妇人有胃热。善食瘦而津液不生。血海竭而名血枯。或脾胃久虚。或形羸气血俱衰。而
致经水不行者。非以上之病。经成孕乃不行也。
或漏不止。
湿热太迫。则经漏不止。或心气不足。火热大炽。旺于血脉中。或身体困热。心烦不得
眠卧。而致经水漏下。阴虚阳搏为崩。
经过作痛。虚中有热。
经水行过而腹中作痛者。血虚有热也。
行而痛者。血实之设。
将行而作痛乃血实。
如不及期。血热乃结。过期血少。闭或血枯。淡者痰多。紫者热故。热极则黑。调荣降
火。
妇人经水。如行不根据期。非有妊娠。皆以上之病。治须调血养血。清阳降火。有寒者温
之。
调理妊娠。清热养血。
妊娠有正气不足。寒热不调。阴阳不得升降。故病有发风痹。忽闷不识人而眩倒者。为
子痫证。有胎气上逼而胀满或疼者为子悬。身忽如水肿多于足肿者为子肿。小便涩者为子淋
。烦闷者为子烦。腹大甚者胎有水气。或发寒热。或胎漏下血。或动为转胞及不能言语之类
。皆胎气不足。治须顺气清热养血也。
一当产后。如无恶阻。大补气血。
恶阻者。如恶露不尽。血上抢心腹痛之类。治可下去其败血。如虚汗不止。遍身疼痛。
或虚烦。小便不禁。玉门不闭。蓐劳血虚而晕之类。皆虚甚也。皆当大补血益气。
虽有杂证。以末治之。
产后如中风伤寒六气为病之类。虽正治。亦须兼补其气血。经言切不可犯禁。谓汗下利
小便也。
大凡小儿。过暖生热。热极生风。风痰积热。随病为治。生有胎恶。月里生惊。生赤生
呕。生黄不便。脐风撮口。
受胎毒甚者。则发惊搐。生赤则如丹涂肌肉。邪气上而呕吐。母受湿热。传胎而发黄。
有生下日久不得大便者。脐风多在生下半月内有此证。盖受胎恶之甚也。
变蒸发热。
小儿变蒸。乃长经脉及腑脏智意也。
风痫癫痫。
钱氏分五痫。有犬痫。羊痫。牛痫。鸡痫。猪痫。其状各不同。
急慢惊风。
如身热面赤。即发搐搦。目睛上视。牙关紧急者。阳证为有余。如因吐利。或吐不泻。
日渐困而色黄。脾虚冷发惊。不甚搐搦。目微上视。手足动者。阴证为不足也。
螈 惊愕。
惊风热甚。则手足战掉。挛 惊恐愕然也。
惊悸昏冒。
惊则心悸不宁。热甚则昏昧。
暴喘吐 。
有喘甚者。俗言马脾风。吐乳食为 。
腹胀鼻 嗽。
胀有寒胀。热胀。脾胀之类。伤风寒为嗽者多。或为乳食盐物所伤而发 喘。
中恶天吊。
有中恶气卒然而病。如目直上视。搦身直强宫瞪之类为天吊。
鹅口重舌。
白屑满舌为鹅口。舌下附肿如舌而短为重舌。心脾热甚也。
木舌弄舌。舌胀大为木舌。脾热甚。舌络紧。乃弄舌也。
客忤夜啼。
心气不足。遇人客或物。则忤而惊。脾脏冷而痛。多夜啼。
脓耳鼻疳。
耳内生疮。脓耳汁出。三焦气热病也。鼻内有疮生疳。
眉炼丹流。
眉骨上生疮。太阳经风热也。丹流者。俗云火焰丹。肌肉上若涂丹。血热甚也。
阴肿便浊。
睾丸发肿。肝经热胜也。小便或白浊亦浊。
舌烂口臭。
心热下陷。风自盛也。胃热则口臭。
龈蚀牙疳。
风热所胜。蚀牙龈至快。俗言走马牙疳。
虫痛吐蛔。
小儿哭而坐卧不安。自按心腹。时大叫。或青或黄。唇慢。目无精光。虫痛也。
疳瘦解颅。
钱氏分五脏疳。筋疳骨疳之类。肾虚解颅也。
便青颊赤。
惊气内感。脾气不和。故泻。色青。心热上攻。故颊赤。
食土饮水。
食土者。胃气不足也。身热饮水。病在内。不饮水。热在外也。
吐泻青白。
泻利青白色。谷不化者胃寒。乳不化者伤食。泻黄红赤黑者。脾胃热毒故也。
昏睡露睛。
睡而露睛者胃虚热。不露睛者胃实热。睡而嚏悸者。将发疮疹也。
呵欠面黄。
呵欠而面赤者风热。青者惊风。黄者脾虚。惊而睡者内热。呵欠气热者。
伤风也。
呷牙咬齿。
手足阳明内热为病。
泻痢脱肛。
泻痢久则肛门纵下。湿热甚而缓纵也。
痈疡瘾疹。疮痘发斑。
钱氏论。小儿受胎恶。发疮疹。初欲发时。有五脏现证。呵欠顿闷者。肝也时发惊悸。
心也
。乍凉乍热。手足冷。脾也。面赤。腮颊赤。喷嚏。肺也。惟肾在腑之下。不能食秽。胎毒
不受。无候也。毒出归一证。肝水泡。肺脓泡。心斑。脾疹也。
惊疳诸积。
如食积乳积之类。
大率为病。肝与脾经。
此二经病多。
脉治凭允。
小儿虎口色脉。如紫。伤风。红伤寒。青惊。白色疳。黑即中恶。黄脾病也。
钱氏方论。男女病情。饮食居处。暴乐暴苦。始乐后苦。皆伤精气。先富后贫。病日失
精。
先贵后贱。虽不中邪。病从内生。名曰脱营。身体日减。气虚无精。良工勿失。脉病证治。
知微可已。举腹痛经。阴证治例。海藏所云。玄机之秘。中脘痛者属脾土。脐腹痛者属少阴
。少腹小腹厥阴分。三部殊涂细酌斟。太阴中土主理中。少阴四逆真武同
。厥阴宜当归四逆。重则回阳霹雳攻。当汗不汗即生黄。当汗汗多因致 。不当汗而若汗之
。蓄血定应无改易。汗多或有变亡阳。阴证脉候须仔细。(并出此事难知)
伤寒咳逆脉散死。仲景之言不虚伪。大抵源流失下生。咳逆喉中阴不内。便 唯宜用泻
心。便硬尤宜大承气。二药神功作者谁。东垣洁古为良制。
Women suffering from stomach heat may have a robust appetite yet become emaciated, with failure to generate body fluids. When the Sea of Blood (Xuehai) is exhausted, it is named "Blood Depletion" (Xueku). Alternatively, due to long-term deficiency of the Spleen and Stomach, or a frail physique with depletion of both Qi and Blood, menstruation may cease. If these conditions are not present, cessation of menstruation indicates pregnancy.
Or there may be continuous dripping of menstrual blood.
