问曰伤寒三日脉浮数而微病患身凉和者何也答曰此为欲解也解以夜半脉浮而解者 然汗出也脉数而解者必能食也脉
微而解者必大汗出也
伤寒三日脉浮数而微病患身复凉和者此为欲解也解于夜半盖脉之浮数身之烦热俱属阳证乃脉之浮数渐有微意身之烦
热已变凉和是邪热之渐退而阴气之续复也待至夜半则阴旺而全复故解于此际而其解也形状不同其脉浮而解者表阳之旺
然汗出也其脉数而解者里阳之旺必能食也其脉微而解者表里之阳俱虚必战摇振栗而大汗出也
问曰病有战而汗出因得解者何也答曰脉浮而紧按之反芤此为本虚故当战而汗出也其人本虚是以发战以脉浮故当汗出
而解也若脉浮而数按之不芤此人本不虚若欲自解但汗出耳不发战也
病有战而汗出因得解者以脉浮而紧是伤寒之脉而按之反芤此为本气之虚本虚则阳气郁于阴邪不能透发故当战栗而后
汗出也其人本虚是以汗前发战以其脉浮则病在皮毛故当汗出而解也若脉浮而数按之不芤此其人本不虚若欲自解但安卧而
汗出耳不至发战也
问曰病有不战而汗出解者何也答曰脉大而浮数故知不战汗出而解也
脉大而浮数阳气盛旺阴邪不能遏郁故不战而汗解也
问曰病有不战不汗出而解者何也答曰其脉自微此以曾经发汗若吐若下若亡血以内无津液此阴阳自和必自愈故不战不
汗出而解也
其脉自微弱则表里无邪此以曾经发汗吐下亡血失津阴不济阳未免烦热时作然表里邪去病根已除迟而津液续复阴阳自
和必当自愈故不战不汗而亦解
问:伤寒发病三天,脉象浮、数而微,病人身体凉爽平和,这是什么原因?
答:这是病情将要解除的表现。解除的时间通常在半夜。脉象浮而解除的,是因为自然出汗;脉象数而解除的,必定食欲恢复(能进食);脉象微而解除的,必定是大汗出。
伤寒发病三天,脉象浮、数而微,病人身体又变得凉爽平和,这是病情将要解除的表现。解除的时间在半夜。因为脉象浮、数,身体烦热,都属于阳证。现在脉象的浮、数逐渐转为微弱,身体的烦热已经变为凉爽平和,这说明邪热逐渐消退,阴气相继恢复。等到半夜时分,阴气旺盛并完全恢复,所以在此时解除。其解除时的表现形态各不相同:脉象浮而解除的,是表阳旺盛,自然出汗而解;脉象数而解除的,是里阳旺盛,必定能够进食而解;脉象微而解除的,是表里阳气都虚弱,必定会出现战栗颤抖而后大汗出而解。
问:有的疾病出现战栗而后出汗,因此得以解除,这是什么原因?
答:脉象浮而紧,重按反而中空(芤),这是因为正气本虚,所以应当出现战栗而后出汗才能解除。这个人原本正气虚弱,所以在发汗前会出现战栗。因为脉象浮,病邪在表,所以应当通过出汗而解除。如果脉象浮而数,重按不中空,说明这个人原本正气不虚,如果想要自行解除,只是安静地出汗而已,不会出现战栗。
疾病出现战栗而后出汗从而得以解除的原因,是因为脉象浮而紧,这是伤寒的典型脉象,但重按反而中空,这是正气本虚。正气虚弱则阳气郁结于阴邪之中,不能透发出来,所以必须经过战栗之后才能出汗解除。这个人原本正气虚弱,所以在出汗前出现战栗。因为脉象浮,病邪在皮毛肌表,所以应当通过出汗而解除。如果脉象浮而数,重按不中空,说明这个人原本正气不虚,如果想要自行解除,只是安静地躺着出汗而已,不会到出现战栗的程度。
问:有的疾病没有战栗而是直接出汗解除,这是什么原因?
答:脉象大而浮数,所以知道不会战栗,而是通过出汗解除。
脉象大而浮数,说明阳气盛旺,阴邪不能被遏制郁结,所以不会战栗,而是通过出汗解除。
问:有的疾病既不战栗也不出汗而自行解除,这是什么原因?
