寸口沉大而滑,沉则为实,滑则为气,实气相搏,血气入于脏即死,入于腑即愈,此为卒厥。不知人,唇青身冷,
为入脏,即死;如身温和,汗自出,为入腑,而复自愈。
( 一作痉)
太阳病,发热无汗,而反恶寒者,名刚 。
太阳病,发热汗出,而不恶寒者,名柔 。(一云恶寒)
太阳病,发热,其脉沉而细者,为 。
太阳病,发其汗,因致 (论云∶发其汗太多,因致 )病者身热足寒,颈项强急,恶寒,时头热,面赤,目脉赤,
独头动摇者,为 。(论云∶独头面摇,卒口噤,背反张者, 病也)。太阳病,无汗,而小便反少,气上冲胸,口噤不
得语,欲作刚 ,葛根汤主之。刚 为病,胸满口噤,卧不着席,脚挛急,其人必 齿可与大承气汤。
病,发其汗已,其脉 如蛇,暴腹胀大者,为欲解,脉如故,反伏弦者,必 。(一云∶ 脉出欲已)。
脉来,按之筑筑而弦,直上下行。
家,其脉伏坚,直上下。
夫风病,下之则 。复发其汗,必拘急。
太阳病,其证备,身体强,KT KT 然,脉沉迟,此为 ,栝蒌桂枝汤主之。 病,有灸疮,难疗。疮家,虽身疼
痛,不可发其汗,汗出则 。太阳病,关节疼烦,脉沉而缓者,为中湿。(论云∶中湿为湿痹,之候,其人小便不利,大
便反快,但当利其小便)病者一身尽疼(一云疼烦),发热,日晡即剧,此为风湿。汗出所致也。(论云∶此病伤于汗出
当风,或久伤取冷所致)
湿家之为病,一身尽疼,发热,而身色熏黄也。湿家之为病,其人但头汗出,而背强,欲得被覆向火。若下之早,
则哕,或胸满,小便利(一云不利),舌上如苔,此为丹田有热,胸上有寒,渴欲饮而不能饮,则口燥也。
湿家下之,额上汗出,微喘,小便利(一云不利)者,死。若下利不止者,亦死。
问曰∶风湿相搏,身体疼痛,法当汗出而解,值天阴雨不止,师云此可发汗,而其病不愈者,何也?答曰;发其汗,
汗大出者,但风气去,湿气续在,是故不愈。若治风湿者,发其汗,微微似欲出汗者,则风湿俱去也。
湿家身烦疼,可与麻黄汤加术四两,发其汗为宜,慎不可以火攻之。
风湿,脉浮,身重、汗出恶风者,防己汤主之。
病患喘,头痛,鼻塞而烦,其脉大,自能饮食,腹中和,无病。病在头中寒湿,故鼻塞,内药鼻中即愈。(论云∶湿
家病,身疼痛,发热,面黄而喘,头痛鼻窒而烦)伤寒八、九日,风湿相搏,身体疼痛,不能自转侧,不呕不渴,脉浮
虚而涩者,桂枝附子汤主之。若其人大便硬,小便自利者,术附子汤主之。风湿相搏,骨节疼烦,掣痛不得屈伸,近之
则痛剧,汗出短气,小便不利,恶风不欲去衣。或身微肿者,甘草附子汤主之。
太阳中热, 是也。其人汗出恶寒,身热而渴也,白虎汤主之。
太阳中 ,身热疼重,而脉微弱,此以夏月伤冷水,水行皮肤中所致也,瓜蒂汤主之。
太阳中 ,发热恶寒,身重而疼痛,其脉弦细芤迟,小便已洒洒然毛耸,手足逆冷,小有劳,身热,口前开,板齿
燥。若发其汗,恶寒则甚,加温针,则发热益甚,数下之,淋复甚。
寸口脉象沉而大且滑,沉脉主里实,滑脉主气滞,实邪与气机相互搏结。若血气陷入五脏则致死,若进入六腑则痊愈,这种病证称为卒厥(突然昏倒)。患者神志不清,嘴唇发青、身体冰冷,这是病邪入脏的表现,预后不良,多致死亡;如果身体温和、自然出汗,这是病邪入腑的表现,将会自行痊愈。
(另一种写法为“痉”)
太阳病,表现为发热、无汗,反而恶寒的,称为刚痓(以项背强直、角弓反张为特征的痉挛性疾病,伴有表实)。
太阳病,表现为发热、有汗,且不恶寒的,称为柔痓(伴有表虚)。
太阳病,发热,但脉象沉而细的,属于痓病范畴。
太阳病,经过发汗治疗后,导致出现痓病的症状:身体发热、脚部寒冷、颈项强直拘急、恶寒、偶尔头部发热、面色发红、眼目脉络充血,只有头部摇动的,诊断为痓病。(医论中说:只有头面部摇动,突然牙关紧闭、背部反折如弓的,是痓病。)太阳病,无汗,小便反而量少,气逆上冲胸部,牙关紧闭不能说话,即将发作刚痓,用葛根汤主治。刚痓发病时,胸中胀满、牙关紧闭,卧床时背部不能贴席(角弓反张严重),小腿肌肉挛急,病人必定会咬碎牙齿,此时可用大承气汤治疗。
痓病患者,发汗后,脉象像蛇行一样蜿蜒曲折,突然腹部胀大的,是病情将要解除的迹象;如果脉象依旧,反而出现伏而弦的脉象,必定再次发生痓病。(另一种说法:脉象浮出是病情欲愈。)
脉象来势,按之感觉筑筑跳动且弦硬,笔直上下运行。
痓病患者,其脉象伏坚,笔直上下运行。
患有风病的人,误用泻下法会导致病情加重。如果再次发汗,必然导致肢体拘急。
