诸掉眩,皆属肝木。
掉、摇也。眩、昏乱旋运也。风主动故也。木郁达之,达、谓吐之也。
诸痒疮疡,皆属心火。
微热则痒,热甚则痛。火郁发之,发、谓疏散之也。
诸肿满、皆属脾土。
食饮不消则生湿,湿则生热。土郁夺之,夺、谓下之令无壅滞也。
诸 郁病痿,皆属肺金。
、谓满也。郁、谓奔迫也。痿、谓手足软弱,无力运动也。金郁拆之,拆、谓解表利
小便也。
诸收引,皆属肾水
收、谓敛也。引、谓急也。皆寒之用也。水郁泄之,泄、谓制其冲逆也。
诸暴强直,支痛 戾,里急筋缩,皆属于风。厥阴风木,乃肝胆之气也。
暴、卒也。强直、筋劲而不柔和也。支痛、坚固支持,筋挛不柔而痛也。 戾、筋缩也。
谓里急筋缩,乖戾失常而病也。然燥金主于紧敛,短缩筋劲,风木为病,反见燥金之化,由
亢则害承乃制也。况风能胜湿而为燥也。风病势甚,而成筋缩者,燥之甚也。故诸甚者,皆
兼乎燥。
诸病喘呕吐酸,暴注下迫,转筋,小便混浊,腹胀如鼓,痈疽疡疹,瘤气结核,吐下霍
乱,瞀郁肿胀,鼻塞鼽衄,血溢血泄,淋闭身热,恶寒战栗,惊惑悲笑,谵语妄答,衄蔑血
污,皆属于热。少阴君火之热,乃真心与小肠之气也。喘、火气也。寒水为阴,主迟缓。热
火为阳,主急数。寒则息迟气微。热则息数气粗,而为喘也。
呕者,胃气热甚则为呕,火气炎上之象也。寒亦主呕,不可执一而论。
吐酸、酸者肝木之味也。由火盛制金,不能平木,则肝木自甚,故为酸也。是以肝热则
口酸。心热则口苦,脾热则口甘,肺热则口辛,肾热则口咸,又或有口淡者、胃热也。
暴注、卒泄也。肠胃热甚,而传化失常,火性疾速,故如是也。
下迫、后重急痛也。火性燥物故也。
转筋、反戾也。热气燥烁于筋,挛螈而痛也。言寒者误,寒虽主于收引,然止为厥逆禁
固,屈伸不便,安得为转筋也。
小便混浊,寒则清洁,热则混浊也。
腹胀如鼓,气为阳,阳为热,气甚,则如是也。
痈、浅而大也。经曰、热胜血则为痈脓也。
疽、深而恶也。疡、有头小疮也。疹、浮小瘾疹也。
瘤气、赤瘤丹 ,热胜气也,火之色也。
结核、火气热甚、则郁结坚硬。如果中核也。不必溃发,但令热气散,则自消矣。
吐下霍乱,三焦为水谷传化之道路,热气甚,则传化失常,而吐泻霍乱,火性燥动故也。
或
大法吐泻颇渴为热,不渴为寒,或热吐泻,始得之亦有不渴者,若不止,则亡津液而后
必渴。寒本不渴,若亡津液过多,则亦燥而渴也。但寒者、脉当沉细而迟,热者、脉当实大
而数。
瞀、昏也。热气甚,则浊乱昏昧也。
郁、怫郁也。结滞壅塞,而气不通畅,所谓热甚则腠理闭密而郁结也。然寒水主于闭藏,
今反属热者,是火热亢极,反兼水化制之故也。
肿胀、热胜于内,则气郁而为肿也。阳气热甚,则腹胀也。火主彰显,升明舒荣,皆肿
胀之象也。
鼻塞、窒塞不通畅也。火主 肿胀,故热客阳明,而鼻中 胀窒塞也。
鼽者、鼻流清涕也。夫五行之理,微则当其本化,甚则兼其鬼贼。经曰,亢则害、承乃
制也。以火炼金,热极而反为水之样也。故肝热甚则出泣,心热甚则出汗,脾热甚则出涎,
肺热甚则出涕,肾热甚则出唾也。
衄者、阳极拂郁于足阳明,火气上蒸于肺,则血妄行,而为鼻衄也。
血溢者、血上出也。血泄者、热客下焦,而大小便血泄也。
淋者、小便涩痛也。热客膀胱,郁结不能渗泄故也。又有遗尿不禁者,经曰、肾主二阴,
水衰而怫郁客其部分,二阴郁结,则痿痹而神无所用,故小便遗失而不能禁止,然则热症明
