{伤寒所致}太阳病,痉湿 ,此三种,宜应别论。
【按】“伤寒所致”四字,甚无所谓,当删之。
太阳病,发热无汗,{反}恶寒者,名曰刚痉。
【按】“反恶寒”之“反”字,衍文也。刚痉证应恶寒,非反也,当删之。
恶寒脉微而复利,利(不)止,亡{血}〔阳〕也,四逆加人参汤主之。
【按】“利止亡血”,如何用大热补药?利止是“利不止”,亡血应是“亡阳”,当改之。
问曰∶人病有宿食,何以别之?师曰∶寸口脉浮而大,按之反涩,尺中亦{微}〔大〕而涩,故知有宿食,
当下之,宜大承气汤。
【按】尺中“微”字,当是“大”字,若是“微”字,断无可下之理,当改之。
假令脉来微去大,故名反,病在里也;脉来{头小本大}〔大去小〕,故名覆,病在表也。上微{头}小者,
(为阴盛),则汗出;下微{本大}〔小〕者,(为阳盛),则为关格不通,不得尿。头无汗者可治,有汗者死。
【按】“脉来头小本大”,当是“脉来大去小”。“上微头小者”,当是“上微小者为阴盛”。“下微本
大者”,当是“下微小者为阳盛”。始与上下之义相属,当改之,补之。
寸口卫气盛名曰高,营气盛名曰章,高章相抟,名曰纲。卫气弱名曰 ,营气弱名曰卑, 卑相抟,名曰
损。卫气和名曰缓,营气和名曰迟,迟缓相抟,名曰{沉}〔强〕。
【按】“名曰沉”之“沉”字,应是“强”字,玩下文可知,当改之。
寸口脉缓而迟,缓则阳气长,其色鲜,其颜光,其声商,毛发长;迟则阴气盛,骨髓生,血满,肌肉紧{薄
鲜硬}。阴阳相抱,营卫俱行,刚柔相得,名曰强也。
【按】“薄鲜硬”三字,不成句,应是衍文,当删之。
北方肾脉,其形何似?师曰∶肾者水也,名曰少阴,其脉沉滑,是肾脉也。肾病自得沉滑而濡者,愈也。
【按】东南西方,皆有其文,惟缺北方,仿经文补之。
问曰∶翕奄沉,名曰滑,何谓也?师曰∶沉为纯阴,翕为正阳,阴阳和合,故令脉滑,关尺自平。阳明
脉微沉,食饮自可;少阴脉微滑,{滑者紧之浮名也,此为阴实},其人必股内汗出,阴下湿也。
【按】“滑者紧之浮名也,此为阴实”二句,与上下之义不属,当是错简。
阳脉{浮}〔濡〕,阴脉弱者,则血虚,血虚则筋急也。其脉{沉}〔弱〕者,营气微也;其脉{浮}〔濡〕而汗
出如流珠者,卫气衰也。
【按】“阳脉浮”,“其脉浮”之二“浮”字,当是“濡”字,若是“浮”字,则与卫气衰、汗出如流珠
之义不属。“其脉沉”之“沉”字,当是“弱”字,若是“沉”字,则与血虚营气微之义不属,当改之。
师曰∶病家人来请云∶病患发热烦极。明日师到,病患向壁卧,此热已去也。设令脉{不}〔自〕和,处言
已愈。
【按】“不和”应是“自和”,若不和,如何言愈?当改之。
[Caused by Cold Damage] Taiyang disease (disease of the Taiyang channel), Jing disease (spasm syndrome), and Shi disease (dampness syndrome), these three types of diseases, should be discussed separately.
[Commentary] The four characters "caused by cold damage" have no significant meaning and should be deleted.
Taiyang disease, with fever, absence of sweating, and aversion to cold, is named Gang Jing (Yang Spasm).
[Commentary] The character "fan" (reversely/oppositely) in "fan ewan han" (reversely averse to cold) is a superfluous character. Gang Jing syndromes should inherently present with aversion to cold; it is not a reversal. It should be deleted.
Aversion to cold, faint pulse, accompanied by diarrhea, where the diarrhea does not cease, indicates loss of Yang Qi (vital energy). It is treated with Sini Jia Renshen Tang (Four Reversals Decoction plus Ginseng).
[Commentary] "Diarrhea ceases, loss of blood"—how can one use strongly hot tonifying medicines? "Diarrhea ceases" should be "diarrhea does not cease"; "loss of blood" should be "loss of Yang Qi". This should be corrected.
Question: A person suffers from retained food (Su Shi), how can it be distinguished? The Master said: The Cun Kou (inch position) pulse is floating and large; upon pressing, it feels reversely choppy; the Chi (cubit position) pulse is also large and choppy. Thus, we know there is retained food.
It should be purged downward; Dachengqi Tang (Major Order the Qi Decoction) is appropriate.
