怒 为呕血,飧泄,煎厥,薄厥,胸满胁痛,食则气逆而不下;为喘渴烦心;为
消脾肥气,目暴盲,耳暴闭,筋缓。怒伤肝,为气逆,悲治怒。
喜 为笑,毛革焦伤,气不收,甚则狂。喜伤心,为气缓,恐治喜。
悲 为阴缩筋挛,肌痹脉痿,男为数溲,女为血崩,酸鼻辛 ,泣则臂麻。悲伤
肺,为气消,喜治悲。
惊 为痰涎,目HT 吐,痴痫不省人事。惊伤神,为气乱,思治惊。
劳 为咽噎喘促,嗽血唾血,腰重痛,骨痿,男少精,女不月。劳伤血气耗,逸
治劳。
思 为不眠,好卧昏瞀,三焦痞塞,咽喉不利,呕苦筋痿,白淫,不嗜饮食。思
伤脾,为气结,怒治思。
恐 伤肾,为气不行,思治恐。
寸口脉但实者,心劳。寸口脉沉,胸中气短,浮而绝者,气辟;大而滑,中有短气。数
而不加六至者,为滑;微弱者少气。尺脉沉滑者,寸白虫。男女皆当以左手尺脉常弱,右手
尺脉常盛,为平。阳盛阴虚,下之安;二寸实大,尺短少,此伤寒之邪,乘其里虚而入于腑
者是也。如尺脉弱寸强,则阴不足阳往乘之,下之安,汗之死。余以类推。脉俱弦,指下又
虚,脾胃虚弱证。食少而渴,痞。腹中痛窄狭,二便不调,脉俱沉紧,按之不鼓,膀胱胜小
肠
也。或泻利不止而腹胀,或纯白赤,或杂血便多,不渴,精神少,或面白脱色,此失血之故
。或面黄而气短,此元气损少之故。是丙火小肠为壬膀胱所克而外走也,屯火投于水,大寒
之证,宜温之则愈。姜、附(各半两)、赤石脂(四钱半,飞)、朱砂(一两,研。)茯苓汤下二
三十丸。
脉,诸按之不鼓为虚寒。二寸短少,谓之阳不足,病在下。脉,诸搏手,为寒凉或寒药
治之,脉虚,亦姜、附。脉二手相似而右为盛,皆胃气虚;二寸求之脾胃,当从阴引阳。脉
中少有力,盛甚则似止,胸中元气不及。脉贵有神。神者,不问迟数之病,中外有力者,为
神
也。脉,诸短为虚。二关脉实,上不至,发汗。下不至,利大便。脉,诸大为虚。二关脉沉
细,纯虚也,宜补之。脉涩与弦而大,按之有力为实,无力为虚。脉沉迟,寸微滑者为实。
二尺不见,或短少,乃食塞,当吐之。凡脉盛大以涩,外有寒证,名寒中。乃寒独留,血脉
泣,故大也。脉大而实,不可益气。滑脉关以上见,为大热;关以下见,为大寒。火并于上
,以丙火化;火并于下,以壬水化。杂病脉沉者,多属痰,宜吐。伤寒寸脉浮滑者,有痰、
宜吐。劳热,脉沉细无火者死。阳脉浮,阴脉弱者,则血虚,血虚则筋急。凡有者为实,无
者为虚。假令脉浮则为阳盛阴虚,脉沉则为阴盛阳虚,此有则彼无,彼有则此无。又如弦则
木实、金亏、土虚。浮诊见者,为腑,为上部,为阳;按之见者,为脏,为下部,为阴。脉
来者,为阳,为气;去者,为阴,为血。假如脉来疾去迟,为阳有余而阴不足也,故曰外实
内虚是也。出以候外,疾为实;入以候内,迟为虚。寸微尺紧为虚损,阴盛阳微之故也。诸
浮脉无根死,脏腑无根故也。
长病脉 虚而涩、虚而滑、虚而缓、微而伏、浮而结、浮而滑、实而大、实而滑
、细而软,
如蛛丝、羹上肥,如屋漏,如雀啄,如霹雳,如贯珠,如水淹。以上此脉,得之则生,反之
则死(一本如水淹之下,注曰皆死脉也。无以上此脉,得之则生,反之则死三句。有识者详
之)卒病与长病条下,反之则死。人病甚,脉不调难差,脉洪者易已。
形脉相应 肥人,脉细欲绝者死。瘦人脉躁者死。身温,脉滑者死。身滑,脉涩
者死。身小,脉大者死。身大脉小者死,身短脉长者死。身长脉短者死。
怒(愤怒)会导致呕血、完谷不化的泄泻、煎厥(因热盛而致的昏厥)、薄厥(因气逆而致的昏厥),伴有胸胁胀满疼痛,进食后气机上逆而不能下行;表现为喘息、口渴、心烦;导致脾脏消瘦、肥气(脾之积病)、眼睛突然失明、耳朵突然闭塞、筋脉弛缓。怒气损伤肝脏,导致气机逆乱,用悲伤的情绪来治疗愤怒。
喜(喜悦)表现为大笑,皮毛干枯焦灼,气机不能收敛,严重时会发狂。喜悦过度损伤心脏,导致气机涣散,用恐惧的情绪来治疗喜悦。
悲(悲伤)表现为阴部收缩、筋脉拘挛、肌肉痹痛、脉道痿弱,男性表现为频繁小便,女性表现为崩漏(大量阴道出血),闻到酸味则鼻子不适,闻到辛味则流泪时手臂麻木。悲伤过度损伤肺脏,导致肺气消耗,用喜悦的情绪来治疗悲伤。
惊(惊恐)表现为痰涎增多,眼睛上翻呕吐,痴痫发作且不省人事。惊恐损伤神志,导致气机紊乱,用思虑的情绪来治疗惊恐。
劳(劳倦)表现为咽喉噎塞、气喘急促、咳嗽吐血、唾中带血、腰部沉重疼痛、骨骼痿弱,男性精液减少,女性月经闭止。劳倦损伤导致气血耗损,用安逸休息的方法来治疗劳倦。
思(思虑)表现为失眠、喜欢躺卧且头昏目眩、三焦痞塞不通、咽喉不利、呕吐苦水、筋脉痿弱、白淫(男子滑精或女子带下清稀如白浊)、食欲不振。思虑过度损伤脾脏,导致气机郁结,用愤怒的情绪来治疗思虑。
寸口脉仅见实象的,是心劳所致。寸口脉沉,胸中气短,脉浮而断绝的,是气机闭塞;脉大而滑的,中间有短气之感。脉数但不到六至(每呼吸一次脉搏跳动次数)的,称为滑脉;脉微弱的是少气(气虚)。尺脉沉滑的,是有寸白虫(绦虫)。男女都应当以左手尺脉常弱、右手尺脉常盛为正常脉象。阳气盛而阴气虚的,用攻下法可安;如果两寸脉实大,尺脉短少,这是伤寒邪气乘里虚而入腑的表现。如果尺脉弱而寸脉强,则是阴不足而阳往乘之,用攻下法可安,用发汗法则致死。其余以此类推。脉象俱弦,指下感觉又虚的,是脾胃虚弱证。食少且口渴,伴有痞满。腹中痛且感觉狭窄,二便不调,脉象俱沉紧,按之不应手(无搏动感),这是膀胱胜小肠(水克火)的缘故。或者泻利不止而腹胀,或者大便纯白赤色,或者夹杂血液且便多,口不渴,精神萎靡,或者面色苍白脱色,这是失血的原因。或者面黄且气短,这是元气亏损少的缘故。这是丙火(小肠)被壬水(膀胱)所克而外走的缘故,如同屯火投入水中,是大寒之证,宜用温补法则可愈。方用干姜、附子(各半两)、赤石脂(四钱半,飞研)、朱砂(一两,研细),茯苓汤送服二三十丸。
