问曰脉病欲知愈未愈者何以别之答曰寸口关上尺中三处大小浮沉迟数同等虽有寒热不解者此脉阴阳为和平虽剧当愈
寸口关上尺中三处大小浮沉迟数同等是无偏阴偏阳之弊虽有寒热不解而此脉阴阳和平即现下之病甚剧亦当自愈以
其脉之不病也阴病见阳脉则生者阴极阳复所以生也阳病见阴脉则死者阴盛阳脱外见烦躁脉真病假所以死也若阳极阴复病
脉皆真则又主生不主死盖缘阴阳二气绝则必死偏则可生平则病愈三部同等平而不偏是以愈也
问曰凡病欲知何时得何时愈答曰假令半夜得病者明日日中愈日中得病者半夜愈何以言之日中得病半夜愈者以阳得阴
则解也半夜得病明日日中愈者以阴得阳则解也
日中得病今日半夜愈者以日中阳盛而病得夜半阴盛以济之则解也夜半得病明日日中愈者以半夜阴盛而病得日中阳盛
以济之则解也
病六七日手足三部脉皆至大烦而口噤不能言其人躁扰者必欲解也若脉和其人大烦目重睑内际黄者此欲解也
病而手足脉俱不至纯阴无阳至六七日手足三部脉皆至是阳回于四末也微阳初复升于群阴之中而为阴邪所遏力弱不能
遽升郁勃鼓荡之际大烦口噤不能言语躁不安者必欲解也盖阴阳一有复机终当战胜而出重围万无久郁之理也若脉至而再见
调和其人阳复不能遽升而大烦一见目重睑内际黄者此欲解也盖太阳膀胱之经起于目之内 睑内际黄者阳明戊土司职卫气
卫气发达而阳出于目也目重者眼皮浓重也人睡初醒眼皮必浓以阳气出于目也(足脉足厥阴之五里在毛际外女子取太冲在
大趾本节后二寸陷中足少阴之太溪在内踝后足太阴箕门在鱼腹上足阳明之跗阳在足跗上即趺阳也见素问三部九候论中)
问:脉象与病症,想要知道疾病是否将要痊愈,如何来辨别呢?
答:在寸口、关上、尺中这三个部位,脉象的大小、浮沉、迟数都同等均匀。即使此时寒热症状尚未解除,但这是因为脉象显示阴阳处于和平状态。虽然病情严重,也应当痊愈。
寸口、关上、尺中三处脉象大小、浮沉、迟数同等,说明没有偏阴或偏阳的弊端。即使当下寒热不解,且病情甚剧,但因为脉象阴阳和平,所以病也会自愈,这是因为脉象本身并未出现病变。所谓“阴病见到阳脉则生”,是因为阴极而阳气回复,所以能生;“阳病见到阴脉则死”,是因为阴盛而阳气脱失,外在表现为烦躁,这是真寒假热的假象,所以会死。如果阳极而阴气回复,病脉皆为真脉,则主生不主死。大概因为阴阳二气断绝则必死,若只是偏颇尚可平复,平和则病愈。三部脉象同等,平和而不偏颇,所以会痊愈。
问:凡是患病,想要知道何时得病、何时痊愈,该如何判断?
答:假如半夜得病,明日日中(中午)痊愈;日中得病,半夜痊愈。为什么这样说呢?日中得病而半夜痊愈,是因为阳气得到阴气的调和而解;半夜得病而明日日中痊愈,是因为阴气得到阳气的调和而解。
日中得病,今日半夜痊愈,是因为日中阳气旺盛,而病得夜半阴气旺盛来济助,从而和解;夜半得病,明日日中痊愈,是因为夜半阴气旺盛,而病得日中阳气旺盛来济助,从而和解。
患病六七日,手足三部脉象皆至(即脉搏明显可触及),患者大烦闷且口噤不能言语,其人躁动不安,这必定是要痊愈的表现。如果脉象调和,其人虽大烦闷,但眼睑沉重,眼睑内侧呈现黄色,这也是将要痊愈的表现。
患病时手足脉象俱不至(摸不到),纯阴无阳。到了六七日,手足三部脉象皆至,这是阳气回复到四肢末梢的表现。微弱的阳气刚刚回复,升发于群阴之中,却被阴邪遏制,力量微弱不能迅速上升,在郁结勃发、鼓荡激荡之际,出现大烦闷、口噤不能言语、躁动不安的症状,这必定是要痊愈。大概阴阳一旦有了回复的契机,最终必定战胜邪气而出重围,绝无长期郁结的道理。如果脉象已至,再见到脉象调和,其人阳气回复但不能迅速上升而出现大烦闷,一见眼睑沉重、眼睑内侧发黄,这就是将要痊愈。大概足太阳膀胱经起于目内眦,眼睑内侧发黄是阳明戊土(脾胃之气)司职卫气。卫气发达,阳气出于目窍。眼睑沉重是指眼皮浓重,人刚睡醒时眼皮必然浓重,这是因为阳气出于目窍。(足部脉象:足厥阴肝经的五里穴在毛际外,女子取太冲穴在大趾本节后二寸陷中;足少阴肾经的太溪穴在内踝后;足太阴脾经的箕门穴在鱼腹上;足阳明胃经的跗阳穴在足背上,即趺阳穴。详见《素问·三部九候论》)
Question: Regarding pulse and disease, how can one determine whether the illness is about to heal? How to distinguish it?
