Library

To treat diseases, one must first investigate their origin and observe the pathogenesis. If the Five Zang organs are not yet deficient, the Six Fu organs are not yet exhausted, the blood vessels are not yet chaotic, and the spirit is not yet scattered, taking medicine will surely lead to recovery. If the disease has already formed, half recovery may be achieved. If the pathological momentum has passed and life is in danger, it will be difficult to preserve.

The method of pulse diagnosis should usually be performed at dawn, when Yin Qi has not yet moved, Yang Qi has not yet dispersed, food and drink have not been taken, the meridians are not yet full, the collaterals are harmonious and balanced, and the Qi and Blood are not yet chaotic. By selecting the pulse, one can know its reversal or smoothness; if it is not the appropriate time, diagnosis should not be conducted. Deeply observing the Three Regions and Nine Probes (Sanbu Jiuhou) and explaining them clearly: ancient skilled physicians were categorized as follows: the superior physician treats the state (harmonizing body and environment), the intermediate physician treats the person, and the inferior physician treats the disease. It is also said: the superior physician diagnoses by listening to sounds, the intermediate physician by observing complexion, and the inferior physician by palpating the pulse. Furthermore: the superior physician treats diseases before they occur, the intermediate physician treats diseases about to occur, and the inferior physician treats diseases that have already occurred. If one does not apply heart and intent, leading to confusion in matters, the patient will be difficult to save.

What are the Three Regions? They are Cun, Guan, and Chi. The upper region corresponds to Heaven and governs the Lung; the middle region corresponds to Humanity and governs the Spleen; the lower region corresponds to Earth and governs the Kidney. What are the Nine Probes? Each region has three probes, totaling nine. The upper region's Heaven probe refers to the arteries on both temples, governing Qi of the head corners; the upper region's Earth probe refers to the arteries on both cheeks, governing Qi of the mouth and teeth; the upper region's Human probe refers to the artery in front of the ear, governing Qi of the ears and eyes. The middle region's Heaven probe is the Hand Taiyin Lung Meridian, governing Lung Qi; the middle region's Earth probe is the Hand Yangming Large Intestine Meridian, governing Chest Qi; the middle region's Human probe is the Hand Shaoyin Heart Meridian, governing Heart Qi. The lower region's Heaven probe is the Foot Jueyin Liver Meridian, governing Liver Qi; the lower region's Earth probe is the Foot Shaoyin Kidney Meridian, governing Kidney Qi; the lower region's Human probe is the Foot Taiyin Spleen Meridian, governing Spleen Qi. Together, these form the Nine Probes.

If the physique is robust but the pulse is thin, with shortness of breath insufficient for respiration, this is a death sign. If the physique is emaciated but the pulse is large, with excessive Qi in the chest, this is a death sign. If the physique and Qi are in harmony, there is life. If the pulse is irregular and disordered, there is disease. If all Nine Probes are discordant, this is a death sign. Ignorant physicians who do not understand the Three Regions and Nine Probes nor the meridians of the four seasons, may use decoctions incorrectly or acupuncture improperly. Following wrong prescriptions to treat disease only adds other ailments, leading to demise. Alas, among the people, half die unjustly; one might say there are no good physicians in the world. Regarding the explanation of classics: Earth, Water, Fire, and Wind combine to form humans. If Fire Qi is imbalanced, the whole body feels steaming hot; if Wind Qi is imbalanced, the whole body becomes stiff and rigid, with all pores closed; if Water Qi is imbalanced, the body swells, with fullness and coarse breathing; if Earth Qi is imbalanced, the limbs cannot move, and speech lacks voice. If Fire departs, the body becomes cold; if Wind stops, Qi ceases; if Water dries up, there is no blood; if Earth scatters, the body cracks. However, ignorant physicians do not contemplate the principles of pulse diagnosis but instead treat symptoms directly, causing the Five Elements within the Zang organs to mutually overcome each other, like a blazing fire with added oil. One must be extremely cautious. When the Four Qi are virtuous and the Four Spirits are harmonious, if even one Qi is imbalanced, hundreds of illnesses arise. If the Four Spirits act abnormally, 404 illnesses may erupt simultaneously. It is also said: 101 illnesses may heal spontaneously without treatment; 101 illnesses require treatment to heal; 101 illnesses are difficult to treat and hard to cure; 101 illnesses represent true death and cannot be treated.