矣。仲景论少阴病热极,曰,溲便遗失、狂言、目反直视不转睛者,肾先绝也。
闭者、大便涩滞也。谓之风热结者,火甚制金,不能平木,则肝木自旺故也。
身热恶寒者,热在表也。寒则腠理闭密,阳气拂郁而然也。
战、动摇也。栗、寒冷也。皆火之象也。此由火热亢极而战。反兼水化制之,故战栗也。
惊者、心卒动而不宁也。火主于动,心火热甚,故惊也。
惑者、惑乱也。火实、则水衰,失志而惑乱也。
志者、肾水之神。
悲者、肺金所主也。笑者、心火所主也。悲笑而五液俱出者,火热亢极,而反兼水化制
之故也。
谵者、多言也。言为心声,心热则多言也。
妄者、虚妄也。火为阳,故外清明而内浊昧。心热甚、则肾衰,而志不精一,见闻虚妄,
而自为问答,神智失常也。
衄蔑血污者,心火热极,则血有余,热气上甚,则为血溢污浊,而见紫黑之象也。
凡是肢体震颤、头晕目眩,都归属于肝木。
掉,即摇动。眩,即昏乱旋转。这是因为风性主动的缘故。对于木郁,应当用“达”法治疗,“达”,指的是催吐的方法。
凡是皮肤瘙痒、疮疡肿毒,都归属于心火。
微热则引起瘙痒,热盛则引起疼痛。对于火郁,应当用“发”法治疗,“发”,指的是疏散的方法。
凡是身体浮肿、腹部胀满,都归属于脾土。
饮食不消化则产生湿邪,湿邪久留则化热。对于土郁,应当用“夺”法治疗,“夺”,指的是攻下之法,使气机没有壅滞。
凡是痞塞、郁病、痿证,都归属于肺金。
痞,指胸腹闷满。郁,指气机奔迫急迫。痿,指手足软弱无力,不能运动。对于金郁,应当用“拆”法治疗,“拆”,指的是解表并通利小便的方法。
凡是筋脉收缩牵引,都归属于肾水。
收,指收敛。引,指拘急。这都是寒邪的作用。对于水郁,应当用“泄”法治疗,“泄”,指的是制约其冲逆之气。
凡是突然发生的肢体强直、支撑部位疼痛、筋脉拘挛扭曲、体内拘急、筋脉短缩,都归属于风。厥阴风木,即是肝胆之气。
暴,即突然。强直,指筋脉僵硬而不柔和。支痛,指坚固支持,筋脉拘挛不柔而疼痛。戾,指筋脉缩短。里急筋缩,指内部拘急、筋脉短缩,乖戾失常而发病。然而燥金主紧敛、短缩、筋劲,风木为病,反而出现燥金的化象,这是由于亢盛则为害,承制方能平衡的道理。况且风能胜湿而化为燥。风病势严重,导致筋缩的,是燥邪严重的表现。所以病情严重的,往往兼夹燥邪。
凡是气喘呕吐酸水、突然腹泻伴有肛门重坠感、转筋、小便浑浊、腹胀如鼓、痈疽疮疹、瘤气结核、吐泻霍乱、头昏郁闷肿胀、鼻塞流涕鼻出血、血液溢出或排泄、淋证闭涩伴身热、恶寒战栗、惊恐迷惑悲笑、胡言乱语妄加回答、鼻血污浊,都归属于热。少阴君火之热,即是真心与小肠之气。
喘,是火气的表现。寒水属阴,主迟缓。热火属阳,主急数。寒则呼吸缓慢、气息微弱。热则呼吸急促、气息粗重,从而形成喘证。
呕,是胃气热盛所致,这是火气炎上的征象。寒邪也能导致呕吐,不可一概而论。
吐酸,酸味是肝木的味道。由于火盛克制肺金,不能平抑肝木,则肝木自盛,所以表现为酸。因此肝热则口酸。心热则口苦,脾热则口甘,肺热则口辛,肾热则口咸,或者口淡无味,那是胃热的表现。
暴注,即突然腹泻。肠胃热盛,传化功能失常,火性疾速,所以如此。
下迫,即肛门重坠急痛。这是火性燥烈的缘故。
转筋,即筋脉反折扭曲。热气燥灼筋脉,导致挛急抽搐而疼痛。说这是寒邪是错误的,寒虽然主收引,但只是导致四肢厥冷、关节固着、屈伸不便,怎么会是转筋呢?
