问曰∶病有霍乱者何?师曰∶呕吐而利,此为霍乱。
问曰∶病者发热,头痛,身体疼,恶寒,而复吐利,当属何病?师曰∶当为霍乱。霍乱吐利止,而复发热也。伤寒,
其脉微涩,本是霍乱,今是伤寒,却四、五日,至阴经上,转入阴必吐利。转筋为病,其人臂脚直,脉上下行,微弦,
转筋入腹,鸡屎白散主之。
夫风之为病当半身不遂,或但臂不遂者,此为痹。脉微而数,中风使然。头痛脉滑者,中风,风脉虚弱也。
寸口脉浮而紧,紧则为寒,浮则为虚,虚寒相搏,邪在皮肤。浮者血虚,络脉空虚,贼邪不泻,或左或右。邪气反
缓,正气则急,正气引邪, 僻不遂。邪在于络,肌肤不仁。邪在于经,则重不胜。邪入于腑,则不识人。邪入于脏,
舌即难言,口吐于涎。
寸口脉迟而缓,迟则为寒,缓则为虚。荣缓则为亡血,卫迟则为中风。邪气中经,则身痒而瘾疹。心气不足,邪气
入中,则胸满而短气。
趺阳脉浮而滑,滑则谷气实,浮则汗自出。
少阴脉浮而弱,弱则血不足,浮则为风,风血相搏,则疼痛如掣。
盛人脉涩小,短气,自汗出,历节疼,不可屈伸,此皆饮酒汗出当风所致也。
寸口脉沉而弱,沉则主骨,弱则主筋;沉则为肾,弱则为肝。汗出入水中如水伤心历节黄汗出故曰历节也。味酸则
伤筋,筋伤则缓,名曰泄。咸则伤骨,骨伤则痿,名曰枯。枯泄相搏,名曰断泄。荣气不通,卫不独行,荣卫俱微,三
焦无所御,四属断绝,身体羸瘦,独足肿大,黄汗出,胫冷假令发热,便为历节也。病历节,疼痛不可屈伸,乌头汤主
之。诸肢节疼痛,身体魁瘰,脚肿如脱,头眩短气,温温欲吐,桂枝芍药知母汤主之。
问:病人出现发热、头痛、身体疼痛、恶寒,同时又发生呕吐和腹泻,这属于什么病?老师回答:应当是霍乱。霍乱的呕吐和腹泻停止后,又再次出现发热。如果是伤寒,其脉象微而涩,原本可能是霍乱,现在诊断为伤寒;过了四五天,病邪传入阴经,转入阴经必然会出现呕吐和腹泻。转筋(肌肉痉挛)这种病,患者手臂和腿部僵硬挺直,脉搏上下行走时呈现微弦之象;如果转筋蔓延至腹部,用鸡屎白散主治。
风邪致病通常表现为半身不遂,或者仅手臂不能活动,这属于痹证。脉象微而数,是中风所致。头痛且脉滑的,是中风,因为风邪导致脉象虚弱。寸口脉浮而紧,紧代表寒,浮代表虚,虚与寒相互搏结,病邪在皮肤。浮脉表示血虚,络脉空虚,外邪无法排出,病邪或偏左或偏右。邪气所在的一侧肌肉松弛,正气所在的一侧则拘急,正气牵引邪气,导致口眼歪斜、肢体运动不利。邪气侵犯络脉,肌肤麻木不仁;邪气侵犯经脉,则身体沉重难以抬举;邪气侵入腑,则神志不清不认识人;邪气侵入脏,则舌强言语困难,口吐涎沫。
寸口脉迟而缓,迟代表寒,缓代表虚。营气缓弱则导致失血,卫气迟缓则易患中风。邪气中伤经脉,则身体瘙痒并出现瘾疹(风团)。心气不足,邪气乘虚而入,则胸满短气。
趺阳脉浮而滑,滑表示胃气充实,浮表示自汗出。
少阴脉浮而弱,弱表示血不足,浮表示有风,风与血相互搏结,则疼痛如撕裂般剧烈。
肥胖之人脉象涩小,伴有短气、自汗出、历节疼痛、关节不可屈伸,这都是饮酒后出汗当风受邪所致。
寸口脉沉而弱,沉主骨,弱主筋;沉脉对应肾,弱脉对应肝。出汗时进入水中,水邪伤心,历节病伴黄汗出,所以称为历节。味酸则伤筋,筋受伤则弛缓,称为泄;味咸则伤骨,骨受伤则痿软,称为枯。枯与泄相互搏结,称为断泄。营气不通,卫气不能独行,营卫俱微弱,三焦失去统御,四肢营养断绝,身体消瘦,唯独脚部肿大,黄汗出,小腿发冷;假如发热,就是历节病。患历节病,疼痛剧烈不可屈伸,用乌头汤主治。各种肢节疼痛,身体关节肿大如结节,脚肿得像要脱落一样,头晕目眩,短气,心中温温欲吐,用桂枝芍药知母汤主治。
Question: What is Huoluan (Stomach Turmoil) disease? The Master replied: Vomiting accompanied by diarrhea constitutes Huoluan.
