太阳病，当恶寒而发热，今自汗出，反不恶寒发热，关上脉细而数，此医吐之过也。若得病一日、二日吐之，腹中
饥，口不能食。三日、四日吐之，不喜糜粥，欲食冷食，朝食暮吐，此医吐之所致也，此为小逆。
太阳病，吐之者，但太阳病当恶寒，今反不恶寒，不欲近衣，此为吐之内烦也。
少阴病，饮食入则吐，心中温温欲吐，复不能吐，始得之，手足寒，脉弦迟，此胸中实，不可下。若膈上有寒饮，
干呕者，不可吐，当温之。
诸四逆厥者，不可吐之，虚家亦然。
大法，春宜吐。
凡服汤吐，中病便止，不必尽剂也。
病如桂枝证，其头不痛，项不强，寸口脉微浮，胸中痞坚，气上撞咽喉，不得息，此为胸有寒，当吐之。
病胸上诸实，胸中郁郁而痛，不能食，欲使人按之，而反有浊唾，下利日十余行，其脉反迟，寸口微滑，此可吐之，
吐之利即止。
少阴病，饮食入则吐，心中温温欲吐，复不能吐，当遂吐之。宿食在上脘，当吐之。
病者手足厥冷，脉乍紧，邪结在胸中，心下满而烦，饥不能食，病在胸中，当吐之。
脉濡而弱，弱反在关，濡反在巅，微反在上，涩反在下，微则阳气不足，涩则无血。阳气反微，中风汗出，而反躁
烦，涩则无血，厥而且寒，阳微不可下，下之则心下痞坚。
动气在右，不可下。下之则津液内竭，咽燥鼻干，头眩心悸。
动气在左，不可下。下之则腹里拘急，食不下，动气反剧，身虽有热，卧反欲蜷。
动气在上，不可下。下之则掌握热烦，身浮冷，热汗自泄，欲水自灌。
动气在下，不可下。下之则腹满，卒起头眩，食则下清谷，心下痞坚。咽中闭塞，不可下。下之则上轻下重，水浆
不下，卧则欲蜷，身体急痛，复下利日十数行。
诸外实，不可下。下之则发微热，亡脉则厥，当脐握热。
诸虚，不可下，下之则渴，引水者易愈，恶水者剧。
脉濡而弱，弱反在关，濡反在巅，弦反在上，微反在下。弦为阳运，微为阴寒，上实下虚，意欲得温。微弦为虚，
虚者不可下。微则为咳，咳则吐涎沫。下之咳则止，而利不休，胸中如虫啮，粥入则出，小便不利，两胁拘急，喘息为
难，颈背相牵，臂则不仁，极寒反汗出，躯冷若冰，眼睛不慧，语言不休，谷气多入，则为除中，口虽欲言，舌不得前。
脉濡而弱，弱反在关，濡反在巅，浮反在上，数反在下，浮则为阳虚，数则为无血，浮则为虚，数则生热。浮则为虚，
自汗而恶寒。数则为痛，振而寒栗。微弱在关，胸下为急，喘汗，不得呼吸。呼吸之中，痛在于胁，振寒相搏，其形如
疟。医反下之，令脉急数，发热，狂走见鬼，心下为痞。小便淋沥，少腹甚坚，小便血也。脉濡而紧，濡则阳气微，紧
则荣中寒。阳微卫中风，发热而恶寒。荣紧胃气冷，微呕心内烦。医以为大热，解肌而发汗，亡阳虚烦躁，心下苦痞坚，
表里俱虚竭，卒起而头眩，客热在皮肤，怅快不得眠，不知胃气冷，紧寒在关元，技巧无所施，汲水灌其身，客热应时
罢，栗栗而振寒，重被而覆之，汗出而冒巅，体惕而又振，小便为微难，寒气因水发，清谷不容间，呕变反肠出，颠倒
不得安，手足为微逆，身冷而内烦，迟欲从后救，安可复追还。脉浮而大，浮为气实，大为血虚，血虚为无阴，孤阳独
下阴部，小便难，胞中虚。今反小便利而大汗出，法卫家当微，今反更实，津液四射，荣竭血尽，干烦不眠，血薄肉消，
而成暴液。医复以毒药攻其胃，此为重虚，客阳去有期，必下如污泥而死。趺阳脉迟而缓，胃气如经。趺阳脉浮而数，
浮则伤胃，数则动脾，此非本病，医特下之所为也。荣卫内陷，其数先微，脉反但浮，其人必坚，气噫而除。何以言之？
脾脉本缓，今数脉动脾，其数先微，故知脾气不治。大便坚，气噫而除，今脉反浮，其数改微，邪气独留，心中则饥，
邪热不杀谷，潮热发渴，数脉当迟缓，脉因前后度数如前，（仲景前字作法）病者则饥。数脉不时，则生恶疮。脉数者，