When Damp-Heat pathogenic factors press excessively, menstrual bleeding continues incessantly. Or when Heart Qi is insufficient and Fire-Heat blazes fiercely, flourishing within the blood vessels, accompanied by bodily heaviness and fever, mental restlessness, and inability to sleep, this leads to leaking menstrual blood. Yin deficiency with Yang pulse palpitation results in Bing (sudden heavy bleeding).
Pain during menstruation belongs to deficiency with internal heat.
Abdominal pain occurring after menstruation has ended is due to Blood deficiency with heat.
Pain occurring during menstruation flow indicates a Blood Excess syndrome.
Pain arising just before menstruation begins is due to Blood excess.
If menstruation occurs ahead of schedule, it is often due to Blood Heat coagulation; if delayed with scanty flow, it may be Amenorrhea (Bijing) or Blood Depletion. Pale color indicates excessive Phlegm-Dampness; purple color indicates Heat; extreme Heat turns the blood black. Treatment requires regulating Ying (Nutritive) Qi and descending Fire.
For women's menstruation, if it does not follow the regular cycle, excluding pregnancy, all are diseases mentioned above. Treatment must regulate and nourish Blood, clear Yang and descend Fire. If Cold is present, warm it.
Regulating pregnancy-related diseases focuses on clearing Heat and nourishing Blood.
During pregnancy, if Righteous Qi is insufficient, leading to disharmony of Cold and Heat, and obstruction of Yin-Yang ascending and descending, various diseases arise. For example, sudden onset of Wind-Bi, followed by sudden fainting, loss of consciousness, and dizziness/collapse, is called Zi Xian (Eclampsia of Pregnancy). Fetal Qi rushing upward causing distension or pain is called Zi Xuan (Floating Fetus). Sudden bodily edema, more pronounced in the feet, is called Zi Zhong (Edema of Pregnancy). Astringent urination is called Zi Lin (Dysuria of Pregnancy). Restlessness and oppression is called Zi Fan (Fretfulness of Pregnancy). Abnormal abdominal enlargement with fluid retention in the fetus, or accompanied by chills and fever, fetal leakage of blood, or occurrence of Zhuo Bao (bladder displacement) and inability to speak, are all due to insufficiency of Fetal Qi. Treatment requires smoothing Qi, clearing Heat, and nourishing Blood.
After childbirth, if there is no E Zu (nausea/vomiting due to retained lochia), one should greatly tonify Qi and Blood.
