(原注：呃逆从脐下起者，肾气虚寒也。在胸臆间者，胃热上冲也。)
呃逆者，气由腹中上冲，其声连续也。有热逆而呃者，以柿蒂枇杷叶(原注：二味烧灰存性，竹茹汤调下)治之。有寒逆而呃者，理中汤加丁香、半夏主之。若水停者，宜分利。食积者，宜消导。火盛者，宜凉膈。痰壅者，宜开豁。惟久病作呃，乃除中之候，不治。
喘短气
喘息喝喝数张口，短气似喘不抬肩。促难布息为实证，短不续息作虚观。表喘桂麻加杏朴，里喘承气陷胸丸。水气正苓加葶苈，痰喘苏葶二陈全。
(原注：朝食暮吐，脾寒也。食入即吐，胃热也。吐清水者，为寒。吐痰涎酸水者，为热。)
有声无物曰干呕，有物无声曰吐，有声有物曰呕吐，多由表邪传里、里气上逆也。有胃热而呕吐者，脉弦数、口燥渴是也。有胃寒而呕吐者，脉弦迟、手足冷是也。有水饮而呕吐者，先渴后呕，呕而复渴是也。若太阳汗出而干呕者，宜桂枝汤；少阴下利而干呕者，宜四逆汤；厥阴吐涎沫而干呕者，宜吴茱萸汤。（凌波按：温病作呕用玉枢丹，亦可用于中毒）
三法伤津胃燥干，阳往乘阴渴亦然。渴欲饮水少少与，莫使停留饮病干。太阳尿少五苓散，阳明大渴白虎先。少阳证具心烦渴，小柴去半加粉添。
若邪热聚胃，耗其津液，以致口燥舌干者，宜急下。若汗下太过，竭其津液，以致口燥咽干者，宜救阴。
悸
悸者，心中筑筑然，动而不能自安，即怔忡也。有水停心下，心火畏水而不能安者，宜半夏茯苓汤。有发汗过多，液去心虚而无依者，宜归脾汤。
振
振者耸然动摇，由汗、吐、下后，气血大虚也，或以真武汤温之，或以人参养荣汤补之。
身动为战，心惕为栗，阴阳相争之象也。正气胜而战者，得汗则解。阴气盛而栗者，助阳为急。
湿热发黄头汗出，小便不利渴阳明。素有寒湿发汗后，黄从湿化太阴经。阳色鲜明阴色暗，太阳血蓄并狂生，表实麻翘赤小豆(原注：加甘草、杏仁、姜、枣、名麻黄连翘赤小豆汤)，里实栀子大黄茵(原注：加黄柏、甘草、名栀子大黄汤)，阴黄茵陈入四逆，便溏尿秘茵五苓。环口黎黑柔污(原注：冷汗也)死，体若烟薰阳绝征。
神昏胃热重阳狂，或用三承(气汤)或三黄(石膏汤)。蓄血发狂小便利，少腹满痛属太阳。阳明蓄血大便黑，其人如狂而喜忘。劫汗惊狂频卧起，参(白)薇龙(骨)牡(蛎)茯神良。
发癍(附痧疹)
(原注：斑疹邪在血络，只宜轻宣凉解，误用升提则衄；或厥，或呛咳，或昏痉，用壅补则雾乱。)
伤寒疹斑失汗下，感而即出时气然。表邪伏郁荣卫分，外泛皮肤血热缠。痧白疹红如肤粟，癍红如豆片连连。红轻赤重黑多死，淡红秽暗毒宜宣，化斑白虎去粳米(加元参犀角)，热甚三黄石膏煎。(原注：咽喉肿痛者，宜射干、牛蒡子、连翘、玄参。)
谵语为实声长旺，乱言无次数更端。郑声为虚声短细，频言重复更呢喃。实主热邪宜清解，虚为神散独参煎。
胃有燥屎则谵语，邪热盛极亦谵语。大便秘而谵语者，宜大承气汤。大便通而谵语者，宜三黄栀子汤。大下血而谵语者，宜补血汤。温病谵语，宜清荣汤。(原注：伤寒谵语，舍燥屎，无他证。温病谵语，有因燥屎，有因邪陷心包。)
循衣摸床撮空
一为阳明热极，宜承汤。然脉实则可下，虚则难治也。一为汗下伤阴，宜独参汤。然小便利则生，不利则死也。若久病见此，乃神散之候，即死。
瘛者筋脉急，急则引而缩也。疭者，筋脉缓，缓则纵而伸也。伸缩不已，名曰瘈疭，俗谓之搐。乃风痰为病也，故癫痫证多有之。
有发热、头痛、身疼而四肢拘急者，为表证。无身热头痛而倦卧不伸、四肢拘急者，为阴证。若汗下后，筋惕肉困而见拘急不仁者，乃气血虚弱，不能荣养筋脉也。
郁者，郁结而气不舒；冒者，昏冒而神不清，多虚寒证也。若瘟疫蓄热内迫而郁冒欲死者，宜下之；新产恶露不行而郁冒难禁者，宜行血。
此证多因汗不彻，阳气郁于肌肤，故蒸于头面，时赤时不赤也，宜微汗之。
欲言而头摇者，里痛也。口噤而头摇者，痉病也。若直视摇头者，难治。
三阳下利则身热；太阴下利则手足温；少阴、厥阴下利，则身凉无热。大抵协热利者，脐下必热，渴欲饮水，发热，脉数，泄下黄赤也；协寒利者，脐下必寒，自利不渴，恶寒，脉微，泄下清谷也。
胃热津耗者，宜下之。汗后津竭者，宜导之。若瘥后食多，胃气难运而不大便者，消导为主；病后血少，肠胃燥结而不大便者，滋润为先。
(原注：点滴俱无者，为癃闭。)
阴虚则小便难，宜六味地黄汤(去山萸，加白芍)。膀胱热则小便不利，宜五苓散。
小便频数者，肾与膀胱俱虚，而客热乘之也。虚则不能制水，热则水道必涩。
肾虚则膀胱之气不约，故小便出而不自知也。若热甚、神昏而遗尿者，当清心解热；阴寒厥逆而遗溺者，当温肾固气。惟直视遗溺，为肾绝不治。
