太阳病恶寒而发热。自汗出而反不恶寒热。关上脉细数者。不可吐之。
少阴病其人欲食。入则吐。心中温温欲吐。复不能吐。手足寒。脉弦迟。干呕。此膈上
有寒。不可吐之。当宜温也。
诸四逆者。不可吐之。
诸虚羸。不可吐之。
新产者。不可吐之。
病者恶寒而不欲近衣。不可吐之。
大法。秋宜下。凡可汤胜丸。中病便止。不必尽之。
少阴病得之口燥咽干。宜急下之。
伤寒病患腹满。不大便者。亦然。
伤寒下痢。三部脉皆和。按其心下坚。宜急下之。
伤寒下痢。脉迟滑者实也。其痢未得便止。当更宜下之。
伤寒病腹中满痛者为实。当宜下之。
伤寒脉数而滑者。有宿食。当下之则愈。
伤寒六七日。目中瞳子不明。无外证。大便难。微热者。此为实。宜急下之。
太阳病七八日。脉微浮者。其人发狂。此下焦有热。小腹当坚而满。小便自利。下血乃
愈。瘀热在里故也。宜下之。
阳明病但头汗出。其身无汗。小便不利。渴汁水浆。此为瘀热在里。身必发黄。宜急下
之。
伤寒有热。而小腹满者。小便反利。为有蓄血。当宜下之。
伤寒病五六日。不大便。绕脐痛。烦躁汗出者。此为有结。汗出后则暂解。日晡则复发
脉实者。当宜下之。
伤寒七八日。身黄如橘。小便不利。其腹微满者。宜下之。
阳明病其人多汗。津液越出。胃中有热。大便必坚。宜下之。
伤寒大下后。六七日不大便。烦热不解。腹满如痛者。此有宿食。宜下之。
伤寒病小便不利。大便乍难乍易。时有微热。不能卧。此胃内有结燥故也。宜下之。
Taiyang disease (disease of the Taiyang channel) presents with aversion to cold and fever. If the patient has spontaneous sweating and, conversely, no longer feels aversion to cold or heat, and the pulse at the Guan position is fine and rapid, emesis should not be used.
In Shaoyin disease (disease of the Shaoyin channel), if the patient desires food but vomits upon eating, feels a sense of nausea in the heart region yet cannot vomit, has cold hands and feet, a wiry and slow pulse, and dry heaving, this indicates cold above the diaphragm. Emesis should not be used; instead, warming methods should be employed.
For all cases involving four-inverse (cold extremities), emesis should not be used.
For all cases of deficiency and emaciation, emesis should not be used.
For women who have recently given birth, emesis should not be used.
If the patient is afraid of cold but does not desire to wear clothes, emesis should not be used.
The general principle is: purgation is suitable in autumn. Decoctions are superior to pills. Stop administering medicine once the disease is addressed; there is no need to finish the entire dose.
When Shaoyin disease manifests with dry mouth and throat, urgent purgation is indicated.
For patients with Shanghan (cold damage) presenting with abdominal fullness and constipation, urgent purgation is also indicated.
In Shanghan with diarrhea, if the pulses in the three positions are harmonious but pressure on the epigastrium reveals hardness, urgent purgation is indicated.
In Shanghan with diarrhea, if the pulse is slow and slippery, it indicates excess. The dysentery will not stop on its own, so further purgation is appropriate.
In Shanghan, abdominal fullness and pain indicate excess, and purgation is indicated.
In Shanghan, a rapid and slippery pulse indicates retained food; purgation will lead to recovery.
In Shanghan, after six or seven days, if the eyes fail to see clearly, there are no exterior signs, defecation is difficult, and there is slight fever, this indicates excess. Urgent purgation is indicated.
In Taiyang disease, after seven or eight days, if the pulse is slightly floating and the patient becomes manic, this is due to heat in the lower jiao (lower burner). The lower abdomen should be hard and full, and urination is normal. Purging blood stasis will lead to recovery because blood-heat is trapped inside. Purgation is indicated.
In Yangming disease (disease of the Yangming channel), if only the head sweats while the body remains dry, urination is difficult, and there is thirst for water and fluids, this indicates blood-heat trapped inside, leading to jaundice. Urgent purgation is indicated.
In Shanghan with fever and lower abdominal fullness, if urination is surprisingly free, it indicates retained blood. Purgation is indicated.
In Shanghan, after five or six days, if there is constipation, periumbilical pain, irritability, and sweating, this indicates internal binding of dry stool. Symptoms may temporarily resolve after sweating but recur in the late afternoon. If the pulse is solid, purgation is indicated.
In Shanghan, after seven or eight days, if the body is yellow like an orange peel, urination is difficult, and the abdomen is slightly full, purgation is indicated.
In Yangming disease, if the patient sweats excessively, causing fluid loss and stomach heat, the stool will inevitably become hard. Purgation is indicated.
After severe purgation in Shanghan, if there is constipation for six or seven days, unresolved irritability and heat, and abdominal fullness resembling pain, this indicates retained food. Purgation is indicated.
In Shanghan, if urination is difficult, defecation alternates between difficulty and ease, there is occasional slight fever, and the patient cannot lie down, this is due to dry stool bound in the stomach/intestines. Purgation is indicated.