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Jingui Yaolue · Essentials from the Golden Cabinet
1. Viscera, Bowels, Channels and Networks · Illness Sequence, Pulses and Signs
Read in English. Switch to Original for word notes, or select text to ask a question.
Thirteen discussions; two passages on pulses and signs.
Edition note: This English renders the supplied classical medical text. Illness names, explanations, prognoses and treatments belong to its historical system. Medicinal names are transliterated where identification is not supplied, and traditional quantities remain unconverted. The recipes are historical records, not modern prescribing instructions.
Question: What does it mean that the superior practitioner treats illness before it occurs?
The Master replies: In treating what has not yet occurred, seeing Liver illness, one knows it will transmit to Spleen and first strengthens Spleen. If Spleen is flourishing in the four seasonal transitions and will not receive the pathogen, do not supplement it. The middling practitioner does not understand transmission: seeing Liver illness, they treat only Liver without strengthening Spleen.
For Liver illness, supplement with sour, assist with scorched-bitter, and benefit it with sweet medicinals to regulate it. Sour enters Liver, scorched-bitter Heart, sweet Spleen. Spleen can injure Kidney. Weakened Kidney qi leaves Water inactive; inactive Water makes Heart Fire flourish. Flourishing Heart Fire injures Lung; injured Lung leaves Metal qi inactive; inactive Metal qi makes Liver qi flourish. Thus strengthening Spleen lets Liver recover of itself. This is the subtle essential of treating Liver by supplementing Spleen. Use it for deficient Liver, not repletion. The classic says, 'Deficiency with deficiency, repletion with repletion; supplement insufficiency and diminish surplus.' This is its meaning. The other viscera follow the same pattern.
People receive the Five Constants and grow through wind qi. Though wind qi generates all things, it can also harm them, as water floats a boat but can overturn it. When the five viscera's original true qi communicates freely, a person is peaceful and harmonious. Visiting qi and pathogenic wind strike people and often kill.
A thousand illnesses do not exceed three paths: first, channels and networks receive a pathogen that enters viscera and bowels, an internal cause; second, the four limbs and nine openings, with transmission through blood vessels, become obstructed, a strike at the external skin; third, harm from sexual activity, metal blades, insects or beasts. Examined in this way, the causes of illness are exhausted.
If a person carefully nourishes life and does not let pathogenic wind invade the channels, or treats it just after it enters them before spreading to viscera and bowels, illness can be restrained. As soon as limbs feel heavy and obstructed, use guiding-and-stretching, breathing exercises, needling, moxibustion or ointment massage; do not let the nine openings close. Further avoid offenses against the king's law, injury by animals, and exhaustion through sexual activity. Moderate the cold, hot, bitter, sour, acrid and sweet in food and medicines, leaving no bodily decline; illness then has no way to enter the couli. Cou is where the Triple Burner communicates with original true qi and blood and qi pour in. Li means the patterned texture of skin, viscera and bowels.
Question: Qi and color appear on an ill person's face; please explain.
The Master replies: Blue-green Nose Tip means abdominal pain; one suffering cold dies. A variant says cold in the abdomen with suffering pain means death. A slightly black Tip means Water qi; yellow means cold above the chest; white lost blood. Slight scarlet appearing out of season means death. Perfectly round eyes mean spasm disorder, not treatable. Further, blue-green means pain, black depletion, scarlet wind, yellow difficult stool, and bright color retained fluids.
The Master says: A quiet speaking voice with a tendency to cry out in fright means illness between bones and joints. A muffled voice that does not carry clearly means illness between Heart and diaphragm. Fine, long, chirping speech means illness in the head; a variant reads pain.
The Master says: Breathing that shakes the shoulders means hardness in the Heart region. Breathing that draws upward qi through the chest means cough. Open-mouthed breathing with short qi means Lung wilting with spitting of foam.
The Master says: Slightly rapid inhalation means illness in the Middle Burner, repletion; purging should bring recovery. A deficient case is not treatable. In Upper Burner illness inhalation is hurried; in Lower Burner illness it reaches far. All are difficult to treat. Breathing with shaking and trembling is not treatable.
The Master says: Movement of the cunkou pulse occurs in its season of flourishing. For example, flourishing Liver has blue-green color; each season follows its own color. If Liver's color should be blue-green but is white instead, a color and pulse out of their season both indicate illness.
Question: What are arriving before arrival, failing to arrive upon arrival, failing to leave upon arrival, and excess upon arrival?
The Master replies: After the winter solstice, at midnight on jiazi, Lesser Yang arises. Yang begins to generate and Heaven becomes warm. Warm weather before jiazi is arriving before arrival. Jiazi reached but no warmth is failing to arrive upon arrival. Jiazi reached but severe cold not resolving is failing to leave upon arrival. Jiazi reached but warmth like midsummer's fifth and sixth months is excess upon arrival.
The Master says: A floating pulse at the front means illness in the exterior; floating at the rear means illness in the interior, with lumbar pain, stiff back and inability to walk. There must be short qi and extreme exhaustion.
Question: The classic says, 'Jue yang acts alone.' What does this mean?
The Master replies: It is yang without yin, hence called jue yang.
Question: A deep, large, slippery cun pulse: depth means repletion, slipperiness qi. Repletion and qi contend. Blood and qi entering viscera mean death, entering bowels recovery. This is sudden reversal. What does it mean?
The Master replies: Blue-green lips and mouth, a cold body: entering viscera, death. A harmonious body with spontaneous sweating: entering bowels, recovery.
Question: Pulse collapse entering viscera means death, entering bowels recovery. What does this mean?
The Master replies: This is not one illness; all illnesses are so. For example, spreading weeping sores starting at the mouth and flowing to the limbs are treatable; flowing from limbs into the mouth are not. Illness outside is treatable; entering the interior means death.
Question: What are the eighteen yang illnesses?
The Master replies: Headache and pulling pain of neck, waist, spine, arms and feet.
What are the eighteen yin illnesses? Cough, upward qi, panting, hiccups, the supplied throat item, bowel rumbling, distention, Heart pain and cramping. Each of the five viscera has eighteen illnesses, totaling ninety. People also have Six Subtleties, each with eighteen illnesses, totaling 108. Five Depletions, Seven Injuries, Six Extremes and the thirty-six women's illnesses are not included.
Text note: The source says Six Subtleties and does not expand every listed category or reconcile these totals with the abbreviated symptom lists.
Clear pathogens occupy the upper region, turbid pathogens the lower; great pathogens strike exterior, small pathogens interior. The pathogen of cooked grain, written with an unusual first graph, enters through the mouth and is retained food. Five pathogens strike by their respective patterns: wind strikes before or in front in this wording, cold at dusk, dampness below and mist above. Wind makes the pulse floating, cold tight; mist harms skin and cou, dampness flows into joints, food harms Spleen and Stomach, extreme cold channels, extreme heat networks.
Question: In illness, what is urgent rescue of the interior or exterior?
The Master replies: After a physician purges, unceasing diarrhea of undigested grain with bodily pain requires urgent rescue of the interior. Later, bodily pain with bowel discharge regulating itself requires urgent rescue of the exterior.
When a longstanding illness is joined by a sudden one, first treat the sudden illness, then the longstanding one.
The Master says: Illnesses of the five viscera each recover upon obtaining what suits them, and each has what it dislikes. What is unwelcome to each causes its illness. If a patient suddenly craves food they ordinarily should not eat, fever must arise.
In illnesses lodged in viscera, if attacking is intended, attack according to what the illness responds to. For example, for thirst give Zhuling Tang. All other cases follow this model.
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