Answer: When the pulses at the Cun Kou (Inch Position), Guan (Bar Position), and Chi (Cubit Position) are equal in magnitude, depth (floating/sinking), and rate (slow/rapid), even if the symptoms of cold and heat have not yet resolved, this indicates that Yin and Yang in the pulse are in a state of harmony. Although the condition may be severe, it will inevitably heal.
The equality of magnitude, depth, and rate at the three positions (Cun Kou, Guan, Chi) indicates no bias towards Yin or Yang. Even if cold and heat persist and the current illness is severe, because the pulse reflects a harmonious balance of Yin and Yang, the disease will self-resolve due to the absence of pathological pulse changes. As stated, "Yin diseases presenting with Yang pulses indicate survival," because when Yin reaches its extreme, Yang recovers, leading to life. Conversely, "Yang diseases presenting with Yin pulses indicate death," because excessive Yin leads to the depletion of Yang; the external manifestation of restlessness is a false sign (true cold, false heat), hence death. If Yang reaches its extreme and Yin recovers, and the pulse reflects true signs rather than false ones, survival is indicated rather than death. Generally, the severance of Qi of Yin and Yang leads to death, while imbalance allows for potential recovery, and harmony leads to healing. The equality of the three positions signifies a balanced, non-biased state, thus indicating healing.
Question: For any illness, how can one predict when it was contracted and when it will heal?
Answer: For instance, if one falls ill at midnight, they will heal at midday (noon); if one falls ill at midday, they will heal at midnight. Why is this so? Healing from a midday-onset illness at midnight occurs because Yang obtains Yin to achieve resolution. Healing from a midnight-onset illness at midday occurs because Yin obtains Yang to achieve resolution.
If an illness contracted at midday heals by midnight, it is because the excess Yang at midday is balanced by the abundant Yin at midnight, achieving resolution. If an illness contracted at midnight heals by midday, it is because the abundant Yin at midnight is balanced by the excess Yang at midday, achieving resolution.
After six or seven days of illness, if the pulses at the hand and foot (three positions on each limb) all become palpable, and the patient experiences great vexation, trismus (lockjaw), inability to speak, and restlessness, this indicates that the disease is about to resolve. If the pulse is harmonious, the patient is greatly vexed, but presents with heavy eyelids and yellowish discoloration at the inner canthus, this also indicates impending resolution.
When the illness causes the pulses at the hands and feet to be imperceptible, indicating pure Yin without Yang, by the sixth or seventh day, the pulses at the three positions of the limbs become palpable. This signifies the return of Yang Qi to the extremities. The slight Yang Qi has just recovered and risen amidst the Yin pathogens but is obstructed by them. Due to weak force, it cannot rise immediately. During the period of stagnation, agitation, and surging, symptoms such as great vexation, trismus, inability to speak, and restlessness occur, which necessarily precede resolution. Essentially, once there is a mechanism for the recovery of Yin and Yang, victory over the pathogen is inevitable, and long-term stagnation is impossible. If the pulse returns and becomes harmonious, and the patient exhibits great vexation due to Yang recovering but unable to rise immediately, accompanied by heavy eyelids and yellowish discoloration at the inner canthus, this indicates resolution. The Foot-Taiyang Bladder Meridian originates at the inner canthus. Yellowish discoloration at the inner canthus relates to the function of Wei Qi (Defensive Qi) governed by Yangming Earth (Spleen/Stomach). When Wei Qi develops, Yang emerges through the eyes. "Heavy eyelids" refers to thickened eyelids; upon waking, eyelids are naturally thick because Yang Qi emerges through the eyes. (Regarding foot pulses: Wuli [GB29] of the Foot-Jueyin Liver Meridian is outside the pubic region; Taichong [LR3] is taken in women, two cun posterior to the metatarsophalangeal joint of the big toe in the depression; Taixi [KI3] of the Foot-Shaoyin Kidney Meridian is posterior to the medial malleolus; Jimen [SP11] of the Foot-Taiyin Spleen Meridian is on the belly of the gastrocnemius; Fuyang [BL58] of the Foot-Yangming Stomach Meridian is on the dorsum of the foot, i.e., Duzhong/Duzi position. See *Su Wen: Lun San Bu Jiu Hou*).