手足寒冷为四逆，冷至肘膝为厥，由阳气内陷，不与阴气相顺接也。始发热，渐至壮逆不厥者，为阳厥，必喜水饮，溺赤，口干，脉沉而数也，宜白虎汤、承气汤。始不发热而厥者，为阴厥，必喜火熨，阴缩，爪青，脉沉而迟也，宜四逆汤。若小儿之病又有食滞而厥者，宜消食；痰闭而厥者，宜豁痰。
阳气衰于下则为寒厥，阴气衰于下则为热厥。凡阴厥胫冷则臂上冷，便利不渴，身倦嗜卧，神志尚清；阳厥则胫冷而臂不冷，狂乱谵妄，神志昏愦。
过汗伤液，阳气大虚，筋肉失养，故惕然而跳、（目闰）然而动也，宜真武汤。
蓄血者热结血瘀，故少腹急满也。太阳蓄血，小便必利；阳明蓄血，大便必黑，其人如狂，善忘，桃仁承气汤主之(原注：瘟疫蓄血去桂枝，加黄连、黄芩、黄柏、栀子、丹皮)。
妇人伤寒中风，遇经水适来，邪随而入，或经水适断，血热而结，其证寒热如疟，甚则谵语，宜小柴胡汤加生地、芍药、丹皮。
狐惑
(原注：其证卧起不安、恶闻食臭、默默欲眠、声哑者，宜甘草泻心汤；咽干者，苦参水外洗之；食肛者，雄黄烧烟熏之；脓成者，宜赤小豆当归散。)
虫蚀下部，为狐。下唇有疮，其咽干，虫蚀其脏，为惑。上唇有疮，其声哑，由热深食少、肠胃空虚、三虫举而求食也。其证目闭神倦，面色无常，桃仁槐子治之。
一为邪热作衄，一为瘀血停留。若阴盛格阳，虚火上炎而假渴者，宜白通加人尿猪胆汁汤。(原注：阳明经热，故欲漱水；热不在胃，故水不下咽。经中热甚，则迫血妄行，故必作衄。)
(原注：脉必微散。)
病后余邪百合成，先察溺时头痛情。起居饮食不自主，药投吐利似神灵。汗后百合知母润，下后百合滑(石代)赭清，吐后百合卵黄补，发热百合滑石平，阴虚百合生地汁，渴用花粉牡蛎并。
伤寒颐毒郁热成，失于汗下耳后生。红俽热痛宜消散，反此神昏命必倾。
新愈脏腑皆不足，卫荣肠胃未通和，多食过劳复生热，枳实栀子六黄瘥。(脉)浮(有表当)汗(脉)沉(有里当)下(无表里证当用)小柴解，燥呕竹叶石膏科，气虚补中益气主，阴亏六味倍参多。
大病新瘥，男女交合，互相传者，为阴阳易。但男病者，为女劳复。其证少腹绞痛、肢节解散、头重不举、眼中生花，男子则卵缩入腹，妇人则痛引阴中，俱用烧裩禅散或竹皮汤治之，得小便利、阴处肿退为愈。(原注：一用韭根一握，煎水送下五苓散，便利则愈。)
(原注：吐蛔虫而厥也。蛔色赤而活者，属胃热，犹可治之；蛔色白而死者，属胃败，不治。)
凡人胃脘忽痛忽止、身上乍热乍凉、面色时赤时白、六脉倏乱倏静、口中吐沫不食者，便是蛔厥之候，由胃虚邪盛、寒热错杂，宜乌梅丸。
太阳干呕，则有头痛发热。少阳干呕，则有胸满胁痛。水气干呕，则有胁下引痛。若阴寒干呕，则外无表证，但脉沉肢厥，或吐涎沫，或下清谷，各随所见证治之。
阳邪不解而面赤者，为佛郁，必脉浮而手足温。虚阳上浮而面赤者，为戴阳，必脉虚而足胫冷。一宜桂枝汤小和之，一宜白通汤急温之，或加入尿猪胆汁为引。
三阳合病口不仁，腹满身重转侧难。谵语遗尿面垢汗，白虎生津益气原。太阳少阳(合病)芩芍草，太阳阳明(合病)葛根(汤)煎，少阳阳明(合病)表里急，大柴胡汤两解焉。
(原注：表里俱病也。)
一日太阳少阴病，头痛口干渴而烦。二日阳明太阴病，满不欲食身热谵。三日少阳厥阴病，耳聋囊缩舌焦卷。水浆不入神昏冒，六日气尽命难全。
阳证身轻气高热，目睛了了面唇红，热烦口燥舌干渴，爪甲红兮小便同(亦红)。阴证身重息短冷，目不了了色不红，无热欲卧厥吐利，小便白兮爪甲青。
(原注：身虽冷而不欲近衣，神虽昏而气色光亮，脉必沉滑有力，乃假阴证也。)
阳盛格阴身肢厥，恶寒烦渴大便难。(脉)沉滑爪赤小便赤，汗(之)下(之)清(之得)宜阴自完。
凡热极失于汗下，阳气亢闭，反兼胜已之化于外，或手足厥逆，或身冷如冰，血凝青紫成片，脉沉而伏甚则闭绝，似阴证矣。但烦渴、谵语、咽干、唇裂、舌苔黄黑、心腹痞满、小便短赤、大便燥结，知为内热。
(原注：身虽烦躁而引衣自覆，口虽燥渴而漱水不下，脉必沉细无力，乃假阳证也。)
阴盛格阳色浅赤，发热不渴厥而烦，下利尿清爪青白，(脉)浮微通脉(四逆汤以)复阳还。
凡阴盛于内，逼其浮游之火于外，面赤、烦躁、咽痛、身热、大便阴结、小便淡黄、惊惶不定、时常郑声，似阳证矣。但脉沉微而迟、渴欲饮水而不能饮，知为内寒。
少阴、阳明俱属土，同主中州，病则先形诸腹。阳明为阳土，阳道实，故病则胃家实而非满。太阴为阴土，阴道虚，故病则腹满而不能实也。凡风、燥、热为阳邪，多犯阳明；寒与湿为阴邪，多犯太阴。阳邪犯阳，则饮食而不呕；阴邪犯阴，则不能食而吐。阳邪犯阳，则不大便；阴邪犯阴，则自利。