脉象,凡是按之不应手的为虚寒。两寸脉短少的,称为阳不足,病在下部。脉象,凡是搏指有力的,用寒凉药或寒性药物治疗;脉虚的,也用干姜、附子。两手脉相似而右脉偏盛的,都是胃气虚;两寸脉求之于脾胃,应当从阴引阳。脉中稍有力,盛大至极则似停止,是胸中元气不及。脉贵在有神。所谓神,不问脉迟或脉数的病证,中外皆有力的,就是有神。脉象,凡是短的为虚。两关脉实,向上不至,用发汗法;向下不至,用通利大便法。脉象,凡是大的为虚。两关脉沉细,纯属虚证,宜用补法。脉涩且弦而大,按之有力为实证,无力为虚证。脉沉迟,寸脉微滑的为实证。两尺脉不见,或短少,是食物堵塞,应当用吐法。凡是脉盛大而涩,外有寒证,名为寒中。这是寒邪独留,血脉凝泣,所以脉大。脉大而实,不可用益气法。滑脉在关以上出现,为大热;在关以下出现,为大寒。火并于上,以丙火(小肠)化;火并于下,以壬水(膀胱)化。杂病脉沉的,多属痰饮,宜用吐法。伤寒寸脉浮滑的,有痰,宜用吐法。劳热,脉沉细无火的预后不良(死)。阳脉浮,阴脉弱的,则血虚,血虚则筋脉拘急。凡是有者为实,没有者为虚。假如脉浮则为阳盛阴虚,脉沉则为阴盛阳虚,此有则彼无,彼有则此无。又如脉弦则是木实、金亏、土虚。浮取见到的,为腑,为上部,为阳;重按见到的,为脏,为下部,为阴。脉来的方向,为阳,为气;脉去的方向,为阴,为血。假如脉来疾去迟,是阳有余而阴不足,所以说外实内虚。出以候外,疾为实;入以候内,迟为虚。寸脉微尺脉紧为虚损,是阴盛阳微的缘故。诸浮脉无根的预后不良(死),是脏腑无根的缘故。
久病的脉象:虚而涩、虚而滑、虚而缓、微而伏、浮而结、浮而滑、实而大、实而滑、细而软,如蛛丝、羹上肥、如屋漏、如雀啄、如霹雳、如贯珠、如水淹。以上这些脉象,得之则生,反之则死(另一版本在水淹之下注曰皆为死脉,没有“以上此脉,得之则生,反之则死”这三句,有见识者详察)。卒病与久病条下,反之则死。人病重,脉不调难治,脉洪大的易愈。
形脉相应:肥胖的人,脉细欲绝的预后不良(死)。瘦人脉躁动的预后不良(死)。身体温热,脉滑的预后不良(死)。身体滑润,脉涩的预后不良(死)。身形小,脉大的预后不良(死)。身形大脉小的预后不良(死),身形短脉长的预后不良(死)。身形长脉短的预后不良(死)。
Anger (Nu) leads to hematemesis, steatorrhea (undigested food in stool), Jian Jue (syncope due to excessive heat), Bo Jue (syncope due to qi rebellion), chest and hypochondriac fullness and pain, qi rebelling upward after eating without descending; manifesting as panting, thirst, vexation; causing emaciation of the spleen, Fei Qi (accumulation disease of the spleen), sudden blindness, sudden deafness, and flaccidity of sinews. Anger injures the Liver, causing qi rebellion; sadness is used to treat anger.
Joy (Xi) manifests as laughter, dry and scorched skin and hair, inability to retain qi, and in severe cases, mania. Excessive joy injures the Heart, causing qi dispersion; fear is used to treat joy.
Sadness (Bei) manifests as contraction of the yin organs, tendon spasm, muscle bi syndrome, pulse withering, frequent urination in men, and metrorrhagia (profuse vaginal bleeding) in women; nasal discomfort at sour smells, arm numbness when weeping at pungent smells. Sadness injures the Lung, causing qi consumption; joy is used to treat sadness.
Fright (Jing) manifests as increased phlegm-saliva, eyes rolling up with vomiting, dementia and epilepsy with loss of consciousness. Fright injures the Shen (Spirit), causing qi chaos; contemplation is used to treat fright.
Fatigue/Labor (Lao) manifests as throat obstruction, panting and shortness of breath, coughing blood or spitting blood, heavy and painful lower back, bone wasting, reduced sperm in men, and amenorrhea in women. Fatigue injures and depletes blood and qi; rest is used to treat fatigue.
