胆者中正之腑也。号曰将军。决断出焉。言能喜怒刚柔也。与肝为表里。足少阳是其经也。虚则伤寒。寒则
恐畏。头眩不能独卧。实则伤热。热则惊悸。精神不守。卧起不宁。又玄水发。则其根在于胆。先从头面起。肿
至足也。又肝咳久不已。则传邪入于胆。呕清苦汁也。又胆病则喜太息。口苦。呕清汁。(一作宿汁。)心中澹澹恐。如
人将捕之。咽仲介介然数唾。又胆胀。则舌(一作胁。)下痛。口苦太息也。邪气客于胆。则梦斗讼。其脉诊在左手
关上浮而得之者。是其部也。胆实热。则精神不守。又胆热则多睡。胆冷则无眠。又左关上脉。阳微者胆虚
也。阳数者胆实也。阳虚者胆绝也。
心者五脏之尊号。帝王之称也。与小肠为表里。神之所舍。又主于血。属于火。旺于夏。手少阴是其经也。凡
夏脉钩。来盛去衰。故曰钩。反此者病。来盛去亦盛。此为太过。病在外。来衰去盛。此为不及。病在内。太过则
令人身热而骨痛。口疮。舌焦。引水不及。则令人烦躁。(一作心。)上为咳唾。下为气泄。其脉来累累如连珠。如循
琅。曰平。脉来累累(一本无此四字。却作喘喘。)连属。其中微曲。曰病。来前曲后倨。如操带钩。曰死。又思虑过
多。则怵惕。怵惕伤心。心伤则神失。神失则恐惧。又真心痛。手足寒。过节五寸。则旦得夕死。夕得旦死。又心有水
气则痹。气滞。身肿。不得卧。烦而躁。其阴肿也。又心中风。则翕翕(一作吸。)发热。不能行立。心中饥而不能食。
食则吐呕。夏心旺。左手寸口脉。洪浮大而散曰平。反此则病。若沉而滑者。水来克火。十死不治。弦而长者。木来归
子。其病自愈。缓而大者。土来入火。为微邪相干。无所害。又心病。则胸中痛。四(一作胁。)肢满胀。肩背臂膊皆痛。
虚则多惊悸。惕惕然无眠。胸腹及腰背引痛。喜(一作善。)悲。时眩仆。心积气。久不去。则苦忧烦。心中痛。实则喜
笑不息。梦火发。心气盛。则梦喜笑。及恐畏。邪气客于心。则梦山邱烟火。心胀。则心烦短气。夜卧不宁。心腹
痛。懊 。肿。气来往上下行。痛有时休作。心腹中热。喜水。涎出。是 蛟( 恐是蛔字。蛟恐是咬字。)心也。心病
则
曰中慧。夜半甚。平旦静。又左手寸口脉。大甚。则手内热赤。(一作服。)肿太甚。则胸中满而烦。澹澹面赤目黄也。
又心病。则先心痛。而咳不止。关膈(一作格。)不通。身重不已。三日死。心虚则畏人。瞑目欲眠。精神不倚。魂魄妄
乱。心脉。沉小而紧。浮主气喘。若心下气坚实不下。喜咽干。手热。烦满。多忘。太息。此得之思忧太过也。其脉急
甚。则
发狂笑。微缓则吐血。大甚则喉闭。(一作痹。)微大则心痛引背。善泪出。小甚则哕。微小则笑消瘅。(一作痹。)滑甚
则
为渴。微滑则心疝引脐。腹(一作肠。)鸣。涩甚则喑不能言。微涩则血溢。手足厥。耳鸣。癫疾。又心脉抟坚而长。主
舌
强不能语。(一作言。)软而散。当慑怯不食也。又急甚则心疝。脐下有病形。烦闷少气。大热上煎。又心病。狂言汗
出如珠。身厥冷。其脉当浮而大。反沉濡而滑甚。色当赤。今反黑者。水克火。十死不治。又心之积。沉之而空
空然。时上下往来。无常处。病胸满HT 。腰腹中热。颊(一作面。)赤咽干。心烦。掌中热甚。则呕血。夏瘥。(本作
春
瘥。)冬甚。宜急疗之。止于旬日也。又赤黑色入口必死也。面黄目赤者亦(一作不。)死。赤如 血。亦死。又忧恚思
虑太过。心气内索。其色反和而盛者。不出十日死。扁鹊曰。心绝则一日死。色见凶多。而人虽健敏。名为行尸。一岁