答:脉象自然微弱,这是因为曾经发过汗,或者用过吐法、下法,或者失血,导致体内津液亏损。此时阴阳自然调和,必定自愈,所以既不战栗也不出汗而解除。
脉象自然微弱,说明表里没有邪气。这是因为曾经发过汗、吐过、下过,或者失血伤津,阴液不足无法济助阳气,难免有时出现烦热。然而表里的邪气已去,病根已除,随着时间推移津液逐渐恢复,阴阳自然调和,必定会自愈,所以既不战栗也不出汗而解除。
Question: In the case of cold damage (Shanghan) on the third day, with a floating (Fu), rapid (Shu), and thready (Wei) pulse, and the patient's body feeling cool and harmonious, what is the reason?
Answer: This indicates that the disease is about to resolve. The resolution typically occurs at midnight. If the pulse is floating and resolves, it is due to spontaneous sweating. If the pulse is rapid and resolves, the patient will definitely be able to eat. If the pulse is thready and resolves, there will definitely be profuse sweating.
In cold damage on the third day, with a floating, rapid, and thready pulse, and the patient's body becoming cool and harmonious again, this indicates that the disease is about to resolve. The resolution occurs at midnight. Floating and rapid pulses, along with bodily irritability and heat, belong to Yang syndromes. Now, the floating and rapid qualities of the pulse are gradually becoming thready, and the bodily irritability and heat have changed to coolness and harmony. This shows that the pathogenic heat is gradually retreating while Yin Qi is sequentially recovering. By midnight, when Yin Qi is prosperous and fully restored, the resolution occurs at this time. The manifestations of resolution differ: if the pulse is floating and resolves, it is due to the prosperity of Exterior Yang, resulting in spontaneous sweating; if the pulse is rapid and resolves, it is due to the prosperity of Interior Yang, and the patient will definitely be able to eat; if the pulse is thready and resolves, it is because both Exterior and Interior Yang are deficient, leading to shivering and trembling followed by profuse sweating.
Question: Why does some disease resolve through shaking/chills followed by sweating?
Answer: A pulse that is floating and tight, but empty (Kou) upon deep pressure, indicates original deficiency. Therefore, chills/shaking must occur before sweating can lead to resolution. Because the person’s original Qi is deficient, shaking occurs prior to sweating. Since the pulse is floating, the pathogen is in the exterior, so resolution occurs through sweating. If the pulse is floating and rapid, and not empty upon deep pressure, the person’s original Qi is not deficient. If self-resolution is desired, only quiet sweating will occur, without shaking.
The reason for resolving through shaking and subsequent sweating is that a floating and tight pulse is characteristic of cold damage, yet deep pressure reveals an empty (Kou) quality, indicating deficiency of Original Qi. When Original Qi is deficient, Yang Qi is constrained within Yin pathogens and cannot penetrate outward, so shivering must precede sweating for resolution. Because the person’s original Qi is deficient, shaking occurs before sweating. Since the pulse is floating, the disease is in the skin and hair (exterior), so resolution occurs through sweating. If the pulse is floating and rapid, and not empty upon deep pressure, the person’s original Qi is not deficient. If self-resolution is desired, only quiet lying down and sweating will occur, without reaching the stage of shaking.
Question: Why does some disease resolve through sweating without shaking?
Answer: A large, floating, and rapid pulse indicates that shaking will not occur, and resolution will come through sweating.
A large, floating, and rapid pulse indicates vigorous Yang Qi. Since Yin pathogens cannot suppress or constrain it, resolution occurs through sweating without shaking.
Question: Why does some disease resolve without shaking and without sweating?
Answer: A naturally weak pulse indicates previous administration of diaphoresis (sweating therapy), emesis, purgation, or blood loss, leading to internal deficiency of Body Fluids (Jin Ye). When Yin and Yang naturally harmonize, self-healing occurs; thus, there is no shaking or sweating during resolution.
A naturally weak and thin pulse indicates no pathogen in the interior or exterior. This is due to previous diaphoresis, emesis, purgation, or blood/fluid loss, where Yin fails to assist Yang, occasionally causing irritability and heat. However, since exterior and interior pathogens have been eliminated and the root of the disease removed, as time passes and Body Fluids gradually recover, Yin and Yang naturally harmonize, leading to self-healing. Thus, resolution occurs without shaking or sweating.