。寒则伤形。热则伤气。气伤则痛。形伤则肿。先
痛后肿。气伤形也。先肿后痛。形伤气也。阴阳变病。标本寒热。如大寒甚。热之不热。谓
以热药治寒不退。
是无火也。热来复去。昼见夜伏。夜发昼见。时节而动。是无火也。当助其心。心虚则
热收于内。故外热不常。
如热而甚。寒之不寒。
谓以寒凉药治热病。而热不能退。
是无水也。寒动复止。倏忽往来。时动时止。是无水也。当助其肾。
肾虚则寒动于中。故外寒不常。
内格呕逆。食不得入。是有火也。病呕而吐。食入反出。
谓食入良久乃吐。
是无火也。暴逆注下。食不及化。是有火也。溏泄而久。止发无常。是无水也。心盛生
热。肾盛生寒。
此心火极而发热。肾水盛而生寒。非虚热虚寒比。
又热不寒。是无火也。寒不得热则无水也。寒之不寒。责其无水。热之不热。责其无火
。热之不久。责心之虚。寒之不久。责肾之少。
又热不寒者。或因寒胜格阳在外。本非热也。寒不得热者。或因阳极似阴。火盛拒寒在
外。
而不得热。本非寒也。寒之不寒。乃水之源衰。火之胜也。热之不热。火不源衰。水之胜也。
审察病机。无失气宜。纪于水火。余气可知。妇室病多。带下赤白。 瘕 疝。妇人有
病。
六气四因。皆同男子。余胎产经水之疾。不可枚举。如带下赤者。热入小肠。白者。热入大
肠。若痢下也。若经水不调。血聚为 瘕。小腹下肿硬。为 疝之疾。
气血为病。经闭不行。
Cold pathogen invades the upper jiao. The stomach is cold while the intestines are hot, leading to the failure of digestion and transformation of food and fluids. This results in epigastric fullness and distension accompanied by diarrhea. Heat qi resides in the upper jiao; the intestines are cold while the stomach is hot, causing rapid digestion with easy hunger, abdominal distension, and difficult, scanty defecation. Accumulated heat stagnates and becomes oppressed, thereby generating various wind syndromes. Cold, wind, and dampness combine to form Bi syndrome (Obstruction Syndrome).
The Classics state: When cold, wind, and dampness combine to cause disease, if wind predominates, it is called Xing Bi (Moving Bi); if Yang heat predominates, it is called Tong Bi (Painful Bi); if dampness predominates, it is called Zhuo Bi (Fixed Bi). If the pathogen is within the blood vessels and circulates throughout the body, it is called Zhou Bi (General Bi).
Pressing the area above the lower abdomen causes internal pain, feeling as if scalded by hot water, with astringent and difficult urination, and clear, profuse nasal discharge; this is called Bao Bi (Bladder Bi). If there is excessive drinking but difficulty in urination, frequent abdominal distension, pain, and undigested stool in diarrhea, or panting, this is called Chang Bi (Intestinal Bi). When Yang qi is abundant and Yin qi is deficient, causing internal heat in the muscles, with a sensation on the back like a mouse crawling, accompanied by stifling discomfort, this is called Re Bi (Heat Bi). When Yang qi is deficient and Yin qi is abundant, and the pathogen exacerbates the condition, it becomes Han Bi (Cold Bi). If dampness predominates, Bi syndrome presents with excessive sweating, tendon spasms, joint pain, and inability to walk, which is called Jin Bi (Tendon Bi).
If bones are painful, unable to be lifted, and ache, it is called Gu Bi (Bone Bi). Regarding Bi pathogens invading the five Zang organs: Fei Bi (Lung Bi) causes vexation, chest fullness, panting, and vomiting; Xin Bi (Heart Bi) involves blocked vessels, with vexation causing palpitations like drumbeats in the heart region, rebellious Qi leading to panting, and dry throat; Gan Bi (Liver Bi) causes fright during sleep and frequent urination; Shen Bi (Kidney Bi) leads to frequent abdominal distension, walking with heels raised and not touching the ground, and inability to lift the head; Pi Bi (Spleen Bi) causes lassitude and weakness of the four limbs, coughing with vomiting of saliva, and upper abdominal fullness. Han Bi in the bones causes heaviness; in vessels, blood coagulation and stasis; in tendons, flexion without extension; in flesh, numbness; in skin, coldness. These five types often do not present with pain. Generally, Bi syndromes curl up when exposed to cold and relax/extend when exposed to heat.
