太阳病,恶寒而发热,今自汗出,反不恶寒而发热,关上脉细而数,此吐之过也。
少阴病,其人饮食入则吐,心中温温欲吐,复不能吐,始得之,手足寒,脉弦运,若膈
上有寒饮,干呕,忌吐,当温之。
诸四逆病厥,忌吐,虚家亦然。
大法春宜吐。
凡服吐汤,中病便止,不必尽剂也。
病如桂枝证,其头项不强痛,寸口脉浮,胸中痞坚,上撞咽喉不得息,此为有寒,宜吐
之。
病胸上诸实,胸中郁郁而痛,不能食,欲使人按之,而反有涎唾下利,日十余行,其脉
反迟,寸口微滑,此宜吐之,利即止。
少阴病,其人饮食入则吐,心中温温欲吐,复不能吐,宜吐之。
病者手足逆冷,脉乍紧,邪结在胸中,心下满而烦,饥不能食,病在胸中,宜吐之。
宿食在上管,宜吐之。
咽中闭塞,忌下,下之则上轻下重,水浆不下。诸外实忌下,下之皆发微热,亡脉则厥
诸虚忌下,下之则渴,引水易愈,恶水者剧。
脉数者忌下,下之必烦,利不止。
尺中弱涩者,复忌下。
脉浮大,医反下之,此为大逆。
太阳证不罢,忌下,下之为逆。
结胸证,其脉浮大,忌下,下之即死。
太阳与阳明合病,喘而胸满者,忌下。
太阳与少阳合病,心下痞坚,颈项强而眩,忌下。
凡四逆病厥者,忌下,虚家亦然。
病欲吐者忌下。
病有外证未解,忌下,下之为逆。
少阴病,食入即吐,心中温温欲死,复不能吐。始得之,手足寒,脉弦迟,此胸中实,
忌下。
伤寒五六日,不结胸,腹濡,脉虚复厥者,忌下。下之亡血则死。
太阳病,表现为恶寒且发热,如今却自汗出,反而不恶寒而发热,关部脉象细而数,这是误用吐法造成的过失。
少阴病,患者饮食入口即吐,心中泛泛欲吐却又吐不出来,初起时手足寒冷,脉象弦而晕眩(注:原文“运”通“晕”,指脉象或症状导致的眩晕感,此处依语境译为脉象异常伴眩晕),如果膈上有寒饮,出现干呕,忌用吐法,应当采用温法治疗。
各种四逆病引起的四肢厥冷,忌用吐法,体质虚弱的人也是如此。
治疗的大原则是春季适宜使用吐法。
凡是服用催吐的汤药,一旦病情缓解就应停止,不必服完全部剂量。
病症类似桂枝汤证,但头颈部不强痛,寸口脉浮,胸中痞塞坚硬,气上冲咽喉导致呼吸不畅,这是因为体内有寒邪,适宜使用吐法。
胸部以上的各种实邪阻滞,胸中郁结疼痛,不能进食,想要让人按压胸部,反而伴有涎唾增多和腹泻,一天十多次,脉象反而迟缓,寸口微滑,这种情况适宜使用吐法,腹泻随即停止。
少阴病,患者饮食入口即吐,心中泛泛欲吐却又吐不出来,适宜使用吐法。
患者手足逆冷,脉象突然紧束,邪气结聚在胸中,心下胀满且烦躁,饥饿却无法进食,病位在胸中,适宜使用吐法。
宿食停滞在上脘,适宜使用吐法。
咽喉部位闭塞不通,忌用泻下法,若误用泻下法,会导致上部虚而下部重坠,水浆无法咽下。各种外实证候忌用泻下法,误用泻下法都会引发轻微发热,若脉象消失则会出现四肢厥冷。各种虚证忌用泻下法,误用泻下法会导致口渴,想喝水且容易痊愈,若厌恶喝水则病情加重。
脉象数的患者忌用泻下法,误用泻下法必定导致心烦,腹泻不止。
尺部脉象弱涩的患者,也忌用泻下法。
脉象浮大,医生反而使用泻下法,这属于严重的逆治错误。
太阳证未解除,忌用泻下法,误用泻下法即为逆治。
结胸证,脉象浮大,忌用泻下法,误用泻下法会导致死亡。
太阳与阳明合病,出现气喘且胸部胀满的,忌用泻下法。
太阳与少阳合病,心下痞塞坚硬,颈项强直且头晕目眩的,忌用泻下法。
凡是患有四逆病四肢厥冷的,忌用泻下法,体质虚弱的人也是如此。
想要呕吐的病证忌用泻下法。
病证仍有表证未解的,忌用泻下法,误用泻下法即为逆治。
少阴病,食物入口即吐,心中泛泛欲死,却又吐不出来。初起时,手足寒冷,脉象弦迟,这是胸中有实邪,忌用泻下法。
伤寒五六天,没有形成结胸证,腹部柔软,脉象虚弱且四肢厥冷的,忌用泻下法。误用泻下法导致亡血则会死亡。
Taiyang disease (disease of the Taiyang channel), characterized by aversion to cold and fever, now presents with spontaneous sweating, contrary absence of aversion to cold but presence of fever, with a fine and rapid pulse at the Guan position; this is an error caused by improper use of emesis.