久数不止，止则邪结，正气不能复，正气却结于脏，故邪气浮之，与皮毛相得。脉数者，不可下，下之必烦，利不止。
少阴病，脉微，不可发其汗，无阳故也。阳已虚，尺中弱涩者，复不可下之。脉浮大，应发其汗，医反下之，此为大逆。
脉浮而大，心下反坚，有热属脏，攻之，不全微汗。属腑溲数则坚，汗多即愈，汗少便难。脉迟，尚未可攻。二阳并病，
太阳初得病时，发其汗，汗先出，复不彻，因转属阳明，欲自汗出，不恶寒，若太阳证不罢，不可下，下之为逆。结胸
证，其脉浮大，不可下，下之即死。太阳与阳明合病，喘而胸满，不可下之。太阳与少阳并病，心下痞坚，颈项强而眩，
勿下之。诸四逆厥者，不可下之，虚家亦然。病欲吐者，不可下之。太阳病，有外证未解，不可下，下之为逆。病发于
阳，而反下之，热入，因作结胸。发于阴，而反下之，因作痞。痞脉浮坚而下之，紧反入里，因作痞。夫病阳多者热，
下之则坚。本虚，攻其热必哕。无阳，阴强而坚，下之，必清谷而腹满。太阴之为病，腹满而吐，食不下，下之益甚，
腹时自痛，胸下结坚。厥阴之为病，消渴，气上撞，心中疼热，饥而不欲食，甚者则欲吐，下之不肯止。少阴病，其人
饮食入则吐，心中温温欲吐，复不能吐。始得之，手足寒，脉弦迟，此胸中实，不可下也。伤寒五、六日，不结胸，腹
濡，脉虚，复厥者，不可下，下之，亡血死。伤寒，发热，但头痛，微汗出。发其汗则不识人。熏之则喘，不得小便，
心腹满。下之则短气而腹满，小便难，头痛背强。加温针则必衄。伤寒，其脉阴阳俱紧，恶寒发热，则脉欲厥。厥者，
脉初来大，渐渐小，更来渐大，是其候也。恶寒甚者，翕翕汗出，喉中痛。热多者，目赤，睛不慧，医复发之，咽中则
伤。若复下之，则两目闭，寒多清谷，热多便脓血。熏之则发黄。熨之则咽燥。小便利者可救。难者，必危殆。伤寒发
热，口中勃勃气出，头痛目黄，鼻衄不可制。贪水者必呕，恶水者厥，下之咽中生疮。假令手足温者，下重便脓血。头
痛目黄者，下之，目闭。贪水者，下之，其脉必厥，其声嘤，咽喉塞，发其汗则战栗，阴阳俱虚。恶水者，下之，里冷
不嗜食，大便完谷出。发其汗，口中伤，舌上苔滑，烦躁。脉数实，不大便六七日，后必便血。复发其汗，小便即自利。
得病二、三日，脉弱，无太阳柴胡证，而烦躁，心下坚。至四日，虽能食，以承气汤，少与微和之，令小安。至六日，
与承气汤一升。不大便六、七日，小便少者，虽不大便，但头坚后溏，未定成其坚，攻之必溏，当须小便利，定坚，乃
可攻之。脏结无阳证，寒而不热（伤寒论云不往来寒热），其人反静，舌上苔滑者，不可攻也。伤寒呕多，虽有阳明证，
不可攻之。
阳明病，潮热，微坚，可与承气汤；不坚，不可与。若不大便六、七日，恐有燥屎，欲知之法，可少与小承气汤。
腹中转失气者，此为有燥屎，乃可攻之。若不转失气者，此但头坚后溏，不可攻之，攻之必腹满不能食。欲饮水者，即
哕，其后发热者，必复坚，以小承气汤和之。若不转失气者，慎不可攻之。
阳明病，身合色赤者，不可攻也。必发热色黄者，小便不利也。
阳明病，当心下坚满，不可攻之。攻之，遂利不止者，死；止者，愈。
阳明病，自汗出，若发其汗，小便自利，此为内竭，虽坚不可攻之。当须自欲大便，宜蜜煎导而通之。若土瓜根及
猪胆汁，皆可以导。下利，其脉浮大，此为虚，以强下之故也，设脉浮革，因尔肠鸣，属当归四逆汤。
太阳病，本应恶寒并伴有发热，现在却自汗出，反而不恶寒、不发热，关部脉象细而数，这是医生误用吐法造成的过失。如果在得病第一天或第二天就使用吐法，患者会感到腹中饥饿，但嘴里不想吃东西；如果在第三天或第四天使用吐法，患者不喜欢喝稀粥，想吃冷食，早上吃晚上吐，这也是医生误用吐法导致的后果，这属于轻微的逆证。