Excessive consumption of rich, greasy foods easily generates severe Ding sores (Furuncles).
This refers to individuals consuming rich and fatty foods, whose internal organs accumulate heat toxins, or those taking mineral medicines, where toxic vapors damage the blood, leading to blood stasis forming various swellings and sores. For example, Ding sores include She Yan Ding (Snake Eye Ding) with two heads; Ma Zi Ding (Hemp Seed Ding) shaped like a hemp seed; Qi Ding (Navel Ding) mostly occurring on the navel; Dao Lian Ding (Knife Sickle Ding) resulting from injury; Zhu Yu Ding (Cornel Ding) concave inside and convex outside; Shui Pao Ding (Water Blister Ding) extremely itchy penetrating to the bone, feeling relieved upon scratching; Hong Si Ding (Red Thread Ding) with red meridians extending straight up from the sore edge like a thread; Huo Ding (Fire Ding) extremely red, swelling severely after three days; Mo Ding (Ink Ding) resembling black blisters; Ying Tao Ding (Cherry Ding) shaped like a cherry; Fu Ao Ding (Floating Bubble Ding) half low and half high; Xie Ding (Flank Ding) occurring on the flanks; Lan Ding (Rotting Ding) where fluid from the sore creates new sores wherever it flows; Ci Ding (Female Ding) sometimes appearing elsewhere, visible when washed with water; Shi Ding (Stone Ding) black like a bean and hard; and cases where three or six new Dings appear daily.
When Ying Qi (Nutritive Qi) does not follow its proper course and rebels within the muscle tissue, abscesses and swellings arise.
Various malignant toxic swellings and sores: large and superficial ones are called Yong (Carbuncle); small and deep-rooted ones are called Ju (Deep Abscess). Those occurring on the head are called Fa Nao (Brain Eruption), starting like a millet grain, with surrounding redness, swelling, and hardness, spreading to the ears and neck, potentially developing into a Yong. Na Ju (Brain Abscess) starts like a yellow Zhi Shi fruit, and after rupture resembles the bottom of a cup, about one cun deep. Fa Bei (Back Eruption) occurs at the Back Shu points, similar to Da Bei (Shoulder-Back Abscess). Internal accumulation of heat toxin causes blood and Qi stagnation, knotting to form Wei Wan Yong (Epigastric Obstruction), or generating Fei Yong (Lung Carbuncle), Chang Yong (Intestinal Carbuncle), or Fu Gu Yong (Attached Bone Carbuncle), also known as Tie Gu Yong (Sticking-to-Bone Carbuncle). Other malignant sores include Mian Lu Chuang (Face Exposing Sore) with pus pockets like incense petals; Zi Xu Chuang (Beard Sore) with pus pockets; Jin Sai Chuang (Golden Cheek Sore) eroding through the cheeks, starting like rice or beans; Juan Mao Chuang (Curly Hair Sore) in the scalp, starting like grapes, with unceasing pain; Fa Ji Chuang (Hairline Sore) starting like yellow millet, itchy or painful; Yan Lou Chuang (Throat Leak Sore) on the Jie Hou (Adam's apple), like an abscess, leaving a hole after rupture; Lv Chun Chuang (Green Lip Sore), Che Er Chuang (Ear-Penetrating Sore), Bi Gan Chuang (Nose Fungus Sore) eroding the nasal bridge; Jing Lou Chuang (Eye Leak Sore) at the inner canthus, discharging pus; Kong Zi Chuang (Confucius Sore), Yi He Chuang (Chin Sore), also named Du Gu Chuang (Single Bone Sore) behind the cheekbones; Yu Zhen Chuang (Jade Pillow Sore) on the occipital bone, like an abscess with a tendon-like projection after rupture; Fen Ling Chuang (Powder Bell Sore) around the neck with red erosion and much discharge; Tian Zhu Chuang (Heavenly Pillar Sore) on the