诸暴强直支痛。 戾里急筋缩。皆属于风。厥阴风木。乃肝胆之气也。
暴。卒也。强直。坚劲也。支痛。支。持也。谓坚固支持。筋挛不柔而痛也。 。缩也
戾
乖戾也。谓筋缩里急。乖戾失常而病也。然燥金主于紧敛。短缩劲切。风木为病。反见燥
金之化者。由亢则害。承乃制也。况风能胜湿而为燥也。风病热甚而成筋 者。燥之甚也。
故甚者皆兼于燥也。
诸病喘呕吐酸。暴注下迫。转筋。小便混浊。腹胀大鼓之如鼓。痈疽疡疹。瘤气结核。
吐下
霍乱。瞀郁肿胀。鼻窒鼽衄。血溢血泄。淋闭。身热恶寒战栗。惊惑悲笑。谵妄。衄 血汗
皆属于热。少阴君火主之。乃真心小肠之气也。
喘。火气甚而为夏热。衰为冬寒。故病寒则气衰而息微。病热则气盛而息粗而为喘也。
呕。
胃膈热甚则为呕。火气炎上之象也。吐酸者。肝木之味也。由火盛制金。不能平木。而肝木
自甚。故为酸也。如饮食热则易于酸矣。或言吐酸为寒者误也。且如酒之味苦而辛热。能养
心火。故饮之则令人色赤气粗。脉洪大而数。语涩谵妄。歌唱悲笑。喜怒如狂。冒昧健忘。
烦渴呕吐。皆热症也。其吐必酸。为热明矣。况热则五味皆浓。经曰。在地为化。化生五味
故五味热食。则味皆浓也。是以肝热则口酸。心热则口苦。脾热则口甘。肺热则口辛。肾
热则口咸。或口淡者胃热也。胃属土。土为万物之母。胃为五脏之本。故伤生冷坚硬之物。
则令人噫醋吞酸。犹寒伤皮毛。能令阳气壅滞而为病热也。俗医妄以为冷。主温和脾胃而复
愈
者。犹伤寒用麻黄桂枝药发表。令汗出而愈也。若久吐酸不已。则不宜温之。当用寒药以下
之。后以凉药调之。所以中酸而不宜食油腻之物者。皆因能令气之壅塞也。暴注。卒泻也。
肠胃热甚。而传化失常。火性疾速故也。下迫。里急后重也。火能燥物。能令下焦急迫也。
转筋。热燥于筋而筋转也。或言转筋为寒者误也。所谓转者动也。阳动阴静。热症明矣。霍
乱吐泻之人。必有转筋之症。大法吐泻烦渴为热。不渴为寒。霍乱转筋而不渴者。未之有也
或曰。以温汤渍之则愈。以冷水沃之则剧。何也。盖温汤能令腠理开发。热气消散。转筋
即止。冷水能令腠理闭密。热气郁塞。转筋不止。世俗见温汤渍之而愈。妄疑为寒也。小便
混浊。天气寒则水清洁。天气热则水混浊。如清水为汤。则自混浊也。腹胀大鼓之如鼓。气
为阳。热甚则气盛。故腹胀满也。痈。浅而大也。经曰。热盛血则为痈脓也。疽。深而恶也
疡。有头小疮也。疹。浮小隐疹也。瘤气。赤瘤丹 。热胜气也。结核。热气郁结坚硬。
如果中核也。不必溃发。但令热气散。自然消也。吐下霍乱。三焦为水谷传化之道路。热气
甚则传化失常。而吐泻霍乱也。或言吐泻为寒者误矣。大法吐泻烦渴为热。不渴为寒。或热
吐泻初得之。亦有不渴者。若止则亡液而后必渴。或寒不渴。若亡津液过多。则亦燥而渴也
大抵完谷不化而色白。吐利腥秽。澄澈清冷。小便清白不涩。身凉不渴。脉沉细而迟者。
寒症也。如小儿病热吐利。乳未消而色尚白。不可便言为寒。当以饮食药物之色别之。若谷
虽不化。而色变非白。小便赤黄。吐利烦渴。脉洪大而数者。热症也。盖泻白为寒。余皆为
热。泻白者。肺金之色也。由寒水甚而制火。不能平金。肺金自甚。故色白也。泻青者。肝
木之色。也由火盛制。金不能平木。肝木自甚。故色青也。如伤寒少阴下利清水。色纯青
仲景以大承气汤下之。为热明矣。泻黄者。脾土之色也。由火甚水衰。脾土自旺。故色黄也
泻红者。心火之色也。泻黑者。肾水之色也。由亢则害。承乃制。火热过极。反兼水化制
之。故色黑也。下痢色黑者即死。又如疮疖皆属火热。其本一也。其标则有五焉。以其在皮
肤之分。属肺金。故出白脓。以其在血脉之分。属心火。故为血疖。以其在肌肉之分。属脾
土。故出黄脓。以其在筋之分。属肝木。故其脓见苍色。深至骨。属肾水。故紫黑血也。若
