伤寒脉濡而弱。阳气不足。不可下之。下之则心下痞。津液内竭。咽燥鼻干也。
伤寒脉浮而紧。浮则为风。紧则为寒。风则伤荣。寒则伤卫。荣卫俱病。骨节烦疼。当
发其汗。而不可下也。
伤寒脉浮濡弱。不得发汗。无阳故也。阳亡虚尽中弱涩者。不可下。
伤寒结胸证。其脉浮大不可下。下之即死矣。
太阳与阳明合病。喘促胸满。不可下。
太阳与少阳合病。心下坚。颈项强而眩。不可下也。
夫四逆病厥者。不可下也。
夫病欲吐者。不可下也。
夫病有外证未解。不可下之。下之为逆也。
夫病发于阳而反下之。热入于咽。作结胸也。
太阴病其人腹满吐食。不可下。下之益甚。
少阳病当心下坚满。不可下。下之。后利不止者死。
少阴病其人虽里和。其病恶寒者。宜灸之。
少阴病吐利。手足逆而发热。脉不足者。灸其少阴。
夫吐下手足厥无脉者。当其厥阴灸之。不温及微喘者死。
伤寒六七日。脉数。手足厥。烦躁不已。灸厥阴。不顺者死。
凡微数之脉不可灸。因热为邪。必致烦逆。内有损骨伤筋血枯之患。脉当以汗解。反以
灸之。邪无所去。因火而盛。病当必重。此为逆治。若欲解者。当发其汗而解也。
In Shaoyang disease, the pulse is soft and weak. This indicates insufficiency of Yang Qi. Purging methods must not be used. If purging is mistakenly applied, it will result in epigastric fullness (pi), exhaustion of body fluids internally, dry throat, and dry nose.
In Shanghan (Cold Damage) disease, the pulse is floating and tight. Floating indicates Wind pathogen; tight indicates Cold pathogen. Wind damages Ying Qi (Nutritive Qi), and Cold damages Wei Qi (Defensive Qi). When both Ying and Wei are diseased, there is vexing pain in the bone joints. Sweating methods should be employed to release the exterior, but purging methods must not be used.
In Shanghan disease, if the pulse is floating, soft, and weak, sweating methods cannot be used because there is a lack of Yang Qi. If Yang Qi is lost and deficiency is extreme, with a middle-weak and choppy pulse, purging must not be used.
In the Jie Xiong syndrome (Chest Binding) of Shanghan, where the pulse is floating and large, purging must not be used. If purging is applied, death will ensue.
When Taiyang and Yangming meridians have combined disease, presenting with panting and chest fullness, purging must not be used.
When Taiyang and Shaoyang meridians have combined disease, presenting with hardness below the heart, stiffness of the neck and nape, and dizziness, purging must not be used.
In Si Ni disease (Four Coldness) presenting with Jue (extremity coldness), purging must not be used.
If a patient desires to vomit, purging must not be used.
If external signs of disease have not yet resolved, purging must not be used. Applying purging in this context is contrary to treatment principles (Ni).
If disease originates in Yang stages and purging is mistakenly applied, heat enters the throat, forming Jie Xiong (Chest Binding).
In Taiyin disease, where the patient has abdominal fullness and vomiting of food, purging must not be used. Purging will exacerbate the condition.
In Shaoyang disease, where there is hardness and fullness at the center below the heart, purging must not be used. If purging is applied and followed by unceasing diarrhea, death will occur.
In Shaoyin disease, although the interior is harmonious, if the patient suffers from aversion to cold, moxibustion is appropriate.
In Shaoyin disease presenting with vomiting and diarrhea, cold extremities, fever, and an insufficient pulse, moxibustion should be applied to the Shaoyin channels.
If vomiting is followed by cold extremities and absence of pulse, moxibustion should be applied to the Jueyin channels. If the extremities do not warm up or slight panting occurs, death will ensue.
In Shanghan disease lasting six or seven days, if the pulse is rapid, extremities are cold, and restlessness persists, moxibustion should be applied to the Jueyin channels. If the condition does not improve or worsens, death will ensue.
Moxibustion must not be used when the pulse is fine and rapid. Since heat is the pathogenic factor, applying moxibustion will inevitably cause vexation and rebellion. It may lead to internal damage to bones and sinews, and depletion of blood. Such conditions should be resolved through sweating. If moxibustion is mistakenly applied instead, the pathogen has no exit, and becomes exacerbated by fire, causing the disease to become severe. This is contrary treatment. To resolve such cases, sweating methods should be used.
After diarrhea ceases, if there is pain in the lower part (lower abdomen/anus), warming methods should be employed. Fried Zhi Shi (Immature Bitter Orange) or heated salt for hot compresses are suitable.