Da Zhui point, coin-sized, red, discharging yellow fluid incessantly. Swelling in women caused by infants sucking/blowing on breasts is called Chui Ru (Blown Breast). Sores caused by heat toxin with cracked nipples are Ru Yong (Breast Carbuncle). Ru Ya, Ru He, also named Ru Yan (Breast Rock/Tumor). Milk retention accumulating internally to form an abscess is named Du Ru (Jealous Breast). There are Yu Yan Chuang (Fish Eye Sore), Cang Chuang (Hidden Sore), Tou Zhang Lou Chuang (Palm-Penetrating Leak Sore), Fan Hua Chuang (Reverse Flower Sore) where flesh everts outward after rupture. Jin Yin Chuang (Oozing Sore) appears on the body, initially slightly itchy, later discharging water, flowing downward. Xia Zhu Chuang (Downward Flowing Sore) between feet and knees, discharging pus continuously, chronic for years. Shui Du Zhong (Water Toxic Swelling) due to dampness injury, causing muscle numbness and sores. Leng Chuang (Cold Sore) resulting from chronic non-healing. Re Chuang (Heat Sore) starts with red base and white head, exuding fluid; severe cases rot into pus and blood, painful or itchy. Yue Shi Chuang (Moon Eclipse Sore) in children on the upper ears and near ear openings; some say it arises with the moon phases, but this is unlikely, as it is actually Wind-Damp-Heat-Toxin. Dong Lan Zhong Chuang (Frozen Rotting Swelling Sore) due to cold, causing Qi and Blood coagulation and stasis, leading to cold skin/flesh, aggregating into red, swollen, painful sores. Commonly called frozen sores, they have red bases and white heads, appearing in pairs like mung beans or cornel seeds, oozing when scratched. Qi Chuang (Lacquer Sore) is caused by lacquer toxicity. Jiu Chuang (Moxa Sore) results from excessive moxibustion; Ai Du (Moxa Toxicity) does not follow the Six Meridians. Also, dietary poisoning, imprudent sexual activity, and prolonged swelling/pain indicate Wei Chuang (Weeping Sore). Chronic sores with unceasing pus discharge are described in the Neijing as "Xian Mai" (Sunken Vessels). Types include Re Zhong (Heat Swelling), Du Zhong (Toxic Swelling), Qi Zhong (Qi Swelling), Feng Zhong (Wind Swelling), Chuang Zhong (Sore Swelling). Small sores discharging pus and blood are Jie (Boil). Sores arising in skin/muscle from Wind-Damp, oozing when scratched, or with white scales are Xuan (Tinea) or Jie (Scabies). Heat-toxin stagnating in limbs causing swelling is Jie Yang (Knotting Yang). Severe heat in sinews/bones causing nail sores and shedding is Fa Zhi Dan Du (Finger-Cutting Erysipelas). Heat-toxin erupting suddenly on skin, red like cinnabar, migrating不定, fatal if it spreads to the abdomen. Fei Chuang (Prickly Heat) arises from sweat meeting dampness, commonly called prickly heat rash. E Mai (Evil Veins) present as sudden red vein protrusions, fluffy and clustered, resembling dead earthworms. Liu Qi (Retained Qi) knots like a mass, mostly behind ears, constituting Liu Qi He Jie (Retained Qi Tuberculosis) and Luo Li (Scrofula). Ma Dao Jia Ying Chuang (Horse Knife Accompanying Goiter Sore), Lou Gu Chuang (Mole Cricket Sore) spread diffusely. Ying Tao Chuang (Cherry Sore) has raised granules, red. Similar to Xia Chui Chuang (Drooping Sore), Bian Du (Groin Abscess), Tian Chuang (Heavenly Sore), Wu Ming E Zhong (Nameless Malignant Swelling). Thus, the Classics state: Ying rebellion causes Blood Stasis; Blood Stasis causes Heat aggregation into Pus. The above discussions on sores and treatment principles are from *Shengji Zonglu* (General Records of Holy Relief).
