子秦二又病，太阳证悉具，其脉浮数，初为阳证，经所受邪也。神术汤解之，未三日变为阴
证。何以然？旺火投盛水也。以其素服三生茶及好食诸冷物，数年来脏腑积而为痼疾，一身
之经皆凝寒浸渍酝酿而成太阴，脉亦从此，而变其状，非浮非沉，上下内外举按极有力，坚
而不柔。非若阳脉来之有源，尺以下至宛中全无，惟三部中独见鼓击，按之触指，突出肤表
，异常紧为甚，所禀元阳无，一身游行之火独萃于胸中，寒气逼之，故搏而大，有加数倍，
往来不可以至数名，纵横不可以巨细状。五日后，文之与姜附等剂而复振摇，又与真武、四
逆等汤，烦躁大渴不止。若更接姜附，其汗必作，其人自疑为热而益饮水，及得水稍苏，斯须
脉陷沉而紧，厥逆神 。至六日晡前后大便秘结，小便赤色而少，强溲得涓滴，时手冷至肘
，足冷至膝，脉将绝而不可救。欲复与四逆等汤，恐烦躁思饮而生变。文之请曰∶何法以治
？余教以乌、附、姜、桂、良姜等佐以芍药，茴香之类，酒糊丸，引而下之，而使不僭。急
服之百丸，昼夜相接，八九阳气从下复生，胸膈不烦躁，不思水，与温剂则微咽，大便软，
屡下气，阴得以出，小便通快成剂如灰汁，脉微生。服丸至千半阳气遍体，作汗而愈。后神
又不全，少气乏力，又与温中等药数服，然后良愈。非平昔饮冷肠胃积寒之久者，脉不如此
之鼓击也。鼓击者何？虽可谓大非大也，忿怒也，宜详审辨认，世罕有之。大抵此脉属紧，
比紧为尤甚，故名鼓击也。仲景云∶诸紧为寒。又云∶脉浮而紧寒在表也，脉沉而紧寒在里
也。紧似弦而非，有如牵绳之状，即为紧也，非带洪而有源也。成无己云∶累累如循长竿，
连连而强直也。通真子歌云∶紧若牵绳转索初。海藏云∶牵绳之紧，循竿之直，二者皆近于
鼓击，鼓击者尤甚于二脉数倍。启玄子云∶盛脉同阳四倍以上，阴之极也。
秦二的儿子又生病了，太阳病（太阳经受邪所致的病证）的症状全部具备，脉象浮而数，起初被认为是阳证，是经络受到邪气侵袭所致。使用神术汤（由苍术、防风、甘草等组成的方剂，具有解表祛湿功效）进行解表治疗，但不到三天就转变为阴证（以虚寒为主要表现的病证）。为什么会这样呢？这就像旺盛的火焰投入大量的冷水中一样（比喻体内阳气被寒凉药物或饮食压制）。因为他平时长期服用三生茶以及喜好食用各种生冷食物，多年来脏腑积聚寒气而形成顽固性疾病，全身的经脉都因凝寒浸渍酝酿而转化为太阴病（太阴脾经虚寒证），脉象也随之改变，形态既不像浮脉也不像沉脉，无论在上、下、内、外部位，举按都非常有力，坚硬而不柔和。不像阳脉那样来势有根源，尺部以下直至宛中穴处完全空虚，只有寸、关、尺三部中间唯独出现鼓击脉（一种脉来搏指、坚劲如鼓皮的特殊脉象），按压时触手突出肤表，异常紧束尤为明显。这是因为禀赋的元阳不足，一身游走运行的火气独聚于胸中，寒气逼迫它，所以搏动盛大，增加了好几倍，往来不能以“至数”（脉搏跳动的次数）来命名，纵横也不能用“巨细”来形容。五天后，文之给予附子、干姜等热性药剂后，患者身体再次摇动不安，又给予真武汤（温阳利水方剂）、四逆汤（回阳救逆方剂）等汤药，导致烦躁和大渴不止。如果继续接续使用附子、干姜，汗出必然发生，病人自己怀疑是热证而更加饮水，等到喝点水稍微舒服一点，片刻之后脉象陷入沉而紧，出现四肢厥逆（手脚冰冷）和神志昏蒙。到了第六日傍晚前后，大便秘结，小便赤色且量少，强行排尿只能得到几滴，有时手冷至肘部，脚冷至膝盖，脉象将绝而无法救治。想要再次给予四逆汤等药剂，又担心烦躁思饮而产生变故。文之请示说：“用什么方法治疗？”我教导他使用乌头、附子、干姜、肉桂、高良姜等药材，佐以芍药、小茴香之类，制成酒糊丸，引导药力下行，使其不致上僭（药性过于猛烈上行）。紧急服用一百丸，昼夜相继，经过八九天，阳气从下部重新生发，胸膈不再烦躁，不想喝水，给予温热药剂则能微微吞咽，大便变软，多次排气，阴寒得以排出，小便通利顺畅，尿液颜色如灰汁般澄清，脉象微微恢复。服用丸药至一千五百粒时，阳气遍布全身，出汗而痊愈。后来神气仍不完全恢复，少气乏力，又给予温中健脾的药物服用数次，然后才良好痊愈。如果不是平日饮用冷水、肠胃积寒已久的情况，脉象不会如此呈现鼓击脉。什么是鼓击脉？虽然可以说它很大，但又不是真正的大脉，像是愤怒时的状态，应当详细审辨识别，世间很少见到。大体上此脉属于紧脉（脉来绷急，状如牵绳转索），比紧脉更为严重，所以称为鼓击脉。张仲景说：各种紧脉都是寒邪所致。又说：脉浮而紧，说明寒邪在表；脉沉而紧，说明寒邪在里。紧脉类似弦脉（端直以长，如按琴弦）但不是，好像牵着绳子的样子，这就是紧脉，不是带有洪脉（脉来宽大，滔滔满指）且有根源的脉象。成无己说：累累如同抚摸长竿，连连强直。通真子歌诀说：紧脉像牵着绳子转动绳索刚开始的样子。海藏（张元素）说：牵绳般的紧脉，抚摸长竿般的直脉，这两种都接近鼓击脉，鼓击脉比这两种脉厉害好几倍。启玄子（王冰）说：盛脉与阳脉相同，超过四倍以上，是阴寒的极致表现。
Qin Er’s son fell ill again. The symptoms of Taiyang disease (a syndrome caused by pathogenic factors invading the Taiyang channel) were fully present, with a floating and rapid pulse. Initially, it was considered a Yang syndrome, resulting from pathogens affecting the meridians. Shen Shu Tang (Cang Zhu, Fang Feng, Gan Cao Decoction, a formula for resolving the exterior and dispelling dampness) was administered to resolve the exterior condition. However, within three days, it transformed into a Yin syndrome (a syndrome characterized