Huangdi Neijing. Lingshu. On the 44th rule of disease diagnosis.

1. The range of diagnostic scale and its diagnostic value are discussed. It shows that from the different changes of skin smoothness, size, cold and heat, and the principle of "knowing the inside from the outside", we can understand the deficiency and excess of the disease, the attributes of cold and heat, the exterior and interior, the upper and lower parts and so on.

second, observe the five colors in the eyes, and you can know what the disease is; The direction extending from the red pulse in the eye to understand what meridian the eye pain belongs to; From the number of red veins appearing on the pupil, the length of cold and heat death period can be predicted.

3. Briefly describe the diagnosis methods of dental caries, jaundice and pregnancy, and the value of blood vessel changes in diagnosis.

Fourth, according to the law of the fluctuation and transformation of Yin and Yang, it is explained that the four seasons have different climates, so different pathological changes can occur from evil to the next season.

Original

The Yellow Emperor asked Qi Bo: I want to ignore the color and pulse, and adjust my ruler alone to tell my illness, so I can know the inside from the outside. What can I do?

Qi Bo said: judging the urgency, the size, the smoothness and astringency, the firmness and crispness of the meat, but the shape of the disease will be determined.

If a person's eyes are slightly carbuncle, such as when he is lying up, his neck is pulsating, and he coughs sometimes. If he presses his hands and feet, his skin will swell with feng shui.

if your feet are slippery, it will be windy. Those who are weak in feet and meat will be relieved, and those who lie down and take off their meat will be cold and hot and will not be cured. Those whose feet and skin are slippery and greasy are also windy. Those with astringent feet and skin are also arthralgia due to wind. Those whose feet and skin are as thick as the scales of a dead fish will drink water. If the skin is very hot, the pulse is full and impetuous, the disease is warm, and if the pulse is full and slippery, the disease will also come out. If the skin is cold, the pulse is small, and there is less gas. Foot skin torch ran (1), first hot and then cold, cold and hot; If the skin is cold first, it will be cold and hot for a long time.

if the elbow is only hot, it is hot above the waist; The hand alone is hot, and it is hot below the waist. Those who are only hot in front of the elbow are hot in front of the elbow; Those who are alone behind the elbow are hot in the shoulder and back. Those who are alone in the arms are hot in the waist and abdomen; Those who are three or four inches below the elbow are hot, and there are worms in the intestine. Heat in the palm, heat in the abdomen; Cold in the palm, cold in the abdomen. Fish with white meat and green veins have cold in their stomachs.

when the torch is hot, people will take the blood if they meet the big ones. The ruler is strong, the pulse is very small, the qi is low, and the embarrassment is increased, and it is dead.

people with red eyes are sick in the heart, white in the lungs, green in the liver, yellow in the spleen and black in the kidney. Those who can't name yellow are sick in their chests.

If the eyes are painful and the pulse is red from top to bottom, it will cause taiyang disease; From the bottom up, Yangming disease; Those who go from the outside to the inside are suffering from shaoyang disease.

when cold and heat were diagnosed, the red pulse went up and down to the pupil, and one pulse was seen, and he died at the age of one. See a pulse and a half, one year old and half dead; See the second pulse and die at the age of two; See the second pulse and a half, two years old and half dead; See three veins and die at the age of three.

According to the origin of yang, the patients who have had dental caries have fever alone, which is in Zuo Zuo, right and right, upper and lower.

For those who diagnose blood vessels, excessive redness and excessive heat, excessive green and excessive pain, excessive black is chronic arthralgia, and excessive redness, darkness and excessive green are common, with cold and heat.

The body aches with yellowish color, yellow teeth, yellow fingernails and jaundice. Lying down to urinate in Huang Chi, those with small and astringent pulse are not addicted to food.

when people are sick, their pulse is small and big, and they are ups and downs. A woman's hand is deficient in yin and her pulse is very severe. If the baby is sick, the person whose head hair goes up will die. It hurts when the green pulse between the ears starts. Red stool and loose bowels (3), small pulse, cold hands and feet, difficult to have; Diarrhea, small pulse, warm hands and feet, and easy discharge.

The four seasons change, and the cold and summer heat prevail, and the heavy yin must be yang, and the double ninth festival must be yin; Therefore, yin dominates cold and yang dominates heat, so cold is hot and hot is cold, so it is said that cold produces heat and heat produces cold, which is also the change of yin and yang.

therefore, it is said that winter hurts from cold, and spring produces furuncle fever; Spring is hurt by wind, summer by diarrhea, summer by heat, autumn by tuberculosis; Autumn hurts from dampness, and winter coughs. It means the order of four seasons.

note

① burning: high fever means burning hands.

② pulse: here refers to red pulse.

③ red petal diarrhea: red, talk about "green". Refers to the stool, such as petal-shaped, blue in color, which is the performance of indigestion.

Translation

The Yellow Emperor asked Qi Bo: I think we can tell the disease only by examining the ruler's skin without looking at the color and feeling the pulse, and infer the internal changes from the external manifestations. What is the method of diagnosing the ruler's skin?