太阳病,证候具备,身体强直,KT KT然(形容身体强直不柔和的样子),脉象沉迟,这是痓病,用栝蒌桂枝汤主治。患过痓病的人,如果有灸疮,难以治愈。有疮疡病史的人,即使身体疼痛,也不可以发汗,因为发汗会导致津液枯竭从而引发痓病。太阳病,关节疼痛烦扰,脉象沉而缓的,属于中湿。(医论中说:中湿即为湿痹,其征象是患者小便不利,大便反而通畅,治疗应当通利小便。)患者全身疼痛(另一种说法为疼痛烦扰),发热,傍晚时分加剧,这是风湿病。这是由于出汗时受风,或久处阴冷环境所致。(医论中说:此病是因为出汗时当风受凉,或长期贪凉受寒所致。)
湿家(素患湿病的人)患病,全身疼痛,发热,且肤色呈熏黄之色。湿家患病,只有头部出汗,背部强直,想要盖被子靠近火源取暖。如果过早使用泻下法,会出现呃逆,或者胸中胀满,小便通利(另一种说法为不通利),舌苔如同覆盖了一层苔垢,这是因为丹田(下焦)有热,胸中有寒,口渴想喝水却喝不下去,导致口腔干燥。
湿家误用泻下法,额头出汗,微喘,小便通利(另一种说法为不通利)的,预后不良,致死。如果腹泻不止的,也致死。
问:风湿相搏,身体疼痛,按照治法应当通过发汗来解除,正值阴雨连绵天气,医生说可以发汗,但病未痊愈,为什么呢?答:发汗后,如果汗出过多,只去了风邪,湿气仍然留存,所以病不愈。治疗风湿病,发汗应当微微似有汗出的样子,这样风湿之邪才能一同去除。
湿家身体烦疼,可以用麻黄汤加白术四两,以发汗为宜,切记不可用火攻疗法。
风湿病,脉象浮,身体沉重、出汗、恶风的,用防己汤主治。
病人气喘,头痛,鼻塞且烦躁,脉象大,饮食正常,腹部平和无病。病位在头中寒湿,所以鼻塞,将药物纳入鼻中即可痊愈。(医论中说:湿家患病,身体疼痛,发热,面色黄且气喘,头痛鼻窒且烦躁。)伤寒八九天,风湿相搏,身体疼痛,不能自行转侧,不呕吐不口渴,脉象浮虚而涩的,用桂枝附子汤主治。如果病人大便干硬,小便自利的,用术附子汤主治。风湿相搏,骨节疼痛烦扰,牵掣作痛不能屈伸,触碰则疼痛剧烈,出汗、短气,小便不利,恶风不想脱衣,或者身体轻微浮肿的,用甘草附子汤主治。
太阳中热,就是暍病(中暑)。病人汗出、恶寒,身体发热且口渴,用白虎汤主治。
太阳中暍(此处指暑湿或冷水伤身),身体发热疼痛沉重,脉象微弱,这是因为夏季损伤了冷水,水气行于皮肤中所致,用瓜蒂汤主治。
太阳中暍,发热恶寒,身体沉重且疼痛,脉象弦细芤迟,小便后洒洒然毛发耸立,手足逆冷,稍微劳作就身体发热,张口呼吸,门齿干燥。如果发汗,恶寒会更严重;加用温针,发热会更厉害;多次泻下,淋证会更加严重。
The pulse at the Cun (inch) position is deep, large, and slippery. A deep pulse indicates excess [solid pathogen], while a slippery pulse indicates Qi stagnation. When excess and Qi contend with each other, if Blood and Qi enter the Zang organs, death ensues; if they enter the Fu organs, recovery occurs. This condition is termed *Cu Jue* (Sudden Syncope). The patient loses consciousness; if the lips are cyanotic and the body cold, it indicates invasion of the Zang organs, leading to death. If the body remains warm and sweat issues spontaneously, it indicates invasion of the Fu organs, and the patient will recover naturally.
(Alternatively written as "Jing" / Spasm)