Treating sores requires pulse diagnosis to avoid confusion. Heavy body with slow pulse indicates Dampness excess; treat by draining dampness. Fever with large pulse indicates restless heat and swelling; treat by clearing heat and cooling Ying. Dizziness and tremors with pain and wiry pulse indicate Phlegm and Wind; treat by descending Phlegm and dispelling Wind. Qi stagnation and Wei obstruction with dry thirst and choppy pulse indicate Blood deficiency and Qi excess; treat by nourishing Blood and draining Qi. Poor appetite and aversion to cold with tight, fine pulse indicate Cold Water excess; treat by draining Cold Water. Differentiate meridians and treat carefully.
These are the pulse formulas for treating sores.
Damp-Heat generates parasites.
Jueyin Wind-Water generates parasites. Sanjiao Yang-Fire is excessively hot, suppressing Lung Metal. Metal suppressed by Fire cannot control Wood. Wood becomes excessive, combined with Spleen-Stomach Damp-Heat, generating parasites such as Taenia (Cun Bai), Ascaris (Chang Hui), and blood flukes.
Water accumulation and Phlegm-Fluids.
If a person was robust but now emaciated, with water moving in the intestines making audible gurgling sounds, it is called Tan Yin (Phlegm-Fluid). If fluid accumulates below the ribs causing pain upon coughing/sputtering, it is called Xuan Yin (Suspension Fluid). If fluid accumulates in the limbs, preventing sweating, causing heavy painful body, it is called Yi Yin (Overflowing Fluid). If coughing prevents lying flat, with shortness of breath and edema-like appearance, it is called Zhi Yin (Supporting Fluid). Liu Yin (Retained Fluid) presents with coldness on the back the size of a hand, or shortness of breath/thirst, limb joint pain, and hypochondriac pain radiating to the Clavicle, worsening with cough. Fu Yin (Hidden Fluid) presents with diaphragmatic fullness, vomiting, panting/cough, fever/chills, back pain, tearing upon attack, chills, and trembling. Phlegm syndromes include Feng Tan (Wind Phlegm), Re Tan (Heat Phlegm), Shi Tan (Damp Phlegm), Jiu Tan (Wine Phlegm), Shi Tan (Food Phlegm), Han Tan (Cold Phlegm).
Eye pain and redness/swelling, scattered essence, Ying Heat.
The Five Wheels of the eye are the essence of the Zang organs and gathering points of major vessels. White sclera belongs to Lung Metal; eyelids (flesh wheel) to Spleen Earth; red vessels to Heart Fire; black pupil/lens (Water Spirit Light) to Kidney Water, also related to Liver Wood. Red sclera indicates Fire invading Lung. Red/swollen eyelids indicate Fire invading Spleen. Obscured vision/black pupil indicates Fire invading Liver/Kidney. Red vessels crossing the eye indicate Self-excess Fire. Night blindness (Que Mu) and internal cataracts result from sudden anger/grief. Sudden redness/swelling/pain, photophobia, tearing, inverted eyelashes, blurred vision, and corneal opacities indicate loss of Essence/Ying protection, due to excess Wind-Heat and Blood Heat.
Toothache and receding gums, distinguished by Cold/Heat.
Toothaches vary: aversion to cold, aversion to heat, both, preferring hot drinks (cold type) or cold drinks (heat type), loose teeth, exposed roots, gum erosion by worms causing bleeding, gum swelling, wind sensitivity in gums, worm-eaten teeth missing/discolored, bleeding gums (Ya Xuan). Weak Stomach Qi failing to resist cold exposes teeth causing pain. Pain with foul odor. Hand-Yangming meridian connects to lower gums, favoring heat. Foot-Yangming meridian connects to upper gums, favoring cold. Teeth are surplus of Kidney, preferring cold/hardness. Causes vary: Heat causes loosening, gum recession, foul odor. Internal Wind-Heat or external Cold-Wind can cause pain. Severe Cold attacking the brain can cause redness and toothache.
Primary diseases of the Five Zang, Heat contention causing severe symptoms.
