郭台尹年来似有劳怯意。胸腹不舒。治之罔效。茫不识病之所存也。闻仆治病。先议后药。姑请诊焉。见
其精神言动。俱如平人。但面色痿黄。有蟹爪纹路。而得五虚脉应之。因窃疑而
诘之曰。足下多怒乎。善忘乎。口燥乎。便秘乎。胸紧乎。胁胀
乎。腹疼乎。渠曰。种种皆然。此何病也。余曰。外证尚未显。然内形已具。将来血蛊之候也。曰。何以
知之。曰。合色与脉而知之也。夫血之充周于身也。荣华先见于面。今色黯不华。既无旧
恙。又匪新 。其所以憔悴不荣者何在。且壮盛之年。而脉见细损。宜一损皮毛。二损肌肉。三损筋骨。不起
于床矣。乃皮毛肌肉步履如故。其所以微弱不健者又何居。是敢直断为血蛊。腹虽未大。而腹大之情形已着。
如瓜瓠然。其日趋于长也易易耳。明哲可不见机于早耶。曰。血蛊乃妇人之病。男子亦有之乎。曰。
男子病此者甚多。而东方沿海一带。比他处更多。医不识所繇来。漫用治气治水之法尝试。夭枉不可胜计。
总缘不究病情耳。所以然者。以东海擅鱼盐之饶。鱼者甘美之味。多食使人热中。盐者咸苦之味。其性偏于
走血。血为阴象。初与热合。不觉其病。日久月增。中焦冲和之气。亦积渐而化为热矣。气热则结。
而血始不流矣。于是气居血中。血裹气外。一似妇女受孕者然。至弥月时。腹如抱瓮矣。但孕系于胞中。如
熟果自落。虫蟠于腹内。如负赘难疗。又不可同语也。究而论之。岂有东方之水土致
然。凡五方之因膏粱浓味椒姜桂糈成热中者。除痈疽消渴等症。不常见外。至胀满一症。人人无不有之。但
微则旋胀旋消。甚则胀久不消而成虫耳。倘能见微知着。宁至相寻于覆辙耶。要知
人之有身。执中央以运四旁者也。今中央反竭四旁以奉其锢。尚有精华发见于色脉间乎。此所以脉细皮寒。
少食多汗。 羸之状。不一而足也。余言当不谬。请自揆之。月余病成。竟不能用。半载而逝。
胡卣臣先生曰。议病开此一法门。后有学人。不可及矣。
Mr. Guo, the Prefectural Administrator, has shown signs of exhaustion and deficiency in recent years. He experiences discomfort in the chest and abdomen, yet treatments have been ineffective, leaving him bewildered about the location of his illness. Hearing that I prioritize analyzing the condition before prescribing medication, he briefly requested a pulse diagnosis. Observing his spirit, speech, and movements, they appeared normal like those of a healthy person. However, his complexion was sallow (yellowish and dull) with crab-claw-like patterns on the skin, and his pulse corresponded to the "Five Deficiencies" (Wu Xu, indicating severe depletion of Qi and Blood). Suspecting this, I privately questioned him, asking: "Do you often feel angry? Are you forgetful? Do you have dry mouth? Is your stool constipated? Do you feel tightness in the chest? Distension in the hypochondrium? Abdominal pain?" He replied, "All these symptoms are present. What disease is this?" I said, "The external manifestations are not yet fully apparent, but the internal pathological foundation is already established; it will eventually develop into Blood Gu (Blood Parasite/Abdominal Mass)." He asked, "How do you know?" I said, "By combining the observation of complexion and pulse. When blood is abundant throughout the body, its luster first appears on the face. Now, your complexion is dark and lacks luster. Since there are no old ailments nor new external invasions, where does the cause of your emaciation and lack of nourishment lie? Moreover, at the prime of life, a fine and damaged pulse should theoretically lead to progressive deterioration—first affecting the skin and hair, then muscles, then sinews and bones—resulting in bedridden state. Yet, your skin, muscles, and gait remain unchanged. So, what causes your weakness and lack of robustness? Therefore, I dare to diagnose this as Blood Gu. Although the abdomen is not yet significantly distended, the pattern of abdominal enlargement is already evident, resembling a gourd, and its tendency to grow daily is easily foreseeable. Would not a wise person notice the signs early?" He asked, "Is Blood Gu a disease exclusive to women? Do men get it too?" I said, "Many men suffer from this, especially in the coastal areas of the East, more so than elsewhere. Physicians, unaware of the etiology, casually try methods for treating Qi stagnation or Water retention, resulting in countless premature deaths. This is ultimately due to failing to investigate the nature of the illness. The reason is that the East Sea region is rich in fish and salt. Fish tastes sweet and delicious; excessive consumption causes heat to accumulate in the middle Jiao. Salt tastes salty and bitter; its nature tends to move the Blood. Blood belongs to Yin. Initially combining with Heat, the pathology is unnoticed. Over time, the harmonious Qi of the Middle Jiao gradually transforms into Heat. Qi Heat leads to coagulation, and Blood begins to stagnate. Thus, Qi resides within the Blood, and Blood wraps around the Qi externally, resembling a pregnant woman. By the ninth month, the abdomen becomes large like an inverted urn. However, pregnancy is located in the uterus, like a ripe fruit falling naturally, which is manageable; whereas parasites coiling in the abdomen are like carrying a heavy burden, difficult to treat, and cannot be compared to pregnancy. In conclusion, is this caused by the water and soil of the East? In fact, people in all directions who consume rich foods, fats, sweets, pepper, ginger, cinnamon, and refined grains, causing heat accumulation in the middle, except for conditions like carbuncles and wasting-thirst which are less common, almost everyone suffers from distension. Mild cases resolve quickly; severe cases persist and transform into 'parasites' (pathological masses). If one could perceive the significant from the minute, would one not avoid repeating the same mistakes? One must understand that the human body relies on the Center (Spleen/Stomach) to govern the four peripheries. Now, the Center is exhausted, serving to nourish the entrenched pathogenic factors, leaving no essence to manifest in the complexion and pulse. This explains why there are fine pulses, cold skin, poor appetite, profuse sweating, and various signs of emaciation. My words are likely correct; please consider them yourself." More than a month later, the disease became established, and treatment proved futile. He passed away half a year later. Mr. Hu Youchen remarked, "This analysis of disease opens a new methodological door; future scholars will find it hard to surpass."