primarily by deficiency and cold). Why did this happen? It is akin to throwing a roaring fire into a large volume of cold water. This occurred because he had long consumed Sansheng Tea and preferred various cold foods. Over the years, cold accumulated in his Zang-Fu organs, forming chronic diseases. The meridians throughout his body underwent condensation and infiltration by cold, transforming into Taiyin disease (Taiyin Spleen deficiency-cold syndrome). Consequently, the pulse also changed: its shape was neither floating nor sunken. Whether palpated superficially or deeply, internally or externally, it felt extremely forceful upon lifting and pressing—hard and unyielding. Unlike Yang pulses which have a distinct origin, the area below the Chi position down to the Wanzhong point was completely empty. Only in the middle of the Cun, Guan, and Chi positions was there a solitary Drumming Pulse (Guji Mai, a special pulse that beats against the finger, firm and stiff like a drum skin). Upon pressing, it protruded against the fingertip, exceptionally tight, especially so. This was due to a lack of innate Yuan Yang (original Yang Qi), causing the wandering fire of the body to gather exclusively in the chest. Compelled by cold, it beat vigorously, increasing several times over. Its rhythm could not be defined by "Zhi Shu" (pulse beats per breath cycle), nor its magnitude described by "Ju Xi" (large or small). Five days later, after Wen Zhi administered hot-natured herbs such as Fuzi (Prepared Aconite Root) and Ganjiang (Dried Ginger), the patient’s body shook restlessly again. Subsequently, Zhen Wu Tang (True Warrior Decoction, a warming yang and promoting diuresis formula) and Si Ni Tang (Frigid Extremities Decoction, a rescuing yang and reversing collapse formula) were given, leading to incessant irritability and extreme thirst. If Jiang (Ginger) and Fu (Aconite) were continued, sweating would inevitably occur. Suspecting heat, the patient drank more water. After drinking, he felt slightly relieved, but shortly thereafter, the pulse sank and became tight, accompanied by Jue Ni (cold extremities) and Shen Ming (mental clouding). By the evening of the sixth day, he suffered from constipation and scanty, reddish urine; forced urination yielded only drops. Sometimes his hands were cold up to the elbows, and feet cold up to the knees. The pulse was nearly imperceptible, rendering him incurable. There was a desire to administer Si Ni Tang again, but fear arose regarding potential complications from irritability and thirst. Wen Zhi