太阳病，如果误用吐法，原本太阳病应当恶寒，现在反而不恶寒，也不想穿衣服，这是因为吐法导致体内产生烦热。
少阴病，饮食入口即吐，心中感觉泛泛欲吐却又吐不出来，刚发病时手足寒冷，脉象弦而迟，这是胸中有实邪阻滞，不可使用下法。如果是膈上有寒饮，出现干呕症状的，也不可用吐法，应当采用温法治疗。
凡是四肢厥冷的病人，不可使用吐法，体质虚弱的人也是如此。
治疗的大原则是：春季适宜使用吐法。
凡是服用催吐汤药，只要病症缓解就停止，不必服完全部剂量。
病症表现像桂枝汤证，但头部不痛，项部不强硬，寸口脉微浮，胸中痞塞坚硬，气向上冲撞咽喉，呼吸不畅，这是胸中有寒邪，应当使用吐法。
胸部有各种实邪积聚，胸中郁闷疼痛，不能进食，想要让人按压胸部，反而吐出浑浊的唾液，每天腹泻十多次，脉象反而迟缓，寸口脉微滑，这种情况可以使用吐法，吐后腹泻就会停止。
少阴病，饮食入口即吐，心中感觉泛泛欲吐却又吐不出来，应当立即使用吐法。宿食停留在上脘，应当使用吐法。
病人手足厥冷，脉象突然变得紧实，邪气结聚在胸中，心下部胀满且烦躁，肚子饿却无法进食，病位在胸中，应当使用吐法。
脉象濡弱，弱脉出现在关部，濡脉出现在寸部（巅指寸口），微脉出现在上部，涩脉出现在下部。阳气不足则脉微，血虚则脉涩。阳气微弱，中风后出汗，反而出现躁动烦乱；血虚则脉涩，既厥冷又畏寒。阳气微弱不可使用下法，误下会导致心下部痞塞坚硬。
脐右有动气，不可使用下法。误下则津液枯竭，咽喉干燥，鼻孔干涩，头晕心悸。
脐左有动气，不可使用下法。误下则腹部拘急，饮食难进，动气反应加剧，身体虽有发热，睡觉却想蜷缩。
脐上有动气，不可使用下法。误下则手掌心热且烦乱，身体浮肿发冷，热汗自出，想喝水甚至想用水浇身。
脐下有动气，不可使用下法。误下则腹部胀满，突然起身时头晕，进食后排泄未消化的食物，心下部痞塞坚硬。咽喉闭塞，不可使用下法。误下则上部轻而下部重，水浆无法咽下，睡觉想蜷缩，身体急痛，再次腹泻一天十几次。
所有外实证，不可使用下法。误下则引发轻微发热，脉搏消失则厥冷，肚脐周围握持感发热。
所有虚证，不可使用下法。误下则口渴，想喝水的容易痊愈，厌恶喝水的病情加重。
脉象濡弱，弱脉在关部，濡脉在寸部，弦脉在上部，微脉在下部。弦脉代表阳气运行，微脉代表阴寒，上实下虚，意念上希望得到温热。微弦为虚证，虚证不可使用下法。脉微则咳嗽，咳嗽则吐出涎沫。误下后咳嗽虽止，但腹泻不止，胸中如虫咬般难受，喝粥则吐出，小便不利，两胁拘急，喘息困难，颈背牵连不适，手臂麻木，极度寒冷反而出汗，身体冰冷如冰，眼睛昏花，言语不休，谷气入胃却无法运化，称为“除中”（胃气将绝之危候），口中虽然想说话，舌头却无法前伸。
脉象濡弱，弱脉在关部，濡脉在寸部，浮脉在上部，数脉在下部。浮脉代表阳虚，数脉代表无血，浮脉即为虚，数脉则生热。浮脉为虚，自汗且恶寒。数脉则为痛，颤抖且寒战。关部脉微弱，胸下急迫，气喘出汗，呼吸困难。呼吸之中，疼痛位于胁部，寒战相互搏结，身形如疟疾状。医生反而使用下法，导致脉象急数，发热，狂跑见鬼，心下部痞塞。小便淋漓不尽，小腹部非常坚硬，尿中带血。
脉象濡而紧，濡则阳气微弱，紧则营血中有寒。阳气微弱卫气受风邪侵袭，发热且恶寒。营血紧束胃气寒冷，轻微呕吐心中烦乱。医生误认为是大热症，使用解肌发汗法，导致亡阳虚烦躁，心下部苦于痞塞坚硬，表里俱虚竭，突然起身则头晕，客热在皮肤，惆怅不快无法入睡，不知道胃气寒冷，紧寒在关元穴处，医生的技巧无处施展，汲水浇淋其身，客热随即消退，但更加栗栗发抖畏寒，盖上厚被覆盖，出汗时头目昏蒙，身体颤抖，小便微难，寒气因水而发作，完谷不化的腹泻没有间隙，呕吐反肠脱出，颠倒不安，手足轻微厥逆，身体冷而内心烦乱，此时再用迟缓之法救治，怎么能够追回呢？