In Taiyang disease, characterized by fever, absence of sweating, and aversion to cold, it is named *Gang Jing* (Yang Spasm/ stiff spasm).
In Taiyang disease, characterized by fever, presence of sweating, and absence of aversion to cold, it is named *Rou Jing* (Yin Spasm / flaccid spasm).
In Taiyang disease, with fever but a deep and fine pulse, it belongs to the category of *Jing* (Spasm).
If Taiyang disease is treated with diaphoresis (sweating), leading to *Jing* disease: the body is hot while the feet are cold, the neck and nape are stiff and rigid, there is aversion to cold, occasional heat in the head, facial redness, congestion of the eye vessels, and only the head trembles, this is diagnosed as *Jing*. (Commentary states: Only head and face trembling, sudden locking of the jaw, and opisthotonos [back bending backward] constitute *Jing* disease.) In Taiyang disease, with no sweating, abnormally scanty urination, Qi rushing upward to the chest, locking of the jaw preventing speech, and impending *Gang Jing*, *Gegen Tang* (Kudzu Decoction) is indicated. In cases of *Gang Jing*, with chest fullness, locked jaw, inability to lie flat due to severe opisthotonos, cramped legs, and likely teeth grinding, *Da Chengqi Tang* (Major Order the Qi Decoction) may be used.
For *Jing* disease, after inducing sweating, if the pulse resembles a snake moving (winding), and sudden abdominal distension occurs, it indicates impending resolution. If the pulse remains unchanged or becomes hidden and wiry, *Jing* will recur. (Alternative view: An emerging pulse indicates recovery.)
The pulse comes feeling pounding and wiry upon pressure, running straight up and down.
In *Jing* patients, the pulse is hidden and firm, running straight up and down.
In wind diseases, purgation leads to worsening. Re-inducing sweating will inevitably cause limb rigidity.