(原注：伤寒伤人身之阳，故喜辛温甘温苦热，以救其阳；温病伤人身之阴，故喜辛凉甘寒甘咸，以救其阴。)
伤寒由毛窍而入，自下而上，始足太阳。寒为阴邪，阴盛必伤阳，故首郁遏太阳经中之阳气，而为头痛、身热等证。温病由口鼻而入，自上而下，始手太阴。温为阳邪，阳盛必伤阴，故首郁遏太阴经中之阴气，而为咳嗽、自汗、口渴、头痛、身热、尺热等证。(原注：伤寒之邪自表传里，温热之邪自里达表。)
中寒卒然倒仆如中风者，乃严寒之气卒犯少阴，而厥逆无脉，此阳气大虚，不胜阴寒厉气也，必口鼻气冷而无痰声。中暑卒然晕倒如中风者，乃酷暑之气鼓运其痰，壅塞心包，此肾水素亏不胜时火燔灼也，必喘乏而无痰声。若中风卒倒，则必手足搐引，痰声壅塞于喉中，甚则如拽锯，于中风门求治法。
六腑病证歌
阳明胃病，腹胀面热，当心而痛，牵引两胁，食饮不下，气阻咽嗌。大肠病证，与胃相及，肠呜濯濯，感寒即泄，当脐而痛，不能久立。小肠有病，小腹拘牵，腰脊疼痛，控引睾丸，耳前肩上，独热独寒。三焦病状，腹气不宣，实则癃闭，小腹尤坚，水溢而胀，决导失官。病在膀胱，肩上独热，小腹偏肿，痛而不息，以手按之，欲使弗得。胆病唾多，喜发太息，口苦嗌干，呕出宿汁，心下澹澹，恐人捕获。
五脏病证辨
心藏神，神有余则笑不休，不足则悲。肺藏气，气有余则喘咳上逆，不足则泄利少气，肝藏血，血有余则怒，不足则恐。脾藏形，形有余则腹胀、经溲不利，不足则四肢不用(原注：脾主四肢)。肾藏志，志其余则腹胀飧泄(原注：肾者胃之关)，不足则厥。(原注：亦有脾虚而腹胀者，多因病，或误服攻下之药而成。)
肝脉有病，其外证面青、好洁、善怒，其内证脐左有动气，按之牢若痛。其病四肢满，闭淋溲，便难，头痛，目眩，耳聋，颊肿、胁下痛引小腹。
心脉有病，其外证面赤、口干、善笑，其内证脐上有动气，按之牢若痛。其病烦心，心痛，掌中热而哕啘，胸胁支满，两臂内痛膺背肩胛间痛，胁下与腰相引而痛。(原注：心火并于肺则喜。)
(Original note: Hiccups originating from below the umbilicus indicate deficiency-cold of Kidney Qi. Those occurring in the chest and diaphragm indicate stomach heat rushing upward.)
Hiccups refer to qi rushing upward from the abdomen, with a continuous sound. For hiccups caused by heat, treat with Persimmon Calyx (Shi Di) and Loquat Leaf (Pi Pa Ye) (Original note: These two herbs are charred to retain their properties and taken down with Bamboo Shavings Decoction). For hiccups caused by cold, treat primarily with Lizhong Tang (Regulate the Middle Decoction) added with Clove (Ding Xiang) and Pinellia Rhizome (Ban Xia). If there is fluid retention, promote diuresis. If there is food stagnation, promote digestion and unblocking. If fire is excessive, clear the diaphragm heat. If phlegm is obstructing, resolve phlegm and open obstruction. Only when hiccups occur in chronic illness is it a sign of Chu Zhong (elimination of middle jiao qi), which is incurable.