Zhang Zhongjing said: To treat various diseases, one should first use decoctions to cleanse the Five Zang and Six Fu organs, open the meridians, regulate Yin and Yang, break up evil Qi, moisten dryness, soothe the skin, and benefit Qi and Blood. Water can purify all things, hence decoctions are used. If limb diseases persist for a long time and wind-cold activates, powders (San) should be used next. Powders can expel evil Qi; for wind-damp bi syndrome where pathogens move between interior and exterior without fixed location, powders can pacify them. Pills (Wan) should be used subsequently; pills can expel wind-cold, break accumulations, dissolve hardness, promote appetite, and harmonize Ying and Wei. Those who can integrate these methods are called Superior Experts, hence it is said "physicians rely on intention." It is also said: Forcing sweating when not needed depletes fluids and leads to death from exhaustion. Failing to induce sweating when needed causes pore closure, leading to death from suffocation. Forcing purgation when not needed causes intestinal opening and uncontrollable diarrhea, leading to death. Failing to purge when needed causes internal restlessness, distension, irritability, and edema, leading to death. Applying moxibustion when not needed allows fire evil to enter the abdomen, disturbing the Zang organs and worsening agitation, leading to death. Failing to apply moxibustion when needed causes cold stagnation to solidify over time, with Qi rushing to the heart and nowhere to dissipate, leading to death from severe illness.

The Yellow Emperor asked: How does excessive evil diffuse? Qibo replied: Correct evil invades from outside into the interior without a fixed residence. When it diffuses into the Zang organs, it has no fixed location, travels with Ying and Wei, and flies with the Hun and Po, causing restless sleep and frequent dreaming. When Qi diffuses into the Fu organs, there is excess externally and deficiency internally; when Qi diffuses into the Zang organs, there is excess internally and deficiency externally. Asked: Do excess and deficiency have visible forms? Replied: Yin excess dreams of crossing large waters with fear; Yang excess dreams of treading on great fires and burning; Yin and Yang both excess dream of killing and destroying each other; Upper excess dreams of flying; Lower excess dreams of falling. Being very full dreams of walking; being very hungry dreams of taking/receiving. Liver Qi excess dreams of anger; Lung Qi excess dreams of fear and crying; Heart Qi excess dreams of laughter and terror; Spleen Qi excess dreams of singing/music, heavy body, and inability to lift limbs; Kidney Qi excess dreams of waist and spine separating. These twelve Excess conditions, upon arrival, are treated with draining methods for immediate relief. If rebellious Qi lodges in the Heart, one dreams of hills and smoke/fire; in the Lung, dreams of flying and seeing metal/iron objects; in the Liver, dreams of forests and trees; in the Spleen, dreams of hills and marshes, broken houses, wind, and rain; in the Kidney, dreams of standing by abysses or being submerged in water; in the Bladder, dreams of wandering; in the Stomach, dreams of eating/drinking; in the Large Intestine, dreams of fields; in the Small Intestine, dreams of towns and streets; in the Gallbladder, dreams of fighting lawsuits or self-mutilation; in the genitalia, dreams of sexual intercourse or fighting; in the neck, dreams of beheading; in the hips, dreams of walking but unable to advance, or living in ditches/traps; in the thighs, dreams of bowing/kneeling in etiquette; in the Bao (uterus/bladder), dreams of urination/feces. These fifteen Deficiency conditions, upon arrival, are treated with tonifying methods for immediate relief.

Those skilled in diagnosis should deeply ponder these meanings to achieve perfection.

The Records of the Grand Historian states: There are six types of diseases that are untreatable: 1. Arrogance and irrationality; 2. Valuing wealth over health; 3. Inability to adapt diet and clothing; 4. Chaos of Yin/Yang and instability of Zang Qi; 5. Emaciation preventing medication intake; 6. Believing in witchcraft rather than medicine. If vital signs remain, appearance unchanged, disease has not entered the couli (skin and hair follicles), needle and drug treatments are timely, and the patient can regulate themselves and trust a good physician, the disease will surely heal.