下利,谷道中痛,当温之以为,宜熬木盐熨之。一方,炙枳实熨之。
问曰∶温病,汗出辄复热,而脉躁疾,不为汗衰,狂言,不能食,病名为何?对曰∶名曰阴阳交,交者,死。人所
以汗出者,生于谷,谷生于精。今邪气交争于骨肉而得汗者,是邪却而精胜。精胜则当能食而不复热。热者,邪气也。
汗者,精气也。今汗出而辄复热者,邪胜也。不能食者,精无俾也。汗而热留者,寿可立而倾也。
夫汗出而脉尚躁盛者,死。此今脉不与汗相应,此不胜其病也。狂言者,是失志,失志者,死。有三死,不见一生,
虽愈必死。
热病,已得汗,而脉尚躁盛,此阳脉之极也,死。其得汗而脉静者,生也。
热病,脉尚躁盛,而不得汗者,此阳脉之极也。死。脉躁盛得汗者,生也。
热病,已得汗,而脉尚躁,喘且复热,勿肤刺,喘甚者,死。
热病,阴阳交者,死。
热病,烦已而汗,脉当静。
太阳病,脉反躁盛者,是阴阳交,死。复得汗,脉静者,生。
热病,阴阳交者,热烦身躁,太阴寸口脉两冲尚躁盛,是阴阳交,死。得汗脉静者,生。
热病,阳进阴退,头独汗出,死。阴进阳退,腰以下至足汗出,亦死。阴阳俱进,汗出已,热如故,亦死。阴阳俱
退,汗出已,寒栗不止,鼻口气冷,亦死。(上热病,阴阳交部。)
热病,所谓并阴者,热病已得汗,因得泄,是谓并阴,故治。(治一作活)
热病,所谓并阳者,热病已得汗,脉尚躁盛,大热,汗之,虽不汗出,若衄,是谓并阳,故治。上热病并阴阳部。
少阴病,恶寒,蜷而利,手足逆者,不治。
少阴病,下利止而眩,时时自冒者,死。
少阴病,其人吐利,躁逆者,死。
少阴病,四逆,恶寒而蜷,其脉不至,其人不烦而躁者,死。
少阴病六、七日,其人息高者,死。
少阴病,脉微细沉,但欲卧,汗出不烦,自欲吐,五、六日自利,复烦躁,不得卧寐者,死。
少阴病,下利,若利止、恶寒而蜷,手足温者,可治。
少阴病,恶寒而蜷,时时自烦,欲去其衣被者,可治。
少阴病,下利止,厥逆无脉,干,烦(一本作干呕)。服汤药,其脉暴出者,死。微细者,生。上少阴部。
伤寒六、七日,其脉微,手足厥,烦躁,灸其厥阴,厥不还者,死。
伤寒,下利,厥逆,躁不能卧者,死。
伤寒,发热,下利至厥不止者,死。
伤寒,厥逆,六、七日不利,便发热而利者,生。其人汗出,利不止者,死。但有阴无阳故也。
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,发热而厥,七日,下利者,为难治。上厥逆部。
热病,不知所痛,不能自收,口干,阳热甚,阴颇有寒者,热在髓,死不治。
热病在肾,令人渴,口干,舌焦黄赤,昼夜欲饮不止,腹大而胀,尚不厌饮,目无精光,死不治。脾伤,即中风,
阴阳气别离,阴不从阳,故以三分,候其死生。
伤寒,咳逆上气,其脉散者,死。谓其人形损故也。
伤寒,下利,日十余行,其人脉反实者,死。病者胁下素有痞,而不在脐旁,痛引少腹,入阴挟阴筋,此为脏结,
死。夫实则谵语,虚则郑声。郑声者,重语是也。直视、谵语、喘满者,死。若下利者,亦死。结胸证悉具,而躁者,
死。吐舌下卷者,死。唾如胶者,难解。舌头四边,徐有津液,此为欲解。病者至经,上唇有色,脉自和,为欲解。色
急者,未解。上阴阳竭尽部。
下利(腹泻),肛门疼痛,应当用温法治疗,适宜用炒过的木盐进行熨烫。另一方法,是用炙过的枳实进行熨烫。
问:温病,出汗后随即又发热,脉搏躁动疾速,不因出汗而减弱,胡言乱语,不能进食,这病名叫什么?答:名叫阴阳交,所谓“交”,意味着死亡。人之所以能出汗,是因为有谷气,谷气化生为精气。现在邪气与精气在骨肉间交争,如果能出汗,说明邪气退却而精气胜利。精气胜利就应当能进食且不再发热。发热,代表邪气;出汗,代表精气。现在出汗后随即又发热,说明邪气胜过精气。不能进食,说明精气得不到补充。出汗后热势仍留存,生命可以立刻倾覆灭亡。
如果出汗后脉搏仍然躁动盛大,这是死证。这是因为现在的脉搏与汗出情况不相适应,说明正气不能战胜疾病。胡言乱语,是神志丧失的表现,神志丧失则死。有三种死征,看不到一丝生机,即使暂时看似痊愈,最终也必死无疑。