以下痢黑者为寒。然则疮疖之出紫黑血者。亦为冷欤。又如赤痢。本湿热之相兼也。举世皆
言赤痢为热。白痢为寒者。误之久矣。殊不知阴阳之道。犹权衡也。一高则必一下。一盛则
必一衰。故阳盛者阴必衰。阴盛者阳必衰。自然之理也。岂有阴阳二气。俱盛于肠胃。而同
为赤白之痢乎。夫痢何也。盖因六七月之交。世之谷肉果菜。饮啖无度。湿热大甚。人受之
感其毒瓦斯于肠胃之间。而为下脓血赤白也。治痢之法。当以苦寒之药治之。如宋朝钱仲阳
处香连丸以治小儿之痢。深得玄理。木香苦温。黄连苦寒。苦能燥湿。寒能胜热。温能开
发肠胃之郁结。愈痢多矣。今世俗医。但以辛热姜桂之药。以治诸痢。病之微者。能令肠胃
开通。郁结消散。偶或一愈。病之甚者。怫热不开。痢疾转甚。轻则为小溲不通水肿之疾。
重则为瞀乱之病而死矣。深可叹哉。又如妇人赤白带下之病。同乎痢也。盖人有十二正经脉
有奇经八脉。带脉者。奇经之一也。起于季胁。回身一周。如束带然。妇人下焦湿热太甚
津液涌溢。从带脉淋沥而下也。举世皆言白带为寒者。亦误矣。凡病此者。必头目昏眩。
口苦舌干。咽嗌不利。小便赤涩。大便闭滞。脉实而数。皆热症也。治带下之法。亦以辛苦
寒药为主。不可骤用燥药及热药。以损人生命也。又如酒蛊而大便濡泻者。亦中湿热也。
或水肿。或发黄。皆湿热也。呜呼。人即有形。不能无病。有生不能无死。然医者但当按法
治之。若标本不明。阴阳不审。误投汤药。实实虚虚而死者。是谁之过欤。故曰。世无良医
枉死者半。诚不诬矣。瞀。神昏而气浊也。郁。热极则腠理郁结。而气道不通也。肿胀。
阳热太甚。则肿满 胀也。如六月庶物隆盛。肿胀之象。明可见矣。鼻窒。谓鼻塞也。伤风
寒于腠理。而为鼻窒。寒能收敛。阳气不通畅也。人侧卧。则下窍通利。上窍反塞者。谓阳
之经。左右相交于鼻也。鼽。鼻出清涕也。衄。鼻出血也。血溢。血出于上窍也。血泄。血
出于下窍也。淋。热客膀胱。小便涩痛也。或曰小便涩而不通为热。遗溲不禁为冷。岂知热
甚客于肾部。干于足厥阴之经。廷孔郁结极甚。气液不能宣通。故痿痹神无所用。津液渗入
膀胱而为溲也。如伤寒少阴热极则遗溲。其理明矣。世传众方。又有冷淋之说。可笑也已。
及观其所治之方。还用榆皮、瞿麦苦寒之药。其说虽妄。其方乃是。由不知造化变通之理。
宜乎认是而作非也。学不明而欲为医。难矣哉。闭。大便涩滞也。由火盛制金。不能平木。
肝木生风。风能胜湿。湿能耗液故也。身热恶寒。邪热在表而反恶寒也。故仲景治伤寒之法
以麻黄汤汗之。或曰寒在皮肤。则热在骨髓。热在皮肤。则寒在骨髓。此说非也。战栗。
谓火热过极。反兼水化制之。故战栗而动摇也。伤寒日深。大汗欲出。必先战栗。热极故也
人恐惧而战栗者。恐则伤肾。水衰故也。惊。心卒动而不宁也。惑。疑惑而志不一也。
悲
谓心血热甚。则凌肺金。金不受制。故发悲哭也。悲哭而涕泪俱出者。如火炼金。反化为
水也。是以肝热盛则出泣。心热盛则出汗。脾热盛则出涎。肺热盛则出涕。肾热盛则出唾。
犹夏热太盛。则林木流津也。笑。心火热甚。喜志发也。或以轻手扰人胁肋 腋。令痒而笑
者。扰乱动摇。火之化也。谵。多言也。心热神乱。则语言妄出也。妄。狂妄也。心热神昏
则目有所见也。衄 血汗。谓鼻出黑血也。
Any sudden onset of limb stiffness, pain in the limbs, as well as tendon cramping and contraction, all belong to Wind pathogen. Jueyin Wind-Wood corresponds to the Qi of the Liver and Gallbladder.