"E Zu" here refers to symptoms like incomplete expulsion of lochia, blood rushing up to the heart causing abdominal pain. Treatment can involve removing the stale blood. If there is endless sweating from deficiency, generalized body pain, or empty irritability, urinary incontinence, or the vaginal opening failing to close, postpartum labor exhaustion, blood deficiency leading to vertigo, etc., these indicate extreme deficiency. All require great tonification of Blood and Qi.
Even if there are miscellaneous diseases, they should be treated as secondary concerns.
Postpartum conditions such as Wind-Stroke, Shang Han (Cold Damage), or illnesses caused by the Six Qi (pathogenic factors), although requiring standard treatment, must also concurrently tonify Qi and Blood. The medical classics state that one must strictly avoid contraindications, specifically referring to the misuse of diaphoresis (sweating), purgation, and promoting urination.
Generally speaking, infants who are overdressed develop internal heat; extreme heat generates Wind; Wind-Phlegm and accumulated Heat require treatment according to the specific disease. Newborns may suffer from convulsions due to fetal toxins, fright at one month old, neonatal erythema or vomiting, neonatal jaundice with constipation, Umbilical Wind (Qifeng) with mouth contraction.
Severe reception of fetal toxins leads to convulsions. Neonatal erythema resembles cinnabar painted on the skin. Pathogenic qi rising causes vomiting. If the mother receives Damp-Heat, it transmits to the fetus causing jaundice. Some infants do not pass stool for days after birth; Umbilical Wind often appears within half a month after birth, indicating severe reception of fetal impurities.
Transformation Fever (Bian Zheng Fa Re).
Pediatric "Bian Zheng" refers to the growth of meridians and the development of wisdom and consciousness of the Zang-Fu organs.
Wind Epilepsy and Epilepsy.
Qian Yi classified epilepsy into five types: Dog Epilepsy, Sheep Epilepsy, Ox Epilepsy, Chicken Epilepsy, and Pig Epilepsy, each with distinct manifestations.
Acute and Chronic Convulsive Disorders (Jing Feng).
If the body is hot, face red, followed by spasms, eyes rolling upward, and jaw stiffness, this is a Yang syndrome indicating Excess. If due to vomiting/diarrhea, or vomiting without diarrhea, becoming increasingly fatigued with sallow complexion, spleen deficiency-cold generating fright, with mild spasms, slight upward eye deviation, and limb tremors, this is a Yin syndrome indicating Deficiency.
Convulsions and Fright.
When Wind-Fright Heat is severe, limbs tremble and shake, leading to contracture. This describes the state of fright and astonishment.
Palpitations and Confusion.
Fright causes palpitations and unrest; severe heat causes confusion.
Sudden Asthma and Vomiting Milk.
Severe asthma is colloquially called "Horse Spleen Wind." Vomiting milk/food is termed "Tu".
Abdominal Distension, Nasal Obstruction, Cough.
Distension includes Cold Distension, Heat Distension, and Spleen Distension. Cough is mostly caused by Wind-Cold damage. It may also be triggered by injury from milk or salty foods, leading to wheezing.
Zhong E (Sudden Evil) and Tian Diao (Heavenly Suspension).
Zhong E involves sudden illness from evil qi, characterized by eyes staring upward, body stiffening, and spasm, known as Tian Diao.
Goat Mouth (E Kou) and Double Tongue (Chong She).
White patches covering the tongue constitute Goat Mouth. Swelling under the tongue resembling a small tongue constitutes Double Tongue, caused by excessive Heat in the Heart and Spleen.
Wood Tongue (Mu She) and Playing Tongue (Nong She).
Swollen and stiff tongue is Wood Tongue, due to severe Spleen Heat tightening the tongue collaterals. Protruding and retracting the tongue is Playing Tongue.
Ke Wu (Guest Intrusion) and Night Crying.
Insufficient Heart Qi leads to fright upon encountering guests or objects. Cold Pain in the Spleen causes frequent night crying.
Suppurative Ear Infection (Nong Er) and Nasal Chan (Bi Gan).
Sores inside the ear with pus discharge is a San Jiao (Triple Burner) Qi Heat disease. Sores and chan sores in the nose.
Eyebrow Dan Liu.
Sores on the eyebrow bone are caused by Wind-Heat in the Taiyang Meridian. "Dan Liu," colloquially Flame Dan, looks like cinnabar painted on the muscle, indicating severe Blood Heat.
Yin Swelling and Turbid Urine.
Swelling of the testicles is due to Heat predominance in the Liver Meridian. White turbid urine is also a turbidity disorder.
Tongue Ulcer and Bad Breath.
Heart Heat sinking down with prevailing Wind. Stomach Heat causes bad breath.