热病,已经出汗,但脉搏仍然躁动盛大,这是阳脉的极端表现,主死。如果出汗后脉搏变得平静,主生。
热病,脉搏仍然躁动盛大,但不能出汗的,这是阳脉的极端表现,主死。脉搏躁动盛大但能出汗的,主生。
热病,已经出汗,但脉搏仍然躁动,伴有气喘且再次发热,不要针刺皮肤(此处指误治或无效治疗),如果气喘严重的,主死。
太阳病,脉搏反而躁动盛大的,这是阴阳交,主死。如果随后出汗,脉搏变平静的,主生。
热病,属于阴阳交的,表现为热、烦、身体躁动,太阴寸口脉两关部仍然躁动盛大,这是阴阳交,主死。如果出汗后脉搏变平静的,主生。
热病,阳气进逼阴气衰退,只有头部出汗,主死。阴气进逼阳气衰退,腰部以下至足部出汗,也主死。阴阳之气同时进逼,出汗后热势依旧,也主死。阴阳之气同时衰退,出汗后寒战不止,鼻息和口气冰冷,也主死。(以上为热病阴阳交部分。)
热病,所谓的“并阴”,是指热病已经出汗,因此得以泄越,这叫并阴,所以可以治疗。(“治”一作“活”。)
热病,所谓的“并阳”,是指热病已经出汗,但脉搏仍然躁动盛大,大热,通过发汗治疗,虽然不出汗,或者出现鼻衄,这叫并阳,所以可以治疗。以上为热病并阴阳部分。
少阴病,腹泻停止但头晕目眩,时常感到眼前发黑昏冒的,主死。
少阴病,四肢厥冷,恶寒且身体蜷缩,脉搏摸不到,人不烦躁但躁动的,主死。
少阴病,脉搏微细沉,只想睡觉,出汗但不烦躁,自己想吐,五到六天出现自发性腹泻,随后又烦躁,不能卧睡的,主死。
少阴病,腹泻,如果腹泻停止,恶寒且身体蜷缩,但手足温暖的,可以治疗。
少阴病,恶寒且身体蜷缩,时常自我烦躁,想要脱去衣被的,可以治疗。
少阴病,腹泻停止,四肢厥冷无脉,口干烦躁(另一版本作干呕)。服用汤药后,如果脉搏突然暴出的,主死。如果脉搏微细的,主生。以上为少阴病部分。
伤寒经过六七天,脉搏微弱,手足厥冷,烦躁,艾灸其厥阴经穴位,如果厥冷不回复的,主死。
伤寒,四肢厥冷,六七天没有腹泻,突然发热并出现腹泻的,主生。如果其人出汗,腹泻不止的,主死。这是因为只有阴气没有阳气的缘故。
伤寒五到六天,没有形成结胸证,腹部柔软,脉搏虚弱且四肢厥冷的,不可使用攻下法,如果误用攻下法,导致亡血,主死。
伤寒,发热而四肢厥冷,到了第七天出现腹泻的,为难治。以上为厥逆部分。
热病,不知道哪里疼痛,不能自主收摄肢体,口干,阳热极盛,阴分却颇有寒意,这是热邪在骨髓,主死,无法治疗。
热邪在肾,使人口渴,口干,舌苔焦黄赤色,昼夜想喝水不停,腹部胀大,仍然不满足于饮水,眼睛失去神采,主死,无法治疗。脾脏受伤,就会中风,阴阳之气分离,阴不从属于阳,所以以三分的比例来观察其生死。
伤寒,咳嗽气逆上冲,脉搏散乱的,主死。这是因为人体形体亏损的缘故。
伤寒,腹泻,一天十多次,脉搏反而坚实的,主死。病人胁下素有痞块,且不在脐旁,疼痛牵引少腹,进入阴部挟持阴筋,这叫脏结,主死。实证会胡言乱语,虚证会语言重复。郑声,就是语言重复的意思。直视、胡言乱语、气喘胸满的,主死。如果伴有腹泻的,也主死。结胸证的各个症状都具备,但出现躁动的,主死。伸舌头且舌头下卷的,主死。唾液像胶一样粘稠的,难以解救。如果舌头四周慢慢有津液,这是病情将要解除。病人到了经期,上唇有血色,脉搏自然调和,这是病情将要解除。如果神色紧急,说明尚未解除。以上为阴阳竭尽部分。
Diarrhea accompanied by pain in the anal region should be treated with warming methods; it is appropriate to apply roasted wood salt via moxibustion-like ironing. Another method involves using processed Zhi Shi (Fructus Aurantii) for ironing.