Wheezing and Shortness of Breath
Rapid breathing with gasping sounds and frequent opening of the mouth; shortness of breath resembling wheezing but without shoulder lifting. Rapid and difficult breathing indicates excess syndrome; short and discontinuous breathing indicates deficiency syndrome. For exterior wheezing, use Guizhi Tang (Cinnamon Twig Decoction) or Mahuang Tang (Ephedra Decoction) added with Apricot Kernel (Xing Ren) and Magnolia Bark (Hou Po). For interior excess wheezing, use Chengqi Tang (Purge the Ganglion Decoction) or Xianxiong Wan (Trap the Chest Pill). For wheezing due to water qi, use Zhengling Tang (Correct Ling Decoction) added with Lepidium Seed (Ting Li Zi). For phlegm wheezing, use Su Ting Erchen Quan (Perilla and Lepidium combined with Erchen Decoction).
Vomiting
(Original note: Vomiting food eaten in the morning at night indicates spleen cold. Vomiting immediately after eating indicates stomach heat. Vomiting clear water indicates cold. Vomiting phlegm-saliva and sour water indicates heat.)
Sound without matter is called dry heaving (Gan Ou); matter without sound is called vomiting (Tu); sound with matter is called vomiting (Ou). This is mostly caused by exterior pathogens transmitting inward and rebellious qi of the interior rising up. For vomiting due to stomach heat, the pulse is wiry and rapid, with dry mouth and thirst. For vomiting due to stomach cold, the pulse is wiry and slow, with cold hands and feet. For vomiting due to fluid retention, there is initial thirst followed by vomiting, and vomiting followed by thirst again. If there is dry heaving with sweating in Taiyang disease, use Guizhi Tang (Cinnamon Twig Decoction); if there is diarrhea with dry heaving in Shaoyin disease, use Sini Tang (Reverse Reversal Decoction); if there is drooling with dry heaving in Jueyin disease, use Wuzhuyu Tang (Evodia Decoction). (Ling Bo's note: For vomiting in warm diseases, Yushu Dan (Jade Peak Pill) can be used, also applicable for poisoning.)
Thirst
The three methods (sweating, emesis, purging) damage fluids causing dry stomach and mouth; yang invading yin also causes thirst. When desiring water, give small amounts frequently to prevent fluid retention becoming a drinking disease. For Taiyang disease with low urine output, use Wuling San (Five-Ingredient Powder with Poria). For Yangming disease with severe thirst, use Baihu Tang (White Tiger Decoction) as the first choice. For Shaoyang disease presenting with irritability and thirst, use Xiao Chaihu Tang (Minor Bupleurum Decoction) removing Ban Xia (Pinellia Rhizome) and adding Hua Fen (Taro Tuber/Glehnia Root).
If pathogenic heat gathers in the stomach, consuming fluids, leading to dry mouth and tongue, urgent purgation is needed. If sweating or purging was excessive, exhausting fluids, leading to dry mouth and throat, saving yin is required.
Palpitations
(Original note: For palpitations caused by fire pathogen, use Guizhi Tang (Cinnamon Twig Decoction) removing Shaoyao (Peony Root), adding Long Gu (Dragon Bone) and Mu Li (Oyster Shell).)
Palpitation refers to a throbbing sensation in the heart, restless and unable to settle, also known as Zheng Chong (palpitations with anxiety). If fluid stops under the heart, and heart fire fears the water and cannot settle, use Banxia Fuling Tang (Pinellia and Poria Decoction). If excessive sweating depletes fluids, leaving the heart deficient and unsupported, use Guipi Tang (Restore the Spleen Decoction).
Trembling
Trembling refers to shaking and swaying, often occurring after sweating, emesis, or purging, due to severe deficiency of qi and blood. It can be treated with Zhenwu Tang (True Warrior Decoction) to warm yang, or Renshen Yangrong Tang (Ginseng Nourishing Glory Decoction) to tonify.
Chills and Shivering
Body movement is called 'Zhan' (shaking/chills); mental fear is called 'Li' (trepidation/shivering); this is a manifestation of yin and yang struggling. If righteous qi wins and shivering occurs, resolution comes with sweating. If yin qi is excessive and shivering occurs, assisting yang is urgent.
Jaundice
Damp-heat jaundice presents with head sweat, difficulty urinating, and thirst, belonging to Yangming. Those with pre-existing cold-dampness who undergo sweating develop jaundice transforming into dampness, belonging to the Taiyin channel. Yang jaundice has a bright color; yin jaundice has a dark color. Taiyang blood accumulation accompanied by mania: for exterior excess, use Mahlian Liaoqiao Chixiaodou Tang (Ephedra, Forsythia, and Adzuki Bean Decoction) (Original note: Added Gan Cao, Xing Ren, Jiang, Zao, named Mahlian Liaoqiao Chixiaodou Tang); for interior excess, use Zhizi Dahuang Yin Chen Tang (Gardenia, Rhubarb, and Capillaris Decoction) (Original note: Added Huang Bo, Gan Cao, named Zhizi Dahuang Tang). Yin jaundice uses Yin Chen (Capillaris Herba) added to Sini Tang (Reverse Reversal Decoction); loose stools and urinary retention use Yinchen Wuling San (Capillaris Five-Ingredient Powder). Blackening around the mouth with cold sweat (Original note: cold sweat) is a death sign; body like smoke-stained is a sign of yang exhaustion.
