是缓脉。传经已尽。火气已去。吉兆也。
此三经皆受病。已入于腑。可下而已。
三阴受邪。为病在里。于法当下。然三阴亦有在经者。在经则宜汗。故云已入于腑
者。可下而已。经曰。临病之工。宜须两审。
王三阳云。成云三阴亦有在经。正阴证亦有在经在腑之谓也。经不云三经皆受病。
可下而已。而必增已入于腑四字。亦以别直中阴经者。则当发汗。非谓阳证传到阴经。
尚有可汗者在也。若阳证传到阴经。纵有未尽入腑者。当用大柴胡汤之时也。岂可再言
发汗哉。
若两感于寒者。一日太阳受之。即与少阴俱病。则头痛、口干。烦满而渴。二日阳
明受之。即与太阴俱病。则腹满。身热。不欲食。谵语。三日少阳受之。即与厥阴俱病。
则
耳聋囊缩而厥。水浆不入。不知人者。六日死。若三阴、三阳、五脏、六腑、皆受病。
则荣卫不行。腑脏不通。则死矣。
阴阳俱病。表里俱伤者。为两感。以其阴阳两感。病则两证俱见。至于传经。则亦
阴阳两经俱传也。始得一日。头痛者。太阳、口干、烦满而渴者。少阴至二日。则太阳
This is a slow pulse (Huan Mai, Slow Pulse). It indicates that the transmission of the disease through the meridians has been completed and the fire pathogen has dissipated; this is an auspicious sign.
These three meridians are all affected by the pathogen, and the pathogen has entered the Fu organs; treatment with purgation (Xia Fa, Purging Method) is appropriate.
When the Three Yin meridians are affected by pathogens, the disease location is in the interior. According to therapeutic principles, purgation should be employed. However, there are cases where the disease remains in the meridians of the Three Yin; if the disease is in the meridians, sweating (Han Fa, Sweating Method) is indicated. Therefore, it is stated that only when the pathogen "has entered the Fu organs" can purgation be used. The classic texts state: "Practitioners facing illness must conduct dual examinations."
Wang San-yang states: Cheng Wu-ji's assertion that "the Three Yin meridians may also have diseases remaining in the meridians" refers precisely to the distinction between Yin syndromes manifesting in the meridians versus the Fu organs. The text does not merely say "if three meridians are affected, purgation may be used," but specifically adds the four characters "has entered the Fu organs." This serves to differentiate from direct invasion (Zhi Zhong, Direct Strike) into the Yin meridians, which requires sweating. It does not imply that when Yang syndromes transmit to the Yin meridians, there remain conditions suitable for sweating. If Yang syndromes transmit to the Yin meridians, even if the pathogen has not completely entered the Fu organs, Da Chai Hu Tang (Major Bupleurum Decoction) should be considered at that time. How could one still speak of using sweating?
If contracted as "Liang Gan" (Double Contraction) due to cold, on the first day, the Taiyang meridian is affected, and simultaneously the Shaoyin meridian becomes diseased; symptoms include headache, dry mouth, vexation, fullness, and thirst. On the second day, the Yangming meridian is affected, and simultaneously the Taiyin meridian becomes diseased; symptoms include abdominal fullness, fever, aversion to food, and delirious speech (Zhan Yu, Delirium). On the third day, the Shaoyang meridian is affected, and simultaneously the Jueyin meridian becomes diseased; symptoms include deafness, retraction of the testicles, and cold extremities (Jue, Cold Reversal), inability to take fluids or food, and unconsciousness. Such patients will die after six days. If the Three Yin and Three Yang meridians, as well as the Five Zang and Six Fu organs, are all affected, then Ying and Wei Qi circulation ceases, and the internal communication of the Zang and Fu organs is blocked; death ensues.
When both Yin and Yang meridians are diseased, and both exterior and interior are injured, it is termed "Liang Gan" (Double Contraction). Because both Yin and Yang meridians contract the pathogen simultaneously, symptoms of both sets of meridians appear concurrently. Regarding the transmission of the disease, it also involves the simultaneous transmission of both Yin and Yang meridians. Upon initial onset, on the first day, headache indicates Taiyang involvement; dry mouth, vexation, fullness, and thirst indicate Shaoyin involvement. By the second day, it involves Taiyang...