Qi Bo said: We can determine what kind of disease it belongs to by examining the emergency or relaxation, high rise or thinness, smoothness or stagnation of the ulnar skin, and the firmness or fragility of the muscles.

I saw a slight edema in the sunken part under the patient's orbit, as if he had just woken up. People in the neck responded to the pulse and coughed from time to time. If you press the patient's hands and feet with your hands, the pressed part can't afford to sink deeply. This is a symptom of feng shui and skin swelling.

It is wind disease that the skin of feet is smooth but not astringent. Soft and weak ulnar muscles are the "relieving carbuncle" disease of drowsiness and slack limbs, like sleeping, and thin muscles are the frequent occurrence of cold and heat, which is not easy to cure; If the skin of the ruler is smooth as ointment, it is wind disease; The skin of feet is stagnant and not slippery, which is wind arthralgia due to deficiency of blood; The skin of the ruler is rough and not moist like dried fish scales, which is the "phlegm-drinking" disease of spleen and soil deficiency and indigestion; The skin of the ruler is burning, and the pulse is grand and restless, which is a febrile disease. If the pulse is grand but not restless, it will be slippery, and the pathogenic factors will be driven out and the righteousness will gradually recover, which is the image that the disease will be cured; The skin of feet is cold and the pulse is small, which is a disease of diarrhea and qi deficiency; The skin of the ruler is hot and burns the hands, and it is a kind of disease with cold and heat exchanges. The skin of the ruler feels cold first, but it feels hot after being pressed for a long time, which is also a kind of disease of cold and heat.

If the skin on the elbow is hot alone, wait for the fever above the waist; If the skin of the wrist is heated alone, it will be heated below the waist; If the front of the elbow is heated alone, the back of the shoulder will be heated; If the back of the elbow is alone, it will cause fever in the shoulder and back; If the middle part of the arm has fever alone, it will cause fever in the waist and abdomen; There are worms in the intestine when the area below the trailing edge of the elbow is three or four inches hot; If the palm is hot, wait for fever in the abdomen; If the palm of your hand is cold, it will be cold in your stomach; Hand thenar white meat has blue blood, but it is cold in the stomach.

The skin of feet is scorched with high heat, and the neck is full of pulse, so it belongs to excessive heat, and it is the main cause of blood loss; If the feet and skin are strong, but the pulse is very small, it will be seen in qi deficiency. If you add boredom, you will die immediately.

If you can see the red disease in the heart, the white disease in the lung, the cyan disease in the liver, the yellow disease in the spleen, the black disease in the kidney, and the yellow disease with other colors but can't be distinguished, the main disease is in the chest.

Eye pain with red collaterals from top to bottom belongs to the disease of Sun Meridian; From the bottom up, it belongs to the disease of Yangming meridian; Walking from the outside to the inside belongs to the disease of shaoyang meridian.

If there is a red pulse in the eye that penetrates the pupil from top to bottom during the diagnosis of diseases with cold and fever, the patient who sees a red pulse will die for one year; See a half-red pulse, half dead a year; He who sees two red veins dies in two years; See two and a half red veins, two years to death; He who sees three red veins dies in three years.

When examining the pain of dental caries, press the pulse of Yangming, and the diseased part will be heated separately, with the disease on the left side, on the right side, on the upper side and on the lower side.

when examining the collaterals, if the skin is red, the collaterals are mostly heat-related; if the skin is blue, it is pain; if the skin is black, it is chronic arthralgia; if the skin is red, black and blue at the same time, it is cold-heat disease and physical pain.

yellow complexion, yellow teeth and yellow nails are jaundice. If you are addicted to lying, urinating in Huang Chi, and your pulse is small and astringent, you are not addicted to food.

The patient's pulse at the mouth of the hand and radius is small and large, and the pulse at the neck is equal in ups and downs, which is a refractory disease. It is a sign of pregnancy that a woman's hands are deficient and her heart is pulsating. When a baby is sick, his hair will stand up and he will die. If the ear collaterals are blue and bulging, the main convulsion is abdominal pain. The stool is bluish green with breast valves, and the disease is difficult to treat because of the weak pulse and cold hands and feet. If the diarrhea pulse is large and the hands and feet are warm, it is easy to treat.

The climate changes all the year round, with cold and summer coming back and forth, and its law is that when the yin is extremely abundant, it turns into yang. Yang turns into yin when it reaches its peak. Yin dominates cold, while Yang dominates heat.

so when it is cold to a certain extent, it will become hot, and when it is hot to a certain extent, it will become cold. Therefore, cold can produce heat, and heat can produce cold. This is the reason for the change of yin and yang. Therefore, if you feel the cold evil in winter, you will not get sick immediately, but warm disease will happen in spring; In spring, wind evil is not the onset, and in summer, diarrhea and dysentery occur; Feeling summer evil in summer is not the onset, and malaria is prone to occur in autumn; In autumn, when you feel damp evil, you will get sick, and in winter, you will get cough. This is due to the different climates of the four seasons, and various diseases occur in the order of spring, summer, autumn and winter.

pedant

febrile diseases are cold and hot. From the degree of cold and hot skin and the degree of changes in eyes, we can understand the specific position of the disease in the body through the differentiation of Yin and Yang. This article has made a detailed description in this respect.