足少阴之疟,令人呕吐甚,多寒热,热多寒少,欲闭户牖而处,其病难已。
足少阴肾经之脉也,肾者,胃之关也,邪阻关门,浊壅于胃,不得降而上逆,故呕吐甚;少阴为至阴之地,
邪伏深而难
达,故发寒热皆多时;其阳胜,则热尤多于寒也;气闭,心抑闷而不爽,故欲闭户独处,以肾邪心火受制故也;
邪在至阴,故病难已。
足厥阴之疟,令人腰痛,少腹满,小便不利,如癃状,非癃也,数便意,恐惧气不足,腹中悒悒。
足厥阴肝经之脉也,肝为肾子,子能令母实,故所现多兼肾证,腰者肾之府,少腹肝之居,故腰痛而少腹
满,肝主遗溺癃闭,此病浅在经,故小便不利,似癃非癃,数数欲便而短之意也;肾主恐,故恐惧;肝郁,气
不接续而少气,《虚实篇》云∶肝气虚则恐,实则怒;腹中悒悒者,窒闷也。
肺疟者,令人心寒,寒热甚,热间善惊,如有所见者,刺手太阴、阳明。
凡一脏受邪,其气横逆,必侮其所不胜,而乘其所胜也。心火为肺金所不胜者,以其邪气横逆,心火被抑
而心寒也;肺主一身之气,一身皆为邪窒,故其发寒发热皆甚也;热间善惊,如有所见者,肝病也,以肺邪势
衰,犹逞余威,乘其所胜也∶目为肝窍,邪侵肝,故目光乱而妄见怪异之物也。刺肺与大肠经,以泄其邪。
足少阴经疟疾,使人严重呕吐,寒热往来频繁,发热多于恶寒,想要关闭门窗独自居住,这种病难以治愈。
这是足少阴肾经的脉证。肾是胃的关口,邪气阻滞在关口,浊气壅塞于胃,不能下降反而上逆,所以呕吐严重;少阴是经脉中至阴的部位,邪气潜伏深重而难以透达,所以发作时寒热持续时间都很长;如果阳气偏胜,那么发热就特别多于恶寒;气机闭塞,心神受抑感到烦闷不舒,所以想要关闭门户独处,这是因为肾邪克制了心火;邪气位于至阴之地,所以病情难愈。
足厥阴经疟疾,使人腰痛,小腹胀满,小便不通畅,像癃闭(排尿困难)的样子,但并非真正的癃闭,只是频频有便意,感到恐惧且气力不足,心中郁闷不畅。
这是足厥阴肝经的脉证。肝是肾的子脏,子能令母实,所以表现出的症状多兼有肾证的特征。腰是肾的外府,小腹是肝的居所,所以出现腰痛和小腹胀满。肝主司遗尿和癃闭,此病邪浅在于经脉,所以小便不利,看似癃闭实则不然,表现为频频想排便却尿量短少的意思;肾主恐,所以产生恐惧感;肝气郁结,气机不接续而导致气短,《虚实篇》说:肝气虚则恐惧,肝气实则易怒;腹中郁闷不畅,是指窒闷的感觉。
肺疟,使人心中发冷,寒热症状剧烈,发热间歇期容易惊悸,好像看到了什么怪异的东西,治疗应针刺手太阴肺经和手阳明大肠经。
凡是某一脏腑受邪,其气机横逆,必定会欺侮它所不能克制的脏腑,并乘袭它所能够克制的脏腑。心火是被肺金所不能克制的(即火克金,此处指金反侮火),因为邪气横逆,心火被抑制而感到心中寒冷;肺主管一身之气,全身都被邪气窒塞,所以发作时的寒热都很剧烈;发热间歇期容易惊悸,好像看到了东西,这是肝病,因为肺邪势力衰退,仍逞余威,乘袭其所胜之脏(木):眼睛是肝的窍穴,邪气侵犯肝脏,所以目光混乱而妄见怪异之物。针刺肺经和大肠经,以泄除邪气。
Malaria of the Foot-Shaoyin (Kidney) Meridian causes severe vomiting, frequent chills and fever, with heat predominating over cold. The patient desires to close doors and windows and stay alone; this condition is difficult to cure.
This pertains to the meridian of the Foot-Shaoyin Kidney. The Kidney serves as the gate of the Stomach. When pathogenic factors obstruct this gate, turbid qi stagnates in the Stomach, failing to descend and instead rebelling upward, resulting in severe vomiting. Shaoyin is the realm of extreme Yin. Pathogens lurking deeply are hard to reach, so both chills and fever last for long durations. If Yang qi prevails, heat will be significantly more than cold. Qi obstruction suppresses the Heart, causing mental depression and discomfort; thus, the patient wishes to stay alone behind closed doors, because Kidney pathogens constrain Heart Fire. Since the pathogen resides in the realm of extreme Yin, the disease is difficult to resolve.
Malaria of the Foot-Jueyin (Liver) Meridian causes lower back pain, fullness in the lower abdomen, and difficulty urinating. It resembles Gong syndrome (difficulty in urination), but is not true Gong; there is a frequent urge to urinate, fearfulness, insufficient Qi, and a feeling of inner depression.
This pertains to the meridian of the Foot-Jueyin Liver. The Liver is the child organ of the Kidney. As the child can strengthen the mother, the symptoms often present with characteristics of Kidney disorders. The lower back is the mansion of the Kidney, and the lower abdomen is the residence of the Liver; hence, lower back pain and lower abdominal fullness occur. The Liver governs enuresis and Gong syndrome. In this case, the pathogen is shallow within the meridian, causing urinary difficulty that mimics Gong but is not true Gong, manifesting as a frequent urge to urinate with scant output. The Kidney governs fear, hence the sensation of fear. Liver Qi stagnation leads to disjointed Qi flow and shortness of breath. The *Chapter on Deficiency and Excess* states: "When Liver Qi is deficient, there is fear; when excessive, there is anger." Inner depression refers to a sensation of stifling blockage.
Lung Malaria causes coldness in the heart, severe chills and fever, and during the intervals of fever, the patient is prone to fright and hallucinations, seeing things that are not there. Treatment involves needling the Hand-Taiyin Lung and Hand-Yangming Large Intestine meridians.
When any single Zang organ is invaded by pathogens, its Qi becomes rebellious and horizontal, inevitably bullying what it cannot overcome and exploiting what it can control. Heart Fire is normally controlled by Lung Metal; however, due to the rebellion of pathogenic factors, Heart Fire is suppressed, leading to a sensation of cold in the heart. The Lung governs the Qi of the whole body. When the entire body is blocked by pathogens, the onset of chills and fever is severe. Fright and hallucinations during fever intervals indicate Liver pathology. Although the Lung pathogen's power has waned, it still exerts residual influence by attacking its controlling element (Wood). The eyes are the orifices of the Liver. When pathogens invade the Liver, vision becomes chaotic, leading to visual hallucinations of strange objects. Needling the Lung and Large Intestine meridians helps to drain the pathogens.