Contemplation/Overthinking (Si) manifests as insomnia, desire to lie down with dizziness and blurred vision, stagnation of the San Jiao (Triple Burner), throat obstruction, vomiting bitter fluid, tendon wasting, Bai Yin (seminal emission or clear leukorrhea), and loss of appetite. Contemplation injures the Spleen, causing qi knotting; anger is used to treat contemplation.
Fear injures the Kidney, causing qi stagnation; contemplation is used to treat fear.
If the Cun Kou (radial artery at the wrist) pulse is only Excess (Shi), it is due to Heart fatigue. If the Cun Kou pulse is Deep (Chen) with shortness of breath in the chest, and Floating (Fu) but intermittent, it indicates qi blockage; if Large (Da) and Slippery (Hua), there is a sensation of shortness of breath within. If rapid but not reaching six beats per respiration, it is called Slippery; if weak and faint, it indicates Qi deficiency. If the Chi (distal) pulse is Deep and Slippery, it indicates Ascaris lumbricoides (pinworms). For both men and women, a normally weak Left Chi pulse and a normally strong Right Chi pulse constitute a balanced state. When Yang is Excess and Yin is Deficient, purgation brings peace; if both Cun pulses are Excess and Large while the Chi pulse is short and scanty, this is pathogenic factors of Shang Han (Cold Damage) entering the Fu organs due to interior deficiency. If the Chi pulse is weak and the Cun pulse is strong, Yin is insufficient and Yang invades; purgation brings peace, but sweating causes death. The rest can be inferred by analogy. If pulses are all Wiry (Xian) and feel empty under the fingers, it is a Syndrome of Spleen and Stomach weakness. With little food intake and thirst, accompanied by epigastric fullness. Abdominal pain with a narrow sensation, irregular bowel movements and urination, pulses are all Deep and Tight (Chen Jin), unresponsive to pressure, indicating the Bladder overcoming the Small Intestine. Or, persistent diarrhea with abdominal distension, or pure white/red stools, or bloody stools with little thirst, mental lethargy, or pale complexion, this is due to blood loss. Or yellow face with shortness of breath, this is due to slight damage of Yuan Qi (Original Qi). This is Bing Fire (Small Intestine) being overcome by Ren Water (Bladder) and moving outward, like fire thrown into water, a Great Cold syndrome, suitable for warming treatment to heal. Formula: Ginger and Aconite (each 0.5 liang), Red Kaolin (4.5 qian, refined), Cinnabar (1 liang, ground), taken as 20-30 pills with Poria Decoction.