Mania
(Original note: When yang pathogen merges with yang, mania occurs. When yin pathogen merges with yin, epilepsy occurs.)
Confusion and stomach heat with heavy yang lead to mania; treat with San Chengqi Tang (Three Purge Ganglion Decoctions) or Sanhuang Shigao Tang (Three-Yellow Gypsum Decoction). Mania due to blood accumulation has free urination, fullness and pain in the lower abdomen, belonging to Taiyang. Yangming blood accumulation has black stool, the person is like manic and forgetful. Mania from forced sweating with frequent lying down and rising is treated well with Shen (Ginseng), Baiwei (Silverweed Root), Longgu (Dragon Bone), Muli (Oyster Shell), and Fushen (Poria with Hostwood).
Macules and Rash (Attached: Sand Rash)
(Original note: Macules and rashes have pathogens in the blood collaterals; only light dispersal and cooling resolution are suitable. Mistakenly using ascending drugs causes epistaxis; or syncope, or choking cough, or coma and convulsions. Using cloying tonics causes chaos.)
Loss of sweating and purging in typhoid leads to rash and macules; contracting and immediate eruption is seasonal qi. Exterior pathogens lie dormant in the Ying and Wei levels, spreading externally on the skin entangled by blood heat. Sand is white, rash is red like skin millet, macules are red like beans connected in patches. Red is mild, crimson is severe, black indicates many deaths. Pale red and turbid dark toxins should be dispersed. Huaban (Resolve Macules) uses Baihu Tang (White Tiger Decoction) removing Jing Mi (Glutinous Rice) (added Yuan Shen, Xi Jiao). Severe heat uses Sanhuang Shigao Jian (Three-Yellow Gypsum Decoction). (Original note: For sore throat and swelling, use Shegan (Belamcanda Rhizome), Niubangzi (Arctium Fruit), Lianqiao (Forsythia Fruit), Xuanshen (Scrophularia Root).)
Delirium and Feeble Speech
(Original note: Delirium with fixed gaze, wheezing/fullness, diarrhea, or short pulse are all incurable.)
Delirium is excess, with long and vigorous voice, confused speech changing frequently. Feeble speech is deficiency, with short and thin voice, frequent repetition and muttering. Excess is due to heat pathogen, suitable for clearing and resolving. Deficiency is scattered spirit, treated with Danshen Jian (Single Ginseng Decoction).
Dry feces in the stomach cause delirium; extreme pathogenic heat also causes delirium. Constipation with delirium requires Dachengqi Tang (Major Purge Ganglion Decoction). Clear bowels with delirium require Sanhuang Zhizi Tang (Three-Yellow Gardenia Decoction). Massive blood loss with delirium requires Buchang Tang (Blood Tonifying Decoction). Warm disease delirium requires Qingying Tang (Clear Nutrient Decoction). (Original note: Typhoid delirium, excluding dry feces, has no other symptoms. Warm disease delirium may be due to dry feces or pathogen sinking into the Pericardium.)
Grasping at Clothes, Picking at Empty Air
One case is extreme Yangming heat, suitable for Cheng Tang (Purge Ganglion Decoction). However, if the pulse is excess, purging is possible; if deficiency, it is difficult to treat. Another case is yin damaged by sweating and purging, suitable for Dushen Tang (Single Ginseng Decoction). However, if urine flows freely, life is possible; if not, death ensues. If seen in chronic illness, it is a sign of spirit scattering, i.e., death.
Clonic-Atonic Convulsions
Chi refers to tendon spasm, where spasm causes contraction. Zong refers to tendon laxity, where laxity causes extension. Continuous extension and contraction is called Chi Zong, commonly known as convulsion. This is a wind-phlegm disease, so epilepsy cases often have it.
Stiffness and Cramping
With fever, headache, body ache, and limb stiffness, it is an exterior syndrome. Without fever/headache, with lethargy, inability to extend limbs, and limb stiffness, it is a yin syndrome. After sweating/purging, if muscle twitching and stiffness with insensitivity occur, it is qi-blood deficiency failing to nourish tendons.
Depression and Vertigo
Yu means depression with stagnant qi; Mao means dizziness with unclear spirit, mostly deficiency-cold syndromes. If plague heat accumulates internally forcing depression and near-death vertigo, purge it. If postpartum lochia stagnation causes unbearable vertigo, move blood.
Oppression
This syndrome is mostly due to incomplete sweating, with yang qi oppressed in the skin and muscles, steaming to the head and face, causing flushing intermittently. Treat with mild sweating.
Head Shaking
Wanting to speak while shaking the head indicates interior pain. Jaw locking with head shaking indicates spasmodic disease. Fixed gaze with head shaking is difficult to treat.
Spontaneous Diarrhea
Taiyang diarrhea presents with fever; Taiyin diarrhea presents with warm hands and feet; Shaoyin and Jueyin diarrhea present with cool body and no fever. Generally, diarrhea with heat has heat below the umbilicus, desire to drink, fever, rapid pulse, and yellow-red stool; diarrhea with cold has cold below the umbilicus, no thirst despite diarrhea, aversion to cold, faint pulse, and undigested food in stool.