脉象浮大，浮代表气实，大代表血虚，血虚即为无阴，孤阳独自下行至阴部，小便困难，胞宫空虚。现在反而小便通利且大汗出，按照常理卫气应当微弱，现在反而更实，津液四散流失，营血枯竭，干枯烦闷不眠，血液稀薄肌肉消瘦，从而形成暴脱之液。医生再用毒药攻伐胃部，这是双重虚损，客阳离去为期不远，必然大便如污泥而死。
趺阳脉迟而缓，表示胃气正常。趺阳脉浮而数，浮则伤胃，数则动脾，这不是原本的疾病，而是医生误用下法造成的。营卫内陷，其数脉先变微，脉象反而只浮，病人必然腹部坚硬，嗳气后暂时舒缓。为什么这样说？脾脉本来缓，现在数脉扰动脾脏，其数脉先变微，所以知道脾气失调。大便坚硬，嗳气后舒缓，现在脉象反而浮，其数脉改微，邪气独留，心中感觉饥饿，邪热不能消化谷物，潮热口渴，数脉应当转为迟缓，脉象前后度数如前，病人则会感到饥饿。数脉不时出现，则生恶疮。脉数者，久数不止，若停止则邪气结聚，正气不能恢复，正气退却结于脏腑，所以邪气浮越，与皮毛相合。脉数者，不可使用下法，误下必致烦乱，腹泻不止。
少阴病，脉微，不可发汗，因为没有阳气。阳气已虚，尺中脉弱涩的，也不可再使用下法。脉浮大，应当发汗，医生反而使用下法，这是严重的逆证。
脉浮大，心下部反而坚硬，有热邪归属脏腑，攻伐它，只能微微出汗。热邪归属腑，小便频数则大便坚硬，汗多则愈，汗少则排便困难。脉迟，尚不可攻伐。二阳并病，太阳初得病时，发汗，汗先出来，但没有发透，因此转属阳明，想要自汗出，不恶寒，如果太阳证未罢，不可使用下法，误下为逆。结胸证，脉象浮大，不可使用下法，误下即死。太阳与阳明合病，喘而且胸满，不可使用下法。太阳与少阳并病，心下部痞塞坚硬，颈项强直且头晕，不要使用下法。凡是四肢厥冷的病人，不可使用下法，体质虚弱的人也是如此。病人想吐的，不可使用下法。太阳病，有表证未解，不可使用下法，误下为逆。病发于阳，反而使用下法，热邪内入，因而造成结胸。病发于阴，反而使用下法，因而造成痞证。痞证脉浮坚而使用下法，紧脉反而入里，因而造成痞证。凡是病阳多者热，误下则坚硬。本虚，攻其热必呃逆。无阳，阴盛而坚硬，误下，必致完谷不化而腹部胀满。太阴病，腹部胀满且呕吐，饮食难进，误下则更严重，腹部时常自痛，胸下结塞坚硬。厥阴病，消渴，气向上冲撞，心中疼热，肚子饿但不想吃东西，严重时想吐，误下则泻痢不止。少阴病，其人饮食入口即吐，心中感觉泛泛欲吐却又吐不出来。刚发病时，手足寒冷，脉象弦迟，这是胸中实邪，不可使用下法。伤寒五、六天，不结胸，腹部柔软，脉虚，再次厥冷的，不可使用下法，误下则亡血死亡。伤寒，发热，只是头痛，微微出汗。发汗则神志不清。熏蒸则气喘，不能小便，心腹胀满。误下则短气而腹部胀满，小便困难，头痛背强。加用温针则必定鼻出血。伤寒，其脉阴阳俱紧，恶寒发热，则脉象欲厥。厥的表现是，脉初来大，渐渐变小，再来又渐渐变大，这是它的征候。恶寒严重的，翕翕出汗，喉咙痛。热多的，眼睛红，眼球昏花，医生再发汗，咽喉则受伤。如果再使用下法，则两眼闭合，寒多则完谷不化，热多则便脓血。熏蒸则发黄。熨烫则咽喉干燥。小便通利的可以救治。难治的，必定危险。伤寒发热，口中勃勃热气外出，头痛目黄，鼻衄不可控制。贪水的必呕吐，恶水的必厥冷，误下则咽喉生疮。假如手足温暖的，下重便脓血。头痛目黄的，误下则目闭。贪水的，误下则脉必厥，声音嘶哑，咽喉堵塞，发汗则战栗，阴阳俱虚。恶水的，误下则里冷不爱吃东西，大便完谷不化。发汗，口中受伤，舌苔滑，烦躁。脉数实，不大便六七天，后来必定便血。再发汗，小便即自利。