之中。祸必至矣。又其人语声前宽而后急。后声不接前声。其声浊恶。其口不正。冒昧喜笑。此风入心也。又心
伤则心坏。为水所乘。身体手足不遂。骨节解。舒缓不自由。下利无休息。此疾急宜治之。不过十日而亡也。
又笑不待呻而复忧。此水乘火也。阴系于阳。阴起阳伏。伏则生热。热则生狂。冒昧妄乱。言语错误。不可采
问。(一作闻。)心已损矣。扁鹊曰。其人唇口赤。即可治。青黑即死。又心疟。则先烦(一作颤。)而后渴。翕翕发热也。
其脉浮紧而大者是也。心气实。则小便不利。腹满。身热而重。温温欲吐。吐而不出。喘息急。不安卧。其脉左寸口
与人迎。皆实大者。是也。心虚则恐惧多惊。忧思不乐。胸腹中苦痛。言语战栗。恶寒。恍惚。面赤目黄。喜衄血。
诊其脉。左右寸口两虚而微者。是也。
胆是居中守正之腑,号称“将军”,决断力由此产生。这说明胆能调节人的喜怒、刚柔性情。胆与肝互为表里,足少阳胆经是其所属经脉。
胆虚则易受寒邪侵袭,受寒则出现恐惧畏缩的症状,头晕目眩,无法独自卧床休息。胆实则易受热邪侵袭,受热则出现惊悸不安,精神不能内守,坐卧不宁。另外,玄水病发作时,其根源在于胆,水肿先从头面部开始,逐渐蔓延至足部。还有,如果肝咳日久不愈,病邪会传入胆,导致呕吐出清稀且味苦的胆汁(另一种说法是宿积的汁液)。此外,胆病患者喜欢长叹气,口苦,呕吐清汁(一作宿汁),心中澹澹然恐惧,好像被人将要抓捕一样,咽喉中有异物感,频频唾吐。还有,胆胀病会导致舌下(一说胁下)疼痛,口苦,喜欢长叹气。邪气客居在胆,人会梦见争斗诉讼。诊脉时,如果在左手关部浮取得到此脉,就是胆病的部位。
胆实热,则精神不能内守。胆热则嗜睡,胆冷则失眠。另外,左手关部脉象,阳气微弱的是胆虚,阳气数急的是胆实,阳气虚弱欲绝的是胆绝。
心是五脏中的尊长,号称“帝王”。心与小肠互为表里,是神志寄居之所,又主司血液,归属于火,在夏季旺盛,手少阴心经是其所属经脉。
凡是夏季的脉象呈钩形,来势盛而去势衰,所以称为钩脉。与此相反的就是病脉。来势盛去势也盛,这叫太过,病在外;来势衰去势盛,这叫不及,病在内。太过则使人身体发热而骨痛,生口疮,舌焦枯,想喝水却喝不够,进而使人烦躁(一说为心神受损)。向上表现为咳嗽吐痰,向下表现为气泄。脉象来时累累如连珠,像抚摸琅玕玉一样,这是平脉。脉象来时累累相连属(另一版本无此四字,作喘喘状),其中微有弯曲,这是病脉。脉象前段弯曲后段僵硬,像拿着带钩的腰带一样,这是死脉。
另外,思虑过多,就会惊恐不安。惊恐损伤心脏,心脏受伤则神气丧失,神气丧失则产生恐惧。还有真心痛,手足寒冷超过肘膝关节五寸,早上发病晚上死亡,晚上发病早上死亡。另外,心有水气停滞则形成痹证,气机阻滞,身体浮肿,不能仰卧,心烦躁动,阴部肿胀。另外,心中风,则翕翕发热,不能行走站立,心中感觉饥饿却吃不下东西,吃了就呕吐。夏季心气旺盛,左手寸口脉洪大浮散为平脉,与此相反则为病脉。如果脉沉滑,是水来克火,十死不治;脉弦长,是木来归子(水生木,此处指母病及子或相生关系,原文意指木气来复),病会自愈;脉缓大,是土来入火(火生土,此处指子盗母气或相乘关系),为轻微邪气干扰,无害。
