寸口脉浮大医反下之此为大逆浮则无血大则为寒寒气相搏则为腹鸣医乃不知而反饮冷水令汗大出水得寒气冷必相搏
其人即KT
凡寸口脉浮大则非里实之证而医反下之此为大逆浮则无血大则为寒盖里气虚寒故脉浮而大也里寒凝涩则木气冲激而
为腹鸣医乃不知以其血寒发热而反饮以冷水令汗大出水得里之寒气寒冷相合搏结不散其人即咽喉噎塞气闭而食阻也KT
与噎通汉书贾山至言祝KT 在前祝鲠在后
趺阳脉浮浮则为虚虚浮相搏故令气KT 言胃气虚竭也脉滑则为哕此为医咎贵虚取实守空迫血脉浮鼻中燥者必衄也
趺阳脉浮浮则为虚虚浮相合故令气KT 缘胃气虚竭则痞塞不通也若脉滑则胃气上逆而为哕此为医工之咎以浮则为虚
反责其内虚以为实而下以取之浮则无血反守其中空以为满而汗以遏之阳亡阴升填塞清道故非噎即哕也若脉浮鼻中干燥者
必将为衄以中虚而气逆故血随气升而为衄也
脉浮而大浮为风虚大为气强风气相搏必成瘾疹身体为痒痒者名泄风久久为痂癞
脉浮而大浮则风气之虚风泄于外也大为卫气之强气闭于内也外风与内气相搏风外泄而气内闭营郁不宣必成瘾疹盖风
性疏泄而气性收敛风欲泄而气闭之泄之不透则营郁而为热血热外发则为斑点而不能透发郁于皮腠之内隐而不显是为瘾疹
之家营郁卫闭欲发不能则身体为痒痒者是为泄风素问风论外在腠理则为泄风泄风者风之欲泄而不透者也风不透泄经血郁
热久而营气蒸腐则为痂癞风论风与太阳俱入行诸脉俞散于分肉之间与卫气相干其道不利故使肌肉愤 而有疡卫气有所凝
而不行故其肉有不仁也癞者营气热腐其气不清故使鼻柱坏而色败皮肤疡溃风寒客于脉而不去名曰癞风肺统卫气而主皮毛
开窍于鼻是以鼻柱坏而皮肤溃也
寸口脉象浮大,医生反而使用攻下法,这是严重的逆治。脉浮说明阴血不足,脉大说明里有寒气,寒邪与正气相互搏结,就会导致肠鸣。医生不了解这一点,反而给病人喝冷水以强行发汗,导致大汗出。水饮遇到体内的寒气,寒冷之气必然相互搏结。
这个人就会出现噎塞的症状。
凡是寸口脉象浮大,就不是里实证的病证,而医生反而使用攻下法,这是严重的逆治。脉浮是因为阴血不足,脉大是因为里有寒气,这是因为里气虚寒,所以脉象表现为浮而大。里的寒气凝滞涩阻,导致肝木之气冲激,从而产生腹鸣。医生不了解病情,因为病人因血寒而发热,反而用冷水让他出汗,水饮得到里的寒气,寒冷相互结合搏结不散,这个人就会咽喉噎塞,气机闭塞,食物受阻。KT(通“噎”)与噎字相通,《汉书·贾山传·至言》中说:“祝KT在前,祝鲠在后。”
趺阳脉象浮,浮则代表胃气虚,虚与浮相互搏结,所以导致气KT(通“痞”,指痞塞不通)。这是说胃气虚竭。如果脉象滑利,就会出现呃逆(哕),这是医生的过错。如果脉象浮且鼻中干燥,必定会发生鼻出血(衄)。
趺阳脉象浮,浮则代表虚,虚与浮相合,所以导致气KT(通“痞”,指痞塞不通)。这是因为胃气虚竭,导致痞塞不通。如果脉象滑,则是胃气上逆而发生呃逆(哕),这是医工的过错,因为浮脉代表虚,医生反而责怪其内虚为实证,从而使用攻下法来取效;浮脉代表无血,医生反而守其中空以为满盛,从而使用发汗法来遏制阳气。阳气亡失,阴气上升,填塞清窍之道,所以不是噎塞就是呃逆。如果脉象浮且鼻中干燥,必将发生鼻出血,因为中焦虚弱而气机上逆,所以血液随着气机上升而导致鼻衄。
脉象浮而大,浮代表风邪和虚损,大代表气机强盛,风邪与气机相互搏结,一定会形成瘾疹(皮肤出现红色丘疹,时隐时现),身体瘙痒。这种症状称为泄风。时间久了会形成痂癞(皮肤增厚、粗糙如癞蛤蟆皮)。
脉象浮而大,浮是风气之虚,风邪发泄于体表;大是卫气之强,气机闭郁于体内。外风与内气相互搏结,风邪向外发泄而气机向内闭郁,营气郁滞不能宣散,一定会形成瘾疹。大概风性疏泄而气性收敛,风想要发泄而气机闭郁它,发泄不透,则营气郁滞化为热,热血外发形成斑点而不能透发,郁积在皮腠之内,隐蔽而不明显,这就是瘾疹的成因。营气郁滞,卫气闭郁,想要发散而不能,所以身体瘙痒。这种瘙痒称为泄风。《素问·风论》说,风邪外在腠理则为泄风,泄风就是风邪想要发泄而不能透达。风邪不能透达发泄,经血郁滞化热,久而久之营气蒸腐,就会形成痂癞。《风论》说,风邪与太阳经之气一起进入,运行于各经脉俞穴,散布于分肉之间,与卫气相干犯,其道不利,所以使肌肉肿胀而有疡疮;卫气有所凝滞而不行,所以肌肉有麻木不仁的感觉。癞症,是因为营气热腐,其气不清,所以使鼻梁塌陷而面色败坏,皮肤溃疡溃烂。肺统摄卫气而主皮毛,开窍于鼻,所以鼻梁塌陷而皮肤溃烂。
The pulse at the Cun Kou (Cun position of the radial artery) is floating and large. The physician, in error, applies purgation; this constitutes a major contraindication. A floating pulse indicates a deficiency of Yin blood, while a large pulse indicates internal Cold. When Cold pathogens contend with healthy Qi, it results in abdominal borborygmus (rumbling). Unaware of this, the physician administers cold water to induce profuse sweating. The ingested water encounters the internal Cold, and the two cold energies inevitably contend with each other.