Constipation
Stomach heat consuming fluids requires purging. Fluid exhaustion after sweating requires guiding (moistening/laxative). Post-recovery overeating causing indigestion and constipation focuses on digestion promotion. Post-illness blood deficiency causing dry intestinal constipation focuses on moistening.
Difficulty Urinating
(Original note: Complete absence of drops is Long Bi (strangury/retention).)
Yin deficiency makes urination difficult; use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) removing Shan Zhu Yu (Cornus Fruit) and adding Bai Shao (White Peony Root). Bladder heat makes urination difficult; use Wuling San (Five-Ingredient Powder with Poria).
Frequent Urination
Frequent urination indicates deficiency of Kidney and Bladder with guest heat invading. Deficiency fails to control water; heat makes the water passage astringent.
Enuresis
Kidney deficiency fails to constrain Bladder qi, so urine leaks out unknowingly. If severe heat and confusion cause enuresis, clear heart and resolve heat. If yin-cold reversal causes enuresis, warm kidney and secure qi. Only fixed gaze with enuresis is kidney exhaustion and incurable.
Reversal Cold
Cold hands and feet is Si Ni (Four Reversals); cold reaching elbows and knees is Jue (Reversal), caused by yang qi sinking inward, failing to connect smoothly with yin qi. Initial fever progressing to intense cold without reversal is Yang Jue (Yang Reversal), preferring water, red urine, dry mouth, deep rapid pulse; use Baihu Tang (White Tiger Decoction) or Chengqi Tang (Purge Ganglion Decoction). Initial non-fever with cold is Yin Jue (Yin Reversal), preferring heat application, yin retraction, blue nails, deep slow pulse; use Sini Tang (Reverse Reversal Decoction). Pediatric cases with food stagnation causing reversal need digestion promotion; phlegm obstruction causing reversal needs phlegm resolution.
Yang deficiency below causes cold reversal; yin deficiency below causes heat reversal. In Yin reversal, calves are cold then arms are cold, bowel/bladder free, no thirst, fatigue, sleepiness, clear mind. In Yang reversal, calves are cold but arms are not, mania/delirium, confused mind.
Muscle Twitching and Trembling
Excessive sweating damages fluids, severe yang deficiency, muscles lose nourishment, causing sudden jumping and trembling. Use Zhenwu Tang (True Warrior Decoction).
Blood Accumulation
Blood accumulation is heat binding and blood stasis, causing lower abdominal urgency and fullness. Taiyang blood accumulation has free urination; Yangming blood accumulation has black stool, manic-like behavior, forgetfulness; treat with Tao Ren Chengqi Tang (Peach Kernel Purge Ganglion Decoction) (Original note: For plague blood accumulation, remove Gui Zhi, add Huang Lian, Huang Qin, Huang Bo, Zhi Zi, Dan Pi).
Heat Entering the Blood Chamber
(Original note: This syndrome is lighter during the day and heavier at night; delirium also occurs at night, due to pathogen entering yin levels.)
Women with typhoid/wind strike encountering menstruation onset, pathogen enters with it; or menstruation just stopped, blood heat binds. Symptoms include chills/fever like malaria, severe delirium; use Xiao Chaihu Tang (Minor Bupleurum Decoction) added with Sheng Di (Rehmannia Root), Shao Yao (Peony Root), Dan Pi (Moutan Bark).
Hu Huo (Fox Confusion)
(Original note: Restlessness, aversion to food smell, silent desire to sleep, hoarse voice; use Gancao Xiexin Tang (Licorice Drain Heat Decoction). Dry throat; wash externally with Kushen water. Anal erosion; fumigate with burning Xionghuang (Realgar). Abscess formed; use Chixiaodou Danggui San (Adzuki Bean and Angelica Powder).)
Parasites eroding lower parts is Hu (Fox). Sores on lower lip, dry throat, parasites eroding viscera is Huo (Confusion). Sores on upper lip, hoarse voice, due to deep heat, poor appetite, empty intestines/stomach, three worms seeking food. Symptoms: eyes closed, lethargy, variable complexion; treat with Tao Ren (Peach Kernel) and Huaizi (Buckwheat Seed).
Rinsing Mouth Without Swallowing
One case is pathogenic heat causing epistaxis; another is lingering blood stasis. If yin excess repels yang, deficieny fire flares causing false thirst, use Baotong Tang (Activate Yang Decoction) added with Human Urine and Pig Gallbladder Bile. (Original note: Yangming channel heat causes desire to rinse; heat not in stomach prevents swallowing. Severe channel heat forces blood to run wild, causing epistaxis.)
Hunger Without Desire to Eat
Stomach qi deficiency with guest heat in chest causes hunger without desire to eat. If vomiting roundworms, use Wu Mei Wan (Mume Pill).
Lily Disease
(Original note: Pulse must be slightly scattered.)