Question: In warm disease, if sweating occurs followed immediately by recurrent fever, with a rapid and restless pulse that does not diminish after sweating, along with delirium and inability to eat, what is the name of this disease? Answer: It is called Yin-Yang Jiao (Intertwining of Yin and Yang), where "Jiao" indicates death. The reason humans sweat is due to grain qi, which generates essence. When pathogenic factors contend with essence in the muscles and bones, sweating indicates that the pathogen is retreating and essence is victorious. If essence is victorious, the patient should be able to eat and fever should cease. Fever represents pathogenic factors; sweating represents essence. Now, if sweating is followed immediately by recurrent fever, it indicates that pathogenic factors are overpowering essence. The inability to eat means essence lacks support. If fever persists despite sweating, life can be lost instantly.
If the pulse remains rapid and vigorous after sweating, it is a sign of death. This is because the pulse does not correspond with the sweating, indicating that healthy qi cannot overcome the disease. Delirium signifies loss of Shen (Spirit); loss of Spirit leads to death. There are three signs of death with no sign of life; even if there is temporary improvement, death is inevitable.
In heat disease, if sweating has occurred but the pulse remains rapid and vigorous, this is the extreme of Yang pulses, indicating death. If the pulse becomes calm after sweating, it indicates survival.
In heat disease, if the pulse remains rapid and vigorous but no sweating occurs, this is the extreme of Yang pulses, indicating death. If the pulse is rapid and vigorous but sweating occurs, it indicates survival.
In heat disease, if sweating has occurred but the pulse remains rapid, accompanied by wheezing and recurrent fever, do not needle the skin. If wheezing is severe, it indicates death.
Heat disease characterized by Yin-Yang Jiao indicates death.
In heat disease, if irritability ceases and sweating occurs, the pulse should become calm.
In Taiyang disease, if the pulse is unexpectedly rapid and vigorous, this is Yin-Yang Jiao, indicating death. If sweating subsequently occurs and the pulse becomes calm, it indicates survival.
In heat disease, characterized by Yin-Yang Jiao, presenting with heat, irritability, and bodily restlessness, if the Cun Kou (inch position) pulse of the Taiyin channel is still rapid and vigorous on both sides, this is Yin-Yang Jiao, indicating death. If the pulse becomes calm after sweating, it indicates survival.
In heat disease, if Yang advances and Yin retreats, with sweating only on the head, it indicates death. If Yin advances and Yang retreats, with sweating from the waist down to the feet, it also indicates death. If both Yin and Yang advance, and sweating occurs but the heat remains unchanged, it indicates death. If both Yin and Yang retreat, and after sweating, chills persist without stopping, with cold breath from the nose and mouth, it also indicates death. (Above: Section on Heat Disease, Yin-Yang Jiao.)
Heat disease referred to as "Bing Yin" (Merging with Yin) occurs when heat disease has sweated, allowing for discharge; this is Bing Yin, and thus it is treatable. ("Zhi" may be read as "Huo" [alive/survive].)