asked, "What method should be used for treatment?" I instructed him to use Wutou (Aconitum Lateralis Radix Preparata), Fuzi, Ganjiang, Rougui (Cinnamon Bark), and Liangjiang (Galangal Rhizome), assisted by Shaoyao (Peony Root) and Huixiang (Fennel Fruit). These were made into pills using wine paste to guide the medicinal action downward, preventing it from soaring upward excessively. He urgently took one hundred pills, day and night without interruption. After eight or nine days, Yang Qi regenerated from the lower body. Irritability in the chest and diaphragm ceased, the desire for water disappeared, and warm agents could be swallowed slightly. Stools softened, frequent flatulence occurred, allowing Yin-Cold to exit. Urination became smooth and clear, resembling ash-water. The pulse faintly reappeared. Upon taking 1,500 pills, Yang Qi pervaded the entire body, sweat ensued, and he recovered. Later, his Shen Qi (Spirit Qi) remained incomplete, with shortness of breath and fatigue. Several doses of Zhong Wen (warming the middle) herbs were administered, after which he improved significantly. Without a history of long-term cold beverage consumption and intestinal cold accumulation, the pulse would not exhibit such Drumming characteristics. What is the Drumming Pulse? Although it may seem large, it is not truly a Large Pulse; it resembles anger. It requires careful differentiation and is rare in clinical practice. Generally, this pulse belongs to the category of Jin Mai (Tight Pulse, tense like a pulled rope), but is more severe than a standard Tight Pulse, hence named Drumming. Zhang Zhongjing stated: All Tight Pulses indicate Cold. He also said: Floating and Tight indicates Cold in the Exterior; Sunken and Tight indicates Cold in the Interior. The Tight Pulse resembles Xian Mai (Wiry Pulse, straight and long like a guitar string) but is not identical; it feels like a pulled rope. It is not associated with Hong Mai (Surging Pulse, broad and full) nor does it have an origin. Cheng Wuji noted: It feels continuous like tracing a long bamboo pole, rigid and straight. Tongzhenzi’s verse states: Tightness is like pulling a rope and turning a cord initially. Haicang (Zhang Yuansu) remarked: The Tightness of a pulled rope and the Straightness of a traced pole are both close to the Drumming Pulse, yet the Drumming Pulse is several times more severe than these two pulses. Qixuanzi (Wang Bing) stated: The Sheng Pulse (Excessive Pulse) is similar to Yang, exceeding four times the normal rate, representing the extreme of Yin-Cold.