Question: A patient presents with fever, headache, body pain, aversion to cold, and simultaneously experiences vomiting and diarrhea. To which disease does this belong? The Master replied: This should be diagnosed as Huoluan. After the vomiting and diarrhea of Huoluan cease, fever may recur. In Taiyang Cold Damage (Taiyang Shanghan), if the pulse is faint and choppy, it was originally Huoluan; now it is Taiyang Cold Damage. After four or five days, when the pathogen enters the Yin meridians and transitions into the Yin level, vomiting and diarrhea will inevitably occur. Regarding the condition of muscle cramps (Zhuanjin), the patient's arms and legs become stiff and straight, and the pulse moving up and down appears slightly wiry. If the cramps extend to the abdomen, Jishibai San (Chicken Dropping White Powder) is the primary prescription.
Diseases caused by Wind typically manifest as hemiplegia (Ban Shen Bu Sui). If only one arm is paralyzed, this belongs to Bi syndrome (Obstruction Syndrome). A pulse that is faint and rapid indicates Zhongfeng (Wind Strike). Headache with a slippery pulse indicates Zhongfeng, where the wind pathogen causes the pulse to appear weak. At the Cun Kou (Radial Artery) position, if the pulse is floating and tight, tightness indicates Cold, and floating indicates Deficiency. The interaction of Deficiency and Cold places the pathogen in the skin. Floating indicates Blood Deficiency, leading to emptiness in the collaterals. The invading pathogen cannot be expelled, affecting either the left or right side. The side affected by the pathogen becomes flaccid, while the healthy side becomes tense. The healthy Qi pulls the pathogen, resulting in facial deviation (Pi Xie) and limb immobility. If the pathogen resides in the collaterals, there is numbness of the skin and muscles. If it resides in the meridians, the body feels heavy and difficult to move. If it enters the Fu organs, consciousness is lost, and the person fails to recognize others. If it enters the Zang organs, speech becomes difficult, and saliva dribbles from the mouth.
At the Cun Kou position, if the pulse is slow and moderate, slowness indicates Cold, and moderation indicates Deficiency. A moderate Ying Qi (Nutritive Qi) indicates loss of blood, while a slow Wei Qi (Defensive Qi) predisposes one to Zhongfeng. If the pathogen strikes the meridians, the body itches and urticaria (Yin Zhen) appears. If Heart Qi is insufficient, the pathogen enters inward, causing chest fullness and shortness of breath.
At the Zu Yang (Dorsalis Pedis Artery) position, if the pulse is floating and slippery, slipperiness indicates substantial food qi, and floating indicates spontaneous sweating.
At the Shao Yin position, if the pulse is floating and weak, weakness indicates insufficient blood, and floating indicates Wind. The interaction between Wind and Blood causes pain as if being torn apart.
In obese individuals, a choppy and small pulse, accompanied by shortness of breath, spontaneous sweating, Li Jie (Joint) pain, and inability to flex or extend joints, is all caused by sweating after drinking alcohol and being exposed to wind.
At the Cun Kou position, if the pulse is deep and weak, depth governs the bones, and weakness governs the sinews; depth corresponds to the Kidney, and weakness corresponds to the Liver. Sweating followed by entering water injures the Heart. Li Jie disease presenting with yellow sweat is termed Li Jie. Sour taste injures sinews; injured sinews become lax, termed Xie (Leakage). Salty taste injures bones; injured bones become atrophic, termed Ku (Withered). The combination of Withered and Leakage is termed Duan Xie (Severance and Leakage). When Ying Qi is blocked and Wei Qi cannot circulate independently, both Ying and Wei become deficient. The San Jiao (Triple Burner) loses its control, and the nourishment of the four limbs is severed. The body becomes emaciated, while only the feet swell. With yellow sweat and cold calves, if fever occurs, it is Li Jie disease. For Li Jie disease characterized by severe pain preventing flexion and extension, Wu Tou Tang (Aconite Decoction) is the primary prescription. For various joint pains, body swelling with nodular enlargements, swollen feet feeling as if detached, dizziness, shortness of breath, and a sensation of warmth with nausea, Gui Zhi Shao Yao Zhi Mu Tang (Cinnamon Twig, Peony, and Anemarrhena Decoction) is the primary prescription.