动数之脉。邪在阳也。汤入而变迟者。阳邪愈也。浮大之脉。邪在表也。而复减小
者。表邪散也。病初躁乱者。邪所烦也。汤入而安静者。药胜病也。是皆为愈证。
凡治温病。可刺五十九穴。
五十九穴者。以泻诸经之温热。针经曰。热病取之诸阳五十九穴。刺以泻其热。而
出其汗。实其阴。而补其不足。所谓五十九刺。两手内外侧各三。凡十二 。五指间各
一。凡八 。足亦如是。头入发际一寸旁三分各三。凡六 。更入发三寸边五。凡十 。
耳前后口下各一。项中一穴。凡六 。巅上一。囟会一。发际一。廉泉一。风池二。天
柱二。又内经曰。热俞五十九。头上五行。行五者。以泻诸阳之热逆也。大杼。膺俞。
缺盆。背俞。此八者。以泻胸中之热也。气冲。三里。巨虚。上下廉。此八者。以泻胃
中之热也。云门。 骨。委中。髓空。此八者。以泻四肢之热也。五脏俞旁五。此十者。
以泻五脏之热也。凡此五十九穴者。皆热之左右也。
又身之穴。三百六十有五。其三十九穴。灸之有害。七十九穴。刺之为灾。并中髓
也。
穴有三百六十五。以应一岁。其灸刺之禁。皆肉薄骨解之处。血脉虚少之分。针灸
并中髓也。
凡脉四损三日死。平人四息。病患脉一至。名曰四损。脉五损。一日死。平人五息。
病患脉一至。名曰五损。脉六损。一时死。平人六息。病患脉一至。名曰六损。
四脏气绝者。脉四损。五脏气绝者。脉五损。五脏六腑俱绝者。脉六损。
脉盛身寒。得之伤寒。脉虚身热。得之伤暑。
内经曰。脉者。血之府也。脉实血实。脉虚血虚。寒则伤血。邪并于血。则血盛而
气虚。故伤寒者。脉盛而身寒。热则伤气。邪并于气。则气盛而血虚。故伤暑者。脉虚
而身热。
脉阴阳俱盛。大汗出。不解者死。
脉阴阳俱盛。当汗出而解。若汗出不解。则邪气内胜。正气外脱。故死。内经曰。汗
出而脉尚躁盛者。死。千金曰。热病已得汗。脉尚躁盛。此阳脉之极也。死。
脉阴阳俱虚。热不止者。死。
脉阴阳俱虚者。真气弱也。热不止者。邪气胜也。内经曰。病温。虚甚者。死。
脉至乍疏乍数者。死。
为天真荣卫之气断绝也。
脉至如转索者。其日死。
为紧急而不软。是中无胃气。故不出其日而死。
谵言妄语。身微热。脉浮大。手足温者生。逆冷脉沉细者。不过一日死矣。
谵言妄语。阳病也。身微热。脉浮大。手足温。为脉病相应。若身逆冷。脉沉细。
为阳病见阴脉。脉病不相应。故不过一日而死。难经曰。脉不应病。病不应脉。是为死
病。
此以前。是伤寒热病证候也。
The pulse is rapid and frequent (Shu Mai), indicating that the pathogenic factor is in the Yang aspect. If the pulse becomes slow (Chi Mai) after taking herbal decoction, it indicates that the Yang pathogen has been resolved. The floating and large pulse (Fu Da Mai) indicates that the pathogen is at the exterior. If the pulse subsequently becomes smaller and weaker, it indicates that the exterior pathogen has dispersed. Restlessness and confusion at the onset of the disease indicate disturbance by the pathogen. Calmness after taking medicine indicates that the therapeutic effect overcomes the disease. These are all signs of recovery.
In general, for the treatment of Warm Disease (Wen Bing), fifty-nine acupoints may be needled.