Gum Erosion and Dental Chan.
Prevailing Wind-Heat rapidly erodes gums, colloquially known as Running Horse Dental Chan.
Worm Pain and Vomiting Ascaris.
Crying children restless in sitting and lying, pressing their own abdomen, screaming occasionally, with lips turning green or yellow, and dull eyes, indicate Worm Pain.
Chan Emaciation and Fontanelle Delay (Jie Lu).
Qian Yi categorized Five Zang Chan disorders, such as Sinew Chan and Bone Chan. Kidney deficiency leads to Jie Lu (delayed closure of fontanelles).
Green Stool and Red Cheeks.
Internal reception of Fright Qi and Disharmony of Spleen Qi cause diarrhea with green stool. Heart Heat attacking upward causes red cheeks.
Eating Earth and Drinking Water.
Eating earth indicates insufficient Stomach Qi. Body heat with desire to drink water indicates internal disease; lack of desire to drink indicates external Heat.
Vomit/Diarrhea Green and White.
Green/white diarrhea with undigested food indicates Stomach Cold. Undigested milk indicates Food Injury. Yellow/red/black/brown diarrhea indicates Heat-Toxin in the Spleen and Stomach.
Deep Sleep with Exposed Eyes.
Sleeping with exposed eyes indicates Stomach Deficiency Heat; sleeping with closed eyes indicates Stomach Excess Heat. Sneezing and palpitations during sleep suggest impending eruption of sores/rashes.
Yawning and Sallow Face.
Yawning with red face indicates Wind-Heat; blue face indicates Wind-Fright; yellow face indicates Spleen Deficiency. Sleeping while frightened indicates Internal Heat. Yawning with hot breath indicates Wind-Strike.
Gnashing Teeth.
Illness caused by Internal Heat in the Hand and Foot Yangming Meridians.
Diarrhea/Dysentery and Rectal Prolapse.
Long-term diarrhea/dysentery causes the anus to relax and prolapse due to severe Damp-Heat causing laxity.
Abscesses, Urticaria, Smallpox/Rubella, Macules.
Qian Yi discussed that fetal toxins cause sores/rashes. At initial eruption, Five Zang signs appear: yawning and lethargy indicate Liver; frequent palpitations/fright indicate Heart; alternating cold/heat with cold hands/feet indicate Spleen; red face/cheeks and sneezing indicate Lung. The Kidney, being lower, does not consume filth and is unaffected by fetal toxin, showing no specific sign. When toxin exits, it manifests uniformly: Liver produces water blisters, Lungs produce pus blisters, Heart produces macules, Spleen produces rashes.
Fright Chan and Various Accumulations.
Such as Food Accumulation and Milk Accumulation.
Most diseases primarily affect the Liver and Spleen Meridians.
These two meridians are prone to disease.
Pulse Diagnosis Relies on Accuracy.
Infant Tiger Mouth (radial artery) colors/pulses: Purple indicates Wind-Strike; Red indicates Shang Han; Blue indicates Fright; White indicates Chan; Black indicates Zhong E; Yellow indicates Spleen Disease.
Qian Yi's Formulas and Theory.
Men and women's conditions, diet, residence, sudden joy or sorrow, starting with joy then sorrow, all injure Essence and Qi. From wealth to poverty, disease depletes essence day by day. From nobility to low status, even without external evil, disease arises internally, named Tuo Ying (Depleted Camp). The body diminishes daily, Qi becomes deficient lacking essence. Skilled physicians must not miss opportunities in pulse, disease, and symptom treatment; knowing subtle changes allows early cure. Regarding Abdominal Pain chapter, Yin Syndrome treatment examples, Haizang's sayings reveal profound secrets: Pain in Zhongwan belongs to Spleen Earth; Pain in navel belongs to Shaoyin; Lower abdomen/Xiaofu belongs to Jueyin. These three regions differ in approach. Taizhong Earth governs Lizhong Tang; Shaoyin uses Si Ni and Zhen Wu together. Jueyin suits Danggui Sini Tang; severe cases use Hu Yang Pi Li Gong. Failure to sweat when indicated leads to Jaundice; excessive sweating when indicated causes... [text missing/garbled]. Sweating when not indicated leads to fixed Blood Stasis. Excessive sweating may transform into Yang Collapse. Yin Syndrome pulse signs must be examined carefully. (All from *Ci Nan Zhi*)
Shang Han with cough/reversal flow and scattered pulse indicates death; Zhang Zhongjing's words are not false. Generally, source loss follows purgation errors. Cough/reversal in throat indicates Yin cannot contain. Loose stools suit Xi Xin Tang; hard stools suit Da Cheng Qi Tang. Who created the divine merit of these two medicines? Dong Yuan and Jie Gu provided good formulations.