[Commentary] The character "wei" (faint/small) in the Chi position should be "da" (large). If it were "faint," there would absolutely be no rationale for purging. It should be corrected.
Suppose the pulse comes faintly and goes largely; this is called "Fan" (Reversal), indicating the disease is in the interior. The pulse comes largely and goes faintly; this is called "Fu" (Covering), indicating the disease is in the exterior. If the upper part [of the pulse/body] is faint and small,
(it is due to excess Yin), then sweating occurs; if the lower part [of the pulse/body] is faint and small, (it is due to excess Yang), then Guan Ge obstruction occurs, preventing urination. If the head has no sweat, it is treatable; if there is sweat, death ensues.
[Commentary] "Pulse comes small at the head and large at the root" should be "pulse comes large and goes small." "Upper faint small head" should be "upper faint small indicates Yin excess." "Lower faint large root" should be "lower faint small indicates Yang excess." Only thus does it align with the meaning of upper and lower. It should be corrected and supplemented.
At the Cun Kou, when Wei Qi (Defensive Qi) is excessive, it is named "Gao" (High); when Ying Qi (Nutritive Qi) is excessive, it is named "Zhang" (Chapter/Manifest). When Gao and Zhang contend together, it is named "Gang" (Cord/Binding). When Wei Qi is weak, it is named "Di" (Low); when Ying Qi is weak, it is named "Bei" (Humble/Low). When Di and Bei contend together, it is named "Sun" (Damage/Decrease). When Wei Qi is harmonious, it is named "Huan" (Slow/Relaxed); when Ying Qi is harmonious, it is named "Chi" (Slow/Delayed). When Huan and Chi contend together, it is named "Qiang" (Strong).
[Commentary] The character "Chen" (Deep) in "named Chen" should be "Qiang" (Strong). This can be inferred from the following text. It should be corrected.
The Cun Kou pulse is Huan (relaxed/slow) and Chi (slow/delayed). Huan indicates the growth of Yang Qi; the complexion is fresh, the face radiant, the voice clear (Shang), and hair long. Chi indicates the abundance of Yin Qi; marrow is generated, blood is full, and muscles are firm. Yin and Yang embrace each other, Ying and Wei circulate together, Gang (firmness) and Rou (softness) coordinate well; this is named "Qiang" (Strength).
[Commentary] The three characters "Bo Xian Ying" (thin, fresh, hard) do not form a coherent sentence and are likely superfluous characters. They should be deleted.
What does the Kidney pulse of the North resemble? The Master said: The Kidney belongs to Water and is named Shao Yin. Its pulse is Chen Hua (deep and slippery); this is the Kidney pulse. In Kidney disease, obtaining a Chen Hua and Ru (soft) pulse indicates recovery.
[Commentary] Texts exist for the Southeast and West, but only the North is missing. I have supplemented it imitating the original scripture.
Question: The pulse gathers suddenly and sinks deeply, named Hua (Slippery) pulse. What does this mean? The Master said: Shen (deep) represents pure Yin; Xi (floating/light) represents correct Yang. Yin and Yang harmonize and combine, thus causing the pulse to be slippery, and the Guan and Chi positions become balanced. The Yangming pulse is slightly deep, and digestion is normal; the Shaoyin pulse is slightly slippery, (the slippery nature is the floating name of the tight pulse, this constitutes an Excess of Yin), the person will necessarily have sweat on the inner thighs and dampness in the genital area.
[Commentary] The two sentences "the slippery nature is the floating name of the tight pulse, this constitutes an Excess of Yin" do not fit the context and are likely misplaced slips (cuojian).
The Yang pulse (superficial touch) is Ru (soft/limp), and the Yin pulse (deep touch) is weak; this indicates Blood deficiency. Blood deficiency leads to tendon tension. The pulse that is weak (deep touch) indicates deficient Ying Qi (Nutritive Qi); the pulse that is soft (superficial touch) with sweat flowing like beads indicates衰 (decline/deficiency) of Wei Qi (Defensive Qi).
[Commentary] The two instances of "Fu" (floating) in "Yang pulse floating" and "its pulse floating" should be "Ru" (soft). If they were "floating," they would not align with the meaning of Wei Qi deficiency and sweat like beads. The character "Chen" (deep) in "its pulse deep" should be "Ruo" (weak). If it were "deep," it would not align with the meaning of Blood deficiency and deficient Ying Qi. It should be corrected.
The Master said: The patient's family came requesting treatment, saying the patient was extremely feverish and irritable. The next day, when the Master arrived, the patient was lying facing the wall; this indicated the heat had subsided. Suppose the pulse is naturally harmonious; one may say the illness is cured.
[Commentary] "Bu he" (not harmonious) should be "Zi he" (naturally harmonious). If it were not harmonious, how could one say the illness is cured? It should be corrected.