Regarding pulses: All pulses that are unresponsive to pressure indicate Deficiency-Cold. Shortness in both Cun pulses is called Yang insufficiency, with disease in the lower part. Regarding pulses: Those that beat forcefully against the finger are treated with cold-natured medicines or cold therapies; if the pulse is Deficient, Ginger and Aconite are also used. If both hands have similar pulses but the Right is stronger, it indicates Stomach Qi deficiency; seeking the Cun pulses relates to Spleen and Stomach, drawing from Yin to guide Yang. If the pulse has slight strength, but becomes extremely strong then seems to stop, it indicates insufficient Yuan Qi in the chest. Pulses value having Shen (Spirit). Shen means regardless of slow or rapid pulses, those that are strong inside and outside possess Shen. Regarding pulses: All Short pulses indicate Deficiency. If both Guan (middle) pulses are Excess but do not reach upwards, use sweating; if they do not reach downwards, use purgation. Regarding pulses: All Large pulses indicate Deficiency. Deep and fine Guan pulses indicate pure Deficiency, suitable for tonification. Pulse Choppy (Se) and Wiry and Large, strong upon pressure indicates Excess, weak indicates Deficiency. Deep and Slow pulse with slightly Slippery Cun indicates Excess. Absence or shortness in both Chi pulses indicates food stagnation, requiring emesis. All pulses that are Large and Excess yet Choppy, with exterior Cold symptoms, are named Han Zhong (Cold Middle). This is cold lingering alone, causing blood vessels to congeal, hence the pulse is Large. Large and Excess pulses should not be treated with qi-tonifying methods. Slippery pulse appearing above the Guan indicates Great Heat; appearing below the Guan indicates Great Cold. Fire merging upwards transforms via Bing Fire (Small Intestine); fire merging downwards transforms via Ren Water (Bladder). In miscellaneous diseases, Deep pulses mostly belong to Phlegm, suitable for emesis. In Shang Han, Floating and Slippery Cun pulses indicate phlegm, suitable for emesis. In labor-fever, Deep and Fine pulses without fire indicate a fatal prognosis. Floating Yang pulses and Weak Yin pulses indicate Blood Deficiency, which causes tendon tension. What is present is Excess, what is absent is Deficiency. For example, Floating pulse indicates Yang Excess and Yin Deficiency; Deep pulse indicates Yin Excess and Yang Deficiency; this is mutual exclusion. Similarly, Wiry pulse indicates Wood Excess, Metal Deficiency, and Earth Deficiency. Floating palpation reveals Fu organs, upper part, and Yang; pressing reveals Zang organs, lower part, and Yin. The coming of the pulse is Yang and Qi; the going is Yin and Blood. If the pulse comes fast and goes slow, it indicates Yang Excess and Yin Deficiency, thus termed Exterior Excess and Interior Deficiency. Coming monitors the exterior, fast indicates Excess; going monitors the interior, slow indicates Deficiency. Slight Cun and Tight Chi indicate Deficiency and Damage, due to Yin Excess and Yang Microness. All Floating pulses without root indicate death, due to lack of root in Zang and Fu organs.
Pulses of chronic illness: Empty and Choppy, Empty and Slippery, Empty and Moderate (Huan), Faint and Hidden (Fu), Floating and Knotted (Jie), Floating and Slippery, Excess and Large, Excess and Slippery, Fine and Soft, like spider silk, fat on soup, like leaking roof, like bird pecking, like thunderclap, like string of pearls, like flooding water. Among these pulses, obtaining them implies survival, reversing them implies death (another version notes below 'flooding water' that all are death pulses, lacking the three sentences 'above these pulses, obtaining them implies survival, reversing them implies death'; let those with insight examine carefully). Under acute and chronic illness sections, reversing them implies death. When the patient is severely ill and the pulse is irregular and hard to correct, a洪 (Hong/Great) pulse indicates easier recovery.
Correspondence of Form and Pulse: In obese people, a Fine pulse nearly imperceptible indicates death. In thin people, a Rapid and Agitated pulse indicates death. Warm body with Slippery pulse indicates death. Smooth body with Choppy pulse indicates death. Small body with Large pulse indicates death. Large body with Small pulse indicates death, Short body with Long pulse indicates death, Long body with Short pulse indicates death.