小便浑浊,寒则清澈,热则浑浊。
腹胀如鼓,气属阳,阳即为热,气盛则如此。
痈,浅表且范围大。经说:热胜血则化为痈脓。
疽,深在且性质恶劣。疡,有头的细小疮口。疹,浮起的小红疹。
瘤气,赤瘤丹熛,是热胜气,火的色泽。
结核,火气热盛,则郁结坚硬。像果核一样。不必溃破发散,只要让热气消散,自然就会消除。
吐下霍乱,三焦是水谷传化的道路,热气极盛,则传化失常,导致吐泻霍乱,这是火性燥动的缘故。
大凡吐泻且颇感口渴的是热证,不渴的是寒证。或者是热性吐泻,初起时也可能不渴,如果不止,耗伤津液后必然口渴。寒本不渴,如果津液亡失过多,也会因干燥而口渴。但是寒证,脉象应当沉细而迟;热证,脉象应当实大而数。
瞀,即昏昧。热气极盛,则浊乱昏昧。
郁,即怫郁。结滞壅塞,气机不通畅,所谓热盛则腠理闭密而郁结。然而寒水主闭藏,现在反而归属于热,这是火热亢极,反而兼有水化来制约的缘故。
肿胀,热胜于内,则气郁而为肿。阳气热盛,则腹胀。火主彰显、升明、舒荣,都是肿胀的征象。
鼻塞,窒塞不通畅。火主肿胀,所以热邪客于阳明经,鼻中肿胀窒塞。
鼽,即鼻流清涕。五行的道理,轻微时表现为本脏的化象,严重时则兼夹所不胜(鬼贼)的化象。经说:亢盛则为害,承制方能平衡。以火炼金,热极反而表现出水的样态。所以肝热甚则流泪,心热甚则出汗,脾热甚则流涎,肺热甚则流涕,肾热甚则吐唾。
衄,即鼻出血。阳极拂郁于足阳明经,火气上蒸于肺,则血液妄行,导致鼻衄。
血溢,指血液从上而出。血泄,指热邪客于下焦,大小便出血。
淋,指小便涩痛。热邪客于膀胱,郁结不能渗泄所致。又有遗尿不禁的情况,经说:肾主二阴,水衰而怫郁客于该部位,二阴郁结,则痿痹而神无所用,所以小便遗失而不能禁止,这显然是热症。仲景论述少阴病热极时说:小便失禁、胡言乱语、眼睛上翻直视不转动,是肾气先绝的表现。
闭,指大便涩滞。称之为风热结者,是因为火甚克制肺金,不能平抑肝木,则肝木自旺的缘故。
身热恶寒,是热在体表。寒则腠理闭密,阳气拂郁而如此。
战,即动摇。栗,即寒冷。这都是火的征象。这是由于火热亢极而战栗,反而兼有水化来制约,所以出现战栗。
惊,即心脏突然跳动而不安宁。火主于动,心火热盛,所以惊。
惑,即迷惑混乱。火实则水衰,意志丧失而迷惑混乱。
志,是肾水的神识。
悲,是肺金所主。笑,是心火所主。悲笑且五液俱出,是火热亢极,反而兼有水化来制约的缘故。
谵,即多言。言语为心声,心热则多言。
妄,即虚妄。火为阳,故外清明而内浊昧。心热甚,则肾衰,意志不精一,见闻虚妄,自己问答,神智失常。
衄蔑血污,心火热极,则血有余,热气上盛,则血液溢出污浊,呈现紫黑的象。
All tremors and dizziness (dizziness, vertigo) belong to Liver Wood.
"Tremor" refers to shaking. "Dizziness" refers to confusion and spinning sensation. This is because Wind has the nature of movement. For Wood stagnation, one should use the "Da" method; "Da" refers to emesis.
All itching and sores/ulcers belong to Heart Fire.
Slight heat causes itching, severe heat causes pain. For Fire stagnation, one should use the "Fa" method; "Fa" refers to dispersing and venting.
All edema and fullness belong to Spleen Earth.
