经云∶尺寸俱浮者,太阳受病也。当一二日发,以其脉上连风府,故头项痛,腰脊强。伤寒,
则发热恶寒。伤风,则鼻塞恶风。然伤风有汗,伤寒无汗。
尺寸俱长者,阳明受病也。当二三日发,以其脉夹鼻络于目,故身热目疼,鼻干不得卧。又曰
不恶寒而作渴,皆为在经。不恶寒反恶热,自汗出,大便难。
尺寸俱弦者,少阳受病也。当三四日发,以其脉循胁络于耳,故胸胁痛而耳聋,口苦咽干,目
眩,往来寒热而呕。此三经受病,未入于腑者,可汗而已。
尺寸俱沉细者,太阴受病也。当四五日发,以其脉布胃中络于嗌,故腹满而咽干,或腹痛手足
温,自利不渴。
尺寸俱沉者,少阴受病也。当五六日发,以其脉贯肾络于肺,系舌本,故口燥
舌干而渴,恶寒,口中和,默默欲寐,时时腹痛,又咽痛三证。
尺寸俱微缓者,厥阴受病也。当六七日发,以其脉循阴器络于肝,故烦满而囊缩,唇青舌卷,
筋急,或渴,不欲食,即吐蛔。此三经皆受病也,已入于腑者,可下而已。此皆自阳经传来者,故
宜下而去之。非若阴经自中之寒,此则为真阴证矣,当用四逆汤辈温之。
太阳伤风,自汗恶风,桂枝汤。伤寒,无汗恶寒,麻黄汤。
阳明不恶寒反恶热,自汗者,大便难,大柴胡汤、小承气汤。汗不止者,胃汁干,急下之,大
承气汤。无汗恶寒,升麻葛根汤。有汗脉迟,微恶寒,为表未解,桂枝汤。无汗脉浮而喘,麻黄汤。
少阳证,病属小柴胡汤。
太阴自利不渴,为脏寒,理中汤、四逆汤。胸中胀满,枳实理中丸。胀满脉浮,桂枝汤。胀满时
痛,桂枝加芍药汤;痛甚,桂枝加大黄汤。
少阴脉沉,口不干,舌不燥,背恶寒,小便清白,四逆汤。始得病,脉沉,反发热,麻黄附子
细辛汤。口燥咽干而渴,急下之,大承气汤。六经中,惟此一经难治,大要以口燥而渴,知其热,
脉沉而迟,别其寒。
厥阴脉微浮,为欲愈;不浮,为未愈,小建中汤。脉浮缓,如疟状,桂枝麻黄各半汤。脉沉短
者,囊必缩,为毒瓦斯入脏,承气汤下之;利不止者,四逆汤。
古籍记载:寸脉和尺脉都呈现浮象的,是太阳经受邪。通常在发病后一到两天出现症状,因为该经脉向上连接风府穴,所以会出现头痛、项部僵硬以及腰脊强痛的症状。如果是伤寒,则表现为发热且恶寒;如果是伤风,则表现为鼻塞且怕风。然而,伤风会有汗出,而伤寒则无汗。
寸脉和尺脉都呈现长象的,是阳明经受邪。通常在发病后两到三天出现症状,因为该经脉夹行于鼻旁并联络眼部,所以会出现身体发热、眼睛疼痛、鼻腔干燥且无法安卧。又说,不恶寒反而感到口渴,病邪都在经络层面。如果不恶寒反而怕热,自汗出,大便困难,也属于此类。
寸脉和尺脉都呈现弦象的,是少阳经受邪。通常在发病后三到四天出现症状,因为该经脉循行于胁肋部并联络耳部,所以会出现胸胁疼痛、耳聋、口苦、咽干、头晕目眩、寒热往来以及呕吐。这三条阳经受病,如果病邪尚未传入腑脏,可以通过发汗的方法治愈。
寸脉和尺脉都呈现沉细象的,是太阴经受邪。通常在发病后四到五天出现症状,因为该经脉分布于胃中并联络咽喉,所以会出现腹部胀满、咽干,或者腹痛、手足温暖、自发性腹泻且不口渴。
寸脉和尺脉都呈现沉象的,是少阴经受邪。通常在发病后五到六天出现症状,因为该经脉贯穿肾脏并联络肺部,系连舌根,所以会出现口燥、舌干而渴、恶寒、口中感觉正常(不苦不燥)、神情沉默想睡觉、时常腹痛,以及咽痛这三种证候。
寸脉和尺脉都呈现微缓象的,是厥阴经受邪。通常在发病后六到七天出现症状,因为该经脉循行于阴器部位并联络肝脏,所以会出现心烦胀满、睾丸收缩、嘴唇发青、舌头卷缩、筋脉拘急,或者口渴、不想进食,甚至吐出蛔虫。这三条阴经都受病时,如果病邪已经传入腑脏,可以通过泻下的方法治愈。这些都是从阳经传变而来的,所以适宜用泻下法祛除病邪。这与阴经直接感受寒邪不同,后者才是真正的阴证,应当使用四逆汤之类的方剂来温补。
太阳经受伤风,表现为自汗、怕风,适用桂枝汤。伤寒,表现为无汗、怕冷,适用麻黄汤。
阳明经受病,不恶寒反而怕热,有汗出的,大便困难,适用大柴胡汤或小承气汤。如果汗出不止,导致胃中津液干枯,需紧急泻下,适用大承气汤。无汗、怕冷的,适用升麻葛根汤。有汗、脉象迟缓、轻微怕冷的,说明表证未解,适用桂枝汤。无汗、脉象浮且气喘的,适用麻黄汤。
少阳经受病,证候归属于小柴胡汤主治范围。
太阴经受病,自发性腹泻且不口渴,属于脏腑虚寒,适用理中汤或四逆汤。胸部胀满,适用枳实理中丸。胀满且脉象浮,适用桂枝汤。胀满且时时作痛,适用桂枝加芍药汤;疼痛剧烈,适用桂枝加大黄汤。