另外,心病,则胸中疼痛,四肢满胀,肩背臂膊都痛。胆虚则多惊悸,惕惕然无法入睡,胸腹及腰背部牵引疼痛,喜欢悲伤,时常眩晕跌倒。心积气,久不消散,则苦恼忧烦,心中疼痛。胆实则喜欢笑个不停,梦见火烧,心气盛,则梦见喜笑以及恐惧畏缩。邪气客居于心,则梦见山丘烟火。心胀,则心烦短气,夜间卧睡不宁,心腹痛,懊恼,肿胀,气在上下往来运行,疼痛有时停止发作。心腹中热,喜欢喝水,流涎,这是蛔虫咬心(注:原文“蛟”恐为“蛔”字,“蛟”恐为“咬”字)。心病则在中午好转,半夜加重,清晨安静。另外,左手寸口脉,大甚,则手心发热发红(一作服药后),肿太甚,则胸中满闷而烦躁,面色澹澹发红,眼睛发黄。
另外,心病,则先心痛,咳嗽不止,关膈不通,身体沉重不止,三天死亡。心虚则害怕别人,闭眼想睡觉,精神不能依靠,魂魄妄乱。心脉沉小而紧,浮脉主气喘。如果心下气坚实不下行,喜欢咽干,手热,烦闷,健忘,长叹气,这是由于思忧太过所致。脉象急甚,则发狂笑;微缓则吐血;大甚则喉闭(一作痹);微大则心痛牵引背部,容易流泪;小甚则呃逆;微小则笑消瘅(一作痹);滑甚则口渴;微滑则心疝牵引脐部,腹部(一作肠道)鸣响;涩甚则失音不能说话;微涩则血溢,手足厥冷,耳鸣,癫疾。另外,心脉搏动坚实而长,主舌强不能言语(一作言);软而散,应当表现为胆怯不想吃东西。另外,脉急甚则心疝,脐下有病形,烦闷少气,大热上煎灼。另外,心病,胡言乱语,汗出如珠,身体厥冷,其脉应当浮而大,如果反而沉濡而滑甚,面色应当红,现在反而黑,是水克火,十死不治。另外,心的积聚,按之空虚,时而上下往来,没有固定位置,病见胸满,腰腹中热,脸颊(一作面)红,咽干,心烦,掌心热甚,则呕血,春季减轻(本作春季减轻),冬季加重,应该紧急治疗,不超过十天就会死亡。另外,赤黑色入口必死。面黄目赤的也死,色如衃血(凝固的血)的,也死。另外,忧恚思虑太过,心气内索,其面色反而调和旺盛的,不出十天死亡。扁鹊说:心绝则一天死亡。面色呈现凶兆的多,人虽然健康敏捷,名为行尸,一年之中,灾祸必定到来。另外,其人说话声音前宽后急,后声接不上前声,声音浑浊恶臭,口角歪斜,冒昧喜笑,这是风邪入心。另外,心脏受伤则心坏,被水邪所乘,身体手足不遂,骨节解散,舒缓不自由,下利无休止,此疾紧急宜治,不过十天就会亡故。另外,笑不待呻吟就又忧愁,这是水乘火。阴系于阳,阴起阳伏,伏则生热,热则生狂,冒昧妄乱,言语错误,不可采问(一作闻)。心已损矣。扁鹊说:其人唇口红赤,即可治;青黑即死。另外,心疟,则先烦(一作颤)而后渴,翕翕发热。其脉浮紧而大的是。心气实,则小便不利,腹满,身热而重,温温欲吐,吐而不出,喘息急,不安卧。其脉左寸口与人迎,皆实大的是。心虚则恐惧多惊,忧思不乐,胸腹中苦痛,言语战栗,恶寒,恍惚,面赤目黄,喜欢鼻出血。诊其脉,左右寸口两虚而微的是。
The Gallbladder is the organ of uprightness, known as the "General," from which decision-making arises. This indicates that it governs human emotions such as joy and anger, as well as rigidity and flexibility. It forms an interior-exterior relationship with the Liver, and its corresponding meridian is the Foot-Shaoyang Gallbladder Meridian.