Indigestion generates Dampness, and Dampness generates Heat. For Earth stagnation, one should use the "Duo" method; "Duo" refers to purgation to remove obstruction and stagnation.
All blockage, stagnation diseases, and flaccidity syndromes belong to Lung Metal.
"Pi" refers to fullness/blockage. "Yu" refers to rushing pressure. "Wei" refers to weakness in the limbs and inability to move. For Metal stagnation, one should use the "Chai" method; "Chai" refers to releasing the exterior and promoting urination.
All retraction and drawing-in belong to Kidney Water.
"Shou" refers to contraction/gathering. "Yin" refers to tension/spasm. These are functions of Cold. For Water stagnation, one should use the "Xie" method; "Xie" refers to controlling rebellious upward flow.
All sudden stiffness and rigidity, supporting pain, twisting deformities, internal urgency with tendon shortening, belong to Wind. Jueyin Wind-Wood corresponds to the Qi of the Liver and Gallbladder.
"Sudden" means abrupt. "Stiffness and rigidity" means tendons are hard and not flexible. "Supporting pain" means firm support, with tendons spasming, inflexible, and painful. "Li" refers to tendon shortening. Internal urgency and tendon shortening refer to pathological deviation from normal function. However, Dryness-Metal governs tightening and gathering, causing shortening and hardness of tendons. When Wind-Wood pathology manifests, it may show the transformation of Dryness-Metal due to the principle that excess leads to harm, and control restores balance. Moreover, Wind can overcome Dampness and transform into Dryness. Severe Wind disease leading to tendon shortening indicates severe Dryness. Therefore, severe cases often involve concurrent Dryness.
All wheezing, vomiting, acid regurgitation, sudden diarrhea with tenesmus, muscle cramps, turbid urine, abdominal distension like a drum, carbuncles, ulcers, rashes, tumor-Qi, tubercles, vomiting and diarrhea with cholera-like symptoms, mental cloudiness and depression with swelling, nasal congestion, rhinorrhea, epistaxis, blood extravasation or hemorrhage, strangury with retention and fever, aversion to cold with shivering, fright, confusion, sadness, laughter, delirium with inappropriate responses, bloody nasal discharge, all belong to Heat. The Heat of Shaoyin Sovereign Fire corresponds to the Qi of the True Heart and Small Intestine.
Wheezing is a manifestation of Fire Qi. Cold-Water is Yin, governing slowness. Hot-Fire is Yang, governing urgency and rapidity. Cold results in slow breathing and weak Qi. Heat results in rapid breathing and coarse Qi, leading to wheezing.
Vomiting occurs when Stomach Qi is excessively hot, representing the image of Fire rising. Cold can also cause vomiting, so one cannot generalize rigidly.
Acid regurgitation: Sourness is the taste of Liver Wood. When Fire is excessive and controls Metal, failing to restrain Wood, Liver Wood becomes hyperactive, resulting in sourness. Thus, Liver Heat causes sour taste. Heart Heat causes bitter taste, Spleen Heat causes sweet taste, Lung Heat causes pungent taste, Kidney Heat causes salty taste. A bland taste may indicate Stomach Heat.
Sudden diarrhea (Baozhu) is acute evacuation. Excessive heat in the intestines and stomach disrupts transmission and transformation; Fire's nature is swift, hence this presentation.
Tenesmus (Xiapo) is heavy, urgent pain in the rectum. This is due to the drying nature of Fire.
Muscle cramps (Zhuanjin) are twisting deformities. Heat dries and scorches the tendons, causing spasms and pain. Attributing this to Cold is incorrect; although Cold governs retraction, it only causes cold limbs, joint fixation, and difficulty flexing/extending, not muscle cramps.
Turbid urine: Cold yields clear urine, Heat yields turbid urine.
Abdominal distension like a drum: Qi belongs to Yang, and Yang is Heat. Excessive Qi leads to this condition.
Carbuncle (Yong): Superficial and large. The Classics state: Heat overcoming Blood transforms into pus and carbuncles.
Abscess (Ju): Deep and malignant. Ulcer (Yang): Small sore with a head. Rash (Zhen): Floating, small maculopapular rash.
Tumor-Qi (Liuqi): Red tumor/Danbing is Heat overcoming Qi, representing the color of Fire.
Tubercles (Jiehe): Excessive Fire Qi causes stagnation and induration, resembling a fruit pit. It need not be ulcerated or vented; if the Heat dissipates, it will resolve spontaneously.
