哲言
师持脉，病患欠者，无病也。○设令向壁卧，闻师到，不惊
起而盼视，若三言三止，脉之咽唾者，此诈病也。设令脉自和，言此病大重，当须服吐下药，针灸数十、百处
乃愈。（张仲景）
病非人之所好，何有诈乎？盖或以争讼，或以斗殴，或妻外家相妒，或名利相关，则人情诈伪出乎其间，使
不有以烛之，则未有不为其欺者。其治之之法，亦为借其欺而反欺之，则真情自露而假病自瘳矣。此亦医家所
必不可少者。（张景岳）
选案
一友所狎之妓，忽仆于地，吐沫肢冷，气息如无。陡见其状，殊为惊骇。因诊气口平和，脉不应证，意其
脉和如此，何以证危如此？第以初未经识，犹不知其为诈也。沉思久之，复诊如故，豁然省悟，岂即仲景之说
乎？遂大声曰∶此病危矣！使非火攻，用如枣栗之艾，连灸眉心、人中、小腹，必不可活。但火灸尚迟，姑先
与药，使其能咽，咽后有声则生，不灸亦可。彼狡奴闻言，窃已惊怖，惟恐火艾着身，药到即咽，少顷即哼出
声而徐起矣。○一相契蓄二外家，其一燕姬，有母随之。二姬相竞，其母助恶，撒赖，遂厥若死，令婢抱坐，自
暮及旦，绝无苏意。延予入室，见其肉浓色黑，面青目瞑，手撒息微，脉伏若脱，亦意其真危也。斯时欲加温
补，虑其逆气未散；欲加开导，虑其脉之似绝。踌躇未决，乃复请诊，则十指交叉抱腹，因疑前番撒手，今既
能叉，岂他人之所为乎？及着手再诊，似有相嫌之意，拽之不动，此更可疑。因出其不意卒猛一扯，顿脱有声，
力强且劲，由是疑释，谓其将死之人，岂犹力有如此？思其脉伏，或肉浓气滞，北人禀赋多有之；或两腋夹紧，
奸人狡诈亦有之。若面青息微，则怒气使然。识见既定，因声言其危，使闻灸法以恐胜之，投药到咽即活。次
日，友询余日昨药果何元妙？予曰∶所秘在言，不过借药为名耳。可见人情难测，使非再诊而再察之，几为所
诳矣。○一戚子为人所殴，卧病旬日，吐血盈盆，喧传人命。医见危剧，束手防累。予后往视，察色无窘苦之
意；诊脉皆和缓如常，始疑继
悟，潜语之曰∶他可欺耶，予亦可欺耶？此尔血耶，抑家禽血耶？其人愕然，遂为调和而散。○一妇妒外家，病剧
僵厥，切牙瞪目，夫惊无措。脉非其病，遂用前法治愈。不但为人造福，且可防人之欺，纪资仓卒之用。（《景岳全书》）
哲言
老师诊脉时，如果病人打哈欠，这是没有生病的表现。○假设病人面向墙壁躺着，听到老师来了，不惊慌起身而是斜眼偷看，说话断断续续（说了又停），切脉时见其吞咽口水，这是装病。即使脉搏平和，若说此病很重，必须服用催吐或泻下的药物，并在数十乃至上百个穴位进行针灸才能痊愈。（张仲景）
疾病并非人们所喜好之事，怎么会有装病呢？大概是因为争讼、斗殴，或是妻子与娘家亲属相互嫉妒，或者涉及名利关系，人情中的欺诈虚伪便从中产生。如果不加以洞察，就没有不被其欺骗的。治疗这种装病的方法，也是利用他们的欺骗而反过来欺骗他们，这样真情自然显露，假病也就自然痊愈了。这也是医生必不可少的手段。（张景岳）
选案
一位朋友宠爱的妓女，突然倒在地上，口吐白沫，四肢冰冷，气息微弱得好像没有了。乍见这情景，非常令人惊骇。于是诊察气口（寸口脉），发现脉搏平和，脉象与症状不符，心想：脉象如此平和，为什么症状看起来如此危重？只是由于初次认识，还不知道她是装病。沉思良久，再次诊脉依然如故，豁然醒悟，难道就是张仲景所说的情况吗？于是大声说道：“这病很危险了！如果不是用火攻，用像枣栗那样大的艾炷，连续灸眉心、人中、小腹穴位，一定不能活命。但是火灸还太迟，暂且先给药，让她能咽下，咽下后发出声音就能活，不灸也可以。”那狡猾的奴仆闻言，心中已惊恐害怕，唯恐火艾烧身，药一到嘴就咽下，过了一会儿就哼出声并慢慢坐起来了。○另一位相好的男子蓄养两个外室，其中一个是燕姬，有母亲跟随。两个姬妾互相竞争，她们的母亲助长恶行，撒泼耍赖，于是昏厥得像死了一样，让婢女抱着坐着，从傍晚到第二天早上，完全没有苏醒的意思。请我进屋诊治，见她肉厚色黑，面色青暗，眼睛紧闭，手松开，气息微弱，脉象伏匿几乎摸不到，也认为她真的危在旦夕。这时想加用温补，担心她的逆气未散；想加用开窍导滞，又担心脉象似绝。犹豫不决，于是再次请求诊脉，只见十指交叉抱腹，因此怀疑前番松手，现在既然能交叉手指，难道是别人做的吗？等到着手再诊，似乎有嫌弃之意，拉她不动，这更可疑。于是出其不意猛然一扯，顿时脱手有声，力气强劲有力，由此疑虑消除，心想将死之人，哪里还有这样的力气？思考她的脉伏，或许是因为肉厚气滞，北方人的体质多有这种情况；或者是两腋夹紧，奸人狡诈也有这种情况。至于面色青暗、气息微弱，则是怒气使然。见识确定后，于是声称病情危重，用灸法来恐吓她，药送到嘴边就活了。第二天，朋友问我昨天的药究竟有什么奥妙？我说：“秘密在于言语，不过是借药物为名罢了。”可见人心难测，如果不是再次诊察，差点被欺骗了。○一个亲戚家的儿子被人殴打，卧床病了十天，吐血满盆，喧传说出了人命。医生见到危急严重的情况，束手无策，怕受牵连。我后来前往探望，观察神色没有窘迫痛苦之意；诊脉都平和舒缓如常，开始怀疑并领悟，悄悄对他说：“别人可以欺骗，我可以欺骗吗？这是你的血，还是家禽的血？”那人愕然，于是为他调和气血而散去。○一个妇人嫉妒娘家亲属，病势严重，僵直昏厥，咬牙瞪眼，丈夫惊慌失措。脉象不符合病症，于是用前面的方法治愈。这不仅为人造福，而且可以防止他人的欺骗，记录以备仓促之用。（《景岳全书》）
Philosophical Remarks
When the master palpates the pulse, if the patient yawns, it indicates no disease. ○ Suppose a patient lies facing the wall; upon hearing the master's arrival, they do not startle or rise but instead cast sidelong glances, speak intermittently (speaking then stopping), and swallow saliva when the pulse is being felt. This is feigned illness. Even if the pulse appears harmonious, claiming that this disease is severe and requires emetic or purgative medicines, along with acupuncture and moxibustion at dozens or even hundreds of points for recovery, is characteristic of such deception. (Zhang Zhongjing)
Disease is not something people desire; why would there be feigned illness? It generally arises from litigation, physical altercations, jealousy between a wife and her natal family members, or disputes involving fame and profit. In these situations, human deceit and hypocrisy emerge. Without the ability to discern them, one will inevitably be deceived. The method for treating feigned illness involves using their own deception against them, thereby revealing the truth and causing the fake illness to heal spontaneously. This is an indispensable skill for physicians. (Zhang Jingyue)
Selected Cases