The Classics state: Liver Heat disease begins with yellow urine, abdominal pain, lethargy, irritability, redness, fever. Heat contention causes madness, hypochondriac fullness/pain, restlessness. Heart Heat disease causes mental distress, heat sensation, heart pain, vexation, vomiting, headache, facial redness, fever without sweat. Spleen Heat causes heavy head, cheek pain, greenish complexion, desire to vomit, fever, vexation, abdominal fullness/diarrhea. Heat contention causes lower back pain. Lung Heat causes aversion to cold, yellow tongue, fever. Heat contention causes panting/cough, pain radiating to chest/back, inability to sigh deeply, unbearable headache, sweating with aversion to cold. Kidney Heat causes lower back pain and soreness, thirst, fever. Heat contention causes neck stiffness, chills/soreness, hot feet, lazy speech, headache. Regarding Five Qi diseases: Heart relates to Intent; Lung to Cough; Liver to Speech; Spleen to Swallowing; Kidney to Yawning; Stomach to Rebellious Qi, hiccups, fear. Lower abdomen issues relate to diarrhea. Lower Jiao overflow relates to water retention. Bladder dysfunction leads to Lin (Strangury). Incontinence leads to Enuresis. These cover Five Disease origins and Five Pathogen disturbances.
Six Fu organs disharmony leads to knotting and carbuncles. Five Zang disharmony leads to nine orifices blockage. Organ transmission transforms into disease, countless in number. Classics state: Heart transmitting Cold to Lung causes Fei Xiao (Lung Wasting-Thirst). Heart transmitting Heat to Lung causes chest fullness, vexation, thirst, shortness of breath, Diaphragm Heat causing Ge Xiao (Diaphragm Wasting-Thirst). Liver transmitting Cold to Heart causes madness. Liver transmitting Heat to Heart is called Sheng Yang (Generating Yang), fatal within four days. Spleen Cold transmitting to Liver causes carbuncles and tendon spasms. Lung Cold transmitting to Kidney presents like a bag holding fluid, generalized edema, soft abdomen, gurgling sound when walking rapidly, irregular cough, called Yong Shui (Surging Water). Spleen Heat transmitting to Liver causes blood hemorrhage/jumping nosebleeds (Jing Nu). Gallbladder receiving Stomach Heat causes spontaneous nosebleeds or persistent bloody discharge. Gallbladder transmitting Heat to Brain causes turbid nasal discharge; chronic cases become chronic nosebleed disease. Kidney Heat transmitting to Spleen transforms into Xu Chang Xie (Deficient Intestinal Diarrhea), untreatable/fatal. Bladder primary Heat causes Lin and hematuria. Bladder transmitting Heat to Small Intestine causes intestinal obstruction and mouth ulcers (Kou Mi). Large Intestine transmitting Heat to Stomach causes polyphagia with emaciation. Stomach Heat transmitting to Gallbladder causes Food Stagnation. Kidney Cold transmitting to Spleen causes carbuncles and shortness of breath. Intestinal accumulated heat causes fluid stagnation, abdominal pain, difficult defecation, forming Lei Jia masses. Treatment examples are in *Xuan Ming Lun*.
"Jian Zang" (Intersecting Transmission) survives; transmission generates the next element.
Classics state: If Heart transmits to Spleen, Spleen to Lung, Lung to Kidney, Kidney to Liver, Liver to Heart, this is transmitting to what it generates. Thus, even severe illness leads to survival.
"Qi Zhuan" (Seven Transmissions) leads to death; transmission controls/restricts.
Example: Heart transmits to Lung, Lung to Liver, Liver to Spleen, Spleen to Kidney, Kidney to Heart. Fire receives Water transmission once; Lung Metal receives Fire transmission twice. Starting from Heart, sequentially transmitting, reaching Lung twice constitutes Seven Transmissions. Thus, Seven Transmissions lead to death. One Zang cannot bear repeated injury. This is transmitting to what it overcomes (Ke).
Five Zang Accumulations (Ji):
Liver is Fei Qi (Fat Qi), under left hypochondrium, size of inverted cup, may have head/feet, chronic cases cause cough/rebellious Qi, malaria, continuing for years.