Vomiting, diarrhea, and Cholera (Huoluan): The Sanjiao is the pathway for food and fluid transmission. Excessive Heat disrupts this process, causing vomiting, diarrhea, and Cholera, due to Fire's drying and agitated nature.
Generally, vomiting/diarrhea with significant thirst indicates Heat; without thirst indicates Cold. In initial Heat-type vomiting/diarrhea, there may be no thirst, but if it persists, loss of body fluids will eventually cause thirst. Cold typically does not cause thirst, but excessive loss of fluids can lead to dryness and thirst. However, Cold patterns present with deep, fine, and slow pulses; Heat patterns present with full, large, and rapid pulses.
"Mao" (Mental cloudiness) refers to dimness. Excessive Heat causes turbidity and confusion.
"Yu" (Depression/Stagnation) refers to frustration. Obstruction and blockage prevent smooth Qi flow. This is described as Heat causing closure of pores and stagnation. Although Cold-Water governs storage, its attribution to Heat here is due to extreme Fire overacting and mimicking Water transformations to control itself.
Swelling: Internal Heat dominance causes Qi stagnation and swelling. Excessive Yang-Heat causes abdominal distension. Fire manifests brightness, ascent, clarity, and flourishing, all images of swelling.
Nasal congestion: Blockage and lack of smooth flow. Fire governs swelling; thus, Heat invading the Yangming meridian causes nasal swelling and blockage.
Rhinorrhea (Qiu): Flow of clear nasal mucus. According to Five Elements theory, mild conditions reflect their own transformation, while severe conditions mimic their conquering element (Ghost-Treasure). The Classics state: Excess leads to harm, control restores balance. Fire melting Metal under extreme heat resembles Water. Thus, excessive Liver Heat causes tears, Heart Heat causes sweat, Spleen Heat causes saliva, Lung Heat causes nasal mucus, and Kidney Heat causes phlegm/saliva.
Epistaxis (Nu): Extreme Yang stagnation in the Foot-Yangming meridian, with Fire Qi steaming upward to the Lungs, causing reckless blood movement and nosebleeds.
Blood extravasation (Xueyi): Blood flowing out from above. Blood hemorrhage (Xuexie): Heat invading the Lower Jiao causing blood in stool or urine.
Strangury (Lin): Painful and difficult urination. Heat invading the Bladder causes stagnation and failure to excrete. Incontinence can also occur; the Classics state: The Kidneys govern the two yin openings. If Water deficiency allows Heat to invade these areas, stagnation leads to flaccidity and numbness, rendering the Shen ineffective, causing urinary incontinence. This clearly indicates a Heat syndrome. Zhang Zhongjing discusses extreme Heat in Shaoyin disease: incontinence, delirium, and eyes fixed upward without movement indicate the exhaustion of Kidney Qi.
Retention (Bi): Difficult and sluggish defecation. Called Wind-Heat accumulation because excessive Fire controls Metal, failing to restrain Wood, leading to Liver Wood hyperactivity.
Fever with aversion to cold indicates Heat at the Exterior. Cold causes pore closure, trapping Yang-Heat.
Shivering (Zhan): Trembling. Chills (Li): Cold sensation. Both are manifestations of Fire. Shivering occurs due to extreme Fire overacting and mimicking Water transformations.
Fright (Jing): Sudden agitation of the Heart without peace. Fire governs movement; excessive Heart-Fire causes fright.
Confusion (Huo): Mental chaos. Excess Fire depletes Water, causing loss of Will (Zhi) and confusion.
Will (Zhi): The spirit of Kidney Water.
Sadness (Bei): Governed by Lung Metal. Laughter (Xiao): Governed by Heart Fire. Sadness and laughter with the discharge of all five fluids result from extreme Fire overacting and mimicking Water transformations.
Delirious speech (Chan): Excessive talking. Speech is the voice of the Heart; Heart Heat causes excessive talking.
Delusion (Wang): Falsehood. Fire is Yang, appearing clear externally but turbid internally. Excessive Heart Heat exhausts the Kidney, causing fragmented Will, false perceptions, self-dialogue, and loss of mental clarity.
Bloody nasal discharge (Nu mie xue wu): Extreme Heart-Fire leads to surplus Blood. Rising Heat causes blood to overflow turbidly, presenting as purple-black discoloration.