得病二、三天，脉弱，没有太阳病和柴胡证的特征，而烦躁，心下部坚硬。到了第四天，虽然能吃饭，给予承气汤，少量给予以微微调和，令其稍安。到了第六天，给予承气汤一升。不大便六、七天，小便少的，虽然不大便，但大便头硬后溏，尚未完全形成坚硬，攻伐必致溏泄，应当等小便通利，确定大便坚硬，才可以攻伐。脏结没有阳证，寒而不热（《伤寒论》说不往来寒热），病人反而安静，舌苔滑的，不可攻伐。伤寒呕吐多，即使有阳明证，也不可攻伐。
阳明病，潮热，大便微硬，可以与承气汤；如果不硬，不可给。如果不大便六、七天，恐怕有燥屎，想知道的方法，可以少量给予小承气汤。如果腹中转出矢气的，这是有燥屎，才可以攻伐。如果不转矢气的，这只是大便头硬后溏，不可攻伐，攻伐必致腹部胀满不能进食。想喝水的，就会呃逆，其后发热的，大便必复硬，用小承气汤调和。如果不转矢气的，千万不可攻伐。
阳明病，全身面色赤红的，不可攻伐。必定发热色黄的，是小便不利。
阳明病，当心下部坚硬胀满，不可攻伐。攻伐，导致腹泻不止的，死亡；停止的，痊愈。
阳明病，自汗出，如果发汗，小便自利，这是津液内竭，虽然大便硬也不可攻伐。应当等病人自己想大便，宜用蜜煎导法通便。或者土瓜根及猪胆汁，都可以用来导引。下利，脉象浮大，这是虚证，因为强行攻下所致，假设脉象浮革，因此肠鸣，属于当归四逆汤证。
Taiyang disease (Disease of the Taiyang/Bladder channel) should present with aversion to cold and fever. Now, there is spontaneous sweating, and conversely, no aversion to cold or fever. The pulse at the Guan position (middle position on the radial artery) is fine and rapid. This is an error caused by the physician's use of emesis (vomiting therapy). If emesis is used on the first or second day of illness, the patient will feel hungry in the abdomen but unable to eat. If emesis is used on the third or fourth day, the patient will dislike congee, desire cold food, and vomit what was eaten in the morning by evening. This is also a consequence of the physician's misuse of emesis, constituting a minor adverse reaction (minor inversion).
In Taiyang disease, if emesis is used, since Taiyang disease should involve aversion to cold, the fact that there is now no aversion to cold and no desire for clothing indicates internal heat and vexation caused by emesis.