Post-illness residual pathogen forms Lily Disease; first observe if headache occurs during urination and emotional state. Autonomic dysfunction in daily life/diet; medication causes vomiting/diarrhea resembling spirit possession. Post-sweat Lily uses Zhi Mu Baihe (Anemarrhena Lily); post-purge uses Huashi Daizhe Baihe (Talcum Magnetite Lily); post-emesis uses Dan Huang Baihe (Egg Yolk Lily); fever uses Huashi Baihe (Talcum Lily); yin deficiency uses Dihuang Baihe (Rehmannia Lily); thirst uses Huafen Musli Baihe (Trichosanthes Oyster Lily).
Parotitis
Typhoid parotid toxin forms郁热 (oppressed heat); failure to sweat/purge causes occurrence behind ears. Redness/swelling/heat/pain requires dissipation; otherwise coma and death.
Food and Labor Relapse
Newly recovered organs are deficient, Wei/Ying/intestines/stomach not harmonized. Overeating/exertion generates heat; use Zhishi Zhizi Chi Xiao Dou Tang (Immature Bitter Orange, Gardenia, and Adzuki Bean Decoction) or Liu Huang Tang (Six-Yellow Decoction) for recovery. (Pulse) floating (exterior syndrome warrants) sweating; (pulse) sunken (interior syndrome warrants) purging; no exterior/interior syndrome uses Xiao Chaihu Tang (Minor Bupleurum Decoction) to resolve. Dry vomiting uses Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction); qi deficiency uses Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction); yin deficiency uses Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) with increased Ginseng.
Yin-Yang Exchange and Female Labor Relapse
After major illness recovery, sexual intercourse transmits disease between men and women, called Yin-Yang Exchange. If only the man was ill, it is Female Labor Relapse. Symptoms: lower abdominal cramping, joint relaxation, heavy head unable to lift, visual hallucinations. Men: testicles retract into abdomen. Women: pain radiating to vagina. Treat with Shao Kun Rang San (Burnt Underwear Powder) or Zhupi Tang (Bamboo Peel Decoction). Recovery indicated by free urination and reduction of genital swelling. (Original note: One handful of Leek root, decocted water to send down Wuling San (Five-Ingredient Powder with Poria); free urination indicates recovery.)
Roundworm Reversal
(Original note: Vomiting roundworms with reversal cold. Red/live roundworms indicate stomach heat, still treatable; white/dead roundworms indicate stomach failure, incurable.)
Sudden epigastric pain stopping suddenly, alternating hot/cold body, alternating red/white face, chaotic/stable six pulses, foaming mouth without eating, are signs of Roundworm Reversal. Caused by stomach deficiency, pathogen excess, mixed cold/heat; use Wu Mei Wan (Mume Pill).
Dry Heaving
Taiyang dry heaving has headache/fever. Shaoyang dry heaving has chest fullness/hypochondriac pain. Water qi dry heaving has hypochondriac pulling pain. Yin-cold dry heaving has no exterior syndrome, but deep pulse/cold limbs, or drooling/undigested stool; treat according to specific manifestations.
Floating Yang
Yang pathogen unresolved with red face is Fu Yu (Oppression), pulse floating, warm limbs. Deficient yang floating up with red face is Dai Yang (Floating Yang), pulse deficient, cold calves. Former uses Guizhi Tang (Cinnamon Twig Decoction) to gently harmonize; latter uses Baotong Tang (Activate Yang Decoction) to urgently warm, or add human urine/pig bile as guide.
Combined Syndrome
Three Yang Combined Syndrome: mouth incoordination, abdominal fullness, heavy body, difficulty turning. Delirium, enuresis, greasy sweat; Baihu Tang (White Tiger Decoction) generates fluids, Qiyuan (Qi Source) tonifies qi. Taiyang-Shaoyang Combined uses Qin-Shao-Gao (Scutellaria-Peony-Licorice); Taiyang-Yangming Combined uses Gegen Tang (Kudzu Decoction); Shaoyang-Yangming Combined with exterior-interior urgency uses Dachaihu Tang (Major Bupleurum Decoction) to resolve both.
Two Channels Simultaneously Affected
(Original note: Exterior and interior simultaneously diseased.)
Day 1: Taiyang-Shaoyin disease, headache, dry mouth/thirst, irritability. Day 2: Yangming-Taiyin disease, fullness, anorexia, fever, delirium. Day 3: Shaoyang-Jueyin disease, deafness, scrotal retraction, scorched/curled tongue. Unable to take fluids, confusion/coma; by Day 6, qi exhausted, life difficult to save.
Differentiating Yang and Yin Syndromes
Yang syndrome: light body, rapid breath, fever, clear eyes, red lips/face, heat/irritation, dry mouth/tongue/thirst, red nails, red urine. Yin syndrome: heavy body, short breath, cold, unclear eyes, pale face, no fever, desire to lie down, reversal/vomiting/diarrhea, white urine, blue nails.
Yang Syndrome Resembling Yin
(Original note: Body cold but no desire for clothing; spirit confused but complexion bright; pulse deep slippery forceful; fake yin syndrome.)
Yang excess repelling yin causes limb reversal, aversion to cold, irritability/thirst, difficult stool. (Pulse) deep slippery, red nails, red urine; sweating/purging/clearing resolves yin naturally.
Generally, extreme heat lacking sweating/purging, yang qi hyperactive and closed, mimics external transformation of overcoming self, or limb reversal, or body cold as ice, blood coagulation purple patches, deep hidden pulse even to closure, resembling yin syndrome. But irritability/thirst, delirium, dry throat, cracked lips, yellow/black tongue coating, chest/abdominal fullness, short red urine, dry hard stool, know it is internal heat.