A courtesan favored by a friend suddenly collapsed, foaming at the mouth, with cold limbs and breath so faint it seemed absent. Witnessing this state was startling. Upon palpating the Cun-Kou pulse (radial artery), I found it harmonious, inconsistent with the symptoms. I thought: If the pulse is so harmonious, why are the symptoms so critical? Initially unfamiliar with her, I did not suspect feigning. After deep contemplation and re-palpation yielding the same result, I suddenly realized: Is this what Zhang Zhongjing described? I then loudly declared, "This condition is critical! Unless fire therapy is applied—using moxa cones as large as dates or chestnuts, continuously moxibusting the Baihui (CV20), Renzhong (GV26), and lower abdomen points—it cannot be saved. However, moxibustion is too late; let us first administer medicine to ensure she can swallow. If she makes a sound after swallowing, she will live; otherwise, moxibustion is unnecessary." Hearing this, the cunning woman was secretly terrified, fearing the burning moxa. She swallowed the medicine immediately. Shortly after, she groaned and slowly sat up. ○ Another acquaintance kept two concubines. One, Yan Ji, was accompanied by her mother. The two concubines competed, and their mothers incited the conflict. One mother threw a tantrum, resulting in syncope resembling death. She was held sitting by a maid from dusk till dawn without regaining consciousness. I was summoned to examine her. She appeared fleshy with dark complexion, face cyanotic, eyes closed, hand relaxed, breath faint, and pulse hidden and nearly imperceptible. I initially suspected genuine criticality. I considered warming and tonifying but feared lingering rebellious Qi; I considered opening orifices but feared the pulse indicated collapse. Hesitating, I requested another examination. Her fingers were interlaced holding her abdomen. I suspected that since she could clasp her hands now, unlike before, someone else might have posed her. Upon touching her again, she seemed to show aversion, resisting my pull. This was suspicious. Suddenly pulling her sharply, she detached with a sound, displaying strong force. My suspicion vanished: Would a dying person have such strength? I reasoned her hidden pulse might be due to thick flesh and stagnant Qi, common in Northern constitutions; or clenched armpits due to deceit. The cyanotic face and faint breath were likely due to anger. With this insight, I declared the condition critical and threatened moxibustion to frighten her. She recovered immediately upon receiving medicine. The next day, my friend asked about the miracle of yesterday's medicine. I replied, "The secret lay in words; the medicine was merely a pretext." Human nature is unpredictable; without repeated examination, I almost fell for the deception. ○ A relative's son was beaten and bedridden for ten days, vomiting blood filling a basin, with rumors of homicide spreading. Physicians, seeing the critical severity, were helpless and afraid of liability. I visited later, observing no expression of distress or pain; the pulse was harmonious and slow, normal. Suspecting and realizing the truth, I whispered privately, "Others may be deceived, but can you deceive me? Is this your blood, or poultry blood?" He was stunned. I then prescribed harmonizing herbs, and he dispersed. ○ A woman, jealous of her natal relatives, suffered severe illness with rigidity and syncope, grinding teeth and staring wide-eyed. Her husband was panicked and at a loss. The pulse did not match the disease. I treated her using the previous method and cured her. This not only benefits others but also prevents deception. Recorded for use in emergencies. (Complete Works of Master Jingyue)