少阴经受病,脉象沉,口不干,舌不燥,背部怕冷,小便颜色清亮,适用四逆汤。刚得病时,脉象沉却反而发热,适用麻黄附子细辛汤。口燥、咽干而渴,需紧急泻下,适用大承气汤。在六经病中,唯独这一经难以治疗,大体原则是通过口燥而渴判断其为热证,通过脉象沉而迟辨别其为寒证。
厥阴经受病,脉象微浮,表示病情将要痊愈;如果不浮,表示未愈,适用小建中汤。脉象浮缓,像疟疾发作时的样子,适用桂枝麻黄各半汤。脉象沉短的,睾丸必定收缩,这是毒邪侵入脏腑,需用承气汤泻下;如果腹泻不止,适用四逆汤。
The classic texts state: When both the cun (inch) and chi (foot) pulses are floating, it indicates disease in the Taiyang (Greater Yang) channel. Symptoms typically manifest within one to two days of onset. Since this channel connects upward to the Fengfu point (GV16), it causes headache, stiffness of the neck, and rigidity of the lower back. In cases of Cold Damage (Shanghan), there is fever and aversion to cold; in cases of Wind Injury (Shangfeng), there is nasal congestion and aversion to wind. However, Wind Injury presents with sweating, whereas Cold Damage presents without sweating.
When both the cun and chi pulses are long, it indicates disease in the Yangming (Yang Brightness) channel. Symptoms typically manifest within two to three days. Since this channel runs alongside the nose and connects to the eyes, it causes body heat, eye pain, dryness of the nose, and inability to lie down comfortably. It is also stated that thirst without aversion to cold indicates the pathogen is in the channel. If there is no aversion to cold but rather aversion to heat, spontaneous sweating, and difficulty with defecation, these are also characteristic.
When both the cun and chi pulses are wiry (xian), it indicates disease in the Shaoyang (Lesser Yang) channel. Symptoms typically manifest within three to four days. Since this channel follows the hypochondrium and connects to the ears, it causes pain in the chest and hypochondrium, deafness, bitter taste in the mouth, dry throat, dizziness, alternating chills and fever, and vomiting. For diseases in these three channels, if the pathogen has not yet entered the fu organs, it can be resolved by inducing sweating.