Heart is Fu Liang (Hidden Beam), starting above umbilicus, arm-sized, extending to epigastrium, chronic cases cause vexation.
Spleen is Pi Qi (Stagnation Qi), in epigastrium, plate-sized, chronic cases cause limb paralysis, jaundice, emaciation despite eating.
Lung is Xi Ben (Gasp/Sigh), under right hypochondrium, cup-sized, chronic cases cause fever/chills, panting, Lung Carbuncle.
Kidney is Ben Tun (Running Piglet), starting in lower abdomen, rising to epigastrium, pig-like movement, intermittent, chronic cases cause panting/reversal, bone萎 (atrophy), shortness of breath.
Classics state: Accumulations occur when a Zang receives pathogenic Qi from the organ that overcomes it, tries to transmit to the organ it overcomes, but meets resistance during its peak time, refuses to accept, returns to the overcoming organ which also refuses, thus knotting into an accumulation.
Types: Shi Ji (Food Accumulation) causes acid regurgitation/abdominal fullness. Jiu Ji (Wine Accumulation) causes yellow eyes/dry mouth. Qi Ji (Qi Accumulation) causes belching/stuffiness. Xian Ji (Saliva Accumulation) causes throat sensation like sawing. Tan Ji (Phlegm Accumulation) causes thick sputum. Pi Ji (Mass Accumulation) causes stabbing hypochondriac pain. Shui Ji (Water Accumulation) causes leg/shin swelling. Xue Ji (Blood Accumulation) results from trauma/stasis or food accumulation. In Six Fu, these are Ju (Gathering) disorders, leading to Gu Zhang (Drum Distension) or Gu Disease.
Distension types: Abdominal, Cold, Heat, Qi, Great Heat, Edematous. Severe cases become Gu. Distension arises from Spleen/Stomach Qi deficiency, failing to transform nutrients/control water/grain, leading to accumulation. Gu Zhang (Drum Distension) features morning fullness preventing evening eating, rebellious Stomach Qi. Gu Disease features lower abdominal pain, seminal emission, white urinary discharge. Zhong Man Yu Pi (Middle Fullness/Stagnant Stiffness).
Classics state: Cold in Zang generates fullness. Taiyin arrival causes Middle Fullness/Accumulated Fullness. Spleen Dampness excess causes abdominal fullness/poor digestion. Lack of Yang prevents transformation. Distension/Dampness stagnates, Qi fails to ascend/descend, knotting into Pi (Stiffness). Epigastric fullness without pain is Xu Pi (Deficiency Stiffness); fluid accumulation/blockage is Shi Pi (Excess Stiffness).
Lifting Qi and regulating ascent/descent is appropriate.
This is the major method for treating Stagnant Pi/Fullness.
The root of the human body is Spleen/Stomach. Headache, tinnitus, nine orifices dysfunction stem from Stomach. Stomach Qi deficiency, extreme deficiency transforms into disease, Five Chaos interfere.
Five Zang/Wu Xing Qi disharmony transmits and transforms into disease.
Dong Yuan's theory represents the "Kingly Way" of learning.
Master Dong Yuan (Li Mingzhi) discussed Spleen/Stomach prosperity/decline: one Deficient, one Excess.
Qi chaos in Wei (Defensive) Qi, Blood rebellion in meridians, Blood/Qi disharmony, hence one Deficient, one Excess, representing confluence of Blood/Qi. See *Suwen: Tiao Jing Lun*.
Five Excesses (Wu Shi) and Five Deficiencies (Wu Xu).
Five Excesses: Surging pulse (Heart), Hot skin (Lung), Abdominal fullness (Spleen), Blockage of front/back orifices (Kidney), Stifling dizziness (Liver).
Five Deficiencies: Fine pulse (Heart), Cold skin (Lung), Shortness of breath (Liver), Diarrhea/incontinence (Kidney), Inability to eat (Spleen). If all five manifest in one disease...
Five Labors (Wu Lao), Seven Damages (Qi Shang), Six Extremes (Liu Ji).
