齐郎中令循病众医皆以为蹶入中而刺之淳于意诊之曰涌疝也令人不得前后溲循曰不得前
后溲
三日矣意饮以火齐汤一饮得前溲再饮大溲三饮而疾愈病得之内所以知循病者切其脉时右口气
急脉无五脏气右口脉大而数数者中下热而涌左为下右为上皆无五脏应故曰涌疝中热故溺赤
也
齐北宫司空命妇出于病众医皆以为风入中病主在肺刺其足少阳脉淳于意诊其脉曰病气疝
客于
膀胱难于前后溲而溺赤病见寒气则遗溺使人腹肿出于病得之欲溺不得因以接内所以知出于病
者切其脉大而实其来难是蹶阴之动脉也脉来难者疝气之客于膀胱也腹之所以肿者言蹶阴之络
结
小腹也蹶阴有过则脉结动动则腹肿意即灸其足蹶阴之脉左右各一所即不遗溺而溲清小腹痛止
即更为火齐汤以饮之三日而疝气散即愈
安陵阪里公乘项处病淳于意诊脉曰牡疝牡疝在膈下上连肺病得之内意谓之慎无为劳力事
则必
呕血死处后蹴 要蹶寒汗出多即呕血意复诊之曰当旦日日夕死即死病得之内所以知项处病者
切其脉得番阳番阳入虚里处旦日死一番一络者牡疝也意曰他所诊期决死生及所治已病众多颇
忘之不能尽识不敢以对
齐章武里曹山跗病淳于意诊其脉曰肺消瘅也加以寒热即告其人曰死不治适其共养此不当
医治
法曰后三日而当狂妄起行欲走后五日死即如期死山跗病得之盛怒而以接内所以知山跗之病者
意切其脉肺气热也脉法曰不平不鼓形弊此五脏高之远数以经病也故切之时不平而代
不平者血不居其处代者时参击并至乍躁乍大也此两络脉绝故死不治所以加寒热者言其人尸夺
尸夺者形弊形弊者不当关灸 石及饮毒药也臣意未往诊时齐太医先诊山跗病灸其足少阳脉口
而饮之半夏丸病者即泄注腹中虚又灸其少阴脉是坏肝刚绝深如是重损病者气以故加寒热所
以
后三日而当狂者肝一络连属结绝乳下阳明故络绝开阳明脉阳明脉伤即当狂走后五日死者肝与
心相去五分故曰五日尽尽则死矣
The Langzhongling (Attendant Gentleman of the Palace) Xun of Qi fell ill. All physicians believed it was Jue Qi entering the center and treated him with acupuncture. Chunyu Yi examined him and said, "This is Yong Han (Surging Hernia), a condition causing inability to urinate or defecate." Xun said, "I have been unable to pass urine or stool for three days." Yi administered Huo Ji Tang (Fire-Regulating Decoction). After one dose, he could urinate; after two doses, he could defecate; after three doses, the disease was cured. The disease originated from internal causes (improper sexual conduct). I knew it was Xun's illness because upon palpating his pulse, the pulse at the right Cun Kou (Radial Pulse Position) was rapid and tense, lacking the harmonious Qi of the five Zang organs. The right Cun pulse was large and rapid; a rapid pulse indicates heat in the middle and lower Jiao with surging Qi. The left corresponds to the lower, the right to the upper, and neither showed correspondence to the five Zang organs, hence termed Yong Han. Heat in the middle Jiao caused the dark red urine.
