〔伤寒所致〕太阳病,痉湿暍,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,「利不止亡阳」〔利止亡血〕也,四逆加人参汤主之 。
【按】
利止亡血,如何用大热补药?利止应是「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「大」〔微
〕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;「脉来大去小」〔脉来头小本大〕,故名覆,
病在表也。「上微小者为阴盛」〔上微头小者〕,则汗出;「下微小者为阳盛」〔下
微本大者〕,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,荣气盛名曰章,高章相抟,名曰纲。卫气弱名曰惵,荣气弱名曰
卑,惵卑相抟,名曰损。卫气和名曰缓,荣气和名曰迟,迟缓相抟,名曰「强」。〔
沉〕
【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□〕,阴阳相抱,荣卫俱行,刚柔相得,名曰强也。
【按】
「薄鲜□」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「濡」〔浮〕,阴脉弱者,则血虚,血虚则筋急也。其脉「弱」〔沉〕者,荣气
微也;其脉「濡」〔浮〕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,则与血虚荣气微
之义不属,当改之。
师曰:病家人来请,云,病人发热烦极,明日师到,病人向壁卧,此热已去也,设令
脉「自」〔不〕和,处言已愈。
【按】
不和应是「自和」,若不和 ,如何言愈?当改之。
【伤寒所致】太阳病,痉湿暍,此三种,宜应别论。
【按语】
“伤寒所致”这四个字,没有什么意义,应当删除。
太阳病,发热无汗,恶寒者,名为刚痉。
【按语】
恶寒前面的“反”字,是衍文(多余的文字),刚痉证候本来就应该恶寒,并非相反,应当删除。
恶寒、脉微并且又腹泻,“腹泻不止导致亡阳”,(原文误作“利止亡血”),用四逆加人参汤主治。
【按语】
“利止亡血”怎么能用大热补药呢?“利止”应该是“利不止”,“亡血”应该是“亡阳”,应当改正。
问:人患病有宿食,如何辨别它?老师说:寸口脉浮而大,用力按压反而涩滞,尺中脉也(原文误作“大”,应为)微而涩,所以知道有宿食,应当用攻下法,适宜用大承气汤。
【按语】
尺中脉的“微”字,应当是“大”字,如果是“微”字,绝对没有可以攻下的道理,应当改正。
假如脉象来势微弱去势盛大,名叫“反”,病在里;(原文误作“脉来大去小”,应为)“脉来头小本大”,名叫“覆”,病在表。(原文误作“上微小者为阴盛”,应为)“上微头小者”,则汗出;(原文误作“下微小者为阳盛”,应为)“下微本大者”,则为关格不通,不能排尿;头部无汗的可以治愈,有汗的死亡。
【按语】
“脉来头小本大”,应当是“脉来大去小”。 “上微头小者”,应当是“上微小者为阴盛”。 “下微本大者”,应当是“下微小者为阳盛”。 这才与上下之义相联系,应当改正并补充。
寸口脉卫气盛叫做“高”,营气盛叫做“章”,高和章相互搏结,叫做“纲”。卫气弱叫做“惵”,营气弱叫做“卑”,惵和卑相互搏结,叫做“损”。卫气和叫做“缓”,营气和叫做“迟”,缓和迟相互搏结,叫做“强”(原文误作“沉”)。
【按语】
“名曰沉”的“沉”字,应该是“强”字,玩味下文可知,应当改正。
寸口脉缓而迟,缓则阳气生长,面色鲜艳,容颜光亮,声音清亮如金(商音),毛发长;迟则阴气盛,骨髓生,血液充盈,肌肉紧实(原文“薄鲜□”三字不成句,为衍文),阴阳相抱,营卫俱行,刚柔相得,叫做“强”。
【按语】
“薄鲜□”这三个字,不成句子,应该是衍文,应当删除。
北方肾脉,它的形态像什么?老师说:肾属水,名叫少阴,其脉沉滑,这就是肾脉。肾病如果自然出现沉滑而濡的脉象,就会痊愈。
【按语】
东南西方都有相关文字,唯独缺少北方的记载,仿照经文进行补充。
问:脉象忽聚忽散且深沉,名叫“滑”,这是什么意思?老师说:沉代表纯阴,翕(浮取时轻举之象)代表正阳,阴阳和谐结合,所以使脉象滑利,关部和尺部自然平和。阳明脉微沉,饮食正常;少阴脉微滑,(原文插入句“滑者紧之浮名也,此为阴实”与上下文义不连贯,当是错简),此人必定大腿内侧出汗,阴部潮湿。
【按语】
“滑者紧之浮名也,此为阴实”这两句,与上下文的义理不相关联,应当是竹简错乱导致的错误。
阳脉(原文误作“濡”,应为)浮,阴脉弱者,则血虚,血虚则筋脉拘急。其脉(原文误作“弱”,应为)弱者,是营气微弱;其脉(原文误作“濡”,应为)浮而且汗出如流珠的,是卫气衰弱。
【按语】
阳脉浮,这两个“浮”字,应当是“濡”字,如果是“浮”字,则与卫气衰弱、汗出如流珠的意义不相关联。其脉沉的“沉”字,应当是“弱”字,如果是“沉”字,则与血虚、营气微弱的意义不相关联,应当改正。
老师说:病人的家属来请医生,说病人发热烦躁至极,第二天医生到了,病人面向墙壁躺着,这说明热邪已去,假如脉象(原文误作“自”,应为)不和,却说已经痊愈。
【按语】
“不和”应该是“自和”,如果不和,怎么能说痊愈呢?应当改正。