Long viewing damages Blood; long lying damages Qi; long sitting damages Flesh; long standing damages Bones; long walking damages Tendons. Mental worry/fatigue constitute Five Labors. Liver damage causes dreams; Heart damage causes forgetfulness; Spleen damage causes excessive drinking; Lung damage causes wasting; Kidney damage causes excessive salivation; Bone damage causes hunger; Pulse damage causes cough. These are Seven Damages. Labor injury leads to Six Extremes: diseases of Qi, Blood, Tendons, Marrow, Bones, Essence.
Five Stagnations (Wu Yu), Seven Emotions (Qi Qing), Nine Qi (Jiu Qi).
Anger makes Qi ascend; Joy makes Qi slacken; Grief consumes Qi; Fear makes Qi descend; Cold contracts Qi; Heat leaks Qi; Fright disrupts Qi; Labor exhausts Qi; Thought knots Qi. (These are Nine Qi).
Worry/thought excessively injure Heart. Cold form/cold drinks excessively injure Spleen. Anger/rebellious Qi excessively injure Liver. Diet/labor excessively injure Spleen. Sitting/sleeping on wet ground/forcing into water injures Kidney. (These are Seven Emotions/Causes).
These arise from Qi movement damaging Form/Spirit. Unregulated joy/anger, labor damaging Qi, Blood/Qi imbalance, Yin/Yang mutual invasion. Yin excess injures Yang; Yang excess injures Yin. Yang excess causes Heat; Yin excess causes Cold. Extreme Cold generates Heat; Extreme Heat generates Cold. Cold damages Form; Heat damages Qi. Qi damage causes pain; Form damage causes swelling. Pain then swelling indicates Qi damaging Form. Swelling then pain indicates Form damaging Qi.
Yin/Yang transformation, Root/Branch, Cold/Heat.
If severe Cold is treated with Heat herbs but remains cold, it indicates "No Fire" (Kidney Yang deficiency). Heat coming and going, day/night variation, seasonal occurrence indicates "No Fire." Treat by assisting Heart. Heart deficiency causes heat to retreat inward, so external heat is intermittent.
If severe Heat is treated with Cold herbs but remains hot, it indicates "No Water" (Kidney Yin deficiency). Cold shaking stopping suddenly, intermittent, indicates "No Water." Treat by assisting Kidney. Kidney deficiency causes internal cold shaking, so external cold is intermittent.
Internal rejection/vomiting, food cannot enter, indicates "Has Fire." Vomiting/regurgitation after long delay indicates "No Fire." Violent diarrhea, undigested food, indicates "Has Fire." Chronic loose stools, irregular onset, indicates "No Water."
Heart excess generates Heat; Kidney excess generates Cold. This is extreme Heart Fire causing fever, excessive Kidney Water causing cold, distinct from Deficient Heat/Cold.
Heat without cold indicates No Fire. Cold without heat response indicates No Water. Failure to respond to Cold treatment blames No Water. Failure to respond to Heat treatment blames No Fire. Brief effect of Heat treatment blames Heart Deficiency. Brief effect of Cold treatment blames Kidney Deficiency.
Heat not responding to Cold may be Cold overcoming Yang repelled externally (false Heat). Cold not responding to Heat may be Yang extreme resembling Yin, Fire rejecting Cold externally (false Cold).
Failure to resolve Cold blames Water source decline, Fire excess. Failure to resolve Heat blames Fire source decline, Water excess. Examine pathogenesis, do not miss Qi appropriateness, record in Water/Fire, other Qi can be inferred.
Women's diseases are numerous: Dai Xia (Leukorrhea) red/white, Lei Jia (Accumulation/Mass), Shan Han (Hernia). Women's diseases share Six Qi and Four Causes with men. Pregnancy, childbirth, menstruation diseases are too many to list. Red leukorrhea indicates Heat entering Small Intestine. White indicates Heat entering Large Intestine. Dysentery. Menstrual irregularity, Blood stasis forms Lei Jia. Lower abdominal swelling/hardness forms Shan Han diseases.
Blood/Qi pathology causes amenorrhea.