In Taiyang disease, where symptoms are complete, the body is stiff, appearing rigid and unyielding, with a deep and slow pulse, this is *Jing*, treated with *Gualou Guizhi Tang* (Trichosanthes Root and Cinnamon Twig Decoction). Patients with a history of *Jing* who have moxibustion sores are difficult to treat. Those with chronic sores, even if experiencing body pain, must not undergo diaphoresis, as sweating will lead to *Jing*. In Taiyang disease, with painful and vexing joints and a deep, slow pulse, it is *Zhong Shi* (Attacked by Dampness). (Commentary states: *Zhong Shi* constitutes Bi syndrome of dampness; signs include difficult urination and loose stools; treatment should promote urination.) Patients suffering from whole-body pain (or painful vexation), fever, worsening in the late afternoon, suffer from Wind-Damp. This results from sweating followed by exposure to wind, or long-term exposure to cold.
In patients prone to dampness (*Shi Jia*), the disease manifests as whole-body pain, fever, and a sallow-yellow complexion. Such patients sweat only on the head, experience back stiffness, and desire warmth from blankets or fire. Premature purgation leads to hiccups or chest fullness, with normal (or difficult) urination, and a tongue coating resembling moss. This indicates heat in the Lower Burner (Dantian) and cold in the Upper Burner (Chest), causing thirst without ability to drink, resulting in dry mouth.
Purgation in damp-prone patients, accompanied by sweating on the forehead, slight panting, and normal (or difficult) urination, indicates death. Profuse diarrhea also indicates death.
Question: In Wind-Damp contention causing body pain, diaphoresis is the standard cure. However, during continuous rainy weather, despite the physician's advice to sweat, the illness persists. Why? Answer: If sweating is excessive, only the wind pathogen is expelled, while dampness remains, hence no recovery. To treat Wind-Damp, induce mild sweating ("slightly moistening"), so that both wind and dampness are eliminated together.
For damp-prone patients with painful vexation, *Mahuang Tang* (Ephedra Decoction) plus four liang of *Baizhu* (Atractylodes Macrocephala Rhizome) is appropriate for diaphoresis. Fire therapy must be strictly avoided.
In Wind-Damp disease, with a floating pulse, heavy body, sweating, and aversion to wind, *Fangji Tang* (Stephania Tetrandra Decoction) is indicated.
A patient suffers from asthma, headache, nasal congestion, and vexation, with a large pulse, yet eats well and has a harmonious abdomen. The pathology lies in Cold-Damp in the head, causing nasal congestion; administering medication into the nose will cure it. (Commentary states: Damp-prone patients with body pain, fever, yellow face, asthma, headache, nasal obstruction, and vexation.) After eight or nine days of Cold Damage, Wind-Damp contends, causing body pain and inability to turn over, without vomiting or thirst, and with a floating, deficient, and choppy pulse, *Guizhi Fuzi Tang* (Cinnamon Twig and Prepared Aconite Decoction) is indicated. If the stool is hard and urination is spontaneous, *Zhu Fuzi Tang* (Atractylodes and Prepared Aconite Decoction) is indicated. In Wind-Damp contention, joint pain and vexation, pulling pain preventing flexion and extension, exacerbated by touch, sweating, shortness of breath, difficult urination, aversion to wind with desire to keep clothes on, or slight edema, are treated with *Gancao Fuzi Tang* (Licorice and Prepared Aconite Decoction).
Taiyang Heat Stroke (*Ye*) is characterized by sweating, aversion to cold, body heat, and thirst, treated with *Baihu Tang* (White Tiger Decoction).
Taiyang Summerheat (caused by cold water injury), with body heat, painful heaviness, and a weak pulse, results from summer consumption of cold water entering the skin, treated with *Gua Di Tang* (Melon Seed Decoction).
Taiyang Summerheat, with fever, aversion to cold, heavy body and pain, wiry-fine-empty-slow pulse, chills after urination, cold extremities, heat upon slight exertion, open-mouth breathing, and dry incisors. Diaphoresis worsens aversion to cold; warming needles increase heat; repeated purgation exacerbates strangury.