"Bao" (sudden) means abrupt. "Qiangzhi" (stiffness and rigidity) refers to the body being stiff and tense. "Zhitong" (supporting pain), "Zhi" means support, referring to the pain caused by tendons and bones being rigidly supported but unable to relax, resulting in spasms and pain. "Li" (deviation/perversion) means abnormality, referring to the dysfunction caused by tendon contraction and abdominal urgency leading to loss of normal physiological function. However, Dryness-Metal governs tightening and contraction, manifesting as shortening and tension. When a Wind-Wood disease manifests with the transformation characteristics of Dryness-Metal, it is due to the principle that "excess leads to harm, and control follows." Moreover, Wind can overcome Dampness and lead to Dryness. If a Wind disease becomes severe with heat, causing tendon contraction, this indicates extreme Dryness. Therefore, severe conditions often involve concurrent Dryness.
Various symptoms such as panting, vomiting, regurgitation of sour fluid, sudden acute diarrhea with tenesmus, muscle twitching/cramps, turbid urine, abdominal distension sounding like a drum upon percussion, carbuncles, ulcers, rashes, tumors, scrofula, tuberculosis-like nodules, cholera with vomiting and diarrhea, mental confusion and depression with swelling, nasal obstruction, rhinorrhea or epistaxis, blood extravasation or hemorrhage, strangury and urinary retention, fever with aversion to cold and shivering, fright, confusion, sadness, inappropriate laughter, delirium, mania, epistaxis, and hematohidrosis all belong to Heat pathogen, governed by Shaoyin Ministerial Fire, corresponding to the Qi of the True Heart and Small Intestine.
"Panting" results from excessive Fire Qi. Abundant Fire Qi constitutes summer heat; deficient Fire Qi constitutes winter cold. Thus, in Cold diseases, Qi is weak and respiration is faint; in Heat diseases, Qi is vigorous and respiration is coarse, leading to panting.
"Vomiting" results from excessive heat in the Stomach and Diaphragm, which is a manifestation of Fire flaring upward.
"Regurgitation of sour fluid": Sour flavor belongs to Liver-Wood. Due to excessive Fire controlling Lung-Metal, preventing Metal from balancing Wood, Liver-Wood becomes hyperactive, thus producing sourness. Just as food becomes sour when heated. Some claim sour regurgitation is due to Cold, which is erroneous. For example, wine has a bitter taste and acrid-hot nature, nourishing Heart Fire. Drinking it causes ruddy complexion, coarse breath, surging and rapid pulse, slurred speech, delirium, singing, crying, laughing, manic anger, dizziness, forgetfulness, irritability, thirst, and vomiting—all are Heat syndromes. The vomit is inevitably sour, clearly indicating Heat. Furthermore, Heat intensifies the five flavors. The Classic states: "On earth it transforms, transforming into the five flavors." Thus, hot foods have intense flavors. Therefore, Liver Heat causes sour mouth, Heart Heat causes bitter mouth, Spleen Heat causes sweet mouth, Lung Heat causes pungent mouth, Kidney Heat causes salty mouth. A bland taste indicates Stomach Heat. The Stomach belongs to Earth, Mother of all things, and is the root of the Five Zang organs. Injuring oneself with raw, cold, or hard foods causes belching and acid regurgitation, similar to how Cold damaging the skin/hair causes Yang Qi stagnation turning into Heat. Folk doctors mistakenly treat this as Cold, using warming herbs for the Spleen/Stomach, akin to using Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) to induce sweat in Taiyang Cold damage. However, chronic acid regurgitation should not be treated with warmth; instead, cold purgatives should be used to drain it, followed by cooling herbs to regulate. Patients with acid regurgitation should avoid greasy food because it causes Qi stagnation.