These fifty-nine points are used to drain the heat and warmth from the various meridians. The *Classic of Acupuncture* (*Zhen Jing*) states: For Heat Diseases, take the fifty-nine points of the Yang meridians; needle them to drain the heat and induce sweating, thereby filling the Yin and tonifying deficiencies. This is referred to as the "Fifty-nine Stabs." They include three points on each side of the inner and outer aspects of both hands, totaling twelve; one point between each of the five fingers, totaling eight; the feet follow the same pattern. At the head, one cun inside the hairline, three points on each side of the midline, totaling six; further back, three cun inside the hairline, five points along the lateral margin, totaling ten; one point each in front of the ear, behind the ear, and below the mouth, plus one point in the nape of the neck, totaling six; one point at the vertex (Baihui), one at Xinhui, one at the hairline (Yintang/Shangxing area contextually, though text says Fa Ji), one at Lianquan, two at Fengchi, and two at Tianzhu. Additionally, the *Inner Canon* (*Nei Jing*) states: There are fifty-nine Heat Shu points. Five rows of five points each on the head are used to drain the rebellious heat of the Yang meridians. Dazhu (BL11), Ying Shu (points in the chest region), Quepen (LI15), and Bei Shu (points on the back) – these eight points – are used to drain heat from the chest. Qichong (ST30), Zusanli (ST36), Shangjuxu (ST37), and Xiajuxu (ST39) – these eight points – are used to drain heat from the stomach. Yunmen (LU2), [Bone point], Weizhong (BL40), and Suikong (Marrow Cavity) – these eight points – are used to drain heat from the four limbs. Five points beside each of the Back-Shu points of the five Zang organs, totaling ten, are used to drain heat from the five Zang organs. All these fifty-nine points are bilateral points for treating heat.
Furthermore, there are three hundred and sixty-five acupoints on the body. Of these, thirty-nine are contraindicated for moxibustion as they cause harm, and seventy-nine are contraindicated for acupuncture as they cause disaster, because needling or moxa here may penetrate to the marrow.
There are three hundred and sixty-five acupoints, corresponding to the days of a year. The contraindications for moxibustion and acupuncture apply to areas where flesh is thin and bones are prominent, and where blood vessels are deficient and sparse; if acupuncture or moxibustion penetrates the marrow, it is harmful.
If the pulse shows "Four Damages" (Si Sun), death occurs within three days. A healthy person breathes four times per respiratory cycle (xi), while a patient with Four Damages has only one pulse beat per cycle. If the pulse shows "Five Damages," death occurs within one day. A healthy person breathes five times per cycle, while the patient has one pulse beat. If the pulse shows "Six Damages," death occurs within one shichen (two hours). A healthy person breathes six times per cycle, while the patient has one pulse beat.
When the Qi of the Four Zang organs is exhausted, the pulse shows Four Damages. When the Qi of the Five Zang organs is exhausted, the pulse shows Five Damages. When the Qi of the Five Zang and Six Fu organs is completely exhausted, the pulse shows Six Damages.
A surging pulse with cold body indicates Cold Damage (Shang Han). A deficient pulse with hot body indicates Summerheat Injury (Shang Shu).
The *Inner Canon* states: The pulse is the residence of blood. A full pulse indicates excess blood; a deficient pulse indicates deficient blood. Cold injures blood; when pathogens congregate in the blood, blood becomes excessive and Qi becomes deficient. Therefore, in Cold Damage, the pulse is surging and the body is cold. Heat injures Qi; when pathogens congregate in Qi, Qi becomes excessive and blood becomes deficient. Therefore, in Summerheat Injury, the pulse is deficient and the body is hot.
If both the Yin and Yang pulses are surging, and profuse sweating does not resolve the condition, death ensues.
If both Yin and Yang pulses are surging, sweating should resolve the condition. If sweating fails to resolve it, it means the pathogenic factor prevails internally while the Righteous Qi collapses externally, leading to death. The *Inner Canon* states: If sweating occurs but the pulse remains restless and surging, death ensues. The *Qian Jin Fang* states: In Heat Disease, if sweat has occurred but the pulse remains restless and surging, this is the extreme of Yang pulses, and death ensues.
If both Yin and Yang pulses are deficient, and fever persists without stopping, death ensues.
Deficient Yin and Yang pulses indicate weak True Qi. Persistent fever indicates prevailing Pathogenic Qi. The *Inner Canon* states: In Warm Disease, severe deficiency leads to death.
If the pulse is irregular, alternating between sparse and frequent, death ensues. This is due to the severance of the innate Ying and Wei Qi.
If the pulse feels like a turning rope (tight and wiry), death occurs on that day. This is because the pulse is tight and unyielding, indicating the absence of Stomach Qi, so death occurs before the day ends.
Delirium and妄语 (wild speech) with slight body heat, a floating and large pulse, and warm hands and feet indicate survival. Conversely, cold extremities and a deep, fine pulse indicate death within one day.
Delirium and wild speech constitute a Yang disease. Slight heat, floating/large pulse, and warm extremities indicate correspondence between pulse and disease. Cold extremities and deep/fine pulse indicate a Yang disease presenting with Yin pulses, meaning the pulse and disease do not correspond. Thus, death occurs within one day. The *Nan Jing* states: When the pulse does not match the disease, and the disease does not match the pulse, it is a fatal disease.
The above describes the syndromes and manifestations of Cold Damage and Heat Diseases.