Yin Syndrome Resembling Yang
(Original note: Body irritable but pulls clothes to cover; mouth dry/thirsty but rinses mouth without swallowing; pulse deep fine weak; fake yang syndrome.)
Yin excess repelling yang shows pale red color, fever without thirst, reversal with irritability, clear urine, blue/white nails. (Pulse) floating/faint, Tongmai (Pulse Reviving) Sini Tang (Reverse Reversal Decoction) restores yang.
Generally, yin excess internally forces floating fire externally, red face, irritability, sore throat, body heat, yin constipation, pale yellow urine, panic, frequent feeble speech, resembling yang syndrome. But pulse deep faint slow, desire to drink but unable to swallow, know it is internal cold.
Taiyin and Yangming Manifestations
(Original note: Foot Taiyin Spleen, Foot Yangming Stomach.)
Shaoyin and Yangming both belong to Earth, governing the Central Pivot; disease manifests first in the abdomen. Yangming is Yang Earth, Yang path is excess, so disease is Stomach excess rather than fullness. Taiyin is Yin Earth, Yin path is deficiency, so disease is abdominal fullness but not solid. Wind, dryness, heat are Yang pathogens, mostly attacking Yangming; cold and dampness are Yin pathogens, mostly attacking Taiyin. Yang pathogen attacking Yang: eats/drinks without vomiting. Yin pathogen attacking Yin: cannot eat, vomits. Yang pathogen attacking Yang: no bowel movement. Yin pathogen attacking Yin: spontaneous diarrhea.
Differentiating Typhoid and Warm Disease
(Original note: Typhoid injures human yang, thus likes pungent-warm, sweet-warm, bitter-hot to rescue yang; Warm disease injures human yin, thus likes pungent-cool, sweet-cool, sweet-salty to rescue yin.)
Typhoid enters via hair pores, bottom-up, starting at Foot Taiyang. Cold is Yin pathogen, yin excess injures yang, first oppressing Taiyang channel yang qi, causing headache, body heat etc. Warm disease enters via nose/mouth, top-down, starting at Hand Taiyin. Warm is Yang pathogen, yang excess injures yin, first oppressing Taiyin channel yin qi, causing cough, spontaneous sweat, thirst, headache, body heat, chi heat etc. (Original note: Typhoid pathogen transmits from exterior to interior; warm-heat pathogen reaches from interior to exterior.)
Abundant qi with cold body results from Typhoid. Deficient qi with hot body results from Summerheat.
Differentiating Cold Stroke, Summerheat Stroke, and Wind Stroke
Cold stroke sudden collapse like wind stroke is severe cold qi suddenly attacking Shaoyin, reversal cold without pulse, severe yang deficiency unable to withstand harsh yin-cold qi, must have cold breath/no phlegm sound. Summerheat stroke sudden fainting like wind stroke is intense summer heat stirring phlegm, blocking Pericardium, kidney water originally deficient unable to withstand time-fire burning, must have panting/fatigue/no phlegm sound. Wind stroke sudden collapse must have limb convulsions, phlegm sound blocking throat, even like sawing; seek treatment in Wind Stroke section.
Six Fu Organs Syndrome Song
Yangming Stomach disease: abdominal distension, facial heat, pain in heart region, radiating to hypochondrium, inability to eat/drink, qi obstruction in throat. Large Intestine disease: related to stomach, borborygmus, diarrhea upon cold exposure, pain at umbilicus, inability to stand long. Small Intestine disease: lower abdominal pulling, waist/spine pain, radiating to testicles, isolated heat/cold in front of ear/shoulder. Sanjiao disease: abdominal qi not circulating, excess strangury, lower abdomen especially hard, water overflow edema, loss of drainage function. Bladder disease: isolated heat on shoulder, lower abdominal swelling, ceaseless pain, pressing hand desires relief. Gallbladder disease: excessive saliva, frequent sighing, bitter taste, dry throat, vomiting old juice, palpitations, fear of capture.
Five Zang Organs Differentiation
Heart stores Spirit; excess spirit laughs incessantly, deficiency spirit grieves. Lung stores Qi; excess qi wheezes/coughs upward, deficiency qi diarrhea/shortness of breath. Liver stores Blood; excess blood anger, deficiency blood fear. Spleen stores Form; excess form abdominal distension/urinary difficulty, deficiency form limbs useless (Original note: Spleen governs limbs). Kidney stores Will; excess will abdominal distension/diarrhea (Original note: Kidney is gate of Stomach), deficiency will reversal. (Original note: Also spleen deficiency causing abdominal distension, mostly due to illness or mistaken purgatives.)
Liver pulse disease: exterior signs green face, cleanliness preference, anger; interior signs moving qi left of umbilicus, firm/painful on pressure. Diseases: limb fullness, strangury, difficult stool, headache, vertigo, deafness, cheek swelling, hypochondriac pain radiating to lower abdomen.
Heart pulse disease: exterior signs red face, dry mouth, laughter; interior signs moving qi above umbilicus, firm/painful on pressure. Diseases: vexed heart, heart pain, hot palms, hiccups, chest/hypochondriac fullness, inner arm pain, chest/back/scapula pain, hypochondriac/waist pulling pain. (Original note: Heart fire merging with Lung likes joy.)