In Shaoyin disease (Disease of the Shaoyin/Kidney-Heart channel), food and drink are vomited upon entry, the heart feels nauseous and desirous of vomiting but cannot do so. At the onset, the hands and feet are cold, and the pulse is wiry and slow. This indicates excess in the chest; purgation (downward draining) is contraindicated. If there is cold fluid above the diaphragm causing dry retching, emesis is also contraindicated; warming treatment should be applied.
For all cases of Sini Jue (Four Reversals/Cold Extremities), emesis is contraindicated, and this applies equally to patients with deficiency conditions.
The general principle states: Emesis is suitable in spring.
When administering decoctions for emesis, stop as soon as the disease is addressed; it is not necessary to finish the entire dose.
If the symptoms resemble Guizhi Tang (Cinnamon Twig Decoction) pattern, but the head does not hurt and the neck is not stiff, and the Cun position (distal position on the radial artery) pulse is slightly floating, with obstruction and hardness in the chest, Qi rushing up to the throat causing breathing difficulty, this indicates cold in the chest, and emesis should be used.
For various excesses in the upper chest, with depression and pain in the chest, inability to eat, desire for someone to press on the chest, yet expectorating turbid saliva, accompanied by diarrhea more than ten times a day, where the pulse is surprisingly slow and the Cun position is slightly slippery, emesis can be used; after emesis, the diarrhea will stop.
In Shaoyin disease, where food and drink are vomited upon entry, the heart feels nauseous and desirous of vomiting but cannot do so, emesis should be performed immediately. For retained food in the upper Wan (upper stomach), emesis should be used.
If the patient has cold extremities, the pulse suddenly becomes tight, and pathogenic factors are knotted in the chest, with fullness and vexation below the heart, hunger but inability to eat, the disease is in the chest, and emesis should be used.
A pulse that is soft and weak, with weakness appearing at the Guan position and softness at the Dian (Cun/top) position, faintness above, and choppy below, indicates insufficient Yang Qi (faint pulse) and lack of Blood (choppy pulse). If Yang Qi is faint, wind-stroke causes sweating and conversely restlessness and vexation; choppy pulse indicates lack of Blood, leading to Jue (reversal/cold extremities) and cold. Faint Yang cannot be treated with purgation; purgation will result in Pi Jian (obstruction and hardness below the heart).
Moving Qi (pulsation) on the right prohibits purgation. Purgation will deplete body fluids, causing dry throat and nose, dizziness, and palpitations.
Moving Qi on the left prohibits purgation. Purgation will cause abdominal cramping, inability to eat, exacerbation of moving Qi, and although the body may have heat, the patient desires to curl up while lying down.
Moving Qi above prohibits purgation. Purgation will cause hot vexation in the palms, floating coldness of the body, spontaneous hot sweating, and a desire to pour water over oneself.
Moving Qi below prohibits purgation. Purgation will cause abdominal fullness, dizziness upon sudden rising, passage of undigested food after eating, and Pi Jian below the heart. Obstruction in the throat prohibits purgation. Purgation will lead to lightness above and heaviness below, inability to take fluids, desire to curl up when lying down, acute body pain, and diarrhea more than ten times a day.
All external excesses prohibit purgation. Purgation will induce slight fever, loss of pulse with Jue, and heat grasped around the navel.
All deficiencies prohibit purgation. Purgation will cause thirst; those who seek water recover easily, while those who reject water worsen.
Pulse is soft and weak, weakness at Guan, softness at Dian, wiry above, faint below. Wiry indicates Yang movement; faint indicates Yin cold. Upper excess and lower deficiency indicate a desire for warmth. Faint and wiry indicate deficiency; deficiency prohibits purgation. Faint pulse leads to coughing and expectoration of saliva. Purgation stops the cough but not the diarrhea, causing a sensation like insect bites in the chest, regurgitation of porridge, difficult urination, spasm of both costal regions, difficult breathing,牽引 (pulling) of neck and back, numbness of arms, extreme cold with sweating, body cold as ice, dull eyes, incessant speech, and "Chuzhong" (elimination of the middle/Stomach Qi exhaustion) where grain enters but is rejected. Although the mouth wants to speak, the tongue cannot move forward.
Pulse is soft and weak, weakness at Guan, softness at Dian, floating above, rapid below. Floating indicates Yang deficiency; rapid indicates lack of Blood. Floating indicates deficiency; rapid generates heat. Floating indicates deficiency, spontaneous sweating, and aversion to cold. Rapid indicates pain, trembling, and chills. Weakness at Guan causes urgency below the chest, wheezing, sweating, and dyspnea. Pain occurs in the hypochondrium during respiration. Chills and tremors interlock, resembling malaria. If the physician erroneously uses purgation, the pulse becomes urgent and rapid, fever ensues, madness with hallucinations occurs, Pi forms below the heart, urination becomes dribbling, the lower abdomen becomes very hard, and hematuria appears.