When both the cun and chi pulses are deep and fine, it indicates disease in the Taiyin (Greater Yin) channel. Symptoms typically manifest within four to five days. Since this channel spreads through the stomach and connects to the throat, it causes abdominal fullness and dry throat, or abdominal pain with warm hands and feet, spontaneous diarrhea without thirst.
When both the cun and chi pulses are deep, it indicates disease in the Shaoyin (Lesser Yin) channel. Symptoms typically manifest within five to six days. Since this channel penetrates the kidney, connects to the lung, and ties to the root of the tongue, it causes dry mouth, dry tongue with thirst, aversion to cold, a normal sensation in the mouth (neither bitter nor dry), a desire to remain silent and sleep, frequent abdominal pain, and sore throat. These constitute the three syndromes of this channel.
When both the cun and chi pulses are slightly slow and moderate, it indicates disease in the Jueyin (Terminal Yin) channel. Symptoms typically manifest within six to seven days. Since this channel follows the genitalia and connects to the liver, it causes irritability and fullness, retraction of the testicles, bluish lips, curled tongue, tendon tension, thirst, anorexia, and even vomiting of roundworms. When these three yin channels are diseased, if the pathogen has entered the fu organs, it can be resolved by purging. These conditions usually transmit from the yang channels, so purgative methods are appropriate to eliminate them. This differs from cold directly attacking the yin channels, which constitutes true yin syndromes requiring warming with formulas such as Sini Tang (Four Reversal Decoction).
For Taiyang Wind Injury with spontaneous sweating and aversion to wind, Guizhi Tang (Cinnamon Twig Decoction) is indicated. For Cold Damage with no sweating and aversion to cold, Mahuang Tang (Ephedra Decoction) is indicated.
For Yangming disease with no aversion to cold but aversion to heat, spontaneous sweating, and difficulty with defecation, Dachaihu Tang (Major Bupleurum Decoction) or Xiao Chengqi Tang (Minor Order the Qi Decoction) are indicated. If sweating persists excessively, leading to dryness of stomach fluids, urgent purging is required using Dachengqi Tang (Major Order the Qi Decoction). For no sweating and aversion to cold, Shengma Gegen Tang (Cimicifugae and Puerariae Decoction) is indicated. For sweating, slow pulse, and mild aversion to cold, indicating unresolved exterior syndrome, Guizhi Tang is indicated. For no sweating, floating pulse, and wheezing, Mahuang Tang is indicated.
Shaoyang syndromes fall under the indication for Xiaochaihu Tang (Minor Bupleurum Decoction).
Taiyin spontaneous diarrhea without thirst indicates interior cold of the zang organs; Lizhong Tang (Regulate the Middle Decoction) or Sini Tang are indicated. For chest fullness, Zhishi Lizhong Wan (Aurantii Fructus Regulating the Middle Pill) is indicated. For fullness with a floating pulse, Guizhi Tang is indicated. For fullness with intermittent pain, Guizhi Ji Shaoyao Tang (Cinnamon Twig Decoction Augmented with Peony) is indicated; for severe pain, Guizhi Da Huang Tang (Cinnamon Twig Decoction Augmented with Rhubarb) is indicated.
For Shaoyin disease with a deep pulse, non-dry mouth, non-dry tongue, aversion to cold on the back, and clear urine, Sini Tang is indicated. At the initial stage, if the pulse is deep but accompanied by fever, Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) is indicated. For dry mouth, dry throat, and thirst, urgent purging with Dachengqi Tang is required. Among the six channels, this one is the most difficult to treat. The general principle is to identify heat by dry mouth and thirst, and distinguish cold by a deep and slow pulse.
For Jueyin disease, a slightly floating pulse indicates impending recovery; if not floating, it indicates non-recovery, treated with Xiaojianzhong Tang (Minor Construct the Middle Decoction). A floating and moderate pulse resembling malaria is treated with Guizhi Mahuang Ge Ban Tang (Half Cinnamon Twig Half Ephedra Decoction). A short and deep pulse indicates retraction of the testicles, signifying toxic pathogens entering the zang organs; this requires purging with Chengqi Tang. If diarrhea persists, Sini Tang is indicated.