Heat disease referred to as "Bing Yang" (Merging with Yang) occurs when heat disease has sweated, yet the pulse remains rapid and vigorous with high fever. Through diaphoresis treatment, although no sweating occurs, or if nasal bleeding (Nu) occurs, this is Bing Yang, and thus it is treatable. Above: Section on Heat Disease Merging with Yin and Yang.
Shaoyin disease with aversion to cold, curling up, diarrhea, and cold extremities is untreatable.
Shaoyin disease with cessation of diarrhea but accompanied by dizziness and frequent sensations of fainting/blackouts indicates death.
Shaoyin disease with vomiting, diarrhea, irritability, and reversal indicates death.
Shaoyin disease with cold limbs, aversion to cold, curling up, absent pulse, non-irritability but restlessness indicates death.
Shaoyin disease lasting six or seven days, with shallow and rapid breathing (Xi Gao), indicates death.
Shaoyin disease with a minute, fine, and deep pulse, desire to sleep, sweating without irritability, spontaneous urge to vomit, spontaneous diarrhea after five to six days, followed by irritability and inability to lie down or sleep, indicates death.
Shaoyin disease with diarrhea: if the diarrhea stops, and although there is aversion to cold and curling up, the hands and feet are warm, it is treatable.
Shaoyin disease with aversion to cold and curling up, frequent self-induced irritability, and desire to remove clothing and blankets, is treatable.
Shaoyin disease with stopped diarrhea, cold limbs, absent pulse, dry mouth, and irritability (another version reads dry heaving). After taking herbal decoctions, if the pulse suddenly bursts forth, it indicates death. If the pulse remains minute and fine, it indicates survival. Above: Shaoyin Section.
Shanghan (Cold Damage) lasting six or seven days, with a minute pulse, cold limbs, and irritability: if moxa is applied to the Jueyin channel and cold limbs do not recover, it indicates death.
Shanghan with diarrhea, cold limbs, and restlessness preventing lying down indicates death.
Shanghan with fever and diarrhea progressing to unceasing cold limbs indicates death.
Shanghan with cold limbs: if there has been no diarrhea for six or seven days, and sudden fever with diarrhea occurs, it indicates survival. However, if the patient sweats and diarrhea continues unceasingly, it indicates death. This is due to having only Yin without Yang.
Shanghan for five or six days, without chest binding syndrome, soft abdomen, weak pulse, and cold limbs: purgation must not be used. If purgation is mistakenly used, causing blood loss, it indicates death.
Shanghan with fever and cold limbs: if diarrhea occurs on the seventh day, it is difficult to treat. Above: Cold Limbs Section.
Heat disease with unknown pain location, inability to control one's body, dry mouth, extreme Yang heat, yet significant Yin cold, indicates heat in the marrow; this is fatal and untreatable.
Heat affecting the Kidney causes thirst, dry mouth, yellow-red scorched tongue coating, incessant desire to drink day and night, abdominal distension, and continued lack of satisfaction with drinking. With eyes lacking luster, it is fatal and untreatable. Spleen injury leads to wind-stroke; Yin and Yang Qi separate, and Yin does not follow Yang. Therefore, prognosis is assessed by observing three parts for signs of life or death.
Shanghan with coughing and rebellious Qi rising, with a scattered pulse, indicates death. This is due to the depletion of the physical form.
Shanghan with diarrhea occurring more than ten times a day, with a surprisingly solid pulse, indicates death. If the patient has had a fixed mass (Pi) under the ribs since long ago, not located beside the navel, with pain radiating to the lower abdomen and into the genital region involving the tendons, this is Zang Jie (Organ Knotting), indicating death. Excess conditions lead to delirious speech; deficiency conditions lead to Zheng Sheng (repetitive speech). Zheng Sheng refers to repetitive utterances. Fixed gaze, delirium, and wheezing/fullness indicate death. If accompanied by diarrhea, it also indicates death. If all symptoms of Chest Binding Syndrome are present but accompanied by restlessness, it indicates death. Tongue protrusion and rolling downward indicate death. Saliva resembling glue is difficult to resolve. If moisture slowly returns to the four sides of the tongue, it indicates impending resolution. If the patient reaches their menstrual cycle, the upper lip shows color, and the pulse is harmonious, it indicates impending resolution. If the complexion appears urgent/tense, resolution has not yet occurred. Above: Section on Exhaustion of Yin and Yang.