"Baozhu" (sudden pouring diarrhea) refers to sudden diarrhea. This is due to excessive heat in the intestines and stomach disrupting transmission and transformation, as Fire nature is swift.
"Xiapo" (tenesmus/pressure below) refers to abdominal urgency and heavy sensation in the rectum. Fire dries substances, causing urgency in the lower jiao.
"Zhuanjin" (tendon twitching/cramp) occurs when heat dries the tendons, causing them to twist. Claiming tendon cramps are due to Cold is wrong. "Zhuan" means movement; Yang moves, Yin is still, clearly indicating a Heat syndrome. Cholera patients with vomiting and diarrhea invariably have tendon cramps. The general rule is: vomiting/diarrhea with irritability and thirst indicates Heat; without thirst indicates Cold. There is no case of cholera with tendon cramps and no thirst.
Some say: "Soaking in warm water cures it; washing with cold water worsens it. Why?" Warm water opens the couli (pores), dissipating heat and stopping cramps. Cold water closes the couli, trapping heat and continuing cramps. Laypeople see improvement with warm water and wrongly suspect Cold.
"Turbid urine": Cold weather makes water clear; hot weather makes it turbid, just as clear water turns turbid when boiled.
"Abdominal distension, drum-like": Qi belongs to Yang. Excessive heat makes Qi vigorous, causing abdominal fullness.
"Yong" (carbuncle): Superficial and large abscess. The Classic says: "Excessive heat rots flesh into pus."
"Ju" (deep abscess): Deep and malignant.
"Yang" (ulcer): Small pustule with a head.
"Zhen" (rash): Floating small hidden rash.
"Liuqi" (tumor qi): Red tumor or erysipelas, indicating heat overcoming Qi.
"Jiehe" (scrofula/nodules): Heat qi constrained and knotted, hard like a fruit pit. It does not need to suppurate; dispersing the heat naturally resolves it.
"Vomiting and diarrhea cholera": The Sanjiao (Triple Burner) is the pathway for food and fluid transmission. Excessive heat disrupts this, causing vomiting, diarrhea, and cholera. Claiming these are Cold is wrong. General rule: Vomiting/diarrhea with thirst is Heat; without thirst is Cold. Early heat-type vomiting/diarrhea may temporarily lack thirst, but after fluid loss, thirst ensues. Cold-type lacks thirst initially, but excessive fluid loss leads to dryness and thirst.
Generally, undigested food in stool with white color, foul-smelling yet clear/cold vomit/stool, clear/unobstructed urine, cool body without thirst, and deep/slow/thin pulse indicate Cold syndrome. In children with heat-type vomiting/diarrhea, if milk is undigested and stool is white, do not immediately diagnose Cold; distinguish by diet/drug colors. If undigested grain is not white, urine is red/yellow, with thirst and surging/rapid pulse, it is Heat. White stool indicates Cold (Lung Metal color); other colors indicate Heat. White stool arises because excessive Cold Water suppresses Fire, failing to control Metal, so Metal dominates. Green stool indicates Liver Wood dominance due to Fire suppressing Metal. Zhang Zhongjing used Dachengqi Tang (Major Order the Qi Decoction) for Shaoyin diarrhea with pure green water, proving it is Heat. Yellow stool indicates Spleen Earth dominance due to excess Fire and deficient Water. Red stool indicates Heart Fire. Black stool indicates Kidney Water, appearing when extreme Heat is controlled by Water transformation. Black dysentery is fatal. Skin boils also stem from Fire/Heat but manifest differently based on location: Skin (Lung Metal) yields white pus; Blood vessels (Heart Fire) yield blood boils; Muscle (Spleen Earth) yields yellow pus; Tendons (Liver Wood) yield greenish pus; Bone (Kidney Water) yields purple-black blood. If black dysentery is Cold, are purple-black boils Cold too? Red dysentery is combined Damp-Heat. The world errs in calling Red Dysentery Heat and White Dysentery Cold. Yin and Yang are like a scale; one rises, the other falls. One excess implies the other deficiency. How can both Yin and Yang be excessive in the intestines simultaneously causing red and white dysentery? Dysentery arises in June/July from excessive intake of grains/meat/fruits, generating intense Damp-Heat toxins in the intestines, expelling pus/blood. Treatment requires bitter-cold herbs. Qian Zhongyang's Xianglian Wan (Costus and Coptis Pill) uses Muxiang (Aucklandiae Radix, bitter-warm) and Huanglian (Coptidis Rhizoma, bitter-cold). Bitter dries Dampness, Cold conquers Heat, Warmth opens stagnation. Modern folk doctors use acrid-hot Ginger/Cinnamon, curing mild cases by opening stagnation but worsening severe cases, leading to edema or death. This is lamentable.