When deficient, it is susceptible to Cold pathogens; Cold invasion leads to fear and timidity, dizziness, and the inability to lie down alone. When excess, it is susceptible to Heat pathogens; Heat invasion leads to palpitations and fright, loss of mental stability, and restlessness in sitting or lying. Furthermore, when Xuan Shui (Dark Water disease) occurs, its root lies in the Gallbladder; edema begins at the head and face and spreads down to the feet. Additionally, if Liver cough persists for a long time without healing, pathogenic factors transmit into the Gallbladder, causing vomiting of clear, bitter bile fluid. Moreover, Gallbladder disease manifests as frequent sighing, bitter taste in the mouth, vomiting of clear fluid (alternative text: old fluid), a sense of emptiness and fear in the heart region as if being hunted, a sensation of obstruction in the throat with frequent spitting. Also, Gallbladder distension causes pain under the tongue (alternative text: hypochondrium), bitter taste, and frequent sighing. When pathogenic factors lodge in the Gallbladder, one dreams of fighting and litigation. Pulse diagnosis reveals this condition at the Guan position on the left hand, where the pulse is floating upon superficial pressure.
Gallbladder Excess-Heat leads to loss of mental stability. Gallbladder Heat causes excessive sleepiness, while Gallbladder Cold causes insomnia. Regarding the pulse at the left Guan position: a weak Yang pulse indicates Gallbladder Deficiency; a rapid Yang pulse indicates Gallbladder Excess; a depleted Yang pulse indicates Gallbladder Exhaustion.
The Heart is the sovereign of the five Zang organs, titled the "Emperor." It forms an interior-exterior relationship with the Small Intestine, houses the Shen (Spirit), governs Blood, corresponds to Fire, and peaks in Summer. Its corresponding meridian is the Hand-Shaoyin Heart Meridian.
Summer pulses are Hook-shaped (Gou), characterized by a vigorous arrival and a declining departure, hence named "Hook." Deviation from this indicates disease. If both arrival and departure are vigorous, it is termed "Excessive," indicating disease in the exterior. If arrival is weak and departure is vigorous, it is termed "Insufficient," indicating disease in the interior. Excessiveness causes body heat and bone pain, mouth ulcers, scorched tongue, and thirst that drinking cannot quench, leading to irritability (alternative text: Heart injury). Upward, it manifests as coughing and expectoration; downward, as Qi leakage. A normal pulse arrives continuously like linked pearls, smooth like touching Langgan jade. A pathological pulse arrives continuously (alternative text: panting-like), connected but slightly curved. A fatal pulse is curved at the front and rigid at the back, resembling handling a belt hook.
Furthermore, excessive thinking leads to fright and alarm. Fright damages the Heart; Heart damage causes loss of Shen; loss of Shen leads to fear. True Heart Pain presents with cold hands and feet extending beyond the elbows and knees by five cun; death occurs in the evening if onset is in the morning, or in the morning if onset is in the evening. Heart accumulation of Water-Qi causes Bi syndrome, Qi stagnation, body edema, inability to lie flat, irritability, and swelling of the yin organs. Wind invading the Heart causes mild fever, inability to walk or stand, a sensation of hunger without appetite, and vomiting after eating. In Summer, when Heart Qi is prosperous, the pulse at the Cun position of the left hand should be洪 (Surging), floating, large, and scattered; deviation indicates disease. A deep and slippery pulse indicates Water overcoming Fire, which is fatal (ten out of ten cases die). A stringy and long pulse indicates Wood returning to nourish (Water generating Wood, implying maternal support or generative cycle restoration), and the disease will heal spontaneously. A slow and large pulse indicates Earth entering Fire (Fire generating Earth, implying child draining mother or overacting), representing minor pathogenic interference with no harm.