Pulse is soft and tight. Soft indicates faint Yang; tight indicates Cold in Ying (Nutritive) level. Faint Yang with Wei (Defensive) wind-stroke causes fever and aversion to cold. Tight Ying with cold Stomach Qi causes slight vomiting and internal vexation. If the physician mistakes this for great heat and uses muscle-relaxing sweating, Yang collapses with deficiency-induced vexation, bitter Pi below the heart, exhaustion of interior and exterior, dizziness upon rising, lingering heat in the skin, discomfort preventing sleep, unawareness of cold Stomach Qi, and tight Cold at Guanyuan (CV4). Techniques fail. Pouring water on the body makes lingering heat cease but causes severe chills. Covering with heavy blankets causes sweating with head cloudiness, trembling, difficult urination, and Cold triggered by water causing continuous passage of undigested food, evisceration, restlessness, slight reversal of hands and feet, cold body with internal vexation. Can delayed rescue retrieve this?
Pulse is floating and large. Floating indicates Qi excess; large indicates Blood deficiency. Blood deficiency means no Yin; solitary Yang descends alone into the Yin region, causing difficult urination and emptiness in the Bao (uterus/bladder). Now, conversely, urination is free and sweating is profuse. Normally, Wei should be slight; now it is excessive, fluids scatter in four directions, Ying exhausts, Blood finishes, dry vexation and insomnia occur, blood thins, flesh wastes, forming sudden fluid collapse. If the physician attacks the Stomach with toxic drugs, this is double deficiency. The departure of lingering Yang is imminent; death will come with stool like mud.
Fuyang (foot yangming) pulse slow and moderate indicates normal Stomach Qi. Fuyang pulse floating and rapid: floating injures Stomach, rapid disturbs Spleen. This is not the original disease but caused by the physician's purgation. Ying and Wei sink inward; the rapid pulse first becomes faint, so the pulse is only floating; the person becomes firm, belches, and feels relieved. Why? Spleen pulse is originally moderate; now rapid pulse moves the Spleen, its rapidity first becomes faint, indicating Spleen Qi dysfunction. Hard stool and belching relief, now pulse floats, rapidity becomes faint, pathogen remains alone. Heart feels hungry, pathogenic heat fails to digest grain, tidal fever and thirst occur. Rapid pulse should become moderate and slow. If pulse degrees remain as before, the patient feels hungry. Irregular rapid pulse generates malignant sores. Rapid pulse, if long-lasting without stopping, stopping implies pathogen knotting; Zheng Qi (Upright Qi) cannot recover. Zheng Qi retreats and knots in Zang organs, so pathogen floats, associating with skin and hair. Rapid pulse prohibits purgation; purgation causes vexation and unceasing diarrhea.
Shaoyin disease, faint pulse, prohibits sweating, due to lack of Yang. If Yang is already deficient and Chi (proximal) position is weak and choppy, purgation is also prohibited. Floating-large pulse should induce sweating; erroneous purgation is a major inversion.