Consequently, the patient develops dysphagia (choking sensation).
Generally, a floating and large pulse at the Cun Kou signifies that there is no excess syndrome in the interior. If the physician erroneously applies purgation, it is a major contraindication. The floating pulse reflects Yin blood deficiency, and the large pulse reflects internal Cold, arising from the deficiency and Cold of the interior Qi. When interior Cold coagulates and causes stagnation, it agitates the Wood Qi (Liver Qi), leading to abdominal borborygmus. Unaware of the pathology, and seeing fever due to Blood Cold, the physician uses cold water to induce sweating. The water combines with the interior Cold, and the cold energies contend and knot without dispersing. Consequently, the patient suffers from throat obstruction, Qi closure, and food impaction. "KT" (a variant character) corresponds to "Ye" (dysphagia/choking). In the *Book of Han*, Jia Shan's *Words of Admonition* states: "Pray for relief from choking on meat before eating, pray for relief from choking on bones after eating."
The pulse at the Fu Yang (Danzhong/Gastric artery) is floating. Floating indicates deficiency. The combination of deficiency and floating leads to Qi stagnation ("KT", corresponding to "Pi", meaning epigastric fullness/stagnation). This describes the exhaustion of Stomach Qi. If the pulse is slippery, hiccups (Yue) occur; this is the fault of the physician. If the pulse is floating and the nose is dry, epistaxis (Nv) will certainly occur.
The pulse at the Fu Yang is floating. Floating indicates deficiency. The combination of deficiency and floating leads to Qi stagnation ("KT", corresponding to "Pi"). This occurs because the exhaustion of Stomach Qi causes blockage and lack of free flow. If the pulse is slippery, it indicates rebellious Stomach Qi causing hiccups (Yue). This is the fault of the medical practitioner: mistaking the floating pulse (indicating deficiency) for an excess condition inside, and thus applying purgation to gain efficacy; mistaking the empty nature indicated by the floating pulse (blood deficiency) for fullness, and thus applying diaphoresis to suppress Yang. The loss of Yang and the rise of Yin fill the clear orifices, resulting either in dysphagia or hiccups. If the pulse is floating and the nasal mucosa is dry, epistaxis (Nv) will inevitably occur. This is because central deficiency leads to rebellious Qi, causing blood to ascend with the Qi, resulting in epistaxis.
A pulse that is floating and large: floating indicates Wind pathogen and deficiency; large indicates strong Qi. When Wind and Qi contend, urticaria (Yin Zhen - transient skin eruptions) will surely form, accompanied by body itching. This condition is called Xie Feng (Leaking Wind). Over time, it may develop into scaly leprosy-like lesions (Jia Lai).
A pulse that is floating and large: floating indicates the deficiency of Wind Qi, with Wind leaking outward; large indicates the strength of Wei Qi (Defensive Qi), with Qi closed inward. External Wind contends with internal Qi. Wind leaks outward while Qi closes inward, causing Ying Qi (Nutritive Qi) to stagnate and fail to disperse. This inevitably forms urticaria. Generally, Wind has a dispersing nature, while Qi has a constricting nature. Wind desires to leak out, but Qi obstructs it. If the leakage is incomplete, Ying Qi stagnates and transforms into Heat. Hot Blood erupts outward as spots but cannot fully penetrate; it remains郁 (stagnant) within the skin and hair follicles, hidden and not obvious, which is the origin of urticaria. With Ying Qi stagnation and Wei Qi closure, the desire to vent cannot be realized, causing body itching. This itching is termed Xie Feng. The *Su Wen: Wind Lun* states that when Wind is external to the Cou Li (interstices), it becomes Xie Feng. Xie Feng refers to Wind that desires to vent but fails to penetrate. If Wind fails to vent, the channel blood stagnates and generates Heat. Over a long period, Ying Qi steams and putrefies, forming scaly lesions. The *Wind Lun* states that Wind enters together with the Taiyang channel, travels through the various acupoints, and scatters between the muscle layers, interfering with Wei Qi. Because the pathway is obstructed, the muscles become swollen and ulcerated; because Wei Qi coagulates and fails to circulate, the flesh becomes insensible. Leprosy-like lesions (Lai) occur because Ying Qi is hot and putrefied, its Qi becoming turbid, causing the nasal bridge to collapse, complexion to deteriorate, and skin to ulcerate. The Lung governs Wei Qi and controls the skin and hair, opening into the nose. Therefore, the nasal bridge collapses and the skin ulcerates.