Heart disease manifests as chest pain, fullness and distension in the four limbs, and pain in the shoulders, back, arms, and upper arms. Deficiency leads to frequent palpitations, alarm, insomnia, pulling pain in the chest, abdomen, and lower back, propensity for sadness, and occasional fainting. Heart Accumulation-Qi, if unresolved, causes distress, worry, and chest pain. Excess leads to incessant laughter, dreaming of fire, and when Heart Qi is prosperous, dreaming of joy, laughter, and fear. Pathogenic factors lodging in the Heart cause dreams of hillsides and smoke/fire. Heart distension causes vexation, shortness of breath, restless sleep at night, heart and abdominal pain, anguish, swelling, Qi moving up and down with intermittent pain. Heat in the heart and abdomen, preference for water, and salivation indicate Ascaris biting the Heart (Note: "Jiao" likely refers to "Hui" [Ascaris] and "Jiao" [bite]). Heart disease improves at noon, worsens at midnight, and stabilizes at dawn. A excessively large pulse at the left Cun position causes hot, red palms (alternative text: post-medication); excessive swelling causes chest fullness and irritability, flushed face, and yellow eyes.
Heart disease initially presents as heart pain, persistent cough, blockage at the Guan-Ge junction, and unrelenting heaviness of the body, leading to death within three days. Deficiency causes fear of others, desire to close eyes and sleep, lack of mental support, and chaotic Hun and Po souls. A deep, small, and tight Heart pulse indicates Qi stagnation below the heart, dry throat, hot hands, vexation, forgetfulness, and sighing, caused by excessive worry. An extremely urgent pulse causes manic laughter; a slightly slack pulse causes hematemesis; an excessively large pulse causes throat closure (alternative text: Bi); a slightly large pulse causes heart pain radiating to the back and tearing; a very small pulse causes hiccups; a minute pulse causes laughter and Xiao-Dan (wasting-thirst) (alternative text: Bi); a slippery pulse causes thirst; a slightly slippery pulse causes Heart Han radiating to the umbilicus and abdominal borborygmus; a choppy pulse causes aphonia; a slightly choppy pulse causes bleeding, cold extremities, tinnitus, and epilepsy. A firm, hard, and long Heart pulse indicates stiff tongue and inability to speak (alternative text: speech); a soft and scattered pulse indicates timidity and anorexia. An extremely urgent pulse causes Heart Han with subumbilical pathology, vexation, shortness of breath, and scorching heat. Manic speech, bead-like sweat, and cold extremities indicate Heart disease; the pulse should be floating and large. If it is instead deep, soft, and slippery, and the complexion is black instead of red, it indicates Water overcoming Fire, which is fatal. Heart accumulation feels empty upon pressure, moves up and down without fixed location, causing chest fullness, heat in waist and abdomen, flushed cheeks, dry throat, vexation, and hot palms leading to hematemesis; it improves in Spring and worsens in Winter, requiring urgent treatment within ten days. Black-red color entering the mouth indicates death. Yellow face with red eyes also indicates death. Color like clotted blood indicates death. Excessive worry and thinking deplete internal Heart Qi; if the complexion appears harmonious and vigorous, death occurs within ten days. Bian Que stated: Heart exhaustion leads to death in one day. Ominous colors appear, and although the person seems healthy and agile, they are called a "walking corpse"; disaster will strike within a year. Speech that starts broad and becomes urgent, with disconnected tones, turbid and foul voice, and crooked mouth, indicates Wind entering the Heart. Heart damage leads to Heart failure, overcome by Water, causing paralysis of body and limbs, joint laxity, unrestricted movement, and continuous diarrhea; this acute condition requires immediate treatment, or death occurs within ten days. Laughter preceding groaning and followed by sorrow indicates Water overcoming Fire. Yin attaches to Yang; Yin rises and Yang hides; hiding generates Heat; Heat generates mania, confusion, and erroneous speech, making inquiry impossible (alternative text: hearing). The Heart is already damaged. Bian Que stated: Red lips and mouth are treatable; blue-black indicates death. Heart Malaria presents with initial vexation (alternative text: tremor) followed by thirst and mild fever; the pulse is floating, tight, and large. Heart Qi Excess causes difficult urination, abdominal fullness, heavy body heat, nausea without vomiting,急促 breathing, and inability to lie flat. The pulse at the left Cun position and Renying is solid and large. Heart Deficiency causes fear, frequent fright, sorrowful thoughts, chest and abdominal pain, trembling speech, aversion to cold, trance, flushed face, yellow eyes, and epistaxis. Diagnosis reveals a deficient and fine pulse at both left and right Cun positions.