Floating-large pulse with reverse Pi hardness below the heart, heat belonging to Zang, attacking it results in only slight sweating. Heat belonging to Fu (Organs) with frequent urination makes stool hard; much sweat leads to recovery, little sweat makes urination difficult. Slow pulse is not yet ready for attack. Two Yangs combined disease: when Taiyang is newly acquired, sweating is induced. Sweat comes out first but is not thorough, thus transferring to Yangming, desiring spontaneous sweating, no aversion to cold. If Taiyang syndrome is not resolved, purgation is prohibited; purgation is inversion. Jie Xiong (Chest Binding) syndrome, floating-large pulse, prohibits purgation; purgation leads to death. Taiyang and Yangming combined disease, wheezing and chest fullness, prohibits purgation. Taiyang and Shaoyin combined disease, Pi hardness below heart, stiff neck and dizziness, do not purge. All Sini Jue prohibit purgation; deficiency families likewise. Disease desiring vomiting prohibits purgation. Taiyang disease, exterior syndrome unresolved, prohibits purgation; purgation is inversion. Disease originating from Yang, reversed by purgation, heat enters, forming Jie Xiong. Disease originating from Yin, reversed by purgation, forms Pi. Pi with floating-hard pulse, purged, tight pulse enters interior, forming Pi. Diseases with much Yang have heat; purgation makes it hard. Original deficiency, attacking heat causes hiccups. No Yang, Yin strong and hard, purgation causes undigested food and abdominal fullness. Taiyin disease: abdominal fullness and vomiting, inability to eat, purgation worsens it, abdominal pain, lower chest binding hardness. Jueyin disease: Xiao Ke (Wasting-Thirst), Qi rushing up, heart pain and heat, hunger but no desire to eat, severe cases desire vomiting, purgation causes unceasing diarrhea. Shaoyin disease: food/drink vomited upon entry, heart nauseous desiring to vomit but cannot. Onset: cold hands/feet, wiry-slow pulse, chest excess, prohibits purgation. Shanghan 5-6 days, no Jie Xiong, soft abdomen, empty pulse, again Jue, prohibits purgation; purgation causes blood loss and death. Shanghan, fever, only headache, slight sweating. Sweating causes unconsciousness. Moxibustion/fumigation causes wheezing, inability to urinate, heart/abdominal fullness. Purgation causes shortness of breath, abdominal fullness, difficult urination, headache, stiff back. Warm needle causes epistaxis. Shanghan, Yin-Yang pulses both tight, aversion to cold and fever, pulse desires Jue. Jue means pulse starts large, gradually small, then gradually large. Severe aversion to cold,翕翕 (light) sweating, sore throat. Much heat: red eyes, dull vision, further sweating injures throat. Further purgation: eyes closed. Much cold: undigested food. Much heat: pus/blood in stool. Fumigation causes jaundice. Ironing causes dry throat. Free urination can be saved. Difficult cases are critical. Shanghan fever, bubbling Qi from mouth, headache, yellow eyes, uncontrollable epistaxis. Water-loving causes vomiting; water-hating causes Jue. Purgation causes ulcers in throat. If hands/feet warm, heaviness below with pus/blood stool. Headache/yellow eyes, purgation causes eye closure. Water-loving, purgation causes Jue pulse, humming voice, throat blockage. Sweating causes shivering, Yin-Yang dual deficiency. Water-hating, purgation causes interior cold, anorexia, undigested stool. Sweating causes mouth injury, slippery tongue coating, vexation. Rapid-excess pulse, no bowel movement 6-7 days, later blood in stool. Further sweating makes urination free.
Illness 2-3 days, weak pulse, no Taiyang or Chaihu signs, but vexation and hard lower chest. By day 4, able to eat, give Chengqi Tang (Mireful Pill Decoction) slightly to harmonize mildly, allowing slight peace. By day 6, give one Sheng of Chengqi Tang. No bowel movement 6-7 days, little urine: even if no BM, only hard head and loose tail, not yet definitively hard, attacking causes loose stool. Wait for free urination and definitive hardness before attacking. Zang Jie (Organ Knotting) has no Yang signs, cold not hot (Shanghan Lun says no alternating cold/heat), patient is quiet, slippery tongue coating prohibits attack. Shanghan with much vomiting, even with Yangming signs, prohibits attack.
Yangming disease, tidal fever, slightly hard stool, can give Chengqi Tang; if not hard, do not give. If no BM 6-7 days, fearing dry stool, method to know: give small amount of Xiao Chengqi Tang (Minor Mireful Pill Decoction). If gas turns in abdomen, this is dry stool, can attack. If no gas, only hard head/loose tail, do not attack; attacking causes abdominal fullness and anorexia. Desiring water causes hiccups. Later fever means stool becomes hard again, harmonize with Xiao Chengqi Tang. If no gas, strictly do not attack.
Yangming disease, whole body red color, prohibits attack. Must have fever and yellow color, indicating difficult urination.
Yangming disease, hard/full below the heart, prohibits attack. Attacking leads to unceasing diarrhea: death. If stops: recovery.
Yangming disease, spontaneous sweating, if sweated, urine free: this is interior exhaustion. Even if hard, do not attack. Wait for desire to defecate; use Honey Suppository (Mi Jian Dao) to guide. Or Melon Root (Tugua Gen) or Pig Bile can guide. Diarrhea, floating-large pulse: this is deficiency, caused by forced purgation. If pulse is floating-leather, with intestinal rumbling, belongs to Danggui Sini Tang (Angelica Decoction for Reversals).