Mingfu (Lady of Rank) Chu of the Beigong Sikong (Palace Constable) in Qi fell ill. All physicians believed it was Wind pathogen entering the center, locating the disease in the Lung, and needled her Foot Shaoyang meridian. Chunyu Yi palpated her pulse and said, "This is Bing Qi Han (Pathogenic Qi Hernia); the pathogenic Qi resides in the Bladder, causing difficulty in urination and defecation with dark red urine. When exposed to cold pathogen, she experiences urinary incontinence and abdominal swelling. Chu contracted this illness due to attempting to urinate but failing, followed immediately by sexual intercourse. I knew it was Chu's illness because her pulse was large, solid, and difficult to feel, which is the arterial manifestation of the Jueyin Meridian. A difficult-to-feel pulse indicates Hernia Qi residing in the Bladder. The abdominal swelling occurs because the collaterals of the Jueyin Meridian are knotted in the lower abdomen. When Jueyin is affected, the pulse knots; when the pulse moves, the abdomen swells. Yi then moxa-ed one point on each side of the Foot Jueyin Meridian. Consequently, urinary incontinence ceased, urination became clear, and lower abdominal pain stopped. Subsequently, Yi administered Huo Ji Tang (Fire-Regulating Decoction). After three days, the Hernia Qi dissipated, and she recovered.
Gongcheng (Commoner of Rank) Xiang Chu of Anling Banli fell ill. Chunyu Yi palpated his pulse and said, "This is Mu Han (Male Hernia). Mu Han is located below the diaphragm and connects upward to the Lung. This disease originates from internal causes." Yi warned him, "Be cautious and do not engage in strenuous labor, otherwise you will vomit blood and die." Later, Xiang Chu played football, twisted his waist, caught cold, sweated profusely, and subsequently vomited blood. Yi re-examined him and said, "He will die on the morning of the next day, towards evening." Xiang Chu indeed died that evening. The disease originated from internal causes. I knew it was Xiang Chu's illness because palpation revealed the Fan Yang pulse entering the Xu Li (Vital Area). He died the next day because one Fan and one Luo constitute Mu Han. Yi stated, "There are many other cases where I predicted life and death or treated cured diseases, but I have largely forgotten them and cannot recall them all, so I dare not answer."
Cao Shanfu of Zhangwu Li in Qi fell ill. Chunyu Yi palpated his pulse and said, "This is Fei Xiao Dan (Lung Wasting-Thirst with Carbuncle), accompanied by alternating chills and fever." He informed the family, "The disease is untreatable and fatal. You should only provide care and nourishment; medical treatment is inappropriate." Medical texts state: "After three days, the patient will become delirious, rise, walk, and desire to run; they will die after five days." He died exactly as predicted. Shanfu contracted this illness due to intense anger followed by sexual intercourse. I knew it was Shanfu's illness because palpation revealed heat in the Lung Qi. The pulse law states: "If the pulse is uneven and does not surge, the physical form is ruined." This is a Jing Meridian disease resulting from the transmission of essence among the five Zang organs from distant to near points. Thus, upon palpation, the pulse was uneven and exhibited Dai Mai (Intermittent Pulse). Unevenness means blood does not reside in its proper place; Dai Mai indicates intermittent beating, surging together, sometimes restless and sometimes large. This is because two collateral vessels are severed, rendering it untreatable and fatal. The accompanying chills and fever indicate severe depletion of Yuan Qi (Primal Qi). Severe depletion leads to ruin of the physical form; when the form is ruined, Moxibustion, Bian Stone therapy, and toxic drugs are contraindicated. Before I visited to diagnose, the Grand Physician of Qi had already treated Shanfu by moxa-ing the Foot Shaoyang pulse opening and administering Banxia Wan (Pinellia Pill). The patient immediately suffered diarrhea and abdominal emptiness. Then, the Shaoyin pulse was moxa-ed, which damaged the Gan Gang (Liver's Yang/Strength) deeply. Such repeated damage depleted the patient's Qi, thereby aggravating the chills and fever. The reason for delirium after three days is that a collateral of the Liver connects and severs at the Yangming Meridian below the breast; thus, the collateral severance opens the Yangming Meridian, and injury to the Yangming Meridian causes delirium and running. Death after five days occurs because the Liver and Heart are separated by five fen (units of measurement); thus, it is said that after five days, the essence is exhausted, and exhaustion leads to death.