[Caused by Cold Damage] Taiyang disease (disease of the Taiyang channel), Jing (spasm), Shi (dampness), and Ye (heatstroke) are these three types; they 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 (rigid spasm).
[Commentary]
The character "fan" (reverse/contrary) before "aversion to cold" is a superfluous character (derivative text). The syndrome of rigid spasm naturally involves aversion to cold; it is not contrary. It should be deleted.
Aversion to cold, faint pulse, and recurrent diarrhea indicate that "unremitting diarrhea leads to collapse of Yang" (the original text erroneously states "stopping diarrhea leads to loss of blood"). Si Ni Jia Ren Shen Tang (Four Reversals plus Ginseng Decoction) should be administered.
[Commentary]
How can large, hot, tonifying medicines be used for "stopping diarrhea leading to loss of blood"? "Stopping diarrhea" should be "unremitting diarrhea," and "loss of blood" should be "collapse of Yang." This should be corrected.
Question: If a person suffers from retained food, how can it be distinguished? The Master said: The Cun Kou (radial artery at the wrist) pulse is floating and large; upon pressing, it feels reverse-choppy (se); the Chi position (distal part of the pulse) is also [erroneously "large" in the text, should be] faint and choppy. Thus, one knows there is retained food. One should use purgation, and Da Cheng Qi Tang (Major Order the Qi Decoction) is appropriate.
[Commentary]
The character "faint" (wei) in the Chi position should be "large" (da). If it were "faint," there would absolutely be no rationale for purgation. This should be corrected.
Suppose the pulse comes faint and goes large; this is named "Fan" (Reverse), indicating the disease is in the interior. [Erroneously "pulse comes large and goes small" in text, should be] "Pulse comes head-small and root-large" is named "Fu" (Covered), indicating the disease is in the exterior. [Erroneously "Upper faint small indicates Yin excess" in text, should be] "Upper faint head-small" causes sweating. [Erroneously "Lower faint small indicates Yang excess" in text, should be] "Lower faint root-large" results in Guan-Ge obstruction (blockage of upper and lower orifices), inability to urinate; if the head has no sweat, it is treatable; if there is sweat, it is fatal.