Women's leukorrhea (red/white discharge) is similar to dysentery. The Dai Mai (Belt Vessel) is one of the Eight Extraordinary Vessels, circling the waist. Excessive Damp-Heat in the lower jiao causes fluids to overflow through the Dai Mai. Calling white leukorrhea Cold is wrong. Symptoms include dizziness, bitter/dry mouth, throat discomfort, red/scanty urine, constipation, and surging/rapid pulse—all Heat. Treatment uses bitter-acrid-cold herbs, avoiding drying/hot herbs to prevent life damage. Wine-gu (parasitic disease from alcohol) with loose stools, edema, or jaundice are also Damp-Heat. Alas, humans have bodies and thus diseases; life implies death. Doctors must follow laws. Misdiagnosing root/branch or Yin/Yang and misprescribing decoctions causing "excess treated as excess, deficiency treated as deficiency" deaths is whose fault? "Half the dead die due to lack of good doctors." This is true.
"Mao" (mental confusion): Spirit is dim, Qi is turbid.
"Yu" (depression/constraint): Extreme heat constrains couli, blocking Qi pathways.
"Zhongzhang" (swelling): Extreme Yang heat causes swelling/fullness, like lush vegetation in June.
"Bizhi" (nasal obstruction): Nasal blockage due to Wind-Cold in couli; Cold constricts, blocking Yang Qi. Lying on side opens lower nostril, blocks upper, due to Yang meridians crossing at nose.
"Qiu" (rhinorrhea): Clear nasal discharge.
"Nv" (epistaxis): Nosebleed.
"Xueyi" (blood extravasation): Blood from upper orifices.
"Xuexie" (blood hemorrhage): Blood from lower orifices.
"Lin" (strangury): Heat in Bladder causing painful/scanty urination. Some say obstructed urination is Heat, enuresis is Cold. But extreme Heat in Kidney region affects Jueyin Liver meridian, blocking the urethral orifice ("Tingkong"), preventing Qi/fluid flow, causing incontinence. Shaoyin heat extreme causes enuresis. Folk theories of "Cold Lin" are laughable, yet their formulas use Yupi (Ulmus Cortex) and Qumai (Dianthi Herba), bitter-cold herbs. The theory is wrong, formula right. Ignorance of transformation principles leads to error. Unlearned medicine is difficult.
"Bi" (constipation/retention): Stool涩滞 (astringent/stagnant). Fire controls Metal, fails to balance Wood; Liver generates Wind, Wind overcomes Dampness, consuming fluids.
"Fever with aversion to cold": Exterior Heat causing aversion to cold. Zhang Zhongjing treats this with Mahuang Tang (Ephedra Decoction) to induce sweat. Claiming "Cold in skin means Heat in marrow" is wrong.
"Zhanli" (shivering): Extreme Heat mimics Water transformation, causing shaking. Deep Shanghan (Cold Damage) with impending sweat causes shivering due to extreme heat. Fear-induced shivering is due to Kidney Water deficiency.
"Jing" (fright): Sudden heart agitation.
"Huo" (confusion): Doubt, unfocused will.
"Bei" (sadness): Excessive Heart Blood Heat harasses Lung Metal; Metal rebels, causing weeping. Tears/mucus resemble fire refining metal into water. Liver Heat tears, Heart Heat sweat, Spleen Heat saliva, Lung Heat mucus, Kidney Heat spit. Like trees sweating in summer heat.
"Xiao" (laughter): Heart Fire excess, Joy spirit emerges. Tickling ribs/armpits causes laughter due to disturbance, a Fire transformation.
"Zhan" (delirious speech): Excessive talking. Heart Heat confuses spirit, causing妄言 (wild speech).
"Wang" (madness): Mania. Heart Heat dims spirit, causing visual hallucinations.