Shaoyin disease (disease of the Shaoyin channel): The patient vomits immediately after eating or drinking, feels nauseous in the heart region but cannot actually vomit. At the onset, the hands and feet are cold, and the pulse is wiry accompanied by dizziness. If there is cold-fluid retention above the diaphragm causing dry heaving, emesis is contraindicated; instead, warming methods should be employed.
For all cases of Sini disease (Four-Chill disease) presenting with Jue (extremity coldness), emesis is contraindicated; the same applies to patients with deficiency constitutions.
The general principle states that emesis is suitable in spring.
When administering emetic decoctions, stop once the illness is resolved; it is not necessary to consume the entire dose.
If the symptoms resemble those of Guizhi Tang (Cinnamon Twig Decoction) syndrome, but without stiffness and pain in the head and neck, with a floating pulse at the Cun Kou (radial artery) position, and hardness/stagnation in the chest with Qi rushing up to the throat obstructing breathing, this indicates the presence of cold pathogen, and emesis is indicated.
For various excess conditions located above the chest, characterized by stifling pain in the chest, inability to eat, desire for abdominal/chest pressure, accompanied by excessive saliva/phlegm and diarrhea occurring more than ten times a day, with a surprisingly slow pulse and slightly slippery pulse at the Cun Kou position, emesis is indicated, and the diarrhea will cease immediately.
Shaoyin disease: The patient vomits immediately after eating or drinking, feels nauseous in the heart region but cannot actually vomit; emesis is indicated.
The patient presents with inverted coldness of the hands and feet, a suddenly tight pulse, pathogenic factors knotted in the chest, fullness and irritability below the heart, hunger but inability to eat. Since the disease is located in the chest, emesis is indicated.
Retained food stagnating in the upper Jiao (Upper Burner/Epigastrium) requires emesis.
Obstruction in the throat is contraindicated for purgation (downward draining). Improper purgation leads to a sensation of lightness above and heaviness below, resulting in the inability to swallow fluids. All exterior excess conditions are contraindicated for purgation; improper purgation causes slight fever, and if the pulse disappears, Jue (extremity coldness) occurs. All deficiency conditions are contraindicated for purgation; improper purgation causes thirst. If the patient desires water, recovery is likely; if the patient abhors water, the condition worsens.
A rapid pulse is contraindicated for purgation; improper purgation causes irritability and unceasing diarrhea.
A weak and choppy pulse at the Chi position is also contraindicated for purgation.
A floating and large pulse, if treated with purgation by the physician, constitutes a major therapeutic error (Ni).
If Taiyang syndrome has not resolved, purgation is contraindicated; improper purgation is considered Ni (adverse/rebellious treatment).
Jie Xiong syndrome (Chest Binding syndrome) with a floating and large pulse is contraindicated for purgation; improper purgation leads to death.
Combined disease of Taiyang and Yangming, presenting with wheezing and chest fullness, is contraindicated for purgation.
Combined disease of Taiyang and Shaoyang, presenting with hardness/stagnation below the heart, stiffness of the neck, and dizziness, is contraindicated for purgation.
All cases of Sini disease with Jue (extremity coldness) are contraindicated for purgation; the same applies to patients with deficiency constitutions.
Conditions where the patient desires to vomit are contraindicated for purgation.
Conditions where exterior signs have not yet resolved are contraindicated for purgation; improper purgation is considered Ni.
Shaoyin disease: Food is vomited immediately upon entry, the patient feels nauseous to the point of despair in the heart region but cannot vomit. At the onset, the hands and feet are cold, and the pulse is wiry and slow. This indicates excess in the chest; purgation is contraindicated.
After five or six days of Shanghan (Cold Damage), if there is no Jie Xiong syndrome, the abdomen is soft, the pulse is deficient, and there is Jue (extremity coldness), purgation is contraindicated. Improper purgation leading to loss of blood results in death.