[Commentary]
"Pulse comes head-small and root-large" should be "pulse comes large and goes small." "Upper faint head-small" should be "upper faint small indicates Yin excess." "Lower faint root-large" should be "lower faint small indicates Yang excess." Only then does it align with the meanings of upper and lower. This should be corrected and supplemented.
At the Cun Kou, excessive Wei Qi (Defensive Qi) is called "Gao" (High); excessive Ying Qi (Nutritive Qi) is called "Zhang" (Brilliant). When Gao and Zhang contend, it is called "Gang" (Cord). Weak Wei Qi is called "Die" (Trembling); weak Ying Qi is called "Bei" (Low). When Die and Bei contend, it is called "Sun" (Damage). Harmonious Wei Qi is called "Huan" (Slow/Relaxed); harmonious Ying Qi is called "Chi" (Late/Sluggish). When Huan and Chi combine, it is called "Qiang" (Strong) [erroneously "Chen" (Deep) in the text].
[Commentary]
The character "Chen" (Deep) in "named Chen" should be "Qiang" (Strong). Examining the following text reveals this. It should be corrected.
At the Cun Kou, a slow and late pulse: Slow indicates Yang Qi growing; the complexion is fresh, the face radiant, the voice clear like metal (Shang tone), and hair grows long. Late indicates Yin Qi abundant; marrow generates, blood fills, and muscles are firm [The three characters "Bo Xian □" do not form a sentence and are derivative text; they should be deleted]. Yin and Yang embrace each other, Ying and Wei circulate together, hardness and softness obtain harmony; this is named "Qiang" (Strong).
[Commentary]
The three characters "Bo Xian □" do not constitute a sentence and are likely derivative text; 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 deep and slippery; this is the Kidney pulse. If Kidney disease naturally presents with a deep, slippery, and soggy pulse, recovery will occur.
[Commentary]
Texts exist for the Southeast and West, but the North is missing. This section is supplemented imitating the classic text.
Question: A pulse that gathers suddenly and sinks deeply is named "Hua" (Slippery). What does this mean? The Master said: Deep represents pure Yin; gathering (floating lightly) represents correct Yang. When Yin and Yang harmonize, the pulse becomes slippery, and the Guan and Chi positions become balanced. The Yang Ming pulse is slightly deep, and digestion is normal; the Shao Yin pulse is slightly slippery, [The inserted sentence "Slippery is the floating name of Tight, this is Yin Excess" does not fit the context and is likely a misplaced bamboo slip], the person will definitely have sweat on the inner thighs and dampness in the genital area.
[Commentary]
The two sentences "Slippery is the floating name of Tight, this is Yin Excess" do not align with the preceding and following logic and are likely errors due to misplaced bamboo slips.
Yang pulse [erroneously "Ru" (Soggy) in text, should be] Floating, Yin pulse weak, indicates Blood deficiency. Blood deficiency leads to tendon tension. The pulse [erroneously "Ruo" (Weak) in text, should be] Weak indicates slight Ying Qi. The pulse [erroneously "Ru" (Soggy) in text, should be] Floating with sweat flowing like pearls indicates Wei Qi decline.
[Commentary]
In "Yang pulse floating," both instances of "Floating" should be "Ru" (Soggy). If they were "Floating," it would not align with the meaning of Wei Qi decline and sweat like pearls. In "the pulse is Soggy," the character "Soggy" should be "Weak." If it were "Soggy," it would not align with the meaning of Blood deficiency and slight Ying Qi. This should be corrected.
The Master said: The patient's family comes to invite the doctor, saying, "The patient is extremely feverish and irritable." The next day, when the doctor arrives, the patient lies facing the wall, indicating the heat has gone. If the pulse [erroneously "Zi" (Self) in text, should be] Bu He (does not harmonize), yet one claims the patient is cured.
[Commentary]
"Bu He" (does not harmonize) should be "Zi He" (harmonizes itself). If it does not harmonize, how can one claim cure? This should be corrected.