医宗金鉴十五卷
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Chapter 15
辨不可汗病脉证篇
Conditions against the use of sweat therapy
01
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,阳微发汗,躁不得眠。
Ru pulse: the pulse is floating and weak.
Rou pulse: the pulse is deep and weak. Wei pulse: the pulse is
weak when pressed slight and hard. Se pulse: the pulse feels
harsh, not smoothly. If the pulse is Ru and Rou. The Rou pulse
feels at the Guan position, and Ru pulse feels when pressed
slightly. Wei pulse feels when pressed slightly, and the Se
pulse feels when pressed deep. It is so said the Guan pulse is
Ru when pressed slight and Rou when pressed deep. With Yang
deficiency, the pulse is Wei at the Chun position. With blood
deficiency, the pulse is Se in the Chi position. If the person
has Wei pulse in the Chun position and Se in the Chi position,
it suggests his Yang and Blood deficiency condition. This is a
condition against the use of sweat therapy. Otherwise the sweat
therapy will cause the depletion of both Yang and Yin, the
person will feel annoyed so that not be able to fall into sleep,
and will have Jue condition (reverse cold in hands and feet).
02
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,不可发汗,发汗则寒栗,不能自还。
If the pulse at the Guan position is Ru
when pressed slightly, and Rou when pressed deep, it is string
at the Chun position, Wei at the Chi position. The string pulse
is the Yangqi movement, and the Wei pulse suggests Cold. For
such upper Shi but lower weak conditions, sweat therapy is
forbidden. Otherwise the person will feel cold and shaking in
the body.
03
诸脉得数动微弱者,不可发汗,发汗则大便难,腹中乾,胃燥而烦,其形相像,根本异源。
If the pulse is frequent and weak, sweat
therapy should not be used. This is a false Shi condition in the
body surface layer, but true weak inside condition. Sweat
therapy will deplete the Jingye (the Yin) , causing dry in
abdomen, hard stool, annoyed. Such condition similar to the
Yangming Hot condition, but it is actually due to Yangming
Dryness condition due to improper sweat.
04
厥,脉紧,不可发汗,发汗则声乱咽嘶,舌萎声不得前。
If the person has reverse cold in the hands
and feet (the Jue condition), and if his pulse is tight[1], sweat
therapy should not be used. Other wise, the sweat therapy will
cause harsh voice or even lose voice.
05
动气在右,不可发汗,发汗则衄而渴,心苦烦,饮即吐水。动气在左,不可发汗,发汗则头眩,汗不止,筋惕内俽。动气在上,不可发汗,发汗则气上冲,正在心端。动气在下,不可发汗,发汗则无汗,心中大烦,骨节苦痛,目晕恶寒,食则反吐,谷不得前。
If there is jumping movement in the right
side of abdomen, the sweat therapy should not be used. This is a
location of Heart and Lung Qi, representing in the abdomen. Such
jumping beat suggests the weakness of Lung Qi and Heart Qi.
Sweat therapy could disturb the blood to hot, to bleeding to
cause nose bleeding, thirsty and annoyed. The Lung Qi is
disturbed, there will have vomiting water after drink.
If the jumping beat feeling is in the left
side of the abdomen, it suggests the disorder of the Liver Qi.
Sweat therapy causes the shrink of the Liver Qi so the person
feels dizzy. If the sweat therapy continues to deplete the
Jingye in the muscle and tendons, there will have muscle jumping
and tingling feelings.
If the jumping beat feels in the upper
abdomen, the heart Qi is in disorder (weakness). Sweat therapy
could cause weak of the Heart Qi, so the Kidney Qi pushes up to
push the front chest of the heart.
If the jumping beat feels in the lower
abdomen, it is the weakness of the Kidney Qi. Sweat therapy
depletes the Kidney liquid (Kidney Yinye), so the person feels
pain in the bones, chilly and no sweat, annoyed, eye dizziness.
If the Spleen Qi is in an over dryness condition, the person
vomit after eat, and the stomach is hard to hold any food.
All in all, jumping beat feeling in the
abdomen indicates a weakness condition in the body, so that
sweat therapy should not be used.
06
咽中闭寒,不可发汗,发汗则吐血,气微绝,手足厥冷,欲得
卧,不能自温。
If person feels close feeling in the
throat, feels hard to swallow, sweat therapy should not be used.
The Shaoyin meridian goes up to the throat. Close in the throat
means the Shaoyin Qi cannot go through the throat. In the strong
sweat therapy, the weak Yangqi in the Shaoyin cannot match the
need of the sweat, so the blood is disturbed to cause bleeding
through vomit, weak in breath, Jue condition, willing to lie
down, and hard to return to warm by the person himself.
07
咳者则剧,数吐涎沫,咽中必乾,小便不利,心中饥烦,
卒时而发,其形似疟,有寒无热,虚而寒栗,咳而发汗,
倦而苦满,腹中复坚。
If the person has frequent cough, it is so
severe that he may spit saliva. After while he will feel dry in
throat, hard in urine, hungry and annoyed.
Such condition happens again and again during the day,
similar to a malaria onset. The person has cold but no hot. The
weakness condition makes him chilly. In such condition, sweat
therapy will cause him wiling to lie down, feel fullness and
hardness in abdomen (due to overwhelming of Yin Qi in the
abdomen).
08
咳而小便利,若失小便者,不可发汗,汗出则四肢厥而逆。
Cough is usually associated with
accumulation of water/liquid in the body and the urine should be
difficult. If the cough with smooth urine, it suggests there is
no such water retention condition in the body. Now, cough with
leak of urine suggests the lower abdomen Yang deficiency, the
bladder cannot hold the urine. In such lower Yangqi weakness
condition, sweat therapy should not be used. Otherwise it will
cause more depletion of the Yangqi, resulting in a Jue
condition.
09
诸逆发汗,病微者难差。剧者言乱,目眩者死,命将难全。
If the sweat therapy should not be used,
but it is used; or if the sweat too much during a sweat therapy,
it means both are wrong treatments that make later treatment
difficult.
10
伤寒头痛,翕翕发热,形象中风,常微汗出,自呕者,下之益烦,心懊倄如饥。发汗则致痉,身强难以屈伸;
之则发黄,不得小便,灸则发咳唾。
In Shanghan disease, if the person has
headache, feels mild and continuous hot, mild sweat, and nausea,
similar to Wind-invasion Taiyang condition, bowel-cleansing
therapy causes more annoyed/impatience feeling so that he may
feel as hungry; sweat therapy will cause Jing disease with the
body tight and hard to bends and stretch; fire-roasting therapy
causes jaundice and hard in urine; and moxibustion therapy
causes cough.
[1] Jue condition and the tight pulse
suggests Shaoyin condition. It is not a candidate for
sweat therapy. Any Jue condition, no matter it is Hot
Jue condition, or Cold Jue condition, all indicating Yin
conditions.
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